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ABSTRACT The importance of the detection of relevant toxins or toxin genes to diagnose Clostridioides difficile infection (CDI) or the prediction of clinical outcomes of CDI has been emphasized in recent years. Although stool culture of C. difficile is not routinely recommended in the era of nonculture methods as the preferred tools for CDI diagnosis, the clinical significance of toxigenic C. difficile growth (tCdG) in stool cultures was analyzed. A clinical study was conducted in medical wards of Tainan Hospital, Ministry of Health and Welfare, in southern Taiwan. Diarrheal adults with fecal glutamate dehydrogenase and C. difficile toxin between January 2013 and April 2020 were included. Of the 209 patients with CDI, 158 (75.6%) had tCdG found in stool cultures, and the rest (51, 24.4%) had no tCdG in stool. Only prior ceftazidime or ceftriaxone therapy was independently associated with no tCdG in stool (odds ratio [OR] 2.17, P = 0.02). Compared to the patients with tCDG in stool, those without tCdG in stool experienced treatment success more often (97.1% versus 67.0%, P

This study quantitatively assesses the use of idioms in psychotherapy sessions of two different clients and the same therapist. Idioms are understood here as phrases that have literal and metaphorical meaning. Moreover, “container expressions” which are based on Lakoff and Johnson's (2002) metaphor: “bodily and emotional states are entities inside the person, the body is a container for emotions, (e. g. to blow one’s top off, spill the heart)” were studied. The results show that higher number of idioms occur in sessions of more emotional intensity and that bigger probability of therapy success is related to more frequent incidence of container expressions. They also illustrate that the use of idiomatic language in psychotherapy is more or less related to personal communicative and cognitive style of a person. I conclude that when used properly, the “container expressions” can fundamentally contribute to naming the most inner feelings, otherwise expressed with difficulty, and this way they can help with major turning points in therapy. [ABSTRACT FROM AUTHOR]

Purpose This study explored the relationship between self-acceptance of stuttering and (1) psychosocial factors (self-esteem, hostility towards others, emotional support, and perceived discrimination); (2) treatment history (support group participation, therapy duration, and perceived therapy success); and (3) previously reported variables in self-acceptance of stuttering, which include age and stuttering severity. Method Participants were 80 adults who stutter who were recruited with assistance from the National Stuttering Association and Board Certified Specialists in Fluency Disorders. Participants completed an electronic survey composed of an acceptance of stuttering scale, psychosocial scales, and a participant information questionnaire. Results Statistical analysis identified significant correlations between participants’ reports of self-acceptance of stuttering and self-esteem, perceived discrimination, hostility towards others, and perceived therapy outcome. Self-esteem was positively correlated with self-acceptance, while hostility towards others and perceived discrimination was negatively correlated with self-acceptance. Participants who perceived their therapy outcome to be successful were significantly more likely to report higher levels of self-acceptance. No significant relationships were found between self-acceptance of stuttering and support group participation, emotional support, stuttering severity, and participant age. Conclusion This exploratory investigation has provided a foundation for future studies on the self-acceptance of stuttering. The findings indicate common psychosocial variables in self-acceptance of stuttering and of other disabilities. The significant relationships between self-acceptance of stuttering and psychosocial and therapeutic variables found need to be further explored to identify its causalities and clinical implications. Learning outcomes The reader will be able to (1) discuss the importance of assessing self-acceptance of stuttering, (2) summarize the literature on self-acceptance of disability, and (3) describe the significant findings related to self-acceptance of stuttering and psychosocial, therapeutic variables. [ABSTRACT FROM AUTHOR]

Background: Vitiligo patients repeatedly experience disinterest from the medical world regarding their disease as it does not cause physical impairment. Several therapeutic options are available for vitiligo management. Objectives: The aim is to study vitiligo management strategy in Jeddah, Saudi Arabia (KSA) as indicated by dermatologists and as experienced by patients. Methods: A written questionnaire was distributed to 132 dermatologists practicing in Jeddah, KSA. Another questionnaire was filled by 186 vitiligo patients attending dermatology outpatient clinic Al-Jedaani Hospital. Results: For 76% of the participating dermatologists in Jeddah, KSA, vitiligo is not a pure cosmetic problem and 69% of the participating dermatologists encourage vitiligo treatment (acknowledged by 65% of patients). The main therapy was topical steroids and narrowband ultraviolet-B (NB-UVB) therapy in vitiligo focalis and vulgaris, respectively, for both children and adults. Of the participating patients, 51%, 57%, and 21% of patients reported getting adequate information from their first dermatologists about the disease name, treatment options, and prognosis, respectively. There is a significant correlation between ever receiving treatment and awareness of the exact diagnosis ( p < 0.01), awareness of treatment options ( p < 0.05) and treatment encouragement ( p < 0.01). Conclusion: Dermatologists in Jeddah, KSA, are enthusiastic about vitiligo management; however, still some patients feel discouraged and misinformed. The study demonstrates the need for national evidence-based guidelines reflecting unique features of patients in this community. [ABSTRACT FROM AUTHOR]

The importance of the detection of relevant toxins or toxin genes to diagnose Clostridioides difficile infection (CDI) or the prediction of clinical outcomes of CDI has been emphasized in recent years. Although stool culture of C. difficile is not routinely recommended in the era of nonculture methods as the preferred tools for CDI diagnosis, the clinical significance of toxigenic C. difficile growth (tCdG) in stool cultures was analyzed. A clinical study was conducted in medical wards of Tainan Hospital, Ministry of Health and Welfare, in southern Taiwan. Diarrheal adults with fecal glutamate dehydrogenase and C. difficile toxin between January 2013 and April 2020 were included. Of the 209 patients with CDI, 158 (75.6%) had tCdG found in stool cultures, and the rest (51, 24.4%) had no tCdG in stool. Only prior ceftazidime or ceftriaxone therapy was independently associated with no tCdG in stool (odds ratio [OR] 2.17, P =  0.02). Compared to the patients with tCDG in stool, those without tCdG in stool experienced treatment success more often (97.1% versus 67.0%, P <  0.001) if treated with metronidazole or vancomycin but had a similar in-hospital mortality or recurrence rate. In the multivariate analysis among 114 patients with CDI treated with metronidazole or vancomycin, treatment success was independently associated with no tCdG in stool (OR 12.7, P =  0.02). Despite the limited utility of stool cultures in CDI diagnoses, no tCdG in stool culture heralds a favorable therapeutic outcome among adults with CDI treated with metronidazole or vancomycin. IMPORTANCE The importance of detecting toxins or toxin genes when diagnosing Clostridioides difficile infections (CDIs) or predicting the severity and outcomes of CDI has been emphasized in recent years. Although the yielding of C. difficile from stool cultures might implicate higher bacterial loads in fecal samples, in an era of nonculture methods for the standard diagnosis of CDIs, clinical significance of positive stool cultures of toxigenic C. difficile was analyzed in this study. Despite the limited ability of stool cultures in CDI diagnoses, no yielding of C. difficile growth might predict the successful CDI therapy.