Social and emotional cognition in patients with severe migraine consulting in a tertiary headache center: A preliminary study

Twenty-three severe migraine participants were studied to investigate social and emotional cognition features and explore their relationship with depression, anxiety and alexithymia. In comparison to normative data, 74% were under the norm for the Faux Pas subtest, 13% for the facial emotion recognition subtest and 52% for the overall composite score of the mini-SEA. Factor 1, Factor 3, and the total score of the TAS-20 were negatively correlated with the Faux Pas subtest. Our preliminary study shows that severe migraine patients present difficulties in inferring mental states, which could be related to alexithymia. It would be useful to identify these impairments in order to improve the quality of care provided.Clinical Trials registration number: NCT03577548.     

Could medications and biologic factors affect post-orthodontic tooth movement changes? A systematic review of animal studies

Immediately after the removal of orthodontic appliances, the teeth might start to drift away from their corrected position in an attempt to reach a new equilibrium. Medications and biologic factors could potentially modulate these processes. The objective of the present systematic review is to systematically investigate and appraise the quality of the evidence regarding the effect of various medications and biologic factors on the rate of relapse following active tooth movement. Search without restrictions in eight databases and hand searching until April 2020 were conducted. Studies performed on animal models investigating the effects of medication and biologic factors on the rate of relapse following orthodontic tooth movement were considered. Following study retrieval and selection, relevant data were extracted and the risk of bias was assessed. Seventeen studies were finally identified, mostly at either high or unclear risk of bias. Ketorolac did not show any significant effects on relapse, while the administration of tetracycline, atorvastatin, psoralen and raloxifene decreased it. Overall, the same result was observed with bisphosphonates with the exception of low dosage of risedronate, which did not have an effect. Osteoprotegerin and strontium resulted in reduced relapse, but not in the immediate post-administration period. Inconsistent or conflicting effects were noted after the use of simvastatin and relaxin. The quality of the available evidence was considered at best as low. It can be concluded that specific medications and biologic factors may have an effect on the rate of relapse following tooth movement. The orthodontist should be knowledgeable about the substances potentially affecting retention.     

Physical activity as a proxy to ameliorate inflammation in patients with type 2 diabetes and periodontal disease at high cardiovascular risk

While the beneficial impact of physical activity has been ascertained in a variety of pathological scenarios, including diabetes and low-grade systemic inflammation, its potential remains still putative for periodontal health. Periodontal disease has been associated with inflammatory systemic alterations, which share a common denominator with type 2 diabetes mellitus and cardiovascular disease. Physical exercise, along with nutritional counseling, is a cornerstone in the treatment and prevention of type 2 diabetes, also able to reduce the prevalence of periodontal disease and cardiovascular risk. In addition, considering the higher incidence of periodontitis in patients with type 2 diabetes compared to healthy controls, the fascinating research question would be whether physical activity could relieve the inflammatory pressure exerted by the combination of these two diseases. This multi-disciplinary viewpoint discusses available literature in order to argument the hypothesis of a “three–way relationship” linking diabetes, periodontitis, and physical activity.     

逐瘀止血汤加减治疗慢性子宫内膜炎气虚血瘀证的疗效观察

目的 评价逐瘀止血汤加减对慢性子宫内膜炎（CE）气虚血瘀证患者妊娠结局的影响及对免疫炎症因子的调节作用。方法 将144例患者随机按数字表法分为观察组和对照组各72例。观察组脱落、失访4例，剔除2例，完成66例；对照组脱落、失访3例，剔除5例，完成65例。两组均给予抗感染治疗14 d。对照组口服妇科千金片，6片/次，3次/d。观察组内服逐瘀止血汤加减，1剂/d。两组疗程均为3个月，并随访6个月。记录治疗前后月经经量、经期和周期变化情况；进行治疗前后宫腔镜和阴道彩色多普勒超声检查，评价子宫内膜形态、子宫内膜容受性（CP）［子宫内膜厚度、阻力指数（RI），搏动指数（PI）和血流指数（FI）］等，并进行子宫内膜病理检查；进行治疗前后气虚血瘀证评分；检测治疗前后月经血白细胞介素-1β（IL-1β），IL-6和肿瘤坏死因子-α（TNF-α）水平和外周血测T淋巴亚群（CD3⁺，CD4⁺，CD8⁺）水平；随访记录妊娠情况和流产情况。进行安全性评价。结果 治疗后观察组经量、经期、周期和月经完全正常率均高于对照组（P<0.05）；观察组子宫内膜厚度和FI均高于对照组（P<0.01），RI和PI均低于对照组（P<0.01）；观察组月经血IL-1β，IL-6和TNF-α水平均低于对照组（P<0.01）；观察组CD3⁺，CD4⁺水平和CD4⁺/ CD8⁺均高于对照组（P<0.01），CD8⁺水平低于对照组（P<0.01）；在6个月随访期间，观察组妊娠率46.97%（31/66），高于对照组的27.69%（18/65）（χ²=5.197，P<0.05）；观察组子宫内膜形态疗效总有效率为96.97%（64/66），高于对照组的86.15%（56/65）（χ²=4.981，P<0.05）；观察组子宫内膜病理组织疗效总有效率为95.45%（63/66），高于对照组的84.62%（55/65）（χ²=4.304，P<0.05）；观察组综合临床疗效总有效率为93.94%（62/66），高于对照组的81.54%（55/65）（χ²=4.696，P<0.05）；两组治疗期间均未发现与中药相关不良反应。结论 逐瘀止血汤加减治疗CE气虚血瘀证患者，可调经月经、减轻临床症状，改善宫腔镜下内膜形态，调节全身和局部的免疫炎症反应，提高了CP，从而改善了妊娠结局，有着较好的综合疗效，且安全。     

阿奇霉素序贯给药辅助治疗小儿大叶性肺炎的效果及对患儿血清炎症因子水平的影响

目的探讨阿奇霉素序贯给药辅助治疗小儿大叶性肺炎的效果及对患儿血清炎症因子水平的影响。方法回顾性分析我院2014年10月至2019年10月收治的120例大叶性肺炎患儿的临床资料,根据治疗方式的不同将其分为对照组(60例,阿奇霉素静脉滴注治疗)和观察组(60例,阿奇霉素序贯给药治疗)。比较两组的治疗效果、不良反应情况、血清炎症因子及肺功能指标水平。结果观察组的治疗总有效率显著高于对照组,不良反应总发生率显著低于对照组(P<0.05)。治疗后,两组的TNF-α、PCT、IFN-γ、TM水平均降低,FVC、TLC、Cdyn水平均升高,且观察组显著优于对照组(P<0.05)。结论阿奇霉素序贯给药辅助治疗小儿大叶性肺炎的效果显著,可有效改善患儿血清炎症因子水平和肺功能指标水平,降低不良反应发生率,值得临床推广应用。     

Patients Are Knowledge Workers in the Clinical Information Space

Background  Limited research exists on patient knowledge/cognition or “getting inside patients'' heads.” Because patients possess unique and privileged knowledge, clinicians need this information to make patient-centered and coordinated treatment planning decisions. To achieve patient-centered care, we characterize patient knowledge and contributions to the clinical information space. Methods and Objectives  In a theoretical overview, we explore the relevance of patient knowledge to care provision, apply historical perspectives of knowledge acquisition to patient knowledge, propose a representation of patient knowledge types across the continuum of care, and include illustrative vignettes about Mr. Jones. We highlight how the field of human factors (a core competency of health informatics) provides a perspective and methods for eliciting and characterizing patient knowledge. Conclusion  Patients play a vital role in the clinical information space by possessing and sharing unique knowledge relevant to the clinical picture. Without a patient''s contributions, the clinical picture of the patient is incomplete. A human factors perspective informs patient-centered care and health information technology solutions to support clinical information sharing.     

阻塞性睡眠呼吸暂停患者血清甲状腺功能指标变化及其影响因素

目的:探讨阻塞性睡眠呼吸暂停患者,血清甲状腺功能指标变化情况,以及相关影响因素。方法:选取2017年6月至2020年6月江门市第二人民医院收治的阻塞性睡眠呼吸暂停患者60例作为研究对象,根据患者的病情,将其分为轻度组(n=20)、中度组(n=21)和重度组(n=19),同时选取非阻塞性睡眠呼吸暂停患者25例作为对照组,了解每组患者的血清甲状腺功能指标情况。结果:中度、重度非阻塞性睡眠呼吸暂停患者的BMI、TSH等指标,明显高于轻度组与对照组。结论:阻塞性睡眠呼吸暂停患者的间歇性缺氧可导致甲状腺激素水平下降。