Microbial resistance to oral antiseptics used in hospitalized patients: A systematic scoping review of randomized clinical trials

AIMS

To evaluate the prevalence and proportions of bacteria resistant to oral antiseptics used in hospitalized patients.

METHODS AND RESULTS

A review of randomized clinical trials (RCTs) was led by implementing the PRISMA extension for scoping reviews including various databases. MeSH terms and keywords were used to assess only RCTs with antiseptic-resistant outcomes. Fourth RCTs met the selection criteria. These trials studied 399 hospitalized patients for respiratory infections or cardiovascular disease. Methicillin-resistant Staphylococcus aureus and Acinetobacter baumannii were predominant pathogens in the chlorhexidine group. It was found that Veillonella parvula and Campylobacter gracilis (57% of the isolates) had resistance to triclosan, while 67% of Pseudomonas, Acinetobacter, and Enterobacter species presented resistance to chlorhexidine. However, an increase in minimal inhibitory concentrations of triclosan or chlorhexidine during the follow-up period was not observed. Moreover, chlorhexidine reduced the amount of S. aureus in dental plaque and the oropharyngeal colonization by aerobic microorganisms; nonetheless, it was unsatisfactory to decrease the occurrence of respiratory infections. No adverse events were reported.

CONCLUSIONS

Resistance of V. parvula and C. gracilis to triclosan, and Pseudomonas, Acinetobacter, and Enterobacter species to chlorhexidine were perceived. However, these resistances did not increase during the follow-up period.

Influence of the Socio-Economic Context on Self-Reported Gingival Bleeding in Individuals of Ethnic Minority Groups: A Multilevel Analysis

INTRODUCTION

To evaluate the influence of the socio-economic context on self-reported gingival bleeding (SRGB) in individuals of ethnic minority groups (IEG).

METHODS

Data from the 2007 National Public Health Survey in Colombia were collected. A multiple-stage stratified sampling was used. Data from 34.843 subjects were collected through interviews. The influence of socio-economic factors on SRGB in IEG was investigated with logistic and multilevel regression analyses.

RESULTS

Out of 34.843 subjects studied, a total of 6.440 individuals were members of ethnic minority groups. SRGB was observed in approximately 5% of IEG. There was a significant difference between IEG and subjects of the rest of the sample (28.403 subjects) regarding SRGB, elementary and high school education, Gross Domestic Product (GDP), Human Development Index (HDI) and Unmet Basic Needs Index (UBNI) disfavouring IEG (P<0.05). The logistic model showed that SRGB was associated with IEG (P<0.001). This association persisted after controlling for confounders. A total of 33 Colombian states (level 2) and 6.440 members (level 1) of ethnic minority groups were included in the multilevel analisys; this model showed that the variance on SRGB was statistically significant at level 1 and 2. However, the variation at IEG level (35%) was smaller than the variation between states (65%) in the multilevel multivariate model.

CONCLUSIONS

SRGB was higher in IEG. Also, GDP, HDI and UBNI were unfavourable factors in the members of ethnic minority groups. Considering these detriment factors and the higher variation between states, this study suggests that socio-economic context affects significantly SRGB in IEG.

Efficacy of antimicrobials in preventing resistance in solid organ transplant recipients: A systematic review of clinical trials

BACKGROUND

In the absence of effective antimicrobials, transplant surgery is not viable, and antirejection immunosuppressants cannot be administered, as resistant infections compromise the life-saving goal of organ transplantation.

AIM

To evaluate the efficacy of antimicrobials in preventing resistance in solid organ transplant recipients.

METHODS

A systematic review was conducted using a search methodology consistent with the preferred reporting items for systematic reviews and meta-analyses. This review included randomized clinical trials that evaluated the efficacy of antimicrobial agents (prophylactic or therapeutic) aimed at preventing antimicrobial resistance. The search strategy involved analyzing multiple databases, including PubMed/MEDLINE, Web of Science, Embase, Scopus, and SciELO, as well as examining gray literature sources on Google Scholar. A comprehensive electronic database search was conducted from the databases' inception until May 2024, with no language restrictions.

RESULTS

After the final phase of the eligibility assessment, this systematic review ultimately included 7 articles. A total of 2318 patients were studied. The most studied microorganisms were cytomegalovirus, although vancomycin-resistant enterococci, Clostridioides difficile, and multidrug-resistant Enterobacterales were also analyzed. The antimicrobials used in the interventions were mainly maribavir, valganciclovir, ganciclovir, and colistin-neomycin. Of concern, all clinical trials showed significant proportions of resistant microorganisms after the interventions, with no statistically significant differences between the groups (mean resistance 13.47% vs 14.39%), except for two studies that demonstrated greater efficacy of maribavir and valganciclovir (mean resistance 22.2% vs 41.1% in the control group; P < 0.05). The total reported deaths in three clinical trials were 75, and there were 24 graft rejections in two studies.

CONCLUSION

All clinical trials reported significant proportions of antimicrobial-resistant microorganisms following interventions. More high-quality randomized clinical trials are needed to corroborate these results.

Efficacy of the finite element analysis in assessing the effects of light curing on the mechanical properties of direct restorative composites: A systematic review

BACKGROUND

Previous studies have identified the effects of light curing techniques on both shrinkage strain and contraction stress buildup in composite restorations. Finite Element Analysis (FEA) has several advantages over other experimental methods for evaluating the mechanical properties of direct dental resins. The objective of this systematic review is to assess the impact of light curing protocols on the shrinkage behaviors and other mechanical properties of direct restorative composites utilizing FEA.

MATERIAL AND METHODS

The search methodology adhered to the PRISMA guidelines and utilized prominent scientific databases. This systematic review was structured around a question formulated PICO framework. To estimate the methodological rigor of the included studies, a quality assessment tool was utilized.

RESULTS

After the final phase of eligibility evaluation, the systematic review incorporated nine studies. Studies employing FEA primarily aimed to investigate the effects of various light curing protocols on shrinkage behaviors, contraction stress, and microleakage in composite restorations. Most FEA models in these studies incorporated key time-dependent parameters related to composite polymerization, such as shrinkage, Young's modulus, Poisson ratio, and resulting creep. FEA can provide valuable insights into the effects of light curing on the mechanical properties of direct restorative composites, its accuracy, and reliability depend on various factors, including the accuracy of input parameters, modeling assumptions, and validation against experimental data.

CONCLUSIONS

The findings underscore the importance of considering various factors such as curing protocol, testing method, composite characteristics, and environmental conditions in understanding, and mitigating the adverse effects of polymerization shrinkage in composite restorations. Key words:Finite Element Analyses, Composite Resins, Light Curing of Dental Resins, Polymerization, Materials Testing, Mechanical Tests.

Hegemony of economic values in conducting clinical trials with a placebo-control group to investigate the treatment of periodontitis in lower-middle-income countries

This article analyzes the bioethical implications of using a control/placebo group when conducting clinical trials (CTs) investigating the treatment of periodontitis. For this, the deductive method was used, proposing the interrelation of values, and a scoping systematic review was carried out. A total of 53% of the CTs reviewed were performed in low- and middle-income (LMI) countries, and 92% used a control/placebo group as a comparison group. Although there is a gold standard for the adjunctive treatment of periodontitis, the research ethics committees of most of the analyzed studies approved the use of control/placebo groups for the performance of CTs that did not explore new therapeutic alternatives. In some cases, the CT protocols were not approved by ethics committees, nor was informed consent used. In the LMI countries, a shorter period of recruitment was observed for patients who attended universities and public hospitals. Likewise, most of the CTs reviewed had public funding, a significant amount of which came from the pharmaceutical industry. Only one CT reported the low economic and educational level of its participants. Furthermore, none of the authors of the reviewed CTs declared conflicts of interest. Although the axiology of techno-science always takes into account at least the epistemic, technical and economic value systems, the hegemony of the economic values imposed by the pharmaceutical industry is evident in the performance of CTs investigating the treatment of periodontitis in LMI countries.

Accuracy of point‑of‑care ultrasonography in the diagnosis of necrotizing fasciitis: A case report

Necrotizing fasciitis is a serious infectious condition that may compromise the patient's life. In the present case study, a 42-year-old male patient was reported. The condition manifested as the presence of subjective fever, general malaise, myalgia, non-productive cough, dysphagia and neck pain ~1 week prior to hospital admission. Vascular dissection was considered as the initial diagnostic suspicion, and thus, angiotomography of neck vessels was performed, ruling out aortic and neck vessel dissection. Radiology indicated negativity for aortic syndrome and cervical vascular disease, but the presence of cervical-mediastinal edema, lamellar fluid between muscular and fatty planes and posterior pulmonary atelectasis, absence of pleural fluid or consolidations, and tonsillar hypertrophy without abscesses. Due to the rapid evolution of the condition, the presence of dyspnea with the need for supplemental oxygen, and the disproportion between the intensity of the pain described by the patient and the external findings observed, the presence of necrotizing fasciitis was considered. Point-of-care ultrasonography was performed, indicating a cobblestone pattern of the subcutaneous cellular tissue, with diffuse thickening of the anterior cervical fascia and increased echogenicity with soft tissue edema posterior to the fascia. Magnetic resonance imaging confirmed the inflammatory findings in the fascia and other cervical soft tissues, without exhibiting any signs of necrosis, but with the presence of abscesses in the visceral and carotid space.

ST‑segment elevation associated with intraparenchymal hemorrhage: A case report

The electrocardiogram (ECG) changes in patients with intraparenchymal hemorrhage (IPH) have remained largely elusive and no case reports are currently available in the scientific literature. The medical management of a patient with ST-segment elevation associated with IPH was described in the present study. The case report describes a 78-year-old male patient who presented with ST-segment elevation in V1, V2, V3 and V4 on ECG. Initially, the case was managed therapeutically as an acute myocardial infarction. Later, the patient was transferred to a higher-level hospital, where a new ECG confirmed ST-segment elevation. Simple skull tomography was also performed, which revealed a spontaneous right basal ganglion in the context of an acute cerebrovascular accident of hypertensive origin. A transthoracic ECG was ordered, which revealed an ejection fraction of 65% with type I diastolic dysfunction due to relaxation disorders and without any signs of ischemia, intracavitary masses or thrombi. In addition to the presence of nonspecific ECG findings, clinicians should consider immediate brain computed tomography to confirm intracranial hemorrhage.

Relationship between physical activity, academic achievement, gender, and learning styles in students of a Latin American Dental School: A cross-sectional study

BACKGROUND

Little is known about the inference that physical activity (PA) may have on academic performance and learning styles of Latin American dental students.

MATERIALS AND METHODS

In this cross-sectional study, an administrative dataset and a voluntary university characterization provided information about PA and academic performance. Moreover, 218 dental students of the University of Antioquia in Colombia completed a structured questionnaire to identify their learning styles. To analyze the information obtained a Pearson correlation, and logistic and linear regression models were implemented.

RESULTS

A total of 131 (60%) students informed being physically active (PA group), and 87 (40%) did not report PA (non-PA group). The results showed a high-grade point average (GPA) in the PA group (P = 0.01). The PA group showed a preference for the theorist and pragmatist learning styles with statistically significant differences between the groups (P = 0.004 and P < 0.0001, respectively). It was also observed a statistically significant Pearson positive correlation between the theorist style and higher GPA (r = 0.15; P = 0.04). The multivariate regression model showed that PA protects against lower means of GPA (odds ratio = 0.3; 95% confidence interval [CI]: 0.09-0.7, P = 0.01). Furthermore, the adjusted linear regression models also showed that PA protects against lower means of the theorist (β= -0.15; 95% CI: -0.02 to - 0.002, P = 0.002) and pragmatist styles (β= -0.18; 95% CI: -0.03 to - 0.006, P = 0.0006). Interestingly, men were statistically significant in all multivariable models.

DISCUSSION

This study suggests that PA is associated with higher academic performance and the theorist and pragmatist styles. Male students were also more physically active; therefore, it is relevant to establish strategies to stimulate physical activities in dental students, especially in women, including extracurricular activities.

Advancing healthcare through laboratory on a chip technology: Transforming microorganism identification and diagnostics

In a recent case report in the World Journal of Clinical Cases, emphasized the crucial role of rapidly and accurately identifying pathogens to optimize patient treatment outcomes. Laboratory-on-a-chip (LOC) technology has emerged as a transformative tool in health care, offering rapid, sensitive, and specific identification of microorganisms. This editorial provides a comprehensive overview of LOC technology, highlighting its principles, advantages, applications, challenges, and future directions. Success studies from the field have demonstrated the practical benefits of LOC devices in clinical diagnostics, epidemiology, and food safety. Comparative studies have underscored the superiority of LOC technology over traditional methods, showcasing improvements in speed, accuracy, and portability. The future integration of LOC with biosensors, artificial intelligence, and data analytics promises further innovation and expansion. This call to action emphasizes the importance of continued research, investment, and adoption to realize the full potential of LOC technology in improving healthcare outcomes worldwide.

Wernicke's Encephalopathy in a Patient With Type III Intestinal Failure: A Case Report

This case is about a 38-year-old male patient with a history of type III intestinal failure due to chronic intestinal pseudo-obstruction caused by gastrointestinal dysmotility, cardiac and intestinal arrhythmia syndrome, dependence on parenteral nutrition, sinus dysfunction, and carrying a pacemaker. The patient presented with symptoms suggestive of a new episode of intestinal obstruction. A contrast-enhanced abdominal computed tomography scan was performed, revealing intestinal obstruction with a transition zone in the jejunum. Non-operative medical management of the obstructive condition was initiated. However, after 10 days of medical management, the patient began experiencing nausea and dizziness. Initially, symptomatic management was provided, but the patient reported persistent vertigo-like sensations. Following evaluation by multiple specialties, magnetic resonance imaging (MRI) was requested, which showed bilateral and symmetrical hyperintensity on T2-weighted images of the dorsomedial aspect of the thalami around the third ventricle, in the periaqueductal gray matter, the mesencephalic tectum, and, to a lesser extent, the bulbar tectum, findings suggestive of Wernicke's encephalopathy. Urgent intravenous thiamine replacement was initiated. After 10 days of effective treatment, the patient exhibited a nearly complete improvement in symptoms. A follow-up MRI was ordered, indicating considerable improvement when compared to the previous study.

Graph Neural Networks-Based Prediction of Drug Gene Interactions of RTK-VEGF4 Receptor Family in Periodontal Regeneration

BACKGROUND

The RTK-VEGF4 receptor family, which includes VEGFR-1, VEGFR-2, and VEGFR-3, plays a crucial role in tissue regeneration by promoting angiogenesis, the formation of new blood vessels, and recruiting stem cells and immune cells. Machine learning, particularly graph neural networks (GNNs), has shown high accuracy in predicting these interactions. This study aims to predict drug-gene interactions of the RTK-VEGF4 receptor family in periodontal regeneration using graph neural networks.

MATERIAL AND METHODS

The study utilized a dataset comprising 19,154 drug-gene interactions to analyze the relationships between drugs and protein-coding genes. The dataset was split into training and testing sets, with 80% of the data used for training and 20% for testing. Cytoscape, an open-source software platform, was employed to visualize and analyze the drug-gene interaction network, and CytoHubba, a plugin, was used to identify highly connected nodes. Topological measures were applied to determine the influence and importance of each node. GNNs were used to manage the complex relationships and dependencies within the graphs.

RESULTS

The drug-gene interaction network, comprising 815 nodes and 13,436 edges, was found to be complex and highly interconnected. It was divided into 11 components, displaying low density and heterogeneity, indicative of a sparse structure. The GNN model achieved 97% accuracy in predicting interaction types, including single protein interactions and protein complex groups.

CONCLUSIONS

The study demonstrates that graph neural networks outperform traditional machine learning methods in predicting drug-gene interactions within the RTK-VEGF protein family in periodontal regeneration, highlighting their potential in advancing therapeutic strategies and drug discovery. Key words:Graph neural networks; drug-gene interactions; RTK-VEGF4 protein family: periodontal regeneration.

Lifestyle habits and academy performance amongst forcibly displaced students: A cross-sectional survey in a school of dentistry

INTRODUCTION

There is no recognised investigation examining the influence of some lifestyle comportments on academic performance (AP) in forcibly displaced students in higher education. Thus, the frequency of physical inactivity (PI), insufficient sleep (IS), alcohol consumption (AC), drug consumption (DC) and cigarette smoking (CS) and the independent and combined consequences of these habits on AP in forcibly displaced dental students were investigated.

MATERIALS AND METHODS

A sample of 185 students was studied (thirty-seven forcibly displaced and 148 non-displaced students). This cross-sectional study used an institutional administrative database that included students' demographic features and lifestyle behaviours. Multivariate analyses were performed to evaluate the independent and combined effects of lifestyle behaviours on AP.

RESULTS

PI, IS, AC, DC and CS were observed in 51%, 43%, 83%, 27% and 16% of forcibly displaced students, respectively. Compared with non-displaced students, forcibly displaced students presented higher frequencies for all of these behaviours (P < .05), lower AP (P < .0001) and lower socio-economic status (P = .003). Unadjusted regression models showed independent and significant associations between forcibly displaced students and PI (P = .01), IS (P = .01), AC (P = .01), DC (P < .0001), CS (P = .02) and low AP (P = .006). The multivariate model for AP and forcibly displaced students increased odds by 4.6 times (1.5-11; 95% CI). Moreover, the lifestyle comportments studied were also statistically significant, showing combined effects. The variables of gender and age were not statistically significant in the adjusted model.

CONCLUSIONS

This research observed high frequencies of the behaviours analysed in forcibly displaced students. Furthermore, independent and combined effects of them on AP were detected.

Lower Extremity Peripheral Arterial Disease and Its Relationship with Adverse Outcomes in Kidney Transplant Recipients: A Retrospective Cohort Study

The purpose of the study was to characterize lower extremity peripheral arterial disease (LEPAD) in a series of kidney transplant patients and to assess the impact on adverse outcomes. A retrospective cohort study was conducted including kidney transplant recipient patients who underwent screening for LEPAD. The outcomes evaluated were classified as perioperative and post-transplant, including cardiovascular events, amputation, mortality, and loss of the graft. A total of 141 renal transplant patients screened for LEPAD were identified, with an average follow-up of 3 years. LEPAD occurred in 14.2% (20/141). No differences in cardiovascular risk factors were found between the groups, except for smoking (45% vs. 24%, p < 0.05). In the group with LEPAD, the most compromised anatomical segment was the infrapopliteus, with no iliac involvement found. The Cox proportional hazards model indicated that the variables age, gender, and weight were significant in patients with LEPAD. There were no differences between the groups in terms of graft loss and death. The infrapopliteal segment is the area of greatest stenosis in kidney transplant patients with LEPAD. Together with smoking, they can explain the presence of major amputations in kidney transplant patients; however, they had no impact on graft functionality or death.

Servicios salud sexual y reproductiva según los adolescentes varones (Bucaramanga, Colombia)

Los adolescentes se enfrentan a diferentes dilemas, que al no ser resueltos oportunamente, plantean grandes riesgos para la salud. Objetivo: caracterizar las necesidades básicas y las expectativas de los adolescentes varones en Bucaramanga, Colombia, desde su percepción, con respecto a los servicios de salud sexual y reproductiva (SSR). Metodología: estudio cualitativo etnográfico, mediante la estrategia de grupos de discusión. Se utilizaron diálogos informales, entrevistas focales y observación. Se seleccionó por conveniencia una muestra de varones adolescentes de Bucaramanga, de estratos 2 al 6, de instituciones públicas y privadas, así como no escolarizados, entre los 13 y los 18 años, con un total de 52 participantes y 7 grupos focales. Resultados: a pesar de las diferencias culturales y socioeconómicas, los jóvenes concuerdan en sus percepciones, necesidades y expectativas acerca de la sexualidad y los servicios de SSR. El análisis final mostró cuatro categorías: experiencias sobre servicios de SSR, ideales sobre servicios de SSR, pornografía y sexualidad. Conclusiones: es evidente la invisibilidad de los servicios de SSR y la percepción no favorable, desde la experiencia de los que la conocen. No obstante lo anterior, los adolescentes consideran necesario contar con esta clase de servicios. Esta investigación conduce a la reflexión sobre el desconocimiento del adolescente varón desde su ser, su sentir y su querer ser.

Histological Evaluation of Internal Dental Resorption: An Analysis of a Cohort of 50 Cases

OBJECTIVE

This study aimed to perform a histological evaluation of teeth diagnosed with internal root resorption.

MATERIALS AND METHODS

A descriptive study involved the examination of 50 human teeth extracted due to an unfavorable prognosis for retention in the oral cavity. Teeth were preserved in 10% buffered formalin and subsequently subjected to the decalcification process. Masson-Goldner staining was applied for comprehensive histological assessment.

RESULTS

In all the 50 teeth examined, resorption gaps within the dentin tissue were identified, accompanied by the presence of reparative cells in the vicinity of these cavities. Marked structural loss and dentin fragmentation were evident, with regions exhibiting fissures and an absence of dentinal tubules.

CONCLUSIONS

The histological evaluation of 50 teeth diagnosed with internal dental resorption revealed significant structural alterations, including resorption lacunae, the presence of multinucleated osteoclast-like cells, and reparative connective tissue. These findings highlight the complex and multifaceted nature of internal dental resorption. These histological insights provide a deeper understanding of the pathological processes involved in internal dental resorption and underscore the necessity for early detection and intervention to mitigate tooth loss and preserve dental health.

Stroke in a Patient With Antiphospholipid Syndrome

Antiphospholipid syndrome (APS) is characterized by the occurrence of thrombotic events and/or obstetric complications in the presence of antiphospholipid antibodies. It is considered one of the most common acquired thrombophilias. The presentation of stroke in patients with APS has been described in some studies; however, it is not frequent enough and there is not much information available regarding the indications for pharmacological thrombolysis and the safety of thrombolytic treatment. Likewise, current evidence does not describe contraindications to thrombolytic therapy in cases of this diagnosis, which makes management with fibrinolysis safe in these cases. A clinical case of stroke is presented in which pharmacological thrombolysis is performed with a successful outcome, without complications of angioedema or bleeding. Likewise, concerning the case, the main neurological manifestations associated with APS, especially in its association with stroke, are described.

Artificial intelligence as a predictive tool for gastric cancer: Bridging innovation, clinical translation, and ethical considerations

With gastric cancer ranking among the most prevalent and deadly malignancies worldwide, early detection and individualized prognosis remain essential for improving patient outcomes. This letter discusses recent advancements in artificial intelligence (AI)-driven predictive tools for gastric cancer, emphasizing a computed tomography-based radiomic model that achieved a predictive accuracy of area under the curve of 0.893 for treatment response in advanced cases undergoing neoadjuvant immunochemotherapy. AI offers promising avenues for predictive accuracy and personalized treatment planning in gastric oncology. Additionally, this letter highlights the comparison of these AI tools with traditional methodologies, demonstrating their potential to streamline clinical workflows and address existing gaps in risk stratification and early detection. Furthermore, this letter addresses the ethical considerations and the need for robust clinical-AI collaboration to achieve reliable, transparent, and unbiased outcomes. Strengthening cross-disciplinary efforts will be vital for the responsible and effective deployment of AI in this critical area of oncology.

Improvement of salivary biomarkers vitronectin and fetuin-A levels in periodontitis patients with coronary artery disease post scaling and root planing

INTRODUCTION

Two biomarkers that are gaining attention for their roles in the progression of both periodontal and cardiovascular diseases are vitronectin and fetuin-A. This study evaluated vitronectin and fetuin-A expression in saliva samples of periodontitis (P) patients with and without coronary artery disease (CAD) after scaling and root planing (SRP).

METHODS

Sixty patients were divided into three groups: PH + SH (periodontally and systemically healthy), P (stage II/III grade B periodontitis), and P + CAD (periodontitis with CAD). Demographic, periodontal, and cardiac parameters were recorded. Unstimulated saliva samples were collected at baseline (day 0) and after SRP. On day 90, periodontal parameters and vitronectin/fetuin-A expression were reassessed.

RESULTS

P + CAD patients had higher age, weight, BMI, and lower income (p < .001, .025, .002, < .001, respectively), along with elevated plaque index, bleeding on probing, probing pocket depth, and reduced clinical attachment levels (p < .001). Vitronectin was elevated, while fetuin-A was lower in P + CAD, but both improved post-SRP (p < .001).

CONCLUSIONS

Enhanced vitronectin and fetuin-A levels post-SRP indicate their potential as biomarkers and therapeutic targets for both periodontal and CAD.

Gradient boosting-based classification of interactome hub genes in periimplantitis with periodontitis - an integrated bioinformatic approach

INTRODUCTION

Peri-implantitis, a destructive inflammatory condition affecting the tissues surrounding dental implants, shares pathological similarities with periodontitis, a chronic inflammatory disease that impacts the supporting structures of natural teeth. This study utilizes a network-based approach to classify interactome hub genes associated with peri-implantitis and periodontitis, aiming to improve understanding of disease mechanisms and identify potential therapeutic targets.

METHODS

We employed gradient boosting and Weighted Gene Co-expression Network Analysis (WGCNA) to predict and classify these interactome hub genes. Gene expression data related to these diseases were sourced from the NCBI GEO dataset GSE223924, and differential gene expression analysis was conducted using the NCBI GEO R tool. Through WGCNA, we constructed a co-expression network to identify key hub genes, while gradient boosting was used to predict these hub genes.

RESULTS

Our analysis revealed a co-expression network comprising 216 genes, including prominent hub genes such as IL17RC, CCN2, BMP7, TPM1, and TIMP1, which are implicated in periodontal disease. The gradient boosting model achieved an 88.2% accuracy in classifying interactome hub genes in samples related to peri-implantitis and periodontitis.

DISCUSSION

These identified genes play roles in inflammation, osteoclast genesis, angiogenesis, and immune response regulation. This study highlights essential hub genes and molecular pathways associated with peri-implantitis and periodontitis, suggesting potential therapeutic targets for developing innovative treatment strategies.

Antimicrobial resistance in patients with odontogenic infections: A systematic scoping review of prospective and experimental studies

BACKGROUND

Patients with odontogenic infections are commonly prescribed antimicrobials on an experiential base without knowing the precise microorganisms implicated. The aim of this systematic scoping review is to evaluate the prevalence and proportions of antimicrobial-resistant species in patients with odontogenic infections.

MATERIAL AND METHODS

A systematic scoping review of scientific evidence was accomplished involving different databases.

RESULTS

Eight randomized clinical trials and 13 prospective observational studies were included. These investigations analyzed 1506 patients. The species that showed higher levels of resistance included aerobic and facultative anaerobe such as Staphylococcus aureus, Streptococcus viridans, Klebsiella pneumoniae, Streptococcus milleri, Enterococcus spp., Pseudomonas aeruginosa, Proteus mirabilis, and Staphylococcus coagulases-negative. In obligate anaerobes sampled were Peptostreptococcos spp., Bacteroides spp., and Prevotella spp. Staphylococcus showed resistance to ampicillin, piperacillin, clindamycin, amoxicillin, metronidazole, and penicillin. Streptococcus had resistance to metronidazole, clindamycin, doxycycline, penicillin, and amoxicillin. Peptostreptococcus spp. presented resistance to penicillin, amoxicillin, erythromycin, and cefalexin. Gram-negative microorganisms had resistance to tetracycline, ciprofloxacin, azithromycin, amoxicillin, erythromycin, and penicillin. Bacteroides spp. exhibited resistance to penicillin, erythromycin, and gentamicin. Prevotella spp. showed resistance to penicillin, amoxicillin, erythromycin, clindamycin, levofloxacin, and imipenem. Finally, Klebsiella spp. displayed resistance to ampicillin, amoxicillin, moxifloxacin, and cefalexin. Interestingly, one clinical trial showed that after therapy there was a reduction in sensitivity of 18% for azithromycin and 26% for spiramycin.

CONCLUSIONS

Most of the microorganisms had resistance to diverse groups of antimicrobials. Suitable antimicrobials must be prescribed founded on the microbial samples, culture susceptibility, and clinical progression of the odontogenic infection. Furthermore, it was observed high levels of resistance to antimicrobials that have been used in local and systemic therapy of oral cavity infections. A preponderance of anaerobic microorganisms over aerobic ones was observed. Key words:Antibiotic resistance, odontogenic infections, efficacy, microorganisms, scoping review.