Dual-time-point PET/CT study protocol can improve the larynx cancer diagnosis.

AIM: To evaluate whether the sequential dual-time-point fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (DTP 18F-FDG PET/CT) study improves the differential diagnosis in the larynx. BACKGROUND: In some cases, the clinical and metabolic similarity of laryngitis and larynx cancer make differential diagnostics difficult when performing standard 18F-FDG PET/CT examinations; therefore, an additional study protocol performance seems to be of reasonable value. MATERIALS AND METHODS: 90 patients (mean age: 61 ± 11 years, range: 41-84 years): 23 women (mean age: 63 ± 10 years, range: 51-84 years) and 67 men (mean age: 61 ± 11 years, range: 41-80 years) underwent delayed 18F-FDG PET/CT examinations at 60 and 90 min post intravenous injection (p.i.) of the radiopharmaceutical 18F-FDG. We compared the metabolic activity of 90 structures divided into following groups: normal larynx (30 patients), laryngitis (30 lesions) and larynx cancer (30 tumors) with maximal and mean standardized uptake value (SUVmax, SUVmean) and the retention index (RI-SUVmax). We used the receiver operating characteristics (ROC) curve to evaluate the SUVmax cut-off values. RESULTS: The SUVmax cut-off value at 60 and 90 min p.i. of 2.3 (sensitivity/specificity: 96.4%/100%) and 2.4 (94.2%/100%), respectively, distinguished normal and abnormal metabolic activity in the larynx. When laryngitis and tumors were compared, the SUVmax cut-off values obtained after initial and delayed imaging were 3.6 (87.5%/52.0%) and 6.1 (58.3%/84%), respectively. The RI-SUVmax of 1.3% (71.4%/88.1%) suggested abnormality, while RI-SUVmax of 6.6%, malignant etiology (75.0%/80.0%). CONCLUSIONS: In this study, the sequential DTP scanning protocol improved the sensitivity and specificity of the PET/CT method in terms of differential diagnosis within the larynx.

Neuropsychological Aspects of Children's Somatic Disorders in Chronic Diseases: Diabetes and Short Stature in the Developmental Period.

Intellectual functioning studies carried out amongst children indicate that chronic diseases like type 1 diabetes and growth hormone deficiency (GHD), may, but do not necessarily, result in intellectual loss. Cognitive functions may decline as a child becomes older, as a disease persists over time and/or due to non-compliance with treatment recommendations or high stress levels. This study aimed to assess the cognitive functioning of children and youths with T1D and GHD-related short stature compared to healthy children. METHODS: The study was carried out on 88 children with type 1 diabetes, 38 children suffering from short stature caused by (GHD), as well as a control group comprising 40 healthy children. Weschler's tests were applied to measure intellectual and cognitive functions. RESULTS: The results suggest that for children suffering from type 1 diabetes and short stature, their chronic childhood diseases per se do not impair cognitive development. It was observed that the higher the age of chronically ill children and the longer the disease persists, the lower their scores in individual cognitive subtests. For healthy children, age is correlated with the acquisition of particular skills and higher scores in specific subtests. CONCLUSIONS: On the basis of qualitative analysis of the cognitive functions subject to the study and close clinical observation of chronically ill children, we have been able to conclude that chronic diseases may alter cognitive functioning.

Prioritizing Positivity, Styles of Rumination, Coping Strategies, and Posttraumatic Growth: Examining Their Patterns and Correlations in a Prospective Study.

Objectives: A growing number of studies indicate that coping with the experience of a crisis event, which causes a breach in the individual's fundamental beliefs regarding the world and his/her place in it, can result in posttraumatic growth. Positive emotions can have an undoing effect on negative emotional arousal and broaden an individual's scope of action, and they can foster posttraumatic growth. This study aimed to examine relations between prioritizing positivity, styles of rumination, coping strategies, and posttraumatic growth. Methods: One hundred and sixty-four Polish adults took part in the study, filling out questionnaires to measure prioritizing positivity, hope, and self-efficacy. Twelve to fifteen months later, 104 of them accepted the invitation to the second part of the study. The participants reported the intensity of rumination associated with the most critical event in their lives, which took place between the first and second stages of the study and the coping strategies they used. Posttraumatic growth and life satisfaction were also measured. Results: Results from hierarchical regressions found that higher levels of prioritizing positivity, deliberate ruminations, and religious coping and lower level of intrusive ruminations were associated with posttraumatic growth. The results also indicate that self-esteem was a significant predictor of life satisfaction. Conclusions: The results of the prospective study confirm that individual differences in prioritizing positivity can relate to a process of posttraumatic growth. Prioritizing positivity was associated with the use of an active coping strategy and deliberate but not intrusive ruminations. Previous studies on the role of prioritizing positivity have focused on the impact on the level of wellbeing of seeking positive emotions in everyday life. Our results show the importance of prioritizing positivity in coping with stress and trauma. These results can be used to design effective psychological intervention techniques to support people experiencing trauma and psychological crises. The results also indicate that life satisfaction has different predictors from posttraumatic growth.

The Influence of Parent Education on the Neurobehavior and Sucking Reflexes of Very Preterm Infants.

The diagnosis of neurobehavioral problems in very preterm neonates helps with planning and applying proper and direct therapeutic interventions. (1) Background: The aim of this study was to determine the direct impact of neurobehavior on the sucking reflex and eating abilities of neonates. (2) Methods: We assessed 18 preterm neonates twice hospitalized at the Gynecology and Obstetrics Clinical Hospital through the use of the Neonatal Behavioral Assessment Scale (NBAS). (3) Results: We found that that a neonate's sucking ability positively correlated with the activity level item from the motor system cluster of the NBAS. (4) Conclusions: Neurobehavior should be closely assessed in very preterm neonates. Firstly, because assessments can detect fundamental problems and help a practitioner plan for early intervention. Secondly, the education of parents regarding the neurobehavior of their child can help in the facilitation of feeding skills and the planning of early rehabilitation.

The Evaluation of Facial Muscles by Surface Electromyography in Very Preterm Infants.

BACKGROUND: It is reported that 40% of preterm infants have problems with eating. Neonatal feeding disorders may be one of the factors increasing neonatal mortality. The aim of our study was to evaluate the muscles involved in suckling and swallowing in premature newborns using surface electromyography (sEMG). We would like to objectively describe the tension of muscles engaged in feeding in order to properly plan the therapy. Another aim was to compare sEMG measurements to gestational age, birth weight, and umbilical blood pH to show which parameters put children at risk of feeding problems. METHODS: Sixteen preterm neonates with gestational age less than 32 weeks, birth weight less than 1500 g, and oral feeding difficulties were analyzed for muscle response and electrical activity of nerves using sEMG (surface electromyography). RESULTS: We found a negative correlation indicating that preterm infants with a younger gestational age had higher suprahyoid muscle tension, and a positive correlation was found between pH value and suprahyoid muscles. The lower the pH value, the lower the tension in the suprahyoid muscles. CONCLUSIONS: sEMG may be a helpful diagnostic tool in the evaluation of the masticatory system of premature infants. Due to the abnormal tone of the muscles responsible for swallowing, it is advisable to rehabilitate as early as possible.

The Importance of Monitoring Neurodevelopmental Outcomes for Preterm Infants: A Comparison of the AIMS, GMA, Pull to Sit Maneuver and ASQ-3.

BACKGROUND: Clinicians and parents should closely monitor the neurodevelopment of very preterm infants. The aim of our study was to compare whether neurodevelopmental assessments completed by parents and those done by specialists yielded similar outcomes. We wanted to check whether the assessments completed by specialists and parents were comparable in outcomes to emphasize the important roles of early assessment of a child and of the parents in their child's treatment and medical care. Another aim was to check whether or not the pull to sit maneuver from the Neonatal Behavioral Assessment Scale (NBAS) is still a parable item in well-known scales of neurodevelopment. METHODS: We assessed 18 preterm neonates in the fourth month of corrected age with scales such as the General Movement Assessment (GMA), the Alberta Infant Motor Scale (AIMS), and the pull to sit maneuver from the NBAS. Finally, we asked parents to complete the Ages and Stages Questionnaire, Third Edition (ASQ-3). RESULTS: We found that the respective assessments completed by specialists and parents are comparable in outcomes. We also found that the pull to sit item from the NBAS was still a valid test since it showed similar findings to those from the AIMS, the GMA, and the ASQ-3. CONCLUSIONS: The pull to sit item from the NBAS is an important item for assessment of very preterm infants. Specialists should also take into consideration the input and concerns of parents when planning for treatment and intervention.

Maternal anxiety in relation to growth failure and growth hormone treatment in children.

Health disorders in mothers and their children are subject to mutual influences arising from the nature of mother-child relationship. The aim of the study was to analyze the issue of anxiety amongst mothers of short children in aspect of growth hormone (GH) therapy in Poland.The study was based on a group of 101 mothers of originally short-stature children: 70 with GH deficiency treated with recombinant human GH and 31 undergoing the diagnostic process, without any treatment. Collected medical data included the child's gender, height and weight, chronological age, bone age delay, and GH therapy duration. For all children the height SDS (standard deviation score of height) and BMI SDS (standard deviation score of body mass index) were calculated. The Spielberger State-Trait Anxiety Inventory (STAI) was used to evaluate anxiety levels among the recruited mothers. Obtained results revealed low trait anxiety levels in all mothers, with no statistically significant differences between the groups. State anxiety levels were significantly higher in mothers of children without diagnosis and treatment than in mothers of children receiving appropriate therapy. Significantly lower levels of maternal state anxiety were observed during the first stage of the GH therapy, and they were further reduced in mothers of children treated for more than 4 years.Growth failure in Polish children is not associated with high maternal anxiety as a personality trait, but lack of diagnosis and lack of appropriate treatment seem to generate high levels of anxiety as a transient state in mothers. The initiation of GH therapy induces a substantial reduction of maternal state anxiety, and the duration of this treatment causes its further decrease. Mothers of short children undergoing diagnostic process could benefit from psychological support, but it seems to be unnecessary when their children are treated with GH.

Coexistence of Post-traumatic Growth and Post-traumatic Depreciation in the Aftermath of Trauma: Qualitative and Quantitative Narrative Analysis.

Objectives: Post-traumatic growth (PTG) and post-traumatic depreciation (PTD) can be defined, respectively, as positive and negative changes in the aftermath of trauma. These changes can be assigned to the following domains: personal strength, relating to others, new possibilities, appreciation of life, spiritual and existential change. The aim of this study was to explore the possibility that positive and negative effects of trauma can coexist and explore the categories of effect. Methods: 72 participants were asked to recount their experience of trauma and answer questions about how it had affected their thinking about themselves and the world. Participants' narratives were analyzed by competent judges and using Linguistic Inquiry and Word Count. Results: The domains in which positive changes were most frequently observed were Personal Strength (26.09%), Relating to Others (24.22%), and Appreciation of Life (21.12%). Negative changes mainly affected Relating to Others (33.33%) and Personal Strength (23.33%). The results were confirmed by quantitative analysis of narratives: participants' narratives of trauma and its consequences contained more words which expressing positive emotions (1.67%) than negative emotions (0.90%), paired-sample t(60) = 9.70, p < 0.001. There were correlations between the frequency of words referring to positive emotions and PTG, r(62) = 0.39, p < 0.01, and between the frequency of words referring to negative emotions and PTG, r(62) = 0.23, p < 0.05. Conclusion: PTG and PTD can coexist and they can be regarded as outcomes of two separate processes. The study results also suggest that although PTG and PTD can coexist, they may be considered different domains of psychological functioning.

How paramedics perceive internal noise in ambulance? sensory processing sensitivity (SPS) and Subjective Noise Assessment.

INTRODUCTION: This article discusses the correlation between sensory processing sensitivity (SPS) as a feature of personality and temperament and paramedics' subjective perception of noise inside an ambulance. Description of the theoretical basis of SPS has been strongly depicted. MATERIALS AND METHODS: : Polish translation of SPS 12-item short scale and a survey concerning the subjective perception of noise inside an ambulance have been used in this research. Assessment of noise included its three sources: emergency vehicle siren, resistance of rolling tires and noise produced by diesel engines. 46 paramedics from mobile emergency care units working in Poznan and the Poznan's district have taken part in the research. Paramedics with higher SPS results were selected, creating a highly sensitive people (HSP) group. RESULTS: : When non-HSP people were compared to paramedics from the HSP group, an emergency signal was considered more burdensome for HSP paramedics. The intensity of noise generated by the vehicle's suspension elements and tires was significantly higher in cars more than 3 years old. Older paramedics (≥30 years old) evaluated the intensity as well as burdensomeness of noise generated by suspension's elements and tires, higher than the younger (<30 years old) ones. CONCLUSIONS: : Both paramedics and drivers as occupational groups are liable to noise, which seems to be particularly harmful and burdensome to the HSP group. Further studies should be provided in this area. This may lead to an increase not only in their productivity but also in their quality of life.