Understanding Nutritional Knowledge and Experiences in Families With a Child Newly Diagnosed With Type 1 Diabetes.

Nutrition is an integral part of diabetes management. Caregiver nutritional knowledge has been implicated in glycemic management of youth with type 1 diabetes. This study assessed the nutritional knowledge of parents/caregivers of children newly diagnosed with type 1 diabetes. Findings suggest there is a need for more targeted support and training during the initial diagnosis and a desire for more technology-related resources such as virtual nutritionist-guided grocery shopping visits. Integrating these interventions into routine care for children with type 1 diabetes will help address the current gaps in caregiver nutritional literacy and their ability to provide appropriate care.

A Case of Constipation and Gastrointestinal Retention of Lisdexamfetamine Dimesylate Capsules in an 11-Year-Old.

Attention deficit hyperactivity disorder (ADHD) has a worldwide prevalence of 5.29% and stimulant medications are considered first-line treatment. Common adverse events with these medications include decreased appetite, increased sleep latency, tics, abdominal pain, and weight loss. Lisdexamfetamine dimesylate (LDX) is a stimulant used for treating ADHD and may lead to gastrointestinal, among other adverse effects. In this report, we present a case of constipation and retention of LDX capsules in the gastrointestinal tract. An 11-year-old male with a diagnosis of ADHD was being treated with once daily LDX 30 mg in our clinic. After about ten weeks of treatment, he was brought to an emergency department due to epigastric pain and constipation. An abdominal X-ray was significant for the presence of approximately 20 capsules in the large intestine. He was admitted to the pediatric gastroenterology service. Following management with two saline enemas, fewer capsules were seen on repeat X-ray. The patient was observed overnight, advised to discontinue LDX and discharged home in a stable condition. LDX may be associated with constipation and retention of intact capsules in the gastrointestinal tract. Further research is warranted to exclude the risk of sympathomimetic toxidrome if intact LDX capsules simultaneously disintegrate in the gastrointestinal tract.

Le trouble de déficit de l'attention avec hyperactivité (TDAH) a une prévalence mondiale de 5,29 % et les médicaments stimulants sont considérés le traitement de première intention. Les effets indésirables communs de ces médicaments sont notamment un appétit réduit, le délai d'endormissement accru, les tics, la douleur abdominale, et la perte de poids. Le dimésylate de lisdexamfétamine (LDX) est un stimulant utilisé pour traiter le TDAH et peut entraîner un effet gastro-intestinal, entre autres effets. Dans cette étude, nous présentons un cas de constipation et de rétention de capsules de LDX dans le tractus gastro-intestinal. Un garçon de 11 ans ayant reçu un diagnostic de TDAH était traité par LDX 30 mg une fois par jour dans notre clinique. Après environ 10 semaines de traitement, il a été amené à un service d'urgence en raison de douleur épigastrique et de constipation. Une radiographie abdominale a révélé la présence de quelque 20 capsules dans le gros intestin. Il a été hospitalisé dans un service de gastro-entérologie pédiatrique. Après une prise en charge avec deux lavements de solution salée, moins de capsules étaient visibles à la radiographie répétée. Le patient a été gardé sous observation pour la nuit, on lui a conseillé de cesser le LDX et il a eu son congé à la maison dans un état stable. Le LDX peut être associé à la constipation et à la rétention de capsules intactes dans le tractus gastro-intestinal. Il faut d'autre recherche pour exclure le risque d'un toxidrome sympathomimétique si des capsules de LDX intactes se désintègrent simultanément dans le tractus gastro-intestinal.

The impact of COVID-19-related changes in media consumption on public knowledge: results of a cross-sectional survey of Pennsylvania adults.

OBJECTIVE: During the COVID-19 pandemic, Americans have increasingly relied on internet versus television news. The extent to which this change in health news consumption practice impacts health knowledge is not known. This study investigates the relationship between most trusted information source and COVID-19 knowledge. METHODS: A cross-sectional online survey was sent to a convenience sample from a list of adults on a central Pennsylvania health system's marketing database 25-31 March 2020. Respondents were grouped by their trusted news sources and comparison of respondent COVID-19 knowledge was made between these groups for 5948 respondents. RESULTS: Those who selected government health websites as their most trusted source were more likely to answer COVID-19 questions correctly than those who selected other internet news sources or television news (OR 1.21, p < .05; 1.08, p > .05; and 0.87, p < .05, respectively). Those who used Facebook as an additional source of news in any way were less likely to answer COVID-19 questions correctly than those who did not (OR 0.93, p < .05). CONCLUSIONS: COVID-19 knowledge correlates with trusted news source. To increase public knowledge of COVID-19 in order to maximize information dissemination and compliance with COVID-19-related public health recommendations, those who provide health information should consider use of the public's most trusted sources of information, as well as monitoring and correcting misinformation presented by other sources. Independent content review for accuracy in media may be warranted in public health emergencies to improve knowledge.

Electroconvulsive Therapy for Depression in Transgender Patients: Case Series and Literature Review.

ABSTRACT: There is very limited information regarding the effectiveness of electroconvulsive therapy (ECT) as a treatment for major depressive disorder in transgender patients. This population is also at risk for comorbid conditions, such as posttraumatic stress disorder and substance use that could impact the outcome of ECT. We report our experience with the use of ECT in this population. Clinical and response characteristics of 7 consecutive cases are described in this series. All patients had multiple psychiatric diagnoses and were refractory to pharmacologic intervention. Pretreatment Beck Depression Inventory-II scores were 45.5 ± 3.2 SEM and posttreatment scores were 21.2 ± 6.4 [P < 0.01]. Suicidality scores reduced by greater than 60%, whereas remission of depression was obtained for 2 of 7, and 4 of 7 showed greater than 50% reduction in depression scores. Treatments were tolerated well using conventional treatment procedures. This case series suggests that ECT can be effective for depressed transgender patients with multiple clinical comorbidities.

Knowledge, Perceptions, and Preferred Information Sources Related to COVID-19 Among Healthcare Workers: Results of a Cross Sectional Survey.

PURPOSE: To compare COVID-19 related knowledge, perceptions, and preferred information sources between healthcare workers and non-healthcare workers. DESIGN: Cross-sectional survey. SETTING: Web-based. SUBJECTS: Convenience sample of Pennsylvanian adults. MEASURES: Primary outcomes were binary responses to 15 COVID-19 knowledge questions weighted by a Likert scale assessing response confidence. ANALYSIS: Generalized linear mixed-effects models to assess comparisons between clinical decision makers (CDM), non-clinical decision makers working in healthcare (non-CDM) and non-healthcare workers (non-HCW). RESULTS: CDMs (n = 91) had higher overall knowledge than non-CDMs (n = 854; OR 1.81 [1.51, 2.17], p < .05). Overall knowledge scores were not significantly different between non-CDMs (n = 854) and non-HCW (n = 4,966; OR 1.03 [0.97, 1.09], p > .05). CONCLUSION: The findings suggest a need for improved education about COVID-19 for healthcare workers who are not clinical decision makers, as they play key roles in patient perceptions and compliance with preventive medicine during primary care visits.