Anesthesia for laryngotracheal reconstruction in a child with single ventricle

The number of children with congenital heart requiring anesthetic care is increasing. We describe the anesthetic management of a child with single ventricle candidate for laryngotracheal reconstruction. The patient suffered from severe subglottic stenosis due to prolonged intubation following Glenn shunt procedure. Anesthetic considerations in the care of patients with single ventricle for non-cardiac surgeries are reviewed. Particular concerns in the airway management of children with severe subglottic stenosis and during the tracheal surgery are also reviewed. © 2021 Wolters Kluwer Medknow Publications. All rights reserved

The acute effect of maximal exercise on plasma beta-endorphin levels in fibromyalgia patients

Background: This study aimed to investigate the effect of strenuous exercise on β-endorphine (β-END) level in fibromyalgia (FM) patients compared to healthy subjects. Methods: We enrolled 30 FM patients and 15 healthy individuals. All study participants underwent a treadmill exercise test using modified Bruce protocol (M.Bruce). The goal of the test was achieving at least 70 of the predicted maximal heart rate (HRMax). The serum levels of β-END were measured before and after the exercise program. Measurements were done while heart rate was at least 70 of its predicted maximum. Results: The mean � the standard deviation (SD) of exercise duration in the FM and control groups were 24.26 � 5.29 and 29.06 � 3.26 minutes, respectively, indicating a shorter time to achieve the goal heart rate in FM patients (P < 0.003). Most FM patients attained 70 HRMax at lower stages (stage 2 and 3) of M.Bruce compared to the control group (70 versus 6.6, respectively; P < 0.0001). Compared to healthy subjects, FM patients had lower serum β-END levels both in baseline and post-exercise status (Mean � SD: 122.07 � 28.56 μg/ml and 246.55 � 29.57 μg/ml in the control group versus 90.12 � 20.91 μg/ml and 179.80 � 28.57 μg/ml in FM patients, respectively; P < 0.001). Conclusions: We found that FM patients had lower levels of β-END in both basal and post-exercise status. Exercise increased serum the β-END level in both groups but the average increase in β-END in FM patients was significantly lower than in the control group. � The Korean Pain Society, 2016

Correlation of invalidation with symptom severity and health status in fibromyalgia

Objective. Invalidation is a new construct in health psychology, especially in diseases with inherently invisible symptoms such as FM. It can potentially affect both the quality of life and disease severity in patients with FM. This study aimed to investigate the correlation of illness invalidation with health status and symptom severity in FM. Methods. A total of 112 consecutive patients with FM referred to the rheumatology clinic were enrolled. Invalidation was measured by the Illness Invalidation Inventory (3*I). To measure patient status and progress of FM, the Revised Fibromyalgia Impact Questionnaire (FIQR) was used and patients' quality of life was assessed by the 12-item Short Form Health Survey (SF-12). Multiple linear regression analyses were performed and Spearman's correlations were calculated. Results. All the patients were female and aged between 18 and 61 years. No significant differences in discounting and lack of understanding between various sources of invalidation were found. The strongest correlation was observed between FIQR symptom score and discounting by work (r = 0.519, P < 0.05). Multiple linear regression analyses revealed that only discounting from the spouse significantly predicted FIQR total scores of FM patients P = 0.03 (CI 0.28, 10.64). Conclusion. Discounting correlated more strongly with SF-12 subscales and FIQR domains than did lack of understanding. The current study revealed that active negative social responses and the source of invalidation are important in predicting symptom severity and quality of life in FM. © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved

Gastric pull-up with laryngeal preservation of the primary synovial sarcoma of the esophagus: A case report

In patients who require a gastric pull-up, despite bilateral injury to the vocal cords and regurgitation, preservation of the larynx can improve their quality of life. © 2021 The Authors. Clinical Case Reports published by John Wiley & Sons Ltd

Sentinel hospital-based surveillance of Rotavirus diarrhea in Iran

Background. Rotavirus is the most common causes of severe, acute diarrhea during childhood and is an important cause of morbidity and mortality in developing countries. We established active hospital-based surveillance of childhood diarrhea to assess the scope of severe rotavirus disease in Iran. Methods. From May 2006 through April 2007, prospective surveillance of rotavirus diarrhea among children aged <5 years was conducted in 5 sentinel hospitals in Iran. Stool samples were tested for rotavirus using a commercially available enzyme immunoassay, and rotavirus-positive samples were genotyped using reverse-transcriptase polymerase chain reaction. Results. Of 2198 children admitted to the hospital for acute gastroenteritis, 1298 (59.1%) had stool samples test positive for rotavirus by enzyme immunoassay. Of the rotavirus episodes, 85% occurred during the first 2 years of life, with the peak prevalence of severe rotavirus disease occurring from September through January. Among the 110 rotavirus-positive samples that were genotyped, G4P[8] was the most commonly detected rotavirus genotype (30.9% of strains). Other commonly detected genotypes included P[8] with G nontypeable (21.8%), G4 with P nontypeable (13.6%), G1[P8] (10.9%), and G2[P4] (5.5%). Conclusions. Rotavirus is the most common cause of severe diarrhea in Iran, which indicates that safe and effective rotavirus vaccination in Iran is a public health priority. © 2009 by the Infectious Diseases Society of America. All rights reserved

Social factors in Iranian medical students' drug use

Background: There is an increasing concern about youth drug use in Iran. Aim: This survey investigated the association between variables in social control theory and social learning theory (having a drug-using friend) with students' self-reported drug use. Design: Self-reporting of the use of cigarettes, cannabis, alcohol and opioids (opiate, heroin). Students responded to the question: "If you have ever used the drug, when was the last time?" The dependent (drug-using) and independent variables were examined in an association model. Participants: One hundred and seventy-three Shiraz Paramedical University Students were selected randomly and asked to complete a questionnaire. Finding: Although the model of drug use for each of the drugs was different, their similarities were more than their differences. Conclusion: There was a significant correlation between social learning theory variables and drug use. Some of social control theory variables had significant correlation with drug use, such as religious attachment in the use of alcohol - but its association with use of other drugs was indirect. The social control theory was not a better explanation than social learning theory. © 2005 Taylor & Francis