The impact of outpatient versus inpatient management on health-related quality of life outcomes for patients with malignant pleural effusion: the OPTIMUM randomised clinical trial.

BACKGROUND: The principal aim of malignant pleural effusion (MPE) management is to improve health-related quality of life (HRQoL) and symptoms. METHODS: In this open-label randomised controlled trial, patients with symptomatic MPE were randomly assigned to either indwelling pleural catheter (IPC) insertion with the option of talc pleurodesis or chest drain and talc pleurodesis. The primary end-point was global health status, measured with the 30-item European Organisation for Research and Treatment of Cancer Quality of Life Core Questionnaire (EORTC QLQ-C30) at 30 days post-intervention. 142 participants were enrolled from July 2015 to December 2019. RESULTS: Of participants randomly assigned to the IPC (n=70) and chest drain (n=72) groups, primary outcome data were available in 58 and 56 patients, respectively. Global health status improved in both groups at day 30 compared with baseline: IPC (mean difference 13.11; p=0.001) and chest drain (mean difference 10.11; p=0.001). However, there was no significant between-group difference at day 30 (mean intergroup difference in baseline-adjusted global health status 2.06, 95% CI -5.86-9.99; p=0.61), day 60 or day 90. No significant differences were identified between groups in breathlessness and chest pain scores. All chest drain arm patients were admitted (median length of stay 4 days); seven patients in the IPC arm required intervention-related hospitalisation. CONCLUSIONS: While HRQoL significantly improved in both groups, there were no differences in patient-reported global health status at 30 days. The outpatient pathway using an IPC was not superior to inpatient treatment with a chest drain.

Effect of Different Light-tip Distances on Shear Bond Strength of Orthodontic Brackets Cured with Light-emitting Diode and High-intensity Light-emitting Diode.

AIM: The aim was to find out whether the light-tip distance affected the shear bond strength of orthodontic brackets when cured with light-emitting diode (LED) and high-intensity LED at four different light-tip distances. MATERIALS AND METHODS: Extracted human premolars were divided into eight groups. Each tooth was embedded in the self-cure acrylic resin block, and brackets were bonded and cured with different lights and different distances. Shear bond strength tests were performed in vitro using the universal testing machine. Data were analyzed using one-way ANOVA test. RESULTS: The descriptive statistics for shear bond strength of orthodontic brackets cured with LED light at 0 mm was 8.49 ± 1.08 MPa, at 3 mm was 8.13 ± 0.85 MPa, 6 mm was 6.42 ± 0.42 MPa, and at 9 mm was 5.24 ± 0.92 MPa, and those cured with high-intensity light at 0 mm was 19.23 ± 4.83 MPa, at 3 mm was 17.65 ± 3.28 MPa, at 6 mm was 13.04 ± 2.36 MPa, and at 9 mm was 11.74 ± 1.4 MPa. Mean shear bond strength was found to decrease as the light-tip distance increased with both light sources. CONCLUSION: Shear bond strength is higher when the light source is close to the surface to be cured, and it decreases as the distance increases. The highest shear bond strength was achieved with high-intensity light. CLINICAL SIGNIFICANCE: Light-emitting diode or high-intensity units can be used for bonding orthodontic brackets without compromising the shear bond strength of the brackets, and that shear bond strength is stronger when the light source is close to the surface to be cured, and it decreases as the distance increases between the light source and the surface.

SARS-CoV-2 seroprevalence among healthcare workers from a tertiary care center in Riyadh, Saudi Arabia.

OBJECTIVES: To calculate the seroprevalence of asymptomatic healthcare workers (HCWs) in our institution. METHODS: We conducted a cross-sectional study among asymptomatic HCWs in a large hospital during the peak of the pandemic (from July to August 2020 and followed them up until February 2021) in Riyadh, Saudi Arabia. We collected the data in a Microsoft Word document after collecting a single serum sample for detection of antibodies from each participant then we compared the results statically in Microsoft Excel tables. RESULTS: We enrolled 188 participants and measured their IgG antibodies from venous blood samples using CLIA. Six (3.2%) had positive antibodies despite being asymptomatic. Most of these were from non-COVID-19 working areas (4 out of 6), but all had an exposure with a positive COVID-19 patient at some point in the preceding 2 months. CONCLUSIONS: Our results are consistent with similar local studies showing low seroprevalence among HCWs while most positive cases are from non-COVID-19 areas. Despite this low seroprevalence, HCWs are still considered a high-risk group; hence, there is a need to encourage strict implementation and adherence to infection control measures and vaccination among HCWs, especially when these measures are relaxed on the national level.

Assessment of Systemic Inflammatory Markers in Patients with Aggressive Periodontitis.

BACKGROUND: "Aggressive periodontitis (AgP) is a destructive disease characterized by the following: The involvement of multiple teeth with a distinctive pattern of periodontal tissue loss; a high rate of disease progression; an early age of onset; and the absence of systemic diseases.'' Chronic low-level bacteremia and systemic inflammatory response have been suggested as a pathogenic link between periodontal disease and systemic disease. The present study was aimed to assess the levels of systemic inflammatory markers in patients with AgP. METHODS: A sample of 50 systemically healthy patients comprised two groups, based on full mouth periodontal examination: Group I healthy individuals, includes 25 periodontally healthy subjects with fully functioning dentition. Group II includes 25 patients diagnosed clinically as AgP. Laboratory blood investigation included white blood cell (WBC) count, neutrophil count, lymphocyte count, and platelet count. Serum protein parameters included total protein (TP), albumin (ALB), and globulin (GLB). Periodontal clinical parameters including plaque index, gingival index, probing pocket depth, and clinical attachment level were recorded. RESULTS: Data analysis shows an increase in WBC, neutrophil, lymphocyte, and platelet count and a decrease in TP, ALB, and GLB in AgP patients when compared to healthy individuals. CONCLUSION: Results of the present study shows an increase in blood parameters and decrease in serum protein parameters in AgP. Hence, AgP could be considered as one of the risk factors associated with the cardiovascular diseases as assessed by changes in the level of systemic inflammatory markers observed.

Influence of erbium, chromium-doped: Yttrium scandium-gallium-garnet laser etching and traditional etching systems on depth of resin penetration in enamel: A confocal laser scanning electron microscope study.

OBJECTIVE: This study was performed to assess the resin tag length penetration in enamel surface after bonding of brackets to identify which system was most efficient. METHODOLOGY: Our study was based on a more robust confocal microscopy for visualizing the resin tags in enamel. Totally, 100 extracted human first and second premolars have been selected for this study and were randomly divided into ten groups of 10 teeth each. In Group 1, the buccal enamel surface was etched with 37% phosphoric acid (3M ESPE), Group 2 with 37% phosphoric (Ultradent). In Groups 5, 6, and 7, erbium, chromium-doped: Yttrium scandium-gallium-garnet (Er, Cr: YSGG) laser (Biolase) was used for etching the using following specifications: Group 5 (1.5 W/20 Hz, 15 s), Group 6 (2 W/10 Hz, 15 s), and Group 7 (2 W/20 Hz, 15 s). In Groups 8, 9, and 10, Er, Cr: YSGG laser (Biolase) using same specifications and additional to this step, conventional etching on the buccal enamel surface was etched with 37% (3M ESPE) after laser etching. In Groups 1, 5, 6, 7, 8, 9, and 10 3M Unitek Transbond XT primer was mixed with Rhodamine B dye (Sigma-Aldrich, Germany) to etched surface and then cured for 20 s. In Group 2, Ultradents bonding agent was mixed with Rhodamine B. In Group 3, 3M Unitek Transbond PLUS, Monrovia, USA, which was mixed with Rhodamine B dye (Sigma-Aldrich, Germany). Group 4, with self-etching primer (Ultradent-Peak SE, USA) was mixed with Rhodamine B dye (Sigma-Aldrich, Germany). Later (3M Unitek, Transbond XT, Monrovia USA) [Figure 1] was used to bond the modified Begg brackets (T. P. Orthodontics) in Groups 1, 3, 5, 6, 7, 8, 9, and 10. In Groups 2, 4 Ultradent-Peak LC Bond was used to bond the modified brackets. After curing brackets were debonded, and enamel depth penetration was assessed using confocal laser scanning microscope. RESULTS: Group J had a mean maximum depth of penetration of 100.876 µm, and Group D was the least having a maximum value of 44.254 µm. CONCLUSIONS: Laser alone groups had comparable depths of penetration to that of self-etching groups but much lower than conventional acid etched groups.