Single versus double suspension sutures for selected cases of obstructive sleep apnea

To compare the results of expansion pharyngoplasty using bilateral single palatal suspension sutures (SSS) versus double suspension sutures (DSS) for the treatment of selected cases of obstructive sleep apnea (OSA) with retropalatal collapse.

http://bit.ly/2QrtpBw

Successful management of recurrent adenoid cystic carcinoma in the deep infratemporal fossa by maxillo-orbito-zygomatic approach

In the case of deep invasion of an infratemporal fossa (ITF) tumor, surgeons find it difficult to gain sufficient visualization and working space by conventional surgical approaches. To overcome these limitations, we have developed a novel surgical technique, maxillo-orbito-zygomatic (MOZ) approach, by combining partial lateral maxillectomy with the conventional orbito-zygomatic approach.

http://bit.ly/2VBwWB9

Foreign Body in Paranasal Sinus: A Late Clinical Presentation

The occurrence of foreign bodies in paranasal sinuses is extremely rare. The symptoms are vague and usually discovered after extra/intracranial complications. They may, therefore, go unnoticed if there isn't a strong clinical suspicion. We present a clinical case of a 64-year-old woman with a paranasal sinus microsurgery history more than 30 years ago, who presented with headache and purulent rhinorrhea. A glass tubular structure was discovered in the ethmoid complex. She underwent functional endoscopic sinus surgery. Since glass is an inert material that doesn't cause foreign body reaction, the patient may not present any symptom or sign. However, if there is obstruction in the drainage of the ostiomeatal complex, it can manifest itself as rhinosinusitis, which we believe happened in our case. To the best of our knowledge, this is probably the first reported case of a glass removed from the ethmoidal sinuses, diagnosed with more than 30 years of evolution.

http://bit.ly/2GXypOM

Successful management of recurrent adenoid cystic carcinoma in the deep infratemporal fossa by maxillo-orbito-zygomatic approach

Publication date: Available online 6 January 2019

Source: Auris Nasus Larynx

Author(s): Takahiro Hongo, Junichi Fukushima, Yoshinori Uchida, Fumihide Rikimaru, Satoshi Toh, Yuichiro Higaki, Muneyuki Masuda

Abstract

Objective

In the case of deep invasion of an infratemporal fossa (ITF) tumor, surgeons find it difficult to gain sufficient visualization and working space by conventional surgical approaches. To overcome these limitations, we have developed a novel surgical technique, maxillo-orbito-zygomatic (MOZ) approach, by combining partial lateral maxillectomy with the conventional orbito-zygomatic approach.

Methods

A 63-year-old male presented with the fifth recurrent adenoid-cystic carcinoma in the right deep ITF. Using a Weber–Ferguson-type incision and partial dismasking, we elevated the skin and scalp flap, while preserving the facial nerve and orbicularis oculi muscle intact in the flap. Then, we performed MOZ osteotomy using three cut lines, the zygomatic arch, the frontozygomatic suture, and from the inferior orbital fissure to the anterolateral wall of the maxilla. Following this, we temporarily elevated the bone flap by partially opening the lateral maxillary sinus. We obtained an excellent surgical view of the ITF, middle skull base, and pterygopalatine fossa with this technique, which facilitated the safe removal of the tumor.

Results

The postoperative course remained almost uneventful, and we obtained favorable cosmetic results.

Conclusions

Our novel MOZ approach could be a robust approach to remove deep ITF tumors.

http://bit.ly/2AHy3X9

Single versus double suspension sutures for selected cases of obstructive sleep apnea

Publication date: Available online 6 January 2019

Source: Auris Nasus Larynx

Author(s): Mohammad Waheed El-Anwar, Sherif Askar, Amr Hassan El-Sinbawy, Ahmed Mohamed Hassan Salem

Abstract

Objective

To compare the results of expansion pharyngoplasty using bilateral single palatal suspension sutures (SSS) versus double suspension sutures (DSS) for the treatment of selected cases of obstructive sleep apnea (OSA) with retropalatal collapse.

Methods

Patients were randomly categorized into two groups: the first group for whom bilateral SSS were performed and a second group for whom bilateral DSS were done. Snoring on the basis of the visual analog scale (VAS), Epworth Sleepiness Scale (ESS), apnea hypopnea index (AHI), lowest O₂ saturation were assessed preoperatively and 6 months postoperatively in all patients.

Results

DSS provided significantly more retroplatal space (p = 0.0137) and less snoring score (p = 0.0005). While no significance difference between SSS and DSS as regard inter pillar distance (p = 0.0985), AHI (p = 0.1677), ESS (p = 0.4094), and lowest O₂ saturation (p = 0.0839).

Conclusion

Both SSS and DSS are simple, rapid, bloodless and effective procedures for treating OSA (in patients with retropalatal collapse) with no temporary or persistent postoperative complications. Adding the second suture in DSS could significantly enlarge more retropalatal space and reduce more snoring scale than SSS.

http://bit.ly/2SLD7QU

Human Biology

Health care: Where are we heading? Monali Amit Shah Advances in Human Biology 2019 9(1):1-1

The incidence of brain tumours in Iran: A systematic review and meta-analysis Soheil Hassanipour, Gholamreza Namvar, Mohammad Fathalipour, Mohammad Ghorbani, Elham Abdzadeh, Saber Zafarshamspour, Shirin Riahi, Abdollah Mohammadian-Hafshejani, Hamid Salehiniya Advances in Human Biology 2019 9(1):2-7 Background: Brain tumours (BTs) constitute approximately 88% of all central nervous system tumours. The present study aimed to determine the age-standardised rate (ASR) of BTs in Iran. Methods: A comprehensive search was conducted on all studies of BTs incidence using Medline/PubMed, Scopus, Embase, Google Scholar and Web of Sciences as international databases and Scientific Information Database, MagIran, IranMedex and IranDoc as Iranian databases until April 2018. This systematic review was done based on the preferred reporting items for systematic reviews and meta-analyses. Results: The primary search yielded 312 relevant studies. A total of 17 studies were included after more detailed retrieval. The results of the random-effect model were demonstrated the ASR of BTs was 4.16 (95% confidence interval [CI], 3.20–5.12) for males and 3.40 (95% CI, 2.67–4.13) for females. Conclusion: The incidence of BTs is lower in Iran compared to other parts of the world. The incidence of nervous system cancers is increasing base on region, geographical, and economic conditions in Iran. Hence, training programmes can be considered to reduce the risk factors, complications of nervous system cancers and early diagnosis of nervous tumors.

The effect of placenta abruption on the risk of intrauterine growth restriction: A meta-analysis Ensiyeh Jenabi, Salman Khazaei, Bita Fereidooni Advances in Human Biology 2019 9(1):8-11 There is a contradict findings on the effect of placenta abruption on the risk of intrauterine growth restriction (IUGR). Therefore, the objective of present meta-analysis was to identify all the eligible studies to assess the effect of placenta abruption on the risk of IUGR. The major electronic databases, including PubMed, Scopus and Web of Science, were searched to identify relevant published studies. The literature search included 551 articles until January 2018 with 35,201 participants. In the end, a total of seven references were remained for this meta-analysis. Two independent authors reviewed the retrieved the studies and extracted data. I2 statistics was used to assess of heterogeneity. The random effects model was conducted to assess pooled effects size. the results of study showed that placenta abruption has a significant effect on the risk of IUGR based on odds ratio results (2.06; 95% confidence interval: 1.57, 2.55). The result reported of the measure of effect was homogeneous (I2 = 0.0%). we presented based on reports in epidemiological studies that placenta abruption is a risk factor for IUGR.

Is breech presentation associated with autism spectrum disorders among children: A meta-analysis Ensiyeh Jenabi, Saeid Bashirian, Salman Khazaei Advances in Human Biology 2019 9(1):12-15 The meta-analysis of case–control and cohort studies was conducted to obtain the association between breech presentation and the risk of autism spectrum disorder (ASD) among children. The search for relevant studies in major electronic databases was performed including; Web of Science, PubMed and Scopus up to May 2018. The odds ratio (ORs) with 95% confidence intervals (CI) was extracted from eligible studies. The pooled estimate of OR was not indicated a significant association between breech presentation and risk of ASD among children (OR = 1.15, 95% CI = 0.93–1.37), but this association was significant in the unadjusted analysis (OR = 1.32, 95% CI = 1.05–1.58). Our findings were not showed that breech presentation is associated with increased risk of ASD among children.

The incidence of testicular cancer in Iran from 1996 to 2017: A systematic review and meta-analysis Soheil Hassanipour, Mohammad Ghorbani, Milad Derakhshan, Hamed Fouladseresht, Shokrollah Mohseni, Elham Abdzadeh, Shirin Riahi, Morteza Arab-Zozani, Hamed Delam, Hamid Salehiniya Advances in Human Biology 2019 9(1):16-20 Objective: Testicular cancer (TC), although it is one of the most unusual cancers, seems to be increasing. There is no accurate information on the incidence of this cancer in Iran. The present study is conducted to evaluate the incidence rates of TC in Iran. Methods: A systematic search was conducted on all published studies of TC incidence using Medline/PubMed, Scopus, Embase, Web of Science, Google Scholar and four Iranian databases (Scientific Information Database, MagIran, IranMedex and IranDoc) until June 2018. This systematic review was done according to the preferred reporting items for systematic reviews and meta-analyses. Result: The database searching yielded 132 potentially relevant studies. A total of 11 studies were included in the study. The results of the random-effects model were demonstrated that the age-standardised rate (ASR) of TC was 1.13, 95% confidence interval (0.97–1.29) among Iranian males. Conclusion: ASR for TC in Iran is lower than the world average; however, it has a higher incidence than other Asian countries.

Effect of cryopreservation on the structural and functional integrity of human periodontal ligament stem cells: A systematic review Rujuta Krishnakant Pandya, Monali Shah, Yesha Shroff, Mrugank Vyas Advances in Human Biology 2019 9(1):21-27 Aim: The aim of the present systematic review was to assess the effect of cryopreservation on the human periodontal ligament (PDL) stem cells and their ability for periodontal regeneration. Materials and Methods: An electronic search without time restrictions was conducted up to August 2017 in indexed databases using the combination of different keywords including cryopreservation, cryofixation, vitrification and human periodontal ligament stem cells. The exclusion criteria included reviews, commentaries, letters to the editor, interviews and updates. The relevant articles were included and data extraction was processed. Results: Dimethyl sulphoxide was used as a cryoprotectant in all the studies which yielded good results. The magnetic freezing proves to be better than the normal freezer. The cryopreserved cells showed no significant difference for viability, proliferation, and regenerative capacities as compared to the fresh human PDL stem cells (PDLSCs), in vitro as well as in vivo. Conclusion: Cryopreservation of the human PDLSCs would serve as an opportunity for future regenerative therapy for the periodontium.

The effect of diabetes on nerve–muscle conduction of tibial and peroneal nerve association with habit and habitat in Bikaner Region Ekta Soni, Priyanka Soni, Jitendra Kumar Acharya Advances in Human Biology 2019 9(1):28-31 Introduction: Diabetes is due to defect in Beta cell of islets of Langerhans, that is seen in pancreas. This defect is responsible for disturbance in blood glucose level. Other factors which are also responsible includes diet, hereditary, immunological factor, lack of exercise etc., The damage to nerves in DM has been assumed to be a result of the interaction of metabolic defects complicated by vasa nervorum abnormalities. Nerve conduction velocity, are standard measurement used to confirm the presence or absence of diabetic neuropathy. In Nerve conduction velocity study common nerves that are studied are common peroneal nerve, tibial nerve and sural nerve. Materials and Methods: The study was planned in Physiology Department in close collaboration with Department of Medicine (Diabetic Section), S.p.mc. Bikaner. A total of 100 subjects for study from diabetic centre, were selected. Institutional ethical clearance was taken before commencement of study from ethical committee of our institution. Results: In present study, maximum number of patients were non-smokers in both study and control groups (87% and 91% respectively) and this difference was found statistically insignificant (P > 0.05). We observed that the patients were vegetarian in both study and control groups and this difference was found statistically insignificant (P > 0.05). The mean peroneal nerve in study group was 42.26 ± 1.95 m/s and in control group it was 52.05 ± 4.78 m/s and the difference was found statistically highly significant (P < 0.001) and mean value of tibial nerve in study group was 41.71 ± 2.29 m/s and in control group it was 49.84 ± 2.67 m/s and the difference was found statistically highly significant (P < 0.001). Conclusion: In our study, we concluded that nerve conduction velocities decreases in tibial and common peroneal nerve in diabetic patients as compared to control. Nerve conduction velocities also decrease with increasing age, increased HbA1C >6.5%.

New insight into the role of electronic apex locators in detecting simulated horizontal root fractures: An In vitro study Mukti M Shah, Vaishali V Parekh, Nidhi J Patel, Parth V Dodiya, Dipak H Chauhan Advances in Human Biology 2019 9(1):32-36 Aim and Objectives: The aim of this study is to check the accuracy of two different electronic apex locators (EALs): Canal Pro and Root ZX – in locating simulated horizontal root fractures (HRFs). Materials and Methods: Forty-five recently extracted, single-rooted, human permanent teeth were selected for the study. Endodontic access cavity was prepared, and canal patency was checked using no. 10-K file. Horizontal fractures were simulated using 0.2-mm thick diamond disk in coronal, middle and/or apical third of root by operator one, until half of the canal was exposed circumferentially. Using both the apex locators, all the fractures were detected by the second operator to confirm the accuracy of EALs. The actual length of the fractures was then measured under ×2.5 magnification, and results were subjected to statistical analysis. Results: Results were analysed using the one-way analysis of variance and Tukey's post hoc test, and the differences between all the test samples were analysed. All the measurements were compared to the actual values separately. A statistically significant difference was determined at 95% confidence level (P ≤ 0.05). Conclusion: Investigated both the EAL are capable of detecting simulated HRF and that the Canal Pro showed a higher accuracy rate.

To determine the prevalence of glucose-6-phosphate dehydrogenase deficiency using a novel water-soluble tetrazolium-8 formazan method' for neonatal screening in region of Himachal Pradesh, India Seema Sharma, Milap Sharma Advances in Human Biology 2019 9(1):37-41 Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is the most significant enzyme defect in India with an incidence ranging from 2% to 27.9% in different communities. Prolonged neonatal jaundice and haemolytic crisis are known to occur in children with G6PD deficiency. Hence, screening of a population for G6PD deficiency is paramount. A Novel water soluble tetrazolium-8 (WST-8) Formazan Method has been used in this study for in-field mass-screening of G6PD in the region of Himachal Pradesh, India. Materials and Methods: In this prospective study, 5652 neonates were screened to assay G6PD activity using WST8/1-methoxy phenazine methosulphate method within the first 48 h of life. Orange colour at the end of the procedure indicated normal G6PD activity while pink or colourless appearance indicated G6PD deficiency. Results: After the screening of 5652 neonates, the prevalence of G6PD deficiency was 12.4%. 45 newborns (6%) had a severe G6PD deficiency. Males were more affected than females (70:30). Furthermore, males had higher prevalence of deficiency than females (64% [n = 29] and 16% [n = 16]). Conclusions: G6PD deficiency assessment by the method used for population screening in the study was easy to do and quite simple. Following this, the high prevalence of this deficiency was noted in Himachal Pradesh. This study highlights the need to do neonatal screening of G6PD deficiency in population so that untowards complications like haemolytic crisis, complications due to neonatal jaundice can be avoided.

Evaluation of the accessible level of iodine in marketed iodised salt in Iran: A comparison with standard recommended values Abolfazl Mohammadbeigi, Ali Salehi, Hamidreza Heidari, Mahdi Asadi-Ghalhari Advances in Human Biology 2019 9(1):42-45 Background: Iodine is one of the essential micronutrients for synthesise and secrete adequate amounts of thyroid gland hormones. Its deficiency is the most important threatening causes for human health. The aim of this study was to evaluate iodine concentration in marketed edible salt samples in Qom city and to compare with existing standards and offering solutions necessary to fix the probably problems. Materials and Methods: A cross-sectional, descriptive study was carried out on 60 samples of 20 brands of marketed edible salt in Qom during 2017. Iodine concentration was evaluated by the British Pharmacopoeia titration method. Results: According to the national standard of Iran during this study, iodine concentration in 51.67% of salt samples was in acceptable limits and 48.33% of samples were out of acceptable ranges. None of the tested samples had iodine content more than the standard limit. Conclusions: To improve salt fortification status and removing iodine deficiency in society, the following actions should be considered: enforcing producers to follow national and international standards, continuous monitoring the producers, necessary legal actions against offending manufacturers and appropriate measures by health ministry and relevant authorities.

Pediatric Neuropsychology

Review of Neurodevelopmental Disorders in Children and Adolescents

Investigating the BRIEF and BRIEF-SR in Adolescents with Mild Traumatic Brain Injury Abstract To date, limited research has investigated the Behavioral Rating Inventory of Executive Function (BRIEF) and BRIEF Self-Report (BRIEF-SR) in adolescents presenting exclusively with mild traumatic brain injuries (mTBI). The present study was retrospective and included 163 adolescents (43% male; M age = 14.80; M days since injury = 34.10) referred for neuropsychological evaluation after mTBI. Results revealed that mean BRIEF and BRIEF-SR clinical scale scores in the sample were generally similar to those in the standardization sample, commensurate with previous literature on the trajectory of cognitive and symptom recovery after mTBI. Adolescents reported significantly higher scores than their parents only on Emotional Control, with no differences emerging on other clinical scales. Confirmatory factor analyses indicated that the two-factor model of the BRIEF-SR (Metacognition and Behavioral Regulation; Comparative Fit Index (CFI) = 0.97) provided relatively and statistically significant better fit than a one-factor model extracted in exploratory analyses. Results also indicated that a three-factor model of the BRIEF capturing Metacognition, Behavioral Regulation, and Emotional Regulation (CFI = 0.98) provided relatively and significantly better fit than the two-factor model. These results suggested that adolescents in the post-acute phase of mTBI recovery may rate their own executive dysfunction in terms of metacognitive and behavioral difficulties, while their parents may observe executive dysfunction in these two dimensions in addition to emotional dysfunction. Relationships to previous literature, limitations of the present study, and implications for clinical practice are discussed.

Test and Book Reviews in Pediatric Neuropsychology

Correction to: Automatized Sequences as a Performance Validity Test? Difficult If You Have Never Learned Your ABCs In the original article the name of author Allyson G. Harrison was misspelled. The original article has been updated and her name is correct here.

Pediatric Performance Validity Testing: State of the Field and Current Research

One-Minute PVT: Further Evidence for the Utility of the California Verbal Learning Test—Children's Version Forced Choice Recognition Trial Abstract Objective To replicate previous research on the forced choice recognition trial for the California Verbal Learning Test—Children's Version (FCR-C). Method Classification accuracy of the FCR-C was computed in 178 children referred for neuropsychological assessment to a tertiary care hospital. Results FCR-C ≤ 14 produced the best combination of sensitivity (.12–.42) and specificity (.88–.96). Unlike some of the criterion performance validity tests (PVTs), base rate of failure on the FCR-C was evenly distributed across age ranges. Conclusion The FCR-C is a quick and inexpensive PVT, unaffected by cognitive maturation, and highly specific to psychometrically defined invalid performance.

Automatized Sequences as a Performance Validity Test? Difficult If You Have Never Learned Your ABCs Abstract Accurate identification of symptom exaggeration is essential when determining whether or not data obtained in pediatric evaluations are valid or interpretable. Apart from using freestanding performance validity tests (PVTs), many researchers encourage use of embedded measures of test-related motivation, including the newly developed automatized sequences test (AST). Such embedded measures are based on identification of performance patterns that are implausible if the test taker is investing full effort; however, it is unclear whether or not persons with pre-existing cognitive difficulties such as specific learning disabilities (SLD) might be falsely accused of poor test motivation due to actual but impaired learning of basic sequences. This study examined the specificity of the AST by reviewing performance of 83 SLD adolescents. Anywhere from 22 to 41% of SLD adolescents investing good effort failed one or more of the tasks included in the AST, and those with lower intelligence scores had higher rates of failure. Clinicians should therefore be cautious if using this PVT with individuals who have a documented history of reading, learning, or intellectual problems.

Detecting Invalid Performance in Youth with Traumatic Brain Injury Using the Child and Adolescent Memory Profile (ChAMP) Lists Subtest Abstract Background Neuropsychological assessment must include determinants of validity. This study sought to develop an embedded performance validity indicator for the Child and Adolescent Memory Profile (ChAMP) Lists verbal memory subtest. Methods Children and adolescents (N = 103; mean age = 14.6 years, SD = 2.4, range = 8–18) who were on average 25 weeks (SD = 15.1) post-traumatic brain injury (TBI; 85% mild and 15% moderate-severe) were administered ChAMP Lists and two stand-alone performance validity tests (PVTs; Test of Memory Malingering; Medical Symptom Validity Test). Nineteen patients were deemed to have invalid performance defined as failure on both PVTs. Binary logistic regression and classification statistics were used to determine a cutoff score for invalid performance on ChAMP Lists using failure on two PVTs as the criterion. Results Invalid performance was not associated with demographics, injury type, or time since injury, but was significantly correlated with ChAMP Lists scaled scores. Only ChAMP Lists Recognition predicted validity grouping and had excellent discrimination (area under the curve of 93%). A cutoff scaled score of 7 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 79% while maintaining specificity at 91%. A more stringent cutoff score of 5 or less on ChAMP Lists Recognition achieved sensitivity for invalid performance at 63% with specificity at 95%. Conclusion This study yields a promising embedded performance validity indicator for ChAMP Lists Recognition with good sensitivity and excellent specificity for detecting invalid performance in youth with TBI.

Why Children Fail the Test of Memory Malingering: Review of False Positive Performance in Pediatric Studies Abstract Rationale The Test of Memory Malingering (TOMM) is a commonly utilized performance validity test currently recommended for pediatric use with children as young as 5 years of age. Yet, a small sample of children struggles to pass the TOMM due to true cognitive difficulties. The systematic search and review identified the reported cases of false positive and overall failing TOMM performance in children. The goal of this project was to increase the understanding of the cognitive constructs and minimum cognitive abilities necessary for children to pass the TOMM. The secondary goal was to use the existing data to suggest clinical guidelines related to use of the TOMM with children. Methods and Results A comprehensive search of PubMed/MEDLINE, EMBASE, Web of Science, and PsycINFO was conducted, returning an initial 12,052 results. After duplicate articles were removed, 10,583 remained; 61 were evaluated for eligibility and 22 were included as our final sample. Results suggested that false positives were observed in children with low IQ, memory issues, complex medical presentation, and younger children. Conclusions Without relevant, quality validation and normative studies, the TOMM should not be used clinically with young children or children suspected of having significant cognitive issues. Failing performance on the TOMM does not necessarily indicate poor effort or invalidate the neuropsychological profile. Instead, it may be reflective of other factors, particularly in children below age 6, children with lower intellectual abilities (especially FSIQ ≤ 75), children with multiple diagnoses, or children with more severe neurological diagnoses. Clinical recommendations are also discussed.

The Rey-Osterrieth Complex Figure: a Useful Measure of Organizational Skills for Adolescents with ADHD? Abstract Deficits in organization, time management, and planning (OTMP) abilities are common in adolescents with attention-deficit/hyperactivity disorder (ADHD) and contribute to impairment. Assessment of these skills is vital, but few measures have been validated for youth with ADHD. The Rey-Osterrieth Complex Figure (ROCF) task is frequently used in research and clinical settings despite limited validity evidence. The present study evaluated whether ROCF performance, as scored via the Boston Qualitative Scoring System, exhibited validity as a measure of OTMP skills in a large (N = 285) sample of adolescents comprehensively diagnosed with ADHD. ROCF performance exhibited minimal associations with measures of OTMP, executive functioning, or aspects of academic impairment affected by OTMP abilities; all correlations were nonsignificant after accounting for the influence of intelligence. Further, ROCF task performance did not differ by ADHD presentation or medication status. Correlations with other variables that may be confounded with ROCF performance (anxiety symptoms, depressive symptoms, parent education) also demonstrated nonsignificant correlations with all BQSS scores. The ROCF may not adequately capture OTMP abilities of adolescents with ADHD; future directions for the assessment of OTMP skills are discussed.