RESUMO
This study aimed to investigate distinct neurometabolites in the anterior cingulate cortex (ACC), right and left thalamus, and insula of patients with fibromyalgia (FM) compared with healthy controls using proton magnetic resonance spectroscopy (MRS). Levels of N-acetylaspartate (NAA), N-acetylaspartylglutamate (NAAG), total NAA (tNAA = NAA + NAAG), myo-inositol (ml), glutamine (Gln), glutamate (Glu), Glx (Glu + Gln), glycerophosphocholine (GPC), total choline (tCho = GPC + phosphocholine) and glutathione (GSH) levels relative to total creatine (tCr) levels including creatine (Cr) and phosphocreatine (PCr) and relative to Cr levels were determined in the ACC, right and left thalamus, and insula in 12 patients with FM and 13 healthy controls using MRS. In the ACC, NAA/tCr (P = 0.028) and tCho/tCr (P = 0.047) were higher in patients with FM. In the right and left insula, tNAA/tCr (P = 0.019, P = 0.007, respectively) was lower in patients with FM. Patients with FM showed lower levels of ml/Cr (P = 0.037) in the right insula than healthy controls. These findings are paramount to understand decisive pathophysiological mechanisms related to abnormal features in the brain and parasympathetic nervous systems in FM. We suggest that the results presented herein may be essential to understand hidden pathological mechanisms and also life system potential as protective and recovering metabolic strategies in patients with FM.
Assuntos
Encéfalo/metabolismo , Encéfalo/patologia , Fibromialgia/metabolismo , Espectroscopia de Ressonância Magnética , Metaboloma , Estudos de Casos e Controles , Colina/metabolismo , Creatina/metabolismo , Humanos , Padrões de Referência , Transtornos de Estresse Pós-Traumáticos/metabolismo , Estresse Psicológico/genéticaRESUMO
OBJECTIVES: So far, dysfunction in mental rotation has been assessed in relation to the left- or right-sided CRPS. Here we examined mental rotation in patients with upper or lower limb CRPS. Considering the potential role of socio-emotional functioning on the perception of body image, we further investigated the association between performance on mental rotation and socio-emotional characteristics. METHODS: We examined the performance of 36 patients with upper or lower limb CRPS on the limb laterality recognition. Accuracy and response times for pictures of hands and feet at 4 rotation angles were evaluated. Socio-emotional functioning was measured by the Interpersonal Reactivity Scale and the Toronto Alexithymia Scale. RESULTS: Patients with upper limb pain showed longer RTs to recognize the laterality of hands than feet (P = 0.002), whereas patients with lower limb pain showed longer RTs for feet than hands (P = 0.039). Exploratory correlation analyses revealed that RTs for feet were negatively correlated with the levels of empathic ability to take another's perspective (P = 0.006) and positively correlated with the level of emotional difficulty in identifying feelings (P = 0.006). CONCLUSIONS: This study is the first to report selectively impaired mental rotation of hands vs feet in patients with upper or lower limb CRPS. The findings suggest that impaired mental rotation derives from relative deficits in the representation of the affected limb. Correlations between impaired mental rotation and socio-emotional inability indicate that an altered body schema may be closely associated with impaired social cognitive aspects in CRPS patients.
Assuntos
Síndromes da Dor Regional Complexa , Cognição Social , Pé , Mãos , Humanos , Tempo de ReaçãoRESUMO
BACKGROUND: The purpose of this study is to analyze and classify morphological features of the nasolacrimal duct (NLD) through 3D reconstruction to help understand the causes and treatment of NLD obstruction. METHODS: In this study, we included 63 males and 55 females who underwent autopsy without NLD obstruction with ages ranging from 20 to 78 years. The NLD was defined from the lacrimal fossa to the opening of the BNLD to the inferior meatus, and all continuous CT images showing the NLD were selected. Segmentation was performed semi-automatically, and the reconstruction and measurement of NLD was performed using the Mimics program. RESULTS: Overall NLD length, bony nasolacrimal duct (BNLD) length, anteroposterior and transverse diameters at the entrance to the BNLD, anteroposterior and transverse smallest diameters of the BNLD, BNLD volume, and lacrimal sac BNLD angle were significantly higher in males than females (p < .05). BNLD direction in the coronal plane was slightly more likely to be inward. The most common type in both sexes was cylinder type (42.0%), males were more likely to have lower-thicker types (34.1%), and females more likely to have upper-thicker types (22.7%). CONCLUSION: There were sex differences in NLD measurements, and females had significantly smaller NLDs. These results may partially explain the increased prevalence of primary acquired NLD obstruction in females. The BNLD tends toward the midline, and inclines posteriorly.
Assuntos
Imageamento Tridimensional , Ducto Nasolacrimal/anatomia & histologia , Ducto Nasolacrimal/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto , Idoso , Cadáver , Dacriocistorinostomia , Feminino , Humanos , Obstrução dos Ductos Lacrimais/terapia , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
Background: Fibromyalgia (FM) and complex regional pain syndrome (CRPS) share many pathological mechanisms related to chronic pain that could contribute to multifactorial pathological mechanisms.Methods: We investigated peripheral metabolites in FM and CRPS patients compared to healthy controls based on cross-sectional study.Results: Mean corpuscular hemoglobin (p < 0.001), mean corpuscular volume (p = 0.014), and total bilirubin levels (p = 0.017) were lower in FM patients than in healthy controls. On the other hand, CRPS patients showed lower levels of total bilirubin than healthy controls (p = 0.037). Creatinine level was lower in FM patients (p = 0.057) compared to healthy controls, particularly when comparing the low-hemoglobin subgroup among FM patients (p = 0.035) with the low-hemoglobin subgroup among healthy controls. Red blood cell count (r = -0.620, p = 0.031), hematocrit (r = -0.593, p = 0.042), and creatinine level (r = -0.598, p = 0.040) showed negative correlations with McGill Pain Questionnaire-Affective (MPQ-A) scores in FM patients. A negative correlation was observed between MCV and McGill Pain Questionnaire-Sensory scores (r = -0.680, p = 0.015) in CRPS patients.Conclusion: We found specific peripheral metabolites that may exhibit different tendency between FM and CRPS patients as well as some common metabolites, which may be associated with peripheral pathology in the patients. Considering this study had a few limitations such as a small sample sizes and using a liberal threshold of significance in the correlation analysis, future studies with larger sample sizes may be needed to generalize these findings.
Assuntos
Síndromes da Dor Regional Complexa/metabolismo , Fibromialgia/metabolismo , Adulto , Síndromes da Dor Regional Complexa/sangue , Síndromes da Dor Regional Complexa/epidemiologia , Estudos Transversais , Feminino , Fibromialgia/sangue , Fibromialgia/epidemiologia , Humanos , Masculino , Pessoa de Meia-Idade , Adulto JovemRESUMO
OBJECTIVE: Although the clinical features and pathophysiology of complex regional pain syndrome (CRPS) have been studied in the peripheral and central nervous systems, few plausible pathological interactions are known among the metabolites in these systems. Thus, the purpose of this study was to investigate abnormal relationships and interactions between peripheral metabolites and central neurometabolites in patients with CRPS. METHODS: Various metabolites and molecules were measured in the peripheral blood, and central neurometabolites in the right and left thalamus using proton magnetic resonance spectroscopy in 12 patients with CRPS and 11 healthy controls. Interactions between peripheral metabolites in blood and central neurometabolites in the right and left thalamus were also investigated. RESULTS: The interactions between peripheral and central metabolites were different in the right and left hemispheres of healthy subjects, suggesting the presence of right hemisphere-dependent energy homeostasis and left hemisphere-dependent acid-base homeostasis that enables effective functioning. The interactions between central and peripheral metabolites in CRPS patients were distinct from those in healthy individuals, supporting the possibility of abnormal interactions and disrupted homeostasis between peripheral and central metabolites, which may result from neuroinflammation and immune system dysfunction. CONCLUSION: To the authors' knowledge, this is the first report describing abnormal metabolic dysfunction and disrupted homeostasis in interactions between metabolites of the peripheral and central nervous systems in CRPS. The approach used to uncover hidden pathophysiologies will improve understanding of how chronic pain can disrupt homeostasis in interactions between two systems and how alternative metabolites can be activated to recover and compensate for pathological dysfunctions in patients with CRPS.
Assuntos
Síndromes da Dor Regional Complexa/metabolismo , Lateralidade Funcional/fisiologia , Homeostase/fisiologia , Tálamo/metabolismo , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espectroscopia de Prótons por Ressonância MagnéticaRESUMO
OBJECTIVES: In Korea, patients diagnosed with complex regional pain syndrome (CRPS) in the army are typically discharged from the army; however, the course of the disease after discharge is not known. The purpose of this study was to investigate the course of CRPS that occurred in the army and to identify the influences of various clinical and psychosocial factors immediately before discharge on the disease course. METHODS: Clinical profiles and psychosocial status were collected from the medical records of 16 patients with CRPS type 1 who were discharged during the period between March 2017 and April 2018. The degree of improvement after discharge was assessed by follow-up evaluation through telephone contact. Cox proportional hazards regression was performed to identify clinical and psychosocial predictors for the rate of recovery. RESULTS: The median time to recovery after discharge was 39 weeks (95% confidence interval [CI] = 8.8-69.2 weeks). The sole predictor for time to recovery after discharge was the time period from the onset of pain to discharge. Each one-week increase in the duration of pain experienced in the military was associated with a 18.2% (95% CI = 5.3%-29.5%) reduction in the rate of recovery after discharge (P = 0.007). CONCLUSIONS: Patients who experienced a short period of pain in the military demonstrated a relatively good prognosis after discharge. This may show how prolonged pain in the army could affect the experience of pain from a social point of view, in that it shows the disease course after a change in the social environment.
Assuntos
Militares , Distrofia Simpática Reflexa/diagnóstico , Escolaridade , Feminino , Seguimentos , Humanos , Masculino , Testes Neuropsicológicos , Medição da Dor , Prognóstico , Recuperação de Função Fisiológica , Distrofia Simpática Reflexa/psicologia , República da Coreia , Estudos Retrospectivos , Meio Social , Adulto JovemRESUMO
Ojjective: The aim of this study was to find peripheral biomarkers and central metabolites affecting neuroinflammation in complex regional pain syndrome (CRPS) patients using [11C]-(R)-PK11195 positron emission tomography (PET) and magnetic resonance spectroscopy (MRS). Methods: Using MRS and PET, we measured associations between neurometabolites and neuroinflammation in 12 CRPS patients and 11 healthy controls. Also, we investigated various peripheral parameters that may affect neuroinflammation in CRPS. Results: We found positive correlations of Lipid (Lip)13a/total creatine (tCr) and Lip09/tCr with neuroinflammation, the distribution volume ratio (DVR) of [11C]-(R)-PK11195 in the right and left insula in CRPS patients. However, these correlations were not found in controls. High hemoglobin levels correlated with decreased neuroinflammation (the DVR of [11C]-(R)-PK11195) in the right thalamus and left insula in healthy controls. We found that high levels of glucose and pH correlated with increased neuroinflammation, but high levels of CO2, basophil, and creatinine were associated with decreased neuroinflammation in the left thalamus and the right and left insula in CRPS patients. Conclusions: This is the first report indicating that elevated neuroinflammation levels are associated primarily with lipids in the brain and pH, glucose, CO2, basophil, and creatinine in the peripheral parameters in CRPS patients. Our results suggest that characterizing the peripheral biomarkers and central metabolites affecting neuroinflammation is essential to understanding the pathophysiology of CRPS.
Assuntos
Biomarcadores/análise , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Síndromes da Dor Regional Complexa/diagnóstico por imagem , Síndromes da Dor Regional Complexa/metabolismo , Adulto , Basófilos , Glicemia/análise , Dióxido de Carbono/sangue , Radioisótopos de Carbono , Creatinina/sangue , Feminino , Humanos , Concentração de Íons de Hidrogênio , Inflamação/diagnóstico por imagem , Inflamação/metabolismo , Isoquinolinas , Lipídeos/análise , Espectroscopia de Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Tomografia por Emissão de Pósitrons/métodos , Compostos RadiofarmacêuticosRESUMO
Dental age estimation of the living is limited because observing the histological structure of teeth is difficult. Therefore, several methods have been proposed to estimate age by observing changes on dental radiographs of pulpal size caused by secondary dentin deposition. This study aims to evaluate the validity of the Kvaal method to estimate the ages of Korean subjects using digital panoramic radiographs and formulate regression equations for use in Korean subjects. We included 266 Korean subjects (age 21-69 years) visiting Chosun University Dental Hospital (Gwangju, South Korea). The pulpal size and width of six tooth types (maxillary central incisor, lateral incisor, second premolar, mandibular lateral incisor, canine, and first premolar) were measured on digital panoramic radiographs according to the Kvaal method. Statistical interobserver/intraobserver reliabilities were calculated to evaluate the reproducibility of the measured values, and correlations between actual ages and measured values were identified. The differences between the predicted ages and the actual age were analyzed. Paewinsky method was also applied and its validity was evaluated. In addition, a series of new regression equations for the age estimation of Korean subjects was produced. When both methods were applied directly to the teeth of the subjects, significant differences were observed between the estimated and chronological ages. The length-related parameters of the teeth of subjects calculated by the original Kvaal method showed no significant correlation. A regression equation derived from the width parameters without the length ratios is proposed for use in Korean subjects.
Assuntos
Determinação da Idade pelos Dentes/métodos , Polpa Dentária/diagnóstico por imagem , Processamento de Imagem Assistida por Computador , Radiografia Panorâmica , Adulto , Idoso , Povo Asiático , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Reprodutibilidade dos Testes , República da Coreia , Raiz Dentária/diagnóstico por imagem , Adulto JovemRESUMO
BACKGROUND: In many countries, routine clinical anaesthesia does not always involve neuromuscular monitoring. In these clinical settings, the efficacy and safety of sugammadex use has not yet been confirmed. We investigated the efficacy and safety of sugammadex in the absence of neuromuscular monitoring. METHODS: One hundred and forty patients who underwent laryngeal microsurgery with the use of rocuronium as a neuromuscular blocking agent, without the use of a neuromuscular monitoring device, were retrospectively investigated. The patients were randomly chosen among all the patients who met the inclusion criteria at a tertiary university hospital between July 2013 and February 2015 and were allocated to group S (sugammadex group) or group P (pyridostigmine group) according to the neuromuscular reversal agent administered. Five patients were excluded from analysis and 135 patients completed the study. Primary outcome was extubation time. Secondary outcomes were anaesthesia time, the correlation between anaesthesia time and extubation time, the total amount of rocuronium, and postoperative adverse events in the post-anaesthesia care unit (PACU). RESULTS: Extubation time was significantly shorter in group S (6.3 ± 3.9 min) than in group P (9.0 ± 5.4 min). Anaesthesia time was also significantly shorter in group S (30.7 ± 10.3 min) than in group P (35.8 ± 12.6 min). In the patients with an anaesthesia time of 30 min or less, there was a positive correlation between anaesthesia time and extubation time in group P (r = 0.453), but there was no significant relationship in group S. The total amount of rocuronium used was higher in group S (0.62 ± 0.11 mg kg(-1)) than in group P (0.38 ± 0.14 mg kg(-1)). Postoperative adverse events in the PACU were comparable between the groups, except for tachycardia events: the incidence of tachycardia was significantly lower in group S (8.0 %) than in group P (17.3 %). CONCLUSIONS: Sugammadex could shorten anaesthesia and extubation times as well as recovery time in the PACU and reduce postoperative hemodynamic complications in a clinical setting in the absence of neuromuscular monitoring. This may enhance the patients' recovery in the operating room and PACU while improving the postoperative condition of patients. TRIAL REGISTRATION: The trial was registered in the UMIN clinical trials registry ( www.umin.ac.jp/ctr/index/htm ; unique trial number: UMIN000016602; registration number: R000019266 ; principal investigator's name: Byung Gun Lim; date of registration: February 22, 2015).
Assuntos
Androstanóis/administração & dosagem , Laringe/cirurgia , Microcirurgia/métodos , gama-Ciclodextrinas/administração & dosagem , Adulto , Extubação , Período de Recuperação da Anestesia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fármacos Neuromusculares não Despolarizantes/administração & dosagem , Período Pós-Operatório , Estudos Retrospectivos , Rocurônio , Sugammadex , Fatores de Tempo , gama-Ciclodextrinas/efeitos adversos , gama-Ciclodextrinas/farmacologiaRESUMO
To produce a compact low-cost tunable filter required for WDM optical communications, a polymeric Bragg reflection filter with an apodized grating structure is proposed. A high-contrast polymeric waveguide is incorporated in order to obtain high reflectivity from a short Bragg grating. To overcome the bandwidth broadening, an apodized grating with a gradually changing depth of surface relief grating along the propagation direction is fabricated through the dry etching with a shadow mask. The apodized polymer grating exhibits 3-dB, 20-dB bandwidths of 0.36 nm, and 0.72 nm, respectively with a 95% reflection. The reflection wavelength is tunable over 14 nm for an applied thermal power of 500 mW.
RESUMO
Objective: The phenotypic heterogeneity and complex disease trajectory complicate the ability to predict specific clinical milestone for individual patients with amyotrophic lateral sclerosis (ALS). Here we developed individualized prediction models to estimate the time to the loss of autonomy in swallowing function. Methods: Utilizing the Pooled Resource Open-Access ALS Clinical Trials (PRO-ACT) database, we built three models of distinct time-to-event prediction algorithms: accelerated failure time (AFT), cox proportional hazard (COX) and random survival forest (RSF) for an individualized risk assessment of the swallowing milestone. The target variable was defined as the time to a decline in the ALSFRS-R swallowing item score to 1 or below, indicating a need for supplementary tube feeding. Results: Internal cross-validation revealed the median concordance index (C-index) of 0.851 (IQR, 0.842-0.859) for AFT, 0.850 (0.841-0.859) for COX and 0.846 (0.839-0.854) for RSF, and all models demonstrated good distributional calibration with predicted and observed event probabilities closely matched across different time intervals. For external validation with a registry dataset with characteristics different from PRO-ACT, the discriminative power was replicated with comparable C-indices for all models, whereas the calibration revealed a left-skewed distribution suggesting a bias towards overestimation of event probabilities in real-world data. While all models were effective at stratifying patients, the results of RSF model, unlike AFT and COX, did not match well with the KM curves of the corresponding risk groups, supporting the importance of nuanced understanding of data structure and algorithmic properties. Conclusion: Our models are implemented into a web application which could be applied to individualized counselling, management and clinical trial design for gastrostomy intervention. Further studies for model optimization will advance personalized care in patients with ALS.
RESUMO
We analysed the skulls and faces of Korean subjects using anthropometric methods to understand the anatomical characteristics of the eyeball and eye orbit region of Korean population and to determine the correlations between the hard and soft tissues around the eyeball and eye orbit region. In total, 82 sections in the region were measured to determine the correlations; among them, 34 showed significant differences by sex, and 6 showed significant differences by age. As the distance from the centre of the eye lens to the eye orbit is calculated as a ratio, we determined that the centre of the eye lens is located relatively on the lateral and superior position in each eye orbit in front view. Fourteen sections that could be used for craniofacial reconstruction/approximation in men and women were selected. Regression equations were derived according to the correlation of each section, and their reliabilities were verified by out of sample validation tests. Therefore, our results increase the accuracy of eyeball position determination, which would be useful for more efficient craniofacial reconstruction/approximation of the Korean population and should improve the efficiency of facial recognition.
Assuntos
Olho , Órbita , Humanos , Feminino , Masculino , Órbita/anatomia & histologia , Adulto , República da Coreia , Pessoa de Meia-Idade , Olho/anatomia & histologia , Adulto Jovem , Face/anatomia & histologia , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Povo Asiático , Idoso , Adolescente , Cefalometria/métodosRESUMO
Eyebrows are the most important facial feature in facial recognition with its shape rated to be more helpful than color or density for facial reconstruction or approximation. However, little extant research has estimated the position and morphological territory of the eyebrow from the orbit. Three-dimensional craniofacial models, produced from CT scans of 180 Koreans autopsied at the National Forensic Service Seoul Institute, were used to conduct metric analyses of subjects (125 males and 55 females) between 19 and 49 (mean 35.1) years. We employed 18 craniofacial landmarks to examine the morphometry of the eyebrow and orbit with 35 pairs of distances per subject measured between landmark and reference planes. Additionally, we used linear regression analyses to predict eyebrow shape from the orbit for every possible combination of variables. The morphology of the orbit has more influence on the position of the superior margin of the eyebrow. In addition, the middle part of the eyebrow was more predictable. The highest point of the eyebrow in female was located more medially than the male. Based on our findings, the equations for estimating the position of the eyebrow from the shape of the orbit is useful information for face reconstruction or approximation.
Assuntos
Sobrancelhas , Órbita , Humanos , Masculino , Feminino , Sobrancelhas/anatomia & histologia , Tomografia Computadorizada por Raios X , Análise de Regressão , Medicina Legal , Imageamento TridimensionalRESUMO
As a technique mainly hiring in forensic investigation field to identify the descents, craniofacial reconstruction (CFR) is also used in archaeology to create the faces from ancient or medieval human remains, when there is little information about his/her appearance. Eung-Cheok Ko (1531-1605) was a writer and scholar in the mid Joseon period. In January of 2019, His mummified body was found at Gumi, Kyeonsangbuk-do, Korea. The remains were anthropologically examined, and archaeological CFR was also requested for this case. This report reveals the case's facial reconstruction process and his portrait that is drawn based on the 3-dimensional CFR result.
RESUMO
PURPOSE: Fibromyalgia (FM) and complex regional pain syndrome (CRPS) share many pathological mechanisms related to chronic pain and neuroinflammation, which may contribute to the multifactorial pathological mechanisms in both FM and CRPS. The aim of this study was to assess neuroinflammation in FM patients compared with that in patients with CRPS and healthy controls. METHODS: Neuroinflammation was measured as the distribution volume ratio (DVR) of [11C]-(R)-PK11195 positron emission tomography (PET) in 12 FM patients, 11 patients with CRPS and 15 healthy controls. RESULTS: Neuroinflammation in FM patients was significantly higher in the left pre (primary motor cortex) and post (primary somatosensory cortex) central gyri (p < 0.001), right postcentral gyrus (p < 0.005), left superior parietal and superior frontal gyri (p < 0.005), left precuneus (p < 0.01), and left medial frontal gyrus (p = 0.036) compared with healthy controls. Furthermore, the DVR of [11C]-(R)-PK11195 in FM patients demonstrated decreased neuroinflammation in the medulla (p < 0.005), left superior temporal gyrus (p < 0.005), and left amygdala (p = 0.020) compared with healthy controls. CONCLUSIONS: To the authors' knowledge, this report is the first to describe abnormal neuroinflammation levels in the brains of FM patients compared with that in patients with CRPS using [11C]-(R)-PK11195 PET. The results suggested that abnormal neuroinflammation can be an important pathological factor in FM. In addition, the identification of common and different critical regions related to abnormal neuroinflammation in FM, compared with patients with CRPS and healthy controls, may contribute to improved diagnosis and the development of effective medical treatment for patients with FM.
Assuntos
Radioisótopos de Carbono/química , Síndromes da Dor Regional Complexa/complicações , Encefalite/diagnóstico por imagem , Fibromialgia/complicações , Isoquinolinas/administração & dosagem , Adulto , Encéfalo/diagnóstico por imagem , Estudos de Casos e Controles , Síndromes da Dor Regional Complexa/diagnóstico por imagem , Feminino , Fibromialgia/diagnóstico por imagem , Humanos , Isoquinolinas/química , Masculino , Pessoa de Meia-Idade , Tomografia por Emissão de PósitronsRESUMO
OBJECTIVE: This study aimed to investigate treatment effects of combination therapy of memantine and acetylcholinesterase inhibitors (AchEIs) compared with AchEIs alone on behavioral and psychological symptoms of dementia (BPSD) in patients with moderate Alzheimer's dementia (AD). METHODS: This was a 12-week, double-blind, randomized, placebo-controlled trial. A total of 148 patients with moderate AD participated in this study. Mini-Mental State Examination, Neuropsychiatric Inventory (NPI), Clinician's Interview-Based Impression of Change plus caregiver input, Gottfries-Bråne-Steen Scale, and Zarit Burden Interview were used as assessment scales. RESULTS: There were no significant differences in age, sex, or education between AChEIs alone and combination groups. The combination group showed significantly more improvement of NPI-disinhibition score (0.76±2.15) than the AChEIs alone group (-0.14±1.71) after 12 weeks. CONCLUSION: Our findings suggest that the combination therapy of memantine and AchEIs might be a beneficial option for reducing disinhibition symptoms of patients with moderate AD compared with AchEIs alone. We believe that clinicians need to consider additional memantine treatment when patients with moderate AD complain disinhibition symptom. A larger clinical trial is needed to further determine the efficacy and advantages of such combination therapy of memantine and AchEIs for treating BPSD of patients with moderate AD.
RESUMO
Mind-body training (MBT) programs are effective interventions for relieving stress and improving psychological capabilities. To expand our previous study which demonstrated the short-term effects of an 8-week online MBT program, the present study investigated whether those short-term effects persist up to a month after the end of the intervention.Among previous participants, 56 (64%) participated in this follow-up study, 25 in the MBT group and 31 in the control group. Outcome measures included the stress response, emotional intelligence, resilience, coping strategies, positive and negative affect, and anger expression of both groups at baseline, at 8 weeks (right after the training or waiting period), and at 12 weeks (a month after the training or waiting period).The MBT group showed a greater decrease in stress response at 8 weeks, and this reduction remained a month after the end of the intervention. The effect of MBT on resilience and effective coping strategies was also significant at 8 weeks and remained constant a month later. However, the improvement to emotional intelligence and negative affect did not persist a month after training.These findings suggest that the beneficial short-term effects of MBT may last beyond the training period even without continuous practice, but the retention of these benefits seems to depend on the outcome variables. Through a convenient, affordable, and easily accessible online format, MBT may provide cost-effective solutions for employees at worksites.
Assuntos
Pessoal de Saúde/psicologia , Terapias Mente-Corpo , Estresse Psicológico/prevenção & controle , Telemedicina , Adaptação Psicológica , Adulto , Afeto , Ira , Inteligência Emocional , Feminino , Seguimentos , Humanos , Resiliência Psicológica , Fatores de TempoRESUMO
This study investigated the relationships of morphology and locations of the nose and nasal aperture by using major craniofacial landmarks on the human skull and face for craniofacial reconstruction/approximation of Koreans. In the frontal view, the positions of bony landmarks on the skull, including the nasal aperture, were correlated with the positions of nasal landmarks vertical to the transverse plane. In profile, the positions of bony landmarks on the skull were correlated with the positions of nasal landmarks horizontal to the coronal plane. Overall, 26 of the 76 measurements demonstrated significant correlations between the corresponding landmarks on the nose and nasal aperture. Simple regression equations were produced from the results. This study showed that the nose and nasal aperture are significantly related to each other in terms of their morphology and location in Koreans. The prediction guidelines, produced as regression formulas, can be applied to craniofacial reconstruction/approximation and bio-anthropological research of Korean skulls. The study results can also be used clinically in rhinoplasty and nasal reconstruction surgery.
Assuntos
Antropometria/métodos , Nariz/anatomia & histologia , Adulto , Cadáver , Cefalometria , Face/anatomia & histologia , Face/diagnóstico por imagem , Feminino , Humanos , Imageamento Tridimensional , Masculino , Pessoa de Meia-Idade , Cavidade Nasal/anatomia & histologia , Cavidade Nasal/diagnóstico por imagem , Nariz/diagnóstico por imagem , República da Coreia , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Adulto JovemRESUMO
Despite academic efforts to study the Indus Valley Civilization (IVC), there have as yet been no successful attempts to unveil the IVC people's craniofacial appearance. We investigated the IVC cemetery area of Rakhigarhi site, which was estimated to be of 2273 ± 38 and 2616 ± 73 years BCE. By craniofacial reconstruction (CFR) procedure using computed tomography (CT) data of two Rakhigarhi skulls (A1 BR02 and A2 BR36), we successfully reconstructed the faces of the IVC individuals who were buried about 4500 years ago. This is the first attempt to unveil scientifically accurate representations of IVC people's actual facial morphology.
Assuntos
Arqueologia , Cemitérios , Civilização , Face/anatomia & histologia , Face/diagnóstico por imagem , Crânio/anatomia & histologia , Crânio/diagnóstico por imagem , Humanos , Índia , Fatores de Tempo , Tomografia Computadorizada por Raios X/métodosRESUMO
Purpose: To determine if there is a positive correlation between increased body mass index (BMI) and dental development in children.
Methods: The records of 500 six- to 13-year-old children were reviewed, and 250 were included in the study. BMI was calculated for each patient. Panoramic radiographs were evaluated, and dental age was estimated using Cameriere's formula. Delta values (dental age, chronological age) were analyzed using the Kruskal-Wallis test. All tests of hypotheses were two-sided at an alpha level of 0.05.
Results: A statistically significant difference in delta was observed among different BMI categories (P <0.001). Larger deltas were observed for obese patients compared to normal weight patients (P = 0.027) and underweight patients (P = 0.012). Prepubertal patients were observed to have larger deltas than pubertal patients (P < 0.001). Differences between sexes were not significant (P = 0.930).
Conclusion: Obese children were more advanced dentally than normal or under-weight children. Older children were more dentally advanced than their chronological age when compared to younger children. As children grew older, the difference between dental age and chronological age decreased.