The ligands 2,4,6-tris(4-methylpyrazol-1-yl)-1,3,5-triazine (Me-TPzT), 2,4,6-tris(4-bromopyrazol-1-yl)-1,3,5-triazine (Br-TPzT), and 2-methoxy-4,6-bis(4-methylpyrazol-1-yl)-1,3,5-triazine (Me-BPzTOMe) have been synthesized and their reactions with some palladium derivatives explored. The palladium fragment [Pd(eta(3)-2-Me-C(3)H(4))(S)(2)](+), S = acetone, reacts in acetone with Me-TPzT or Br-TPzT in a 3:1 molar ratio to generate new complexes in which two allylpalladium fragments are present and the TPzT ligands have been partially hydrolyzed: [{Pd(eta(3)-C(4)H(7))}(2)(X-BPzTO)]A, X-BPzTO = 4,6-bis[4-methyl(or bromo)pyrazol-1-yl]-1,3,5-triazin-2-olate (X = Me, A = BF(4), 1; A = PF(6), 2; A = CF(3)SO(3), 3; A = p-MeC(6)H(4)SO(3), 4; X = Br, A = CF(3)SO(3), 5). When the ligand Me-BPzTOMe is made to react with only 1 equiv of the palladium solvate, compound 6, [Pd(eta(3)-2-Me-C(3)H(4))(Me-BPzTOMe)]CF(3)SO(3), is isolated. Reaction of 6 with another 1 equiv of the palladium derivative leads to 3. The intermediate 7, [{Pd(eta(3)-2-Me-C(3)H(4))}(2)(Me-BPzTOMe)]CF(3)SO(3), has been isolated as an almost pure compound. The reaction of Me-BPzTOMe with 1 equiv of [Pd(C(6)F(5))(2)(cod)] (cod = 1,5-cyclooctadiene) leads to the complex [Pd(C(6)F(5))(2)(Me-BPzTOMe)], 8. Attention has been focused on the dynamic behavior, related with metallotropic phenomena, of the new complexes. (1)H NMR variable-temperature studies of complexes 1, 6, and 8 have been carried out. For 8, only one static species is observed, while, for 1 and 6, two isomers are detected at low temperature. Different DeltaG(c)() activation energies at the coalescence temperature have been determined and are ascribed to processes implying Pd-N bond ruptures. For 6, two different barriers are detected, corresponding to Pd-N(triazine) or Pd-N(pyrazole) bond ruptures. From the DeltaG(c)() data, it is concluded that the main driving force of the hydrolysis process is the formation of a better coordinating ligand. The molecular structure of 4 has been determined by X-ray diffraction. The meso isomer, in which the two C-Me axes of the allylic groups are oriented in the same direction, is found in the solid state.

Background gamification is a potentially attractive option for improving balance and reducing falls. Objectives to assess the effect of balance training using the NintendoTM Wii game console on balance (primary outcome), falls and fear of falling. Design quasi-randomised, open-label, controlled clinical trial in parallel groups, carried out on community-dwelling patients over 70 years, able to walk independently. Participants were assigned 1:1 to the intervention or control group. Balance training was conducted using the Nintendo WiiFit TM twice a week for 3 months. Balance was assessed using the Tinetti balance test (primary outcome), the unipedal stance and the Wii balance tests at baseline, 3 months and 1 year. Falls were recorded and Fear of falling was assessed by the Falls Efficacy Scale (Short-FES-I). Results 1,016 subjects were recruited (508 in both the intervention and the control group; of whom 274 and 356 respectively completed the 3-month assessment). There was no between-group difference in the Tinetti balance test score, with a baseline mean of 14.7 (SD 1.8) in both groups, and 15.2 (1.3) at 3 months in the intervention group compared to 15.3 (1.7) in controls; the between-group difference was 0.06 (95% CI 0.30–0.41). No differences were seen in any of the other balance tests, or in incident falls. There was a reduction in the fear of falling at 3 months, but no effect at 1 year. Conclusions the study found no effect of balance training using the Nintendo TM Wii on balance or falls in older community-dwelling patients. The study protocol is available at clinicaltrials.gov under the code NCT02570178.

Identifying the complexities of the effect of sex on stroke risk, etiology, and lesion progression may lead to advances in the treatment and care of ischemic stroke (IS) and non-traumatic intracerebral hemorrhage patients (ICH). We studied the sex-related discrepancies on the clinical course of patients with IS and ICH, and we also evaluated possible molecular mechanisms involved. The study's main variable was the patient's functional outcome at 3-months. Logistic regression models were used in order to study the influence of sex on different inflammatory, endothelial and atrial dysfunction markers. We recruited 5,021 patients; 4,060 IS (54.8% male, 45.2% female) and 961 ICH (57.1% male, 42.9% female). Women were on average 5.7 years older than men (6.4 years in IS, 5.1 years in ICH), and more likely to have previous poor functional status, to suffer atrial fibrillation and to be on anticoagulants. IS patients showed sex-related differences at 3-months regarding poorer outcome (55.6% women, 43.6% men, p < 0.0001), but this relationship was not found in ICH (56.8% vs. 61.9%, p = 0.127). In IS, women had higher levels of NT-proBNP and 3-months worse outcome in both cardioembolic and non-cardioembolic stroke patients. Stroke patients showed sex-related differences in pre-hospital data, clinical variables and molecular markers, but only IS patients presented independent sex-related differences in 3-months poor outcome and mortality. There was a relationship between the molecular marker of atrial dysfunction NT-proBNP and worse functional outcome in women, resulting in a possible indicator of increased dysfunction.

Purpose: Alveolar osteitis (AO) is the most common postoperative complication of dental extractions. The purpose of this study was to compare the effectiveness of 1% versus 0.2% chlorhexidine (CHX) gel in reducing postoperative AO after surgical extraction of mandibular third molars, and assess the impact of treatment on the Oral HealthRelated Quality of Life (OHRQoL). Material and Methods: This clinical study was a randomized, double-blind clinical trial. Eighty eight patients underwent surgical extraction of one retained mandibular third molar with the intra-alveolar application of 0.2% CHX gel. Afterwards, they were assigned to one of two groups: 1% CHX gel (n=42) or 0.2% CHX gel (n=46). The patients applied the gel twice a day to the wound for one week. All patients were evaluated for AO. Results: In the 0.2% CHX gel group, 13% of AO incidence was found, while in the 1% CHX gel group, AO incidence was 7%, a difference that was not statistically significant. Variables such as sensation of pain and inflammation at baseline and during one week, as well as OHRQoL of the patients at 24 hours and 7 days post-extraction, gave no statistically significant differences. Conclusions: There are no significant differences in AO after surgical extraction of mandibular third molars, when comparing applying 1% CHX gel twice a day for 7 days with 0.2% CHX gel. Key words:Alveolar osteitis, chlorhexidine gel, third molar.

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Background: Recent preclinical studies have shown that regulatory T cells (Treg) play a key role in the immune response after ischemic stroke (IS). However, the role of Treg in human acute IS has been poorly investigated. Our aim was to study the relationship between circulating Treg and outcome in human IS patients. Methods: A total of 204 IS patients and 22 control subjects were recruited. The main study variable was good functional outcome at 3 months (modified Rankin scale ≤2) considering infarct volume, Early Neurological Deterioration (END) and risk of infections as secondary variables. The percentage of circulating Treg was measured at admission, 48, 72 h and at day 7 after stroke onset. Results: Circulating Treg levels were higher in IS patients compared to control subjects. Treg at 48 h were independently associated with good functional outcome (OR, 3.5; CI: 1.9-7.8) after adjusting by confounding factors. Patients with lower Treg at 48 h showed higher frequency of END and risk of infections. In addition, a negative correlation was found between circulating Treg at 48 h (r = − 0.414) and 72 h (r = − 0.418) and infarct volume. Conclusions: These findings suggest that Treg may participate in the recovery of IS patients. Therefore, Treg may be considered a potential therapeutic target in acute ischemic stroke.

BackgroundBalance alteration is a risk factor for falls in elderly individuals that has physical, psychological and economic consequences. The objectives of this study are to evaluate the usefulness of an intervention utilizing the Nintendo™ Wii console in order to improve balance, thereby decreasing both the fear of falling as well as the number of falls, and to evaluate the correlation between balance as determined by the console and the value obtained in the Tinetti tests and the one foot stationary test.Methods/DesignThis is a controlled, randomized clinical trial of individual assignment, carried out on patients over 70 years in age, from five primary care centers in the city of Mataró (Barcelona). 380 patients were necessary for the intervention group that carried out the balance board exercises in 2 sessions per week for a 3 month period, and 380 patients in the control group who carried out their usual habits. Balance was evaluated using the Tinetti test, the one foot stationary test and with the console, at the start of the study, at the end of the intervention (3 months) and one year later. Quarterly telephone follow-up was also conducted to keep track of falls and their consequences.DiscussionThe study aimed to connect the community with a technology that may be an easy and fun way to assist the elderly in improving their balance without the need to leave home or join rehabilitation groups, offering greater comfort for this population and decreasing healthcare costs since there is no need for specialized personnel.Trial registrationCurrent Control Trial NCT02570178.