Socioeconomic Status (SES) indicators, such as educational attainment, are social determinants of heart disease. Marginalization related Diminished Returns (MDRs) refer to smaller health benefits of high SES for racial and ethnic minorities compared to the majority group. It is still unknown, however, if MDRs also apply to the effects of education on heart disease.
Using a nationally representative sample, we explored racial/ethnic variation in the link between educational attainment and heart disease among American adults.
We analyzed data (n=25,659) from a nationally representative survey of American adults in 2013. The first wave of the Population Assessment of Tobacco and Health – Adult (PATH-Adult) study was used. The independent variable was education (college graduate, high school graduate, less than a high school diploma). The dependent variable was any heart disease. Age and gender were the covariates. Race, as well as ethnicity, were the moderators. Logistic regressions were used to analyze the data.
Individuals with higher educational attainment had lower odds of heart disease. Race and ethnicity showed statistically significant interactions with education, suggesting that the protective effect of higher education on reducing odds of heart disease was smaller for Hispanic and Black people than for non-Hispanic and White individuals.
Education reduces the risk of heart disease better among non-Hispanic Whites than for Hispanics and Blacks. Therefore, we may expect a disproportionately higher than expected risk of heart disease in Hispanics and Blacks with high educational attainment. Future research should test if the presence of high levels of environmental and behavioral risk factors contribute to the high risk of heart disease in highly educated Black and Hispanic Americans. Policymakers should not reduce health inequalities to just gaps in SES because disparities are present across SES levels, with high SES Blacks and Hispanics remaining at risk of health problems.
Dental trauma is one of the most commonly seen injuries involving teeth and surrounding structures. The frequent causes of dental trauma are usually falls, traffic accidents, fights and sports injuries. Rapid treatment can prevent long-term damage to the orofacial structures and save the teeth. Ellis class 2 fracture is classified as the involvement of enamel and dentin excluding pulp. Dental practitioners are used to treating Ellis class 2 fracture very often in their dental practice and is usually considered as a dilemma among dental practitioners for the different treatment modalities followed for treatment of Ellis class 2 fracture. A survey is done among dental practitioners to assess the different treatment modalities followed by them in the case of Ellis class 2 fracture.
Materials and Methods:
A survey was done among 380 dental practitioners in the Chennai region in which 360 dental practitioners responded. The survey was distributed through electronic media and other means of communication. The survey data was collected, analysed and interpreted.
The results suggested that about 90% of dental practitioners had adequate knowledge and attitude towards the management of dental traumatic injuries. However, the practical application of the different treatment modalities was seen to be varied among dental practitioners. Based on this survey it was clear that majority of the dental practitioners in Chennai have good knowledge, attitude but there was a lack of clinical practice regarding the different treatment modalities followed by general practitioners for Ellis class 2 fracture.
The survey shows that dental practitioners have a sound knowledge, attitude, but the practical application of the various treatment modalities available was seen to vary among various dental practitioners for Ellis class 2 fracture.
The prevalence of type 1 and type 2 diabetes mellitus (DM) is increasing worldwide. The prevalence might even be higher in low-income countries. As a result, type 1 and type 2 DM and their complications are imposing a high burden on patients (e.g. hospitalization, disability and death). In Ethiopia, there are limited studies focusing on the complications of type 1 and type 2 DM. Thus, we assessed the prevalence of type 1 and type 2 DM complications and associated factors in selected hospitals in western Ethiopia.
This cross-sectional study included 257 adult patients with DM attending the chronic care clinics of Nedjo general and Nekemte referral hospitals. The study was carried out between March 1 and April 30, 2016 using a pre-tested self-administered questionnaire and chart review.
Of the 257 patients, 87 (33.9%) had ≥1 DM complication. Acute and chronic complications accounted for 9.3% and 24.5% of the total DM patients, respectively. The age of the patients (p=0.024), family history of DM (p=0.038), DM duration (p=0.015), DM regimen (p=0.041), and the occurrence of other chronic diseases (p=0.006) were significantly associated with DM complications.
The findings of this study revealed that 1 out of 3 adults with DM have ≥1 complication in our chronic ambulatory care clinics. Diabetic keto-acidosis was the most common acute complication whereas hypertension was the most common chronic complication. The presence of DM complications was associated with the age of the patients, duration of DM, family history of DM, DM regimen and the presence of other chronic diseases.
To evaluate the repeatability of the fast measurement of the visual acuity (VADC) and contrast sensitivity (CSDC) defocus curves with a new test as well as the agreement of measurements at far distance obtained with the Early Treatment Diabetic Retinopathy Study (ETDRS) chart and the ClinicCSF test for measuring Contrast Sensitivity Function (CSF).
Records from fifty-nine subjects implanted with Multifocal Intraocular Lenses (MIOLs) were retrieved from our database. VADC and CSDC were measured from +1.00 D to -4.00 D in 0.50 D steps. The agreement with the ETDRS and the CSF at far distance was assessed in comparison to the 0 D location of the VADC and the CSDC, respectively. The repeatability was evaluated in 34 subjects who consecutively repeated two measures.
Median Visual Acuity (VA) was -0.1 logMAR with the VADC at 0 D of defocus and 0 logMAR with the ETDRS (p>0.05). A total of 45.8% of eyes showed no differences between both tests and the difference was less than one line of VA in 96.6% of the eyes. The intrasubject repeatability was under one line of VA along all the defocus curve except for positive defocus levels. The CSDC showed the best agreement with the CSF for 18 cycles per degree. The CSDC was less repeatable than VADC. Mean time spent on completing the VADC and CSDC was 7.81 and 7.98 minutes, respectively.
The VADC showed good agreement with the ETDRS and good repeatability despite the short testing time. In contrast, poorer repeatability was found for CSDC. Our method would facilitate the inclusion of VADC in clinical practice as it is a fast test, being also the first one including the measure of CSDC.
The purpose of this study was to evaluate the efficacy and durability of five different dentin desensitizers (Gluma Desensitizer Powergel, Bifluorid 12, Gluma Self Etch Bond, D/Sense Crystal, Nupro Sensodyne Prophylaxis Paste with Novamin) on tubule occlusion and dentin permeability reduction in vitro.
The quantitative changes in permeability of 100 dentin discs were measured after desensitizer treatments and following post-treatments of 6% citric acid challenge for 1 min or immersion in artificial saliva for 24 hours under hydrostatic pressure generated by a computerised fluid filtration meter. Qualitative SEM analyses were also carried out.
Dentin permeability decreased after desensitizer application in all groups. Nevertheless, only the difference between ‘Gluma Self Etch Bond’ and ‘Nupro Sensodyne Prophylaxis Paste with Novamin’ groups was significantly different (p<0.05). Dentin permeability increased significantly after post-treatments (p<0.05). There was no statistically difference among the citric acid-subgroups (p>0.05). Of all the artificial saliva-subgroups, only the difference between ‘D/Sense Crystal’ and ‘Bifluorid 12’ was significantly different (p<0.05). In SEM analysis, morphological changes were detected on the dentin surface and within the tubules following desensitizer treatments and post-treatments.
All the desensitizers significantly reduced dentin permeability by changing the morphology of the dentin surface and/or dentinal tubules. Following post-treatments, there was some reduction in the efficacy of the desensitizers which was represented by the reduction in permeability values. SEM analysis revealed some physical changes in the dentin structure which can partly give an explanation to the reduced efficacy of tested desensitizers.
Corona Virus Disease (COVID -19) patients present mainly with respiratory manifestations and viral pneumonia. The cardiovascular system presentation includes early signs of acute myocardial injury. Cardiac troponin I (cTnI) is a gold-standard biomarker for necrosis and myocardial risk assessment.
Aim of the work:
This study aimed to assess the prognostic value of cTnI in COVID-19 patients.
We report a prospective study that included 92 COVID-19 patients admitted to the El Helal Hospital, Sohag, Egypt. Upon admission, routine investigations including cTnI, chest Computed Tomography (CT), and Electrocardiogram (ECG) were carried out. The patients admitted to the intensive care unit (ICU) also had echocardiography.
More than half of the patients (55.4%) were admitted to ICU; cTnI level was elevated in 30 patients (58.8%), of whom 17 died (56.7%). There were statistically significant differences regarding the relation between cTnI level, D-dimer and the need for ICU admission and death (p=0.001).
We conclude that cardiac troponin I levels are a prognostic factor for ICU admission and mortality in COVID-19 patients.
Phacoemulsification of rock-hard cataracts is challenging because the leathery epinucleus at the posterior plate often found in such cataracts tends to prevent smooth dissection of the nucleus. We devised an Epinucleus scraping technique to overcome this problem.
The epinucleus is initially stripped of the hard endonucleus using a new instrument. The isolated endonucleus can then be readily chopped and divided with a phaco chopper or in the usual manner.
Phacoemulsification of rock-hard cataracts can be carried out safely and easily with epinucleus scraping technique.
Under normal conditions, the heart obtains ATP through the oxidation of fatty acids, glucose, and ketones. While fatty acids are the main source of energy in the heart, under certain conditions, the main source of energy shifts to glucose where pyruvate converts into lactate, to meet the energy demand. The Warburg effect is the energy shift from oxidative phosphorylation to glycolysis in the presence of oxygen. This effect is observed in tumors as well as in diseases, including cardiovascular diseases. If glycolysis is more dominant than glucose oxidation, the two pathways uncouple, contributing to the severity of the heart condition. Recently, several studies have documented changes in metabolism in several cardiovascular diseases; however, the specific mechanisms remain unclear.
This literature review was conducted by an electronic database of Pub Med, Google Scholar, and Scopus published until 2020. Relevant papers are selected based on inclusion and exclusion criteria.
A total of 162 potentially relevant articles after the title and abstract screening were screened for full-text. Finally, 135 papers were included for the review article.
This review discusses the effects of alterations in glucose metabolism, particularly the Warburg effect, on cardiovascular diseases, including heart failure, atrial fibrillation, and cardiac hypertrophy.
Reversing the Warburg effect could become a potential treatment option for cardiovascular diseases.