Search Results (89)

This scoping review mapped and critically reviewed the extant literature exploring associations between oral disease status and adverse pregnancy outcomes among women residing in sub-Saharan Africa. A literature search was conducted in July 2023 using PubMed, Cochrane Library and Google Scholar. The articles selected were those published in the English language between 1990 and 2022. After screening 833 potential studies, 15 articles met the inclusion criteria. Among these, 12 (80.0%) adopted a descriptive research design, while 3 (20.0%) used experimental methodologies. Eight (53.3%) studies were conducted in East Africa, fourteen (93.3%) studies were hospital-based, and one (6.7%) study was community-based. Periodontitis was linked with low birth weight, preterm birth, preterm birth and low birthweight, stunting, wasting, and underweight in most studies. Periodontitis was, however, not linked with adverse pregnancy outcomes in four studies. Caries was not linked with adverse pregnancy outcomes, but its sequalae was linked with low birth weight, preterm birth, neonatal stunting, and small head circumference. Two studies showed that periodontal diseases were linked with preeclampsia and chorioamnionitis. Maternal poor oral hygiene was linked with stunting. Two other studies showed no links between maternal periodontal disease and preterm premature rupture of membranes, eclampsia, spontaneous abortion, and vaginal bleeding. Furthermore, two intervention studies found that the treatment of periodontal diseases during pregnancy reduced the risk of adverse pregnancy outcomes. Further studies are needed to fully elucidate the effect size of the links observed between oral diseases and adverse pregnancy outcomes in sub-Saharan Africa. Full article

Mandibular third molars are the most commonly impacted teeth. The prevalence and pattern of impacted mandibular third molars in patients presenting to the Obafemi Awolowo University Teaching Hospitals Complex, a tertiary hospital in south-western Nigeria, are largely unknown. This retrospective study examined 469 patient records, extracting socio-demographic and clinical information for analysis. It also determined the prevalence and pattern of impacted mandibular third molars from January 2015 to December 2019. The positioning of impacted teeth was assessed via periapical radiographs utilizing Winter’s classification. Data were subjected to analysis with IBM SPSS version 20, utilizing frequencies, percentages, and likelihood ratios, with statistical significance set at p < 0.05. The prevalence of impacted mandibular third molars within the study cohort was 2.51%, with a higher incidence observed in the 21–29 age group (p < 0.001). Mesioangular impaction was the most prevalent, with pericoronitis being the primary reason for extraction, and periodontal pockets being the most common associated pathology. Full article

Psychosocial trauma has accompanied mankind since time immemorial and has been sufficiently portrayed in art and literature to suggest that posttraumatic stress disorder may be as old as combat itself. Since war is more frequent in human history than peace, public health measures are confined to mitigating the detrimental impact of battlefield experiences on combat participants. At present, PTSD outcome studies show mixed results, marked by high nonresponse rates, therapy dropout, and completed suicide, suggesting that novel strategies are urgently needed. Those of us who work routinely with combat veterans have noted an increasing trend of patients preferring mindfulness-based therapies as opposed to trauma-centered treatments, such as prolonged exposure or trauma-focused cognitive behavioral therapy. Preference for mindfulness over trauma-based therapies appears to coincide with the shift in research focus from the amygdala and fear to the insular cortex and interoceptive awareness. Therefore, rethinking PTSD as insular pathology is driven by the recent findings that neurons in this cortical area not only regulate cardiac rhythm but also record past intestinal inflammations. These discoveries likely explain the high comorbidity of stress-related disorders with premature endothelial senescence and a dysfunctional intestinal barrier. Moreover, the identification of the cholinergic anti-inflammatory pathway and the revelation that endothelial cells express alpha-7 nicotinic receptors has brought PTSD prevention and early detection within reach. In this narrative review, we discuss the relationship between early vascular aging, gut barrier disruption, and PTSD. We also examine the link between this pathology and faulty interoceptive awareness, surmising that hypertension and decreased heart rate variability are PTSD risk factors, while lipopolysaccharide, lipopolysaccharide binding protein, soluble CD14, microbial cell-free DNA, acyloxyacyl hydrolase, and IL22 comprise early detection markers of this disorder. Full article

Idiopathic pulmonary fibrosis (IPF), hypersensitivity pneumonitis (HP) and systemic sclerosis (SSc) are among the most common entities that cause pulmonary fibrosis. Alveolar collapse with subsequent collapse induration of lung tissue is thought to contribute to the fibrotic transformation. The purpose of this study was to examine lung tissue in computed tomography (CT) of non-diseased appearance during expiration for signs of increased density suggesting collapsibility in fibrosing lung diseases. We further analyzed the diaphragmatic movements during the respiratory cycle to determine relationships between density differences and the apex–diaphragm diameter. Significant differences in attenuation changes between inspiration and expiration of unaffected lung parenchyma were detected between IPF and controls and between HP and controls for all lung lobes (p < 0.001). Only minor differences were found between SSc and controls. There was no clinically relevant difference between patients with IPF and those with HP. The measured absolute apex–diaphragm diameter in inspiration and expiration demonstrated a statistically significant difference between patients with IPF versus normal controls. However, the diaphragmatic excursions were not different between these groups. Compared to controls, CT lung density increases significantly more during expiration in the fibrotic lungs of IPF and HP patients. The observed increase in density might indicate the collapse of alveoli during expiration and may represent a common pathophysiologic feature of fibrosing lung diseases. The density changes and lung extensions do not have the same ratios across different diseases and controls. Full article

The aim of this scoping review was to map the research that links oral health and sustainable development goals (SDGs). The question that guided this review was what is the published evidence specifically linking oral health and SDGs? The search of articles published between 2015 and June 2023 in English was conducted in June 2023 in PubMed, Web of Science, Cumulative Index to Nursing and Allied Health Literature, and Scopus. The extracted data from the 12 of the 520 publications that met the inclusion criteria were synthesized. These were publications from the African (n = 2) and European (n = 1) regions. Ten of the studies were not country specific. There were three observational studies. The referenced SDGs were SDG 1 (n = 1), SDG 3 (n = 11), SDG 4 (n = 3), SDG 5 (n = 2), and SDG 13 (n = 1). The studies linking oral health to SDG3 discussed a range of issues related to integrated oral health care, dental education on the SDGs, improved health equalities, access to universal health care, and sustainable health approaches. The small number of studies identified suggests the need to take proactive steps to generate research-based evidence that explores the interplay between oral diseases, oral health, and SDGs to address the dearth in the literature. By so doing, resources allocated to the SDGs can also be effectively uses to control oral diseases. Full article

This study investigates the impact of more densely populated urban environments proxied by the number of skyscrapers on the obesity prevalence among young vs. old populations at a US statewide level. Obesity is a global pandemic, as well as a major risk factor for a long series of health problems and increased mortality rates. We employ a quadratic model, which relaxes the a priori assumption of the monotonic rise or drop in obesity prevalence with the number of skyscrapers. The outcomes demonstrated a U-shaped curve and a sharper decrease (increase) in the projected obesity prevalence with the number of skyscrapers in the range of 0–147 (147–270) skyscrapers for the old population age cohorts above 65 years old. One possible explanation is the different motivation for physical activity among dissimilar age cohorts. While younger people are focused on maintaining a slim body shape, older people identify with the importance of sports. The public policy outcome of our study is the need to implement different recommendations in dissimilar urban environments based on age cohort stratification. Given that skyscrapers are the manifestation of wealth economics and present the typical characteristics of modern cities, which, in turn, are the future of economic development and productivity, these recommendations might prove to be important. Full article

Untreated early childhood caries (ECC) is a global public health concern. In the short term, untreated ECC can lead to pain, infection, and disrupted sleep, among other issues. In the long term, it is associated with poor oral health in later life, increased risk of caries in permanent teeth, and adverse effects on physical and psychological development. There may be a link between untreated ECC and adverse cognitive and neurodevelopmental outcomes in young children, although the exact pathways are not fully understood. One possible pathway is through the relationship between mastication and brain stimulation. Impaired masticatory function due to ECC can affect the hippocampus, a key region responsible for memory and learning. Furthermore, untreated ECC can cause chronic inflammation, leading to the release of pro-inflammatory cytokines that may damage the brain. Sleep disturbances resulting from ECC-related pain and discomfort can also impact brain development and cognitive functioning. Additionally, frequent use of antibiotics and analgesics to address ECC-related infections can disrupt the gut microbiome, potentially affecting the brain through the gut–brain axis. Untreated ECC can cause nutritional deficiencies and elevated nutritional risk, and can further hinder brain development. Addressing ECC comprehensively with early childhood health initiatives can help mitigate potential long-term consequences and promote optimal brain development in young children. Full article

Background: Human herpes virus-6 (HHV-6) is a ubiquitous virus known as an etiological agent of exanthem subitum. HHV-6-encephalitis in immunocompetent children is a rare complication of the primary infection. There are a lack of data on the prevalence of HHV-6-encephalitis in Russia. The aim of our study was to analyze the prevalence of HHV-6 DNA in the cerebrospinal fluid (CSF) of immunocompetent children with suspected acute meningoencephalitis. Materials and Methods: A total of 712 CSF samples were tested using qualitative PCR over 12 years at N.F. Filatov Children’s City Clinical Hospital No.5, Saint-Petersburg, Russia. Results: HHV-6 DNA was detected in 20 (2.8%) of the samples. Retrospectively, we analyzed the medical records of 15 cases. There were seven boys and eight girls from 1 month to 7 years old; the mean age was 22.3 ± 5.6 months. Most HHV-6 DNA-positive cases were due to the primary form of HHV-6 infection. There were, in total, four cases of HHV-6-meningoencephalitis. All the children had a complete recovery, without neurological deficits or death. Conclusions: HHV-6 encephalitis is a very rare disease in immunocompetent children (four cases among 712 samples over 12 years). Additional studies are needed to develop accurate diagnostic criteria and therapeutic approaches. Full article

This scoping review provides an overview of the tools used to assess for early childhood caries (ECC) in Nigeria. A search of the literature in African Journals Online, Google Scholar, Medline, and Cochrane database was conducted in June 2023 using the PRISMA-ScR guidelines. A combination of keywords related to caries risk assessment, preschool children, and evaluation tools was used for the search. Studies reported in English and assessing ECC were extracted. Descriptive statistics were used to summarise the information on study characteristics, types of caries assessment tools, and study outcome. Caries assessment tools were divided into behavioural, social, and biological. After screening 964 potential studies, 16 were included in the review. ECC assessment tools were categorised into behavioural (snacking, frequency of consumption of refined carbohydrate in-between-meals, dental service utilisation, frequency of tooth brushing, use of fluoridated toothpaste, breast and bottle feeding patterns and duration), biological (birth rank, age, sex, anthropometric measures, molecular characterisation of isolated organisms, presence of plaque), and social (socioeconomic status of the child’s household, mother’s level of education, maternal income, occupation of the father, maternal decision-making ability). Twelve studies used behavioural assessment tools, 11 used biological, and 11 used social tools. Furthermore, 11 (70.1%) used a combination of tools, four (25.0%) used only biological tools, and one (6.2%) used only behavioural tools to assess ECC experience. No study screened for the risk of caries. In conclusion, we identified the need for comprehensive studies to identify the risk indicators of ECC in Nigeria. This will support the development of a caries risk assessment tool appropriate for the country context. Full article

The decarbonization of transport is a global initiative aimed at reducing greenhouse gas emissions and addressing the risks of global warming. This article explores the potential connections between the decarbonization of transport and oral health, highlighting the need for further research in this area. Emissions from vehicle exhausts, such as carbon dioxide, methane, and nitrous oxide, may have a modest impact on the risk of early childhood caries and other oral health diseases like periodontal diseases, oral cancer, and dental caries. Active transportation, which promotes regular exercise, has beneficial effects on overall health, including stimulating salivary protein production and reducing the risk of diabetes and cardiovascular diseases, both of which are linked to poor oral health. Transitioning to electric vehicles can also reduce noise pollution, positively impacting mental well-being, which is associated with improved oral hygiene practices. Furthermore, the development of sustainable infrastructure, including efficient public transportation systems, can enhance access to dental services. Further research is needed to establish stronger evidence for these connections and to explore how the global decarbonization of transport agenda can incorporate oral health considerations. Full article

Background: The effects of the use of continuous glucose monitoring (CGM) in elite endurance athletes are unclear. This case study reported the blood glucose (BG) levels of a female national-level marathon runner during a real-world marathon race. Methods: Heart rate and BG levels were monitored throughout the race. Results: The runner completed the race in 2:46 h:min, which was an improvement from her previous personal record by just under one min. Her BG levels were stable from approximately 5–40 km of the race at a mean concentration of 7.13 mmol/L, with a standard deviation of 0.20 mmol/L and a coefficient of variation of 2.8%. Increases in BG levels and heart rate were observed 6 min after the race and during the 40–42.195 km section, respectively. Conclusions: The runner broke her own record and exhibited stable BG levels throughout the race, with the highest BG value detected immediately after the race. Considering that quantity, content, and timing of pre-race meals and supplementation during the race can affect BG levels, future studies should assess additional detailed parameters in more detail and monitor multiple races with the same elite endurance athletes to acquire more definitive evidence on CGM usefulness among elite endurance athletes. Full article

Aim: to explore the psychological wellbeing and work-related quality of life amongst United Kingdom (UK) health and social care workers during the COVID-19 pandemic. Subject and methods: Health and social care professionals within nursing, midwifery, allied health professions, social care and social work occupations working in the UK during the pandemic were recruited. Repeated cross-sectional online surveys were conducted during six time periods of the pandemic (May–July 2020, November–February 2021, May–July 2021, November 2021–February 2022, May–July 2022 and November 2022–February 2023). Results: Over 14,000 participants completed the surveys during the data collection periods. The findings revealed that over the pandemic, psychological wellbeing and work-related quality of life scores significantly decreased. Conclusions: The overall psychological wellbeing and work-related quality of life of health and social care workers during the COVID-19 pandemic significantly declined. Further research is warranted on the lasting impact of the pandemic on this workforce. The health and social care workforce needs support to prevent further deterioration and to rebuild its wellbeing and resilience. Full article

The purpose of the present study was to review all available work published within the last decade focusing on coping strategies in stroke caregivers and their impact on quality of Life (QoL) and psycho-emotional status. A literature search of two databases (MEDLINE, Scopus) was conducted to identify all relevant full-text English studies published between 2013–2023. Sixteen articles were traced and were finally included. Cognitive and behavioral coping strategies were beneficial for stroke caregivers’ and survivors’ QoL. The level of mutuality in the caregiver-survivor relationship was associated with the impact of depressive symptoms on caregivers’ QoL and the protective effect of mutuality on survivors’ QoL over time. The level and quality of social support were positively associated with QoL for stroke caregivers and survivors. Caregivers’ preparedness was a moderator for the impact of depression on both caregivers’ and survivors’ QoL. High levels of spirituality had a significant role in ameliorating the negative impact of depressive symptoms on the psychological and physical QoL of stroke caregivers and survivors. In conclusion, the study of coping strategies can be used as a psychological reserve in the process of stroke rehabilitation and actively contribute to improving the QoL of both caregivers and stroke survivors. Full article

There exist a plethora of studies examining the psychological and physical impacts of COVID-19 on infected victims. Fewer studies have been published assessing the different types of impacts that an individual’s COVID-19 infection has on close friends and family members. This is the first scoping review to gauge the reported psychosocial issues and daily hassles that impact the relatives and friends of infected individuals. This study was conducted by inputting key terms/MeSH terms into selected internet databases to locate prospective studies. The frameworks of scoping reviews by Arksey et al. and the preferred reporting items for systematic review and meta-analyses (PRISMA) were utilized in the methodology for identifying and selecting the studies. After data extraction, 37 studies were deemed suitable for analysis. The findings generated from each study were placed into combined categories. A total of 16 combined categories were generated from the amalgamation of the findings. The results show that psychosocial feelings (e.g., anxiety, stress, and depression) were the category with the highest prevalence of grouped findings. The results from this study may serve as the impetus for future interventions targeting the alleviation of psychosocial feelings or day-to-day hassles associated with having a loved one inflicted with a severe illness. Full article

Polypharmacy, the use of multiple and potentially inappropriate medications, is an increasing problem among older adults. The global polypharmacy prevalence is 34.6% in patients with COVID-19, and polypharmacy in COVID-19 increases with age. The present paper proposes that polypharmacy in older adults with COVID-19 and other comorbid conditions is linked to the medication outcome reporting bias of randomized controlled trials. Outcome reporting bias can occur when treatment efficacy is reported as relative risk reductions, which overestimates medication benefits and exaggerates disease/illness risk reductions compared to unreported absolute risk reductions. The comorbidities common in patients with COVID-19 include high blood pressure, cardiovascular disease, dementia or cerebrovascular disease, and diabetes. Accordingly, the present paper reassesses the relative and absolute risk reductions in clinical trials from a small convenience sample of antihypertension, statin, anticoagulant, and antihyperglycemic medications. Examples demonstrate a wide gap between reported relative risk reductions and unreported absolute risk reductions in medication clinical trials. This paper concludes that medication clinical trial outcome reporting bias is an important upstream factor that contributes to biased medication benefits and poor clinical decision making, leading to polypharmacy in older adults with COVID-19 and other comorbid conditions. Public health campaigns are urgently needed to educate the public about the link between polypharmacy and medication outcome reporting bias. Full article