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Fusarium head blight (FHB) and stem rust (SR) threaten the sustainability of wheat production worldwide. Fhb1 and Sr2 confer partial durable resistance to FHB and SR, respectively. Despite resistant alleles of both genes are linked in repulsion, lines with Fhb1-Sr2 in coupling were developed at the University of Minnesota, USA. Marker-assisted backcrossing was used to incorporate the coupled Fhb1-Sr2 into four elite INIA-Uruguay spring wheat varieties lacking both genes and expressing different levels of FHB and SR resistance. In each case, the initial cross between the donor line and recurrent parent was backcrossed three times. Genotypes carrying Fhb1-Sr2 were selected using the molecular marker UMN10. In BC3F3 families, retention of Fhb1-Sr2 was further confirmed with the markers SNP3BS-8 and Sr2-ger9 for Fhb1 and Sr2, respectively. BC3F3 homozygous lines contrasting at UMN10, SNP3BS-8 and Sr2-ger9 were obtained to quantify the effect of Fhb1-Sr2 on the resistance to FHB under controlled conditions and to SR under field conditions. After 26 months period, successful introgression of Fhb1-Sr2 into the four cultivars was achieved, representing novel wheat genetic resources. Lines homozygous for the resistant alleles of Fhb1 were significantly more resistant to FHB as reflected by an 18% reduction of average FHB area under the disease progress curve. A significant effect of Sr2 on SR field resistance was observed in lines derived from the most susceptible cultivar ‘Génesis 2375’. The most resistant lines to both diseases are expected to be valuable genetic resources in breeding for durable resistance to FHB and SR.
Gatherings where people are eating and drinking can increase the risk of getting and spreading SARS-CoV-2 among people who are not fully vaccinated; prevention strategies like wearing masks and physical distancing continue to be important for some groups. We conducted an online survey to characterise fall/winter 2020–2021 holiday gatherings, decisions to attend and prevention strategies employed during and before gatherings. We determined associations between practicing prevention strategies, demographics and COVID-19 experience. Among 502 respondents, one-third attended in person holiday gatherings; 73% wore masks and 84% practiced physical distancing, but less did so always (29% and 23%, respectively). Younger adults were 44% more likely to attend gatherings than adults ≥35 years. Younger adults (adjusted prevalence ratio (aPR) 1.53, 95% CI 1.19–1.97), persons who did not experience COVID-19 themselves or have relatives/close friends experience severe COVID-19 (aPR 1.56, 95% CI 1.18–2.07), and non-Hispanic White persons (aPR 1.57, 95% CI 1.13–2.18) were more likely to not always wear masks in public during the 2 weeks before gatherings. Public health messaging emphasizing consistent application of COVID-19 prevention strategies is important to slow the spread of COVID-19.
We present the most sensitive and detailed view of the neutral hydrogen (
${\rm H\small I}$
) emission associated with the Small Magellanic Cloud (SMC), through the combination of data from the Australian Square Kilometre Array Pathfinder (ASKAP) and Parkes (Murriyang), as part of the Galactic Australian Square Kilometre Array Pathfinder (GASKAP) pilot survey. These GASKAP-HI pilot observations, for the first time, reveal
${\rm H\small I}$
in the SMC on similar physical scales as other important tracers of the interstellar medium, such as molecular gas and dust. The resultant image cube possesses an rms noise level of 1.1 K (
$1.6\,\mathrm{mJy\ beam}^{-1}$
)
$\mathrm{per}\ 0.98\,\mathrm{km\ s}^{-1}$
spectral channel with an angular resolution of
$30^{\prime\prime}$
(
${\sim}10\,\mathrm{pc}$
). We discuss the calibration scheme and the custom imaging pipeline that utilises a joint deconvolution approach, efficiently distributed across a computing cluster, to accurately recover the emission extending across the entire
${\sim}25\,\mathrm{deg}^2$
field-of-view. We provide an overview of the data products and characterise several aspects including the noise properties as a function of angular resolution and the represented spatial scales by deriving the global transfer function over the full spectral range. A preliminary spatial power spectrum analysis on individual spectral channels reveals that the power law nature of the density distribution extends down to scales of 10 pc. We highlight the scientific potential of these data by comparing the properties of an outflowing high-velocity cloud with previous ASKAP+Parkes
${\rm H\small I}$
test observations.
The addition of reproductive fluids (RF) to the culture media has shown benefits in different embryonic traits but its long-term effects on the offspring phenotype are still unknown. We aimed to describe such effects in pigs. Blood samples and growth parameters were collected from piglets derived from in vitro-produced embryos (IVP) with or without RF added in the culture media versus those artificially inseminated (AI), from day 0 to month 6 of life. An oral glucose tolerance test was performed on day 45 of life. We show here the first comparative data of the growth of animals produced through different assisted reproductive techniques, demonstrating differences between groups. Overall, there was a tendency to have a larger size at birth and faster growth in animals derived from in vitro fertilization and embryo culture versus AI, although this trend was diminished by the addition of RFs to the culture media. Similarly, small differences in hematological indices and glucose tolerance between animals derived from AI and those derived from IVP, with a sex-dependent effect, tended to fade in the presence of RF. The addition of RF to the culture media could contribute to minimizing the phenotypical differences between the in vitro-derived and AI offspring, particularly in males.
En este artículo se dan a conocer los resultados de la investigación arqueobotánica realizada en el distrito minero San José del Abra, en el norte de Chile. Esta mina, tras ser explotada inicialmente durante el período Intermedio tardío, fue incorporada posteriormente al Tawantinsuyu, produciéndose una reorganización e intensificación de la producción minera. Las excavaciones realizadas en el campamento Inkawasi-Abra permitieron recuperar una amplia diversidad de restos vegetales provenientes de distintos ecosistemas y pisos ecológicos de la región, los cuales cumplieron roles primordiales al interior del espacio habitacional. Por una parte, sustentaron la subsistencia de los mitayos atacameños, incluyendo alimentación, combustible y materias primas, y por otra, formaron parte de contextos ceremoniales y de preparación de alimentos de carácter comunal relacionados al comensalismo político, las relaciones de reciprocidad y la ritualidad minera. Gran parte de las plantas analizadas provienen de las quebradas y oasis atacameños, incluyendo productos agrícolas, chañar (Geoffroea decorticans) y algarrobo (Prosopis sp.), sumado a otras plantas silvestres y domesticadas provenientes de ambientes puneños, valles bajos y la costa pacífica. Lo anterior permite dibujar el mapa de relaciones y redes de abastecimiento de la mina durante el período incaico, así como aportar al conocimiento de los mineros que sustentaron la producción en San José del Abra.
The objective of this study was to evaluate the effect of different intercropping and spacing arrangements of corn (Zea mays L) and crotalaria (Crotalaria spp) on the agronomic characteristics, chemical composition and forage digestibility. The experiment was distributed in a randomized complete block design with a 2 × 2 + 1 factorial scheme. The treatments were two cultivation systems (corn + Crotalaria juncea (CCJ) intercropping, and corn + Crotalaria ochroleuca (CCO) intercropping), in two spacing arrangements (A1 (corn and crotalaria sown in the same row) and A2 (corn and crotalaria sown in alternate rows)) plus control (single corn monocropping (CSC)), with six replicates per treatment, for 2 years. Forage plants were harvested when the corn grain reached the doughy-farinaceous phenological stage. Forage mass (total and of each species), morphological composition, chemical composition and in vitro digestibility were evaluated. The forage accumulation was higher for the A1 spatial arrangement. In the second year, the highest total forage mass was verified in the CCO intercropping (11 140 kg/ha). The highest corn mass (9402 kg/ha) was observed for CSC. The highest crotalaria mass was observed in the CCJ intercropping in both years. Regarding the chemical composition, CCJ and CCO intercropping had the highest crude protein concentration. The lowest acid detergent fibre concentration was observed in CSC and CCO intercropping, directly reflecting the in vitro dry matter digestibility coefficients. It is concluded that C. ochroleuca, sown between corn rows, had higher forage accumulation and nutritive value among the treatments tested in this experiment.
Attrition rates in smoking cessation treatments are high, particularly in persons with substance use disorders. It is estimated that about 55%% disengage prematurely at treatment, meaning that a large portion will not benefit from smoking abstinence. So far, no previous studies have examined predictors of dropouts in a smoking cessation treatment with persons with SUD.
Objectives
The study was two-fold: 1) to analyze the percentage of
early-, late-dropouts and completers, and 2) to examine sociodemographic, psychological, and substance-related predictors of dropouts.
Methods
A total of 86 participants (69.8% males; Mage=43.84, SD=9.917) were randomly assigned to two psychological smoking cessation treatment: cognitive-behavioral treatment (CBT) (n=51) or CBT + contingency management (CM) (n=35). Interventions were delivered during eight consecutive weeks
Results
Of the 86 participants who completed the baseline assessment, 21 did not start treatment, 17 dropped out of treatment during treatment, and the remaining 48 completed the treatment. Predictors of early-dropout were younger age (B=-.234; p=.024; OR=.792) and lower number of days in SUD treatment (B= -.005; p=.026; OR=.995). Patients’ primary substance of use was associated with reduced early-dropouts; compared to cocaine users, alcohol (B=-1.827; p=.043; OR=.161) and opioids (B=-3.408; p=.018; OR=.033) related to improved attrition. Late dropout was directly related to higher number of tobacco use cessation attempts (B=.407; p=.039; OR=1.502).
Conclusions
Incorporating strategies to improve attendance and completion rates in SUD populations should be a priority. Mobile reminders, offering online therapies, or CM to reinforce attendance to therapy may be considered.
Levetirazetam is an antiepileptic drug with psychiatric adverse reactions. It includes psychosis, paranoia or hallucinations. The frequency is less than 1%.
Objectives
To describe and study a case of Psychosis produced by Levetirazetam
Methods
Retrospective review of clinical records and complementary test, including psychiatry, electrophysiology and neurology. Diagnosis schales such as Salamanca Questionnaire were used as suport.
Results
A 42-year-old woman diagnosed with tuberous sclerosis and undergoing treatment with levetirazetam acudes to the emergency department for behavioral disorders. She has presented an episode of aggression against a relative threatening him with a kitchen knife. The family reports that since the change in antiepilepticus 1 month ago, the patient has presented strange behaviors. Te Patient is conscious, uncooperative. Barely Approachable. Suspicious of her surroundings, with psychomotor restlessness, self-reference ideas and sparse speech. Auditory hallucinations seem to be present, as well as depressed and irritable mood. Psychic and somatic anxiety is found. Levetirazetam is discontinued, being replaced by valproic acid. Risperidone is started at a 3 mg dose. Treatment is well tolerated, and clinical stability is achived. Cluster A personality traits are found. Complementary test Blood and Urine simples, Imaging tests (CT and MRI), electroencephalogram and Electrocardiogram show no alterations
Conclusions
Levetirazetam can cause psychiatric adverse effects. it is important to make a proper diagnosis before a first psychotic outbreak in later life. Drugs that can produce psychiatric side effects should be identified and patients should be inform.
The coronavirus disease 2019 (COVID-19) pandemic and the resulting containment measures, such as “lockdown” and “social distancing”, have had important consequences on people’s mental and physical health.
Objectives
We aimed to study the effect of social isolation and subsequent re- exposure and eventual changes in general and ED-specific psychopathology in people with Eating Disorders (EDs).
Methods
Three-hundred twelve Italian people with EDs (179 Anorexia Nervosa, 83 Bulimia Nervosa, 48 Binge Eating Disorder and 22 Other Specific Feeding Eating Disorder) were asked to fill-in an online survey to explore several dimensions such as: anxiety, depression, panic, insomnia, suicide ideation, stress, post-traumatic stress and obsessive-compulsive symptoms. Differences in ED specific and general symptoms among the 3 investigated time periods (before, during and after the end of lockdown) were assessed with a one-way ANOVA with repeated measures. Subsequently, ED diagnosis was introduced as covariate in the analysis in order to investigate the possible contribution on psychopathological changes.
Results
ED core symptoms increased during the lockdown but most of them returned to pre-COVID19 levels at re-opening. The severity of general psychopathology also increased during the lockdown and persisted high in the following phase, except for depression and suicide ideation. None of this symptoms was affected by ED diagnosis, participants’age and illness duration.
Conclusions
People with EDs showed worsening of both general and specific psychopathology; moreover, changes in general psychopathology persisted in the re-opening period suggesting a higher stress vulnerability in this kind of patients.
Skin-Picking Disorder (SPD) is psychiatric condition characterized by recurrent and excessive picking of the skin. There are several attempts to stop the behavior and it causes negative consequences such as dermatological complications and functional impairment.
Objectives
The aim of this study is to describe a case report of SPD.
Methods
Data was collected retrospectively from case notes.
Results
A 30 year-old male, married with 2 children, currently on sick leave, was admitted to the Day Hospital at Centro Hospitalar Psiquiátrico de Lisboa (CHPL) with worsen skin-picking behaviour and functional impairment. During childhood the patient would “cut my toe nails the wrong way so that I could fix them”. By adolescence the patient suffered from acne and felt the need to “solve” them and take out the pus. Over the years the skin-picking behaviour spread to other areas of the body, mainly dorsal and chest areas. Before being admitted to the Day Hospital the episodes were daily and had 2-3 hours duration, using scissors and tweezers and evolving his family, asking his wife’s help with picking. He is being treated with fluoxetine 80 mg, risperidone 2 mg and N-acetylcysteine 1200 mg and Cognitive Behavioural Therapy. He is also participating in the Day Hospital activities that include occupational therapy, movement therapy, psychoeducation. After 2 months he has a few 20 minutes episodes per week, spends more time with his children and thinks about coming back to work.
Conclusions
SPD is a severe and debilitating illness that benefits from a multidisciplinary approach.
The psychopathological causes that advise against a bariatric surgical procedure include any state that puts at risk the modification of habits and beliefs regarding eating behavior, wich condition weight loss and health improvement.
Objectives
To Study the psychiatric profile of patients rejected for bariatric surgery at the Complejo Hospitalario Asistencial de León (León, Spain).
Methods
Retrospective observational study. All patients for whom bariatric surgery procedure has been contraindicated for psychopathological reasons are included. 145 patients were evaluated in the context of the protocol for bariatric surgery. The following diagnostic scales were used as support: Salamanca Questionnaire, Plutchik Impulsivity Scale, Attitudes towards change in patients with eating disorders (ACTA), Bulimia Investigatory Test Edinburgh e, and European Quality of Life-5 Dimensions.
Results
41 Patients were rejected for psychiatric reasons (28.28%). The most frequent diagnoses are impulse control disorder (39%), followed by eating disorder (27%). Other diagnoses found are: depressive disorder (10%), adjustment disorder (5%), personality disorders, intellectual disability and generalized anxiety disorder (3%) 78% of them are women.
Conclusions
Uncontrolled psychiatric pathology is a contraindication to bariatric surgery. Impulse control disorder and eating disorder are related to overweight and obesity, so a diagnosis and treatment are necessary prior planning surgical procedure. Psychopathological variables determine the success of bariatric surgery procedures and it is mandatory to consider them in the process.
Concerns have been raised about ecological momentary assessment (EMA) acceptability among patients with schizophrenia spectrum disorders (SSD), which is of major relevance during the e-Mental health-focused COVID-19 pandemic.
Objectives
To investigate i) the levels of adherence to a passive smartphone-based EMA tool, the Evidence-Based Behavior (eB2), among SSD patients; and ii) putative predictors of this.
Methods
Sample: SSD (F20-29-ICD10) outpatients, age 18-64, without financial incentives, recruited over 17/06/2019-11/03/2020 at the Hospital Universitario Fundación Jiménez Díaz (Madrid, Spain). Those who accepted the eB2 installation -users- and those who did not -non-users- were compared in sociodemographic, clinical, premorbid adjustment, neurocognitive, psychopathological, insight and metacognitive variables by a multivariable binary logistic regression model.
Results
Sample (N=77): n=41 males; age: 47.69±9.76 years, n=24 users (31.2%). n=14 users (70%) had the eB2 installed at follow-up (median=14.50 weeks).
Multivariable binary logistic regression model on ‘user’ as outcome
Acceptability of a smartphone-based EMA application among SSD patients was low. Age (young) and good premorbid adjustment predicted acceptability. e-Mental Health methods need to be tailored for patients with SSD. Otherwise, these highly vulnerable individuals may be neglected by e-health-based services in the post-COVID-19 years ahead.
Schizophrenia it’s a deteriorating illness, where the cognitive impairment it’s one of the predominant components in this process. Theory of neurodevelopment, the most widely recognized, explains that cognition will depend most of it, on premorbid development. However, other factors explain this impairment, such as the cardiovascular risk factors (CVRF).
Objectives
The purpose of this study is to determine cognitive impairment and the domains affected in a sample of patients who suffered schizophrenia and almost one CVRF.
Methods
Cross-sectional study. Patients diagnosed with schizophrenia and at least one poorly controlled CVRF (diabetes, hypercholesterolemia, arterial hypertension or active smoking) were selected. Screen for Cognitive Impairment in Psychiatry (SCIP) scale was used to evaluate cognitive impairment and the domains affected.
Results
Preliminary data of twenty patients were included (60% men, mean age: 50 years). At CVRF in the sample, no diabetes was found, 75% had hypercholesterolemia, 15% arterial hypertension and 20% active smoking. SCIP scale showed deficits in word learning and delayed learning in 95% of the sample (n=19). The domain less affected was verbal fluency, affected in 55% of the sample (n=11). Additionally, moderate to severe cognitive impairment was observed in 65% of the sample (n=13).
Conclusions
More than half of the patients with schizophrenia and CVRF have a moderate to severe cognitive impairment. Intervention at CVRF could reduce the severity of cognitive impairment, improving functionality in these patients.
Schizoaffective disorder is a psychotic disorder of controversial nosological entity. Affective symptomatology and psychotic features of varying intensity coexist simultaneously in him throughout evolution. The lack of consensus on the existence of this entity determines its diagnostic delay and the absence of specific treatment guidelines.
Objectives
To review the diagnostic criteria for schizoaffective disorder and the published scientific evidence on the efficacy and safety of the different therapeutic options available. To analyze the efficacy of a multidisciplinary treatment plan implemented in an intensive follow-up program, presenting the evolution of a clinical case.
Methods
To review the psychiatric history and psychopathological evolution of a patient diagnosed with schizoaffective disorder from the beginning of an intensive follow-up program in a day center to the present. Review the existing scientific evidence on the usefulness of the treatments used in this nosological entity.
Results
This is a longitudinal and retrospective study of a clinical case in which the areas for improvement are analyzed before implementing a multidisciplinary therapeutic program and the favorable results obtained today. Currently, the patient is euthymic and attenuated and chronic positive and negative symptoms persist that do not interfere with his functionality.
Conclusions
From the implementation of an individualized, personalized and multidisciplinary maintenance treatment plan, an overall improvement in psychopathological stability and functional recovery is observed. Among the psychopharmacological options in this patient, Paliperidone Long Acting Injection (PLAI) stands out for its long-term efficacy and safety.
It has been shown that long-acting treatments can significantly improve adherence, control symptom, and reduce the risk of relapse compared to oral drugs. However, limited real world evidence is available as to whether there are differences among the various formulations marketed.
Objectives
This study aims to assess the impact on several prognosis variables of PP1M,PP3M,AOM and OAP drugs.
Methods
All adults (≥18 years) with schizophrenia who were initiated on PP1M, PP3M, AOM, or OAP treatment (chlorpromazine,levomepromazine,fluphenazine,haloperidol,ziprasidone,zuclopenthixol,olanzapine,quetiapine,asenapine,amisulpride, risperidone,aripiprazole,paliperidone) between 2017 and 2018 were identified in IQVIA’s database(1.8M of inhabitants from 4 Spanish areas). The rate of hospitalizations, emergency room visits, and treatment persistence was calculated using the Kaplan-Meier method. Survival curves were compared using the log-rank test (Sidak-adjustment),and Cox´s Hazard Ratios (HR) were used for the comparison between groups.
Results
Data from 2275 patients were analyzed (PP1M= 387;PP3M=490;AOM=75;OAP=1323).The mean age of patients was 46.8(14.95) years, and 62.9% were male. The hospitalization rate at 12 months was significantly lower (p<0.01) for PP3M (8.3%) than for AOM (21.2%), PP1M (22.1%),and OAP (29.4%).When compared with PP3M use, the HRs were 2.17 for PP1M, 2.22 for AOM,and 2.90 for OAP. Emergency room visits rate at 12 months was also significantly lower (p<0. 01) for PP3M (23%) than for PP1M (36.9%), OAP (43.5%),and AOM (46.2%). Persistence rates were higher for PP3M (91%) than for any other treatment (p<0.01).
Conclusions
Our results outline that patients treated with PP3M experienced fewer relapses and decompensations compared to all other treatments analyzed, which might help improve the prognosis and quality of life of patients.
Conflict of interest
This study was sponsored by Janssen. M. García and P. López are employees of Janssen.
People with borderline personality disorder are at higher risk of repeating suicidal behavior. At the same time, numerous publications have demonstrated the relationship between cocaine dependence and suicide attempts of repetition.
Objectives
Review the relationship between cocaine addiction, borderline personality disorder and repeated suicide attempts. Present through a clinical case the effectiveness of a comprehensive and multidisciplinary therapeutic plan with different mental health devices.
Methods
To review the psychopathological evolution of a patient with a diagnosis of borderline personality disorder; dependence to the cocaine; Harmful alcohol consumption and suicidal behavior from the beginning of follow-up in mental health services to the present. Review the existing scientific evidence on the relationship between cocaine addiction and repeated suicide attempts. Analyze the eficacy of the different treatments available.
Results
This is a longitudinal and retrospective study of the psychiatric history and evolution of a clinical case since the implementation of an individualized therapeutic program and the favorable results obtained. Intensive outpatient follow-up was carried out for high suicide risk and hospitalization in a psychiatric hospitalization unit, day care centre and therapeutic community.
Conclusions
At present, the patient remains in abstinence with remission of suicidal ideation. The literature has shown the usefulness of intensive mental health follow-up programs to achieve remission of suicidal ideation and maintain abstinence from illegal substances.
Smoking rates are quite high among overweight and obese individuals. Many smokers with excess weight are at increased risk for health complications and report that concern about post-cessation weight gain is a barrier to quitting. It is necessary to perform studies to assess the efficacy of interventions for smoking cessation among individuals with excess weight.
Objectives
To describe in-treatment behaviors, in terms of smoking and weight, in an integrated intervention for smoking cessation and weight gain management.
Methods
A total of 16 smokers (37.5% females, Mage=52.31, SD=9.58) were randomly assigned to one of the two following 8-week smoking cessation conditions: 1) Cognitive-Behavioral Treatment (CBT) for gradual smoking cessation + a Weight Gain Prevention (WGP) module for weight stability (n=7); 2) the same treatment alongside Contingency Management (CM) for smoking abstinence (n=9). Smoking behavior (cigarettes per day, carbon monoxide (CO) in expired air and urine cotinine) and weight were tracked at every visit from baseline through the end of treatment.
Results
Cigarettes per day significantly decreased in both conditions (p≤.028), as well as CO (p≤.018) and cotinine (p≤.043). Regarding body weight gain, participants maintained their body weight (Kg) from baseline to the end of treatment (CBT+WGP: Δkg= .671, CBT+WGP+CM: Δkg= .667, p≥.058) and their BMI (CBT+WGP: 30.56 vs. 30.85, CBT+WGP+CM: 29.74 vs. 29.85, p≥.139).
Conclusions
Preliminary data indicated that a multicomponent intervention to promote gradual smoking cessation and prevent weight gain facilitates in-treatment tobacco reduction and weight stability. CM procedures improved in-treatment smoking behaviors.
The prevalence of schizophrenia is close to 1 percent internationally. According to the 2019 census, the population in the province of León, our study population, is 460,001 inhabitants.
Objectives
To study the distribution of schizofrenia in the area covered by the Complejo Asistencial Universitario de León, Spain.
Methods
This is a retrospective and cross-sectional descriptive study. The data of the hospitalizations of the last 10 years (2009-2019) will be obtained in any service of the CAULE of the 28 basic health areas of the province of León, with a diagnosis of schizophrenia. Prevalence will be calculated. The rate of schizophrenia will be calculated for the decade per 1000 inhabitants.
Results
3133 admissions identified 1576 unique patients. It is the decade of 50-59 where the largest number of hospitalizations is concentrated. Most entered directly into the psychiatry hospital care. It is 2019 where the most income is produced and 2017 the one with the least. The rate of schizophrenia is 3,2 Per 1000 inhabitants.
Conclusions
Hospitalizations for schizophrenia is concentrated in the decade of the 40-49 years. The diagnosis of schizophrenia is frecuently delayed until negative symptoms appear. There is an upward trend in hospitalizations per year in the last decade. The rate of schizophrenia is higher in areas where consanguinity is present and where the prison is located.
Clozapine is a second-generation antipsychotic agent approved for treatment-resistant schizophrenia and risk reduction of recurrent suicidal behavior in schizophrenia and schizoaffective disorder. Given the known negative consequences of relapse of severe mental disorders for both mother and infant, the maintenance of clozapine during pregnancy is recommended.1 Studies of pregnancy regarding to clozapine have demonstrated a heterogenous range of neonatal and infant complications.2
Objectives
To evaluate neonatal and infants outcomes of clozapine exposure in pregnancy.
Methods
We report three cases of infants exposed to clozapine politherapy throughout pregnancy. The dose range for all women on clozapine was 200-600 mg/day. Infants were evaluated between 4-6 months of chronological age with the Bayley-III infant development scale (BSID-III)3 and with the Alarme Détresse Bébé Scale (ADBB)4 for the detection of early-signs of withdrawal.
Results
Women remained stable during pregnancy but presented obesity and gestational diabetes. Clozapine Newborn were born to term by caesarean section due to breech presentation (N=2) or instrumental delivery due to loss of fetal well-being (N=1). They presented normal weight (3500-3800 gr). Two presented Apgarmin1-5 9/10 and one Apgarmin1-5 6/8 which showed lethargy and low alertness during the first weeks of life. All showed normal capacity for sociability, reciprocity and development of language and communication. However, one baby had scores in the low normal zone for cognition and another for motor skills.
Conclusions
The infant’s risks of clozapine exposure during pregnancy should be discussed with women and weighed against those associated with other treatments and/or with untreated severe mental illness.
The diagnosis of hypochondria has disappeared in the new classification of mental illness. About 25% of patients who were diagnosed with hypochondria now fall into the category illness anxiety disorder. This disorder constitutes a new diagnostic category in DSM5 and is included within the somatic symptom and related disorders.
Objectives
We propose to carry out a bibliographic review off the new diagnostic category of illness anxiety disorder.
Methods
We present the clinical case of a 27-year-old man in the context of the Covid19 pandemic.
Results
The illness anxiety disorder is characterized by being concerned about having or acquiring a serious illness. Somatic symptoms are not present, but if they are, they are of mild intensity. The level of concern is excessive or disproportionate if there is any disease or if there is a high risk of developing it. There is a high level of health anxiety and the individual is easily alarmed by personal health status. It is a disorder that tends to be chronic and recurrent. The exact comorbidity is still unknown. However, it is important to keep in mind that hypochondria concurs with anxiety disorders and depressive disorders. Treatment is based on the cognitive restructuring of bodily symptoms. In addition, exposure therapy and acceptance and commitment therapy are also effective. Regarding pharmacological treatment, SSRIs are useful in relation with comorbidity.
Conclusions
Illness anxiety disorder is characterized by significant attention to somatic concerns in medical places, making it very useful for primary care professionals.