Title: We All Carry a Personal Cloud of Germs, ChemicalsCategory: Health NewsCreated: 9/20/2018 12:00:00 AMLast Editorial Review: 9/21/2018 12:00:00 AM (Source: MedicineNet Allergies General)
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LAKEVILLE, MINN. [September 10, 2018] - ImageTrend, Inc. announced the Nevada Department of Health and Human Services has selected ImageTrend for multiple solutions for the state's health information technology. The interconnected software will provide documentation and reporting for EMS, licensure of EMS care providers and healthcare data interoperability among hospitals, healthcare registries, EMS and HIEs. Karen Beckley, Bureau of Health Protection and Preparedness Chief said, "The new contract between the Division of Public and Behavioral Health, Emergency Medical Services Program and ImageTrend will facilitate increased communication, surveillance, monitoring and reporting of all emergency medical services incidents including data and information related to statewide opioid use...
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Title: We All Carry a Personal Cloud of Germs, ChemicalsCategory: Health NewsCreated: 9/20/2018 12:00:00 AMLast Editorial Review: 9/21/2018 12:00:00 AM (Source: MedicineNet Allergies General)
MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.
LAKEVILLE, MINN. [September 10, 2018] - ImageTrend, Inc. announced the Nevada Department of Health and Human Services has selected ImageTrend for multiple solutions for the state's health information technology. The interconnected software will provide documentation and reporting for EMS, licensure of EMS care providers and healthcare data interoperability among hospitals, healthcare registries, EMS and HIEs. Karen Beckley, Bureau of Health Protection and Preparedness Chief said, "The new contract between the Division of Public and Behavioral Health, Emergency Medical Services Program and ImageTrend will facilitate increased communication, surveillance, monitoring and reporting of all emergency medical services incidents including data and information related to statewide opioid use...
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We aimed to present our series of gastrointestinal neuroendocrine tumours (GI-NETs) in order to illustrate and highlight the associated contrast-enhanced multi-detector computed tomography (MDCT) features. We also attempted to identify a relationship between MDCT imaging and the 2010 World Health Organization (WHO) classification system.
We selected all patients with pathologically proven GI-NETs diagnosed between January 2010 and August 2017. Only patients undergone contrast-enhanced MDCT imaging in the immediate preoperative period were included in our study. Later, two expert radiologists retrospectively assessed MDCT intestinal and extra-intestinal signs. We also analysed the relationship between MDCT imaging and the 2010 WHO classification.
A total of 20 patients (13 males, 7 females, age range 37–89 years, mean age 69.9 years) were included in our study. The majority of GI-NETs (85%) occurred in the small bowel and mainly in the terminal ileum. Forty-five percentage of our GI-NETs were diagnosed after an access to emergency medical service for obstruction symptoms or gastrointestinal bleeding. Regarding intestinal signs, 15/20 patients showed an intraluminal nodular mass and 5/20 a wall thickening. Extra-intestinal signs were present in 75% of cases. Desmoplastic reaction and lymph nodes metastases were significantly correlated with higher grade of GI-NETs.
The majority of GI-NETs appears as intraluminal mass often associated with extra-intestinal signs. We found a significantly correlation between higher grade of GI-NETs and extra-intestinal signs. MDCT imaging may be useful in predicting the pathological classification of GI-NETs.
We aimed to present our series of gastrointestinal neuroendocrine tumours (GI-NETs) in order to illustrate and highlight the associated contrast-enhanced multi-detector computed tomography (MDCT) features. We also attempted to identify a relationship between MDCT imaging and the 2010 World Health Organization (WHO) classification system.
We selected all patients with pathologically proven GI-NETs diagnosed between January 2010 and August 2017. Only patients undergone contrast-enhanced MDCT imaging in the immediate preoperative period were included in our study. Later, two expert radiologists retrospectively assessed MDCT intestinal and extra-intestinal signs. We also analysed the relationship between MDCT imaging and the 2010 WHO classification.
A total of 20 patients (13 males, 7 females, age range 37–89 years, mean age 69.9 years) were included in our study. The majority of GI-NETs (85%) occurred in the small bowel and mainly in the terminal ileum. Forty-five percentage of our GI-NETs were diagnosed after an access to emergency medical service for obstruction symptoms or gastrointestinal bleeding. Regarding intestinal signs, 15/20 patients showed an intraluminal nodular mass and 5/20 a wall thickening. Extra-intestinal signs were present in 75% of cases. Desmoplastic reaction and lymph nodes metastases were significantly correlated with higher grade of GI-NETs.
The majority of GI-NETs appears as intraluminal mass often associated with extra-intestinal signs. We found a significantly correlation between higher grade of GI-NETs and extra-intestinal signs. MDCT imaging may be useful in predicting the pathological classification of GI-NETs.
Title: We All Carry a Personal Cloud of Germs, ChemicalsCategory: Health NewsCreated: 9/20/2018 12:00:00 AMLast Editorial Review: 9/21/2018 12:00:00 AM (Source: MedicineNet Allergies General)
MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.
Title: We All Carry a Personal Cloud of Germs, ChemicalsCategory: Health NewsCreated: 9/20/2018 12:00:00 AMLast Editorial Review: 9/21/2018 12:00:00 AM (Source: MedicineNet Allergies General)
MedWorm Message: If you are looking to buy something in the January Sales please visit TheJanuarySales.com for a directory of all the best sales in the UK. Any income gained via affiliate links keeps MedWorm running.
Authors: PMID: 30242343 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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Conclusions: The Mandarin CAPE-V addresses some limits of the English version. It also demonstrates good intrarater and interrater reliability, comparable to those of GRBAS. PMID: 30242389 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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Conclusions: Congenital hearing loss puts children at continued risk of language deficits, especially for phonologically based skills. Two interventions that appear to ameliorate that risk are providing a period of bimodal stimulation and strong literacy instruction. PMID: 30242344 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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Authors: PMID: 30242343 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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Conclusions: The Mandarin CAPE-V addresses some limits of the English version. It also demonstrates good intrarater and interrater reliability, comparable to those of GRBAS. PMID: 30242389 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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Conclusions: Congenital hearing loss puts children at continued risk of language deficits, especially for phonologically based skills. Two interventions that appear to ameliorate that risk are providing a period of bimodal stimulation and strong literacy instruction. PMID: 30242344 [PubMed - as supplied by publisher] (Source: Journal of speech, language, and hearing research : JSLHR)
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Diabetes mellitus (DM) is a metabolic culprit known to perpetuate several disease processes. The relationship between hearing loss (HL) and type 2 DM (T2DM) remains unclear despite the vast volume of research devoted to this topic. We conducted this study with the aim to evaluate HL among T2DM patients and to assess the relationship between severity of HL, glycosylated hemoglobin (HbA1c) levels and duration of T2DM. Design: a time bound descriptive crosssectional study. Setting: tertiary care hospital of South India. Subjects: subjects with T2DM, aged from 40 to 60 years (excluding hypertension, chronic noise exposure and history of smoking or ototoxicity) were included. Methods: Non-random convenience sampling. Details were gathered using a self-administered, semistructured questionnaire and the hearing was assessed by pure tone audiometry. Data was analysed using SPSS. A large proportion of the sampled population had audiological assessments suggestive of SensoriNeural HL (SNHL). 90.2% had a bilateral distribution of HL; however, only 39% of patients reported having any associated ear complaints. No statistically significant associations were obtained between severity of HL, glycaemic control, duration of diabetes or gender. Bilateral SNHL is a complication associated with T2DM. Duration and glycaemic control are independent variables and do not statistically influence the severity of HL. However, this study demonstrated that many patients with SNHL had no symptoms and also lacked awareness of HL in DM. Therefore routine assessment of hearing should be considered in the diabetic population.
Diabetes mellitus (DM) is a metabolic culprit known to perpetuate several disease processes. The relationship between hearing loss (HL) and type 2 DM (T2DM) remains unclear despite the vast volume of research devoted to this topic. We conducted this study with the aim to evaluate HL among T2DM patients and to assess the relationship between severity of HL, glycosylated hemoglobin (HbA1c) levels and duration of T2DM. Design: a time bound descriptive crosssectional study. Setting: tertiary care hospital of South India. Subjects: subjects with T2DM, aged from 40 to 60 years (excluding hypertension, chronic noise exposure and history of smoking or ototoxicity) were included. Methods: Non-random convenience sampling. Details were gathered using a self-administered, semistructured questionnaire and the hearing was assessed by pure tone audiometry. Data was analysed using SPSS. A large proportion of the sampled population had audiological assessments suggestive of SensoriNeural HL (SNHL). 90.2% had a bilateral distribution of HL; however, only 39% of patients reported having any associated ear complaints. No statistically significant associations were obtained between severity of HL, glycaemic control, duration of diabetes or gender. Bilateral SNHL is a complication associated with T2DM. Duration and glycaemic control are independent variables and do not statistically influence the severity of HL. However, this study demonstrated that many patients with SNHL had no symptoms and also lacked awareness of HL in DM. Therefore routine assessment of hearing should be considered in the diabetic population.
Quality of life has become a key outcome in assessing the effectiveness of treatments and interventions in health.
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Quality of life has become a key outcome in assessing the effectiveness of treatments and interventions in health.
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Type I insulin allergy can be a challenging condition, and there is no international consensus on how to establish the diagnosis. Measurement of specific IgE and skin testing have been cornerstones in the diagnostic work-up. However, these tests have limitations, mainly lack of correlation between test results and clinical findings. At the Allergy Centre, Odense University Hospital, patients with suspected insulin allergy have been evaluated since 2003. The aim of this study was to establish a systematic approach to diagnose and treat patients with insulin allergy.
The study was conducted retrospectively by retrieving data from the Allergy Centre database on patients with suspected insulin allergy evaluated from 2003 to 2017. The examination comprised a comprehensive medical history, specific IgE against insulin and intracutaneous tests (ICT) with different insulins.
A total of 144 patients were examined on suspicion of insulin allergy of which 110 had negative specific IgE in serum. Of the remaining 34 patients, 33 had ICT performed; 2 had negative ICTs, while 31 had one or more positive ICT. All 34 patients had mild symptoms, and 4 could obtain symptom relief with antihistamines or local steroids, 9 could be managed with oral antidiabetics, and 7 were switched to other insulins. The final 14 patients were offered an insulin pump because of reactions to many different insulins, many positive ICTs, unmanageable diabetes, young age and compliance, or convenience.
Insulin allergy can be managed by a systematic approach, and symptom relief is obtainable in most patients.
Type I insulin allergy can be a challenging condition, and there is no international consensus on how to establish the diagnosis. Measurement of specific IgE and skin testing have been cornerstones in the diagnostic work-up. However, these tests have limitations, mainly lack of correlation between test results and clinical findings. At the Allergy Centre, Odense University Hospital, patients with suspected insulin allergy have been evaluated since 2003. The aim of this study was to establish a systematic approach to diagnose and treat patients with insulin allergy.
The study was conducted retrospectively by retrieving data from the Allergy Centre database on patients with suspected insulin allergy evaluated from 2003 to 2017. The examination comprised a comprehensive medical history, specific IgE against insulin and intracutaneous tests (ICT) with different insulins.
A total of 144 patients were examined on suspicion of insulin allergy of which 110 had negative specific IgE in serum. Of the remaining 34 patients, 33 had ICT performed; 2 had negative ICTs, while 31 had one or more positive ICT. All 34 patients had mild symptoms, and 4 could obtain symptom relief with antihistamines or local steroids, 9 could be managed with oral antidiabetics, and 7 were switched to other insulins. The final 14 patients were offered an insulin pump because of reactions to many different insulins, many positive ICTs, unmanageable diabetes, young age and compliance, or convenience.
Insulin allergy can be managed by a systematic approach, and symptom relief is obtainable in most patients.
For many residents and young practicing oral and maxillofacial surgeons (OMSs), debt from student loans is burdensome. The stress associated with having educational debt well over $350,000 has direct and indirect impacts on graduates' personal and professional aspirations. Likewise, the stressors associated with rising debt loads and interest rates impact the future of our specialty, our communities, and our patients. Even within the last 10 years, the financial climate affecting members of our profession has changed dramatically.
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Percutaneous approaches to the mandibular condyle occupy a critical place in its open treatment. The selection of preauricular, submandibular, or retromandibular approaches depends mainly on the superoinferior level of the fracture site. Visualizing the path of dissection is straightforward using these traditional approaches. However, a number of percutaneous approaches, especially for condylar fractures, have been reported since the turn of the century.1 The developers of such approaches expounded their views on maximizing the surgical site exposure and minimizing morbidities,2 such as facial nerve injuries or visible scarring.
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Studies have demonstrated mammalian target of rapamycin (mTOR) and 70-kDa ribosomal S6 kinase (p70s6k) to be tumour suppressors in many cancers. These factors may have synergistic functions in tongue squamous cell carcinoma (TSCC), which is the most common malignant cancer in the oral region. We aimed to investigate the expression of the mTOR-p70s6k axis in TSCC patients and its biological function in TSCC cell lines.
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The vestibulo-ocular reflex (VOR) is the main gaze stabilising system during rapid head movements. The VOR is highly plastic and its gain (eye/head velocity) can be increased via training that induces an incrementally increasing retinal image slip error signal to drive VOR adaptation. Using the unilateral incremental VOR adaptation technique and horizontal active head impulses as the vestibular stimulus, we sought to determine the factors important for VOR adaptation including: the total training time, ratio and number of head impulses to each side (adapting and non-adapting sides; the adapting side was pseudo-randomised left or right) and exposure time to the visual target during each head impulse. We tested 11 normal subjects, each over 5 separate sessions and training protocols. The basic training protocol (protocol one) consisted of unilateral incremental VOR adaptation training lasting 15 min with the ratio of head impulses to each side 1:1. Each protocol varied from the basic. For protocol two, the ratio of impulses were in favour of the adapting side by 2:1. For protocol three, all head impulses were towards the adapting side and the training only lasted 7.5 min. For protocol four, all impulses were towards the adapting side and lasted 15 min. For protocol five, all head impulses were to the adapting side and the exposure time to the visual target during each impulse was doubled. We measured the active and passive VOR gains before and after the training. Albeit with small sample size, our data suggest that the total training time and the visual target exposure time for each head impulse affected adaptation, whereas the total number and repetition rate of head impulses did not. These data have implications for vestibular rehabilitation, suggesting that quality and duration of VOR adaptation exercises are more important than rapid repetition of exercises.
For many residents and young practicing oral and maxillofacial surgeons (OMSs), debt from student loans is burdensome. The stress associated with having educational debt well over $350,000 has direct and indirect impacts on graduates' personal and professional aspirations. Likewise, the stressors associated with rising debt loads and interest rates impact the future of our specialty, our communities, and our patients. Even within the last 10 years, the financial climate affecting members of our profession has changed dramatically.
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Authors: Chakrabarty S, Kahler JP, van de Plassche MAT, Vanhoutte R, Verhelst SHL Abstract The activity of proteases is tightly regulated, and dysregulation is linked to a variety of human diseases. For this reason, ABPP is a well-suited method to study protease biology and the design of protease probes has pushed the boundaries of ABPP. The development of highly selective protease probes is still a challenging task. After an introduction, the first section of this chapter discusses several strategies to enable detection of a single active protease species. These range from the usage of non-natural amino acids, combination of probes with antibodies, and engineering of the target proteases. A next section describes the different types of detection tags that facilitate the read-out p...
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Percutaneous approaches to the mandibular condyle occupy a critical place in its open treatment. The selection of preauricular, submandibular, or retromandibular approaches depends mainly on the superoinferior level of the fracture site. Visualizing the path of dissection is straightforward using these traditional approaches. However, a number of percutaneous approaches, especially for condylar fractures, have been reported since the turn of the century.1 The developers of such approaches expounded their views on maximizing the surgical site exposure and minimizing morbidities,2 such as facial nerve injuries or visible scarring.
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Authors: Desrochers GF, Pezacki JP Abstract Successful viral infection, as well as any resultant antiviral response, relies on numerous sequential interactions between host and viral factors. These interactions can take the form of affinity-based interactions between viral and host macromolecules or active, enzyme-based interactions, consisting both of direct enzyme activity performed by viral enzymes and indirect modulation of the activity of the host cell's enzymes via viral interference. This activity has the potential to transform the local microenvironment to the benefit or detriment of both the virus and the host, favouring either the continuation of the viral life cycle or the host's antiviral response. Comprehensive characterisation of enzymatic activity during viral infect...
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Studies have demonstrated mammalian target of rapamycin (mTOR) and 70-kDa ribosomal S6 kinase (p70s6k) to be tumour suppressors in many cancers. These factors may have synergistic functions in tongue squamous cell carcinoma (TSCC), which is the most common malignant cancer in the oral region. We aimed to investigate the expression of the mTOR-p70s6k axis in TSCC patients and its biological function in TSCC cell lines.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2IakIc5
The vestibulo-ocular reflex (VOR) is the main gaze stabilising system during rapid head movements. The VOR is highly plastic and its gain (eye/head velocity) can be increased via training that induces an incrementally increasing retinal image slip error signal to drive VOR adaptation. Using the unilateral incremental VOR adaptation technique and horizontal active head impulses as the vestibular stimulus, we sought to determine the factors important for VOR adaptation including: the total training time, ratio and number of head impulses to each side (adapting and non-adapting sides; the adapting side was pseudo-randomised left or right) and exposure time to the visual target during each head impulse. We tested 11 normal subjects, each over 5 separate sessions and training protocols. The basic training protocol (protocol one) consisted of unilateral incremental VOR adaptation training lasting 15 min with the ratio of head impulses to each side 1:1. Each protocol varied from the basic. For protocol two, the ratio of impulses were in favour of the adapting side by 2:1. For protocol three, all head impulses were towards the adapting side and the training only lasted 7.5 min. For protocol four, all impulses were towards the adapting side and lasted 15 min. For protocol five, all head impulses were to the adapting side and the exposure time to the visual target during each impulse was doubled. We measured the active and passive VOR gains before and after the training. Albeit with small sample size, our data suggest that the total training time and the visual target exposure time for each head impulse affected adaptation, whereas the total number and repetition rate of head impulses did not. These data have implications for vestibular rehabilitation, suggesting that quality and duration of VOR adaptation exercises are more important than rapid repetition of exercises.
Authors: Chakrabarty S, Kahler JP, van de Plassche MAT, Vanhoutte R, Verhelst SHL Abstract The activity of proteases is tightly regulated, and dysregulation is linked to a variety of human diseases. For this reason, ABPP is a well-suited method to study protease biology and the design of protease probes has pushed the boundaries of ABPP. The development of highly selective protease probes is still a challenging task. After an introduction, the first section of this chapter discusses several strategies to enable detection of a single active protease species. These range from the usage of non-natural amino acids, combination of probes with antibodies, and engineering of the target proteases. A next section describes the different types of detection tags that facilitate the read-out p...
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Authors: Desrochers GF, Pezacki JP Abstract Successful viral infection, as well as any resultant antiviral response, relies on numerous sequential interactions between host and viral factors. These interactions can take the form of affinity-based interactions between viral and host macromolecules or active, enzyme-based interactions, consisting both of direct enzyme activity performed by viral enzymes and indirect modulation of the activity of the host cell's enzymes via viral interference. This activity has the potential to transform the local microenvironment to the benefit or detriment of both the virus and the host, favouring either the continuation of the viral life cycle or the host's antiviral response. Comprehensive characterisation of enzymatic activity during viral infect...
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We have designed the expiratory positive airway pressure (EPAP) mask to provide a new sort of therapeutic strategies for Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS). And this study aims to assess the safety, efficacy and compliance of the EPAP therapy.
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To elucidate potential role of cephalometric measurements to predict tongue base obstruction as observed on drug Induced Sleep Computed Tomography (DIS-CT).
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We have designed the expiratory positive airway pressure (EPAP) mask to provide a new sort of therapeutic strategies for Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS). And this study aims to assess the safety, efficacy and compliance of the EPAP therapy.
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To elucidate potential role of cephalometric measurements to predict tongue base obstruction as observed on drug Induced Sleep Computed Tomography (DIS-CT).
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Unlike many other surgical disciplines, there is no study in the literature that quantitatively assesses the progress of academic output of dental students and residents in oral and maxillofacial surgery. The value of research in medicine is heavily emphasized, and medical students and residents alike are motivated to participate in impactful research that will allow them to advance the specialty of their interest (1, 2). However, the same level of importance has not been placed on increased academic productivity in the earliest stages of training in this specialty.
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Open reduction and internal fixation (ORIF) of mandible fractures may require manipulation of the mental nerve to facilitate osseous reduction and plate fixation, which may lead to prolonged or permanent paresthesia. The aim of this study was to evaluate and correlate the subjective and objective neurosensory recovery of the mental nerve following skeletonization in ORIF of mandible fractures.
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Patients with Robin Sequence (RS) typically present with airway obstruction and feeding impairment during infancy. Some require an operation to relieve the airway obstruction, such as tongue-lip adhesion (TLA), mandibular distraction osteogenesis (MDO), or tracheostomy (trach). As the airway obstruction is usually the cause of the feeding difficulties, oral feeding may improve after the airway obstruction is resolved. Patients with prolonged inability to feed orally, however, will require gastrostomy tube (G-tube) insertion.
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Cone-Beam Computed Tomography (CBCT) and/or panoramic radiography are critical in planning implant surgery to avoid complications, but the literature lacks consensus on the absolute indications for CBCT. Some studies suggest panoramic images alone may suffice for routine cases, while the American Academy of Oral and Maxillofacial Radiology recommends CBCT for all implant surgeries. Indications for CBCT are perhaps most unclear in the posterior mandible where the surgeon must contend with both the inferior alveolar canal (IAC) and lingual concavities (LC).
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Hybrid maxillomandibular (MMF) systems were recently developed. These systems are composed of an arch bar fixated to the alveolus with screws rather than with circumdental wires. Perceived problems with hybrid MMF systems are the risk of damage to the surrounding tissues and teeth secondary to screw insertion and patient compliance with the length of fixation. Recent studies illustrate the efficacy of these systems.1,2 This study presents preliminary results of an ongoing clinical trial aimed to evaluate the clinical benefits of the OmniMax system, applied to patients undergoing repair of uncomplicated mandibular fracture(s) through various outcome measures.
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The maxillary horizontal relapse following Le Fort I advancement has been estimated to be 10%-50%. This retrospective review examines the direct relationship of the amount of maxillary advancement to the amount of relapse. We hypothesize that the greater the advancement, the greater the relapse amount.
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The purpose this study is to analyze the integrity of the human mandibular angle after block graft harvest from mandibular body.
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Unlike many other surgical disciplines, there is no study in the literature that quantitatively assesses the progress of academic output of dental students and residents in oral and maxillofacial surgery. The value of research in medicine is heavily emphasized, and medical students and residents alike are motivated to participate in impactful research that will allow them to advance the specialty of their interest (1, 2). However, the same level of importance has not been placed on increased academic productivity in the earliest stages of training in this specialty.
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Evaluating the outcomes of the alveolar bone grafting procedures in patients has been challenging for a multitude of reasons, including the limited number of patients, their demographic heterogeneity and complex anatomy, and differences in treatment protocols at various institutions. The purpose of this study was to use Cone Beam Computed Tomography (CBCT) analysis to evaluate the long-term radiographic outcomes of anterior iliac crest bone grafting (AICBG) on cleft lip patients who had an associated alveolar cleft with the aim to discover patient or clinical factors that influence the long-term radiographic success of the surgically repaired cleft sites.
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Open reduction and internal fixation (ORIF) of mandible fractures may require manipulation of the mental nerve to facilitate osseous reduction and plate fixation, which may lead to prolonged or permanent paresthesia. The aim of this study was to evaluate and correlate the subjective and objective neurosensory recovery of the mental nerve following skeletonization in ORIF of mandible fractures.
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Between 5% and 20% of patients following primary palatoplasty have velopharyngeal dysfunction (VPD) resulting in hypernasal speech. Common operations to treat this include pharyngeal flap and sphincter pharyngoplasty. Both of these procedures change the anatomy of the velopharyngeal port and carry the risk of obstructive sleep apnea and/or hyponasal speech. As an alternative to avoid these risks, revision palatoplasty using bilateral buccal flaps (RPBBF) has received increased attention.1 The aim of this study is to assess the perceptual, acoustic, and aerodynamic characteristics of speech before and after RPBBF to treat VPD and evaluate postoperative complications.
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Patients with Robin Sequence (RS) typically present with airway obstruction and feeding impairment during infancy. Some require an operation to relieve the airway obstruction, such as tongue-lip adhesion (TLA), mandibular distraction osteogenesis (MDO), or tracheostomy (trach). As the airway obstruction is usually the cause of the feeding difficulties, oral feeding may improve after the airway obstruction is resolved. Patients with prolonged inability to feed orally, however, will require gastrostomy tube (G-tube) insertion.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2QW3EKP
Cone-Beam Computed Tomography (CBCT) and/or panoramic radiography are critical in planning implant surgery to avoid complications, but the literature lacks consensus on the absolute indications for CBCT. Some studies suggest panoramic images alone may suffice for routine cases, while the American Academy of Oral and Maxillofacial Radiology recommends CBCT for all implant surgeries. Indications for CBCT are perhaps most unclear in the posterior mandible where the surgeon must contend with both the inferior alveolar canal (IAC) and lingual concavities (LC).
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National licensure scores act as surrogates for subsequent endpoints in medical practice. For national licensure, strong pre-interview screening tests predictive of future cognitive performance exist – that of Grade Point Average (GPA), Medical College Admission Test (MCAT) (Tamblyn, Abrahamowicz, Dauphinee, Wenghofer, Jacques, Klass, et al. 2007). The same does not hold true for national licensure endpoints reflective of personal/professional characteristics. To the same extent, GPA and MCAT does not adequately address the need for prediction of outcomes associated with personal/professional characteristics.
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Hybrid maxillomandibular (MMF) systems were recently developed. These systems are composed of an arch bar fixated to the alveolus with screws rather than with circumdental wires. Perceived problems with hybrid MMF systems are the risk of damage to the surrounding tissues and teeth secondary to screw insertion and patient compliance with the length of fixation. Recent studies illustrate the efficacy of these systems.1,2 This study presents preliminary results of an ongoing clinical trial aimed to evaluate the clinical benefits of the OmniMax system, applied to patients undergoing repair of uncomplicated mandibular fracture(s) through various outcome measures.
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The maxillary horizontal relapse following Le Fort I advancement has been estimated to be 10%-50%. This retrospective review examines the direct relationship of the amount of maxillary advancement to the amount of relapse. We hypothesize that the greater the advancement, the greater the relapse amount.
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The purpose this study is to analyze the integrity of the human mandibular angle after block graft harvest from mandibular body.
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Evaluating the outcomes of the alveolar bone grafting procedures in patients has been challenging for a multitude of reasons, including the limited number of patients, their demographic heterogeneity and complex anatomy, and differences in treatment protocols at various institutions. The purpose of this study was to use Cone Beam Computed Tomography (CBCT) analysis to evaluate the long-term radiographic outcomes of anterior iliac crest bone grafting (AICBG) on cleft lip patients who had an associated alveolar cleft with the aim to discover patient or clinical factors that influence the long-term radiographic success of the surgically repaired cleft sites.
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Between 5% and 20% of patients following primary palatoplasty have velopharyngeal dysfunction (VPD) resulting in hypernasal speech. Common operations to treat this include pharyngeal flap and sphincter pharyngoplasty. Both of these procedures change the anatomy of the velopharyngeal port and carry the risk of obstructive sleep apnea and/or hyponasal speech. As an alternative to avoid these risks, revision palatoplasty using bilateral buccal flaps (RPBBF) has received increased attention.1 The aim of this study is to assess the perceptual, acoustic, and aerodynamic characteristics of speech before and after RPBBF to treat VPD and evaluate postoperative complications.
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National licensure scores act as surrogates for subsequent endpoints in medical practice. For national licensure, strong pre-interview screening tests predictive of future cognitive performance exist – that of Grade Point Average (GPA), Medical College Admission Test (MCAT) (Tamblyn, Abrahamowicz, Dauphinee, Wenghofer, Jacques, Klass, et al. 2007). The same does not hold true for national licensure endpoints reflective of personal/professional characteristics. To the same extent, GPA and MCAT does not adequately address the need for prediction of outcomes associated with personal/professional characteristics.
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The vestibulo-ocular reflex (VOR) is the main gaze stabilising system during rapid head movements. The VOR is highly plastic and its gain (eye/head velocity) can be increased via training that induces an incrementally increasing retinal image slip error signal to drive VOR adaptation. Using the unilateral incremental VOR adaptation technique and horizontal active head impulses as the vestibular stimulus, we sought to determine the factors important for VOR adaptation including: the total training time, ratio and number of head impulses to each side (adapting and non-adapting sides; the adapting side was pseudo-randomised left or right) and exposure time to the visual target during each head impulse. We tested 11 normal subjects, each over 5 separate sessions and training protocols. The basic training protocol (protocol one) consisted of unilateral incremental VOR adaptation training lasting 15 min with the ratio of head impulses to each side 1:1. Each protocol varied from the basic. For protocol two, the ratio of impulses were in favour of the adapting side by 2:1. For protocol three, all head impulses were towards the adapting side and the training only lasted 7.5 min. For protocol four, all impulses were towards the adapting side and lasted 15 min. For protocol five, all head impulses were to the adapting side and the exposure time to the visual target during each impulse was doubled. We measured the active and passive VOR gains before and after the training. Albeit with small sample size, our data suggest that the total training time and the visual target exposure time for each head impulse affected adaptation, whereas the total number and repetition rate of head impulses did not. These data have implications for vestibular rehabilitation, suggesting that quality and duration of VOR adaptation exercises are more important than rapid repetition of exercises.
The vestibulo-ocular reflex (VOR) is the main gaze stabilising system during rapid head movements. The VOR is highly plastic and its gain (eye/head velocity) can be increased via training that induces an incrementally increasing retinal image slip error signal to drive VOR adaptation. Using the unilateral incremental VOR adaptation technique and horizontal active head impulses as the vestibular stimulus, we sought to determine the factors important for VOR adaptation including: the total training time, ratio and number of head impulses to each side (adapting and non-adapting sides; the adapting side was pseudo-randomised left or right) and exposure time to the visual target during each head impulse. We tested 11 normal subjects, each over 5 separate sessions and training protocols. The basic training protocol (protocol one) consisted of unilateral incremental VOR adaptation training lasting 15 min with the ratio of head impulses to each side 1:1. Each protocol varied from the basic. For protocol two, the ratio of impulses were in favour of the adapting side by 2:1. For protocol three, all head impulses were towards the adapting side and the training only lasted 7.5 min. For protocol four, all impulses were towards the adapting side and lasted 15 min. For protocol five, all head impulses were to the adapting side and the exposure time to the visual target during each impulse was doubled. We measured the active and passive VOR gains before and after the training. Albeit with small sample size, our data suggest that the total training time and the visual target exposure time for each head impulse affected adaptation, whereas the total number and repetition rate of head impulses did not. These data have implications for vestibular rehabilitation, suggesting that quality and duration of VOR adaptation exercises are more important than rapid repetition of exercises.
Chronic flaccid facial paralysis (FFP>2 years) may be approached with static and dynamic techniques. An horizontal zonal assessment evaluates the upper, middle, and lower thirds of the face. Surgery is tailored to an individual's deficits, goals, and health status. While dynamic reanimation is the gold standard for rehabilitation, there are cases in which static approaches are more appropriate or may be used as an adjunct to dynamic techniques. This article focuses on the surgical management of FFP primarily using static approaches to the individual zones of the face to create resting symmetry.
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This article describes the most widely used clinician-graded and patient-reported outcome measures, and describes facial rehabilitation strategies for acute and chronic facial palsy, and rehabilitation following dynamic facial reanimation surgery. The multimodality rehabilitation of the facial palsy patient is determined by the extent of facial nerve injury, specific functional deficits, the presence of synkinesis, and the patient's individual goals. Appropriate intervention, including patient education, soft tissue mobilization, neuromuscular reeducation, and chemodenervation, decreases facial tension and improves facial muscle motor control, physical function, facial expression, and quality of life.
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Leaders in health care play a large role in successful achievement of quality and safety goals through an overt commitment to both quality and safety, fostering a culture of quality improvement and clear and consistent communication of goals and plans. Specific training for frontline providers, managers, and staff is critical in developing skilled leaders with a quality and safety orientation. Many models exist for organizational leadership development, and exemplars of quality and safety leadership have openly shared the keys to their successes for others to raise the bar.
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Stringent regulatory standards for reprocessing medical devices and equipment have proliferated in response to patient safety incidents in which improperly disinfected or contaminated endoscopes lead to large-scale disease transmission or outbreaks. This article details best practices in reprocessing reusable and single-use devices in otolaryngology, with particular attention to flexible fiberoptic endoscopes/nasophyarngoscopes, nasal speculums, and other clinic and operating room instruments. High-risk devices require sterilization, whereas lower risk devices may be reprocessed using various disinfection procedures. Reprocessing practices have implications for adequacy, efficiency, and cost. Nuanced understanding of procedures and their rationale ensures delivery of safe, ethical, and quality patient care.
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Chronic flaccid facial paralysis (FFP>2 years) may be approached with static and dynamic techniques. An horizontal zonal assessment evaluates the upper, middle, and lower thirds of the face. Surgery is tailored to an individual's deficits, goals, and health status. While dynamic reanimation is the gold standard for rehabilitation, there are cases in which static approaches are more appropriate or may be used as an adjunct to dynamic techniques. This article focuses on the surgical management of FFP primarily using static approaches to the individual zones of the face to create resting symmetry.
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This article describes the most widely used clinician-graded and patient-reported outcome measures, and describes facial rehabilitation strategies for acute and chronic facial palsy, and rehabilitation following dynamic facial reanimation surgery. The multimodality rehabilitation of the facial palsy patient is determined by the extent of facial nerve injury, specific functional deficits, the presence of synkinesis, and the patient's individual goals. Appropriate intervention, including patient education, soft tissue mobilization, neuromuscular reeducation, and chemodenervation, decreases facial tension and improves facial muscle motor control, physical function, facial expression, and quality of life.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2N2fXCe
Leaders in health care play a large role in successful achievement of quality and safety goals through an overt commitment to both quality and safety, fostering a culture of quality improvement and clear and consistent communication of goals and plans. Specific training for frontline providers, managers, and staff is critical in developing skilled leaders with a quality and safety orientation. Many models exist for organizational leadership development, and exemplars of quality and safety leadership have openly shared the keys to their successes for others to raise the bar.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader https://ift.tt/2zsePEz
Stringent regulatory standards for reprocessing medical devices and equipment have proliferated in response to patient safety incidents in which improperly disinfected or contaminated endoscopes lead to large-scale disease transmission or outbreaks. This article details best practices in reprocessing reusable and single-use devices in otolaryngology, with particular attention to flexible fiberoptic endoscopes/nasophyarngoscopes, nasal speculums, and other clinic and operating room instruments. High-risk devices require sterilization, whereas lower risk devices may be reprocessed using various disinfection procedures. Reprocessing practices have implications for adequacy, efficiency, and cost. Nuanced understanding of procedures and their rationale ensures delivery of safe, ethical, and quality patient care.
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This study investigated differences in suprahyoid muscle activity in elderly adults during tongue-hold swallowing (THS) according to tongue protrusion length to determine the most effective tongue protrusion length during THS. A total of 52 healthy participants (34 females and 18 males) aged 69–92 years were included. Changes in suprahyoid muscle activation during normal swallowing and THS with 1/3rd and 2/3rd tongue protrusions using surface electromyography were observed. Suprahyoid muscle activation significantly increased with the increasing tongue protrusion length (p < 0.05). Depending on the responses of the participants based on tongue protrusion length, participants were categorized into the increase group [increased suprahyoid muscle activity with tongue protrusion, n = 36 (1/3rd THS compared to normal swallowing) or 38 (2/3rd THS compared to normal swallowing)] or decrease group [decreased suprahyoid muscle activity with tongue protrusion, n = 16 (1/3rd THS compared to normal swallowing) or 14 (2/3rd THS compared to normal swallowing)]. The functional reserve of the increase group was significantly higher than that of the decrease group (p < 0.05). Many elderly people were found to have increased activation of the suprahyoid muscle during THS; however, others showed the opposite. Therefore, it is necessary to confirm the degree of suprahyoid muscle activation during THS so that the patient can perform the exercise at the tongue protrusion length that can maximize the effect of the exercise. For individuals who cannot overcome even a small amount of tongue protrusion (e.g., 1/3rd MTPL), replacing THS with another exercise may be considered.
This study investigated differences in suprahyoid muscle activity in elderly adults during tongue-hold swallowing (THS) according to tongue protrusion length to determine the most effective tongue protrusion length during THS. A total of 52 healthy participants (34 females and 18 males) aged 69–92 years were included. Changes in suprahyoid muscle activation during normal swallowing and THS with 1/3rd and 2/3rd tongue protrusions using surface electromyography were observed. Suprahyoid muscle activation significantly increased with the increasing tongue protrusion length (p < 0.05). Depending on the responses of the participants based on tongue protrusion length, participants were categorized into the increase group [increased suprahyoid muscle activity with tongue protrusion, n = 36 (1/3rd THS compared to normal swallowing) or 38 (2/3rd THS compared to normal swallowing)] or decrease group [decreased suprahyoid muscle activity with tongue protrusion, n = 16 (1/3rd THS compared to normal swallowing) or 14 (2/3rd THS compared to normal swallowing)]. The functional reserve of the increase group was significantly higher than that of the decrease group (p < 0.05). Many elderly people were found to have increased activation of the suprahyoid muscle during THS; however, others showed the opposite. Therefore, it is necessary to confirm the degree of suprahyoid muscle activation during THS so that the patient can perform the exercise at the tongue protrusion length that can maximize the effect of the exercise. For individuals who cannot overcome even a small amount of tongue protrusion (e.g., 1/3rd MTPL), replacing THS with another exercise may be considered.
Program attrition is a major problem in substance use treatment. It is not clear which client and treatment variables are related to successful completion. This study aimed to identify client variables associa...
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Program attrition is a major problem in substance use treatment. It is not clear which client and treatment variables are related to successful completion. This study aimed to identify client variables associa...
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Morphine and oxycodone are considered as wide-spreadly used opioids for moderate/severe cancer pain. However, debate exists about the evidence regarding their relative tolerability and underlying results.
A systematic search of online electronic databases, including PubMed, Embase, Cochrane library updated on October 2017 were conducted. The meta-analysis was performed including the studies that were designed as randomized controlled trials.
In total, seven randomized clinical trials met our inclusion criteria. No statistical differences in analgesic effect between oxycodone and morphine were observed. Both the pooled analysis of API (MD =0.01, 95% CI -0.22 – 0.23; p = 0.96) and WPI (MD = − 0.05, 95% CI -0.21 – 0.30; p = 0.72) demonstrated clinical non-inferiority of the efficacy of morphine compared with oxycodone, respectively. Additionally, no significant difference in PRR response was observed in either oxycodone or morphine that were used in patients (MD =0.99, 95% CI -0.88 – 1.11; p = 0.87). With the pooled result of AEs indicating the comparable safety profiles between the 2 treatment groups, the meta-analysis on the nausea (OR = 1.20, 95% CI 0.90–1.59; p = 0.22), vomiting (OR = 1.33, 95% CI 0.75–2.38; p = 0.33), somnolence (OR = 1.35, 95% CI 0.95–1.93; p = 0.10), diarrhea (OR = 1.01, 95% CI 0.60–1,67; p = 0.98), and constipation (OR = 1.04, 95% CI 0.77–1.41; p = 0.79) was conducted, respectively.
In the current study, no remarkable difference was identified either in analgesic efficacy or in tolerability of oxycodone and morphine as the first-line therapy for patients with moderate to severe cancer pain. Thus, no sufficient clinical evidence on the superior effects of oxycodone to morphine was provided in this experimental hypothesis.
Morphine and oxycodone are considered as wide-spreadly used opioids for moderate/severe cancer pain. However, debate exists about the evidence regarding their relative tolerability and underlying results.
A systematic search of online electronic databases, including PubMed, Embase, Cochrane library updated on October 2017 were conducted. The meta-analysis was performed including the studies that were designed as randomized controlled trials.
In total, seven randomized clinical trials met our inclusion criteria. No statistical differences in analgesic effect between oxycodone and morphine were observed. Both the pooled analysis of API (MD =0.01, 95% CI -0.22 – 0.23; p = 0.96) and WPI (MD = − 0.05, 95% CI -0.21 – 0.30; p = 0.72) demonstrated clinical non-inferiority of the efficacy of morphine compared with oxycodone, respectively. Additionally, no significant difference in PRR response was observed in either oxycodone or morphine that were used in patients (MD =0.99, 95% CI -0.88 – 1.11; p = 0.87). With the pooled result of AEs indicating the comparable safety profiles between the 2 treatment groups, the meta-analysis on the nausea (OR = 1.20, 95% CI 0.90–1.59; p = 0.22), vomiting (OR = 1.33, 95% CI 0.75–2.38; p = 0.33), somnolence (OR = 1.35, 95% CI 0.95–1.93; p = 0.10), diarrhea (OR = 1.01, 95% CI 0.60–1,67; p = 0.98), and constipation (OR = 1.04, 95% CI 0.77–1.41; p = 0.79) was conducted, respectively.
In the current study, no remarkable difference was identified either in analgesic efficacy or in tolerability of oxycodone and morphine as the first-line therapy for patients with moderate to severe cancer pain. Thus, no sufficient clinical evidence on the superior effects of oxycodone to morphine was provided in this experimental hypothesis.
Journal of Magnetic Resonance Imaging, EarlyView.
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Journal of Magnetic Resonance Imaging, EarlyView.
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Date: 09/23/18 Source: National Public Radio Author: Susan Brink Vaccinations have saved millions, maybe billions, of lives, says Michael Kinch, associate […]
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Date: 09/21/18 Source: The Inquire, philly.com Author: Marie McCullough The patient's head and neck cancer came roaring back, spreading to his lymph […]
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Date: 09/23/18 Source: National Public Radio Author: Susan Brink Vaccinations have saved millions, maybe billions, of lives, says Michael Kinch, associate […]
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Date: 09/21/18 Source: The Inquire, philly.com Author: Marie McCullough The patient's head and neck cancer came roaring back, spreading to his lymph […]
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Date: 09/23/18 Source: National Public Radio Author: Susan Brink Vaccinations have saved millions, maybe billions, of lives, says Michael Kinch, associate […]
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Date: 09/21/18 Source: The Inquire, philly.com Author: Marie McCullough The patient's head and neck cancer came roaring back, spreading to his lymph […]
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Date: 09/23/18 Source: National Public Radio Author: Susan Brink Vaccinations have saved millions, maybe billions, of lives, says Michael Kinch, associate […]
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Date: 09/21/18 Source: The Inquire, philly.com Author: Marie McCullough The patient's head and neck cancer came roaring back, spreading to his lymph […]
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Publication date: Available online 23 September 2018
Source: Archives of Oral Biology
Author(s): Jonghwa Won, Ji Hyun Kim, Seog Bae Oh
Magnesium, the second most abundant cation in cellular fluid, is critical for mineralization of hard tissues. Among the molecules involved in cellular Mg2+ homeostasis, functional impairment of Mg2+ permeable ion channel TRPM7 or Mg2+ transporter CNNM4 have been found to result in severe hypomineralization of the enamel and dentin. However, molecular expressions of TRPM7, CNNM4 and their respective homologues have not been fully investigated in adult odontoblasts.
Expressions of TRPM6, TRPM7, CNNM1, CNNM2, CNNM3, CNNM4 were screened in acutely dissociated rat odontoblasts by single cell RT-PCR. Among these candidates, expression levels of TRPM7 and CNNM4 were compared along the odontoblast layer by immunohistochemical analysis. Finally, the coexpression pattern of TRPM7 and CNNM4 in subcellular regions was examined by immunocytochemical analysis.
ScRT-PCR revealed high expression rate of TRPM7 and CNNM4 in odontoblasts, with CNNM4 detected almost exclusively in TRPM7-positive odontoblasts. However, CNNM2 and CNNM3 were detected in only a small population of odontoblasts, and TRPM6 and CNNM1 were not detected even in the pulp tissue. Immunohistochemical analysis revealed higher CNNM4 expression in the apical odontoblast layer than the coronal area, in contrast to the ubiquitous expression of TRPM7. Lastly, immunocytochemical analysis revealed colocalization of CNNM4 with TRPM7 in the odontoblastic process.
CNNM4 and TRPM7 may serve as main Mg2+ regulators in odontoblasts, possibly with selective involvement of CNNM4 in apical dentin formation or mineralization. Colocalization of TRPM7 and CNNM4 in the odontoblastic process suggest functional coupling of these two molecules to maintain Mg2+ homeostasis.
Publication date: Available online 23 September 2018
Source: Archives of Oral Biology
Author(s): Jonghwa Won, Ji Hyun Kim, Seog Bae Oh
Magnesium, the second most abundant cation in cellular fluid, is critical for mineralization of hard tissues. Among the molecules involved in cellular Mg2+ homeostasis, functional impairment of Mg2+ permeable ion channel TRPM7 or Mg2+ transporter CNNM4 have been found to result in severe hypomineralization of the enamel and dentin. However, molecular expressions of TRPM7, CNNM4 and their respective homologues have not been fully investigated in adult odontoblasts.
Expressions of TRPM6, TRPM7, CNNM1, CNNM2, CNNM3, CNNM4 were screened in acutely dissociated rat odontoblasts by single cell RT-PCR. Among these candidates, expression levels of TRPM7 and CNNM4 were compared along the odontoblast layer by immunohistochemical analysis. Finally, the coexpression pattern of TRPM7 and CNNM4 in subcellular regions was examined by immunocytochemical analysis.
ScRT-PCR revealed high expression rate of TRPM7 and CNNM4 in odontoblasts, with CNNM4 detected almost exclusively in TRPM7-positive odontoblasts. However, CNNM2 and CNNM3 were detected in only a small population of odontoblasts, and TRPM6 and CNNM1 were not detected even in the pulp tissue. Immunohistochemical analysis revealed higher CNNM4 expression in the apical odontoblast layer than the coronal area, in contrast to the ubiquitous expression of TRPM7. Lastly, immunocytochemical analysis revealed colocalization of CNNM4 with TRPM7 in the odontoblastic process.
CNNM4 and TRPM7 may serve as main Mg2+ regulators in odontoblasts, possibly with selective involvement of CNNM4 in apical dentin formation or mineralization. Colocalization of TRPM7 and CNNM4 in the odontoblastic process suggest functional coupling of these two molecules to maintain Mg2+ homeostasis.
Null cell adenoma is composed of adenohypophyseal cells that show no evidence of any specific cell type differentiation by immunohistochemistry or transcription factors like pituitary-specific positive transcription factor 1 and steroidogenic factor 1. Though rare, pituitary ependymoma and germinoma are also known to occur at sellar region and in such instances, it is challenging to differentiate them from a pituitary null cell adenoma featuring papillary architecture and perivascular pseudo-rosettes. We describe a case of an elderly diabetic lady presenting with headache and blurring of vision for past 3 months due to a sellar tumour. The histology was diagnostically challenging with notable presence of numerous perivascular pseudo-rosettes and negative immunoreactivity for all pituitary hormones. The differential diagnosis and importance of ancillary techniques is discussed.
Null cell adenoma is composed of adenohypophyseal cells that show no evidence of any specific cell type differentiation by immunohistochemistry or transcription factors like pituitary-specific positive transcription factor 1 and steroidogenic factor 1. Though rare, pituitary ependymoma and germinoma are also known to occur at sellar region and in such instances, it is challenging to differentiate them from a pituitary null cell adenoma featuring papillary architecture and perivascular pseudo-rosettes. We describe a case of an elderly diabetic lady presenting with headache and blurring of vision for past 3 months due to a sellar tumour. The histology was diagnostically challenging with notable presence of numerous perivascular pseudo-rosettes and negative immunoreactivity for all pituitary hormones. The differential diagnosis and importance of ancillary techniques is discussed.
Controlled space closure in cases of isolated lower second premolar aplasia (ILSPA) without maxillary counterbalancing extraction is challenging. Anterior anchorage loss may occur during space closure resulting in compromised occlusal results in terms of an absence of proper canine guidance during laterotrusive mandible movements.
In order to evaluate the effectiveness of Herbst telescope anchorage in combination with double-cable, pull mechanics and a completely customized lingual appliance for orthodontic space management in cases of ILSPA, we tested the null hypothesis that there is a significant deterioration in the sagittal canine relationship towards an Angle-Class-II occlusion expressed as a loss of anterior anchorage following space closure with molar mesialization.
Twenty-five consecutively de-bonded subjects (female / male 17 / 8; aged at T0 (start of MB Tx) 12.3 to 20.6 years; mean age 15.0 / SD 1.7 years) were included in this retrospective analysis using the inclusion criteria of least of one lower second premolar aplasia; completed treatment with a totally customized lingual appliance (CCLA) in combination with Herbst telescopes. Exclusion criteria were the absence of counterbalancing maxillary extractions, as well as additional tooth aplasia other than lower second premolars. A total of 33 single, lower premolar aplasia space closures (right / left sided 17 / 16) were assessed using plaster casts and intra-oral photographs scaled to the plaster casts, at bonding (T0), Herbst insertion (T1), following gap closure (T2) and de-bonding (T3). Parallelism of roots was controlled by panoramic x-rays at T3.
The mean aplasia space at T0 was 7.5 mm (SD 2.6). Complete space closure was achieved in all 33 situations. The null hypothesis was rejected. There was a significant improvement in the initial canine relationships (mean 3.5 mm distal occlusion at T0) to a mean 0.1 mm at T3. When evaluated against the individual treatment plan, the following amounts of planned improvements were achieved: space closure 100%, canine relationship 97.5%, overjet 93.9%, overbite 96.4%, parallel roots in space closure site 93.9%.
Herbst telescope anchorage in combination with double-cable pull mechanics and a CCLA for orthodontic space closure can deliver predictable, high-quality treatment results.
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Natasha A. Sokol, Cassandra A. Okechukwu, Jarvis T. Chen, S.V. Subramanian, Vaughan W. Rees
Earlier cannabis initiation is associated with more severe neuropsychiatric and social consequences. The authors investigated whether mothers' cannabis use is associated with earlier cannabis initiation by their children.
Mother and child data were from the National Longitudinal Survey of Youth 1979 (1980–1998 waves) and Child and Young Adults (1988–2014 waves) cohorts, respectively. Cox proportional hazard models assessed the effect of maternal cannabis use prior to a child's adolescence on the child's risk of subsequent cannabis initiation. Models were stratified by race and child's age category (6–16, 17–24, ≥25 years). Adjusted analyses controlled for sociodemographic variables. Analyses were conducted in 2017.
Median age of cannabis initiation for children of maternal ever users was age 16years compared with age 18years among children of maternal never users. Children of 1-year and multiple-year users were at increased risk of cannabis initiation between ages 6 and 16years (hazard ratio=1.38, p<0.001, and hazard ratio = 1.45, p<0.001, respectively). Effects were slightly stronger among non-Hispanic non-black children.
As cannabis legalization expands across the U.S., adult use may become increasingly normative. This study indicates that maternal cannabis use may be a risk factor for early initiation among their offspring. Preventive interventions should consider strategies to delay initiation among children of cannabis users.
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Deborah I. Levine
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Tannaz Moin, Laura J. Damschroder, Mona AuYoung, Matthew L. Maciejewski, Kathryn Havens, Kristyn Ertl, Elena Vasti, Jane E. Weinreb, Nanette I. Steinle, Charles J. Billington, Maria Hughes, Fatima Makki, Bradley Youles, Robert G. Holleman, H. Myra Kim, Linda S. Kinsinger, Caroline R. Richardson
Online Diabetes Prevention Programs (DPPs) can be scaled up and delivered broadly. However, little is known about real-world effectiveness and how outcomes compare with in-person DPP. This study examined online DPP weight loss and participation outcomes and secondarily compared outcomes among participating individuals with parallel in-person interventions.
A large non-randomized trial supplemented by a comparative analysis of participating individuals from a concurrent trial of two parallel in-person programs: in-person DPP and the Veterans Administration's standard of care weight loss program (MOVE!).
Obese/overweight Veterans with prediabetes enrolled in online DPP (n = 268) between 2013 and 2014. Similar eligibility criteria were used to enroll in-person participants between 2012 and 2014 (n = 273 in-person DPP, n = 114 MOVE!) within a separate trial.
Online DPP included a virtual group format, live e-coach, weekly modules delivered asynchronously, and wireless home scales. In-person programs included eight to 22 group-based, face-to-face sessions.
Weight change at 6 and 12 months using wirelessly uploaded home scale data or electronic medical record weights from clinical in-person visits. Outcomes were analyzed between 2015 and 2017.
From 1,182 invitations, 268 (23%) participants enrolled in online DPP. Among these, 158 (56%) completed eight or more modules; mean weight change was –4.7kg at 6 months and –4.0kg at 12 months. In a supplemental analysis of participants completing one or more sessions/modules, online DPP participants were most likely to complete eight or more sessions/modules (87% online DPP vs 59% in-person DPP vs 55% MOVE!, p < 0.001). Online and in-person DPP participants lost significantly more weight than MOVE! participants at 6 and 12 months; there was no significant difference in weight change between online and in-person DPP.
An intensive, multifaceted online DPP intervention had higher participation but similar weight loss compared to in-person DPP. An intensive, multifaceted online DPP intervention may be as effective as in-person DPP and help expand reach to those at risk.
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Anup Srivastav, Alissa O'Halloran, Peng-Jun Lu, Walter W. Williams
English-speaking non-Hispanic Asians (Asians) in the U.S. include populations with multiple geographic origins and ethnicities (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese). Health behaviors and outcomes can differ widely among Asian ethnicities, and highlight the importance of subgroup analysis. Aggregating Asians may mask differences in influenza vaccination across various ethnicities.
Combined data from 2013 to 2015 Behavioral Risk Factor Surveillance System, a population-based, telephone survey of the non-institutionalized, U.S. population aged ≥18years, were analyzed in 2017 to assess influenza vaccination among Asians. Weighted proportions were calculated. Multivariable logistic regression was used to determine independent associations between sociodemographic factors and receipt of influenza vaccination.
Influenza vaccination varied widely among Asian ethnicities, both nationally and by state. Overall, 42.1% of Asians reported having received an influenza vaccine, similar to vaccination among whites (42.4%). Coverage ranged from 36.1% among Koreans to 50.9% among Japanese. Factors independently associated with influenza vaccination among some or all Asian ethnicities included age (≥50 years), female, never married, high school or higher education, annual household income ≥$75,000, possession of medical insurance and personal healthcare provider, routine checkup in the previous year, and presence of certain chronic conditions.
Though Asians and whites had similar overall influenza vaccination coverage, differences existed between Asian ethnicities, both nationally and by state. This information may help community-based, state-level, and national-level public health agencies to support targeted approaches for outreach to these populations, such as improving cultural and linguistic access to care, to improve influenza vaccination.
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Linda Van Horn, Alan Peaceman, Mary Kwasny, Eileen Vincent, Angela Fought, Jami Josefson, Bonnie Spring, Lisa M. Neff, Niki Gernhofer
Technology-enhanced antenatal diet and lifestyle intervention could prevent excess gestational weight gain and benefit mother and child.
A randomized clinical trial.
Overweight and obese ethnically diverse pregnant women in Chicago, Illinois, were enrolled between October 2012 and December 2015, with antenatal data collection completed by July 2016. Analysis was completed June 2017.
Participants were randomized when their fetus was gestational age 16 weeks to dietitian-led Dietary Approaches to Stop Hypertension diet and physical activity coaching that was received as three individual and six group counseling sessions by phone and webinar. A commercially available smartphone application was used for self-monitoring diet and physical activity. Telephone, text message prompts, and e-mail reminders encouraged adherence and website viewing. Usual-care, "web-watcher" participants were e-mailed biweekly newsletters and publicly available maternity website links.
The primary outcome was gestational weight gain measured at baseline, 24 weeks, and 35.0–36.6 weeks. Secondary outcomes included weekly rate of gestational weight gain, newborn anthropometrics, maternal diet quality, physical activity, and blood pressure.
Among 281 participants randomized (n=140 in intervention, n=141 in usual care, BMI 25 to <40, and age range 18–40 years), 37% were non-white and 274 completed antenatal data collection (n=139 in the intervention group and n=135 in the usual-care group). Gestational weight gain differed significantly by intervention group (difference, 1.7kg, p=0.01) and rate of weight gain was 0.4 (SD=0.2) vs 0.5 (SD=0.2) kg/week. No significant differences were noted in birth weight, percentage body fat, or adverse pregnancy outcomes, but more cesarean sections (55 [40%] vs 37 [27%]) occurred among the intervention group.
Technology-enhanced Dietary Approaches to Stop Hypertension diet and lifestyle intervention resulted in significantly less total gestational weight gain over 35 weeks with no adverse infant outcomes. Nutrient quality improved without an adverse impact on rate of prematurity. Increased cesarean delivery requires further exploration. The National Academy of Medicine goals were not achieved by the majority of participants. Obesity prevention preconception is needed.
clinicaltrials.gov Identifier: NCT01631747.
Controlled space closure in cases of isolated lower second premolar aplasia (ILSPA) without maxillary counterbalancing extraction is challenging. Anterior anchorage loss may occur during space closure resulting in compromised occlusal results in terms of an absence of proper canine guidance during laterotrusive mandible movements.
In order to evaluate the effectiveness of Herbst telescope anchorage in combination with double-cable, pull mechanics and a completely customized lingual appliance for orthodontic space management in cases of ILSPA, we tested the null hypothesis that there is a significant deterioration in the sagittal canine relationship towards an Angle-Class-II occlusion expressed as a loss of anterior anchorage following space closure with molar mesialization.
Twenty-five consecutively de-bonded subjects (female / male 17 / 8; aged at T0 (start of MB Tx) 12.3 to 20.6 years; mean age 15.0 / SD 1.7 years) were included in this retrospective analysis using the inclusion criteria of least of one lower second premolar aplasia; completed treatment with a totally customized lingual appliance (CCLA) in combination with Herbst telescopes. Exclusion criteria were the absence of counterbalancing maxillary extractions, as well as additional tooth aplasia other than lower second premolars. A total of 33 single, lower premolar aplasia space closures (right / left sided 17 / 16) were assessed using plaster casts and intra-oral photographs scaled to the plaster casts, at bonding (T0), Herbst insertion (T1), following gap closure (T2) and de-bonding (T3). Parallelism of roots was controlled by panoramic x-rays at T3.
The mean aplasia space at T0 was 7.5 mm (SD 2.6). Complete space closure was achieved in all 33 situations. The null hypothesis was rejected. There was a significant improvement in the initial canine relationships (mean 3.5 mm distal occlusion at T0) to a mean 0.1 mm at T3. When evaluated against the individual treatment plan, the following amounts of planned improvements were achieved: space closure 100%, canine relationship 97.5%, overjet 93.9%, overbite 96.4%, parallel roots in space closure site 93.9%.
Herbst telescope anchorage in combination with double-cable pull mechanics and a CCLA for orthodontic space closure can deliver predictable, high-quality treatment results.
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Natasha A. Sokol, Cassandra A. Okechukwu, Jarvis T. Chen, S.V. Subramanian, Vaughan W. Rees
Earlier cannabis initiation is associated with more severe neuropsychiatric and social consequences. The authors investigated whether mothers' cannabis use is associated with earlier cannabis initiation by their children.
Mother and child data were from the National Longitudinal Survey of Youth 1979 (1980–1998 waves) and Child and Young Adults (1988–2014 waves) cohorts, respectively. Cox proportional hazard models assessed the effect of maternal cannabis use prior to a child's adolescence on the child's risk of subsequent cannabis initiation. Models were stratified by race and child's age category (6–16, 17–24, ≥25 years). Adjusted analyses controlled for sociodemographic variables. Analyses were conducted in 2017.
Median age of cannabis initiation for children of maternal ever users was age 16years compared with age 18years among children of maternal never users. Children of 1-year and multiple-year users were at increased risk of cannabis initiation between ages 6 and 16years (hazard ratio=1.38, p<0.001, and hazard ratio = 1.45, p<0.001, respectively). Effects were slightly stronger among non-Hispanic non-black children.
As cannabis legalization expands across the U.S., adult use may become increasingly normative. This study indicates that maternal cannabis use may be a risk factor for early initiation among their offspring. Preventive interventions should consider strategies to delay initiation among children of cannabis users.
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Deborah I. Levine
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Tannaz Moin, Laura J. Damschroder, Mona AuYoung, Matthew L. Maciejewski, Kathryn Havens, Kristyn Ertl, Elena Vasti, Jane E. Weinreb, Nanette I. Steinle, Charles J. Billington, Maria Hughes, Fatima Makki, Bradley Youles, Robert G. Holleman, H. Myra Kim, Linda S. Kinsinger, Caroline R. Richardson
Online Diabetes Prevention Programs (DPPs) can be scaled up and delivered broadly. However, little is known about real-world effectiveness and how outcomes compare with in-person DPP. This study examined online DPP weight loss and participation outcomes and secondarily compared outcomes among participating individuals with parallel in-person interventions.
A large non-randomized trial supplemented by a comparative analysis of participating individuals from a concurrent trial of two parallel in-person programs: in-person DPP and the Veterans Administration's standard of care weight loss program (MOVE!).
Obese/overweight Veterans with prediabetes enrolled in online DPP (n = 268) between 2013 and 2014. Similar eligibility criteria were used to enroll in-person participants between 2012 and 2014 (n = 273 in-person DPP, n = 114 MOVE!) within a separate trial.
Online DPP included a virtual group format, live e-coach, weekly modules delivered asynchronously, and wireless home scales. In-person programs included eight to 22 group-based, face-to-face sessions.
Weight change at 6 and 12 months using wirelessly uploaded home scale data or electronic medical record weights from clinical in-person visits. Outcomes were analyzed between 2015 and 2017.
From 1,182 invitations, 268 (23%) participants enrolled in online DPP. Among these, 158 (56%) completed eight or more modules; mean weight change was –4.7kg at 6 months and –4.0kg at 12 months. In a supplemental analysis of participants completing one or more sessions/modules, online DPP participants were most likely to complete eight or more sessions/modules (87% online DPP vs 59% in-person DPP vs 55% MOVE!, p < 0.001). Online and in-person DPP participants lost significantly more weight than MOVE! participants at 6 and 12 months; there was no significant difference in weight change between online and in-person DPP.
An intensive, multifaceted online DPP intervention had higher participation but similar weight loss compared to in-person DPP. An intensive, multifaceted online DPP intervention may be as effective as in-person DPP and help expand reach to those at risk.
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Anup Srivastav, Alissa O'Halloran, Peng-Jun Lu, Walter W. Williams
English-speaking non-Hispanic Asians (Asians) in the U.S. include populations with multiple geographic origins and ethnicities (e.g., Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese). Health behaviors and outcomes can differ widely among Asian ethnicities, and highlight the importance of subgroup analysis. Aggregating Asians may mask differences in influenza vaccination across various ethnicities.
Combined data from 2013 to 2015 Behavioral Risk Factor Surveillance System, a population-based, telephone survey of the non-institutionalized, U.S. population aged ≥18years, were analyzed in 2017 to assess influenza vaccination among Asians. Weighted proportions were calculated. Multivariable logistic regression was used to determine independent associations between sociodemographic factors and receipt of influenza vaccination.
Influenza vaccination varied widely among Asian ethnicities, both nationally and by state. Overall, 42.1% of Asians reported having received an influenza vaccine, similar to vaccination among whites (42.4%). Coverage ranged from 36.1% among Koreans to 50.9% among Japanese. Factors independently associated with influenza vaccination among some or all Asian ethnicities included age (≥50 years), female, never married, high school or higher education, annual household income ≥$75,000, possession of medical insurance and personal healthcare provider, routine checkup in the previous year, and presence of certain chronic conditions.
Though Asians and whites had similar overall influenza vaccination coverage, differences existed between Asian ethnicities, both nationally and by state. This information may help community-based, state-level, and national-level public health agencies to support targeted approaches for outreach to these populations, such as improving cultural and linguistic access to care, to improve influenza vaccination.
Publication date: Available online 24 September 2018
Source: American Journal of Preventive Medicine
Author(s): Linda Van Horn, Alan Peaceman, Mary Kwasny, Eileen Vincent, Angela Fought, Jami Josefson, Bonnie Spring, Lisa M. Neff, Niki Gernhofer
Technology-enhanced antenatal diet and lifestyle intervention could prevent excess gestational weight gain and benefit mother and child.
A randomized clinical trial.
Overweight and obese ethnically diverse pregnant women in Chicago, Illinois, were enrolled between October 2012 and December 2015, with antenatal data collection completed by July 2016. Analysis was completed June 2017.
Participants were randomized when their fetus was gestational age 16 weeks to dietitian-led Dietary Approaches to Stop Hypertension diet and physical activity coaching that was received as three individual and six group counseling sessions by phone and webinar. A commercially available smartphone application was used for self-monitoring diet and physical activity. Telephone, text message prompts, and e-mail reminders encouraged adherence and website viewing. Usual-care, "web-watcher" participants were e-mailed biweekly newsletters and publicly available maternity website links.
The primary outcome was gestational weight gain measured at baseline, 24 weeks, and 35.0–36.6 weeks. Secondary outcomes included weekly rate of gestational weight gain, newborn anthropometrics, maternal diet quality, physical activity, and blood pressure.
Among 281 participants randomized (n=140 in intervention, n=141 in usual care, BMI 25 to <40, and age range 18–40 years), 37% were non-white and 274 completed antenatal data collection (n=139 in the intervention group and n=135 in the usual-care group). Gestational weight gain differed significantly by intervention group (difference, 1.7kg, p=0.01) and rate of weight gain was 0.4 (SD=0.2) vs 0.5 (SD=0.2) kg/week. No significant differences were noted in birth weight, percentage body fat, or adverse pregnancy outcomes, but more cesarean sections (55 [40%] vs 37 [27%]) occurred among the intervention group.
Technology-enhanced Dietary Approaches to Stop Hypertension diet and lifestyle intervention resulted in significantly less total gestational weight gain over 35 weeks with no adverse infant outcomes. Nutrient quality improved without an adverse impact on rate of prematurity. Increased cesarean delivery requires further exploration. The National Academy of Medicine goals were not achieved by the majority of participants. Obesity prevention preconception is needed.
clinicaltrials.gov Identifier: NCT01631747.
