Case report: Challenges and implications of conduction system pacing in pediatrics: Case series.

Cardiac electrical stimulation in children usually is needed in the setting of complete congenital atrioventricular block, atrioventricular block after heart surgery, and bradycardia associated with some specific channelopathies. In cases of atrioventricular block, the high percentage of ventricular stimulation raises concern on the deleterious effects of chronic stimulation of the right ventricle. In recent years, physiologic stimulation has developed as a valid approach for adult patients and a great interest has risen in offering conduction system pacing also to the pediatric population. We present three pediatric cases of stimulation of the conduction system (His bundle or left bundle branch), in order to show the intrinsic particularities and challenges implied in these new techniques.

Suicidal Behavior in the First Wave of the COVID-19 Pandemic.

PURPOSE OF REVIEW: Since the declaration of the COVID-19 pandemic, there have been numerous social changes to try to ​​contain the spread of the disease. These sudden changes in daily life have also changed the way we relate to others, in addition to creating a climate of uncertainty and fear. Therefore, the objective of this review is to compile published data of the consequences of suicidal behavior in the first months from the onset of the pandemic. RECENT FINDINGS: The analysis reflects a concern about issues related to suicide since the beginning of the pandemic. A large number of online surveys have been released and have provided data on relatively large populations. The percentage of the population with suicidal ideation in that period seems to be approximately 5-15%. Many studies associate suicidal ideation with being young, female, and presence of sleep problems. Surveys of healthcare workers do not seem to indicate a higher prevalence of suicidal ideation compared to the general population. The incidence of suicide attempts seen in emergency departments did not seem to change, while the number of visits for other issues, unrelated to suicide, did decrease. The few studies on completed suicide do not indicate an increase in incidence in these first 6 months since March 2020, when the WHO declared the start of the pandemic. It does not seem that there have been major changes in the figures related to suicidal behavior in the studies from the first wave of the COVID-19 pandemic, although it is still too early to know the consequences it will have long term. The social and economic damages resulting from the pandemic will certainly take a long time to recover.

Acute and long-term success of ventricular tachycardia ablation in patients with ischemic heart disease in a Mexican center.

Objective: . To report the results of ventricular tachycardia (VT) catheter ablation in ischemic heart disease (IHD), and to identify risk factors associated with recurrence in a Mexican center. Materials and methods: . We made a retrospective review of the cases of VT ablation performed in our center from 2015 to 2022. We analyzed the characteristics of the patients and those of the procedures separately and we determined factors associated with recurrence. Results: . Fifty procedures were performed in 38 patients (84% male; mean age 58.1 years). Acute success rate was 82%, with a 28% of recurrences. Female sex (OR 3.33, IC 95% 1.66-6.68, p=0.006), atrial fibrillation (OR 3.5, IC 95% 2.08-5.9, p=0.012), electrical storm (OR 2.4, IC 95% 1.06-5.41, p=0.045), functional class greater than II (OR 2.86, IC 95% 1.34-6.10, p=0.018) were risk factors for recurrence and the presence of clinical VT at the time of ablation (OR 0.29, IC 95% 0.12-0.70, p=0.004) and the use of more than 2 techniques for mapping (OR 0.64, IC 95% 0.48-0.86, p=0.013) were protective factors. Conclusions: . Ablation of ventricular tachycardia in ischemic heart disease has had good results in our center. The recurrence is similar to that reported by other authors and there are some factors associated with it.

A Review on the General Stability of Mood Disorder Diagnoses Along the Lifetime.

PURPOSE OF REVIEW: The purpose of this review is to review the most recent literature regarding diagnostic stability of mood disorders, focusing on epidemiological, clinical-psychopathological, and neurobiological data for unipolar and bipolar affective disorders. RECENT FINDINGS: Unipolar depression follows a chronic course in at least half of all cases and presents a considerable diagnostic stability across all age ranges. Studies using latent class analysis are allowing improved profiling of depressive subtypes and assessment of their prevalence. Advances have been made in our understanding of the neurobiological underpinnings of depression, with data highlighting the roles of amyloid deposits, the ApoE4 allele, and atrophy of the anterior hippocampus or frontal cortex. The diagnostic instability of bipolar disorder is manifest in the early years, seen in both the extent of diagnostic delay and the high rate of diagnostic conversion from unipolar depression. Regarding disruptive mood dysregulation disorder, we have little data to date, but those which exist indicate a high rate of comorbidity and minimal diagnostic stability for this disorder. Diagnostic stability varies substantially among mood disorders, which would be related to the validity of current diagnostic categories and our diagnostic accuracy.

Suicidality in Subjects With Anxiety or Obsessive-Compulsive and Related Disorders: Recent Advances.

PURPOSE OF REVIEW: Historically, anxiety disorders have not been considered as important determinants of suicide, but in the last years, many works have challenged this assumption. Here, we will review the available evidence on the relationship between suicide and anxiety disorders (e.g., obsessive-compulsive disorder, post-traumatic stress disorder, generalized anxiety disorder, panic disorder, and body dysmorphic disorder), with special emphasis on findings published in the last years. RECENT FINDINGS: Overall, anxiety disorders increase the risk of suicide. Specifically, 16% of patients with social anxiety disorder reported suicidal ideation in the previous month, and 18% of them had a history of suicide attempts. Similarly, in patients with panic disorder, suicidal ideation prevalence ranged between 17 and 32%, and 33% of them had a history of suicide attempts. Generalized anxiety disorder (GAD) was the most frequent anxiety disorder in completed suicides (present in 3% of people who committed suicide) and also subthreshold GAD was clearly linked to suicide ideation. Post-traumatic stress disorder was positively associated with suicidal ideation, and in patients with obsessive-compulsive disorder, suicide ideation rates ranged from 10 to 53% and suicide attempts from 1 to 46%. Body dysmorphic disorders presented a suicide ideation prevalence of about 80%. Suicide risk is increased in subjects with anxiety disorder. This risk is higher in the presence of comorbidities, but it is not clear whether it is independent from such comorbidities in some disorders.

Cognitive, Emotional, Temperament, and Personality Trait Correlates of Suicidal Behavior.

Suicide is one of the leading causes of violent death in many countries and its prevention is included in worldwide health objectives. Currently, the DSM-5 considers suicidal behavior as an entity that requires further study. Among the three validators required for considering a psychiatric disorder, there is one based on psychological correlates, biological markers, and patterns of comorbidity. This review includes the most important and recent studies on psychological factors: cognitive, emotional, temperament, and personality correlates (unrelated to diagnostic criteria). We included classic factors related to suicidal behavior such as cognitive, inflexibility, problem-solving, coping, rumination, thought suppression, decision-making, autobiographical memory, working memory, language fluency, burdensomeness, belongingness, fearless, pain insensitivity, impulsiveness, aggressiveness, and hopelessness. The personality correlates reported are mainly based on the personality theories of Cloninger, Costa and McCrae, and Eysenck. Moreover, it explores conceptual links to other new pathways in psychological factors, emptiness, and psychological pain as a possible origin and common end path for a portion of suicidal behaviors.

Alteraciones en mucosa bucal y percepción de salud oral en adultos mayores portadores de prótesis / Oral mucosal alterations and oral health perception in older adults bearing dental prostheses

Actualmente, los problemas asociados al progresivo envejecimiento de la población son objeto de mayor atención, debido al aumento de las personas mayores, especialmente en las sociedades industrializadas. En el corto y el mediano plazo, estaremos frente a una población importante de adultos mayores; así, se tendrá que asumir la atención de este grupo poblacional. Estas personas pueden haber perdido piezas dentarias y la instalación de un aparato protésico constituye una solución para rehabilitar la función del sistema estomatognático. La terapia prostodóntica debe conservar la salud de los tejidos bucales y disminuir la resorción ósea. El descubrimiento y la prevención de las lesiones significará prolongar la esperanza y la calidad de vida de las personas de la tercera edad. La forma en que las personas perciben su salud bucal está relacionada con el bienestar; una boca saludable contribuye a que se sienta bien y ayuda a su satisfacción. Por ello, la percepción de salud bucal puede ser considerada como un factor predictor de la calidad de vida y se asocia a una variedad de indicadores de salud general y conductas saludables. Existen estudios que informan sobre la asociación entre la autopercepción de la salud bucal global con la autopercepción específica de limitaciones funcionales bucales. Los instrumentos para evaluar la calidad de vida relacionada con la salud bucal, son sensibles para detectar la influencia de los tratamientos odontológicos en la percepción del paciente sobre su salud bucal, lo que podría ser útil para relacionar satisfacción y percepción del paciente en relación a su rehabilitación(AU)

Alteraciones en mucosa bucal y percepción de salud oral en adultos mayores portadores de prótesis / Oral mucosal alterations and oral health perception in older adults bearing dental prostheses

Actualmente, los problemas asociados al progresivo envejecimiento de la población son objeto de mayor atención, debido al aumento de las personas mayores, especialmente en las sociedades industrializadas. En el corto y el mediano plazo, estaremos frente a una población importante de adultos mayores; así, se tendrá que asumir la atención de este grupo poblacional. Estas personas pueden haber perdido piezas dentarias y la instalación de un aparato protésico constituye una solución para rehabilitar la función del sistema estomatognático. La terapia prostodóntica debe conservar la salud de los tejidos bucales y disminuir la resorción ósea. El descubrimiento y la prevención de las lesiones significará prolongar la esperanza y la calidad de vida de las personas de la tercera edad. La forma en que las personas perciben su salud bucal está relacionada con el bienestar; una boca saludable contribuye a que se sienta bien y ayuda a su satisfacción. Por ello, la percepción de salud bucal puede ser considerada como un factor predictor de la calidad de vida y se asocia a una variedad de indicadores de salud general y conductas saludables. Existen estudios que informan sobre la asociación entre la autopercepción de la salud bucal global con la autopercepción específica de limitaciones funcionales bucales. Los instrumentos para evaluar la calidad de vida relacionada con la salud bucal, son sensibles para detectar la influencia de los tratamientos odontológicos en la percepción del paciente sobre su salud bucal, lo que podría ser útil para relacionar satisfacción y percepción del paciente en relación a su rehabilitación