Prevalence, patterns, and predictors of patient-reported non-motor outcomes at 30 days after acute stroke: Prospective observational hospital cohort study.

BACKGROUND: Adverse non-motor outcomes are common after acute stroke and likely to substantially affect quality of life, yet few studies have comprehensively assessed their prevalence, patterns, and predictors across multiple health domains. AIMS: We aimed to identify the prevalence, patterns, and the factors associated with non-motor outcomes 30 days after stroke. METHODS: This prospective observational hospital cohort study-Stroke Investigation in North and Central London (SIGNAL)-identified patients with acute ischemic stroke or intracerebral hemorrhage (ICH) admitted to the Hyperacute Stroke Unit (HASU) at University College Hospital (UCH), London, between August 1, 2018 and August 31, 2019. We assessed non-motor outcomes (anxiety, depression, fatigue, sleep, participation in social roles and activities, pain, bowel function, and bladder function) at 30-day follow-up using the Patient-Reported Outcome Measurement Information System-Version 29 (PROMIS-29) scale and Barthel Index scale. RESULTS: We obtained follow-up data for 605/719 (84.1%) eligible patients (mean age 72.0 years; 48.3% female; 521 with ischemic stroke, 84 with ICH). Anxiety (57.0%), fatigue (52.7%), bladder dysfunction (50.2%), reduced social participation (49.2%), and pain (47.9%) were the commonest adverse non-motor outcomes. The rates of adverse non-motor outcomes in ⩾ 1, ⩾ 2 and ⩾ 3 domains were 89%, 66.3%, and 45.8%, respectively; in adjusted analyses, stroke due to ICH (compared to ischemic stroke) and admission stroke severity were the strongest and most consistent predictors. There were significant correlations between bowel dysfunction and bladder dysfunction (κ = 0.908); reduced social participation and bladder dysfunction (κ = 0.844); and anxiety and fatigue (κ = 0.613). We did not identify correlations for other pairs of non-motor domains. CONCLUSION: Adverse non-motor outcomes were very common at 30 days after stroke, affecting nearly 90% of evaluated patients in at least one health domain, about two-thirds in two or more domains, and almost 50% in three or more domains. Stroke due to ICH and admission stroke severity were the strongest and most consistent predictors. Adverse outcomes occurred in pairs of domains, such as with anxiety and fatigue. Our findings emphasize the importance of a multi-domain approach to effectively identify adverse non-motor outcomes after stroke to inform the development of more holistic patient care pathways after stroke.

Comparison of Surface Roughness and Color Stability of Different Denture Characterizing Composite Resins: The Effect of Different Surface Treatments.

PURPOSE: This study aimed to investigate the effect of surface treatment and type of composite resin material on the color stability and surface roughness of different denture characterizing composites. MATERIALS AND METHODS: Two nanohybrids [Gradia Plus Gum, (GP) and SR Nexco Paste Gingiva, (SR)] and one microhybrid gingiva-colored composite resin [Amaris Gingiva, (AG)] were investigated. A total of 120 disk-shaped samples were prepared, 40 of each material. Samples were divided into two groups (n = 20) for each material according to the surface treatment applied: conventional polishing (control) and coated with a sealant in addition to the surface polishing. All groups were thermocycled. The surface roughness (Ra) was measured using a profilometer after thermal cycling. The samples were then divided into 2 subgroups (n = 10) and stored for 7 days in distilled water or coffee solution. Color differences (ΔE00 ) were calculated with a spectrophotometer. Results were evaluated with Kruskal-Wallis and Mann-Whitney U statistical analysis. RESULTS: The type of denture characterizing composite material and surface treatment method revealed statistically significant differences for the ΔE00 (after immersion both in coffee and distilled water) and the Ra values of denture characterizing composite (p < 0.001 for both). All sealed groups showed significantly higher Ra than the all polished groups. Both in the polished groups and the sealant applied groups, the GP had the highest mean Ra values (0.29 ±0.05 µm and 0.47 ±0.09 µm, respectively). It was followed by SR (0.23 ±0.06 µm and 0.41 ±0.10 µm, respectively), and AG groups (0.20 ±0.06 µm and 0.39 ±0.09 µm, respectively). According to the mean ΔE00 results, all composite groups showed significantly higher ΔE00 values immersed in coffee solutions compared to distilled water. In coffee solutions, the highest ΔE00 was observed in the polished GP (1.90 ±0.40), and the lowest ΔE00 was observed in the polished SR (0.97 ±0.36). The sealed groups showed higher ΔE00 than the polished groups, except for GP. CONCLUSIONS: The surface roughness value of sealant applied groups were significantly higher than those of the polished groups. The surface sealant application significantly increased the staining of all composite groups compared to conventional polishing, except for GP.

Proton Nuclear Magnetic Resonance Spectroscopy Analysis of Mixtures of Chlorhexidine with Different Oxidizing Agents Activated by Photon-Induced Photoacoustic Streaming for Root Canal Irrigation.

Objective: The aim of this in vitro study was to investigate the possible interactions between photon-induced photoacoustic streaming (PIPS™)-activated oxidizing agents and 2% chlorhexidine digluconate. Background data: There is no information about the safety of laser-activated oxidizing agents in combination usage with chlorhexidine gluconate. Materials and methods: Groups were designed as follows G1: 98% para-chloroaniline (PCA); G2: 2% chlorhexidine (CHX); G3: 5.25% sodium hypochlorite (NaOCl) +2% CHX; G4: 5.25% NaOCl (30 sec PIPS activated) +2% CHX; G5: 5.25% NaOCl (60 sec PIPS activated) +2% CHX; G6: 3.5% chlorine dioxide (ClO2) + 2% CHX; G7: 3.5% (ClO2) (30 sec PIPS activated) +2% CHX; G8: 3.5% (ClO2) (60 sec PIPS activated) +2% CHX. The laser-irrigation protocol was performed with an erbium:yttrium-aluminum-garnet laser with a wavelength of 2940 nm equipped with a 140 mm long endodontic fiber tip (PIPS) using 10 mJ at 15 Hz (0.15 W), per pulse operating outputs. Groups were analyzed with proton nuclear magnetic resonance spectroscopy, using PCA as an internal standard. Results: No free PCA was formed in any groups of mixtures or after PIPS activation. Conclusions: Mixing of 3.5% ClO2 and 2% CHX does not form bulky precipitates, unlike the mixture NaOCl + CHX. PIPS activation does not cause changes in reactions of oxidizing agents.