Search

Background: Lateral and medial elbow tendinopathies are common soft tissue disorders affecting 1–3% of the general population, causing significant pain and functional impairment in the elbow and upper limb. While often associated with overuse and repetitive strain, their exact etiology, including potential associations with prior injuries in adjacent joints, remains unclear. This preliminary study aims to explore the distribution of lateral and medial elbow tendinopathies and investigate the occurrence of previous lesions in adjacent joints among diagnosed individuals, providing foundational insights for future research. Methods: A multicenter cross-sectional observational study was conducted involving 90 subjects diagnosed with lateral and/or medial elbow tendinopathy. The data collection occurred during the initial consultations, including demographic information, clinical assessments, and history of prior injuries in adjacent joints. Results: Among the sample, 44.4% reported prior injuries to adjacent joints in the affected upper limb, with 45.6% of these injuries identified as musculotendinous in nature. The analysis also showed that the type of elbow tendinopathy was significantly associated with sex (p = 0.01) and occupational origin (p = 0.022). Conclusions: While a notable percentage of the subjects reported prior musculoskeletal injuries in the same limb, the study's geographic limitations and reliance on self-reported data introduce potential recall bias. These preliminary findings suggest a possible relationship between prior adjacent joint injuries and elbow tendinopathy. Further research with larger sample sizes and more rigorous study design is needed to confirm these observations and explore the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Background: Hospitalized children need adequate sleep to favor early recovery. Methods: To study the sleep pattern of children admitted to a pediatric inpatient unit, a cross-sectional study was carried out at a reference hospital in northern Spain. The main study variables were medical specialty of admission, sleep-inducing treatment, hours of sleep at home and during admission, number of nocturnal awakenings, and reasons for awakening. Differences in the hours of sleep and nighttime awakenings between the initial period and at six months were calculated using the Student's t-test. Results: We included 100 baseline patients and 100 post-intervention patients. Up to 4% of the baseline sample and 3% of the six-month sample had been prescribed a sleep-promoting drug. Regarding awakenings, 79% of the children in the baseline sample suffered awakenings, with a mean of 1.98 awakenings (range 1–13). At six months, the percentage of children who experienced awakenings decreased by 17%, with a mean of 1.34 (range 1–5). In the baseline sample, 48% were caused by nursing care, decreasing to 34% after the intervention. Conclusions: An educational intervention with the implementation of targeted evidence-based practices is a useful measure for improving the sleep pattern by decreasing the number of awakenings. [ABSTRACT FROM AUTHOR]

Purpose: Long Covid syndrome is a multiorgan condition with multiple sequelae affecting quality of life, capacity to work and daily activities. The advantages that new technologies can offer are presented as an opportunity in the current healthcare framework. Objective: This research aimed to explore people with Long Covid's experiences with a digital physiotherapy practice intervention, during four weeks. Methods: Qualitative semistructured interviews were conducted by video call. Thirty‐two Long Covid participants were invited to join an in‐depth interview once the intervention was completed. Participants were queried on their intervention experiences and perceptions, as well as any lifestyle changes made, as a result of receiving digital physiotherapy practice. The interviews were transcribed and analysed using inductive qualitative content analysis. Results: In‐depth qualitative analysis has revealed four themes that reflect participants' perceptions of digital physiotherapy intervention. The helpfulness of the exercises, interaction with the physiotherapist, the domestic use of technology and the future of digital health practice were the topics highlighted by Long Covid participants. Some improvements have been suggested including video sounds and the need to introduce face‐to‐face sessions. Participants stated that interventions were helpful and superior to printed exercise sheets, mobile phone apps and usual care received. This intervention did not present major barriers, highlighting the importance of personalized care and continuity in the provision of health services. Conclusion: The digital physiotherapy practice is perceived by people with Long Covid as an appropriate method for the care of their health needs. Participants stated the need for this type of intervention in the public health system, where it would eliminate waiting lists, facilitate accessibility and improve existing care. Patient and Public Contribution: Participants contributed to the interpretation of the data acquired in the interview. Clinical Trial Registration: Trial registration NCT04742946. [ABSTRACT FROM AUTHOR]

Objective: To identify differences in the muscle mechanical properties of the pelvic floor (PF) and lumbar paravertebral (LP) muscles between young nulliparous and uni/multiparous women. Secondarily, specific behaviors, depending on the presence or absence or urinary incontinence (UI), were also researched. Design: Case–control study. Setting: Higher education institution. Participants: One hundred young women participated, divided into two groups depending on whether they had vaginal birth (nulliparous or uni/multiparous). Each group included women with and without UI. Main measures: A muscle mechanical properties (tone, stiffness, decrement—inverse of elasticity—, and viscoelastic properties: relaxation and creep) assessment of the PF and LP muscles were performed with a hand-held tonometer. Results: Tone and stiffness of both sides of the PF presented group by UI interaction (p < 0.05), with uni/multiparous women with UI showing higher tone and stiffness compared to multiparous women without UI. In LP muscles, uni/multiparous women showed greater tone and stiffness on the right and left sides [−2.57 Hz (95% confidence interval −4.42,−0.72) and −79.74 N/m (−143.52,−15.97); −2.20 Hz (−3.82,−0.58) and −81.30 N/m (−140.66-,21.95), respectively], as well as a decrease in viscoelastic properties compared to nulliparous women [relaxation: 2.88 ms (0.31,5.44); creep: 0.15 (0.01,0.30); relaxation: 2.69 ms (0.13,5.25); creep: 0.14 (0,0.28), respectively]. Conclusions: Vaginal birth and UI have a differential influence on the muscle mechanical properties of the PF and LP muscles. The determination of muscle mechanical properties by externally applied hand-held tonometry improves the knowledge of the lumbopelvic status, with applicability in clinical and research fields. [ABSTRACT FROM AUTHOR]

Objectives: Determine visual 50:50% color difference acceptability thresholds (AT) for regions of the dental color space with varying chromaticity. Methods: A 40‐observer panel belonging to two different groups (dentists and laypersons) evaluated 144 dental resin composites pairs (divided in three different sets of 48 pairs according to chroma value: Low Chroma (LC), Medium Chroma (MC) and High Chroma (HC) placed 40 cm away and inside of a viewing cabinet (D65 Standard light source; diffuse/0° geometry). A Takagi–Sugeno–Kang (TSK) fuzzy approximation was used for fitting the data points and calculate the 50:50% acceptability thresholds in CIEDE2000. A paired t‐test was used to evaluate the statistical significance between thresholds differences and Bonferroni correction was applied. Results: The CIEDE2000 50:50% AT were ∆E00 = 2.84, ∆E00 = 2.31 and ∆E00 = 1.80 for LC, MC and HC sets of sample pairs, respectively. The 50:50% AT values were statistically significant between the different sets of sample pairs, as well as the 50:50% AT values obtained for different observer groups. Conclusions: 50:50% CIEDE2000 acceptability thresholds for dentistry are significantly different depending on the chromaticity of the samples. Observers show higher acceptability for more achromatic samples (low chroma value) than for more chromatic samples. Clinical Significance: The difference in the AT for distinct regions of the dental color space can assist professionals as a quality control tool to assess clinical performance and interpret visual and instrumental findings in clinical dentistry, dental research, and subsequent standardization processes. [ABSTRACT FROM AUTHOR]

This study used secondary data from a randomized controlled trial of a Brief Motivational Intervention (BMI) to examine whether Non-White participants had different treatment results compared to White participants. The outcome variables of this study were divided into primary outcomes (heavy drinking and consequences associated with alcohol use) and secondary outcomes (cognitive variables such as motivation to change alcohol use, and behavioral variables, including protective behavioral strategies). Linear regression analyses were conducted with the PROCESS macro for SPSS, to test if race or ethnicity moderated the relationship between BMI and each treatment outcome. Data was collected at two time points, six weeks and three months after treatment. This study showed that race or ethnicity did not moderate treatment results for the four outcome variables. Additional within-group effect sizes were calculated for all racial and ethnic categories, showing that Hispanic/Latine and Black participants had larger effect sizes in all the outcome variables. The discussion examines the potential strength of Motivational Interviewing due to its client-centered spirit, which naturally allows for incorporating values and identity-based factors, such as culture, into the session. The results suggest similar BMI outcomes among White and Non-White emerging adults who engage in heavy drinking, potentially due to its client-centered approach. This is a preliminary study, and the results are therefore tentative. [ABSTRACT FROM AUTHOR]

Background In proximal occlusions, the effect of reperfusion therapies may differ between slow or fast progressors. We investigated the effect of intravenous thrombolysis (IVT) (with alteplase) plus mechanical thrombectomy (MT) versus thrombectomy alone among slow versus fast stroke progressors. Methods The SWIFT-DIRECT trial data were analyzed: 408 patients randomized to IVT+MT or MT alone. Infarct growth speed was defined by the number of points of decay in the initial Alberta Stroke Program Early CT Score (ASPECTS) divided by the onset-to-imaging time. The primary endpoint was 3-month functional independence (modified Rankin scale 0-2). In the primary analysis, the study population was dichotomized into slow and fast progressors using median infarct growth velocity. Secondary analysis was also conducted using quartiles of ASPECTS decay. Results We included 376 patients: 191 IVT+MT, 185 MT alone; median age 73 years (IQR 65-81); median initial National Institutes of Health Stroke Scale (NIHSS) 17 (IQR 13-20). The median infarct growth velocity was 1.2 points/hour. Overall, we did not observe a significant interaction between the infarct growth speed and the allocation to either randomization group on the odds of favourable outcome (P=0.68). In the IVT+MT group, odds of any intracranial hemorrhage (ICH) were significantly lower in slow progressors (22.8% vs 36.4%; OR 0.52, 95% CI 0.27 to 0.98) and higher among fast progressors (49.4% vs 26.8%; OR 2.62, 95% CI 1.42 to 4.82) (P value for interaction <0.001). Similar results were observed in secondary analyses. Conclusion In this SWIFT-DIRECT subanalysis, we did not find evidence for a significant interaction of the velocity of infarct growth on the odds of favourable outcome according to treatment by MT alone or combined IVT+MT. However, prior IVT was associated with significantly reduced occurrence of any ICH among slow progressors whereas this was increased in fast progressors. [ABSTRACT FROM AUTHOR]

Copyright of Gerokomos is the property of Indemm Farma SL and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Burnout syndrome (BS) has a negative impact among health professionals. Aims: Our research objective is to quantify the level of burnout in health workers of the Spanish National Health System during the COVID-19 pandemic using and comparing two independent measurement instruments. Methods: Cross-sectional, descriptive and multicenter study conducted through an anonymous online survey among health workers of the National Health System, measuring the level of burnout using the Maslach Burnout Inventory (MBI) and the Copenhagen Burnout Inventory (CBI). Results: A total of 448 questionnaires were analyzed, the mean age of the participants was 43.53 years (range: 20–64), 365 (81.5%) women. 161 (35.9%) participants presented BS measured with the MBI and 304 (67.9%) measured with the CBI. Regarding work contract, those who had greater job stability presented a higher degree of cynicism with respect to the eventual ones (p =.010), the eventual ones presenting higher mean scores in professional efficacy (p =.034). Urban workers had higher scores of exhaustion (p <.001) and cynicism (p <.001) than those living in rural areas. When comparing both tests, a high predictive value for exhaustion and cynicism was found to measure BS through the CBI (AUC = 0.92 and 0.84, respectively) and a low AUC with respect to the predictive value for efficacy (AUC = 0, 59). Conclusions: The results obtained show a high level of BS among the health workers who participated in our study. Both tests have an excellent correlation in the degree of exhaustion and cynicism, but not in efficacy. The BS measurement must be performed with at least two validated instruments to increase its reliability. [ABSTRACT FROM AUTHOR]

INTRODUCTION Small-area estimation methods are an alternative to direct survey-based estimates in cases where a survey's sample size does not suffice to ensure representativeness. Nevertheless, the information yielded by small-area estimation methods must be validated. The objective of this study was thus to validate a small-area model. METHODS The prevalence of smokers, ex-smokers, and never smokers by sex and age group (15-34, 35-54, 55-64, 65-74, >75 years) was calculated in two Spanish Autonomous Regions (ARs) by applying a weighted ratio estimator (direct estimator) to data from representative surveys. These estimates were compared against those obtained with a small-area model applied to another survey, specifically the Spanish National Health Survey, which did not guarantee representativeness for these two ARs by sex and age. To evaluate the concordance of the estimates, we calculated the intraclass correlation coefficient (ICC) and the 95% confidence intervals of the differences between estimates. To assess the precision of the estimates, the coefficients of variation were obtained. RESULTS In all cases, the ICC was ≥0.87, indicating good concordance between the direct and small-area model estimates. Slightly more than eight in ten 95% confidence intervals for the differences between estimates included zero. In all cases, the coefficient of variation of the small-area model was <30%, indicating a good degree of precision in the estimates. CONCLUSIONS The small-area model applied to national survey data yields valid estimates of smoking prevalence by sex and age group at the AR level. These models could thus be applied to a single year's data from a national survey, which does not guarantee regional representativeness, to characterize various risk factors in a population at a subnational level. [ABSTRACT FROM AUTHOR]

Background: Migraine is one of the most prevalent and disabling medical diseases in the world. The periaqueductal gray matter and the red nucleus play an important role in its pathogenesis. Our aim was to evaluate the echogenicity of the periaqueductal gray matter and the red nucleus in patients with migraine, by means of transcranial ultrasound. Methods: In this cross-sectional study, a group of patients with migraine (according to the International Classification of Headache Disorders) and a group of control subjects with comparable age-and-sex distribution were prospectively included. We evaluated the area and echogenicity of the periaqueductal gray matter and the red nucleus by means of transcranial ultrasound, both bedside and posteriorly analyzed with the medical image viewer Horos. Results: We included 115 subjects: 65 patients with migraine (39 of them with chronic migraine and 26 with episodic migraine), and 50 controls. Median disease duration in patients with chronic migraine was 29 (IQR: 19; 40) years, with a median of 18 (IQR: 14; 27) days of migraine per month. The area of the periaqueductal gray matter was larger in patients with chronic migraine compared to episodic migraine and controls (0.15[95%CI 0.12;0.22]cm2; 0.11[95%CI 0.10;0.14]cm2 and 0.12[95%CI 0.09;0.15]cm2, respectively; p = 0.043). Chronic migraine patients showed an intensity of the periaqueductal gray matter echogenicity lower than controls (90.57[95%CI 70.87;117.26] vs 109.56[95%CI 83.30;122.64]; p = 0.035). The coefficient of variation of periaqueductal gray matter echogenicity was the highest in chronic migraine patients (p = 0.009). No differences were observed regarding the area or intensity of red nucleus echogenicity among groups. Conclusion: Patients with chronic migraine showed a larger area of echogenicity of periaqueductal gray matter, a lower intensity of its echogenicity and a higher heterogenicity within this brainstem structure compared to patients with episodic migraine and controls. The echogenicity of the periaqueductal gray matter should be further investigated as a biomarker of migraine chronification. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of thickness on color and translucency of a multi‐color polymer‐infiltrated ceramic‐network (PICN) material. Methods: Specimens of 0.5, 1.0, 1.5 mm thicknesses were obtained by sectioning VITA ENAMIC® multiColor (E‐MC) High Translucent CAD‐CAM blocks (1M1‐HT, 1M2‐HT, 2M2‐HT, 3M2‐HT, and 4M2‐HT). Spectral reflectance and color coordinates were measured on white and black backgrounds using a spectroradiometer, CIE D65 illuminant and CIE 45°/0° geometry. CIEDE2000 color and translucency differences (ΔE00 and ΔTP00) between thicknesses and adjacent layers were evaluated using their respective 50:50% perceptibility and acceptability thresholds (PT00 and AT00). Results: In general, ΔE00 between thicknesses for all shades and layers were above AT00 in general. Chroma decreased from cervical to incisal layers with statistically significant differences (p < 0.05), and ΔE00 between sequential layers were above PT00, for all shades and thicknesses. TP00 decreased from 0.5 to 1.5 mm and increased from cervical to incisal layers for all shades with statically significant translucency differences (p < 0.05). In general, for all thicknesses, TPT00 < ΔTP00 < TAT00 for sequential layers. Conclusions: The gradient in color and translucency of E‐MC PICN material was influenced by the thickness of the CAD‐CAM block. In addition, color and TP transition values between the layers depends on the thickness and shade. Clinical significance: The effect of thickness must be taken into account by dental technicians and dentists when CAD‐CAM multicolor PICN materials are used. [ABSTRACT FROM AUTHOR]

Background: Kahoot! is an educational tool allowing teachers to create a series of gamified tests with the aim of reinforcing educational content, thus improving the teaching-learning process. The objective of this project is to evaluate the acquisition of content through gamified tests with Kahoot! and reward cards compared to the traditional teaching methodology (contents not reinforced). Methods: This Physiotherapy Teaching Innovation Project (PTIP) was carried out in four subjects of the Degree in Physiotherapy at the University of Jaén (Spain). The teachers responsible for each subject were instructed in the use of Kahoot! and reward cards. These teachers randomly selected the contents that were going to be reinforced with Kahoot! while the other 50% of the contents would not be reinforced. In the final exam of each subject, the results related to the reinforced contents were compared with those non-reinforced and the degree of satisfaction of the students with the experience was evaluated. Results: A total of 313 students participated in this PTIP. In all subjects, we determined a significant increase in the number of correct answers in an improvement range from 7% (95% CI 3.85 to 9.38) to more than 20% (95% CI 17.61 to 26.86) in favor of the questions that alluded to reinforced content using Kahoot! compared to the non-reinforced contents. More than 90% of the participants considered the use of Kahoot! useful and motivating. Our findings showed that Kahoot! motivated more than 65% of students to study daily. Conclusions: The students obtained better academic results in the questions related to contents reinforced with tests through Kahoot! and reward cards compared to those non-reinforced, showing that this methodology can be an effective tool to promote retention and content assimilation. [ABSTRACT FROM AUTHOR]

Background: Our main objective was to determine the evolution of IgG and IgA antibodies directed against SARS-CoV-2 protein S in the blood of lactating women and in breast milk. Methods: A cohort of 110 uninfected and vaccinated breastfeeding women was followed-up for 6 months at the Marqués de Valdecilla University Hospital, Spain, in 2020. An additional group of 23 breastfeeding mothers who had no previously documented infection and had not been vaccinated against SARS-CoV-2 were included as a control group. The antibodies in blood and breast milk and their evolution at 6 months post-vaccination were analysed. Results: One hundred ten breastfeeding mothers were included; 70 women (63.6%) were vaccinated with two doses of BNT162b2, 20 women (18.2%) received two doses of mRNA-1273, and 20 women (18.2%) received a single dose of ChAdOx1-S. No evidence of differences between concentrations of antibodies was found according to the type of vaccine, with the exception of serum IgA antibodies, which was higher in women vaccinated with mRNA-1273: mean [95%CI]: 0.05 AU/mL [0.03,0.06] with mRNA-1273, 0.02 AU/mL [0.01,0.03] with BNT162b2 and 0.01 AU/mL [0.00,0.03] with ChAdOx1-S, ANOVA p value = 0.03. The lack of difference between vaccines was also found when anti-S1 specific IgG in serum and breast milk were measured. Conclusions: In lactating women vaccinated against COVID-19, anti-SARS-CoV-2 antibodies can be detected in both serum and breastmilk 6 months after receiving the second dose, although their concentrations decreased when compared with concentrations reached immediately after vaccination. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of layering strategy and substrate color on the masking ability of resin composites. Materials and Methods: A1‐shaded specimens from Charisma Diamond and Filtek Z350XT were produced using different layering strategies. Color measurements were made by a reflectance spectrophotometer over A2, C2, A3.5, C3, C4 substrates. Color differences were calculated and interpreted by the 50%:50% perceptibility and acceptability visual thresholds. Data was analyzed by Kruskal–Wallis and Dunn post hoc test. Chi‐square test was used to determine the association between masking ability, and independent variables. Results: Color differences were significantly lower on A2 and C2 in comparison with C4 for the majority of the layering strategies. Acceptable matches were observed on most of the combinations over A2. Moderately unacceptable mismatches were observed in most of the combinations over C2 and A3.5. Clearly unacceptable mismatches were observed on the C3 and C4. The ΔE00 color shifts were predominantly influenced by ΔL00 for all layering strategies and substrate colors. Conclusion: Masking ability was affected by the layering strategy and substrate color. Acceptable masking was associated with A2 and C2, and with layering strategy composed of 0.5 mm enamel opacity and 1.0 mm dentin opacity thicknesses, using the Filtek Z350XT. Clinical Significance: Resin composites—shade A1—applied by different layering strategies with a final thickness of 1.5 mm were able to mask mild and moderately discolored substrates. Severely discolored substrates were not masked effectively. [ABSTRACT FROM AUTHOR]

Background This study sought to analyse the trend in smoking-attributable mortality (SAM) in Spain among the population aged ≥35 years across the period 1990–2018. Methods SAM was estimated by applying a prevalence-independent method, which uses lung cancer (LC) mortality as a proxy of tobacco consumption. We sourced observed mortality from the National Institute of Statistics (Spain), LC mortality rates in smokers and never smokers from the Cancer Prevention Study I–II, and relative risks from 5 US cohorts. Estimates of annual SAM by cause of death, sex and age are shown, along with crude and annual standardised SAM rates. The trend in standardised all-cause and LC rates was analysed using a joinpoint regression model. Results Tobacco caused 1 717 150 deaths in Spain in the period 1990–2018. Among men, cancers replaced cardiovascular diseases–diabetes mellitus (CVD–DM) as the leading group of tobacco-related cause of death in 1994. Among women, CVD–DM remained the leading cause of death throughout the period. Trend analysis of standardised SAM rates due to all causes and LC showed a decrease in men and an increase in women. Conclusions The tobacco epidemic in Spain across the period 1990–2018 has had an important impact on mortality and has evolved differently in both genders. SAM is expected to increase dramatically in women in the coming years. SAM data highlight the importance of including a gender perspective in SAM analyses, in designing more effective and comprehensive public health interventions and in developing gender-specific tobacco control policies to curb tobacco consumption. [ABSTRACT FROM AUTHOR]

The quality of the health information presented on the Internet is a public health problem, anyone can spread information even if it is false. One factor that influences the quality is the language in which it is presented. It is known that 85% of cancer patients search about their disease, and it influences the decisions they would take concerning their treatment. Spanish speakers are the second largest population after Mandarin Chinese, but the main scientific and medical information is published in English. The aim of this study was to compare the quality of pediatric cancer information on the Internet provided in English and Spanish languages. A Google chrome search was performed in both languages using the words "children cancer." Three different validated tools to assess the quality of the information were used (JAMA benchmarks, DISCERN and HONcode). For all the tools used, the information in English was of better quality than Spanish information. We found a significant difference between the DISCERN and JAMA benchmark. Only 26.74% of the English and 3.57% of the Spanish websites fit all the DISCERN criteria and 25 % of the English and 13.39% of the Spanish websites fit the 4 JAMA criteria. The HONcode was no different between both languages. The health institutions should verify the health information presented on the Internet and issue recommendations which are the best sites to use. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to validate the World Society for Emergent Surgery (WSES) scale for the management of acute left-sided colonic diverticulitis (ALCD). Methods: An observational study based on a prospective database of patients with ultrasound (US) and computerized tomography (CT) confirmed ALCD was conducted at our center from April 2018 to May 2019. The primary outcome was the success rate of outpatient management. Secondary outcomes were the association between different WSES stages, clinical and analytical parameters, treatments modalities, and outcomes, and the accuracy of US for management decisions. Results: A total of 230 patients were included. Outpatient management was successful in 51/53 (96.23%) cases with ALCD stage 0 and 62/72 (86.11%) patients with stage 1A. There were no differences in age (p = 0.076) or the presence of pericolic air bubbles (p = 0.06) between patients who underwent admission or outpatient management. Clinical and analytical data, treatment decisions, and outcomes showed statistically significant differences between WSES stages. In 7/12 patients with stage 2A, percutaneous drainage or emergency surgery was required. All cases with stage 2B (distant air) underwent conservative management without the need for emergency or elective surgery. The accuracy of US WSES stages for management decisions, when compared with CT, was 96.96%. Conclusion: The WSES classification for ALCD seemed to be valid helping clinicians in the decision-making process to select between admission or outpatient management. Differences in clinical and analytical data, elected treatments, and outcomes were found between WSES stages. The US WSES stages showed high accuracy for management decisions. [ABSTRACT FROM AUTHOR]

Objectives: To know the sociodemographic profile of the adult over 60 years of age with symptoms of depression in Correctional Institutions. Through an exploratory and descriptive approach using simple and inferential statistics. Materials and methods: Descriptive, observational, cross-sectional study and quantitative research. Our study corresponds to any inmate over 60 years of age in Correctional Institutions of Gran Canaria. España. Our study was developed in two phases, the first phase a screening to detect depression using the Yesavage Geriatric Depression Scale and the second phase focused on a greater depth, in the inmate is profile, through a sociodemographic questionnaire. Research results: The study included 81 inmates. The prevalence of depression was 35.8% where there is no statistically significant association between depression and the centers (P=0.731). The average age was 63.8±5 years, being 91.4% men, 7.4% women. According to marital status, 44.4% were divorced, 35.9% with low economic status and 40% with a primary education. The predominant pathology is the Circulatory System (n=22), and as a consequence, its pharmacology. [ABSTRACT FROM AUTHOR]

The link between engagement in non-suicidal self-injury (NSSI)–related activities on SNS (e.g. viewing, commenting, sharing and uploading NSSI content) with body image and NSSI behaviour remains under researched in adolescents with EDs. The main aim of the current research was to examine associations between NSSI-related activities on SNS with body image and NSSI behaviour severity among female adolescents diagnosed with an ED. A total of 52 female adolescents (mean age = 15.35 years, SD = 1.49) diagnosed with an ED completed self-report questionnaires related to NSSI behaviour, SNS usage and body image. Participants were divided into two groups: low NSSI behaviour severity (from 0 to 10 NSSI behaviours; n = 28) and high NSSI behaviour severity (more than ten NSSI behaviours; n = 24). Within the high NSSI severity group, individuals that comment and share NSSI online content significantly reported higher negative body image. A hierarchical binary logistic regression showed that the frequency of NSSI online content on SNS emerged as significant predictor of NSSI behaviour severity within last year after controlling for body image and searching for ED content on SNS. Our findings suggest that not only searching for ED content, but also being daily engaged in NSSI online activities may increase the risk of NSSI behaviour severity in female adolescents with EDs. [ABSTRACT FROM AUTHOR]

Sexual dysfunction, psychosis, and antipsychotics are known to be related, but the precise association between them is still unknown. Most evidence about the prevalence of sexual dysfunction in people treated with antipsychotic drugs comes from studies with restrictive samples. That is why our main objective was to determine the prevalence of sexual dysfunction in a real‐life sample of outpatients treated with antipsychotics, considering gender. A cross‐sectional naturalistic study was developed, including people treated with long‐acting injectable antipsychotics, with or without other psychotropic drugs. Participants were interviewed to assess sexual satisfaction through a Likert scale (0 to 10) and the presence of sexual dysfunction (the Psychotropic‐Related Sexual Dysfunction Questionnaire, PRSexDQ‐SALSEX). The participants also had a blood test to determine prolactin (men and women) and testosterone levels (men only). A total of 131 people participated in the study (90 men and 41 women). Some extent of sexual dysfunction was found in 62.2% of men and 51.2% of women. The most frequent sexual dysfunction symptom for both genders was the loss of libido (45%). Hyperprolactinemia was present in 56% of men and 61% of women. The presence of sexual dysfunction was associated with higher doses of antipsychotics, hyperprolactinemia, and smoking in men and with smoking and hyperprolactinemia in postmenopausal women. This study provides real‐life evidence of sexual dysfunction and hyperprolactinemia in persons treated with long‐acting injectable antipsychotics segregated by gender. The high rates of sexual dysfunction and hyperprolactinemia detected corroborate the need to consider these aspects in clinical practice. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the effectiveness and color stability of bleaching techniques on blood‐stained teeth. Material and Methods: The teeth were stained by blood and allocated to groups: walking bleach, inside/outside, and in‐office bleaching. L*, a*, b*, C*, h° color coordinates were measured using a clinical spectrophotometer at baseline, weekly (T1‐T2‐T3), and at 1‐week (T4), 6‐months (T5), and 1‐year (T6) follow‐up evaluations. ΔEab*, ΔE00, and ΔWID were calculated between sequential evaluation timepoints and between baseline and each evaluation timepoint. Color coordinates and WID differences in each timepoint and technique were analyzed by Wilcoxon Signed Rank, Kruskal‐Wallis and Mann–Whitney U test, respectively. ΔEab*, ΔE00, and ΔWID were interpreted by color visual thresholds. Results: The techniques presented a significant increase in L* and WID and, a significant decrease in a* and b* until the completion of treatments. Statistical differences between the techniques for a*, b* and WID were observed from T1 until T3. All techniques demonstrated excellent effectiveness for ΔEab*, ΔE00, and ΔWID between baseline and each evaluation and follow‐up timepoints. However, at T6, it was possible to identify a rebound effect for all techniques. Conclusions: All bleaching techniques presented excellent effectiveness. The stability of the whitening produced was maintained for 6 months. Clinical Significance: Effective whitening of blood‐stained teeth was achieved using walking bleach (sodium perborate), inside/outside (hydrogen peroxide ‐ 7.5%) and in‐office techniques (hydrogen peroxide ‐ 35%). The bleaching techniques were effective after the completion of the treatments. A slight rebound was observed at 1 year follow‐up. [ABSTRACT FROM AUTHOR]

Objective: To perform a comprehensive review of the use of artificial intelligence (AI) and machine learning (ML) in dentistry, providing the community with a broad insight on the different advances that these technologies and tools have produced, paying special attention to the area of esthetic dentistry and color research. Materials and methods: The comprehensive review was conducted in MEDLINE/PubMed, Web of Science, and Scopus databases, for papers published in English language in the last 20 years. Results: Out of 3871 eligible papers, 120 were included for final appraisal. Study methodologies included deep learning (DL; n = 76), fuzzy logic (FL; n = 12), and other ML techniques (n = 32), which were mainly applied to disease identification, image segmentation, image correction, and biomimetic color analysis and modeling. Conclusions: The insight provided by the present work has reported outstanding results in the design of high‐performance decision support systems for the aforementioned areas. The future of digital dentistry goes through the design of integrated approaches providing personalized treatments to patients. In addition, esthetic dentistry can benefit from those advances by developing models allowing a complete characterization of tooth color, enhancing the accuracy of dental restorations. Clinical significance: The use of AI and ML has an increasing impact on the dental profession and is complementing the development of digital technologies and tools, with a wide application in treatment planning and esthetic dentistry procedures. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVES: Passive and active immunity transfer through human milk (HM) constitutes a key element in the infant's developing immunity. Certain infectious diseases and vaccines have been described to induce changes in the immune components of HM. METHODS: We conducted a prospective cohort single-institution study from February 2 to April 4, 2021. Women who reported to be breastfeeding at the time of their coronavirus disease 2019 (COVID-19) vaccination were invited to participate. Blood and milk samples were collected on day 14 after their second dose of the vaccine. Immunoglobulin G (IgG) antibodies against nucleocapsid protein as well as IgG, immunoglobulin M and immunoglobulin A (IgA) antibodies against the spike 1 protein receptor-binding domain against severe acute respiratory syndrome coronavirus 2 (anti-SARS-CoV-2 RBD-S1) were analyzed in both serum and HM samples. RESULTS: Most of the participants (ie, 94%) received the BNT162b2 messenger RNA COVID-19 vaccine. The mean serum concentration of anti-SARS-CoV-2 RBD-S-IgG antibodies in vaccinated individuals was 3379.6 ± 1639.5 binding antibody units per mL. All vaccinated study participants had anti-SARS-CoV-2 RBD-S1-IgG, and 89% of them had anti-SARS-CoV-2 RBD-S-IgA in their milk. The antibody concentrations in the milk of mothers who were breastfeeding 24 months were significantly higher than in mothers with breastfeeding periods <24 months (P < .001). CONCLUSIONS: We found a clear association between COVID-19 vaccination and specific immunoglobulin concentrations in HM. This effect was more pronounced when lactation periods exceeded 23 months. The influence of the lactation period on immunoglobulins was specific and independent of other variables. [ABSTRACT FROM AUTHOR]

Background and Objectives: The objective of mindfulness‐based stress reduction (MBSR) programmes is to promote awareness of the present moment without judging, evaluating or reacting to the different thoughts or emotions that may arise. Development of these abilities appears especially important for healthcare professionals. The objective of this study was to evaluate the effectiveness and medium‐ and long‐term effects of a MBSR programme for primary care (PC) health professionals on their health‐related quality of life and quality of work life. Design: Randomised clinical trial using an intervention and control group with follow‐up of the experimental group. Setting: Primary Care centres in the Alicante Public Health Service (Spain). Participants: Participants were PC health professionals (N = 58) divided between an intervention group receiving the 8‐week MBSR programme and a control group receiving a theoretical training session alone. Method: Both groups were evaluated at baseline and at 8 weeks, and the intervention group was additionally evaluated at 3‐, 6‐, 9‐ and 12‐month postprogramme. Results: In comparison to the control group, the intervention group obtained higher scores postintervention for mindfulness, health‐related quality of life, mood and compassion satisfaction and a lower score for burnout. Improvements in mindfulness, mood and burnout syndrome persisted at 12 months after the programme. Conclusions: In conclusion, MBSR is an effective intervention to enhance the health‐related quality of life and quality of work life of Primary Care Health professionals. [ABSTRACT FROM AUTHOR]

Objective Previous studies have demonstrated that emotional stress, changes in lifestyle habits and infections can worsen the clinical course of migraine. We hypothesize that changes in habits and medical care during coronavirus disease 2019 (COVID-19) lockdown might have worsened the clinical course of migraine. Design Retrospective survey study collecting online responses from migraine patients followed-up by neurologists at three tertiary hospitals between June and July 2020. Methods We used a web-based survey that included demographic data, clinical variables related with any headache (frequency) and migraine (subjective worsening, frequency, and intensity), lockdown, and symptoms of post-traumatic stress. Results The response rate of the survey was 239/324 (73.8%). The final analysis included 222 subjects. Among them, 201/222 (90.5%) were women, aged 42.5 ± 12.0 (mean±SD). Subjective improvement of migraine during lockdown was reported in 31/222 participants (14.0%), while worsening in 105/222 (47.3%) and was associated with changes in migraine triggers such as stress related to going outdoors and intake of specific foods or drinks. Intensity of attacks increased in 67/222 patients (30.2%), and it was associated with the subjective worsening, female sex, recent insomnia, and use of acute medication during a headache. An increase in monthly days with any headache was observed in 105/222 patients (47.3%) and was related to symptoms of post-traumatic stress, older age and living with five or more people. Conclusions Approximately half the migraine patients reported worsening of their usual pain during the lockdown. Worse clinical course in migraine patients was related to changes in triggers and the emotional impact of the lockdown. [ABSTRACT FROM AUTHOR]

Objective: To evaluate color, lightness, chroma, hue, and translucency adjustment potential of resin composites using CIEDE2000 color difference formula. Methods: Three resin composites (Filtek Universal, Harmonize, and Omnichroma) were tested. Two types of specimens were prepared: an outer base shade with an inner hole filled with test shades and single‐composite specimens of all shades. Spectrorradiometric reflectances measurements and subsequent CIELAB color coordinates and translucency parameter (TP) were performed. Color (CAP00), lightness, chroma, hue, and translucency (TAP00) adjustment potential using CIEDE2000 color difference were computed. Color and transparency differences among composite materials and shades were statistically tested (P < 0.05). Results: Positive CAP00 and TAP00 values were found for majority of tested materials. CAP00 values ranged from −0.14 to 0.89, with the highest values found for Omnichroma (>0.75 in all cases). TAP00 values ranged from −0.06 to 0.86 with significant translucency differences among dual and single specimens. Omnichroma exhibited the highest adjustment potential for all color dimensions studied. Conclusions: Lightness, hue, chroma, and translucency adjustment potential have been introduced using CIEDE2000 color difference formula, and have shown their usefulness to evaluate blending effect in dentistry. Color coordinates and translucency adjustment potential were dependent on dental material. Omnichroma exhibited the most pronounced blending effect. Clinical significance: Resin composites with increased color and translucency adjustment may simplify shade selection, making this process easier and less time consuming. Furthermore, these materials might facilitate challenging and complex color matching situations. [ABSTRACT FROM AUTHOR]

Objective: Evaluate the masking ability of bleach‐shade resin composites applied by multilayering techniques over colored substrates. Materials and methods: Disc‐shaped specimens were fabricated from bleach‐shade resin composites using different multilayering techniques. Substrates were produced in opaque ceramic discs simulating colored substrates (A2, A3, A3.5, C2, C3, C4) and a bleached tooth (0M1). Color coordinates were obtained using a reflectance spectrophotometer. Color difference was calculated by CIEDE2000 using coordinates of 0 M1 ceramic as standard reference. Data were analyzed by one‐way ANOVA and Tukey's post‐hoc test (p ≤ 0.05). Masking ability interpretation was based on perceptibility and acceptability thresholds. Results: All combinations presented ΔE00 above the acceptable threshold (ΔE00>1.8), ranging from 2.49 to 7.42, regardless of the restorative system, multilayering strategy or substrate color. Multilayering combinations placed over A2, A3 and A3.5 were moderately (1.8<ΔE00≤3.6) and clearly unacceptable (3.6<ΔE00≤5.4), combinations associated with C2, C3 and C4 were clearly unacceptable and, extremely unacceptable (ΔE00>5.4). Lower ΔE00 was observed for combinations with 0.5 mm extra white enamel layer (2.49), or 1.0 mm white dentin layer (2.69), over A2 and A3.5 substrates. Lightness difference showed the greatest contribution to ΔE00. Conclusions: Bleach‐shade resin composite systems applied by the multilayering technique were not able to ensure effective masking ability. Clinical significance: Bleach‐shade resin composites applied with different combinations of the multilayering technique were not effective in masking colored substrates. Alternative strategies, techniques and dental materials should be explored to obtain acceptable masking. [ABSTRACT FROM AUTHOR]

Copyright of Matronas Profesion is the property of Ediciones Mayo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Previous studies have shown worse cognitive performance in cluster headache (CH) patients compared to healthy controls; however, little is known about cognitive performance in episodic CH (ECH) patients outside and inside the active cluster (AC). Objective: Our aim is to compare cognitive function in ECH patients outside and inside the AC. Methods: In this cross‐sectional, observational study, four neuropsychological tests (Trail Making Test [TMT], Stroop Test [ST], verbal fluency [VF], and Symbol Digit Modalities Test [SDT]) were completed by 21 ECH patients at two different points in time: outside and inside the AC. We also assessed self‐reported sleep quality and the presence of anxiety or depressive symptoms. Scores were compared. Results: There was not any difference between the scores of the neuropsychological tests performed outside and inside the AC (TMT‐A: 23 vs. 23.5; p = 0.984; TMT‐B: 96.5 vs. 85.9; p = 0.104; ST word reading: 101.0 vs. 101.2; p = 0.938; ST color naming: 73.0 vs. 73.4; p = 0.858; ST color word: 44.0 vs. 46.0; p = 0.498; SDMT: 44.0 vs. 44.6; p = 0.961; VF phonemic: 29.5 vs. 30.2; p = 0.714; VF semantic: 20 vs. 21; p = 0.489). We found a worsening in the sleep quality component of the Pittsburgh Sleep Quality Index median scores in patients outside the AC (2 vs. 1; p = 0.046). Conclusions: Our findings suggest that patients with ECH have a similar cognitive performance outside and during the AC. [ABSTRACT FROM AUTHOR]

Objective To investigate the effects of the inclusion of motor imagery (MI) principles into early physical therapy on pain, disability, pressure pain thresholds (PPTs), and range of motion in the early postsurgical phase after total knee arthroplasty (TKA). Methods A randomized clinical trial including patients with knee osteoarthritis who have received TKA was conducted. Participants were randomized to receive five treatment sessions of either physical therapy with or without MI principles in an early postsurgical phase after a TKA (five days after surgery). Pain intensity (visual analog scale [VAS], 0–100), pain-related disability (short-form Western Ontario McMaster Universities Osteoarthritis Index [WOMAC], 0–32), pressure pain thresholds (PPTs), and knee range of motion were assessed before and after five daily treatment sessions by an assessor blinded to the subject's condition. Results Twenty-four participants completed data collection and treatment. The adjusted analysis revealed significant group*time interactions for WOMAC (F = 17.29, P  = 0.001, η2 = 0.48) and VAS (F = 14.56, P  < 0.001, η2 = 0.45); patients receiving physiotherapy and MI principles experienced greater improvements in pain (Δ –28.0, 95% confidence interval [CI] = –43.0 to –13.0) and pain-related disability (Δ –6.0, 95% CI = –8.3 to –3.7) than those receiving physiotherapy alone. No significant group*time interactions for knee range of motion and PPTs were observed (all, P  > 0.30). Conclusions The application of MI to early physiotherapy was effective for improving pain and disability, but not range of motion or pressure pain sensitivity, in the early postsurgical phase after TKA in people with knee osteoarthritis. [ABSTRACT FROM AUTHOR]

Background: During 24‐hour on‐call shifts medical residents are exposed to diverse circumstances such as sleep deprivation and stress. Objective: Our aim is to assess the effect of 24‐hour on‐call shifts on medical residents' headache‐related disability. Methods: The Migraine Disability Assessment Scale (MIDAS), the Headache Impact Test (HIT–6), the Pittsburgh Sleep Quality Index (PSQI), and the Hospital Anxiety and Depression Scale (HADS) questionnaires were administered to medical residents who had never performed on‐call shifts at baseline and 6 months after beginning 24‐hour on‐call shifts. Scores were compared. Results: About 66 medical residents completed this study. About 21.2% (n = 14) had history of migraine, 42.4% (n = 28) had a history of tension‐type headache (TTH) and 12.1% (n = 8) had a history of both migraine and TTH. Among medical residents with migraine, the median MIDAS score was significantly higher after starting 24‐hour on‐call shifts than at a baseline (4.0 vs 8.0; Wilcoxon, P =.001), meaning that, on average, disability increased from little or no disability, to moderate disability. No difference in HIT‐6 scores was found. The median score of PSQI and HADS was higher at 6 months (PSQI: 7.0 vs 8.0; P =.003), (HADS: 5.0 vs 8.0; P <.001) for the general group. Conclusions: In medical residents with migraine, migraine‐related disability increased after starting 24‐hour on‐call shifts. We also found a worsening in depression and anxiety symptoms and self‐reported sleep quality in medical residents with and without headache history. [ABSTRACT FROM AUTHOR]

Background Cluster headache is one of the most disabling of all headache conditions. Although some studies have investigated the psychological profile of patients with cluster headache, research on its impact on cognitive function in patients with episodic cluster headache outside the cluster bout is scant. Methods Cross-sectional study to evaluate various aspects of neuropsychological assessment and cognitive function including working memory, selective attention, verbal fluency, and executive function in 40 patients with episodic cluster headache. The patients were compared with 40 age-, gender-, and level of education–matched healthy controls. Results Episodic cluster headache patients performed significantly worse than healthy controls on all cognitive tests, except for the Interference Score (P  = 0.281). They had significantly higher Hospital Anxiety Scale scores (P  = 0.002). However, we found no significant association between cognitive performance, anxiety, sleep quality, and disease duration. Conclusions Patients with episodic cluster headache outside the bout showed worse executive functioning, working memory, language, and selective attention compared with healthy controls, regardless of the duration of disease or sleep quality. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To determine 50:50% perceptibility threshold (PT) and 50:50% acceptability threshold (AT) for computer‐simulated samples of human gingiva using CIEDE2000 and CIELAB color difference formulas. Materials and Methods: Each of the 60 pairs of simulated human gingiva was displayed on a calibrated monitor, together with three pairs of upper central incisors of different lightness. The color of gingiva left and right from the midline was compared. A total of 30 observers (15 dentists, 15 laypersons) participated in the study. CIEDE2000 and CIELAB formulas were used to calculate the thresholds and a Takagi‐Sugeno‐Kang Fuzzy Approximation model was used as fitting procedure. Paired t‐test (α = 0.05) was used in evaluation of statistical significance of differences. Results: The PT and AT for CIEDE2000 and 95% confidence intervals were 1.1 [0.4, 1.7] and 2.8 [1.8, 4.0], respectively. Corresponding CIELAB values were 1.7 [0.2, 2.6] and 3.7 [2.1, 5.7]. Significant differences (P < .01) were recorded between PT and AT, between the corresponding threshold values in CIEDE2000 and CIELAB formulas as well as between dentists and laypersons. Conclusions: The difference between the perceptibility and acceptability threshold for gingiva was statistically significant in both CIEDE2000 and CIELAB. The same was true for differences between the corresponding thresholds using two color difference formulas, and between dentists and laypersons. Visual thresholds of human gingiva were not dependent upon lightness of adjacent teeth. Overall, CIEDE2000 color difference formula provided better fit than CIELAB formula in the evaluation of color difference thresholds of human gingiva. Clinical Significance: The data on visual thresholds for healthy human gingiva can be used as quality control tool/guide for selection and evaluation of dental materials, interpretation of color‐related findings in clinical dentistry and research, and for standardization in dentistry. It is of particular value that this study was designed based on in‐vivo color evaluation of healthy keratinized gingiva of subjects of different ethnicities, age groups, and gender. [ABSTRACT FROM AUTHOR]

Abstract: Objective: To design colorimetric and spectral models of gingival shade guides that adequately represent the color of human gingiva. Materials and Methods: A previously compiled database on the spectral reflectance of healthy keratinized gingiva was used for optimization. Coverage Error (CE) and Maximal Error (ME) were optimized using CIELAB and CIEDE2000 color difference formulas. A two‐phase process included an FCM algorithm and a nonlinear optimization. A t test was used to compare the performance of the different numbers of clusters/tabs in gingival shade guide models (α = .05). Results: CIELAB CE and ME for shade guide models with 3 to 6 clusters ranged from 3.1 to 3.9 (P = .028 for 3 vs. 4; and P = .033 for 5 vs. 6 cluster/tab comparison), while the corresponding CIEDE2000 range was from 2.1 to 2.8 (P < .001 for 3 vs. 4 tabs; P < .025 for 4 vs. 5; and P = 0.029 for 5 vs. 6 tab comparisons). The percentage of data points exhibiting a CIELAB color difference lower than the acceptability threshold ranged from 48.7% to 71.4%, and from 52.9% to 82.4%. for CIEDE2000. Conclusions: An increase in the number of clusters in the gingival shade guide models was associated with a decrease in coverage error (better match) to human gingiva. Gingival shade guide models with only 4 tabs provided a CIELAB and CIEDE2000 coverage error lower than the acceptability threshold for gingival color. Spectral clustering of human gingiva was determined to be valid. CIEDE2000 color difference formula outperformed the CIELAB formula in the optimization process. Clinical Significance: Providing a shade guide model with a small number of tabs and a coverage error lower than the 50:50% acceptability threshold would be an optimal solution for shade matching in dentistry. However, no actual gingival or tooth shade guide complies with this. The clustering method, with optimization of both Coverage Error and Maximal Error and spectral clustering that enables more reliable color formulation of cluster representatives of shade guide models, represents an advance when it comes to computer modeling in dentistry. [ABSTRACT FROM AUTHOR]

The aim of this study was to measure pain levels in noncommunicative patients with severe trauma who required tracheal suctioning and mobilization and to determine the utility of the Behavioral Indicators of Pain Scale (ESCID) in these cases. The pain scores for the procedures were recorded on Days 1, 3, and 6 of the patients’ stay in the intensive care unit. These assessments were performed at 3 moments: before, during, and after the application of the procedures. Because of the longitudinal character of the study, data were fitted into a multivariate model using the Generalized Estimating Equations method. The sample of 124 patients comprised 77.4% males and 22.6% females with an average age of 45.93 ( SD = 16.43) years. A significant increase ( p < .01) in the ESCID score was observed during the application of the procedures that produced similar pain levels. Kappa coefficient value obtained for interobserver agreement of ESCID scale scores during the application of care procedures at the intervals being evaluated was greater than 0.84, which should be interpreted as almost perfect. The ESCID scores increased during 2 care procedures that are frequently carried out in intensive care units and indicated that they produced similar pain levels. [ABSTRACT FROM AUTHOR]

Context and Objective To describe clinical and resource utilization patterns in patients with refractory neuropathic pain ( NeP) who were prescribed pregabalin for the first time in routine medical practice in primary care settings. Methods Post-hoc analysis of a 12-week prospective observational study including pregabalin naïve adult patients with refractory chronic NeP of at least 6-months duration. Self-reported pain intensity, disability, sleep disturbances, symptoms of anxiety and depression, disability, health-related quality of life ( HRQoL), health care resource utilization, and corresponding costs were assessed in this post-hoc analysis. Results One thousand three hundred fifty-four patients were enrolled in the study, and three treatment groups were identified: 1) 598 patients replaced prior pain treatments with pregabalin as monotherapy; 2) 589 added pregabalin to their existing pain treatments; and 3) 167 other pain treatments were prescribed according with physician routine medical practice. Statistically significant differences were reported at baseline for intensity of pain, patient disability, severity of depressive symptoms, and HRQoL ( P < 0.01 in all cases). No statistically significant differences were reported among the three treatment groups for anxiety severity or sleep disturbances. Subjects who received add-on pregabalin had greater use of direct and indirect resources vs the other groups, resulting in significantly higher quarterly overall costs per patient: €2,397 (2,308), €2,470 (1,857), and €3,110 (2,496), respectively ( P < 0.001). Conclusion These findings suggest that primary care physicians chose pregabalin as an option for treating refractory patients who tended to have much more severe NeP profiles, costing society more than when they chose other therapeutic strategies not including pregabalin. [ABSTRACT FROM AUTHOR]

Objectives. To improve the monitoring and control of glycated haemoglobin in insulin-dependent children. This article describes an educational intervention for this purpose where One Touch UltraSmart™ Software was used to manage diabetes. The results showed that this intervention helped to reduce the levels of blood glucose and glycated haemoglobin to less than 7%. Background. Various research studies have been performed on the effective control of glycated haemoglobin values in diabetic children by means of technological devices. However, none of this research has evaluated the impact of an educational intervention in conjunction with the use of monitoring instruments such as One Touch UltraSmart. Design. We present an 18-month longitudinal, analytical and observational study of 37 type 1 diabetic patients, 9-16 years of age. For each patient, initial and final values of glycated haemoglobin and the number of blood glucose controls were recorded. Methodology. For the purposes of our study seven educational workshops, attended by diabetic children and their parents, were conducted. In addition, participants were asked to complete a brief questionnaire so that information could be gathered regarding the eating and exercise habits of the patients. Results. This educational intervention using One Touch UltraSmart led to a statistically significant average reduction of glycated haemoglobin. Conclusions. Our research showed that the use of One Touch UltraSmart in the context of an educational intervention raised the awareness of the diabetic children and thus helped them to effectively control their disease and to fully understand the necessity of having good dietary and exercise habits. Relevance to clinical practice. It can be concluded that the educational intervention led to a significant improvement in the dietary habits of these patients and also helped them to exercise regularly, all of which has a positive impact on their health. [ABSTRACT FROM AUTHOR]

Simple Summary: Photodynamic therapy (PDT) is used for the treatment of in situ cutaneous squamous cell carcinoma (cSCC), the second most common form of skin cancer, as well as for its precancerous form, actinic keratosis. However, relapses after the treatment can occur. Transforming growth factor β1 (TGFβ1) produced by cancer-associated fibroblasts (CAFs) in the tumor microenvironment has been pointed as a key player in the development of cSCC resistance to other therapies, such as chemotherapy. Here, we demonstrate that TGFβ1 produced by CAFs isolated from patients with cSCC can drive resistance to PDT in SCC cells. This finding opens up novel possibilities for strategy optimization in the field of cSCC resistance to PDT and highlights CAF-derived TGFβ1 as a potential target to improve the efficacy of PDT. As an important component of tumor microenvironment, cancer-associated fibroblasts (CAFs) have lately gained prominence owing to their crucial role in the resistance to therapies. Photodynamic therapy (PDT) stands out as a successful therapeutic strategy to treat cutaneous squamous cell carcinoma. In this study, we demonstrate that the transforming growth factor β1 (TGFβ1) cytokine secreted by CAFs isolated from patients with SCC can drive resistance to PDT in epithelial SCC cells. To this end, CAFs obtained from patients with in situ cSCC were firstly characterized based on the expression levels of paramount markers as well as the levels of TGFβ1 secreted to the extracellular environment. On a step forward, two established human cSCC cell lines (A431 and SCC13) were pre-treated with conditioned medium obtained from the selected CAF cultures. The CAF-derived conditioned medium effectively induced resistance to PDT in A431 cells through a reduction in the cell proliferation rate. This resistance effect was recapitulated by treating with recombinant TGFβ1 and abolished by using the SB525334 TGFβ1 receptor inhibitor, providing robust evidence of the role of TGFβ1 secreted by CAFs in the development of resistance to PDT in this cell line. Conversely, higher levels of recombinant TGFβ1 were needed to reduce cell proliferation in SCC13 cells, and no induction of resistance to PDT was observed in this cell line in response to CAF-derived conditioned medium. Interestingly, we probed that the comparatively higher intrinsic resistance to PDT of SCC13 cells was mediated by the elevated levels of TGFβ1 secreted by this cell line. Our results point at this feature as a promising biomarker to predict both the suitability of PDT and the chances to optimize the treatment by targeting CAF-derived TGFβ1 in the road to a more personalized treatment of particular cSCC tumors. [ABSTRACT FROM AUTHOR]

The article discusses a study on progressive aging of the population that has increased prevalence of chronic diseases and multimorbidity. It informs of dysphagia as a major health concern in older individuals living in nursing homes. It informs that the study reviewed the effect of pharmacotherapy in elderly patients with dysphagia whose oral dosage forms were altered.

In the absence of randomised head-to-head trials, we conducted a population-adjusted indirect treatment comparison (PA-ITC) of phase III trial data to evaluate the relative efficacy and safety of maintenance olaparib and bevacizumab alone and in combination in patients with newly diagnosed, advanced ovarian cancer and a BRCA mutation (BRCAm). An unanchored PA-ITC was performed on investigator-assessed progression-free survival (PFS) data. Individual patient data from SOLO1 (olaparib versus placebo) and from BRCA-mutated patients in PAOLA-1/ENGOT-ov25 (olaparib plus bevacizumab versus placebo plus bevacizumab) were pooled. Each arm of PAOLA-1 was weighted so that key baseline patient characteristics were similar to the SOLO1 cohort. Analyses were performed in patients with complete baseline data. Weighted Cox regression analysis was used to estimate the comparative efficacy of different maintenance therapy strategies, supplemented by weighted Kaplan–Meier analyses. Data from SOLO1 patients (olaparib, n = 254; placebo, n = 126) were compared with data from BRCA-mutated PAOLA-1 patients (olaparib plus bevacizumab, n = 151; placebo plus bevacizumab, n = 71). Adding bevacizumab to olaparib was associated with a numerical improvement in PFS compared with olaparib alone (hazard ratio [HR] 0.71; 95% confidence interval [CI] 0.45–1.09). Statistically significant improvements in PFS were seen with olaparib alone versus placebo plus bevacizumab (HR 0.48; 95% CI 0.30–0.75), olaparib plus bevacizumab versus placebo (0.23; 0.14–0.34), and placebo plus bevacizumab versus placebo (0.65; 0.43–0.95). Results of this hypothesis-generating PA-ITC analysis support the use of maintenance olaparib alone or with bevacizumab in patients with newly diagnosed, advanced ovarian cancer and a BRCAm. [Display omitted] • We compared olaparib maintenance strategies in newly diagnosed BRCA-mutated OC. • Our population-adjusted indirect treatment comparison used SOLO1 and PAOLA-1 data. • Results support the use of maintenance olaparib alone or with bevacizumab. [ABSTRACT FROM AUTHOR]