Abstract
Aim
To assess whether periodontitis is associated with cognitive decline and its progression as well as with certain blood‐based markers of Alzheimer's disease.
Materials and Methods
Data ...from a 2‐year follow‐up prospective cohort study (
n
= 101) was analysed. Participants with a previous history of hypertension and aged ≥60 years were included in the analysis. All of them received a full‐mouth periodontal examination and cognitive function assessments (Addenbrooke's Cognitive Examination (ACE) and Mini‐Mental State Examination MMSE). Plasma levels of amyloid beta (Aβ)
1‐40
, Aβ
1‐42
, phosphorylated and total Tau (p‐Tau and t‐Tau) were determined at baseline, 12 and 24 months.
Results
Periodontitis was associated with poor cognitive performance (MMSE:
β
= −1.5 0.6) and progression of cognitive impairment (hazard ratio HR = 1.8; 95% confidence interval: 1.0–3.1). Subjects with periodontitis showed greater baseline levels of p‐Tau (1.6 0.7 vs. 1.2 0.2 pg/mL,
p
< .001) and Aβ
1‐40
(242.1 77.3 vs. 208.2 73.8 pg/mL,
p
= .036) compared with those without periodontitis. Concentrations of the latter protein also increased over time only in the periodontitis group (
p
= .005).
Conclusions
Periodontitis is associated with cognitive decline and its progression in elderly patients with a previous history of hypertension. Overexpression of p‐Tau and Aβ
1‐40
may play a role in this association.
Downregulation of the T cell system has been proposed as a mechanism to block immunity in colonic cancer (CC). However, little has been studied about circulating αβ and γδ T cells and their ...immunological status in newly diagnosed patients. The aim of this study was to characterize the αβ and γδ T cell subsets in peripheral blood of patients with CC matched with healthy volunteers. In this prospective case-control study, blood samples were obtained from 96 patients with newly diagnosed treatment-naïve infiltrating colonic adenocarcinoma and 48 healthy volunteers. Pathological report at surgery was obtained from all CC patients. A significant decrease in CD3+ γδ T cells and CD3+CD8+ γδ T cells (p<0.001) were observed in CC patients. Apoptosis was significantly increased in all conventional and both αβ and γδ T cell subsets in patients with CC vs healthy subjects. γδ T cells were decreased in peripheral blood of patients with microscopic infiltration in tissues, history of cancer and synchronous colon cancer (p < 0.05). IFN-γ was significantly reduced in CC patients compared to controls. Cytotoxic effector γδ T cells TEMRA (CD8 and CD56) are the proportionally most abundant T cells in peripheral blood of CC patients. Patients with CC present a deep downregulation in the systemic T-cell immunity. These variations are evident through all tumor stages and suggest that a deficiency in γδ T cell populations could be preventing control of tumor progression. This fact prove the role of immunomodulation on CC carcinogenesis.
•A prospective analysis of APO treatment of 22 PD patients in the initial stages of advanced PD.•Motor and non-motor symptoms, cognitive function and quality of life were assessed over 6 months.•APO ...resulted in significant improvements in motor function, but dyskinesia did not worsen.•Overall non-motor symptom burden was reduced, and sleep/fatigue and mood improved with APO.•APO also improved apathy, quality of life scores and executive functioning (attention, planning)
Parkinson’s disease (PD) patients usually start treatment with apomorphine infusion (APO) in later stages of advanced PD (aPD). This timing limits the evaluation of its motor efficacy and other potential clinical benefits throughout the full course of aPD.
We prospectively analyzed the effect of APO on motor and non-motor symptoms, cognitive function and quality of life (QoL) in 22 PD patients with early stage aPD, defined as: age < 71 years and diagnosis of aPD for < 3 years.
At baseline, mean (±SD) age and disease duration were 59.4 ± 6.1 and 8.7 ± 3.5 years, respectively. After 6 months of APO treatment, daily off-time decreased from 4.98 ± 2.37 to 1.48 ± 1.47 h (p ≤ 0.001) and UPDRS IV scores from 7.00 ± 2.58 to 5.32 ± 2.48 (p = 0.018). Dyskinesia did not worsen with APO despite an overall increase in levodopa equivalent daily dose. Mean NMSS scores improved with APO, from 52.50 ± 27.24 to 38.68 ± 27.17 (p = 0.002), with particular improvements in apathy and sleep quality. Mean PDQ-39 score was reduced with APO from 31.96 ± 11.93 to 19.27 ± 11.86 (p ≤ 0.001). Overall, cognition did not change after APO, while slight improvements were observed in executive functioning (attention and planning). All but one patient eventually underwent subthalamic deep brain stimulation.
In patients with early stage initial aPD, s substantial benefit of APO was observed on motor symptoms, driven by a 70% reduction in off-time versus baseline, superior to that observed in previous prospective studies. APO also improved frontal dysfunction in PD patients.
A lo largo de la historia existe constancia de una estrecha relación del cerdo ibérico con las tierras salmantinas que ha generado un amplio legado. Esta simbiosis, ha dejado en herencia un modelo de ...explotación sostenible del terreno forestal en forma de monte hueco o dehesa y un saber hacer en la elaboración de los embutidos. El objetivo del estudio consiste en mostrar el potencial turístico que tiene la puesta en valor de la cultura tangible e intangible derivada del manejo en el territorio y del curado de los derivados del cerdo ibérico. Para el análisis territorial hemos utilizado diversas fuentes primarias y el trabajo de campo con la ayuda de herramientas para el tratamiento de datos y la representación cartográfica. Los resultados del estudio demuestran que el cerdo ibérico se ha erigido en un recurso actual en el marco de la modalidad de turismo gastronómico con variadas ofertas (visita a museos, instalaciones y dehesas, degustaciones o ferias).
Background
Analysis of cross‐reactivity is necessary for prescribing safe cephalosporins for penicillin allergic patients. Amoxicillin (AX) is the betalactam most often involved in immediate ...hypersensitivity reactions (IHRs), and cefadroxil (CX) the most likely cephalosporin to cross‐react with AX, since they share the same R1 side chain, unlike cefuroxime (CO), with a structurally different R1. We aimed to analyse cross‐reactivity with CX and CO in patients with confirmed IHRs to AX, including sIgE recognition to AX, CX, CO, and novel synthetic determinants of CX.
Methods
Fifty‐four patients with confirmed IHRs to AX based on skin test (ST) and/or drug provocation test (DPT) were included. Serum sIgE to AX and benzylpenicillin was determined by Radioallergosorbent test (RAST). Two potential determinants of CX, involving intact or modified R1 structure, with open betalactam ring, were synthesised and sIgE evaluated by RAST inhibition assay.
Results
Tolerance to CX (Group A) was observed in 64.8% cases and cross‐reactivity in 35.2% cases (Group B). Cross‐reactivity with CO was only found in 1.8% cases from Group B. ST to CX showed a negative predictive value of 94.6%. RAST inhibition assays showed higher recognition to CX as well as to both synthetic determinants (66% of positive cases) in Group B.
Conclusions
Cross‐reactivity with CX in AX allergic patients is 35%, being ST not enough for prediction. R1, although critical for recognition, is not the unique factor. The synthetic determinants of CX, 1 ‐(HOPhG‐Ser‐Bu) and 2 ‐(pyrazinone) are promising tools for determining in vitro cross‐reactivity to CX in AX allergic patients.
ABSTRACT
Background
Studies comparing the clinical efficacy of apomorphine infusion (APO) with subsequent subthalamic deep brain stimulation (STN‐DBS) in advanced Parkinson's disease (aPD) are ...currently lacking. Retrospective data have shown that patients treated with APO are usually older, have a more prolonged disease, and a more severe phenotype.
Objective
To compare the benefit of APO with that of STN‐DBS on motor, non‐motor, cognitive, and quality of life in the same patient when given sequentially.
Methods
We prospectively analyzed 20 aPD patients over 3 different treatment phases: baseline (optimized medical treatment), during APO treatment, and during subsequent STN‐DBS treatment. The APO and STN‐DBS phases were stable for 6 months, and evaluation of the different treatments was separated by 6 months.
Results
Compared to baseline, APO, and STN‐DBS reduced mean daily off time by 70.5% and 89.3% (P = 0.012), respectively, and scores for Unified Parkinson's Disease Rating Scale (UPDRS) IV by 27.5% and 80.5% (P ≤ 0.001), Non‐motor symptoms scale (NMSS) by 24.6% and 49.3% (P ≤ 0.001), Montgomery Asberg depression scale (MADRS) by 7.4% and 39.0% (P = 0.27), Starkstein apathy scale (SAS) by 51.1% and 39.9% (P = 0.734), Parkinson's disease sleep scale 2 (PDSS‐2) by 25.7% and 56.7% (P ≤ 0.001), and Parkinson's disease questionnaire 39 item (PDQ‐39) by 39.6% and 64.9% (P ≤ 0.001). Global cognition did not change with either therapy, but phonetic fluency worsened after STN‐DBS compared to APO (P = 0.022).
Conclusions
Both APO and STN‐DBS improved motor and non‐motor symptoms and quality of life compared to optimized medical treatment in aPD. Overall, STN‐DBS was the most effective treatment, but APO showed a pronounced benefit on motor symptoms. Effective treatment for aPD should not be delayed, even when waiting for surgery.
In recent years, there has been an increase in the number of reported incidents of child-to-parent violence (CPV); however, this type of intra-family violence remains vastly understudied compared ...with other forms of family violence. The aim of this study is to analyze the relationship between family communication and verbal CPV through the mediation of adolescent perceived stress. The sample consisted of 2399 Spanish students of both genders between the ages of 11 and 20 years. Results show that problematic family communication is a risk factor for the presence of verbally abusive behavior towards parents, with a direct and indirect relationship through perceived stress. Open family communication is presented as a protective factor against verbally abusive behavior due to a negative relationship with perceived stress. Results point to a mediating role of perceived stress, which would explain the mechanism which links the quality of family communication to verbal violence towards parents. Implications of these results are discussed.
Oral health status among dental students has been widely studied, and while the repercussions of certain factors, such as personality type, adherence to healthy lifestyle habits and certain eating ...patterns, have been considered in the past, this study aims to study the combination of such factors and to carry out, in addition, clinical examinations that could provide deeper knowledge of real oral health status. A sample of 195 dental students was gathered and basic sociodemographic data (gender, age, nationality, hygiene habits, body mass index (BMI)) were collected, and type A personality scale (ERCTA), emotional eating (EE) and healthy lifestyle scale (EVS) values were registered. Descriptive analysis, Pearson correlations, a hierarchical linear regression model and moderation analysis were performed. Results showed that higher EE values were associated with a higher BMI, an increase in the decayed, missing, and filled teeth (DMFT) index, a higher number of carious and filled teeth, a higher ERCTA and a lower adherence to the EVS. Likewise, a higher DMFT was associated with a higher BMI, higher bleeding on probing index (BOP) values, higher ERCTA values and lower adherence to EVS. Dental floss disuse, BMI, EE and EVS predicted 25.3% of DMFT. In addition, a type A personality has a moderating effect only in those with medium and high EE levels.
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