ObjectivesTo determine the effect of root canal irrigants on the hydrophobicity and adherence of Staphylococcus epidermidis (S. epidermidis) to root canal dentin in vitro.Materials and MethodsRoot dentin blocks (n = 60) were randomly divided into 4 groups based on the irrigation regimen: group 1, saline; group 2, 5.25% sodium hypochlorite (NaOCl); group 3, 5.25% NaOCl followed by 17% ethylenediaminetetraacetic acid (EDTA); group 4, same as group 3 followed by 2% chlorhexidine (CHX). The hydrophobicity of S. epidermidis to root dentin was calculated by cell surface hydrophobicity while the adherence was observed by fluorescence microscopy, and bacteria were quantified using ImageJ software (National Institutes of Health). Statistical analysis of the data was done using Kruskal-Wallis test and Mann-Whitney U test (p = 0.05).ResultsThe hydrophobicity and adherence of S. epidermidis to dentin were significantly increased after irrigating with group 3 (NaOCl-EDTA) (p < 0.05), whereas in group 4 (NaOCl-EDTA-CHX) both hydrophobicity and adherence were significantly reduced (p < 0.05).ConclusionsThe adherence of S. epidermidis to dentin was influenced differently by root canal irrigants. Final irrigation with CHX reduces the bacterial adherence and may impact biofilm formation.
Background: Inequities in health care predispose Indigenous populations to poor health outcomes. The objective of this study was to examine patient survival and other post-transplant outcomes of kidney transplantation among Indigenous patients compared with non-Indigenous populations. Methods: A systematic review of MEDLINE, EMBASE, and Google Scholar was undertaken from inception to September 30, 2019, using a computerized search. Publication descriptors and methodological and statistical details were extracted. Articles were assessed using the methodological index for non-randomized studies (MINORS) scale. Results: Twelve studies were included. All studies were retrospective and published between 2004 and 2018. Mean Indigenous patient age was 40 (range: 8-76), while non-Indigenous was 41 (range: 6-74). Mean sample size for Indigenous populations was 398 (range: 24-1459), while for non-Indigenous patients was 1102 (range: 53-7555). Eight studies examined indigenous populations in Australia, two in Canada, one in the United States, and one in New Zealand. All studies were considered of high methodological quality and clinically homogenous. Results indicated that patient survival, graft survival, and delayed graft function were significantly reduced among Indigenous populations compared with non-Indigenous populations. Conclusions: Post-transplant outcomes among various Indigenous populations are significantly worse compared with non-Indigenous populations. The reasons for poor outcomes are likely multifactorial. Improved standardized reporting of transplant outcomes of Indigenous patients is necessary to better inform healthcare services and improve clinical outcomes. K E Y W O R D S epidemiology, health outcomes, indigenous, kidney transplantation
Objective: We investigated the effect of anticoagulation on endovascular aneurysm repair outcomes, including the development of type II endoleaks and reintervention rates.Methods: The patient and aneurysm characteristics, procedure details, and postoperative outcomes were collected for consecutive patients who had undergone endovascular aneurysm repair from 2010 to 2019. The patient groups were stratified by anticoagulation use and the presence or absence of a type II endoleak. The groups were compared using the c 2 test, Student t test, or univariate or multivariate logistic regression analyses, as appropriate.Results: We included 581 patients (age, 77.1 6 82 years; 82.6% male) with a mean follow-up of 3.99 6 2.4 years. During follow-up, 233 patients developed a type II endoleak. No significant differences were found in comorbidities or aneurysm size (mean, 51.5 6 19.3 mm) between the patients with and without a type II endoleak. Anticoagulation was associated with the occurrence of type II endoleaks (50% for patients on anticoagulation vs only 38.9% for patients not receiving anticoagulation; P ¼ .06). No association was found between anticoagulation, a type II endoleak, and survival. In a logistic regression model that included age, sex, abdominal aortic aneurysm (AAA) size, type II endoleak, and anticoagulation, only AAA size was associated with mortality (odds ratio [OR], 1.01; 95% confidence interval [CI], 1.004-1.03; P ¼ .01). The results from the logistic regression models confirmed the association of anticoagulation and type II endoleaks (OR, 1.57; 95% CI, 0.97-2.5; P ¼ .06). Age was also associated with the development of type II endoleaks (OR, 1.03; 95% CI, 1.009-1.05; P ¼ .005). Additional comorbidities and patient factors, including sex, AAA size, and antiplatelet use, were not associated with the development of endoleaks. On logistic regression modelling, type II endoleaks and anticoagulation use were both independently associated with increased reintervention rates (OR, 3.2; 95% CI, 2.0-5.0; P < .0001; and OR, 2.5; 95% CI, 1.4-4.5; P ¼ .002, respectively).Conclusions: We found an association between anticoagulation and type II endoleaks. Both the presence of a type II endoleak and anticoagulation use were associated with a higher reintervention rate, with no appreciable effects on long-term survival.
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