Efficacy of anti-biofilm protocols for cleansing full dentures in hospitalized individuals

According to a recent study, soaking dentures in 1% sodium hypochlorite for 10 minutes without any brushing was found to be a simple, quick, affordable, and efficient way to clean the dentures of hospitalized patients. This study’s results were published in the Journal of applied oral science.

The maxillary complete dentures of 340 hospitalized participants were subjected to random cleaning using 17 different protocols (n=20 participants). The cleaning methods included brushing with distilled water, neutral liquid soap, or toothpaste, (considered as controls), as well as immersion in chemical solutions such as 1% sodium hypochlorite, alkaline peroxide, 0.12% or 2% chlorhexidine digluconate. Additionally, some dentures were subjected to microwave irradiation (650 W for 3 min), either alone or in combination with brushing. The effectiveness of these protocols was assessed by evaluating the biofilm of the intaglio surface of the maxillary complete dentures before and after cleaning. Two methods used for evaluation include : microbiological quantitative cultures on blood agar and Sabouraud Dextrose Agar (CFU/mL) as well as denture biofilm coverage area (%). The collected data were analyzed using the Wilcoxon and Kruskal-Wallis tests.

Significant reductions in the percentage area of denture biofilm and microbial and fungal load were achieved by all 17 protocols. The most significant reductions in denture biofilm area were observed with 1% hypochlorite solution with or without brushing, and with 2% chlorhexidine solution and microwave irradiation combined with brushing. The greatest reductions in microbial and fungal load were noted in groups that used 1% hypochlorite solutions and 2% chlorhexidine, as well as microwave irradiation, regardless of brushing .

Thus, it can be concluded that a single immersion of dentures in 1% sodium hypochlorite for 10 minutes, without brushing is a simple, quick, cost-effective, and efficient method for cleaning dentures in hospitalized patients.

Patients with metastatic castration-resistant prostate cancer benefit from niraparib plus abiraterone acetate and prednisone

A recent study suggests that patients with metastatic castration-resistant prostate cancer (mCRPC) and BRCA alterations showed clinically relevant outcomes when treated with niraparib plus abiraterone acetate and prednisone (AAP). This study’s results were published in the Annals of Oncology.

The phase 3, MAGNITUDE trial included 212 HRR+ patients with/without BRCA1/2 alterations. They were randomized in a 1:1 ratio to receive 200mg of niraparib orally plus AAP (1000 mg/10 mg orally) or placebo plus AAP. At the second prespecified interim analysis (IA2), the secondary endpoints assessed were time to symptomatic progression, time to initiation of cytotoxic chemotherapy and overall survival (OS).

It was found that at IA2 with 24.8 months of median follow-up, niraparib plus AAP showed significantly prolonged radiographic progression-free survival (rPFS) (19.5 versus 10.9 months; hazard ratio (HR) = 0.55 [95% confidence interval (CI) 0.39-0.78] consistent with the first prespecified interim analysis. Similarly, in the total HRR+ population, rPFS was also prolonged. In the niraparib plus AAP group, time to symptomatic progression and time to initiation of cytotoxic chemotherapy showed improvements. Even the analysis of OS with niraparib plus AAP in the BRCA1/2 subgroup demonstrated a lower hazard ratio.

From the above results, it is clear that niraparib plus AAP in patients with BRCA1/2-altered mCRPC, may demonstrate an improved rPFS and other clinically relevant outcomes.

Renal relapse in ANCA-associated vasculitis can be predicted by the presence of CD4 + T cells in the urine

A recent study demonstrated that urinary CD4 + T-cell counts have the potential to identify individuals with antineutrophil cytoplasmic antibodies (ANCA)-associated vasculitis who are at a significant risk of experiencing renal relapse within a 6-month period. This study’s findings were published in the Journal of the American Society of Nephrology.

The PRE-FLARED was a prospective multicenter biomarker study that enrolled 102 individuals with ANCA-associated vasculitis in remission. This study aimed to predict the occurrence of renal relapse by quantifying the levels of urinary CD4 + T-cell subsets through flow cytometry at the baseline, and then monitoring the clinical outcomes during a six-month follow-up period.

Out of the total participants, 2 had non-renal flares, 10 experienced renal relapses, and 90 remained in stable remission. Patients who relapsed had a significantly higher median baseline urinary CD4 + T-cell count compared to those in remission. The analysis of urinary CD4 + T-cell counts using receiver operating characteristic curve showed an area under the curve value of 0.88 for predicting renal flares, hematuria, proteinuria, and outperforming ANCA titers. With a cutoff of 490 CD4 + T cells per 100 ml urine, the sensitivity and specificity in identifying patients with future renal flares were 60% and 97.8%, respectively. Combining urinary CD4 + T-cell counts with proteinase-3 ANCA levels in a post hoc analysis suggested improved predictive performance in the PR3 + subgroup. Additionally, the number of urinary CD4 + T cells demonstrated a limited correlation with a decline in glomerular filtration rate (GFR) and an increase in proteinuria over the follow-up period.

According to the above study, urinary CD4+ T-cell counts could be used to detect individuals with ANCA-associated vasculitis who face a considerable risk of renal relapse within six months. The incorporation of these counts with ANCA levels has been shown to enhance the accuracy of relapse prediction.

The effect of repetitive preheating of bulk-fill resin composite on postoperative hypersensitivity

A recent study demonstrated that the postoperative dentin hypersensitivity was not negatively affected by the repeated preheating cycles of bulk-fill resin composite prior to curing. This finding could be significant as it indicates that the same resin composite syringe can undergo multiple preheating cycles during clinical use before it is completely consumed. Additionally, this practice offers the advantage of improved handling properties. This study’s findings were published in the journal, BMC oral health. 
This randomized controlled clinical trial included a total of 105 patients with posterior teeth and proximal decay without any signs of irreversible pulpitis. The patients underwent preparation for Class II restorations and received treatment using bulk-fill resin composite. They were divided into three groups based on the number of preheating cycles for the resin composite syringe. Group I received no preheating, serving as the control group at room temperature. Group II had the resin composite preheated once, while Group III had it preheated ten cycles. The patients were evaluated for postoperative dentin hypersensitivity using the visual analogue scale (VAS) at three different time intervals: day one, one week, and one month after the restorative treatment. 
The scores of the three groups during the three time intervals were close to zero, except on the initial day when VAS scores reached a maximum of 3 for groups I and II. There was no significant alteration in hypersensitivity scores over time for groups II and III, as indicated by P-values of 0.135 and 0.368, respectively. However, group I exhibited a significant variance from the VAS score noted on the first day compared to the subsequent time periods.
Based on the above results, it can be concluded that the repeated preheating cycles of bulk-fill resin composite prior to curing did not have a negative impact on postoperative dentin hypersensitivity. This finding could be of utmost importance as it suggests that the resin composite syringe can be subjected to multiple preheating cycles before it is completely utilized. Additionally, this approach provides the benefit of enhanced handling properties. 
 

Effect of erythropoiesis-stimulating agents on the systolic and diastolic blood pressure of hemodialysis patients

According to a recent study, erythropoiesis-stimulating agents (ESAs) have been linked to a significant rise in both systolic blood pressure (SBP) and diastolic blood pressure (DBP) among hemodialysis patients, resulting in an increase of approximately 5mmHg. This study’s results were published in the journal, Medicina Clinica. 
This study comprised a systematic review and meta-analysis of 34 clinical trial studies found in multiple databases, such as Web of Science, Science Direct, Cochrane Library, PubMed, Embase, Scopus, and Google Scholar, from the years 1980 to 2022. The assessment of article quality was conducted using the Jadad scale checklist, and the data was analyzed utilizing Stata 15 software.
The results demonstrated a significant increase in both SBP and DBP post-ESA consumption compared to pre-consumption levels. The mean difference in SBP was recorded as 4.84mmHg (95% confidence interval: 2.74-6.94, p-value <0.001) and in DBP was 4.69mmHg (95% confidence interval: 2.67-6.71, p-value <0.001). No indication of publication bias was found. The meta-regression analysis indicated that factors such as quality assessment score, sample size, and geographical location of the study played a significant role in the observed heterogeneity in mean SBP difference (p-value ≤0.20). Similarly, for DBP, quality assessment score, sample size, and follow-up duration were identified as significant variables (p-value ≤0.20).
The results of the above study demonstrated that ESAs have been associated with a notable increase in both systolic and diastolic blood pressure in hemodialysis patients, leading to a rise of around 5mmHg.