Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 27, Issue 4
http://ift.tt/2gMufKj
Τετάρτη 14 Δεκεμβρίου 2016
Masthead
Source:Operative Techniques in Otolaryngology-Head and Neck Surgery, Volume 27, Issue 4
http://ift.tt/2gMufKj
Experimental study of the mechanical stabilization of electric arc furnace dust using fluid cement mortars
Publication date: 15 March 2017
Source:Journal of Hazardous Materials, Volume 326
Author(s): E.F. Ledesma, J.R. Jiménez, J. Ayuso, J.M. Fernández, J.de Brito
This article shows the results of an experimental study carried out in order to determine the maximum amount of electric arc furnace dust (EAFD) that can be incorporated into fluid cement-based mortars to produce mechanically stable monolithic blocks. The leaching performance of all mixes was studied in order to classify them according to the EU Council Decision 2003/33/EC. Two mortars were used as reference and three levels of EAFD incorporation were tested in each of the reference mortars. As the incorporation ratio of EAFD/cement increases, the mechanical strength decreases. This is due to the greater EAFD/cement and water/cement ratios, besides the presence of a double-hydrated hydroxide of Ca and Zn (CaZn2(OH)6·2H2O) instead of the portlandite phase (Ca(OH)2) in the mixes made with EAFD, as well as non-hydrated tricalcium silicate. A mass ratio of 2:1 (EAFD: cement-based mortar) can be added maintaining a stable mechanical strength. The mechanical stabilization process also reduced the leaching of metals, although it was not able to reduce the Pb concentration below the limit for hazardous waste. The high amount of EAFD mechanically stabilized in this experimental study can be useful to reduce the storage volume required in hazardous waste landfills.
http://ift.tt/2hGsXm6
NK cells in host responses to viral infections
Source:Current Opinion in Immunology, Volume 44
Author(s): Viola C Lam, Lewis L Lanier
Natural killer (NK) cells are cytotoxic innate lymphocytes that play an important role in viral clearance. NK cell responses to viral infections were originally believed to be non-specific and lacked immune memory recall responses. It is now appreciated that NK cell responses to viral infections can be specific and in some cases memory recall responses are established. Increasing evidence also illuminates the complexity of NK cell interactions with both innate and adaptive immune cells. Here, we summarize the evidence for NK cell-specific memory responses to viral infections and the intricate reciprocal interactions between NK cells and other immune cells that dictate their activation and effector functions.
http://ift.tt/2hrc0LO
Using the BITOLA system to identify candidate molecules in the interaction between oral lichen planus and depression
Source:Behavioural Brain Research, Volume 320
Author(s): Yuanbo Zhan, Shuang Zhou, Ying Li, Sen Mu, Ruijie Zhang, Xuejing Song, Feng Lin, Ruimin Zhang, Bin Zhang
Exacerbations of oral lichen planus (OLP) have been linked to the periods of psychological stress, anxiety and depression. The specific mechanism of the interaction is unclear. The aim of this study was to explore the candidate genes or molecules that play important roles in the interaction between OLP and depression. The BITOLA system was used to search all intermediate concepts relevant to the "Gene or Gene Product" for OLP and depression, and the gene expression data and tissue-specific gene data along with manual checking were then employed to filter the intermediate concepts. Finally, two genes (NCAM1, neural cell adhesion molecule 1; CD4, CD4 molecule) passed the follow-up inspection. By using the text mining can formulate a new hypothesis: NCAM1 and CD4 were identified as involved or potentially involved in the interaction between OLP and depression. These results offer a new clue for the experimenters and hold promise for developing innovative therapeutic strategies for these two diseases.
http://ift.tt/2hxBvIQ
Revisions to the Behavioral Risk Factor Surveillance System Sleep Questions
Study Objectives:
To revise and enhance the current Behavioral Risk Factor Surveillance System (BRFSS) sleep questions for detection of sleep/wake disorders that contribute to health burden.
Methods:
A descriptive qualitative design was used to guide the investigation. The three methods were (1) a review of the current evidence on sleep related screening questions (including the results from the parent study validating the current BRFSS questions), (2) interviews with sleep experts about the questions they use in their clinical practice to screen for sleep problems, and (3) interviews with lay people to discuss contextual meanings, feelings, and beliefs about sufficient and restful sleep and not feeling rested.
Results:
Recommendations for revisions of the current BRFSS questions.
Conclusions:
The current BRFSS questions should be refined to better screen for sleep disorders.
Citation:
Jungquist CR, Klingman KJ, Dickerson SS. Revisions to the Behavioral Risk Factor Surveillance System sleep questions. J Clin Sleep Med 2016;12(12):1585–1592.
http://ift.tt/2gBWND7
Sleep Well!: A Pilot Study of an Education Campaign to Improve Sleep of Socioeconomically Disadvantaged Children
Study Objectives:
Socioeconomically disadvantaged children are at risk for poor sleep hygiene and increased sleep problems. This pilot study examined the efficacy of Sleep Well!, a parent-based sleep education endeavor, which supplemented an outreach program that provides beds to socioeconomically disadvantaged children.
Methods:
In addition to receiving a bed, 152 children (mean age = 5.95 years, 57.2% boys) were randomly assigned to sleep education (3 messages: bedtime before 21:00; no caffeine; keep electronics out of the bedroom) or control (dental hygiene education) conditions. All education was provided at both the time of scheduling and delivery of a bed to each child. Parent-reported sleep data were collected at baseline and at 4-week follow-up.
Results:
Provision of a bed was associated with reduced bedroom electronics and increased parent-reported nighttime sleep duration for all children. However, relative to control children, intervention children showed even greater reductions in electronics (baseline mean = 1.91 items, follow-up mean = 0.85 items) and improvements in sleep duration (baseline mean = 9.75 hours, follow-up mean = 10.19 hours). There was no intervention effect for caffeine consumption or bedtime from baseline to follow-up.
Conclusions:
Providing beds to socioeconomically disadvantaged children resulted in increased sleep duration and decreased use of electronics at bedtime, while the combination of a bed and brief parent sleep education conferred additional sleep benefits. Further study of brief child sleep interventions is warranted, particularly among socioeconomically disadvantaged children who are at risk for sleep problems.
Citation:
Mindell JA, Sedmak R, Boyle JT, Butler R, Williamson AA. Sleep well!: A pilot study of an education campaign to improve sleep of socioeconomically disadvantaged children. J Clin Sleep Med 2016;12(12):1593–1599.
http://ift.tt/2hGh3Zo
The Relationship between Snoring Sound Intensity and Morning Blood Pressure in Workers
Study Objectives:
This study aimed to determine the consequences of snoring independent of obstructive sleep apnea (OSA) and hypothesized that snoring sound intensity, as assessed by mean tracheal sound (TS) energy (Leq), is related to morning blood pressure (BP).
Methods:
A home-based TS monitoring study was performed for two nights on 191 workers in Japan using an IC recorder. Leq and the respiratory disturbance index (RDI) were calculated from the TS data. RDI was used as a marker of OSA severity. Systolic and diastolic BP measurements in the evening and morning (eSBP/eDBP and mSBP/mDBP, respectively) were done before and after TS recording. The data of the second night were analyzed.
Results:
Leq was significantly related to both mSBP and mDBP (r = 0.32, p < 0.0001; r = 0.34, p < 0.0001, respectively). Leq was also significantly related to morning BP after adjustment for age, sex, and body mass index. However, the relationship was no longer significant when both RDI and Leq were included in the multiple regression model. In non-apneic, non-obese subjects, Leq was significantly related to both mSBP and mDBP (r = 0.38, p < 0.0001; r = 0.33, p = 0.0004, respectively). In this group, Leq was associated with mSBP after adjusting for all confounding factors (n = 106, p = 0.022).
Conclusions:
The association between night TS intensity and morning BP suggests a pathological role of heavy snoring. To understand this association, a prospective cohort study in a general population is warranted.
Commentary:
A commentary on this article appears in this issue on page 1581.
Citation:
Furukawa T, Nakano H, Yoshihara K, Sudo N. The relationship between snoring sound intensity and morning blood pressure in workers. J Clin Sleep Med 2016;12(12):1601–1606.
http://ift.tt/2gBTb43
Obstructive Sleep-Disordered Breathing Is More Common than Central in Mild Familial Dysautonomia
Study Objectives:
In familial dysautonomia (FD) patients, sleep-disordered breathing (SDB) might contribute to their high risk of sleep-related sudden death. Prevalence of central versus obstructive sleep apneas is controversial but may be therapeutically relevant. We, therefore, assessed sleep structure and SDB in FD-patients with no history of SDB.
Methods:
11 mildly affected FD-patients (28 ± 11 years) without clinically overt SDB and 13 controls (28 ± 10 years) underwent polysomnographic recording during one night. We assessed sleep stages, obstructive and central apneas (≥ 90% air flow reduction) and hypopneas (> 30% decrease in airflow with ≥ 4% oxygen-desaturation), and determined obstructive (oAI) and central (cAI) apnea indices and the hypopnea index (HI) as count of respective apneas/hypopneas divided by sleep time. We obtained the apnea-hypopnea index (AHI4%) from the total of apneas and hypopneas divided by sleep time. We determined differences between FD-patients and controls using the U-test and within-group differences between oAIs, cAIs, and HIs using the Friedman test and Wilcoxon test.
Results:
Sleep structure was similar in FD-patients and controls. AHI4% and HI were significantly higher in patients than controls. In patients, HIs were higher than oAIs and oAIs were higher than cAIs. In controls, there was no difference between HIs, oAIs, and cAIs. Only patients had apneas and hypopneas during slow wave sleep.
Conclusions:
In our FD-patients, obstructive apneas were more common than central apneas. These findings may be related to FD-specific pathophysiology. The potential ramifications of SDB in FD-patients suggest the utility of polysomnography to unveil SDB and initiate treatment.
Commentary:
A commentary on this article appears in this issue on page 1583.
Citation:
Hilz MJ, Moeller S, Buechner S, Czarkowska H, Ayappa I, Axelrod FB, Rapoport DM. Obstructive sleep-disordered breathing is more common than central in mild familial dysautonomia. J Clin Sleep Med 2016;12(12):1607–1614.
http://ift.tt/2hGnwmP
Adherence to Positive Airway Pressure Therapy in Hospitalized Patients with Decompensated Heart Failure and Sleep-Disordered Breathing
Study Objectives:
Sleep-disordered breathing (SDB) has been implicated as a risk factor for the development of several adverse cardiovascular outcomes, but can be mitigated with positive airway pressure therapy (PAP). The nonadherence of patients with SDB on PAP in the outpatient setting ranges from 29% to 84%. However, adherence of PAP in patients with congestive heart failure (CHF) admitted for decompensated CHF and in whom SDB has been diagnosed in the hospital setting is not known. We hypothesized that despite a diagnosis in the hospital, the compliance of these patients with PAP therapy would not be different from the well-established adherence in patients with a diagnosis and treatment in the outpatient setting.
Methods:
The study was a retrospective analysis of patients admitted to an academic tertiary care hospital between March 2013 and February 2014. Patients presenting with decompensated CHF were screened and high-risk patients were started on PAP empirically and advised to undergo a postdischarge polysomnogram. Compliance of the patients with PAP was tracked for over 12 mo. Data from a similar outpatient group who underwent polysomnography during the study period were also reviewed.
Results:
Ninety-one patients underwent polysomnograhy postdischarge. Of the 91 patients, 81 patients agreed to PAP therapy. One patient was excluded as data were missing. The adherence at 3, 6, and 12 mo was 52%, 37%, and 27%, which was not significantly different than an outpatient control group. There was a trend for those with CHF plus SDB and compliant with PAP to have a higher probability of survival compared to those who were noncompliant (p = 0.07).
Conclusions:
Adherence of patients to PAP therapy in whom a SDB diagnosis is made during acute hospitalization for heart failure is comparable to patients in the ambulatory setting. Adherence in first 3 mo is a predictive marker for improved survival trend.
Citation:
Sharma S, Chakraborty A, Chowdhury A, Mukhtar U, Willes L, Quan SF. Adherence to positive airway pressure therapy in hospitalized patients with decompensated heart failure and sleep-disordered breathing. J Clin Sleep Med 2016;12(12):1615–1621.
http://ift.tt/2gBTcF9
Sleep-Disordered Breathing and Effects of Noninvasive Ventilation in Patients with Late-Onset Pompe Disease
Study Objectives:
In neuromuscular disease, non-invasive ventilation (NIV) is indicated if sleep-disordered breathing (SDB) or significant respiratory muscle weakness (RMW) is present. We investigated immediate and long-term effects of NIV on sleep and nocturnal ventilation in patients with late-onset Pompe disease (LOPD).
Methods:
Polysomnography and transcutaneous capnometry were performed in 22 adult patients. If indicated, NIV was initiated the subsequent night and follow-up sleep studies were scheduled. Sleep quality and health-related quality of life (HRQoL) were self-assessed using standard questionnaires.
Results:
Fourteen patients received enzyme replacement therapy (ERT), five patients were treatment-naÏve, and three individuals had previously stopped ERT. Fifteen patients reported symptoms of SDB, all showing abnormal sleep studies. Two patients had obstructive sleep apnea (OSA), three patients showed both OSA and nocturnal hypercapnia, four individuals had nocturnal hypercapnia, and two patients had both OSA and daytime hypercapnia. Four patients showed normal apnea-hypopnea index and CO2 measures but nocturnal tachypnea, orthopnea, and significant RMW were present. Supine forced vital capacity (FVC) and positional drop of FVC were independent predictors of SDB. In patients with SDB, HRQoL was significantly reduced. NIV was initiated in 15 individuals and led to significant improvement of ventilation and oxygenation in the first night of treatment. Follow-up sleep studies revealed stable normoxia and normocapnia without deterioration of sleep outcomes for up to 40 months.
Conclusions:
In LOPD, SDB is common and comprises both hypoventilation and OSA. NIV significantly improves respiration already in the first night of treatment. NIV warrants nocturnal long-term normoventilation without deterioration of sleep quality.
Citation:
Boentert M, Dräger B, Glatz C, Young P. Sleep-disordered breathing and effects of noninvasive ventilation in patients with late-onset Pompe disease. J Clin Sleep Med 2016;12(12):1623–1632.
http://ift.tt/2hGpbZZ
Importance of Urinary Drug Screening in the Multiple Sleep Latency Test and Maintenance of Wakefulness Test
Study Objectives:
Multiple sleep latency testing (MSLT) and the maintenance of wakefulness test (MWT) are gold-standard objective tests of daytime sleepiness and alertness; however, there is marked variability in their interpretation and practice. This study aimed to determine the incidence of positive drug screens and their influence on MSLT, MWT, and polysomnographic variables.
Methods:
All patients attending Eastern Health Sleep Laboratory for MSLT or MWT over a 21-mo period were included in the study. Urinary drug screening for amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, methadone, and opiates was performed following overnight polysomnography (PSG). Demographics and PSG variables were compared.
Results:
Of 69 studies, MSLT (43) and MWT (26), 16% of patients had positive urinary drug screening (7 MSLT; 4 MWT). Drugs detected included amphetamines, cannabinoids, opiates, and benzodiazepines. No patient self-reported use of these medications prior to testing. No demographic, MSLT or MWT PSG data or overnight PSG data showed any statistical differences between positive and negative drug screen groups. Of seven MSLT patients testing positive for drug use, one met criteria for the diagnosis of narcolepsy and five for idiopathic hypersomnia. On MWT, three of the four drug-positive patients had a history of a motor vehicle accident and two patients were occupational drivers.
Conclusions:
These findings indicate drug use is present in patients attending for daytime testing of objective sleepiness and wakefulness. These data support routine urinary drug screening in all patients undergoing MSLT or MWT studies to ensure accurate interpretation in the context of illicit and prescription drug use.
Citation:
Anniss AM, Young A, O'Driscoll DM. Importance of urinary drug screening in the multiple sleep latency test and maintenance of wakefulness test. J Clin Sleep Med 2016;12(12):1633–1640.
http://ift.tt/2gBYlgz
Validation of a Suprasternal Pressure Sensor for Sleep Apnea Classification in Children
Study Objectives:
The recognition and characterization of respiratory events is crucial when interpreting sleep studies. The aim of the study was to validate the PneaVoX sensor, which integrates the recording of respiratory effort by means of suprasternal pressure (SSP), respiratory flow, and snoring for the classification of sleep apneas in children.
Methods:
Sleep recordings of 20 children with a median age of 7.5 (0.5–16.5) years were analyzed. Scoring of apneas according to the American Academy of Sleep Medicine (AASM) guidelines using nasal pressure, oronasal thermal sensor and respiratory efforts by means of respiratory inductance plethysmography (RIP), was compared to a scoring using the PneaVoX sensor and nasal pressure, without the oronasal thermal sensor nor RIP, during a dual blind study.
Results:
The percentage of sleep time recording without artifacts was 97%, 97%, 87%, 65%, and 98% for the respiratory flow and SSP from the PneaVoX sensor, oronasal thermal sensor, nasal pressure, and RIP, respectively. As compared to the AASM scoring with RIP, sensitivity and specificity of the SSP for the scoring of central apneas were 75% and 99% for the first reader, and 70% and 100% for the second reader, respectively. Sensitivity and specificity for the scoring of obstructive apneas were 98% and 75%, and 100% and 70%, respectively. A significant number of apneas scored as central by RIP were scored as obstructive by the SSP.
Conclusions:
The PneaVoX sensor has a high degree of scorability in children. The PneaVoX sensor is a useful adjunct for characterizing apneas.
Citation:
Amaddeo A, Fernandez-Bolanos M, Olmo Arroyo J, Khirani S, Baffet G, Fauroux B. Validation of a suprasternal pressure sensor for sleep apnea classification in children. J Clin Sleep Med 2016;12(12):1641–1647.
http://ift.tt/2hGjOK3
Growing Up with Type 1 Narcolepsy: Its Anthropometric and Endocrine Features
Study Objectives:
To evaluate the effect of type 1 narcolepsy (NT1) on anthropometric and endocrine features in childhood/adolescence, focusing on patterns and correlates of weight, pubertal development, and growth in treated and untreated patients.
Methods:
We collected anthropometric (height, weight, body mass index (BMI) z-scores), pubertal, metabolic, and endocrine data from 72 NT1 patients at diagnosis and all available premorbid anthropometric parameters of patients from their pediatric files (n = 30). New measurements at 1-y reassessment in patients undergoing different treatments were compared with baseline data.
Results:
We detected a high prevalence of overweight (29.2%), obesity (25%), metabolic syndrome (18.8%), and precocious puberty (16.1%), but no signs of linear growth alterations at diagnosis. According to anthropometric records, weight gain started soon after NT1 onset. At 1-y follow-up reassessment, sodium oxybate treatment was associated with a significant BMI z-score reduction (−1.29 ± 0.30, p < 0.0005) after adjusting for baseline age, sex, sleepiness, and BMI.
Conclusions:
NT1 onset in children/adolescents is associated with rapid weight gain up to overweight/obesity and precocious puberty without affecting growth. In our study, sodium oxybate treatment resulted in a significant weight reduction in NT1 overweight/obese patients at 1-y follow-up.
Citation:
Ponziani V, Gennari M, Pizza F, Balsamo A, Bernardi F, Plazzi G. Growing up with type 1 narcolepsy: its anthropometric and endocrine features. J Clin Sleep Med 2016;12(12):1649–1657.
http://ift.tt/2gBTXOq
A Nationwide Cross-Sectional Survey of Sleep-Related Problems in Japanese Visually Impaired Patients: Prevalence and Association with Health-Related Quality of Life
Study Objectives:
This questionnaire-based cross-sectional study was conducted (1) to estimate the prevalence of sleep-related problems, and (2) to explore factors associated with lower physical/mental quality of life (QOL), particularly addressing sleep-related problems among Japanese visually impaired people.
Methods:
This nationwide questionnaire-based survey was administered to visually impaired individuals through the Japan Federation of the Blind. Visually impaired individuals without light perception (LP) (n = 311), those with LP (n = 287), and age-matched and gender-matched controls (n = 615) were eligible for this study. Study questionnaires elicited demographic information, and information about visual impairment status, sleep-related problems, and health-related quality of life.
Results:
Visually impaired individuals with and without LP showed higher prevalence rates of irregular sleep-wake patterns and difficulty maintaining sleep than controls (34.7% and 29.4% vs. 15.8%, 60.1% and 46.7% vs. 26.8%, respectively; p < 0.001). These sleep-related problems were observed more frequently in visually impaired individuals without LP than in those with LP. Non-restorative sleep or excessive daytime sleepiness was associated with lower mental/physical QOL in visually impaired individuals with LP and in control subjects. However, visually impaired individuals without LP showed irregular sleep-wake pattern or difficulty waking up at the desired time, which was associated with lower mental/physical QOL.
Conclusions:
Sleep-related problems were observed more frequently in visually impaired individuals than in controls. Moreover, the rates of difficulties were higher among subjects without LP. Sleep-related problems, especially circadian rhythm-related ones, can be associated with lower mental/physical QOL in visually impaired individuals without LP.
Citation:
Tamura N, Sasai-Sakuma T, Morita Y, Okawa M, Inoue S, Inoue Y. A nationwide cross-sectional survey of sleep-related problems in Japanese visually impaired patients: prevalence and association with health-related quality of life. J Clin Sleep Med 2016;12(12):1659–1667.
http://ift.tt/2hGh1Rg
Depth and Distribution of Symptoms in Restless Legs Syndrome/ Willis-Ekbom Disease
Study Objectives:
To determine the depth and distribution of sensory discomfort in idiopathic restless legs syndrome/Willis-Ekbom disease (RLS) and RLS concurrent with other leg conditions, specifically peripheral neuropathy, sciatica, leg cramps, and arthritis.
Methods:
RLS subjects (n = 122) were divided into 71 idiopathic RLS and 51 RLS-C, or Comorbid, groups. All subjects were examined by an RLS expert, answered standardized RLS questionnaires, and received a body diagram to draw the location and depth of their symptoms.
Results:
Age was 63.04 ± 12.84 years, with 77 females and 45 males. All patients had lower limb involvement and 43/122 (35.25%) also had upper limb involvement. Of the 122 subjects, 42.62% felt that the RLS discomfort was only deep, 9.84% felt that the discomfort was only superficial, and 47.54% felt both superficial and deep discomfort. There were no defining characteristics in depth or distribution of RLS sensations that differentiated those patients with idiopathic RLS from those patients with RLS associated with other comorbid leg conditions. The sensation of arthritis was felt almost exclusively in the joints and not in the four quadrants of the leg, whereas the exact opposite was true of RLS sensations.
Conclusions:
Depth and distribution cannot be used as a discriminative mechanism to separate out idiopathic RLS from RLS comorbid with other leg conditions. Although seen in clinical practice, the total absence of patients with non-painful RLS only in the joints in the current study attests to the rarity of this presentation and raises the possibility of misdiagnosis under these circumstances. We recommend that such patients not be admitted to genetic or epidemiological studies.
Citation:
Yeh P, Ondo WG, Picchietti DL, Poceta JS, Allen RP, Davies CR, Wang L, Shi Y, Bagai K, Walters AS. Depth and distribution of symptoms in restless legs syndrome/Willis-Ekbom disease. J Clin Sleep Med 2016;12(12):1669–1680.
http://ift.tt/2gC1IDS
High School Start Times and the Impact on High School Students: What We Know, and What We Hope to Learn
Study Objectives:
Several organizations have provided recommendations to ensure high school starts no sooner than 08:30. However, although there are plausible biological reasons to support such recommendations, published recommendations have been based largely on expert opinion and a few observational studies. We sought to perform a critical review of published evidence regarding the effect of high school start times on sleep and other relevant outcomes.
Methods:
We performed a broad literature search to identify 287 candidate publications for inclusion in our review, which focused on studies offering direct comparison of sleep time, academic or physical performance, behavioral health measures, or motor vehicular accidents in high school students. Where possible, outcomes were combined for meta-analysis.
Results:
After application of study criteria, only 18 studies were suitable for review. Eight studies were amenable to meta-analysis for some outcomes. We found that later school start times, particularly when compared with start times more than 60 min earlier, are associated with longer weekday sleep durations, lower weekday-weekend sleep duration differences, reduced vehicular accident rates, and reduced subjective daytime sleepiness. Improvement in academic performance and behavioral issues is less established.
Conclusions:
The literature regarding effect of school start time delays on important aspects of high school life suggests some salutary effects, but often the evidence is indirect, imprecise, or derived from cohorts of convenience, making the overall quality of evidence weak or very weak. This review highlights a need for higher-quality data upon which to base important and complex public health decisions.
Citation:
Morgenthaler TI, Hashmi S, Croft JB, Dort L, Heald JL, Mullington J. High school start times and the impact on high school students: what we know, and what we hope to learn. J Clin Sleep Med 2016;12(12):1681–1689.
http://ift.tt/2hGnmMl
Severe Postictal Hypoxemia-Associated Seizure in a 12-Year-Old Child
A 9 year-old girl with developmental delay and seizure disorder presented for evaluation of witnessed breathing pauses during sleep that were not associated with snoring or gasping. Polysomnography showed a generalized seizure with post ictal central apnea associated with severe desaturation and a post central apnea brief seizure. This case report discusses the pathophysiology of post-ictal desaturations and breathing abnormalities during seizures and their possible association with sudden unexpected death in epilepsy. The case also demonstrates the utility of polysomnography for the diagnosis of breathing abnormalities associated with seizures.
Citation:
DelRosso LM, Hoque R, Mitchell C, Ly NP. Severe postictal hypoxemia-associated seizure in a 12-year-old child. J Clin Sleep Med 2016;12(12):1691–1693.
http://ift.tt/2gBXH2k
Progression of Polysomnographic Abnormalities in Mucolipidosis II (I-Cell Disease)
Mucolipidosis II (Inclusion cell or I-cell disease) is an autosomal recessive lysosomal storage disorder clinically comparable to the mucopolysaccharidoses (MPS), characterized by progressive respiratory and neurologic deterioration. Sleep problems, especially obstructive sleep apnea (OSA) and disrupted sleep architecture, are observed in other lysosomal storage diseases but have not been described in mucolipidosis II. We report the progression of polysomnographic abnormalities in a child with mucolipidosis II, demonstrated by worsening sleep-related hypoventilation, OSA, and sleep state fragmentation despite advancing PAP therapy. Background slowing and reduction in spindle activity on limited EEG may reflect progressive CNS disease affecting thalamic neurons.
Citation:
Wooten WI, Muhlebach MS, Muenzer J, Loughlin CE, Vaughn BV. Progression of polysomnographic abnormalities in mucolipidosis II (I-cell disease). J Clin Sleep Med 2016;12(12):1695–1696.
http://ift.tt/2hGq4Sg
Regulation of bone remodeling by vitamin K2
Abstract
All living tissues require essential nutrients such as amino acids, fatty acids, carbohydrates, minerals, vitamins, and water. The skeleton requires nutrients for development, maintaining bone mass and density. If the skeletal nutritional requirements are not met, the consequences can be quite severe. In recent years, there has been growing interest in promotion of bone health and inhibition of vascular calcification by Vitamin K2. This vitamin regulates bone remodeling, an important process necessary to maintain adult bone. Bone remodeling involves removal of old or damaged bone by osteoclasts and its replacement by new bone formed by osteoblasts. The remodeling process is tightly regulated; when the balance between bone resorption and bone formation shifts to a net bone loss results in the development of osteoporosis in both men and women. In this review, we focus on our current understanding of the effects of vitamin K2 on bone cells and its role in prevention and treatment of osteoporosis.
This article is protected by copyright. All rights reserved.
http://ift.tt/2h1vXoM
Hyposalivation and xerostomia among Parkinson's disease patients and its impact on quality of life
Abstract
Objective
Parkinson's disease (PD) adversely affects oral health (OH). However, the informative value of xerostomia compared to objective parameters and its impact on quality of life (QoL) is still unclear. This study aimed to explore whether xerostomia correlates with hyposalivation and to define its impact on OH-related QoL.
Materials and methods
Whole stimulated saliva (WSS) was collected from 30 PD patients and 30 matched healthy controls. Objective parameters (Community Periodontal Index of Treatment Needs, plaque/ gingivitis index, mucosa situation and cheilitis angularis), and questionnaires (German Oral Health Impact Profile [OHIPG]-14, visual analogue scale [VAS], xerostomia [yes/no], and the Unified Parkinson's Disease Rating Scale-II) were assessed.
Results
87% PD patients showed hyposalivation versus 50% of controls (p=0.001). 50% of PD patients reported xerostomia, none of controls (p<0.001). The OHIPG-14 was impaired in PD patients compared to controls (p<0.001), PD patients with xerostomia reported mean VAS values of 4.1 (SD 2.2). WSS did not correlate with VAS values.
Conclusions
Half of PD patients reported xerostomia and underestimated their xerostomic status, with higher probability than healthy controls. WSS did not reflect the grade of xerostomia. PD patients suffered from impaired OH-related QoL. Dental teams should not overlook these oral health risks.
This article is protected by copyright. All rights reserved.
http://ift.tt/2gMdMGj
Evaluation of the p-AKT, p-JNK and FoxO3a function in the oral epithelial dysplasia malignance
Abstract
Objectives
To evaluate the expression of p-AKT, p-JNK, FoxO3a and KI-67 in samples of Oral Squamous Cell Carcinoma (OSCC) and Oral Epithelial Dysplasias (OEDs) to understand their possible involvement in the malignant transformation process of oral lesions.
Materials And Methods
Tissue samples of 20 cases of OSCCs, 20 OEDs and normal oral mucosa were subjected to immunohistochemistry reactions for anti-p-Akt, anti-p-JNK, anti-FoxO3a and anti-Ki-67 antibodies. It was analyzed quantitative (number of immunostained cells) and qualitative (immunostaining intensity) parameters in different cell immunostaining sublocations.
Results
Nuclear p-AKT was observed significantly greater immunostaining in OSCC (21.2 ± 19.0) than in dysplasias (7.9 ± 8.1) and control (1.8 ± 4.7) (p = 0.002). Immunostaining of strong nuclear p-JNK was greater in controls (48.3 ± 13.7) than in OEDs (11.0 ± 10.3) and OSCCs (1.1 ± 1.3) (p<0.001). Strong nuclear immunostaining of FoxO3a proved to be absent in OSCCs (0.0 ± 0.1) with little staining on dysplasias (3.2 ± 5.4) and increased expression in controls (13.5 ± 4.8) (p<0.001). Immunostaining of strong nuclear ki-67 was grater in OSCCs (48.1±49.6) than in OED (11.8±10.6) and controls (1.9±2.0) (p<0.001).
Conclusions
Malignant process of OEDs in this research may involve the same mechanisms of established malignant lesions.
This article is protected by copyright. All rights reserved.
http://ift.tt/2hxwct9
An update on the implications of Cyclin D1 in oral carcinogenesis
Abstract
Cyclin D1 promotes cell cycle progression during G1 phase, a key event in G1-S transition. The protein is encoded by gene CCND1, located in chromosomal band 11q13. Cyclin D1 plays key roles in cell biology, including: cell proliferation and growth regulation, mitochondrial activity modulation, DNA repair, and cell migration control. CCND1 gene and its protein cyclin D1 are frequently altered by different molecular mechanisms, including amplification, chromosomal translocations, mutations, and activation of the pathways involved in cyclin D1 expression, alterations which appear to be essential in the development of human cancers, including oral carcinoma. This is the first published review of the specific features of cyclin D1 overexpression in oral oncogenesis. Starting with the physiological regulation of cyclin D1, there is an evaluation of its functions, overexpression mechanisms, and the implications of the oncogenic activation of CCND1/cyclin D1 in OSCC. The potential diagnostic and prognostic value of cyclin D1 is reviewed. The influence of CCND1/cyclin D1 on tumor size and clinical stage is reported, and an update is provided on the utilization of cyclin D1 as therapeutic target and on the combination of cyclin D1 inhibitors with cytotoxic agents. Future research lines in this field are also proposed.
This article is protected by copyright. All rights reserved.
http://ift.tt/2hmqImP
Phenotype and genotype analyses in seven families with dentinogenesis imperfecta or dentin dysplasia
Abstract
Objective
Hereditary dentin defects can be categorised into two classes according to their clinical manifestations: dentinogenesis imperfecta (DGI), which includes three types (DGI-I, DGI-II, and DGI-III) and dentin dysplasia (DD), which includes two types (DD-I and DD-II). This study investigated the phenotypic characteristics and genetic causes of hereditary dentin defects in seven Chinese families.
Materials And Methods
Seven families affected with DGI-II, DGI-III, or DD-II were enrolled. Clinical examinations were performed to determine the phenotypic characteristics, and DNA samples were collected for Sanger sequencing.
Results
Clinical diagnoses revealed DGI-II in five families, DGI-III in one family, and DD-II in one family. Variants of the dentin sialophosphoprotein (DSPP) gene were found in six of the seven families. Of these, c.52G>T was identified in two families. Each of the remaining four families had a different variant: c.2684delG, c.52-2A>G, c.1874-1877delACAG, and c.3509-3521del13bp; the last three variants were novel.
Conclusions
This is the first study to analyse all three important types of hereditary dentin defect and include comprehensive genetic analyses of both dentin sialoprotein and dentin phosphoprotein in Chinese families. This study expands the spectrum of DSPP variants, highlighting their associated phenotypic continuum.
This article is protected by copyright. All rights reserved.
http://ift.tt/2hxx6Wm
Could Calcified Triglyceride Bone Cement Be an Alternative Graft Material in Maxillary Sinus Augmentation?.
The ideal graft material for maxillary sinus augmentation is still a matter of controversy and the search for a more appropriate bone substitute for use continues. The aim of this study was to evaluate bone formation as a sign of the regeneration following maxillary sinus augmentation in rabbits using 3 different biomaterials, one of which is a newly developed graft material; calcified triglyceride bone cement (CTBC). Twenty-one New Zealand rabbits were used and randomly divided into 3 groups. Bilateral maxillary sinus augmentation was carried out and autogenous bone (AB), bovine hydroxyapatite (BHA), and CTBC were administered. Maxillary sinuses were dissected after fourth and eighth weeks of the operation. The bone formation was evaluated by stereological and histopathological analysis and the data were analyzed statistically. When the volume of primary bone is compared, statistically significant differences were found among all groups at both of the fourth and eighth weeks. The highest value was obtained from AB applied group. In BHA and CTBC applied groups, active bone formation, osseointegration of graft materials were observed at both fourth and eighth weeks. In CTBC applied group, primary bone formation was only seen as linked to the continuation of parent sinus bony wall. The efficiency of primary bone formation of CTBC was found less than AB and BHA. Of the 3 graft materials tested, BHA is the strongest alternative to AB graft for maxillary sinus augmentation. (C) 2016 by Mutaz B. Habal, MD.
http://ift.tt/2h1qC0U
http://ift.tt/2h1qC0U
Analysis of Anatomical Characteristics and Morphometric Aspects of Infraorbital and Accessory Infraorbital Foramina.
Objective: This study aimed to perform a morphological and morphometric study of the characteristics of the infraorbital foramen (IOF) and accessory infraorbital foramen (AIOF) in Brazilian skulls. Methods: A sample calculation determined a total of 94 human skulls to be evaluated by a trained examiner for number, shape, diameters, and location of IOF in relation to anatomical landmarks. Number, size, shape, diameters, location, orientation, position, and distances in relation to anatomical landmarks were evaluated for the AIOF. Descriptive analysis, paired t test, Wilcoxon test, Pearson and Spearman correlations were used. Results: A total of 188 IOFs and 48 AIOFs were found. Circular outline was the predominant shape for both IOFs and AIOFs. Infraorbital foramens presented in left sides had a significantly greater transverse diameter and distance from medial margin of the orbit when compared with IOFs located on the right sides (P
http://ift.tt/2gJUumo
http://ift.tt/2gJUumo
A Rare Patient with Facial Duplication.
Facial duplication, in whole or in part, is a very rare malformation. It may be symmetrical or asymmetric. Those cases that have been reported in the literature constitute a spectrum extending from simple nasal duplication to complete separation of 2 faces. Up to now there are some reports of eye, nose, mandible, or maxilla duplication separately. But there is no report of oral orifice or lips duplication. The present article reports a case of a newborn girl who presented with 2 mouths and also duplication of zygoma and maxilla. Then, we describe her stages of treatment from birth through now that she has 20 years. (C) 2016 by Mutaz B. Habal, MD.
http://ift.tt/2h1mi1I
http://ift.tt/2h1mi1I
Microsurgical Forehead Reconstruction.
Reconstruction of the forehead remains challenging. Especially in cases of large or even complete forehead defects, local flaps and skin grafting may not be an option, necessitating free flap coverage. The aim of this retrospective case series was to develop an algorithmic surgical approach as well as to evaluate surgical and aesthetic outcomes of microvascular-based forehead reconstructions, using gracilis muscle or anterolateral thigh flaps in 15 cases. The mean size of the defects was 84.6 (range: 25-160, +/-44.1) cm2, all with significant area of bone exposure. The free flap reconstructions included 7 gracilis muscle flaps, covered with 1.2-mm-thick unmeshed split-thickness skin grafts, and 8 anterolateral thigh flaps with a mean size of the free flaps of 160 (range: 56-300, +/-78.6) cm2. In all patients, wound healing at the donor site was uneventful. Minor complications occurred in 3 patients and required small revision procedures. This case series demonstrates that microsurgical reconstruction of multiple entities of forehead defects poses a reliable method, especially in large and complex defects. In our opinion, given low risks for major complications and superior aesthetic results, the gracilis muscle flap covered with unmeshed split-thickness skin graft is ideally suited to reconstruct the forehead and should be one of first choices. (C) 2016 by Mutaz B. Habal, MD.
http://ift.tt/2gJZibu
http://ift.tt/2gJZibu
Mandibular Contouring During Orthognathic Surgery Using the Modified Hunsuck Technique.
Square face or prominent mandibular angle is a major concern in Asian women. In class III patients, mandibular setback may lead to a wider lower face that is not preferred in Asian culture. In order to achieve better aesthetic outcomes, simultaneous mandibular contouring to reduce the width of the lower face is required for some patients. This article details the authors' procedures modified from Hunsuck techniques of sagittal split osteotomy. This modified Hunsuck technique provides an alternative option to obtain a desirable mandibular outline. The long-term stability is also comparable to traditional methods. (C) 2016 by Mutaz B. Habal, MD.
http://ift.tt/2h1lSIC
http://ift.tt/2h1lSIC
New JAG1 mutation causing Alagille Syndrome presenting with severe hypercholesterolemia: Case report with emphasis on genetics and lipid abnormalities
The Journal of Clinical Endocrinology &Metabolism, Early Release.
http://ift.tt/2hG4Zar
DNA methylation is an independent prognostic marker of survival in adrenocortical cancer
The Journal of Clinical Endocrinology &Metabolism, Early Release.
http://ift.tt/2gBSk3b
Clinical features and management of non-HIV related lipodystrophy in children: a systematic review
The Journal of Clinical Endocrinology &Metabolism, Early Release.
http://ift.tt/2hGbhXM
PKA-RIIB deficiency induces brown fat-like adipocytes in inguinal WAT and promotes energy expenditure in male FVB/NJ mice
Endocrinology, Early Release.
http://ift.tt/2hxeaaj
A refill for the brain mineralocorticoid receptor: The benefit of cortisol add-on to dexamethasone therapy
Endocrinology, Early Release.
http://ift.tt/2hmnZKh
17β-HSD type 12-like is responsible for maturation-inducing hormone synthesis during oocyte maturation in masu salmon
Endocrinology, Early Release.
http://ift.tt/2hxjCdo
Diet polyphenol curcumin stimulates hepatic Fgf21 production and restores its sensitivity in high fat diet fed male mice
Endocrinology, Early Release.
http://ift.tt/2hmoBPL
Gestational Hyperandrogenism in Developmental Programming
Endocrinology, Early Release.
http://ift.tt/2hxn87e
Silencing Med12 Gene Reduces Proliferation of Human Leiomyoma Cells Mediated via Wnt/β-Catenin Signaling Pathway
Endocrinology, Early Release.
http://ift.tt/2hmuMU8
PKA-RIIB deficiency induces brown fat-like adipocytes in inguinal WAT and promotes energy expenditure in male FVB/NJ mice
Endocrinology, Early Release.
http://ift.tt/2hxeaaj
A refill for the brain mineralocorticoid receptor: The benefit of cortisol add-on to dexamethasone therapy
Endocrinology, Early Release.
http://ift.tt/2hmnZKh
17β-HSD type 12-like is responsible for maturation-inducing hormone synthesis during oocyte maturation in masu salmon
Endocrinology, Early Release.
http://ift.tt/2hxjCdo
Diet polyphenol curcumin stimulates hepatic Fgf21 production and restores its sensitivity in high fat diet fed male mice
Endocrinology, Early Release.
http://ift.tt/2hmoBPL
Gestational Hyperandrogenism in Developmental Programming
Endocrinology, Early Release.
http://ift.tt/2hxn87e
Silencing Med12 Gene Reduces Proliferation of Human Leiomyoma Cells Mediated via Wnt/β-Catenin Signaling Pathway
Endocrinology, Early Release.
http://ift.tt/2hmuMU8
Visual Context Enhanced: The Joint Contribution of Iconic Gestures and Visible Speech to Degraded Speech Comprehension
Purpose
This study investigated whether and to what extent iconic co-speech gestures contribute to information from visible speech to enhance degraded speech comprehension at different levels of noise-vocoding. Previous studies of the contributions of these 2 visual articulators to speech comprehension have only been performed separately. Method
Twenty participants watched videos of an actress uttering an action verb and completed a free-recall task. The videos were presented in 3 speech conditions (2-band noise-vocoding, 6-band noise-vocoding, clear), 3 multimodal conditions (speech + lips blurred, speech + visible speech, speech + visible speech + gesture), and 2 visual-only conditions (visible speech, visible speech + gesture). Results
Accuracy levels were higher when both visual articulators were present compared with 1 or none. The enhancement effects of (a) visible speech, (b) gestural information on top of visible speech, and (c) both visible speech and iconic gestures were larger in 6-band than 2-band noise-vocoding or visual-only conditions. Gestural enhancement in 2-band noise-vocoding did not differ from gestural enhancement in visual-only conditions. Conclusions
When perceiving degraded speech in a visual context, listeners benefit more from having both visual articulators present compared with 1. This benefit was larger at 6-band than 2-band noise-vocoding, where listeners can benefit from both phonological cues from visible speech and semantic cues from iconic gestures to disambiguate speech.http://ift.tt/2hwmM0B
Propositional Density in Spoken and Written Language of Czech-Speaking Patients With Mild Cognitive Impairment
Purpose
Propositional density (PD) is a measure of content richness in language production that declines in normal aging and more profoundly in dementia. The present study aimed to develop a PD scoring system for Czech and use it to compare PD in language productions of older people with amnestic mild cognitive impairment (aMCI) and control participants matched on age, gender, and education. Method
Groups of patients with aMCI and cognitively healthy control participants (N = 20 each) provided short spoken and written language samples. Two samples were elicited for each modality, 1 describing recent events and 1 describing childhood memories. Series of neuropsychological tests were administered. The groups were compared using t-tests and the relations between measures using correlation coefficients. Results
PD was lower in spoken productions of patients with aMCI, compared with control participants, but only in language samples using remote memories. PD in these samples was related to verbal fluency and education but not to working memory. PD in written samples did not differ between participants with aMCI and control participants. Conclusions
PD in spoken language reflects the cognitive decline in people with aMCI, but the effect is relatively mild. The results support the existing findings that PD is related to verbal fluency.http://ift.tt/2huk7qP
Εγγραφή σε:
Αναρτήσεις (Atom)