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Endocrine, Metabolic & Immune Disorders... Jul 2024Type 2 Diabetes Mellitus (T2DM) represents a significant and pressing worldwide health concern, necessitating the quest for enhanced antidiabetic pharmaceuticals....
BACKGROUND
Type 2 Diabetes Mellitus (T2DM) represents a significant and pressing worldwide health concern, necessitating the quest for enhanced antidiabetic pharmaceuticals. Guanidine derivatives, notably metformin and buformin, have emerged as pivotal therapeutic agents for T2DM management.
AIMS
The present study introduces an efficient one-pot synthesis method for the production of symmetrical guanidine compounds.
METHODS
This synthesis involves the reaction of isothiocyanates with secondary amines, employing an environmentally friendly and recyclable reagent, tetrabutylphosphonium tribromide (TBPTB).
RESULTS
A comprehensive assessment of the biological activity of the synthesized guanidine compounds, specifically in the context of T2DM, has been rigorously conducted.
CONCLUSION
Additionally, computational analyses have unveiled their substantial potential as promising antidiabetic agents. Results highlight the relevance of these compounds in the ongoing pursuit of novel therapeutic solutions for T2DM.
.PubMed: 38956919
DOI: 10.2174/0118715303287962240621053459 -
Endocrine, Metabolic & Immune Disorders... Jul 2024Malabsorption syndromes are known chronic complications of bariatric surgery. Therefore, it is recommended to take oral supplementation with multivitamins. Wernicke's...
BACKGROUND
Malabsorption syndromes are known chronic complications of bariatric surgery. Therefore, it is recommended to take oral supplementation with multivitamins. Wernicke's encephalopathy represents an acute neuropsychiatric syndrome associated with alcoholism or severe malnutrition; sporadic cases of this potential complication related to bariatric surgery are described in the literature. We present a case of Wernicke's encephalopathy due to severe vitamin B1 deficiency after bariatric surgery.
CASE REPORT
A 31-year-old woman with deaf-mutism from the age of 3 years old, operated 3 months before with a mini-gastric bypass for severe obesity, was transferred to our unit after accessing the emergency room. In the immediate medical history, there was the sudden and rapid decline in vision, leading to complete loss of vision, marked asthenia, and paresthesia in the four limbs. Considering the previous bariatric surgery, the diagnosis of non-alcoholic Wernicke's syndrome was suspected, for which IV therapy with Vitamin B1 was started at a dosage of 5 vials of 200 mg in 100 cc of saline solution (three times a day for the first 72 hours, subsequently 1 once/day). After 12 hours, there was an improvement in visual acuity, and the symptoms completely resolved within 48 hours. She was discharged with complete resolution of all symptoms after 1 month.
CONCLUSION
Initial vision loss without confusion or encephalopathy is one atypical presentation of Wernicke syndrome. Clinical suspicion must be high in case of alcoholism or post-bariatric surgery. Early recognition of atypical symptoms, including vision loss, and timely administration of therapy improves the prognosis of this potentially reversible but time-dependent neurological emergency.
PubMed: 38956916
DOI: 10.2174/0118715303318400240624104538 -
The Journal of Contemporary Dental... Apr 2024To elucidate the factors that determine the success of direct pulp capping (DPC) in permanent teeth with pulp exposure due to dental caries.
AIM
To elucidate the factors that determine the success of direct pulp capping (DPC) in permanent teeth with pulp exposure due to dental caries.
MATERIALS AND METHODS
A comprehensive electronic search from 1980 to 2023 across PubMed, Scopus, and ISI Web databases was conducted using specific keywords and MeSH terms in Q1 or Q2 journals. Only prospective/retrospective clinical studies in English on 15 or more human permanent teeth with carious pulpal exposure treated with DPC agents-mineral trioxide aggregate (MTA), Biodentine, or calcium hydroxide with a rubber dam and minimum 1-year follow-up, were considered. The factors retrieved and analyzed were based on study design, patient age, sample size, type of cavity, exposure size and location, pulp diagnosis, solutions to achieve hemostasis, hemostasis time, capping material, restoration type, follow-up period, methods of evaluation, and overall success.
REVIEW RESULTS
Out of 680 articles, only 16 articles were selected for the present systematic review on application of the selection criteria. A wide age range of patients from 6 to 88 years were considered among these studies with sample sizes ranging from 15 to 245 teeth with reversible pulpitis being the predominant diagnosis of the cases. Mineral trioxide aggregate as a capping material was evaluated in 4 studies as a lone agent, while compared with other capping agents such as biodentine or calcium hydroxide in 7 studies. The follow-up period ranged from 9 days to nearly 80 months. While both clinical and radiographic evaluation was carried out in all studies, cold testing dominated the clinical tests while IOPR was the common radiograph considered. Mineral trioxide aggregate success rate was higher and similar to biodentine than calcium hydroxide.
CONCLUSION
Direct pulp capping has a high and predictable success rate in permanent teeth with carious exposure to reversible and irreversible pulpitis. Currently, mineral trioxide aggregate and biodentine have better long-term results in DPC than calcium hydroxide, hence, they should be used as an alternative to calcium hydroxide. Definitive restoration within a short period improves long-term prognosis.
CLINICAL SIGNIFICANCE
The significance of this review lies in its provision of evidence-based information on the effectiveness of DPC and the factors that influence its success. By considering these factors, clinicians can optimize treatment outcomes and improve the long-term prognosis of the treated teeth. This systematic review serves as a valuable resource for clinicians and researchers in the field of endodontics. How to cite this article: Gomez-Sosa JF, Granone-Ricella M, Rosciano-Alvarez M, . Determining Factors in the Success of Direct Pulp Capping: A Systematic Review. J Contemp Dent Pract 2024;25(4):392-401.
Topics: Humans; Dental Pulp Capping; Dental Caries; Calcium Compounds; Silicates; Calcium Hydroxide; Pulp Capping and Pulpectomy Agents; Oxides; Aluminum Compounds; Drug Combinations; Treatment Outcome; Dental Pulp Exposure
PubMed: 38956856
DOI: 10.5005/jp-journals-10024-3673 -
The Journal of Contemporary Dental... Apr 2024The aim of the current study was to assess the cleaning and smear layer removal efficacy of two different rotary files with or without chemical agents on primary teeth.
AIM
The aim of the current study was to assess the cleaning and smear layer removal efficacy of two different rotary files with or without chemical agents on primary teeth.
MATERIALS AND METHODS
For the study, 90 extracted primary maxillary incisors without internal or external resorption and with at least two-thirds of complete roots were chosen. Then, based on the kind of instruments used to clean and shape the canals, they were randomly assigned to three experimental groups, each consisting of 30 teeth. Group-I: The canal was instrumented manually with K-files, Group-II: The canal was instrumented with Kedo-S files, Group-III: The canal was instrumented with Kedo-SG Blue files. After the canals were finally instrumented, 2 mL of QMix solution was used to irrigate 15 samples from each group. The samples were subsequently allowed to remain in the canals for 90 seconds in order to eliminate the smear layer. After that a stereomicroscope was used to assess the cleaning effectiveness.
RESULTS
With irrigant solution, the highest mean value was found in manual K-files (2.86 ± 0.34), followed by Kedo-S files group (1.34 ± 0.26) and Kedo-SG Blue files (1.28 ± 0.18). Without irrigant solution, the highest mean value was found in manual K-files (2.92 ± 0.22) followed by Kedo-S files group (1.44 ± 0.18) and Kedo-SG Blue files (1.36 ± 0.14). There was a statistically significant difference found at all the three levels.
CONCLUSION
On conclusion, the current study's findings demonstrated that irrigation solution was significantly more effective in cleaning and removing smear layers from pediatric rotary files than manual K-files.
CLINICAL SIGNIFICANCE
The effectiveness of endodontic therapy depends on a successful chemomechanical preparation. The canals are instrumented using either hand files or rotary instruments; there are several irrigation and instrumentation techniques. In order to completely sterilize the canals, chemical agents are utilized for irrigation during instrumentation. Due to their numerous biological, antibacterial, anti-inflammatory, and antioxidant qualities, many natural compounds are also utilized as irrigants. How to cite this article: Abushanan A. Evaluation of the Smear Layer Removal Ability of Various Rotary Files with/without Chemical Agents on Primary Teeth: An In Vitro Study. J Contemp Dent Pract 2024;25(4):354-357.
Topics: Tooth, Deciduous; Smear Layer; Humans; Root Canal Preparation; Root Canal Irrigants; In Vitro Techniques; Dental Instruments; Biguanides; Incisor; Equipment Design; Dental Pulp Cavity; Polymers
PubMed: 38956851
DOI: 10.5005/jp-journals-10024-3657 -
The Journal of Contemporary Dental... Apr 2024The study aimed to assess the microleakage of nanoparticle-based (NPB) cyanoacrylate sealer and epoxy resin-based (ERB) sealer using radioisotope method and confocal...
AIM OF THE STUDY
The study aimed to assess the microleakage of nanoparticle-based (NPB) cyanoacrylate sealer and epoxy resin-based (ERB) sealer using radioisotope method and confocal laser scanning microscopy (CLSM).
MATERIALS AND METHODS
A total of 100 single-rooted teeth were collected; specimens were accessed, instrumented, and irrigated, and randomly distributed into 4 groups of 25 samples each: Group I: Positive control, group II: Negative control, group III: Obturated with NPB sealer, and group IV: Obturated with ERB sealer. All samples were immersed in 99mTc pertechnetate solution, for 3 hours after which radioactivity was estimated under a Gamma camera. The radioactivity released by specimens before and after nail varnish removal was statistically analyzed. After 2 weeks, the same samples were used for CLSM analysis. The sealer tubular penetration depth was measured at the deepest level for each group using ZEN lite 2012. Data collected was statistically evaluated.
RESULTS
The amount of radioactivity observed at first in group III and group IV was 194.76 and 599.12 units, respectively, with -value < 0.001, indicating significant interaction, and after nail varnish removal, it was 89.68 and 468.44 units, respectively, with a -value < 0.001; again, indicating statistical significance. Hence, the radioactivity of NPB sealer was found to be lower than ERB sealer in both cases, indicating better sealing of the former. The photomicrographs show that mean value of dye penetration in NPB sealer in first, second, and third segment from apex was 85.06, 75.73, and 66.09, respectively; while in the case of ERB sealer, those were 597.28, 461.17, and 195.68, respectively; with -value < 0.001; signifying that NPB sealer exhibited higher resistance to microleakage than ERB sealer.
CONCLUSION
The NPB sealer can become a potential root canal sealer in future endodontics due to superior physiochemical properties attributed to the cyanoacrylate and incorporated nanoparticles.
CLINICAL SIGNIFICANCE
The study clinically signifies that we can equally use the radioisotopic method along with confocal method while conducting the microleakage studies. In addition, NPB sealer can be an emerging replacement with better properties than gold standard root canal sealers for clinical use. How to cite this article: Shetty C, Qaiser S, Shetty A, . Evaluation of Microleakage of Nanoparticle-incorporated Cyanoacrylate Root Canal Sealer Using the Radioisotopic Method: An In Vitro Study. J Contemp Dent Pract 2024;25(4):335-341.
Topics: Dental Leakage; Root Canal Filling Materials; Humans; Nanoparticles; In Vitro Techniques; Microscopy, Confocal; Epoxy Resins; Cyanoacrylates; Root Canal Obturation; Sodium Pertechnetate Tc 99m; Materials Testing
PubMed: 38956848
DOI: 10.5005/jp-journals-10024-3683 -
Physiologia Plantarum 2024Clubroot disease caused by Plasmodiophora brassicae is becoming a serious threat to rapeseed (Brassica napus) production worldwide. Breeding resistant varieties using CR...
Clubroot disease caused by Plasmodiophora brassicae is becoming a serious threat to rapeseed (Brassica napus) production worldwide. Breeding resistant varieties using CR (clubroot resistance) loci is the most promising solution. Using marker-assisted selection and speed-breeding technologies, we generated Brassica napus materials in homozygous or heterozygous states using CRA3.7, CRA08.1, and CRA3.2 loci in the elite parental line of the Zhongshuang11 background. We developed three elite lines with two CR loci in different combinations and one line with three CR loci at the homozygous state. In our study, we used six different clubroot strains (Xinmin, Lincang, Yuxi, Chengdu, Chongqing, and Jixi) which are categorized into three groups based on our screening results. The newly pyramided lines with two or more CR loci displayed better disease resistance than the parental lines carrying single CR loci. There is an obvious gene dosage effect between CR loci and disease resistance levels. For example, pyramided lines with triple CR loci in the homozygous state showed superior resistance for all pathogens tested. Moreover, CR loci in the homozygous state are better on disease resistance than the heterozygous state. More importantly, no negative effect was observed on agronomic traits for the presence of multiple CR loci in the same background. Overall, these data suggest that the pyramiding of triple clubroot resistance loci conferred superior resistance with no negative effects on agronomic traits in Brassica napus.
Topics: Brassica napus; Disease Resistance; Plant Diseases; Plasmodiophorida; Plant Breeding; Phenotype
PubMed: 38956798
DOI: 10.1111/ppl.14414 -
European Journal of Sport Science Jul 2024Inconsistent and restricted definitions of injury have contributed to limitations in determining injury rates and identifying risk factors for running-related injuries... (Review)
Review
Inconsistent and restricted definitions of injury have contributed to limitations in determining injury rates and identifying risk factors for running-related injuries (RRIs). The aim of this scoping review was to investigate the definitions and surveillance methods of RRIs. A systematic electronic search was performed using PubMed, Scopus, SPORTDiscuss, MEDLINE, and Web of Science databases. Included studies were published in English between January 1980 and June 2023 which investigated RRIs in adult running populations, providing a definition for a general RRI. Results were extracted and collated. 204 articles were included. Three primary criteria were used to define RRIs: physical description, effect on training and medical intervention, while three secondary criteria are also associated with definitions: cause/onset of injury, location, and social consequences. Further descriptors and sub-descriptors form these criteria. The use of Boolean operators resulted in nine variations in definitions. Inconsistency is evident among definitions of RRIs. Injury definitions seem to be important for two main reasons: firstly, determining accurate injury rates, and secondly, in research examining risk factors. For the latter, definitions seem to be very limited, only capturing severe injuries and failing to recognise the full development process of RRIs, precluding the identification of conclusive risk factors. A potential two-approach solution is the initial use of a broad definition acting as a gatekeeper for identifying any potential injury, and follow-up with an extensive surveillance tool to capture the specific consequences of the varying severity of RRIs.
Topics: Humans; Risk Factors; Running; Athletic Injuries; Terminology as Topic
PubMed: 38956793
DOI: 10.1002/ejsc.12123 -
International Neurourology Journal Jun 2024To investigate the efficacy of an intravesical instillation of hyaluronic acid (HA) combined with epidermal growth factor (EGF) for the treatment of interstitial...
Intravesical Instillation of Hyaluronic Acid With Epidermal Growth Factor for Restoring Urothelial Denudation and Alleviating Oxidative Stress in Lipopolysaccharide-Induced Interstitial Cystitis of Rats.
PURPOSE
To investigate the efficacy of an intravesical instillation of hyaluronic acid (HA) combined with epidermal growth factor (EGF) for the treatment of interstitial cystitis (IC) using a lipopolysaccharide (LPS)-induced IC animal model.
METHODS
A total of 24 female Sprague-Dawley rats were randomized to 4 groups: sham control, IC, HA, and treatment (HA/ EGF) groups. A polyethylene-50 tube was placed inside the bladder of each animal. IC was induced by twice-weekly instillations of LPS for 3 weeks, which resulted in chronic injury of the urothelium. Animals in the sham control group only received saline instillation. Treatment solutions of HA and HA/EGF were given on days 0, 7, and 14 after IC induction (400 μL of HA in a concentration of 0.4 mg/0.5 mL and 400 μL of NewEpi, a commercialized HA/EGF mixture containing 2 μg of EGF and 0.4 mg of sodium hyaluronate). Animals were sacrificed on day 21 for further examinations.
RESULTS
The HA/EGF group showed visible improvement in hematuria with a significant reduction of red blood cells in the urine compared to the HA group. Histological examination revealed that HA/EGF treatment reversed the abnormalities developed in IC, including infiltration of inflammatory cells, irregular re-epithelialization, and fibrotic tissue. Moreover, HA/ EGF significantly reduced the levels of proinflammation cytokines (tumor necrosis factor-α, interleukin [IL]-6, and IL-1β) and substantially lowered the elevated oxidative stress biomarker malondialdehyde, yet restored the levels of antioxidant enzymes glutathione peroxidase and superoxide dismutase, with superior results than HA treatment. Cystometry studies indicated that HA/EGF significantly prolonged intercontraction interval and increased micturition volume.
CONCLUSION
HA/EGF has been demonstrated as a more effective treatment for enhancing the urothelium lining and reducing inflammatory changes to alleviate clinical symptoms associated with IC in rats, compared to HA alone.
PubMed: 38956770
DOI: 10.5213/inj.2448028.014 -
Trials Jul 2024Hypertensive disorders of pregnancy (HDP) pose significant risks to both maternal and fetal health, contributing to global morbidity and mortality. Management of HDP is...
Prospective validation of a mobile health application for blood pressure management in patients with hypertensive disorders of pregnancy: study protocol for a randomized controlled trial.
BACKGROUND
Hypertensive disorders of pregnancy (HDP) pose significant risks to both maternal and fetal health, contributing to global morbidity and mortality. Management of HDP is complex, particularly because of concerns regarding potential negative effects on utero-placental circulation and limited therapeutic options due to fetal safety. Our study investigates whether blood pressure monitoring through a mobile health (mHealth) application can aid in addressing the challenges of blood pressure management in pregnant individuals with HDP. Additionally, we aim to assess whether this intervention can improve short-term maternal and fetal outcomes and potentially mitigate long-term cardiovascular consequences.
METHODS
This prospective, randomized, single-center trial will include 580 pregnant participants who meet the HDP criteria or who have a heightened risk of pregnancy-related hypertension due to factors such as multiple pregnancies, obesity, diabetes, or a history of HDP in prior pregnancies leading to preterm birth. Participants will be randomized to either the mHealth intervention group or the standard care group. The primary endpoint is the difference in systolic blood pressure from enrollment to 1 month after childbirth. The secondary endpoints include various blood pressure parameters, obstetric outcomes, body mass index trajectory, step counts, mood assessment, and drug adherence.
CONCLUSIONS
This study emphasizes the potential of mHealth interventions, such as the Heart4U application, to improve blood pressure management in pregnant individuals with HDP. By leveraging technology to enhance engagement, communication, and monitoring, this study aims to positively impact maternal, fetal, and postpartum outcomes associated with HDP. This innovative approach demonstrates the potential of personalized technology-driven solutions for managing complex health conditions.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05995106. Registered on 16 August 2023.
Topics: Humans; Pregnancy; Female; Prospective Studies; Mobile Applications; Telemedicine; Hypertension, Pregnancy-Induced; Blood Pressure; Randomized Controlled Trials as Topic; Antihypertensive Agents; Blood Pressure Monitoring, Ambulatory; Treatment Outcome; Adult; Time Factors
PubMed: 38956675
DOI: 10.1186/s13063-024-08200-y -
Reproductive Health Jul 2024Today, person-centred care is seen as a cornerstone of health policy and practice, but accommodating individual patient preferences can be challenging, for example...
BACKGROUND
Today, person-centred care is seen as a cornerstone of health policy and practice, but accommodating individual patient preferences can be challenging, for example involving caesarean section on maternal request (CSMR). The aim of this study was to explore Swedish health professionals' perspectives on CSMR and analyse them with regard to potential conflicts that may arise from person-centred care, specifically in relation to shared decision-making.
METHODS
A qualitative study using both inductive and deductive content analysis was conducted based on semi-structured interviews. It was based on a purposeful sampling of 12 health professionals: seven obstetricians, three midwives and two neonatologists working at different hospitals in southern and central Sweden. The interviews were recorded either in a telephone call or in a video conference call, and audio files were deleted after transcription.
RESULTS
In the interviews, twelve types of expressions (sub-categories) of five types of conflicts (categories) between shared decision-making and CSMR emerged. Most health professionals agreed in principle that women have the right to decide over their own body, but did not believe this included the right to choose surgery without medical indications (patient autonomy). The health professionals also expressed that they had to consider not only the woman's current preferences and health but also her future health, which could be negatively impacted by a CSMR (treatment quality and patient safety). Furthermore, the health professionals did not consider costs in the individual decision, but thought CSMR might lead to crowding-out effects (avoiding treatments that harm others). Although the health professionals emphasised that every CSMR request was addressed individually, they referred to different strategies for avoiding arbitrariness (equality and non-discrimination). Lastly, they described that CSMR entailed a multifaceted decision being individual yet collective, and the use of birth contracts in order to increase a woman's sense of security (an uncomplicated decision-making process).
CONCLUSIONS
The complex landscape for handling CSMR in Sweden, arising from a restrictive approach centred on collective and standardised solutions alongside a simultaneous shift towards person-centred care and individual decision-making, was evident in the health professionals' reasoning. Although most health professionals emphasised that the mode of delivery is ultimately a professional decision, they still strived towards shared decision-making through information and support. Given the different views on CSMR, it is of utmost importance for healthcare professionals and women to reach a consensus on how to address this issue and to discuss what patient autonomy and shared decision-making mean in this specific context.
Topics: Humans; Female; Patient-Centered Care; Sweden; Qualitative Research; Pregnancy; Decision Making, Shared; Cesarean Section; Patient Preference; Attitude of Health Personnel; Patient Participation; Adult; Decision Making
PubMed: 38956635
DOI: 10.1186/s12978-024-01831-z