Relationships Between Maternal Perinatal Mood, Sex of Infant, and Disappointment with Sex of Infant in a North American Sample.

OBJECTIVES: Little is known about the relationships between sex of infant, disappointment with sex of infant, and risk for perinatal depression, particularly in societies where the nature of parental sex preference is thought to be "balanced" between male and female offspring. We sought to explore relationships between these variables in a North American population. METHODS: In this exploratory study, we used data from a large Canadian prospective longitudinal study in which data were collected at up to four timepoints: during pregnancy, and at 1 week, 1 month and 3 months postpartum. Data about sex of infant, maternal preference for, and disappointment in sex of infant were recorded at the first possible timepoint; while at each postpartum timepoint infant fussiness and EPDS scores were recorded. We performed a mixed-effects linear regression to evaluate relationships between these variables. RESULTS: In our sample of N = 207 women, EPDS scores were higher for mothers of male versus female infants, and independently associated with infant fussiness. There was no interaction between sex of infant and maternal disappointment, or between maternal disappointment and EPDS scores. CONCLUSIONS: Mothers of male infants may have slightly more depressive symptoms than mothers of female infants regardless of maternal preference for, or disappointment in sex of infant; sex-specific biological risk factors for PPD should be explored.

Self-Stigma in Relatives of people with Mental Illness scale: development and validation.

BACKGROUND: Serious mental illness (SMI) is profoundly stigmatised, such that there is even an impact on relatives of people with SMI. Aims To develop and validate a scale to comprehensively measure self-stigma among first-degree relatives of individuals with SMI. METHOD: We conducted group interviews focusing on self-stigma with first-degree relatives (n = 20) of people with SMI, from which 74 representative quotations were reframed as Likert-type items. Cognitive interviews with relatives (n = 11) identified 30 items for the Self-Stigma in Relatives of people with Mental Illness (SSRMI) scale. Relatives (n = 195) completed the scale twice, a month apart, together with four external correlate scales. RESULTS: The 30-item SSRMI was reliable, with scores stable over time. Its single-factor structure allowed generation of a 10-item version. Construct validity of 30- and 10-item versions was supported by expected relationships with external correlates. CONCLUSIONS: Both versions of the SSRMI scale are valid and reliable instruments appropriate for use in clinical and research contexts. Declaration of interest None.

[Transperitoneal laparoscopic adrenalectomy]. / Suprarrenalectomía laparoscópica transperitoneal.

OBJECTIVES: To present our results with transperitoneal laparoscopic adrenalectomy after completion of 70 procedures. MATERIAL AND METHODS: Between July 2002 and December 2010, transperitoneal laparoscopic adrenalectomy was performed in 70 patients with the following diagnoses: Conn syndrome (22 cases), nonfunctioning adenomas (18), Cushing syndrome (10), pheochromocytomas (7), myelolipomas (4), metastasis after treatment of primary nonadrenal tumors (6), ganglioneuroma (1), adrenal gland hematoma (1) and adrenal carcinoma (1). We describe the size, surgical and hospitalization times, blood loss, need for transfusion, surgical complications and rate of conversion to open surgery. RESULTS: Of 70 patients, 35 were men and 35 women (1:1) with a mean age of 58.2 years (range, 82.2- 29.1). The most common site was left (58%) compared to right (42%). The mean size of the surgical specimen was 5.11 cm, mean surgical time was 119.2 minutes (50-240) and mean operative bleeding was 140.6 (30-800) cc. Only 3 patients required blood transfusion. The mean time until oral feeding was 17 hours, and the mean hospital stay was 4.3 (2-15) days. Complications included 2 cases of surgical infections, 1 of prolonged paralytic ileus, and 1 of splenic laceration and 1 of intestinal perforation which both which required reconversion to open surgery (4.28%). CONCLUSIONS: Laparoscopic adrenalectomy is a safe procedure, with a low percentage of complications and a short hospital stay. The choice of this approach will depend on the surgeon's experience with the lesion etiology and size in each case.

In vitro antibacterial activity of glass-ionomer cements.

The in vitro antibacterial activity of the glass-ionomer restorative cements Ketac-Cem, Ketac-Bond, Ketac-Silver and Vitrebond was studied in conjunction with 32 strains of five bacteria involved in the development of caries: Streptococcus spp., Lactobacillus spp., Actinomyces spp., Porphyromonas spp. and Clostridium spp. The agar plate diffusion method was used for the cultures, which included a chlorhexidine positive control. All the glass-ionomer cements tested inhibited bacterial growth, but with considerable differences in the scope of their action. Of the four cements, Vitrebond, a resin-modified glass-ionomer cement, was determined to be the most effective bacterial inhibitor.

Antibacterial activity of four dentin bonding systems.

The antibacterial action of bonding systems Gluma 2000, Syntac, Prisma Universal Bond 3, Scotchbond Multipurpose and Prime-Bond was tested against 32 strains of the caries-producing bacteria Streptococcus spp., Lactobacillus spp., Actinomyces spp., Porphyromonas spp. and Clostridium spp. An agar plate diffusion method was used with chlorhexidine as the positive control. Assays were performed in triplicate for each component (primer and adhesive) of the bonding systems. All the adhesives were found to inhibit bacterial growth but with differences in their spectra of action. The sum action of the Scotchbond Multipurpose components were most inhibitory and Prime-Bond was found to be the least effective system.

Antibacterial activity of resin adhesives, glass ionomer and resin-modified glass ionomer cements and a compomer in contact with dentin caries samples.

A total of 103 clinical samples of carious dentin were used to study the antibacterial action of different dental resin adhesive materials (Gluma 2000, Syntac, Prisma Universal Bond 3, Scotchbond Multi-Purpose and Prime&Bond 2.0) glass ionomer cements (Ketac-Cem, Ketac-Bond, Ketac-Silver, Ketac-Fil) resin-modified glass ionomer cements (Fuji II LC, Vitremer and Vitrebond) and a compomer (Dyract). The agar plate diffusion method was used for the microbial cultures and a chlorhexidine control. The growth of the caries-producing microorganisms was effectively inhibited by the Vitremer and Vitrebond cements, and to a lesser extent by the Scotchbond Multi-Purpose adhesive system. Overall, there were statistically significant differences in the antibacterial activity of the products tested.

Antibacterial activity of glass-ionomer restorative cements exposed to cavity-producing microorganisms.

The antibacterial activity of the glass-ionomer restorative cements Ketac-Fil, Ketac-Silver, Fuji II LC, and Vitremer was studied in vitro, in conjunction with a total of 32 strains of five bacterial genera that may be associated with dental caries: Streptococcus spp, Lactobacillus spp, Actinomyces spp, Porphyromonas spp, and Clostridium spp. Agar plate diffusion was the method used for the bacterial cultures, which included a chlorhexidine control. All four glass-ionomer cements were found to inhibit bacterial growth, though with noteworthy differences in their spheres of action. Vitremer was the cement determined to have the greatest antibacterial effects, whereas Ketac-Silver presented the least inhibitory action.

NANDA nursing diagnoses identification and validation in a neonatal unit.

OBJECTIVE: To identify the problems nurses encounter in a Neonatal Unit and adapt them to the corresponding NANDA (North American Nursing Diagnosis Association) diagnostic categories for their validation in our environment. DESIGN: A Nominal Group Technique (NGT) was developed to identify the problems that nurses detect and solve. Identified problems were catalogued with their corresponding diagnostic label using the NANDA diagnostic taxonomy. A concordance study was carried out between two observers, using the Kappa coefficient. RESULTS: During the study period, 36 different NANDA diagnostic categories were identified for use. From these, 5 have been validated with an excellent or good concordance (K > 0.70) and 2 with an average concordance (0.70 > K > 0.40). The remaining categories did not occur with enough frequency during the study period to apply statistical treatment. CONCLUSIONS: The diagnostic categories validated in our Unit occur frequently, are easily identified by the nurses, and can be used in patient care plans. Non-validated categories may become valid in subsequent studies.

Psychometric properties of the MSPSS and NOS in psychiatric outpatients.

Prior research has demonstrated the utility of the Multidimensional Scale of Perceived Social Support (MSPSS) and the Network Orientation Scale (NOS) as measures of perceived social support among nonpsychiatric samples. The primary objective of this study was to determine whether these two scales can be used reliably among psychiatric outpatients, in particular those with schizophrenia or a major affective disorder. Subjects were 144 outpatients, aged 21 to 67 years, who completed the MSPSS and NOS. Results demonstrated high internal consistency for the MSPSS and adequate internal consistency for the NOS. In addition, convergent validity was demonstrated. Scores on both scales for these psychiatric outpatients were found to be lower as compared to "normals."

Risk of diarrheal disease in Ecuadorian day-care centers.

To determine the risk for diarrheal disease (DD) in day-care centers (DCC) for children residing in a poor urban slum area of Quito, Ecuador, compared with that for children from the same environment but cared for in their own residential home (RH), a prospective age-, sex- and locale-controlled study of DD was conducted, including 115 children in DCC and 115 in RH, ages 12 to 42 months. The overall incidence of DD was 46/1000 child weeks. Diarrhea was more common in DCC than in RH (relative risk (RR), 1.75; 95% confidence interval (CI), 1.38 to 2.22; P < 0.001). Poor hygienic practices were more prevalent in DCC than in RH. The use of reused water for child handwashing before eating and for washing raw vegetables was associated with a higher risk of DD in DCC than in RH (RR = 4.08, CI 2.93 to 5.67, P < 0.001; RR = 3.90, CI 2.79 to 5.44, P < 0.001, respectively). These two practices were risk factors in the DCC (RR = 2.74, CI 2.08 to 3.68, P < 0.001; RR = 2.05, CI 1.55 to 2.71, P < 0.001, respectively) when compared with their absence in the same DCC. Shigella (RR = 3.58, CI 1.19 to 10.78, P < 0.02), Aeromonas (RR = 10.47, CI 1.35 to 81.05, P < 0.01), rotavirus (RR = 2.86, CI 1.87 to 4.39, P < 0.001) and Giardia (RR = 1.59, CI 1.00 to 2.59, P < 0.05) were more common in DCC than in RH. More than two-fifths of the Shigella and Aeromonas isolates were resistant to trimethoprim-sulfamethoxazole.(ABSTRACT TRUNCATED AT 250 WORDS)

Compliance with clinic attendance by outpatients with schizophrenia.

OBJECTIVE: The purposes of the study were to determine rates of compliance with appointments among patients with schizophrenia who had been treated for more than four years in an outpatient clinic, to explore reasons for missed appointments, and to determine whether treatment modalities affected compliance rates. METHODS: Chi square analysis was used to compare attendance rates over a 12-month period of 55 patients who were nonrandomly assigned to a monthly group and 56 patients who were nonrandomly assigned to be seen in individual treatment every one to two months. Patients were asked to give reasons for missed appointments. RESULTS: From 71 to 86 percent of the patients kept their clinic appointments each month. Forgetting the appointment and transportation difficulties were the most common reasons for nonattendance. Compliance rates of patients in the two treatment modalities differed during only three of the 12 months: during two of those months subjects in individual treatment had higher compliance rates than those in groups. CONCLUSIONS: The results suggest that treatment modality has little impact on compliance and that compliance may be increased by letter and phone prompts and by staff awareness of patients' problems such as transportation and finances.

Tomographic imaging of opaque and low-contrast objects in range-independent waveguides.

A feasibility study is presented for acoustic tomographic imaging of arbitrarily shaped objects in range-independent oceanic waveguides. One of the main obstacles in the efficient use of tomographic imaging is that tomographic systems usually allow for a number of different independent solutions which satisfy the same systems of equations. This adverse property of acoustic tomography is especially pronounced in underdetermined systems characterized by null spaces of tomographic matrices which relate measured data to an unknown sound-speed distribution. In fact, acoustic tomography is usually underdetermined and the null space problem becomes critical in many applications. Acoustic tomography in many instances yields blurred images precluding its efficient use for mapping underwater objects in oceanic waveguides. How to improve the resolving power of tomographic imagery in waveguides is shown. A new technique based on the sliding window approach is suggested which uses constrained traveltime inversion. The method will be tested on mapping opaque and low-contrast acoustic objects placed in range-independent waveguides. The method is fast since it does not directly invert tomographic matrices of large rank but instead carries out summation over nonzero elements of tomographic matrices. It can be proved that constrained inversion compensates for limited angular aperture recording and thus can be applied to practical problems with incomplete angular aperture. This work is limited to processing of transmitted signals. A separate study will be devoted to the analysis of reflection data.

A study of different parameters of cell-mediated immunity in patients with active and chronic tuberculosis.

A study was carried out on cell-mediated immunity in healthy persons and patients with tuberculosis in order to extend the diagnostic capacity in tuberculosis. We studied the relation between baciloscopy and the state of specific cell-mediated immunity in vivo (Mantoux) and in vitro (leukocyte migration inhibition assay with PPD-RT 23 to evaluate specific cell-mediated immunity and PHA to evaluate nonspecific immunity) in 131 patients with active tuberculosis, in 63 patients with chronic tuberculosis, in 62 healthy persons and 10 individuals living with tuberculosis patients. The results demonstrate that the percentage of reaction was very low in both tests, being of no statistical significance the difference between patients with active or with chronic tuberculosis, although it was significant in the control group. In about half of the patients with active tuberculosis a positive baciloscopy could be observed; the percentage was much lower in patients suffering from chronic tuberculosis, the difference between the two groups significant from a statistical point of view. At the same time when we carried out an evolutionary study in 10 patients with positive baciloscopy, we observed a slight capacity of conversion of immunity when the baciloscopy was negative.

Porfirias hepáticas / Hepatic porphyrias

Las porfirias hepáticas son afecciones metabólicas de baja prevalencia. Sin embargo, en Chile se ha ido conformando una casuística importante y creciente, en la medida que se ha divulgado el conocimiento y los recursos diagnósticos de estas afecciones. En nuestro país se han descrito casos de las 6 principales variedades de porfiria. La sintomatología de estas afecciones es abundante y multisistémica. Ella puede ser limitante de una vida normal e incluso invalidante y con compromiso estético si existe un componente cutáneo externo. En las variedades que se acompañan de crisis agudas puede haber amenaza de muerte si no se diagnostican y tratan oportuna y adecuadamente. Las variedades cutánea tarda y protoporfiria cursan frecuentemente con daño hepático y con notable gravedad. El diagnóstico de porfiria se sospecha clínicamente , pero por la inespecificidad de de sus síntomas y signos bebe confirmarse con los correspondientes exámenes de laboratorio. Los pacientes portadores de porfiria pueden excretar cantidades normales de porfirias o de sus precursores, pero raramente de todas ellas. En ocaciones, un paciente en estado de su enfermedad puede tener secreción normal de todas las porfirias y precursores. Por otra parte, es posible observar hiperporfirinuria en afecciones distintas de las prorfirias. Medidas preventivas y terapias simples pero oportunas pueden aliviar los síntomas y evitar la muerte. Entre estas es posible destacar la sobrecarga de hidratos de carbono y la infusión de hematina en las crisis agudas y la práctica de sangrías o la administración de cloroquina en las formas con compromiso cutáneo