Summary
A 9‐year‐old 390 kg games pony presented with acute onset of grade 5/5 (AAEP) right hindlimb (RH) lameness. During clinical examination, the source of lameness was localised to the tarsal ...region. Radiographic examination identified a closed, simple, nondisplaced, incomplete fracture of the calcaneal shaft. The pony was initially treated with box rest; however, despite an initial good response, the horse re‐presented with a grade 5/5 (AAEP) RH lameness, 2 weeks after initial presentation. The decision was made to treat the fracture using a tarsal sleeve cast extending from mid‐third of the tibia/crus to the level of distal metatarsus. The cast was replaced every 2 weeks and maintained for a total of 8 weeks. After cast removal, the horse was kept on strict box rest for 3 weeks. After discharge from the hospital, in‐hand walking exercise from the stable was commenced and gradually increased over a 4‐week period. The horse was then gradually reintroduced to small paddock turnout exercise for eight further weeks. The horse was able to return to full athletic function. Conservative treatment using a tarsal sleeve cast should be considered only in horses presenting an incomplete nondisplaced fracture of the calcaneal shaft.
COVID-19 pandemic had a great impact on mental health, both in the general population and psychiatric patients. Little is known about the difference between these two populations in perceiving the ...pandemic as a traumatic event. The aim of the study was to compare psychiatric patients and healthy controls (HC) in terms of change over time of post-traumatic (PTSD) symptoms. Demographic and clinical variables were collected. Impact of Event Scale Revised (IES-R) scores were registered at T1 as lockdown period (March-April 2020) and T2 as restarting (May-June 2020). Descriptive analyses and linear regression models were performed. A total of 166 outpatients and 57 HC were recruited. Time (F = 15.76; p < 0.001) and diagnosis (F = 4.94; p < 0.001) had a significant effect on the change of IES-R scores, which resulted T1 > T2 (p < 0.001), except for subjects affected by Obsessive-Compulsive Disorder (OCD). Overall, IES-R scores were < in patients than in HC (p = 0.02), particularly in the schizophrenia (SKZ) subgroup (p < 0.001). IES-R scores of subjects with personality disorders (PDs) resulted to be > HC, although not statistically significant. The lockdown period was perceived as more traumatic than the reopening phase by both groups, with the exception of OCD patients, probably because of the clinical worsening associated with the urge of control against risks of contamination. Overall, HC reported more PTSD symptoms than psychiatric patients did, particularly SKZ ones. PD patients, in contrast, may be more vulnerable to PTSD symptoms probably as a result of poor coping skills. Together with OCD patients, subjects with PDs may need closer monitoring during the different phases of the pandemic. Trial Registration: ClinicalTrials.gov Identifier: NCT04694482
Summary
Definitive diagnosis of a deep digital flexor tendon insertional lesion within the right fore foot was made by magnetic resonance imaging (MRI) examination and the lesion subsequently treated ...by injection with platelet‐rich plasma. MRI was used to guide positioning of the needle to achieve highly accurate injection. The volume injected was found to approximate the calculated lesion volume. On the basis of experience with this case, MRI‐guided injection of insertional deep digital flexor tendon lesions of the foot of horses under general anaesthesia is practicable. This technique is likely to be more accurate than the other techniques described (computed tomography, ultrasonography) and carries no risk of exposure to radiation (radiography).
Introduction Efficacy of antipsychotic medications is nowadays confirmed, but their effectiveness is biased by the generally low compliance to therapy associated to psychotic patients. Psychiatric ...intramuscular depot pharmacotherapy represents a good option to increase compliance and to improve the outcome. Objective We indirectly assessed compliance to oral antipsychotic therapy by psychopathological and clinical scores, and compared it to results obtained on patients who were assuming intramuscular antipsychotic therapies, whose compliance is assumed to be total. Aim Our purpose was to discriminate differences in outcome between clients who were provided a psychopharmacological oral treatment, and those who take a depot psychopharmacotherapy. Methods We collected psychopathological and clinical data on 100 schizophrenic patients attending our outpatient psychiatric services; we divided our sample in two subgroups according to the type of therapy (oral vs depot). We matched patients depending on sex, age, schizophrenia subtype and age at onset, and compared psychopathological variables (BPRS, PANSS, NRS, SWS and number of hospitalizations) on 32 couples. Results We did not find any statistically significant difference between the two subgroups, as regards the outcome. Conclusion Efficacy to long-term oral antipsychotic therapy is similar to that shown by depot medications, suggesting that compliance between the two types of long-term therapies is high and comparable. We conclude that, balancing the pros and cons while choosing the typology of treatment, doctors should pay more attention to patient's needs and preferences and to a good therapeutic alliance rather than to potential side effects and general outcome.
Introduction We have studied the strategic behaviour of schizophrenic patients playing the Dictator Game (DG) and the Ultimatum Game (UG). The model of Homo economicus predicted by traditional ...economical theories describes the individual involved in economical negotiations as a selfish, rational trader, whose leading purpose is to maximize his utility function. Neuroeconomy contradicts this model supplying data that show a more emotive, irrational behaviour in normal people involved in bargaining tasks. Objective To study how people affected by schizophrenia allocate a resource when asked if sharing it or not, and how their behaviour change during a negotiation, in which strategic mentalizing can help to gain some good. Aim To demonstrate that schizophrenic patients would not show an increment in their offers as Proposers in UG compared to DG and would not refuse unfair offers as Responders. Methods 19 schizophrenic patients and 10 controls were tested with DG and UG. Participants underwent 24 trials of DG as Dictators, 24 trials of UG as Offerers and 24 trials of UG as Responders. Results In the schizophrenic group UG mean offers were not significantly higher than DG offers, while controls showed the opposite. Compared to controls, schizophrenic patients showed a higher propensity to accept unfair offers. Moreover schizophrenic patients' behaviour was not influenced by the type of player (avatar vs human being). Conclusions Our study presents data that assimilate schizophrenic subjects to homo economicus: in fact, compared to normal people, schizophrenic patients show “more rational” bargaining behaviour, due to ToM deficit.
Introduction Genetic factors and gene-environment interactions together contribute over 80% of the liability for developing schizophrenia. Schizophrenia runs in families and there are significant ...variations in the incidence of schizophrenia, with urbanicity, male gender, and a history of migration being associated with a higher risk for developing the illness. Objective To collect anamnestic data on 100 schizophrenic clients attending our psychiatric outpatient services. Aim To investigate the possible implications of psychiatric familiarity on the severity of the illness. Methods We defined two distinct subgroups of patients on the basis of familiarity and matched patients for age and illness onset. We estimated the global severity of symptoms on the basis of psychometric results and number of hospitalizations during the last three years. We correlated psychometric scores with familiarity for a psychiatric disease. Results We confirmed a higher prevalence of psychiatric diagnoses among patients' families compared to the general population: 29% of our patient sample was found to have at least one parent or brother with a reliable psychiatric diagnosis. Surprisingly, we found that patients with a positive familiarity did not show a worse psychopathological profile compared to patients with a silent familiar history. Conclusions Families with a complex psychiatric history, in which more than one component attends our services, are strictly supervised in order to prevent stressful life events, generally more frequent in problematic families. This accurate monitoring may have contributed to the slighter intensity of symptoms found in schizophrenic patients with a positive familiarity for psychiatric diagnoses.
Introduction Many work in the field of sleep research, have lead to the development of hypotheses on the neurobiological mechanisms underlying dream mentation that may prove useful to our ...understanding of psychosis. From a phenomenological perspective, formal features globally defined as cognitive bizarreness have been shown to be equally represented in the dream and waking mentation of both schizophrenic and manic psychotic patients as in the dreams of healthy subjects. Objective The objective of this study was to perform a content analysis on a sample of dreams reported by psychotic patients and by a healthy control population. Aim We want to evaluate whether the dream experience is influenced or not by the state of acute psychosis. Methods We analyzed 210 dream reports of 72 inpatients ward for an acute psychotic break, 36 males and 36 females. Content analysis was performed by using the Hall/Van de Castle Scale, so the contents of dream reports were grouped into 9 categories (characters, social interactions, activities, emotions, settings, objects, descriptives, fortune/misfortune, success/failure). All contents were then quantified and compared with those found in the healthy control population. Results The only statistically significant differences were a lower number of familiar settings in the dreams of female psychotic patients (h = −0.51) and lower aggressivity indices in the dreams of male psychotic patients (h = −0.49). Conclusion As dreams are basically the same in patients and controls, we can argue that the dreaming mental activity is not directly influenced by the psychotic mental state.
Response to drug treatment is under the sophisticated control of complex signalling pathways and gene regulatory networks. Indeed, drug-induced modulation of dysregulated gene expression and altered ...synaptic plasticity are critical steps for the successful treatment of neuropsychiatric disorders. Among the antipsychotic drugs, clozapine (CLZ) is widely considered to be the most effective medication for the treatment of schizophrenia. However, due to its high risk for severe side effects, CLZ use is currently restricted to patients who do not respond to other antipsychotics. Nonetheless, up to 20% of patients are considered nonresponders to CLZ treatment. The mechanism of action underlying CLZ's exceptional clinical efficacy in SCZ is not fully understood. In this context, in vitro molecular and functional assessment of patient-derived glutamatergic and GABAergic neurons’ properties are mandatory to reveal the mechanisms underlying CLZ responsiveness and might mirror the clinical response. Here, we will describe the generation of hiPSCs from SCZ patients, classified based on their response to conventional treatments, to CLZ or total resistance to every treatment. These patient-specific hiPSCs have been converted into enriched cortical glutamatergic neurons and parvalbumin-positive GABAergic interneurons populations that are under inspection to reveal phenotypic and molecular/pharmacological aspects correlating with patient-specific responsivity pattern to CLZ treatment. These results might help to unveil the molecular basis of treatment response profiles that can be exploited to predict response to antipsychotic drugs and that might help to develop personalized treatments, more individually tailored and less hazardous.
