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1.
Oper Dent ; 49(4): 388-402, 2024 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-38978303

RESUMEN

OBJECTIVE: To systematically evaluate the clinical performance of deep margin elevation (DME) technique in terms of pulpal and periodontal health of teeth. METHODS AND MATERIALS: An exploratory search was performed in PubMed, Scopus, Embase, Web of Science, and Google Scholar up to September 2023 by two authors independently. This systematic review was performed in accordance with Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Systematic Reviews (PRISMA-SR) and registered with PROSPERO-CRD42022382082. A custom-designed spreadsheet was used to extract the data. The quality of each study was evaluated by means of the Joanna Briggs Institute (JBI) risk of bias (ROB) tool specific for each study design. RESULTS: A total of 5363 articles was obtained through an electronic database search, the grey literature, and a hand search. 2814 duplicates were removed, and an additional 2535 articles were also removed, as they did not meet the eligibility criteria. Following the screening of titles and abstracts, 16 articles were selected for full text reading, from which 10 articles were included for final qualitative analysis. DME was predominantly done with resin-based composite or glass ionomer cement (GIC). Parameters like periodontal pocket depth and bleeding on probing were within normal limits in all teeth with DME. Only one study checked the histological outcome and concluded that DME had no negative effect on the periodontium. Most of the studies used indirect restoration (composite/lithium disilicate/Emax) over the DME layer. The follow-up period ranged between 6 months and 12 years. CONCLUSION: The level of evidence of this review is low, but DME was successful in all teeth, without any deleterious effect on pulp and periodontium.


Asunto(s)
Pulpa Dental , Humanos , Periodoncio/patología
2.
Ophthalmol Retina ; 5(1): 71-77, 2021 01.
Artículo en Inglés | MEDLINE | ID: mdl-32562885

RESUMEN

PURPOSE: Retinal screening examinations can prevent vision loss resulting from diabetes but are costly and highly underused. We hypothesized that artificial intelligence-assisted nonmydriatic point-of-care screening administered during primary care visits would increase the adherence to recommendations for follow-up eye care in patients with diabetes. DESIGN: Prospective cohort study. PARTICIPANTS: Adults 18 years of age or older with a clinical diagnosis of diabetes being cared for in a metropolitan primary care practice for low-income patients. METHODS: All participants underwent nonmydriatic fundus photography followed by automated retinal image analysis with human supervision. Patients with positive or inconclusive screening results were referred for comprehensive ophthalmic evaluation. Adherence to referral recommendations was recorded and compared with the historical adherence rate from the same clinic. MAIN OUTCOME MEASURE: Rate of adherence to eye screening recommendations. RESULTS: By automated screening, 8.3% of the 180 study participants had referable diabetic eye disease, 13.3% had vision-threatening disease, and 29.4% showed inconclusive results. The remaining 48.9% showed negative screening results, confirmed by human overread, and were not referred for follow-up ophthalmic evaluation. Overall, the automated platform showed a sensitivity of 100% (confidence interval, 92.3%-100%) in detecting an abnormal screening results, whereas its specificity was 65.7% (confidence interval, 57.0%-73.7%). Among patients referred for follow-up ophthalmic evaluation, the adherence rate was 55.4% at 1 year compared with the historical adherence rate of 18.7% (P < 0.0001, Fisher exact test). CONCLUSIONS: Implementation of an automated diabetic retinopathy screening system in a primary care clinic serving a low-income metropolitan patient population improved adherence to follow-up eye care recommendations while reducing referrals for patients with low-risk features.


Asunto(s)
Instituciones de Atención Ambulatoria , Inteligencia Artificial , Retinopatía Diabética/diagnóstico , Procesamiento de Imagen Asistido por Computador/métodos , Tamizaje Masivo/métodos , Atención Primaria de Salud/métodos , Retina/diagnóstico por imagen , Femenino , Estudios de Seguimiento , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos
3.
Ultramicroscopy ; 194: 215-220, 2018 11.
Artículo en Inglés | MEDLINE | ID: mdl-30179755

RESUMEN

Laser beam (He-Ne - 6328 A0) induced deflection in uncoated, Au, and Al coated Si microcantilevers (MCs) of various dimensions was studied, using an AFM head, to examine the induced stress contribution from photothermal and photostriction phenomenon. The laser beam was made to incident sequentially on front and back surfaces of the MC, by flipping it, and results were compared in terms of deflection magnitude, direction of bending and response time. In case of uncoated MCs, it was observed that the induced deflection was always in the direction of the incident laser beam with a fast response. In contrast, in metal (Au, Al) coated MCs, deflection direction was found to be dependent on laser beam exposure side with two orders of enhanced deflection sensitivity and slow response time. The former is attributed to photostriction effect while the latter is explained on the basis of photothermal effect in bimetallic MCs. Flipping experiments on bimettalic MCs, further revealed that stress contribution from these two source mechanisms crucially depends on MC dimensions and direction of laser exposure.

4.
Prog Transplant ; 25(3): 257-62, 2015 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-26308786

RESUMEN

Background-Reasons underlying disparities in outcomes in liver resections between patients who are African American and patients who are not are poorly understood. Methods-An observational longitudinal cohort study was performed. Clinical data were collected from medical records of 166 patients (59 African American, 107 not) undergoing partial hepatectomy between 2004 and 2012. Univariate and multivariate analyses were performed. Results-African Americans patients undergoing partial hepatectomy were more likely to be female, heavier, have hemangiomas or adenomas, and have hepatic steatosis on explant. Intraoperatively, African Americans had longer surgical times, higher estimated blood loss, and greater use of blood products. Major postoperative complications were significantly more common in African Americans. Multivariable modeling demonstrated that race, history of hepatitis C, and estimated blood loss were the only variables that were independently associated with a major complication; however, baseline serum creatinine level was the only variable that significantly modified the effect of race on complications. Conclusions-African Americans with normal serum creatinine levels had a similar rate of complication to patients who were not African American, but as the baseline serum level of creatinine increased, the odds ratio for a complication developing increased dramatically in the African American patients, suggesting that the disparities seen are predominantly driven by a subset of African American patients who have preexisting renal insufficiency.


Asunto(s)
Disparidades en Atención de Salud , Hepatectomía/estadística & datos numéricos , Neoplasias Hepáticas/cirugía , Negro o Afroamericano , Estudios de Cohortes , Femenino , Humanos , Neoplasias Hepáticas/etnología , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Retrospectivos , South Carolina
5.
Clin Transplant ; 29(3): 222-6, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25557762

RESUMEN

BACKGROUND: One primary purpose of transplant is to improve quality of life (QOL) in renal transplant recipients (RTRs) ≥ 50 yr of age, where death with a functioning graft limits life years gained. We aimed to determine the impact of induction therapy, with its subsequent effects on rejection, infection, and readmissions, on QOL. METHODS: Subanalysis of patients ≥ 50 yr of age that participated in a single-center, prospective, risk-stratified, randomized, open-label study. Two hundred RTRs ≥ 50 yr of age. INTERVENTIONS: All patients received either rabbit antithymocyte globulin (rATG) or interleukin 2 receptor antagonists (IL-2RA) in addition to tacrolimus (FK), mycophenolate mofetil (MMF), and corticosteroids in a randomized fashion. Outcome analyses included safety, efficacy, and QOL. RESULTS: Results reported 1 yr post-transplant. Of 111 patients ≥ 50 yr old, 48 received IL-2RA and 63 received rATG. Baseline characteristics were similar between groups. Patients that received rATG had a trend toward lower acute rejection rates, fewer readmissions, and fewer supratherapeutic tacrolimus troughs, with similar rates of infections. QOL analysis demonstrated patients that received rATG were significantly more likely to have improvements in physical and social functioning after transplant. CONCLUSIONS: Contrary to the common practice, T-cell depletion in recipients ≥ 50 yr of age may be beneficial.


Asunto(s)
Rechazo de Injerto/prevención & control , Inmunosupresores/uso terapéutico , Quimioterapia de Inducción/métodos , Trasplante de Riñón , Corticoesteroides/uso terapéutico , Factores de Edad , Anciano , Anciano de 80 o más Años , Animales , Anticuerpos Monoclonales Humanizados/uso terapéutico , Suero Antilinfocítico/uso terapéutico , Daclizumab , Quimioterapia Combinada , Femenino , Humanos , Inmunoglobulina G/uso terapéutico , Masculino , Persona de Mediana Edad , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapéutico , Readmisión del Paciente/estadística & datos numéricos , Estudios Prospectivos , Calidad de Vida , Conejos , Tacrolimus/uso terapéutico , Resultado del Tratamiento
6.
Ultramicroscopy ; 146: 79-82, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25127517

RESUMEN

This paper reports the effect of dimensions of microcantilever (MC) on its resonance frequency and bending upon adsorption of water molecules. Study is conducted on three MCs having the dimensions of 450 × 40 × 2.5 µm(3) (MC1), 225 × 30 × 3 µm(3) (MC2) and 125 × 35 × 4.5 µm(3) (MC3). The measured resonant frequency showed the expected negative shift in MC1, initially positive followed by a negative shift in MC2 and only positive shift in MC3 during adsorption. This behavior is attributed to changes in the stiffness of the MC associated with the surface stress. The surface stress generated on the MC has been derived from its bending measurements upon water adsorption. The change in the stiffness of MC evaluated from an independent estimate of expected frequency shift showed that the relative stiffness change of MC increases linearly with the surface stress scaled with cube of width to height ratio of MCs, confirming the dimensional dependence of adsorption induced stiffness change.

7.
Diabetologia ; 49(5): 953-7, 2006 May.
Artículo en Inglés | MEDLINE | ID: mdl-16520917

RESUMEN

AIMS/HYPOTHESIS: Autoimmunity to insulin, glutamic acid decarboxylase and the tyrosine-phosphatase-like protein IA-2 is associated with type 1 diabetes. The production of self-molecules in thymus and secondary lymphoid tissues is critical for self-tolerance; reduced levels may impair tolerance and predispose to autoimmunity, as shown for insulin. Alternative splicing causes differential expression of IA-2 gene (PTPRN) transcripts and IA-2 protein in human thymus and spleen compared with pancreas. IA-2 sequences not present in lymphoid tissues become autoimmune targets in type 1 diabetes. The beta cell molecule islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP) is an autoantigen in the non-obese diabetic (NOD) mouse, a model of type 1 diabetes. IGRP is a candidate autoantigen in the human disease, but robust assays for IGRP autoantibodies and/or autoreactive T cells are not available. Both full-length and IGRP splice variants encoded by the G6PC2 gene are expressed in the pancreas. In this study we tested the hypothesis that IGRP splice variants could be differentially expressed in thymus and spleen compared with the pancreas. METHODS: We evaluated the expression of G6PC2 transcripts in matched human thymus, spleen and pancreas specimens by RT-PCR. RESULTS: Alternative splicing results in differential expression of G6PC2 transcripts in thymus and spleen compared with pancreas. The full-length transcript is expressed in human pancreas but not in thymus or spleen. Five alternative spliced forms are always expressed in pancreas but those lacking exons 2, 3 and 4, alone or in combination, were rarely detected in thymus or spleen. CONCLUSIONS/INTERPRETATION: Differential tissue expression might favour autoimmune responses to IGRP in humans; target epitopes may be encoded by exons 3 and 4, or at the junctions of the conserved exons in the spliced transcripts. This information may aid in designing synthetic peptides for the identification of IGRP-specific autoreactive T cells in patients with type 1 diabetes.


Asunto(s)
Empalme Alternativo , Diabetes Mellitus Tipo 1/inmunología , Glucosa-6-Fosfatasa/genética , Islotes Pancreáticos/enzimología , Páncreas/enzimología , Bazo/enzimología , Timo/enzimología , Secuencia de Bases , Cartilla de ADN , Diabetes Mellitus Tipo 1/enzimología , Regulación Enzimológica de la Expresión Génica , Glucosa-6-Fosfatasa/inmunología , Glucosa-6-Fosfatasa/metabolismo , Humanos , Especificidad de Órganos , Subunidades de Proteína , ARN Mensajero/genética , Linfocitos T/inmunología , Transcripción Genética
8.
Bioresour Technol ; 95(1): 113-4, 2004 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-15207304

RESUMEN

Larvicidal efficacies of extracts of five species of Cucurbitacious plants, Momordica charantia, Trichosanthes anguina, Luffa acutangula, Benincasa cerifera and Citrullus vulgaris were tested against the late third larval age group of Culex quinquefasciatus. The larval mortality was observed after 24 h exposure. The LC50 values of M. charantia, T. anguina, L. acutangula, B. cerifera and C. vulgaris were 465.85, 567.81, 839.81, 1189.30 and 1636.04 ppm respectively.


Asunto(s)
Cucurbitaceae , Culex/efectos de los fármacos , Insecticidas/farmacología , Extractos Vegetales/farmacología , Animales , Larva/efectos de los fármacos , Hojas de la Planta/química
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