Factors Involved in the Perception of Enamel Dyschromic Lesions—A Questionnaire-Based Study

Dyschromic lesions (DLs) of tooth enamel are common disorders, with multiple etiologies and various clinical forms, that raise public health concerns. This study aimed to determine the factors that influence the perception of DLs and to assess the perceived need for dental treatment in various clinical cases. A paper-based questionnaire with attached images of frontal teeth exhibiting different DLs was distributed to patients, dental students, and dentists. A total of 383 volunteers participated in this study, and their answers were statistically described and analyzed. This study found that in cases with multiple, well-demarcated areas of opacities associated with diffuse opacities on neighboring teeth, most respondents noticed and reported only the most severe lesions, disregarding the minor ones. The contrast of the lesion with the color of the substrate influenced the overall perception and a significant correlation between these two variables was found. However, the color of the DLs did not significantly impact the overall perception of the lesions. A higher overall perception of DLs was significantly correlated with a favorable opinion regarding the need for treatment. Furthermore, gender and medical background were significantly associated with the overall perception of DLs.

Cutaneous allodynia in pediatric and adolescent patients and their mothers: A comparative study

Background Allodynia in adults with migraine is related to disease duration. In pediatric patients with migraine, the same proportion reported allodynia in the first six months of migraine presentation as in prolonged disease. This study examined a possible association between migraine pediatric allodynia and maternal allodynia. Methods We interviewed children with migraine first, and then their mothers, regarding allodynia and headache symptoms. We reviewed hospital charts on pediatric medical background and headache symptoms. Mothers and children older than 11 years filled the Strengths and Difficulties Questionnaire. Results Ninety-eight children with migraine, mean age 13.49 ± 3.1 years, and their mothers, mean age 43.5 ± 6.2 years were recruited to the study. Pediatric allodynia was associated with maternal allodynia; the latter was reported in 82.8% of children with allodynia versus 35.3% of children without allodynia (p < 0.001). Maternal migraine was reported in 44 (68.7%) of children with allodynia versus 16.3% without allodynia, p < 0.001. No difference was found in Strengths and Difficulties Questionnaire scores, between children with and without allodynia. Conclusions Pediatric allodynia is associated with maternal migraine. Genetic and environmental factors such as maternal behavior may contribute to reduced pain threshold.

Asthma, allergies and respiratory symptoms in different activity groups of swimmers exercising in swimming halls

Background Respiratory symptoms are common in competitive swimmers. However, among these and in swimmers at other activity levels the swimming distance, the total spent time in swimming halls and their medical background varies. Our objectives were, first, to assess their medical histories and the associations with respiratory symptoms among swimmers in different activity groups and then second, to study the pulmonary function findings and related medications in competitive swimmers who exercise in swimming hall environments the most. Methods First, 1118 participants consisting of 133 competitive-, 734 fitness- and 251 occasional swimmers answered questionnaires concerning their medical background, their respiratory symptoms in connection to swimming distance and their amount of time spent in swimming halls. Secondly, in 130 competitive swimmers, pulmonary function was tested by spirometry and a specific questionnaire was used to assess respiratory symptoms, medical histories and prescribed medication. Results Respiratory symptoms were reported by 18% of the studied swimmers. Competitive swimmers had significantly more symptoms than fitness- and occasional swimmers. Naturally competitive swimmers swum more than 2000 m and stayed by the pool more than 90 min, longer than the other activity groups of swimmers. Spirometry testing showed airway obstruction in 15 swimmers, which was 12% of the 130 competitive swimmers. 21 of them, had physician-diagnosed asthma and 16 of these individuals had prescribed medication for it. Conclusions Competitive swimmers had the highest swimming hall exposure and reported significantly more respiratory symptoms. A high prevalence of airway obstruction findings in competitive swimmers with asthma and allergies suggests a need for future recommendations for regular testing and special medical care for competitive swimmers.

Computational Predictions for OCD Pathophysiology and Treatment: A Review

Obsessive compulsive disorder (OCD) can manifest as a debilitating disease with high degrees of co-morbidity as well as clinical and etiological heterogenity. However, the underlying pathophysiology is not clearly understood. Computational psychiatry is an emerging field in which behavior and its neural correlates are quantitatively analyzed and computational models are developed to improve understanding of disorders by comparing model predictions to observations. The aim is to more precisely understand psychiatric illnesses. Such computational and theoretical approaches may also enable more personalized treatments. Yet, these methodological approaches are not self-evident for clinicians with a traditional medical background. In this mini-review, we summarize a selection of computational OCD models and computational analysis frameworks, while also considering the model predictions from a perspective of possible personalized treatment. The reviewed computational approaches used dynamical systems frameworks or machine learning methods for modeling, analyzing and classifying patient data. Bayesian interpretations of probability for model selection were also included. The computational dissection of the underlying pathology is expected to narrow the explanatory gap between the phenomenological nosology and the neuropathophysiological background of this heterogeneous disorder. It may also contribute to develop biologically grounded and more informed dimensional taxonomies of psychopathology.

SWOT Analysis of the Universiti Sains Malaysia Medical Educationists’ Preparations to Make a Regional Medical Education Hub: A Qualitative Study

The aim of this study was to analyse the strengths, weaknesses, opportunities and threats that describe the current circumstances of medical educationists in the School of Medical Sciences in Universiti Sains Malaysia (USM), particularly towards preparing themselves for becoming a regional hub in medical education. A total of 21 documents, including nine strategic management records, three department meeting documents and nine researchers’ observation journals were engaged in this study. The gained data were clustered by themes for each of the four categories which were strengths, weaknesses, opportunities and threats regarding medical educationists in the USM. High motivation and interest of the lecturers, interest in writing, presence of medical background, experienced in clinicals, experienced in management, presence of good health status, presence of postgraduate medical education and the presence of international students were designated as strengths of medical educationists. Presence of personal challenges, a majority of young lecturers and a majority with no PhD were stated as weaknesses of medical educationists. Positive support from family, strong support from the top administration to the medical education department, positive attention to individual instructors, two instructors having a PhD, supportive cadre, positive international perception to the department of medical education and large opportunities for research and school-provided grants were indicated as opportunities for medical educationists. Financial issues and facilities were expressed as threats to medical educationists. Consistent with the positive mode to move forward, there is a good chance for the USM medical faculty to become a medical education hub.

Does Time to Theatre Affect The Ability to Achieve Fracture Reduction in Tibial Plateau Fractures?

AimsThe primary aim of this study was to assess the effect of time to surgery on fracture reduction, assessed as residual articular step, in cases of tibial plateau fracture (TPF). The secondary aim was to assess the effect of pre-operative demographics and residual articular step on patient reported outcomes (PROMs) following TPF.MethodBetween 2006 and 2017 all surgically treated TPF patients managed by a single surgeon at our institution were prospectively consented for the study of fracture outcomes. Timing to surgical intervention, reduction of articular step, age, gender, medical background, fracture classification, mechanism of injury and PROMs (Lysholm Scores and Knee Injury and Osteoarthritis Outcome Scores (KOOS)) were recorded and analysed. Reduction of articular step, defined as <2mm, was assessed by a single blinded examiner using measurements on plain radiographs on PACS.ResultsOne hundred seventeen patients were enrolled, 52 with Schatzker II, four with Schatzker IV and 61 with Schatzker VI fractures. Patients were followed-up to a mean time of 3.9 years. The ability to achieve fracture reduction was negatively influenced by time to theatre with the odds of achieving reduction decreasing 17% each day post-injury (p = 0.002). An increased time to theatre was associated with reduced Lysholm scores at the one-year mark (p = 0.01). The ability to achieve fracture reduction did not influence PROMs within the study period.ConclusionDelay in surgical fixation negatively affects fracture reduction in TPF and may delay recovery. However, residual articular step did not influence the investigated PROMs in the cohort investigated over the mid-term (mean of 3.9 years).

Consumption of Food Supplements during the Three COVID-19 Waves in Poland—Focus on Zinc and Vitamin D

Food supplements (FS) are a concentrated source of vitamins, minerals, or other ingredients with nutritional or other physiological effects. Due to their easy availability, widespread advertising, and sometimes low price, increased consumption of this group of preparations has been observed. Therefore, the aim of the study was to assess the knowledge and intake of FS during the COVID-19 pandemic in Poland, with particular reference to FS containing zinc and vitamin D. It was noted that both of the above ingredients were used significantly more often by people with higher education (59.0%), with a medical background or related working in the medical field (54.5%), and/or exercising at home (60.1%). Preparations containing vitamin D were used by 22.8% of the respondents in the first wave, 37.6% in the second wave, and 32.9% in the third wave. To sum up, we showed the highest consumption of vitamin and mineral supplements, and preparations containing zinc and vitamin D were taken significantly more often by people with higher medical and related education. This indicates a high awareness of health aspects and the need for preventive measures in these groups.

398 Outcome of Laparoscopic Cholecystectomy in Patients Over 80 Years Old

Background Gallstone disease is a common cause of morbidity in old patients. Conservative treatment is usually the first line of treatment due to concerns about the risk of surgery. In our study we are trying to assess the outcome of laparoscopic cholecystectomy in patients over 80 years old. Method Retrospective cohort study done in a large district general hospital where good number of laparoscopic cholecystectomy is done every year. Main outcome is Mortality, return to theatre and post op ITU admission. Data collected from patients records. Results 74 patients in total were operated on. 14 operations were done as emergency (during the same inpatient admission). Indication for surgery varied between cholecystitis, pancreatitis and biliary colic. But the main indication in the emergency group was acute cholecystitis. 55 % of the patients had significant medical background with ASA 3. 30 days mortality was 0 in both emergency and elective groups. 2 patients required ITU admission post op, mainly for premorbid status, and both were in the emergency group. There was only one return to theatre in the emergency group for washout. 90% of the elective group patients were done as day case with no post op complications. Conclusions Laparoscopic cholecystectomy is safe operation to be done in the elderly population. ITU admission is mainly because of the patient’s co-morbidities so patients should be selected carefully and have proper pre op assessment.

Labrador Emergencies and St. Anthony Institutional Care: Medical Cases of Donald McI. Johnson for the Grenfell Association, 1928–29

In contemporaneous and retrospective publications, British physician Donald McI. Johnson wrote about medical cases in 1928–29 for the organization founded by Wilfred Grenfell in Newfoundland and Labrador. The availability of one physician’s cases in published and institutional forms allows consideration of discursive representations of patients for general and clinical readers in the two decades of Johnson’s writing. This study places these cases within the context of Johnson’s medical background and his escape to rural practice in a remote locale, one that emphasized emergency operations in Labrador and hospital care in the organization’s main hospital in St. Anthony. In this way, it broadens knowledge of medical care provided by visiting physicians and considers ways in which such physicians represented local patients in publications for the general reader. Although it determines that Johnson was unique, it indicates the value of the fuller study of publications by other physicians associated with the Grenfell organization.