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- Astvaldsdottir, Alfheidur, et al.
(författare)
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Longevity of posterior resin composite restorations in adults : A systematic review
- 2015
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Ingår i: Journal of Dentistry. - : Elsevier BV. - 0300-5712 .- 1879-176X. ; 43:8, s. 934-954
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Forskningsöversikt (refereegranskat)abstract
- Objective: To conduct a systematic review of the literature on the longevity of posterior resin composite restorations in adults. Material and methods: A systematic literature search was conducted according to predetermined criteria for inclusion and exclusion. The studies selected were prospective clinical trials with a minimum follow-up time of 4 years, 40 restorations per experimental group and an annual attrition rate of less than 5%. Initially, abstracts and full-text articles were assessed independently and the assessment was subsequently agreed on by five reviewers. The methodological quality of the studies was assessed according to the Swedish Council on Health Technology Assessment (SBU) standard checklist for determining the extent to which studies meet basic quality criteria. Results: In all, the literature search identified 4275 abstracts and 93 articles were read in fulltext. There were eighteen studies which met the criteria for inclusion, eight of which were included in the analysis. There were 80 failures of restorations with a total follow-up time at risk for failure of 62,030 months. The overall incidence rate for all causes of failure was 1.55 lost restorations per 100 restoration years. The most common biological reason for failure (a total of 31 restorations) was secondary caries, with or without fracture of the restoration. The quality of the evidence was low. Conclusions: In an efficacy setting, the overall survival proportion of posterior resin composite restorations is high. The major reasons for failure are secondary caries and restoration fracture which supports the importance of adequate follow-up time. Clinical significance: The overall survival proportion of posterior composite restorations was high, but the results cannot be extrapolated to an effectiveness setting. The importance of adequate follow-up time is supported by the finding that secondary caries often occurred after 3 years or later.
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| 3. |
- Dagerhamn, Jessica
(författare)
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Genetic content of clinical pneumococcal isolates and its relation to disease outcome
- 2009
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Streptococcus pneumoniae is a Gram-positive bacterium that can cause a wide range of diseases. These include otitis media, sinusitis, pneumonia and meningitis. It can, however, also cause asymptomatic carriage thereby behaving almost like a commensal. It is of great interest to try to determine factors playing a role for if the bacterium will cause carriage or whether it will cause an invasive disease (meaning that the bacterium is sampled from the blood or the meninges). The aim of this thesis is to investigate differences in genetic content in invasive and carriage isolates. In the first study we set out to see how well a molecular typing method, MLST, and genetic content as determined by microarray correlated. We found that isolates differing in up to two MLST alleles and belonging to the same clonal complex clustered together using microarray data. Hence the method of MLST, measuring differences in 7 house-keeping genes, correlates well with genetic content as determined by microarray. We also suggest an alternative typing method, a PCR consisting of 25 accessory genes, which gives the same discrimination as MLST clonal complexes. This method must, however be investigated further. In paper II we wanted to see how well isolates differing in more than two alleles, and still belonging to the same clonal complex correlated genetically. We found that both the number of alleles differing and if the isolates compared were of the same CC and / or Serotype affected the number of genes differing. For the three larger CCs investigated we saw that for one of them the number of genes increased with the number of alleles differing. For the other two there was a large increase when the serotype of the isolates compared shifted, indicating the possibility that these CC:s in fact come from more than one ancestor ST. Paper III investigated the genetic content of isolates of different invasive disease potential to see if any particular accessory region was associated with either carriage or invasiveness. No obvious candidate was found. ARs 6 and 34 were found in most of the invasive isolates and were absent in most of the isolates of low invasive disease potential and were tested for invasiveness in a mouse model of infection. We were not able to see any differences between knock-out mutants of these regions and the wild type. This, in addition to the fact that many genes found to be important for virulence in STM screens were absent, suggest that there is a great genetic redundancy affecting the ability of different isolates to cause invasive disease. In the fourth study we determined the invasive disease potential of isolates from Stockholm, Sweden 1997-2004. Invasiveness for serotype well matched previous studies with serotype 1, 4, 7F having a high invasive disease potential and 6A, 19F and 23 F having a low invasive disease potential. We did, however, find differences between clonal types of the same serotype, for serotypes 14 and 6B. We further investigated 6B by whole genome microarray and whole genome sequencing and found a number of differences. Among these are two different variants of the important protein PspA and the absence of PcpA, important for disease in the lung, from one of our isolates. We were also able to determine that the four serotype 6B isolates differed in presence/ absence of prophages, a factor that may be of importance for virulence.
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| 4. |
- Iwarsson, Erik, et al.
(författare)
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Analysis of cell-free fetal DNA in maternal blood for detection of trisomy 21, 18 and 13 in a general pregnant population and in a high risk population - a systematic review and meta-analysis
- 2017
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Ingår i: Acta Obstetricia et Gynecologica Scandinavica. - : WILEY-BLACKWELL. - 0001-6349 .- 1600-0412. ; 96:1
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Forskningsöversikt (refereegranskat)abstract
- IntroductionThe aim of this study was to review the performance of non-invasive prenatal testing (NIPT) for detection of trisomy 21, 18 and 13 (T21, T18 and T13) in a general pregnant population as well as to update the data on high-risk pregnancies. Material and methodsSystematic review and meta-analysis. PubMed, Embase and the Cochrane Library were searched. Methodological quality was rated using QUADAS and scientific evidence using GRADE. Summary measures of diagnostic accuracy were calculated using a bivariate random-effects model. ResultsIn a general pregnant population, there is moderate evidence that the pooled sensitivity is 0.993 (95% CI 0.955-0.999) and specificity was 0.999 (95% CI 0.998-0.999) for the analysis of T21. Pooled sensitivity and specificity for T13 and T18 was not calculated in this population due to the low number of studies. In a high-risk pregnant population, there is moderate evidence that the pooled sensitivities for T21 and T18 are 0.998 (95% CI 0.981-0.999) and 0.977 (95% CI 0.958-0.987) respectively, and low evidence that the pooled sensitivity for T13 is 0.975 (95% CI 0.819-0.997). The pooled specificity for all three trisomies is 0.999 (95% CI 0.998-0.999). ConclusionsThis is the first meta-analysis using GRADE that shows that NIPT performs well as a screen for trisomy 21 in a general pregnant population. Although the false positive rate is low compared with first trimester combined screening, women should still be advised to confirm a positive result by invasive testing if termination of pregnancy is under consideration.
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