Bone erosions associated with systemic bone loss on HR-pQCT in women with longstanding polyarticular juvenile idiopathic arthritis.

OBJECTIVES: To analyze longstanding polyarticular juvenile idiopathic arthritis (pJIA) for possible associations between localized bone damage (erosions), and systemic bone loss. Besides, to compare the systemic bone mass of pJIA with healthy controls. METHODS: Thirty-four pJIA women and 99 healthy controls (HC) were included. Radius and tibia of all subjects were scanned by HR-pQCT. Volumetric bone mineral density (vBMD), bone microarchitecture, and -finite element parameters were analyzed. Patients underwent HR-pQCT of 2nd and 3rd metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the dominant hand, for bone erosions quantification. RESULTS: The mean age of patients was 31.5 ± 7.4yrs with a mean disease duration of 21.7 ± 9.2yrs. Bone erosions were detectable in 79% of patients. The number of bone erosions was positively correlated with cortical porosity (Ct.Po) at tibia (r = 0.575, p = 0.001), and radius (r = 0.423, p = 0.018); and negatively correlated with cortical vBMD at tibia (r=-0.420, p = 0.015). In a logistic regression analysis, adjusted for anti-CCP, the presence of bone erosions was independently associated with Ct.Po at radius (p = 0.018) and cortical vBMD at tibia (p = 0.020). Moreover, cortical and trabecular vBMD, trabecular number, and µ-finite element parameters were decreased in patients compared to HC (p < 0.05). CONCLUSION: Bone erosions in longstanding pJIA women were associated with decreased cortical bone parameters, and these patients showed systemic bone impairment at peripheral sites compared with healthy controls.

Membrane lipid composition of Carnobacterium maltaromaticum CNCM I-3298, a highly cryoresistant lactic bacterium.

The growing consumption of fermented products has led to an increasing demand for lactic acid bacteria (LAB), especially for LAB tolerant to freezing/thawing conditions. Carnobacterium maltaromaticum is a psychrotrophic and freeze-thawing resistant lactic acid bacterium. The membrane is the primary site of damage during the cryo-preservation process and requires modulation to improve cryoresistance. However, knowledge about the membrane structure of this LAB genus is limited. We presented here the first study of the membrane lipid composition of C. maltaromaticum CNCM I-3298 including the polar heads and the fatty acid compositions of each lipid family (neutral lipids, glycolipids, phospholipids). The strain CNCM I-3298 is principally composed of glycolipids (32%) and phospholipids (55%). About 95% of glycolipids are dihexaosyldiglycerides while less than 5% are monohexaosyldiglycerides. The disaccharide chain of dihexaosyldiglycerides is composed of α-Gal(1-2)-α-Glc chain, evidenced for the first time in a LAB strain other than Lactobacillus strains. Phosphatidylglycerol is the main phospholipid (94%). All polar lipids are exceptionally rich in C18:1 (from 70% to 80%). Regarding the fatty acid composition, C. maltaromaticum CNCM I-3298 is an atypical bacterium within the genus Carnobacterium due to its high C18:1 proportion but resemble the other Carnobacterium strains as they mostly do not contain cyclic fatty acids.

Ecology and extent of freshwater browning - What we know and what should be studied next in the context of global change.

Water browning or brownification refers to increasing water color, often related to increasing dissolved organic matter (DOM) and carbon (DOC) content in freshwaters. Browning has been recognized as a significant physicochemical phenomenon altering boreal lakes, but our understanding of its ecological consequences in different freshwater habitats and regions is limited. Here, we review the consequences of browning on different freshwater habitats, food webs and aquatic-terrestrial habitat coupling. We examine global trends of browning and DOM/DOC, and the use of remote sensing as a tool to investigate browning from local to global scales. Studies have focused on lakes and rivers while seldom addressing effects at the catchment scale. Other freshwater habitats such as small and temporary waterbodies have been overlooked, making the study of the entire network of the catchment incomplete. While past research investigated the response of primary producers, aquatic invertebrates and fishes, the effects of browning on macrophytes, invasive species, and food webs have been understudied. Research has focused on freshwater habitats without considering the fluxes between aquatic and terrestrial habitats. We highlight the importance of understanding how the changes in one habitat may cascade to another. Browning is a broader phenomenon than the heretofore concentration on the boreal region. Overall, we propose that future studies improve the ecological understanding of browning through the following research actions: 1) increasing our knowledge of ecological processes of browning in other wetland types than lakes and rivers, 2) assessing the impact of browning on aquatic food webs at multiple scales, 3) examining the effects of browning on aquatic-terrestrial habitat coupling, 4) expanding our knowledge of browning from the local to global scale, and 5) using remote sensing to examine browning and its ecological consequences.

Demographic and Clinical Characteristics Associated with Minimally Invasive Glaucoma Surgery Use: An Intelligent Research in Sight (IRIS®) Registry Retrospective Cohort Analysis.

PURPOSE: Minimally invasive glaucoma surgery (MIGS) is increasingly performed at the time of cataract extraction. Understanding the demographic and clinical characteristics of patients undergoing MIGS procedures may provide insight into patient selection. This study evaluates racial-ethnic and other differences in the use of MIGS in persons with cataract and open-angle glaucoma (OAG). DESIGN: Retrospective cohort study using Intelligent Research in Sight (IRIS) Registry data. PARTICIPANTS: Patients aged ≥ 40 years with a diagnosis of OAG and no history of MIGS or cataract surgery who were undergoing cataract extraction, with or without MIGS, during 2013 to 2017 in the United States. METHODS: Multivariable logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (CIs). MAIN OUTCOME MEASURES: Variables assessed include age, sex, race-ethnicity, disease severity, insurance type, census region, comorbidity, and cup-to-disc ratio (CDR). RESULTS: The odds of MIGS use was greater among patients who were aged ≥ 60 years (OR, 1.10 [95% CI, 1.05-1.16]); Black (OR, 1.11 [CI, 1.07-1.15]) compared with White; a Medicare recipient (OR, 1.12 [CI, 1.10-1.15]) versus privately insured; or in the Midwest (OR, 1.32 [CI, 1.28-1.36]) or Northeast (OR, 1.26 [CI, 1.22-1.30]) compared with the South. Having moderate rather than mild glaucoma (OR, 1.07 [CI, 1.04-1.11]) and a higher CDR (OR for 0.5 to 0.8 vs. <0.5, 1.24 [CI, 1.21-1.26]; OR for >0.8 to 1.0 vs. <0.5, 1.27 [CI, 1.23-1.32]) were also each associated with increased odds of MIGS use. Use of MIGS was less likely in women (OR, 0.96 [CI, 0.94-0.98]); patients taking 5 to 7 glaucoma medications (OR, 0.94 [CI, 0.90-0.99]) compared with 1 to 2 medications; and patients with severe, compared with mild, glaucoma (OR, 0.64 [CI, 0.61-0.67]). CONCLUSIONS: This analysis highlights the importance of capturing race-ethnicity data and other pertinent patient characteristics in electronic health records to provide insight into practice patterns. Such data can be used to assess the long-term performance of MIGS and other procedures in various patient populations.

Relationship between functionality and depression among elderly patients with hip or femoral fractures / The Health Sciences Journal

Introduction@#The sudden loss of ability to perform one's role increases an elderly person's awareness of his dependency on others and creates emotional frustration. The study aimed to determine the relationship between functionality and depression among elderly persons with fracture of the hip or femur.@*Methods @#This was a correlational study using the Geriatric Depression Scale and Barthel Index Tool to measure depression and functionality, respectively, among randomly sampled geriatric patients admitted in an orthopedic hospital. Spearman rho was used to determine the relationship between functionality and depression.@*Results @#Majority of the 43 respondents were women and the mean age of the sample was 70 years. The respondents had a low level of functionality with a mean Barthel Index of 8.3. Around 85% had mild or severe depression. The Spearman's rho showed a moderate negative relationship between functionality and depression which was statistically significant (r = -0.51, p < 0.01).@*Conclusion @#Among geriatric patients with femoral or hip fractures, patients with low functionality tend to be depressed.

Perceived occupational hazards of sanitary inspectors from two urban cities in the Philippines

OBJECTIVE: This study aimed to describe the occupational hazards perceived by sanitary inspectors (SIs) from the City of Manila (Manila) and Quezon City (QC) as they perform their administrative and technical roles. METHODS: Hazards and control measures were identified using self-administered questionnaires distributed among Sls of Manila and QC from November to December 2010. RESULTS: The most frequently perceived hazards are slips, trips and falls, and verbal assault seen consistently present among 8 out of 9 roles. Harsh climatic condition on the other hand is the hazard perceived to be the riskiest as seen consistently in 8 out of 9 roles. Of the respondents, 28% did not receive formal training in the field of sanitary inspection and 64% did not have work shifts as administrative control measures; 90% said that personal protective equipment (PPE) were not made available to them and were not used by them. CONCLUSION AND RECOMMENDATIONS: The most frequently perceived hazards encountered by SIs are slips, trips and falls, harsh climatic conditions, unwarranted complaints, and verbal assault. On the other hand, harsh climatic conditions, unwarranted complaints, and slips, trips and falls are the occupational hazards which are consistently present and perceived to pose the most risk in more than five roles. Provision of PPE and improvement in the implementation of administrative control measures is recommended. Moreover, further studies involving SIs' actual experiences, SIs from rural areas and control measures present in the workplace are suggested.

Assessment of bias in methodology for randomized controlled trials published on implant dentistry.

PURPOSE: The purpose of this study was to assess randomized controlled trials (RCTs) published on implant dentistry over a 10-year period (1991 to 2000), based on the reporting of control of potential sources of bias in the design methodology. MATERIALS AND METHODS: A MEDLINE search was conducted for RCTs using keywords dental implant and publication type randomized controlled trial. Three areas of trial methodology were assessed: (1) adequate reporting of randomization procedure, (2) blinding in assessment of outcomes, and (3) handling of subject withdrawals in data analysis. A score of 1 or 0 was assigned for each of the three potential sources of bias. Thus, the maximum quality score for an RCT is 3 and the minimum is 0. RESULTS: Forty-three articles met criteria for classification as RCTs. Method of randomization was explicit in 51% of the RCTs, but only 12% incorporated blinding in the assessment of outcome. Ninety-eight percent accounted for all subjects at the end of the study. Looking at overall quality scores, only 2% of RCTs adequately reported on control of bias in the three areas examined, 56% were deficient in one area, and 42% were deficient in two areas. CONCLUSION: Reporting of randomization procedures and blinding in outcomes assessment for most implant RCTs was inadequate. Subject retention and documentation of subject withdrawals were adequately reported.

Influence of remaining coronal tooth structure location on the fracture resistance of restored endodontically treated anterior teeth.

STATEMENT OF PROBLEM: A restored endodontically treated tooth is less likely to fracture when there is axial tooth structure between the core base and preparation finish line. However, an accurate prognosis requires knowing whether fracture resistance depends on a complete circumferential distribution of tooth structure or tooth structure in a specific location related to the applied force. PURPOSE: This in vitro study investigated the fracture resistance of restored endodontically treated teeth when residual axial tooth structure was limited to one half the circumference of the crown preparation. MATERIAL AND METHODS: Fifty extracted maxillary anterior teeth were sectioned 18 mm from their apices, endodontically treated, and divided into 5 groups of 10 teeth each. Four groups were prepared with full shoulder crown preparations having axial wall heights of 2 mm around the preparation circumferences. In 3 of the groups with axial tooth structure, one half of the axial tooth structure was removed, palatally, labially, or proximally, and groups were identified according to the site of retained coronal tooth structure. For the fifth group, all axial tooth structure was removed to the level of the preparation shoulder. Thus, in 1 group the axial walls were circumferential, 360 degrees around the preparations (Complete group), in 3 groups the axial walls were continuous for 180 degrees (Palatal, Labial, and Proximal groups), and the last group had no retained coronal tooth structure incisal to the finish line (Level group). All 50 prepared teeth were then restored with quartz fiber posts (Bisco), composite resin (Bisco) cores, and metal crowns. A universal testing machine compressively loaded the tooth specimens from the palatal at a crosshead speed of 0.5 cm/min at an angle of 135 degrees to the long axis of teeth until failure occurred. A survival analysis was conducted using a log-rank test followed by Holm-Sidak pairwise tests (alpha=.05) to detect significant differences in median failure load between groups. The mode of failure was determined by visual inspection of all specimens. RESULTS: The median failure load (P<.001) was 607 N, 782 N, 358 N, 375 N, and 172 N for the Complete, Palatal, Labial, Proximal, and Level groups, respectively. The predominant mode of failure was an oblique palatal to facial root fracture for the groups with remaining coronal tooth structure. In the Level group, post debonding was the predominant mode of failure. CONCLUSION: For restored endodontically treated teeth that do not have complete circumferential tooth structure between the core and preparation finish line, the location of the remaining coronal tooth structure may affect their fracture resistance.

Effect of no ferrule on failure of teeth restored with bonded posts and cores.

This study investigated how the absence of a ferrule affected the failure load of teeth that had been restored with bonded fiber posts and resin cores. There was a significant difference (p < 0.001) between the ferrule and nonferrule groups' load to failure. For the ferrule group, root fracture was the predominant mode of failure; in the nonferrule group, debonding failures were predominant.

Study of chronic hemolytic anaemia patients in Rio de Janeiro: prevalence of anti-human parvovirus B19 IgG antibodies and the development aplastic crises.

The prevalence of anti-human parvovirus B19 IgG antibodies was determined in sera from 165 chronic hemolytic anemia patients, receiving medical care at Instituto Estadual de Hematologia (IEHE), Rio de Janeiro, during the year of 1994. This sample represents around 10% of the chronic hemolytic anemia patients attending at IEHE. Most of these patients (140) have sickle cell disease. Anti-B19 IgG antibodies were detected in 32.1% of patients. No statistically significant difference (p > 0.05) was seen between IgG antibody prevalence in male (27.8%) and female (35.5%) patients. Anti-B19 IgG antibodies were more frequent in older (37.6%) than younger (28.2%) than 20 years old patients, although this difference had no statistical significance (p > 0.05). Anti-B19 IgG antibody prevalence showed that 67.9% of patients enrolled in the study were susceptible to B19 acute infection. With the aim to detect acute B19 infection, patients follow up continued until February 1996. During this period four patients presented transient aplastic crisis due to human parvovirus B19 as confirmed by the detection of specific IgM antibodies. All four patients were younger than 20 years old, and 3 were younger than 10 years old. Three of them were sickle cell disease patients. Three of the four acute B19 infection occurred during 1994 springtime.

Study of chronic hemolytic anaemia patients in Rio de Janeiro: prevalence of anti-human parvovirus B19 IgG antibodies and the developement of transient aplastic crises

The prevalence of anti-human parvovirus B19 IgG antibodies was determined in sera from 165 chronic hemolytic anemia patients, receiving medical care at Instituto Estadual de Hematologia (IEHE), Rio de Janeiro, during the year of 1994. This sample represents around 10 percent of the chronic hemolytic anemia patients attending at IEHE. Most of these patients (140) have sickle cell disease. Anti-B19 IgG antibodies were detected in 32.1 percent of patients. No statistically significant difference (p > 0.05) was seen between IgG antibody prevalence in male (27.8 percent) and female (35.5 percent) patients. Anti-B19 IgG antibodies were more frequent in older (37.6 percent) than younger (28.2 percent) than 20 years old patients, although this difference had no statistical significance (p > 0.05). Anti-B19 IgG antibody prevalence showed that 67.9 percent of patients enrolled in the study were susceptible to B19 acute infection. With the aim to detect acute B19 infection, patients follow up continued until February 1996. During this period four patients presented transient aplastic crisis due to human parvovirus B19 as confirmed by the detection of specific IgM antibodies. All four patients were younger than 20 years old, and 3 were younger than 10 years old. Three of them were sickle cell disease patients. Three of the four acute B19 infection occurred during 1994 springtime