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1.
PLOS Glob Public Health ; 4(3): e0002311, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38507403

RESUMO

OBJECTIVES: Use of electronic cigarettes (ECs), also known as vaping, has gained remarkable popularity globally during the last decade especially among young people. Current evidence suggests that vaping may be associated with health risks. The aim of this study is to evaluate whether vaping increases the risk for initiation and progression of periodontal disease; and to appraise the clinical changes seen in patients using e-cigarettes, and how these changes impact the management of periodontal disease. STUDY SELECTION, DATA AND SOURCES: A comprehensive electronic search was conducted on the PubMed, Scopus and Embase databases using the following search terms: Electronic Cigarettes OR vaping OR electronic nicotine delivery systems OR e-cigarettes AND Periodontitis. The search was limited to studies published from 1st January 2012 to 31st December 2022. RESULTS: A total of 23 clinical studies focusing on the effect of e-cigarette smoking on the periodontal clinical parameters, levels of inflammatory mediators, alteration in periodontal microflora, and response to periodontal treatment were found to be eligible for inclusion in the review. Vaping may be associated with greater clinical attachment loss (CAL) compared to non-smokers. Moreover, ECs are also associated with unfavorable effects on periodontal microbial counts, biomarkers of inflammation and oxidative stress. CONCLUSIONS: Vaping may play a role in the initiation and progression of periodontal disease by altering the host response resulting in the release of inflammatory cytokines and periodontal microflora. Clinical studies show deleterious effects of vaping on periodontal health as well as less favourable response to periodontal treatment is observed in e-cigarette users compared to non-smokers. However, compared to cigarette smoking, the effects of vaping are less remarkable.

2.
BMC Med Educ ; 24(1): 282, 2024 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-38481299

RESUMO

BACKGROUND: Contemporary undergraduate dental education aims to equip the dental students with clinical competence, empathy, and professionalism to enable them to deliver safe and effective dental care to the communities. The purpose of this study was to assess the self-reported preparedness of final year dental students and interns at three Saudi dental institutions, using the pre-validated Dental Undergraduates Preparedness Assessment Scale (DU-PAS). METHODS: A cross-sectional study design was employed to assess the self-reported preparedness of the participants using the DU-PAS. Following ethics approval, a probability sampling technique was used to recruit undergraduate dental students and interns from three dental institutions in Saudi Arabia. The data was collected online on Google Forms and all participants provided their consent to participate in the study prior to providing their responses to DU-PAS. RESULTS: Responses were received from 397 participants including 171 males and 226 females yielding a response rate of 60.3%. The total mean score of the participants was 81.85 ± 13.11. Although higher scores were reported in males, the interaction between gender and DU-PAS scores were not significant. Interaction between DU-PAS scores and stage of education showed significant effect of the stage of education with interns reporting higher overall scores. The participants reported that they were able to perform most clinical procedures independently. However, low confidence was reported in performing multi-rooted endodontics, fabrication of removable dentures and orthodontic assessment. The participants also expressed their confidence in a wide range of behavioural attributes related to communication, teamworking and professionalism. However, lack of experience was noted in referral for oral cancer, interpreting research, and evaluation of new dental products using an evidence-based approach. CONCLUSION: The study provides useful insights into the self-reported preparedness of undergraduate dental students and interns in three dental institutions. While the overall preparedness of the participants was comparable to their international peers, the findings underscore the need for further enhancements to the teaching and training of undergraduate students particularly in multirooted endodontics, removable prosthodontics and orthodontics.


Assuntos
Endodontia , Estudantes de Odontologia , Masculino , Feminino , Humanos , Autorrelato , Arábia Saudita , Estudos Transversais , Endodontia/educação
3.
Colloids Surf B Biointerfaces ; 237: 113834, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38479259

RESUMO

Precise diagnosis of complex and soft tumors is challenging, which limits appropriate treatment options to achieve desired therapeutic outcomes. However, multifunctional nano-sized contrast enhancement agents based on nanoparticles improve the diagnosis accuracy of various diseases such as cancer. Herein, a facile manganese-hafnium nanocomposites (Mn3O4-HfO2 NCs) system was designed for bimodal magnetic resonance imaging (MRI)/computed tomography (CT) contrast enhancement with a complimentary function of photodynamic therapy. The solvothermal method was used to fabricate NCs, and the average size of Mn3O4 NPs and Mn3O4-HfO2 NCs was about 7 nm and 15 nm, respectively, as estimated by TEM. Dynamic light scattering results showed good dispersion and high negative (-33 eV) zeta potential, indicating excellent stability in an aqueous medium. Mn3O4-HfO2 NCs revealed negligible toxic effects on the NCTC clone 929 (L929) and mouse colon cancer cell line (CT26), demonstrating promising biocompatibility. The synthesized Mn3O4-HfO2 NCs exhibit significant enhancement in T1-weighted magnetic resonance imaging (MRI) and X-ray computed tomography (CT), indicating the appropriateness for dual-modal MRI/CT molecular imaging probes. Moreover, ultra-small Mn3O4-HfO2 NCs show good relaxivities for MRI/CT. These nanoprobes Mn3O4-HfO2 NCs further possessed outstanding reactive oxygen species (ROS) generation ability under minute ultraviolet light (6 mW·cm-2) to ablate the colon cancer cells in vitro. Therefore, the designed multifunctional Mn3O4-HfO2 NCs were ideal candidates for cancer diagnosis and photodynamic therapy.


Assuntos
Neoplasias do Colo , Nanocompostos , Nanopartículas , Fotoquimioterapia , Camundongos , Animais , Manganês , Háfnio , Imageamento por Ressonância Magnética , Tomografia Computadorizada por Raios X , Neoplasias do Colo/diagnóstico por imagem , Neoplasias do Colo/tratamento farmacológico
4.
Clin Cosmet Investig Dermatol ; 17: 399-407, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38352065

RESUMO

We present the case of a 58-year-old male patient who presented with pruritic skin plaques and papules on the scalp, face, back, and back of the hands for over a year. The symptoms worsened upon exposure to sunlight and improved on cloudy days. Despite previous attempts at treatment with glucocorticoid ointment and antihistamine drugs, the patient experienced progressive aggravation of symptoms. Physical examination revealed hypertrophic and infiltrating nodules, with significant scratches and local exudation. Skin biopsy confirmed the diagnosis of sun-induced dermatosis. The patient was initiated on tofacitinib, an oral Janus Kinase inhibitor, along with a halometasone ointment, oral ebastine tablets, and strict sun protection. Over the course of four revisits spanning four months, the patient experienced a significant improvement in symptoms, with the rash almost disappearing and pruritus subsiding. The treatment was well tolerated and no adverse effects were observed. Follow-up for six months post-treatment showed no recurrence of symptoms. This case highlights the efficacy of tofacitinib in managing sun-induced pruritic plaques and suggests it as a potential therapeutic option in similar cases.

5.
Environ Monit Assess ; 196(3): 262, 2024 Feb 13.
Artigo em Inglês | MEDLINE | ID: mdl-38351411

RESUMO

Water being the most important fluid supporting the life as well as industry is getting sparse and polluted day by day. Activated carbon (AC) can be utilized in various applications of significant environmental impact and sustainable living such as carbon dioxide sensing and capturing, air purification, and water recycling. However, in the wake of the recent corona pandemic which resulted in global lockdown and took the entire world by shock, a cost-effective and simple synthesis of such a useful material remains dire need of time. Therefore, this paper describes a simple and cost-effective synthesis of activated carbon (AC) of high porosity and surface area derived from the pruning of conocarpus and azadirachta trees. In reference to the study under consideration, alongside numerous others, a furnace was employed to synthesize activated carbon. However, our approach utilized a more conventional methodology wherein the environmental parameters were not optimized. In furnace-based procedures, factors such as temperature, pressure, and humidity are meticulously regulated, contrasting with the conventional methodologies where such parameters lack optimal control. Consequently, employing a furnace does not constitute a cost-effective approach for the physical activation of organic samples thus proving a furnace is not imperative for physical activation. The synthesis was carried out by physical activation in the form of carbonization followed by chemical activation with potassium hydroxide (KOH). The influence of activated carbon from each pruning over filtration of water containing industrial dye was investigated. Activation temperature and impregnation ratio of 600-800 °C and 1:5 were selected respectively. X-ray diffraction patterns (XRD) for all AC samples indicted the appearance of broad peaks at 2θ value of 20-30° which confirms the presence of carbon in the sample. The physical morphology arrangement by SEM analysis showed uneven arrangement of pores of conocarpus which indicated higher iodine number and hence higher adsorption capacity of 442.13 mg/g.


Assuntos
Azadirachta , Hidróxidos , Compostos de Potássio , Poluentes Químicos da Água , Águas Residuárias , Carvão Vegetal/química , Monitoramento Ambiental , Poluentes Químicos da Água/química , Água , Adsorção
6.
Eur J Dent Educ ; 28(2): 655-662, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38282273

RESUMO

Multiple-choice questions (MCQs) are the most popular type of items used in knowledge-based assessments in undergraduate and postgraduate healthcare education. MCQs allow assessment of candidates' knowledge on a broad range of knowledge-based learning outcomes in a single assessment. Single-best-answer (SBA) MCQs are the most versatile and commonly used format. Although writing MCQs may seem straight-forward, producing decent-quality MCQs is challenging and warrants a range of quality checks before an item is deemed suitable for inclusion in an assessment. Like all assessments, MCQ-based examinations must be aligned with the learning outcomes and learning opportunities provided to the students. This paper provides evidence-based guidance on the effective use of MCQs in student assessments, not only to make decisions regarding student progression but also to build an academic environment that promotes assessment as a driver for learning. Practical tips are provided to the readers to produce authentic MCQ items, along with appropriate pre- and post-assessment reviews, the use of standard setting and psychometric evaluation of assessments based on MCQs. Institutions need to develop an academic culture that fosters transparency, openness, equality and inclusivity. In line with contemporary educational principles, teamwork amongst teaching faculty, administrators and students is essential to establish effective learning and assessment practices.


Assuntos
Educação em Odontologia , Avaliação Educacional , Humanos , Estudantes , Aprendizagem , Redação
7.
Eur J Dent Educ ; 28(1): 191-205, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37698270

RESUMO

INTRODUCTION: The ability to perform uncomplicated tooth extractions is a core clinical skill in undergraduate dental education. The aim of this study was to evaluate pre-extraction assessment skills of dental students and interns and explore their self-perceived confidence in performing these tooth extractions. MATERIALS AND METHODS: A cross-sectional survey investigated the self-perceived confidence to perform the extraction for a set of eight expert-rated cases. The participants were dental students at three different stages, that is, in Years 4 and 5 of the Bachelor of Dental Surgery (BDS) programme and interns. The participants were asked to rate the difficulty level of each of the eight tooth extraction cases. The self-perceived confidence of the participants to perform extraction of each was also explored. Finally, the participants were asked to identify the main reason for the perceived lack of confidence. RESULTS: A total of 199 responded to the survey, yielding a response rate of 94.7%. The effect of grade of extraction (the expert rating of cases) and stage of education on difficulty ratings was assessed using a mixed three stage of education × 4-grade ANOVA, with response (Difficult = 1, Easy = 0) as the dependent variable. The results showed that there was a correlation between the stage of education and grade of extraction and affected the self-perceived confidence of the participants. Gender showed a significant impact with females categorizing significantly more cases as difficult. A three-way contingency table (counts of each confidence-level response by stage of education by expert rating of cases) suggests a statistically significant association between the three factors. Most participants identified limited clinical exposure as the main reason for their perceived lack of confidence. CONCLUSION: The findings of this study show that a majority of the participants were able to recognize tooth extraction cases which were beyond the scope of their training stage with females reporting a lower confidence. Increased clinical exposure to a wider range of tooth extraction cases with varying levels of difficulty may contribute to improving the self-confidence of undergraduate dental students and interns.


Assuntos
Educação em Odontologia , Estudantes de Odontologia , Feminino , Humanos , Estudos Transversais , Extração Dentária , Assistência Odontológica , Competência Clínica
8.
Eur J Dent Educ ; 28(1): 206-211, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37550893

RESUMO

INTRODUCTION: Open-source generative artificial intelligence (AI) applications are fast-transforming access to information and allow students to prepare assignments and offer quite accurate responses to a wide range of exam questions which are routinely used in assessments of students across the board including undergraduate dental students. This study aims to evaluate the performance of Chat Generative Pre-trained Transformer (ChatGPT), a generative AI-based application, on a wide range of assessments used in contemporary healthcare education and discusses the implications for undergraduate dental education. MATERIALS AND METHODS: This was an exploratory study investigating the accuracy of ChatGPT to attempt a range of recognised assessments in healthcare education curricula. A total of 50 independent items encompassing 50 different learning outcomes (n = 10 per item) were developed by the research team. These included 10 separate items based on each of the five commonly used question formats including multiple-choice questions (MCQs); short-answer questions (SAQs); short essay questions (SEQs); single true/false questions; and fill in the blanks items. Chat GPT was used to attempt each of these 50 questions. In addition, ChatGPT was used to generate reflective reports based on multisource feedback; research methodology; and critical appraisal of the literature. RESULTS: ChatGPT application provided accurate responses to majority of knowledge-based assessments based on MCQs, SAQs, SEQs, true/false and fill in the blanks items. However, it was only able to answer text-based questions and did not allow processing of questions based on images. Responses generated to written assignments were also satisfactory apart from those for critical appraisal of literature. Word count was the key limitation observed in outputs generated by the free version of ChatGPT. CONCLUSION: Notwithstanding their current limitations, generative AI-based applications have the potential to revolutionise virtual learning. Instead of treating it as a threat, healthcare educators need to adapt teaching and assessments in medical and dental education to the benefits of the learners while mitigating against dishonest use of AI-based technology.


Assuntos
Inteligência Artificial , Estudantes de Odontologia , Humanos , Educação em Odontologia , Aprendizagem , Currículo
9.
SLAS Discov ; 29(2): 100129, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38101570

RESUMO

Combination therapies have improved outcomes for patients with acute myeloid leukemia (AML). However, these patients still have poor overall survival. Although many combination therapies are identified with high-throughput screening (HTS), these approaches are constrained to disease models that can be grown in large volumes (e.g., immortalized cell lines), which have limited translational utility. To identify more effective and personalized treatments, we need better strategies for screening and exploring potential combination therapies. Our objective was to develop an HTS platform for identifying effective combination therapies with highly translatable ex vivo disease models that use size-limited, primary samples from patients with leukemia (AML and myelodysplastic syndrome). We developed a system, ComboFlow, that comprises three main components: MiniFlow, ComboPooler, and AutoGater. MiniFlow conducts ex vivo drug screening with a miniaturized flow-cytometry assay that uses minimal amounts of patient sample to maximize throughput. ComboPooler incorporates computational methods to design efficient screens of pooled drug combinations. AutoGater is an automated gating classifier for flow cytometry that uses machine learning to rapidly analyze the large datasets generated by the assay. We used ComboFlow to efficiently screen more than 3000 drug combinations across 20 patient samples using only 6 million cells per patient sample. In this screen, ComboFlow identified the known synergistic combination of bortezomib and panobinostat. ComboFlow also identified a novel drug combination, dactinomycin and fludarabine, that synergistically killed leukemic cells in 35 % of AML samples. This combination also had limited effects in normal, hematopoietic progenitors. In conclusion, ComboFlow enables exploration of massive landscapes of drug combinations that were previously inaccessible in ex vivo models. We envision that ComboFlow can be used to discover more effective and personalized combination therapies for cancers amenable to ex vivo models.


Assuntos
Neoplasias Hematológicas , Leucemia Mieloide Aguda , Humanos , Sinergismo Farmacológico , Combinação de Medicamentos , Leucemia Mieloide Aguda/tratamento farmacológico , Leucemia Mieloide Aguda/metabolismo , Leucemia Mieloide Aguda/patologia , Panobinostat/uso terapêutico , Neoplasias Hematológicas/tratamento farmacológico
10.
Eur J Dent Educ ; 28(2): 559-566, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38098132

RESUMO

INTRODUCTION: Preparedness for independent clinical practice is a core goal of undergraduate dental education. The aim of this study was to evaluate the self-reported preparedness for the dental practice among new dental graduates from a University in the Middle East. METHODS: Following ethics approval, a purposive sampling techniques were used to invite newly qualified dental graduates at a Middle Eastern University. A validated research instrument, namely the Dental Undergraduate Preparedness Assessment Scale (DU-PAS), was used to evaluate the self-perceived preparedness of the participants. Data collection was undertaken online using Google Forms and data were analysed to compute the descriptive statistics, reliability and demographic differences among the participants. RESULTS: A total of 82 participants provided their response yielding a response rate of 68%. The participants included 49 males and 33 females. The overall reliability of DU-PAS was excellent. (α = 0.93). The participants included less than 40% of participants were able independently to prescribe medications, assess orthodontics needs and perform endodontic treatment on multirooted teeth. In addition, more than 65% indicated low confidence in evaluating new dental materials and products, interpreting new research findings and behavioural management of children. CONCLUSION: The present findings identified strengths and weaknesses of new dental graduates from a Middle Eastern university. The participants were confident in basic clinical skills but lower confidence was reported for complex dental procedures. The findings highlight the learning needs of new dental graduates and can serve to inform the undergraduate curriculum to enhance the preparedness of future cohorts of dental graduates.


Assuntos
Currículo , Educação em Odontologia , Masculino , Feminino , Criança , Humanos , Universidades , Reprodutibilidade dos Testes , Estudantes , Competência Clínica , Inquéritos e Questionários
11.
Curr Probl Cardiol ; 49(1 Pt C): 102167, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37871711

RESUMO

BACKGROUND: The effect of sacubitril/valsartan on patients with heart failure (HF) with preserved ejection fraction (HFpEF) is a topic of ongoing debate. METHODS: Medline was queried from inception through the last week of May 2023 for randomized studies assessing the effects of sacubitril/valsartan in patients with HFpEF. For continuous outcomes, we pooled either the geometric mean ratios (gMR) or weighted mean difference (WMD) with 95% confidence intervals (CI). For dichotomous outcomes, we pooled Risk ratios (RR) with 95% CI. RESULTS: Four trials were included (N=8,129). Compared to the control, sacubitril/valsartan was associated with a reduction in NT-proBNP levels (gMR: 0.84, 95% CI 0.80, 0.88) and improvement in KCCQ score (WMD: 0.85, 95% CI: 0.02, 1.67). We observed no differences for HF hospitalization (RR: 0.90, 95% CI: 0.79, 1.01), cardiovascular mortality (RR: 0.83, 95% CI: 0.52, 1.32), all-cause mortality (RR: 0.99, 95% CI: 0.86-1.13) and improvement (RR: 1.15, 95% CI: 0.93, 1.42) or worsening (RR: 0.92, 95% CI: 0.78, 1.09) of NYHA class between the sacubitril/valsartan and comparator group. Sacubitril/valsartan was generally safe, and patients were less likely to have a ≥50% decline in eGFR compared to control (RR: 0.60, 95% CI: 0.39, 0.92). CONCLUSION: Pooled analysis suggests that sacubitril/valsartan reduces natriuretic peptide levels and improves the quality of life in patients with HFpEF, which may translate into better clinical outcomes as observed by a numerical trend towards improvement in major HF outcomes with sacubitril/valsartan therapy.


Assuntos
Insuficiência Cardíaca , Humanos , Angiotensinas/farmacologia , Angiotensinas/uso terapêutico , Insuficiência Cardíaca/tratamento farmacológico , Neprilisina/farmacologia , Neprilisina/uso terapêutico , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Volume Sistólico/fisiologia , Valsartana/uso terapêutico , Valsartana/farmacologia , Antagonistas de Receptores de Angiotensina/farmacologia , Antagonistas de Receptores de Angiotensina/uso terapêutico
12.
BMC Med Educ ; 23(1): 948, 2023 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-38087290

RESUMO

BACKGROUND: Utilization of Virtual Reality haptic simulation (VRHS) to aid in the training of various pre-clinical skills is of recent interest. The aim of this study was to evaluate the impact of VRHS in restorative dentistry on the learning experiences and perceptions of dental students. METHODS: An interventional study design was utilized to recruit third year students. All participants provided informed consents and were randomly divided into two groups. Group 1: Initially performed a Class I cavity preparation with the VRHS, followed by the same exercise using the phantom head/ acrylic typodont teeth in a conventional simulation environment (CSE). Group 2: Initially performed Class I preparations in a CSE, followed by the same exercise using VRHS. Both groups performed the exercises on a lower right first molar. To understand students' perception, an online questionnaire was circulated. Data analysis involved Chi-square tests, independent t-tests and Mann-Whitney U-tests using the R statistical environment package. RESULTS: A total of 23 dental students participated in this study. Although student's perceptions were similar in both groups, a strong agreement that VRHS training might be used to supplement standard pre-clinical training was noted. Advancements to the VRHS hardware and software are required to bridge the gap and provide a smooth transition to clinics. CONCLUSION: Novice dental students generally perceived VRHS as a useful tool for enhancing their manual dexterity. Dental institutions should endorse virtual reality technology with caution, ensuring a planned integration into the curriculum to optimize benefit. Feedback is pivotal to effective learning in simulation-based education, and the triangulation of feedback could serve as a powerful aid to maximize the learning experience.


Assuntos
Tecnologia Háptica , Realidade Virtual , Humanos , Educação em Odontologia , Interface Usuário-Computador , Odontologia , Simulação por Computador , Competência Clínica
14.
Vasc Health Risk Manag ; 19: 691-705, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37941540

RESUMO

Sexual dysfunction pertains to any issue that hinders an individual from attaining sexual contentment. This health issue can have a significant impact on the quality of life and psychological health of affected individuals. Sexual dysfunction can generate stress, anxiety, depression, and low self-esteem, which can lead to a reduction in overall life satisfaction and the quality of interpersonal relationships. Sexual dysfunction can manifest as erectile dysfunction in men or lack of sexual desire in women. Although both sexes can experience sexual problems, there are some significant differences in the manifestation of sexual dysfunction between men and women. In men, sexual dysfunction is usually physical and associated with problems such as erectile dysfunction, while in women, sexual dysfunction is usually related to psychological factors. Additionally, there was an association between hypertension and sexual dysfunction in both the sexes. In men, hypertension can cause erection problems, whereas in women, it can cause vaginal dryness and a decrease in sexual desire. Furthermore, antihypertensive drugs can negatively impact sexual function, which can decrease adherence to drug treatment. However, nebivolol, an antihypertensive drug, has beneficial effects on erectile dysfunction in men. This is believed to be because nebivolol improves blood flow to the penis by producing nitric oxide, which can help improve erections.


Assuntos
Disfunção Erétil , Hipertensão , Masculino , Humanos , Feminino , Anti-Hipertensivos/efeitos adversos , Disfunção Erétil/diagnóstico , Disfunção Erétil/tratamento farmacológico , Disfunção Erétil/epidemiologia , Nebivolol/uso terapêutico , Qualidade de Vida/psicologia , Hipertensão/diagnóstico , Hipertensão/tratamento farmacológico , Hipertensão/epidemiologia
15.
JCO Precis Oncol ; 7: e2300302, 2023 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-37944074

RESUMO

PURPOSE: Juvenile myelomonocytic leukemia (JMML) is an aggressive pediatric malignancy with myelodysplastic and myeloproliferative features. Curative treatment is restricted to hematopoietic stem-cell transplantation. Fludarabine combined with cytarabine (FLA) and 5-azacitidine (AZA) monotherapy are commonly used pre-transplant therapies. Here, we present a drug screening strategy using a flow cytometry-based precision medicine platform to identify potential additional therapeutic vulnerabilities. METHODS: We screened 120 dual- and 10 triple-drug combinations (DCs) on peripheral blood (n = 21) or bone marrow (n = 6) samples from 27 children with JMML to identify DCs more effectively reducing leukemic cells than the DCs' components on their own. If fewer leukemic cells survived a DC ex vivo treatment compared with that DC's most effective component alone, the drug effect was referred to as cooperative. The difference between the two resistant fractions is the effect size. RESULTS: We identified 26 dual- and one triple-DC more effective than their components. The differentiation agent tretinoin (TRET; all-trans retinoic acid) reduced the resistant fraction of FLA in 19/21 (90%) samples (decrease from 15% [2%-61%] to 11% [2%-50%] with a mean effect size of 3.8% [0.5%-11%]), and of AZA in 19/25 (76%) samples (decrease from 69% [34%-100+%] to 47% [17%-83%] with a mean effect size of 16% [0.3%-40%]). Among the resistant fractions, the mean proportion of CD38+ cells increased from 7% (0.03%-25%; FLA) to 17% (0.3%-38%; FLA + TRET) or from 10% (0.2%-31%; AZA) to 51% (0.8%-88%; AZA + TRET). CONCLUSION: TRET enhanced the effects of FLA and AZA in ex vivo assays with primary JMML samples.


Assuntos
Transplante de Células-Tronco Hematopoéticas , Leucemia Mielomonocítica Juvenil , Criança , Humanos , Leucemia Mielomonocítica Juvenil/tratamento farmacológico , Leucemia Mielomonocítica Juvenil/diagnóstico , Leucemia Mielomonocítica Juvenil/patologia , Tretinoína/farmacologia , Tretinoína/uso terapêutico , Azacitidina/uso terapêutico
16.
BMC Oral Health ; 23(1): 924, 2023 11 25.
Artigo em Inglês | MEDLINE | ID: mdl-38007460

RESUMO

BACKGROUND: Oral health of preschool children remains a concern globally. Primary healthcare providers are in a vital position to support preventive oral care programmes. This study explored current practices, perception and barriers of primary health care professionals towards oral health promotion program of children in Qatar. METHODS: The qualitative research used focus group discussions and interviewed a total of 108 participants that were audio recorded and transcribed verbatim. Four major themes emerged and were analysed to explore contextual patterns within the data. RESULTS: Participants acknowledged the high prevalence of caries in children and identified the causes in the local context which included parental practices, poor dietary habits, impact of culture lack of oral health knowledge, limitations in the healthcare system, and negative role of the media. However, complex barriers were exposed, including lack of time and ownership, system coordination between organizations, and lack of policy. CONCLUSION: Health professionals and bureaucrats involved in decision-making held a positive attitude towards oral health prevention programs and were enthusiastic to initiate and support these programs.


Assuntos
Cárie Dentária , Saúde Bucal , Pré-Escolar , Humanos , Promoção da Saúde , Catar , Cárie Dentária/prevenção & controle , Pesquisa Qualitativa , Atenção Primária à Saúde
17.
Ann Med ; 55(2): 2276816, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37930932

RESUMO

BACKGROUND/AIMS: Acute pancreatitis is a common condition of the digestive system, but sometimes it develops into severe cases. In about 10-20% of patients, necrosis of the pancreas or its periphery occurs. Although most have aseptic necrosis, 30% of cases will develop infectious necrotizing pancreatitis. Infected necrotizing pancreatitis (INP) requires a critical treatment approach. Minimally invasive surgical approach (MIS) and endoscopy are the management methods. This meta-analysis compares the outcomes of MIS and endoscopic treatments. METHODS: We searched a medical database until December 2022 to compare the results of endoscopic and MIS procedures for INP. We selected eligible randomized controlled trials (RCTs) that reported treatment complications for the meta-analysis. RESULTS: Five RCTs comparing a total of 284 patients were included in the meta-analysis. Among them, 139 patients underwent MIS, while 145 underwent endoscopic procedures. The results showed significant differences (p < 0.05) in the risk ratios (RRs) for major complications (RR: 0.69, 95% confidence interval (CI): 0.49-0.97), new onset of organ failure (RR: 0.29, 95% CI: 0.11-0.82), surgical site infection (RR: 0.26, 95% CI: 0.07-0.92), fistula or perforation (RR: 0.27, 95% CI: 0.12-0.64), and pancreatic fistula (RR: 0.14, 95% CI: 0.05-0.45). The hospital stay was significantly shorter for the endoscopic group compared to the MIS group, with a mean difference of 6.74 days (95% CI: -12.94 to -0.54). There were no significant differences (p > 0.05) in the RR for death, bleeding, incisional hernia, percutaneous drainage, pancreatic endocrine deficiency, pancreatic exocrine deficiency, or the need for enzyme use. CONCLUSIONS: Endoscopic management of INP performs better compared to surgical treatment due to its lower complication rate and higher patient life quality.


Assuntos
Endoscopia , Pancreatite Necrosante Aguda , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Endoscopia/métodos , Pancreatite Necrosante Aguda/cirurgia , Pâncreas/cirurgia , Necrose , Resultado do Tratamento
18.
BMC Sports Sci Med Rehabil ; 15(1): 160, 2023 Nov 27.
Artigo em Inglês | MEDLINE | ID: mdl-38008712

RESUMO

BACKGROUND: Complex training is found effective in improving physical performance in various sports. There is a paucity of research evidence comparing the efficacy of complex vs. plyometric training in cricket players. The study aimed to compare the efficacy of complex and plyometric training on physical performance parameters in cricket players. METHODS: Participants (n = 42 Male; age group = 18-26 years) were randomly allocated into three groups, complex training group (CTG) (n = 14; BMI = 20.51 ± 2.23), plyometric training group (PTG) (n = 14; BMI = 20.57 ± 2.82), and control group (CG) (n = 14; BMI = 20.51 ± 2.23). CTG and PTG received their respective training twice weekly, and CG received routine training for four weeks. Pre and post-intervention assessments of core muscle strength (CM), multistage fitness (MF), push-up (PU), lateral cone jump (LCJ), and stationary vertical jump (SVJ) were performed. This study has been registered in clinicaltrials.gov (ID: NCT05646914, on 05/12/2022). RESULTS: A significant difference was observed between CTG vs. CG for CM (p ≤ 0.01), LCJ (p < 0.05), and SVJ (p ≤ 0.01), similarly in PTG vs. CG for CM (p-value), LCJ (p ≤ 0.05) and SVJ (p ≤ 0.01). However, No significant difference was found between PTG vs. CTG for any variables (p ≥ 0.05). Also, No significant difference in MF and PU was found between the groups (p ≥ 0.05). CONCLUSIONS: Complex training has been found to have effects similar to plyometric training alone. Therefore, either of the two strategies can be used to improve the performance of male cricket players.

19.
Clin Cosmet Investig Dermatol ; 16: 2957-2963, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37876381

RESUMO

Background: Hypertrophic scars, commonly occurring after trauma or surgery in critical areas like the head and joints, pose significant challenges to both physical and mental health due to their impact on skin function and aesthetics. While the complex pathogenesis involves fibroblast activation and collagen deposition, effective treatments are lacking, underscoring the importance of exploring pathogenesis and targeted therapies. Hesperidin, a bioactive compound in citrus fruits with diverse health benefits, including anti-fibrotic and anti-angiogenic effects, is the focus of this study with the aim of investigating its impact on hypertrophic scar formation, given its potential to promote blood flow and improve skin microcirculation. Objective: This study aimed to observe the inhibitory effect of topical hesperidin on hypertrophic scars in rabbits. Methods: A total of 8 healthy adult New Zealand white rabbits were used to establish a rabbit hypertrophic scarring animal model. Five wounds were created on each rabbit's two ears, with three wounds on the left ear (groups A, B, and C) and two wounds on the right ear (groups D and E). After six days of wound drying postoperatively, the wounds were locally treated with medication as followed: group A, 0.1% hesperidin; group B, 1% hesperidin; group C, 1% triamcinolone acetonide; group D, Vaseline; and group E, blank control without any medication. After 28 days, the scar tissue samples were collected for histological examination. Results: The results showed that the scar texture of groups B and C was softer and lighter in color, and the number of fibroblasts, capillaries, and inflammatory cells in the tissue was significantly less than those in the other three groups. The hypertrophic scar indices of groups B and C were significantly smaller than those of groups A, D, and E, and the difference was statistically significant (P < 0.05). There were no significant difference between groups B and C. Conclusion: Topical application of hesperidin demonstrated promising potential for reducing hypertrophic scar formation in rabbits.

20.
Evid Based Dent ; 24(4): 184-185, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37864016

RESUMO

DATA SOURCES: The following databases were searched for publications up to May 2020: Web of Science, EMBASE, CENTRAL, Medline and CINAHL. Additionally, previously published reviews were hand searched. STUDY SELECTION: Clinical studies conducted in English language were considered, encompassing cohorts of more than four vaping individuals who have encountered inadvertent side effects. Both adult and paediatric populations were included. In vitro, animal studies and systematic or literature reviews were excluded from the analysis. DATA EXTRACTION AND SYNTHESIS: Two independent reviewers screened 1125 studies following deduplication. Two-hundred and eight full-text studies were assessed for eligibility. RESULTS: Thirty-two studies met the inclusion criteria. Diverse study designs were included, comprising of cross-sectional, randomised controlled trials, case-control studies, cohort studies, case series investigations and non-randomised trials. Of note, four studies focused on paediatric patients. Most reported side effects were cough, throat and mouth irritation and intra-oral lesions. CONCLUSIONS: While the direct side effects of e-cigarettes are well-documented, the long-term effects remain uncertain.


Assuntos
Sistemas Eletrônicos de Liberação de Nicotina , Otolaringologia , Vaping , Adulto , Criança , Humanos , Estudos Transversais , Faringe , Vaping/efeitos adversos
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