Trajectory of the development of caries in the permanent dentition of 12- to 16-year-old students based on a latent class growth model analysis in Liuyang / 口腔疾病防治

Objective@# To explore the trajectory of the development of permanent caries in 12- to 16-year-old students in Liuyang and to provide a reference for the prevention and management of caries.@*Methods@#Primary and secondary school students who were registered within the Liuyang jurisdiction were screened for caries from September to November by the Liuyang Center for Disease Control and Prevention. A total of 7 297 students between the ages of 12 and 16 years with complete permanent dentition caries monitoring records and traceable deciduous dentition caries monitoring records were selected from 2013 to 2019, and a zero-inflated negative binomial-latent class growth model (ZINB-LCGM) was established to describe the trajectory of the development of individual caries using the decayed missing filled teeth (DMFT) indicators. @*Results@# DMFT of 12- to 16-year-old students in Liuyang were mainly decayed teeth (DT), with the majority occurring in the first permanent molar. According to the ZINB-LCGM model, the students were classified into three latent categories, "slow growth pattern" (28.55%), "rapid growth pattern" (6.59%), and "stable pattern" (64.86%), which followed different nonlinear caries growth trajectories. Females with deciduous teeth caries were more likely to have trajectories showing a “rapid growth pattern” and a “slow growth pattern”. There were significant differences in the trajectories between men and women, as well as between those with and without primary dentition caries. @*Conclusion @# The trajectory of the development of caries in 12-16-year-old students shows heterogeneity in terms of different developmental patterns of latent categories, suggesting that females with deciduous dental caries should receive more attention.

Patterns of instrumental activities of daily living between community-dwelling older adults / Padrões de atividades instrumentais de vida diária entre idosos da comunidade

ABSTRACT The ability to perform instrumental activities of daily living (IADLs) is an important marker within the aging process, as it reflects the level of independence to perform in the real world. However, there is a scarcity of studies that investigate the different performance profiles among older adults. Objective: To investigate the heterogeneity present in the community of elderly people, grouping them based on characteristics and patterns observed through an objective performance-based assessment. Methods: Participants were selected according to the following inclusion criteria: fluency in Portuguese, 360 years, regular participation in a social program offered by the government of Rio de Janeiro, and absence of a caregiver. The evaluation of IADLs was determined by the total and brief version of the University of California, San Diego Performance-Based Skills Assessment (UPSA) and the Lawton and Brody IADL scale. The Brief Cognitive Screening Battery and the Mini-Mental State Examination were used to characterize the sample, in addition to the Geriatric Depression Scale. A total of 61 elderly people with an average age of 72.5 years, predominantly females (85.2%), and average education of 11.2 were evaluated and grouped according to their performance at UPSA through clustering analysis. Results: The analysis revealed three grouping patterns, subdividing the sample into subgroups that differed significantly in terms of age, education, global cognition, and all instrumental activities assessed by UPSA — planning, finance, communication, transportation, and household chores. Conclusions: This study was able to identify the heterogeneity present between the elderly people in the different factors that compose the IADLs through a performance-based assessment.

RESUMO A capacidade para realização das atividades instrumentais da vida diária (AIVDs) é um importante marcador no envelhecimento, uma vez que reflete o grau de independência para atuação no mundo real. No entanto, há uma escassez de estudos que se proponham a investigar os diferentes perfis de desempenho entre idosos. Objetivo: Investigar a heterogeneidade presente em idosos da comunidade, agrupando-os a partir de características e padrões observados através de uma avaliação objetiva baseada em desempenho. Métodos: Participantes foram selecionados conforme critérios de inclusão: ter fluência no Português; ter 60 ou mais anos; participar de forma regular no programa de casas de convivência do Rio de Janeiro e não possuir cuidador. A avaliação das AIVDs foi determinada pela versão total e breve do The University of California, San Diego Performance-Based Skills Assessment (UPSA) e pela escala AIVD de Lawton e Brody. A Bateria Breve de Rastreio Cognitivo e o Miniexame do Estado Mental foram utilizados para caracterização da amostra, além da Escala de Depressão Geriátrica. Um total de 61 idosos com idade média de 72,5 anos, predominantemente do sexo feminino (85,2%) e escolaridade média de 11,2 foram avaliados e agrupados de acordo com o seu desempenho no UPSA por meio de uma análise de cluster. Resultados: A análise revelou três padrões de agrupamento, subdividindo a amostra em subgrupos que se diferenciaram significativamente em termos de idade, escolaridade, cognição global e todas as atividades instrumentais avaliadas pelo UPSA — planejamento, finanças, comunicação, transporte e habilidades domésticas. Conclusões: O presente estudo foi capaz de identificar a heterogeneidade presente na população idosa entre os diferentes fatores que compõe as AIVDs por meio de uma avaliação baseada em desempenho.

Differences in Colistin-resistant Acinetobacter baumannii Clinical Isolates Between Patients With and Without Prior Colistin Treatment

BACKGROUND: The increasing morbidity and mortality rates associated with Acinetobacter baumannii are due to the emergence of drug resistance and the limited treatment options. We compared characteristics of colistin-resistant Acinetobacter baumannii (CR-AB) clinical isolates recovered from patients with and without prior colistin treatment. We assessed whether prior colistin treatment affects the resistance mechanism of CR-AB isolates, mortality rates, and clinical characteristics. Additionally, a proper method for identifying CR-AB was determined. METHODS: We collected 36 non-duplicate CR-AB clinical isolates resistant to colistin. Antimicrobial susceptibility testing, Sanger sequencing analysis, molecular typing, lipid A structure analysis, and in vitro synergy testing were performed. Eleven colistin-susceptible AB isolates were used as controls. RESULTS: Despite no differences in clinical characteristics between patients with and without prior colistin treatment, resistance-causing genetic mutations were more frequent in isolates from colistin-treated patients. Distinct mutations were overlooked via the Sanger sequencing method, perhaps because of a masking effect by the colistin-susceptible AB subpopulation of CR-AB isolates lacking genetic mutations. However, modified lipid A analysis revealed colistin resistance peaks, despite the population heterogeneity, and peak levels were significantly different between the groups. CONCLUSIONS: Although prior colistin use did not induce clinical or susceptibility differences, we demonstrated that identification of CR-AB by sequencing is insufficient. We propose that population heterogeneity has a masking effect, especially in colistin non-treated patients; therefore, accurate testing methods reflecting physiological alterations of the bacteria, such as phosphoethanolamine-modified lipid A identification by matrix-assisted laser desorption ionization-time of flight, should be employed.

Lower Loading Dose of Prasugrel Compared with Conventional Loading Doses of Clopidogrel and Prasugrel in Korean Patients Undergoing Elective Coronary Angiography: A Randomized Controlled Study Evaluating Pharmacodynamic Efficacy

BACKGROUND AND OBJECTIVES: Although prasugrel allows for rapid and potent platelet inhibition, the efficacy and safety of lower doses of prasugrel for patients of East Asian ethnicity has not yet been investigated. We compared the effect of a lower loading dose (LD) of prasugrel with conventional LDs of clopidogrel and prasugrel in Korean patients. SUBJECTS AND METHODS: Forty-three Korean patients undergoing coronary angiography were enrolled in the study. Participants were randomly administered LDs of clopidogrel 600 mg, prasugrel 30 mg or prasugrel 60 mg prior to coronary angiography. Platelet reactivity was assessed at baseline and at the time of peak platelet inhibition using light transmission aggregometry (LTA), the VerifyNow assay, and multiple electrode aggregometry. RESULTS: Although baseline platelet reactivity between the groups showed no significant differences, at the time of peak platelet inhibition, the prasugrel 30 mg (18.9+/-10.0%) and 60 mg groups (13.8+/-10.8%) showed significantly more potent platelet inhibition than the clopidogrel 600 mg group (52.9+/-15.8%; p<0.001) by LTA. However, there were no significant differences between the prasugrel 30 mg and 60 mg groups (p=0.549). CONCLUSION: The loading effect of prasugrel 30 mg was more potent than clopidogrel 600 mg and was not significantly different from prasugrel 60 mg.

Análisis de la composición poblacional de aislados venezolanos de Trypanosoma cruzi I, provenientes de un hospedador humano, un insecto triatomineo y un reservorio natural / Analysis of the population composition of venezuelans isolates of Trypanosoma cruzi I fron a human host, a triatomine insect and a nature reservoir

Se analizó la composición poblacional de aislados venezolanos pertenecientes al grupo Tel, provenientes de distintos hospedadores. El análisis fue realizado mediante la clonación de los aislados utilizando la técnica de plaqueo, de la cual se originaron clones de cada uno que posteriormente fueron comparados mediante la técnica de Amplificación Aleatoria de ADN Polimórfico (RAPD). La observación de los perfiles de bandas obtenidos mediante electroforesis en gel de agarosa, mostró diferencias en cuanto al número y la posición de bandas en los clones obtenidos de los aislados provenientes de humano y del reservorio natural (Dildelphis marsupiales), mientras que para el aislado proveniente del vector (Triatoma ningromaculata), todos los clones generaron perfiles de bandas similares. Estos resultados evidencian una heterogeneidad poblacional para el caso de los dos primeros aislados. El índice de variabilidad genética fue diferente para cada uno de los aislados, siendo mayor para dos aislados provenientes de dos pacientes chagásicos, mostrando un valor de 0.1652 y 0.0853 respectivamente, mientras que para el aislado proveniente del reservorio natural, se obtuvo un valor de 0.0312. Estos resultados indican polimorfismo existente entre clones provenientes de un mismo aislado, siendo indicativo de la existencia de heterogeneidad intrapoblacional, lo cual pudiese tener implicaciones en la diversidad de manifestaciones clínicas reportadas para infecciones con T. cruzi I.

It was analyzed the population composition of Venezuelan isolates belonging to the genotype Tel from different hosts. The analysis was carried out through the cloning of the isolates using the plating technique, obtaining clones of each one of them, which were afterward compared using the random amplified plymorphic DNA technique (RAPD). The observation of bands'profiles obtained by agarose gel electrophoresis, showed differences regarding to the number and position of the bands between the isolates from both humans and natural reservoir (Dildelphis marsupialis), except for the clones obtained from the vector isolate (triatoma nigromaculata), where all of them gave the same pattern of bands. This result reveals the presence of population heterogeneity for the isolates from human and natural host. The genetic variability index was different in each one of the isolates, being higher for the isolates fron two chagasic patientes, showing values of 0.1652 and 0.0853 respectivivly; and for the isolate fron the natural reservoir the index value was 0.0312. These results reveals the presence of polymorphism between the clones obtained from the same isolate, showing the existence of intra popultaion heterogenicity, wich might have implications on the diversity of clinical manifestations previously reported with T. cruzi I infections.