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British Dental Journal Jun 2024
Topics: Humans; Mouth Diseases; United Kingdom; Health Care Costs
PubMed: 38942861
DOI: 10.1038/s41415-024-7556-8 -
British Dental Journal Jun 2024As temporomandibular disorders (TMDs) become ever more prevalent in both primary and secondary care settings, successful management is increasingly challenging in both...
As temporomandibular disorders (TMDs) become ever more prevalent in both primary and secondary care settings, successful management is increasingly challenging in both sectors. The authors aim to explore the dilemma of TMD management as the patient journeys through from primary to secondary care and offer educational tools to support practitioners in managing this complex patient cohort, as well as outlining alternative solutions for the delivery of TMD management strategies.
Topics: Humans; Temporomandibular Joint Disorders; Primary Health Care; Secondary Care
PubMed: 38942856
DOI: 10.1038/s41415-024-7506-5 -
British Dental Journal Jun 2024
Topics: Leadership; Humans; United Kingdom; Patient Care Team; Oral Health
PubMed: 38942840
DOI: 10.1038/s41415-024-7579-1 -
BMJ Paediatrics Open Jun 2024Limited evidence exists regarding children receiving home healthcare devices (HHDs). This study aimed to describe the range and type of HHD use by children with chronic...
BACKGROUND
Limited evidence exists regarding children receiving home healthcare devices (HHDs). This study aimed to describe the range and type of HHD use by children with chronic medical conditions in Japan and explore factors leading to increased use of these devices.
METHODS
This retrospective cohort study was conducted using data from the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Children receiving HHD aged ≤18 years between April 2011 and March 2019 were included. Children newly administered HHD between 2011 and 2013 were followed up for 5 years, and logistic regression analysis was performed to assess the relationship between increased HHD use and each selected risk factor (comorbidity or types of HHD). The models were adjusted for age category at home device introduction, sex and region.
RESULTS
Overall, 52 375 children receiving HHD were identified. The number (proportion) of children receiving HHD increased during the study period (11 556 [0.05%] in 2010 and 25 593 [0.13%] in 2018). The most commonly administered HHD was oxygen (51.0% in 2018). Among the 12 205 children receiving HHD followed up for 5 years, 70.4% and 68.3% who used oxygen or continuous positive airway pressure, respectively, were released from the devices, while only 25.8% who used mechanical ventilation were released from the device. The following diagnosis/comorbidities were associated with increased HHD use: other neurological diseases (OR): 2.85, 95% CI): 2.54-3.19), cerebral palsy (OR: 2.16, 95% CI: 1.87 to 2.49), congenital malformations of the nervous system (OR: 1.70, 95% CI: 1.34 to 2.13) and low birth weight (OR: 1.68, 95% CI: 1.41 to 2.00).
CONCLUSIONS
This study provides nationwide population-based empirical data to clarify the detailed information regarding children receiving HHD in Japan. This information could assist healthcare professionals in improving the quality of life of these children and their families and help health policymakers consider measures.
Topics: Humans; Japan; Retrospective Studies; Female; Male; Child; Home Care Services; Child, Preschool; Infant; Adolescent; Chronic Disease; Infant, Newborn
PubMed: 38942589
DOI: 10.1136/bmjpo-2024-002685 -
The American Journal of Medicine Jun 2024African-Americans and Hispanic Americans experience a higher incidence and prevalence of dementia than white Americans while also experiencing more environmental,... (Review)
Review
African-Americans and Hispanic Americans experience a higher incidence and prevalence of dementia than white Americans while also experiencing more environmental, metabolic and nutritional factors potentially promoting such disparities. Greater exposure to air, water and soil pollutants including toxic metals associated with neurodegeneration accrue to both minorities, as does worse dental care than whites exposing them to periodontitis raising dementia risk. Hispanic Americans experience greater occupational exposure to herbicides and pesticides develop more non-alcoholic fatty liver disease (NAFLD) predisposing to dementia. African-Americans have a greater likelihood of both Vitamin D deficiency and magnesium deficiency increasing neuroinflammation and dementia risk. Both have greater air pollution exposure, a known dementia risk. Nutritional changes including greater nut consumption and reduced sugar drink consumption, improved dental care, and reduced toxicant exposure may help reduce this higher risk of dementia among African Americans and Hispanic Americans.
PubMed: 38942346
DOI: 10.1016/j.amjmed.2024.06.023 -
European Journal of Dentistry Jun 2024This study evaluated surface roughness, biaxial flexural strength, and phase transformation of 5Y-PSZ after grinding and polishing with different protocols.
Effect of Grinding and Polishing Protocols on Surface Roughness, Flexural Strength, and Phase Transformation of High-Translucent 5 mol% Yttria-Partially Stabilized Zirconia.
OBJECTIVES
This study evaluated surface roughness, biaxial flexural strength, and phase transformation of 5Y-PSZ after grinding and polishing with different protocols.
MATERIAL AND METHODS
Two commercial 5Y-PSZ, Lava Esthetic (L) and Cercon xt (C), were used and divided into 3 groups: LC and CC represented unpolished control groups; LE and CE were polished with protocol I (EVE DIASYNT® PLUS HP following with EVE DIACERA RA); and LJ and CJ were polished with protocol II (Superfine diamond bur following with Jota ZIR Gloss polishing kit). Surface roughness was evaluated after polishing step-by-step with a contact-type profilometer. After high-gross polishing, the specimens were subjected to biaxial flexural strength test, crystallographic microstructure analysis using an X-ray diffractometer (XRD), and surface micro-topography using scanning electron microscopy (SEM).
STATISTICAL ANALYSIS
Surface roughness differences after each step and biaxial flexural strength between groups were evaluated with one-way ANOVA, followed by Bonferroni post-hoc analysis. Changes in surface roughness across four different time points within groups were assessed using one-way repeated measures ANOVA, followed by Bonferroni post-hoc analysis.
RESULTS
After high-gross polishing, both polishing protocols showed significantly lower surface roughness than the grinding group ( < 0.05). The LE and CE groups exhibited the highest surface roughness values, which were significant differences from the LJ and CJ groups ( < 0.05). The LE group showed significantly lower biaxial flexural strength compared to the LC group ( < 0.05). However, there was no statistically significant difference in the CE and CJ groups compared to the control group ( > 0.05). Furthermore, all polishing protocols did not change the phase transformation of zirconia.
CONCLUSION
Polishing protocol II provided a smoother surface than the protocol I after high-gross polishing, while the biaxial flexural strength of materials remained unaffected.
PubMed: 38942054
DOI: 10.1055/s-0044-1787001 -
Journal of the Mechanical Behavior of... Jun 2024Tooth extraction is a common clinical procedure with biomechanical factors that can directly influence patient outcomes. Recent development in atraumatic extraction...
BACKGROUND AND OBJECTIVE
Tooth extraction is a common clinical procedure with biomechanical factors that can directly influence patient outcomes. Recent development in atraumatic extraction techniques have endeavoured to improve treatment outcomes, but the characterization of extraction biomechanics is sparse. An axisymmetric inverse finite element (FE) approach is presented to represent the biomechanics of vertical atraumatic tooth extraction in an ex-vivo swine model.
METHODS
Geometry and boundary conditions from the model are determined to match the extraction of swine incisors in a self-aligning ex vivo extraction experiment. Material parameters for the periodontal ligament (PDL) model are determined by solving an inverse FE problem using clusters of data obtained from 10 highly-controlled mechanical experiments. A seven-parameter visco-hyperelastic damage model, based on an Arruda-Boyce framework, is used for curve fitting. Three loading schemes were fit to obtain a common set of material parameters.
RESULTS
The inverse FE results demonstrate good predictions for overall force-time curve shape, peak force, and time to peak force. The fit model parameters are sufficiently consistent across all three cases that a coefficient-averaged model was taken that compares well to all three cases. Notably, the initial modulus ,u, converged across trials to an average value of 0.472 MPa with an average viscoelastic constant g of 0.561.
CONCLUSIONS
The presented model is found to have consistent parameters across loading cases. The capability of this model to represent the fundamental mechanical characteristics of the dental complex during vertical extraction loading is a significant advancement in the modelling of extraction procedures. Future work will focus on verifying the model as a predictive design tool for assessing new loading schemes in addition to investigating its applications to subject-specific problems.
PubMed: 38941913
DOI: 10.1016/j.jmbbm.2024.106641 -
Journal of Arrhythmia Jun 2024Atrioventricular nodal reentrant tachycardia (AVNRT) sometimes recurs even after anatomical slow pathway (SP) ablation targeting the rightward inferior extension (RIE)....
BACKGROUND
Atrioventricular nodal reentrant tachycardia (AVNRT) sometimes recurs even after anatomical slow pathway (SP) ablation targeting the rightward inferior extension (RIE). This multicenter study aimed to determine the reasons for AVNRT recurrence.
METHODS AND RESULTS
Forty-six patients were treated successfully for recurrent AVNRT. Initial treatment was for 38 slow-fast AVNRTs, 3 fast-slow AVNRTs, 2 slow-slow AVNRTs, 2 slow-fast and fast-slow AVNRTs, and 1 noninducible AVNRT. All initial treatments were of RF application to the RIE; SP elimination was achieved in 11, dual AVN physiology was seen in 29, and AVNRT remained inducible in 5. The recurrent AVNRTs included 34 slow-fast AVNRTs, 6 fast-slow AVNRTs, 3 slow-slow AVNRTs, 2 slow-fast and fast-slow AVNRTs, and 1 slow-fast and slow-slow AVNRTs. Successful ablation site was within the RIE in 39 and left inferior extension in 7. In 30 of 39, the successful RIE site was in the same area or higher than that of the initial procedure.
CONCLUSION
For a high majority (around 85%) of patients in whom AVNRT recurs after initial ablation success, the site of a second successful procedure will be within the RIE even though the RIE was originally targeted. Furthermore, a high majority (around 86%) of sites of successful ablation will be higher than those originally targeted.
PubMed: 38939776
DOI: 10.1002/joa3.13060 -
Case Reports in Otolaryngology 2024Cocaine is the second most consumed drug worldwide, more than 0.4% of the global population, and has become a real public health problem in recent years. Its inhalation...
BACKGROUND
Cocaine is the second most consumed drug worldwide, more than 0.4% of the global population, and has become a real public health problem in recent years. Its inhalation causes significant centrofacial lesions, grouped under the name cocaine-induced midline destructive lesion (CIMDL). These destructions are due to the conjunction of the vasoconstrictor, local prothrombogenic effects, and cytotoxic effects of cocaine. The ischemia produced by this substance is due to vasoconstriction that leads to nasal tissue necrosis and perforation of the nasal septum secondary to chondral necrosis. . A 36-year-old man, previously grappling with cocaine addiction, was hospitalized to undergo comprehensive clinical, microbiological, and radiological examinations because he was suffering from the emergence of crusts and ulceration in the nasal mucosa, accompanied by a palate perforation, a 39°C fever, and chills. Standard bacteriological culture was positive for coagulase-negative staphylococci and , while mycological culture was positive for . The CT scan images of the sinuses confirmed the presence of palatal perforation and total destruction of the nasal septum, cartilaginous portion, maxillary sinus medial wall, lower and middle turbinates, and middle meatus. Nasal endoscopy revealed an exposition of the bony wall and displayed the exposition of the occipital bone's clivus. A diagnosis of CIMDL was confirmed. Antibiotic therapy was decided based on antibiogram results by the consulting microbiologist. Debridement of necrotic tissue was done by nasal endoscopy with local cleaning and was repetitive during the first week to maintain the best cleanliness possible. The patient was discharged with oro-nasal hygiene instructions and referred for prosthetic rehabilation. As for the cocaine addiction, the patient was in follow-up with a psychologist in a specialized centre.
CONCLUSION
The care is multidisciplinary. Psychological help and assistance are essential to guide patients to become cocaine free and to avoid a relapse. Weaning is a prerequisite for surgery. Rehabilitation of speech and swallowing is necessary. Many local flaps or micro-anastomoses are possible.
PubMed: 38939732
DOI: 10.1155/2024/7109261 -
JACC. Advances Oct 2023Cardiac rehabilitation (CR) is strongly recommended for a spectrum of cardiovascular conditions and procedures including aortic valve replacement.
BACKGROUND
Cardiac rehabilitation (CR) is strongly recommended for a spectrum of cardiovascular conditions and procedures including aortic valve replacement.
OBJECTIVES
The purpose of this study was to characterize patient and hospital factors associated with CR participation after transcatheter aortic valve replacement (TAVR) and determine which factors explain hospital-level variation in CR participation.
METHODS
We linked clinical and administrative claims data from patients who underwent TAVR at 24 Michigan hospitals between January 1, 2016 and June 30, 2020 and obtained rates of CR enrollment within 90 days of discharge. Sequential mixed models were fit to evaluate hospital variation in 90-day post-TAVR CR participation.
RESULTS
Among 3,372 patients, 30.6% participated in CR within 90-days after discharge. Several patient factors were negatively associated with CR participation after TAVR including older age, Medicaid insurance, atrial fibrillation/flutter, dialysis use, and slower baseline 5-m walk times. There was substantial hospital variation in CR participation after TAVR ranging from 5% to 60% across 24 hospitals. Patient case mix did not explain hospital variation in CR across hospitals with median OR numerically increasing from 2.11 (95% CI: 1.62-2.67) to 2.13 (95% CI: 1.61-2.68) after accounting for patient-level factors.
CONCLUSIONS
Less than 1 in 3 patients who underwent TAVR in Michigan participated in CR within 90-days of discharge. Although several patient factors are associated with CR participation, hospital-level variation in CR participation after TAVR is not explained by patient case mix. Identifying hospital processes of care that promote CR participation after TAVR will be critical to improving CR participation after TAVR.
PubMed: 38938330
DOI: 10.1016/j.jacadv.2023.100581