Coagulation and heamostasis is a very important process in healing for any minor or major injury. Hemostasis or haemostasis is a process which literally means stopping of bleeding due to vasoconstruction. There are three stages in which Hemostasis takes place – Vascular spasm or Vasoconstriction (blood vessels constrict for a short duration), Platelets form a [...]
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Τρίτη 7 Νοεμβρίου 2017
Role of Vitamin K, Liver and Vascular wall in Hemostasis and Coagulation
The effect of different dosage regimens of tranexamic acid on blood loss in bimaxillary osteotomy: a randomized, double-blind, placebo-controlled study
The purpose of this study was to compare the effects of three dosage regimens of intravenous tranexamic acid and normal saline placebo on blood loss and the requirement for transfusion during bimaxillary osteotomy. A prospective, randomized, double-blind, placebo-controlled study was performed. Eighty patients scheduled for elective bimaxillary osteotomy were divided into four groups: a placebo group and three groups receiving a single dose of tranexamic acid 10, 15, or 20mg/kg body weight after the induction of anaesthesia. (Source: International Journal of Oral and Maxillofacial Surgery)
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Evaluation of peri-implant bone levels and soft tissue dimensions around zirconia implants —a three-year follow-up study
The aim of this study was to measure bone levels around zirconia implants during follow-up of up to 3 years. Additionally, the effect of clinical contact point positions on the papilla deficit was evaluated. Eighty-one patients with 105 zirconia implants were examined at the 3-year follow-up. Bone levels were measured on the date of implant placement and at 3 months, 1year, and 3 years thereafter. Distances between the first bone –implant contact and the contact point of the crowns and between the bone level at the adjacent tooth and the contact point of the crowns were assessed. (Source: International Journal of Oral and Maxillofacial Surgery)
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Biomaterials in temporomandibular joint replacement: current status and future perspectives —a narrative review
The alloplastic total temporomandibular joint (TMJ) prosthesis has a long history, with many different materials and designs used. While several of these materials have proven valuable over time, many others have not been suitable for implantation, resulting in failure and the need for explantation of the implant. Because of the failure of several of these systems, the use of alloplastic prostheses has reduced dramatically, despite their advantages over autogenous restoration. The aim of this narrative review is to discuss the criteria that must be met by a biomaterial in order for it to be considered suitable for implantation, as well as the common complications that can occur. (Source: International Journal of Oral and Maxillofacial Surgery)
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An ancestry-based approach for detecting interactions
ABSTRACT
Background
Epistasis and gene-environment interactions are known to contribute significantly to variation of complex phenotypes in model organisms. However, their identification in human association studies remains challenging for myriad reasons. In the case of epistatic interactions, the large number of potential interacting sets of genes presents computational, multiple hypothesis correction, and other statistical power issues. In the case of gene-environment interactions, the lack of consistently measured environmental covariates in most disease studies precludes searching for interactions and creates difficulties for replicating studies.
Results
In this work, we develop a new statistical approach to address these issues that leverages genetic ancestry, defined as the proportion of ancestry derived from each ancestral population (e.g., the fraction of European/African ancestry in African Americans), in admixed populations. We applied our method to gene expression and methylation data from African American and Latino admixed individuals, respectively, identifying nine interactions that were significant at 
Conclusion
We show that genetic ancestry can be a useful proxy for unknown and unmeasured covariates in the search for interaction effects. These results have important implications for our understanding of the genetic architecture of complex traits.
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Integrative sparse principal component analysis of gene expression data
ABSTRACT
In the analysis of gene expression data, dimension reduction techniques have been extensively adopted. The most popular one is perhaps the PCA (principal component analysis). To generate more reliable and more interpretable results, the SPCA (sparse PCA) technique has been developed. With the "small sample size, high dimensionality" characteristic of gene expression data, the analysis results generated from a single dataset are often unsatisfactory. Under contexts other than dimension reduction, integrative analysis techniques, which jointly analyze the raw data of multiple independent datasets, have been developed and shown to outperform "classic" meta-analysis and other multidatasets techniques and single-dataset analysis. In this study, we conduct integrative analysis by developing the iSPCA (integrative SPCA) method. iSPCA achieves the selection and estimation of sparse loadings using a group penalty. To take advantage of the similarity across datasets and generate more accurate results, we further impose contrasted penalties. Different penalties are proposed to accommodate different data conditions. Extensive simulations show that iSPCA outperforms the alternatives under a wide spectrum of settings. The analysis of breast cancer and pancreatic cancer data further shows iSPCA's satisfactory performance.
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Tooth loss: does it affect dietary intake and nutritional status?
This review of the impact of tooth loss on dietary intake and nutritional status included 8 low quality cohort studies. Weak and inconsistent evidence of an association was seen. Further high quality studies are needed.
The post Tooth loss: does it affect dietary intake and nutritional status? appeared first on National Elf Service.
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Prevalence of papular urticaria caused by flea bites and associated factors in children 1–6 years of age in Bogotá, D.C.
Papular urticaria is a chronic inflammatory disease caused by exposure to arthropod bites. The disease has been reported in children attending medical centers, but the causes as the risk factors associated wit...
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Leukotriene receptor antagonism may not be effective in atopic dermatitis treatment after all
Summary
What is known and Objective
Literature evidence suggests leukotriene involvement in the pathogenesis of atopic dermatitis. This article aimed to discuss whether the off-label use of montelukast, a leukotriene receptor antagonist, is justifiable for the treatment of atopic dermatitis.
Comment
Most non-randomized studies supported the use of montelukast for atopic dermatitis treatment. However, evidence from these studies should be interpreted with caution as it is relatively weak due to the absence of randomization, control groups and blinding processes, subjecting the results to high risk of selection and reporting biases. The inconsistent findings across RCTs may be related to the limited number of patients, nuances in study designs, varying severity of disease and the concomitant use of steroids in some of the studies.
What is new and Conclusion
Current literature evidence is limited to rationally support the use of montelukast in atopic dermatitis treatment. For now, the conventional treatments should be preferred in the clinical setting.
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Effect of zoledronic acid therapy on postmenopausal osteoporosis between the Uighur and Han population in Xinjiang: An open-label, long-term safety and efficacy study
Summary
What is known and objective
Postmenopausal osteoporosis is becoming an urgent health problem in China. A once-yearly infusion of zoledronic acid can be very effective for the treatment of postmenopausal osteoporosis in significantly reducing the risk of hip, vertebral and other fractures. This study aimed to investigate zoledronic acid treatment on postmenopausal osteoporosis in Uighur and Han patients in Xinjiang province, China.
Methods
A self-controlled and prospective trial design was adopted. A total of 155 Uighur and 151 Han patients were enrolled. All subjects received an intravenous infusion of zoledronic acid (5 mg) at day 0 (baseline) and at 12 months. Patients were followed up for 24 months; the bone mineral density (BMD) of the left total hip and L1–L4 vertebrae was measured at day 0 and at 24 months.
Results and discussion
BMD was significantly higher after zoledronic acid treatment compared with baseline levels in all patients, as assessed at 24 months. Moreover, the BMD of left total hip increased with 2.7% in the Han group was significantly higher than that of the Uighur group with 1.4% (left total hip, 95% CI: 2.6% to 2.8% in Han group vs 1.2% to 1.4% in Uighur group). The BMD of L1–L4 vertebrae increased with 2.2% in the Han group was significantly higher than that of the Uighur group with 1.6% (L1–L4 vertebrae, 95% CI, 2.0% to 2.4% in Han group vs 1.4% to 1.7% in Uighur group); P < .001. There was no significant difference in drug-related adverse effects between the two groups (P > .05).
What is new and conclusion
Zoledronic acid appears to be more effective in postmenopausal osteoporosis in Han than in Uighur subjects. The reasons for this require further investigation.
The BMD of both left total hip and lumbar spine was significantly increased in Han group than in Uighur group at 24 months after a once-yearly intravenous infusion of zoledronic acid in postmenopausal osteoporosis patients.
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Dental Select Names Mark Coyne as New President
Dental Select today announced that it has named Mark Coyne as President of the company. Brent Williams, who founded the company in 1989, will continue to serve as Chief Executive Officer.
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A shared decision-making tool for obstructive sleep apnea without tonsillar hypertrophy: A randomized controlled trial
Objectives/Hypothesis
Shared decision-making is a process whereby patients and clinicians jointly establish a treatment plan integrating clinical evidence and patient values and preferences. Although this approach has been successfully employed in numerous medical disciplines, often using shared decision-making tools, otolaryngologic research assessing its use is scant. Our primary objective was therefore to determine if the tools we developed reduced decisional conflict for children with obstructive sleep apnea without tonsillar hypertrophy.
Study Design
Prospective, single-blind, randomized controlled trial.
Methods
We enrolled consecutive patients meeting inclusion criteria who were referred to our multidisciplinary upper airway center. Study patients used a shared decision-making tool whereas controls did not. Measures of decisional conflict (SURE [Sure of myself, Understanding information, Risk benefit ratio, Encouragement], CollaboRATE, and the Decisional Conflict Scale [DCS]) were obtained pre- and postvisit.
Results
We assessed 50 families (study group = 24, controls = 26). The mean age was 8.8 ± 6.6 years, 44% were female, 86% were white, and the mean obstructive apnea-hypopnea index was 12.7 ± 15.6 events/hour. The previsit mean DCS score was similar for controls (42.7) and study patients (40.8) (P = .38). The postvisit mean DCS score for controls was 13.3 and for study patients 6.1 (P = .034). Improvement in this score was greater in the study group (P = .03). At previsit evaluation, 63% of controls and 58% of study patients were unsure about their options. Postvisit, this improved to 4.1% and 0%, respectively.
Conclusions
Families counseled regarding treatment options using shared decision-making tools had significantly less decisional conflict than those who did not use these tools. These positive outcomes suggest that clinicians should consider integrating this approach into clinical practice.
Level of Evidence
1b Laryngoscope, 2017
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Total septal perforation repair with a pericranial flap: Radio-anatomical and clinical findings
Objectives/Hypothesis
Endonasal surgeries are the primary cause of septal perforation (SP). However, trauma, inflammation, infections, neoplasms, or abuse of inhaled drugs can also cause SP. Septal repair is indicated in patients who experience nasal obstruction, crusting, intermittent epistaxis, purulent discharge, or nasal whistling and in those who fail conservative treatment. Multiple approaches have been suggested to repair the SP; however, none has been universally adopted. This study explores the feasibility of repairing a total SP using the pericranial flap (PCF).
Study Design
Anatomical cadaver and radiological study plus case study.
Methods
Total nasal septectomy and endoscopic reconstruction with a PCF was performed in 12 injected cadaveric specimens. Maximum length and area of the nasal septum and the PCF were measured in 75 computed tomography scans. Based on the anatomical study and the radiological measurements of the cadavers, one patient underwent total nasal septum repair.
Results
Anatomic measurements showed that the nasal septum has a mean length of 5.8 ± 0.7 cm, whereas the PCF was on average 18.4 ± 1.3 cm long (mean surface area 121.6 ± 17.7 cm2). Radiological measurements revealed that the PCF should provide a surface area of 40.9 ± 4.2 cm2 to account for the total septal area and an additional 30% to account range for potential scar retraction. For total septum repair, the distal edge of the PCF had to be placed 0.8 ± 2.0 cm (3.4 ± 8.7°) from the adopted reference point (vertical projection of the external ear canal). Total septal reconstruction was performed successfully in one patient without complications.
Conclusions
Radio-anatomical data and a case study demonstrate that a PCF allows complete endoscopic repair of the nasal septum.
Level of Evidence
NA Laryngoscope, 2017
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Three-dimensional endoscopy for endoscopic salvage nasopharyngectomy: Preliminary report of experience
Background
Prospective, observational study to assess the efficacy of salvage nasopharyngectomy for recurrent nasopharyngeal carcinoma (NPC) via the endoscopic endonasal approach using a three-dimensional (3D) high-definition endoscopic system.
Methods
Between 2016 and 2017, 30 patients with recurrent NPC were recruited. Patient demographics, tumor characteristics, and perioperative data were recorded. Instrument ergonomics and perceived advantages were assessed by the operating, assisting, and observing surgeons.
Results
The majority (70%) of patients received radiotherapy alone as the initial treatment for NPC, and tumor recurred after a mean interval of 16.8 months. The tumor (T) classifications of the recurrent (R) tumors were: RT1: 46.7%; RT2: 33.3%; and RT3: 20.0%. The mean operative time was 293.3 minutes, and no conversion to open approach was necessary. Internal carotid artery dissection was required in nine patients, and the resection and repair of dura was required in six patients. The most common method of reconstruction was free vastus lateralis flap (46.7%). Microscopically clear resection margins were achieved in 73.3% of patients. The mean hospital stay was 6.8 days. There was no hospital mortality. One patient developed minor secondary hemorrhage, whereas the other developed transient contralateral vocal cord paralysis. On quantitative assessment, surgeons noticed a significant advantage of the 3D system with regard to depth and size perception, anatomy identification, and hand–eye coordination, whereas there was no significant difference in terms of strain sensation and dizziness.
Conclusion
The 3D high-definition endoscopic system improves the precision of endoscopic nasopharyngectomy, particularly when dissection of the internal carotid artery and dura is required.
Level of Evidence
4. Laryngoscope, 2017
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The contribution of cochlear implants to postural stability
Objectives
To determine whether spatial auditory cues provided by cochlear implants can improve postural balance in adults with severe deafness.
Methods
In the presence of spatial white noise, 13 adult cochlear implantees wore head and lumbar-mounted inertial sensors while standing in the dark for 30 seconds in two auditory conditions: hearing assistive devices on and off.
Results
Stability was improved with implants on (aided condition) compared to off (unaided condition) with respect to differences in mean head velocity (Cohen's d = 0.912, P = 0.006) as well as to root mean square (RMS) acceleration (Cohen's d = 0.456, P = 0.048). This was particularly evident in measures of anteroposterior accelerations (mean difference = 0.034 m/s2; Cohen's d = 0.612; P = 0.011).
Conclusion
The decrease in RMS head acceleration and velocity while wearing cochlear implants suggests that they could be recognized as balance implants in addition to auditory implants. The clinical importance of this finding in various patient populations remains to be determined.
Level of Evidence
4. Laryngoscope, 2017
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Proton density–weighted laryngeal magnetic resonance imaging in systemically dehydrated rats
Objectives/Hypothesis
Dehydrated vocal folds are inefficient sound generators. Although systemic dehydration of the body is believed to induce vocal fold dehydration, this causative relationship has not been demonstrated in vivo. Here we investigate the feasibility of using in vivo proton density (PD)–weighted magnetic resonance imaging (MRI) to demonstrate hydration changes in vocal fold tissue following systemic dehydration in rats.
Study Design
Animal study.
Methods
Sprague-Dawley rats (n = 10) were imaged at baseline and following a 10% reduction in body weight secondary to withholding water. In vivo, high-field (7 T), PD-weighted MRI was used to successfully resolve vocal fold and salivary gland tissue structures.
Results
Normalized signal intensities within the vocal fold decreased postdehydration by an average of 11.38% ± 3.95% (mean ± standard error of the mean [SEM], P = .0098) as compared to predehydration levels. The salivary glands experienced a similar decrease in normalized signal intensity by an average of 10.74% ± 4.14% (mean ± SEM, P = .0195) following dehydration. The correlation coefficient (percent change from dehydration) between vocal folds and salivary glands was 0.7145 (P = .0202).
Conclusions
Ten percent systemic dehydration induced vocal fold dehydration as assessed by PD-weighted MRI. Changes in the hydration state of vocal fold tissue were highly correlated with that of the salivary glands in dehydrated rats in vivo. These preliminary findings demonstrate the feasibility of using PD-weighted MRI to quantify hydration states of the vocal folds and lay the foundation for further studies that explore more routine and realistic magnitudes of systemic dehydration and rehydration.
Level of Evidence
NA Laryngoscope, 2017
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Development and external validation of a risk-prediction model to predict 5-year overall survival in advanced larynx cancer
Objectives/Hypothesis
TNM-classification inadequately estimates patient-specific overall survival (OS). We aimed to improve this by developing a risk-prediction model for patients with advanced larynx cancer.
Study Design
Cohort study.
Methods
We developed a risk prediction model to estimate the 5-year OS rate based on a cohort of 3,442 patients with T3T4N0N+M0 larynx cancer. The model was internally validated using bootstrapping samples and externally validated on patient data from five external centers (n = 770). The main outcome was performance of the model as tested by discrimination, calibration, and the ability to distinguish risk groups based on tertiles from the derivation dataset. The model performance was compared to a model based on T and N classification only.
Results
We included age, gender, T and N classification, and subsite as prognostic variables in the standard model. After external validation, the standard model had a significantly better fit than a model based on T and N classification alone (C statistic, 0.59 vs. 0.55, P < .001). The model was able to distinguish well among three risk groups based on tertiles of the risk score. Adding treatment modality to the model did not decrease the predictive power. As a post hoc analysis, we tested the added value of comorbidity as scored by American Society of Anesthesiologists score in a subsample, which increased the C statistic to 0.68.
Conclusions
A risk prediction model for patients with advanced larynx cancer, consisting of readily available clinical variables, gives more accurate estimations of the estimated 5-year survival rate when compared to a model based on T and N classification alone.
Level of Evidence
2c Laryngoscope, 2017
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Cricothyroid joint type as predictor for vocal fold elongation in professional singers
Objective
Vocal fold (VF) elongation vocal folds depends on two factors: the activity of the laryngeal muscles and the cricothyroid joint (CTJ). The aim of the study was to show the influence of the CTJ on VF elongation while singing a sustained vowel at different pitches.
Study Design
Prospective study.
Methods
Forty-nine female professional singers (25 sopranos, 24 altos) were recruited. Three-dimensional images of the larynx derived from high-resolution computed tomography scanning were obtained at the mean speaking fundamental frequency (F0) and one (F1) and two octaves (F2) above this pitch.
Results
From F0 to F1, all three CTJ types showed equal elongation of the VF (type A: 14%, type B/C: 13%). From F1 to F2, VF elongation was 8% in singers with type A and 4% in those with type B/C (P < 0.0001).
Conclusion
The stability of the CTJ directly influences VF during singing. This is the first study to show this relationship in vivo.
Level of Evidence
4. Laryngoscope, 2017
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Lack of long-term add-on effect by montelukast in postoperative chronic rhinosinusitis patients with nasal polyps
Objectives/Hypothesis
Eosinophils and mast cells are among the key cells in inflammatory diseases like chronic rhinosinusitis (CRS) and asthma. Leukotriene antagonists have proven to be effective in the treatment of asthma, but data about their efficacy in CRS are scarce, whereas data on montelukast as an add-on treatment to intranasal corticosteroids (INCS) in a postoperative setting are completely lacking.
Study Design
Prospective, randomized, open-label trial.
Methods
In this trial with long-term follow-up, we evaluated the efficacy of montelukast as an add-on treatment to INCS in postoperative CRS with nasal polyp (CRSwNP) patients. CRSwNP patients (N = 72) undergoing endoscopic sinus surgery were randomized in two arms for the postoperative treatment. One group (N = 36) received INCS in monotherapy, whereas the other group (N = 36) received INCS in association with montelukast for 1 year. The efficacy of montelukast with INCS was evaluated by assessing both subjective (total five-symptom score [T5SS]) and objective (nasal polyp score [NPS], Lund-Mackay [LMK] score, and subjective olfactometry [Barcelona Smell Test 24]) outcome parameters and compared with the gold standard of INCS in monotherapy.
Results
After 1 year of surgery, T5SS, NPS, and LMK score were significantly reduced in patients treated with either INCS or INCS plus montelukast, without significant differences between the two treatment arms. Improvement of smell loss by olfactometry was also observed with no differences between arms. Similar findings were observed at 3 and 6 months.
Conclusions
These results suggest that the addition of montelukast to INCS should not be recommended in the treatment of postoperative CRSwNP patients.
Level of Evidence
1b Laryngoscope, 2017
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Cough strength and expiratory force in aspirating and nonaspirating postradiation head and neck cancer survivors
Objective
Expiratory functions that clear aspiration from the airway are compromised in patients with neurogenic dysphagia for whom cough and expiratory force may be impaired by the primary disease process. The relationship between expiratory function, cough, and aspiration is less clear in head and neck cancer (HNC) survivors for whom the disease process does not directly impact the lower respiratory system. Our objective was to compare mechanisms of airway clearance (expiratory force and cough) with aspiration status in postradiated HNC survivors.
Study Design
Cross-sectional study.
Methods
One hundred and three disease-free HNC survivors ≥ 3-months postradiotherapy referred for modified barium swallow studies were prospectively enrolled regardless of dysphagia status. Maximum expiratory pressures (MEPs) and peak cough flow (PCF) measures were taken at enrollment and examined as a function of aspiration status using generalized linear regression methods.
Results
Thirty-four (33%) patients aspirated. Maximum expiratory pressure and PCF demonstrated a moderate positive correlation (Pearson's r = 0.35). Adjusting for sex and age, MEPs were on average 19.2% lower (21.1 cm H2O, 95% confidence interval [CI] 5.3, 36.8) among aspirators. Peak cough flow was also 14.9% lower (59.6 L/minute, 95% CI 15.8, 103.3) among aspirators after adjusting for age and sex.
Conclusion
Expiratory functions were depressed in postradiated HNC aspirators relative to nonaspirators, suggesting that airway protection impairments may extend beyond disrupted laryngopharyngeal mechanisms in the local treatment field. Exercises to strengthen subglottic expiratory force-generating capacity may offer an adjunctive therapeutic target to improve airway protection in chronic aspirators after head and neck radiotherapy.
Level of Evidence
2b. Laryngoscope, 2017
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Examination of olfactory training effectiveness in relation to its complexity and the cause of olfactory loss
Objective
Although the effectiveness of olfactory training (OT) had already been documented, the optimal regimen for such training remains unexplored. We examined whether the complexity of OT, namely alteration of odor quantity and quality, increases its effectiveness.
Design
One-hundred eight patients (Mage = 60.1 ± 1) with postinfectious (n = 57) or idiopathic (n = 51) olfactory dysfunction underwent OT preceded and followed by examination of olfactory function.
Methods
Subjects were randomly assigned to one of the three experimental conditions: 1) simple training comprising four basic, single-molecule substances; 2) complex training involving four odor mixtures; and 3) odor-altering training in which patients changed sets of mixtures every 2 months.
Results
The analysis of variance revealed that the benefit seen in this sample was not affected by the complexity of OT with regard to odor mixtures or alteration of odor type. The highest increase of the Sniffin' Sticks (Burghardt GmbH; Wedel, Germany) threshold, discrimination, and identification (and overall TDI) score was observed in postinfectious patients.
Conclusion
We conclude that the outcomes of OT are not strongly influenced by the training regimen. However, further investigation of OT regimens is required, particularly with regard to training duration.
Level of Evidence
2b. Laryngoscope, 2017
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Swadlincote dentists paint their lips blue to raise awareness for mouth cancer
Giggles could be heard among staff at Hughes and Owen Dental Care this week after dentists painted their lips blue to raise awareness of mouth cancer. The practice, which has outlets in Belmont Street, in Swadlincote, and Lichfield Street, in Burton, raised a few eyebrows among patients too as staff wore blue lipstick as it urged people to become more aware of their mouths and recognise the early warning signs of mouth cancer.
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Early life socioeconomic determinants of dietary score and pattern trajectories across six waves of the Longitudinal Study of Australian Children
Background
Social patterning of dietary-related diseases may partly be explained by population disparities in children's diets. This study aimed to determine which early life socioeconomic factors best predict dietary trajectories across childhood.
MethodsFor waves 2–6 of the Baby (B) Cohort (ages 2–3 to 10–11 years) and waves 1–6 of the Kindergarten (K) Cohort (ages 4–5 to 14–15 years) of the Longitudinal Study of Australian Children, we constructed trajectories of dietary scores and of empirically derived dietary patterns. Dietary scores, based on the Australian Dietary Guidelines, summed children's consumption frequencies of seven groups of foods or drinks over the last 24 hours. Dietary patterns at each wave were derived using factor analyses of 12–16 food or drink items. Using multinomial logistic regression analyses, we examined associations of baseline single (parental education, remoteness area, parental employment, income, food security and home ownership) and composite (socioeconomic position and neighbourhood disadvantage) factors with adherence to dietary trajectories.
ResultsAll dietary trajectory outcomes across both cohorts showed profound gradients by composite socioeconomic position but not by neighbourhood disadvantage. For example, odds for children in the lowest relative to highest socioeconomic position quintile being in the 'never healthy' relative to the 'always healthy' score trajectory were OR=16.40, 95% CI 9.40 to 28.61 (B Cohort). Among the single variables, only parental education consistently predicted dietary trajectories.
ConclusionChild dietary trajectories vary profoundly by family socioeconomic position. If causal, reducing dietary inequities may require researching underlying pathways, tackling socioeconomic inequities and targeting health promoting interventions to less educated families.
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Factors across the life course predict womens change in smoking behaviour during pregnancy and in midlife: results from the National Child Development Study
Background
Tobacco smoking before, during and after pregnancy remains one of the few preventable factors associated with poor health outcomes for mothers and their children. We investigate predictors across the life course for change in smoking behaviour during pregnancy and whether this change predicts smoking status in midlife.
MethodsData were from the National Child Development Study (1958 British birth cohort). We included female cohort members who reported a first pregnancy up to age 33 years. Among 1468 women who smoked before pregnancy, we examined predictors reported in childhood (age 11 years), adolescence (age 16 years) and early adulthood (age 23 years) of change in smoking behaviour from 12 months before to during pregnancy using log-binomial regression. The association between change in smoking behaviour during pregnancy and smoking status in midlife (age 55 years) was examined while adjusting for predictors across the life course.
ResultsAmong prepregnancy smokers (39%), 26% reduced and 35% quit smoking during pregnancy. Parental smoking and lower social class during childhood, and early adulthood lower social class, depression, early smoking initiation, high smoking intensity, living with a smoker, no pregnancy planning and early motherhood were associated with lower probability of smoking reduction or cessation in pregnancy. Compared with women who smoked before and during pregnancy, women who reduced or quit were two times more likely to be non-smoker at age 55 years (95% CI 1.76 to 2.20).
ConclusionsFindings from this population-based birth cohort study lend support for smoking cessation strategies that target those at risk at various stages across the life course.
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Influence of affordability of alcohol on educational disparities in alcohol-related mortality in Finland and Sweden: a time series analysis
Background
Prices of alcohol and income tend to influence how much people buy and consume alcohol. Price and income may be combined into one measure, affordability of alcohol. Research on the association between affordability of alcohol and alcohol-related harm is scarce. Furthermore, no research exists on how this association varies across different subpopulations. We estimated the effects of affordability of alcohol on alcohol-related mortality according to gender and education in Finland and Sweden.
MethodsVector-autoregressive time series modelling was applied to the quarter-annual aggregations of alcohol-related deaths and affordability of alcohol in Finland in 1988–2007 and in Sweden in 1991–2008. Alcohol-related mortality was defined using information on both underlying and contributory causes of death. We calculated affordability of alcohol index using information on personal taxable income and prices of various types of alcohol.
ResultsAmong Finnish men with secondary education, an increase of 1% in the affordability of total alcohol was associated with an increase of 0.028% (95% CI 0.004 to 0.053) in alcohol-related mortality. Similar associations were also found for affordability for various types of alcohol and for beer only in the lowest education group. We found few other significant positive associations for other subpopulations in Finland or Sweden. However, reverse associations were found among secondary-educated Swedish women.
ConclusionsOverall, the associations between affordability of alcohol and alcohol-related mortality were relatively weak. Increased affordability of total alcoholic beverages was associated with higher rates of alcohol-related mortality only among Finnish men with secondary education.
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Maternal health and social outcomes after having a child taken into care: population-based longitudinal cohort study using linkable administrative data
Background
We investigated whether mothers experience changes to their health and social situation after having a child taken into care by child protection services, then compared these outcomes with those found in mothers whose children were not taken into care.
MethodsThe cohort includes mothers whose first child was born in Manitoba between 1 April 1998 and 31 March 2011. Mothers whose children were taken into care after age 2 (n=1591) were compared with a matched group of women whose children were not taken into care (n=1591).
ResultsThe rates of mental illness diagnoses, treatment use and social factors were significantly higher for mother whose children were taken into care, both in the 2 years before and in the 2 years after the index date. These adjusted relative rates (ARRs) increased significantly for anxiety (before ARR=2.71, after ARR=3.55), substance use disorder (3.77–5.95), physician visits for mental illness (2.83–3.66), number of prescriptions (psychotropic: 4.35–5.86; overall: 2.34–2.94), number of different prescriptions (psychotropic: 2.70-3.27; overall: 1.62–1.70), residential mobility (1.40–1.63) and welfare use (2.07–2.30).
ConclusionThe health and social situation of mothers involved with child protection services deteriorates after their child is taken into care. Mothers would benefit from supports during this time period to ensure that the outcomes they experience after the loss of their child do not become another barrier to reunification.
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Age-period-cohort analysis of trends in blood pressure and body mass index in children and adolescents in Hong Kong
Background
The declining or fluctuating trend in blood pressure (BP) despite the rising trend in body mass index (BMI) during childhood and adolescence is unexplained. We decomposed trends in BP and BMI to identify the relevance of early-life and contemporaneous factors.
MethodsWe assessed the relative contribution of age, period and cohort to secular trends in BP in children and adolescents (9–18 years) from 1999 to 2014 and BMI (6–18 years) from 1996 to 2014 in Hong Kong, China.
ResultsAfter accounting for age, period effects contributed more than cohort effects to the overall fluctuating BP trend and the rising BMI trend observed in this Chinese population. For both sexes, BP fell from the start of period to a low point in 2003–2005 but then rose. BMI rose strongly across the period before levelling off in 2009–2010. Earlier cohorts (born in 1983–1984) had higher BP and BMI than later cohorts.
ConclusionWith globalisation and associated lifestyle changes, successive generations of children and adolescents in a recently developed Chinese setting had lower BP and BMI, but this fall was offset until recently by population-wide increase in BMI. School-based health promotion efforts could have partly mitigated the population-wide rise in child and adolescent BMI, while socioeconomic transition or other factors could be relevant to changes in BP between generations. Explaining these trends will help identify early-life factors that may contribute to a healthier start as well as contemporaneous factors that may protect against rising trends in adiposity.
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Alcohol consumption, smoking and development of visible age-related signs: a prospective cohort study
Background
Visible age-related signs indicate biological age, as individuals that appear old for their age are more likely to be at poor health, compared with people that appear their actual age. The aim of this study was to investigate whether alcohol and smoking are associated with four visible age-related signs (arcus corneae, xanthelasmata, earlobe crease and male pattern baldness).
MethodsWe used information from 11 613 individuals in the Copenhagen City Heart Study (1976–2003). Alcohol intake, smoking habits and other lifestyle factors were assessed prospectively and visible age-related signs were inspected during subsequent examinations.
ResultsThe risk of developing arcus corneae, earlobe crease and xanthelasmata increased stepwise with increased smoking as measured by pack-years. For alcohol consumption, a high intake was associated with the risk of developing arcus corneae and earlobe crease, but not xanthelasmata.
ConclusionsHigh alcohol consumption and smoking predict development of visible age-related signs. This is the first prospective study to show that heavy alcohol use and smoking are associated with generally looking older than one's actual age.
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Operationalisation and validation of the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) fall risk algorithm in a nationally representative sample
Background
Preventing falls and fall-related injuries among older adults is a public health priority. The Stopping Elderly Accidents, Deaths, and Injuries (STEADI) tool was developed to promote fall risk screening and encourage coordination between clinical and community-based fall prevention resources; however, little is known about the tool's predictive validity or adaptability to survey data.
MethodsData from five annual rounds (2011–2015) of the National Health and Aging Trends Study (NHATS), a representative cohort of adults age 65 years and older in the USA. Analytic sample respondents (n=7392) were categorised at baseline as having low, moderate or high fall risk according to the STEADI algorithm adapted for use with NHATS data. Logistic mixed-effects regression was used to estimate the association between baseline fall risk and subsequent falls and mortality. Analyses incorporated complex sampling and weighting elements to permit inferences at a national level.
ResultsParticipants classified as having moderate and high fall risk had 2.62 (95% CI 2.29 to 2.99) and 4.76 (95% CI 3.51 to 6.47) times greater odds of falling during follow-up compared with those with low risk, respectively, controlling for sociodemographic and health-related risk factors for falls. High fall risk was also associated with greater likelihood of falling multiple times annually but not with greater risk of mortality.
ConclusionThe adapted STEADI clinical fall risk screening tool is a valid measure for predicting future fall risk using survey cohort data. Further efforts to standardise screening for fall risk and to coordinate between clinical and community-based fall prevention initiatives are warranted.
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Understanding bias in relationships between the food environment and diet quality: the Coronary Artery Risk Development in Young Adults (CARDIA) study
Background
The relationship between food environment exposures and diet behaviours is unclear, possibly because the majority of studies ignore potential residual confounding.
MethodsWe used 20 years (1985–1986, 1992–1993 2005–2006) of data from the Coronary Artery Risk Development in Young Adults (CARDIA) study across four US cities (Birmingham, Alabama; Chicago, Illinois; Minneapolis, Minnesota; Oakland, California) and instrumental variables (IV) regression to obtain causal estimates of longitudinal associations between the percentage of neighbourhood food outlets (per total food outlets within 1 km network distance of respondent residence) and an a priori diet quality score, with higher scores indicating higher diet quality. To assess the presence and magnitude of bias related to residual confounding, we compared results from causal models (IV regression) to non-causal models, including ordinary least squares regression, which does not account for residual confounding at all and fixed-effects regression, which only controls for time-invariant unmeasured characteristics.
ResultsThe mean diet quality score across follow-up was 63.4 (SD=12.7). A 10% increase in fast food restaurants (relative to full-service restaurants) was associated with a lower diet quality score over time using IV regression (β=–1.01, 95% CI –1.99 to –0.04); estimates were attenuated using non-causal models. The percentage of neighbourhood convenience and grocery stores (relative to supermarkets) was not associated with diet quality in any model, but estimates from non-causal models were similarly attenuated compared with causal models.
ConclusionIgnoring residual confounding may generate biased estimated effects of neighbourhood food outlets on diet outcomes and may have contributed to weak findings in the food environment literature.
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Underemployment and its impacts on mental health among those with disabilities: evidence from the HILDA cohort
Background
Underemployment (defined as when a person in paid employment works for fewer hours than their desired full working capacity) is increasingly recognised as a component of employment precarity. This paper sought to investigate the effects of underemployment on the mental health of people with disabilities.
MethodsUsing 14 waves of the Household, Income and Labour Dynamics in Australia survey, we used fixed-effects models to assess whether the presence of a disability modified the association between underemployment and mental health. Both disability and underemployment were assessed as time-varying factors. Measures of effect measure modification were presented on the additive scale.
ResultsThe experience of underemployment was associated with a significantly greater decline in mental health when a person reported a disability (mean difference –1.38, 95% CI –2.20 to –0.57) compared with when they did not report a disability (mean difference –0.49, 95% CI –0.84 to –0.14). The combined effect of being underemployed and having a disability was nearly one point greater than the summed independent risks of having a disability and being underemployed (–0.89, 95% CI –1.75 to –0.03).
ConclusionPeople with disabilities are more likely to experience underemployment and more likely to have their mental health adversely affected by it. There is a need for more research and policy attention on how to ameliorate the effects of underemployment on the mental health of persons with disabilities.
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Explaining time changes in oral health-related quality of life in England: a decomposition analysis
Background
Oral diseases are highly prevalent and impact on oral health-related quality of life (OHRQoL). However, time changes in OHRQoL have been scarcely investigated in the current context of general improvement in clinical oral health. This study aims to examine changes in OHRQoL between 1998 and 2009 among adults in England, and to analyse the contribution of demographics, socioeconomic characteristics and clinical oral health measures.
MethodsUsing data from two nationally representative surveys in England, we assessed changes in the Oral Health Impact Profile-14 (OHIP-14), in both the sample overall (n=12 027) and by quasi-cohorts. We calculated the prevalence and extent of oral impacts and summary OHIP-14 scores. An Oaxaca-Blinder type decomposition analysis was used to assess the contribution of demographics (age, gender, marital status), socioeconomic position (education, occupation) and clinical measures (presence of decay, number of missing teeth, having advanced periodontitis).
ResultsThere were significant improvements in OHRQoL, predominantly among those that experienced oral impacts occasionally, but no difference in the proportion with frequent oral impacts. The decomposition model showed that 43% (–4.07/–9.47) of the decrease in prevalence of oral impacts reported occasionally or more often was accounted by the model explanatory variables. Improvements in clinical oral health and the effect of ageing itself accounted for most of the explained change in OHRQoL, but the effect of these factors varied substantially across the lifecourse and quasi-cohorts.
ConclusionsThese decomposition findings indicate that broader determinants could be primarily targeted to influence OHRQoL in different age groups or across different adult cohorts.
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Determinants of social inequalities in stroke incidence across Europe: a collaborative analysis of 126 635 individuals from 48 cohort studies
Background
Knowledge on the origins of the social gradient in stroke incidence in different populations is limited. This study aims to estimate the burden of educational class inequalities in stroke incidence and to assess the contribution of risk factors in determining these inequalities across Europe.
Materials and methodsThe MORGAM (MOnica Risk, Genetics, Archiving and Monograph) Study comprises 48 cohorts recruited mostly in the 1980s and 1990s in four European regions using standardised procedures for baseline risk factor assessment and fatal and non-fatal stroke ascertainment and adjudication during follow-up. Among the 126 635 middle-aged participants, initially free of cardiovascular diseases, generating 3788 first stroke events during a median follow-up of 10 years, we estimated differences in stroke rates and HRs for the least versus the most educated individuals.
ResultsCompared with their most educated counterparts, the overall age-adjusted excess hazard for stroke was 1.54 (95% CI 1.25 to 1.91) and 1.41 (95% CI 1.16 to 1.71) in least educated men and women, respectively, with little heterogeneity across populations. Educational class inequalities accounted for 86–413 and 78–156 additional stroke events per 100 000 person-years in the least compared with most educated men and women, respectively. The additional events were equivalent to 47%–130% and 40%–89% of the average incidence rates. Inequalities in risk factors accounted for 45%–70% of the social gap in incidence in the Nordic countries, the UK and Lithuania-Kaunas (men), but for no more than 17% in Central and South Europe. The major contributors were cigarette smoking, alcohol intake and body mass index.
ConclusionsSocial inequalities in stroke incidence contribute substantially to the disease rates in Europe. Healthier lifestyles in the most disadvantaged individuals should have a prominent impact in reducing both inequalities and the stroke burden.
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A shared data approach more accurately represents the rates and patterns of violence with injury assaults
Background
To investigate whether sharing and linking routinely collected violence data across health and criminal justice systems can provide a more comprehensive understanding of violence, establish patterns of under-reporting and better inform the development, implementation and evaluation of violence prevention initiatives.
MethodsPolice violence with injury (VWI) crimed data and emergency department (ED) assault attendee data for South Wales were collected between 1 April 2014 and 31 March 2016 to examine the rates and patterns of VWI. Person identifiable data (PID) were cross-referenced to establish if certain victims or events were less likely to be reported to criminal justice services.
ResultsA total of 18 316 police crimed VWI victims and 10 260 individual ED attendances with an assault-related injury were considered. The majority of ED assault attendances (59.0%) were unknown to police. The key demographic identified as under-reporting to police were young males aged 18–34 years, while a significant amount of non-reported assaults involved a stranger. The combined monthly age-standardised rates were recalculated and on average were 74.7 (95% CI 72.1 to 77.2) and 66.1 (95% CI 64.0 to 68.2) per 100 000 population for males and females, respectively. Consideration of the additional ED cases resulted in a 35.3% and 18.1% increase on the original police totals for male and female VWI victims.
ConclusionsThis study identified that violence is currently undermeasured, demonstrated the importance of continued sharing of routinely collected ED data and highlighted the benefits of using PID from a number of services in a linked way to provide a more comprehensive picture of violence.
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Fluoride exposure and indicators of thyroid functioning: study design and data analysis considerations
Barberio et al1 reported that there was no evidence of a relationship between fluoride exposure and the diagnosis of a thyroid condition among a subsample of respondents available from Statistics Canada's Canadian Health Measures Survey. On review, however, their data show that the mean urinary fluoride (UF) level in patients with primary hypothyroidism was 0.60 mg/L compared with 0.55 mg/L for individuals without this condition. In other words, the mean UF levels in respondents with primary hypothyroidism were higher than without. However, it is the reported ranges of UF levels from either groups that is particularly revealing. For example, among individuals with primary hypothyroidism, UF levels were found to range from 0.22 to 0.98 mg/L. The range reported in the controls was 0.49 to 0.61 mg/L.1 What these data show is that among patients with primary hypothyroidism, a subgroup of patients had very low UF levels with another subgroup...
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Maternal ambient air pollution, preterm birth and markers of fetal growth in Rhode Island: results of a hospital-based linkage study
Background
Maternal exposure to ambient air pollution has been associated with higher risk of preterm birth and reduced fetal growth, but heterogeneity among prior studies suggests that additional studies are needed in diverse populations and settings. We examined the associations between maternal ambient air pollution levels, risk of preterm birth and markers of fetal growth in an urban population with relatively low exposure to air pollution.
MethodsWe linked 61 640 mother–infant pairs who delivered at a single hospital in Providence, Rhode Island, from 2002 to 2012 to birth certificate and hospital discharge data. We used spatial-temporal models and stationary monitors to estimate exposure to fine particulate matter (PM2.5) and black carbon (BC) during pregnancy. Using generalised linear models, we evaluated the association between pollutant levels, risk of preterm birth and markers of fetal growth.
ResultsIn adjusted models, an IQR (2.5 µg/m3) increase in pregnancy-average PM2.5 was associated with ORs of preterm birth of 1.04 (95% CI 0.94 to 1.15) and 0.86 (0.76 to 0.98) when considering modelled and monitored PM2.5, respectively. An IQR increase in modelled and monitored PM2.5 was associated with a 12.1 g (95% CI –24.2 to –0.1) and 15.9 g (95% CI –31.6 to –0.3) lower birth weight. Results for BC were highly sensitive to choice of exposure metric.
ConclusionIn a population with relatively low exposures to ambient air pollutants, PM2.5 was associated with reduced birth weight but not with risk of preterm birth.
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Maternal Diabetes Mellitus and Genital Anomalies in Male Offspring: A Nationwide Cohort Study in two Nordic Countries.
Background: Diabetes in pregnancy has been associated with an increased risk of congenital malformations overall, but studies on genital anomalies in boys are conflicting and possible causal mechanisms are not well understood. Previous studies have mainly assessed pre-gestational and gestational diabetes in combination. Yet considering the vulnerable time windows for the genital anomalies, associations could well differ between types of diabetes and between the two genital anomalies and we therefore aimed to study this further. Methods: A population-based cohort study of 2,416,248 singleton live-born boys from Denmark (1978-2012) and Sweden (1987-2012) was carried out using Danish and Swedish register-based data. Using Cox regression models, we estimated hazard ratios for hypospadias and cryptorchidism according to maternal diabetes. We considered type and severity of diabetes, as well as timing of diagnosis in relation to birth. Results: Pre-gestational type 1 diabetes was associated with a higher risk of both genital anomalies. The highest risks were seen for boys of mothers with diabetic complications (hazard ratio for hypospadias = 2.33, [95% confidence interval: 1.48, 3.66] and hazard ratio for cryptorchidism = 1.92, [95% confidence interval: 1.39, 2.65]). Gestational diabetes was associated with slightly increased risks of both genital anomalies. Conclusions: These results are consistent with the hypothesis that poor glycemic control may interfere with fetal genital development in the critical early period of organogenesis. Given the widespread and increasing occurrence of diabetes, these results are of public health importance. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Methadone versus buprenorphine for opioid use dependence and risk of neonatal abstinence syndrome.
Background: Our objective was to estimate the association between methadone and neonatal abstinence syndrome compared with buprenorphine using a probabilistic bias analysis to account for unmeasured confounding by severity of addiction. Methods: We used a cohort of live-born infants exposed in utero to methadone or buprenorphine for maternal opioid maintenance therapy at Magee-Womens Hospital in Pittsburgh, PA from 2013-2015 (n=716). We determined exposure and outcome status using pharmacy billing claims. We used log-binomial regression models to assess association of treatment with neonatal abstinence syndrome after adjusting for parity, maternal race, age, delivery year, employment, hepatitis c, smoking, marital, and insurance status. We implemented probabilistic bias analysis, informed by an internal validation study, to assess the impact of unmeasured confounding by severity of addiction. Results: Infants exposed to methadone in utero were more likely to experience neonatal abstinence syndrome compared with those exposed to buprenorphine [RR: 1.3, 95% CI: 1.2, 1.5]. After adjustment, infants exposed to methadone were more likely (adjusted RR 1.3, 95% CI: 1.1, 1.5) than infants exposed to buprenorphine to have the syndrome. In the validation cohort (n=200), severe addiction was more common in methadone- versus buprenorphine-exposed deliveries (77% vs. 32%). However, adjustment for severe addiction in the bias analysis only slightly attenuated the association (RR 1.2, 95% CI: 1.0, 1.4), supporting conventional analysis. Conclusions: Methadone is associated with increased risk of neonatal abstinence syndrome compared with buprenorphine in infants exposed in utero. This association is subject to minimal bias due to unmeasured confounding by severity of addiction. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Commentary: Towards open source epidemiology.
No abstract available
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Bilateral cochlear implantation or bimodal listening in the paediatric population: Retrospective analysis of decisive criteria
In children with bilateral severe to profound hearing loss, bilateral hearing can be achieved by either bimodal stimulation (CIHA) or bilateral cochlear implantation (BICI). The aim of this study was to analyse the audiologic test protocol that is currently applied to make decisions regarding the bilateral hearing modality in the paediatric population.
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Evaluation of peri-implant bone levels and soft tissue dimensions around zirconia implants—a three-year follow-up study
The aim of this study was to measure bone levels around zirconia implants during follow-up of up to 3 years. Additionally, the effect of clinical contact point positions on the papilla deficit was evaluated. Eighty-one patients with 105 zirconia implants were examined at the 3-year follow-up. Bone levels were measured on the date of implant placement and at 3 months, 1year, and 3 years thereafter. Distances between the first bone–implant contact and the contact point of the crowns and between the bone level at the adjacent tooth and the contact point of the crowns were assessed.
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The effect of different dosage regimens of tranexamic acid on blood loss in bimaxillary osteotomy: a randomized, double-blind, placebo-controlled study
The purpose of this study was to compare the effects of three dosage regimens of intravenous tranexamic acid and normal saline placebo on blood loss and the requirement for transfusion during bimaxillary osteotomy. A prospective, randomized, double-blind, placebo-controlled study was performed. Eighty patients scheduled for elective bimaxillary osteotomy were divided into four groups: a placebo group and three groups receiving a single dose of tranexamic acid 10, 15, or 20mg/kg body weight after the induction of anaesthesia.
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Biomaterials in temporomandibular joint replacement: current status and future perspectives—a narrative review
The alloplastic total temporomandibular joint (TMJ) prosthesis has a long history, with many different materials and designs used. While several of these materials have proven valuable over time, many others have not been suitable for implantation, resulting in failure and the need for explantation of the implant. Because of the failure of several of these systems, the use of alloplastic prostheses has reduced dramatically, despite their advantages over autogenous restoration. The aim of this narrative review is to discuss the criteria that must be met by a biomaterial in order for it to be considered suitable for implantation, as well as the common complications that can occur.
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Targeting de novo lipogenesis as a novel approach in anti-cancer therapy
Targeting de novo lipogenesis as a novel approach in anti-cancer therapy
Targeting <i>de novo</i> lipogenesis as a novel approach in anti-cancer therapy, Published online: 07 November 2017; doi:10.1038/bjc.2017.374
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CXCR4/CXCR7/CXCL12 axis promotes an invasive phenotype in medullary thyroid carcinoma
CXCR4/CXCR7/CXCL12 axis promotes an invasive phenotype in medullary thyroid carcinoma
CXCR4/CXCR7/CXCL12 axis promotes an invasive phenotype in medullary thyroid carcinoma, Published online: 07 November 2017; doi:10.1038/bjc.2017.364
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Serum squamous cell carcinoma antigen as an early indicator of response during therapy of cervical cancer
Serum squamous cell carcinoma antigen as an early indicator of response during therapy of cervical cancer
Serum squamous cell carcinoma antigen as an early indicator of response during therapy of cervical cancer, Published online: 07 November 2017; doi:10.1038/bjc.2017.390
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Interferon regulatory factor 1 priming of tumour-derived exosomes enhances the antitumour immune response
Interferon regulatory factor 1 priming of tumour-derived exosomes enhances the antitumour immune response
Interferon regulatory factor 1 priming of tumour-derived exosomes enhances the antitumour immune response, Published online: 07 November 2017; doi:10.1038/bjc.2017.389
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It is vital to identify the underlying cause of chronic laryngopharyngeal neuropathy
We reviewed, with great interest, the paper entitled "Randomized double blind trial of amitriptyline versus placebo in treatment of chronic laryngopharyngeal neuropathy," by Jang et al. [1]. This is an excellent work. The authors found that subjective laryngopharyngeal symptoms improved in 67% patients of an amitriptyline group and in 44% patients of a placebo group. However, we believe that the inclusion criteria and exclusion criteria were somewhat inappropriate. Also, the measures of clinical outcomes could have been improved.
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Adenoidectomy and chronic nasal obstruction developing after failure of nasal steroid therapy
We reviewed, with great interest, the paper entitled "Role of adenoidectomy in chronic nasal obstruction after nasal steroid therapy failure" by Ciolek et al. [1]. This is excellent work. In the study, the authors document an average rate of respiratory allergies, but a high rate of asthma, among patients who fail nasal steroid therapy to treat chronic nasal obstructions. The authors suggest that adenoidectomy was highly efficacious in this subset of patients. However, adenoidectomy may not be necessary.
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The Microbiology And Assoicated Risk Factor In Alloplastic Total Joint Infections: A Twenty-Year Retrospective Study
Prosthetic joint infection (PJI) is a rare complication of temporomandibular joint replacement (TJR). This study aims to evaluate TJR PJI at our institution over a 20-year period including: microorganisms cultured, antibiotic resistances patterns, and intraoperative protocols of TJR.
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Is there a difference with intraarticular injections of corticosteroids, hyaluranate or placebo for temporomandibular osteoarthritis
Corticosteroids are widely used for treatment of temporomandibular joint (TMJ) osteoarthritis. The purpose of this study is to investigate the effects of corticosteroids on TMJ osteoarthritis compared to placebo or hyaluronate.
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Smoking and drinking may cause failures in dental fillings
Indulging in drinking alcohol or smoking may not only damage your teeth but also lead to increased incidences of failure in dental fillings, warned researchers. The findings, led by researchers from the University of Pittsburgh, showed that within two years of the dental procedure, fillings failed more often in patients who drank alcohol, while the overall filling failure rate was higher in men who smoked.
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Sirona Dental Systems (SIRO) vs. Its Peers Head to Head Comparison
Sirona Dental Systems is one of 85 public companies in the "Advanced Medical Equipment & Technology" industry, but how does it contrast to its peers? We will compare Sirona Dental Systems to similar businesses based on the strength of its risk, analyst recommendations, dividends, earnings, valuation, profitability and institutional ownership. Sirona Dental Systems' peers have higher revenue and earnings than Sirona Dental Systems.
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Clara Harris, infamous Houston dentist who ran over husband, released from prison
Convicted killer Clara Harris looks toward her supporters after the end of testimony Tuesday, Jan. 16, 2007 in Houston. Mildred Harris and her husband, Gerald, have filed a $5 million wrongful death lawsuit against Clara Harris in the July 2002 killing of orthodontist David Harris.
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Not All Pacifiers Are Created Equal: A Mechanical Examination of Pacifiers and Their Influence on Suck Patterning
Purpose
Many pacifier companies advertise that their product is the "best choice" to support proper sucking, feeding, and dental development; however, very little evidence exists to support these claims. As the primary differences across pacifiers are structural and mechanical, the goals of this study were to measure such properties of commercially available pacifiers and to examine how these properties alter suck patterning in healthy, full-term infants. Method
Seven commonly utilized pacifiers were mechanically tested for pull and compression stiffness levels and categorized into nipple shape types based on their aspect ratio. Next, 3 pacifiers (Soothie, GumDrop, and Freeflow) with the most salient differences in pull stiffness levels with 2 different pacifier nipple types were tested clinically on 16 full-term infants (≤ 6 months old) while measuring non-nutritive suck (NNS). Results
A repeated measures analysis of variance revealed significant differences between NNS burst duration (p = .002), NNS cycles per burst (p = .002), and NNS cycles per minute (p = .006) and pacifier type. With each significant dependent measure, pairwise comparisons showed that the GumDrop and Freeflow pacifiers differed significantly on these measures. Conclusions
Pacifier compression, pull stiffness, and nipple shape type yield different NNS dynamics. These findings motivate further investigation into pacifier properties and suck patterning in young infants.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://article/doi/10.1044/2017_AJSLP-16-0226/2662909/Not-All-Pacifiers-Are-Created-Equal-A-Mechanical
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Comparison of Abbott Architect®, Siemens Immulite® and Diasorin Liaison® for determination of Epstein–Barr virus serological diagnosis
Publication date: Available online 7 November 2017
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Catherine François, Christine Segard, Maryline Bouvier, Martine Stefanski, Christine Pannier, Patricia Zawadzki, Catherine Roussel, Denise Hecquet, Gilles Duverlie, Etienne Brochot, Sandrine Castelain
This study compared the performance of three automated immunoassays, Architect® (Abbott), Immulite® (Siemens) and Liaison® (Diasorin), for Epstein–Barr virus (EBV) serology. Ninety-one serum samples collected in Amiens University Hospital were analyzed for the presence of Viral Capsid Antigen (VCA) IgG and IgM and Epstein–Barr Nuclear Antigen (EBNA) IgG. The agreement between the three assays was calculated for each marker individually and for determination of the EBV profile, based on interpretation of the combination of these three EBV markers.Although similar results were obtained with Architect® and Liaison®, several discordant results were observed with Immulite®, particularly for EBNA IgG. A large number of EBNA IgG-positive results was observed, which interfered with interpretation of the EBV profile. In contrast, Immulite® performed similarly to the two other assays for detection of VCA IgM.
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Occurrence and improvement of renal dysfunction and serum potassium abnormality during administration of liposomal amphotericin B in patients with haematological disorders: A retrospective analysis
Publication date: Available online 7 November 2017
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Hiroyuki Yamazaki, Tadakazu Kondo, Kazunai Aoki, Kouhei Yamashita, Akifumi Takaori-Kondo
Liposomal amphotericin B (L-AMB) has the potential to cause two major adverse events, renal dysfunction and serum potassium abnormality; however, appropriate clinical management of these events remains unclear. We retrospectively analyzed data regarding 128 haematology patients who received L-AMB in our institute and examined the association between clinical characteristics and renal dysfunction or serum potassium abnormality. We found that the median weight-normalized dose of L-AMB was 2.69mg/kg and the median administration period was 16days. The overall occurrence rates of renal dysfunction and hypokalemia were 55.7% and 76.6%, respectively. Multivariate analysis revealed that pre-existing renal dysfunction (P=0.017) and concomitant use of nephrotoxic (P<0.0001) or antifungal drugs (P=0.012) were independent risk factors for renal dysfunction. A higher infusion volume did not mitigate the risk of renal dysfunction. Hypokalemia occurred significantly less often in men (P=0.028) and in patients who concomitantly used nephrotoxic drugs (P=0.013). Approximately 40% of the adverse events were improved at 30days after L-AMB termination and there was no significant association between these adverse events improvement and L-AMB dosage or infusion volume. Of note, hyperkalemia was observed in more patients who received allogeneic hematopoietic stem cell transplantation (P=0.0303) and concomitant treatment with nephrotoxic drugs (P=0.0281). These results suggest that imprudent reduction of L-AMB dose or redundant intravenous infusion may have minimal benefit for critical patients with suspected invasive fungal infection.
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Pharmacotherapy for Angiotensin-Converting Enzyme Inhibitor–Induced Angioedema: A Systematic Review
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Diffusion Tensor Imaging of Central Auditory Pathways in Patients with Sensorineural Hearing Loss: A Systematic Review
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Clinicopathologic Factors Predictive of Occult Lymph Node Involvement in Cutaneous Head and Neck Melanoma
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Impact of Biopsy Modality on the Management of Cutaneous Melanoma of the Head and Neck
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Foxtail Ingestion in an Asymptomatic Child: A True Emergency?
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Outcomes of Drug-Induced Sleep Endoscopy–Directed Surgery for Pediatric Obstructive Sleep Apnea
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Utility of Neck, Height, and Tonsillar Size to Screen for Obstructive Sleep Apnea among Obese Youth
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Clinical Significance of Low 2-Methoxyestradiol Levels in Serum and Tissue of Recurrent Juvenile-Onset Laryngeal Papillomatosis
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Comparison of Medical Therapy Alone to Medical Therapy with Surgical Treatment of Peritonsillar Abscess
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Predicting the Outcome after Acute Unilateral Vestibulopathy: Analysis of Vestibulo-ocular Reflex Gain and Catch-up Saccades
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Pharmacotherapy for Angiotensin-Converting Enzyme Inhibitor–Induced Angioedema: A Systematic Review
Otolaryngology-Head and Neck Surgery, Ahead of Print.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AgQfnO
via IFTTT
Diffusion Tensor Imaging of Central Auditory Pathways in Patients with Sensorineural Hearing Loss: A Systematic Review
Otolaryngology-Head and Neck Surgery, Ahead of Print.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hRq14z
via IFTTT
Clinicopathologic Factors Predictive of Occult Lymph Node Involvement in Cutaneous Head and Neck Melanoma
Otolaryngology-Head and Neck Surgery, Ahead of Print.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2Ah6PDY
via IFTTT
Impact of Biopsy Modality on the Management of Cutaneous Melanoma of the Head and Neck
Otolaryngology-Head and Neck Surgery, Ahead of Print.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hRpRtZ
via IFTTT
Foxtail Ingestion in an Asymptomatic Child: A True Emergency?
Otolaryngology-Head and Neck Surgery, Ahead of Print.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2AgPVW8
via IFTTT
Outcomes of Drug-Induced Sleep Endoscopy–Directed Surgery for Pediatric Obstructive Sleep Apnea
Otolaryngology-Head and Neck Surgery, Ahead of Print.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hQB3H5
via IFTTT
Utility of Neck, Height, and Tonsillar Size to Screen for Obstructive Sleep Apnea among Obese Youth
Otolaryngology-Head and Neck Surgery, Ahead of Print.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2Ajt8ci
via IFTTT
Clinical Significance of Low 2-Methoxyestradiol Levels in Serum and Tissue of Recurrent Juvenile-Onset Laryngeal Papillomatosis
Otolaryngology-Head and Neck Surgery, Ahead of Print.
from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hPDqKl
via IFTTT
Comparison of Medical Therapy Alone to Medical Therapy with Surgical Treatment of Peritonsillar Abscess
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Predicting the Outcome after Acute Unilateral Vestibulopathy: Analysis of Vestibulo-ocular Reflex Gain and Catch-up Saccades
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Evaluating Intracochlear Trauma after Cochlear Implant Electrode Insertion through Middle Fossa Approach in Temporal Bones
Otolaryngology-Head and Neck Surgery, Ahead of Print.
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Risk factors for tooth loss in middle and older age after up to 10 years: An observational cohort study
Source:Archives of Oral Biology
Author(s): Alexander Jochen Hassel, Volkan Safaltin, Sabine Grill, Johannes Schröder, Hans-Werner Wahl, Anna-Luisa Klotz, Edriss Habibi, Peter Rammelsberg, Andreas Zenthöfer
ObjectiveThe objective of this research was to identify risk factors for tooth loss in two older birth cohorts, quinquagenarians and septuagenarians, after up to 10 years of clinical observation.DesignOne hundred and twenty-three participants were recruited from the Interdisciplinary Study of Adult Development (ILSE) and examined at baseline and up to 10 years after. Thirty-nine and 84 participants belonged to the older (OC; born in 1930/32) cohort and younger (YC; born in 1950/52) cohort, respectively. Each participant underwent a dental examination comprising evaluation of the dental status (number of teeth, prosthetic restorations), Plaque Index (PI), Gingival Index (GI), DMF-S, periodontal probing depths (PD) and tooth mobility (TM). Incidence of tooth loss over the study period was calculated for both cohorts as well as for the grouped dental target variables. A logistic regression model for tooth loss (0=tooth present/1=tooth lost) was compiled with possible binary confounders.ResultsDuring the study period, 1.2 (1.9) and 2.6 (2.6) teeth were lost in YC and OC, respectively, reflecting correspondent loss rates of 5% and 14% (p<0.001). However, primarily TM >1 merged into substantial tooth loss (60%). The regression analysis confirmed the bivariate findings. Middle- and older-aged people, quinquagenarians and septuagenarians, show relevant tooth loss. Older age and worse oral health issues were identified as risk factors for tooth loss (p<0.007).ConclusionsThe predominant predictor of tooth loss seems to be tooth mobility. With the rising challenges due to aging in several societies, knowing the risks might help clinicians when weighing treatment strategies and should encourage refining preventive measures for older patients.
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Pathologic Reporting of Tall-Cell Variant of Papillary Thyroid Cancer: Have We Reached a Consensus?
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Adenoidectomy and chronic nasal obstruction developing after failure of nasal steroid therapy
Source:American Journal of Otolaryngology
Author(s): Zhengcai Lou
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Enhancing Workforce Capacity to Improve Vaccination Data Quality, Uganda
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Enhancing Surveillance and Diagnostics in Anthrax-Endemic Countries
A. R. Vieira et al.
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Centers for Disease Control and Prevention Public Health Response to Humanitarian Emergencies, 2007–2016
A. T. Boyd et al.
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Responding to Communicable Diseases in Internationally Mobile Populations at Points of Entry and along Porous Borders, Nigeria, Benin, and Togo
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Prioritizing Zoonoses for Global Health Capacity Building—Themes from One Health Zoonotic Disease Workshops in 7 Countries, 2014–2016
S. J. Salyer et al.
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Frameworks for Preventing, Detecting, and Controlling Zoonotic Diseases
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Surveillance Training for Ebola Preparedness in Côte d’Ivoire, Guinea-Bissau, Senegal, and Mali
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Use of a Diagonal Approach to Health System Strengthening and Measles Elimination after a Large Nationwide Outbreak in Mongolia
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US Federal Travel Restrictions for Persons with Higher-Risk Exposures to Communicable Diseases of Public Health Concern
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Synergies between Communicable and Noncommunicable Disease Programs to Enhance Global Health Security
D. Kostova et al.
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Two women indicted on identity theft charges after dentist visit
Two Chicago women were indicted on charges of identity theft by a Lake County grand jury Nov. 1 in Waukegan , according to the Lake County State's Attorney's office and the Deerfield Police Department. The charges against Kaya Washington, 28, and Beverly Henry, 40, both of Chicago, came after an investigation by Deerfield police that included a subpoena of Facebook records to determine the identity of one of the women, according to Deerfield Police detective Brad Tokarz.
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Correction to: Effects of a multi-level intervention on the pattern of physical activity among in-school adolescents in Oyo state Nigeria: a cluster randomised trial
After publication of the article [1], it has been brought to our attention that there is an error in figure 1. The number of excluded secondary schools should read "50" and not "72". The rest of the data in th...
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A comparison of licensed and un-licensed artisanal and small-scale gold miners (ASGM) in terms of socio-demographics, work profiles, and injury rates
Artisanal and small-scale gold mining (ASGM) represents one of the most hazardous work environments. While formalization of this sector has been suggested (e.g., Minamata Convention) as a means to improve work...
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Social capital and health in China: exploring the mediating role of lifestyle
Although social capital as a key determinant of health has been well established in various studies, little is known about how lifestyle factors mediate this relationship. Understanding the cross-relationships...
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Correction to: The GREENH-City interventional research protocol on health in all policies
After publication of the article [1], it has been brought to our attention that in the original publication the third author's name was spelt incorrectly. The correct spelling is "Emmanuelle Faure". This was prev...
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Correction to: The effectiveness of a life style modification and peer support home blood pressure monitoring in control of hypertension: protocol for a cluster randomized controlled trial
After publication of the article [1], it has been brought to our attention that the methodology outlined in the original article was not able to be fully carried out. The article planned a two armed randomized co...
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Buccal Plate Preservation with Immediate Implant Placement and Provisionalization: 5-Year Follow-Up Outcomes
Abstract
Purpose
Despite socket preservation and/or immediate implant placement, resorption of the buccal plate after dental extraction continues to pose esthetic challenges to clinicians. Buccal plate preservation (BPP) is a technique that has been recently proposed with an aim to reduce the incidence of such resorption. This study was conducted to assess the long-term efficacy of BPP in maintaining the thickness of the buccal cortical plate after immediate implant insertion and provisionalization.
Materials and Methods
Ten consecutive patients were included in this study. Each patient underwent extraction of a non-restorable tooth, BPPPBPP, single immediate implant placement and immediate provisionalization. Cone beam CT scans were taken 3 months after surgery (T1) and 5 years after surgery (T2) to evaluate the effectiveness and longevity of the BPPPBPP technique in maintaining the augmented bone width. Two distinct measurements were taken for bone evaluation: (a) R1: 1 mm apical to the implant platform and (b) R2: 5 mm apical to the implant platform. The long axis of the implant was used as a fixed reference. Statistical test analysis was conducted using the SPSS software. Student's t test was used to assess statistical significance, and a p value of < 0.05 was considered significant.
Results
There were six females and four males in the study. The mean age of the sample was 37.6 years (range 23–64 years). At T1, the mean bone thickness of the buccal plate was found to be 2.36 mm at R1 (range: 1.9–3.1), and 2.23 at R2 (range: 1.9–3). At the T2 interval, the mean thickness of the plate was 2.28 mm at R1 (range: 1.7–3) and 2.18 at R2 (range: 1.9–3). The differences in these mean values were not statistically significant.
Conclusions
BPPPBPP is an effective means for augmentation and maintenance of the buccal cortical plate around an immediately placed and provisionalized dental implant. It is a viable alternative to socket preservation with the added benefit that it allows for immediate implant placement.
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Effects of increased apical enlargement on the amount of unprepared areas and coronal dentine removal: a micro-computed tomography study
Abstract
Aim
To evaluate the effects of progressive apical enlargement on the amount of unprepared root canal surface area and remaining dentine thickness.
Methodology
The root canals of 30 extracted mandibular incisors with Vertucci′s type I configuration were instrumented with rotary HyFlex instruments (Coltene-Whaledent, Altstätten, Switzerland) up to 4 instruments larger than the first one that bound at the working length (WL). Teeth were scanned in a micro-computed tomography (micro-CT) device before canal preparation and after instrumentation with the 2nd, 3rd and 4th larger instruments. The amount of unprepared surface area in the full canal or in the apical 4 mm as well as the remaining dentine thickness at 10 mm from the WL were calculated and compared. The general linear model for repeated measures adjusted by Bonferroni's post hoc test was used for statistic analysis.
Results
There was a significant reduction in the amount of unprepared areas after each increase in preparation size (P<0.01). This was observed for both the full canal length and the 4-mm apical segment. The amount of remaining dentine was also significantly reduced after each file size (P<0.01). However, thickness always remained above 1 mm, even after using the largest instrument.
Conclusion
Apical preparations up to 4 sizes larger than the first one to bind at the WL caused a significant progressive reduction in the unprepared canal area.
This article is protected by copyright. All rights reserved.
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Saint John inmate reports trying to pull his own tooth after being denied care
Matthew Hudson, an inmate at the Saint John Regional Correctional Centre, says he's been denied access to a dentist, despite living with pain from a fractured tooth for four months. An inmate at the Saint John jail says he's in so much discomfort he tried to extract his own tooth after being denied dental care.
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"Oral Oncol"[jour]; +24 new citations
24 new pubmed citations were retrieved for your search. Click on the search hyperlink below to display the complete search results:
These pubmed results were generated on 2017/11/07
PubMed comprises more than millions of citations for biomedical literature from MEDLINE, life science journals, and online books. Citations may include links to full-text content from PubMed Central and publisher web sites.
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Scedosporium apiospermum infection of the urinary system with a review of treatment options and cases in the literature
Abstract
Infection with Scedosporium species is associated with significant morbidity and mortality and is becoming increasingly common, especially in immunocompromised patients. We describe the presentation and successful management of an immunocompromised patient with Scedosporium apiospermum infection of the upper urinary tract system, a rare disease manifestation. The current literature on urinary tract scedosporiosis is further reviewed with emphasis on treatment options and limitations of current antifungal therapy.
This article is protected by copyright. All rights reserved.
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Influenza and Pneumocystis jirovecii pneumonia in an allogeneic hematopoietic stem cell transplantation recipient: Co-infection or superinfection?
Abstract
Influenza infection and Pneumocystis jirovecii pneumonia (PJP) in hematopoietic stem cell transplant (HSCT) patients are well characterized, however no dual infections have been reported in this patient population and little evidence of mechanisms of interaction between the two infections exists. We present a 53-year-old male allogeneic HSCT patient on immunosuppressive therapy for the treatment of graft-versus-host disease initially diagnosed with influenza A H3, and later PJP. Despite the development of acute respiratory distress syndrome, the patient was successfully treated with appropriate antimicrobial therapy and aggressive supportive care. This case demonstrates the necessity of maintaining a high index of suspicion for fungal (including PJP) co-infection or superinfection in the setting of worsening influenza infection.
This article is protected by copyright. All rights reserved.
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The influence of immunosuppressants on direct-acting antiviral therapy is dependent on hepatitis C virus genotype
Abstract
Background
Direct-acting antivirals (DAA) have substantially increased sustained virological response rates after liver transplantation, with improved tolerance compared to interferon-based therapy. The influence of immunosuppressive agents on the efficacy of DAAs has not been clarified.
Methods
Subgenomic HCV replicons for genotype (GT) 1b, 2b, 3a and 4a were treated with the mammalian target of rapamycin (mTOR) inhibitors everolimus and sirolimus or with the calcineurin inhibitors (CNI) cyclosporine or tacrolimus, either alone or in combination with selected DAAs. Cell proliferation-related effects were excluded with MTT assays. HCV replication activity was quantified by quantitative real-time polymerase chain reaction or luciferase assay.
Results
Addition of either mTOR inhibitor to the DAA daclatasvir resulted in a 30% increase in antiviral activity compared to daclatasvir alone for HCV GT2a, GT3a and GT4a (all P ≤0.01). Similar results were obtained using sofosbuvir and ledipasvir. In contrast, addition of either mTOR inhibitor to daclatasvir induced a 30% reduction in antiviral activity in GT1b cells (P≤ .01 versus daclatasvir alone). Neither CNI affects the antiviral activity of the DAAs in any HCV GT.
Conclusion
For patients with HCV GT2a, GT3a or GT4a infection, mTOR-based immunosuppressive therapy may be beneficial, whereas CNI-based therapy may be more efficacious in GT1b patients.
This article is protected by copyright. All rights reserved.
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