Αρχειοθήκη ιστολογίου

Αλέξανδρος Γ. Σφακιανάκης
ΩτοΡινοΛαρυγγολόγος
Αναπαύσεως 5
Άγιος Νικόλαος Κρήτη 72100
2841026182
6032607174

Κυριακή 4 Δεκεμβρίου 2022

In-utero Exposure to Maternal Diabetes and the Risk of Cerebral Palsy: A Population-based Cohort Study

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Background: Evidence on the effects of in utero exposure to maternal diabetes on cerebral palsy in offspring is limited. We aimed to examine the effects of pre-gestational (PGDM) and gestational diabetes (GDM) separately on CP risk and the mediating role of increased fetal size. Methods: In a population-based study, we included all live births in Ontario, Canada, between 2002–2017 followed up through 2018 (n=2,110,177). Using administrative health data, we estimated crude and adjusted associations between PGDM or GDM and CP using Cox proportional hazards models to account for unequal follow-up in children. For the mediation analysis, we used marginal structural models to estimate the controlled direct effect of PGDM (and GDM) on the risk of CP not mediated by large-for-gestational age (LGA). Results: During the study period, 5,317 children were diagnosed with CP (187 exposed to PGDM and 171 exposed to GDM). Children of mothers with PGDM showed an increased risk {hazard ratio [HR]: 1.84 [95% confidence interval (CI): 1.59, 2.14]} after adjusting for maternal sociodemographic and clinical factors. We found no associations between GDM and CP (adjusted HR: 0.91 (0.77, 1.06)). Our mediation analysis estimated that LGA explained 14% of the PDGM–CP association. Conclusions: In this population-based birth cohort study, maternal pre-gestational diabetes was associated with increased risk of CP, and the increased risk was not substantially mediated by the increased fetal size. Copyright © 2022 Wolters Kluwer Health, Inc. All rights reserved.
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The Effect of Two Different Simulation Modalities in Palliative Care Teaching on Nursing Students' Knowledge, Satisfaction, Self-confidence, and Skills: A Randomized Controlled Trial

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imageNursing students from developing countries have limited opportunities to experience palliative care. Standardized patient and low-fidelity simulations can provide realistic palliative care experiences for students. However, limited research is available on simulation-based education in Palestine. Testing and using these two types of simulation methods may be the best solution for developing countries that lack adequate resources. This study aimed to test the effects of low-fidelity simulation compared with standardized patient simulation in palliative care teaching on nursing students' knowledge, satisfaction, confidenc e, and skills. The study was a randomized controlled trial of 70 nursing students in their sophomore year. Students' knowledge was assessed with the Palliative Care Quiz for Nursing test; satisfaction and confidence with the Learner Satisfaction and Self-confidence in Learning; and skills rated by two researchers. Students' knowledge improved significantly on the posttest compared with the pretest, without significant differences between both groups. The findings showed that the utilization of the two methods in students' clinical training for scenario has the same effect on the satisfaction and confidence. The skills of the standardized patient group improved significantly more than the low-fidelity group. The study revealed that both simulation modalities are effective for palliative care nursing students.
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The association between trauma and interpersonal problems

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Abstract

Objective

Previous research has documented associations between trauma and interpersonal problems. We examined the impact of trauma on interpersonal problems among depressed patients seeking treatment in a community mental health setting.

Methods

A total of 453 patients seeking treatment and screened for a comparative effectiveness study of therapies for depression were included. We conducted analyses relating the 32-item inventory of interpersonal problems (IIP-32) to trauma measures.

Results

99.1% of the sample experienced a traumatic event. There were significant associations between the total number of traumas, the number of sexually and physically assaultive traumas, and both gender and race. The number of sexually assaultive traumas was significantly related to the IIP-32 "too caring" subscale (simple r = 0.167, p < 0.001). Controlling for demographics and other IIP-32 subscales, the total number of traumas remained significantly related to the IIP-32 "too caring" domain (partial r = 0.163, p < 0.001).

Conclusions

Traumatic events are prevalent among community populations and these experiences are associated with certain interpersonal problems. Trauma and interpersonal problems are key issues for the treatment of patients in the community mental health setting.

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Tideglusib enhances odontogenic differentiation in human dental pulp stem cells in vitro

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Abstract

Aim

Tideglusib is a small molecule agonist of the canonical Wnt pathway. The present study investigated the influence of Tideglusib on human dental pulp stem cell (hDPSC) proliferation, apoptosis, migration, and odonto/osteogenic differentiation.

Methodology

hDPSCs were treated with 50 nM, 100 nM, or 200 nM Tideglusib. β-catenin accumulation was detected by immunofluorescence staining. Colony forming unit ability was assessed by staining with Coomassie blue. Cell cycle progression and cell apoptosis were investigated using flow cytometry. Cell migration was examined using an in vitro wound healing assay. Osteogenic differentiation was examined using alkaline phosphatase (ALP) staining, alizarin red s staining, and osteogenic-related gene expression. The gene expression profile was examined using a high throughput RNA sequencing technique. All experiments were repeated using cells derived from at least four different donors (n = 4). The Mann Whitney U test was used to identify significant differences for two independent group comparisons. For three or more group comparison, statistical differences were assessed using the Kruskal Wallis test followed by a pairwise comparison. The significance level was set at 5% (p< /i> < 0.05).

Results

Tideglusib activated the Wnt signaling pathway in hDPSCs as demonstrated by an increase in cytoplasmic β-catenin accumulation and nuclear translocation. Tideglusib did not affect hDPSC proliferation, cell cycle progression, cell apoptosis, or cell migration. In contrast, 50 nM and 100 nM Tideglusib significantly enhanced mineralisation and osteogenic marker gene expression (RUNX2, ALP, BMP2, and DSPP) (p < 0.05).

Conclusions

Tideglusib enhanced the odonto/osteogenic differentiation of hDPSCs. Therefore, incorporating this bioactive molecule in a pulp capping material could be a promising strategy to promote dentine repair.

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Fenestration and dehiscence defects in maxillary anterior teeth using two classification systems

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Abstract

Background

The primary objective of the study was to assess the buccal bone thickness (BT), evaluate and compare the prevalence of bone fenestration and dehiscence in anterior maxillary teeth using cone-beam computed tomography (CBCT).

Methods

Images of 300 maxillary anterior teeth were investigated. The BT was measured at the bone crest, 3,6,9 mm from the bone crest, and apical. Fenestration and dehiscence were recorded according to Yang and Pan's classification. Student's t-test and one-way ANOVA were performed for statistical analysis.

Results

Fenestration and dehiscence rates were 35.66% and 20%, respectively. Type-III fenestration was higher in group 3(>65 years) (P=0.028). Type-I and IV fenestration and CII DII dehiscence were more common in canines (P>0.05). Fenestration involving 2/3 (46.76%) and 1/3 (44.84%) of the root length was more common. Fenestrations involving the entire root was 8.4%. Most of the dehiscence (63.3%) involved 1/3 of the root length. Dehiscence involving 2/3 of the root length and the entire root were 5% and 9.95%, respectively. The coexistence of fenestration and dehiscence was 8.3%. Dehiscence on the palatal aspect was detected in 1.65% of the anterior maxilla.

Conclusions

The rate of BT ≤1 mm was 80.08%, and ≥2 mm was 3.66%. Fenestration was most common in canines. Fenestration was mostly located in the apical third, while dehiscence was mostly located in the coronal third. © 2022 Australian Dental Association.

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Comparison of quality of life and psychological distress in patients with tongue cancer undergoing a total/subtotal glossectomy or extended hemiglossectomy and free flap transfer: a prospective evaluation

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The aim of this study was to assess changes in the quality of life and psychological distress of patients with tongue cancer undergoing total/subtotal glossectomy (TG) or extended hemiglossectomy (HG) and free flap transfer. Differences between the two groups were compared using the Short Form 8-Item Health Survey (SF-8) and Hospital Anxiety and Depression Scale (HADS). Of the 43 patients with tongue cancer, 24 (56%) underwent TG and 19 (44%) underwent HG. The general health and social functioning scores in the SF-8 and depression in the HADS were significantly worse in the TG group than in the HG group at 12 months after surgery, indicating that patients in the TG group may experience social isolation and psychological distress, and have difficulty in employability even 12 months after su...
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The Management of Salivary Fistulas

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Semin Plast Surg
DOI: 10.1055/s-0042-1759561

Postoperative salivary fistula is an especially undesirable complication because it can be difficult to address, may delay postoperative radiation, and always delays enteral nutrition. Patients who are malnourished, have already undergone radiotherapy, or are hypothyroid are at higher risk of developing this problem. Conservative measures work in most patients, but a significant percentage of patients require intervention beyond pr essure dressings and tincture of time. Medications, hyperbaric oxygen therapy, and surgical intervention may be required when fistulas do not heal in a timely manner. Decisions about the approach and timing of more aggressive interventions are part of the art of medicine since definitive scientific protocols are lacking.
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