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Charge: More than a half-century ago, Richard Hofstadter identified the “paranoid style” as an important feature of American politics. However, in A Lot of People are Saying, Russell Muirhead and Nancy L. Rosenblum argue that a “new” form of conspiracism has begun to infect contemporary American political life. Whereas “old” conspiracy theorists sought hidden evidence to describe why things are not as they seem, Muirhead and Rosenblum argue that purveyors of the new conspiracism make no attempt to substantiate their theories. In light of this fact-free approach, the authors thus warn that contemporary conspiracy theorists pose an unprecedented danger to foundational elements of American democracy, including political parties and knowledge-producing institutions. Moreover, Muirhead and Rosenblum assert, “The new conspiracism moved into the White House with the inauguration of Donald Trump” (p. 1), “the conspiracist in chief” (p. ix). If there is merit to this argument, then the fate of Trump’s reelection bid carries monumental consequences for the future of American democracy, as well as the way in which the United States responds to the unprecedented coronavirus pandemic. We therefore asked a range of scholars to comment on Muirhead’s and Rosenblum’s bold set of claims.
Psychiatric illnesses have a high prevalence in the general population. Psychiatric illnesses affect the way other medical processes develop: age of onset, distribution by gender, type an evolution, and the training of the psychiatrists in caring for them.
To describe the characteristics and the medical problems of patients who have been consulted by an Internal Medicine Liaison Unit while hospitalized in the Psychiatric Unit of a third level hospital. Comparison of the general profile of these patients and their consultations with that done to patients hospitalizad in the rest of the hospital.
Descriptive retrospective study from September 2007 to May 2010. Use of a centralized database created with of all the administrative and clinical details regarding the consultation. A p ≤ 0.05 has statistical significance.
648 patients were identified (40,7% men). Mean age 52.4 years. Mean stay 3 days. 34,4% were solved in one visit. Mortality rate 0,3%. 94,1% of discharges were due to recovery, the rest were transfered to another service.
Distribution by major diagnostic groups: infectious 16,2%, cardiorespiratory 15,4%, mental illness 12,9%, metabolic 10,4%, tumoral 8,5%, digestive 8,2%, not defined 8,2%, hematologic 5%, others 15,2%.
The psychiatric patient is clearly younger and the female gender is slightly higher (59,3%) than in the control group. In this group the infectious and cardiorespiratoty illnesses predominate. The percentage of psychiatric consultations (34,1%; 648) over our global (1906) is impressive since the number of psychiatric inpatients is not proportional to this number.
Auditory hallucinations in deaf people are known since the XIX century. However, research in this area is scarce.
Auditory hallucinations can be caused by alterations in receptors, stimulus carrying routes or cerebral centres. Therefore, they can take place in persons without mental illness.
Bibliographical review in literature and pub med using as key words: “Auditory hallucinations, Auditory deficit,
– There is always chronic hearing loss caused by an auditory injury.
– Higher prevalence in females with acute or gradual onset.
– Usually unilateral.
– Most common phenomena are musical hallucinations.
– Not associated with other types of hallucinations.
– Can be modified by attention and will.
– It is a hallucinosis.
– Not accompanied by disturbances of consciousness, memory or judgment.
– Treatment of hearing impairment leads to healing. Results are unsatisfactory with psychotropic drugs. Psychoeducation may lead to improvements.
The existence of auditory hallucinations with consciousness of unreality rules out an organic pathology. It is important to assess hearing, because an entity has been defined by musical auditory hallucinations with unreality conscious and with preserved judgment, memory and consciousness, in patients with acquired hearing loss, mainly women and elderly, called by many professionals ACBS. Awareness of this entity by specialists in otolaryngology and psychiatry is essential.
Mentally ill patients have rates of medical comorbidity and mortality higher than the rest of the population. They require adequate medical care that isn't usually.
Emphasis on physical health problems affecting the mentally ill patients, analyze situations that may motivate and possible solutions.
Bibliographical review in the literature and pub med using key words: “medical comorbidity, severe mental illness, psychopharmacological treatments”
Mentally ill patients have greater medical comorbidity and higher mortality rate than the general population. in patients with schizophrenia life expectancy is 20% lower and mortality risk of 1.5–3 times higher than the rest of population. Affective disorders are associated with a standardized mortality ratio for medical reasons also high. Studies show that excess mortality in patients with severe mental illness is 60% due to natural causes and 40% to unnatural causes (28% suicide and 12% accidents). This increased mortality is mainly due to cardio-respiratory and infectious disease. Low socioeconomic class, lack of social care, poor medical care, bad habits (poor diet, sedentary, toxics) and adverse effects of psychopharmacological treatments are the main factors. Despite this, detection and treatment of physical illness is low. It is estimated that between 30% and 47% of these patients are untreated.
Improved medical care of these patients would improve their performance and quality of life. A system for each type of mental health to screening, assessment, diagnosis and treatment of somatic diseases, and a protocol for referral to appropiate medical/surgical centers are required.
Endocannabinoid system has been highlighted as one of the most relevant research topics by neurobiologists, pharmacists, basic scientists and clinicians. The association between endocannabinoids and its congeners and mood disorders is relatively recent. However, evidence from both clinical and preclinical studies is increasing and many researchers point out endocannabinoid system and particularly endocannabinoids and congeners as promising pharmacological targets.
Aims and objectives
The main objective of this study is to compare the plasma concentrations of endocannabinoids and congeners between a sample of patients with depression and a sample of control subjects, and the influence of variables such as age, body mass index, gender, severity of symptoms, and antidepressant medication.
Plasma concentrations of endocannabinoids and congeners will be analyzed in 69 patients with depression from primary care and 47 controls using mass spectrometry analysis.
Statistically significant differences in 2-arachidonoylglycerol and monoacylglycerols were found between both samples. Somatic symptoms of depression seems to be more related to these compounds that to cognitive-affective symptoms. In addition, differences between mildly and moderately depressed patients were found in concentrations of AEA, LEA, DGLEA and POEA. Patients with antidepressant medication showed higher levels of 2-AG, DGLEA and OEA.
The results of this study provide evidence supporting the hypothesis that in depression there is a dysregulation of the inflammatory signaling and, consequently the immune system. The results of this study could also support the realization of translational research to better understand the mechanisms of this widely distributed system.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Endocannabinoid System (ECS) has been highlighted as one of the most relevant research topics by neurobiologists, pharmacists, basic scientists and clinicians (Skaper and Di Marzo, 2012). Recent work has associated major depressive disorder with the ECS (Ashton and Moore, 2011). Despite the close relationship between depression and bipolar disorders, as far as we know, there is no characterization of ECS and congeners in a sample of patients with bipolar disorders.
Aims and objectives
The objective of this work is to characterize the plasma levels of endocannabinoids and congeners in a sample of patients with bipolar disorders.
The clinical group was composed by 19 patients with a diagnosis of bipolar disorders using SCID-IV (First et al., 1999). The control group was formed by 18 relatives of first- or second-degree of the patients.
The following endocannabinoids and congeners were quantified: N-palmitoleoylethanolamide (POEA), N-palmitolylethanolamide (PEA), N-oleoylethanolamide (OEA), N-stearoylethanolamide (SEA), N-arachidonoylethanolamide (AEA), N-dihomo-γ-linolenoylethanolamide (DGLEA), N-docosatetraenoylethanolamide (DEA), N-linoleoylethanolamide (LEA), N-docosahexaenoylethanolamide (DHEA), 2-arachidonoylglycerol (2-AG), 2-linoleoylglycerol (2-LG), and 2-oleoylglycerol (2-OG).
The result showed statistically significant lower levels of AEA, DEA and DHEA in clinical sample. Previous research also identified lower levels of AEA in depressed women (Hill et al., 2008, 2009). Until date, it is unknown if DEA and DHEA have some effect on EC receptors, and whether they have some direct effects on endocannabinoids.
It would be necessary to carry our other research with a larger sample, which could allow the control of potential confounding variables.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Patients suffering from paranoid schizophrenia, require long-term anti-psychotic treatment, which provide, in addition to adequate efficacy both positive and negative symptoms, a good safety and tolerability profile that would ensure adequate adherence to prevent relapse.
To analyze the efficacy, tolerability and therapeutic adherence over a year after the introduction of aripiprazole depot in patients diagnosed with paranoid schizophrenia previously treated with other oral or depot anti-psychotics [1,2,3].
One-year prospective longitudinal study with a sample size of 23 patients diagnosed with schizophrenia in outpatient treatment. Study variables (baseline, 6 and 12 months): Brief Psychiatric Rating Scale (BPRS), clinical global impression (CGI), mean dose of aripiprazole depot, previous treatments, adherence, relapse rate, prolactin levels, sexual dysfunction, BMIs.
Twenty-three patients (71% men, 29% women) diagnosed with paranoid schizophrenia were identified. Improvement was obtained in the different study variables with statistically significant difference (P ≤ 0.05).
Following the introduction of aripiprazole depot in patients diagnosed with schizophrenia previously treated with other oral or depot anti-psychotics in our study, we conclude that maintaining therapeutic efficacy a better tolerability and safety profile, better therapeutic adherence and consequently lower relapse rate were achieved.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Tuberous sclerosis complex is a rare genetic disorder leading to the growth of hamartomas in multiple organs, including cardiac rhabdomyomas. Children with symptomatic cardiac rhabdomyoma require frequent admissions to intensive care units, have major complications, namely, arrhythmias, cardiac outflow tract obstruction and heart failure, affecting the quality of life and taking on high healthcare cost. Currently, there is no standard pharmacological treatment for this condition, and the management includes a conservative approach and supportive care. Everolimus has shown positive effects on subependymal giant cell astrocytomas, renal angiomyolipoma and refractory seizures associated with tuberous sclerosis complex. However, evidence supporting efficacy in symptomatic cardiac rhabdomyoma is limited to case reports. The ORACLE trial is the first randomised clinical trial assessing the efficacy of everolimus as a specific therapy for symptomatic cardiac rhabdomyoma.
ORACLE is a phase II, prospective, randomised, placebo-controlled, double-blind, multicentre protocol trial. A total of 40 children with symptomatic cardiac rhabdomyoma secondary to tuberous sclerosis complex will be randomised to receive oral everolimus or placebo for 3 months. The primary outcome is 50% or more reduction in the tumour size related to baseline. As secondary outcomes we include the presence of arrhythmias, pericardial effusion, intracardiac obstruction, adverse events, progression of tumour reduction and effect on heart failure.
ORACLE protocol addresses a relevant unmet need in children with tuberous sclerosis complex and cardiac rhabdomyoma. The results of the trial will potentially support the first evidence-based therapy for this condition.
In South-western Atlantic waters, individuals of the southern right whale (SRW) Eubalaena australis spend part of the year (the austral winter and spring) in northern inshore waters where they breed and then migrate to southern feeding grounds during the summer. Mar del Plata (MDP) is located between two main reproductive areas (Península Valdés-Argentina and Santa Catarina-Brazil). The purpose of the present study is to report the presence of SRWs on their journey off the coast of MDP based on sighting records during the past half century. We carried out whale observations through systematic weekly coastal marine mammal surveys in different points of the MDP area from 1966 to 2016. The first SRW sighting was recorded in 1970; since then, sighting frequency has gradually increased, reaching a peak of 28 sightings (N = 63 whales) in 2016. These are unique long-term sighting records of SRWs in Argentina and the first on their journey off the shores of Buenos Aires province. We expect that these results will help local authorities to regulate tourism and other activities in the area and thereby contribute to the conservation of the species.
The need to diversify the biomedical research workforce is well documented. The importance of fostering the careers of fledgling underrepresented background (URB) biomedical researchers is evident in light of the national and local scarcity of URB scientists in biomedical research. The Career Education and Enhancement for Health Care Research Diversity (CEED) program at the University of Pittsburgh Institute for Clinical Research Education (ICRE) was designed to promote career success and help seal the “leaky pipeline” for URB researchers. In this study, we aimed to quantify CEED’s effect on several key outcomes by comparing CEED Scholars to a matched set of URB ICRE trainees not enrolled in CEED using data collected over 10 years.
We collected survey data on CEED Scholars from 2007 to 2017 and created a matched set of URB trainees not enrolled in CEED using propensity score matching in a 1:1 ratio. Poisson regression was used to compare the rate of publications between CEED and non-CEED URB trainees after adjusting for baseline number of publications.
CEED has 45 graduates. Seventy-six percent are women, 78% are non-White, and 33% are Hispanic/Latino. Twenty-four CEED Scholars were matched to non-CEED URB trainees. Compared to matched URB trainees, CEED graduates had more peer-reviewed publications (p=0.0261) and were more likely to be an assistant professor (p=0.0145).
Programs that support URB researchers can help expand and diversify the biomedical research workforce. CEED has been successful despite the challenges of a small demographic pool.
Attention to intersex persons in French legislation and regulation dates back to 1970 when an administrative instruction tried to deal with the issues raised by the birth of an intersex person. Since then, not much has happened, as French politicians either did not perceive this as a problem, or, more recently, clearly did not want to deal with the issue. However, recently, some ministerial questions were asked and some official reports were published. In February 2017, both the Senate and Human Rights Defender (ombudsman) issued reports on the situation of intersex persons. Public statements were also made by French officials, the most important by the President of the French Republic on 17 March 2017, in which he called for ‘a ban on surgeries performed on intersex infants which is increasingly regarded as a mutilation’. So far, these developments have not been not followed by legislative change. When the Senate had the opportunity to deal with the problems that intersex persons encounter regarding their sex marker/civil status, it refused to do so. This apparent lack of political interest led an intersex individual to decide, with the help of lawyers (including the author of this chapter), to turn to the courts in order to ask the judges whether or not it was possible for an intersex person to be registered with a neutral sex in France. the reason for this approach was that unlike politicians, courts have to answer the questions they are asked, even the Cour de cassation, which is one of the French Supreme Courts. However their hopes were dashed by that court on 4 May 2017. 12 On that day, the Cour de cassation held, for the first time ever in France, that no special sex marker could be granted to intersex individuals: ‘neutral’ (neutre) was deemed not to be available as a legal sex marker concerning civil status. Very recently, the same court also issued a judgment where it refused an intersex person the right to access to a criminal court on the basis of the limitation period.
OBJECTIVES/SPECIFIC AIMS: The need to diversify the biomedical research workforce is well documented. The Career Education and Enhancement for Health Care Research Diversity (CEED) program at the University of Pittsburgh Institute for Clinical Research Education (ICRE) promotes success and helps seal the “leaky pipeline” for under-represented background (URB) biomedical researchers with a purposefully designed program consisting of a monthly seminar series, multilevel mentoring, targeted coursework, and networking. METHODS/STUDY POPULATION: Over 10 program years, we collected survey data on characteristics of CEED Scholars, such as race, ethnicity, and current position. We created a matched set of URB trainees not enrolled in CEED during that time using propensity score matching in a 1:1 ratio. RESULTS/ANTICIPATED RESULTS: Since 2007, CEED has graduated 45 Scholars. Seventy-six percent have been women, 78% have been non-White, and 33% have been Hispanic/Latino. Scholars include 20 M.D.s and 25 Ph.D.s. Twenty-eight CEED Scholars were matched to non-CEED URB students. Compared with matched URB students, CEED graduates had a higher mean number of peer-reviewed publications (9.25 vs. 5.89; p<0.0001) were more likely to hold an assistant professor position (54% vs. 14%; p=0.004) and be in the tenure stream (32% vs. 7%; p=0.04), respectively. There were no differences in Career Development Awards (p=0.42) or Research Project Grants (p=0.24). DISCUSSION/SIGNIFICANCE OF IMPACT: Programs that support URB researchers can help expand and diversify the biomedical research workforce. CEED has been successful despite the challenges of a small demographic pool. Further efforts are needed to assist URB researchers to obtain grant awards.
The ‘crowding effect’ is a result of competition by parasites within a host for finite resources. Typically, the severity of this effect increases with increasing numbers of parasites within a host and manifests in reduced body size and thus fitness. Evidence for the crowding effect is mixed – while some have found negative effects, others have found a positive effect of increased parasite load on parasite fitness. Parasites are consumers with diverse trophic strategies reflected in their life history traits. These distinctions are useful to predict the effects of crowding. We studied a parasitic castrator, a parasite that usurps host reproductive energy and renders the host sterile. Parasitic castrators typically occur as single infections within hosts. With multiple parasitic castrators, we expect strong competition and evidence of crowding. We directly assess the effect of crowding on reproductive success in a barnacle population infected by a unique parasitic castrator, Hemioniscus balani, an isopod parasite that infects and blocks reproduction of barnacles. We find (1) strong evidence of crowding in double infections, (2) increased frequency of double infections in larger barnacle hosts with more resources and (3) perfect compensation in egg production, supporting strong space limitation. Our results document that the effects of crowding are particularly severe for this parasitic castrator, and may be applicable to other castrators that are also resource or space limited.
As a whole neurogenetic diseases are a common group of neurological disorders. However, the recognition and molecular diagnosis of these disorders is not always straightforward. Besides, there is a paucity of information regarding the diagnostic yield that specialized neurogenetic clinics could obtain. We performed a prospective, observational, analytical study of the patients seen in a neurogenetic clinic at a tertiary medical centre to assess the diagnostic yield of a comprehensive diagnostic evaluation that included a personalized clinical assessment along with traditional and next-generation sequencing diagnostic tests. We included a cohort of 387 patients from May 2008 to June 2014. For sub-group analysis we selected a sample of patients whose main complaint was the presence of progressive ataxia, to whom we applied a systematic molecular diagnostic algorithm. Overall, a diagnostic mutation was identified in 27·4% of our cohort. However, if we only considered those patients where a molecular test could be performed, the success rate rises to 45%. We obtained diagnostic yields of 23·5 and 57·5% in the global group of ataxic patients and in the subset of ataxic patients with a positive family history, respectively. Thus, about a third of patients evaluated in a neurogenetic clinic could be successfully diagnosed.
Congenital heart diseases are common in foetuses, with an incidence greater than six times that of chromosomal abnormalities; however, experts in cardiac anatomy have evaluated only the foetuses of pregnant women with increased risk for congenital heart disease. Over the years, it has become clear that congenital heart disease occur in foetuses of low-risk women. In the mid-1980s, a proposal to expand the assessment of cardiac anatomy was presented to obstetricians in order to improve prenatal screening. With the aim to systematise and improve the diagnosis of congenital heart disease in foetuses, the International Society of Ultrasound in Obstetrics and Gynecology established an ultrasound heart examination guideline. In this review, we have described the important features of this guideline and discussed the applications of this tool in clinical practice.
We performed a literature search of the National Library of Medicine for publications released between 2000 and 2012; we used search terms pertinent to congenital heart disease, such as foetal echocardiography, foetal heart and cardiac screening examination.
The guidelines serve as a standard and help to systematise the screening for congenital heart diseases, but we think that some topics may be added to design the most appropriate screening method. However, we cannot expand the topics to be evaluated in this examination without good training of sonographers who undergo this screening.
Although the screening standardisation is a good tool to be used in day-to-day practice, the increment of aortic and ductal archs and colour Doppler to heart screening could be useful to detect further cardiac defects.
Plasma surface activation and antibacterial properties of nanocomposites of polypropylene/silver nanoparticles (PP/nAg) and nylon-6/silver nanoparticles (Ny6/nAg) were investigated. The nanocomposites were prepared by melt blending assisted by ultrasound, while surface activation was achieved by means of argon plasma. To evaluate the antimicrobial properties of the nanocomposites, pathogen microorganisms such as Pseudomonas aeruginosa and Aspergillus niger were tested. Scanning Electron Microscopy (SEM) analyses showed a uniform dispersion of nanoparticles within the polymer matrix, though the presence of some agglomerates was also appreciated. On the other hand, surface topography by Atomic Force Microscopy (AFM) suggested that ions from the argon plasma generated ion collisions with the surface of the nanocomposites removing or etching polymer from surface and improving silver nanoparticles exposure, increasing their antimicrobial properties as corroborated by antimicrobial analyses. Nanocomposites exposed to argon plasma presented higher antimicrobial properties than the ones not exposed. These results indicated that plasma treatment increased the contact area of the nanoparticles with the microorganisms and enhanced the antimicrobial properties of nanocomposites. The results also showed that PP/nAg nanocomposites presented higher bacterial inhibition than Ny6/nAg nanocomposites, indicating that the chemical structure of the polymer also plays a big role in the final performance of the composite.