IntroductionCraniofacial surgery is a specialized field that addresses congenital and acquired deformities of the head and face. While the physical outcomes of craniofacial surgery are ...well-documented, less attention has been given to the psychological well-being of adult patients. This abstract aims to explore self-esteem issues among adult patients treated at the Craniofacial Surgery Sector of HCPA (Hospital de Clínicas de Porto Alegre), where a substantial proportion of adult patients have reported self-esteem problems.Objectives1. To assess the prevalence of self-esteem issues among adult patients (≥18 years old) attending the HCPA Craniofacial Surgery Sector.2. To examine potential contributing factors to self-esteem problems in this specific patient population.3. To evaluate the impact of self-esteem on the mental health and psychosocial functioning of adult craniofacial surgery patients.4. To propose recommendations for psychosocial support and intervention strategies tailored to the needs of adult patients in this context.MethodsThis cross-sectional study involved 132 adult patients who had undergone or were scheduled for craniofacial surgery at HCPA. Participants reported self-esteem issues in their talk with the hospital’s physicians, and their medical records were reviewed to collect demographic and clinical data. Additionally, participants provided information about their mental health status and psychosocial functioning.ResultsAmong the 39 adult patients included in the study, 37 (94.9%) reported experiencing self-esteem issues, such as lack of confidence or feeling unattractive. The most commonly reported contributing factors were visible facial differences, social interactions, and prior surgical experiences. Patients with lower self-esteem had a higher likelihood of reporting symptoms of depression and anxiety and reported lower overall psychosocial functioning compared to those with higher self-esteem.ConclusionsThis reveals a strikingly high prevalence of self-esteem issues among adult patients attending the Craniofacial Surgery Sector at HCPA. These findings underscore the importance of recognizing and addressing the psychological well-being of adult craniofacial surgery patients. Comprehensive psychosocial support, including counseling, peer support, and interventions to enhance self-esteem, should be integrated into the care of these patients. By addressing self-esteem concerns, healthcare providers can improve the mental health and overall quality of life of adult craniofacial surgery patients.Disclosure of InterestNone Declared
IntroductionThe Pierre-Robin sequence (PRS), characterized by micrognathia, glossoptosis, and cleft palate, has long been a subject of clinical interest. Recent research suggests a potential ...association between PRS and cognitive or psychiatric disorders. This study explores this intriguing connection, shedding light on the complex interplay between craniofacial anomalies and mental health.ObjectivesThis study aims to establish a comprehensive understanding of the relationship between Pierre-Robin Sequence and psychiatric disorders. Specifically, our objectives include: assessing prevalence, evaluating impact and informing clinical practice. This research aims to improve the holistic care and mental well-being of individuals with craniofacial malformations, contributing to a more comprehensive approach in the field of psychiatry.MethodsThis cross-sectional study was conducted at a prominent referral hospital named Hospital de Clínicas de Porto Alegre, an international reference in Pierre-Robin Sequence, during the month of August 2023.Participant Selection: Patients with PRS. Inclusion criteria encompassed individuals of all ages and both genders.Data Collection: Trained medical personnel conducted structured interviews with participants to gather demographic information, medical history, and details of their craniofacial conditions.Medical Records Review: Medical records were reviewed to corroborate craniofacial diagnoses and identify any comorbid conditions.Statistical Analysis: Data were analyzed using appropriate statistical techniques to assess the association between PRS and psychiatric disorders.Ethical Considerations: The study adhered to all ethical guidelines, with informed consent obtained from participants or their legal guardians. Ethical approval was obtained from the hospital’s Institutional Review Board.Data Handling: Confidentiality and data security were ensured throughout the study, with all data anonymized to protect participant privacy.ResultsIn our study, we assessed 28 different patients with Pierre-Robin Sequence, comprising 13 females and 15 males. The youngest patient was 2 months old, while the oldest was 22 years old. The mean age of the patients was 4.75 years, with a median of 3 years and a standard deviation of 5.36 years.Among the patients, 6 exhibited psychiatric disorders, split between 4 males and 2 females. Their average age was 10 years, with a median of 9 years and a standard deviation of 4.2. The youngest patient with evidence of a psychiatric disorder was 5 years old.ConclusionsThis study underscores a concerning reality within the Pierre-Robin population, pointing to a high prevalence of psychiatric disorders. These findings highlight the urgent need for integrated care, emphasizing the importance of early psychiatric assessment and tailored interventions to enhance the overall well-being of individuals facing the challenges of PRS.Disclosure of InterestNone Declared
IntroductionCraniofacial malformations have long been associated with a heightened risk of psychiatric disorders. Understanding this link is crucial, as it can inform early intervention and support ...for affected individuals, enhancing their overall well-being. Research in this area aims to shed light on the prevalence and nature of these disorders within the craniofacial population, ultimately improving healthcare and quality of life for affected individuals.ObjectivesThis study aims to establish a comprehensive understanding of the relationship between craniofacial malformations and psychiatric disorders. Specifically, our objectives include: assessing prevalence, identifying risk factors, evaluating impact and informing clinical practice. This research aims to improve the holistic care and mental well-being of individuals with craniofacial malformations, contributing to a more comprehensive approach in the field of psychiatry.MethodsThis cross-sectional study was conducted at a prominent referral hospital named Hospital de Clínicas de Porto Alegre during the month of August 2023.Participant Selection: Patients with craniofacial malformations of all ages and both genders.Data Collection: We conducted structured interviews with participants to gather demographic information, medical history, and details of their craniofacial conditions.Medical Records Review: Medical records were reviewed to corroborate craniofacial diagnoses and identify any comorbid conditions.Statistical Analysis: Data were analyzed using appropriate statistical techniques to assess the association between craniofacial malformations and psychiatric disorders.Ethical Considerations: The study adhered to all ethical guidelines, with informed consent obtained from participants or their legal guardians. Ethical approval was obtained from the hospital’s Institutional Review Board.Data Handling: Confidentiality and data security were ensured throughout the study, with all data anonymized to protect participant privacy.ResultsIn our study, we assessed 132 different patients, comprising 62 females and 70 males. The youngest patient was 2 months old, while the oldest was 56 years old. The mean age of the patients was 16.22 years, with a median of 9 years, a harmonic mean of 18 years, and a standard deviation of 15.23 years.Among the patients, 24 exhibited psychiatric disorders, evenly split between 12 males and 12 females. Their average age was 16.21 years, with a median of 10 years, a harmonic mean of 6.13, and a standard deviation of 14.57. The youngest patient with evidence of a psychiatric disorder was 2 years old.Image:Image 2:ConclusionsOur study underscores the prevalence of psychiatric disorders among craniofacial patients, which seems to be greater than the general population, emphasizing the need for integrated care that considers both medical and psychological aspects, thus enhancing the overall well-being of these individuals.Disclosure of InterestNone Declared
Background
A large proportion of age‐related fecal incontinence is attributed to weakness or degeneration of the muscles composing the anal continence organ. However, the individual role of these ...muscles and their functional interplay remain poorly understood.
Methods
This study employs a novel technique based on the combination of MR imaging and FLIP measurements (MR‐FLIP) to obtain anatomical and mechanical information simultaneously. Unlike previous methods used to assess the mechanics of the continence organ, MR‐FLIP allows inter‐individual comparisons and statistical analysis of the sphincter morpho‐mechanical parameters. The anatomy as well as voluntary and involuntary mechanical properties of the anal continence organ were characterized in 20 healthy senior volunteers.
Results
Results showed that the external anal sphincter (EAS) forms a funnel‐like shape with wall thickness increasing by a factor of 2.5 from distal (6 ± 0 mm) to proximal (15 ± 3 mm). Both voluntary and involuntary mechanical properties in this region correlate strongly with the thickness of the muscle. The positions of least compliance and maximal orifice closing were both located toward the proximal EAS end. In addition, maximal contraction during squeeze maneuvers was reached after 2 s, but high muscle fatigue was measured during a 7 s holding phase, corresponding to about 60% loss of the energy produced by the muscles during the contraction phase.
Conclusions
This work reports baseline parameters describing the morpho‐mechanical condition of the sphincter muscle of healthy elderly volunteers. New parameters were also proposed to quantify the active properties of the muscles based on the mechanical energy associated with muscle contraction and fatigue. This information could be used to assess patients suffering from AI or for the design of novel implants.
The mechanisms by which continence is maintained remain poorly understood. Therefore, we report a first statistical analysis of the involuntary (compliance) and voluntary (muscle work) mechanical properties of the healthy continence organ along the anal canal.
This work presents baseline parameters for implant design and proposes new mechanical biomarkers for quantifying continence. In addition, this study provides evidence that the proximal segment of the anal canal plays a prominent role in mechanically maintaining continence.
Aim
Continence results from a complex interplay between anal canal (AC) muscles and sensorimotor feedback mechanisms. The passive ability of the AC to withstand opening pressure – its compliance – ...has recently been shown to correlate with continence. A functional lumen imaging probe (FLIP) is used to assess AC compliance, although it provides no anatomical information. Therefore, assessment of the compliance specific anatomical structures has not been possible, and the anatomical position of critical functional zones remains unknown. In addition, the FLIP technique assumes a circular orifice cross‐section, which has not been shown for the AC. To address these shortcomings, a technique combining FLIP with a medical imaging modality is needed.
Method
We implemented a new research method (MR‐FLIP) that combines FLIP with MR imaging. Twenty healthy volunteers underwent MR‐FLIP and conventional FLIP assessment. MR‐FLIP was validated by comparison with FLIP results. Anatomical markers were identified, and the cross‐sectional shape of the orifice was investigated.
Results
MR‐FLIP provides compliance measurements identical to those obtained by conventional FLIP. Anatomical analysis revealed that the least compliant AC zone was located at the proximal end of the external anal sphincter (EAS). The cross‐sectional shape of the AC was found to deviate only slightly from circularity in healthy volunteers.
Conclusion
The proposed method is equivalent to classical FLIP. It establishes for the first time direct mapping between local tissue compliance and anatomical structure, which is key to gaining novel insights into (in)continence. In addition, MR‐FLIP provides a tool for better understanding conventional FLIP measurements in the AC by quantifying its limitations and assumptions.
Faecal samples from children between 3 months and 5 yrs were investigated for the presence of methanogenic bacteria. Methanobacteria were not detected in faecal samples obtained from children under ...27 months of age. At 27 months only one subject harbored methanobacteria; the number of methanobacteria hosts subsequently increased with age, with an incidence of 40% at 3 years and 60% at 5 years. The appearance of methanobacteria was not directly related to introduction of particular foods in the child's diet, which after 2 years becomes similar to that of Italian adults. These dietary changes could give rise to some physical-chemical modifications of the enteric lumen thus causing the conversion of the intestinal flora to an adult pattern and, in most subjects, the development of methanobacteria.
Background/Aims: There are a variety of factors that affect the quality of colonoscopy bowel preparations, although the relationship between the level of health literacy (HL) and the quality of bowel ...preparations has yet to be clarified. The present study evaluated the effect of HL on the quality of bowel preparation prior to a colonoscopy. Materials and Methods: The data of 150 patients who underwent a colonoscopy for colorectal cancer screening and in whom the quality of bowel preparation was scored during the colonoscopy were recorded prospectively. The European Health Literacy Survey Questionnaire (HLS-EU-Q47) was used to evaluate HL prior to the colonoscopy, and the Boston bowel preparation scale was used to evaluate the quality of the bowel preparation during the colonoscopy. The demographic characteristics of the patients, the presence of comorbidities, socioeconomic characteristics (marital status, income level, and educational level), HLS-EU-Q47 questionnaire, and Boston bowel preparation scale scores were recorded and evaluated. Results: A significant linear relationship was identified between the general HL index score, the cleanliness of the colonic segments (right, transverse, and left colon) and the total Boston bowel preparation scale score (p=0.013, p=0.010, p=0.008, p=0.001, respectively). In a HL subgroup analysis, a significant linear relationship was noted between disease prevention and health promotion index, the cleanliness of the colonic segments (right, transverse, and left colon), and the total Boston bowel preparation scale score. It was observed that an increase in the health care index resulted in an increase in the cleanliness of the relevant colonic segments and the total Boston bowel preparation scale score. No relationship was found between the right, transverse, and left colon and the total Boston bowel preparation scale scores and gender, age, Body Mass Index (BMI), comorbidity, marital status, level of income, or educational level. Conclusion: The level of HL affects the quality of colonoscopy bowel preparations. Keywords: Health literacy, HLS-EU-Q47, bowel preparation, colonoscopy
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