Κυριακή 25 Δεκεμβρίου 2022

Chronic Oral Diseases Burden: the confluence of caries and periodontitis throughout life

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Abstract

Aim

To investigate the confluence of caries and periodontitis indicators from adolescence to elderhood among Americans.

Methods

This cross-sectional study explored the grouping among a set of caries and periodontitis indicators [the proportion of sites with bleeding on probing (BoP), moderate probing pocket depth (PPD, 4-5mm), severe PPD (≥ 6mm), moderate clinical attachment level (CAL, 3-4mm), severe CAL (≥ 5mm), number of teeth with furcation involvement, number of decayed teeth, number of teeth with pulp involvement and the number of missing teeth] in 14,421 Americans from the NHANES III. Exploratory Factorial Analysis (EFA) was used to determine the constructs between those indicators (factorial loading ≥ 0.3). These analyses were stratified by age and confirmed with a confirmatory factorial analysis. We also performed a sensitivity analysis using the NHANES 2011-2014.

Results

Two constructs were extracted. The first, Chronic Oral Diseases Burden, grouped caries indicators with moderate PPD and moderate CAL for the youngest subjects (13 to 39 y-old); while for the subjects over 50 y-old, the Chronic Oral Disease Burden grouped caries indicators with severe CAL and PPD and furcation involvement. The second construct, Periodontal Destruction, grouped only periodontitis indicators.

Conclusion

Caries and periodontitis indicators grouped consistently across the different age ranges in lapse times of 25 years.

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Customised acoustic therapy delivered through a web‐based platform – an innovative approach to tinnitus treatment

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Abstract

Objectives

Customised acoustic therapy aims to moderate the neural pathways implicated in the pathophysiology of tinnitus. This study aimed to assess the efficacy of customised acoustic therapy administered via a web-based treatment platform.

Design

Clinical trial with prospective recruitment. 58 participants underwent six weeks of customised acoustic therapy.

Setting

Treatment was delivered for 2 hours each day using a smartphone, tablet or computer. Treatment was integrated into usual daily activities.

Participants

Participants with subjective tinnitus were recruited through public and private otolaryngology clinics and electronic and print media.

Main Outcomes Measured

FiveQ, a novel 5 question tinnitus questionnaire, was measured at baseline and each week of treatment. Statistical analyses, including Wilcoxon, Mann-Whitney and mixed linear regression, were used to assess treatment efficacy and identify factors associated with treatment response.

Results

39/58 participants (67.2%) had an improvement in symptom severity scores, 4 had no change (6.9%) and 15 had a decline from baseline (25.9%). Mean FiveQ scores improved by 22.9% from 40.8 (SD=21.4) at baseline to 31.5 (SD=21.3) following 6 weeks of treatment (p<0.001). With the exception of the slight tinnitus group, all other groups (from mild to catastrophic) demonstrated a treatment response. Participants with low frequency tinnitus (<2000 Hertz) had a significantly greater treatment response (p<0.001).

Conclusion

Customised acoustic therapy administered via a web-based platform demonstrated encouraging efficacy. At least mild symptoms at baseline and low frequency tinnitus were associated with a greater treatment response. Customised acoustic therapy offers accessible and efficacious tinnitus treatment, however longer term clinical studies are required to confirm the observed initial benefit is maintained.

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Attentional biases for sad faces in offspring of mothers with a history of major depression: trajectories of change from childhood to adolescence

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Background

Theorists have proposed that the way children process social–emotional information may serve as a mechanism of risk for the intergenerational transmission of depression. There is growing evidence that infants and children of mothers with a history of major depressive disorder (MDD) during the child's life exhibit attentional avoidance of sad faces, which has been proposed as an early emerging emotion regulation strategy. In contrast, there is clear evidence that at-risk and depressed adolescents and adults exhibit difficulty disengaging attention from sad faces.

Methods

Seeking to link these two literatures, the current U.S.-based study used eye tracking within the context of an accelerated longitudinal design to assess attentional biases in 8–14-year-old offspring of mothers with a history MDD during the child's life (n = 123) or no history of MDD (n = 119) every six months for two years, allowing us to map trajectories of attention from age 8 to 16.

Results

Mother MDD history moderated age-based changes in children's gaze duration to sad (t[240] = 2.44, p = .02), but not happy (t[240] = 0.11, p = .91) or angry (t[240] = 0.67, p = .50), faces. Consistent our hypotheses, offspring of mothers with MDD exhibited significantly less attention to sad faces than offspring of never depressed mothers before age 8.5 but significantly more attention to sad faces after age 14.5, which was due to an increase in gaze duration to sad faces from childhood to adolescence among offspring of mothers with MDD (t[122] = 5.44, p < .001) but not among offspring of never depressed mothers (t[118] = 1.49, p = .14).

Conclusions

It appears that the form, and perhaps function, of attentional bias may shift across development in at-risk youth. To the extent that this is true, it has significant implications not only for theories of the intergenerational transmission of depression risk but also for prevention and early intervention efforts designed to reduce this risk.

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Neuroendokrine Tumoren im Kopf-, Halsbereich

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Laryngorhinootologie
DOI: 10.1055/a-1976-9641

Hintergrund Neuroendokrine Tumoren (NET) sind benigne oder maligne Neoplasien, die entwicklungsgeschichtlich der Neuralleiste oder paraganglionären Zellen des vegetativen Nervensystems entstammen. Die alte Bezeichnung Karzinoid (karzinomähnlicher Tumor) ist noch sehr verbreitet, jedoch inzwischen obsolet. Lediglich 0,5–2 % aller Neoplasien des Menschen sind neuroendokrine Tumoren, welche überwiegend gastrointestinal oder bronchopulmonal lokalisiert sind. Die Inzidenz beträgt 9.263/100.000. Jedoch ist nur 1 % der Kopf-Hals-Tumore neuroendokriner Genese. Fallzahlstarke Langzeitstudien und Leitlinien zur Diagnose und Therapie im Kopf-Hals Bereich fehlen. Ziel dieser Arbeit ist der wertende Vergleich bekannter Therapiestrategien und daraus folgender Krankheitsverläufe sowie deren Vergleich mit dem Schrifttum anhand eigener Fälle unterschiedlicher Lokalisation und Ausdehnung. Patienten und Methoden In unserer Klinik wurden zwischen 2010 und 2017 14 Patienten mit neuroendokrinen Tumoren im Kopf-Hals-Bereich behandelt. 8 Patienten davon wurden primär operativ mit adjuvanter Radiochemotherapie versorgt. 6 Patienten erhielten eine primäre Radiochemotherapie in kurativer Absicht. 1 Patient erhielt auf Grund des Tumorprogress nach der primären Radiochemotherapie eine weitere Chemotherapie mit palliativer Indikation. Ergebnisse Die Tumorlokalisationen verteilen sich auf den Larynx (n = 7), die Glandula parotis (n = 2) und auf die Nasenhaupt- und -nebenhöhlen (n=5). Von den 8 operierten Patienten konnte in sechs Fällen eine in-sano Resektion (R0) erreicht werden. Die im Kollektiv gemessene Gesamtüberlebensrate beträgt im Mittel 19±6 Monate. Von den 14 untersuchten Patienten erlitten zwei Patienten ein Rezidiv, wovon ein Patient nach 7 Monaten verstarb und ein Patient 32 Monate nach der Nachresektion Rezidiv-frei lebt. In zwei Fällen sprach das NET nicht auf die kombinierte RCT an und die Patienten verstarben jeweils nach sechs und 13 Monaten. Die Überlebenszeit ist abhängig vom T-Stadium des NET sowie vom Erreichen einer R0-Resektion. Die R0-Resektion bietet eine höhere Überlebenswahrscheinlichkeit als die primäre RCT. Schlussfolgerung Patienten mit NET des Kopf-Hals-Bereiches müssen in spezialisierten Zentren interdisziplinär behandelt werden. Zur Erfassung dieser Daten ist eine Tumordatenbank notwendig. Jedoch sind aufgrund der niedrigen Inzidenz keine Studien auf hohem Evidenzniveau zu erwarten. Nach effizienter Diagnosestellung sollte zeitliche Verzögerung unmittelbar im Rahmen einer interdisziplinären Tumorkonferenz eine individuelle auf den Patienten zugeschnittene Therapie erfolgen.
[...]

Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany

Article in Thieme eJournals:
Table of contents  |  Abstract  |  Full text

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Computer‐based performance approach for critical thinking assessment in children

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Abstract

Background

Critical thinking (CT) has been identified as one of the key skills in the modern world. Despite a variety of CT assessment systems for secondary school and higher education, there is a shortage of CT assessments for children.

Aims

To fill the gap, we developed a computer-based performance assessment (CPBA) of CT with automatic scoring. In the study, we analysed: (1) To what extent is the internal structure of the critical thinking assessment tool confirmed? (2) What are the patterns of students' behaviour within the CPBA? (3) To what extent is the convergent validity of the CPBA supported?

Sample and Methods

The sample consists of 1689 students, aged 9–11 years. To answer the research questions, the following quantitative data analysis methods were selected. The Bayesian Network was applied to investigate the internal structure. Latent Class Analysis was used to investigate the patterns of students' behaviour. To verify the convergent validity, the students were asked to solve the standardized math and language literacy tests.

Results and Conclusions

The theoretically expected internal structure of the CPBA was confirmed: the two-factor structure (the Analysis of information and the Making inferences subskills of CT) describes the data appropriately. Moreover, CT was described not as a list but as a sequence of cognitive operations. Four different strategies that lead to different results of CT were revealed. A weak positive correlation between the results of the CPBA and the achievement tests confirmed the test validity.

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Treatment outcomes and cost comparisons for older adults with T4 laryngeal squamous cell cancer

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Abstract

Background

To evaluate treatment modalities of T4 larynx cancer in older adults using SEER-Medicare.

Methods

The database was queried for patients aged 66 and older with nonmetastatic T4 laryngeal squamous cell cancer from 2006 to 2015. Treatment modalities compared were surgery plus chemoradiation (SCR), surgery plus radiation (SR), chemoradiation (CR), surgery (S), and radiation (R). Multivariate analysis and Kaplan–Meier methods were used to explore the relationship of treatment modality and survival. Total cancer-related costs were calculated.

Results

A total of 438 patients met inclusion criteria. Patients receiving CR or SR had similar CSS to SCR (HR 1.36 and HR 1.24, respectively). Those receiving S (HR 2.00) or R (HR 2.41) had significantly worse CSS. Similar findings were observed for OS. Cancer care-related costs were not significantly different but highest in SCR ($162215) and lowest in R ($121421).

Conclusion

Older patients with T4 larynx cancer had similar survival rates when treated with CR, SR, and SCR. Average total health care costs were not significantly different between modalities. Patients not eligible for triple-modality could consider these other treatment options.

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enzyme replacement therapy followed by stem cell transplantation in children with Gaucher disease type 1 and 3

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Abstract

Background

Gaucher disease (GD) is a lysosomal storage disorder, characterized by hepatosplenomegaly, pancytopenia, bone diseases, with or without neurological symptoms. Plasma glucosylsphingosine (lyso-Gb1), a highly sensitive and specific biomarker for GD, has been used for diagnosis and monitoring the response to treatment. Enzyme replacement therapy (ERT) is an effective treatment for the non-neurologic symptoms of GD. Neuronopathic GD (type 2 and 3) accounts for 60%–70% of the Asian affected population.

Methods

We explored combination therapy of ERT followed by hematopoietic stem cell transplantation (HSCT) and its long-term outcomes in patients with GD type 3 (GD3).

Results

Four patients with GD3 and one with GD type 1 (GD1) underwent HSCT. The types of donor were one matched-related, one matched-unrelated, and three haploidentical. The age at disease onset was 6–18 months and the age at HSCT was 3.8–15 years in the patients with GD3. The latest age at follow-up was 8–22 years, with a post-HSCT duration of 3–14 years. All patients had successful HSCT. Chronic graft-versus-host disease occurred in one patient. The enzyme activities were normalized at 2 weeks post HSCT. Lyso-Gb1 concentrations became lower than the pathological value. All of the patients are still alive and physically independent. Most of them (4/5) returned to school. None of the patients with GD3 had seizures or additional neurological symptoms after HSCT, but showed varying degrees of cognitive impairment.

Conclusions

ERT followed by HSCT could be considered as an alternative treatment for patients with GD3 who have a high risk of fatal neurological progression.

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Involuntary evaluation of others' emotional expressions depends on the expresser's group membership. Further evidence for the social message account from the extrinsic affective Simon task

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Abstract

The social message account (SMA) hypothesizes that the evaluation of emotional facial expressions depends on the ethnicity of the expressers. For example, according to SMA, a happy face of a member of a prejudiced ethnicity is immediately interpreted as potentially malevolent. Evidence for this approach was found initially in evaluative priming (EP) and approach-avoidance tasks (AA) by showing an emotion × ethnicity interaction on positivity scores (EP) and approach scores (AA), respectively. Recently, attempts to replicate the EP results failed. Due to the inconclusive EP results, it was important to examine the influence of ethnicity on processing of emotional expression with another task testing involuntary evaluations. The extrinsic affective Simon task was used with stimuli varying on emotion (happy vs. fear) and ethnicity (White-Caucasian vs. Middle-Eastern men). This task was chosen because in contrast to EP (where faces are presented as task-irrelevant primes) faces are t ask-relevant. Experiment 1 yielded an emotion × ethnicity interaction with regard to positivity scores that fit SMA predictions. The results are also important in challenging a recent theoretical alternative to SMA, namely the processing conflict account. A generalization of the emotion × ethnicity pattern to learned arbitrary in- and out-groups (Experiment 2) failed, suggesting that involuntary processing of (task-irrelevant) group status depends on perceptual features.

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high‐viscosity glass ionomer restorative systems in small class II restorations

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Abstract

Objective

Evaluate and compare the 5-year clinical performance of three high-viscosity glass ionomer restorative materials in small class II restorations.

Materials and Methods

Forty patients, each with four class II restorations, were enrolled in this trial. A total of 160 restorations were placed, 25% for each material, as follows: three high-viscosity conventional glass ionomer restorative systems (Ketac Universal Aplicap, EQUIA Forte and Riva Self Cure HV) and a microhybrid resin composite system (Filtek Z250). Clinical evaluation was performed at baseline and after 1, 3, and 5 years by two independent examiners using FDI criteria. Epoxy resin replicas were observed under scanning electron microscope (SEM) to examine surface characteristics. Data were analyzed with Kruskal-Wallis, Mann–Whitney U, Friedman, and Wilcoxon signed-rank tests (p < 0.05).

Results

The success rates were 100% for resin composite, 97.4% for Ketac Universal, and 94.9% for both EQUIA Forte and Riva HV restorations. Statistically significant differences were observed between all groups in terms of surface luster and color match criteria (p < 0.05). Statistically significant changes were found over time for all criteria except for fracture of material, postoperative hypersensitivity, recurrence of caries, tooth integrity, periodontal response, adjacent mucosa, and oral health criteria (p > 0.05). SEM evaluations were in accordance with the clinical findings.

Conclusions

Although drawbacks in surface luster and color match appeared over the 5-year evaluation period, the three high-viscosity glass ionomer restorative materials provided successful clinical performance in small to medium sized class II cavities compared to microhybrid resin composite.

Clinical Significance

Glass ionomer restorations exhibited clinical performance similar to that of microhybrid resin composite restorations in small class II cavities subsequent to 5-year evaluation.

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Efficacy of stabilization splint and low level laser therapy for patients with chronic closed lock from non‐reducible displaced temporo‐mandibular joint discs. A parallel randomized clinical trial

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Abstract

Background

Stabilization splint therapy (SST) and low level laser therapy (LLLT) are effective non-invasive treatment for temporo-mandibular disorder (TMD) patients. However, the specific efficacy of each therapy in patients with chronic closed lock (CCL) from temporo-mandibular joints (TMJ) disc displacement without reduction (DDwoR) remains unknown.

Aim

To assess and compare the efficacy of SST and LLLT alone or in combination in patients with CCL from TMJ DDwoR .

Methods

This parallel randomized clinical trial included 42 patients who were diagnosed with CCL from TMJ DDwoR. Patients were allocated equally and randomly into three treatment groups: group I received combined SST and LLLT, group II received LLLT and group III received SST. Maximum mouth opening (MMO), visual analogue scale (VAS), muscle and joint palpation scores, and time required to achieve normal state, were evaluated at baseline, one week, two weeks, four weeks, three months, and six months after the intervention. Data was collected and analyzed using SPSS software.

Results

Regarding MMO and VAS, a statistically significant improvement was found between group I versus group II and versus group III at all evaluation times. Regarding muscle and joint palpation scores, a statistically significant difference was found between group I versus group III, while non-significant difference was found between group I and group II. A statistically significant faster improvement was found in group I versus group III and versus group II.

Conclusion

All treatment modalities can be effective in management of CCL from a TMJ DDwoR cases but the combined SST and LLLT group seems to provide the best and quickest improvement.

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