Purpose To investigate the impact of sleep on the development of early childhood caries (ECC). Methods Seven electronic databases and grey literature were searched with various keyword combinations. Two reviewers independently selected studies, extracted data, and assessed the risk of bias using the Newcastle–Ottawa Scale. The studies were included if they evaluated the impact of sleep parameters on the caries experience or severity of ECC in children under 6 years of age. Results Four cross-sectional studies and two longitudinal studies were included. Children who had irregular bedtimes had a 66–71% higher chance of developing ECC. Children who slept after 11 pm might have a 74–85% higher chance of developing ECC. Children who slept less than 8 h during the night had a 30% increased risk of caries than children who slept more than 11 h. Conclusion Irregular or late bedtime and fewer sleeping hours could be an independent risk factor for ECC. The risk of ECC might be related inversely in a dose–response manner to the number of sleep hours.
Background. Between August 1984 and November 1989, the Hoosier Oncology Group conducted a Phase III study comparing cyclophosphamide (CTX) with cyclophosphamide, doxorubicin, and methotrexate (CAM) in patients with hormone‐refractory metastatic prostatic cancer to determine whether the addition of doxorubicin and methotrexate to the cyclophosphamide regimen conferred any survival advantage. Methods. One hundred three patients were registered and randomized, 99 were evaluable for response, and all were evaluable for survival results. All had histologically confirmed metastatic prostatic cancer and had not responded to hormonal therapy. Fifty‐three patients received CTX alone, and 50 received CAM. Seventy‐one patients (69%) had evaluable disease, and 32 (31%) had measurable disease. Results. There were no complete responses and only four (13%) partial responses in the patients with measurable disease. There was no difference in overall survival time between the two treatment arms in either patients with a Karnofsky performance status (KPS) of 80‐100 (median survival, 9.0 versus 9.5 months; P = 0.93) or in those with a KPS of 50‐70 (median survival, 5.0 versus 6.0 months; P = 0.51). There was no difference in overall time to progression between the two treatment arms (median time to progression; 4.4 versus 6.2 months; P = 0.07). Toxicity was tolerable in both regimens. Conclusions. It was concluded that there was no survival advantage to CAM over CTX alone. New chemo‐therapeutic agents with greater activity against prostatic cancer must be identified.
Background The complementary feeding period is a time of unparalleled dietary change for every human, during which the diet changes from one that is 100% milk to one that resembles the usual diet of the wider family in less than a year. Despite this major dietary shift, we know relatively little about food and nutrient intake in infants worldwide and virtually nothing about the impact of baby food “pouches” and “baby-led weaning” (BLW), which are infant feeding approaches that are becoming increasingly popular. Pouches are squeezable containers with a plastic spout that have great appeal for parents, as evidenced by their extraordinary market share worldwide. BLW is an alternative approach to introducing solids that promotes infant self-feeding of whole foods rather than being fed purées, and is popular and widely advocated on social media. The nutritional and health impacts of these novel methods of infant feeding have not yet been determined. Objective The aim of the First Foods New Zealand study is to determine the iron status, growth, food and nutrient intakes, breast milk intake, eating and feeding behaviors, dental health, oral motor skills, and choking risk of New Zealand infants in general and those who are using pouches or BLW compared with those who are not. Methods Dietary intake (two 24-hour recalls supplemented with food photographs), iron status (hemoglobin, plasma ferritin, and soluble transferrin receptor), weight status (BMI), food pouch use and extent of BLW (questionnaire), breast milk intake (deuterium oxide “dose-to-mother” technique), eating and feeding behaviors (questionnaires and video recording of an evening meal), dental health (photographs of upper and lower teeth for counting of caries and developmental defects of enamel), oral motor skills (questionnaires), and choking risk (questionnaire) will be assessed in 625 infants aged 7.0 to 9.9 months. Propensity score matching will be used to address bias caused by differences in demographics between groups so that the results more closely represent a potential causal effect. Results This observational study has full ethical approval from the Health and Disability Ethics Committees New Zealand (19/STH/151) and was funded in May 2019 by the Health Research Council (HRC) of New Zealand (grant 19/172). Data collection commenced in July 2020, and the first results are expected to be submitted for publication in 2022. Conclusions This large study will provide much needed data on the implications for nutritional intake and health with the use of baby food pouches and BLW in infancy. Trial Registration Australian New Zealand Clinical Trials Registry ACTRN12620000459921; http://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=379436. International Registered Report Identifier (IRRID) DERR1-10.2196/29048
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