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Bacterial DNA gyrase and topoisomerase IV inhibition has emerged as a promising strategy for the cure of infections caused by antibiotic-resistant bacteria. The Novel Bacterial Topoisomerase Inhibitors (NBTIs) bind to a different site from that of the quinolones with novel mechanism of action. This evades the existing target-mediated bacterial resistance associated with quinolones. This article presents our efforts to identify in vitro potent and broad-spectrum antibacterial agent 4l., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Competing Interests: Disclosure None of the authors reported any disclosures.

Odontogenic cysts impact the adjacent dentition and maxillary sinus. A combined transnasal, transoral approach for removal offers reduced recurrence rates and favorable sinonasal outcomes compared with historic transoral-only approaches., (© 2024 The Authors. The Laryngoscope published by Wiley Periodicals LLC on behalf of The American Laryngological, Rhinological and Otological Society, Inc.)

Background: Active surveillance (AS) is standard care for most men with low-risk prostate cancer (PC); yet, many men on AS eventually undergo curative therapy. Interventions to lower the risk of cancer progression and fear of recurrence among men on AS for PC are needed., Objective: To determine the effect of aerobic exercise on cardiorespiratory fitness, body size, and quality of life (QOL) among men on AS for PC., Design, Setting, and Participants: We conducted a 1:1 randomized controlled trial among 51 men with low-risk PC who elected AS. Participants were enrolled at the University of California, San Francisco., Intervention: The 16-wk intervention included a home-based walking program with a nonlinear exercise prescription tailored to baseline fitness level, heart rate monitor, and weekly phone call with an exercise physiologist. Controls received printed materials., Outcome Measurements and Statistical Analysis: Cardiorespiratory fitness was measured using VO 2 peak; secondary outcomes included change in body size, anxiety, and QOL. Analyses were based on intention to treat., Results and Limitations: Between 2016 and 2021, we randomized 51 men to intervention (n = 26) or control (n = 25). Follow-up was 88% (45/51), 85% (22/26) in the intervention and 92% (23/25) in the control group. At 16 wk, the intervention group had a higher mean VO 2 peak than the control group (31.9 ± 4.7 vs 27.2 ± 4.8 ml/kg/min; group × time effect p value: <0.001). Additionally, the intervention group reported less fear of PC recurrence and urinary obstruction/irritation, while controls reported more of these two QOL measures, from 0 to 16 wk (p = 0.04 and 0.03, respectively). Two participants discontinued the intervention, including one due to knee pain related to the study., Conclusions: A home-based walking program improved VO 2 peak and reduced urinary obstruction/irritation and fear of recurrence among men on AS for PC., Patient Summary: Moderate to vigorous aerobic exercise improves fitness and quality of life among men on active surveillance for prostate cancer., (Copyright © 2023 The Authors. Published by Elsevier B.V. All rights reserved.)

Understanding the genetic adaptations that occurred as humans migrated out of Africa to higher latitudes helps explain on a population-wide level how UV radiation (UVR) exposure will have varying consequences and benefits in patients of different skin pigmentations. It has been hypothesized that the need for efficient vitamin D synthesis was the primary driver for the skin-lightening process that evolutionarily occurred as humans migrated to higher latitudes. This review analyzes the level of support for the hypothesis that skin lightening occurred to enable adequate vitamin D synthesis in populations that migrated to areas with less UVR. Our literature search supported the hypothesis that through natural selection and intricate genetic adaptations, humans who migrated to areas with lower levels of UVR underwent a skin-lightening process to avoid the consequences of vitamin D deficiency. Our review includes an analysis of migration patterns out of Africa and how these affected pigmentation genes that are found in certain ethnic populations can be used to better understand this critical adaptation process when counseling patients on the need for sun protection.

Objective: Maxillary sinusitis can be a sequela of medication-related osteonecrosis of the jaw (MRONJ). This study aims to characterize the microbiome of maxillary MRONJ with concurrent maxillary sinusitis and radiographic maxillary sinus opacification to determine if there is a relationship between the microbiome of MRONJ and sinus disease., Study Design: This retrospective case series was conducted using electronic health records from the University of Pennsylvania and affiliated hospitals. The target population was surgically managed maxillary MRONJ patients. The primary predictor variables were tissue culture results. The primary outcomes were maxillary sinusitis or maxillary sinus opacification. Statistical analysis was performed using chi-squared tests at the 95% confidence interval., Results: Thirty-nine subjects were selected: 25 had sinus opacification and 11 had sinusitis. Resident bacteria were present in 90% of subjects, nonresident bacteria in 74%, and opportunistic organisms in 15%. There were significantly more subjects with chronic sinusitis microbes (79%) than without. There were significantly more gram-positive anaerobes, specifically Propionibacterium, as well as the gram-negative facultative anaerobe, Capnocytophaga, in subjects with concurrent sinusitis., Conclusions: Maxillary MRONJ with concurrent maxillary sinusitis may be associated with gram-positive anaerobic species, Propionibacterium, and Capnocytophaga colonization. Maxillary MRONJ patients may benefit from sinus evaluation and concurrent surgical intervention., (Copyright © 2024. Published by Elsevier Inc.)

Aims: To outline key factors that contribute to oral health issues of refugees and asylum seekers and provide management strategies for dental providers to teach desensitization and fear reduction for this special population., Methods and Results: We researched published literature in the PubMed database and incorporated lessons gained from treating refugee and asylee patients at a Vulnerable Populations Clinic (VPC) at an urban academic dental school. Refugees and asylees are at high risk for oral conditions due to a tendency to not seek routine dental treatment, psychological stressors, and various systemic factors. Oral health providers can teach patients desensitization and fear reduction by working to gain patients' trust by having effective communication and prioritizing comfort in the dental operatory. Providers should also utilize translation, psychological, and/or multicultural support services during their management of care., Conclusion: By having a stronger understanding of the key causes of oral health issues among refugees and asylees in the United States, dental providers can better approach managing care for this vulnerable patient population. The concepts of teaching desensitization and fear reduction utilized for this special population can be applied to managing care for the wider special needs patient community., (© 2022 Special Care Dentistry Association and Wiley Periodicals LLC.)

Background: Culture of bronchoalveolar lavage (BAL) specimens takes time to report. We tested whether a molecular diagnostic test could accelerate donor lung assessment and treatment., Methods: We compared BioFire Film Array Pneumonia Panel (BFPP) with standard of care (SOC) tests on lung allograft samples at three time points: (1) donor BAL at organ recovery, (2) donor bronchial tissue and airway swab at implantation, and (3) first recipient BAL following lung implantation. Primary outcomes were the difference in time to result (Wilcoxon signed-ranked tests) and the agreement in results between BFPP and SOC assays (Gwet's agreement coefficient)., Results: We enrolled 50 subjects. In donor lung BAL specimens, BFPP detected 52 infections (14 out of 26 pathogens in the panel). Viral and bacterial BFPP results were reported 2.4 h (interquartile range, IQR 2.0-6.4) following BAL versus 4.6 h (IQR 1.9-6.0, p = 0.625) for OPO BAL viral SOC results and 66 h (IQR 47-87, p < .0001) for OPO BAL bacterial SOC results. Although there was high overall agreement of results between BAL-BFPP versus OPO BAL-SOC tests (Gwet's AC p < .001 for all), the level of agreement differed among 26 pathogens designed in BFPP and differed by types of specimens. BFPP could not detect many infections identified by SOC assays., Conclusions: BFPP decreased time to detection of lung pathogens among donated lungs, but it cannot replace SOC tests due to the limited number of pathogens in the panel., (© 2023 The Authors. Transplant Infectious Disease published by Wiley Periodicals LLC.)

The scenario presented is of a patient in the dental chair who had history of myocardial infarction and history of stent placed in the left anterior descending coronary artery who now presents with acute chest pain, chest tightness, and extreme dizziness. Confirming cardiopulmonary arrest and beginning basic life support are the first steps in the management followed by defibrillation, advanced cardiac life support, post-resuscitation care, and long-term management., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Dentists should be equipped to treat any allergic reaction in a dental office and in this scenario, anaphylaxis is noted after administration of a penicillin derivative given before a dental procedure. Identification of signs and symptoms related to anaphylaxis is vital and appropriate management of the patient is the key. The dental management of the scenario goes into the diagnosis and management of anaphylaxis in a dental office., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Purpose: Oral and maxillofacial surgery (OMS) residencies commonly affiliate with Veterans Affairs Medical Centers (VAMC) to extend care for veterans. This study quantifies the surgical experience of residents at the Corporal Michael J. Crescenz (CMC) VAMC in Philadelphia, Pennsylvania and determines the number of programs affiliated with VA Medical Centers, to enumerate the educational benefits and improve veteran healthcare., Methods: The dental project manager logs from 2012 through 2021 of the CMC VAMC operating room were analyzed, and cases were categorized into 12 groups. The implant cases from 2012 through 2021 were quantified. Program affiliations were determined using a VA Office of Academic Affiliation report., Results: There were 1359 procedures (760 cases) performed. Dentoalveolar (n = 967) was the most common category, and extractions (n = 384) were the most common procedure. The least cases and procedures were performed in 2012 (n = 14; n = 23). The most cases were performed in 2019 (n = 137), and the most procedures were performed in 2019 and 2021 (n = 255). There were 3133 implants placed. There are 40 OMS programs affiliated with VA Medical Centers; more dual degree (n = 24) than single degree (n = 16) programs having an affiliation., Conclusion: The CMC VAMC offers robust dentoalveolar experience and is increasing in surgical volume, representing the expected needs of an aging veteran population. An increasing budget and millions of eligible veterans indicates VA medical centers nationally will continue to provide valuable surgical experiences., (© 2023 American Dental Education Association.)

Dentists should be trained to treat any allergic reaction in a dental office, and in this scenario, allergic reaction to latex-based product (rubber dam) is illustrated. Identification of signs and symptoms related to latex allergies is vital, and all dentists should be trained in the appropriate management of such a patient. The dental management of the scenario describes details of the diagnosis and management of latex-related allergies in a dental office for both adults and children., (Copyright © 2023 Elsevier Inc. All rights reserved.)

All dentists should be trained in the diagnosis and management of seizures in a dental chair. Although epilepsy is a common etiological factor, there are other medical situations whereby seizures are manifested. Once a seizure is suspected and other causes of altered consciousness or involuntary motor movements are ruled out, proper management should commence immediately. The first step in management is to immediately remove/stop all provocative factors, like bright flashing lights, drill sounds, and such. Benzodiazepines remain as the first-line treatment for patients with continued seizures before activating emergency medical services., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Dentists should be equipped to treat an allergic reaction in a dental office, and in this scenario, the potential allergic reaction is noted after administration of a common local anesthetic lidocaine with epinephrine. The allergic reaction quickly escalates to a full-blown anaphylaxis, and the management of such an episode is detailed in this article., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Although dental treatment in a patient with well-controlled type 2 diabetes mellitus is uncomplicated, hypoglycemia is one of the most dreaded complications among diabetics and remains as one of the leading causes of endocrine medical emergencies. Identification and prompt treatment is important to all dental practitioners. This scenario goes into the diagnosis and management of medication-induced hypoglycemia., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Patients with extreme dental anxiety and dental phobia are candidates for syncope attacks in a dental chair. Early recognition and management of these episodes is important. Vasovagal syncope is often preceded by prodromal signs and symptoms like facial pallor, diaphoresis, fainting, dizziness, nausea, or vomiting. If any element of the patient's airway, breathing, or cardiovascular system is no longer intact, the provider should commence emergency basic life support protocols and notify emergency medical services immediately., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Accidental foreign body aspiration is not uncommon during a dental procedure and remains a real risk for many dental procedures. Although approximately 50% of patients are asymptomatic after aspiration of a foreign body, understanding the appropriate next steps in management of these patients is critical in preventing morbid and even lethal outcomes in some instances. Appropriate knowledge of identification and management of such instances is important for all practicing dentists. This article goes into the diagnosis and management of both uncomplicated foreign body ingestion and complicated foreign body aspirations., (Copyright © 2023 Elsevier Inc. All rights reserved.)