Computational Model Based on Optical Coherence Tomography (OCT) Skin Scanning to Identify and Quantify Acute Radiation Dermatitis (ARD): A Prospective Diagnostic Study.

BACKGROUND: Acute radiation dermatitis (ARD) is the most widely reported radiotherapy-induced adverse event. Currently, there is no objective or reliable method to measure ARD. OBJECTIVE: Our main objective was to identify and quantify the effects of radiotherapy with a computational model using optical coherence tomography (OCT) skin scanning. Secondary objectives included determining the ARD impact of different radiotherapeutic schemes and adjuvant topical therapies. METHODS: We conducted a prospective, single-center case series study in a tertiary referral center of patients with breast cancer who were eligible for whole breast radiotherapy (WBRT). RESULTS: A total of 39 women were included and distributed according to the radiotherapeutic schemes (15, 20, and 25 fractions). A computational model was designed to quantitatively analyze OCT findings. After radiotherapy, OCT scanning was more sensitive revealing vascularization changes in 84.6% of the patients (vs 69.2% of the patients with ARD by clinical examination). OCT quantified an increased vascularization at the end of WBRT (P<.05) and a decrease after 3 months (P=.032). Erythematous skin changes by OCT were more pronounced in the 25-fraction regime. CONCLUSION: An OCT computational model allowed for the identification and quantification of vascularization changes on irradiated skin, even in the absence of clinical ARD. This may allow the design of standardized protocols for ARD beyond the skin color of the patients involved.

Computational Model Based on Optical Coherence Tomography (OCT) Skin Scanning to Identify and Quantify Acute Radiation Dermatitis (ARD): A Prospective Diagnostic Study.

BACKGROUND: acute radiation dermatitis (ARD) is the most widely reported radiotherapy-induced adverse event. Currently, there is no objective or reliable method to measure ARD. OBJECTIVE: our main objective was to identify and quantify the effects of radiotherapy with a computational model using optical coherence tomography (OCT) skin scanning. Secondary objectives included determining the ARD impact of different radiotherapeutic schemes and adjuvant topical therapies. METHODS: we conducted a prospective, single-center case series study in a tertiary referral center of patients with breast cancer who were eligible for whole breast radiotherapy (WBRT). RESULTS: a total of 39 women were included and distributed according to the radiotherapeutic schemes (15, 20, and 25 fractions). A computational model was designed to quantitatively analyze OCT findings. After radiotherapy, OCT scanning was more sensitive revealing vascularization changes in 84.6% of the patients (vs 69.2% of the patients with ARD by clinical examination). OCT quantified an increased vascularization at the end of WBRT (P < .05) and a decrease after 3 months (P = .032). Erythematous skin changes by OCT were more pronounced in the 25-fraction regime. CONCLUSION: an OCT computational model allowed for the identification and quantification of vascularization changes on irradiated skin, even in the absence of clinical ARD. This may allow the design of standardized protocols for ARD beyond the skin color of the patients involved.

Systematic review of childhood and adolescent risk and prognostic factors for persistent abdominal pain.

This review aimed to identify childhood and adolescence risk and prognostic factors associated with onset and persistence of persistent abdominal pain and related disability and assess quality of the evidence. While findings suggest a possible role for negative emotional symptoms and parental mental health as risk and prognostic factors for onset and persistence of persistent abdominal pain, the evidence is of poor quality overall and nonexistent when it comes to prognostic factors associated with disability. CONCLUSION: Further research is needed to increase confidence in existing evidence and to explore new factors. This research will inform prevention.

Resistance in Escherichia coli: variable contribution of efflux pumps with respect to different fluoroquinolones.

AIMS: Resistance to fluoroquinolones is partially the result of a decrease in drug accumulation in Escherichia coli through different mechanisms. However, the variable contribution of these mechanisms with respect to different fluoroquinolones is poorly investigated. Therefore, the current study aimed to compare the contribution of resistance attributed to efflux-mediated mechanisms for different fluoroquinolones. METHODS AND RESULTS: Susceptibility of enrofloxacin, marbofloxacin and ciprofloxacin were compared after treatment with an efflux pump inhibitor in 17 ciprofloxacin-resistant E. coli isolates, and also the expression profile of the genes encoding the porins and efflux pumps involved in this resistance was evaluated. After treatment with the efflux pump inhibitor Phe-Arg-ß-naphthylamide (PAßN), susceptibilities differed significantly between antimicrobial agents, the decrease for MIC being higher for enrofloxacin than for marbofloxacin or ciprofloxacin. AcrB expression level increased significantly (+26%) in ciprofloxacin-resistant E. coli isolates compared with ciprofloxacin-susceptible isolates, whereas the expression level decreased for ompF (-50%) and ompC (-30%). CONCLUSIONS: There was a higher contribution of resistance nodulation division (RND) efflux pumps to resistance to hydrophobic fluoroquinolones. SIGNIFICANCE AND IMPACT OF THE STUDY: Comparison between expression profile of efflux pumps and hydrophobicity of the antimicrobial agents could result in variable resistance for different fluoroquinolones.

[New information and communication technologies in the treatment of chronic pain]. / Nuevas tecnologías de la información y la comunicación en el tratamiento del dolor crónico.

OBJECTIVE: To review the literature for evidence of the effectiveness of chronic pain treatments that apply new information and communication technologies, namely, the Internet and computer-assisted treatments. METHODS: We carried out a systematic search of the literature indexed on MEDLINE and PsycInfo. RESULTS: Eight articles were selected. In 5, the new technologies were used to implement treatments online while in the other 3 studies technology was used to create forums for patient discussion. CONCLUSIONS: In general the results of the studies reviewed demonstrate that treatments based on new technologies are effective and efficient and that patients hold positive attitudes toward them. However, reviewed results were not always consistent, probably because of differences in how the studies were designed.

[The Color Analog Scale: a valid instrument for measuring pain intensity in Catalan-speaking children?]. / La Coloured Analogue Scale: un instrumento válido para medir la intensidad del dolor en niños catalano-parlantes?

OBJECTIVE: To evaluate the validity of the Color Analog Scale (CAS) for assessing pain intensity in a Catalan-speaking pediatric population. PATIENTS AND METHODS: We compared children's CAS pain intensity ratings with their scores on the Catalan version of the Faces Pain Scale-Revised (FPS-R). We also compared the CAS to ratings of affective experience of pain evaluated with the Facial Affective Scale (FAS). RESULTS: A total of 124 Catalan-speaking children aged 7 to 15 years admitted to the pediatric wards of 3 university hospitals participated in the study. The results supported the construct and criterion validity of the CAS in the Catalan population. Correlation between CAS and FPS-R scores was high and significant (r=0.87; P <.001). Similarly, pain intensity scores correlated significantly with emotional discomfort recorded with the FAS (r = 0.34; P < .001). Most of the children, regardless of sex or age, reported a preference for the FPS-R over the CAS. CONCLUSIONS: The results of the present study provide preliminary evidence of the convergent, discriminant, and criterion validity of the CAS in this setting. The CAS appears to be valid for measuring pain intensity in Catalan-speaking children and adolescents between the ages of 7 and 15 years.

Effect of triterpenoids on the inflammation induced by protein kinase C activators, neuronally acting irritants and other agents.

In order to establish the mode of the anti-inflammatory activity of triterpenoids, 11 naturally occurring compounds were assayed on mouse ear oedema induced by the protein kinase C activators, mezerein, 12-O-tetradecanoylphorbol-13-acetate (TPA), two 12-deoxyphorbol-13-monoesters (13-tetradecanoate (DPT) and 13-phenylacetate (DPP)) and bryostatin 1, and by resiniferatoxin, xylene and arachidonic acid. The effects on bradykinin-induced paw oedema and on the rat skin inflammation caused by hydrogen peroxide were also examined. The oedema induced by mezerein and DPT was reduced to different extents by the triterpenoids administered epicutaneously (0.5 mg per ear). Against DPT-induced oedema, lupane and oleanane derivatives were the most effective compounds. Oleananes and lupanes possessing a carboxyl group were active against bryostatin 1-induced oedema. Most of the triterpenoids were ineffective against the neurogenic inflammation caused by resiniferatoxin and xylene. Many triterpenoids, especially oleanane and lupane alcoholic derivatives, were active against the plantar oedema induced by bradykinin and on the intradermal inflammation induced by hydrogen peroxide. In conclusion, the anti-inflammatory activity of triterpenoids may depend on inhibition of protein kinase C, without any involvement of neurogenic inflammatory mechanisms.

Superoxide scavenging properties of flavonoids in a non-enzymic system.

The superoxide anion scavenging activity of 38 flavonoids, some of them isolated from Sideritis mugronensis, Sideritis javalambrensis and Cayaponia tayuya were investigated by measurement of their inhibition of nitroblue tetrazolium reduction. Isoorientin, orientin, amentoflavone, leucocyanidol, eriodictyol, datiscetin and robinetin behaved as potent scavengers and structure-activity relationships were established.

[The perinatal period and pediatric psychiatry. Reflections on the interworking of a maternity department]. / Périnatalité et pédopsychiatrie. Réflexions sur la travail d'un inter-secteur dans une maternité.

This work is an assessment of the results of routine meetings between a children's psychiatrist and mothers with their new born babies in a general district hospital's maternity department. The approach is to look for early detection of faults in the mother-child relationship. Difficulties can be grouped into simple categories. The presence of a paediatric psychiatrist in a maternity department has made it possible to show up the value of specialised help early on as much for the 25% of women who are distressed after delivery as for the 6-7% that are really worrying cases.

Improvement of growth performance and sanitary status of weaned piglets fed a bovine colostrum-supplemented diet.

The present study investigated the effect of 3 different durations of feeding a diet supplemented with defatted bovine colostrum (Col) on growth performance and sanitary status of the weaned piglet. At 28 d of age, piglets were weaned and fed 1 of the 2 following diets: a control (Ctrl) starter diet or a starter diet supplemented with Col. Two experiments were conducted. In Exp. 1, 310 piglets (12 pens consisting of 10 piglets/pen and 10 pens consisting of 19 piglets/pen) were allocated to 1 of the 2 dietary treatments for 12 d. In Exp. 2, 522 piglets (18 pens consisting of 10 piglets/pen and 18 pens consisting of 19 piglets/pen) were allocated to 1 of the following 3 dietary treatments: fed the Ctrl diet from d 1 to 12 (Ctrl), Col diet from d 1 to 4 and then the Ctrl diet up to d 12 (Col-4d), or the Col diet from d 1 to 6 and then the Ctrl diet up to d 12 (Col-6d). For both experiments, a commercial second-phase diet was fed to piglets from d 12 to 46. Feed intake, growth performance, and cleanliness of floor and hindquarters of animals were investigated during the first 7 wk postweaning. In Exp. 1, from d 0 to 12, ADFI, ADG, and G:F were 16 (P = 0.004), 23 (P < 0.001), and 5% (P = 0.069) greater, respectively, in Col piglets compared with Ctrl piglets. Thereafter, ADFI and ADG were 7 (P < 0.001) and 9% (P < 0.001) greater, respectively, in Col piglets than Ctrl piglets (d 12 to 46). On d 12 after weaning, piglets fed the Col diet had more normal feces (+13%) and less soft or liquid feces (-9 and -4%, respectively) than piglets fed the Ctrl diet (P = 0.06). Compared with Ctrl piglets, feeding the Col diet led to more days with normal feces for the floor cleanliness (+22%; P < 0.001) from d 7 to 11. In Exp. 2, compared with Ctrl piglets, ADFI, ADG, and G:F were 8, 23, and 13% greater (P < 0.05) in Col-6d piglets from d 0 to 9, whereas values for Col-4d piglets were intermediate and did not differ from the values of the other dietary treatments. On d 9 after weaning, piglets fed the Col-4d or the Col-6d diet had more normal feces (+6 and +4%, respectively) and less liquid feces (-4 and -3%, respectively) than piglets fed the Ctrl diet (P = 0.08). No long lasting effects were observed thereafter. In conclusion, there was a reduction of weaning-induced growth check and diarrheal episodes in weaned piglets fed the Col diet. The beneficial effects of the bovine colostrum were observed beyond the period of treatment when the supplementation covered the first 6 d postweaning, which corresponded to the acute phase of postweaning digestive disturbances.

Mothers' and fathers' responses to their child's pain moderate the relationship between the child's pain catastrophizing and disability.

Preliminary evidence suggests that pain catastrophizing in children may be important in understanding how parents respond to their child's pain. However, no study has investigated whether parental responses, in turn, moderate the impact of child's catastrophizing upon pain outcomes. The present study was designed to address this, and investigated the association of the child's catastrophizing with different types of parental responses (ie, solicitousness, discouragement and coping promoting responses) and the extent to which parental responses moderate the association between the child's catastrophizing and disability. Participants were 386 school children and their parents. Analyses revealed significant associations between the child's pain catastrophizing and parental responses, but with mothers and fathers evidencing different patterns; ie, higher levels of the child's catastrophizing were significantly associated with lower levels of solicitousness by fathers, and with higher levels of discouragement by mothers. Moderation analyses indicated that father's solicitiousness moderated the association between catastrophizing and disability; the positive association between catastrophizing and the child's disability was further strengthened when fathers reported low levels of solicitousness, but became less pronounced when fathers reported high levels of solicitousness. Findings also revealed a moderating impact of mothers' and fathers' promotion of their child's well behaviour/coping. Specifically, the detrimental impact of child catastrophizing upon disability was less pronounced when parents reported high promotion of their child's well behaviours/coping. The findings of the present study suggest the importance of assessing and targeting parental responses to their child's pain to alter the adverse impact of the child's pain catastrophizing on pain outcomes.

Effects of level of feed intake on pancreatic exocrine secretions during the early postweaning period in piglets.

The objective of this study was to determine the influence of the level of feed intake and a 2-d feed restriction period on the postweaning adaptation of pancreatic exocrine secretions. At 33 d of age, 18 piglets fitted with 2 permanent catheters (for pancreatic juice collection and reintroduction) were weaned and allocated to 1 of the following 2 dietary treatments for 5 d: restricted feed allocation (restricted) or gradually increasing feed allocation (control). Pancreatic juice was collected daily during both basal and prandial periods. The basal period was defined as the period from 1400 to 1700 h (i.e., 5 to 8 h after the morning meal), whereas the prandial period was defined as the period from 30 min before to 60 min after the morning meal (given at 0900). Digestive enzyme activities and antibacterial activity were determined. Pancreatic protein secretion was 44% less (P < 0.05) in restricted piglets than in control piglets during the basal period. Trypsin secretion was affected by feed-restriction of piglets. The meal did not affect protein and trypsin secretions in restricted piglets, whereas at d 3 postweaning, protein and trypsin secretions and trypsin specific activity in control piglets were 9-, 105-, and 25-fold greater (P < 0.001) during the first 30 min after the meal than before the meal. Lipase and amylase secretions were not affected by variations in feed intake. The secretion of antibacterial activity in restricted piglets was greater (P < 0.05) than that of control piglets only at d 5. The extended feed restriction period increased the basal secretion of antibacterial activity (P = 0.09) and postprandial secretion of amylase (P = 0.05). In conclusion, a low level of feed intake during the early postweaning period decreased pancreatic protein and trypsin secretions, whereas a 2-d feed restriction period enhanced secretions of amylase and antibacterial activity. In addition, our results indicate that during periods of dietary adaptation, such as at weaning, measurements of enzyme activities in the tissue do not accurately reflect the enzyme secretion.

Minority language education in unbalanced bilingual situations: a case for the linguistic interdependence hypothesis.

This paper is placed in the linguistic and sociocultural context of Eastern Aragon, a region of Spain where two contact languages (Spanish and Catalan) coexist in an unbalanced situation favoring Spanish. The research was prompted by the regulation for the teaching of Catalan in that area, by means of the Cooperation Agreement signed by the Spanish Educational Ministry (MEC) and the local autonomous Cultural and Educational Department of the Diputación General de Aragon in November 1986. A comparative analysis is made between Eastern Aragon students' linguistic competence in Catalan and Spanish; a further comparison is established between these students and others living in bilingual Catalonia and in monolingual Aragon. We conclude by pointing out that the Linguistic Interdependence Hypothesis accounts for the results obtained in the study.

Valoración de la escala de dolor de caras-revisada (faces pain scale-revised) para evaluar la intensidad del dolor pediátrico en niños castellano parlantes / Assessment of the faces pain scale-revised for measuring pain severity in children

Objetivos:El objetivo principal de esta investigación era determinarlas propiedades psicométricas de la versión españolade la Faces Pain Scale-Revised (FPS-R) como medida de laintensidad de dolor en niños castellano parlantes.Material y método:Para evaluar la validez y fiabilidad de la escala se utilizarondos muestras independientes. La primera formada por119 niños y adolescentes hospitalizados por motivos diferentes.Se les preguntó acerca de su estado afectivo utilizandola escala afectiva facial (EAF) y acerca de la intensidadde su dolor utilizando la FPS-R y la escala analógica decolor (EAC). La segunda muestra estaba formada por 231escolares. En este caso se les pidió que se imaginaran enocho situaciones dolorosas e hipotéticas, y que estimasenel nivel de intensidad de dolor asociado a cada una utilizandola FPS-R y la EAC. Resultados:En el grupo de sujetos hospitalizados, los informes sobrela intensidad del dolor fueron muy similares, independientementede si se utilizaba la FPS-R o la EAC, los índicesde correlación entre 0,82 y 0,91. La relación entre laintensidad de dolor y el estado afectivo de los niños tambiénfue significativa estadísticamente (r = 0,33, p < 0,01).En el grupo de escolares, los índices de correlación se situaronentre 0,79 y 0,94. Los valores de la fiabilidad testretesten el Inventario de Acontecimientos Dolorosos fueronsignificativos y se situaron entre 0,43 y 0,67.Conclusiones:En general, los resultados de este trabajo aportan unasprimeras evidencias sobre la fiabilidad y la validez de convergenciay de criterio de la EDC-R. Más aun, los datos recogidossugieren que, independientemente de la edad y/oel sexo de los participantes, estos prefieren la escala de carasa la escala analógica de color

Objectives:The main objective of this study was to determine psychometricproperties of the Spanish version of the FacesPain Scale–Revised (FPS-R) as a measure of pain severityin Spanish-speaking children.Material and method:In order to assess the validity and reliability of this scale,two independent samples were used. The first included119 children and adolescents taken to the hospital due todifferent reasons. They were asked about their affectivecondition using the facial affective scale (FAS) and aboutthe severity of their pain using the FPS-R and the colouredanalogue scale (CAS). The second sample included 231schoolchildren. In this case, they were asked to imagineeight hypothetical painful situations and to estimate painseverity associated to each of them using FPS-R and CAS.Results:In the group of subjects hospitalized, the reported painseverity was very similar, regardless whether or not they assessedpain through FPS-R or CAS, with correlation coefficientsranging from 0.82 to 0.91. The association betweenpain severity and affective condition of children was also statisticallysignificant (r = 0.33, p < 0.01). In the schoolchildrengroup, the correlation coefficients ranged from 0.79 to0.94. Test-retest reliability scores in the Painful Events Inventorywere significant, ranging from 0.43 to 0.67.Conclusions:In general, this findings provide early evidences of thereliability and validity of convergence and criteria of theFDS-R. Moreover, our evidences suggest that, regardlessthe age and/or sex of the participants, they prefer the facespain scale to the coloured analogue scale

Nuevas tecnologías de la información y la comunicación en eltratamiento del dolor crónico / New information and communication technologies in the treatment of chronic pain

OBJETIVO: Revisar la evidencia disponible acerca de laefectividad de los tratamientos para el dolor crónico queutilizan las nuevas tecnologías de la información y comunicación(TIC), específicamente: Internet y tratamientosasistidos por ordenador.MÉTODO: Se realizó una búsqueda sistemática enMedline y Psycinfo.RESULTADOS: A partir de esta búsqueda se seleccionaron8 artículos. En 5 de ellos se utilizaron las NT pararealizar tratamientos a distancia mientras que en el restose utilizaron para crear y mantener foros de discusiónentre pacientes.CONCLUSIONES: En general, los resultados de los estudiosmuestran que los tratamientos basados en las TICresultan efectivos y eficientes, además de ser percibidospositivamente por los pacientes. No obstante, los resultadosno son siempre consistentes, probablemente por lasdiferencias en los diseños de los estudios revisados (AU)

OBJETIVE: To review the literature for evidence of theeffectiveness of chronic pain treatments that apply newinformation and communication technologies, namely, theInternet and computer-assisted treatments.METHODS: We carried out a systematic search of theliterature indexed on MEDLINE and PsycInfo.RESULTS: Eight articles were selected. In 5, the newtechnologies were used to implement treatments onlinewhile in the other 3 studies technology was used to createforums for patient discussion.CONCLUSIONS: In general the results of the studiesreviewed demonstrate that treatments based on newtechnologies are effective and efficient and that patientshold positive attitudes toward them. However, reviewedresults were not always consistent, probably because ofdifferences in how the studies were designed (AU)

La Coloured Analogue Scale: ¿un instrumento válido para medir la intensidad del dolor en niños catalano-parlantes? / The Color Analog Scale: a valid instrument for measuring pain intensity in Catalan speaking children?

OBJETIVOS: Evaluar la validez de la Coloured Analogue Scale (CAS) para valorar la intensidad del dolor en pediatría en población catalano-parlante. PACIENTES Y MÉTODOS: Se han comparado los rangos de intensidad de dolor señalados por los niños en la CAS con los informados mediante la versión catalana de la Faces Pain Scale- Revised (FPS-R). También se ha comparado la intensidad del dolor evaluada con la CAS con las puntuaciones de la experiencia afectiva del dolor, evaluadas con la Facial Affective Scale (FAS). RESULTADOS: Un total de 124 niños catalano-parlantes de entre 7 y 15 años, hospitalizados en los servicios pediátricos de tres hospitales universitarios, participaron en este estudio. Los resultados respaldan la validez de constructo y de criterio de la Coloured Analogue Scale en población catalana. La correlación entre las puntuaciones de la CAS y de la FPS-R fue elevada y significativa (r=0,87, p<0,001). Igualmente, las puntuaciones en intensidad de dolor se correlacionaron significativamente con el malestar emocional registrado con la FAS (r=0,43, p<0,001). Con independencia del género y la edad de los participantes, la mayoría de los niños informó preferir la FPS-R a la CAS. CONCLUSIONES: Los resultados de este trabajo aportan unas primeras evidencias sobre la validez convergente, de criterio y discriminante de la CAS. Parece, pues, que se trata de una escala válida para evaluar la intensidad de la experiencia del dolor en niños y adolescentes catalano- parlantes de edades comprendidas entre los 7 y los 15 años (AU)

OBJECTIVE: To evaluate the validity of the Color Analog Scale (CAS) for assessing pain intensity in a Catalan-speaking pediatric population. PATIENTS AND METHODS: We compared children’s CAS pain intensity ratings with their scores on the Catalan version of the Faces Pain Scale-Revised (FPSR). We also compared the CAS to ratings of affective experience of pain evaluated with the Facial Affective Scale (FAS). RESULTS: A total of 124 Catalan-speaking children aged 7 to 15 years admitted to the pediatric wards of 3 university hospitals participated in the study. The results supported the construct and criterion validity of the CAS in the Catalan population. Correlation between CAS and FPS-R scores was high and significant (r=0.87; P<.001). Similarly, pain intensity scores correlated significantly with emotional discomfort recorded with the FAS (r=0.34; P<.001). Most of the children, regardless of sex or age, reported a preference for the FPS-R over the CAS. CONCLUSIONS: The results of the present study provide preliminary evidence of the convergent, discriminant, and criterion validity of the CAS in this setting. The CAS appears to be valid for measuring pain intensity in Catalan-speaking children and adolescents between the ages of 7 and 15 years (AU)