Effects of a Dementia Special Care Unit on the Changes in Physical Function, Cognitive Function, and Problematic Behaviors among Nursing Home Residents.

BACKGROUND: This study compared changes in physical function, cognitive function, and problematic behaviors among nursing home residents with dementia between the dementia specialized care and general units. METHODS: To assess the effects of a dementia specialized care unit (D-SCU), this study applied the difference-in-differences method. While the D-SCU was introduced in July 2016, the service was provided in January 2017. We defined the pre-intervention period as July 2015 to December 2016 and the post-intervention period as January 2017 to September 2018. We matched long-term care (LTC) insurance beneficiaries using the propensity score matching method to minimize selection bias. After this matching, two new groups were obtained, each with 284 beneficiaries. To characterize the actual effects of the D-SCU on physical function, cognitive function, and problematic behaviors among dementia beneficiaries, we conducted a multiple regression analysis that controlled for demographics, LTC need, and LTC benefit utilization. RESULTS: The physical function score significantly increased according to the time effect, and the interaction term between time and the use of D-SCU was significant. Therefore, the activities of daily living (ADL) score of the control group increased by 5.01 points more than that in the group of beneficiaries using the D-SCU (p<0.001). However, the interaction term had no significant effect on cognitive function or problematic behavior. CONCLUSION: These results revealed the partial effect of the D-SCU on LTC insurance. Further research is required that considers the variables of service providers.

Vestibular evoked myogenic potential according to middle ear condition in chronic otitis media with tympanic membrane perforation.

CONCLUSION: Vestibular evoked myogenic potential (VEMP) function results can vary between individuals with different middle ear conditions. Therefore, by analyzing VEMP results after paper patching, we can predict the condition of the middle ear in chronic otitis media (COM) patients. OBJECTIVES: VEMP responses decrease with impairment of sound transmission, such as in conductive hearing loss (CHL). COM with tympanic membrane (TM) perforation is a common disorder that causes various degrees of CHL. The aim of this study was to evaluate and clarify the VEMP responses in patients with COM with different middle ear pathology. METHODS: This study included 50 patients with unilateral COM with TM perforation. Initial pure-tone audiometry (PTA) and VEMP responses were recorded. After paper patching, PTA and VEMP were re-performed. Each VEMP response was compared with those of the healthy controls. Moreover, VEMP responses between pre- and post-paper patching were compared. RESULTS: There was a positive correlation between normalizing of VEMP parameters, such as p13 and VEMP asymmetry ratio (VAR), and reduction of air-bone gap in patients with COM after paper patching. The VEMP response in patients with COM with intact ossicle and clean mucosa was more normalized compared with those in patients with COM with different middle ear conditions.

Associations between promoter polymorphism -106A/G of interleukin-11 receptor alpha and papillary thyroid cancer in Korean population.

BACKGROUND: The interleukin11 (IL11) and IL11 receptor alpha (IL11RA) are involved in cellular growth, differentiation, invasiveness, and tumor progression in several tumors. We investigated whether coding single nucleotide polymorphisms (cSNPs) of IL11 and promoter SNP IL11RA would contribute to the development of papillary thyroid cancer (PTC). We also assessed the relationships between IL11 and IL11RA SNPs and the clinicopathologic characteristics of PTC. METHODS: One coding SNP, designated as rs1126757, Ala82Ala, in IL11 and one promoter SNP, designated as rs1061758, -106A/G, in IL11RA were genotyped using direct sequencing in 94 patents with PTC and 213 patients without PTC (controls). Genetic data were analyzed using commercially available software. The patients with PTC were dichotomized and compared with respect to clinicopathologic characteristics of PTC. RESULTS: We found an association between PTC and the coding SNP(rs1061758) in IL11RA (codominant model 1 [G/G vs. A/G], odds ratio [OR] = 2.91, 95% confidence interval [CI], 1.44-5.89; P = .003; codominant model 2 [G/G vs. A/A], OR = 2.95, 95% CI, 1.30-6.72; P = .01; and dominant model, OR = 2.92, 95% CI, 1.47-5.80; P = .002). Moreover, SNP rs1061758 in IL11RA was associated with the multifocality of PTC (codominant model 2 [A/A vs. G/G], OR = 9.56, 95% CI, 1.77-51.69; P = .009; and recessive model, OR = 7.22, 95% CI, 1.72-30.3; P = .007). Genotype and allele analyses of SNP variant rs1126757 in IL11 revealed no statistically significant differences between patients with PTC and controls. CONCLUSION: Our results suggest that an IL11RA promoter polymorphism--rs1061758--may be associated with the risk of PTC in the Korean population. In addition, rs1061758 might be related to the multifocality of PTC.

Changes in taste function related to obesity and chronic otitis media with effusion.

OBJECTIVE: To evaluate changes in taste threshold in patients with chronic otitis media with effusion (COME) and their relationship with body mass index. A relationship has been suggested between pediatric obesity and COME, and we hypothesized that changes in taste function may occur in children with COME and that such changes may be associated with changes in body weight. DESIGN: A prospective, nonrandomized, case-control study. SETTING: A university tertiary care center. SUBJECTS: The experimental group comprised 42 children with COME who underwent tympanostomy tube insertion, and the control group, 42 children without otitis media with effusion. Patients were enrolled between September 2007 and August 2009. MAIN OUTCOME MEASURE: Taste threshold was measured by electrogustometry, and 4 standard taste solutions (sucrose, sodium chloride, citric acid, and quinine hydrochloride) were used in chemical taste tests. RESULTS: Body mass index was significantly higher in the COME than in the control group (P = .02). Electrogustometry showed that the anterior part of the tongue had a significantly higher taste threshold in the COME than in the control group (anterior right, P = .03; anterior left, P = .04), and chemical taste test results showed that sweet and salty tastes were significantly lower in the COME group (sweet, P = .02; salty, P = .04). CONCLUSION: These results showed that COME can cause changes in taste and that these changes may be related to pediatric obesity.

IgA and Differentiation-associated Transcription Factors in Chronic Otitis Media with Effusion.

OBJECTIVES: Inadequate antibody responses to pathogens may lead to the recurrence of otitis media with effusion (OME). Although B-cell production by antibodies is controlled by transcription factors, the status of these factors has not been assessed in patients with OME. METHODS: Expression of immunoglobulin was measured by enzyme-linked immunosorbent assay. Expression of transcription factors Bcl-6, Blimp-1, Pax-5, and XBP-1 was assessed by RT-PCR in the middle-ear fluid of 29 children with >4 OME episodes in 12 months or >3 episodes in 6 months (the OME-prone group) and in 32 children with <3 OME episodes in 12 months (OME group). The relationship between recurrence of OME and expression levels of immunoglobulins and transcription factors in middle-ear fluid was determined. RESULTS: The concentration of IgA in middle-ear fluid was significantly lower in the OME-prone than in the OME group, as was the expression of mRNA encoding the transcription factors Blimp-1 and XBP-1 (P<0.05 each). Expression of mRNA encoding the transcription factors Bcl-6 and Pax-5 was more intense in the OME-prone than in the OME group, but these differences were not significant (P>0.05). CONCLUSION: Lower concentrations of IgA, Blimp-1 and XBP-1 in middle ear fluid of patients with OME may be related to OME recurrence and chronicity.