Tuesday, May 17, 2022

Oral swabs tested with Xpert MTB/RIF Ultra for diagnosis of pulmonary tuberculosis in children: a diagnostic accuracy study

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Abstract
Background
Microbiological diagnosis of childhood tuberculosis may be difficult. Oral swabs are a potential non-invasive alternative to sputum for diagnosis.
Methods
A prospective diagnostic accuracy study of oral swabs (buccal and tongue) for pulmonary tuberculosis (PTB) diagnosis in children (aged ≤15 years) in two South African hospital sites. Children with cough of any duration and either: a positive tuberculin skin test, TB contact, loss of weight or chest X-ray suggestive of PTB were enrolled. Two induced sputum specimens were tested with Xpert MTB/RIF (or Ultra) and liquid culture. Oral swabs were taken preceding sputum, frozen and later tested with Xpert MTB/RIF Ultra. Children were classified as microbiologically confirmed TB, Unconfirmed TB (received TB treatment) or unlikely TB according to NIH consensus definitions based on sputum microbiological results.
Results
Among 291 participants (median age 32 [IQR 14-73] months), 57 (20%) were living with HIV and 87 (30%) were malnourished. 90 (31%) had confirmed PTB (six (7%) with rifampicin-resistant TB), 157 (54%) unconfirmed PTB and 44 (15%) unlikely TB. One oral swab was obtained from 126 (43%) participants (96 tongue, 30 buccal) and two swabs from 165 (57%) (110 tongue, 55 buccal). Sensitivity was low; 22% (95% CI 15-32) for all swabs combined (confirmed PTB as reference), but specificity was high (100%, 95% CI 91-100). The highest sensitivity was 33% (15-58) among participants living with HIV. Overall yield was 6.9% with one oral swab, and 7.2% with two.
Conclusions
Ultra on oral swabs provides poor yield for microbiologic PTB confirmation in children.
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Effects of different universal adhesives and surface treatments on repair bond strength between resin composites

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Objective

This study aimed to evaluate the effects of different universal adhesives and surface treatments on the repair bond strength between resin composites.

Materials and Methods

A total of 220 composite samples were divided into three groups according to the adhesive resin to be applied: 1) Scotchbond Universal, 2) G-Premio Bond, and 3) Peak Universal Bond. They were then divided into seven subgroups according to surface treatments (n = 10): A) air abrasion, B) air abrasion+silane, C) hydrofluoric acid, D) hydrofluoric acid+silane, E) air abrasion+hydrofluoric acid+silane, F) silane, and G) no surface treatment (negative control). After surface treatment, a repair composite was applied. Samples aged in the thermocycle were subjected to micro-tensile bond strength testing. Cohesive strength values of 10 non-aged composite blocks were used as a positive control. Kruskal–Wallis and one-way ANOVA tests were used for statistical evaluation. Fractured surfaces were evaluated using a scanning electron microscope.

Results

In Scotchbond Universal and G-Premio Bond, the mean micro-tensile bond strength value of the no surface treatment subgroup was significantly lower than that of the positive control. All subgroups of Peak Universal Bond showed similar values to the positive control.

Conclusion

While Scotchbond Universal and G-Premio Bond required mechanical roughening before adhesive application, Peak Universal Bond did not require any surface treatment.

Clinical Significance

Different universal adhesives may show different repair bonding strengths with different surface treatments. Since achieving a standard in this regard can be associated with many independent factors, clinicians should determine how to apply the adhesive they use most effectively with the most appropriate surface treatment based on their own clinical experience.

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The Conventional Technique Versus the No-touch Isolation Technique for Primary Tumor Resection in Patients With Colon Cancer (JCOG1006): A Multicenter, Open-label, Randomized, Phase III Trial

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imageObjective: This phase III trial evaluated whether the no touch was superior to the conventional in patients with cT3/T4 colon cancer. Background: No touch involves ligating blood vessels that feed the primary tumor to limit cancer cell spreading. However, previous studies did not confirm the efficacy of the no touch. Methods: This open-label, randomized, phase III trial was conducted at 30 Japanese centers. The eligibility criteria were histologically proven colon cancer; clinical classification of T3–4, N0–2, andM0; and patients aged 20 to 80years. Patients were randomized (1:1) to undergo open surgery with conventional or the no touch. Patients with pathological stage III disease received adjuvant capecitabine chemotherapy. The primary endpoint was disease-free survival (DFS) according to the intention-to-treat principle. Results: Between January 2011 and November 2015, 853 patients were randomized to the conventional group (427 patients) or the no touch group (426 patients). The 3-year DFS were 77.3% [95% confidence interval (CI) 73.1%–81.0%] and 76.2% (95% CI 71.9%–80.0%) in the conventional and no touch groups, respectively. The superiority of no touch was not confirmed: hazard ratio for DFS = 1.029 (95% CI 0.800– 1.324; 1-sided P = 0.59). Operative morbidity was observed in 31 of 427 conventional patients (7%) and 26 of 426 no touch patients (6%). All grade adverse events were similar between the conventional and no touch groups. No in-hospital mortality occurred in either group. Conclusion: The present study failed to confirm the superiority of the no touch.
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Relationship between meteorological factors, air pollutants and hand, foot and mouth disease from 2014 to 2020

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Meteorological factors and air pollutants have been reported to be associated with hand, foot, and mouth disease (HFMD) epidemics before the introduction of vaccine. However, there is limited evidence for stud...
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Effects of Adolescent-Focused Integrated Social Protection on depression: A Pragmatic Cluster-Randomized Controlled Trial of Tanzania’s Cash Plus Intervention

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Abstract
We assessed the impacts of Tanzania's Cash Plus adolescent-focused intervention on depression. In this pragmatic cluster-randomized controlled trial, 130 villages were randomly allocated to intervention or control (1:1). Youth aged 14-19 years living in households receiving governmental cash transfers were invited to participate. The intervention included an intensive period (12-session course) and aftercare period (9-months mentoring, productive grants, and strengthened health services). We examined intervention impacts on the 10-item Centre for Epidemiological Studies Depression Scale (0-30) and exhibiting depressive symptomatology (≥10 scale), which were collected at baseline (April-June 2017), midline (May-July 2018), and endline (June-August 2019). Using intention-to-treat methodology, logistic and generalized linear models estimated effects for binary and continuous outcomes, respectively. Quantile regressions (QR) estimated effects acr oss the scale. From 2458 baseline participants, 941 intervention and 992 control adolescents were re-interviewed at both follow-ups. At endline, the intervention reduced the odds of depressive symptomatology (adjusted odds ratio 0.67 [95% CI 0.52 to 0.86]), with an undetectable mean scale difference (effect -0.36 [95%CI -0.84 to 0.11]). QR results demonstrated an intervention effect along the upper distribution of the scale. Integration of multi-sectoral initiatives within existing social protection shows potential to improve mental health among youth in low-resource settings.
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The influence of implant design on implant stability in low‐density bone under guided surgical template in inexperienced surgeons: A pilot randomized controlled clinical trial using resonance frequency analysis

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Abstract

Introduction

There are several factors that greatly influence implant stability with implant design being a paramount factor; however, few studies investigate its impact.

Aim

To investigate the implant stability in relation to two different implant designs, a cylindrical shaped single-threaded design (CS/ST) and a tapered shaped double-threaded design (TS/DT) using resonance frequency analysis over the first 8 weeks after implantation.

Materials and Methods

Twenty-eight implants were randomly allocated using computer-generated random numbers into two groups and were placed as single tooth implant in the posterior arch in human jaw as specimens. iCAT™ CBCT scan (Hatfield, PA) was used to determine the bone density according to Misch's Bone classification. The osseotomy sites were prepared and implants were placed with guided surgical template by inexperienced surgeons which were prepared with the same implant planning software (3shape® implant studio). The implant stability was measured using the resonance frequency analysis Osstell® ISQ (Osstell AB, Sweden) on the implant level over the first 8 weeks at three different time intervals. A mean implant stability quotient (ISQ) value was recorded at each measurement time points. The first ISQ of each implant recorded at the time of implant placement were considered as baseline and were the so-called primary stability.

Results

All 28 dental implants were analyzed. A similar pattern of implant stability changes was observed in both implant designs. A significant decreased was found at the first 4 weeks after implantation (p < 0.05) before ascending to maximum cumulative stability by the eighth week (p < 0.05). Between the two groups, TS/DT group had a higher mean ISQ values than that of the CS/ST group at all three observation periods but did not reach statistical significance (p = 0.69). Regarding different types of bone, TS/DT showed a significant difference in mean ISQ values in D4 bone. To date, all 28 implants are in function with no failure/and or complications.

Conclusions

The difference in implant design did not significantly influence the implant stability. TS/DT shows superiority over CS/ST when placed in D4 bone and offer a significant advantage due to their positive bounce back of the ISQ values by the eighth week after implant installation.

Clinical Trial Registration: TCTR20211020005.

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