Obesity/overweight and dental caries experience in children and adolescents: an umbrella review.

PURPOSE: The present umbrella review aimed to synthesize and critically assess the methodological and reporting quality of previous systematic reviews about the potential relationship between obesity or overweight and caries dental experience in pediatric patients. METHOD: Electronic database and manual searches were conducted in PubMed, Embase, and Cochrane Library up to July 2023. The risk of bias assessment of eligible systematic reviews was performed using the Risk Of Bias In Systematic reviews (ROBIS) tool. A systematization of the results was carried out in order to understand the possible relationship between the two conditions. RESULTS: Electronic and manual searches identified 136 titles and abstracts. After the removal of duplicates, 15 full-text articles were assessed for eligibility. Six studies were excluded, resulting in 8 systematic reviews and 1 scoping review that met the inclusion criteria. Five were systematic reviews without meta-analysis and the rest were conducted with quantitative analysis. CONCLUSION: Conflicting findings to date from this umbrella review suggest that the relationship between obesity and dental caries in children is still inconclusive and likely to be complex.

Dog-Assisted Therapy (DAT) for the management of anxiety during paediatric dental care. A scoping review.

AIM: Distraction techniques in paediatric dentistry can be effective in decreasing the child's attention span from an unpleasant or stressful procedure. Distraction is achieved through imagination, audio, and/or visual stimuli. It has been shown that the accompaniment and participation of animals or pets, specifically dogs (Dog-Assisted Therapy or DAT), during medical, oral, and therapeutic activities can improve the physical and mental health of patients, especially children. However, there is limited information available regarding the impact of incorporating a certified therapy dog into the paediatric dental environment as a distraction strategy to alleviate anxiety levels during dental procedures. METHODS: This scoping review aimed to identify and review published articles concerning the use of DAT in paediatric dentistry. The article discusses indications, benefits, and potential risks to human health and safety in clinical settings. Eligible sources encompass clinical trials, observational studies, and narrative reviews written in either English or Spanish and published over the last two decades, sourced from four electronic databases. Ultimately, seven pertinent studies were included in the review. CONCLUSION: DAT presents itself as a promising alternative in managing anxiety and stress among children during dental visits. The integration of a therapy dog and its handler into the paediatric oral care team should be thoughtfully considered by clinicians as a means to enhance the comfort and compliance of apprehensive patients.

Evaluación del perfil de seguridad del medicamento tocilizumab en pacientes sospechosos o confirmados por COVID-19 / Evaluation of the safety profile of the drug tocilizumab in patients suspected or confirmed by COVID-19

Introducción: La enfermedad de COVID-19, es una enfermedad emergente cuya patogénesis se relaciona con la tormenta de citocina, la interleucina 6 juega un papel importante en la tormenta de citocinas. El medicamento tocilizumab, es un anticuerpo monoclonal humanizado, el cual se une al receptor soluble IL-6. En pacientes con COVID-19 se ha observado que el uso de tocilizumab disminuye la inflamación exacerbada. Ante este nuevo uso del medicamento es relevante establecer el balance beneficio-riesgo en estos pacientes con COVID-19, identificando con ello las reacciones adversas a medicamentos que pueden estar relacionadas al uso de tocilizumab. Materiales y métodos: Estudio de farmacovigilancia descriptivo y transversal en una cohorte retrospectiva en pacientes sospechosos o confirmados por COVID-19 en el Instituto Nacional de Cardiología Ignacio Chávez de la Ciudad de México, México en el periodo 05 de mayo del 2020 al 20 de enero del 2021. Resultados: De los 36 pacientes participantes en este estudio, la edad promedio fue 53 años, de los cuales 30 fueron hombres y 6 fueron mujeres. Las comorbilidades identificadas en este estudio fue la hipertensión arterial sistémica, seguida de la diabetes mellitus tipo II. En la evaluación de los estudios de laboratorio se observó que 2 pacientes desarollaron neutropenia moderada, mientras que en 5 pacientes se identificó trombocitopenia leve y 2 pacientes desarrollaron trombocitopenia moderada. Las infecciones bacterianas identificadas en el estudio con el uso del medicamento fueron: 5 aislamientos de Klebsiella oxytoca, 4 a Escherichia coli y 4 a Pseudomonas aeruginosa... (AU)

Introduction: COVID-19 is a new emerging disease which pathogenesis is mediated by a cytokines storm, interleukin 6 plays an important part of this storm. Tocilizumab is a humanized monoclonal antibody that binds to the IL-6 receptor. In patient with COVID-19, exacerbated inflammation has been observed to decrease when given tocilizumab. Due to the new use of this drug is relevant to stablish the risk-benefit ratio in COVID-19 patients, by identifying the drug adverse reactions that may be related to the use of tocilizumab. Material and methods: Descriptive and cross-sectional pharmacovigilance study in a retrospective cohort in patients suspected or confirmed by COVID-19 in the National Institute of Cardiology in Mexico City, Mexico from May 5, 2020 to January 20, 2021. Outcomes: From 36 patients in this study, the average age was 53 years of which 30 were men and 6 were women. The comorbidities identified in this study were systemic arterial hypertension followed by type II diabetes mellitus. Evaluating the laboratory results we observed 2 patients developed moderate neutropenia, 5 patients presented mild thrombocytopenia and 2 patients moderate thrombocytopenia. The bacterial infections identified in the study with the use of the tocilizumab were: 5 isolates Klebsiella oxytoca, 4 isolates Escherichia coli and 4 Pseudomonas aeruginosa. Conclusion: Knowing the possible drug adverse reactions that occurred in patients with COVID-19 who were administered tocilizumab, allow us to the identify the risks associated with the drug, determining the safety profile and be alert of bacterial infections, neutropenia, and thrombocytopenia, throughout a pharmacotherapeutical follow up, thereby identifying possible associated alterations possibly restated with the use of tocilizumab. (AU)

Online Cognitive-Behavioral Intervention on Adherence and Quality of Life in Elderly Adults with Diabetes: Two cases study

During the COVID-19 pandemic, elderly adults with type 2 diabetes mellitus (T2DM) have experienced difficulties to adhere to their therapy (TA), a situation which not only has had an impact on their glycemic control, but on their quality of life (QoL) as well. Telepsychology has proved to be an effective alternative to treat health-related complications in patients with this disease, however, results of same are unknown among the Latin American population. The aim of this study was determining the effect of Online Cognitive-Behavioral Therapy on TA, overall QoL and specific QoL in two elderly adults with T2DM. The case of a 62-year-old woman and a 60-year-old man who was offered an intervention consisting of nine sessions offered through a video conference platform is presented. The procedure included: psychoeducation, self-control training techniques, behavior reinforcement, feedback and problem solving. The Objective Clinical Change (OCC) evidences an increase in TA behaviors, such as use of medications, following a healthy diet (OCC≥ 0.20) and monitoring capillary blood glucose in the medium term (four months). Likewise, improve specific QoL for T2DM patients (OCC≤ -0.20). It is concluded that telepsychology is a low-cost, safe, feasible and effective type of therapy to increase and maintain TA behaviors, as well as to improve the QoL of patients suffering T2DM. Even though, more research is needed to increase the effectiveness of this therapy modality (AU)

Treatment of ectopic eruption of the maxillary first permanent molar in children and adolescents: A scoping review.

AIM: Ectopic eruption of the first permanent molar (EFUPM) is defined as its local disturbed eruptive behaviour, positioning too mesially against the distal aspect of the second upper primary molar during the developing mixed dentition. The EFUPM prevalence is up to 6% and affects both genders equally. The present study aimed to perform a scoping review to collect the most relevant studies published in the last 30 years and focused on the different strategies, traditional and novel, for treating irreversible uni- or bilateral EFUPM in children. This review also aimed to make recommendations and map the gaps in this clinical topic. METHODS: An electronic and manual search was conducted in five databases according to previously established eligibility criteria, using different combinations of keywords, MeSH terms, and Boolean operators. Titles, abstracts, and full-text articles were screened and selected by pre-calibrated reviewers. A data charting was also accomplished for summarising the overview of the evidence. CONCLUSION: Paediatric dentists must learn to diagnose and treat this condition early in order to allow the prevention of future malocclusions and other clinical sequelae. Practitioners have at their disposal a variety of corrective options available for the successful resolution of EFUPM.

MutSα expression predicts a lower disease-free survival in malignant salivary gland tumors: an immunohistochemical study.

BACKGROUND: Appropriate DNA replication is vital to maintain cell integrity at the genomic level. Malfunction on DNA repair mechanisms can have implications related to tumor behavior. Our aim was to evaluate the expression of key complexes of the DNA mismatch-repair system MutSα (hMSH2-hMSH6) and MutSß (hMSH2-hMSH3) in a panel comprising the most common benign and malignant salivary gland tumors (SGT), and to determine their association with disease-free survival. MATERIAL AND METHODS: Ten cases of normal salivary gland (NSG) and 92 of SGT (54 benign and 38 malignant) were retrieved. Immunohistochemistry was performed for hMSH2, hMSH3, hMSH6. Scanned slides were digitally analyzed based on the percentage of positive cells with nuclear staining. Cases were further classified in MutSαhigh and MutSßhigh based on hMSH2-hMSH6 and hMSH3-hMSH6 expression, respectively. RESULTS: hMSH3 expression was lower in malignant SGT compared to NSG and benign cases. Adenoid cystic carcinoma (ACC) cases with perineural invasion presented a lower percentage of hMSH3 positive cells. hMSH6 was downregulated in both benign and malignant SGT compared to NSG. Malignant SGT cases with MutSαhigh expression had lower disease-free survival compared to MutSαlow cases. A 10.26-fold increased risk of presenting local recurrence was observed. CONCLUSIONS: Our findings suggest that a lack of hMSH3 protein function is associated with a more aggressive phenotype (malignancy and perineural invasion) and that MutSα overexpression predicts a poor clinical outcome in malignant SGT.

Biological effects of sodium fluoride varnishes used in remineralisation of enamel: An in vitro study.

AIM: During the last three decades, fluoride varnishes have been recognised as effective strategies for caries prevention in the young-child population and have contributed to a decrease in its prevalence worldwide. The present study aimed to assess in vitro the level of cytotoxicity and genotoxicity in human primary pulp fibroblasts (DPFs) of two NaF varnishes. MATERIALS AND METHODS: Four experimental assays were carried out (MTS, Mitotracker® system [mitochondrial function and morphology], Live/Dead®, and Comet) to assess the morphology, viability, and genotoxicity of two NaF varnishes (Duraphat® and Clinpro White®, both at two different concentrations). The essays were conducted on cultured pulp fibroblasts, grouped in four experimental and two control groups. Collected data were analysed by one-way ANOVA followed by the post hoc Bonferroni test. RESULTS: Some morphological changes of DPFs could be detected after the NaFVs stimulation. Most DPFs incubated in Duraphat (22.6 mg/L) maintained their morphological characteristics, except for a small decrease in cell size and shorter cytoplasmic projections (filopodia); DPFs treated with Clinpro White Varnish (22.6 mg/L) presented a morphology and size similar to the control group. DPFs exposed to Duraphat (113 mg/L) exhibited significant morphological alterations with considerable cell size increases and DPFs treated with Clinpro White Varnish (113 mg/L) showed a slight cell size increase without noticeable morphological anomalies. The Duraphat (22.6 mg/L) and Clinpro White Varnish (22.6 mg/L) groups promoted 31% and 35% cell proliferation, respectively, whereas DPFs proliferation with Duraphat (113 mg/L) decreased up to 59%, and cell proliferation with Clinpro White Varnish (113 mg/L) was similar to that of control. CONCLUSION: All tested varnishes induced changes in the fibroblastic mitochondria. In general, Duraphat was less biocompatible and caused a change in the number of mitochondria compared to Clinpro White Varnish.

Collagen based electrospun materials for skin wounds treatment.

Materials used for wound care have evolved from simple covers to functional wound dressings with bioactive properties. Electrospun nanofibers show great similarity to the natural fibrillar structure of skin extracellular matrix (ECM); therefore, by mimic, the morphology of ECM, nanofibers show high potential for facilitating the healing of skin injuries. Besides morphology, scaffold composition is another important parameter in the production of bioactive wound dressings. Collagen type I is the main structural protein of skin ECM is biocompatible, biodegradable, and its extraction from animal sources is relatively simple. The fabrication of electrospun wound dressings based on collagen and its blends have been studied for skin tissue engineering applications. This review focus on the new advances of collagen electrospun materials for skin wound treatment. It summarizes the recent research on pristine collagen, collagen blends, and collagen surface modifications on nanofibers mats. Finally, the strategies for three-dimensional nanofibers production will also be discussed.

Oxidation of sulfonamides by ferrate(VI): Reaction kinetics, transformation byproducts and toxicity assesment.

This study was aimed at the degradation of sulfonamides (SNs) via oxidation with Fe(VI). The reaction kinetics, identification of degradation byproducts and their toxicity were investigated. The pH solution and Fe(VI) loading had significant effects on the degradation of the sulfonamides. The maximum degradation rate occurred at pH 3.0 with a 6:1 ratio Fe(VI): sulfonamide, obtaining 100% degradation of 15 mg L-1 SN within 5 min. Although Fe(VI) also showed an appreciable reactivity towards SNs (kapp = 9.85-19.63 × 102 M-1 s-1) at pH 7. The influence of solution pH on the values of kapp can be explained considering the specific reaction between Fe(VI) and SNs. Degradation rates are also influenced by the presence of inorganic ions in different water matrixes. For this reason, ions present in groundwater enhanced the SNs degradation through a synergistic effect among carbonates, sulfates and Fe(VI). Degradation byproducts identified, through UPLC analysis, allowed us to proposed three degradation pathways depending on pH. At acid pH there is a cleavage of C-S and S-N bonds. At neutral pH nitroso and nitro-derivates are formed. At basic pH hydroxylation is the main reaction. The cytotoxicity assay of HEK-293 and J774 cell lines exposed to Fe(VI) indicated that transformation byproducts had a lower toxicity than SNs as baseline products. Accordingly, this research suggests that Fe(VI) can act as a chemical oxidant to remove SNs antibiotics and it can be used to treat antibiotic pollution in wastewater.

Management of the oral hemangiomas in infants and children: Scoping review.

BACKGROUND: Pediatric oral hemangiomas are benign vascular tumors that can be seen from birth, particularly in females. Hemangiomas are most frequent located in the lips and usually regress spontaneously, thus they do not require any type of treatment in most cases. The present scoping review pretended to synthesize the most relevant and currently available information from the international dental literature published in the last 25 years, regarding the management of pediatric oral hemangiomas. MATERIAL AND METHODS: An exhaustive literature search was performed in four electronic databases (PubMed, Embase, Google Scholar, and Cochrane). Initially, 241 related titles and abstracts were found. After the duplication removal, screening, and assessment processes, 37 records were included for full-text reading. Finally, 20 articles in the English language were included in the scoping review for data extraction and assessment. RESULTS: We identified and subsequently discussed three fundamental issues associated to the management of pediatric oral hemangiomas: (i) clinical characteristics, differential diagnosis, and histopathological findings; (ii) evolution and complications; and (iii) current available treatment modalities. CONCLUSIONS: Although these like-tumor lesions are uncommon, pediatric dentistry practitioners must be familiar with the inherent clinical characteristics, diagnosis approaches, and currently available treatment options. Nowadays, surgical removal and non-invasive medical/pharmacologic therapies are the best management modalities for pediatric oral hemangiomas.

Treatment of ankyloglossia with dental laser in paediatric patients: Scoping review and a case report.

AIM: The two aims of this article were to conduct a scoping review of current knowledge regarding laser treatment of ankyloglossia in children and to report a case of a male paediatric patient with ankyloglossia treated with laser surgery. METHODS: A comprehensive literature search was carried out on the following electronic databases: PubMed; Embase; Google Scholar; The Cochrane Library, and Dentistry and Oral Science Source (EBSCO). RESULTS: The initial search identified 278 references. After the process of title/abstract screening, 61 articles received a full-text reading; finally, 17 articles were selected. According to this scoping literature review, lingual frenulectomy managed with laser surgery provides a more efficient and comfortable treatment for both the paediatric patient and the dentist compared with conventional scalpel/blades/suturing techniques. Nevertheless, further high-quality studies on the clinical efficacy of laser devices for lingual frenulectomy in paediatric populations are required. CONCLUSION: Early diagnosis and treatment of ankyloglossia are fundamental for the adequate functional oral development of paediatric patients. Laser surgery for lingual frenulectomy provides a more efficient and comfortable treatment for both the child and the paediatric dentist compared to traditional scalpel/blade methods.

Fabrication and in vitro behavior of dual-function chitosan/silver nanocomposites for potential wound dressing applications.

We report the synthesis and in vitro evaluation of dual-function chitosan-silver nanoparticles (CTS-AgNPs) films with potential applications as wound dressings. We attempted to formulate nanocomposite films with appropriate AgNPs concentrations to simultaneously display antibacterial activity and suitability for cell culture. Nanocomposites were obtained by CTS-mediated in situ chemical reduction of AgNO3. Circular-shape AgNPs (sizes ca. 7-50 nm) well distributed within the CTS matrices were obtained in concentrations from 0.018 to 0.573 wt%. Efficacy (bacteriostatic and bactericidal properties) of CTS-AgNPs films to decrease planktonic and biofilm bacterial growth was AgNPs concentration- and bacteria strain-dependent. Films showed significant antibacterial activity against Gram-negative E. coli and P. aeruginosa and Gram-positive S. aureus. Antibacterial activity against S. epidermidis was moderated. Films suitability for cell culture was characterized using primary human fibroblasts (HF). HF displayed cell viability higher than 90% and the characteristic fusiform morphology of adhered fibroblast upon culture on films with AgNPs concentration ≤ 0.036 wt%. HF cultured on these films also showed positive expression of tropoelastin, procollagen type I and Ki-67, characteristic proteins of extracellular matrix and proliferative cells, respectively. In vitro assays demonstrated that cytocompatibility/antibacterial properties decreased/increased as silver concentration increased, suggesting that CTS-AgNPS nanocomposite films with ≈0.04-0.20 wt% might be considered as potential temporary dual-function wound dressings.

Sulfonamides degradation assisted by UV, UV/H2O2 and UV/K2S2O8: Efficiency, mechanism and byproducts cytotoxicity.

The objective of this study was to analyze the effectiveness of UVC, UVC/H2O2 and UVC/K2S2O8 on the degradation of SAs. Rate constant values increased in the order SMZ < SDZ < SML and showed the higher photodegradation of sulfonamides with a penta-heterocycle. Quantum yields were 1.72 × 10-5 mol E-1, 3.02 × 10-5 mol E-1, and 6.32 × 10-5 mol E-1 for SMZ, SDZ and SML, respectively, at 60 min of treatment. R254 values show that the dose habitually utilized for water disinfection is inadequate to remove this type of antibiotic. The initial sulfonamide concentration has a major impact on the degradation rate. The degradation rates were higher at pH 12 for SMZ and SML. SMZ and SML photodegradation kλ values are higher in tap versus distilled water. The presence of radical promoters generates a greater increase in the degradation rate, UVC/K2S2O8 cost less energy, a mechanism was proposed, and the degradation by-products are less toxic than the original product.

Non-syndromic craniosynostosis in children: Scoping review.

BACKGROUND: Craniosynostosis (CS) is a complex condition consisting of the early fusion of one or more cranial sutures in the intrauterine stage. The affected infant exhibits abnormal head shape at time of birth or shortly thereafter. It can be observed in normal individuals (non-syndromic CS or NSCS) or as a part of a multisystem syndrome. The purposes of the present article were to carry out a scoping review on Non-Syndromic CS and to discuss the most important findings retrieved. MATERIAL AND METHODS: The steps of this scoping review were as follows: first, to pose a research question; second, to identify relevant studies to answer the research question; third, to select and retrieve the studies; fourth, to chart the critical data, and finally, to collate, summarize, and report the results from the most important articles. Relevant articles published over a 20-year period were identified and retrieved from five Internet databases: PubMed; EMBASE; Cochrane Library; Google Scholar, and EBSCO. RESULTS: Fourteen articles were finally included in the present scoping review. The following four most important clinical issues are discussed: (i) normal cranial development, clinical manifestations, and pathogenesis of NCSC; (ii) clinical evaluation of NCSC; (iii) treatment and post-surgical follow-up; and (iv) additional considerations. CONCLUSIONS: NSCS may be present with associated head shapes. Multiple early surgical reconstructive options are currently available for the disorder. Pediatric Dentistry practitioners must be familiarized with this condition and form part of a multi-approach health team as those responsible for the opportune oral health care of the affected child.

Oral management of children with Henoch-Schönlein Purpura and associated Glomerulonephritis: a scoping review.

AIM: To perform a scoping review of the existing literature in order to gather the most relevant information in the paediatric dentistry field related to the oral management of children affected by Henoch-Schönlein Purpura and associated Glomerulonephritis (HSPG). MATERIALS AND METHODS: Using scoping review methodology for the screening and selection of valid articles, the steps of this review were the following: first, to pose a research question; second, to identify relevant studies; third, to select and retrieve the studies; fourth, to chart the critical data, and finally, to collate, summarise, and report the results from the included articles. Relevant articles published over a 25-year period, up to July 31, 2017, were identified and retrieved from four Internet databases: PubMed; EMBASE/Ovid; Ebsco/Dentistry & Oral Science Source, and the Cochrane Collaboration Library. RESULTS: By title and abstract screening and after removing duplicates, four articles were finally included in the scoping review. According to the extracted data, the following are the most important clinical issues to be considered: (1) the disease can appear as a consequence of a dental treatment, such as those indicated for oral infectious processes; (2) children with HSPG are highly susceptible to dental caries and apical periodontitis, and (3) in affected children, oral infectious foci must be exhaustively eradicated in order to avoid the dissemination of the infection. CONCLUSIONS: Paediatric Dentists should be aware of HSPG, because the disease can be triggered or worsen subsequent to dental treatment. Adequate treatment of oral active infectious processes, together with an exhaustive oral preventive programme and long-term patient screening, are the best management approaches for children with HSPG.

A video eyeglasses/earphones system as distracting method during dental treatment in children: A crossover randomised and controlled clinical trial.

AIM To evaluate the effectiveness of a Video Eyeglasses/Earphones System (VEES) as distracting device in reducing anxiety in children during dental procedures carried out under local anaesthesia. MATERIALS AND METHODS: In this crossover clinical trial, 36 Frankl scale II and III children aged 5-8 years received different dental procedures in two sessions, with and without the VEES system. In the control visit, they were not exposed to this distraction stimulus, but traditional non-aversive behaviour management was applied. Each dental session was divided into four phases (explanation, anaesthetic injection, rubber-dam/clamp placement, and high-speed hand piece work for 5 min). Pain in each treatment phase was assessed by the following measurements: the Face, Legs, Activity, Cry, Consolability (FLACC) scale. Pulse rate, and oxygen saturation measurements were employed to evaluate the state of anxiety. Comparison of the outcomes of two interventions were statistically analysed through the Wilcoxon Signed-rank Test. RESULTS: There were no statistical differences between the results of the two interventions (VEES vs. no VEES/behavioural management) during the four treatment phases on assessment by any of the measurements employed. CONCLUSIONS: The VEES method was not more effective than traditional non-aversive behavioural techniques for reducing anxiety and pain perception in children undergoing dental treatment.

Dental approach for Apert syndrome in children: a systematic review.

BACKGROUND: Apert Syndrome (AS), or type I acrocephalosyndactyly, is a rare, congenital craniosynostosis condition resulting from missense mutations in the gene encoding fibroblast growth factor receptor 2. It is characterized by three specific clinical features: brachycephalic skull; midface hypoplasia, and limb abnormalities (syndactyly of hands and feet). The disorder exhibits variable presentations in bones, brain, skin, internal organs, and in the oral/maxillofacial region. The aim of the present paper was to show the main results from a systematic review of AS. MATERIAL AND METHODS: A search of the literature was performed from April to June 2016 in five electronic databases. Clinical interventional or observational studies, reviews, and case reports were included. The present systematic review was carried out strictly following PRISMA and Cochrane Collaboration criteria. RESULTS: A total of 129 potential references were identified. After reviewing titles and abstracts, 77 of these did not meet the desired criteria and were discarded. The full text of the remaining 52 manuscripts was critically screened. Finally, 35 relevant papers were identified for inclusion in the present systematic review and classified according to topic type. CONCLUSIONS: According to the information gathered, dentistry practitioners must be able to supply an early diagnosis through the recognition of AS clinical features and provide correct oral management. Additionally, they should be integrated in a multidisciplinary medical care team in order to improve the quality of life of the affected patients.

Combined antibacterial/tissue regeneration response in thermal burns promoted by functional chitosan/silver nanocomposites.

We report the combined antibacterial/tissue regeneration responses to thermal burns promoted by functional chitosan/silver nanocomposites (CS/nAg) with ultralow silver content (0.018wt.%, 7-30nm). Our approach allows one to produce CS/nAg nanocomposites without silver nanoparticles (nAg) agglomeration, with bactericide potency higher than 1wt.% of nAg (ca. 10nm) content and, promoting the healing process in controlled thermal burns. CS/nAg films exhibit high antibacterial activity against S. aureus and P. aeruginosa after 1.5h of incubation, demonstrating the bacterial penetration into hydrated films and their interaction with nAg. Additionally, exceptional healing of induced thermal burns was obtained by increasing myofibroblasts, collagen remodeling, and blood vessel neoformation. These factors are associated with epiderma regeneration after 7days of treatment with no nAg release. Our results corroborate the controlled synthesis of nAg embedded in CS matrix with combined antibacterial/biocompatibility properties aiming to produce functional nanocomposites with potential use in wound dressing and health care applications.

Dental management of pediatric patients affected by pulmonary atresia with ventricular septal defect: A scoping review.

BACKGROUND: Congenital Heart Diseases (CHD) involves a wide range of pathological conditions, such as Pulmonary Atresia with Ventricle Septal Defect (PA/VSD). This disorder leads to the systemic circulation of oxygen-poor blood (cyanosis), with associated features and consequences in the oral cavity. MATERIAL AND METHODS: Using scoping review methodology for screening and article selection, the primary objectives of this paper were as follows: first, to pose a research question; second, to identify relevant studies in order to answer the research question; third, to select and retrieve the studies; fourth, to chart the critical data, and finally, to collate, summarize, and report the results from the most important articles on the dental management of children affected with PA/VSD. Relevant articles (Randomized Controlled Trials [RCT], reviews, observational studies, and clinical case reports) published over a 10-year period were identified and retrieved from four Internet databases: PubMed; Embase/Ovid; Cochrane Library, and Google Scholar. RESULTS: By title and abstract screening and after removing duplicates, 24 articles were finally included in the present scoping review. According to the extracted data, the following are the most important clinical issues to be considered when treating children with PA/VSD in the dental setting: prevalence of dental caries; prevention of dental disease (oral hygiene and diet); bacteremia and infective endocarditis risk, and child behavior control and treatment under general anesthesia. CONCLUSIONS: Pediatric Dentists should bear in mind that early diagnosis and treatment, together a long-term follow-up of children with PA/VSD, continue to be the best approaches for achieving enhanced patient psychological well-being and, in consequence, their good quality of life.