Bunnmoon1608

modialysis.Treacher Collins syndrome (TCS OMIM 154500) is an autosomal dominant craniofacial disorder belonging to the heterogeneous group of mandibulofacial dysostoses. OBJECTIVE To investigate four Treacher Collins syndrome patients of the Sgaw Karen family living in Thailand. METHOD Clinical examination, hearing tests, lateral cephalometric analyses, Computed tomography, whole exome sequencing, and Sanger direct sequencing were performed. RESULTS All of the patients affected with Treacher Collins syndrome carried a novel TCOF1 mutation (c.4138_4142del; p.Lys1380GlufsTer12), but clinically they did not have the typical facial gestalt of Treacher Collins syndrome, which includes downward-slanting palpebral fissures, colobomas of the lower eyelids, absence of eyelashes medial to the colobomas, malformed pinnae, hypoplastic zygomatic bones, and mandibular hypoplasia. Lateral cephalometric analyses identified short anterior and posterior cranial bases, and hypoplastic maxilla and mandible. Computed tomography showed fusion of malleus and incus, sclerotic mastoid, hypoplastic middle ear space with a soft tissue remnant, dehiscence of facial nerve, and monopodial stapes. CONCLUSION Treacher Collins syndrome in Sgaw Karen patients has not been previously documented. This is the first report of monopodial stapes in a TCS patient who had aTCOF1 mutation. The absence of a common facial phenotype and/or the presence of monopodial stapes may be the effects of this novel TCOF1 mutation. This article is protected by copyright. All rights reserved.OBJECTIVES Tracheostomy is commonly used in intensive care units and in head and neck departments. Airway obstruction due to occluded cuffless tracheostomy tubes themselves remains unknown, although capping trials are commonly used before decannulation. The aim of this study is to evaluate the extent to which airway obstruction can be caused by occluded cuffless tubes in patients who underwent head and neck surgery. DESIGN Prospective Research Outcome. SETTINGS University teaching hospital. PARTICIPANTS Fiftypatients requiring transient tracheostomy after head and neck surgery. MAIN OUTCOME MEASURES A flow volume loop (FVL) through the mouth using a portable spirometer, with the occluded fenestrated cuffless tube, was measured before and immediately after decannulation, by obstructing the orifice of tracheostomy tube. The measurement of FVL recordedthe forced vital capacity (FVC), forced expiratory volume in 1 second(FEV1 ), peak expiratory flow (PEF), forced expiratory flow at 50%of FVC, peak inspiratory flow (PIF), forced inspiratory flow at 50% of FVC. RESULTS A statistically significant difference between all spirometric parameters was found. Mean PEF and PIF respectively increased from 2.8 to 4.5 L/s (P less then 0.0001), and 2.3 to 2.7 L/s (P less then 0.01) before and after decannulation, with a strong positive correlation (r =0.7; P less then 0.05). A mean expiratory (34%) and inspiratory (9%) airflow reductionwas observed due to cannula. CONCLUSIONS Occluded cufflesstracheostomy tubes cause a dramatic airflow obstruction, mainly in the expiratory phase of FVL. This should be taken into account during capping trials. This article is protected by copyright. All rights reserved.Childhood malnutrition, associated with poor diet, is a clear public health threat in Sri Lanka, with high rates of under-nutrition and micronutrient deficiencies coupled with the growing risk of overweight/obesity in urban locations. This study explored the dietary diversity and food intake of urban living Sri Lankan preschool children. A cross-sectional analysis of the baseline data from a cohort study was conducted with parents/caregivers of children aged 2-6 years, from 21 preschool centres in Kurunegala District, Sri Lanka. Demographic and socio-economic factors, dietary diversity score (DDS) (n = 597) and food intake (n = 458) (using a food frequency questionnaire) were assessed. Children had a mean DDS of 4.56 ± 0·85 out of 9, with most (91.1%) in the medium DDS category (DDS of 3.1-6.0), consuming rice as most common food. Lentils were consumed more than any meat or alternative food groups at all DDS levels. Child DDS differs with parent/caregiver age and ethnicity. Mean daily intakes of fruit (1.02) and vegetables (0.84) servings align with approximately half of national recommendations, with less than 20% of children meeting daily recommendations. More than one-third consumed sugary snacks and confectionaries daily and 1 in 10 had them twice a day. Around 40% reported watching television while eating the evening meal. Despite the majority having reasonable DDSs (medium category), findings highlighted inadequate intakes of fruits and vegetables, excessive intakes of sugary snacks and unhealthy dietary and social behaviours, suggests the need for population-based interventions to promote healthier dietary habits. © 2020 The Authors. ONO-AE3-208 Prostaglandin Receptor antagonist Maternal & Child Nutrition published by John Wiley & Sons Ltd.PURPOSE To create a snapshot of common practices for 3D-CRT and intensity-modulated radiation therapy (IMRT) QA through a large-scale survey and compare to TG-218 recommendations. METHODS A survey of 3D-CRT and IMRT QA was constructed at and distributed by the IROC-Houston QA center to all institutions monitored by IROC (n = 2,861). The first part of the survey asked about methods to check dose delivery for 3D-CRT. The bulk of the survey focused on IMRT QA, inquiring about treatment modalities, standard tools used to verify planned dose, how assessment of agreement is calculated and the comparison criteria used, and the strategies taken if QA fails. RESULTS The most common tools for dose verification were a 2D diode array (52.8%), point(s) measurement (39.0%), EPID (27.4%), and 2D ion chamber array (23.9%). When IMRT QA failed, the highest average rank strategy utilized was to remeasure with the same setup, which had an average position ranking of 1.1 with 90.4% of facilities employing this strategy. The second highest average ranked strategy was to move to a new calculation point and remeasure (54.9%); this had an average ranking of 2.1. CONCLUSION The survey provided a snapshot of the current state of dose verification for IMRT radiotherapy. The results showed variability in approaches and that work is still needed to unify and tighten criteria in the medical physics community, especially in reference to TG-218's recommendations. © 2020 The Authors. Journal of Applied Clinical Medical Physics published by Wiley Periodicals, Inc. on behalf of American Association of Physicists in Medicine.