Gastroesophageal reflux symptoms in infants in a rural population: longitudinal data over the first six months

<p>Abstract</p> <p>Background</p> <p>Increasing numbers of infants are receiving prescription medications for symptoms associated with gastroesophageal reflux. Our aim was to prospectively measure reported gastroesophageal reflux symptoms in healthy term infants for the first six months of life.</p> <p>Methods</p> <p>In a prospective cohort study in the rural Upper Peninsula of Michigan, 128 consecutive maternal-infant pairs were followed for six months and administered the Infant Gastroesophageal Reflux Questionnaire Revised (I-GERQ-R) at the one-month, two-month, four-month, and six-month well-child visits.</p> <p>Results</p> <p>The I-GERQ-R scores decreased with age. Average scores were 11.74 (SE = 5.97) at one-month, 9.97(4.92) at two-months, 8.44(4.39) at four-months, and 6.97(4.05) at six months. Symptoms associated with colic were greatest at one month of age.</p> <p>Conclusion</p> <p>Symptoms of gastroesophageal reflux as measured by the I-GERQ-R decrease with age in the first six months of life in otherwise healthy infants; however the I-GERQ-R may have difficulty differentiating gastroesophageal reflux disease from colic in those under 3 months of age.</p

Incomplete gastric metaplasia in children with insulin-dependent diabetes mellitus and celiac disease. An ultrastructural study

BACKGROUND: The association of insulin-dependent diabetes mellitus (IDDM) and celiac disease (CD) has been widely reported in children but the relationship between the two conditions is incompletely understood. Moreover, specific studies on intestinal biopsies of patients with the association of the two diseases are still lacking. METHODS: We studied the ultrastructure of the duodenal mucosa in 12 patients with both IDDM and CD. RESULTS: All patients had either total or partial atrophy of duodenal mucosa. In seven subjects, an accumulation of electrondense granules in the apical cytoplasm of groups of enterocytes was found. In four of them, a double population of granules existed (mean diameter: 400-800 nm and 100-200 nm respectively) showing a biphasic pattern. In the other three patients, only smaller granules (100- 200 nm) were found in the enterocytes. CONCLUSIONS: The present work suggests that patients with IDDM/CD may represent a subgroup in the context of the CD population. Intestinal biopsies of such individuals often show accumulation of electrondense granules in the apical cytoplasm of enterocytes that can be interpreted as incomplete gastric metaplasia

Virulence traits and novel drug delivery strategies for mucormycosis post-COVID-19: a comprehensive review

The outbreak of a fatal black fungus infection after the resurgence of the cadaverous COVID-19 has exhorted scientists worldwide to develop a nutshell by repurposing or designing new formulations to address the crisis. Patients expressing COVID-19 are more susceptible to Mucormycosis (MCR) and thus fall easy prey to decease accounting for this global threat. Their mortality rates range around 32-70% depending on the organs affected and grow even higher despite the treatment. The many contemporary recommendations strongly advise using liposomal amphotericin B and surgery as first-line therapy whenever practicable. MCR is a dangerous infection that requires an antifungal drug administration on appropriate prescription, typically one of the following: Amphotericin B, Posaconazole, or Isavuconazole since the fungi that cause MCR are resistant to other medications like fluconazole, voriconazole, and echinocandins. Amphotericin B and Posaconazole are administered through veins (intravenously), and isavuconazole by mouth (orally). From last several years so many compounds are developed against invasive fungal disease but only few of them are able to induce effective treatment against the micorals. Adjuvant medicines, more particularly, are difficult to assess without prospective randomized controlled investigations, which are challenging to conduct given the lower incidence and higher mortality from Mucormycosis. The present analysis provides insight into pathogenesis, epidemiology, clinical manifestations, underlying fungal virulence, and growth mechanisms. In addition, current therapy for MCR in Post Covid-19 individuals includes conventional and novel nano-based advanced management systems for procuring against deadly fungal infection. The study urges involving nanomedicine to prevent fungal growth at the commencement of infection, delay the progression, and mitigate fatality risk

A rare case of leaking thoracic aortic aneurysm in a patient with massive pulmonary embolism

The aim of this study was to report a rare case of a leaking thoracic aorta aneurysm in a female patient with massive pulmonary embolism. A 70-year-old woman with hypertension who had suffered a cerebral vascular accident 2 years ago presented with urinary tract infection, dehydration, and anemia. While in hospital, she was diagnosed with pulmonary embolism, and anticoagulation therapy was started using heparin. As the tachycardia persisted with a further drop in hemoglobin levels, and because a new left-sided pleural effusion was revealed on chest radiograph, a chest CT with a CT angiography was performed. It revealed a large leaking aneurysm of the descending thoracic aorta. This was treated by inserting an endovascular stent. This rare case shows the importance of investigating for other serious coexistent causes of tachycardia in patients with pulmonary embolism during treatment

Nonlinear coordination strategy between renewable energy sources and fuel cells for frequency regulation of hybrid power systems

This study proposes an advanced control strategy for the coordination of an energy storage system (ESS) based on fuel cells (FCs) and renewable energy sources (RESs) to enhance frequency dynamic performance in hybrid power systems (HPSs). The proposed coordination control strategy is based on the nonlinear proportional-integral (NPI) controller, which increases the system's flexibility in dealing with disturbances and changing operating conditions. In addition, it improves the system's dynamic response and attempts to address system weakness caused by highly penetrating RESs. The proposed NPI controller is optimally designed using a new optimization algorithm, called dandelion optimizer (DO), whose proficiency and effectiveness are verified by comparing its performance with other well-known optimization algorithms used in the literature; particle swarm optimization (PSO), grey wolf optimization (GWO), and ant lion optimization (ALO) algorithms considering various standard objective functions. Furthermore, the proposed NPI controller performs better than other control strategies used in the literature under load/RESs fluctuations. The effectiveness of the proposed nonlinear coordination control strategy is examined and investigated through a self-contained HPS that includes a diesel generator, RESs (i.e., photovoltaic and wind power plants), battery ESS, flywheel ESS, aqua electrolyzer for hydrogen production, FCs, electric vehicles, and customer loads. The simulation results carried out by the MATLAB software demonstrate the superior performance of the proposed DO-optimized NPI controller for HPS frequency regulation, even when the power system's parameters have substantial variations. Moreover, the results revealed that the proposed strategy significantly reduces the frequency deviation by approximately 95% compared to the conventional coordination strategy based on the fixed contribution of RESs and by 90% compared to the adaptive coordination control based on the PI controller

Influence of Concentration Levels of β-Tricalcium Phosphate on the Physical Properties of a Dental Adhesive

Our study assessed the influence of integrating 5% and 10% tricalcium phosphate (β-TCP-Ca3(PO4)2.) nanoparticles into a dental adhesive on the adhesive’s bonding. To evaluate the filler nanoparticles, scanning electron microscopy (SEM), Energy Dispersive X-Ray (EDX) spectroscopy, Fourier-transform infrared (FTIR) spectroscopy, and micro-Raman spectroscopy techniques were used. Shear Bond strength (SBS) testing, degree of conversion (DC) analysis, investigation of the adhesive–dentin interface, and biofilm experiments were conducted. The SEM micrographs revealed non-uniform agglomerates, while the EDX demonstrated the existence of oxygen ‘O’ (24.2%), phosphorus ‘P’ (17.4%) and calcium ‘Ca’ (60.1%) in the β-TCP nanoparticles. The FTIR and micro-Raman spectra indicated characteristic bands for β-TCP containing materials. The 10 wt.% β-TCP adhesive presented the highest SBS values (NTC-10 wt.% β-TCP: 33.55 ± 3.73 MPa, TC-10 wt.% β-TCP: 30.50 ± 3.25 MPa), followed by the 5 wt.% β-TCP adhesive (NTC-5 wt.% β-TCP: 32.37 ± 3.10 MPa, TC-5 wt.% β-TCP: 27.75 ± 3.15 MPa). Most of the detected failures after bond strength testing were adhesive in nature. The β-TCP adhesives demonstrated suitable dentin interaction by forming a hybrid layer (with few or no gaps) and resin tags. The β-TCP adhesives (10 wt.%) revealed lower DC values compared to control. The incorporation of 5 and 10 wt.% concentrations of β-TCP particles resulted in an increase in SBS values. A linear decline in DC values was witnessed when the nanoparticle concentration was increased. Further research focusing on exploring the influence of higher filler concentrations on adhesive’s properties is recommended

Surface Properties of Polymer Resins Fabricated with Subtractive and Additive Manufacturing Techniques

This study aimed to compare the surface roughness, hardness, and flexure strength of interim indirect resin restorations fabricated with CAD-CAM (CC), 3D printing (3D), and conventional techniques (CV). Twenty disk (3 mm &times; &Oslash;10 mm) and ten bar specimens (25 &times; 2 &times; 2 mm) were fabricated for the CC, 3D, and CV groups, to be used for surface roughness, micro-hardness, and flexural strength testing using standardized protocol. Three indentations for Vickers micro-hardness (VHN) were performed on each disk and an average was identified for each specimen. Surface micro-roughness (Ra) was calculated in micrometers (&mu;m) using a 3D optical non-contact surface microscope. A three-point bending test with a universal testing machine was utilized for assessing flexural strength. The load was applied at a crosshead speed of 3 mm/min over a distance of 25 mm until fracture. Means and standard deviations were compared using ANOVA and post hoc Tukey&ndash;Kramer tests, and a p-value of &le;0.05 was considered statistically significant. Ra was significantly different among the study groups (p &lt; 0.05). Surface roughness among the CC and CV groups was statistically comparable (p &gt; 0.05). However, 3D showed significantly higher Ra compared to CC and CV samples (p &lt; 0.05). Micro-hardness was significantly higher in 3D samples (p &lt; 0.05) compared to CC and CV specimens. In addition, CC and CV showed comparable micro-hardness (p &gt; 0.05). A significant difference in flexural strength was observed among the study groups (p &lt; 0.05). CC and 3D showed comparable strength outcomes (p &gt; 0.05), although CV specimens showed significantly lower (p &lt; 0.05) strength compared to CC and 3D samples. The 3D-printed provisional restorative resins showed flexural strength and micro-hardness comparable to CAD-CAM fabricated specimens, and surface micro-roughness for printed specimens was considerably higher compared to CAD-CAM and conventional fabrication techniques

Influence of TiO2 and ZrO2 Nanoparticles on Adhesive Bond Strength and Viscosity of Dentin Polymer: A Physical and Chemical Evaluation

The present study aimed to formulate an experimental adhesive (EA) and reinforce it with 5 wt.% titanium dioxide (TiO2) or zirconium oxide (ZrO2) to yield 5% TiO2 and 5% ZrO2 adhesives, respectively, and then analyze the impact of this reinforcement on various mechanical properties of the adhesives. The EA contained a blend of monomers such as bisphenol A glycol dimethacrylate (BisGMA), triethylene glycol dimethacrylate (TEGDMA), 2-hydroxyethyl methacrylate (HEMA), and ethyl 4-dimethylamino benzoate and camphorquinone. The EA included ethyl 4-dimethylamino benzoate and camphorquinone photo-initiators, and diphenyliodonium hexafluorophosphate (DPIHP) was also included to act as an electron initiator. The TiO2 and ZrO2 nanoparticles were incorporated into the EA post-synthesis. To characterize the filler nanoparticles, scanning electron microscopy (SEM) and line-energy dispersive X-ray (EDX) spectroscopy were performed. The adhesives were characterized by analyzing their rheological properties, shear-bond strength (SBS), and interfacial failure types. Further, the resin–dentin interface was also analyzed via SEM. The TiO2 nanoparticles were spherically shaped on the SEM micrographs, while the ZrO2 nanoparticles were seen as non-uniformly shaped agglomerates. The EDX mapping demonstrated the presence of Ti and oxygen for TiO2 and Zr and oxygen for the ZrO2 nanoparticles. Both 5% TiO2 and 5% ZrO2 adhesives revealed decreased viscosity as compared with the EA. The 5% TiO2 adhesive demonstrated higher SBS values for both non-thermocycled (NTC) and thermocycled samples (NTC: 25.35 ± 1.53, TC: 23.89 ± 1.95 MPa), followed by the 5% ZrO2 adhesive group (NTC: 23.10 ± 2.22, TC: 20.72 ± 1.32 MPa). The bulk of the failures (&gt;70%) were of adhesive type in all groups. The SEM analysis of the resin–dentin interface revealed the development of a hybrid layer and resin tags (of variable depth) for the EA and 5% TiO2 groups. However, for the 5% ZrO2 group, the hybrid layer and resin tag establishment appeared compromised. Reinforcement of the EA with TiO2 or ZrO2 caused an increase in the adhesive’s SBS (with the 5% TiO2 group demonstrating the highest values) in comparison with the EA (without nanoparticles). However, both nanoparticle-containing adhesives revealed decreased viscosity compared with the EA (without nanoparticles). Further studies investigating the impact of diverse filler concentrations on the properties of adhesives are suggested