The influence of composite resin restorations and lining on radiographic diagnosis and decision-making: an in vitro investigation

The objective of this study was to evaluate the influence of resin-based restorations on the interpretation of digital and conventional radiographic images and to correlate the proposed diagnosis with decision-making. Class II cavities were prepared in one of the proximal surfaces of extracted human molars. Teeth were divided into five groups (n = 10) according to the restoratives used: Natural Flow (NF) and Filtek Supreme (FS); Filtek Flow (FF) and FS; Tetric Flow (TF) and FS; Protect Liner F (PLF) and FS; and FS alone. Bitewing radiographs were taken using conventional and digital systems. Subjective analysis was performed for each surface: no restoration; restored teeth; or restored teeth with gap. Based on the given diagnosis, clinical conduct was then indicated. Material radiopacity was determined according to ISO 4049. A Fisher exact test evaluated the influence of the restoratives on the diagnosis. Means were compared using ANOVA and the Games-Howell test. A Friedman test was used to analyze the influence of the systems on the diagnosis, and a binomial test was used to analyze the association between the presence of gaps and the decision to replace the restoration (P = 0.05). For each system, TF+FS was significantly associated with a high percentage of correct diagnoses. The opposite was the case for PLF+FS, which differed from all other groups. Radiographic systems presented similar behaviors, except for NF+FS. Apart from PLF, adequate radiopacity was observed. Diagnosis was influenced by restorative materials, regardless of the radiographic system used. The low radiopacity of PLF led to a greater number of erroneous diagnoses. Moreover, the decision-making process was influenced strongly by the given diagnosis.     

Patient education in Parkinson's disease: Formative evaluation of a standardized programme in seven European countries

OBJECTIVE: To evaluate a newly developed education programme for Parkinson's disease (PD) patients. METHODS: The programme consisted of eight sessions and aimed at improving knowledge and skills related to self-monitoring, health promotion, stress management, depression, anxiety, social competence, and social support, all with special reference to PD. The programme was formatively evaluated in seven European countries (Spain, Finland, Italy, The Netherlands, United Kingdom, Estonia, Germany) with 151 patients diagnosed with idiopathic PD. The evaluation included patients' ratings of the comprehensibility and feasibility of the programme as well as mood ratings before and after each session. Patients also completed questionnaires at the beginning and end of the programme to explore possible changes in disease-related psychosocial problems, quality of life, and depression. RESULTS: The programme was feasible to run, and patients were able to understand its elements. Patients reported mood elevations following individual sessions and reduced disease-related psychosocial problems after completing the programme. There were no substantial differences in results between cultures. CONCLUSION: Patient education appears to have potential as a useful and feasible intervention, complementing medical treatment in PD. PRACTICE IMPLICATIONS: The present programme will soon be available in seven European languages and can be tested in different health care systems.     

Father’s obesity programs the adipose tissue in the offspring via the local renin–angiotensin system and MAPKs pathways,especially in adult male mice

Purpose

Studies demonstrated the influence of mother’s obesity on offspring. However, the father is also related to programming the future generation. The study aimed to evaluate the effects of father’s obesity upon white adipose tissue (WAT) remodeling, resulting in activation of signaling pathways and inflammation in male and female offspring.

Methods

Male C57BL/6 mice received control diet (lean father group; 17% energy from lipids) or high-fat diet (obese father group; 49% energy from lipids) for 8 weeks before mating. The mothers received control diet throughout the experiment. Mice were mated: lean mother and lean father, and lean mother and obese father. Offspring received control diet from weaning until 3 months of age when they were studied.

Results

In the offspring, father’s obesity led to decreased QUICKI with impairment of the insulin signaling pathway in both sexes. In line with these findings, in white adipose tissue, male offspring demonstrated hypertrophied adipocytes, enhanced proinflammatory cytokines, overactivation of components of the local renin–angiotensin system (RAS) and extracellular signal-regulated kinase 1/2 (ERK1/2), and inhibition of peroxisome proliferator-activated receptors (alpha and gamma).

Conclusions

We observed that father’s obesity influences the offspring in adult life, with an impairment in insulin homeostasis, adipocyte remodeling, and adipose tissue overexpression of IL-6 and TNF-alpha in male offspring. The activation of local RAS and ERK1/2, a concomitant PPAR diminishing, and impairment in phosphorylation of AKT and IRS-1 could explain at least in part the findings regardless of the increase in body mass in the offspring.

     

Depression and Its Correlates Among Brazilian Immigrants in Massachusetts,USA

The goal of this paper is to assess the frequency of depression symptoms among Brazilian immigrants living in Massachusetts, the second largest Brazilian immigrant population in the United States, and to identify correlates of depression. A convenience sample of Brazilian immigrants aged 18 or older residing in Massachusetts was used. Data were collected from December 2013 to March 2014, in the Consulate General of Brazil in Boston and in three religious events, using a structure questionnaire and the Center for Epidemiological Studies Depression Scale (CES-D). Depression symptoms were observed in 35.3% of the respondents, with equal distribution by sex. Correlates of depression were low income, being single, poor English proficiency, and poor self-perception of health. These results suggest a need for community outreach, sensitization, and counseling, in Portuguese and adapted to the culture of Brazilian immigrants.     

Pharmacy technician involvement in community pharmacy medication therapy management

Objectives

To assess the impact of technician involvement on the completion of medication therapy management (MTM) services in a community pharmacy setting and to describe pharmacists' and technicians' perceptions of technician involvement in MTM-related tasks and their satisfaction with the technician's role in MTM.

Neuroprotective effect of omega-3 polyunsaturated fatty acids in the 6-OHDA model of Parkinson's disease is mediated by a reduction of inducible nitric oxide synthase

Objective: Parkinson's disease (PD) is characterized by deterioration of the nigrostriatal system and associated with chronic neuroinflammation. Glial activation has been associated with regulating the survival of dopaminergic neurons and is thought to contribute to PD through the release of proinflammatory and neurotoxic factors, such as reactive nitric oxide (NO) that triggers or exacerbates neurodegeneration in PD. Polyunsaturated fatty acids (PUFAs) exert protective effects, including antiinflammatory, antiapoptotic, and antioxidant activity, and may be promising for delaying or preventing PD by attenuating neuroinflammation and preserving dopaminergic neurons. The present study investigated the effects of fish oil supplementation that was rich in PUFAs on dopaminergic neuron loss, the density of inducible nitric oxide synthase (iNOS)-immunoreactive cells, and microglia and astrocyte reactivity in the substantia nigra pars compacta (SNpc) and striatal dopaminergic fibers.

Methods: The animals were supplemented with fish oil for 50 days and subjected to unilateral intrastriatal 6-hydroxydopamine (6-OHDA)-induced lesions as a model of PD.

Results: Fish oil mitigated the loss of SNpc neurons and nerve terminals in the striatum that was caused by 6-OHDA. This protective effect was associated with reductions of the density of iNOS-immunoreactive cells and microglia and astrocyte reactivity.

Discussion: These results suggest that the antioxidant and antiinflammatory properties of fish oil supplementation are closely related to a decrease in dopaminergic damage that is caused by the 6-OHDA model of PD.     

An Economic Evaluation of the Impact,Cost, and Medicare Policy Implications of Chronic Nonhealing Wounds

Objective

The aim of this study was to determine the cost of chronic wound care for Medicare beneficiaries in aggregate, by wound type and by setting.