Microbiological analysis of bacterial plaque of periodontal disease on dogs and effects of antibioticotherapy on it

Objetivou-se determinar a microbiota da placa bacteriana subgengival de cães com doença periodontal (DP) e estabelecer o efeito da antibioticoterapia. Avaliaram-se 20 cães com graus variados de DP e coletaram-se amostras da placa bacteriana subgengival antes e após antibioticoterapia. Preconizou-se antibioticoterapia distinta em dois grupos, com 10 animais cada: clindamicina (G1) e metronidazol + espiramicina (G2). Observou-se crescimento bacteriano subgengival na maioria dos cães com DP e correlação entre a severidade da DP e a idade dos animais. Houve redução significativa no crescimento bacteriano após a antibioticoterapia e o antibiograma demonstrou maior sensibilidade à clindamicina, seguido da espiramicina; todos os microrganismos foram resistentes ao metronidazol. ___________________________________________________________________________________________________ ABSTRACTThe objective was to determine microbiote of the subgingival bacterial plaque of dogs with periodontal disease (PD) and establish the effect of antibioticotherapy on its reduction. Twenty dogs with varied stages of PD were evaluated and samples of their subgingival bacterial plaque were collected. Distinct antibiotic protocols were used in two groups with ten animals each: clindamycin (G1) and metronidazole + espiramycin (G2). New subgingival samples were collected 15 days after antibiotic therapy started. There were observed subgingival bacterial culture on most dogs with PD and correlation between severity of PD and age. There was reduction of bacterial growth in 20% of the samples after treatment and antibiogram showed higher sensibility to clindamycin, followed by espiramycin - all microorganisms were resistant to metronidazole

Use of Surgical Laser for Excision of a Neurofibroma Associated With Neurofibromatosis Type-1

Introduction: Neurofibromatosis type 1 (NF1) is an autosomal dominant genetic disorder that affects approximately 1/3500 individuals. Various bone manifestations and peripheral nerves neoplastic lesions associated with NF1 are seen in the jaws. Several oral manifestations may occur in this disorder; therefore the dentist’s knowledge and multidisciplinary management of these patients are extremely important.Case Presentation: In the present article, we present the use of a high-power surgical laser to excise a neurofibroma in a patient with several intraoral manifestations associated with NF1.Conclusion: The use of diode laser (808 nm) for excision biopsy of tongue nodules showed no thermal damage to the tissue, allowing an adequate histopathological analysis of the neurofibrom

The surgical safety checklist and patient outcomes after surgery: a prospective observational cohort study, systematic review and meta-analysis

© 2017 British Journal of Anaesthesia Background: The surgical safety checklist is widely used to improve the quality of perioperative care. However, clinicians continue to debate the clinical effectiveness of this tool. Methods: Prospective analysis of data from the International Surgical Outcomes Study (ISOS), an international observational study of elective in-patient surgery, accompanied by a systematic review and meta-analysis of published literature. The exposure was surgical safety checklist use. The primary outcome was in-hospital mortality and the secondary outcome was postoperative complications. In the ISOS cohort, a multivariable multi-level generalized linear model was used to test associations. To further contextualise these findings, we included the results from the ISOS cohort in a meta-analysis. Results are reported as odds ratios (OR) with 95% confidence intervals. Results: We included 44 814 patients from 497 hospitals in 27 countries in the ISOS analysis. There were 40 245 (89.8%) patients exposed to the checklist, whilst 7508 (16.8%) sustained ≥1 postoperative complications and 207 (0.5%) died before hospital discharge. Checklist exposure was associated with reduced mortality [odds ratio (OR) 0.49 (0.32–0.77); P\u3c0.01], but no difference in complication rates [OR 1.02 (0.88–1.19); P=0.75]. In a systematic review, we screened 3732 records and identified 11 eligible studies of 453 292 patients including the ISOS cohort. Checklist exposure was associated with both reduced postoperative mortality [OR 0.75 (0.62–0.92); P\u3c0.01; I2=87%] and reduced complication rates [OR 0.73 (0.61–0.88); P\u3c0.01; I2=89%). Conclusions: Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine

Prospective observational cohort study on grading the severity of postoperative complications in global surgery research

Background The Clavien–Dindo classification is perhaps the most widely used approach for reporting postoperative complications in clinical trials. This system classifies complication severity by the treatment provided. However, it is unclear whether the Clavien–Dindo system can be used internationally in studies across differing healthcare systems in high- (HICs) and low- and middle-income countries (LMICs). Methods This was a secondary analysis of the International Surgical Outcomes Study (ISOS), a prospective observational cohort study of elective surgery in adults. Data collection occurred over a 7-day period. Severity of complications was graded using Clavien–Dindo and the simpler ISOS grading (mild, moderate or severe, based on guided investigator judgement). Severity grading was compared using the intraclass correlation coefficient (ICC). Data are presented as frequencies and ICC values (with 95 per cent c.i.). The analysis was stratified by income status of the country, comparing HICs with LMICs. Results A total of 44 814 patients were recruited from 474 hospitals in 27 countries (19 HICs and 8 LMICs). Some 7508 patients (16·8 per cent) experienced at least one postoperative complication, equivalent to 11 664 complications in total. Using the ISOS classification, 5504 of 11 664 complications (47·2 per cent) were graded as mild, 4244 (36·4 per cent) as moderate and 1916 (16·4 per cent) as severe. Using Clavien–Dindo, 6781 of 11 664 complications (58·1 per cent) were graded as I or II, 1740 (14·9 per cent) as III, 2408 (20·6 per cent) as IV and 735 (6·3 per cent) as V. Agreement between classification systems was poor overall (ICC 0·41, 95 per cent c.i. 0·20 to 0·55), and in LMICs (ICC 0·23, 0·05 to 0·38) and HICs (ICC 0·46, 0·25 to 0·59). Conclusion Caution is recommended when using a treatment approach to grade complications in global surgery studies, as this may introduce bias unintentionally

Critical care admission following elective surgery was not associated with survival benefit: prospective analysis of data from 27 countries

This was an investigator initiated study funded by Nestle Health Sciences through an unrestricted research grant, and by a National Institute for Health Research (UK) Professorship held by RP. The study was sponsored by Queen Mary University of London