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Methane (CH4) is a greenhouse gas (GHG) produced and released by eructation to the atmosphere in large volumes by ruminants. Enteric CH4 contributes significantly to global GHG emissions arising from animal agriculture. It has been contended that tropical grasses produce higher emissions of enteric CH4 than temperate grasses, when they are fed to ruminants. A number of experiments have been performed in respiration chambers and head-boxes to assess the enteric CH4 mitigation potential of foliage and pods of tropical plants, as well as nitrates (NO3−) and vegetable oils in practical rations for cattle. On the basis of individual determinations of enteric CH4 carried out in respiration chambers, the average CH4 yield for cattle fed low-quality tropical grasses (>70% ration DM) was 17.0 g CH4/kg DM intake. Results showed that when foliage and ground pods of tropical trees and shrubs were incorporated in cattle rations, methane yield (g CH4/kg DM intake) was decreased by 10% to 25%, depending on plant species and level of intake of the ration. Incorporation of nitrates and vegetable oils in the ration decreased enteric CH4 yield by ∼6% to ∼20%, respectively. Condensed tannins, saponins and starch contained in foliages, pods and seeds of tropical trees and shrubs, as well as nitrates and vegetable oils, can be fed to cattle to mitigate enteric CH4 emissions under smallholder conditions. Strategies for enteric CH4 mitigation in cattle grazing low-quality tropical forages can effectively increase productivity while decreasing enteric CH4 emissions in absolute terms and per unit of product (e.g. meat, milk), thus reducing the contribution of ruminants to GHG emissions and therefore to climate change.
This work presents updates in the diagnostics systems, magnetohydrodynamics (MHD) calculations and simulations of microwave heating scenarios of the small modular Stellarator of Costa Rica 1 (SCR-1). Similarly, the design of a flexible bolometer and magnetic diagnostics (a set of Mirnov coils, Rogowski coils and two diamagnetic loops) are introduced. Furthermore, new MHD equilibrium calculations for the plasma of the SCR-1 device were performed using the VMEC code including the poloidal cross-section of the magnetic flux surfaces at different toroidal positions, profiles of the rotational transform, magnetic well, magnetic shear and total magnetic field norm. Charged particle orbits in vacuum magnetic field were computed by the magnetic field solver BS-SOLCTRA (Vargas et al. In 27th IAEA Fusion Energy Conference (FEC 2018), 2018. IAEA). A visualization framework was implemented using Paraview (Solano-Piedra et al. In 23rd IAEA Technical Meeting on the Research Using Small Fusion Devices (23rd TM RUSFD), 2017) and compared with magnetic mapping results (Coto-Vílchez et al. In 16th Latin American Workshop on Plasma Physics (LAWPP), 2017, pp. 43–46). Additionally, simulations of microwave heating scenarios were performed by the IPF-FDMC full-wave code. These simulations calculate the conversion of the ordinary waves to extraordinary waves and allow us to identify the location where the conversion takes place. Finally, the microwave heating scenarios for the $330^{\circ }$ toroidal position are presented. The microwave heating scenarios showed that the O–X–B mode conversion is around 12–14 %. It was possible to identify the spatial zone where the conversion takes place (upper hybrid frequency).
Two studies to date have been published regarding the prevalence of the metabolic syndrome in bipolar patients. The unadjusted prevalence rates reported were 30% and 32%. The aim of this study was to evaluate the prevalence of the metabolic syndrome in a group of 142 bipolar patients from Spain.
Methods:
Bipolar patients (ICD-10 criteria) from 11 centres in Spain were assessed cross-sectionally for metabolic syndrome according to the NCEP ATP III criteria.
Results:
The mean age was 47.3 (SD 14.5), 51.1% were male. On average, patients were receiving 2.8 (SD 1.3) drugs for the treatment of their bipolar disorder. Ninety-one percent were receiving mood stabilizers, 63.4% antipsychotics and 29.6 antidepressants. Eighty-seven percent of the antipsychotics prescribed were atypicals. The overall prevalence of metabolic syndrome in our sample was 24.6% Fifty-seven percent of the sample met the criterion for abdominal obesity, 37.4% for met the criterion for hypertriglyceridemia, 36.4% for low HDL-cholesterol, 25.2% for high blood pressure and 12.5% for high fasting glucose. No statistically significant difference was found between with and without the metabolic syndrome for gender, illness status (acute versus in remission), CGI-S-BP scores and number of medications used. Patients taking tow mood stabilizers had significantly higher metabolic syndrome rates than patients taking one mood stabilizer and than patients without mood stabilizer treatment (40% versus 17.8% and 11.1% respectively, p .02).
Conclusions:
The prevalence of the metabolic syndrome in bipolar patients is high. It appears to be higher than that estimated for the Spanish general population.
The prevalence of mood disorders (anxiety and depression) during pregnancy seems to be similar to the women of the same group without pregnancy. Women with recurrent depression and euthimic women who discontinued antidepressants medication during pregnancy are particularly at high risk for depressive illness. Data about perinatal effects of SSRI antidepressants are gradually accumulating and are controversial. Two meta-analyses and some controlled studies don't find increased risk for major malformations in SSRI-exposed newborn. However, other studies find an increased risk of congenital malformations, poor birth outcomes and neonatal complications.
Neonatal morbidity in infant newborn of women treated with antidepressant drugs.
We examine the relation between the pharmacological treatment of the maternal anxiety/depression during the pregnancy and acute morbidity in infant newborns.
Materials and Methods
Study group of 66 infant newborn of pregnant women with a diagnoses of major depressive episode or defined anxiety disorders according to DSM-IV, who were in treatment with antidepressant drugs during pregnancy. Control group: 120 newborn of healthy pregnant women, who did not receive any treatment, and were contemporary of the same gestational age and sex. Criteria of exclusion: demonstrated toxic consumption (alcohol, cocaine, cannabis, opiates, drug of synthesis). Studied variables: Type of childbirth and analgesia; weight and age of gestation; pH of umbilical artery and Apgar test; presence of malformations; morbidity; feeding; withdrawal syndrome.
Results
Infant newborn of mothers exposed to the antidepressant treatment suffered from more pathology than those of the control group (16/66 vs. 14/114; 24.2% vs.12.3%; p=0.038). Two smaller malformations in the study group were observed, a preauricular appendix (group A) and one moderate pielocilicilar ectasy (group C), both in mothers who received paroxetine (2/60; 3.3% vs. 0/114; 0%, p=0.05, Fisher p=0.118, NS). Only one infant newborn displayed compatible clinical signs with moderate withdrawal syndrome (irritability, vomits) from a mother treated with venlafaxine. No case of convulsions was observed. Breast feeding was less frequent in the group of antidepressant treated mothers (38/66, 57.6% vs. 86/116, 74,1%, p=0.032).
Conclusions
The treatment with antidepressant drugs during pregnancy is necessary for some women. The clinician must weigh the relative risks of various treatment options and take into account individual patient wishes. Although the antidepressant drugs suppose an increased risk for the newborn, it could be assumable for the benefit that represents maintain the mother in an euthimic situation.
We propose to discuss the clinical management, as well as, the accuracy of the psychiatric and obstetric controls to minimize the neonatal complications.
Borderline personality disorder (BPD) is believed to be frequent among adolescents. While several prospective studies have assessed the use of mental health services among adults who suffer from BPD, few studies have provided adolescent data. This paper presents findings from the first assessment point of the European Research Network on Borderline Personality Disorder (EURNET BPD) study. In this study, we described treatment utilization of 85 adolescents with BPD (M = 16.5 years old). In line with adult findings, patients with BPD reported greater mental healthcare service use (outpatient: 98%; inpatient: 79%) compared to controls. Phenothiazine, a sedative neuroleptic, was the most frequently prescribed treatment. 47% of patients received psychotherapy; one-third of these patients received psychodynamic therapy. For all psychopathological variables, patients who received psychotherapy did not differ from those who did not receive psychotherapy; however, psychotherapy was more frequent among females. These data suggest that psychotherapy may be difficult to access for adolescents suffering from BPD, especially males.
The presence of mental illness in any of the parents can be a stressful factor in the child and be in certain way generator of disease. AIMS describe and quantify the psychiatric family history in patients who were consecutively referred to the outpatient department of children and adolescent psychiatry,mental health community center of collado villalba, Madrid
Material and method:
Obtain data of a series of cases filing a card of the 18-year-old minor patients who in September, October, November and December, 2007 come for the first time to our mental health community center.
Results:
The total number of patients were 114. There were psychiatric family history in 36,8% (N=42), the mother was or had been in psychiatric treatment in 28% (N=31)) of the cases, the father in 15% (N=17) and the brothers in 7 % (N=8), the most frequent diagnoses in mothers it were neurosis in 21 % (N=24), toxic abuse in 3,5% (N=4) and personality disorder in 1,8% (N=2), toxic abuse was the most frequent with 8,8% (N=10) in parents, followed by neurosis diagnosed in 4,4% (N=5), the most frequent diagnoses in brothers was the emotional disorder in 4,4,% (N=5). The mean age of parents was 41,34 (SE =6,34), in mothers was 38,43 (SE=6,59).
Conclusions:
We have to consider the existence of some kind of psychiatric family history in the therapeutic plan of the patient.
The prevalence of mood disorders (anxiety and depression) during pregnancy seems to be similar to the women of the same group without pregnancy. Women with recurrent depression and euthimic women who discontinued antidepressants medication during pregnancy are particularly at high risk for depressive illness. Data about perinatal effects of SSRI antidepressants are gradually accumulating and are controversial. Two meta-analyses and some controlled studies don't find increased risk for major malformations in SSRI-exposed newborn. However, other studies find an increased risk of congenital malformations, poor birth outcomes and neonatal complications.
Neonatal morbidity in infant newborn of women treated with antidepressant drugs. We examine the relation between the pharmacological treatment of the maternal anxiety/depression during the pregnancy and acute morbidity in infant newborns.
Material and Methods
Study group of 66 infant newborn of pregnant women with a diagnoses of major depressive episode or defined anxiety disorders according to DSM-IV, who were in treatment with antidepressant drugs during pregnancy. Control group: 120 newborn of healthy pregnant women, who did not receive any treatment, and were contemporary of the same gestational age and sex. Criteria of exclusion: demonstrated toxic consumption (alcohol, cocaine, cannabis, opiates, drug of synthesis). Studied variables: Type of childbirth and analgesia; Weight and age of gestation; pH of umbilical artery and Apgar test; Presence of malformations; Morbidity; Feeding; Withdrawal syndrome.
Results:
Infant newborn of mothers exposed to the antidepressant treatment suffered from more pathology than those of the control group (16/66 vs. 14/114; 24.2% vs.12.3%; p=0.038). Two smaller malformations in the study group were observed, a preauricular appendix (group A) and one moderate pielocilicilar ectasy (group C), both in mothers who received paroxetine (2/60; 3.3% vs. 0/114; 0%, p=0.05, Fisher p=0.118, NS). Only one infant newborn displayed compatible clinical signs with moderate withdrawal syndrome (irritability, vomits) from a mother treated with venlafaxine. No case of convulsions was observed. Breast feeding was less frequent in the group of antidepressant treated mothers (38/66, 57.6% vs. 86/116, 74,1%, p=0.032).
Conclusions:
The treatment with antidepressant drugs during pregnancy is necessary for some women. The clinician must weigh the relative risks of various treatment options and take into account individual patient wishes. Although the antidepressant drugs suppose an increased risk for the newborn, it could be assumable for the benefit that represents maintain the mother in an euthimic situation. We propose to discuss the clinical management, as well as, the accuracy of the psychiatric and obstetric controls to minimize the neonatal complications.
A prospective study in treatment-resistant schizophrenic patients was performed over 10 years to evaluate the therapeutic response to clozapine and the variables related to this treatment. Eighty schizophrenic and schizoaffective patients (according to Diagnostic and Statistical Manual [DSM]-IIIR criteria), considered as refractory (previously resistant to at least two different typical neuroleptics), were studied. The average dose of clozapine was 267 mg/d. The clinical variables considered were: Brief Psychiatric Rating Scale (BPRS), number of admissions before and after clozapine treatment and the Strauss-Carpenter scale as measures of efficacy; Premorbid Adjustment Scale (PAS), to assess personal and social adjustment before illness; Karolinska Personality Scale (KPS) to assess stable traits of personality; and the Simpson-Angus scale as a measure of extrapyramidal symptoms. Sixty percent of patients showed a significant improvement after clozapine treatment. Side-effects were mild and well tolerated, with no cases of haematological disturbance and only five withdrawals because of adverse events. The severity of the episode, according to BPRS score and anxiety as a personal trait, are related to good prognosis. Other relationships between improvement and clinical and demographic variables are discussed.
To carry out a cost-consequences analysis for 50mg-desvenlafaxine in the second-line outpatient treatment of major depressive disorder (MDD) from the payer (National Health System) perspective in Spain.
Methods
The model (Markov simulation) follows a cohort of MDD patients through 1 year after failure of first-line treatment with a SSRI and estimates outcome measures (% remission and depression-free days) accrued and costs incurred during outpatient treatment of MDD. Selected comparator is usual care (UC), which is assumed to be made of a mix of duloxetine and venlafaxine that make up the majority of the serotonin-norepinephrine reuptake inhibitor (SNRI) market in Spain. The model also considers drug treatment beyond the second-line of therapy (3rd and 4th-lines) in cases of patient discontinuation or lack of remission according with outcomes from STAR-D trial and other clinical trial published. The model generates outcomes and cost from the NHS in year 2014.
Results
Due to fewer discontinuations, desvenlafaxine was associated with numerically more depression-free days and a higher percentage of patients in remission versus UC: 1.7 days and 0.5% more in remission. Also, healthcare costs were lower with desvenlafaxine than with UC: €1,114 vs. €1,224 (-110€).
Conclusion
In patients who have not responded to a first-line SSRI therapy, desvenlafaxine-50mg was clinically similar in effectiveness but a less costly option, approximately 9% lower, compared with a weighted average of duloxetine and venlafaxine for the second-line treatment of MDD patients from a payer (NHS) perspective in Spain.
To model the cost and consequences of desvenlafaxine and venlafaxine in the second-line outpatient treatment of major depressive disorder (MDD) from the payer (National Health System) perspective in Spain.
Methods
The model (a Markov simulation) follows a cohort of MDD patients through 1 year after failure of first-line treatment with a Selective-Serotonin-Reuptake-Inhibitor (SSRI) and estimates outcome measures (% in remission and depression-free days) accrued and costs incurred during outpatient treatment of MDD. Selected comparator is venlafaxine because its actual generic price. The model also considers drug treatment switching beyond the second-line of therapy (3rd line) or changing to another drugs in 4th-line in cases of patient discontinuation or lack of remission according with outcomes from STAR-D trial. Efficacy of drugs was extracted from clinical trial published. The model generates outcomes and cost from the NHS in year 2014.
Results
Due to fewer discontinuations, desvenlafaxine was associated with numerically more depression-free days and a higher percentage of patients in remission versus venlafaxine: 1.7 days and 0.5% more in remission. Also, healthcare costs were a little bit lower with desvenlafaxine than with venlafaxine: €1,114 vs. €1,166 (-52€).
Conclusion
In patients who have not responded to a first-line SSRI therapy, desvenlafaxine-50mg was clinically similar in effectiveness but a less costly option (about 5% lower) compared with venlafaxine for the second-line treatment of MDD patients from a payer (NHS) perspective in Spain.
Resilience enables people to develop and regain mental health in the face of adversity, and is related to recovery. There are no current measures of resilience for Bipolar Disorder (BD).
Aims
To develop and validate a BD specific resilience measure, and examine relationships between resilience and recovery-related variables.
Objectives
(1) Describe the development and psychometric evaluation of the Spanish 23-item Resilience to Bipolar Disorder (RBD) questionnaire. (2) Test relationships between RBD scores and recovery-related variables in BD.
Method
The 41-item RBD questionnaire (developed based on prior qualitative research) was completed by 113 participants with BD, along with measures related to quality of life, functioning and recovery. Exploratory Factor Analysis (EFA) using Principal Axis Factoring with promax rotation was conducted to identify redundant items and underlying factors. Reliability and Confirmatory Factor Analysis (CFA) for the resulting factorial structure were assessed.
Results
EFA identified 23RBD items suitable for retention, structured within five factors. Cronbach αs were all satisfactory (all αs ≥ .76) at both subscale and total score level. Convergent validity was supported through positive correlations between RBDand the Resilience Scale-25. Additionally, the RBD correlated significantlywith quality of life, well-being, personal recovery, functional impairment and symptoms. CFA fit indexes supported the five factor structure of the RBD scale.
Conclusions
TheRBD is a reliable and valid measure of resilience in BD, being associated with measures related to quality of life, functioning and recovery, which is consistent with previous research in resilience and mental health in other psychiatric populations.
The oculomotor system is closely linked to the neural circuits of attention. Recent evidence shows a novel role for eye vergence in orienting visual attention.
Objectives
Identify patterns of attention disruption through eye vergence.
Aim
We investigated whether modulation in attention related eye vergence is disrupted in ADHD.
Methods
We measured eye vergence in children previously diagnosed with ADHD while performing a cue/no-cue task and compared the results to agematched controls.
Results
We observed a strong modulation in the angle of vergence in the control group but not in the ADHD group. In addition, in the control group the modulation in eye vergence was different between the cue and no-cue condition. This difference was absent in the ADHD group.
Conclusions
Our study supports the observation of deficient binocular vision in ADHD children. We argue that the observed disruption in eye vergence modulation in ADHD children is proof of a deficient cognitive processing of sensory information. Our work may provide new insights into attention disorders, like ADHD.
Little is known about medical students’ interest in their training on drug addiction, their personal experience of consumption and whether these aspects influence the detection of addiction in patients.
Objectives:
To study the interest of medical students enrolled on the psychiatry course in the area of addictions, and evaluate the influence of such interest, a history of personal consumption and gender on the detection of addiction in patients.
Aims&Methods:
Voluntary participation was offered to all students from academic years 2008–2009 to 2012–2013. Of the 505 potential students, 336 questionnaires were collected, of which 71.13% were female.
Results:
Of the respondents, 88.5% considered that drug dependence issues are important to their professional future and 63% that the approach to drug-related diseases is important. A total of 34% of the students had already assessed addicted patients in their previous clinical training. The students report consuming alcohol(69%), cigarettes(19.5%) and illegal drugs(15.8%). The female students consumed fewer illegal drugs than the men(p0.022) and more frequently considered that the list of topics to be covered was appropriate(p0.021). The male students consumed more illegal drugs more frequently(p 0.005), knew more consumers(p 0.023), and those who drink alcohol consumed more illegal drugs than women(p < 0.005). However, the men seemed to have assessed fewer addicted patients in their previous clinical experience(p0.094).
Conclusions:
Consumption among medical students may have a normalizing role on consumption and prevent the detection of addicts. It is important to educate and raise awareness on drugs, as this may influence detection. The focus should be particularly on the male group.
Legal and illegal drugs can cause psychotic symptoms, in cocaine-dependent patients the prevalence of these symptoms may reach 86% (Vorspan, 2012). It is estimated that 13–32% of cocaine-dependent patients have kinaesthetic hallucinations (Siegel, 1978; Mahoney, 2008; Roncero, 2012).
Objectives
To compare the prevalence of substance-induced psychotic symptoms and compare the use of welfare/social resources and social adjustment among cocaine-dependent patients (CD) and other substances dependences (OtherD).
Methods
Two hundred and six patients seeking treatment at the Addictions and Dual Diagnosis Unit of the Vall d’Hebron. Patients were assessed by ad hoc questionnaire designed to collect demographic data and psychotic symptoms associated with consumption, a record of the care/social resources used by the patient and the scale of social adaptation (SASS). A descriptive and bivariate analysis of the data was performed.
Results
CD were 47.1% vs. 52.9% OtherD (66.1% alcohol, 17.4% cannabis, 8.3% opioid, 8.3% benzodiazepines/other drugs). Of cocaine dependent-patients, 65.6% present psychotic symptoms vs. 32.1% for the OtherD. Different exhibiting psychotic symptoms are: self-referential (69.7% vs. 30.7%), delusions of persecution (43.4% vs. 12.2%), hallucinations (49.4% vs. 14.3%), auditory hallucinations (43.5% vs. 11.4%), visual hallucinations (30.4% vs. 5.7%) and kinaesthetic hallucinations (7.2% vs. 2.9%).
Cocaine-dependent patients significantly use more health care resources in reference addiction unit (76.3% vs. 62.4%, P:.035) and infectious diseases (22.7% vs. 5.5%, P:.000) and justice-related (50.5% vs. 26 resources 0.6%; P:1.001) and less resources and mental health (25.8% vs. 43.1%; P:.013).
Regarding social adaptation, no differences were found in the SASS. Kinaesthetic hallucinations do not appear to be related to a greater use of resources and in social adaptation.
References not available.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Mephedrone is a synthetic cathinone derivative included in the class of “New-Novel Psychoactive Substances”. Synthetic cathinones are marketed as “bath salts” or “plant food” and gained notable popularity for similar effects to 4-methylenedioxymethamphetamine (MDMA, ecstasy), or amphetamines. Mephedrone is commonly consumed simultaneously with alcohol.
Objectives and aims
The aim of the present study was to evaluate the interactions between mephedrone and ethanol in humans.
Methods
Twelve healthy male, recreational users of psychostimulants participated as outpatients in four experimental sessions. They received a single oral dose of mephedrone (200 mg) and alcohol (0.8 g/kg), mephedrone placebo and alcohol (0.8 g/kg), mephedrone (200 mg) and placebo alcohol, and both placebos. Design was double-blind, double-dummy, randomized, cross-over and controlled with placebo. Study variables included: vital signs (blood pressure, heart rate, temperature, and pupil diameter), subjective effects (visual analogue scales-VAS, ARCI-49 item short form, and VESSPA questionnaire).
Results
The combination produced an increase in the cardiovascular effects of mephedrone and induced more intense feeling of euphoria and well-being in comparison to mephedrone and alcohol. Mephedrone reduced the drunkenness and sedation produced by alcohol.
Conclusions
These results are similar to those obtained with the combination of other psychostimulants as amphetamines and MDMA. Abuse liability of the combination is greater that induced by mephedrone.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Shared decision-making denotes a structured process that encourages full participation by patient and provider in making complex medical decisions. There has been extensive and growing interest in its application to long-term illnesses but surprisingly not in severe psychiatric disorders, such as schizophrenia. However, the great majority of schizophrenics are capable of understanding treatment choices and making rational decisions. Although the main justification for shared decision-making is ethical, several randomized controlled trials support its effectiveness in improving the quality of decisions, but robust evidence in objective health outcomes is needed.
Aims and objectives
Of the study: to demonstrate the effectiveness, measured as treatment adherence and readmissions at 3, 6 and 12 months, of shared decision making in the choice of antipsychotic treatment at discharge.
Of the oral presentation: to present the study design; to make an interim report of the data obtained at the moment of the congress.
Methods
Randomized controlled trial, prospective, two parallel groups, not masked, comparing two interventions (shared decision making and treatment as usual). Study population: Inpatients diagnosed of schizophrenia and schizoaffective disorders (ICD-10/DSM-IV-R: F20 y F25) at Adult Acute Hospitalization Unit at Jerez General Hospital.
Results
Currently in the recruiting phase with 55 patients included in the study. An interim analysis of at least half of the target sample size.
Conclusions
We will show the study design and decision tools employed. Conclusions in relation to the effectiveness (adherence and readmissions) and subjective perception.
Disclosure of interest
The authors have not supplied their declaration of competing interest.