Sociodemographic,behavioral, and clinical factors associated with low atrial fibrillation knowledge among older adults with atrial fibrillation: The SAGE-AF study

BackgroundManagement of AF requires patient engagement in disease management which requires adequate knowledge about AF.ObjectiveTo identify the patient characteristics associated with low AF knowledge among older adults with AF.MethodsThe SAGE-AF cohort enrolled adults aged ≥65 diagnosed with AF in 2016?2018. Patient characteristics associated with low AF knowledge (<6/8 JAKQ items correct) were examined using multivariable adjusted logistic regression models.ResultsParticipants (N = 950) were on average 74 years old (SD: 6.7), 50 % female, and 87 % non-Hispanic white. The average JAKQ score was 68.7 (SD: 17.1), and 78 % had low AF knowledge. Participants aged ≥ 75 (OR: 1.55, 95 % CI: 1.03, 2.33), without a college degree (OR: 0.46, 95 % CI: 0.32, 0.65), cognitively impaired (OR: 1.72, 95 % CI: 1.15, 2.58), with a history of anxiety (OR: 1.76, 95 % CI: 1.09, 2.83), myocardial infarction (OR: 1.82, 95 % CI: 1.08, 3.07), and heart failure (OR: 1.84, 95 % CI: 1.16, 2.91) were more likely to have low AF knowledge.Practice implicationsCharacteristics available in the electronic medical record may identify patients at risk for low AF knowledge. Formal assessment of AF knowledge may identify areas of weakness and allow for targeted education.     

Dental stem cells as an alternative source for cardiac regeneration

Dental tissues contains stem cells or progenitors that have high proliferative capacity, are clonogenic in vitro and demonstrate the ability to differentiate to multiple type cells involving neurons, bone, cartilage, fat and smooth muscle. Numerous experiments have demonstrated that the multipotent stem cells are not rejected by immune system and therefore it may be possible to use these cells in allogeneic settings. In addition, these remarkable cells are easily abundantly available couple with less invasive procedure in isolating comparing to bone marrow aspiration. Here we proposed dental stem cells as candidate for cardiac regeneration based on its immature characteristic and propensity towards cardiac lineage via PI3-Kinase/Aktsignalling pathway.     

Impact of carotid tortuosity on outcome after endovascular thrombectomy

Neurological Sciences - Endovascular thrombectomy (EVT) is efficacious in patients with large vessel occlusion stroke (LVO). We explored whether internal carotid (ICA) tortuosity increases the...     

Primary Immunodeficiency Diseases in Children: 15 Year Experience in a Tertiary Care Medical Center in Qatar

Background

Primary immunodeficiency diseases (PID) are a group of heterogeneous, rare, genetic, mainly childhood disorders that affect specific components of immune system leading to serious complications.

Objectives

This study is aimed at describing the prevalence and the categories of PID, the ages of onset and the diagnosis, the clinical presentations, the treatment modalities and the overall outcome of affected patients.

Materials and Methods

A retrospective study was conducted on 131 pediatric patients (aged 0–14 years) diagnosed with PID at Hamad General Hospital during a 15-year period (1998–2012).

Results

Data of 131 patients (75 males & 56 females) was analyzed with an estimated prevalence of 4.7 PID patients per 100,000 children younger than 14 years of age. The most common type of PID was predominantly antibody deficiency (23.7 %), followed by other well-defined immunodeficiency syndromes (22.9 %), 19.1 % combined T and B cell immunodeficiency, but rare CVID, and no cases of complement deficiency. The mean onset age was 24.01 months and diagnosis age was 42.2 months. Recurrent infections, particularly pneumonia (48.9 %), failure to thrive (34.4 %), otitis media (26 %), sepsis (23.7 %), and chronic diarrhoea (21.4 %) were commonest presenting conditions. P. aeruginosa (15.7 %), Salmonella species (13.2 %), and Non-TB mycobacteria (13.2 %) were the most common bacterial isolates. The overall mortality rate was 21.4 % with combined immunodeficiency’s accounting for 53.4 % of deaths.

Conclusions

This study reveals that PIDs are not rare in children in Qatar; and like other studies predominantly antibody deficiencies are the most common. Strategies that reinforce awareness and education of practicing physicians, bone marrow transplantation, and establishing PID national registry should be adopted to reduce mortality and morbidity of PID patients in Qatar.     

Prospective Clinical Trial Evaluating a New Implant System for Implant Survival,Implant Stability and Radiographic Bone Changes

Background: There are a few prospective studies reporting on new implant systems. When a new implant is brought to market, prospective trials should be carried out to determine the predictability of that system. Purpose: This prospective study evaluates implant survival, Resonance Frequency Analysis (RFA), and crestal bone level changes for a new implant system (Neoss System, Bimodal surface, Neoss Ltd, Harrogate, UK). Materials and Methods: Seventy‐six patients, 38 females (age ranging from 23 to 57 years) and 38 males (ranging in age from 17 to 85 years) received 100 Neoss implants. Patients were consecutively enrolled in the study if they were missing one or more teeth in either arch, or a single tooth was scheduled for removal and immediate implant replacement. Evaluated implants were 4, 4.5, or 5 mm wide and were 7, 9, 11, 13, or 15 mm long. A one‐stage approach was followed. At first stage and prior to healing abutment placement RFA measurements were taken. Measurements were retaken at second stage. Fifty‐one implants were placed for restoration of single missing teeth and 49 were for short span implant bridges. Results: The cumulative survival rate at 1‐ to 2‐year interval was 93%. Average initial RFA measurement for all implants was 72.06, while the average final score was 72.58. These changes were not statistically significant. Changes in RFA scores for maxillary implants were insignificant. Forty‐two paired mandibular RFA measurements were evaluated. Initial and final mean mandibular RAF measurements were 73.65 (SD 9.203) and 77.186 (SD 6.177), respectively. These changes were statistically significant (p = .02). Sixty‐four paired radiographs were available for evaluation. Between examinations, there was an average –0.6 mm of bone loss, which was statistically significant (p = .03). On average, 4.0‐mm‐wide implants lost 0.1 mm of bone when compared with 5‐mm‐wide implants. These differences were insignificant (p = .86). Bone loss was adjusted for implant length, and tooth position and there were small, but clinically insignificant changes. Five‐millimeter‐wide implants lose 0.2 mm more than 4.0‐mm‐wide implants (p = .7). Maxillary incisors lose the least amount of bone 0.152 (p = .33). Conclusions: The implants tested in this study had initially high RAF readings, indicating good primary stability. RFA readings for implants placed in the mandible improved from baseline and the changes were statistically significant. Marginal bone levels revealed clinically insignificant bone loss from implant installation to second stage. Loss of seven implants with initially high RFA readings is surprising.     

Dental arch parameters of the displacement and nondisplacement sides in subjects with unilateral palatal canine ectopia

Objective:To compare arch perimeter and teeth size, number, and shape between the two sides of the dental arch—the canine displacement side (DS) and the nondisplacement side (NDS)—in subjects with unilateral palatally displaced canine (PDC).Materials and Methods:Orthopantomograms (OPTs) of 240 subjects with unilateral PDC and 240 OPT matching controls were used. Additionally, study casts of 100 study subjects and 100 controls were used. The age of subjects ranged between 14 and 25 years. Dental casts were digitized and several parameters were recorded.Results:The transverse width from midpalatal line to the buccal segment and the palatal area on the DS was larger than that in the NDS (P < .05 to .001), with no difference in tooth size between both sides. Maxillary second premolars, canines, and lateral incisors in the PDC group were smaller than those in control group. Peg-shaped lateral incisors were significantly more frequent in the study group (P < .001).Conclusions:The transverse width of the DS was larger than that of the NDS. Both sides were generally smaller than those of the control group. Tooth size in the DS was comparable to that in the NDS but smaller than those of the control group. A missing or peg-shaped lateral incisor was the most common reported anomaly.     

Influence of Mg/CTAB ratio on the structural,physicochemical properties and catalytic activity of amorphous mesoporous magnesium silicate catalysts

This study investigated the physicochemical and catalytic properties of mesoporous magnesium silicate catalysts prepared at various Mg/CTAB ratios (0.25, 0.50, 0.75 and 1.00). The XPS analysis detected a mixture of enstatite and magnesium carbonate species when the Mg/CTAB ratio was 0.25, and 0.50. A mixture of forsterite and magnesium carbonate species were detected when the Mg/CTAB ratio was 0.75 whereas for the Mg/CTAB ratio of 1.00, enstatite and magnesium metasilicate species were detected. A catalyst with the Mg/CTAB ratio of 1.00 demonstrated the highest catalytic activity in the oxidation of styrene. The styrene conversion rate was 59.0%, with 69.2% styrene oxide (StO) selectivity. The H₂O₂ molecules were activated regio-specifically by the magnesium species to prevent rapid self-decomposition while promoting selective interaction with styrene. All the parameters that influence the styrene conversion and product selectivity were evaluated using analysis of variance (ANOVA) with Tukey''s test. The ANOVA analysis showed that the reaction time (h), Mg/CTAB ratio, styrene/H₂O₂ ratio, catalyst loading (mg) and temperature (°C) affect styrene conversion and product selectivity (StO) significantly (p < 0.05). The oxidation of styrene was well fitted to the pseudo-first-order model. The activation energy, E_a of the catalysed styrene epoxidation reaction was calculated to be 27.7 kJmol⁻¹. The catalyst can be reused several times without any significant loss in its activity and selectivity. The results from this study will be useful in designing and developing low cost, high activity catalysts from alkaline earth metals.

Increasing the magnesium content in direct synthesis will lead to the formation of different magnesium active sites that increase the styrene oxide selectivity under the same reaction conditions.