COVID-19 and Oral Surgery: a narrative review of preoperative mouth rinses

Cilj: Obaviti narativni pregled predloženih preoperativnih protokola za ispiranje usne šupljine prije oralno-kirurških zahvata da bi se u aerosolu suzbila pojavnosti virusa SARS-CoV-2. Izvori: Pretražene su znanstvene baze podataka PubMed, MedLine, CINAHN i Scopus kako bi se pronašli relevantni radovi objavljeni do trećeg tjedna travnja 2020. godine. Ovo istraživanje dopunjeno je pretraživanjem putem internetske tražilice te ručnim pretraživanjem međunarodnih i nacionalnih smjernica. Odabir istraživanja: Uključena su istraživanja i protokoli u kojima se predlaže preoperativno ispiranje usta kao mjera tijekom pandemije virusa COVID-19. S obzirom na to da je dostupan mali broj istraživanja, obavljen je pregled narativne literature. Ukupno se 15 referencija (11 članaka i 4 smjernice) smatralo mjerodavnima i kritički je analizirano. Zaključak: Rezultati pokazuju visoku heterogenost u predloženim protokolima. Potrebna su daljnja istraživanja da bi se bolje razumjele značajke i epidemiološka obilježja novog virusa te da bi se ispitala učinkovitost uobičajenih antiseptika protiv virusa SARS-CoV-2 u budućim kliničkim ispitivanjima. No upotreba klorheksidina, vodikova peroksida, providon-jodida i cetilpiridinijeva klorida, sa svrhom prevencije širenja bolesti uzrokovane virusom COVID-19, u različitim je časopisima opisana kao poželjna.Objective: To provide a narrative review of the preprocedural mouth rinse protocols suggested for oral surgery in order to contrast the presence of SARS-CoV-2 in aerosol. Sources and Methods: Electronic searches were performed in medical databases PubMed, Medline, CINAHN and Scopus to identify relevant studies published up until the third week of April 2020. This research was supplemented by exploration through a web-based search engine as well as a manual search for international and national guidelines. Studies and protocols which suggested preoperative mouth rinsing as a recommended measure during the COVID-19 outbreak were included. Given the small number of studies, a narrative literature review was conducted. In total, 15 references (11 articles and 4 guidelines) were considered relevant and were critically analysed. Conclusion: The findings show a high heterogeneity in the protocols suggested. Further research is required to better understand the viral features and epidemiologic characteristics of this new virus and to test the efficacy of commonly used antiseptics against SARS-CoV-2 in future clinical trials. However, the use of chlorhexidine, hydrogen peroxide, PVP-I and cetylpyridinium chloride in contrasting the spread of Covid-19 is described as advisable and substantial in different publications

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Ten-year results of a Screening Program during pregnancy for children’s dental caries prophylaxis

Introduction: Dental caries is a multifactorial disease with many contributing factors in the genesis of risk (11). Streptococcus mutans (SM) is a gram positive, facultative anaerobe commonly found in the human oral cavity. Described for the first time in 1924 by Clarke, is the main germ responsible for the caries disease (5, 9). In fact, SM produces an insoluble extracellular polysaccharide sucrose which plays an important role as a mediator of the adhesiveness, both as a cementing molecule for other microorganisms, and to create a protected site where the microorganism can proliferate (6, 9, 10). Its presence in the plaque is not equal for all people and is closely related to sugar consumption (9). Its transmission can take place early in the life of the child through the mother’s saliva (2, 3, 4, 8).The early acquisition of this organism is associated with Early Childhood Caries (ECC) and then creates a primary colonization which is hardly removed (1, 7). Paying special attention to the health of women and children, this work aimed to decrease the incidence of childhood tooth decay, streamlining preventive efforts in a population at risk. Methods: Since 1999, all women referred to our clinic in the second trimester of pregnancy or during childbirth were offered the opportunity to perform a simple test to measure the presence of SM in saliva and have been given some advice (diet, hygiene, fuoro-prophylaxis, dental visit). The sampling of saliva was performed after chewing one paraffin tablet for about 1 minute. For the microbiological examination the technique of dip-slide test (CTR bacteria, Ivoclar Vivadent) was used; results were classified according to semi-quantitative classes of microorganism concentration.Women were classified positive when bacterial concentration was 100000 CFU/ml. Besides a general advice on hygiene and diet, these women were invited to undergo a prophylactic treatment with chlorhexidine, a disinfectant with bactericidal properties against SM. Results: 84% of surveyed women adhered to the screening (29% pregnant women, 55% in the puerperium). In the 12-year study, 2170/7213 (30%) women had a positive saliva test and were administered chlorhexidine. Conclusions: By means of a prenatal screening involving different professionals (microbiologist, obstetriciangynecologist, pediatrician, oral-hygienist) we could assess the likelihood of vertical transmission of SM from mother to child, and give the mothers medical advice on the risk of tooth decay in children. Preliminary data on the incidence of caries in children of those women who tested positive at the screening, confirm that our program has an important role in preventing childhood tooth decay

Clutter loss measurements in suburban environment at 26 GHz and 40 GHz

Last World Radiocommunication Conference in 2015 (WRC-15), identified several frequency bands between 24.25 GHz and 86 GHz as possible candidates for the deployment of future terrestrial IMT-2020/5G systems. Agenda item 1.13 of next WRC-19 invites ITU-R to conduct and complete sharing and compatibility studies, taking into account the protection of services to which the band is allocated on a primary basis for the identified frequency bands. To conduct the studies in sharing scenarios between terrestrial 5G and the other affected services, mainly satellite and terrestrial fixed links; the interference signal at the receiver needs to be calculated by using the appropriate propagation model. Among the propagation models to be used, ITU-R Recommendation P. 2108-0 [Rec1] proposes a statistical clutter loss model for Earth-space and Aeronautical. This model, is based on theoretical equations and has been complemented with simulations [Rep1]. Hence, there is a need to validate it with real measurements. To this aim, the Joint Research Centre has conducted a first measurement campaign to characterize clutter loss in suburban environment at 26 GHz and 40 GHz. This document describes the scenario, the measurement setup and shows the initial results and comparisons.JRC.E.2-Technology Innovation in Securit

Substantial discrepancies exist between registered protocol and published manuscript in trials on exercise interventions for chronic low back pain:a meta-research study

OBJECTIVES: Reporting bias, prevalent in biomedical fields, can undermine evidence credibility. Our objective was to evaluate the proportion of discrepancies between registered protocols and published manuscripts in randomized controlled trials (RCTs) on exercise interventions for patients with chronic low back pain (CLBP).STUDY DESIGN AND SETTING: Cross-sectional meta-research study.STUDY SELECTION: We started from the 2021 'Exercise therapy for chronic low back pain' Cochrane Review to select all RCTs reporting a protocol registration on a primary register of the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) or in ClinicalTrials.gov.DATA EXTRACTION: We extracted data from both registered protocol and published manuscript of RCTs, collecting recruitment and administrative information (e.g., record dates) and details of trial characteristics (e.g., outcomes, arms, statistical analysis plan details). Independent pairs of reviewers assessed discrepancies between registered protocol and published manuscript for the reporting of primary and secondary outcomes domains, measurement instruments, time-points, number of arms and statistical analysis plans (if attached). Outcome discrepancies were characterized as addition, omission, upgrade or downgrade.RESULTS: We included 116 RCTs reporting an available protocol registration. Overall, 100 RCTs (86.2%) distinguished between primary and secondary outcomes. Of these, 39 RCTs (39.0%) reported one or more discrepancies in primary outcomes, and 78 RCTs (78.0%) reported one or more discrepancies in secondary outcomes. Focusing on discrepancies for the primary outcome, 64.5% of added, upgraded or downgraded outcomes favored statistically significant effects. Few RCTs (n=6) reported discrepancies in the number of arms. Statistical analysis plans were poorly reported in the registered protocols (n=3) for being compared to the publications.CONCLUSION: We found substantial outcome discrepancies comparing registered protocols and published manuscripts in RCTs assessing exercise interventions for patients with CLBP, with some impacting the statistical significance of the effects. Readers are encouraged to approach RCTs results in this field with caution.</p