Publications by authors named "Deepak Mehta"

94 Publications

Successful Repair of Non-facing Sinus ALCAPA Associated With Left-Sided Cardiomegaly Using Takeuchi Technique.

Cureus 2021 Aug 27;13(8):e17493. Epub 2021 Aug 27.

Radiology, Shree Krishna Hospital, Karamsad, IND.

Anomalous left coronary artery from the pulmonary artery (ALCAPA) is a rare congenital heart disease that may present isolated or may be associated with other cardiac malformations. Most of the patients develop symptoms during infancy but some may remain asymptomatic up to adulthood. Symptoms range from mild distress to severe irritability and feed intolerance. We report a case of a five-month-old male child who presented with congestive heart failure and was diagnosed as a case of ALCAPA with left atrial and left ventricular dilation based on two-dimensional echocardiography and computed tomography (CT) coronary angiogram. Left main coronary artery was shown to be arising from the posteroinferior wall of main pulmonary artery. Various surgical approaches have been suggested in the repair but the Takeuchi technique was preferred owing to its origin from the non-facing sinus of the pulmonary artery and co-existing dilatation of left atria and ventricle. The surgery was uneventful and there were no postoperative complications. A cardiac CT dynamic study was also done on the follow-up visit five months later and no signs of abnormality or complications were reported. Early intervention is necessary to prevent irreversible cardiac complications and early mortality.
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http://dx.doi.org/10.7759/cureus.17493DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8476186PMC
August 2021

Influence of Filler Composition on the Refractive Index of Four Different Enamel Shades of Composite Resins.

J Contemp Dent Pract 2021 May 1;22(5):557-561. Epub 2021 May 1.

Department of Restorative Dental Science, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.

Aim And Objective: The purpose of this study was to measure the refractive index of four commercially available enamel resin composites, using optical coherence tomography (OCT) and their relationship with the atomic composition of the composite resin fillers utilizing an energy-dispersive X-ray fluorescence spectrometer (EDX).

Materials And Methods: Four different enamel composites, namely Enamel HRi color UE3, Enamel HFO color GE3, Vit-l-escence color Pearl Frost, and Amelogen Plus color Enamel White were tested. For each composite, disks with different thicknesses were fabricated and then light-cured according to the manufacturer's instructions. The disks were then stored in deionized water under 36.5 °C for at least 7 days. Each of the samples from the four different groups was measured in five distinctive points to analyze the optical and physical length using optical coherence tomography (OCT). Elemental analysis of all four different enamel shades of the composite was done using an EDX.

Results: The filler contents showed interesting differences in elemental composition and concentration; however, Si seemed to be a common filler component. The HRi composite presented a distinctive composition compared to other materials and was the only composite that showed a smaller percentage of SiO, and also was the only composite that contained compounds, such as PO, ZnO, CaO, LaO, and VO. The optical coherence tomography analysis showed the refractive index values of all tested enamel composites. Among the four different enamel composite resins tested, the enamel HRi composite demonstrated the most ideal refractive index to mimic natural enamel.

Conclusion: The enamel HRi composite demonstrated a distinctive filler composition and this could be the main reason behind its higher refractive index. Nonetheless, it remains unclear how much of an impact this feature has in the final esthetic outcome of anterior composite restorations, where many other optical phenomena are also important.

Clinical Significance: The clinical success of any esthetic restorative procedure depends on diagnosing the proper treatment plan and also on executing this treatment with the right materials. On direct esthetic restorations, knowing the optical properties of such materials is fundamental, as they should be able to replicate both natural enamel and dentin. How to cite this article: Beolchi RS, Mehta D, Pelissier B, . Influence of Filler Composition on the Refractive Index of Four Different Enamel Shades of Composite Resins. J Contemp Dent Pract 2021;22(5):557-561.
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May 2021

Genetic Polymorphisms of NLRP3 (rs4612666) and CARD8 (rs2043211) in Periodontitis and Cardiovascular Diseases.

Biology (Basel) 2021 Jun 27;10(7). Epub 2021 Jun 27.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Background: The existing data show that inflammasomes play a role in periodontal disease pathogenesis. However, their role in the pathogenesis of periodontitis and coronary heart disease remains unclear. This study had the objective of assessing NLRP3 (rs4612666) and CARD8 (rs2043211) gene polymorphisms in dental plaque and blood of generalized chronic periodontitis (CP) patients in the presence and absence of coronary heart disease (CHD).

Methods: A total of 70 subjects were divided into two groups, including CP and CP + CHD subjects. Demographic variables, periodontal, and cardiac parameters were recorded from both groups. Subgingival plaque and blood samples were obtained from both groups and were subjected to further molecular analysis for NLRP3 (rs4612666) and CARD8 (rs2043211) expression and allele change using conventional polymerase chain reaction (PCR) and gene sequencing (Sanger's method).

Results: Amongst the demographic variables, age, and monthly income were statistically significant between the two groups. Plaque index (PI), clinical attachment level (CAL), high-density lipoprotein (HDL), and low density-lipoprotein (LDL) exhibited statistically significant levels between the two groups. NLRP3 (rs4612666) and CARD8 (rs2043211) genes showed a statistically significant association of allele change (frequency) among the groups. In general, when all of the parameters were compared to the allele change of the genes, statistically significant relationships were found between the two groups.

Conclusions: The present study expressed an allele change of the investigated genes which could profoundly affect the pathobiology of the two diseases under investigation.
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http://dx.doi.org/10.3390/biology10070592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301148PMC
June 2021

Viability of Quercetin-Induced Dental Pulp Stem Cells in Forming Living Cellular Constructs for Soft Tissue Augmentation.

J Pers Med 2021 May 18;11(5). Epub 2021 May 18.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Autogenous gingival grafts used for root coverage or gingival augmentation procedures often result in donor site morbidity. Living cellular constructs as an exogenous alternative have been proven to be associated with lower morbidity. With the available background information, the present study aims to assess if quercetin-induced living cell constructs, derived from dental pulp stem cells, have the potential to be applied as a tool for soft tissue augmentation. The characterized dental pulp stem cells (positive for CD73, CD90, and negative for CD34, HLA-DR) were expanded in Dulbecco's Modified Eagle's medium (DMEM) supplemented with 10 mM quercetin. The handling properties of the quercetin-induced dental pulp stem cell constructs were assessed by visual, and tactile sensation. A microscopic characterization using hematoxylin and eosin staining, and qRT-PCR-based analysis for stemness-associated genes (OCT4, NANOG, SOX2, and cMyc) was also performed. Dental pulp stem cells without quercetin administration were used as the control. Dental pulp stem cell constructs induced by quercetin easily detached from the surface of the plate, whereas there was no formation in the control cells. It was also simple to transfer the induced cellular construct on the flattened surface. Microscopic characterization of the constructs showed cells embedded in a tissue matrix. Quercetin also increased the expression of stemness-related genes. The use of quercetin-induced DPSC living constructs for soft tissue augmentation could provide an alternative to autogenous soft tissue grafts to lower patient morbidity and improve esthetic outcomes.
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http://dx.doi.org/10.3390/jpm11050430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158115PMC
May 2021

Surgical Techniques for Tonsillectomy and Perioperative Respiratory Complications in Children.

Otolaryngol Head Neck Surg 2021 Jun 1:1945998211015176. Epub 2021 Jun 1.

Division of Pediatric Otolaryngology, Department of Otolaryngology, Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA.

Objectives: The aim of this study was to determine the incidence of perioperative respiratory complications in children following tonsillectomy with cold and hot dissection surgical techniques.

Study Design: The study was a retrospective cohort study.

Setting: Retrospective chart review was performed for all children presenting for a tonsillectomy at Texas Children's Hospital from November 2015 to December 2017.

Methods: Pre- and intraoperative patient factors, including surgical technique with cold or hot dissection (electrocautery or radiofrequency ablation), and perioperative anesthetic factors were collected to determine the incidence of perioperative respiratory complications.

Results: A total of 2437 patients underwent a tonsillectomy at Texas Children's Hospital from November 2015 to December 2017. The incidence of perioperative respiratory complications was 20.0% (n = 487). Sickle cell disease, cardiac disease, reactive airway disease, pulmonary disease, age >2 and <3 years, and obesity, defined as a body mass index >95th percentile for age, were significant for overall perioperative respiratory complications. There was no difference in the incidence of perioperative respiratory complications in children undergoing tonsillectomy by cold or hot dissection.

Conclusion: Perioperative respiratory complications following tonsillectomy are more affected by patient factors than surgical technique.
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http://dx.doi.org/10.1177/01945998211015176DOI Listing
June 2021

Parathyroid Hormone Secretion and Receptor Expression Determine the Age-Related Degree of Osteogenic Differentiation in Dental Pulp Stem Cells.

J Pers Med 2021 Apr 27;11(5). Epub 2021 Apr 27.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Objective: To demonstrate the levels of parathyroid hormone secretion and genetic expressions of parathyroid hormone (PTH) and PTH1 receptor (PTH1R) genes in the dental pulp stem cells (DPSCs) from different age groups before and after induction of osteogenic differentiation. In addition, we also wanted to check their correlation with the degree of osteogenic differentiation.

Methods: Human primary DPSCs from three age groups (milk tooth (SHEDs), 7-12 years old; young DPSCs (yDPSCs), 20-40 years old; old DPSCs (oDPSCs), 60+ years old) were characterized for mesenchymal stem cell (MSC) markers. DPSCs were subjected to osteogenic differentiation and functional staining. Gene expression levels were analyzed by qRT-PCR. Surface receptor analysis was done by flow cytometry. Comparative protein levels were evaluated by ELISA.

Results: All SHEDs, yDPSCs, and oDPSCs were found to be expressing mesenchymal stem cell markers. SHEDs showed more mineralization than yDPSCs and oDPSCs after osteogenic induction. SHEDs exhibited higher expression of PTH and PTH1R before and after osteogenic induction, and after osteogenic induction, SHEDs showed more expression for RUNX2, ALPL, and OCN. Higher levels of PTH were observed in SHEDs and yDPSCs, and the number of PTH1R positive cells was relatively lower in yDPSCs and oDPSCs than in SHEDs. After osteogenic induction, SHEDs were superior in the secretion of OPG, and the secretions of ALPL and PTH and the number of PTH1R positive cells were relatively low in the oDPSCs.

Conclusions: The therapeutic quality of dental pulp stem cells is largely based on their ability to retain their stemness characteristics. This study emphasizes the criterion of aging, which affects the secretion of PTH by these cells, which in turn attenuates their osteogenic potential.
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http://dx.doi.org/10.3390/jpm11050349DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8144966PMC
April 2021

Modulation of the Dental Pulp Stem Cell Secretory Profile by Hypoxia Induction Using Cobalt Chloride.

J Pers Med 2021 Mar 30;11(4). Epub 2021 Mar 30.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

The action of stem cells is mediated by their paracrine secretions which comprise the secretory profile. Various approaches can be used to modify the secretory profile of stem cells. Creating a hypoxic environment is one method. The present study aims to demonstrate the influence of CoCl in generating hypoxic conditions in a dental pulp stem cell (DPSCs) culture, and the effect of this environment on their secretory profile. DPSCs that were isolated from human permanent teeth were characterized and treated with different concentrations of CoCl to assess their viability by an 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and proliferation by a cell counting kit (CCK)-8 assay. The gene expression level of hypoxia-inducible factor 1-alpha (HIF-1α) was analyzed by quantitative real time polymerase chain reaction (qRT-PCR) to demonstrate a hypoxic environment. Comparative evaluation of the growth factors and cytokines were done by cytometric bead array. Gene expression levels of transcription factors OCT4 and SOX2 were analyzed by qRT-PCR to understand the effect of CoCl on stemness in DPSCs. DPSCs were positive for MSC-specific markers. Doses of CoCl up to 20 µM, did not negatively affect cell viability; in low doses (5 µM), it promoted cell survival. Treatment with 10 µM of CoCl significantly augmented the genetic expression of HIF-1α. Cells treated with 10 µM of CoCl showed changes in the levels of growth factors and cytokines produced. It was very evident that CoCl also increased the expression of OCT4 and SOX2, which is the modulation of stemness of DPSCs. A CoCl treatment-induced hypoxic environment modulates the secretory profile of DPSCs.
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http://dx.doi.org/10.3390/jpm11040247DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066657PMC
March 2021

Antimicrobial Efficacy of Silver Nanoparticles as Root Canal Irrigant's: A Systematic Review.

J Clin Med 2021 Mar 10;10(6). Epub 2021 Mar 10.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Removal of microbes is imperative during endodontic therapy. Due to their antimicrobial property, silver nanoparticles have been used for endodontic irrigation of the root canals. The objective of the present study was to provide a qualitative analysis of the published literature assessing silver nanoparticles as root canal irrigants. A search of PubMed, SCOPUS, Web of Science, and Embase databases was done without any time restriction. Articles published in English were included. Data were extracted and the risk of bias was assessed. Of the 154 studies identified, after screening according to the inclusion criteria, five in vitro studies were included. The results indicate that silver nanoparticles have an anti-microbial effect to varying degrees depending on certain factors. Within the limitations of the present studies that have a moderate to low risk of bias, an antimicrobial effect of silver nanoparticles is observed. Silver nanoparticles have the potential to be used as endodontic irrigants, although their efficacy depends on particle size and the duration of contact which require further investigation.
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http://dx.doi.org/10.3390/jcm10061152DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7999954PMC
March 2021

Assessing the Potential Association Between Microbes and Corrosion of Intra-Oral Metallic Alloy-Based Dental Appliances Through a Systematic Review of the Literature.

Front Bioeng Biotechnol 2021 15;9:631103. Epub 2021 Mar 15.

Division of Oral Pathology, Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Systematic review assessing the association between oral microorganisms and corrosion of intra-oral metallic alloy-based dental appliances. PubMed, Scopus, and Web of Science were searched using keyword combinations such as microbes and oral and corrosion; microbes and dental and corrosion; microorganisms and oral and corrosion; microorganisms and dental and corrosion. Out of 141 articles, only 25 satisfied the selection criteria. s, sulfate-reducing bacteria, sulfate oxidizing bacteria, Veilonella, Actinomyces, were found to have a potential association with corrosion of intraoral metallic alloys such as stainless steel, titanium, nickel, cobalt-chromium, neodymium-iron-boron magnets, zirconia, amalgam, copper aluminum, and precious metal alloys. The included studies inferred an association between oral microorganisms and intra-oral metallic alloys-based dental appliances, although, it is vital to acknowledge that most studies in the review employed an simulation of the intra-oral condition.
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http://dx.doi.org/10.3389/fbioe.2021.631103DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8005604PMC
March 2021

Perinatal characteristics and early childhood follow up after ex-utero intrapartum treatment for head and neck teratomas by prenatal diagnosis.

Prenat Diagn 2021 03 9;41(4):497-504. Epub 2021 Feb 9.

Division of Fetal Therapy and Surgery, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA.

Background: Ex utero intrapartum treatment (EXIT) is utilized for safe delivery when a baby has a compromised airway. The purpose of this retrospective study was to examine the indications and outcomes of 11 children presenting with airway occluding oropharyngeal and cervical teratomas.

Methods: Study of all children with an airway occluding teratoma delivered via EXIT (2001-2018) in our unit. Primary outcomes included survival and tracheostomy at discharge. Data are reported using descriptive statistics as median (range) and rate (%).

Results: We performed 45 EXIT procedure performed between January 2001 and April 2018. Of these, eleven were for cervical and/or upper airway teratoma. Ten (91%) cases had associated polyhydramnios, two (18%) developed nonimmune hydrops, and eight (72%) delivered preterm. Six (45.5%) were performed as an emergency. Estimated blood loss was 1000 ml (500, 1000). The neonatal mortality rate was 18% (2/11) and 33% (3/9) of the survivors were discharged with a tracheostomy.

Conclusion: EXIT is a reasonable option for delivery of babies with an occlusive upper airway mass. Neonatal survival depends on individualized factors but may be as high as 82% in those with teratoma.
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http://dx.doi.org/10.1002/pd.5894DOI Listing
March 2021

EXIT ( Intrapartum Treatment) to Airway Procedure for Twin Fetuses With Oropharyngeal Teratomas: Lessons Learned.

Front Surg 2020 26;7:598121. Epub 2020 Oct 26.

Texas Children's Hospital, Houston, TX, United States.

intrapartum treatment (EXIT) to airway has been described as a safe method to secure challenging fetal airways while on placental support. Herein, we present a unique case of a monochorionic-diamniotic twin pregnancy where both fetuses presented with oropharyngeal tumors requiring airway securement on placental bypass. A multidisciplinary tabletop simulation was convened to allow for personnel coordination between multiple services, OR equipment allocation, and preparation for a range of possible clinical scenarios. A tabletop simulation was chosen for planning since this is a simulation methodology commonly used for preparation in acute, high intensity multidisciplinary situations such as disaster preparation, and allows for exploration of multiple potential scenarios when outcomes are uncertain. The twins were urgently delivered for decreased fetal movement and decelerations in Twin B at 28 weeks 6 days. Twin A was delivered EXIT to airway while Twin B had debulking of the tumor on placental support, with subsequent airway securement through a tracheostomy. In conclusion, for complex fetal procedures, detailed pre-operative planning with tabletop simulation may be a useful tool in achieving successful patient outcomes.
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http://dx.doi.org/10.3389/fsurg.2020.598121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649142PMC
October 2020

Eosinophilic esophagitis with and without airway involvement in children - A comparative analysis.

Int J Pediatr Otorhinolaryngol 2020 Dec 8;139:110422. Epub 2020 Oct 8.

Baylor College of Medicine, 1 Baylor Plaza, Houston, TX, 77030, USA; Texas Children's Hospital, 6621 Fannin Street, Houston, TX, 77030, USA. Electronic address:

Background: Eosinophilic esophagitis (EoE) is an allergic disease characterized by marked eosinophilic infiltration and inflammation of the esophagus eventually leading to esophageal dysfunction. This condition at times may involve the airway leading to breathing difficulties.

Objective: To compare the course of EoE in patients with or without airway involvement.

Methods: A retrospective chart review was done on patients with a diagnosis of Eosinophilic Esophagitis and that were managed in our Aerodigestive clinic from 2012 to 2018. A total of 121 EoE patients were included in the study. Each patient's disease course was examined for pertinent information including - but not limited to - age at presentation, allergies, endoscopic and pathology results, treatments prescribed, and time to resolution. The data was analyzed for any differences between the airway and non-airway groups for each of these variables.

Results: The variables that were analyzed showed no significant difference between patients suffering from EoE with (n = 19) and without (n = 102) airway involvement. However, patients with airway disease trended towards being younger in age at presentation as compared to those without airway symptoms (6.68 years vs. 9.69 years, p = 0.69). Analysis of endoscopic and pathology findings revealed no difference. Similarly, no differences were found between the prescribed treatments. Kaplan-Meier estimates of time to disease remission indicated that 50% of patients had resolution at one year, regardless of airway involvement (p = 0.31).

Conclusions: Our findings indicate that the disease course of patients with EoE does not vary depending on the presence of airway symptoms. Thus, patients with airway symptoms should not be diagnosed or treated any different than those without airway symptoms.
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http://dx.doi.org/10.1016/j.ijporl.2020.110422DOI Listing
December 2020

Pediatric obstructive sleep apnea revisited: Perioperative considerations for the pediatric Anesthesiologist.

Int J Pediatr Otorhinolaryngol 2020 Dec 3;139:110420. Epub 2020 Oct 3.

Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Pediatric obstructive sleep apnea presents in up to 7% of children and represents a constellation from nasal turbulence to cessation in gas exchange. There are numerous end organ sequelae including neurocognitive morbidity associated with persistent OSA. Adenotonsillectomy (AT), the first line therapy for pediatric OSA, has not been demonstrated to reduce all end organ morbidity, specifically neurological and behavioral morbidity. Furthermore, certain at-risk populations are at higher risk from neurocognitive morbidity. Precise knowledge and perioperative planning is required to ensure optimal evidence-based practices in children with OSA. This comprehensive review covers the seminal perioperative implications of OSA, including preoperative polysomnography, pharmacotherapeutics, and postoperative risk stratification.
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http://dx.doi.org/10.1016/j.ijporl.2020.110420DOI Listing
December 2020

Competency-Based Assessment Tool for Pediatric Esophagoscopy: International Modified Delphi Consensus.

Laryngoscope 2021 05 9;131(5):1168-1174. Epub 2020 Oct 9.

Department of Otolaryngology, Head and Neck Surgery, Stanford University, Lucile Salter Packard Children's Hospital, Palo Alto, California, U.S.A.

Objectives/hypothesis: Create a competency-based assessment tool for pediatric esophagoscopy with foreign body removal.

Study Design: Blinded modified Delphi consensus process.

Setting: Tertiary care center.

Methods: A list of 25 potential items was sent via the Research Electronic Data Capture database to 66 expert surgeons who perform pediatric esophagoscopy. In the first round, items were rated as "keep" or "remove" and comments were incorporated. In the second round, experts rated the importance of each item on a seven-point Likert scale. Consensus was determined with a goal of 7 to 25 final items.

Results: The response rate was 38/64 (59.4%) in the first round and returned questionnaires were 100% complete. Experts wanted to "keep" all items and 172 comments were incorporated. Twenty-four task-specific and 7 previously-validated global rating items were distributed in the second round, and the response rate was 53/64 (82.8%) with questionnaires returned 97.5% complete. Of the task-specific items, 9 reached consensus, 7 were near consensus, and 8 did not achieve consensus. For global rating items that were previously validated, 6 reached consensus and 1 was near consensus.

Conclusions: It is possible to reach consensus about the important steps involved in rigid esophagoscopy with foreign body removal using a modified Delphi consensus technique. These items can now be considered when evaluating trainees during this procedure. This tool may allow trainees to focus on important steps of the procedure and help training programs standardize how trainees are evaluated.

Level Of Evidence: 5. Laryngoscope, 131:1168-1174, 2021.
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http://dx.doi.org/10.1002/lary.29126DOI Listing
May 2021

Polysomnography in children with obstructive sleep apnoea and neurocognitive disorders.

Clin Otolaryngol 2020 Nov 16;45(6):885-888. Epub 2020 Sep 16.

Baylor College of Medicine, Houston, TX, USA.

Objective: The neurocognitive associations in paediatric obstructive sleep apnoea (OSA) are well known; however, whether polysomnographic features can predict these associations is unknown. Therefore, the primary objective of this study was to compare common polysomnographic parameters in children with OSA in the presence and absence of neurocognitive dysfunction.

Methods: Polysomnography data for children ages 3-6 years with mild-moderate OSA who as defined by AHI between 5 and 10 were analysed from a single sleep centre at a tertiary paediatric hospital from January 2016 to December 2018. The following parameters were identified: arousals per hour, percentage of time asleep, apnoea-hypopnoea index (AHI), oxygen desaturation nadir during sleeps, baseline oxygen saturation during sleep, time spent with SpO less than 90%, maximum transcutaneous CO2, per cent of the total sleep time spent with TcCO greater than 50 mmHg, age, body mass index (BMI), gender and type of disability in the neurocognitive dysfunction group. Neurocognitive diagnoses were recorded. Those with syndromic comorbidities were excluded. The study cohort was then compared to a cohort of 200 subjects with OSA and no neurocognitive disorders matched for age, gender and BMI. A paired column analysis by chi-squared analysis was then undertaken between the two groups.

Results: A total of 200 children were identified (126 males and 74 females) in the neurocognitive dysfunction group (OSA with neurocognitive dysfunction) and compared with 200 children in the control group (OSA without neurocognitive dysfunction) (113 males and 87 females). There were no statistical differences between groups.

Conclusion: Commonly used polysomnographic indices are not predictive of neurocognitive dysfunction in paediatric OSA.
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http://dx.doi.org/10.1111/coa.13619DOI Listing
November 2020

Mandibular Distraction in Robin Sequence With Multi-Level Airway Disease: Always Contraindicated?

J Craniofac Surg 2020 Oct;31(7):1883-1887

Division of Plastic Surgery, Michael E. DeBakey Department of Surgery, Baylor College of Medicine.

In patients with Pierre Robin sequence (PRS), understanding the mechanism of airway obstruction and the potential for concurrent airway lesions is important for determining appropriate intervention. When concomitant airway anomalies are present with PRS, mandibular distraction osteogenesis alone is often contraindicated and unsuccessful at alleviating the obstruction, mandating the need for tracheostomy. Herein, the authors present the second-reported case of PRS with concomitant complete tracheal rings and highlight the importance collaborative surgical efforts to avoid tracheostomy. Our patient was born with signs and symptoms of PRS and concomitant complete tracheal rings. At birth, he developed respiratory compromise that was resistant to invasive and noninvasive intervention and was transferred to our care. The severity of his airway compromise necessitated operative intervention. Due to the patient's complex medical condition, avoiding the long-term sequelae of a tracheostomy and performing mandibular distraction was favorable. However, due to his multi-level airway disease, a 2-staged approach was planned: sliding tracheoplasty to release the tracheal rings, followed by mandibular distraction to correct the micrognathia. The patient tolerated both procedures and was successfully distracted and eventually weaned into room air. When managing patients with PRS in the setting of severe respiratory distress, securing the airway and carefully evaluating for concomitant airway anomalies is crucial. Even in the setting of multi-level airway disease where mandibular distraction is typically contraindicated, by directly addressing each anatomic level of airway obstruction, the airway can be safely secured and the resultant consequences of tracheostomy can be avoided. Careful planning with a multidisciplinary team is essential.
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http://dx.doi.org/10.1097/SCS.0000000000006620DOI Listing
October 2020

Parental assessment of pain control following pediatric adenotonsillectomy: Do opioids make a difference?

Int J Pediatr Otorhinolaryngol 2020 Jul 10;134:110045. Epub 2020 Apr 10.

Department of Anesthesiology, Perioperative and Pain Medicine, Texas Children's Hospital, USA; Baylor College of Medicine, USA.

Introduction: Postoperative prescribing of opioids following pediatric adenotonsillectomy can have negative consequences including unnecessary opioid exposure and potential for respiratory depression. While guidelines from The American Academy of Otolaryngology/Head & Neck Surgery recommend treatment of post adenotonsillectomy pain using acetaminophen and ibuprofen, many providers continue to prescribe opioids and may do so, in part with concern for parental dissatisfaction with post-operative analgesia. Our aim was to determine whether a post-operative prescription for opioids affects parental assessment of pain control following pediatric adenotonsillectomy.

Methods: This post-operative survey assessed the parental assessment of pain control in 324 patients, ages 1-17 years undergoing adenotonsillectomy. This study was conducted at a quaternary care children's hospital in Houston, Texas from December 1, 2018 through March 31, 2019. Post-operative pain regimens included acetaminophen and ibuprofen or combination hydrocodone/acetaminophen in addition to ibuprofen for post-operative analgesia based on the attending surgeons prescribing preferences. The primary study outcome was identification of the proportion of parents rating their child's analgesia following pediatric adenotonsillectomy as poor or inadequate based on the post-operative analgesic regimen including opioids.

Results: Of the 798 surveys sent, the response rate was 42% (324/775) of those who received the survey email, and 69% (324/470) for those who opened the email. Between the opioid and non-opioid groups, there was no difference in gender (male; 48% vs. 51.3%; p = 0.58), race/ethnicity (white; 53% vs. 46%; p = 0.35) or insurance status (insured; 62% vs. 50.9%; p = 0.06). The proportion of parents who rated their child's pain as poor or inadequately controlled following adenotonsillectomy was relatively rare: 9% and 5% in the non-opioid and opioid groups, respectively. Parents rating their child's pain as excellent with regards to pain control following adenotonsillectomy were 58% and 50% in the non-opioids and opioid groups respectively.

Conclusion: The results of this study indicate that non-opioid analgesic regimens following pediatric adenotonsillectomy were not associated with decreased parental satisfaction or an increasing assessment of poor or inadequately controlled pain. Limiting opioid exposure following pediatric adenotonsillectomy is feasible and does not result in worse parental satisfaction with the analgesic plan.
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http://dx.doi.org/10.1016/j.ijporl.2020.110045DOI Listing
July 2020

Validity of laryngomalacia classification systems: A multi-institutional agreement study.

Clin Otolaryngol 2020 07 13;45(4):471-476. Epub 2020 Apr 13.

Division of Otolaryngology Head & Neck Surgery, Division of Pediatric Surgery, Department of Surgery, University of Alberta, Edmonton, Alberta, Canada.

Objectives: To determine the agreement of paediatric otolaryngologists on classifying laryngomalacia (LM).

Design: Intra- and interobserver agreement study of two classification systems.

Setting: Three tertiary referral paediatric centres.

Participants: Three paediatric otolaryngologists, who were blinded to any clinical details, interpreted the videos of children diagnosed with LM using the Holinger and Olney classifications independently. They rated the videos twice with a washout period of at least 2 weeks.

The Main Outcome Measures: Inter- and intra-observer agreement measured by overall Fleiss kappa and unweighted Cohen's kappa coefficients. The secondary outcome measures were inter- and intra-observer agreement on the individual anatomical subunits of the supraglottis affected by LM, characterised by the subcategories of the classifications.

Results: Video records of infants and children <18 years who had an endoscopic diagnosis of LM from 2012 to 2017 were retrospectively chosen for inclusion (n = 73). The overall Fleiss kappa coefficient was 0.25 (95% CI 0.18-0.32) amongst the raters using the Holinger classification and 0.31 (95% CI 0.21-0.42) for the Olney classification. Intra-observer agreement using the Holinger classification was 0.30 (95% CI 0.18-0.42), 0.62 (95% CI 0.23-0.85) and 0.84 (95% CI 0.75-0.94], whilst the Olney classification yielded values of 0.41 (95% CI 0.26-0.56), 0.51 (95% CI 0.29-0.63) and 0.63 (95% CI 0.48-0.78).

Conclusions: The agreement on types of LM between expert observers is modest using the Holinger and Olney classifications. This has significant implications for accurately diagnosing LM and exposes potential obstacles against credible pooling of data and extrapolation of information.
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http://dx.doi.org/10.1111/coa.13530DOI Listing
July 2020

Atmospheric cold plasma (ACP) treatment improved in-package shelf-life of strawberry fruit.

J Food Sci Technol 2020 Jan 22;57(1):102-112. Epub 2019 Aug 22.

Center of Innovative and Applied Bioprocessing (CIAB), Knowledge City, Sector-81, Mohali, Punjab 140306 India.

The aim of this study was to investigate the effect of atmospheric cold plasma (ACP) treatment on the microbial inactivation, physicochemical properties, and shelf-life of strawberry fruit with its extended in-package storage at room (25 °C) and refrigerated (4 °C) temperature. ACP treatment of 10, 15 and 30 min was studied on strawberry fruit using a dielectric barrier discharge (DBD) at 60 kV with an input voltage of 260 V at 50 Hz. The shelf-life of ACP treated strawberry was extended to 5 days at 25 °C and 9 days at 4 °C in sealed ACP package. However, non-treated packaged strawberry was degraded in 2 days. ACP treatment of 15 min resulted in 2 log reduction of microbial load and enhanced the concentration of chlorogenic acid, hyprin, phloretin, vanillin, gallic acid, 4-hydroxybenzaldehyde and rutin during in-package storage of 5 day (~ 120 h) at 25 °C with respect to control ( < 0.05). In addition, ACP treatment of 15 min at 60 kV was also found to increase the total phenolic content and antioxidant activity. However, total soluble solids, pH and moisture were not affected with ACP treatment ( > 0.05). Therefore, ACP treatment of 15 min with in-package storage of 5 days (~ 120 h) was found to be advantageous for increasing the shelf-life and functional quality of strawberry fruit.
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http://dx.doi.org/10.1007/s13197-019-04035-7DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6952511PMC
January 2020

Competency-Based Assessment Tool for Pediatric Tracheotomy: International Modified Delphi Consensus.

Laryngoscope 2020 11 10;130(11):2700-2707. Epub 2019 Dec 10.

Department of Otolaryngology-Head and Neck Surgery, Oregon Health and Science University, Pediatric Otolaryngology, Doernbecher Children's Hospital, Portland, Oregon, U.S.A.

Objectives/hypothesis: Create a competency-based assessment tool for pediatric tracheotomy.

Study Design: Blinded, modified, Delphi consensus process.

Methods: Using the REDCap database, a list of 31 potential items was circulated to 65 expert surgeons who perform pediatric tracheotomy. In the first round, items were rated as "keep" or "remove," and comments were incorporated. In the second round, experts were asked to rate the importance of each item on a seven-point Likert scale. Consensus criteria were determined a priori with a goal of 7 to 25 final items.

Results: The first round achieved a response rate of 39/65 (60.0%), and returned questionnaires were 99.5% complete. All items were rated as "keep," and 137 comments were incorporated. In the second round, 30 task-specific and seven previously validated global rating items were distributed, and the response rate was 44/65 (67.7%), with returned questionnaires being 99.3% complete. Of the Task-Specific Items, 13 reached consensus, 10 were near consensus, and 7 did not achieve consensus. For the 7 previously validated global rating items, 5 reached consensus and two were near consensus.

Conclusions: It is feasible to reach consensus on the important steps involved in pediatric tracheotomy using a modified Delphi consensus process. These items can now be considered to create a competency-based assessment tool for pediatric tracheotomy. Such a tool will hopefully allow trainees to focus on the important aspects of this procedure and help teaching programs standardize how they evaluate trainees during this procedure.

Level Of Evidence: 5 Laryngoscope, 130:2700-2707, 2020.
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http://dx.doi.org/10.1002/lary.28461DOI Listing
November 2020

Pediatric Drug Induced Sleep Endoscopy: A Simple Sedation Recipe.

Ann Otol Rhinol Laryngol 2020 May 6;129(5):428-433. Epub 2019 Dec 6.

Department of Anesthesiology, Perioperative and Pain Medicine, Baylor College of Medicine, Texas Children's Hospital, Houston, TX, USA.

Objective: To describe a minimalist approach to sedating children for DISE procedures.

Methods: We searched existing literature and derived and tested our algorithm on patients using evidence-based studies.

Results: We were able to successfully sedate, without airway intervention, 15 highly complex children with a variety of comorbidities for DISE procedures.

Conclusion: We describe a minimalistic sedation approach for DISE procedures in highly complex children. Further studies are required to compare this regimen to natural sleep states.
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http://dx.doi.org/10.1177/0003489419892292DOI Listing
May 2020

Impact of atmospheric non-thermal plasma and hydrothermal treatment on bioactive compounds and microbial inactivation of strawberry juice: A hurdle technology approach.

Food Sci Technol Int 2020 Jan 1;26(1):3-10. Epub 2019 Aug 1.

Center of Innovative and Applied Bioprocessing (CIAB), Mohali, India.

The aim of this study was to investigate the hurdle effect of combining atmospheric cold plasma (ACP) with hydrothermal treatment on ascorbic acid, individual polyphenolic compounds, total phenolic content, and microbial inactivation of strawberry juice. Strawberry juice was treated with ACP for 10 and 15 min using dielectric barrier discharge at 60 kV with the input voltage of 260 V. The ascorbic acid concentration was retained maximum only in ACP treatment followed by ACP + hydrothermal treatment. Furthermore, ACP treatment for 10 min coupled with hydrothermal treatment resulted in the higher concentration of gallic acid, epigallocatechin, phloretin, naringin, hyprin, and 4-O-caffeoylquinic acid with respect to control ( < 0.05). In addition, ACP treatment for 10 min at 60 kV in combination with hydrothermal treatment resulted in increased total phenolic content ( < 0.05). Moreover, a 2-log microbial reduction was found in processed strawberry juice with ACP coupled-hydrothermal treatment in comparison to control juice ( < 0.05). Therefore, ACP treatment of 10 min followed by hydrothermal treatment was found to be advantageous processing for strawberry juice to retain nutritional quality and decrease microbial load. Moreover, further optimization of ACP or hydrothermal processing with utilization of preservatives could be achieved for desired microbial inactivation for an industrial process.
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http://dx.doi.org/10.1177/1082013219865360DOI Listing
January 2020

Predictive Factors for Perinatal Outcomes of Infants Diagnosed With Micrognathia Antenatally.

Ear Nose Throat J 2021 Jan 3;100(1):NP16-NP20. Epub 2019 Jun 3.

Department of Pediatric Otolaryngology, 3984Texas Children's Hospital, Houston, TX, USA.

Introduction: Advances in fetal imaging have allowed us to identify abnormalities previously not appreciated. With this study, we hope to identify factors predicting a difficult airway at birth and review the perinatal outcomes of these patients.

Methods: Sixteen patients with antenatally diagnosed micrognathia were reviewed from a tertiary care hospital database from 2011 to 2016. Jaw index (JI), amniotic fluid index (AFI), glossoptosis, gastric size, and oropharynx obliteration were assessed. The airway support required at birth, specialist team involvement, and outcomes were evaluated.

Results: Nine (56.3%) of 16 patients had JI <5th percentile, 3 (33.3%) of 9 had difficult intubation, 2 (22.2%) of 9 needed an emergency tracheostomy, and 1 (11.1%) of 9 died. Seven patients had polyhydramnios, 2 (28.6%) of 7 had difficult intubation, 2 (28.6%) of 7 required tracheostomy, and 1 (14.3%) of 7 died. Twelve patients had either JI <5th percentile or abnormal AFI, 5 (41.7%) of 12 had difficult intubation, 2 (16.7%) of 12 required tracheostomy, and 1 (8.33%) of 12 died. For the group without otolaryngology consultation, 8 (50%) of 16, 1 (12.5%) of 8 had difficult intubation and 1 (12.5%) of 8 died because airway was not secured after 45 minutes of resuscitation.

Conclusion: Jaw index <5th percentile or abnormal AFI predicts a difficult airway. A multidisciplinary approach with otolaryngology involvement for airway intervention may be required at birth.
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http://dx.doi.org/10.1177/0145561319855641DOI Listing
January 2021

Outcomes Using a Postoperative Protocol in Pediatric Single-Stage Laryngotracheal Reconstruction.

Ann Otol Rhinol Laryngol 2021 Aug 15;130(8):861-867. Epub 2019 Feb 15.

Texas Children's Hospital, Houston, TX, USA.

Objectives: The aim of this study was to evaluate single-stage laryngotracheal reconstruction (ssLTR) outcomes before and after the implementation of a postoperative care protocol in pediatric patients.

Methods: A case-control study with chart review was conducted at 2 tertiary academic centers from 2010 to 2016. Pediatric patients who underwent ssLTR with a postoperative care protocol were compared with those who did not receive care under this protocol. Data regarding perioperative management were collected and compared using χ and Wilcoxon rank tests. Planned extubation, length of intubation in the intensive care unit, and complications were examined.

Results: Nineteen patients completed ssLTR after the protocol was initiated, and 26 prior patients were used as control subjects. Planned extubation failed in 9 patients (35%) in the control group compared with 1 patient (5%) in the protocol group ( < .05). Using a structured protocol demonstrated a decrease in delayed extubation and intensive care unit stay ( < .05). Despite more postprotocol patients' requiring posterior graft placement, preprotocol patients were less likely to be extubated within 7 days ( < .05).

Conclusions: The authors propose an intensive care unit protocol that uses a combination of pharmacologic agents to optimally reduce the risk for adverse events that delay time to extubation and thus decannulation. Timely extubation was more likely with the use of this postoperative care protocol using a multidisciplinary approach involving otolaryngologists, pharmacists, intensivists, and anesthesiologists.
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http://dx.doi.org/10.1177/0003489419830107DOI Listing
August 2021

Cervical lymphatic malformations: Prenatal characteristics and ex utero intrapartum treatment.

Prenat Diagn 2019 03;39(4):287-292

Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Baylor College of Medicine and Texas Children's Hospital, Houston, TX, USA.

Background: The ex utero intrapartum treatment (EXIT) is utilized to transition fetuses with prenatally diagnosed airway obstruction to postnatal life. We describe the unique clinical course, diagnosis, treatment, and outcomes of patients with cervical lymphatic malformation (CLM) managed with EXIT.

Methods: Review of fetuses with diagnosed CLM was delivered by EXIT (2001-2018) in a tertiary referral fetal center. Outcomes included survival, tracheostomy at discharge, neonatal course after delivery, and pulmonary hypoplasia. Data are reported as median [range] and rate (%).

Results: Out of 45 patients delivered by EXIT, 10 were delivered for CLM: seven had polyhydramnios, one had nonimmune hydrops, five delivered preterm, and three were emergency EXITs. The EXIT time and estimated blood loss were 125 minutes (95, 158) and 900 mL (500, 1500), respectively. Airway was secured in all. There was one neonatal death (day 8) with prematurity, sepsis, and pulmonary hypoplasia. Three out of nine were discharged with a tracheostomy.

Conclusion: In CLM, close monitoring for structural neck involvement and development of polyhydramnios are important and may be an indication for EXIT as the optimal delivery mode. An experienced multidisciplinary team is a key factor for an effective approach to the obstructed airway in CLM.
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http://dx.doi.org/10.1002/pd.5428DOI Listing
March 2019

Prefabricated Laser Sintered Composite Veneers and Occlusal Vertical Dimensions: Case Reports.

J Contemp Dent Pract 2018 Nov 1;19(11):1417-1423. Epub 2018 Nov 1.

Department of Prosthodontics, KLE Society's Institute of Dental Sciences, Bengaluru, Karnataka, India.

Aim: To highlight the concept of prefabricated veneers and occlusal vertical dimension (OVD) and series of case report using edelweiss prefabricated veneer system.

Background: Edelweiss prefabricated veneer system presents a concept of biofunctional esthetics using laser sintered composite resins. The system's biofunctionality and versatile area of application combined with its time and cost saving procedure make the Edelweiss veneer and occlusion system a sound investment for the future.

Case Description: A series of case reports treated using prefabricated laser sintered composite veneer system has been presented.

Conclusion: Prefabricated veneer is a milestone in operative dentistry, as it contributes tremendously to direct composite application, helping a larger number of our patients to receive esthetic restorations that are more conservative and affordable.

Clinical Significance: The prefabricated composite veneering technique provides a minimally invasive, chair-side technique for esthetic and full mouth rehabilitation.
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November 2018

Efficient and economic process for the production of bacterial cellulose from isolated strain of Acetobacter pasteurianus of RSV-4 bacterium.

Bioresour Technol 2019 Mar 14;275:430-433. Epub 2018 Dec 14.

Center of Innovative and Applied Bioprocessing (CIAB), Sector-81 (Knowledge City), Mohali 140306, Punjab, India. Electronic address:

In the present investigation, several residues from agro-forestry industries such as rice straw acid hydrolysate, corn cob acid hydrolysate, tomato juice, cane molasses and orange pulp were evaluated as the economical source for the production of bacterial cellulose. The bacterial cellulose attained the significant yield of 7.8 g/L using tomato juice, followed by 3.6 g/L using cane molasses and 2.8 g/L using orange pulp after 7 days of incubation. Furthermore, the optimum pH and temperature of fermentation for maximum production of bacterial cellulose was 4.5 and 30 ± 1 °C. The identified bacterium Acetobacter pasteurianus RSV-4 has been deposited at repository under the accession number MTCC 25117. The produced bacterial cellulose was characterized through FTIR, SEM, TGA and DSC and found to be of very good quality. The bacterial cellulose produced by identified strain on these various agro-waste residues could be a cost effective technology for commercial its production.
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http://dx.doi.org/10.1016/j.biortech.2018.12.042DOI Listing
March 2019

Structured care to improve outcomes in primary single stage laryngotracheal reconstruction.

Int J Pediatr Otorhinolaryngol 2018 Nov 23;114:71-75. Epub 2018 Aug 23.

Children's Hospital of Pittsburgh of UPMC, Department of Pediatric Otolaryngology, Head and Neck Surgery, Pittsburgh, PA, USA; Texas Children's Hospital, Department of Pediatric Otolaryngology, Head and Neck Surgery, Houston, TX, USA.

Purpose: To examine single stage laryngotracheal reconstruction (SSLTR) care to reduce complication and failure rate.

Methods: Forty-five patients that underwent primary SSLTR were examined retrospectively. All had pre-operative direct laryngoscopy and bronchoscopy, esophagoscopy with biopsy and MRSA screening. Pre-operative subglottic stenosis (SGS) grade and associated comorbidities were recorded. Intraoperative graft location and type was documented. Hospital course and results were evaluated and compared to cited literature.

Results: The median age at reconstruction was 2 years (0-15 years). 42.2% were male. 66.7% had gastroesophageal disease and 24.4% a MRSA history. Grade 2 SGS was noted pre-operatively in 37.8% and grade 3 or 4 in 57.7% of patients. Post-surgical hospital course was examined. 77.8% of patients were extubated on planned date. 95.6% of patients had operation specific successful decannulation. Graft type and variations of graft placement as well as MRSA and GERD status didn't affect procedure success rate. Active GERD was related to failure of extubation on planned day (p = 0.02). An abnormal pre-operative swallowing examination was associated with higher complication rates (p = 0.03).

Conclusion: Utilizing a more structured approach to SSLTR work-up and addressing potential SSLTR pitfalls may result in higher operation specific decannulation rates. Pre-operative GERD and swallowing dysfunction were associated with higher rates of adverse events.
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http://dx.doi.org/10.1016/j.ijporl.2018.08.023DOI Listing
November 2018

Outcome measures for pediatric laryngotracheal reconstruction: International consensus statement.

Laryngoscope 2019 01 27;129(1):244-255. Epub 2018 Aug 27.

University of Arkansas School for Medical Sciences, Department of Otolaryngology-Head & Neck Surgery, Arkansas Children's Hospital, Little Rock, Arkansas.

Objectives: Develop multidisciplinary and international consensus on patient, disease, procedural, and perioperative factors, as well as key outcome measures and complications, to be reported for pediatric airway reconstruction studies.

Methods: Standard Delphi methods were applied. Participants proposed items in three categories: 1) patient/disease characteristics, 2) procedural/intraoperative/perioperative factors, and 3) outcome measures and complications. Both general and anatomic site-specific measures were elicited. Participants also suggested specific operations to be encompassed by this project. We then used iterative ranking and review to develop consensus lists via a priori Delphi consensus criteria.

Results: Thirty-three pediatric airway experts from eight countries in North and South America, Europe, and Australia participated, representing otolaryngology (including International Pediatric Otolaryngology Group members), pulmonology, general surgery, and cardiothoracic surgery. Consensus led to inclusion of 19 operations comprising open expansion, resection, and slide procedures of the larynx, trachea, and bronchi as well as three endoscopic procedures. Consensus was achieved on multiple patient/comorbidity (10), disease/stenosis (7), perioperative-/intraoperative-/procedure-related (16) factors. Consensus was reached on multiple outcome and complication measures, both general and site-specific (8 general, 13 supraglottic, 15 glottic, 17 subglottic, 8 cervical tracheal, 12 thoracic tracheal). The group was able to clarify how each outcome should be measured, with specific instruments defined where applicable.

Conclusion: This consensus statement provides a framework to communicate results consistently and reproducibly, facilitating meta-analyses, quality improvement, transfer of information, and surgeon self-assessment. It also clarifies expert opinion on which patient, disease, procedural, and outcome measures may be important to consider in any pediatric airway reconstruction patient.

Level Of Evidence: 5 Laryngoscope, 129:244-255, 2019.
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http://dx.doi.org/10.1002/lary.27445DOI Listing
January 2019

Tomato processing byproduct valorization in bread and muffin: improvement in physicochemical properties and shelf life stability.

J Food Sci Technol 2018 Jul 2;55(7):2560-2568. Epub 2018 May 2.

Center of Innovative and Applied Bioprocessing (CIAB), Sector-81, Knowledge City, Mohali, PB 140306 India.

Tomato processing industry generates huge waste like tomato skin, seed, and pulp which creates environmental issues. Since tomato pomace contains bioactive compounds and pigments, present study was conducted to investigate the effect of tomato pomace addition on physicochemical characteristics and shelf-life stability of the developed bread and muffin. Refined flour was partially substituted with 35 and 40% tomato pomace in bread and muffin, respectively. Tomato pomace addition in bread and muffin was observed to significantly ( < 0.05) increase the dietary fiber, vitamin C, antioxidant activity and minerals (Na, K, Mg, Ca, Fe). The color parameters for bread and muffins were quantified in terms of L* (lightness), a* (redness/greenness) and b* (yellowness/blueness). There was an increase in a* and b*, while L* values decreased. Tomato based bread and muffin were found to possess softer texture as compared to control products. Microbial study has depicted the enhanced shelf-life of tomato based bread and muffin. Shelf life of preservative added tomato based bread was 8 days and muffins were 12 days. Tomato pomace could be a very useful commodity for incorporation into bread and muffin to have a complete nutritive food product.
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http://dx.doi.org/10.1007/s13197-018-3176-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6033793PMC
July 2018
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