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OBJECTIVES/GOALS: To develop feasible screening methods for activity of the enzyme Glucose-6-phosphate dehydrogenase (G6PD) with point of care applicability. METHODS/STUDY POPULATION: Current knowledge establishes the relevance of G6PD as a critical therapeutic determinant for effective antimalarial therapy due to the occurrence of mutations that lead to post-treatment severe adverse effects. We present our findings on development of cost effective point-of-care screening methodologies to ascertain G6PD deficiency. RESULTS/ANTICIPATED RESULTS: Using Patient Cohort Explorer and data from the Department of Pathology, we established the prevalence of G6PD deficiency at the University of Mississippi Medical Center, Jackson, MS as high as 11.8% (African-American males in all population, n = 2518). Next, for selection of potential target groups, we set up a protocol for recruitment of volunteers based on ethnic background, parental ethnicity, and medical history. G6PD activity was evaluated using point of care methods [Trinity Biotech test or CareSTART Biosensor], and Gold Standard quantitative spectrophotometric assay (LabCorp). Determinations in >20 subjects have showed comparable concordance. If used with a conservative interpretation of the signal, the Trinity Biotech test showed superior potential for use in the field relative to the CareSTART Biosensor. DISCUSSION/SIGNIFICANCE OF IMPACT: We established the prevalence of G6PD deficiency in our medical center. We have also setup tests for point-of-care assessment of G6PD. Pending evaluation of the relative tests performance, we will be in position to screen individuals and select them for a prospective clinical trial to evaluate the safety of antimalarial agents on scope of G6PD deficiency.
Hypocalcaemia is the most common complication after total or completion thyroidectomy. This study assesses recent evidence on predictive factors for post-thyroidectomy hypocalcaemia in order to identify the patients affected and aid prevention.
Two authors independently assessed articles and extracted data to provide a narrative synthesis. This study was an updated systematic search and narrative review regarding predictors of post-thyroidectomy hypocalcaemia using the Ovid Medline, Embase, Cochrane and Cinahl databases. Results were limited to papers published from January 2012 to August 2019.
Sixty-three observational studies with a total of 210 401 patients met the inclusion criteria. The median incidence was 27.5 per cent for transient biochemical hypocalcaemia, 12.5 per cent for symptomatic hypocalcaemia and 2.2 per cent for permanent hypocalcaemia. The most frequent statistically significant predictor of hypocalcaemia was peri-operative parathyroid hormone level. Symptomatic hypocalcaemia and permanent hypocalcaemia were seen more frequently in patients undergoing concomitant neck dissection.
Many factors have been studied for their link to post-thyroidectomy hypocalcaemia, and this study assesses the recent evidence presented in each case.
Evidence indicates that Antarctic minke whales (AMWs) in the Ross Sea affect the foraging behaviour, especially diet, of sympatric Adélie penguins (ADPEs) by, we hypothesize, influencing the availability of prey they have in common, mainly crystal krill. To further investigate this interaction, we undertook a study in McMurdo Sound during 2012–2013 and 2014–2015 using telemetry and biologging of whales and penguins, shore-based observations and quantification of the preyscape. The 3D distribution and density of prey were assessed using a remotely operated vehicle deployed along and to the interior of the fast-ice edge where AMWs and ADPEs focused their foraging. Acoustic surveys of prey and foraging behaviour of predators indicate that prey remained abundant under the fast ice, becoming successively available to air-breathing predators only as the fast ice retreated. Over both seasons, the ADPE diet included less krill and more Antarctic silverfish once AMWs became abundant, but the penguins' foraging behaviour (i.e. time spent foraging, dive depth, distance from colony) did not change. In addition, over time, krill abundance decreased in the upper water column near the ice edge, consistent with the hypothesis (and previously gathered information) that AMW and ADPE foraging contributed to an alteration of prey availability.
We previously reported an association of Dysbindin gene (DTNBP1) variants with Bipolar Disorder I (BPI) patients (Pae, C. U., A. Serretti, et al. (2006)). This paper extends previous results investigating the possible role of DTNBP1 variants on response to acute mood stabilizer treatment. Moreover, we recently reported positive association results of heat-shock -70 family proteins (HSP70) and genetic variations and antidepressant response (Pae, C. U., A. Serretti, et al. (2007)). Since evidence stands for a possible involvement of chaperone activity in Bipolar Disorder pathophysiology, a pharmacogenetic approach was used to investigate the role of HSP70 on acute antimanic effect. A sample of 45 BPI were treated for an average of 36.52 (±19.87) days with mood stabilizers (lithium, valproate, carbamazepine), evaluated using the Clinical Global Impression (CGI) scale and the Young Mania Rating Scale (YMRS) and genotyped for their DTNBP1 variants (rs3213207 A/G, rs1011313 C/T, rs2005976 G/A, rs760761 C/T and rs2619522 A/C) and HSP70 variants (rs2227956 C/T, rs2075799 A/G, rs1043618 C/G, rs562047 C/G, rs539689 C/G). No association was found between the investigated variations and response to mood stabilizer treatment even considering possible stratification factors. The small number of subjects is an important limitation to our study, nonetheless, Dysbindin and HSP 70 seem not to be involved in acute antimanic efficacy.
No evidence-based therapy for borderline personality disorder (BPD) exhibits a clear superiority. However, BPD is highly heterogeneous, and different patients may specifically benefit from the interventions of a particular treatment.
From a randomized trial comparing a year of dialectical behavior therapy (DBT) to general psychiatric management (GPM) for BPD, long-term (2-year-post) outcome data and patient baseline variables (n = 156) were used to examine individual and combined patient-level moderators of differential treatment response. A two-step bootstrapped and partially cross-validated moderator identification process was employed for 20 baseline variables. For identified moderators, 10-fold bootstrapped cross-validated models estimated response to each therapy, and long-term outcomes were compared for patients randomized to their model-predicted optimal v. non-optimal treatment.
Significant moderators surviving the two-step process included psychiatric symptom severity, BPD impulsivity symptoms (both GPM > DBT), dependent personality traits, childhood emotional abuse, and social adjustment (all DBT > GPM). Patients randomized to their model-predicted optimal treatment had significantly better long-term outcomes (d = 0.36, p = 0.028), especially if the model had a relatively stronger (top 60%) prediction for that patient (d = 0.61, p = 0.004). Among patients with a stronger prediction, this advantage held even when applying a conservative statistical check (d = 0.46, p = 0.043).
Patient characteristics influence the degree to which they respond to two treatments for BPD. Combining information from multiple moderators may help inform providers and patients as to which treatment is the most likely to lead to long-term symptom relief. Further research on personalized medicine in BPD is needed.
Especially medical students set high academic standard, and try hard to achieve because they are requested to studying medicine perfectly. Multidimensional perfectionism scale (MPS) is used to measure perfectionism in medical student. The purpose of the present study was to investigate the relationships between stress and various factors including perfectionism.
We enrolled 159 medical students from University of Ulsan college of Medicine. We used the Medical Stress scale (MSS), the Multidimensional Perfectionism Scale(MPS), the patient health questionnaire-9(PHQ-9), the academic motivation scale (AMS), the insomnia severity scale(ISS), and The revised neo personality inventory.
To analyze data, we used Pearson's correlation and logistic regression analysis. In the first step- Pearson's correlation analysis, a motivation, PHQ-9, ISI, perfectionism and neuroticism traits of NEO-PI significantly correlated with stress level (P < 0.001). In the second step, logistic regression analysis indicated that students who feel high level of academic stress (MSS score ≥ 28) are also related to a motivation, insomnia, perfectionism and neuroticism traits of NEO-PI (R2 = 0.389, P < 0.05).
Student who tend to be perfect feel more academic stress. The high level of stress related to insomnia and a motivation in medical student. Moreover, personality trait also can influences their psychological stress level.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Evidence suggests a relationship between exposure to trauma and higher levels of symptoms and poorer functional outcomes in early psychotic patients (EPP). However, the impact of the age at the time of exposure to trauma in this association is as yet unknown.
To examine the potential differential impact of trauma, according to age at the time of exposure, on the level of functioning and on the psychopathological profile of EPP followed-up prospectively.
Two hundred and fifty-five EPP aged 18–35 were followed-up prospectively over 36 months. Patients who had faced at least one experience of abuse or neglect were classified according to age at the time of first exposure (early-trauma: before age 12; late-trauma: between age 12 and 16), and then compared with unexposed patients (non-trauma). The level of symptoms was assessed using the Positive and Negative Syndrome Scale. The Young Mania Rating Scale, and the Montgomery-Asberg Depression Rating Scale. The level of functioning was assessed with the global assessment of functioning.
Comparisons over the 3 years of treatment with non-trauma patients revealed that:
– late-trauma patients only showed more negative symptoms (P = 0.029) as compared to non-trauma patients.
The age at the time of exposure to trauma has a modulating effect on its impact on symptoms and functional outcome in EPP and it should be systematically examined in clinical and experimental settings.
Disclosure of interest
The authors have not supplied their declaration of competing interest.