Quality of life in children with sleep-disordered breathing

Children may present sleep-disordered breathing (SDB) and suffer with adverse effects upon their quality of life.ObjectiveThis study assessed the quality of life of children with SDB, compared subjects with obstructive sleep apnea syndrome (OSAS) and primary snoring (PS), and identified which areas in the OSA-18 questionnaire are more affected.MethodsThis is a historical cohort cross-sectional study carried out on a consecutive sample of children with history of snoring and adenotonsillar hyperplasia. The subject's quality of life was assessed based on the answers their caregivers gave in the OSA-18 questionnaire and on diagnostic polysomnography tests.ResultsA number of 59 children participated in this study with mean age of 6.7 ± 2.26 years. The mean score of the OSA-18 was 77.9 ± 13.22 and the area most affected were “caregiver concerns” (21.8 ± 4.25), “sleep disturbance” (18.8 ± 5.19), “physical suffering” (17.3 ± 5.0). The impact was low in 6 children (10.2%), moderate in 33 (55.9%) and high in 20 (33.9%). PS was found in 44 children (74.6%), OSAS in 15 (25.6%). OSAS had higher score on “physical suffering” area than PS (p = 0.04). The AI (r = 0.22; p = 0.08) and AHI (r = 0.14; p = 0.26) were not correlated with OSA-18.ConclusionSleep disordered breathing in childhood cause impairment in quality of life and areas most affected the OSA-18 were: “caregiver concerns”, “sleep disturbance” and “physical suffering”. OSAS has the domain “physical suffering” more affected than primary snorers.     

Biofilm formation by oral clinical isolates of Candida species

We have conducted a longitudinal study to quantify biofilms in oral clinical isolates of Candida species (spp.) from adults with local and systemic predisposing factors for candidiasis. A total of 69 yeast isolates from 63 Mexican patients were evaluated. These isolates (39 C. albicans, 15 C. tropicalis, 7 C. glabrata, 4 C. krusei, 1 C. lusitaniae, 1 C. kefyr, 1 C. guilliermondii and 1 C. pulcherrima) were obtained from two clinical sites: 62.3% (n = 43) from the oral mucosa of totally and partially edentulous patients, and 37.7% (n = 26) from the oral mucosa of diabetics. In addition, Candida ATCC strains were used as controls for each experiment. The kinetics of biofilm formation were measured by 2,3-bis(2-methoxy-4-nitro-5-sulfophenyl)-5-[(phenylamino)carbonyl]-2H-tetrazolium hydroxide [XTT] reduction; each isolate was tested at 6, 12 and 24 h. Biofilm formation is dependent on the Candida spp. and its clinical origin. On average, the oral isolates of C. glabrata are strong biofilm producers, whereas C. albicans and C. tropicalis are moderate producers. The most common species in our population was C. albicans. While the kinetics of C. albicans biofilm formation varies between oral isolates, it generally maintains steady growth from 2 to 48 h, when it reaches its maximum growth.     

National down syndrome patient database: Insights from the development of a multi‐center registry study

The Down Syndrome Study Group (DSSG) was founded in 2012 as a voluntary, collaborative effort with the goal of supporting evidenced‐based health care guidelines for individuals with Down syndrome (DS). Since then, 5 DS specialty clinics have collected prospective, longitudinal data on medical conditions that co‐occur with DS. Data were entered by clinical staff or trained designees into the National Down Syndrome Patient Database, which we created using REDCap software. In our pilot year, we enrolled 663 participants across the U.S., ages 36 days to 70 years, from multiple racial and ethnic backgrounds. Here we report: (i) the demographic distribution of participants enrolled, (ii) a detailed account of our database infrastructure, and (iii) lessons learned during our pilot year to assist future researchers with similar goals for other patient populations. © 2015 Wiley Periodicals, Inc.     

Pure transumbilical SILS gastric bypass with mechanical circular gastrojejunal anastomosis feasibility

Background

Since Wittgrove introduced the laparoscopic version of the gastric bypass in 1994, the interest still remains in the decrease of the abdominal wall trauma in order to optimize the benefits of laparoscopy on postoperative pain, cosmesis, hospital stay, and convalescence in bariatric patients. This work is to report the feasibility of gastric bypass surgery by a pure transumbilical single-incision laparoscopic surgery (SILS) with a mechanical circular gastrojejunal anastomosis.

Methods

Thirty-four patients (10 males and 24 females) were offered to receive gastric bypass with circular mechanical gastrojejunal anastomosis by Single Incision Laparoscopic Surgery (SILS) using pure transumbilical access. Anastomotic leak occurrence was the primary end-point. Patients demographics, operative time, additional trocarts, hemorrhage, intra abdominal abscess, length of post-operative stay, readmission, 30 days death, gastrojejunal anastomosis stricture, marginal ulcers, reflux complains, seromas, incisional hernias, and % excess BMI loss were also recorded in a prospective database.

Results

Primary end-point showed no anastomotic leak occurrence during the hospital stay or during the first 30 post-operative days. SILS gastric bypass with a circular mechanical gastrojejunal anastomosis is feasible and seems to be safe.     

The effects of tramadol added to articaine on anesthesia duration.

OBJECTIVE: In this study the effect of tramadol added to articaine on the duration of anesthetic effect in a mandibular blockade was evaluated. STUDY DESIGN: A double-blind, randomized, placebo-controlled clinical trial with patients experiencing pain after removal of an impacted mandibular third molar was conducted. Patients were randomly allocated into 2 groups: group C (n = 24), control (C), articaine 4%, 1:100:000 epinephrine, 1.5 cartridges (2.7 mL) and saline (1 mL) into surgical site; group T, articaine 4%, 1:100:000 epinephrine, 1.5 cartridges (2.7 mL) and tramadol (T) 50 mg (1 mL) into the surgical site. The difficulty of the removal procedure, duration of the operation, and sensory blockade were also evaluated. RESULTS: The duration of the anesthetic effect elicited by articaine in group T (246.0; 140-287) was significantly longer than that in group C (124.5; 79-154 min). CONCLUSION: Tramadol can be used as an adjunctive drug in the management of pain since it improves the quality of transoperative anesthesia.     

Climate and Leishmaniasis in French Guiana

To study the link between climatic variables and the incidence of leishmaniasis a study was conducted in Cayenne, French Guiana. Patients infected between January 1994 and December 2010. Meteorological data were studied in relation to the incidence of leishmaniasis using an ARIMA model. In the final model, the infections were negatively correlated with rainfall (with a 2-month lag) and with the number of days with rainfall > 50 mm (lags of 4 and 7 months). The variables that were positively correlated were temperature and the Multivariate El Niño Southern Oscillation Index with lags of 8 and 4 months, respectively. Significantly greater correlations were observed in March for rainfall and in November for the Multivariate El Niño/Southern Oscillation Index. Climate thus seems to be a non-negligible explanatory variable for the fluctuations of leishmaniasis. A decrease in rainfall is linked to increased cases 2 months later. This easily perceptible point could lead to an interesting prevention message.     

A small-molecule Psora-4 acts as a caloric restriction mimetic to promote longevity in C. elegans

GeroScience - In populations around the world, the fraction of humans aged 65 and above is increasing at an unprecedented rate. Aging is the main risk factor for the most important degenerative...