High rate of clinically relevant improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis

BACKGROUND The minimal clinically important difference(MCID)is defined as the smallest meaningful change in a health domain that a patient would identify as important.Thus,an improvement that exceeds the MCID can be used to define a successful treatment for the individual patient.AIM To quantify the rate of clinical improvement following anatomical total shoulder arthroplasty for glenohumeral osteoarthritis.METHODS Patients were treated with the Global Unite total shoulder platform arthroplasty between March 2017 and February 2019 at Herlev and Gentofte Hospital,Denmark.The patients were evaluated preoperatively and 3 months,6 months,12 months,and 24 months postoperatively using the Western Ontario Osteoarthritis of the Shoulder index(WOOS),Oxford Shoulder Score(OSS)and Constant-Murley Score(CMS).The rate of clinically relevant improvement was defined as the proportion of patients who had an improvement 24 months postoperatively that exceeded the MCID.Based on previous literature,MCID for WOOS,OSS,and CMS were defined as 12.3,4.3,and 12.8 respectively.RESULTS Forty-nine patients with a Global Unite total shoulder platform arthroplasty were included for the final analysis.Mean age at the time of surgery was 66 years(range 49.0-79.0,SD:8.3)and 65%were women.One patient was revised within the two years follow-up.The mean improvement from the preoperative assessment to the two-year follow-up was 46.1 points[95%confidence interval(95%CI):39.7-53.3,P<0.005]for WOOS,18.2 points(95%CI:15.5-21.0,P<0.005)for OSS and 37.8 points(95%CI:31.5-44.0,P<0.005)for CMS.Two years postoperatively,41 patients(87%)had an improvement in WOOS that exceeded the MCID,45 patients(94%)had an improvement in OSS that exceeded the MCID,and 42 patients(88%)had an improvement in CMS that exceeded the MCID.CONCLUSION Based on three shoulder-specific outcome measures we find that approximately 90%of patients has a clinically relevant improvement.This is a clear message when informing patients about their prognosis.

A cross-sectional study on the nurses’attitude towards rapid response system activation for clinically deteriorated patients

Background:Hospitals have reported that implementing rapid response system activation(RRS)activation has increased patient safety.As a result,there has been growing interest in identifying factors that lead to successful RRS activation.While introducing an automated RRS activation system has prompted nurses to be more vigilant about monitoring vital signs,it has not necessarily encouraged them to conduct thorough patient assessments to identify early signs of deterioration.Purpose:The current study aimed to assess nurses’attitudes towards RRS activation for clinically deteriorated patients in the clinical units of King Abdul-Aziz Hospital.Methods:A descriptive cross-sectional research design was utilised in the study,and 144 nurses working in the medical and surgical units of King Abdul-Aziz Hospital were recruited to participate using a convenient non-probability sampling technique.Results:The study’s findings reported that nurses have a positive attitude towards RRS benefits(Mean=3.70;SD=0.70).Their overall attitude towards RRS activation among clinically deteriorated patients is still low positive(Mean=2.71;SD=0.61).The nurses’attitudes towards RRS benefits significantly differ among nationalities and the clinical area/unit where they were assigned,with a P-value of 0.0194 and 0.000,respectively.Attitudes towards RRS barriers significantly differ among nationality(P-value=0.0037),education level(P-value=0.0032),area of assignment(P-value=0.020),and whether they have a good understanding of abnormal observations(P-value=0.0122).Regarding the nurses’attitude towards management belief,the significant result is only with the clinical area/unit of assignment with a P-value of 0.000.Conclusion:The current study found a low positive attitude towards RRS activation among ward nurses,especially given that monitoring vital signs is critical to their job.Nurses may fear being perceived as clinically inept for redundant activations caused by poor quality,but their attitude towards activating the RRS in clinical deterioration is still largely negative.This is because most RRSs rely on ward nurses to recognise clinical deterioration and manually alert responders through phone calls,hospital communication systems,or face-to-face communication.

Establishing and clinically validating a machine learning model for predicting unplanned reoperation risk in colorectal cancer

BACKGROUND Colorectal cancer significantly impacts global health,with unplanned reoperations post-surgery being key determinants of patient outcomes.Existing predictive models for these reoperations lack precision in integrating complex clinical data.AIM To develop and validate a machine learning model for predicting unplanned reoperation risk in colorectal cancer patients.METHODS Data of patients treated for colorectal cancer(n=2044)at the First Affiliated Hospital of Wenzhou Medical University and Wenzhou Central Hospital from March 2020 to March 2022 were retrospectively collected.Patients were divided into an experimental group(n=60)and a control group(n=1984)according to unplanned reoperation occurrence.Patients were also divided into a training group and a validation group(7:3 ratio).We used three different machine learning methods to screen characteristic variables.A nomogram was created based on multifactor logistic regression,and the model performance was assessed using receiver operating characteristic curve,calibration curve,Hosmer-Lemeshow test,and decision curve analysis.The risk scores of the two groups were calculated and compared to validate the model.RESULTS More patients in the experimental group were≥60 years old,male,and had a history of hypertension,laparotomy,and hypoproteinemia,compared to the control group.Multiple logistic regression analysis confirmed the following as independent risk factors for unplanned reoperation(P<0.05):Prognostic Nutritional Index value,history of laparotomy,hypertension,or stroke,hypoproteinemia,age,tumor-node-metastasis staging,surgical time,gender,and American Society of Anesthesiologists classification.Receiver operating characteristic curve analysis showed that the model had good discrimination and clinical utility.CONCLUSION This study used a machine learning approach to build a model that accurately predicts the risk of postoperative unplanned reoperation in patients with colorectal cancer,which can improve treatment decisions and prognosis.

The minimal clinically important difference for gait speed in significant unilateral vestibular hypofunction after vestibular rehabilitation

Gait speed is a valid measure of both physical function and vestibular health.Vestibular rehabilitation is useful to improve gait speed for patients with vestibular hypofunction,yet there is little data to indicate how changes in gait speed reflect changes in patient-reported health outcomes.We determined the minimal clinically important difference in the gait speed of patients with unilateral vestibular hypofunction,mostly due to deafferentation surgery,as anchored to the Dizziness Handicap Index and the Activities Balance Confidence scale,validated using regression analysis,change difference,receiveroperator characteristic curve,and average change methods.After six weeks of vestibular rehabilitation,a change in gait speed from 0.20 to 0.34 m/s with 95%confidence was required for the patients to perceive a significant reduction in perception of dizziness and improved balance confidence.

Detection of Clinically Significant Warm Reactive Anti-A1 in a Post Red Blood Cells Transfusion Patient with Acute Lymphoblastic Leukemia

The purpose of this article is to report that some anti-A1 that react at 37°C are IgG antibodies and are clinically significant, as they can cause the destruction of a proportion of A1 cells in vivo following the transfusion of red blood cells. Therefore, when a serum of an individual contains anti-A1, further testing of the plasma against group A1, A2, and O by referencing red blood cells and individual cells against anti-A1 lectin (Dolichos biflorus lectin) must be performed. Confirming the specificity of anti-A1 by referencing red blood cells is also important in selecting the appropriate blood for transfusion. ABO antibodies are naturally occurring and activate the complement cascade, making them more likely to cause severe transfusion reactions compared to antibodies to other RBC antigens.

Detection rate of clinically insignificant prostate cancer ncreases with repeat prostate biopsies

To analyze if clinically insignificant prostate cancer （CIPC） is more frequently detected with repeat prostate biopsies, we retrospectively analyzed the records of 2146 men diagnosed with prostate cancer after one or more prostate biopsies. The patients were divided into five groups according to the number of prostate biopsies obtained, e.g, group I had one biopsy, group 2 had two biopsies and group 3 had three biopsies. Of the 2146 patients diagnosed with prostate cancer, 1956 （91,1%）, 142 （6.6%）, 38 （1.8%）, 9 （0.4%） and 1 （0.1%） men were in groups 1, 2, 3, 4 and 5, respectively. Groups 4 and 5 were excluded because of the small sample sizes. The remaining three groups （groups 1, 2 and 3） were statistically analyzed. There were no differences in age or prostate-specific antigen level among the three groups. CIPC was detected in 201 （10.3%）, 28 （19.7%） and 9 （23.7%） patients in groups 1, 2 and 3, respectively （P〈O.O01）. A multivariate analysis showed that the number of biopsies was an independent predictor to detect ClPC （0R=2.688 for group 2; 0R=4.723 for group 3）. In conclusion, patients undergoing multiple prostate biopsies are more likely to be diagnosed with CIPC than those who only undergo one biopsy. However, the risk still exists that the patient could have clinically significant prostate cancer. Therefore, when counseling patients with regard to serial repeat biopsies, the possibility of prostate cancer overdiagnosis and overtreatment must be balanced with the continued risk of clinically significant disease.

Risk factors for clinically significant macular edema in a multi-ethnics population with type 2 diabetes

·AIM:To determine the risk factors of clinically significant macular edema (CSME) in patients with non-proliferative diabetic retinopathy (NPDR) in a multi-ethnics Malaysian population. ·METHODS:We performed a case control study in which 150 patients with bilateral NPDR and CSME in either eye were compared to 150 patients with bilateral NPDR and no CSME in both eyes. CSME and NPDR were graded according to Early Treatment of Diabetic Retinopathy Study criteria. Student’s t-test, odds ratio and multiple logistic regression analysis were performed to analyze the duration of diabetes, body mass index (BMI), blood pressure(BP), total cholesterol, low density lipoprotein (LDL), high density lipoprotein (HDL), triglycerides (TG), fasting blood glucose (FBG), HbA1c, full blood count, serum creatinine and proteinuria between the two groups. ·RESULTS:Both groups were matched in terms of age, gender and ethnicity. Duration of diabetes, total serum cholesterol, serum LDL, FBG, HbA1c and serum creatinine were significantly higher in the CSME group (P <0.05). The hemoglobin, packed cell volume were significantly lower in the CSME group (P <0.05). There was no significant difference for serum HDL, TG, BMI, systolic and diastolic BP. Multiple logistic regression analysis showed that total serum cholesterol and HbA1c had significantly high odds of developing CSME. ·CONCLUSION:HbA1c and total cholesterol are the two most important risk factors associated with CSME in patients with NPDR.

Responsiveness and minimal clinically important difference of the Chinese version of the Low Vision Quality of Life Questionnaire after cataract surgery

AIM: To investigate the Chinese version of the Low Vision Quality of Life Questionnaire(CLVQOL) as an instrument for obtaining clinically important changes after cataract surgery.METHODS: Patients underwent cataract surgery in Shanghai General Hospital, Shanghai Jiao Tong University, who fit the inclusion criteria were recruited. Two CLVQOLs were administered, including a preoperative CLVQOL and a CLVQOL at the end of the 3 mo follow-up period, and were completed using face-to-face interviews or phone interviews conducted by trained investigators. The minimal clinically important difference(MCID) was calculated using an anchor-based method and a distribution method. In addition, the responsiveness of the questionnaire was measured.RESULTS: A total of 155 residents were enrolled. The average visual acuity(VA) preoperatively was 0.08(SD=0.05), and it increased to 0.47(SD=0.28) at the end of followup. Statistically significant positive changes in the CLVQOL scores indicated significant improvement of vision related quality of life after cataract surgery. With the larger value between the two results as the final value, the MCID values of the CLVQOL(scores of the four scales as well as the total score) were 8.94, 2.61, 4.34, 3.10 and 17.63, respectively. The CLVQOL has both good internal and external responsiveness.CONCLUSION: CLVQOL scores are appropriate instruments for obtaining clinically important changes after cataract surgery. This study is an effective exploration for establishingcataract surgery efficacy standards, which helps clinical and scientific research workers in ophthalmology to gain a more in-depth understanding when using CLVQOL.

Perioperative complications of radical retropubic prostatectomy in patients with locally advanced prostate cancer： a comparison with clinically localized prostate cancer

Radical prostatectomy （RP） continues to be an effective surgical therapy for prostate carcinoma, particularly for organ-confined prostate cancer （PCa）. Recently, RP has also been used in the treatment of locally advanced prostate cancer. However, little research has been performed to elucidate the perioperative complications associated with RP in patients with clinically localized or locally advanced PCa. We sought to analyse the incidence of complications in these two groups after radical retropubic prostatectomy （RRP）. From June 2002 to July 2010, we reviewed 379 PCa patients who underwent RRP in our hospital. Among these cases, 196 had clinically localized PCa （Tla-T2c group 1）, and 183 had locally advanced PCa （ ≥ T3,： group 2）. The overall complication incidence was 21.9%, which was lower than other studies have reported. Perioperative complications in patients with locally advanced PCa mirror those in patients with clinically localized PCa （26.2% vs. 17.8%, P=0.91）. Our results showed that perioperative complications could not be regarded as a factor to consider in regarding RP in patients with cT3 or greater.

Establishing minimum clinically important difference values for the Patient-Reported Outcomes Measurement Information System Physical Function, hip disability and osteoarthritis outcome score for joint reconstruction, and knee injury and osteoarthritis out

AIM To establish minimum clinically important difference(MCID) for measurements in an orthopaedic patient population with joint disorders.METHODS Adult patients aged 18 years and older seeking care for joint conditions at an orthopaedic clinic took the Patient-Reported Outcomes Measurement Information System Physical Function(PROMIS~? PF) computerized adaptive test(CAT), hip disability and osteoarthritis outcome score for joint reconstruction(HOOS JR), and the knee injury and osteoarthritis outcome score for joint reconstruction(KOOS JR) from February 2014 to April 2017. MCIDs were calculated using anchorbased and distribution-based methods. Patient reports of meaningful change in function since their first clinic encounter were used as an anchor.RESULTS There were 2226 patients who participated with a mean age of 61.16(SD = 12.84) years, 41.6% male, and 89.7% Caucasian. Mean change ranged from 7.29 to 8.41 for the PROMIS~? PF CAT, from 14.81 to 19.68 for the HOOS JR, and from 14.51 to 18.85 for the KOOS JR. ROC cut-offs ranged from 1.97-8.18 for the PF CAT, 6.33-43.36 for the HOOS JR, and 2.21-8.16 for the KOOS JR. Distribution-based methods estimated MCID values ranging from 2.45 to 21.55 for the PROMIS~? PF CAT; from 3.90 to 43.61 for the HOOS JR, and from 3.98 to 40.67 for the KOOS JR. The median MCID value in the range was similar to the mean change score for each measure and was 7.9 for the PF CAT, 18.0 for the HOOS JR, and 15.1 for the KOOS JR.CONCLUSION This is the first comprehensive study providing a wide range of MCIDs for the PROMIS? PF, HOOS JR, and KOOS JR in orthopaedic patients with joint ailments.

Lag of accommodation predicts clinically significant change of spherical equivalents after cycloplegia

AIM: To evaluate related factors with the change of spherical equivalents(ΔSE) and determine the suitable predictor of clinically significant ΔSE(≥0.50 D) with cyclopentolate hydrochloride on Chinese children. METHODS: A total of 145 right eyes of 145 children aged 4 to 15 y were enrolled. Intraocular pressure, axial length and lag of accommodation(LOA) were assessed before cycloplegia induced by 3 drops of 1% cyclopentolate at 5-minute intervals. SE was measured before and 1 h after the first drop of cyclopentolate. ΔSE was compared between different gender groups and among refractive groups. Multivariate linear regression analysis was performed to find related factors with ΔSE. ROC analysis was used to figure out the suitable predictor of clinically significant ΔSE.RESULTS: For the total 145 eyes, the mean SE reached up to-0.70±1.86 D from-1.30±1.62 D, with the mean ΔSE of 0.60±0.55 D. The mean ΔSE were 0.63±0.55 D and 0.57±0.56 D respectively in the male and female group(P=0.40). The mean ΔSE was significantly different among different refractive groups(P<0.0001), with the ΔSE of hyperopia group(1.12±0.64 D) larger than that of the emmetropia(0.56±0.43 D, P=0.001) and myopia group(0.32±0.28 D, P<0.0001). The ΔSE was correlated with LOA(B=-0.54, P<0.0001), cycloplegic SE(B=0.10, P<0.0001) and age(B=-0.04, P=0.015). ROC curve indicated that LOA predicted clinically significant ΔSE by 82% [area under the curve(AUC)=0.82] alone, while the value was slightly improved to 85%(AUC=0.85) in combination with axial length and 86%(AUC=0.86) in association with axial length as well as age.CONCLUSION: After cycloplegia with cyclopentolate, the ΔSE decreases with larger LOA, longer axial length and older age. Specifically, LOA plays a more vital role in predicting clinically significant ΔSE.

Psychopathological outcomes and defence mechanisms in clinically healed adults with a paediatric cancer history: an exploratory study

Background The incidence of paediatric cancers has increased in recent years;however,with advances in the treatment of paediatric cancer,almost 80%of children and adolescents who receive a diagnosis of cancer become long-term survivors.Given the high stress levels associated with cancer,it becomes important to ascertain the risk and likelihood of psychiatric disorders in adult paediatric cancer survivors.Aims This study aims to investigate the relationship between defence styles and predisposition to psychiatric diseases in adults with a history of paediatric cancer.Methods We performed an explorative study on a sample of 66 clinically healed adults with a history of paediatric cancer(survivors)during follow-up visits at the University Hospital‘Policlinico G Rodolico’of Catania(Italy)and 98 healthy controls among medicine students.We administered the Defence Mechanism Inventory(DMI)to assess defence styles.The Symptom Checklist-90-Revised(SCL-90-R)and the Davidson Trauma Scale(DTS)were administered to assess psychopathological indices.We conducted comprehensive statistical analysis based on correlation analysis and mediation analysis to investigate the relationship between defence styles and psychopathological outcomes in survivors compared with controls.Results The survivors obtained statistically significant lower values in TAO,PRO and TAS defence styles and a higher value in REV.Both groups showed non-pathlogical mean scores in DTS and SCL-90-R(with an exception of the obsessive-compulsive subscale),with lower mean values among survivors.The results of mediation analysis showed that TAS had mediation effects on interpersonal sensitivity,anxiety,PSDI,GSI and avoidance,while TAO had mediation effects on DTS total score and intrusivity.Thus,for these psychopathological indices,the effect of the oncological pathology was indirect and mediated by TAO or TAS.Our analysis exlcluded mediation effects between the remaining variables and defence styles.Conclusion Integrating data from mediation and correlation analysis,we found how the decreasing of TAS utilization in survivors as the consequence of cancer history,has decreased interpersonal sensitivity,anxiety and GSI score in these subjects compared with controls.Similary,the decrease of TAO utilization played a role in lower values of DTS total score and intrusivity subscale.Unexpectedly,our analysis excluded relationships between cancer history,other defence styles and psycopathological scores as we initially assumed.

Relationship between subgroups of central and lateral lymph nodemetastasis in clinically node-negative papillary thyroid carcinoma

BACKGROUND Lymph node metastasis(LNM) of papillary thyroid carcinoma(PTC) has a certain regularity and occurs first to the central lymph node and then to the lateral lymph node. The pathway of PTC LNM can guide surgical prophylactic lymph node dissection(LND) for clinical surgeons.AIM To investigate the relationship between subgroups of central LNM and lateral LNM in unilateral clinically node-negative PTC(cN0-PTC).METHODS Data were collected for 1089 PTC patients who underwent surgical treatment at the Department of Endocrine and Breast Surgery of the First Hospital of Chongqing Medical University from January 2016 to December 2017. A total of 388 unilateral cN0-PTC patients met the inclusion criteria and were enrolled in this study. The clinical and pathological data for these 388 patients who underwent total thyroidectomy + central LND + lateral LND were retrospectively analyzed. The relationship between the central LNM and lateral LNM subgroups was investigated.RESULTS The coincidence rate of cN0-PTC was only 30.0%.Optimal scaling regression analysis showed that sex(57.1% vs 42.9%, P = 0.026), primary tumor size(68.8% vs 31.2%, P = 0.008), tumor location(59.7% vs 40.3%, P = 0.007), extrathyroid extension(ETE)(50.6% vs 49.9%, P = 0.046), and prelaryngeal LNM(57.1% vs 42.9%, P = 0.004) were significantly associated with ipsilateral level-II LNM. Their importance levels were 0.122, 0.213, 0.172, 0.110, and 0.227, respectively. Primary tumor size(74.6% vs 30.2%, P = 0.016), pretracheal LNM(67.5% vs 32.5%, P < 0.001), and paratracheal LNM(71.4% vs 28.6%, P < 0.001) were significantly associated with ipsilateral level-Ⅲ LNM. Their importance levels were 0.120, 0.408, and 0.351, respectively. Primary tumor size(72.1% vs 27.9%, P = 0.003), ETE(70.4% vs 29.6%, P = 0.016), pretracheal LNM(68.3% vs 31.7%, P=0.001), and paratracheal LNM(80.8% vs 19.2%, P < 0.001) were significantly associated with ipsilateral level-IV LNM. Their importance levels were 0.164, 0.146, 0.216, and 0.472, respectively.CONCLUSION The LNM pathway of thyroid cancer has a certain regularity. For unilateral cN0-PTC patients with a tumor diameter > 2 cm and pretracheal or ipsilateral paratracheal LNM, LND at ipsilateral level Ⅲ and level IV must be considered. When there is a tumor in the upper third of the thyroid with prelaryngeal LNM, LND at level II, level Ⅲ and level IV must be considered.

Visual pathways involvement in clinically isolated syndrome in children

AIM: To investigate extent and nature of visual pathways involvement in children with clinically isolated syndrome(CIS).METHODS: Forty-seven patients(age 11-17y) with CIS, which later proved to be multiple sclerosis(MS)onset, and 30 controls underwent visual evoked potentials(VEP) investigation within 12 d from the appearance of the first signs of disease. Latency and amplitude of P100 peak were compared with normative data and between groups.RESULTS: In 58% patients, including those without signs of retrobulbar neuritis, significant slowing of conduction along the central visual pathways(P100latency lengthening) is seen. P100 amplitudes drop(signs of axonal damage) are registered less frequently(29% cases).CONCLUSION: The results indicate that visual pathways are often affected in the MS onset; mostly demyelination signs are seen. Despite MRI significance for MS diagnostic, VEPs proved to be still effective in early diagnosis of MS in children.

Drain fluid biomarkers for prediction and diagnosis of clinically relevant postoperative pancreatic fistula:A narrative review

Clinically relevant postoperative pancreatic fistula(CR-POPF)has continued to compromise patient recovery post-pancreatectomy despite decades of research seeking to improve risk prediction and diagnosis.The current diagnostic criteria for CR-POPF requires elevated drain fluid amylase to present alongside POPFrelated complications including infection,haemorrhage and organ failure.These worrying sequelae necessitate earlier and easily obtainable biomarkers capable of reflecting evolving CR-POPF.Drain fluid has recently emerged as a promising source of biomarkers as it is derived from the pancreas and hence,capable of reflecting its postoperative condition.The present review aims to summarise the current knowledge of CR-POPF drain fluid biomarkers and identify gaps in the field to invigorate future research in this critical area of clinical need.These findings may provide robust diagnostic alternatives for CR-POPF and hence,to clarify their clinical utility require further reports detailing their diagnostic and/or predictive accuracy.

X-Ray Induced Mutation Frequency at the <i>Hypoxanthine Phosphoribosyltransferase</i>Locus in Clinically Relevant Radioresistant Cells

To elucidate the molecular mechanisms underlying cellular radioresistance, clinically relevant radioresistant cell lines were established via long-term exposure to X-rays with stepwise dose escalation. Established cells continue to proliferate despite exposure to 2 Gy X-rays/day for more than 30 days, a standard protocol in cancer radiotherapy. DNA repair fidelity in radioresistant and the parental cells by evaluating the mutation frequency at the hypoxanthine phosphoribosyltransferase (HPRT) locus after exposure to X-rays was determined. Mutation spectrum at the HPRT locus was examined by multiplex polymerase chain reaction. Rejoining kinetics of X-ray-induced DNA double strand breaks (dsbs) was evaluated by the detection of phosphorylated histone H2AX (γH2AX) after X-irradiation. The fold increase in the HPRT mutation frequency due to acute radiation was similar between radioresistant and the parental cell lines. However, fractionated radiation (FR) consisting of 2 Gy X-rays/day increased the mutation frequency at the HPRT locus in parental but not in radioresistant cells. Analysis of the FR-induced mutations at the HPRT locus revealed a high frequency of deletion mutations (>70%) in parental but not in radioresistant cells. As assessed by γH2AX immunostaining, DNA dsbs induced by acute exposure to 10 Gy of X-rays were repaired to the control level within 7 days in radioresistant but not in the parental cells. Moreover, 2 Gy × 5 FR increased the number of γH2AX-positive cells in parental cultures but not in radioresistant cultures. DNA dsbs induced by 2 Gy/day FR are repaired with fidelity in radioresistant but not in parental cells.

The Effects of a Single Bout of Exercise on Mood and Self-Esteem in Clinically Diagnosed Mental Health Patients

Objectives: Research has highlighted the importance of regular exercise within the general population and mental health groups in regard to mood and self-esteem, as well as single bout exercise within the general population. However, research into single bout exercise in mental health population is lacking. This study investigated the impact of a single bout of exercise, on mood and self-esteem, in patients with a wider clinical mental health diagnosis. Design: A quantitative questionnaire was completed immediately pre and post a single, 45 minute bout of moderate intensity exercise, consisting of the Brunel Universal Mood States (BRUMS) questionnaire and the Rosenberg Self Esteem Scale (RSE). Methods: Participants attending a mental health hospital with a clinical mental health diagnosis (N = 54) completed the questionnaire. Information regarding physical activity levels, mental health diagnosis and length of hospital stay were collated. Results: A significant improvement was identified on the RSE as well as the BRUMS (depression, anger, confusion, anxious tension and vigour) over time. Conclusion: The significant findings highlight the importance of exercise promotion within this population group, and the potentially beneficial role that a single bout of exercise can have on mood and self-esteem in patients experiencing mental health problems.

Phantom bite syndrome:Revelation from clinically focused review

Phantom bite syndrome(PBS),also called occlusal dysesthesia,is characterized by persistent non-verifiable occlusal discrepancies.Such erroneous and unshakable belief of a“wrong bite”might impel patients to visit multiple dental clinics to meet their requirements to their satisfaction.Subsequently,it takes a toll on their quality of life causing,career disruption,financial loss and suicidal thoughts.In general,patients with PBS are quite rare but distinguishable if ever encountered.Since Marbach reported the first two cases in 1976,there have been dozens of published cases regarding this phenomenon,but only a few original studies were conducted.Despite the lack of official classification and guidelines,many authors agreed on the existence of a PBS“consistent pattern”that clinicians should be made aware.Nevertheless,the treatment approach has been solely based on incomplete knowledge of etiology,in which none of the proposed theories are fully explained in all the available cases.In this review,we have discussed the critical role of enhancing dental professionals’awareness of this phenomenon and suggested a comprehensive approach for PBS,provided by a multidisciplinary team of dentists,psychiatrists and exclusive psychotherapists.

Seroprevalence of Brucellosis among Clinically Suspected Human Cases Presenting at Health Facilities in Namibia from 2012 to 2017

Brucellosis is a zoonosis global importance.Brucella abortus and Brucella melitensis are the main species responsible for this disease in humans and production losses in domestic ruminants.Unpasteurized milk,home-made cheese and ice cream,and meat present a risk for human infection[1].

Antimicrobial Activity of Polyalthia longifolia (Sonn.) Thw. var. Pendula Leaf Extracts Against 91 Clinically Important Pathogenic Microbial Strains

The methanol, acetone and 1,4-dioxan fractions of leaves of Polyalthia longifolia (Sonn.) Thw. were evaluated for antibacterial and antifungal activity. 91 clinically important strains were used for the study which were both clinical isolates as well as identified strains. Piperacillin and gentamicin were used as standards for antibacterial assay, while nystatin and flucanazole were used as standards for antifungal assay. The antibacterial activity was more pronounced against gram positive bacterial and fungal strains. Poor activity was shown against gram negative bacterial strains studied.