Comprehensive assessment of the estrogenic activity of resin composites.

Resin-based dental composites have been developed to restore decayed teeth or modify tooth color due to their excellent physical and chemical properties. Such composites may have intrinsic toxicity due to components released into the mouth during the early stage of polymerization, and afterward as a result of erosion or material decomposition. In addition, resin-based dental composites have potential environmental pollutant by elution of monomers and degradation. Since certain monomers of resin matrices are synthesized from bisphenol A (BPA), which acts as an estrogenic endocrine disruptor, these resin matrices may have estrogenic activity. Therefore, the estrogenic endocrine-disrupting activity of various dental composites should be evaluated. In this study, we evaluated the estrogenic endocrine-disrupting activity of 10 resin composites by using a BRET-based estrogen receptor (ER)α and ERß dimerization assays and ER transactivation assay. BPA, BisDMA, BisGMA, BisEMA, TEGDMA, HMBP, and DMPA mediated ERα dimerization, and BPA, BisDMA, and DMPA also mediated ERß dimerization. Except for UDMA and CQ, all the compounds were identified as estrogen agonists or antagonists. In-depth information for the safe use of dental composites was acquired, and it was confirmed how the component of dental composites acts in the ER signaling pathway. Further studies on the low-dose and long-term release of these compounds are needed to ensure the safe use of these resin-based dental composites.

Pharmacist-Led Collaborative Medication Management for the Elderly with Chronic Kidney Disease and Polypharmacy.

Inappropriate polypharmacy is likely in older adults with chronic kidney disease (CKD) owing to the considerable burden of comorbidities. We aimed to describe the impact of pharmacist-led geriatric medication management service (MMS) on the quality of medication use. This retrospective descriptive study included 95 patients who received geriatric MMS in an ambulatory care clinic in a single tertiary-care teaching hospital from May 2019 to December 2019. The average age of the patients was 74.9 ± 7.3 years; 40% of them had CKD Stage 4 or 5. Medication use quality was assessed in 87 patients. After providing MMS, the total number of medications and potentially inappropriate medications (PIMs) decreased from 13.5 ± 4.3 to 10.9 ± 3.8 and 1.6 ± 1.4 to 1.0 ± 1.2 (both p < 0.001), respectively. Furthermore, the number of patients who received three or more central nervous system-active drugs and strong anticholinergic drugs decreased. Among the 354 drug-related problems identified, "missing patient documentation" was the most common, followed by "adverse effect" and "drug not indicated." The most frequent intervention was "therapy stopped". In conclusion, polypharmacy and PIMs were prevalent in older adults with CKD; pharmacist-led geriatric MMS improved the quality of medication use in this population.

Assessment of Independent Risk Factors of Developing Pneumothorax During Percutaneous Core Needle Lung Biopsy: Focus on Lesion Depth.

BACKGROUND: Previous studies identifying risk factors for pneumothorax in percutaneous core needle lung biopsies reported inconsistent and contradictory results. OBJECTIVES: We aimed to identify independent risk factors for pneumothorax associated with computed tomography (CT)-guided percutaneous core needle lung biopsy (PCNB). PATIENTS AND METHODS: We retrospectively reviewed 591 biopsy procedures for focal lung lesions. Risk factors for pneumothorax as a complication after lung biopsy were determined by univariate and multivariate analyses of variables including the patient's age, gender, lesion depth from the pleural surface, lesion size, lesion location, presence or absence of fissure crossing by the needle, emphysema in the same lobe where the biopsy was performed, and the final diagnosis of the biopsy lesion. RESULTS: Pneumothorax occurred in 100 (16.9%) of 591 procedures. Based on univariate analyses, significant risk factors affecting the incidence of pneumothorax were patient gender (P = 0.039), lesion depth from the pleural surface (P < 0.001), fissure crossing by the needle (P = 0.002), and the presence of emphysema (P = 0.009). From the multivariate analysis, an increased rate of pneumothorax was strongly correlated with lesion depth from the pleural surface (odds ratio [OR], 1.71; 95% confidence interval [CI], 1.50 - 1.96; P < 0.001) and the presence of emphysema (OR, 2.95; 95% CI, 1.73 - 5.04; P < 0.001). CONCLUSION: Lesion depth from the pleural surface and the presence of emphysema were strongly correlated with the increasing incidence of pneumothorax after CT-guided PCNB. Our results may be applicable for the risk management of PCNBs to reduce pneumothorax as a complication.