Diet and anxiety. An exploration into the Orthorexic Society

The modern food system has radically modified the social-anthropological framework that informs food choices. To explore factors that influence food choices within this modified framework, eight focus groups consisting of women 15-45 years old were conducted in Nova Scotia (Canada). Using a grounded theory approach, two main themes emerged centered around (1) perceptions of a changing culinary order that emphasizes individual dietary responsibility and decision making and (2) the confusion/anxiety experienced as participants try to assimilate the information generated by today’s modern food system. Participants inextricably linked food and health to the point where it was the central organizing determinant guiding their food selection. They also felt the need to make informed dietary choices, but perceived their search for a healthy diet to be thwarted by the amount, type, and accuracy of information concerning the elements in today’s food products. A constant search for accurate information and the instability of what participants consider expert advice contribute to feelings of anxiety around food choices and a sense of futility in their efforts to navigate through the information available. The focus group discussions reflected the emergence of an Orthorexic Society, whereby individuals are socialized to take charge of their own dietary health. They do so constrained by a food system that is increasingly complex, contradictory, and opaque and where commercial dietary regimes offer quick yet incomplete solutions.     

Human T lymphotropic virus 1 and hepatitis C virus as risk factors for inflammatory dermatoses in HIV-positive patients

BACKGROUND: Dermatoses are common in HIV-infected patients. Infections caused by human T lymphotropic virus 1 (HTLV-1) and hepatitis C virus (HCV) are also associated with dermatoses, and their coinfection with HIV has been described. The aim of this study was to investigate the influence of HTLV-1 and HCV in increasing the frequency of dermatological diseases in HIV-positive patients. METHODS: This cross-sectional study included patients infected with HIV and dermatoses, who consulted the Service of Dermatology Outpatient Clinic of the Health Department of the State of Rio Grande do Sul, in southern Brazil. Their care included the taking of a history and a physical examination, complementary examinations for diagnostic purposes, HTLV-1 and HCV serology, measurement of CD4 lymphocyte count and HIV viral load, and recording of the use of antiretroviral drugs. RESULTS: One hundred and five HIV-positive patients with dermatoses were evaluated. Positivity for HTLV-1 occurred in 12 patients (12.5%) and that for HCV in 35 patients (38%). The most frequently found dermatoses were infectious and inflammatory in origin. A significant statistical association was found between HIV and HTLV-1 coinfection, with dermatoses of inflammatory origin (P = 0.03; CI = 1.14-2.83). CONCLUSIONS: It is important to consider the high rate of positivity for HTLV-1 and HCV in the HIV-positive patients (12.5 and 38%, respectively). A higher risk of inflammatory dermatoses is found in patients who are simultaneously positive for HTLV-1 and HIV, indicating the possible importance of this coinfection in the development or worsening of certain dermatological diseases.     

Prognostic factors for brain metastasis in women presenting cervical cancer

Journal of Neuro-Oncology - Although rare, brain metastases (BM) from cervical cancer (CC) are highly lethal. Adequate patient selection for specific treatments can improve survival rates in...     

Clinical patterns and risk factors in scleritis: a multicentric study in Colombia

Graefe's Archive for Clinical and Experimental Ophthalmology - This study aims to describe the clinical characteristics of scleritis in a large cohort of Colombian patients and identify factors...     

Conservative approach to the treatment of keratocystic odontogenic tumor

The odontogenic keratocyst, also known as the keratocystic odontogenic tumor, is an aggressive, intraosseous lesion of odontogenic origin that presents a high rate of recurrence. Treatment modalities include aggressive surgical procedures and more conservative approaches that significantly influence the lesion's recurrence potential. The purpose of this case report was to demonstrate a conservative approach in the treatment of an extensive keratocystic odontogenic tumor, located in the mandible's posterior region, using decompression and enucleation.     

Outcomes after laparoscopic surgery in neonates with hypoplastic heart left heart syndrome

Background/Purpose

Laparoscopy has advanced the care of children for a variety of pediatric surgical diseases. However, complication rates for laparoscopic interventions in neonates with hypoplastic left heart syndrome (HLHS) have not been well described. The purpose of this study is to present the largest reported series of laparoscopic surgery performed in patients with HLHS.

Methods

We conducted a single-institution, retrospective chart review for all neonates with HLHS who underwent a laparoscopic procedure from September 2002 to March 2005. Data regarding patient characteristics, intraoperative monitoring, previous cardiac surgery, perioperative complications, and postoperative mortality were assessed.

Results

Twelve patients with HLHS underwent a total of 13 operations during the study period (8 combined Nissen fundoplication and gastrostomy tubes, 3 isolated gastrostomy tubes, 1 Ladd procedure, and 1 combined Nissen fundoplication and gastrocutaneous fistula closure). All cases were completed laparoscopically. Patients had undergone palliative cardiac surgery but were not completely corrected; therefore, they were cyanotic. Perioperative complications were observed in 6 patients (3 gastrostomy tube site infections, 1 small bowel obstruction, 1 postoperative sepsis, and 1 urinary tract infection). There was no mortality in this series.

Conclusions

From this experience, it appears that laparoscopy can be performed safely and with satisfactory outcomes in patients with HLHS. However, a multidisciplinary approach, including the availability of a skilled and experienced cardiac anesthesia team, is believed to be critical to optimize outcomes in these critically ill children.