Temporomandibular joint (TMJ) ankylosis is the abnormal fusion of TMJ anatomical components that impedes free jaw movements. This restriction in motion ranges from minimal to complete inability to open the jaw. 1 This condition can be categorized into true or false categories in which true ankylosis is attributed to pathological conditions of the TMJ, whereas false ankylosis (Pseudoankylosis) is applied to restrictions of movement resulting from extracapsular abnormalities outside the TMJ. 2-3 Literature reveals that trauma is the first leading cause of temporomandibular joint disorder (TMD).
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Σάββατο 16 Φεβρουαρίου 2019
Pseudoankylosis Between Lateral Pterygoid Plates and Mandible: Report of one case
Do oral and maxillofacial surgeons over-prescribe opioids after extraction of asymptomatic third molars?
Opioid abuse is a public health concern. Oral opioids are prescribed following removal of third molars, but the amount needed for adequate postoperative analgesia is unknown. The purpose of this study was to quantify opioid need after third molar extractions.
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Pseudoankylosis Between Lateral Pterygoid Plates and Mandible: Report of one case
Temporomandibular joint (TMJ) ankylosis is the abnormal fusion of TMJ anatomical components that impedes free jaw movements. This restriction in motion ranges from minimal to complete inability to open the jaw. 1 This condition can be categorized into true or false categories in which true ankylosis is attributed to pathological conditions of the TMJ, whereas false ankylosis (Pseudoankylosis) is applied to restrictions of movement resulting from extracapsular abnormalities outside the TMJ. 2-3 Literature reveals that trauma is the first leading cause of temporomandibular joint disorder (TMD).
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gs8wpf
Do oral and maxillofacial surgeons over-prescribe opioids after extraction of asymptomatic third molars?
Opioid abuse is a public health concern. Oral opioids are prescribed following removal of third molars, but the amount needed for adequate postoperative analgesia is unknown. The purpose of this study was to quantify opioid need after third molar extractions.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ih4KAA
Fragmented Fat: A New Method for Harvesting and Processing of Lipograft
Fat transfer has been recognized as an attractive tool for gluteal and breast augmentation, but harvesting limitations still represent a drawback, especially for post bariatric patients, as massive adipose deflation makes traditional liposuction less effective. On the other hand, circumferential apronectomies usually discard considerable amounts of viable fat tissue1.
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Fragmented Fat: A New Method for Harvesting and Processing of Lipograft
Fat transfer has been recognized as an attractive tool for gluteal and breast augmentation, but harvesting limitations still represent a drawback, especially for post bariatric patients, as massive adipose deflation makes traditional liposuction less effective. On the other hand, circumferential apronectomies usually discard considerable amounts of viable fat tissue1.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2tpmv6H
Pseudoankylosis Between Lateral Pterygoid Plates and Mandible: Report of one case
Temporomandibular joint (TMJ) ankylosis is the abnormal fusion of TMJ anatomical components that impedes free jaw movements. This restriction in motion ranges from minimal to complete inability to open the jaw. 1 This condition can be categorized into true or false categories in which true ankylosis is attributed to pathological conditions of the TMJ, whereas false ankylosis (Pseudoankylosis) is applied to restrictions of movement resulting from extracapsular abnormalities outside the TMJ. 2-3 Literature reveals that trauma is the first leading cause of temporomandibular joint disorder (TMD).
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gs8wpf
Do oral and maxillofacial surgeons over-prescribe opioids after extraction of asymptomatic third molars?
Opioid abuse is a public health concern. Oral opioids are prescribed following removal of third molars, but the amount needed for adequate postoperative analgesia is unknown. The purpose of this study was to quantify opioid need after third molar extractions.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ih4KAA
Pseudoankylosis Between Lateral Pterygoid Plates and Mandible: Report of one case
Temporomandibular joint (TMJ) ankylosis is the abnormal fusion of TMJ anatomical components that impedes free jaw movements. This restriction in motion ranges from minimal to complete inability to open the jaw. 1 This condition can be categorized into true or false categories in which true ankylosis is attributed to pathological conditions of the TMJ, whereas false ankylosis (Pseudoankylosis) is applied to restrictions of movement resulting from extracapsular abnormalities outside the TMJ. 2-3 Literature reveals that trauma is the first leading cause of temporomandibular joint disorder (TMD).
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gs8wpf
Do oral and maxillofacial surgeons over-prescribe opioids after extraction of asymptomatic third molars?
Opioid abuse is a public health concern. Oral opioids are prescribed following removal of third molars, but the amount needed for adequate postoperative analgesia is unknown. The purpose of this study was to quantify opioid need after third molar extractions.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Ih4KAA
Loudness Trumps Pitch in Politeness Judgments: Evidence from Korean Deferential Speech.
Authors: Idemaru K, Winter B, Brown L, Oh GE Abstract Social meaning is not conveyed through words alone, but also through how words are produced phonetically. This paper investigates the role of loudness and pitch in determining the perception of politeness-related judgments in Korean. It has been proposed that high pitch is universally associated with polite or deferential social meanings. In contrast to this, Experiment 1 examined the perceptual effect of pitch and found no effect. Experiment 2 tested the effect of loudness, and found that listeners associate quieter speech with deference. Finally, Experiment 3 investigated the simultaneous effects of loudness and pitch, and found again that loudness had a consistent effect, whereas pitch only had a weak effect. Analyses of indi...
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Update in the classification and the role of intra‐arterial stenting in the management of carotid body paragangliomas
Abstract
Background
To review the Shamblin classification of carotid body paragangliomas (CBPs) and the role of intra‐arterial stenting in their surgical management.
Methods
Retrospective case series of 20 patients with 28 CBPs that were surgically resected at our center. Intra‐arterial stenting was performed in Shamblin II and II classes.
Results
The mean follow‐up was 47.8 months. Five (17.9%) tumors were Shamblin class I, 15 (53.6%) were class II, and 8 (28.6%) were class III. Thirteen (68.4%) CBPs were associated with other paragangliomas. The internal carotid artery (ICA) was stented preoperatively in eight (28.6%) cases and occluded in four (14.3%) cases. The tumor extended to the jugular foramen in six cases (21.4%). Intraoperatively, there was an ICA injury in one case of Shamblin II CBP in the present era.
Conclusions
The proposed classification enables the clinician to plan the management of the ICA and the right approach. Stenting of the ICA gives a chance for complete tumor removal with arterial preservation.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GuTxuS
Loudness Trumps Pitch in Politeness Judgments: Evidence from Korean Deferential Speech.
Authors: Idemaru K, Winter B, Brown L, Oh GE Abstract Social meaning is not conveyed through words alone, but also through how words are produced phonetically. This paper investigates the role of loudness and pitch in determining the perception of politeness-related judgments in Korean. It has been proposed that high pitch is universally associated with polite or deferential social meanings. In contrast to this, Experiment 1 examined the perceptual effect of pitch and found no effect. Experiment 2 tested the effect of loudness, and found that listeners associate quieter speech with deference. Finally, Experiment 3 investigated the simultaneous effects of loudness and pitch, and found again that loudness had a consistent effect, whereas pitch only had a weak effect. Analyses of indi...
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2RO7x3P
Update in the classification and the role of intra‐arterial stenting in the management of carotid body paragangliomas
Abstract
Background
To review the Shamblin classification of carotid body paragangliomas (CBPs) and the role of intra‐arterial stenting in their surgical management.
Methods
Retrospective case series of 20 patients with 28 CBPs that were surgically resected at our center. Intra‐arterial stenting was performed in Shamblin II and II classes.
Results
The mean follow‐up was 47.8 months. Five (17.9%) tumors were Shamblin class I, 15 (53.6%) were class II, and 8 (28.6%) were class III. Thirteen (68.4%) CBPs were associated with other paragangliomas. The internal carotid artery (ICA) was stented preoperatively in eight (28.6%) cases and occluded in four (14.3%) cases. The tumor extended to the jugular foramen in six cases (21.4%). Intraoperatively, there was an ICA injury in one case of Shamblin II CBP in the present era.
Conclusions
The proposed classification enables the clinician to plan the management of the ICA and the right approach. Stenting of the ICA gives a chance for complete tumor removal with arterial preservation.
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Academic achievement of adolescents with asthma or atopic disease
Abstract
Background
Over a fifth of children and adolescents suffer with asthma or atopic disease. It is unclear whether asthma impacts academic performance in children and adolescents, and little is known about the association of eczema, food allergy or hay fever and academic performance.
Objective
To examine whether asthma, eczema, food allergy or hay fever impacts on adolescent academic performance and to assess the role of unmeasured confounding.
Methods
This study used the Childhood and Adolescent Twin Study of Sweden cohort born 1992‐1998. At age 9‐12 years, parents reported on their child's ever or current asthma, eczema, food allergy and hay fever status (n= 10963). At age 15, linked national patient and medication register information was used to create current and ever asthma definitions including severe and uncontrolled asthma for the same children. Academic outcomes in Grade 9 (age 15‐16 years) included: eligibility for high‐school (Grades 10‐12), and total mark of the best 16 subject units, retrieved from the Grade 9 academic register. Whole cohort analyses adjusted for known covariates were performed, and co‐twin control analyses to assess unmeasured confounders.
Results
There were no associations found for asthma or food allergy at 9‐12 years and academic outcomes in adolescence. In addition, at age 15, there were no statistically significant associations with current, ever, severe or uncontrolled asthma and academic outcomes. Eczema and hay fever at age 9‐12 years were found to be positively associated with academic outcomes, however, co‐twin control analyses did not support these findings, suggesting the main analyses may be subject to unmeasured confounding.
Conclusion and clinical relevance
Having asthma or an atopic disease during childhood or adolescence does not negatively impact on academic performance. This information can be used by clinicians when talking with children and parents about the implications of living with asthma or atopic disease.
This article is protected by copyright. All rights reserved.
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Academic achievement of adolescents with asthma or atopic disease
Abstract
Background
Over a fifth of children and adolescents suffer with asthma or atopic disease. It is unclear whether asthma impacts academic performance in children and adolescents, and little is known about the association of eczema, food allergy or hay fever and academic performance.
Objective
To examine whether asthma, eczema, food allergy or hay fever impacts on adolescent academic performance and to assess the role of unmeasured confounding.
Methods
This study used the Childhood and Adolescent Twin Study of Sweden cohort born 1992‐1998. At age 9‐12 years, parents reported on their child's ever or current asthma, eczema, food allergy and hay fever status (n= 10963). At age 15, linked national patient and medication register information was used to create current and ever asthma definitions including severe and uncontrolled asthma for the same children. Academic outcomes in Grade 9 (age 15‐16 years) included: eligibility for high‐school (Grades 10‐12), and total mark of the best 16 subject units, retrieved from the Grade 9 academic register. Whole cohort analyses adjusted for known covariates were performed, and co‐twin control analyses to assess unmeasured confounders.
Results
There were no associations found for asthma or food allergy at 9‐12 years and academic outcomes in adolescence. In addition, at age 15, there were no statistically significant associations with current, ever, severe or uncontrolled asthma and academic outcomes. Eczema and hay fever at age 9‐12 years were found to be positively associated with academic outcomes, however, co‐twin control analyses did not support these findings, suggesting the main analyses may be subject to unmeasured confounding.
Conclusion and clinical relevance
Having asthma or an atopic disease during childhood or adolescence does not negatively impact on academic performance. This information can be used by clinicians when talking with children and parents about the implications of living with asthma or atopic disease.
This article is protected by copyright. All rights reserved.
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Issue Information
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Issue Information
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Issue Information ‐ TOC
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Reply to Wood et al.
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In this Issue: Graphical Abstracts
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Issue Information ‐ Cover and Editorial Board
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Issue Information ‐ TOC
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Reply to Wood et al.
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In this Issue: Graphical Abstracts
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Issue Information ‐ Cover and Editorial Board
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Validation of APACHE IV score in postoperative liver transplantation in southern Brazil: a cohort study
Publication date: Available online 15 February 2019
Source: Brazilian Journal of Anesthesiology (English Edition)
Author(s): Edison Moraes Rodrigues Filho, Anderson Garcez, Wagner Luis Nedel
Abstract
Background
Liver transplantation is the only curative therapeutic modality available for individuals at end-stage liver disease. There is no reliable method of predicting the early postoperative outcome of these patients. The Acute Physiology and Chronic Health Evaluation (APACHE) is a widely used model for predicting hospital survival and benchmarking in critically ill patients. This study evaluated the calibration and discrimination of APACHE IV in the postoperative period of elective liver transplantation in the southern Brazil.
Methods
This was a clinical prospective and unicentric cohort study included 371 adult patients in the immediate postoperative period of elective liver transplantation from January 1, 2012 to December 31, 2016.
Results
In this study, liver transplant patients who evolved to hospital death had a significantly higher APACHE IV score (82.7 ± 5.1 vs. 51.0 ± 15.8; p < 0.001) and higher predicted mortality (6.5% [4.4–20.2%] vs. 2.3% [1.4–3.5%]; p < 0.001). The APACHE IV score showed an adequate calibration (Hosmer-Lemeshow – H-L = 11.37; p = 0.181) and good discrimination (Receiver Operator Curve – ROC of 0.797; Confidence Interval 95% – 95% CI 0.713–0.881; p < 0.0001), although Standardized Mortality Ratio (SMR = 2.63), (95% CI 1.66–4.27; p < 0.001) underestimate mortality.
Conclusions
In summary, the APACHE IV score showed an acceptable performance for predicting a hospital outcome in the postoperative period of elective liver transplant recipients.
Resumo
Background
O transplante de fígado é a única modalidade terapêutica curativa disponível para indivíduos com doença hepática terminal. Não há método confiável de prever o resultado pós-operatório imediato desses pacientes. A Avaliação de Doença Aguda com bases Fisiológicas (estudo APACHE) é um modelo amplamente utilizado para prever a sobrevida hospitalar e fazer a avaliação comparativa de pacientes criticamente enfermos. Este estudo avaliou a calibração e discriminação do APACHE IV no pós-operatório de transplante hepático eletivo no sul do Brasil.
Métodos
Estudo clínico prospectivo de coorte em centro único que incluiu 371 pacientes adultos no pós-operatório imediato de transplante hepático eletivo de 1 de janeiro de 2012 a 31 de dezembro de 2016.
Resultados
Neste estudo, pacientes com transplante hepático que evoluíram para óbito hospitalar obtiveram escore APACHE IV significativamente maior (82,7 ± 5,1 vs. 51,0 ± 15,8; p < 0,001) e mortalidade prevista mais alta (6,5% [4,4% –20,2%] vs 2,3% [1,4% –3,5%], p < 0,001). O escore APACHE IV mostrou uma calibração adequada (Hosmer-Lemeshow – H-L = 11,37; p = 0,181) e boa discriminação (Receiver Operator Curve – ROC de 0,797; intervalo de confiança de 95% – IC 95% 0,713-0,881; p < 0,0001), embora a taxa de mortalidade padronizada (Standardized Mortality Ratio – SMR = 2,63), (IC 95% 1,66-4,27; p < 0,001) subestime a mortalidade.
Conclusões
Em resumo, o escore APACHE IV mostrou um desempenho aceitável para predizer um desfecho hospitalar no período pós-operatório de receptores eletivos de transplante hepático.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2V3RAZd
Validation of APACHE IV score in postoperative liver transplantation in southern Brazil: a cohort study
Publication date: Available online 15 February 2019
Source: Brazilian Journal of Anesthesiology (English Edition)
Author(s): Edison Moraes Rodrigues Filho, Anderson Garcez, Wagner Luis Nedel
Abstract
Background
Liver transplantation is the only curative therapeutic modality available for individuals at end-stage liver disease. There is no reliable method of predicting the early postoperative outcome of these patients. The Acute Physiology and Chronic Health Evaluation (APACHE) is a widely used model for predicting hospital survival and benchmarking in critically ill patients. This study evaluated the calibration and discrimination of APACHE IV in the postoperative period of elective liver transplantation in the southern Brazil.
Methods
This was a clinical prospective and unicentric cohort study included 371 adult patients in the immediate postoperative period of elective liver transplantation from January 1, 2012 to December 31, 2016.
Results
In this study, liver transplant patients who evolved to hospital death had a significantly higher APACHE IV score (82.7 ± 5.1 vs. 51.0 ± 15.8; p < 0.001) and higher predicted mortality (6.5% [4.4–20.2%] vs. 2.3% [1.4–3.5%]; p < 0.001). The APACHE IV score showed an adequate calibration (Hosmer-Lemeshow – H-L = 11.37; p = 0.181) and good discrimination (Receiver Operator Curve – ROC of 0.797; Confidence Interval 95% – 95% CI 0.713–0.881; p < 0.0001), although Standardized Mortality Ratio (SMR = 2.63), (95% CI 1.66–4.27; p < 0.001) underestimate mortality.
Conclusions
In summary, the APACHE IV score showed an acceptable performance for predicting a hospital outcome in the postoperative period of elective liver transplant recipients.
Resumo
Background
O transplante de fígado é a única modalidade terapêutica curativa disponível para indivíduos com doença hepática terminal. Não há método confiável de prever o resultado pós-operatório imediato desses pacientes. A Avaliação de Doença Aguda com bases Fisiológicas (estudo APACHE) é um modelo amplamente utilizado para prever a sobrevida hospitalar e fazer a avaliação comparativa de pacientes criticamente enfermos. Este estudo avaliou a calibração e discriminação do APACHE IV no pós-operatório de transplante hepático eletivo no sul do Brasil.
Métodos
Estudo clínico prospectivo de coorte em centro único que incluiu 371 pacientes adultos no pós-operatório imediato de transplante hepático eletivo de 1 de janeiro de 2012 a 31 de dezembro de 2016.
Resultados
Neste estudo, pacientes com transplante hepático que evoluíram para óbito hospitalar obtiveram escore APACHE IV significativamente maior (82,7 ± 5,1 vs. 51,0 ± 15,8; p < 0,001) e mortalidade prevista mais alta (6,5% [4,4% –20,2%] vs 2,3% [1,4% –3,5%], p < 0,001). O escore APACHE IV mostrou uma calibração adequada (Hosmer-Lemeshow – H-L = 11,37; p = 0,181) e boa discriminação (Receiver Operator Curve – ROC de 0,797; intervalo de confiança de 95% – IC 95% 0,713-0,881; p < 0,0001), embora a taxa de mortalidade padronizada (Standardized Mortality Ratio – SMR = 2,63), (IC 95% 1,66-4,27; p < 0,001) subestime a mortalidade.
Conclusões
Em resumo, o escore APACHE IV mostrou um desempenho aceitável para predizer um desfecho hospitalar no período pós-operatório de receptores eletivos de transplante hepático.
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Pseudoankylosis Between Lateral Pterygoid Plates and Mandible: Report of one case
Publication date: Available online 16 February 2019
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Mohammed Suliman Alsaleh, Hussam Ziad Alsalem, Mohammed Abdullah Assiri, Nasser Marje Almhidy
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Comment on: “Does Accurate Positioning of the Temporomandibular Joint Titanium Condylar Prosthesis Prevent Complications?”
Publication date: Available online 15 February 2019
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Salvatore Sembronio, Alessandro Tel, Massimo Robiony
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Pseudoankylosis Between Lateral Pterygoid Plates and Mandible: Report of one case
Publication date: Available online 16 February 2019
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Mohammed Suliman Alsaleh, Hussam Ziad Alsalem, Mohammed Abdullah Assiri, Nasser Marje Almhidy
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Comment on: “Does Accurate Positioning of the Temporomandibular Joint Titanium Condylar Prosthesis Prevent Complications?”
Publication date: Available online 15 February 2019
Source: Journal of Oral and Maxillofacial Surgery
Author(s): Salvatore Sembronio, Alessandro Tel, Massimo Robiony
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Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study
Infertility-related stress can seriously impact the fertility quality of life (QoL) of infertile women. Resilience, as a coping resource, can effectively combat psychological stress. This study aimed to evalua...
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Adverse events in oral immunotherapy for the desensitization of cow’s milk allergy in children: a randomized controlled trial
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Sarah De Schryver, Bruce Mazer, Ann Clarke, Yvan St. Pierre, Duncan Lejtneyi, Alexandra Langlois, Bahar Torabi, Wei W. Zhao, Edmond S. Chan, Ingrid Baerg, Moshe Ben-Shoshan
Abstract
Background
This study focuses on side effects of cow's milk oral immunotherapy (CM-OIT) using consensus definitions of food-induced anaphylaxis.
Objective
To evaluate the risk of allergic reactions (ARs) and to identify risk factors associated with higher risk of anaphylactic ARs (AARs) during CM-OIT in children.
Methods
Clinical charts of children receiving CM-OIT were carefully reviewed.ARs were defined as single-organ ARs and AARs were defined as involvement of 2 organ systems and/or hypotension in response to CM protein. Descriptive statistics were used to represent demographics, occurrence, reaction characteristics and co-morbidities. Poisson analysis was performed to evaluate risk factors associated with AARs.
Results
Among 41 children undergoing CM-OIT, 11 discontinued the treatment (N=26.8%). The mean age at challenge was 12.1 years (SD 3.6) and half were male (56.1%). The mean number of AARs per patient was 6.0 (SD 3.5) versus a mean of 17.4 (SD11.9) non-anaphylactic ARs per patient. Among withdrawals from OIT, the mean number of AARs per patient was 8.3 versus 5.1 in non-withdrawals.
AARs were more frequent in children with higher sIgE for alpha-lactalbumine and casein at baseline [1.11 (95% CI 1.01, 1.22) and 1.01(1.0, 1.03 ) respectively]. Children with resolved eczema and higher sIgE for beta – lactoglobuline at baseline [0.13 (95% CI 0.04, 0.46) ], [0.96 (95% CI 0.94, 0.99)] respectively, were less likely to develop AARs.
Conclusion
Although the majority of ARs during OIT are non anaphylactic, AARs occur frequently. Children with higher sIgE for alpha-lactalbumine and casein at baseline seem to be at higher risk for AARs during OIT.
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Low cross-reactivity between cisplatin and other platinum salts
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Justine Pasteur, Laure Favier, Corinne Pernot, Mathieu Guerriaud, Charlotte Bernigaud, Côme Lepage, Jean-Louis Jouve, Nicolas Isambert, Evelyne Collet
Abstract
Background
Hypersensitivity reactions to platinum salts (PS) (cisplatin (CI), carboplatin (CA) and oxaliplatin (OX)) can be severe and their incidence is increasing due to their widespread use in cancer treatment.
Objective
To determine the rate of cross-reactivity between platinum salts and whether CI can be administered without prior allergy testing in patients with a history of CA or OX hypersensitivity.
Methods
From September 2002 to April 2016, patients with suspected immediate PS hypersensitivity were tested and cross-reactivity between the three PS was evaluated. We then studied patients who were given cisplatin without desensitization after immediate hypersensitivity to other PS.
Results
A total of 155 patients were included. Skin tests were positive in 97 patients (OX: 51, CA: 43 and CI: 3). Cross-reactivity to CA in OX-allergic patients was 45% (23/51) (95%CI: 36% to 66%) and cross-reactivity to OX in CA-allergic patients was 37% (16/43) (95%CI: 23% to 53%). In contrast, cross-reactivity to CI was 0% (0/51) (95%CI: 0% to 7%) in OX-allergic patients and 7% (3/43) (95%CI: 2% to 17%) in CA-allergic patients. All these 3 patients had previously been exposed to CI in previous courses of chemotherapy. CI was initiated in 24 patients with proven hypersensitivity to CA or OX and had no hypersensitivity reactions.
Conclusion
Initiating CI in patients with proven immediate hypersensitivity to CA or OX appeared to be safe in our study.
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Screening for inhalation technique errors with electronic medication monitors
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): William C. Anderson, Rahul Gondalia, Heather E. Hoch, Leanne Kaye, Stanley J. Szefler, David A. Stempel
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The European Society for Immunodeficiencies (ESID) Registry Working Definitions for the Clinical Diagnosis of Inborn Errors of Immunity
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Markus G. Seidel, Gerhard Kindle, Benjamin Gathmann, Isabella Quinti, Matthew Buckland, Joris van Montfrans, Raphael Scheible, Stephan Rusch, Lukas M. Gasteiger, Bodo Grimbacher, Nizar Mahlaoui, Stephan Ehl, Michael Albert, Sarah Beaussant Cohen, Jacinta Bustamante, Andrew Cant, Jean-Laurent Casanova, Helen Chapel, Genevieve de Saint Basile, Esther de Vries
Abstract
Patient registries are instrumental for clinical research in rare diseases. They help to achieve a sufficient sample size for epidemiological and clinical research and to assess the feasibility of clinical trials. The European Society for Immunodeficiencies (ESID) registry currently comprises information on >25,000 patients with inborn errors of immunity (IEI). The prerequisite of a patient to be included into the ESID registry is an IEI either defined by a defect in a gene included in the disease classification of the international union of immunological societies (IUIS), or verified by applying clinical criteria. Because a relevant number of patients, including those with common variable immunodeficiency (CVID), representing the largest group of patients in the registry, remains without a genetic diagnosis, consensus on classification of these patients is mandatory. Here, we present clinical criteria for a large number of IEI that were designed in expert panels with external review. They were implemented for novel entries and verification of existing datasets from 2014, yielding a substantial refinement. For instance, 8% of adults and 27% of children with CVID (176 out of 1704 patients) were reclassified to 22 different immunodeficiencies, illustrating progress in genetics, but also the previous lack of standardized disease definitions. Importantly, apart from registry purposes, the clinical criteria are also helpful to support treatment decisions in the absence of a genetic diagnosis or in patients with variants of unknown significance.
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Severe Necrotic Reaction to 23-Valent Polysaccharide Pneumococcal Vaccine in a Patient With STAT3 Deficiency
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Mervin Piñones, Cecilia Vizcaya, Guillermo Pérez-Mateluna, Rodrigo Hoyos-Bachiloglu, Arturo Borzutzky
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AAAAI/ACAAI subcutaneous immunotherapy (SCIT) surveillance study (2013-2017): fatalities, infections, delayed reactions and use of epinephrine auto-injectors
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Tolly G. Epstein, Gary M. Liss, Karen Murphy Berendts, David I. Bernstein
Abstract
Background
SCIT is highly effective but safety risks exist.
Objective
The aims of this study were to: 1) identify clinical practices that could influence fatal and non-fatal systemic allergic reactions (SRs) to SCIT; and 2) identify SCIT-associated infections.
Methods
From 2008-2016, 27-51% of AAAAI/ACAAI members completed an annual survey of SCIT-related SRs of varying severity. Post-injection local cutaneous and systemic infections were queried for 2014-2016. For 2014-2016, respondents were queried about timing of onset of SRs, post-injection waiting times, and prescription/use of epinephrine auto-injectors.
Results
Data were gathered on 54.4 million injection visits (2008-2016). Two confirmed fatalities from SCIT occurred between 2008-2014. An additional five confirmed fatalities occurred between 2015-2017. No infections occurred in 17.3 million injection visits (2014-2016). Among practices monitoring patients for at least 30 minutes, 15% of SRs occurred after 30 minutes. Practices prescribing an epinephrine auto-injector >90% of the time (29% of practices) did not experience lower rates of delayed Grade 3/4 SRs. Of patients experiencing Grade 3/4 delayed SRs, 26% and 8% used prescribed self-injectable epinephrine devices during 2014-2015 and 2015-2016, respectively.
Conclusions
There is an unexplained slight increase in SCIT-related fatalities for 2015-2017, although mean annual reported events over 9 years (0.8 fatal reactions/year) have declined. SCIT-related infections were not identified during two years of surveillance. The 15% incidence of delayed-onset SRs (> 30 min) is similar to a prior annual survey. Prescribing epinephrine auto-injectors for SCIT does not appear to improve outcomes, possibly due to low rates of self-administration.
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Do youth ask asthma providers the questions they want to ask?
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Scott A. Davis, Richard F. Brown, Robyn Sayner, Delesha Carpenter, Charles Lee, Nacire Garcia, Daniel S. Reuland, Gail Tudor, Ceila E. Loughlin, Betsy Sleath
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Bullous Fixed Drug Eruption Caused by Etoricoxib Confirmed by Patch Testing
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Leonor Carneiro-Leão, Josefina Rodrigues Cernadas
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Resilience acts as a moderator in the relationship between infertility-related stress and fertility quality of life among women with infertility: a cross-sectional study
Infertility-related stress can seriously impact the fertility quality of life (QoL) of infertile women. Resilience, as a coping resource, can effectively combat psychological stress. This study aimed to evalua...
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Adverse events in oral immunotherapy for the desensitization of cow’s milk allergy in children: a randomized controlled trial
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Sarah De Schryver, Bruce Mazer, Ann Clarke, Yvan St. Pierre, Duncan Lejtneyi, Alexandra Langlois, Bahar Torabi, Wei W. Zhao, Edmond S. Chan, Ingrid Baerg, Moshe Ben-Shoshan
Abstract
Background
This study focuses on side effects of cow's milk oral immunotherapy (CM-OIT) using consensus definitions of food-induced anaphylaxis.
Objective
To evaluate the risk of allergic reactions (ARs) and to identify risk factors associated with higher risk of anaphylactic ARs (AARs) during CM-OIT in children.
Methods
Clinical charts of children receiving CM-OIT were carefully reviewed.ARs were defined as single-organ ARs and AARs were defined as involvement of 2 organ systems and/or hypotension in response to CM protein. Descriptive statistics were used to represent demographics, occurrence, reaction characteristics and co-morbidities. Poisson analysis was performed to evaluate risk factors associated with AARs.
Results
Among 41 children undergoing CM-OIT, 11 discontinued the treatment (N=26.8%). The mean age at challenge was 12.1 years (SD 3.6) and half were male (56.1%). The mean number of AARs per patient was 6.0 (SD 3.5) versus a mean of 17.4 (SD11.9) non-anaphylactic ARs per patient. Among withdrawals from OIT, the mean number of AARs per patient was 8.3 versus 5.1 in non-withdrawals.
AARs were more frequent in children with higher sIgE for alpha-lactalbumine and casein at baseline [1.11 (95% CI 1.01, 1.22) and 1.01(1.0, 1.03 ) respectively]. Children with resolved eczema and higher sIgE for beta – lactoglobuline at baseline [0.13 (95% CI 0.04, 0.46) ], [0.96 (95% CI 0.94, 0.99)] respectively, were less likely to develop AARs.
Conclusion
Although the majority of ARs during OIT are non anaphylactic, AARs occur frequently. Children with higher sIgE for alpha-lactalbumine and casein at baseline seem to be at higher risk for AARs during OIT.
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Low cross-reactivity between cisplatin and other platinum salts
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Justine Pasteur, Laure Favier, Corinne Pernot, Mathieu Guerriaud, Charlotte Bernigaud, Côme Lepage, Jean-Louis Jouve, Nicolas Isambert, Evelyne Collet
Abstract
Background
Hypersensitivity reactions to platinum salts (PS) (cisplatin (CI), carboplatin (CA) and oxaliplatin (OX)) can be severe and their incidence is increasing due to their widespread use in cancer treatment.
Objective
To determine the rate of cross-reactivity between platinum salts and whether CI can be administered without prior allergy testing in patients with a history of CA or OX hypersensitivity.
Methods
From September 2002 to April 2016, patients with suspected immediate PS hypersensitivity were tested and cross-reactivity between the three PS was evaluated. We then studied patients who were given cisplatin without desensitization after immediate hypersensitivity to other PS.
Results
A total of 155 patients were included. Skin tests were positive in 97 patients (OX: 51, CA: 43 and CI: 3). Cross-reactivity to CA in OX-allergic patients was 45% (23/51) (95%CI: 36% to 66%) and cross-reactivity to OX in CA-allergic patients was 37% (16/43) (95%CI: 23% to 53%). In contrast, cross-reactivity to CI was 0% (0/51) (95%CI: 0% to 7%) in OX-allergic patients and 7% (3/43) (95%CI: 2% to 17%) in CA-allergic patients. All these 3 patients had previously been exposed to CI in previous courses of chemotherapy. CI was initiated in 24 patients with proven hypersensitivity to CA or OX and had no hypersensitivity reactions.
Conclusion
Initiating CI in patients with proven immediate hypersensitivity to CA or OX appeared to be safe in our study.
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Screening for inhalation technique errors with electronic medication monitors
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): William C. Anderson, Rahul Gondalia, Heather E. Hoch, Leanne Kaye, Stanley J. Szefler, David A. Stempel
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The European Society for Immunodeficiencies (ESID) Registry Working Definitions for the Clinical Diagnosis of Inborn Errors of Immunity
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Markus G. Seidel, Gerhard Kindle, Benjamin Gathmann, Isabella Quinti, Matthew Buckland, Joris van Montfrans, Raphael Scheible, Stephan Rusch, Lukas M. Gasteiger, Bodo Grimbacher, Nizar Mahlaoui, Stephan Ehl, Michael Albert, Sarah Beaussant Cohen, Jacinta Bustamante, Andrew Cant, Jean-Laurent Casanova, Helen Chapel, Genevieve de Saint Basile, Esther de Vries
Abstract
Patient registries are instrumental for clinical research in rare diseases. They help to achieve a sufficient sample size for epidemiological and clinical research and to assess the feasibility of clinical trials. The European Society for Immunodeficiencies (ESID) registry currently comprises information on >25,000 patients with inborn errors of immunity (IEI). The prerequisite of a patient to be included into the ESID registry is an IEI either defined by a defect in a gene included in the disease classification of the international union of immunological societies (IUIS), or verified by applying clinical criteria. Because a relevant number of patients, including those with common variable immunodeficiency (CVID), representing the largest group of patients in the registry, remains without a genetic diagnosis, consensus on classification of these patients is mandatory. Here, we present clinical criteria for a large number of IEI that were designed in expert panels with external review. They were implemented for novel entries and verification of existing datasets from 2014, yielding a substantial refinement. For instance, 8% of adults and 27% of children with CVID (176 out of 1704 patients) were reclassified to 22 different immunodeficiencies, illustrating progress in genetics, but also the previous lack of standardized disease definitions. Importantly, apart from registry purposes, the clinical criteria are also helpful to support treatment decisions in the absence of a genetic diagnosis or in patients with variants of unknown significance.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2IvodxV
Severe Necrotic Reaction to 23-Valent Polysaccharide Pneumococcal Vaccine in a Patient With STAT3 Deficiency
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Mervin Piñones, Cecilia Vizcaya, Guillermo Pérez-Mateluna, Rodrigo Hoyos-Bachiloglu, Arturo Borzutzky
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gu4v3F
AAAAI/ACAAI subcutaneous immunotherapy (SCIT) surveillance study (2013-2017): fatalities, infections, delayed reactions and use of epinephrine auto-injectors
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Tolly G. Epstein, Gary M. Liss, Karen Murphy Berendts, David I. Bernstein
Abstract
Background
SCIT is highly effective but safety risks exist.
Objective
The aims of this study were to: 1) identify clinical practices that could influence fatal and non-fatal systemic allergic reactions (SRs) to SCIT; and 2) identify SCIT-associated infections.
Methods
From 2008-2016, 27-51% of AAAAI/ACAAI members completed an annual survey of SCIT-related SRs of varying severity. Post-injection local cutaneous and systemic infections were queried for 2014-2016. For 2014-2016, respondents were queried about timing of onset of SRs, post-injection waiting times, and prescription/use of epinephrine auto-injectors.
Results
Data were gathered on 54.4 million injection visits (2008-2016). Two confirmed fatalities from SCIT occurred between 2008-2014. An additional five confirmed fatalities occurred between 2015-2017. No infections occurred in 17.3 million injection visits (2014-2016). Among practices monitoring patients for at least 30 minutes, 15% of SRs occurred after 30 minutes. Practices prescribing an epinephrine auto-injector >90% of the time (29% of practices) did not experience lower rates of delayed Grade 3/4 SRs. Of patients experiencing Grade 3/4 delayed SRs, 26% and 8% used prescribed self-injectable epinephrine devices during 2014-2015 and 2015-2016, respectively.
Conclusions
There is an unexplained slight increase in SCIT-related fatalities for 2015-2017, although mean annual reported events over 9 years (0.8 fatal reactions/year) have declined. SCIT-related infections were not identified during two years of surveillance. The 15% incidence of delayed-onset SRs (> 30 min) is similar to a prior annual survey. Prescribing epinephrine auto-injectors for SCIT does not appear to improve outcomes, possibly due to low rates of self-administration.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2IeUZDb
Do youth ask asthma providers the questions they want to ask?
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Scott A. Davis, Richard F. Brown, Robyn Sayner, Delesha Carpenter, Charles Lee, Nacire Garcia, Daniel S. Reuland, Gail Tudor, Ceila E. Loughlin, Betsy Sleath
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2Gs6aH1
Bullous Fixed Drug Eruption Caused by Etoricoxib Confirmed by Patch Testing
Publication date: Available online 15 February 2019
Source: The Journal of Allergy and Clinical Immunology: In Practice
Author(s): Leonor Carneiro-Leão, Josefina Rodrigues Cernadas
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Reconstruction of the temporomandibular joint: a comparison between prefabricated and customized alloplastic prosthetic total joint systems
Publication date: Available online 15 February 2019
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): B.J. Siegmund, K. Winter, P. Meyer-Marcotty, J. Rustemeyer
Abstract
The implantation of an alloplastic total temporomandibular joint (TMJ) prosthesis is an innovative approach for the treatment of end-stage TMJ disorders. Two types of system exist: prefabricated (stock) and customized computer-aided design/computer-aided manufacturing (CAD/CAM) devices. A clinical study was performed to evaluate the effectiveness of these two designs. Twenty-eight patients treated between 2015 and 2017 were included and assigned to two groups: stock prostheses (group 1) and customized CAD/CAM prostheses (group 2). Clinical evaluations were performed at five time-points up to 6 months postoperative. Parameters included maximum interincisal opening, pain, diet, complications, and subjective well-being at the end of follow-up. Differences between pre-surgery and 6-month post-surgery values were highly significant (P < 0.001). No patient required a liquid diet at the end of treatment, and 66% of group 1 patients and 100% of group 2 patients reported improved well-being. Complications were observed in 32% of patients and included temporary paralysis of the facial nerve. In conclusion, clinical outcomes of stock and CAD/CAM prostheses suggested great improvements in mouth opening and reduction of pain as a result of the rehabilitation of TMJ function. Results showed comparable data for the two types of prosthesis design at 6 months postoperative.
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Locally advanced mammary analogue secretory carcinoma of the parotid gland
Publication date: Available online 15 February 2019
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): N. Tokuzen, H. Goda, K. Nakashiro
Abstract
Mammary analogue secretory carcinoma (MASC) has recently been recognized as a salivary gland tumour that is characterized by the ETV6–NTRK3 fusion gene. A case of locally advanced MASC of the parotid gland in a 67-year-old man is presented here. The patient visited the hospital due to a large right infra-auricular mass, which had been enlarging gradually over a period of 2 years. Contrast-enhanced computed tomography (CT) demonstrated a multilocular mass, 75 × 63 mm in size, containing a fluid component with non-uniform contrast effects in the interior portion. The mass had invaded the orbit, skull base, and parapharyngeal space. The patient had neither lymph node nor distant metastasis. The tumour showed tubular and ductal proliferation lined by a single layer of neoplastic cuboidal cells with clear foamy cytoplasm. Characteristic hobnail cells were observed. Expression of ETV6–NTRK3 fusion transcript in the tumour tissues was confirmed by RT-PCR. The final diagnosis was MASC (T4bN0M0, stage IVB). The patient received cetuximab together with radiotherapy at a total dose of 66 Gy. After treatment, CT showed a slightly reduced tumour volume, indicating stable disease. More than 56 months after treatment, the patient remains alive with no remarkable change in the tumour.
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Accuracy of custom-fitted temporomandibular joint alloplastic reconstruction and virtual surgical planning
Publication date: Available online 15 February 2019
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): S. Sembronio, A. Tel, F. Costa, M. Isola, M. Robiony
Abstract
The purpose of this study was to evaluate the accuracy of temporomandibular joint (TMJ) custom-made replacements by means of virtual surgical planning.
The authors review 11 TMJ custom-made prostheses made of both mandibular and fossa components. Surgeries were virtually planned and patient-specific devices were designed together with surgical cutting and positional guides. Three-dimensional models for both preoperative planning and postoperative computed tomography scans were generated and overlapped in order to evaluate differences in measurements. Correlation between virtual preoperative and real postoperative prosthesis positioning was described by Lin's coefficient.
Results of statistical analysis showed an almost perfect concordance. Wilcoxon's matched-pairs test showed no statistically significant deviation between preoperative virtual surgical planning and postoperative results. Colour map analysis confirmed the correspondence between virtually planned positioning of the devices and postoperative results. All the prostheses were placed with great accuracy.
In conclusion, virtual surgical planning, surgical guides and patient-specific devices provide accuracy and precision in surgery for custom-made TMJ replacement.
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Influence of mandibular setback surgery on three-dimensional pharyngeal airway changes
Publication date: Available online 15 February 2019
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): S.-T. Lee, J.-H. Park, T.-G. Kwon
Abstract
The aim of this study was to investigate the factors influencing three-dimensional changes in pharyngeal airway space after mandibular setback surgery. Airway changes in 48 skeletal class III patients who had undergone mandibular setback surgery alone (n = 25, group 1) or with maxillary surgery (n = 23, group 2) were analyzed. Linear parameters, cross-sectional area, and volumes of the pharyngeal airway were evaluated before (T0), immediately after (T1), and 1 year after surgery (T2) by cone beam computed tomography. Although the reduced airway volume and cross-sectional area recovered slightly in the long term after surgery, the total pharyngeal airway volume (TPV) was significantly reduced compared to baseline, by 15% in group 1 and 12% in group 2. Regression analysis showed that maxillary posterior impaction in two-jaw surgery had a protective effect on preserving TPV. A change in body mass index from T0 to T2 was an important predictor of decreased TPV in one-jaw surgery patients. Maxillary posterior impaction can be a reliable option for compensating the pharyngeal airway reduction after mandibular setback surgery. Postoperative weight gain can increase the risk of postoperative pharyngeal airway reduction. Therefore, these factors need to be considered before and after mandibular setback surgery.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GuKJ8a
Reconstruction of the temporomandibular joint: a comparison between prefabricated and customized alloplastic prosthetic total joint systems
Publication date: Available online 15 February 2019
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): B.J. Siegmund, K. Winter, P. Meyer-Marcotty, J. Rustemeyer
Abstract
The implantation of an alloplastic total temporomandibular joint (TMJ) prosthesis is an innovative approach for the treatment of end-stage TMJ disorders. Two types of system exist: prefabricated (stock) and customized computer-aided design/computer-aided manufacturing (CAD/CAM) devices. A clinical study was performed to evaluate the effectiveness of these two designs. Twenty-eight patients treated between 2015 and 2017 were included and assigned to two groups: stock prostheses (group 1) and customized CAD/CAM prostheses (group 2). Clinical evaluations were performed at five time-points up to 6 months postoperative. Parameters included maximum interincisal opening, pain, diet, complications, and subjective well-being at the end of follow-up. Differences between pre-surgery and 6-month post-surgery values were highly significant (P < 0.001). No patient required a liquid diet at the end of treatment, and 66% of group 1 patients and 100% of group 2 patients reported improved well-being. Complications were observed in 32% of patients and included temporary paralysis of the facial nerve. In conclusion, clinical outcomes of stock and CAD/CAM prostheses suggested great improvements in mouth opening and reduction of pain as a result of the rehabilitation of TMJ function. Results showed comparable data for the two types of prosthesis design at 6 months postoperative.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2IhpBUG
Locally advanced mammary analogue secretory carcinoma of the parotid gland
Publication date: Available online 15 February 2019
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): N. Tokuzen, H. Goda, K. Nakashiro
Abstract
Mammary analogue secretory carcinoma (MASC) has recently been recognized as a salivary gland tumour that is characterized by the ETV6–NTRK3 fusion gene. A case of locally advanced MASC of the parotid gland in a 67-year-old man is presented here. The patient visited the hospital due to a large right infra-auricular mass, which had been enlarging gradually over a period of 2 years. Contrast-enhanced computed tomography (CT) demonstrated a multilocular mass, 75 × 63 mm in size, containing a fluid component with non-uniform contrast effects in the interior portion. The mass had invaded the orbit, skull base, and parapharyngeal space. The patient had neither lymph node nor distant metastasis. The tumour showed tubular and ductal proliferation lined by a single layer of neoplastic cuboidal cells with clear foamy cytoplasm. Characteristic hobnail cells were observed. Expression of ETV6–NTRK3 fusion transcript in the tumour tissues was confirmed by RT-PCR. The final diagnosis was MASC (T4bN0M0, stage IVB). The patient received cetuximab together with radiotherapy at a total dose of 66 Gy. After treatment, CT showed a slightly reduced tumour volume, indicating stable disease. More than 56 months after treatment, the patient remains alive with no remarkable change in the tumour.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2GyNpSn
Accuracy of custom-fitted temporomandibular joint alloplastic reconstruction and virtual surgical planning
Publication date: Available online 15 February 2019
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): S. Sembronio, A. Tel, F. Costa, M. Isola, M. Robiony
Abstract
The purpose of this study was to evaluate the accuracy of temporomandibular joint (TMJ) custom-made replacements by means of virtual surgical planning.
The authors review 11 TMJ custom-made prostheses made of both mandibular and fossa components. Surgeries were virtually planned and patient-specific devices were designed together with surgical cutting and positional guides. Three-dimensional models for both preoperative planning and postoperative computed tomography scans were generated and overlapped in order to evaluate differences in measurements. Correlation between virtual preoperative and real postoperative prosthesis positioning was described by Lin's coefficient.
Results of statistical analysis showed an almost perfect concordance. Wilcoxon's matched-pairs test showed no statistically significant deviation between preoperative virtual surgical planning and postoperative results. Colour map analysis confirmed the correspondence between virtually planned positioning of the devices and postoperative results. All the prostheses were placed with great accuracy.
In conclusion, virtual surgical planning, surgical guides and patient-specific devices provide accuracy and precision in surgery for custom-made TMJ replacement.
from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2IfSYXu
Influence of mandibular setback surgery on three-dimensional pharyngeal airway changes
Publication date: Available online 15 February 2019
Source: International Journal of Oral and Maxillofacial Surgery
Author(s): S.-T. Lee, J.-H. Park, T.-G. Kwon
Abstract
The aim of this study was to investigate the factors influencing three-dimensional changes in pharyngeal airway space after mandibular setback surgery. Airway changes in 48 skeletal class III patients who had undergone mandibular setback surgery alone (n = 25, group 1) or with maxillary surgery (n = 23, group 2) were analyzed. Linear parameters, cross-sectional area, and volumes of the pharyngeal airway were evaluated before (T0), immediately after (T1), and 1 year after surgery (T2) by cone beam computed tomography. Although the reduced airway volume and cross-sectional area recovered slightly in the long term after surgery, the total pharyngeal airway volume (TPV) was significantly reduced compared to baseline, by 15% in group 1 and 12% in group 2. Regression analysis showed that maxillary posterior impaction in two-jaw surgery had a protective effect on preserving TPV. A change in body mass index from T0 to T2 was an important predictor of decreased TPV in one-jaw surgery patients. Maxillary posterior impaction can be a reliable option for compensating the pharyngeal airway reduction after mandibular setback surgery. Postoperative weight gain can increase the risk of postoperative pharyngeal airway reduction. Therefore, these factors need to be considered before and after mandibular setback surgery.
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Adenoid cystic carcinoma with high-grade transformation forming spindle cell component of the submandibular gland
Publication date: Available online 16 February 2019
Source: Auris Nasus Larynx
Author(s): Masaru Miyazaki, Mikiko Aoki, Kaori Koga, Makoto Hamasaki, Yoshikazu Sugiyama, Kensuke Midorikawa, Daisuke Hamatake, Michio Masaki, Yasushi Takamatsu, Akinori Iwasaki, Toshifumi Sakata, Toshitaka Nagao, Kazuki Nabeshima
Abstract
Adenoid cystic carcinoma (AdCC) with high-grade transformation (AdCC-HGT) is rare, and AdCC-HGT with spindle cell component is particularly rare. The patient was a 65-year-old man with a 5 cm sized swelling of the right submandibular gland. Submandibular sialoadenectomy was performed. Histopathological findings mainly showed conventional AdCC, and minorly showed two other components: (1) the pleomorphic component, a proliferation of atypical pleomorphic epithelial cells forming solid or small clusters and accompanied by necrosis; (2) the spindle cell component, containing atypical spindle cells invading the stroma. Postoperative chemoradiotherapy was performed. Multiple right lung nodular lesions were found on the contrast-enhanced chest CT one month after the surgery. Thoracoscopic pulmonary resection was performed. The lung tumors exhibited a proliferation of atypical spindle cells, accompanied by necrosis. We considered that the spindle cell component of the AdCC-HGT of the submandibular gland developed lung metastases. The patient died seven months after submandibular sialoadenectomy due to respiratory failure. Although rare, our case highlights the importance of recognising spindle cell components in conventional AdCC; even if the area is small, these high-grade transformation areas can metastasise and become prognostic factors.
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A through year behavior of 137Cs in a Japanese flowering cherry tree in relation to that of potassium
Publication date: June 2019
Source: Journal of Environmental Radioactivity, Volume 202
Author(s): Toshihiro Yoshihara, Vasyl Yoschenko, Kenji Watanabe, Koji Keitoku
Abstract
To understand the transfer of radiocesium (137Cs) in inside of deciduous trees, changes in 137Cs activity concentrations, primarily derived from the Fukushima accident in March 2011, were observed in the upper parts of a Japanese flowering cherry tree (Prunus x yedoensis cv. Somei-Yoshino) between 2015 and 2018. The sampling of the foliar parts occurred over the entire leaf life span from winter bud to litterfall and those of the branches were distinguished based on emergence years (2017, 2016, 2015, 2014–2011, and 2010/before). First, every tissue demonstrated a clear seasonal variation in 137Cs activity concentration. Second, a synchrony of seasonal variations in 137Cs activity concentration with those in the biological analogue of K concentration was observed in foliar parts during their growth season, but not in branches nor during the other seasons. With respect to the timing of changes in each tissue with tree phenology, it is possible that K and 137Cs alternate between leaves and branches via the same translocation mechanisms. The resorption efficiencies (i.e., 1 − [the concentrations in the last litterfall]/[the maximum concentrations in green leaves]) of K and 137Cs were 76% and 46% in average, respectively. In addition, both leaf buds and branches played an important role as reservoirs during dormancy. The buds storage ratio before and after bud burst (i.e., [the inventories in buds at the end of defoliation]/[those before and after bud burst]) for K were 0.57 and 0.10 in median, respectively, and those for and 137Cs were 1.14 and 0.14 in median, respectively. Consequently, the transfer of 137Cs in inside of trees was still visible seven years after deposition, even though the annual reduction in 137Cs activity concentration was apparent in each tissue.
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Evaluation of body size and temperature on 137Cs uptake in marine animals
Publication date: June 2019
Source: Journal of Environmental Radioactivity, Volume 202
Author(s): Derin M. Thomas, Nicholas S. Fisher
Abstract
137Cs bioaccumulation and retention in seven different marine animal species, including crustaceans, mollusc larvae, and fish larvae were compared under different temperature conditions (10 °C, 18 °C and 25 °C). Replicate animals were experimentally exposed to 0.5 nM 137Cs dissolved in filtered seawater for 3 days, and their 137Cs contents were periodically measured using gamma spectrometry. Among the seven species, 137Cs bioconcentration factors ranged from 14 to 239 at the end of the exposure periods. Following uptake, the137Cs loss rate constants from the animals ranged from 5 to 50% d−1 and were unaffected by temperature or animal size. The 137Cs bioconcentration factors were directly related to animal size and hence their surface: volume ratios, consistent with the conclusion that Cs sorption from the aqueous phase is the principal uptake mechanism in these animals. With the exception of gastropods, temperature had no major influence on Cs uptake and efflux in the experimental species.
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Effect of ionizing radiation on physiological and molecular processes in plants
Publication date: June 2019
Source: Journal of Environmental Radioactivity, Volume 202
Author(s): Sergey V. Gudkov, Marina A. Grinberg, Vladimir Sukhov, Vladimir Vodeneev
Abstract
The study of effects of ionizing radiation (IR) on plants is important in relation to several problems: (I) the existence of zones where background radiation – either natural or technogenic – is increased; (II) the problems of space biology; (III) the use of IR in agricultural selection; (IV) general biological problems related to the fundamental patterns and specifics of the effects of IR on various living organisms. By now, researchers have accumulated and systematized a large body of data on the effects of IR on the growth and reproduction of plants, as well as on the changes induced by IR at the genetic level. At the same time, there is a large gap in understanding the mechanisms of IR influence on the biochemical and physiological processes – despite the fact that these processes form the basis determining the manifestation of IR effects at the level of the whole organism. On the one hand, the activity of physiological processes determines the growth of plants; on the other, it is determined by changes at the genetic level. Thus, it is the study of IR effects at the physiological and biochemical levels that can give the most detailed and complex picture of IR action in plants.
The review focuses on the effects of radiation on the essential physiological processes, including photosynthesis, respiration, long-distance transport, the functioning of the hormonal system, and various biosynthetic processes. On the basis of a large body of experimental data, we analyze dose and time dependences of the IR-induced effects – which are qualitatively similar – on various physiological and biochemical processes. We also consider the sequence of stages in the development of those effects and discuss their mechanisms, as well as the cause-effect relationships between them. The primary IR-induced physicochemical reactions include the formation of various forms of reactive oxygen species (ROS) and are the cause of the observed changes in the functional activity of plants. The review emphasizes the role of hydrogen peroxide, a long-lived ROS, not only as a damaging agent, but also as a mediator – a universal intracellular messenger, which provides for the mechanism of long-distance signaling. A supposition is made that IR affects physiological processes mainly by violating the regulation of their activity. The violation seems to become possible due to the fact that there exists a crosstalk between different signaling systems of plants, such as ROS, calcium, hormonal and electrical systems. As a result of both acute and chronic irradiation, an increase in the level of ROS can influence the activity of a wide range of physiological processes – by regulating them both at the genetic and physiological levels. To understand the ways, by which IR affects plant growth and development, one needs detailed knowledge about the mechanisms of the processes that occur at the (i) genetic and (ii) physiological levels, as well as their interplay and (iii) knowledge about regulation of these processes at different levels.
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Fit-for-purpose modelling of radiocaesium soil-to-plant transfer for nuclear emergencies: a review
Publication date: May 2019
Source: Journal of Environmental Radioactivity, Volume 201
Author(s): Talal Almahayni, Nicholas A. Beresford, Neil M.J. Crout, Lieve Sweeck
Abstract
Numerous radioecological models have been developed to predict radionuclides transfer from contaminated soils to the food chain, which is an essential step in preparing and responding to nuclear emergencies. However, the lessons learned from applying these models to predict radiocaesium (RCs) soil-to-plant transfer following the Fukushima accident in 2011 renewed interest in RCs transfer modelling. To help guide and prioritise further research in relation to modelling RCs transfer in terrestrial environments, we reviewed existing models focussing on transfer to food crops and animal fodders.
To facilitate the review process, we categorised existing RCs soil-to-plant transfer models into empirical, semi-mechanistic and mechanistic, though several models cross the boundaries between these categories. The empirical approach predicts RCs transfer to plants based on total RCs concentration in soil and an empirical transfer factor. The semi-mechanistic approach takes into account the influence of soil characteristics such as clay and exchangeable potassium content on RCs transfer. It also uses ʻbioavailableʼ rather than total RCs in soil. The mechanistic approach considers the physical and chemical processes that control RCs distribution and uptake in soil-plant systems including transport in the root zone and root absorption kinetics.
Each of these modelling approaches has its advantages and disadvantages. The empirical approach is simple and requires two inputs, but it is often associated with considerably uncertainty due to the large variability in the transfer factor. The semi-mechanistic approach factorises more soil and plant parameters than the empirical approach; therefore, it is applicable to a wider range of environmental conditions. The mechanistic approach is instrumental in understanding RCs mobility and transfer in soil-plant systems; it also helps to identify influential soil and plant parameters. However, the comlexity and the large amount of specific parameters make this approach impractical for nuclear emergency preparedness and response purposes.
We propose that the semi-mechanistic approach is sufficiently robust and practical, hence more fit for the purpose of planning and responding to nuclear emergencies compared with the empirical and mechanistic approaches. We recommend further work to extend the applicability of the semi-mechanistic approach to a wide range of plants and soils.
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Differences in Prenatal Care by Presence and Type of Maternal Disability
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Willi Horner-Johnson, Frances M. Biel, Aaron B. Caughey, Blair G. Darney
Introduction
Prior studies have found that women with disabilities are less likely to receive adequate prenatal care than women without disabilities. However, little is known about differences in patterns of prenatal care by type of disability. Therefore, this study examined timing and frequency of prenatal care among women with physical, sensory, or intellectual/developmental disabilities compared with women without disabilities.
Methods
This was a retrospective cohort study using linked maternal and infant hospital discharge and birth certificate data for all births in California in 2000–2012 (N=6,745,201). Analyses were conducted in 2017–2018. Modified Poisson regression analyses compared women with each type of disability with women without disabilities on trimester of prenatal care initiation and number of prenatal care visits.
Results
Women with intellectual/developmental disabilities or with limited hearing had significantly higher RR of delaying prenatal care initiation until the second or third trimester (intellectual/developmental disabilities: adjusted RR=1.21, 95% CI=1.09, 1.33; hearing: adjusted RR=1.11, 95% CI=1.02, 1.21), whereas women with physical disabilities and limited vision had lower risk of delaying care (physical: adjusted RR=0.91, 95% CI=0.88, 0.94; vision: adjusted RR=0.85, 95% CI=0.73, 0.99). Women with limited hearing or vision or intellectual/developmental disabilities had higher risk of receiving fewer prenatal visits than recommended, compared with women without disabilities. Women with physical disabilities or intellectual/developmental disabilities had higher RR of receiving more than the typical number of visits.
Conclusions
There were key differences in prenatal care utilization by disability type, reflective of particularly pronounced disparities for women with intellectual/developmental disabilities and women with limited hearing. Delays in receipt of prenatal care and low numbers of prenatal care visits may contribute to the poorer birth outcomes that have been observed previously in these groups. Targeted interventions are needed to improve uptake of prenatal care in these vulnerable populations.
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Documentation of ENDS Use in the Veterans Affairs Electronic Health Record (2008–2014)
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Mike Conway, Danielle L. Mowery, Brett R. South, Gregory J. Stoddard, Wendy W. Chapman, Olga V. Patterson, Shu-Hong Zhu
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Temporal Patterns in Chlamydia Repeat Testing in Massachusetts
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Elizabeth C. Dee, Katherine K. Hsu, Benjamin A. Kruskal, John T. Menchaca, Bob Zambarano, Noelle Cocoros, Brian Herrick, Michelle D. Payne Weiss, Ellen Hafer, Diana Erani, Mark Josephson, Jessica Young, Elizabeth A. Torrone, Elaine W. Flagg, Michael Klompas
Introduction
National guidelines recommend test-of-cure for pregnant women and test-of-reinfection for all patients with chlamydia infections in order to interrupt transmission and prevent adverse sequelae for patients, partners, and newborns. Little is known about retesting and positivity rates, and whether they are changing over time, particularly in private sector practices.
Methods
Electronic health record data on patients with chlamydia tests were extracted from three independent clinical practice groups serving ≅20% of the Massachusetts population. Records were extracted using the Electronic medical record Support for Public Health platform (esphealth.org). These data were analyzed for temporal trends in annual repeat testing rates by using generalized estimating equations after index positive chlamydia tests between 2010 and 2015 and for differences in intervals to first repeat tests among pregnant females, non-pregnant females, and males. Data extraction and analysis were performed during calendar years 2017 and 2018.
Results
An index positive C. trachomatis result was identified for 972 pregnant female cases, 10,309 non-pregnant female cases, and 4,973 male cases. Test-of-cure 3–5 weeks after an index positive test occurred in 37% of pregnant females. Test-of-reinfection 8–16 weeks after an index positive test occurred in 39% of pregnant females, 18% of non-pregnant females, and 9% of males. There were no significant increases in test-of-cure or test-of-reinfection rates from 2010 to 2015. Among cases with repeat tests, 16% of pregnant females, 15% of non-pregnant females, and 16% of males had positive results.
Conclusions
Chlamydia test-of-cure and test-of-reinfection rates are low, with no evidence of improvement over time. There are substantial opportunities to improve adherence to chlamydia repeat testing recommendations.
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Long-Term Effectiveness of a Lifestyle Intervention: A Pragmatic Community Trial to Prevent Metabolic Syndrome
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Davood Khalili, Samaneh Asgari, Mojtaba Lotfaliany, Neda Zafari, Farzad Hadaegh, Amir-Abbas Momenan, Armin Nowroozpoor, Firoozeh Hosseini-Esfahani, Parvin Mirmiran, Parisa Amiri, Fereidoun Azizi
Introduction
The purpose of this study is to evaluate the long-term effectiveness of a community-based lifestyle education on primary prevention of metabolic syndrome in a middle-income country.
Study design
This study followed 3,180 individuals free of metabolic syndrome who were under the coverage of three health centers in Tehran from 1999 until 2015. They were undergoing triennial examinations resulting in four re-exams. People in one of three areas received interventions consisting of family-, school-, and community-based educational programs, including a face-to-face educational session at baseline. Data were analyzed considering the incidence of metabolic syndrome at each re-exam and also repeated-measure analysis including all re-exams together. Weighting was considered to correct selection bias because of loss to follow-up. Data were analyzed in 2017.
Results
After 3 years, 149 of 852 participants in the intervention and 471 of 2,328 people in control area developed metabolic syndrome at first re-exam resulting in a RR of 0.78 (95% CI=0.67, 0.92). The difference between groups remained unchanged up to the 6-year follow-up (RR=0.79, 95% CI=0.66, 0.93, at second re-exam), but disappeared during the third and fourth re-exams (RR=1.04, 95% CI=0.91, 1.18 and RR=1.03, 95% CI=0.91, 1.16, respectively). Marginal models for longitudinal data showed a significant interaction between intervention and time of re-exams. Further analyses showed that the effect of the intervention might have been rooted in improvement of lipid profile and glucose level.
Conclusions
In a middle-income country, face-to-face educational sessions followed by a long-term maintenance community-level educational program could reduce the risk of metabolic syndrome for up to 6 years. A booster face-to-face session is recommended to retain this preventive effect.
Trial registration
This study is registered at Iran Registry for Clinical Trials (http://irct.ir) IRCT138705301058N1.
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Vaccination Practices Among Obstetrician/Gynecologists for Non-pregnant Patients
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Sean T. O'Leary, Laura E. Riley, Megan C. Lindley, Mandy A. Allison, Lori A. Crane, Laura P. Hurley, Brenda L. Beaty, Michaela Brtnikova, Margaret Collins, Alison P. Albert, Allison K. Fisher, Angela J. Jiles, Allison Kempe
Introduction
Many non-pregnant women see obstetrician-gynecologists as their sole source of medical care, yet little is known about vaccination practices of obstetrician-gynecologists for non-pregnant patients. The objectives were to assess, among a national sample of obstetrician-gynecologists, practices related to vaccine delivery in non-pregnant patients and factors associated with stocking and administering more than three different vaccines to non-pregnant patients.
Methods
E-mail and mail surveys were administered July–October 2015, with analyses performed during October–November 2015 and April–June 2018.
Results
The response rate was 73% (353/482). Human papillomavirus (92%); influenza (82%); and tetanus, diphtheria, acellular pertussis vaccines (50%) were the vaccines most commonly assessed, with the remaining vaccines assessed by <40% of respondents. Vaccines most commonly administered by obstetrician-gynecologists to non-pregnant patients included human papillomavirus (81%); influenza (70%); and tetanus, diphtheria, acellular pertussis (54%). The remaining vaccines were administered by <30% of obstetrician-gynecologists. Factors associated with routinely administering more than three vaccines to non-pregnant patients included working in a hospital-, public health–, or university-associated clinic (RR=1.87, 95% CI=1.35, 2.58, referent to private practice); a larger practice (more than five providers; RR=1.54, 95% CI=1.05, 2.27); perceiving fewer financial barriers (RR=0.74, 95% CI=0.57, 0.96); fewer practice-associated barriers (RR=0.71, 95% CI=0.55, 0.92); and greater patient barriers (RR=1.62, 95% CI=1.33, 1.98).
Conclusions
Human papillomavirus; influenza; and tetanus, diphtheria, acellular pertussis vaccines are the only vaccines routinely assessed and administered to non-pregnant patients by most obstetrician-gynecologists. Given their role as the sole source of care for many women, obstetrician-gynecologists could make a positive impact on the vaccination status of their non-pregnant patients.
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Nicotine Dependence and Pre-Enlistment Suicidal Behavior Among U.S. Army Soldiers
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Laura Campbell-Sills, Ronald C. Kessler, Robert J. Ursano, Xiaoying Sun, Steven G. Heeringa, Matthew K. Nock, Sonia Jain, Murray B. Stein
Introduction
Identification of modifiable risk factors for suicidal behaviors is a priority for the U.S. Army. This study investigated associations of nicotine dependence with suicidal behaviors among incoming soldiers.
Methods
Lifetime DSM-IV nicotine dependence, mental disorders, suicidal behaviors, and their ages of onset were retrospectively assessed in the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) New Soldier Study. Discrete-time survival analysis of person-year data from 30,436 soldiers was performed to evaluate associations of nicotine dependence with subsequent suicidal ideation, plans, and attempts. Among respondents with lifetime ideation (n=4,060), models tested associations of nicotine dependence with progression from ideation to first onset of plan, from plan to first attempt, and, among ideators without plans, from ideation to first unplanned attempt. A hierarchy of models incorporated increasing controls for other risk factors. Data were collected in 2011–2012 and analyzed in 2017–2018.
Results
In models controlling for sociodemographic characteristics, nicotine dependence was associated with onset of all suicidal behaviors (AORs, 2.07–4.08, p<0.001) and with each type of progression of suicidal behavior (AORs, 1.48–2.44, p<0.005). After adjusting for childhood adversities and mental disorders, nicotine dependence remained associated with onset of ideation (AOR=1.27, 95% CI=1.10, 1.46, p=0.001) and attempt (AOR=1.83, 95% CI=1.41, 2.37, p<0.001); and with progression from ideation to unplanned attempt (AOR=2.03, 95% CI=1.17, 1.74, p<0.001).
Conclusions
Nicotine dependence exhibited associations with onset of suicidal ideation and suicide attempt—and with progression from ideation to unplanned attempt—that were independent of other measured risk factors. Awareness of associations of nicotine dependence with suicidal behaviors may inform risk assessment, facilitate targeting of prevention efforts, and provide further impetus for reducing nicotine dependence.
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Wellness Committee Status and Local Wellness Policy Implementation Over Time
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Carolyn D. McIlree, Hannah G. Lane, Yan Wang, Erin R. Hager
Introduction
Local Wellness Policies are school-district documents containing guidelines for schools to promote nutrition/physical activity. In cross-sectional studies, schools with wellness committees are more likely to implement Local Wellness Policies. This prospective cohort study examines associations between wellness committee status over time and change in Local Wellness Policy implementation using a biennial, statewide survey.
Methods
School administrators completed surveys following the 2012–2013 (Wave I) and 2014–2015 (Wave II) school years, including a 17-item Local Wellness Policy implementation scale. Four wellness committee status categories included established (both Waves, 35%); new (Wave II only, 22%); discontinued (Wave I only, 13%); and never (neither Wave, 30%). Linear mixed models conducted in 2017–2018 compared LWP implementation change across status groups, accounting for clustering and school characteristics.
Results
Of 1,333 schools, 701 had Wave I data (53%); 748 Wave II (56%); and 441 both (33%). Schools were 69% elementary, 56% suburban, and 35% and 28% had majority (≥75%) African American/Hispanic or low-income student body, respectively. At Wave I, schools with wellness committees (established/discontinued groups) had higher Local Wellness Policy implementation (mean=32.0, SD=11.5, and mean=28.3, SD=11.4, respectively) compared with schools without committees (never/new: mean=15.4, SD=10.7 and mean=17.6, SD=11.4, respectively, F=64.9, p≤0.001). Over time, never and established groups maintained low and high Local Wellness Policy implementation, respectively. Compared with never, new committees increased implementation by 9.9 points (SE=1.8, p<0.001), and discontinued committees decreased by 11.2 (SE=2.1, p<0.001).
Conclusions
Forming and maintaining wellness committees encourages Local Wellness Policy implementation and should be a recommended strategy for school wellness promotion.
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A Primary Care Intervention to Prevent Repeat Pregnancy Among Teen Mothers
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Amy Lewin, Stephanie J. Mitchell, Deirdre A. Quinn, Towanda M. Street, Kristine Schmitz, Lee S. Beers
Introduction
The purpose of this study is to determine the effectiveness of a patient-centered medical home intervention for teen parent families in reducing rates of unintended repeat pregnancy in the first 2 years postpartum.
Methods
A prospective quasi-experimental evaluation was conducted with 98 African American, low-income, teen mother (aged <20 years) participants who received either the intervention or standard pediatric primary care. All participants completed structured interviews at baseline (child aged 2 months) and at follow-ups 12 and 24 months later. Data were collected from 2011 to 2015. Participants reported number of pregnancies, contraception used at last intercourse, depressive symptoms, and romantic status of the relationship with the baby's father. Analyses were conducted from 2015 to 2017.
Results
Logistic regression showed that mothers in the intervention group were half as likely as mothers who received standard pediatric primary care to have a repeat pregnancy within 2 years (OR=0.55, p=0.16). The main effect of the intervention on lower rates of repeat pregnancy was mediated by higher rates of contraceptive use. Depression was associated with higher odds of repeat pregnancy, but did not appear to mediate the intervention effect.
Conclusions
This comprehensive and integrated model of care for teen parents may be an effective method to prevent rapid repeat pregnancies in this vulnerable population.
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Neighborhood Food Environment and Dementia Incidence: the Japan Gerontological Evaluation Study Cohort Survey
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Yukako Tani, Norimichi Suzuki, Takeo Fujiwara, Masamichi Hanazato, Katsunori Kondo
Introduction
Interventions targeting built environmental factors may encourage older people to engage in favorable behaviors and decrease dementia risk, but epidemiologic evidence is limited. This study investigated the association between neighborhood food environment and dementia incidence.
Methods
A 3-year follow-up (2010–2013) was conducted among participants in the Japan Gerontological Evaluation Study, a population-based cohort study of older adults aged ≥65 years. Dementia incidence for 49,511 participants was assessed through the public long-term care insurance system. Availability of food stores (defined as the number of food stores selling fruits and vegetables within 500 meters or 1 kilometer of residence) was assessed for each participant using objective (GIS-based) and subjective (participant-reported) measurements. Data were analyzed from 2017 to 2018.
Results
A total of 3,162 cases of dementia occurred during the follow-up. Compared with the highest quartile for objective availability of food stores, the hazard ratio adjusting for age and sex was 1.60 (95% CI=1.43, 1.78) for the second-lowest quartile. Compared with the highest subjective availability of food stores, the hazard ratio was 1.74 (95% CI=1.49, 2.04) for the lowest category. After successive adjustment for sociodemographic characteristics, health status, and other geographic neighborhood factors (availability of restaurants, convenience stores, and community centers), the hazard ratio remained statistically significant.
Conclusions
Lower food store availability was associated with increased dementia incidence. Given that food shopping is a routine activity and a main motive for going out among older adults, increasing the availability of food stores may contribute to dementia prevention.
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Physical Activity Levels and New Public Transit: A Systematic Review and Meta-analysis
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): Christina Xiao, Yevgeniy Goryakin, Michele Cecchini
Context
Physical inactivity is a public health concern as it contributes to the rising burden of noncommunicable diseases. Introducing new public transportation options, such as extending or building new light rail or bus rapid transit stations, could encourage commuters to walk to and from public transit stops, thus increasing their physical activity levels. Despite previous research generally finding positive associations between public transit usage and physical activity levels, few have summarized the association between introducing new public transportation options and different intensities of physical activity. This study aimed to systematically review the current evidence and perform a meta-analysis on this association.
Evidence acquisition
Ten databases were systematically searched for studies published between 1997 and 2017. To ensure comparability, study outcomes were converted to MET hours/week. A random effects meta-analysis and sensitivity analysis were then conducted.
Evidence synthesis
Nine studies were identified to be included in the systematic review, of which five were eligible for meta-analysis. Pooled results suggest that building new public transit options is associated with a statistically significant increase in light to moderate physical activity levels by 1.76 MET hours/week (95% CI=0.19, 3.32, p=0.03). This is equivalent to increasing walking and other light to moderate physical activity by about 30 minutes per week, relative to baseline. No significant effect was found for the moderate to vigorous physical activity outcome.
Conclusions
Results show new public transit options can substantially contribute to increasing low- to moderate-intensity exercise levels, which has the potential to improve health on a population scale.
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Racial Differences in Maintaining Optimal Health Behaviors Into Middle Age
Publication date: March 2019
Source: American Journal of Preventive Medicine, Volume 56, Issue 3
Author(s): John N. Booth, Norrina B. Allen, David Calhoun, April P. Carson, Luqin Deng, David C. Goff, David T. Redden, Jared P. Reis, Daichi Shimbo, James M. Shikany, Stephen Sidney, Bonnie Spring, Cora E. Lewis, Paul Muntner
Introduction
Earlier development of cardiovascular disease risk factors in blacks versus whites may result from differences in maintaining health behaviors. Age-specific racial differences in maintaining health behaviors from ages 18 to 50 years were determined.
Methods
In 1985–1986, the population-based Coronary Artery Risk Development in Young Adults study enrolled 5,115 participants aged 18–30 years. In 2017, a total of 2,485 blacks and 2,407 whites with one or more optimal health behaviors at baseline who attended one or more of seven follow-up exams over 25 years (i.e., through 2010–2011) were analyzed. The primary outcome, maintaining four or more optimal health behaviors, included BMI <25; never smoking; ≥150 minutes/week of moderate to vigorous physical activity; no/moderate alcohol intake (women/men: zero to seven/zero to 14 drinks per week); and Dietary Approaches to Stop Hypertension diet adherence score ≥15 (i.e., baseline highest quartile). Hazard ratios comparing blacks with whites for maintaining optimal health behaviors were calculated among participants with each optimal behavior at baseline.
Results
From ages 18 to 50 years, 2.6% of blacks and 9.2% of whites maintained four or more optimal health behaviors (for optimal BMI: 16.0% and 30.1%, smoking status: 74.6% and 78.4%, physical activity: 17.7% and 21.4%, alcohol intake: 68.4% and 64.6%, diet adherence: 3.9% and 10.3%, respectively). The multivariable adjusted hazard ratio comparing blacks with whites was 0.63 (95% CI=0.56, 0.72) for maintaining four or more optimal health behaviors (for optimal BMI: 0.82 [95% CI=0.66, 1.01], smoking status: 0.57 [95% CI=0.52, 0.62], physical activity: 0.83 [95% CI=0.75, 0.91], alcohol intake: 1.19 [95% CI=1.03, 1.37], diet adherence: 0.71 [95% CI=0.61, 0.82]).
Conclusions
Fewer blacks than whites maintained four or more optimal health behaviors until age 50 years, but maintenance was low among both races.
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Adenoid cystic carcinoma with high-grade transformation forming spindle cell component of the submandibular gland
Publication date: Available online 16 February 2019
Source: Auris Nasus Larynx
Author(s): Masaru Miyazaki, Mikiko Aoki, Kaori Koga, Makoto Hamasaki, Yoshikazu Sugiyama, Kensuke Midorikawa, Daisuke Hamatake, Michio Masaki, Yasushi Takamatsu, Akinori Iwasaki, Toshifumi Sakata, Toshitaka Nagao, Kazuki Nabeshima
Abstract
Adenoid cystic carcinoma (AdCC) with high-grade transformation (AdCC-HGT) is rare, and AdCC-HGT with spindle cell component is particularly rare. The patient was a 65-year-old man with a 5 cm sized swelling of the right submandibular gland. Submandibular sialoadenectomy was performed. Histopathological findings mainly showed conventional AdCC, and minorly showed two other components: (1) the pleomorphic component, a proliferation of atypical pleomorphic epithelial cells forming solid or small clusters and accompanied by necrosis; (2) the spindle cell component, containing atypical spindle cells invading the stroma. Postoperative chemoradiotherapy was performed. Multiple right lung nodular lesions were found on the contrast-enhanced chest CT one month after the surgery. Thoracoscopic pulmonary resection was performed. The lung tumors exhibited a proliferation of atypical spindle cells, accompanied by necrosis. We considered that the spindle cell component of the AdCC-HGT of the submandibular gland developed lung metastases. The patient died seven months after submandibular sialoadenectomy due to respiratory failure. Although rare, our case highlights the importance of recognising spindle cell components in conventional AdCC; even if the area is small, these high-grade transformation areas can metastasise and become prognostic factors.
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A through year behavior of 137Cs in a Japanese flowering cherry tree in relation to that of potassium
Publication date: June 2019
Source: Journal of Environmental Radioactivity, Volume 202
Author(s): Toshihiro Yoshihara, Vasyl Yoschenko, Kenji Watanabe, Koji Keitoku
Abstract
To understand the transfer of radiocesium (137Cs) in inside of deciduous trees, changes in 137Cs activity concentrations, primarily derived from the Fukushima accident in March 2011, were observed in the upper parts of a Japanese flowering cherry tree (Prunus x yedoensis cv. Somei-Yoshino) between 2015 and 2018. The sampling of the foliar parts occurred over the entire leaf life span from winter bud to litterfall and those of the branches were distinguished based on emergence years (2017, 2016, 2015, 2014–2011, and 2010/before). First, every tissue demonstrated a clear seasonal variation in 137Cs activity concentration. Second, a synchrony of seasonal variations in 137Cs activity concentration with those in the biological analogue of K concentration was observed in foliar parts during their growth season, but not in branches nor during the other seasons. With respect to the timing of changes in each tissue with tree phenology, it is possible that K and 137Cs alternate between leaves and branches via the same translocation mechanisms. The resorption efficiencies (i.e., 1 − [the concentrations in the last litterfall]/[the maximum concentrations in green leaves]) of K and 137Cs were 76% and 46% in average, respectively. In addition, both leaf buds and branches played an important role as reservoirs during dormancy. The buds storage ratio before and after bud burst (i.e., [the inventories in buds at the end of defoliation]/[those before and after bud burst]) for K were 0.57 and 0.10 in median, respectively, and those for and 137Cs were 1.14 and 0.14 in median, respectively. Consequently, the transfer of 137Cs in inside of trees was still visible seven years after deposition, even though the annual reduction in 137Cs activity concentration was apparent in each tissue.
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Evaluation of body size and temperature on 137Cs uptake in marine animals
Publication date: June 2019
Source: Journal of Environmental Radioactivity, Volume 202
Author(s): Derin M. Thomas, Nicholas S. Fisher
Abstract
137Cs bioaccumulation and retention in seven different marine animal species, including crustaceans, mollusc larvae, and fish larvae were compared under different temperature conditions (10 °C, 18 °C and 25 °C). Replicate animals were experimentally exposed to 0.5 nM 137Cs dissolved in filtered seawater for 3 days, and their 137Cs contents were periodically measured using gamma spectrometry. Among the seven species, 137Cs bioconcentration factors ranged from 14 to 239 at the end of the exposure periods. Following uptake, the137Cs loss rate constants from the animals ranged from 5 to 50% d−1 and were unaffected by temperature or animal size. The 137Cs bioconcentration factors were directly related to animal size and hence their surface: volume ratios, consistent with the conclusion that Cs sorption from the aqueous phase is the principal uptake mechanism in these animals. With the exception of gastropods, temperature had no major influence on Cs uptake and efflux in the experimental species.
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