The new Code of Ethics of the World Psychiatric Association: A fresh look at the ethical issues of the psychiatric profession.

This article develops the WPA's new Code of Ethics that was developed in 2020. It succeeds the Declaration of Hawaii of 1977 and the Declaration of Madrid of 1996. The Code is divided into four sections that cover the practice of psychiatry in clinical practice, education, research and publication as well as public mental health. We will discuss the new ethical issues that this Code raises in parallel with the development of psychiatry and psychiatrists' role in society in recent years.

Improving the optical, thermal, mechanical, electrical properties and antibacterial activity of PVA-chitosan by biosynthesized Ag nanoparticles: Eco-friendly nanocomposites for food packaging applications.

In this study, nanocomposite films were produced by blending polyvinyl alcohol (PVA) and chitosan (Cs) polymers with 70 % PVA and 30 % Cs, incorporating silver nanoparticles (Ag NPs) via a solution-casting method. The research aims to investigate the impact of the biosynthesized Ag NPs by Chenopodium murale leaf extract on optical, morphological, mechanical, thermal, electrical, and antibacterial properties. XRD analysis showed a decrease in crystallinity degree with Ag NPs addition. TEM revealed Ag NPs in cubic and spherical shapes with an average size of 23.4 nm. SEM and AFM indicated surface morphology changes. FT-IR spectra showed interaction between Ag ions and the blend. The energy gap decreased with increasing Ag NPs concentration. TGA exhibited enhanced thermal stability. Mechanical properties improved significantly. AC electrical conductivity and dielectric parameters were studied. Antibacterial activity against Gram-positive and Gram-negative bacteria was observed. Overall, PVA/Cs-Ag NPs films show promise for food packaging and optoelectronic applications.

Evaluation of bone gain in horizontal ridge augmentation using titanium mesh in combination with different flap advancement techniques: a randomized clinical trial.

The aim of this study was to investigate and compare the clinical and radiographic bone gain in guided bone regeneration with titanium mesh, for four different advancement techniques: periosteal releasing incision (PRI), double flap incision (DFI), modified periosteal releasing incision (MPRI), and coronally advanced lingual flap (CALF). Forty patients with a partially edentulous mandible were allocated randomly to four study groups (PRI, DFI, MPRI, CALF; 10 patients in each). Clinical bone gain (primary outcome) and radiographic bone gain were evaluated. In addition, correlations between study variables (clinical and radiographic bone gain, flap advancement, mesh exposure area and percentage exposure, pain, and swelling) were explored. CALF exhibited the highest mean clinical bone gain (4.12 ± 1.37 mm) and PRI the lowest (2.60 ± 1.36 mm); the mean clinical bone gain differed significantly among the groups (P < 0.001). The highest mean radiographic bone gain was seen in the CALF group (3.54 ± 1.65 mm) and the lowest in the PRI group (2.06 ± 1.11 mm); the mean radiographic bone gain also differed significantly among the groups (P < 0.001). The correlation analysis revealed positive correlations between flap advancement and radiographic bone gain (P = 0.003) and between swelling and pain (P = 0.007). An inverse correlation was found between flap advancement and swelling (P = 0.049), mesh exposure area and clinical bone gain (P = 0.022), and mesh exposure percentage and clinical bone gain (P = 0.017). In summary, the highest clinical and radiographic bone gain was observed for CALF, while the lowest was observed for PRI.

Clinico-pathologic disparities of breast cancer in Hispanic/Latina women.

BACKGROUND: Breast cancer is the leading cause of cancer death in Hispanic/Latina women nationwide. Limited cancer research has been conducted in this population. El Paso, Texas is a large border city with a population of around 900,000, of which 85% are Latinos and would provide a suitable setting for this study. The aim of this study is to evaluate ethnic differences and cancer characteristics in Hispanic/latina women with breast cancer. METHODS: After IRB approval, we retrospectively analyzed the variables of patients with breast cancer treated consecutively at a large tertiary medical center in El Paso, TX between 2005-2015. Descriptive statistics, bivariate, and multivariable analyses were conducted. RESULTS: 1,252 patients were identified. Mean age at diagnosis was 57 years. 1074 were Hispanics/Latinas (86%). When comparing Hispanics versus non-Hispanics, 31% of Hispanics compared to 24% Non-Hispanics were diagnosed at age <50 (P = 0.043). More Hispanics are uninsured (34%) compared to Non-Hispanics (25%) (p = 0.008). Hispanics presenting with advanced stages were more likely to be uninsured (P = 0.02). CONCLUSIONS: This analysis confirms that Hispanics/Latinas are diagnosed with breast cancer at a younger age and are more commonly uninsured than Non-Hispanics. We did not observe significant differences in the prevalence of ER+, triple negative or Her2 -neu positive disease or stages at presentation between the 2 groups in this cohort, however the non-Hispanic group was constituted only 14% of the studied population. A larger multi-institutional comparative study is being conducted to confirm these findings.

[Cerebral venous thrombosis during tuberculous meningoencephalitis]. / Thromboses veineuses cérébrales au cours de la méningo-encéphalite tuberculeuse.

Cerebral venous thrombosis is a rare disease characterized by its clinical polymorphism and multiplicity of risk factors. Infections represent less than 10% of etiologies. Tuberculosis is not a common etiology, only a few observations are published in the literature. Between January 2005 and March 2015, 61 patients were hospitalized for neuro-meningeal tuberculosis. Among them, three young women had presented one or more cerebral venous sinus thromboses. No clinical feature was observed in these patients; vascular localizations were varied: sagittal sinus (2 cases), lateral sinus (2 cases) and transverse sinus (1 case). With anticoagulant and antituberculosis drugs, the outcome was favorable in all cases. During neuro-meningeal tuberculosis, the existence of consciousness disorders or neurological focal signs is not always the translation of encephalitis, hydrocephalus, tuberculoma or ischemic stroke; cerebral venous sinus thrombosis may be the cause and therefore should be sought.

Anti-inflammatory mechanism of alminoprofen: action on the phospholipid metabolism pathway.

Alminoprofen is a nonsteroidal anti-inflammatory drug (NSAID) of the phenylpropionic acid class. It has anti-inflammatory properties different from the classical NSAID. Using both in vitro systems of cells in culture and in vivo models of inflammation, we report here that alminoprofen possesses both antiphospholipase A2 (PLA2) activity and anti-cycloxygenase (COX) activity. The PLA2 targeted by alminoprofen is likely the secretory phospholipase A2 (sPLA2) while the COX targeted is the COX-2.

Selenium status of healthy Turkish children.

Selenium concentrations, in blood plasma, red blood cells, hair of 61 healthy children, ages 0-14 yr, were determined using hydride generation atomic absorption spectrometry. Starting from late lactation period, selenium concentrations in all these matrices were found to be increasing with age. A good correlation was found between erythrocyte and plasma, hair and plasma, and hair and erythrocyte selenium concentrations. Although plasma, erythrocyte, and hair selenium concentrations of girls seemed to be higher than that of boys (only in erythrocytes), selenium concentrations of girls were found to be significantly (p < 0.002) higher than that of boys, 71 +/- 9 ng/mL, vs 65 +/- 10 ng/mL, respectively. Selenium status of Turkish children is found to be lower than that found in the literature; marginal selenium deficiency could be important in the development of some selenium deficiency related diseases. There is a need for extension of this study to healthy children from different regions in Turkey and to different disease states.

Congenital prepubic sinus.

We report the fifth case of congenital prepubic sinus that goes from the anterior wall of the bladder through the public symphysis to the skin. The various embryological theories that could be responsible for this pathology are discussed, and according to us, it seems to be a variant of dorsal urethral duplication.

The Kalicinski ureteral folding technique for megaureter in children. Experience in 23 cases.

We report our series of 16 children with 23 megaureters: 7 were refluxing, 11 were obstructive (7 primary and 4 secondary), 3 both refluxing and obstructive and 2 nonrefluxing nonobstructive. These patients had a Kalicinski folding-under remodeling of their megaureter and Cohen or Lead-better reimplantation. Success rate was 96% with only 2 failures: 1 recurrent low-grade reflux treated with subureteric Teflon injection and 1 stenosis that necessitated reoperation. Kalicinski's technique with Cohen type reimplantation is one of the best alternatives for megaureters, mainly because it does not present the disadvantages of the excisional procedure.

Congenital esophageal stenosis.

We report 6 new cases of congenital esophageal stenosis (CES) that presented to us with special diagnostic and management problems and review the literature on this subject. Gastroesophageal reflux and achalasia are important differential diagnoses of esophageal stenosis, they may be associated with CES making appropriate management even more difficult. Treatment is also controversial, ranging from simple dilatation to segmental resection. CES should be present in every pediatric surgeon's mind should dysphagia occur on the introduction of semisolid food or esophageal food impaction, with a segmental stenosis demonstrated at esophagogram even when more obvious diagnoses are evoked.

Congenital cyst of the pancreas. Antenatal diagnosis.

We hereby report the third case of antenatal diagnosis of congenital cyst of the pancreas. It is a very rare lesion and could present as a differential diagnosis of any intra-abdominal cystic mass. Early treatment is easy and prevents complications such as ascites and pancreatitis in case of intra-pancreatic enteric duplication.

Mesenchymal hamartomas of the liver may be associated with increased serum alpha foetoprotein concentrations and mimic hepatoblastomas.

A mesenchymal hamartoma (MH) of the liver in a seven-month-old girl was associated with slightly elevated alpha fetoprotein (AFP) concentrations (320 microg/L, normal < 25 after six months of age). Hepatocytes were abundant at the periphery of the tumour at histopathological examination. These were slightly atypical and expressed AFP immunohistochemically. In two other girls, aged 14 months and two months respectively, with MH and increased serum AFP concentrations (320 microg/L and 7500 microg/L, respectively), hepatoblastomas were misdiagnosed preoperatively. MH of the liver with increased serum AFP concentrations may thus mimic hepatoblastoma radiologically if cysts are lacking, and foetal hepatoblastoma pathologically if a biopsy samples only the peripheral hepatocellular component of the MH.

Neurenteric cyst: antenatal diagnosis and therapeutic approach.

We hereby report the second case of antenatally diagnosed "neurenteric cyst" in the literature. The patient we describe presented as a neonatal respiratory distress syndrome (NRDS) which did not respond to a vigorous resuscitation. Anomaly of the antenatal ultrasonography and of the initial chest x-ray added to the non-response to therapy, led us to an urgent thoracic scan and to a lifesaving thoracotomy. We think that every posterior mediastinal cystic mass, with or without vertebral malformations, diagnosed antenatally, should raise the possibility of neurenteric cyst. The perinatal management of the newborn to be, will thus be simplified. This will lead to a better outcome.

Parental attitudes toward mouthguards.

An 11-item, one-page questionnaire was mailed to 1800 parents chosen at random in the Henrico County, VA public school system. Parents were asked questions such as "who should be responsible for mouthguard wear?" "what sports should require mouthguards?" and "has [their] child ever sustained an oral or facial injury?" The parental responses indicate that mouthguard enforcement is the responsibility of both parents and coaches. Of the total injuries reported, 19% were sustained in basketball, 17% in baseball, and 11% in soccer. Despite these high injury rates, however, there was a lack of perceived need for mouthguard use in these sports. When asked which sports should require a mouthguard rule, the sports that generated the most responses were, in decreasing order, football, boxing, ice hockey, wrestling, field hockey, and karate. Parents were more likely to require mouthguards for their sons than daughters, and more likely to require them for their children who participated in a mandatory mouthguard sport, a contact sport, or who had been previously injured. The authors conclude that because parents view themselves as equally responsible as coaches for maintaining mouthguard use, both groups should be targeted and approached as a possible source for the recommendation of mandatory mouthguard rules in basketball, baseball, and soccer.

[Acute interstitial nephritis with uveitis. A case report]. / Néphrite interstitielle aiguë avec uvéite. A propos d'un cas.

Dobrin et al described in 1975 the first case report with acute renal failure due to tubulo-interstitial nephritis accompanied by uveitis and an inflammatory syndrome. The young adults are frequently involved and the complete resolution is usually obtained after corticosteroid treatment; this contrasts with the tendency towards relapse of the uveitis. The etiology and the pathogenesis of this syndrome remain unknown. We report the case of a woman which the renal function was incompletely reversible with corticosteroids.

[Periaortic fibrosis with pericardial and perirenal involvement: apropos of a case]. / Fibrose périaortique avec envahissement péricardique et périrénal: à propos d'un cas.

The authors report a case of right ventricular insufficiency by constrictive pericarditis revealing aortic and retroperitoneal fibrosis. Only one similar case has been published. We discuss the etiology of this affection, the possible analogies with idiopathic systemic fibrosis and Takayasu's disease and the possible participation of thyroiditis disease and therapy (particularly propranolol).

Human leukocyte antigen in genodermatosis.

Tissue typing performed on the lymphocytes of 41 patients, including: 23 patients with ichthyosis (15 of autosomal dominant and 8 of the x-linked variety; 8 patients with tuberous sclerosis (epiloia); and 10 patients with acrodermatitis enteropathica (AEP). In addition, tissue typing was performed for a control group of 80 healthy unrelated subjects of the same ethnic origin as the patients. A significant increase of A2 antigen or its crossreacting antigen A28 was detected among the three diseases studied. A significant increase of HLA-A2 antigen was found in autosomal dominant ichthyosis, while the x-linked variety showed significant association with HLA-Cw2. A significant association with HLA-A28 antigen was noticed in both epiloia and AEP. The suggested mechanisms of such association may be referred to as incidental genetic linkage with mutants causing disease or deficiency.

Ultrastructure of Trichophyton violaceum.

BACKGROUND: The ultrastructure of different fungi have been described in recent literature; however, few reports have concerned dermatophytes. METHODS: Fine structure of Trichophyton violaceum was observed using electron microscopy. RESULTS: Hyphae appeared as branched segmented filaments with a cell wall consisting of two layers. Thin electron dense plasma membrane was evident continuous with the inner surface of the cell wall. Septal walls with central pores and a uniform electron opacity plugs were seen. The hyphae were multinucleated and the cytoplasm contained endoplasmic reticulum, mitochondria, and vacuoles. CONCLUSIONS: Although these findings showed ultrastructural similarities of the cell wall with Microsporum canis, Microsporum gypseum and Microsporum audouinii, there were some points of difference in the ultrastructure of the hyphae in Epidermophyton floccosum, and in the mitochondria of Trichophyton mentagrophytes as described by other investigators.