Salivary cortisol levels and dental anxiety in children with attention deficit hyperactivity disorder

Attention deficit hyperactivity disorder (ADHD) is a common developmental disorder. The present study tested the hypotheses that children with ADHD, particularly those exhibiting severe hyperactivity and impulsivity, have a different stress reaction (measured by salivary cortisol) during a dental recall visit and are more dentally anxious than children in a control group. Eighteen children with ADHD and a control group of 71 children, all 13 yr of age, underwent a clinical dental examination and completed the Corah Dental Anxiety Scale (CDAS). Four saliva samples were gathered for analysis of cortisol: one prior to dental examination, one after, and two the following morning. The subgroup ADHD with hyperactivity/impulsivity had statistically significantly lower cortisol levels than the control group 30 min after awakening. When cortisol values were plotted on a timeline, this subgroup always had lower cortisol concentrations than children in the control group. There was a significant correlation between CDAS scores and cortisol concentrations prior to the dental examination in both the ADHD and the control group. Behavioral expressions of anxiety in children with ADHD may be different from those in other children, not only due to the characteristics of their disorder, but also because of lower stress reactivity.     

Anterior disc displacement with reduction and symptomatic hypermobility in the human temporomandibular joint: prevalence rates and risk factors in children and teenagers

AIMS: To assess the prevalence rates and risk factors of anterior disc displacement with reduction (ADDR) and symptomatic hypermobility in a large sample of children and teenagers. Prevalence rates were also established in samples of young adults and adults. METHODS: Children from 7 Dutch primary and secondary schools (n = 1,833) aged 4 to 18 years (mean age +/- SD 10.8 +/- 3.9 years), 220 dental students aged 19 to 30 years (mean age +/- SD 21.9 +/- 3.6 years), and 100 dental school employees more than 30 years old (mean age +/- SD 43.5 +/- 9.8 years) were examined. The presence of ADDR or symptomatic hypermobility was scored using well-defined clinical criteria. For the children only, an additional standardized oral history and clinical examination were performed to assess possible risk factors. Odds ratios (ORs) were calculated with the use of logistic multivariate regression analysis. RESULTS: The prevalence rate of ADDR in at least 1 of the 2 joints increased during childhood and adolescence and stabilized into adulthood at about 26.6%. In children and teenagers, besides age (OR = 1.06 for boys, OR = 1.23 for girls), risk factors for ADDR were a history of orthodontics (OR = 1.57), an increasing overbite (OR = 1.15), and protrusion (OR = 1.12). In children and teenagers, the prevalence rate of symptomatic hypermobility was higher for girls (13.8%) than for boys (8.2%). Besides gender (OR = 2.07), risk factors for symptomatic hypermobility were race (OR = 2.61 for non-Caucasians), masticatory muscle pain (OR = 1.95), and increasing maximum mouth opening (OR = 1.08). CONCLUSION: In children and teenagers, ADDR and symptomatic hypermobility have different prevalence rates and risk factors.     

Which competencies are necessary for clinical perfusion in Germany? Interviews with perfusionists

BACKGROUND: The professional education of cardiovascular perfusionists in Germany and the expertise required for successful practice have not often been studied. Here, the necessary skills for clinical cardiovascular perfusion-ists are described. METHOD: The prerequisites for the practice of the profession, expected future developments and the question of the positioning of a future professional perfusionist training within the educational system were discussed with ten experienced perfusionists. These individuals were interviewed in a semi-standardized fashion following an interview manual and the interviews were evaluated using qualitative research methods. RESULTS: The professional skills currently required of per-fusionists correspond to the list of activities published by the German Society of Cardiovascular Enginering. New areas are knowledge of management and, increasingly, social competence and self-management skills. Future tasks for perfusionists will be more diversified than at present. CONCLUSION: Training for perfusionists should be made broader than it is today. The current restructuring taking place in the profession makes interdisciplinary orientation and increased emphasis on practical training necessary. Academic level education is both feasible and desirable.     

Epilepsy and other comorbidities in Down syndrome

Zeitschrift für Epileptologie - Down syndrome (DS) is the most common cause of intellectual disability. Due to many genetic and biochemical aberrations, people with DS suffer from several...     

Epilepsie und geistige Behinderung,Update 2022

Zeitschrift für Epileptologie -     

Spezifika der Lehre in der Gefäßchirurgie im interdisziplinär-chirurgischen Setting

Die Chirurgie - Es sollen die komplexen Veränderungen in der gefäßchirurgischen Lehre, Gemeinsamkeiten/Unterschiede zur Allgemeinchirurgie, Spezifika der Lehre/Lehrinhalte sowie...