Notes

Dysphagia due to quickly arranged hyperinflation of an swallowable intragastric mechanism.
The self and self-experience are often assumed to play an important role in adolescent patients presenting with severe somatic symptoms and bodily distress. Nonetheless, most empirical work on this subject is confined to studies of personality and patients' experience of negative emotionality. This study aims to move beyond mere descriptions of symptoms, traits and distress, and consequently adopts a narrative approach to self-experience in adolescent chronic fatigue syndrome (CFS).

The self-confrontation method (SCM) is a well-validated instrument to systematically analyze narrative self-experience. The SCM was used to study 42 adolescents with CFS, compared to 36 adolescents with juvenile idiopathic arthritis (JIA) and 25 matched healthy controls. The Child Health Questionnaire (CHQ-CF87) was used to assess mental health, self-esteem, and physical and psychosocial functioning.

Both patient groups reported significantly less positive self-experience of autonomy and success compared to healthy controls.ination of high negative and low positive self-experience. These findings stress the need for strategies that empower patients towards a 'management of the self'.
Castleman's disease (CD) is a benign and rare lymphoid tissue disease of undetermined origin. It affects the neck infrequently; therefore its preoperative diagnosis is difficult and can be confused with other hypervascular lesions.

We present a case of unicentric hyaline-vascular CD in the posterior cervical space (PCS) evaluated by MRI and initially presumed to be a cervical schwannoma.

As shown with our case, unicentric CD should be included in the differential diagnosis for masses in the PCS, especially when a hypervascular lesion like a schwannoma is suspected. The finding of central low intensity areas in a fissured and radial pattern in T2 sequences can help to consider CD when dealing with PCS masses as shown by previous cases and our reported experience.
As shown with our case, unicentric CD should be included in the differential diagnosis for masses in the PCS, especially when a hypervascular lesion like a schwannoma is suspected. The finding of central low intensity areas in a fissured and radial pattern in T2 sequences can help to consider CD when dealing with PCS masses as shown by previous cases and our reported experience.
Mucormycosis is an opportunist infection usually affecting immunocompromised patients. It is rare and often fatal. The pathogen is filamentous fungus of the mucorales order. Studies discuss the clinical, diagnostic and therapeutic aspects of ENT mucormycosis, insisting on early clinical diagnosis, laboratory data not being contributive within satisfactory time limits.

A retrospective study included 4 patients with ENT mucormycosis diagnosed over a 13-year period, from January 2000 to December 2012.

The study included 2 male and 2 female patients, aged from 3 to 77 years. Two patients were diabetic. There were 2 cases of sinonasal mucormycosis and 2 of otologic involvement. Diagnosis was founded on anatomopathologic and mycologic examination. A fatal issue occurred in 1 case with otocerebral involvement.

Otorhinolaryngologic mucormycosis is a rare fungal infection, which needs to be borne in mind. Rhinocerebral lesions are the most common clinical manifestations. Involvement of the ear is very rare. Diagnosis is often difficult, but should be as early as possible. Treatment, initiated urgently, associates antifungal treatment, surgical resection and control of risk factors. The prognosis remains in all cases severe.
Otorhinolaryngologic mucormycosis is a rare fungal infection, which needs to be borne in mind. Rhinocerebral lesions are the most common clinical manifestations. Involvement of the ear is very rare. Diagnosis is often difficult, but should be as early as possible. Treatment, initiated urgently, associates antifungal treatment, surgical resection and control of risk factors. The prognosis remains in all cases severe.The design of hybrid poly-ε-caprolactone (PCL)-self-assembling peptides (SAPs) matrices represents a simple method for the surface functionalization of synthetic scaffolds, which is essential for cell compatibility. This study investigates the influence of increasing concentrations (2.5%, 5%, 10% and 15% w/w SAP compared to PCL) of three different SAPs on the physico-chemical/mechanical and biological properties of PCL fibers. We demonstrated that physico-chemical surface characteristics were slightly improved at increasing SAP concentrations the fiber diameter increased; surface wettability increased with the first SAP addition (2.5%) and slightly less for the following ones; SAP-surface density increased but no change in the conformation was registered. These results could allow engineering matrices with structural characteristics and desired wettability according to the needs and the cell system used. The biological and mechanical characteristics of these scaffolds showed a particular trend at increasing SAP concentrations suggesting a prevailing correlation between cell behavior and mechanical features of the matrices. As compared with bare PCL, SAP enrichment increased the number of metabolic active h-osteoblast cells, fostered the expression of specific osteoblast-related mRNA transcripts, and guided calcium deposition, revealing the potential application of PCL-SAP scaffolds for the maintenance of osteoblast phenotype.Increasing enrolment rates could place schools in a crucial position to support mental health in low-income and middle-income countries. In this Review, we provide evidence for mental health interventions in schools in accordance with a public mental health approach spanning promotion, prevention, and treatment. We identified a systematic review for mental health promotion, and identified further prevention and treatment studies. this website Present evidence supports schools as places for promotion of positive aspects of mental health using a whole-school approach. Knowledge of effectiveness of prevention and treatment interventions is more widely available for conflict-affected children and adolescents. More evidence is needed to identify the many elements likely to be associated with effective prevention and treatment for children exposed to a range of adversity and types of mental disorders. Dissemination and implementation science is crucial to establish how proven effective interventions could be scaled up and implemented in schools.
Social anxiety disorder-a chronic and naturally unremitting disease that causes substantial impairment-can be treated with pharmacological, psychological, and self-help interventions. We aimed to compare these interventions and to identify which are most effective for the acute treatment of social anxiety disorder in adults.

We did a systematic review and network meta-analysis of interventions for adults with social anxiety disorder, identified from published and unpublished sources between 1988 and Sept 13, 2013. We analysed interventions by class and individually. Outcomes were validated measures of social anxiety, reported as standardised mean differences (SMDs) compared with a waitlist reference. This study is registered with PROSPERO, number CRD42012003146.

We included 101 trials (13 164 participants) of 41 interventions or control conditions (17 classes) in the analyses. Classes of pharmacological interventions that had greater effects on outcomes compared with waitlist were monoamine oxidase inhiMD -0·56, 95% CrI -1·03 to -0·11) and interpersonal psychotherapy, mindfulness, and supportive therapy (-0·82, -1·41 to -0·24).

Individual CBT (which other studies have shown to have a lower risk of side-effects than pharmacotherapy) is associated with large effect sizes. Thus, it should be regarded as the best intervention for the initial treatment of social anxiety disorder. For individuals who decline psychological intervention, SSRIs show the most consistent evidence of benefit.

National Institute for Health and Care Excellence.
National Institute for Health and Care Excellence.
Lithium is the established standard in the long-term treatment of bipolar disorder, but several new drugs have been assessed for this indication. We did a network meta-analysis to investigate the comparative efficacy and tolerability of available pharmacological treatment strategies for bipolar disorder.

We systematically searched Embase, Medline, PreMedline, PsycINFO, and the Cochrane Central Register of Controlled Trials for randomised controlled trials published before June 28, 2013, that compared active treatments for bipolar disorder (or placebo), either as monotherapy or as add-on treatment, for at least 12 weeks. The primary outcomes were the number of participants with recurrence of any mood episode, and the number of participants who discontinued the trial because of adverse events. We assessed efficacy and tolerability of bipolar treatments using a random-effects network meta-analysis within a Bayesian framework.

We screened 114 potentially eligible studies and identified 33 randomised control manic episode and depressive episode relapse or recurrence and the better quality of the supporting evidence, lithium should remain the first-line treatment when prescribing a relapse-prevention drug in patients with bipolar disorder, notwithstanding its tolerability profile.

None.
None.
Major depression is an important complication of cancer. However, reliable data are lacking for the prevalence of depression in patients with cancer in different primary sites, the association of depression with demographic and clinical variables within cancer groupings, and the proportion of depressed patients with cancer receiving potentially effective treatment for depression. We investigated these questions with data from a large representative clinical sample.

We analysed data from patients with breast, lung, colorectal, genitourinary, or gynaecological cancer who had participated in routine screening for depression in cancer clinics in Scotland, UK between May 12, 2008, and Aug 24, 2011. Depression screening was done in two stages (first, Hospital Anxiety and Depression Scale; then, major depression section of the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition). Data for depression status were linked with demographic and clinical data obtainet Office of the Scottish Government.
Although effective, Carpentier technique for mitral regurgitation presents two "Achille's heel" the resection of the whole prolapsing section of posterior mitral leaflet (PML) including chordae tendinae and the annular distortion due to plication. An alternative technique of limited PML resection, which preserves mitral anatomy decreasing the impact on valve function, and 9-year outcome are presented.

Since April 2005 till March 2014, of 205 patients affected by mitral prolapse scheduled for repair (mitral valve repair), 54 patients have been included in the study. The rationale of the new technique was to limit PML resection to achieve a fair reduction of the prolapsing scallop(s) height, to avoid leaflet and annular distortion, and to spare the coaptation surface and other substantial structures. According to the observation that the posterior smooth zone of PML is quite free from chordal insertions, an elliptical slice of tissue was resected from this area. Annuloplasty and neochordal insertion when indicated completed the procedure.
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