Maternal and paternal attachment in high-risk adolescents: Unique and interactive associations with anxiety and depressive symptoms.

Anxiety and depressive symptoms are common, comorbid, and consequential for adolescents. Attachment theory suggests that styles of relationships with parents, developed from patterns of interactions over time, contribute to risk for these internalizing symptoms. This may be especially relevant for high-risk, clinically severe adolescents. However, most research focuses primarily on attachment relationships to mothers. Some theoretical perspectives also suggest that attachment to other caregivers (such as fathers) may not only be uniquely important for understanding internalizing symptoms but may also interact with maternal attachment. Therefore, it is important to examine these attachment relationships in tandem. The present study examines associations between attachment and internalizing symptoms in a sample of 1,141 youth (12-20 years old; 54.0% female, 96.5% White) from a multisite residential treatment facility. Youth reported on attachment anxiety and avoidance with both parents, as well as anxiety and depressive symptoms. Response surface analyses were used to examine curvilinear, interactive, and fit effects using a model comparison approach. Overall, for patterns of anxious attachment, the best-fitting models reflected simple additive and linear effects. For avoidant attachment, best-fitting models included interactions and fit patterns, suggesting the meaning of maternal attachment was dependent on paternal and vice versa. After accounting for covariates, however, maternal attachment was the sole predictor in most models except attachment avoidance predicting depressive symptoms. These results have implications for attachment theory and research, and further work untangling these complex effects may inform clinical practice for high-risk adolescents. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Clinical factors affecting the efficacy of melasma treatment using the Q-switched 1064 Nd: YAG laser mode in a group of Venezuelan female patients.

The influence of melasma risk factors on the effectiveness of laser toning treatment in Venezuelan females was investigated. Clinical evaluation was performed (n = 64) including ultrasound and thyroid hormone profile. All patients underwent face exposure with laser toning, eight sessions weekly. VISIA percentiles corresponding to dark brown spots determined before and after treatment were compared by ANOVA. Differences between percentile values before and after treatment for each patient were calculated and expressed as percentages. An improvement of ≥30% was considered as significant. Spearman rank correlations between improvement and clinical parameters were determined. A significant increase (p > .005) of the median of the percentiles in the overall group was observed. However, only 62.5% of the patients exhibited an improvement of ≥30% at the right malar, 73.4% at the frontal and 71.8% at the left malar areas. Hormonal contraception during treatment (right malar: p < .0001 left malar: p = .0035), thyroid disorders (right malar: p < .0001; frontal: p = .011; left malar: p < .0001) and photoaging (right malar: p = .0235; frontal: p = .0237; left malar: p = .0137) were inversely associated to melasma improvement after treatment. Prolonged use of sunscreen improved significantly (right malar: p < .001; frontal: p = .016 and left malar: p = .025) treatment effectiveness.

Low to Normal Plasma Levels of Marinobufagenin 24 Hours or More after an Ischemic Stroke: A Pilot Study.

BACKGROUND: Numerous studies have demonstrated a strong relationship between circulating levels of marinobufagenin (MBG) and salt-sensitivity. Since salt-sensitive hypertensives have increased plasma levels of MBG and are known to be at a higher risk of having cardiovascular events, stroke and increased mortality, we evaluated the possibility of an association between MBG and ischemic stroke. In this pilot study, we determined plasma MBG levels in patients after surviving an ischemic stroke compared to similar age and gender groups of treated hypertensives and normotensive controls. METHODS: We measured plasma MBG levels in a total of 40 participants subdivided into three groups: After an ischemic stroke STR (n = 13), participants with a diagnosis of hypertension receiving blood pressure medication HT (n = 14) and normotensive control subjects CTL (n = 13). We used inferential statistics (parametric or non-parametric) and ordered logistic regression models (unadjusted and adjusted) and all statistical analyses were performed using Stata 14. RESULTS: We did not include a subject from the CTL group because of a diagnosis of glucose-6-phosphate dehydrogenase deficiency and an extreme plasma MBG value of 2,246 pmol/L. Participants' mean age was 60.4 ± 11.5 years; 56% were male. There was no significant difference between study groups (p > 0.05) for gender, age, and body mass index. HbA1c levels were significantly higher in the STR as compared to the CTL p < 0.05). In the STR group MBG levels were below the normal range (< 200 pmol/L) in three (23%), eight (61%) were in the normal range (200-400 pmol/L), while two (16%) had increased MBG values (> 400 pmol/L). Also, among the STR, the plasma MBG levels did not differ between those receiving and not receiving thrombolytic therapy (p > 0.05). From the 14 HT participants, six (43%) had MBG plasma levels within the normal range, and eight (57%) had high concentrations (> 400 pmol/L). Four (29%) of the treated hypertensives had extreme MBG levels (> 1,000 pmol/L) and normal values of blood pressure. CONCLUSION: There was no significant elevation of plasma MBG in survivors 24 h or more after an ischemic stroke. The extreme values of plasma MBG in 29% of the treated hypertensives suggests the presence of salt-sensitivity and a possible side effect of a specific combination of medications. Both of these findings contribute new knowledge to the design of studies to define if there is an MBG molecular mechanism underlying the complex associations among salt-sensitivity, hypertension, and ischemic stroke.

Bezoar gástrico de plástico como causa de pancreatitis aguda: reporte de un caso y revisión de la literatura / Gastric plastic bezoar causing acute pancreatitis: case report and literature review

Introducción. Un bezoar se define como un elemento no digerible atrapado en algún punto del tubo digestivo, el cual puede ser ingerido de forma intencional o accidental. El primer reporte de un bezoar en la literatura médica lo hizo Baudamant en 1779. Caso clínico. Se presenta un caso de un bezoar de plástico, un cepillo dental, como causa de pancreatitis aguda y su manejo por laparoscopia, con una revisión de la literatura. Discusión y conclusiones. Aunque los bezoares gástricos son poco frecuentes, y más aún el de plástico, es importante tenerlos en cuenta como causa de pancreatitis aguda. Definitivamente, el abordaje laparoscópico es el ideal en pacientes sin obstrucción intestinal o inestabilidad hemodinámica

Introduction: A bezoar is defined as an indigestible element trapped somewhere in the gastrointestinal tract, which can be ingested intentionally or accidentally. The first report of a Bezoar in the medical literature was by W. Baudamant in 1779. Case report: We present the case of a plastic bezoar, a toothbrush, as the cause of acute pancreatitis and its management by laparoscopy, and a literature review. Discussion and conclusions: Although gastric bezoars are rare conditions, and furthermore so plastic bezoars, it is important to take them into account as a rare cause of acute pancreatitis. Definitely the laparoscopic approach is ideal for patients without intestinal obstruction or hemodynamic instability

Impact of Day of the Week and Time of Arrival on Ischemic Stroke Management.

OBJECTIVE: The purpose of this study was to evaluate the association between measures of patient arrival day (weekday or weekend day), day part (nighttime vs. daytime) and hour (regular hours vs. off hours) at the stroke unit of the Emergency Department of the Puerto Rico Medical Center and the following time-to-treatment measures: door-to-CT-scan, door-to-needle, and stroke-onset-to-treatment. METHODS: In this retrospective study, the data of 54 patients was obtained from the stroke unit of the Puerto Rico Medical Center through the Get With The Guidelines- Stroke Registry. Inclusion criteria were as follows: having an ischemic stroke within the period covering from August 2008 through February 2010 and being at least 18 years old. Associations between patient arrival time and timeliness of interventions were assessed using t-tests/Mann-Whitney tests and chi-square tests/Fisher's exact tests, as appropriate. RESULTS: The majority of the patients (74%) were men. The mean and standard deviation of age was 67±14 years. The median of times for door-to-CT-scan and onset to treatment were 15 minutes (interquartile range=15) and 2.7 hours (interquartile range=0.6), respectively. The mean and standard deviation for door-to-needle time was 77±18 minutes. No differences were found for any of the variables in terms of arrival date, day part or hour (p>0.05). The median time for door-to-CT- scan was shorter for patients receiving intravenous tissue plasminogen activator treatment than it was for those not receiving such treatment (12 minutes vs. 20 minutes; p=0.02). CONCLUSION: The timeliness of the stroke management interventions did not differ significantly in terms of arrival day, day part, or hour.

Aplicación de la Minería de Datos para el análisis de información clínica. Estudio Experimental en cardiopatías isquémicas / Title: Application of Data Mining for analysis of clinical information. Experimental study on coronary heart disease

En Cuba, como resultado de la atención a pacientes que padecen cardiopatía isquémica se generan grandes volúmenes de información anualmente. El análisis exhaustivo de dicha información tiene un gran valor de cara a las investigaciones científicas en cardiología. En este trabajo se expone un ejemplo de aplicación de la minería de datos para el apoyo a la toma de decisiones en esta especialidad de la medicina, a partir del estudio de las coronariografías realizadas a pacientes con cardiopatía isquémica(AU)

In Cuba, large amounts of information are generated every year as a result of the treatment of patients with ischemic heart disease. A thorough analysis of this information has great value for the scientific research in cardiology. This paper presents an example of applying data mining techniques to support the decision making process in this specialty. It exposes the results of the study of the data from coronary angiographies performed in patients with ischemic heart disease(AU)