bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevention and screening of Osteonecrosis of Jaw (ONJ): the Alessandria experience of a multidisciplinary team on a 900-patient population
Authors: Fasciolo Antonella , Fusco Vittorio , De Martino Iolanda , Alessio Manuela , Brigo Paola , Tartara Daniela , Campora Riccardo Alberto , Rossi Maura 
Published: April 2021

PATIENTS AT RISK OF OSTEONECROSIS OF THE JAW (ONJ) INCLUDE MOSTLY CANCER AND MYELOMA PATIENTS RECEIVING ANTIRESORPTIVE TREATMENTS (BISPHOSPHONATES AND DENOSUMAB) WITH/WITHOUT BIOLOGICAL AGENTS, BUT ALSO PATIENTS WITH OSTEOPOROSIS AND RHEUMATOLOGIC DISORDERS. ONJ CASES WERE FIRSTLY DIAGNOSED IN OUR HOSPITAL ON 2005. SINCE 2006, A ONJ MULTIDISCIPLINARY TEAM WAS ESTABLISHED (INCLUDING MAXILLOFACIAL SURGEONS / DENTISTS, ONCOLOGISTS, HEMATOLOGISTS, NURSES, RADIOLOGISTS, NUCLEAR MEDICINE AND OTHER MEDICINE SPECIALISTS, DATA MANAGERS). PREVENTIVE (RISK REDUCTION) MEASURES BEFORE ANTIRESORPTIVE TREATMENT (DENTAL VISIT, DENTAL PANORAMIC RX, EVENTUAL TEETH EXTRACTIONS, DENTAL AND DENTURE CARE) HAVE BEEN PLANNED, ACCORDING TO EARLY RECOMMENDATIONS AND THEIR MODIFICATIONS. FURTHERMORE IN THE OSTEONECROSIS PREVENTION AND SCREENING OFFICE OTHER PATIENTS RECEIVED CARE IF : A) ONJ WAS SUSPECTED AFTER TREATMENT FOR CANCER AND MYELOMA IN NEIGHBORING HOSPITALS, OR B) ONJ WAS SUSPECTED AMONG OSTEOPOROSIS PATIENTS IN THE TERRITORY BY PRIVATE PRACTICE DENTISTS. MORE THAN 900 PATIENTS WERE VISITED AND REGISTERED IN 2006-2020 YEARS. CASES OF SUSPECTED ONJ WERE 127 (45 MALE, 82 FEMALE). TWENTY-FOUR CASES WERE EXCLUDED BY ANALYSIS DUE TO UNCONFIRMED DIAGNOSIS OR INSUFFICIENT DATA. CHARACTERISTICS OF 103 CASES OF ONJ CONFIRMED ACCORDING TO ITALIAN (SIPMO-SICMF) DEFINITION AND RECOMMENDATIONS WERE REVIEWED. DISEASE: 40 BREAST CANCER; 16 PROSTATE CANCER; 11 MYELOMA; 7 RENAL CELL CANCER; 4 LUNG CANCER; 7 OTHER CANCERS; 18 OSTEOPOROSIS AND OTHER NON MALIGNANT DISORDERS. DISTRIBUTION OF DRUGS ASSOCIATED TO ONJ (ZOLEDRONIC ACID, DENOSUMAB, PAMIDRONATE, ALENDRONATE, RISEDRONATE, IBANDRONATE, CLODRONATE, BEVACIZUMAB, SUNITINIB) CHANGED ALONG YEARS.
Diagnostic Accuracy of Bone Scintigraphy in the Early Prediction of MRONJ
Authors: Rocchetti Federica , Giulietti Marco , Pergolini Daniele , Palaia Gaspare , Gaglioti Domenico , Romeo Umberto , Del Vecchio Alessandro 
Published: April 2021

Since Medication-Related Osteonecrosis of the Jaw (MRONJ) is challenging to treat, prevention and early detection are fundamental to limit progression. While some imaging techniques such as computed tomography (CT) scans are helpful to estimate the extent of osteonecrosis in clinically evident MRONJ, methods for early detection and identification of patients at risk for MRONJ need further investigations. The aim of our retrospective study was to evaluate the role of bone scintigraphy (BS) in the early prediction of MRONJ. BS of patients treated with antiangiogenic or antiresorptive therapy for bone metastases were evaluated for pathological tracer uptake of the jaws. Sensitivity, specificity, predictive values of BS for the prediction of MRONJ were investigated. Moreover, the latency from the first presence of pathological tracer uptake in BS to clinically evident MRONJ was determined. The significance of pathologic BS for MRONJ detection was calculated by Fisher’s exact test and the odds ratio was determined.

A total of 19 patients with representative BS were recruited from our Department database. Whole body BS in anterior and posterior positions were reviewed by a specialist in nuclear medicine, blinded to MRONJ diagnosis, for pathological tracer uptake of the jaws. Results were compared to development of clinically evident MRONJ. Sensitivity and specificity of BS for MRONJ prediction were respectively 90% and 82%. Positive and negative predictive values were 64% and 96%, respectively. Median time from the first presence of pathological tracer uptake in BS to clinically evident MRONJ was 20.3 months (range 7–41). Pathologic findings on BS were significantly (p < 0.001) more often observed in patients who developed MRONJ compared to patients who did not. The risk to develop MRONJ was 41.4-fold increased when BS was pathologic. According to our results, BS is an accurate method for the prediction of MRONJ.
A primary prevention strategy: oral hygiene and correct lifestyles among patients at risk of developing drug-related osteonecrosis of the Jaw
Authors: Mosaico Giovanna , Casu Cinzia 
Published: April 2021

Skeletal complications caused by osteoporosis or bone metastases are associated with considerable pain, increased mortality and reduced quality of life. Agents that prevent bone resorption, such as bisphosphonates or denosumab, can reduce the risk of fractures and are widely used in patients with osteoporosis or bone cancer metastases. Drug-related osteonecrosis of the jaw (MRONJ) is a rare but potentially serious adverse event associated with cumulative high doses of bisphosphonates or denosumab. MRONJ is a known potential side effect of long-term bisphosphonate therapy. Other risk factors for osteonecrosis of the jaw (ONJ) ​​include the use of glucocorticoids, maxillary or mandibular bone surgery, poor oral hygiene, chronic inflammation, diabetes mellitus, dental prostheses, and other medications, including antiangiogenic agents. Prevention strategies for elimination and stabilization of oral disease include completion of necessary oral surgery prior to initiation of antiresorptive drug therapy, use of antibiotics before and / or after the procedure, and rinsing of the mouth with chlorhexidine antimicrobial, adequate wound healing after tooth extraction and maintenance of good oral hygiene. The primary goal of treatment should be to improve the patient's quality of life by managing pain and infections, preventing the development of new lesions and slowing the progression of the disease. As a multi-professional team, dentists and dental hygienists play a key role in the primary prevention of MRONJ. However, the need for a standardized multidisciplinary approach, with a sustained dialogue between the specialists involved, should always be adopted in order to improve the effectiveness of preventive strategies and improve the patient's quality of life.

This treatise describes the preventive treatment and management of patients with this condition.
Safety and efficacy of sectorial resection with piezoelectric device in ONJ
Authors: Bacci Christian , Boccuto Mariagrazia , Cerrato Alessia , Grigoletto Anna , Zanette Gastone , Angelini Annalisa , Sbricoli Luca 
Published: April 2021

Aim of the study was to evaluate the efficacy and safety of sectorial bone resection with piezoelectric device in patients with STAGE 1 and 2 (SIPMO/SICMF) ONJ.
Materials and methods: A retrospective study was conducted in cancer and osteometabolic patients with ONJ of Stage 1 or Stage 2 according to SIPMO/SICMF 2.0 who underwent to sectorial bone resection with piezoelectric device and contextual first intention closure.
All procedures were performed in local anesthesia and conscious sedation, in out-patients clinical setting.
Treatment was considered efficient in case of complete epithelization of the site, complete resolution of symptoms and absence of exposure of bone. Piezoelectric device was used without other rotating handpieces.
All patients were followed up at 2 weeks, 8 weeks and 6 months after the surgery.
Results: 10 patients, from 45 to 83 (average 68.4) years old, 7 females and 3 males, were identified.
Bisphosphonates were administrated in 7 cases (zoledronate) for oncological reasons, 2 patients for osteometabolic reasons (1 alendronate, 1 hybandronate) while in 1 case for algodystrophy (an off-label use of clodronate).
8 mandibular sectorial osteotomies and 2 maxillary were performed, with a single recurrence.
3 patients were heavy smokers: this surprising did not compromise the outcome.
Conclusions: According to our case studies the use of piezoelectric device in sectorial bone resection in ONJ seem to be effective and easy to use.
Histological findings of osteonecrosis spotted prior to tooth extractions. Should we consider tooth extraction still the main trigger event?
Authors: Mauceri Rodolfo , Panzarella Vera , Iurato Carbone Martina , Oteri Giacomo , Marcianó Antonia , Di Fede Olga , Campisi Giuseppina 
Published: April 2021

Osteonecrosis of the jaw (ONJ) is an adverse drug reaction described as the progressive destruction and death of bone that affects the mandible and maxilla of patients exposed to the treatment with medications known to increase the risk of disease, in the absence of a previous radiation treatment.

Tooth extraction often precedes the manifestation of ONJ; indeed, it is sometimes called trigger event and it have also been considered as risk factors for the onset of ONJ.

As a consequence, some of the guidelines recommend avoiding tooth extractions in patients at risk of ONJ; however, a growing body of evidence indicates that dental/periodontal infection prior to extraction, rather than dental extraction may represent the main local risk factor for ONJ.

Ten patients at risk of ONJ have undergone tooth extractions. They were identified and included in our retrospective monocentric clinical investigation.

Patients underwent tooth extractions with standardized procedures (PROMaF protocol), and bone biopsies were taken.

Extractions were performed due to symptomatic, non-restorable teeth in patient at risk of ONJ; histological findings of ONJ were observed in all samples.

This outcome may highlight that the proof of non‐exposed ONJ might be the histopathologic confirmation of necrotic bone, as stated by European task force on MRONJ. Additionally, alveolar biopsy should possibly be taken in every case of suspected ONJ, which needs an proper and prompt management for successful healing.
Curative Rates of Medication-Related Osteonecrosis of the Jaw Following Application of the SICMF-SIPMO Surgical Treatment Algorithm
Authors: Bettini Giordana , Saia Giorgia , Perra Elena Sofia , Tognin Laura , Franco Piero , Bedogni Giorgio , Bedogni Alberto 
Published: April 2021

BACKGROUND. Management of Medication related osteonecrosis of the jaw (MRONJ) is challenging and there is little evidence about the effectiveness of treatments.
The present study aims at assessing the value of the SICMF-SIPMO MRONJ staging system as a predictor of treatment success.

PATIENTS & METHODS. We performed a 10-years longitudinal cohort study at the Unit of Maxillofacial Surgery of Padova University (Italy). The study was approved by the local Ethical Committee of the University Hospital of Padova (CESC 4920/AO/20 - 24 September 2020). Patients were included in the study if they satisfied the SICMF-SIPMO clinico-radiological diagnostic criteria of MRONJ and were staged accordingly. Patients were assigned to each surgical treatment based on the SICMF-SIPMO classification. Patients were followed up at three-month intervals up to 1-year and underwent a CT scan of the jaws at three, six, and twelve months postoperatively.

RESULTS. Overall, a total of 70 patients reached the 12-month follow-up and 75 operated jaw sites were available for the analysis.The cumulative curative rate (CR) at 1-year follow-up was 85.3%. MRONJ recurred in 9 jaw sites (12%). The curative rates did not significantly differ between maxilla and mandible (87% vs. 84%). The underlying disease highly influenced the CR of MRONJ, with cancer patients more likely to develop recurrences within 1 year (CR cancer = 76% ; CR osteoporosis =100%). Bone curettage and sequestrectomy showed the highest CR in MRONJ stage 1, regardless of the underlying disease (88.2%). Marginal resection proved to be successful in MRONJ stage 2 with an overall curative rate of 81%. Nevertheless, MRONJ stage 2 patients with cancer showed high recurrence rates when treated with marginal resection. Segmental resection proved highly successful in MRONJ stage 2 (88.2%) and MRONJ stage 3 (92.9%). Of note, segmental resections in MRONJ stage 2 were mostly performed in cancer patients (12/15).

CONCLUSION. In conclusion, the stage-related surgical algorithm proposed by SICMF-SIPMO can be safely used and it should be implemented to select the appropriate surgical treatment for MRONJ patients. Further studies are warranted before its final validation.
PREVALENCE AND ANTIMICROBIAL SUSCEPTIBILITY PATTERN OF EXTENDED SPECTRUM ?-LACTAMASE (ESBL) PRODUCING GRAM NEGATIVE BACILLI (KLEBSIELLA PNEUMONIA) IN A TERTIARY CARE TEACHING HOSPITAL, IN SOUTHERN-WEST KOTA DISTRICT OF RAJASTHAN (INDIA).
Authors: Meena Gopal Lal , Soni Ghanshyam , Maheshwari Deepak 
Published: April 2021

Background and Objectives: The resistance to broad spectrum ?-lactams which is mediated by the extended spectrum beta lactamase (ESBL) enzyme is an increasing problem now-a-days. This resistance mechanism has been responsible for nosocomial outbreaks, serious therapeutic failure if it is not detected on time and the outbreak of multidrug resistant, gram negative pathogens that need expensive control measures.
Aim: To know the prevalence of ESBL production in klebsiella pneumoniae and antibiotic sensitivity pattern to 3rd generation of cephalosporins in Govt. Medical College Kota.
Material and Methods: The study was conducted in Department of Microbiology, Kota Medical College, Kota, Rajasthan, from dec.2018 to dec.2019. Due permission from institutional ethical committee was obtained. This is descriptive observational study. All data were collected and analyzed with the help of suitable statistical parameters.
A total of 101 consecutive, nonrepetitive, gram negative isolates, which were resistant to one of the third generation cephalosporins (cefotaxime,ceftriaxone or ceftazidime) were selected as “Suspicious for ESBL production” as recommended by the Clinical and Laboratory Standards Institute (CLSI). These isolates were confirmed for ESBL production by the double disc synergy test (DDST) and the phenotypic confirmatory disc diffusion test (PCDDT) and they were further confirmed by the E-test ESBL strip randomly.
Result: Out of the 101 isolates by double disc synergy test (DDST) 45.54% (46) of Klebsiella pneumoniae isolates were ESBL producers, while PCDDT detected 58.41% (59) Klebsiella pneumoniae isolates as ESBL producers (p value<0.05). Randomly selected isolates were further confirmed by the E-test ESBL strip, which showed a highly significant correlation with PCDDT.
Key words: Antimicrobial Susceptibility, Klebsiella pneumoniae, Gram Negative bacilli, Cephalosporins
Implicações da pandemia de COVID-19 nos hábitos alimentares de brasileiros: revisão integrativa
Authors: Lima Evely Rocha , Silva Thalane Souza Santos , Vilela Alba Benemérita Alves , Rodrigues Vanda Palmarella , Boery Rita Narriman Silva de Oliveira 
Published: April 2021

A pandemia da COVID-19 alterou a rotina dos brasileiros, gerando impactos diretos nos seus hábitos alimentares. Objetivo: Analisar as implicações da pandemia de COVID-19 nos hábitos alimentares de brasileiros, a partir da produção científica publicada em 2020. Metodologia: Estudo de revisão integrativa da literatura, cuja busca de artigos foi realizada no portal da Biblioteca Virtual em Saúde, em dezembro de 2020, empregando os descritores em inglês: food, eating habits, food consumption, COVID-19, Coronavirus infections. Foram incluídas publicações de artigos originais, de abordagem quantitativa ou qualitativa, realizados no Brasil entre abril e novembro de 2020. Os dados extraídos foram: título, autor, ano, revista, objetivos, metodologia, população/amostra, resultados e conclusões de cada estudo. Resultados: As mudanças alimentares resultantes da pandemia diferiram a depender do grupo etário e das condições socioeconômicas e de saúde do indivíduo. Na maioria dos artigos analisados observou-se impactos negativos, com destaque para o aumento do consumo de alimentos ultraprocessados e redução do consumo de vegetais, especialmente em adultos com depressão, indivíduos de menor renda e escolaridade. O consumo de alimentos não saudáveis frequentemente esteve combinado com o estilo de vida sedentário, representando comportamentos de risco para o desenvolvimento de doenças crônicas não transmissíveis. Entretanto, alguns estudos revelaram mudanças positivas nos hábitos alimentares de adultos, com aumento discreto no consumo de marcadores de alimentação saudável, e redução do consumo de fast foods por adolescentes. Considerações finais: Estudos longitudinais são necessários para melhor compreender os impactos da pandemia da COVID-19 nos hábitos alimentares, bem como para nortear ações de enfrentamento à doença e aos desdobramentos desse fenômeno mundial na saúde dos brasileiros.
Fatores que influenciam na adesão vacinal de mães usuárias da Atenção Primária à Saúde
Authors: Iori Daltro Moreira , Siqueira Valéria Maria Carvalho , Almeida Caroline Rodrigues de , Labegalini Célia Maria Gomes 
Published: April 2021

Objetivo: Analisar os fatores que influenciam as mães na adesão vacinal. Metodologia: Pesquisa qualitativa, exploratória e descritiva, realizada com 18 mães que utilizam uma Unidade Básica de Saúde. Os dados foram coletados por meio de entrevista apoiada por um roteiro, estes foram transcritos e submetidos a análise temática. Seguiram-se todos os preceitos éticos vigentes. Resultados: Participaram do estudo 18 mulheres, com idades entre 20 e 39 anos, as mães ressaltam que o principal benefício da vacinação é a prevenção e proteção para algumas doenças transmissíveis, em relação aos possíveis malefícios as mesmas destacam que os benefícios os superam. A respeito dos impactos da diminuição da cobertura vacinal, as mães deste estudo ressaltam que pode haver a eminência de seus filhos contraírem doenças infecto contagiosas devido a lacuna imunológica que seria suprida pela vacina. Conclusão: O estudo identificou que as mães são as principais responsáveis pela vacinação das crianças, e o principal fator para a adesão vacinal é a prevenção e proteção para algumas doenças transmissíveis. As participantes relatam que os benefícios da imunização superam os malefícios, e estes se relacionam a possiblidade de efeitos adversos, e a dor durante o procedimento invasivo.
Influence of different polishing and aging periods on the surface roughness of composite resins
Authors: Okida Ricardo Coelho , Hoshino Isis Almela Endo , Romanini Lívia Patrícia , Fontes Amanda Maslen , Bueno Esteves Lara Maria , Anchieta Rodolfo Bruniera 
Published: April 2021

The aim of this study was to evaluate the influence of the polishing period on surface roughness (Ra) before and after thermal aging in four composite resins - CR (Durafill VS, Vittra APS, Filtek Z350XT and Spectra Smart). This in vitro study evaluated: (1) CR in 4 levels; (2) polishing period (PP) in three levels (immediate, 7 and 14 days) and (3) artificial aging in two levels: without aging and after 10,000 cycles. For this, 240 CR specimens were allocated into 12 groups (n=20) according to PP with SofLex Pop On disks. For Ra, 3 measurements on the top surface of each specimen were performed with a diamond tip and constant load of 4mN and 0.25mm/s. Next, the specimens were aged in thermocycling, with temperatures of 5° and 55°C, during 30 seconds in each temperature, and repeated testing afterwards. The data were submitted to statistical tests with 5% significance. The alteration in Ra was observed only in the late polishing in the period of 7 days, where the Durafill VS CR showed higher Ra in comparison to the other CRs. After thermocycling, the groups showed significant difference only with late polishing in the 21-day period; the nanoparticulated RCs (Z350XT˂Vittra APS) recorded the highest Ra values, followed by the microhybrid (DurafillVS) and nanohybrid (Spectra Smart) RCs, respectively. Thus, late polishing in the 7-day and immediate period provided higher Ra values, especially for the nanohybrid and microhybrid composite resins.
Prototype Sistem Kontrol Air Sawah Otomatis Berdasarkan Level Air Berbasis Mikrokontroler Atmega8535 Pada Desa Bontoraja Kabupaten Bulukumba
Authors: Candra Adi 
Published: April 2021

Prototype sistem kontrol air sawah otomatis berdasarkan level air berbasis mikrokontroler atmega8535 pada desa bontoraja kabupaten Bulukumba, Prototype ini dibuat untuk mengontrol pemberian air pada sawah sehingga para petani tidak lagi mengalami kesulitan dalam mengatur air sawahnya. Melalui pengumpulan data dan studi pustaka alat ini dirancang menggunakan sistem kontrol otomatis berdasarkan ketinggian air sawah. Prototype sistem kontrol air sawah Otomatis Berdasarkan level air berbasis Miktrokontroler ini dilengkapi dengan sensor level air yang berfungsi sebagai input dan tombol switch untuk peninjaun data ketinggian air. Mikrokontroler yang digunakan adalah ATmega8535 yang berfungsi sebagai media pemproses berdasarkan input yang masuk dan mengontrol output. Perangkat lunak yang digunakan untuk mengoperasikan mikrokontroler adalah bahasa BASIC COMPAILER. Sistem Output dari sistem ini adalah berupa motor AC. Putaran motor AC digunakan untuk mengalirkan air masuk dan keluar dari sawah.
Association Between Finger-to-Nose Kinematics and Upper Extremity Motor Function in Subacute Stroke: A Principal Component Analysis
Authors: Chen Ze-Jian , He Chang , Xia Nan , Gu Ming-Hui , Li Yang-An , Xiong Cai-Hua , Xu Jiang , Huang Xiao-Lin 
Published: April 2021

BackgroundKinematic analysis facilitates interpreting the extent and mechanisms of motor restoration after stroke. This study was aimed to explore the kinematic components of finger-to-nose test obtained from principal component analysis (PCA) and the associations with upper extremity (UE) motor function in subacute stroke survivors.MethodsThirty-seven individuals with subacute stroke and twenty healthy adults participated in the study. Six kinematic metrics during finger-to-nose task (FNT) were utilized to perform PCA. Clinical assessments for stroke participants included the Fugl-Meyer Assessment for Upper Extremity (FMA-UE), Action Research Arm Test (ARAT), and Modified Barthel Index (MBI).ResultsThree principal components (PC) accounting for 91.3% variance were included in multivariable regression models. PC1 (48.8%) was dominated by mean velocity, peak velocity, number of movement units (NMU) and normalized integrated jerk (NIJ). PC2 (31.1%) described percentage of time to peak velocity and movement time. PC3 (11.4%) profiled percentage of time to peak velocity. The variance explained by principal component regression in FMA-UE (R2 = 0.71) were higher than ARAT (R2 = 0.59) and MBI (R2 = 0.29) for stroke individuals.ConclusionKinematic components during finger-to-nose test identified by PCA are associated with UE motor function in subacute stroke. PCA reveals the intrinsic association among kinematic metrics, which may add value to UE assessment and future intervention targeted for kinematic components for stroke individuals.Clinical Trial RegistrationChinese Clinical Trial Registry (http://www.chictr.org.cn/) on 17 October 2019, identifier: ChiCTR1900026656.