Evaluation of appendicitis risk prediction models in adults with suspected appendicitis

Background Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results Some 5345 patients across 154 UK hospitals were identified, of which two‐thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut‐off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut‐off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision‐making by identifying adults in the UK at low risk of appendicitis were identified

Bioassay of amoxicillin in rats

Few reports are available about tissue concentration of amoxicillin. The techniques used to measure tissue concentration usually require rupture and are expensive. The objective of the present study is to assess the utility of an animal model to predict tissue concentration of amoxicillin using induced granulomatous tissue. We used 160 rats with four polyurethane sponges previously implanted in their backs. At 7, 14, 21 and 28 d after sponge introduction, groups of eight animals each received 3.5, 7.0, 40.0 or 80.0 mg/kg of amoxicillin (p.o.) or 1 ml of 0.9% NaCl solution (control group). One hour after drug administration, 10 mu l of serum and granulomatous tissue were obtained. Tissue and serum were placed on different plates containing Mueller Hinton agar inoculated with 10(8) cfu (colony forming unit) of Staphylococcus aureus (ATCC 25923), and the diameters of the inhibition zones were measured after 18 h of incubation. Analysis of variance showed no statistically significant differences (p>0.05) among time periods for the same dose of amoxicillin, These results suggest that the pharmacokinetics of amoxicillin did not change in relation to the development of granulomatous tissue; therefore this method is valid to measure the tissue concentration of amoxicillin.2391033103

Quantitative evaluation of marginal leakage of two resin composite restorations using two filling techniques

This in vitro study evaluated the marginal leakage of two light-cured resin composites used for posterior restorations using two filling techniques. Standardized Class V cavities were made on the enamel vestibular surface of 30 freshly extracted sound inferior bovine incisors. The teeth were randomly restored according to three experimental groups (Group 1-Z250 with 1 mm vertical increments; Group 2-Z250 with 1 min horizontal increments; Group 3-SureFil with 1 mm horizontal increments). All samples were thermo-cycled (3000 cycles at 5degreesC and 55degreesC) with a dwell time of one minute at each temperature and immersed in a dye solution for 12 hours. After being ground into powder, the samples were individually immersed into glass tubes with absolute alcohol. The solution was centrifuged and the supernatant was analyzed using a spectrophotometer to quantify its dye concentration. Results showed that Group 2 exhibited the lowest leakage means, which was significantly different from Groups 1 and 3 (p<0.05). It was concluded that despite the lower leakage means exhibited by medium viscosity composites, no restorative material or filling technique was able to avoid leakage.27547547

Cross-sectional study of correlation between mandibular incisor crowding and third molars in young Brazilians

Objectives: The aim of this study was to evaluate transversally the clinical correlation between lower incisor crowding and mandible third molar. Study Design: Three hundred healthy volunteers (134 male and 166 female), aged 20.4 (+/- 2.4) years-old were submitted to a complete clinical examination and filled up a questionnaire about gender, age, total teeth number and presence or absence of superior and inferior third molar. After a recent panoramic radiography were evaluated. The multiple logistic regression showed that none of the studied factors influenced the mandibular incisor crowding. Results: The proportion of both molars present or both absent was higher than the other conditions (Chi-square, p.05) the mandibular incisor crowding. Despite the statistical significance, wear orthodontics appliances showed a little correlation (odds ratios < 1.0) in the mandibular incisor crowding. Conclusion: Presence of maxillary and/or mandibular third molars has no relation with the lower incisor crowding.183E505E50

Phototherapy and resistance training prevent sarcopenia in ovariectomized rats

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)The aim of this study was to histologically and biochemically analyze the effects of light-emitting diode therapy (LEDT) associated with resistance training to prevent sarcopenia in ovariectomized rats. Forty female Wistar rats (12 months old, 295-330 g) were bilaterally ovariectomized and divided into four groups (n = 10 per group): control-sedentary (C), resistance training (T), LEDT-sedentary (L), and LEDT plus resistance training (LT). Trained rats performed a 12-week water-jumping program (3 days per week) carrying a load equivalent to 50-80 % of their body mass strapped to their back. Depending on the group protocol, the LED device (850 nm, 100 mW, 120 J/cm(2), spot size 0.5 cm(2)) was used either as the only method or after the resistance training had been performed. The device was used in the single point contact mode (for 10 min). The irradiated region was the center of the greater trochanter of the right femur and the middle third of the rectus femoris muscle was subsequently analyzed histomorphometrically. Significant increases (p < 0.05) were noted for the muscle volume of the T (68.1 +/- 19.7 %), the L (74.1 +/- 5.1 %), and the LT (68.2 +/- 11.5 %) groups compared to the C group (60.4 +/- 5.5 %). There were also significant increases in the concentrations of IGF-1, IL-1, and TNF-alpha in the muscles of the treated groups (p < 0.05). Animals in the LT group showed a significant increase in IL-6 compared to T, L, and C groups (p < 0.05). These findings suggest that resistance training and LEDT can prevent sarcopenia in ovariectomized rats.28614671474Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Environmental contamination before, during, and after dental treatment

Purpose: To verify environmental contamination by collecting microorganisms from dental equipment surfaces before, during and after clinical procedures. Methods: Sterile swabs were used to collect the samples from dental-chair push buttons, 3 -in-1 syringes, X-ray tubes, computer keys, doorknobs, and light handles before (P1), during (P2) and after (P3) clinical procedures, in the undergraduate clinic of the Dental School of Piracicaba, University of Campinas, Brazil. These samples were spread on BHI agar and incubated at 37 degrees C for 24 hours. Other dishes containing the same material were incubated at 37 degrees C in 10% CO2 for 48 hours. The resulting microorganisms were counted and classified using the Gram staining and biochemical tests. Microorganism counts among the periods and groups were analyzed by Kruskal-Wallis test (alpha=5%). Results: The most prevalent microorganisms were Viridans group streptococci, Sthaphylococcus epidermidis and Baccillus subtilis. Push buttons were the most contaminated (P < 0.05). Microorganisms were most prevalent during clinical procedures (P < 0.05). Microorganism counts were higher in P2 than in P1 and P3 (P < 0.05). Clinical activity caused an increase in the number of environmental microorganisms, where Viridans group streptococci were the most prevalent contaminant found on equipment surfaces.18534034

Antimicrobial activity of garlic, tea tree oil, and chlorhexidine against oral microorganisms

To compare the antimicrobial activity of tea tree oil, garlic, and chlorhexidine solutions against oral microorganisms. Method: The five-week study consisted of thirty subjects. The first week was considered baseline. All subjects used a control solution (second week), and were randomly divided into the three groups (third week): G1-0.12% chlorhexidine; G2-2.5% garlic (Allium sativum, L.); and G3-0.2% tea tree oil (Melaleuca alternifolia). Dishes containing blood agar and Mitis Salivarius Bacitracin agar (MSB) were inoculated with the subjects' saliva (collected twice a week). Total microorganisms and mutans streptococci were counted in blood agar and MSB, respectively. Results: Chlorhexidine and garlic groups showed antimicrobial activity against mutans streptococci, but not against other oral microorganisms. The tea tree oil group showed antimicrobial activity against mutans streptococci and other oral microorganisms. Maintenance of reduced levels of microorganisms was observed only for garlic and tea tree oil during the two consecutive weeks (fourth and fifth). Unpleasant taste (chlorhexidine 40%, tea tree oil 30%, garlic 100%), burning sensation (chlorhexidine 40%, tea tree oil 60%, garlic 100%), bad breath (chlorhexidine 40%, tea tree oil 20%, garlic 90%), and nausea (chlorhexidine 0%, tea tree oil 10%, garlic 30%) were reported.52643343