COVID-19 is a serious threat to human health and development.The acute burden of the pandemic includes more than 18.2 million deaths worldwide,and is unprecedented in modern times.This represents only a fraction of th...COVID-19 is a serious threat to human health and development.The acute burden of the pandemic includes more than 18.2 million deaths worldwide,and is unprecedented in modern times.This represents only a fraction of the total burden,as it excludes infection sequelae.An effective global strategic paradigm has been missing throughout the pandemic.The‘flattening the curve’approach neglected the importance of infection sequelae,and being centered on healthcare capacity was conceptually contrary to a people-centered health system.In March 2022,the World Health Organization revised its pandemic approach,importantly shifting emphasis away from managing transmission and towards prevention.Despite limitations,this now recognizes the role of infection sequelae,whose impact is becoming clearer in both variety and scale.Drawing on the foundational concepts of Sun Tzu and Carl von Clausewitz,most country approaches do not qualify as strategies,but rather as operational plans.They are also largely ineffective,neglecting infection sequelae,viral evolution dangers and other parameters.The purpose of this article is to summarize the evidence on COVID-19 infection sequelae,and alongside other contextual parameters use this to motivate that infection should be prevented.This is then used to answer the question:What is an effective strategy against COVID-19?展开更多
Background:There is limited evidence of the effects of local anesthesia(LA)on outcomes of non-surgical periodontal treatment(NSPT),in particular among the Chinese.This retrospective cohort study aimed to evaluate the ...Background:There is limited evidence of the effects of local anesthesia(LA)on outcomes of non-surgical periodontal treatment(NSPT),in particular among the Chinese.This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes.Methods:Data from periodontal examinations of 3980 patients were used.The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015.Descriptive analyses included changes in probing depth(PD)and the Mazza bleeding index(BI).Two-level(patient and tooth)logistic regression models and three-level(patient,tooth,and site)linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD≥5 mm.Decreases in PD and BI at sites under LA using the initial PD were also compared.Results:A significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia(NLA)group(0.98 vs.0.54 mm,t=24.12,P<0.001).A significantly higher probability of decreases was found in the LA group in BI(percentages of teeth with BI>1 and BI>2)for all teeth(16.7%vs.13.8%,t=3.75,P<0.001;34.7%vs.28.1%,t=6.73,P<0.001)and PD for teeth with PD≥5mm(32.3%vs.17.3%,t=28.48,P<0.001).The difference in PD between the LA and NLA groups increased as the initial PD increased.The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD<7 mm;however,it increased to 0.41 to 1.37 mm for sites with a baseline PD≥7 mm.Conclusions:LA improved the decrease in PD after NSPT.Root debridement at sites with initial PD≥7 mm should be performed under routine LA.展开更多
文摘COVID-19 is a serious threat to human health and development.The acute burden of the pandemic includes more than 18.2 million deaths worldwide,and is unprecedented in modern times.This represents only a fraction of the total burden,as it excludes infection sequelae.An effective global strategic paradigm has been missing throughout the pandemic.The‘flattening the curve’approach neglected the importance of infection sequelae,and being centered on healthcare capacity was conceptually contrary to a people-centered health system.In March 2022,the World Health Organization revised its pandemic approach,importantly shifting emphasis away from managing transmission and towards prevention.Despite limitations,this now recognizes the role of infection sequelae,whose impact is becoming clearer in both variety and scale.Drawing on the foundational concepts of Sun Tzu and Carl von Clausewitz,most country approaches do not qualify as strategies,but rather as operational plans.They are also largely ineffective,neglecting infection sequelae,viral evolution dangers and other parameters.The purpose of this article is to summarize the evidence on COVID-19 infection sequelae,and alongside other contextual parameters use this to motivate that infection should be prevented.This is then used to answer the question:What is an effective strategy against COVID-19?
基金Supported by grants from the Peking University School and Hospital of Stomatology(PKUSS20180205&PKUSS20130201).
文摘Background:There is limited evidence of the effects of local anesthesia(LA)on outcomes of non-surgical periodontal treatment(NSPT),in particular among the Chinese.This retrospective cohort study aimed to evaluate the effects of LA on short-term treatment outcomes of NSPT and to determine under what circumstances LA should be prescribed to improve these outcomes.Methods:Data from periodontal examinations of 3980 patients were used.The data were from 3-month re-evaluation records of an electronic periodontal charting record system in the Department of Periodontology of Peking University School and Hospital of Stomatology from June 2008 to January 2015.Descriptive analyses included changes in probing depth(PD)and the Mazza bleeding index(BI).Two-level(patient and tooth)logistic regression models and three-level(patient,tooth,and site)linear regression models were constructed to analyze the influence of LA on PD for all teeth/sites and teeth/sites with an initial PD≥5 mm.Decreases in PD and BI at sites under LA using the initial PD were also compared.Results:A significantly higher mean decrease in PD after NSPT was found in the LA group than in the no local anesthesia(NLA)group(0.98 vs.0.54 mm,t=24.12,P<0.001).A significantly higher probability of decreases was found in the LA group in BI(percentages of teeth with BI>1 and BI>2)for all teeth(16.7%vs.13.8%,t=3.75,P<0.001;34.7%vs.28.1%,t=6.73,P<0.001)and PD for teeth with PD≥5mm(32.3%vs.17.3%,t=28.48,P<0.001).The difference in PD between the LA and NLA groups increased as the initial PD increased.The difference between the two groups was 0.12 to 0.22 mm for sites with a baseline PD<7 mm;however,it increased to 0.41 to 1.37 mm for sites with a baseline PD≥7 mm.Conclusions:LA improved the decrease in PD after NSPT.Root debridement at sites with initial PD≥7 mm should be performed under routine LA.
