COVID-19 and Oral Surgery: a narrative review of preoperative mouth rinses

Cilj: Obaviti narativni pregled predloženih preoperativnih protokola za ispiranje usne šupljine prije oralno-kirurških zahvata da bi se u aerosolu suzbila pojavnosti virusa SARS-CoV-2. Izvori: Pretražene su znanstvene baze podataka PubMed, MedLine, CINAHN i Scopus kako bi se pronašli relevantni radovi objavljeni do trećeg tjedna travnja 2020. godine. Ovo istraživanje dopunjeno je pretraživanjem putem internetske tražilice te ručnim pretraživanjem međunarodnih i nacionalnih smjernica. Odabir istraživanja: Uključena su istraživanja i protokoli u kojima se predlaže preoperativno ispiranje usta kao mjera tijekom pandemije virusa COVID-19. S obzirom na to da je dostupan mali broj istraživanja, obavljen je pregled narativne literature. Ukupno se 15 referencija (11 članaka i 4 smjernice) smatralo mjerodavnima i kritički je analizirano. Zaključak: Rezultati pokazuju visoku heterogenost u predloženim protokolima. Potrebna su daljnja istraživanja da bi se bolje razumjele značajke i epidemiološka obilježja novog virusa te da bi se ispitala učinkovitost uobičajenih antiseptika protiv virusa SARS-CoV-2 u budućim kliničkim ispitivanjima. No upotreba klorheksidina, vodikova peroksida, providon-jodida i cetilpiridinijeva klorida, sa svrhom prevencije širenja bolesti uzrokovane virusom COVID-19, u različitim je časopisima opisana kao poželjna.Objective: To provide a narrative review of the preprocedural mouth rinse protocols suggested for oral surgery in order to contrast the presence of SARS-CoV-2 in aerosol. Sources and Methods: Electronic searches were performed in medical databases PubMed, Medline, CINAHN and Scopus to identify relevant studies published up until the third week of April 2020. This research was supplemented by exploration through a web-based search engine as well as a manual search for international and national guidelines. Studies and protocols which suggested preoperative mouth rinsing as a recommended measure during the COVID-19 outbreak were included. Given the small number of studies, a narrative literature review was conducted. In total, 15 references (11 articles and 4 guidelines) were considered relevant and were critically analysed. Conclusion: The findings show a high heterogeneity in the protocols suggested. Further research is required to better understand the viral features and epidemiologic characteristics of this new virus and to test the efficacy of commonly used antiseptics against SARS-CoV-2 in future clinical trials. However, the use of chlorhexidine, hydrogen peroxide, PVP-I and cetylpyridinium chloride in contrasting the spread of Covid-19 is described as advisable and substantial in different publications

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Severe early onset preeclampsia: short and long term clinical, psychosocial and biochemical aspects

Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks gestational age. It occurs in approximately 3-5% of pregnancies and it is still a major cause of both foetal and maternal morbidity and mortality worldwide1. As extensive research has not yet elucidated the aetiology of preeclampsia, there are no rational preventive or therapeutic interventions available. The only rational treatment is delivery, which benefits the mother but is not in the interest of the foetus, if remote from term. Early onset preeclampsia (<32 weeks’ gestational age) occurs in less than 1% of pregnancies. It is, however often associated with maternal morbidity as the risk of progression to severe maternal disease is inversely related with gestational age at onset2. Resulting prematurity is therefore the main cause of neonatal mortality and morbidity in patients with severe preeclampsia3. Although the discussion is ongoing, perinatal survival is suggested to be increased in patients with preterm preeclampsia by expectant, non-interventional management. This temporising treatment option to lengthen pregnancy includes the use of antihypertensive medication to control hypertension, magnesium sulphate to prevent eclampsia and corticosteroids to enhance foetal lung maturity4. With optimal maternal haemodynamic status and reassuring foetal condition this results on average in an extension of 2 weeks. Prolongation of these pregnancies is a great challenge for clinicians to balance between potential maternal risks on one the eve hand and possible foetal benefits on the other. Clinical controversies regarding prolongation of preterm preeclamptic pregnancies still exist – also taking into account that preeclampsia is the leading cause of maternal mortality in the Netherlands5 - a debate which is even more pronounced in very preterm pregnancies with questionable foetal viability6-9. Do maternal risks of prolongation of these very early pregnancies outweigh the chances of neonatal survival? Counselling of women with very early onset preeclampsia not only comprises of knowledge of the outcome of those particular pregnancies, but also knowledge of outcomes of future pregnancies of these women is of major clinical importance. This thesis opens with a review of the literature on identifiable risk factors of preeclampsia

Discutindo a educação ambiental no cotidiano escolar: desenvolvimento de projetos na escola formação inicial e continuada de professores

A presente pesquisa buscou discutir como a Educação Ambiental (EA) vem sendo trabalhada, no Ensino Fundamental e como os docentes desta escola compreendem e vem inserindo a EA no cotidiano escolar., em uma escola estadual do município de Tangará da Serra/MT, Brasil. Para tanto, realizou-se entrevistas com os professores que fazem parte de um projeto interdisciplinar de EA na escola pesquisada. Verificou-se que o projeto da escola não vem conseguindo alcançar os objetivos propostos por: desconhecimento do mesmo, pelos professores; formação deficiente dos professores, não entendimento da EA como processo de ensino-aprendizagem, falta de recursos didáticos, planejamento inadequado das atividades. A partir dessa constatação, procurou-se debater a impossibilidade de tratar do tema fora do trabalho interdisciplinar, bem como, e principalmente, a importância de um estudo mais aprofundado de EA, vinculando teoria e prática, tanto na formação docente, como em projetos escolares, a fim de fugir do tradicional vínculo “EA e ecologia, lixo e horta”.Facultad de Humanidades y Ciencias de la Educació

Ten-year results of a Screening Program during pregnancy for children’s dental caries prophylaxis

Introduction: Dental caries is a multifactorial disease with many contributing factors in the genesis of risk (11). Streptococcus mutans (SM) is a gram positive, facultative anaerobe commonly found in the human oral cavity. Described for the first time in 1924 by Clarke, is the main germ responsible for the caries disease (5, 9). In fact, SM produces an insoluble extracellular polysaccharide sucrose which plays an important role as a mediator of the adhesiveness, both as a cementing molecule for other microorganisms, and to create a protected site where the microorganism can proliferate (6, 9, 10). Its presence in the plaque is not equal for all people and is closely related to sugar consumption (9). Its transmission can take place early in the life of the child through the mother’s saliva (2, 3, 4, 8).The early acquisition of this organism is associated with Early Childhood Caries (ECC) and then creates a primary colonization which is hardly removed (1, 7). Paying special attention to the health of women and children, this work aimed to decrease the incidence of childhood tooth decay, streamlining preventive efforts in a population at risk. Methods: Since 1999, all women referred to our clinic in the second trimester of pregnancy or during childbirth were offered the opportunity to perform a simple test to measure the presence of SM in saliva and have been given some advice (diet, hygiene, fuoro-prophylaxis, dental visit). The sampling of saliva was performed after chewing one paraffin tablet for about 1 minute. For the microbiological examination the technique of dip-slide test (CTR bacteria, Ivoclar Vivadent) was used; results were classified according to semi-quantitative classes of microorganism concentration.Women were classified positive when bacterial concentration was 100000 CFU/ml. Besides a general advice on hygiene and diet, these women were invited to undergo a prophylactic treatment with chlorhexidine, a disinfectant with bactericidal properties against SM. Results: 84% of surveyed women adhered to the screening (29% pregnant women, 55% in the puerperium). In the 12-year study, 2170/7213 (30%) women had a positive saliva test and were administered chlorhexidine. Conclusions: By means of a prenatal screening involving different professionals (microbiologist, obstetriciangynecologist, pediatrician, oral-hygienist) we could assess the likelihood of vertical transmission of SM from mother to child, and give the mothers medical advice on the risk of tooth decay in children. Preliminary data on the incidence of caries in children of those women who tested positive at the screening, confirm that our program has an important role in preventing childhood tooth decay

Clutter loss measurements in suburban environment at 26 GHz and 40 GHz

Last World Radiocommunication Conference in 2015 (WRC-15), identified several frequency bands between 24.25 GHz and 86 GHz as possible candidates for the deployment of future terrestrial IMT-2020/5G systems. Agenda item 1.13 of next WRC-19 invites ITU-R to conduct and complete sharing and compatibility studies, taking into account the protection of services to which the band is allocated on a primary basis for the identified frequency bands. To conduct the studies in sharing scenarios between terrestrial 5G and the other affected services, mainly satellite and terrestrial fixed links; the interference signal at the receiver needs to be calculated by using the appropriate propagation model. Among the propagation models to be used, ITU-R Recommendation P. 2108-0 [Rec1] proposes a statistical clutter loss model for Earth-space and Aeronautical. This model, is based on theoretical equations and has been complemented with simulations [Rep1]. Hence, there is a need to validate it with real measurements. To this aim, the Joint Research Centre has conducted a first measurement campaign to characterize clutter loss in suburban environment at 26 GHz and 40 GHz. This document describes the scenario, the measurement setup and shows the initial results and comparisons.JRC.E.2-Technology Innovation in Securit

BAG-1 proteins protect cardiac myocytes from simulated ischemia/reperfusion-induced apoptosis via an alternate mechanism of cell survival independent of the proteasome

BAG-1 (Bcl-2-associated athanogene-1) proteins interact with the HSC70 and HSP70 heat shock proteins and have been proposed to promote cell survival by coordinating the function of these chaperones with the proteasome to facilitate protein degradation. Consistent with this proposal, previous analyses in cancer cells have demonstrated that BAG-1 requires protein domains important for HSC70/HSP70 and proteasome binding in order to interfere with the growth inhibition induced by heat shock (Townsend, P. A., Cutress, R. I., Sharp, A., Brimmell, M., and Packham, G. (2003) Cancer Res., 63, 4150–4157). Moreover, cellular stress triggered the relocalization of the cytoplasmic BAG-1S (36 kDa) isoform to the nucleus, and both BAG-1S and the constitutively nuclear localized BAG-1L (50 kDa) isoform suppressed heat shock-induced apoptosis to the same extent, suggesting a critical role in the nucleus. Because ischemia (I) and reperfusion (R) are important stress signals in acute and chronic heart disease, we have examined the expression and function of BAG-1 proteins in primary cardiac myocytes (CMs) and the Langendorff-perfused intact heart. The expression of both BAG-1 isoforms, BAG-1S and BAG-1L, was rapidly induced following ischemia in rat CM, and this was maintained during subsequent reperfusion. In control hearts, BAG-1S and BAG-1L were readily detectable in both the nucleus and the cytoplasm. However, BAG-1S did not relocate to the nucleus following simulated I/R. BAG-1 interacted with both RAF-1 and HSC70 in CMs and the whole heart, and binding to HSC70 was increased following I/R. Overexpression of the human BAG-1S and BAG-1 M isoforms significantly reduced CM apoptosis following simulated I/R. By contrast, BAG-1L or BAG-1S fused to a heterologous nuclear localization sequence failed to protect CM. Finally, overexpression of BAG-1 deletion and point mutants unable to bind HSC70/HSP70 failed to offer cardioprotection. Surprisingly, a deletion mutant lacking the N-terminal ubiquitin-like domain, which mediates interaction with the proteasome, still promoted cardioprotection. Therefore, BAG-1 has a novel cardioprotective role, mediated via association with HSC70/HSP70, which is critical upon cytoplasmic localization but independent of the BAG-1 ubiquitin-like domain. Our studies demonstrate that BAG-1 can influence cellular response to stress by multiple mechanisms, potentially influenced by the cell type and nature of the stress signal. <br/

Search for narrow resonances using the dijet mass spectrum in pp collisions at s√=8 TeV

Results are presented of a search for the production of new particles decaying to pairs of partons (quarks, antiquarks, or gluons), in the dijet mass spectrum in proton-proton collisions at s√=8  TeV. The data sample corresponds to an integrated luminosity of 4.0  fb−1, collected with the CMS detector at the LHC in 2012. No significant evidence for narrow resonance production is observed. Upper limits are set at the 95% confidence level on the production cross section of hypothetical new particles decaying to quark-quark, quark-gluon, or gluon-gluon final states. These limits are then translated into lower limits on the masses of new resonances in specific scenarios of physics beyond the standard model. The limits reach up to 4.8 TeV, depending on the model, and extend previous exclusions from similar searches performed at lower collision energies. For the first time mass limits are set for the Randall–Sundrum graviton model in the dijet channel