Heterogeneity of Lung Function Phenotypes in Sarcoidosis: Role of Race and Sex Differences.

Rationale: Historically, sarcoidosis was described as a restrictive lung disease, but several alternative phenotypes of pulmonary function have been observed. Pulmonary function phenotypes in sarcoidosis may represent different clinical and/or molecular phenotypes. Objectives: To characterize the prevalence of different pulmonary function phenotypes in a large and diverse sarcoidosis cohort from a tertiary care referral center. Methods: We identified individuals seen between 2005-2015 with a confirmed diagnosis of sarcoidosis. Data were collected from the first pulmonary function test (PFT) performed at our institution which included spirometry and diffusing capacity of the lung for carbon monoxide (DlCO). Demographics and clinical data were collected. Chi-squared analyses and multiple linear regressions were done to assess statistical differences and associations. Global Lung Function Initiative equations were used to calculate percent predicted measurements for spirometry and DlCO. Results: Of 602 individuals with sarcoidosis, 93% (562) had pulmonary involvement, 64% (385) were female, and 57% (341) were Black. Of those with pulmonary involvement, 56% had abnormal pulmonary function. Lung function impairment phenotypes included: 47% restriction, 22% obstruction, 15% isolated reduction in DlCO, and 16% combined obstructive restrictive phenotype. Restriction was the most common PFT phenotype among Black individuals (41%), while no lung impairment was most common among White individuals (66%) (P < 0.001). Males more frequently had obstruction (19%) compared with females (9%) P = 0.001, and females had more restriction (30%) compared with males (21%) P = 0.031. Conclusions: Among individuals with sarcoidosis and pulmonary function impairment, less than half demonstrated a restrictive phenotype. There were significant differences in pulmonary function phenotypes by race and sex.

EFFECT OF GOAL-ORIENTEDPATIENT CENTRIC HEALTH CARE PROFESSIONAL INTERVENTION ON BLOOD GLUCOSE CONTROL INTYPE 2 DIABETES MELLITUSANDLEVEL OF PATIENT SATISFACTION.

The risk of complications, and thus the quality of life, for elderly diabetic patients is greatly affected by inadequate blood glucose control. Examining how Type 2 diabetic patients(T2DM)' complication rates and overall satisfaction with health care professional care change in response to a goal-oriented patient centric health care professional intervention. One hundred people were analysed in this study. Patients were randomly assigned to Category A (n=50) and Category B (n=50), following the random control method. Category A patients (n=50) received standard care, while Category B patients (n=50) received the goal-oriented patient centric health care professional intervention for their (T2DM). Both Categories were evaluated for their health care professional impact and health care professional satisfaction after a period of 12 weeks and compared. These three variables: blood glucose, blood pressure (DBP, mmHg) and low-density lipoprotein (Bad) Cholesterol Level (LDL-C levels)are all risk factors for problems in individuals suffering with T2DM. This improvement effect was statistically significant when compared to that seen in Category A. Both groups' self-management scores improved after the intervention compared to their baseline levels; however, the experimental group's scores improved much more than those of the Category A group. Furthermore, patients in the Category B group were more likely to adhere to their treatment protocol and the incidence of complications was lower in the Category B group compared to the Category A group (p<0.05). In addition, Category B had a higher average health care professional satisfaction along with good quality of life in comparison to Category A.

Bruxism: a literature review.

Parafunctional activities associated with the stomatognathic system include lip and cheek chewing, nail biting, and teeth clenching. Bruxism can be classified as awake or sleep bruxism. Patients with sleep bruxism are more likely to experience jaw pain and limitation of movement, than people who do not experience sleep bruxism. Faulty occlusion is one of the most common causes of bruxism that further leads to temporomandibular joint pain. Bruxism has been described in various ways by different authors. This article gives a review of the literature on bruxism since its first description.