Investigating the Effect of Selenium Nanoparticles on Mineral Trioxide Aggregates as a Promising Novel Dental Material.

Aim: To enhance mineral trioxide aggregate high plasticity (MTA HP), a commonly used dental calcium silicate cement, by incorporating selenium nanoparticles (SeNPs) known for their antioxidant and anti-inflammatory properties. The objectives included investigating the impact of SeNPs on the setting time and chemical properties of MTA HP. Materials and Methods: We performed a comprehensive study to formulate and profile SeNPs integrated into MTA HP. Diverse concentrations of SeNPs were introduced into MTA HP, and the commencement and culmination of the setting process were gauged employing a Gillmore needle cabinet. The chemical composition was validated using Fourier transform infrared spectroscopy with attenuated total reflectance and X-ray diffraction analysis. Results: The incorporation of SeNPs led to remarkable improvements. Notably, SeNPs positively affected the setting time of MTA HP, with faster setting times corresponding to higher SeNPs concentrations. Chemical analyses confirmed the successful integration of SeNPs with MTA HP. These enhancements make the material may be suitable for dental applications, especially due to its accelerated setting time. Conclusions: MTA HP incorporated with SeNPs represents a significant advancement in dental materials. Its faster setting time, combined with the antioxidant and anti-inflammatory properties of selenium, provides dental professionals with an efficient and time-saving option for complex treatments. This novel nanomaterial holds promise for improving dental procedures and patient outcomes.

Management of the infant born to a mother with tuberculosis: a systematic review and consensus practice guideline.

Infants born to mothers with tuberculosis disease are at increased risk of developing tuberculosis disease themselves. We reviewed published studies and guidelines on the management of these infants to inform the development of a consensus practice guideline. We searched MEDLINE, CINAHL, and Cochrane Library from database inception to Dec 1, 2022, for original studies reporting the management and outcome of infants born to mothers with tuberculosis. Of the 521 published papers identified, only three met inclusion criteria and no evidence-based conclusions could be drawn from these studies, given their narrow scope, variable aims, descriptive nature, inconsistent data collection, and high attrition rates. We also assessed a collection of national and international guidelines to inform a consensus practice guideline developed by an international panel of experts from different epidemiological contexts. The 16 guidelines reviewed had consistent features to inform the expert consultation process. Two management algorithms were developed-one for infants born to mothers considered potentially infectious at the time of delivery and another for mothers not considered infectious at the time of delivery-with different guidance for high and low tuberculosis incidence settings. This systematic review and consensus practice guideline should facilitate more consistent clinical management, support the collection of better data, and encourage the development of more studies to improve evidence-based care.

Chemical analysis of mineral trioxide agregate mixed with hyaluronic acids as an accelerant.

MATERIALS AND METHOD: Mineral trioxide aggregate (MTA) has many clinical applications in dentistry; the main drawback is the long setting. The main objective is to investigate and compare the chemical effect of using two commercially available hyaluronic acid hydrogels (HA) instead of distilled water for mixing MTA as an accelerant of setting time. Test materials were divided into three groups; Group 1: (control) mixing MTA with distilled water supplied by the manufacturer; Group 2: mixing MTA with a hybrid cooperative complex of high and low molecular weight HA (Profhilo®); Group 3: mixing MTA with High molecular weight / non-cross-linked HA (Jalupro®). Mixing time, and setting time (initial and final) were determined, Fourier-transform infrared spectroscopy, Energy-dispersive X-ray spectroscopy, Field emission Scanning Electron Microscopy, and X-ray diffraction were performed. RESULTS: mixing time, initial, and final setting time for (MTA + HA) groups were significantly different and lower in comparison to the control group (p < 0.05). This study revealed higher expression of calcium silicate hydrate and calcium hydroxide expression with higher Ca release in the MTA + HA group than the control group. CONCLUSION: commercially available HA demonstrated better chemical properties when used as a mixing medium for MTA. The Mixing and setting time for MTA + HA group were significantly shorter than those of the control group were. Thus, commercially available HA can be used as a mixing medium for MTA.

Predictors of Intensive Care Admission in Hypoxemic Bronchiolitis Infants, Secondary Analysis of a Randomized Trial.

OBJECTIVES: To evaluate in a preplanned secondary analysis of our parent randomized controlled trial predictors of intensive care unit (ICU) admission in infants with bronchiolitis and analyze if these predictors are equally robust for children receiving high-flow or standard-oxygen. STUDY DESIGN: A secondary analysis of a multicenter, randomized trial of infants aged <12 months with bronchiolitis and an oxygen requirement was performed using admission and outcome data of all 1472 enrolled infants. The primary outcome was ICU admission. The predictors evaluated were baseline characteristics including physiological data and medical history. RESULTS: Of the 1472 enrolled infants, 146 were admitted to intensive care. Multivariate predictors of ICU admission were age (weeks) (OR: 0.98 [95% CI: 0.96-0.99]), pre-enrolment heart rate >160/min (OR: 1.80 [95% CI: 1.23-2.63]), pre-enrolment SpO2 (transcutaneous oxygen saturation) (%) (OR: 0.91 [95% CI: 0.86-0.95]), previous ICU admission (OR: 2.16 [95% CI: 1.07-4.40]), and time of onset of illness to hospital presentation (OR: 0.78 [95% CI: 0.65-0.94]). The predictors were equally robust for infants on high-flow nasal cannula therapy or standard-oxygen therapy. CONCLUSION: Age <2 months, pre-enrolment heart rate >160/min, pre-enrolment SpO2 of <87%, previous ICU admission and time of onset of ≤2 days to presentation are predictive of an ICU admission during the current hospital admission of infants with bronchiolitis independent of oxygenation method used. TRIAL REGISTRATION: ACTRN12613000388718.

Chemical analysis of mineral trioxide agregate mixed with hyaluronic acids as an accelerant

Abstract Mineral trioxide aggregate (MTA) has many clinical applications in dentistry; the main drawback is the long setting. The main objective is to investigate and compare the chemical effect of using two commercially available hyaluronic acid hydrogels (HA) instead of distilled water for mixing MTA as an accelerant of setting time. Materials and method: Test materials were divided into three groups; Group 1: (control) mixing MTA with distilled water supplied by the manufacturer; Group 2: mixing MTA with a hybrid cooperative complex of high and low molecular weight HA (Profhilo®); Group 3: mixing MTA with High molecular weight / non-cross-linked HA (Jalupro®). Mixing time, and setting time (initial and final) were determined, Fourier-transform infrared spectroscopy, Energy-dispersive X-ray spectroscopy, Field emission Scanning Electron Microscopy, and X-ray diffraction were performed. Results: mixing time, initial, and final setting time for (MTA + HA) groups were significantly different and lower in comparison to the control group (p < 0.05). This study revealed higher expression of calcium silicate hydrate and calcium hydroxide expression with higher Ca release in the MTA + HA group than the control group. Conclusion: commercially available HA demonstrated better chemical properties when used as a mixing medium for MTA. The Mixing and setting time for MTA + HA group were significantly shorter than those of the control group were. Thus, commercially available HA can be used as a mixing medium for MTA.

Resumo O agregado de trióxido mineral (MTA) tem muitas aplicações clínicas em odontologia, mas a principal desvantagem é a longa presa. O objetivo principal é investigar e comparar o efeito químico do uso de dois hidrogéis de ácido hialurônico (HA) disponíveis comercialmente em vez de água destilada para misturar o MTA como um acelerador do tempo de presa. Materiais e método: Os materiais de teste foram divididos em três grupos: Grupo 1: (controle) misturando o MTA com água destilada fornecida pelo fabricante; Grupo 2: misturando o MTA com um complexo cooperativo híbrido de HA de alto e baixo peso molecular (Profhilo®); Grupo 3: misturando o MTA com HA de alto peso molecular/não reticulado (Jalupro®). Foram determinados o tempo de mistura e o tempo de presa (inicial e final), a espectroscopia de infravermelho com transformada de Fourier, a espectroscopia de raios X com dispersão de energia, a microscopia eletrônica de varredura com emissão de campo e a difração de raios X. Resultados: o tempo de mistura, o tempo de presa inicial e final dos grupos (MTA + HA) foram significativamente diferentes e menores em comparação com o grupo de controle (p < 0,05). Esse estudo revelou maior expressão de silicato de cálcio hidratado e expressão de hidróxido de cálcio com maior liberação de Ca no grupo MTA + HA do que no grupo de controle. Conclusão: a HA disponível comercialmente demonstrou melhores propriedades químicas quando usada como meio de mistura para o MTA. O tempo de mistura e de presa do grupo MTA + HA foi significativamente menor do que o do grupo de controle. Portanto, a HA disponível comercialmente pode ser usada como meio de mistura para o MTA.

Thickness and yttria percentage influences the fracture resistance of laminate veneer zirconia restorations.

OBJECTIVES: Mechanical properties are cardinal for the long-term clinical success of laminate veneer restorations but the selection of new restorative materials should ideally be based on clinical evidence, therefore, in vitro testing of dental materials is a good alternative to evaluate their properties and understand their behavior so this study aimed to compare and evaluate the effect of two different thicknesses and yttria percentage on the fracture resistance of laminate veneer zirconia restorations. MATERIALS AND METHODS: Forty laminate veneer restoration prepared from partial sintering zirconia of 3Y (yttria), 5Y (yttria), combined 3Y&5Y (yttria), and lithium disilicate. Specimens were assigned into four main groups according to their percentage of yttria content (n = 10) and subgrouped into two thicknesses (0.5 mm thickness and 0.3 mm thickness) (n = 5) as follows: Group I, II, III, and IV (Group I for lithium disilicate (control), Group II for 3Y zirconia, Group III for 5Y zirconia, and Group IV for combined 3Y&5Y zirconia), each of them subdivided according to their thickness into two subgroups (n = 5 for each one) and resistance to fracture for each restoration was evaluated using a universal testing machine. Data were analyzed using a one-way analysis of variance and Duncan's tests at a 5% level of significance. RESULTS: The thickness of laminate veneer restoration significantly affects the fracture resistance value of all type of laminate veneers restorations (fracture resistance mean value was highest for 0.5 mm thickness and lower for 0.3 mm thickness restorations) and yttria percentage significantly affect fracture resistance value of zirconia laminate veneer restorations (fracture resistance mean value was highest for 0.5 mm thickness of 3Y zirconia [865 N] and combined 3Y&5Y zirconia [846 N]). CONCLUSIONS: Reducing the thickness of laminate zirconia veneer restorations to 0.3 mm reduces its fracture resistance and increasing yttria percentage had an adverse effect on fracture resistance of zirconia laminate veneer restorations.

Nasal High Flow in Room Air for Hypoxemic Bronchiolitis Infants.

Background: Bronchiolitis is the most common reason for hospital admission in infants, with one third requiring oxygen therapy due to hypoxemia. It is unknown what proportion of hypoxemic infants with bronchiolitis can be managed with nasal high-flow in room air and their resulting outcomes. Objectives and Settings: To assess the effect of nasal high-flow in room air in a subgroup of infants with bronchiolitis allocated to high-flow therapy in a recent multicenter randomized controlled trial. Patients and Interventions: Infants allocated to the high-flow arm of the trial were initially treated with room air high-flow if saturations were ≥85%. Subsequently, if oxygen saturations did not increase to ≥92%, oxygen was added and FiO2 was titrated to increase the oxygen saturations. In this planned sub-study, infants treated during their entire hospital stay with high-flow room air only were compared to infants receiving either standard-oxygen or high-flow with oxygen. Baseline characteristics, hospital length of stay and length of oxygen therapy were compared. Findings: In the per protocol analysis 64 (10%) of 630 infants commenced on high-flow room air remained in room air only during the entire stay in hospital. These infants on high-flow room air were on average older and presented with moderate hypoxemia at presentation to hospital. Their length of respiratory support and length of stay was also significantly shorter. No pre-enrolment factors could be identified in a multivariable analysis. Conclusions: In a small sub-group of hypoxemic infants with bronchiolitis hypoxemia can be reversed with the application of high-flow in room air only. Trial registration: ACTRN12615001305516.

FTIR and SEM of a novel chemical conditioning on the zirconia intaglio surface

Objectives: The aim of this study was to evaluate chemical and topographical changes in the intaglio zirconia surface induced by chemical conditioning solutions using FTIR and SEM analysis. Material and method: twelve plates for each FTIR and SEM tests from each zirconia materials (UPCERA HT White, BruxZir® Solid Zirconia, and Copran® Multilayer), milled by a Yenadent CAD/CAM system, sintered and divided randomly into a three groups. A different surface conditioning was applied to the intaglio surface of each group: 30% hydrogen peroxide, 30% citric acid and control group. Result and discussion: by using of the FTIR spectroscopy, an evidence of new bands formation appeared at 1637cm-1 and 3352cm-1 due to the high oxidizing effect of hydrogen peroxide, and at 630cm-1 and 1663cm-1 due to the chelating action of citric acid, and simultaneously, SEM assessment of the surface topography took place, to identify lines, scratches, or surface dissociation that appeared on the intaglio zirconia surface after conditioning. Conclusion: such analysis provides an enhancement of new convenient, less expensive, reliable trials to improve micro-bond strength of luting cement to Y-TZP ceramics.

Predicting acute viral hepatitis serum markers (A and E) in patients with suspected acute viral hepatitis attending primary health care centers in Baghdad: a one year cross-sectional study.

BACKGROUND: Viral hepatitis is an important preventable infectious disease with various rates of occurrence in different areas of the world. The main objective of the present study was to evaluate the role of some risk factors in predicting a positive acute viral hepatitis marker among patients with suspected acute viral hepatitis in a primary health care setting in Baghdad. Besides, finding out the occurrence of jaundice, contribution of viruses A and E to the cases that have occurred in Baghdad province was also searched for. METHODS: Over a period of 1 year a descriptive cross sectional study was carried out at the primary health care centers in Baghdad. A questionnaire form was used to collect data about demographic factors and the results of the investigations. Total serum bilirubin and bilirubin in urine were done at the primary health care center laboratory. The rest of the sera samples were sent to Hepatitis referral Lab at Central Public Health Laboratory (CPHL) to be tested for anti HAV IgM and anti HEV IgM using ELISA technique. RESULTS: A total of 7,576,372 consultations to primary health care centers were recorded in Baghdad. Among those a total of 2,692 cases (35.5 per 100,000 consultations) were labeled as acute viral hepatitis cases. A positive hepatitis viral marker (A, B, C and E) was found in 1,332 cases (17.6 per 100,000 consultations). More than two fifths (44.8%) of cases were positive for anti-HAV antibodies and another 1.6% had positive anti-HEV antibodies. CONCLUSION: During 1 year period, the rate of occurrence of suspected acute viral hepatitis cases was 35.5 per 100000 of consultations to the primary health care centers in Baghdad. Of the total suspected cases, only 17.6 per 100000 of the consultations were positive for one of the viral hepatitis markers. Those who tested positive for one of the viral hepatitis markers represent 49.5% of the suspected cases. Proportion of anti HAV IgM positive tests among suspected cases was 44.8%. Factors that were able to predict positive Anti HAV IgM were (younger age group, negative history of cupping or tattooing, negative past history of jaundice). Male gender was the least important predictor of a positive case for anti HAV IgM. Proportion of Anti HEV IgM positive tests among suspected cases was 1.6%. Of the factors studied, only age was able to predict a positive Anti HEV IgM in those more than 15 years. Further studies are recommended.