Backgrounds: The recent growth of older adult immigrants and the increased burden of Alzheimer’s disease and related dementias (ADRD) call for validation of the assessment tools and timely detection of cognitive impairment. In particular, older Chinese Americans are among the fastest growing populations in the U.S., who are at high risk for delayed diagnosis and deficient management of ADRD due to limited knowledge of dementias and barriers to healthcare access. The value of the MMSE as a screening tool in detecting ADRD is well documented in western countries. Yet, little is known about the psychometric characteristics of a Chinese version of the MMSE (CMMSE) in older Chinese immigrants, whose cognitive test performances may relate to cultural and linguistic differences. Purpose: The study aims to assess factor structure and psychometric properties of CMMSE among older Chinese immigrants in the United States. Methods: Participants were recruited from the greater Chicago area in the Population-based Study of Chinese Elderly (PINE). The sample included 3,126 respondents aged 60 or over, who selected Chinese dialects in completing face-to-face interviews. A bifactor analysis was conducted to test unidimensionality of the CMMSE. Rasch modeling was used to assess scale properties. Age, sex, and education were tested for differential item functioning (DIF). Results: A bifactor analysis identified a unidimensional general factor with 30 items, reflecting a single underlying construct of cognitive capacity. We also found five concurrent subdomains with 19 items. The general factor explained 71 percent of the variance in the CMMSE. The Rasch model provided evidence of construct validity with acceptable item fit statistics. The DIF analysis showed that item biases were generally negligible. Conclusion: The CMMSE appeared to be a valid, reliable screening instrument for cognitive impairment in the US Chinese older adults. Findings provided support for the use of the CMMSE in detecting cognitive…
TOPICAL TREATMENTS TO REDUCE SEVERITY OF RADIATION DERMATITIS IN BREAST CANCER PATIENTS-A SYSTEMATIC REVIEW
Breast cancer (BC) patients are likely to undergo radiotherapy (RT) treatment which may lead to the development of the skin toxicity, radiodermatitis (RD). The purpose of this systematic review is to evaluate the effectiveness of topical interventions in reducing the severity of RD in females BC patients. Appropriate clinical studies were independently identified through a bibliographic search in PubMed and clinicaltrials.gov. Nine randomised, controlled clinical trials (RCTs) which stated a clear inclusion and exclusion criteria, were included in this review. The studies included in this review were conducted in the last 10 years and researched the effectiveness of only topical therapies on female BC patients. The severity of RD starting at baseline 0 to endpoint was measured using the Radiation Therapy Oncology Group (RTOG) scale, and results show most patients experienced a RTOG score change of 0-1 or 0-2. A significant relationship between results obtained from 0-1 and 0-2 was shown (p < 0.00001). Results suggest Radioskin 1&2 cream is the most effective topical treatment for RD as 95% of patients experienced a RTOG score change of 0-1 compared to 5% experiencing 0-2. However, controlled treatments like general care and Aqua Cream seem to be the least effective, as 1.9% of patients administrating general care experienced a RTOG score change of 0-1 compared to 41.9% experiencing 0-2.
Periodontitis is a chronic inflammatory disease that is initiated by the accumulation of dental biofilm, where dysbiosis leads to a chronic non-resolving condition, and destructive inflammatory response. The destruction of tissues that we clinically recognize as periodontitis (that is, destruction of the periodontal ligament, periodontal pocket formation and alveolar bone resorption) is caused mainly by the host’s inflammatory response to the bacterial challenge presented by the biofilm . Periodontitis affects, in its severe forms, approximately 10% of the global population, which represents almost 750 million people worldwide. The prevalence of periodontitis among all adults aged 30 years and over registered by the National Health and Nutrition Examination Survey (NHANES) in the United States is 46% . In addition, periodontitis has been found to be more severe and 3 times more likely to occur in patients with diabetes mellitus (DM) compared to the general population [14,25], and the level of glycemic control is the key to determining risk, and similar to other diabetes complications, the risk of periodontitis increases with a worse glycemic index . DM, a chronic non-communicable metabolic disease, occurs when blood glucose levels are increased, or because the body cannot produce any, or enough insulin, or use insulin effectively .
The cerebrovascular accident (CVA) is defined as a neurological disease capable of debilitating or leading to death. It develops through the obstruction or rupture of a blood vessel, causing the tissues around the lesion to lack oxygen and compatible substrates for correct functioning. The aforementioned pathology is a case of great concern for public health worldwide. Every year, about 17 million individuals are affected by stroke and 6.5 million of these patients die, leaving 26 million with sequelae and/or permanently incapacitated. The risk factors for the onset of stroke are divided into two classes, the first of which comprises the non-modifiable, which include age, color, ethnicity and heredity, and the second, the modifiable ones: arterial hypertension, cardiovascular pathologies, dyslipidemias, overweight, diabetes mellitus, smoking, alcoholism, high hematocrit/inflammatory process, periodontal disease and antiphospholipid antibody. Hypertension is the most prevalent risk factor, with about 80% of the cause among the types of stroke. The prevention of stroke in relation to risk factors consists of small daily and consecutive gestures. Adhering to a good diet is essential, this action will prevent overweight and facilitate the reduction of cholesterol, as well as the practice of daily physical activities is extremely important to keep away from sedentary lifestyle. There are many risk factors, although there is more emphasis on high hypertension, diabetes mellitus and smoking.
INCIDENCE OF HYPOTENSION AND ASSOCIATED-RISK FACTORS IN EPIDURAL ANESTHESIA WITH 2% LIDOCAINE AND EPINEPHRINE DURING ELECTIVE CESAREAN SECTION, EFFICACY AND SAFETY ASSESSMENT
Background: Cesarean section is a worldwide common surgery that requires anesthetic techniques. Many local anesthetics are being now used, but are associated with, dose- dependent and at different level, some side effects including toxicity. Hypotension was described as the first and threat side effect associated to neuraxial techniques. Despite many preventive strategies, it continues to challenge anesthesia providers around the world. Lidocaine was found to be less toxic compared with others commonly used and has been recommended for anesthesia procedures requiring large dose of local anesthetic including epidural anesthesia. The main purpose of this research was to determine the incidence of hypotension and identify the possible risk factors associated with it and thus, assess the efficacy and safety when lidocaine is applied together with epinephrine, in epidural anesthesia for elective cesarean delivery. Materials and methods: This retrospective observational institutional-based study, recruited 612 parturients who underwent elective cesarean section under epidural anesthesia with 2% lidocaine and 1/200000 epinephrine, at 1st affiliated hospital of Chongqing Medical University in 2019. Exclusion criteria included any contraindication to elective cesarean section delivery, general anesthesia, baseline systolic blood pressure < 100mmh and > 140 mm hg, gestational age < 37 weeks and > 42 weeks etc. SPSS 26.0 version and different appropriated tests were used for statistical analysis. P value < 0.05 was accepted as statistically significant. Results: The hypotension incidence was 13.2%, and identified factors associated with it were Baseline Systolic Blood Pressure < 120mmhg, gestational age < 40 weeks, maternal body weight ≤ 60 kg and duration of cesarean delivery (surgery) > 45 minutes. Conclusion: The variables in correlation with increased hypotension rate are baseline systolic blood pressure, gestational age, maternal weight, and surgery duration. 2%Lidocaine with epinephrine as adjuvant presented best outcomes towards both mother and neonates, was therefore efficacy and safe under…
Introduction: Alzheimer’s disease is a more common neurodegenerative disease, affecting 25 million people worldwide, or accounting for about 60 to 70% of all dementia cases. There is currently no exact mechanism to explain the pathophysiology of Alzheimer’s disease, however, cascading metabolic amyloid and post-translational review of tau protein are used as major hypotheses. Objective: To demonstrate in the literature new approaches in the development of Alzheimer’s disease modifiers. Methodology: For the accomplishment of this study made in the bibliographical survey of scientific literature and respect to the approached subject, in the databases PUBMED, ScienceDirect, Scielo and Scopus. Results: Alzheimer’s disease-modifying drugs are not yet available, but many patients may, however, develop phase III clinical trials and are intended to modify as pathological stages leading to the disease. As disease-modifying therapies under study, these changes also affect Aβ and tau protein and also cause inflammation and oxidative damage. The results obtained in the clinical trials performed were positive and promising and are still under study. The results show that there is still a long way to go in the development of Alzheimer’s disease modifying drugs. Conclusion: The results demonstrated that there is still a long way to go in the development of Alzheimer’s disease modifying drugs, but nevertheless levels at the research level should be continued in order to improve the pathophysiology of the disease and find an effective treatment for this disease the same.
RELATIONSHIP BETWEEN PHYSICAL ACTIVITY LEVELS AND SOCIOECONOMIC STATUS ON THE QUALITY OF LIFE OF MORBID OBESE CANDIDATES FOR BARIATRIC SURGE
Objective: To investigate the relationship between perception of quality of life, levels of physical activity and socioeconomic status of morbidly obese candidates for bariatric surgery, registered in the outpatient clinic of HC/UFPE/EBSERH. Methods: Cross-sectional observational research conducted with sixty-two morbidly obese individuals candidates for bariatric surgery with age=39,53±10,72 years and BMI=50,05±9,26 kg/m², where they were interviewed using the IPAQ, SF-36 and ABEP questionnaires. Spearman’s correlation was used to correlate continuous variables and differences between groups were analyzed using the Kruskal-Wallis test. Results: The Physical Functioning domain had a significantly higher score (p=0,01) for the level of Moderate physical activity (61,05±25,03; n=19) compared to the Low level (40,83±23,20; n=30); the Role-Physical domain had a significantly higher score (p=0,029) for the level of High physical activity (65,38±36,14; n=13) compared to those of Low level (35,83±35,77; n=30). Individuals of socioeconomic status B (n=17) had scores significantly higher than individuals of status C (n=45) in the Physical Functioning [X² (1) = 4,800; p
ACUTE EFFECTS OF STRENGTH TRAINING WITH DIFFERENT INTENSITIES ON INFLAMMATORY MARKERS OF GRADE III OBESE WOMEN
Objective: To compare the acute effects of a high-intensity (AI) resistance training protocol with a moderate-intensity (MI) resistance training protocol on inflammatory markers in grade III obese women. Methods: This is a crossover controlled clinical trial carried out with 9 obese grade III women (BMI=48.29±5.06 kg/m²; age=35.22±10.93 years), where blood samples were collected in the pre, 15 minutes and 24 hours after two different training protocols, high and moderate intensity, being analyzed the plasma concentrations of the cytokines IL-2, IL-4, IL-6, IL-10, TNF-α and IFN- γ. For data analysis, the Friedman and Mann-Whitney tests were used. Participants performed the AI protocol and one week later the MI protocol. The training consisted of 4 exercises with the total volume equalized, with intensities 75 and 85% of 1RM for the MI and AI protocols, respectively. Results: There were no significant differences between the three temporal measures in the AI group [IL-02 (p=0.459); IL-04 (p=0.368); IL-06 (p=0.368); IL-10 (p=0.895); TNF-α (p=0.895) and IFN-γ (p=0.895)] or MI [IL-02 (p=0.459); IL-04 (p=0.368); IL-06 (p=0.459); IL-10 (p=0.368); TNF-α (p=0.641) and IFN-γ (p=0.121)]. In the analysis between groups, the IL-04 value was significantly higher in the AI group at the PRE moment (p=0.008), with no other significant difference for any of the variables and moments analyzed. Conclusion: Moderate and high intensity strength training protocols did not cause acute changes in the inflammatory profile of grade III obese women, and can be applied to this audience without harming low-grade chronic inflammation.
PHOTODYNAMIC POTENTIAL OF XANTHENIC PHOTOSENSITIZERS ABOUT A STANDARD STRAIN OF PSEUDOMONES AERUGINOSA
Introduction: Microbial control has proven to be an increasingly difficult obstacle to be controlled, making it a constant research focus. Researchers seek new alternative methods guaranteeing treatment without the use of antimicrobials or associating them, since its used has being neglected, causing an increase in the resistance of microorganisms, making it even more difficult to choose a treatment. The microorganism under study was Pseudomonas aeruginosa, a gram-negative, highly virulent bacterium found in the community and in a hospital environment, with difficult control due to its high capacity for antibiotic resistance, favored by the incorrect use of antibiotic therapies. Photodynamic Therapy consists of the use of a dye associated with the irradiation of a light on the microorganism, promotes dye-light-bacteria interaction, so that it can be inhibited or have its capacity for proliferation reduced. Objective: This research aimed to present an alternative method to its treatment through the use of xanthene dyes and a photosensitizer in a way that would sensitize the bacteria. Plants of the Baixada Maranhese (Punica granatum and Terminalia cattapa) and an LED light source that was irradiated for 40 seconds. The combinations between dye, plant extracts and elimination were organized into 7 groups. Results: The two most successful groups had combinations with the dye Rosa-bengal and in the presence of light, their bactericidal potential was strengthened. In the group in which Punica granatum extract was used alone, there was bacterial proliferation in the absence of the light source; in its presence, the reduction of colonies was not aesthetically relevant. Conclusion: Photodynamic Therapy presents itself as a new resource, acting independently of antibiotic therapy, avoiding and, concomitantly, reducing bacterial resistance. Thus, it appears as a viable alternative in the treatment of patients with “diabetic foot”, considering its possible application with different types of photosensitizers or even in combination…
POTENTIALS OF NUTRITIONAL FOLLOW-UP IN A DIABETIC PATIENT HOSPITALIZED WITH ULCERATION TABLE IN PLANT REGION
Introduction: Approximately 15% of diabetic individuals are affected with foot ulceration, one of the main causes of lower limb amputation. The percentage of diabetic survival after amputation of a lower limb (MI) is 50% three years after the surgical procedure and the mortality rate varies between 39% to 68% after five years. The impact on the quality of life of diabetic people is high, not only economically, the feelings involved contribute to a negative prognosis. Therefore, adequate metabolic and nutritional control, as well as periodic assessment of immunity and comorbidities, should be part of the therapeutic routine of diabetic patients. Experience report: The work in question refers to the nutritional approach performed on a 71-year-old female patient admitted to the hospital with an ulcer in the right plantar region. In anthropometry, the nutritional status indicators indicated eutrophy with nutritional risk. The biochemical evaluation identified anemic condition and sepsis. Physical evaluation showed the presence of edema in the right and left MI. Glycemic and blood pressure levels were monitored daily. A hypercaloric and hyperprotein diet was prescribed, plus protein supplementation with specific immunomodulators for special metabolic situations that prevent energy-protein malnutrition, in addition to the adequacy of vitamins and minerals, in order to avoid nutritional deficiencies arising from the drug-nutrient interaction. Nutritional monitoring lasted 13 days. Ulceration regressed from the entire plantar region, only to the right hallux, which was amputated. Final considerations: There was an improvement in nutritional and biochemical parameters until hospital discharge.