Oral and maxillofacial surgery patient satisfaction with telephone consultations during the COVID-19 pandemic.

Due to the COVID-19 pandemic most oral and maxillofacial surgical (OMFS) units have moved to conducting patient consultations over the telephone. The aim of this study was to assess patients' satisfaction with telephone consultations during the COVID-19 pandemic. A retrospective survey was conducted of OMFS patients at our hospital who had telephone consultations between 1 April - 8 June 2020. The survey was conducted by independent interviewers and used the Generic Medical Interview Satisfaction Scale (G-MISS) along with a previously published additional questionnaire. Variables recorded included age, gender, theme of consultation, grade of clinician, and type of consultation. Statistical analysis was performed to assess for any differences between patient groups. The records of 150 consecutive patients were reviewed and 135 met inclusion criteria. A total of 109 patients completed the survey giving a response rate of 80.74%. The total G-MISS score for satisfaction was high, which indicates a high level of satisfaction among all patients. We found no statistical difference in satisfaction when comparing patients in terms of gender, age, theme of consultation, or level of clinician. A significant difference was found in compliance levels between review and new patients, with review patients demonstrating higher compliance levels (p=0.004). Overall, 83.48% of patients said they would be willing to have a telephone consultation in future. The majority of patients in this study reported high levels of satisfaction with telephone consultations. New patients reported lower levels of compliance which may suggest this type of consultation is less suited to telephone consultation.

Environmental risk factors associated with pediatric idiopathic pulmonary hemorrhage and hemosiderosis in a Cleveland community.

BACKGROUND: Unexplained pulmonary hemorrhage and hemosiderosis are rarely seen in infancy. A geographic cluster of 10 infants with this illness was identified in a large pediatric referral hospital in Cleveland, Ohio, during the period of January 1993 through December 1994. One infant died of severe respiratory failure. METHODS: A case-control study was conducted. Three control infants were matched by age with each case infant. All study infants' guardians were interviewed. Questions were asked about child care practices and home conditions for the period before case infants' illnesses. All infants' records were reviewed, their homes were visited, and a structural and environmental survey was conducted. RESULTS: All 10 case infants were black, and 9 were male, whereas 50.0% of control infants were male, and 83.3% were black. The case infants' mean age was 10.2 weeks (range, 6 weeks to 6 months). Matched analysis demonstrated that case infants' homes were more likely to have had water damage preceding the pulmonary hemorrhage event (odds ratio, 16.25; 95% confidence interval, 2.55 to infinity). Case infants were also more likely to have had close relatives with pulmonary hemorrhage (odds ratio, 33.14; 95% confidence interval, 5.10 to infinity). In addition, 50.0% of case infants experienced recurrent pulmonary hemorrhaging after returning to their homes. CONCLUSION: The results of this investigation of a cluster of infants with massive, acute pulmonary hemorrhage and hemosiderosis suggest that the affected infants may have been exposed to contaminants in their homes. Epidemiologic clues, such as water damage in the case infants' homes, suggest that environmental risk factors may contribute to pulmonary hemorrhage.

Mezerein and 12-deoxyphorbol 13-isobutyrate, protein kinase C ligands with differential biological activities, do not distinguish PKC-isotypes alpha, beta 1, beta 2, and gamma.

Previous in vitro experiments have shown that the phorbol-like diterpenes 12-deoxyphorbol 13-isobutyrate (dPB), and possibly mezerein, have multiple biological target sites which differ from one another in apparent affinity for dPB by 12.5-780 fold and for mezerein by 24-fold. These two compounds are thus very important ligands because of their potential PKC isotype-selectivity. In the present study they were found to have binding affinities differing by a maximum of only 1.6-fold among recombinant protein kinase C (PKC) isotypes alpha, beta 1, beta 2, and gamma (the "A-group") in a [3H]phorbol dibutyrate binding assay. The apparent Ki's were 92-140 nM for dPB and 68-92 nM for mezerein. Our results are consistent with short-term 12-deoxyphorbol ester-induced mouse skin inflammation being mediated at least in part by one or more A-group PKC isotypes. The data also indicate that the pharmacologically distinguishable target sites previously established for mezerein and dPB must include one or more binding sites not found in the A-group of PKC isotypes and that mezerein has a high-affinity, non-A-group target site in brain.