bluuebunny/crossref_metadata_2025 huggingface dataset:
Modulation of Biofilm of Strains Isolated from Patients with Chronic Obstructive Pulmonary Disease by Levofloxacin, Moxifloxacin, Ciprofloxacin, Amoxicillin/Clavulanic Acid and Ceftriaxone
Authors: Drago L. , Mattina R. , Legnani D. , Romanò C.L. , Vianello E. , Ricci C. , De Vecchi E.
Published: January 2017

The ability of levofloxacin, moxifloxacin, ciprofloxacin, amoxicillin/clavulanic acid and ceftriaxone to interfere on biofilm produced by Pseudomonas aeruginosa, Haemophilus influenzae and Streptococcus pneumoniae isolated from patients with chronic obstructive pulmonary disease was evaluated. The effects of antibiotics were evaluated on formation of biofilm (at 1/2, 1/4 and 1/8 X MIC) and on preformed biofilm (at epithelial lining fluid peak concentrations) by means of a spectrophotometric method. Levofloxacin was the most active compound followed by ciprofloxacin, moxifloxacin and amoxicillin/clavulanic acid and ceftriaxone. Levofloxacin may contribute to clear the reservoir of pathogens involved in chronic obstructive pulmonary disease, thus leading to decreased occurrence of acute exacerbations.
Lactoferrin Decreases Inflammatory Response by Cystic Fibrosis Bronchial Cells Invaded with Burkholderia Cenocepacia Iron-Modulated Biofilm
Authors: Valenti P. , Catizone A. , Pantanella F. , Frioni A. , Natalizi T. , Tendini M. , Berlutti F.
Published: January 2017

In cystic fibrosis (CF) high iron concentration in airway secretion plays a pivotal role in bacterial multiplication and biofilm formation as well as in inflammatory response. Burkholderia cenocepacia, an opportunistic facultative pathogen responsible for chronic lung infections and cepacia syndrome, recurrently infects CF patients. Lactoferrin (Lf), an iron binding multifunctional glycoprotein synthesized by exocrine glands and neutrophils, has been found at higher concentration in the airway secretions of infected CF patients than in healthy subjects. Here the influence of milk derivative bovine lactoferrin (bLf), an emerging important regulator of iron and inflammatory homeostasis, on invasiveness of B. cenocepacia iron-modulated biofilm, as well as on inflammatory response by infected CF bronchial (IB3-1) cells, is reported, bLf did not significantly affect invasion efficacy by biofilm-forming B. cenocepacia clinical strains. Conversely, the addition of bLf to cell monolayers during infection significantly decreased the pro-inflammatory Interleukin (IL)-1β and increased the antiinflammatory IL-11 expression compared to that observed in cells infected in the absence of bLf. The bLf ability to modulate genes expressed following B. cenocepacia infection seems related to its localization to the nucleus of infected IB3-1 cells. These results provide evidence for a role of bLf in the protection of infected CF cells from inflammation-related damage, thus extending the therapeutic potential of this multifunctional natural protein.
Severe Necrotizing Pneumonia Complicating Influenza A (H1N1): The Role of Immunologic Interaction
Authors: Guidi R. , Osimani P. , Azzari C. , Resti M. , De Benedictis F.M.
Published: January 2017

This report describes the successful management of a documented necrotizing pneumonia due to Streptococcus pneumoniae in a child with pandemic influenza A (H1N1). The importance of early recognition of bacterial superinfection in patients with influenza and the immunologic interactive mechanisms between viruses and bacteria in determining respiratory diseases are highlighted. The role of modern molecular techniques in improving diagnostic microbiology sensitivity and informing consequent clinical care is emphasized.
Contact Allergic Dermatitis to Gold in a Tattoo: A Case Report
Authors: Tammaro A. , Tuchinda P. , Persechino S. , Gaspari A.
Published: January 2017

The art of tattooing has increasing in recent decades. Allergic sensitivity to one of the pigments is the most frequent cause of dermatological reactions at the site of the tatoo. Gold is a new pigment used in tatooing, because of its bright yellow color and luster. Allergy to this metal is uncommon. To our knowledge, this is the first reported case of allergic contact dermatitis to gold in a tattoo.
Lupus Mastitis in Systemic Lupus Erythematosus: A Rare Condition Requiring a Minimally Invasive Diagnostic Approach
Authors: Lucivero G. , Romano C. , Ferraraccio F. , Sellitto A. , De Fanis U. , Giunta R. , Guarino A. , Auriemma P.P. , Benincasa M. , Iovino F.
Published: January 2017

Breast involvement is a rare event in SLE patients. The most frequent presentation is lupus panniculitis with skin erithema, tenderness, and parenchymal nodules. However, when breast masses are detected in SLE patients without significant superficial inflammation, it is mandatory to rule out breast carcinoma. Here, we report the case of a 47-year-old woman with an 18-year-long history of SLE, who presented with a suspicious breast mass. Since surgical trauma has been reported to be able to exacerbate breast inflammation in lupus mastitis, an ultrasound-guided minimally invasive Mammotome biopsy was performed to obtain tissue samples for histological and immunohistochemical examinations. Histology was consistent with lupus mastitis. The patient was already on mycophenolate mofetil and hydroxychloroquine. At the latest follow-up visit 6 years later, no progression of the breast lesion was observed.
Antiblastic Treatment, for Solid Tumors, during Pregnancy: A Crucial Decision
Authors: Berretta M , Di Francia R , Lleshi A , De Paoli P , Li Volti G , Bearz A , Del Pup L , Tirelli U , Michieli M
Published: January 2017

Cancer is the second leading cause of death during the reproductive years complicating between 0.02% and 0.1% of pregnancies. The incidence is expected to rise with the increase in age of childbearing. The most common types of pregnancy-associated cancers are: cervical cancer, breast cancer, malignant melanoma, Hodgkin's lymphoma, non-Hodgkin's lymphoma and ovarian cancer. The relatively rare occurrence of pregnancy-associated cancer precludes conducting large, prospective studies to examine diagnostic, management and outcome issues. The treatment of pregnancy-associated cancer is complex since it may be associated with adverse fatal effects. In pregnant patients diagnosed with cancer during the first trimester, treatment with multidrug anti-cancer chemotherapy is associated with an increased risk of congenital malformations, spontaneous abortions or fetal death, and therefore, should follow a strong recommendation for pregnancy termination. Second and third trimester exposure is not associated with teratogenic effect but increases the risk of intrauterine growth retardation and low birth weight. There are no sufficient data regarding the teratogenicity of most cytotoxic drugs. Almost all chemotherapeutic agents were found to be teratogenic in animals and for some drugs only experimental data exist. Moreover, no pharmacokinetic studies have been conducted in pregnant women receiving chemotherapy in order to understand whether pregnant women should be treated with different doses of chemotherapy. This article reviews the available data regarding the different aspects of the treatment of cancer during pregnancy.
Antidepressant Drug, Desipramine, Alleviates Allergic Rhinitis by Regulating Treg and Th 17 Cells
Authors: Zhang Y. , Zhen H. , Yao W. , Bian F. , Mao X. , Yang X. , Jin S.
Published: January 2017

Allergic rhinitis (AR) is characterized by IgE-mediated immediate hypersensitivity and usually progresses to chronic nasal inflammation, with depression as one of its comorbidities. The importance of treating the depression in AR patients has been increasingly recognized. Desipramine is a representative of tricyclic-antidepressant agents. In the present study we investigate whether desipramine has therapeutic effects on AR inflammation. BALB/C mice were sensitized by intraperitoneal injection of ovalbumin (OVA), followed by repeated challenge with OVA intranasally. Desipramine was administered orally to treat the mice. The nasal symptoms (sneezing, nasal scratching etc.) of AR were evaluated to determine the severity of AR. Cytokines in the nasal lavage fluid (NALF), including interferon-γ (IFN-γ), interleukin 4 (IL-4) and serum OVA-specific immunoglobulin E (IgE) antibody were measured by ELISA. The regulatory T cells (Treg) and T helper cells 17 (Th17) were quantified by flow cytometric analysis. As a result, the repeated oral administration of desipramine attenuated the nasal symptoms (sneezing and nasal rubbing) in AR mice. Desipramine also suppressed the serum OVA-specific IgE and IL-4 levels, but had no effect on IFN-γ level. Moreover, desipramine treatment up regulated CD4+CD25+Foxp3+Treg cells, which were found down-regulated in established AR mice. Meanwhile, desipramine administration attenuated CD4+IL-17+ Th17 cells, which were significantly increased in AR mice. These results suggest that the antidepressant drug, desipramine, also has anti-allergic action, which was possibly achieved by reducing allergen-specific IgE and Th2 cytokine production and maintaining a balance between Treg and Th17 cells. Thus, this study provide the first evidence that desipramine may be utilized to treat allergic diseases, especially for those allergic patients with depression or depression patients with allergy.
Effects of Sodium Hyaluronate in Children with Recurrent Upper Respiratory Tract Infections: Results of a Randomised Controlled Study
Authors: Macchi A. , Castelnuovo P. , Terranova P. , Digilio E.
Published: January 2017

Hyaluronic acid is a major component of many extracellular matrices that plays a role in the regulation of vasomotor tone and mucous gland secretion, and in the modulation of the inflammatory process in upper and lower airways. This pilot study was aimed at evaluating the effects of nasal washes with 9 mg nebulised sodium hyaluronate given for 15 days per month over 3 months in 75 paediatric patients with recurrent upper respiratory tract infections (URTI). Eligible patients were randomized to treatment with nasal washes containing 9 mg sodium hyaluronate plus saline solution or saline alone, according to an open-label, parallel group design, with blind observer assessment. Ciliary motility, which was assessed based on a 0–3 point rating scale (0 = absent, 1 = < 5 minutes, 2 = ≥ 5 and ≤ 10 minutes, 3 = > 10 minutes) was the primary study endpoint. The secondary efficacy variables included cytological (presence of neutrophils, eosinophils and mast cells), microbiological (presence of bacteria and mycetes), endoscopical (presence of adenoid hypertrophy and biofilm) and clinical (presence of rhinitis, post-nasal drip, nasal dyspnoea) parameters. The two treatment groups (mean age 7.5 years, 53% of males) were comparable for baseline data, except a higher mean age in the control group than in the treated group. Treatment with 9 mg sodium hyaluronate was associated with significantly greater improvements (p<0.001 between groups) in primary outcome ciliary motility [odds ratio (OR) 13.61; 95% CI 4.51–41.00 in the univariate regression analysis that examined the probability of improvement]. Treatment with 9 mg sodium hyaluronate was also significantly superior to saline alone in adenoid hypertrophy (p<0.001; OR 14.72; 95% CI 4.74–45.68), presence of bacteria (p = 0.026; OR 2.95; 95% CI 1.15–7.55), neutrophils (p = 0.002; OR 4.51; 95% CI 1.75–11.62), rhinitis (p = 0.040; OR 10.47; 95% CI 3.10–35.31), nasal dyspnoea (p = 0.047; OR 3.80; 95% CI 1.09–13.19) and biofilm (p = 0.049; OR 9.90; 95% CI 2.61–37.47). Advantages of 9 mg of sodium hyaluronate over control on postnasal drip and presence of mycetes (although evident) did not reach the level of statistical significance. The superiority of the treated group over saline alone was confirmed in a multivariate logistic regression analysis that took into account age as confounding factor. The number of days of absence from school was significantly lower in the 9 mg sodium hyaluronate group compared to controls (p<0.001 between groups). A 3-month intermittent treatment with 9 mg sodium hyaluronate with nasal washes plus saline solution was associated with significant improvements in ciliary motility and in cytological, microbiological, endoscopic and clinical outcomes compared to saline, in children with recurrent URTI.
The Role and Clinical Significance of Yes-Associated Protein 1 in Human Osteosarcoma
Authors: Zhang Y-H. , Li B. , Shen L. , Shen Y. , Chen X-D.
Published: January 2017

Yes-associated protein 1 (YAP1) is an oncogene that plays multiple roles in the tumorigenesis and progression of many malignances. The present study aimed to investigate the clinical significance of YAP1 expression in human osteosarcoma (OS) and explore the molecular mechanisms of YAP1 activity in OS MG-63 cells. The expression of YAP1 was assessed by immunohistochemical assay using a tissue microarray procedure. A loss-of-function approach was used to investigate the effects of small hairpin RNA-mediated knockdown of YAP1 on the expression of RUNX2, CyclinD1, and matrix metalloproteinase-9 (MMP-9) as well as the proliferative activities and invasive potential in OS MG-63 cells (evaluated by MTT and Transwell assays, respectively). The expression of YAP1 protein in OS tissues was significantly higher than that in ANCT, and was closely associated with gender ( P = 0.013) and Enneking staging ( P = 0.035), but it did not correlate with age, tumor location, or distant metastases of OS patients ( P > 0.05, each). Knockdown of YAP1 resulted in downregulation of the expression of RUNX2, CyclinD1, and MMP-9 and inhibited the proliferation and invasion of MG-63 cells. Our findings suggest that YAP1 is highly expressed in OS tissues, and increased expression of this molecule is correlated with the gender and Enneking staging of osteosarcoma patients. Knockdown of YAP1 may inhibit the proliferation and invasion of OS cells through downregulation of the RUNX2 pathway, thereby representing a potential therapeutic target for the treatment of cancer.
Rage Gene Polymorphism in Heart Failure Patients with and without Angiographic Evidence of Significant Coronary Atherosclerosis
Authors: Falcone C. , Bozzini S. , Matrone B. , Colonna A. , Falcone R. , Calcagnino M. , Pelissero G.
Published: January 2017

Heart failure (HF) is a multifactorial disorder in which clinical, environmental and genetic components take part. For this reason it is possible that common gene variants could affect development, progression and response to pharmacological therapy. In recent years the role of AGEs in the pathogenesis of cardiovascular diseases has become recognized but little is known about the role of the AGE-RAGE system in heart failure. The aim of the present study was to identify possible relationship between -374 T/A RAGE gene polymorphism with heart failure. The population in this study consists of 386 subjects with HF, selected according to the presence of depressed Left Ventricular Ejection Fraction (LVEF) <45%, and 639 patients with CAD documented at coronary angiography. Within the population with HF there are 228 patients with disease secondary to not ischemic cause and 158 with post-ischemic condition. The sample of AA genotype was significantly lower in patients with post-ischemic HF in respect to HF secondary to non-ischemic causes (p<0.001). A significant difference between the two groups was also observed regarding the allele frequency. In addition, differences in the allelic and the genotypic frequencies of homozygous genotypes were found between the HF patients free from evidence of coronary significant lesions and patients with at least one hemodynamically significant coronary lesion, both HF and CAD. In patients with at least one vessel compromised the presence of A allele and the homozygous AA genotype were significantly lower than in patients with lesion-free coronary. In conclusion, our research reveals that the -374 T/A polymorphism is related to the genesis of atherosclerotic coronary artery disease but not to its evolution. The protective role of AA genotype in respect to atheromatous disease is therefore confirmed also in the HF population with non-ischemic origin.
Graves' Disease, Hypoparathyroidism, Systemic Lupus Erythematosus, Alopecia, and Angioedema: Autoimmune Polyglandular Syndrome Variant or Coincidence?
Authors: Melcescu E. , Kemp E.H. , Majithia V. , Vijayakumar V. , Uwaifo G.I. , Koch C.A.
Published: January 2017

Data on coexisting Graves' disease (GD), hypoparathyroidism, and systemic lupus erythematosus (SLE) are limited. The thyroid and parathyroid glands may be extra sensitive to irradiation damage in an underlying autoimmune condition. A 34-year-old black woman presented with tetanic-like cramps, easy skin bruising, fatigue, weight gain, nocturia and back pain. She was previously diagnosed with GD in 2001 and underwent radioiodine therapy (RAI) in 9/01 using 6 mCi. PostRAI (November 2001) she developed hypocalcemia and hypothyroidism (2/02). In 2007, SLE was diagnosed. In October 2009, s-calcium and PTH were still low at 7.1 mg/dl and 9 pg/mL, respectively, although the patient denied symptoms on vitamin D and calcium supplementation. To identify possible autoimmune damage of the parathyroids, we evaluated the presence of activating antibodies to the CaSR and also analyzed the DNA sequence of all 6 translated exons and flanking intronic sequences of her CaSR gene for a functionally significant CaSR mutation but neither was positive. The initial autoimmune damage to her thyroid and possibly parathyroid glands followed by irradiation of them seems to have contributed to her developing both hypoparathyroidism (11/01) and hypothyroidism (2002). The patient could potentially have had parathyroid autoantibodies in 2001 that disappeared by 2009 when she was tested for them. We consider that the multiple autoimmune conditions developed over the past decade of her life with the concurrent irradiation contributing to her brittle hypoparathyroidism. Select patients with GD and perhaps parathyroid autoantibodies with a slowly developing destructive impact on the parathyroid glands may then develop overt hyoparathyroidism with rather low dose RAI ablation. This patient adds to the evolving spectrum of polyglandular syndrome variants.
Expression of ADAM28 and IGFBP-3 Genes in Patients with Colorectal Cancer — A Preliminary Report
Authors: Nowakowska-Zajdel E. , Mazurek U. , Wierzgoń J. , Kokot T. , Fatyga E. , Ziółko E. , Klakla K. , Błażelonis A. , Waniczek D. , Głogowski Ł. , Kozowicz A. , Niedworok E. , Muc-Wierzgoń M.
Published: January 2017

Adamalisynes ( ADAMs) play an important role in inter-membrane interactions, cell adhesion and fusion processes and protein shedding from the cell surface. Many reports indicate that members of the ADAMs family are overexpressed in human cancer. The aim of the present study was to evaluate ADAM28 and Insulin Like Growth Factor Binding Protein-3 ( IGFBP-3)) gene expression in colorectal carcinoma tissues with regard to the overweight or obese status of the patients using an oligonucleotide microarray technique. Fresh tissue specimens were obtained from colorectal cancer patients during surgical treatment. Eighteen specimens from tumour and 18 normal tissue specimens from colorectal cancer patients at clinical stages III and IV were analysed. The examined patients were divided into two groups; those with BMI≥25 and those with normal BMI. The control group consisted of 18 specimens of non-neoplastic colon tissues, which were divided between overweight/obese and normal body weight patients. The gene transcriptional activity from the specimens was analysed using an oligonucleotide microarray technique. Microarrays and rinsing and marking solutions were prepared according to the procedure in the Gene Expression Analysis Technical Manual. The following conclusions were made: i) change of ADAM28 and IGFBP-3 genes expression are present in the normal tissue in overweight/obese patients with colorectal cancer only; ii) the observed molecular variability of ADAM28 and IGFBP-3 expression may be an initial process of cancer proliferation; iii) the histopathologically normal surgical margin in this group of patients was not equal to the molecular margin.
Overuse of Prescription and OTC Non-Steroidal Anti-Inflammatory Drugs in Patients with Rheumatoid Arthritis and Osteoarthritis
Authors: Cavagna L. , Caporali R. , Trifirò G. , Arcoraci V. , Rossi S. , Montecucco C.
Published: January 2017

Non-steroidal anti-inflammatory drugs (NSAIDs) have been demonstrated to have significant cardiovascular and gastrointestinal toxicity; high dose of intake and concomitant use of multiple compounds or corticosteroids are factors that increase the risk of NSAID toxicity. In this paper we described our experience on NSAIDs misuse (both prescribing and OTC formulations), particularly relevant in the setting of rheumatoid arthritis (39.5% of patients) and osteoarthritis (47% of patients). We also evaluated causes underlying NSAIDs misuse (e.g. not satisfactory pain control, other painful conditions, etc).
Ethical Issues concerning Participants in Community Surveys of Child and Adolescent Mental Disorders
Authors: Lépine Suzanne , Smolla Nicole
Published: January 2017

Objective:

Considering that a literature review yielded limited information on ethical issues concerning participants in child and adolescent mental health community surveys, the authors identify and discuss some of these issues.

Method:

First, the authors present the ethical principles set forth by the National Council on Bioethics in Human Research (NCBHR) and evoked by the 1998 Tri-Council Policy Statement, underscoring their importance as guidelines for establishing ethical standards for research with children. Second, they describe the general objectives and currently preferred methods of child psychiatric surveys. Third, they discuss issues pertaining to the validity and innocuousness of structured interview guides, the limitations of parental authorization and children's assent, and the complexity of clinical interventions based on ethical grounds.

Conclusions:

The authors emphasize the importance of developing empirical knowledge regarding the questions raised and bringing the social stakeholders concerned into the debate.
Transcultural Psychiatry: Personal Experiences and Canadian Perspectives
Authors: Prince Raymond H
Published: January 2017

In the mid-1950s, a unique section of transcultural psychiatric studies was established within the McGill Department of Psychiatry. These personal recollections describe the backgrounds, methods, and motivations of those most involved and suggest why such a specialized study should have emerged in Canada and at McGill. Some of the major controversies and developments in the field are explored, focusing on the question of culture-bound syndromes and their occasional biological underpinnings. The relevance of transcultural psychiatry to psychiatric practice is discussed.

La psychiatrie transculturelle: experiences vécues et perspectives canadiennes
Different Perspectives of the Therapeutic Alliance and Therapist Technique in 2 Forms of Dynamically Oriented Psychotherapy
Authors: Ogrodniczuk John S , Piper William E , Joyce Anthony S , McCallum Mary
Published: January 2017

Objective:

This study addresses several issues concerning patients' and therapists' perceptions of key therapy process variables. This includes examining whether patients and therapists differ in their perceptions of the therapeutic alliance and therapist technique, what the relation is between perceptions of the alliance and technique, and whether these perceptions are predictive of treatment outcome.

Method:

Patient and therapist perceptions of the therapy process were provided in a comparative trial of 2 forms of short-term individual dynamic psychotherapy. Patients (n = 144) were randomly assigned to each condition. Treatment outcome was assessed using a large, comprehensive battery of reliable measures.

Results:

The findings revealed several differences in the patients' and therapists' ratings of the alliance and technique in the 2 forms of therapy. Patient ratings of the alliance and technique were predictive of treatment outcome.

Conclusion:

The findings contribute to understanding the extent to which therapy participants share views of therapy processes and highlight the importance of the therapist's attending to the patient's perception of therapy.
Physical Illness as an Outcome of Chronic Anxiety Disorders
Authors: Bowen RC , Senthilselvan A , Barale A
Published: January 2017

Background:

The literature indicates increased rates of some medical conditions in patients with anxiety disorders. We used the Saskatchewan Health databases to examine the development of nonpsychiatric medical diseases in patients with anxiety disorders. This study has a large population base, and the Saskatchewan health plan does not limit the provision of services to this populaiton.

Method:

We observed the annual incidence of specified medical conditions in patients with anxiety disorders and in control subjects over a 10-year period. Subjects in both groups had not been treated for the specified medical conditions before the start of the observation period.

Results:

The anxiety cohort had a significantly higher relative risk of developing medical diseases compared with the control group. The highest relative risk, indicated by the hazard ratio, was for cerebrovascular disease (hazard ratio 2, 95% CI 1.09–3.65). Hazard ratios were significant for cerebrovascular disease and atherosclerosis as well as for ischemic heart, gastrointestinal, hypertensive, and respiratory diseases.

Conclusions:

This study provides additional evidence for an association between anxiety disorder and the later development of medical morbidity.
Patient Factors Associated with Missed Appointments in Persons with Schizophrenia
Authors: Coodin Shalom , Staley Douglas , Cortens Barb , Desrochers Rob , McLandress Sandy
Published: January 2017

Objective:

There is limited research on factors that may predict missed appointments. This study examined correlates to missed appointments in a sample of persons attending an outpatient schizophrenia program.

Method:

We measured the rate of missed appointments for 342 outpatients with severe and persistent mental illness (that is, with diagnoses of schizophrenia, schizoaffective disorder, and delusional disorder) attending a psychiatric outpatient clinic over a period of 2 years and 3 months. We collected and analyzed demographic and clinical variables to ascertain differences between patients with high and low rates of nonattendance.

Results:

Patients who missed 20% or more of their appointments were significantly younger, were more likely to abuse drugs and alcohol, and manifested lower levels of community functioning.

Conclusions:

This profile may be useful in helping clinicians to schedule appointments for this clinical population, to identify those who may need community outreach services, and to improve their treatment prospects.
Service Use for Mental Health Reasons: Cross-Provincial Differences in Rates, Determinants, and Equity of Access
Authors: Vasiliadis Helen-Maria , Lesage Alain , Adair Carol , Boyer Richard
Published: January 2017

Objectives:

In 2002, Canada undertook its first national survey on mental health and well-being, including detailed questioning on service use. Mental disorders may affect more than 1 person in 5, according to past regional and less comprehensive mental health surveys in Canada, and most do not seek help. Individual determinants play a role in health resource use for mental health (MH) reasons. This study aimed to provide prevalence rates of health care service use for MH reasons by province and according to service type and to examine determinants of MH service use in Canada and across provinces.

Methods:

We assessed the prevalence rate (95% confidence interval [CI]) of past-year health service use for MH reasons, and we assessed potential determinants cross-sectionally, using data collected from the Statistics Canada Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2). We estimated models of resource use with logistic regression (using odds ratios and 95%CIs).

Results:

The prevalence of health service use for MH reasons in Canada was 9.5% (95%CI, 9.1% to 10.0%). The highest rates, on average, were observed in Nova Scotia (11.3%; 95%CI, 9.6% to 13.0%) and British Columbia (11.3%; 95%CI, 10.1% to 12.6%). The lowest rates were observed in Newfoundland and Labrador (6.7%; 95%CI, 5.3% to 8.0%) and Prince Edward Island (7.5%; 95%CI, 5.8% to 9.3%). In Canada, the general medical system was the most used for MH reasons (5.4%; 95%CI, 5.1% to 5.8%) and the voluntary network sector was the least used (1.9%; 95%CI, 1.7% to 2.1%). No difference was observed in the rate of service use between specialty MH (3.5%; 95%CI, 3.2% to 3.8%) and other professional providers (4.0%; 95%CI, 3.7% to 4.3%). In multivariate analyses, after adjusting for age and sex, the presence of a mental disorder was a consistent predictor of health service use for MH across the provinces.

Conclusions:

There is up to a twofold difference in the type of service used for MH reasons across provinces. The primary care general medical system is the most widely used service for MH. Need remains the strongest predictor of use, especially when a mental disorder is present. Barriers to access, such as income, were not identified in all provinces. Different sociodemographic variables played a role in service seeking within each province. This suggests different attitudes toward common mental disorders and toward care seeking among the provinces.
Variations in the Prevalence of Psychiatric Disorders and Social Problems across Canadian Provinces
Authors: Thompson Angus H
Published: January 2017

Objective:

To determine provincial 12-month prevalence rates for selected psychiatric disorders and to assess the association between these and the Canadian Social Problem Index (SPI).

Method:

Psychiatric data for depression, mania, panic disorder, social phobia, and agoraphobia were derived from the results of the 2002 Canadian Community Health Survey: Mental Health and Well-Being. The Canadian SPI was updated for 2002, and correlations were calculated between the SPI and the 5 diagnostic prevalence values across provinces.

Results:

The results showed that the SPI had maintained its tendency to increase from east to west in Canada, a trend reflected by depression and mania. The psychiatric disorders did not show strong correlations with the SPI in 2002, but depression and mania did show relatively strong associations with index values from earlier years. High-to-low ratios across provinces for individual social problems averaged over 5, and the results were essentially of the same magnitude for the ranges of particular psychiatric diagnoses.

Conclusions:

The differences in need found here suggest that per capita allocation of funding for mental health and social programs may not be appropriate. The mixed findings on the association between mental disorders and social problem behaviour across provinces leads to more research questions than research answers.
Pharmacotherapies in the Management of Obsessive—Compulsive Disorder
Authors: Blier Pierre , Habib Rami , Flament Martine F
Published: January 2017

Few medications are effective in treating obsessive–compulsive disorder (OCD). As monotherapy, only potent serotonin (5-HT) reuptake inhibitors (SRIs) consistently exert an intrinsic therapeutic action in OCD. Their use in OCD, however, differs from their use in depression. This paper first reviews the evidence supporting the key role of 5-HT as a pivotal neurotransmitter in the anti-OCD response. Then, we describe the practicalities of SRI use, followed by the steps that can be taken when these medications do not produce an adequate clinical response. We provide specifics for the treatment of children and adolescents with OCD. We include a brief description of the brain circuitry involved in OCD and the mechanisms of action of the pharmacologic agents reported to be effective in this disorder, as well as those that are useful in depression but not in OCD. We present this information to promote better understanding of the research endeavours needed to develop new pharmacotherapeutic approaches.
What's under the ROC? An Introduction to Receiver Operating Characteristics Curves
Authors: Streiner David L , Cairney John
Published: January 2017

It is often necessary to dichotomize a continuous scale to separate respondents into normal and abnormal groups. However, because the distributions of the scores in these 2 groups most often overlap, any cut point that is chosen will result in 2 types of errors: false negatives (that is, abnormal cases judged to be normal) and false positives (that is, normal cases placed in the abnormal group). Changing the cut point will alter the numbers of erroneous judgments but will not eliminate the problem. A technique called receiver operating characteristic (ROC) curves allows us to determine the ability of a test to discriminate between groups, to choose the optimal cut point, and to compare the performance of 2 or more tests. We discuss how to calculate and compare ROC curves and the factors that must be considered in choosing an optimal cut point.
Child and Adolescent Mental Health Policy and Plans in Canada: An Analytical Review
Authors: Kutcher Stan , Hampton Mary Jane , Wilson Jeffrey
Published: January 2017

Objective:

Child and adolescent mental disorders are common, with a substantial disease burden, yet services for young people are nationally inadequate. As services should be based on policies and (or) plans, we analyzed the availability and content of child and adolescent mental health policies and plans in all provinces and territories.

Method:

The World Health Organization (WHO) framework for Child and Adolescent Mental Health Policy and Plans was applied.

Results:

Four provinces in Canada have a child and adolescent mental health policy and (or) plan. The other provinces do not have a policy or plan in place, or else try to integrate these components into existing mental health strategies. Among the policies and plans that exist, there is substantial variability regarding content as well as degree of adherence to the WHO template. Five essential content areas: legislation and human rights, information systems, quality improvement, improving access to and use of psychotropics, and human resource development and training are poorly or very poorly addressed in existing policies and (or) plans.

Conclusion:

This lack of specific policy and (or) plans for child and adolescent mental health care and the variability of content in plans that exist may help explain why child and adolescent mental health services are poorly developed across Canada. We suggest that a national child and adolescent mental health policy framework be developed for Canada so that the provinces and territories may be encouraged to create or amend their current child and adolescent mental health frameworks in a manner that may enhance national cohesion and commonly addresses service needs in this population.
Increased Depressive Symptoms in Female but Not Male Adolescents Born at Low Birth Weight in the Offspring of a National Cohort
Authors: Van Lieshout Ryan J , Boylan Khrista
Published: January 2017

Objectives:

To test if being born at low birth weight (LBW; <2500 g) or being small for gestational age (SGA; <10th percentile for gestational age [GA]) are associated with increased levels of depressive symptoms in youth and, if so, when these first emerge, if the relation is sex-specific, and whether this effect is direct or mediated by early life difficulties.

Method:

Associations between LBW, SGA, and depressive symptoms at ages 4 to 7 years and 10 to 14 years were tested in 1230 children born to the female participants of the National Longitudinal Study of Youth using linear regression models adjusting for maternal age, ethnicity, education, weight, depressive symptoms, marital status, and income. We also adjusted for GA, the child's age, and depressive symptoms at ages 4 to 7 years. Attention-deficit hyperactivity disorder (ADHD) symptoms and short-term memory at ages 8 to 10 years were also assessed for their putative role in mediating this relation.

Results:

LBW and SGA were associated with increased levels of depressive symptoms in adolescent girls only. This persisted despite adjustment for perinatal factors and was not accounted for by putative mediators. In males and females, increased levels of depressive symptoms were associated with elevated maternal pre-pregnancy weight, depression, and single marital status, as well as childhood ADHD and depressive symptoms. Similar results were found for infants born SGA.

Conclusions:

Our results support the existence of a female-specific association between LBW, SGA, and adolescent depressive symptoms. Differences in exposures to maternal mediators of stress or developmental factors may underlie these findings.
Obsessions religieuses et religiosité
Authors: Khoubila Adil , Kadri Nadia
Published: January 2017

Objectif:

Connaître la prévalence des obsessions religieuses dans une consultation de psychiatrie générale, étudier les caractéristiques sociodémographiques et cliniques des patients qui ont des obsessions religieuses, et enfin explorer la relation entre ces obsessions et la religiosité.

Méthode:

Nous avons exploré, dans une consultation de psychiatrie générale ( n = 1 500), les patients souffrant d'un trouble obsessionnel-compulsif (TOC), puis au sein de cet échantillon, nous avons recherché ceux qui avaient des obsessions religieuses.

Résultats:

Le TOC a été observé chez 9,6 % ( n = 144) des patients. Les obsessions religieuses sont les obsessions les plus fréquentes et ont été constatées chez 31,3 % ( n = 45) des patients au sein de ce groupe. Quarante cinq sujets ( n = 45) ayant des obsessions religieuses ont été comparés à 99 sujets ( n = 99) ayant d'autres types d'obsessions. Le nombre total d'obsessions est significativement plus élevé chez les patients ayant des obsessions religieuses. Les patients ayant des obsessions religieuses ont un score significativement plus élevé à l'échelle de religiosité.

Conclusion:

Ces résultats suggèrent que les obsessions religieuses sont fréquentes chez les patients souffrant du TOC, et qu'elles sont associées à la religiosité.
Perceived Discrimination among People with Self-Reported Emotional, Psychological, or Psychiatric Conditions in a Population-Based Sample of Canadians Reporting a Disability
Authors: Kassam Aliya , Williams Jeanne , Patten Scott
Published: January 2017

Objective:

The prevalence of perceived discrimination among people reporting an emotional, psychological, or psychiatric condition in a population of people with a disability has not been studied. Our study evaluated a model that integrated having an emotional, psychological, or psychiatric condition while accounting for age, sex, education, employment, marital status, immigration status, and type of community to estimate the prevalence of perceived discrimination in the population of people with a disability. We hypothesized that higher levels of perceived discrimination would occur in people reporting an emotional, psychological, or psychiatric condition.

Method:

The Participation and Activity Limitation Survey (PALS) by Statistics Canada is a postcensual survey of community residents reporting health-related impairments. PALS was used to evaluate the interaction between self-reported emotional, psychological, or psychiatric conditions and demographic variables and the odds of experiencing discrimination.

Results:

In the overall sample, 14.5% perceived discrimination and 18.2% reported having an emotional, psychological, or psychiatric condition. Thirty-five per cent of people with such conditions perceived discrimination. When adjusting for covariates, people reporting an emotional, psychological, or psychiatric condition were 3 times more likely to perceive having been discriminated against than people without such conditions. Across medical conditions, perceived discrimination was higher in people who also reported an emotional, psychological, or psychiatric condition.

Conclusions:

The results demonstrate that perceived discrimination and the presence of an emotional, psychological, or psychiatric condition frequently co-occur in people with a disability and therefore programs aimed at reducing the discrimination of emotional, psychological, or psychiatric conditions should take this into account.
An Examination of the Impact of Attention-Deficit Hyperactivity Disorder on IQ: A Large Controlled Family-Based Analysis
Authors: Biederman Joseph , Fried Ronna , Petty Carter , Mahoney Laura , Faraone Stephen V
Published: January 2017

Objective:

Although children with attention-deficit hyperactivity disorder (ADHD) have, on average, lower intelligence quotient (IQ) scores than control subjects, the reasons for these deficits remain unknown. Because IQ is highly familial, we investigated whether children with ADHD have a decrement in IQ from expectations based on parental IQ.

Method:

Subjects were 276 children with ADHD and 239 control subjects of similar age and sex. Expected IQ was calculated based on biological parents' estimated IQ. A significant discrepancy between observed and expected estimated IQ was defined by a child scoring 15 IQ points or more lower than expected, based on parental IQ.

Results:

Compared with control subjects, children with ADHD were significantly more likely to have lower than expected estimated IQ scores based on parental IQ, though this finding was accounted for by a small subgroup of children with ADHD who had an IQ 15 points or more lower than expected, based on parental IQ. These children were more likely to be female, have higher psychopathological, neuropsychological, educational, and interpersonal deficits, as well as higher rates of perinatal complications.

Conclusions:

Group differences in IQ scores between children with and without ADHD reported in the literature may be accounted for by a subgroup of children with ADHD who have a large decrement in IQ from expectations based on parental IQ. Although perinatal complications may explain these findings, more work is needed to better understand the etiology of these IQ deficits.
Psychoanalytic Contributions to the Study of Gender Issues
Authors: Barbieri Norma B
Published: January 2017

Objective:

To explore the issue of gender development and its applications and implications with respect to dynamic psychiatry.

Method:

Gender study is approached in this paper as a continually evolving process of thinking about male and female attributes, similarities, and differences. The paper reviews a specific thematic area of the extensive literature on the subject.

Results:

Gendered psychosexual development and identity construction are intertwined and determined by multibiopsychosocial factors. Freud's theory on femininity is briefly reviewed from the perspective of new theoretical developments.

Conclusions:

The paper highlights the fact that gender is becoming a useful conceptual tool in clinical practice, teaching, and neurosciences.
The Economic Burden of Schizophrenia in Canada
Authors: Goeree Ron , O'Brien Bernie J , Goering Paula , Blackhouse Gordon , Agro Karen , Rhodes Anne , Watson Jan
Published: January 2017

Objective:

To estimate the financial burden of schizophrenia in Canada in 1996.

Method:

Using a prevalence-based approach, all direct health care costs, administrative costs of income assistance plans, and costs of incarceration attributable to schizophrenia were determined. Also included was the value of lost productivity associated with premature mortality and morbidity. In addition to using published papers and documents, direct contact was made with representatives from various provincial and federal programs for estimates of the direct health care and non-health care costs.

Results:

The estimated number of persons with schizophrenia in Canada in 1996 was 221 000, with equal distribution between males and females. The direct health care and non-health care cost was estimated to be $1.12 billion in 1996. In addition, another $1.23 billion in lost productivity associated with morbidity and premature mortality was attributable to schizophrenia.

Conclusions:

The total financial burden of schizophrenia in Canada was estimated to be $2.35 billion in 1996. The largest category of cost was morbidity (52%), followed by acute care and psychiatric hospital admissions (14% and 10% respectively). Given the magnitude of these cost estimates, there are large potential cost savings with more effective management and control of this debilitating disease.
Methylmercury in fish from the southern Baltic Sea and coastal lagoons as a function of species, size, and region
Authors: Polak-Juszczak Lucyna
Published: January 2017

Background:

Methylmercury (MeHg) is a highly toxic compound that traverses the blood–brain barrier with deleterious effects to the central nervous system. Exposure is generally through the ingestion of contaminated fish. Fish are a main source of MeHg.

Goals and methods:

The aim of this study was to determine the dependence of MeHg concentrations on fish species and age, the percentage of MeHg in total mercury (THg) and risk assessment depending on the size of fish. Assays of THg and MeHg were performed on the muscle tissues of 18 species of fish.

Results:

The investigations indicated there were differences in the mercury concentrations depending on fish size. THg and MeHg concentrations in the muscles of fish species that have a wide length distribution were strongly, positively correlated with fish length. However, concentrations of MeHg were strongly, positively correlated with those of THg in all the fish species investigated. Variation in the percentage share of MeHg in THg in the muscles of fish of large sizes was also noted within species, but this correlation was not noted in small-sized fish. The dose of MeHg in small-sized fish species was estimated and the risk posed to consumer health was assessed using mean MeHg concentrations determined for different fish species.

Conclusions:

For species of fish that occur within a wide length distribution, the dose of MeHg should be assessed separately in different length classes. Fish consumption of small-sized species poses no health risk.