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Musical hallucinations are a rare phenomenon in clinical practice. The purpose of this study was to analyze the clinical spectrum of musical hallucinations.
We analysed demographic and clinical features of cases published in English, Italian, French or Spanish between 1991 and 2006 registered in MEDLINE, including three of our own cases. The cases were separated into four groups according to their main diagnoses (hearing impairment; psychiatric disorder; neurological disorder; toxic or metabolic disorder).
115 patients with musical hallucinations were included, of which 63.5% were female. The mean age was 57,25 years. Main diagnoses were: psychiatric disorder (46.1%; schizophrenia 30.4%), neurological disorder (21,7%), hearing impairment (17,4%), toxic or metabolic disorder (12.2%) and 2.6% other diagnoses.
61.7% patients presented simple diagnoses while 36.5% presented two or more diagnoses. 2.1% of patients didn't receive any diagnoses. 35.7% of patients and 60.9% of non psychiatric patients presented hearing impairment.
Both instrumental and vocal were the more frequent musical hallucinations and most of the patients had insight about the abnormality of their perceptions. Another kind of hallucinations was present in 40.9% of patients, auditory hallucinations being the most common. Also, 38,3% of the global sample had abnormalities in brain structural image (MRI, CT).
Musical hallucinations are a heterogeneous phenomenon in clinical practice. published cases describe them as more common in women and in psychiatric and neurological patients. Hearing impairment seem to be an important risk factor in the development of musical hallucinations.
Prevalence of cardiovascular disease is high in schizophrenia. Our aim is to estimate the prevalence of cardiovascular risk factors (CVRF) among schizophrenia patients.
National cross-sectional study in patients diagnosed with schizophrenia under treatment with second generation antipsychotics and admitted to short-stay hospitalisation units.
A sample of 733 consecutively admitted patients was enrolled; the most prevalent CVRFs were smoking 71% (95% CI: 67–74%) and hypercholesterolemia 66% (61–70%) followed by hypertriglyceridemia 26% (26–32%), hypertension 18% (15–21%) and diabetes 5% (4–7%). Metabolic syndrome showed 19% (95% CI: 16–23%) prevalence or, according to updated definitions (Clin Cornerstone 7  36–45), 24% (95% CI: 20–28%). The rate of patients within the high-risk range of a 10-year fatal cardiovascular event was 6.5%. CVRFs under routine management were diabetes (60%), hypertension (28%) and, to a lesser extent, dyslipemia (14%). Treatment for CVRFs was associated to gender, men for hypertension OR = 25.34, p < 0.03 and women for diabetes OR = 0.02, p < 0.03.
We found that CVRFs in schizophrenia were prevalent and under-diagnosed, and thus with insufficient therapeutic management.
Auditory and musical hallucinations have been reported in patients as an adverse effect of the use of opioids. Hearing loss, old age, and female gender are considered risk factors in the development of musical hallucinations. The aim of this report is to describe a case of a patient with auditory and musical hallucinations and to discuss the role of an opioid –tramadol- in the origin of those.
An 80 years old woman experiencing auditory hallucinations was referred to our hospital from an emergency room. The patient had bilateral mild hearing loss and was receiving tramadol 112.5 mg/daily during the last year for cervical pain. In the last ten months, she had been gradually noticing the voice of her dead husband coming from under her pillow, as well as intermittently hearing popular songs being played inside her head. The patient had good insight on both types of abnormal perceptions, which were reported as increasingly unpleasant through time.
Tramadol was discontinued and pimocide (range 1-4 mg/day) and loracepam (2.5 mg/day) were introduced, achieving the improvement of the hallucinations and the anxiety associated with them.
The outcome of this case supports the hypotheses that Opioids could induce musical hallucinations. Hearing impairment, old age, and gender could be underlying risk factors on the development of musical hallucinations.
A new species of the genus Lyperosomum Looss, 1899, from the intestine of the golden-fronted woodpecker (Melanerpes aurifrons) from northern Mexico is described. Lyperosomum cuauhxinqui sp. n. is morphologically distinguished from other congeneric species from the Americas by a higher oral/ventral sucker ratio and its body length and width. The sequences of domains D1–D3 of the large subunit (LSU) of nuclear ribosomal DNA and cytochrome c oxidase subunit 1 (cox 1) from the mitochondrial DNA of the new species were obtained and compared with available sequences from GenBank. The genetic divergence estimated between the new species and other congeneric species ranged from 2 to 6% and 13.4 to 17.3% for LSU and cox 1, respectively. Phylogenetic analyses based on the two (LSU and cox 1) molecular markers consistently showed that L. cuauhxinqui sp. n. was nested within the genus Lyperosomum, with strong bootstrap support (100%) and Bayesian posterior probabilities (1.0). In particular, the LSU tree indicated that the sequence of the new species is closely related to sequences from Zonorchis alveyi, Zonorchis delectans and Zonorchis sp. from Central America, suggesting that these sequences should be transferred to the genus Lyperosomum. The new species represents the first record from Mexico and the fifth species identified in the Americas. Our study also revealed that the taxonomy of the genus Lyperosomum should be re-examined by combining molecular, morphological and ecological characteristics.
A new species of the genus Plagiorhynchus Lühe, 1911 from the intestine of the long-billed curlew (Numenius americanus) from northern Mexico is described. Plagiorhynchus (Plagiorhynchus) aznari n. sp. is morphologically distinguished from other congeneric species from the Americas by having a trunk expanded anteriorly and a cylindrical proboscis, armed with 19 longitudinal rows of hooks, with 14–15 hooks each row. Nearly complete sequences of the small subunit and large subunit of the nuclear ribosomal DNA of the new species were determined and compared with available sequences from GenBank. Phylogenetic analyses inferred from the two molecular markers consistently showed that P. (Plagiorhynchus) aznari n. sp. is closely related to P. (Plagiorhynchus) allisonae, and this clade is sister to a clade formed by P. (Prosthorhynchus) transversus and P. (Prosthorhynchus) cylindraceus from Plagiorhynchidae. The new species represents the second record of the genus in Mexico and the fourth species in the Americas. The phylogenetic relationships among the members of the order Polymorphida in this study provide significant insights into the evolution of ecological associations between parasites and their definitive hosts. Our analyses suggest that the colonization of marine mammals, fish-eating birds and waterfowl in Polymorphidae might have occurred independently, from a common ancestor of Centrorhynchidae and Plagiorhynchidae that colonized terrestrial birds and mammals.
We describe an algorithm that can fit the properties of the dwarf galaxy progenitor of a tidal stream, given the properties of that stream. We show that under ideal conditions (the Milky Way potential, the orbit of the dwarf galaxy progenitor, and the functional form of the dwarf galaxy progenitor are known exactly), the density and angular width of stars along the stream can be used to constrain the mass and radial profile of both the stellar and dark matter components of the progenitor dwarf galaxy that was ripped apart to create the stream. Our provisional fit for the parameters of the dwarf galaxy progenitor of the Orphan Stream indicates that it is less massive and has fewer stars than previous works have indicated.
The Centro de Laseres Pulsados in Salamanca, Spain has recently started operation phase and the first user access period on the 6 J 30 fs 200 TW system (VEGA 2) already started at the beginning of 2018. In this paper we report on two commissioning experiments recently performed on the VEGA 2 system in preparation for the user campaign. VEGA 2 system has been tested in different configurations depending on the focusing optics and targets used. One configuration (long focal length
cm) is for underdense laser–matter interaction where VEGA 2 is focused onto a low density gas-jet generating electron beams (via laser wake field acceleration mechanism) with maximum energy up to 500 MeV and an X-ray betatron source with a 10 keV critical energy. A second configuration (short focal length
cm) is for overdense laser–matter interaction where VEGA 2 is focused onto a
thick Al target generating a proton beam with a maximum energy of 10 MeV and temperature of 2.5 MeV. In this paper we present preliminary experimental results.
Neoechinorhynchus is one of the most speciose genera of acanthocephalans, with approximately 116 described species. A recent study, aimed at establishing the genetic diversity of Neoechinorhynchus in Middle American freshwater fishes, validated nine species molecularly and morphologically and revealed the existence of 10 putative candidate species. Neoechinorhynchus golvani, a parasite commonly found in cichlids throughout Middle America with an allegedly large intraspecific morphological variability, was found to represent a species complex; species delimitation methods uncovered three additional genetic lineages. Here, we re-analyse the morphological and molecular data for N. golvani species complex infecting cichlids in that geographical area. A multivariate analysis of variance (MANOVA) was conducted particularly for the length of apical, middle and posterior hooks of the species/lineages of Neoechinorhynchus in cichlids, revealing morphological variation in the length of apical hooks for Lineage 8, although no morphological distinction was observed for Lineages 9 and 10. A new concatenated phylogenetic analysis of one mitochondrial and two ribosomal DNA genes was used to further corroborate the species delimitation among lineages; Neoechinorhynchus Lineage 8 was found to be morphologically and genetically distinct from its sister taxa, N. golvani and other two undescribed genetic lineages, and is formally described as a new species. Neoechinorhynchus costarricense n. sp. is described from the intestines of eight species of cichlids in Costa Rica. The new species is distinguished from the other species/lineages of Neoechinorhynchus in cichlids mainly by the size of the apical hooks of the proboscis.
Members of the genus Neoechinorhynchus Stiles & Hassall, 1905 are endoparasites of freshwater fishes, brackish water fishes, and freshwater turtles distributed worldwide. In North America, 33 species have been described. One of the most widely distributed species in the eastern United States and Canada is Neoechinorhynchus (Neoechinorhynchus) cylindratus, a common acanthocephalan that infects centrarchid fishes. In the current study, adult specimens of N. (N) cylindratus were collected from largemouth bass (Micropterus salmoides) from the Purificación River in northern Mexico. In the same freshwater system, two additional congeneric species (Neoechinorhynchus (Neoechinorhynchus) emyditoides and Neoechinorhynchus (Neoechinorhynchus) panucensis) were collected and analysed. Sequences of the large subunit, internal transcribed spacers ITS1 and ITS2, 5.8S from nuclear DNA, and sequences of the cytochrome c oxidase subunit I (cox 1) from mitochondrial DNA were generated and aligned with other sequences obtained from GenBank. Maximum likelihood and Bayesian inference analyses inferred for each dataset showed that N. (N) panucensis, N. (N) emyditoides and N. (N) cylindratus were nested within several clades, indicating that these species do not share a common ancestor. Our phylogenies also revealed that the genus Neoechinorhynchus is paraphyletic, requiring further taxonomic revision using phylogenetic systematics and re-examination of morphological and ecological data. The presence of several N. (N) cylindratus adults in northern Mexico allowed us to typify this species for the first time using a combination of morphological and molecular characteristics. The current record shows a wide distribution range of N. (N) cylindratus across Canada, the United States and Mexico in the Nearctic region.
Tapeworms of the family Gryporhynchidae are endoparasites of fish-eating birds distributed worldwide. Currently the family contains 16 genera classified on the basis of the morphology of the rostellar apparatus, rostellar hooks and strobilar anatomy. However, the phylogenetic relationships among the genera are still unknown. In this study, sequences of the near complete 18S (SSU) and 28S (LSU) from rDNA of 13 species of gryporhynchids (adult specimens) representing eight genera (Cyclustera, Dendrouterina, Glossocercus, Gryporhynchidae gen. sp., Neovalipora, Paradilepis, Parvitaenia, Valipora) and one species of metacestode from fish (Neovalipora) were generated. Additionally, sequences of metacestodes of the genera Amirthalingamia, Neogryporhynchus, Paradilepis, Parvitaenia and Valipora from Africa recently added to the GenBank database were analysed. Phylogenetic relationships were inferred using maximum-likelihood (ML) and Bayesian inference of each (SSU and LSU) dataset. The phylogenetic analyses indicated that the family Gryporhynchidae is a well-supported monophyletic group within the Cyclophyllidea. The trees inferred with SSU and LSU datasets had similar topologies and suggested that the genera Glossocercus (two species sequenced) and Paradilepis (four spp.) are monophyletic. In contrast, Dendrouterina, Parvitaenia and Valipora are paraphyletic, suggesting that the species composition of these genera should be critically reviewed. Interestingly, species of the genera that use the same groups of definitive hosts such as herons (Ardeidae), cormorants (Phalacrocoracidae) and ibis (Threskiornithidae) are together in the phylogenetic tree, even though they differ markedly from each other in some morphological characters, especially shape and size of rostellar hooks.
The family Clinostomidae Lühe, 1901 contains 29 species allocated to seven genera, of which Clinostomum Leidy, 1856 is the most diverse, with c. 14 valid species. The diversity of Clinostomum has been assessed, combining morphological and molecular data. The genetic library for species in this genus has increased steadily, although there is little or no information for the other genera included in the family. Molecular phylogenetic relationships among the genera of clinostomids have not been assessed, and their classification is still based on morphological traits. The monotypic Ithyoclinostomum was described from a fish-eating bird in Brazil, and its metacercariae have been found in several locations in South America, parasitizing erythrinid freshwater fishes. We collected unusually large metacercariae from the body cavity of cichlids in several locations across Middle America. These metacercariae exhibited some resemblance to Ithyoclinostomum, although several differences prevent their inclusion in Ithyoclinostomum dimorphum, casting doubt on their taxonomic identification. The main objective of this paper was to characterize the metacercariae collected in cichlids using both morphology and molecular data from three molecular markers, and to assess the molecular phylogenetic relationships among the genera of Clinostomidae to establish the position of the newly generated sequences. We took a conservative position and tentatively placed the metacercariae as belonging to Ithyoclinostomum.
The clinical and pathologic characterisation of two fatal cases of tick-borne rickettsiosis in rural (El Valle) and urban (City of Panama) Panama are described. Clinical and autopsy findings were non-specific, but the molecular analysis was used to identify Rickettsia rickettsii in both cases. No ticks were collected in El Valle, while in the urban case, R. rickettsii was detected in Rhipicephalus sanguineus s.l., representing the first molecular finding in this tick in Panama and Central America.
Adults of Hysteromorpha triloba (Rudolpi, 1819), Lutz, 1931 inhabit primarily the intestine of cormorants across the globe, whereas metacercariae have been found in the body cavity of freshwater fishes of the families Cyprinidae, Ictaluridae, Ariidae, Pimelodidae and Catostomidae. In this study, adults and metacercariae identified as H. triloba were collected from the Neotropical cormorant (Nannopterum brasilianus) and from the Mexican tetra fish (Astyanax mexicanus) from the Gulf of Mexico and Pacific Ocean slopes in the Neotropical region. Partial DNA sequences of the mitochondrial gene cytochrome c oxidase subunit I (cox 1) and the internal transcribed spacers (ITS1, 5.8S and ITS2) of nuclear ribosomal DNA were generated for both developmental stages, and were compared with available sequences of H. triloba from the Nearctic region. The genetic divergence between metacercariae and adults of H. triloba from the Neotropical and Nearctic region (Canada) associated with the double-crested cormorant (Nannopterum auritus), ranged from 0 to 5.5% for cox 1 and from 0 to 0.2% for ITS. Phylogenetic analyses inferred with both molecular markers using maximum likelihood and Bayesian inference placed the adults and metacercariae in a single clade, confirming that both stages are conspecific. Our data confirmed that H. triloba is a widely distributed species across the Americas, parasitizing both the Neotropical and Nearctic cormorants in Argentina, Brazil, Venezuela, Mexico, USA and Canada.
Two new species of Andracantha (Polymorphidae) are described from the intestine of the shags Leucocarbo chalconotus (Gray) and Phalacrocorax punctatus (Sparrman), and the penguin Eudyptula minor (Forster) from southern South Island, New Zealand. Andracantha leucocarboi n. sp. is distinguished from its congeners by having no genital or ventral trunk spines, but possessing a scattering of small spines between the anterior fields of spines. This is the first record of a species of Andracantha from a penguin. Circumbursal papillae are illustrated in a scanning electron micrograph for the first time in the polymorphids. Andracantha sigma n. sp. is distinguished by the sigmoid shape of its largest proboscis hook, hook VIII, and having the ventral field separated from the posterior disc field by an aspinous gap. A Maximum Likelihood tree from cox1 and large ribosomal subunit (LSU) data shows A. leucocarboi n. sp. to be more closely related to A. gravida than A. sigma n. sp. and the genus Andracantha as sister to Corynosoma spp. Genetic distances between species of Andracantha are comparatively large. A key to the species of Andracantha is provided.
Members of the genus Uvulifer are distributed worldwide and infect aquatic snails and freshwater fishes as first and second intermediate hosts, respectively, and fish-eating birds (kingfishers) as definitive hosts. Metacercariae of Uvulifer spp. were collected from the fins and skin of 20 species of freshwater fishes in Mexico, Guatemala, Honduras, Nicaragua and Costa Rica, and the adults were recovered from the intestine of kingfishers in four localities of Mexico. The genetic divergence among 76 samples (64 metacercariae and 12 adults) was estimated by sequencing the 28S and 5.8S nuclear genes, as well as the internal transcribed spacers ITS1 and ITS2, and one mitochondrial gene (cox1). Maximum likelihood and Bayesian inference analyses inferred with each dataset showed a high genetic diversity within the genus Uvulifer across Middle America, revealing the existence of four genetic lineages that exhibit some level of host specificity to their second intermediate hosts. The metacercariae of lineage 1 were associated with characids and cyprinids in central and northern Mexico. Metacercariae of lineages 2 and 3 were associated with cichlids distributed widely across Middle America. The lack of adults of these lineages in kingfishers, in lineages 2 and 3, or the fact that just a few adult specimens were recovered, as in lineage 1, prevented a formal description of these species. The metacercariae of lineage 4 were found in poeciliids, across a distribution range comprising Mexico, Guatemala, Honduras and Nicaragua, and the adult was found in the green kingfisher in Mexico. The number of specimens sampled for lineage 4, for both gravid adults and metacercariae, allowed us to describe a new species, Uvulifer spinatus n. sp. We describe the new species herein and we discuss briefly the genetic diversity in Uvulifer spp. and the importance of using DNA sequences to properly characterize parasite diversity.
Members of the genus Drepanocephalus are endoparasites of fish-eating birds of the families Phalacrocoracidae and Sulidae distributed across the Americas. Currently, Drepanocephalus contains three species, i.e. D. spathans (type species), D. olivaceus and D. auritus. Two additional species, D. parvicephalus and D. mexicanus were transferred to the genus Petasiger. In the current study, available DNA sequences of D. spathans, D. auritus and Drepanocephalus sp., were aligned with newly generated sequences of D. spathans and Petasiger mexicanus. Phylogenetic analyses inferred with three nuclear (LSU, SSU and ITS1, 5.8S, ITS2) and two mitochondrial (cox1, nad1) molecular markers showed that the sequences of D. spathans and D. auritus are nested together in a single clade with very low genetic divergence, with Petasiger mexicanus as its sister species. Additionally, P. mexicanus was not a close relative of other members of the genus Petasiger, showing that P. mexicanus actually belongs to the genus Drepanocephalus, suggesting the need to re-allocate Petasiger mexicanus back into the genus Drepanocephalus, as D. mexicanus. Morphological observations of the newly sampled individuals of D. spathans showed that the position of the testes is variable and testes might be contiguous or widely separated, which is one of the main diagnostic traits for D. auritus. Our results suggest that D. auritus might be considered a synonym of D. spathans and, as a result, the latter represents a species with a wide geographic range across the Americas, parasitizing both the Neotropical and the double-crested cormorant in Argentina, Brazil, Paraguay, Venezuela, Colombia, Mexico, USA and Canada.
The aim of the present study was to assess the association of gestational diabetes mellitus (GDM) with prenatal and postnatal depressive symptoms in a sample of pregnant women in Greece.
Earlier research supports a relationship between depression and diabetes, but only a few studies have examined the relationship between GDM and perinatal depressive symptomatology.
A total of 117 women in their third trimester of pregnancy participated in the study. Demographic and obstetric history data were recorded during women’s third trimester of pregnancy. Depressive symptoms were assessed with the validated Greek version of the Edinburg Postnatal Depression Scale (EPDS) at two time points: on the third trimester of pregnancy and on the first week postpartum.
Prevalence of GDM was 14.5%. Probable diagnosis of depression occurred for 12% of the sample during the antenatal assessment and 15.1% in the postpartum assessment. In the first week postpartum, women with GDM had significantly higher postpartum (but no antenatal) EPDS scores compared with the non-GDM cohort. In conclusion, GDM appears to be associated with depressive symptoms in the first week postpartum. Clinical implications and recommendations for future research are discussed, emphasizing the importance of closely monitoring women with GDM who seem more vulnerable to developing depressive symptomatology during the postnatal period.
To determine whether demographic characteristics or balance examination findings can predict the adherence of older people with instability to a vestibular rehabilitation programme.
A prospective case–control study was conducted of 120 patients aged 65 years or more (mean age, 77.3 ± 6.33 years). Two groups were classified according to patients’ adherence with the follow-up post-rehabilitation protocol. Analysed variables included: age, sex, body mass index, Timed Up and Go test findings, computerised dynamic posturography, Dizziness Handicap Inventory scores and Short Falls Efficacy Scale – International questionnaire results, number of falls, and type of vestibular rehabilitation.
Two groups were established: adherents (99 individuals) and non-adherents (21 individuals). There were differences between the groups regarding: sex (female-to-male ratio of 4.8:1 in adherents and 1.63:1 in non-adherents), age (higher in non-adherents) and voluntary movement posturographic test results (non-adherents had poorer scores).
The patients most likely to abandon a vestibular rehabilitation programme are very elderly males with low scores for centre of gravity balancing and limits of stability.