Evaluation of Fecal Inflammatory Biomarkers to Identify Bacterial Diarrhea Episodes: Systematic Review and Protocol for the Enterics for Global Health Shigella Surveillance Study.

Background: The measurement of fecal inflammatory biomarkers among individuals presenting to care with diarrhea could improve the identification of bacterial diarrheal episodes that would benefit from antibiotic therapy. We reviewed prior literature in this area and describe our proposed methods to evaluate 4 biomarkers in the Enterics for Global Health (EFGH) Shigella surveillance study. Methods: We systematically reviewed studies since 1970 from PubMed and Embase that assessed the diagnostic characteristics of inflammatory biomarkers to identify bacterial diarrhea episodes. We extracted sensitivity and specificity and summarized the evidence by biomarker and diarrhea etiology. In EFGH, we propose using commercial enzyme-linked immunosorbent assays to test for myeloperoxidase, calprotectin, lipocalin-2, and hemoglobin in stored whole stool samples collected within 24 hours of enrollment from participants in the Bangladesh, Kenya, Malawi, Pakistan, Peru, and The Gambia sites. We will develop clinical prediction scores that incorporate the inflammatory biomarkers and evaluate their ability to identify Shigella and other bacterial etiologies of diarrhea as determined by quantitative polymerase chain reaction (qPCR). Results: Forty-nine studies that assessed fecal leukocytes (n = 39), red blood cells (n = 26), lactoferrin (n = 13), calprotectin (n = 8), and myeloperoxidase (n = 1) were included in the systematic review. Sensitivities were high for identifying Shigella, moderate for identifying any bacteria, and comparable across biomarkers. Specificities varied depending on the outcomes assessed. Prior studies were generally small, identified red and white blood cells by microscopy, and used insensitive gold standard diagnostics, such as conventional bacteriological culture for pathogen detection. Conclusions: Our evaluation of inflammatory biomarkers to distinguish diarrhea etiologies as determined by qPCR will provide an important addition to the prior literature, which was likely biased by the limited sensitivity of the gold standard diagnostics used. We will determine whether point-of-care biomarker tests could be a viable strategy to inform treatment decision making and increase appropriate targeting of antibiotic treatment to bacterial diarrhea episodes.

Dental school quality assessment: Effect of student calibration on the outcomes of fixed prosthodontic cases.

BACKGROUND: Quality assurance (QA) of predoctoral dental student laboratory work is an essential part of the learning process that involves evaluating the student's ability, providing constructive feedback, helping develop the students' ability to self-assess, and promoting collegiality and communication among students, faculty, and laboratories. Faculty calibration, while often difficult to coordinate, is also necessary to providing consistent student feedback. AIM: The purpose of this study was to evaluate whether periodic calibration exercises with the fourth-year dental students and faculty impacted the number of student cases rejected during Quality Assurance evaluation of fixed prosthodontic cases submitted to The Dental College of Georgia laboratory tracking. CONCLUSION: Findings from this study provided evidence that ongoing calibration did result in a reduced number of incoming QA rejections in all periods reviewed except for one in which there was significant turnover among department faculty affecting QA calibration for that time period.

Subperiosteal implant overdenture fabrication using existing custom Dolder bar attachments.

Endosseous root-form implants are the most popular type of implant used today. However, patients may present with subperiosteal implants that need treatment with a removable prosthesis. This case report describes the fabrication of a new set of overdentures for 30-year-old subperiosteal implants using the patient's current dentures as a guide to establish a proper vertical dimension of occlusion and occlusal scheme. In addition, the patient's older set of dentures was used as the record bases in an effort to reuse the existing custom Dolder bar attachments. Esthetics and lip support were enhanced by selecting new teeth and adjusting the tooth positions. The patient was pleased with the esthetic and functional results of the new overdentures.

Resin Bonding of a Lithium-Disilicate Crown Using a Ligated Rubber Dam: A 2-Year Case Report.

Enduring glass-ceramic restorations greatly depend on the quality of adhesion of the crown to enamel and dentin. Proper isolation is vital to the success of bonded ceramic restorations. The rubber dam has long been considered the primary method of preventing contamination of the operating field, a crucial requisite for adhesion. However, many dentists do not use rubber dam isolation due to its penchant for slowing down procedures. The authors present a case report that describes a technique for the indirect bonding of a ceramic restoration to a maxillary first molar using rubber dam isolation in conjunction with a floss ligature,a method that is aimed at optimizing operator effectiveness and efficiency.

Esthetic management of white spot lesions by using minimal intervention techniques of bleaching and resin infiltration: A clinical report.

Dental fluorosis and hypocalcification manifest as white spot lesions and/or brown discolorations. With dental fluorosis, mottled layers in enamel can also be present depending on severity. Treatment options have varied in such situations, depending on severity, and can range from conservative to more invasive. This clinical report focuses on a combination of bleaching and resin infiltration as one of the more conservative treatment options.

Treatment and esthetic management of traumatized maxillary central incisors with endodontic therapy and the inside/outside bleaching technique: A clinical report.

Traumatic dental injuries most commonly occur to the maxillary central incisors, occasionally resulting in tooth discoloration and prompting affected patients to seek dental treatment. Other negative sequelae of trauma to teeth include root resorption that can complicate definitive treatment planning to manage discoloration. This article describes the conservative esthetic management of discolored traumatized teeth through the inside/outside bleaching technique after endodontic therapy for external inflammatory root resorption.

Minimally invasive esthetic improvement in a patient with dental fluorosis by using microabrasion and bleaching: A clinical report.

Dental fluorosis is a condition that produces unesthetic coloration of enamel because of excessive fluoride ingestion during enamel formation. Its appearance can range in severity from mildly white and opaque to dark brown and can lead a patient to seek dental treatment. Historically, these lesions have been masked, either with direct or indirect restorations, but more conservative treatment options are now available, including the combination of microabrasion and bleaching. This clinical report describes the use of these treatment options to address a young patient's dental fluorosis.

A multidisciplinary approach to the management of a maxillary midline diastema: A clinical report.

A maxillary midline diastema (MMD) is a common complaint of dental patients. An MMD can be closed with treatment from different disciplines, including operative dentistry and orthodontics. A comprehensive smile analysis is also a necessity before beginning treatment. This article highlights the closure of a 3-mm MMD by using a combination of orthodontics and direct composite resin restorations.