Hot Articles

Background: Mental illness symptoms can trigger substance use cravings, which are strongly associated with relapse. Aim: Our study examines differences in substances craved among adults entering inpatient mental health (MH) and substance use disorder (SUD) treatment programs in 2018. Method: Our sample includes 2,486 adults; 1,686 adults admitted to MH programs and 800 adults admitted to SUD programs. We conducted chi-square tests and Fisher’s exact tests to determine group differences, with a Bonferroni correction to adjust the alpha for multiple tests. Results: We found that patients programmed to SUD services more often reported alcohol (39.99 vs. 49.63%; x2 (1, N = 2,488) =20.56, p

Background: The emergence of acne scars due to skin damage in the acne healing process and causes psychological effects. The management of acne scars can be done in several methods. Microneedling is a very simple, safe, effective, and minimally invasive therapeutic technique compared to other therapeutic modalities in acne scars. The resulting wound is micro-sized, and promotes the growth of growth factors and collagen production. We aimed to assess the effectiveness of using microneedling as an acne scar treatment option. A systematic review and meta-analysis were qualitatively and quantitatively conducted from RCTs, assessing the effectiveness of microneedling in reducing the severity of acne scars according to Goodman and Baron in the treatment of acne scars. Methods: Medline Pubmed, PMC, Scopus, Google Scholar, and JDC library, eligible search. Ten studies (n=514) were analyzed qualitatively with 2 studies (n=53 subjects) and quantitatively analyzed by 2 studies (n=90 subjects). Both analyzes were included in the meta-analysis. The mean age of the participants was 40.5 years. The application of microneedling intervention as monotherapy or a combination in patients with acne scarring was followed for at least 16 weeks, the results obtained were the mean reduction in the degree of acne scarring after microneedling. Result: The combination of microneedling treatment obtained a qualitative decrease in the degree of acne scars according to Goodman and Baron with a Z value (-4.299) and P=

Objectives: To determine the ability of handgrip strength combined with body mass index (BMI, kg/m2) to estimate body fat percentage (BF%) in middle-aged and older Asian adults. Methods: Middle-aged and older Asian adults (n=459, males=197) were randomly divided into a validation and model development group (n=303) and cross-validation group (n=156). A whole-body scan using dual energy x-ray absorptiometry measured BF%. Bland-Altman plots, standard error of the estimates, total errors and mean absolute errors were used to compare prediction equations. Stepwise regression analysis was used to determine a new prediction equation for middle-aged and older Asian adults. Right and left handgrip strength, age, sex and BMI were included in the analysis. Results: A previously developed prediction equation that included handgrip strength poorly predicted BF% in our current sample with the mean difference being -6.0 ± 4.2%. Predicted BF% values were significantly lower than measured BF% values (22.7% vs. 28.7%, p

Background: Hernia repair surgery is a procedure frequently performed today, both in elective or outpatient settings as in an emergency context. Hernia is defined as a condition in which part of an organ or its fascia protruded through the wall of the cavity containing it. Quite often in the emergency department incarcerated hernias are found, and in most cases, the content of the hernia sac is the omentum or small intestine. In very rare instances, the appendix can be found inside the hernia sac. When the appendix is found in the hernia sac it is called an “Amyand Hernia”, regardless if it is inflamed or not, with the incidence of appendicitis in an inguinal hernia being 0.07-0.13%. Preoperative diagnosis of an Amyand hernia is a clinical and often a Radiological challenge, being in many cases misdiagnosed as an incarcerated inguinal hernia. Usually, the diagnosis of Amyand’s hernia is an incidental finding during surgical repair of an inguinal hernia. There is still no real consensus on the ideal surgical treatment approach for this pathology. Clinical Case: A 72-year-old man, with a known reducible right inguinal hernia awaiting surgical repair presented to the Emergency Department with acute abdominal pain, nausea, vomiting and a painful right groin mass. He was diagnosed with an incarcerated right inguinal hernia and taken to the operating room for emergency surgery. An open approach was performed with a transverse right inguinal incision and the inflamed appendix was identified inside the inguinal sac. The patient was submitted to an appendectomy and subsequently, using the Bassini technique, had the incarcerated inguinal hernia corrected. Conclusion: Preoperative clinical and imaging diagnosis of amyand´s hernia is rare and difficult. More prospective studies should be carried out in order to standardize the treatment of this pathology. The diagnosis of Amyand´s hernia should be in…

Solitary rectal ulcer syndrome (SRUS) is an uncommon benign disease characterized by a combination of symptoms, clinical and histological findings, where men and women are affected equally, with a small predominance in women. Various treatment strategies have been advocated, ranging from conservative management to a variety of surgical procedures. Can laparoscopic ventral rectopexy be a good alternative for patients who do not respond to conservative treatment? Given the rarity of this pathology, we chose to present the case.

The first report of patients with the SARS-CoV-2 was in Wuhan on December 2019. In few months the virus was disseminated around the world and has caused millions of deaths. A striking and recurrent finding was the more severe disease and increased numbers of fatal cases in old adults. Vaccines were developed in a record period of time and since then a massive program of vaccination has been installed in several countries. Nevertheless, the decrease in the levels of specific antibody after six months of the first dose in young adults and the reports of fatal cases in vaccinated older patients have suggested that a 3rd dose of vaccine is required. From the first report until now it has been clear that the immune system plays an important role in the disease development and patient outcome. Our group showed recently that healthy old individuals present changes in the immune system that have been reported as immunosenescence and inflammageing. Therefore, our aim was to correlate the findings obtained in healthy old adults with cases of COVID-19 from literature in order to identify possible common factors. The further understanding of how the changes occurring in the immune system during the ageing process can affect the response to SARS-CoV-2 virus could contribute for the development of vaccines or more specific therapies to the aged population.

Life expectancy for patients living with Cystic Fibrosis (CF) is increasing year on year and there is growing interest in the ageing process in CF. Telomeres are repetitive sequences of DNA that cap the ends of eukaryotic chromosomes and shorten with ongoing cell division, thus providing a marker of replicative history and biological ageing. We aimed to investigate whether telomere length as a function of age differs between patients with CF and healthy individuals and whether telomere length is associated with severity of the patient’s CF condition. Peripheral blood samples and demographic data were collected from 47 consenting patients (age 1 to 57 years) with CF attending their routine annual review appointment at the All Wales Adult CF Centre and Noah’s Ark Children’s’ Hospital in Cardiff, UK. Telomere length profiles were assessed from peripheral blood samples, using the high resolution single telomere length analysis technique (STELA) and compared to healthy control telomere length data. Patients with CF had significantly shorter telomere lengths than healthy individuals, when adjusting for age (p

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…

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 [38]. Periodontitis affects, in its severe forms, approximately 10% of the global population, which represents almost 750 million people worldwide[16]. 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% [8]. 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 [33]. 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 [15].