Key lifestyles and health outcomes across 16 prevalent chronic diseases: A network analysis of an international observational study.

Background: Central and bridge nodes can drive significant overall improvements within their respective networks. We aimed to identify them in 16 prevalent chronic diseases during the coronavirus disease 2019 (COVID-19) pandemic to guide effective intervention strategies and appropriate resource allocation for most significant holistic lifestyle and health improvements. Methods: We surveyed 16 512 adults from July 2020 to August 2021 in 30 territories. Participants self-reported their medical histories and the perceived impact of COVID-19 on 18 lifestyle factors and 13 health outcomes. For each disease subgroup, we generated lifestyle, health outcome, and bridge networks. Variables with the highest centrality indices in each were identified central or bridge. We validated these networks using nonparametric and case-dropping subset bootstrapping and confirmed central and bridge variables' significantly higher indices through a centrality difference test. Findings: Among the 48 networks, 44 were validated (all correlation-stability coefficients >0.25). Six central lifestyle factors were identified: less consumption of snacks (for the chronic disease: anxiety), less sugary drinks (cancer, gastric ulcer, hypertension, insomnia, and pre-diabetes), less smoking tobacco (chronic obstructive pulmonary disease), frequency of exercise (depression and fatty liver disease), duration of exercise (irritable bowel syndrome), and overall amount of exercise (autoimmune disease, diabetes, eczema, heart attack, and high cholesterol). Two central health outcomes emerged: less emotional distress (chronic obstructive pulmonary disease, eczema, fatty liver disease, gastric ulcer, heart attack, high cholesterol, hypertension, insomnia, and pre-diabetes) and quality of life (anxiety, autoimmune disease, cancer, depression, diabetes, and irritable bowel syndrome). Four bridge lifestyles were identified: consumption of fruits and vegetables (diabetes, high cholesterol, hypertension, and insomnia), less duration of sitting (eczema, fatty liver disease, and heart attack), frequency of exercise (autoimmune disease, depression, and heart attack), and overall amount of exercise (anxiety, gastric ulcer, and insomnia). The centrality difference test showed the central and bridge variables had significantly higher centrality indices than others in their networks (P < 0.05). Conclusion: To effectively manage chronic diseases during the COVID-19 pandemic, enhanced interventions and optimised resource allocation toward central lifestyle factors, health outcomes, and bridge lifestyles are paramount. The key variables shared across chronic diseases emphasise the importance of coordinated intervention strategies.

Estudio clínico comparativo entre articaína y lidocaína / A clinical comparative study between articaine and lidocaine

El propósito de este estudio fue comparar el efecto anestésico entre la lidocaína y el clorhidrato de articaína. Hipótesis: el clorhidrato de articaína tiene mejor efecto anestésico. Materiales y métodos: cartuchos comerciales de lidocaína (xylocaína) y articaína (medicaína) fueron usados para algunos procedimientos en pacientes sanos. La edad fue de 18 a 30 años, con una media de 26 años. Solamente un cartucho de anestesia fue utilizado por procedimiento por el mismo operador. Fue registrada la información sobre tiempo de latencia, duración de la anestesia, así como el grado de dolor obtenido por el paciente. Resultados: mayor eficacia del clorhidrato de articaína sobre la lidocaína con mayor tiempo de duración, bien tolerada por los pacientes y con reportes al dentista de ausencia de dolor. Conclusión: el clorhidrato de articaína tiene algunas ventajas sobre la lidocaína en relación al control de dolor y menor tiempo operatorio