Upper airway outcomes following midface distraction osteogenesis: a systematic review.

The objective of this paper is to systematically review the airway outcomes following distraction osteogenesis of midface with the goal of (1) deriving clinically oriented insights and (2) identifying gaps in knowledge to stimulate future research. Medline, EMBASE and Cochrane databases were searched and studies were included if subjects of any age had midface retrusion/hypoplasia and underwent midface distraction osteogenesis. Outcome measures of interest were any respiratory or airway associated measures, and reports of adverse events. A total of 368 abstracts were generated from the literature searches; 16 studies met the criteria for data extraction and analysis. All 16 studies were observational. Generally, midface distraction osteogenesis was reported to improve respiratory status and was well tolerated. Specifically, favorable outcomes in cephalometry (9 studies), polysomnography (9 studies), and decannulation rates (8 studies) were reported. In conclusion, upper airway status was improved in most patients who underwent midface distraction osteogenesis, yet long-term results and consistent objective measures are lacking. Studies reviewed were retrospective case series and details regarding patients who did not improve were deficient. A standardized prospective multicenter cohort trial with long-term patient follow up is required.

Identification of predictors of Salmonella shedding in adult horses presented for acute colic.

BACKGROUND: Colic has been associated with shedding of Salmonella. Horses with salmonellosis typically develop diarrhea, fever, and leukopenia. Overlooking additional predictors may result in failure to detect shedding horses and increase environmental contamination. OBJECTIVES: Evaluate associations between signalment and clinicopathologic data during early hospitalization and Salmonella shedding in horses treated for acute colic. ANIMALS: Horses with acute colic admitted to a referral hospital. A total of 59 horses shedding Salmonella compared to 108 Salmonella-negative horses. METHODS: Retrospective case-control study evaluating patient and Salmonella culture data. Associations between variables and Salmonella shedding were identified using logistic regression. Two multivariable models were developed pertaining to (1) information available within 24 hours of admission and (2) clinical findings that developed later during hospitalization. RESULTS: Variables retained for multivariable model 1 indicated that Warmbloods and Arabians had increased odds for shedding Salmonella, as did horses requiring surgery (OR, 2.52; 95% CI, 1.10-5.75) or having more severe gastrointestinal disease (OR, 2.59; 95% CI, 1.08-6.20). Retained variables for model 2 demonstrated that horses that were treated surgically (OR, 1.60; 95% CI, 0.70-3.62), developed fever >103°F (OR, 2.70; 95% CI, 0.92-7.87), had abnormal leukocyte count (OR, 1.38; 95% CI, 0.61-3.09), or became inappetent and lethargic (OR, 16.69; 95% CI, 4.08-68.24) had increased odds for shedding Salmonella. CONCLUSIONS AND CLINICAL IMPORTANCE: In horses with acute colic that present without signs of diarrhea, fever, or leukopenia, additional predictors associated with shedding Salmonella could be used to more promptly identify horses likely to shed organisms.

Risk factors associated with Neospora caninum infections in cattle in Argentina.

From 2003 through 2007, serum samples from 5594 dairy and beef heifers and cows in Argentina were assessed to quantify the association between presence of Neospora caninum antibodies and history of abortion, type of exploitation, and age category of animals. Animals with a history of abortion were 85% more likely (P<0.01) to be positive to N. caninum than animals without a record of abortion. For a given category (age) of animals, being in a dairy operation increased the odds of being N. caninum-positive. Replacement dairy heifers were 76% more likely (P<0.01) to be N. caninum-positive than beef cows. These results suggest that postnatal exposure may be more frequent in dairy operations than in beef herds and provide insight into the epidemiology of the disease in one of the most important livestock production regions of the world.

Sex chromosome chimerism and the freemartin syndrome in Rideau Arcott sheep.

In cattle, nearly all heifers born co-twin to a male are freemartins, XX/XY chimeras that exhibit a characteristic masculinized phenotype. However, in sheep, while litters containing males and females are common, freemartins are relatively rare. The primary aim of this study was to determine the frequency and features of XX/XY chimerism in female Rideau Arcott sheep. Also, breeding records were used to investigate the effect of litter size and sex ratios, as well as the genetic basis of the condition. Finally, the migration and transcriptional competence of cells of the opposite sex in the XX/XY female and male chimeras was explored. Genomic DNA (gDNA) from peripheral blood cells of ewes was screened by PCR for the male-specific SRY gene. Of 230 lambs screened, 10 were identified as chimeras. Litter size and sex ratio showed no statistically significant effect on the frequency of chimerism. PCR and FISH analysis confirmed the presence of opposite sex cells in female and male chimeras, and in the case of ewes, their migration to tissues other than blood. Transcriptional activity of SRY and AMH was detected in gonads of ewes, whereas XIST expression was detected in white blood cells of chimeric rams. It was concluded that the frequency of sex chromosome chimerism in Rideau Arcott sheep is estimated at 4.35%, with no significant effect of litter size and sex ratio. Moreover, as it was shown that opposite sex cells can migrate to tissues other than blood and be transcriptionally active in chimeric sheep, we speculate on the role they can play in these animals.

Family reinforcement of illness behavior: a comparison of adolescents with chronic fatigue syndrome, juvenile arthritis, and healthy controls.

Parental encouragement of illness behavior is hypothesized to correlate with psychosocial dysfunction in adolescents with chronic illness. To explore this hypothesis, adolescents aged 11 to 17 years with chronic fatigue syndrome (CFS) (n = 10), juvenile rheumatoid arthritis (JRA) (n = 16), and healthy adolescents (n = 14) were recruited for the study. Measures included the Achenbach parent and youth self report forms, the Family Adaptability and Cohesion Evaluation Scale-II (FACES II), the Children's Depression Rating Scale, and number of days absent from school. The Illness Behavior Encouragement Scale (IBES) generated measures of parental reinforcement of illness behavior. As predicted, the teens with CFS scored statistically higher on measures of depression, total competence, and number of days of school missed in the previous 6 months (mean = 40). Children with JRA scored significantly lower than the CFS group on the measure of parental reinforcement of illness behavior. The healthy group produced intermediate scores. Results and implications for future clinical and research activity are discussed.

Oestrogens and psychological well-being.

The last decade has seen increased interest in the role of hormones, including oestrogens, not only in regulating growth, sexual development and reproduction but in maintaining a sense of psychological well-being. Episodes of change in oestrogen levels, whether increasing or decreasing, are high-risk periods for the emergence of psychological symptoms in some women. This may be due to a 'kindling effect' for women with previous psychological disturbance, an effect on circadian rhythm activity and therefore altered neurovegetative functions, or an effect on central rhythmic functioning between the hypothalamus and the cerebral cortex, all mediated by effects on neurotransmitter systems. Data supporting these hypotheses come from animal studies as well as converging research in several areas including the study of psychological side-effects of oral contraceptives, the study of mood and cognitive disturbances related to the menstrual cycle, the studies of states of hormonal change such as pregnancy and the menopause and, of course, studies of women with psychiatric disorders such as major depression, seasonal affective disorder and dementia. Improvement in such symptoms via hormonal therapies or other interventions will probably lead to better quality of life for women and may actually impede the deterioration associated with ageing and certain medical illnesses. Current data support a relationship between oestrogen and psychological well-being.

Practical denture disinfection.

Dental laboratory personel are at risk of contracting infections from dental prostheses that have not been properly disinfected. A 4% chlorhexidine scrub for 15 seconds followed by a 3-minute contact time with a chlorine dioxide solution was effective in disinfecting contaminated dentures. Chair-side disinfection of dental prostheses before laboratory procedures is the key to keeping microbial contamination out of the dental laboratory.

Reflections on the face of Japan: a multivariate craniofacial and odontometric perspective.

Craniofacial variables for modern and prehistoric Japanese were subjected to multivariate analysis to test the relationships of the people of Japan with mainland Asian and Oceanic samples. The modern Japanese are tied to Koreans, Chinese, Southeast Asians, and the Yayoi rice agriculturalists who entered Japan in 300 B.C. Together they make up a Mainland-Asia cluster of related populations. The prehistoric Jomon foragers, the original inhabitants of the Japanese archipelago, are the direct ancestors of the modern Ainu, who made a recognizable contribution to the warrior class--the Samurai--of feudal Japan. Together, they are associated with Polynesians and Micronesians in a Jomon-Pacific cluster of related populations. Jomon-to-Ainu tooth size reduction proceeded at the same rate as that observable in the post-Pleistocene elsewhere in the Old World.