Aim This study assessed the associations of prediabetes and insulin resistance with bleeding on probing (BOP) and periodontitis among adults. Materials and methods We included 1,191 Hispanic adults aged 40-65 years, free of diabetes, enrolled in the San Juan Overweight Adults Longitudinal Study. Pre-diabetes was defined as impaired fasting glucose (IFG), impaired glucose tolerance (IGT), or impaired glycated hemoglobin. Impaired one-hour plasma glucose (1hPG) was defined as levels>155 mg/dL. Insulin resistance was defined using the study population-specific 75th percentile (HOMA-IR≥3.13). High BOP was defined as percentage of teeth with bleeding ≥30%. Periodontitis was defined according to the CDC/AAP definition. Results After multivariable adjustment for age, gender, education, smoking status, alcohol consumption, physical activity, obesity, HDL-C, and plaque index, prediabetes with and without 1hPG, IFG, impaired 1hPG, IGT, and HOMA-IR were significantly associated with high BOP; prediabetes, IFG, and impaired 1hPG were significantly associated with severe periodontitis. Most of these associations remained significant when the analyses were restricted to non-smokers. Conclusions This study suggests associations between prediabetes and insulin resistance with BOP and periodontitis. Given the high prevalence of impaired glucose metabolism and periodontitis, the assessment of the temporal sequence of these associations are of utmost importance.

The world faces an exceptional new public health concern caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), subsequently termed the coronavirus disease 2019 (COVID-19) by the World Health Organization (WHO). Although the clinical symptoms mostly have been characterized, the scientific community still doesn´t know how SARS-CoV-2 successfully reaches and spreads throughout the central nervous system (CNS) inducing brain damage. The recent detection of SARS-CoV-2 in the cerebrospinal fluid (CSF) and in frontal lobe sections from postmortem examination has confirmed the presence of the virus in neural tissue. This finding reveals a new direction in the search for a neurotherapeutic strategy in the COVID-19 patients with underlying diseases. Here, we discuss the COVID-19 outbreak in a neuroinvasiveness context and suggest the therapeutic use of high doses of melatonin, which may favorably modulate the immune response and neuroinflammation caused by SARS-CoV-2. However, clinical trials elucidating the efficacy of melatonin in the prevention and clinical management in the COVID-19 patients should be actively encouraged.

Objetivo: Determinar/establecer la relación entre los factores socio-demográficos y las dimensiones de calidad de atención del cuidado y satisfacción en los cuidadores de los pacientes geriátricos agudos ingresados en el Hospital Virgen del Valle (Toledo, España).<br /><br />Metodología: Diseño: Estudio descriptivo transversal. Ámbito de estudio: Hospital geriátrico de Toledo (España).Sujetos de estudio: Cuidadores principales de los pacientes geriátricos ingresados en el Hospital Virgen del Valle de Toledo, en las Unidades de Agudos. Tamaño muestral: 267 cuidadores (p= 0.5, intervalo de confianza del 95%, e= 0.06).Instrumento de medida; Cuestionario validado, basado en el modelo SERVQUAL, para medir la satisfacción con la atención recibida. Determinaciones: Para determinar el efecto de las variables predictoras en el nivel de satisfacción, se realizaron análisis de regresión lineal simple y multivariante. <br /><br />Resultados: La valoración global sobre la satisfacción general con la atención y con los cuidados es “mediatamente buena”, siempre obteniendo puntuación más alta en la valoración de los cuidados que en la atención en general. En relación con los ítems estudiados sobre la satisfacción y sobre las dimensiones de calidad y perfil del cuidador, se han encontrado diferencias estadísticamente significativas en: género, edad, nivel de estudios del cuidador, tiempo de hospitalización, nivel de dependencia del enfermo, comparten domicilio o no, e ingresos anteriores.<br /><br />Conclusión-Esencia: Existe una necesidad urgente de aumentar el nivel de conocimiento sobre los cuidadores y conocer sus expectativas sobre el cuidado, para elaborar estrategias de cuidado acordes con sus preferencias. El conocimiento de las deficiencias detectadas sobre el cuidado proporciona a los profesionales datos sobre donde se debe intervenir para conseguir cambios favorables para aumentar la satisfacción.<br /><br />

We evaluated the relationship between glucose abnormalities and periodontitis in overweight/obese individuals. Eight hundred and seventy (870) diabetes-free participants aged 40–65 years completed the three-year follow-up in the San Juan Overweight Adults Longitudinal Study. The ADA thresholds for fasting and 2-h post-load glucose and HbA1c were used to define prediabetes. The NHANES methods were used to assess periodontitis. Multivariable linear regression was used to evaluate the relationship between baseline glucose metabolism measures and periodontitis at follow-up, adjusting for potential confounders. There was no association between impaired glucose measures and mean pocket depth (PD), mean clinical attachment loss (CAL), or mean percent of sites ≥5 mm PD. Impaired glucose tolerance (IGT) was associated with a lower mean percent of sites ≥5 mm CAL (β = −1.6, p = 0.037). Prediabetes and impaired fasting glucose (IFG) were associated with improvement in mean percent of sites ≥5 mm PD (β = −1.4, p = 0.022; β = −1.6, p = 0.032; respectively). IFG and IGT were associated with improvement in mean percent of sites with ≥5 mm CAL (β = −1.6, p = 0.038; β = −1.9, p = 0.020; respectively). In conclusion, there were no consistent associations between baseline prediabetes or insulin resistance and periodontitis progression over a three-year period.