Accuracy of the cutoff value of the third molar maturity index: an Egyptian study

Abstract Background This study aimed to test the sensitivity and specificity of the third molar maturity index (I3M) cutoff value to discriminate between individuals above and below 18 years of age in an Egyptian sample. Material and methods Digital images of 247 orthopantographs (97 boys and 150 girls) were evaluated. The cutoff value of I3M obtained from the results of Cameriere et al. (Int J Legal Med 122:493–497, 2008) was evaluated in both girls and boys. Results Sensitivity (the proportion of individuals being 18 years of age or older) was 95% and 73% in boys and girls, respectively. Meanwhile, specificity (the proportion of individuals younger than 18) was 100% in boys and 97% in girls. The proportion of correctly classified boys was 97% while it was 59% in girls. Conclusion It can be concluded that the third molar maturity index can discriminate between individuals who are 18 years and over and those under 18 with higher accuracy in boys

Novel antibacterial and bioactive silicate glass nanoparticles for biomedical applications

In this work, the authors propose a new quick sol–gel procedure for bioglass nanoparticles production containing 10% mol of silver (AgBGs). These new AgBGs are characterized by Zeta potential analysis, scanning electron microscopy with X-ray microanalysis (SEM/EDS), X-ray powder diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), and microbiological tests to confirm their bioactive and antibacterial properties. SEM shows that the average particle size is less than 200 nm and EDS confirms the successful incorporation of Ag2O in the bioglass matrix. XRD confirms the amorphous nature of the AgBGs and, after SBF immersion, reveals their bioactive behavior with the presence of crystalline phase of calcium silicate and phosphorus oxide, which are also detected by FTIR analysis. FTIR also confirms the formation of typical siloxane bonds resulting from the condensation of silicate glass. Lastly, it is found that the developed AgBGs has an antibacterial effect against two different types of bacteria, thus demonstrating their ability to reduce the bacterial infection within 16 h.The authors want to acknowledge the financial support from the Portuguese Foundation for Science and Technology through the project BioSeaGlue with the reference EXPL/CTM-BIO/0646/2013, and also the European program FEDER/COMPETE for the financial support through project LA ICVS/3Bs-2014-2015.info:eu-repo/semantics/publishedVersio

Utility of EUS following endoscopic polypectomy of high-risk rectosigmoid lesions

BACKGROUND: The utility of endoscopic ultrasound (EUS) compared with standard white light endoscopy (WLE) following recent polypectomy of high-risk colorectal polyps is unknown. OBJECTIVE: To assess the incremental yield of EUS after endoscopic polypectomy of a high-risk rectal lesion. DESIGN: Retrospective cohort. SETTING: Tertiary referral center. MATERIALS AND METHODS: Patients referred for EUS following attempted endoscopic resection of a high-risk rectal neoplasm, defined as a tubulovillous adenoma, tubular adenoma with high-grade dysplasia, carcinoid, carcinoma in-situ or adenocarcinoma (CA). INTERVENTIONS: Sigmoidoscopy ± mucosal biopsy and EUS ± fine-needle aspiration (FNA) to evaluate for: (1) Residual polyp/tumor in the rectal wall or (2) peritumoral adenopathy. MAIN OUTCOME: Sensitivity and specificity for detection of residual neoplasia for WLE ± biopsy (WLE/BX) and EUS ± FNA for cancer (CA group) or benign disease (non-CA group). The incremental yield of EUS defined as: (1) Residual intramural neoplasia not present on WLE ± BX and; (2) abnormal peritumoral adenopathy. RESULTS: A total of 70 patients (mean age 64 ± 11 years, 61% male) with a final diagnosis of CA (n = 38) and non-CA (n = 32) were identified. There was no difference between the sensitivity and specificity of WLE alone (65% and 84%), WLE with biopsy (71% and 95%), and EUS (59% and 84%), for the detection of residual neoplasia (P > 0.05 for all). EUS identified 3 masses missed by WLE, all in the CA group. A malignant (n = 2) or benign (n = 3) node was identified in 5 (13%) CA patients; EUS-FNA in two showed residual malignancy in one and a reactive lymph node (LN) in one. No LNs were identified in the non-CA patients. LIMITATIONS: Retrospective design, incomplete follow-up in some patients. CONCLUSION: Following endoscopic polypectomy of high-risk rectal neoplasia, the incremental yield of EUS compared with WLE/BX for evaluation of residual disease appears limited, especially in patients with benign disease

Biomedical applications of natural-based polymers combined with bioactive glass nanoparticles

In recent years, the combination of natural polymers with nanoparticles has permitted the development of sophisticated and efficient bioinspired constructs. In this regard, the incorporation of bioactive glass nanoparticles (BGNPs) confers a bioactive nature to these constructs, which can then induce the formation of a bone-like apatite layer upon immersion in a physiological environment. Moreover, the incorporation of bioactive glass nanoparticles has been found to be beneficial; the constructs proved to be biocompatible, promote cell adhesion and spreading, and regulate osteogenic commitment. This review provides a summary and discussion of the composition, design, and applications of bioinspired nanocomposite constructs based on BGNPs. Examples of nanocomposite systems will be highlighted with relevance to biomedical applications. It is expected that understanding the principles and the stateof-the-art of natural nanocomposites may lead to breakthroughs in many research areas, including tissue engineering and orthopaedic devices. The challenges regarding the future translation of these nanostructured composites into clinical use are also summarized.A´lvaro J. Leite acknowledges the Portuguese Foundation for Science and Technology (FCT) for his doctoral grant (SFRH/BD/73174/2010).info:eu-repo/semantics/publishedVersio

Rationing tests for drug-resistant tuberculosis - who are we prepared to miss?

BACKGROUND: Early identification of patients with drug-resistant tuberculosis (DR-TB) increases the likelihood of treatment success and interrupts transmission. Resource-constrained settings use risk profiling to ration the use of drug susceptibility testing (DST). Nevertheless, no studies have yet quantified how many patients with DR-TB this strategy will miss. METHODS: A total of 1,545 subjects, who presented to Lima health centres with possible TB symptoms, completed a clinic-epidemiological questionnaire and provided sputum samples for TB culture and DST. The proportion of drug resistance in this population was calculated and the data was analysed to demonstrate the effect of rationing tests to patients with multidrug-resistant TB (MDR-TB) risk factors on the number of tests needed and corresponding proportion of missed patients with DR-TB. RESULTS: Overall, 147/1,545 (9.5%) subjects had culture-positive TB, of which 32 (21.8%) had DR-TB (MDR, 13.6%; isoniazid mono-resistant, 7.5%; rifampicin mono-resistant, 0.7%). A total of 553 subjects (35.8%) reported one or more MDR-TB risk factors; of these, 506 (91.5%; 95% CI, 88.9-93.7%) did not have TB, 32/553 (5.8%; 95% CI, 3.4-8.1%) had drug-susceptible TB, and only 15/553 (2.7%; 95% CI, 1.5-4.4%) had DR-TB. Rationing DST to those with an MDR-TB risk factor would have missed more than half of the DR-TB population (17/32, 53.2%; 95% CI, 34.7-70.9). CONCLUSIONS: Rationing DST based on known MDR-TB risk factors misses an unacceptable proportion of patients with drug-resistance in settings with ongoing DR-TB transmission. Investment in diagnostic services to allow universal DST for people with presumptive TB should be a high priority

Advantages and disadvantages of an objective selection process for early intervention in employees at risk for sickness absence

<p>Abstract</p> <p>Background</p> <p>It is unclear if objective selection of employees, for an intervention to prevent sickness absence, is more effective than subjective 'personal enlistment'. We hypothesize that objectively selected employees are 'at risk' for sickness absence and eligible to participate in the intervention program.</p> <p>Methods</p> <p>The dispatch of 8603 screening instruments forms the starting point of the objective selection process. Different stages of this process, throughout which employees either dropped out or were excluded, were described and compared with the subjective selection process. Characteristics of ineligible and ultimately selected employees, for a randomized trial, were described and quantified using sickness absence data.</p> <p>Results</p> <p>Overall response rate on the screening instrument was 42.0%. Response bias was found for the parameters sex and age, but not for sickness absence. Sickness absence was higher in the 'at risk' (N = 212) group (42%) compared to the 'not at risk' (N = 2503) group (25%) (OR 2.17 CI 1.63–2.89; p = 0.000). The selection process ended with the successful inclusion of 151 eligible, i.e. 2% of the approached employees in the trial.</p> <p>Conclusion</p> <p>The study shows that objective selection of employees for early intervention is effective. Despite methodological and practical problems, selected employees are actually those at risk for sickness absence, who will probably benefit more from the intervention program than others.</p

Slightly saline water increases the larviculture efficiency of freshwater Neotropical fish

O objetivo deste trabalho foi avaliar o efeito de água levemente salinizada sobre a larvicultura intensiva do tambaqui, matrinxã, apaiari e piau, durante os dias iniciais de alimentação. As larvas foram mantidas em água artificialmente salinizada, em concentrações de 0 (água doce) a 14 g L‑1 de NaCl (intervalo de 2,0 g L‑1 ), e foram alimentadas com duas porções diárias de náuplios de Artemia, de acordo com protocolo para cada espécie, em delineamento inteiramente casualizado, com três repetições. Larvas de tambaqui, matrinxã e apaiari podem ser cultivadas em até 2 g L‑1 de concentração salina, sem prejuízos ao crescimento e à sobrevivência. Larvas de piau foram mais tolerantes e suportaram até 4 g L‑1 de concentração salina. Acima disto, a mortalidade dos peixes aumentou e chegou a 100% à concentração de 6 g L‑1 (matrinxã e apaiari) e de 10 g L‑1 (tambaqui). A salinização da água a 2 g L‑1 proporcionou maior taxa de sobrevivência a larvas de matrinxã e maior crescimento a larvas de tambaqui, apaiari e piau. Estas duas últimas espécies apresentaram melhor crescimento com a maior quantidade de náuplios. Água salinizada a 2 g L‑1 é benéfica para as espécies estudadas, pois otimiza o potencial de crescimento das larvas e o uso de náuplios de Artemia como alimento vivo.The objective of this work was to evaluate the effect of slightly saline water in an intensive larviculture of tambaqui, matrinxã, apaiari, and piau, during the initial days of active feeding. Larvae were reared in artificial saline water, at concentrations from 0 (freshwater) to 14 g L‑1 NaCl (at a 2.0 g L‑1), and fed with two portions of Artemia nauplii, following a specific protocol for each species, in a completely randomized design, with 3 replicates. Tambaqui, matrinxã and apaiari larvae can be reared at saline concentrations till 2 g L‑1 without impairing growth and survival. Piau larvae were more tolerant and endured saline water until 4 g L‑1. At saline concentrations above that, fish mortality increased and reached 100% at 6 g L‑1, for matrinxã and apaiari, and at 10 g L‑1, for tambaqui. Saline water at 2 g L‑1 provided a higher survival for matrinxã, and higher growth for tambaqui, apaiari and piau. These last two species showed a better growth performance with the highest quantity of nauplii. Slightly saline water at 2 g L‑1 is beneficial to these studied species, as it optimizes larval growth potential and the use of Artemia nauplii as live food

O ethos e o pathos na sala de parto

RESUMO Objetivo Compreender o ethos e o pathos presentes nos discursos de mulheres parturientes e profissionais de saúde no contexto da sala de parto. Método Pesquisa qualitativa do tipo interpretativa. Utilizou-se o método da Análise do Discurso. Participaram das entrevistas 36 mulheres e 24 profissionais de saúde de maternidades do interior de Minas Gerais. Resultados Os discursos sinalizam a concepção que as mulheres têm do parto, centrada no olhar do outro e nas suas representações; as dificuldades das enfermeiras para operacionalizar o cuidado e construir uma imagem profissional autônoma. O discurso médico enfatiza a especialidade, a capacidade de intervir em situações de risco e as mudanças no status da profissão. Conclusões A construção do ethos de médicos e enfermeiros é fundamental para o delineamento de campos de saberes mais flexíveis e parauma atuação profissional condizente com os seus papéis e comprometida com os preceitos éticos e legais do cuidado obstétrico

Las imágenes de graffiti : enunciación, narratividad y espacio

BibliografíaCopia digital. Alicante : Biblioteca Virtual Miguel de Cervantes, 201