Association between traditional Chinese medicine body constitution deviation and chronic pelvic pain: A cross-sectional study.

OBJECTIVE: Chronic pelvic pain (CPP) is one of the most challenging conditions that physicians and patients face nowadays. This study aimed to assess the traditional Chinese medicine (TCM) body constitution profiles, demographic characteristics, and lifestyle of women suffering from CPP. MATERIALS AND METHODS: This study included 378 female patients of reproductive potential from a single Obstetrics and Gynecology clinic in Taiwan. Data were collected using the Short Form 36 Health Survey Questionnaire (SF-36), the TCM Body Constitution Deviation (BCQ-44) Questionnaire, and the Behavior Rating Scale. The chi-squared test, the Kruskal-Wallis test, the Mann-Whitney U test, and Spearman's correlation were used to analyze the data. RESULTS: TCM body composition deviation was correlated with the level of pain in patients with CPP. Moreover, the quality of life (QOL) of these patients was found to be affected by the level of pain. Additionally, the QOL was correlated with the TCM body composition deviation profile. CONCLUSION: The TCM BCQ-44 can be used in the medical practice to assess patients' health status and can also serve as a guide to address the risk factors for CPP.

Sedation Quality and Cardiorespiratory, Echocardiographic, Radiographic and Electrocardiographic Effects of Intramuscular Alfaxalone and Butorphanol in Spanish Greyhound Dogs.

The quality of sedation and changes in cardiorespiratory variables after the intramuscular administration of alfaxalone and butorphanol in Spanish greyhound dogs were evaluated. Twenty-one adult dogs were included. The dogs received alfaxalone (2 mg/kg) and butorphanol (0.2 mg/kg) intramuscularly. Sedation scoring, cardiorespiratory parameters (including blood gas analysis), echocardiography, thoracic radiography and electrocardiography were performed before sedation and 30 min after drug administration. Moderate sedation was observed, and side effects, such as tremors, nystagmus and auditory hyperesthesia, were noticed. Statistically significant changes in heart rate, invasive blood pressure, pH, arterial saturation of O2 and partial pressure of O2 and CO2 were found. Echocardiographic variables, including end-diastolic volume, left ventricular diameter in diastole, aortic and pulmonic flow, diastolic transmitral flow and left atrial/aortic ratio, and electrocardiography parameters, including PQ interval and QT interval, showed statistically significant changes. In conclusion, the intramuscular administration of alfaxalone and butorphanol to healthy dogs produced moderate sedation with mild cardiorespiratory, echocardiographic and electrocardiographic changes, without alterations in cardiac size on radiographic images.

Histological and biochemical evaluation of plasma rich in growth factors treatment for grade II muscle injuries in sheep.

The purpose of this study was to perform a histological and biochemical evaluation of the influence of plasma rich in growth factors (PRGF) on muscle regeneration process after a surgically induced grade II muscle laceration. A randomized, single blind, controlled experimental research was conducted including twenty-one adult healthy sheep, randomly divided in three groups (n = 7). A grade II surgical section was performed in the biceps femoris muscle of both hindlimbs. After two days (basal time), intralesional infiltration of autologous PRGF or Saline solution was randomly administered in both hindlimbs. Treatment was repeated once a week. Animal groups were euthanized at 1 (T1), 2 (T2) or 4 (T4) weeks. Histological assessment showed that PRGF intralesional injection induced a significant decrease of inflammatory cells density, significant higher centrally nucleated fibers percentage and significantly smaller fibrotic areas compared to Saline-treated muscles at T1, T2 and T4. Also, lower vascular density, with lower capillaries cross-sectional area, in PRGF group compared to Saline was observed. Biochemical analysis revealed a significant higher expression level of MYOD1, MYF5 and MYOG genes in PRGF groups at T1 compared to Saline treated muscles. At ultrastructural level, PRGF groups presented scarce edema and loss of connective tissue structure, as well as higher mitochondrial density adequately associated to the sarcomere unit in contrast to the Saline group. In conclusion, histological, biochemical, and ultrastructural results showed that PRGF treatment improved muscle regeneration process leading to more mature histological aspect in newly formed muscle tissue after a surgically induced grade II muscle injury.

CroniCare: Platform for the Design and Implementation of Follow-Up, Control and Self-Management Interventions for Chronic and Multimorbidity Patients Based on Mobile Technologies.

The project proposes to facilitate the design and evaluation of interventions based on mobile technologies and information systems in order to improve the capacity for self-management, empowerment and control of chronic and multimorbidity patients. The system allows to create customizable apps according to the needs of primary care and specialized care. The project includes an evaluation of the impact of the care model, as well as the effectiveness and efficiency of the intervention through a study with 124 multimorbidity patients.

Determinants of Breast-Conserving Therapy in Early-Stage Breast Cancer Patients: A Nationwide Study.

INTRODUCTION: Evidence from previous studies and treatment guidelines suggested that breast-conserving therapy (BCT) is the treatment of choice for early-stage breast cancer. However, in the last decades, surgeons have noticed a high percentage of mastectomies done in this population. The aim of this study is to explore the factors associated with not choosing BCT among eligible patients with early-stage breast cancer. MATERIALS AND METHODS: This study uses a retrospective cohort design. Demographic and clinical characteristics derived from The Taiwan Cancer Registry Database, the National Health Insurance Database and the Death File Database from January 1, 2004 to December 31, 2014. Patients were followed until December 31, 2015. To explore the associated factors related to BCT, we used univariate and multivariate logistic regression analysis. RESULTS: A total sample of 25,967 stage I breast cancer patients was included. Among them, 12,191 underwent BCT and 13,776 underwent mastectomy as their primary treatment. The logistic regression analysis reveals that age, pay-for-performance (P4P) program participation, number of affected lymph nodes, tumor size and location, were determinants of BCT. Interestingly enough, histological type did not reach the significance level. CONCLUSION: This study shows that personal and clinical characteristics influence the treatment choice in stage 1 breast cancer patients.

Survival and complications with a surgical approach in advanced hypopharyngeal cancer.

BACKGROUND AND OBJECTIVES: The treatment paradigm for advanced hypopharyngeal cancer has shifted from surgical approaches to organ preservation. However, recent studies indicated that surgical approaches may be associated with better survival rates. This study aimed to conduct a head-to-head comparison of survival outcomes and complications with surgical versus nonsurgical approaches using a nationwide database. METHODS: Using a nationwide data set, we gathered 2196 propensity score-matched patients with stage III/IVa hypopharyngeal cancer. We compared survival rates and complications among patients with surgical and nonsurgical cancer treatment. RESULTS: Patients with stage III and IVa hypopharyngeal cancer who underwent initial surgery had significantly better 5-year overall survival and disease-free survival rates compared to their nonsurgical counterparts. There were no significant differences in long-term complications with regard to swallowing. CONCLUSIONS: These results suggest that patients who underwent initial surgery for advanced hypopharyngeal cancers had better survival rates and equivalent long-term function.

Determinants of Breast-Conserving Therapy in the Asian Population: A Systematic Review.

BACKGROUND: Treatment guidelines recommend breast-conserving therapy (BCT) for patients with early-stage breast cancer. However, Asian patients choose mastectomy over BCT, and the factors influencing this choice are unknown. This review aimed to identify the factors most frequently reported in the Eastern and Southeastern Asian population influencing the choice of BCT for treatment of early-stage breast cancer. METHODS: PRISMA guidelines were followed, and PubMed and EMBASE databases were used. The literature search initially identified 4619 articles; abstract screening and full-text screening were performed on 150 and 19 articles, respectively, and 9 articles were finally included in the study. RESULTS: Selection of BCT was associated with sociodemographic factors, such as high socioeconomic status and education level and young age at diagnosis; clinicopathological factors, such as small tumor size and mammographically detected tumors; and healthcare provider factors, such as treatment from a female doctor or from a breast specialist. However, not selecting BCT was associated with personal factors, such as fear of recurrence and avoidance of further treatment. CONCLUSIONS: The process of making a treatment decision is complicated and involves many factors influencing patients' choice of surgery type. Exploring these factors helps to elucidate why patients do not choose BCT as their treatment option.

Cartilage regeneration using a novel autologous growth factors-based matrix for full-thickness defects in sheep.

PURPOSE: To investigate the chondrogenic-regenerative properties of a novel autologous-made matrix composed of hyaline cartilage chips combined with a growth factors-based clot for full-thickness defects in sheep. METHODS: A full-thickness, 8-mm diameter cartilage defect was created in the weight-bearing area of the medial femoral condyle in 6 sheep. Treatment consisted of surgical implantation of an autologous-based matrix of hyaline cartilage chips combined with a clot of plasma poor in platelets and intraarticular injection of plasma rich in growth factors. Outcome measures at 1, 3 and 6 months included macroscopic International Cartilage Repair Society (ICRS) score, histological and immunohistochemical analysis for collagen expression, and transmission electron microscopy study. RESULTS: The 6-month macroscopic evaluation showed nearly normal (11.1 ± 0.7) cartilage repair assessment. The ICRS score was significantly higher at 6 months compared to 3 months (5.5 ± 1.3; p < 0.0001) and 1 (1.1 ± 0.4; p < 0.0001) month. At 6 months, hyaline cartilage tissue filling the defect was observed with adequate integration of the regenerated cartilage at the surrounding healthy cartilage margin. At 6 months, mature chondrons and cartilage matrix contained collagen fibers with masked fibrillary structure, and the expression of collagen in the newly formed cartilage was similar in intensity and distribution pattern compared to the healthy adjacent cartilage. CONCLUSIONS: This novel treatment enhanced chondrogenesis and regenerated hyaline cartilage at 6 months with nearly normal macroscopic ICRS assessment. Histological analysis showed equivalent structure to mature cartilage tissue in the defect and a collagen expression pattern in the newly formed cartilage similar to that found in adjacent healthy articular cartilage. The present technique may have clinical application for chondral injuries in humans because this procedure is cheap (no need for allograft, or expensive instrumentation/biomaterials/techniques), easy and fast-performing through a small arthrotomy, and safe (no rejection possibility because the patients' own tissue, cells, and plasma are used).

Temporal control in the voicing contrast: Evidence from surgery-related apraxia of speech.

The goal of this study was to investigate the phonetic realisation of the voicing feature in two tumour resection-related Spanish speakers with apraxia of speech. Temporal parameters related to the phonological contrast of voicing in Spanish have been analysed for intervocalic voiced and voiceless obstruents embedded in isolated words and nonwords, and compared with data collected from healthy speakers. Results indicate that in devoiced productions, where VOT values fitted the 'voiceless stops' category, vowel duration values matched those of voiced stops and suggested the preservation of contextual voicing cues. An attempt at preserving a consonant/vowel duration ratio consistent with aerodynamic predictions for voicing contrast has been observed in apraxic correct production as well as in devoicing errors, but not in the control group, which could be interpreted as a compensatory mechanism.

Evaluation of gastric and bladder tonometry as indicators of tissue perfusion in induced hypotension in dogs.

OBJECTIVE: To evaluate the use of gastric (PgCO2 ) and bladder (PbCO2 ) tonometry for assessing tissue hypoperfusion in dogs during sevoflurane-induced hypotension, and to compare these measurements with delivery of oxygen, arterial oxygen content, and plasma lactate concentration. DESIGN: Prospective experimental trial. SETTING: University veterinary teaching hospital. ANIMALS: Fourteen adult Beagle dogs. INTERVENTIONS: Anesthetic induction was performed by mask with sevoflurane and oxygen. Heart rate, direct arterial pressures, respiratory rate, and end-tidal carbon dioxide were recorded; arterial blood samples were taken to measure blood gases, and venous samples were sampled to measure plasma lactate. A tonometric catheter was introduced into the stomach to measure PgCO2 . Samples of saline from the balloon of a Foley catheter placed in the bladder were collected every 10 minutes and used to measure PbCO2 by gas analysis. Tonometry measurements, plasma lactate, and oxygen delivery and consumption were compared at 3 time points: at baseline, during hypotension, and during treatment periods. A hypotensive period (mean arterial pressure (MAP) < 60 mm Hg) of 15 minutes was induced by an overdose of sevoflurane, whereas during the treatment period, a constant-rate infusion of dopamine (10 µg/kg/min) was administered intravenously for 40 minutes. MEASUREMENTS AND MAIN RESULTS: Values for PgCO2 and PbCO2 increased significantly during the hypotensive period, and correlations were found between these values and the delivery of oxygen. Gastric tonometry values had stronger correlations compared with bladder tonometry values. CONCLUSIONS: Gastric and bladder tonometry can be used to detect hypoperfusion. Further studies are warranted to determine the potential use of gastric and bladder tonometry in assessing dogs in clinical situations.

Cardiotrophin-1 reduces ischemia/reperfusion injury during liver transplant.

BACKGROUND: Orthotopic liver transplantation (OLT) is currently the elective treatment for advanced liver cirrhosis and acute liver failure. Ischemia/reperfusion damage may jeopardize graft function during the postoperative period. Cardiotrophin-1 (CT-1) has demonstrated cytoprotective properties in different experimental models of liver injury. There is no evidence to demonstrate its potential use in the prevention of the ischemia/reperfusion injury that occurs during OLT. The present study is the first report to show that the administration of CT-1 to donors would benefit the outcome of OLT. MATERIALS AND METHODS: We tested the cytoprotective effect of CT-1 administered to the donor prior to OLT in an experimental pig model. Hemodynamic changes, hepatic histology, cell death parameters, activation of cell signaling pathways, oxidative and nitrosative stress, and animal survival were analyzed. RESULTS: Our data showed that CT-1 administration to donors increased animal survival, improved cardiac and respiratory functions, and reduced hepatocellular injury as well as oxidative and nitrosative stress. These beneficial effects, related to the activation of AKT, ERK, and STAT3, reduced caspase-3 activity and diminished IL-1ß and TNF-α expression together with IL-6 upregulation in liver tissue. CONCLUSIONS: The administration of CT-1 to donors reduced ischemia/reperfusion injury and improved survival in an experimental pig model of OLT.

Comparison of the cardiopulmonary parameters after induction of anaesthesia with alphaxalone or etomidate in dogs.

OBJECTIVE: To compare the cardiorespiratory effects and quality of induction of and recovery from anaesthesia following etomidate or alphaxalone-HPCD IV. STUDY DESIGN: Randomized 'blinded' cross-over study. Twenty-four hours was allowed between phases. ANIMALS: Eight healthy adult Beagles (four male, four female). METHODS: Dogs were anaesthetized with sevoflurane for instrumentation, then allowed to awake. They then received etomidate (treatment E) or alphaxalone-HPCD (treatment A) intravenously to effect. Heart rate (HR), body temperature, invasive arterial pressures (AP), systemic vascular resistance index (SVRI), stroke volume index, cardiac index (CI), contractility, respiratory rate, central venous pressure, and capnometry were obtained before anaesthetic induction (baseline), 30 seconds and 1 minute after induction, after intubation, one minute after intubation, and for every 5 minutes afterwards until the dog began to swallow and the trachea was extubated. Arterial bloods were taken for analyses before induction, after intubation and every 10 minutes thereafter. The dogs breathed room air. The quality of induction of and recovery from anaesthesia were scored categorically. Statistical analyses used anova for repeated measures, paired t-tests or Wilcoxon signed rank-test as relevant. Significance was set at p < 0.05. RESULTS: The induction doses required were (mean ± SD) 2.91 ± 0.41 mg kg(-1) and 4.15 ± 0.7 mg kg(-1) for treatment E and A respectively. No significant changes in cardiovascular parameters were observed with treatment E. Treatment A resulted in statistically significant increases in HR and CI and reductions of APs and SVRI. Time to extubation was longer with treatment A (25 ± 7 minutes) than with treatment E (17 ± 4 minutes). Dogs became hypoxic with both treatments. The quality of induction and recovery were excellent with treatment A, but significantly less satisfactory with treatment E (recovery score, treatment E median 1, range 0-2; treatment A median 0, range 0-1). CONCLUSIONS AND CLINICAL RELEVANCE: Alphaxalone-HPCD caused significant tachycardia and increase in CI, and statistically (but not clinically) significant decreases in APs and SVRI. Etomidate caused no statistically significant cardiovascular changes. Quality of recovery was better with alfaxalone-HPCD. Both agents caused short-lived hypoxia, and oxygen supplementation is advisable.

Associations between a history of breast feeding, malocclusion and parafunctional habits in Puerto Rican children.

UNLABELLED: Studies relating breast-feeding, malocclusion and parafunctional habits in young children are scarce. PURPOSE: The purpose of this study is to evaluate the associations of a history of breast-feeding, incidence of malocclusion and parafunctional habits. METHODS: The dental records of a sample of 540 children aged 6 to 72 months screened for oral conditions and behavioral risk factors were evaluated for variables such as a history of breastfeeding, malocclusion and parafunctional habits. Descriptive statistics using the EPI-INFO Program and Chi-square test at the 0.05 level of probability were performed. RESULTS: The results showed that the mean age of the children was 28 months +/- 14. The mothers' mean age was 26.4 years +/- 6. The prevalence of breast-feeding was 34% with a mean breast-feeding time period of 3 m +/- 3.7. About 95% of the children had a history of bottle-feeding and 90% showed some evidence of malocclusion at the time of dental examination. The main malocclusion problems were space deficiency (closed contacts among incisors) (31%), open bites (6%) and crossbites (5%). A habit of thumb sucking was reported in 32% of the cases and pacifier use in 21%. there were significant differences for the following variables: mother's age and breast-feeding time period; number of children in family and breast-feeding time period; breast-feeding history and breast-feeding time with bottle use, malocclusion and thumb sucking habit; and gender and thumb-sucking habit. CONCLUSION: It is concluded that breast-feeding practices and time period are behavioral factors that contribute in the prevention of malocclusion in addition to decreasing the practice of parafunctional habits in preschool children.

Tratamiento odontológico bajo anestesia general ofrecido por el Hospital Pediátrico Universitario de Puerto Rico durante los años 1989-1994 / Dental treatment under general anesthesia offered at the Hospital Pediátrico Universitario de Puerto Rico during the years 1989-1994

One hundred and fourteen mentally retarded (MR) and non-mentally retarded (NMR) patients were divided into two groups and categorized according to the condition presented. Age, sex, and type of procedure performed were recorded for each patient. On the MR group 32 per cent were over 17 years of age. On the NMR group 51 per cent were under 6 years of age. The sex distribution was similar in both groups. Exodontia was the most frequently performed dental procedure. The MR group was composed of those who presented only mental retardation (42 per cent), cerebral palsy (17 per cent), epilepsy (15 per cent), syndromes (7 per cent), endocrinopathies (7 per cent), hydrocephalus (5 per cent) and other conditions (7 per cent). The NMR group was composed of those who presented cardiopathy (7 per cent), bottle syndrome (42 per cent), hemotopathy (11 per cent), maxillofacial disorders (24 per cent) and other conditions (16 per cent).