Milleregan4668

AIMS To systematically review the literature addressing the following focused questions "What is the efficacy of either (#1) alternative or (#2) additional methods to professional mechanical plaque removal (PMPR) on progression of attachment loss during supportive periodontal therapy (SPT) in periodontitis patients?". METHODS A systematic search for randomized clinical trials was performed. Change in clinical attachment level (CAL) from baseline was the primary outcome. RESULTS Routine PMPR performed with either a combination of ultrasonic/hand instruments or ErYag laser showed similarly effective in preventing CAL loss. Moreover, a routine SPT regimen based on PMPR led to stability of CAL irrespective of a daily sub-antimicrobial doxycycline dose (SDD). Finally, an adjunctive photodynamic therapy (PDT) did not enhance the magnitude of CAL gain when sites with probing depth≥ 4 mm were repeatedly treated. After pooling all data, the results of the meta-analysis showed no statistical differences in CAL change from baseline mean overall CAL change was -0.233 mm (95% confidence interval -1.065, 0.598; p=0.351). CONCLUSIONS Weak evidence indicate that in treated periodontitis patients enrolled in a 3-4 month SPT based on PMPR, ErYag laser (as alternative), SDD and PDT (as additional) do not produce a greater clinical effect on periodontal conditions compared to PMPR. This article is protected by copyright. All rights reserved.The stress generation model posits that not only stressful life-events predict depressive symptoms, but also depressive-prone individuals think and behave in ways that make them more vulnerable to experience life-stress. Evidence has supported the bi-directional relationship between stress and depressive symptoms, and there has been an attempt in identifying vulnerability factors for stress generation. Yet, there is a need for studies focusing on multiple risk factors and a replication of findings in non-Western samples. The aim of the present study was to examine the role of rumination and excessive reassurance seeking (ERS) in stress generation in a sample of Turkish young adults. A sample of 318 Turkish college students reported on their rumination, ERS, intensity of stressful life-events and depressive symptoms. A subsample of 162 participants also completed a measure of life-events 5 months later. Cross-sectional results showed that rumination and ERS contribute to life-stress over and above depressive symptoms and gender. Mediational analyses indicated that ERS does not mediate the relationship between rumination and life-stress at 5 months. Rather, rumination fully mediated the relationship between ERS and future life-stress. Results provide evidence for stress generation, and highlight the interconnection between rumination and ERS. © 2020 International Union of Psychological Science.AIM This study examined whether enhanced susceptibility of steatotic liver to I/R injury is due to impaired recruitment of bone marrow (BM) progenitors of LSECs (also called sprocs) with diminished repair of injured LSECs and whether restoring signaling to recruit BM sprocs reduces I/R injury. METHODS Hepatic vessels were clamped for 1 hour in rats fed a high fat, high fructose (HFHF) diet for 5, 10, or 15 weeks. MMP-9 antisense oligonucleotides (ASO) or an MMP inhibitor were used to induce liver-selective MMP-9 inhibition. RESULTS HFHF rats had mild, moderate and severe steatosis, respectively, at 5-, 10-, and 15-weeks. I/R injury was enhanced in HFHF rats; this was accompanied by complete absence of hepatic VEGF-sdf1 signaling, leading to lack of BM sproc recruitment. Liver-selective MMP-9 inhibition to protect against proteolytic cleavage of hepatic VEGF using either MMP-9 ASO or intraportal MMP inhibitor in 5- and 10-week HFHF rats enhanced hepatic VEGF-sdf1 signaling, increased BM sproc recruitment, and reduced ALT by 92 and 77% at 5 weeks and by 80 and 64% at 10-weeks of HFHF diet, respectively. After I/R injury in 15-week HFHF rats, the MMP inhibitor reduced active MMP-9 expression by 97%, ameliorated histologic evidence of injury, and reduced ALT by 58%, which is comparable to control rats sustaining I/R injury. Rescue therapy with intraportal MMP inhibitor, given after ischemia, in the 5-week HFHF rat reduced ALT by 71% and reduced necrosis. CONCLUSIONS Lack of signaling to recruit BM sprocs that repair injured LSECs renders steatotic liver more susceptible to I/R injury. Liver-selective MMP-9 inhibition enhances VEGF-sdf1 signaling and recruitment of BM sprocs, which markedly protects against I/R injury, even in severely steatotic rats. This article is protected by copyright. All rights reserved.BACKGROUND Generalized anxiety disorder (GAD) and major depressive disorder (MDD) are prevalent in patients with asthma. These disorders may increase asthma severity and decrease asthma control. No studies have evaluated the impact of achieving antidepressant target dose optimization compared with not achieving antidepressant target doses on asthma control in uninsured and underinsured patients. OBJECTIVE To evaluate the impact of achieving antidepressant target dose optimization in uninsured and underinsured adult asthma patients with GAD and/or MDD on the risk of severe asthma exacerbations and number of asthma-related outcomes. METHODS We conducted a retrospective cohort study of uninsured and underinsured adult asthma patients with GAD and/or MDD who have been initiated on a single antidepressant and maintained on a stable dose for 8 weeks (index date). see more Eligible patients were followed for 12-24 months after the index date and separated into those who achieved a target dose (target group) and those who didhose who were titrated to achieve target doses had a reduced risk of severe asthma exacerbations and a lower number of asthma-related outcomes than those who were not optimized to achieve target doses. © 2020 Pharmacotherapy Publications, Inc.This paper argues that assessing personal responsibility in healthcare settings for the allocation of medical resources would be too privacy-invasive to be morally justifiable. In addition to being an inappropriate and moralizing intrusion into the private lives of patients, it would put patients' sensitive data at risk, making data subjects vulnerable to a variety of privacy-related harms. Even though we allow privacy-invasive investigations to take place in legal trials, the justice and healthcare systems are not analogous. The duty of doctors and healthcare professionals is to help patients as best they can-not to judge them. Patients should not be forced into giving up any more personal information than what is strictly necessary to receive an adequate treatment, and their medical data should only be used for appropriate purposes. Medical ethics codes should reflect these data rights. When a doctor asks personal questions that are irrelevant to diagnose or treat a patient, the appropriate response from the patient is 'none of your business'.