Outcomes of Childhood Asthma and Wheezy Bronchitis. A 50-Year Cohort Study

Rationale: Cohort studies suggest that airflow obstruction is established early in life, manifests as childhood asthma and wheezy bronchitis, and continues into early adulthood. Although an association between childhood asthma and chronic obstructive pulmonary disease (COPD) in later life has been demonstrated, it is unclear if childhood wheezy bronchitis is associated with COPD. Objectives: To investigate whether childhood wheezy bronchitis increases the risk of COPD in the seventh decade. Methods: A cohort of children recruited in 1964 at age 10 to 15 years, which was followed up in 1989, 1995, and 2001, was followed up again in 2014 when at age 60 to 65 years. Discrete time-to-event and linear mixed effects models were used. Measurements and Main Results: FEV1 and FVC were measured. COPD was defined as post-bronchodilator FEV1/FVC <0.7. Childhood wheezing phenotype was related to 1989, 1995, 2001, and 2014 spirometry data. Three hundred thirty subjects, mean age 61 years, were followed up: 38 with childhood asthma; 53 with childhood wheezy bronchitis; and 239 control subjects (of whom 57 developed adulthood-onset wheeze between ages 16 and 46 yr). In adjusted multivariate analyses, childhood asthma was associated with an increased risk of COPD (odds ratio, 6.37; 95% confidence interval, 3.73–10.94), as was childhood wheezy bronchitis (odd ratio 1.81; 95% confidence interval, 1.12–2.91). The COPD risk increased with childhood asthma, and wheezy bronchitis was associated with reduced FEV1 that was evident by the fifth decade and not an accelerated rate of FEV1 decline. In contrast, adulthood-onset wheeze was associated with accelerated FEV1 decline. Conclusions: Childhood wheezy bronchitis and asthma are associated with an increased risk of COPD and reduced ventilatory function

Regenerative Endodontic Procedures, Disinfectants and Outcomes: A Systematic Review

Aims: This systematic review aims to identify and synthesise available evidence to determine the clinical and radiographic outcomes of REP involving any disinfection irrigant together with a non-antibiotic intracanal medicament. Methods: Experimental and observational studies evaluating the outcomes of REP in immature non-vital permanent teeth in 6-16 year olds, where the protocol used any type of disinfectant irrigant together with a non-antibiotic intracanal medicament (non-setting calcium hydroxide) were included. Data was narratively synthesised and presented in respect to the primary outcome (elimination of symptoms and infection) and secondary outcomes (increase in root length/width; positive response to vitality testing; patient-reported outcomes; adverse effects). Main findings: 1628 studies were identified, of which five met the eligibility criteria for inclusion in the review. Studies included one randomised control trial and four observational studies. All five studies showed an absence of clinical signs and symptoms for all teeth postoperatively with radiographic resolution or absence of pathology following the disinfection stages of the REP used. Choice of secondary outcomes were inconsistent but included further root development, coronal discolouration and root canal calcifications postoperatively. There was a high risk of bias in all five studies and subsequently the quality of the evidence base was judged to be low. Principle conclusions: REP using a non-antibiotic disinfectant approach appears capable of providing satisfactory outcomes for a non-vital immature permanent tooth. Further high-quality research is required before solid recommendations towards clinical practice guidelines for the disinfection portion of REP can be implemented

Comparing endocrown restorations on permanent molars and premolars: a systematic review and meta-analysis

Objectives The objective of this systematic review was to evaluate the success of endocrown restorations on molars in comparison with endocrown restorations on premolars. Registration number The methodology for this review is registered with the PROSPERO database (CRD42019149543). Data sources Medline, Embase, Dentistry & Oral Sciences Source and Cochrane CENTRAL were searched through January 2020, supplemented with hand searching of additional relevant journals. Data selection and data extraction Two independent reviewers screened studies against predefined inclusion criteria and extracted data. Data analysis Narrative analysis was carried out and random-effects meta-analysis was performed where possible. Results Out of the selected eight studies, reported success rate of endocrown restoration in molars varied from 72.73% to 99.57% and in premolars ranged from 68.75% to 100%, with a follow-up range of 3-19 years. The pooled odds ratio and 95% confidence intervals for failure rates in molars compared to premolars in four studies selected for meta-analysis were 1.096 (95% CI: 0.280, 4.292). Conclusions These findings showed similar success rates and no difference in the rate of endocrown failures between molars and premolars, thus suggesting that premolars may be considered suitable candidates for endocrowns. However, the findings should be interpreted with caution due to methodological limitations of the included studies. Further better quality and specifically designed controlled trials directly comparing the clinical performance of endocrowns on molars and premolars are required

Levels of house dust mite allergen in cars [Razine alergena prašinskih grinja u automobilima]

This small study investigated house dust mite (HDM) allergen levels in cars and their owners’ homes in north-east Scotland. Dust samples from twelve households and cars were collected in a standardised manner. The dust samples were extracted and measured for the Dermatophagoides group 2 allergens (Der p 2 and Der f 2) and total soluble protein. Allergen levels at homes tended to be higher than in the cars, but not significantly. However, they significantly correlated with paired car dust samples expressed either per unit weight of dust or soluble protein (rho=0.657; p=0.02 and 0.769; p=0.003, respectively). This points to house-to-car allergen transfer, with the car allergen levels largely reflecting levels in the owner’s home. Car HDM allergen levels were lower than those reported in Brazil and the USA. Twenty-five percent of the houses and none of the cars had allergen levels in dust greater than 2000 ng g-1. This value is often quoted as a threshold for the risk of sensitisation, although a number of studies report increased risk of sensitisation at lower levels. This small study does not allow for characterisation of the distribution of HDM allergen in vehicles in this geographic area, or of the likely levels in other warmer and more humid areas of the UK. Cars and other vehicles are an under-investigated micro-environment for exposure to allergenic material. U ovome smo preliminarnom istraživanju izmjerili razine alergena prašinskih grinja u automobilima i domovima njihovih vlasnika u sjevernoistočnoj Škotskoj. Uzorci prašine uzeti su na standardizirani način iz dvanaest domova i dvanaest odgovarajućih automobila. Nakon ekstrakcije izmjerene su razine 2. skupine alergena grinja roda Dermatophagoides (Der p 2 i Der f 2) te njihove ukupne topljive bjelančevine. Razine alergena u kućama bile su mahom više nego u automobilima, ali ne značajno. Uočena je međutim značajna korelacija njihovih razina s razinama u automobilima, bez obzira na to jesu li iskazane udjelom težine po gramu prašine ili topljivim bjelančevinama (rho=0,657; p=0,02 odnosno 0,769; p=0,003). To upućuje na prijenos alergena iz kuće u auto tj. pokazuje da razine alergena u autima odražavaju razine u domovima njihovih vlasnika. Razine alergena kućnih prašinskih grinja u automobilima u Škotskoj bile su niže od onih izmjerenih u Brazilu i SAD-u. U 25 % domova razina alergena bila je viša od 2000 ng g-1, a ni u jednom uzorku nije izmjerena razina viša od te. Ta se vrijednost često smatra graničnom za rizik od senzitizacije, premda neka istraživanja govore o povišenom riziku od senzitizacije i pri nižim razinama alergena. Rezultati ovog istraživanja ne daju uvida u stvarnu prisutnost alergena kućnih prašinskih grinja u vozilima u sjeveroistočnoj Škotskoj niti upućuju na to kolike bi mogle biti njihove razine u toplijim i vlažnijim krajevima Ujedinjenog Kraljevstva. Automobili i ostala vozila zanemareni su kao izvori izloženosti alergenima

Protocol for a systematic review to identify and weight the indicators of risk of asthma exacerbations in children aged 5-12 years

No abstract available

Occupational airborne exposure in relation to Chronic Obstructive Pulmonary Disease (COPD) and lung function in individuals without childhood wheezing illness: A 50-year cohort study

Background Evidence from longitudinal population-based studies relating occupational exposure to the full range of different forms of airborne pollutants and lung function and airway obstruction is limited. Objective To relate self-reported COPD and lung function impairment to occupational exposure to different forms of airborne chemical pollutants in individuals who did not have childhood wheeze. Methods A prospective cohort study was randomly selected in 1964 at age 10–15 years and followed up in 1989, 1995, 2001 and 2014 (aged 58–64) by spirometry and respiratory questionnaire. Occupational histories were recorded in 2014 and occupational exposures assigned using an airborne chemical job exposure matrix. The risk of COPD and lung function impairment was analyzed in subjects, who did not have childhood wheeze, using logistic and linear regression and linear mixed effects models. Results 237 subjects without childhood wheeze (mean age 60.6 years, 47% male) were analyzed. There was no association between any respiratory outcomes and exposure to gases, fibers, mists or mineral dusts and no consistent associations with exposure to fumes. Reduced FEV1 was associated with longer duration (years) of exposure to any of the six main pollutant forms - vapors, gases, dusts, fumes, fibers and mists (VGDFFiM) with evidence of a dose-response relationship (p-trend=0.004). Exposure to biological dusts was associated with self-reported COPD and FEV1<Lower Limit of Normal (LLN) (adjusted odds ratio [95%CI] 4.59 [1.15,18.32] and 3.54 [1.21,10.35] respectively), and reduced FEF25–75% (adjusted regression coefficients [95% CIs] −9.11 [−17.38, −0.84] respectively). Exposure to vapors was associated with self-reported COPD and FEV1<LLN (adjOR 6.46 [1.18,35.37] and 4.82 [1.32,17.63]). Longitudinal analysis demonstrated reduced FEV1 and FEF25–75% associated with exposure to biological dusts or vapors. Conclusions People with no history of childhood wheezing who have been occupationally exposed to biological dusts or vapors or had longer duration of lifetime exposure to any VGDFFiM are at a higher risk of reduced lung function at age 58–64 years. Occupational exposure to biological dusts or vapors also increased the risk of self-reported COPD

Impact of COVID-19 pandemic on characteristics, extent and trends in child maltreatment in 34 Euro-CAN COST Action countries: a scoping review protocol.

Introduction While the factors commonly associated with an increased risk of child maltreatment (CM) were found to be increased during COVID-19, reports of actual maltreatment showed varying trends. Similarly, evidence regarding the impact of COVID-19 on CM within the European Cooperation on Science and Technology and Network Collaborative (COST) Action countries remains inconsistent. This scoping review aims to explore the extent and nature of evidence pertaining to CM within the countries affiliated with the Child Abuse and Neglect in Europe Action Network (Euro-CAN), funded by the COST. Methods and analysis Key electronic databases were searched to identify eligible papers, reports and other material published between January 2020 and April 2023: PubMed, EMBASE, PsycINFO, Social Policy and Practice, Scopus and Web of Science. To cover the breadth of evidence, a systematic and broad search strategy was applied using a combination of keywords and controlled vocabulary for four concepts: children, maltreatment, COVID-19 and Euro-CAN countries, without restrictions on study design or language. Grey literature was searched in OpenGrey and Google Scholar. Two reviewers will independently screen full-text publications for eligibility and undertake data extraction, using a customised grid. The screening criteria and data charting will be piloted by the research team.The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews will be followed to present the results. Results will be summarised in a tabular form and narratively. Ethics and dissemination This review will identify and summarise publicly available data, without requiring ethical approval. The findings will be disseminated to the Euro-CAN Network and reported to the COST Association. They will also be published in a peer-reviewed journal. This protocol is registered on Open Science Framework

Impact of COVID-19 pandemic on characteristics, extent and trends in child maltreatment in 34 Euro-CAN COST Action countries: a scoping review protocol

Introduction While the factors commonly associated with an increased risk of child maltreatment (CM) were found to be increased during COVID-19, reports of actual maltreatment showed varying trends. Similarly, evidence regarding the impact of COVID-19 on CM within the European Cooperation on Science and Technology and Network Collaborative (COST) Action countries remains inconsistent. This scoping review aims to explore the extent and nature of evidence pertaining to CM within the countries affiliated with the Child Abuse and Neglect in Europe Action Network (Euro-CAN), funded by the COST. Methods and analysis Key electronic databases were searched to identify eligible papers, reports and other material published between January 2020 and April 2023: PubMed, EMBASE, PsycINFO, Social Policy and Practice, Scopus and Web of Science. To cover the breadth of evidence, a systematic and broad search strategy was applied using a combination of keywords and controlled vocabulary for four concepts: children, maltreatment, COVID-19 and Euro-CAN countries, without restrictions on study design or language. Grey literature was searched in OpenGrey and Google Scholar. Two reviewers will independently screen full-text publications for eligibility and undertake data extraction, using a customised grid. The screening criteria and data charting will be piloted by the research team. The Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) extension for scoping reviews will be followed to present the results. Results will be summarised in a tabular form and narratively. Ethics and dissemination This review will identify and summarise publicly available data, without requiring ethical approval. The findings will be disseminated to the Euro-CAN Network and reported to the COST Association. They will also be published in a peer-reviewed journal. This protocol is registered on Open Science Framework

Clinical care of childhood sexual abuse: a systematic review and critical appraisal of guidelines from European countries

Background: The clinical management of Child sexual abuse (CSA) demands specialised skills from healthcare professionals due to its sensitivity, legal implications, and serious physical health and mental health effects. Standardised, comprehensive clinical practice guidelines (CPGs) may be pivotal. In this systematic review, we examined existing CSA national CPGs (NCPGs) from European countries to assess their quality and reporting. Methods: We systematically searched six international databases and multiple grey literature sources, reporting by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards. Eligible guidelines were CSA guidance from national health agencies or societies in 34 COST Action 19106 Network Countries (CANC), published between January 2012 and November 2022. Two independent researchers searched, screened, reviewed, and extracted data. NCPGs were compared for completeness with reference WHO 2017 and 2019 guidelines. We used the Appraisal of Guidelines for Research and Evaluation (AGREE II) to appraise quality and reporting. PROSPERO: CRD42022320747. Findings: Of 2919 records identified by database searches, none met inclusion criteria. Of 4714 records identified by other methods, 24 NCPGs from 17 (50%) of CANC countries were included. In 17 (50%) of eligible countries, no NCPGs were found. Content varied significantly within and between countries. NCPGs lacked many components in state-of-the art clinical practice compared to WHO reference standards, particularly in safety and risk assessment, interactions with caregivers, and mental health interventions. Appraisal by AGREE II revealed shortcomings in NCPG development, regarding scientific rigour, stakeholder involvement, implementation and evaluation. Interpretation: A notable number of European countries lack an NCPG; existing NCPGs often fall short. The healthcare response to CSA in Europe requires a coordinated approach to develop and implement high-quality CPGs. We advocate for a multidisciplinary team to develop a pan-European CSA guideline to ensure quality care for survivors

The Use of Low-Level Laser Therapy to Reduce Postoperative Morbidity After Third Molar Surgery: A Systematic Review and Meta-Analysis

Purpose Surgical removal of third molars carries morbidity and significantly affects patients' quality-of-life. This study aims to investigate whether administration of low-level laser therapy (LLLT) is effective in reducing postoperative morbidity in patients undergoing surgical removal of mandibular third molars compared with placebo. Material and Methods A systematic review and meta-analysis involving a comprehensive search strategy implemented across 5 electronic databases. This was supplemented by hand searching and contacting international experts and grey literature. Titles, abstracts, and full articles were scrutinized for studies meeting the inclusion criteria. All randomized controlled trials comparing treatment group of LLLT with a placebo control group were eligible for inclusion. The outcomes variables were postoperative pain, swelling, and trismus. Risk of bias and methodological quality assessment was carried out. We pooled data statistically, and meta-analyses were carried out using a random-effects model. Results Seventeen randomized controlled trials were included in this systematic review, all of which were considered to have a low risk of bias. Participants, aged 13 to 70 years, and 35% women, totaled 1064. Meta-analyses found significant reductions in standardized mean differences (SMDs) in swelling at day 2 and day 7 postoperatively (SMD, −0.611; 95% confidence interval, −0.968, −0.234 and SMD, −0.532; 95% confidence interval, −0.795, −0.269). There were nonsignificant reductions in SMD in pain and trismus at day 2 and day 7 postoperatively. Conclusions LLLT significantly reduces swelling after extraction of mandibular third molars compared with placebo. LLLT has not shown to reduce postoperative pain and trismus. LLLT does not cause adverse effects. There is currently insufficient evidence available, to promote the investment in LLLT vs the net clinical benefit. Randomized controlled trials with larger sample size and standardized study design and outcome measures are required, to make definitive recommendations to clinicians on its use on patients