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Functional gastrointestinal disorders (FGIDs) are common and cause significant morbidity. Psychiatric comorbidities associated with FGIDs include anxiety and depression. However, little is understood about the factors that modulate this association. The aim of this study was to examine the association between FGIDs and depression and anxiety, and to determine the covariates influencing this association in a New Zealand cohort.The Christchurch IBS cOhort to investigate Mechanisms FOr gut Relief and improved Transit (COMFORT) study is an observational case-control study that recruited FGID cases and healthy controls between 2016 and 2018. In addition to the collection of a wide range of biological samples, participants completed questionnaires concerning socioeconomic status, physical activity, smoking, alcohol intake, anxiety, and depression (the latter two measured using the Hospital Anxiety and Depression Score [HADS]). A multivariate analysis was performed using the significant covariates from the univariate analyses to test whether their effect was independently significant on anxiety and depression.A total of 315 participants (57 with diarrhea-predominant IBS (IBS-D), 30 with constipation-predominant IBS (IBS-C), 41 with mixed-IBS (IBS-M), 16 with functional diarrhea (FD), 42 with functional constipation (FC), and 129 controls); mean age 53 years (range 18-70 years), 221 (70%) female) completed the questionnaires. Anxiety (odds ratio [OR] 2.85 [95% confidence interval [CI] 1.64-4.94, p 0.01) and depression (OR 3.40 [95% CI 1.35-8.55, p = 0.01]) were strongly associated with FGID cases versus controls. Lower economic living status (p 0.01) was an independent covariate associated with depression, while lower economic living status (p 0.005) and abdominal pain (p = 0.005) were both independently associated with anxiety.In addition to the established associations between FGIDs and anxiety and depression, we have shown that the economic standard of living, pain, and IBS phenotype are significant independent covariates. This study demonstrates the range of lifestyle and demographic factors that modulate morbidity associated with FGIDs and may provide targets for intervention.

Introduction: Singapore’s ageing population is likely to see an increase in chronic eye conditions in the future. This study aimed to estimate the burden of eye diseases among resident Singaporeans stratified for age and ethnicity by 2040. Materials and Methods: Prevalence data on myopia, epiretinal membrane (ERM), retinal vein occlusion (RVO), age macular degeneration (AMD), diabetic retinopathy (DR), cataract, glaucoma and refractive error (RE) by age cohorts and educational attainment from the Singapore Epidemiology of Eye Diseases (SEED) study were applied to population estimates from the Singapore population model. Results: All eye conditions are projected to increase by 2040. Myopia and RE will remain the most prevalent condition, at 2.393 million (2.32 to 2.41 million) cases, representing a 58% increase from 2015. It is followed by cataract and ERM, with 1.33 million (1.31 to 1.35 million), representing an 81% increase, and 0.54 million (0.53 to 0.549 million) cases representing a 97% increase, respectively. Eye conditions that will see the greatest increase from 2015 to 2040 in the Chinese are: DR (112%), glaucoma (100%) and ERM (91.4%). For Malays, DR (154%), ERM (136%), and cataract (122%) cases are expected to increase the most while for Indians, ERM (112%), AMD (101%), and cataract (87%) are estimated to increase the most in the same period. Conclusion: Results indicate that the burden for all eye diseases is expected to increase significantly into the future, but at different rates. These projections can facilitate the planning efforts of both policymakers and healthcare providers in the development and provision of infrastructure and resources to adequately meet the eye care needs of the population. By stratifying for age and ethnicity, high risk groups may be identified and targeted interventions may be implemented. Key words: Ophthalmology, System dynamics

Systemic lupus erythematosus (SLE) is a systemic, chronic, inflammatory, autoimmune disease characterized by multi-organ and - system involvement such as the kidneys and hematologic and central nervous systems. The clinical presentation of the disease is extremely variable. Systemic findings, nephritis, neuropsychiatric disease, and cytopenia are more common in children than in adults at presentation. Chorea typically manifests with jerky, involuntary, and purposeless movements, involving the face, four limbs, and neck. In addition, patients suffer from dysarthria, gait disturbance, and neuropsychiatric symptoms. Chorea can be the first finding of SLE during childhood. Herein we reported a 13-year female patient who presented with movement and speech disorders and who was diagnosed chorea-related SLE.

Objective: This study aims to evaluate the effectiveness of local hyaluronic acid (HA) administration to surgically remove impacted third molar sockets and measure pain, swelling, and trismus. Materials and Methods: The study included a total of 25 healthy patients aged 18-29 years with asymptomatic bilaterally impacted lower third molars. All cases have been performed under local anesthesia. In the study group, 0.8% HA (Gengigel®) was applied in the postextraction sockets of the right third molars and in the control group nothing was applied to the extraction sockets of the left third molars. Postoperative pain, trismus, and swelling were evaluated on the 1st, 3rd, and 7th postoperative days. Results: No difference was determined between groups in facial swelling and maximum mouth opening. However, the amount of pain significantly reduced in HA groups according to visual analog scale (P = 0.001). Conclusion: The results of this study showed that HA can produce an analgesic action in postextraction sockets after surgical removal of impacted teeth and therefore it has a clinical benefit to reduce usage of nonsteroidal anti-inflammatory drugs after dentoalveolar surgery.Keywords: Hyaluronic acid, pain, surgery, third molar

International audience

International audience

Contains fulltext : 136496.pdf (Publisher’s version ) (Open Access) OBJECTIVE: The objective of the study was to understand the extent to which financial incentives such as Payment by Results and other payment mechanisms motivate kidney centres in England to change their practices. DESIGN: The study followed a qualitative design. Data collection involved 32 in-depth semistructured interviews with healthcare professionals and managers, focusing on their subjective experience of payment structures. PARTICIPANTS: Participants were kidney healthcare professionals, clinical directors, kidney centre managers and finance managers. Healthcare commissioners from different parts of England were also interviewed. SETTING: Participants worked at five kidney centres from across England. The selection was based on the prevalence of home haemodialysis, ranging from low (8%) prevalence, with at least one centre in each one of these categories at the time of selection. RESULTS: While the tariff for home haemodialysis is not a clear incentive for its adoption due to uncertainty about operational costs, Commissioning for Quality and Innovation (CQUIN) targets and the Best Practice Tariff for vascular access were seen by our case study centres as a motivator to change practices. CONCLUSIONS: The impact of financial incentives designed at a policy level is influenced by the understanding of cost and benefits at the local operational level. In a situation where costs are unclear, incentives which are based on the improvement of profit margins have a smaller impact than incentives which provide an additional direct payment, even if this extra financial support is relatively small.