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Class II Division 1 Adolescent Treatment with Twin Block and Fixed Orthodontic Appliances: 3-Dimensional Changes of the Temporomandibular Joint
No full textIntroduction: Skeletal Class II division 1 malocclusions with a retrognathic mandible can be treated with Twin Block and fixed orthodontic appliances in growing adolescent patients. Objective: The aim of this case report was to show successful treatment results following step-by-step procedures determined by visualizing the changes of the temporomandibular joint (TMJ) area using cone-beam computed tomography (CBCT) images.Case report: A 10-year, 8-month-old female adolescent with skeletal Class II division 1 (ANB, 6.2°), severe overjet (8.4 mm), and overbite (7.8 mm) was treated with Twin Block and fixed orthodontic appliances. After wearing an active plate for 4 months, a Twin Block appliance for 9 months, a retainer with an inclined plane for 13 months, and fixed orthodontic treatment for 17 months, her skeletal Class II was corrected. After 39 months of posttreatment retention, good treatment results were maintained with favorable occlusion and facial balance. Acceptable 3-dimensional changes of the TMJ area were identified using cone-beam computed tomography images.Conclusion: A female adolescent patient with skeletal Class II division 1 malocclusion, severe overjet and overbite, and mandibular retrusion was treated using Twin Block and fixed orthodontic appliances. Acceptable 3-dimensional changes in the TMJ area and 2-dimensional growth of the mandible were identified using CBCT and cephalometric images
Examining the interrelationships between mindfulness-based interventions, depression, inflammation, and cancer survival
No full textAbstract
Depression is highly prevalent in those diagnosed with cancer and is also associated with poorer prognostic outcomes. Mindfulness-based interventions are effective in reducing depressive symptoms and improving quality of life in patients with cancer. The objective of this review was to investigate whether mindfulness practices can improve survival and, if so, what mechanisms of action may contribute to these outcomes. Although no long-term studies have investigated this hypothesis, the current literature supports an inflammatory basis for depression, implicating proinflammatory cytokines and hypothalamic-pituitary-adrenal axis dysfunction as contributing factors. Markers of inflammation, such as interleukin-6, tumor necrosis factor-α, and cortisol, are all found at elevated concentrations in many depressed individuals. These exact mechanisms are associated with higher mortality in patients with cancer. Mindfulness has been studied for its effects on cytokine and cortisol levels, and there are promising data to support that the intervention can measurably decrease inflammation. Therefore, it is conceivable that mindfulness programs can affect survival in this population. There are limited data on the long-term effects of mindfulness on depression and inflammatory markers in patients with cancer, and there are potential barriers to the implementation of mindfulness-based interventions as part of a comprehensive treatment plan. Therefore, it is necessary to further explore these questions through longitudinal studies to establish a survival correlation
Ability360 Program Evaluation and Modification
Get PDFHealth care in the United States has shifted over the past several decades, from an emphasis on addressing morbidity and mortality to health promotion and overall quality of life (Centers for Disease Control and Prevention [CDC], 2018a). As a result, clinicians in various fields have begun to incorporate considerations for wellness initiatives in addition to preventive strategies. The phrase health-related quality of life (HRQOL) refers to “an individual’s or group\u27s perceived physical and mental health over time” (CDC, 2018a, p. 7). As specified in that definition, HRQOL can be viewed at an individual or community level. For individuals, this includes the physical and mental health perceptions, such as those about energy level or mood, and related factors including health risks, conditions, functional status, social support, and socioeconomic status (CDC, 2018a). For communities, this may include community-wide resources, environmental conditions, policies, and other practices that may influence a larger population’s perceptions of health and functional status (CDC, 2018a).
The World Health Organization (WHO) defines the quality of life (QOL) as “an individual’s perceptions of their position in life in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards, and concerns” (WHO, 2012, p. 11). What is common between these definitions is a person-specific and context-based perception of health. It is important then to consider how QOL is experienced by different people or groups, and what factors support or hinder a person’s pursuit of their desired QOL
The Clinical Practice Characteristics, Self-Confidence, and Barriers Related to Treatment Following Concussion Among Athletic Trainers
No full textThere is limited information about the use and perceptions of interventions postconcussion. The purpose of this study was to examine the treatment characteristics, self-reported confidence and perceptions of treatment, and barriers to treatment implementation. More than 50% of respondents utilized interventions for cervicogenic (55.5%, n = 85/153) and migraine symptoms (82.4%, n = 126/153). While respondents utilized and believed they should implement treatments, more than half referred to another healthcare professional (e.g., physical therapy, physician, psychologist) to perform treatment interventions. Finally, those in the clinic setting report having more adequate staff to perform treatments compared with high schools (p = .003). The continued use of interdisciplinary teams’ postconcussion and the development of lower cost staff and resource interventions may help to increase adoption
Diagnosis, management, and prevention of acute rheumatic fever in the United States
No full textAbstract
Acute rheumatic fever is a multisystem autoimmune disease caused by infection with group A streptococcus. The condition most commonly affects children ages 5 to 14 years who are from low-income populations. The diagnosis is clinical; however, the 2015 Jones Criteria can help support it. Acute rheumatic fever poses a significant health risk secondary to rheumatic heart disease. Although acute rheumatic fever is rare in the United States, outbreaks still occur, and certain populations continue to be at increased risk. This article describes how to identify acute rheumatic fever and provides prompt management and prevention strategies to reduce patient risk for lifelong complications
Inhibition of Escherichia coli ATP synthase and cell growth by dietary pomegranate phenolics
No full textHistorically, people have been using pomegranate to alleviate many disease conditions. Pomegranate is known for its antiinflammatory, antioxidant, neuroprotective, anticancer, and antibacterial properties. In the current study, we examined effects of 8 dietary phenolics present in pomegranate (DPPs)—cyanidin-3-glucoside, cyanin chloride, delphinidin-3-glucoside, delphinidin-3,5-diglucoside, pelargonidin-3-glucoside, pelargonin chloride, punicalagin, and punicalin—on Escherichia coli ATP synthase and cell growth. DPPs caused complete or near complete (89%–100%) inhibition of wild-type E. coli ATP synthase and partial (5%–64%) inhibition of mutant enzymes αR283D, αE284R, βV265Q, and γT273A. Growth inhibition of wild-type, null, and mutant strains in the presence of DPPs were lower than that of isolated wild-type and mutant ATP synthase. On a molar scale, cyanin chloride was the most potent, and pelargonidin-3-glucoside was the least effective inhibitor of wild-type ATP synthase. Partial inhibition of mutant enzymes confirmed that αR283D, αE284R, βV265Q, and γT273A are essential in the formation of the phytochemical binding site. Our results establish that DPPs are potent inhibitors of wild-type E. coli ATP synthase and that the antimicrobial nature of DPPs can be associated with the binding and inhibition of microbial ATP synthase. Additionally, selective inhibition of microbial ATP synthase by DPPs is a useful method to combat antimicrobial resistance
Part I: Missouri\u27s Fentanyl Poisonings Rise to Record Levels
No full textMissourians are dying of fentanyl poisoning at an unprecedented rate. We identified growth areas in Missouri for fatal fentanyl encounters in rural and western counties. Though the deaths occur for a multitude of reasons, a growing trend adds to the surge in fentanyl fatalities: poisonings from counterfeit pills. The tablets are often labeled with brand names for alprazolam or oxycodone, but may contain only fentanyl at a dangerous level. Teenagers find counterfeit pills all too easily via social media. Believing they have found an easy way to obtain a quick high or relief of minor pain and anxiety, they take the pill alone in their bedroom, with no possibility of reversing a fatal fentanyl dose. There is a wide range of respiratory depression from illicit drugs containing fentanyl. We reviewed the physiologic respiratory response to drugs containing fentanyl that varies with genetics and the unpredictable amount of fentanyl contained in illicit drugs
High grade uterine adenosarcoma with sarcomatous overgrowth in a young woman amenable to primary surgical reduction: A case study and literature review
No full textMullerian adenosarcomas are rare and often low-grade mixed tumors that typically respond well to optimal surgical resection. However, adenosarcoma with sarcomatous overgrowth (ASSO) is a high-grade mixed tumor commonly associated with invasion, metastasis, and a poor prognosis. The health care providers herein report a case study of a patient diagnosed with ASSO who has maintained remission status for 19 months following radical surgical resection alone. The patient, a 24-year-old Caucasian female without significant medical history, initially complained of abdominal fullness, pelvic pressure, altered menses, and unintentional weight loss. A necrotic cervical mass was present on the exam; mass biopsy revealed spindle cell sarcoma with rhabdomyosarcomatous differentiation. The patient underwent exploratory laparotomy, total abdominal hysterectomy, bilateral salpingectomy, radical tumor debulking, and pelvic and periaortic lymph node dissection. Histopathological diagnosis of the resected specimen was consistent with ASSO, limited to 0.7 cm out of 2.0 cm of myometrial thickness, with negative lymph node and parametrial tissue, consistent with Stage IB disease. She did not receive adjuvant chemotherapy or radiation and has remained disease-free to date. Because of the rarity of ASSO and lack of abundant case study reports, uniform clinical guidelines for treatment following surgical resection of a high-grade adenosarcoma remain unclear. However, the case study below may suggest that radical surgical debulking of this disease with negative margins in young patients with early-stage disease can be sufficient in treating high-grade ASSO, despite their typical aggressive nature
Impact of brushing with charcoal on tooth color and enamel loss: An in vitro study
No full textPurpose: To evaluate the whitening efficacy of charcoal powder compared to a whitening toothpaste and the surface loss using scanning electron microscopy (SEM) and confocal laser scanning microscope (CLSM). Methods: 60 human extracted teeth were randomly assigned to two groups: Treatment (T, charcoal group: Premium Nature) and Control (C, whitening toothpaste group: Colgate Optic White). Teeth in the treatment group were brushed with a charcoal paste. Teeth shade was evaluated before and after the intervention. Lightness was assessed using both VITA classical shade guide and VITA Easyshade V. Changes within and between the group were evaluated by the paired-sample t-test and independent sample t-test. Surface roughness (Ra) of samples was performed using SEM, and to assess surface loss a CLSM was used. Results: At baseline, there were no significant differences in teeth lightness, chroma, or hue between both the charcoal and the whitening toothpaste groups (P\u3e 0.05). After 21 days of brushing, teeth brushed with the whitening toothpaste were significantly lighter (VITA Easyshade mean score: 78.34, SD: 8.397; VITA classical A1-D4 shade mean: 8.90, SD: 4.475) than the charcoal group (VITA Easyshade mean: 69.70, SD: 6.364; VITA classical A1-D4 shade mean: 11.77; SD: 3.421) (P\u3c 0.001). In addition, there was a significant reduction in lightness (i.e., increase in darkness) within the charcoal group after the intervention (P\u3c 0.001). There was no significant difference in chroma and hue between the charcoal and the whitening toothpaste groups (P\u3e 0.05). There was no significant tooth loss nor roughness change (P= 0.867) for both groups when compared with natural tooth structure. Brushing teeth with the charcoal paste tested for 21 days had no effect on tooth lightness, chroma, or hue. Charcoal powder had no significant effect on tooth surface roughness