RESUMEN
BACKGROUND: The determination of the protective and risk factors associated with Internet gaming disorder (IGD) is among the most important pathways to the development of prevention strategies for IGD. Previous research has shown that familial factors are associated with IGD. In our study, we aimed to assess the parental attitude of adolescents with IGD and investigate psychiatric comorbidity. METHODS: We assessed family structure, family relationship, parental attitude (in a bi-directional assessment), and psychiatric comorbidity in 50 adolescents aged 12-18 years who meet DSM-5 criteria for IGD in comparison with the control group. Parental attitudes were assessed with the Parental Attitude Research Instrument (filled by the mother) and the Parenting Style Inventory (filled by adolescents). RESULTS: Our findings suggest that according to mothers' opinions there were no significant differences in the subscale scores between the IGD group and the control group. On the other hand, acceptance-involvement and psychological autonomy subscale scores of the PSI filled by adolescents were found to be significantly lower in the IGD group. Limit setting in areas other than the Internet was significantly lower in the IGD group. High rates of psychiatric comorbidity were also found in adolescents with IGD. CONCLUSIONS: Our study identified that adolescents with IGD perceived their parents "cared less about them" and "minded less on their autonomy" compared with the control group. Our survey demonstrated that parental attitudes may be among the risk factors for IGD and the presence of psychiatric comorbidity may affect the management of IGD.
Asunto(s)
Trastorno de Adicción a Internet/epidemiología , Padres/psicología , Adolescente , Actitud Frente a la Salud , Conducta Adictiva/psicología , Niño , Comorbilidad , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Relaciones Familiares/psicología , Humanos , Internet , Trastorno de Adicción a Internet/psicología , Masculino , Factores de Riesgo , Encuestas y Cuestionarios , Juegos de Video/psicologíaRESUMEN
Recently, colistin has become a salvage therapy in the treatment of serious Intensive Care Unit infections owing to the emergence of extensively drug-resistant (XDR) bacterial isolates. This study aimed to show the effectiveness of colistin in critically ill patients with renal failure. A prospective case-control study of 94 patients admitted to medical intensive care units of a university hospital from December 2008 to June 2010 was conducted. All patients had infections with XDR Acinetobacter baumannii or Pseudomonas aeruginosa and received colistin. Cases comprised 39 patients with chronic renal failure (CRF) and controls were other patients without CRF. Apart from the male dominancy in the CRF group, there was no statistical difference between the two groups regarding demographic characteristics, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and site and type of infection. In patients who completed colistin therapy, bacteriological cure was seen in 87% of patients with CRF and 95% of patients without CRF (P=0.890). Mortality in patients with CRF was similar to that in patients without CRF (44% and 42%, respectively) (P=0.999). Nephrotoxicity developed in 23.6% of patients in the control group. Concomitant nephrotoxic agents and total defined daily dose of colistin did not affect the development of nephrotoxicity. The mortality rate was 38% in patients with nephrotoxicity, similar to the mortality rate in patients without nephrotoxicity (36%) (P=0.999). In conclusion, in critically ill patients with CRF, colistin therapy, although used at a reduced dosage, was as effective as in patients without CRF.
Asunto(s)
Antibacterianos/administración & dosificación , Antibacterianos/efectos adversos , Infecciones Bacterianas/complicaciones , Infecciones Bacterianas/tratamiento farmacológico , Colistina/administración & dosificación , Colistina/efectos adversos , Fallo Renal Crónico/patología , APACHE , Acinetobacter baumannii/efectos de los fármacos , Acinetobacter baumannii/aislamiento & purificación , Lesión Renal Aguda/inducido químicamente , Adulto , Anciano , Anciano de 80 o más Años , Infecciones Bacterianas/microbiología , Infecciones Bacterianas/mortalidad , Estudios de Casos y Controles , Enfermedad Crítica , Farmacorresistencia Bacteriana Múltiple , Femenino , Hospitales Universitarios , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Pseudomonas aeruginosa/efectos de los fármacos , Pseudomonas aeruginosa/aislamiento & purificación , Análisis de Supervivencia , Resultado del TratamientoRESUMEN
The aim of this study is to determine the effective concentrations of chlorhexidine on the release for prolonged periods of time from a novel hydrogel system. A hydrogel that exhibits a volume phase transition in response to temperature was synthesized by radiation copolymerization of ethylene glycol vinyl ether and butyl vinyl ether in the presence of crosslinking agent, diethylene glycol divinyl ether. Hydrogel samples in the disc form (diameter, 10 mm and height, 1.5 mm) were utilized as a matrix for the release of an antimicrobial agent, chlorhexidine diacetate. Chlorhexidine loading into the hydrogel was performed by water sorption at 4 degrees C, which allows high swelling and thus high loading capacity, i.e., approximately 36 mg drug per gram of dry gel. Chlorhexidine release was examined as short-term (24 h) and long-term (27 days) by UV spectrophotometer. Microbial studies were carried out by micro-dilution method in order to determine the effectiveness of the drug release. Minimum inhibitory concentration values for the pathogens of Streptococcus mutans and Lactobacillus casei were determined. The long-term chlorhexidine release is initially very fast. After that, the drug release reaches a slow but a steady rate. Such a release pattern provides an effective drug release. The prolonged release of chlorhexidine is continued up to the 27th day. MIC values for the two pathogens have been shown that the release rate from disc is effective to inhibit the growth of pathogens. These in vitro drug release results suggested that the thermosensitive hydrogel system developed in this study can be evaluated as a delivery system for the release of chlorhexidine.