ABSTRACT
Background. Infants in neonatal intensive care are at risk of swallowing difficulties; in particular oropharyngeal dysphagia (OPD) and oesophageal dysphagia (OD). OPD is treated by speech-language therapists while OD is managed by doctors. Diagnosis of dysphagia is a challenge as equipment for instrumental evaluations is not readily available. Additional information to guide clinical assessment may be valuable. Objective. To determine whether risk profiles of infants (=32 weeks' gestation) in a neonatal intensive care unit (NICU) and diagnosed with OPD or OD were distinctly different from one another. Methods. Non-probability convenience sampling was used to select 49 participants. Based on modified barium swallow (MBS) examinations; three groups of participants were identified: no dysphagia (n=11); OPD (n=13) and OD (n=25). Clinical data were collected to investigate associations between risk profiles and type of dysphagia. Results. Factors such as gestational age; birth weight; poor weight gain and Apgar scores showed no association with either type of dysphagia in the sample of infants with a mean gestational age of 35.53 weeks. Increased NICU stay; increased chronological age; problematic breastfeeding and use of tube feeding showed an association with OPD. Three risk factors; namely intrauterine growth restriction; premature rupture of membranes and nutritive sucking difficulties were associated with OD. Conclusion. Risk profiles associated with the two types of dysphagia may guide NICU personnel and speech-language therapists; especially in settings where no MBS equipment is available
Subject(s)
Critical Care , InfantABSTRACT
Objective: It is posited that the effect of depression on BMD is dependent on the severity of depression. Conflicting evidence exists regarding this possible association. This study investigated the association between depression and low bone mineral density (BMD). Methods: The hypothesis was investigated in a random sample of volunteers (n=40) and in premenopausal female psychiatric patients (n=5) diagnosed with recurrent severe major depression. The outcome measures were BMD (DEXA); depression (Beck Depression Inventory and Psychological General Well-being Scale) and 24-hour saliva cortisol levels (ELISA). In a comparison of women (4 of the 40 i.e. ""control"" subjects) with negligible symptoms of depression and the five patients with severe recurrent major depression- BMD; depression; saliva cortisol and bone turnover markers were measured and compared. Pro-inflammatory status (IL-1 and TNF-alpha) was investigated in the psychiatric patients only. Results: In the random - non clinical - sample of women (n=40); 26 exhibited normal BMD and 14 exhibited low BMD. Depressive symptoms and cortisol levels were not significantly different between these two groups. Women with severe recurrent major depression(n=5) exhibited lower median BMD T-scores; higher overall bone turnover and higher 24-hour cortisol levels compared to ""control"" subjects (n=4). The psychiatric patients also exhibited elevated IL-1 levels. Conclusion: The effect of depression on BMD may be dependent on the depression severity. IL-1 and cortisol are possible mediators in depression-induced BMD loss
Subject(s)
Bone Density , Depression , Pilot Projects , Premenopause , WomenABSTRACT
Objective. The purpose of this study was to compare the nature and proportion of total injuries occurring at Stellenbosch Rugby Football Club in Stellenbosch; South Africa;between the years 1973 - 1975 and 2003 - 2005. Design. Retrospective; descriptive study. Main outcome measures. Injured rugby players from the Stellenbosch Rugby Football Club from the different time periods were included in the study. Results from the 1973 - 1975 time period were obtained from two previously published articles (Roy; 1974; Van Heerden; 1976); while data from the 2003 - 2005 time period were available through the Stellenbosch University Rugby Injury Database. Results. An increase in the proportion of head and facial injuries from 1973 - 1975 (21) to 2003 - 2005 (42) was found as well as a doubling in the proportion of concussions between the two time periods (12- 23). There was an overall decrease in total injuries between the two time periods. Conclusion. The findings highlight the high and increased proportion of head and facial injuries in the game of rugby at the Stellenbosch Rugby Football Club. This is a matter that should be further investigated