Supporting parents during disclosure of a child's disability

Parents of disabled children often describe the disclosure of their child's diagnosis as a traumatic experience. The quality of support provided to family members at the time of disclosure helps alleviate their suffering and improve their resilience. With better insight into the psychological processes involved, healthcare professionals can ensure proper supportive care in each situation.     

Potential oral manifestations of cardiovascular drugs

Oral Diseases (2010) 16 , 769–773 Objective: The aim of this work was to determine the frequency and nature of oral manifestations secondary to use of cardiovascular drugs. Methods: Five hundred and thirty one patients attending an adult cardiology clinic in Saudi Arabia were questioned about the occurrence of oral dryness, dysgeusia, or burning sensation and were clinically evaluated for the presence of oral mucosal or gingival disease. Data were statistically analyzed with chi‐squared tests, odds ratios and Student’s t‐test. Results: Oral symptoms and/or signs were recorded in 75 (14.1%) patients with xerostomia being the most common (7.5%), followed by lichenoid (lichen planus‐like) lesions (3.6%) and dysgeusia (1.9%). Xerostomia was significantly more frequent in patients with a history of diabetes mellitus and in female patients (P < 0.05). There were no statistically significant differences (P > 0.05) between patients with or without oral manifestations when age, gender, cardiovascular risk factor, cardiac disease, type of cardiac drug used or the number of medications were assessed. There was a trend for xerostomia to be less frequent in patients receiving therapy with angiotensin converting enzyme inhibitors and a slight trend of xerostomia to be more likely with increased number of non‐cardiac and total number of agents per subject. The number of non‐cardiac and total medications taken by patients with potential oral manifestations tended to be greater than that of patients without oral manifestations. Conclusions: The frequency of potential oral manifestations in patients receiving cardiovascular agents was 14.1%. The occurrence and character of the oral manifestations had no significant relation with individual cardiac drugs, although there was a trend for oral manifestations to be likely with increasing number of drugs.     

Longitudinal Physical Activity Changes in Older Men in the Osteoporotic Fractures in Men Study

OBJECTIVES: To describe the change in physical activity (total, leisure, household, occupational) in men over a mean 5‐year follow‐up period and to identify sociodemographic and health factors associated with change in physical activity. DESIGN: Prospective cohort study; Osteoporotic Fractures in Men Study; data collected March 2000 through May 2006. SETTING: Six U.S. clinical centers. PARTICIPANTS: Volunteer sample of ambulatory community‐dwelling men aged 65 and older (N=5,161). MEASUREMENTS: Self‐reported physical activity assessed at baseline and Visit 2 (V2) (5 years apart) according to the Physical Activity Scale for the Elderly (PASE) (unitless, relative measure of physical activity). RESULTS: At baseline, PASE scores averaged 16.8±35.5 for occupational, 37.0±34.0 for leisure, 95.9±43.2 for household, and 149.7±67.6 for total physical activity. Occupational (?6.2±33.9), leisure (?3.2±37.3), household (?9.9±44.3), and total (?19.3±67.7) physical activity change scores declined, on average, from baseline to V2. On average, change in total PASE scores declined more with age: ?15.6±71.6 for men younger than 70, ?16.4±67.0 for men aged 70 to 74, ?21.4±66.9 for men aged 75 to 79, and ?29.5±60.7 for men aged 80 and older. Living alone, smoking cigarettes, poor health, and higher blood pressure were associated with greater declines in physical activity over time. Although average scores declined, some older men (1,335, 26%) reported increasing physical activity levels. Better physical and mental health, living with others, and being younger were associated with the probability of increasing physical activity over time. CONCLUSION: Over the 5‐year period, the majority of men reported declines in total physical activity. Older men in poor health who live alone have a high risk of physical activity declines and may be an important group to target for exercise interventions.     

Depression in mothers of burned children

Summary The treatment of burned children needs to address also their psychic state. Since the child’s emotional state depends heavily on the emotional state of its parents, especially the mother’s, interest should also be focused on diagnosing and treating secondary psychiatric disorders in mothers of burned children. The aim of this work was to study the prevalence of depression in mothers of burned children and its predicting factors. Methods: The enrolment of mothers of burned children was done in the Burns Department, Ibn Rushd University Hospital in Casablanca, Morocco. Twenty-eight mothers of seriously burned children agreed to participate in this study. A psychiatric interview was conducted after informed consent was obtained. The mothers completed a questionnaire; the diagnosis was made according to DSM IV criteria using the Mini International Neuro-psychiatric Interview (MINI). The Hamilton Depression Rating Scale and the Hamilton Anxiety Rating Scale were used to evaluate respectively the intensity of depression and the level of anxiety. Social functioning was assessed by the Global Assessment of Functioning scale (GAF). The minimum time interval between the child’s being burned and the interview with the mother was one month. Results: The prevalence of depression was 35.7%, which is much higher in the mothers of burned children as compared to the general population. Several risk factors were found such as: several burned children or burn of the only child, severity and complications of burn, and the socio-economic level. Conclusion: Depression is a common disorder in mothers of burned children. Thus early screening for depression in mothers and psychological and psychiatric support must be provided in conjunction with the treatment of the burned child.     

Predicting prognosis in patients with stroke treated with intravenous alteplase through blood pressure changes: A machine learning-based approach

The use of machine learning (ML) in predicting disease prognosis has increased, and researchers have adopted different methods for variable selection to optimize early screening for AIS to determine its prognosis as soon as possible. We aimed to improve the understanding of the predictors of poor functional outcome at three months after discharge in AIS patients treated with intravenous thrombolysis and to construct a highly effective prognostic model to improve prediction accuracy. And four ML methods (random forest, support vector machine, naive Bayesian, and logistic regression) were used to screen and recombine the features for construction of an ML prognostic model. A total of 352 patients that had experienced AIS and had been treated with intravenous thrombolysis were recruited. The variables included in the model were NIHSS on admission, age, white blood cell count, percentage of neutrophils and triglyceride after thrombolysis, tirofiban, early neurological deterioration, early neurological improvement, and BP at each time point or period. The model's area under the curve for predicting 30-day modified Rankin scale was 0.790 with random forest, 0.542 with support vector machine, 0.411 with naive Bayesian, and 0.661 with logistic regression. The random forest model was shown to accurately evaluate the prognosis of AIS patients treated with intravenous thrombolysis, and therefore they may be helpful for accurate and personalized secondary prevention. The model offers improved prediction accuracy that may reduce rates of misdiagnosis and missed diagnosis in patients with AIS.     

Incidental finding of a bilateral complete ossification of stylo‐hyoid chain and thyro‐hyoid ligaments

Ossification of stylohyoid chain corresponds to the ossification of stylohyoid ligament that can vary from thin short to thick long ossification and can be associated with other calcifications. We report in this case a bilateral non painful complete ossification of the stylohyoid complex extended to the thyrohyoidien ligament.