Purpose
The ability to identify and focus care to patients at higher risk of moderate to severe postoperative pain should improve analgesia and patient satisfaction, and may affect reimbursement. We ...undertook this multi-centre cross-sectional study to identify preoperative risk factors for moderate to severe pain after total hip (THR) and knee (TKR) replacement.
Methods
A total of 897 patients were identified from electronic medical records. Preoperative information and anaesthetic technique was gained by retrospective chart review. The primary outcomes were moderate to severe pain (pain score ≥ 4/10) at rest and with activity on postoperative day one. Logistic regression was performed to identify predictors for moderate to severe pain.
Results
Moderate to severe pain was reported by 20 % at rest and 33 % with activity. Predictors for pain at rest were female gender (OR 1.10 with 95 % CI 1.01–1.20), younger age (0.96, 0.94–0.99), increased BMI (1.02, 1.01–1.03), TKR vs. THR (3.21, 2.73–3.78), increased severity of preoperative pain at the surgical site (1.15, 1.03–1.30), preoperative use of opioids (1.63, 1.32–2.01), and general anaesthesia (8.51, 2.13–33.98). Predictors for pain with activity were TKR vs. THR (1.42, 1.28–1.57), increased severity of preoperative pain at the surgical site (1.11, 1.04–1.19), general anaesthesia (9.02, 3.68–22.07), preoperative use of anti-convulsants (1.78, 1.32–2.40) and anti-depressants (1.50, 1.08–2.80), and prior surgery at the surgical site (1.28, 1.05–1.57).
Conclusions
Our findings provide clinical guidance for preoperative stratification of patients for more intensive management potentially including education, nursing staffing, and referral to specialised pain management.
Although ocular manifestations are reported in patients with COVID-19, consensus on ocular tropism of SARS-CoV-2 is lacking. Here, we infect K18-hACE2 transgenic mice with SARS-CoV-2 using various ...routes. We observe ocular manifestation and retinal inflammation with production of pro-inflammatory cytokines in the eyes of intranasally (IN)-infected mice. Intratracheal (IT) infection results in dissemination of the virus from the lungs to the brain and eyes via trigeminal and optic nerves. Ocular and neuronal invasions are confirmed using intracerebral (IC) infection. Notably, the eye-dropped (ED) virus does not cause lung infection and becomes undetectable with time. Ocular and neurotropic distribution of the virus in vivo is evident in fluorescence imaging with an infectious clone of SARS-CoV-2-mCherry. The ocular tropic and neuroinvasive characteristics of SARS-CoV-2 are confirmed in wild-type Syrian hamsters. Our data can improve the understanding regarding viral transmission and clinical characteristics of SARS-CoV-2 and help in improving COVID-19 control procedures.
To investigate the concordance of results of blood and tissue cultures in patients with pyogenic spondylitis.
We searched for patients with pyogenic spondylitis in whom microorganisms were isolated ...from both blood and tissue cultures by retrospective review of medical records in three tertiary university-affiliated hospitals between January 2005 and December 2015. The species and antimicrobial susceptibility patterns of isolates from blood and tissue cultures were compared.
Among 141 patients with pyogenic spondylitis in whom microorganisms were isolated from both blood and tissue cultures, the species of blood and tissue isolates were identical in 135 patients (95.7%, 135/141). Excluding the four anaerobic isolates, we investigated antimicrobial susceptibility patterns of 131 isolates of the same species from blood and tissue cultures. Antibiotic susceptibility patterns were identical in 128 patients (97.7%, 128/131). The most common isolates were Staphylococcus aureus (86 patients; 85 concordant and one discordant), followed by streptococcus (24 patients; 22 concordant and two discordant), and Escherichia coli (eight patients; all concordant).
We suggest that a positive blood culture from patients with pyogenic spondylitis could preclude the need for additional tissue cultures, especially when S. aureus and streptococcus grew in blood cultures.
Abstract Background and aim Adipocyte fatty acid-binding protein (FABP4) is abundantly expressed in adipocytes and plays a role in glucose homeostasis. We analysed the relationship between serum ...FABP4 levels and the progression of metabolic syndrome in healthy adults. Methodsand results A total of 465 subjects were selected from participants in a medical check-up programme at a Health Promotion Center. Baseline serum FABP4 levels were measured, and the subjects were evaluated for the presence of metabolic syndrome (MetS) according to the recommendations of the American Heart Association/National Heart, Lung, and Blood Institute. The subjects were re-evaluated 4 years later. Baseline FABP4 concentrations were significantly higher in subjects with MetS than in those without MetS ( P < 0.001). At the 4-year follow-up, subjects in the highest FABP4 tertile at baseline exhibited higher values for body mass index, fat mass and percent body fat, as well as blood pressure, fasting glucose, total cholesterol, triglycerides, low-density lipoprotein (LDL)-cholesterol, insulin, homeostasis model assessment of insulin resistance, monocyte chemoattractant protein-1 and tumor necrosis factor-α levels (all P < 0.05). The subjects with higher FABP4 levels had lower HDL-cholesterol concentrations ( P < 0.05). After adjustment for age, sex, change in percent body fat and baseline values for other metabolic and inflammatory parameters, FABP4 levels at baseline were shown to be strongly associated with the development of MetS by year 4 (odds ratio (OR), 5.75; 95% confidence interval (CI), 2.71–12.23 for highest tertile vs. lowest tertile, P < 0.001) Conclusion Baseline serum FABP4 levels appear to be a significant predictor for the future development of MetS, independent of pro-inflammatory cytokines.
To characterize antifungal principles from the methanol extract of Magnolia obovata and to evaluate their antifungal activities against various plant pathogenic fungi. Four neolignans were isolated ...from stem bark of M. obovata as antifungal principles and identified as magnolol, honokiol, 4-methoxyhonokiol and obovatol. In mycelial growth inhibition assay, both magnolol and honokiol displayed more potent antifungal activity than 4-methoxyhonokiol and obovatol. Both magnolol and honokiol showed similar in vivo antifungal spectrum against seven plant diseases tested; both compounds effectively suppressed the development of rice blast, tomato late blight, wheat leaf rust and red pepper anthracnose. 4-Methoxyhonokiol and obovatol were highly active to only rice blast and wheat leaf rust respectively. The extract of M. obovata and four neolignans had potent in vivo antifungal activities against plant pathogenic fungi. Neolignans from Magnolia spp. can be used and suggested as a novel antifungal lead compound for the development of new fungicide and directly as a natural fungicide for the control of plant diseases such as rice blast and wheat leaf rust.
Abstract Aims This study investigated the relationship between markers of overall glucose exposure, postprandial glucose excursions and glycaemic variability in patients with type 2 diabetes mellitus ...(T2DM). Methods A total of 63 patients with T2DM (mean age 56 years) were enrolled. All wore a continuous glucose monitoring system (CGMS) device for 72 h to collect data on markers of overall glucose exposure, postprandial glucose excursions and glycaemic variability parameters. Results Spearman's correlation analysis revealed significant correlations between all markers of overall glucose exposure and various parameters related to glucose excursions. The percent coefficient of variation (CV) showed the strongest correlation with glycated albumin ( r = 0.470, P < 0.01). In participants with HbA1c levels < 7.5% ( n = 33), almost all glycaemic markers and glycaemic variability parameters were significantly correlated with each other. Also, all postprandial glucose excursion parameters showed significant correlation with other glycaemic markers, and all markers of overall glucose exposure were significantly related to mean glucose, postprandial glucose excursions and glycaemic variability parameters (except CV). In contrast, in participants with HbA1c levels ≥ 7.5% ( n = 30), no parameters of postprandial glucose excursions and glycaemic variability were related to any markers of chronic glycaemia. Conclusion Postprandial glucose excursions may explain glycaemic variability and total glucose exposures in well-controlled T2DM patients.
Background and Objective
Wingless‐type MMTV integration site family (Wnt)/β‐catenin signaling plays an essential role in cellular differentiation and matrix formation during skeletal development. ...However, little is known about its role in tooth‐root formation. In a previous study, we found excessive formation of dentin and cementum in mice with constitutive β‐catenin stabilization in the dental mesenchyme. In the present study we analyzed the molar roots of these mice to investigate the role of Wnt/β‐catenin signaling in root formation in more detail.
Material and Methods
We generated OC‐Cre:Catnb+/lox(ex3) mice by intercrossing Catnb+/lox(ex3) and OC‐Cre mice, and we analyzed their mandibular molars using radiography, histomorphometry and immunohistochemistry.
Results
OC‐Cre:Catnb+/lox(ex3) mice showed impaired root formation. At the beginning of root formation in mutant molars, dental papilla cells did not show normal differentiation into odontoblasts; rather, they were prematurely differentiated and had a disorganized arrangement. Interestingly, SMAD family member 4 was upregulated in premature odontoblasts. In 4‐wk‐old mutant mice, molar roots were about half the length of those in their wild‐type littermates. In contrast to excessively formed dentin in crown, root dentin was thin and hypomineralized in mutant mice. Biglycan and dentin sialophosphoprotein were downregulated in root dentin of mutant mice, whereas dentin matrix protein 1 and Dickkopf‐related protein 1 were upregulated. Additionally, ectonucleotide pyrophosphatase/phosphodiesterase 1 was significantly downregulated in the cementoblasts of mutant molars. Finally, in the cementum of mutant mice, bone sialoprotein was downregulated but Dickkopf‐related protein 2 was upregulated.
Conclusion
These results suggest that temporospatial regulation of Wnt/β‐catenin signaling plays an important role in cell differentiation and matrix formation during root and cementum formation.
Visible-light-sensitive Ag and Au nanocluster loaded Bi2O4 (Ag–Bi2O4 and Au–Bi2O4) semiconductor photocatalysts have been synthesized. The composite materials exhibited increased photocatalytic ...degradation of the azo-dye pollutant, Methyl Orange (MO). In addition, Au–Bi2O4 (Au-7% wt) showed the highest MO degradation rate (0.05904 min−1) i.e. 7.69 times higher than the pristine Bi2O4 and 1.4 times higher than 1% Ag–Bi2O4. The optical properties of the composites showed that the band gaps of the composite samples 1% Ag–Bi2O4 and 7% Au–Bi2O4 were 1.96 eV and 2.09 eV, respectively. The increase in the degradation rate is attributed to the decrease of the recombination rate of photoinduced e−/h+, caused by the enhanced charge transfer between the metal nanoparticles and Bi2O4 as confirmed in the photocurrent measurements. The photocurrent measurements showed increase in the transients output by 8.25 times and 2.75 times for 1% Ag–Bi2O4 & 3% Au–Bi2O4, respectively as compared to that of the pristine Bi2O4. These features further aided the increase in the photocatalytic efficiency while retaining the original physical properties, thus showing the robustness of Bi2O4 as a photocatalyst.
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