Teledentistry for improving access to, and quality of oral health care: A protocol for an overview of systematic reviews and meta-analyses.

Digital technologies are becoming essential to address and optimize the suboptimal performance of healthcare systems. Teledentistry involves the use of information and communication technology to improve access to oral health care and the quality of oral health care delivery. Several systematic reviews (SRs) have been conducted to synthesize evidence on the effectiveness of teledentistry but with conflicting results. The aim of this review is to comprehensively summarize available SRs and provide evidence on the impact of teledentistry on access to oral care, patients' and oral healthcare providers' outcomes, quality of oral health care and costs. This protocol has been registered with the International Prospective Register of Systematic Reviews (PROSPERO CRD42022373964). Six electronic databases including MEDLINE (Ovid), Embase (Embase.com), CINAHL (EBSCO), Web of Science, Cochrane Library and Epistemonikos will be searched for SRs of quantitative, qualitative, and mixed reviews evaluating teledentistry modalities involving both patients and/or oral health care providers (OHCPs). We will include studies published in English or French. The outcomes will include patients' outcomes (e.g., access to oral health care, patient-reported outcomes, and patient-reported experiences); patient indicators (e.g., clinical outcomes, adherence to treatment, adverse outcomes and costs); and OHCP indicators (e.g., diagnostic accuracy, barriers and enablers costs and equity). Two independent reviewers will perform data screening, data extraction and will assess the quality of included studies using AMSTAR 2 and ROBIS tools. Data will be synthesized narratively and presented by tables and graphs. We will report any overlap of primary studies in the SRs. A statement on the strength of evidence for each outcome will be provided if possible. This review will inform decision-makers, patients, OHCPs, and researchers on the potential effectiveness, benefits, and challenges of teledentistry and support them in making recommendations for its use. Results will be disseminated through peer-reviewed publications, presentations at conferences, and on social media.

Oral health care and living environment for older people: a scoping review protocol.

OBJECTIVE: This scoping review will map the literature on the extent of knowledge on living environment oral health care (LIVEOR) by examining its different terminologies, its description, the stakeholders involved, the implementation characteristics, and the outcomes reported by the authors. INTRODUCTION: Older people want to receive oral health care in their current living environment. Although several authors have explored some aspects of LIVEOR for older people, there are still inconsistent findings regarding the extent of this model of care. INCLUSION CRITERIA: This scoping review will include quantitative, qualitative, and mixed method studies, as well as any type of knowledge synthesis on LIVEOR involving people aged 60 years and over. The search will not be limited by language, time frame, geographic location, or publication date. METHODS: We will use the JBI methodology for scoping reviews and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR). The search will include MEDLINE, CINAHL, Embase, Web of Science, and the Cochrane Library. A hand-search of the references of the included studies, and a gray literature search will also be conducted. Two independent reviewers will screen titles, abstracts, and full texts of selected studies, and perform data extraction. Findings are expected to explore what is known of LIVEOR targeting older people and to identify any knowledge gaps for future studies. We will disseminate our findings mostly through peer-reviewed publications. REVIEW REGISTRATION: Open Science Framework https://osf.io/e7fm2.

Reliability and accuracy of a semi-automatic segmentation protocol of the nasal cavity using cone beam computed tomography in patients with sleep apnea.

OBJECTIVES: The objectives of this study included using the cone beam computed tomography (CBCT) technology to assess: (1) intra- and inter-observer reliability of the volume measurement of the nasal cavity; (2) the accuracy of the segmentation protocol for evaluation of the nasal cavity. MATERIALS AND METHODS: This study used test-retest reliability and accuracy methods within two different population sample groups, from Eastern Asia and North America. Thirty obstructive sleep apnea (OSA) patients were randomly selected from administrative and research oral health data archived at two dental faculties in China and Canada. To assess the reliability of the protocol, two observers performed nasal cavity volume measurement twice with a 10-day interval, using Amira software (v4.1, Visage Imaging Inc., Carlsbad, CA). The accuracy study used a computerized tomography (CT) scan of an OSA patient, who was not included in the study sample, to fabricate an anthropomorphic phantom of the nasal cavity volume with known dimensions (18.9 ml, gold standard). This phantom was scanned using one NewTom 5G (QR systems, Verona, Italy) CBCT scanner. The nasal cavity was segmented based on CBCT images and converted into standard tessellation language (STL) models. The volume of the nasal cavity was measured on the acquired STL models (18.99 ± 0.066 ml). RESULTS: The intra-observer and inter-observer intraclass correlation coefficients for the volume measurement of the nasal cavity were 0.980-0.997 and 0.948-0.992 consecutively. The nasal cavity volume measurement was overestimated by 1.1%-3.1%, compared to the gold standard. CONCLUSIONS: The semi-automatic segmentation protocol of the nasal cavity in patients with sleep apnea and by using cone beam computed tomography is reliable and accurate. CLINICAL RELEVANCE: This study provides a reliable and accurate protocol for segmentation of nasal cavity, which will facilitate the clinician to analyze the images within nasoethmoidal region.

Integrating equity, diversity and inclusion throughout the lifecycle of AI within healthcare: a scoping review protocol.

INTRODUCTION: Artificial intelligence (AI) has the potential to improve efficiency and quality of care in healthcare settings. The lack of consideration for equity, diversity and inclusion (EDI) in the lifecycle of AI within healthcare settings may intensify social and health inequities, potentially causing harm to under-represented populations. This article describes the protocol for a scoping review of the literature relating to integration of EDI in the AI interventions within healthcare setting. The objective of the review is to evaluate what has been done on integrating EDI concepts, principles and practices in the lifecycles of AI interventions within healthcare settings. It also aims to explore which EDI concepts, principles and practices have been integrated into the design, development and implementation of AI in healthcare settings. METHOD AND ANALYSIS: The scoping review will be guided by the six-step methodological framework developed by Arksey and O'Malley supplemented by Levac et al, and Joanna Briggs Institute methodological framework for scoping reviews. Relevant literature will be identified by searching seven electronic databases in engineering/computer science and healthcare, and searching the reference lists and citations of studies that meet the inclusion criteria. Studies on AI in any healthcare and geographical settings, that have considered aspects of EDI, published in English and French between 2005 and present will be considered. Two reviewers will independently screen titles, abstracts and full-text articles according to inclusion criteria. We will conduct a thematic analysis and use a narrative description to describe the work. Any disagreements will be resolved through discussion with the third reviewer. Extracted data will be summarised and analysed to address aims of the scoping review. Reporting will follow the Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews. The study began in April 2022 and is expected to end in September 2023. The database initial searches resulted in 5,745 records when piloted in April 2022. ETHICS AND DISSEMINATION: Ethical approval is not required. The study will map the available literature on EDI concepts, principles and practices in AI interventions within healthcare settings, highlight the significance of this context, and offer insights into the best practices for incorporating EDI into AI-based solutions in healthcare settings. The results will be disseminated through open-access peer-reviewed publications, conference presentations, social media and 2-day workshops with relevant stakeholders.

Patients experience and satisfaction with immediate loading of implant-supported overdentures - A qualitative study.

OBJECTIVES: To explore the perspectives and experiences of edentate individuals in regard to the immediate-loading protocol of an implant-supported overdenture. METHODS: A qualitative approach and interpretive description methodology was used. Seventeen edentate individuals (mean age: 61.9 ± 6.6 years) who received implant-supported overdentures through an immediate-loading protocol participated. Audio-recorded, semi-structured, in-depth interviews, each with a 60-90-minute duration, were conducted by two trained interviewers. The interview guide was developed based on Perneger's Detailed Model. Qualitative data were analyzed using a thematic approach including interview debriefing, transcript coding, data display, inductive thematic analysis, and interpretation. RESULTS: Three main themes emerged from the interviews: patient awareness and engagement with treatment, experience-shaped expectations, and immediate gratification. All patients expressed satisfaction with the treatment. Providing detailed information, good communication, and accessibility of the dental care provider had a significant impact on patient satisfaction with prosthetic care. Patients highlighted that the high cost of implant therapy was the major barrier to receiving this treatment in the private sector and perceived dental insurance coverage as a facilitator of this process. CONCLUSIONS: Study findings conclude that patient awareness about immediate-loading protocol improved their treatment engagement, and patient satisfaction with the treatment outcomes was higher than anticipated. The satisfaction was primarily related to prosthesis stability, receiving the prosthesis the same day, and low cost of treatment. Patients' positive experience and satisfaction with the immediate-loading protocol indicate that this treatment modality should be considered in treatment planning for edentate individuals. CLINICAL SIGNIFICANCE: The perceptions and experiences of edentulous patients gathered in this study highlight their satisfaction with immediate loading for implant-supported overdentures. This therapeutic modality can be considered a viable option in treatment planning for edentulous individuals.

Obesity and the Risk of Developing Kidney Stones: A Systematic Review and Meta-analysis.

Obesity is a growing problem that causes various metabolic disorders and organ dysfunction. The present systematic review and meta-analysis examined the impact of obesity on the risk of kidney stones. This meta-analysis was designed according to PRISMA guidelines. This extensive search was conducted on June 6, 2022, using relevant keywords in databases including PubMed, Web of Science, EMBASE, and Scopus. The data collected from observational studies were recorded in a datasheet. Odds Ratio (OR) and their 95% confidence intervals (CI) evaluated the overall effect size. The Cochran Q test and the statistic I2 were used to evaluate the heterogeneity of studies. Egger's and Begg's tests assessed potential publication bias. We included 15 observational studies published between 2005 to 2022 in this analysis. Compared to nonobese individuals, the OR for developing kidney stones in obese participants was 1.35 (95% CI: 1.20 to 1.52, P < .001). Considering geographical location, the OR for the risk of developing kidney stones in obese individuals was 1.51 (95% CI: 1.11 to 2.05, P = .009) in North America, 1.33 (95% CI: 1.16 to 1.51, P < .001) in Europe, and 1.18 (95% CI: 1.08 to 1.29, P < .001) in Asia. Begg's test results (P = .625) demonstrated no publication bias. However, Egger's test results (P = .005) indicated publication bias. Based on the results, obesity increases the risk of kidney stone development. Therefore, community health programs should be implemented to reduce the incidence of obesity and lower the risk of kidney stones.  DOI: 10.52547/ijkd.7223.

Dialogue with Key Stakeholders on Digital Technology for Oral Health: Meeting Report.

On September 7, 2022, the University of Montpellier in France hosted a meeting with digital oral health technology developers, Chief Dental Officers, policy makers, the World Health Organization, the International Telecommunication Union, and academia on digital oral health technologies.

Virtual Oral Health across Canada: A Critical Comparative Analysis of Clinical Practice Guidances during the COVID-19 Pandemic.

During the COVID-19 pandemic, teledentistry was suggested as a cost-effective and promising approach to improve access to oral health care. In response, Canadian provincial and territorial dental regulatory authorities (DRAs) published teledentistry-related clinical practice guidances (TCPGs). However, an in-depth comparison between them is needed to understand their gaps and commonalities so as to inform research, practice, and policy. This review aimed to provide a comprehensive analysis of TCPGs published by Canadian DRAs during the pandemic. A critical comparative analysis of these TCPGs published between March 2020 and September 2022 was conducted. Two members of the review team screened the official websites of dental regulatory authorities (DRAs) to identify TCPGs and performed data extraction. Among Canada's 13 provinces and territories, only four TCPGs were published during the relevant time period. There were some similarities and differences in these TCPGs, and we identified gaps pertaining to communication tools and platforms, and measures to safeguard patients' privacy and confidentiality. The insights from this critical comparative analysis and the unified workflow on teledentistry can aid DRAs in their development of new or an improvement to existing TCPGs or the development of nationwide TCP guidelines on teledentistry.

Palatal brushing for the treatment of denture stomatitis: A multicentre randomized controlled trial.

PURPOSE: To determine the effectiveness of palatal brushing in the treatment of denture-related erythematous stomatitis (DES) in complete denture wearers. METHODS: This two-parallel-arm RCT was conducted in three university clinics in Brazil, Canada, and Chile. Participants (n=77) were randomly allocated to receive (i) instructions for palatal brushing and standard oral/denture hygiene ("intervention"); or (ii) standard oral/denture hygiene instructions only ("control"). Data collection was carried out at the baseline and at 3 and 6 months after intervention. Outcomes included the magnitude of oral Candida carriage and the degree of inflammation of denture-bearing tissues. Groups were compared using generalized estimating equations and chi-square test (α=0.05). RESULTS: Palatal inflammation levels were reduced significantly in the "intervention" compared to "control" group at 6 months (intervention: 70%, control: 40%; chi-square, p=0.04). There was no between-group significant difference in the Candida count from denture and palatal biofilms; however, a subgroup analysis restricted to baseline Candida carriers showed further reduction with the intervention at 6 months. No adversity was observed by trialist or reported by participants. CONCLUSIONS: Including palatal brushing in oral instructions for denture wearers has positive impact on DES-related mucosal inflammation. Thus, our findings endorse the inclusion of palatal brushing in standard oral hygiene instructions to treat DES.

Integrating Equity, Diversity, and Inclusion Throughout the Lifecycle of Artificial Intelligence for Better Health and Oral Health Care: A Workshop Summary.

Professors Elham Emami and Samira Rahimi organized and co-led an international interdisciplinary workshop in June 2023 at McGill University, built upon an intersectoral approach addressing equity, diversity and inclusion within the field of AI.

Anti-inflammatory response to curcumin supplementation in chronic kidney disease and hemodialysis patients: A systematic review and meta-analysis.

Objective: This study was designed to determine the association curcumin has on pro-inflammatory biomarkers in patients with chronic kidney disease (CKD (and in those receiving hemodialysis (HD). Materials and Methods: This meta-analysis was undertaken following PRISMA guidelines. An extensive systematic review was undertaken until 10/11/2021 using PubMed, Web of Science (ISI), and Scopus databases. The standardized mean difference (SMD) and 95% confidence intervals (CI) were used to estimate the overall effect size of curcumin on serum high-sensitivity C-reactive protein (hs-CRP), and pro-inflammatory cytokines including interleukin 6 (IL-6), and tumor necrosis factor α (TNF-α) in patients with CKD and those receiving HD. Results: Overall, ten randomized controlled trials (RCTs) comprising 523 patients were incorporated into the systematic review and meta-analysis. The results showed that when compared with control groups, there was no significant effect observed linking curcumin and IL-6 (SMD = 0.24%, 95% CI = -0.14 to 0.62, p = 0.221), TNF-α (SMD = 0.11%, 95% CI = -0.19 to 0.40, p = 0.480) or hs-CRP (SMD = -0.17%, 95% CI = -0.36 to 0.03, p = 0.093). The analysis determined no publication bias related to the influence of curcumin on IL-6, TNF-α or acute phase reactant, hs-CRP. The Egger's and Begg's test results were not statistically significant (p˃0.20). Conclusion: In patients with CKD and those receiving HD, the use of curcumin supplementation has no statistically significant effect on the anti-inflammatory biomarkers reviewed in this study.

Patient satisfaction with e-oral health care in rural and remote settings: a systematic review.

BACKGROUND: During the past decade e-oral health technology has been used to address the oral health care challenges in rural and remote settings. This review systematically evaluated the literature on patient satisfaction with e-oral health care in rural and remote communities. METHODS: The systematic review included interventional and observational studies published between 1946 and 2021, in the Cochrane Central Register of Controlled Trials, MEDLINE, EMBASE, and Global Health. Patient satisfaction with received oral health care using self-reported measures, at any time after the intervention, was the main outcome of the review. The other primary outcomes were undesirable consequences of the health care (e-health or conventional) such as diagnostic error. The secondary outcomes considered were waiting time, number of visits, travel, and the cost of oral health care. Two independent researchers assessed the risk of bias using the ROBINS-I risk of bias assessment tool for non-randomized studies. RESULTS: Among 898 studies, 16 studies were included in the review. In most studies reporting patient satisfaction, all patients had shown willingness for teleconsultation for a dental problem and they were mostly satisfied due to saved travel time, saved working days, and prompt treatment onset. Most of the studies acknowledged teledentistry as a cost-effective and cost-saving method. Moreover, the teledentistry consultations showed diagnostic reliability and validity values comparable to conventional dental consultations. The majority of studies were considered level 4 and 3b, due to limited sample populations, analysis based on limited alternatives or costs, non-consistent sensitivity analysis, failure to appropriately control known confounders, and/or failure to carry out an appropriate follow-up of patients. CONCLUSION: Available evidence indicates that e-oral health is associated with higher patient satisfaction and has been found to be an effective and reliable method for patients in rural and remote areas. Therefore, in these areas, the use of e-oral health should be encouraged. However, methodological inconsistencies in the current evidence suggest the need for long-term cohort studies and clinical trials, as well as cost analysis on e-oral health in rural settings. SYSTEMATIC REVIEW REGISTRATION: The systematic review protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number CRD42016039942.

Effect of probiotics on urinary tract infections in children: A systematic review and meta-analysis.

BACKGROUND: Urinary tract infections (UTIs) are the most prevalent bacterial infections that occur in children worldwide. OBJECTIVE: This meta-analysis aims to investigate the utility of probiotics as preventive therapy in children with a UTI. METHODS: The Web of Science, PubMed, and Scopus were searched for articles that investigated the relationship between probiotic consumption and the risk of UTIs. The quality of the articles was evaluated using the Jadad scale. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effects model. Subgroup analyses and sensitivity analyses were also conducted. The Cochran Q test and the statistic I2 were used to evaluate heterogeneity. To determine any potential publication bias, the Egger's and Begg's tests were used. RESULTS: In total, eleven studies were selected for systematic review and meta-analysis. Compared to children who did not receive probiotics, the OR of developing or having a recurring urinary tract infection in those who received probiotics was 0.94 (95% CI; 0.88-0.999; p-value=0.046). The Begg's and Egger's tests showed no evidence of publication bias between probiotics and the risk of developing new or recurring urinary tract infections. CONCLUSION: Based on this systematic review and meta-analysis, probiotics could be an alternative therapy for children who are at risk of developing a UTI. They are non-pharmaceutical options and could be used as natural prophylaxis for UTIs. However, the currently published evidence does not irrefutably confirm that probiotics provide a protective effect against urinary bacterial infections. Therefore, there need to be large-scale randomized clinical trials undertaken to investigate the possible prophylaxis of probiotics.

Investigation of Fusobacterium Nucleatum in saliva and colorectal mucosa: a pilot study.

As evidence has been linking the oral bacterium Fusobacterium nucleatum (F. nucleatum) to colorectal tumorigenesis, we aimed to produce preliminary data on the expression of F. nucleatum in both oral and colorectal body sites in cases diagnosed with colorectal neoplasms (CRN) and CRN-free controls. We conducted a pilot hospital-based case-control study among patients who underwent colonoscopy examination. Saliva samples and biopsies from healthy colon mucosa from CRN cases and CRN-free controls, and from tumors in cases, were collected, as well as data on periodontal condition and potential CRN risk factors. A total of 22 CRN cases and 21 CRN-free controls participated in this study, with a total of 135 biospecimens collected and analyzed by qPCR for detection and quantification of F. nucleatum. The detection rate of F. nucleatum was 95% in saliva samples and 18% in colorectal mucosa specimens. The median (95% CI) salivary F. nucleatum level was 0.35 (0.15-0.82) and 0.12 (0.05-0.65) in case and control groups, respectively, with a Spearman correlation of 0.64 (95% CI 0.2-0.94) between F. nucleatum level in saliva and healthy colorectal mucosa in controls. Our study results support the need for and the feasibility of further studies that aim to investigate the association between oral and colorectal levels of F. nucleatum in CRN cases and controls.Clinical Relevance: Considering the current evidence linking F. nucleatum to colorectal carcinogenesis, investigating the role of oral F. nucleatum expression in its colorectal enrichment is crucial for colorectal cancer screening and prevention avenues.

Aragonite toothpaste for management of dental calculus: A double-blinded randomized controlled clinical trial.

OBJECTIVES: Aragonite from animal origin such as cuttlefish bone powder is an abrasive with hardness properties ideal for calculus removal. The purpose of this randomized controlled trial was to test the efficacy of a cuttlebone-derived aragonite toothpaste in removing dental calculus. MATERIALS AND METHODS: Eighty-one patients who fulfilled the inclusion criteria were blindly and randomly assigned into two study groups. The intervention treatment group (n = 40) received cuttlebone toothpaste (Dr. D-Tart) and the control group (n = 41) received an off-the-shelf commercial toothpaste (Crest). Evaluations were performed before and after scaling and polishing procedures done at 3 months in order to evaluate the toothpaste's ability to remove calculus and to prevent calculus formation. Calculus, stains, plaque, and gingival indices scores, and patient satisfaction surveys were compared at baseline (first visit), 3, and 9 months, using generalized linear models and Wald's χ2 test. RESULTS: At the end of the 3-month period, the intervention group showed a 30% reduction in total calculus compared to the baseline score (p = .0006) and 45% less total calculus compared to the control group (p = .0001). Six months after scaling, the mean calculus score for Crest users was 42% higher than that for Dr. D-Tart users (p = .0692). There was a significant improvement in the gingival health of cuttlebone toothpaste users at the observed intervals, and both kinds of toothpaste achieved comparable results in terms of plaque and stains removal. CONCLUSIONS: Aragonite toothpaste can remove calculus, prevent calculus formation, and improve gingival health. Patients are generally satisfied with the performance of the aragonite toothpaste. CLINICAL SIGNIFICANCE: Animal-derived aragonite toothpaste (Dr. D-Tart) shows promising efficacy in removing calculus, preventing calculus formation, and for the improvement of gingival health. CLINICAL TRIAL ID: A08-M35-16B.

Effect of personalized musical intervention on burden of care in dental implant surgery: A pilot randomized controlled trial.

OBJECTIVE: To explore a personalized musical intervention's effect on burden of care during dental implants placement. METHODS: Randomized Controlled Trial in 24 dental implant surgery patients. A personalized music intervention (Music Care© application) or an audiobook control condition was administered. Burden of care (a composite outcome including self-reported anxiety, pain, and dissatisfaction felt during surgery), expected pain prior to surgery, pre- and post-surgery affect, memory of pain felt during surgery, and participants' emotional judgments of the music and audiobook listening were assessed. RESULTS: The personalized music intervention significantly reduced the burden of care for dental implant surgery (p = 0.02; d = 1.07). Both groups reported positive affect after surgery, but the music group felt better. The pain remembered after seven postoperative days was significantly lower in the music group (p = 0.02). Participants judged the music listened to during surgery as more relaxing and pleasant than the audiobook (p = 0.002 and p = 0.001, respectively). CONCLUSIONS: Personalized music intervention could be effective in decreasing patients' burden of care during dental implant surgery. These results need to be confirmed by a rigorous randomized control trial. CLINICAL SIGNIFICANCE: The burden of care associated with the pain and anxiety experienced during dental implant surgery can be reduced using a personalized and standardized music intervention. This approach may provide a simple complementary approach to improve surgical care in various settings.

Prevalence of reflux nephropathy in Iranian children with solitary kidney: results of a multi-center study.

BACKGROUND: Given the importance of the function of the remnant kidney in children with unilateral renal agenesis and the significance of timely diagnosis and treatment of reflux nephropathy to prevent further damage to the remaining kidney, we aimed to determine the prevalence of reflux nephropathy in this subgroup of pediatric patients. METHODS: In general, 274 children referred to pediatric nephrologists in different parts of Iran were evaluated, of whom 199 had solitary kidney and were included in this cross-sectional study. The reasons for referral included urinary tract infection (UTI), abnormal renal ultrasonography, being symptomatic, and incidental screening. Demographic characteristics, including age and gender were recorded. History of UTI and presence of vesicoureteral reflux (VUR) were evaluated. RESULTS: Of the 274 children evaluated in this study with the mean age (SD) of 4.71 (4.24) years, 199 (72.6%) had solitary kidney. Among these, 118 (59.3%) were male and 81 (60.7%) were female, 21.1% had a history of UTI, and VUR was present in 23.1%. The most common cause of referral was abnormal renal ultrasonography (40.2%), followed by incidental screening (21.1%), being symptomatic (14.1%), and UTI (5.5%). In 116 children (58.3%), the right kidneys and in 83 (41.7%) the left kidneys were absent. Besides, 14.6% of the participants had consanguineous parents and 3% had a family history of solitary kidney. Upon DMSA scan, the single kidney was scarred in 13.1%, of which only 7.5% were associated with VUR. In addition, proteinuria and hematuria were observed in 6.5% and 1.5% of children, respectively. CONCLUSIONS: The prevalence of reflux nephropathy was 7.5% in children with solitary kidney with a male predominance. Given the relatively high prevalence of reflux nephropathy in these children, screening for VUR in the remnant kidney appears to be essential in this population.

Periodontal disease as a risk factor for sporadic colorectal cancer: results from COLDENT study.

Colorectal cancer remains the top leading cancer worldwide. Accumulating evidence suggests periodontal pathogens are involved in colorectal carcinogenesis, indicating the need for high-quality epidemiological evidence linking periodontal disease (PD) and colorectal cancer (CRC). Thus, we conducted the first population-based case-control study that was specifically designed to investigate the association between compromised oral health and sporadic CRC. A total of 348 incident cases of colon or rectal cancer, and 310 age and sex frequency-matched controls, from the Montreal island and Laval population participated in the study. Data were collected on PD and on several CRC risk factors using validated questionnaires. A life-course approach was used to document long-term history regarding lifestyle factors. Multivariable unconditional logistic regression analysis was used to estimate the rate ratio (RR) quantifying the association between CRC and PD. Results showed that the rate of new diagnosis of CRC in persons with a positive history of PD was 1.45 times higher than in those with a negative history of PD adjusting for age, sex, BMI, education, income, diabetes, family history of CRC, regular use of non-steroidal anti-inflammatory drugs, lifetime cumulative smoking, lifetime consumption of red meats, processed meats, and alcoholic drinks, and lifetime total physical activity score (adjusted RR = 1.45; 95% CI 1.04-2.01; p = 0.026). Our results support the hypothesis of an association between PD and sporadic CRC risk.

Detection of Fusobacterium nucleatum subspecies in the saliva of pre-colorectal cancer patients, using tandem mass spectrometry.

OBJECTIVE: Rising evidence links Fusobacterium nucleatum (F. nucleatum) with its four subspecies; nucleatum, polymorphum, animalis, and vincentii, with the development of colorectal cancer (CRC) and its precursor colorectal adenoma (CRA). This study aims to optimize a technique for and explore the capability of matrix-assisted laser-desorption ionization-tandem time-of-flight mass spectrometry (MALDI-TOF/TOF MS) to detect F. nucleatum subspecies directly from the saliva samples of CRA patients and controls without preculturing. DESIGN: Saliva samples were collected from four CRA patients and eight controls. Proteins were extracted and subjected to solid-phase extraction fractionation, enzymatically digested, and analyzed by MALDI-TOF/TOF MS. F. nucleatum subspecies strains were cultured and used as a positive control. RESULTS: A proteomics approach was developed to identify F. nucleatum subspecies directly from saliva samples. With this approach, the bacterial culturing step, which could take up to seven days, was bypassed. Overall, 157 F. nucleatum subspecies proteins were detected in the saliva samples. F. nucleatum subsp. nucleatum was absent in the patients while detected in half of the controls. CONCLUSION: This study presents a novel technique for detecting F. nucleatum subspecies from saliva specimens that could later be employed to better understand a potential role of those subspecies in CRC development.