Background : Strict regimens of restricted caloric intake and daily physical exercise are life-saving in Prader–Willi syndrome (PWS) but are extremely challenging in home environments. ...PWS-specialized hostels (SH) succeed in preventing morbid obesity and in coping with behavioral disorders; however, effects of restricted living environments on quality of life (QOL) have not been described. Evidence on QOL is critical for clinicians involved in placement decisions. Methods : We examined the impact of living in SH versus at home or in non-specialized hostels (H and NSH) on QOL, behavior, and health parameters. All 58 adults (26 males) followed-up in the National Multidisciplinary Clinic for PWS were included: 33 resided in SH, 18 lived at home, and 7 lived in NSH. Questionnaires were administered to primary caregivers to measure QOL, and data were obtained from the medical records. Results : The H and NSH group were compared with those for adults in SH. Despite strict diet and exercise regimens, QOL was similar for both groups. Eight-year follow-up showed that food-seeking behavior decreased in SH but increased in H and NSH. BMI, cholesterol, and triglyceride levels were lower in SH. Conclusions : Our results suggest that living in SH is associated with benefits for physical health and behavior without negatively affecting QOL.
Hyperphagia leading to severe obesity with increased morbidity and mortality is the major manifestation of Prader‐Willi syndrome. Caring for these individuals in a home environment is challenging and ...stressful for caregivers and families. Residential hostels specifically for PWS adults offer programs of diet, exercise, and vocational opportunities, but long‐term effects of PWS hostel living have not been reported. We studied long‐term changes in body mass index (BMI) for PWS adults living in residential hostels compared with age‐matched controls living with families at home. The study included all 34 individuals (18 men) aged >17 years with genetically confirmed PWS living in residential hostels. BMI was recorded at the time of yearly clinic visits and compared to 23 PWS adults (10 men) living at home. BMI on entering the hostel was 36.3 ± 11.0 kg/m2 and decreased to 27.0 ± 5.6 kg/m2 (p < 0.001) after 6.9 ± 3.9 years. For 21 residents, a slight rise of BMI to 28.8 kg/m2 was observed 5.1 ± 2.5 years after the lowest value was achieved. BMI of 23 PWS adults at home was 36.8 ± 12.7 kg/m2 versus 27.9 ± 7.1 kg/m2 for hostel residents in the same age range (p = 0.008). From 2008 to 2019, there were five deaths among PWS individuals aged 18–40 years living at home, compared with one death (a 43‐year‐old man) among hostel residents. Adults with PWS living in hostels lose weight, maintain BMI values in a normal to mildly overweight range, and have lower mortality in contrast to individuals in a family home environment.
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BFBNIB, FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
The present article reports how a dental implant with an internal port dental implant valve approach (DIVA) can be utilized as oroantral port to treat chronic rhinosinusitis (CRS) in a minimally ...invasive manner.
Eleven patients (age mean 68.1 years) with CRS were subjected to the transimplant lavage technique. For three patients the CRS treatment was performed via previously installed dental implants, and for another eight patients the implantation procedure was combined with the CRS treatment. The moment the implant was fully installed, the sinus membrane was punctured via the implant channel. Upon completion of the pus drainage the sinus was irrigated with normal saline, followed by the injection of a steroid solution (100 mg hydrocortisone).
Patients began to report symptomatic improvement from the first day after the first-session procedure. Nine patients had complete relief of most of their symptoms (nasal obstruction/discharge, anosmia/hyposmia) at day 30. The follow- up nasal endoscopy demonstrated no evidence of active sinus disease. All the implants used were found to be well-osseointegrated and still in use for prosthetic purposes. Clinical and radiologic results showed stability and no recurrence in the follow-up period.
The dental implant with an internal central port and integral dedicated sealing screw may be used for irrigation, observation, and further treatment of the maxillary sinus in cases of CRS.
Paperwhite Narcissus of the Tazetta group is one of the most important flower crops in Israel, with more then 20 million bulbs exported annually for both dry sales and flower production. Recent ...releases by The Volcani Center (Agricultural Research Organization) of cvs. 'Ariel' and 'Inbal', require adequate protocols for flowering manipulation and extending blooming prior to December and after January, as is common under ambient conditions in Israel. Flowering physiology, including intrabulb flower development, storage, and forcing methods of the new cultivars, were studied in comparison with cv. 'Ziva'. For September 1 and October 15 planting, bulb storage under ambient conditions (open shed) or at 25 °C was followed by two weeks of chilling at 13 or 9 °C. Post-harvest storage at 25 °C enhanced intrabulb flower differentiation, and pre-planting chilling promoted intrabulb scape elongation, but scapes' final length were shorter then in the control. For January 1 planting, bulbs were kept at 30 °C with a consequent delay in intrabulb flower differentiation. A two-week chilling at 17, 13, or 9 °C resulted in a shorter period from planting to bloom. Early and late plantings resulted in a smaller number of flowers per inflorescence, as compared with planting on October 15. The information presented may serve for devising useful forcing protocols for quality production of N. tazetta flowers.
