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Central Community Health Characteristics for first time Zealand.
AIM This study aimed to examine associations between cognitive impairment and quality of life and healthcare utilization in patients with chronic kidney disease (CKD) stages 3 to 5. METHODS A cross-sectional study was conducted in 379 outpatients with a mean age of 65.7 years at tertiary care hospitals in Thailand. Cognitive function was measured using the Mini-Mental State Examination, and quality of life was measured using the five-dimension European quality of life (EQ-5D-5L) multi-attribute utility instrument. The effects of cognitive impairment on the likelihood of reporting 'no problems' for each EQ-5D dimension, the quality of life scores and healthcare utilization were determined using an appropriate multivariate analysis. RESULTS The prevalence of cognitive impairment in patients with CKD stages 3 to 5 was 15.8% (95% confidence interval [CI], 12.3, 19.9). Patients with cognitive impairment had a significantly lower likelihood of achieving good outcomes in the mobility, self-care, usual activities and anxiety/depression dimensions of the EQ-5D-5L than those with normal cognition. Patients with cognitive impairment had a significantly lower quality of life score than those with normal cognition by 0.06 points (95% CI, 0.01, 0.10). Cognitive impairment increased the number of emergency visits (rate ratio, RR, 3.47; 95% CI, 1.45, 8.29). Compared to CKD stage 3, CKD stage 5 decreased the quality of life score by 0.06 points (95% CI, 0.01, 0.10) and increased the rate of hospitalization (RR, 2.29; 95% CI, 1.27, 4.12). CONCLUSION Cognitive impairment in patients with CKD was associated with lower quality of life scores and increased healthcare utilization. © 2020 Asian Pacific Society of Nephrology.BACKGROUND Reports of oral manifestations of granulomatosis with polyangiitis (GPA) usually refer to single-case reports; "strawberry gingivitis" has been increasingly reported. OBJECTIVE To study the clinicopathological findings of four patients in which the diagnosis of GPA was suspected from the observation of their oral lesions and compare these to existent data. METHODS Retrospective study of a case series. RESULTS One patient presented typical "strawberry gingivitis" with localized disease and negative ANCA results. Two patients presented rapidly growing oral ulcers associated with systemic compromise and high ANCA levels. One patient presented with a chronic granulomatous lesion that leaded to palatal perforation. CONCLUSION Oral manifestations of GPA may vary from rapidly evolving lesions in acutely ill patients to chronic and locally destructive lesions in slowing developing disease. These differences are also evident in the histopathological findings. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.BACKGROUND Laboratory tests play an important role in the diagnosis of syphilis. This study aimed to compare and assess the performance of the Abbott chemiluminescent microparticle immunoassay (CMIA) and the ChIVD light-initiated chemiluminescent assay (LICA) in the detection of Treponema pallidum (TP) antibody. METHODS A total of 10 498 serum samples were detected with two assays, and the Treponema pallidum particle agglutination assay (TPPA) and recombinant immunoblot assay (RIBA) methods were used for confirmation. The sensitivity, specificity, positive predictive value, and negative predictive value of the Abbott CMIA and ChIVD LICA were calculated. The coincidence rate between two assays was also evaluated. The causes of false positive and false negative of two assays were studied. RESULTS For the Abbott CMIA and ChIVD LICA, the sensitivity was 94.44% and 98.15%, the specificity was 99.89% and 99.81%, the positive predictive value was 93.29% and 88.83%, and the negative predictive value was 99.91% and 99.97%, respectively. The coincidence rate between Abbott CMIA and ChIVD LICA was 99.26%, and κ value was .790. The disease of infertility, hypertensive disease, liver disease, and cancer were the common causes of false positive in both assays, while infertility was also the main reason lead to false negative. CONCLUSION Our results demonstrated that the Abbott CMIA and ChIVD LICA generally had high sensitivity and specificity and therefore may be suitable for the detection of TP antibody and screening for syphilis. © 2020 The Authors. Journal of Clinical Laboratory Analysis Published by Wiley Periodicals, Inc.Nonexudative age-related macular degeneration (NE-AMD) represents the leading cause of blindness in the elderly. Currently, there are no available treatments for NE-AMD. We have developed a NE-AMD model induced by superior cervical ganglionectomy (SCGx) in C57BL/6J mice, which reproduces the disease hallmarks. selleck inhibitor Several lines of evidence strongly support the involvement of oxidative stress in NE-AMD-induced retinal pigment epithelium (RPE) and outer retina damage. Melatonin is a proven and safe antioxidant. Our aim was analysing the effect of melatonin in the RPE/outer retina damage within experimental NE-AMD. The treatment with melatonin starting 48 h after SCGx, which had no effect on the ubiquitous choriocapillaris widening, protected visual functions and avoided Bruch´s membrane thickening, RPE melanin content, melanosome number loss, retinoid isomerohydrolase (RPE65)-immunoreactivity decrease, and RPE and hotoreceptor ultrastructural damage induced within experimental NE-AMD exclusively located at the central temporal (but not nasal) region. Melatonin also prevented the increase in outer retina/RPE oxidative stress markers and a decrease in mitochondrial mass at 6 weeks post-SCGx. Moreover, when the treatment with melatonin started at 4 weeks post-SCGx, it restored visual functions and reversed the decrease in RPE melanin content and RPE65-immunoreactivity. These findings suggest that melatonin could become a promising safe therapeutic strategy for NE-AMD. © 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.A cross-sectional pilot study was conducted in men followed in fertility consultations, from the portuguese Trás-os-Montes and Alto Douro region, in order to associate several lifestyle factors with the spermatic parameters. Of a total of 522 men, 373 were compared based on the occupational exposure to harmful factors, smoking habits and practice of physical exercise per week, and the other 149 men according to their body mass index (normal weight vs. overweight vs. obesity). In the absence of harmful occupational factors, physical exercise seems to be associated with sperm quality improvement, whether individuals smoke or not. When exposed to harmful environments, non-smokers that practice physical exercise more than two times per week tended to present the best vitality, normal morphology and sperm concentration (p > .05). However, if they smoke, physical exercise seems not enough to enhance the spermatic parameters. The BMI correlated negatively with the spermatic quality, especially with sperm concentration (p less then .
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