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The Olrog’s Gull Larus atlanticus is an endemic and threatened species of the south-western Atlantic. Little is known about its movements during the non-breeding period. The objective of this study was to analyse the migration of the species by tracking adults from Bahía San Blas (Buenos Aires province, Argentina) with geolocators and using information of sightings of ringed gulls. Differences between males and females were evaluated using tracking data and ringed data were used to determine age differences. A single core area (kernel 50%) from 21 tracked birds was identified. This area included the study colony and also other breeding colonies located up to 300 km to the north. The range area (kernel 95%) included coastal areas up to 1,000 km from the colony. All sightings of ringed gulls (n = 41) occurred north of the breeding colony, however 12 adult individuals were sighted during the winter in its breeding grounds. Our results suggest the occurrence of partial migration behavior in Olrog’s Gull. The migration pattern reported here implies than during the non-breeding season, breeding and wintering areas away from the nesting grounds should be considered as one system in the design of conservation strategies for this regionally threatened gull.
To determine whether increased physiological arousal immediately after trauma or at emergency admission can predict post-traumatic stress disorder (PTSD) in motor vehicle accident (MVA) survivors with physical injuries.
Methods
We included 119 MVA survivors with physical injuries. In this prospective cohort study, heart rate (HR) and blood pressure (BP) were assessed during ambulance transport (T1) and at hospital admission (T2). One and four months after the accident, we assessed patients for PTSD (Davidson trauma scale, confirmed with the structured clinical interview for DSM-IV axis I disorders). Multivariate logistic regression models assessed the relationship between HR or BP and PTSD.
Results
PTSD was diagnosed in 54 (45.4%) patients at 1 month and in 39 (32.8%) at 4 months. In the multivariate analysis, HR at T1 or at T2 predicted PTSD at 1 month (OR=1.156, 95% CI [1.094;1.221] p < 0.0001). Only HR at T1 (not at T2) predicted PTSD at 4 months (OR=1.059, 95% CI [1.013; 1.108] p = 0.012). Injury severity predicted PTSD at 4 months (OR=1.207, 95% CI [1.085; 1.342] p = 0.001). A cut-off of 84 beats per minute yielded a sensitivity of 62.5% and a specificity of 75.0% for PTSD.
Conclusions
HR measured at the scene of MVA and severity of injury predicted PTSD 4 months later.
Data from elderly suicides was obtained from two previous studies of community suicides in two localities of Northern Spain, namely, Oviedo between 1983 and 1990, and Gijón between 1975 and 1986. Data from the two localities were obtained by the revision of court register cases. A retrospective study on elderly suicide (over 60 years of age) was carried out. Mean annual specific rates for the elderly in Oviedo for 1982–1991 were 37.7 (58.1 for men and 23.3 for women) and for those in Gijón for the period 1975–1986, 23.4 (40 for men and 11.5 for women). A marked increase was seen in the rates for Gijón from the first (1975–1978) to the last period (1983–1986). This was particularly marked in men. The greatest increase in the rate was seen in men over 75 from Gijón and in those between 1970–1974 from Oviedo. In contrast a decrease was seen in the 65–69 age group rates for both men and women. A tendency for the rates to increase was seen but no important increase for elderly suicides was evident.
To describe validation process of the new apathy scale for institutionalized dementia patients (APADEM-NH).
Methods
100 elderly, institutionalized patients with diagnosis of probable Alzheimer Disease (AD) (57%), possible AD (13%), AD with cerebral vascular disease (CVD) (17%), Lewy Bodies Dementia (11%) and Parkinson associated to dementia (PDD) (2%). All stages of the disease severity according to the Global Deterioration Scale (GDS) and Clinical Dementia Rating (CDR) were assessed. The Apathy Inventory (AI), Neuropsychiatric Inventory (NPI), Cornell scale for depression, and the tested scale were applied. Re-test and inter-rater reliability was carried out in 50 patients. The feasibility and acceptability, reliability, validity, and measurement precision were analyzed.
Results
APADEM-NH final version consists of 26 items and 3 dimensions: Deficit of Thinking and Self-Generated behaviors (DT): 13 items, Emotional Blunting (EB): 7 items, and Cognitive Inertia (CI): 6 items. Mean application time was 9.56 minutes and 74% of applications were fully computable. All subscales showed floor and ceiling effect lower than 15%. Internal consistency was excellent for each dimension (Cronbach’s α DT = 0.88, α EB = 0.83, α CI= 0.88);Test-retest reliability for the items was kW=0,48-0,92; Inter-rater reliability reached kW values 0.84-1.00; The APADEM-NH total score showed a low/moderate correlation with apathy scales (Spearman ρ, AI =0.33; NPI-Apathy= 0,31), no correlation with depression scales (NPI-Dementia = -0.003; Cornell= 0,10), and high internal validity (ρ =0.69 0.80).
Conclusions
APADEM-NH is a brief, psychometrically acceptable, and valid scale to assess apathy in patients from mild to severe dementia and discerning between apathy and depression.
Tapentadol is a centrally-acting synthetic analgesic which acts as a mu-opioid receptor agonist as well as a norepinephrine re-uptake inhibitor. It is use to treat cronic pain. Most prevalence adverse effects are gastrointestinal and nervous symptoms. Furthermore, it has objectified, with less frequency, psychiatric disturbances.
Objetives
To analyse the relationship between a maniac episode and tapentadol.
Methods
Forty-nine-year-old female, with personal history of dyslipidemia and lumbar herniated discs in L4-L5, L5-S1, in treatment with tapentadol 200 mg/day for 20 days and no past psychiatric history. She was admitted to the Psychiatry Department due to a maniac episode, with desinhibition, pressure and loud speech, euphoria, megalomaniac delusion and sleep disturbance for the last 10 days. Young Mania Rating Scale (YMRS) was 36 points. Olanzapina 15 mg/day was introduced and tapentadol was removed. Symptoms remitted quickly and 6 days later, at discharge, YMRS was 4 points. One year later, the patient continued to be asymptomatic.
Results
Opioids can produce psychiatric disorders like hallucination, sleep disorders, depressed mood, disorientation, agitation, nervousness, restlessness, euphoric mood. Secondary mania to tapentadol mechanism is unknown, but having opiate cases described, it is possible to attribute this episode to tapentadol.
Conclusions
– Secondary mania is associated with various medical conditions, including vitamin B12 deficiency, brain injury, HIV infection and drugs such as alcohol, caffeine, sympathomimetics, steroids, bupropion, isoniazid, clarithromycin and opioids.
– Further research is required to determine if the maniac episode was only isolated by the tapentadol or it is the beginning of a bipolar disorder.
Recently, a renaissance of interest in ‘negative symptoms’ as emotional withdrawal or blunted affect, has occurred. Some investigators believe that these symptoms are important indicators of outcome, of response to treatment and of a distinct underlying pathologic process.
Research on the negative-symptom syndrome in schizophrenia has been handicapped until recently.
Aims:
This research aims at studying whether acute phase proteins, precisely, Alpha1-glycoprotein, can be considered as a marker of negativesymptom in Schizophrenia.
Methods:
29 chronic schizophrenics were assessed by the Positive and Negative Syndrome Scale (PANSS). A routine blood test including Alpha1-glycoprotein levels was carried out.
Results:
Alpha1-glycoprotein shows a positive correlation, according to Pearson correlation coefficient, with the Negative Scale at an almost significant level (p=.05), and at a significant level in the following items, Blunted affect (p=.03), Passive/apathetic Social Withdrawal (p=.01) of the Negative spectrum and Poor Attention (p=.02) of the General Psychopathology Scale.
Conclusions:
There is a significant correlation with two Negative variables and an almost significant one, spite of the small sample, with the Negative Scale. Further studies with bigger samples are needed in order to consider alpha1-glycoprotein as a schizophrenia negative psychopathology marker.
Behavioral training in neurofeedback has proven to be an essential complement to generalize the effects of pharmacological support in subjects who have Attention Deficit with Hyperactivity Disorder (ADHD). The goal is to stimulate cortical activation, especially in disorders that require increasing intervals of attention and capacity of self-regulation and control. Therefore, this investigation attempts to verify the efficacy of neurofeedback compared with Pharmacological support and the combination of both. Participants were classified into four groups: Control group, students with ADHD who did not receive either pharmacological support of neurofeedback (n = 33, 11 girls and 22 boys); neurofeedback group (n = 33, 11 girls and 22 boys); pharmacological support group (n = 34, 15 girls and 19 boys), and combined group (neurofeedback + pharmacological support; n = 31, 11 girls and 20 boys). Participants were assessed at three levels (assessment of symptoms –EDAHassessment of execution –TOVA- and assessment of cortical activation –QEEG-) at two different moments (before treatment initiation and after treatment). The EEG-Spectrum was used for the neurofeedback intervention. The design was an ex-post-facto descriptive with four treatment groups (pharmacological support, neurofeedback, combined) and a control group that did not receive intervention initially. Results indicate that the combined group obtained more benefits and that the neurofeedback group improved to a greater extent in executive control than the pharmacological support group. It is concluded that this kind of training is an excellent alternative to stimulate activation in subjects with ADHD.
It is well known that mental illneses are associated with higher prevalence of somatic disorders when compared to the general population. We observed that, at the time of admission to the Acute Psychiatric Unit (APU) at our Hospital, many patients have associated urinary tract infection.
Objectives:
To determine the characteristics of patients that present with urinary tract infection on admission to the APU
Methods:
From all admissions to the APU during 2011, patients with urinalysis, sediment and culture suggesting urinary tract infection were recruited for this study.
Results:
83 out of the 229 patients admitted to the APU had urinary tract infection at the moment of admission. Most common psychiatric diagnoses in patients with urinary tract infection were: mood disorders (37.35%), psychotic disorders (22.89%) and personality disorders (14.46%) Of these 83 patients, 72.29% had a history of previous psychiatric admissions and 91.67% had a new admission with an associated urinary tract infection.
Figure
[readmissions]
Conclusions:
A high percentage of patients admitted to our APU have recurrent urinary tract infections. Urinary tract infections may play a negative impact on their psychopathological evolution and may be associated with the need for hospital admission.
Comorbidity between alcoholism and depression has long been acknowledged, and the possibility that similar brain mechanisms, involving both serotonergic (5-HT) and noradrenergic systems (NE), underlie both pathologies has been suggested. Thus, inhibitors of NE and 5HT uptake have been proposed for the treatment of alcoholism, as they have shown to reduce alcohol intake in various animal models. However, most of the studies mentioned were carried out acutely and there is a lack of knowledge of the possible long-term effects. Clinical studies report an overall low efficacy of antidepressant treatment on alcohol consumption, or even a worsened prognosis. In addition, several cases of alcohol dependence following antidepressant treatment have been reported in the literature.
Objectives
We aimed at comparing the acute and chronic effects of the treatment with the antidepressant drug reboxetine on alcohol consumption.
Methods
We used a rat model of alcohol self-administration, and two different schedules of reboxetine administration (acute and chronic).
Results
Our results confirm the acute suppressant effects of reboxetine on alcohol consumption but indicate that, when this drug is administered chronically in a period of abstinence from alcohol, it can significantly increase the rate of alcohol self-administration.
Conclusions
These results are important for the understanding of the clinical reports describing cases of increased alcohol consumption after antidepressant treatment, and suggest that much more research is needed to fully understand the long term effects of antidepressants, which remain the most widely prescribed class of drugs.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The personality disorders are defined according to the DSM-5 like “an enduring maladaptive patterns of behavior, cognition and inner experience, exhibited across many contexts and deviating markedly from those accepted by the individual's cultures. These patterns develop in adolescence and the beginning of adulthood, and are associated with significant distress or disability”. The personality disorders can be a risk factor for different processes of the psychiatric pathology like suicide. The personality disorders are classified in 3 groups according to the DSM-5:
– cluster A (strange subjects): paranoid, schizoid and schizotypal;
– cluster B (immature subjects): antisocial, bordeline, histrionic and narcissistic;
– cluster C (frightened subjects): avoidant, dependent and obsessive-compulsive.
Aims
To describe the influence of personality disorders in suicide attempts.
Methodology
Exhibition of clinical cases.
Results
In this case report, we exhibit three clinical cases of suicide attempts which correspond to a type of personality disorder belonging to each of the three big groups of the DSM-5 classification, specifically the paranoid disorder of the cluster A, the disorder borderline of cluster B and the obsessive compulsive of cluster C.
Conclusions
The personality disorders have a clear relation with the suicide attempts, increasing this influence in some of them, especially the borderline personality disorder.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Methanol poisoning is uncommon but potentially lethal. The way of poisoning is usually oral. However, in a small number of cases, inhalated methanol poisoning was described. Most of these occurred among patients suffering a disorder by use of this substance. This type of poisoning has an insidious presentation, that complicates its diagnosis. This poisoning may be lethal. It may produce a chronic and severe affectation of the central nervous system in those who survive to the poisoning. After diagnosis, it is compulsory to act quickly, and it often requires advanced vital support and hemodialysis.
Objectives
Educate the Mental Health professionals about a type of disorder by consumption increasingly more frequent in some cities across Europe. This is a high fatality related poisoning that emergency and general psychiatrists should know as it is increasingly common in Europe.
Methods
We present the case of a 20-year-old patient, treated at the emergency department of our hospital in context of metanol inhalation. The patient regularly attended to our Dual Pathology outpatient unit due to a severe inhalant use disorder. Several stays at the intensive care unit had been recorded and he already presented with severe optic nerve affectation.
Discussion
In recent years there has been an increase in inhalant abuse in Europe, which is still underestimated by our poor knowledge about its potential toxicity.
Conclusion
Inhalated methanol poisoning occurs with a typical presentation, and may appear after suicide trial or overdose. Mental health professional should become aware of its potential lethality to approach properly to these patients.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
There is a low prevalence of eating disorders among men. In many cases, the disorder arises as a means of avoiding psychosocial maturation. Various psychiatric comorbidities such as depression or obsessive-compulsive disorder are frequently found in these patients.
Objectives
To analyze psychiatric symptoms in relation to a case of anorexia nervosa.
Methods
Pubmed revision on clinical presentation of anorexia nervosa in male. Review of patient medical records.
Results
A 23-years-old male with diagnosis of restricting anorexia nervosa was treated and followed since 2012. In July 2015, the patient, who was clinically stabilized for a year, had decreased gradually intake. Suddenly he showed a decreased consciousness, followed by an absence of response and mutism that motivated hospital admission. The diagnosis was dissociative stupor. A research in women with eating disorders shows a prevalence of pathological dissociation between 4.8 and 48.6%. After recovering a normal consciousness, he presented clinical features of anorexia nervosa according DSM 5 criteria. The patient remained two months until he reached his previous BMI (17) to continue an outcome treatment. Despite of several years of specific treatment for anorexia nervosa, both parents and patient still did not accept the diagnosis. Cultural constructions of eating disorders as a “women's illness” mean that men may fail to recognise their disorder.
Conclusions
There is a delay of diagnosis of anorexia nervosa in men. The lack of research on men's experiences and the cultural construction of anorexia nervosa as a female problem may contribute to underdiagnose eating disorders in men.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Psychiatric patients tend to have severe metabolic alterations of multifactorial causes, lifestyle, diet, drug use and psychopharmacological treatment, especially antipsychotic drugs which act as risk factors for cardiovascular disease, strokes, infections and complications of diseases basal negatively influencing its evolution and prognosis.
Objectives
Rating the profile lipid and the prevalence of obesity in patients registered as disorder mental severe in treatment with antipsychotics.
Aims/methods
A descriptive study was performed taking as variables to take into account levels of cholesterol, triglycerides, weight and size.
Results
Of the 28 patients included in the study 7 refused to perform the corresponding measurements. Of the 21 remaining, 3 showed values higher than 150 mg/dl triglycerides and cholesterol figures higher than 200 mg/dl. Other 3 patients presented hypercholesterolemia without alteration of triglycerides and 2 hypertriglyceridemia without elevation of the cholesterol. Concerning the IMC, found that 7 patients presented overweight (BMI > 25 and < 30) and 5 patients obesity (BMI > 30). Of the 8 patients with lipid disorders, 2 had prescribed treatment with risperidone (oral or injectable) more quetiapine, 2 oral risperidone as monotherapy, risperidone1 more amisulpride, 1 quetiapine more aripiprazole, quetiapine 1 in monotherapyand 1 injection invega more oxcarbamacepina.
Conclusions
We found lipid alterations in a 38.1% of patients and a BMI greater than 25 in a 57.14% of 21 patients who agreed to the study. The most prescribed antipsychoticamong these patients were risperidone (5 patients) followed closely by quetiapine (4 patients).
Disclosure of interest
The authors have not supplied their declaration of competing interest.
There is substantial evidence suggesting that individual variability in antipsychotic treatment response could be genetically determined. Disrupted-in-Schizophrenia 1 (DISC1) gene has been previously associated to the illness and to treatment response in a sample of patients suffering from psychosis. However, there is a lack of studies on the effect of DISC1 on treatment response in samples of first episode psychosis.
Objectives
The aim of this study was to explore the relation between variations in DISC1 gene and treatment response to antipsychotics in a sample of drug-naïve patients with a first episode of psychosis.
Methods
Two hundred and twenty Caucasian drug-naive patients experiencing a first episode of non-affective psychosis were genotyped for rs821616 (Ser704Cys), rs6675281 (Leu607Phe) and rs1000731. Early (6 weeks) response to antipsychotic treatment was assessed with the Brief Psychiatric Rating Scale, the Scale for the Assessment of Positive Symptoms, and the Scale for the Assessment of Negative Symptoms. Other clinical and socio-demographic variables were recorded to eliminate potential confounding effects.
Results
We found a significant association between rs1000731 and treatment response. Thus, those patients homozygous for the G allele of rs1000731 were more frequently non-responders, measured with SANS, after 6 weeks of treatment, than those carrying the A allele (X2 = 4.019; P = 0.032). Moreover, when analysing the clinical improvement longitudinally, we observed that those patients carrying the A allele for the rs1000731 presented a greater improvement in positive symptoms dimension (F = 8.905; P = 0.003).
Conclusions
Our results suggest a minor contribution to antipsychotic drug response of genetic alterations in the DISC1 gene.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
In recent times, nanotechnology has drawn the attention of the scientific community because of the wide variety of applications that can be done with it, from food packaging to targeted drug delivery; the use of nanoparticles has been a breakthrough in science that has now reached the market. Silver nanoparticles (Ag NPs) have unique properties due to the oscillation of electrons in the superficial plasmon. These nanostructures have been used in different applications in the area of nanomedicine, such as: targeted drug delivery, sensing and imaging, anti-fungal, anti-cancerous and biosensors. It has become evident that pathogenic bacteria are resisting antibiotics such as Penicillin becoming one of the most worrying topics in the world. People in the science community fear the day when we no longer can use these antibiotics, because the resistance of bacteria became too great, leaving us defenceless against any type of pathogens and possibly causing a catastrophe. However, we theorize that the possible solution to this problem could be the use of silver nanoparticles, given that there has not been a documented bacterial adaptation strategy that could give them resistance to Ag NPs. The purpose of this study is to find how the water-stable silver nanoparticles interact with different strains, including Gram negative and Gram-positive bacteria. The main objectives of our research were to synthesize and characterize water stable silver nanoparticles and test their potential bactericidal activity. We synthesized our Ag NPs using sodium citrate as a reducing agent. After synthesizing the nanoparticles, their optical properties were characterized by Ultraviolet-visible spectroscopy (UV-Vis); crystalline structure was evaluated with Electron Diffraction (ED) and X-Ray Diffraction (XRD); morphology was assessed by High Resolution Transmission Electron Microscopy (HR-TEM). Fourier Transform Infra-Red Spectroscopy (FT-IR) was used to indicate functional groups involved in the nanoparticle capping. Cultures were prepared with agarose and inoculated with the following bacterial strains: Bacillus cereus (Gram +), Micrococcus luteus (Gram +), Staphylococcus aureus (Gram +), Escherichia coli (Gram -), Citrobacter freundii (Gram -), Enterobacter aerogenes (Gram -), Klebsiella pneumoniae (Gram -), Proteus mirabilis (Gram -), Proteus vulgaris (Gram -) and Serratia marcescens (Gram -). Preliminary tests showed an inhibition diameter that surpassed 1.0 cm in all bacterial strains. We expect our Ag NPs to have a potential antibacterial activity towards all types of bacteria, due to oxidation of silver (Ag0 to Ag+).
The aim of the current study was to examine the heterogeneity of functional outcomes in first episode psychosis (FEP) patients and related clinical, neurocognitive and sociodemographic factors using a cluster analytic approach.
Method
A large sample of FEP patients (N = 209) was functionally reassessed 10 years after the first contact with an early intervention service. Multiple baseline, 3-year and 10-year follow-up variables were explored.
Results
The cluster analysis emphasized the existence of six independent clusters of functioning: one cluster was normal overall (42.16%), two clusters showed moderate interpersonal (9.63%) or instrumental (12.65%) deficits, two clusters showed more severe interpersonal (12.05%) or interpersonal and instrumental (13.85%) deficits and there was a significantly overall impaired cluster (9.63%). Cluster comparisons showed that several baseline and follow-up factors were differentially involved in functional outcomes.
Conclusions
The current study demonstrated that distinct clusters of functioning in FEP patients can be identified. The fact that a variety of profiles was observed contributes to a better understanding of the nature of the heterogeneity characterizing FEP patients and has clinical implications for developing individualized treatment plans.
Earthquakes may lead to a reaction to severe stress and adjustment disorders (RSSAD). On September 7, 19, and 23, 2017, Mexico was struck by many severe earthquakes. The aim of this study was to examine whether there was an increase in the number of consultations and RSSAD in a psychiatric emergency department in Mexico City after these earthquakes.
Methods
We studied retrospectively the diagnosis and triage assessment from a Mexican psychiatric emergency department database from September 1 to November 30, 2017, and analyzed RSSAD and the number of consultations after the earthquakes.
Results
A total of 1,811 psychiatric emergency consultations were registered from the period of study. A total of 141 consultations represented RSSAD. There was a significant increase of RSSAD after the September 23, 2017, earthquake. The triage assessment revealed that the urgency of the consultations was higher immediately after the earthquakes.
Conclusion
Natural disasters, such as earthquakes, may trigger diverse RSSAD leading to increased emergency consultations, especially when those disasters are repetitive. Mental health professionals should be adequately trained and sensitized for possible acute disaster victims. (Disaster Med Public Health Preparedness. 2019;13:686–690).
This research evidences the impact of Materials Science and Engineering Clubs as an outreach effort to expand the education and training required for a competitive Nanotechnology workforce beyond traditional STEM areas. An engineering perception questionnaire was implemented as a pre-test/post-test to track student perceptions and goals throughout the academic year to identify trends amongst gender and school level groups. Findings (107 students) show a perceived increase in student knowledge and interest for different fields of study, based on pre/post-test responses, with differences amongst gender and school level groups (middle school and high school). Also, significant differences in students’ aspirations for higher education degree were found among school level and gender. Results show that over 20% of participants increased their aspirations to higher education degrees and their interests in pursuing STEM degrees at end of the academic year. Specific findings on engineering perceptions and perceived level of knowledge and interest in science, engineering, materials, and nanotechnology as a result of club participation and student’s educational aspirations, expectations and future study plans are discussed along with implications for future STEM education.