A survey of use of mTOR inhibitors in patients with lymphangioleiomyomatosis listed for lung transplant.

BACKGROUND: Lymphangioleiomyomatosis (LAM) is an uncommon indication for lung transplantation. The use of mechanistic target of rapamycin (mTOR) inhibitors, which are the mainstay of treatment in progressive LAM, in patients awaiting lung transplant is controversial. We sought to examine worldwide practice patterns in use of mTOR inhibitors in LAM patients on the lung transplant waiting list. METHODS: We designed and disseminated an online survey about institution-specific practice patterns, particularly regarding listing LAM patients for lung transplant and use of mTOR inhibitors in those patients on the transplant waitlist. RESULTS: Of the 49 unique respondent programs, 83.6% had previously listed a LAM patient for lung transplant. Thirteen centers allowed patients to continue on mTOR inhibitor until time of lung transplant. None of those centers reported any complications or deaths attributable to mTOR inhibitor adverse effects. CONCLUSION: There exists significant variability in practice patterns concerning the use of mTOR inhibitors in LAM patients on the lung transplant waiting list. Our survey suggests favorable outcomes for those patients that did continue mTOR inhibitor up to time of transplant. Further data regarding the risk of anastomotic complication with use of mTOR inhibitors in the pre-transplant period would help provide clarity in this debate.

Determining the Influence of Oral Health Infotainment Module on Behavior and Oral Hygiene of 6-year-old School-children and their Mothers in Davangere City.

AIM AND BACKGROUND: Dental plaque and calculus are common in school-aged children worldwide causing unsatisfactory oral health. This stage is a critical time to establish attitudes, beliefs, and shape an individual's health-related behavior. Moreover, parental oral health knowledge and attitudes are known to influence their child's oral health and hygiene. MATERIALS AND METHODS: A cross-sectional study with a two-stage intervention trial involving a sample of 6-year-olds from two schools in Davangere city was done. Children were randomly allocated into three intervention groups by lottery method. Data included plaque index (PI) modified for 6-year-old children at baseline, 30th day, and at 60th day. Children and their mothers were requested to fill a self-administered questionnaire. The statistical analysis used ANOVA followed by Tukey's post hoc test and measures ANOVA. p ≤ 0.05 was considered statistically significant. RESULTS: There was a significant reduction in the PI modified in 6-year-olds within and among the three groups at the end of 60 days (p = 0.001). Maximum reduction was seen in group II followed by group III and thereafter group I in both the age-groups. CONCLUSION: The study shows that at 60 days, the oral health infotainment module involving parental support was able to achieve appreciable improvement in the child's oral health and hygiene and inculcate a better attitude toward oral self-care. HOW TO CITE THIS ARTICLE: Potlia I, Naveen Kumar PG, Ramesh MV, et al. Determining the Influence of Oral Health Infotainment Module on Behavior and Oral Hygiene of 6-year-old Schoolchildren and their Mothers in Davangere City. Int J Clin Pediatr Dent 2021;14(5):633-639.

Effects of drug abuse, smoking and alcohol on donor hearts and lungs.

Potential heart and lung donors with a history of illicit drugs and/or smoking and alcohol are frequently offered, though there is no clear guidance on when it is safe to use these organs. A review of the literature on effects of drugs, alcohol and smoking on donor outcomes, and the effects of these on the intact heart and lung was undertaken. There has been a marked increase in deaths from opioid abuse in many developed countries, though recent evidence suggests that outcomes after cardiothoracic transplantation are equivalent to nonopioid donor causes of death. For donor smoking, there is an increased risk with lung transplantation; however, that risk is less when compared to further waiting on the transplant list for a nonsmoking alternative. Heavy alcohol consumption does not adversely affect heart transplantation, and there is no clear evidence of adverse outcomes after lung transplantation. There are no overall effects of cannabis or cocaine on survival after heart or lung transplantation. In all these cases, careful donor assessment can establish if a particular organ can be used. In most cases, use of drugs requires careful assessment, but is not in of itself a contraindication to cardiothoracic transplantation.