Characterization and Comparison of Ocular Surface Microbiome in Newborns

The ocular microbiome is of fundamental importance for immune eye homeostasis, and its alteration would lead to an impairment of ocular functionality. Little evidence is reported on the composition of the ocular microbiota of term infants and on the impact of antibiotic prophylaxis. Methods: A total of 20 conjunctival swabs were collected from newborns at birth and after antibiotic treatment. Samples were subjected to 16S rRNA sequencing via system MiSeq Illumina. The data were processed with the MicrobAT software and statistical analysis were performed using two-way ANOVA. Results: Antibiotic prophylaxis with gentamicin altered the composition of the microbiota. In detail, a 1.5- and 2.01-fold reduction was recorded for Cutibacterium acnes (C. acnes) and Massilia timonae (M. timonae), respectively, whereas an increase in Staphylococcus spp. of 6.5 times occurred after antibiotic exposure. Conclusions: Antibiotic prophylaxis altered the ocular microbiota whose understanding could avoid adverse effects on eye health

The efficacy and the safety of eltrombopag in pediatric patients with severe aplastic anemia: a systematic review

BackgroundAcquired aplastic anemia (AAA) in pediatric patients is a rare disorder characterized by hypocellular bone marrow and pancytopenia. Eltrombopag, an oral thrombopoietin receptor agonist, provides a hematologic improvement in adults with severe aplastic anemia (SAA) refractory to immunosuppressive therapy (IST). The association of ELT and IST was approved by the US Food and Drug Administration (FDA) for adults and children ≥2 years of age as a first-line treatment for SAA. However, the effects of ELT on pediatric patients with SAA remain controversial and limited.Methods and findingsWe conducted a systematic review of the most recent literature from Pubmed, Web of Science, and Embase, published up to 20th December 2022, in order to evaluate the available evidence on the efficacy and safety of ELT added to IST for the treatment of SAA in the pediatric population.ConclusionEltrombopag added to the IST has shown a good safety profile, without manifestations of excessive toxic effects, although not all the results obtained from our studies support the addition of ELT to the IST in the first-line treatment of children with SAA.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier: CRD42022325859

Accuracy of temporomandibular disorders diagnosis evaluated through the diagnostic criteria for temporomandibular disorder (DC/TDM) Axis II compared to the Axis I evaluations: a systematic review and meta-analysis

Abstract Background The temporomandibular joint (TMJ) is a complex joint that facilitates mandibular movements during speech, chewing, and swallowing activities. The Axis I evaluation of the DC/TMD focuses on assessing physical diagnoses related to TMDs. It includes an assessment of pain and functional limitations, such as jaw opening range, joint sounds, and joint tenderness. The Axis II evaluation of the DC/TMD provides information on the patient’s psychological status and quality of life. This Systematic Review with Meta-Analysis aimed to evaluate the accuracy of Temporomandibular Disorders diagnosis considered through the Diagnostic Criteria for Temporomandibular Disorder (DC/TDM) axis II compared to the Axis I evaluations. Methods A search was made in PubMed, Web of Science and Lilacs for articles published from the inception until 20 January 2023. We applied the Population, Exposure, Comparator, and Outcomes (PECO) model [1] to assess document eligibility. Only studies that evaluated patients by DC/TMD Axis I and Axis II were considered. Review Manager version 5.2.8 (Cochrane Collaboration) was used for the pooled analysis. We measured the odds ratio (OR) between the two groups (Axis I and Axis II). Results Fifty-one articles were selected because of the search. Four papers were excluded before the screening: 2 pieces were not in English, and two were reviewed. The remaining 47 articles were selected for the title and abstract screening to evaluate whether they met the PECO criteria. Among these, four papers were established; the overall effect showed that there was no difference in TMD diagnosis between Axis I and Axis II (RR 1.17; 95% CI: 0.80– 1.71; Z:0.82; P = .41), suggesting that there is no difference between Axis I and Axis II. Conclusion In conclusion, DC/TMD is an effective tool for the diagnosis of TMD. It improves the accuracy of TMD diagnosis, allows for the classification of subtypes, and assesses psychosocial factors that may impact the development or maintenance of TMD symptoms

Emerging Roles of the Iron Chelators in Inflammation

Iron is a crucial element for mammalian cells, considering its intervention in several physiologic processes. Its homeostasis is finely regulated, and its alteration could be responsible for the onset of several disorders. Iron is closely related to inflammation; indeed, during inflammation high levels of interleukin-6 cause an increased production of hepcidin which induces a degradation of ferroportin. Ferroportin degradation leads to decreased iron efflux that culminates in elevated intracellular iron concentration and consequently iron toxicity in cells and tissues. Therefore, iron chelation could be considered a novel and useful therapeutic strategy in order to counteract the inflammation in several autoimmune and inflammatory diseases. Several iron chelators are already known to have anti-inflammatory effects, among them deferiprone, deferoxamine, deferasirox, and Dp44mT are noteworthy. Recently, eltrombopag has been reported to have an important role in reducing inflammation, acting both directly by chelating iron, and indirectly by modulating iron efflux. This review offers an overview of the possible novel biological effects of the iron chelators in inflammation, suggesting them as novel anti-inflammatory molecules

Economic inequalities and temporomandibular disorders: A systematic review with meta-analysis

Introduction: Temporomandibular disorders (TMDs) are a common and debilitating condition that affects millions of people globally. Despite extensive research on TMDs, the exact causes of these conditions remain unclear. However, various factors, including genetics, injury and stress, have been implicated in their development. In addition to these traditional risk factors, the literature suggests that socioeconomic status (SES) may also play a role in the development and progression of TMDs. By synthesizing the available evidence, this review will provide a comprehensive understanding of the role of SES in TMDs and will inform the development of targeted interventions to reduce the burden of these disorders among individuals with lower SES. Methods: We conducted this systematic review followed the recommendations of the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) 2020. PubMed, Scopus and Lilacs were searched using the terms: ((socio-economic status OR economic status) AND (temporomandibular disorders OR temporomandibular joint) from the inception until February 10, 2023. We applied the following questions: (P) Participants consisted of human subjects. (E) The Exposure consisted of low economic stats. (C) The Comparison: subjects reporting low economic status were compared to subjects reporting medium-high economic status. (O) The Outcome consisted of TMDs diagnosis. Review Manager version 5.2.8 (Cochrane Collaboration; 2014) software was applied to perform the pooled analysis. Results: The included subjects in this review were 14 607. Among them, 631 reported a low economic income, 1880 a medium-high economic income, 4617 were blue-collar workers and 7478 were white-collar workers or entrepreneurs. Among those reporting a low economic income or belonging to the blue-collar workers 12.93% (679/5248) presented sign/symptoms of TMD or a diagnosis of TMD whereas 10.6% (997/9358) of those with a high economic income/white-collar worker. Conclusion: We observed a slightly higher prevalence of TMD among individuals with a low economic income Further research is needed to better understand this relationship and to develop effective interventions to reduce the burden of TMD among individuals with low income

Prevalence of Temporomandibular Disorders in subjects affected by Parkinson Disease: a systematic review and metanalysis

Introduction: While Temporomandibular disorders (TMDs) are not typically considered a primary symptom of Parkinson disease (PD), recent studies have documented a correlation between aging and TMDs, a cluster of conditions affecting the temporomandibulr joint and surrounding musculature, thereby underscoring the potential for an increased frequency of TMDs in the aging PD population. Objective: The purpose of this review is to systematically evaluate the existing literature on the topic and provide a comprehensive overview of the prevalence of TMDs in patients with PD. Methods: To determine eligibility, we utilized the Population (human subjects), Exposure (PD), Comparator (PD vs non-PD subjects), and Outcomes (TMD) (PECO) model. To conduct this systematic review, we searched for articles published in PubMed, Web of Science, and Lilacs from the beginning until April150, 2023. Results: Three study were selected. All together they comprised a total of 55828 subjects, out of which 12629 were affected by PD or Parkinsonism, and the remaining 43199 were non-PD subjects matched for age and sex. The study aimed to evaluate the prevalence of TMDs in subjects affected by PD. The results showed that 193/12629 (1,53%) of PD individuals presented with TMD symptoms or were diagnosed with TMD, while 260/43199 (0,6%) of non-PD subjects were diagnosed with the same. The meta-analysis, showed that there was a higher TMD prevalence in PD subjects compared to non-PD subjects (RR 1.57; 95% CI: 1.30- 1.89). Conclusion: The studies reviewed suggest a possible association between TMD and PD. Further research is needed to clarify the relationship between TMD and PD and to identify possible mechanisms and treatment strategies

Conservative treatment of Temporomandibular Joint condylar fractures: A systematic Review conducted according to PRISMA guidelines and the Cochrane Handbook for Systematic Reviews of Interventions

Objective: Fractures of the mandibular condyle are the most common jaw fractures. There are several treatment approaches. There is the nonsurgical and surgical approach. The purpose of this systematic literature review is to evaluate the indications and contraindications of either method to help the clinician make the best treatment choice. Materials and methods: Pubmed, Web of Science and Lilacs were systematically searched until 20/05/2023. Clinical trials were selected to compare the two treatments for condyle fracture and evaluate indications and contraindications. Results: Out of 2515 papers, four studies were included. The surgical approach allows faster functional recovery and decreases patient discomfort. The study analyzes under what circumstances a surgical procedure is more practical than a nonsurgical one. Conclusion: There is no evidence regarding the reliability of either method. Both have superimposable results. However, age, type of occlusion and other factors direct the clinician toward a surgical choice

Temporomandibular disorders and orofacial neuropathic pain in children and adolescents: a systematic review

: Pediatric orofacial pain (OFP) is a blanket term referring to the pain of soft and hard tissue in the face, neck and headaches affecting subjects younger than 18. OFP encompasses pain due to various causes, i.e., (i) Temporomandibular Disorders (TMD), (ii) Headache, and (iii) Neuropathies. This review aims to provide an overview of these three causes of OFP. The inclusion criteria are: (1) articles in English; (2) human studies; (3) clinical trials; (4) systematic review. Data from the included studies using a customized data extraction on a Microsoft Excel sheet. PubMed, Web of Science and Lilacs were systematically searched. The time window considered for the electronic search was from 01 January 1950 to 21 October 2022. A total of 3399 articles published were found from electronic searches. Finally, six full-text articles satisfied the inclusion criteria. The included studies have been published over the past 27 years (1993 to 2020). The studies analyzed were conducted in various parts of the world: USA, Argentina, Canada, South America (Brazil), and India. A total of 308 subjects were analyzed. TMD, headache, and neuropathies are among the leading causes of orofacial pain. Lifestyle changes and psychological approaches could be curative. However, some patients need pharmacotherapy. Regarding the inadequate treatment of pain after hospital discharge due to the difficulty of following the scheduled intervals prescribed, remote monitoring through telemedicine tools could be a solution in the future. Several conditions present with pain in children and adolescents; in most of them, pain is the most prominent symptom. This review found that one of the most critical causes of OFP is temporomandibular dysfunction. Treatment is founded on a multidisciplinary approach

The safety of blinatumomab in pediatric patients with acute lymphoblastic leukemia: A systematic review and meta-analysis

Background: Blinatumomab is a bispecific CD19-directed CD3 T-cell engager that has proven efficacy in children with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). Despite its efficacy, it has also been associated with the development of potentially serious adverse events such as the cytokine release syndrome (CRS) and neurologic events. The present meta-analysis aimed to assess the safety profile of blinatumomab in terms of serious adverse events, CRS, and neurologic events (such as seizure and encephalopathy) in pediatric patients with B-cell ALL. Methods and findings: A systematic review was conducted in Pubmed up to December 10, 2021 to retain pediatric clinical trials on blinatumomab. A random effect meta-analysis approach was used. This study followed the PRISMA statement. Four out of the 255 initial references were selected, of which 2 were phase 1/2 clinical trials and 2 phase 3 clinical trials. Blinatumomab was associated with a lower risk of serious adverse events (Risk ratio RR, 0.56; 95% CI, 0.32-0.99), febrile neutropenia (RR, 0.13; 95% CI, 0.06-0.26), infection (RR, 0.40; 95% CI, 0.29-0.56), and grade ≥ 3 adverse events (RR, 0.79; 95% CI, 0.67-0.93) compared to chemotherapy. No difference in the risk of CRS (RR, 8.37; 95% CI, 0.27-260.97) and seizure (RR, 6.43; 95% CI, 0.79-53.08) was observed between groups, while for encephalopathy a higher risk was associated with blinatumomab compared to chemotherapy (RR, 8.90; 95% CI, 1.08-73.29). Conclusion: Our data support the good safety profile of bliantumomab in treating pediatric patients with B-ALL

Prevalence of temporomandibular disorders in children and adolescents evaluated with Diagnostic Criteria for Temporomandibular Disorders: A systematic review with meta-analysis

BackgroundThe prevalence of temporomandibular disorders (TMDs) in children and adolescents is not well-known. This is partly because TMD is not often diagnosed in children and partly because there is no agreed-upon definition of TMD. There is a growing body of evidence to suggest that there are gender differences in the prevalence and presentation of TMD in adult. The aim was to assess the prevalence of TMDs in subjects aged 8-19 evaluated with Diagnostic Criteria for TMDs (DC/TMD) and to assess gender differences. MethodsPubMed, Web of Science and Lilacs were systematically searched until 30 November 2022, to identify studies presenting children and adolescents patients affected by TMDs. ResultsOut of 40 papers, three studies were included. The included subjects in this review were 1914 (1093 female and 821 male). Seven hundred and thirty-six on 1914 patients (38.4%) presented TMD. Among 1093 female, 489 (44.7%) presented TMD, while 247/821 male (30%) experienced TMD. Meta-analysis revealed that the female had a higher TMD prevalence than male (RR 2.10; 95% CI: 1.21-3.65). ConclusionTMD prevalence in children and adolescence varies between 20% and 60%. Female had a higher prevalence of TMDs compared to male