Long-term neuro-psychiatric sequelae of Japanese encephalitis in two pediatric travellers

Abstract Objective Patient's trust in physicians is a significant predictor of continuity, adherence, and satisfaction with care. However, it is unclear what influences a woman's trust in her physician. This study sought to determine if women's trust in their clinicians was affected by unexpected outcomes at the time of delivery. Study Design This is a secondary analysis of a prospective cohort of 300 postpartum women with gestational diabetes mellitus. Participants completed the validated Trust in Physician Scale during their postpartum hospitalization. Participants' scores were compared based on their exposure to an unexpected pregnancy outcome. Results Of the 300 women consented to participate in this study, 294 completed the Trust in Physician Scale. The mean overall trust score was 80/100 with a range of 42 to 100. Unexpected pregnancy outcomes occurred in 41% (120) of women in this cohort. There was no significant difference in the trust score between women who did and did not have at least one unexpected outcome (0.79 vs. 0.79, p = 0.93). Additionally, there was no significant association between the trust score and any individual unexpected pregnancy outcome. Conclusion Unexpected pregnancy outcomes are not associated with changes in women's trust in their obstetric clinicians. These results emphasize the antepartum period as the essential time for patient–physician relationship building which has important implications for postpartum follow-up and long-term psychiatric sequelae from unexpected outcomes.

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Explosive-driven double-blast exposure: molecular, histopathological, and behavioral consequences

Scientific Reports ◽

10.1038/s41598-020-74296-2 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Erin K. Murphy ◽

Diego Iacono ◽

Hongna Pan ◽

Jamie B. Grimes ◽

Steven Parks ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Protein Level ◽

Tau Phosphorylation ◽

Behavioral Changes ◽

Phosphorylated Tau ◽

Total Tau ◽

Blast Exposure ◽

Psychiatric Sequelae ◽

Relevant Finding

Abstract Traumatic brain injury generated by blast may induce long-term neurological and psychiatric sequelae. We aimed to identify molecular, histopathological, and behavioral changes in rats 2 weeks after explosive-driven double-blast exposure. Rats received two 30-psi (~ 207-kPa) blasts 24 h apart or were handled identically without blast. All rats were behaviorally assessed over 2 weeks. At Day 15, rats were euthanized, and brains removed. Brains were dissected into frontal cortex, hippocampus, cerebellum, and brainstem. Western blotting was performed to measure levels of total-Tau, phosphorylated-Tau (pTau), amyloid precursor protein (APP), GFAP, Iba1, αII-spectrin, and spectrin breakdown products (SBDP). Kinases and phosphatases, correlated with tau phosphorylation were also measured. Immunohistochemistry for pTau, APP, GFAP, and Iba1 was performed. pTau protein level was greater in the hippocampus, cerebellum, and brainstem and APP protein level was greater in cerebellum of blast vs control rats (p < 0.05). GFAP, Iba1, αII-spectrin, and SBDP remained unchanged. No immunohistochemical or neurobehavioral changes were observed. The dissociation between increased pTau and APP in different regions in the absence of neurobehavioral changes 2 weeks after double blast exposure is a relevant finding, consistent with human data showing that battlefield blasts might be associated with molecular changes before signs of neurological and psychiatric disorders manifest.

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Long-Term Epidemiological Dynamics of Japanese Encephalitis Infection in Gansu Province, China: A Spatial and Temporal Analysis

American Journal of Tropical Medicine and Hygiene ◽

10.4269/ajtmh.20-0179 ◽

2020 ◽

Vol 103 (5) ◽

pp. 2065-2076

Author(s):

Xuxia Wang ◽

Li Su ◽

Hongwen Zhu ◽

Wenbiao Hu ◽

Jing An ◽

...

Keyword(s):

Japanese Encephalitis ◽

Temporal Analysis ◽

Gansu Province ◽

Spatial And Temporal Analysis

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Comprehensive Care of an 8-year-old Boy Following Traumatic Amputation of the Glans Penis

PEDIATRICS ◽

10.1542/peds.44.2.271 ◽

1969 ◽

Vol 44 (2) ◽

pp. 271-273

Author(s):

H. Bartlett Vincent ◽

Michael B. Rothenberg

Keyword(s):

Psychiatric Care ◽

Comprehensive Care ◽

Primary Physician ◽

Total Care ◽

Third Person ◽

Psychiatric Sequelae ◽

The Third Person ◽

Difficult Cases

We have presented a case of a child severely traumatized, both physically and emotionally. We feel that this and similarly difficult cases are well within the field of competent, comprehensive care that the pediatrician can provide. By means both of his proximity to the problems and in most cases by his familiarity with the psychological makeup of the patient, he is in the best position not only to initiate but to carry through prophylactic psychiatric care. The goals of minimizing both the trauma of hospitalization and long-term psychiatric sequelae can best be met by the pediatrician who can, in a non-threatening and in a non-pressuring manner, first listen to and then talk with the child and outline the thoughts and feelings that might occur in children similarly incapacitated. The child's ability to communicate can be facilitated by using a three-step process including the "third person technique" and the "option play" which have been outlined. Finally, it is our impression that the pediatrician often underestimates his ability to assume the role of primary physician, who is responsible for the total care of the child.

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