A Randomized Pilot Trial of a School‐Based Psychoeducational Intervention for Children with Asthma

Abstract

Background

Asthma is a common childhood illness with high morbidity and mortality among minority and socioeconomically disadvantaged children. Disparities are not fully accounted for by differences in asthma prevalence, highlighting a need for interventions targeting factors associated with poorer asthma control. One such factor is psychological stress.

Objective

Here, we examine the feasibility and acceptability of "I Can Cope (ICC)," a school‐based stress management and coping intervention for children with asthma.

Methods

A parallel randomized pilot trial was conducted. One hundred and four low income children (mean age 10 years; 54% male; 70% African American) with persistent asthma were recruited from 12 urban schools and randomized to: (1) ICC or one of two control conditions: (2) "Open Airways for Schools (OAS)" – an asthma education intervention or (3) no treatment.

Results

71% of eligible children participated in the study, with a dropout rate of 12%. ICC was rated as highly acceptable by participating children and parents. Preliminary efficacy data suggest that when compared with no treatment, ICC resulted in decreased symptoms of depression, perceived stress, and child‐reported symptoms of asthma, and improvements in sleep quality and child‐reported asthma control. There were no intervention‐related changes in objective measures of asthma morbidity. The magnitude of intervention effects on psychological function did not differ between the ICC and OAS groups.

Conclusions

Results support the feasibility and acceptability of utilizing school‐based interventions to access hard to reach children with asthma. Preliminary findings offer support for future, large‐scale efficacy studies of school‐based interventions designed to target multiple factors that contribute to asthma disparities.

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Longitudinal analysis to better characterize Asthma‐COPD Overlap Syndrome (ACOS): Findings from an adult asthma cohort in Korea (COREA)

Abstract

Background

Asthma‐chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS), which has received much attention, has not been unanimously defined.

Objective

In this study, we tried to demonstrate that longitudinally defined ACOS is more useful in the real‐world than blending patients with asthma and COPD.

Methods

The study patients had undergone two consecutive pulmonary function tests measured at least 3 months apart (n = 1,889). We selected the patients who had positive bronchodilator response or methacholine provocation tests (n = 959). Next, we defined ACOS as a patient with a persistent airflow obstruction [forced expiratory volume in 1 sec (FEV1)/forced vital capacity < 0.7] that was identified twice consecutively by an interval of at least 3 months (n = 228).

Results

The proportions of patients who were older, male, and smokers were significantly higher, and baseline lung function was lower in patients with ACOS. In the longitudinal analysis, the mean change in lung function was high, and a greater decline in FEV1 was observed in patients with ACOS. In addition, we compared ACOS and severe asthma, and we also performed a cluster analysis and compared the results with our definition of ACOS. According to our definition, ACOS is an independent subtype with distinctive characteristics. Finally, a genome‐wide association study (GWAS) was performed to identify genetic variations associated with ACOS, but no significant single nucleotide polymorphisms were identified.

Conclusion

Our findings suggest that ACOS should be defined longitudinally and considered as an independent subgroup distinguished by inherited environmental factors rather than as a genetically distinct independent group.

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Identification and characterization of a naïve CD8+ T‐cell repertoire for benzylpenicillin

Abstract

Background

Beta‐lactams allergy is the most commonly reported drug allergy and constitutes an important health problem. We previously showed the pre‐existence of a naïve CD4+ T‐cell repertoire for benzylpenicillin (BP) coupled to human serum albumin (HSA) but little is known about the naïve CD8+ T‐cell repertoire specific for BP.

Objective

The purpose of this work was to identify naïve CD8+ T cells specific for BP and to explore mechanisms dictating their activation.

Methods

Co‐cultures were established with naïve CD8+ T cells and autologous dendritic cells (DCs) loaded with HSA‐BP or free BP. T cells were restimulated once a week with autologous DCs loaded with HSA‐BP or BP. The specific CD8+ T cell response was measured using an IFN‐γ ELISpot assay.

Results

When using free BP, we were able to detect a naïve CD8+ T‐cell repertoire for BP in the 6 out of 7 tested healthy donors. However, our results showed that HSA‐BP was recognized by naïve CD8+ T cells in only one donor out of five tested healthy donors. Using free BP, we evidenced its binding to cellular proteins in DCs that was concentration dependent and was correlated with BP‐specific CD8+ T‐cell activation. Moreover, the BP‐specific CD8+ T‐cell response was MHC class I dependent and required intracellular processing and proteasome activity.

Conclusion and clinical relevance

This work showed the existence of a naïve CD8+ T‐cell repertoire for BP when DCs were treated with free BP suggesting that patients could be immunized by haptenated peptides from cellular proteins generated in antigen‐presenting cells.

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Validation of childhood asthma predictive tools: a systematic review

Abstract

Background

There is uncertainty about the clinical usefulness of currently available asthma predictive tools. Validation of predictive tools in different populations and clinical settings is an essential requirement for the assessment of their predictive performance, reproducibility and generalizability. We aimed to critically appraise asthma predictive tools which have been validated in external studies.

Methods

We searched MEDLINE and EMBASE (1946‐2017) for all available childhood asthma prediction models and focused on externally validated predictive tools alongside the studies in which they were originally developed. We excluded non‐English and non‐original studies. PROSPERO registration number is CRD42016035727.

Results

From 946 screened papers, 8 were included in the review. Statistical approaches for creation of prediction tools included chisquare tests, logistic regression models and the least absolute shrinkage and selection operator. Predictive models were developed and validated in general and high‐risk populations. Only three prediction tools were externally validated: the Asthma Predictive Index, the PIAMA, and the Leicester asthma prediction tool. A variety of predictors has been tested, but no studies examined the same combination. There was heterogeneity in definition of the primary outcome among development and validation studies, and no objective measurements were used for asthma diagnosis. The performance of tools varied at different ages of outcome assessment. We observed a discrepancy between the development and validation studies in the tools' predictive performance in terms of sensitivity and positive predictive values.

Conclusions

Validated asthma predictive tools, reviewed in this paper, provided poor predictive accuracy with performance variation in sensitivity and positive predictive value.

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Aggregation induced emission of diketopyrrolopyrrole (DPP) derivatives for highly fluorescent red films

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00403J, Paper

Tae Gyu Hwang, Jeong Yun Kim, Jin Woong Namgoong, Jae Moon Lee, Sim Bum Yuk, Se Hun Kim, Jae Pil Kim
Triphenylamine moieties substituted diketopyrrolopyrrole derivatives showed highly emissive characteristics in solid film state by aggregation induced emission.
To cite this article before page numbers are assigned, use the DOI form of citation above.
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Aggregation induced emission of diketopyrrolopyrrole (DPP) derivatives for highly fluorescent red films

Photochem. Photobiol. Sci., 2019, Advance Article
DOI: 10.1039/C8PP00403J, Paper

Tae Gyu Hwang, Jeong Yun Kim, Jin Woong Namgoong, Jae Moon Lee, Sim Bum Yuk, Se Hun Kim, Jae Pil Kim
Triphenylamine moieties substituted diketopyrrolopyrrole derivatives showed highly emissive characteristics in solid film state by aggregation induced emission.
To cite this article before page numbers are assigned, use the DOI form of citation above.
The content of this RSS Feed (c) The Royal Society of Chemistry

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The role of ultrasound in the diagnosis of the coexistence of primary hyperparathyroidism and non-medullary thyroid carcinoma

Abstract

Background

The coexistence of primary hyperparathyroidism(PHPT) and papillary thyroid cancer(PTC) is a known entity; it is a rare and complicated setting for diagnostic imaging.

Methods

After reviewing clinical data of 112 patients who had been treated for PHPT in our facility between January 2015 and December 2017, we identified 7 non-medullary thyroid carcinoma (NMTC) (6.25%). All of them had taken an ultrasound scan and undergone operation. In addition, we have also reviewed relevant reports from other facilities addressing PHPT and NMTC (Mainly PTC).

Results

The 7 NMTCs were all pathologically confirmed PTC in our study, and they consisted of 6 parathyroid adenomas and 1 parathyroid carcinoma. 1 of the 7 patients had 2 malignant PTC nodules with neck lymph node metastasis, the rest 6 had single-focal PTC. Processing previous report data supported an association between PHPT and PTC, although the coexistence of PHPT and PTC is rare, but it does happen. Ultrasound, as an effective examination, would help screen the simultaneous lesions before operation, thus to avoid second surgery if not observed for both diseases at initial stage.

Conclusions

Ultrasound is a necessary choice for preoperative localization, because it has the ability to simultaneously examine the thyroid and parathyroid lesions.

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The role of ultrasound in the diagnosis of the coexistence of primary hyperparathyroidism and non-medullary thyroid carcinoma

Abstract

Background

The coexistence of primary hyperparathyroidism(PHPT) and papillary thyroid cancer(PTC) is a known entity; it is a rare and complicated setting for diagnostic imaging.

Methods

After reviewing clinical data of 112 patients who had been treated for PHPT in our facility between January 2015 and December 2017, we identified 7 non-medullary thyroid carcinoma (NMTC) (6.25%). All of them had taken an ultrasound scan and undergone operation. In addition, we have also reviewed relevant reports from other facilities addressing PHPT and NMTC (Mainly PTC).

Results

The 7 NMTCs were all pathologically confirmed PTC in our study, and they consisted of 6 parathyroid adenomas and 1 parathyroid carcinoma. 1 of the 7 patients had 2 malignant PTC nodules with neck lymph node metastasis, the rest 6 had single-focal PTC. Processing previous report data supported an association between PHPT and PTC, although the coexistence of PHPT and PTC is rare, but it does happen. Ultrasound, as an effective examination, would help screen the simultaneous lesions before operation, thus to avoid second surgery if not observed for both diseases at initial stage.

Conclusions

Ultrasound is a necessary choice for preoperative localization, because it has the ability to simultaneously examine the thyroid and parathyroid lesions.

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Functional Reconstruction of Mandibular Segment Defects with Individual Preformed Reconstruction Plate and CTA-aided Iliac Crest Flap

Publication date: Available online 18 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Maorui Zhang, Pengcheng Rao, Delin Xia, Libo Sun, Xiaoxiao Cai, Jingang Xiao

Abstract

Purpose

With the development of imaging technology and computer-assisted surgery in oral and maxillofacial surgery, digital technology is widely used in vascularized bone flap grafts for mandible reconstruction. The aim of our study is to use digital technology throughout the treatment process to demonstrate that digital techniques can provide a reliable and accurate match between the mandible and the iliac crest flap to achieve functional reconstruction of mandibular segment defects.

Patients and Methods

Twenty patients underwent three-dimension computed tomography (3D CT), mirroring technology, 3D model prototyping and computed tomography angiography (CTA) for treatment planning. Individual preformed reconstruction plates were fabricated and iliac crest flaps were designed preoperatively. After complete resection of the mandibular lesion, the iliac crest flap was shaped to reconstruct the mandibular defects.

Results

During follow-up (range 12 to 36 months), the facial shape, facial symmetry, mouth opening of all patients were well recovered. 3D-CT reconstruction was also taken to evaluate the height, width, length, and bone healing of the iliac crest flap. Postoperative examination revealed ideal bone union between the iliac crest flap and the mandible at 6 months. Nine patients received implant-supported fixed dentures to restore the dentition. After follow-up, all patients were satisfied with their facial esthetics and function. The neo-mandible provides a suitable three-dimensional position for implant-supported fixed partial dentures.

Conclusion

Use of digital techniques throughout the whole course of treatment improves the predictability and convenience of functional mandibular reconstruction. Individual preformed reconstruction plates and CTA effectively guaranteed the accuracy of iliac flap preparation.

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Perioperative Management For the Cocaine-Positive Patient Undergoing Elective Surgery Under General Anesthesia

Publication date: Available online 18 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Nicholas P. Saggese, Christopher Chang, Vito A. Cardo

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The Electronic Medical Record and Its Impact on Oral and Maxillofacial Surgery Training: Friend or Foe?

Publication date: Available online 18 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Mina D. Fahmy, Andrew J. Gross

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Pediatric Laryngeal Electromyography Technique for Vocal Fold Immobility Using Bipolar Double Hookwire Electrodes

Publication date: Available online 18 January 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Sarah N. Bowe, Carissa J. Wentland, Christopher J. Hartnick

Abstract

Vocal fold immobility (VFI) is a common cause of dysphonia and dysphagia in children. Laryngeal electromyography (LEMG) is an important adjunctive test in its diagnosis and treatment. In this study, we present an alternative technique in which bipolar double hookwire electrodes allow simultaneous placement and recordings from the bilateral thyroarytenoid and posterior cricoarytenoid muscles. Details of the technique are shown for a 5 y/o F with history of Neurofibromatosis Type 2 with left VFI and aspiration and dysphonia. This modified technique for pediatric LEMG has the potential to be a useful tool in predicting return of laryngeal function.

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Caregiver perception of speech quality in patients with ankyloglossia: comparison between surgery and non-treatment

Publication date: Available online 18 January 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Srihari Daggumati, Jason E. Cohn, Matthew J. Brennan, Marissa Evarts, Brian J. McKinnon, Alyssa R. Terk

Abstract

Objectives

Our objective was to determine if there are differences in caregiver perception of speech for patients that undergo frenulectomy compared to patients that were not surgically treated.

Introduction

Ankyloglossia is a controversial topic without standardized treatment guidelines. Although there have been several studies suggesting that breastfeeding does improve after frenulectomy, there is a paucity of literature that investigates the relationship between ankyloglossia and speech.

Methods

A retrospective chart review was conducted to identify patients with ankyloglossia. Patients were categorized into surgical treatment (frenulectomy) and non-treatment groups. Caregivers of both groups were contacted by phone and surveyed on speech quality and tongue mobility using Likert scores. Mann Whitney-U testing was used to determine if there were significant differences in perceived speech quality between the surgical and non-surgical groups.

Results

The caregivers of seventy-seven patients participated in the phone survey: 46 (60%) children in the surgical group and 31 (40%) children in the non-surgical group who participated in the phone survey. There were no differences in difficulty with speech (p=0.484) and tongue mobility (p=0.064) between the two groups. However, patients that underwent surgical intervention for ankyloglossia reported less difficulty with tongue tasks (p<0.001) compared to those who were not surgically treated. Additionally, 50% of patients that underwent surgery had a documented family history of ankyloglossia which was significantly higher than 16.1% in the non-surgical group (p=0.002).

Conclusions

It appears that children with ankyloglossia might have similar speech quality following frenulectomy in comparison to speech quality without treatment. Children who undergo frenulectomy may experience improvements in tongue tasks. This data should encourage further research on the management of speech concerns in children with ankyloglossia.

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Functional Reconstruction of Mandibular Segment Defects with Individual Preformed Reconstruction Plate and CTA-aided Iliac Crest Flap

Publication date: Available online 18 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Maorui Zhang, Pengcheng Rao, Delin Xia, Libo Sun, Xiaoxiao Cai, Jingang Xiao

Abstract

Purpose

With the development of imaging technology and computer-assisted surgery in oral and maxillofacial surgery, digital technology is widely used in vascularized bone flap grafts for mandible reconstruction. The aim of our study is to use digital technology throughout the treatment process to demonstrate that digital techniques can provide a reliable and accurate match between the mandible and the iliac crest flap to achieve functional reconstruction of mandibular segment defects.

Patients and Methods

Twenty patients underwent three-dimension computed tomography (3D CT), mirroring technology, 3D model prototyping and computed tomography angiography (CTA) for treatment planning. Individual preformed reconstruction plates were fabricated and iliac crest flaps were designed preoperatively. After complete resection of the mandibular lesion, the iliac crest flap was shaped to reconstruct the mandibular defects.

Results

During follow-up (range 12 to 36 months), the facial shape, facial symmetry, mouth opening of all patients were well recovered. 3D-CT reconstruction was also taken to evaluate the height, width, length, and bone healing of the iliac crest flap. Postoperative examination revealed ideal bone union between the iliac crest flap and the mandible at 6 months. Nine patients received implant-supported fixed dentures to restore the dentition. After follow-up, all patients were satisfied with their facial esthetics and function. The neo-mandible provides a suitable three-dimensional position for implant-supported fixed partial dentures.

Conclusion

Use of digital techniques throughout the whole course of treatment improves the predictability and convenience of functional mandibular reconstruction. Individual preformed reconstruction plates and CTA effectively guaranteed the accuracy of iliac flap preparation.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MgbFZc

Perioperative Management For the Cocaine-Positive Patient Undergoing Elective Surgery Under General Anesthesia

Publication date: Available online 18 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Nicholas P. Saggese, Christopher Chang, Vito A. Cardo

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2sxKCjf

The Electronic Medical Record and Its Impact on Oral and Maxillofacial Surgery Training: Friend or Foe?

Publication date: Available online 18 January 2019

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Mina D. Fahmy, Andrew J. Gross

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2MjfNrE

Pediatric Laryngeal Electromyography Technique for Vocal Fold Immobility Using Bipolar Double Hookwire Electrodes

Publication date: Available online 18 January 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Sarah N. Bowe, Carissa J. Wentland, Christopher J. Hartnick

Abstract

Vocal fold immobility (VFI) is a common cause of dysphonia and dysphagia in children. Laryngeal electromyography (LEMG) is an important adjunctive test in its diagnosis and treatment. In this study, we present an alternative technique in which bipolar double hookwire electrodes allow simultaneous placement and recordings from the bilateral thyroarytenoid and posterior cricoarytenoid muscles. Details of the technique are shown for a 5 y/o F with history of Neurofibromatosis Type 2 with left VFI and aspiration and dysphonia. This modified technique for pediatric LEMG has the potential to be a useful tool in predicting return of laryngeal function.

from #Head and Neck by Sfakianakis via simeraentaxei on Inoreader http://bit.ly/2FMuv90

Caregiver perception of speech quality in patients with ankyloglossia: comparison between surgery and non-treatment

Publication date: Available online 18 January 2019

Source: International Journal of Pediatric Otorhinolaryngology

Author(s): Srihari Daggumati, Jason E. Cohn, Matthew J. Brennan, Marissa Evarts, Brian J. McKinnon, Alyssa R. Terk

Abstract

Objectives

Our objective was to determine if there are differences in caregiver perception of speech for patients that undergo frenulectomy compared to patients that were not surgically treated.

Introduction

Ankyloglossia is a controversial topic without standardized treatment guidelines. Although there have been several studies suggesting that breastfeeding does improve after frenulectomy, there is a paucity of literature that investigates the relationship between ankyloglossia and speech.

Methods

A retrospective chart review was conducted to identify patients with ankyloglossia. Patients were categorized into surgical treatment (frenulectomy) and non-treatment groups. Caregivers of both groups were contacted by phone and surveyed on speech quality and tongue mobility using Likert scores. Mann Whitney-U testing was used to determine if there were significant differences in perceived speech quality between the surgical and non-surgical groups.

Results

The caregivers of seventy-seven patients participated in the phone survey: 46 (60%) children in the surgical group and 31 (40%) children in the non-surgical group who participated in the phone survey. There were no differences in difficulty with speech (p=0.484) and tongue mobility (p=0.064) between the two groups. However, patients that underwent surgical intervention for ankyloglossia reported less difficulty with tongue tasks (p<0.001) compared to those who were not surgically treated. Additionally, 50% of patients that underwent surgery had a documented family history of ankyloglossia which was significantly higher than 16.1% in the non-surgical group (p=0.002).

Conclusions

It appears that children with ankyloglossia might have similar speech quality following frenulectomy in comparison to speech quality without treatment. Children who undergo frenulectomy may experience improvements in tongue tasks. This data should encourage further research on the management of speech concerns in children with ankyloglossia.

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Treatment of military acoustic accidents with N-Acetyl-L-cysteine (NAC)

. (Source: International Journal of Audiology)

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Low-intensity repetitive transcranial magnetic stimulation over prefrontal cortex in an animal model alters activity in the auditory thalamus but does not affect behavioural measures of tinnitus.

This study used a guinea pig model of hearing loss and tinnitus to investigate effects of low-intensity rTMS (LI-rTMS) over PFC on tinnitus and spontaneous activity in auditory thalamus. In addition, immunohistochemistry for calbindin and parvalbumin in PFC was used to investigate the possible mechanism of action of LI-rTMS. Three treatment groups were compared: sham treatment, LI, low frequency (1 Hz) or LI, high frequency (10 Hz) rTMS (10 min/day, 2 weeks, weekdays only). None of the treatments affected the behavioural measures of tinnitus but spontaneous activity was significantly increased in auditory thalamus after 1 Hz and 10 Hz treatment. Immunostaining showed significant effects of rTMS on the density of calcium-binding protein expressing neurons in the dorsal regions of the ...

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