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Cureus Oct 2023Orthodontic treatment signifies a transformative journey for individuals seeking not only enhanced oral health but also a boost in aesthetics and self-confidence.... (Review)
Review
Orthodontic treatment signifies a transformative journey for individuals seeking not only enhanced oral health but also a boost in aesthetics and self-confidence. Nonetheless, the protracted timeline associated with conventional orthodontic care has been a persistent concern for both patients and practitioners. In this comprehensive review, we embark on an exploration of innovative strategies aimed at expediting orthodontic tooth movement (OTM). By doing so, we aspire to curtail treatment duration and mitigate potential risks, ultimately culminating in an elevated and more fulfilling patient experience. Traditionally, orthodontists heavily leaned on surgical techniques to hasten tooth movement. However, the recent landscape of orthodontics has been profoundly shaped by technological advancements and groundbreaking research findings, ushering in an era characterized by the embrace of minimally invasive approaches. These progressive methodologies encompass procedures like Piezocision, Discision, and Microosteoperforation (Alveocentesis). Beyond the obvious benefits of reduced patient discomfort, these techniques significantly truncate treatment periods, a development that addresses a primary concern of many patients. Moreover, this review delves into non-invasive alternatives, including cyclic vibrations, photobiomodulation, direct light electric current, and static or pulsed magnetic fields, as well as systemic and local administration of biological substances and hormones, all of which hold substantial promise in optimizing OTM. Furthermore, our exploration extends to a diverse spectrum of medications that have demonstrated their efficacy in expediting OTM. These encompass NSAIDs, acetaminophen, corticosteroids, bisphosphonates, herbal medicine biomaterials, and synthetic biomaterials like graphene dioxide. Every technique and medication is subjected to meticulous evaluation, taking into account its indications, contraindications, advantages, disadvantages, clinical implications, and limitations. Through this review, we endeavor to equip orthodontic professionals with a profound understanding of these innovative strategies. By doing so, we enable them to make informed decisions, tailored meticulously to meet the unique needs of each patient. In an ever-evolving field like orthodontics, staying abreast of these advancements becomes paramount, ultimately contributing to heightened treatment efficacy and enhanced patient satisfaction. The adoption of these innovative strategies not only holds the potential for improved clinical outcomes but also champions a patient-centric approach that could fundamentally reshape the landscape of orthodontic care.
PubMed: 37954770
DOI: 10.7759/cureus.46824 -
The Cochrane Database of Systematic... Jun 2023Routine monitoring of gastric residuals in preterm infants on tube feeds is a common practice in neonatal intensive care units used to guide initiation and advancement... (Review)
Review
BACKGROUND
Routine monitoring of gastric residuals in preterm infants on tube feeds is a common practice in neonatal intensive care units used to guide initiation and advancement of enteral feeding. There is a paucity of consensus on whether to re-feed or discard the aspirated gastric residuals. While re-feeding gastric residuals may aid in digestion and promote gastrointestinal motility and maturation by replacing partially digested milk, gastrointestinal enzymes, hormones, and trophic substances, abnormal residuals may result in vomiting, necrotising enterocolitis, or sepsis.
OBJECTIVES
To assess the efficacy and safety of re-feeding when compared to discarding gastric residuals in preterm infants. SEARCH METHODS: Searches were conducted in February 2022 in Cochrane CENTRAL via CRS, Ovid MEDLINE and Embase, and CINAHL. We also searched clinical trial databases, conference proceedings, and the reference lists of retrieved articles for randomised controlled trials (RCTs) and quasi-RCTs.
SELECTION CRITERIA
We selected RCTs that compared re-feeding versus discarding gastric residuals in preterm infants.
DATA COLLECTION AND ANALYSIS
Review authors assessed trial eligibility and risk of bias and extracted data, in duplicate. We analysed treatment effects in individual trials and reported the risk ratio (RR) for dichotomous data and the mean difference (MD) for continuous data, with respective 95% confidence intervals (CIs). We used the GRADE approach to assess the certainty of evidence.
MAIN RESULTS
We found one eligible trial that included 72 preterm infants. The trial was unmasked but was otherwise of good methodological quality. Re-feeding gastric residual may have little or no effect on time to regain birth weight (MD 0.40 days, 95% CI -2.89 to 3.69; 59 infants; low-certainty evidence), risk of necrotising enterocolitis stage ≥ 2 or spontaneous intestinal perforation (RR 0.71, 95% CI 0.25 to 2.04; 72 infants; low-certainty evidence), all-cause mortality before hospital discharge (RR 0.50, 95% CI 0.14 to 1.85; 72 infants; low-certainty evidence), time to establish enteral feeds ≥ 120 mL/kg/d (MD -1.30 days, 95% CI -2.93 to 0.33; 59 infants; low-certainty evidence), number of total parenteral nutrition days (MD -0.30 days, 95% CI -2.07 to 1.47; 59 infants; low-certainty evidence), and risk of extrauterine growth restriction at discharge (RR 1.29, 95% CI 0.38 to 4.34; 59 infants; low-certainty evidence). We are uncertain as to the effect of re-feeding gastric residual on number of episodes of feed interruption lasting for ≥ 12 hours (RR 0.80, 95% CI 0.42 to 1.52; 59 infants; very low-certainty evidence).
AUTHORS' CONCLUSIONS
We found only limited data from one small unmasked trial on the efficacy and safety of re-feeding gastric residuals in preterm infants. Low-certainty evidence suggests re-feeding gastric residual may have little or no effect on important clinical outcomes such as necrotising enterocolitis, all-cause mortality before hospital discharge, time to establish enteral feeds, number of total parenteral nutrition days, and in-hospital weight gain. A large RCT is needed to assess the efficacy and safety of re-feeding of gastric residuals in preterm infants with adequate certainty of evidence to inform policy and practice.
Topics: Infant; Infant, Newborn; Humans; Enterocolitis, Necrotizing; Infant, Premature; Stomach; Birth Weight; Cognition
PubMed: 37387544
DOI: 10.1002/14651858.CD012940.pub3 -
Environmental Research Mar 2024A good old gateway theory that electronic-cigarettes (e-cigarettes) are widely recognized as safer tobacco substitutes. In actuality, demographics also show that vaping... (Review)
Review
A good old gateway theory that electronic-cigarettes (e-cigarettes) are widely recognized as safer tobacco substitutes. In actuality, demographics also show that vaping cannibalizes smoking, the best explanation of the data is the "common liability". However, the utilization of e-cigarette products remains a controversial topic at present. Currently, there has been a widespread and substantial growth in e-cigarette use worldwide owing to their endless new flavors and customizable characteristics. Furthermore, e-cigarette has grown widespread among smokers as well as non-smokers, including adolescents and young adults. And some studies have shown that e-cigarette users are at greater risk to start using combustible cigarettes while e-cigarettes use was also observed the potential benefits to people who want to quit smoking or not. Although it is true that e-cigarettes generally contain fewer toxic substances than combustible cigarettes, this does not mean that the chemical composition in e-cigarettes aerosols poses absolutely no risks. While concerns about toxic substances in e-cigarettes and their widespread use in the population are reasonable, it is also crucial to consider that e-cigarettes have been associated with the potential for promoting smoking cessation and the clinically relevant improvements in users with smoking-related pathologies. Meanwhile, there is still short of understanding of the health impacts associated with e-cigarette use. Therefore, in this review, we discussed the health impacts of e-cigarette exposure on oral, nasal, pulmonary, cardiovascular systems and brain. We aspire for this review to change people's previous perceptions of e-cigarettes and provide them with a more balanced perspective. Additionally, we suggest appropriate adjustments on regulation and policy for e-cigarette to gain greater public health benefits.
Topics: Adolescent; Young Adult; Humans; Electronic Nicotine Delivery Systems; Smoking; Tobacco Smoking; Tobacco Products; Electronics
PubMed: 38157958
DOI: 10.1016/j.envres.2023.118056 -
Journal of Inflammation Research 2023Endothelial cells (ECs) are widely distributed inside the vascular network, forming a vital barrier between the bloodstream and the walls of blood vessels. These... (Review)
Review
Endothelial cells (ECs) are widely distributed inside the vascular network, forming a vital barrier between the bloodstream and the walls of blood vessels. These versatile cells serve myriad functions, including the regulation of vascular tension and the management of hemostasis and thrombosis. Inflammation constitutes a cascade of biological responses incited by biological, chemical, or physical stimuli. While inflammation is inherently a protective mechanism, dysregulated inflammation can precipitate a host of vascular pathologies. ECs play a critical role in the genesis and progression of vascular inflammation, which has been implicated in the etiology of numerous vascular disorders, such as atherosclerosis, cardiovascular diseases, respiratory diseases, diabetes mellitus, and sepsis. Upon activation, ECs secrete potent inflammatory mediators that elicit both innate and adaptive immune reactions, culminating in inflammation. To date, no comprehensive and nuanced account of the research progress concerning ECs and inflammation in vascular-related maladies exists. Consequently, this review endeavors to synthesize the contributions of ECs to inflammatory processes, delineate the molecular signaling pathways involved in regulation, and categorize and consolidate the various models and treatment strategies for vascular-related diseases. It is our aspiration that this review furnishes cogent experimental evidence supporting the established link between endothelial inflammation and vascular-related pathologies, offers a theoretical foundation for clinical investigations, and imparts valuable insights for the development of therapeutic agents targeting these diseases.
PubMed: 37641702
DOI: 10.2147/JIR.S418166 -
Biomolecules Oct 2023Aging is a natural and inescapable phenomenon characterized by a progressive deterioration of physiological functions, leading to increased vulnerability to chronic... (Review)
Review
Aging is a natural and inescapable phenomenon characterized by a progressive deterioration of physiological functions, leading to increased vulnerability to chronic diseases and death. With economic and medical development, the elderly population is gradually increasing, which poses a great burden to society, the economy and the medical field. Thus, healthy aging has now become a common aspiration among people over the world. Accumulating evidence indicates that substances that can mediate the deteriorated physiological processes are highly likely to have the potential to prolong lifespan and improve aging-associated diseases. Foods from natural sources are full of bioactive compounds, such as polysaccharides, polyphenols, carotenoids, sterols, terpenoids and vitamins. These bioactive compounds and their derivatives have been shown to be able to delay aging and/or improve aging-associated diseases, thereby prolonging lifespan, via regulation of various physiological processes. Here, we summarize the current understanding of the anti-aging activities of the compounds, polysaccharides, polyphenols, carotenoids, sterols, terpenoids and vitamins from natural food sources, and their modes of action in delaying aging and improving aging-associated diseases. This will certainly provide a reference for further research on the anti-aging effects of bioactive compounds from natural food sources.
Topics: Aged; Humans; Aging; Carotenoids; Polyphenols; Vitamins; Terpenes; Sterols; Polysaccharides
PubMed: 38002283
DOI: 10.3390/biom13111600 -
The Science of the Total Environment Aug 2023Anthropogenic activities generally consume non-renewable resources and release polluting substances into the environment. Concerning agriculture, the cropping systems... (Review)
Review
Anthropogenic activities generally consume non-renewable resources and release polluting substances into the environment. Concerning agriculture, the cropping systems are almost based on exploiting non-renewable resources. In recent years, increasing interest has been devoted to reusing agricultural, food and other biomass wastes, considered relevant as they can be seen as resources rich in compounds that can find numerous applications. Biomass biorefining has been successfully applied and has opened up sustainable alternatives to the disposal of agricultural, agroindustrial and food wastes. In this area, an emerging, smart and environmentally friendly way to reduce the impact of waste on the environment is to obtain innovative materials for agriculture. Therefore, as part of biobased strategies, the use of waste biomass to obtain biostimulants and biogenic nanoparticles for crops has recently been proposed. Some research has shown that appropriate biostimulants and biobased nanomaterials have the potential to counteract some of the problems that plague agriculture. The above materials can improve crop performance, enhance crop tolerance to biotic and abiotic stresses, and improve plant nutrition. In light of the above, this review aspires, in the first part, to provide an overview of the ideas and central points that characterize the concept of bioeconomy and circular economy. In the second part, on the other hand, the most recent studies related to the valorization of various types of wastes leading to innovative biobased materials and their application in agriculture are presented. In particular, biostimulants and nanoparticles obtained through biogenic synthesis using agroindustrial and plant residues have been considered. In conclusion, the studies reported in this review show that the use of some biomasses to obtain the above materials represents a sustainable way of waste management and valorization, enabling innovative biobased materials for agriculture.
Topics: Waste Management; Agriculture; Crops, Agricultural; Nanostructures; Nanoparticles
PubMed: 37150469
DOI: 10.1016/j.scitotenv.2023.163912 -
The American Journal of Sports Medicine Dec 2023Injecting bioactive substances into the knee is common in orthopaedic practice, and recently it has been shown to mitigate risk factors for posttraumatic osteoarthritis....
BACKGROUND
Injecting bioactive substances into the knee is common in orthopaedic practice, and recently it has been shown to mitigate risk factors for posttraumatic osteoarthritis. Therefore, understanding the influence of these injections on postoperative infection rate is imperative.
HYPOTHESIS
Postinjury aspiration and corticosteroid injection (CSI) of the knee before anterior cruciate ligament (ACL) reconstruction (ACLR) would not increase the risk of postoperative infection.
STUDY DESIGN
Cohort Study; Level of evidence, 3.
METHODS
All patients between the ages of 10 and 65 years who underwent primary bone-patellar tendon-bone ACLR by 1 fellowship-trained sports medicine orthopaedic surgeon between January 1, 2011, and September 8, 2020, at 1 of 2 major academic centers were evaluated for inclusion. A total of 693 patients were included, with 273 patients receiving postinjury and preoperative aspiration and CSI. A postoperative infection was defined as a patient returning to the operating room for an intra-articular washout. The intervals-measured in days-between the CSI and ACLR and between ACLR and the final follow-up were recorded. To further evaluate the infection risk in each cohort (total cohort; aspiration and injection cohort; no aspiration and injection cohort), the upper 95% confidence bound for the infection risk was calculated for each cohort.
RESULTS
There were no postoperative infections in the 693 patients included in this study. The upper 95% confidence bounds were 0.4%, 1.1%, and 0.7% for the total cohort, the cohort that underwent aspiration and injection, and the cohort that did not, respectively. The median number of days between the surgical date and that of the aspiration and injection was 34 days, and the mean follow-up for the entire cohort was 337.4 days (95% CI, 307.6-367.3).
CONCLUSION
Postinjury and preoperative aspiration and CSI is a safe intervention that can be used before ACLR. Future studies with larger sample sizes, longer patient follow-ups, and multiple surgeons would be helpful to both better understand infection risk and better identify the influence of CSI on preventing posttraumatic osteoarthritis.
Topics: Humans; Child; Adolescent; Young Adult; Adult; Middle Aged; Aged; Anterior Cruciate Ligament Injuries; Cohort Studies; Knee Joint; Anterior Cruciate Ligament Reconstruction; Postoperative Complications; Osteoarthritis
PubMed: 37975540
DOI: 10.1177/03635465231211606 -
Journal of the American Academy of... Nov 2023The modern era for mental health parity in the US began in 1996, when Congress enacted the Mental Health Parity Act (MHPA), which required equivalence in aggregate...
The modern era for mental health parity in the US began in 1996, when Congress enacted the Mental Health Parity Act (MHPA), which required equivalence in aggregate lifetime and annual dollar limits for mental health benefits and medical/surgical benefits. Mental health parity generally refers to the equal treatment of mental health conditions and physical health conditions in insurance plans, the substance of which extends far beyond equivalence in the dollar limits of benefits. Mental health parity is a foundational aspiration that has not yet been fulfilled in the US; this article describes details of subsequent legislation that has created new opportunity to finish the work that was started by MHPA, to achieve actual mental health parity, with particular reference to the needs of children.
Topics: Child; Humans; United States; Mental Health; Insurance Coverage; Mental Health Services; Mental Disorders; Substance-Related Disorders; Insurance, Health
PubMed: 37230286
DOI: 10.1016/j.jaac.2023.03.019 -
Maternal and Child Health Journal Dec 2023Many cisgender women affected by homelessness and substance use desire pregnancy and parenthood. Provider discomfort with patient-centered counseling about reproductive...
Improving Reproductive Health Communication Between Providers and Women Affected by Homelessness and Substance Use in San Francisco: Results from a Community-Informed Workshop.
OBJECTIVES
Many cisgender women affected by homelessness and substance use desire pregnancy and parenthood. Provider discomfort with patient-centered counseling about reproductive choices and supporting reproductive decisions of these women poses barriers to reproductive healthcare access.
METHODS
We used participatory research methods to develop a half-day workshop for San Francisco-based medical and social service providers to improve reproductive counseling of women experiencing homelessness and/or who use substances. Guided by a stakeholder group comprising cisgender women with lived experience and providers, goals of the workshop included increasing provider empathy, advancing patient-centered reproductive health communication, and eliminating extraneous questions in care settings that perpetuate stigma. We used pre/post surveys to evaluate acceptability and effects of the workshop on participants' attitudes and confidence in providing reproductive health counseling. We repeated surveys one month post-event to investigate lasting effects.
RESULTS
Forty-two San Francisco-based medical and social service providers participated in the workshop. Compared to pre-test, post-test scores indicated reduced biases about: childbearing among unhoused women (p < 0.01), parenting intentions of pregnant women using substances (p = 0.03), and women not using contraception while using substances (p < 0.01). Participants also expressed increased confidence in how and when to discuss reproductive aspirations (p < 0.01) with clients. At one month, 90% of respondents reported the workshop was somewhat or very beneficial to their work, and 65% reported increased awareness of personal biases when working with this patient population.
CONCLUSIONS FOR PRACTICE
A half-day workshop increased provider empathy and improved provider confidence in reproductive health counseling of women affected by homelessness and substance use.
Topics: Humans; Female; Pregnancy; Health Communication; Reproductive Health; San Francisco; Ill-Housed Persons; Substance-Related Disorders
PubMed: 37204587
DOI: 10.1007/s10995-023-03671-y