bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of l-carnitine supplementation on inflammatory factors, oxidative stress, and clinical outcomes in patients with sepsis admitted to the intensive care unit (ICU): study protocol for a double blind, randomized, placebo-controlled clinical trial
Authors: Keshani Mahdi , Alikiaii Babak , Askari Gholamreza , Yahyapoor Farveh , Ferns Gordon A. , Bagherniya Mohammad
Published: February 2022

Background

Sepsis is a common cause for admission to the intensive care unit (ICU), and its incidence has been increasing. It is associated with a significant increase in serum inflammatory biomarkers such as C-reactive protein (CRP) and cytokines such as interleukin 1 (IL-1), IL-6, and tumor necrosis factor (TNF). Sepsis is also associated with pathophysiological changes that include fluid accumulation in the lungs, eventually leading to acute respiratory distress syndrome (ARDS), tissue edema, hypotension, and acute kidney injury (AKI). Conventional therapies include antibiotics, but these may have important adverse effects, so novel therapeutic approaches are required. In animal studies, l-carnitine improves antioxidant status, and in some clinical trials, it has been shown to reduce inflammation. It has also been shown to improve respiratory distress and help maintain coenzyme A homeostasis, metabolic flexibility, promoting the normal function of the tricarboxylic acid (TCA) cycle, and oxidation of fatty acids by peroxisomes. We aim to determine the effects of very high doses of l-carnitine on inflammatory factors, oxidative stress, and clinical outcomes of patients with sepsis in ICU.

Method and design

In this double-blind, randomized controlled clinical trial, we will use block randomization of 60 patients with sepsis, aged between 20 and 65 years from Al-Zahra Hospital, Isfahan, Iran. The intervention group (n = 30) will receive three capsules of l-carnitine (each capsule contains 1000 mg l-carnitine; totally 3000 mg/day) for 7 days, and a control group (n = 30) will receive a placebo with the same dose and for the same duration in addition to usual care. At baseline, scores for clinical and nutritional status (Acute Physiology and Chronic Health Evaluation II (APACHE II), Sequential Organ Failure Assessment (SOFA), Quick SOFA (qSOFA), and NUTRIC Score) will be assessed. At beginning and end point of the study, inflammatory markers (CRP, erythrocyte sedimentation rate (ESR)), oxidative stress status (total oxidative stress (TOS), total antioxidant capacity (TAC)), and clinical variables will be evaluated also. The mortality rate will be assessed within 28 days of the beginning of the intervention.

Discussion

Because of the anti-inflammatory and antioxidant properties of l-carnitine, it is possible that using a high dose of 3000 mg daily of this nutritional supplement may reduce inflammation and oxidative stress and improve subsequent mortality of critically ill patients with sepsis.

Trial registration

Iranian Registry of Clinical Trials IRCT20201129049534N1. Registered on 2 May 2021.
Systematic review of quantitative preference studies of treatments for rheumatoid arthritis among patients and at-risk populations
Authors: Simons Gwenda , Caplan Joshua , DiSantostefano Rachael L. , Veldwijk Jorien , Englbrecht Matthias , Bywall Karin Schölin , Kihlbom Ulrik , Raza Karim , Falahee Marie
Published: February 2022

Treatments used for rheumatoid arthritis (RA) are under investigation for their efficacy to prevent RA in at risk groups. It is therefore important to understand treatment preferences of those at risk. We systematically reviewed quantitative preference studies of drugs to treat, or prevent RA, to inform the design of further studies and trials of RA prevention. Stated preference studies for RA treatment or prevention were identified through a search of five databases. Study characteristics and results were extracted, and the relative importance of different types of treatment attributes was compared across populations. Twenty three studies were included 20 of RA treatments (18 of patients; 2 of the general public) and 3 prevention studies with first-degree relatives (FDRs). Benefits, risks, administration method and cost (when included) were important determinants of treatment choice. A benefit was more important than a risk attribute in half of the studies of RA treatment that included a benefit attribute and 2/3 studies of RA prevention. There was variability in the relative importance of attributes across the few prevention studies. In studies with non-patient participants, attributes describing confidence in treatment effectiveness/safety were more important determinants of choice than in studies with patients. Most preference studies relating to RA are of treatments for established RA. Few studies examine preferences for treatments to prevent RA. Given intense research focus on RA prevention, additional preference studies in this context are needed. Variation in treatment preferences across different populations is not well understood and direct comparisons are needed.
LncRNA HOTAIR facilitates high glucose-induced mesangial cell proliferation, fibrosis and oxidative stress in diabetic nephropathy via regulating miR-147a/WNT2B axis
Authors: Wang Xin , Wang Wei , HuangFu Weizhong , Liu Zhonghua , Zhao Feng
Published: February 2022

Background

Long non-coding RNAs (lncRNAs) have been shown to be involved in the regulation of many disease progression. However, the role of lncRNA HOX transcript antisense RNA (HOTAIR) in diabetic nephropathy (DN) remains unclear.

Methods

High glucose (HG)-induced human mesangial cells (HMC) was used to construct DN cell models in vitro. HMC proliferation was evaluated by CCK8 assay and EDU staining. Protein levels of proliferation markers, fibrosis markers, and wingless-type family member 2B (WNT2B) were measured using western blot analysis. HMC oxidative stress was assessed by determining the levels of oxygen species and malondialdehyde, as well as superoxide dismutase activity. Relative expression levels of lncRNA HOTAIR, microRNA (miR)-147a, and WNT2B were examined using quantitative real-time PCR. The interaction between miR-147a and lncRNA HOTAIR or WNT2B was confirmed by dual-luciferase reporter assay and RIP assay.

Results

Our data showed that lncRNA HOTAIR knockdown could inhibit the proliferation, fibrosis, and oxidative stress in HG-induced HMC. LncRNA HOTAIR could serve as a sponge of miR-147a. The inhibition effect of lncRNA HOTAIR silencing on the biological functions of HG-induced HMC could be reversed by miR-147a inhibitor. WNT2B was targeted by miR-147a, and its overexpression also overturned the suppressive effect of miR-147a on the proliferation, fibrosis, and oxidative stress of HG-induced HMC.

Conclusion

In total, our research pointed out that lncRNA HOTAIR could mediate miR-147a/WNT2B axis to promote DN progression.
Isokinetic muscle strength cannot be related to the odds ratio of musculoskeletal injuries in young elite wrestlers
Authors: Hoseini Alireza , Zarei Mostafa , Nobari Hadi , Hovanloo Fariborz , Abbasi Hamed , Pérez-Gómez Jorge
Published: February 2022

Background

Wrestling is considered one of the oldest sports in the world. There is a high rate of injuries in Wrestling. To prevent injuries, it is necessary to identify the risk factors. Despite the functional importance of strength in wrestling, few studies have investigated the relationship between isokinetic strength and the rate of injuries in the sport.

Objectives

The objective of the present study was to investigate the relationship between the isokinetic strength of elite wrestlers and the rate of injuries prospectively.

Method

A total of 72 young wrestlers with at least 2 years of experience in the Tehran Wrestling Premier League participated in this study. Before the start of the competition season, the isokinetic strength of flexor and extensor muscles of the knee and shoulder were measured at different velocities by an isokinetic dynamometer. The injuries and training hours of these wrestlers were then recorded for nine months.

Results

The study results showed no significant relationship between isokinetic strength of flexor and extensor muscles of the knee or shoulder at different angular speeds of 60, 180, and 300°/s. There was neither significant between the ratio of the strength flexor/extensor for knee and/or shoulder in young elite wrestlers with injuries.

Conclusion

Isokinetic strength of lower and upper limb muscles alone cannot predict wrestlers' injuries. Therefore, the use of these tests is not recommended to evaluate the risk of injury in this population.
Towards a culture of open scholarship: the role of pedagogical communities
Authors: Azevedo Flávio , Liu Meng , Pennington Charlotte R. , Pownall Madeleine , Evans Thomas Rhys , Parsons Sam , Elsherif Mahmoud Medhat , Micheli Leticia , Westwood Samuel J. ,   Framework for Open, Reproducible Research Training (FORRT)
Published: February 2022

The UK House of Commons Science and Technology Committee has called for evidence on the roles that different stakeholders play in reproducibility and research integrity. Of central priority are proposals for improving research integrity and quality, as well as guidance and support for researchers. In response to this, we argue that there is one important component of research integrity that is often absent from discussion: the pedagogical consequences of how we teach, mentor, and supervise students through open scholarship. We justify the need to integrate open scholarship principles into research training within higher education and argue that pedagogical communities play a key role in fostering an inclusive culture of open scholarship. We illustrate these benefits by presenting theFramework for Open and Reproducible Research Training (FORRT), an international grassroots community whose goal is to provide support, resources, visibility, and advocacy for the adoption of principled, open teaching and mentoring practices, whilst generating conversations about the ethics and social impact of higher-education pedagogy. Representing a diverse group of early-career researchers and students across specialisms, we advocate for greater recognition of and support for pedagogical communities, and encourage all research stakeholders to engage with these communities to enable long-term, sustainable change.
Physical activity specifically evokes release of cell-free DNA from granulocytes thereby affecting liquid biopsy
Authors: Neuberger Elmo W. I. , Sontag Stephanie , Brahmer Alexandra , Philippi Keito F. A. , Radsak Markus P. , Wagner Wolfgang , Simon Perikles
Published: February 2022

Physical activity impacts immune homeostasis and leads to rapid and marked increase in cell-free DNA (cfDNA). However, the origin of cfDNA during exercise remains elusive and it is unknown if physical activity could improve or interfere with methylation based liquid biopsy. We analyzed the methylation levels of four validated CpGs representing cfDNA from granulocytes, lymphocytes, monocytes, and non-hematopoietic cells, in healthy individuals in response to exercise, and in patients with hematological malignancies under resting conditions. The analysis revealed that physical activity almost exclusively triggered DNA release from granulocytes, highlighting the relevance as a pre-analytical variable which could compromise diagnostic accuracy.

Graphical Abstract
A protocol for a scoping review to map the assessment approaches in optometry education programmes globally
Authors: van Staden Diane , Chetty Verusia , Munsamy Alvin Jeffrey
Published: February 2022

Background

The training of optometrists aims to prepare practitioners with critical thinking skills who utilise their education and experience to solve clinical problems in real-life practice. Professional competencies should inform assessment, and as such, assessment methods for learning should encompass a wide range of approaches. The objective of this scoping review is therefore to map assessment approaches utilised within optometry education programmes globally.

Methods

This study is a scoping review based on the PRISMA methodology. The review will be guided by the following research question, “What are the assessment approaches that inform optometry training globally?”. This was validated by the Population-Concept-Context framework according to the methodology for Joanna Briggs Institution Scoping Reviews. Relevant peer-reviewed studies and grey literature conducted during the last 10 years will be identified from electronic databases including CINAHL, PubMed, PROquest and ERIC. The search strings using keywords such as “Optometry students and staff”, “Assessments” and “Optometry education” will be conducted using Boolean logic. An independent reviewer will conduct all title screening, two independent reviewers will conduct abstract and full article screening, followed by data extraction. Thereafter, a thematic analysis will be conducted. The Mixed Method Appraisal Tool version 2018 will be used for quality appraisal of mapped studies.

Discussion

The review will document evidence of assessment approaches utilised in optometry training globally. Considering the exit level competencies required in the basic job function of an optometrist, a coherence in assessment approaches and relevant rationale for these would be expected, if the accredited (regulated) training programmes follow a competency-based model.
Therapeutic community-oriented day treatment program for Korean women with alcohol use disorder: a non-randomized pilot feasibility trial
Authors: Lee Insuk , Lee Mihyoung , Choi Scott Seung W.
Published: February 2022

Background

The prevalence of alcohol use disorder (AUD) among women in South Korea has been rising, causing public health problems. Yet women’s treatment needs are mostly unmet in South Korea due to the lack of women-focused treatment programs. This study evaluated the feasibility, acceptability, and clinical outcomes of a therapeutic community (TC)-oriented day treatment program for Korean women with AUD on alcohol abstinence self-efficacy, forgiveness, and spirituality.

Methods

The current study employed a quasi-experimental, non-equivalent control group design with a pretest and posttest. Participants were assigned to 6-month TC-oriented day treatment program (n = 19) or usual treatment (n = 21). Feasibility (treatment completion rate) and acceptability (overall program satisfaction) were assessed. Alcohol abstinence was measured as a clinical outcome at baseline, 3 months, and 6 months. Repeated measures using Alcohol Abstinence Self-Efficacy (AASE), Enright Forgiveness Inventory-Korea (EFI-K), and Spiritual Assessment Scale (SAS) were also obtained from both conditions at those three time points.

Results

Fifteen participants (78.9%) in the intervention group successfully completed the program. The overall program satisfaction ratings were very high (4.9 ± 0.2). Continuous abstinence rates at 6 months were significantly higher in the treatment group (78.9%) than in the control group (9.5%). Results of the two-way repeated measures ANOVA indicated that statistically significant two-way (group × time) interaction effects were found for the intervention group on AASE, EFI-K, and SAS but not for the control group on any of the outcomes.

Conclusion

The current study demonstrated the feasibility and acceptability of implementing a TC-oriented intensive day treatment program to promote recovery in Korean women with AUD. This intervention merits further investigation as a potential strategy to help address alcohol abstinence self-efficacy, forgiveness and spirituality.

Trial registration: KCT0006386 (Cris.nih.go.kr).
Estimating the effect of practicing nursing professionals density on cumulative carbapenem-resistance prevalence in gram-negative invasive Isolates: a 30 European country observational modeling study
Authors: Kaba Hani E. J. , Scheithauer Simone
Published: February 2022

Background

The burden of antimicrobial-resistance, specifically carbapenem-resistance in gram-negative bacteria (CRGN), presents a serious public health threat worldwide. In Europe, Southern and Eastern countries (SEC) display a higher CRGN-prevalence as compared to Northern and Western countries (NWC). Since SEC also display lower nurse-density on average, we hypothesized that the occurrence of CRGN might correlate with nurse understaffing and therefore aimed at quantifying a potential independent effect of nurse-density on total CRGN in Europe.

Methods

A 30-country cross-sectional study was conducted. Cumulative six-year CRGN-prevalence (2011–2016) in four gram-negative bacterial species was determined based on > 700 k clinical invasive isolates (EARS-net). We performed multivariable log-linear regression to provide estimations of the effect of nurse-density while adjusting to various health-system variables.

Results

Multivariable analysis (adj.-R2 ~ 93%) suggested an average 0.4% [95%-CI 0.2–1.0%] CRGN-increase due to a decrement of one practicing nurse per week of hospital-stay of one population individual. Our modeling provided CRGN-estimations in two non-EARS-net countries (Switzerland and Turkey), which were almost equal to empirically estimated values (CAESAR-Network). Furthermore, a nurse-density-dependent moderation of the inter-species distribution balance was a likely pathway of the observed effect. These observations were specific for CRGN, in contrast to other resistance types in the same species.

Conclusions

This is the first attempt of quantifying potential nurse-density effects on antimicrobial-resistance at national level. Our results suggest an increase in CRGN by decreasing nurse-density. Nurse-density is thus a novel factor that might improve our understanding of the unbalanced CRGN-distribution among sub-European regions. Consequently, integrating nurse-density in future AMR-policies could be beneficial.
Depressive symptomatology, temperament and oxytocin serum levels in a sample of healthy female university students
Authors: Veiga L. , Carolino E. , Santos I. , Veríssimo C. , Almeida A. , Grilo A. , Brito M. , Santos M. C.
Published: February 2022

Background

Depressive symptomatology is prevalent among female university students with adverse effects on their quality of life and academic performance. Previous research suggested associations between depressive symptomatology and oxytocin levels and between depressive symptomatology and Temperament Traits. Despite this evidence, to the best of our knowledge no research has studied the effects fboth oxytocin serum levels and temperament dimensions on depressivesymptoms in a healthy sample. The present study aimed to analyse the effect of oxytocin levels and temperament traits on depressive symptomatology in healthy female university students.

Methods

All participants completed the Beck Depression Inventory and the Adult Temperament Questionnaire. Blood samples were collected between 8 and 8H30 a.m. after 12 h of fasting and between 5 and 8 day of the menstrual cycle and serum oxytocin levels were quantified using a commercial enzyme-linked immunosorbent assay. A hierarchical multiple regression model using a stepwise method was conducted to identify predictors of depression.

Results

Forty-five women aged between 18 and 25 years old (19.37 ± 1.32 years) volunteered to participate in this study. Depressive symptomatology was negatively associated with oxytocin serum levels and "Negative affect" and positively associated with "Effortful control" and "Activation Control". In the final regression model, only oxytocin level was a predictor (B = − 0.090, p < 0.0001), the model explaining 65.2% of the depression variation. Oxytocin played a mediation role between "Negative affects" and Depressive symptomatology.

Conclusions

Our results showed that oxytocin level, rather than personality dimensions, was associated with depressive symptomatology. These results highlight the relevance of the discussion on the use of oxytocin as a biological marker of emotional and social symptoms that characterize depression.
Living conditions of migrants in bavarian forensic psychiatry – acculturation, language competence and perceived ward climate
Authors: Titze L. , Dudeck M.
Published: February 2022

Introduction

From 2014 on, the rate of persons with a migration background in Germany rose steadily, in forensic psychiatric hospitals even disproportionally. Although daily work is aggravated through language barriers and cultural differences, general therapy processes have not been appropriately adapted yet and extensive research is lacking.

Objectives

Therefore the aim was to get a picture of the current situation of patients with a migration background in 11 Bavarian forensic psychiatry.

Methods

237 Patients with a migration background (first or second generation) were asked about their sociocultural background, their acculturation tendency (by rating the Frankfurter Acculturation Scale), their German language ability and their estimation of the ward climate (by the Essen Climate Evaluation Schema).

Results

51.8% of the participants were able speak German on an A- level, 13.1% on a B- level and 35.1% on a C- level. Patients of our sample oriented themselves more towards Germany and less towards their country of origin, compared to the control sample. Further, they experienced safety significantly lower and patient cohesion and mutual support higher than the forensic reference sample.

Conclusions

One possible explanation for the patients’ orientation is the lack of possibilities to act out their cultural traditions. Because of the patients’ limited German knowledge and cultural misunderstandings, they could feel less safe. To conclude, the group of patients with a migration background is important not solely due to its size. But its heterogeneity makes universally applicable statements not easy. Migration backgrounds have to be considered within the psychiatric setting and individual therapy plans have to be made.
Mind the gap! transition from child & adolescent to adult mental health services: A narrative review and results of 18 months consultation
Authors: Cajão R. , Martins M. , Estrada J. , Lima G.
Published: February 2022

Introduction

Discontinuity in child and adolescent mental health services (CAMHS) and adult mental health services (AMHS) constitutes an important challenge in mental health care. In the last decade, efforts have been made to better define the transitioning population and build consensual models for CAMHS-AMHS’ transition.

Objectives

We aim to present our protocol and transition consultation results on the scope of published literature.

Methods

Description of protocol and casuistic of 18 months’ transition consultation at Centro Hospitalar Barreiro-Montijo. The literature found on PubMed was published from 2008 to 2020 and was reviewed using the keywords: transition, CAMHS, AMHS, adolescent, mental health service, young people. Articles with full text available written in English and French were selected. The included clinical studies focused on populations with neurodevelopmental disorders, psychotic disorders, non-suicidal self-harm and suicidal attempts.

Results

Forty-four articles were included, published from 2008 to 2020. 4 articles were excluded on basis of language and diagnosis criteria (eating disorders). Twelve were reviews, 24 were clinical studies and 4 were opinion articles. There are cultural and referral issues that explain the loss of patients in this transition gap. Individuals with history of severe mental illness were more frequently referred than those with neurodevelopmental disorders. Optimal transition is defined as adequate transition planning with a flexible age cut-off and continuity of care following transition.

Conclusions

For the vast majority of service users, transition from CAMHS to AMHS is poorly planned, executed and experienced. Improving transition models is essential to the patients autonomy’ promotion and a stronger adult mental health.
Functional connectivity between brain regions underlying executive control and language in schizophrenia patients with history of auditory verbal hallucination
Authors: Panikratova Y. , Lebedeva I. , Tomyshev A. , Kaleda V. , Vlasova R.
Published: February 2022

Introduction

Schizophrenia patients with auditory verbal hallucinations (AVH) demonstrate impaired functional connectivity (FC) between brain regions, involved in executive functions and language. However, as most studies compare patients to healthy controls, the specificity of these findings either for schizophrenia in general or for AVH is unclear.

Objectives

We aimed to compare whole-brain resting-state FC of main language brain regions between schizophrenia patients with and without history of AVH and healthy controls.

Methods

Schizophrenia male patients with (n=31; mean age 29,8±11,6) or without history of AVH (n=16; 29±12,4) and 39 healthy male controls (30±8,9) underwent resting-state fMRI on 3T Philips scanner. No between-group differences in age, illness duration, and severity of clinical symptoms except AVH were revealed. Regions of interest (ROIs) were taken from the independent fMRI study with conventional language localizer and included left inferior frontal gyrus (l_IFG) and superior temporal gyri (STG) bilaterally. Whole-brain FC of each ROI was compared between groups (ANCOVA; p<.005 voxelwise; p(FDR)<.017 clusterwise, corrected for number of ROIs) with post hoc tests.

Results

Decreased FC between each STG (left and right) and anterior cingulate cortex (ACC) was revealed in all patients, compared to healthy controls. Patients with history of AVH, compared to other groups, showed decreased FC between l_IFG and ACC.

Conclusions

Disrupted fronto-temporal FC is non-specific for AVH and characterizes all schizophrenia patients. Patients with history of AVH have impaired FC between the l_IFG, underlying language production, and ACC, involved in differentiation between language production and comprehension. The study was supported by RFBR grant 18-013-01214.
Affective and cognitive impairments in patients with epilepsy
Authors: Blazhina I. , Korostiy V.
Published: February 2022

Introduction

The most common psychiatric conditions in epilepsy are depression, anxiety, behavioral, psychotic disorders and cognitive disorders as well as those which can be caused by convulsive seizures.

Objectives

The aims of the research were to define cognitive and affective impairments in patients with epilepsy and their quality of life. Since the presents of cognitive impairments and affective disorders have a considerable impact on the functioning of patients, their socialization and the level of their disability.

Methods

We studied the features of clinical and psychopathological manifestations in patients suffering from epilepsy. The study covered 100 patients (47 men and 53 women) who were in inpatient care. The following psychodiagnostic techniques were used: the test of 10 words of Luria, the MOCA test, the Münsterberg test, Mini-Mult test, the quality of life scale, the Hamilton scale of depression and anxiety.

Results

The following data of the study were observed: 88 % patients had decreased memory, 38% had symptoms of depression, 28% had mild situational or neurotic depression, 8% had moderate depression, 2% had severe depression, 20% had a state of severe anxiety, 16% had symptoms of anxiety. The average rate of quality of life among all examined people was 67.5 out of 100.

Conclusions

The results of the conducted research indicate the need for further study of the features of the comorbid pathology in epilepsy and development and implementation pharmacological and nonpharmacological methods for treatments of epilepsy.
Autistic traits predict obsessive-compulsive symptoms: Study in a clinical sample
Authors: Pinto-Gouveia C. , Araujo A. , Pereira A.T. , Cabaços C. , Renca S. , Macedo A.
Published: February 2022

Introduction

Co-occurrence of obsessive-compulsive disorder (OCD) and autism spectrum disorder (ASD) features is well stablished. Diagnosis of OCD increases the risk of a later diagnosis of ASD, and vice versa. Moreover, a recent combined genome-wide association study identified a shared polygenic risk between the two disorders. Our preliminary results also indicate that OCD patients have higher levels of autistic traits than individuals from the community.

Objectives

To determine which autistic dimensions (social skill, communication, attention switching, attention to detail imagination) are predictors of OC symptoms.

Methods

39 OCD patients (52,5% female; 19 to 64 years old) answered the Portuguese versions of the Autism-Spectrum Quotient for Adults and Obsessive Compulsive Inventory – Revised (OCI-R). Spearman correlation and linear multiple regression tests were performed using SPSS.

Results

The OCI-R global score showed positive correlations with some AQ dimensions (attention switching, attention to detail and communication). The regression model showed that attention to detail (β = .43, p = .01) and attention switching (β = .33, p = .038) explained 36% of obsessive-compulsive symptoms variance.

Conclusions

Our results are in line with a dimensional perspective of psychopathological continua and indicate that the overlap between OCD and ASD occurs through shared neurocognitive processes. We suggest that, besides being a predisposing factor for social difficulties (e.g.: facial/emotion recognition) in ASD, attention to detail and deficits in attention switching may also lead to difficulties to dismiss repetitive thoughts or extinguish behaviours in OCD. Future studies should investigate the distinctive features and underlying processes between OCD/ASD.
Dementia and COVID-19 pandemia: The situation in various European countries
Authors: Stoppe G.
Published: February 2022

COVID-19 pandemia means a special threat to elderly patients in nursing homes. Dementia sufferers, who make up most of nursing home clients throughout Europe, have been in a critical situation. They bear a higher risk of delirium when affected by the virus. They often do not understand and easily forget, how to use a mask and keep the distance required. In many institutions the elderly were isolated and could not even take their meals together. And finally they do not recognize and even fear nursing staff and other personnel, which has to wear “protective clothes”. Caregivers were told not to visit their loved ones any more.

Where available, modern techniques werde used. Skype and/or Zoom, Facetime telephone should replace face to face contacts. Some insitutions offered visitor rooms, where clients and visitors were separated by acrylic windows and microphones were applied. In some areas, physicians’ visits were reduced to a minimum.

Just recently, regular testing of staff and clients in nursing homes has been introduced. However, this is consuming staff time, which - again - is taken from the patients. We discuss, whether the elderly and their caregivers could set their own preferences.

Disclosure

No significant relationships.
Prescribing of adjuvant analgesics among patients in primary care and specialized pain clinic
Authors: Malenkova E. , Zagorulko O.
Published: February 2022

Introduction

Chronic low back pain (CLBP) is one of the most resistant pain conditions and is often combined with psychoemotional disorders [1].

Objectives

To analyze the frequency of prescribing adjuvant analgesics among patients with CLBP by specialists of the outpatient department and specialized pain clinic.

Methods

The prospective study included 269 patients (group 1) with CLBP treated in an outpatient department and 253 patients (group 2) of specialized pain clinic. We analyzed gender, age, duration, and severity of pain (using the visual analogue scale-VAS), frequency of prescribing anticonvulsants and antidepressants, as well as their combination in both groups. The data were analyzed with IBM SPSS Statistics.

Results

Among the patients of both groups, women predominated (65.3% in group 1 and 57.2% in group 2). The average age was 61.8±14.5 and 58.9±12.7, in the first and second groups, respectively. The disease duration was longer in group 2 (6.8±3.9 years, and 4.5 ± 2.7 in group 1, p<0.05). Pain intensity was comparable in both groups (4.3±2.8 and 5.1±2.5, p<0.067 on VAS). Antidepressants there were prescribed 16.1% and 52.9%, p<0.05, anticonvulsants - 18.8% and 33.2 %, p<0.05, their combination - 2.2% and 13.8%, p<0.05 in the first and second groups, respectively.

Conclusions

Adjuvant analgesics are more often prescribed to patients of specialized pain clinics. It may be associated with more severe descriptions of chronic pain syndrome, as well as insufficient awareness of modern approaches to the management in this category of patients by specialists in primary health care. References: 1.Zagorulko, Medvedeva Russ Pain J. 2019
Mental health conditions in people searching for aesthetic treatments: The importance of early detection
Authors: Viegas F. Gonçalves , Figueiredo I. , Ferreira F. , Lourenço A.
Published: February 2022

Introduction

It’s established that aesthetic dysfunctions can be associated with psychiatric conditions. In present times, considering the exponential growth of minimally invasive and accessible techniques, alongside with ideals of beauty present in everyday life through exposure in social media, the importance of early detection of mental illness and its impact on the respective outcome should be emphasized.

Objectives

To review evidence regarding psychiatric disorders in people searching for aesthetic treatments and their impact on the outcome.

Methods

Literature review using Medline database.

Results

Around 50% of individuals seeking aesthetic procedures fulfill the diagnostic criteria for psychiatric disorders. The prevalence of Body Dysmorphic Disorder (BDD) can vary from 5-15%, with some studies showing a prevalence of more than 50%. Patients with heightened BDD symptoms are less satisfied with the outcomes of aesthetic procedures which could result in exacerbation of said symptoms. With regards to eating disorders, evidence suggests the initial satisfaction following aesthetic procedures, when observed, is usually transitory, not leading to long-term changes in self-perception relating to body image, nor improving prognosis or quality of life. There’s also some evidence suggesting that personality disorders may be a predictor of poor satisfaction with the results of aesthetic treatments.

Conclusions

Awareness should be raised in this matter, since psychiatric conditions are more common in patients seeking aesthetic treatments and early identification can lead to a better prognosis by providing patients with the mental health treatment they need; this could also reduce the probability of dissatisfaction and subsequent aggravation of psychiatric symptoms following aesthetic interventions.
A case of late-onset and long term of anti-nmda-receptor encephalitis in a 50-year-old patient with psychosis and cognitive decline
Authors: Palchikova Y. , Zalutskaya N. , Gomzyakova N. , Mikhailov V. , Ananyeva N.
Published: February 2022

Introduction

Anti-NMDA-receptor encephalitis is a severe rare acute form of encephalitis caused by an autoimmune process with the synthesis of autoantibodies to the glutamate receptors. The average age of onser is estimated to be 23-25 years. A typical clinical picture consist of prodromal, psychotic, areactive, hyperkinetic phases, and a phase of gradual regression of symptoms. The disease usually lasts for a several weeks with spontaneous recovery or fatal outcome and caused by neoplastic process. Our case demonstrates that the course of anti-NMDAR encephalitis is possible at more mature age in the form of a long process with cultural features, without significant catadrome, inflammation and associated neoplastic process.

Objectives

50-year-old woman complained about hypomnesia, anosmia and dissomnia. The disease began with impaired consciousness, disorientation, seizures and memory loss 4 years ago. After 3 weeks IgG to the herpes simplex and cytomegalovirus were detected. Then after a discharge with no improvement and visit of Lama, the symtoms described above spontaneously reduced and schizophrenia-like psychosis developed, accompanied by mild neurological and severe neurocognitive symptoms, weight loss, intolerance to antipsychotics in minimal daily doses. This state was mantained till 2020.

Methods

Examination included: CBC, metabolic panel, coagulogram, tumor markers, CSF, MRI, PET, specialists.

Results

CBC, metabolic blood analysis, tumor markers - within the reference values. CSF: cytosis 9/3, glucose 5.5 mmol/l, Pandi++, Nonnet-Apeltau+, antibodies to the NMDA receptor - 8. MRI: signs of the consequences of encephalitis. PET: no signs of metabolic activity of the malignant process.

Conclusions

This case brings additional data about a couse, age of onset, duration and trigger factors for anti-NMDAR encephalitis.
Filiation delusion: A rare presentation
Authors: Rodrigues A.C. , Oliveira C.
Published: February 2022

Introduction

The filliation delusion was first described in 1950 by Ey as a false belief about belonging to a family group other than one’s own. Since then, 70 years have passed and litterature is still scarce on this type of presentation.

Objectives

Using a case report as a starting point, the aim of this article is to review data on the various frameworks of delusional development, while discussing in what capacity social cognition impairment, theory of mind and overall lack of insight, typical in schizophrenic patients, could be related to this type of delusion.

Methods

The authors present a case report of an episode of a filliation delusion in a patient with chronic schizophrenia. A search on PubMed and ClinicalKey was performed, from which the relevant publications were selected and reviewed.

Results

The case referes to a 64 year old woman previously diagnosed with schizophrenia who developed, over the period of two years, a filliation delusion. The patient believed having been born in Russia and being subsequently adopted by different families. There was history of irregular attendance to consultations and non-compliance to treatment.

Conclusions

There is still lack of proper investigation regarding the development of delusions in schizophrenic patients. Social cognition and insight are important predictors of functioning, and might behave as a marker of liability to psychosis. This should have strong implications in these patients’ treatment approaches. The lack of consensual measurement instruments make it difficult to draw solid conclusions, and this should be the main focus moving forward.
The health economic potential of harnessing placebos in treatment of ADHD
Authors: Hamberger J. , Meissner K. , Hinterberger T. , Loew T.
Published: February 2022

Introduction

Placebo research investigated the underlying mechanisms of placebo effects, but they are rarely used to optimize treatments. Ethical and legal concerns have been raised, but research demonstrated that placebo mechanisms can be used without patients’ deception: Experimental studies showed that half of drugs in treatment of attention-deficit/hyperactivity disorder (ADHD) combined with open-label placebos could be as effective as standard medication to reduce ADHD symptoms.

Objectives

To estimate the health economic advantages of harnessing the combination of open-label placebos with standard medication in ADHD.

Methods

For preliminary estimation of the mean treatment costs, the 12-months prevalence of ADHD in children and adolescents aged 5 to 14 years as well as the percentage of medication treatments were extracted from the literature. Mean treatment costs per patient and year were calculated for four treatment plans (different drugs and dosages) with both treatment with standard medication and half of drugs in combination with placebos.

Results

A 12-months prevalence of 4.3% equals around 260,000 children and adolescents with a compulsory health insurance in Germany. Of those, around 40-50% are equally treated with two standard drugs and two different dosages. Full standard drug treatments cost around 119 million EUR, and treatment with half of drugs in combination with placebos cost around 66 million EUR.

Conclusions

The combination of open-label placebos with half of standard medication could considerably reduce health costs. Reduction of side effects still must be considered. However, current studies are of experimental nature and lasted for no longer than two weeks.
Psychedelics: A new era of treatment?
Authors: Torres S.
Published: February 2022

Introduction

Psychedelics - including LSD (lysergic acid diethylamide), psilocybin, DMT (N, N-dimethyltryptamine), ayahuasca and mescaline - have an ancient history across various civilizations. In 1950, after LSD’s discovery by Hofmann, psychedelics enjoyed a short-lived relationship with psychiatry, before prohibitive legislature emerging in response to the recreational use in the mid-1960s. However, the last decade has witnessed a renewed scientific interest in psychedelics - a phenomenon referred to as the ‘Psychedelic Renaissance’.

Objectives

Review the pharmacology of psychedelic drugs and the latest evidence of its therapeutic potentials in anxiety, mood and addictive disorders.

Methods

Literature review performed on PubMed and Google Scholar databases, using the keywords “psychedelics”, “hallucinogens”, “d-lysergic acid diethylamide (LSD)”, “psilocybin”, “ayahuasca”, “mescaline”, “DMT (N,N-dimethyltryptamine)”.

Results

The psychedelics or “classic hallucinogens” can be subdivided into three sub-classes: the plant-derived tryptamines (psilocybin and ibogaine) and phenethylamines (mescaline), and the semisynthetic ergolines (LSD). The therapeutic potentials are mediated by an agonist action on 5-HT2A receptors expressed in frontal and paralimbic structures involved in mood and emotion regulation, introspection, interoception and self-consciousness. Stimulation of 5-HT2ARincreases the glutamatergic tone and neuroplasticity and is accompanied by reduced amygdala activity, reducing anxiety. Experimental, open-label, and RCTs showed anxiolytic, antidepressive, and antiaddictive effects with psychedelics. As examples, psilocybin and LSD reduced anxiety and depression in cancer patients and symptoms of alcohol and tobacco dependence, and ayahuasca reduced depression in treatment-resistant depression.

Conclusions

Despite the promising effects of psychedelics on anxiety, depression and addiction, the evidence is still preliminary, waiting for long-term studies with bigger samples.

Conflict of interest

No significant relationships.
Group treatment experience in a brief psychiatry hospitlization unit
Authors: Pinilla R. , Aragones U. , Ordoñez B. , Sotillos A. , Mata A. Hernández
Published: February 2022

Introduction

Joseph Pratt, a sanatorium doctor, at the beginning of the 20th century began to organize groups of patients in order to transmit information about their illness, observing that those who came had a better evolution. In the twenties, Jacob L. Moreno, would make the leap towards mental health, transferring the group format to the treatment of mental disorders. At the same time, Lazell and Marsh began to carry out psychoeducational groups with admitted schizophrenic patients.

Objectives

Present experience of a psychotherapeutic group in a brief psychiatry hospitalization unit.

Methods

Non-directional, voluntary group, with daily frequency and 30 minutes duration. Between 8-15 patients participated. Participation in the group required compliance with 2 rules: respecting word turns and speaking from one’s own experience. The sessions were organized in three parts, 1. Opening of the group: the rules are remembered and we welcome new patients. 2. Group: dialogue between patients 3. Group closure: summary of the session and dismissal of discharge patients.

Results

The following topics were addressed: - The experience of admission; traumatic vs restorative. - The difficulties they expected to encounter after discharge. - Aspects related to family bonding, between equals and couples. As difficulties we find: - The heterogeneity in the symptoms of the patients. - Voluntary participation in the group. - Conflicts reactive to non-compliance with the rules.

Conclusions

Group therapies in brief hospitalization units have great therapeutic potential.

Conflict of interest

No significant relationships.
Approaching psychotherapy for people from international buddhist organisations
Authors: Anders A.I.M.
Published: February 2022

Introduction

Mindfulness techniques, which are currently widely used in psychosomatics and psychotherapy, pose challenges when treating people coming from Buddhist groups for several reasons.

Objectives

For their treatment, it is important to take into account decontextualized terms that underlie crucial group dynamics and the effects of damaging neologisms in international Buddhist organizations.

Methods

In the current research project, this topic is approached in combining quantitative with qualitative data. Whereas the data collection is still ongoing, the replies of twelve people are presented.

Results

As commitments to secrecy hinder people to ask for psychotherapy for long, they were asked on their thoughts about secrecy in Buddhist groups. Five of them agreed that acts against them were declared secret, which they then further specified. Six probands agreed having witnessed acts directed toward others being sworn to secrecy, four of which told this was about sexual abuse. Whereas nine agreed having experienced enemy images being built up, three agreed and specified how their own freedom was impaired and six witnessed and specified other group members’ freedom having been constrained. While six persons agreed that it was assumed in their group one or more persons could ‘purify’ someone else in the sense of a ‘karma purification’ and specified their replies, two replied this concept was used to rationalize actions towards themselves and how it has affected.

Conclusions

As for psychotherapy, it is important to take into account rationalization of violence and abuse through neologisms, pseudotherapies and structural issues in context.

Conflict of interest

This research is funded by the German Federal Ministry of Education and Research (BMBF).
Monerdaktar: A large online mental health service to improve access to care in bangladesh during the COVID-19 pandemic
Authors: Rashid Soron T. , Chowdhury Z.F.
Published: February 2022

Background

More than 92% of people in Bangladesh are deprived from any sort of mental health care due to severe scarcity of mental health professionals, widespread stigma, lack of awareness, the inability to travel from remote area to Dhaka and maintaining the cost of travel and clinics. Moreover, the COVID-19 crisis made the scenario worse. To solve this problem we designed, developed and implemented “Monerdaktar”.

Methods

The process development Monerdaktar- website and mobile application started with the initial idea and concept by TRS followed by extensive literature review and naturalistic observation of the mental health care service delivery from two tertiary hospitals in Bangladesh. We conducted 3 focus group discussion with the patients, their care givers, mental health professions. Based on the user feedback and technical suggestion of the mental health professional and IT professionals we developed the prototype of the Monerdaktar mobile application and website. After piloting for two months, the final version of the mobile application and website was finalized incorporating the feedback of the patients and experts.

Result

Monerdaktar created the unique opportunity to connect with the most the reputed mental health professional both psychiatrists and clinical psychologists online. Moreover, monerdaktar delivered the service free of cost to more than 700 clients during the peak of COVID crisis in Bangladesh.

Conclusion

The COVID-19 crisis has potentiated the acceptance and adaptation of the Moenrdaktar solved the long-standing crisis of access to mental health care in Bangladesh and ensure the evidence-based care from anywhere.

Disclosure

The Monerdaktar website and mobile application was design and developed by under the leadership of Dr. Tanjir Rashid Soron. Though the initial support was delivered free of cost, the consulting expert psychiatrist and Clinical Psychologist may take their