Direct Oral Anticoagulants Versus Vitamin K Antagonists in Real-life Patients With Atrial Fibrillation. A Systematic Review and Meta-analysis

Introduction and objectives

To assess the effectiveness of direct oral anticoagulants vs vitamin K antagonists in real-life patients with atrial fibrillation.

The genetic abnormality in the beta cell determines the response to an oral glucose load

Aims/hypothesis: We assessed how the role of genes genetic causation in causing maturity-onset diabetes of the young (MODY) alters the response to an oral glucose tolerance test (OGTT). Methods: We studied OGTT in 362 MODY subjects, from seven European centres; 245 had glucokinase gene mutations and 117 had Hepatocyte Nuclear Factor –1 alpha (HNF-1α) gene mutations. Results: BMI and age were similar in the genetically defined groups. Fasting plasma glucose (FPG) was less than 5.5 mmol/l in 2 % glucokinase subjects and 46 % HNF-1 α subjects (p < 0.0001). Glucokinase subjects had a higher FPG than HNF-1 α subjects ([means ± SD] 6.8 ± 0.8 vs 6.0 ± 1.9 mmol/l, p < 0.0001), a lower 2-h value (8.9 ± 2.3 vs 11.2 ± 5.2 mmol/l, p < 0.0001) and a lower OGTT increment (2-h – fasting) (2.1 ± 2.3 vs 5.2 ± 3.9 mmol/l, p < 0.0001). The relative proportions classified as diabetic depended on whether fasting (38 % vs 22 %, glucokinase vs HNF-1 α) or 2-h values (19 % vs 44 %) were used. Fasting and 2-h glucose values were not correlated in the glucokinase subjects (r = –0.047, p = 0.65) but were strongly correlated in HNF-1 α subjects (r = 0.8, p < 0.001). Insulin concentrations were higher in the glucokinase subjects throughout the OGTT. Conclusion/interpretation: The genetic cause of the beta-cell defect results in clear differences in both the fasting glucose and the response to an oral glucose load and this can help diagnostic genetic testing in MODY. OGTT results reflect not only the degree of hyperglycaemia but also the underlying cause. [Diabetologia (2002) 45: 427–435] Received: 13 September 2001 and in revised form: 26 November 2001     

Oral magnesium for relief in pregnancy‐induced leg cramps: a randomised controlled trial

Leg cramps are common in pregnant women. Currently, there is no standard treatment for pregnancy‐induced leg cramps. The objective of this study was to evaluate the therapeutic efficacy of oral magnesium in pregnant women with leg cramps. This double‐blinded, randomised, placebo‐controlled trial included 86 healthy pregnant women, 14–34 weeks of gestation who had leg cramps at least twice per week. The study period was 4 weeks. Eighty women completed the study. Forty‐one women were assigned to magnesium bisglycinate chelate (300 mg per day) and 39 women to placebo. Details of leg cramps were recorded before beginning the treatment and the fourth week of study. Outcome measure was the reduction of cramp frequency after treatment and cramp intensity measured by 100‐mm visual analogue scale. Fifty per cent reduction of cramp frequency was significantly higher in the magnesium group than the placebo group (86.0% vs. 60.5%, P = 0.007). The 50% reduction of cramp intensity was also significantly higher in the treatment group than in the placebo group (69.8% vs. 48.8%, P = 0.048). There were no significant differences between the two groups in terms of side effects such as nausea and diarrhoea. These results demonstrated that oral magnesium supplement can improve the frequency and intensity of pregnancy‐induced leg cramps. Therefore, oral magnesium may be a treatment option for women suffering from pregnancy‐induced leg cramps.     

Standardized nursing and clinical efficacy of OxyContin in reducing oral mucosal pain in patients with nasopharyngeal carcinoma: A randomized,double-blind,placebo-controlled study protocol

Background:Pain caused by oral mucositis (OM) is the main problem in the process of concurrent chemoradiotherapy for the nasopharyngeal carcinoma (NPC). This protocol aims to explore the standardized nursing and therapeutic effect of OxyContin on OM pain in the patients with NPC undergoing the concurrent chemoradiotherapy.Methods:The experiment is a randomized clinical research, which was granted through the Research Ethics Committee of Shandong Provincial Third Hospital (No.20200802097). In this research, 90 NPC patients with OM induced by chemotherapy are enrolled, and the score of visual analogue >5 and the grade of OM >1 are evaluated. Patients with known allergy to OxyContin, the opioid abuse history, or major organ dysfunction, for instance, hepatic insufficiency, renal failure, and respiratory and heart failure, as well as a series of severe mental illness are excluded from our research. Patients in study groups receive standardized nursing and oral OxyContin. Patients in control groups only receive oral OxyContin. The analgesic effect could be assessed with the comparison of the visual analogue scale after and before the treatment. Safety evaluations contain the assessment of the vital signs, laboratory tests, as well as adverse events. The Karnofsky performance status standards of the International Cancer Control Union is utilized to evaluate the quality of life.Results:The comparison of outcomes after taking OxyContin in both groups will be shown in Table ​Table1Table1 .Table 1The comparison of outcomes after taking OxyContin in both groups.

Functional ability and oral health among older people: a longitudinal study from age 75 to 80

OBJECTIVE: To examine whether functional ability at age 75 and age 80 is associated with oral health and use of dental services cross-sectionally and whether changes in functional ability from age 75 to age 80 are associated with oral health and regular use of dental services at age 80. DESIGN: The study included a random sample of 75-year-olds at baseline and a follow-up study 5 years later. The data are treated as two cross-sectional studies at age 75 and 80, respectively, and as a longitudinal study from age 75 to 80. SETTING: The western part of Copenhagen County. PARTICIPANTS: The two cross-sectional studies of 75- and 80-year-old people included 411 and 321 persons, respectively. The longitudinal study from age 75 to 80 included the 326 persons who participated in both surveys. MEASUREMENTS: Oral health status was measured roughly by number of teeth and chewing ability. Use of dental services was measured by frequency of visits to a dentist or denturist. Functional ability was measured by two scales on mobility in relation to tiredness and need of help. Changes in mobility from age 75 to 80 is described as (1) improved or sustained good, (2) decreased, and (3) sustained poor. Gender, chronic diseases, self-rated health, socio-demographic factors, living alone, and social relations were included as possible confounders. RESULTS: The odds ratio of having no or few teeth was 1.7 (1.1-2.6) in 75-year-old individuals who felt tired in mobility, 1.7 (1.0-2.9) in 80-year-old persons who needed help with mobility, and 2.7 (0.94-7.5) in persons with sustained need of help with mobility from age 75 to 80. The odds ratio of chewing difficulties was 1.7 (1.1-2.8) in 80-year-old people in need of help, and 1.8 (1.1-3.0) in persons age 75 to 80 needing sustained help. Dentate 80-year-old persons who felt tired in mobility had an odds ratio of 2.0 (0.94-4.2) of not using dental services. CONCLUSIONS: The results indicate that oral impairment (e.g., having no or few teeth), oral functional limitations (e.g., chewing problems), and general functional limitations (e.g., mobility problems) are interrelated and that prevention of disabilities should be aimed at both functional limitations and oral health problems if the intention is to promote a good life in old age. In addition, the results point to the importance of taking problems in mobility seriously in delivering preventive services to old people because people who are tired or dependent on help seem to be at a higher risk of not using dental services regularly.     

Effects of Glycine‐Based Ionic Liquid on Spherulite Morphology of Poly(l‐Lactide)

Crystalline morphology, lamellar assembly, spherulitic growth rate, and physical properties of poly(l ‐lactide acid) (PLLA) modified by a room‐temperature ionic liquid (IL), N‐alkyl‐substituted‐glycine ester [N,N‐dimethyl‐N‐propyl glycine ethyl ester (DMPGlyET)⁺] bis(fluoromethanesufonyl)imide [TFSI^?], are investigated by using polarized optical microscopy, optical microscopy, differential scanning calorimetric, and atomic‐force microscopy. Thermal analyses and in situ microscopy characterization reveal the PLLA/IL mixture with upper‐critical‐solution‐temperature behavior. Crystalline morphology of PLLA is significantly changed by the addition of IL to display massive diversification of spherulites morphology which has never been reported before in neat PLLA or PLLA blends with polymers. The morphological change and diversifications in PLLA/IL mixture are associated with strong interactions between PLLA and IL, which impede the melt crystallization of PLLA and tend to form PLLA nuclei of various geometry shapes. In addition, neat PLLA is generally brittle with extensive crack formation during postcrystallization cooling process; however, with the addition of IL, cracks are reduced or diminished entirely, potentially to enhance the performance and properties of PLLA.

     

Liquid Chromatography at Critical Conditions of Poly(propylene)

Liquid chromatography at critical conditions (LCCC) of poly(propylene) (PP) holds unique potential to further augment the understanding of molecular heterogeneities present in PP. The critical conditions for isotactic poly(propylene) (iPP) and syndiotactic poly(propylene) (sPP) have been identified using porous graphitic carbon as stationary phase and combinations of adsorption and desorption promoting solvents. It is found that 1,2,4‐trichlorobenzene is a stronger desorption promoting eluent compared to 1,2‐dichlorobenzene, while 2‐octanol shows a weaker adsorption promoting effect compared to 2‐ethyl‐1‐hexanol for all stereo‐isomeric forms of PP. The fraction of desorption promoting solvent needs to reach critical conditions decreased in a linear manner with the temperature. High temperature 2D liquid chromatography with infrared detection provides quantitative information about the fractions of the constituents (iPP and ethylene–propylene copolymer) of a model high impact PP sample at LCCC of iPP.

     

Science in society: challenges and opportunities for indigenous knowledge in the present-day context

Generally, when we talk or think about science, we refer to that of Western or industrialized societies, assuming that science is only there in those societies and quite often implying that scientific rigour or interest is absent in other societies. The role of science is to help mankind meet the various demands for exploiting natural resources in the best possible way without adversely affecting the environment. In most societies, there exists a rich body of knowledge based on how to meet the demands of that particular society but quite often these are ignored. We need to look at indigenous science and technology particularly when an existing body of knowledge is available. Perhaps it is better to develop it instead of disregarding it in the name of scientific progress. The prevailing health and medical system, the Western system, has unfortunately failed to meet the needs of all. In most countries, frightening policy changes place less and less emphasis on the social and welfare sectors and higher emphasis on the economic and infrastructure sectors. As such, funds allocated to health are going down. The implications of such a trend in countries where health insurance is unaffordable for the majority, is unimaginable. In this changing situation, the conditions of the poor, particularly the indigenous people, have become critical. In this paper, challenges and opportunities for indigenous health practices are examined in the context of forest situations, forest policy and related environmental issues.