Are breath-holding spells always innocuous: A case report

The diverse clinical manifestations of Langerhans cell histiocytosis (LCH) present a dilemma to clinicians and pediatricians play an important role in its diagnosis and multidisciplinary approach. LCH, previously known as histiocytosis X, is an uncommon hematological disorder characterized by uncontrolled stimulation and proliferation of normal antigen-presenting cells, Langerhans cells. The purpose of this report is to describe the case of a 7-month-old female child with multisystem involvement who presented with breath-holding spells and to discuss the clinical, radiological, and histopathological features of LCH.

Dosimetric comparison of three?dimensional conformal radiation therapy, intensity?modulated radiation therapy, and volumetric?modulated arc therapy for free?breathing whole?breast irradiation: A planning study

Background: Currently, recommended heart dose constraints are difficult to meet in whole?breast irradiation (WBI) for left?sided breast cancer patients, who cannot be treated with the deep inspiration breath hold. We performed a radiotherapy planning study to establish if the use of intensity?modulated radiation therapy (IMRT) or volumetric?modulated arc therapy (VMAT) allows for better sparing of the heart and its subvolumes than the three?dimensional conformal radiation therapy (3D?CRT), and how these attempts affect the dose delivered to the other organs. Methods: A total of 17 left?sided and 10 right?sided consecutive patients treated with free?breathing WBI were retrospectively included. The 3D?CRT, IMRT, and VMAT plans were generated. Several dose杤olume parameters and plan quality indices were compared, separately for the left? and right?sided plans. Results: All the techniques fulfilled the planning objectives. In the left?sided plans, there was no heart or left ventricle dose reduction with IMRT, nor with VMAT; the maximum dose in the left anterior descending coronary artery was reduced with VMAT (P = 0.005); V5 for the contralateral breast, contralateral lung, and total?body increased markedly in VMAT, and for the ipsilateral lung (V5IL) also in IMRT, compared with 3D?CRT (P < 0.001). In the right?sided plans, the V5 values, except for V5IL, did not differ between the three techniques. Conclusions: IMRT and VMAT had a limited heart?sparing benefit in the left?sided free?breathing WBI, at the cost of increased low?dose volumes, measured by V5. The low?dose volumes are not increased by IMRT or VMAT in the right?sided WBI, where heart sparing is not a problem, but the attempts to reduce cardiac doses in the left?sided WBI increase them.

Hipoventilação relacionada ao sono de origem central secundária à deficiência de biotinidase: relato de caso / Sleep-related hypoventilation due to partial biotinidase deficiency: a case repor

RESUMO: A hipoventilação relacionada ao sono de origem central resulta em hipercapnia relacionada ao sono na vigência de condições normais do sistema respiratório e excluindo-se outros fatores. Os pacientes portadores dessa patologia podem se apresentar assintomáticos ou com queixas de cefaleia matinal, déficit cognitivo e fadiga, além de eventos como a observação de respiração superficial. No presente relato, descreve-se o caso de uma paciente de três anos, com exame físico geral e neurológico normais, desenvolvimento neuropsicomotor adequado, apresentando irregu-laridades respiratórias e bradicardia durante o sono. Encaminhada para investigação de distúrbios respiratórios do sono, sendo diagnosticada com hipoventilação relacionada ao sono. Através do estudo genético, evidenciou-se a deficiência de biotinidase como a possível causa da sintomatologia, comprovada por dosagens enzimáticas e teste genético molecular. O tratamento medicamentoso foi iniciado precocemente, determinando resolução dos sintomas descritos. A importância do presente relato se encontra na apresentação da deficiência da biotinidase com quadro cardiorrespiratório isolado em criança neurologicamente normal, ademais trata-se de um caso em que a etiologia de Breath-Holding Spells foi a deficiência dessa enzima. Correspondência sugerida pela resolução da hipoventila-ção central após a introdução da biotina. Além disso, nesse caso, os sintomas Apparent Life-Threatening Events, que aterrorizam o observador e até o profissional, foram solucionados com tratamento simples, a ingesta oral de biotina. Esse relato de caso corrobora com a expansão das possibilidades de manifestações fenotípicas das formas tardias de deficiência de biotinidase, como o fenótipo da Síndrome da Hipoventilação Central. (AU)

ABSTRACT: Idiopathic sleep-related hypoventilation occurs in individuals with hypercapnia during sleep in normal conditions of the respiratory system in the absence of other disorders. Patients with this condition may be asymptomatic or have complaints of morning headache, cognitive deficit and fatigue, and observation of shallow breathing. This report describes the case of a 3-year-old patient with normal physical and neurological exam, appropriate neuropsychomotor development, presenting breathing irregularities, and bradycardia during sleep. The patient was referred to an investigation for sleep respiratory disturbs and was diagnosed with hypoventilation related to sleep. The genetic study, done by enzymatic dosages and molecular genetic tests, showed the deficiency of biotinidase as a possible cause of symptomatology. The drug treatment was initiated early with the resolution of the symptoms. The present clinical report highlights the biotinidase deficiency with an isolated cardiorespiratory condition in a neurologically normal child, which also led to Breath-Holding Spells. This relation was suggested after central hypoventilation resolution following biotin introduction. Besides, Apparent Life-Threatening Events symptoms, which terrify the observer and even professionals, disappeared after the oral intake of biotin. Finally, this case report corroborates the expansion of possibilities for the phenotypic manifestations of late cases from biotinidase deficiency, as the SHC phenotyp. ((AU)

Impact of inorganic salts on vase life and postharvest qualities of the cut flower of Perpetual Carnation / Investigar os efeitos dos sais inorgânicos na vida dos vasos e nas qualidades pós-colheita da flor de corte do Cravo Perpétuo

Abstract This study was carried out in the laboratory of Shangqiu Institute of Technology, Henan to investigate the effect of a different combination of inorganic salt on the quality and physiological characteristics of cut flowers (CFs) of Perpetual Carnation. Furthermore, to find out the best preservation solution of inorganic salt that can enhance the ornamental value of CFs of Carnation and prolong its vase life. Sucrose, 8-hydroxyquinoline, paclobutrazol, salicylic acid and different kinds of inorganic salts were added as a preservation solution. And the same amount of distilled water was used as control. The effects of these various inorganic salts on the morphological characteristics including vase life, changes in flower stems, fresh weight (FW) and water balance and the physiological characteristics including contents of malondialdehyde (MDA), cell membrane permeability and the contents of proline of carnation were investigated. The CFs placed in vase solution with inorganic salts showed significant changes in its morphology and physiological characteristics as compared to control. The changes in flower diameter (FD), FW, malondialdehyde and cell membrane permeability showed an increasing trend first and then decreasing. The value of water balance was observed with a downward trend. However, the vase life, FD, the contents of malondialdehyde, contents of proline and FW of CFs held in the preservative solution containing inorganic salts were increased than that of control. The fresh preservative solution contained sucrose 3% + 8-hydroxyquinoline (8-HQ) (200 mg·L‾1) + paclobutrazol (100 mg·L‾1) + salicylic acid (SA) (25 mg·L‾1) + CaCl2 (100 mg·L‾1) has the best effect on longevity (34 days), FW and FD of carnation CFs. This solution has improved the ornamental and physiological characteristics of fresh carnation CFs.

Resumo Este estudo foi realizado no laboratório do Instituto de Tecnologia de Shangqiu, Henan, para investigar o efeito de diferentes combinações de sal inorgânico na qualidade e características fisiológicas de flores cortadas do Cravo Perpétuo. Além disso, para descobrir a melhor solução de preservação de sal inorgânico que pode aumentar o valor ornamental das flores cortadas de Cravo e prolongar a vida do vaso. Sucrose, 8-hidroxiquinolina, paclobutrazol, ácido salicílico e diferentes tipos de sais inorgânicos foram adicionados como uma solução de preservação. E a mesma quantidade de água destilada foi usada como controle. Os efeitos destes vários sais inorgânicos sobre as características morfológicas incluindo a vida dos vasos, alterações nos caules, peso fresco e balanço hídrico e as características fisiológicas incluindo conteúdo de malondialdeído (MDA), permeabilidade da membrana celular e conteúdo de prolina de cravo foram investigados. As flores de corte colocadas em solução de vaso com sais inorgânicos apresentaram mudanças significativas em sua morfologia e características fisiológicas em relação ao controle. As alterações no diâmetro das flores, no peso fresco, no malondialdeído e na permeabilidade da membrana celular mostraram uma tendência crescente primeiro e depois decrescendo. O valor do balanço hídrico foi observado com tendência de queda. No entanto, a vida útil do vaso, o diâmetro da flor, o conteúdo de malondialdeído, o conteúdo de prolina e o peso fresco de flores cortadas mantidos na solução preservativa contendo sais inorgânicos foram aumentados em relação ao controle. A solução conservante fresca continha sacarose 3% + 8-hidroxiquinolina (8-HQ) (200 mg·L‾1) + paclobutrazol (100 mg·L‾1) + ácido salicílico (SA) (25 mg·L‾1) + CaCl2 (100 mg·L‾1) tem o melhor efeito na longevidade (34 dias), peso fresco e diâmetro de flor de flores cortadas de cravo. Esta solução melhorou as características ornamentais e fisiológicas das flores frescas de cravo.

Clinical features of infants with breath-holding spells and the characteristics of electroencephalogram as well as heart rate during the episode / 中华实用儿科临床杂志

Objective:To analyze the electroencephalogram (EEG) characteristics, heart rate (HR) changes and clinical characteristics during the episode of breath-holding spells(BHS), thus providing refe-rences for the differential diagnosis of infants with BHS.Methods:This was a retrospective single-center analysis involving consecutive 14 infants with HBS admitted in Wuhan Children′s Hospital, Tongji Medical College, Huazhong University of Science & Technology from November 2016 to December 2019.Results:A total of 16 episodes of crying-induced BHS were detected in the EEG of 14 infants, of which 3 were mild episodes without loss of consciousness and 13 were severe episodes with loss of consciousness.During the mild episodes, EEG presented a phase with slow-slow mode, and the average duration of each phase was (23.3±5.8) s and (16.7±5.8) s, respectively.In addition, the average recovery time from unconsciousness in 13 severe episodes was (16.7±12.3) s. Among the 13 severe episodes, EEG of 12 episodes presented a phase with slow-flat-slow mode, and the average duration of each phase was (26.4±8.5) s, (8.0±5.1) s and (84.6±46.6) s, respectively.Besides, the second slow wave phase usually started by the generalized delta rhythm with predominance in leads of anterior brain, with the average duration at (6.7±1.5) s. During the 16 episodes of BHS, cyanosis occurred in the first phase of slow wav, and loss of consciousness occurred in the flat phase.Transient bradycardia was observed in the second slow wave phase of 7 episodes, the first slow wave phase of 4 episodes and the flat phase of 2 episodes.Conclusions:Typical EEG pattern of in infants with mild BHS is slow-slow mode, and most of them with severe BHS is slow-flat-slow mode.In the first slow wave phase, slow wave always evolves rapidly.The unconsciousness mostly occurs in the flat period, the lasting time of which is closely related to the duration of the flat phase.The generalized delta rhythm with predominance in leads of anterior brain mostly starts in the second slow wave phase.A brief bradycardia often accompanies with the episodes of BHS in infants.

Tuberculosis case finding and case holding practices in selected Drug Abuse Treatment and Rehabilitation Centers (DATRCS) in Luzon, Philippines

@#<p style="text-align: justify;"><strong>Background and Objectives:</strong> Tuberculosis (TB) remains a public health problem in the Philippines despite trends indicating a decline in the burden of disease. Persons who use drugs who are confined in government-retained drug abuse treatment and rehabilitation centers (DATRCs) face an increased risk for TB because of the congestion in the facility coupled with the absence of guidelines on TB management specific to DATRCs. Thus, this study was conducted to document the current case finding and case holding practices as well as TB treatment pathway in six (6) Luzon-based, government-retained DATRCs.</p><p style="text-align: justify;"><strong>Methods:</strong> Key informant interviews were conducted with DATRC personnel involved in TB diagnosis and management in six selected DATRCs in Luzon, Philippines. Interviews were transcribed and coded for thematic analysis. We compared the DATRC practices with the provisions of the 2014 National TB Control Program (NTP) Manual of Procedures. Results were validated through a workshop with (a) a group of physicians and rehabilitation practitioners assigned in other DATRCs; and (b) a group of experts who have experience in managing or overseeing DATRCs in the country.</p><p style="text-align: justify;"><strong>Results:</strong> Two physicians and four nurses participated in the interviews. Variations in case finding and case holding practices in six DATRCs have been found. National guidelines exist for congregate settings but are more specific to jails/prisons, which are administratively and operationally different from DATRCs.</p><p style="text-align: justify;"><strong>Conclusion:</strong> Development of special guidelines for TB case finding and case holding in DATRCs as well as staff training on the latest NTP Manual of Procedures are recommended. However, gaps and inequities posed by the current set-up underscore the need to address health system-wide factors affecting the practice and performance of these facilities.</p><p style="text-align: justify;"><strong>Key Words:</strong> tuberculosis, case finding, case holding, drug abuse treatment and rehabilitation centers, Philippines</p>

As experiências emocionais e o intelecto: Os aportes de Bion e Winnicott / Emotional experiences and the intellect: The contributions of Bion and Winnicott / Las experiencias emocionales y el intelecto: Los aportes de Bion y Winnicott

Este artigo aborda como o intelecto interage com as experiências emocionais. Constata-se existir cada vez mais indivíduos, de diferentes faixas etárias, que priorizam a busca de informações instantâneas sem investir no desenvolvimento do pensar/conhecer, bem como indivíduos que se desenvolvem intelectualmente, porém não conseguem lidar de modo compatível com as experiências emocionais. Propomos, no presente trabalho, uma reflexão sobre os aspectos defensivos que permeiam o desenvolvimento emocional/intelectual segundo Bion e Winnicott.

This article discusses how the intellect interacts with emotional experiences. Evidence shows that there are more and more individuals from different age groups who prioritize the search for instant information without investing in the development of thinking / knowing, as well as individuals who develop intellectually, but cannot cope with the emotional experiences. In this paper, we propose a reflection on the defensive aspects that permeate the emotional / intellectual development according to Bion and Winnicott.

Este artículo analiza cómo el intelecto interactúa con las experiencias emocionales. Existen evidencias de que hay cada vez más personas de diferentes grupos de edad que priorizan la búsqueda de informaciones instantáneas sin invertir en el desarrollo del pensamiento / conocimiento, así como personas que se desarrollan intelectualmente, pero no pueden hacer frente a las experiencias emocionales. En este artículo, proponemos una reflexión sobre los aspectos defensivos que impregnan el desarrollo emocional / intelectual según Bion y Winnicott.

Effect Of Yoga And Pranayama On Chest Expansion And Breath Holding Time In Chefs Exposed To Cooking Fumes

Background: Chefs exposed to cooking fumes are at risk due to the toxic products that are produced during cooking. Studies have shown that exposure to cooking fumes decreases lung capacities, affects breathing and cause other respiratory diseases. Yoga strengthens the respiratory musculature due to which chest and lungs inflate & deflate to fullest possible extent & muscles are made to work to maximal extent. Pranayama makes efficient use of abdominal & diaphragmatic muscles and improves the respiratory apparatus. Aim: The present study was done to determine the effect of Yoga & Pranayama on chest expansion & breath holding time in chefs exposed to cooking fumes. Methods: In this experimental study 30 chefs exposed to cooking fumes who fulfilled the inclusion and exclusion criteria using Medical research council questionnaire for respiratory symptoms were selected for yoga and pranayama program for 6 weeks, 3 sessions per week for 45 minutes. Pre and post respiratory functions were assessed by measuring chest expansion and breath holding time. Stastical analysis was done by using Wilcoxan test to compare the pre & post chest expansion. Paired t test was used to compare the pre & post breath holding time. Results: There was significant increase in chest expansion and breath holding time compared to pre yoga and pranayama practice. Conclusion: This study showed that there is significant effect of yoga and pranayama on chest expansion & breath holding on chefs.

El cromo-levadura y la ractopamina afectan el perfil de ácidos grasos y la calidad de la carne en cerdos / Chromium-yeast and ractopamine affect the profile of fatty acids and quality of meat in pigs

RESUMEN Los consumidores de cerdo demandan productos bajos en grasa y sin aditivos que afecten la salud humana. El objetivo de este trabajo fue evaluar el efecto del cromo-levadura o ractopamina adicionadas a la dieta de cerdos, sobre el rendimiento, las características de la canal y la calidad de la carne. Se distribuyeron 20 cerdos de manera aleatoria en cuatro tratamientos: sin adición de cromo-levadura, ni ractopamina (T1); 10ppm de ractopamina (T2); 0,2ppm de cromo-levadura (T3) y 0,4ppm de cromo- levadura (T4). Se determinó el espesor de la grasa dorsal al inicio, al intermedio y al final del estudio. El rendimiento en canal caliente y fría se estimó en el frigorífico. Muestras de la cabeza del lomo fueron tomadas para evaluar pH, resistencia al corte, goteo, temperatura, retención de agua y contenido de ácidos grasos. Se realizó un análisis descriptivo de los datos y de Kruskal-Wallis, para determinar el efecto del tratamiento sobre las variables medidas. Ninguna suplementación afectó la ganancia de peso, peso final, conversión alimenticia, consumo alimento, rendimiento en canal caliente, rendimiento canal fría y grasa dorsal (P>0,05). La resistencia al corte aumentó con la ractopamina, pero disminuyó con el cromo-levadura. Las pérdidas por goteo fueron significativas con 0,2ppm de cromo-levadura, pero no lo fueron con 0,4ppm de cromo-levadura o ractopamina. No se encontró efecto de la ractopamina sobre los ácidos grasos, pero sí del cromo-levadura. Tanto el cromo-levadura como la ractopamina modifican características de la carne, como la dureza y el perfil de ácidos grasos.

ABSTRACT The consumers of pork demand products low in fat and free of additives that affect the human health. The objective of this study was to evaluate the effect of chromium-yeast or ractopamine added to the diet of pigs on the performance, characteristics of the carcass and meat quality. Twenty pigs were randomized to four treatments: without the addition of chromium-yeast or ractopamine (T1); 10ppm of ractopamine (T2); 0.2ppm of chromium-yeast (T3) and 0.4ppm of chromium-yeast (T4). The backfat thickness was evaluated at the beginning, at the intermediate and at the end of the experiment. Hot carcass yield and cold carcass yield was evaluated in the slaughter house. Loin samples were taken to evaluate pH, shear force, drip loss, temperature, water retention and fatty acid composition. A descriptive analysis of the data and Kruskal-Wallis was carried out to determine the effect of the treatment on the measured variables. Any supplementation affected significantly weight gain, final weight, feed conversion, feed intake, hot carcass yield, cold carcass yield and backfat thinkness (P>0,05). Shear force increased with ractopamine, but decreased with chrome-yeast. Drip losses were significant at 0.2ppm chromium-yeast, but were not significant at 0.4ppm chromium-yeast or ractopamine. There was no effect of ractopamine on fatty acids, but with chromium-yeast was significant. Both chrome-yeast and ractopamine modify meat characteristics such as hardness and fatty acid profile.

El diagnóstico de trastorno del espectro autista (TEA) a temprana edad del niño y sus consecuencias en el encuentro-desencuentro entre los padres y su hijo / Le diagnostique trouble du spectre autistique (TSA), en bas âge et ses consequénces dans la rencontre o la divergence entre les parents et leur enfant / The autism spectrum disorder (ASD) at an early age and its consequences on the encounters and missed encounters between parents and their children / O diagnóstico de transtorno do espectro do autismo (TEA) em terna idade da criança e suas consequências no encontro-desencontro entre os pais e o filho

En los últimos años llegan a mi consulta niñas y niños entre los dos y los nueve años de edad diagnosticados tempranamente con TEA. Dicho diagnóstico es realizado, por otros profesionales, que desde la observación fenomenológica ubican en el niño alguna de las características presente en el cuadro clínico de autismo. A partir de tres viñetas clínicas con padres (de modalidades psíquicas e historias diferentes), reflexionaré qué les sucedió en el desencuentro con su bebé y de qué manera la enunciación de determinado tipo de diagnóstico imposibilitó que ese desencuentro inicial se transforme en un encuentro conjunto madre-hijo y padre-hijo. Cuando ocurre la posibilidad de este encuentro entre los padres y su hijo, el mismo se constituye en el punto de partida de un desarrollo más pleno de la subjetividad del niño(AU)

Ces dernières anneés, ils sont arrivés a mon cabinet des filles et fils entre les deux et les neuf ans qui portent le diagnostic TSA. Ce diagnostic a été fait par des professionels qui, du point de vue de l'observation phenomenologique, ont trouve dans l'enfant quelque charactéristiques du cadre autiste. A partir de trois vignettes cliniques (les parents ont de modalités psichiques et d'histoires differénts) je refléchirai sur la divergence entre eux et leur bébé et comment l'énunciation de ce diagnostic empêche la transformation de cette divergence initial dans une rencontre conjoint merè -fils et perè-fils. Quand cette rencontre entre les parents et leur fils est possible, elle se transforme en partie constituante d'une développement plus pleine de la subjectivité del' enfant(AU)

In recent years I came across consultations of children between two and nine years old who had been previously diagnosed with ASD at an early age. Such diagnose was made by other professionals who, from a phenomenological analysis, place the patient under some features of the clinical picture of autism. Taking into account three clinical vignettes with parents of diverse psychic modalities and stories, I will reflect over the past events that lead to a missed encounter with their babies and in which way the annunciation of a determined diagnose precludes the possibility of that missed encounter to transform into a joint meeting parent-child. When an encounter parent-child occurs, it represents the starting point of a fulfilled development of the child's subjectivity(AU)

Nos últimos anos, meninos e meninas com idades entre dois e nove anos diagnosticados com TEA chegam cedo ao meu consultório. Esse diagnóstico é feito por outros profissionais que, a partir da observação fenomenológica, localizam na criança algumas das características presentes no quadro clínico do autismo. A partir de três vinhetas clínicas com pais (de modalidades psíquicas e histórias diferentes), refletirei sobre o que aconteceu com eles no desencontro com seu bebê e como a enunciação de um certo tipo de diagnóstico torna impossível que esse desencontro inicial se torne um encontro conjunto mãe-filho e pai e filho. Quando a possibilidade desse encontro entre os pais e o filho ocorre, torna-se o ponto de partida para um desenvolvimento pleno da subjetividade da criança(AU)

Tornar-se mãe: Construindo o vínculo parento-filial na adoção tardia / Becoming a Mother: Establishing the Parent-Child Bond in Late Adoption / Convertirse en madre: Construyendo el vínculo parento-filial en la adopción tardía

Este estudo teve como objetivo investigara construção do vínculo parento-filial na adoção tardia. Foi realizado um estudo de caso, com base nos dados obtidos por meio de uma entrevista semiestruturada com uma mãe adotiva. Evidenciou-se a importância de a mãe se colocar disponível frente às necessidades da filha, permitindo que vivências anteriores à adoção fossem reparadas. A partir de uma leitura winnicottiana foi possível destacar que, assim como nos casos em que houve gestação biológica, os pais adotivos devem experienciar o estado de "preocupação materna primária", mesmo em momento tardio, oferecendo holding e funcionando como ambiente suficientemente bom para a criança. Constatou-se que mãe e filha se colocaram na relação, construindo o vínculo afetivo de forma mútua. O preparo dos pretendentes à adoção se mostrou essencial diante dos desafios do percurso de construção do vínculo parento-filial, sendo ressaltada a colaboração dos Grupos de Apoio à Adoção.(AU)

The purpose of this article was to investigate the establishment of the parent-child bond in late adoption. The authors conducted a case study based on data collected in a semi-structured interview with an adoptive mother. The researchers noted the importance of the mother showing herself available to face the needs of the child, allowing for experiences previous to the adoption to be repaired. By a Winnicottian approach, the authors highlighted that, same as in cases of biological gestation; adoptive parents must experience the state of primary maternal preoccupation, even if it happens late, offering a healthy holding environment for the child. The researchers also observed that mother and daughter placed themselves in the relationship, building an emotional bond in a mutual fashion. The preparation of aspiring adoptive parents was shown essential to face the challenges of establishing a parent-child bold, a path in which Adoption Support Groups also played an important supporting role.(AU)

Este estudio tuvo como objetivo investigar la construcción del vínculo parento-filial en la adopción tardía. Fue realizado un estudio de caso, con base en los datos obtenidos a través de una entrevista semiestructurada con una madre adoptiva. Se evidenció la importancia de la madre hacerse disponible frente a las necesidades de la hija, permitiendo que vivencias anteriores a la adopción fuesen reparadas. A partir de una lectura winnicottiana fue posible destacar que, así como en los casos en que hubo gestación biológica, los padres adoptivos deben sentir el estado de "preocupación materna primaria", aunque en un momento tardío, ofreciendo "holding" y funcionando como ambiente suficientemente sano para el niño. Se constató que madre e hija se colocaron en la relación, construyendo un vínculo afectivo de forma mutua. La preparación de los pretendientes a la adopción se mostró esencial frente a los desafíos del recorrido de construcción del vínculo parento-filial, siendo resaltada la colaboración de los Grupos de Apoyo a la Adopción.(AU)

Influence analysis of temperature-holding nursing in the anesthesia and stress state during the recovery period of general anesthesia / 中国实用护理杂志

Objective To discuss the influence of temperature-holding nursing in the anesthesia and stress state during the recovery period of general anesthesia for patients with thoracoscopic lung surgery. Methods 120 patients with thoracoscopic lung surgery underwent the general anesthesia from January 2017 to July 2018 in our hospital were selected and randomly assigned to two groups, 60 cases in each group. At the recovery period, the control group was treated with conventional nursing; the observation group was treated with conventional nursing and temperature-holding nursing. At each time period, the body temperature, stress response and postoperative rehabilitation conditions were probed. Results At the end of the operation 30 minutes, 60 minutes and the end of the operation, the body temperature of the observation group was (36.39 ± 0.34)°C, (36.50 ± 0.38)°C, (36.56 ± 0.38)°C, and the control group was (35.49 ± 0.31)°C, (35.63 ± 0.41) °C, (36.17 ± 0.52)°C, the difference between the two groups was statistically significant (t=15.15, 12.01, 4.69, P<0.05). NE was (279.3 ± 87.4)ng/L, (321.5 ± 110.6)ng/L, (363.5±108.2) ng/L at 30 min, 60 min, and end of surgery. E was (342.5±81.6)ng/L, (320.2± 59.4)ng/L, (169.4±54.2)ng/L at 30 min, 60 min, and end of surgery. NE in the control group were (244.8± 87.5)ng/L, (390.8±98.6)ng/L, (469.7±97.7)ng/L, and E was (129.5±39.6)ng/, (187.0±51.3) ng/L, (327.6 ± 68.9) ng/L, and he difference between the two groups was statistically significant (t=2.161~13.979, P<0.05).The operation time, the postoperative retention time of PACU, the complete recovery of consciousness and the time of removal of tracheal catheter in the observation group were (65.93±21.94) min, (32.85±3.22) min, (18.60±5.26) min, (24.19±6.73) min, respectively. The groups were (87.52±18.42) min, (50.06 ± 4.27) min, (26.54 ± 4.81) min, (32.40 ± 8.05) min, and the difference between the two groups was statistically significant (t=5.838~24.927, P<0.05). Conclusion The temperature-holding nursing can improve the recovery conditions and reduce the stress response for patients with thoracoscopic lung surgery. It is worthy of clinical promotion.

Influence analysis of temperature-holding nursing in the anesthesia and stress state during the recovery period of general anesthesia / 中国实用护理杂志

Objective@#To discuss the influence of temperature-holding nursing in the anesthesia and stress state during the recovery period of general anesthesia for patients with thoracoscopic lung surgery.@*Methods@#120 patients with thoracoscopic lung surgery underwent the general anesthesia from January 2017 to July 2018 in our hospital were selected and randomly assigned to two groups, 60 cases in each group. At the recovery period, the control group was treated with conventional nursing; the observation group was treated with conventional nursing and temperature-holding nursing. At each time period, the body temperature, stress response and postoperative rehabilitation conditions were probed.@*Results@#At the end of the operation 30 minutes, 60 minutes and the end of the operation, the body temperature of the observation group was (36.39±0.34)°C, (36.50±0.38)°C, (36.56±0.38)°C, and the control group was (35.49±0.31)°C, (35.63±0.41) °C, (36.17±0.52)°C, the difference between the two groups was statistically significant (t=15.15, 12.01, 4.69, P<0.05). NE was (279.3±87.4)ng/L, (321.5±110.6)ng/L, (363.5±108.2) ng/L at 30 min, 60 min, and end of surgery. E was (342.5±81.6)ng/L, (320.2±59.4)ng/L, (169.4±54.2)ng/L at 30 min, 60 min, and end of surgery. NE in the control group were (244.8±87.5)ng/L, (390.8±98.6)ng/L, (469.7±97.7)ng/L, and E was (129.5±39.6)ng/, (187.0±51.3) ng/L, (327.6 ±68.9) ng/L, and he difference between the two groups was statistically significant (t=2.161~13.979, P <0.05).The operation time, the postoperative retention time of PACU, the complete recovery of consciousness and the time of removal of tracheal catheter in the observation group were (65.93±21.94) min, (32.85±3.22) min, (18.60±5.26) min, (24.19±6.73) min, respectively. The groups were (87.52±18.42) min, (50.06±4.27) min, (26.54±4.81) min, (32.40±8.05) min, and the difference between the two groups was statistically significant (t=5.838~24.927, P<0.05).@*Conclusion@#The temperature-holding nursing can improve the recovery conditions and reduce the stress response for patients with thoracoscopic lung surgery. It is worthy of clinical promotion.

The ergonomic analysis of different holding gun methods for standing guard soldiers / 中华劳动卫生职业病杂志

Objective@#To study the effects of different holding gun methods and gun weight on health when standing guard, and propose a way to support the health of long-term standing guard soldiers.@*Methods@#We created different percentile mannequins by Classic JACK, and adjusted the standing guard posture based on its standards for soldiers. The pressure on lumbar L4/L5 and moment on ankles and knees were analysied for different holding gun methods and gun weight. Then the mathematical models of joint load, gun weight and body mass index were studied by multiple regression analysis.@*Results@#Holding gun methods and gun weight influence the force characteristics on ankles, knees and lumbar L4/L5. Holding gun with a brace and hands applying downward force -2 kgf could significantly reduce lumbar L4/L5 pressure. When the hand force is -5, -3, -4, -3, -2, -1, 0, 1, 2 kgf, and the weight of the gun is 0, Lumbar vertebrae L4/L5 joint pressure of people with different body mass index(P1, P5, P55, P95, P99) are the smallest, respectively 269, 281, 321, 408, 444 N, and the same change trend occurs when the weight of the gun is 2, 4, and 8 kg.The moment on ankles and knees were less with the same holding gun method and the hands downward force ranged from 0 to -4 kgf, and the higher the body mass index is, the more the hands downward force needed to make the moment on ankles and knees zero. That is, the moment on ankles could be zero when the hands downward force ranged from -1 to -3 kgf, the moment on knees could be zero when the hands downward force ranged from -1.1 to -3.7 kgf.@*Conclusion@#To reduce the pressure on lumbar L4/L5 and moment on ankles and knees, so as to cut down occupational risk of long-standing operation, we advise the long-term standing guard soldiers holding gun with a brace and hands applying downward force -2 kgf.

Lo extraño en la anorexia / THE STRANGE THING IN ANOREXY

En continuidad con lo trabajado en el artículo anterior publicado en este anuario titulado "Rechazo de lo femenino", y en relación a los crecientes fenómenos de violencia hacia el cuerpo de la mujer, haremos foco en el maltrato al cuerpo en las anorexias severas, ubicando como operadores de lectura los conceptos de extranjeridad, hospitalidad y enemistad. Consideramos que el cuerpo de la mujer porta lo femenino.En tanto lo femenino se constituye como lo Otro, lo ajeno, lo extranjero; si la extranjeridad no es alojada, se transforma en hostilidad y enemistad. Haremos entonces un recorrido por los conceptos mencionados, para recalar en la anorexia y situar algunas coordenadas de lo femenino como alteridad no alojada y por tanto rechazada en esta modalidad sintomática actual

Following the work in the previous article published in this yearbook entitled "Rejection of the feminine", and in relation to the growing phenomena of mistreatment of the woman's body, we will focus on the mistreatment of the body in severe anorexias, placing as reading drivers the concepts of foreignness, hospitality and enmity.We consider that the woman's body carries the feminine. As long as the feminine is constituted as the Other, the alien, the foreign; If foreignness is not held, it becomes hostility and enmity. We will then take review the aforementioned concepts, to arrive at anorexia and place some coordinates of the feminine as an unheld alternativ and therefore rejected in this current symptomatic modality

Breath Holding Spasms – a clinical review

Breath holding spasms are common psychological problems seen in children and may serve as a markerfor stubbornness and anger. There are no clear clinical guidelines for the management of breath holdingspasms whereas a medical and psychological approach works best in both cases. The present paper is aclinical review on breath holding spasms for psychiatrists and serves as an overview of the topic. Variousmedical and non medical interventions are also discussed along with management.

Optimization of the Flip Angle and Scan Timing in Hepatobiliary Phase Imaging Using T1-Weighted, CAIPIRINHA GRE Imaging

PURPOSE: This study was designed to optimize the flip angle (FA) and scan timing of the hepatobiliary phase (HBP) using the 3D T1-weighted, gradient-echo (GRE) imaging with controlled aliasing in parallel imaging results in higher acceleration (CAIPIRINHA) technique on gadoxetic acid-enhanced 3T liver MR imaging. MATERIALS AND METHODS: Sixty-two patients who underwent gadoxetic acid-enhanced 3T liver MR imaging were included in this study. Four 3D T1-weighted GRE imaging studies using the CAIPIRINHA technique and FAs of 9° and 13° were acquired during HBP at 15 and 20 min after intravenous injection of gadoxetic acid. Two abdominal radiologists, who were blinded to the FA and the timing of image acquisition, assessed the sharpness of liver edge, hepatic vessel clarity, lesion conspicuity, artifact severity, and overall image quality using a five-point scale. Quantitative analysis was performed by another radiologist to estimate the relative liver enhancement (RLE) and the signal-to-noise ratio (SNR). Statistical analyses were performed using the Wilcoxon signed rank test and one-way analysis of variance. RESULTS: The scores of the HBP with an FA of 13° during the same delayed time were significantly higher than those of the HBP with an FA of 9° in all the assessment items (P < 0.01). In terms of the delay time, images at the same FA obtained with a 20-min-HBP showed better quality than those obtained with a 15-min-HBP. There was no significant difference in qualitative scores between the 20-min-HBP and the 15-min-HBP images in the non-liver cirrhosis (LC) group except for the hepatic vessel clarity score with 9° FA. In the quantitative analysis, a statistically significant difference was found in the degree of RLE in the four HBP images (P = 0.012). However, in the subgroup analysis, no significant difference in RLE was found in the four HBP images in either the LC or the non-LC groups. The SNR did not differ significantly in the four HBP images. In the subgroup analysis, 20-min-HBP imaging with a 13° FA showed the highest SNR value in the LC-group, whereas 15-min-HBP imaging with a 13° FA showed the best value of SNR in the non-LC group. CONCLUSION: The use of a moderately high FA improves the image quality and lesion conspicuity on 3D, T1-weighted GRE imaging using the CAIPIRINHA technique on gadoxetic acid, 3T liver MR imaging. In patients with normal liver function, the 15-min-HBP with a 13° FA represents a feasible option without a significant decrease in image quality.

The effects of finger-holding force ball on preventing unplanned extubation in ICU patients / 中华护理杂志

Objective To observe the effects of finger-holding force ball on prevention of unplanned extubation in ICU patients.Methods A convenient sampling method was used to select 70 patients from January to June 2017 who received tracheal intubation,femoral vein catheterization or bladder catheter.From April to June 2017,35 patients were selected as the experimental group,and hand restraint was strengthened by means of finger-holding force ball.Thirty-five patients recruited from January to March 2017 were selected as the control group,and wrist restraint was performed by routine method.The risk rate of extubation and the skin injury of the wrist in two groups were compared.Results The risk rate of extubation in the experimental group for femoral vein catheterization,bladder catheter and tracheal intubation was 6.37 cases/1000 catheter days,0 and 5.68 cases/1000 catheter days,lower than 200.00 cases/1000 catheter days,177.60 cases/1000 catheter days,and 230.34 cases/1000 catheter days in the control group,with statistically significant differences(P＜0.001);redness and skin injury at wrist restraint site in the experimental group was 5.71％ and 0,lower than 22.86％ and 17.14％ in the control group,and the differences were statistically significant (P＜0.05).Conclusion The finger-holding force ball is easy to use,the effects are good,and it is much more comfortable to use the finger-holding force ball than traditional restraint tools.

Metabolism of broilers subjected to different lairage times at the abattoir and its relationship with broiler meat quality / Metabolismo de frangos de corte submetidos a diferentes tempos de espera no abatedouro e sua relação com a qualidade da carne

An investigation was made into the effects of different lairage times and the position of chicken crates during transport to the slaughterhouse on the biochemical and hematological profile and physical parameters of broilers, such as color and pH of their breast meat. The treatments were defined by the animals slaughtered after 0, 2, 4 and 6 hours of lairage time at the slaughterhouse, transported in crates located in the top and bottom layers of the truck. It was found that increasing the lairage time at the slaughterhouse to over two hours reduced the number of lymphocytes and increased the heterophil/lymphocyte (H/L) ratio and the basophil count in the hemogram. In addition, lactate dehydrogenase (LDH) activity and cholesterol levels increased and plasma triglyceride and glucose levels decreased. The position of the crates in the truck altered the creatine kinase (CK) activity, and the highest enzyme activity was found in birds transported in the top layer of crates in the truck. Furthermore, the long lairage time in the slaughterhouse increased the pH and the value of a* (redness value) and decreased the lightness value of breast fillets. The interaction significant between 4 and 6 hours of lairage time and the position of the crate in the top layer of the truck favored the development of dark, firm, dry (DFD) meat.(AU)

Este trabalho objetivou a avaliação dos efeitos dos diferentes tempos de espera e da posição das caixas de transporte no caminhão sobre perfil bioquímico e hematológico, além de parâmetros físicos da carne, como cor e pH do peito, de frangos de corte. Os tratamentos foram definidos pelos animais abatidos com zero, duas, quatro e seis horas de espera no abatedouro, posicionados nas partes superior e inferior do caminhão. Como resultado, verificou-se que o aumento do tempo de espera no abatedouro, acima de duas horas, resultou em redução no número de linfócitos, elevação da razão heterófilos/ linfócitos (H/L) e de basófilos no hemograma. Houve aumento da atividade de lactato desidrogenase (LDH), dos níveis de colesterol e redução de triglicerídeos e glicose no plasma. O posicionamento das caixas na parte superior da carroceria do caminhão elevou a enzima creatina quinase (CK) sanguínea. Além disso, o tempo prolongado na área de espera aumentou o pH final e o valor de a* (teor de vermelho) e diminuiu a luminosidade dos filés. A interação significante dos fatores tempo de espera de quatro e seis horas e a posição superior das caixas de transporte propiciaram o desenvolvimento de carnes duras, firmes e escuras (DFD) em frangos de corte.(AU)

Impact of inorganic salts on vase life and postharvest qualities of the cut flower of Perpetual Carnation

Abstract This study was carried out in the laboratory of Shangqiu Institute of Technology, Henan to investigate the effect of a different combination of inorganic salt on the quality and physiological characteristics of cut flowers (CFs) of Perpetual Carnation. Furthermore, to find out the best preservation solution of inorganic salt that can enhance the ornamental value of CFs of Carnation and prolong its vase life. Sucrose, 8-hydroxyquinoline, paclobutrazol, salicylic acid and different kinds of inorganic salts were added as a preservation solution. And the same amount of distilled water was used as control. The effects of these various inorganic salts on the morphological characteristics including vase life, changes in flower stems, fresh weight (FW) and water balance and the physiological characteristics including contents of malondialdehyde (MDA), cell membrane permeability and the contents of proline of carnation were investigated. The CFs placed in vase solution with inorganic salts showed significant changes in its morphology and physiological characteristics as compared to control. The changes in flower diameter (FD), FW, malondialdehyde and cell membrane permeability showed an increasing trend first and then decreasing. The value of water balance was observed with a downward trend. However, the vase life, FD, the contents of malondialdehyde, contents of proline and FW of CFs held in the preservative solution containing inorganic salts were increased than that of control. The fresh preservative solution contained sucrose 3% + 8-hydroxyquinoline (8-HQ) (200 mg·L1) + paclobutrazol (100 mg·L1) + salicylic acid (SA) (25 mg·L1) + CaCl2 (100 mg·L1) has the best effect on longevity (34 days), FW and FD of carnation CFs. This solution has improved the ornamental and physiological characteristics of fresh carnation CFs.

Resumo Este estudo foi realizado no laboratório do Instituto de Tecnologia de Shangqiu, Henan, para investigar o efeito de diferentes combinações de sal inorgânico na qualidade e características fisiológicas de flores cortadas do Cravo Perpétuo. Além disso, para descobrir a melhor solução de preservação de sal inorgânico que pode aumentar o valor ornamental das flores cortadas de Cravo e prolongar a vida do vaso. Sucrose, 8-hidroxiquinolina, paclobutrazol, ácido salicílico e diferentes tipos de sais inorgânicos foram adicionados como uma solução de preservação. E a mesma quantidade de água destilada foi usada como controle. Os efeitos destes vários sais inorgânicos sobre as características morfológicas incluindo a vida dos vasos, alterações nos caules, peso fresco e balanço hídrico e as características fisiológicas incluindo conteúdo de malondialdeído (MDA), permeabilidade da membrana celular e conteúdo de prolina de cravo foram investigados. As flores de corte colocadas em solução de vaso com sais inorgânicos apresentaram mudanças significativas em sua morfologia e características fisiológicas em relação ao controle. As alterações no diâmetro das flores, no peso fresco, no malondialdeído e na permeabilidade da membrana celular mostraram uma tendência crescente primeiro e depois decrescendo. O valor do balanço hídrico foi observado com tendência de queda. No entanto, a vida útil do vaso, o diâmetro da flor, o conteúdo de malondialdeído, o conteúdo de prolina e o peso fresco de flores cortadas mantidos na solução preservativa contendo sais inorgânicos foram aumentados em relação ao controle. A solução conservante fresca continha sacarose 3% + 8-hidroxiquinolina (8-HQ) (200 mg·L1) + paclobutrazol (100 mg·L1) + ácido salicílico (SA) (25 mg·L1) + CaCl2 (100 mg·L1) tem o melhor efeito na longevidade (34 dias), peso fresco e diâmetro de flor de flores cortadas de cravo. Esta solução melhorou as características ornamentais e fisiológicas das flores frescas de cravo.