Determination of home-made wine selected parameters and study of honey addition impact on pro-healthy components content

The chemical characteristic of home-made wine, based on the vinification process of Maréchal Foch grapes with minimal intervention, was discussed. The addition of honey in the vinification process has been studied to improve the parameters of the pro-health properties of wine. Assays of antioxidant capacity, pH, colour intensity, total acidity, histamine, tyramine, tryptamine and phenylethylamine contents were carried out during the fermentation, maturation and storage processes. Moreover, the discussed above and selected oenological and quality parameters (organic acids, metals, total and free sulphur dioxide, alcohol content) of obtained wines were compared with commercial wines. Obtained results of allergenic compounds (SO2 and histamine) showed a significantly lower level for home-made wines. The presence of honey during the fermentation process significantly improved the antioxidant parameters, titratable acidity, and influenced the final product colour intensity and colour brilliance. The obtained data show that home-produced wine seems to be a valuable alternative to traditional commercial production due to the lack of chemical additives and potentially allergenic substances in the presence of compounds that enhance human health. Moreover, minimal intervention during fermentation, no filtering step, no chemical additives, processing aids and clarifying substances suggest that home-made wine can be considered natural.

Minimal intervention dentistry for managing carious lesions into dentine in primary teeth: an umbrella review

Purpose This umbrella review systematically appraised published systematic reviews on Minimal Intervention Dentistry interventions carried out to manage dentine carious primary teeth to determine how best to translate the available evidence into practice, and to provide recommendations for what requires further research. Method An experienced information specialist searched MEDLINE, Embase, Cochrane Database of Systematic Reviews, Epistemonikos, Joanna Briggs Institute Database of Systematic Reviews and Implementation Reports, and the NIHR Journals Library. In addition, the PROSPERO database was searched to identify forthcoming systematic reviews. Searches were built around the following four concepts: primary teeth AND caries/carious lesion AND Minimal Intervention Dentistry AND systematic review/meta-analysis. Searches were restricted to English language, systematic reviews with/without meta-analyses published between January 2000 and August 2020. Two reviewers independently screened all titles and abstracts. Interventions included involved no dentine carious tissue removal (fissure sealants, resin infiltration, topical application of 38% Silver Diamine Fluoride, and Hall Technique), non-restorative caries control, and selective removal of carious tissue involving both stepwise excavation and atraumatic restorative treatment. Systematic reviews were selected, data extracted, and risk of bias assessed using ROBIS by two independent reviewers. Studies overlap was calculated using corrected covered area. Results Eighteen systematic reviews were included in total; 8 assessed the caries arresting effects of 38% Silver Demine Fluoride (SDF), 1 on the Hall Technique (HT), 1 on selective removal of carious tissue, and eight investigated interventions using atraumatic restorative treatment (ART). Included systematic reviews were published between 2006 and 2020, covering a defined time frame of included randomised controlled trials ranging from 1969 to 2018. Systematic reviews assessed the sealing efficacy of fissure sealants and resin infiltration in carious primary teeth were excluded due to pooled data reporting on caries arrest in both enamel and outer third of dentine with the majority of these carious lesions being limited to enamel. Therefore, fissure sealants and resin infiltration are not recommended for the management of dentinal caries lesions in primary teeth. Topical application of 38% SDF showed a significant caries arrest effect in primary teeth (p < 0.05), and its success rate in arresting dental caries increased when it was applied twice (range between 53 and 91%) rather than once a year (range between 31 and 79%). Data on HT were limited and revealed that preformed metal crowns placed using the HT were likely to reduce discomfort at time of treatment, the risk of major failure (pulp treatment or extraction needed) and pain compared to conventional restorations. Selective removal of carious tissue particularly in deep carious lesions has significantly reduced the risk of pulp exposure (77% and 69% risk reduction with one-step selective caries removal and stepwise excavation, respectively). ART showed higher success rate when placed in single surface compared to multi-surface cavities (86% and 48.7–88%, respectively, over 3 years follow-up). Conclusion Minimal Intervention Dentistry techniques, namely 38% SDF, HT, selective removal of carious tissue, and ART for single surface cavity, appear to be effective in arresting the progress of dentinal caries in primary teeth when compared to no treatment, or conventional restorations. There is clear need to increase the emphasis on considering these techniques for managing carious primary teeth as a mainstream option rather than a compromise option in circumstances where the conventional approach is not possible due to cooperation or cost.

Nonrestorative Management of Dental Caries

The World Dental Federation (FDI) policy statement in 2016 advocated evidence-based caries-control measures for managing dental caries. The caries management philosophy has shifted from the traditional surgical manners to minimal intervention dentistry. Minimal intervention dentistry aims to extend the longevity of natural teeth. It places the nonrestorative approaches as a priority. The nonrestorative approaches for caries management aim to tackle the etiological factors of dental caries. Caries can be prevented or reversed by restricting the sugar intake and its frequency in the diet, improving oral hygiene practices, and using fluoride toothpaste. This article aims to present strategies for the nonrestorative management of dental caries, which are divided into four components to address the different etiological factors of dental caries. The first component is controlling dental plaque. Strategies for plaque control include oral hygiene instruction, motivational interviewing, mechanical plaque control, and chemical plaque control. The second component for nonrestorative management is reducing the risk of caries by identifying caries risk factors and protective factors, assessing personal caries risk, and customizing a treatment plan. Evidence-based measures for caries prevention include using fluoride, and dental sealants should be provided. The third component includes topical treatment to remineralise early carious lesions. The last component is long-term follow-up. Appropriate strategy adoption for the nonrestorative management of dental caries prolongs the life span of the teeth and sustains the good oral health of patients.

Minimal Invasive Dentistry: An Emerging Trend

When first introduced, the term Minimal Intervention Dentistry (MID) referred to use of smaller and more conservative cavity preparations. Today, concept is much broader, being a philosophy of care related to risk assessment of individual patients, early detection of oral disease, targeted preventively orientated strategies and limited surgical intervention appropriate to level of disease1-3. “Extension for prevention” which was previously taught has been changed to “Prevention of extension”. Though concept of MID has been stressed upon for more than a decade, but its uptake has not been global. MID should be the standard of care in modern dentistry, as it avoids over-zealous restorative interventions as well as supervised neglect. As dental profession worldwide grapples with challenges of dealing with high rates of dental diseases in socially disadvantaged and medically compromised patients, it is even more important to incorporate these concepts into practice to deal with challenge of management of oral diseases. This review focuses on the concept and techniques of minimal invasive dentistry as an emerging trend in paediatric dentistry. Keywords: paediatric dentistry, MID

Large infantile haemangioma of the cheek: A case report

Infantile haemangiomas (IH) or Strawberry naevi as were previously called are common neoplasms of childhood. The tendency to spontaneously involute differentiates this tumour from other vascular neoplasms. Though many treatment modalities have been described with advances in understanding of tumour pathology, it has been consistently found that minimal intervention under watchful observation offers the best chance of getting the best result in the long term. Though parents are extremely nervous, seeing the grotesque nature of these tumours, patient, firm counselling and reassurance is all that is required in most cases for successful management.

Meditation for adults with non-specific low back pain: a systematic review and meta-analysis

Objectives We aim to determine the effectiveness of meditation for adults with non-specific low back pain. Methods We searched PubMed, EMBASE, PEDro, Scopus, Web of Science, Cochrane Library, and PsycINFO databases for randomized controlled trials that investigated the effectiveness of meditation in adults with non-specific low back pain. Two reviewers rated risk of bias using the PEDro scale and the certainty of the evidence using the GRADE approach. Primary outcomes were pain intensity and disability. Results We included eight trials with a total of 1,234 participants. Moderate-certainty evidence shows that meditation is better than usual care for disability at short-term (SMD = −0.22; 95% CI = −0.42 to −0.02). We also found that meditation is better than usual care for pain intensity at long-term (SMD = −0.28; 95% CI = −0.54 to −0.02). There is no significant difference for pain intensity between meditation and minimal intervention or usual care at short and intermediate-term. We did not find differences between meditation and minimal intervention for disability at intermediate-term or usual care in any follow-up period. Conclusions We found small effect sizes and moderate-certainty evidence that meditation is slightly better than minimal intervention in the short-term for disability. Low-certainty of evidence suggests that meditation is slightly better than usual care for pain in the long-term. Meditation appears to be safe with most trials reporting no serious adverse events.

Speech and language therapy in palliative care

Palliative care is an emerging specialty within the field of speech and language therapy. The discipline is currently under-represented both in specialist services and research. Many patients in the palliative phase suffer problems with swallowing (dysphagia) and communication, the core domains of speech and language therapy practice. This chapter provides an overview of difficulties encountered in these domains by people with life-limiting conditions together with common approaches to assessment and management. Assessment and management should be person-centred, integrated into multidisciplinary care, and seek to maintain function using minimal intervention for maximum gain. More research is needed to inform appropriately integrated, person-centred models of speech and language therapy provision that enable difficulties with communication and swallowing to be addressed proactively alongside other symptoms and care needs. Difficulties in these domains are currently under-identified and undertreated in many cases.