The aim of this article was to study the influence of anxiety (both state and trait) in postoperative recovery after extraction of third molar together, to establish the role of each of the aspects ...of anxiety in the results you obtained in an independent and complementary way.
We performed a prospective study of a consecutive series of 88 patients who underwent lower third molar extractions. Before being provided with any information about the operation, patients were asked to complete the Spielberger State-Trait Anxiety Inventory- Trait and State. We have evaluated postoperative swelling and pain, patients completed a 10-point visual analog scale (VAS) at home each day (at approximately the same time of day as the operation) until day 8 after surgery, when the sutures were removed.
Regarding postoperative variables between positive and negative trait anxiety groups, consumption of analgesic drugs was higher in positive trait anxiety group in a statistically significant way, while these differences were detected only on specific occasions regarding pain and swelling.
In the present study, anxiety was taken into account and showed a significant effect in explaining postoperative pain and taking analgesics.
Highlights ► Creatine produced a protective effect against 6-hydroxydopamine-induced cell death. ► The protective effect of creatine involves PI3K/AKT, PKA and PKC. ► ERK1/2 and CaMKII modulation is ...implicated in the protective effect of creatine. ► Creatine reversed the decline in GSK-3β phosphorylation induced by 6-OHDA. ► Creatine could be a potent protective factor for catecholaminergic cell survival.
In recent years, stagnation in the number of kidneys from after brain-dead donors (DBD) has stimulated the use of non–heart beating donors (NHBDs). Herein we present our 5-year experience with type ...II Maastricht NHBDs in renal transplantation.
All patients (n = 50) in this study received type II Maastricht NHBD kidneys (March 2012 to February 2017), with a median follow-up of 33 months.
Mean donor age was 39 ± 12 years, mean creatinine 1.24 ± 0.2 mg/dL, and the most frequently observed blood group (donors and recipients) was type A (64%). Recipients were slightly younger (51 ± 11 years old), with mean time on dialysis of 30 ± 24 months. Almost all were primary transplants. Pre-transplant panel-reactive antibodies (PRA) were <25%; initial immunosuppression was thymoglobulin, corticosteroids, mycophenolate mofetil, and delayed introduction of tacrolimus. Six percent were nonfunctioning kidneys; 79.6% presented with delayed renal function (mean duration 14 ± 9 days). Acute rejection was seen in 6% of patients. Mean creatinine at month 3 was 1.7 ± 0.8 mg/dL, and 1.5 ± 0.8 mg/dL in the first year. The last available mean creatinine was 1.54 ± 0.7 mg/dL. Proteinuria in the third month, first year, and third year was 0.70, 0.41, and 0.26 g/d, respectively. Recipient survival at the first, third, and fifth year was 100%, 100%, and 86%, and when graft-censored for death was 94%, 91%, and 91%, respectively. The incidence of acute rejection during first year was 6%, and 2% in the second year. Exitus incidence was 4% and cytomegalovirus infection was 21.3%. BK viremia between 1000 and 10,000 copies/mL was seen in 4.3%, and reached >10,000 copies/mL in 2.1%.
Type II NHBD has shown limited frequency of nonfunctioning kidney and high functional delay. The results in survival and renal function are very acceptable, comparable with levels seen in donation after brain death.
Summary
Apical periodontitis (AP) is an inflammatory lesion around the apex of a tooth caused by bacterial infection of the pulp canal system. AP appears radiographically as a radiolucent periapical ...lesion (RPL). The elective treatment for teeth with AP is root canal treatment (RCT). No study is available about the frequency of RPL and RCT in patients with inherited coagulation disorders (ICD). The aim of this study was to investigate the prevalence of RPL and RCT in patients with ICD and control subjects. In a cross‐sectional study, the radiographic records of 58 patients with haemophilia A, haemophilia B or von Willebrand's disease (study group) and 58 control subjects were examined. The frequency of RPL and RCT was assessed using digital panoramic radiographs and the Periapical Index. RPL in one or more teeth was found in 67.2% of patients with ICD and in 48.3% of control subjects (odds ratio = 2.20; P = 0.038). At least one RCT was found in 34.5% and 65.5% of subjects in the study and control groups respectively (odds ratio = 0.28; P = 0.001). Multivariate logistic regression analysis indicated that subjects with ICD had RPL with higher likelihood than control subjects (odds ratio = 7.4; P = 0.0005). Patients with ICD disorders showed a significantly higher prevalence of RPL and lower frequency of RCT than control patients.
IntroductionAdvancements in and accessibility to effective antiretroviral therapy has improved the life expectancy of people living with HIV, increasing the proportion of people living with HIV ...reaching older age (≥60 years), making this population's health‐related quality of life (HRQoL) more relevant. Our aim was to identify the determinants of poor HRQoL in people living with HIV aged ≥60 years and compare them with those of their younger counterparts.MethodsWe used data from the ‘Vive+’ study, a cross‐sectional survey conducted between October 2019 and March 2020, nested within the PISCIS cohort of people living with HIV in Catalonia and the Balearic Islands, Spain. We used the 12‐item short‐form survey (SF‐12), divided into a physical component summary (PCS) and a mental component summary (MCS), to evaluate HRQoL. We used the least absolute shrinkage and selection operator for variable selection and used multivariable regression models to identify predictors.ResultsOf the 1060 people living with HIV (78.6% males) who participated in the study, 209 (19.7%) were aged ≥60 years. When comparing older people living with HIV (≥60 years) and their younger counterparts, older people exhibited a worse PCS (median 51.3 interquartile range {IQR} 46.0–58.1 vs. 46.43 IQR 42.5–52.7, p < 0.001) but a similar MCS (median 56.0 IQR 49.34–64.7 vs. 57.0 IQR 48.9–66.3, p = 0.476). In the multivariable analysis, cognitive function correlated with a PCS (β correlation factor β −0.18, p = 0.014), and depressive symptoms and satisfaction with social role correlated with an MCS (β 0.61 and β −0.97, respectively, p < 0.001) in people living with HIV aged ≥60 years.ConclusionDepressive symptoms, poor cognitive function, and lower satisfaction with social roles predict poorer HRQoL in older people living with HIV. These factors need to be considered when designing targeted interventions.
Purpose To report the clinical features and the results after an early vitrectomy of a case of a Terson syndrome following an aneurysmal subarachnoid hemorrhage
Methods 32 years old male with ...decreased visual acuity (VA) of the right eye (RE) of evolution difficult to determine. As recent precedent a month before stands out a subarachnoid and parenchymal hemorrhage secondary to ruptured aneurysm of the right medial cerebral artery, treated by external ventricular drainage and posterior surgical clipping with satisfactory outcome. The examination revealed visual acuity of light perception in RE and funduscopy shows widespread vitreous haze with impossibility of glimpse the retina, with fibrinous‐looking condensations
Results Suspecting Terson syndrome a pars plana vitrectomy is performed with aspiration of subhyaloid bleeding in the posterior pole. The patient achieved a VA of 0.9 and the funduscopy shows the demarcation zone of ancient bleeding in the posterior pole
Conclusion Terson's syndrome is the combination of intraocular bleeding and subarachnoid hemorrhage secondary to rupture of an aneurysm. The bleeding can be intraretinal, subretinal or vitreal. It is a commonly underdiagnosed pathology. It is associated with worse neurological prognosis with higher rates of morbidity and mortality. However, vitreous hemorrhage is usually resolved spontaneously within a few months, and generally has good long‐term visual prognosis. But early vitrectomy is indicated in bilateral cases, persistent bleeding or proliferative vitreoretinopathy
Current land surface schemes in weather and climate models make use of the so-called coupled photosynthesis–stomatal conductance (
A–g
s
) models of plant function to determine the surface fluxes ...that govern the terrestrial energy, water and carbon budgets. Plant physiology is controlled by many environmental factors, and a number of complex feedbacks are involved, but soil moisture control on root water uptake is primary, particularly in sub-tropical to temperate ecosystems. Land surface models represent plant water stress in different ways, but most implement a water stress factor,
β
, which ranges linearly (more recently also curvilinearly) between
β
= 1 for unstressed vegetation and
β
= 0 at the wilting point, expressed in terms of volumetric water content (
θ
).
β
is most commonly used to either limit
A
or
g
s
, and hence carbon and water fluxes, and a pertinent research question is whether these treatments are in fact interchangeable. Following Egea et al. (Agricultural and Forest Meteorology, 2011, 151 (10), 1,370–1,384) and Verhoef et al. (Agricultural and Forest Meteorology, 2014, 191, 22–32), we have implemented new
β
treatments, reflecting higher levels of biophysical complexity in a state-of-the-art LSM, Joint UK Land Environment Simulator, by allowing root zone soil moisture to limit plant function non-linearly and via individual routes (carbon assimilation, stomatal conductance, or mesophyll conductance) as well as any (non-linear) combinations thereof. The treatment of
β
does matter to the prediction of water and carbon fluxes: this study demonstrates that it represents a key structural uncertainty in contemporary LSMs, in terms of predictions of gross primary productivity, energy fluxes and soil moisture evolution, both in terms of climate means and response to a number of European droughts, including the 2003 heat wave. Treatments allowing
ß
to act on vegetation fluxes via stomatal and mesophyll routes are able to simulate the spatiotemporal variability in water use efficiency with higher fidelity during the growing season; they also support a broader range of ecosystem responses, e.g., those observed in regions that are radiation limited or water limited. We conclude that current practice in weather and climate modelling is inconsistent, as well as too simplistic, failing to credibly simulate vegetation response to soil water stress across the typical range of variability that is encountered for current European weather and climate conditions, including extremes of land surface temperature and soil moisture drought. A generalized approach performs better in current climate conditions and promises to be, based on responses to recently observed extremes, more trustworthy for predicting the impacts of climate change.
Premacular haemorrhage in patient with leukaemia PRIETO CALVO, E; EGEA ESTOPINAN, C; IDOIPE CORTA, M ...
Acta ophthalmologica (Oxford, England),
September 2011, 2011-09-00, 20110901, Letnik:
89, Številka:
s248
Journal Article
Recenzirano
Purpose Blood dyscrasia has been associated with premacular haemorrhages. The combination of severe anaemia and thrombocytopenia has been hypothesised to cause reduced coagulability and loss of ...endothelial cell integrity, allowing blood leakages through the jeopardised endothelial barrier.
Methods Prospective, interventional, single case report. A 20‐year‐old man, treated with chemotherapy for acute lymphoid leukaemia, is referred with a sudden loss of vision in his left eye (LE). Funduscopic examination revealed a sharply demarcated, dome‐shaped premacular haemorrhage, with approximately one diameter‐disk of size. The spectral‐domain OCT(SD‐OCT) scan showed that the cleavage plane of blood accumulation was located under the internal limiting membrane (sub‐ILM). Considering the location and the size of the haemorrhage we decided to perform a conservative management with periodic checks.
Results Four months later, the macular haemorrhage had been reabsorbed and vision had improved. The SD‐OCT scan revealed the total absorption of blood, with signs of thickening of the internal limiting membrane.
Conclusion Therapeutic options in premacular haemorrhages (conservative management, laser membranotomy or vitrectomy) should be established on an individual basis, considering in each case, the underlying disease, bilaterality of the process, duration and severity of bleeding, lens transparency, age and general condition of the patient.
C1858T single nucleotide polymorphism in PTPN22 encoding the R620W allele variant of Lyp-PTPN22 (a protein phosphatase negatively regulating T-cell activation) has been associated with autoimmunity. ...This work has investigated the possible association between PTPN22 C1858T (rs2476601) polymorphism and rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc) in a Colombian population.
A case-control study included 1,042 samples from 413 RA, 94 SLE and 101 SSc patients and 434 healthy controls. The TaqMan allele discrimination assay was used for genotyping.
The case-control study provided robust evidence of association between allele 1858T and RA (p=5E-05), as well as between 1858T and SLE (p=0.004). These observations were confirmed for both diseases by meta-analysis (p=2E-04, pooled OR 1.9; 1.3-2.7 95% CI for RA; p<0.0001, pooled OR 2.8, 1.8-4.5 95% CI for SLE). No significant association was observed between 1858T and SSc (p=0.98, OR 1.11, 0.46-2.65 95% CI).
The study suggested that the PTPN22 1858T variant influences RA and SLE genetic background but not that of SSc in the Colombian population.
ObjectivesTo describe the epidemiology of sexually transmitted infections (STIs), identify and characterise socio-epidemiological clusters and determine factors associated with HIV ...coinfection.DesignRetrospective population-based cohort.SettingCatalonia, Spain.Participants42 283 confirmed syphilis, gonorrhoea, chlamydia and lymphogranuloma venereum cases, among 34 600 individuals, reported to the Catalan HIV/STI Registry in 2017–2019.Primary and secondary outcomesDescriptive analysis of confirmed STI cases and incidence rates. Factors associated with HIV coinfection were determined using logistic regression. We identified and characterized socio-epidemiological STI clusters by Basic Health Area (BHA) using K-means clustering.ResultsThe incidence rate of STIs increased by 91.3% from 128.2 to 248.9 cases per 100 000 population between 2017 and 2019 (p<0.001), primarily driven by increase among women (132%) and individuals below 30 years old (125%). During 2017–2019, 50.1% of STIs were chlamydia and 31.6% gonorrhoea. Reinfections accounted for 10.8% of all cases and 6% of cases affected HIV-positive individuals. Factors associated with the greatest likelihood of HIV coinfection were male sex (adjusted OR (aOR) 23.69; 95% CI 16.67 to 35.13), age 30–39 years (versus <20 years, aOR 18.58; 95% CI 8.56 to 52.13), having 5–7 STI episodes (vs 1 episode, aOR 5.96; 95% CI 4.26 to 8.24) and living in urban areas (aOR 1.32; 95% CI 1.04 to 1.69). Living in the most deprived BHAs (aOR 0.60; 95% CI 0.50 to 0.72) was associated with the least likelihood of HIV coinfection. K-means clustering identified three distinct clusters, showing that young women in rural and more deprived areas were more affected by chlamydia, while men who have sex with men in urban and less deprived areas showed higher rates of STI incidence, multiple STI episodes and HIV coinfection.ConclusionsWe recommend socio-epidemiological identification and characterisation of STI clusters and factors associated with HIV coinfection to identify at-risk populations at a small health area level to design effective interventions.
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