Dental erosive wear and salivary flow rate in physically active young adults

Background Little attention has been directed towards identifying the relationship between physical exercise, dental erosive wear and salivary secretion. The study aimed i) to describe the prevalence and severity of dental erosive wear among a group of physically active young adults, ii) to describe the patterns of dietary consumption and lifestyle among these individuals and iii) to study possible effect of exercise on salivary flow rate. Methods Young members (age range 18-32 years) of a fitness-centre were invited to participate in the study. Inclusion criteria were healthy young adults training hard at least twice a week. A non-exercising comparison group was selected from an ongoing study among 18-year-olds. Two hundred and twenty participants accepted an intraoral examination and completed a questionnaire. Seventy of the exercising participants provided saliva samples. The examination was performed at the fitness-centre or at a dental clinic (comparison group), using tested erosive wear system (VEDE). Saliva sampling (unstimulated and stimulated) was performed before and after exercise. Occlusal surfaces of the first molars in both jaws and the labial and palatal surfaces of the upper incisors and canines were selected as index teeth. Results Dental erosive wear was registered in 64% of the exercising participants, more often in the older age group, and in 20% of the comparison group. Enamel lesions were most observed in the upper central incisors (33%); dentine lesions in lower first molar (27%). One fourth of the participants had erosive wear into dentine, significantly more in males than in females (p = 0.047). More participants with erosive wear had decreased salivary flow during exercise compared with the non-erosion group (p < 0.01). The stimulated salivary flow rate was in the lower rage (≤ 1 ml/min) among more than one third of the participants, and more erosive lesions were registered than in subjects with higher flow rates (p < 0.01). Conclusion The study showed that a high proportion of physically active young adults have erosive lesions and indicate that hard exercise and decreased stimulated salivary flow rate may be associated with such wear

Immunohistochemistry profiles of breast ductal carcinoma: factor analysis of digital image analysis data

<p>Abstract</p> <p>Background</p> <p>Molecular studies of breast cancer revealed biological heterogeneity of the disease and opened new perspectives for personalized therapy. While multiple gene expression-based systems have been developed, current clinical practice is largely based upon conventional clinical and pathologic criteria. This gap may be filled by development of combined multi-IHC indices to characterize biological and clinical behaviour of the tumours. Digital image analysis (DA) with multivariate statistics of the data opens new opportunities in this field.</p> <p>Methods</p> <p>Tissue microarrays of 109 patients with breast ductal carcinoma were stained for a set of 10 IHC markers (ER, PR, HER2, Ki67, AR, BCL2, HIF-1α, SATB1, p53, and p16). Aperio imaging platform with the Genie, Nuclear and Membrane algorithms were used for the DA. Factor analysis of the DA data was performed in the whole group and hormone receptor (HR) positive subgroup of the patients (n = 85).</p> <p>Results</p> <p>Major factor potentially reflecting aggressive disease behaviour (i-Grade) was extracted, characterized by opposite loadings of ER/PR/AR/BCL2 and Ki67/HIF-1α. The i-Grade factor scores revealed bimodal distribution and were strongly associated with higher Nottingham histological grade (G) and more aggressive intrinsic subtypes. In HR-positive tumours, the aggressiveness of the tumour was best defined by positive Ki67 and negative ER loadings. High Ki67/ER factor scores were strongly associated with the higher G and Luminal B types, but also were detected in a set of G1 and Luminal A cases, potentially indicating high risk patients in these categories. Inverse relation between HER2 and PR expression was found in the HR-positive tumours pointing at differential information conveyed by the ER and PR expression. SATB1 along with HIF-1α reflected the second major factor of variation in our patients; in the HR-positive group they were inversely associated with the HR and BCL2 expression and represented the major factor of variation. Finally, we confirmed high expression levels of p16 in Triple-negative tumours.</p> <p>Conclusion</p> <p>Factor analysis of multiple IHC biomarkers measured by automated DA is an efficient exploratory tool clarifying complex interdependencies in the breast ductal carcinoma IHC profiles and informative value of single IHC markers. Integrated IHC indices may provide additional risk stratifications for the currently used grading systems and prove to be useful in clinical outcome studies.</p> <p>Virtual Slides</p> <p>The virtual slide(s) for this article can be found here: <url>http://www.diagnosticpathology.diagnomx.eu/vs/1512077125668949</url></p

Effectiveness of Mechanisms and Models of Coordination between Organizations, Agencies and Bodies Providing or Financing Health Services in Humanitarian Crises: A Systematic Review.

BACKGROUND: Effective coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises is required to ensure efficiency of services, avoid duplication, and improve equity. The objective of this review was to assess how, during and after humanitarian crises, different mechanisms and models of coordination between organizations, agencies and bodies providing or financing health services compare in terms of access to health services and health outcomes. METHODS: We registered a protocol for this review in PROSPERO International prospective register of systematic reviews under number PROSPERO2014:CRD42014009267. Eligible studies included randomized and nonrandomized designs, process evaluations and qualitative methods. We electronically searched Medline, PubMed, EMBASE, Cochrane Central Register of Controlled Trials, CINAHL, PsycINFO, and the WHO Global Health Library and websites of relevant organizations. We followed standard systematic review methodology for the selection, data abstraction, and risk of bias assessment. We assessed the quality of evidence using the GRADE approach. RESULTS: Of 14,309 identified citations from databases and organizations' websites, we identified four eligible studies. Two studies used mixed-methods, one used quantitative methods, and one used qualitative methods. The available evidence suggests that information coordination between bodies providing health services in humanitarian crises settings may be effective in improving health systems inputs. There is additional evidence suggesting that management/directive coordination such as the cluster model may improve health system inputs in addition to access to health services. None of the included studies assessed coordination through common representation and framework coordination. The evidence was judged to be of very low quality. CONCLUSION: This systematic review provides evidence of possible effectiveness of information coordination and management/directive coordination between organizations, agencies and bodies providing or financing health services in humanitarian crises. Our findings can inform the research agenda and highlight the need for improving conduct and reporting of research in this field

Nurses' workload and its relation with physiological stress reactions

OBJECTIVE: to analyze the relation between the workload and the physiological stress reactions among nurses working at a hospital service. METHODS: cross-sectional, correlational, quantitative study, involving 95 nurses, in 2011 and 2012. Spearman's bivariate Correlation Test was used. RESULTS: most subjects are female, between 23 and 61 years old and working between 21 and 78 hours per week. The most frequent physiological reactions were back pain, fatigue/exhaustion, stiff neck and stomach acidity, with 46.3% of the subjects presenting low and 42.1% moderate physiological stress responses. No correlation was found between the workload and the physiological stress responses. CONCLUSION: although most of the nurses work more than 36 hours/week, physiologically, they do not present high reaction levels in response to stress. These workers deal with conflicts in the vertical and horizontal relations between professionals, family members and patients. In that sense, taking care of professionals who offer health services can be a fundamental strategy, as good user care mainly depends on healthy teams.OBJETIVO: analisar a relação entre a carga horária de trabalho e as reações fisiológicas do estresse, entre enfermeiros de unidade hospitalar. MÉTODOS: estudo transversal, correlacional, quantitativo, realizado com 95 enfermeiros em 2011 e 2012. De forma bivariada, utilizou-se o teste de correlação de Spearman. RESULTADOS: a maioria dos sujeitos pertencia ao sexo feminino, faixa etária entre 23 e 61 anos, trabalhando de 21 a 78 horas semanais. As reações fisiológicas mais frequentes foram dores lombares, fadiga/exaustão, rigidez no pescoço e acidez estomacal, sendo que 46,3% dos sujeitos apresentaram baixas respostas fisiológicas ao estresse e moderadas em 42,1%. Não houve correlação entre a carga horária de trabalho e as reações fisiológicas do estresse. CONCLUSÃO: embora a maioria dos enfermeiros exercesse suas funções por mais de 36 horas/semana, fisiologicamente não apresentavam reações elevadas de resposta ao estresse. Tais trabalhadores lidavam com conflitos nas relações verticais e horizontais entre profissionais, familiares e pacientes. Nesse sentido, cuidar de profissionais que oferecem serviços de saúde pode ser estratégia fundamental, uma vez que bons atendimentos aos usuários dependem, principalmente, de equipes saudáveis.OBJETIVO: analizar la relación entre la carga horaria de trabajo y las reacciones fisiológicas de estrés entre enfermeros de servicio hospitalario. MÉTODOS: estudio trasversal, correlacional, cuantitativo, desarrollado con 95 enfermeros en 2011 y 2012. De forma bivariada, fue utilizada la Prueba de Correlación de Spearman. RESULTADOS: la mayoría de los sujetos es del sexo femenino, rango de edad entre 23 y 61 años y trabaja de 21 a 78 horas semanales. Las reacciones fisiológicas más frecuentes fueron dolores de espalda, fatiga/agotamiento, rigidez en el cuello y acidez estomacal, siendo que 46,3% de los sujetos revelaron bajas respuestas fisiológicas al estrés y moderadas en 42,1%. No fue encontrada correlación entre la carga horaria de trabajo y las reacciones fisiológicas del estrés. CONCLUSIÓN: aunque la mayoría de los enfermeros ejerza su función por más de 36 horas/semana, fisiológicamente no muestran reacciones elevadas de respuesta al estrés. Tales trabajadores lidian con conflictos en las reacciones verticales y horizontales entre profesionales, familiares y pacientes. En ese sentido, cuidar de profesionales que ofrecen servicios de salud puede ser estrategia fundamental, ya que buena atención a los usuarios depende principalmente de equipos saludables

New perspectives on the ecology and evolution of siboglinid tubeworms

Siboglinids are tube-dweling annelids that are important members of deep-sea chemosynthetic communities, which include hydrothermal vents, cold seeps, whale falls and reduced sediments. As adults, they lack a functional digestive system and rely on microbial endosymbionts for their energetic needs. Recent years have seen a revolution in our understanding of these fascinating worms. Molecular systematic methods now place these animals, formerly known as the phyla Pogonophora and Vestimentifera, within the polychaete clade Siboglinidae. Furthermore, an entirely new radiation of siboglinids, Osedax, has just recently been discovered living on whale bones. The unique and intricate evolutionary association of siboglinids with both geology, in the formation of spreading centres and seeps, and biology with the evolution of large whales, offers opportunities for studies of vicariant evolution and the calibration of molecular clocks. Moreover, new advances in our knowledge of siboglinid anatomy coupled with molecular characterization of microbial symbiont communities are revolutionizing our knowledge of host-symbiont relationships in the Metazoa. Despite these advances, considerable debate persists concerning the evolutionary history of siboglinids. Here we review the morphological, molecular, ecological and fossil data in order to address when and how siboglinids evolved. We discuss the role of ecological conditions in the evolution of siboglinids and present possible scenarios of the evolutionary origin of the symbiotic relationships between siboglinids and their endosymbiotic bacteria