Efficacy and Safety of Aripiprazole in Borderline Personality Disorder: A Systematic Review.

Aripiprazole is an atypical antipsychotic medication, and its use in treating borderline personality disorder (BPD) is debatable because it is not FDA-approved for treating BPD. This study aimed to investigate the efficacy and safety of aripiprazole in patients with BPD. On July 2, 2021, the protocol (CRD42021256647) was registered in PROSPERO. PubMed, Scopus, Web of Science, Ovid-Medline, Embase, PsycINFO, and Cochrane (CENTRAL) were searched without regard for language or publication date. We also searched trial registries on ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform. Randomized clinical trials with adult patients diagnosed with BPD met the inclusion criteria. The Cochrane risk of bias for randomized trials (RoB-2) method was used to assess the quality of the included studies. We included two previously published randomized clinical trials. There were 76 patients with BPD, with 38, 12, and 26 assigned to the aripiprazole, olanzapine, and placebo groups, respectively. Most patients (88.16%) were females, with ages ranging from 22.1 to 28.14 yr. Aripiprazole has been proven to reduce anxiety, depression, anger, hostility, clinical severity, and obsessive-compulsive behavior, insecurity, melancholy, anxiety, aggressiveness/hostility, phobic anxiety, paranoid thinking, psychoticism, and somatization. The adverse effects were headache, insomnia, restlessness, tremor, and akathisia. The risk of bias was considerable in both trials, which is somewhat problematic considering that prejudice can lead to incorrect outcomes and conclusions. Aripiprazole has demonstrated encouraging outcomes in the treatment of patients with BPD. More randomized controlled studies are needed.

Neurological and Psychological Sequelae Associated With Multisystem Inflammatory Syndrome in Children.

Importance: Acute neurological involvement occurs in some patients with multisystem inflammatory syndrome in children (MIS-C), but few data report neurological and psychological sequelae, and no investigations include direct assessments of cognitive function 6 to 12 months after discharge. Objective: To characterize neurological, psychological, and quality of life sequelae after MIS-C. Design, Setting, and Participants: This cross-sectional cohort study was conducted in the US and Canada. Participants included children with MIS-C diagnosed from November 2020 through November 2021, 6 to 12 months after hospital discharge, and their sibling or community controls, when available. Data analysis was performed from August 2022 to May 2023. Exposure: Diagnosis of MIS-C. Main Outcomes and Measures: A central study site remotely administered a onetime neurological examination and in-depth neuropsychological assessment including measures of cognition, behavior, quality of life, and daily function. Generalized estimating equations, accounting for matching, assessed for group differences. Results: Sixty-four patients with MIS-C (mean [SD] age, 11.5 [3.9] years; 20 girls [31%]) and 44 control participants (mean [SD] age, 12.6 [3.7] years; 20 girls [45%]) were enrolled. The MIS-C group exhibited abnormalities on neurological examination more frequently than controls (15 of 61 children [25%] vs 3 of 43 children [7%]; odds ratio, 4.7; 95% CI, 1.3-16.7). Although the 2 groups performed similarly on most cognitive measures, the MIS-C group scored lower on the National Institutes of Health Cognition Toolbox List Sort Working Memory Test, a measure of executive functioning (mean [SD] scores, 96.1 [14.3] vs 103.1 [10.5]). Parents reported worse psychological outcomes in cases compared with controls, particularly higher scores for depression symptoms (mean [SD] scores, 52.6 [13.1] vs 47.8 [9.4]) and somatization (mean [SD] scores, 55.5 [15.5] vs 47.0 [7.6]). Self-reported (mean [SD] scores, 79.6 [13.1] vs 85.5 [12.3]) and parent-reported (mean [SD] scores, 80.3 [15.5] vs 88.6 [13.0]) quality of life scores were also lower in cases than controls. Conclusions and Relevance: In this cohort study, compared with contemporaneous sibling or community controls, patients with MIS-C had more abnormal neurologic examinations, worse working memory scores, more somatization and depression symptoms, and lower quality of life 6 to 12 months after hospital discharge. Although these findings need to be confirmed in larger studies, enhanced monitoring may be warranted for early identification and treatment of neurological and psychological symptoms.

Lesiones dentales asociadas a enfermedad por reflujo gastroesofágico en pediatría / Dental Injuries Associated with Gastroesophageal Reflux Disease in Pediatrics

Acta Pediátrica Hondureña, Vol. 11 No.2/ Octubre 2020 a Marzo 2021 1186 El reflujo gastroesofágico (RGE) es el paso fisio- lógico del contenido gástrico hacia el esófago, presente en condiciones normales a cualquier edad y es uno de los problemas gastrointestinales más comunes en niños. El estado nutricional es adecuado y muchas veces por arriba de los per- centiles de peso y talla y es un niño "vomitador feliz". En cambio, la enfermedad por reflujo gas- troesofágico (ERGE) está asociada con síntomas molestos respiratorios, digestivos, trastornos durante el sueño, lesiones dentales las que en un gran número de casos pasan desapercibidas y son notadas hasta que han causado un daño signifi- cativo y pueden ir desde prurito, ardor de muco- sa, aumento de la sensibilidad dental y lingual, sabor amargo, erosiones hasta caries dental, estas cumplen un importante papel en la edad pediá- trica, sobre todo cuando el niño presenta trastor- nos en las funciones neurosensoriales, motoras, como daño neurológico secundario a encefalo- patía hipóxico isquémica, defectos del tubo neu- ral, atresia esofágica y enfermedades degene- rativas. Dentro de las complicaciones de ERGE cabe resaltar neumonía por broncoaspiración, otitis, faringoamigdalitis, crup y compromiso en el estado nutricional. La ERGE tiene gran impor- tancia médica y social debido al incremento en su incidencia y a los síntomas duraderos ya que reducen la calidad de vida. La habilidad de poder distinguir entre las mani- festaciones clínicas de RGE y ERGE en los dife- rentes grupos etarios nos permite identificar que pacientes deben ser extensamente evaluados y manejados con tratamiento conservador o si es- tos requieren ser derivados al odontólogo pedia- tra. Debido a que existe desconocimiento acerca de las lesiones dentales que se producen en la ERGE decidimos hacer la presente revisión ya que es muy importante que el personal de salud: estudiantes, médicos y odontólogos sean capaces de identificar, diagnosticar e implementar reco- mendaciones apropiadas, dar tratamiento espe- cífico tanto desde el punto de vista médico como dental dadas las repercusiones que esta conlleva y así derivar oportunamente...(AU)

Cisticercosis: reporte de caso / Cysticercosis: case Report

La teniasis humana/cisticercosis es una enfer-medad zoonótica causada por la Taenia solium. Fue declarada por la OMS como una de las enfermedades tropicales potencialmente erra-dicables que afecta a las personas más pobres con condiciones ambientales desfavorables. En nuestro país, Honduras, la Dra. Rina Girard de Kaminsky en 1991 encontró tasas de infección de 2-7/1000 en el Hospital Escuela, 10/1000 en el sur y 0-6/1000 en los departamentos de Cortés y Atlántida. La transmisión es a través de un círculo cerdo-humano; en el cual el cerdo lleva las larvas quísticas en su carne (cisticerco-sis), el humano la Taenia adulta (teniasis) en la luz del intestino. La cisticercosis se debe a la infección que puede ser asintomática o sintomática: diarrea, dolor abdominal, migración de proglótides y cisticercos al Sistema Nervioso Central (SNC). El diagnóstico se basa en el cuadro clínico, demostración de los huevos o quistes, pruebas inmunológicas ELISA: inmunoelectroforesis, Tomografía axial computarizada y resonancia magnética. Su tratamiento farmacológico es: Praziquantel y Albendazol a dosis de 10-20 mg/kg/día una dosis, y en Neurocisticercosis 10 días de tratamiento el cual deberá iniciarse una vez controlado el cuadro convulsivo y la hiper-tensión endocraneana. Se presenta un caso de Teniasis en un lactante de 8 meses alimentado exclusivamente con leche materna. El objetivo del presente estudio es reconocer su aparición en cualquier edad, incluyendo los menores de 1 año además de recordar que es erradicable y que se pueden prevenir las complicaciones...(AU)

Discrimination of wine lactic acid bacteria by Raman spectroscopy.

Species of Lactobacillus, Pediococcus, Oenococcus, and Leuconostoc play an important role in winemaking, as either inoculants or contaminants. The metabolic products of these lactic acid bacteria have considerable effects on the flavor, aroma, and texture of a wine. However, analysis of a wine's microflora, especially the bacteria, is rarely done unless spoilage becomes evident, and identification at the species or strain level is uncommon as the methods required are technically difficult and expensive. In this work, we used Raman spectral fingerprints to discriminate 19 strains of Lactobacillus, Pediococcus, and Oenococcus. Species of Lactobacillus and Pediococcus and strains of O. oeni and P. damnosus were classified with high sensitivity: 86-90 and 84-85%, respectively. Our results demonstrate that a simple, inexpensive method utilizing Raman spectroscopy can be used to accurately identify lactic acid bacteria isolated from wine.

Relación entre el nivel de conocimiento sobre cáncer cervical y la exposición a sus factores de riesgo en usuarias atendidas en los consultorios externos del Instituto Nacional Materno Perinatal, febrero - marzo del 2016 / Relationship between the level of knowledge about cervical cancer and exposure to risk factors in the users attended in the External Consult at the National Institute Maternal Perinatal, February - March 2016

Objetivo: Relacionar el nivel de conocimiento sobre cáncer cervical y la exposición a sus factores de riesgo en usuarias atendidas en los consultorios externos del Instituto Nacional Materno Perinatal, febrero - marzo del 2016. Metodología: Estudio descriptivo, correlacional y transversal, que tuvo como muestra a 361 usuarias atendidas en el consultorio externo del Instituto Nacional Materno Perinatal durante los meses de febrero a marzo del 2016. En el análisis descriptivo, para los valores cuantitativos se estimaron medidas de tendencia central y de dispersión; para los valores cualitativos se estimaron frecuencias. Asimismo, se calculó la relación mediante la prueba de Chi cuadrado, la cual se consideró significativa cuando tuvo un valor de p<0.05. Resultados: El nivel de conocimiento sobre cáncer cervical de las usuarias atendidas en los consultorios externos del Instituto Nacional Materno Perinatal fue de Medio (49 por ciento) a Alto (34 por ciento). Las usuarias tuvieron una mayor exposición a los factores de riesgo como presentar síntomas o signos de infección vaginal (64.5 por ciento), tener de dos a más parejas sexuales (58.7 por ciento), tener de dos a más hijos (44.3 por ciento), tener una alimentación deficiente de vegetales todos los días (38.8 por ciento), inicio de relaciones sexuales menor o igual a 17 años (36.6 por ciento) y haber tenido de dos a más partos (29.9 por ciento). Se observó que hubo relación significativa entre el número de parejas sexuales y el nivel de conocimiento sobre cáncer de cuello uterino (p=0.013). También hubo una relación significativa entre el nivel de conocimiento bajo sobre cáncer cervical y la alimentación deficiente de vegetales (p=0.006). Conclusión: El nivel de conocimiento sobre cáncer cervical se relaciona de manera significativa con la exposición a dos o más parejas sexuales y a la alimentación deficiente de alimentos vegetales en usuarias atendidas en los consultorios externos del Instituto Nacional...

Objective: Relate the level of knowledge about cervical cancer and exposure to risk factors in users attended in outpatient clinics of the National Maternal Perinatal Institute, February-March 2016. Methodology: A descriptive, correlational and cross-sectional study, which was sample as 361 users assisted in the outpatient clinic of the National Maternal and Perinatal Institute during the months of February to March 2016. In descriptive analysis, quantitative values for measures of central tendency and dispersion were estimated for the qualitative values were estimated frequencies. The relationship also was calculated using the chi-square test, which is considered significant when it had a value of p<0.05. Results: The level of knowledge about cervical cancer users assisted in the outpatient clinics of the Maternal Perinatal Institute National was Medium (49 per cent) to high (34 per cent). The users had greater exposure to risk factors such as symptoms or signs of vaginal infection (64.5 per cent) have two or more sexual partners (58.7 per cent), have two more children (44.3 per cent), having a feed deficient vegetables every day (38.8 per cent), onset of less than or equal to 17 years (36.6 per cent) have had sexual intercourse and two more deliveries (29.9 per cent). It is observed that there was significant relationship between the number of sexual partners and the level of knowledge about cervical cancer (p = 0.013). There was also a significant relationship between low level of knowledge about cervical cancer and poor nutrition of vegetables (p = 0.006). Conclusions: The level of knowledge about cervical cancer is related significantly with exposure to two or more sexual partners and poor nutrition from plant foods in users attended in outpatient clinics of the National Maternal Perinatal Institute, February-March 2016.

Raman spectroscopy and chemometrics for identification and strain discrimination of the wine spoilage yeasts Saccharomyces cerevisiae, Zygosaccharomyces bailii, and Brettanomyces bruxellensis.

The yeasts Zygosaccharomyces bailii, Dekkera bruxellensis (anamorph, Brettanomyces bruxellensis), and Saccharomyces cerevisiae are the major spoilage agents of finished wine. A novel method using Raman spectroscopy in combination with a chemometric classification tool has been developed for the identification of these yeast species and for strain discrimination of these yeasts. Raman spectra were collected for six strains of each of the yeasts Z. bailii, B. bruxellensis, and S. cerevisiae. The yeasts were classified with high sensitivity at the species level: 93.8% for Z. bailii, 92.3% for B. bruxellensis, and 98.6% for S. cerevisiae. Furthermore, we have demonstrated that it is possible to discriminate between strains of these species. These yeasts were classified at the strain level with an overall accuracy of 81.8%.

History of maltreatment among unintentional injury deaths: analyses of Texas child fatality review data, 2005-2007.

OBJECTIVE: This report examines unintentional injury deaths among children with and without a history of child maltreatment. METHODS: Data are from reviews of 1192 unintentional injury deaths occurring among children in Texas during 2005-2007. The study examined differences in child demographic characteristics, injury mechanism, and supervisor status at time of death between children with and without maltreatment history by using descriptive statistics and χ² tests. Separate analyses compared characteristics of asphyxia, drowning, and poisoning deaths. RESULTS: In 10% of the unintentional injury deaths that were reviewed, the child had a history of maltreatment. The prevalence of a history of maltreatment was highest among black decedents and lowest among white decedents. Prevalence of a history of maltreatment was highest among infant decedents and lowest among youth decedents, ages 10-14 years. Among deaths where there was no maltreatment history, 54% were due to motor vehicle related incidents, whereas 51% of deaths among children with maltreatment history were caused by drowning, asphyxia, and poisoning. Supervisors of child decedents with a history of maltreatment were significantly more likely to have been alcohol impaired (6.9% vs 1.6%; p<0.0005), or asleep (12.1% vs 6.6%; p=0.03) at the time of death. Differences between child decedents with and without maltreatment history were observed in infant sleep surface in suffocation deaths, location and barrier type in drowning deaths, and substance type in poisoning deaths. CONCLUSIONS: These data show that the mechanisms and circumstances surrounding unintentional injury deaths among children with a history of maltreatment differ from those without a history of maltreatment. This underscores the need for appropriate interventions to prevent unintentional and intentional injuries in families with a history of maltreatment.