Acculturation and drinking behavior among Latinxs: a narrative review.

Research suggests that acculturation is associated with increased alcohol consumption among Latinxs. The purpose of this narrative review is to contribute to this literature by examining the association between acculturation and alcohol use within current theoretical and etiological frameworks on cultural norms, acculturative stress, and acculturative gaps. This review also compares the utility of these explanatory frameworks for guiding future research. Two databases (PubMed and PsycInfo) were used to identify peer-reviewed studies pertaining to the associations between acculturation and alcohol use among Latinxs. Studies that examined drinking norms, acculturative stress, acculturation gaps, and drinking behavior in Latinxs were included. The types of study approaches and designs included quantitative, qualitative, cross-sectional, cohort, and longitudinal studies published between January 2000 and December 2021. Quality assessment and data synthesis were conducted by two reviewers. A total of 65 articles reporting empirical studies were included in the final review. Eighteen studies did not utilize a specific framework, but generally supported that acculturation is associated with increased alcohol consumption and alcohol related consequences among Latinxs. Additionally, sixteen studies examined cultural norms, twenty-two examined acculturative stress, while only nine utilized a gap discrepancy framework. Studies examining drinking norms appeared to largely explain changes in drinking behavior among Latinas, while studies examining acculturative stress seemed to be better equipped to explain changes in drinking behavior among Latino men. Meanwhile, the Gap Discrepancy Model articulates the gap between old and new cultural influences and can be conceptualized as an additional dimension of acculturative stress.

Effects of Bariatric Surgeries on Male and Female Fertility: A Systematic Review.

BACKGROUND: Morbid obesity has been known to decrease fertility in both men and women. This review aimed to examine current evidence of the effects of bariatric surgeries on fertility parameters including sex hormones in both men and women, seminal outcomes in men, menstrual cycle, PCOS symptoms, and pregnancy in women, and sexual function in both men and women. METHODS: Three databases (PubMed, Web of Science, and Academic Search Premier) were used with key terms of bariatric surgery, bariatric surgical procedures, infertility, reproductive health, pregnancy, and fertility. Studies with male and/or female patients were included. Study types included retrospective chart reviews, observational, qualitative, cross-sectional, cohort, and longitudinal studies published in January 2008-June 2018. The search was performed on June 21-26, 2018. Quality assessment and data synthesis were conducted. RESULTS: A total of 18 articles were included in the final review. Seven studies included only men, ten included only women, and one included both men and women. Bariatric surgery significantly improved hormonal balance and sexual functions in both males and females, sperm count in males, and pregnancy in females. The strongest evidence was found on bariatric surgery's effects on sex hormones. No study with males asked whether the participants actually conceived a child with their partners after the bariatric surgery. Most weaknesses in all articles reviewed were lack of discussion on confounding variables and many did not differentiate surgical types. CONCLUSION: Bariatric surgery most effectively improved sex hormones. Further research is needed on direct pregnancy outcomes for both men and women.

Congenital Central Hypoventilation Syndrome: A Case-Based Learning Opportunity for Neonatal Clinicians.

Congenital central hypoventilation syndrome (CCHS) is a rare and sporadic neurocristopathy characterized by alveolar hypoventilation and autonomic nervous system dysfunction. CCHS manifests quickly after birth, initially as respiratory distress. Mortality risk is estimated at 38 percent, with a median age of death of three months of age. A timely and accurate diagnosis is critical. Genetic testing for PHOX2B gene mutations is necessary to confirm the diagnosis; however, laboratory turnaround time often imposes an additional 7-14-day waiting period on an often anxious family. Neonatal clinicians should recognize that families require disease-specific education, emotional support, and time to rehearse daily caregiving in preparation for discharge. Therefore, this article presents the key clinical, pathophysiologic, and diagnostic factors, as well as a discussion of discharge needs. A case report of an infant, born to parents with no known history of CCHS, is included as a case-based learning opportunity for readers.

Histopathological characteristics of cutaneous lesions caused by Leishmania Viannia panamensis in Panama.

Cutaneous leishmaniasis (CL) is an endemic disease in the Republic of Panama, caused by Leishmania (Viannia) parasites, whose most common clinical manifestation is the presence of ulcerated lesions on the skin. These lesions usually present a chronic inflammatory reaction, sometimes granulomatous, with the presence of lymphocytes, plasma cells and macrophages. This study describes the histopathological characteristics found in the skin lesions of patients with CL caused by Leishmania (V.) panamensis in Panama. We analyzed 49 skin biopsy samples from patients with clinical suspicion of CL, by molecular tests (PCR for subgenus Viannia and HSP-70) and by Hematoxylin-Eosin staining. Samples were characterized at the species level by PCR-HSP-70/RFLP. From the 49 samples studied, 46 (94%) were positive by PCR and were characterized as Leishmania (V.) panamensis. Of these, 48% were positive by Hematoxylin-Eosin staining with alterations being observed both, in the epidermis (85%) and in the dermis (100%) of skin biopsies. The inflammatory infiltrate was characterized according to histopathological patterns: lymphohistiocytic (50%), lymphoplasmacytic (61%) and granulomatous (46%) infiltration, being the combination of these patterns frequently found. The predominant histopathological characteristics observed in CL lesions caused by L. (V.) panamensis in Panama were: an intense inflammatory reaction in the dermis with a combination of lymphohistiocytic, lymphoplasmacytic and granulomatous presentation patterns and the presence of ulcers, acanthosis, exocytosis and spongiosis in the epidermis.

Neural breathing pattern in newborn infants pre- and postextubation.

AIM: To describe the neural breathing pattern before and after extubation in newborn infants. METHODS: Prospective, observational study. In infants deemed ready for extubation, the diaphragm electrical activity (EAdi) was continuously recorded from 30 minute before to two hours after extubation. RESULTS: Total of 25 neonates underwent 29 extubations; 10 extubations resulted in re-intubation within 72 hours. Postextubation, there was an increase in peak EAdi (EAdi-max) and EAdi-delta (peak minus minimum EAdi) in both groups. The pre- to postextubation change in EAdi-max (8.9-11.1 µv) and EAdi-delta (6-8 µv) was less in the failure group in comparison with the change in EAdi-max (10.2-13.4 µv) and EAdi-delta (6.3-10.6 µv) in the success group, (p = 0.02 and 0.01, respectively). CONCLUSION: In our neonatal cohort, extubation failure was associated with a smaller increase in peak and delta EAdi after extubation. If confirmed, these findings indicate an important cause of extubation failure in preterm infants.