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The World Health Organization emphasizes the importance of developing programs of mental health promotion and prevention to ensure the wellbeing of young people. Mental health literacy in schools is an example of universal prevention intervention. The objective of this article is to conduct a systematic review of the mental health literacy interventions in the educational setting that are being carried out at the international level and to describe and evaluate, as well, an experience at the local level. A search has been carried out in PubMed to identify experimental studies on mental health literacy interventions in the educational setting including primary and/or secondary. Out of 245 references identified, 13 experimental studies were included in the review and its quality was assessed. Results show that these programs increase mental health knowledge, improve help-seeking and reduce stigma behavior. In Barcelona, the Espaijove.net mental health literacy program has been running since 2008. In the last seven school courses (2012-2019) workshops have been provided to 24,118 secondary school students, of whom 11,678 completed a post-workshop satisfaction questionnaire. The results show that the program has been interesting, useful, has resolved students' doubts and that they would recommend it to other students, and a better reception by the girls.The European Society for Clinical Nutrition and Metabolism (ESPEN) presents a new series of "practical guidelines" based on previously published scientific guidelines. A first example of such a Practical Guideline has been completed and published recently (ESPEN practical guideline Clinical Nutrition in inflammatory bowel disease), other will follow soon. The practical guidelines are generated by shortening and restructuring of the Scientific guidelines and by presenting the content using flow charts for a fast navigation through the content. The practical guidelines serve as templates for IT-based versions for the smartphone, tablet and PC, for lay versions and for translations into different languages. These efforts are part of a new guideline dissemination and implementation program ESPEN launched in 2018 also with support by the United European Gastroenterology society. First results are presented.
Sarcoidosis is a multi-systemic disease characterized by non-caseating granulomas. Bone involvement initially considered as rare and described as a peripheral osteitis of the hands and feet, has recently been reported on the axial skeleton.
We report 4 clinical observations of sarcoidosis (3 women, 1 man) with axial bone involvement located to the spine (n=4), pelvic bone (n=2), scapular bone (n=2), sternum (n=1), mandible (n=1). Sarcoidosis was already diagnosed in 3 cases. Bone pain was the main symptom, related in 3 cases. Magnetic resonance imaging appeared to be the best imaging test Histological bone analysis revealed typical granulomatous lesions (n=2). Treatment included corticosteroids (n=4), hydroxychloroquine (n=2), and methotrexate (n=2), with a good efficacy on bone pain in symptomatic patients.
These 4 cases, as well as recent literature, illustrate bone involvement of sarcoidosis on the axial skeleton. It is symptomatic in around 50% of cases but may be a source of significant disability. Differential diagnosis with neoplasm may require bone histological analysis. This condition appears to be responsive to usual treatments for sarcoidosis.
These 4 cases, as well as recent literature, illustrate bone involvement of sarcoidosis on the axial skeleton. It is symptomatic in around 50% of cases but may be a source of significant disability. Differential diagnosis with neoplasm may require bone histological analysis. This condition appears to be responsive to usual treatments for sarcoidosis.Infections are a frequent cause of cerebral vasculitis, important to diagnose because a specific treatment may be required. Cetuximab Infection-associated vasculitis can be caused by angiotropic pathogens (varicella zoster virus, syphilis, aspergillus). They can be associated with subarachnoidal meningitis (tuberculosis, pyogenic meningitis, cysticercosis). They can appear contiguously to sinuses or orbital infection (aspergillosis, mucormycosis). Finally, they also may be due to an immune mechanism in the context of chronic infections (hepatitis B virus, hepatitis C virus, human immunodeficiency virus). Cerebral vasculitis are severe conditions and their prognosis is directly linked to early recognition and diagnosis. Infectious causes must therefore be systematically considered ahead of cerebral vasculitis, and the appropriate investigations must be determined according to the patient's clinical context. We propose here an update on the infectious causes of cerebral vasculitis, their diagnosis modalities, and therapeutic options.When swallowing, a clicking in the throat may uncommonly occur, causing great discomfort and pain. This unpleasant event may lead health professionals to attribute the symptoms to psychogenic aetiology. The case of a 49-year-old female is presented, who reported an audible bilateral clicking in the throat, associated with neck and throat pain when swallowing or turning her neck. From the ENT examination and palpation of the neck during patient swallowing, we located the source of the clicking on the left. However, during palpation from side to side, the patient suffered bilateral pain. Laryngeal computed tomography with a 3D reconstruction showed a short distance between the hyoid bone and the superior part of the thyroid cornua, accompanied by posterior-medially displaced bilateral superior cornua in the thyrohyoid region. The bilateral sensation of throat pain during swallowing or palpation, in combination with our desire to maintain laryngeal symmetry, led us to a two-sided exeresis of the superior thyroid cornua. This resulted in immediate and complete relief of the symptoms. Although it is an uncommon complaint, clicking larynx syndrome should be considered as a differential diagnosis.COVID-19 is a new pandemic, caused by Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-Cov2) infection and characterized by a broad spectrum of clinical manifestations. Inflammation and the innate immune system have been recently recognized as pivotal players in the most severe forms, characterized by significantly elevated levels of pro-inflammatory cytokines. In this setting, several studies have also reported the presence of abnormalities in coagulation parameters and platelets count, possibly identifying a subgroup of patients with poor prognosis. Some reports of full-blown thromboembolic events are emerging. Among the possible mechanisms underlying coagulation dysfunction, the so-called "cytokine storm" seems to play a pivotal role. Other candidate factors include virus-specific mechanisms, related to the virus interaction with renin angiotensin system (RAS) and the fibrinolytic pathway, but also comorbidities affecting these patients. Coagulation dysfunction is therefore a candidate risk factor for adverse outcomes in COVID-19 and should be carefully addressed in clinical practice.
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