Bisphenol A Detection in Various Brands of Drinking Bottled Water in Riyadh, Saudi Arabia Using Gas Chromatography/Mass Spectrometer

Purpose: To assess whether bisphenol A contamination occurred in seven brands of bottled drinking water in Riyadh, Saudi Arabia.Methods: Liquid-liquid extraction (using dichloromethane) was used to analytically extract bisphenol A from drinking water bottles and a gas chromatograph-mass spectrometer was employed for its detection using a splitless capillary column and helium as the carrier gas.Results: The concentration of bisphenol A (BPA) was high in all the bottled water brands tested. The mean concentration of BPA of the bottled water stored indoors (4.03 ng/L) was significantly lower than that stored outdoors (7.5 ng/L).Conclusion: Our results show that significant amounts of BPA leached from bottle containers into the water. Long storage of bottled water under direct sunlight should be avoided to reduce the risk of human exposure to BPA

Protective psychosocial factors and dental caries in children and adolescents: a systematic review and meta-analysis

BACKGROUND: Psychosocial protective factors include dispositional and family attributes that may reduce the occurrence of dental caries. AIM: This review analysed the evidence on the relationship between protective psychosocial factors and dental caries in children and adolescents. DESIGN: Primary studies involving children and adolescents were searched in the following electronic databases: Medline, SCOPUS, LILACS, SciELO, and Web of Science. The reference lists were also screened. Protective psychosocial factor descriptors were in accordance with the salutogenic theory. The outcome was clinical measure of dental caries. Quality assessments were performed using the Newcastle-Ottawa scale. RESULTS: The final search resulted in 35 studies, including 7 cohort, one case-control, and 27 cross-sectional studies. Most studies were of moderate quality. Meta-analyses revealed that low parental internal locus of control (cohort studies: OR = 1.42, 95% CI: 1.20-1.64; cross-sectional studies: OR = 1.30, 95% CI: 1.19-1.41), high parental external chance (OR = 1.20, 95% CI: 1.10-1.29), and high maternal sense of coherence (OR = 0.77, 95% CI: 0.62-0.93) were associated with dental caries in children. High social support (OR = 0.81, 95% CI: 0.68-0.93) and greater self-efficacy (OR = 1.50, 95% CI: 1.12-1.22) were also associated with dental caries in adolescents. CONCLUSIONS: The current evidence suggests that some salutogenic factors are important protective factors of dental caries during childhood and adolescence

ICAR: endoscopic skull‐base surgery

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Increasing frailty is associated with higher prevalence and reduced recognition of delirium in older hospitalised inpatients: results of a multi-centre study

Purpose Delirium is a neuropsychiatric disorder delineated by an acute change in cognition, attention, and consciousness. It is common, particularly in older adults, but poorly recognised. Frailty is the accumulation of deficits conferring an increased risk of adverse outcomes. We set out to determine how severity of frailty, as measured using the CFS, affected delirium rates, and recognition in hospitalised older people in the United Kingdom. Methods Adults over 65 years were included in an observational multi-centre audit across UK hospitals, two prospective rounds, and one retrospective note review. Clinical Frailty Scale (CFS), delirium status, and 30-day outcomes were recorded. Results The overall prevalence of delirium was 16.3% (483). Patients with delirium were more frail than patients without delirium (median CFS 6 vs 4). The risk of delirium was greater with increasing frailty [OR 2.9 (1.8–4.6) in CFS 4 vs 1–3; OR 12.4 (6.2–24.5) in CFS 8 vs 1–3]. Higher CFS was associated with reduced recognition of delirium (OR of 0.7 (0.3–1.9) in CFS 4 compared to 0.2 (0.1–0.7) in CFS 8). These risks were both independent of age and dementia. Conclusion We have demonstrated an incremental increase in risk of delirium with increasing frailty. This has important clinical implications, suggesting that frailty may provide a more nuanced measure of vulnerability to delirium and poor outcomes. However, the most frail patients are least likely to have their delirium diagnosed and there is a significant lack of research into the underlying pathophysiology of both of these common geriatric syndromes

Systematic review and meta-analysis of the complications of salvage total laryngectomy

Background and objectives: Management paradigms in laryngeal cancer have shifted to "organ preservation" chemoradiotherapy protocols. hi the event of treatment failure, salvage total laryngectomy remains the only curative treatment option. However a comprehensive review of the complications of this procedure has not been reported. Methods: A systematic review of the literature was performed using keywords "salvage laryngectomy" to retrieve relevant publications between January 2000 and August 2015. Results: Of the 407 articles retrieved from the literature search, 50 studies encompassing 3292 patients were included. Forty-nine studies reported pharyngocutaneous fistula which occurred in 859 patients (pooled incidence 28.9%; 95% confidence intervals 25.5-32.5%). Twenty-four studies reported complications in addition to PCF and these included wound complications (infection, dehiscence and necrosis), dysphagia, bleeding, and pharyngeal and stomal stenosis. Conclusions: Overall complication rate was 67.5%, Pharyngocutaneous fistula was the commonest complication with a pooled incidence of 28.9%. Crown Copyright (C) 2016 Published by Elsevier Ltd. All rights reserved