A case-control study of paternal and maternal age as risk factors in mood disorders

Objective: Advanced parental age might constitute a risk factor for various disorders. We tested whether this concerns also mood disorder patients.

Methods: The study included 314 subjects (42 bipolar-BD patients; 21 manics and 21 depressives, 68 unipolar-UD, and 204 normal controls-NC). Analysis of Covariance (ANCOVA) and the calculation of the Relative Risk (RR) and the Odds Ratio (OR) were used for the analysis.

Results: Paternal age differed between NC and UD patients (29.42?±?6.07 vs. 32.12?±?5.54; p?=?.01) and manics (29.42?±?6.07 vs. 35.00?±?5.75; p?=?.001) and maternal age between NC and manics (25.46?±?4.52 vs. 31.43?±?4.75; p?<?.001) and manic and UD (31.43?±?4.75 vs. 26.75?±?6.03; p?=?.002). The RR and OR values suggested that advanced parental age constitutes a risk factor for the development of mood disorders.

Conclusions: In a non-dose dependent and gender-independent, advanced parental age constitutes a risk factor for the development of BD with index episode of mania (probably manic predominant polarity); only advanced paternal age constitutes a risk factor for the development of UD and BD with index episode of depression (probably depressive predominant polarity). This is the first study suggesting differential effect of advanced parental age depending on predominant polarity of BD.     

Survival After Stereotactic Body Radiation Therapy for Clinically Diagnosed or Biopsy-Proven Early-Stage NSCLC: A Systematic Review and Meta-Analysis

Introduction

Stereotactic body radiation therapy (SBRT) is a promising curative treatment for early-stage NSCLC. It is unclear if survival outcomes for SBRT are influenced by a lack of pathological confirmation of malignancy and staging of disease in these patients. In this systematic review and meta-analysis, we assess survival outcomes after SBRT in studies with patients with clinically diagnosed versus biopsy-proven early-stage NSCLC.

In vitro cariostatic effect of whitening toothpastes in human dental enamel-microhardness evaluation.

OBJECTIVE: The aim of this study was to evaluate, in vitro, the cariostatic effect of whitening toothpastes. METHODS AND MATERIALS: Ninety-five dental fragments were obtained from nonerupted third molars. The fragments were embedded in polystyrene resin and sequentially polished with abrasive papers (400-, 600-, and 1,000-grit) and diamond pastes of 6, 3, and 1 microm. The fragments were assigned in five groups according to toothpaste treatment: G1 = Rembrandt Plus with Peroxide; G2 = Crest Dual Action Whitening; G3 = Aquafresh Whitening Triple Protection; and the control groups: G4 = Sensodyne Original (without fluoride); G5 = Sensodyne Sodium Bicarbonated (with fluoride). The initial enamel microhardness evaluations were done. For 2 weeks the fragments were submitted daily to a de-remineralization cycle followed by a 10-minute toothpaste slurry. After that, the final microhardness tests were done. The percentage of mineral loss of enamel was determined for statistical analysis. Analysis of variance and the Tukey test were applied. RESULTS: The results did not show statistically significant differences in mineral loss among groups G1, G2, G3, and G5, which statistically differ from G4 (toothpaste without fluoride). G4 showed the highest mineral loss (P < or = .05). CONCLUSION: The whitening toothpastes evaluated showed a cariostatic effect similar to regular, nonwhitening toothpaste.     

Factors influencing fluoride ingestion from dentifrice by children

Kobayashi CAN, Belini MR, Italiani FM, Pauleto ARC, Julianelli de Araújo J, Tessarolli V, Grizzo LT, Pessan JP, Machado MAAM, Buzalaf MAR. Factors influencing fluoride ingestion from dentifrice by children. Community Dent Oral Epidemiol 2011; 39: 426–432. © 2011 John Wiley & Sons A/S Abstract – Objective: This study assessed the percentage of the amount of dentifrice loaded onto the toothbrush that is ingested by children, taking into account age, the amount of dentifrice used during toothbrushing, and the dentifrice flavor. Methods: The sample consisted of 155 children of both genders attending public kindergartens and schools in Bauru, Brazil, divided into 5 groups (n = 30–32) of children aged 2, 3, 4, 5 and 6 years old. The dentifrices used were Sorriso? (1219 ppm F, peppermint‐flavored) and Tandy? (959 ppm F, tutti‐frutti‐flavored). The assessment of fluoride intake from dentifrices was carried out six times for each child, using 0.3, 0.6, and 1.2 g of each dentifrice, following a random, crossover distribution. Brushing was performed by the children or their parents/caregivers according to the home habits and under the observation of the examiner. Fluoride present in the expectorant and on toothbrush was analyzed with an ion‐specific electrode after HMDS‐facilitated diffusion. Fluoride ingestion was indirectly derived. Results were analyzed by 3‐way repeated‐measures anova and Tukey’s tests (P < 0.05) using the percent dentifrice ingested as response variable. Results: Age and percent dentifrice ingested for both dentifrices, and the three amounts used were inversely related (P < 0.0001). Percent dentifrice ingested was significantly higher after the use of Tandy? under all conditions of the study when compared with Sorriso? (P < 0.0001). Significant differences were observed when brushing with 0.3 g when compared with 1.2 g, for both dentifrices tested (P < 0.05). Conclusions: The results indicate that all variables tested must be considered in preventive measures aiming to reduce the amount of fluoride ingested by young children.     

NSF workshop report: Discovering general principles of nervous system organization by comparing brain maps across species

Efforts to understand nervous system structure and function have received new impetus from the federal Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative. Comparative analyses can contribute to this effort by leading to the discovery of general principles of neural circuit design, information processing, and gene‐structure‐function relationships that are not apparent from studies on single species. We here propose to extend the comparative approach to nervous system ‘maps' comprising molecular, anatomical, and physiological data. This research will identify which neural features are likely to generalize across species, and which are unlikely to be broadly conserved. It will also suggest causal relationships between genes, development, adult anatomy, physiology, and, ultimately, behavior. These causal hypotheses can then be tested experimentally. Finally, insights from comparative research can inspire and guide technological development. To promote this research agenda, we recommend that teams of investigators coalesce around specific research questions and select a set of ‘reference species' to anchor their comparative analyses. These reference species should be chosen not just for practical advantages, but also with regard for their phylogenetic position, behavioral repertoire, well‐annotated genome, or other strategic reasons. We envision that the nervous systems of these reference species will be mapped in more detail than those of other species. The collected data may range from the molecular to the behavioral, depending on the research question. To integrate across levels of analysis and across species, standards for data collection, annotation, archiving, and distribution must be developed and respected. To that end, it will help to form networks or consortia of researchers and centers for science, technology, and education that focus on organized data collection, distribution, and training. These activities could be supported, at least in part, through existing mechanisms at NSF, NIH, and other agencies. It will also be important to develop new integrated software and database systems for cross‐species data analyses. Multidisciplinary efforts to develop such analytical tools should be supported financially. Finally, training opportunities should be created to stimulate multidisciplinary, integrative research into brain structure, function, and evolution. J. Comp. Neurol. 522:1445–1453, 2014. © 2014 Wiley Periodicals, Inc.     

Fundamentals of Endoscopic Surgery cognitive examination: development and validity evidence

Background

Flexible endoscopy is an integral part of surgical care. Exposure to endoscopic procedures varies greatly in surgical training. The Society of American Gastrointestinal and Endoscopic Surgeons has developed the Fundamentals of Endoscopic Surgery (FES), which serves to teach and assess the fundamental knowledge and skills required to practice flexible endoscopy of the gastrointestinal tract. This report describes the validity evidence in the development of the FES cognitive examination.

Methods

Core areas in the practice of gastrointestinal endoscopy were identified through facilitated expert focus groups to establish validity evidence for the test content. Test items then were developed based on the content areas. Prospective enrollment of participants at various levels of training and experience was used for beta testing. Two FES cognitive test versions then were developed based on beta testing data. The Angoff and contrasting group methods were used to determine the passing score. Validity evidence was established through correlation of experience level with examination score.

Results

A total of 220 test items were developed in accordance with the defined test blueprint and formulated into two versions of 120 questions each. The versions were administered randomly to 363 participants. The correlation between test scores and training level was high (r = 0.69), with similar results noted for contrasting groups based on endoscopic rotation and endoscopic procedural experience. Items then were selected for two test forms of 75 items each, and a passing score was established.

Conclusions

The FES cognitive examination is the first test with validity evidence to assess the basic knowledge needed to perform flexible endoscopy. Combined with the hands-on skills examination, this assessment tool is a key component for FES certification.     

A systematic review of synthetic and biologic materials for abdominal wall reinforcement in contaminated fields

Background

Guidelines recommend the use of bioprosthetics for abdominal wall reinforcement in contaminated fields, but the evidence supporting the use of biologic over synthetic non-absorbable prosthetics for this indication is poor. Therefore, the objective was to perform a systematic review of outcomes after synthetic non-absorbable and biologic prosthetics for ventral hernia repair or prophylaxis in contaminated fields.

Methods

The systematic literature search identified all articles published up to 2013 that reported outcomes after abdominal wall reinforcement using synthetic non-absorbable or biologic prosthetics in contaminated fields. Studies were included if they included at least 10 cases (excluding inguinal and parastomal hernias). Quality assessment was performed using the MINORS instrument. The main outcomes measures were the incidence of wound infection and hernia at follow-up. Weighted pooled proportions were calculated using a random effects model.

Results

A total of 32 studies met the inclusion criteria and were included for synthesis. Mean sample size was 41.4 (range 10–190), and duration of follow-up was >1 year in 72 % of studies. Overall quality was low (mean 6.2, range 1–12). Pooled wound infection rates were 31.6 % (95 % CI 14.5–48.7) with biologic and 6.4 % (95 % CI 3.4–9.4) with synthetic non-absorbable prosthetics in clean-contaminated cases, with similar hernia rates. In contaminated and/or dirty fields, wound infection rates were similar, but pooled hernia rates were 27.2 % (95 % CI 9.5–44.9) with biologic and 3.2 % (95 % CI 0.0–11.0) with synthetic non-absorbable. Other outcomes were comparable.

Conclusions

The available evidence is limited, but does not support the superiority of biologic over synthetic non-absorbable prosthetics in contaminated fields.