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Abstract Objective The study objective was to determine risk factors for severity of juvenile-onset recurrent respiratory papillomatosis (RRP) at first endoscopic evaluation. Methods Based on a review of all cases undergoing surgery for juvenile-onset RRP in two pediatric otolaryngology departments in the USA and France, the following severity risk factors were analyzed: number of laryngeal levels involved, extension to the subglottis, and bilateral involvement. Results Thirty-two patients were included, with 571 endoscopic procedures. Number of endoscopies per patient varied according to initial extension: 30.67 procedures when all three levels were involved, 15.57 procedures when two and 14.08 procedures when only one (P = 0.03). The odds ratio for risk of > 14 procedures in 3-level involvement was 20.43 (P = 0.047). Initial subglottic extension tended to be associated with more endoscopic procedures (23.67 vs 15.56, P = 0.16). Conclusions RRP severity correlated with initial laryngeal extension of papillomatous lesions at first endoscopy. This finding allowed a short 3-item assessment scale to be created for routine use, complementary to Derkay's assessment scale. [ABSTRACT FROM AUTHOR]

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Background: In 2005, 40% of motor-vehicle occupant deaths in the group aged 16–19 years involved passengers. Although seatbelts can reduce crash mortality by 50% or more, little is known about the differences in driver-versus-passenger seatbelt use among teens. Methods: In 2007, data from the 2001 and 2003 Youth Risk Behavior Surveys were analyzed for 12,731 black, white, and Hispanic high school students aged ≥16 years reporting seatbelt use as both drivers and passengers. Seatbelt use was compared for driver- and passenger-seat positions, and stratified by age, gender, race/ethnicity, school grades, and histories of either drinking and driving or riding with a drinking driver. Results: Overall, 59% of students always used seatbelts when driving, but only 42% always buckled up as passengers. Across all covariate strata, passenger seatbelt use was significantly less prevalent than driver seatbelt use (p<0.001). A concordance analysis showed that only 38% of students always wore seatbelts both when driving and while riding as a passenger. Multivariate analyses indicated that, regardless of seat position, seatbelt use was lower for young men, blacks, students with poor grades, and students who reported either drinking and driving or riding with a drinking driver. Conclusions: U.S. high school students aged ≥16 years are significantly less likely to wear seatbelts as passengers than as drivers. Interventions designed to promote seatbelt use among teens need to address this disparity. [Copyright &y& Elsevier]

Objective: This prospective study characterizes trajectories of symptoms and impairment in pediatric patients with abdominal pain not associated with identifiable organic disease.Method: The Children's Somatization Inventory and the Functional Disability Inventory were administered four times over 5 years to 132 patients (6-18 years old) seen in a pediatric gastroenterology clinic. Individual trajectories were empirically grouped and correlates of trajectory group membership at baseline were evaluated.Results: A model with three unique trajectories was found to adequately fit both symptom and impairment data. Two trajectories indicated relatively long-term improvement and one indicated continued high levels of symptoms and impairment. At baseline, the long-term risk group did not have the most severe pain but had significantly more anxiety, depression, lower perceived self-worth, and more negative life events.Conclusions: These results indicate that several distinct trajectories of relatively long-term outcomes may exist in children with functional abdominal pain. One trajectory indicated long-term risk for a high level of symptoms and impairment. Psychosocial correlates of long-term risk for physical symptoms and impairment, such as child-reported stress and internalizing symptoms, may be useful for treatment planning. [ABSTRACT FROM AUTHOR]

Provides information on a study which compared the outcomes of children who received negligible amounts of outpatient treatment to children receiving more treatment. Methodology of the study; Results and discussion of the study.

Acute neuropathic pain (ANP) resulting from civilian and combat traumatic injuries has dramatic impact on society at large as it poses with significant personal and economic burden. With opioid abuse epidemic currently in public eye across all levels of society, it is pertinent new therapeutic modalities are needed to effectively treat and resolve ANP. Neuroinflammation is recognized as one of the primary drivers of acute neuropathic to chronic pain transition leading to prolonged disability and loss of productivity. We hypothesize that the lack of molecular and cellular targeting specificity to effectively engage key cellular players in the neuronal injury milieu leads to non-opioid and local analgesia pain control failures in some patients. Here we present novel nanomedicine strategies for targeted non-opioid drug delivery directly to the key cells at the site of injury, immune cells and nerves. Since drug delivery is cell targeted, smaller drug doses are expected to produce similar or improved therapeutic effects over non-targeted therapies. Further we achieve overall dramatically decreased systemic exposure (up to 1000 fold), which can diminish unwanted side effects. Presented nanomedicine formulations provide sustained drug release leading to dosing frequency decrease and extended duration of therapeutic effects (up to 30 days or longer). As designed, these pain directed nanomedicines could improve patient response to treatment while minimizing systemic exposure/overdose risk, tolerance and/or dependency. To the best of our knowledge this is the first example of dual administration (systemic and local) nanomedicine design for acute post-trauma pain applicable to both civilian and military settings. We present fabrication and optimization of immune cell and nerve targeted nanoformulations. Evaluation for controlled release kinetics and safety of the these systems with optimized drug payloads in vivo in rat models of nerve injury and mouse inflammatory pain models following local and systemic administration is also presented. [ABSTRACT FROM AUTHOR]

Highlights: [•] We assessed fluency of conversational speech of 472 preschool-age children. [•] Preschool-age children's disfluency counts are not normally distributed. [•] Non-stuttered disfluencies can be used to augment talker group classification criteria. [•] Boys produce more non-stuttered disfluencies than girls. [•] Parental concern for stuttering is strongly associated with stuttered disfluency frequency. [Copyright &y& Elsevier]

Abstract: Sea bass (Dicentrarchus labrax) fisheries are becoming increasingly abundant along eastern Atlantic coastlines, especially in the ICES sub-areas IV, VII and VIII, but they are still not being managed by the European Union TAC (Total Allowed Catches) system. Scientific information about these sea bass stocks is limited, but the fishery is currently managed or modelled based upon these data, separated into the ICES divisions. Clearly, failure to manage satisfactorily the fishery may lead to a decline in stocks. We therefore investigated the structure of Atlantic sea bass populations at eight microsatellite loci in the Bay of Biscay and the English Channel and, additionally, at five selected loci in Ireland and Scotland. Genetic data showed no significant population differentiation between the Bay of Biscay and the English Channel samples, either for juvenile or adult individuals, indicating substantial gene flow. These results contrast with tag-recapture data that indicated restricted movements of individuals within the Bay of Biscay or the English Channel, and little exchange between them. These apparently contradictory genetic and tag-recapture results can be reconciled by various aspects of sea bass biology, factors that should be considered in stock management. Furthermore, the results indicate some local genetic differentiation in the Irish sample when compared to other samples, possibly indicating a complex population structure of sea bass around the British Isles. This point should be further investigated, but results clearly indicate that sea bass stock management should not be based only upon the currently recognized ICES divisions. [Copyright &y& Elsevier]

Abstract: Concerning any socioprofessional category, some addictive drugs like cocaine are responsible for many complications. The authors relate two case reports of young patients who suffered from cardiovascular accidents due to this drug. The first one was diagnosed with an ischemic stroke caused by carotid artery dissection and a leg distal vascular obliteration, the second one with a myocardial infarction with transient left ventricular dysfunction. Through these two case reports, the authors take stock of the pathophysiological and therapeutic knowledge of cardiovascular accidents after cocaine intake. [Copyright &y& Elsevier]

Amiodarone can induce severe hyperthyroidism that justifies its withdrawal and initiation of antithyroid drugs. Impossibility to stop amiodarone, failure to control hyperthyroidism and unfavourable evolution can lead to thyroidectomy. Cardiac manifestations, persistence of hyperthyroidism and interactions between amiodarone and anaesthetic or haemodynamic drugs may contraindicate anaesthesia. We report nine consecutive cases of amiodarone-associated hyperthyroidism that prompted us to perform thyroidectomy under general anaesthesia. The features and anaesthetic data of patients were noted. The antithyroid medical treatment failed in all patients. After thyroidectomy, evolution was favourable in all nine cases, without any intra or postoperative complication, in spite of the extent of hyperthyroidism and the severity of the associated cardiac problems. Despite potential high risks, thyroidectomy for amiodarone-induced hyperthyroidism does not seem to increase morbidity or mortality and allows a quick return to euthyroidism and reintroduction of amiodarone. [Copyright &y& Elsevier]

Backgrounds: The aim of this study was to assess the relationship between the level of ambulatory physical activity, measured by physical activity tracker, and the clinical components of physical frailty, among nursing home residents.Methods: We proceeded in 3 steps: (1) Validation of the physical activity tracker (i.e. the Pebble): 24 volunteer adults walked on a treadmill. The number of steps recorded by the Pebble worn by the subjects was compared with the number of steps counted by the investigators, by means of the Intra-class correlation coefficients (ICC). (2) Measurement of ambulatory physical activity, using the Pebble trackers, over a 7-day period. (3) Relationship between the results obtained with the Pebble trackers (step 2) and subjects' clinical characteristics, linked to physical frailty.Results: ICC data, showed that the reliability of the Pebble was better when it was worn at the foot level (ICC ranged from 0.60 to 0.93 depending on the tested speed). Gait speed is also an important determinant of the reliability, which is better for low gait speed. On average, the 27 nursing home residents included in the second step of this study walked 1678.4±1621 (median=1300) steps per day. Most physical components of frailty measured in this study were significantly different between subjects who walked less than 1300 steps per day and those who were more active.Conclusion: This study showed that nursing home residents have a poor ambulatory physical activity, assessed using a physical activity tracker, which is associated with poorer physical performances and higher disability. [ABSTRACT FROM AUTHOR]