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European Eating Disorders Review : the... May 2024The DSM-5 classification introduced new Feeding and Eating Disorders (FED) diagnostic categories, notably Avoidant and Restrictive Food Intake Disorder (ARFID), which,...
OBJECTIVE
The DSM-5 classification introduced new Feeding and Eating Disorders (FED) diagnostic categories, notably Avoidant and Restrictive Food Intake Disorder (ARFID), which, like other FED, can present psychiatric and gastrointestinal symptoms. However, paediatric clinical research that focuses on children below the age of 12 years remains scarce. The aim of this study was first to investigate the clinical features of FED in a cohort of children, second to compare them according to their recruitment (gastroenterology or psychiatry unit).
METHOD
This non-interventional retrospective cohort study analysed 191 patients in a French paediatric tertiary care centre (gastroenterology n = 100, psychiatry n = 91). The main outcome variables were clinical data (type of FED, BMI, nutritional support, chronic diseases, psychiatric comorbidities, sensory, sleep, language disorders, gastrointestinal complaints, adverse life events, family history). The outcome was defined by a Clinical Global Impression of Change-score.
RESULTS
FED diagnoses were ARFID (n = 100), Unspecified FED (UFED, n = 57), anorexia nervosa (AN, n = 33) and one pica/rumination. Mean follow-up was 3.28 years (SD 1.91). ARFID was associated with selective and sensory disorders (p < 0.001); they had more anxiety disorders than patients with UFED (p < 0.001). Patients with UFED had more chewing difficulties, language disorder (p < 0.001), and more FED related to chronic disease (p < 0.05) than patients with ARFID and AN. Patients with AN were female, underweight, referred exclusively to the psychiatrist, and had more depression than patients with ARFID and UFED (p < 0.001). The gastroenterology cohort included more UFED, while the psychiatry cohort included more psychiatric comorbidities (p < 0.001). A worse clinical outcome was associated with ARFID, a younger age at onset (p < 0.001), selective/sensory disorders and nutritional support (p < 0.05).
CONCLUSION
ARFID and UFED children were diagnosed either by gastroenterologists or psychiatrists. Due to frequently associated somatic and psychiatric comorbidities, children with FED should benefit from a multidisciplinary assessment and care.
Topics: Humans; Female; Child; Male; Retrospective Studies; Cohort Studies; Gastroenterology; Feeding and Eating Disorders; Sensation Disorders; Eating
PubMed: 38308450
DOI: 10.1002/erv.3063 -
Operative Neurosurgery (Hagerstown, Md.) Jan 2024The incidence of posterior inferior cerebellar artery (PICA) aneurysms is estimated to be between 0.5% and 3% of total aneurysm cases.1 Most patients with these...
The incidence of posterior inferior cerebellar artery (PICA) aneurysms is estimated to be between 0.5% and 3% of total aneurysm cases.1 Most patients with these aneurysms typically present with subarachnoid hemorrhage, although there are instances in which patients may present with symptoms resulting from mass effect exerted on the brain stem or lower cranial nerves.1,2 Treatment options for PICA aneurysms include endovascular procedures, surgical clipping, or bypass techniques.2 Surgical treatment is considered more effective for partially thrombosed aneurysms compared with endovascular approaches.3 In addition, endovascular coiling of these aneurysms carries the potential risk of coil migration and subsequent reopening of the aneurysm lumen.4 In certain instances, thrombosed PICA aneurysms have the potential to simulate the radiological characteristics of alternative pathologies, such as cavernous malformations or brainstem tumors.5-7 This situation can result in misdiagnosis and inappropriate management. We present the case of a patient who exhibited symptoms of imbalance and dysfunction in the lower cranial nerves. Magnetic resonance imaging findings indicated a possible cavernous malformation in the medulla oblongata. However, further investigation revealed that the underlying cause was a thrombosed PICA aneurysm. The patient was successfully treated through surgical clipping. The patient consented to the procedure and to the publication of his/her image.
PubMed: 38295399
DOI: 10.1227/ons.0000000000001077 -
The Journal of Nervous and Mental... Feb 2024Pica indicates the persistent ingestion of inedible substances over a period of at least 1 month, being discordant to the individual's cognitive development level and... (Review)
Review
Pica indicates the persistent ingestion of inedible substances over a period of at least 1 month, being discordant to the individual's cognitive development level and not directly attributable to cultural or social normative practices. The literature suggests that the prevalence of pica varies significantly according to the social and clinical context. It can co-occur with psychiatric disorders, with its etiology being poorly understood and most likely multifactorial. In this article, we report the case of a patient in her 50s with a clinical setting compatible with soap ingestion variant of pica disorder. In addition to the variety of ingested substances, pica can be associated with heterogeneous behavior, mainly of the obsessive-compulsive spectrum. Despite recent research, this condition is still a target of much speculation. This is a very rare and challenging presentation of a soap ingestion variant of pica with very few similar cases described to date.
Topics: Female; Humans; Eating; Pica; Prevalence; Soaps; Middle Aged
PubMed: 38290104
DOI: 10.1097/NMD.0000000000001716 -
Acta Neurochirurgica Jan 2024Multiple vessels from the anterior inferior cerebellar artery-posterior inferior cerebellar artery common trunk (APC) variation of the posterior circulation can cause...
How I do it: endoscopic microvascular decompression for hemifacial spasm associated with anterior inferior cerebellar artery-posterior inferior cerebellar artery common trunk.
BACKGROUND
Multiple vessels from the anterior inferior cerebellar artery-posterior inferior cerebellar artery common trunk (APC) variation of the posterior circulation can cause hemifacial spasm (HFS).
METHOD
Endoscopic microvascular decompression (eMVD) was performed using 0° and 30° endoscopes through a retrosigmoid keyhole. The root exit zone (REZ) was decompressed by transpositioning the offending anterior inferior cerebellar artery (AICA) and posterior inferior cerebellar artery (PICA) arising from the APC under excellent endoscopic view.
CONCLUSION
eMVD is an advanced, minimally invasive and reliable technique to resolve the neurovascular conflict (NVC) in HFS due to offenders from APC.
Topics: Humans; Hemifacial Spasm; Microvascular Decompression Surgery; Endoscopy; Basilar Artery; Heart Defects, Congenital
PubMed: 38289407
DOI: 10.1007/s00701-024-05963-w -
Women's Health (London, England) 2024Anemia is a significant public health concern, primarily affecting young children, pregnant and postpartum women, and menstruating adolescent girls and women. This study...
Prevalence and factors influencing anemia in women of reproductive age visiting a tertiary care hospital (Jinnah Postgraduate Medical Center) in Karachi: A cross-sectional study.
INTRODUCTION
Anemia is a significant public health concern, primarily affecting young children, pregnant and postpartum women, and menstruating adolescent girls and women. This study aimed to evaluate the prevalence of anemia and associated factors in women of reproductive age visiting a tertiary care hospital in Karachi, Pakistan.
OBJECTIVE
The primary objective was to determine the prevalence of anemia in women of reproductive age, while the secondary objective was to investigate potential causes of anemia within this demographic group.
DESIGN
A prospective cross-sectional approach was employed, adhering to Strengthening the Reporting of Observational Studies in Epidemiology guidelines. A questionnaire-based method was used to assess anemia, and data were collected from women aged 14 to 40 years.
METHOD
The study was conducted at the Jinnah Postgraduate Medical Center from January to May 2023. The study was approved by the Institutional Review Board of Jinnah Sindh Medical University (Institutional Review Board reference number JSMU/IRB/2023/699). A sample of 397 women was included, and various demographic and lifestyle factors were assessed.
RESULTS
In this study of 397 participants, 71.5% were found to have anemia, primarily microcytic anemia (48.2%). Anemia prevalence was highest among the 14-18 years age group (80.7%) and those from lower socioeconomic backgrounds (73.6%). Factors such as frequent tea consumption, irregular mealtimes, and pica consumption were associated with higher anemia rates. Pregnant women and those with more children were at a heightened risk of anemia.
CONCLUSION
The study reveals a notable prevalence of anemia among women of reproductive age with a surprising emphasis on younger individuals and lower socioeconomic groups. Dietary habits, lifestyle choices, and pregnancy status play significant roles in anemia development. Targeted interventions are essential, particularly for younger women, those from disadvantaged backgrounds, and pregnant individuals, to combat anemia effectively in this region.
Topics: Adolescent; Female; Humans; Pregnancy; Anemia; Cross-Sectional Studies; Prevalence; Prospective Studies; Risk Factors; Tertiary Care Centers; Young Adult; Adult
PubMed: 38282529
DOI: 10.1177/17455057241227364 -
World Neurosurgery Apr 2024Posterior inferior cerebellar artery aneurysms are likely to be fusiform, yet they hardly enlarge to mimic a tumor in the posterior fossa on radiology. They constitute...
Posterior inferior cerebellar artery aneurysms are likely to be fusiform, yet they hardly enlarge to mimic a tumor in the posterior fossa on radiology. They constitute about 3%-4% of all cerebral aneurysms. A 65-year-old woman presented with tremor in her right upper limb for 1 year and intermittent dizziness for 8 months. Interestingly, magnetic resonance imaging revealed 2 unanimously enhanced masses like mother and daughter located in the right cerebellum hemisphere. The lesion was resected via surgery, and histopathology established the diagnosis of an aneurysm. Her tremor and dizziness subsided 3 months after the surgery, and at her 2-year follow-up she was well with no further neurologic deficits.
Topics: Humans; Female; Aged; Dizziness; Tremor; Intracranial Aneurysm; Vertebral Artery; Cerebellum; Neoplasms
PubMed: 38280627
DOI: 10.1016/j.wneu.2024.01.099 -
Ear, Nose, & Throat Journal Jan 2024The ascending pharyngeal artery (APA) travels with the parapharyngeal internal carotid artery (pICA) in the parapharyngeal space (PPS). This study aimed to investigate...
The ascending pharyngeal artery (APA) travels with the parapharyngeal internal carotid artery (pICA) in the parapharyngeal space (PPS). This study aimed to investigate the anatomical variations of the APA, and to explore their implications for endoscopic surgery in the PPS. Dissection of the APA in the PPS was performed on 10 cadaveric specimens (20 sides). The relationship between APA and PPS tumors was retrospectively reviewed in 20 patients, attempting to ascertain the APA during the resection of 10 pre-styloid and 10 retro-styloid PPS tumors. During the cadaveric dissections, the APA was identified at the medial, posteromedial, or bilateral aspects of the pICA in 12 (60%) and 4 (20%) sides, respectively. In the remaining 4 sides (20%), the APA branched into several subcategory arteries lying at the medial and lateral aspects of the pICA. Branches of the APA were observed in 13/20 sides (65%). Two branches were found in 9/13 sides and 3 branches in 4/13, respectively. The APA was only identifiable in 1/10 (10%) of pre-styloid tumors, a patient with basal cell adenoma. In contrast, the APA was encountered surrounding the pICA in 8/10 (80%) of patients with retro-styloid tumors, all of which were schwannomas. No inadvertent injury of the APA or the pICA occurred in this cohort. With identification of the ascending pharyngeal artery on preoperative magnetic resonance imaging, it may serve as an additional landmark during the endoscopic extirpation of tumors arising in the PPS.
PubMed: 38279791
DOI: 10.1177/01455613231222370 -
Physical Review Letters Jan 2024A measurement of time-dependent CP violation in the decays of B^{0} and B[over ¯]^{0} mesons to the final states J/ψ(→μ^{+}μ^{-})K_{S}^{0},...
A measurement of time-dependent CP violation in the decays of B^{0} and B[over ¯]^{0} mesons to the final states J/ψ(→μ^{+}μ^{-})K_{S}^{0}, ψ(2S)(→μ^{+}μ^{-})K_{S}^{0} and J/ψ(→e^{+}e^{-})K_{S}^{0} with K_{S}^{0}→π^{+}π^{-} is presented. The data correspond to an integrated luminosity of 6 fb^{-1} collected at a center-of-mass energy of sqrt[s]=13 TeV with the LHCb detector. The CP-violation parameters are measured to be S_{ψK_{S}^{0}}=0.717±0.013(stat)±0.008(syst) and C_{ψK_{S}^{0}}=0.008±0.012(stat)±0.003(syst). This measurement of S_{ψK_{S}^{0}} represents the most precise single measurement of the CKM angle β to date and is more precise than the current world average. In addition, measurements of the CP-violation parameters of the individual channels are reported and a combination with the LHCb Run 1 measurements is performed.
PubMed: 38277604
DOI: 10.1103/PhysRevLett.132.021801 -
European Heart Journal Jun 2024
Topics: Humans; Aortic Valve Stenosis; Cicatrix; Ventricular Remodeling; Male; Aged; Female; Myocardium
PubMed: 38271583
DOI: 10.1093/eurheartj/ehae067 -
Cureus Jan 2024Adult ingestion of foreign bodies in the digestive system is a common clinical challenge, often involving mentally impaired individuals, criminals, and drug dealers or...
Adult ingestion of foreign bodies in the digestive system is a common clinical challenge, often involving mentally impaired individuals, criminals, and drug dealers or occurring accidentally. Encounters with multiple sharp foreign bodies are infrequent and pose significant risks, including gastrointestinal (GI) bleeding, perforation, internal fistulas, and infection. The choice between endoscopy and emergency surgery for removal is contentious, with the less invasive endoscopy typically favored as the first line of management, depending on the foreign body's location and endoscopic accessibility. The current literature on the treatment of numerous sharp foreign bodies is sparse. This case report illustrates the successful endoscopic removal of a large quantity of sharp foreign bodies (35 half blades) from the upper GI tract, utilizing various extraction tools. It also aims to contribute to the existing literature regarding management strategies for ingested sharp foreign bodies. A comprehensive account is provided of the clinical presentation, imaging studies, consultations, and endoscopic procedures performed, culminating in the patient's safe discharge from our facility.
PubMed: 38268993
DOI: 10.7759/cureus.52856