Citations

Background This goal of this study was to understand the patterns of expressed emotions (EEs) in adolescent eating disorders. As such, this study compared EE among families of adolescents with anorexia nervosa ( AN ), bulimia nervosa ( BN ), and a psychiatric control group, major depressive disorder ( MDD ). This study also examined the influence of family status (intact vs. nonintact) and the presence of siblings on EE . Methods Two‐hundred and fifteen adolescents (ages 12–19) and their families were recruited for this study including 121 adolescents with AN , 54 adolescents with BN , and 40 adolescents with MDD . Adolescents with at least one parent completed the Standardized Clinical Family Interview. Adolescents completed structured diagnostic interviews to assess eligibility for the study, as well as a standardized questionnaire to assess depression. Results Analyses revealed that fathers showed higher levels of critical comments to adolescents with BN or MDD than those with AN , whereas mothers made more critical comments toward patients with BN . Mothers made the least number of positive remarks toward patients with MDD . In terms of the influence of family status, fathers from intact families showed more expressions of warmth and were less critical than fathers from nonintact families, whereas mothers from intact families were less critical but also made fewer positive remarks than mothers from nonintact families. The presence of siblings appeared to reduce mothers’ expression of warmth and emotional overinvolvement. Conclusions Unique patterns of EE were found to characterize AN , BN , and MDD . Family status and the presence of siblings exert an influence on EE that should be taken into consideration in future research.

Background Environmental enteric dysfunction (EED) is an asymptomatic intestinal disorder affecting populations living in conditions of poor sanitation and hygiene. The study tested intestinal barrier function in infants with EED. Methods We prospectively studied an advanced high-performance liquid chromatography mass spectrometry assay of urine collected after oral intake of the monosaccharide, L-rhamnose and the disaccharide, lactulose, in 112 children from three continents. Findings Compared to the US cohort (n=27), the cohorts of children from Peru (n=19) and Zambia (n=85) were older with evidence of growth impairment. The median (range) of age (months) was 8.0 (2.0 to 13.0), 27.0 (15.0 to 29.0) and 21.0 (12.0 to 36.0), respectively. The median (range) of height for age Z score was −0.1 (−1.8 to 2.4), −1.8 (−3.3 to −0.2) and −2.3 (−8.5 to 1.2), respectively. Among children with valid sugar data (n=22 USA, n=19 Peru, n=73 Zambia), there were no significant differences in the median rhamnose urine concentrations between the three groups. The median (range) lactulose concentration (µg/mL) was 6.78 (0.29 to 31.90), 47.60 (4.23 to 379.00) and 75.40 (0.67 to 873.00) in the US, Peruvian and Zambian cohorts, respectively (p<0.001). The lactulose/rhamnose ratio (LRR) was higher in cohorts from Peru (0.75, 0.15, 5.02) and Zambia (2.26, 0.08, 14.48) compared to the US (0.14, 0.06, 1.00) cohort (p<0.001). In a multivariate effect modification model, higher weight-for-age z scores were associated with lower post-dose lactulose when rhamnose excretion was constant (p=0.003). Conclusions This non-invasive two saccharide permeability protocol measures changes in intestinal permeability in children with EED and permits the identification of individuals for interventional trials.

AimThe aim of this study was to compare passive muscle stiffness in children with cerebral palsy (CP) and children with typical development using a novel ultrasound technique: ultrasound shear wave elastography (SWE).MethodWe conducted a prospective study of 13 children with CP (six females and seven males, median age 5y 1mo [interquartile range 4y 4mo–7y 8mo]) and 13 children with typical development (six females and seven males, median age 5y 3mo [interquartile range 4y 4mo–9y 4mo]). Demographic information and physical exam measurements were obtained in addition to shear modulus measurements (passive muscle stiffness) of the lateral gastrocnemius muscle at 20° plantar flexion, 10° plantar flexion, and 0° plantar flexion using SWE.ResultsChildren with CP had significantly greater shear modulus measurements at all three foot positions (p<0.050). When the shear modulus values were normalized to the baseline value for each child, there was no significant difference between the two groups.InterpretationPassive muscle stiffness, measured without the influence of spasticity, is greater in children with CP than in children with typical development when a muscle is at slack and at stretch. When shear modulus was normalized, the results indicate that muscle in children in both groups responds similarly to passive stretch. Further work includes evaluating effect of botulinum toxin on passive muscle properties.

Background: Needle biopsy has proven to be a potentially adequate method for initial biopsy of many soft-tissue and bone lesions. To help optimize this procedure, this study sought to test the characteristics of several needles, including a steerable needle. Materials and Methods: Five needle types were tested, including a steerable needle. Animal muscle tissue was used for all testing. The following experiments were performed: (1) sample collection with different needle types, (2) histological analysis of needle track, (3) observation of steerable needle characteristics using CT-guidance. Results: Sample collection: The Menghini 21 g and Chiba 22 g needles were graded as excellent for ease of use and integrity of sample. Histologic evaluation showed good specimen preservation with all needle types. Histological analysis of needle track: tracks created by the Menghini 21 g and Spinal 20 g needles both showed no histologically detectable damage to surrounding tissue. Observation of steerable Menghini needle under CT-guidance: needle advanced easily through tissue, even when maximally curved. Small, large, and double curves were feasible to avoid obstacles and reach targets. There was no deflection or change in position of the needle tip when the stylet was removed. Needle withdrawal did not damage surrounding tissue. Conclusions: Compared to the other needles, the steerable needle was found to be durable and easy to use, allowing for precise navigation around vital structures yielding superior integrity of sample tissue.

AbstractObjectiveThe risk of hypertension in adults who regularly take a nap is controversial. The objective of this meta‐analysis was to assess the associations between napping and hypertension.MethodsA literature search was performed using MEDLINE, EMbase and The Cochrane Database of Systematic Reviews from inception through October, 2015. Studies that reported relative risks, odd ratios or hazard ratios comparing the risk of hypertension in individuals who regularly take nap were included. Pooled risk ratios (RR) and 95% confidence interval (CI) were calculated using a random‐effect, generic inverse variance method.ResultsNine observational studies with 112,267 individuals were included in the analysis to assess the risk of hypertension in nappers. The pooled RR of hypertension in nappers was 1.13 with 95% CI (0.98 to 1.30). When meta‐analysis was limited only to studies assessing the risk of hypertension in daytime nappers, the pooled RR of hypertension was 1.19 with 95% CI (1.06 to 1.35). The data on association between nighttime napping in individuals who work night shift and hypertension were limited, only one observational study reported reduced risk of hypertension in nighttime nappers with odds ratio of 0.79 with 95% CI (0.63 to 1.00).ConclusionsOur meta‐analysis demonstrates a significant association between daytime napping and hypertension. Future study is needed to assess the potential benefits of HTN screening for daytime nappers.