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Clinical Research in Cardiology :... Jun 2023Device-related thrombus (DRT) after left atrial appendage occlusion (LAAO) is potentially linked to adverse events. Although clinical reports suggest an effect of the...
BACKGROUND
Device-related thrombus (DRT) after left atrial appendage occlusion (LAAO) is potentially linked to adverse events. Although clinical reports suggest an effect of the device type and position on the DRT risk, in-depth studies of its mechanistic basis are needed. This in silico study aimed to assess the impact of the position of non-pacifier (Watchman) and pacifier (Amulet) LAAO devices on surrogate markers of DRT risk.
METHODS
The LAAO devices were modeled with precise geometry and virtually implanted in different positions into a patient-specific left atrium. Using computational fluid dynamics, the following values were quantified: residual blood, wall shear stress (WSS) and endothelial cell activation potential (ECAP).
RESULTS
In comparison to an ostium-fitted device position, deep implantation led to more residual blood, lower average WSS and higher ECAP surrounding the device, especially on the device's atrial surface and the surrounding tissue, suggesting increased risk for potential thrombus. For the non-pacifier device, an off-axis device orientation resulted in even more residual blood, higher ECAP and similar average WSS as compared to an ostium-fitted device position. Overall, the pacifier device showed less residual blood, higher average WSS and lower ECAP, compared to the non-pacifier device.
CONCLUSIONS
In this in silico study, both LAAO device type and implant position showed an impact on potential markers of DRT in terms of blood stasis, platelet adhesion and endothelial dysfunction. Our results present a mechanistic basis for clinically observed risk factors of DRT and the proposed in silico model may aid in the optimization of device development and procedural aspects.
PubMed: 37291248
DOI: 10.1007/s00392-023-02228-x -
Acta Paediatrica (Oslo, Norway : 1992) Jul 2023
Topics: Female; Humans; Infant; Breast Feeding; Fear; Pacifiers; Bottle Feeding
PubMed: 37277973
DOI: 10.1111/apa.16780 -
The Journal of Contemporary Dental... Mar 2023The aim of the study was to assess maternal knowledge about oral health practices for children along with oral hygiene perceptions of mothers during pregnancy in the...
AIM
The aim of the study was to assess maternal knowledge about oral health practices for children along with oral hygiene perceptions of mothers during pregnancy in the city of Thessaloniki, Greece.
MATERIALS AND METHODS
This cross-sectional study was conducted among 300 newly delivered mothers who were admitted to the obstetrician/gynecological (OB/GYN) University Clinic in Thessaloniki, Greece, to give birth. A three-part, self-reported, 40-item questionnaire was designed, collecting socioeconomic data, perceptions, and practices regarding maternal oral hygiene during pregnancy and their knowledge in relation to children's oral health. Collected data were recorded, tabulated, and statistically analyzed with SPSS (Version 24.0), and p < 0.05 was accepted as statistically significant.
RESULTS
The sample consisted of mainly Greek, married, university alumni mothers less than 35 years of age. Self-reports of oral hygiene practices during gestation were sufficient but an inadequate level of regular dental visits was recorded. Poor knowledge was equally noted, regarding children's oral health, in the domains of fluoride toothpaste usage, the age of the first dental visit, supervised toothbrushing, nighttime breastfeeding, potential hazards of pacifier use, and thumb sucking. All factors were significantly associated with the mothers' education level ( < 0.05).
CONCLUSION
Newly-delivered mothers presented with a lack of knowledge regarding mother/caregiver-related risk factors associated with early childhood caries (ECC), the timing of establishing a dental home, and misconceptions about the safety of dental visits during pregnancy.
CLINICAL SIGNIFICANCE
Healthcare professionals interacting with pregnant women or young mothers are a vital element to bridge the existing gap in knowledge and assist those socially and educationally deprived.
Topics: Humans; Female; Child; Child, Preschool; Pregnancy; Mothers; Oral Health; Oral Hygiene; Greece; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Dental Caries
PubMed: 37272133
DOI: 10.5005/jp-journals-10024-3494 -
PloS One 2023Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high...
BACKGROUND
Pacifier use can interfere with nurturing care practices such as breastfeeding, soothing, and sleeping. Due to contradicting beliefs, recommendations, and the high frequency of pacifier use, understanding its associations may support shaping equitable public health recommendations. This study explored the socio-demographic, maternal, and infant characteristics associated with pacifier use among six-months old infants in Clark County, Nevada.
METHOD
Cross-sectional survey was conducted in 2021 with a sample of mothers (n = 276) of infants under six months old in Clark County, Nevada. Participants were recruited through advertisements in birth, lactation, pediatric care centers, and social media. We used binomial and multinomial logistic models to assess the association between pacifier use and the age of pacifier introduction, respectively, with household, maternal, infant, healthcare characteristics, and feeding and sleeping practices.
RESULTS
More than half of the participants offered pacifiers (60.5%). Pacifier use was higher among low-income households (OR (95% CI) 2.06 (0.99-4.27)), mothers who identified as non-Hispanic (OR (95% CI) 2.09 (1.22-3.59)), non-first-time mothers (OR (95% CI) 2.09 (1.11-3.05)), and bottle-feeding infants (OR (95% CI) 2.76 (1.35-5.65)). Compared to those who did not introduce a pacifier, non-Hispanic mothers (RRR (95% CI) 2.34 (1.30-4.21)) and bottle-fed infants (RRR (95% CI) 2.71 (1.29-5.69)) had a higher risk of introducing pacifier within two weeks. Likewise, infants living in food insecure households (RRR (95% CI) 2.53 (0.97-6.58)) and mothers who have more than one child (RRR (95% CI) 2.44 (1.11-5.34)) had a higher risk of introducing a pacifier after two weeks.
CONCLUSION
Pacifier use is independently associated with maternal income, ethnicity, parity, and bottle feeding among six-month-old infants living in Clark County, Nevada. Household food insecurity increased the relative risk of introducing a pacifier after two weeks. Qualitative research on pacifier use among families with diverse ethnic/racial backgrounds is needed to improve equitable interventions.
Topics: Female; Pregnancy; Child; Humans; Infant; Pacifiers; Nevada; Cross-Sectional Studies; Breast Feeding; Mothers; Demography
PubMed: 37104304
DOI: 10.1371/journal.pone.0285097 -
Cardiac Electrophysiology Clinics Jun 2023Left atrial appendage closure aims to eliminate the stasis component of Virchow triad by eliminating a cul-de-sac that favors thrombosis, particularly when atrial... (Review)
Review
Left atrial appendage closure aims to eliminate the stasis component of Virchow triad by eliminating a cul-de-sac that favors thrombosis, particularly when atrial contractility becomes inefficient, such as in atrial fibrillation. Left atrial appendage closure devices have a common objective of sealing the appendage completely, with device stability and avoidance of device thrombosis. Two main device designs have been used to perform left atrial appendage closure: those that use a pacifier design (lobe + disk) and those that use a plug (single lobe) design. This review highlights the potential features and benefits of the single-lobe devices.
Topics: Humans; Follow-Up Studies; Treatment Outcome; Atrial Appendage; Echocardiography, Transesophageal; Atrial Fibrillation; Thrombosis; Cardiac Catheterization
PubMed: 37076231
DOI: 10.1016/j.ccep.2023.01.007 -
Journal of Bronchology & Interventional... Jan 2024The Galaxy System (Noah Medical) is a novel robotic endoluminal platform using electromagnetic navigation combined with integrated tomosynthesis technology and augmented...
BACKGROUND
The Galaxy System (Noah Medical) is a novel robotic endoluminal platform using electromagnetic navigation combined with integrated tomosynthesis technology and augmented fluoroscopy. It provides intraprocedural imaging to correct computerized tomography (CT) to body divergence and novel confirmation of tool-in-lesion (TIL). The primary aim of this study was to assess the TIL accuracy of the robotic bronchoscope with integrated digital tomosynthesis and augmented fluoroscopy.
METHODS
Four operators conducted the experiment using 4 pigs. Each physician performed between 4 and 6 nodule biopsies for 20 simulated lung nodules with purple dye and a radio pacifier. Using Galaxy's "Tool-in-Lesion Tomography (TOMO+)" with augmented fluoroscopy, the physician navigated to the lung nodules, and a tool (needle) was placed into the lesion. TIL was defined by the needle in the lesion determined by cone-beam CT.
RESULTS
The lung nodule's average size was 16.3 ± 0.97 mm and was predominantly in the lower lobes (65%). All 4 operators successfully navigated to all (100%) of the lesions in an average of 3 minutes and 39 seconds. The median number of tomosynthesis sweeps was 3 and augmented fluoroscopy was utilized in most cases (17/20 or 85%). TIL after the final TOMO sweep was 95% (19/20) and tool-touch-lesion was 5% (1/20). Biopsy yielding purple pigmentation was also 100% (20/20).
CONCLUSION
The Galaxy System demonstrated successful digital TOMO confirmed TIL success in 95% (19/20) of lesions and tool-touch-lesion in 5% (1/20) as confirmed by cone-beam CT. Successful diagnostic yield was achieved in 100% (20/20) of lesions as confirmed by intralesional pigment acquisition.
Topics: Humans; Animals; Swine; Lung Neoplasms; Bronchoscopy; Robotic Surgical Procedures; Lung; Electromagnetic Phenomena
PubMed: 37072895
DOI: 10.1097/LBR.0000000000000923 -
Archives of Orthopaedic and Trauma... Sep 2023This study prospectively investigated the pain response and physiological parameters [heart rate (HR) and oxygen saturation (SpO)] during sequential casting in bilateral...
INTRODUCTION
This study prospectively investigated the pain response and physiological parameters [heart rate (HR) and oxygen saturation (SpO)] during sequential casting in bilateral clubfoot. Additionally, it explored the role of non-nutritive sucking and human care contact on the observed responses during casting.
METHODS
Subjects were allotted to control group (Group A with no intervention) and two intervention groups (Group B: non-nutritive sucking intervention, Group C: human care contact intervention). Neonatal Infant Pain Score (NIPS), heart rate (HR), and oxygen saturation (SpO) were used to assess the response.
RESULTS
The three groups matched in age and gender characteristics of the participants. Pain response was noted across all groups. The left foot demonstrated a statistically significant preexisting tachycardia which rose further during casting (p < 0.01). Intergroup comparisons revealed that the alteration for NIPS during casting was in following sequence (Group A > C > B, p < 0.00001). The effect of interventions offered in Group B and C lasted in the post-cast period as well (B > C).
CONCLUSION
The clubfoot child exhibited moderate pain response during casting of both feet. A tachycardia was noted prior to initiation of second cast which further exaggerated with subsequent cast. Pacifier (non-nutritive sucking) intervention produced better control of pain response than human care contact during casting for both feet.
Topics: Infant; Infant, Newborn; Humans; Child; Clubfoot; Casts, Surgical; Treatment Outcome; Pain
PubMed: 37052665
DOI: 10.1007/s00402-023-04877-z -
Journal of Clinical Medicine Mar 2023Sleep bruxism (SB) is a masticatory muscle activity during sleep, and its clinical manifestation in young children is still unclear. The aim of the present study was to...
Sleep bruxism (SB) is a masticatory muscle activity during sleep, and its clinical manifestation in young children is still unclear. The aim of the present study was to evaluate the role of anamnestic information in predicting possible SB in children aged 4-12 years. In a cross-sectional retrospective exploratory study, the dental files of 521 children were examined with regard to the following anamnestic information: gender, age, medical conditions associated with ear, nose, and throat (ENT), respiratory disorders, use of methylphenidate (Ritalin), oral habits, and bruxing during sleep. A child was defined as presenting possible SB when a positive report was received from parents regarding such behavior (SB positive, No. = 84). There were no age- and/or gender-wise differences between SB-positive children and children whose parents did not report SB behavior (SB negative). SB-positive children suffered more from ENT and respiratory disorders than children without SB. Additionally, the use of pacifiers/finger sucking, as well as snoring, were more common among SB-positive children as compared to their SB-negative counterparts (Chi-square). The variables which were found to significantly increase the odds of possible SB in children were mouth breathing, ENT problems, and use of a pacifier or finger sucking (forward stepwise logistic regression). Clinicians should look for clinical signs of possible SB in children whose anamnesis reveals one or more of these anamnestic signals.
PubMed: 37048648
DOI: 10.3390/jcm12072564 -
International Journal of Clinical... 2023To determine the presence of and and their association with extrinsic and intrinsic variables in 6-18-month-old infants.
AIM
To determine the presence of and and their association with extrinsic and intrinsic variables in 6-18-month-old infants.
METHODS
This was an analytical, cross-sectional study of 65 6-18-month-old infants who visited the Centers for Early Childhood in Buenos Aires City. Three groups were established according to the presence of teeth-group I (GI)-edentulous infants, group II (GII)-infants with 1-8 teeth, and group III (GIII)-infants with 9-16 teeth. Data on the variables, diet, use of artificial teats, and oral hygiene were gathered using a self-administered questionnaire. An oral examination was performed according to the International Caries Detection and Assessment System (ICDAS II) criterion. A saliva sample was taken by aspiration with a sterile plastic syringe. Cariogenic (CS) were counted using the adherence test in modified gold broth (AT-MGB). Molecular detection and quantification were performed by quantitative polymerase chain reaction (qPCR) (gtfB, gtfT, and tuf).
RESULTS
A total of 12% of infants received oral hygiene, 38% used bottles, 30% used pacifiers, and 55% had sugar intake. and were detected in 57.1 and 28.6% of the children with caries, respectively. Groups I, II, and III had CS counts of log 2, 3.4, and 3.7, respectively. was detected in 26.7% of GI, 52.9% of GII, and 85.7% of GIII, while was detected in 13.3%, 35.3%, and 57.7%, respectively.
CONCLUSION
The prevalence of was higher than in all groups. The presence of CS was significantly associated with sugar intake. No association was found between and and the presence of caries, hygiene habits, or use of artificial teats.
CLINICAL SIGNIFICANCE
This study supports the role of diet in developing a cariogenic biofilm in children under 2 years of age.
HOW TO CITE THIS ARTICLE
Cornejo CF, Soken LJ, Salgado PA, Detection of and and Their Association with Oral Microbiome Stressors in 6-18-month-old Infants. Int J Clin Pediatr Dent 2023;16(1):68-73.
PubMed: 37020757
DOI: 10.5005/jp-journals-10005-2489