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Whereas both groups showed significant improvements from baseline to study end in absolute levels of A1C, the PSEG group had a more pronounced clinical improvement, but no statistical improvement, in A1C compared with the conventional diabetes self-management education-only group. PSEG participants exhibited statistically significant improvement in diabetes-related quality of life at 8months.

Our study demonstrates the benefits of peer-support education above and beyond the impact of diabetes self-management education on diabetes-related quality of life in an underserved Mayan community in Mexico.

Our study demonstrates the benefits of peer-support education above and beyond the impact of diabetes self-management education on diabetes-related quality of life in an underserved Mayan community in Mexico.

The purpose of this study was to assess the relationship between the number of microcatheters required for prostatic artery embolization (PAE) and the anatomy of the prostatic artery (PA).

All consecutive patients who underwent PAE between May 2017 and December 2018 were included. The anatomical description of the PAs was assessed by both global cone beam computed tomography and selective angiography and data on the resources used, in terms of microcatheters, were prospectively collected.

A total of 215 consecutive patients (mean age, 66±8.7 [SD] years; range 45-93 years), with a mean International Prostate Symptom Score of 21±7.4 (SD) and a mean prostate volume on magnetic resonance imaging of 88±38 (SD) mL (range 30-200mL) underwent PAE. A single PA was observed in 347 hemipelvises (347/411; 84.4%) and double PAs in 64 (64/411; 15.6%). Eighty percent (173/215 patients) of PAEs were performed using a single microcatheter. Type I PA anatomy required significantly more microcatheters (1.15±0.39 [SD]; range 1-3), than type II (1.04±0.19 [SD]; range 1-2), type III (1.09±0.34 [SD]; range 1-3) and type IV (1.06±0.27 [SD]; range 1-2) (P=0.01 for all).

PAE is feasible with limited per-intervention changes in devices for all types of PA anatomy encountered. This could help in the design of appropriate reimbursement policies in various healthcare settings.

PAE is feasible with limited per-intervention changes in devices for all types of PA anatomy encountered. XCT790 manufacturer This could help in the design of appropriate reimbursement policies in various healthcare settings.

Supra- and intercondylar elbow fractures are surgically challenging given the intra-articular comminution. Various surgical approaches have been described. Among these-olecranon osteotomy-provides optimal joint exposure but is associated with several complications. Tension band wiring (TBW) is the most commonly used fixation method. We hypothesized that double screw fixation would lead to fewer surgical revisions than TBW (all causes included) after olecranon osteotomy.

We carried out a single-center retrospective study of 39 patients, treated between January 2007 and April 2016, for a supra- or intercondylar elbow fracture using the transolecranon exposure. There were 34 type C fractures (13 C1, 6 C2 and 15 C3), 3 type B fractures and 2 type A fractures, based on the AO classification. Fourteen patients received double screw fixation and 25 received TBW. The primary outcome measure was the number of surgical revisions, regardless of cause. Secondary outcome measures were the number of surgical revisions es operated by a transolecranon approach.

IV.

IV.

The purpose of this study was to document the effect of coronavirus disease 2019 (COVID-19) on patients presenting to the University of Washington Oral and Maxillofacial Surgery (UW OMS) with an odontogenic infection.

The investigators designed a retrospective cohort study and enrolled a sample of 889 subjects who presented for an odontogenic infection from March 19 to June 18 in the years 2017, 2018, 2019, and 2020. The primary predictor variable was OMS consultation for an odontogenic infection during a non-COVID-19 (2017, 2018, and 2019) year (control) or during the COVID-19 pandemic in 2020 (experimental). The primary outcome variable was treatment rendered. Appropriate univariate and bivariate statistics were computed, and the level of significance was set at .05 for all tests.

There was no significant difference in the incidence of OMS consults in the 2 cohorts (P>.05). The number of patients presenting to the UW emergency department (ED) for an odontogenic infection decreased from an average of 246 in non-COVID years to 151 in 2020. Patients in the experimental cohort were more likely (55 vs 30.0%; P=.04) to present primarily to UW than a dentist and were less likely to undergo an incision and drainage (70.0 vs 88.8%; P=.04), aerosol-generating procedure (70.0 vs 88.8%; P=.04), and incision and drainage in the ED (15.0 vs 41.3%; P=.03).

The investigators did not find evidence of increased hospital or ED burden by odontogenic infections during the COVID-19 pandemic.

The investigators did not find evidence of increased hospital or ED burden by odontogenic infections during the COVID-19 pandemic.

The prevalence of Type 2 Diabetes Mellitus among adolescents in the United States continues to rise, following the trajectory of the obesity epidemic which posits not only a substantial health burden to our society, but also a significant threat to the wellbeing of America's youth. While a number of studies have explored the perception of the risk for developing diabetes in the adult population in the United States, this data is minimal for the adolescent population. In this study, we examined the self-perceived risk of diabetes among adolescents with overweight/obesity.

Cross-sectional study of 808 non-diabetic U.S. adolescents overweight or obese, ages 12-19, who completed a physical exam and in-home interview during the 2011-2014 National Heath and Nutritional Examination Survey (NHANES).

Of adolescents with obesity, African Americans (aOR 0.27, 95% CI 0.15, 0.51) and Hispanic Americans (aOR 0.50, 95% CI 0.28, 0.90) were significantly less likely to perceive themselves as being at risk for developing diabetes/prediabetes compared to Non-Hispanic Whites. Additionally, individuals with overweight (aOR 13.1, 95% CI 4.54, 37.5) and obesity (aOR 3.40, 95% CI 1.71, 6.74) who had been informed by their physician that they were at risk for diabetes, were significantly more likely to perceive themselves to be at risk for diabetes.

Significant racial differences exist in the self-perceived risk for diabetes among U.S. adolescents with overweight and obesity. Further investigation focused on preventing the development of diabetes among at-risk adolescents who do not comprehend their risk, i.e. through more effective healthcare communication, is warranted.

Significant racial differences exist in the self-perceived risk for diabetes among U.S. adolescents with overweight and obesity. Further investigation focused on preventing the development of diabetes among at-risk adolescents who do not comprehend their risk, i.e. through more effective healthcare communication, is warranted.

To evaluate efficacy, renal safety and tolerability of sodium-glucose cotransporter 2 inhibitors (SGLT2i) in a cohort of patients with type 2 diabetes (T2DM) aged ≥65 years.

We retrospectively evaluated 364 elderly individuals with T2DM starting SGLT2i from June 2015 to June 2018. Patients were divided into 2 subgroups based on median age (70 years). Linear mixed effect models were used to estimate changes in glycated hemoglobin (HbA1c), body mass index (BMI), and glomerular filtration rate (eGFR). SGLT2i discontinuation rate and causes of treatment interruption were also recorded.

A significantly higher percentage of patients achieved HbA1c <7.5% (46.7% vs. 31.6%, p < 0.01) and <8.0% (68.9% vs. 47.2%, p < 0.01) compared to baseline. Each year of therapy was associated with an average HbA1c decrease of 0.34% (p < 0.01) and BMI loss of 0.71 kg/m

(p < 0.01), without significant interaction across age classes. In the younger group eGFR increased by 1.02 ml/min/year, while in the older group it declined by 0.42 ml/min/year (p = 0.08). Overall discontinuation rate during the follow-up period was similar across age groups (34.2% vs. 36.1%, long-rank p = 0.26). Genitourinary infections were the most frequent cause of treatment interruption (15.8% vs. 17.2%, p = 0.69) in both study groups, while persistent eGFR decline (4.4%) and orthostatic hypotension (1.7%) were only present in older age class.

Efficacy, renal safety and tolerability of SGLT2i were similar in people >70 compared to 65-70 years of age, suggesting that a wider use should not be worried even in the elderly. However, some caution must be paid to the occurrence of persistent eGFR decline and orthostatic hypotension, especially in patients >70 years old.

70 years old.Among the main social and legislative changes as regards family matters that have taken place in Spain in the last few years, are included (i) the gradual increase in legal disputes between parents, and (ii) the introduction of Law 26/2015 on Child Protection, which modified Law 41/2002 on the Freedom of the Patient. These searched for a balance between the rights of minors and the powers of the parents, particularly when the former had not reached 16 years or had sufficient maturity or, having reached it, the decision puts their life or health at severe risk. Likewise, it has led to a jurisprudence that determines that, for any minor, there are particularly sensitive, "special" or "important" health care actions, such as psychotherapy or surgical treatments, which require, with exceptions, the consent of both parents for it to be carried out. All this, however, subject to the discretion of the doctor responsible, who must always look after the best interests of the minor. For this reason, healthcare for minors, occasionally, lead to complex conflicts as regards information and consent by the parents, particularly when they do not agree. A review is presented on the current legislative framework and the main legal concepts that regulate the healthcare of minors as regards information and consent relative to health, as well a healthcare protocol for the care of minors in situations of conflict between parents, developed in the Gregorio Marañón Hospital of Madrid, and endorsed by the Official Medical Collegiate of Madrid.

Patients with multiple myeloma (MM) aged≤ 65 to 70 years, with a good Eastern Cooperative Oncology Group performance status and no major comorbid conditions, are considered potential candidates for autologous stem cell transplant (ASCT) and will be treated with novel agent-based induction therapy for 4 to 6 cycles before ASCT.

We analyzed the data from 326 patients with MM who had received novel agent-based induction before ASCT at our center to evaluate the effect of induction therapy on ASCT response, stem cell mobilization, engraftment characteristics, and survival. The median age was 52 years (range, 29-72 years), 216 patients were men (66.3%), 32.7% had stage III using the Revised Multiple Myeloma International Staging System, and 15.8% had high-risk cytogenetics. Of the 326 patients, 75 (23.0%) had undergone ASCT in second remission after salvage therapy for relapse. Also, 194 patients (59.5%) had received doublet induction therapy and 132 (40.5%) had received triplet induction therapy.

Triplet-based induction therapy was superior to doublet-based therapy for response (95.