Maximum voluntary molar bite force in subjects with normal occlusion

The aims of this investigation were to determine whether stabilization of maximum voluntary bite force (MVBF) occurs between 15 and 18 years of age in subjects with a normal occlusion, and to assess the influence of gender, body mass index (BMI), morphological occlusion, and jaw function measured by the number of occlusal contacts, overjet, overbite, maximal mouth opening, mandibular deflection during opening, sagittal slide between the retruded contact position and the intercuspal position, and number of dental restorations. The sample comprised 60 Caucasian subjects aged 15 (15 males and 15 females) and 18 (14 males and 16 females) years with a neutral occlusion, balanced facial profile, and absence of a previous orthodontic history. Bite force measurements were undertaken using a portable occlusal force gauge on both the left and the right sides of the jaw in the first molar region during maximal clenching. Two independent samples t-tests and multiple regression were used for statistical analysis. MVBFs were age and gender related (P<0.05). Males showed a significant increase in bite force between 15 and 18 years of age (P=0.002), but gender differences were significant only in the 18-year-olds (P=0.003). In subjects with a neutral occlusion, MVBF could best be predicted using multiple regression from age and gender. The regression model accounted for 31.3 percent of the variance in MVBF (P=0.031), with gender contributing 17.9 percent and age 7.9 percent. Morphological occlusion, jaw function, and BMI explained the remaining 5.5 percent of variance. While controlling for all other parameters, the independent contribution of gender to the prediction of MVBF was 16.2 percent, age 6 percent, number of occlusal contacts 3.2 percent, and BMI 1.3 percent.     

Neonatal risk mortality scores as predictors for health-related quality of life of infants treated in NICU: a prospective cross-sectional study

Purpose

To determine the relationship of Apgar scores, gestational age and neonatal risk mortality scores to health-related quality of life (HRQoL) for infants at the age of 8 months treated after birth in neonatal intensive care unit (NICU).

Methods

All surviving infants treated in two-third level NICUs in Rijeka, Croatia (from August 2013 to August 2014) were included in this prospective, cross-sectional study. For all neonates, the Score for Neonatal Acute Physiology (SNAP), SNAP with Perinatal Extension (SNAP-PE) and their simplified modifications (SNAP II and SNAP-PE II) were calculated. At the corrected age of 8 months, the Pediatric Quality of Life Questionnaire (PedsQL)—infant scale—was completed by parents of surviving infants. Multiple regression analysis was performed in order to assess the value of neonatal risk mortality scores, Apgar scores and gestational age as possible predictors of HRQoL, measured by questionnaire score.

Results

A strong correlation has been found between SNAP and 5-min Apgar scores to HRQoL. A positive correlation was also found between gestational age and HRQoL.

Conclusion

SNAP and 5-min Apgar scores are important outcome indicators, can aid clinicians’ and parents’ decision making on the benefits and burdens of acute medical interventions and help determine quantities of medical treatment. Educated medical staff, effective and efficient medical treatment and a high quality of care which prevent adverse events in the first minute of life should be a priority in efforts to improve the future quality of life.

     

Preoperative assessment of ovarian tumors by CA 125 measurement and transvaginal color Doppler ultrasound

The accuracy of combined use of serum CA 125 and transvaginal color Doppler for preoperative assessment of ovarian lesions in premenopausal patients was evaluated. Seventy-six ovarian lesions were analyzed the day before surgery using transvaginal color Doppler ultrasound. On the same day, serum CA 125 was measured in each patient. A novel index is proposed for the detection of ovarian malignancy combining resistance index (RI) obtained from newly formed vessels within the ovarian lesion and serum CA 125 level: (RI/CA 125) x 100. Values below the cut-off value of 1.5 were associated with a high risk of ovarian malignancy. Assessment of ovarian lesions by the novel index had a sensitivity and specificity of 94.44% and 100%, while positive and negative predictive values were 100% and 98.31%, respectively. The best prediction of ovarian malignancy was achieved by a combined use of transvaginal color Doppler ultrasound and serum CA 125 in the form of index: (RI/CA 125) x 100.     

Antihypertensive effect of metoprolol in diuretic-treated,mild primary hypertension

Metoprolol tartrate was administered to 41 patients with mild essential hypertension already treated with a diuretic for a period of 2 weeks. In the majority of those patients, other step 2 antihypertensive agents either failed to control high blood pressure or caused adverse reactions. All other antihypertensive agents except diuretics were discontinued during the 2-week wash-out period. Patients with a diastolic blood pressure of 95 to 104 mmHg (inclusive) received oral metoprolol at a dose of 50mg twice daily for 2 weeks. Subsequently, metoprolol titration was individualized on a bi-weekly basis until either the diastolic blood pressure was = 90 mmHg and/or a maximal daily dose of 300mg of metroprolol was reached. The analysis of efficacy and safety was done for a total period of 14 weeks. Diastolic blood pressure and heart rates were significantly reduced (P≤0.05) in all treatment groups. Minor adverse reactions such as mild fatigue in 11 patients, nervousness in 2, and leg cramps in 2 patients were reported. Transient skin rash, dizziness, headache, chest pain, insomnia, and cold extremities were also reported in one patient each. It is concluded from the present study that metropolol (in twice daily dose) in combination with a diuretic is safe, effective, and well tolerated in the treatment of mild hypertension.     

Visceral and cutaneous sensory testing in patients with painful bladder syndrome

AIMS: Our aims were to determine whether subjects with painful bladder syndrome (PBS) demonstrate characteristics of visceral pain syndromes: visceral hyperalgesia, expanded loci of referral of bladder sensation, increased bladder pain with repetitive filling, lower thresholds to cutaneous stimulation in relevant dermatomes, abnormal response to repetitive cutaneous stimulation in relevant dermatomes, and also to develop easily applied measures for PBS pain evaluation and management. METHODS: We recruited PBS subjects and control subjects with no bladder pain and with either stress urinary incontinence (SUI) or no incontinence. Subjects underwent three bladder fills up to maximum 300 ml and mapped bladder fullness/discomfort, rating any pain present. Cutaneous current perception thresholds (CPTs) were tested at 2000 Hz, 250 Hz, 5 Hz at C5, T6, T10, T12, S3 dermatomes. Repetitive supra-threshold stimulation in trains of 15 stimuli 2 sec apart were then administered to T12, S3 dermatomes. RESULTS: PBS subjects demonstrated hyperalgesia to bladder filling and tended to sense bladder discomfort at both suprapubic and vulvar/urethral sites. There was no difference in CPTs at any dermatome at any stimulating frequency. PBS and SI subjects tended not to habituate to repetitive stimuli, while asymptomatic controls tended to habituate to repetitive stimulation. CONCLUSIONS: PBS subjects demonstrate bladder hyperalgesia and may sense bladder discomfort at sites other than suprapubic. Rating of bladder discomfort and sensory mapping during cystometry usefully distinguishes between PBS subjects and controls.     

Modulation of neutrophil and inflammation markers in chronic obstructive pulmonary disease by short-term azithromycin treatment

The anti-inflammatory potential of azithromycin in chronic obstructive pulmonary disease (COPD) patients was explored following a standard oral dosing regimen. Patients with moderate and severe COPD were treated with azithromycin (500 mg, n=16) or placebo (n=8) once daily for 3 days in a randomized, double blind design, to compare effects on inflammation markers with those seen in a previous study in healthy volunteers. A battery of tests was made on serum, blood neutrophils and sputum on days 1 (baseline), 3, 4, 11, 18 and 32. In comparison to placebo, azithromycin resulted in an early transient increase in serum nitrites plus nitrates (day 3), associated with a tendency towards an increase in the blood neutrophil oxidative burst to phorbol myristic acetate. Subsequently, prolonged decreases in blood leukocyte and platelet counts, serum acute phase protein (including C reactive protein) and soluble E-selectin and blood neutrophil lactoferrin concentrations and a transient decrease in serum interleukin-8 were observed. Blood neutrophil glutathione peroxidase activity showed a prolonged increase after azithromycin treatment. The biphasic facilitatory-then-inhibitory response to azithromycin seen in healthy volunteers is not so clearly detectable in COPD patients, only potential anti-inflammatory effects. Treatment for longer periods may give therapeutic anti-inflammatory benefit in these patients.     

232. Das traumatologische Labor der Chirurgischen Universitätsklinik Köln-Lindenthal

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