Improvement in health-related quality of life with recombinant factor IX prophylaxis in severe or moderately severe haemophilia B patients: results from the BAX326 Pivotal Study.

Little is known about the health-related quality of life (HRQoL) burden of haemophilia B. The aim of this study was to assess HRQoL burden of haemophilia B, the benefit of recombinant factor IX (rFIX) prophylaxis and the HRQoL benefit of achieving a zero annual bleed rate. Subjects receiving rFIX (BAX326) prophylaxis or on-demand completed the SF-36 survey. Baseline SF-36 scores were compared to the general US population scores to understand the HRQoL burden. Changes in SF-36 scores between baseline and follow-up were tested using t-tests. Subgroup analysis was conducted to examine SF-36 change among subjects who switched to BAX326 prophylaxis. SF-36 scores were also compared between those with zero bleeds and those who bled during the study. Compared to the US norms, subjects reported lower average scores in all physical and several mental HRQoL domains. At follow-up, prophylaxis subjects reported statistically significant and clinically meaningful improvements in overall physical HRQoL, as measured by the Physical Component Score (PCS) (mean change 2.60, P = 0.019), Bodily Pain (BP) (3.45, P = 0.015) and Role Physical (RP) domains (3.47, P = 0.016). Subjects who switched to prophylaxis from intermittent prophylaxis or on-demand experienced more pronounced improvements not only in the PCS (3.21, P = 0.014), BP (3.71, P = 0.026), RP (4.43, P = 0.008) but also in Vitality (3.71, P = 0.04), Social Functioning (5.06, P = 0.002) and General Health domains (3.40, P = 0.009). Subjects achieving zero bleeds reported lower BP (P = 0.038). Prophylaxis with BAX326 significantly improved HRQoL in patients with moderately severe or severe haemophilia B by reducing bleeds.

Degradation of Orange II by Fenton reaction using ilmenite as catalyst.

This work deals with the degradation of the azo-dye Orange II (OII) by a heterogeneous process with dark Fenton. Natural and purified ilmenites from Colombian soil were used as catalysts. The catalysts have different physicochemical properties and are basically composed of TiO2 and Fe2O3. Ilmenites (FeTiO3), raw materials highly available at low cost, were studied by means of conventional metallography (polished grain mounts), as well as BET, XRD, and XRF in order to determine their possible source area and the factors that influence their use as a catalyst for OII degradation. The pH, the ilmenite amount, the initial CH2O2, and the temperature of the reaction system were studied. Complete degradation of dye was observed within 7 h, while 90 % of OII was removed in 7 h using Cumaribo Ilmenite. Graphical Abstract ᅟ.

Biomarkers of cardiovascular disease are increased in untreated chronic periodontitis: a case control study.

BACKGROUND: The aim of this study was to evaluate the endothelial function, systemic inflammatory biomarkers and subgingival microbial profile associations in patients with and without periodontal disease. METHODS: Forty-four patients, half with chronic moderate to severe periodontitis (cases) and half gingivitis and incipient periodontitis (controls) were recruited. Anthropometric, clinical, biochemical parameters, endothelial function, subgingival microbiota, and eight plasma biomarkers of cardiovascular disease were assessed in both groups. RESULTS: Both groups were comparable in anthropometric parameters, blood pressure, and number of positive metabolic syndrome components. Univariate analyses demonstrated significantly higher plasma levels of E-selectin (64.5 ± 30.9 vs 43.8 ± 22.2; P = 0.026) and myeloperoxidase (MPO) (103 ± 114.5 vs 49.1 ± 35.6; P = 0.032) in cases than controls. In addition, significantly higher levels of E-selectin, MPO and ICAM-1 were found in periodontitis patients after adjustment by age and waist circumference. Red complex microorganisms were more frequently detected by culture and polymerase chain reaction in patients with severe to moderate periodontitis. CONCLUSIONS: Subgingival red complex bacteria and important cardiovascular risk markers were increased in untreated chronic moderate to severe periodontitis cases. Periodontitis seems to be associated with systemic inflammation that could increase the risk of cardiovascular events. The causal relation between periodontal infections and cardiovascular disease requires further research.

Dolor crónico en el paciente anciano / Chronic pain in elderly patient

El dolor crónico es muy común en personas ancianas. El dolor es una experiencia sensitiva desagradable a la cual los médicos prestan poca atención, posiblemente por varias razones: los pacientes no mueren a causa del dolor, el dolor es una queja subjetiva, el manejo adecuado del dolor consume tiempo, el médico siente temor por los posibles efectos adversos de los analgésicos etc. El entendimiento de la físiopatología del dolor crónico facilita un adecuado manejo. En este sentido se puede dividir el dolor crónico en tres grandes tipos: nociceptivo (somático o visceral, por ejemplo: osteoartritis, enfermedad isquémica, etc.), neuropático (periférico o central, por ejemplo: neuralgia postherpética, dolor posterior a evento cerebrovascular, etc.) y dolor psicógeno. Aunque las personas ancianas son más propensas a padecer los efectos adversos de los medicamentos, en general la mayoría de analgésicos son seguros y efectivos en este grupo poblacional. Se recomienda iniciar con los analgésicos de uso común como acetaminofén, el cual se puede combinar con opioides suaves del tipo de la codeína, para dolor moderado. En el paciente geriátrico debe evitarse el uso de AINES por períodos prolongados de tiempo. Los analgésicos opioides han sido controvertidos para usar en ancianos pero en realidad han sido subutilizados ya que la probabilidad de desarrollar farmacodependencia en esta población es muy baja. Otras estrategias no farmacológicas como terapia física, ejercicio dirigido, TENS, técnicas de relajación, etc. bien sea solas o en combinación con fármacos siempre deben formar parte integral del manejo del anciano con dolor crónico