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There is controversy regarding whether the addition of cover gowns offers a substantial benefit over gloves alone in reducing personnel contamination and preventing pathogen transmission.
Simulated patient care interactions.
To evaluate the efficacy of different types of barrier precautions and to identify routes of transmission.
In randomly ordered sequence, 30 personnel each performed 3 standardized examinations of mannequins contaminated with pathogen surrogate markers (cauliflower mosaic virus DNA, bacteriophage MS2, nontoxigenic Clostridioides difficile spores, and fluorescent tracer) while wearing no barriers, gloves, or gloves plus gowns followed by examination of a noncontaminated mannequin. We compared the frequency and routes of transfer of the surrogate markers to the second mannequin or the environment.
For a composite of all surrogate markers, transfer by hands occurred at significantly lower rates in the gloves-alone group (OR, 0.02; P < .001) and the gloves-plus-gown group (OR, 0.06; P = .002). Transfer by stethoscope diaphragms was common in all groups and was reduced by wiping the stethoscope between simulations (OR, 0.06; P < .001). Compared to the no-barriers group, wearing a cover gown and gloves resulted in reduced contamination of clothing (OR, 0.15; P < .001), but wearing gloves alone did not.
Wearing gloves alone or gloves plus gowns reduces hand transfer of pathogens but may not address transfer by devices such as stethoscopes. Cover gowns reduce the risk of contaminating the clothing of personnel.
Abnormalities in the semantic and syntactic organization of speech have been reported in individuals at clinical high-risk (CHR) for psychosis. The current study seeks to examine whether such abnormalities are associated with changes in brain structure and functional connectivity in CHR individuals.
Automated natural language processing analysis was applied to speech samples obtained from 46 CHR and 22 healthy individuals. Brain structural and resting-state functional imaging data were also acquired from all participants. Sparse canonical correlation analysis (sCCA) was used to ascertain patterns of covariation between linguistic features, clinical symptoms, and measures of brain morphometry and functional connectivity related to the language network.
In CHR individuals, we found a significant mode of covariation between linguistic and clinical features (r = 0.73; p = 0.003), with negative symptoms and bizarre thinking covarying mostly with measures of syntactic complexity. In the entire sample, separate sCCAs identified a single mode of covariation linking linguistic features with brain morphometry (r = 0.65; p = 0.05) and resting-state network connectivity (r = 0.63; p = 0.01). In both models, semantic and syntactic features covaried with brain structural and functional connectivity measures of the language network. However, the contribution of diagnosis to both models was negligible.
Syntactic complexity appeared sensitive to prodromal symptoms in CHR individuals while the patterns of brain-language covariation seemed preserved. Further studies in larger samples are required to establish the reproducibility of these findings.
For patients with methicillin-resistant Staphylococcus aureus (MRSA) colonization, a traditional fist-bump greeting did not significantly reduce MRSA transfer in comparison to a handshake. However, transfer was reduced with a modified fist bump that minimized the surface area of contact and when hand hygiene was performed before the handshake.
Patients with schizophrenia show a deficit in emotion recognition through facial expression and the low sense of familiarity may be a factor involved. However, the emotion facial expression in families of patients could be disturbed and be another factor related to the deficit in emotion recognition and in sense of familiarity in schizophrenia.
To assess the emotion facial expression in a sample of 21 families of patients with schizophrenia and families of healthy controls.
22 healthy volunteers, all of them professionals of mental health, were assessed with the Ekman Test of emotion recognition in unfamiliar people which was photographed by expressing the 6 Ekman’s basic emotions. The task was composed of 42 pictures, half of them from families of patients and the other half from families of healthy control.
Volunteers recognize worse emotions in relatives of patients than in relatives of control group and this difference was statistically significant (Wilcoxon W = -4.13; p = .001). The average of pictures correctly recognized from families of patients was lower than pictures from families of control group (54.28% vs. 82%).
The emotion facial expression in families of patients with schizophrenia seems worse than in families of healthy controls. It could be a factor involved in face emotion recognition deficit in schizophrenia.
To assess the psychometric properties of the Spanish version of the Index of Spouse Abuse (ISA), and validate it against external criteria of intimate partner violence (IPV).
A case control, transversal study was designed. Spanish version of the ISA was administered to 405 women (223 controls and 182 IPV cases). Spanish items weights were developed. Internal consistency was assessed through Cronbach's alfa, and factor structure by means of principal component analysis (PCA). Receiver operating characteristic (ROC) analysis was used to validate the ISA against external criteria.
PCA analysis yielded two factors that accounted the 69% of variance, and reproduced partially the original factors: physical (ISA-P) and non-physical (ISA-NP). Internal consistency coefficients oscillated between 0,88 and 0,98. For the ISA global score, the AUC value for detecting IPV was 0,99; and 0,89 for detecting physical IPV. The optimal cut-off scores were 13 for detecting IPV, and 15 for detecting physical IPV. For the ISA subscales, 6 was the optimal cut-off score for the ISA-P, and 13 was the optimal cut-off for the ISA-NP.
The Spanish version of the ISA is a valid and reliable instrument for detecting and measuring the intensity of the IPV in Spanish women population.
Patients with schizophrenia show a deficit in emotion recognition through facial expression. Familiarity means the implicit memory of past affective experiences and it involves fast cognitive processes and it is triggered by certain signals.
To assess the emotion recognition in familiar and unfamiliar faces in a sample of schizophrenic patients and healthy controls.
18 outpatients diagnosed with schizophrenia (DSM-IVTR) and 18 healthy volunteers were assessed with the Ekman Test of emotion recognition in unfamiliar faces. In addition each subject was accompanied by 4 familiar people (parents, siblings or friends), which was photographed by expressing the 6 Ekman’s basic emotions.
Schizophrenic patients recognize worse emotions in their relatives than in neutral faces, a greater extent than controls (Mann-Whitney U = 81, p = .01). The patient group showed a mean score on the Ekman test (neutral faces) lower than control group (16 (SD 2.38) versus 17.82 (2.13; U p = 0.03). Regarding familiar faces, the group patients showed a worse performance than the control group (13.22 (3.8) versus 17.18 (2.82); U p = 0.00). In both tests, the highest number of errors was with emotions of anger and fear. The patients group showed a lower level of familiarity and emotional valence to their families (U = 33, p < 0.01).
The sense of familiarity may be a factor involved in face emotion recognition and it may be disturbed in schizophrenia.
Major depressive disorder is a serious mental disorder with high prevalence and recurrence rate. Once depression is diagnosed, effective pharmacological treatments must be rapidly initiated. Depression etiology and responsiveness to antidepressants have been related to the activity of the hypothalamic-pituitary-adrenal (HPA) axis. Depressed subjects do not respond equally to the same drug. This variability could be explained by interindividual genetic differences related to HPA axis, including CRHR1 receptor.
To associate the salivary cortisol levels, prior to antidepressant treatment, and the CRHR1 rs242939 polymorphism with the response to therapy with fluoxetine.
We performed a pharmacogenetic prospective longitudinal study including clinic follow-up, endocrine and genetic evaluations. After diagnosis, patients started the pharmacotherapy. the severity of the disease and clinical response were evaluated by the Hamilton Depression Rating Scale (HAM-D). Rapid and slow responses were considered as reductions in the HAM-D scores of at least 50% at the third and eight weeks respectively.
157 patients were recruited. Salivary cortisol levels at 8:00AM were lower in rapid responders than in not responders (p-value = 0.0122). No differences were observed after eight weeks of treatment. the rs242939 polymorphism was in Hardy Weinberg equilibrium (p = 0,24) and was significantly associated with early response (p = 0.019). there was no association after two month of therapy.
Discussion and conclusions:
Alterations in the CRHR1 receptor may significantly impact the regulation of stress response. the association observed in this study may be related with some refractoriness in the regulation of CRHR1 gene in non responders.
Emergency situations related to mental disorders represent a significant proportion of all medical emergencies. Over the last years we have been witness to an upturn in the incidence of psychiatry emergency service because to change of mood.
To determine the profile of the patient who requires psychiatric attention with changing of mood in our area in different seasons.
This is a prevalence and prospective study in which the dependent variable is taken as change of mood and we also use three more independent variables that are age sex and seasonality. The seasonality (spring period and summer period) will be at the same time the form of divided the population in two groups to compare.
Out of all the consultations for changing of mood in the emergency service during the first period (113 patients), 34% were men and 66% were women. The age range of 36–50 years was more frequent for women and the age range of 51–65 years was more frequent for men. in the second period (with 162 patients), 137 women (86%) and 25 men (14%). in this case, the most common age range was 36–50 years, both for women and for men.
The epidemiological and clinical characteristics of patients with changing of mood assessed by the emergency service are described from a naturalistic approach.
Which Chi2 we will discover if the population who has been taken between woman and man is significant and with the median, we will also determine if the age ranges are enough significant to confirm our hypothesis.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Involuntary admissions continue to be a controversial topic in psychiatry. However, it is well known that psychosocial rehabilitation treatment is more successful when the patient is involved in it improving awareness and adherence to treatment.
This study examined admissions patterns, including voluntary, involuntary, and partly voluntary admissions to a subacute psychiatric hospital.
This is a transversal study. All patients admitted for a medium-term psychiatric treatment since 01/06/2014 to 30/11/2015 were included. Patients's basic sociodemographic and clinical data were collected and compiled in a database. Descriptive statistics were performed using SPSS Software.
A total of 88 patients (52% men; mean age: 48.6 years) composed the sample. In 58% of cases, schizophrenia and schizoaffective disorder were the diagnoses motivating the admission. Among 88 patients, 44 (50%) had voluntary admissions, 16 (18.2%) had involuntary admissions, 27 (30.7%) had partly voluntary admissions and just one patient (1.1%) had partly involuntary admissions. Seventy-one (80.1%) patients had voluntary admissions at discharge, and only one of them escape from hospital and did not finish the treatment.
In the short term involuntary hospitalization has benefits, however also can have adverse long-term consequences for the patient-therapist allegiance, breaking the psychotherapeutic relationship and making the patient abandon treatment. It's important to reassess the condition of admission and work with the patient the need to engage in treatment.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Several studies report that Clozapine is more effective in reducing symptoms of schizophrenia, producing clinically meaningful improvements and postponing relapse than other antipsychotic strategies.
To analyze the prescription of Clozapine in a sample of 88 inpatients admitted to a subacute psychiatric hospitalization unit.
This is a transversal study. All patients admitted for a medium-term psychiatric treatment since 01/06/2014 to 30/11/2015 were included. Data about socio-demographical status and clinical situation were obtained and compiled in a database. This study compares patients receiving clozapine treatment with those who receive other psychopharmacologic treatment. Statistics were performed using SPSS Software.
Eighty-eight patients (52% men; mean age: 48.6 years) composed the sample. In 58% of cases, schizophrenia and schizoaffective disorder were the diagnoses motivating the admission. Within the 51 patients with Schizophrenia o Schizoaffective Disorder, 16 of them (31.4%) received Clozapine. Comparing clozapine group vs non-clozapine group, there were no significant differences between the groups in terms of sex, civil state or working state. Instead, Clozapine group patients were older, had a major number of previous hospitalization admissions and had a larger trajectory of their disorder.
Patients requiring treatment with Clozapine had a major number of hospital admissions and had more often committed suicide attempts, suggesting a more severe course of the disorder. They were older than the non-clozapine group. Clozapine is delayed in its use among resistant-treatment patients. It is worth highlighting that only 16 cases of Schizophrenia inpatients received Clozapina. It could mean that Clozapine is underprescribed.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Ichthyosporean parasites (order Dermocystida) can cause morbidity and mortality in amphibians, but their ecology and epidemiology remain understudied. We investigated the prevalence, gross and histologic appearance, and molecular phylogeny of a novel dermocystid in the state-endangered silvery salamander (Ambystoma platineum) and the co-occurring, non-threatened small-mouthed salamander (Ambystoma texanum) from Illinois. Silvery salamanders (N = 610) were sampled at six ephemeral wetlands from 2016 to 2018. Beginning in 2017, 1–3 mm raised, white skin nodules were identified in 24 silvery salamanders and two small-mouthed salamanders from five wetlands (prevalence = 0–11.1%). Skin biopsy histology (N = 4) was consistent with dermocystid sporangia, and necropsies (N = 3) identified infrequent hepatic sporangia. Parasitic 18S rRNA sequences (N = 5) from both salamander species were identical, and phylogenetic analysis revealed a close relationship to Dermotheca viridescens. Dermocystids were not identified in museum specimens from the same wetlands (N = 125) dating back to 1973. This is the first report of Dermotheca sp. affecting caudates in the Midwestern United States. Future research is needed to determine the effects of this pathogen on individual and population health, and to assess whether this organism poses a threat to the conservation of ambystomatid salamanders.
All livestock animal species harbour complex microbial communities throughout their digestive tract that support vital biochemical processes, thus sustaining health and productivity. In part as a consequence of the strong and ancient alliance between the host and its associated microbes, the gut microbiota is also closely related to productivity traits such as feed efficiency. This phenomenon can help researchers and producers develop new and more effective microbiome-based interventions using probiotics, also known as direct-fed microbials (DFMs), in Animal Science. Here, we focus on one type of such beneficial microorganisms, the yeast Saccharomyces. Saccharomyces is one of the most widely used microorganisms as a DFM in livestock operations. Numerous studies have investigated the effects of dietary supplementation with different species, strains and doses of Saccharomyces (mostly Saccharomyces cerevisiae) on gut microbial ecology, health, nutrition and productivity traits of several livestock species. However, the possible existence of Saccharomyces which are indigenous to the animals’ digestive tract has received little attention and has never been the subject of a review. We for the first time provide a comprehensive review, with the objective of shedding light into the possible existence of indigenous Saccharomyces of the digestive tract of livestock. Saccharomyces cerevisiae is a nomadic yeast able to survive in a broad range of environments including soil, grass and silages. Therefore, it is very likely that cattle and other animals have been in direct contact with this and other types of Saccharomyces throughout their entire existence. However, to date, the majority of animal scientists seem to agree that the presence of Saccharomyces in any section of the gut only reflects dietary contamination; in other words, these are foreign organisms that are only transiently present in the gut. Importantly, this belief (i.e. that Saccharomyces come solely from the diet) is often not well grounded and does not necessarily hold for all the many other groups of microbes in the gut. In addition to summarizing the current body of literature involving Saccharomyces in the digestive tract, we discuss whether the beneficial effects associated with the consumption of Saccharomyces may be related to its foreign origin, though this concept may not necessarily satisfy the theories that have been proposed to explain probiotic efficacy in vivo. This novel review may prove useful for biomedical scientists and others wishing to improve health and productivity using Saccharomyces and other beneficial microorganisms.
Starburst galaxies at z ∼ 2 – 4 are among the most intensely star-forming galaxies in the universe. The way they accrete their gas to form stars at such high rates is still a controversial issue. ALMA has detected the CH+ (J = 1-0) line in emission and/or absorption in all the gravitationally lensed starburst galaxies targeted so far at z ∼ 3. Its unique spectroscopic and chemical properties enable CH+ to highlight the sites of most intense dissipation of mechanical energy. The absorption lines reveal highly turbulent, massive reservoirs of low-density molecular gas. The broad emission lines, arising in myriad UV-irradiated molecular shocks, reveal powerful galactic winds. The CH+ lines therefore probe the fate of prodigious energy releases, due to infall and/or outflows, and primarily stored in turbulence before being radiated by cool molecular gas. The turbulent reservoirs act as mass and energy buffers over the duration of the starburst phase.