Psychopathology and problematic social media use among children and adolescents: what possible links?

Introduction

Social Media (SM) have recently gained substantial popularity among youth. However, the relationship between problematic use of social media (PUSM) and psychopathology in children and adolescents remains unclear.

Objectives

To study in a population of children and adolescents followed in outpatient psychiatry unit, the prevalence, and psychopathological factors linked to PUSM.

Methods

A descriptive study was led among child and adolescent’s psychiatry patients. Parents were asked to provide answers for the Child Behaviour Checklist (CBCL). PUSM was assessed using the Bergen Social Media Addiction Scale (BSMAS). Mental disorders’ related data were extracted from patients’ medical records.

Results

Our study included 76 patients with a mean age of 14.2 ± 2.6 [11,18] years and a sex-ratio of 1. The prevalence of PUSM was estimated at 9.2% in our population according to the conservative approach, rising to 48.7% according to the liberal approach. Anxiety (32.4%) and depressive disorders (24.3%) were most prevalent among patients with PUSM. BSMAS scores were significantly higher among patients with smoking habits (p=0.03). CBCL T-scores interpretation showed internalizing and externalizing disorders among 80.3% and 64.5% patients respectively. BSMAS scores were significantly higher among patients belonging to the clinical range of all the CBCL syndrome scales, except for social problems, and among patients suffering from both internalizing and externalizing disorders (p=0.005).

Conclusions

PUSM was shown to be more prevalent among clinical populations compared to healthy controls. Research has indicated a potential link between PIUSM and psychopathology; however, the significance of the correlation remains unclear.

Disclosure

No significant relationships.

problematic social media use among child and adolescent psychiatry consultants: family risk factors

Introduction

the problematic use of social media (PUSM) is considered nowadays as a behavioural addiction. Social media seem to provide an ephemeral escape especially for children suffering from dysfunctional families and abuse.

Objectives

To study in a population of children and adolescents followed in outpatient child psychiatry unit, the prevalence, and family risk factors related to PUSM.

Methods

a descriptive study was conducted among child and adolescent psychiatry consultants. Parents were asked to provide answers for the BSMAS (Bergen Social Media Addiction Scale). We used a self-administered questionnaire and the BSMAS to assess patients’ social media’s use characteristics and the APGAR Family Test to assess their satisfaction with their family functioning.

Results

The prevalence of PUSM was estimated at 9.2% in our population according to the conservative approach, rising to 48.7% according to the liberal approach. APGAR Family Test scores were negatively correlated with BSMAS scores (Pearson’s coefficient= -0.37; p=0.002). Significantly higher scores were found in cases of exposure to physical (p=0.001) or moral (p=0.037) abuse and among patients who witnessed spousal violence (p=0.041), and whose parents had a lower level of education. A positive and significant correlation was found between parents’ and adolescents’ BSMAS scores (p=0.04).

Conclusions

Psychopathological fragility triggered by poor family functioning expose to the risk of PUSM. The implementation of preventive strategies and a rigorous and global management of these adolescents are imperative to fight against this disorder.

Disclosure

No significant relationships.

[Prenatal bonding and effect of recalled maternal overprotection in its development]

OBJECTIVES

Explore the relationship between the recalled bond of pregnant women to their own mothers and the development of prenatal attachment.

METHODS

Women with a single-fetal pregnancy who consulted the outpatient service of the maternity "C" ward of the center of maternity and neonatology of Tunis and had perceived fetal movements were included. Maternal-fetal attachment was assessed by the Prenatal Attachment Inventory (PAI), and the Parental Bonding Instrument (PBI) was used to evaluate experienced bond to mother. Socio demographic and clinical data were collected on a pre-established form.

RESULTS

Eighty respondents were retained from 95 recruited pregnant women. Their ages ranged from 19 to 44 with an average of 32 years. The rate of primiparity was of 28.7 % and half of pregnancies were identified at risk. The mean score of PAI was 55.3 (ET=10.79). Means scores of PBI "care" dimension and "overprotection" dimension were respectively of 26.26 (ET=5.82) and 17 (ET=6.38). The four types of maternal bonding according to the PBI scores were distributed as follow: affectionate constraint (31.3 %), affectionless control (35 %), optimal bonding (21.3 %) and weak bonding (12.5 %). The two PBI dimensions "care" and "overprotection" were significantly and negatively correlated (P<0.05). The PAI scores were not correlated with the PBI "care" dimension scores but were significantly and negatively correlated with the "overprotection" dimension scores (P<0.,01). In order to better explore this association, the "overprotection" dimension scores were studied according to the 21 items of the PAI. A negative and significant correlation was found only with three of the PAI items: item 12 (P<0;01), 15, and 20 (P<0;05).

CONCLUSIONS

Our findings suggest that pregnant women whose mothers showed more overprotective and controlling behaviors could be at risk of developing a weak maternofetal attachment. Further research is needed.

Quality of life of children operated for bladder exstrophy

INTRODUCTION

Bladder exstrophy is a rare malformation with functional and psychological issues affecting children's quality of life. This study aims to evaluate the urinary continence and the quality of life of patients operated for bladder exstrophy in our institution.

METHODS

This is a retrospective study including fifteen patients operated for bladder exstrophy between 1995 and 2015. All patients underwent a physical examination and an interview with a psychiatrist. Urinary continence was evaluated by dryness periods. Quality of life was evaluated by the QoL SF-36 scale.

RESULTS

All patients underwent primary early bladder closure. Posterior osteotomy was performed initially in 6 cases, and during the redo surgery in 7 cases. Leakage was recorded in 4 cases, fistula in 9 patients. Twelve patients had one or more redo surgery. Final bladder closure success rate was of 80%. Additional continence surgical procedures were performed by a Young Dees technique in 8 cases and with bladder enlargement associated with Mitrofanoff continent derivation in 5 cases. Only two patients over fifteen did not use diapers. All the items of QoL score according SF-36 were under the normal value (75%) except physical functioning and physical limitation. These scores go worst with age. Scores were better for continent boys in both physical and psychological items, but the difference was not significant However, significant difference was observed between boys having less than 3 surgeries and those having more than three procedures. Psychological and social scores were better for girls than for boys and differences were significant.

CONCLUSIONS

The risk of urinary incontinence is high in children managed for bladder exstrophy. Boys are more affected than girls with subsequent psychological and social repercussions. In our study, quality of life depends more on number of surgery than continence results. Psychological problems should be screened early for accurate treatment.

LEVEL OF EVIDENCE

3.

[Profile of the victims of sexual violence in child psychiatry consultation]

INTRODUCTION

Child sexual abuse is a major health problem that remains under-declared and under-reported worldwide. In this paper we have taken an interest in establishing the profile of the victims in a clinical population of children consulting for sexual abuse.

METHOD

We conducted a descriptive retrospective study in the child and teenager psychiatry department of the Mongi-Slim hospital (Tunis, Tunisia). We included all patients referred for treatment or medical expertise during the period from January 2013 to June 2019 and recorded sociodemographic data and clinical characteristics on pre-established charts from patient files.

RESULTS

The total number of consultants was 150 patients with 61,33 % of female subjects (n=92). The average age was 9,9 years old with extremes ranging from 2 to 18 years old. The assault was unique in 62,7 % and happened in a place known by the victim in 47,33 %. Sexual abuse with non-penetrating contact was the most frequent (48 %). The average age at which the first sexual abuse happened was 9 years old. In the vast majority of cases, the abuser was a male. Concerning the identity of the abuser, he was someone of the family in 37,3 % of the cases and in half of these cases, he was the father. In the other cases where the abuser wasn't a family member, the identity was known by the child and/or his family in 48,66 %. A psychiatric diagnosis was made in 58 % of the cases with a percentage of 52,1 % among girls and 60,3 % among boys. Main diagnoses were acute stress disorder in 10,6 %, post trauma stress disorder in 19,3 %, adjustment disorder in14,6 % and a major depressive disorder in 8 %.

CONCLUSION

Knowing the profile of victims of child sexual abuse and taking into consideration the social and psychiatric impact can help in adapting the means to intervene properly in order to take care of the victims and prevent such abuse.

Living with type 1 diabetes mellitus: How does the condition affect children's and adolescents' quality of life?

OBJECTIVE

Our study aimed to measure the health-related quality of life (QoL) of Tunisian children and adolescents with type 1 diabetes mellitus (T1MD).

METHODS

This cross-sectional study included 48 patients aged 3-18 years with T1MD, diagnosed for at least 6 months, and their parents, who underwent outpatient examinations from September to December 2018. The children's QoL was assessed using the PedQL 3.0 Diabetes Module exploring five dimensions: diabetes symptoms, treatment barriers, treatment adherence, worry, and communication problems. Parents shared their perception of their children's QoL through the PedQL 4.0 parents' report (general health and emotional, social, and scholar functioning). Glycemic control was assessed using the last glycated haemoglobin (HbA_1c) values.

RESULTS

The patients' average QoL score was 80.52 (±13.61) without significant differences between gender and age. The longer the duration of the disease, the worse the glycemic control. Girls and adolescents seemed to have poorer glycemic control. Boys and adolescents had more difficulties in all aspects of QoL. Parents perceived a worse QoL than that reported by their sons/daughters (72.34±16.42; P=0.006).

CONCLUSION

These findings emphasize the importance of an interdisciplinary, biopsychosocial, and family-centered care approach to patients with T1MD.

Abstract P4-10-18: Patterns of failure in a predominately black, inner city cohort of triple negative breast cancer patients at a single institution

Introduction: Triple negative breast cancer (TNBC) accounts for 12-17% of breast cancer (BC) in the US, but behaves much more aggressively. It occurs more commonly in younger, black women and death within two years of diagnosis is more common in this subset of BC compared to hormone receptor positive BC. At the University of Maryland Greenebaum Comprehensive Cancer Center, we see a higher proportion of TNBC and present our comprehensive evaluation of the patterns of failure in women with TNBC treated at our urban breast center.

Materials/Methods: A retrospective review of TNBC patients treated from 2005-2017 identified 198 patients with Stage I (33%), Stage II (47%), Stage III (16%) and Stage IV (4%) TNBC. The patients were all female, median age of 54 years (range 22-86 years), 64% black, 40% married, 7% BRCA mutated, and 3% HIV positive. Tumor characteristics revealed 93% infiltrating ductal carcinoma, 68% grade 3, and 18% with lymphovascular space invasion. Self-palpation of the lesion occurred in 76% of women, and the lesion was in the upper outer quadrant 62% of the time. Thirty percent of pts had neoadjuvant and 67% adjuvant chemotherapy. Ninety-eight percent of pts underwent surgical resection, 55% had lumpectomy and 61% sentinel lymph node biopsy. Adjuvant radiation was given in 56% of patients with a median dose of 60 Gy (range 16-70 Gy). Chi-square testing was used to compare variables, while logistic regression with Kaplan-Meier estimate was used to calculate overall survival (OS) and freedom from recurrence (FFR).

Results: With a median follow up of 45 months, 33 (17%) documented failures occurred. At time of first documented failure, 30% were local (L), 6% regional (R), 22% distant (D), 6% combination of L/R, 12% combination of L/R/D, 9% L/D, and 15% R/D, with a total combined failure pattern in 42% of pts. There was no significant difference in failure patterns between white and black pts (p=0.50, Table 1). The 2 and 5 year OS was 88% and 80%, respectively. Median survival was not reached in our cohort. The 2 and 5-year FFR was 90% and 84%, respectively with a median time to any failure of 16 months after initiation of therapy and median OS of 29 months for these pts.

Conclusion: Our work shows that with modern BC therapies treatment outcomes for pts with TNBC are improved and 84% are free of disease at 5 yrs after the initial diagnosis. The patterns of failure in TNBC are complex, did not vary by race, and showed the largest proportion of our pts (58%) failing in distant and locoregional sites simultaneously, while an additional 30% of pts fail locally only. These failure patterns did not differ significantly based on race. Future efforts will identify pts most at risk for treatment failure for consideration of treatment intensification, as salvage options are limited when treatment failure occurs.

Comparison of Failure Patterns Between White and Black PatientsFailure PatternWhite (n,%)Black (n,%)p-valueLocal only2 (22.5)8 (33) Regional only1 (11)1 (4) Distant only2 (22.5)5 (21)p=0.496Local and Regional0 (0)2 (8) Local and Distant0 (0)3 (13) Regional and Distant3 (33)2 (8) Local, Regional and Distant1 (11)3 (13) 

Citation Format: Rice SR, Cherng H-R, Hamza M, Murali S, Rosenblatt P, Bellavance E, Cheston S, Amin N, Nichols EM. Patterns of failure in a predominately black, inner city cohort of triple negative breast cancer patients at a single institution [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P4-10-18.

Vascular access outcome with a dedicated vascular team based approach

The objective of this study is to determine the impact of a dedicated vascular team in the early detection of complications and improvement of vascular access patency. A dedicated vascular access team comprised four dialysis nurses, a vascular access coordinator and led by a physician. They were assigned for the surveillance and care of all vascular accesses. The team presented problematic cases in the regular quality meeting with documentation of access blood flow, dynamic venous pressure, findings of hematoma, prolonged bleeding, swelling, low arterial pressures, steal syndrome, recirculation studies and dialysis adequacy. In case of failed recirculation or persistently elevated dynamic venous pressure, further evaluation was done either a fistulogram or review by a vascular surgeon. A total of 226 problematic vascular access cases were detected during the study (January 2014 to October 2017). The majority were in 41-70 years age group. A total of 248 referrals were given. Two hundred cases were referred for fistulogram, but it was performed in 188 patients. Vascular access stenosis was detected in 153 patients (81.3%) and angioplasty was performed in 137 (89.5%) of these patients. Fifteen (9.8%) patients were managed conservatively and one patient refused angioplasty. The 15 cases managed conservatively continued to work normally. One patient who refused to angioplasty later clotted his fistula during the follow-up period. Out of 41 cases who were totally noncompliant to referral, nine (22%) clotted their fistula during the follow-up period. In 12 cases in whom fistulogram was requested, but the request was declined by the primary hospital, five patients (41.6%) clotted their fistulas. Subgroup analysis showed that in patients who had both failed recirculation and high venous pressure, the prevalence of stenosis was 90% and angioplasty was performed in 94.4%. In patients who had failed recirculation and low arterial pressure, stenosis was detected in 85.7% and angioplasty was performed in 100% of cases. A dedicated vascular team approach for the care of dialysis vascular access helps in early identification of complications and improve vascular access outcome.

Depression and anxiety among Tunisian medical students “binge viewers”

Introduction

Since the advent of online streaming television, a new behavioural phenomenon have emerged among millennial, named “binge watching” that is viewing more than two episodes of a TV show in the same sitting. Whether or not this behaviour reflects emotional difficulties has been poorly studied.

Aims

Describe the phenomenon and search a possible link with depression and anxiety.

Methods

Fifty medical students were recruited. A questionnaire exploring the circumstances, the purpose and the outcome of the binge viewing was fulfilled. The Beck depressive inventory and the state-trait anxiety inventory were passed for the assessment of depression and anxiety.

Results

Among the 50 students questioned, 68% met the criteria of binge viewers and 64.7% of them adopted this behaviour at least once a week with an overall average of screen exposure of 3.8 hours in one sitting. Before the binge watching, 35.3% reported excitement and 29.4% boredom and have used it mostly to pass time (47.1%) and for fun (44.1%). Participants have felt more relaxed and happier after the viewing. Mild depression was found in 10 cases and moderate depression in 5 cases. Anxiety scores averaged 35.38 for state anxiety and 40.32 for trait anxiety. An inverse relationship was found between depression and anxiety scores and the frequency of the binge watching and its exposure duration. The correlation was hover non significant.

Conclusions

Could it be that the binge watching is a means of fighting against anxiety and depression rather than an evidence of emotional difficulties? Further studies are needed.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

[Oral health in asthmatic children using inhaled therapy. Study in the UTH of Casablanca]

OBJECTIVE

The aim of the study was to investigate oral health in asthmatic children using inhaled therapy and to compare the oral health status according to β2 agonist and corticosteroid dose administrated.

METHODS

The study group composed of 160 children aged between 2 and 15 years old who had bronchial asthma at different degrees of severity, the children followed at university hospital of Casablanca. A questionnaire was filled referring to oral health habits. For dental examinations, world health organization criteria and for plaque indices the Silness and Löe plaque index were used. Oral mucosal was examined to detect candidiasis or ulcerations.

RESULTS

The dental plaque registered was 1,13 ± 0,64. The mean DMFT was 3,75 ± 1,53 and the mean DMFT was 5,50 ± 3,02. A statistically significant higher average DMFT and DMFT values were observed with higher dose of β2 agonist (p < 0,05). Almost a third of studied population had oral candidiasis and 6,9% had ulcerations. These oral mucosal lesions were particularly observed in children receiving inhaled corticosteroid higher than 400 µg/j (P < 10-5) and they were lower in children using a spacer device and rinsing the mouth after treatment (P < 10-5).

CONCLUSION

The results suggest higher caries susceptibility and oral mucosal lesions among asthmatic children undergoing inhaled treatment with β2 agonist and corticosteroid. A special attention by doctors and health professionals of these patients is necessary and asthmatic children are recommended to adopt more precautionary oral hygiene practices.

Effect of metformin and sitagliptin on doxorubicin-induced cardiotoxicity in adult male albino rats

The use of doxorubicin (DOX) as an antitumor therapeutic agent is limited due to its cardiotoxic effects. Metformin (Met) and sitagliptin (Sitg) are suggested to improve cardiac function. The present study aimed to determine the potential protective effects of Met and Sitg on DOX-induced cardiotoxicity. Rats were divided into six groups: groups I, II, and III received normal saline, Met, and Sitg, respectively. Groups IV, V, and VI received DOX only, Met + DOX, and Sitg + DOX, respectively. Heart tissue was used for biochemical assays which measured cardiac reduced glutathione (GSH), thiobarbituric acid reactive substances (TBARS), and tumor necrosis factor α (TNF-α). Serum creatinine kinase (CK) and lactate dehydrogenase (LDH) were also measured. The heart apex was prepared for histological (hematoxylin and eosin) and immunohistochemical examination. Intoxication of DOX was associated with a significant elevation in serum CK-MB and LDH, reduction in cardiac GSH, and increased TBARS and TNF-α compared to the controls. Administration of Met or Sitg to DOX-intoxicated rats suppressed serum CK-MB and LDH. Moreover, cardiac GSH was elevated with decreased TBARS and TNF-α. These results were confirmed by histological study. Met and Sitg caused inhibition of caspase 3 and upregulation of B-cell lymphoma 2 (Bcl-2) expression in DOX-intoxicated animals. Sitg was found to exert a significantly better protective effect compared to that of Met. It was concluded that Sitg might be more effective than Met in reducing myocardial injury in DOX-induced cardiotoxicity in rats.

Ultrasonic Fluid Level Measuring Device

Accurate measurement of fluid level is very vital both in industrial and consumer market. Ultrasonic technology is one of the solutions used by the industry. However, an optimized balance between cost and features are a must for almost all target applications. The ultrasonic level measurement is used mainly when a non-contact measurement is required. Precise measurement of low-range distance (level) is the main objective for this project. This device can measure level in the range of 0.02m to 4m with an accuracy of 1cm. This measuring system is based on ultrasonic sound utilizing an Atmega328P low-power microcontroller. The system transmits a burst of ultrasonic sound waves towards the subject and then receives the corresponding echo. An HC-SR04 ultrasonic Module is used to both generate and detect the ultrasound required for level computation. The time taken for the ultrasonic burst to travel the distance from the system to the subject and back to the system is accurately measured. This level is displayed on an alphanumeric LCD with an accuracy of ± 2.5cm. The minimum depth that this system can measure is 2cm and is limited by the transmitter's transducer settling-time. The maximum height that can be measured is 4 meters. The amplitude of the echo depends on the reflecting material, shape, and size. Sound-absorbing targets such as carpets and reflecting surfaces less than two square feet in area reflect poorly. The maximum measurable range is lower for such subjects. If the amplitude of the echo received by the system is so low that it is not detectable by the ultrasonic module, the system goes out of range. This is indicated by displaying the error message OOR (Out-of-Range) on the LCD.

Interventional pain management: a commentary

The care of pain patients often requires a specialized knowledge base and skill set that allows the pain medicine specialist with tools necessary for optimal patient outcomes. Interventional pain medicine is the field of judiciously and appropriately applying such skills in the diagnosis and treatment of chronic pain; with the increasing prevalence of the disease, it cannot be overemphasized that providers must be equipped with the knowledge and skills to provide the care needed. This commentary provides brief, point-of-care information for providers of pain therapies in a portable, easy-to-navigate format. With continued advances made in interventions available to treat pain, this article offers up-to-date details of and instructions for the use of procedural techniques as well as a concise yet informative discussion of the evidence supporting their application. We will discuss some of the most commonly performed procedures. The article presents the readers with a clear understanding of the background, indication, as well as the clinical utility of the discussed procedures. It is important to note the evidence is strong in comparison with other modalities, for example, multiple pharmacologic agents that are considered mainstream, generally accepted management tools have been approved by the U.S. Food and Drug Administration after 12-week trials. Multiple interventional techniques have reported trials of 6-42 months in duration. It must be mentioned, however, that stronger evidence, namely, level 1 studies (double-blinded, controlled studies with long follow-up and outcome measures documenting both pain relief as well as functional improvement) are needed to provide a basis for interventional care.

Etiology of pleural effusion among adults in the state of Qatar: a l-year hospital-based study

There have been no systematic studies of diseases causing pleural effusion in Qatar. This prospective, hospital-based study involved all adult patients (> 15 years) with pleural effusions who were admitted to referral hospitals over a 1-year period. A total of 200 cases of pleural effusion were identified (152 males and 48 females); mean age 45.1 (SD 18.5) years. A majority of patients (73.5%) were non-Qataris, mostly from the Asian subcontinent. The most frequent cause of pleural effusions was tuberculosis (32.5%), followed by pneumonia (19%), cancer (15.5%) and cardiac failure (13%). The most frequent cause of malignant effusion was bronchogenic carcinoma (38.7%), whereas Gram-positive organisms were the most frequent isolates from empyema fluid (62.5%). Histological examination and culture of pleural biopsy were the most useful diagnostic workup for tuberculosis effusions, whereas repeated cytological examination of pleural fluid and pleural biopsy were most useful for malignant effusions.

Cross sectional study of psychiatric comorbidities among adolescents with obsessive compulsive symptoms

Background

Obsessive symptoms among children and adolescent age groups are increasing, an observation made by mental health professions working with this age group. Our epidemiological study is targeting secondary school students to estimate the prevalence of obsessive symptoms, obsessive compulsive disorder and to evaluate psychiatric comorbidities among students with obsessive compulsive symptoms.

Materials and methods

The study is a cross sectional carried on 1299 secondary school students, the sample size was chosen based on an estimated OCD prevalence of 2% in literature. Equal samples were recruited from the 3 educative zones in Alexandria Governorate. Obsessive compulsive symptoms were assessed by the Arabic version of Lyeton obsessive inventory child version LOI-CV. Students scoring above 35 were subjected to the Mini International Neuropsychiatric Interview for children MINI-KID Arabic version to assess psychiatric comorbidities. OCD patient students detected by MINI-KID were assessed by psychiatric interview to confirm fulfilling criteria of OCD according to DSM IV - TR criteria.

Results

The sample was equally distributed according to gender with 51.7% and 48.3% of males and females respectively. The prevalence of obsessive compulsive symptoms was 15.5%, while that of obsessive compulsive disorder was 2.2%. Comorbidity with other psychiatric disorders was high for substance abuse 18.9%, Dysthymia 16.4%, social phobia 15.9%, Major depression 13.9%, Generalized anxiety disorder 12.9%.

Conclusion

The prevalence of obsessive compulsive symptoms is high among adolescent age group, there is high Comorbidity between obsessive symptoms and psychiatric disorders particularly substance abuse, mood disorders and non OCD Anxiety spectrum disorders.

[Risk of caries in orthodontics: descriptive study on 155 patients]

INTRODUCTION

The aim of this survey was to study the prevalence of tooth decay, to assess oral hygiene control, to analyze the different risk factors for caries in orthodontics, and to determine recommendations.

PATIENTS AND METHODS

We studied 155 patients managed in the unit, for three months and 19 days. The main indicators used were: the DMF index; Loe and Silness's gingival index, and Silness and Loe's plate index.

RESULTS

The plate index ranged between 0.08 and 2.4, with a mean of 1.12 ± 0.48; the gingival index ranged between 0 and 2, with a mean of 0.67 ± 0.43; the DMF index ranged between 0 and 21, with a mean of 5.77 ± 4.52.

DISCUSSION

The orthodontist has a major role to play in the prevention of caries before and after treatment. Recommendations and patient information should be adapted to risk for dental caries.

[Polyarteritis nodosa with a spontaneous recovery]

BACKGROUND

The periarteritis nodosa (PAN) is a serious necrotizing vasculitis. Healing is, classically, obtained after a long-term treatment using corticosteroids and immunosuppressive agents.

PURPOSE

Reporting the case of a NAP or was spontaneous healing without having recourse to any immunosuppressive treatment.

CASE REPORT

We report an observation of a patient aged 27 monitoring for manic-depressive psychosis hospitalized for a fever during the course associated with high blood pressure (hypertension), a weight loss, asthenia and myalgia. Biology was a biological inflammatory syndrome (SIB), a creatinine 115 micromol/l. The survey infectious and immunological balance were negative. The arteriography showed a strongly evocative of the NAP. We have seen no sign of poor prognosis. The recovery was spontaneous after a short period of evolution with an amendment clinical and biological weapons. The patient was put under anti-HTA and reviewed regularly to the consultation.

CONCLUSION

An analogy is drawn between such developments and already reported in some cases of viral PAN. The actual frequency of self-limitting PAN is unknown. The scarcity of cases reported in the literature may in part be attributed to ignorance.

HU-210 shows higher efficacy and potency than morphine after intrathecal administration in the mouse formalin test

The discovery of endocannabinoids opens up new perspectives in experimental pain research. Here we present data for the excellent antinociceptive properties of the synthetic cannabinoid, R(-)-7-hydroxy-delta-6-tetra-hydrocannabinol-dimethylheptyl (HU-210), after intrathecal and oral administration in mice. It is known that cannabinoids depress motor activity. Therefore, these compounds are suspected of influencing antinociceptive tests. Our behavioural tests (RotaRod, tail flick) clearly show that HU-210 affects nociceptive behaviour even at dosages which do not yet influence motor activity. Moreover, spinal microdialysis (5 microl/min) in the dorsal horn of freely moving mice showed an enhancement of prostaglandin production during the formalin test. HU-210 applied via artificial cerebral spinal fluid during microdialysis perfusion increases prostaglandin concentrations under both baseline and formalin test conditions. Indomethacin reduces the HU-210 effect on pronociceptive prostaglandin production but does not reinforce the antinociceptive properties of HU-210. Thus, HU-210 shows antinociceptive properties that are independent of its influence on the prostaglandin pathway.

[The etiology of hypercalcemia: a study of 47 cases in a hospital internal medicine service]

In this study, we are presented the clinical and the aetiologic features of 47 patients having hypercalcemia (total serum calcium > or = 2.7 mmol/l). Our results show a positive significantly correlation between the degree of the hypercalcemia and the severity of the clinical symptomatology. As for to the aetiology, the multiple myeloma, the hyperparathyroid and the neoplastic process constituted 78% of the total aetiology.