A randomized, placebo-controlled trial of prednisone in early Henoch Schönlein Purpura [ISRCTN85109383]

BACKGROUND: Henoch Schönlein Purpura (HSP) is the most common systemic vasculitis of childhood. There is considerable controversy over whether children with HSP should be treated with corticosteroids. The goal of this study was to investigate whether early corticosteroid administration could reduce the rate of renal or gastrointestinal complications in children with HSP. METHODS: Forty children with HSP, seen in the emergency room of a tertiary-care, paediatric centre, entered a randomized, double-blind, placebo controlled study. The treatment group (n = 21) received oral prednisone, 2 mg/kg/day for one week, with weaning over a second week, while the placebo group (n = 19) received an identical appearing placebo. Co-primary outcomes were the rate of renal involvement at one year and the rate of acute gastrointestinal complications. Co-primary outcomes were analysed using Fisher's Exact test. RESULTS: At one year, there was no difference in the rate of renal involvement (3/21 prednisone group vs. 2/19 placebo group, P = 1.0). There was also no statistically significant difference in the rate of acute gastrointestinal complications (2/21 prednisone group vs. 3/19 placebo group, P = 0.7). Two children in the placebo group did experience intussusceptions compared with none in the prednisone group (P = 0.2). CONCLUSIONS: Early prednisone therapy in HSP does not appear to reduce the risk of renal involvement at one year, or the risk of acute gastrointestinal complications. There may be a reduced risk of intussusception. The routine, early use of prednisone in uncomplicated HSP cannot be recommended at this time

Differential Patterns of Food Appreciation during Consumption of a Simple Food in Congenitally Anosmic Individuals: An Explorative Study

Food is evaluated for various attributes. One of the key food evaluation domains is hedonicity. As food is consumed, its hedonic valence decreases (due to prolonged sensory stimulation) and hedonic habituation results. The aim of the present study was to investigate changes in food pleasantness ratings during consumption of a simple food by individuals without olfactory experience with food as compared to normosmics. 15 congenital anosmics and 15 normosmic controls were each presented with ten 10 g banana slices. Each was visually inspected, then smelled and chewed for ten seconds and subsequently rated for hedonicity on a 21-point scale. There was a significant difference in pleasantness ratings between congenital anosmics and controls (F(1, 26) = 6.71, p = .02) with the anosmics exhibiting higher ratings than the controls, a significant main repeated-measures effect on the ratings (F(1.85, 48) = 12.15, p<.001), which showed a decreasing trend over the course of consumption, as well as a significant portion*group interaction (F(1.85, 48) = 3.54, p = .04), with the anosmic participants experiencing a less pronounced decline. The results of the present explorative study suggest that over the course of consumption of a simple food, congenitally anosmic individuals experience differential patterns of appreciation of food as compared to normosmics. In this particular case, the decrease of hedonic valence was less pronounced in congenital anosmics

Avaliação do perfil auditivo de militares de um quartel do Exército Brasileiro Audiometric assessment for military personnel

No serviço militar, os sujeitos estão expostos a ruídos contínuos em oficinas e a ruídos de impacto provenientes de armas de fogo e detonações. Estes ruídos indesejáveis são capazes de causar lesão ao sistema auditivo, muitas vezes irreversível, além de outros efeitos em todo o organismo. OBJETIVO: Avaliar os perfis auditivos de um grupo de militares e, em face dos resultados, incentivar a implementação de medidas preventivas para perdas auditivas, como programa de conservação auditiva. FORMA DE ESTUDO: Coorte transversal. MATERIAL E MÉTODO: Avaliação auditiva de 97 sujeitos que trabalham em uma organização militar do Exército, por meio de entrevista, otoscopia e exames audiométricos. RESULTADOS: 38,1% dos militares examinados apresentaram alterações audiométricas supostamente induzidas por ruído, predominantemente nos artilheiros, com predomínio da perda auditiva unilateral. 64,5% dos militares examinados não utilizava proteção adequada. CONCLUSÃO: A grande ocorrência da perda auditiva entre os militares e a falta de proteção adequada à exposição ao ruído indica a necessidade de se implantarem, nesta categoria, medidas de prevenção de perda auditiva.<br>The individuals rendering the military service are often liable to frequent noise in factories and discharge sounds deriving from firearms and detonations. These sort of undesirable sounds cause lesions the auditory system, which are sometimes irreversible, besides provoking bad effects to the body as a whole. AIM: Evaluating the auditory profiles from a specific group of military personnel, and according to the achieved results to promote the incentive towards the implantation of preventive measures related to auditory losses, such as auditory preservation programs. STUDY DESIGN: Transversal cohort. MATERIAL AND METHOD: Auditory evaluation of 97 individuals working in a military organization, which included interviews, as well as otoscopic and audiometric tests. RESULTS: From the total examined personnel, 38,1% presented audiometric changes supposedly noise-induced since these changes prevailed in the artillerymen, being the unilateral hearing loss predominant. The use of no proper protection equipment was observed in 64,5% of the total examined military personnel. CONCLUSION: The high level of hearing loss occurrences found between the military personnel joined to the absence of proper protection equipment for the exposition to noises, indicate the need of implanting prevention measures to avoid hearing losses among theses professionals

COVID

With the COVID-19 pandemic, chemosensory dysfunction are among the most prevalent symptoms. Most reports are subjective evaluations, which have been suggested to be unreliable. The objective is to test chemosensory dysfunction and recovery based on extensive psychophysical tests in COVID-19 during the course of the disease. Prospective cohort study. A total of 111 patients from four centers participated in the study. All tested positive for SARS-COV-2 with RT-PCR. They were tested within 3 days of diagnosis and 28 to 169 days after infection. Testing included extensive olfactory testing with the Sniffin' Sticks test for threshold, discrimination and identification abilities, and with the Taste Sprays and Taste Strips for gustatory function for quasi-threshold and taste identification abilities. There was a significant difference in olfactory function during and after infection. During infection 21% were anosmic, 49% hyposmic, and 30% normosmic. After infection only 1% were anosmic, 26% hyposmic, and 73% normosmic. For gustatory function, there was a difference for all taste qualities, but significantly in sour, bitter, and total score. Twenty-six percent had gustatory dysfunction during infection and 6.5% had gustatory dysfunction after infection. Combining all tests 22% had combined olfactory and gustatory dysfunction during infection. After infection no patients had combined dysfunction. Chemosensory dysfunction is very common in COVID-19, either as isolated smell or taste dysfunction or a combined dysfunction. Most people regain their chemosensory function within the first 28 days, but a quarter of the patients show persisting dysfunction, which should be referred to specialist smell and taste clinics for rehabilitation of chemosensory function. 3 Laryngoscope, 131:1095-1100, 2021