124 research outputs found
Medical microbiology in dentistry
МИКРОБИОЛОГИЯСТОМАТОЛОГИЯСТОМАТОГНАТИЧЕСКИЕ БОЛЕЗНИУЧЕБНЫЕ ПОСОБИЯВключены разделы с информацией о наиболее распространенных стоматологических болезнях, ассоциированных с инфекциями, их патогенезе, лабораторной диагностике, профилактике и лечении
A Review of the External Validity of Clinical Trials with Beta-Blockers in Heart Failure
This is an open-access article distributed under the terms of the Creative Commons CC-BY-NC 3.0 License.Background: Beta-blockers (BBs) are the mainstay prognostic medication for all stages of chronic heart failure (CHF). There are many classes of BBs, each of which has varying levels of evidence to support its efficacy in CHF. However, most CHF patients have one or more comorbid conditions such as diabetes, renal impairment, and/or atrial fibrillation. Patient enrollment to randomized controlled trials (RCTs) often excludes those with certain comorbidities, particularly if the symptoms are severe. Consequently, the extent to which evidence drawn from RCTs is generalizable to CHF patients has not been well described. Clinical guidelines also underrepresent this point by providing generic advice for all patients. The aim of this review is to examine the evidence to support the use of BBs in CHF patients with common comorbid conditions.
Methods: We searched MEDLINE, PubMed, and the reference lists of reviews for RCTs, post hoc analyses, systematic reviews, and meta-analyses that report on use of BBs in CHF along with patient demographics and comorbidities.
Results: In total, 38 studies from 28 RCTs were identified, which provided data on six BBs against placebo or head to head with another BB agent in ischemic and nonischemic cardiomyopathies. Several studies explored BBs in older patients. Female patients and non-Caucasian race were underrepresented in trials. End points were cardiovascular hospitalization and mortality. Comorbid diabetes, renal impairment, or atrial fibrillation was detailed; however, no reference to disease spectrum or management goals as a focus could be seen in any of the studies. In this sense, enrollment may have limited more severe grades of these comorbidities.
Conclusions: RCTs provide authoritative information for a spectrum of CHF presentations that support guidelines. RCTs may provide inadequate information for more heterogeneous CHF patient cohorts. Greater Phase IV research may be needed to fill this gap and inform guidelines for a more global patient population
A systemic review of the impact of wildfires on sleep disturbances
Wildfires present a serious risk to humans as well as to the environment. Wildfires cause loss of lives, economic losses, expose people to personal as well as collective trauma, and compro-mise the mental health of survivors. Sleep disturbances are highly prevalent following a traumatic event; however, their prevalence is not well established amongst those confronted by natural disasters such as wildfires. The aim of this systematic review is to synthesise the empirical findings per-taining to wildfires and the prevalence of sleep disturbances in the general community affected by this natural disaster. We searched EBSCO, PsychINFO, Medline, SpringerLink, CINAHL Complete, EMBASE, PubMed, Scopus and Cochrane Library between January 2012 and March 2021. Five studies met the inclusion criteria. Findings from this systematic review suggest that sleep disturbances, assessed one to ten months following the fires, are highly prevalent in wildfire survivors, with insomnia (ranging between 63–72.5%) and nightmares (ranging between 33.3–46.5%), being the most prevalent sleep disturbances reported in this cohort. Results also highlight the significant associa-tions between sleep disturbances and post-traumatic symptoms following the trauma of wildfires. There is a possible link between sleep disturbance prevalence, severity of, and proximity to fires. © 2021 by the authors. Licensee MDPI, Basel, Switzerland
Prevalence and predictors of sleep and trauma symptoms in wildfire survivors
This study aimed to establish the prevalence and to identify predictors of insomnia, nightmares and post-traumatic stress disorder (PTSD) in wildfire survivors. MethodA total of 126 (23 males, 102 females, and 1 nonbinary individual, Mage = 52 years, SD = 14.4) wildfire survivors from Australia, Canada and the USA took part in an online survey. Participants completed a demographic questionnaire and self-report measures including: The Insomnia Severity Index (ISI), PTSD Checklist for DSM-5 (PCL-5), and Disturbing Dream and Nightmare Severity Index (DDNSI). ResultsResults showed that 49.2% of the sample reported clinical insomnia on the ISI, 28.7% reported nightmares on the DDNSI, and 77.88% reported PTSD symptoms on the PCL-5. Fear for life of others ( Pearson's r = .40, .21, .31), and the impact of smoke ( Pearson's r, .47, .25,.41) significantly correlated with insomnia, nightmares and PTSD symptoms, respectively. Hierarchical regression showed that smoke was a significant predictor of insomnia
Reconciling actual and perceived rates of predation by domestic cats
© 2015 The Authors. Ecology and Evolution published by John Wiley & Sons Ltd.The predation of wildlife by domestic cats (Felis catus) is a complex problem: Cats are popular companion animals in modern society but are also acknowledged predators of birds, herpetofauna, invertebrates, and small mammals. A comprehensive understanding of this conservation issue demands an understanding of both the ecological consequence of owning a domestic cat and the attitudes of cat owners. Here, we determine whether cat owners are aware of the predatory behavior of their cats, using data collected from 86 cats in two UK villages. We examine whether the amount of prey their cat returns influences the attitudes of 45 cat owners toward the broader issue of domestic cat predation. We also contribute to the wider understanding of physiological, spatial, and behavioral drivers of prey returns among cats. We find an association between actual prey returns and owner predictions at the coarse scale of predatory/nonpredatory behavior, but no correlation between the observed and predicted prey-return rates among predatory cats. Cat owners generally disagreed with the statement that cats are harmful to wildlife, and disfavored all mitigation options apart from neutering. These attitudes were uncorrelated with the predatory behavior of their cats. Cat owners failed to perceive the magnitude of their cats' impacts on wildlife and were not influenced by ecological information. Management options for the mitigation of cat predation appear unlikely to work if they focus on "predation awareness" campaigns or restrictions of cat freedom. We consider both the ecological consequence of owning a domestic cat and the attitudes of cat owners. Our findings suggest cat owners fail to perceive the magnitude of their cats' impacts on wildlife, with no correlation between the observed and predicted prey return rates among predatory cats. On the basis of opinions of cat owners in this study, management options for the mitigation of cat predation appear unlikely to work if they focus on "predation awareness" campaigns, or restrictions of cat freedom.published_or_final_versio
Effects of long-term exposure to an electronic containment system on the behaviour and welfare of domestic cats
Free-roaming cats are exposed to a variety of risks, including involvement in road traffic accidents. One way of mitigating these risks is to contain cats, for example using an electronic boundary fence system that delivers an electric ‘correction’ via a collar if a cat ignores a warning cue and attempts to cross the boundary. However, concerns have been expressed over the welfare impact of such systems. Our aim was to determine if long-term exposure to an electronic containment system was associated with reduced cat welfare. We compared 46 owned domestic cats: 23 cats that had been contained by an electronic containment system for more than 12 months (AF group); and 23 cats with no containment system that were able to roam more widely (C group). We assessed the cats’ behavioural responses and welfare via four behavioural tests (unfamiliar person test; novel object test; sudden noise test; cognitive bias test) and an owner questionnaire. In the unfamiliar person test, C group lip-licked more than the AF group, whilst the AF group looked at, explored and interacted more with the unfamiliar person than C group. In the novel object test, the AF group looked at and explored the object more than C group. No significant differences were found between AF and C groups for the sudden noise or cognitive bias tests. Regarding the questionnaire, C group owners thought their cats showed more irritable behaviour and AF owners thought that their cats toileted inappropriately more often than C owners. Overall, AF cats were less neophobic than C cats and there was no evidence of significant differences between the populations in general affective state. These findings indicate that an electronic boundary fence with clear pre-warning cues does not impair the long term quality of life of cat
A review of the external validity of clinical trials with beta-blockers in heart failure
Beta-blockers (BBs) are the mainstay prognostic medication for all stages of chronic heart failure (CHF). There are many classes of BBs, each of which has varying levels of evidence to support its efficacy in CHF. However, most CHF patients have one or more comorbid conditions such as diabetes, renal impairment, and/or atrial fibrillation. Patient enrollment to randomized controlled trials (RCTs) often excludes those with certain comorbidities, particularly if the symptoms are severe. Consequently, the extent to which evidence drawn from RCTs is generalizable to CHF patients has not been well described. Clinical guidelines also underrepresent this point by providing generic advice for all patients. The aim of this review is to examine the evidence to support the use of BBs in CHF patients with common comorbid conditions.We searched MEDLINE, PubMed, and the reference lists of reviews for RCTs, post hoc analyses, systematic reviews, and meta-analyses that report on use of BBs in CHF along with patient demographics and comorbidities.In total, 38 studies from 28 RCTs were identified, which provided data on six BBs against placebo or head to head with another BB agent in ischemic and nonischemic cardiomyopathies. Several studies explored BBs in older patients. Female patients and non-Caucasian race were underrepresented in trials. End points were cardiovascular hospitalization and mortality. Comorbid diabetes, renal impairment, or atrial fibrillation was detailed; however, no reference to disease spectrum or management goals as a focus could be seen in any of the studies. In this sense, enrollment may have limited more severe grades of these comorbidities.RCTs provide authoritative information for a spectrum of CHF presentations that support guidelines. RCTs may provide inadequate information for more heterogeneous CHF patient cohorts. Greater Phase IV research may be needed to fill this gap and inform guidelines for a more global patient population.Pupalan Iyngkaran, Samia R. Toukhsati, Merlin C. Thomas, Michael V. Jelinek, David L. Hare and John D. Horowit
A systematic review of social and environmental factors and their implications for indoor cat welfare
Animal Extinctions
Extinctions refer to the death of a single or multiple species (or taxon) and are common in the history of life on this planet. Using the fossil record, it has been estimated that 99.9% of the species that existed on earth is now extinct. Extinctions occur when a species fails to meet or adapt to changing environmental forces (such as global warming or cooling, habitat loss, destruction, or fragmentation) or when species origination is low, creating ecological niches for new, better adapted, species. This process of “background” extinction and new species evolution is natural, occurs continuously, and describes the way life diversified and radiated on this planet. However, when extinctions involve vast numbers of species and appear to occur around the same time in many different regions, as may be the case in modern times, they are termed “mass extinctions”; these are much less common, but greatly reduce species diversity. There is much debate and little consensus as to the cause and timescale of mass extinctions, generally referred to as the “Big Five” extinction events, which mark the point of transition to new geological epochs. This chapter will focus on the modern-day Holocene–Anthropocene extinction, which attributes the possible loss of up to 58,000 species per year to human activities
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