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Journal of Dental Sciences Oct 2023Twin studies are crucial to assess the relative contribution of genetic and environmental factors. This study was conducted to evaluate association between deleterious...
ABSTRACT BACKGROUND/PURPOSE
Twin studies are crucial to assess the relative contribution of genetic and environmental factors. This study was conducted to evaluate association between deleterious oral habits and dental caries-periodontal parameters among Turkish twins.
MATERIALS AND METHODS
The study comprised 143 pairs of dizygotic (DZ) twins and 59 pairs of monozygotic (MZ) twins aged 3-15 years. Twins were examined for dental caries, plaque index, gingival index, bleeding on probing and deleterious oral habits. Mann Whitney U test was used to examine the data.
RESULTS
The MZ twin pairs consisted of 60 male and 58 female twin pairs, whereas the DZ twin pairs consisted of 144 male and 142 female. The mean age of the twins was 9.63 ± 3.0 in MZ twins and 9.47 ± 3.2 in DZ twins. The mean DMFS value of MZ twins with bruxism is higher than those of MZ twins without bruxism ( = 0.001). The mean DMFS value of DZ twins with pacifier sucking is lower than those without ( = 0.007). A statistically significant difference was found between MZ twins with and without nail biting in terms of bleeding on probing and dmfs values ( = 0.035; = 0.012). The mean values of the plaque index increased due to the mouth breathing in DZ twins ( = 0.024). Regarding the bleeding on probing, there was a statistically significant difference between MZ twins with and without atypical swallowing ( = 0.016).
CONCLUSION
These findings suggest that dental caries-periodontal parameters are similarly affected by deleterious oral habits in MZ and DZ twins.
PubMed: 37799885
DOI: 10.1016/j.jds.2023.05.009 -
The Journal of Allergy and Clinical... Aug 2023Parent-child saliva contact during infancy might stimulate the child's immune system for effective allergy prevention. However, few studies have investigated its...
BACKGROUND
Parent-child saliva contact during infancy might stimulate the child's immune system for effective allergy prevention. However, few studies have investigated its relation to allergy development in school-age children.
OBJECTIVE
We sought to investigate the relationship between parent-child saliva contact during infancy and allergy development at school age.
METHODS
We performed a large multicenter cross-sectional study involving Japanese school children and their parents. The self-administered questionnaires including questions from the International Study of Asthma and Allergies in Childhood were distributed to 3570 elementary and junior high school children in 2 local cities. Data were analyzed for the relationship between saliva contact during infancy (age <12 months) and the risk of allergy development, specifically eczema, allergic rhinitis, and asthma. For detailed Methods, please see the Methods section in this article's Online Repository at www.jacionline.org.
RESULTS
The valid response rate was 94.7%. The mean and median age of children was 10.8 ± 2.7 and 11 (interquartile range, 9-13) years, respectively. Saliva contact via sharing eating utensils during infancy was significantly associated with a lower risk of eczema (odds ratio, 0.53; 95% CI, 0.34-0.83) at school age. Saliva contact via parental sucking of pacifiers was significantly associated with a lower risk of eczema (odds ratio, 0.24; 95% CI, 0.10-0.60) and allergic rhinitis (odds ratio, 0.33; 95% CI, 0.15-0.73), and had a borderline association with the risk of asthma in school-age children.
CONCLUSIONS
Saliva contact during infancy may reduce the risk of developing eczema and allergic rhinitis in school-age children.
PubMed: 37779525
DOI: 10.1016/j.jacig.2023.100108 -
Journal of Family Medicine and Primary... Aug 2023Sudden infant death syndrome (SIDS) is a leading cause of infant mortality all over the world. Mortality due to SIDS can be averted by educating families and caretakers...
Awareness of sudden infant death syndrome and its associated risk factors among Saudi mothers attending well-baby clinics at PHC, PSMMC, Riyadh, Saudi Arabia: A cross-sectional study.
INTRODUCTION
Sudden infant death syndrome (SIDS) is a leading cause of infant mortality all over the world. Mortality due to SIDS can be averted by educating families and caretakers about safe practices for putting infants to sleep. However, the knowledge, attitude, and practices of mothers while putting the infant to sleep is a gray areas in literature.
AIMS AND OBJECTIVES
The objectives of the study were to measure the knowledge and awareness about SIDS and its associated risk factors practiced among Saudi mothers attending well-baby clinics in Saudi Arabia to develop appropriate educational program-based interventions for safe practices of infant care.
METHODS
This cross-sectional study was carried out among 385 mothers attending well-baby clinics of primary health care (PHC) and prince sultan military medical city (PSMMC) in Riyadh Saudi Arabia. Information was captured on sociodemographic characteristics, the health status of mothers and infants, knowledge, attitude, and practice followed by mothers while putting infants to sleep.
RESULTS
From a total number of 385 responses, 350 participants were eventually included in the final sample due to the incompletion of the questionnaire of 350 mothers; only 26% ( = 93) mothers had heard of SIDS. However, 259 mothers were willing to attend the awareness session. Only 94 mothers had knowledge as well as practicing the correct behavior of putting the infant to sleep on the back referred to as "good behavior concordant pairs." Similarly, other good practices include not co-sharing a bed with the infant, removing pillows, blankets, and other wedged objects, using a pacifier, breastfeeding the infant during sleep, not using multiple quilts, not covering the infant's head with a quilt, not using a head cap. The number of good behavior concordant pairs (in green) were 124, 38, 56, 98, 18, 117, and 68 respectively.
CONCLUSIONS
The rate of knowledge and practice for good behavior regarding SIDS was low among Saudi mothers in Riyadh Saudi Arabia. SIDS-related deaths can be averted by improving the understanding of SIDS risk reduction practices among mothers by using health promotion strategies.
PubMed: 37767455
DOI: 10.4103/jfmpc.jfmpc_1768_22 -
Neurourology and Urodynamics Jan 2024Cystometry is essential for evaluating bladder function. However, children may react negatively to the physical pain of urethral catheterization or anxiety and fear of... (Randomized Controlled Trial)
Randomized Controlled Trial
INTRODUCTION
Cystometry is essential for evaluating bladder function. However, children may react negatively to the physical pain of urethral catheterization or anxiety and fear of an unfamiliar environment. These pain responses during the cystometry procedure may interfere with the cystometry procedure and make it difficult to interpret the cystometry result. In this regard, the International Children's Continence Society has advised performing cystometry while holding infants as an effective nonpharmacological pain management method, but there is insufficient evidence to support this.
PURPOSE
This study aimed to analyze the effect of parental holding on reducing pain in children during cystometry.
METHODS
This was an experimental study in a randomized controlled pre-post test design. A total of 64 participants aged 6-18 months were recruited. During cystometry, the participants in the experimental group were placed on the parent's laps and held in the parents' arms. The participants in the control group were laid down on the examination table. During the procedure, both groups of parents were allowed to touch their children in all ways except holding them and to use the pacifier if they wished. The behavioral (face, leg, activity, cry, consolability scale) and physiological (oxygen saturation and heart rate) pain responses were measured at three-time points (immediately, 3, and 10 min after urethral catheter insertion).
RESULTS
Comparing the two groups, in the experimental group, the behavioral pain response at 3 min after urethral catheter insertion (t = -2.165, p = 0.034) and 10 min after (t = -3.155, p = 0.002) was decreased compared with that immediately after urethral catheter insertion. In addition, oxygen saturation increased more (t = 2.021, p = 0.048), and the heart rate decreased more (t = -2.033, p = 0.047) at 10 min than at 3 min after urethral catheter insertion in the experimental group.
CONCLUSIONS
This study revealed that parental holding could reduce pain responses during cystometry in children. Further research is required to confirm the applicability and usefulness of parental holding during cystometry.
Topics: Infant; Child; Humans; Child, Preschool; Pain; Urinary Catheterization; Heart Rate; Anxiety; Parents
PubMed: 37746884
DOI: 10.1002/nau.25284 -
PloS One 2023Waste of polymer products, especially plastics, in nature has become a problem that caught the awareness of the general public during the last decade. The macro- and...
Waste of polymer products, especially plastics, in nature has become a problem that caught the awareness of the general public during the last decade. The macro- and micro polymers in nature will be broken down by naturally occurring events such as mechanical wear and ultra-violet (UV) radiation which will result in the generation of polymeric particles in the nano-size range. We have recently shown that polystyrene and high-density polyethylene macroplastic can be broken down into nano-sized particles by applying mechanical force from an immersion blender. In this article, we show that particles in the nano-size range are released from silicone and latex pacifiers after the same treatment. Additionally, boiling the pacifiers prior to the mechanical breakdown process results in an increased number of particles released from the silicone but not the latex pacifier. Particles from the latex pacifier are acutely toxic to the freshwater filter feeding zooplankter Daphnia magna.
Topics: Animals; Latex; Microplastics; Polymers; Daphnia; Silicones
PubMed: 37703259
DOI: 10.1371/journal.pone.0289377 -
International Journal of Audiology Sep 2023Describe the ear and hearing outcomes in Aboriginal infants in an Australian urban area.
OBJECTIVE
Describe the ear and hearing outcomes in Aboriginal infants in an Australian urban area.
DESIGN
Aboriginal infants enrolled in the prospective cohort study had ear health screenings at ages 2-4, 6-8 and 12-18 months and audiological assessment at ∼12 months of age. Sociodemographic, environmental characteristics, otoscopy, otoacoustic emissions, tympanometry and visual reinforcement audiometry data were collected.
STUDY SAMPLE
125 infants were enrolled in the study; 67 completed audiological assessment, 62, 54, and 58 of whom attended ear screenings at 2-4, 6-8 and 12-18 months.
RESULTS
Of the children that attended the audiological assessment, 36.5%, 50% and 64.3% of infants had otitis media (OM) at 2-4, 6-8 and 12-18 months. Using a 10 dB correction factor, 44.8% of infants had hearing loss (HL) (≥ 25 dB HL) at ∼ 12 months of age. More males (X=5.4 (1df, p = 0.02)) and infants with OM at audiological assessment (X=5.8 (1df, p = 0.02)) had HL. More infants that used a pacifier at 12-18 months of age had HL (X=4.7 (1df, p = 0.03)).
CONCLUSION
Aboriginal infants in an urban area have high rates of HL and OM, which requires early surveillance and timely treatment to reduce the medical and developmental impacts of OM and HL.
PubMed: 37694733
DOI: 10.1080/14992027.2023.2252177 -
Ciencia & Saude Coletiva Sep 2023The return to work of lactating mothers has been identified as an important risk factor for breastfeeding interruption. We proposed to identify factors associated with...
The return to work of lactating mothers has been identified as an important risk factor for breastfeeding interruption. We proposed to identify factors associated with breastfeeding abandonment in the first month after return. 252 women working at a hospital who had children aged 12 to 36 months and who were still breastfeeding when returned to work answered a questionnaire containing questions on sociodemographic characteristics, pregnancy, childbirth, breastfeeding and work-related factors. The associations were estimated using adjusted prevalence ratio (aPR), calculated with the hierarchical Poisson multivariable regression model. The following factors showed a significant association with breastfeeding abandonment: using a pacifier (aPR 4.58), cohabiting with someone other than partner (aPR 3.77), having no intention or having doubts about maintaining breastfeeding after returning (aPR 3.39), having a college degree (aPR 2.66), having no support from the infant's caregiver (aPR 2.26), and infant being older when the woman returned to work (PR 1.16 for each additional month of infant age). Longer duration of exclusive breastfeeding was a protective factor (aPR 0.990). Most of the factors associated with discontinuation of breastfeeding in the first month after the mother's return to work are not directly related to the woman's work.
Topics: Child; Infant; Pregnancy; Humans; Female; Breast Feeding; Lactation; Mothers; Return to Work; Delivery, Obstetric
PubMed: 37672461
DOI: 10.1590/1413-81232023289.19162022 -
Radiology Sep 2023Background At follow-up CT after left atrial appendage occlusion (LAAO), hypoattenuation thickening (HAT) on the atrial aspect of the device is a common finding but the...
Background At follow-up CT after left atrial appendage occlusion (LAAO), hypoattenuation thickening (HAT) on the atrial aspect of the device is a common finding but the clinical implications require further study. Purpose To assess the association of HAT grade at follow-up CT with clinical characteristics and outcomes in patients who underwent LAAO. Materials and Methods This prospective study included consecutive participants with atrial fibrillation and who were at high risk for stroke (CHADS-VASc score ≥4) who underwent LAAO and were administered pacifier or nonpacifier devices at two French medical centers between January 2012 and November 2020. Postprocedure CT images were evaluated by two radiologists in consensus and device-specific interpretation algorithms were applied to classify HAT as low grade (low suspicion of thrombosis) or high grade (high suspicion of thrombosis). The association between HAT grade and clinical characteristics was assessed using multinomial logistic regression, and variables associated with risk of stroke were assessed using a Cox proportional hazard model. Results This study included 412 participants (mean age, 76 years ± 8 [SD]; 284 male participants) who underwent follow-up CT at a mean of 4.2 months ± 1.7 after LAAO. Low-grade and high-grade HAT were depicted in 98 of 412 (23.8%) and 21 of 412 (5.1%) participants, respectively. High-grade HAT was associated with higher odds of antithrombotic drug discontinuation during follow-up (odds ratio, 9.5; 95% CI: 3.1, 29.1; < .001), whereas low-grade HAT was associated with lower odds of persisting left atrial appendage patency (odds ratio, 0.46; 95% CI: 0.27, 0.79; = .005). During a median follow-up of 17 months (IQR, 11-41 months), stroke occurred in 24 of 412 (5.8%) participants. High-grade HAT was associated with stroke (hazard ratio, 4.6; 95% CI: 1.5, 14.0; = .008) and low-grade HAT ( = .62) was not. Conclusion Low-grade HAT was a more common finding at CT performed after LAAO CT (24%) than was high-grade HAT (5%), but it was associated with more favorable outcomes than high-grade HAT, which was associated with higher stroke risk. © RSNA, 2023 See also the editorial by Choe in this issue.
Topics: Humans; Male; Aged; Atrial Appendage; Prospective Studies; Stroke; Heart Atria; Tomography, X-Ray Computed
PubMed: 37668517
DOI: 10.1148/radiol.230462 -
Journal of Human Lactation : Official... Nov 2023Although WhatsApp can be used to provide continuous lactation support, there are few studies on this subject. (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Although WhatsApp can be used to provide continuous lactation support, there are few studies on this subject.
RESEARCH AIMS
To determine the influence of lactation support provided through WhatsApp on the duration and exclusivity of breastfeeding, initiation of complementary feeding, breastfeeding problems, breastfeeding difficulties score, and the use of bottles and pacifiers.
METHODS
We conducted a randomized controlled trial assessing the efficacy of education and support provided through the cell phone based WhatsApp application. There were 129 primiparous participants recruited while attending a Baby-Friendly Hospital in Istanbul, Turkey. Participants were randomized to intervention ( = 64) and control ( = 65) groups. All participants received the same routine postpartum breastfeeding education in the hospital, and the intervention group received additional continuous breastfeeding education for 6 months. For both groups, data was collected by telephone interview on Days 7 and 15, and Months 1, 2, 4, and 6 months. -tests were used to assess inter-group differences in duration of exclusivity of breastfeeding. Mixed-model ANOVA was used to compare breastfeeding difficulties scores. Chi-square tests were used to compare breastfeeding problems, feeding practices, and the proportion of the use of bottles and pacifiers.
RESULTS
The mean duration of exclusive breastfeeding for groups receiving breastfeeding support was higher (4.75, = 1.72) than that of the control group (2.21, = 1.98; = 0.001). The change in the mean breastfeeding difficulties severity score between the initial and final measurements (17.03, = 8.66) was more in the intervention group than the control group (11.42, = 10.34, = 4.081, = 0.001). The proportion of exclusive breastfeeding in the 6th month was higher in the intervention group (62.5%) than in the control group (10.8%; = 0.001).
CONCLUSIONS
The use of cellphone applications are accessible to both patients and health workers and offer a low-cost alternative for providing uninterrupted breastfeeding support.
Topics: Female; Humans; Infant; Breast Feeding; Counseling; Lactation; Postnatal Care; Postpartum Period; Infant, Newborn
PubMed: 37646262
DOI: 10.1177/08903344231192948 -
The Cochrane Database of Systematic... Aug 2023Pain in the neonate is associated with acute behavioural and physiological changes. Cumulative pain is associated with morbidities, including adverse neurodevelopmental... (Review)
Review
BACKGROUND
Pain in the neonate is associated with acute behavioural and physiological changes. Cumulative pain is associated with morbidities, including adverse neurodevelopmental outcomes. Studies have shown a reduction in changes in physiological parameters and pain score measurements following pre-emptive analgesic administration in neonates experiencing pain or stress. Non-pharmacological measures (such as holding, swaddling and breastfeeding) and pharmacological measures (such as acetaminophen, sucrose and opioids) have been used for analgesia. This is an update of a review first published in 2006 and updated in 2012.
OBJECTIVES
The primary objective was to evaluate the effectiveness of breastfeeding or supplemental breast milk in reducing procedural pain in neonates. The secondary objective was to conduct subgroup analyses based on the type of control intervention, gestational age and the amount of supplemental breast milk given.
SEARCH METHODS
We searched CENTRAL, MEDLINE, Embase, CINAHL and trial registries (ICTRP, ISRCTN and clinicaltrials.gov) in August 2022; searches were limited from 2011 forwards. We checked the reference lists of included studies and relevant systematic reviews.
SELECTION CRITERIA
We included randomised controlled trials (RCTs) or quasi-RCTs of breastfeeding or supplemental breast milk versus no treatment/other measures in neonates. We included both term (≥ 37 completed weeks postmenstrual age) and preterm infants (< 37 completed weeks' postmenstrual age) up to a maximum of 44 weeks' postmenstrual age. The study must have reported on either physiological markers of pain or validated pain scores.
DATA COLLECTION AND ANALYSIS
We assessed the methodological quality of the trials using the information provided in the studies and by personal communication with the authors. We extracted data on relevant outcomes, estimated the effect size and reported this as a mean difference (MD). We used the GRADE approach to assess the certainty of evidence.
MAIN RESULTS
Of the 66 included studies, 36 evaluated breastfeeding, 29 evaluated supplemental breast milk and one study compared them against each other. The procedures conducted in the studies were: heel lance (39), venipuncture (11), intramuscular vaccination (nine), eye examination for retinopathy of prematurity (four), suctioning (four) and adhesive tape removal as procedure (one). We noted marked heterogeneity in the control interventions and pain assessment measures amongst the studies. Since many studies included multiple arms with breastfeeding/supplemental breast milk as the main comparator, we were not able to synthesise all interventions together. Individual interventions are compared to breastfeeding/supplemental breast milk and reported. The numbers of studies/participants presented with the findings are not taken from pooled analyses (as is usual in Cochrane Reviews), but are the overall totals in each comparison. Overall, the included studies were at low risk of bias except for masking of intervention and outcome assessment, where nearly one-third of studies were at high risk of bias. Breastfeeding versus control Breastfeeding may reduce the increase in heart rate compared to holding by mother, skin-to-skin contact, bottle feeding mother's milk, moderate concentration of sucrose/glucose (20% to 33%) with skin-to-skin contact (low-certainty evidence, 8 studies, 784 participants). Breastfeeding likely reduces the duration of crying compared to no intervention, lying on table, rocking, heel warming, holding by mother, skin-to-skin contact, bottle feeding mother's milk and moderate concentration of glucose (moderate-certainty evidence, 16 studies, 1866 participants). Breastfeeding may reduce percentage time crying compared to holding by mother, skin-to-skin contact, bottle feeding mother's milk, moderate concentration sucrose and moderate concentration of sucrose with skin-to-skin contact (low-certainty evidence, 4 studies, 359 participants). Breastfeeding likely reduces the Neonatal Infant Pain Scale (NIPS) score compared to no intervention, holding by mother, heel warming, music, EMLA cream, moderate glucose concentration, swaddling, swaddling and holding (moderate-certainty evidence, 12 studies, 1432 participants). Breastfeeding may reduce the Neonatal Facial Coding System (NFCS) score compared to no intervention, holding, pacifier and moderate concentration of glucose (low-certainty evidence, 2 studies, 235 participants). Breastfeeding may reduce the Douleur Aigue Nouveau-né (DAN) score compared to positioning, holding or placebo (low-certainty evidence, 4 studies, 709 participants). In the majority of the other comparisons there was little or no difference between the breastfeeding and control group in any of the outcome measures. Supplemental breast milk versus control Supplemental breast milk may reduce the increase in heart rate compared to water or no intervention (low-certainty evidence, 5 studies, 336 participants). Supplemental breast milk likely reduces the duration of crying compared to positioning, massage or placebo (moderate-certainty evidence, 11 studies, 1283 participants). Supplemental breast milk results in little or no difference in percentage time crying compared to placebo or glycine (low-certainty evidence, 1 study, 70 participants). Supplemental breast milk results in little or no difference in NIPS score compared to no intervention, pacifier, moderate concentration of sucrose, eye drops, gentle touch and verbal comfort, and breast milk odour and verbal comfort (low-certainty evidence, 3 studies, 291 participants). Supplemental breast milk may reduce NFCS score compared to glycine (overall low-certainty evidence, 1 study, 40 participants). DAN scores were lower when compared to massage and water; no different when compared to no intervention, EMLA and moderate concentration of sucrose; and higher when compared to rocking or pacifier (low-certainty evidence, 2 studies, 224 participants). Due to the high number of comparator interventions, other measures of pain were assessed in a very small number of studies in both comparisons, rendering the evidence of low certainty. The majority of studies did not report on adverse events, considering the benign nature of the intervention. Those that reported on adverse events identified none in any participants. Subgroup analyses were not conducted due to the small number of studies.
AUTHORS' CONCLUSIONS
Moderate-/low-certainty evidence suggests that breastfeeding or supplemental breast milk may reduce pain in neonates undergoing painful procedures compared to no intervention/positioning/holding or placebo or non-pharmacological interventions. Low-certainty evidence suggests that moderate concentration (20% to 33%) glucose/sucrose may lead to little or no difference in reducing pain compared to breastfeeding. The effectiveness of breast milk for painful procedures should be studied in the preterm population, as there are currently a limited number of studies that have assessed its effectiveness in this population.
Topics: Female; Infant; Infant, Newborn; Humans; Milk, Human; Breast Feeding; Pain, Procedural; Pain; Acetaminophen
PubMed: 37643989
DOI: 10.1002/14651858.CD004950.pub4