Paucity of high‐quality studies reporting on salt and health outcomes from the science of salt: A regularly updated systematic review of salt and health outcomes (April 2017 to March 2018)

The purpose of this review is to identify, summarize, and critically appraise studies on dietary salt and health outcomes that were published from April 2017 to March 2018. The search strategy was adapted from a previous systematic review on dietary salt and health. Identified studies were screened based on a priori defined criteria to identify publications eligible for detailed critical appraisals. Overall, 6747 citations were identified by the search strategy, and 42 health outcome studies were identified. Three of the 42 studies met the criteria for methodological quality and health outcomes and underwent detailed critical appraisals and commentary. In addition, a systematic review and meta‐analysis was critically appraised, although it did not strictly meet our methodological criteria. All four of the studies critically appraised found that sodium reduction improved blood pressure, especially in individuals with hypertension. In addition, sodium reduction reduced albuminuria in patients with stage 1‐3 chronic kidney disease. Examination of the time course of blood pressure responses to sodium reduction revealed lowering sodium in the context of an average American diet may not produce maximal blood pressure reductions within a 4‐week intervention period. This review provides further evidence of the benefit of sodium reduction for blood pressure lowering and gives insights into the subgroups of the population that may derive the greatest benefit from sodium reduction and the time course required to see benefit. Only three high‐quality studies were identified during this 12‐month review period, highlighting the critical need for more well‐conducted rigorous studies in this area.     

Pediatric head trauma: parent, parent-child, and family functioning 2 weeks after hospital discharge

OBJECTIVE: To investigate effects of pediatric head trauma on parent mental health, parent-child relationship and family functioning 2 weeks after discharge. METHODS: Ninety-seven mothers and 37 fathers of 106 preschool children hospitalized with head injury completed Mental Health Inventory (MHI), Parenting Stress Index, Family Adaptability and Cohesion Evaluation Scales II (FACES II) and Multidimensional Scale of Perceived Social Support (MSPSS) 2 weeks after discharge, and perceived injury severity, Parental Concerns Scale (PCS), Parental Stressors Scale: Pediatric Intensive Care Unit (PSS: PICU), and MHI 24-48 h after hospital admission. RESULTS: Mental health after discharge was related to social support and baseline mental health. Mothers' parental distress was related to perceived injury severity and social support. Greater family cohesion was related to baseline mental health, social support, and being in a two-parent family for mothers, and to social support for fathers. CONCLUSIONS: Parents' mental health and social support were important for parent mental health and family cohesion after discharge. Perceived injury severity and parent reactions to hospitalization also played a role.     

Immune evasion by Mycobacterium tuberculosis: living with the enemy

Mycobacterium tuberculosis is successful as a pathogen because of its ability to persist in an immunocompetent host. This bacterium lives within the macrophage, a cell whose function is the elimination of microbes. Recent advances have improved our understanding of how M. tuberculosis evades two major antimicrobial mechanisms of macrophages: phagolysosome fusion and the production of toxic reactive nitrogen intermediates. M. tuberculosis also modulates antigen presentation to prevent the detection of infected macrophages by CD4(+) T cells.     

Retrospective review of the reduction of oral pressure ulcers in mechanically ventilated patients: a change in practice

Hospital-acquired pressure ulcers (HAPU) are a growing concern in patient care. Mucosal pressure ulcers (PUs) on the lips, mouth, gums, and tongue caused by oral intubation and their securement devices can be difficult to identify and prevent. In an effort to address this problem and reduce mucosal PU, implementation of an alternative securement device, the Hollister ETAD endotracheal (ET) tube securing device, in conjunction with the B&B Medical Universal Bite Block, was introduced at our institution, a level 1 trauma and burn center, in July 2007. The ETAD was later replaced by the Hollister AnchorFast ET tube securing device in December 2007. By April 2009, they became the standard devices and method used to secure oral ET tubes. We hypothesized the use of the new securement devices and bite block would lead to a decrease of HAPUs on the lips, mouth, gums, and tongue of orally intubated critical care patients because these allow for better oral assessment and ET tube manipulation to redistribute pressure. Using data collected from our electronic medical record and our HAPU incidence tracking system, we analyzed the number of PUs on the lips, mouth, gums, and tongue of orally intubated patients in our preintervention (phase 1) group compared with the data from our postintervention (phases 2 and 3) groups. A clinically significant decrease in the reported incidence of HAPUs on the lips, mouth, gums, and tongue was noted in our phases 2 and 3 groups following introduction of the ETAD, AnchorFast, and Universal Bite Block in our institution.     

Psychometric evaluation of the Spanish and English versions of the spiritual coping strategies scale

The Spiritual Coping Strategies (SCS) Scale measures how frequently religious and nonreligious (spiritual) coping strategies are used to cope with a stressful experience. This study's purpose is to evaluate the psychometric properties of the newly translated Spanish version of the SCS. A total of 51 bilingual adults completed the SCS in Spanish and English, with 25 completing them again 2-3 weeks later. Internal consistency reliability for the Spanish (r = 0.83) and English (r = 0.82) versions of the SCS in the total sample were good. Test-retest reliability was .84 for the Spanish and .80 for the English version. Spanish and English responses to the SCS items and the resulting score for the subscales and the total scale were not significantly different. Scores on the English and Spanish versions were correlated as expected with time since the stressful event and happiness with family and with spouse or partner, supporting the validity of the Spanish SCS. Study findings support the reliability and validity of the newly translated Spanish SCS.