Probiotic Lactobacillus rhamnosus GG prevents alveolar bone loss in a mouse model of experimental periodontitis

Abstract

Aim

This study investigated the role of Lactobacillus rhamnosus GG on bone loss and local and systemic inflammation in an in vivo mouse model of experimental periodontitis.

Materials and methods

Experimental periodontitis was induced in mice by oral inoculation with Porphyromonas gingivalis and Fusobacterium nucleatum over a period of 44 days. The probiotic LGG was administered via oral inoculation or oral gavage prior to, and during disease induction. The antimicrobial activity of LGG on the inoculum was also tested. Alveolar bone levels and gingival tissue changes were assessed using in vivo micro-computed tomography and histological analysis. Serum levels of mouse homologues for IL-8 were measured using multiplex assays.

Results

Pre-treatment with probiotics either via oral gavage or via oral inoculation significantly reduced bone loss (p < 0.0001) and gingival inflammation (p < 0.0001) when compared with periodontitis group. Oral gavage treatment group had significantly less TRAP positive cells (p < 0.02) then periodontitis group. LGG showed no antimicrobial activity against Porphyromonas gingivalis and Fusobacterium nucleatum.

Conclusions

LGG effectively supresses bone loss in a mouse model of induced periodontitis irrespective of the mode of administration.

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Assessment of biologically aggressive, recurrent glandular odontogenic cysts for mastermind-like 2 (MAML2) rearrangements: histopathologic and fluorescent in situ hybridization (FISH) Findings in eleven cases

Abstract

Background

Glandular odontogenic cyst (GOC) demonstrates a significant predilection toward localized biologic aggressiveness and recurrence. GOC shares certain histopathologic features with intraosseous mucoepidermoid carcinoma (IMEC). The current investigation evaluates a group of recurrent, biologically aggressive GOCs to determine if any cases demonstrated unique histologic features or Mastermind – like2 (MAML2) rearrangements common to IMEC.

Methods

Microscopic slides from eleven previously diagnosed GOGs were stained with hematoxylin and eosin and assessed by two study participants for ten classic histopathologic features required to establish a diagnosis of GOC. Cases were evaluated utilizing break-apart fluorescent in situ hybridization (FISH) analysis for the presence of MAML2 gene rearrangements. Clinical and demographic data on all patients were recorded.

Results

The mean age for patients included in the study was 55.27 years with a range of 36 to 72 years. The most common presenting symptom was a jaw expansion and all cysts presented initially as a unilocular or multilocular radiolucency. CYSTS displayed a minimum of 6 of 10 histologic parameters necessary for a diagnosis of GOC. One case demonstrated MAML2 rearrangements by FISH. That case also showed marked ciliation of cyst lining epithelial cells and extensive mucous secreting goblet cell proliferation.

Conclusion

Findings in the current study are in concert with previous investigations, and although this study finds ONLY LIMITED molecular evidence to support the premise that recurrent biologically aggressive GOCs are a precursor to IMEC, detection of MAML2 rearrangements in one case suggests that such a theoretic transition, while rare, is possible.

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Association of Dental and Maxillary Sinus Pathologies with Ear, Nose and Throat Symptoms

Abstract

Objectives

To investigate the correlation between cone beam computerized tomography (CBCT) findings in the maxillary sinus, Ear-Nose-Throat (ENT) symptoms and dental pathologies in asymptomatic patients.

Materials and methods

A total 81 patients were referred for CBCT and filled a standard ENT visual analog scale (VAS) questionnaire. CBCT images were analyzed for sinus ostium obstruction, Schneiderian membrane thickening, sinus floor turbidity and the presence of polyps. Dental pathologies were evaluated with the aid of CBCT images, periapical x-rays and clinical examination. A possible correlation between the CBCT findings and the ENT/dental parameters was examined by applying Student's t-test and the chi-square test.

Results

Despite being asymptomatic, most of the 81 patients reported ENT symptoms in the questionnaire, thereby indicating that these symptoms were mainly subclinical. A significant correlation was found between the presence of polyps in the sinus and a decrease in smell/taste. Obstruction of the sinus meatus was associated with coughing; Turbidity was associated with ear congestion. Thickening of the Schneiderian membrane showed an association with both coughing and ear congestion. The mean number of missing posterior teeth correlated with postnasal drip and nasal congestion. Periapical pathology was associated with nasal discharge/runny nose.

Conclusions

The results emphasize the need to evaluate ENT symptoms when radiographic findings are identified in CBCT.

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A novel PITX2 mutation in non-syndromic oro-dental anomalies

Abstract

Objective

To identify oro-dental characteristics and genetic etiology of a family affected with non-syndromic oro-dental anomalies.

Subjects and methods

Physical and oral features were characterised. DNA was collected from an affected Thai family. Whole exome sequencing was employed to identify the pathogenic variants associated with inherited oro-dental anomalies. The presence of the identified mutation was confirmed by Sanger sequencing.

Results

We observed unique oro-dental manifestations including oligodontia, retained primary teeth, taurodont molars, peg-shaped maxillary central incisors, high attached frenum with nodule, and midline diastema in the proband and her mother. Mutation analyses revealed a novel heterozygous frameshift deletion, c.573_574delCA, p.L193QfsX5, in exon 5 of PITX2A in affected family members. The amino acid alterations, localised in the transcriptional activation domain 2 in the C terminus of PITX2, were evolutionarily conserved. Mutations in PITX2 have been associated with autosomal-dominant Axenfeld-Rieger syndrome and non-syndromic eye abnormalities, but never been found to cause isolated oral anomalies.

Conclusions

This study for the first time demonstrates that the PITX2 mutation could lead to non-syndromic oro-dental anomalies in humans. We propose that the specific location in the C-terminal domain of PITX2 is exclusively necessary for tooth development.

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Outcomes of oral lichen planus and oral lichenoid lesions treated with topical corticosteroid

Abstract

Objective. To determine corticosteroid treatment effectiveness in patients with Oral Lichen Planus/Oral Lichenoid Lesions (OLP/OLL). Material and methods. Twenty-one OLP and eighty-one OLL patients received 0.05% clobetasol propionate (CP) or 0.05% triamcinolone acetonide (TA) in aqueous solution (AS) or orabase (OB), evaluating responses to treatment and follow-up compliance. Results. Lesions were atrophic (72/102; 70.6%), extensive (58/100; 58%), producing eating difficulties (62/102; 60.8%) and spontaneous pain (30/102; 29.4%); 50 patients (49%) received CP-AS. The mean±sd percentage of follow-ups attended was 43±32%. Symptom remission was achieved in 46% of patients receiving CP-AS, 36.36% of those receiving TA-AS, 20% of those receiving CP-OB, and 25% of those receiving TA-OB. Follow-up compliance was poor in 66.7% of patients. Among 51 patients with continuous symptoms, 64.7% evidenced total remission at treatment completion; among 33 with intermittent symptoms, 73.1% had outbreaks 2-3 times/year and 51.5% controlled outbreaks with <6 corticosteroid applications. Adverse effects were observed in 7 patients (6.8%) (moon face, hirsutism, capillary fragility) in induction stage, subsiding with dose; among 15 patients under maintenance treatment for >6 months, 1 showed hypothalamic–pituitary–adrenal (HPA) axis inhibition but not adrenal insufficiency. Conclusions. Our treatment proved highly effective and safe. Recall programs are desirable to enhance follow-up compliance.

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Exploring Summarization Differences for Two Types of Expository Discourse in Adolescents With Traumatic Brain Injury

Purpose

Annually, nearly 700,000 U.S. children and adolescents experience a traumatic brain injury (TBI). Many of them struggle academically, despite failing to qualify for special education services because their cognitive communication impairments are subtle.

Method

In this exploratory study, five adolescents with TBI provided verbal summaries of two expository lectures (compare–contrast, cause–effect) and participated in cognitive and expressive syntax testing. Their performance on these tasks was compared descriptively to that of 50 adolescents with typical development.

Results

For adolescents with TBI, mean summary quality scores for both exposition types were at least 1 SD lower than those of adolescents with typical development and notably 2 SDs below for the cause–effect passage. The adolescents with TBI who had below-average cognitive scores showed better performance on compare–contrast summaries compared to cause–effect, whereas the majority of adolescents with typical development showed the opposite tendency.

Conclusions

These results provide preliminary evidence that students with TBI, particularly those with cognitive deficits, may struggle with expository discourse despite acceptable performance on a measure of expressive syntax. This study also indicates that researchers should explore how students with TBI perform on academically relevant discourse tasks in order to inform future assessment and intervention efforts.

Supplemental Materials

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A National Survey of Simulation Use in University Programs in Communication Sciences and Disorders

Purpose

This study provides a framework for understanding the range and diversity of simulation use, along with the benefits and challenges to the growth of simulation in university programs in communication sciences and disorders (CSD) across the United States.

Method

A web-based questionnaire was developed and deployed to educators in undergraduate and graduate speech-language pathology and audiology programs in the American Speech-Language-Hearing Association EdFind database (N = 309). Responses from 44% (n = 136) of the American Speech-Language-Hearing Association–accredited CSD programs were analyzed.

Results

Overall, 51% (n = 69) of respondents reported using simulations in clinical education. Of the 5 categories of health care simulation, programs most often employed standardized patients and/or computer-based simulations. Barriers to using simulations included a lack of knowledge, limited financial resources, undertrained faculty, and little guidance from accrediting bodies. A significant number of respondents (n = 66) agreed with the statement that simulated experiences could account for up to 25% of required direct clinical hours in speech-language pathology and audiology.

Conclusions

Results of this study suggest an emerging acceptance of simulations as a method of augmenting clinical education within CSD programs. Expanding educational efforts and increasing opportunities for faculty training are essential in realizing the full potential of future professionals using simulations in CSD.

Supplemental Material

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Cognitive Function and Quality of Life in Head and Neck Cancer Patients

This case series investigates the associations between cognitive function and quality of life in patients prior to treatment for head and neck cancer.

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Association Between Head and Neck Squamous Cell Carcinoma Survival, Smoking at Diagnosis, and Marital Status

This cohort study examines the association between survival and smoking status at the time of diagnosis of head and neck squamous cell carcinoma and the association between marital status and smoking in these same patients.

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Weaning Children With Aspiration From Thickened Fluids

This case series describes the experience of a systematic weaning process in children who received thickened liquids due to oropharyngeal dysphagia and identified risk of aspiration.

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The Next 19 Years of the American Head and Neck Society

The Presidential Address presented at the 2017 American Head and Neck Society (AHNS) includes a brief history of the AHNS, current update, and thoughts on the future of the organization.

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Granulomatosis With Polyangiitis

This Viewpoint examines the continued use of the name Wegner granulomatosis despite the 2011 consensus to change the name of the disease to granulomatosis with polyangiitis.

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Evaluation of a physical activity intervention for new parents: protocol paper for a randomized trial

Identifying critical life transitions in people's physical activity behaviors may illuminate the most opportune intervention apertures for chronic disease prevention. A substantive evidence base now indicates ...

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Investigation of Acute Flaccid Paralysis Reported with La Crosse Virus Infection, Ohio, USA, 2008–2014

M. J. Hennessey et al.

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Mitogenomic diversity and differentiation of the Buryats

Mitogenomic diversity and differentiation of the Buryats

Mitogenomic diversity and differentiation of the Buryats, Published online: 09 November 2017; doi:10.1038/s10038-017-0370-2

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Evaluation of Gamma-Radiation Inactivation of a Bioterrorism Agent, Bacillus anthracis Spores, on Different Materials

Abstract

Decontamination of suspected packages, such as sealed envelopes, liquids and tools that are likely contaminated with biological agents is of great importance. In this study, we aimed to determine the gamma radiation dose required for the decontamination of paper, fabric and liquid materials without causing any damage to the structure of these materials. Each study group included 11 pieces of paper, fabric and sterile saline contaminated with 0.8 × 10⁵ virulent Bacillus anthracis (B. anthracis) spores. These specimens were exposed to doses of 5.49, 11.58, 17.21, 21.75, 27 and 33.1 kilogray (kGy) of gamma radiation from a cobalt-60 source. After irradiation of all the samples, a viability assessment of the B. anthracis spores was performed. It was found that full decontamination was achieved with 11.58 kGy on the paper samples and 17.21 kGy on the fabric and liquid samples. It was concluded that a dose of 20 kGy of gamma radiation may be recommended for the inactivation of B. anthracis for some surfaces when especially sensitive and valuable materials cannot be wet decontaminated were exposed. In addition, serologic and molecular assays of the suspected packets can be performed for forensic purposes without damaging existing evidence in a bioterror incident.

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Necrotizing Microascus tracheo-bronchitis in a bilateral lung transplant recipient

Abstract

Invasive fungal infections are a major cause of mortality among solid organ transplant recipients. Scopulariopsis species and their teleomorph Microascus are molds found in soil and decaying organic matter. We report here the case of a woman who underwent bilateral lung transplantation for severe emphysema. On day 25 after transplantation, endobronchial green-black lesions were detected during routine endoscopy. Endobronchial swabs, biopsies, and broncho-alveolar lavage samples were positive for Microascus cirrosus. This fungal infection developed despite voriconazole given for previous persistent invasive aspergillosis. Treatment consisted of a combination of antifungal medication (voriconazole, terbinafine, amphotericin B, and caspofungin) and endoscopic resection of necrosed bronchial mucosa. A favorable clinical outcome was achieved after 7 weeks of treatment. Seven cases of Scopulariopsis/Microascus infection have been previously described in solid organ transplant recipients. Only two survived after treatment with an antifungal combination therapy including echinocandins, posaconazole, and terbinafine. In immunocompromised patients, infection by Microascus species is a rare but life-threatening event because of innate resistance to most common antifungal drugs. Our patient was successfully cured by combined therapy including intravenous voriconazole and caspofungin, oral terbinafine, and inhaled voriconazole and amphotericin B administered for 7 weeks in association with iterative endoscopic debridement to reduce fungal inoculum.

This article is protected by copyright. All rights reserved.

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Association between baseline serum hepcidin levels and infection in kidney transplant recipients: Potential role for iron overload

Abstract

Background

The liver-synthesized peptide hepcidin is a key regulator of iron metabolism and correlates with total iron stores. We analyzed the association between pre-transplant hepcidin-25 levels and infection after kidney transplantation (KT).

Methods

Serum hepcidin-25 levels were measured at baseline by high-sensitivity ELISA in 91 patients undergoing KT at our institution between December 2011 and March 2013. The impact of this biomarker on the incidence of post-transplant infection (excluding lower urinary tract infection) during the first year was assessed by Cox regression.

Results

Mean hepcidin-25 level was 82.3 ± 67.4 ng/mL and strongly correlated with serum ferritin (Spearman's rho = 0.703; P <.001). There were no significant differences in hepcidin-25 levels between patients with or without overall infection (96.4 ± 67.5 vs 72.6 ± 66.7 ng/mL; P = .101). Such difference was evident for opportunistic (128.9 ± 75.0 vs 73.0 ± 62.3 ng/mL; P =.003) and, to a lesser extent, surgical-site infection (107.5 ± 73.3 vs 76.5 ± 65.2 ng/mL; P = .087). Patients with hepcidin-25 levels ≥72.5 ng/mL had higher 12-month cumulative incidence of overall infection (51.2% vs 29.2%; P = .032). After multivariate adjustment hepcidin-25 ≥72.5 ng/mL acted as an independent risk factor for overall (adjusted hazard ratio [aHR]: 3.86; 95% confidence interval [CI]: 1.49-9.96; P = .005) and opportunistic infection (aHR: 4.32; 95% CI: 1.18-15.75; P = .027).

Conclusion

Elevated baseline serum hepcidin-25 levels were associated with increased risk of infection after KT, suggesting a role for iron overload in the individual susceptibility to post-transplant infection.

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Florida couple face child-abuse charges over daughter's rotting teeth

A new report cautions that problems in a child's teeth, gums or mouth could be a sign of abuse or neglect. Research from the American Academy of Pediatrics and the American Academy of Pediatric Dentistry showed that injuries and infections in and around the mouth often appear in children who are abused or neglected.

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The game of the seven moons

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A penny for your preferences

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Basic Sciences for Dental Students

The 'all-in-one' solution to mastering basic sciences in preclinical dentistry Basic Sciences for Dental Students is a cutting edge textbook specifically designed to support the needs of early years undergraduate dental students. Written by leaders in dental education and active oral and dental researchers involved with student assessment, the text explains the basic science that underpins the dental curriculum in undergraduate dental courses worldwide Read More...

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Decision Making in Dental Implantology: Atlas of Surgical and Restorative Approaches

Decision Making in Dental Implantology: Atlas of Surgical and Restorative Approaches offers an image-based resource to both the surgical and restorative aspects of implant therapy, presenting more than 2,000 color images with an innovative case-by-case approach. Read More...

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Regionally variant collagen alignment correlates with viscoelastic properties of the disc of the human temporomandibular joint

Publication date: Available online 8 November 2017
Source:Archives of Oral Biology
Author(s): Shawn Gutman, Daniel Kim, Solaiman Tarafder, Sergio Velez, Julia Jeong, Chang H. Lee
ObjectiveTo determine the regionally variant quality of collagen alignment in human TMJ discs and its statistical correlation with viscoelastic properties.DesignFor quantitative analysis of the quality of collagen alignment, horizontal sections of human TMJ discs with Pricrosirius Red staining were imaged under circularly polarized microscopy. Mean angle and angular deviation of collagen fibers in each region were analyzed using a well-established automated image-processing for angular gradient. Instantaneous and relaxation moduli of each disc region were measured under stress-relaxation test both in tensile and compression. Then Spearman correlation analysis was performed between the angular deviation and the moduli. To understand the effect of glycosaminoglycans on the correlation, TMJ disc samples were treated by chondroitinase ABC (C-ABC).ResultsOur imaging processing analysis showed the region-variant direction of collagen alignment, consistently with previous findings. Interestingly, the quality of collagen alignment, not only the directions, was significantly different in between the regions. The angular deviation of fiber alignment in the anterior and intermediate regions were significantly smaller than the posterior region. Medial and lateral regions showed significantly bigger angular deviation than all the other regions. The regionally variant angular deviation values showed statistically significant correlation with the tensile instantaneous modulus and the relaxation modulus, partially dependent on C-ABC treatment.ConclusionOur findings suggest the region-variant degree of collagen fiber alignment is likely attributed to the heterogeneous viscoelastic properties of TMJ disc that may have significant implications in development of regenerative therapy for TMJ disc.



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Histamine stimulates secretion of extracellular vesicles with nucleotidase activity in rat submandibular gland

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Débora Alejandra González, Martín Matías Barbieri van Haaster, Emmanuel Quinteros Villarruel, Macarena Brandt, María Belén Benítez, Graciela Mabel Stranieri, Betina Orman
BackgroundExtracellular vesicles released by different cells have been isolated from diverse fluids including saliva. We previously reported that rat submandibular glands secrete nanovesicles that catalyze hydrolysis of ATP, ADP and AMP, which are actors of the purinergic signaling system along with adenosine. Extracellular nucleotides like ATP and adenosine are involved in the regulation of inflammatory processes and apoptosis. Histamine, a widely distributed biogenic amine, is involved in inflammatory response.ObjectiveTo test if activation of histamine receptors in rat submandibular gland promotes changes in the release of vesicles with nucleotidase activity that could modulate purinergic signaling.MethodsRat submandibular glands were incubated in the absence or presence of histamine and JNJ7777120, an antagonist for H4 receptors. Extracellular vesicles were isolated from incubation media by differential centrifugation. Vesicular nucleotidase activity was measured following Pi release by 3mM MgATP, MgADP or MgAMP.ResultsHistamine increased the release of vesicles with nucleotidase activity in a concentration dependent manner. JNJ7777120 significantly reduced this effect. Vesicular nucleotidases obtained in the absence or presence of histamine promoted Pi production from ATP, ADP and AMP.ConclusionThe results show a relationship between histamine and the regulation of purinergic signaling, which could be important in the modulation of inflammatory processes.



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Nitric oxide and arginase levels in peri-implant tissues after delayed loading

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Ceren Gokmenoglu, Nurdan Ozmeric, Caglar Sungur, Raziye Sahin Bildik, Imge Erguder, Serenay Elgun
ObjectiveNitric oxide (NO) is synthesized from the conversion of L-arginine to L-citrulline by NO synthase (NOS). Arginase can compete with NOS for the common substrate L-arginine, and thus inhibit NO production. NO levels and arginase ezyme might affect the bone remodeling cycle around implants. The aim of this studywas to investigate NO and arginase levels in gingival crevicular fluid (GCF), peri-implant sulcular fluid (PISF), and saliva.Materials and methodsTwenty patients with one or more implants (Straumann^®; Institute Straumann AG, Basel, Switzerland) restored with fixed crown prostheses were included in the study. Plaque index (PI), gingival index (GI), probing depth (PD), and bleeding on probing (BOP) were recorded from six sites of each tooth and implant at baseline and at months 1, 3, and 6 after loading. The saliva, GCF, and PISF were collected at baseline and at months 1, 3, and 6 after loading. NO level and arginase enzyme were evaluated in GCF, PISF, and saliva.ResultsArginase and NO levels in saliva did not change significantly from baseline to months 1, 3, and 6. However, both PISF NO and arginase levels showed an increased pattern from baseline to month 6. NO levels were significantly higher at months 3 and 6, compared to baseline, while PISF arginase levels increased significantly from baseline to months 3 and 6.ConclusionNO and arginase enzyme measurements in saliva, GCF, and PISF may be beneficial in the determination of current peri-implant tissues. In particular, PISF might provide more information than saliva.



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Selection in mixtures of food particles during oral processing in man

Publication date: January 2018
Source:Archives of Oral Biology, Volume 85
Author(s): Hilbert W. van der Glas, Esther H.-J. Kim, Anis Z. Mustapa, Wijdan R. Elmanaseer
ObjectivesTwo processes underlie food comminution during chewing: (1) selection, i.e. every particle has a chance of being placed between the teeth and being subjected to (2) breakage. Selection decreases with particle number by saturation of breakage sites, and it depends on competition between smaller and larger particles for breakage sites. Theoretical models were tested which describe competition between various sizes X. In the one-way model, small particles cannot compete with larger ones because of their smaller height. In the two-way model, small particles may compete when piled between antagonistic teeth.DesignFive subjects participated in one-chew experiments on cubes made of Optosil^®. The critical particle number (nc(X)) at which saturation starts, and the number of breakage sites (nb(X)) were determined by varying particle numbers (nX) for single-sized cubes of 1.7-6.8mm. Using nc(X) and nb(X), the models predicted relationships between number of selected particles (ns(X)) and nX in one-chew experiments using simple mixtures with only two sizes. A fixed number (mean 6 or 26) of larger cubes (X=6.8 or 3.4mm) was mixed with various numbers (16–1024) of smaller cubes (X=4.8, 2.4 or 1.7mm), thus varying the factors X, nX, and possible particle piling (for X<4mm).ResultsThe one-way model was largely followed with small numbers of smaller particles and the two-way model with large numbers.ConclusionsThe two-way model applies to chewing a food which yields a loose aggregation of different-sized particles following an initial phase, whereas other circumstances may be favourable for the one-way model. As conditions of a food bolus can be approached by embedding hard Optosil particles in a soft medium, the models will, apart from dentistry, be of interest for controlling flavour release in food engineering.



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Endoscopic endonasal surgery for pituitary adenomas extending to the oculomotor cistern

Abstract

Background

Extension of a pituitary adenoma to the oculomotor cistern harbors the risk of oculomotor nerve impairment and further extension into the interpeduncular cistern. The role of endoscopic endonasal surgery for those lesions was investigated.

Methods

The medical records were retrospectively analyzed. Attention was paid to the oculomotor nerve function and removal rate of the tumor within the oculomotor and interpeduncular cisterns.

Results

Six patients were eligible for the study, including 2 with oculomotor nerve palsy. The tumor from the oculomotor and interpeduncular cistern was removed in all except on one side of the case with bilateral tumor extension. The oculomotor nerve palsy demonstrated partial recovery in both cases during the 3-month follow-up.

Conclusion

The pituitary adenoma extending to the oculomotor cistern can be removed under the endoscope. Improvement of oculomotor nerve palsy can be achieved, and further tumor extension into the interpeduncular cistern can be prevented.

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Outpatient versus inpatient thyroidectomy: A systematic review and meta-analysis

Abstract

Background

Outpatient thyroidectomy has gained popularity due to improved resource utilization.

Methods

We conducted a systematic review and meta-analysis using MEDLINE, EMBASE, CINAHL, Web of Science, and the Cochrane library. We included all studies examining the outcomes of outpatient thyroidectomy as compared with those of inpatient thyroidectomy. Risk of bias was assessed using the Newcastle-Ottawa scale. Postoperative complications (hematoma, hypocalcemia, and recurrent laryngeal nerve injury) and readmission/reintervention rates were compared.

Results

After screening 1665 records, 10 nonrandomized observational studies were included. There were fewer complication rates in the outpatient group than the inpatient group (relative risk [RR] 0.56; 95% confidence interval [CI] 0.37-0.83). There was no difference in readmission/reintervention rates (RR 0.60; 95% CI 0.33-1.09).

Conclusion

The results suggest outpatient thyroidectomy may be as safe as inpatient thyroidectomy in appropriately selected patients. The results are limited by high risk of bias. Well-designed prospective studies are necessary to further assess the safety of outpatient thyroidectomy.

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Small bowel obstruction after transoral robotic surgery

Abstract

Background

Head and neck surgery is not often considered a risk factor for intestinal ileus and small bowel obstruction. However, many of these patients may have had prior abdominal surgery, a known risk factor for small bowel obstruction, and may be at risk for bowel obstruction after a surgical procedure of the head and neck.

Methods

We present a case describing a patient who, after undergoing transoral robotic surgery, experienced delayed postoperative ileus and eventual small bowel obstruction requiring exploratory laparotomy and bowel resection.

Results

Although the patient required total parenteral nutrition for several days, he eventually was able to resume tube feeds, and after several months was able to tolerate an oral diet.

Conclusion

Although uncommon complications of head and neck surgery, intestinal ileus and small bowel obstruction can develop as the result of stress/inflammation, postoperative narcotic pain medication, and prior abdominal surgery.

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CASTLE tumor of the parotid: First documented case, literature review, and genetic analysis of the cancer

Abstract

Background

Carcinoma showing thymus-like elements (CASTLE) is a rare tumor that normally affects the thyroid gland and was thought to arise from either the remnants of the branchial pouch or the ectopic cervical thymic tissue. These tumors show strong immunopositivity for CD5, P63, and CD117. Most CASTLE of the thyroid gland is treated with surgery with or without adjuvant radiotherapy or chemotherapy.

Method

A 55-year-old woman presented with a slow-growing right parotid mass. A right total parotidectomy and ipsilateral selective neck dissection were performed and the diagnosis of CASTLE was made after confirmation with an immunohistochemistry test. She received radiotherapy postoperatively.

Results

Genetic sequencing showed alterations in the PPARG, BRCA2, and NOTCH1 genes. She remained disease free for >1 year after treatment.

Conclusion

We believe that this is the first reported case of CASTLE in the parotid gland. Clinicians should be aware of this rare entity and consider this differential diagnosis after ruling out other common parotid lesions.

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Management of chyle leakage after thyroidectomy, cervical lymph node dissection, in patients with thyroid cancer

Abstract

Background

The purpose of this study was to evaluate the incidence and pattern of chyle leakage after thyroidectomy and/or cervical lymph node dissection and to establish management protocols for chyle leakage.

Methods

Patients who underwent surgical management for thyroid cancer were analyzed retrospectively.

Results

For this study, 131 patients with chyle leakage were identified; the overall incidence was 0.9%. Of them, 43.7% of patients underwent central neck dissection without lateral neck dissection, and chyle leakage was easily controlled with conservative management. Patients whose chyle drainage was reduced by >50% after dietary modification had a significantly shorter hospital stay (P < .001); NPO was the most effective dietary modification.

Conclusion

The occurrence of chyle leakage after central compartment dissection even without lateral neck dissection was not rare, but was easily controlled with conservative management. Surgical management should be considered if the drainage amount does not decrease by >50% of the original amount of the day of detection after 2 days of NPO.

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India Is Overtaking China as the World’s Largest Emitter of Anthropogenic Sulfur Dioxide

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Mitogenomic diversity and differentiation of the Buryats

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Site of asteroid impact changed the history of life on Earth: the low probability of mass extinction

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Pesticide use in agriculture and Parkinson’s disease in the AGRICAN cohort study

Abstract

Background and Aim

Epidemiological studies have reported an increased risk of Parkinson's disease (PD) in farmers exposed to pesticides, but no clear conclusion can be drawn on the type of pesticide and duration of use associated with an effect. In the French agricultural cohort AGRICAN, we assessed associations between PD and pesticide use according to the types of livestock and crops grown, including exposure to some active ingredients with duration of use.

Methods

Self-reported PD and history of lifetime exposure to 13 crops and 5 types of animals and pesticide use were collected at enrolment (2005–07) among 181 842 participants. Exposure to selected active ingredients and duration of use lifelong were assessed with the crop-exposure matrix PESTIMAT. Associations between pesticide use and PD were estimated by logistic regression according to crops and livestock, adjusted for sex, age, educational level, smoking status and alcohol consumption.

Results

PD was reported by 1732 subjects (1.2%) at enrolment in the cohort. Pesticide use lifelong was associated with an increased risk of PD in all types of activities [odds ratio (OR) = 1.31 (cattle) to 1.79 (peas), P < 0.05]. Rotenone, diquat, paraquat and several dithiocarbamates were associated with an increased risk of PD [OR = 1.31 (cuprobam) to 1.57 (rotenone)], especially in farmers with the longest exposure.

Conclusions

Our work suggests that the risk of PD is increased in farmers exposed to pesticides on several French crops and livestock, and supports additional evidence of an association of PD with dithiocarbamate fungicides, rotenone and the herbicides diquat and paraquat.

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Early life exposure to China’s 1959–61 famine and midlife cognition

Abstract

Background

Existing studies of the 1944–45 Dutch famine found little evidence of the association between early life malnutrition and midlife cognition.

Methods

Among 2446 rural participants born between 1958 and 1963 in the China Health and Retirement Longitudinal Study, we examined effects of exposure to China's 1959–61 Great Leap Forward famine during prenatal and early postnatal life, on four cognitive measures in 2011 (baseline) and changes in cognition between 2011 and 2013 (first follow-up). We obtained difference-in-differences (DID) estimates of the famine effects by exploiting temporal variation in the timing and duration of famine exposure across six birth cohorts born between 1958 and 1963, together with geographical variation in famine severity at the prefecture level.

Results

After adjusting for gender, marital status and provincial fixed effects, we found that the 1961 cohort who experienced full-term prenatal and partial-term postnatal exposures to famine had lower scores on the Telephone Interview of Cognitive Status (TICS), a test of drawing pentagons, and general cognition at age 50 years compared with the unexposed 1963 cohort. Adjusting for education, the famine effects on drawing pentagons and general cognition were fully attenuated, but the effect on TICS persisted. We also found a robust negative famine effect on the longitudinal change in general cognition during the 2-year follow-up in the 1959 cohort.

Conclusions

Severe nutritional deprivation during prenatal and postnatal periods has a lasting impact on cognitive performance in Chinese adults in their early 50s.

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Identifying the Macro-Level Drivers of Adolescent Fertility Rate in Latin America: The Role of School-Based Sexuality Education

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Early improvement in food cravings are associated with long-term weight loss success in a large clinical sample

Early improvement in food cravings are associated with long-term weight loss success in a large clinical sample

Early improvement in food cravings are associated with long-term weight loss success in a large clinical sample, Published online: 09 November 2017; doi:10.1038/ijo.2017.238

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Mortality in adults with and without diabetes: is the gap widening?

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Effects of chronic exposure of hydroxychloroquine/ chloroquine on the risk of cancer, metastasis, and death: a population-based cohort study on patients with connective tissue diseases

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Journals’ TOP guidelines transparency level should be disclosed

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Automatic differentiation of rigid body dynamics for optimal control and estimation

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Decentralized multi-robot allocation of tasks with temporal and precedence constraints

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Primary tumor volume measurements in Ewing sarcoma: MRI inter- and intraobserver variability and comparison with FDG-PET

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This domestic abuse survivor receives a new smile, for free

Dr. Kenny Wilstead, a dentist in Marshall, Texas, fixed a domestic abuse survivor's tooth for free. Kyleigh Scott came in for a wisdom tooth extraction, when Dr. Wilstead noticed a broken tooth from an incident where her ex head-butted her.

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Safety of everolimus plus exemestane in patients with hormone-receptor-positive, HER2-negative locally advanced or metastatic breast cancer: results of phase IIIb BALLET trial in Spain.

Safety of everolimus plus exemestane in patients with hormone-receptor-positive, HER2-negative locally advanced or metastatic breast cancer: results of phase IIIb BALLET trial in Spain.

Clin Transl Oncol. 2017 Nov 07;:

Authors: Ciruelos E, Vidal M, Martínez de Dueñas E, Martínez-Jáñez N, Fernández Y, García-Sáenz JA, Murillo L, Carabantes F, Beliera A, Fonseca R, Gavilá J

Abstract
BACKGROUND: Everolimus with exemestane has shown promising activity in patients with hormone-receptor (HR)-positive HER2-negative endocrine-resistant advanced breast cancer. It is necessary, therefore, to characterize the safety profile of this new combination in the real-world clinical setting and in the broadest possible population.
PATIENTS AND METHODS: Post-menopausal women with HR-positive HER2-negative advanced breast cancer progressing after prior non-steroidal aromatase inhibitors (NSAIs) were included. The objectives of this analysis were to evaluate the safety profile of this combination in a subset of Spanish patients in the BALLET trial and to characterize grade 3 and 4 adverse events (AEs) in routine clinical practice in Spain.
RESULTS: Between September 2012 and July 2013, 429 patients (20% of the overall study population) were included in the BALLET study in 52 hospitals in Spain, of whom 100 (23%) were ≥ 70 years. The median treatment duration was 3.14 and 3.03 months for exemestane and everolimus, respectively. The most common reasons for discontinuation of treatment were local reimbursement of everolimus (43%), followed by disease progression (31%) and the incidence of AEs (15%). The most frequent AEs causing permanent discontinuation were pneumonitis (4%), asthenia (2%) and stomatitis (2%). Overall, 87% of patients experienced at least one AE of any grade, 30% of patients at least one grade 3 AE and 2% of patients a grade 4 AE.
CONCLUSION: The safety profile in Spanish patients of the BALLET trial is consistent with the results obtained in the overall population of the trial, as well as in previous clinical trials.

PMID: 29116433 [PubMed - as supplied by publisher]

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Evaluating the benefits and adverse effects of an enthracycline-taxane-capecitabine combined regimen in patients with early breast cancer.

Related Articles

Evaluating the benefits and adverse effects of an enthracycline-taxane-capecitabine combined regimen in patients with early breast cancer.

Oncotarget. 2017 Oct 06;8(46):81636-81648

Authors: Zhang J, Fu F, Lin Y, Chen Y, Lu M, Chen M, Yang P, Huang M, Wang C

Abstract
Capecitabine in addition to anthracycline-taxane based regimens for patients with early breast cancer (EBC) has been reported in previous clinical trials, but the reported efficacy of this regimen remained inconsistent. In order to clarify the survival benefit of this regimen, a meta-analysis was performed. The systematic literature search was conducted in PubMed, the Cochrane library and Google scholar. The hazard ratios (HRs) were used to evaluate the efficacy and adverse events. The result indicated that capecitabine combine with an anthracycline-taxane based regimen would significantly improve DFS (HR = 0.87, 95% CI 0.77-0.97) and OS (HR = 0.78, 95% CI 0.66-0.91) compared with the controls. In subgroup analysis, we found that capecitabine improved the DFS in hormone receptor negative (HR = 0.72, 95% CI 0.53-0.92) and triple negative (HR = 0.67, 95% CI 0.49-0.86) EBC patients. However, adding capecitabine might also increase the occurrence of some side-effects, such as hand-foot syndrome, stomatitis and diarrhea. Capecitabine combined with an anthracycline-taxane based regimen maybe effective and well-tolerated by patients with EBC, especially for triple negative breast cancer, and might be a good clinical choice.

PMID: 29113420 [PubMed]

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MouthWatch, LLC Showcasing Teledentistry for Urban and Suburban Private Practices During the Greater New York Dental Meeting

 

I've been working with the MouthWatch system for a few weeks now and am very impressed.  It does a great job of allowing communication between my office, other offices, and my lab.  Also the cameras provide very nice clinical images and are very affordable.  If you are looking for new cameras and a way to increase communication, give MouthWatch a look!

 

Here's info from the company about the upcoming Greater New York Meeting:

 

 

MouthWatch, LLC a leader in intraoral imaging, digital case presentation and teledentistry solutions, will be showcasing private practice applications of its TeleDent™ teledentistry platform at booth #3430 during the Greater New York Dental Meeting.

 

According to MouthWatch CEO Brant Herman, "For the past few years, our TeleDent™ all-in-one teledentistry platform has been proving itself on the front lines of public health and other innovative care delivery models of dentistry.  The Greater New York meeting is an ideal place to introduce TeleDent™ to private practice specialists and GP dentists from both urban and suburban areas. We're looking forward to demonstrating the benefits of virtual collaboration and secure case data sharing."

 

Herman says the cost-effectiveness and ease-of-use his company's TeleDent™ platform make it well-suited for the following teledentistry applications:

 

• Specialist/GP Collaboration – Teledentistry is a catalyst for collaborative care and increased referrals. The results include positive patient outcomes and reduced risk of failure in complex cases.

 

• Dentist-Owned Hygiene Clinics –A full service dental office can be linked to remote hygiene clinics that the dentist also owns and operates. 

 

• DSO Resource Sharing – Teledentistry enables DSOs and groups to offer live or asynchronous consults with a rotating specialist no matter which location they are currently working in. 

 

• Dentist / Dental Lab Collaboration –  Dentists and dental lab operators can 

share CBCT images, digital impression files and patient photos to increase case accuracy and ultimately ensure patient satisfaction. This capability can be especially valuable in treatment planning and completing complex restorative cases.

 

"Of course, we will continue to serve the public health sector and assist with improving access to and equity of care," explained Herman. "At the same time, TeleDent™ provides unique business and clinical opportunities for private practices and DSOs in urban and suburban settings. It's is an ideal way for these practices to implement teledentistry. Our mission is to transform and enhance the delivery of care throughout dentistry."

 

For more information about MouthWatch, visit www.MyMouthWatch.com, call 877-544-4342 or send an email to Info@MouthWatch.com.

 

About MouthWatch, LLC:  

Headquartered in Metuchen, New Jersey, MouthWatch, LLC is a leader in intraoral imaging devices, digital case presentation tools and teledentistry solutions. The company is dedicated to finding new ways to constantly improve the dental health experience for both patient and provider

 

The founders and management team of MouthWatch have relevant backgrounds and successful track records in dentistry, consumer products and communications. Since 2012, this team has pioneered the integration of digital imagery and communications technology in the field of dentistry. Their cumulative experience makes it possible for the company to take the lead in introducing the benefits of telemedicine to the world of dentistry. 

 

 

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Effect of Oral Administration of a Mixture of Probiotic Strains on SCORAD Index and Use of Topical Steroids in Young Patients With Moderate Atopic Dermatitis: A Randomized Clinical Trial.

Effect of Oral Administration of a Mixture of Probiotic Strains on SCORAD Index and Use of Topical Steroids in Young Patients With Moderate Atopic Dermatitis: A Randomized Clinical Trial.

JAMA Dermatol. 2017 Nov 08;:

Authors: Navarro-López V, Ramírez-Boscá A, Ramón-Vidal D, Ruzafa-Costas B, Genovés-Martínez S, Chenoll-Cuadros E, Carrión-Gutiérrez M, Horga de la Parte J, Prieto-Merino D, Codoñer-Cortés FM

Abstract
Importance: Oral intake of new probiotic formulations may improve the course of atopic dermatitis (AD) in a young population.
Objective: To determine whether a mixture of oral probiotics is safe and effective in the treatment of AD symptoms and to evaluate its influence on the use of topical steroids in a young population.
Design, Setting, and Participants: A 12-week randomized, double-blind, placebo-controlled intervention trial, from March to June 2016, at the outpatient hospital Centro Dermatológico Estético de Alicante, Alicante, Spain. Observers were blinded to patient groupings. Participants were children aged 4 to 17 years with moderate atopic dermatitis. The groups were stratified and block randomized according to sex, age, and age of onset. Patients were ineligible if they had used systemic immunosuppressive drugs in the previous 3 months or antibiotics in the previous 2 weeks or had a concomitant diagnosis of intestinal bowel disease or signs of bacterial infection.
Interventions: Twelve weeks with a daily capsule containing freeze-dried powder with 109 total colony-forming units of the probiotic strains Bifidobacterium lactis CECT 8145, B longum CECT 7347, and Lactobacillus casei CECT 9104 and maltodextrin as a carrier, or placebo (maltodextrin-only capsules).
Main Outcomes and Measures: SCORAD index score and days of topical steroid use were analyzed.
Results: Fifty children (26 [50%] female; mean [SD] age, 9.2 [3.7] years) participated. After 12 weeks of follow-up, the mean reduction in the SCORAD index in the probiotic group was 19.2 points greater than in the control group (mean difference, -19.2; 95% CI, -15.0 to -23.4). In relative terms, we observed a change of -83% (95% CI, -95% to -70%) in the probiotic group and -24% (95% CI, -36% to -11%) in the placebo group (P < .001). We found a significant reduction in the use of topical steroids to treat flares in the probiotic arm (161 of 2084 patient-days [7.7%]) compared with the control arm (220 of 2032 patient-days [10.8%]; odds ratio, 0.63; 95% CI, 0.51 to 0.78).
Conclusions and Relevance: The mixture of probiotics was effective in reducing SCORAD index and reducing the use of topical steroids in patients with moderate AD.
Trial Registration: clinicaltrials.gov Identifier: NCT02585986.

PMID: 29117309 [PubMed - as supplied by publisher]

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Solitary Fibrous Tumor of the Tongue: An Uncommon Cause of Obstructive Sleep Apnea

Abstract

Introduction

Solitary fibrous tumor is an uncommon mesenchymal neoplasm that may be found in any location. To date, only a few cases of solitary fibrous tumor involving the tongue have been reported.

Case Summary

We present the case of a 31-year-old man with a history of progressively worsening snoring and daytime sleepiness. Polysomnography revealed severe obstructive sleep apnea. An attempt to treat sleep apnea by continuous positive airway pressure and oral appliance led to a poor clinical response. CT and MRI scans findings revealed a large mass in the tongue base partially obstructing the airway. After the excision of the mass all symptoms, included daytime somnolence, disappeared and a polysomnographic examination showed the normalization of the somnographic parameters.

Discussion

Although OSA is rarely caused by tumors, each patient with sleep disorders breathing should be examined carefully for the potential presence of an upper aero-digestive tract neoplasm that may contribute to obstruction.

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Issue Information

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Spanish validation of the 10-item Connor–Davidson Resilience Scale (CD-RISC 10) with non-professional caregivers

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Perceptions of a psychoeducation program for caregivers of persons with dementia at end of life: a qualitative study

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The role of meaning in life in community-dwelling older adults with depression and relationship to other risk factors

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The effects of intraocular lens implant type on mood: a response to Zambrowski et al.

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Forgiveness and late life functioning: the mediating role of finding ego-integrity

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Outcomes in knowledge, attitudes and confidence of nursing staff working in nursing and residential care homes following a dementia training programme

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Spanish validation of the 10-item Connor–Davidson Resilience Scale (CD-RISC 10) with non-professional caregivers

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Perceptions of a psychoeducation program for caregivers of persons with dementia at end of life: a qualitative study

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The role of meaning in life in community-dwelling older adults with depression and relationship to other risk factors

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The effects of intraocular lens implant type on mood: a response to Zambrowski et al.

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Forgiveness and late life functioning: the mediating role of finding ego-integrity

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Outcomes in knowledge, attitudes and confidence of nursing staff working in nursing and residential care homes following a dementia training programme

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Future and recent issues

(Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

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Editorial Board

(Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

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Contents

(Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

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Information for authors

(Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

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Masthead

(Source: Operative Techniques in Otolaryngology - Head and Neck Surgery)

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Early improvement in food cravings are associated with long-term weight loss success in a large clinical sample

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Technical Quality of Complete Dentures: Influence on Masticatory Efficiency and Quality of Life

Abstract

Purpose

To evaluate the effect of the technical quality of conventional complete dentures (CD) on masticatory efficiency and quality of life (QoL) of denture wearers during a 1-year follow-up.

Materials and Methods

A prospective clinical trial with 32 edentulous patients (mean age of 60.2 years) wearing mandibular and maxillary dentures was conducted. All patients were evaluated wearing their preexisting dentures and after 3, 6, and 12 months postinsertion of new dentures. A reproducible method for objective evaluation of the technical quality of CDs was employed. Masticatory efficiency was evaluated by the colorimetric method using beads as artificial testing food. The oral health impact on patient QoL was measured using the OHIP-EDENT (Oral Health Impact Profile in Edentulous Adults) questionnaire. The nonparametric Wilcoxon test was applied to reveal any differences in technical quality between the preexisting and new dentures. The Friedman test was used to detect differences in masticatory efficiency and oral health impact on QoL. Spearman's correlation was applied to reveal correlation between the variables.

Results

Comparing preexisting and new dentures, significant improvement was found in technical quality between the dentures (p < 0.001). There was no statistically significant difference in masticatory efficiency. A significant decrease was found in the total OHIP-EDENT scores after denture replacement. A positive correlation was found between technical quality and OHIP in the new denture wearers (p = 0.011).

Conclusions

According to the results of this study, denture quality significantly improved patients' oral health-related QoL; however, insertion of new dentures did not influence masticatory efficiency.

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Reviewer Acknowledgements 2017

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Adrenal Schwannoma Treated with Open Adrenalectomy: a Case Report

Abstract

Adrenal schwannomas are very rare tumors accounting for only 0.2% of the adrenal tumors. These are very difficult to diagnose preoperatively and usually present as incidental non-secreting adrenal masses in asymptomatic patients or in patients with non-specific complaints. Computed tomography (CT) and magnetic resonance imaging (MRI) are required to aid the diagnosis, but adrenal schwannomas cannot be distinguishably confirmed on the basis of imaging alone. Histopathological examination (HPE) is essential for accurate diagnosis. We report a rare case of a right adrenal schwannoma in a 68-year-old man. The clinical evaluation was unremarkable and the radiological examination revealed a suprarenal mass lesion on ultrasonography (USG). CT revealed a right adrenal mass which was purported to be likely malignant. Right adrenalectomy was performed by the open approach along with excision of the surrounding enlarged lymph nodes. The postoperative course was uneventful. HPE established the adrenal mass to be a schwannoma, a benign tumor arising from Schwann cells, an exceedingly unusual occurrence in the adrenal glands. A non-secreting adrenal mass can be easily misjudged and the exact diagnosis of the lesion cannot be made sure of without both radiologic and pathologic confirmation. Unilateral adrenal primary or metastatic lesions need pathological confirmation as it can dramatically affect prognosis. Unusual tumors of the adrenal gland like schwannomas may be found incidentally or otherwise and will generate difficulties in establishing the right management. Complete excision is the treatment of choice whenever feasible and will also clarify pathology.

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Net primary productivity and its partitioning in response to precipitation gradient in an alpine meadow

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Unlocking the biomineralization style and affinity of Paleozoic fusulinid foraminifera

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Feeding capability in the extinct giant Siamogale melilutra and comparative mandibular biomechanics of living Lutrinae

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Field-relevant doses of the systemic insecticide fipronil and fungicide pyraclostrobin impair mandibular and hypopharyngeal glands in nurse honeybees (Apis mellifera)

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Study on the characteristics of future precipitation in response to external changes over arid and humid basins

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Influence of Precipitation and Crop Germination on Resource Selection by Mule Deer (Odocoileus hemionus) in Southwest Colorado

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Acoustic Mapping of Thermohaline Staircases in the Arctic Ocean

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A common neonicotinoid pesticide, thiamethoxam, alters honey bee activity, motor functions, and movement to light

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A Solution-Processable, Nanostructured, and Conductive Graphene/Polyaniline Hybrid Coating for Metal-Corrosion Protection and Monitoring

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Polymorphic regenerated silk fibers assembled through bioinspired spinning

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Grazing exclusion by fencing non-linearly restored the degraded alpine grasslands on the Tibetan Plateau

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Productivity benefits of warming at regional scale could be offset by detrimental impacts on site level hydrology

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1000-Year Quasi-Periodicity of Weak Monsoon Events in Temperate Northeast Asia since the Mid-Holocene

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Spatio-temporal trends in crop damage inform recent climate-mediated expansion of a large boreal herbivore into an agro-ecosystem

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Radiological Investigation of High Background Radiation Areas

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Multipartite viruses: adaptive trick or evolutionary treat?

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Chemical and cellular oxidant production induced by naphthalene secondary organic aerosol (SOA): effect of redox-active metals and photochemical aging

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Imidacloprid and chlorpyrifos insecticides impair migratory ability in a seed-eating songbird

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CAD-FE modeling and analysis of class II restorations incorporating resin-composite, glass ionomer and glass ceramic materials

Publication date: Available online 8 November 2017
Source:Dental Materials
Author(s): Pietro Ausiello, Stefano Ciaramella, Massimo Martorelli, Antonio Lanzotti, Antonio Gloria, David C. Watts
ObjectivesTo investigate the influence of specific resin-composite, glass ceramic and glass ionomer cement (GIC) material combinations in a "multi-layer" technique to replace enamel and dentin in class II mesio-occlusal-distal (MOD) dental restorations using 3D-Finite Element Analysis (FEA).MethodsFour 3D-FE models (A–D) of teeth, adhesively restored with different filling materials, were created and analyzed in comparison with a 3D model (E) of a sound lower molar. Models A, B & C had "multilayer" constructions, consisting of three layers: adhesive, dentin replacement and enamel replacement.Model A: had a low modulus (8GPa) composite replacing dentin and a higher modulus (12GPa) composite replacing enamel.Model B: had a GI cement replacing dentin and a higher modulus (12GPa) composite replacing enamel.Model C: had a low modulus (8GPa) composite replacing dentin and a very high modulus (70GPa) inlay replacing enamel.Model D: had a lithium disilicate inlay replacing both dentin and enamel with a luting cement base-layer.Polymerization shrinkage effects were simulated and a load of 600N was applied. All the materials were assumed to behave elastically throughout the entire deformation.ResultsModel A showed the highest stress distribution along all the adhesive interfaces of the shrinking resin-based materials with a critical condition and failure risk marginally and internally. Model D, by contrast, showed a more favorable performance than either of the multilayer groups (A–C). Stress and displacement plots showed an elastic response similar to that obtained for the sound tooth model. Model B and Model C performed according to their bilayer material properties. The use of a non-shrink dentin component simulating a GIC clearly affected the shrinkage stress at the basis of the Model B; while the bulk resin composite having a 12GPa Young's modulus and linear polymerization shrinkage of 1% strongly influenced the biomechanical response in the bucco-lingual direction.SignificanceDirect resin-based composite materials applied in multilayer techniques to large class II cavities, with or without shrinking dentin layers, produced adverse FEA stress distributions and displacements. An indirect lithium disilicate inlay used to replace lost dentin and enamel in posterior restored teeth generated lower stress levels, within the limits of the elastic FEA model.



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Unilateral Vocal Fold Paralysis in Children: State-of-the-Art Treatment

Abstract

Purpose of the Review

The goal of this chapter is to present the most up-to-date options in managing unilateral vocal fold paralysis (VFP) in the pediatric population. As this condition affects multiple systems, and options are multiple, it is important to be aware of the potential risks and benefits of each possibility in order to facilitate informed decision making.

Recent Findings

The use of laryngeal electromyography in the workup of VFP has more recently been popularized as an adjunct in the diagnosis and prognosis for recovery. Moreover, advances in laryngeal reinnervation surgery show promise in the pediatric population. Finally, laryngeal pacing and the use of fibroblast growth factors are important new future directions in the field.

Summary

Management of unilateral vocal fold paralysis in children can be challenging with many treatment options available. A personalized and tailored approach to each patient is warranted.

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Unilateral Vocal Fold Paralysis in Children: State-of-the-Art Treatment

Abstract

Purpose of the Review

The goal of this chapter is to present the most up-to-date options in managing unilateral vocal fold paralysis (VFP) in the pediatric population. As this condition affects multiple systems, and options are multiple, it is important to be aware of the potential risks and benefits of each possibility in order to facilitate informed decision making.

Recent Findings

The use of laryngeal electromyography in the workup of VFP has more recently been popularized as an adjunct in the diagnosis and prognosis for recovery. Moreover, advances in laryngeal reinnervation surgery show promise in the pediatric population. Finally, laryngeal pacing and the use of fibroblast growth factors are important new future directions in the field.

Summary

Management of unilateral vocal fold paralysis in children can be challenging with many treatment options available. A personalized and tailored approach to each patient is warranted.

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Corrections

Publication date: Available online 8 November 2017
Source:The Lancet Infectious Diseases





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Subject Index Vol. 6, 2017

Eur Thyroid J 2017;6:331-332

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Contents Vol. 6, 2017

Eur Thyroid J 2017;6:I-VI

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Author Index Vol. 6, 2017

Eur Thyroid J 2017;6:328-330

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Cross-cultural adaptation and validation of the Spanish version of the Paediatric Throat Disorders Outcome Test (T-14)

Abstract

Objectives

The Paediatric Throat Disorders Outcome Test (T-14) is a disease-specific questionnaire that parents are requested to complete; it aims to assess the quality of life related to tonsil and adenoid disease or its treatment in children with throat disorders. The aim of this study was to validate the Spanish adaptation of the T-14, thus allowing comparison across studies and facilitating international multicentre projects.

Design, setting and participants

This was a multicentre prospective instrument validation study. Guidelines for the cross-cultural adaptation process from the original English-language scale into a Spanish-language version were followed. The psychometric properties (reproducibility, reliability, validity, responsiveness) of the Spanish version ("T-14-s" for "T-14-Spanish") were assessed in 50 consecutive children undergoing adeno/tonsillectomy (both before and six months after surgery) and in a separate cohort of 50 unaffected children in a comparable age range .

Main outcome measures and results

Test-retest reliability (γ = 0.83) and internal consistency reliability (α = 0.94) were adequate. The T-14-s demonstrated satisfactory construct validity (r > 0.40). The instrument showed excellent between-group discrimination (P < 0.0001) and a high responsiveness to change (effect size = 2.09).

Conclusions

The Spanish version of the T-14 (T-14-s) is a valid tool for measuring the subjective severity of throat disorders, and its use is recommended.

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Noise Induced Hearing Loss – An Examination of the Methods of Assessment in a Cross-sectional Study of 87 Industrial Workers

Abstract

Objectives

The surveillance of noise-induced hearing loss (NIHL) according to the Health & Safety Executive (HSE) differs from the medico-legal criteria used to assess NIHL. Our study compares the two systems and proposes a novel method of simplifying the medico-legal criteria and applying it to ascertain noise-induced hearing loss.

Design

The anonymised audiograms of a group of 87 industrial workers from a single site were analysed with both methods.

Results

The comparison showed approximately one-third of the workers assessed in this study had their noise-induced hearing loss underestimated by the HSE criteria. The majority of these individuals were over 40 years of age.

Conclusions

The HSE criteria for noise-induced hearing loss needs review and re-alignment with the medico-legal criteria to address the discrepancy between the two systems.

This article is protected by copyright. All rights reserved.

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