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Introduction: Femoral fractures in elderly individuals present significant health challenges, often leading to increased morbidity and mortality. Acute kidney injury (AKI) during hospitalization further complicates outcomes, yet the interaction between AKI severity and comorbidities, as quantified by the Charlson Comorbidity Index (CCI), remains poorly understood in this population. This study aimed to assess the associations between AKI severity and the CCI and between AKI severity and one-year mortality postfemoral fracture in elderly patients. Methodology: This study utilized data from the Multiparameter Intelligent Monitoring in Intensive Care (MIMIC-IV) database and focused on elderly patients (> 65 years) admitted with hip fractures. Patients were categorized based on AKI stage according to the KDIGO criteria and CCI scores. The primary outcome assessed was all-cause mortality one year after hospital discharge. The statistical analyses included logistic regression, Cox proportional hazards regression and moderation analysis with the Johnson–Neyman technique to evaluate associations between AKI and long-term mortality and between the CCI and long-term mortality. Results: The analysis included 1,955 patients and revealed that severe AKI (stages 2 and 3) was independently associated with increased one-year mortality. Notably, the CCI moderated these associations significantly. A lower CCI score was significantly correlated with greater mortality in patients with severe AKI. The impact of severe AKI was greater for those with a CCI as low as 3, more than doubling the observed one-year mortality rate. In contrast, higher CCI scores (≥8) did not significantly impact mortality. Sensitivity analyses supported these findings, underscoring the robustness of the observed associations. Conclusion: This study elucidates the complex interplay between AKI severity and comorbidities and long-term mortality in elderly hip fracture patients. These findings underscore the importance of considering both AKI severity and comorbidity burden in prognostic assessments and intervention strategies for this vulnerable population. Targeted interventions tailored to individual risk profiles may help mitigate the impact of AKI on mortality outcomes, ultimately improving patient care and outcomes. Further research is warranted to explore the underlying mechanisms involved and refine risk stratification approaches in this population. [ABSTRACT FROM AUTHOR]

Manihot esculenta Crantz is originally from the Amazon region of Brazil, which has the highest genetic diversity. Due to the wide adaptation of cassava to the most diverse environments, the evolutionary forces acted on the crop, resulting in a more complex genetic structure. This study evaluated the population structure and the genetic diversity through 25 SSR markers of 144 sweet cassava accessions collected in seven places in the south of Brazil. All the loci analyzed were polymorphic and showed several alleles per loci with a mean of 3.36 alleles and 38 rare alleles in the population. The mean value of polymorphism information content (PIC) was 0.488, which indicates that the markers were informative and the mean observed heterozygosity was 0.644, while the mean expected heterozygosity was 0.557. The sweet cassava accessions were divided into 10 groups based on the population structure analysis. There was a moderate genetic differentiation (PhiPT = 0.106) among the sweet cassava subpopulations. The wide genetic variability among the studied accessions of sweet cassava demonstrates the importance of the emergency in the conservation of plants in germplasm banks, because the intense change in agriculture; the expansion of areas occupied by soybeans, corn, and other crops; and also the farmers' migration from rural areas to urban areas reduced cassava cultivation over time, and as a consequence, genetic variability has been lost. [ABSTRACT FROM AUTHOR]

Aim This study evaluated the effects of scaling and root planing ( SRP) on gingival crevicular fluid ( GCF) and serum levels of adipokines in patients with chronic periodontitis ( CP) with or without obesity. Methods Twenty patients with obesity and 20 patients without obesity, all with CP, received SRP. Serum and GCF levels of resistin, adiponectin, leptin, tumour necrosis factor [ TNF]- α and interleukin [ IL]-6 were evaluated by enzyme-linked immunosorbent assay at baseline, 3, 6 and 12 months post-therapy. Results SRP reduced the amounts of TNF- α in deep sites and increased the concentration of adiponectin in shallow sites of non-obese patients ( p < 0.05). SRP increased the concentrations of TNF- α and leptin in patients with obesity ( p < 0.05). GCF levels of TNF- α were higher in patients with obesity than in patients without obesity at all time-points ( p < 0.05). There were no changes in serum levels of any adipokines for any group after therapy ( p > 0.05). Patients with obesity exhibited higher serum levels of leptin at all time-points and IL-6 at 3 months post-therapy ( p < 0.05). Conclusions Obesity may modulate systemic and periodontal levels of adipokines in favour of pro-inflammation, independently of periodontal therapy. SRP did not affect the circulating levels of adipokines in patients with or without obesity. [ABSTRACT FROM AUTHOR]

Background We have recently developed a periodontal diagnostic tool that was validated in non-smokers with periodontitis. Tobacco smoking is a recognized risk factor for periodontal diseases that can mask gingival bleeding and lead to a false negative diagnosis. Therefore, the purpose of current study is to further validate this instrument in smokers with periodontal diseases. Methods Using a portable optical near-infrared spectrometer, optical spectra were obtained, processed and evaluated from healthy ( n = 108), gingivitis ( n = 100), and periodontitis ( n = 79) sites of 54 systemically healthy smokers. A modified Beer-Lambert unmixing model that incorporates a non-parametric scattering loss function was used to determine the relative contribution of deoxygenated haemoglobin (Hb) and oxygenated haemoglobin (HbO2) to the overall spectrum. The balance between tissue oxygen delivery and utilization in periodontal tissues was then assessed. Results Tissue oxygen saturation was significantly decreased in the gingivitis ( p = 0.016) and periodontitis ( p = 0.007) sites, compared to the healthy sites. There was a trend towards increased concentration of Hb and decreased concentration of HbO2 from healthy to diseased sites, without statistical significance ( p > 0.05). Conclusions Optical spectroscopy can determine tissue oxygenation profiles of healthy and diseased sites in smokers. The spectral profile of periodontal sites in smokers generally resembles those from non-smoking patients. [ABSTRACT FROM AUTHOR]

Aim The aim of this randomized controlled clinical trial was to evaluate the clinical effects of chlorhexidine ( CHX) application in a full-mouth disinfection ( FMD) protocol in poorly controlled type-2 diabetic subjects with generalized chronic periodontitis. Material and Methods Thirty-eight subjects were randomly assigned into FMD group ( n=19): full-mouth scaling and root planing ( FMSRP) within 24 h + local application of CHX gel + CHX rinses for 60 days or Control group ( n = 19): FMSRP within 24 h + local application of placebo gel + placebo rinses for 60 days. Clinical parameters, glycated haemoglobin and fasting plasma glucose were assessed at baseline, 3, 6 and 12 months post-therapies. Results All clinical parameters improved significantly at 3, 6 and 12 months post-therapies for both groups ( p < 0.05). There were no significant differences between groups for any clinical parameters, and glycemic condition at any time-point ( p > 0.05). Conclusions The treatments did not differ with respect to clinical parameters, including the primary outcome variable (i.e. changes in clinical attachment level in deep pockets), for up to 12 months post-treatments. [ABSTRACT FROM AUTHOR]

A crude bioactive EtOH extract of the twigs of Casearia obliqua afforded two new clerodane diterpenes, caseobliquins A (1) and B (2). Additionally, bioactivity-directed fractionation on a bioactive hexane extract of the leaves from this species led to the isolation of the known clerodane diterpenes rel-6beta-hydroxyzuelanin-2beta-benzoate and rel-2alpha-hydroxyzuelanin-6beta-benzoate (3 and 4) as a mixture and 2beta-hydroxyzuelanin-6beta-cinnamate (5). The structures of the new clerodanes 1 and 2 were established on the basis of their 1D and 2D NMR spectroscopic data, and the new compound 1 and the known substance 5 had their absolute configurations determined by circular dichroism spectroscopy. The cytotoxicity of several of the compounds isolated was evaluated against a small panel of human tumor cell lines.