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To evaluate the frequency of side effects associated with intake of metronidazole (MTZ) + amoxicillin (AMX) in periodontal treatment, and to explore associations between these events and patients' features.Data of five randomized clinical trials testing MTZ + AMX adjunctive to mechanical therapy were evaluated. Volunteers answered an adverse event questionnaire.Information from 656 subjects was assessed. The frequency of side effects in the antibiotic- and placebo-treated groups ranged from 1.0% to 17.7% and 0.9% to 13.7%, respectively. The events more frequently observed in the antibiotic than in the placebo group were diarrhoea and metallic taste (p lt; .05). Diabetes significantly raised the odds of a patient reporting discomfort (odds ratio [OR] = 2.6), diarrhoea (OR = 4.0), weakness (OR = 6.0) and excessive sleepiness (OR = 2.9). In systemically healthy volunteers, using antibiotics 3 months post-mechanical treatment (healing phase) (OR = 3.0), being a woman (OR = 3.9) and aged ≤49 (OR = 4.5) significantly increased the chances of reporting adverse events.The occurrence of side effects during MTZ + AMX treatment ranged from uncommon (1%) to very common (17.7%). The main factors raising the chances of a patient reporting adverse events were diabetes and taking antibiotics in the healing phase, instead of in the active phase of treatment. Patients ≤ 49 years old and females also tend to report more side effects.

Our study aimed to determine the relationship of antidepressant medicine use with periodontal diseases, exploring the association of different pharmacological classes of antidepressant with observations of clinical attachment loss (CAL) and alveolar bone level (BL) in patients with periodontitis.Existing evidence on the impact of antidepressant medication on periodontal tissues has focused on some classes only and is still unclear. Therefore, this retrospective study evaluated the association of different antidepressant classes with clinical attachment loss (CAL) and alveolar bone level (BL).This study was carried out in a population of patients aged ≥ 30 years old with periodontitis who sought treatment at the University of Florida from 2014 to 2018. The following variables were obtained from patients' records; usage of antidepressant medications and their pharmacological classes (selective serotonin reuptake inhibitors [SSRI], serotonin-norepinephrine reuptake inhibitors [SNRI], tricyclic, atypical, and monoamine oxidase inhibitors [MAO]), age, gender, smoking habit, mild systemic diseases, CAL, and cement-enamel junction (CEJ) and alveolar bone crest (BC) distance, defined as BL, in the Ramfjord index teeth.Five hundred and eighty-two periodontitis patients were evaluated, of which 113 (19.4%) were antidepressant users. Antidepressant users exhibited significantly lower BL and fewer sites with severe CAL (≥5 mm), than non-users (p .05). Among all single-class antidepressant users, the SSRI users showed significantly less CAL and lower BL than non-users (p .05). Patients taking combinations of the different classes of antidepressants also showed better CAL and BL than non-users. Generalized linear models, including variables such as gender, age, systemic diseases, and smoking, demonstrated that antidepressant users were more likely to have lower mean BL and fewer sites with severe bone loss (i.e. BL 3 and5 mm) than non-users (p .05).Antidepressant medications were associated with higher alveolar bone level and less clinical attachment loss in patients with periodontitis. When the different classes of antidepressants were analyzed individually, only the SSRI class users and the multiple-class users showed significantly less periodontal breakdown than non-users.

The aim of this study was to perform a 5-year follow-up analysis of a previously-published randomized trial (RCT) evaluating the 2-years effects of metronidazole (MTZ) plus amoxicillin (AMX) as adjuncts to scaling and root planing (SRP) in the treatment of periodontitis in type 2 diabetic patients.Volunteers who received periodontal treatment in the aforementioned RCT were selected for clinical and microbiological evaluation. Patients did not receive regular supportive periodontal therapy (SPT) from 2 to 5 years post-treatment.Of the patients enrolled in the RCT, 43% entered this study (n = 10/control and 15/test group). Most of clinical parameter values, including the number of sites with probing depth ≥ 5 mm (primary outcome variable), were reduced at 5 years post-therapy when compared with baseline in the antibiotic-treated group (P 0.05), but presented higher values than those at 2 years (P 0.05). The mean proportions of microbial complexes did not differ between MTZ+AMX+SRP and SRP-only groups at 5 years post-treatment (P 0.05).Diabetic patients treated with adjunctive MTZ+AMX were better maintained over a period of 5 years than those treated with SRP only. However, the clinical and microbiological benefits obtained up to 2 years post-treatment were not fully sustained in these patients who did not receive SPT between 2 and 5 years post-treatment.

The primary aim of this randomized in vitro study was to compare the effectiveness of carbide, fibreglass and polymer burs on resinous remnant removal after bracket debonding, by the evaluation of enamel surface roughness and morphology. The secondary objective was to compare the time dispended on the procedures.The buccal surfaces of 28 bovine incisors were analysed by a profilometer to initial roughness measurement (Ra-T1). Brackets were bonded with a light-cured resin and debonded with a debonding plier. The samples were randomly divided into four groups, according to the bur used (n=7): A-Tungsten carbide; B-Fibreglass; C-Polymer; D-Polymer with 75% ethanol pre-treatment. The second roughness measurements were made after resin removal (Ra-T2). Time for removal procedures was also recorded. The third measurements were made after polishing (Ra-T3). Scanning Electronic Microscopy was performed in two samples of each group: after resin removal and after polishing. Results of roughness and time measurements were statically analysed by analysis of variance with post-hoc Bonferroni.After polishing, tungsten carbide (P=0.1555) and fibreglass burs provided final surface roughness statistically similar to the baseline condition (P=1.0000). Yet, polymer burs, associated (P0.0001) or not to alcohol (P0.0001), provided surface roughness significantly higher when compared to baseline values. Polymer burs were more time-consuming on resinous remnant removal than tungsten carbide and fibreglass burs (P0.05).Polymer burs were less effective and more time-consuming to remove the remaining resin than tungsten carbide and fibreglass burs. The polishing step created smoother surfaces regardless of the burs used for resin removal.

Made available in DSpace on 2022-05-01T13:41:34Z (GMT). No. of bitstreams: 0 Previous issue date: 2022-01-01 Introduction: The correction of maxillary transverse discrepancy is achieved by means of rapid maxillary expansion, which may be performed by conventional or surgically-assisted rapid maxillary expansion, and more recently, by miniscrew-assisted rapid palatal expansion (MARPE). This study assessed the bone thickness of the palate on cone-beam computed tomography (CBCT) images for placement of mini-implants and anchorage of MARPE. Methods: The sample consisted of 223 CBCT scans from patients of both genders (137 females and 86 males) aged ≥18 years. By using the Image Studio software (Anne Solutions, São Paulo, Brazil), measurements of the bone thickness of the palate were performed bilaterally, as follows: in the axial plane, the bone thicknesses were determined in the anterior region (distal face of the first premolars) and the posterior region (distal face of the first molars), at 3 mm and 6 mm laterally to the midpalatal suture. So in the sagittal plane, the bone thicknesses of the palate were measured in these placements from the palatal cortical to the nasal floor cortical in the anterior region at 30°, 45°, and 90°. In the posterior region, the bone thickness was determined only at 90°. The statistical tests used were the Kruskal-Wallis H test (analysis of variance on ranks) with Dunn's post-hoc test and Mann-Whitney U test (P

The aims of this study were: 1) to compare the levels of cytokines between healthy and diseased sites, in patients with untreated periodontitis; 2) to correlate cytokine levels with each other and with key periodontal pathogens, in healthy and diseased sites.Paired gingival crevicular fluid (GCF) samples were obtained from two healthy (probing depth (PD) and clinical attachment level (CAL) ≤3 mm without bleeding) and two diseased sites (PD and CAL ≥5 mm with bleeding on probing [BoP]) of patients with generalized stage III/IV grade B/C periodontitis. GCF levels of eighteen cytokines and subgingival levels of seven periodontal pathogens were assessed by multiplex immunoassay and qPCR, respectively.A total of 112 subjects and 448 GCF samples were analyzed. The GCF levels of GM-CSF, IL-17, IL-1β, IL-2, IL-21, IL-23 and TGF-β were significantly higher in the diseased than in the healthy sites (p 0.05). Levels of IL-8 and MIP-1α were significantly higher in the healthy than in the diseased sites (p 0.05). In the healthy sites, IL-8 and MIP-1α formed an independent cluster of cytokines and, MIP-1α positively correlated with Porphyromonas gingivalis (p 0.05). In deep sites, smoking negatively associated with GM-CSF, IL-10, IL-17, IL-23, IL-5, IL-6, IL-7, IL-8 and MIP-1α levels (p 0.05).Diseased sites exhibited increased levels of T helper 17-related cytokines and TGF-β while healthy sites presented increased levels of the chemokines, IL-8 and MIP-1α. Patients with periodontitis may not only have inflammation in diseased deep sites, but also present significant hidden subclinical inflammation in their shallow clinically healthy sites.

This study investigated the effects of Brazilian Red Propolis (BRP) extract on seven-day-old multispecies subgingival biofilms. Mixed biofilm cultures containing 31 species associated with periodontal health or disease were grown for six days on a Calgary device. Then, mature biofilms were treated for 24 h with BRP extract at different concentrations (200&ndash, 1600 &micro, g/mL), amoxicillin (AMOXI) at 54 &micro, g/mL (positive control) or vehicle (negative control). Biofilm metabolic activity was determined by colorimetry, and bacterial counts/proportions were determined by DNA&ndash, DNA hybridization. Data were analyzed by Kruskal&ndash, Wallis and Dunn&rsquo, s tests. Treatment with BRP at 1600, 800 and 400 &mu, g/mL reduced biofilm metabolic activity by 56%, 56% and 57%, respectively, as compared to 65% reduction obtained with AMOXI. Mean total cell counts were significantly reduced in all test groups (~50&ndash, 55%). Lower proportions of red, green and yellow complex species were observed upon treatment with BRP (400 &micro, g/mL) and AMOXI, but only AMOXI reduced the proportions of Actinomyces species. In conclusion, BRP extract was as effective as AMOXI in killing seven-day-old multispecies biofilm pathogens and did not affect the levels of the host-compatible Actinomyces species. These data suggest that BRP may be an alternative to AMOXI as an adjunct in periodontal therapy. In vivo studies are needed to validate these results.

A recently developed orthodontic wire alloy known as GUMMETAL® is claimed to deliver more physiological forces to correct dental mispositioning. However, its mechanical characteristics have not been fully characterized yet. This study aimed to determine and compare the elastic properties of different wire alloys, such as nickel–titanium (NiTi), stainless steel (SS), and GUMMETAL®, and assess their unloading forces when combined with either conventional or self-ligating brackets (CL and SL) when correcting dental crowding. All wires had a 0.016″ cross-section diameter. A three-point bending test was performed to assess the maximum deflection of each wire. Then, a subsequent analysis measured the unloading force for each wire/bracket system in a dental crowding clinical simulation device. The test was carried out in a universal testing machine with a cross-speed displacement of 0.5 mm/min. Data were recorded in different ranges and statistically evaluated using two-way analysis of variance. GUMMETAL® displayed higher unloading mean forces in SL brackets (2228.78 cN) than CL brackets (1967.38 cN) for the 1.6–3.0 deflection interval (p = 0.018). Within this interval, NiTi showed higher forces when used with CL brackets (2683.06 cN) than with SL brackets (1179.66 cN) (p < 0.0001). For the CL bracket systems, SS wires showed higher forces (2125.31 cN) in the 1.0–1.6 deflection interval than the other two wire alloys (NiTi, 1541.52 cN and GUMMETAL®, 852.65 cN) (p < 0.0001). SS wires also displayed lower forces with SL brackets (1844.01 cN) than in CL brackets (2125.31 cN) (p = 0.049). Thus, only GUMMETAL® revealed to be an optimal choice for SL brackets, whereas NiTi for CL brackets. [Figure not available: see fulltext.]

Reabilitações implantossuportadas têm sido uma grande alternativa no tratamento de perda dentária nos últimos anos. Devido a essa crescente evolução da implantodontia nota-se o crescimento da incidência das doenças peri-implantares como a peri-implantite. O objetivo desse estudo prospectivo longitudinal foi avaliar a remodelação óssea peri-implantar em pacientes restaurados com implantes cone morse com plataforma switching em acompanhamento de 10 anos. Foram recrutados pacientes com reabilitações sobre implantes cone morse com diâmetro variando de 3,5 a 5,5 mm de diâmetro, 7 a 13 mm de comprimento e tratamento de superfície com ácido e jateamento instalados em plataforma switching na clínica de Implantodontia da Universidade Guarulhos no período entre 1995 e 2016. Foram selecionados 44 pacientes reabilitados com um total de 202 implantes, entretanto apenas 32 implantes foram avaliados no acompanhamento de 10 anos. O sucesso cumulativo dos implantes foi de 87,5% em 120 meses assim como uma remodelação óssea, em média, por volta de 1,1 mm e uma incidência de peri-implantite de 12,5%. Os implantes cone morse com plataforma switching apresentou um alto índice de sucesso e baixa incidência de perda óssea peri-implantar e peri-implantite pelo menos no acompanhamento de 10 anos.

Two key aims of diagnostic research are to accurately and precisely estimate disease prevalence and test sensitivity and specificity. Latent class models have been proposed that consider the correlation between subject measures determined by different tests in order to diagnose diseases for which gold standard tests are not available. In some clinical studies, several measures of the same subject are made with the same test under the same conditions (replicated measurements), and thus, replicated measurements for each subject are not independent. In the present study, we propose an extension of the Bayesian latent class Gaussian random effects model to fit the data with binary outcomes for tests with replicated subject measures. We describe an application using data collected on hookworm infection carried out in the municipality of Presidente Figueiredo, Amazonas State, Brazil. In addition, the performance of the proposed model was compared with that of current models (the subject random effects model and the conditional (in)dependent model) through a simulation study. As expected, the proposed model presented better accuracy and precision in the estimations of prevalence, sensitivity and specificity. Copyright © 2017 John Wiley & Sons, Ltd.

BACKGROUND Previous studies have suggested an association between taking antidepressants and dental implant failure. This study aimed to investigate the association of different antidepressant classes with dental implant failure. METHODS This retrospective study included patients that received dental implants at the University of Florida from 2011 to 2016. The variables of implant failure, antidepressant use and classes (selective serotonin reuptake inhibitors [SSRI], serotonin-norepinephrine reuptake inhibitors [SNRI], tricyclic antidepressants [TCA], atypical antidepressants [AA], and monoamine oxidase inhibitors [MAOI]), age, sex, smoking, mild systemic diseases, and implant location were obtained from patients' records. Odds ratio (OR) and confidence interval (CI) of implant failure in patients taking different antidepressant classes, in relationship to non-antidepressant users, were estimated, and the influence of multiple variables on implant failure were investigated. RESULTS A total of 771 patients and 1,820 implants were evaluated. The statistically significant predictors for implant failure included smoking (OR = 5.221), use of antidepressants (OR = 4.285), posterior maxilla location (OR = 2.911), mild systemic disease (OR = 2.648), and age (OR = 1.037) (P

This study investigated the antimicrobial effects of the ethanolic extract of Brazilian red propolis (BRP) on multispecies biofilms. A seven-day-old subgingival biofilm with 32 species was grown in a Calgary device. Biofilms were treated with BRP (1,600, 800, 400 and 200 μg ml

BACKGROUND AND OBJECTIVES Strontium ranelate is a medication indicated for the treatment of osteoporosis that presents concomitant anti-resorptive and osteoanabolic dual biological activity. However, the effects of strontium ranelate on alveolar bone have been poorly explored. Furthermore, to date, there are no data on the effects of this medication on alveolar bone loss (BL) during conditions of estrogen deficiency. Therefore, the aim of this study was to evaluate the effects of strontium ranelate on ligature-induced periodontitis in estrogen-deficient and estrogen-sufficient rats. METHODS Ninety-six rats were assigned to one of the following groups: sham-surgery + water (estrogen-sufficient; n = 24); ovariectomy + water (estrogen-deficient; n = 24), sham-surgery + strontium ranelate (ranelate/estrogen-sufficient; n = 24) and; ovariectomy + strontium ranelate (ranelate/estrogen-deficient; n = 24). The rats received strontium ranelate or water from the 14th day after ovariectomy until the end of the experiment. On the 21st day after ovariectomy, one first mandibular molar received a ligature, while the contralateral tooth was left unligated. Eight rats per group were killed at 10, 20, and 30 days after ligature placement. Bone loss (BL) and trabecular bone area (TBA) were analyzed in the furcation area of ligated and unligated teeth at all experimental times by histometry. Tartrate-resistant acid phosphatase (TRAP) positive cells and immunohistochemical staining for osteocalcin (OCN), osteopontin (OPN), osteoprotegerin (OPG), and receptor activator of NF-КB ligand (RANKL) were assessed in the ligated teeth at 30 days after ligature placement. RESULTS At 10 and 30 days, ligated teeth of the estrogen-deficient group exhibited higher BL, when compared to all other groups (P

The aim of this review is to summarize the evidence on associations between diabetes mellitus (DM) and complications around dental implants. Electronic database searches of MEDLINE, EMBASE, JBI Database of Systematic Reviews and Implementation Reports, Cochrane Database of Systematic Reviews and the PROSPERO register were performed from 1990 up to and including May 2018, using MeSH terms and other keywords. Systematic reviews and meta-analyses investigating the associations of DM and implant complications (failure, survival, bone loss, peri-implant diseases, and post-surgery infection) were eligible. The quality of the included reviews was determined using the Assessment of Multiple Systematic Reviews Tool 2 (AMSTAR 2). Twelve systematic reviews were included. Implant survival rates ranged from 83.5% to 100%, while implant failure rates varied from 0% to 14.3% for subjects with DM. The three meta-analyses performed for event “implant failure” reported no statistically significant differences between diabetic and non-diabetic subjects. An apparently increased risk of peri-implantitis is reported in patients with DM. According to the AMSTAR 2 classification, 50% of the reviews were classified as being of “critically low”, 25% as of “low” and 25% as of “moderate” quality. Evidence indicates high levels of survival and low levels of failure of implants inserted in patients with DM. However, DM was assessed as a whole in the majority of studies and, the actual influence of hyperglycemia on implant survival/failure is still uncertain. DM/hyperglycemia seems to be associated with a high risk of peri-implantitis. However, this conclusion is based on a limited number of systematic reviews.

Aim This study evaluated the levels of sclerostin (SOST) and Dickkopf (DKK)-1 in the chronic periodontitis (CP) associated with type 2 diabetes (DM) and/or smoking. Relationships between SOST, DDK1, RANKL, OPG, IL-1s, IL-6 and TNF-α, and pathogens were assessed. Material and Methods The study population included non-diabetic non-smokers (control), non-smokers with DM (DM group), non-diabetic smokers (S group) and smokers with DM (SDM group), all with CP. Serum and gingival levels of SOST, DKK1, RANKL, OPG, IL-1s, IL-6 and TNF-α were evaluated by multiplex immunoassay. Gene expressions of these biomarkers and subgingival levels of pathogens were assessed by qPCR. Results Gingival protein and/or mRNA levels of DKK1 and SOST were higher in subjects with DM and/or smoking than in controls (p

This study assessed the impact of chronic periodontitis (CP) and CP associated with type 2 diabetes mellitus (DM) and/or smoking on the serum ratios of pro- to anti-inflammatory cytokines. Subjects were assigned into one of the following groups: control (n = 25, non-diabetic non-smokers with no history of periodontitis), CP (n = 26, non-diabetic non-smokers with CP), DMCP (n = 30, non-smokers with DM and CP), SCP (n = 27, non-diabetic smokers with CP), and SDMCP (n = 22, smokers with type 2 DM and CP). Serum levels of 18 cytokines were measured using multiplex immunoassays. Six ratios of pro-inflammatory to anti-inflammatory cytokines were significantly higher in the CP group than in the control group (p

espanolObjetivo: Investigar la influencia de la adicion de particulas de fosfato de calcio en el grado de conversion (GC) de los compuestos experimentales. Metodo: Se evaluaron cuatro compuestos experimentales: G1- Solo matriz organica basada en metacrilato (MM), G2- Adicion de particulas de vidrio de bario (2 µm),G3- Adicion de nanoparticulas de dihidrato de fosfato dicalcico (DCPD) funcionalizadas,G4- Adicion de nanoparticulas DPCD funcionalizadas con TEDGMA.El contenido de carga inorganica fue del 20% en volumen. El GC se evaluo mediante el metodo de espectroscopia infrarroja transformada de Fourier (FTIR). Resultados: Hubo un aumento en el GC para todos los grupos en funcion del tiempo, sin diferencias estadisticas hasta 5 segundos.A partir de los 11 segundos, el grupo de DCPD puro presento un GC mas bajo que los otros grupos (p portuguesObjetivo: Investigar a influencia da adicao de particulas de fosfato de calcio na cinetica de polimerizacao e no grau de conversao (GC) de compositos. Metodo: Quatro compositos experimentais foram avaliados: G1- Apenas matriz orgânica a base de metacrilato (MM), G2- Adicao de particulas de vidro de bario (2 µm) a MM, G3- Adicao de nanoparticulas de di-hidrato de fosfato dicalcico(DCPD) nao funcionalizadas a MM,G4- Adicao denanoparticulas de DPCD funcionalizadas a MM.O conteudo de carga inorgânica foi 20% em volume. O GC foi avaliado por Espectroscopia Infravermelho com Transformada de Fourier. Resultados: Houve aumento do GC para todos os grupos em funcao do tempo,sem diferenca estatistica ate 5s.A partir de 11s, o grupo DCPD puro apresentou GC inferior aos demais grupos (p EnglishObjective: To investigate the influence of the addition of calcium phosphate particles on the polymerization kinetics and degree of conversion (DC) of experimental composites. Method: Four experimental composites were evaluated. : G1- Only methacrylate-based organic matrix (MM), G2- Addition of barium glass particles (2 µm) to the MM, G3- Addition of dicalcium phosphate dihydrate (DCPD) nanoparticles non-functionalized, G4- Addition of DPCD nanoparticles functionalized with TEDGMA. The inorganic filler content was 20% by volume. The CG was evaluated by the Fourier- -Transformed Infrared spectroscopy method (FTIR). Results: There was an increase in DC for all groups as a function of time, with no statistical difference up to 5s.From 11s, the non-functionalized DCPD group presented lower DC than the other groups (p

Aim To evaluate whether obesity affects the subgingival microbial composition of patients with periodontal health or chronic periodontitis (CP). Materials and methods Based on periodontal parameters, body mass index and waist-hip ratio, 166 patients were allocated into one of the following groups: Normal weight (NW) patients with periodontal health (n=44), NW patients with CP (n=40), Obese patients with periodontal health (n=40) and obese patients with CP (n=42). Six subgingival biofilm samples per patient were analyzed for their content of 40 bacterial species using Checkerboard DNA-DNA hybridization. Results Obese patients with CP harbored higher levels and/or higher proportions of several periodontal pathogens than those with NW and CP, including A. actinomycetemcomitans, E. nodatum, F. nucleatum ss vincentii, P. micra, P. intermedia, T. forsythia, P. melaninogenica and T. socranskii. The proportions of most of these pathogens, as well C. rectus and E. corrodens, were more increased in the diseased sites of the obese patients than in those with NW. Furthermore, the healthy sites of the obese patients, presenting or not CP, also exhibited higher proportions of some of the pathogens than patients with NW. Conclusions Obesity is associated with increased levels and proportions of periodontal pathogens, especially in patients with CP. This article is protected by copyright. All rights reserved.

Introduction For adequate disease control the World Health Organization has proposed the diagnosis and treatment of latent tuberculous infection (LTBI) in groups of risk of developing the disease such as children. There is no gold standard (GS) test for the diagnosis of LTBI. The objective of this study was to estimate the prevalence of LTBI in young children in contact with a household case of tuberculosis (TB-HCC) and determine the accuracy and precision of the Tuberculin Skin Test (TST) and QuantiFERON-TB Gold in-tube (QFT) used in the absence of a GS. Methods We conducted a cross-sectional study in children up to 6 years of age in Manaus/Brazil during the years 2009–2010. All the children had been vaccinated with the BCG and were classified into two groups according to the presence of a TB-HCC or no known contact with tuberculosis (TB). The variables studied were: the TST and QFT results and the intensity and length of exposure to the index tuberculosis case. We used the latent class model to determine the prevalence of LTBI and the accuracy of the tests. Results Fifty percent of the children with TB-HCC had LTBI, with the prevalence depending on the intensity and length of exposure to the index case. The sensitivity and specificity of TST were 73% [95% confidence interval (CI): 53–91] and 97% (95%CI: 89–100), respectively, versus 53% (95%CI: 41–66) and 81% (95%CI:71–90) for QFT. The positive predictive value of TST in children with TB-HCC was 91% (95%CI: 61–99), being 74% for QFT (95%CI: 47–95). Conclusions This is one of the first studies to estimate the prevalence of LTBI in children and the parameters of the main diagnostic tests using a latent class model. Our results suggest that children in contact with an index case have a high risk of infection. The accuracy and the predictive value of the two tests did not significantly differ. Combined use of the two tests showed scarce improvement in the diagnosis of LTBI.

This study evaluated the effects of scaling and root planing (SRP) on gingival crevicular fluid (GCF) and serum levels of adipokines in patients with chronic periodontitis (CP) with or without obesity.Twenty patients with obesity and 20 patients without obesity, all with CP, received SRP. Serum and GCF levels of resistin, adiponectin, leptin, tumour necrosis factor [TNF]-α and interleukin [IL]-6 were evaluated by enzyme-linked immunosorbent assay at baseline, 3, 6 and 12 months post-therapy.SRP reduced the amounts of TNF-α in deep sites and increased the concentration of adiponectin in shallow sites of non-obese patients (p 0.05). SRP increased the concentrations of TNF-α and leptin in patients with obesity (p 0.05). GCF levels of TNF-α were higher in patients with obesity than in patients without obesity at all time-points (p 0.05). There were no changes in serum levels of any adipokines for any group after therapy (p 0.05). Patients with obesity exhibited higher serum levels of leptin at all time-points and IL-6 at 3 months post-therapy (p 0.05).Obesity may modulate systemic and periodontal levels of adipokines in favour of pro-inflammation, independently of periodontal therapy. SRP did not affect the circulating levels of adipokines in patients with or without obesity.

With the massive deployment of broadband access to the end-users and the improved hardware capabilities of end devices, peer-to-peer (P2P) networking paradigm is consistently gaining terrain over the typical client-server approach. In most of the modern countries, today’s Internet connectivity has sufficient conditions to unleash P2P applications such as video-on-demand or real-time television. It is known that the use of P2P based systems to distribute delay sensitive applications raises technical problems mainly associated with the system’s instability caused by the peer churn effect. In this article, we propose a framework to distribute delay sensitive 3D video content using a hybrid client-server and P2P approach. The proposed platform uses P2P application-level multicast trees at the access networks, delegating typical server operations at super-peers who are domain and geographically distributed. Results are based on real testbed implementation show quick reaction at peer level.

Two key aims of diagnostic research are to accurately and precisely estimate disease prevalence and test sensitivity and specificity. Latent class models have been proposed that consider the correlation between subject measures determined by different tests in order to diagnose diseases for which gold standard tests are not available. In some clinical studies, several measures of the same subject are made with the same test under the same conditions (replicated measurements), and thus, replicated measurements for each subject are not independent. In the present study, we propose an extension of the Bayesian latent class Gaussian random effects model to fit the data with binary outcomes for tests with replicated subject measures. We describe an application using data collected on hookworm infection carried out in the municipality of Presidente Figueiredo, Amazonas State, Brazil. In addition, the performance of the proposed model was compared with that of current models (the subject random effects model and the conditional (in)dependent model) through a simulation study. As expected, the proposed model presented better accuracy and precision in the estimations of prevalence, sensitivity and specificity. Copyright © 2017 John WileySons, Ltd.

Performance evaluation of diagnostic tests is critical in the search for accurate diagnoses. A gold standard test is usually absent in parasitology, thus rendering satisfactory assessment of diagnostic accuracy difficult. Moreover, reliability (assessed by the study of repeatability) is a rarely studied characteristic of diagnostic tests. This study compared and evaluated the performance (repeatability, concordance and accuracy) of the spontaneous sedimentation technique (SST) and the Paratest for the diagnosis of Giardia lamblia, Entamoeba histolytica complex, Blastocystis spp., Ascaris lumbricoides, hookworm, Trichuris trichiura and Calodium hepaticum. Fecal samples of 143 individuals were separated into three replicates for each test. Concordance and homogeneity of the results between replicates of each test and between tests were evaluated. Proportions of positives, sensitivity and specificity were estimated using a Bayesian Latent Class Model. High repeatability of both tests was found for the detection of intestinal parasites, except for Blastocystis spp. and hookworm. Concordance between tests was generally high (concordance correlation coefficient, 0.72-0.88), except for Blastocystis spp., hookworm and T. trichiura. The Paratest detected more cases of Blastocystis spp. and fewer of hookworm than the SST. The tests were quite discordant in the detection of T. trichiura. A low sensitivity (39.4-49.2% for SST, 35.8-53.8% for Paratest) and a high specificity (93.2-97.2%) were found for both tests. The Paratest presented a slightly higher sensitivity for the diagnosis of Blastocystis spp. (53.8%), and SST did so for hookworm (49.2%). This is the first study on repeatability and accuracy (using a Bayesian approach) of two spontaneous sedimentation techniques. These results suggest underdiagnosis of little dense parasitic forms due to technical limitations in both tests. We conclude that the combined study of repeatability, concordance and accuracy is a key strategy for better evaluation of the performance of tests and is also useful for the identification of technical limitations.

Current developments in 3D technology have triggered an increasing user interest in experiencing this technology however the distribution of 3D media to a large amount of users raises significant technical challenges mainly due to bandwidth and delay restrictions associated with the multiple views of content. In this paper, we discuss a hypothetical distribution scenario that uses multiple multicast trees over peer-to-peer networks for 3D real-time content distribution and present a new algorithm for the creation of multiple multicast trees. Furthermore, this paper also proposes a mechanism to deal with peer failures, based on offline computation of backup trees and selective updates upon peer failure. The algorithm is evaluated through simulation results obtained by our own developed Java simulator.