Prevalence of Body Dysmorphic Disorder in Private Aesthetic Clinical Settings in Four Latin American Countries: A Cross-Sectional Study.

BACKGROUND: Body dysmorphic disorder (BDD) is a psychiatric condition characterized by persistent concern with non-existent or minor defects in one's physical appearance. BDD can be difficult to identify as patients often have limited insight into the condition. OBJECTIVE: We aimed to determine the prevalence of BDD in patients presenting to private aesthetic clinical settings in four Latin American countries. METHODS: We conducted a cross-sectional study From August to October 2022 to evaluate the prevalence of BDD among 360 patients seeking nonsurgical cosmetic procedures in Chile, Mexico, Argentina, and Colombia using the Dysmorphic Concern Questionnaire (DCQ). We reported prevalence estimates for the lowest and highest previously proposed DCQ cutoff points. RESULTS: The DCQ total scores in the study population ranged from 0 to 21, with a mean total score of 5.1 ± 3.4. The prevalence of positive screening results for BDD (total DCQ score ≥ 9) was 15.8%. The prevalence of a likely diagnosis of BDD (total DCQ score of ¥ 17) was 0.83%. LIMITATIONS: The convenience sample limited the generalizability of the findings to Latin America. CONCLUSION: We encourage colleagues to be more mindful of this diagnosis and to facilitate earlier psychological evaluation in patients who are positive for BDD. LEVEL OF EVIDENCE III: This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

The role of T56 in controlling the flexibility of the distal histidine in dehaloperoxidase-hemoglobin from Amphitrite ornata.

The activation of dehaloperoxidase-hemoglobin (DHP) to form a ferryl intermediate requires the distal histidine, H55, to act as an acid base catalyst. The lack of ancillary amino acids in the distal pocket to assist in this process makes H55 even more important to the formation of active intermediates than in conventional peroxidases. Therefore, one can infer that the precise conformation H55 may greatly affect the enzymatic activity. Using site-direct mutagenesis at position T56, immediately adjacent to H55, we have confirmed that subtle changes in the conformation of H55 affect the catalytic efficiency of DHP. Mutating T56 to a smaller amino acid appears to permit H55 to rotate with relatively low barriers between conformations in the distal pocket, which may lead to an increase in catalytic activity. On the other hand, larger amino acids in the neighboring site appear to restrict the rotation of H55 due to the steric hindrance. In the case of T56V, which is an isosteric mutation, H55 appears less mobile, but forced to be closer to the heme iron than in wild type. Both proximity to the heme iron and flexibility of motion in some of the mutants can result in an increased catalytic rate, but can also lead to protein inactivation due to ligation of H55 to the heme iron, which is known as hemichrome formation. A balance of enzymatic rate and protein stability with respect to hemichrome formation appears to be optimum in wild type DHP (WT-DHP).

Prevalence of Body Dysmorphic Disorder Among Patients Seeking Breast Reconstruction.

BACKGROUND: Body dysmorphic disorder (BDD) is characterized by a preoccupation with a slight or imagined defect in physical appearance. It has significant implications for patients who desire breast reconstruction, because patient satisfaction with the aesthetic outcome is a substantial contributor to the success of the procedure. OBJECTIVES: The authors estimated the prevalence of BDD among women seeking breast reconstruction by surveying patients with the previously validated Dysmorphic Concerns Questionnaire (DCQ). METHODS: One hundred eighty-eight women who presented for immediate or delayed breast reconstruction completed the DCQ anonymously, during initial consultation with a plastic surgeon. Two groups of respondents were identified: those who desired immediate reconstruction and those who planned to undergo delayed reconstruction. The prevalence of BDD among breast reconstruction patients was compared between the 2 groups, and the overall prevalence was compared with published rates for the general public. RESULTS: Body dysmorphic disorder was significantly more prevalent in breast reconstruction patients than in the general population (17% vs 2%; P < .001). It also was much more common among patients who planned to undergo delayed (vs immediate) reconstruction (34% vs 13%; P = .004). CONCLUSIONS: Relative to the general public, significantly more women who sought breast reconstruction were diagnosed as having BDD. Awareness of the potential for BDD will enable clinicians to better understand their patients' perspectives and discuss realistic expectations at the initial consultation. Future studies are warranted to examine the implications of BDD on patient satisfaction with reconstructive surgery. LEVEL OF EVIDENCE: 3.

Molecular engineering of polymeric carbon nitride based Donor-Acceptor conjugated copolymers for enhanced photocatalytic full water splitting.

Research based on the full water splitting via heterogenous semiconducting photocatalyst is a significant characteristic nevertheless challenging for determining the energy and environmental crises. With respect to this, a photocatalytic water splitting by visible light through heterojunction semiconductors has been anticipated as a route to the sustainable energy. For the first time, we integrate a potential conjugated donor-acceptor (DA) co-monomer such as 2, 3-dichloroquinoxaline (DCQ) within the structure of polymeric carbon nitride (PCN) by a facile one-pot co-polymerization process. The DCQ which is acting as an organic motif that simulates a nucleophilic attack on the hosting PCN semiconductor which extends into a long chain of the polymer having enormous surface area and remarkable photocatalytic activity for H2 and O2 evolution as compared to the parental CNU. The supremacy of molecular geometry with DA ratio is effectively studied by absorbent, calculated band gap and migration of electrons on the photocatalytic performance of as-synthesized CNU-DCQx co-polymer. The density functional theory (DFT) calculation deliver supplementary evidence for the positive incorporation of DCQ in to the PCN matrix with reduced band gap upon copolymerization. Further, the hydrogen evolution rate (HER) for pure CNU with 14.2 µmol/h while for CNU-DCQ18.0 it is estimated at 124.9 µmol/h which remarkably fueled almost eight times more than blank sample. Similarly, the oxygen evolution rate (OER) analysis indicates the production 0.2 µmol/h (visible) and 1.5 µmol/h (non-visible) for CNU. However, the OER of copolymerized CNU-DCQ18.0 is found to be 1.9 µmol/h (visible) and 12.8 µmol/h (non-visible) which almost nine times higher than parental CNU. Hence, the output of this work reflects as an important step on the way to tailor-designed and elucidate the promising role of D-π-A system for the rational motifs of productive photocatalysts for forthcoming request.

Linking Cell Dynamics With Gene Coexpression Networks to Characterize Key Events in Chronic Virus Infections.

The host immune response against infection requires the coordinated action of many diverse cell subsets that dynamically adapt to a pathogen threat. Due to the complexity of such a response, most immunological studies have focused on a few genes, proteins, or cell types. With the development of "omic"-technologies and computational analysis methods, attempts to analyze and understand complex system dynamics are now feasible. However, the decomposition of transcriptomic data sets generated from complete organs remains a major challenge. Here, we combined Weighted Gene Coexpression Network Analysis (WGCNA) and Digital Cell Quantifier (DCQ) to analyze time-resolved mouse splenic transcriptomes in acute and chronic Lymphocytic Choriomeningitis Virus (LCMV) infections. This enabled us to generate hypotheses about complex immune functioning after a virus-induced perturbation. This strategy was validated by successfully predicting several known immune phenomena, such as effector cytotoxic T lymphocyte (CTL) expansion and exhaustion. Furthermore, we predicted and subsequently verified experimentally macrophage-CD8 T cell cooperativity and the participation of virus-specific CD8+ T cells with an early effector transcriptome profile in the host adaptation to chronic infection. Thus, the linking of gene expression changes with immune cell kinetics provides novel insights into the complex immune processes within infected tissues.

Patient Acceptance of Lactulose Varies Between Indian and American Cohorts: Implications for Comparing and Designing Global Hepatic Encephalopathy Trials.

BACKGROUND: Lactulose is the first-line drug for hepatic encephalopathy (HE), but its acceptance widely differs between Western and Eastern studies. Patient preference for lactulose between different parts of the world has not been examined systematically. AIM: To define the preferences and reasons behind acceptance of lactulose in patients from USA and India. METHODS: A discrete-choice questionnaire with six hypothetical scenarios was constructed. Situations 1-3 studied preference for lactulose vs no-lactulose, while 4-6 studied preference for high-dose vs low-dose lactulose varying the overt HE prevention at 6 months and adverse event rates in each situation. This was administered to outpatient cirrhotics without prior/current experience with lactulose after dedicated education. RESULTS: 100 patients (50 Indian, 50 USA) with similar MELD scores were included. A significantly higher proportion of Indian respondents agreed to lactulose in all situations compared to Americans. While their acceptance of lactulose decreased in the situation with the least difference in overt HE prevention, it was consistently higher than Americans. In the high-dose vs low-dose scenario, the relative proportion of American respondents accepting high-dose increased with the higher presented protection against overt HE. On the other hand, Indian respondents remained largely consistent with low-dose lactulose option. CONCLUSIONS: There are significant variations in the acceptance of lactulose in Indian and American populations. The acceptance increases with a more favorable perceived benefit/risk profile, which is strongly influenced by socio-cultural factors. These results have important implications when designing, comparing and interpreting HE trials from different parts of the world.

Validation of Spanish Language Evaluation Instruments for Body Dysmorphic Disorder and the Dysmorphic Concern Construct.

Dysmorphic concern (DC) refers to excessive preoccupation with a slight or imagined defect in physical appearance with social avoidance and behavior directed at controlling the defect in appearance. This study attempted to adapt the factor structure of two instruments that cover the DC construct, the Dysmorphic Concern Questionnaire (DCQ) and the Body Dysmorphic Disorder Examination Self-Report (BDDE-SR), to Spanish and establish their psychometric properties. A total of 920 subjects (62.7% women, Mage = 32.44 years) participated. Exploratory and Confirmatory Factor Analysis of both scales found adequate goodness of fit indices. A one-dimensional structure was found for the DCQ and two first-order factors (dissatisfaction/preoccupation with body image (BI) and BI avoidance behavior) were identified for the BDDE-SR. The psychometric test-retest reliability and validity properties (content, convergent, and discriminant) were satisfactory. It is suggested that the DC construct includes both cognitive and behavioral aspects and may represent a continuum of severity with Body Dysmorphic Disorder at the end.

Novel Spectrophotometric Method for the Assay of Captopril in Dosage Forms using 2,6-Dichloroquinone-4-Chlorimide.

A simple spectrophotometric method was developed for the determination of captopril (CPL) in pharmaceutical preparations. The method is based on coupling captopril with 2,6-dichloroquinone-4-chlorimide (DCQ) in dimethylsulphoxide. The yellow reaction product was measured at 443 nm. The absorbance-concentration plot was rectilinear over the range of 10-50 µg/mL with minimum detection limit (LOD) of 0.66 µg/mL and a quantification limit (LOQ) of 2.0 µg/mL. The different experimental parameters affecting the development and stability of the color were carefully studied and optimized. The proposed method was successfully applied to the analysis of commercial tablets and the results were in good agreement with those obtained using official and reference spectrophotometric methods. Hydrochlorothiazide which is frequently co-formulated with CPL did not interfere with the assay. A proposal of the reaction pathway was presented.