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Despite the rapid increase in disability and death due to Parkinson’s disease and associated psychiatric comorbidities (psychosis, depression, cognitive impairment, anxiety), the quest for a clear pathophysiological mechanism and treatment remains elusive. Numerous studies aim to identify a metabolomic fingerprint for PD and new, promising biomarkers are discovered with implications beyond neurodegenerative diseases, such as novel markers as predictors of bipolar type in depressed patients.Changes in neuronal microenvironment employ electrochemical techniques, such as cyclic voltammetry, used in both animal and human models of PD to monitor dopamine (DA) alterations in vivo, with high spatial and temporal resolution.
Our aim is to investigate the latest scientific literature on PD and associated neuropsychiatric disorders and review the applications cyclic voltammetry has in recent technological advances in the field.
To gain a broad understanding of the subject, we have consulted multiple scientific literature databases (PubMed, Google Academic, Science Direct) using the keywords “cyclic voltammetry, Parkinson’s disease, psychiatric disorders, dopamine” and included original research articles published in the last 10 years
The first in situ measurement of DA release in the human brain has been demonstrated in a sequential investment task, with implications for future research in decision-making behavior.
One study combines cyclic voltammetry and wireless telemetry for in vivo recording of changes in extracellular levels of DA, with high temporal and spatial resolution.
Disulfide nanorod-graphene-β-cyclodextrin nanocomposites biosensors have been succesfully used in detecting DA in rodent brain and human blood serum samples, with implications for minimally invasive measuring techniques.
Animal studies use cyclic voltammetry to monitor changes in DA levels in cerebrospinal fluid and plasma of mouse models of PD and investigate DA metabolism, release, uptake and receptor sensitivity in Knock-out mice, with implications for the diurnal variation of extracellular DA tone and release.Furthermore, a human alpha-synuclein-expressing mouse model of PD exhibited increased extracellular DA concentrations, decreased DA uptake and relieved paired-stimulus depression.
Cyclic voltammetry is a powerful tool in the expansion to humans of electrochemical recording techniques in PD. The final aim is to investigate DA neuron physiology before neurodegeneration onset and to measure neurotransmitter release in real time.
Psychiatric symptoms related with menstrual cycle vary from dysphoria to psychosis. There are only a few cases of menstrual psychosis reported, all characterized by acute onset, against a background of normality, brief duration, with full recovery and a circa-mensual periodicity.
We report a case of dissociative disorder, in a teenage girl, with atypical presentation and an unusual periodicity of symptoms and recoveries.
Presentation of a case of dissociative disorder, followed by a review of the similar cases described in the literature.
We are presenting a case of a 15 years old female, who presented in our Emergency Department for confusion, anxiety, negativism in verbal and non-verbal response, bradylalia and bradypsychia, insomnia for over 48 hours. The symptoms suddenly began two days before arrival in our clinic. From the patient’s personal history, we retain the following: menarche at 14 years old, irregular periods, hypermenorrhea. Patient was born premature, G=1200g, spastic diplegia, periventricular leukomalacia (MRI – 2018). Three similar episodes happened a year ago, with one month periodicity, with spontaneous remission after 5-6 days. Patient was treated with antipsychotics and benzodiazepines for the second and the third episode, but the treatment was stopped six month ago. The investigations results were normal, except for a high level of plasmatic cortisol. Patient fully recovered in the day the menses stopped.
We considered this case to be atypical due to the sudden debut and recovery and there are still some remaining questions. Is it hormonal related, menstrual related or is it exclusively a psychiatric condition?
Chronic diseases have often been associated with depression or other psychiatric conditions. Despite the fact that renal transplantation offers children a chance at a better life, it could also raise some challenges. Dealing with a severe medical condition such as chronic renal disease and multidrug therapy with potential long term side-effects from the early years of life can affect a child’s emotional and social development.
Reporting a case which represents a challenge in treating an adolescent with depression and renal failure.
A 15 year old male with multiple admissions (between the ages of 12 and 15) for recurrent feelings of inadequacy and worthlessness due to his appearance, impaired social skills, hostility towards society, suicide ideation and aggressive behaviour. Moreover, his medical history includes CRS (congenital renal disease), kidney transplant at the age of 2 followed with transplant rejection in 2019. Currently he is under haemodialysis and multiple drug prescriptions associated with his severe medical condition which interferes with the psychotropic treatment.
This case quests what the better choice of intervention is for depression associated with aggressive behavior in a child with kidney failure and with no significant improvement in psychotherapy?
Autism spectrum disorder (ASD) is characterized by persistent deficits in social communication and social interaction across multiple contexts and it is marked by repetitive sensory–motor behaviours and restricted interests or activities. Now recognized to occur in up to 1% of the population, the prevalence of ASD has registered a steady increase in the past two decades. Heterogeneity of presentation is a hallmark with comorbid psychiatric and medical morbidities frequently reported. Comorbidities mask and delay the diagnosis and are the cause of inadequate therapies.
In the present paper, we studied a cohort of patients with ASD, investigating the rates and types of psychiatric and medical comorbidities.
A retrospective study of psychiatric and medical comorbidities was carried out on a sample of 120 participants that met ASD criteria according to DSM-V. The patients were examined with a detailed medical history, physical examination, as well as some additional functional, imaging, laboratory and genetic investigations. The associated conditions considered were: attention deficit/hyperactivity disorder (ADHD), epilepsy, intellectual disability, gastrointestinal symptoms, ophtalmologic manifestations, infections.
Of the 120 ASD subjects referred, 25 (20.8%) received the diagnosis of epilepsy. ADHD was established in 24 cases (20%). IQ score was obtained in half of the patients, 43.3% of them presenting a severe intellectual disability (IQ<35). Respiratory disorders occured in 25% of the cases. Ophtalmological findings were observed in 9.1% of the cases. Other frequent comorbidities included motor disturbances and feeding problems.
A better understanding of comorbidities in ASD patients improves interdisciplinary collaboration, thus facilitating effective treatment programs.
chronic neurological diseases such as multiple sclerosis (MS) and Parkinson's disease (PD) determines highly social impact through direct and indirect cost burden, so that management of quality of life(QoL) of these patients is often difficult.
to assess whether the relantionship between depression and chronic neurological diseases is relevant in quantifying QoL.
to proove that associated depression in patients with serious neurological diseases should not be minimized.
we followed up 20 patients (10 with MS-mean age 39.1, mainly women and 10 with PD-mean age 55.8, mainly men) during one year after diagnosis of depression; the mean time of disease evolution was 7.83 years for MS patients and 6.33 for PD patients; we compared them with a lot o patients matching as age and sex diagnosed with depression, without other comorbidities. Both lots were assessed every 3 month by Beck Depression Inventory, Fatigue Impact Scale and QoL Short form-36 scores. Time of positive diagnosis was over one year, even if symptoms were present for at least double time.
patients with chronic neurological diseases had a less favourable outcome, especially young women, than control group, revealing more problems especially in somatization field and in accepting psychiatric help; there were also more drug interactions that led to patient compliance difficulties.
even if there is resistance in accepting psychiatric diagnosis and treatment, we must do all efforts to persuade patients to undergo specialized treatment and supportive psychotherapy in order to improve their's quality of life.
For a long period ADHD was considered to be a diagnostic limited to childhood. In the 1970s, clinical evidence showed symptoms in adults diagnosed with ADHD in childhood. Evidence shows that 15-20% of the parents of children with ADHD could also qualify for this diagnostic.
The aim of this study was to see whether parents of children diagnosed with ADHD have traits significant for this pathology and how these symptoms correlate with the ones experienced by their children.
Inattention and hyperactivity/impulsivity symptoms were assessed in parents of children diagnosed with ADHD and the most severe traits found were compared with those of their children.
In the study were included 93 parents of 50 children diagnosed with ADHD by a specialist in Child Psychiatry. For each child parents completed the ADHD-Rating Scale and for assessment of their symptoms, the Diagnostic Interview Voor ADHD (DIVA) was applied to parents.
34% of parents of children diagnosed with ADHD fulfill criteria for Adult ADHD. The most significant correlation was found between ADHD-RS scores for hyperactivity/impulsivity and DIVA scores for this kind of symptomatology. The little number of subjects represents a clear limitation, as this was performed as a pilot study.
Considering the high prevalence of ADHD in parents of diagnosed children and also the impact of their impairment over their children’s education, it is important to quantify this risk and rise awareness of the need for ADHD screenings in parents of children diagnosed with this pathology.
Children with autism spectrum disorders (ASD) have a less definitive hand preference for certain actions as opposed to neurotypical children. Moreover, left-handedness in children with ASD has been associated with more echolalia. The objective was to conduct a screening of potential risk and associated features for autism spectrum disorders, among which the hand preference of the child. The current aim is to compare the perceived handedness of children with autism spectrum disorders with that of children with other psychiatric pathologies.
Eight hundred and forty-two parents completed our risk and associated features screening questionnaire. Out of these, 494 answered the question regarding handedness (209 had children diagnosed with ASD). This asked the parents to state how they perceived their child's handedness. An ADOS assessment has been conducted for 170 of the children whose parents were included in the study, based on clinical relevance for the case. The data were analysed using Excel and SPSS 22.0. For the comparisons, Chi2 and the Kruskal–Wallis test were used.
Children with ASD had more left-handedness (χ2(2) = 12.54, P = 0.002). There were no differences between boys and girls in terms of perceived handedness in any of the groups. There were no differences in the ADOS scores according to the perceived hand laterality (χ2(2) = 0.58, P = 0.74).
Rightward-asymmetry in regions of corpus callosum has been reported to correlate with symptoms severity in ASD. The finding of different perceived handedness in children with ASD versus children with other psychiatric pathologies is useful for designing appropriate, individualized training programs for motor therapy.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
From assortative mating theory to genetic background, several ethipathogenic hypotheses in ASD deal with the traits of parents.
several ethipathogenic hypotheses in ASD deal with the traits of parents. The objectives of our study were to measure the ADHD and autism spectrum disorder quotients in parents of children diagnosed with ASD comorbid with ADHD and to correlate the measurements for the tests in parents with those in their children. The specific aim was to identify whether any significant correlations exist.
Fifty-two pairs of parents of children with autism spectrum disorders and ADHD were included in this study, based on informed consent and the ethical committee's approval. The child's diagnosis was established by a specialist in child and adolescent psychiatry, based on the child's clinical symptoms and on specific diagnostic scales, such as the ADOS and ADHD-rating scale. The parents completed an Autism Spectrum Quotient Scale (ASQS) and an adult ADHD scale. The data were analyzed using SPSS 22.0 and Excel. The correlations were verified using Spearman's non-parametric correlation test.
There was a strong correlation between the parents’ ADHD scores (r = 0.5, P < 0.001), and a reverse medium correlation between the mother's ADHD score and the child's ADOS score (r = –0.32, P = 0.02). The father's ASQS and ADHD scores correlated between each other (r = 0.31, P = 0.02). There were no correlations between the parents’ and the child's ADHD score, nor between the child's ADOS score and the parents’ ASQS scores.
Our results suggest that ADHD symptoms in parents of children with autism spectrum disorders comorbid with ADHD might be predictors for the child's prognosis.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Background Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.
Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.
Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?
Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
Given the finite nature of global phosphorus (P) resources, there is an increasing concern about balancing agronomic and environmental impacts from P usage on dairy farms. Data from a 3-year (2009–2011) survey were used to assess farm-gate P balances and P use efficiency (PUE) on 21 intensive grass-based dairy farms operating under the good agricultural practice (GAP) regulations in Ireland. Mean stocking rate (SR) was 2·06 livestock units (LU)/ha, mean P surplus was 5·09 kg/ha, or 0·004 kg P/kg milk solids (MS), and mean PUE was 0·70. Phosphorus imports were dominated by inorganic fertilizer (7·61 kg P/ha) and feeds (7·62 kg P/ha), while exports were dominated by milk (6·66 kg P/ha) and livestock (5·10 kg P/ha). Comparison to similar studies carried out before the introduction of the GAP regulations in 2006 indicated that P surplus, both per ha and per kg MS, has significantly decreased (by 74 and 81%, respectively) and PUE increased (by 48%), mostly due to decreased inorganic fertilizer P import and improvements in P management. There has been a notable shift towards spring application of organic manures, indicating improved awareness of the fertilizer value of organic manures and good compliance with the GAP regulations regarding fertilizer application timing. These results suggested a positive impact of the GAP regulations on dairy farm P surplus and PUE, indicating an improvement in both environmental and economic sustainability of dairy production through improved resource use efficiencies. Such improvements will be necessary to achieve national targets of improved water quality and increased dairy production. Results suggest that optimizing fertilizer and feed P imports combined with improved on-farm P recycling are the most effective way to increase PUE. Equally, continued monitoring of soil test P (STP) and P management will be necessary to ensure that adequate soil P fertility is maintained. Mean P surplus was lower and PUE was much higher than the overall mean surplus (15·92 kg P/ha) and PUE (0·47) from three studies of continental and English dairy farms, largely due to the low import system that is more typical in Ireland, with seasonal milk production (compact spring calving), low use of imported feeds and high use of grazed grass.
There is increasing concern about balancing agronomic and environmental gains from nitrogen (N) usage on dairy farms. Data from a 3-year (2009–2011) survey were used to assess farm-gate N balances and N use efficiency (NUE) on 21 intensive grass-based dairy farms operating under the good agricultural practice (GAP) regulations in Ireland. Mean stocking rate (SR) was 2·06 livestock units (LU)/ha, mean N surplus was 175 kg/ha, or 0·28 kg N/kg milk solids (MS), and mean NUE was 0·23. Nitrogen inputs were dominated by inorganic fertilizer (186 kg N/ha) and concentrates (26·6 kg N/ha), whereas outputs were dominated by milk (40·2 kg N/ha) and livestock (12·8 kg N/ha). Comparison with similar studies carried out before the introduction of the GAP regulations in 2006 would suggest that N surplus, both per ha and per kg MS, have significantly decreased (by 40 and 32%, respectively) and NUE increased (by 27%), mostly due to decreased inorganic fertilizer N input and improvements in N management, with a notable shift towards spring application of organic manures, indicating improved awareness of the fertilizer value of organic manures and good compliance with the GAP regulations regarding fertilizer application timing. These results would suggest a positive impact of the GAP regulations on dairy farm N surplus and NUE, indicating an improvement in both environmental and economic sustainability of dairy production through improved resource-use efficiencies. Such improvements will be necessary to achieve national targets of improved water quality and increased efficiency/sustainability of the dairy industry. The weak impact of SR on N surplus found in the present study would suggest that, with good management, increased SR and milk output per ha may be achievable, while decreasing N surplus per ha. Mean N surplus was lower than the overall mean surplus (224 kg N/ha) from six studies of northern and continental European dairy farms, while mean NUE was similar, largely due to the low input/output system that is more typical in Ireland, with seasonal milk production (compact spring calving), low use of concentrates, imported feed and forages, high use of grazed grass and lower milk yields per ha.
Chromatin is the complex of deoxyribonucleic acid (DNA) with
proteins that exists in eukaryotic cell nuclei. Chromatin was
extracted from livers of Wistar rats and subjected to a 248-nm
excimer laser radiation, in doses of 0.5–3 MJ/m2.
An UV excimer laser Iofan 1701, with 40-mJ dose/pulse and frequency
of 30 Hz was used. The radiolysis of chromatin was analyzed by (1)
1H-NMR spectroscopy, (2) steady-state fluorescence, (3)
time-resolved fluorescence, and (4) fluorescence resonance energy
transfer (FRET) methods. The laser action on chromatin determines
bigger values of the transverse relaxation time (T2),
which indicates less bound water in the chromatin structure, therefore
a more injured one. The chromatin intrinsic fluorescence decreases
on laser action, proving the destruction of the chromatin protein
structure. By the time-resolved fluorescence we established
that the relative contribution of the excited state lifetime
of bound ethidium bromide to chromatin DNA diminishes with the
laser dose. This denotes single- and double-strand breaks produced
in DNA structure. By the FRET method, the energy transfer
efficiency and the distance between dansyl chloride and acridine
orange coupled at chromatin were determined. The distance increases
with laser action. The determination of the chromatin structure
modification in an excimer laser field can be of real interest
in medical applications.
Amorphous 55wt%Cr-45wt%Ni films (60 nm thick) supported on EM copper grids were irradiated in air at normal incidence with a ruby laser (λ∼, 0.694 μm) through a ≈ 1.5 mm diameter diaphragm using one single laser pulse of 60 ns (FWHM) with fluences ranging from 120 to 540 J.m−2. The structure of the irradiated films is studied by TEM and TED. As a rule due to the appearance of thermal gradients between the centre and the mesh edge of the EM grid, the crystallization took place under various conditions of reaction from liquid phase, liquid melted layers , activated diffusion in solid state, to under threshold conditions for the development of the crystalline nuclei in the amorphous matrix. Periodic resonant and unreso-nant structures also developed in the liquid melted layers.
The crystallization and oxidation processes of thin, free-standing (FS), sputtered Cr films under the action of cw CO2 laser irradiation were studied by transmission electron microscopy (TEM) and transmission electron diffraction (TED). The crystallization is induced at power densities above 28.65 W cm−2, dwell time of 1 s, and the oxidation at power densities of 48.1 W cm−2 and longer dwell times.
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