Diagnosis of Rett syndrome: can a radiograph help?

Rett syndrome (RS), a neurodevelopmental disorder almost exclusively affecting girls, is associated with severe intellectual and motor disability. In the absence of biological markers, diagnosis is determined by a set of clinical criteria. In a previous study in Scotland, shortening of the fourth metatarsal was reported clinically in 20% of classical RS cases aged 5 years or older. The Australian Rett Syndrome Study database has facilitated a population-based radiological study of the hands and feet of girls with RS. Straight radiographs of hands and feet were available from 94 cases, representing 70.1% of the known RS population in Australia. Control radiographs were matched for age, sex, and laterality. Relative shortening of the fourth metacarpal/metatarsal was assessed using the sign method. A short ulna (negative ulna variance) was defined as the distal articular surface of the ulna being at least 5mm proximal to the distal articular surface of the radius. A positive metacarpal sign was twice as common in verified cases of RS than in controls in the right but not the left hand. A short ulna was more common in subjects with RS than in controls. A short fourth metatarsal was also more common among subjects with RS. More than half (56.6%) the girls with RS over the age of 4 years had a negative ulnar variance in either wrist or a metatarsal sign in either foot. These findings will assist with the diagnosis of RS and may help direct research towards the location of the molecular defect.     

Radiographic and histologic periapical findings of root canal treated teeth in cadaver

The success of root canal treatment can be subjectively evaluated both clinically and radiographically. Normally, the recall radiograph is the main factor in evaluating success or failure.Objectives. This study evaluated periapical areas of root canal treated teeth by correlating radiographic and histologic findings.Study design. Jaws were resected from cadavers and radiographed. Those teeth that had received root canal treatment were evaluated for success or failure based on radiographic criteria. Teeth and surrounding bone were then removed en bloc and prepared for light microscopy. Untreated teeth without periapical pathosis were examined as controls.Results. Root canal treated teeth classified as failures were found to consistently have inflammatory resorptive lesions at the periapices. In contrast, those treated teeth classified as radiographically successful showed varying reactions ranging from normal uninflamed to mildly inflamed.Conclusions. Those classified as failure showed consistent inflammation. However, the majority of our examined treated teeth were radiographically normal and exhibited no periapical inflammation.     

蛇葡萄根的保肝降酶及抗自由基损伤作用

用D-氨基半乳糖(D-GalN)制备大鼠急性肝损伤模型,检测血清谷丙转氨酶(ALT)、谷草转氨酶(AST)和肝匀浆超氧化物歧化酶(SOD)、丙二醛(MDA)含量,观察肝组织病理变化,以探讨中药蛇葡萄根对急性肝损害的保护作用。结果显示:蛇葡萄很能显著降低血清ALT、AST含量,提高SOD含量,降低MDA含量,高剂量组还能减轻肝细胞受损程度。提示蛇葡萄根具有保肝降酶及抗自由基损伤作用。     

Lived experiences of young adults facing a recent diagnosis of cancer: A phenomenological study

Introduction

Young adulthood is a period of prosperity and freshness characterized by developmental achievement, which can be inhibited by various diseases such as cancer. Typically considered a terminal disease, if diagnosed in young adulthood, cancer may trigger a tremendous psychosomatic shock. The nature of facing a recent cancer diagnosis affects the whole coping process. Addressing young adults' experiences at the confirmation point of cancer diagnosis will facilitate supporting them through the early recognition of probable problems in the future. Therefore, the present study aimed to analyse the lived experiences of young adults facing a recent cancer diagnosis.

Methods

This qualitative study adopted an interpretive phenomenology design. In this study, 12 patients (with an age range of 20–40) were selected using the purposive sampling method. Data collection was done through in-depth, semistructured interviews. The data were analysed following the method proposed by Diekelmann et al.

Findings

Three main themes and nine subthemes were extracted from the data: (1) spiritual detachment and then acceptance through spirituality in the form of denial and then forced acceptance, sense of guilt and spiritual help-seeking, and anger towards God and then humbleness, (2) the shock of facing an extraordinary life shaped by disturbed role-play and unusual lifestyle, (3) anticipatory anxiety concerning the sense of rejection, negative perspective towards future, inability to afford the costs and worries about the future of the family members.

Conclusion

This was the first study providing significant insights into the experiences of young adults facing a recent cancer diagnosis. The diagnosis of cancer can shadow all aspects of young adults' lives. The findings of the present study empower healthcare professionals to provide newly diagnosed young adults with appropriate health services.

Patient Contributions

To identify and recruit the participants, we explained the objectives of the present study to the unit managers either by phone or in person. The participants were approached and interviewed by three authors. Participation was voluntary and the participants received no financial contribution for their time.     

Interaction between functional health literacy and telehomecare: Short‐term effects from a randomized trial

This study was conducted as part of a randomized, controlled trial, and explored whether the introduction of a Danish telehomecare intervention, referred to as ‘the Telekit’, and its associated educational components affect functional health literacy. The study sample consisted of 60 chronic obstructive pulmonary disease patients in the intervention group who received the Telekit, and 56 in the control group; all participants were collected from the large‐scale, randomized TeleCare North trial by consecutive sampling. To avoid recall bias, the design did not include a baseline measurement, comparing instead the post‐intervention measurements between the intervention and control groups. First, the comparability of the two groups was determined, and statistically significant differences in their functional health literacy scores were examined using an independent t‐test. Furthermore, the associations between functional health literacy and both groups were tested using multiple regression analysis. No statistically significant difference was observed between the intervention and control groups, suggesting that the introduction of the Telekit and its associated educational components has no effect on functional health literacy. However, further research should be conducted using a larger sample.     

The Need for Cultural Safety in Injury Prevention

Public health nurses are on the front line of injury prevention initiatives. However, within injury prevention interventions and research, issues pertaining to culture are often addressed through the employment of one of the three approaches: cultural competency, cultural appropriateness, and/or cultural sensitivity. When using these approaches, it is often suggested that it is only those who are the recipients of an intervention or the focus of research that “have” culture. The injury prevention designer's/provider's/researcher's own culture, as well as the ways in which it may influence the interventions or research, is typically rendered invisible. In this paper, we provide an overview and illustrations of the use of cultural competency, cultural appropriateness, and cultural sensitivity in injury prevention initiatives, as well as each approach's shortcomings. We then introduce cultural safety, an approach that has not yet gained traction in injury prevention but has had significant uptake within nursing in general, and argue that it has the potential to overcome many other approaches' shortcomings and thus may lead to more effective and socially just injury prevention initiatives.