A comparative study of masticatory performance in complete denture patients before and after application of soft liner

BackgroundTo compare the masticatory performance in complete denture patients before and after application of soft liner and to assess the effect of aging of soft liner on masticatory performance at different intervals of time.MethodsA total of 30 complete denture wearers between age of 64 and 80 years, were selected from both the sex (20 men, 10 women). This study evaluated the effect of before and after application of chair-side soft liner on masticatory performance of complete denture wearers by using raw carrots and roasted peanut as the test food. This study further evaluated the cushioning effect of chair-side soft liner material at the interval period of 1week, 4 weeks, 8 weeks, 12 weeks and 16 weeks.ResultsThere were significant differences in masticatory performance without soft liner as compared to with soft liner at different intervals of time. The performance was found to be significantly higher for raw carrot as compared to roasted peanut (p < 0.001). For both the materials peak performance was recorded at 4th week.ConclusionThe use of soft liner helps in increasing the masticatory performance among complete denture wearers.     

Contemporary Management of Ischemic Mitral Regurgitation at Coronary Artery Bypass Grafting

BackgroundRecent guidelines for the treatment of moderate or severe ischemic mitral regurgitation (IMR) in patients undergoing coronary artery bypass grafting (CABG) have changed. This study assessed the real-world impact of changing guidelines on the management of IMR during CABG over time. We hypothesized that the utilization of mitral valve repair for IMR would decrease over time, whereas mitral valve replacement for severe IMR would increase.MethodsPatients undergoing CABG in a statewide collaborative database (2011-2020) were stratified by severity of IMR. Trends in mitral valve repair or replacement were evaluated. To account for differences of the patients, propensity score–matched analyses were used to compare patients with and without mitral intervention.ResultsA total of 11,676 patients met inclusion criteria, including 1355 (11.6%) with moderate IMR and 390 (3.3%) with severe IMR. The proportion of patients undergoing mitral intervention for moderate IMR decreased over time (2011, 17.7%; 2020, 7.5%; P_trend = .001), whereas mitral replacement for severe IMR remained stable (2011, 11.1%; 2020, 13.3%; P_trend = .14). Major morbidity was higher for patients with moderate IMR who underwent mitral intervention (29.1% vs 19.9%; P = .005). In a propensity analysis of 249 well-matched pairs, there was no difference in major morbidity (29.3% with mitral intervention vs 23.7% without; P = .16) or operative mortality (1.2% vs 2.4%; P = .5).ConclusionsConsistent with recent guideline updates, patients with moderate IMR were less likely to undergo mitral repair. However, the rate of replacement for severe IMR did not change. Mitral intervention during CABG did not increase operative mortality or morbidity.     

TORCH检查的意义及应对措施

目的：为有效贯彻落实优生优育政策,临床探究孕妇产前TORCH检查的意义并根据结果分析相对应对措施。方法方便选取并回顾性分析该院2014年7月—2015年7月期间300例入院进行产检的孕妇,对49例出现不良妊娠以及60名正常者TORCH检查进行比照。结果不良妊娠组与正常组孕妇在年龄、孕周、孕次上差异无统计学意义,P>0.05;正常组弓形虫感染、风疹病毒、巨细胞病毒、乙肝检查、单纯疱疹病毒Ⅰ、梅毒螺旋体检查、单纯疱疹病毒Ⅱ分别为0.0%、0.0%、1.7%、1.7%、3.3%、1.7%,不良妊娠组依次为6.1%、10.2%、8.2%、12.2%、6.1%、14.3%,两组在乙肝检查异常率上差异无统计学意义,P>0.05,不良妊娠组较正常组在弓形虫感染、风疹病毒、巨细胞病毒、单纯疱疹病毒Ⅰ、单纯疱疹病毒Ⅱ异常率高,P<0.05。结论孕妇产前TORCH检查对避免不良妊娠、胎儿先天缺陷、畸形、死胎等情况均有重要意义。     

基于信息技术的社区卫生服务绩效管理模式设计

本研究针对社区卫生服务绩效管理工作中的实际问题,探讨社区卫生服务与信息技术之间的结合点,设计社区卫生服务经费测算模型、评分基准、考核方案、异常绩效分析知识库等,以期通过信息化手段提升社区卫生服务绩效管理效率,构建基于信息技术的新型社区卫生服务绩效考核标准循证机制、信息流通机制和过程监督反馈机制。     

Correlation between Braden Scale and Palliative Performance Scale in advanced illness

This study describes the significant correlation between the Braden Scale (BS) and the Palliative Performance Scale (PPS) in patients with advanced illness that has not been previously reported. The analysis was based on a prospective sequential case series of 664 patients suffering from advanced illness who were referred to a regional palliative medicine programme in Toronto, Canada. Baseline BS and PPS scores assessed within 24 hours of referral were considered for analysis. After controlling for age, gender, consult site and diagnosis (cancer versus non cancer), we observed a significant positive correlation between baseline PPS and BS scores (r = 0·885, P < 0·001). These findings suggest that for patients with advanced illness where BS is not routinely used, PPS could be considered as a proxy for pressure ulcer risk assessment.     

Global left-ventricular function by tissue Doppler imaging in pediatric dialysis patients

Cardiovascular abnormalities are observed in most children with end-stage renal disease (ESRD). The aim of this study was evaluation of left-ventricular (LV) myocardial performance using tissue-Doppler imaging (TDI) in patients with ESRD. Twenty-five patients with ESRD and 25 healthy gender- and age-matched control subjects were assessed with conventional M-mode echocardiography, pulsed-wave Doppler (PWD), and TDI. Myocardial Performance Index (MPI) and LV mass index (LVMI) were calculated. MPI and conventional echo-Doppler indices were compared in the ESRD and control groups. Significant differences were present in the mean systolic and diastolic blood pressure (BP) between children with ESRD and healthy children (p = 0.007 and p < 0.001, respectively). The mean LVMI was significantly greater in the patient group (p < 0.001). The tissue-Doppler MPI of patients was significantly higher than that in healthy children (p < 0.001). LVMI was significantly correlated with systolic and diastolic BP. MPI obtained by TDI was significantly correlated with LVMI. Our study confirms that LV dysfunction is present in patients with ESRD and hypertension is an important risk factor.     

Continuous monitoring tools for pediatric surgical outcomes: an example using biliary atresia

Purpose

Continuous monitoring tools can be used to monitor surgical outcomes over time. We illustrate the use of CUmulative SUM (CUSUM) charts in monitoring outcomes of Kasai portoenterostomy for treatment of biliary atresia at a supraregional unit.

Methods

Data on 57 consecutive infants who underwent a Kasai portoenterostomy performed by a single surgeon between June 1994 and June 2006 were collected. A procedure was defined as successful if clearance of jaundice (plasma bilirubin level <20 μmol/l) was achieved within 6 months of surgery. We applied cumulative observed-minus-expected, sequential probability ratio test (SPRT), and zero-resetting SPRT CUSUM charts and compared the results with those of standard aggregate data analyses. An expected failure rate of 43.0%, based on the national average failure rate, was used.

Results

The failure rate observed after 57 operations was 29.8%. The zero-resetting SPRT chart indicated a lower-than-expected failure rate earlier than did the aggregate data analyses and any of the other continuous monitoring techniques.

Conclusions

The CUSUM chart method provides ongoing feedback that can be used for continuous monitoring of the outcome of a procedure to ensure that standards of care are maintained. Its use as a routine monitoring tool in pediatric surgery deserves wider recognition.     

The sight of others' pain modulates motor processing in human cingulate cortex

Neuroimaging evidence has shown that a network including cingulate cortex and bilateral insula responds to both felt and seen pain. Of these, dorsal anterior cingulate and midcingulate areas are involved in preparing context-appropriate motor responses to painful situations, but it is unclear whether the same holds for observed pain. Participants in this functional magnetic resonance imaging study viewed short animations depicting a noxious implement (e.g., a sharp knife) or an innocuous implement (e.g., a butter knife) striking a person's hand. Participants were required to execute or suppress button-press responses depending on whether the implements hit or missed the hand. The combination of the implement's noxiousness and whether it contacted the hand strongly affected reaction times, with the fastest responses to noxious-hit trials. Blood oxygen level-dependent signal changes mirrored this behavioral interaction with increased activation during noxious-hit trials only in midcingulate, dorsal anterior, and dorsal posterior cingulate regions. Crucially, the activation in these cingulate regions also depended on whether the subject made an overt motor response to the event, linking their role in pain observation to their role in motor processing. This study also suggests a functional topography in medial premotor regions implicated in "pain empathy," with adjacent activations relating to pain-selective and motor-selective components, and their interaction.     

Effects of combined whole body vibration and resistance training on lower quadrants electromyographic activity,muscle strength and power in athletes

BackgroundWhole body vibration (WBV) with resistance training is one of the increasing ways of gaining ankle and foot complex muscle strength and power for the rehabilitative and prophylactic purpose in athletes.ObjectiveThe purpose of the study was to compare the effects of combined WBV and resistance training (RVE) with strength training alone (RE) on alteration of gastrocnemius lateralis and vastus medialis obliquus muscle activity and strength, and power performance in athletes.MethodsThe study was performed on 23 university-level male athletes who were randomized into two groups as RVE (n = 12; age 22.2 ± 1.94 years) and RE (n = 11; age 21.60 ± 1.78 years). The training program was scheduled three times per week for six weeks (18 sessions). Gastrocnemius lateralis (GL) and vastus medialis obliquus (VMO) were measured for muscle activity and isometric strength with surface EMG device and handheld dynamometer respectively. Counter-movement jump (CMJ) was used for measuring power. All the participants were assessed for outcome measures at baseline and then after 6 weeks. Group (RVE vs. RE) by time (pre vs. post) effects were compared through a 2-way interaction utilizing mixed model repeated measure ANOVA.ResultsAfter training, VMO muscle activity (group effects) increased significantly in the RVE group (p < 0.05). However, both the groups showed statistically significant time and group × time interaction effects for muscle activity of VMO, isometric strength (VMO and GL), and CMJ (p < 0.05).ConclusionWBV might serve as an adjunct modality for enhancement of the neuromuscular activity of the VMO muscle. However, RVE had no additive effect when compared to RE alone on muscle strength and power in athletes. The long-term impacts of combined WBV and resistance training on other foot and ankles muscle should be investigated in future studies.