Effect of initiation-inhibition and handedness on the patterns of the P50 event-related potential component: a low resolution electromagnetic tomography study

<p>Abstract</p> <p>Background</p> <p>Recent research recognizes the association between handedness, linguistic processes and cerebral networks subserving executive functioning, but the nature of this association remains unclear. Since the P50 event related potential (ERP) is considered to reflect thalamocortical processes in association with working memory (WM) operation the present study focuses on P50 patterns elicited during the performance of a linguistic related executive functioning test in right- and left-handers.</p> <p>Methods</p> <p>In 64 young adults with a high educational level (33 left-handed) the P50 event-related potential was recorded while performing the initiation and inhibition condition of a modified version of the Hayling Sentence Completion test adjusted to induce WM. The manual preference of the participants was evaluated with the use of the Edinburgh Handedness Inventory (EHI).</p> <p>Results</p> <p>P50 showed greater amplitudes in left- than in right-handers, mainly in frontal leads, in the initiation condition. Reduced amplitudes in inhibition compared to initiation condition were observed in left-handers. Low Resolution Electromagnetic Tomography (LORETA) analysis showed lower frontal lobe activation in the inhibition than in the initiation condition in both right- and left-handers. Also, LORETA yielded that right-handers exhibited greater activation in the inhibition condition than left-handers. Additionally, LORETA showed assymetrical hemispheric activation patterns in right-handers, in contrast to symmetrical patterns observed in left-handers. Higher P50 amplitudes were recorded in right-hemisphere of right-handers in the initiation condition.</p> <p>Conclusion</p> <p>Brain activation, especially the one closely related to thalamocortical function, elicited during WM operation involving initiation and inhibition processes appears to be related to handedness.</p

Mechanical and electrochemical characterization of 3D printed orthodontic metallic appliances after in vivo ageing

Objectives: Three-dimensional (3D) printing technology is a promising technique for fabricating custom orthodontic metallic appliances. Aim of this study was to assess the effect of intraoral aging on the mechanical / electrochemical properties of 3D-printed orthodontic metallic appliances. Methods: Twelve molar orthodontic distalization appliances 3D-printed from cobalt chromium (Co-Cr) alloy were retrieved after intraoral use and twenty blocks fabricated under similar conditions were used as control. The samples' microstructural / elemental composition assessment was assessed with SEM/EDS, while their mechanical properties (modulus of elasticity [EIT], Martens hardness [HM] and the elastic index [ηIT]) were measured by instrumented indentation testing. Finally, the samples' electrochemical features were assessed with a potentiostat-connected cell arrangement in terms of open circuit potential (OCP), corrosion potential (Ez), current density (I300) and breaking potential (Epit). Results were analyzed by t-test / Mann-Whitney test (α = 0.05). Results: The used Co-Cr alloy was found to have a highly homogenous structure with no significant differences between retrieved and new specimens in HM (4037.7 ± 215.6 vs 4090.9 ± 259.8 N/mm2), EIT (120.0 ± 13.2 vs 123.8 ± 12.9 GPa), or nIT (28.4 ± 2.6 vs 28.6 ± 2.9 %) (P > 0.05 in all instances). Metallic surfaces retained the same oxidation tendency and oxide dissolution rate in passive region in both groups (P > 0.05 for OCP, Ez, and I300). However, intraorally-aged specimens had a significantly lower breakdown potential due to degraded protection efficacy of surface oxide (P = 0.003 for Epit). Significance: The tested 3D-printed Co-Cr orthodontic appliances present clinically-acceptable mechanical properties that remained unaffected by intraoral ageing, which however degraded the protection of surface oxide against pitting corrosion. Keywords: 3D printing; Co-Cr alloys; Corrosive resistance; Electrochemical behavior; Intraoral ageing; Orthodontic appliances

Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report

BACKGROUND: The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight. CASE PRESENTATION: A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to her treatment regimen for about 9 months. After the remission of depression, and the discontinuation of fluoxetine, she experienced an increase in appetite and subsequently excessive weight gain of 52 kg. Re-administration of fluoxetine did not reverse the situation. The patient developed diabetes mellitus, which was successfully controlled with metformin 1700 mg/day. The addition at first of orlistat 360 mg/day and later of topiramate 200 mg/day has helped her to lose a significant part of the weight gained (30 kg). CONCLUSION: The case suggests a probable association between the remission of depressive symptomatology and weight gain in a schizophrenic patient

Proximal screws placement in intertrochanteric fractures treated with external fixation: comparison of two different techniques

<p>Abstract</p> <p>Background</p> <p>To compare two different techniques of proximal pin placement for the treatment of intertrochanteric fractures in elderly patients utilizing the Orthofix Pertrochanteric Fixator.</p> <p>Methods</p> <p>Seventy elderly high-risk patients with an average age of 81 years were treated surgically for intertrochanteric fracture, resulting from a low energy trauma. Patients were randomly divided in two groups regarding to the proximal pin placement technique. In Group A the proximal pins were inserted in a convergent way, while in Group B were inserted in parallel.</p> <p>Results</p> <p>All fractures healed uneventfully after a mean time of 98 days. The fixator was well accepted and no patient had significant difficulties while sitting or lying. The mean VAS score was 5.4 in group A and 5.7 in group B. At 12 months after surgery, in group A the average Harris Hip Score and the Palmer and Parker mobility score was 67 and 5.8, respectively. In group B, the average Harris Hip Score and the Palmer and Parker mobility score was 62 and 5.6, respectively. No statistically significant difference was found regarding the functional outcome. The mean radiographic exposure during pin insertion in Group A and Group B was 15 and 6 seconds, respectively. The difference between the two groups, regarding the radiographic exposure, was found to be significant.</p> <p>Conclusion</p> <p>Proximal screw placement in a parallel way is simple, with significant less radiation exposure and shorter intraoperative duration. In addition, fixation stability is equal compared to convergent pin placement.</p

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat

Correction to: Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

The original version of this article unfortunately contained a mistake

Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients: the DecubICUs study

Funder: European Society of Intensive Care Medicine; doi: http://dx.doi.org/10.13039/501100013347Funder: Flemish Society for Critical Care NursesAbstract: Purpose: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients. Methods: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis. Results: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9–27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6–16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2–1.8), stage II (OR 1.6; 95% CI 1.4–1.9), and stage III or worse (OR 2.8; 95% CI 2.3–3.3). Conclusion: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat