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Τετάρτη 8 Ιουνίου 2022

Prevalence of antibiotic resistance genes in the oral cavity and mobile genetic elements that disseminate antimicrobial resistance: A systematic review

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Abstract

Objective

To assess the prevalence of antibiotic resistance genes in the oral cavity and identify mobile genetic elements (MGEs) important in disseminating them. Additionally, to assess if age, geographic location, oral site, bacterial strains and oral disease influence the prevalence of these genes.

Methods

Three electronic databases (Medline, Embase and the Cochrane Library) were used to search the literature. Journals and the grey literature were also hand-searched. English language studies from January 2000 to November 2020 were selected. Primary screening was performed on the titles and abstracts of 1509 articles generated. One hundred and forty-seven full texts were obtained to conduct the second screening with strict inclusion and exclusion criteria.

Results

Forty-four final articles agreed with the inclusion criteria. Half of the studies were classed as low quality. tet(M) was the most prevalent gene overall and the conjugative transposon Tn916 the most common mobile genetic element associated with antibiotic resistance genes in the oral cavity. In babies delivered vaginally tet(M) was more prevalent, whilst tet(Q) was more prevalent in those delivered by C- section. Generally, countries with higher consumption of antibiotics had higher numbers of antibiotic resistance genes. Agricultural as well as medical use of antibiotics in a country should always be considered. Between healthy, periodontitis and peri-implantitis subjects, there was no difference in the prevalence of tet(M) however erm(B), tet(M) and tet(O) was higher in carious active children than the non-carious group. Subjects with poor oral hygiene have more pathogenic bacteria that carry resistance genes compared to those with good oral hygiene. E. faecalis isolates demonstrated significant tetracycline resistance (tet(M) up to 60% prevalence in samples) and erythromycin resistance (erm(B) up to 61.9% prevalence in samples), periodontal pathogens showed significant beta-lactam resistance with blaZ and cfxA present in up to 90–97% of samples and the normal oral flora had a high level of erythromycin resistance with mef(A/E) present in 65% of S. salivarius isolates. The most common resistance gene was tet(M) in root canals, cfxA in subgingival plaque erm(B) in supragingival plaque and tet(W) in 100% of whole saliva samples.

Conclusions

The review highlights that although many studies in this area have been performed, 50% were classed as low quality. We advise the following recommendations to allow firm conclusions to be drawn from future work: the use of large sample sizes, investigate a broad range of antibiotic resistance genes, improved methodologies and reporting to improve the quality of genetic testing in microbiology and randomisation of subject selection.

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Influence of bone morphology on the mechanobiological stimuli distribution of maxillary anterior labial bone: A biomechanical study

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Abstract

Objective

This study intended to ascertain the dimensional effects of labial bone thickness and height on the mechanobiological stimuli distribution of maxillary anterior labial bone through biomechanical analysis.

Material and methods

Twelve 3D finite element models of an anterior maxillary region with an implant were computer-simulated, including four levels of labial bone thicknesses (2, 1.5, 1.0, and 0.5 mm) and three levels of labial bone heights (normal, reduced by 1/3, reduced by 1/2). A 45° buccolingual oblique load of 100 N was applied to the implant restoration.

Results

Equivalent stress and principal strain mainly concentrated on crestal bone around the implant neck. The maximum equivalent stress in bone decreased as labial bone mass decreased, while the maximum principal strain and the displacement of dental implant increased as labial bone mass decreased. No significant difference of these three indicators was observed, when the labial bone thickness changed in the range of 2.0–1.0 mm with sufficient labial bone height.

Conclusions

In terms of biomechanics, the thickness of labial bone plate was recommended ≥1 mm. Sufficient labial bone height was warranted to prevent the stability of the implants from being seriously affected. The labial bone heights were more effective than thicknesses on the mechanobiological stimuli response of the dental implant-bone system.

Clinical significance

For this 3D finite element study, the biomechanical responses under different bone mass conditions were explored, in order to predict the process of bone remodeling and provide valid clinical recommendations for the decision-making process regarding the choices of tissue augmentation for some specific esthetic implantation cases for future clinical applications.

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Data Analytics for Diagnosis and Prediction of Central Line–Associated Bloodstream Infections in Critical Care Units

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imageCentral line–associated bloodstream infections are among the leading causes of in-hospital deaths in the United States and are a significant factor for increased morbidity, mortality, and healthcare costs. This study integrates several hospital data systems into a case-controlled database to use data analytics for the identification of significant central line–associated bloodstream infection risk factors and develop time-varying patient risk scores for central line–associated bloodstream infections. A case-control study was performed utilizing patient data collected from various sources then gathered and organi zed into a case-controlled dataset for analysis examining various patient-specific attributes for central line–associated bloodstream infections. Training and testing sets were created, and multivariate logistic regressions were used to identify risk factors for central line–associated bloodstream infection. Furthermore, the Cox proportional hazards model was used to infer the hazard rate and risk score for central line–associated bloodstream infections for each individual patient during hospitalization. Significant attributes for central line–associated bloodstream infection cases were the ICU location (P = .008), time from insertion (P ≤ .001), number of surgeries (P = .003), and number of central line manipulations (P = .003). Real-time data analytics and point of care at the bedside can facilitate precision care for patients with an elevated central line–associated bloodstream infection risk, subsequently changing the way healthcare prevents hospital-acquired infecti ons.
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Effect of Telehealth Interventions on Blood Pressure Control: A Meta-analysis

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imageThe aim of this study was to find out the effects of telehealth interventions on blood pressure control by conducting a meta-analysis. Six databases were used. The literature review covered the period between December 1, 2020, and January 26, 2021. The meta-analysis was conducted by comprehensive Meta-Analysis Software version 2.2. Categorical variables were analyzed by odds ratios at a confidence interval of 95%. In data formatting and analysis, independent groups (sample size, P value); independent groups (mean, SD); Cohen's d, SE; and paired groups (N, P value) were used. The bias risk was assessed based on the Revise d Cochrane Risk-of-Bias Tool for Randomized Trials. Total sample size including 22 studies was 11 120. It was determined that interventions performed through telehealth applications had a significant effect on blood pressure control (odds ratio = −0.14; 95% confidence interval = −0.20 to −0.08; P
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In Vitro Analysis of Shear Stress: CAD Milled vs Printed Denture Base Resins with Bonded Denture Tooth

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Abstract

Purpose

: As the fabrication of computer-aided design (CAD) milled and 3D printed denture base resins with bonded denture teeth increase in popularity, there is a need for research comparing the shear bond stress of milled and printed denture base resins with bonded denture teeth to that of a conventional heat processed denture base.

Materials and methods

: Denture base resin specimens (n = 9) were fabricated according to manufacturers' instructions using a novel test design. Two milled (Ivobase CAD PMMA, Ivoclar Vivadent and Polident PMMA, Polident Dental) and two 3D printed (Denture Base LP Resin, Formlabs and Lucitone Digital Print, Dentsply Sirona) materials were used. Conventional heat processed polymethylmethacrylate was used as the control (Lucitone 199, Dentsply Sirona, USA). Denture teeth (VITA Vitapan XL T44, #8, VITA Zahnfabrik) were bonded to their respective bases using denture tooth bonding agent (Ivobase CAD bonding system, Ivoclar). Specimens were aged in water for 600 hours at 37˚C and loaded until failure in a Universal testing machine. Shear bond stress was calculated. All specimens were evaluated for mode of failure and select specimens under scanning electron microscope and vertical scanning interferometry. Data were analyzed with one-way ANOVA followed by Tukey test (IBM SPSS) and fracture analysis performe d.

Results

: Shear stress was highest for the heat processed control (mean = 180 N ±26.76) and Polident test groups (mean = 180 N ±34.90). Milled specimens were not significantly different from the control (p = 0.076 for IvoBase CAD and 1.00 for Polident), while the printed groups were significantly different from the control (p = 0.012 for Formlabs Denture Base Resin and p = 000 for Carbon Lucitone Digital Print). Milled denture base resins perform similarly to heat processed denture base resin and better than 3D printed denture bases.

Conclusion

: For complete denture wearers, all resin materials used in this study may be clinically acceptable, as the sheer stress for all groups was higher than the reported maximum biting force of complete denture patients. However, for implant retained prostheses, the incorporation of additional retentive features should be considered when bonding denture teeth to printed bases. More research is needed to evaluate methods to increase the bond strength of denture teeth to printed denture base resins.

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Interdisciplinary Management of a Patient with Dentinogenesis Imperfecta Type II Using a Combination of CAD‐CAM and Analog Techniques: A Clinical Report

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Abstract

Type II dentinogenesis imperfecta is an autosomal dominant condition that affects dentin which increase the complexity of the predictability of the restorative treatment. Computer-aided design and computer-aided manufacturing (CAD-CAM) technologies permit the creation of highly accurate devices and dental prostheses that simplify the planning and execution of advanced implant surgery and full-mouth rehabilitation. This clinical report presents the interdisciplinary management of a 20-year-old male with dentinogenesis imperfecta type II. In this article, a combination of analog and CAD-CAM technologies were used to fabricate devices that aided planning, assisted intermaxillary fixation and implant placement, served as interim prostheses, and permitted the accurate establishment of esthetics and occlusion of the definitive full-arch prostheses.

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Reverse Liver Spleen Uptake on [68Ga]Ga-PSMA-11 PET/CT

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imageAn 80-year-old man underwent [68Ga]Ga-PSMA-11 PET/CT for staging of high-risk prostate cancer. Homogeneously increased liver uptake, more than 3-fold the splenic uptake, was seen. There was no hepatic lesion evident on CT. A higher liver to splenic uptake is more typical of some 18F-labeled PSMA PET/CT but unusual in 68Ga-labeled PSMA PET/CT scan. Further evaluation revealed a history of impaired renal function, bilateral renal atrophy, relatively decreased renal uptake of [68Ga]Ga-PSMA-11, and prominent bowel activity. We concluded that impaired renal function and subsequent poor excretion resulted in increased hepatic excretion, hence the unusual increased homogeneous hepatic uptake.
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COVID‐19 and Platelet Traits: A Bi‐directional Mendelian Randomization Study

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Abstract

Objective

This study aimed to evaluate the host genetic liability of covid-19 with platelet traits using the Mendelian Randomization (MR) approach.

Method

We conducted a bi-directional two-sample MR using summary statistics from the largest genome-wide association study (GWAS) of three covid-19 severity (SARS-CoV-2 infection, covid-19 hospitalization and severe covid, N~1,059,456 to 1,557,411) and four platelet traits (mean platelet volume [MPV], plateletcrit, platelet distribution width, and platelet count; N=408,112). Inverse variance weighted (IVW), median weighted, MR-Egger, and contamination mixture methods were used to estimate the causal association.

Result

Null and inconsistent association in the IVW and sensitivity analyses were observed for SARS-CoV-2 infection and covid-19 hospitalization with platelet traits. For severe covid-19, significant associations with MPV and platelet count were observed in the IVW and sensitivity analyses, w ith the betaIVW of 0.01 (95% CI: 0.005 to 0.016, p-value=3.51x10-4) and -0.009 (95% CI: -0.015 to -0.002, p-value=0.008) per doubling in odds of severe covid-19, respectively. Conversely, null associations were observed for platelet traits with covid-19 traits.

Conclusion

Host genetic liability to severe covid-19 was causally associated with increased MPV and reduced platelet count, which may provide insight in evaluating hypercoagulability and thromboembolic events in covid-19 patients.

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SARS‐CoV‐2and Mutation RT‐qPCR Test Positivity Correlation with ABO and Rh Blood Types

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ABSTRACT

Introduction

Studies show that there may be a relationship between ABO blood type and SARS-CoV-2transmission. It was aimed to determine by investigating the blood type of patients whose one-step reverse transcription and real-time polymerase chain reaction (RT-qPCR) test was positive for Sars-CoV-2.

Materials and Methods

ABO and Rh blood type of individuals whose RT-qPCR test was positive for SARS-CoV-2were examined and an evaluation was made to identify whether there was a relationship between them or not.

Results

The blood type data of 44.928 SARS-CoV-2positive RT-qPCR test results has been obtained. 17.656 (39.29%) were delta, 8048 (17.91%) were alpha, 800 (1.78%) were beta and 3000 (6.67%) were omicrons while 15.424 (34.33%) SARS-CoV-2positive mutation was found to be negative.

Discussion

Our study suggests that O and Rh (-) blood types may provide protection against delta, AB and Rh (+) blood types may hinder omicron infection while A and Rh (+) blood types may be more vulnerable to alpha and delta while B and Rh (+) are more sensitive to beta mutation.

Conclusion

Molecular mechanism underlying the relationship between blood types and SARS-CoV-2infection needs further molecular studies and multi-centered studies.

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