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INTRODUCTION: The majority of cases of Clostridioides difficile infection (CDI) respond to antibiotic treatment. Fecal microbiota transplantation (FMT) has been accepted as an effective treatment in cases of recurrent CDI. AIM: Our aim was to describe the clinical results of FMT performed for the treatment of recurrent CDI. MATERIAL AND METHODS: The study was conducted on patients with recurrent CDI treated with FMT through colonoscopy, within the time frame of January 2021 and December 2023. Demographic and clinical data were collected, including pre-FMT treatment data, the FMT success rate, and clinical progression during follow-up. Telephone surveys were carried out to evaluate satisfaction. RESULTS: Thirteen patients with a mean age of 55 years underwent FMT (including 7 patients above 65 years of age and one pregnant woman). Patients presented with a median of 3 previous episodes of CDI (range 2-4). The median time interval from first episode of CDI to FMT was 4 months (range 3-10). The effectiveness of a single FMT session was 100%. During post-FMT follow-up (median of 11 months, range 3-32), 3 patients have presented with a new CDI episode, and a successful second FMT was performed on 2 of them. No adverse events were registered, and all patients had a positive perception of FMT. CONCLUSIONS: In the present study, despite its small size, FMT through colonoscopy was shown to be a safe, effective, and lasting therapy in cases of recurrent CDI, concurring with results from larger studies.
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Background: The Neotropics harbors the largest species richness of the planet; however, even in well-studied groups, there are potentially hundreds of species that lack a formal description, and likewise, many already described taxa are difficult to identify using morphology. Specifically in small mammals, complex morphological diagnoses have been facilitated by the use of molecular data, particularly from mitochondrial sequences, to obtain accurate species identifications. Obtaining mitochondrial markers implies the use of PCR and specific primers, which are largely absent for non-model organisms. Oxford Nanopore Technologies (ONT) is a new alternative for sequencing the entire mitochondrial genome without the need for specific primers. Only a limited number of studies have employed exclusively ONT long-reads to assemble mitochondrial genomes, and few studies have yet evaluated the usefulness of such reads in multiple non-model organisms. Methods: We implemented fieldwork to collect small mammals, including rodents, bats, and marsupials, in five localities in the northern extreme of the Cordillera Central of Colombia. DNA samples were sequenced using the MinION device and Flongle flow cells. Shotgun-sequenced data was used to reconstruct the mitochondrial genome of all the samples. In parallel, using a customized computational pipeline, species-level identifications were obtained based on sequencing raw reads (Whole Genome Sequencing). ONT-based identifications were corroborated using traditional morphological characters and phylogenetic analyses. Results: A total of 24 individuals from 18 species were collected, morphologically identified, and deposited in the biological collection of Universidad EAFIT. Our different computational pipelines were able to reconstruct mitochondrial genomes from exclusively ONT reads. We obtained three new mitochondrial genomes and eight new molecular mitochondrial sequences for six species. Our species identification pipeline was able to obtain accurate species identifications for up to 75% of the individuals in as little as 5 s. Finally, our phylogenetic analyses corroborated the identifications from our automated species identification pipeline and revealed important contributions to the knowledge of the diversity of Neotropical small mammals. Discussion: This study was able to evaluate different pipelines to reconstruct mitochondrial genomes from non-model organisms, using exclusively ONT reads, benchmarking these protocols on a multi-species dataset. The proposed methodology can be applied by non-expert taxonomists and has the potential to be implemented in real-time, without the need to euthanize the organisms and under field conditions. Therefore, it stands as a relevant tool to help increase the available data for non-model organisms, and the rate at which researchers can characterize life specially in highly biodiverse places as the Neotropics.
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Genoma Mitocondrial , Mamíferos , Análisis de Secuencia de ADN , Animales , Mamíferos/genética , Genoma Mitocondrial/genética , Análisis de Secuencia de ADN/métodos , Nanoporos , Colombia , ADN Mitocondrial/genética , Filogenia , Quirópteros/genética , Secuenciación de Nanoporos/métodosRESUMEN
The use of artificial intelligence algorithms (AI) has gained importance for dental applications in recent years. Analyzing AI information from different sensor data such as images or panoramic radiographs (panoramic X-rays) can help to improve medical decisions and achieve early diagnosis of different dental pathologies. In particular, the use of deep learning (DL) techniques based on convolutional neural networks (CNNs) has obtained promising results in dental applications based on images, in which approaches based on classification, detection, and segmentation are being studied with growing interest. However, there are still several challenges to be tackled, such as the data quality and quantity, the variability among categories, and the analysis of the possible bias and variance associated with each dataset distribution. This study aims to compare the performance of three deep learning object detection models-Faster R-CNN, YOLO V2, and SSD-using different ResNet architectures (ResNet-18, ResNet-50, and ResNet-101) as feature extractors for detecting and classifying third molar angles in panoramic X-rays according to Winter's classification criterion. Each object detection architecture was trained, calibrated, validated, and tested with three different feature extraction CNNs which are ResNet-18, ResNet-50, and ResNet-101, which were the networks that best fit our dataset distribution. Based on such detection networks, we detect four different categories of angles in third molars using panoramic X-rays by using Winter's classification criterion. This criterion characterizes the third molar's position relative to the second molar's longitudinal axis. The detected categories for the third molars are distoangular, vertical, mesioangular, and horizontal. For training, we used a total of 644 panoramic X-rays. The results obtained in the testing dataset reached up to 99% mean average accuracy performance, demonstrating the YOLOV2 obtained higher effectiveness in solving the third molar angle detection problem. These results demonstrate that the use of CNNs for object detection in panoramic radiographs represents a promising solution in dental applications.
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Aprendizaje Profundo , Tercer Molar , Redes Neurales de la Computación , Radiografía Panorámica , Radiografía Panorámica/métodos , Humanos , Tercer Molar/diagnóstico por imagen , Algoritmos , Inteligencia Artificial , Procesamiento de Imagen Asistido por Computador/métodosRESUMEN
This study aimed to establish differences in third-party attention through a toy-building activity among children between 9 and 11 years old from three cultural backgrounds: Rural Mapuche, Urban Mapuche and non-Indigenous Chilean. It was also examined whether third-party attention is related to learning a previously observed activity. Third-party attention involves maintaining two or more foci of interest simultaneously without losing attention and or interrupting the course of a task. It is of interest to study because it may undergo changes as a result of exposure to schooling. Given that these groups differ in cultural practices and years of formal schooling, the hypothesis was that it might be possible to identify differences in their attention patterns. The results showed that it seems like practices of Rural Mapuche families encourage third-party attention much more so than the other groups; therefore, the learning of skills arises in constellations of cultural practices that involve children's living conditions and guide their development.
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BACKGROUND: The dramatic reconfigurations of work-family roles and social boundaries resulting from the social restrictions imposed during the Covid-19 pandemic led working mums to look for online sites as spaces of emotional support and regulation where they could vent their emotions, share their concerns and griefs, and seek advice. They also became interactional spaces where mums' relevant identities were reassessed and enacted as they aimed to balance work-family roles and improve their wellbeing. The paper explores how working mums discursively negotiated their multiple identities in an online support forum during times of global struggle, how these identity constructions reflect the domains of Work-Family Conflict (WFC) and how working mums perceived these identities are related to their mental health. METHODS: 127 posts of Chilean working mums published in a public online support forum for working mums collected during the first half of 2020 were analysed in three phases. The first one involved a thematic analysis to identify themes and subthemes related to working mums' identity construction in the data. The second phase involved conducting a narrative analysis of working mums' microstorias in order to identify a master narrative crafted by these working mums, and contesting and conforming ideologies of motherhood, among others. Finally, the third phase involved a fine-grained discourse analysis of the most representative extracts illustrating working mums' identity negotiation. RESULTS: The sociolinguistic analysis showed that working mums' discourses displayed three themes of self-reflection, namely, diminishing self-care, reassessing their self, and enhancing self through self-care. Identity-related sub-themes for each main theme are discussed and discursively analysed. Two main points are emphasised: (1) the identity that was most salient in working mums' discourse was their personal identity (rather than work-family roles and identities), and (2) microstorias allowed working mums to challenge the hegemonic power of dominant discourses around their identities and their work-family roles. CONCLUSIONS: The study shows that a sociolinguistic approach to the exploration of working mums' identity negotiation is useful to highlight the ways in which mums contest binary assumptions of work-family roles and the need to reconsider working mums' life domains so that they reflect working mums' actual identity needs and lived experiences. Future lines of research are outlined.
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COVID-19 , Salud Mental , Humanos , COVID-19/psicología , Femenino , Adulto , Familia/psicología , Identificación Social , Madres/psicología , Apoyo Social , Equilibrio entre Vida Personal y Laboral , SARS-CoV-2RESUMEN
La terapéutica endodóntica se apoya básicamente en dos modelos teóricos o paradigmas: el concepto de "tubo hueco" técnico y quirúrgico esencialmente mecanicista, y el modelo terapéutico para conductos radiculares, que busca la restitución ad integrum de los tejidos apicales y el hueso alveolar que los rodea. La instrumentación debe complementarse con la limpieza por irrigación abundante y la obturación con un biomaterial bioactivo, con características reológicas que permitan su adaptación plástica a las paredes del conducto radicular y module la respuesta de los tejidos hacia la regeneración con aposición de tejido calcificado en el foramen apical (AU)
Endodontic therapy is basically based on two theoretical models or paradigms, which are the concept of the technical and surgical "hollow tube", essentially mechanistic, and the therapeutic model of root canals, which seeks the ad integrum restitution of the apical tissues and bone. alveolar that surrounds them. The instrumentation must be complemented with cleaning by abundant irrigation, and with a bioactive biomaterial, with rheological characteristics that allows its plastic adaptation to the walls of the root canal and modulates the response of the tissues towards regeneration with apposition of calcified tissue in the apical foramen (AU)
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Humanos , Femenino , Adulto , Materiales Biocompatibles , Preparación del Conducto Radicular/instrumentación , Retratamiento , Enfermedades Periapicales/complicaciones , Irrigantes del Conducto Radicular/uso terapéutico , Ápice del Diente , Diente MolarRESUMEN
BACKGROUND: Protocols are currently being studied in preventing postoperative complications after exodontia. PURPOSE: This systematic review and meta-analysis aims to evaluate whether the application of intra-alveolar honey reduces inflammatory complications after the extraction of mandibular third molars (CRD 42.023.467.041). METHODS: Searches were carried out in six electronic databases. Clinical trials comparing intra-alveolar honey administration with non-intervention or placebo after mandibular third molar extraction were selected to assess their impact on postoperative inflammatory parameters. The Cochrane ROB 2 tool was used to assess the bias risk in included studies, Stata software to conduct a meta-analysis for quantitative synthesis, and the GRADE system to evaluate the certainty of the evidence. RESULTS: This systematic review included 5 studies with 330 participants, and two studies were included in the meta-analysis. The results of the meta-analysis demonstrated that postoperative pain on the second day [MD: - 1.05; 95% CI - 2 to - 0.1] and fifth day [MD: - 0.97; 95% CI - 1.97 to - 0.03] was lower in the honey group compared to the control group. Total analgesic consumption [MD: - 4.77; 95% CI - 6.73 to - 2.81] was also lower in patients in the intervention group. The descriptive results indicated that honey appears to be beneficial in controlling edema, reducing trismus, and improving healing after extraction of third molars. Alveolar osteitis showed inconclusive results. CONCLUSIONS: The use of intra-alveolar honey after extraction of mandibular third molars seem to be associated with pain reduction. For the other outcomes, the results remain uncertain.
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Miel , Inflamación , Tercer Molar , Dolor Postoperatorio , Complicaciones Posoperatorias , Extracción Dental , Humanos , Inflamación/etiología , Inflamación/prevención & control , Mandíbula/cirugía , Tercer Molar/cirugía , Dolor Postoperatorio/prevención & control , Dolor Postoperatorio/etiología , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/prevención & control , Extracción Dental/efectos adversos , Diente Impactado/cirugíaRESUMEN
PURPOSE: Myelomeningocele (MMC) is a prevalent neural tube closure defect often associated with hydrocephalus, necessitating surgical intervention in a significant proportion of cases. While ventriculoperitoneal shunting (VPS) has been a standard treatment approach, endoscopic third ventriculostomy (ETV) has emerged as a promising alternative. However, factors influencing the success of ETV in MMC patients remain uncertain. This retrospective observational study aimed to identify clinical and radiological factors correlating with a higher success rate of ETV in MMC patients. METHODS: Medical records of MMC patients who underwent ETV at a tertiary care center between 2015 and 2021 were reviewed. Demographic, clinical, and radiological data were analyzed. ETV success was defined as the absence of further hydrocephalus treatment during follow-up. RESULTS: Of 131 MMC patients, 21 met inclusion criteria and underwent ETV. The overall success rate of ETV was 57.1%, with a six-month success rate of 61.9%. Age ≤ 6 months was significantly associated with lower ETV success (25%) compared to older patients (76.9%) (OR: 0.1; 95% CI 0.005-2.006; p = 0.019). Radiological factors, including posterior fossa dimensions and linear indices, did not exhibit statistically significant associations with ETV success. CONCLUSION: Age emerged as a significant factor affecting ETV success in MMC patients, with younger patients exhibiting lower success rates. Radiological variables did not significantly influence ETV outcomes in this study. Identifying predictors of ETV success in MMC patients is crucial for optimizing treatment strategies and improving patient outcomes.
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Hidrocefalia , Meningomielocele , Neuroendoscopía , Tercer Ventrículo , Ventriculostomía , Humanos , Ventriculostomía/métodos , Meningomielocele/complicaciones , Meningomielocele/cirugía , Hidrocefalia/cirugía , Hidrocefalia/etiología , Hidrocefalia/diagnóstico por imagen , Femenino , Masculino , Tercer Ventrículo/cirugía , Tercer Ventrículo/diagnóstico por imagen , Estudios Retrospectivos , Lactante , Neuroendoscopía/métodos , Pronóstico , Preescolar , Resultado del Tratamiento , NiñoRESUMEN
PURPOSE: This study aims to conduct a thorough analysis, both quantitative and qualitative, of bibliometric parameters related to preemptive analgesia (PA) in oral surgical procedures (OSP). METHODS: Research trends on PA in OSP using ibuprofen were reviewed through bibliometric analysis of 68 journal articles published from 1991 to 2022 in the Web of Science database. Bibliometric indicators were applied to analyze the journal article data, including the annual distribution of publications and literature growth, document types, citation indicators to measure qualitative research performance, and keyword mapping to identify research trends. The results were imported into RStudio, and the Bibliometrix package was used to prepare and analyze the metadata. RESULTS: The 68 included articles received a total of 900 citations, ranging from 1 source to 72 citations with some fluctuations. The papers on PA in OSP using ibuprofen had an average of 16.85 citations per paper. These publications were originated from 25 countries, with the highest contributions from Brazil (n = 17), the USA (n = 13), and Turkey (n = 8). The top five major contributing journals were the International Journal of Oral and Maxillofacial Surgery, Journal of Oral and Maxillofacial Surgery, Journal of Cranio-Maxillo-Facial Surgery, Journal of Periodontology, and Acta Odontologica Scandinavica, representing more than half of all selected papers. CONCLUSION: Papers focused on PA in OSP received numerous citations. The citation per article correlated with the number of publications at the affiliation, author, country, and journal levels. However, there is still a scarcity of studies in this field.
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Bibliometría , Ibuprofeno , Procedimientos Quirúrgicos Orales , Ibuprofeno/uso terapéutico , Humanos , Dolor Postoperatorio/prevención & control , Dolor Postoperatorio/tratamiento farmacológico , Analgesia/métodos , Analgésicos no Narcóticos/uso terapéuticoRESUMEN
This study aimed to systematically review the literature to evaluate the effectiveness of virtual reality in reducing anxiety and pain in patients undergoing third molar surgeries. Clinical trials evaluating patients who used virtual reality (VR) compared with no VR in the management of pain or anxiety after third molar extractions were included. A literature search was conducted in five electronic databases to identify relevant articles: Medline (PubMed interface), Web of Science, Virtual Health Library, Embase, and Scopus. There were no restrictions on the time or language of publication. The risk of bias was assessed using the Cochrane Risk of Bias Tool for Randomised Trials (RoB 2.0). A total of six studies were included in the qualitative analysis and three in the quantitative analysis. The results of the meta-analyses on anxiety revealed that patients in the intervention group before VR already showed less anxiety compared to those in the control group (-0.28 [-0.44 to -0.13, 95%CI] I²=24.51%. In the post-intervention evaluation, the group that received VR remained with a lower level of anxiety and a slight reduction compared to the pre-intervention. (-0.34 [-0.49 to -0.19, 95%CI] I²=36.61%. Virtual reality can be a clinical resource in dental care because it seems to cause a small reduction in anxiety, and with still uncertain results in the reduction of postoperative pain in extractions of third molars.
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Tercer Molar , Dolor Postoperatorio , Extracción Dental , Realidad Virtual , Humanos , Tercer Molar/cirugía , Extracción Dental/psicología , Dolor Postoperatorio/prevención & control , Dolor Postoperatorio/etiología , Ansiedad al Tratamiento Odontológico/prevención & control , Ansiedad al Tratamiento Odontológico/psicologíaRESUMEN
OBJECTIVES: This study aimed to assess whether awake bruxism and masticatory muscle activity could be related to external root resorption (ERR) in second molars adjacent to impacted mandibular third molars. MATERIALS AND METHODS: Sixty patients, with requests for a cone-beam, computed tomography, were divided into two groups: ERR (patients with ERR in the second molar, n = 30), and control group (n = 30). Awake bruxism was assessed through the Oral Behaviors Checklist (OBC) and an ecological momentary assessment (EMA). Surface electromyography (EMG) was used to assess the masseter and anterior temporal muscle function. Normality and homogeneity of variances were demonstrated. Descriptive analysis was performed, using the T-test and Chi-square test to compare the characteristics of the groups. A multiple regression model was performed. RESULTS: The ERR group presented more non-functional oral activities related to awake bruxism than the control group, according to OBC (p = 0.027) and EMA (p = 0.035). In addition, the ERR group had higher EMG activity than the control group in rest and isotonic protocols (p < 0.05). CONCLUSIONS: Awake bruxism and greater masticatory muscle activity seem to be related to the presence of ERR in second molars adjacent to impacted mandibular third molars. CLINICAL RELEVANCE: The results of the present study can reinforce the theory that triggering ERR in the second molars adjacent to impacted mandibular third molars may be related to mechanical forces coming from the masticatory function.
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Tomografía Computarizada de Haz Cónico , Electromiografía , Tercer Molar , Resorción Radicular , Diente Impactado , Humanos , Tercer Molar/diagnóstico por imagen , Tercer Molar/fisiopatología , Femenino , Masculino , Diente Impactado/fisiopatología , Diente Impactado/diagnóstico por imagen , Adulto , Resorción Radicular/fisiopatología , Resorción Radicular/diagnóstico por imagen , Diente Molar/fisiopatología , Bruxismo/fisiopatología , Músculos Masticadores/fisiopatología , Mandíbula/fisiopatología , Mandíbula/diagnóstico por imagenRESUMEN
Objective: To examine the areas of the maxillary tuberosity (MT) (coronal, apical, width, and height) with respect to the presence or absence of the third molar to establish possible anatomical limitations for molar distalization. Methods: A total of 277 tuberosities were evaluated through sagittal computed tomography (CT) images, divided for measurement into coronal (free of bone), apical (area of influence of the maxillary sinus), and tuberosity (bony area) zones, and stratified by the presence or absence of the third molar, sex, and two age subgroups. Mann-Whitney U test was used to compare the groups considering the third molar. Results: The medians of the width and height of the tuberosity decreased significantly in the absence of the third molar (P < 0.001). The apical area also showed differences, with negative values in the absence of the third molar and positive values in the presence of the third molar (P < 0.001). However, no differences were observed for the coronal area (P > 0.05). Conclusions: In the absence of the third molar, the size of the MT, represented by its width and height, was smaller and negative values (decrease) were observed for the maxillary sinus. The sagittal CT provides useful information regarding the amount of bone tissue available for distalization and relationship of the second molar with respect to the maxillary sinus, which allows individualizing each case in relation to the amount and type of movement expected.
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OBJECTIVE: This study evaluated the efficacy of Valeriana officinalis L. and Passiflora incarnata L. to control anxiety, surgical discomfort, and changes in vital signs of patients undergoing extraction of two unilateral third molars. MATERIALS AND METHODS: This study is a randomized, triple-blinded clinical trial. Fifty-four patients were allocated into three groups (Valeriana officinalis L., Passiflora incarnata L., and placebo). Anxiety levels were assessed using the State-Trace Anxiety Inventory (STAI) index, surgical discomfort using the QCirDental, and through the measurement of vital signs. The surgical times evaluated were before (T0), during (T1), and after surgery (T2). RESULTS: There was evidence that both Valeriana officinalis L. and Passiflora incarnata L., reduced STAY-S scores between T0 and T2 (p < .05), unlike placebo (p = .129). There was no change in surgical discomfort in all groups over time, and vital signs presented variable results. CONCLUSION: Phytotherapy drugs showed a reduction in anxiety state compared to the placebo group during third molar extraction procedure. CLINICAL TRIAL REGISTRATION: klRBR-6kcxvrc, March 10, 2022.
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Ansiedad al Tratamiento Odontológico , Tercer Molar , Fitoterapia , Extractos Vegetales , Extracción Dental , Valeriana , Humanos , Femenino , Masculino , Tercer Molar/cirugía , Adulto , Ansiedad al Tratamiento Odontológico/prevención & control , Extractos Vegetales/uso terapéutico , Passiflora , Adulto JovenRESUMEN
Lymphoma is one of the most frequently diagnosed tumors in FeLV-infected cats. Extranodal lymphomas include lymphomas in ocular and periocular tissues, such as the third eyelid (TEL), which is an uncommonly diagnosed type of lymphoma in cats. This study aimed to describe the clinicopathological features of lymphoma in the TEL of two FeLV-infected cats. A retrospective study in two anatomic pathology laboratories was performed, and two cases met the inclusion criteria. A 4-year-old, female cat (case 1), positive for FIV gp40 antigen and FeLV gp70 antigen by immunohistochemistry (IHC), and a male cat of 22 months old (case 2), positive both serologically for FeLV p27 antigen and for FeLV gp70 antigen by IHC, were referred to veterinary clinics with unilateral swelling and mass in the TEL, which had rapid growth in case 2. Histological and immunohistochemical analysis established the final diagnosis of diffuse large B-cell lymphoma in both cases. The cat in case 2 died 4 months after the diagnosis, with clinical worsening prior to death. Necropsy was not performed in either case, which precluded the definition of a primary or secondary involvement. However, the ocular lesions were the reason for consultation in both cases and it may have been an initial manifestation of a multicentric disease. Thus, FeLV-infected cats with clinical finding of eyelid swelling or mass formation should have lymphoma as a differential diagnosis, and a complete physical examination should be performed to detect extraocular involvement.
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OBJECTIVE: To evaluate the efficacy of pregabalin and dexamethasone coadministration in preemptive analgesia and anxiety control in lower third molar surgery. MATERIALS AND METHODS: A triple-blind, split-mouth clinical trial conducted with patients divided into two groups: control group, receiving placebo and dexamethasone, and test group, receiving pregabalin and dexamethasone preoperatively. The evaluated variables were pain, measured by the Visual Analog Scale (VAS), anxiety assessed through the State-Trait Anxiety Inventory (STAI) questionnaires, hemodynamic parameters [Blood Pressure (BP), Heart Rate (HR), Oxygen Saturation (SpO2)], and sedation assessed by the Ramsay scale. RESULTS: A total of 31 patients were included. The test group exhibited a significant reduction in pain at 2,4,6,8,12,16,24, and 48 h after surgery and in the consumption of rescue analgesics. Anxiety, evaluated by STAI and VAS, showed a significant decrease in the test group (p < 0.001). Additionally, there was a significant decrease in BP at most of the assessed time points (p < 0.05) and a significant reduction in HR at two different time intervals (p = 0.003 and p = 0.009), indicating a positive effect in the test group. There was no significant difference in SpO2 between the groups. Sedation assessment revealed a significant difference at all time points favoring the test group (p < 0.05). There were no significant postoperative adverse effects. CONCLUSIONS: Pregabalin coadministered with dexamethasone demonstrated significant efficacy in controlling postoperative pain and anxiety, as well as a sedative effect. CLINICAL RELEVANCE: The coadministration of pregabalin with dexamethasone may presents potential advantages in both pain modulation and psychological well-being of individuals undergoing third molar surgeries. TRIAL REGISTRATION: Brazilian Clinical Trials Registry (REBEC), No. RBR-378h6t6.
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Analgésicos , Dexametasona , Quimioterapia Combinada , Tercer Molar , Dimensión del Dolor , Dolor Postoperatorio , Pregabalina , Extracción Dental , Humanos , Pregabalina/uso terapéutico , Dexametasona/administración & dosificación , Dexametasona/uso terapéutico , Tercer Molar/cirugía , Masculino , Femenino , Dolor Postoperatorio/prevención & control , Dolor Postoperatorio/tratamiento farmacológico , Analgésicos/uso terapéutico , Adulto , Ansiedad al Tratamiento Odontológico/prevención & control , Resultado del Tratamiento , Encuestas y Cuestionarios , Manejo del Dolor/métodosRESUMEN
Introduction Hydrocephalus is a condition characterized by the abnormal accumulation of cerebrospinal fluid within the brain's ventricular system. It can stem from obstructive and nonobstructive causes. Pregnancy introduces physiopathological changes that may heighten the risk of developing or worsening symptomatic hydrocephalus. Nevertheless, comprehensive reports on this aspect, especially regarding surgical interventions, remain scarce. Case Report A young woman with a history of recurrent headaches experienced a worsening of her symptoms at the onset of her pregnancy. A magnetic resonance imaging (MRI) in the first trimester revealed increased ventricular dilation, indicating an obstructive cause due to aqueduct stenosis. During a neurosurgical board meeting, treatment options were discussed, considering the identifiable obstruction, the heightened intra-abdominal pressure associated with pregnancy, and the risk of ventricular shunt dysfunction. The patient underwent an endoscopic third ventriculostomy (ETV) without complications, leading to both symptom relief and a successful conclusion to the pregnancy. Discussion Neurosurgical procedures in pregnant women are uncommon due to the increased risks to both the mother and the fetus. However, when performed by a qualified multidisciplinary team, they can lead to positive outcomes. In cases of hydrocephalus during pregnancy, ETV appears to be a viable alternative for surgical intervention, particularly when hydrocephalus becomes symptomatic and an obstructive cause is identified, whether in patients with existing shunts or those with newly developed hydrocephalus.
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Mastitis is the most common disease of dairy cattle and can be manifested in clinical and subclinical forms. The overuse of antimicrobials in the treatment and prevention of mastitis favours antimicrobial resistance and milk can be a potential route of dissemination. This study aimed to evaluate the biological quality of bulk tank milk (BTM) and the microbiological quality and signs of mastitis of freshly milked raw milk. In addition, to evaluate antimicrobial resistance in Enterobacteriaceae and Staphylococcus spp. isolated from freshly milked raw milk. None of the farms were within the official Brazilian biological quality limits for BTM. Freshly milked raw milk with signs of clinical (CMM), subclinical (SCMM) and no signs (MFM) of mastitis were detected in 6.67%, 27.62% and 65.71% samples, respectively. Most samples of freshly milked raw milk showed acceptable microbiological quality, when evaluating the indicators total coliforms (78.10%), Escherichia coli (88.57%) and Staphylococcus aureus (100%). Klebsiella oxytoca and S. aureus were the most prevalent microorganisms in SCMM and MFM samples. Antimicrobial resistance and multidrug resistance (MDR) were observed in 65.12% and 13.95% of Enterobacteriaceae and 84.31% and 5.88% of Staphylococcus spp., respectively, isolated from both SCMM and MFM samples. Enterobacteriaceae resistant to third-generation cephalosporin (3GCR) (6.98%) and carbapenems (CRE) (6.98%) and methicillin-resistant S. aureus (MRSA) (4.88%) were observed. Antimicrobial-resistant bacteria can spread resistance genes to previously susceptible bacteria. This is a problem that affects animal, human and environmental health and should be evaluated within the one-health concept.
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Antibacterianos , Farmacorresistencia Bacteriana , Enterobacteriaceae , Mastitis Bovina , Leche , Staphylococcus , Animales , Bovinos , Leche/microbiología , Mastitis Bovina/microbiología , Enterobacteriaceae/efectos de los fármacos , Enterobacteriaceae/aislamiento & purificación , Femenino , Staphylococcus/efectos de los fármacos , Brasil , Antibacterianos/farmacología , Infecciones por Enterobacteriaceae/veterinaria , Infecciones por Enterobacteriaceae/microbiología , Infecciones por Enterobacteriaceae/tratamiento farmacológico , Infecciones Estafilocócicas/veterinaria , Infecciones Estafilocócicas/microbiología , Infecciones Estafilocócicas/tratamiento farmacológico , Infecciones Asintomáticas , Pruebas de Sensibilidad Microbiana/veterinariaRESUMEN
Selective outcome reporting (SOR) can threaten the validity of results found in clinical trials. Some studies in the literature have analyzed SOR in dentistry, but there is no study that has observed SOR in clinical trials in oral and maxillofacial surgery. Impacted third molar surgery is one of the most used models in clinical trials to study mainly analgesic and anti-inflammatory drug interventions. Our study aimed to evaluate the prevalence of SOR in publications employing the third molar extraction clinical trial model, and to verify whether there was an association between the statistical significance of outcomes and other characteristics that could lead to SOR. A systematic search was performed on the ClinicialTrials.gov platform for randomized clinical trial protocols, using the condition of third molar extraction. The corresponding published articles were sourced in PubMed, Scopus, and Embase databases, and compared with the registered protocols regarding the methodological data, in terms of: sample calculation, primary outcome identification, end-point periods, insertion of new outcomes in the publication, and results of outcomes. 358 protocol records were retrieved; 87 presented their corresponding articles. SOR was identified in 28.74% of the publications, and had a significant relationship with changes in the protocol, insertions of new outcomes, and discrepancies in the types of study. General risk of bias was found to be low. There were associations between SOR and the discrepancies in terms of the type of study, the choice of new outcome, and changes in the history of protocol records. The prevalence of SOR in clinical research using the third molar extraction surgery model is moderate. The quality of the scientific reporting of the results and, consequently, the certainty of evidence relating to the intervention tested can be overstated, increasing the chances of misinterpretation by health professionals.
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Tercer Molar , Ensayos Clínicos Controlados Aleatorios como Asunto , Extracción Dental , Tercer Molar/cirugía , Humanos , Diente Impactado/cirugía , Sesgo de Publicación , Proyectos de InvestigaciónRESUMEN
The aim of this split-mouth randomized clinical trial was to evaluate the clinical outcomes (operative time, edema, trismus, and pain), the immediate histological effects, the alveolar repair (2 and 4 months), and the quality of life after the extraction of impacted third molars using high-speed pneumatic and electrical rotation. Sixteen patients underwent extraction of the two mandibular third molars with a minimum interval of 15 days. On one side of the participant's mouth, high-speed pneumatic rotation was used (Control Group-CG) while for the other side, high-speed electrical rotation was used (Study Group-SG). Statistical analysis included ANOVA repeated measures and Pearson correlations. SG group showed: shorter operative time (p = 0.019), less pain (p = 0.034), swelling (p < 0.001) and trismus (p = 0.025) on the 1st postoperative day; less pain (p = 0.034) and trismus (p = 0.010) on the 3rd postoperative day; less trismus (p = 0.032) on the 7th postoperative day; and better quality of life (p = 0.007). No differences were observed for peripheral bone damage or bone density of alveolar repair at 2 and 4 months between groups. Electric high-speed rotation provided better postoperative clinical parameters of pain, edema and trismus when compared with pneumatic high-speed rotation for mandibular third molar surgery.Trial registration: Brazilian Registry of Clinical Trials registration number RBR-4xyqhqm ( https://ensaiosclinicos.gov.br/rg/RBR-4xyqhqm ).
Asunto(s)
Tercer Molar , Trismo , Humanos , Tercer Molar/cirugía , Rotación , Estudios Prospectivos , Calidad de Vida , Dolor Postoperatorio , Extracción Dental , Boca , EdemaRESUMEN
BACKGROUND: Type 1 diabetes increases the prevalence of urinary incontinence and may be responsible for additional changes to those existing in a regular gestational period. This study aimed to describe the presence and symptoms of urinary incontinence in pregnant women with type 1 diabetes. METHODS: In this Cross-sectional case control study, forty pregnant women in third gestational trimester were allocated in two equal groups - control group (CG) and type 1 diabetic group (1DMG). The patients answered the International Consultation on Incontinence Questionnaire Short Form and, to characterize the sample, they answered the Pregnancy Physical Activity Questionnaire, gynecological history and, after delivery, the newborn weight was registered. The groups were compared using the Student's T Test for parametric variables and the U-Mann Whitney Test for non-parametric variables, both at 5% probability. RESULTS: The International Consultation on Incontinence Questionnaire Short Form score (p = 0.026) is higher in 1DMG (3.95 ± 4.70) compared to CG (1.05 ± 2.23). No correlations were found between time of diagnosis, HbA1c and newborn weight in relation to ICIQ-SF and other variables in CG and 1DMG with ICIQ-SF (p < 0.05). CONCLUSION: Type 1 diabetes mellitus, in the third trimester of gestation, seem to be associated with increase in the ICIQ-SF score.
HIGHLIGHTS: No correlation between gestational characteristics and urinary incontinence symptoms.The diabetic women group had more episiotomies and abortions.The diabetic women had higher scores in the total score of the International Consultation on Incontinence Questionnaire - Short Form (ICIQ-SF).