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Abstract Objectives This article examines the efficacy of two bioactive dental composites in preventing demineralization while preserving their mechanical and physical properties. Materials and methods The study compares Beautifil Kids and Predicta® Bioactive Bulk-Fill (Predicta) composites with conventional dental composite. Flexural strength and elastic modulus were evaluated using a universal testing machine. A pH-cycling model assessed the composites’ ability to prevent dentin demineralization. Color stability and surface roughness were measured using a spectrophotometer and non-contact profilometer, respectively, before and after pH-cycling, brushing simulation, and thermocycling aging. Results Beautifil Kids exhibited the highest flexural strength and elastic modulus among the materials (p 0.05). Predicta exhibited greater color change after brushing and increased surface roughness after thermocycling aging (p

BACKGROUND: ICU and other patients hospitalized with corona-virus disease 2019 (COVID-19) are more susceptible to secondary infections. Undetected secondary infections tend to have a severe clinical impact, associated with prolonged hospitalization and higher rates of inpatient mortality. OBJECTIVES: Estimate the prevalence of secondary infections, determine the frequency of microbial species detected at different body sites, and measure the association between secondary infections and outcomes among hospitalized COVID-19 patients. DESIGN: Cross-sectional analytical study. SETTING: Tertiary care center in Riyadh PATIENTS AND METHODS: Data were collected through retrospective chart review of hospitalized COVID-19 patients >18 years old from March 2020 until May 2022 at King Saud University Medical City (27 months). Rates of secondary infections among hospitalized COVID-19 patients were described and data on clinical outcomes (intensive care admission, invasive management procedures and mortality) was collected. MAIN OUTCOME MEASURES: Features and rates of infection and mortality. SAMPLE SIZE: 260 RESULTS: In total, 24.2% of the study population had secondary infections. However, only 68.8% of patients had secondary infection testing, from which 35.2% had a confirmed secondary infection. These patients had a significantly higher prevalence of diabetes mellitus (P

Purpose: This study conducted a simulation needs assessment on diverse ongoing residency training programs supervised by the Saudi Commission for Health Specialties (SCFHS) in Saudi Arabia. The goal was to develop a standardized methodological approach to integrate simulation as a teaching tool for any ongoing training program., Methods: A mixed-methods approach is used in four steps to focus on top educational needs and integrate simulation into the curriculum. The first step was the selection of 38 residency training programs based on the scoring criteria tool. Of these, nine were selected as target programs. The next step was champion recruitment, where two faculty representatives from each specialty were trained to become specialty champions. The third step was a targeted audience needs assessment, consisting of four phases: curriculum review; a targeted audience survey; stakeholders' interview; and selection of top educational requirements generated by the first three phases. Lastly, the fourth step used an integration simulation sheet to build common themes for incorporating simulation into the program curriculum., Results: Out of 38 programs, the nine selected top-ranked specialties completed the process, and roadmaps were developed. Using the combined list of all skills and behaviors, the final score proportion was calculated and then ranked. A list of the top needed skills and behaviors was compiled as follows: Obstetrics and Gynecology 10/84, Emergency Medicine (ER) 80/242, Intensive Care Unit 20/139, Internal Medicine (IM) 37/102, Pediatric 82/135, Ear, Nose, and Throat (ENT) 49/125, General Surgery (GS) 55/114, Plastic Surgery 24/165, and Family Medicine (FM) 59/168., Conclusion: Findings from this process could be used by the supervisory bodies at a country level and assist decision-makers to determine which criteria to use in the needs assessment to integrate simulation into any ongoing residency training program., Competing Interests: All authors report no conflicts of interest in relation to this work and certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript., (© 2022 Alzoraigi et al.)

Introduction: Bacterial infections in CF patients are common and start early in life. The prognosis of the disease is substantially dependent on chronic respiratory infection and inflammation. Pseudomonas aeruginosa (PA) infection or chronic colonization have been established to cause a chronic decline in pulmonary function (PFT), and/or increase CF mortality., Objectives: To obtain the prevalence of all bacterial pathogens in our CF patients and assess their evolution over time., Method: A retrospective review of 327 patients with confirmed CF of all age groups, who had respiratory culture samples at the first visit and on a regular follow-up between January 1, 1990 and December 2018, was conducted., Results: A total of 327 patients had a respiratory culture obtained at presentation. Two hundred and sixteen (66%) of 327 patients are alive, while 111 (34%) have died. Respiratory cultures were taken from nasopharyngeal aspiration (NPA) in 199 patients (61%), tracheal aspirate in 9 (3%), bronchoalveolar lavage (BAL)in one (0.29%), and in 124 patients (38%), sputum was induced. The eastern province contributed to the highest number of patients (122, 37.7%). There is a persistent increase in the prevalence of the common bacteria over the follow-up period of 7 years, namely Hemophilus influenzae (H. influenzae), Staphylococcus aureus (S. aureus), and all Pseudomonas (P. aeruginosa) culture types.Comparing cultures from the first and last follow-up visits, there was an increase in the prevalence of all ( P. aeruginosa ) cultures from 120 (34%) to 137 (53%), and a decrease in the prevalence of ( S. aureus ) and ( H. influenzae ) during the same follow-up period., Conclusion: There is a progressive increase in the number of patients with the most pathogenic types of bacteria because of the advanced age at presentation. As more adult patients are enrolled, there is a need for improved awareness regarding the early eradication of pathogenic bacteria to prevent progressive pulmonary damage., Competing Interests: No conflict of interest between authors., (© 2021 Publishing services provided by Elsevier B.V. on behalf of King Faisal Specialist Hospital & Research Centre (General Organization), Saudi Arabia.)

Introduction: The Texas Children's Hospital Lung Transplant Program undertook consideration of its first non-resident, non-citizen for lung transplantation in 2011., Methods: Four referrals from the Royal Embassy of Saudi Arabia were received, and two patients were evaluated from 2011 to 2013., Results: After a suitable candidate and family was identified, the program adopted a systematic approach to ensure that all the necessary elements of pre-transplant care, informed consent, and post-transplant care could be effectively delivered., Conclusion: The use of hospital translation services and the development of a strong professional relationship with a well-trained pediatric respirologist in Saudi Arabia combined with an excellent early post-transplant clinical course provide lessons that may be of help to other transplant programs considering international patients as candidates for solid organ transplantation., (© 2021 Publishing services provided by Elsevier B.V. on behalf of King Faisal Specialist Hospital & Research Centre (General Organization), Saudi Arabia.)

Introduction: Congenital lobar overinflation (CLO) is a congenital overinflation of a pulmonary lobe. The treatment choice depends on the severity of its symptoms. Surgical intervention is indicated for patients with significant symptomatology, while a conservative approach is used to treat incidental and mildly symptomatic lesions. However, the conservative approach for children with mild symptoms is not very common among pulmonologist. Therefore, we evaluated this approach to treating mildly symptomatic children., Methods: This retrospective study examined mildly symptomatic patients ( n  = 14) with a radiological diagnosis of CLO between June 2005 and August 2018 who were treated conservatively at KFSHRC in Riyadh. The participants' ages ranged between two days and four years, with follow-up period ranged from four months to 10 years., Results: Fourteen patients with CLO-who were 2 days to four years old and comprised 10 boys (71.4%) and four girls (28.6%)-were treated conservatively. All patients were symptomatic upon presentation, and their main clinical findings were tachypnea (85.7%) and dyspnea (78.6%). A single lobe was affected for ten patients (71.4%). Congenital cardiac anomalies founded in six patients (42.9%). Radiological image showed overinflation of all patients' affected lobes. Significant mediastinal displacement was observed among two patients (14.3%). During their follow-up periods, nine patients (64.3%) became asymptomatic, three (21.4%) showed improvement, and two (14.3%) remained symptomatic and underwent lobectomy., Conclusions: The good outcomes for mildly symptomatic children with CLO in our series indicate that the conservative approach can be considered to treat these children at any age, along with close follow-up., Competing Interests: The authors have no conflicts of interest to declare., (© 2022 The Authors.)