BACKGROUND

The global impact of the COVID-19 pandemic has instigated a profound public health crisis, particularly affecting professionals like dentists who, due to their close interaction with saliva—a potential viral reservoir—and the aerosols generated during specific procedures, face elevated risks of infection. To mitigate this, the Centers for Disease Control and Prevention (CDC) and the Philippine Dental Association (PDA) have established guidelines for averting cross-infection in dental settings

OBJECTIVE

This study, conducted in an urbanized Metro Manila City, delves into the infection control practices of dentists amid the pandemic.

METHODS

Dentists from a Metro Manila city dental chapter were invited to participate in an online survey (Google Forms) consisting of participants' demographics, patient triage, engineering, administrative controls, disinfection personal hygiene, personal protective equipment (PPE), and waste management practices. Descriptive statistics, employing frequency distributions and percentages, summarized the dentists' adherence to infection control protocols.

RESULTS

Out of forty-nine respondents (49), the majority (92%) provided their teams' orientation on COVID-19 infection control protocols before reopening. Notably, 57% deferred elective procedures and 43% postponed aerosolgenerating procedures (AGPs). Only 39% utilized rubber dam isolation during AGPs. Most respondents reported full implementation of recommended administrative controls during the pandemic, with 92% isolating their treatment areas from other parts of the clinic. Most respondents adopted high-efficiency particulate air (HEPA) filtration units (82%) as one of their clinic’s engineering controls, and an extraoral vacuum machine, accounting for 71% of the respondents. The most common disinfection product used by the participants was alcohol, which was at 94%. Additionally, over 90% adhered to all recommended hand hygiene practices for both dental staff and patients. For the waste management protocols, only 55% of the respondents have their infectious waste collected by third-party Treatment Storage and Disposal (TSD) facilities.

CONCLUSION

The data shows that with the guidelines posted by both the PDA and CDC, the city’s dental practitioners could still provide services to the community in the safest manner at the time by being updated and following the infection control practices suggested by both organizations. Although some areas could have been improved, such as third-party waste management and the utilization of RT-PCR testing, some of these problems could have been attributed to the lack of availability in their areas.

Public Health ; Philippines ; Interprofessional Education ; World Health Organization ; Centers For Disease Control And Prevention, U.s. ; Centers For Disease Control And Prevention (u.s.)

BACKGROUND

The global impact of the COVID-19 pandemic has instigated a profound public health crisis, particularly affecting professionals like dentists who, due to their close interaction with saliva—a potential viral reservoir—and the aerosols generated during specific procedures, face elevated risks of infection. To mitigate this, the Centers for Disease Control and Prevention (CDC) and the Philippine Dental Association (PDA) have established guidelines for averting cross-infection in dental settings.

OBJECTIVE

This study, conducted in an urbanized Metro Manila City, delves into the infection control practices of dentists amid the pandemic.

METHODS

Dentists from a Metro Manila city dental chapter were invited to participate in an online survey (Google Forms) consisting of participants' demographics, patient triage, engineering, administrative controls, disinfection personal hygiene, personal protective equipment (PPE), and waste management practices. Descriptive statistics, employing frequency distributions and percentages, summarized the dentists' adherence to infection control protocols.

RESULTS

Out of forty-nine respondents (49), the majority (92%) provided their teams' orientation on COVID-19 infection control protocols before reopening. Notably, 57% deferred elective procedures and 43% postponed aerosolgenerating procedures (AGPs). Only 39% utilized rubber dam isolation during AGPs. Most respondents reported full implementation of recommended administrative controls during the pandemic, with 92% isolating their treatment areas from other parts of the clinic. Most respondents adopted high-efficiency particulate air (HEPA) filtration units (82%) as one of their clinic’s engineering controls, and an extraoral vacuum machine, accounting for 71% of the respondents. The most common disinfection product used by the participants was alcohol, which was at 94%. Additionally, over 90% adhered to all recommended hand hygiene practices for both dental staff and patients. For the waste management protocols, only 55% of the respondents have their infectious waste collected by third-party Treatment Storage and Disposal (TSD) facilities.

CONCLUSION

The data shows that with the guidelines posted by both the PDA and CDC, the city’s dental practitioners could still provide services to the community in the safest manner at the time by being updated and following the infection control practices suggested by both organizations. Although some areas could have been improved, such as third-party waste management and the utilization of RT-PCR testing, some of these problems could have been attributed to the lack of availability in their areas.

Human ; Male ; Female ; Adult: 25-44 Yrs Old ; Middle Aged: 45-64 Yrs Old ; Aged: 65-79 Yrs Old ; World Health Organization ; Residence Characteristics ; Quarantine ; Public Health ; Centers For Disease Control And Prevention (u.s.) ; Covid-19 ; Centers For Disease Control And Prevention, U.s.

Ischemic heart disease (IHD) remains the most common cause of death while cerebrovascular disease (CVD) is the third most common in the Philippines. IHD and CVD represent complications resulting from prevalent non-communicable diseases (NCDs) and risk factors which present important opportunities for primary and secondary prevention.

This study aimed to pilot a sustainable multisectoral approach for community-based screening and management of cardiovascular (CV) risk factors and determine the effects of a multisectoral collaboration approach on the rate of screening, prevalence and control rates for selected risk factors.

This is a quality improvement project that determines the baseline prevalence and control rates of CV risk factors followed by intense screening efforts with support from private partnerships. The project's core components are: (a) capacity building (b) information dissemination; (c) service provision; and (d) health monitoring. Rates of screening, prevalence and control were monitored over a two-year period.

A total of 94,125 patients were screened through the ONE Cavite Project over two years (January 2021 to December 2022). A total of 61,271 were newly identified as having hypertension (65.1%), 24,069 diagnosed with diabetes mellitus type 2 (25.6%), 29,257 diagnosed to have dyslipidemia (31.1%) and 13,204 smokers (14.0%) were identified.

Intensification of screening was successful in improving identification of individuals with NCDs. The impact of continued educational support for both providers and patients in this study reaffirmed its role as a central component of NCD diagnosis, management and prevention.

Hypertension ; Diabetes Mellitus ; Dyslipidemias ; Myocardial Ischemia ; Primary Prevention

Ischemic heart disease (IHD) remains the most common cause of death while cerebrovascular disease (CVD) is the third most common in the Philippines. IHD and CVD represent complications resulting from prevalent non-communicable diseases (NCDs) and risk factors which present important opportunities for primary and secondary prevention.

This study aimed to pilot a sustainable multisectoral approach for community-based screening and management of cardiovascular (CV) risk factors and determine the effects of a multisectoral collaboration approach on the rate of screening, prevalence and control rates for selected risk factors.

This is a quality improvement project that determines the baseline prevalence and control rates of CV risk factors followed by intense screening efforts with support from private partnerships. The project's core components are: (a) capacity building (b) information dissemination; (c) service provision; and (d) health monitoring. Rates of screening, prevalence and control were monitored over a two-year period.

A total of 94,125 patients were screened through the ONE Cavite Project over two years (January 2021 to December 2022). A total of 61,271 were newly identified as having hypertension (65.1%), 24,069 diagnosed with diabetes mellitus type 2 (25.6%), 29,257 diagnosed to have dyslipidemia (31.1%) and 13,204 smokers (14.0%) were identified.

Intensification of screening was successful in improving identification of individuals with NCDs. The impact of continued educational support for both providers and patients in this study reaffirmed its role as a central component of NCD diagnosis, management and prevention.

Hypertension ; Diabetes Mellitus ; Dyslipidemias ; Myocardial Ischemia ; Primary Prevention

OBJECTIVE: To summarize the research progress on knee laxity of biomechanics and prevention and treatment after posterior cruciate ligament (PCL) reconstruction. METHODS: The domestic and international literature on the prevention and treatment of knee laxity after PCL reconstruction in recent years was extensively reviewed and analyzed. RESULTS: Different degrees of knee laxity often occur after PCL reconstruction, which can lead to poor prognosis in patients. The causes are associated with a variety of factors, including abnormal graft remodeling (such as differences in healing time and biomechanics among different types of grafts), tunnel position deviation (such as graft wear caused by the "killer turn" effect), and mechanical factors in postoperative rehabilitation (such as improper early weight-bearing and range of motion). These factors may promote graft elongation, increase early posterior tibial translation, and thereby induce knee laxity. CONCLUSION While PCL reconstruction improves knee stability, it is crucial to focus on and prevent postoperative knee laxity. However, current surgical methods are limited by factors such as graft characteristics, surgical technique flaws, and rehabilitation protocols, and thus can not fully correct the issue of abnormal postoperative laxity. Surgical techniques and treatment strategies still need further improvement and optimization to enhance patients' postoperative outcomes and quality of life.
Humans ; Joint Instability/surgery* ; Posterior Cruciate Ligament Reconstruction/adverse effects* ; Posterior Cruciate Ligament/surgery* ; Knee Joint/physiopathology* ; Biomechanical Phenomena ; Range of Motion, Articular ; Postoperative Complications/prevention & control* ; Knee Injuries/surgery*

OBJECTIVE: To optimize the perioperative management experiences for breast cancer patients undergoing direct-to-implant-based breast reconstruction, and provide reference for clinical practice. METHODS: A comprehensive review of recent domestic and international literature was conducted to systematically summarize the key points of perioperative management for direct-to-implant-based breast reconstruction, including preoperative health education, intraoperative strategies, and postoperative management measures, along with an introduction to the clinical experiences of West China Hospital of Sichuan University. RESULTS: Standardized perioperative management can effectively reduce the incidence of complications and achieve excellent cosmetic outcomes and quality of life after operation. Preoperative management includes proactive health education to alleviate patients' anxiety and improve treatment compliance, as well as comprehensive assessment by surgeons of the patient's physical condition and reconstructive expectations to select the most appropriate implant. Intraoperative management consists of strict aseptic technique, minimizing implant exposure, preserving blood supply to the nipple-areola complex (e.g., by using minimally invasive techniques or indocyanine green angiography, etc), and meticulous hemostasis. Postoperative management encompasses multimodal analgesia, individualized drain management (such as early removal or retaining a small amount of fluid to optimize contour), infection prevention and control (including topical and systemic antibiotics, ultrasound-guided minimally invasive drainage), guidance on rehabilitation exercises (early activity restriction followed by gradual recovery), and regular follow-up to evaluate aesthetic results and monitor for complications. CONCLUSION Establishing a standardized, multidisciplinary perioperative management framework markedly enhances surgical safety and patient satisfaction, thereby providing a replicable benchmark for direct-to-implant-based breast reconstruction across diverse clinical settings.
Humans ; Female ; Breast Neoplasms/surgery* ; China ; Perioperative Care/methods* ; Breast Implants ; Mammaplasty/methods* ; Breast Implantation/methods* ; Postoperative Complications/prevention & control* ; Quality of Life ; Mastectomy

OBJECTIVE: To review current status of clinical application and research progress of different anticoagulants in perioperative period of free flap transplantation. METHODS: A comprehensive review of recent relevant literature was conducted, focusing on clinical research concerning the application of anticoagulants in the perioperative period of free flap transplantation. The administration route, timing, dosage selection, effectiveness, and safety of commonly used and novel anticoagulants were summarized. RESULTS: At present, the anticoagulants mainly used in the perioperative period of free flap transplantation include drugs for venous thrombosis prophylaxis, drugs for arterial thrombosis prophylaxis, and physical/colloidal anticoagulants, etc. The administration strategies can be classified into two major categories: single-agent anticoagulation and combined anticoagulation. Single-agent anticoagulation mainly includes unfractionated heparin, low-molecular-weight heparin, aspirin, and novel anticoagulants. Combined anticoagulation is commonly a synergistic anticoagulation regimen dominated by heparin drugs, combined with aspirin, different antiplatelet drugs, and expansion agents. Studies indicate that perioperative anticoagulant administration can effectively reduce the risk of thrombosis in free flaps and improve the overall flap survival rate. However, significant differences exist in the impact of drug types, administration routes, initiation timing, and dosage intensity on efficacy and bleeding risk. A unified, standardized application protocol has not yet been established. In addition, there has been a growing number of studies on novel anticoagulant drugs. However, their superiority and optimal application strategies in the field of free flap transplantation still necessitate more high-quality evidence. CONCLUSION Perioperative anticoagulation therapy represents one of the key strategies for improving the survival rate of free flaps. However, there is still a lack of high-level evidence to establish a standard protocol. Future research should focus on the optimization of individualized anticoagulation strategies, the validation of the effectiveness of new anticoagulants, and the exploration of the advantages of different anticoagulation strategies. At the same time, attention should be paid to balancing anticoagulation and bleeding risks to promote the standardization of clinical practice and the improvement of treatment safety.
Humans ; Anticoagulants/therapeutic use* ; Free Tissue Flaps/blood supply* ; Thrombosis/prevention & control* ; Perioperative Care/methods* ; Heparin/therapeutic use* ; Heparin, Low-Molecular-Weight/administration & dosage* ; Perioperative Period ; Aspirin/therapeutic use*

Objective The prevalence of drug-resistant Mycobacterium tuberculosis (Mtb) strains is exacerbating the global burden of tuberculosis (TB), highlighting the urgent need for new treatment strategies for TB. Methods The recombinant adenovirus vaccine expressing cyclic di-adenosine monophosphate (c-di-AMP) phosphodiesterase B (CnpB) (rAd-CnpB), was administered to normal mice via mucosal immunization, either alone or in combination with drug therapy, to treat Mtb respiratory infections in mice.Enzyme-linked immunosorbent assay (ELISA) was used to detect the levels of antibodies in serum and bronchoalveolar lavage fluid (BALF). Real-time quantitative PCR was performed to assess the transcription levels of cytokines interferon γ(IFN-γ) and interleukin 10(IL-10) in mouse lungs. Flow cytometry was used to determine the proportions of CD4⁺ and CD8⁺ T cell subsets in the lungs and spleens. ELISA was employed to measure the levels of cytokines IFN-γ, IL-2, IL-10, inflammatory factors IL-6, and tumor necrosis factor α (TNF-α) secreted by spleen cells following antigen stimulation. The bacteria loads in the lungs and spleens of Mtb-infected mice were enumerated by plate counting methods. Resluts Intranasal immunization with rAd-CnpB induced high titers of IgG in mouse serum and the production of IgG and IgA in BALF, along with alterations in T lymphocyte subsets in the lungs and spleens. Administration of rAd-CnpB, either alone or in combination with drugs, to Mtb-infected mice significantly increased serum IgG levels as well as IgA and IgG levels in BALF. rAd-CnpB immunization promoted the secretion of CnpB-specific cytokines and inflammatory factors by splenocytes in Mtb-infected mice. However, rAd-CnpB immunotherapy, either alone or combined with drugs, did not significantly affect the bacterial loads in the lungs and spleens of mice with Mtb respiratory infections. Conclusion Mucosal immunization with rAd-CnpB induced significant mucosal, humoral and cellular immune responses in mice, and significantly enhanced CnpB-specific cellular immune responses in Mtb-infected mice.
Animals ; Adenoviridae/immunology* ; Mycobacterium tuberculosis/genetics* ; Mice ; Female ; Phosphoric Diester Hydrolases/genetics* ; Tuberculosis Vaccines/administration & dosage* ; Tuberculosis/prevention & control* ; Mice, Inbred BALB C ; Cytokines ; Lung/microbiology* ; Immunization ; Bronchoalveolar Lavage Fluid/immunology* ; Immunity, Mucosal

Objective To explore the mechanism by which gentiopicroside (GPS) prevents macrophage-mediated hepatic fibrosis by regulating the macrophage migration inhibitory factor (MIF)-secreted phosphoprotein 1 (SPP1) signaling pathway in hepatic stellate cells. Methods LX-2 cells were divided into control group, transforming growth factor β(TGF-β) group, and TGF-β combined with GPS (25, 50, 100, 150 μmol/mL) groups. Cell proliferation was detected by EDU assay, cell invasion was assessed by Transwell^TM assay, and the protein expressions of α-smooth muscle actin (α-SMA) and type I collagen (COL1A1) were measured by Western blot. M1-type macrophage-conditioned medium (M1-CM) was used to treat LX-2 cells in the TGF-β group and TGF-β combined with GPS group. The concentrations of inducible nitric oxide synthase (iNOS) and arginase 1 (Arg1) in the cell supernatant, as well as cell proliferation, invasion ability, and the expressions of α-SMA and COL1A1 were detected. Bioinformatics analysis was performed to identify the target intersections of GPS, hepatic fibrosis, and macrophage-related genes. Drug affinity responsive target stability (DARTS) experiments and Western blot were used to verify the regulatory effect of GPS on MIF. Furthermore, LX-2 cells were divided into control group, TGF-β group, TGF-β combined with M2-CM group, TGF-β and oe-NC combined with M2-CM group, and TGF-β and oe-MIF combined with M2-CM group to analyze the concentrations of iNOS and Arg1 in the cell supernatant, as well as changes in cell proliferation, invasion, and the expressions of α-SMA and COL1A1. LX-2 cells were also divided into control group, TGF-β group, TGF-β combined with oe-NC group, TGF-β combined with oe-MIF group, and TGF-β and oe-MIF combined with GPS group to determine the protein expressions of MIF and SPP1 by Western blot. A rat model of hepatic fibrosis was constructed to explore the potential therapeutic effects of GPS on hepatic fibrosis in vivo. Results Compared with the control group, the proliferation and invasion abilities of LX-2 cells in the TGF-β group were increased, and the protein expressions of α-SMA and COL1A1 were enhanced. GPS intervention inhibited the proliferation and invasion of LX-2 cells under TGF-β conditions and reduced the expressions of α-SMA and COL1A1. Compared with the control group, the concentration of iNOS in the cell supernatant of the TGF-β group was upregulated, while the concentration of Arg1 was decreased. M1-CM treatment further increased the concentration of iNOS, decreased the concentration of Arg1, and promoted cell proliferation and invasion, as well as upregulated the expressions of α-SMA and COL1A1 on the basis of TGF-β intervention. However, GPS could reverse the effects of M1-CM intervention. Bioinformatics analysis revealed that MIF was one of the target intersections of GPS, hepatic fibrosis, and macrophage-related genes, and GPS could target and inhibit its expression. Compared with the TGF-β group, after M2-CM intervention, the concentration of iNOS in the cell supernatant decreased, the concentration of Arg1 increased, the proliferation and invasion abilities of LX-2 cells were reduced, and the expressions of α-SMA and COL1A1 were weakened. However, overexpression of MIF reversed the effects of M2-CM intervention. Western blot results showed that compared with the control group, the protein expressions of MIF and SPP1 were enhanced in the TGF-β group. Overexpression of MIF further enhanced the expressions of MIF and SPP1, while GPS intervention inhibited the expressions of MIF and SPP1. In the animal experiment, GPS intervention treatment alleviated liver injury in rats with hepatic fibrosis and inhibited the expressions of MIF and SPP1, as well as α-SMA and COL1A1 in liver tissue. Conclusion GPS may prevent macrophage-mediated hepatic fibrosis by inhibiting the MIF-SPP1 signaling pathway in hepatic stellate cells.
Hepatic Stellate Cells/metabolism* ; Signal Transduction/drug effects* ; Macrophage Migration-Inhibitory Factors/genetics* ; Liver Cirrhosis/prevention & control* ; Macrophages/drug effects* ; Iridoid Glucosides/pharmacology* ; Humans ; Cell Proliferation/drug effects* ; Animals ; Cell Line ; Collagen Type I/metabolism* ; Collagen Type I, alpha 1 Chain ; Intramolecular Oxidoreductases/genetics* ; Rats ; Transforming Growth Factor beta/pharmacology* ; Actins/metabolism*

PURPOSE: Intertrochanteric fractures undergoing proximal femoral nail antirotation (PFNA) surgery are associated with significant hidden blood loss. This study aimed to explore whether intramedullary administration of tranexamic acid (TXA) can reduce bleeding in PFNA surgery for intertrochanteric fractures in elderly individuals. METHODS: A randomized controlled trial was conducted from January 2019 to December 2022. Patients aged over 60 years with intertrochanteric fractures who underwent intramedullary fixation surgery with PFNA were eligible for inclusion and grouped according to random numbers. A total of 249 patients were initially enrolled, of which 83 were randomly allocated to the TXA group and 82 were allocated to the saline group. The TXA group received intramedullary perfusion of TXA after the bone marrow was reamed. The primary outcomes were total peri-operative blood loss and post-operative transfusion rate. The occurrence of adverse events was also recorded. Continuous data was analyzed by unpaired t-test or Mann-Whitney U test, and categorical data was analyzed by Pearson Chi-square test. RESULTS: The total peri-operative blood loss (mL) in the TXA group was significantly lower than that in the saline group (577.23 ± 358.02 vs. 716.89 ± 420.30, p = 0.031). The post-operative transfusion rate was 30.67% in the TXA group and 47.95% in the saline group (p = 0.031). The extent of post-operative deep venous thrombosis and the 3-month mortality rate were similar between the 2 groups. CONCLUSION We observed that intramedullary administration of TXA in PFNA surgery for intertrochanteric fractures in elderly individuals resulted in less peri-operative blood loss and decreased transfusion rate, without any adverse effects, and is, thus, recommended.
Humans ; Tranexamic Acid/administration & dosage* ; Hip Fractures/surgery* ; Male ; Aged ; Female ; Fracture Fixation, Intramedullary/adverse effects* ; Blood Loss, Surgical/prevention & control* ; Antifibrinolytic Agents/administration & dosage* ; Aged, 80 and over ; Bone Nails ; Middle Aged ; Blood Transfusion/statistics & numerical data*