Day-care center attendance and risk of Asthma—A systematic review

Publication date: Available online 7 July 2018

Source: Allergologia et Immunopathologia

Author(s): Carlos Ochoa Sangrador, Alba Vázquez Blanco

Abstract

Introduction and Objectives

Asthma and other wheezing disorders are common chronic health problems in childhood. We aim to evaluate whether the attendance by children under three years of age to day-care centers is a protector or risk factor in the development of recurrent wheezing or asthma in the following years of their lives.

Methods

Systematic review of published cohort or cross-sectional studies, without any time limitation. We searched in PubMed, Cinhal, Cuiden and Scopus (EMBASE included). The quality of the studies was evaluated using the Newcastle-Ottawa Scale. Disagreements were solved by mutual consensus. Weighted odds ratio (ORs) were estimated using RevMan 5.3, following random effects models.

Results

We selected 18 studies for qualitative analysis, nine cohort studies and nine cross-sectional studies. Day-care center attendance is associated with an increased risk of early recurrent wheezing (four studies; 50,619 subjects; adjusted OR 1.87 [1.21 to 2.88]; I² 91%) and asthma before the age of six (five studies; 5412 subjects; adjusted OR 1.59 [1.26 to 2.01]; I² 0%), but not later (five studies; 5538 subjects; adjusted OR 0.86 [0.55 to 1.32]; I² 76%).

Conclusions

Children attending day-care center during the first years of life have a higher risk of recurrent wheezing during the first three years and asthma before the age of six, but not later. This risk must be taken into account to inform parents in order to choose what kind of care children should have throughout infancy and to implement preventive measures to reduce its impact.

https://ift.tt/2KEIQbA

Congenital Loss of Permanent Teeth in a Chinese Patient with Congenital Insensitivity to Pain with Anhidrosis Due to Two Novel Mutations in the NTRK1 Gene

Publication date: Available online 7 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Xiao-Meng Xue, Yan-Qing Liu, Pai Pang, Chang-Fu Sun

Abstract

Congenital insensitivity to pain with anhidrosis (CIPA), also known as hereditary sensory and autonomic neuropathy type IV, is an extremely rare autosomal recessive disorder. This study investigated the oral and craniofacial manifestations of a seven-year-old Chinese male affected by CIPA identified two novel mutations in the NTRK1 gene, and a new feature of the disorder was revealed. The patient had typical features, including insensitivity to pain, anhidrosis, and mental retardation; recurrent fractures and osteoporosis were also noted. His oral and craniofacial manifestations included congenital blepharoptosis, a large number of missing teeth, serious tooth abrasion, severe soft tissue injuries, and dental caries. Radiographic examination revealed congenital loss of the permanent tooth germs, thin and weak alveolar bone of the mandible, and a fracture of the right mandible. This report extends the spectrum of NTRK1 mutations observed in patients diagnosed with CIPA and is the first study to propose that congenital loss of permanent teeth may occur in CIPA patients. Furthermore, it highlights the importance of including an oral and maxillofacial surgeon and a pediatric dentist on the multidisciplinary team.

https://ift.tt/2N0b659

Is long term follow up mandatory for Stage I oral tongue cancer?

Publication date: Available online 7 July 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Robert A. Ord, Amal Isaiah, Donita Dyalram, Joshua E. Lubek

Abstract

Objective

The objective of this study was to analyze the outcomes and possible risk factors for late recurrence of patients with pathologically Stage I oral tongue squamous cell carcinomas (SCC) considered to be disease free at 3 years.

Materials and Methods

Retrospective study design evaluating all patients with pathologic Stage I oral tongue cancer within a tertiary care center between 2003-2013 followed for a minimum of 36 months.

Results

112 patients met inclusion criteria for long-term analysis. Despite the high OS of 92.2% for true pT1N0M0 disease, a total of 25/112 patients (22.3%) failed initial surgery, developing late disease recurrence (>36 months follow-up) either locally 19.6% (n=22), regionally 4.4% (n=5) or second primary disease 11.6% (n=13). Eleven (50%) of the patients who recurred locally were able to be salvaged with a second surgery, requiring no further treatment (mean 48.7 months). Projected 10-year disease free survival and overall survival was 61 and 89%, respectively. 33% (n=3/9) of deaths occurred in long-term patients considered to be disease free at 36 months.

Conclusion

Stage I tongue SCC is more common in females and is associated with pre-existing leukoplakia. Although overall survival is excellent, a high failure rate either due to local recurrence or a new second primary is seen over an extended time period. Long-term follow-up is mandatory as local salvage rates are excellent if diagnosed early. Regional failure carries a poor prognosis.

https://ift.tt/2KFDKM4

A reproductive and developmental screening study of the fungal toxin ochratoxin A in Fischer rats

Abstract

The presence of the mycotoxin ochratoxin A (OTA) in cereal grains is due to the growth of toxigenic Penicillium mold on stored crops. Human exposure to OTA is higher in infants, toddlers, and children than in adolescents and adults, based on exposure assessments of ng OTA consumed/kg body weight/day. Ochratoxin A is nephrotoxic and teratogenic in animals, but its effects on juveniles exposed during the reproduction and development period have not been studied. To address this, Fischer rats were exposed to 0, 0.16, 0.4, 1.0, or 2.5 mg OTA/kg diet throughout breeding, gestation, and lactation and its adverse effects were assessed in adult rats and their offspring on postnatal day (PND) 21. There were no effects on implantation but post-implantation fetotoxicity was observed in the 2.5 mg/kg dose group, corresponding to a calculated dose of 167.0 μg/kg bw/day in dams. Adverse effects on body and kidney weights and on clinical parameters indicative of renal toxicity were significant in adult rats exposed to 1.0 mg OTA/kg diet (55.2 and 73.3 μg/kg bw/day in adult males and females, respectively) and in PND21 rats at the 0.4 mg/kg dose (33.9 μg/kg bw/day in dams), suggesting that weanling rats were more sensitive to OTA than adults. Overall, nephrotoxicity was the primary effect of OTA in weanling rats exposed throughout gestation and lactation at sub-fetotoxic concentrations in diet.

https://ift.tt/2zjkXB7

Novel minor HLA DR associated antigens in type 1 diabetes

Publication date: Available online 7 July 2018

Source: Clinical Immunology

Author(s): Denise Müller, Tanja Telieps, Anne Eugster, Christina Weinzierl, Manja Jolink, Anette-Gabriele Ziegler, Ezio Bonifacio

Abstract

Type 1 diabetes is an autoimmune disease leading to insulin deficiency. Autoantibodies to beta cell proteins are already present in the asymptomatic phase of type 1 diabetes. Recent findings have suggested a number of additional minor autoantigens in patients with type 1 diabetes. We have established luciferase immunoprecipitation systems (LIPS) for anti-MTIF3, anti-PPIL2, anti-NUP50 and anti-MLH1 and analyzed samples from 500 patients with type 1 diabetes at onset of clinical disease and 200 healthy individuals who had a family history of type 1 diabetes but no evidence of beta cell autoantibodies. We show significantly higher frequencies of anti-MTIF3, anti-PPIL2 and anti-MLH1 in recent onset type 1 diabetes patients in comparison to controls. In addition, antibodies to NUP50 were associated with HLA-DRB1*03 and antibodies to MLH1 were associated with HLA-DRB1*04 genotypes.

Graphical abstract

https://ift.tt/2u9q0xS

Silicone-Induced Foreign Body Reaction: An Unusual Differential Diagnosis of Posterolateral Hip Pain

Background. Silicone injection is commonly used for soft tissue augmentation for esthetic purposes. It is not without complications. Case presentation. We present a case of a 31-year-old woman presenting with refractory left lateral hip pain. Magnetic resonance imaging of the patient's pelvis revealed innumerable small low signal foci throughout the gluteus maximus and overlying subcutaneous fat bilaterally consistent with injectable material, possibly silicone. Conclusions. This case report emphasizes that silicone-induced granulomatosis must be considered in the differential diagnosis of hip pain when evaluating a patient who has had access to plastic surgery or clandestine operators.

https://ift.tt/2KWLUMc

Qualitative evaluation of hybrid layer formation using Er:YAG laser in QSP mode for tooth cavity preparations

Abstract

The purpose of this study was to evaluate the thickness and qualitative characteristics of the hybrid layer after two cavity preparation methods, using Er:YAG laser in QSP mode and conventional carbide burs. Additionally, two different adhesive techniques were investigated using etch-and-rinse and self-etch adhesive systems. Sixty sound human third molars were used and were randomly divided into four groups (n = 15). In the first two groups, large (4 mm length, 3 mm wide, and 3 mm deep) class I cavities were prepared using Er:YAG laser (2.94 μm) in QSP mode, while in the other two groups, the cavities were prepared using carbide burs. After cavity preparations, two different adhesive techniques with GLUMA® 2 Bond (etch-and-rinse) and Clearfil™ Universal Bond Quick (self-etch) were applied. For the qualitative evaluation of the formed hybrid layer, photomicrographs were taken using SEM, and elemental semi-quantitative analysis was performed using EDS to confirm the extent of the hybrid layer. One-way ANOVA was applied to verify the existence of statistically significant differences, followed by Tukey test for post hoc comparisons (Bonferroni corrected), and the level of significance was set at a = 0.05. The laser-treated groups exhibited higher hybrid layer thickness than bur-treated groups (p < 0.001). Between the laser-treated groups, etch-and-rinse technique presented higher hybrid layer thickness than self-etch technique (p < 0.001), while between the bur-treated groups, no significant differences were detected (p = 0.366). Er:YAG laser cavity preparations in QSP mode may be advantageous for adhesion of composite restorations, but more data are necessary to confirm its clinical effectiveness.

https://ift.tt/2J0UQOQ