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Borderline Personality Disorder and... Jul 2024Psychiatrists often hesitate to diagnose borderline personality disorder (BPD). While individuals with BPD have reported both positive and negative experiences upon...
BACKGROUND
Psychiatrists often hesitate to diagnose borderline personality disorder (BPD). While individuals with BPD have reported both positive and negative experiences upon receiving their diagnosis, no study has specifically explored this issue among parents. Parents of children diagnosed with BPD can benefit from recently developed family-support interventions such as the Family Connections program. Our study aimed to explore the experiences of parents learning about their child's BPD diagnosis and to investigate the impact of the Family Connections program on their experiences.
METHODS
This qualitative study, conducted in France following the five-stage IPSE method, involved parents of children with BPD recruited through the Family Connections association in Versailles. We conducted semi-structured interviews and used purposive sampling for data collection until data saturation was reached. Data analysis was performed using a descriptive and structuring approach with NVivo 12 software to elucidate the structure of lived experiences.
RESULTS
The study included 21 parents. The structure of the lived experiences was characterized by three central axes: (1) the long and difficult road to diagnosis; (2) communicating the BPD diagnosis to parents: a necessary step; (3) the pitfalls of receiving the diagnosis. The Family Connections program provided significant support in these areas, particularly in understanding the diagnosis, enhancing communication with their child, and reducing social isolation.
CONCLUSION
These findings highlight the challenges parents face when receiving a BPD diagnosis for their child and underscore the need for an early, clear, and detailed explanation of the diagnosis. The specific experiences of receiving the diagnosis are indicative of the broader care experience parents undergo and highlight their need and right to be informed, supported, and guided throughout their child's treatment.
PubMed: 38946002
DOI: 10.1186/s40479-024-00258-z -
Journal of Nutritional Science and... 2024This study examined the relationship between the frequency of consuming cold or hot meal/drink during summer and the nutritional status, appetite, and energy intake...
This study examined the relationship between the frequency of consuming cold or hot meal/drink during summer and the nutritional status, appetite, and energy intake among Japanese older people. The cross-sectional study was conducted in August 2021, targeting 60 adults aged 65 y and older. The Mini Nutritional Assessment (MNA) was used for nutritional status evaluation, the Simplified Nutritional Appetite Questionnaire (SNAQ) for appetite scoring, and food frequency questionnaire to assess energy intake. Participants reported on the frequency of consuming cold or hot meal/drink during the summer. Those who reported consuming hot meals "moderate" (p=0.033) or "frequent" (p=0.005) during summer had a higher BMI than those who reported minimal consumption. Participants who reported "frequent" consumption of hot meals in summer had higher MNA scores than those who reported "minimal" consumption (p=0.014). Participants who reported a "frequent" consumption of hot meals had higher SNAQ scores compared to those who reported "minimal" (p<0.001) or "moderate" (p=0.001). Similarly, participants who reported a "frequent" consumption of hot drinks had higher SNAQ scores than those reporting "minimal" (p=0.021) or "moderate" (p=0.008). The nutritional status and appetite during summer in Japanese older people were associated with the frequency of consuming hot meals and drinks.
Topics: Humans; Aged; Male; Nutritional Status; Female; Appetite; Japan; Cross-Sectional Studies; Energy Intake; Meals; Seasons; Aged, 80 and over; Nutrition Assessment; Hot Temperature; Surveys and Questionnaires; Body Mass Index; Feeding Behavior; Diet; East Asian People
PubMed: 38945895
DOI: 10.3177/jnsv.70.288 -
Yakugaku Zasshi : Journal of the... 2024An overwhelming surge of information regarding preparedness for postvaccination side effects had caused widespread confusion approximately since April 2021, when the...
An overwhelming surge of information regarding preparedness for postvaccination side effects had caused widespread confusion approximately since April 2021, when the coronavirus disease 2019 (COVID-19) vaccination had started for the general population in Japan. Notably, this resulted in a remarkably increased shortage of OTC acetaminophen formulations. The aim of this study was to elucidate the actual responses of the public in such an environment, how individuals acquired and understood information related to the management of postvaccination side effects, and how they obtained and used antipyretic analgesics before and after COVID-19 vaccination. We conducted a web-based survey in January 2022, targeting 400 individuals aged ≥20 years, who had received two COVID-19 vaccine doses, and excluded qualified professionals such as physicians and pharmacists. The results revealed that 67% of the respondents had obtained antipyretic analgesics in anticipation of adverse effects after vaccination, whereas 38% had taken these medicines before and/or after the second vaccination. Possible misappropriation of medicines from others, preventive administration, and lack of dosage and administration confirmation are the problems identified in medication acquisition and usage. Additionally, avoidance of antipyretic analgesics based on information without scientific evidence was observed. This study revealed no small amount of inappropriate use of medicines in situations, such as the COVID-19 pandemic, where there is an "infodemic" of mixed-quality information. Pharmacists, as experts in medication, should play a crucial role in promoting appropriate medication usage by consistently staying updated with the latest scientific evidence and proactively supporting OTC drug selection and counseling medication.
Topics: Humans; Antipyretics; Pharmacists; COVID-19 Vaccines; Male; Female; Middle Aged; Adult; Acetaminophen; Japan; Surveys and Questionnaires; Professional Role; Vaccination; Aged; Young Adult; Nonprescription Drugs; COVID-19
PubMed: 38945850
DOI: 10.1248/yakushi.23-00183 -
American Journal of Critical Care : An... Jul 2024Death after resuscitation from cardiac arrest is common. Although associated factors have been identified, knowledge about their relationship with specific modes of...
BACKGROUND
Death after resuscitation from cardiac arrest is common. Although associated factors have been identified, knowledge about their relationship with specific modes of death is limited.
OBJECTIVE
To identify clinical factors associated with specific modes of death following cardiac arrest.
METHODS
This study involved a retrospective medical record review of patients admitted to a single health care center from January 2015 to March 2020 after resuscitation from cardiac arrest who died during their index hospitalization. Mode of death was categorized as either brain death, withdrawal of life-sustaining therapies due to neurologic causes, death due to medical causes, or withdrawal of life-sustaining therapies due to patient preference. Clinical characteristics across modes of death were compared.
RESULTS
The analysis included 731 patients. Death due to medical causes was the most common mode of death. Compared with the other groups of patients, those with brain death were younger, had fewer comorbidities, were more likely to have experienced unwitnessed and longer cardiac arrest, and had more severe acidosis and hyperglycemia on presentation. Patients who died owing to medical causes or withdrawal of life-sustaining therapies due to patient preference were older and had more comorbidities, fewer unfavorable cardiac arrest characteristics, and fewer days between cardiac arrest and death.
CONCLUSIONS
Significant associations were found between several clinical characteristics and specific mode of death following cardiac arrest. Decision-making regarding withdrawal of care after resuscitation from cardiac arrest should be based on a multimodal approach that takes account of a variety of personal and clinical factors.
Topics: Humans; Male; Female; Retrospective Studies; Aged; Middle Aged; Heart Arrest; Cause of Death; Withholding Treatment; Cardiopulmonary Resuscitation; Brain Death; Aged, 80 and over; Age Factors; Comorbidity; Patient Preference
PubMed: 38945819
DOI: 10.4037/ajcc2024145 -
American Journal of Critical Care : An... Jul 2024Use of noninvasive ventilation in patients with acute respiratory distress syndrome (ARDS) is debated. The COVID-19 pandemic posed challenges due to high patient volumes...
BACKGROUND
Use of noninvasive ventilation in patients with acute respiratory distress syndrome (ARDS) is debated. The COVID-19 pandemic posed challenges due to high patient volumes and worldwide resource strain.
OBJECTIVES
To determine associations between use of noninvasive ventilation in adult patients with moderate to severe ARDS due to SARS-CoV-2 pneumonia, progression to intubation, and hospital mortality.
METHODS
This retrospective cohort study included patients in an institutional COVID-19 registry. Adult patients were included if they were admitted for COVID-19 between March 1, 2020, and March 31, 2022, and developed moderate to severe ARDS. Primary outcomes were progression to intubation and hospital mortality in patients who received noninvasive ventilation or mechanical ventilation. A secondary outcome was successful treatment with noninvasive ventilation without intubation.
RESULTS
Of 823 patients who met inclusion criteria, 454 (55.2%) did not receive noninvasive ventilation and 369 (44.8%) received noninvasive ventilation. Patients receiving noninvasive ventilation were more likely to require mechanical ventilation than were patients not receiving noninvasive ventilation. Among patients requiring endotracheal intubation, those receiving noninvasive ventilation had a higher likelihood of mortality. Patients receiving noninvasive ventilation had lower severity-adjusted odds of survival to discharge without intubation than did patients not receiving noninvasive ventilation.
CONCLUSION
Patients with moderate to severe ARDS due to SARS-CoV-2 pneumonia treated with noninvasive ventilation had increased likelihood of progression to endotracheal intubation and hospital mortality.
Topics: Humans; COVID-19; Male; Female; Retrospective Studies; Middle Aged; Noninvasive Ventilation; Respiratory Distress Syndrome; Hospital Mortality; Aged; Intubation, Intratracheal; SARS-CoV-2; Severity of Illness Index; Respiration, Artificial; Adult
PubMed: 38945818
DOI: 10.4037/ajcc2024663 -
Brain and Behavior Jul 2024To analyze the efficacy and associated factors affecting the prognosis in patients with disturbance of consciousness after hyperbaric oxygen (HBO) treatment.
OBJECTIVE
To analyze the efficacy and associated factors affecting the prognosis in patients with disturbance of consciousness after hyperbaric oxygen (HBO) treatment.
METHODS
A retrospective study was carried out on patients with disorders of consciousness (DOC) receiving HBO treatment from January to January 2022 in the Second Department of Rehabilitation Medicine of the Second Hospital of Hebei Medical University, China.
RESULTS
HBO therapy improved the Glasgow Coma Scale (GCS) and Chinese Nanjing Persistent Vegetative State Scale (CNPVSS), as well as the clinical efficacy in patients with DOC. The comparison of GCS and CNPVSS scores in patients with DOC before and after HBO treatment was all statistically significant, with 325 patients (67.1%) showing effective results and 159 patients (32.9%) having unchanged outcomes. Univariate analysis indicated that there were statistically significant differences in age, HBO intervention time, HBO treatment times, pre-treatment GCS score, and etiology and underlying diseases between the good and poor prognoses groups. Multivariate regression analysis showed that HBO intervention time ≤7 days, HBO treatment > times, high GCS score before HBO treatment, and brain trauma were independent influencing factors in achieving a good prognosis for patients with DOC. Low pre-treatment GCS scores were an independent risk factor for a poor prognosis in patients with brain trauma while being male, late HBO intervention time, fewer HBO treatment times, and low pre-treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after a stroke. Being ≥50 years of age, late HBO intervention time, and low pre-treatment GCS scores were independent risk factors for a poor prognosis in patients with DOC after hypoxic-ischaemic encephalopathy.
CONCLUSION
HBO therapy can improve the GCS, CNPVSS scores and clinical efficacy in patients with DOC, and the timing of HBO intervention ≤7 days, times of HBO treatment, high pre-treatment GCS score, and brain trauma were the independent influencing factors of good prognosis in patients with DOC.
Topics: Humans; Hyperbaric Oxygenation; Retrospective Studies; Male; Female; Consciousness Disorders; Middle Aged; Adult; Aged; Glasgow Coma Scale; Prognosis; Treatment Outcome; Young Adult; Adolescent; China
PubMed: 38945804
DOI: 10.1002/brb3.3588 -
Clinics in Liver Disease Aug 2024Measurement of hepatic venous pressure gradient (HVPG) effectively mirrors the severity of portal hypertension (PH) and offers valuable insights into prognosis of liver... (Review)
Review
Measurement of hepatic venous pressure gradient (HVPG) effectively mirrors the severity of portal hypertension (PH) and offers valuable insights into prognosis of liver disease, including the risk of decompensation and mortality. Additionally, HVPG offers crucial information about treatment response to nonselective beta-blockers and other medications, with its utility demonstrated in clinical trials in patients with PH. Despite the widespread dissemination and validation of noninvasive tests, HVPG still holds a significant role in hepatology. Physicians treating patients with liver diseases should comprehend the HVPG measurement procedure, its applications, and how to interpret the results and potential pitfalls.
Topics: Humans; Hypertension, Portal; Portal Pressure; Hepatic Veins; Prognosis; Severity of Illness Index
PubMed: 38945633
DOI: 10.1016/j.cld.2024.03.009 -
Food Research International (Ottawa,... Aug 2024This study aimed to evaluate the Free Drawing method to assess food consumption information compared to the Free Listing method. Furthermore, the citation frequencies of... (Comparative Study)
Comparative Study
This study aimed to evaluate the Free Drawing method to assess food consumption information compared to the Free Listing method. Furthermore, the citation frequencies of dairy products consumed by adolescents were compared in Brazilian regions. Adolescents (14-17 years old, n = 265, n = 53 for each region, North, South, Northeast, Midwest, and Southeast regions) listed or drew the dairy products they consumed using Free Listing or Free Drawing. The contingency tables were constructed, and the cognitive saliency indexes (CSI) were calculated. Multiple Factor Analysis (MFA) was performed, and the RV indices were determined. The adolescents listed/drew 55 dairy products, grouped into 10 categories. The Free Listing method resulted in greater citation frequencies of dairy products. The Free Drawing method resulted in richer and more detailed information, with specifications of the type of product consumed within the category, flavor, type of packaging, and brand. The dairy products with the highest citation frequencies/CSI by adolescents were milk, cheese, and fermented milk. The South and Southeast regions observed greater citation frequencies and diversity of dairy products (prevalence in 6 categories). The CSI did not depend on the method, but it was affected by the region (p < 0.05). The sensory methods showed high similarity considering the categories of dairy products (RV = 0.80) and regions (RV = 0.79). It is concluded that the Free Drawing method proved to be an alternative to Free Listing for evaluating adolescents' consumption information of dairy products in an intracultural study in Brazil.
Topics: Adolescent; Brazil; Humans; Dairy Products; Male; Female; Consumer Behavior; Feeding Behavior; Diet Surveys
PubMed: 38945603
DOI: 10.1016/j.foodres.2024.114583 -
Food Research International (Ottawa,... Aug 2024Fungal contaminations of cereal grains are a profound food-safety and food-security concern worldwide, threatening consumers' and animals' health and causing enormous...
Fungal contaminations of cereal grains are a profound food-safety and food-security concern worldwide, threatening consumers' and animals' health and causing enormous economic burdens. Because far-ultraviolet C (far-UVC) light at 222 nm has recently been shown to be human-safe, we investigated its efficacy as an alternative to thermal, chemical, and conventional 254 nm UVC anti-fungal treatments. Our microplasma-based far-UVC lamp system achieved a 5.21-log reduction in the conidia of Aspergillus flavus suspended in buffer with a dose of 1032.0 mJ/cm, and a 5.11-log reduction of Fusarium graminearum conidia in suspension with a dose of 619.2 mJ/cm. We further observed that far-UVC treatments could induce fungal-cell apoptosis, alter mitochondrial membrane potential, lead to the accumulation of intracellular reactive oxygen species, cause lipid peroxidation, and result in cell-membrane damage. The lamp system also exhibited a potent ability to inhibit the mycelial growth of both A. flavus and F. graminearum. On potato dextrose agar plates, such growth was completely inhibited after doses of 576.0 mJ/cm and 460.8 mJ/cm, respectively. To test our approach's efficacy at decontaminating actual cereal grains, we designed a cubical 3D treatment chamber fitted with six lamps. At a dose of 780.0 mJ/cm on each side, the chamber achieved a 1.88-log reduction of A. flavus on dried yellow corn kernels and a 1.11-log reduction of F. graminearum on wheat grains, without significant moisture loss to either cereal type (p > 0.05). The treatment did not cause significant changes in the propensity of wheat grains to germinate in the week following treatment (p > 0.05). However, it increased the germination propensity of corn kernels by more than 71% in the same timeframe (p < 0.05). Collectively, our results demonstrate that 222 nm far-UVC radiation can effectively inactivate fungal growth in liquid, on solid surfaces, and on cereal grains. If scalable, its emergence as a safe, cost-effective alternative tool for reducing fungi-related post-harvest cereal losses could have important positive implications for the fight against world hunger and food insecurity.
Topics: Fusarium; Aspergillus flavus; Edible Grain; Ultraviolet Rays; Spores, Fungal; Food Contamination; Food Irradiation; Food Microbiology; Reactive Oxygen Species
PubMed: 38945594
DOI: 10.1016/j.foodres.2024.114550 -
BMJ Case Reports Jun 2024Extranodal involvement in diffuse large B-cell lymphoma (DLBCL) is defined as disease outside of the lymph nodes and occurs in up to one-third of patients, though...
Extranodal involvement in diffuse large B-cell lymphoma (DLBCL) is defined as disease outside of the lymph nodes and occurs in up to one-third of patients, though multiorgan extranodal involvement is rare. Here, we describe a case of a patient presenting with widely metastatic lesions, including involvement of the lung, parotid gland, breast, pancreas, femur and multiple soft tissue masses, with initial concern for primary breast malignancy. Breast pathology and imaging were consistent with triple-expressor, double-hit stage IV high-grade B-cell lymphoma with extensive extranodal involvement. Extranodal involvement is a poor prognostic factor associated with high rates of treatment failure, and novel therapies targeting CD19 are currently being studied for relapsed and refractory DLBCL. Extranodal disease is a complex entity that can involve virtually any organ system and should be considered for new presentations of malignancy.
Topics: Humans; Lymphoma, Large B-Cell, Diffuse; Female; Middle Aged; Breast Neoplasms; Lung Neoplasms; Parotid Neoplasms; Pancreatic Neoplasms; Antineoplastic Combined Chemotherapy Protocols; Fatal Outcome
PubMed: 38945554
DOI: 10.1136/bcr-2023-257416