Activiteit

High prevalence rates have been reported for physical inactivity, mobility limitations, and falls in older adults. Home-based exercise might be an adequate means to increase physical activity by improving health- (i.e., muscle strength) and skill-related components of physical fitness (i.e., balance), particularly in times of restricted physical activity due to pandemics.

The objective of this study was to examine the effects of home-based balance exercises conducted during daily tooth brushing on measures of balance and muscle strength in healthy older adults.

Fifty-one older adults were randomly assigned to a balance exercise group (n = 27; age 65.1 ± 1.1 years) or a passive control group (n = 24; age 66.2 ± 3.3 years). The intervention group conducted balance exercises over a period of eight weeks twice daily for three minutes each during their daily tooth brushing routine. Cell Cycle inhibitor Pre- and post-intervention, tests were included for the assessment of static steady-state balance (i.e., Romberg test), dynamic ecommended for older adults to improve balance and muscle strength.

The applied lifestyle balance training program conducted twice daily during tooth brushing routines appears not to be sufficient in terms of exercise dosage and difficulty level to enhance balance and muscle strength in healthy adults aged 60-72 years. Consequently, structured balance training programs using higher exercise dosages and/or more difficult balance tasks are recommended for older adults to improve balance and muscle strength.

There is a lack of studies regarding the optimal timing for endoscopic retrograde cholangiopancreatography (ERCP) in patients with cholangitis caused by distal malignant biliary obstruction (MBO). This study aims to investigate the optimal timing of ERCP in patients with acute cholangitis associated with distal MBO with a naïve papilla.

A total of 421 patients with acute cholangitis, associated with distal MBO, were enrolled for this study. An urgent ERCP was defined as being an ERCP performed within 24h following emergency room (ER) arrival, and early ERCP was defined as an ERCP performed between 24 and 48h following ER arrival. We evaluated both 30-day and 180-day mortality as primary outcomes, according to the timing of the ERCP.

The urgent ERCP group showed the lowest 30-day mortality rate (2.2%), as compared to the early and delayed ERCP groups (4.3% and 13.5%) (P < 0.001). The 180-day mortality rate was lowest in the urgent ERCP group, followed by early ERCP and delayed ERCP groups (39.4%, 44.8%, 60.8%; P = 0.006). A subgroup analysis showed that in both the primary distal MBO group, as well as in the moderate-to-severe cholangitis group, the urgent ERCP had significantly improved in both 30-day and 180-day mortality rates. However, in the secondary MBO and mild cholangitis groups, the difference in mortality rate between urgent, early, and delayed ERCP groups was not significant.

In patients with acute cholangitis associated with distal MBO, urgent ERCP might be helpful in improving the prognosis, especially in patients with primary distal MBO or moderate-to-severe cholangitis.

In patients with acute cholangitis associated with distal MBO, urgent ERCP might be helpful in improving the prognosis, especially in patients with primary distal MBO or moderate-to-severe cholangitis.

Children’s oral health is a prevalent health concern in Indigenous communities in Canada and globally. Compared to an early childhood caries prevalence rate of 57% in non-Indigenous Canadian school-age children, some Indigenous communities face rates exceeding 90%. Despite the high prevalence rates of caries and other oral health concerns in Indigenous children, qualitative research on oral health has focused on Indigenous adults. This study sought to uncover children and youths’ oral health experiences and understandings in two Anishnabeg communities in Quebec.

A focused ethnography was conducted using participatory research principles, and included interviews with key informants, children, and youth, as well as participant observation of oral health activities. Analysis was iterative and concurrent with data collection.

Themes include (1) children and youth primarily described oral health in relation to their teeth only; (2) children and youth have motivators for maintaining oral health, including consequences of poor oral health and its influence on self-presentation; (3) oral health is ‘put on the side table’, and not highly prioritized by children or adults; (4) children and youth recognize the people in their lives that influence their oral health; and (5) children and youth demonstrate agency in oral health matters.

These results demonstrate the valuable perspectives that Anishnabeg children and youth have regarding their oral health, and are of value to other Indigenous communities that strive to address similar oral health concerns.

These results demonstrate the valuable perspectives that Anishnabeg children and youth have regarding their oral health, and are of value to other Indigenous communities that strive to address similar oral health concerns.

Despite the high incidence of spondyloarthritis (SpA) as an extra-intestinal manifestation of Crohn’s disease (CD), the immunopathogenesis of CD-associated SpA remains largely unknown.

We tried to explore molecular mechanisms accounting for the development of CD-associated SpA in a patient successfully treated with infliximab.

Peripheral blood mononuclear cells (PBMCs) before infliximab treatment were stimulated with Toll-like receptor (TLR) ligands to measure pro-inflammatory cytokine responses. Endoscopic biopsy samples before and after infliximab treatment were subjected to quantitative polymerase chain reaction.

PBMCs from this CD-associated SpA patient exhibited higher production of pro-inflammatory cytokines upon stimulation with TLR ligands than PBMCs from healthy controls. Induction of remission by infliximab was associated with the downregulation of pro-inflammatory cytokine responses in the small intestinal mucosa, which is continually exposed to TLR ligands.

Excessive pro-inflammatory cytokine responses to TLR ligands might underlie the immunopathogenesis of CD-associated SpA.