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The pediatric obesity has become a real problem for the public health. One estimates that about 16% of the Belgian pediatric population and up to 33% of the Americans are concerned by this problematic. 70% of the teenagers will remain obese once adult if no treatment is proposed during the childhood. Because of that evolution, some journalists wrote: "that the old continent would be able to catch up with the new world in the next ten years". The malnutrition is not however the only factor at the origin of the obesity. The sedentary lifestyle (lack of exercise, TV, Internet, video games) the domestic organization, the "various emotional stress "are to be blamed. It is without taking into consideration the paradox of our consumption society that while extolling the cult of the slim, young and dynamic body, etc., pushes us to consume more, encouraging in some social and cultural surroundings to go for the immediate pleasure to the detriment of the knowledge - understanding - of our own body. Which places the obese child in an existential paradox. If on top of it there is a domestic predisposition to the plumpness, the kilograms in excess are threatening the unsecured child and new sufferings stand out on the horizon : relational unrests, isolation, social dismissal, reduction of the esteem of selfesteem as well as lack of confidence, less freedom, depression, etc. Not only are they victims of mockeries, aggressiveness and exclusion, the children put their health in danger. On those children we can notice an increase of the impact of cardiovascular pathologies, diabetes, cancers of the intestines, etc. In "Clairs Vallons" we put the hypothesis that the children and the teenagers who come here in custody could suffer from a lack of presence as well as people listening to them and that therefore to would search for comfort in eating. We consider that all interventions based solely on the interdiction of the symptom have no result, causes more suffering and a displacement of the symptom. The therapeutic work to the Dietary Residency of "Clairs Vallons" consists therefore in a global approach of the child within a multidisciplinary team (pediatrician, dietitian, psychologist, physiotherapist, social assistant, orthofenist, educator and teacher) all united around the concept "to eat happy".
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PMID:[Multidisciplinary approach of the obese child to the dietary residency of "Clairs Vallons"]. 1624 Aug 63

The heterogeneity of somatizing patients influences outcomes, especially in unselected samples in primary care. A cluster analysis was performed as secondary analysis on an existing data set of 127 somatizing patients included in a randomized controlled clinical trial. Anxiety and depression (HADS), number and intensity of physical symptoms (SOMS), physical and emotional functioning (short form of the SF-36 Health Survey), health beliefs (KKU-G), and psychological distress (General Health Questionnaire) were used for clustering. Outcome, treatment satisfaction, and diagnosis were calculated and compared for the clusters. We differentiated three groups from this analysis: one with elevated emotional and physical stress, one in which emotional stress dominated, and one with low emotional and physical stress. The three groups did not differ in diagnoses of somatoform disorders. The high-stress groups improved over time, whereas the depression and emotional-functioning scores in the low-stress group deteriorated. All patients were satisfied with the treatment provided. Deterioration in the scores of the low-stress group may be a result of a clinically valuable change process, in that patients who were initially in denial were able to open up and admit their problems. The increased satisfaction with treatment supports this interpretation. This so-called response shift must be taken into account in the planning of studies.
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PMID:Differentiation of somatizing patients in primary care: why the effects of treatment are always moderate. 1631 4

High emotional stress in medical students has been observed in many studies. Our aim in this article was to assess the prevalence of symptoms of anxiety and depression among Estonian medical students and to find relationships between sleep complaints and emotional symptoms. The study group consisted of 413 medical students, ages 19-33 years, at the University of Tartu. Each was asked to complete two questionnaires: the Emotional State Questionnaire (EST-Q), containing 28 questions, and the Questionnaire on Sleep and Daytime Habits, with 25 questions. The anxiety and depression subscales from the EST-Q were applied. From the study group, 21.9% students had symptoms of anxiety, and 30.6% had symptoms of depression. The frequency of anxiety and depressive symptoms was higher in females. In regression and multiple regression analysis, we determined which sleep problems were related to emotional symptoms. The associations were different for men and women. In women, anxiety remained significantly related to waking up because of nightmares and feeling tired in the morning; depressive symptoms were related to difficulties in getting to sleep at night, waking up because of nightmares and nocturnal eating habits, daytime sleepiness, and sleepiness during school lessons. In men, significant relations were clear only for depression: difficulties in falling asleep at night before an exam and subjective sleep quality. The study demonstrated that a high percentage of medical students had emotional symptoms. We found that some sleep problems indicated underlying symptoms of anxiety and depression.
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PMID:Symptoms of anxiety and depression in Estonian medical students with sleep problems. 1655 63

The two main aetiologies of transient amnesia in the elderly are idiopathic transient global amnesia (TGA) and iatrogenic or toxic amnesia. Vascular and epileptic amnesia are less common. According to the literature, transient psychogenic amnesia, which is a frequent cause of amnesia at age 30 to 50, is very rare in the elderly. TGA is the prototypical picture of transient amnesia. It occurs more often after age 50, with no identified cause, even if some authors accept emotional stress or minor head trauma as occasional precipitants. The mechanism of TGA remains a matter of discussion. It may be the consequence of a spreading depression similar to that described in migraine with aura, but other arguments support an ischemic mechanism. Iatrogenic amnesias are mainly caused by benzodiazepines (BZs) or anticholinergics. The former may occur in a non-anxious subject, who is not a usual consumer of BZ and takes a single dose. The latter are more often due to a hypersensitivity to anticholinergic drugs, in particular in patients presenting with a covert, incipient Alzheimer's disease. A vascular origin must be considered when amnesia is accompanied by other neurological symptoms, and when the regression of the amnesic disorder is slow, lasting several days. It results from lesions involving various mechanisms and locations, mainly subcortical. Partial seizures, most often mesio-temporal, more rarely frontal, may be the cause of transient amnesia in the elderly, in the absence of a past history of epilepsy. The red flag supportive of an epileptic origin is the repetition of stereotyped amnesic episodes. EEG demonstration of seizures may be difficult and the response to antiepileptic drugs effective on partial seizures is usually good.
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PMID:[Transient amnesia in the elderly]. 1655 16

Cardiac patients, psychiatric patients, and certain ethnic groups experiencing acute stressful circumstances are at risk for unexpected sudden death. Although stress is associated with changes in autonomic neural function, its role as a potential risk factor for sudden unexpected death in epilepsy (SUDEP) is not known. The association of epilepsy with cardiac abnormalities, such as neurogenic arrhythmias and microscopic perivascular and interstitial fibrosis, and with depression and anxiety indicates that emotional stress should be evaluated as a potential risk factor for SUDEP. The impact of adverse emotional states on the autonomic control of cardiac rhythm is a known important factor leading to cardiac dysrhythmias in humans and other species. The interaction between emotional factors and the arrythmogenic potential of epileptiform discharges and the possibility of benefit from stress management intervention need to be investigated.
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PMID:Stress and sudden death. 1687 8

This study examines mental health issues among women of different sexual orientations. An anonymous survey was administered at 33 health care sites across the United States; the sample (N = 1304) included lesbians (n = 524), bisexual (n = 143) and heterosexual women (n = 637). Not only did sexual orientation influence the probability of experiencing emotional stress, but also whether a bisexual woman or lesbian had disclosed her sexual orientation (was "out") impacted the likelihood of having or having had mental health problems. Bisexual women and lesbians experienced more emotional stress as teenagers than did heterosexual women. Bisexual women were more than twice as likely to have had an eating disorder compared to lesbians. If a bisexual woman reported being out she was twice as likely to have had an eating disorder compared to a heterosexual woman. Lesbians who were not out and bisexual women who were out were 2-2.5 times more likely to experience suicidal ideation in the past 12 months. Lesbians and bisexual women who were not out were more likely to have had a suicide attempt compared to heterosexual women. Lesbians used psychotherapy for depression more commonly than did heterosexual or bisexual women. This is one of the few studies that compares lesbians, bisexual and heterosexual women. The implications of these findings are discussed.
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PMID:Mental health issues: a comparison of lesbian, bisexual and heterosexual women. 1689 25

Chronic fatigue syndrome (CFS) is thought to have a worldwide prevalence of 0.4-1% with approximately 240,000 patients in the UK. Diagnosis is based on clinical criteria and critically depends on exclusion of other physical and psychiatric diseases. Studies of pathogenesis have revealed immune system abnormalities and chronic immune activation, dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis, brain abnormalities, evidence of emotional stress (comprising host aspects) and evidence of exogenous insults, for example, various microbial infections (Epstein-Barr virus, enteroviruses, parvovirus B19, Coxiella burnetii and Chlamydia pneumoniae), vaccinations and exposure to organophosphate chemicals and other toxins (comprising environmental aspects). Emotional stress appears to be very important as it reduces the ability of the immune system to clear infections, it's presence has been shown to determine whether or not an individual develops symptoms upon virus infection, and it leads to activation of the HPA axis. But, emotional stress is distinct from depression, the presence of which precludes a diagnosis of CFS. There is no specific treatment for CFS other than the much underutilised approach of specific treatment of virus infections. Current priorities are to understand the molecular pathogenesis of disease in terms of human and virus gene expression, to develop a diagnostic test based on protein biomarkers, and to develop specific curative treatments.
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PMID:Chronic fatigue syndrome. 1697 17

Two patients presented with transient left ventricular apical ballooning (takotsubo cardiomyopathy) induced by emotional stress caused by the Central Niigata Prefecture Earthquake in 2004. These patients complained of chest pain immediately after the earthquake. In patient 1, electrocardiography (ECG) showed slight ST elevation in leads V5 to V6 and 1 mm ST depression in lead III. Serial ECG revealed inverted giant T waves in leads V3 to V6 and inverted T waves in leads I, II, aVL and aVF 13 days after the earthquake occurred. Patient 2 also complained of chest pain right after the earthquake, but consulted a doctor 15 days after the earthquake occurred. ECG showed inverted giant T wave in leads V1 to V6 and inverted T waves in leads I, II and aVL. Transthoracic echocardiography showed hypokinesis of the apical area of the left ventricle with normokinesis in the basal area in both patients. Coronary angiography showed no stenotic segments and coronary spasms were not induced by provocative testing. Serial cardiac radionuclide single photon emission computed tomography of myocardial functional sympathetic innervation using iodine-123-metaiodobenzyl-guanidine (MIBG) and thiallium-201 (201Tl) showed an MIBG uptake defect and increased wash-out in the apical area, but only mild decrease of apical 201Tl uptake. Due to strong emotional stress, earthquakes may induce transient left ventricular apical ballooning (takotsubo cardiomyopathy).
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PMID:Transient left ventricular apical ballooning developing after the Central Niigata Prefecture Earthquake: two case reports. 1735 86

This is the first scientific research in Lithuania and Latvia that involves a national cross-sectional study of the seamen of two different countries--Lithuania and Latvia--including the evaluation and comparison of seamen's working environment, lifestyle, health, the prevalence of health-damaging risk factors, as well as the causative relationships between the objective and subjective health evaluation and psycho-emotional stress experienced at sea. The aim of the study was to investigate the frequency and predictors of the psycho-emotional stress experienced at sea by Lithuanian and Latvian seamen. Beside the common statistical methods, the logistic stepwise regression analysis was used in order to find the risk factors of the self-rated stress and to correct the risk estimates for the confounding variables. Seamen of both countries indicated that they experienced psycho-emotional stress after, on the average, 2.7-2.8 months from the beginning of the voyage. More than one-half (57.5%) of Latvian seamen stated that they had experienced psycho-emotional stress, whereas the respective percentage of Lithuanian seamen was smaller (46.1%). The obtained findings showed that, having evaluated the influence of all the analyzed factors (industry-specific, health and lifestyle, medical and demographic), there was no significant difference between the seamen of the two countries concerning the experience of psycho-emotional stress on the ship. The following main prognostic factors related to the occurrence of psycho-emotional stress on the ship were determined: higher or specialized secondary education level (p<0.001), age of 35-44 or 45-54 years (p<0.01), 9-10 or 11-12 hours of work per day when being exposed to detrimental factors (p<0.01), the evaluation of one's health status as "average" (p<0.05), and evaluation of one's physical capacity as "quite good" or "average" (p<0.01). The occurrence of psycho-emotional stress was mostly influenced by work in the environment requiring increased visual strain (p<0.001) and vibration (p<0.05). We found that the following factors were associated with the occurrence of psycho-emotional stress on the ship: depression that occurred more frequently at sea than on shore (p<0.001), disturbed working and resting regimen due to time zone changes (p<0.001), and disturbed regular sexual life (p<0.001). Many of the unique aspects of seafaring are unchangeable. However, it possible to modify, supplement, or develop new strategies to reduce the impact these factors have on the health of individual seafarers.
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PMID:Association between environment and psycho-emotional stress experienced at sea by Lithuanian and Latvian seamen. 1702 75

Vasovagal syncope refers to a reflex cardiovascular depression that gives rise to loss of consciousness with bradycardia and profound vasodilatation. This response commonly occurs during regional anesthesia, hemorrhage or supine inferior vena cava compression in pregnancy. The changes in circulatory response from the normal maintenance of arterial pressure to parasympathetic activation and sympathetic inhibition may cause severe hypotension. This change is triggered by reduced cardiac venous return as well as episodes of emotional stress, excitement or pain. Occasionally, these vasovagal responses may be unpredictable and may dramatically proceed to asystole with circulatory collapse, and may even result in death. In these circumstances, hypotension may be more severe than that caused by bradycardia alone, because of unappreciated vasodilatation. Regional anesthesia, decreased venous return, hemorrhage and abnormal fetal presentation cumulatively increase the risk of vasovagal syncope in cesarean section patients. When a vasovagal response occurs, ephedrine is the drug of first choice because of its combined action on the heart and peripheral blood vessels. Epinephrine must be used early in established cardiac arrest, especially after high regional anesthesia.
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PMID:Perioperative vasovagal syncope with focus on obstetric anesthesia. 1717 65


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