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BACKGROUND: Treatment of sciatica due to lumbar disc herniation can be surgical or conservative. Conservative management has been described to be effective in 90% of patients; however, in most studies no consistent treatment concept was used. OBJECTIVES: In the present study, we evaluated the effect of a combined nonsurgical management (McKenzie physiotherapy, gabapentin, and periradicular injections) in 40 patients during a 10-day inpatient treatment. METHODS: In addition to the neuro-orthopedic examination, pain severity at rest and after walking were assessed. The Oswestry pain disability scale, the pain severity scale, and the painDETECT scale were examined to assess neuropathic pain components. The duration of incapacity for work and the requirement of a later surgery were recorded. Examinations were performed on the day of admission, on days 3, 6, 10, and 84, 3 months after discharge. RESULTS: During conservative treatment, a continuous reduction of pain and an improvement of the straight leg raise test as well as finger-to-floor distance could be documented. As the three treatment options were introduced with a time delay, it could be demonstrated that all significantly contributed to the improvement. All treatments were tolerated without side-effects and persistent improvement after 12 weeks. On admission, 32% of patients revealed a neuropathic pain component which decreased to 7% at the follow-up. A total of 28 patients showed impaired muscle strength on admission, which decreased to 7 patients on follow-up. Electromyography revealed pathological results in 70% of patients examined. A significant improvement of quality of life (Oswestry Disability Index [ODI]) could be observed and the patients returned to work after 5.8 weeks. Only 3/40 patients required surgical management due to persistent pain. CONCLUSION: The combined nonsurgical operative treatment program is effective and well tolerated.
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Touch is a universal nonverbal action often used by romantic partners to demonstrate affection and care for each other. Attitudes toward touch might be particularly relevant across periods of relational strain-such as the transition to parenthood-when couples face many novel stressors and shifting priorities which can interfere with their sexual and affectionate experiences. New parent couples (N = 203) completed self-report measures online across six time-points (two prenatal). We tested whether couples' attitudes toward touch (touch aversion, touch for affection, touch for emotion regulation) at baseline (20 weeks mid-pregnancy) predicted their frequency of sexual and affectionate behaviors from mid-pregnancy through 12-month postpartum. Both partners' more positive attitudes toward touch (i.e., for affection and emotion regulation) and lower aversive attitudes toward touch, as measured in mid-pregnancy, predicted couples' higher frequency and variety of sexual and affectionate behaviors at 3-month postpartum. Touch attitudes generally did not predict the degree of change in the frequency or variety of sexual or affectionate behaviors, with one exception: non-birthing parents' more positive attitudes toward touch for emotion regulation in mid-pregnancy predicted a slower decline in couples' affectionate behaviors across pregnancy. Findings underscore a link between new parents' attitudes toward touch and their subsequent sexual and affectionate behaviors, particularly in the early postpartum period. New parents need to navigate novel sexual changes and a nonverbal strategy such as touch might be useful to promote intimacy and care.
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BACKGROUND: Systemic lupus erythematosus (SLE) is a chronic multi-systemic autoimmune disease. SLE patients may experience a wide range of physical, psychological, and social perception of well-being influenced by the patient illness that are not always fully captured by descriptions of the disease's physiological consequences alone. Nowadays, patients with SLE have a better survival than decades ago, nevertheless still experience a low health related quality of life (HRQoL). Assessing disease activity in SLE is crucial to the physician as it forms the basis for treatment decisions, moreover careful evaluation for respiratory involvement should be routinely considered. More chronic lung disease related to SLE can have a significant negative effect on patient well-being and physical performance status and are detrimental to quality of life. OBJECTIVE: The aim of this study was to evaluate quality of life changes in SLE patients using Lupus QoL scale, assessing their correlation with different disease aspects particularly pulmonary manifestations and predictors for worse QoL. MATERIALS AND METHODS: Total of 60 SLE patients, who fulfilled the 2012 Systemic Lupus International Collaborating Clinics (SLICC) criteria, were enrolled in this study. Disease activity was measured by systemic lupus erythematosus disease activity index (SLEDAI) and quality of life was assessed by Lupus QoL. Pulmonary evaluation included pulmonary function tests parameters (PFTs), mMRC dyspnea scale, HRCT score, and pulmonary damage index. RESULTS: Lupus QoL had a strong significant correlations with PFTs FEV1, FVC, and DLCO (r = 0.79, 0.78, 0.76, p < .001), respectively}, while Lupus QoL had strong negative correlations with both mMRC dyspnea scale and HRCT score (r = -0.96, -0.85, p < .001), respectively, and moderate negative correlation with neuropsychiatric lupus (NPSLE) (r = -0.61, p < .001). Weak negative correlations were found between Lupus QoL, photosensitivity, alopecia, Raynaud's and renal affection (r = -0.29, -0.30, -0.30, 0.38, p = .03, .02, .02, .002), respectively. NPSLE and pulmonary involvement were the most consistent predictors of low HRQoL [contributing 36% and 18% of the variance of Lupus QoL], respectively. CONCLUSION: Lupus QoL is negatively correlated with different SLE clinical parameters particularly pulmonary manifestations. Neuropsychiatric, pulmonary, renal affection, and SLEDAI are the best determinants for worse Lupus QoL.
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Pneumopatias , Lúpus Eritematoso Sistêmico , Humanos , Qualidade de Vida , Índice de Gravidade de Doença , DispneiaRESUMO
Parenting stress and child psychopathology are closely linked in parent-child dyads, but how the bidirectional association varies across childhood and adolescence, and shifts depending on maternal affection are not well understood. Guided by the transactional model of development, this longitudinal, prospective study examined the bidirectional relations between parenting stress and child internalizing and externalizing problems and investigated the moderating role of maternal affection from childhood to adolescence. Participants were from the Future of Families and Child Wellbeing Study, a diverse, nationally representative sample of 2,143 caregiving mothers who completed assessments at children ages 5, 9, and 15. Using cross-lagged panel modeling, we found bidirectional effects between parenting stress and child internalizing and externalizing problems. However, additional multigroup analyses showed that bidirectional associations depend on the levels of maternal affection. In the high maternal affection group, parenting stress at age 5 predicted higher internalizing and externalizing problems at age 9, and reverse child-to-parent paths were found from age 9 to age 15. In contrast, only one cross-lagged path was found in the low maternal affection group. Findings suggest that maternal affection can heighten the transactional associations between parenting stress and child psychopathology.
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BACKGROUND: Klebsiella pneumoniae is a major pathogen of bacterial liver abscess in Asia. Particularly, patients with community-acquired Klebsiella pneumoniae liver abscess (CA-KPLA) tend to have a higher risk of invasive infection and pulmonary is a common invasive infectious site, making it a global clinical crisis. Therefore, considerable attention should be focused on the early prediction and active treatment strategies of such patients. METHODS: The clinical data of 127 CA-KPLA cases hospitalized from January 2017 to February 2022 were collected from a single center. Risk factors were analyzed by the use of univariable and multivariable analysis. Furthermore, independent risk factors of pulmonary affection were utilized to construct a predictive nomogram. RESULTS: The incidence of pulmonary affection in KPLA patients was 57.5% (73/127) and the majority manifested as nodular lesions with cavities and pleural effusion in chest CT images. Based on the predictive nomogram, the SOFA score (>2) was defined as the most dominant independent risk factor for the occurrence of pulmonary affection, followed by the maximum diameter of liver abscess (>3 cm), multiple liver abscesses, bacteremia, and badly-controlled diabetes sequentially. The validation of this nomogram also demonstrated good discriminative ability and satisfactory consistency. Finally, early drainage of liver abscess, initial combinational antibiotics, and early Carbapenem-including antibiotic usage were established as favorable factors for therapy in pulmonary affected CA-KPLA patients. CONCLUSION: This study provided an effective model for the early prediction of pulmonary affection in patients with CA-KPLA and some rational strategies for their early therapeutic remission.
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Infecções Comunitárias Adquiridas , Infecções por Klebsiella , Abscesso Hepático Piogênico , Pneumonia , Humanos , Klebsiella pneumoniae , Infecções por Klebsiella/tratamento farmacológico , Infecções por Klebsiella/epidemiologia , Infecções por Klebsiella/microbiologia , Klebsiella , Abscesso Hepático Piogênico/epidemiologia , Abscesso Hepático Piogênico/tratamento farmacológico , Antibacterianos/uso terapêutico , Infecções Comunitárias Adquiridas/epidemiologia , Infecções Comunitárias Adquiridas/tratamento farmacológico , Pneumonia/tratamento farmacológicoRESUMO
PURPOSE: This study aimed to determine the factors associated with new onset father-to-infant (paternal) bonding failure from 1 to 6 months postpartum. METHODS: This was a prospective birth-cohort study. Paternal bonding failure was evaluated using the Japanese version of the Mother-to-Infant Bonding Scale (MIBS-J) at 1 and 6 months postpartum. For cut-off scores, overall bonding failure, MIBS-J total scores ≥ 5; subscale for lack of affection, MIBS-J_LA scores ≥ 3; and subscale for anger/rejection, MIBS-J_AR scores ≥ 3 were used in this study. Multivariate regression analysis was performed to analyze relative variables. RESULTS: We analyzed 872 fathers. The frequency of new-onset overall bonding failure, lack of affection, and anger/rejection was 5.6%, 4.9%, and 6.3%, respectively. For new-onset overall bonding failure, significant associated factors were paternal childcare leave (adjusted odds ratio [AOR] 3.192; 95% confidence interval [CI] 1.203-8.469), paternal new-onset depression symptoms (AOR 3.181; 95% Cl 1.311-7.716), and maternal new-onset overall bonding failure (AOR 4.595; 95% Cl 1.119-18.866). For new-onset lack of affection, significant associated factors were preterm birth (AOR 4.189; 95% Cl 1.473-11.913) and paternal new-onset depression symptoms (AOR 3.290; 95% Cl 1.294-8.362). For new-onset anger and rejection, significant associated factors were paternal childcare leave (AOR 3.142; 95% Cl 1.138-8.676), paternal new-onset depression symptoms (AOR 2.829; 95% Cl 1.133-7.068), and maternal new-onset anger/rejection (AOR 7.064; 95% Cl 2.300-21.700). CONCLUSIONS: The factors associated with new-onset paternal bonding failure from 1 to 6 months postpartum were paternal childcare leave, preterm birth, paternal postpartum depression symptoms, and maternal bonding failure.
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Depressão Pós-Parto , Nascimento Prematuro , Masculino , Feminino , Humanos , Lactente , Recém-Nascido , Criança , Relações Mãe-Filho , Estudos de Coortes , Japão/epidemiologia , Estudos Prospectivos , Inquéritos e Questionários , Período Pós-Parto , Mães , PaiRESUMO
Previous studies have identified associations between affectionate communication and blood lipid levels but been limited by small, homogenous samples and failed replication attempts. Moreover, no study has tested the prediction derived from affection exchange theory that stress mediates the association between affectionate behavior and health. Using secondary analyses of data from the Midlife in the United States (MIDUS) Refresher study Biomarker Project, this paper remedies these limitations by testing the prediction that stress mediates the association between kissing and serum levels of triglycerides, high-density lipoproteins, and low-density lipoproteins using a large probability sample of U.S. American adults (N = 863). Results indicate significant indirect effects of kissing frequency on triglycerides and high-density lipoproteins for participants who reported kissing seven or more times in the previous month.
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Comunicação , Lipídeos , Adulto , Humanos , Estados Unidos , Estudos de Amostragem , Triglicerídeos , Lipoproteínas HDLRESUMO
Individuals who perceive greater support or approval for their relationships from friends and family also report greater relationship stability and commitment and better mental and physical health (known as the "social network effect"). These associations have been explained, in part, through three cognitive-affective processes: uncertainty reduction, cognitive balance, and dyadic identity formation. However, we know less about cognitive-behavioral mechanisms that might help explain the social network effect. In this study, we propose and test a model in which physical affection-sharing acts as one such behavioral mechanism. In a sample of 1848 individuals in same-sex (n = 696), mixed-sex (n = 1045), and gender-diverse (n = 107) relationships, we found support for our overall model. Our findings suggest that perceived support for one's relationships is a significant predictor of perceived support for physical affection-sharing, which in turn predicts the frequency of affection-sharing in private and public contexts and, ultimately, relationship well-being. However, we also found that relationship type moderates these associations, highlighting how the experience of sharing affection with one's partner changes for many in marginalized relationships, especially in public. We conclude by discussing how our findings contribute to theories of social support for relationships, underscoring the importance of considering affective, cognitive, and behavioral factors relevant to the process. We also emphasize the understudied role of context in shaping affection-sharing experiences across all relationship types.
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BACKGROUNDS: The impact of relationships in early childhood may be long-lasting and reaching to mid to late life. Limited studies have investigated the associations between parenting style and different aspects of well-being beyond adolescence. The current study aims to examine the association between parenting styles and multiple dimensions of functioning in mid-and later-life adults. METHODS: We used data from China Health and Retirement Longitudinal Study (CHARLS). Generalized Estimating Equation (GEE) was applied to examine the association between retrospective parenting styles/behaviors in childhood and health outcome. RESULTS: Compared with authoritative style, authoritarian style predicted worse self-rated health (coefficient = - 0.13, P < 0.001), cognitive function (- 0.23, P < 0.05) and depressive symptom (0.87, P < 0.001). Paternal affection was associated with more health outcome in mid- and late life than maternal affection. Only paternal affection was a significant predictor of mid- and late life health among male adults, while both paternal and maternal affection were strong predictors among female adults. Authoritative style was associated more positive health outcomes in mid- and late life among adults with literate parents than those with illiterate parents. CONCLUSION: This study provides evidence for the link between parenting behaviors in early life stage and physical and psychological functioning in mid- to late adulthood. Authoritative style, and the memory of parental affection, particularly from father and educated parents, could have long-lasting positive influence on children's physical and mental well-being, which further support the life-course perspective on human development.
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Poder Familiar , Aposentadoria , Adulto , China/epidemiologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Estudos RetrospectivosRESUMO
BACKGROUND: Affection exchange theory (AET) explains the value of received affection for overall wellbeing in family relationships. However, this study extends prior work by investigating AET in grandmother-grandchild relationships and grandchildren's individual well-being. This study seeks to understand the relationships between adult grandchildren's received grandmother affection and health-related behaviors such as diet, exercise, substance abuse, and sleep. METHODS: This cross-sectional study included 229 university student participants. Multiple regression analyses were performed to analyze received grandmother affection and grandchildren's health behaviors. RESULTS: Using cross-sectional survey methods, it was found that grandchildren's reports of received memories and humor, and celebratory affection influenced grandchildren's dietary behaviors. Received love and esteem, memories and humor, and celebratory affection was also associated with grandchildren's exercise behaviors. CONCLUSIONS: Grandchildren who receive grandmother affection may be likely to engage in the well-being process by engaging in health behaviors, while those who are not receiving affection might suffer the health consequences in adulthood. These findings support the assumption of affection exchange theory that received family affection, in this case, grandmother affection leads to positive health outcomes such as enhanced dietary and exercise behaviors among grandchildren.
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Avós , Adulto , Humanos , Estudos Transversais , Comportamentos Relacionados com a Saúde , Relação entre GeraçõesRESUMO
This study compared public versus private affection-sharing experiences of individuals in mixed-sex (N = 1018), same-sex (N = 561), and gender-diverse (N = 96) relationships. Private affection-sharing was similar across groups, except those in mixed-sex relationships reported somewhat less comfort doing so. Despite having a stronger desire to engage in public affection-sharing, those in same-sex and gender-diverse relationships shared public affection less frequently, were less comfortable doing so, refrained from doing so more often, and experienced much higher levels of vigilance related to public affection-sharing, compared to those in mixed-sex relationships. Heightened PDA-related vigilance may have health consequences, as higher levels were associated with worse psychological and physical well-being in all groups. However, individuals in same-sex relationships showed weaker associations between vigilance and well-being than those in mixed-sex relationships, suggesting possible resilience. Still, engaging in vigilance may take its toll, potentially serving as a mechanism through which minority stress works its effects. When we controlled for PDA-related vigilance, psychological and physical well-being levels in same-sex relationships increased relative to mixed-sex peers.
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In January 2019, a 30-year-old woman admitted to our inpatient department presented with undulating fever, pain in several joints, and significantly elevated liver enzymes and lactate dehydrogenase. After extended examination, infection with Brucella melitensis with liver, musculoskeletal, and pulmonary involvement was diagnosed and treated. Diagnosis was based on clinical examination, laboratory findings including seroconversion as a proof of immune response, magnetic resonance imaging, three-phase bone scintigraphy, and F18 FDG-PET (F-18 Flourdeoxyglucose positron emission tomography) illustrating the bone involvement and its normalization upon treatment. After treatment the patient showed a remarkable improvement of clinical symptoms within a short period. The patient remained symptom free and polymerase chain reaction (PCR) testing for brucellosis was negative, even at the follow-up examination 12 months after the end of the antibiotic therapy. The family members were also examined due to the similar travel history, and by this, brucellosis was also diagnosed in her husband but not in her children.
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Brucella melitensis , Brucelose , Adulto , Antibacterianos/uso terapêutico , Brucelose/complicações , Brucelose/diagnóstico , Brucelose/tratamento farmacológico , Criança , Feminino , Humanos , Fígado , Imageamento por Ressonância MagnéticaRESUMO
Semantic-rich speech emotion recognition has a high degree of popularity in a range of areas. Speech emotion recognition aims to recognize human emotional states from utterances containing both acoustic and linguistic information. Since both textual and audio patterns play essential roles in speech emotion recognition (SER) tasks, various works have proposed novel modality fusing methods to exploit text and audio signals effectively. However, most of the high performance of existing models is dependent on a great number of learnable parameters, and they can only work well on data with fixed length. Therefore, minimizing computational overhead and improving generalization to unseen data with various lengths while maintaining a certain level of recognition accuracy is an urgent application problem. In this paper, we propose LGCCT, a light gated and crossed complementation transformer for multimodal speech emotion recognition. First, our model is capable of fusing modality information efficiently. Specifically, the acoustic features are extracted by CNN-BiLSTM while the textual features are extracted by BiLSTM. The modality-fused representation is then generated by the cross-attention module. We apply the gate-control mechanism to achieve the balanced integration of the original modality representation and the modality-fused representation. Second, the degree of attention focus can be considered, as the uncertainty and the entropy of the same token should converge to the same value independent of the length. To improve the generalization of the model to various testing-sequence lengths, we adopt the length-scaled dot product to calculate the attention score, which can be interpreted from a theoretical view of entropy. The operation of the length-scaled dot product is cheap but effective. Experiments are conducted on the benchmark dataset CMU-MOSEI. Compared to the baseline models, our model achieves an 81.0% F1 score with only 0.432 M parameters, showing an improvement in the balance between performance and the number of parameters. Moreover, the ablation study signifies the effectiveness of our model and its scalability to various input-sequence lengths, wherein the relative improvement is almost 20% of the baseline without a length-scaled dot product.
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Covid-19 is a polymorphic disease, characterized in some patients by persistent symptoms several weeks or even months after the initial manifestations of SARS-CoV-2 infection. This is referred to as "long Covid" or post-Covid-19 disease. The polysymptomatic and fluctuating nature of these clinical manifestations generates questions and concerns for patients. To meet their care needs, the regional health agencies have worked with local health care providers to develop appropriate care pathways.
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COVID-19 , Humanos , SARS-CoV-2 , Procedimentos Clínicos , Pessoal de Saúde , Síndrome de COVID-19 Pós-AgudaRESUMO
Self-esteem is an attitude about the self that predicts psychopathology and general well-being. Parenting practices have been shown to be related to self-esteem, but these estimates are confounded because parents and children share genes. The aim of the present study was to use the monozygotic (MZ) twin difference design to isolate the non-shared environmental impact of remembered parenting on self-esteem. In a sample of 1328 adults (345 MZ twin pairs, 319 DZ twin pairs), retrospective reports of maternal and paternal affection were related to self-esteem, all of which were significantly heritable. Using MZ difference scores, paternal affection differences, but not maternal affection differences, were significantly related to self-esteem differences. These results suggest that parenting provided by the father directly impacts self-esteem through non-shared environmental mechanisms. Maternal affection, on the other hand, impacts self-esteem through shared genes (not shared environment, as shared environment was not a significant aspect of self-esteem). This has implications for parenting intervention programs.
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Poder Familiar/psicologia , Comportamento Paterno/psicologia , Autoimagem , Adulto , Atitude , Bases de Dados Factuais , Meio Ambiente , Feminino , Humanos , Masculino , Comportamento Materno/psicologia , Relações Pais-Filho , Pais/psicologia , Estudos Retrospectivos , Gêmeos Dizigóticos/genética , Gêmeos Monozigóticos/genética , Gêmeos Monozigóticos/psicologia , Estados UnidosRESUMO
Eugen Bleuler, the founder of the concept of schizophrenia, pointed out that psychotic patients were able to live in two disjoint worlds (namely, the social, intersubjective world and the delusional world). He termed this phenomenon "double bookkeeping," but did not provide any conceptual elaboration of this phenomenon or its possible mechanisms. Double bookkeeping has been neglected in mainstream psychiatry, but it has been addressed in recent theoretical work, however mainly concerned with the issue of delusion. In this article, we present clinical material that supports the view that double bookkeeping manifests itself across various psychotic phenomena and its antecedent may be observed in premorbid (pre-onset) phases as well as in the schizotypal disorder. We try to conceptualize double bookkeeping to concretize an often atmospheric perception of paradoxicality in the encounter with the patient. A phenomenological analysis of double bookkeeping suggests an instability in the affective ("auto-affection") articulation of selfhood. We point to four main implications of our presentation: (1) diagnostic, (2) epistemological, (3) therapeutic and (4) pathogenetic research.
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Esquizofrenia , Psicologia do Esquizofrênico , Estado de Consciência , Humanos , PsiquiatriaRESUMO
Background Mother-infant bonding is an emerging perinatal issue. While emergency cesarean deliveries are associated with a risk of bonding disorders, the mode of anesthesia used for emergency cesarean deliveries has never been studied in this context. We aimed to investigate the impact of administering general anesthesia and neuraxial anesthesia to women undergoing cesarean deliveries on mother-infant bonding. Methods This was a retrospective, propensity score-matched multivariable analysis of 457 patients who underwent emergency cesarean deliveries between February 2016 and January 2019 at a single teaching hospital in Japan. The Mother-Infant Bonding Scale (MIBS) scores at hospital discharge and the 1-month postpartum outpatient visit were evaluated in the general anesthesia and the neuraxial anesthesia groups. A high score on the MIBS indicates impaired mother-infant bonding. Results The primary outcome was the MIBS score at hospital discharge in propensity score-matched women. After propensity score matching, the median [interquartile range (IQR)] MIBS scores were significantly higher in the general anesthesia group than those in the neuraxial anesthesia group at hospital discharge [2 (1-4) vs. 2 (0-2); P = 0.015] and at the 1-month postpartum outpatient visit [1 (1-3) vs. 1 (0-2); P = 0.046]. In linear regression analysis of matched populations, general anesthesia showed a significant and positive association with the MIBS scores at hospital discharge [beta coefficient 0.867 (95% confidence interval [CI] 0.147-1.59); P = 0.019] but not at the 1-month postpartum outpatient visit [0.455 (-0.134 to 1.044); P = 0.129]. Conclusion General anesthesia for emergency cesarean delivery is an independent risk factor associated with impaired mother-infant bonding.
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Anestesia Geral , Cesárea/métodos , Tratamento de Emergência/métodos , Relações Materno-Fetais , Apego ao Objeto , Período Pós-Parto/psicologia , Assistência ao Convalescente/métodos , Assistência ao Convalescente/estatística & dados numéricos , Anestesia Epidural/métodos , Anestesia Epidural/psicologia , Anestesia Geral/métodos , Anestesia Geral/psicologia , Anestesia Obstétrica/métodos , Feminino , Humanos , Recém-Nascido , Japão , Gravidez , Estudos Retrospectivos , Inquéritos e QuestionáriosRESUMO
AIM: To evaluate the association between use of assisted reproductive technology (ART) and mother-to-infant bonding. METHODS: Using nationwide birth cohort study with periodical follow-ups for mothers and children during pregnancy and at 1 year after delivery, mothers were classified following three groups; infertility group with ART: 2792 mothers; infertility group with non-ART treatment (ovulation induction and intrauterine insemination): 3835 mothers and unaided pregnancy group: 78 726 mothers. Data on maternal and child health as well as basic characteristics were collected via medical records and self-administered questionnaires. The Japanese version of Mother-to-Infant Bonding Scale was used to evaluate maternal bonding style. To evaluate the association between ART and maternal bonding toward babies, multivariate analysis was used with adjustment for potential confounders such as babies' sex, socio-economic status and history of maternal mental disorders. RESULTS: Multivariate logistic regression analysis indicated that ART was slightly but significantly associated with an increased risk of maternal lack of affection toward their newborn (adjusted odds ratio 1.10, 95% confidence interval 1.02-1.20), while non-ART was significantly associated with both maternal lack of affection and anger/rejection toward the newborn. No substantial association was observed between ART and overall Mother-to-Infant Bonding Scale score (adjusted odds ratio 1.03, 95% confidence interval 0.94-1.12). Very slight negative correlations were observed between poor mother-to-infant bonding and good infant mental and physical development at both 6 months and 1 year. CONCLUSION: ART may exert a negative influence on maternal emotion after delivery, but this does not have strong correlation with child development evaluated by mothers.
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Comportamento Materno/psicologia , Relações Mãe-Filho , Mães/psicologia , Apego ao Objeto , Técnicas de Reprodução Assistida , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Japão , Masculino , Fatores de Risco , Fatores SocioeconômicosRESUMO
Background: A wide range in the prevalence of molar-incisor-hypomineralization (MIH) has been reported. Population-based studies are recommended. However, such studies are expensive and time-consuming.Objectives: To estimate the magnitude of MIH condition among 8-year-olds based on routine oral health examinations and to associate first permanent molar (FPM) affection with that of other permanent teeth over time.Materials and methods: This retrospective study, with cross-sectional and longitudinal components, was based on electronic oral health records; all 8-year-olds examined between 2002 and 2016 were included.Results: The average estimated prevalence of MIH was 8.3%; yearly range was 4.8-15.9%. The mean number of affected teeth was 1.4; 62% had one affected tooth. One-surface defects were the most frequent (66%). Asymmetric distribution of affected teeth was observed. In follow-up, 10.7%, 8.4%, and 11.2% had at least one affected permanent canine, premolar, or second permanent molar, respectively. The proportion of children with other MIH-affected permanent teeth was higher in the group with ≥2 MIH-affected teeth than in group with one affected FPM at the age of 8.Conclusions: The average prevalence of MIH was comparable to that reported elsewhere. The number of MIH-affected teeth at early mixed dentition predicts the affection of other permanent teeth over time, mainly that of permanent canines. Further screening of children with MIH is recommended to improve individually tailored early preventive and restorative dental care.
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Hipoplasia do Esmalte Dentário , Incisivo , Criança , Estudos Transversais , Hipoplasia do Esmalte Dentário/epidemiologia , Humanos , Dente Molar , Saúde Bucal , Prevalência , Estudos RetrospectivosRESUMO
COVID-19 disease is a systemic inflammatory viral reaction starting with the viral phase followed by the inflammatory phase. The first phase is rather mild and asymptomatic with only a small subset of infected patients turning into the inflammatory phase with high mortality. Patients with pre-existing cardiovascular diseases and cardiovascular risk factors pose a considerably higher risk to develop severe or lethal COVID-19 disease course. COVID-19 affects not only the epithelial cells of the lung parenchyma via ACE2, but also endothelial cells across the whole body thus leading to generalized endothelial damage and inflammation, so-called endotheliitis. The histological morphology of endotheliitis comprises the accumulation of lymphocytes, plasma cells and macrophages beneath the endothelial cells and within the perivascular spaces. Endothelial cells play an important role in the regulation of vascular tone and the maintenance of vascular homeostasis. Endotheliitis thus can shift the vascular equilibrium towards more pronounced vasoconstriction with subsequent organ ischemia, inflammation with associated tissue edema and a procoagulant state. Patients with pre-existing endothelial dysfunction (male sex, smoking, hypertension, diabetes, obesity, and established cardiovascular disease) are particularly vulnerable and have adverse outcomes in COVID-19. This is a rationale for approaches to stabilize the endothelium. Most of these findings have been established from autopsies since the outbreak of the pandemic.