bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical experience of combination therapy of infliximab and total glucosides of paeony for severe psoriasis with liver disorder history
Authors: Hu Yu , Lin Lin , Cui Pangen , Yao Xu , Luan Chao , Hao Zhimin , Chen Min
Published: June 2017

Severe psoriasis patients are reported to have a higher risk of liver abnormalities. Treatment option for severe psoriasis patients with liver disorder history remains a great challenge. Hepatic toxicity and long-term safety are the major concerns. Hence it is necessary to look for safer and more effective treatment for those patients. This retrospective review evaluated safety and efficacy of combination therapy of infliximab and TGP in treating 13 severe psoriasis patients with liver disorder history.Thirteen patients with severe psoriasis, including 8 men and 5 women, with a mean age of 37.3 ± 12.3 were observed. The patients experienced a mean course of psoriasis of 11.2 ± 7.1 years. The mean PASI score was 29.3 ± 12.9. All patients have the history of liver disorder. In our study, these patients were treated with infliximab at a dose of 5mg/kg and TGP at a dose of 1.8g/day. No liver test abnormalities were seen during combination therapy. After treatment, 61.5% patients showed PASI 50 response at week 2, and 81.8% patients have PASI 75 response at week 6. The mean time for achieving PASI 75 and PASI 90 improvement was 4.2 week and 9.6 week, respectively. Conclusion: Our observation demonstrates that combined therapy of infliximab and TGP is effective and safe in the treatment of severe psoriasis, especially for the patients with liver disorder history.
Por que (não) ler a obra horaciana como fonte de informações autobiográficas?
Authors: Piccolo Alexandre
Published: June 2017

Quando o poeta latino Horácio diz “eu” em seus textos (epodos, odes, sátiras, epístolas), podemos ver, nas diferentes instâncias desse pronome pessoal, expressões que revelam alguma faceta de um eu empírico? - eis a pergunta que nos guia nesse artigo. Não raro velado por tópoi da tradição e por alusões a outros poetas gregos, o discurso lírico costuma dificultar a construção de uma imagem pessoal do poeta. Por outro lado, a natureza peculiar do texto epistolar pode nos auxiliar a refinar os traços da persona poética rumo a uma aparência real do poeta. A fronteira entre o que é textual e o que pode ser pessoal é uma das dificuldades dessa tarefa. 
famaque cum domino fugit ab urbe suo: aspectos da fama na poesia de exílio de Ovídio
Authors: Michalopoulos Andreas N.
Published: June 2017

Através de sua poesia pré-exílio, Ovídio revela grande interesse em Fama/fama em todos os seus significados e funções: reputação pessoal, fama literária, tradição literária e mitológica, rumor, boato. Ovídio é obcecado por sua própria reputação como poeta, enquanto também emprega Fama/fama como fonte de inspiração e como fonte de informação numa ampla variedade de temas e tópicos. Seu grande interesse em Fama/fama culmina em sua famosa descrição de seu domicílio no livro XII das Metamorfoses. O objetivo deste artigo é discutir o uso e o papel de Fama/fama na poesia do exílio de Ovídio, escrita num momento em que as circunstâncias da vida do poeta mudaram dramaticamente. O poeta se encontra em arredores bárbaros e incivilizados, longe da linda e confortável vida da capital. A discussão dos poemas selecionados dos Tristia e das Epistulae ex Ponto ilustrarão de forma promissória a relação de Ovídio com a Fama/fama.

Abstract

Throughout his pre-exilic poetry Ovid shows a keen interest in Fama/fama in all its meanings and functions: personal reputation, literary fame, literary and mythological tradition, rumour, hearsay. Ovid is obsessed with his own reputation as a poet, while he also employs Fama/fama as a source of inspiration and as a source of information on a wide variety of themes and topics. His great interest in Fama/fama culminates in his famous description of her abode in the 12th book of the Metamorphoses. The object of this paper is to discuss the use and the role of Fama/fama in Ovid’s exilic poetry, written at a time when the circumstances of the poet’s life changed dramatically. The poet finds himself in barbaric and uncivilized surroundings, away from the beautiful and comfortable life of the capital. The discussion of selected poems from the Tristia and the Epistulae ex Ponto will hopefully illustrate Ovid’s relationship with Fama/fama.

Keywords: Ovid; Fama; exile poetry 
What is so ‘classical’ about Classical Reception? Theories, Methodologies and Future Prospects
Authors: Bakogianni Anastasia
Published: June 2017

This paper delivered at the University of Rio on 3rd June 2015 seeks to explore different approaches to the most fundamental questions in classical reception studies. What is classical reception? And more particularly what is so ‘classical’ about classical reception? It discusses current trends in theory and methodology via an analysis of two cinematic receptions of the ancient story of Electra; one that proclaims its debt to a classical text while the other masks its classical connections.

Resumo

Este trabalho apresentado na Universidade Federal do Rio de Janeiro em 3 de junho de 2015 busca explorar as diferentes abordagens sobre as questões mais fundamentais dos estudos de recepção dos clássicos. O que é a recepção dos clássicos? E, mais especificamente, o que há de tão ‘clássico’ na recepção dos clássicos? O trabalho discute tendências correntes na teoria e metodologia através de uma análise de duas recepções cinematográficas da história antiga de Electra: uma que proclama sua dívida ao texto clássico, enquanto que a outra mascara suas conexões clássicas.

Palavras-chave: recepção dos clássicos; Electra; Cacoyannis; Angelopoulos
A new species of Ischaemum L. (Poaceae) from Kerala, India
Authors: Sunil C. N. , Madhanan V. Nithya , Krishnan C.R. Remya , Kumar V.V. Naveen , Simi M. S. , Jyothi K. J.
Published: June 2017

Ischaemum sreenarayanii, a new species of Ischaemum L. is described andillustrated with detailed notes on distribution, conservation status and phenology. The new species is similar to I. santapaui and I. nairii but differs in number of attributes having up to 1.3 cm long filiform tip of the leaf apex, villous pseudopetiole of upper leaves and 4-6 conspicuous annular transverse ridges and winged margins of the sessile spikelet.Keywords: Ischaemum; New species; Poaceae; Kerala; India.Bangladesh J. Plant Taxon. 24(1): 3338, 2017 (June)
The Impact of Demographical Variables on Perceived Corporate Reputation
Authors: Yuncu Volkan , Fidan Uzeyir
Published: June 2017

Over the past few decades, the topic of reputation management has arisen as one of the most popular fields of study. Hence, investigating the main causes and consequences of reputation has also been of much interest for a great many academicians from various disciplines. However, among numerous variables used to determine the way reputation is perceived, the impacts of demographics seem to have been neglected. Therefore, in order to fill a gap deserving the attention of quantitative research, in this survey, which is an attempt to enhance the understanding of the way reputation is perceived by different individuals, we aimed at determining whether such demographical variables as age, gender, educational status and level of income have a significant effect on the way reputation is perceived. Consequently, it was found that some of the demographic variables were closely associated with the way reputation is perceived by different individuals.
Malkom Khan’s Approach Toward Political Modernization from above in Iran
Authors: Shahriari Kamyab
Published: June 2017

Malkom Khan (1833-1908) was a very significant scholar in the Qajar and constitutional era and the first to propose political modernization in order to change the traditional structure of government and replace it with a new and modern one. He was aware of the fact that Iran’s backwardness and chaotic situation was the result of the traditional and despotic political structure of government. This paper examines the political thought of Malkom Khan and his approach toward modernization of the political structure of government in the first period of his political life as activist and theorist. Research shows that his approach toward the political modernization program was political modernization from above or in other words, a form of state-building. His strategy to accomplish this goal can be described as getting Iranians to accept western civilization and the principles of order without changing them.
Research on the Use of Listening Strategies by Chinese Non-English Major College Students-A Comparison between Skillful and Unskillful Listeners
Authors: Ma Xiu-hua
Published: June 2017

Based on the researches of listening strategies at home and abroad, this study tries to explore the use of listening strategy by Chinese non-English major college students under the internet autonomous learning environment. The results from the questionnaires and interviews of listening strategies used by different level students have some implications for teachers. Listening strategies play an important role in the process of listening comprehension and skillful listeners tend to use all the listening strategies more frequently than the unskillful ones in their listening activities. So it is necessary for college English teachers to conduct strategy training in students’ listening comprehension especially in this new learning environment.
The Standard of Speech Sounds-On a Reform for International Phonetic Alphabet
Authors: Gua Hans
Published: June 2017

Elements and structures of the International Phonetic Alphabet (IPA) are imperfect and far from the standard. The IPA is too complex to learn and use directly for the most people. Few linguists can master the current IPA completely. The fatal shortcomings are that phonemes or symbols are too many, but syllables aren’t defined or counted in the IPA. The standard speech sounds or new IPA will be made according to the information theory. There are not only phonemes, but also syllables in the new IPA. The standard phonemes and syllables are the best codes of human speech sounds. The broad transcriptions are the standard sounds in the new IPA. The standard sounds and new IPA must become a production which can be learned and used by the global citizens directly and frequently.
Reviewer Acknowledgements for Journal of Geography and Geology, Vol. 8, No. 1
Authors: Luo Lesley
Published: June 2017

Reviewer Acknowledgements for Journal of Geography and Geology, Vol. 8, No. 1
Reviewer Acknowledgements for Journal of Geography and Geology, Vol. 8, No. 2
Authors: Luo Lesley
Published: June 2017

Reviewer Acknowledgements for Journal of Geography and Geology, Vol. 8, No. 2
Reviewer Acknowledgements for Journal of Geography and Geology, Vol. 8, No. 4
Authors: Luo Lesley
Published: June 2017

Reviewer Acknowledgements for Journal of Geography and Geology, Vol. 8, No. 4
The Mechanisms of Action of Reproductive Toxins
Authors: Mattison Donald R.
Published: June 2017

A general discussion of the mechanism of action or reproductive toxins is presented Reproductive toxicants may produce their adverse effects by one of several mechanisms. Some xenobiotics may act directly, either by virtue of chemical reactivity (eg, oocyte destruction by alkylating, agents) or by structural similarity to endogenous molecules (eg, hormone antagonists). Other xenobiolies interrupt reproductive processes indirectly either by metabolic processing to a direct‐acting toxicant (eg, prohormone or metabolic activation to reactive intermediate) or by altering endocrine homeostasis (eg, increased steroid clearance). Selected examples of compounds demonstrating reproductive toxicity by one or more of these mechanisms are tabulated and an extensive bibliography of reproductive toxins is attached.
Investigating Structural Requirements for the Antiproliferative Activity of Biphenyl Nicotinamides
Authors: Majellaro Maria , Stefanachi Angela , Tardia Piero , Vicenti Chiara , Boccarelli Angelina , Pannunzio Alessandra , Campanella Federica , Coluccia Mauro , Denora Nunzio , Leonetti Francesco , de Candia Modesto , Altomare Cosimo Damiano , Cellamare Saverio
Published: June 2017

A number of trimethoxybenzoic acid anilides, previously studied as permeability glycoprotein (P‐gp) modulators, were screened with the aim of identifying new anticancer agents. One of these compounds, which showed antiproliferative activity against resistant MCF‐7 cell line, was selected as the hit structure. Replacement of the trimethoxybenzoyl moiety with a nicotinoyl group, in order to overcome solubility issues, led to a new series ofN‐biphenyl nicotinoyl anilides, among which a nitro derivative,N‐(3′,5′‐difluoro‐3‐nitro‐[1,1′‐biphenyl]‐4‐yl)nicotinamide (3), displayed antiproliferative activity against MCF‐7 and MDA‐MB‐231 cells in the nanomolar range. The search for a bioisostere of the nitro group led to nitrile analogueN‐(3‐cyano‐4′‐fluoro‐[1,1′‐biphenyl]‐4‐yl)nicotinamide (36), which shows a strong increase in activity against MCF‐7 and MDA‐MB‐231 cells. Compound36induced a dose‐dependent accumulation of G2‐ and M‐phase MCF‐7 cell populations, and a decrease in S‐phase cells. Relative to vinblastine, a well‐known potent antimitotic agent, compound36also induced G1‐phase arrest at low doses (20–40 nm), but did not inhibit in vitro tubulin polymerization.
Is Low FMR1 CGG Repeat Length in Males Correlated with Family History of BRCA‐Associated Cancers? An Exploratory Analysis of Medical Records
Authors: Adamsheck Hallee C. , Petty Elizabeth M. , Hong Jinkuk , Baker Mei W. , Brilliant Murray H. , Mailick Marsha R.
Published: June 2017

The FMR1 gene has been studied extensively with regard to expansions and premutations, but much less research has focused on potential effects of low CGG repeat length. Previous studies have demonstrated that BRCA1/2 positive women are more likely to have an FMR1 genotype with one low CGG allele, and that women with both FMR1 alleles in the low CGG repeat range are more likely to have had breast cancer compared to women with normal numbers of CGG repeats. However, there has been no research as to whether low CGG repeat length impacts cancer risks in men. Therefore, this study aimed to examine cancer incidence and related risk factors in men with low CGG repeat length in the FMR1 gene. We utilized subject data from the Marshfield Personalized Medicine Research Project to compare cancer‐related diagnoses between 878 males with low CGG repeat length (< 24 repeats) and 368 male controls with CGG repeats in the normal range (24 to 40 repeats). We utilized ICD‐9 codes to examine various cancer diagnoses, family histories of cancer, other non‐malignant neoplasms, cancer surveillance, and genetic susceptibility. Men with low CGG repeats were identified to have significantly higher rates of family history of any cancer type (p = 0.011), family history of any BRCA‐associated cancer (p = 0.002), and specifically, family history of prostate cancer (p = 0.007). The mean number of BRCA‐associated cancer diagnoses (breast, prostate, pancreatic, and melanoma) per individual in the low CGG group was slightly higher than that of the control group, with this difference trending toward significance (p = 0.091). Additionally, men with low CGG repeats had significantly higher rates of connective/soft tissue neoplasms (p = 0.026). Additional research is needed to replicate the observations reported in this preliminary exploratory study, particularly including verification of ICD‐9 codes and family history by a genetic counselor.
Family Communication, Risk Perception and Cancer Knowledge of Young Adults from BRCA1/2 Families: a Systematic Review
Authors: Young Alison L. , Butow Phyllis N. , Vetsch Janine , Quinn Veronica F. , Patenaude Andrea F. , Tucker Katherine M. , Wakefield Claire E.
Published: June 2017

Understanding challenges in familial communication of cancer risk has informed genetic service delivery. Parent‐child interactions have received considerable attention, but few studies focus on young adulthood experiences within BRCA1/2 families. Young adults are approaching, or at a life stage where awareness of hereditary cancer risk is vital for informed choice of risk management options. This review assesses family communication, risk perception and cancer knowledge held by 18–40 year old individuals who have a parent with a BRCA1/2 gene mutation or carry the gene mutation themselves. Thirteen papers met the inclusion criteria. One utilized a ‘mixed methods’ methodology and the remaining used a qualitative approach. Findings were synthesized into themes and reported narratively. In general, parents are communicating openly about genetic risk with young adult offspring, but there is evidence that some young adults are withholding information from their parents about their own test results. Risk perception is influenced by a family history of cancer, childbearing plans and health providers’ advice. Misconceptions about genetic risk appear to be common and gaps in hereditary cancer knowledge are evident. It is unclear whether incorrect knowledge was passed from parents to offspring. Health providers need to provide developmentally appropriate services for emerging adults (18–25 years old), with particular support in navigating through risk management options.
Problems of Screening for Psychiatric Comorbidity in the Medically Ill: What Can be Recommended?
Authors: Diefenbacher A.
Published: June 2017

CL-psychiatrists have to work under severe time pressure in acute care setting. Hence, it is necessary to have an armamentarium of screening tools for disorders most frequently met in the general hospital. This presentation will discuss such tools for delirium, alcohol abuse, depression, personality disorders (“how to manage difficult patients”), attachment styles. On a conceptual level, the so-called “situational approach” in cl-psychiatry will be discussed.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Interdisciplinary Treatment and Complex Rehabilitation of Internally Displaced Persons in University Clinic
Authors: Korostiy V. , Platynuk O.
Published: June 2017

Introduction

Over 1,5 million of them are Ukrainians who were forced to leave their home after Crimea annexation and military conflict in the East of Ukraine.

Objectives

By 2015, the University Clinic asked 156 people displaced from Lugansk and Donetsk regions. Reasons treatment: all patients were somatic complaints. In screening: using the scale hospital, all patients were found higher rates of anxiety and depression. Overall, 48% of patients abandoned psychiatric examination, even 24% of psychological counseling.

Aims

Screening of IDPs’ mental health who sought medical help in somatic clinic (University clinic KhNMU) and estimation of efficiency of interdisciplinary treatment and complex rehabilitation.

Methods

Psychodiagnostical, clinical-psychological, clinical-psychopathological.

Results

Clinical examination during the period of acute stress reactions was observed, dominated by anxiety disorders, prolonged depressive reaction. Anxiety disorders were found in 56.5%, prolonged depressive reaction in 32.0%, post-traumatic stress disorder in 10.5% of patients. The treatment of the underlying disease, complex psychological and physical rehabilitation. Psychological rehabilitation included CBT, relaxation, art therapy. Physical rehabilitation includes kinesiotherapy and TRE. A set of measures of physical rehabilitation led to reduction of anxiety to physiological levels in all mentally healthy patients, reduce the severity of psychosomatic symptoms in the structure of the underlying disease, increased satisfaction with the results of treatment by 28.5%.

Conclusions

Analysis of mental health study of IDPs and evaluation of comprehensive rehabilitation in terms of the University Clinic show the need for screening mental state when applying for medical assistance and the desirability of psychological and physical rehabilitation of patients during hospital stay somatic profile.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Native vs. Migrants – same Opportunities or Discriminated? – Psychiatry Trainees's Views from the EFPT Brain Drain Study
Authors: Costa M. Pinto da , Tomori S. , Mogren T. , Biskup E. , Baessler F. , Frydecka D. , Killic O. , Group E. Research
Published: June 2017

Introduction

It is a well known fact that qualified health professionals generally migrate to high-income, developed regions. Nevertheless, the perceptions of this immigrant skilled health workforce on access to opportunities or feeling discriminated in their host countries, have not yet been explored or adequately addressed.

Objectives

This work has focused on the perceptions of immigrant psychiatry trainees in several European countries about their views on having equal access to opportunities as natives or feeling discriminated.

Methods

A semi-structured 61-item questionnaire was circulated by National Coordinators in each country and was completed by 2281 psychiatric trainees from 33 European countries between year 2013 and 2014. Data has been analysed using the Software Package for Social Sciences for Windows v. 22.0 (SPSS Inc. Chicago, IL).

Results

In these findings, more than one in ten psychiatry trainees across Europe were immigrants, with top host countries being Switzerland, Sweden and UK. Satisfaction with migration and the perception of having equal opportunities as the native trainees varied depending on the host country they migrated to. More than one-third of the trainees felt discriminated, not having the same opportunities as the local colleagues, especially concerning the work opportunities and the academic conditions. Still, nearly two-thirds considered having the same opportunities than natives.

Conclusions

A high number of immigrant psychiatry trainees subjectively feels they do not have the same opportunities as local trainees. Further research about factual and perceived discrimination by immigrant workforce should be done.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Atypical Callosal Morphology in Developmental Language Disorder
Authors: Luders E. , Kurth F. , Pigdon L. , Conti-Ramsden G. , Reilly S. , Morgan A.
Published: June 2017

Introduction

Developmental language disorder (DLD) is common, yet the neurobiology of DLD is poorly understood. A key hypothesis suggests atypical functional lateralization of language, which might be accompanied structurally by a deficit in inter-hemispheric connectivity of language-related regions. Indeed, aberrations of the corpus callosum have been associated with language deficits in children with frank neurological lesions and/or born pre-term. In contrast, studies examining the corpus callosum in children with DLD remain elusive.

Objective

We aimed to expand this largely understudied field by comparing callosal morphology between 17 children with DLD and 17 typically developing children carefully matched for sex and age.

Methods

We analyzed high-resolution structural magnetic resonance imaging data applying a well-validated computational approach, which captures the thickness of the corpus callosum with a high regional specificity at 100 equidistant points.

Results

As shown in Fig. 1, we observed a significantly thinner corpus callosum, particularly in the splenium, in children with DLD compared to typically developing controls (DLD < CTL).

Conclusions

These findings indicating pronounced aberrations in the brain's largest whiter matter tract make an important contribution to an understudied field of research and support the theory that DLD is accompanied by atypical lateralization of language function.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Case Report Klinefelter Syndrome and Multiple Sclerosis as the Cause of Psychosis
Authors: Rodriguez Rodriguez A. , Blanco Fernández R. , Vizcaino da Silva M. , Fernández Fernández R. , Mendez Gonzalez O.
Published: June 2017

Introduction and goals

Forty-three-year-old male diagnosed with Klinefelter syndrome and showing radiological findings suggesting a demyelinating pathology who presents several psychiatric manifestations including megalomaniacal ideation, delusion, lack of impulse control and behavioral alterations.

Clinical case

Forty-three-year-old male diagnosed with Klinefelter syndrome at the age of 31, presenting several psychiatric pathologies since adolescence: delusions, megalomania, mood fluctuation, and high impulsiveness. The patient had a poor therapeutic response to anti-psychotic drugs and ECT. He was hospitalized up to 9 times, but the full control of the symptomatology was not achieved. During his last hospitalization, a MRI revealed lesions compatible with a demyelinating pathology.

Discussion

A higher prevalence of schizophrenia spectrum disorders has been described among patients suffering from Klinefelter syndrome, which might explain the role of the X chromosome in the susceptibility to psychiatric disorders, particularly to psychosis. Furthermore, the brain structure alterations presented by patients suffering from Klinefelter syndrome are similar to those described among schizophrenic patients: small brain volume, lateral cerebral ventricular enlargement and reduced temporal gyrus, amygdala, insula and cingulate cortex. Patients suffering from multiple sclerosis are more prone to psychiatric disorders, such as mood swing, aggressiveness or psychosis, which are not concurrent with the physical progression of the disease, sometimes being its first manifestation. Even when being patchy and multifocal, demyelination seems to be concentrated in the frontal lobes, related to the cognitive and affective functions and the personality.

Conclusions

Both multiple sclerosis and Klinefelder syndrome may alter the brain structure, mainly in the frontal lobe, and predispose to psychiatric disorders.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
In Search of Possible Peripheral Biomarkers for Suicide: Similarities Between Platelet and Cerebrospinal Fluid Proteome (Preliminary Results)
Authors: Semančíková E. , Tkáčiková S. , Talian I. , Bencková M. , Pálová E. , Sabo J.
Published: June 2017

Despite the fact that proteomic analysis is becoming widely used in various medical branches its use in psychiatry is still very limited. Majority of psychiatric proteomic research is still oriented mostly on Alzheimer's disease, schizophrenia and depression but very few studies focus on suicidality. We decided, based on the current knowledge, to study suicidal behaviour with the use of proteomics to compare cerebrospinal fluid and platelets. We hypothesized that the same protein group can be detected in pathways that are part of platelet degranulation process in the platelet proteome and cerebrospinal fluid proteome. Based on these findings we suppose, that with use of proteomic analysis a specific protein (group of proteins) can be identified in both, cerebrospinal fluid and platelet proteome in patients with suicidal behavior.

Group of proteins identified in our sample in the reactome pathway database (release of platelet secretary granule components and exocytosis of platelet granule contents) supports the idea of link between central nervous system and platelets (“the periphery”). Further research is needed to clarify whether the identified group of proteins taking part in platelet pathways can be used as peripheral biomarkers for suicidal behavior.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Effects of Hazardous Alcohol use on Neurocognition in HIV Positive Individuals
Authors: Spies G. , Hoddinott G. , Beyers N. , Seedat S.
Published: June 2017

Introduction

There is significant evidence that HIV is brain degenerative and long-term infection can impair cognitive functioning. In South Africa, alcohol remains the dominant substance of abuse and lifetime alcohol dependence has been found to impair memory, executive function and visuospatial capabilities. The individual liability of alcohol and HIV on neurocognitive function have been well demonstrated, however there is relatively little evidence of the potentially aggravating effects of this dual burden on neurocognitive outcomes.

Objectives

The present study is ongoing and sought to identify the effects of hazardous alcohol use on neurocognitive functioning in the context of HIV infection.

Aims

To describe the association between HIV and harmful alcohol use on neuropsychological test performance in a cohort of adults in the Western Cape of South africa.

Methods

participants (n = 50) were tested using a battery of neuropsychological tests sensitive to the effects of HIV on the brain. Self-reported alcohol use was recorded using the alcohol use identification test (AUDIT). Results The sample consisted of 47 females and 3 males. All participants were HIV-positive and on antiretroviral therapy. A total of 23 (46%) participants reported no alcohol use and 27 (54%) reported drinking alcohol on the AUDIT.

Results

revealed a significant difference between groups on the Stroop colour word test, with poorer performance evident among the alcohol users (P = 0.008).

Conclusion

Alcohol use in the context of HIV infection contributes to poorer executive function. These preliminary data provide evidence for a synergistic relationship between HIV infection and alcohol use.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
A Case of Erotomanic Delusion in Dementia
Authors: Arts M. , Petrykiv S. , Fennema J. , De Jonge L.
Published: June 2017

Introduction

In dementia, delusions are common with prevalence up to 75%. However, erotomanic delusions, or De Clerambault's syndrome, are a rarity in dementia. To date, only six case-reports have been described in vascular dementia, frontotemporal dementia, and Alzheimer's dementia.

Objectives

To present a case of De Clerambault's syndrome in an older adult diagnosed with vascular dementia.

Aims

To review available literature on De Clerambault's syndrome in dementia.

Methods

A case report is presented and discussed followed by a literature review.

Results

We report a 72-year-old female with a history of right posterior cerebral artery infarction. The patient developed a sudden onset erotomanic delusion after she met a male patient of her age during her stay in a dementia day care center. She was agitated, disorientated, presented with confabulation, and showed a dysphoric mood. On MMSE she scored 14/30, the clock-drawing test revealed visuospatial deficits. On MRI, the right occipital lobe showed an encephalomalacia. The patient was treated with sertraline 50 mg/day and olanzapine 5 mg/day. Her erotomanic delusions improved after 3 months of treatment.

Conclusion

De Clerambault's syndrome is a rare and poorly understood disorder with generally a poor response to treatment. Some cases were successfully treated with atypical anti-psychotics. However, further research is needed to explore the course and treatment of this delusion.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Adherence to Mediterranean Diet Moderates the Association Between Medical Multi-morbidity and Depressive Symptoms in Elderly Outpatients
Authors: Bersani F.S. , Vicinanza R. , d’Ottavio E. , Biondi M. , Cacciafesta M. , Troisi G.
Published: June 2017

Background

Depressive symptoms in the elderly are related to the advancing of age, loss of life purpose, medical multi-morbidity, cognitive decline and social-economic problems mounting evidence suggests that lifestyle behaviors and certain dietary patterns may improve mood and overall well-being in older adults. In the present study we investigated (i) the association of adherence to Med-Diet with depressive symptoms and multi-morbidity in a cohort of geriatric medical outpatients and (ii) the role of Med-Diet in mediating the association between depressive symptoms and multi-morbidity.

Methods

Morbidity was assessed using the severity index of cumulative illness rating scale for geriatrics (CIRSG-SI). Montreal cognitive assessment (MoCA) and geriatric depression scale (GDS) were administrated to evaluate cognitive and depressive symptoms. Adherence to Med-Diet was evaluated using the Med-Diet 14-Item questionnaire (MDQ). Pearson correlation was used to test association between variables. The Preacher and Hayes’ strategy was used to test the mediational model.

Results

One hundred and forty-three subjects were included in the study. Significant inverse correlations of MDQ with GDS (r = -0.317; P < 0.001) and CIRSG-SI (r = -0.247; P = 0.003) were found, with and without adjustment for potential confounders. A direct correlation between CIRSG-SI and GDS was also observed (r = 0.304; P = 0.001), with this association being moderated by MDQ (b = 0.386; P = 0.047).

Conclusion

These findings (i) add to the accumulating evidence that Med-Diet is crucially involved in the regulation of physical and mental health of elderly people, and (ii) suggest that a Mediterranean-style diet may contribute to protect elderly subjects with higher levels of polypathology/multi-morbidity from the development of depressive symptoms.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The Psycho-geriatric Patient in the Emergency Room (ER) of the Maggiore della Carità Hospital in Novara
Authors: Di Tullio E. , Vecchi C. , Venesia A. , Girardi L. , Molino C. , Camera P. , Chiarelli serra M. , Gramaglia C. , Feggi A. , Zeppegno P.
Published: June 2017

Introduction

Due to population aging, the health system will face increasing challenges in the next years. Concerning mental disorders, they are major public health issues in late life, with mood and anxiety disorders being some of the most common mental disorder among the elderly. For this reason, increasing attention has to be paid to the evaluation of the elderly in psychiatry emergency settings.

Objectives

To evaluate the socio-demographic and clinical features of over 65 patients referred to psychiatric consultations in the ER of “Maggiore della Carità” Hospital in Novara, in a 7 years period.

Aims

The analysis of the characteristics of the study sample could be potentially useful in resource planning in order to better serve this important segment of the general population.

Methods

Determinants of ER visits for over 65 patients referred to psychiatric evaluation were studied retrospectively from 2008 to 2015.

Results

Elderly patients made up 14,7% (n = 458) of all psychiatric evaluation in the ER (n = 3124). About two thirds (65,9%) were females and one third were males (34,1%). The mean age of patients recruited was 75.11 years. The majority of subjects (68.6%) presented without a diagnosis of Axis I according to DSM-IV. The other most frequent diagnosis was “cognitive disorders” (11.4%) and “mood disorders” (10.9%).

Conclusions

The large proportion of patients without a diagnosis of Axis I, could be related to the misunderstanding of the psychosocial aspects of aging. Preliminary results highlight the importance of research on this topic, considering population aging and the impact of mental disorders in late-life.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Evidence of Accelerated Biological Ageing in Post-traumatic Stress Disorder
Authors: Lindqvist D.
Published: June 2017

Post-traumatic stress disorder (PTSD) is a common and debilitating condition, affecting between 10–20% of soldiers returning from combat zones, and with even higher prevalence rates in Veterans Affairs healthcare settings. PTSD is associated with an increased risk for various medical illnesses, many of which are commonly seen with older age. This raises the possibility that PTSD is associated with accelerated biological aging at the cellular level. Accelerated biological aging occurs when biological age outpaces chronological age, and this process is driven by a number of biological mechanisms including immune activation, oxidative stress, and mitochondrial dysfunction.

In this workshop I will present data from our research group and others pertaining to the biological mechanisms underlying accelerated cellular aging in PTSD. Most, but not all, studies have found that PTSD is associated with shorter mean leukocyte telomere length, an indicator of accelerated cellular aging. Mitochondrial dysfunction has been implicated in PTSD and our research group found evidence of a “u-shaped” relationship between PTSD symptom severity and mitochondrial DNA copy number. For what concerns immunity, we have recently found that PTSD subjects have increased blood levels of pro-inflammatory markers, a more senescent and dysfunctional profile of NK cells and impaired synthesis of nitric oxide. Finally, I will discuss the possibility of accelerated epigenetic aging in combat-exposed individuals with and without PTSD, using DNA methylation data.

Disclosure of interest

The author has not supplied his declaration of competing interest.
Evolutionism and Involutionism in the Ontogenesis of а Late Age
Authors: Pishchikova L.
Published: June 2017

Individual human development from birth to death is defined as the ontogenesis. The ability of the human psyche to development and to system acquisition of mental and social functions is called evolutionism. The psyche property, causing a gradual loss in the process of ontogenesis of biological, psychological and social functions is defined as involutionism.

Involutivitionism of higher mental functions manifests in their folding in the sequence reverse to the formation. Process of involution is uneven and abrupt. This is caused by their constant interaction with the evolution processes, that are struggling with age-related destruction and disruption and are responsible for the ongoing adaptation, although at a lower ontogenetical level.

In the event of critical psycho traumatic situations, which are related to the impact of jet-psychological, somatoneurological factors, there is a failure of adaptation mechanisms, decompensation develops, the action of the involutive mechanisms increases, which leads to a lower level of social functioning. In this interaction biological and social factors act in their unity and predetermine disadaptation options, while the latter, in their turn, determine intensification of involutive processes.

Because of the interaction of these processes mental aging unevenly affects higher mental functions with the advent of favorable (adamantix) and unfavorable forms, determined by the development of mental disorders and dementia. Favorable aging can manifest itself by specific quantitative somatoneurological and mental changes that do not lead to the loss of adaptation. Under favorable aging life experience, professional skills, biological, social, adaptive resources are preserved, evolutionary development of the older person continues.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.
Antipsychotics in Dementia
Authors: Poças A. , Almeida S.
Published: June 2017

Behaviour disorders and psychosis may represent a greater challenge in patients with dementia. There are evidence-based recommendations to assess psychological and behavioral symptoms of dementia and the practice guidelines of American psychiatric association (APA) reinforce general principles of good clinical care. However, when these patients initiate a psychotropic, the agents often continue to be prescribed for a long time, even after the symptoms disappeared. The recommendation of reduce/stop an antipsychotic medication within 4 months of initiation may seem counterintuitive when the patient is better, with remission of the original symptoms. However, the studies showed that a large amount of patients with dementia can discontinue antipsychotic medication without a return of agitation or psychosis. Older patients are a particularly susceptible population and the risk/benefit of any medication should be carefully considered. For most patients the risk of harm outweighs the profits of continuing treatment and we need a routine evaluation of this factor to identify these cases.

It's important to reduce unnecessary medications but agitation and psychosis associated with severe distress also carry serious risks; discontinuing these medications can be dangerous so we need to manage it with caution evaluating each case as an individual one.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Factors associated with job satisfaction among physicians in a university hospital
Authors: Derbel C. , Braham A. , Souilem A. , Ben Romdhane A. , gallala R. , Ben Nasr S. , Bannour A.S. , Ben Hadj Ali B.
Published: June 2017

Introduction

Several professional and personal factors determine the degree of job satisfaction (JS) which is a necessary condition to ensure good quality work, especially for physicians working in university hospitals (UH).

Aims

To determine the degree of JS in a population of physicians working in UH and to determine the factors associated with the JS.

Method

Cross-sectional, descriptive and analytical study involving 96 physicians with different grades in Farhat Hached University Hospital, Sousse, Tunisia. We used Job Satisfaction Scale (JSS) to assess the degree of JS, Hospital Anxiety And Depression Scale to assess anxiety and depression, Maslach Burnout Inventory to determine burnout (BT).

Results

The average age was 28.15 ± 4.10 years. Doctors with medical specialty were the majority (65.6%). Most doctors were dissatisfied with their work (67.7%). The socio-demographic factor associated with ST was the young age (P = 0.00). Occupational factors associated with JS were: shorter time worked in the department (P = 0.02), lack of outpatient day (P = 0.01), a lower number of outpatient day (P = 0.02), dissatisfaction with the work schedule (P = 0.004), lack of safety (P = 0.00), salary (P = 0.00), non-operating skills (P = 0.00), the distribution of tasks (P = 0.00), the conditions of the guards (P = 0.00), ignorance of the laws governing the department (P = 0.00), BT (P = 0.01) and depression (P = 0.00).

Conclusion

The majority of our subjects were dissatisfied with their work. Several factors, especially the professional ones contribute to this state. It is necessary to take steps on these factors to improve the performance of doctors working in university hospitals to provide better care for patients.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The phenomenon of psychological adaptation to the professional activities of doctors
Authors: Kozhyna A. , Mykhaylov V. , Viyun V.
Published: June 2017

Disorders of adaptation of young doctors and students to their the professional activities.

The study was designed to develop a system of psychological adjustment and psychoprophylactic support during professional training based on a systematic approach to the study of the mechanisms of formation of psychological adaptation to the professional activities of doctors.

It was conducted comprehensive examination of 405 interns and of 615 last year's students of medical universities in Ukraine. 211 interns had adaptation disorders. The data demonstrated individual and personal, social and psychological factors, mechanisms and conditions of psychological adaptation to medical work.

The necessary components of psychological readiness for independent productive activities on the basis of high value professional identity, a positive attitude to the profession, perception of the patient as a personality in a certain psychological state, choice of interpersonal relationships and the use of ethical and deontological knowledge and skills at different stages of treatment process.

The results showed that females have a higher level of disorders of adaptation to professional activity, compared with males. High level of disadaptation, which requires using of emergency measures was founded at 9.2% of men and 12.5% women; moderate level of desadaptation, which requires mandatory intervention of psychologists, conducting rehabilitation programs - 10.3% men, 14.0% women; mild level of desadaptation, in which the useful work of advisory experts - 36.2% and 42.1% respectively.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
The reality of domestic violence in the US
Authors: Gonçalves J. , Lima C.
Published: June 2017

According to the United States department of justice, domestic violence is defined as “a pattern of abusive behaviours in any relationship that are used by one partner to gain or maintain power and control over another intimate partner”. It involves a pattern of coercive behaviour in intimate relationships whereby the behaviour is controlled through humiliation, intimidation, fear, and often intentional physical, emotional or sexual injury. Domestic violence crosses all ethnic, socioeconomic and age groups, and is also prevalent in same sex relationships.

Over six million children are severely assaulted by family members every year in the United States; a man beats a woman every twelve seconds; women who leave their batterer are at 75% greater risk of being killed by their batterer than those who stay; and one third of police time is spending on answering domestic violence calls.

In domestic violence situations the intervention is frequently in crisis, where the victims “fight” for survival, and it is necessary to give proper answers according to the victim's needs. The professionals that work directly with domestic violence assume that there is a strong bond connecting the domestic violence with mental health. In the United States 90% of domestic violence survivors report extreme emotional distress; 47.5% report having been diagnosed with post-traumatic stress disorder; 14.7% report anxiety; 20% depression. Mental illnesses are frequently observed in domestic violence survivors.

Disclosure of interest

The authors have not supplied their declaration of competing interest.
Hydrocephalus and Psychiatric Disorders: About a Clinical Case
Authors: Snene H.
Published: June 2017

Introduction

Hydrocephalus is a neurological disease caused by excessive accumulation of cerebrospinal fluid following an abnormal secretion, circulation and absorption. It is considered the most common reversible cause of dementia but still an underestimated cause of psychiatric disorders.

Objectives

Highlighting the possible association of hydrocephalus in some psychiatric disorders and know how to adapt the management of this co-morbidity.

Clinical Vignette

He is Mr O.Y, aged 27, unmarried, his parents divorced, lives with his mother. He had surgery in 2012 to the orthopedic service for disabling scoliosis. No significant psychiatric family history. Discovery of a tri ventricular hydrocephalus in 2011 requiring regular monitoring neurology.

Indeed Mr O.Y followed the CMP for a mood disorder requiring antidepressant treatment based. The evolution of disorder was marked by the installation of a hallucinatory and delusional syndrome motivating several hospitalizations and relapses iterative partial response to various therapies.

Mr O.Y was received a ventricular shunt within the sound hydrocephalus.

The postoperative course was marked a progressive amendment acoustic verbal hallucinations and delusions of persecution.

The conduct was to gradually reduce the dose of antipsychotic (Risperdal) to the stop. No recurrence pathological productions.

Conclusions

Psychiatric disorders may mark the evolution of hydrocephalus. Share against the indications and side effects of some psychotropic drugs, the management of this co-morbidity may be difficult. Further studies are needed to better elucidate causality for this association and to develop appropriate therapeutic consensus.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.