Characteristics of unintentional ingestion of oral non-steroidal anti-inflammatory drugs and analgesics in preschool children

We characterised accidental ingestion of non-steroidal anti-inflammatory drugs and non-opioid analgesics in children aged 0–5 years between 2009 and 2019 by analysing records of telephone consultations with the Croatian Poison Control Centre (CPCC) and cases treated at the Children’s Hospital Zagreb (CHZ). Among the total of 466 identified cases (411 from CPPCC records and 55 from CHS hospital records), the most frequently ingested drugs were ibuprofen (47 %), paracetamol (20 %), ketoprofen (15 %), and diclofenac (11 %). In 94 % of the cases unsupervised children ingested the drug left within their reach. The remaining 6 % were dosing errors by parents or caregivers and involved liquid formulations as a rule. Our findings can serve as real-life examples informing preventive measures.KEY WORDS: diclofenac, ibuprofen, ketoprofen, NSAIDs, overdose, paracetamol, poisoning, toddlers     

Self-Healing Systems in Silicon Anodes for Li-Ion Batteries

Self-healing is the capability of materials to repair themselves after the damage has occurred, usually through the interaction between molecules or chains. Physical and chemical processes are applied for the preparation of self-healing systems. There are different approaches for these systems, such as heterogeneous systems, shape memory effects, hydrogen bonding or covalent–bond interaction, diffusion, and flow dynamics. Self-healing mechanisms can occur in particular through heat and light exposure or through reconnection without a direct effect. The applications of these systems display an increasing trend in both the R&D and industry sectors. Moreover, self-healing systems and their energy storage applications are currently gaining great importance. This review aims to provide general information on recent developments in self-healing materials and their battery applications given the critical importance of self-healing systems for lithium-ion batteries (LIBs). In the first part of the review, an introduction about self-healing mechanisms and design strategies for self-healing materials is given. Then, selected important healing materials in the literature for the anodes of LIBs are mentioned in the second part. The results and future perspectives are stated in the conclusion section.     

Using the Penn State Worry Questionnaire to identify individuals with generalized anxiety disorder: a receiver operating characteristic analysis

We report on the use of the Penn State Worry Questionnaire (PSWQ) to identify individuals with generalized anxiety disorder (GAD). Fifty individuals with primary or secondary GAD and 114 individuals with social anxiety disorder (without GAD) completed the PSWQ. In receiver operating characteristic analyses, a score of 65 simultaneously optimized sensitivity and specificity in discriminating individuals with GAD from individuals with social anxiety disorder. Results support the use of the PSWQ in screening individuals likely to meet criteria for GAD who present for treatment at an anxiety disorders specialty clinic.     

Impact of chronic pain on the spouse: marital, emotional and physical consequences

The effects of chronic illness on marital relationships and the spouses' emotional and physical health were examined in chronic pain patients, their spouses, and a control sample of spouses of diabetic patients. Results indicated that pain patients and their spouses experienced considerable change in marital and sexual satisfaction. Patients with better marital adjustment also reported higher overall pain levels and had more solicitous and maritally satisfied spouses. Spouses' marital adjustment was positively associated with patients' marital satisfaction and spouses' own mood. Spouses' dysphoric mood was related to patients' negative appraisal of the pain experience, spouses' perceived lack of life control, and spouses' marital dissatisfaction. Although spouses of chronic pain patients showed no more physical symptoms than spouses of diabetics, they reported significantly more pain symptoms that were related to elevated levels of depressed mood. The results indicate that not only is chronic pain associated with problems in the marital relationship but heightened distress and physical symptoms in spouses as well. These effects are related less to the existence of a chronic pain problem per se but rather to patients' and spouses' manner of coping with the situation.     

Effects of Single-Dose Preemptive Pregabalin and Intravenous Ibuprofen on Postoperative Opioid Consumption and Acute Pain after Laparoscopic Cholecystectomy

Purpose: Non-opioid medications as a part of multimodal analgesia has been increasingly suggested in the management of acute post-surgical pain. The present study was planned to compare the efficacy of the combination of pregabalin plus ?v ibuprofen. Methods: 58 patients were included in this prospective, randomized, double-blinded study. The pregabalin group (Group P, n = 29) received 150 mg pregabalin, the pregabalin plus ibuprofen group (Gropu PI, n = 29) received 150 mg pregabalin and 400mg ?v ibuprofen before surgery. Postoperative fentanyl consumption, additional analgesia requirements and PACU stay were recorded. Postoperative analgesia was performed with patient-controlled IV fentanyl. Results: VAS scores in the group PI were statistically lower at PACU, 1and 2 hours at rest, at PACU, 1, 2, 4, 12 and 24 hours on movement compared to the group P (P < 0.05). Opioid consumption was statistically significantly higher in the group P compared to the group PI (130.17 ± 60.27 vs 78.45 ± 60.40 μq, respectively, P < 0.001) and reduced in the 4th 24 hours by 55% in group PI. Rescue analgesia usage was statistically significantly higher in the group P than in the group PI (16/29 vs 7/29, respectively, P < 0.001). Four patient in the group PI did not need any opioid drug. Besides, PACU stay was shorter in the group PI than the group P (10.62 ± 2.38 vs 15.59 ± 2.11 min, respectively, P < 0.001). Conclusion: Preemptive pregabalin plus ?v ibuprofen in laparoscopic cholecystectomy reduced postoperative opioid consumption. This multimodal analgesic aproach generated lower pain scores in the postoperative period.     

Acute HIV seroconversion presenting with active tuberculosis and associated with high levels of T-regulatory cells

A patient with well-defined acute HIV infection who developed concomitant pulmonary tuberculosis during the retroviral acute syndrome is reported here. In this patient high levels of T-regulatory cells (Tregs) and a low proliferation response to M. tuberculosis were initially detected, which normalized throughout follow-up. This case calls for the consideration of tuberculosis in patients in the early stages of HIV, and emphasizes the need for further study of the potential causal relationship between Treg cells and the risk of TB reactivation in HIV patients.     

Tested communication strategies for providing information to patients in medical consultations: A scoping review and quality assessment of the literature

ObjectivesTo systematize the scientific knowledge of empirically tested strategies for verbally providing medical information in patient-physician consultations.MethodsA scoping review searching for terms related to physician, information, oral communication, and controlled study. Four pairs of reviewers screened articles. For each selected study, we assessed the quality and summarized aspects on participants, study, intervention, and outcomes. Information provision strategies were inductively classified by types and main categories.ResultsAfter screening 9422 articles, 39 were included. The methodological quality was moderate. We identified four differently used categories of strategies for providing information: cognitive aid (n = 13), persuasive (n = 8), relationship- (n = 3), and objectivity-oriented strategies (n = 4); plus, one “mixed” category (n = 11). Strategies were rarely theoretically derived.ConclusionsCurrent research of tested strategies for verbally providing medical information is marked by great heterogeneity in methods and outcomes, and lack of theory-driven approaches. The list of strategies could be used to analyse real life communication.Practice implicationsFindings may aid the harmonization of future efforts to develop empirically-based information provision strategies to be used in clinical and teaching settings.     

The immunological significance of histological changes in the spleen and liver in mouse malaria

The spleens and livers of mice were investigated histologically on various days subsequent to infection with Plasmodium berghei yoelii using immunofluorescence and autoradiography. At the height of the parasitaemia, at a time when nonspecific immunosuppression is known to occur, the `thymus-dependent area' round the central arteriole of the spleen was replaced by proliferating lymphoid cells many of which were IgG containing plasmablasts. There was also at this time a considerable decrease in small lymphocytes in this area. The significance of these findings is discussed in relation to the non-specific immunosuppression. In addition evidence for immune complex deposition was obtained in a number of tissues.     

Chronic Pain and Telomere Length in Community-Dwelling Adults: Findings From the 1999 to 2002 National Health and Nutrition Examination Survey

Chronic pain is a common condition associated with psychological distress, functional impairments, and age-associated comorbidity. Preliminary studies, on the basis of relatively small sample sizes, suggest that the combination of chronic pain and stress is associated with telomere shortening, a widely recognized marker of cellular aging. We sought to determine the cross-sectional association of chronic pain with telomere length in 7,816 community-dwelling adults ages 20 years and older who participated in the 1999 to 2002 National Health and Nutrition Examination Survey. Consistent with previous studies, leukocyte telomere length was assessed using the quantitative polymerase chain reaction method and compared with a DNA reference standard to compute a telomere to single copy gene ratio. Standardized, in-person interviews were used to identify chronic regional pain and chronic widespread pain in 784 (10.0%) and 266 (3.4%) participants, respectively. Older age, male sex, obesity, and less physical activity were associated with shorter telomere length (P?<.05 for all comparisons); however, there was no association of chronic pain with telomere length. The age-adjusted means (standard error) of telomere length telomere to single copy gene ratios were 1.04 (.02), 1.03 (.02), and 1.02 (.02) in participants with no chronic pain, chronic regional pain, and chronic widespread pain, respectively (P?=?.69). In addition, chronic pain did not modify the effects of age, sex, race/ethnicity, education, or psychological distress on telomere length. In summary, chronic regional and widespread pain were not associated with telomere length in this nationally representative study; however, we could not determine associations of pain duration and severity with telomere length because of limitations in pain assessment data.