Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 28, Issue 4
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Παρασκευή 10 Νοεμβρίου 2017
Information for authors
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 28, Issue 4
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Sleep Dentists Win Big With Project Rose
Project Rose Team: Gary Baxter, Dr. Rebecca Lauck, Dr. Brandon Hedgecock, Isiah Robertson, Dr. Harry Sugg, D. Gergen, Dr. Ed Hobbs, Eric Dickerson
As a country, we have satisfaction in being American, but each community also value's their own individual cultures. The American Sleep and Breathing Academy (ASBA) wants to release an official statement of support and pride for the communities in Florida and surrounding areas as well as Houston communities effected by Hurricane Harvey and Hurricane Irma. With different disasters in different areas come different recoveries but, nevertheless, recovery is inevitable.
The resilience of the communities damaged are stunning and marvelous, but not shocking. It is especially magnificent to see Houston rally behind the Houston Astros, major league contenders for the championship of America's pastime, and NFL legend/Rose of Texas Earl Campbell's Project Rose, a project dedicated to enhancing the safety of sports and improving sleep and wellness in communities throughout the country. After the devastating hurricane, Earl Campbell and Gary Baxter wanted to focus on adding to the local economy in Houston. They are doing so by launching sleep and wellness programs in 17 hospitals/clinics throughout Houston.
The wellness program is designed with an emphasis on preventive care and a healthier lifestyle. An ounce of prevention can save a pound of problems. That's why Project Rose Wellness Program is proudly offering the next generation of innovative lab testing, food/nutrition education, mental and physical health exercises, and providing a unique approach to understanding everyone's lifestyle requirements for better health.
Strengthening the ties of communities adds to the fortitude and unity of the entire country. The American Sleep and Breathing Academy thanks everyone involved for their contribution and unwavering capacity to recover quickly from difficult times.
Call David Gergen at 602-478-9713 to see how you can become involved.
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The spillover influence of partner's education on myocardial infarction incidence and survival.
Background: Education is believed to have positive spillover effects across network connections. Partner's education may be an important resource preventing the incidence of disease and helping patients cope with illness. We examined how partner's education predicted myocardial infarction (MI) incidence and survival net of own education and other socioeconomic resources in Finland. Methods: A sample of adults aged 40-69 at baseline in Finland in 1990 was followed up for MI incidence and mortality during the period 1991-2007 (n=354,100). Results: Lower own and spousal education both contributed independently to a higher risk of MI incidence and fatality when mutually adjusted. Having a partner with basic education was particularly strongly associated with long-term fatality in women with a hazard ratio of 1.53 (95% confidence interval 1.22, 1.92) compared to women with tertiary level educated partners. There was some evidence that the incidence risk associated with basic spousal education was weaker in those with own basic education. The highest risks of MI incidence and fatality were consistently found in those without a partner, whereas the most favorable outcomes were in households where both partners had a tertiary level of education. Conclusions: Accounting for spousal education demonstrates how health-enhancing resources accumulate to some households. Marriage between people of similar educational levels may therefore contribute to the widening of educational differences in MI incidence and survival. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Validation of Cancer Cases Using Primary Care, Cancer Registry, and Hospitalization Data in the UK.
Background: In the United Kingdom, hospital or cancer registry data can be linked to electronic medical records for a subset of general practices and years. Methods: We used Clinical Practice Research Datalink data (2004-2012) from patients treated for overactive bladder. We electronically identified provisional cases of 10 common cancers in General Practitioner Online Database data and validated them by medical profile review. In practices with linkage to Hospital Episodes Statistics and National Cancer Data Repository (2004-2010), we validated provisional cancer cases against these data sources. This linkage also let us identify additional cancer diagnoses in individuals without cancer diagnosis records in the General Practitioner Online Database. Results: Among 50,840 patients, 1,486 provisional cancer cases were identified in the General Practitioner Online Database for 2004-2012. Medical profile review confirmed 93% of 661 cases in non-linked practices (range, 100% of non-Hodgkin lymphomas and uterine cancer to 77% of skin melanomas) and 96% of 825 cases in linked practices (100% of kidney and uterine cancers to 92% of melanomas). In the subset of linked practices, for 2004-2010, 720 cases were confirmed, of which 68% were identifiable in the General Practitioner Online Database (range, 90% of breast to 36% of kidney cancers). Conclusions: Most cases of cancer identified electronically in the General Practitioner Online Database were confirmed. A substantial proportion of cases, especially of cancer types not typically managed by general practitioners, would be missed without Hospital Episodes Statistics and National Cancer Data Repository data (and are likely missed in non-linked practices). Registration (before study conduct): European Union electronic Register of Post-Authorisation Studies (EU PAS Registry) number EUPAS5529, http://ift.tt/2zwWaYK This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
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Exposure to passive smoking and impairment in physical function in older people.
No abstract available
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Yorgo Foods Inc is Recalling Various Flavors of Hommus Because of Possible Health Risk
Yorgo Foods Inc of Manchester NH, is recalling select varieties of Hommus and Baba Ghannouj, because they have the potential to be contaminated with Listeria monocytogenes, an organism which can cause serious and sometimes fatal infections in young children, frail or elderly people, and others with weakened immune systems. Although healthy individuals may suffer only short-term symptoms such as high fever, severe headache, stiffness, nausea, abdominal pain and diarrhea, Listeria infection can cause miscarriages and stillbirths among pregnant women.
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Eine seltene Differentialdiagnose des supraglottischen Larynxödems
Laryngo-Rhino-Otol
DOI: 10.1055/s-0043-121343
Georg Thieme Verlag KG Stuttgart · New York
Article in Thieme eJournals:
Table of contents | Full text
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Left parasternal approach for Bentall procedure in a patient of Marfan syndrome with severe pectus excavatum
Abstract
Annuloaortic ectasia with ascending aortic aneurysm with severe aortic regurgitation with severe left ventricular dysfunction is a serious condition especially in patients with Marfan syndrome (MFS) simultaneously having severe pectus excavatum (PE) deformity. We report our left parasternal approach in such patient in whom median sternotomy was not feasible. We achieved excellent exposure of dislocated heart and great vessels enabling Bentall procedure. Since patient did not consent for combined correction of chest wall deformity, we plan to undertake it later. Therefore, we conclude that left parasternal approach is feasible for standard aortic root replacement surgery in severe PE.
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Transcatheter mitral valve replacement
Abstract
Mitral valve disease is a growing clinical problem. Surgical mitral valve repair and replacement remains the treatment of choice with excellent long-term clinical outcomes. However, a large number of symptomatic patients were deemed too high-risk undergoing surgical correction. Catheter-based technology has been in development to address this unmet need. Transcatheter mitral valve replacement devices are such technology and are currently undergoing clinical investigation. A systematic overview is being presented in the article.
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In-vitro comparison of mechanical resistance between two straight plates and a Y-plate for fixation of mandibular condyle fractures
To compare the mechanical resistance of conventional plates with a modified Y-plate in mandibular condyle fracture.
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Tailored resections in oral and oropharyngeal cancer using narrow band imaging
In a previous pilot study we observed that intra-operative narrow-band imaging (NBI) helps achieve clear superficial resection margins. The aim of this study was to verify if the use of intra-operative NBI can help to obtain tailored resections and if it is influenced by the lesion site, aspects not investigated in our previous study.
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Using simulators to teach pediatric airway procedures in an international setting
There has been a growing shift towards endoscopic management of laryngeal procedures in pediatric otolaryngology. There still appears to be a shortage of pediatric otolaryngology programs and children's hospitals worldwide where physicians can learn and practice these skills. Laryngeal simulation models have the potential to be part of the educational training of physicians who lack exposure to relatively uncommon pediatric otolaryngologic pathology.
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Hearing loss in children with primary ciliary dyskinesia
To evaluate the type and severity of hearing impairment in pediatric patients with primary ciliary dyskinesia (PCD) and relate these measures to patient demographics, treatment options, and other otologic factors.
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In-continuity neck dissection: long-term oncological outcomes in squamous cell carcinoma of the buccal mucosa
To introduce in-continuity neck dissection (ND) in squamous cell carcinoma of the buccal mucosa (BMSCC) and to determine its impact on the oncologic outcomes of these patients.
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The proposed ‘concordance-statistic for benefit’ provided a useful metric when modeling heterogeneous treatment effects
Clinical prediction models that support treatment decisions are usually evaluated for their ability to predict the risk of an outcome rather than treatment benefit – the difference between outcome risk with versus without therapy. We aimed to define performance metrics for a model's ability to predict treatment benefit.
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Dr. Harry Sugg: Supporting an Academy That Fights on Your Behalf
NFL Legend Eric Dickerson, David Gergen, Dr. Harry Sugg
When considering the political/NFL ties the American Sleep and Breathing Academy (ASBA) holds, value in being a member and advantages over non-members certainly becomes apparent. However, that isn't the only reason the ASBA has become the fastest growing academy in the field of dental sleep medicine. Under the direction of David Gergen, the academy really focuses on a multidisciplinary approach. Having worked for pioneers in orthodontics and dental sleep medicine, David understands what we as dentists treating OSA need to be successful which translates to an overall improvement on patient outcomes and industry advances. Simply putting it, we have an academy fighting on our behalf.
Since 2012, the ASBA has had representatives of the academy meet in Washington D.C. with senators, congressmen and legislatures in charge of rulemaking relating to our field. Oral appliance therapy hasn't been properly recognized as a legitimate treatment option; in my humble opinion the ASBA is about to change all of that. The medical profession has never been truly educated on oral appliance therapy and achieving level ground starts with us dentists obtaining the best possible education.
For example, in our industry we have a very disappointing situation occurring with large companies who grew off the backs of trained and established sleep dentists hiring kids right out of school with no sleep experience and providing a measly nine hours of online education and calling them experts. Our industry has been undermined enough. Dr. Elliott Alpher was first to tell me, "The ASBA is the only sleep academy fighting for the dentists' rights in the OSA arena. The efforts will become stronger as the ASBA grows. The more members we have the more firepower we'll have. I am so pleased that I have joined this academy." I urge any dentist who is interested in sleep medicine to join the ASBA like I did and stand proud.
-Dr. Harry Sugg, DDS
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Types of Health Insurance Plans
With the rising cost of medical treatment, it makes a lot of sense to have some type of health coverage, regardless of age and status in life. When shopping for health insurance, it's important to know a few important things about it first.
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Density functional study of the thermodynamic properties and phase diagram of the magnesium hydride
Publication date: March 2018
Source:Calphad, Volume 60
Author(s): Hasan S. AlMatrouk, Viorel Chihaia, Valentin Alexiev
This paper focuses primarily on the P-T phase diagram determination by considering six polymorphs of magnesium hydride (α - rutile TiO2, P42/mnm, β - cubic modified CaF2, Pa3¯, γ - orthorhombic PbO2, Pbcn, δ' - orthorhombic, Pbca and cubic - Fm3¯m). The Gibbs free energy and other thermodynamic properties were evaluated by DFT-based thermodynamic calculations, within the frame of the quasi-harmonic approximation, for the pressure range 0–10GPa and temperatures between 0 and 1200K. Furthermore, the structural, energetic, and electronic properties of the investigated structures are conversed.
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Reconciling SGTE and ab initio enthalpies of the elements
Publication date: March 2018
Source:Calphad, Volume 60
Author(s): Axel van de Walle
The CALPHAD framework is built on assumption that all phases have a well-defined free energy over all accessible composition, temperature and pressure conditions. Unfortunately, it is common for phases to exhibit mechanical instabilities in at least some range of conditions, thus precluding direct experimental measurements and hindering computational efforts. A pragmatic solution has often been to extrapolate free energies from stable region into the unstable regions, but extrapolations from different systems that share a common phase may not agree and extrapolated free energies can unintentionally lie below the free energy of stable phases. Computational approaches that aim to directly calculate the free energy of unstable phases offer a promising avenue to address these issues. Among them, the recently proposed "inflection detection" scheme lies on a strong theoretical footing. We provide further support for this approach by demonstrating that it yield free energies that agree very well with the widely used SGTE (Scientific Group Thermodata Europe) data for pure elements. This finding suggest that it may be possible to get the best of both worlds: obtain a theoretically justified definition of the free energy of mechanically unstable phases and preserve much of existing empirical standards for the assignments of such free energies.
Graphical abstract
Highlights
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Molecular characterization of virulence and antimicrobial resistance profile of Shigella species isolated from children with moderate to severe diarrhea in northeastern Brazil
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Pedro Henrique Quintela Soares de Medeiros, Aldo Ângelo Moreira Lima, Marjorie Moreira Guedes, Alexandre Havt, Mariana Duarte Bona, Luís Carlos Rey, Alberto Melo Soares, Richard Littleton Guerrant, Bernhard H. Weigl, Ila Fernanda Nunes Lima
Molecular characterization of virulence and antimicrobial resistance profiles were determined for Shigella species isolated from children with diarrhea in Fortaleza, Brazil. Fecal specimens were collected along with socioeconomic and clinical data from children with moderate to severe diarrhea requiring emergency care. Shigella spp. were isolated by standard microbiological techniques and we developed four multiplex polymerase chain reaction assays to detect 16 virulence-related genes (VRGs). Antimicrobial susceptibility tests were performed using disk diffusion assays. S. flexneri and S. sonnei were the predominant serogroups. S. flexneri was associated with low monthly incomes, more severe disease, higher number of VRGs, and presence of pic, set, and sepA genes. The SepA gene was associated with more intense abdominal pain. S. flexneri was correlated with resistance to ampicillin and chloramphenicol, while S. sonnei was associated with resistance to azithromycin. Strains harboring higher numbers of VRGs were associated with resistance to more antimicrobials. We highlight the correlation between presence of S. flexneri and sepA, and increased virulence and suggest a link to socioeconomic change in northeastern Brazil. Additionally, antimicrobial resistance was associated with serogroup-specificity in Shigella spp. and increased bacterial VRGs.
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Antibody test for Legionella pneumophila detection
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Noemí Párraga-Niño, Sara Quero, Naroa Uria, Oscar Castillo-Fernandez, Josune Jimenez, Francesc-Xavier Muñoz, Miquel Sabrià, Marian Garcia-Nuñez
Legionella pneumophila is a ubiquitous, pathogenic, bacterium responsible for Legionnaires' disease (LD). The detection of these bacteria both in environmental and clinical samples is mainly performed by culture plate method which requires up to 10 days to obtain results. Nowadays, there are commercial antibodies against this bacterium, but they have not been tested against all subgroups of L. pneumophila sg 1 or serogroups 1-16 or their cross-reactions with other non-Legionella bacteria. Indeed, many of these antibodies became available when only 8 serogroups of L. pneumophila had been described.We tested 7 antibodies and found that two (Mab 8/5 and OBT) specifically detected all the subgroups of L. pneumophila sg 1, one without cross-reactions (Mab8/5). Moreover, the LP3IIG2 antibody detected almost all serogroups tested with lower rates of cross-reactivity, resulting in a specific sensitive antibody for the detection of L. pneumophila. LP3IIG2 presented higher rate of cross-reactivity against respiratory non-Legionella isolates, thereby contraindicating its clinical applicability.
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Antimicrobial activity of plazomicin against Enterobacteriaceae producing carbapenemases from 50 Brazilian medical centers
Publication date: Available online 10 November 2017
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Andreza Faria Martins, Larissa Bail, Carmen Antonia Sanches Ito, Keite da Silva Nogueira, Tanise Vendruscolo Dalmolin, Amanda Silva Martins, Jaime Luis Lopes Rocha, Alisa W. Serio, Felipe Francisco Tuon
BackgroundPlazomicin is a next-generation aminoglycoside with activity against Enterobacteriaceae, including carbapenemase-producing Enterobacteriaceae (CPE).ObjectiveThe aim of this study was to evaluate the activity of plazomicin against CPE (Klebsiella spp., E. coli, Serratia spp., Enterobacter spp., Citrobacter spp., Morganella spp., Proteus spp., Providencia spp.) from different Brazilian hospitals.MethodsA total of 4000 carbapenem-resistant Enterobacteriaceae isolates were collected from clinical samples in 50 Brazilian hospitals during 2013–2015. Of these, 499 carbapenem-resistant isolates (CLSI criteria) were selected for further evaluation via broth microdilution to assess for the activity of plazomicin, colistin, tigecycline, meropenem, amikacin and gentamicin. Additionally, the isolates were assessed for the presence of carbapenemase genes (blaKPC, blaNDM, blaOXA-48-like, blaIMP, blaBKC, blaGES and blaVIM) by polymerase chain reaction (PCR). When PCR was positive to blaOXA-48-like, blaIMP, blaGES and blaVIM, the carbapenemase genes were sequenced.ResultsblaKPC was the most prevalent carbapenemase gene found (n=397), followed by blaNDM (n=81), blaOXA-48 (n=12) and blaIMP-1 (n=3). Other genes were identified in only one isolate each: blaBKC-1, blaGES-16, blaGES-1, blaOXA-370, blaVIM-1. One isolate had two carbapenemase genes (blaKPC and blaNDM). 33% of the isolates were non-susceptible to colistin, 24% to tigecycline, 97% to meropenem, 50% to amikacin and 82% to gentamicin (via EUCAST criteria). The plazomicin MIC50/90 was 0.5/ ≥ 64mg/L, with 84% of MICs ≤2mg/L and 87% of MICs ≤4mg/L. Elevated MICs to plazomicin were not associated with a specific carbapenemase or bacterial species.ConclusionThe MICs of plazomicin against CPE were lower than that of other aminoglycosides. Plazomicin is a promising drug for the treatment of CPE infections.
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In vitro activity of tedizolid against the Mycobacterium abscessus complex
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Fabrice Compain, Daria Soroka, Beate Heym, Jean-Louis Gaillard, Jean-Louis Herrmann, Delphine Dorchène, Michel Arthur, Vincent Dubée
Infections due to Mycobacterium abscessus carry a poor prognosis since this rapidly growing mycobacterium is intrinsically resistant to most antibiotics. Here, we evaluate the in vitro activity of the new oxazolidinone tedizolid against a collection of 44M. abscessus clinical isolates. The MIC50s and MIC90s of tedizolid (2 and 8μg/mL, respectively) were 2- to 16-fold lower than those of linezolid. There was no difference between the three M. abscessus subspecies. Time-kill assays did not show any bactericidal activity at 4- and 8-fold the MIC. Combination of tedizolid with clarithromycin was synergistic against 1 out of 6 isolates, while indifferent interactions were observed for tedizolid combined with tigecycline, ciprofloxacin, and amikacin.
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SPM-1-producing Pseudomonas aeruginosa ST277 Clone Recovered from Microbiota of Migratory Birds
Source:Diagnostic Microbiology and Infectious Disease
Author(s): Willames M.B.S. Martins, Ana Clara Narciso, Rodrigo Cayô, Stéfanie Vanessa Santos, Lorena C.C. Fehlberg, Patrícia Locosque Ramos, João Batista da Cruz, Ana Cristina Gales
The production of São Paulo Metallo-β-lactamase (SPM-1) is the most common carbapenem resistance mechanism detected among multidrug-resistant (MDR) Pseudomonas aeruginosa clinical isolates in Brazil. Dissemination of SPM-1-producing P. aeruginosa has been restricted to the nosocomial settings, with sporadic reports of environmental isolates due to contamination by hospital sewage. Herein, we described the detection and molecular characterization of SPM-1-producing P. aeruginosa recovered from the microbiota of migratory birds in Brazil. Three hundred gram-negative bacilli (GNB) were recovered from cloacal and choanal swabs of Dendrocygna viduata during a surveillance study for detection of carbapenem resistant isolates. All isolates were identified by MALDI-TOF MS. Molecular typing was performed by PFGE and MLST. MICs were determined by agar dilution, except for polymyxin B. Antibiotic resistance genes were detected by PCR followed by DNA sequencing. Transcriptional levels of oprD and efflux system encoding genes were also carried out by qRT-PCR. Nine imipenem-resistant P. aeruginosa isolates were recovered with seven of them carrying blaSPM-1. Additional resistance genes (rmtD-1, blaOXA-56,aacA4 and aac(6′)-Ib-cr) were also detected in all nine isolates. The SPM-1-producing isolates showed high MICs for all β-lactams, fluoroquinolones, and aminoglycosides, being susceptible only to polymyxin B. Interestingly, all isolates showed the same PFGE pattern and belonged to ST277. Overexpression of MexXY-OprM and MexAB-OprM was observed in those isolates that did not harbor blaSPM-1. Our results suggest that migratory birds might have played a role in the dissemination of SPM-1-producing P. aeruginosa within the Brazilian territory.
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The effect of a regimen of Antifungal cream use on episodes of acute adenolymphangitis (ADL) among lymphedema patients: An application using marginal structural models
Publication date: Available online 10 November 2017
Source:Journal of Epidemiology and Global Health
Author(s): K.E. Mues, M. Klein, D.G. Kleinbaum, W.D. Flanders, L.M. Fox
Episodes of adenolymphangitis (ADL) are a recurrent clinical aspect of lymphatic filariasis (LF) and a risk factor for progression of lymphedema. Inter-digital entry lesions, often found on the web spaces between the toes of those suffering from lymphedema, have been shown to contribute to the occurrence of ADL episodes. Use of antifungal cream on lesions is often promoted as a critical component of lymphedema management.Our objective was to estimate the observed effect of antifungal cream use on ADL episodes according to treatment regimen among a cohort of lymphedema patients enrolled in a morbidity management program. We estimated this effect using marginal structural models for time varying confounding.In this longitudinal study, we estimate that for every one-unit increase in the number of times one was compliant to cream use through 12 months, there was a 23% (RR = 0.77 (0.62, 0.96)) decrease in the number of ADL episodes at 18 months, however the RR's were not statistically significant at other study time points. Traditionally adjusted models produced a non-significant RR closer to the null at all time points.This is the first study to estimate the effect of a regimen of antifungal cream on the frequency of ADL episodes. This study also highlights the importance of the consideration and proper handling of time-varying confounders in longitudinal observational studies.
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American Sleep and Breathing Academy Members Urged to Call Their Senators
However, the bill is stalled in a committee and needs help from constituents to move it forward before Congress adjourns in December. That's why Drs. Elliott Alpher and Neal Seltzer are calling on their fellow ASBA members to take action by contacting their own Senators to ask that the bill passed out of committee. To streamline the process, please use the toolkit, which contains a sample phone script and letter to your senator. Here is a toolkit to make the outreach by phone or letter easier.
The toolkit consists of a phone script and a letter, which can be easily personalized. Members are asked to call during November to move the bill to action before the end of the year. It would be especially helpful to call Committee Members that have jurisdiction over the measure.
On October 26, 2017, Drs. Elliott Alpher and Neal Seltzer met with representatives of Senator Cory Booker (D- NJ), Senator Kirstin Gillibrand (D-NY) and Senator Debbie Stabenow (D- MI).
ASBA member Richard Klein worked behind the scenes to arrange the meeting with Stabenow who is a member of the influential budget and finance committees.
"We need to reach each member of the Senate," Dr. Neal Seltzer said." We have met with four so far. With the help of the membership, we can contact all the senators."
During their Senate meetings, Drs. Alpher and Seltzer explained the need to have a dental sleep expert appointed to the Medical Review Board. This body sets health guidelines, including the diagnosis and treatment of OSA for transportation workers. Currently there are no sleep medical experts among the five members.
The staffers were especially interested in a letter Dr. Alpher received from the FMCSA in response to his letter to Department of Transportation Secretary Elaine Chao. FMCSA Associate Administrator for Policy, Larry Minor, responded that the agency had decided the current methods of diagnosing and treating OSA among transportation workers are "adequate."
Drs. Alpher and Seltzer also volunteered to provide medical and scientific expertise to the Senators as the legislation works its way through the process.
"In all three offices, we were well received," said Dr. Alpher. "They were genuinely interested in willing to follow-through on our offers to help them gain some certainty for transportation workers."
TOOLKIT
Write A Letter
- FIND THE ADDRESS OF YOUR SENATOR HERE
- Cut and paste the letter below onto your letterhead
- REPLACE the highlighted portions
The Honorable <Full Name>
United States Senate
NUMBER BUILDING
Washington, DC <ZIP>
Dear Senator <NAME>:
My name is <Your Name> and I am one of your constituents and I live in <Your City>.
I am writing to ask for your support for the Senate Bill –– S.1883, to require the Department of Transportation to finish the rule for obstructive sleep apnea diagnosis and treatment among transportation workers.
The importance of safety for both the traveling public and the individual transportation workers cannot be overstated. It seems every day, there is a news report of another fatal accident caused by obstructive sleep apnea. But we need federal uniformity for both transportation workers and the traveling public. There's a bill that's languishing right now in committee and I ask you to support its passage. S-1883 will compel the Department of Transportation to finish the work on a rule that will provide for testing and treatment of obstructive sleep apnea among the nation's truckers and rail workers.
Without federal certainty, people are dying. The National Transportation Safety Board ruled recently that obstructive sleep apnea was to blame for two rail accidents.
Under the current guidelines transportation workers face even more confusing, contradictory and costly for the workers. The Medical Review Board, which sets the standards and trains the certified medical examiners to conduct physicals, has no dental sleep medicine or other sleep professional among its members. We need a dental sleep medical specialist appointed to that board.
There is no one trained in the diagnosis and treatment of obstructive sleep apnea on the board and none of the certified medical examiners have experience in diagnosing the disease. In fact, drivers have said they often receive different results, depending upon the examiner. Then, drivers and railway workers face paying as much as $5,000 out-of-pocket for just one expensive treatment option that offers no guarantees of success.
Right now, as many as 18 million people are living undiagnosed. Those include railway operators and truck drivers, who are at higher risk because they lead more sedentary lives and maintain less regular sleep schedules.
Obstructive sleep apnea is a killer and if you know someone who snores, pay attention. Snoring is the body's warning sign that the person is not getting sufficient oxygen and is at risk for obstructive sleep apnea. It is linked to so many life-threatening diseases such as heart attacks, strokes, high blood pressure, type 2 diabetes, depression, Alzheimer's Disease and even glaucoma. I know you would agree that anything we can do to improve the health and safety of the traveling public and transportation workers is beneficial to all.
I am asking that you call for S.1883 to be advanced in the SURFACE TRANSPORTATION AND MERCHANT MARINE INFRASTRUCTURE, SAFETY AND SECURITY subcommittee.
Thank you for your time and consideration.
Sincerely,
<YOUR NAME>
Make a Phone Call
Phone Script in Support of Senate Bill –– S.1883, to require the Department of Transportation to finish the rule for obstructive sleep apnea diagnosis and treatment among transportation workers
- Find Your Senator
- Call the Capitol Switchboard –– 202-224-3121
- Ask for Your Senator
- When the staffer answers ––
- Ask for the staff member who handles TRANSPORTATION ISSUES
What to Say
Thank you for taking my call. My name is <Your Name> and I live in <Your City>.
I am one of your constituents.
- I am calling to talk to you about the importance of safety for both the traveling public and the individual transportation workers. There's a bill that's languishing right now in committee and I ask you to support its passage. S-1883 will compel the Department of Transportation to finish the work on a rule that will provide for testing and treatment of obstructive sleep apnea among the nation's truckers and rail workers.
- Without federal certainty, people are dying. The National Transportation Safety Board ruled recently that obstructive sleep apnea was to blame for two rail accidents.
- Under the current guidelines transportation workers face even more confusing, contradictory and costly for the workers. The Medical Review Board, which sets the standards and trains the certified medical examiners to conduct physicals, has no dental sleep medicine or other sleep professional among its members. We need a dental sleep medical specialist appointed to that board.
- There is no one trained in the diagnosis and treatment of obstructive sleep apnea on the board and none of the certified medical examiners have experience in diagnosing the disease. In fact, drivers have said they often receive different results, depending upon the examiner. Then, drivers and railway workers face paying as much as $5,000 out-of-pocket for just one expensive treatment option that offers no guarantees of success.
- Right now, as many as 18 million people are living undiagnosed. Those include railway operators and truck drivers, who are at higher risk because they lead more sedentary lives and maintain less regular sleep schedules.
- I don't know whether you know, but obstructive sleep apnea is a killer and if you know someone who snores, pay attention. Snoring is the body's warning sign that the person is not getting sufficient oxygen and is at risk for obstructive sleep apnea.
- It is linked to so many life-threatening diseases such as heart attacks, strokes, high blood pressure, type 2 diabetes, depression, Alzheimer's Disease and even glaucoma. I know you would agree that anything we
- I am asking that you call for S.1883 to be advanced in the SURFACE TRANSPORTATION AND MERCHANT MARINE INFRASTRUCTURE, SAFETY AND SECURITY subcommittee, where it is stuck.
Thank you for your time and consideration.
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The use of an electronic clinical rule to discontinue chronically used benzodiazepines and related Z drugs
Abstract
Purpose
The chronic use of benzodiazepines and benzodiazepine-related drugs (BZ/Z) in older people is common and not without risks. The objective of this study was to evaluate whether the implementation of a clinical rule promotes the discontinuation of chronically used BZ/Z for insomnia.
Methods
A clinical rule, generating an alert in case of chronic BZ/Z use, was created and applied to the nursing home (NH) setting. The clinical rule was a one-off intervention, and alerts did not occur over time. Reports of the generated alerts were digitally sent to NH physicians with the advice to phase out and eventually stop the BZ/Z. In cases where the advice was adopted, a follow-up period of 4 months on the use of BZ/Z was taken into account in order to determine whether the clinical rule alert led to a successful discontinuation of BZ/Z.
Results
In all, 808 NH patients were screened. In 161 (19.1%) of the patients, BZ/Z use resulted in a clinical rule alert. From these, the advice to phase out and stop the BZ/Z was adopted for 27 patients (16.8%). Reasons for not following the advice consisted of an unsuccessful attempt in the past (38 patients), patients family and/or patient resistance (37 patients), the non-continuous use of BZ/Z (32 patients) and indication still present (27 patients). Of the 12 NH physicians, seven adopted the advice.
Conclusions
The success rate of a clinical rule for discontinuation of chronically used BZ/Z for insomnia was low, as reported in the present study. Actions should be taken to help caregivers, patients and family members understand the importance of limiting BZ/Z use to achieve higher discontinuation rates.
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Rotten teeth extractions reveal growth in child poverty, dentists say
Ministry of Health data shows the percentage of Kiwi 5-year-olds found to have rotten teeth at community dental clinics decreased from 49 per cent in 2001 to 40 per cent in 2016. During the same period, children aged 0 to 14 years old requiring general anaesthetic for rotten teeth removal increased from 4500 to 7500 , according to ministry data.
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Closing a Diastema – With Bioclear Matrices
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Knockdown of LncRNA ANRIL suppresses cell proliferation, metastasis, and invasion via regulating miR-122-5p expression in hepatocellular carcinoma
Abstract
Objective
Previous studies reported that lncRNA antisense non-coding RNA in the INK4 locus (ANRIL) was upregulated in hepatocellular carcinoma (HCC) tissues and decreased expression of ANRIL could suppress cell proliferation, metastasis, and invasion and induce apoptosis of HCC cells. However, the molecular mechanism of ANRIL involved in HCC tumorigenesis is still unknown.
Methods
The expressions of ANRIL and miR-122-5p in HCC tissues and cells were quantified by qRT-PCR. MTT assay, colony formation assay, wound healing assay, and transwell invasion assay were performed to evaluate cell growth, metastasis, and invasion, respectively. RNA immunoprecipitation (RIP) assay and luciferase reporter assay were performed to determine whether ANRIL could directly bind to miR-122-5p in HCC cells. Xenograft tumor experiment was conducted to confirm the biological role and underlying mechanism of ANRIL in vivo.
Results
The results showed that ANRIL was upregulated and miR-122-5p was downregulated in HCC tissues and cells. ANRIL was negatively correlated with miR-122-5p expression in HCC tissues. Knockdown of ANRIL or miR-122-5p overexpression suppressed HCC cell viability, colony formation ability, metastasis, and invasion. ANRIL was demonstrated to directly bind to miR-122-5p and inhibit its expression. Forced expression of ANRIL abolished the inhibitory effect of miR-122-5p overexpression on HCC progression. In vivo experiment demonstrated that ANRIL knockdown impeded tumor growth in vivo and increased miR-122-5p expression.
Conclusion
Our finding suggested that knockdown of ANRIL suppressed cell proliferation, metastasis and invasion via regulating miR-122-5p expression in HCC, illustrating the underlying mechanism of the oncogenic role of ANRIL in HCC.
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Vocal fold augmentation under local anesthesia using autologous fascia
Abstract
Vocal fold augmentation by injection of autologous fascia has been used since the 1990s with excellent safety record in 500 operations done under general anaesthesia. It is safe from risks arising from allergic or other foreign body adverse reactions. Fascia provides long-term augmentation and remains stable 3-10 years after injection.
Vocal fold augmentation under local anaesthesia is excellent alternative for those unfit for general anaesthesia, providing aid to fragile and weak persons with vocal fold paralysis. However, all of available synthetic materials resorb within 6-24 months.
Fascia injection under local anaesthesia provides the possibility for a long-term vocal fold medialization while avoiding risk of general anaesthesia. Fascia lata harvesting and processing is easily done (as shown in video) followed by injection into the vocal fold. The whole procedure is done under local anaesthesia. Procedure offers long-term vocal fold medialization, fine tuning the amount of the medialization by immediate feedback from the patient's voice. Operation time is one hour.
This article is protected by copyright. All rights reserved.
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Antı-β2 Glycoprotein I Antibodies in Children with Rheumatologic Disorders
Abstract
Anti-beta-2-glycoprotein I antibodies (anti-β2GPI) which are the main antiphospholipid antibodies that characterize the autoimmune "antiphospholipid syndrome" are pathogenic and are contributing to thrombosis. We aimed to evaluate the presence and the diagnostic importance of these antibodies in children with different rheumatologic diseases with or without thrombosis risk. A total of 100 children with different rheumatologic diseases evaluated retrospectively. The mean anti-β2GPI IgG (p = 0.108), IgA (p = 0.547), and IgM (p = 0.807) levels showed no statistically significant difference between different diagnosis groups. But anti-β2GPI IgA and IgM levels were higher in SLE patient group. The mean anti-β2GPI IgG (p = 0.375), IgA (p = 0.811), and IgM (p = 0.276) levels were not also showed difference between disease groups with/without predisposition to thrombosis even though concentrations were higher in thrombosis group. In children with rheumatological complaints, anti-β2GPI antibody measurements should not be the first diagnostic criteria if vasculitis is not thought as the primary defect underlying the clinical symptoms.
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Tailored resections in oral and oropharyngeal cancer using narrow band imaging
Source:American Journal of Otolaryngology
Author(s): Giancarlo Tirelli, Marco Piovesana, Alberto Vito Marcuzzo, Annalisa Gatto, Matteo Biasotto, Rossana Bussani, Lorenzo Zandonà, Fabiola Giudici, Francesca Boscolo Nata
PurposeIn a previous pilot study we observed that intra-operative narrow-band imaging (NBI) helps achieve clear superficial resection margins. The aim of this study was to verify if the use of intra-operative NBI can help to obtain tailored resections and if it is influenced by the lesion site, aspects not investigated in our previous study.Materials and methodsThe resection margins of 39 oral and 22 oropharyngeal squamous cell carcinomas were first set at 1.5cm from the macroscopic lesion boundary (white light, WL, tattoo). Then, the superficial tumor extension was more precisely defined with NBI, giving rise to three possible situations: NBI tattoo larger than the WL tattoo, NBI tattoo coinciding with the WL tattoo, or NBI tattoo smaller than the WL tattoo. For each of these situations the space comprised between the NBI and WL tattoos was defined "NBI positive", "NBI null", and "NBI negative", respectively. Resections were performed following the outer tattoo. The number of clear superficial resection margins, and the pathological response on the "NBI-positive" and the "NBI-negative" areas were recorded.ResultsWe obtained 80.3% negative superficial resection margins. NBI provided a more precise definition of superficial tumor extension in 43 patients. Sensitivity, specificity, positive and negative predictive values were 94.4%, 64%, 79.1% and 88.9%, respectively; a test of proportions demonstrated they were not influenced by tumor site.ConclusionsNBI could allow for real-time definition of superficial tumor extension with possible tailored resections and fewer positive superficial resection margins; it is not influenced by tumor site.
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Reconstruction of preauricular soft tissue defects using a superiorly based rotation advancement scalp flap - A novel approach to the surgical treatment of preauricular sinuses
Source:American Journal of Otolaryngology
Author(s): Bernard Tan, Lee Tee Sin, Ian Loh
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Prevalence of Diabetes Mellitus in People Clinically Diagnosed with Periodontitis: A Systematic Review and Meta-analysis of Epidemiologic Studies
Abstract
Objectives
Diabetes mellitus and periodontitis are complex chronic diseases with an established bidirectional relationship. This systematic review evaluated in subjects with professionally diagnosed periodontitis the prevalence and odds of having diabetes.
Methods
The MEDLINE-PubMed, CENTRAL and EMBASE databases were searched. Prevalence of diabetes mellitus among subjects with periodontitis were extracted or if possible calculated.
Results
From the 803 titles and abstracts that came out of the search, 29papers met the initial criteria.
Prevalence of diabetes was 9.4% among subjects with periodontitis and 12.8%among subjects without periodontitis. Based on sub-analysis, for subjects with periodontitis, the prevalence of diabetes was 6.5%when diabetes was self-reported, compared to 17.3%when diabetes was clinically assessed. The highest prevalence of diabetes among subjects with periodontitis was observed in studies originating from Asian countries(17.2%,n=16647) and the lowest in studies describing populations from Europe(4.3%(n=7858). The overall odds ratio for diabetes patients to be among subjects with periodontitis as compared to those without periodontitis was 2.59(95%CI[2.12;3.15]). A substantial variability in the definitions of periodontitis, combination of self-reported and clinically assessed diabetes, lack of confounding for diabetes control in included studies introduces estimation bias.
Conclusions
The overall prevalence and odds of having diabetes is higher within periodontitis populations compared to people without periodontitis. Self-reported diabetes underestimates the prevalence when compared to this condition assessed clinically. Geographical differences were observed: the highest diabetes prevalence among subjects with periodontitis was observed in studies conducted in Asia and the lowest in studies originating from Europe.
This article is protected by copyright. All rights reserved.
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New dental office opens in Carolina Forest
Ocean Bay Dental Care in Carolina Forest, a full-service family dental practice, is set to open on Nov. 30 in its new building on International Drive. The dental clinic will be operated by dentists Jesse Blair and John Steppe, and staffed to perform routine cleanings and fillings as well as cosmetic services, said a statement announcing the opening.
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Mini-implants and narrow diameter implants as mandibular overdenture retainers: A systematic review and meta-analysis of clinical and radiographic outcomes
Summary
This study reviews the clinical and radiographic outcomes of Mini-implants (MI) and Narrow Diameter Implants (NDI) as mandibular overdenture (MO) retainers. Six databases were consulted for clinical studies that evaluated implants with diameter ≤ 3.5 mm. Data on the MI and NDI for survival and success rate and peri-implant bone loss and were collected and submitted to meta-analysis. Thirty-six studies were included, 24 reporting MI performance and 12 describing NDI results. The MI group comprised data from 1 cross-sectional clinical study, 3 retrospective longitudinal (RL) clinical studies, 13 prospective longitudinal (PL) clinical studies and 7 randomized clinical trials (RCT) with follow-up periods ranging from 1 day to 7 years. Eight studies used conventional loading, thirteen used immediate loading, two studies used both loading types and one study did not report. The NDI group comprised data from 3 RL clinical studies, 6 PL clinical studies and 3 RCT with follow-up ranging from 6 months to 10 years. Ten studies used conventional loading, 1 study used immediate loading and 1 study did not report. The average survival rates of MI and NDI studies were 98% and 98%, respectively, while the average success rates were 93% and 96%, respectively. The average peri-implant bone loss after 12, 24, and 36 months was 0.89, 1.18, and 1.02 mm for MI and 0.18, 0.12, and -0.32 mm for NDI. Both MI and NDI showed adequate clinical behavior as overdenture retainers. The NDI showed a better long-term predictability to retain OM with most studies adopting conventional loading.
This article is protected by copyright. All rights reserved.
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Regeneration dynamics of mixed stands of Pinus pinaster Ait. and Pinus pinea L. in Central Spain
Abstract
The dynamics of mixed stands are more complex and less studied than those of monospecific stands. The objective of this work was to analyze the variables involved in seedling occurrence and seedling survival in mixed stands of Pinus pinaster and P. pinea in Mediterranean areas. From 2011 to 2016, regeneration of both species was monitored at two sites located in Central Spain. We installed 72 regeneration plots where seedling dynamics were monitored. All the trees in the study areas were measured and mapped. Additionally, we took hemispherical photographs in each regeneration plot. The average density of P. pinea seedlings over the study period was almost 20 times larger than that of P. pinaster. Our results indicate that the seedlings of both species grow under moderate light conditions. In addition, we found that the occurrence of seedlings of both species was related to the structure of the stand. P. pinea seedlings grew where the density and size of P. pinaster trees were low and where P. pinea trees provided moderately sheltered conditions, whereas the number of P. pinaster seedlings was related to under intermediate densities of P. pinaster trees. Furthermore, seedling survival was positively associated with age of the seedlings and negatively with the August average maximum temperature. The temporal continuity of mixed stands of P. pinea and P. pinaster in the study area is compromised by the observed lack of regeneration of P. pinaster.
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Tenosynovitis caused by Mycobacterium malmoense in two kidney transplant recipients and review of the literature
Abstract
We report two unrelated cases of tenosynovitis caused by Mycobacterium malmoense in kidney transplant recipients. Both patients received immunosuppression and were referred to our tertiary hospital because of persisting complaints lasting >6 months not responding to corticosteroids or surgery. The mycobacterial cultures were positive for the slow-growing M. malmoense after several weeks of incubation. The patient in Case 1 was treated with a combination of surgical debridement and antibiotics, whereas the patient in Case 2 was only treated surgically. Both cases illustrate the doctor's delay in diagnosing mycobacterial infections, and remind us that nontuberculous mycobacterial infections should be part of the differential diagnosis of tenosynovitis, especially in immunocompromised patients.
This article is protected by copyright. All rights reserved.
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Use of a hepatitis C virus (HCV) RNA-positive donor in a treated HCV RNA-negative liver transplant recipient
Abstract
The shortage of livers has led most transplant centers to use extended criteria donors. Hepatitis C virus (HCV) RNA-positive donors are typically not given to patients who have cleared HCV. A 64-year-old male with chronic hepatitis C, genotype 1b was listed for LT with hepatocellular carcinoma. While on the waiting list, the patient was treated with sofosbuvir, ledipasvir, and ribavirin and achieved an HCV RNA <15 IU/mL by week 10. At week 18 of a planned 24-week treatment course, the patient underwent deceased-donor LT and received an organ from an anti-HCV-positive donor. Treatment was stopped at LT. At week 3 post LT, HCV RNA was detectable and revealed a genotype 3 HCV infection, compatible with transplantation of an organ with established infection. With retreatment with sofosbuvir, daclatasvir, and ribavirin for 12 weeks, the patient achieved a sustained virologic response. This report highlights how antiviral therapies can be used to optimize the outcomes of HCV-infected transplant patients.
This article is protected by copyright. All rights reserved.
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Vox Populi, Vox Dei (The Voice of the People is the Voice of God)
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Letters From Our Readers.
Letters From Our Readers.
Angle Orthod. 2017 Nov;87(6):925
Authors: Hu X, Xu J
PMID: 29120244 [PubMed - in process]
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Letters From Our Readers.
Letters From Our Readers.
Angle Orthod. 2017 Nov;87(6):926
Authors: Koerich L, Lindauer SJ, Weissheimer A
PMID: 29120243 [PubMed - in process]
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EHASO: Lessons for the Future.
EHASO: Lessons for the Future.
Angle Orthod. 2017 Nov;87(6):924
Authors: Conley RS
PMID: 29120242 [PubMed - in process]
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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.
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.
J Oral Pathol Med. 2017 Nov 09;:
Authors: Greer RO, Eskendri J, Freedman P, Ahmadian M, Murakami-Walter A, Varella-Garcia M
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. This article is protected by copyright. All rights reserved.
PMID: 29121421 [PubMed - as supplied by publisher]
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Fear of evaluation unpacked: day-to-day correlates of fear of negative and positive evaluation
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NRP2 and CD63 Are Host Factors for Lujo Virus Cell Entry.
NRP2 and CD63 Are Host Factors for Lujo Virus Cell Entry.
Cell Host Microbe. 2017 Nov 08;22(5):688-696.e5
Authors: Raaben M, Jae LT, Herbert AS, Kuehne AI, Stubbs SH, Chou YY, Blomen VA, Kirchhausen T, Dye JM, Brummelkamp TR, Whelan SP
Abstract
Arenaviruses cause fatal hemorrhagic disease in humans. Old World arenavirus glycoproteins (GPs) mainly engage α-dystroglycan as a cell-surface receptor, while New World arenaviruses hijack transferrin receptor. However, the Lujo virus (LUJV) GP does not cluster with New or Old World arenaviruses. Using a recombinant vesicular stomatitis virus containing LUJV GP as its sole attachment and fusion protein (VSV-LUJV), we demonstrate that infection is independent of known arenavirus receptor genes. A genome-wide haploid genetic screen identified the transmembrane protein neuropilin 2 (NRP2) and tetraspanin CD63 as factors for LUJV GP-mediated infection. LUJV GP binds the N-terminal domain of NRP2, while CD63 stimulates pH-activated LUJV GP-mediated membrane fusion. Overexpression of NRP2 or its N-terminal domain enhances VSV-LUJV infection, and cells lacking NRP2 are deficient in wild-type LUJV infection. These findings uncover this distinct set of host cell entry factors in LUJV infection and are attractive focus points for therapeutic intervention.
PMID: 29120745 [PubMed - in process]
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Hygiene practices in removable prosthodontics: A systematic review.
Hygiene practices in removable prosthodontics: A systematic review.
Int J Dent Hyg. 2017 Nov 09;:
Authors: Papadiochou S, Polyzois G
Abstract
OBJECTIVE: To systematically review the recent scientific evidence about the hygiene practices of removable prostheses relative to the effectiveness, colour and dimensional stability. This review aimed also to identify patients' attitudes and habits towards denture hygiene.
METHODS: Three electronic databases (MEDLINE/PubMed, Scopus and Cochrane Library) were screened, in English language, between January 1995 and December 2016. A supplementary hand search in the reference list of the identified articles was also performed. Controlled clinical trials (CCTs) involving patients with no clinical signs of denture stomatitis along with a comprehensive aim to assess the effectiveness of hygiene interventions and their impact on prosthesis colour and dimensional stability were eligible for inclusion.
RESULTS: Following a thorough screening of titles/abstracts/full texts and consideration of the defined inclusion criteria, 21 CCTs examined the effectiveness of the hygiene approaches, 3 evaluated the colour stability of dentures subjected to hygiene practices, 2 examined the dimensional stability of dentures following microwave disinfection and 30 studies registered patients' attitudes and habits towards denture hygiene.
CONCLUSIONS: Combined application of different hygiene interventions, including brushing or ultrasound vibration in conjunction with chemical agents, leads to more effective outcomes (reduction in denture biofilm percentage and/or number of microorganisms' colony-forming units). The dimensional stability seems to be unaltered, but the number of clinical trials was limited. Critical concentrations of cleansing solutions along with the duration of their implementation influence the serviceability of dentures regarding colour stability. Brushing represents the most commonly applied hygiene practice, while denture wearers' attitudes are not complied with the recommended guidelines considering the reported frequency of hygiene practices and the continuous denture wear.
PMID: 29120113 [PubMed - as supplied by publisher]
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Comparative Study of Fusogenic Activity of H1 and H5 Subtypes Influenza Virus Hemagglutinins.
| Related Articles |
Comparative Study of Fusogenic Activity of H1 and H5 Subtypes Influenza Virus Hemagglutinins.
Bull Exp Biol Med. 2017 Nov 09;:
Authors: Kononova AA, Cheresiz SV, Chechushkov AV, Razumova YV, Pokrovskii AG
Abstract
Influenza virus hemagglutinins are surface proteins responsible for fusion of the viral and cellular membranes. Their capacity to mediate membrane fusion (fusogenic activity) is studied by various methods, including the syncytium formation and pseudovirus transduction methods. We constructed plasmids coding for genes of three H1 and one H5 hemagglutinins and compared their fusogenic activities. Hemagglutinin capacity to induce syncytium formation did not always correlate with the transduction activity of the respective pseudoviruses. Hemagglutinin H5 exhibited high fusogenic activity in studies by both methods, however, two of the studied H1 hemagglutinins induced the formation of syncytia, but did not mediate pseudovirus transduction. This could be due to different capsid sizes of influenza virus and vesicular stomatitis virus, which determines their different permeability through the fusion pore.
PMID: 29119400 [PubMed - as supplied by publisher]
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Contribution of oxidative stress in acute intestinal mucositis induced by 5 fluorouracil (5-FU) and its pro-drug capecitabine in rats.
| Related Articles |
Contribution of oxidative stress in acute intestinal mucositis induced by 5 fluorouracil (5-FU) and its pro-drug capecitabine in rats.
Toxicol Mech Methods. 2017 Nov 08;:1-24
Authors: Rtibi K, Selmi S, Grami D, Amri M, Sebai H, Marzouki L
Abstract
This study was designed to examine the contribution of oxidative stress in gastrointestinal disorders after an intraperitoneal administration of 5-FU (100mg/kg b.w.) and capecitabine oral administration (500mg/kg b.w.). The animals were divided into three groups: Group A (NaCl, 10ml/kg b.w.) considered as control group, group B was intoxicated by 5-FU and the group of animals (group C) treated with capecitabine (CAP). To evaluate the secretory and enteropooling effects, we were used as a hypersecretion agent (MgSO4, 1ml/100g b.w.). The mucosal gastro-intestinal specimens were scraped and examined for biological markers of oxidative stress and intracellular mediators. These anticancer drugs caused many intestinal damages manifested by an elevation of fluid accumulation and imbalance in electrolytes secretion. Also, the intestinal tissues from treated rats showed a significant increase in malondialdehyde (MDA), protein carbonylation and H2O2 production. However, a significant depletion of enzymatic and non-enzymatic antioxidant, such as, glutathione peroxidase (GPx), superoxide dismutase (SOD), catalase (CAT) and sulfhydryl groups (-SH). These effects were related with histopatological damage and a perturbation of intracellular mediators. As expected, these disturbances were observed in the group of rats poisoned by the MgSO4. Data suggest the contribution of oxidative stress in chemotherapy-induced many disorders in intestinal tract.
PMID: 29117755 [PubMed - as supplied by publisher]
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Probiotic Lactobacillus rhamnosus GG prevents alveolar bone loss in a mouse model of experimental periodontitis.
Probiotic Lactobacillus rhamnosus GG prevents alveolar bone loss in a mouse model of experimental periodontitis.
J Clin Periodontol. 2017 Nov 09;:
Authors: Gatej SM, Marino V, Bright R, Fitzsimmons TR, Gully N, Zilm P, Gibson RJ, Edwards S, Bartold PM
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. This article is protected by copyright. All rights reserved.
PMID: 29121411 [PubMed - as supplied by publisher]
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Adaptive intelligent cascade control of a ball-riding robot for optimal balancing and station-keeping
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Associations between maternal lifestyle factors and neonatal body composition in the Screening for Pregnancy Endpoints (Cork) cohort study
Abstract
Background
Neonatal body composition likely mediates fetal influences on life long chronic disease risk. A better understanding of how maternal lifestyle is related to newborn body composition could thus inform intervention efforts. Methods
Using Cork participant data (n = 1754) from the Screening for Pregnancy Endpoints (SCOPE) cohort study [ECM5(10)05/02/08], we estimated how pre-pregnancy body size, gestational weight gain, exercise, alcohol, smoking and diet were related to neonatal fat and fat-free mass, as well as length and gestational age at birth, using quantile regression. Maternal factors were measured by a trained research midwife at 15 gestational weeks, in addition to a 3rd trimester weight measurement used to calculate weight gain. Infant body composition was measured using air-displacement plethysmography. Results
Healthy (versus excess) gestational weight gain was associated with lower median fat-free mass [−112 g, 95% confidence interval (CI): −47 to −176) and fat mass (−33 g, 95% CI: −1 to −65) in the offspring; and a 103 g decrease in the 95th centile of fat mass (95% CI: −33 to −174). Maternal normal weight status (versus obesity) was associated with lower median fat mass (−48 g, 95% CI: −12 to −84). At the highest centiles, fat mass was lower among infants of women who engaged in frequent moderate-intensity exercise early in the pregnancy (−92 g at the 95th centile, 95% CI: −168 to −16). Lastly, women who never smoked tended to have longer babies with more fat mass and fat-free mass. No other lifestyle factors were strongly related to infant body composition. Conclusions
These results suggest that supporting healthy maternal lifestyles could reduce the risk of excess fat accumulation in the offspring, without adversely affecting fat-free mass development, length or gestational age.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2zv8qZD
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A two-step method for variable selection in the analysis of a case-cohort study
Abstract
Background
Accurate detection and estimation of true exposure-outcome associations is important in aetiological analysis; when there are multiple potential exposure variables of interest, methods for detecting the subset of variables most likely to have true associations with the outcome of interest are required. Case-cohort studies often collect data on a large number of variables which have not been measured in the entire cohort (e.g. panels of biomarkers). There is a lack of guidance on methods for variable selection in case-cohort studies. Methods
We describe and explore the application of three variable selection methods to data from a case-cohort study. These are: (i) selecting variables based on their level of significance in univariable (i.e. one-at-a-time) Prentice-weighted Cox regression models; (ii) stepwise selection applied to Prentice-weighted Cox regression; and (iii) a two-step method which applies a Bayesian variable selection algorithm to obtain posterior probabilities of selection for each variable using multivariable logistic regression followed by effect estimation using Prentice-weighted Cox regression. Results
Across nine different simulation scenarios, the two-step method demonstrated higher sensitivity and lower false discovery rate than the one-at-a-time and stepwise methods. In an application of the methods to data from the EPIC-InterAct case-cohort study, the two-step method identified an additional two fatty acids as being associated with incident type 2 diabetes, compared with the one-at-a-time and stepwise methods. Conclusions
The two-step method enables more powerful and accurate detection of exposure-outcome associations in case-cohort studies. An R package is available to enable researchers to apply this method.from ! ORL Sfakianakis via paythelady.61 on Inoreader http://ift.tt/2hkG7D5
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Additive Manufacturing: A Comparative Analysis of Dimensional Accuracy and Skin Texture Reproduction of Auricular Prostheses Replicas
Abstract
Purpose
The use of computer-aided design/computer-aided manufacturing (CAD/CAM) and additive manufacturing in maxillofacial prosthetics has been widely acknowledged. Rapid prototyping can be considered for manufacturing of auricular prostheses. Therefore, so-called prostheses replicas can be fabricated by digital means. The objective of this study was to identify a superior additive manufacturing method to fabricate auricular prosthesis replicas (APRs) within a digital workflow.
Materials and Methods
Auricles of 23 healthy subjects (mean age of 37.8 years) were measured in vivo with respect to an anthropometrical protocol. Landmarks were volumized with fiducial balls for 3D scanning using a handheld structured light scanner. The 3D CAD dataset was postprocessed, and the same anthropometrical measurements were made in the CAD software with the digital lineal. Each CAD dataset was materialized using fused deposition modeling (FDM), selective laser sintering (SLS), and stereolithography (SL), constituting 53 APR samples. All distances between the landmarks were measured on the APRs. After the determination of the measurement error within the five data groups (in vivo, CAD, FDM, SLS, and SL), the mean values were compared using matched pairs method. To this, the in vivo and CAD dataset were set as references. Finally, the surface structure of the APRs was qualitatively evaluated with stereomicroscopy and profilometry to ascertain the level of skin detail reproduction.
Results
The anthropometrical approach showed drawbacks in measuring the protrusion of the ear's helix. The measurement error within all groups of measurements was calculated between 0.20 and 0.28 mm, implying a high reproducibility. The lowest mean differences of 53 produced APRs were found in FDM (0.43%) followed by SLS (0.54%) and SL (0.59%)––compared to in vivo, and again in FDM (0.20%) followed by SL (0.36%) and SLS (0.39%)––compared to CAD. None of these values exceed the threshold of clinical relevance (1.5%); however, the qualitative evaluation revealed slight shortcomings in skin reproduction for all methods: reproduction of skin details exceeding 0.192 mm in depth was feasible.
Conclusion
FDM showed the superior dimensional accuracy and best skin surface reproduction. Moreover, digital acquisition and CAD postprocessing seem to play a more important role in the outcome than the additive manufacturing method used.
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Fear of evaluation unpacked: day-to-day correlates of fear of negative and positive evaluation
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A Simple Method for Quantification of Five Urinary Porphyrins, Porphobilinogen and 5-Aminolevulinic Acid, Using Liquid Chromatography Tandem Mass Spectrometry
Abstract
Analysis of porphyrins and 5-aminolevulinic acid (ALA), porphobilinogen (PBG) in physiological liquids is required for diagnosis and follow-up of porphyrias. High performance liquid chromatography (HPLC) and liquid chromatography tandem mass spectrometry (LC–MS) methods with higher specificity and sensitivity have been developed. The major disadvantage of those methods is that they require longer extraction times due to their matrix effects. The present study suggests a simple, fast, sensitive, and specific assay for determination of Coproporphyrin, 5-carboxylporphyrin, 6-carboxylporphyrin, 7-carboxylporphyrin, Uroporphyrin I and ALA, PBG in urine sample by direct injection without sample pre-treatment using LC–MS. For the purposes of the present study LC–MS device was set to multiple reaction monitoring (MRM) and positive ion mode. Porphyrins and ALA, porphobilinogen were characterized by their MS/MS product ion, spectra. ALA, PBG and 5 porphyrins were detected simultaneously. Limit of detection for Coproporphyrin, 5-carboxylporphyrin, 6-carboxylporphyrin, 7-carboxylporphyrin, Uroporphyrin I were 2 nmol/L, where it was 5 μmol/L for ALA and 2 μmol/L for porphobilinogen. The present study suggests that the present method is very effective compared to many other available methods for it does not require pre-treatment, provides simultaneous results of ALA, PBG and 5 porphyrins quantitatively in a shorter span of time, and has suitable sensitivity and selectivity. LC–MS technique was used clinically for the determination of urine porphyrin levels.
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High occurrence of osteoarthritic histopathological features unaccounted for by traditional scoring systems in lateral femoral condyles from total knee arthroplasty patients with varus alignment
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Local dentist offering free dental care for vets
Calderon-Melendez is fourth generation military man and the patriarch of a family of five, but like many veterans, he can't get dental coverage through the Department of Veterans Affairs. "To get a cleaning, even with three insurances, it's an outrageous expense and not everyone qualifies," said Calderon-Melendez.
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Hearing Preservation Cochlear Implantation: a Review of Audiologic Benefits, Surgical Success Rates, and Variables That Impact Success
Abstract
Purpose of Review
The objectives of this review are as follows: (1) examine the audiologic benefits of hearing preservation, (2) review rates of successful hearing preservation, and (3) analyze variables that impact hearing preservation success.
Recent Findings
Hearing preservation has been shown to confer the following audiologic benefits: better speech understanding in complex listening environments, superior sound localization, and improved music appreciation. There is a notable lack of standardized criteria for reporting of hearing preservation outcomes—this leads to considerable heterogeneity across studies. Rates of functional (i.e., aidable) hearing preservation generally range between 50 and 90%. Studies demonstrate higher preservation rates and more durable hearing outcomes with shorter, straight electrode arrays.
Summary
With advances in CI technology and surgical techniques, residual hearing can be preserved after CI surgery in the majority of patients. Cochlear implant recipients with preserved hearing demonstrate better speech understanding, sound localization, and improved music appreciation.
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Safety, pharmacokinetics and pharmacodynamics of single rising doses of BI 655064, an antagonistic anti-CD40 antibody in healthy subjects: a potential novel treatment for autoimmune diseases
Abstract
Purpose
The CD40–CD40L pathway is a promising treatment target for autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus and lupus nephritis. The safety, pharmacokinetics and pharmacodynamics of BI 655064, a novel humanised antagonistic anti-CD40 monoclonal antibody, were investigated in this first-in-human trial.
Methods
Healthy male subjects (n = 72) were randomised 3:1, within each BI 655064 dose group, to single intravenous (IV; 0.2–120 mg) or subcutaneous (SC; 40–120 mg) doses of BI 655064 or placebo. Safety, plasma exposure, CD40 receptor occupancy and CD40L-induced CD54 upregulation were assessed over 12 weeks.
Results
Adverse events (AEs) were reported in 43% of subjects (n = 31). Frequency and intensity of AEs were generally similar between BI 655064 and placebo and showed no dose relationship. The most frequent AEs were headache and nasopharyngitis. One mild rash and one local reaction occurred with SC BI 655064; two serious AEs were reported, both judged unrelated to BI 655064. Pharmacokinetic evaluation demonstrated a more than proportional increase in plasma exposure relative to BI 655064 dose, with a terminal half-life between 4 h and 4 days IV and approximately 5 days SC; doses ≥ 20 mg IV and 120 mg SC showed > 90% CD40 receptor occupancy and inhibition of CD54 upregulation, which lasted 7 days in the 120 mg IV and SC groups.
Conclusions
Single doses up to 120 mg BI 655064 IV and SC were well tolerated and showed a high potential to block the CD40–CD40L pathway, supporting further clinical development of BI 655064 in patients with autoimmune disease.
Trial registration
ClinicalTrials.gov Identifier: NCT01510782
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Hearing Preservation Cochlear Implantation: a Review of Audiologic Benefits, Surgical Success Rates, and Variables That Impact Success
Abstract
Purpose of Review
The objectives of this review are as follows: (1) examine the audiologic benefits of hearing preservation, (2) review rates of successful hearing preservation, and (3) analyze variables that impact hearing preservation success.
Recent Findings
Hearing preservation has been shown to confer the following audiologic benefits: better speech understanding in complex listening environments, superior sound localization, and improved music appreciation. There is a notable lack of standardized criteria for reporting of hearing preservation outcomes—this leads to considerable heterogeneity across studies. Rates of functional (i.e., aidable) hearing preservation generally range between 50 and 90%. Studies demonstrate higher preservation rates and more durable hearing outcomes with shorter, straight electrode arrays.
Summary
With advances in CI technology and surgical techniques, residual hearing can be preserved after CI surgery in the majority of patients. Cochlear implant recipients with preserved hearing demonstrate better speech understanding, sound localization, and improved music appreciation.
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Identification of 16q21 as a modifier of nonsyndromic orofacial cleft phenotypes
ABSTRACT
Orofacial clefts (OFCs) are common, complex birth defects with extremely heterogeneous phenotypic presentations. Two common subtypes—cleft lip alone (CL) and CL plus cleft palate (CLP)—are typically grouped into a single phenotype for genetic analysis (i.e., CL with or without cleft palate, CL/P). However, mounting evidence suggests there may be unique underlying pathophysiology and/or genetic modifiers influencing expression of these two phenotypes. To this end, we performed a genome-wide scan for genetic modifiers by directly comparing 450 CL cases with 1,692 CLP cases from 18 recruitment sites across 13 countries from North America, Central or South America, Asia, Europe, and Africa. We identified a region on 16q21 that is strongly associated with different cleft type (P = 5.611 × 10−8). We also identified significant evidence of gene–gene interactions between this modifier locus and two recognized CL/P risk loci: 8q21 and 9q22 (FOXE1) (P = 0.012 and 0.023, respectively). Single nucleotide polymorphism (SNPs) in the 16q21 modifier locus demonstrated significant association with CL over CLP. The marker alleles on 16q21 that increased risk for CL were found at highest frequencies among individuals with a family history of CL (P = 0.003). Our results demonstrate the existence of modifiers for which type of OFC develops and suggest plausible elements responsible for phenotypic heterogeneity, further elucidating the complex genetic architecture of OFCs.
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Πέμπτη 9 Νοεμβρίου 2017
Differences in medication adherence are associated with beliefs about medicines in asthma and COPD
Adherence to medication is crucial for achieving treatment control in chronic obstructive lung diseases. This study refers to the "necessity-concerns framework" and examines the associations between beliefs a...
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Vocal assessment of addicts on methadone therapy via the RBH scale and objective acoustic parameters
Publication date: Available online 10 November 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Veljko Mirkov, Slobodan M. Mitrović
IntroductionA large number of people around the world struggle daily to become free of their addiction to illegal psychoactive substances. In order to create an atmosphere of improved supervision, established communication and improved quality of life for drug addicts, centers have been set up to provide methadone as a substitute.ObjectiveThe aim of the research was to assess the vocal features of drug addicts on methadone therapy via subjective and objective parameters, to ascertain if vocal damage has occurred and to determine whether subjective and objective acoustic vocal parameters are related, and how.MethodsThe research included 34 adults of both genders who were undergoing methadone treatment. A subjective vocal evaluation assessed voice pitch and clarity, while the subjective acoustic analysis utilized the Roughness-Breathiness-Hoarseness scale of roughness-breathiness-hoarseness. Objective acoustic analysis was conducted after recording and analyzing an uninterrupted vocal /a/ of at least three seconds duration, using the "GllotisController" software.ResultsThe subjective acoustic analysis using the Roughness-Breathiness-Hoarseness scale showed pathological values in 52.9% male and 47% female participants. The average values of the roughness-breathiness-hoarseness for the entire sample were 0.91, 0.38 and 0.50, respectively. Lower roughness was associated with a higher fundamental frequency (f0) and lower jitter and shimmer values (p<0.05). There was a statistically significant correlation between breathiness, jitter (p<0.01) and shimmer (p<0.05), and between hoarseness and jitter (p<0.01).ConclusionA statistically significant correlation was found between the two subjective vocal assessments, voice clarity and pitch, and Roughness-Breathiness-Hoarseness scale, and the parameters of the objective acoustic vocal assessment.
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The protective effects of whortleberry extract against cisplatin-induced ototoxicity in rats
Publication date: Available online 10 November 2017
Source:Brazilian Journal of Otorhinolaryngology
Author(s): Doğukan Özdemir, Abdulkadir Özgür, Yıldıray Kalkan, Suat Terzi, Levent Tümkaya, Adnan Yılmaz, Metin Çeliker, Engin Dursun
IntroductionCisplatin is one of the main chemotherapeutic agents used for the treatment of many types of cancer. However, ototoxicity, one of the most serious side effects of cisplatin, restricts its usage.ObjectiveWe aimed to investigate the protective effects of whortleberry extract against cisplatin-induced ototoxicity by evaluating hearing and histopathological cochlear damage and by measuring the biochemical parameters affected byoxidative stress.MethodsForty-eight male rats were included in the study after performing Distortion Product Otoacoustic Emission test to confirm that their hearing levels were normal. The rats were randomly divided into six groups: the control group, the sham group, and, which received only whortleberry extract, only cisplatin, cisplatin+100mg whortleberry extract, cisplatin+200mg whortleberry extract, respectively. Audiologic investigation was performed by performing the Distortion Product Otoacoustic Emission test at the beginning and at the eighth day of the study. Cardiac blood samples were collected for biochemical analysis, and the rats were sacrificed to obtain cochlear histopathological specimens on the eighth day.ResultsThe results revealed that whortleberry protects hearing against cisplatin-induced ototoxicity independent of the dose. However, high doses of whortleberry extract are needed to prevent histopathological degeneration and oxidative stress.ConclusionThe results obtained in this study show that whortleberry extract has a protective effect against cisplatin-induced ototoxicity.
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An unconventional approach to dental health that works
One of the greatest fears for most people is a trip to the dentist, especially if they know there is work to be done. The grinding, pulling, smells, and needles are not exactly a situation that drums up warm and cozy feelings.
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Treating periodontitis to prevent heart disease – evidence unclear
Only 1 trial at high risk of bias was included in this recent update of a 2014 Cochrane review of periodontal therapy for preventing cardiovascular disease (CVD) providing insufficient evidence to support or refute whether periodontal therapy can prevent the recurrence of CVD in the long term in patients with chronic periodontitis.
The post Treating periodontitis to prevent heart disease – evidence unclear appeared first on National Elf Service.
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Effect of Home Bleaching on the Translucency of CAD/CAM Systems
Abstract
Purpose
To evaluate the effect of a home bleaching agent (Opalescence PF) on the translucency of CAD/CAM ceramic systems.
Materials and Methods
The 28 sintered ceramic specimens (IPS Empress CAD and IPS e.max CAD; 15 mm long, 10 mm wide, 1 mm thick) were divided into two subgroups as control and bleaching groups (n = 7). Carbamide peroxide (CP), 16%, home bleaching agent was applied onto the surface of each specimen for 6 hours per day for 7 days. A spectrophotometer (VITA Easyshade Advance) was used to measure the CIE L*a* b* coordinates and the reflectance value (Y) of the specimens on white and black backgrounds. The translucency parameter (TP), contrast ratio (CR), and opalescence parameter (OP) of the specimens were calculated. The data were statistically analyzed using Kolmogorov–Smirnov, one-way ANOVA, Tukey's test, and Pearson's correlation.
Results
Statistically significant differences in the TP values after 16% CP bleaching treatment were observed (p ˂ 0.05); however, no significant differences were found in the OP and CR values after the surface treatment (p ˃ 0.05).
Conclusions
According to our study, patients who have all-ceramic restorations in their mouths should be careful when using home bleaching agents, because whitening agents can affect the translucency of all-ceramic restorations such as e.max CAD and Empress CAD.
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Nuclear IGF-1R predicts chemotherapy and targeted therapy resistance in metastatic colorectal cancer
Nuclear IGF-1R predicts chemotherapy and targeted therapy resistance in metastatic colorectal cancer
Nuclear IGF-1R predicts chemotherapy and targeted therapy resistance in metastatic colorectal cancer, Published online: 09 November 2017; doi:10.1038/bjc.2017.279
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Summary Low-fidelity, simulation-based psychomotor skills training is a valuable first step in the educational approach to mastering com...
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Here we report on the treatment of a 38-year-old woman with primary cutaneous γδT-cell lymphoma, which is a rare subset of cutaneous T-cell ...
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Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182, Treatment of basilar artery stenosis w...
