Accuracy of Parent-Reported Allergies and Medications in Pediatric Dentistry.

Purpose: To measure the accuracy of parent-reported allergies and medication usage by comparing parental reports during dental con- sultations to medical reports from their child's primary care physician. Methods: A retrospective chart review was performed for 862 eligible patients 17 years and younger seen in the Department of Pediatric Dentistry at Franciscan Children's, Boston, Mass., USA, and who were required to obtain medical clearance prior to initiating dental treatment with sedation or general anesthesia. Allergies were categorized into three groups: food, environmental, and drug allergies. Allergies in each category reported by the parents were compared to the physician-reported allergies to assess for accuracy. Medications reported by the parents were also compared to the total number of medications reported by the physician and categorized as a full, partial, or non-match. Results: The sensitivity of parental identification for drug, food, and environmental allergies was 50.9 percent, 48.1 percent, and 18.8 percent, respectively. Of the 245 patients taking prescription medications, 53.1 percent of parents were unable to identify any of their child's medications, 22.9 percent of parents were partially able to identify their child's medications, and only 24.1 percent of parents were able to identify their child's medications fully. Among parents of children who take one or more medications as reported by their physician, the average reporting accuracy was 34.7 percent. Conclusion: Utilizing interprofessional collaboration is warranted in identifying accurate reports of patient allergies and medication usage in the pediatric population to prevent adverse reactions and improve the overall quality of dental care.

Accuracy of parent-reported health history in a dental setting.

BACKGROUND: Obtaining thorough documentation of a patient's medical history is important for dental care professionals, as oral health is connected intricately to systemic health. The purpose of this study was to assess the accuracy of parent-reported health history for pediatric patients in a dental setting. METHODS: A retrospective chart review was conducted on 863 patients 17 years and younger. Parent-reported health history was compared with subsequent physician-to-dentist consultations. The most common diagnoses were grouped on the basis of International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, categories. RESULTS: The sensitivity of parent report of health conditions was highest for reporting mental and behavioral disorders (75.1%; 95% CI, 69.6% to 80.0%), followed by nervous system diseases (63.0%; 95% CI, 47.5% to 76.8%), respiratory conditions (47.9%; 95% CI, 37.6% to 58.4%), congenital conditions (46.3%; 95% CI, 30.7% to 62.6%), and cardiovascular conditions (25.0%; 95% CI, 11.4% to 43.4%) and was lowest for hematologic conditions (12.2%; 95% CI, 4.1% to 26.2%). Parents of children 6 years and older and those with private insurance had higher sensitivity for reporting mental and behavioral conditions than those with children younger than 6 years or having Medicaid (P < .0001). The specificity of parent-reported health conditions ranged from 96.0% for mental and behavioral disorders to 99.8% for hematologic conditions. CONCLUSIONS: Sensitivity varied widely, showing that parents may be unreliable in their report of children's health histories and that dentists cannot rely solely on parents when obtaining health history. PRACTICAL IMPLICATIONS: In advocating for patient safety, especially for those with special needs and complex medical conditions, this study supports the use of medical evaluation before dental treatment and for the integration of dental and electronic health records.

Breastfeeding and Early Childhood Caries: Findings from the National Health and Nutrition Examination Survey, 2011 to 2018.

Purpose: Childhood caries is a highly prevalent disease that is intricately connected to diet and other social and behavioral factors. While it has been established that breastfeeding confers many health benefits for children, previous research found no consensus on the relationship between breastfeeding and caries. The purpose of this study was to examine the relationship between early childhood caries (ECC) and the length of time breastfeeding using the National Health and Nutrition Examination Survey (NHANES). Methods: Four cycles of NHANES (2011 to 2018) were analyzed, including 3,234 children ages two to five years. The association between breastfeeding duration and incidence of ECC and severe earlychildhood caries (S-ECC) was evaluated using logistic regression, adjusting for age, ethnicity, education, income, last dental visit, and sugar-sweetened beverages. Results: In the study population, 16.9 percent had ECC and 12.2 percent had S-ECC. Breastfeeding six months to one year, one to two years, or over two years was not associated with higher odds of ECC or S-ECC than breastfeeding for zero to six months after adjusting for covariates. Conclusions: There was no statistically significant relationship between breastfeeding and early childhood caries, and breastfeeding duration was not associated with increased caries risk. More research from well-controlled analytical studies is needed to establish or refute a relationship between breastfeeding and ECC.

Use of Mental Health Care and Unmet Needs for Health Care Among Lesbian and Bisexual Chinese-, Korean-, and Vietnamese-American Women.

OBJECTIVE: This study examined associations between sexual orientation of Asian-American women and receipt of mental health care and unmet need for health care. METHODS: Computer-assisted self-interviews were conducted with 701 unmarried Chinese-, Korean-, and Vietnamese-American women ages 18 to 35. Multivariate regression models examined whether lesbian and bisexual participants differed from exclusively heterosexual participants in use of mental health care and unmet need for health care. RESULTS: After the analyses controlled for mental health status and other covariates, lesbian and bisexual women were more likely than exclusively heterosexual women to have received any past-year mental health services and reported a greater unmet need for health care. Sexual-minority women were no more likely to have received minimally adequate care. CONCLUSIONS: Given the high rates of mental health problems among Asian-American sexual-minority women, efforts are needed to identify and overcome barriers to receipt of adequate mental health care and minimize unmet health care needs.

SIRT1 inactivation evokes antitumor activities in NSCLC through the tumor suppressor p27.

UNLABELLED: P27(Kip1) (CDKN1B) regulates cellular proliferation and senescence, and p27(Kip1) deficiency in cancer is strongly correlated with poor prognosis of multiple cancer types. Understanding the mechanism of p27(Kip1) loss in cancer and the consequences of restoring p27(Kip1) levels is therefore critical for effective management during therapy. Here, SIRT1, a class III histone deacetylase (HDAC), is identified as an important regulator of p27(Kip1) expression. Mechanistically, SIRT1 reduces p27(Kip1) expression by decreasing p27(Kip1) protein stability through the ubiquitin-proteasome pathway. In addition, SIRT1 silencing suppresses non-small cell lung cancer (NSCLC) proliferation and induces senescence in a p27(Kip1)-dependent manner. Furthermore, SIRT1 silencing dramatically suppresses tumor formation and proliferation in two distinct NSCLC xenograft mouse models. Collectively, these data demonstrate that not only SIRT1 is an important regulator of p27(Kip1) but also SIRT inhibition induces senescence and antigrowth potential in lung cancer in vivo. IMPLICATIONS: SIRT1 is a key regulator of p27 protein levels and SIRT1 inhibition is a viable strategy for NSCLC therapy by means of p27 reactivation.

Identification of a novel polyprenylated acylphloroglucinol­derived SIRT1 inhibitor with cancer­specific anti-proliferative and invasion-suppressing activities.

SIRT1, a class III histone deacetylase, plays a critical role in regulating cancer cell growth, migration and invasion, which makes it a potential target for cancer therapeutics. In this study, we screened derivatives of several groups of natural products and identified a novel SIRT1 inhibitor JQ-101, a synthetic derivative of the polyprenylated acylphloroglucinol (PPAP) natural products, with an IC(50) for SIRT1 of 30 µM in vitro, with 5-fold higher activity for SIRT1 vs. SIRT2. Exposure of tumor cells to JQ-101 significantly enhanced acetylation of p53 and histone H4K16 at known sites of SIRT1 deacetylation, validating SIRT1 as its cellular target. JQ-101 suppressed cancer cell growth and survival by targeting SIRT1, and also exhibited selective cytotoxicity towards a panel of human tumor cell lines, while producing no toxicity in two normal human cell types at comparable concentrations. JQ-101 induced both apoptosis and cell senescence, and suppressed cancer cell invasion in vitro. In summary, we have identified JQ-101 as a new SIRT1 inhibitor which may have potential application in cancer treatment through its ability to induce tumor cell apoptosis and senescence and suppress cancer cell invasion.

Fractured Identity: A Framework for Understanding Young Asian American Women's Self-harm and Suicidal Behaviors.

Despite the high suicide rate among young Asian American women, the reasons for this phenomenon remain unclear. This qualitative study explored the family experiences of 16 young Asian American women who are children of immigrants and report a history of self-harm and/or suicidal behaviors. Our findings suggest that the participants experienced multiple types of "disempowering parenting styles" that are characterized as: abusive, burdening, culturally disjointed, disengaged, and gender-prescriptive parenting. Tied to these family dynamics is the double bind that participants suffer. Exposed to multiple types of negative parenting, the women felt paralyzed by opposing forces, caught between a deep desire to satisfy their parents' expectations as well as societal expectations and to simultaneously rebel against the image of "the perfect Asian woman." Torn by the double bind, these women developed a "fractured identity," which led to the use of "unsafe coping" strategies. Trapped in a "web of pain," the young women suffered alone and engaged in self-harm and suicidal behaviors.

SIRT1 enhances matrix metalloproteinase-2 expression and tumor cell invasion in prostate cancer cells.

BACKGROUND: Matrix metalloproteinase-2 (MMP2) has been shown to play an important role in cancer cell invasion and the expression of MMP2 is associated with the poor prognosis of prostate cancer; however, the mechanism of MMP2 expression is largely unknown. SIRT1 is a nicotinamide adenine dinucleotide-dependent histone deacetylase (class III HDAC) that has recently been shown to have implications in regulating cancer cell growth and apoptosis. The purpose of this study is to determine the role of SIRT1 in regulating MMP2 expression and tumor invasion in prostate cancer cells. METHODS: The interfering RNAi was used to knockdown SIRT1 from prostate cancer cells. Immunoblots, RT-PCR, zymographic assays, co-immunoprecipitation, analysis and transwell assays were used to examine the effects of SIRT1 silencing on MMP2 expression and activity, on SIRT1 and MMP2 interaction, and on prostate cancer cell invasion. The immuno-histochemical assay was performed to study SIRT1 expression in prostate cancer tissues. RESULTS: We show that SIRT1 associates and deacetylates MMP2 and SIRT1 regulates MMP2 expression by controlling MMP2 protein stability through the proteosomal pathway. Thus, we demonstrated a novel mechanism in that MMP2 expression can be regulated at the posttranslational level by SIRT1. Furthermore, we determined that SIRT1 inhibition reduced prostate cancer cell invasion and SIRT1 is highly expressed in advanced prostate cancer tissues. CONCLUSIONS: SIRT1 is an important regulator of MMP2 expression, activity, and prostate cancer cell invasion. Overexpressed SIRT1 in advanced prostate cancer may play an important role in prostate cancer progression.