Need for systematic screening for IGD in adolescent psychiatric inpatients.

Psychiatric comorbidities are frequent in adolescents with internet gaming disorder (IGD). In contrast, the proportion of IGD among adolescents hospitalized for a psychiatric disorder has not been documented yet. In addition, parental ratings of IGD could be useful for diagnosis, but very few data exist on this issue. The objectives of this study were to: (1) assess the prevalence of IGD among adolescent psychiatric inpatients, using the Ten-Item Internet Gaming Disorder Test (IGDT-10), and (2) assess the parental version developed for this study (IGDT-10-P). A total of 102 patients, aged from 12 to 17 years old, were included from four psychiatric units of the French region Auvergne-Rhône-Alpes, during a 6-month inclusion period. Adolescents completed the IGDT-10 while one of their parents completed the IGDT-10-P. The inclusion rate among the eligible population was 57.95%. The prevalence of IGD in the sample, based on the IGDT-10 and IGDT-10-P, was 6.00% and 12.79%, respectively. Psychometric features of the IGDT-10-P indicated excellent internal consistency, a good model fit to the one factor model in confirmatory factor analysis, a strong correlation with gaming time, and a moderate correlation with the IGDT-10. Our results support the need for a systematic screening of IGD among adolescents hospitalized for a psychiatric disorder. Future studies should aim to confirm and explain the prevalence gap between self- and parent-reported criteria.

Osteoblastoma of the mandible: systematic review of the literature and report of a case.

Benign osteoblastoma is a bone tumour that seldom occurs in the facial bones. The objective of this article is to add one more case of this rare lesion to the academic literature and to provide a systematic review of previously published cases. A new case of benign osteoblastoma is presented and clinical, radiographic and microscopic aspects, as well as differential diagnosis, treatment and follow-up are discussed. The importance of the correct diagnosis of this type of lesion is stressed, since it presents a clinical, radiographic and microscopic similarity to other bone lesions, including malignant tumours, which may lead the professional into conducting the case in an improper manner.

A contribution to the diagnosis of the small dentigerous cyst or the paradental cyst.

The aim of this study was to verify the relationship between the radiographically measured width of the pericoronal space (PS) and the microscopic features of the follicle in order to contribute to the diagnosis of small dentigerous cysts and paradental cysts. One hundred and thirty unerupted teeth (UT) and thirty-five partially erupted teeth (PET) were radiographed and extracted. The radiographic analysis consisted of measuring the width of the PS. The results of the radiographic analysis were compared with those of the histopathologic examination of the dental follicle. The width of the PS ranged from 0.1 to 5.6 mm. The most frequently observed lining of the follicles was a reduced enamel epithelium (REE) (68.4%) in UT and a hyperplastic stratified squamous epithelium (HSSE) (68.5%) in PET. Inflammation was present in 36.1% of the UT and in 82.8% of the PET. There was a statistically significant association between the presence of stratified squamous epithelium (SSE) and PS enlargement for UT (p < 0.05). There was a tendency of association between inflammation and PS enlargements in PET and, possibly, in UT, despite the absence of statistical significance. Surgically, we did not detect bone cavitation or luminal cystic contents in pericoronal spaces smaller than 5.6 mm. We suggest that the first radiographic diagnosis for a PS enlargement, in most of the routine clinical cases, should be of "inflammation of the follicle". The hypothesis of "dentigerous cyst" or "paradental cyst" is suggested as a second diagnosis. The final differential diagnosis between a small dentigerous or a paradental cyst and a pericoronal follicle depends on clinical and/or surgical findings, such as the presence of bone cavitation and cystic content.

Zoonotic sporotrichosis. Transmission to humans by infected domestic cat scratching: report of four cases in São Paulo, Brazil.

BACKGROUND: Sporotrichosis is a chronic, granulomatous, deep mycosis caused by the dimorphic fungus Sporothrix schenckii that usually results in indolent cutaneous lesions. OBJECTIVE: To describe four cases of human sporotrichosis transmitted by domestic cats in south-eastern Brazil. METHODS: Confirmation of the diagnosis was performed by histopathology, culture, and/or inoculation of hamsters. RESULTS: In all cases, the clinical findings in both cat and human groups were highly distinctive of the disease. In all human cases, there was a previous history of cat scratching before the development of lymphocutaneous lesions. Histopathology of the human lesions demonstrated the classical granulomatous and exudative pattern with scarce or absent fungal elements. Conversely, in cats, the cutaneous lesions were multiple, extensive, necrotic, exudative, and ulcerated. Histopathology revealed a widespread histiocytic reaction with a large number of fungal organisms. Disseminated lymphatic and visceral mycotic infection was observed in two necropsied cats. CONCLUSIONS: Domestic cats may be an important carrier of agents of sporotrichosis to humans.

Renal lesions in leprosy: a retrospective study of 199 autopsies.

In the present work, 199 patients with leprosy who underwent autopsy between 1970 and 1986 were retrospectively studied to determine the prevalence, types, clinical characteristics, and etiologic factors of renal lesions (RLs) in leprosy. Patients were divided into two groups: 144 patients with RLs (RL+) and 55 patients without RLs (RL-). RLs observed in 72% of the autopsied patients were amyloidosis (AMY) in 61 patients (31%), glomerulonephritis (GN) in 29 patients (14%), nephrosclerosis (NPS) in 22 patients (11%), tubulointerstitial nephritis (TIN) in 18 patients (9%), granuloma in 2 patients (1%), and other lesions in 12 patients (6%). AMY occurred most frequently in patients with lepromatous leprosy (36%; nonlepromatous leprosy, 5%; P < 0.01), recurrent erythema nodosum leprosum (33%; P < 0.02), and trophic ulcers (27%; 0.05 < P < 0.10). Ninety-seven percent of AMY was found in patients with lepromatous leprosy, 88% showed recurrent trophic ulcers, and 76% presented with erythema nodosum leprosum. NPS was found in older patients with arterial hypertension, neoplastic diseases, infectious diseases, and vasculitis associated with GN. Most patients with AMY presented with proteinuria (95%) and renal failure (88%). The most frequent causes of death were renal failure in patients with AMY (57%), infectious diseases in patients with GN (41%) and TIN (45%), and cardiovascular diseases in patients with NPS (41%). No difference in survival rates was observed among RL- patients and those with AMY, GN, NPS, or TIN.

Effects of affect, stereotype consistency, and valence of behavior on causal attributions.

The authors examined 3 hypotheses about the effects of 2 positive and 2 negative affects on causal attributions. On the basis of cognitive appraisal theories of emotion, they predicted that the grateful and angry participants would attribute causality for like-valenced behaviors to the target more strongly than would the happy and sad participants, respectively. Following an affect-induction procedure, 229 Anglo-American participants read a description of an African American target whose behavior was stereotype consistent or stereotype inconsistent and positive or negative in valence. As predicted, when the behavior was negative, the angry participants attributed it more strongly to the target than did the sad participants. When the behavior was positive, the grateful participants attributed it more strongly to the target than did the happy participants. The importance of distinguishing among affects and considering their multidimensional nature in predicting effects on social judgments is emphasized.

Gastroesophageal reflux disease: New oral findings.

OBJECTIVE: The objective of this study was to investigate the effects of gastroesophageal reflux disease (GERD) on dentition, salivary function, and oral mucosa. STUDY DESIGN: Thirty-one patients with esophagitis underwent medical evaluation, which included taking their medical history, performing both an esophagogastroduodenoscopy and esophagus biopsy, and conducting a stomatologic examination. The latter consisted of an extraoral and intraoral physical examination, saliva tests (flow, buffer capacity, and pH), and biopsy and morphometry of the palatal mucosa, as well as taking a history of the patients' habits. Fourteen healthy volunteers from the same population were used as a control group. RESULTS: No relationship between GERD and changes in the oral cavity was shown by saliva tests, oral clinical examination, or histopathologic examination of the palatal mucosa. However, morphometric analysis of the palatal epithelium showed a statistically significant difference between the patients with GERD and the control group. CONCLUSIONS: GERD is associated with microscopic alterations in the palatal mucosa (epithelial atrophy and increased fibroblast number), which are only detected by morphometry.

Serial Mitsuda tests for identification of reactional tuberculoid and reactional borderline leprosy forms.

The authors studied the Mitsuda reaction in 37 leprosy patients (18 reactional tuberculoid, 19 reactional borderline cases) and compared the results with clinical findings, histopathology and bacilloscopy. Evaluation of the Mitsuda reaction was carried out on days 30, 60, 90 and 120. Most of the reactional tuberculoid patients showed a Mitsuda reaction of +3 in opposition to the reactional borderline patients who showed only +. Bacilloscopic analysis revealed that in 75% of the reactional tuberculoid cases there were rare or no bacilli; bacilli were present in 95% of the reactional borderline cases. The authors conclude that reactional tuberculoid cases have a greater ability to clear bacilli than reactional borderline cases, and that the Mitsuda reaction is a useful tool for the differentiation between these two types of leprosy.

"Why don't they just call the cops?": Reasons for differential police contact among women with abusive partners.

Incidents of domestic violence are frequently not reported to police (e.g., Johnson, 1990; Langan & Innes, 1986; Roy, 1977), and people commonly assume that women's reasons for not calling about violence by a current or former partner are intrapersonal (e.g., shame, embarrassment, love). However, few researchers have asked battered women themselves about the frequency of their police contacts and their reasons for not calling the police. In this study, participants were recruited from a battered women's shelter and asked about their experiences with the police over the prior 6 months. Two thirds of the sample had had contact with the police during that time, but most did not have as much contact with the police as they had needed. Women gave multiple reasons for not calling the police; these reasons frequently included situational barriers, such as being physically prevented from using the telephone and/or being threatened with more violence. Only 3% of the sample reported that shame, embarrassment, or love were their sole reasons for not calling the police. Underreporting was related to previous (negative) experience with the police, as well as to the level of violence experienced. The practical implications of these findings are discussed.

Reduction of epidermal cell proliferation in skin lesions in lepromatous leprosy is greater than in indeterminate and tuberculoid leprosy lesions.

We have compared epidermal cell proliferation in skin biopsies from areas with lesions to contralateral areas without lesions in patients with indeterminate, tuberculoid and lepromatous leprosy. Cell proliferation was determined as the percentage of labeled cells in the basal and suprabasal epidermal layers, using autoradiographic preparations of skin biopsies taken 1 hr after a 3H-thymidine intradermal injection. We have found a significant reduction in epidermal cell proliferation in areas with lesions in the three groups of patients. The greatest reduction occurred in lepromatous patients. In lesions of patients with indeterminate or tuberculoid leprosy, the reduction was the same, and in both groups it was smaller than in lepromatous patients. In the areas without lesions, the index of labeled cells was similar to that of "normal" skin of nonleprosy patients. In the contralateral unaffected areas from leprosy patients and in "normal" skin from nonleprosy patients, as well as in affected areas from patients with indeterminate leprosy, epidermal cell labeling was greater in the suprabasal layer than in the basal layer. In lesions of lepromatous patients, cell labeling was greater in the basal layer than in the suprabasal layer. Our findings suggest that the reduction of epidermal cell proliferation in leprosy patients is restricted to the cell-mediated immune response, more intense in lepromatous leprosy. It does not seem to be related to denervation, which is greater in tuberculoid leprosy.

[Assessment of the Mitsuda reaction in lepromatous patients inactive before and after immunotherapy]. / Avaliação da reação de Mitsuda em pacientes virchovianos inativos antes eapós imunoterapia.

In this study the immunopotentiator levamisole as well as a mixture of BCG/Mycobacterium leprae were investigated in inactive lepromatous leprosy patients by using the Mitsuda reaction as a parameter. Twenty lepromatous patients ten years ago classified as histologically negative for Mitsuda's test were divided into three groups: five patients that were only retested with Mitsuda antigen; eight patients that received oral levamisol and seven patients that received a mixture of alive BCG plus autoclaved M. leprae. The results indicated that: 1) the levamisole did not alter the reactivity to lepromin in any of the patients studied; 2) neither the changes in the reactivity to lepromin by using the mixture (3 cases) nor those that occurred spontaneously (3 cases) were clear. They properly reflected the natural variation of patients with some degree of resistance to Mycobacterium leprae.