This study is about the clinical uses of three antidepressants( escitalopram, desvenlafaxine, vortioxetine) in the treatment of anxioun depression.

The purpose of this study was to compare the efficacy and safety of escitalopram, desvenlafaxine, vortioxetine, and aripiprazole augmentation with escitalopram in the acute treatment of anxious depression.

Patients (n=189) with DSM5 major depression and high levels of anxiety were evenly randomized to escitalopram, desvenlafaxine, vortioxetine, and aripiprazole augmentation with escitalopram in a six-week, randomized, rater-blinded, head to head comparative trial. Changes in overall depressive and anxiety symptoms were assessed.

Patients demonstrated similar baseline-to-endpoint improvement in HAMD and HAMA total scores. Patients also demonstrated similar response rate and remission rate in HAMD and HAMA. In analysis of individual HAMD and HAMA items, desvenlafaxine had greatly reduced scores for anxiety somatic (p=0.013), hypochondriasis (p=0.014), cardiovascular symptoms (p=0.005), respiratory symptoms (p=0.013) compared to escitalopram or vortioxetine. Each treatment were well tolerated with no significant differences.

These results showed no significant differences in efficacy and tolerability of escitalopram, desvenlafaxine, vortioxetine, and aripiprazole augmentation with escitalopram in this subtype of patients with anxious depression during the acute phase treatment.

No significant relationships.

Understand how the built environment can affect safety and efficiency outcomes during doffing of personal protective equipment (PPE) in the context of coronavirus disease 2019 (COVID-19) patient care.

We conducted (1) field observations and surveys administered to healthcare workers (HCWs) performing PPE doffing, (2) focus groups with HCWs and infection prevention experts, and (3) a with healthcare design experts.

This study was conducted in 4 inpatient units treating patients with COVID-19, in 3 hospitals of a single healthcare system.

The study included 24 nurses, 2 physicians, 1 respiratory therapist, and 2 infection preventionists.

The doffing task sequence and the layout of doffing spaces varied considerably across sites, with field observations showing most doffing tasks occurring around the patient room door and PPE support stations. Behaviors perceived as most risky included touching contaminated items and inadequate hand hygiene. Doffing space layout and types of PPE storage and work surfaces were often associated with inadequate cleaning and improper storage of PPE. Focus groups and the design charrette provided insights on how design affording standardization, accessibility, and flexibility can support PPE doffing safety and efficiency in this context.

There is a need to define, organize and standardize PPE doffing spaces in healthcare settings and to understand the environmental implications of COVID-19–specific issues related to supply shortage and staff workload. Low-effort and low-cost design adaptations of the layout and design of PPE doffing spaces may improve HCW safety and efficiency in existing healthcare facilities.

Necrotising otitis externa is a severe ear infection for which there are no established diagnostic or treatment guidelines.

This study described clinical characteristics, management and outcomes for patients managed as necrotising otitis externa cases at a UK tertiary referral centre.

A total of 58 (63 per cent) patients were classified as definite necrotising otitis externa cases, 31 (34 per cent) as probable cases and 3 (3 per cent) as possible cases. Median duration of intravenous and oral antimicrobial therapy was 6.0 weeks (0.49–44.9 weeks). Six per cent of patients relapsed a median of 16.4 weeks (interquartile range, 23–121) after stopping antimicrobials. Twenty-eight per cent of cases had complex disease. These patients were older (p = 0.042), had a longer duration of symptoms prior to imaging (p < 0.0001) and higher C-reactive protein at diagnosis (p = 0.005). Despite longer courses of intravenous antimicrobials (23 vs 14 days; p = 0.032), complex cases were more likely to relapse (p = 0.016).

A standardised case-definition of necrotising otitis externa is needed to optimise diagnosis, management and research.

This study aimed to analyse if there were any associations between patulous Eustachian tube occurrence and climatic factors and seasonality.

The correlation between the monthly average number of patients diagnosed with patulous Eustachian tube and climatic factors in Seoul, Korea, from January 2010 to December 2016, was statistically analysed using national data sets.

The relative risk for patulous Eustachian tube occurrence according to season was significantly higher in summer and autumn, and lower in winter than in spring (relative risk (95 per cent confidence interval): 1.334 (1.267–1.404), 1.219 (1.157–1.285) and 0.889 (0.840–0.941) for summer, autumn and winter, respectively). Temperature, atmospheric pressure and relative humidity had a moderate positive (r = 0.648), negative (r = –0.601) and positive (r = 0.492) correlation with the number of patulous Eustachian tube cases, respectively.

The number of patulous Eustachian tube cases was highest in summer and increased in proportion to changes in temperature and humidity, which could be due to physiological changes caused by climatic factors or diet trends.

Over the past two decades, early detection and early intervention in psychosis have become essential goals of psychiatry. However, clinical impressions are insufficient for predicting psychosis outcomes in clinical high-risk (CHR) individuals; a more rigorous and objective model is needed. This study aims to develop and internally validate a model for predicting the transition to psychosis within 10 years.

Two hundred and eight help-seeking individuals who fulfilled the CHR criteria were enrolled from the prospective, naturalistic cohort program for CHR at the Seoul Youth Clinic (SYC). The least absolute shrinkage and selection operator (LASSO)-penalized Cox regression was used to develop a predictive model for a psychotic transition. We performed k-means clustering and survival analysis to stratify the risk of psychosis.

The predictive model, which includes clinical and cognitive variables, identified the following six baseline variables as important predictors: 1-year percentage decrease in the Global Assessment of Functioning score, IQ, California Verbal Learning Test score, Strange Stories test score, and scores in two domains of the Social Functioning Scale. The predictive model showed a cross-validated Harrell's C-index of 0.78 and identified three subclusters with significantly different risk levels.

Overall, our predictive model showed a predictive ability and could facilitate a personalized therapeutic approach to different risks in high-risk individuals.

To conduct international comparisons of self-reports, collateral reports, and cross-informant agreement regarding older adult psychopathology.

We compared self-ratings of problems (e.g. I cry a lot) and personal strengths (e.g. I like to help others) for 10,686 adults aged 60–102 years from 19 societies and collateral ratings for 7,065 of these adults from 12 societies.

Data were obtained via the Older Adult Self-Report (OASR) and the Older Adult Behavior Checklist (OABCL; Achenbach et al., 2004).

Cronbach’s alphas were .76 (OASR) and .80 (OABCL) averaged across societies. Across societies, 27 of the 30 problem items with the highest mean ratings and 28 of the 30 items with the lowest mean ratings were the same on the OASR and the OABCL. Q correlations between the means of the 0–1–2 ratings for the 113 problem items averaged across all pairs of societies yielded means of .77 (OASR) and .78 (OABCL). For the OASR and OABCL, respectively, analyses of variance (ANOVAs) yielded effect sizes (ESs) for society of 15% and 18% for Total Problems and 42% and 31% for Personal Strengths, respectively. For 5,584 cross-informant dyads in 12 societies, cross-informant correlations averaged across societies were .68 for Total Problems and .58 for Personal Strengths. Mixed-model ANOVAs yielded large effects for society on both Total Problems (ES = 17%) and Personal Strengths (ES = 36%).

The OASR and OABCL are efficient, low-cost, easily administered mental health assessments that can be used internationally to screen for many problems and strengths.

Patulous Eustachian tube appears to be caused by a concave defect in the anterolateral wall of the tubal valve of the Eustachian tube. This study aimed to compare the clinical features of patulous Eustachian tube patients with or without a defect in the anterolateral wall of the tubal valve.

Sixty-six patients with a patulous Eustachian tube completed a questionnaire, which was evaluated alongside endoscopic findings of the tympanic membrane, nasal cavity and Eustachian tube orifice.

Females were more frequently diagnosed with a patulous Eustachian tube, but the valve defect was more common in males (p = 0.007). The ratio of patulous Eustachian tube patients with or without defects in the anterolateral wall of the tubal valve was 1.6:1. Weight loss in the previous six months and being refractory to conservative management were significantly associated with the defect (p = 0.035 and 0.037, respectively). Symptom severity was significantly higher in patients with the defect.

Patulous Eustachian tube patients without a defect in the anterolateral wall of the tubal valve can be non-surgically treated more often than those with the defect. Identification of the defect could assist in making treatment decisions for patulous Eustachian tube patients.

The prevalence of internet game use among children and adolescents has been increased in the recent years.

Internet addiction has been found to cause various psychiatric symptoms and psychological problems. Internet addiction has been found to cause various psychiatric symptoms and psychological problems.

The aim of this study was to examine the association between problematic internet game use and psychiatric symptoms in a sample of the Child and Adolescent Psychiatric Clinic, Ulsan University Hospital.

We analyzed data from 447 subjects who first visit the Child and Adolescent Psychiatric Clinic of the Ulsan University Hospital. The level of Internet addiction was categorized as either high-risk (≥108; group 3), potential risk (95 to 107; group 2), or no risk (≤94, group 1) based on the total score. Data were analyzed using SPSS version 17.0 and one-way ANOVA and multiple logistic regression method were used.

Thirteen adolescents met the criteria for high risk group of internet game addiction. in the high risk group, 10 were male and 3 were female adolescents. There was an mean difference among group 3 (high risk)< 1 (no risk),2 (potential risk) in AHI ; whereas group 3 (high risk)>1 (no risk), 2 (potential risk) in BDI, BAI, inattention, hyperactivity/impulsivity and K-ARS score. with multiple logistic regression analysis, K-scale was significantly related with male sex, BDI, ARShyperactivity/ impulsivity score.

We conclude that having male sex, happiness and depressive symptoms is associated with the risk of developing internet use disorders.