Long-term prognosis for the clicking jaw

Ninety-four patients who complained of clicking of the temporomandibular joint not associated with pain were followed up for varying lengths of time. Analysis of the follow-up indicates that approximately 70% of the patients who have a painless, clicking temporomandibular joint will eventually have pain and that the use of a nonrepositioning occlusal splint does not lessen the likelihood of pain ensuing.     

Pediatric growth patterns in youth‐onset type 2 diabetes mellitus: Implications for physiologically‐based pharmacokinetic models

An accurate understanding of the changes in height and weight of children with age is critical to the development of models predicting drug concentrations in children (i.e., physiologically‐based pharmacokinetic models). However, curves describing the growth of a typical population of children may not accurately characterize growth of children with various conditions, such as obesity. Therefore, to develop height and weight versus age growth curves for youth who were diagnosed with type 2 diabetes, we extracted data from electronic medical records. Robust nonlinear models were parameterized to the equations describing height and weight versus age as defined by the Centers for Disease Control and Prevention (CDC). CDC z‐scores were calculated using an internal program. The growth curves and z‐scores were compared to CDC norms. Youth with type 2 diabetes were increasingly heavier than CDC norms from early childhood. Except for a period around puberty, youth with type 2 diabetes were, on average, shorter than CDC norms, resulting in shorter average adult height. Deviations in growth were apparent in youth who develop type 2 diabetes; such deviations may be expected for other conditions as well, and disease‐specific growth curves should be considered during development of model‐informed drug development for pediatric conditions.

Study Highlights

• WHAT IS THE CURRENT KNOWLEDGE ON THE TOPIC?

The Centers for Disease Control and other agencies have developed growth curves that represent typical children, but they do not extend beyond the 97th percentile. The growth of many children with type 2 diabetes is therefore not represented by these curves.

• WHAT QUESTION DID THIS STUDY ADDRESS?

How does the height and weight of children who are diagnosed with type 2 diabetes change with age relative to a population of typically developing children?

• WHAT DOES THIS STUDY ADD TO OUR KNOWLEDGE?

Children who develop type 2 diabetes have growth patterns that deviate from the norm.

• HOW MIGHT THIS CHANGE CLINICAL PHARMACOLOGY OR TRANSLATIONAL SCIENCE?

Given that physiologically‐based pharmacokinetic scaling factors, such as liver volume, are based on body surface area, which is, itself, derived from height and weight, disease‐specific growth curves should be considered for modeling and simulation of dosing for pediatric drug development and clinical applications.     

Comparative Evaluation of Rapid Isothermal Amplification and Antigen Assays for Screening Testing of SARS-CoV-2

Human transmission of SARS-CoV-2 and emergent variants of concern continue to occur globally, despite mass vaccination campaigns. Public health strategies to reduce virus spread should therefore rely, in part, on frequent screening with rapid, inexpensive, and sensitive tests. We evaluated two digitally integrated rapid tests and assessed their performance using stored nasal swab specimens collected from individuals with or without COVID-19. An isothermal amplification assay combined with a lateral flow test had a limit of detection of 10 RNA copies per reaction, and a positive percent agreement (PPA)/negative percent agreement (NPA) during the asymptomatic and symptomatic phases of 100%/100% and 95.83/100%, respectively. Comparatively, an antigen-based lateral flow test had a limit of detection of 30,000 copies and a PPA/NPA during the asymptomatic and symptomatic phases of 82.86%/98.68% and 91.67/100%, respectively. Both the isothermal amplification and antigen-based lateral flow tests had optimized detection of SARS-CoV-2 during the peak period of transmission; however, the antigen-based test had reduced sensitivity in clinical samples with qPCR Ct values greater than 29.8. Low-cost, high-throughput screening enabled by isothermal amplification or antigen-based techniques have value for outbreak control.     

Auditory deprivation affects processing of motion,but not color

Event-related potentials (ERPs) were recorded in response to color changes of isoluminant, high spatial frequency gratings and to motion of grayscale, low spatial frequency gratings in 11 normally hearing and 11 congenitally deaf adults. The stimuli were designed to activate preferentially the ventral and dorsal streams of visual processing, respectively. Color changes evoked prominent P1 and N1 components in the ERP; motion evoked an early, focal positivity (the P-INZ), a minimal P1, and a prominent N1. Color changes elicited similar ERP components in hearing and deaf participants. In contrast, motion elicited larger amplitude and more anteriorly distributed N1 components in deaf than hearing participants. These results suggest that early auditory deprivation may have more pronounced effects on the functions of the dorsal visual pathway than on functions of the ventral pathway.     

ADHD and cannabis use in young adults examined using fMRI of a Go/NoGo task

Children diagnosed with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for substance abuse. Response inhibition is a hallmark of ADHD, yet the combined effects of ADHD and regular substance use on neural networks associated with response inhibition are unknown. Task-based functional Magnetic Resonance Imaging (fMRI) data from young adults with childhood ADHD with (n?=?25) and without (n?=?25) cannabis use ≥ monthly in the past year were compared with a local normative comparison group (LNCG) with (n?=?11) and without (n?=?12) cannabis use. Go/NoGo behavioral and fMRI data were evaluated for main and interaction effects of ADHD diagnosis and cannabis use. ADHD participants made significantly more commission errors on NoGo trials than controls. ADHD participants also had less frontoparietal and frontostriatal activity, independent of cannabis use. No main effects of cannabis use on response inhibition or functional brain activation were observed. An interaction of ADHD diagnosis and cannabis use was found in the right hippocampus and cerebellar vermis, with increased recruitment of these regions in cannabis-using controls during correct response inhibition. ADHD participants had impaired response inhibition combined with less fronto-parietal/striatal activity, regardless of cannabis use history. Cannabis use did not impact behavioral response inhibition. Cannabis use was associated with hippocampal and cerebellar activation, areas rich in cannabinoid receptors, in LNCG but not ADHD participants. This may reflect recruitment of compensatory circuitry in cannabis using controls but not ADHD participants. Future studies targeting hippocampal and cerebellar-dependent function in these groups may provide further insight into how this circuitry is altered by ADHD and cannabis use.