Influence of melatonin supplementation on tissue response of endodontic sealers in Wistar rats.

OBJECTIVE: This study evaluated the influence of melatonin supplementation on tissue's response of endodontic sealers in Wistar rats. METHODOLOGY: Forty-eight rats received subcutaneous implants of four polyethylene tubes: one empty (control) and three filled with endodontic sealers (AH Plus, Endofill and Sealapex). Half of the animals were supplemented with melatonin (ME) and the remaining treated with water (WA) for 15 days before the implantation until euthanasia, forming the groups: control-WA, AH Plus-WA, Endofill-WA, Sealapex-WA, Control-ME, AH Plus-ME, Endofill-ME and Sealapex-ME. After 5, 15 and 30 days, (n = 8) tubes were removed and evaluated in H&E., immunohistochemistry, PSR, VK and POL. The results were statistically analyzed (p < 0.05). RESULTS: In animals treated with water, Endofill-WA evoked more intense inflammatory infiltrate compared to AH Plus-WA and Control-WA in a 30-day period (p < 0.05). In animals supplemented with melatonin, there was any difference among endodontic sealers' response in any period of analysis (p > 0.05). Comparing the individual response of each sealer, over a 30-day period, Endofill-ME and Sealapex-ME showed less inflammatory infiltrate compared to Endofill-WA and Sealapex-WA, respectively (p < 0.05). Immunostaining for IL-6 and TNF-α was less intense for all groups in animals supplemented with melatonin, in most periods, except for the Endofill sealer (p < 0.05). Furthermore, Endofill-ME at 5 days and AH-Plus-ME at 30 days showed a higher percentage of mature collagen fibers compared to the Endofill-WA and AH Plus-WA, respectively (p < 0.05). Positive structures for von Kossa staining and birefringent to polarized light were observed only for Sealapex-WA and Sealapex-ME in all periods. CONCLUSIONS: It can be concluded that melatonin influences the tissue response to endodontic sealers, modulating the inflammatory and reparative process.

Efficacy, Safety, and Cost-Effectiveness of Healthium Theruptor Versus 3M Tegaderm Versus Plain Gauze Dressing for Wound Dressings Used in Abdominal and Joint Surgeries: A Prospective, Multicentric, Randomized Study.

Background In the realm of surgical and postoperative care, the application of wound dressings is a standard practice to facilitate healing, minimize infection risks, and offer a protective barrier against pathogens for optimal recovery. For instance, Theruptor is an active advanced wound care product with patented microbicidal technology. In the present study, we conducted a randomized clinical trial to compare the clinical efficacy and safety of Healthium Theruptor, 3M Tegaderm, and plain gauze dressings in patients undergoing abdominal and joint surgeries. Methodology This was a multicenter, prospective, three-arm, randomized, double-blind study conducted between April and November 2022 at three different sites in India, viz., All India Institute of Medical Sciences, Jodhpur; Mahatma Gandhi Medical College and Research Institute, Puducherry; and SRM Institute of Science and Technology, Chennai. A total of 210 patients were randomized to receive either of the following three interventions: Theruptor, Tegaderm, and plain gauze dressing (n = 70 each) based on computer-generated randomization sequences using sequentially numbered, opaque, sealed envelopes. Demographic data and surgery details were obtained and recorded at baseline. Parameters such as rate of wound healing, incidence of surgical site infections (SSIs), adverse events, product performance, and pain score were assessed and compared during the weekly follow-up visits until 28 days. In addition, wound assessments using the Stony Brook Scar evaluation scale, Cardiff Wound Impact Questionnaire, and Modified Hollander Wound Evaluation Scale were conducted to provide additional insights on the efficacy of the dressings (days 3, 7, 14, and 28). Lastly, the cost of wound management was assessed at the end of the study. The statistical analysis of the data was performed using a one-way analysis of variance followed by a Bonferroni post-hoc test on GraphPad software. Results All three dressings were equally effective in healing the wound and reducing the incidence of SSIs. The median healing time was estimated to be seven days. Further, no significant difference was observed in wound dehiscence, wound pain, clinical wound parameters, cosmetic assessment, and quality of life among the three groups (p > 0.05) during the follow-up visits. However, the product performance of Theruptor and Tegaderm was significantly better than plain gauze dressing in terms of ease of application (82.87% and 84.13% vs. 71.7%), ease of removal (83.09% and 83.67% vs. 70.79%), comfort to wear (82.59% and 84.47% vs. 72.83%), exudate management (84.35% and 85.7% vs. 77.23%), mean wear time in hours (65.57 and 65.92 vs. 49 hours), and mobility of the patient (p < 0.05). Further, the total cost of wound management with Theruptor dressing was significantly lower than with Tegaderm dressing (₹1117.2 ± 269.86 vs. ₹1474 ± 455.63; p < 0.0001). Conclusions Although all three dressings were equally safe and clinically efficacious, Theruptor was more cost-effective with better product performance. Thus, Theruptor may be a considerate option in the postoperative wound management of abdominal and joint surgeries.

Identification of Virulence Markers and Phylogenetic Groups' Association, and Antimicrobial Susceptibility of Uropathogenic Escherichia coli Isolates.

BACKGROUND: Urinary tract infections represent a world public health problem, which is caused mainly by Uropathogenic Escherichia coli. Although they are originally found in the intestinal microbiota in the majority of the cases, urinary tract infections can also be caused by intra-intestinal pathogenic E. coli. OBJECTIVE: The main objective of our research is to identify the virulence factors generally associated with different pathotypes across phylogenetic groups. METHODS: E. coli were isolated from patients with urinary tract infections. Antimicrobial susceptibility tests, virulence genes and phylogroups were prospected. The data analysis were performed using the chi-square and Fisher exact test. RESULTS: In total, 72.2% of isolates showed multidrug resistant. We have also depicted an important association between E. coli from inpatients with UTIs and pap and hlyA genes (p-0.041 and p-0.019 respectively). The predominant phylogenetic group in our isolates is B2 (45.4%) followed by D (12.4%). Our results showed that 9.3% of isolates have an unknown phylogroup which shows a significant association with astA gene (p-0.008). We have as well found a significant association between B2 and three virulence genes namely pap, hlyA and invE (p-0.002, p-0.001, p-0.025 respectively); B1 and pap, hlyA genes (p-0.049 and p-0.021 respectively); E and afa gene (p-0.024). CONCLUSION: Certain virulence factors have been shown to be potential targets for drug design and therapeutic pathways in order to deal with the antimicrobial resistance problem enhanced by antibiotic therapy.

Role of adherent and invasive Escherichia coli in Crohn's disease: lessons from the postoperative recurrence model.

OBJECTIVE: We used the postoperative recurrence model to better understand the role of adherent and invasive Escherichia coli (AIEC) bacteria in Crohn's disease (CD), taking advantage of a well-characterised postoperative cohort. DESIGN: From a prospective, multicentre cohort of operated patients with CD, AIEC identification was performed within the surgical specimen (M0) (N=181 patients) and the neoterminal ileum (n=119 patients/181) during colonoscopy performed 6 months after surgery (M6). Endoscopic postoperative recurrence was graded using Rutgeerts' index. The mucosa-associated microbiota was analysed by 16S sequencing at M0 and M6. Relative risks or ORs were adjusted on potential confounders. RESULTS: AIEC prevalence was twofold higher within the neoterminal ileum at M6 (30.3%) than within the surgical specimen (14.9%) (p<0.001). AIEC within the neoterminal ileum at M6 was associated with higher rate of early ileal lesions (i1) (41.6% vs 17.1%; aRR 3.49 (95% CI 1.01 to 12.04), p=0.048) or ileal lesions (i2b+i3) (38.2% vs 17.1%; aRR 3.45 (95% CI 1.06 to 11.30), p=0.040) compared with no lesion (i0). AIEC within the surgical specimen was predictive of higher risk of i2b-endoscopic postoperative recurrence (POR) (aOR 2.54 (95% CI 1.01 to 6.44), p=0.049) and severe endoscopic POR (aOR 3.36 (95% CI 1.25 to 9.06), p=0.017). While only 5.0% (6/119) of the patients were AIEC-positive at both M0 and M6, 43.7% (52/119), patients with history of positive test for AIEC (M0 or M6) had higher risk of ileal endoscopic POR (aOR 2.32 (95% CI 1.01 to 5.39), p=0.048)), i2b-endoscopic postoperative recurrence (aOR 2.41 (95% CI 1.01 to 5.74); p=0.048) and severe endoscopic postoperative (aOR=3.84 (95% CI 1.32 to 11.18), p=0.013). AIEC colonisation was associated with a specific microbiota signature including increased abundance of Ruminococcus gnavus. CONCLUSION: Based on the postoperative recurrence model, our data support the idea that AIEC are involved in the early steps of ileal CD. TRIAL REGISTRATION NUMBER: NCT03458195.

Influence of supplement administration of omega-3 on the subcutaneous tissue response of endodontic sealers in Wistar rats.

AIM: Natural substances such as omega-3 have been used in the medical field due to their numerous properties and, in particular, modulating effect on the systemic and local inflammatory processes. Thus, this study evaluated the influence of omega-3 supplementation on the subcutaneous tissue response of endodontic sealers in Wistar Rats. METHODOLOGY: Polyethylene tubes were implanted in the subcutaneous tissue of 48 animals (one empty for control and three filled with Sealapex, AH Plus or Endofill). The animals were treated with omega-3 (TO) or water (TW). Treatments started 15 days before implantation until euthanasia. After 5, 15 and 30 days (n = 8), animals were euthanized and polyethylene tubes and surrounding tissue were removed and processed for histological analysis. The inflammatory reaction was analysed by Haematoxylin and Eosin stain and immunolabelling for IL-6 and TNF-α. The collagen maturity was analysed by picrosirius red stain and calcium deposition by von Kossa stain and polarized light. Results were statistically analysed (p < .05). RESULTS: Amongst TW sealer groups, Endofill evoked a more intense inflammatory infiltrate compared with AH Plus and control in the 30-day period (p = .009). However, in TO sealer groups, there was no difference amongst the sealers and control in all periods (p > .05). Comparing each sealer as a function of the supplementation with water or omega-3, there are differences for Endofill (p = .001) and Sealapex (p = .005) in the 30-day period, presenting lower inflammatory infiltrate in the animals treated with omega-3. A higher percentage of immature fibres was observed at 15 and 30 days in the TO group, compared with the TW group (p < .05). The deposition of calcium particles was observed only by Sealapex in all periods, despite the supplementation procedure. CONCLUSIONS: Omega-3 supplementation influence the tissue reactions of endodontic sealers, modulating inflammation, the immunolabelling of IL-6 and TNF-α, the repair process and it does not interfere with calcium deposition.

Transcultural adaptation of Patient-Reported Outcomes in Obesity (PROS) questionnaire for Brazil. / Adaptação transcultural do questionário Patient-Reported Outcomes in Obesity (PROS) para utilização no Brasil.

OBJECTIVE: To perform a cross-cultural adaptation and validation in the Brazilian cultural context of questionnaire Patient-Reported Outcomes in Obesity (PROS). METHODS: The cross-cultural adaptation process involved the translation from original English language into Brazilian Portuguese by two qualified and independent translators. The back-translation was performed by two English language teachers who were native speakers, without any medical knowledge of the original scale. An expert committee was created with researchers to assess semantic, idiomatic, experiential and conceptual equivalence. The pre-test of the Brazilian version, named PROS-Br, was carried out with ten adults with obesity. To assess the psychometric properties of the instrument, a cross-sectional epidemiological study was carried out. The population consisted of 120 Brazilian adults with obesity who went to the appointment at a school-clinic. The Item Response Theory and Factor Analysis with Principal Component Extraction was used for the psychometrics analysis. To measure reliability, the α-Cronbach indicator was used. RESULTS: In the reliability analysis, α-Cronbach was 0.82. Two factors explained 58.3% of the total variance in the principal component analysis, involving behavioral and physical aspects. Item Response Theory curves showed that all questions have discriminatory characteristics, pointing to the adequacy of the proposed version. CONCLUSION: The Brazilian version was proven valid and reliable to measure the quality of life of individuals with obesity, allowing one to develop intervention strategies, plan and execute actions at services and for public health policies.

OBJETIVO: Realizar a adaptação transcultural e a validação, no contexto cultural brasileiro, do instrumento de impacto da obesidade Patient-Reported Outcomes in Obesity (PROS). MÉTODOS: O processo de adaptação transcultural contou com a tradução do idioma original, inglês, para o português, executada por dois tradutores qualificados e independentes. A retrotradução foi realizada por dois professores de inglês, nativos, sem qualquer conhecimento médico nem da escala original. Um comitê de especialistas foi composto de pesquisadores para avaliar as equivalências semântica, idiomática, experiencial e conceitual. O pré-teste da versão brasileira, denominada PROS-Br, foi realizado com dez indivíduos adultos com obesidade. Para a avaliação das propriedades psicométricas, foi realizado um estudo epidemiológico de delineamento transversal. A população foi composta de 120 indivíduos adultos com obesidade, brasileiros, presentes para consulta médica em ambulatório-escola. Para análises psicométricas, foram utilizadas a Teoria de Resposta ao Item e análise fatorial com extração de componentes principais. Para aferição da confiabilidade foi utilizado o indicador α-Cronbach. RESULTADOS: Na análise de confiabilidade, o PROS-Br apresentou α-Cronbach de 0,82. Dois fatores explicaram 58,3% da variância total na análise de componentes principais, envolvendo aspectos comportamentais e físicos. As curvas da Teoria de Resposta ao Item mostraram que todas as perguntas apresentam características discriminatórias, apontando para a adequação da versão brasileira proposta. CONCLUSÃO: A versão brasileira mostrou-se válida e confiável para aferir a qualidade de vida de indivíduos com obesidade, possibilitando desenvolver estratégias de intervenção, planejamento e execução de ações nos serviços e na política pública de saúde.

Adaptação transcultural do questionário Patient-Reported Outcomes in Obesity (PROS) para utilização no Brasil / Transcultural adaptation of Patient-Reported Outcomes in Obesity (PROS) questionnaire for Brazil

RESUMO: Objetivo: Realizar a adaptação transcultural e a validação, no contexto cultural brasileiro, do instrumento de impacto da obesidade Patient-Reported Outcomes in Obesity (PROS). Métodos: O processo de adaptação transcultural contou com a tradução do idioma original, inglês, para o português, executada por dois tradutores qualificados e independentes. A retrotradução foi realizada por dois professores de inglês, nativos, sem qualquer conhecimento médico nem da escala original. Um comitê de especialistas foi composto de pesquisadores para avaliar as equivalências semântica, idiomática, experiencial e conceitual. O pré-teste da versão brasileira, denominada PROS-Br, foi realizado com dez indivíduos adultos com obesidade. Para a avaliação das propriedades psicométricas, foi realizado um estudo epidemiológico de delineamento transversal. A população foi composta de 120 indivíduos adultos com obesidade, brasileiros, presentes para consulta médica em ambulatório-escola. Para análises psicométricas, foram utilizadas a Teoria de Resposta ao Item e análise fatorial com extração de componentes principais. Para aferição da confiabilidade foi utilizado o indicador α-Cronbach. Resultados: Na análise de confiabilidade, o PROS-Br apresentou α-Cronbach de 0,82. Dois fatores explicaram 58,3% da variância total na análise de componentes principais, envolvendo aspectos comportamentais e físicos. As curvas da Teoria de Resposta ao Item mostraram que todas as perguntas apresentam características discriminatórias, apontando para a adequação da versão brasileira proposta. Conclusão: A versão brasileira mostrou-se válida e confiável para aferir a qualidade de vida de indivíduos com obesidade, possibilitando desenvolver estratégias de intervenção, planejamento e execução de ações nos serviços e na política pública de saúde.

ABSTRACT: Objective: To perform a cross-cultural adaptation and validation in the Brazilian cultural context of questionnaire Patient-Reported Outcomes in Obesity (PROS). Methods: The cross-cultural adaptation process involved the translation from original English language into Brazilian Portuguese by two qualified and independent translators. The back-translation was performed by two English language teachers who were native speakers, without any medical knowledge of the original scale. An expert committee was created with researchers to assess semantic, idiomatic, experiential and conceptual equivalence. The pre-test of the Brazilian version, named PROS-Br, was carried out with ten adults with obesity. To assess the psychometric properties of the instrument, a cross-sectional epidemiological study was carried out. The population consisted of 120 Brazilian adults with obesity who went to the appointment at a school-clinic. The Item Response Theory and Factor Analysis with Principal Component Extraction was used for the psychometrics analysis. To measure reliability, the α-Cronbach indicator was used. Results: In the reliability analysis, α-Cronbach was 0.82. Two factors explained 58.3% of the total variance in the principal component analysis, involving behavioral and physical aspects. Item Response Theory curves showed that all questions have discriminatory characteristics, pointing to the adequacy of the proposed version. Conclusion: The Brazilian version was proven valid and reliable to measure the quality of life of individuals with obesity, allowing one to develop intervention strategies, plan and execute actions at services and for public health policies.

Study of hydrocellular functional material as microbicidal wound dressing for diabetic wound healing.

A hydrocellular functional material as a wound dressing is developed and it is found to be superior in its efficacy as compared to some of the comparator controls in diabetic wound healing studies. A study on wound contraction and Histopathological analysis is done in rats. The efficacy of the dressing is comparable to the established wound dressings like Carboxymethyl cellulose alginate dressings and autolytic enzyme based hydrogel. It is found to be superior to Polyhexamethylene biguanide dressing used as reference controls in this study.The reason for good wound healing performance of the dressing can be attributed to a combined property of effective exudates management and broad spectrum antimicrobial effect. The concept of functional hydro cellular material has shown good results due to the excellent balance of exudates pickup and drying it out. This ensures moist wound healing conditions on the wound. Because of its porous nature it allows good air flow and gaseous exchange in the structure.The cationic sites created on the surface of the dressing ensure a good antimicrobial action on the exudates in the dressing. It reduces the infection load on the wound. The nonleaching property of the dressing also helps in preventing the generation of more resistant and mutant strains of the microbes.The developed dressing can be used as a relatively durable long lasting dressing for wound management in diabetic wounds. The need of repetitive wound dressing changes can be brought down with this concept of dressing. It is not only cost effective in terms of its material cost but also is a cost effective solution when entire wound management cost is considered. Such novel wound dressing material can change the quality of life of diabetic wound patients especially in developing world, where access to functional advanced wound care dressings is limited.

Beneficial Effects of Natural Mineral Waters on Intestinal Inflammation and the Mucosa-Associated Microbiota.

Natural mineral water (NMWs) intake has been traditionally used in the treatment of various gastrointestinal diseases. We investigated the effect of two French NMWs, one a calcium and magnesium sulphate, sodium chloride, carbonic, and ferruginous water (NMW1), the other a mainly bicarbonate water (NMW2) on the prevention of intestinal inflammation. Intestinal epithelial cells stimulated with heat inactivated Escherichia coli or H2O2 were treated with NMWs to evaluate the anti-inflammatory effects. Moderate colitis was induced by 1% dextran sulfate sodium (DSS) in Balbc/J mice drinking NMW1, NWW2, or control water. General signs and histological features of colitis, fecal lipocalin-2 and pro-inflammatory KC cytokine levels, global mucosa-associated microbiota, were analyzed. We demonstrated that both NMW1 and NMW2 exhibited anti-inflammatory effects using intestinal cells. In induced-colitis mice, NMW1 was effective in dampening intestinal inflammation, with significant reductions in disease activity scores, fecal lipocalin-2 levels, pro-inflammatory KC cytokine release, and intestinal epithelial lesion sizes. Moreover, NMW1 was sufficient to prevent alterations in the mucosa-associated microbiota. These observations, through mechanisms involving modulation of the mucosa-associated microbiota, emphasize the need of investigation of the potential clinical efficiency of such NMWs to contribute, in human beings, to a state of low inflammation in inflammatory bowel disease.

The exploration of the dispersal of British military families in England following the Strategic Defence and Security Review 2010.

Strictly relying on publicly available data, this study depicts and quantifies the spatial pattern of England's military families with dependent children. England's Service Pupil Premium for the financial years between 2011 and 2019 is used as a proxy variable to estimate the density of service children at the parliamentary constituency level. Methodologically, the approach allows an assessment of spatial movements of a population or a cohort. The results inform policy makers by providing evidence-based findings about the location of England's military families and how the distribution has changed between 2011 and 2019. The results show empirical evidence supporting the hypothesis that, at a macro scale, beyond commuting distance, England's military families are becoming increasingly dispersed. We argue that the findings unveil spatial dynamics that have practical issues of housing, employment, and education regarding military families.