Enhancing parental knowledge of childhood and adolescence safety: An interventional educational campaign

Background:Safeguarding children and adolescents from unintentional injuries is a significant concern for parents and caregivers. With them staying more at home during the coronavirus disease 2019 pandemic, more educational tools and valid educational programs are warranted to improve parental knowledge and awareness about childhood and adolescences’ safety. This study aims to explore the effectiveness of childhood and adolescence safety campaigns on parents’ knowledge and attitude toward preventable injuries.Methods:This was a pre–post experimental study, in which the predesigned assessments were used as an evaluation tool before and after attending a childhood and adolescence safety campaign. The pre–post assessment question included questions to evaluate the socio-demographic status, followed by knowledge questions in line with the current childhood and adolescence safety campaign. The outcomes of interest were assessed before and after attending the campaign''s stations.Results:Three hundred eight parents volunteered to participate in this study. Their knowledge score improved from 36.2 [standard deviation (SD) 17.7] to 79.3 (SD 15.6) after attending the Campaign (t value = 34.6, P < .001). Both, perceptions on the preventability of accidents and the parents’ perceived usefulness of educational campaigns showed improvements, with (t value = 6.3, P < .001) and (t value = 3.097, P < .001), respectively.Conclusion:The educational childhood and adolescence safety campaign for caregivers in Saudi Arabia resulted in a significant increase in the overall knowledge and attitudes toward childhood and adolescence''s safety. As children and adolescents are currently staying at home more, additional educational tools and programs are warranted to promote safe practices among parents and caregivers.     

Effect of bariatric surgery on pregnancy outcome

Objective

To compare the perinatal outcomes of women who delivered before with women who delivered after bariatric surgery.

Methods

A retrospective study was undertaken to compare perinatal outcomes of women who delivered before with women who delivered after bariatric surgery in a tertiary medical center between 1988 and 2006. A multivariate logistic regression model was constructed to control for confounders.

Results

During the study period, 301 deliveries preceded bariatric surgery and 507 followed surgery. A significant reduction in rates of diabetes mellitus (17.3% vs 11.0; P = 0.009), hypertensive disorders (23.6% vs 11.2%; P < 0.001), and fetal macrosomia (7.6% vs 3.2%; P = 0.004) were noted after bariatric surgery. Bariatric surgery was found to be independently associated with a reduction in diabetes mellitus (OR 0.42, 95% CI 0.26-0.67; P < 0.001), hypertensive disorders (OR 0.38, 95% CI 0.25-0.59; P < 0.001), and fetal macrosomia (OR 0.45, 95% CI 0.21-0.94; P = 0.033).

Conclusion

A decrease in maternal complications, such as diabetes mellitus and hypertensive disorders, as well as a decrease in the rate of fetal macrosomia is achieved following bariatric surgery.     

The effect of oral contraceptive pill for cycle scheduling prior to GnRH-antagonist protocol on IVF cycle parameters and pregnancy outcome

Objective To evaluate the effect of oral contraceptive pills (OCP) pretreatment on IVF cycle outcome in GnRH-antagonist protocol. Design Retrospective cohort study. Setting Major tertiary university-affiliated center. Patients All patients treated with GnRH antagonist in our IVF unit during the last 3 years were included in the study. Overall 1,799 IVF cycles were performed. Of these, in 604 cycles OCP pretreatment was used prior to GnRH-antagonist for cycle scheduling. Patients were divided into two age groups—young group aged ≤35 years and older group aged ≥36 years. Interventions The young group underwent 927 cycles, 281 cycles with OCP pretreatment and 646 cycles without. The older group underwent 872 cycles, 323 cycles with OCP pretreatment and 549 cycles without. Data was analyzed within each age group. Main outcome measures Treatment duration and total dose of FSH IU used for stimulation, number of oocytes retrieved, implantation and pregnancy rates. Results All OCP-pretreated cycles required significantly longer stimulation than non-pretreated cycles (young: 10.76 vs. 9.21 days; older: 10.48 vs. 8.73 days, respectively) and higher total dose of FSH IU (young: 3,210 IU vs. 2,565 IU; older: 4,973 IU vs. 3,983 IU, respectively). There were no other differences in cycle characteristics between groups. Implantation and pregnancy rates were not affected by OCP pretreatment. Conclusions OCP pretreatment can be offered as a mode for cycle scheduling prior to GnRH-antagonist protocol, though it may be associated with longer stimulation and higher gonadotropin consumption. Capsule OCP prior to GnRH-antagonist protocol enables cycle scheduling without compromising cycle outcome and patient’s age is not a limitation in decision making for the use of this approach.     

A mixability theory for the role of sex in evolution

The question of what role sex plays in evolution is still open despite decades of research. It has often been assumed that sex should facilitate the increase in fitness. Hence, the fact that it may break down highly favorable genetic combinations has been seen as a problem. Here, we consider an alternative approach. We define a measure that represents the ability of alleles to perform well across different combinations and, using numerical iterations within a classical population-genetic framework, show that selection in the presence of sex favors this ability in a highly robust manner. We also show that the mechanism responsible for this effect has been out of the purview of previous theory, because it operates during the evolutionary transient, and that the breaking down of favorable genetic combinations is an integral part of it. Implications of these results and more to evolutionary theory are discussed.     

Treatment of deep sternal wound infections post-open heart surgery by application of activated macrophage suspension

Postoperative sternal wound infection remains a significant complication and generally causes considerable morbidity and mortality. Macrophages play a major role in the process of wound healing. In order to evaluate the efficacy of local injection of activated macrophage suspensions into open infected sternal wound space, a retrospective case-control study was conducted. Sixty-six patients with deep sternal wound infection treated by activated macrophages (group 1) and 64 patients with deep sternal wound infection treated by sternal reconstruction surgery with various regional flaps (group 2), were matched for gender, age, and risk index. In up to 54 months of follow-up of group 1, 60 patients (91%) achieved complete wound closure. Two (3%) late deaths occurred unrelated to the procedure. Mortality rate in group 2 was 29.7% (19/64). Duration of hospitalization was 22.6 days in group 1 vs. 56.2 days in group 2. Patients with deep sternal wound infection following open heart surgery that were treated by activated macrophages had significantly less mortality as well as significant reduction of hospitalization in comparison to the surgically treated group. These results illustrate the advantages of using a biologically based activated macrophage treatment.     

Two cases of a penetrating keratoplasty with tissue from a donor who had undergone LASIK surgery.

PURPOSE: To report two cases of penetrating keratoplasty using tissue from a donor who had undergone laser-assisted in situ keratomileusis (LASIK) surgery before its transplantation. PARTICIPANTS: Two patients who had penetrating keratoplasties and received donor corneas from eyes that had previous LASIK. INTERVENTION: The two patients underwent corneal transplantation by two different surgeons who were unaware that the donor eyes had previous LASIK treatment. RESULTS: Penetrating keratoplasty was completed without complication in both cases, although a separation of the corneal lamellae was noted during surgery in one of the cases. The two patients are doing well at 5.5 months postsurgery. CONCLUSION: With the increasing popularity of laser refractive surgery, eye banks should increase their awareness and refine screening techniques to rule out refractive surgery in the donor corneas. The long-term follow-up of those patients will reveal if surgical success was compromised by prior refractive surgery.     

Is the G2019S LRRK2 mutation common in all southern European populations?

Mutations in the leucine-rich repeat kinase 2 (LRRK2) gene, especially the G2019S mutation, have been identified as a common cause of Parkinson's disease in southern European and other Mediterranean populations (Iberians, Ashkenazi Jews and North African Arabs). Owing to the geographic and historic vicinity of Greece with areas of high prevalence of LRRK2 mutations we studied the frequency of the G2019S mutation in a well characterized cohort of familial and sporadic Parkinson's disease patients of Greek origin from mainland Greece. The prevalence of the LRRK2 R1441C mutation and the G2385R Asian polymorphism was also determined. We identified no patients with any of the studied mutations/polymorphisms. Very low prevalence of the LRRK2 G2019S mutation has been reported in other southern European populations. LRRK2 mutations appear to be limited in certain populations and differing ancestry and founder effects may explain the reported variability. Accurate estimations of the frequency and penetrance of different LRRK2 mutations are essential for correct and cost-efficient use of genetic testing and proper genetic counseling of patients with Parkinson's disease.     

Estimating implant size in chin augmentation: A simplified approach

A receding chin, colloquially known as a weak chin, is a significant aesthetic impediment to a pleasing face. Multiple techniques exist to evaluate the poorly projecting chin, but most are imprecise when it comes to choosing the proper implant size. This choice is further complicated by the impracticality of commercially available chin implants. Most implant manufacturers offer only three to four categories of implants (small, medium, large, etc) that differ in size from one company to another, making the choice of the proper implant size a real challenge.The present paper discusses a new approach to precise sizing of the chin implant, based primarily on the degree of chin convexity (curvature of the chin pad) in the profile view. Examples of mentoplasties performed using the chin convexity principle are presented.     

High yields of K-ras mutations in intraductal papillary mucinous tumors and invasive adenocarcinomas induced by N-nitroso(2-hydroxypropyl)(2-oxopropyl)amine in the pancreas of female Syrian hamsters

Ductal adenocarcinoma, the most common form of pancreatic cancerin humans, is associated with activation of the K-ras oncogenein