“The particulars of loss”: Grief Memoirs and Their Pragmatic Applications

Death is commonly pushed to the periphery in contemporary society, leaving the grief-struck to endure the turbulent nature of their loss alone. Unsurprisingly, our mortality-denying times have witnessed the proliferation and popularity of grief memoirs. However, not every text will resonate with every reader, and the selection of appropriate, relatable texts is made more difficult with the overabundance of digital data in our lives. This essay explores select life-altering states of grief addressed in autobiographical accounts of loss and compares the details with the assessment of these states in bereavement literature. The correlations and disparities between the literary and the clinical reveal that the personal nature of grief memoirs makes them a suitable aid in the education of helping professionals and in therapy. Greater familiarity with grief memoirs among therapists may increase their visibility among the bereaved. To facilitate the selection and assessment of proper texts, a closer collaboration between literary scholars specializing in trauma narratives and helping professionals who use bibliotherapy is needed

Resistance to thyroid hormone with a mutation of the thyroid β receptor gene in an eight-month-old infant — a case report

Introduction: Resistance to thyroid hormone (RTHβ) is a rare syndrome of impaired tissue responsiveness to thyroid hormones (THs). The disorder has an autosomal dominant or recessive pattern of inheritance. Most of the reported mutations have been detected in the thyroid hormone receptor β gene (THRβ). Case report: Authors present an eight-month-old infant with poor linear growth, decreased body weight, tachycardia, positive family history, and neonatal features suggestive of RTHβ. Both our patient and his mother had elevated free thyroxine, free triiodothyronine, and non-suppressed thyrotropin (TSH) concentration. The fluorescent sequencing analysis showed a heterozygous mutation c.728G > A in TRβ gene. This pathogenic variant is known to be associated with THR. Conclusions: The clinical presentation of RTHb is variable, ranging from isolated biochemical abnormalities to symptoms of thyrotoxicosis or hypothyroidism. The syndrome should be suspected in patients with increased serum TH level, accompanied by a normal or elevated TSH concentration. The affected patients require individualised management.Introduction: Resistance to thyroid hormone (RTHβ) is a rare syndrome of impaired tissue responsiveness to thyroid hormones (THs). The disorder has an autosomal dominant or recessive pattern of inheritance. Most of the reported mutations have been detected in the thyroid hormone receptor β gene (THRβ). Case report: Authors present an eight-month-old infant with poor linear growth, decreased body weight, tachycardia, positive family history, and neonatal features suggestive of RTHβ. Both our patient and his mother had elevated free thyroxine, free triiodothyronine, and non-suppressed thyrotropin (TSH) concentration. The fluorescent sequencing analysis showed a heterozygous mutation c.728G > A in TRβ gene. This pathogenic variant is known to be associated with THR. Conclusions: The clinical presentation of RTHb is variable, ranging from isolated biochemical abnormalities to symptoms of thyrotoxicosis or hypothyroidism. The syndrome should be suspected in patients with increased serum TH level, accompanied by a normal or elevated TSH concentration. The affected patients require individualised management

Discriminación de aceites de oliva comestibles mediante espectroscopía de fluorescencia sincrónica y análisis multivariante

The potential of fluorescence spectroscopy for the classification of olive oils was investigated. Synchronous fluorescence spectra were collected in the region of 240-700 nm with the wavelength intervals of 10, 30, 60 and 80 nm. Successive projection algorithm (SPA) was applied for the determination of representative wavelengths while the linear discriminant analysis (LDA) method was used to classify olive oils. The classification error of the method was low (0,9-6,4%) for measurements collected at all wavelength intervals. The best classification accuracy was obtained for synchronous fluorescence intensities acquired at 10 selected wavelengths with the wavelength interval equal to 10 nm.Se ha investigado el potencial de la espectroscopía de fluorescencia para la clasificación de los aceite de oliva. Para ello, se recogieron espectros de fluorescencia sincrónica en el rango de 240-700 nm con intervalos de longitud de onda de 10, 30, 60 y 80 nm. Las proyecciones algorítmicas sucesivas (SPA) se aplicaron para la determinación de las longitudes de onda representativas mientras que el método de análisis discriminante lineal (LDA) se empleó para clasificar los aceites de oliva. Se obtuvo un error de clasificación del método bajo (0,9-6,4%) para las medidas recogidas en todos los intervalos de onda. La mejor precisión de clasificación se obtuvo para intensidades de fluorescencia sincrónica adquiridos a 10 longitudes de onda seleccionadas con intervalos de longitud de onda de 10 nm

Structure and phase stability of nanocrystalline Ce1−xLnxO2−x/2−δ (Ln = Yb, Lu) in oxidizing and reducing atmosphere

The structure and phase evolution of nanocrystalline Ce1−xLnxO2−x/2−δ (Ln = Yb, Lu, x = 0 − 1) oxides upon heating in H2 was studied for the first time. Up to 950 °C the samples were single-phase, with structure changing smoothly with x from fluorite type (F) to bixbyite type (C). For the Lu-doped samples heated at 1100 °C in the air and H2, phase separation into coexisting F- and C-type structures was observed for ~0.40 < x < ~0.70 and ~0.25 < x < ~0.70, respectively. It was found also that addition of Lu3+ and Yb3+ strongly hinders the crystallite growth of ceria during heat treatment at 800 and 950 °C in both atmospheres. Valency of Ce and Yb in Ce0.1Lu0.9O1.55−δ and Ce0.95Yb0.05O1.975−δ samples heated at 1100 °C was studied by XANES and magnetic measurements. In the former Ce was dominated by Ce4+, with small contribution of Ce3+ after heating in H2. In the latter, Yb existed exclusively as 3+ in both O2 and H2

The position of a duodenal diverticulum in the area of the major duodenal papilla and its potential clinical implications

Background: Although duodenal diverticula are associated with less frequent pathology than the colonic diverticula in the large intestine, their periampullary position may have significant clinical implications. The aim of the study was to identify any possible correlation between the type of localisation of the major duodenal papilla, duodenal diverticula, and some particular clinical issues. Materials and methods: In total, 628 patients (408 females and 220 males; aged 21–91 years), who underwent endoscopic retrograde cholangiopancreatography were included in this study. The patients were divided into two groups: a study group comprising 66 (10.5%) patients with periampullary position of diverticula (group A), and a control group comprising 562 (89.5%) patients without diverticula (group B). Results: A duodenal diverticulum was diagnosed in the periampullary position in 66/628 (10.5%) patients: 41 women (aged 52–91 years) and 25 men (aged 54–83 years). Conclusions: Three types of localisation were observed for the major duodenal papilla with regard to the diverticula, with the most common type being next to each other (type III). In patients with diverticula, similar frequencies of gallstone occurrence are observed in men and women. Patients with papilla in the diverticulum who underwent cholecystectomy are more prone to develop lithiasis

The usefulness of SPECT-CT with radioisotope-labeled leukocytes in diagnosing lead-dependent infective endocarditis

Background. Lead-dependent infective endocarditis (LDIE) is a life-threatening complication of permanent transvenous cardiac pacing. According to the 2015 European Society of Cardiology (ECS) guidelines, the diagnosis of LDIE is based on the modified Duke criteria (MDC), while single-photon emission computed tomography with conventional computed tomography (SPECT-CT) with radioisotope-labeled leukocytes serves as an additional tool in difficult cases. The major challenge is to differentiate between true vegetation and a thrombus.   Objectives. The aim of the study was to evaluate the usefulness of SPECT-CT with radioisotope-labeled leukocytes in diagnosing LDIE in patients with intracardiac masses (ICMs).   Material and Methods. The prospective registry included 40 consecutive patients admitted with an ICM on the lead and suspicion of LDIE. The confirmation or rejection of the LDIE diagnosis was made according to an algorithm based on the MDC. The cohort was divided into 2 groups: patients with definite and possible LDIE diagnoses based on the MDC (the LDIE-positive group), and patients with negative LDIE diagnoses according to the MDC (the LDIE-negative group). All patients underwent SPECT-CT with radioisotope-labeled leukocytes. The diagnostic ability of SPECT-CT was compared to the gold standard MDC.   Results. The LDIE-positive group with diagnosis based on the MDC consisted of 19 patients (LDIE definite – 11; LDIE possible – 8). The LDIE diagnosis was rejected on the basis of the MDC in 21 patients. The SPECT-CT results were compared with the MDC results and showed 73.7% sensitivity, 81.0% specificity, 77.5% accuracy, 77.8% positive predictive value (PPV), 77.3% negative predictive value (NPV), likelihood ratio positive (LR+) 3.868, likelihood ratio negative (LR–) 0.325, and moderate agreement (κ = 0.548, p < 0.001). After the exclusion of 5 patients treated with antibiotics at the time of the SPECT-CT, LR+ and LRimproved to 5.250 and 0, respectively, and inter-test agreement amounted to almost perfect concordance (κ = 0.773, p < 0.001).   Conclusion. Single-photon emission computed tomography with conventional CT with radioisotopelabeled leukocytes is a useful, efficient, single-step test for diagnosing LDIE