Efficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: A systematic review and meta‐analysis of randomized clinical trials

alexandrossfakianakis shared this article with you from Inoreader Efficacy and safety of carbohydrate counting versus other forms of dietary advice in patients with type 1 diabetes mellitus: A systematic review and meta‐analysis of randomized clinical trials Via Journal of Human Nutrition and Dietetics Abstract Background and aims Diabetes mellitus (DM) is one of the most prevalent chronic non-communicable diseases globally, and the only way to reduce its complications is good glycemic control. Insulin remains the only approved treatment for type 1 DM (T1DM) and is used by many with Type 2 DM (T2DM). Carbohydrate counting is considered the ideal way to calculate meal-related insulin doses since it allows greater flexibility in diet and could, in some people, reduce the burden of the disease. This systematic review's primary objective was to assess carbohydrate counting efficacy in reducing glycated hemoglobin (HbA1c) and safety by not increasing hypoglycemia risk, inducing an increase in body weight or blood lipids, and reducing the quality of life of people with T1DM. Methods We included randomized controlled clinical trials with a parallel-group design comparing any carbohydrate counting forms with standard care or other forms of dietary advice or insulin dose calculation in people with T1DM with a follow up period of at least three months and with no restrictions in language, age, or settings. As a primary outcome, we consider the change of HbA1c within at least three months. Secondary outcomes were hypoglycemia events, body weight changes, blood lipids levels, and the total daily insulin dose. We also evaluated health-related quality of life changes and diabetes treatment satisfaction questionnaires. Results Data from 11 studies with 899 patients were retrieved with a mean follow of 52 ± 35.5 weeks. Carbohydrate counting is not better in reducing HbA1c, SMD – 0.24% (95%CI -0.68 to 0.21) than all dietary advice forms. However, this finding was highly heterogeneous. We identified three studies that account for most of the heterogeneity using clustering algorithms. A second analysis excluding these studies shows a meaningful HbA1c reduction, SMD – 0.52% (95%CI -0.82 to -0.23) with low heterogeneity. In the subgroup analysis, carbohydrate counting significantly reduces HbA1c compared to usual diabetes education. Carbohydrate counting doesn't relate to any substantial change in blood lipids, body weight, hypoglycemia risk, or daily insulin dose. Finally, we analyzed the effect of trial duration with HbA1c reduction and found no significant change related to time. Conclusions Carbohydrate counting is an efficacious technique to safely reduce HbA1c in adults and children compared to standard diabetes education. And its effect doesn't seem to change with prolonged time. Standardization in reporting important outcomes like hypoglycemia and quality of life is vital to produce comparable evidence in carbohydrate counting clinical trials. This SR was registered in PROSPERO under code: CRD42020218499. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anal human papillomavirus infection in kidney transplant recipients compared with immunocompetent controls

alexandrossfakianakis shared this article with you from Inoreader Anal human papillomavirus infection in kidney transplant recipients compared with immunocompetent controls Via Clinical Infectious Diseases Advance Access Abstract Background Kidney transplant recipients (KTRs) have increased risk of human papillomavirus (HPV)-related anogenital (pre-)cancers, including anal high-grade intraepithelial lesions (HSIL) and cancer. Previous studies on anal high-risk HPV among KTRs are sparse. Methods In a cross-sectional study, we included 247 KTRs and 248 controls from a dermatology department and five nephrology departments in Denmark during 2016–2017. All participants underwent a n anal cytobrush sample which was tested for HPV-DNA. Participants completed a questionnaire on lifestyle and sexual habits. We used logistic regression to estimate odds ratios (ORs) of anal hrHPV in KTRs compared with controls and risk factors for anal hrHPV in KTRs. Results The anal hrHPV prevalence was higher in female KTRs (45.5%) than controls (27.2%). Female KTRs had almost three-fold higher adjusted odds of anal hrHPV than controls (ORadjusted = 2.87, 95% confidence interval[CI], 1.57–5.22). In contrast, among men we did not observe increased prevalence or odds of anal hrHPV in KTRs compared with controls (prevalence: 19.4% vs 23.6%; ORadjusted = 0.85, 95%CI, 0.44–1.64). Among hrHPV positive KTRs, 63% and 52% of men and women, respectively, were infected with hrHPV types covered by the nonavalent HPV vaccine (16/18/31/33/45/52/58). Current smoking, >10 lifetime sexual partners, history of genital warts, and among men having had re ceptive anal sex, were risk factors for anal hrHPV in KTRs. Conclusion Female KTRs had increased risk of anal hrHPV compared with immunocompetent controls. Our findings highlight that pre-transplant HPV vaccination should be considered to prevent anal HSIL and cancer caused by anal hrHPV infection in KTRs. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

HIGH RATE OF HCV REINFECTION AMONG RECENTLY INJECTING DRUG USERS: RESULTS FROM THE TRAP HEP C PROGRAM – A PROSPECTIVE NATIONWIDE, POPULATION-BASED STUDY

alexandrossfakianakis shared this article with you from Inoreader HIGH RATE OF HCV REINFECTION AMONG RECENTLY INJECTING DRUG USERS: RESULTS FROM THE TRAP HEP C PROGRAM – A PROSPECTIVE NATIONWIDE, POPULATION-BASED STUDY Via Clinical Infectious Diseases Advance Access Abstract Background The Treatment as Prevention for Hepatitis C program started in 2016 in Iceland, offering treatment with direct-acting antivirals to hepatitis C virus (HCV)-infected individuals. Reinfections through injection drug use (IDU) can hamper elimination efforts. We determined reinfection rates (RIR) of HCV among patients in the program. Methods Clinical data were gathered prospectively. The study cohort consisted of HCV-cured patients with an estima ted sustained virologic response between February 1st 2016 and November 20th 2018, with follow-up until November 20th 2019. The observation period and time until reinfection was estimated using a single random point imputation method coupled with Monte Carlo simulation. The RIR was expressed as reinfections/100 person-years (PYs). Results 640 treatments of 614 patients (417 males, mean age 44.3 years) resulted in cure, with 52 reinfections subsequently confirmed in 50 patients (37 males). Follow-up was 672.1 PYs with median time to reinfection of 231.7 days. History of IDU was reported by 523 patients (84.8%) and recent IDU with 220 (34.4%) treatments. Stimulants were the preferred injected drug in 85.5% of patients with history of IDU. The RIR was 7.7/100 PYs. Using multivariate Cox proportional hazards models for interval-censored data, age (HR 0.96, 95% CI 0.94-0.99) and recent IDU (HR 2.91, 95% CI 1.48-5.76) were significantly associated with reinfection risk. Conclusions The RIR is high in a setting of widespread stimulant use, particularly in young people with recent IDU. Regular follow up is important among high-risk populations to diagnose reinfections early and reduce transmission. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Three-dimensional volumetric analysis of the efficiency of marsupialization in patients with mandibular dentigerous cysts involving impacted third molars

alexandrossfakianakis shared this article with you from Inoreader Three-dimensional volumetric analysis of the efficiency of marsupialization in patients with mandibular dentigerous cysts involving impacted third molars Via ScienceDirect Publication: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Publication date: Available online 18 April 2022 Source: Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology Author(s): Masatoshi Hirayama, Kazushige Inoue, Hidetaka Arita, Nozomu Takahashi, Hikaru Nakashima, Junki Sakata, Manabu Maeshiro, Yuka Nagao, Shunsuke Gohara, Keisuke Yamana, Yuichiro Matsuoka, Akira Yuno, Masafumi Nakamoto, Kenta Kawahara, Masashi Nagata, Akiyuki Hirosue, Daiki Fukuma, Ryoji Yoshida, Hideki Nakayama View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does the Modified Frailty Index (mFI-5) Predict Adverse Outcomes in Maxillofacial Fracture Repair?

alwin shared this article with you from Inoreader Does the Modified Frailty Index (mFI-5) Predict Adverse Outcomes in Maxillofacial Fracture Repair? Via Journal of Oral and Maxillofacial Surgery Frailty has been recognized as a predictor of postoperative adverse outcomes in many surgical subspecialties. The purpose of this study was to evaluate the relationship between frailty and complications in patients undergoing operative repair of facial fractures. (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Efficacy and Safety of Concentrated Growth Factor Fibrin on the Extraction of Mandibular Third Molars: A Prospective, Randomized, Double-Blind Controlled Clinical Study

alwin shared this article with you from Inoreader Efficacy and Safety of Concentrated Growth Factor Fibrin on the Extraction of Mandibular Third Molars: A Prospective, Randomized, Double-Blind Controlled Clinical Study Via Journal of Oral and Maxillofacial Surgery To investigate the efficacy and safety of concentrated growth factor fibrin (CGF) for the extraction of mandibular third molars. (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Reconstruction of Segmental Mandibular Defects with Use of Avascular Fibula Grafts

alwin shared this article with you from Inoreader Reconstruction of Segmental Mandibular Defects with Use of Avascular Fibula Grafts Via Journal of Oral and Maxillofacial Surgery Functional and cosmetic defects involving the maxillofacial complex may result from traumatic injury, developmental deformities, infections, and iatrogenic injury. Reconstruction of large segmental defects with the use of vascularized free flaps has been considered the gold standard in recent years. There are many logistical and economic considerations with vascularized free flaps, and therefore the authors aim to discuss an alternative. After appropriate patient selection, the use of non-vascularized reconstruction techniques has been shown to be effective. (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Does Liposomal Bupivicaine Injection Decrease Postoperative Opioid Usage following Bimaxillary Surgery?

alwin shared this article with you from Inoreader Does Liposomal Bupivicaine Injection Decrease Postoperative Opioid Usage following Bimaxillary Surgery? Via Journal of Oral and Maxillofacial Surgery Among patients undergoing bimaxillary surgery, does the use of liposomal bupivacaine injection reduce the use of opioid analgesics and/or length of hospital admission in the postoperative period? (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Malignant Transformation of Ossifying Fibroma to Juvenile Aggressive Ossifying Fibroma to Fibroblastic Osteosarcoma: A Case Report

alwin shared this article with you from Inoreader Malignant Transformation of Ossifying Fibroma to Juvenile Aggressive Ossifying Fibroma to Fibroblastic Osteosarcoma: A Case Report Via Journal of Oral and Maxillofacial Surgery The researchers present a case of mandibular juvenile ossifying fibroma (JOF) undergoing malignant transformation to fibroblastic osteosarcoma (FOS) and propose to use this unique case report. In contrast to extragnathic OS (osteosarcoma), comprehensive genomic studies of gnathic OS are lacking and, hence, there are no validated diagnostic and therapeutic molecular targets for gnathic OS. Distinguishing fibroblastic OS of the jaws from its close mimics, such as ossifying fibroma (OF) and fibromatosis of the jaws, poses major challenge for pathologists. (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Enlargement of Inferior Alveolar Nerve Canal and Mental Neuropathy Associated with B-cell Lymphoma: A Case Report and Literature Review

alwin shared this article with you from Inoreader Enlargement of Inferior Alveolar Nerve Canal and Mental Neuropathy Associated with B-cell Lymphoma: A Case Report and Literature Review Via Journal of Oral and Maxillofacial Surgery Enlargement of an inferior alveolar nerve canal (IANC) on radiographic imaging can indicate the presence of a wide variety of pathologic entities. Oral and maxillofacial surgeons have the unique opportunity to regularly examine panoramic radiographs, and must exercise proficient clinical judgement when noting abnormal findings on imaging. While malignant processes associated with IANC enlargement are uncommon, these pathologies do occur and may be associated with significant sequelae, especially when accompanied by a delay in diagnosis in treatment. (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Mortality and Associated Variables of Full-mouth Extractions

alwin shared this article with you from Inoreader Mortality and Associated Variables of Full-mouth Extractions Via Journal of Oral and Maxillofacial Surgery Full-mouth extractions (FMEs) are common procedures that are classically performed electively due to caries and periodontal disease. Up to 17% of adults over the age of 65 and 2% of adults aged 20-64 in the United States are edentulous. At the University of Cincinnati Medical Center, approximately 250 FMEs are performed annually with nearly half performed on adults over the age of 50. There is currently an absence of data on this patient population and their overall outcomes. The authors hypothesize that FMEs are often performed on socioeconomically and medically vulnerable populations, thereby further compromising their conditions and potentially contributing to their demise. (Source: Journal of Oral and Maxillofacial Surgery) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Evaluation of Clinical Significance of Lymphovascular Space Invasion in Stage IA Endometrial Cancer

alwin shared this article with you from Inoreader Evaluation of Clinical Significance of Lymphovascular Space Invasion in Stage IA Endometrial Cancer Via Oncology Conclusion: LVSI was not a prognostic factor of not only stage IA endometrial cancer, but also stage IA low-grade cancer. (Source: Oncology) View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.