Foreign body (FB) ingestion is a common problem in children under 5 years of age and is one of the main indications for endoscopy. The aim of the present study was to describe the clinical, ...radiographic, and endoscopic characteristics of patients with FB ingestion, as well as the factors associated with the anatomic location and the type of object ingested.
An analytic cross-sectional study was conducted on all patients with FB ingestion seen at the gastroenterology service from January 2013 to December 2018. The data were analyzed using the SPSS program, obtaining frequencies, percentages, medians, and interquartile ranges. Associations were assessed through the chi-square test.
Eighty-five patients (52 males and 33 females) were included, with a median age of 4 years. The most common symptom was vomiting (29.4%). Two radiographic projections were carried out in 72.9% of the cases and the stomach was the site where the FB was most frequently visualized (32.9%). The objects most commonly ingested were coins (36%), with esophageal location (p<0.05), as well as objects with a diameter larger than 2cm (p<0.05). An endoscopic procedure was performed on 76 patients (89.4%) for FB extraction, with findings of erythema (28.9%), erosion (48.6%), ulcer (10.5%) and perforation (1.3%).
Numerous factors should be taken into account in the approach to FB ingestion in pediatric patients, including type and size of the FB, time interval from ingestion to hospital arrival, and patient clinical status and age.
La ingestión de cuerpo extraño (CE) es un problema común en niños menores de 5 años, siendo una de las principales indicaciones para realizar endoscopias. El propósito de este estudio es describir las características clínicas, radiográficas y endoscópicas de pacientes con ingesta de CE, así como factores asociados con la localización anatómica y el tipo de objeto ingerido.
Estudio transversal analítico del total de pacientes con ingesta de CE en el servicio de gastroenterología de enero de 2013 a diciembre de 2018. Los datos se analizaron con el programa SPSS®, y se obtuvieron frecuencias, porcentajes, medianas, rangos intercuartílicos y, además, se buscaron asociaciones mediante Chi-cuadrado.
Se incluyeron 85 pacientes, 52 varones y 33 mujeres, la mediana de edad fue de 4 años. El síntoma más común fue el vómito (29.4%). En el 72.9% de los casos se realizaron dos proyecciones radiográficas, siendo el estómago el sitio donde se visualizó con más frecuencia (32.9%). Los objetos más comúnmente ingeridos fueron monedas (36%) con localización principalmente esofágica (p<0.05) así como objetos con diámetro mayor a 2cm (p<0.05). En 76 pacientes (89.4%) se realizó algún procedimiento endoscópico para su extracción, encontrando eritema (28.9%), erosiones (48.6%), úlceras (10.5%) y perforación (1.3%).
En el abordaje por ingesta de CE en pacientes pediátricos, deben tenerse en cuenta numerosos factores, incluyendo tipo y tamaño del CE, tiempo transcurrido desde la ingesta, estado clínico y edad del paciente.
Persistent Idiopathic Dentoalveolar Pain (PIDAP) is an orofacial neuropathic pain, which can be difficult to diagnose and is usually accompanied by increasing anxiety from both the patient and the ...treating dentist. A case of a 38-year-old female patient is presented, and it is shown the diagnostic process and therapeutic approach. The interdisciplinary management accompanied by several pharmacological lines is highlighted: Botulinum toxin was used as an adjunctive treatment allowing it to decrease systemically administered medications dosing and therefore its possible side effects. This condition usually affects psychosocial aspects of the patient and has a major impact on his quality of life. It is very important before initiating an invasive clinical treatment, obtaining a clear differential diagnosis and assessing in some cases the presence of non-odontogenic pain, such as PIDAP.
Ed Zigler was a champion for underprivileged youth, one who worked alongside communities to fight for long-lasting systemic changes that were informed by his lifespan and ecological perspective on ...the development of the whole child. This paper reports on the development, implementation, and preliminary outcomes of an intervention that embodied the Zigler approach by adopting a community participatory research lens to integrate complementary insights across community-based providers (promotoras), Latinx immigrant families, and developmental psychologists in the service of promoting parent-child relationship quality and preventing youth aggression and violence. Analyses from the first 112 Latinx mother-youth dyad participants (46% female children, ages 8-17) in the resultant, Confía en mí, Confío en ti, eight-week intervention revealed significant pre-post increases in purported mechanisms of change (i.e., attachment security, reflective functioning) and early intervention outcomes (i.e., depressive, anxiety, and externalizing problems). Treatment responses varied by youth age. A case analysis illustrated the lived experiences of the women and children served by this intervention. We discuss future directions for the program, as well as challenges to its sustainability. Finally, we consider Ed's legacy as we discuss the contributions of this work to developmental science and our understanding of attachment relationships among low-income immigrant Latinx families.
Bruxism an Issue Between the Myths and Facts Cervantes-Chavarría, Andrés R.; Utsman Abarca, Robert; Herrero Babiloni, Alberto
Odovtos,
09/2022, Volume:
24, Issue:
3
Journal Article
Peer reviewed
Open access
Is our goal in this paper to discuss the current concepts about bruxism, a topic that has been a matter of discussion on the dental field for many years. Recent International efforts have been made ...to challenge bruxism old definitions; this has derivate to a consensus and an actual new concept that defines bruxism as a behavior instead of a disorder. As a behavior, it is explained in this review how it can have negative health consequences, can be innocuous and how new research support that bruxism can even be a protective factor. Different etiological factors are reviewed in this paper as well the influence of external and internal mechanism related to medications, emotional stress, systemic factors, and potential pharmacological pathways. Moreover, it is briefly summarized the role of oral appliances on sleep bruxism. Finally, clinical considerations and recommendation for the dental professional regarding sings that should be notice during the exam are part of this overview.
ResumenIntroducciónLos niños con estreñimiento funcional presentan frecuentemente alteraciones de la distensibilidad y sensación defecatoria, que se pueden valorar mediante manometría anorrectal ...(MAR). En este estudio evaluamos la utilidad de los parámetros que se obtienen en la MAR en niños con incontinencia fecal retentiva (IFR).Material y métodosIncluimos a niños de 4 a 17 años con estreñimiento funcional a quienes se realizó MAR. ResultadosUn total de 35 niños fueron incluidos: 21 presentaban estreñimiento funcional y 14, estreñimiento con IFR. Los niños con estreñimiento funcional e IFR toleraron mayores volúmenes en la insuflación de aire para desencadenar urgencia defecatoria y dolor a la máxima tolerabilidad, en comparación con quienes no presentan IFR. Identificamos un punto de corte de 135 ml de aire de máxima tolerabilidad para discriminar niños con IFR. ConclusionesLa máxima tolerabilidad fue el parámetro más útil para evaluar IFR en niños con estreñimiento funcional.
Type 2 diabetes mellitus (DM2) is strongly associated with other comorbidities such as obesity, atherosclerosis, and hypertension. Obesity is associated with sustained low-grade inflammatory response ...due to the production of proinflammatory cytokines. This inflammatory process promotes the differentiation of some myeloid cells, including myeloid-derived suppressor cells (MDSCs). In this study, two groups of individuals were included: DM2 patients and non-DM2 individuals with similar characteristics. Immunolabeling of CD15+ CD14- and CD33+ HLA-DR-/low was performed from whole peripheral blood, and samples were analyzed by flow cytometry, and frequencies of MDSCs and the relationship of these with clinical variables, cytokine profile (measured by cytometric bead array), and anthropometric variables were analyzed. The frequency of CD33+ HLA-DR-/low MDSCs (that produce IL-10 and TGF-β, according to an intracellular detection) is higher in patients with DM2 (P<0.05), and there is a positive correlation between the frequency of CD15+ CD14- and CD33+ HLA-DR-/low MDSC phenotypes. DM2 patients have an increased concentration of serum IL-5 (P<0.05). Also, a negative correlation between the frequency of CD15+ CD14- MDSCs and LDL cholesterol was found. Our group of DM2 patients have an increased frequency of mononuclear MDSC CD33+ HLA-DR-/low that produce TGF-β and IL-10. These cytokines have been associated with immune modulation and reduced T cell responses. DM2 and non-DM2 subjects show a similar cytokine profile, but the DM2 patients have an increased concentration of IL-5.
•Patients with high-risk rectal cancer are generally treated with chemoradiotherapy followed by surgery.•Compliance of postoperative chemotherapy in rectal cancer patients is known to be low.•In this ...study patients were randomized to the standard treatment of chemoradiotherapy or short-course radiotherapy followed by chemotherapy prior to surgery.•Short-course radiotherapy and preoperative chemotherapy was associated with considerable toxicity.•Yet, high compliance of systemic therapy could be achieved by giving it after short-course radiotherapy and prior to surgery.•There were no differences in the details of surgical procedures or postoperative complications.
Preoperative chemoradiotherapy (CRT) followed by total mesorectal excision is widely accepted as the standard of care for high-risk rectal cancer. Adjuvant chemotherapy is advised in several international guidelines, although the survival benefit remains unclear and compliance is poor. The current multidisciplinary approach has led to major improvements in local control, yet the occurrence of distant metastases has not decreased accordingly. The combination of short-course radiotherapy (SCRT) and chemotherapy in the waiting period before surgery might have several benefits, including higher compliance, downstaging and better effect of systemic therapy.
This is an investigator-initiated, international multicentre randomized phase III trial. High-risk rectal cancer patients were randomized to SCRT followed by chemotherapy (6 cycles CAPOX or alternatively 9 cycles FOLFOX4) and subsequent surgery, or long-course radiotherapy (25–28 × 2–1.8 Gy) with concomitant capecitabine followed by surgery and optional postoperative chemotherapy (8 cycles CAPOX or 12 cycles FOLFOX4) according to local institutions’ policy. The primary endpoint is time to disease-related treatment failure. Here, we report the compliance, toxicity and postoperative complications in both study groups.
Between June 2011 and June 2016, 920 patients were enrolled. Of these, 901 were evaluable (460 in the experimental arm and 441 in the standard arm). All patients in the experimental arm received 5 × 5 Gy radiotherapy, and 84% of all patients received at least 75% of the prescribed chemotherapy. In the standard arm, the compliance for CRT was 93% and 58% for postoperative chemotherapy. Toxicity ≥grade 3 occurred in 48% of patients in the experimental arm, compared to 25% of patients in the standard arm during preoperative treatment and 35% of patients during postoperative chemotherapy. No statistically significant differences in surgical procedures or postoperative complications were observed.
High compliance (84%) of preoperative systemic treatment could be achieved with the experimental approach. Although considerable toxicity was observed during preoperative therapy, this did not lead to differences in surgical procedures or postoperative complications. Longer follow-up time is needed to assess the primary endpoint and related outcomes.
In this study we seek to better understand the experience of children exposed to parental negative conditional regard (NCR), a parenting practice where parents’ emotional availability is contingent ...on behavioral compliance rather than provided unconditionally. We propose that children parented with greater levels of NCR will show stronger negative reactions (i.e., physiological, subjective appraisal) to situations involving the expression of vulnerability than those parented with lesser levels of NCR, as the former will lack primary regulation strategies (e.g., asking for help), making vulnerability harder to resolve. We expect these children will display stronger reactions to situations involving expressing vulnerability to caregivers as they may fear rejection, after controlling for their responses to vulnerability alone. With a diverse sample of school-aged children (
N
= 109, 8–12 years of age), we test whether NCR, measured using parent- and child-reports, is associated with children’s negative reactions to hypothetical situations where 1) attachment needs are evoked (experience-only vignettes) and 2) attachment needs are evoked and vulnerability is expressed through help-seeking (HS vignettes). Children’s RSA profiles and subjective appraisals of hypothetical children were collected in a standardized laboratory paradigm. Results indicate that while parent-reported greater caregiver use of NCR was not significantly associated with physiology or appraisals, child-reported NCR was significantly associated with lower RSA and more negative appraisals of the hypothetical child when expressing vulnerability to the caregiver (HS vignettes). Implications of these findings are discussed in terms of attachment theory in middle childhood.
Highlights
Examines conditional regard as a form of insensitive parenting that may interfere with adaptive attachment behavior.
Examines subjective and physiological aspects of children’s reactions to vulnerability.
Negative conditional regard is linked to negative physiological and subjective reactions to vulnerability.
Results offer indirect support for understanding conditional regard as disrupting attachment processes.
A method has been developed and optimized in order to detect and quantify the non-protein amino acid β-N-methylamino-l-alanine(BMAA) in cyanobacteria. The novelty of the method is that we have used ...methanol instead of acetonitrile as the eluent. The method includes extraction with 0.1 M trichloroacetic acid (free BMAA) or protein hydrolysis with 6 M hydrochloric acid (total BMAA), derivatization with AQC (6-aminoquinolyl-N-hydroxysuccinimidyl carbamate) and reversed-phase high-performance liquid chromatography analysis with fluorescence detection (HPLC/FD). Detection limits ranged from 0.35 to 0.75 pg injected, while quantification limits ranged from 1.10 to 2.55 pg injected for total and free BMAA hydrolysis, respectively. The linear response range was up to 850 pmol in both methods, embracing three orders of magnitude. The method was successfully applied to a lyophilized estuarine species of Nostoc (LEGE 06077). All previous published methods for BMAA quantification, using HPLC/FD, have reported the usage of acetonitrile. This is the first report using methanol as the mobile phase. Although the elution strength differs with both solvents, the final method proved efficient for the quantification of BMAA in this complex sample. The method resulted effective, low-priced, and simple, being suitable for routine monitoring of BMAA in cyanobacteria.
► This is, to our knowledge, the first report of BMAA measurement in cyanobacteria using methanol as the eluent. ► This is the first report that BMAA was detected in Nostoc sp from estuarine Portuguese water. ► We presented here an optimized and simple method for BMAA measurement.
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