Are Open Science Practices in Dentistry associated with higher Altmetric scores and citation rates?

AIM: Open science, a set of principles and practices, aims to make scientific research more accessible and accountable, benefiting scientists and society. This study evaluated whether adopting open science practices (OSPs) correlates with higher citation rates and Altmetric scores. METHODS: A random sample of randomised clinical trials (RCTs) on dental caries published between 2000 and 2022 was selected. A systematic PubMed search identified relevant RCTs, and data on OSPs - study registration, open methodology, open software, open scripts, open analysis plan, open data, open peer review, and open access (OA) - were manually collected by two independent assessors. The Robot Reviewer tool automatically evaluated the risk of bias (RoB). Outcomes included the total number of citations and the Altmetric Attention Score. Associations between OSPs, RoB, and other explanatory variables with the outcomes were assessed using binomial negative regression analysis, and expressed as Incidence Rate Ratio (IRR; α =.05). RESULTS: In total, 323 papers were analysed. At least one OSP was adopted in 57.5% (n=186) of the articles, dropping to 39.6% (n=128) without OA. Papers with protocol registration (IRR: 1.45; 95% CI: 1.15, 1.82) and OA publication (IRR: 1.24; 95% CI: 1.01, 1.53) had higher citation rates. Conversely, papers in full OA journals had fewer citations (IRR: 0.67; 95% CI: 0.52, 0.87). After adjusting for RoB, low-risk studies showed higher citation rates (IRR: 1.48; 95% CI: 1.14, 1.91), while OA lost significance. For Altmetric scores, registered and OA manuscripts showed higher scores (IRR: 3.74; 95% CI: 2.00, 7.01; IRR: 1.69; 95% CI: 1.04, 2.75), with registration remaining significant after adjusting for RoB and impact factor (IRR: 3.71; 95% CI: 1.97-6.99). CONCLUSION: The adoption of OSPs demonstrated a partial correlation with citation rates and Altmetric scores in RCTs on dental caries; however, these effects are complex and seem more related to the journal's impact factor. CLINICAL SIGNIFICANCE: The citations and the attention to clinical trials in dentistry, which could drive clinical decision-making and the elaboration of policies and recommendations, seem to be driven more by the journal's prestige than by the adoption of OSPs.

Which Dental Procedures Lead to Greater Distress During Children's Dental Treatment? A Cohort Study

ABSTRACT Objective: To assess children's self-reported distress during dental procedures and investigate risk factors. Material and Methods: A total of 163 children (3-10 years old) were included from a clinical trial on diagnostic strategies for evaluating restorations in primary teeth. Treatment plans were elaborated based on the clinical examination performed at the baseline of the study. Dentists performed 742 dental procedures, and an external evaluator collected children's self-reported distress through the Wong Backer Facial Scale (WBFS) and dentists' opinions about children's behavior during the treatment. Kruskal-Wallis Test was performed to compare the distress and the dentists' perception of the different dental procedures, and multilevel ordered logistic regression analysis was conducted to the evaluate association between explanatory variables and the outcomes. Results: More complex procedures caused more distress in children (p=0.017), with a 5.5 times higher risk than simple operative treatments. Similarly, dentists reported children's worse behavior (p<0.001). Older children (older than 7 years) reported less distress than younger children (OR 0.52; CI 0.30-0.87; p=0.014). Patients reported greater distress in the first consultations, reducing the chance of higher scores by 16% in the next interventions. Conclusion: Children experience higher levels of distress during their first treatment appointments. More complex operative procedures and the child's age below 7 years were risk factors associated with greater distress during dental treatment.

Infarto cerebral en mujer joven con la enfermedad por el coronavirus del 2019 y sin factores de riesgo cardiovasculares: reporte de caso / Acute stroke in young woman with coronavirus disease 19 and no cardiovascular risk factor: case report

RESUMEN INTRODUCCIÓN: La COVID-19 se acompaña de eventos tromboembólicos venosos y arteriales en pacientes con historia de hipertensión y aterosclerosis. Se reporta el caso de una paciente joven y sin factores de riesgo cardiovascular que adquirió la infección por el SARS-COV2 y luego presentó un accidente cerebrovascular isquémico. CASO: Paciente de 44 años hospitalizada por la covid-19 en tratamiento protocolario con anticoagulación, esteroide y oxígeno suplementario. Al día 7 del inicio de los síntomas respiratorios presentó infarto cerebral por trombosis de arteria carótida derecha, arteria cerebral media derecha e izquierda y edema cerebral hemisférico derecho, tras lo cual fue diagnosticada con muerte encefálica. El estudio vascular no documentó una etiología diferente a la covid-19. DISCUSIÓN: Se plantea que la infección condiciona un estado inflamatorio sistémico, endotelialitis, ulceración de placas ateroscleróticas preexistentes e hipercoagulabilidad. Lo anterior facilita la aparición de trombosis vascular. Es frecuente encontrar elevación de reactantes de fase aguda y de los productos del metabolismo de la fibrina. El accidente cerebrovascular (ACV) isquémico se ha descrito en el 1 al 5 % de los pacientes con la covid-19. En pacientes con factores de riesgo cardiovascular, durante las primeras 2 semanas desde el inicio de los síntomas respiratorios, el compromiso isquémico suele afectar a múltiples territorios vasculares. CONCLUSIÓN: La covid-19 por sí sola es un factor de riesgo para trombosis arterial secundaria a la inflamación sistémica y estados de hipercoagulabilidad, por lo que debe ser tenida en cuenta en el estudio de ACV isquémico en pacientes jóvenes.

ABSTRACT INTRODUCTION: It is known that COVID-19 is associated with venous and arterial thromboembolic events in patients with history of hypertension and atherosclerosis. Herein, it is presented a case of a young woman without known cardiovascular risk, who was infected by SARS-COV 2 and then an ischemic stroke. CASE: 44 years-old woman with moderate COVID-19 in protocolary treatment with anticoagulants, steroid and oxygen. In the seventh day since symptoms onset, she presented acute ischemic stroke due to acute thrombosis of right carotid artery, and right and left medial cerebral arteries, then rapidly developed malignant cerebral edema and brain death. Vascular study failed to report and etiology other than COVID-19. DISCUSSION: It is suggested that the infection produces a systemic inflammatory state, endothelialitis, ulceration of preexisting atherosclerotic plaques, and hypercoagulability that facilitate thrombosis. Ischemic stroke is described in 1 to 5% of COVID-19, it is common to find an elevation of acute phase reactants and products of fibrin metabolism. Multiple vascular territories are usually compromised in patients with known cardiovascular risk factors and 12 days after the onset of symptoms. CONCLUSION: COVID-19 by itself is a risk factor for arterial thrombosis secondary to systemic infection and hypercoagulability states and it should be taken into account in the study of ischemic stroke in young patients.

Influence of two caries detection strategies on the quality of life of preschool children: An analysis of secondary outcomes of a 2-Year randomized clinical trial.

OBJECTIVE: This randomized clinical trial aimed to evaluate the influence of two caries diagnosis strategies, and subsequent management, on oral health-related quality of life (OHRQoL) of preschoolers. Additionally, the association of the OHRQoL outcomes with the clinician-centred primary outcome used in the main study was also explored. MATERIALS AND METHODS: This study refers to the OHRQoL secondary outcomes analyses of the so-called RCT 'CARDEC-1'. Three- to 6-year-old children were randomly allocated in two caries detection strategies in primary molars: visual inspection (VIS) or visual + radiographic (RAD) assessment. Participants were diagnosed and treated according to the allocated group and followed up for 2 years. Caregivers answered the Early Childhood Oral Health Impact Scale (ECOHIS) at baseline and after 2 years. Intention-to-treat analysis was performed. ECOHIS scores at baseline and 2 years later were compared using the Mann-Whitney test. Effect sizes, change scores and the minimally important difference (MID) were also compared between groups. Additional analysis was performed to assess if OHRQoL variables could reflect the primary clinical outcome (number of new operative interventions during the follow-up), observing if these met the Prentice criteria. RESULTS: Two hundred and five children had the ECOHIS answered in both period times (18.7% attrition rate). There was a decrease in total ECOHIS scores, as well as for different domains for both trial groups, with effect sizes varying from 0.43 to 0.77. Comparisons between groups, however, did not show significant differences. In the additional analysis, the OHRQoL variables met the Prentice criteria and presented the same trends observed with the clinician-centred primary endpoint. CONCLUSION: Caries detection performed by visual inspection alone or associated with radiographic method does not influence the long-term impact on OHRQoL. Furthermore, OHRQoL variables reflect clinical outcomes in this type of clinical trial. CLINICALTRIALS: gov NCT02078453.

Mental well-being among patients with congenital heart disease and heart failure during the COVID-19 pandemic.

Patients with congenital heart disease (CHD) show increasing survival. We evaluated the influence of COVID-19 confinement on the mental well-being of patients with CHD. Descriptive, cross-sectional, observational epidemiological study in a cohort of 242 patients with CHD over 14 years old recruited consecutively from a single adolescent and adult CHD outpatient unit. Patients were sent an online questionnaire to determine clinical, demographic and the 12-element general health questionnaire (GHQ-12) data during the COVID-19 quarantine. 242 out of 407 (59%) patients with CHD, to whom the questionnaire was sent, responded to the survey. 98 (42%) patients were between 14 and 24 years old and 133 (58%) were over 25 years old. Of the total, 119 (51%) were male. 123 (51%), 88 (36%) and 31 (13%) patients with CHD had mild, moderate, and severe anatomical complexity respectively. 11 (4.5%) out of 242 patients with CC presented heart failure (HF) symptoms, requiring 18% of them admission to the hospital emergency department during the pandemic (P=0.002). In relation to the GHQ-12 questionnaire, patients with CHD and HF enjoyed less their daily activities (81% vs. 51%, P=0.043) and had less self-confidence (46% vs. 18%, P=0.041) than those without HF symptoms. In conclusion, patients with CHD and HF, during the COVID-19 quarantine, presented a lower capacity to enjoy daily activities and self-confidence than CHD without HF symptoms.

COVID-19 quarantine and depression in patients with congenital heart disease.

COVID-19 outbreak has brought tremendous psychological pressure to the general population, especially to those with associated cardiovascular disease. An online Patient Health Questionnaire (PHQ-9) survey on consecutive congenital heart disease (CHD) patients, was carried out to determine depression during the Spanish coronavirus disease (COVID-19) quarantine. Two-hundred forty-two out of 407 (59%) CHD patients answered the survey, 123 (51%) had mild defects, 88 (36%) moderate and 31 (13%) great defects, most of them between 18 and 24 years old and 51% were male. Patients were dichotomized to no or mild (PHQ-9 < 10) and moderate to severe (≥ 10) depressive symptoms. Thirty-four (14%) patients showed a PHQ-9 ≥ 10 and 10 of them (29%) were under anxiolytic or antidepressant treatment during the quarantine. During the study period, 9 (4%) patients had COVID-19 symptoms. Patients with a NYHA above 2 (P=0.025), living in houses without garden or balcony (P=0.014), needing psychological/psychiatric evaluation/medication in the previous 12 months or being under anxiolytic/antidepressant treatment during the confinement had, significantly, a PHQ-9 score ≥ 10 (P < 0.001). Being under anxiolytic/antidepressant treatment during the coronavirus pandemic [OR 3.92 (95% CI 1.05-14.66), P=0.043] and having previous psychological/psychiatric evaluation in the previous 12 months to the quarantine [OR 3.82 (95% CI 1.16-12.54), P=0.027] were the only variables that reached statistical significance, in the multivariable analysis, as predictors of a pathological PHQ-9 questionnaire (score ≥ 10). In conclusion depression was frequent during the COVID-19 quarantine among CHD patients, with only a third of them being under anxiolytic or antidepressant treatment. Needing psychological/psychiatric evaluation/treatment during the previous 12 months to the lockdown was a predictive factor for an abnormal PHQ-9 score.

Variablilidad de la presión arterial, hipertensión arterial nocturna y su asociación con tabaquismo / Blood pressure variability, nocturnal hypertension and its association with smoking / Variabilidade da pressão arterial, hipertensão arterial noturna e sua associação com o tabagismo

Resumen: Introducción: La hipertensión arterial y el tabaquismo son factores de riesgo independientes para el desarrollo de eventos cardiovasculares. El consumo de tabaco determina una elevación aguda de la presión arterial por acción del sistema simpático. Sin embargo los efectos a largo plazo son contradictorios. El aumento de la variabilidad de la presión arterial y la presencia de hipertensión arterial nocturna se asocia con eventos cardiovasculares adversos independientemente de los niveles de presión arterial. Objetivos: Evaluar la asociación entre tabaquismo e hipertensión arterial diurna, nocturna y variabilidad. Material y Métodos: Estudio analítico, observacional, transversal, multicéntrico, que incluye pacientes hipertensos mayores de 18 años con monitoreo ambulatorio de la presión arterial (MAPA). Resultados: Se incluyeron 391 pacientes, siendo 14.6% fumadores. Se encontraron cifras de presión arterial diurna sistólica y diastólica más elevadas en pacientes tabaquistas (p=0.204, p=0.087, respectivamente). Se observó una asociación significativa entre la hipertensión arterial nocturna y la presencia de diabetes mellitus e índice de masa corporal aumentado. No se encontró asociación entre el consumo de tabaco y los distintos patrones de variabilidad, así como tampoco con la hipertensión arterial nocturna. Conclusiones: El grupo de pacientes fumadores presentó una tendencia a cifras de presión arterial media diurna sistólica y diastólica más elevadas que los no fumadores, lo que podría sugerir que el tabaquismo incide en el control de cifras de presión arterial.

Abstract: Introduction: Hypertension and smoking are independent risk factors for the development of cardiovascular events. Tobacco use causes an acute elevation of blood pressure due to the action of the sympathetic system. However, the long-term effects are contradictory. Increased variability in blood pressure and the presence of nocturnal arterial hypertension are associated with adverse cardiovascular events regardless of blood pressure levels. Objectives: To evaluate the association between smoking and daytime and nighttime arterial hypertension and variability. Material and Methods: Analytical, observational, cross-sectional, multicenter study, which includes hypertensive patients over 18 years of age with ambulatory blood pressure monitoring (ABPM). Results: 391 patients were included, being 14.6% smokers. Higher levels of systolic and diastolic daytime blood pressure were found in smoking patients (p = 0.204, p = 0.087, respectively). A significant association was observed between nocturnal arterial hypertension and the presence of diabetes mellitus and increased body mass index. No association was found between tobacco consumption and the different patterns of variability, as well as with nocturnal arterial hypertension. Conclusions: The group of smoking patients showed a trend towards higher mean daytime systolic and diastolic blood pressure figures than non-smokers, which could suggest that smoking affects the control of blood pressure numbers.

Resumo: Introdução: Hipertensão e tabagismo são fatores de risco independentes para o desenvolvimento de eventos cardiovasculares. O uso do tabaco provoca elevação aguda da pressão arterial devido à ação do sistema simpático. No entanto, os efeitos de longo prazo são contraditórios. O aumento da variabilidade da pressão arterial e a presença de hipertensão arterial noturna estão associados a eventos cardiovasculares adversos, independentemente dos níveis de pressão arterial. Objetivos: Avaliar a associação entre tabagismo e hipertensão arterial diurna e noturna e variabilidade. Materiai e Métodos: Estudo analítico, observacional, transversal, multicêntrico, que inclui hipertensos maiores de 18 anos com monitorização ambulatorial da pressão arterial (MAPA). Resultados: Foram incluídos 391 pacientes, sendo 14,6% tabagistas. Níveis mais elevados de pressão arterial diurna sistólica e diastólica foram encontrados em pacientes fumantes (p = 0,204, p = 0,087, respectivamente). Foi observada associação significativa entre hipertensão arterial noturna e presença de diabetes mellitus e aumento do índice de massa corporal. Não foi encontrada associação entre o consumo de tabaco e os diferentes padrões de variabilidade, bem como com a hipertensão arterial noturna. Conclusões: O grupo de pacientes fumantes apresentou tendência a valores médios de pressão arterial sistólica e diastólica mais elevados do que os não fumantes, o que pode sugerir que o tabagismo afeta o controle dos valores da pressão arterial.

Toxicological assessment of mesoporous silica particles in the nematode Caenorhabditis elegans.

Here we report the toxicological evaluation of mesoporous silica particles (MSPs) in the nematode C. elegans. Specifically, we have investigated the effect of bare micro- (M0) and nano-sized (N0) MSPs, and their corresponding functionalized particles with a starch derivative (Glu-N) (M1 and N1, respectively) on C. elegans ageing parameters. The toxicity of MSPs, their impact on C. elegans lifespan, movement capacity, progeny and ability to survive upon exposure to acute oxidative stress were assessed. This study demonstrated that both size particles assayed (M0 and N0), labeled with rhodamine and monitored through fluorescence microscopy, are ingested by the nematode. Moreover, toxicity assays indicated that bare nano-sized particles (N0) have a negative impact on the C. elegans lifespan, reducing mobility and progeny production. By contrast, micro-sized particles (M0) proved innocuous for the nematodes. Furthermore, functionalization of nanoparticles with starch derivative reduced their toxicity in C. elegans. Thus, oral intake of N1 comparatively increased the mean lifespan and activity rates as well as resistance to oxidative stress. The overall findings presented here demonstrate the influence of MSP size and surface on their potential toxicity in vivo and indicate the silica-based mesoporous particles to be a potential support for encapsulation in oral delivery applications. Furthermore, the good correlation obtained between healthy aging variables and viability (mean lifespan) validates the use of C. elegans as a multicellular organism for nanotoxicology studies of MSPs.

Responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) is related to dental treatment complexity.

BACKGROUND: The responsiveness of the Early Childhood Oral Health Impact Scale (ECOHIS) has varied greatly across studies; hence, we hypothesized that this discrepancy could be related to the complexity of dental treatment received. Thus, we aimed to evaluate the responsiveness of the ECOHIS to changes in oral health-related quality of life (OHRQoL) following dental treatments of varying complexity in preschool children. METHODS: Preschool children aged 3 to 6 years were selected; their parents responded to the ECOHIS at baseline. The parents responded to the ECOHIS again and a global transition question 30 days after the children were treated. The type of treatment received by the children was categorized according to complexity, as follows: 1) non-operative treatment only, 2) restorative treatment, and 3) endodontic treatment and/or tooth extraction. Change scores and effect sizes (ES) were calculated for total scores, as well as considering the different treatment types and global transition question responses. RESULTS: Of the 152 children who completed the study, the ECOHIS yielded large ES for total scores (0.89). The children showed increasing ES values associated with better perception of improvement, assessed by the global transition question. The magnitude of ES after treatment was related to treatment complexity (0.53, 0.92 and 1.43, for children who received non-operative treatment only, restorative treatment, and endodontic treatment and/or tooth extraction, respectively). CONCLUSIONS: Parents whose children required more complex dental treatment are more likely to perceive treatment-related changes to OHRQoL assessed with the ECOHIS.

Immunosuppression as a Possible Risk Factor for Interferon Nonresponse in Ocular Surface Squamous Neoplasia.

PURPOSE: The mechanism by which ocular surface squamous neoplasia (OSSN) responds to topical interferon-alpha-2b (IFNα2b) is not known. We report the cases of 3 immunosuppressed patients whose tumors did not respond to topical IFNα2b therapy. The purpose of this series is to shed light on potential mechanisms of IFNα2b in OSSN. METHODS: Retrospective case series of 3 immunosuppressed patients whose biopsy-proven OSSN did not respond to topical IFNα2b treatment. RESULTS: Three white, immunosuppressed males (mean age 70 years, range 66-76) were diagnosed with OSSN. Topical IFNα2b 1 million units/mL was administered 4 times a day and used for a mean of 5 months (range 2-7 mo) without an adequate response. All patients were then switched to 5-fluorouracil. Successful eradication of OSSN was achieved in 2 cases, and improvement of OSSN in another. The latter patient was switched to mitomycin-C with subsequent resolution of OSSN. CONCLUSIONS: These cases suggest that an intact immune system may be an important link between IFNα2b therapy and tumor resolution. As such, topical IFNα2b may not be an optimal choice for patients with underlying immunosuppression. It may be more effective in this patient population to switch to a non-immune-modulating therapy such as 5-fluorouracil or mitomycin-C.

Ultrasound in EMG-Guided Biopsies: A Prospective, Randomized Pilot Trial.

INTRODUCTION: At our institution, core muscle biopsies are performed on muscles selected using electromyography (EMG). Ultrasound (US) guidance is not used routinely. The aim of this study was to determine if US guidance of EMG selected muscles would increase the diagnostic yield of the biopsy as compared to the current practice standards. METHODS: Two trained physicians performed 40 randomized biopsies (US guided or traditional approach). The amount of tissue obtained in each biopsy was recorded (volume and mass), along with the final pathologic diagnosis in each case and incidence of complications. RESULTS: Forty patients were studied. Sixteen muscle biopsies were done with US guidance; 50% had a definitive diagnosis, and 38% did not. In the non-US guidance group, 58% had a definitive diagnosis, and 33% did not. CONCLUSIONS: US did not provide any additive advantage when used to guide biopsy in a muscle previously selected for biopsy with EMG. Muscle Nerve 54: 786-788, 2016.

Urinary podocalyxin as a marker of preeclampsia in a Hispanic population.

BACKGROUND: Preeclampsia is associated with significant materno-fetal morbidity and mortality. Podocyturia due to podocyte damage seems to be associated with the disease. The objective of this study was to evaluate the usefulness of urinary podocalyxin as a marker of preeclampsia in a Hispanic population. METHODS: 63 patients were studied. 25 patients had preeclampsia/eclampsia (PE-E). 38 patients had normal pregnancies and served as control group. 24 hour proteinuria, urine protein/creatinine (UPC), urinary podocalyxin and perinatal outcomes were measured. A Podocalyxin ELISA test was used to detect podocyturia. RESULTS: Mean age (years), mean±SD was 30.5±5.4 in normal patients vs 30.6±5.8 in PE-E, p=0.98. Median gestational age (weeks) was, 38 (range 21-42) for normal pregnancies and 36 (range 24-40) for patients with PE-E, <0.001. Urine podocalyxin/creatinine on admission (ng/mg), median [IQR] in normal patients was 55.9 [29.4, 74.9] vs 109.7 [63.8, 234.1] in PE-E, p=0.001. After adjusting for admission proteinuria, urinary podocalyxin remained independently associated with preeclampsia: OR=1.0040 (95% CI 1.0003-1.0078), p=0.03. There was low to moderate correlation between UPC and urinary podocalyxin, Spearman's =0.31, p=0.01. In PE-E, post-partum urine podocalyxin was lower, median [IQR]: 69.7 [32.7, 184.8] p=0.19 vs admission. There was a trend towards more podocyturia and proteinuria in patients with eclampsia, comparing to those with preeclampsia. There was no association observed between podocyturia and neonatal mortality, IUGR or Apgar scores. CONCLUSIONS: Significantly higher levels of urinary podocalyxin are seen in preeclampsia/eclampsia. They tend to normalize after delivery.

Validez y utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población femenina de Medellín, Colombia / Diagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian female population

OBJETIVO: Evaluar la validez y la utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de conducta alimentaria (TCA) en población femenina. DISEÑO: Estudio observacional de validación de pruebas. Emplazamiento: Realizado en la ciudad de Medellín en nivel de atención comunitaria de consulta psiquiátrica mixta (pública y privada). Participantes: Veinticinco mujeres con edades entre 15 y 25 años que cumplieran criterios DSM-IV-TR para anorexia y bulimia nerviosa y 111 controles sin TCA. Mediciones principales: La muestra de casos fue por conveniencia y en controles, aleatoria simple. Se comparó el «criterio de oro» (entrevista estructurada por psiquiatra para determinar el cumplimiento o no de criterios de inclusión de caso de TCA) con el EAT-26, y al instrumento se le hizo validación cultural y semántica, validación factorial, evaluación de confiabilidad, así como determinación del mejor punto de corte por medio de la curva ROC. RESULTADOS: En EAT-26 subyacen 4 dominios: bulimia, dieta, preocupación por la comida y control oral. El alfa de Cronbach fue de 92,1%, y el mejor valor de corte, el de 11 y más puntos (sensibilidad del 100% y especificidad del 85,6%). CONCLUSIÓN: El EAT-26 modificado y abreviado es un instrumento multidimensional, con excelentes valores de confiabilidad y sensibilidad, y con un adecuado valor de especificidad, apropiado para el cribado de posible TCA en población de riesgo y útil en atención primaria para su detección temprana en mujeres jóvenes

OBJECTIVE: To establish diagnostic validity and usefulness of EAT-26 for the risk assessment of Eating Disorder (ED) in a female population. Description: Observational validation study questionnaire. Setting: Performed in a Medellin city community care level of mixed (public and private)psychiatric consultation. Subjects: Twenty five subjects aged 15 to 25 with DSM-IV-TR diagnostic criteria for anorexia and bulimia nervosa and 111 controls without ED. Main outcomes measures: The case sample was for convenience and in controls an aleatory simple one. Gold standard (structured psychiatrist interview confirming the fulfillment of ED case inclusion criteria) was compared with EAT-26 questionnaire; reliability was assessed, cultural, semantics and factorial validation was made and the best cut-off score was established with the ROC curve. RESULTS: Four domains remain in the instrument: bulimia, dieting, food preoccupation and oral control. The Cronbach's alpha was 92.1% and a score of 11 and over is the best cut-off (sensitivity100%, and specificity 85.6%). CONCLUSIONS: This modified and abbreviated EAT-26 questionnaire is an ideal multidimensional instrument for ED screening in risk population, with excellent reliability and sensitivity values and satisfactory specificity. EAT-26 is a useful measure to be considered when strategies for ED early detection are implemented in young women

Polymer composites containing gated mesoporous materials for on-command controlled release.

Polyamidic nanofibrous membranes containing gated silica mesoporous particles, acting as carriers, are described as novel hybrid composite materials for encapsulation and on-command delivery of garlic extracts. The carrier system consists of MCM-41 solids functionalized in the outer surface, with linear polyamines (solid P1) and with hydrolyzed starch (solid P2), both acting as molecular gates. Those particles were adsorbed on electospun nylon-6 nanofibrous membranes yielding to composite materials M1 and M2. FE-SEM analysis confirmed the presence of particles incorporated on the nylon nanofibers. The release of the entrapped molecules (garlic extract) from the P1, P2, M1, and M2 materials was evaluated using cyclic voltammetry measurements. Electrochemical studies showed that at acidic pH P1 and M1 were unable to release their entrapped cargo (closed gate), whereas at neutral pH both materials release their loading (open gate). Dealing with P2 and M2 materials, in the absence of pancreatin a negligible release is observed (closed gate), whereas in the presence of enzyme the load is freely to diffuse to the solution. These newly developed composite nanomaterials, provide a homogeneous easy-to-handle system with controlled delivery and bioactive-protective features, having potential applications on pharmacology, medical and engineering fields.

[Diagnostic validity and usefulness of the Eating Attitudes Test-26 for the assessment of eating disorders risk in a Colombian female population]. / Validez y utilidad diagnóstica de la escala EAT-26 para la evaluación del riesgo de trastornos de la conducta alimentaria en población femenina de Medellín, Colombia.

OBJECTIVE: To establish diagnostic validity and usefulness of EAT-26 for the risk assessment of Eating Disorder (ED) in a female population. DESCRIPTION: Observational validation study questionnaire. SETTING: Performed in a Medellin city community care level of mixed (public and private) psychiatric consultation. SUBJECTS: Twenty five subjects aged 15 to 25 with DSM-IV-TR diagnostic criteria for anorexia and bulimia nervosa and 111 controls without ED. MAIN OUTCOMES MEASURES: The case sample was for convenience and in controls an aleatory simple one. Gold standard (structured psychiatrist interview confirming the fulfillment of ED case inclusion criteria) was compared with EAT-26 questionnaire; reliability was assessed, cultural, semantics and factorial validation was made and the best cut-off score was established with the ROC curve. RESULTS: Four domains remain in the instrument: bulimia, dieting, food preoccupation and oral control. The Cronbach's alpha was 92.1% and a score of 11 and over is the best cut-off (sensitivity 100%, and specificity 85.6%). CONCLUSIONS: This modified and abbreviated EAT-26 questionnaire is an ideal multidimensional instrument for ED screening in risk population, with excellent reliability and sensitivity values and satisfactory specificity. EAT-26 is a useful measure to be considered when strategies for ED early detection are implemented in young women.

Pregnancy and myasthenia gravis.

PURPOSE OF REVIEW: Myasthenia gravis (MG) is an acquired autoimmune disorder characterized by fluctuating ocular, limb, or oropharyngeal muscle weakness due to an antibody-mediated attack at the neuromuscular junction. The female incidence of MG peaks in the third decade during the childbearing years. A number of exacerbating factors may worsen MG, including pregnancy. When treatment is needed, it must be carefully chosen with consideration of possible effects on the mother with MG, the pregnancy, and the fetus. RECENT FINDINGS: Decisions are complex in the treatment of women with MG contemplating pregnancy or with presentation during pregnancy. While data is largely observational, a number of characteristic patterns and issues related to risk to the patient, integrity of the pregnancy, and risks to the fetus are recognized. Familiarity with these special considerations when contemplating pregnancy is essential to avoid potential hazards in both the patient and the fetus. Use of immunosuppressive agents incurs risk to the fetus. Deteriorating MG with respiratory insufficiency poses risk to both the mother and the fetus. SUMMARY: This article reviews available information regarding expectations and management for patients with MG in the childbearing age. Treatment decisions must be individualized based on MG severity, distribution of weakness, coexisting diseases, and welfare of the fetus. Patient participation in these decisions is essential for successful management.