A frontal lobe syndrome case unresponsive to schizophrenia treatment

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
Gökhan Evcili, Muhammed Nur Öğün, Uygar Utku.



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Psychosis Related With Hashimoto Thyroiditis: A case report

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
Ruken Ağaçhanlı, Özlem Devrim Balaban, Menekşe Sıla Yazar, Nezih Eradamlar.
Hashimoto's thyroiditis is an autoimmune disease characterized with inflammation of the thyroid gland. Psychiatric symptoms are frequently seen with Hashimoto's thyroiditis. Major depression is the most common affective disorder with a prevalence of %33-43. Psychotic disorders can be seen in the rate of %5. In this case report; a patient, recently diagnosed with hypothyroidism and involved into a psychotic process due to his hypothyroidism, is discussed. The patient's refusal of oral intake and lack of parenteral preparation of thyroxine in our country were the factors that made the treatment more complicated. The aim of this case report is to emphasize the importance of the routine laboratory examinations especially during the first admittion to the hospital. And we want to underline the difficulty of thyroid replacement therapy of patients who do not or can not get oral medication due to lack of preparation of parenteral thyroxine in our country.


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A DİFFİCULT INTENSIVE CARE FOLLOW UP; A THİRTEEN YEARS OLD SUICIDE BY HANGING

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
İsa YILDIZ, Esma Söylemez, Hüsna Karadayı, Mansur Kürşad Erkuran, Hakan Bayır, Hamit Yoldaş.
Suicide among young population, which increased day by day is a global challenge. The factors that problems within the family, drug addiction increase the risk of suicide besides internal and external pressures, increase in childhood depression can lead to the selection of rare methods such as hanging with rope in young age. This situation can return to intensive care by increasing the suicide rate in younger age. Psychosocial support is very important in this age group. In this report, thirteen years old girl was found hanging by suicide after resuscitation attempts were monitored in an intensive care will be discussed.


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Lafora Disease Presenting Wıth Acute Anxiety: A Case Report

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
ESRA Özdemir DEMİRCİ.
Psychiatric disorders are seen more frequently in patients with epilepsy than in the general population. Personality changes, psychosis, obsessive-compulsive symptoms and mood or anxiety disorders can occur in association with epilepsy. Anxiety disorders and depression are most common psychiatric disorders in patients with epilepsy. Lafora disease (LD) is a treatment resistant epilepsy with onset in the teenage years, followed by progressively worsening myoclonus, seizures, visual hallucinations and cognitive decline, leading to a vegetative state in status myoclonicus and death. Different neuropsychiatric symptoms can be seen in patients with LD during the course of the disease. There are as yet no reports on how often patients with epilepsy, such as LD, presented with psychiatric symptoms to clinics at the first onset of the disease. No case of LD presenting with an anxiety disorder before seizures was found in the literature. Herein the case of a 14-year-old female adolescent who presented with acute severe anxiety before seizures began will be discussed.


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Aripiprazole Augmentation Of Clomipramine Therapy In Treatment-Resistant Obsessive-Compulsive Disorder: Case Series

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
Filiz İzci, Murat Yalçın, Sümeyye Yasemin Kurtuluş Çallı, Yağmur Sever, Rabia Bilici.
Obsessive-compulsive disorder (OCD) is a chronic disorder characterised by recurrent intrusive thoughts and repetitive rituals, causing significant distress and functional loss. Studies show evidence about serotonergic and dopaminergic mechanisms in neuropathogenesis of OCD. Selective serotonin re-uptake inhibitors (SSRI) are considered first line treatment in OCDs but treatment resistance may occur in 40-60% of cases treated with SSRIs. Augmentation of antidepressants with atypical antipsychotics is an important treatment option in treatment-resistant patients with OCD. In this article, we aimed to present five OCD cases with treatment-resistance in which we obtained good outcomes, with addition of aripiprazole 10-30 mg per day to clomipramine therapy.


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Venlafaxine Induced Hair Loss: A Case Report

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
Esra Yancar Demir.
Objective:, Hairloss side-effect due to SNRIs are limited to case reports. Case: E is a 33 years old. Since her twenties, she suffers from symptoms of depression and anxiety like anhedonia, insomnia once or twice a year. This time she had been suffering from depressive mood, unwillingness, pessimism, aggresiveness for 4 months and she appealed to our clinic as she felt that her symptoms were worsening. She was diognosed as major depression reccurrent type according to DSM-4 and venlafaxine 75 mg/day treatment was started. At the first she was continued with same treatment. At the end of second month she reported witht he complaint of hair-loss. Her laborotuary findings including thyroid function tests, vitamin B-12 and D were all normal. As the organic reasons that might have caused the problem were sidelined, it was thought that venlafaxine might be the cause and it was discontinued .At the first month control after discontinuation hairloss had clearly been decreased . Conclusion: Clinicians should be aware that hairloss dueto venlafaxine,even rare, might be seen and such a complaint of a patient using venlafaxine shouldnt be over looked


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Psychometric Properties of the Turkish Version of the Adult ADHD Self-Report Scale (ASRS-v1.1) in a Sample of Inpatients with Alcohol Use Disorder

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
Cuneyt Evren, Gokhan Umut, Muge Bozkurt, Gulsen Teksin-Unal, Ruken Agachanli, Bilge Eren.
Objective: The Adult attention deficit hyperactivity disorder (ADHD) Self-Report Scale (ASRS) allows dimensional self-rating assessment of ADHD according to DSM-IV. Turkish version of the scale was validated in university students. The aim of the present study was to evaluate psychometric properties of the Turkish version of the ASRS in a sample of inpatients with alcohol use disorder (AUD). Method: Participants included 190 inpatients with AUD. Participants were evaluated with the ASRS and the Adult ADD/ADHD DSM-IV Based Diagnostic Screening and Rating Scale (Adult ADHD Scale). Results: The ASRS-18 (18 item version) was found to be psychometrically sound adult ADHD screening measure with high convergent validity when compared with Adult ADHD Scale (r=0.738; 0.694 for inattentive-IN subscale and 0.690 for hyperactive/impulsive-HI subscale) and to have a Cronbach's α of 0.863 (0.822 for IN subscale and 0.775 for HI subscale). Two components accounted for 31.13% and 9.27% of total variance respectively for the ASRS-18. Subscales were highly correlated with total ASRS-18 score (n=190, r=0.887, r=0.886 respectively) and moderately correlated with each other (r=0.571). Test-retest correlation was moderate (n=120, r=0.677) for IN subscale whereas test-retest correlation was high for HI subscale (r=0.774) and for ASRS-18 (r=0.765). The ASRS-18 had sensitivity and specificity scores of 0.81 and 0.75, respectively, when using the optimal cut-off score of 30. Additionally, the ASRS-18 showed good discriminant validity as it significantly differentiated alcohol dependent inpatients with a risk of ADHD from those without. The ASRS-6 (6 item version) showed similar psychometric properties as ASRS-18, although sensitivity score (0.75) was lower than ASRS-18, whereas specificity score (0.79) was similar with ASRS-18, when using the optimal cut-off score of 10 is taken for ASRS-6. Conclusion: These findings support the Turkish version of the ASRS (both 18 item and 6 item versions) as reliable and valid adult ADHD screening instrument that measures two dimension construct among inpatients with AUD.


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An investigation of the relationship between adolescents’ subjective well-being and perceived parental attitudes

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
Tuğba Sarı, İsa Özkan.
ABSTRACT Does the subjective well-being of adolescents differ with respect to parental attitudes as theoretical literature explains? Purpose: This study aims to investigate the relationship between parental attitude and subjective well-being among adolescents. Methods: The target population of the study has been composed of the students of secondary schools in Safranbolu District of Karabuk in 2013-2014 school year. Research sample has been formed with 659 students from randomly selected three different secondary schools. "PersonalInformation Form", "Parental Attitude Scale" and "Subjective Well-Being Scales for Adolescents" have been used for data collection. Mann-Whitney U Test and Kruskal Wallis H Test with Bonferroni correction have been used in data analysis. Results: A meaningful difference between parental attitude and subjective well-being level that adolescents have perceived has been found (p>0,05). The level of subjective well-being of adolescents who perceive their parents as democratic and tolerant is higher than the adolescents who perceive their parents as careless and authoritative. Conclusion and discussion: In the light of the foregoing findings, it has been concluded that positive attitude and support of parents enhance the level of subjective well-being of adolescents. The results have been discussed in consideration of findings and related theoretical background and some suggestions for practitioner and educators are given. Key Words: Adolescent, parental attitude, and subjective well-being


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Relationship between clinical characteristics and empathic responding in patients with major depressive disorder

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
Okan Ekinci, Aslı Ekinci.
Aim To our knowledge, there is no study specifically examined the relation between clinical features and empathic responding in patients with MDD. Our aim was to examine cognitive and affective empathic responding of patients with major depressive disorder and to explore the possible relations between the clinical features and empathy. Methods The sociodemographic and clinical properties of 83 patients with major depression were recorded. Beck Depression Inventory (BDI) was used to assess severity of depression. Hopelessness level was measured by Beck Hopelessness Scale ( BHS). Patients empathic ability was evaluated by using Interpersonal Reactivity Index (IRI) and results were compared with 85 healthy controls. We used Pearson correlation and general linear model analysis to evaluate the manner in which the variables contributed to IRI scores. Results Perspective Taking (IRI-PT), Empathic concern (IRI-EC) and Fantasy (IRI-FS) subscores were all substantially lower in subjects with depression than in healthy comparison subjects while Personal Distress (IRI-PD) subscore was higher than in healthy subjects. There were significant effects of gender on the scores of IRI-EC and IRI-FS. Lower IRI-FS and IRI- PD scores were found to be significantly related to high suicide risk in depression. Conclusion Based on our results, patients with major depressive disorder have significantly impaired empathy measures compared to normal population. Our findings also suggest a close relationship among suicidality and empathy in patients with MDD. Keywords: major depressive disorder, empathy, suicide, hopelessness, gender


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Quality of Life and Psychopathology among Parents of Children with Atopic Dermatitis

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
Şeref Şimşek, Tuba Tuncel, Tuğba Yüksel, Ayşen Çetemen, M. Fuat Gürkan.
Objective: The mothers of children diagnosed with atopic dermatitis (AD) may be impacted in many different ways. The aim of the present study was to compare quality of life, anxiety, depression, and alexithymia symptoms between mothers of children diagnosed with AD and mothers of healthy children. Method: The study included mothers of 34 children who were diagnosed with atopic dermatitis between June 2012 and July 2013 and mothers of 35 healthy children. In the study, short form 36 (SF 36) was used to evaluate quality of life, while the Toronto alexithymia scale (TAS) was used to evaluate alexithymia level, the state-trait anxiety inventory (STAI) was used to evaluate anxiety symptoms, and the Beck Depression Scale (BDS) was used to evaluate depression symptoms. Results: There was no statistically significant difference between the mothers of AD patients and control subjects in terms of quality of life, anxiety, depression, and alexithymia. In addition, there was no significant difference in disease severity or symptoms scale scores between the two groups. Conclusions: These results may suggest that mother's mental health is not affected in the early stage of the disease. In later stages of the disease, mothers of children with AD may become psychologically affected. Long-term follow up studies are required to clarify this distinction.


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Premature and Normal Menopause: An Evaluation in Terms of Stress, Marital Adjustment and Sex Roles

2016-03-25T20-21-33Z
Source: Düşünen Adam: The Journal of Psychiatry and Neurological Sciences
Meral Önder, Ayşegül Durak Batıgün.
Introduction: Middle age period brings about particular difficulties for some adults, because of the physiological and psychological changes. The physiological changes occuring in this period is called andropause for males and menopause for females. While it starts about 40-50 years of age in general, it might be at an earlier stage of life for some women which is called premature menopause, indicating the climacterium. Aim: The main aim of this srudy is to compare two groups of women with premature menopause and normal menopause in terms of stress reactions, ways of coping, marital adjustment, and sex roles. Method: Data were collected from a total of 224 women, 82 of which had premature menopause (under age 40), and 142 had normal menopause (above age 40). The participants were given Demographic Information Form, Stress Reactions Scale, Ways of Coping Inventory, Marital Adjustment Scale, and Bem Sex Roles Inventory to obtain data. Results: The t-test analysis has revealed that the premature menopause group had higher scores in stress reactions, lower scores in self confident and optimistic ways of coping with stres, and lower scores in marital adjustment, compared to the normal menopause group. The predictive variables for both groups were found to be degree of agreement in marriage, helpless style, and searching for social support by regression analysis. The masculine sex role was the predictor of only the premature menopause group. Discussion: The results were discussed within the framework of the related literature, and the implications were presented for the mental health practices.


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Effectiveness of Lumbopelvic Exercise in Colon Cancer Survivors.

Introduction: This study evaluated the effectiveness of lumbopelvic exercise in improving health-related fitness, anthropometric measurements and body composition in colon cancer survivors (CCS). Methods: Forty-six CCS (35% female, n=14) were assigned to two groups for this randomized controlled clinical trial: a trunk muscle stabilization exercise program group (CO-CUIDATE) and a usual-care group. The CO-CUIDATE program was conducted for 8 weeks (3 times per weeks). The primary endpoint was isometric abdominal strength measured using the trunk curl test. The secondary endpoints used were isometric back strength, functional capacity, lower-body flexibility, weight and anthropometric measurements evaluated at baseline, after the physical exercise program and after 6 months of follow-up. A trained member of the research group with 5 years of experience working with cancer patients and who was blinded to the patient group assessed the variables. All physical tests were carried out with multiple observations. Results: The adherence to intervention was 88.36%, and 2 drop-outs (10.5%) were recorded. Minor side effects, including discomfort with the exercises in the first sessions, were reported by the participants. ANOVA demonstrated significant differences in group x time interactions for isometric abdominal strength (F= 7.7; p= 0.001), functional capacity (F= 4.6; p= 0.015), lower-body flexibility (right, F= 4.3, p= 0.021 and left, F= 3.6, p= 0.034) and waist circumference (F= 5.7; p= 0.07), which were the best values for the CO-CUIDATE group. No significant changes in isometric back strength, weight, hip circumference or body composition were observed. Conclusion: An 8-week program based on stabilization exercises is a promising strategy to increase health-related fitness and reduce waist circumference in CCS. An exercise program based on lumbopelvic exercise is a feasible intervention to improve the control of deep abdominal muscles and health-related fitness. TRIAL REGISTRATION: Clinical Trials.gov NCT02052050 (available in http://ift.tt/1ZCfEz2) (C) 2016 American College of Sports Medicine

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Sleep Extension before Sleep Loss: Effects on Performance and Neuromuscular Function.

Purpose: To investigate the effects of 6 nights of sleep extension on motor performance and associated neuromuscular function before and after one night of total sleep deprivation (TSD). Methods: Twelve healthy men participated in two experimental conditions (randomized cross-over design): extended sleep (EXT, 9.8 +/- 0.1 h time in bed) and habitual sleep (HAB, 8.2 +/- 0.1 h time in bed). In each condition, subjects performed 6 nights of either EXT or HAB at-home followed by an assessment of motor performance and neuromuscular function at baseline (D0) and after one night of TSD, i.e. 34-37 h of continuous wakefulness (D1). Maximal voluntary contractions with superimposed femoral nerve electrical and transcranial magnetic stimulations and stimulations on relaxed muscles were investigated before and after submaximal isometric knee extensor exercises performed until task failure. Results: Time to exhaustion was longer in EXT compared to HAB (+3.9 +/- 7.7% and +8.1 +/- 12.3% at D0 and D1, respectively). Performance at D1 decreased from D0 similarly between conditions (-7.2 +/- 5.6% and -3.7 +/- 7.3% in HAB and EXT, respectively). At D1, the rating of perceived exertion during exercise was lower in EXT compared to HAB (-7.2 +/- 7.5%) with no difference at D0. No difference was observed in voluntary activation between the two conditions. Conclusions: Six nights of sleep extension improved sustained contraction time to exhaustion and this result cannot be explained by smaller reductions in voluntary activation, measured by both nerve and transcranial magnetic stimulation. The beneficial effect on motor performance in the extended sleep condition was likely due to reduced ratings of perceived exertion after TSD. (C) 2016 American College of Sports Medicine

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Dendritic Cells Are Involved in the Effects of Exercise in a Model of Asthma.

Introduction: Investigate the effects of aerobic exercise (AE) on both the maturation of dendritic cells (DCs) and the activation of lymphocytes in a mouse model of chronic allergic airway inflammation. Methods: C57Bl/6 mice distributed into Control, Exercise, OVA and OVA+Exercise groups were submitted to OVA sensitization and challenge. Treadmill training was performed for 4 weeks, and mice were assessed for classical features of chronic allergic airway inflammation, as well as dendritic cell activation and T lymphocyte response. Results: AE reduced OVA-induced eosinophilic inflammation as observed in bronchoalveolar lavage fluid (BALF) (p

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Effects of Exercise on Doxorubicin-Induced Skeletal Muscle Dysfunction.

Introduction: Chemotherapy treatment with doxorubicin (DOX) can have a negative impact on normal skeletal muscle function. Recent research demonstrates the potential value of exercise in alleviating DOX-induced cardiotoxicity. Yet up to now, little research has been done to examine whether exercise might also be effective in addressing DOX's skeletal muscle side effects, especially since post-treatment skeletal muscle dysfunction may cause patient difficulties with completing activities of daily living. The main aim of this study was to examine how resistance training (RT) and treadmill (TM) training play a role in preventing DOX-induced skeletal muscle dysfunction. Methods: Male Sprague-Dawley rats were randomly placed into a RT, TM, or sedentary (SED) group for 10 weeks and then received either a bolus injection of DOX (15 mg/kg) or saline (SAL) as a control. Skeletal muscle function was then assessed ex vivo 5 days following injection. Results: SED animals treated with DOX showed significantly lower maximal twitch force, maximal rate of force production and maximal rate of force decline versus SED+SAL in the soleus (type 1 muscle). In the extensor digitorum longus (EDL) (type 2 muscle), treatment with DOX resulted in a significantly lower maximal rate of force production and maximal rate of force decline. RT preserved maximal twitch force and maximal rate of force decline in the SOL. TM attenuated DOX-induced fatigue in the SOL but not in the EDL. Conclusion: These findings suggest that RT and TM prior to DOX could be useful in preserving skeletal muscle function and minimizing fatigue after chemotherapy, but this protection may be dependent upon skeletal muscle type. (C) 2016 American College of Sports Medicine

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The Relevance of Sex Differences in Performance Fatigability.

Performance fatigability differs between men and women for a range of fatiguing tasks. Women are usually less fatigable than men and this is most widely described for isometric fatiguing contractions, and some dynamic tasks. The sex difference in fatigability is specific to the task demands so that one mechanism is not universal, including any sex differences in skeletal muscle physiology, muscle perfusion and voluntary activation. However, there are substantial knowledge gaps about the task dependency of the sex differences in fatigability, the involved mechanisms and the relevance to clinical populations and with advanced age. The knowledge gaps are in part due to the significant deficits in the number of women included in performance fatigability studies despite a gradual increase in the inclusion of women over the last 20 years. Therefore, this review 1) provides a rationale for the limited knowledge about sex differences in performance fatigability, 2) summarizes the current knowledge on sex differences in fatigability and the potential mechanisms across a range of tasks, 3) highlights emerging areas of opportunity in clinical populations, and 4) suggests strategies to close the knowledge gap and understanding the relevance of sex differences in performance fatigability. The limited understanding about sex differences in fatigability in healthy and clinical population presents as a field ripe with opportunity for high impact studies. Such studies will inform on the limitations of men and women during athletic endeavors, ergonomic tasks and daily activities. Because fatigability is required for effective neuromuscular adaptation, sex difference in fatigability studies will also inform on optimal strategies for training and rehabilitation in both men and women. (C) 2016 American College of Sports Medicine

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Translating Fatigue to Human Performance.

Despite flourishing interest in the topic of fatigue-as indicated by the many presentations on fatigue at the 2015 annual meeting of the American College of Sports Medicine-surprisingly little is known about its impact on human performance. There are two main reasons for this dilemma: (1) the inability of current terminology to accommodate the scope of the conditions ascribed to fatigue, and (2) a paucity of validated experimental models. In contrast to current practice, a case is made for a unified definition of fatigue to facilitate its management in health and disease. Based on the classic two-domain concept of Mosso, fatigue is defined as a disabling symptom in which physical and cognitive function is limited by interactions between performance fatigability and perceived fatigability. As a symptom, fatigue can only be measured by self-report, quantified as either a trait characteristic or a state variable. One consequence of such a definition is that the word fatigue should not be preceded by an adjective (e.g., central, mental, muscle, peripheral, and supraspinal) to suggest the locus of the changes responsible for an observed level of fatigue. Rather, mechanistic studies should be performed with validated experimental models to identify the changes responsible for the reported fatigue. As indicated by three examples (walking endurance in old adults, time trials by endurance athletes, and fatigue in persons with multiple sclerosis) discussed in the review, however, it has proven challenging to develop valid experimental models of fatigue. The proposed framework provides a foundation to address the many gaps in knowledge of how laboratory measures of fatigue and fatigability impact real-world performance. (C) 2016 American College of Sports Medicine

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Validity of Consumer-Based Physical Activity Monitors for Specific Activity Types.

PURPOSE: Consumer-based physical activity (PA) monitors are popular for individual tracking of PA variables. However, current research has not examined how these monitors track energy expenditure (EE) and steps in distinct activities. This study examined the accuracy of the Fitbits One, Zip, and Flex and Jawbone UP24 for estimating EE and steps for specific activities and activity categories. METHODS: Thirty subjects completed a structured protocol consisting of three sedentary, four household, and four ambulatory/exercise activities. All subjects began by lying on a bed for 10 min; 10 other activities were performed for 5 min each. Indirect calorimetry (COSMED) and researcher-counted steps were criterion measures for EE and step counts, respectively. The Omron HJ-720IT pedometer was used as a comparison of step count accuracy. EE and steps were compared to criterion measures using the Friedman repeated-measures nonparametric test and mean absolute percent error (MAPE). RESULTS: All PA monitors predicted EE within 8% of COSMED for sedentary activity but overestimated EE by 16-40% during ambulatory activity. All monitors except the Fitbit Flex (within 8% of criterion) underestimated EE by 27-34% during household activity. EE predictions were accompanied with MAPE >10%. For household activity, the Fitbit Flex estimated steps within 10% of researcher-counted steps; all other monitors underestimated steps by 35-64%. All monitors estimated steps within 4% of researcher-counted steps and displayed MAPE

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Validity of an Integrative Method for Processing Physical Activity Data.

Accurate assessments of both physical activity and sedentary behaviors are crucial to understand the health consequences of movement patterns and to track changes over time and in response to interventions. PURPOSE: The study evaluates the validity of an integrative, machine-learning method for processing activity monitor data in relation to a portable metabolic analyzer (OM; Oxycon Mobile) and direct observation (DO). METHODS: Forty-nine adults (ages 18-40) each completed 5-minute bouts of 15 activities ranging from sedentary to vigorous intensity in a laboratory setting while wearing the ActiGraph (AG) on the hip, the activPAL (AP) on the thigh and the OM. Estimates of energy expenditure (EE) and categorization of activity intensity were obtained from the AG processed with Lyden's Sojourns method (SOJ) and from our new Sojourns Including Posture (SIP) method, which integrates output from the AG and AP. Classification accuracy and estimates of EE were then compared to criterion measures (OM, DO) using confusion matrices and comparisons of mean absolute error of the log (MAE ln Q). RESULTS: The SIP method had a higher overall classification agreement [79%, 95% CI: 75%, 82%] than the SOJ [56%, 95% CI: 52%, 59%] based on DO. Compared to OM, estimates of EE from SIP had lower MAE ln Q than SOJ for light (0.21 vs. 0.27), moderate (0.33 vs. 0.42) and vigorous (0.16 vs. 0.35) intensity activities. CONCLUSIONS: The SIP method was superior to SOJ for distinguishing between sedentary and light activities as well as estimating EE at higher intensities. Thus, SIP is recommended for research in which accuracy of measurement across the full range of activity intensities is of interest. (C) 2016 American College of Sports Medicine

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Primary colorectal lymphoma comprising both components of diffuse large B-cell lymphoma and mucosa-associated lymphoid tissue lymphoma combined with cytomegalovirus colitis

Abstract

A 16-year-old girl presented to our hospital with diarrhea and abdominal pain. The macroscopic findings of colonoscopy revealed multiple submucosal tumors and multiple ulcers, which were localized in the sigmoid colon, and diffuse granular mucosa which extended to the total colon. The pathological diagnosis was malignant lymphoma comprising both components of diffuse large B-cell lymphoma (DLBCL) and mucosa-associated lymphoid tissue (MALT) lymphoma, because the large lymphoma cells were CD20+, CD10−, and CD5−. Furthermore, immunohistochemical analysis of colorectal biopsy samples from multiple ulcers revealed cytomegalovirus (CMV)-positive cells. The patient was diagnosed with primary colorectal lymphoma comprising both components of DLBCL and MALT lymphoma combined with CMV colitis. She received anti-viral medication and chemotherapy.

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Medical Gerontology in Clinical Practice

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Mirko Grujic.



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The Differential Algorithm Between Rheumatologic and Malign Diseases

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Arbnore Batalli Këpuska, Lidvana Spahiju, Ramush Bejiq, Rufadije Manqestena, Valbona Stavileci, and Zana Ibraimi.
Objective: The aim of this study is to determine the differential algorithm between rheumatism and malignant diseases. For every pediatrician, to be warned when attending joint pain and child arthralgia and prevent and treat within time malignant diseases. Methods: Our case presented in Pediatric Clinic, was referred by Regional Hospital of Ferizaj with suspected diagnose of Febris Rheumatica and Arthralgia. The main complaint was joint pain. Initially the patient was admitted at Cardiology and Rheumatology department. Then after examinations was referred to Hemato-Oncology department. Hospitalized during the period from 12.12.2014 to 18.01.2015. Results: Bone marrow biopsy as terminal diagnostic tool reviled severe malignant hematologic disease, which was masked by clinical and lab findings as Febris Rheumatica. Conclusion: Arthralgia as one of childs often complain, should have a special attention paid to, as it might be a warning sign for a lot of diseases. Steroid treatment should not be used before final diagnose of the disease and before rolling out hematologic etiology with peripheral blood smear.


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Nurses’ Perceptions of Futile Medical Care

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Somayeh Rostami, Hedayat Jafari.
The increasing progress in medical and health sciences has enhanced patient survival over the years. However, increased longevity without quality of life in terminally ill patients has been a challenging issue for care providers, especially nurses, since they are required to determine the futility or effectiveness of treatments. Futile care refers to the provision of medical care with futile therapeutic outcomes for the patient. Interest in this phenomenon has grown rapidly over the years. In this study, we aimed to review and identify nurses perceptions of futile care, based on available scientific resources. In total, 135 articles were retrieved through searching scientific databases (with no time restrictions), using relevant English and Farsi keywords. Finally, 16 articles, which were aligned with the study objectives, were selected and evaluated in this study. Overlapping studies were excluded or integrated, based on the research teams opinion. According to the literature, futile care cannot be easily defined in medical sciences, and ethical dilemmas surrounding this phenomenon are very complex. Considering the key role of nurses in patient care and end-of-life decision-making and their great influence on the attitudes of patients and their families, support and counseling services on medical futility and the surrounding ethical issues are necessary for these members of healthcare teams.


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Assessing Factors That Affect Coping Strategies Among Nursing Personnel

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Sofia Zyga, Stavroula Mitrousi, Victoria Alikari, Athanasios Sachlas, John Stathoulis, Evangelos Fradelos, Georgios Panoutsopoulos, Lavdaniti Maria.
Introduction: The nursing profession is characterized as one of the most stressful professions. A significant number of international surveys prove that nurses experience anxiety that often is accompanied by intense symptoms that negatively affect their work performance and their psychological mood. Aim: To evaluate the ways of coping in stress adopted by the nursing staff and their relationship with sociodemographic and job characteristics. Methodology: A cross-sectional, quantitative study was conducted in seven hospitals of Peloponnese Region, Greece. The study took place between April 2013-June 2013 and 395 nurses completed the Ways of Coping questionnaire. Socio-demographic, educational and job characteristics of nurses were, also, recorded. Results: Strategies focused on the problem were adopted to a greater extent more by postgraduate nurses, head nurses, and nurses with greater working experience. Intensive Care Unit nurses mainly adopted the strategy of denial while strategies focused on emotions were mostly adopted by females. Age and marital status did not affect significantly the choice of coping strategies. Conclusions: According to our findings several demographic factors that affect coping in stressful situations can be investigated and such an investigation could offer useful research findings for consideration.


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Contact with Health-care Service Expectation and Reality of Situation Experienced by Immigrants Seeking Swedish Health-care

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Ferid Krupic, Sahmir Sadic, Nabi Fatahi.
Aim: The aim of the study was to investigate how immigrants from Bosnia and Herzegovina, Somalia and Kosovo experienced contact with Swedish health-care regarding meeting with health-care professionals. Material and Methods: Eighteen participants, nine men and nine women from Bosnia and Herzegovina, Somalia and Kosovo participated in focus group interviews (FGI). Data were collected from April 2013 to April 2014 through three group interviews using open-ended questions. A qualitative approach, incorporating a critical incident technique (CIT) was used. Results: The findings highlighted patients negative experiences regarding the Swedish health care system. Their main complaints concerned delayed ambulances, lack of doctors in outpatient clinics, long journeys to the hospital and long waiting time at the emergency department. Lack of information about the disease, difficulties seeing a doctor in the department, poor language skills and insufficient interpreters were some of other difficulties that mentioned by participants. Conclusions: In order to provide satisfactory health care to patient with different ethnic backgrounds, it is important to be aware of their vulnerable situation and their limit capacity to express their needs. This research could be a starting point in developing strategies for reducing ethnicity-based misunderstandings and inequalities in the health-care system.


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Use of Orthodontic Treatment Needs Indices for Oral Health Survey

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Enita Nakas, Alisa Tiro, Lejla Redzepagic Vrazalica, Dzana Hadzihasanovic.
Aim: The aim of our study is to compare incidence of orthodontic malocclusion based on occlusal indices and Index of Orthodontic Treatment Need (IOTN), and to evaluate the most commonly used method among the dentists for orthodontic treatment in Sarajevo. Material and Methods: The sample consisted of 110 (31 female and 79 male)subjects older than 16 years with complete permanent dentition. Subjects were examined according to Occlusal Index (Angle classification of malocclusion, overjet, overbite, dental arch crowding and tooth rotation) and IOTN index. We conduct survey regarding which indexes are used in deciding on orthodontic treatment need, among primary health care and Orthodontist. Results: The present study show differences between the presence of malocclusion and treatment need as assessed by these two used indices. Based on the survey that we conduct all primary health care doctors use Occlusal Index to decide need for orthodontic treatment, more than 95% of orthodontic specialist use Occlusal Index for treatment need estimation. Conclusion: When measuring and grading treatment needs we should rely on Index of orthodontic treatment need. In such high demand for orthodontic treatment need it is necessary to establish need for the orthodontic treatment as fundamental, so that individuals with greatest treatment need can be assigned priority.


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Fluoride: a Review of Use and Effects on Health

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Domen Kanduti, Petra Sterbenk, and Barbara Artnik.
Introduction. Appropriate oral health care is fundamental for any individuals health. Dental caries is still one of the major public health problems. The most effective way of caries prevention is the use of fluoride. Aim. The aim of our research was to review the literature about fluoride toxicity and to inform physicians, dentists and public health specialists whether fluoride use is expedient and safe. Methods. Data we used in our review were systematically searched and collected from web pages and documents published from different international institutions. Results. Fluoride occurs naturally in our environment but we consume it in small amounts. Exposure can occur through dietary intake, respiration and fluoride supplements. The most important factor for fluoride presence in alimentation is fluoridated water. Methods, which led to greater fluoride exposure and lowered caries prevalence, are considered to be one of the greatest accomplishments in the 20th century`s public dental health. During pregnancy, the placenta acts as a barrier. The fluoride, therefore, crosses the placenta in low concentrations. Fluoride can be transmitted through the plasma into the mothers milk; however, the concentration is low. The most important action of fluoride is topical, when it is present in the saliva in the appropriate concentration. The most important effect of fluoride on caries incidence is through its role in the process of remineralization and demineralization of tooth enamel. Acute toxicity can occur after ingesting one or more doses of fluoride over a short time period which then leads to poisoning. Today, poisoning is mainly due to unsupervised ingestion of products for dental and oral hygiene and over-fluoridated water. Conclusion. Even though fluoride can be toxic in extremely high concentrations, it`s topical use is safe. The European Academy of Paediatric Dentistry (EAPD) recommends a preventive topical use of fluoride supplements because of their cariostatic effect.


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Medication Adherence in Elderly with Polypharmacy Living at Home: a Systematic Review of Existing Studies

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Erika Zelko, Zalika Klemenc-Ketis, Ksenija Tusek-Bunc.
Background: We wanted to systematically review the available evidence to evaluate the drug adherence in elderly with polypharmacy living at home. Methods: We performed a literature search using MEDLINE, ISI Web of Science, ProQuest, EMBASE, SCOPUS, Springer Link, Sage Journals and CINAHL. We used the following terms: Medication Adherence, Medication Compliance, Polypharmacy, and Elderly. The search was limited to English-language articles. We included only clinical trials, systematic reviews, meta-analysis and cross-sectional studies. Results: A total of seven articles were included in this systematic review after applying the search strategy. Six studies dealt with the prevalence of medication adherence and its correlates in patients aged 65 years or more with polypharmacy. Two studies dealt with the effect of various interventions on medication adherence in patients aged 65 years or more with polypharmacy. Conclusion: The available literature on the polypharmacy and drug adherence in elderly living at home is scarce and further studies are needed.


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The Role of Target Organ Diagnostic Approach in Seasonal Allergic Rhinitis: Nasal Smear Eosinophils

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Jasmina Nurkic, Mona Al Ahmad, Nermina Arifhodzic, Edin Jusufovic.
Background: Allergic rhinitis (AR) related to local weeds pollen sensitization (Chenopodiaceous family) is the most common cause of respiratory allergy in Kuwait. Local nasal accumulation of different cells typical of allergic inflammation is responsible for clinical symptoms of AR. Although nasal smear for Eosinophils (NSE) is one of the earliest included valuable test in diagnosis of AR, with time is underestimated. Aim: Explore possible correlation of natural pollen allergen stimulation with appearance and quantity of Eosinophils in nasal smear. Methods: A group of randomly selected patients with clinical history suggestive for seasonal AR (SAR), who came to Al Rashed Allergy Center in period from October 2014 to October 2015, obtain Nasal Smear for Eosinophils as a screening test before further diagnostic evaluation. Nasal samples were collected by passing a sterile swab, from each nasal cavity, along the medial surface of the inferior turbinate 2 to 3 times and the specimen smeared on a clear glass slide. Nasal smears were examined by light microscopy after staining with hematoxylin and eosin stain. Skin prick test is performed in all symptomatic patients with a battery of inhalant allergens that include local pollens. The control group was recruited, with their voluntary consent, from the medical stuff with a negative history of any allergic nasal symptoms. In this group we performed only nasal smear for Eosinophils. Air Biology Laboratory Kuwait provided us with daily pollen count. Results: From total 158 study participants, 132 had SAR symptoms and are divided in four groups. Fifth, control, group is non symptomatic. For 38.6% of symptomatic patients NSE were positive, while 45% of these patients have negative SPT. From 62.1% NSE negative patients, 37.8% have negative SPT. Our results showed expected positive correlation of NSE positive patients with pollen season in Kuwait, in SPT positive group. However, presence of Eosinophils in nasal smear was moderate to high also in patients with negative SPT during the highest peak of season, in contrast to control group. Conclusion: NES showed moderate sensitivity, relatively high specificity and importance as screening test in SPT negative patients. Evaluation of AR demand wide and improved diagnostic approach due to significant number of SPT negative patients with positive NSE based on natural allergen stimulation. Our results emphasize locale allergic response of nasal mucosa and importance of target organ diagnostic approach.


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Antimicrobial Resistance of Escherichia Coli Strains Isolated from Urine at Outpatient Population: a Single Laboratory Experience

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Sabina Mahmutovic Vranic, Aida Uzunovic.
Objectives: The aim of this study was to examine antimicrobial resistance of Escherichia coli strains isolated from urine in outpatient population. Material and methods: We performed a retrospective study for tree months period, between January 1st and March 31st, 2015, at the Department of Microbiology and Parasitology, Faculty of Medicine, University of Sarajevo. We determined the E. coli antimicrobial resistance in 556 first urine samples from outpatient population of Hrasno community in Sarajevo, Bosnia and Herzegovina. E. coli is the most frequent agent causing urinary tract infections in outpatients as well. The standard methods of descriptive statistics were performed for data analysis. Results: We observed the highest antimicrobial resistance of E. coli for ampicillin (82,79%), followed by trimethoprim-sulfamethoxazole (40,86%), nalidixic acid (19,35%), cephazolin (7,52%), nitrofurantoin (5,37%), gentamicin (2,15% ) and ciprofloxacin (4,30%). Conclusions: The results of study showed that E. coli has the highest resistance to ampicillin and trimethoprim-sulfamethoxazole in outpatient population of Hrasno community.


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Utilisation Analysis of Antihypertensive Drugs in Bosnia and Herzegovina for the Time-period 2013–2015

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Kenan Selmanovic, Svjetlana Loga Zec, NenadVanis, Lamija Zecevic, Manja Setkic, Azra Rasic, Enver Zerem.
Objective: Expenditures for drugs are increasingly burdening already insufficient funds for health protection. This is especially evident in less developed European countries such as Bosnia and Herzegovina. The question is whether such analyses can help save funds for financing treatment for diseases, with an emphasis on a more rational choice of drug for appropriate indication, whereby clinical complications of hypertension would be prevented and patients would have quality of their lives improved. Aim: Focus of research has been set on analysis of use of antihypertensive drugs in Bosnia and Herzegovina in the time-period January 2013March 2015. Use of all drugs for treatment of hypertension in that time-period in the country has been shown in an unbiased manner. Methods: The study is designed as retrospective-prospective comparative research of use of antihypertensive drugs in BiH in a certain time-period. Data are collected from relevant drug utilisation database which has been established in Bosnia and Herzegovina since 2013. Results: We have calculated financial expenditure for prescribed antihypertensives in the time- period of 2013, 2014 and Q1 2015. Use of antihypertensives at the country level for this time-period is BAM 200,242,218. At the country level, physicians are most often opting for combination therapy: ACE inhibitors + diuretics (20.2%) and ACE inhibitors + Ca channel antagonists (18.0%). Conclusion: In this research, it has been shown that modern drugs are used for treatment of hypertension in Bosnia and Herzegovina. These drugs are used in the same order as they are prescribed in developed countries.


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Cost of Febrile Neutropenia Treatment in Bosnia and Herzegovina

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Tarik Catic, Alma Mekic-Abazovic, Samra Sulejmanovic.
Febrile neutropenia is common chemotherapy complication significantly impacting patients outcomes, quality of life and costs, too. Febrile neutropenia (FN) often leads to hospitalization, the need for intravenous antibiotics and use of granulocyte colony-stimulating factors (GCSF) in order to avoid its complications. Cost of febrile neutropenia is well described in literature, but no study has been performed in Bosnia and Herzegovina. We have conducted observational cohort study with aim to describe and present costs of FN treatment from payers (providers) perspective. Only direct medical costs from one middle-sized oncology Clinic in Bosnia and Herzegovina database have been included and presented. We found that overall cost in five months period (January-May 2015) were almost 30.000 euros, or 1.0035 euro per episode/patient in average. The highest cost are allocated to hospitalization (40%), followed by GCSF (36%), while rest of costs are generated by laboratory tests performed and drug application. Proportion of costs is in line with other published studies even with huge differences in absolute values, mainly to low prices of services in Bosnia and Herzegovina. This was the first study on costs of chemotherapy induced FN in Bosnia and Herzegovina suggesting that significant costs are inquired by this conditions and that further research should be performed including larger patient population and other clinical oncology data, including pharmacoeconomic analysis.


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The Frequency of Risk Factors on Trends of Pancreatic cancer in Kosovo

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Naser Ramadani, Kreshnike Dedushi, Sefedin Muçaj, Serbeze Kabashi, Naim Jerliu, Astrit Hoxhaj.
The aim: The aim of this paper is to analyze different factors that influence the trends of pancreatic cancer mortality and morbidity of patients treated at the UCCK of Kosovo. Within this study, we have evaluated pancreatic cancer risk factors, durability and lethality regarding Kosovan patients who have been diagnosed and treated within Kosovo. The study in question is that of retrospective research traversing the period of 2011-2015. Materials and methodology: This retrospective research study includes 362 patients recently diagnosed with pancreatic cancer, 2011-2015 at the University Clinical Center of Kosovo in Pristina. The main important factors included in this study are: age, sex and risk factors that altogether have considerable influence in incidence of pancreatic cancer. The imaging diagnostics are performed with the use of 2D ECHO Phillips, MSCT Sensation 64 and 6 and 1.5T MRI Symphony Siemens that are situated in the Radiologic Clinic of UCCK. The statistic data were obtained from NIPH of Kosovo and Agency of Statistics of Kosovo. Results: Out of the total number of the 362 patients diagnosed with pancreatic cancer, the mortality in all age groups was higher at male patients61.6 % of cases (n=223) with the highest number found at 5160 years age group. The 38.4 % (n= 139) were female patients with the highest incidence frequency at F 6170 years age group. The F/M ratio is 1:1.6. The plane nicotine users were found at 34 % (n=123) while the joined, nicotine/alcohol addiction was detected at 26 % (n= 94). The 18.5% (n=67) have had established diagnose of the diabetes mellitus tip II and 9.6 % (n=35) have undergone the medical treatment of the gastroduodenal peptic ulcerations. The total number of deaths is 310 (85.6%) and there are only 52 patients (14.4%) still alive. The mortality rate of the pancreatic cancer in Kosovo was 17.2 in 100.000 residents while the morbidity rate was 2.8 in 100.000 residents. Discussion and conclusion: This retrospective research study intends to present the role of the risk factor, that influence the mortality and morbidity of the pancreatic cancer in Kosovo and finally, to compare these results with similar studies abroad with aim to prevent the pancreatic cancer. The analyses of the obtained statistical data shows that the nicotine addiction play important role in incidence of the pancreatic cancer as well as alcohol addiction, presence of the diseases such are diabetes mellitus tip II and gastroduodenal peptic ulcers.


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Determination of Maternal Serum Zinc, Iron, Calcium and Magnesium During Pregnancy in Pregnant Women and Umbilical Cord Blood and their Association with Outcome of Pregnancy

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Fahimeh Khoushabi, Mohammad Reza Shadan, Ali Miri, Javad Sharifi-Rad.
Background: Trace elements and specially minerals are critical for the development of fetus. Many minerals are transferred to the fetus for fetal stores in the latter part of the pregnancy. It has been shown that various trace elements such as Zinc, Iron, Calcium and Magnesium are metabolically interrelated and there is alteration in their concentration during pregnancy. Beyond pregnancy is associated with increased demand of all the nutrients and deficiency of any of these could affect pregnancy, delivery and outcome of pregnancy. Aim: To study the levels of trace elements namely zinc, iron, magnesium and calcium in maternal and umbilical cord blood and their association with pregnancy outcome. Methods: Sixty pregnant women in Zabol, Iran were selected from those who had registered their names for the prenatal care and who had followed up till the 3rd trimester of pregnancy ending in child birth. Biochemical parameters analyzed with help of the biochemical laboratory. Data were analyzed by SPSS software. Results: The mean biochemical profile such, serum calcium, magnesium, zinc and iron in the pregnant women were as follow: in the 1st trimester 8.3, 1.9, 74.9 and 74.4 μg/dl respectively; in the 2nd trimester 8.5, 1.9, 73.1 and 79.3 μg/dl, respectively; in the 3rd trimester 8.6, 1.9, 68.4, and 82.2 μg/dl, respectively. In the umbilical cord blood, the mean serum calcium, magnesium, zinc and iron were 8.5, 1.9, 84.1, and 89.8 μg/dl, respectively. The mean serum calcium and magnesium during the three trimesters of pregnancy were not significantly different from that in the umbilical cord blood, while the mean serum zinc and iron in the umbilical cord blood were significantly different (p


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Appearance of Neurodevelopmental Disorders in Children Delivered Post-term: a Cross-section Study

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Mladenka Vukojevic, Ines Trninic, Arta Dodaj, Masa Manenica, Tatjana Barisic, Sandra Stojic.
Goal: To analyze the appearance of neurodevelopmental disorders in children delivered post-term and to find out whether prolonged pregnancy may be a cause of such disorders in a selected group participants. Patients and methods: This study included a cohort of 34 children born post-term suffering from neurodevelopmental disorders who were treated at the Service for psycho-physiological and speaking disorders in Mostar, Bosnia and Herzegovina during an 18-year period. Results: There were 59.4% of male and 40.6% female patients (P=0.002). The most common neurodevelopmental disorder in the sample was intellectual disability (38.2%), followed by epilepsy (26.4%), delayed psychomotor development (14.7%), and cerebral palsy (11.7%) (P


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Existence of Rule of Halves in Hypertension: an Exploratory Analysis in an Indian Village

2016-03-25T18-49-58Z
Source: Materia Socio Medica
Nafis Faizi, Anees Ahmad, Najam Khalique, Mohammad Salman Shah, Mohammad Shibly Khan, Mohd Maroof.
Introduction: India is a country in transition, the population is graying and the non communicable diseases are rising. In the rural areas of India, the detection of hypertension is poor because of limited healthcare facilities and poor awareness among the people. In one such village, Mirzapur, adopted by the Aligarh Muslim University, there is a planned project to control hypertension in the villages through some innovative approaches. This study was the assessment phase of this project for mass management of hypertension to steer and guide the next phase of the project. Aim: The main objectives of this study were: to determine the prevalence of hypertension in residents ≥ 40 years in Mirzapur village, Aligarh, and, to assess the presence of rule of halves in hypertension Results and Discussion: The present study in residents more than 40 years of age in the Mirzapur village in Aligarh found that the prevalence of hypertension in the study population was 41.9%, with a higher prevalence in older age groups. The mean blood pressure of the study population was found to be 100.03±13.17 mm Hg. The high prevalence reported in the present study reflects and reaffirms the increasing trend of hypertension in not only the urban, but also rural India, at least in the older age group. The problem of hypertension, due to its silent and asymptomatic nature, frequently depicts a rule of halves in places with weaker health system and an equally weaker health awareness and information among populations and the same is true for this village. Conclusion: There is an urgent need to conduct similar researches in other adopted villages of the country for the sake of inclusive development to find the exact burden of this silent and asymptomatic killer. More importantly, there is a need to find innovative solutions to combat the problem of hypertension detection and management.


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Accuracy of radiographic estimation of small bowel dimensions in pediatric patients with short bowel syndrome

Journal of Pediatric Surgery

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Randomized trial of hepatic artery embolization for hepatocellular carcinoma using doxorubicin-eluting microspheres compared with embolization with microspheres alone

Journal of Clinical Oncology

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Antiviral response and resistance analysis of treatment-naïve HCV-infected patients receiving single and multiple doses of GS-9190

Journal of Viral Hepatitis

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Colorectal cancer risk and nitrate exposure through drinking water and diet

International Journal of Cancer

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Chronic hepatitis B virus infection: Disease revisit and management recommendations

Journal of Clinical Gastroenterology

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Evidence of surgical outcomes fluctuates over time: results from a cumulative meta-analysis of laparoscopic versus open appendectomy for acute appendicitis

BMC Gastroenterology

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Socioeconomic risk factors for celiac disease burden and symptoms

Journal of Clinical Gastroenterology

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Calcium and 1,25-dihydroxyvitamin D3 modulate genes of immune and inflammatory pathways in the human colon: a human crossover trial

American Journal of Clinical Nutrition

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Clinical efficacy and safety of oral Qing–Dai in patients with ulcerative colitis: A single-center open-label prospective study

Digestion

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Flavored intravenous ondansetron administered orally for the treatment of persistent vomiting in children

Journal of Tropical Pediatrics

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Heme iron intake, dietary antioxidant capacity, and risk of colorectal adenomas in a large cohort study of French women

Cancer Epidemiology, Biomarkers & Prevention

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Detection of active Epstein-Barr virus infection in duodenal mucosa of patients with refractory celiac disease

Clinical Gastroenterology and Hepatology

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Evidence-based clinical management of acute malignant colorectal obstruction

Journal of Clinical Gastroenterology

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Blood Lipid Concentrations and Colorectal Adenomas: A Systematic Review and Meta-Analysis of Colonoscopy Studies in Asia, 2000–2014

American Journal of Epidemiology

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Interference with daily activities and major adverse events during esophageal pH monitoring with bravo wireless capsule versus conventional intranasal catheter: a systematic review of randomized controlled trials

Diseases of the Esophagus

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Primary care physician perspectives on hepatitis C management in the era of direct-acting antiviral therapy

Digestive Diseases and Sciences

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Determinants of infant mortality in last two decades: a bibliometric analysis

2016-03-25T01-08-47Z
Source: International Journal of Community Medicine and Public Health
Serap Taskaya, Mustafa Demirkiran.
Background: Infant mortality has a great importance as a measurement of child survival year by years. The first aim of this study was to determine the predictors of infant mortality in last two decades with a bibliometric and a content analysis. A secondary objective was to examine the frequency of publications by year, the distribution of articles by country location and, to determine how data were collected and analyzed. Methods: It was a bibliometric analysis of web of science database for years 1996-2015. A total of 289 eligible articles were identified. The publications were analyzed by publication years, contributions of the countries, data collection tools, study designs and determinants. Results: The annual number of infant mortality related articles increased from 7 articles in 1996 to 27 articles in 2015. The largest studies were made in the USA. Many of articles used records, national statistics or cohort study for data collection. Logistic and linear analysis model were performed commonly. Illness/infection, birth weight, and gestational age were the most important factors affecting infant mortality. Conclusions: This study provides a useful reference to researchers for the future research directions. The results of this study are also expected to provide evidence-based information to health policymakers to evaluate the best policy approaches for efforts on reducing infant mortality.


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Prevalence of dental caries in male children from 3 to 14 years of age of Bundelkhand region

2016-03-25T01-08-47Z
Source: International Journal of Community Medicine and Public Health
Arvind Jain, Vandana Jain, Sheenu Malik Suri, R. K. Jain.
Background: Dental caries is a public health problem in developing countries like India. The problem is dreadful among children particularly of low socio-economic status in rural area. The present study was planned to assess the prevalence of dental caries among children of rural Bundelkhand region. Methods: The present study was conducted in the male children attending the paediatric OPD in Tikamgarh district of Madhya Pradesh. The age group considered for study was from 3 to 14 years of age. Results: The overall prevalence of the dental caries in male children was found to be 82.62% with mean DMFT/dmft to be 3.58 and the prevalence is higher in middle childhood group of 7-10 years (87.09%) as compared to pre-school group including 3-6 years (81.07%) and late childhood group of 11-14 years (75.72%). Conclusions: The study population showed a very high prevalence of 82.62% among male children of Bundelkhand region. It indicates the need for educating the population about the causative factors for dental caries and immediate intervention in the form of dental health education.


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To determine the pattern and effects of verbal, emotional and physical abuse in both sexes

2016-03-25T01-08-47Z
Source: International Journal of Community Medicine and Public Health
Anchit Bharat, Nikita Jain, Bharat Kumar Gupta, Vinay Bharat.
Background: Abuse is a word used for bad effect or for a bad purpose and is of several types. Presence of abuse in a civilized society is the major obstacle in achieving complete health. In India there has been 760 percent increase in abuse rate from 1971 to 2009. We listen a lot about abuses against fairer sex, but there exist abuses against males too. So, we decided to undertake this study to find out whether both sexes suffer from abuse or not and what are their pattern and effects? Methods: Predesigned questionnaires were distributed to 100 males and 100 females aged 15 to 55 years, requested to honestly and completely fill and return. Collected data was analyzed under set format of scoring. Results: Frequency of verbal abuse was 33.57% in males and 18.71% in females while overall frequency was 25.15% and its effects were in 36.33% males and 22.66% females, while the overall effect was observed in 30.66%. Frequency of emotional abuse was 25.42% in males and 20.14% in females while overall frequency was 29.25% and its effects were in 29.33% males and 23% females, while the overall effect was observed in 28.33%. Frequency of physical abuse was 25.71% in males and 14.85% in females while overall frequency was 22.8% and its effects were in 39.33% males and 22.66% females, while overall effect was observed in 29.33%. There was no statistically significant co-relation of effects and types of different abuses with gender, age, socio-economic status and religion (p


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Acute Erosive Esophagitis As a Rare Complication of Severe Pediatric Diabetes Ketoacidosis

No abstract available

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The Gut Is a Key Player in Cystic Fibrosis Malnutrition

No abstract available

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Serum Vitamin D Depends Less on Latitude Than on Skin Color and Dietary Intake During Early Winter in Northern Europe

Objectives: To evaluate if dietary vitamin D intake is adequate for sufficient vitamin D status during early winter in children living in Sweden, irrespective of latitude or skin color. Methods: As part of a prospective, comparative, 2-center intervention study in northern (63°N) and southern (55°N) Sweden, dietary intake, serum 25-hydroxyvitamin D (S-25(OH) D), associated laboratory variables, and sociodemographic data were studied in 5 to 7-year-old children with fair and dark skin in November and December. Results: Two hundred six children with fair/dark skin were included, 44/41 and 64/57 children in northern and southern Sweden, respectively. Dietary vitamin D intake was higher in northern than southern Sweden (P = 0.001), irrespective of skin color, partly due to higher consumption of fortified foods, but only met 50–70% of national recommendations (10 μg/day). S-25(OH) D was higher in northern than southern Sweden, in children with fair (67 vs 59 nmol/L; P 

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Fe-D Up: Ending Iron and Vitamin D Deficiency in Toddlers

No abstract available

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Toxic-metabolic Risk Factors in Pediatric Pancreatitis: Recommendations for Diagnosis, Management, and Future Research

ABSTRACT: Pancreatitis in children can result from metabolic and toxic risk factors, but the evidence linking these factors is sparse. We review the evidence for association or causality of these risk factors in pancreatitis, discuss management strategies, and their rationale. We conducted a review of the pediatric pancreatitis literature with respect to the following risk factors: hyperlipidemia, hypercalcemia, chronic renal failure, smoking exposure, alcohol, and medications. Areas of additional research were identified. Hypertriglyceridemia of 1000 mg/dL or greater poses an absolute risk for pancreatitis; persistent elevations of calcium are predisposing. Further research is necessary to determine whether end-stage renal disease leads to increased pancreatitis in children similar to adults. It is unknown whether cigarette smoking exposure, which clearly increases risk in adults, also increases risk in children. The role of alcohol in pediatric pancreatitis, whether direct or modifying, needs to be elucidated. The evidence supporting most cases of medication-induced pancreatitis is poor. Drug structure, improper handling of drug by host, and bystander status may be implicated. Other pancreatitis risk factors must be sought in all cases. The quality of evidence supporting causative role of various toxic and metabolic factors in pediatric pancreatitis is variable. Careful phenotyping is essential, including search for other etiologic risk factors. Directed therapy includes correction/removal of any agent identified, and general supportive measures. Further research is necessary to improve our understanding of these pancreatitis risk factors in children.

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Epigenetics in Paediatric Gastroenterology, Hepatology, and Nutrition: Present Trends and Future Perspectives

ABSTRACT: Epigenetics can be defined as stable, potentially heritable changes in the cellular phenotype caused by mechanisms other than alterations to the underlying DNA sequence. As such, any observed phenotypic changes including organ development, aging, and the occurrence of disease could be driven by epigenetic mechanisms in the presence of stable cellular DNA sequences. Indeed, with the exception of rare mutations, the human genome-sequence has remained remarkably stable over the past centuries. In contrast, substantial changes to our environment as part of our modern life style have not only led to a significant reduction of certain infectious diseases but also seen the exponential increase in complex traits including obesity and multifactorial diseases such as autoimmune disorders. It is becoming increasingly clear that epigenetic mechanisms operate at the interface between the genetic code and our environment, and a large body of existing evidence supports the importance of environmental factors such as diet and nutrition, infections, and exposure to toxins on human health. This seems to be particularly the case during vulnerable periods of human development such as pregnancy and early life. Importantly, as the first point of contact for many of such environmental factors including nutrition, the digestive system is being increasingly linked to a number of "modern" pathologies. In this review article, we aim to give a brief introduction to the basic molecular principals of epigenetics and provide a concise summary of the existing evidence for the role of epigenetic mechanisms in gastrointestinal health and disease, hepatology, and nutrition.

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Ustekinumab for Resistant Pediatric Crohn Disease

No abstract available

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Serum Autotaxin Activity Correlates With Pruritus in Pediatric Cholestatic Disorders

Objective: Pruritus is a common symptom of cholestatic liver disorders. The present study aimed at evaluating autotaxin (ATX), a lysophospholipase recently identified as potential cause for cholestatic pruritus, in pediatric cholestatic diseases presenting with or without itching. Methods: A cohort of 45 children consisting of 14 patients experiencing itching (Alagille syndrome [n = 10], complete extrahepatic biliary atresia [n = 2], neonatal sclerosing cholangitis (n = 1), progressive familial intrahepatic cholestasis type 2 [n = 1]), 9 patients with bile acid synthesis defects (3β-hydroxy-C27-steroid-oxidoreductase [n = 7] and Δ4–3-oxosteroid-5β-reductase deficiency [n = 2]), and 22 healthy children were studied. Serum ATX activity and total serum bile salt were determined enzymatically, ATX protein content was semiquantified by Western blotting. Using real-time polymerase chain reaction, ATX mRNA expression was studied in HepG2 cells treated with farnesoid-X-receptor agonists or vehicle. Results: Serum ATX activity was increased in pruritic children with Alagille and other cholestatic syndromes (mean ± standard deviation: 16.1 ± 4.3 nmol · mL−1 · min−1) compared with children with nonpruritic cholestatic diseases with bile acid synthesis defects (10.4 ± 4.7 nmol · mL−1 · min−1; P 

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Age of Onset of Functional Constipation

ABSTRACT: In a review of 538 children with functional constipation, we analyzed ages of presentation and onset, symptom duration, and behavioral/developmental problems. We divided the subjects into quartiles (Q1–Q4) based on age of onset. Median onset age was 2.3 years. The oldest group had the shortest symptom duration before referral at 1.8 ± 1.8 years (compared with Q3 to Q1, P = 0.039, P = 0.001, P 

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Home-Based Screening for Biliary Atresia Using Infant Stool Color Cards in Canada: Quebec Feasibility Study

Objectives: Biliary atresia (BA) is a leading cause of liver failure and liver transplantation in pediatrics. BA manifests by 3 weeks of life with jaundice and pale stools. Delayed diagnosis and surgical intervention with Kasai portoenterostomy after 3 months of age is significantly associated with poor prognosis for native liver survival. A national Taiwan infant stool color card (SCC) screening program has entirely eliminated late Kasai portoenterostomy >90 days of age and improved native liver survival. A recent large-scale prospective cohort study in British Columbia, Canada, indicated that distribution of SCC on the maternity ward was feasible, led to high utilization rate, and was cost-effective. The aim of the present study was to assess the generalizability of this screening strategy in another Canadian jurisdiction with a different sociodemographic profile. Methods: An SCC was distributed to families of newborns discharged at St Mary's Hospital Center, Montreal, Quebec. Families were instructed to monitor their infant's stool color for 21 days and then complete and mail the SCC to the study center. Phone surveys to families who did not return cards were used to estimate total card utilization rate. Results: Two thousand two hundred forty-six infants were eligible for inclusion; 99.9% were enrolled. Mail SCC return rate was 63.3%. No cases of BA were identified. All of the 118 families who completed the phone survey reported that they had utilized the SCC. Conservative and optimistic estimates for total card utilization rates were 82% and 100%, respectively. Conclusions: The high enrollment and utilization rates in this screening study strongly support the feasibility of implementing a Canadian SCC screening program to improve outcomes of children with BA.

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Decreased Expression of Enterocyte Nutrient Assimilation Genes and Proteins in the Small Intestine of Cystic Fibrosis Mouse

Objectives: Cystic fibrosis (CF) has major effects on the intestinal tract with potential consequences on nutrition, but these are not fully understood. I investigated the possibility of altered enterocyte maturation in CF, as suggested by decreased enterocyte nutrient assimilation gene expression in published transcriptome analysis of the small intestine of CF mouse. Methods: In CF and wild-type (WT) mice, enterocyte gene/protein expression was analyzed by quantitative realtime polymerase chain reaction (qRT-PCR), enzyme histochemistry, immunohistochemistry, and Western blot. One group of mice was maintained on a control liquid diet; to manipulate the gut microbiota, a second group was treated with oral antibiotics; to improve hydration of the gut lumen, a third group was given a laxative drinking solution. Results: On the control diet in the CF intestine, there were decreased levels (67%–85% reduction of WT levels) of enterocyte genes/proteins. Antibiotics did not normalize the expression of enterocyte markers in the CF mouse. In contrast, the laxative treatment of CF mice significantly increased expression to near WT levels. Conclusions: These studies suggest that the environment of the CF intestinal lumen plays a role in reduced maturation of enterocytes. Because changing the gut lumen environment can affect enterocyte maturation, this is not a cell-autonomous effect of loss of CF transmembrane conductance regulator.

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Hepatoblastoma in Children With Congenital Portosystemic Shunts

ABSTRACT: Two children developed hepatoblastoma concurrent with congenital portosystemic shunts (PSSs) (Abernethy malformations). Both underwent operative ligation of their PSSs. One received concurrent tumor resection, whereas the other was deemed initially unresectable and underwent biopsy followed by neoadjuvant chemotherapy. Although benign hepatic masses, such as focal nodular hyperplasia and nodular regenerative hyperplasia, are common in patients with Abernethy malformations, malignant tumors have also been documented and should always be considered in the differential diagnosis of a patient with a congenital PSS and a hepatic mass.

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Intensive, Manual-based Intervention for Pediatric Feeding Disorders: Results From a Randomized Pilot Trial

Objectives: The aim of this pilot study was to investigate feasibility and preliminary efficacy of an intensive, manual-based behavioral feeding intervention for children with chronic food refusal and dependence on enteral feeding or oral nutritional formula supplementation. Methods: Twenty children ages 13 to 72 months (12 boys and 8 girls) meeting criteria for avoidant/restrictive food intake disorder were randomly assigned to receive treatment for 5 consecutive days in a day treatment program (n = 10) or waitlist (n = 10). A team of trained therapists implemented treatment under the guidance of a multidisciplinary team. Parent training was delivered to support generalization of treatment gains. We tracked parental attrition and attendance, as well as therapist fidelity. Primary outcome measures were bite acceptance, disruptions, and grams consumed during meals. Results: Caregivers reported high satisfaction and acceptability of the intervention. Three participants (1 intervention; 2 waitlist) dropped out of the study before endpoint. Of the expected 140 treatment meals for the intervention group, 137 (97.8%) were actually attended. The intervention group showed significantly greater improvements (P 

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Resolution of Hepatic Artery Thrombosis in 2 Pediatric Liver Transplant Patients

ABSTRACT: Hepatic artery thrombosis (HAT) is a serious complication after liver transplantation. This is the first report of spontaneous resolution of HAT in pediatric liver transplant patients on low molecular weight heparin therapy. A total of 2 patients, a 26-month-old boy who presented with acute liver failure and required emergent liver transplantation and a 15-year-old boy with ulcerative colitis and autoimmune hepatitis-primary sclerosing cholangitis overlap underwent liver transplantation for progressive cirrhosis; both developed HAT during the postoperative period. They were both treated with low molecular weight heparin. Follow-up imaging for both patients showed resolution of HAT without evidence of collateral flow.

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Same Quality but Not the Same Impact: Citations Related to Publications About Celiac Disease in JPGN and AJG

No abstract available

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Liver Disease in Pediatric Patients With Ataxia Telangiectasia: A Novel Report

Objective: Ataxia telangiectasia (A-T) is a rare genetic multiorgan disease. Although gastrointestinal involvement is known, hepatic involvement in A-T has not been investigated. We aimed to study the hepatic involvement in a large cohort of patients with A-T. Methods: A retrospective review of patients, studied from January 1986 to January 2015 at a National A-T Center. Clinical data including demographic, genetic, laboratory, nutritional, radiographic, and histological data were retrieved. Results: Fifty-three patients, 27 (49%) boys, age 14.6 ± 5.2 years (range 5.9–26.1 years), were included. Twenty-three patients (43.4%), age 9.9 ± 5.1 years, had consistently abnormal liver enzymes. The mean enzyme levels were alanine aminotransferase 76.8 ± 73.8 IU/L, aspartate aminotransferase 70 ± 50 IU/L, alkaline phosphatase 331 ± 134 IU/L, and gamma glutamyl transferase 114.7 ± 8 IU/L. Evaluation of other etiology of liver disease was negative. Ultrasonography revealed fatty liver in 9 of them (39%). Liver biopsy was performed in 2 patients, revealing mild-to-moderate steatosis in both, and fibrosis in 1 patient. Progression to advanced liver disease occurred in 2 of 23 (9%) patients within 2 to 5 years. Dyslipidemia was significantly associated with abnormal liver enzymes: 3 of 30 (10%) patients without abnormal liver enzymes versus 10 of 23 (45.5%) patients with abnormal liver enzymes, respectively (P 

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Symptom Association: An Imperfect Pairing

No abstract available

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Temporal Association Between Reflux-like Behaviors and Gastroesophageal Reflux in Preterm and Term Infants

Objectives: Multichannel intraluminal impedance studies (MII-pH) have become the criterion standard for the diagnosis of gastroesophageal reflux (GER). Several clinical signs and symptoms that are attributed to GER during infancy may not be related to true reflux. Our objective was to correlate the observed reflux-like behaviors to reflux events on MII-pH studies. Methods: This is a retrospective study on infants being evaluated for GER with MII. During the MII-pH study, the infants were observed for clinical behaviors. Symptom Index (SI), symptom sensitivity index (SSI), and symptom association probability were used to correlate symptoms with reflux events. Results: Of 58 infants (40 preterm, 18 term) included in the study, only 6 infants (10%) had an abnormal MII-pH study. Irritability (32 infants), bradycardia (20), and desaturation (18) were the common signs and symptoms. A total of 2142 (755 acidic and 1386 nonacidic) reflux episodes and 953 clinical reflux behaviors were recorded. The incidence and pattern of GER was similar in preterm and term infants. There was no significant difference in GER episodes and acid exposure in preterm infants fed orally or via nasogastric tube. The symptom association probability was abnormal in only 6 (19%), 1 (5%), and 5 (28%) infants with irritability, bradycardia, and desaturation, respectively. Conclusions: The prevalence of GER as detected by MII-pH was low (10%) in symptomatic preterm and term infants. The incidence and pattern of GER was similar in preterm and term infants. The majority of suspected clinical reflux behaviors did not correlate with reflux events.

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Health-Related Quality of Life in Spanish Children With Coeliac Disease

Objectives: The aim of the study was to assess health-related quality of life (HRQOL) using the Coeliac Disease Dutch Questionnaire (CDDUX) in Spanish children with coeliac disease. Methods: The CDDUX was cross-culturally adapted according to international consensus guidelines. HRQOL was assessed in coeliac members of the Madrid Coeliac Association ages 8 to 18 years using the adapted CDDUX. Cronbach α coefficient was determined as a measure of intraquestionnaire reliability and intraclass correlation coefficients as a measure of reliability between scores awarded by children and parents. Demographic and clinical variables associated with HRQOL were also assessed. Results: A total of 1602 children of 3122 registered Madrid Coeliac Association members ages 8 to 18 years were invited to participate. The questionnaire was completed by 480 families (30%): 214 only by parents, 214 by parents and their children, and 52 only by children. Cronbach α coefficient for the total score for parents was 0.90, and for children 0.88 (0.75–0.90 by scales). Mean total (standard deviation [SD]) HRQOL scores in children and parents were 55.5 (SD 12.7) and 53.89 (SD 12.19), respectively, with no differences detected in paired comparisons between the 2 groups. Significantly worse HRQOL scores were recorded in children showing a nonclassical clinical presentation, in those not adhering to treatment and in those reporting difficulties in following the diet. Conclusions: The CDDUX questionnaire emerged as reliable for use in Spanish children with celiac disease. Overall, both children and parents felt the disease had no substantial negative impacts on patient HRQOL.

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