Summary
Background
Capillary malformation–arteriovenous malformation (CM‐AVM) syndrome is a rare syndrome with characteristic skin lesions that are associated with fast‐flow vascular malformations ...(FFVMs) in one‐third of patients. Few case series have been described, and none in Spain.
Aim
To identify the prevalence of dermatological parameters, FFVMs and associated features in a large series of patients with CM‐AVM.
Methods
We conducted an observational study of patients with CM‐AVM syndrome diagnosed in 15 Spanish hospitals over 3 years. The main clinical, radiological, genetic findings and associated diseases were analysed.
Results
In total, 64 patients were assessed. In 26.5% of cases, the diagnosis was incidental. In 75% of patients, there was one significantly larger macule, which we termed the ‘herald patch’. FFVMs were detected in 34% of the patients, with 30% located on the skin, 7.8% in the brain and in 1.5% in the spine. There was a positive family history in 65% of the 64 patients. Genetic analysis was performed for RASA1 mutations in 57 patients, of whom 42 (73%) had a positive result. All 4 patients tested for EPHB4 mutations had a positive result. No tumour lesions were detected in the series, except for five infantile haemangiomas.
Conclusions
Our data on clinical lesions, associated FFVM, family history and genetics are similar to those previously published in the literature. An extensive data analysis failed to demonstrate any statistically significant association between the presence of an FFVM and any clinical, familial or genetic parameter that could predict its onset, although a link between the presence of a herald patch on the midline face and the presence of a brain FFVM was observed. We did not detect any genotype–phenotype correlation.
IntroductionCoronavirus disease 2019 (COVID-19) modify voluntary admission rates to psychiatric wards in the early phases following pandemic onset. Older patients have higher COVID-19 distress scores ...because elderly people are at risk for COVID-19 infection.ObjectivesThe present investigation aimed at admission rates of elderly patients to a General Hospital Psychiatric Ward during the lockdown due to the COVID-19, compared to similar periods of 2018 and 2019.MethodsAnonymized data on psychiatric admissions (n=55) from one general hospital psychiatric ward have been obtained and analysed. We compared admission characteristics between April and June of 2018 and 2019 with the same period of 2020 (lockdown).ResultsDuring the COVID-19 lockdown, a significant reduction in psychiatric hospitalizations of older patients (aged >65 years) was observed in the lockdown (69.2%; χ2=4.823,df=1,p=0.028) in contrast with young patients (26.7% reduction). There was a reduction of 14% in admission due to suicidal behaviour (IRR = 0.57; 95% CI: 0.11-2.75; p=0.48), 25% in depression (IRR = 0.28; 95% CI: 0.64-1.25; p=0.09) and 50% in psychotic disorders (IRR = 0.33; 95% CI: 0.07-1.48; p=0.15). There was none admission by dementia during the lockdown.ConclusionsChanges in the number of psychiatric admissions, particularly for older patients, were observed during the COVID-19 lockdown. During this period, their fear levels could modify their psychiatric admission rates. We suggest that the decrease of psychiatric admissions in the elderly was due to fear of contagion in hospitals.Disclosure of InterestNone Declared
Introduction
Functioning in acute inpatient psychiatric units has been challenged by the Coronavirus disease 2019 (COVID-19). Patients with more severe mental health symptoms changed their rates of ...voluntary admission to psychiatric wards during the onset of the pandemic. Peritraumatic distress scores and increased likelihood of being psychologically affected by the COVID-19 pandemic can lead to a psychiatric admission. However, other factors could prevent hospitalization.
Objectives
The present investigation aimed at admission rates of patients by depression, adjustment disorder or suicidal behaviour to a General Hospital Psychiatric Ward. We compared the lockdown due to COVID-19 in 2020 to similar periods of 2018 and 2019.
Methods
The data of one general hospital psychiatric ward admissions have been obtained and analysed. We compared admission characteristics of 237 patients between April and June of 2018 and 2019 with 79 patients in the same period of 2020 (lockdown).
Results
During the COVID-19 lockdown, there was a 35.8% reduction in psychiatric admissions and a significant reduction in psychiatric admission was observed due to suicidal behaviour (IRR = 0.49; 95% CI: 0.26-0.89; p=0.002) and depression (IRR = 0.24; 95% CI: 0.08-0.68; p=0.007), but similar rates of adjustment disorders (IRR = 1.12; 95% CI: 0.58-2.15; p=0.73).
Conclusions
We suggest that patients with depression or suicidal behaviour avoided admission, for fear of contagion in hospitals. Also, greater family support could prevent self-injurious behaviours. By contrast, other disorders continued to require the same admission rate, since the social consequences derived from confinement could lead to the genesis or worsening of symptoms, such as adjustment disorders.
Disclosure of Interest
None Declared
The Palaeogene sedimentary successions of the Duero Basin host an important record of fossil vertebrates, especially mammals and reptiles. The main fossil sites are placed at the west margin ...(Salamanca and Zamora areas) spanning from the Lutetian to the late Priabonian; and at the southeast tip (Almazán Basin) mainly Bartonian in age. The continued study of the sites is supplying new data that will improve the chronostratigraphy and the correlation between the western and eastern regions of the basin. The diversity and phylogenetic relationships of the represented fauna have been revised in recent years with the reassignment of some remains and the diagnosis of some new taxa. Four lineages of turtles are represented: Podocnemididae (Neochelys), Carettochelyidae (Allaeochelys), Trionychidae and Testudinidae (Pelorochelon). Crocodyliform paleobiodiversity is composed of notosuchians (close to Iberosuchus) and, at least, three crocodylian lineages: Planocraniidae (Duerosuchus), Alligatoroidea (Diplocynodon) and Crocodyloidea ('Asiatosuchus'). The distribution of these taxa is not homogeneous throughout the basin, and a deep transformation is recognised throughout the middle Eocene. The fitting of the distribution and relationships of the reptilian fauna from the Duero Basin provides valuable information to understand some faunistic dynamics such as the endemism process of northwestern Iberia from the middle of the Eocene.
Schizophrenia and bipolar disorder include patients with different characteristics, which may hamper the definition of biomarkers. One of the dimensions with greater heterogeneity among these ...patients is cognition. Recent studies support the identification of different patients' subgroups along the cognitive domain using cluster analysis. Our aim was to validate clusters defined on the basis of patients' cognitive status and to assess its relation with demographic, clinical and biological measurements. We hypothesized that subgroups characterized by different cognitive profiles would show differences in an array of biological data. Cognitive data from 198 patients (127 with chronic schizophrenia, 42 first episodes of schizophrenia and 29 bipolar patients) were analyzed by a K-means cluster approach and were compared on several clinical and biological variables. We also included 155 healthy controls for further comparisons. A two-cluster solution was selected, including a severely impaired group and a moderately impaired group. The severely impaired group was associated with higher illness duration and symptoms scores, lower thalamus and hippocampus volume, lower frontal connectivity and basal hypersynchrony in comparison to controls and the moderately impaired group. Moreover, both patients' groups showed lower cortical thickness and smaller functional connectivity modulation than healthy controls. This study supports the existence of different cognitive subgroups within the psychoses with different neurobiological underpinnings.
The identification of the cerebral substrates of psychoses such as schizophrenia and bipolar disorder is likely hampered by its biological heterogeneity, which may contribute to the low replication ...of results in the field. In this study we aimed to replicate in a completely new sample and supplement the results of a previous study with additional data on this topic. In the aforementioned study we identified a schizophrenia cluster characterized by high mean cortical curvature and low cortical thickness, subcortical hypometabolism and progressive negative symptoms. Here, we have used magnetic resonance images from 61 schizophrenia and 28 bipolar patients, as well as 51 healthy controls and a cluster analysis to search for possible subgroups primarily characterized by cerebral structural data. Diffusion tensor imaging (fractional anisotropy, FA), cognition, clinical data and electroencephalographic (EEG) modulation during a P300 task were used to validate the possible clusters. Two clusters of patients were identified. The first cluster (29 schizophrenia and 18 bipolar patients) showed decreased cortical thickness and area values, as well as lower subcortical volumes and higher cortical curvature in some regions, as compared to the second cluster. This first cluster also showed decreased FA in frontal lobe connections and worse cognitive performance. Although this cluster also showed longer illness duration, there were first episode patients in both clusters and treatment doses and types were not different between clusters. Both clusters of patients showed decreased EEG task-related modulation. In conclusion, our data give additional support to a distinct biologically based cluster encompassing schizophrenia and bipolar disorder patients with cortical and subcortical alterations, hampered cortical connectivity and lower cognitive performance.
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•Two subgroups can be identified across schizophrenia and bipolar disorder based on neuroanatomy.•Reduced cortical thickness and increased folding characterize one of the subgroups.•That subgroup showed hampered structural connectivity and cognition.•Both groups did not differ on functional activity modulation during cognitive tasks.
Uncontrolled inflammation following COVID-19 infection is an important characteristic of the most seriously ill patients. The present study aims to describe the clusters of inflammation in COVID-19 ...and to analyze their prognostic role. This is a retrospective observational study including 15,691 patients with a high degree of inflammation. They were included in the Spanish SEMI-COVID-19 registry from March 1, 2020 to May 1, 2021. The primary outcome was in-hospital mortality. Hierarchical cluster analysis identified 7 clusters. C1 is characterized by lymphopenia, C2 by elevated ferritin, and C3 by elevated LDH. C4 is characterized by lymphopenia plus elevated CRP and LDH and frequently also ferritin. C5 is defined by elevated CRP, and C6 by elevated ferritin and D-dimer, and frequently also elevated CRP and LDH. Finally, C7 is characterized by an elevated D-dimer. The clusters with the highest in-hospital mortality were C4, C6, and C7 (17.4% vs. 18% vs. 15.6% vs. 36.8% vs. 17.5% vs. 39.3% vs. 26.4%). Inflammation clusters were found as independent factors for in-hospital mortality. In detail and, having cluster C1 as reference, the model revealed a worse prognosis for all other clusters: C2 (OR = 1.30,
p
= 0.001), C3 (OR = 1.14,
p
= 0.178), C4 (OR = 2.28,
p
< 0.001), C5 (OR = 1.07,
p
= 0.479), C6 (OR = 2.29,
p
< 0.001), and C7 (OR = 1.28,
p
= 0.001). We identified 7 groups based on the presence of lymphopenia, elevated CRP, LDH, ferritin, and D-dimer at the time of hospital admission for COVID-19. Clusters C4 (lymphopenia + LDH + CRP), C6 (ferritin + D-dimer), and C7 (D-dimer) had the worst prognosis in terms of in-hospital mortality.
The design and synthesis of Aviram–Ratner‐type molecular rectifiers, featuring an anilino‐substituted extended tetracyanoquinodimethane (exTCNQ) acceptor, covalently linked by the σ‐spacer ...bicyclo2.2.2octane (BCO) to a tetrathiafulvalene (TTF) donor moiety, are described. The rigid BCO spacer keeps the TTF donor and exTCNQ acceptor moieties apart, as demonstrated by X‐ray analysis. The photophysical properties of the TTF‐BCO‐exTCNQ dyads were investigated by UV/Vis and EPR spectroscopy, electrochemical studies, and theoretical calculations. Langmuir–Blodgett films were prepared and used in the fabrication and electrical studies of junction devices. One dyad showed the asymmetric current–voltage (I–V) curve characteristic for rectification, unlike control compounds containing the TTF unit but not the exTCNQ moiety or comprising the exTCNQ acceptor moiety but lacking the donor TTF part, which both gave symmetric I–V curves. The direction of the observed rectification indicated that the preferred electron current flows from the exTCNQ acceptor to the TTF donor.
Aviram–Ratner mechanism of rectification: A molecular dyad, closely resembling the original design by Aviram and Ratner, featuring a strong donor (TTF), separated by a rigid insulating σ‐spacer from a strong extended TCNQ acceptor (exTCNQ), has been designed, synthesized, and fully characterized. Langmuir–Blodgett films were prepared and showed the asymmetric current–voltage (I–V) curve characteristic for rectification, whereas control compounds containing the TTF but not the exTCNQ unit or featuring the exTCNQ acceptor moiety but lacking the TTF donor showed symmetric I–V curves.
Nanopowders or nanoparticles can be used as building blocks for the preparationof new materials with a prescribed structure. Monte Carlo simulations have shownthat the morphological properties (bulk ...porosity and surface roughness) of agranular deposit can be tailored by properly adjusting the velocity of theparticles approaching the deposit. Based on these theoretical predictions,experiments have been conducted to prepare nanostructured materials from carbonnanoparticles. By electrohydrodynamic atomization of a liquid suspension (carbonnanoparticles dispersed in ethanol), an electrospray of small droplets isgenerated. The charged droplets are driven by the electric field with theethanol evaporating along the droplet path, leaving dry nanoparticles thatdeposit on the collecting surface. The surface roughness of the resultingmaterial has been characterized as a function of the voltage drop. Moreover,catalytic suspensions of platinum supported on carbon nanoparticles (Pt/C) inNafion®-alcohol solutions have been electrosprayed overcarbon paper to prepare electrodes for proton exchange membrane fuel cells(PEMFC). The fuel cell power density was measured as a function of the platinumloading and the range of parameters leading to optimal platinum utilization wasobtained.
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