Accuracy of Plusoptix S04 in children and teens

Objective: To compare refraction measurements of young patients obtained using Plusoptix S04 with those obtained using cycloplegic retinoscopy.Design: Cohort study.Participants: Data were collected from 64 patients (128 eyes), aged 2–19 years.Methods: All eyes underwent photorefraction using Plusoptix S04 with or without cycloplegia and cycloplegic retinoscopy. Eyes with a maximum spherical and cylinder range of −7.00 to +5.00 were excluded from the study.Results: The difference in spherical equivalents between Plusoptix S04 without cycloplegia and cycloplegic retinoscopy was more than ± 0.50 D in 70.2% of the eyes. In 100 eyes (78.1%), photorefraction underestimated the hyperopic refractive error. The cylinder powers determined by Plusoptix S04 and cycloplegic retinoscopy were similar. The difference in the spherical equivalents between Plusoptix S04 with cycloplegia and cycloplegic retinoscopy was + 0.50 D in 89.8% of the eyes. In 96 eyes (75%), photorefraction with cycloplegia overestimated the hyperopic refractive error. The difference in cylindrical power determined using Plusoptix S04 with cycloplegia and cycloplegic retinoscopy was statistically significant (paired ttest, p = 0.009).Conclusions: The statistically significant difference in spherical equivalent values obtained using Plusoptix S04 with or without cycloplegia and cycloplegic retinoscopy suggests that Plusoptix S04 is more in evaluating the cylinder power and axis in young patients. Our results also suggest that Plusoptix S04 is not an accurate tool to estimate the refraction in children.     

The Prevalence of Cryptosporidium spp. in Children,Taiz District,Yemen

Background

This is the first work done on cryptosporidiosis among the children in Taiz, Yemen.

Methods

A number of 712 samples were collected from children of different ages (ranging from 1 month to 12 years) from Dec 2006 to Aug 2007. The collected samples were examined by Sheather''s sugar floatation and Modified Ziehl- Neelsen stain as well as ELISA methods. The test results were statistically analyzed by SPSS software.

Results

The overall positive percentage was 43.7%. The higher incidence (36.2%) was occurred in males while the lowest incidence (32.7%) was observed in females (r=0.876; P=0.001). The correlation between infected cases and the type of drinking water was r =0.121. Among the cases examined by ELISA (92 cases), 26.1% were infected. The correlation between seropositivity and gender was r=0.652 (P=0.031).

Conclusion

Cryptosporidium spp. is a significant pathogen among children at Taiz. Fresh water supplies, education, eating habits and domestic animals are considered the main sources for transmission of cryptosporidiosis.     

The emotional impact of orthognathic surgery and conventional orthodontics

Previous research by the authors has pointed to depressive reactions among orthognathic surgery patients during the fixation-removal stage and up to 9 months later. However, less is known about emotional shifts among persons who choose to undergo conventional orthodontic treatment after considering surgical orthodontics. In the current study, a standard measure of mood states was applied to 90 surgical patients and 66 who had considered surgery but decided against it. Of these, 33 were undergoing orthodontic treatment and 33 were having no treatment. The mood scale and measures of personality were first applied before surgery and then during orthodontic treatment, just after surgery, at fixation removal, and 6 months after surgery. Nonsurgical respondents completed questionnaires at the same time as their matched surgical respondents. Scores on tension and fatigue increased significantly among surgical patients from before surgery to immediately after surgery and dropped to presurgical levels when fixation was removed. Anger-hostility increased at fixation removal but declined within 5 months. Postsurgical discomfort, pain, and paresthesia, and interpersonal and oral function problems were correlated with postsurgery emotional state. On the later questionnaires, which corresponded to the later periods of orthodontic treatment, patients who had opted for conventional orthodontic treatment reported that they experienced greater depression, anger, and tension. These patients may be particularly vulnerable to emotional problems because their orthodontic treatment may be more complex and of longer duration than that of the typical orthodontic patient. These results point to the importance of continued psychological support for both orthodontic and surgical patients throughout their course of treatment.     

Smoking, a weak predictor of periodontitis in older adults

BACKGROUND: The impact of smoking habits on periodontal conditions in older subjects is poorly studied. AIMS: To assess if a history of smoking is associated with chronic periodontitis and medical history in older subjects. MATERIAL AND METHODS: The medical and dental history was collected from 1084 subjects 60-75 years of age. Smoking history information was obtained from self-reports. Periodontal variables [clinical probing depth (PD)>/=5.0 mm, clinical attachment levels (CALs) >/=4.0 mm], and radiographic evidence of alveolar bone loss were assessed. RESULTS: 60.5% had never smoked (NS), 32.0% were former smokers (FS) (mean smoke years: 26.1 years, SD+/-13.1), and 7.5% were current smokers (CS) (mean smoke years 38.0 years, (SD+/-12.1). The proportional distribution of CAL >/=4.0 mm differed significantly by smoking status (NS and CS groups) (mean difference: 12.1%, 95% confidence interval (CI): 1.5-22.6, p<0.02). The Mantel-Haenszel common odds ratio between smoking status (CS+FS) and periodontitis (>20% bone loss) was 1.3 (p<0.09, 95% CI: 0.9-2.0) and changed to 1.8 (p<0.02, 95% CI: 1.3-2.7) with 30 years of smoking as cutoff. A weak correlation between number of years of smoking and CAL>/=4.0 mm was demonstrated (r(2) values 0.05 and 0.07) for FS and CS, respectively. Binary logistic forward (Wald) regression analysis demonstrated that the evidence of carotid calcification, current smoking status, gender (male), and the number of remaining teeth were explanatory to alveolar bone loss. CONCLUSIONS: A clinically significant impact on periodontal conditions may require 30 years of smoking or more. Tooth loss, radiographic evidence of carotid calcification, current smoking status, and male gender can predictably be associated with alveolar bone loss in older subjects.     

Long-term assessment of psychologic outcomes of orthognathic surgery.

PURPOSE: This long-term study of post-orthognathic surgery patients aimed at assessing perceptions of problems with physical and psychologic functioning, self-concept, body image, and satisfaction with the surgical outcome based on subjective evaluations. In addition, the patient's perception of self-concept, body image, and function was compared with the perception of pretreatment patients and controls with no treatment need. Patients and Methods: One hundred seventeen patients who underwent orthognathic surgery 10 to 14 years earlier and participated in a psychologic study 10 years earlier received questionnaires that were composed of 4 instruments designed to assess these factors. A sample of 92 persons representing a population without treatment need and 39 patients requesting treatment for a malocclusion served as control groups. RESULTS: The findings of this study support the hypothesis that improvement in appearance brought about by orthognathic surgery is associated with improvement in psychosocial adjustment. Orthognathic surgery resulted in subjective estimation of function, appearance, health, and interpersonal relationships that was higher than that among pretreatment and no-treatment control groups. The level of body image and self-esteem approximated but did not reach that of a nonpatient population. CONCLUSIONS: In view of the current psychologic and social environment, patients should be offered the appropriate treatment to correct a disfigurement if it is subjectively perceived by them as a handicap, in part to improve the psychologic outcome.     

Oral Disease Beliefs, Behaviors, and Health Status of Korean-Americans

Previous research with other ethnic minorities has shown that culture and age cohort, as well as language and economic limitations, act as barriers to obtaining dental care and maintaining good oral health. This study compared self-reported oral health attitudes, self-efficacy, and dental practices of 20 younger and 23 elderly Korean-Americans. Oral assessments were also conducted to determine plaque and gingival status, and root and coronal caries. Significant differences emerged in health self-efficacy (P less than .01) and preventive health orientation (P less than .002). Elderly had fewer teeth (P less than .0001), more decayed and filled root surfaces (P less than .05 and P less than .004, respectively), and more decayed and filled coronal surfaces (P less than .001 and P less than .03). Both groups showed higher levels of distal and mesial plaque than occlusal and cervical plaque; however, the elderly had higher rates of both (P less than .0001). Gingival status was also worse for the elderly, on distal and mesial (P less than .01), facial (P less than .01), and lingual (P less than .01) surfaces. These differences are striking, since the elderly reported visiting the dentist more recently (P less than .0001); but most of these visits were for prosthodontic and emergency care. Better preventive dental care and education are necessary for elderly immigrants who have not been exposed to preventive dentistry in their home countries.     

Naevus comedonicus of the scalp

We report the case of a 3-year-old boy with naevus comedonicus, characterized by confluent clusters of dilated follicular orifices plugged with keratinous material that resemble open comedones, located on the scalp.     

The Impact of Trans-thoracic Ultrasound on Cardiac Injuries

Objective:

To determine the impact of trans-thoracic ultrasound (TTUS) in patients with chest trauma and potential cardiac injuries and to determine the outcome of patients with cardiac injury detected on TTUS.

Method:

Data were obtained from the Trauma Registry for all patients presenting alive to the University Hospital of the West Indies during the 10-year period commencing January 1, 2001 and who were subjected to a TTUS or emergency thoracotomy for cardiac injuries, or had cardiac injuries at postmortem. In addition to demographics, variables analysed included mechanism and site of injury and outcome.

Results:

Of 405 patients being subjected to a TTUS during the period, 12 (3%) had cardiac injuries. During the same period, 63 patients in the Trauma Registry had proven cardiac injuries. Transthoracic ultrasound was thus conducted on 19% of all patients with cardiac injuries. Three patients had positive TTUS but no cardiac injuries. Of the patients with injuries, the mean age was 30.4 years, 92.1% were male and 65% were as a result of stab wounds, while 22% were as a result of gunshot wounds. The right ventricle was the most common site of injury, accounting for 41% of cases, while the left ventricle, both ventricles and other sites accounted for 27%, 17% and 14%, respectively. Ninety per cent of the group was subjected to emergency thoracotomy; mortality of the entire group was 48%, including one patient who had TTUS.

Conclusions:

This review demonstrates that cardiac injuries remain lethal, diagnosis is largely clinical and TTUS may be over-utilized, having little impact on clinical outcome of patients presenting with this injury.