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Baseline kidney function following kidney transplantation is often used in research and clinical decision-making yet is not well defined. Here, a method to determine baseline function was proposed and validated on three single-center retrospective cohorts consisting of 922 patients from Belgium (main cohort) and two validation cohorts of 987 patients from the Netherlands and 519 patients from Germany. For each transplant, a segmented regression model was fitted on the estimated glomerular filtration rate (eGFR) evolution during the first-year post-transplantation. This yielded estimates for change point timing, rate of eGFR change before and after change point and eGFR value at change point, now considered the "baseline function". Associations of eGFR evolution with recipient/donor characteristics and the graft failure rate were assessed with linear regression and Cox regression respectively. The change point occurred on average at an eGFR value of 43.7±14.6 mL/min/1.73m 2 , at a median time of 6.5 days post-transplantation. Despite significant associations with several baseline donor-recipient characteristics (particularly, donor type; living vs deceased), the predictive value of these characteristics for eGFR value and timing of the change point was limited. This followed from a large heterogeneity within eGFR trajectories, which in turn indicated that favorable levels of kidney function could be reached despite a suboptimal initial evolution. Segmented regression consistently provided a good fit to early eGFR evolution, and its estimate of the change point can be a useful reference value in future analyses. Thus, our study shows that baseline kidney function after transplantation is heterogeneous and partly related to pretransplant donor characteristics., (Copyright © 2024 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Graft failure and recipient death with functioning graft are important competing outcomes after kidney transplantation. Risk prediction models typically censor for the competing outcome thereby overestimating the cumulative incidence. The magnitude of this overestimation is not well-described in real-world transplant data. This retrospective cohort study analyzed data from the European Collaborative Transplant Study (CTS; n = 125 250) and from the American Scientific Registry of Transplant Recipients (SRTR; n = 190 258). Separate cause-specific hazard models, using donor and recipient age as continuous predictors, were developed for graft failure and recipient death. The hazard of graft failure increased quadratically with increasing donor age and decreased decaying with increasing recipient age. The hazard of recipient death increased linearly with increasing donor and recipient age. The cumulative incidence overestimation due to competing risk-censoring was largest in high-risk populations for both outcomes (old donors/recipients), sometimes amounting to 8.4 and 18.8 percentage points for graft failure and recipient death, respectively. In our illustrative model for post-transplant risk prediction, the absolute risk of graft failure and death is overestimated when censoring for the competing event, mainly in older donors and recipients. Prediction models for absolute risks should treat graft failure and death as competing events., (Copyright © 2024 American Society of Transplantation & American Society of Transplant Surgeons. Published by Elsevier Inc. All rights reserved.)

Systematic screening for BKPyV-DNAemia has been advocated to aid prevention and treatment of polyomavirus associated nephropathy (PyVAN), an important cause of kidney graft failure. The added value of performing a biopsy at time of BKPyV-DNAemia, to distinguish presumptive PyVAN (negative SV40 immunohistochemistry) and proven PyVAN (positive SV40) has not been established. Therefore, we studied an unselected cohort of 950 transplantations, performed between 2008-2017. BKPyV-DNAemia was detected in 250 (26.3%) transplant recipients, and positive SV40 in 91 cases (9.6%). Among 209 patients with a concurrent biopsy at time of first BKPyV-DNAemia, 60 (28.7%) biopsies were SV40 positive. Plasma viral load showed high diagnostic value for concurrent SV40 positivity (ROC-AUC 0.950, 95% confidence interval 0.916-0.978) and the semiquantitatively scored percentage of tubules with evidence of polyomavirus replication (pvl score) (0.979, 0.968-0.988). SV40 positivity was highly unlikely when plasma viral load is below 4 log 10 copies/ml (negative predictive value 0.989, 0.979-0.994). In SV40 positive patients, higher plasma BKPyV-DNA load and higher pvl scores were associated with slower viral clearance from the blood (hazard ratio 0.712, 95% confidence interval 0.604-0.839, and 0.327, 0.161-0.668, respectively), whereas the dichotomy positivity/negativity of SV40 immunohistochemistry did not predict viral clearance. Although the pvl score offers some prognostic value for viral clearance on top of plasma viral load, the latter provided good guidance for when a biopsy was unnecessary to exclude PyVAN. Thus, the distinction between presumptive and proven PyVAN, based on SV40 immunohistochemistry, has limited clinical value. Hence, management of BKPyV-DNAemia and immunosuppression reduction should be weighed against the risk of occurrence of rejection, or exacerbation of rejection observed concomitantly., (Copyright © 2023 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

Background: A rise in the incidence of some autoimmune disorders has been described. However, contemporary estimates of the overall incidence of autoimmune diseases and trends over time are scarce and inconsistent. We aimed to investigate the incidence and prevalence of 19 of the most common autoimmune diseases in the UK, assess trends over time, and by sex, age, socioeconomic status, season, and region, and we examine rates of co-occurrence among autoimmune diseases., Methods: In this UK population-based study, we used linked primary and secondary electronic health records from the Clinical Practice Research Datalink (CPRD), a cohort that is representative of the UK population in terms of age and sex and ethnicity. Eligible participants were men and women (no age restriction) with acceptable records, approved for Hospital Episodes Statistics and Office of National Statistics linkage, and registered with their general practice for at least 12 months during the study period. We calculated age and sex standardised incidence and prevalence of 19 autoimmune disorders from 2000 to 2019 and used negative binomial regression models to investigate temporal trends and variation by age, sex, socioeconomic status, season of onset, and geographical region in England. To characterise co-occurrence of autoimmune diseases, we calculated incidence rate ratios (IRRs), comparing incidence rates of comorbid autoimmune disease among individuals with a first (index) autoimmune disease with incidence rates in the general population, using negative binomial regression models, adjusted for age and sex., Findings: Among the 22 009 375 individuals included in the study, 978 872 had a new diagnosis of at least one autoimmune disease between Jan 1, 2000, and June 30, 2019 (mean age 54·0 years [SD 21·4]). 625 879 (63·9%) of these diagnosed individuals were female and 352 993 (36·1%) were male. Over the study period, age and sex standardised incidence rates of any autoimmune diseases increased (IRR 2017-19 vs 2000-02 1·04 [95% CI 1·00-1·09]). The largest increases were seen in coeliac disease (2·19 [2·05-2·35]), Sjogren's syndrome (2·09 [1·84-2·37]), and Graves' disease (2·07 [1·92-2·22]); pernicious anaemia (0·79 [0·72-0·86]) and Hashimoto's thyroiditis (0·81 [0·75-0·86]) significantly decreased in incidence. Together, the 19 autoimmune disorders examined affected 10·2% of the population over the study period (1 912 200 [13·1%] women and 668 264 [7·4%] men). A socioeconomic gradient was evident across several diseases, including pernicious anaemia (most vs least deprived area IRR 1·72 [1·64-1·81]), rheumatoid arthritis (1·52 [1·45-1·59]), Graves' disease (1·36 [1·30-1·43]), and systemic lupus erythematosus (1·35 [1·25-1·46]). Seasonal variations were observed for childhood-onset type 1 diabetes (more commonly diagnosed in winter) and vitiligo (more commonly diagnosed in summer), and regional variations were observed for a range of conditions. Autoimmune disorders were commonly associated with each other, particularly Sjögren's syndrome, systemic lupus erythematosus, and systemic sclerosis. Individuals with childhood-onset type 1 diabetes also had significantly higher rates of Addison's disease (IRR 26·5 [95% CI 17·3-40·7]), coeliac disease (28·4 [25·2-32·0]), and thyroid disease (Hashimoto's thyroiditis 13·3 [11·8-14·9] and Graves' disease 6·7 [5·1-8·5]), and multiple sclerosis had a particularly low rate of co-occurrence with other autoimmune diseases., Interpretation: Autoimmune diseases affect approximately one in ten individuals, and their burden continues to increase over time at varying rates across individual diseases. The socioeconomic, seasonal, and regional disparities observed among several autoimmune disorders in our study suggest environmental factors in disease pathogenesis. The inter-relations between autoimmune diseases are commensurate with shared pathogenetic mechanisms or predisposing factors, particularly among connective tissue diseases and among endocrine diseases., Funding: Research Foundation Flanders., Competing Interests: Declaration of interests NC is funded by a personal fellowship from the Research Foundation Flanders (grant number 12ZU922N) and declares royalties from Oxford University Innovation. SM is funded by a Wellcome Trust Career Development Award (223024/Z/21/Z) and is supported by the NIHR Imperial Biomedical Research Centre. IBM declares honoraria from AbbVie; grant support paid to his university from AstraZeneca and Eli Lilly; participation on data safety monitoring boards or advisory boards of AstraZeneca, Bristol Myers Squibb, Eli Lilly, Novartis, Janssen, GlaxoSmithKline, AbbVie, Cabaletta, Compugen, Causeway, Gilead, Moonlake, Reflexion, UCB, and XinThera; patents from Novartis; leadership roles with Evelo, Versus Arthritis, and Greater Glasgow and Clyde Health Board; and stock or stock options with Evelo, Compugen, and Cabaletta. JJVM has received funding to his institution from Amgen and Cytokinetics for his participation in the Steering Committee for the ATOMIC-HF, COSMIC-HF, and GALACTIC-HF trials and meetings and other activities related to these trials; has received payments through Glasgow University from work on clinical trials, consulting, and other activities from Alnylam, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Cardurion, Dal-Cor, GlaxoSmithKline, Ionis, KBP Biosciences, Novartis, Pfizer, and Theracos; and has received personal lecture fees from the Corpus, Abbott, Hikma, Sun Pharmaceuticals, Medscape/Heart.Org, Radcliffe Cardiology, Alkem Metabolics, Eris Lifesciences, Lupin, ProAdWise Communications, Servier Director, and Global Clinical Trial Partners. NS declares consulting fees or speaker honoraria, or both, from Abbott Laboratories, Afimmune, Amgen, AstraZeneca, Boehringer Ingelheim, Eli Lilly, Hanmi Pharmaceuticals, Janssen, Merck Sharp & Dohme, Novartis, Novo Nordisk, Pfizer, Roche Diagnostics, and Sanofi; and grant support paid to his university from AstraZeneca, Boehringer Ingelheim, Novartis, and Roche Diagnostics. KK is supported by the National Institute for Health Research (NIHR) Applied Research Collaboration East Midlands and the NIHR Leicester Biomedical Research Centre. KK has also acted as a consultant, speaker, or received grants for investigator-initiated studies for AstraZeneca, Abbott, Amgen, Napp, Bayer, Novartis, Novo Nordisk, Sanofi-Aventis, Lilly, Merck Sharp & Dohme, Boehringer Ingelheim, Oramed Pharmaceuticals, and Applied Therapeutics. PNT declares personal consulting fees from Immunovant and leadership roles in the Society for Endocrinology and British Thyroid Association. All other authors declare no competing interests. The views expressed are those of the authors and not necessarily those of the funder., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

To monitor the COVID-19 epidemic in Cuba, data on several epidemiological indicators have been collected on a daily basis for each municipality. Studying the spatio-temporal dynamics in these indicators, and how they behave similarly, can help us better understand how COVID-19 spread across Cuba. Therefore, spatio-temporal models can be used to analyze these indicators. Univariate spatio-temporal models have been thoroughly studied, but when interest lies in studying the association between multiple outcomes, a joint model that allows for association between the spatial and temporal patterns is necessary. The purpose of our study was to develop a multivariate spatio-temporal model to study the association between the weekly number of COVID-19 deaths and the weekly number of imported COVID-19 cases in Cuba during 2021. To allow for correlation between the spatial patterns, a multivariate conditional autoregressive prior (MCAR) was used. Correlation between the temporal patterns was taken into account by using two approaches; either a multivariate random walk prior was used or a multivariate conditional autoregressive prior (MCAR) was used. All models were fitted within a Bayesian framework., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Background: Some autoimmune diseases are associated with an increased risk of cardiovascular disease. We aimed to determine whether or not this is true, and to what extent, for a broad range of autoimmune conditions., Methods: In this population-based study, we used linked primary and secondary care records from the Clinical Practice Research Datalink (CPRD), GOLD and Aurum datasets, to assemble a cohort of individuals across the UK who were newly diagnosed with any of 19 autoimmune diseases between Jan 1, 2000, and Dec 31, 2017, younger than 80 years at diagnosis, and free of cardiovascular diseases up to 12 months after diagnosis. We also assembled a matched cohort with up to five individuals matched on age, sex, socioeconomic status, region, and calendar year, who were free of autoimmune disease and free of cardiovascular diseases up to 12 months after study entry. Both cohorts were followed up until June 30, 2019. We investigated the incidence of 12 cardiovascular outcomes and used Cox proportional hazards models to examine differences in patients with and without autoimmune diseases., Findings: Of 22 009 375 individuals identified from the CPRD databases, we identified 446 449 eligible individuals with autoimmune diseases and 2 102 830 matched controls. In the autoimmune cohort, mean age at diagnosis was 46·2 years (SD 19·8), and 271 410 (60·8%) were women and 175 039 (39·2%) were men. 68 413 (15·3%) people with and 231 410 (11·0%) without autoimmune diseases developed incident cardiovascular disease during a median of 6·2 years (IQR 2·7-10·8) of follow-up. The incidence rate of cardiovascular disease was 23·3 events per 1000 patient-years among patients with autoimmune disease and 15·0 events per 1000 patient-years among those without an autoimmune disease (hazard ratio [HR] 1·56 [95% CI 1·52-1·59]). An increased risk of cardiovascular disease with autoimmune disease was seen for every individual cardiovascular disease and increased progressively with the number of autoimmune diseases present (one disease: HR 1·41 [95% CI 1·37-1·45]; two diseases: 2·63 [2·49-2·78]); three or more diseases: 3·79 [3·36-4·27]), and in younger age groups (age <45 years: 2·33 [2·16-2·51]; 55-64 years: 1·76 [1·67-1·85]; ≥75 years: 1·30 [1·24-1·36]). Among autoimmune diseases, systemic sclerosis (3·59 [2·81-4·59]), Addison's disease (2·83 [1·96-4·09]), systemic lupus erythematosus (2·82 [2·38-3·33]), and type 1 diabetes (2·36 [2·21-2·52]) had the highest overall cardiovascular risk., Interpretation: These findings warrant targeted cardiovascular prevention measures, in particular in younger patients with autoimmune diseases, and further research into pathophysiological mechanisms underlying these complications., Funding: Horizon 2020 Marie Skłodowska-Curie Actions and European Society of Cardiology., Competing Interests: Declaration of interests JJVM reports personal fees for lectures from Abbott, Alkem Metabolics, Eris Lifesciences, Hikma, Lupin, Sun Pharmaceuticals, Medscape/Heart.Org, ProAdWise Communications, Radcliffe Cardiology, Servier, and the Corpus; and fees paid to their university for steering committees and advisory board membership, trial planning, being principal investigator or co-principal investigator for trials, consulting and advising, and travel expenses from Cytokinetics, Amgen, AstraZeneca, Theracos, Ionis Pharmaceuticals, DalCor, Cardurion, Novartis, GSK, Bayer, KBP Biosciences, Boehringer Ingelheim, and Bristol-Myers Squibb. All other authors declare no competing interests., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Starting from historic reflections, the current SARS-CoV-2 induced COVID-19 pandemic is examined from various perspectives, in terms of what it implies for the implementation of non-pharmaceutical interventions, the modeling and monitoring of the epidemic, the development of early-warning systems, the study of mortality, prevalence estimation, diagnostic and serological testing, vaccine development, and ultimately clinical trials. Emphasis is placed on how the pandemic had led to unprecedented speed in methodological and clinical development, the pitfalls thereof, but also the opportunities that it engenders for national and international collaboration, and how it has simplified and sped up procedures. We also study the impact of the pandemic on clinical trials in other indications. We note that it has placed biostatistics, epidemiology, virology, infectiology, and vaccinology, and related fields in the spotlight in an unprecedented way, implying great opportunities, but also the need to communicate effectively, often amidst controversy., (Copyright © 2020 The Authors. Published by Elsevier Inc. All rights reserved.)

The evolution of kidney allograft survival remains insufficiently studied in the context of the changing donor and recipient demographics. Since European data are lacking we performed a cohort study (1986-2015) that, based on the Collaborative Transplant Study, included 108 787 recipients of brain-death kidney donors in 135 hospitals across 21 European countries. We analyzed the hazard rate of kidney failure after transplantation. Between 1986 and 1999, improvement in graft survival was more pronounced in the short term than in the long term: one-, five- and ten-year hazard rates after transplantation declined 64% (95% confidence interval, 61%-66%), 53% (49%-57%) and 45% (39%-50%), respectively. Between 2000 and 2015, hazard rates at one, five and ten years post-transplant declined respectively 22% (12-30%), 47% (36-56%) and 64% (45-76%). Improvement in graft survival in the first five years post-transplant was significantly less since 2000, while improvement after five years was comparable to before. During the 2000-2015 period improvement of graft survival was greater in the long than in the short term. These changes were independent of changing donor and recipient characteristics, and reflect the evolution in global kidney transplant management over the past decades. Unfortunately, after accounting for the evolution of donor and recipient characteristics, we found that short-term improvement in graft survival decreased since 2000, while long-term improvement remained unchanged in Europe. Thus, deceleration of short-term graft survival improvement in more recent years illustrates an unmet need for innovation., (Copyright © 2018 International Society of Nephrology. Published by Elsevier Inc. All rights reserved.)

This study investigates the relationship between sound levels, pre-slaughter handling during loading and pork quality. Pre-slaughter variables were investigated from loading till slaughter. A total of 3213 pigs were measured 30 min post-mortem for pH(30LT) (M. Longissimus thoracis). First, a sound level model for the risk to develop PSE meat was established. The difference in maximum and mean sound level during loading, mean sound level during lairage and mean sound level prior to stunning remained significant within the model. This indicated that sound levels during loading had a significant added value to former sound models. Moreover, this study completed the global classification checklist (Vermeulen et al., 2015a) by developing a linear mixed model for pH(30LT) and PSE prevalence, with the difference in maximum and mean sound level measured during loading, the feed withdrawal period and the difference in temperature during loading and lairage. Hence, this study provided new insights over previous research where loading procedures were not included., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

Lung lesions of about 1000 pigs (nN) were scored in the slaughter line. Carcass weight, back fat thickness, loin muscle depth, pHi and PQMi were measured on 460 pigs. Twenty-four hours after slaughter pHu, PQMu, brightness, redness, yellowness and drip loss were measured on 59 carcasses. A score for lung lesions was assessed at batch level, based on observations of all pigs in that batch, i.e. about 130. Pigs systematically selected from batches scoring more than 25% lung lesions had a lower pH of LD muscle (P≤0.0003) and a six fold higher risk for P(ale)S(oft)E(xudative) traits (P≤0.050) compared to batches scoring less than 5%., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

This study investigates whether sound levels above 85 dB(A), determined in literature as a critical sound level to induce stress in pigs, has also an effect on the pH of pork. Sound levels were recorded during pre-slaughter phases. A measure was taken after the arrival of the truck at the slaughterhouse, during unloading, lairage and just before stunning. The pH of the Longissimus thoracis or lumborum, 30 min after sticking (pH(30LT)) was measured. 8508 pigs were examined and the pH was measured on the carcasses. The results show that the cut-off value of 85 dB(A) during the pre-slaughtering phase is not only a threshold to evaluate animal welfare but can also be associated with a slower drop of pH if sound levels are b85 dB(A). Finally a linear mixed model for pH(30LT) was built with the sound level during lairage and the sound level prior to stunning as independent variables, having statistically the highest impact on pH(30LT) of pork.

Environmental variables, as sound levels, were collected during the pre-slaughter process in 18 different Belgian commercial slaughterhouses. Four pre-slaughter phases were determined: firstly after arrival of the truck at the slaughterhouse and just before unloading, secondly during unloading, thirdly at lairage and finally while moving to the stunner. A total of 8508 pigs was examined during the pre-slaughter process, of which the pH(LT) (M. longissimus thoracis), at 30 min post-mortem was measured. For each pre-slaughter phase, variables which might influence pork quality were determined. Moreover, this study made it possible to infer a checklist to represent and predict PSE traits of pork for all kind of pre-slaughter situations. The checklist shows also that the impact on pork quality is more decisive for the variables measured close to the stunning phase. Hence, this information is useful for the industry to optimize handling of pigs, reducing the risk for PSE traits.

Objective: The Cognitive Performance Scale (CPS) is generated from five items of the interRAI/ Minimum Data Set instruments, a comprehensive geriatric assessment method. CPS was initially designed to assess cognition in residential care, where it has shown good psychometric performance. We evaluated the performance of the interRAI Acute Care in identifying cognitive impairment among patients hospitalized on acute geriatric wards., Methods: An observational study was conducted on two geriatric wards. Trained raters independently completed the interRAI Acute Care and the Mini-Mental State Examination (MMSE) in 97 inpatients (85 ± 5 years; 67% female). The level of agreement between CPS and MMSE was explored using comparisons of means, agreement coefficients, and diagnostic accuracy., Results: Cognitive impairment was present in 61% of the participants. Average MMSE scores were significantly different between groups with low CPS scores compared with those with high CPS scores (p <0.05). CPS explained only 48.8% of the variability in MMSE. Agreement in defining cognitively impaired subjects was moderate (percentage observed agreement, 68%; κ = 0.41). With MMSE score less than 24 as a gold standard, diagnostic accuracy of CPS was moderate (area under curve = 0.73), with low sensitivity, but excellent specificity. When lowering the MMSE cutoff to less than 18 and focusing on patients with severe cognitive impairment, CPS agreement coefficients and sensitivity increased but specificity decreased. Using education-adjusted MMSE cutoffs did not substantially affect the results., Conclusion: CPS can be used for coarse triage between intact and severe cognitive impairment. Although promising results have been obtained in residential and community settings, our results suggest that CPS fails to differentiate across different levels of cognitive impairment in hospitalized geriatric patients., (Copyright © 2013 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.)

A total of 12,725 pigs originating from 90 transports were followed up at 17 Belgian commercial slaughterhouses. The effects of several pre-slaughter parameters concerning transport, unloading, lairage, pig handling, stunning and season on fresh meat quality based on pH measurements 30 minutes (min) after slaughter were investigated. Meat quality was measured on 4285 pigs. Ten pre-slaughter parameters had a significant effect on meat pH after separate introduction of the variable as a fixed effect in the model. Simultaneous analysis of these variables in the global model revealed that the pH was influenced by four main risk factors, namely the mean noise level produced during unloading, the percentage of panting pigs, the use of an electric prod and season. Meat quality in terms of the percentage of potentially PSE carcasses was better in summer than spring or autumn and could be explained by a lower observed pre-stunning stress in summer., (Copyright © 2010 The American Meat Science Association. Published by Elsevier Ltd. All rights reserved.)

In this prospective study we compared the incidence of late acute rejections (LAR) and changes in serum-creatinine over time between compliers and noncompliers with immunosuppressive therapy more than 1 year post transplantation and explored the relative contribution of non-compliance and other risk factors in the occurrence of LAR. One hundred and forty-six adult renal transplant recipients were followed during a 5-year period. Patients were interviewed at the beginning of the study and categorized as non-compliers if they admitted to have skipped immunosuppressive medication on a regular basis during the previous 12 months. The occurrence of LAR during the follow-up period was recorded. We identified 22.6% non-compliers of which 21.2% experienced a late acute rejection compared with 8% in the group of compliers at 5 years postinclusion (p < 0.05). Kaplan-Meier survival analysis showed a decreased rejection free time in non-compliers compared with compliers (p = 0.03). Non-compliant patients had a 3.2 higher risk of LAR (Cox regression analysis, p = 0.005). Non-compliers experienced a higher increase in serum-creatinine over time (Linear Mixed Models, p < 0.001). Non-compliance in renal transplant patients more than 1-year post transplantation is associated with an increased risk for LAR and a higher increase in serum-creatinine during the following 5 years., (Copyright 2004 Blackwell Munksgaard)

Objective: The purpose of this study was to determine whether nondiabetic women with recurrent vaginal candidiasis have an impaired glucose metabolism., Study Design: A case-control study of 62 otherwise healthy women who were attending a vaginitis clinic > or =3 times a year for symptoms of Candida vaginitis, positive microscopy, and at least one positive Candida culture and of 32 Candida-negative control subjects, all of whom were undergoing standardized oral glucose tolerance testing., Results: Women with recurrent bacterial vaginal infections did not differ from women without infections, so both groups comprised the control group. Women with recurrent vaginal candidiasis had a greater mean body mass index than the control subjects (23.5 vs 21.4, P =.001). They had no more incidences of overt or preclinical diabetes mellitus than the control subjects (6/62 vs 0/32 incidents), but a greater proportion of them had at least one glucose concentration above the 95th percentile (36% vs 12%, P =.016). Glucose concentrations were higher in recurrent vaginal candidiasis cases than in control subjects at 0 (89 vs 85 mg/dL,P =.049), 30 (139 vs 126 mg/dL, P =.05), and 60 minutes (123 vs 102 mg/dL, P =.009) after the intake of 75 g of glucose. Fasting concentration of glycosylated hemoglobin was 25% higher in women with recurrent vaginal candidiasis (5 vs 4 g/dL, P =.0006), even after correction for body mass index. Compared with control subjects, ingestion of 75 g of glucose led to a 15% increase of serum glucose levels in women with recurrent vaginal candidiasis (P =.01). As expected, most of these differences were largely mediated by an increased body mass index., Conclusion: The tolerance to glucose in nondiabetic women with recurrent vaginal candidiasis is discretely impaired. Glucose tolerance testing is of value in women with recurrent vaginal candidiasis, but the interpretation of the obtained values should not be limited to the diagnosis of preclinical diabetes mellitus.

In orthodontic treatment, sliding is frequently used to cause tooth movement. Inherent to this technique is the generation of a counteracting frictional force. In this pilot study, a fretting test consisting of reciprocating tangential displacements was used to investigate test parameters influencing frictional forces during sliding processes. Tests were run at a normal load of 2 N and a frequency of 1 Hz for tangential displacement strokes of 200 microm. Stainless steel orthodontic wires with cross-sections of .017 x .025 in (W17) and .018 x .025 in (W18), and brackets with slot sizes of .018 in (B18) and .022 in (B22) were used. A specific centered positioning method was developed to achieve a parallel alignment of the wire and the bracket slot. The experimental results indicated the significant role of the centered positioning method on the friction value. Implementation of the centered positioning method resulted in a friction force ranging from 0.89 N to 0.97 N at a 200 microm displacement amplitude and 1 Hz frequency, corresponding to a coefficient of friction ranging from 0.45 to 0.49 for the B18-W17 and the B22-W17 bracket-wire combinations, respectively. When the centered positioning method was not used, significantly higher values for the coefficient of friction were found for both bracket-wire combinations. The slot-filling, bracket-wire combinations (B18-W18 and B22-W22) resulted in an increased coefficient of friction and therefore are not recommended as sliding systems.

This study presents the development of a kit formulation for the preparation of 99mTc-DMP-HSA, followed by a comparison of such kit-prepared 99mTc-DMP-HSA to 99mTc-RBCs in a volunteer. Reconstitution of the labeling kits with up to 5.55 GBq 99mTc afforded 99mTc-DMP-HSA preparations with a > 95% radiochemical purity for up to 8 h. Only minor differences were observed in the global distribution of both tracer agents, whereas the calculated ejection fractions were almost identical. The effective dose equivalent of 99mTc-DMP-HSA is 8.68 microSv/MBq.

Objectives: The purpose of this study was to evaluate the in vitro peel/shear bond strength of a selection of orthodontic bracket adhesives to human premolar teeth., Methods: Twenty-two commercially available bracket adhesives were used to bond the same bracket type (Miniature Twin, 3M Unitek, Monrovia, CA. USA) on 264 intact human premolar teeth and then adhesively tested to failure. Peel/shear bond strength values were calculated in newtons and megapascals. The site of bond failure was scored according to the Adhesive Remnant Index. Statistics included one-way analysis of variance and Tukey's Studentized Range test together with Weibull analysis. The latter is a survival analysis able to describe the performance of a material., Results: The mean bond strengths varied from 9.9 MPa for Concise to 4.1 MPa for Heliosit Orthodontic. The overall F-test showed a significant difference (P < 0.0001). No significant differences in bond strength were found between Concise, AccuBond, Imperva Dual, Transbond XT, Kurasper and Spectrum., Conclusion: Concise and AccuBond are among the materials of choice for bonding fixed orthodontic appliances to teeth. These materials combine high bond strength with a reliable bond that is easily and quickly debonded.

Objectives: The adhesive capacity of 17 different bracket types was evaluated in an in vitro peel/shear test., Methods: Silane-treated metal bars were used as substrates with all bonding being performed using the orthodontic adhesive Concise. The effect of aluminium oxide air abrasion on the bonding performance of recycled metal bracket bases was evaluated. Morphological examination of the bracket bases was carried out under scanning electron microscopy. Statistics analysis included one-way ANOVA with Tukey's Studentized Range Test, two-way ANOVA and Weibull analysis., Results: Mean peel/shear bond strength values range from 13.9 MPa for Allure Accu Arch, a ceramic bracket type, to 1.6 MPa for the plastic bracket CeramaFlex Advant Edge. Allure Accu Arch performed the best of all the ceramic brackets. However, bracket wing fracture was observed. The metal brackets Mini masters and Omni Arch showed no significant difference in bond strength compared with the ceramic bracket Allure Accu Arch (P < 0.01)., Conclusion: The type of the bracket base determines its adhesive capacity. Sandblasting the base of recycled metal brackets had no uniform effect.