Do we really listen? Vázquez, P. García; Martinez, R. Gomez
European psychiatry,
04/2021, Letnik:
64, Številka:
S1
Journal Article
Recenzirano
Odprti dostop
Introduction
The improvement perceived by the patients is a subjective measure of the psychic state, while the clinical evaluation corresponds to an objective evaluation of the psychopathological ...improvement performed by a psychiatrist. It is therefore relevant to evaluate whether these parameters evolve in a common way after patients have undergone an intervention in Day Hospital focusing on first psychotic episodes.
Objectives
Study the relationship between subjective improvement and clinical evaluation.
Methods
This is a prospective study, which includes consecutive patients admitted to the Day Hospital during 2018. Their objective clinical improvement was assessed by means of the PANSS and GAF scales at admission and discharge. Subjective clinical improvement was assessed using an anonymous Likert scale with a score between 1 and 7. Sociodemographic data and other satisfaction parameters were also collected. A statistical analysis was performed using Pearson’s correlation.
Results
A total of 73 patients were included. The perception of improvement on the part of the patients is very high presenting average values close to the maximum in almost all the evaluated items. The correlation between subjective improvement and PANSS variation presented a Pearson value 0.008; p = .957 and with the GAF variation presented a Pearson correlation of -0.066; p = .578 which indicates that there is no significant correlation between the variables.
Diagnostic groups
Frequency
Percentage
Drugs
1
1,4
Psychosis
37
50.7
Affective
21
28.8
Neurosis
10
13.7
Personality
3
4.1
Total
72
Conclusions
Clinical evaluation and subjective perception of improvement are independent parameters.
Gender matters Vázquez, P. García; Martinez, R. Gomez
European psychiatry,
04/2021, Letnik:
64, Številka:
S1
Journal Article
Recenzirano
Odprti dostop
Introduction
Recently, the seasonal pattern of bipolar disorder has been accepted, with the clinical, diagnostic, treatment and prognostic consequences that this entails. It is interesting to study ...its epidemiological characteristics, such as the influence of gender on this pattern.
Objectives
To study the influence of gender in the Seasonal Pattern of Bipolar Disorder.
Methods
A systematic review was carried out by means of a bibliographic search in Ovid MEDLINE of articles published in the last ten years (2010-2020), using the following keywords: bipolar disorder, seasonal pattern and gender: Those studies carried out in patients who presented a seasonal pattern were selected, and the influence of gender on this was studied.
Results
The initial search showed a total of 92 articles, of which 7 met the inclusion criteria. It was found that, indeed, gender influences both the clinical characteristics and the course, management and prognosis of the seasonality of bipolar disorder.
Conclusions
The diagnosis of the Seasonal Pattern in Bipolar Disorder continues to be an important challenge. Women more frequently present PE, associated with manic, depressive or mixed episodes, while men in depressive episodes. Men are more frequently associated with Bipolar Disorder type II and depressive episodes, and women with rapid cycling and eating disorders. Male manic episodes are associated with psychotic symptoms, and with greater severity in admissions. Women have a higher risk of Seasonal Pattern than men, with the clinical and prognostic repercussions that this entails.
Pain as relief Vázquez, P. García; Martinez, R. Gomez
European psychiatry,
04/2021, Letnik:
64, Številka:
S1
Journal Article
Recenzirano
Odprti dostop
Introduction
Dermatitis artefacta (DA) is a condition whereby self-induced skin damage is the means used to satisfy a desire to assume the sick role.
Objectives
To describe clinical evaluation, ...diagnosis, treatment and evolution of an 15 years-old woman with DA.
Methods
Retrospective review of clinical records, including dermatology, psychiatry and Pathology.
Results
A 15-year-old woman, who come to the Child Psychiatry consultations derived by the Dermatology Service, which is attended by the appearance of multiple bullous lesions throughout the body. Since August, the patient has reported a worsening of her mood, with feelings of loneliness and vital emptiness, with somatic and psychic anxiety referred. In the Dermatology office, she does not recognize self-infliction and the patient is derived to psychiatry consultation and solicited a skin biopsia. In the psychiatric interview, she recognizes that burns occur with a deodorant spray. She admitted doubts about her sexuality for months, claiming to be homosexual for the first time. When she burns, feels pleasure and relief. At the exploration: She wears a gay pride flag bracelet. Expressionless attitude. Cold contact. Approachable. Slightly collaborative. Without major affective disorders. No somatic anxiety, nor psychic. Short speech, impoverished language. Personality traits Cluster B and C. •Salamanca Questionnaire: Dependent personality, and in the background anxiety and histrionic. •Plutchik Impulsivity Scale: 14. •Toronto Alexithymia Scale: 64
Conclusions
The prognosis of the condition is variable, but it has been shown that resolution of the underlying psychosocial stressor leads to improvement. Multinucleated keratinocytes, a pathognomonic lesion of cryodermatitis artefacta, are discovered in the Pathology.
A cup of coffee, what else? Vázquez, P. García; Martinez, R. Gomez
European psychiatry,
04/2021, Letnik:
64, Številka:
S1
Journal Article
Recenzirano
Odprti dostop
Introduction
Caffeine is the worldwide most frequently consumed psychostimulant. Its availability is nearly unlimited and in Europe it is not subject to state regulation. n the DSM-5 “caffeine use ...disorder” is categorized as a possible future disorder that currently needs further study.
Objectives
To describe clinical evaluation, diagnosis, treatment and evolution of a 24 years old female patient.
Methods
A 24-year-old woman admitted to the Dual Pathology Unit with a diagnosis of: unspecified psychotic disorder, mild intellectual disability and borderline disorder. In week 17 of admission, she decided to suspend the medication, with significant improvement. Therapeutic permits increase and Wais-III is repeated, resulting in having a limited intellectual capacity. Two months after being discharged, she was readmitted with manic symptoms. The nursing staff discover that she was drinkiing a large amount of caffeine (up to 4 liters / day). After gradually stopping caffeine intake, she was discharged without psychopharmacological treatment, being able to lead a normalized life, even studying a medium degree. No more incomes were need.
Results
Caffeine produces psychomotor-activating, reinforcing, and arousing effects.
Conclusions
The pattern of caffeine use of patients should be considered in the medical practice. The psychostimulant properties of caffeine are reviewed and compared with those of prototypical psychostimulants able to cause substance use disorders.
The magnetic field assisted adsorption is a non-conventional method employed in removal of water pollutants and due to the promising results found until now, we have applied this procedure with ...single and binary systems. Zeolites and carbons were employed as adsorbents materials, which were modified with calcium and iron to improve its adsorption and magnetic properties, respectively. Adsorbents were physicochemical (elemental analysis, SEM/EDX analysis, X-ray diffraction and FT-IR spectroscopy) and magnetically characterized to describe their composition, textural and magnetic behavior under magnetic field exposition. Adsorption isotherms were conducted in batch systems with and without magnetic field using as contaminants Cd2+, Zn2+, Basic Blue 9, Basic Green 1, Reactive Black 5 and Reactive Red 2. The results are indicating that there are increments when was applied the magnetic field up to 114% and 55% in single solutions, and 15% and 63% in binary mixtures for heavy metals and dyes, respectively. Finally, with the purpose to elucidate the adsorption mechanism the characterization, adsorption capacities and molecular simulation were correlated to explain the phenomena involved and the role played by magnetic field in improving results.
•A novel non-conventional method has been used successfully for the removal of dyes and heavy metals in binary solutions.•The magnetic field generates a more significant effect on the adsorbate than on the adsorbent.•The magnetic field has a greater effect on the cationic species.
Cardiovascular diseases account for the highest mortality rate in the United States. The major underlying mechanism driving the onset and maintenance of cardiovascular diseases is atherosclerosis. ...Atherosclerosis is a chronic disease affecting large and medium-size arteries; it proceeds through four main stages along different decades of life, beginning at birth. Atherosclerosis is a consequence of oxidative stress, where homeostasis between endogenous antioxidants and reactive oxygen species is disrupted. Failure of intrinsic antioxidants and prophylactic antioxidant supplements to prevent atherosclerosis formation is an ongoing area of research in the race to avert, manage and cure atherosclerosis.
The purpose of this work was to elucidate the actions of reactive oxygen species and oxidative stress on the formation of atherosclerosis as well as the different stages of atherosclerosis and the different mechanisms to prevent it. Through an extensive review of scientific literature, this paper correlates cell damage caused by oxidative stress to atheromatous plaque formation, as well as an in-depth analysis of high-density lipoproteins and enzymatic and non-enzymatic antioxidant role on atherosclerosis prevention. The antioxidant mechanism is overwhelmed by atherosclerotic processes and fails to be the ideal treatment of atherosclerosis. There is no scientific data that correlates prophylactic and non-prophylactic antioxidant treatment to a decrease in mortality or comorbidities pertaining to atherosclerosis. This is thought to be due to lack of consensus of optimal therapeutic doses, lack of reliable markers indicating which patient is to benefit from therapy and the chemical complexity of antioxidants in vivo. Current treatments for atherosclerosis include HMG-CoA reductase inhibitors which directly target low-density lipoproteins to tackle atherosclerotic plaque formation.
HMG-CoA reductase inhibitors are not enough for the treatment of atherosclerosis given the complexity of the disease which has immune, musculoskeletal, genetic and hematologic aspects besides the involvement of lipids and lipoproteins. Therefore, other pharmacologic targets such as the PCSK9 enzyme and NFK- β should be researched in depth as possible treatments for atherosclerosis.
Adsorption studies were carried out to determine the behavior of three carbonaceous adsorbents with different magnetic orderings (ferromagnetic, paramagnetic, and diamagnetic) and the effect of an ...external magnetic field on the adsorption of a cation (lead, Pb2+) and an anion (fluoride, F–). Two different static magnetic field intensities were used to analyze the sensitivity of the adsorption system as a function of the applied magnetic field, based on computational simulations, with the aim of determining the degree of magnetization of each system and the distribution of the flow density generated by each magnetic field application system. The results of the adsorption studies for the removal of Pb2+ showed a correlation between the adsorption capacities and the magnetic ordering of the adsorbent material. Particularly, the activated carbon of bituminous coal (ferromagnetic) showed an increase of 15%, whereas bone char (paramagnetic) showed an increase of 6%. On the other hand, this behavior was not observed in the studies for the removal of fluoride.
Background
Hematopoietic cell transplantation (HCT) outcomes, including infectious complications, change between centers and countries. Thus, the aim of this study was to report the incidence of ...infections and isolated pathogens among recipients of HCT and the association with mortality at a tertiary referral center in Mexico.
Methods
Two hundred and eighty‐two patients undergoing autologous or allogeneic HCT between January 2005 and December 2018 at the National Institute of Medical Sciences and Nutricion Salvador Zubiran were included.
Results
In autologous HCT (n = 176), within the preengraftment and the early postengraftment, 130 (74%) and 31 (18%) recipients presented infections, respectively. Within the preengraftment, the early postengraftment, and the late postengraftment, 81 (76%), 34 (33%), and 58 (60%) allogeneic HCT recipients presented infections, respectively. Non‐relapse mortality (NRM) as a result of infections occurred in 1 (0.6%) and 5 (5%) autologous and allogeneic HCT recipients, respectively.
Conclusions
Our results demonstrated that despite our limited resources, infections were not a significant burden for NRM among HCT recipients. More importantly, the isolation rates were higher than international studies, which could be explained by the existence of a specialized infectious diseases department and laboratory, which we consider key elements for the establishment of an HCT program worldwide.
•Symbolic-numeric comparison lies on complex brain functional interacting networks.•EEG coherence analysis depict functional brain activation underlying math skills.•Children with lower math skills ...need more attentional control & processing resources.•Brain functional connectivity discerns between high and low math skills in children.
Symbolic numerical magnitude processing is crucial to arithmetic development, and it is thought to be supported by the functional activation of several brain-interconnected structures. In this context, EEG beta oscillations have been recently associated with attention and working memory processing that underlie math achievement. Due to that EEG coherence represents a useful measure of brain functional connectivity, we aimed to contrast the EEG coherence in forty 8-to-9-year-old children with different math skill levels (High: HA, and Low achievement: LA) according to their arithmetic scores in the Fourth Edition of the Wide Range Achievement Test (WRAT-4) while performing a symbolic magnitude comparison task (i.e. determining which of two numbers is numerically larger). The analysis showed significantly greater coherence over the right hemisphere in the two groups, but with a distinctive connectivity pattern. Whereas functional connectivity in the HA group was predominant in parietal areas, especially involving beta frequencies, the LA group showed more extensive frontoparietal relationships, with higher participation of delta, theta and alpha band frequencies, along with a distinct time–frequency domain expression. The results seem to reflect that lower math achievements in children mainly associate with cognitive processing steps beyond stimulus encoding, along with the need of further attentional resources and cognitive control than their peers, suggesting a lower degree of numerical processing automation.