Children's perceptions of peers with somatic symptoms: the impact of gender, stress, and illness

OBJECTIVE: To investigate how illness characteristics influence children's responses to ill peers. METHODS: A sample of 363 4th and 5th graders responded to a vignette describing a peer with abdominal pain. In a 2 x 2 x 2 x 2 design, conditions varied by (a) evidence for organic disease, (b) presence of stress, (c) sex of vignette character, and (d) sex of respondent. Children rated symptom severity, liking for the peer, and whether the peer should be excused from normal responsibilities. RESULTS: Same sex preferences significantly influenced children's liking for a peer. Children viewed symptoms with an organic etiology as more severe than those without one. Under certain conditions, symptom severity judgments mediated the relation between the presence of organic disease and (a) liking and (b) granting relief from responsibility. The presence of stress had little effect on ratings of symptom severity, liking, or relief from responsibility. CONCLUSIONS: Gender and evidence of organic disease influence children's perceptions of and responses to symptomatic peers.     

Critical analysis of intravenous immunoglobulin therapy for recurrent miscarriage

Critical analysis of intravenous immunoglobulin therapy for recurrent miscarriage An alloimmune abnormality is believed to be the cause of recurrent miscarriage in couples in whom no other cause can be identified. Because of its immunosuppressive properties, intravenous immunoglobulin (IVIG) is used as a treatment for this disorder. The purpose of this study was to determine whether IVIG improves the chance of successful pregnancy in women with recurrent miscarriage by using individual patient data from efficacy trials. Detailed information on each patient enrolled in these trials was obtained to evaluate the efficacy of IVIG and investigate the effect of clinical variability on pregnancy outcome. Data from 125 patients in the IVIG group and 115 patients in the placebo group were available for analysis. Although the number of previous miscarriages and female age were both negative prognostic factors for successful outcome, there was no significant improvement in successful pregnancy or live birth rate with IVIG. Subgroup analyses indicated that timing of IVIG administration may be important. The results of the present study highlight the importance of stratification for known confounders, so that the role of IVIG can be evaluated in more detail. The collective evidence thus far indicates that IVIG does not have a therapeutic effect that is clinically meaningful.     

The measurement of CA 125 and placental protein 14 in uterine flushings in women with recurrent miscarriage; relation to endometrial morphology

The concentrations of CA 125 and placental protein 14 (PP14)were measured in uterine flushings obtained throughout the lutealphase of the cycle from eight normal fertile women. The concentrationsof both proteins increased in a similar pattern throughout theluteal phase of the cycle, with the most dramatic increase occurring6 days after their luteinizing hormone surge (day LH +6). However,a greater variation in CA 125 concentrations was seen comparedto that seen for PP14. The concentrations were compared to thoseobtained on day LH + 7 of the cycle from a group (n equals;35) of women with recurrent miscarriage. The ranges in concentrationof PP14 and CA 125 in the flushings of fertile and recurrentmiscarriage patients were very similar. However, a greater proportionof women with recurrent miscarriage (55%) had low concentrations(<5 ng/ml) of PP14 than in the control group (12.5%) andthe concentrations of PP14 in the uterine flushings were significantlyless (P < 0.05) in women with recurrent miscarriage comparedto the normal fertile group. There was no significant differencein the concentrationof CA 125 in the uterine flushings betweenthe two groups. Histological observation of the endometrialbiopsy samples from recurrent miscarriage patients gave menstrualcycle datings that ranged from day LH +2.5 to LH +6.5 with retardedendometrium (;day LH +5) in 12 of 35 (34%) patients. Of these12 patients, 10 (83%) had low PP14 concentrations and six (50%)had low CA 125 concentrations in their uterine flushings. Inthe recurrent miscarriage patients with histologically normal(sequals; day LH +5) endometrial development, 10 out of 23 (43%)also had low PP14 concentrations and 8 out of 23 (35%) had lowCA 125 in their uterine flushings. The results suggest thatPP14 is better than CA 125 as a marker for endometrial functionin this group of women. In some cases (52%) the low concentrationsof PP14 in the uterine flushings couldbe explained by retardedendometrial development but for the others the reduction inPP14 concentration in the uterine flushing was not associatedwith retardation of endometrial development.     

Absence of the left inferior thyroid artery: clinical implications

Dissection of an adult male cadaver revealed an absence of the left inferior thyroid artery; its usual area of distribution to the thyroid gland was supplied by the right inferior thyroid artery. Absence of the left inferior thyroid artery occurs in 1-6% of cases. The inferior thyroid artery arises commonly from the thyrocervical trunk, passes posterior to the carotid sheath and supplies the inferior pole of the corresponding lobe of the thyroid gland; its branches can course anterior or posterior to or between branches of the recurrent laryngeal nerve. During thyroid surgery it is imperative to identify the relationship of the inferior thyroid artery to the recurrent laryngeal nerve or to establish its absence because injury to the nerve can be a major complication; awareness of significant variations of the surgical anatomy of the thyroid gland is vital for preserving the integrity of important structures.     

Are Anti-Beta2-Glycoprotein-I Antibodies Markers for Recurrent Pregnancy Loss in Lupus Anticoagulant/Anticardiolipin Seronegative Women?

Problem  Anti-beta₂-Glicoprotein-1 antibodies (anti-β₂GPI-ab) have been related to recurrent miscarriage (RM) with conflicting results. The aim was to evaluate the role of anti-β₂-GPI-ab as unique biological marker in RM related to antiphospholipid (aPL).
Method of study  A cohort study that included 59 cases, divided in two groups, was designed: group 1 comprised 43 pregnant women with 'obstetric' antiphospholipid syndrome (APS) and group 2 included 16 cases with similar complaints but only having repeatedly anti-β₂-GPI-ab. Previous thrombosis and/or inherited thrombophilia were excluded. Lupus anticoagulant, anticardiolipin antibodies (aCA), anti-β₂-GPI-ab, and other autoantibodies were analyzed. Miscarriages, premature births, pre-eclampsia, live births, placental and systemic thromboses were studied.
Results  No differences in previous obstetric complications were detected ( P  =   1.00–0.164). After the treatment, differences in number of obstetric complications were not seen ( P  =   1.00). Live births were similar in two groups (88.4% and 93.7%; P  =   1.00). Placental thrombosis was equal in both groups, 93.3% versus 80% ( P  =   1.00).
Conclusion  These results suggest that anti-β₂-GPI-ab may be considered a biological marker for obstetric APS.     

Association of bacterial vaginosis with a history of second trimester miscarriage

The aim of this study was to determine whether bacterial vaginosis(BV) is associated with a history of recurrent pregnancy loss.A total of 500 consecutive patients attending the RecurrentMiscarriage Clinic were screened for the presence of BV. Inwomen who had had at least one late miscarriage BV was foundtwice as commonly (27/130; 21%) as in women who had had onlyearly losses (31/370; 8%) (P<0.001). The difference was evenlarger (26 versus 8%) if women who had had term pregnancieswere excluded. Moreover, BV was found three times more commonlyin Afro-Caribbean women [17 (29%) of 58] than in Caucasian women[36 (9%) of 379] and, in both groups of women, BV was diagnosedat least twice as frequently in those with a history of at leastone late miscarriage than in those who had experienced firsttrimester pregnancy losses only (P<0.001). The conditionoccurred twice as often among smokers than non-smokers and,in both groups, it was at least twice as common in women witha history of at least one late miscarriage as in those who hadhad early pregnancy losses only (P<0.001). However, the relationshipbetween BV and smoking was independent of ethnic origin. Womenwho douched with chloroxylenol were mostly Afro-Caribbean andhad BV more than twice as often as women who did not douche.     

基于网络药理学及分子对接预测安子调冲方中和血中药对免疫相关复发性流产的作用机制

目的：应用网络药理学及分子对接技术探讨安子调冲方（ATF）中起和血作用的鸡血藤–蒲黄炭（JXT–PHT对治疗免疫相关复发性流产（IRRPL）的作用机制,为进一步对ATF的拆方研究奠定基础。方法：利用TCMSP和HERB数据库进行化合物成分检索,在Swiss Target Prediction数据库预测药物作用靶点。使用Genecards和ImmPort数据库获取IRRPL相关靶点。利用jvenn绘制韦恩图,得到潜在作用靶点。在STRING数据库构建蛋白互作（PPI）网络,并分析关键作用靶点。构建“和血作用中药–成分–靶点–疾病”网络,在Cytoscape 3.10.0中可视化,并分析核心成分。应用DAVID(v2023q1)数据库,对潜在作用靶点进行基因本体（GO）和京都基因和基因组数据库（KEGG）功能富集分析。最后通过AutoDock–Vina(v1.2.5)对关键作用靶点和核心成分执行分子对接,在PyMOL 2.5进行可视化。结果：共筛选出ATF中起和血作用的JXT–PHT 31个活性成分,预测靶点586个,IRRPL相关靶点226个,潜在作用靶点38个,构建PPI网络并分析后得...     

小儿再发性腹痛的病因学分析

目的 分析小儿再发性腹痛的病因以及相关的因素为临床选择辅助检查及诊断提供依据或参考。方法 268例再发性腹痛患儿选人调查对象,对其进行病因学调查,调查内容包括年龄、性别、季节、诱因、部位等8个因素,进行分析。选择相关的辅助检查确定病因。结果 有52例有器质性疾病(19．4％),以慢性胃炎居首位。与发作有关的因素有季节、年龄、情绪反应。结论 小儿再发性腹痛绝大多数属于功能性疾病,只有少数由器质性原因引起,但仍应引起足够重视,谨慎的选择辅助检查,避免漏诊。     

Elevated sperm DNA fragmentation does not predict recurrent implantation failure

In this study, we sought to determine whether sperm DNA fragmentation (DFI%) and high DNA stainability (HDS%) evaluated by sperm chromatin structure assay (SCSA) predict recurrent implantation failure (RIF) or pregnancy rate. A retrospective study was performed of consecutive cycles of ICSI treatment from 2009 to 2018. A total of 386 couples that underwent 1,216 frozen embryo transfer (FET) cycles were analysed. Mean female and male age was 34 ± 3.6 years and 37.3 ± 6.6 years, respectively, and a median total motile sperm count (TMSC) was 43.5 [9.9–105.5] million. Overall median DFI% and HDS% was 12 [7.1–18.9] and 9.6 [6.5–14.4] respectively. On multivariable analysis, DFI% and HDS% were not associated with RIF (DFI%: OR = 1.01, 95% CI: 0.98–1.04, p = .414; HDS%: OR = 0.97, 95% CI: 0.94–1.01, p = .107) or IVF success, defined as clinical pregnancy (DFI%: OR = 1.00, 95% CI: 0.99–1.01, p = .641; HDS%: OR = 1.01, 95% CI: 0.99–1.02, p = .565). We found that neither DFI% or HDS%, as assessed by SCSA, were predictive of RIF or pregnancy rate. This finding suggests that sperm DNA fragmentation does not predict RIF or pregnancy rate.     

Flexor Tenosynovectomy for Recurrent Carpal Tunnel Syndrome: A Retrospective Case Series of 108 Hands

Background: The etiology of recurrent carpal tunnel syndrome (CTS) is unclear, and outcomes following secondary surgery in this demographic have been poorer than primary surgery. Fibrosis and hypertrophy have been identified in the flexor tenosynovium in these patients. The authors use flexor tenosynovectomy (FTS) for recurrent CTS after primary carpal tunnel release and present a review of these patients. Methods: A retrospective chart review was performed of 108 cases of FTS for recurrent CTS from 1995 to 2015 by 4 attending surgeons at one institution. Demographic information, symptoms, and outcomes were among the data recorded. A phone survey was conducted on available patients where the shortened version of the Disabilities of the Arm, Shoulder and Hand Questionnaire (QuickDASH) and satisfaction were assessed. Results: Average office follow-up was 12 months. Average age was 57.5 years. A total of 104 (96%) reported symptom improvement and 48 (44%) reported complete symptom resolution. Forty patients were available for long-term follow-up at an average 6.75 years postoperatively via phone interview. Average QuickDASH score was 31.2 in these patients. Thirty-six (90%) of 40 patients were initially satisfied at last office visit, and 31 (78%) of 40 were satisfied at average 6.9 years, a maintenance of satisfaction of 86%. Satisfied patients were older (58 years) than unsatisfied patients (51 years). Conclusion: Both long-term satisfaction and QuickDASH scores in our cohort are consistent with or better than published results from nerve-shielding procedures. The authors believe a decrease in both carpal tunnel volume and potential adhesions of fibrotic or inflammatory synovium contributes to the benefits of this procedure. This remains our procedure of choice for recurrent CTS.