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Identifying an Association Between Sensory Processing and Food Sensitivities
Get PDFIntroduction: Feeding difficulties are quite common in children and can lead to a multitude of poor health outcomes. Children with sensory processing difficulties can present with feeding difficulties. The relationship between sensory processing and feeding difficulties in children has been previously researched. However, most of the existing research focuses on children diagnosed with autism spectrum disorder. Methods: The purpose of the present study was to identify the association between sensory processing and food sensitivities in children of varying diagnoses using retrospective data. In the study, the researcher included 47 children who presented to an outpatient pediatric clinic for a feeding evaluation . Using SPSS to determine the correlations between scores on the Sensory Processing Measure (SPM) or Sensory Processing Measure-Preschool (SPM-P), the Brief Assessment of Mealtime Behaviors in Children (BAMBIC), and a Food Preference Checklist, the researcher conducted correlational statistics . Results: The researchers found weak correlations between scores on the SPM/SPM-P and scores on the BAMBIC and Food Preference Checklist. Moderate correlations were found between specific test items on the BAMBIC related to food selectivity and the body awareness subtest of the SPM/SPM-P. One BAMBIC test item also had a moderate correlation with the total sensory score of the SPM/SPM-P. Discussion: The researcher found some associations between sensory processing and feeding, particularly with body awareness. The results indicate the importance of identifying and addressing body awareness (proprioception) and oral motor skills in children presenting with feeding difficulties. Based on the results, implications exist for occupational therapy practice and future research. Conclusion: The current study aimed to identify the associations between sensory processing and food sensitivities in children of varying diagnoses. Statistically significant results were found, demonstrating that body awareness (proprioception) is correlated to feeding
The Effects of a Teletherapy Follow-Up Education Program on the Quality of Life and Self-Care Management of Lymphedema Among Breast Cancer Patients: A Doctoral Capstone Experience
Get PDFBackground and Purpose. The primary purpose of this doctoral capstone research project was to evaluate the effect of a teletherapy follow-up education program on the participants’ quality of life in lymphedema management. A secondary objective was to determine whether an increase occurred in compliance and independence in the following recommended lymphedema management protocols within the home setting. Methods. A 14-week prospective study design was conducted at Banner Gateway Medical Center (BGMC). Eight female subjects (mean age of 61.88 years) were recruited and randomized into two treatment groups. The control group resumed care as usual. The intervention group participated in a weekly, hour-long teletherapy session covering lymphedema-related topics. Results. The statistical analysis of the Wilcoxon test demonstrated no significant difference between the intervention group and control group in all outcomes. The data showed minimally clinical improvements in each collected outcome measure when comparing pre-data to post-data. The study concluded a lack of statistical significance found in the data between the two groups, however, participants reported a positive review and experience of the intervention. Conclusion. This study did not find any statistical significance between treatment groups but did not lead to negative outcomes. Occupational therapists possess the skill and knowledge to address the gap in care seen in post-treatment needs of cancer patients battling post- complications such as lymphedema. Researchers should explore more options in teletherapy as a feasible supplementary tool to increase compliance in long-term self-care among breast cancer patients to promote better quality of life
SATB2 and MDM2 Immunoexpression and Diagnostic Role in Primary Osteosarcomas of the Jaw
No full textPrimary osteosarcomas of the jaw (OSJ) are rare, accounting for 6% of all osteosarcomas. This study aims to determine the value of SATB2 and MDM2 immunohistochemistry (IHC) in differentiating OSJ from other jawbone mimickers, such as benign fibro-osseous lesions (BFOLs) of the jaw or Ewing sarcoma of the jaw. Certain subsets of osteosarcoma harbor a supernumerary ring and/or giant marker chromosomes with amplification of the 12q13–15 region, including the murine double-minute type 2 (MDM2) and cyclin-dependent kinase 4 (CDK4) genes. Special AT-rich sequence-binding protein 2 (SATB2) is an immunophenotypic marker for osteoblastic differentiation. Cases of OSJ, BFOLs (ossifying fibroma and fibrous dysplasia) of the jaw, and Ewing sarcoma of the jaw were retrieved from the Departments of Oral Pathology and Oral Medicine, Faculty of Dentistry, Obafemi Awolowo University and Lagos State University College of Medicine, Nigeria. All OSJ retrieved showed histologic features of high-grade osteosarcoma. IHC for SATB2 (clone EP281) and MDM2 (clone IF2), as well as fluorescence in situ hybridization (FISH) for MDM2 amplification, were performed on all cases. SATB2 was expressed in a strong intensity and diffuse staining pattern in all cases (11 OSJ, including a small-cell variant, 7 ossifying fibromas, and 5 fibrous dysplasias) except in Ewing sarcoma, where it was negative in neoplastic cells. MDM2 was expressed in a weak to moderate intensity and scattered focal to limited diffuse staining pattern in 27% (3/11) of cases of OSJ and negative in all BFOLs and the Ewing sarcoma. MDM2 amplification was negative by FISH in interpretable cases. In conclusion, the three cases of high-grade OSJs that expressed MDM2 may have undergone transformation from a low-grade osteosarcoma (LGOS). SATB2 is not a dependable diagnostic marker to differentiate OSJ from BFOLs of the jaw; however, it could serve as a valuable diagnostic marker in differentiating the small-cell variant of OSJ from Ewing sarcoma of the jaw, while MDM2 may be a useful diagnostic marker in differentiating OSJ from BFOLs of the jaw, especially in the case of an LGOS or high-grade transformed osteosarcoma
Frankly Invasive Carcinoma Ex-intraductal Carcinoma: Expanding on an Emerging and Perplexing Concept in Salivary Gland Tumor Pathology
No full textIntraductal carcinoma (IDC) of the salivary glands is an uncommon and enigmatic tumor, our understanding of which is rapidly evolving. Recent studies have demonstrated multiple IDC subtypes and consistent gene fusions, most frequently involving RET. Because IDC is a ductal proliferation surrounded by flattened myoepithelial cells, it was previously presumed to be analogous to breast ductal carcinoma in situ, but recent evidence has shown that the myoepithelial cells of fusion-positive IDC harbor the same genetic alterations of the ductal cells and are therefore neoplastic. In addition, there are rare reports of fusion-positive IDC with overt areas of irregular invasion lacking myoepithelial cells, but this phenomenon is not well documented or understood. This study aims to better characterize these frankly invasive carcinoma ex-IDC. All cases of frankly invasive carcinoma ex-IDC were obtained from the authors’ files. Inclusion criteria included a component of concurrent or antecedent IDC and/or a fusion known to be associated with IDC. Immunohistochemistry (S100, SOX10, mammaglobin, androgen receptor, p63, p40) and molecular analysis (targeted RNA sequencing or large panel DNA next generation sequencing) was performed. Clinical follow-up was obtained from medical records. Ten cases of frankly invasive carcinoma ex-IDC were identified. The tumors occurred in 8 men and 2 women ranging from 33 to 82 years (mean, 66.3). All but one case arose in the parotid gland. In 4 cases, the IDC component was intercalated duct type. It was mixed apocrine/intercalated duct in two, and in the remaining 4 cases, no residual IDC was identified. The frankly invasive carcinomas were remarkably heterogeneous, ranging from minimally to widely invasive beyond the confines of the IDC, low-grade to high-grade, with morphologies that varied from duct-forming to those having clear cell or sarcomatoid features, to frankly apocrine. The original diagnoses for these cases were (adeno) carcinoma, not otherwise specified (n = 6), salivary duct carcinoma (n = 3), and secretory carcinoma (n = 1). All cases harbored fusions: NCOA4::RET (n = 6), TRIM33::RET (n = 2), TRIM27::RET (n = 1), and STRN::ALK (n = 1). Clinically, one tumor recurred locally, cervical lymph node metastases occurred in five patients, and distant metastasis later developed in four of these patients. Our findings highlight striking diversity in frankly invasive carcinomas that arise from fusion-positive IDC, a tumor which may serve as a precursor neoplasm like pleomorphic adenoma. These carcinomas vary in their extent of invasion, grade, histologic appearances, and clinical behavior. Importantly, in contrast to pure IDC, which is believed to be indolent, many frankly invasive cases were aggressive. Because RET and ALK fusions are targetable, it is important to recognize the broad spectrum of frankly invasive carcinomas that can arise from IDC, particularly because some cases are completely overrun or recur without any recognizable IDC component. These results suggest fusion analysis may be of clinical benefit on any salivary gland (adeno) carcinoma, not otherwise specified or salivary duct carcinoma
The Influence of Movement on the Cerebrospinal Fluid Pressure of the American Alligator (Alligator mississippiensis)
No full textThis study was undertaken to document how the cerebrospinal fluid (CSF) pressure varied during movements and physiological activities. Using surgically implanted pressure catheters; the CSF pressure was recorded from sub-adult American alligators (Alligator mississippiensis) under anesthesia and post-recovery. Pressures were recorded during physiological activities (the cardiac cycle; passive and active ventilation); manual manipulation of the anesthetized animals (foot sweeps; tail oscillations; and body bends); as well as voluntary movements post-recovery (changes in body tone; defensive strikes; and locomotion). The CSF pulsations associated with the cardiac cycle had the lowest mean amplitude (3.7 mm Hg); during active ventilation and defensive strikes; the alligators routinely generated CSF pressure spikes in excess of 100 mm Hg. The recorded CSF pressures appear to be caused by a variety of mechanisms including vascular pressure; fluid inertia; and possible physical displacement of the spinal cord. The results of the study suggest that any model of CSF dynamics or perfusion should incorporate the episodic high-pressure CSF pulsations associated with movement
NaV1.9 current in muscle afferent neurons is enhanced by substances released during muscle activity
No full textSkeletal muscle contraction triggers the exercise pressor reflex (EPR) to regulate the cardiovascular system response to exercise. During muscle contraction, substances are released that generate action potential activity in group III and IV afferents that mediate the EPR. Some of these substances increase afferent activity via G-protein-coupled receptor (GPCR) activation, but the mechanisms are incompletely understood. We were interested in determining if tetrodotoxin-resistant (TTX-R) voltage-dependent sodium channels (NaV) were involved and investigated the effect of a mixture of such compounds (bradykinin, prostaglandin, norepinephrine, and ATP, called muscle metabolites). Using whole cell patch-clamp electrophysiology, we show that the muscle metabolites significantly increased TTX-R NaV currents. The rise time of this enhancement averaged ∼2 min, which suggests the involvement of a diffusible second messenger pathway. The effect of muscle metabolites on the current-voltage relationship, channel activation and inactivation kinetics support NaV1.9 channels as the target for this enhancement. When applied individually at the concentration used in the mixture, only prostaglandin and bradykinin significantly enhanced NaV current, but the sum of these enhancements was \u3c1/3 that observed when the muscle metabolites were applied together. This suggests synergism between the activated GPCRs to enhance NaV1.9 current. When applied at a higher concentration, all four substances could enhance the current, which demonstrates that the GPCRs activated by each metabolite can enhance channel activity. The enhancement of NaV1.9 channel activity is a likely mechanism by which GPCR activation increases action potential activity in afferents generating the EPR
A descriptive and comparative analysis of injuries reported in USA Cycling-sanctioned competitive road cycling events
No full textBackground: Competition in road cycling events is common, yet little is known about the nature and disposition of injuries sustained in these events. The purpose of this study is to describe injured body regions and the disposition of injuries sustained by cyclists during competitive road cycling events. Methods: Data regarding body region injured and injury disposition were retrospectively analyzed from a convenience sample of 1053 injury reports (male: n = 650 [61.7%], age = 33.4 ± 13.6 years; female: n = 116 [11.0%], age = 33.3 ± 13.9 years; missing: n = 284 [27.0%]) completed during the 2016 competitive season. Results: A total of 1808 injuries were reported. Injured body regions included upper extremity (46.5%, n = 841), lower extremity (32.2%, n = 583), head/neck (10.4%, n = 189), torso/back (5.2%, n = 95), face (4%, n = 87), and internal/other (0.7%, n = 13). There were 1.37 ± 0.81 injuries recorded per report. Dispositions following injury were medical attention (34.1%, n = 316), ambulance/EMS (19.3%, n = 179), report only (15% n = 139), referred (13.0% n = 121), released to parent/personal vehicle (12.1% n = 112), refused care (4.1% n = 38), and continued riding (2.5% n = 23). Males (34.0%, n = 212) received medical attention more frequently than females (23.3%), p \u3c 0.05. Females received EMS transport (29.1%, n = 30) more frequently than males (16.8%, n = 105), p \u3c 0.05. Conclusions: Upper extremity is the most injured body region in this data set. Following injury, racers often receive medical attention and a substantial percentage require transport by EMS. Clinical relevance: Anticipating the nature of injuries sustained by cyclists may promote positive health outcomes by ensuring medical teams are prepared for the immediate medical needs of cyclists
Early Sport Specialization in College Athletes and the Impact on Health-Related Quality of Life: A Critically Appraised Topic
No full textClinical Scenario: Youth athletes may specialize in a sport of their choosing, or based on external pressures, to pursue elite status in that sport. Current evidence shows an association between highly specialized athletes and an increase in injuries as well as a connection between injury and lower health-related quality of life (HRQOL). Clinical Question: In college athletes, do early sport specialization characteristics (ie, age at specialization and degree of specialization) impact current HRQOL? Summary of Key Findings: The literature was searched for studies that investigated the age of specialization (early vs late) or degree of specialization (high, moderate, and low) and the impact on HRQOL. (1) The search returned 6 possible studies related to the clinical question. Three of the studies met the inclusion criteria and were used for this appraisal. (2) Two of the 3 included studies reported that highly specialized athletes noted lower HRQOL. (3) One study found there to be no significant difference in HRQOL between athletes who specialized early versus late but did find those who specialized early to have a greater incidence of injuries that required surgery. Clinical Bottom Line: There is moderate evidence that early sport specialization is associated with lower HRQOL compared with late sport specialization. It is important to educate athletes, parents, and coaches on the potential detriments that are associated with early sport specialization to allow stakeholders to make informed decisions regarding participation. Strength of Recommendation: Grade B evidence exists to support the idea that early, intensive sport specialization may be associated with decreased HRQOL in current college athletes
Applying the Value Transformation Framework in Federally Qualified Health Centers to Increase Clinical Measures Performance
No full textIntroduction:The transition in health care from a volume-based to value-based model of care, combined with pressures brought about by the COVID-19 pandemic, makes the need for efficiency and coordination of the health center system imperative. The Value Transformation Framework (VTF), developed with health centers in mind, provides an organizing framework to support transformation of infrastructure, care delivery, and people systems.Methods:NACHC applied the VTF within a cohort of health centers across the country to drive systems change and improve performance on measures of clinical care.Results:A comparison of health centers participating in application of the VTF relative to nonparticipating health centers nationally showed improvement during 3 years of program implementation. Significant differences (p \u3c.05) favoring health centers who participated were noted for screening of colorectal cancer (p \u3c.001), depression (p \u3c.001), hypertension (p \u3c.001), obesity (p =.001), and cervical cancer (p =.011). Performance for diabetes control also favored participating programs, although the difference did not quite reach significance (p =.45).Conclusions:Applying a systems approach, organized by the VTF, with evidence-based interventions and deployed in a learning community, can result in improved performance across multiple measures of clinical care