198 results
Systematics and life cycles of four avian schistosomatids from Southern Cone of South America
- P. Oyarzún-Ruiz, R. Thomas, A. Santodomingo, M. Zamorano-Uribe, M. Moroni, L. Moreno, S. Muñoz-Leal, V. Flores, S. Brant
-
- Journal:
- Journal of Helminthology / Volume 98 / 2024
- Published online by Cambridge University Press:
- 03 June 2024, e47
-
- Article
- Export citation
-
Relative to the numerous studies focused on mammalian schistosomes, fewer include avian schistosomatids particularly in the southern hemisphere. This is changing and current research emerging from the Neotropics shows a remarkable diversity of endemic taxa. To contribute to this effort, nine ducks (Spatula cyanoptera, S. versicolor, Netta peposaca), 12 swans (Cygnus melancoryphus) and 1,400 Physa spp. snails from Chile and Argentina were collected for adults and larval schistosomatids, respectively. Isolated schistosomatids were preserved for morphological and molecular analyses (28S and COI genes). Four different schistosomatid taxa were retrieved from birds: Trichobilharzia sp. in N. peposaca and S. cyanoptera that formed a clade; S. cyanoptera and S. versicolor hosted Trichobilharzia querquedulae; Cygnus melancoryphus hosted the nasal schistosomatid, Nasusbilharzia melancorhypha; and one visceral, Schistosomatidae gen. sp., which formed a clade with furcocercariae from Argentina and Chile from previous work. Of the physid snails, only one from Argentina had schistosomatid furcocercariae that based on molecular analyses grouped with T. querquedulae. This study represents the first description of adult schistosomatids from Chile as well as the elucidation of the life cycles of N. melancorhypha and T. querquedulae in Chile and Neotropics, respectively. Without well-preserved adults, the putative new genus Schistosomatidae gen. sp. could not be described, but its life cycle involves Chilina spp. and C. melancoryphus. Scanning electron microscopy of T. querquedulae revealed additional, undescribed morphological traits, highlighting its diagnostic importance. Authors stress the need for additional surveys of avian schistosomatids from the Neotropics to better understand their evolutionary history.
Molecular detection of Histoplasma capsulatum in organ samples from bats randomly captured in urban areas of Araraquara, São Paulo state, Brazil
- Jessica A. Ruiz-Muñoz, Gabriela Rodríguez-Arellanes, José A. Ramírez, Laura E. Carreto-Binaghi, Ana M. Fusco-Almeida, Maria J. S. Mendes-Giannini, Blanca E. García-Pérez, Maria L. Taylor
-
- Journal:
- Epidemiology & Infection / Volume 152 / 2024
- Published online by Cambridge University Press:
- 06 May 2024, e83
-
- Article
-
- You have access Access
- Open access
- HTML
- Export citation
-
The mycosis histoplasmosis is also considered a zoonosis that affects humans and other mammalian species worldwide. Among the wild mammals predisposed to be infected with the etiologic agent of histoplasmosis, bats are relevant because they are reservoir of Histoplasma species, and they play a fundamental role in maintaining and spreading fungal propagules in the environments since the infective mycelial phase of Histoplasma grows in their accumulated guano. In this study, we detected the fungal presence in organ samples of bats randomly captured in urban areas of Araraquara City, São Paulo, Brazil. Fungal detection was performed using a nested polymerase chain reaction to amplify a molecular marker (Hcp100) unique to H. capsulatum, which revealed the pathogen presence in organ samples from 15 out of 37 captured bats, indicating 40.5% of infection. Out of 22 Hcp100-amplicons generated, 41% corresponded to lung and trachea samples and 59% to spleen, liver, and kidney samples. Data from these last three organs suggest that bats develop disseminated infections. Considering that infected bats create environments with a high risk of infection, it is important to register the percentage of infected bats living in urban areas to avoid risks of infection to humans, domestic animals, and wildlife.
56 Dunning-Kruger Effect and Anxiety in a Mexican population
- Natalia L. Acosta, Krissy E. Smith, Tara L. Victor, David H. Hardy, Alberto L. Fernandez, Raymundo Cervantes, Ana Paula P. Quiñones, Carolina G. Castañeda, Jill Razani, Isabel D.C. Muñoz, Daniel W. Lopez-Hernandez
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 841-842
-
- Article
-
- You have access Access
- Export citation
-
Objective:
The Dunning-Krueger effect is a cognitive bias where individuals tend to overestimate their abilities in areas where they are less competent. The Cordoba Naming Test (CNT) is a 30-item confrontation naming task. Hardy and Wright (2018) conditionally validated a measure of perceived mental workload called the NASA Task Load Index (NASA-TLX). Researchers reported that workload ratings on the NASA-TLX increased with increased task demands on a cognitive task. Anxiety is known as an emotion that can make an individual more susceptible to develop a mental health condition. We examine if the Dunning-Krueger effect occurs in a Mexican population with and without current symptoms of anxiety and possible factors driving individuals to overestimate their abilities on the CNT. We predicted the abnormal symptoms of anxiety (ASA) group would report better CNT performance, report higher perceived workloads on the CNT, and underperform on the CNT compared to the normal symptoms of anxiety (NSA) group. We also predicted the low-performance group would report better CNT performance, report higher perceived workloads on the CNT, and underperform on the CNT compared to the high-performance group.
Participants and Methods:The sample consisted of 192 Mexican participants with NSA (79 low-performance & 113 high-performance) and 74 Mexican participants with ASA (44 low-performance & 30 high-performance). Participants completed the CNT, NASA-TLX, and the Hospital Anxiety and Depression Scale (HADS) in Spanish. The NASA-TLX was used to evaluate perceived workloads after the completion of the CNT. Meanwhile, the HADS was used to create our anxiety groups. Finally, CNT raw scores were converted into T-scores, which then were averaged to create the following two groups: low-performance (CNT T-Score <50) and high-performance (CNT T-Score 50+). A series of 2x2 ANCOVAs, controlling for gender were used to evaluate CNT performance and perceived workloads.
Results:We found a significant interaction where the low-performance ASA and the high-performance NSA groups demonstrated better CNT performance and reported higher perceived workloads (i.e., performance, temporal demand) on the CNT compared to their respective counterparts (i.e., low-performance NSA & high-performance ASA groups), p's<.05, ηp's2=.02. We found a main effect where the high-performance group outperformed the low-performance group on the CNT and reported lower perceived workloads on the CNT, p's<.05, ηp's2 =.04-.46.
Conclusions:The Dunning-Krueger effect did not occur in our sample. Participants that demonstrated better CNT performance also reported higher perceived workloads regardless of their current symptoms of anxiety. A possible explanation can be our sample's cultural norms of what would be considered as abnormal symptoms of anxiety, is a normal part of life, decreasing the possibilities to experience self-efficacy distoritions. Future studies should investigate whether the Dunning-Kruger effect may be influencing other aspects of cognitive functioning subjectively in Mexicans residing in Mexico and the United States with and without current symptoms of anxiety.
27 Aging Affects Cordoba Naming Test Performance
- Jasman Sidhu, Krithika Sivaramakrishnan, Raymundo Cervantes, Sarah Saravia, Luz Estrada, Dulce Garcia, Alexia Barrio, Isabel D. Munoz, Enrique Lopez, Tara L. Victor, Alberto L. Fernandez, Daniel W. Lopez-Hernandez
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 339-340
-
- Article
-
- You have access Access
- Export citation
-
Objective:
The Cordoba Naming Test (CNT) is a 30-item confrontation naming test developed in Argentina. A common confrontation naming task used in the United States is the Boston Naming Test (BNT). Research shows that age affects BNT performance in the 60-item long form. In fact, studies show that scores on confrontation naming tasks increase in childhood and continue to improve until approximately 40 years of age. However, after this period, scores start to subsequently decline, and especially so after 70 years of age. On the other hand, some studies have reported that older adults maintain high BNT performance despite advancing age. To our knowledge, no study has investigated the aging effects of the CNT across various age groups. We expected CNT scores to increase significantly from young adulthood to mid-adulthood and then significantly decline with advancing age.
Participants and Methods:The present study sample consisted of 272 neurologically and psychologically healthy participants with a mean age of 27.06 (SD = 12.21) with 14.29 years of education completed (SD = 2.46). Participants were divided into six different age groups: 18-19-year-old group, 20-29-year-old group, 30-39-year-old group, 40-49-year-old group, 50-59-year-old group, and 60-69-year-old group. All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in English. The CNT consisted of 30 black and white line drawings, ranging from easy to hard difficulty. An ANCOVA, controlling for gender, was used to evaluate CNT performance between the six age groups. We used a threshold of p < .05 for statistical significance.
Results:Results revealed significant group differences between the six age groups on the CNT, p = .000, ηp2 = .14. A post-hoc test revealed that the 30-39-year-old group outperformed the 18-19-year-old, 20-29-yearold, and 60-69-year-old groups on the CNT. Finally, the 40-49-year-old group outperformed the 18-19-year-old and 60-69-year-old groups on the CNT.
Conclusions:As we predicted, participants demonstrated steady improvement in the CNT until the age of 40. However, we found that until the age of 60, CNT performance started to decline significantly. Our data suggests that CNT performance declines significantly at the age of 60 compared to previous research using the BNT. Research shows other demographic variables (e.g., gender, linguistic factors) influence BNT performance. Future investigations on the CNT using a healthy sample should use a multivariate statistical analysis method to help explain influencing factors across aging. This research can have the potential to improve public health to better support and understand individuals from diverse backgrounds.
35 Bilingualism and Time Perspective in Hispanic-Americans Speed Attention
- Daniel W. Lopez-Hernandez, Krissy E. Smith, Isabel D. C. Munoz, Tara L. Victor
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 447-448
-
- Article
-
- You have access Access
- Export citation
-
Objective:
Differences between monolinguals and bilinguals have been documented in neuropsychological test performance. Various explanations have been provided to explain why differences exist among these language groups. Hispanic-Americans are individuals born and reside in the United States and have a family background extending to one of the Spanish-speaking countries in Latin America or Spain. Furthermore, Hispanic-American children from Hispanic homes where Spanish is their first language find themselves academically at a disadvantage because their English vocabulary may be lower than English monolinguals. Time perspective (TP) refers to an individual’s orientation towards the past, present, or future. One’s ability to change their TP in order to adapt to changes in cultural context can result in optimal psychological well-being. In one study, researchers reported no relationship existed between ethnicity and TP on cognition. To our knowledge, no study has examined the relationship between language and TP in Hispanic-Americans’ speed attention performance. Therefore, it was predicted that monolinguals would outperform bilinguals on speed attention tasks. Next, it was predicted that monolinguals would report higher scores on future time orientation compared to bilinguals, and bilinguals would report higher scores on past and present time orientation compared to monolinguals. Finally, differences in TP would correlate with speed attention tasks between language groups.
Participants and Methods:The sample consisted of 119 Hispanic-Americans with a mean age of 19.45 (SD = 1.43). Participants were broken into three groups: English first language monolingual (EFLM), English first language bilingual (EFLB), and English second language bilingual (ESLB). The Comalli Stroop part A and B, Trail Making Test part A, and Symbol Digit Modalities Test written and oral parts were used to evaluate speed attention and the Zimbardo Time Perspective Inventory was used to evaluate time orientation in our sample.
Results:ANOVAs revealed the EFLM group outperformed the ESLB group on the Comalli Stroop part B, p = .020, np2 = .07. Next, we also found on the Symbol Digit Modalities Test written part the EFLB group outperformed both bilingual groups, p = .025, np2 = .06. Regarding TP, the EFLB group reported higher past negative orientation compared to the EFLM group, p = .033, np2 = .06. Additionally, we found the bilingual groups reported higher present-fatalistic compared to the EFLM group, p = .023, np2 = .06. Pearson’s correlation revealed no significant correlations between TP and speed attention tasks on any of our language groups.
Conclusions:As expected, the EFLM group outperformed the ESLB group on several speed attention tasks, but the EFLM group only outperformed the EFLB group on the Symbol Digit Modalities Test written part. Additionally, we found that our EFLB sample reported higher orientation of the past and present compared to monolinguals. Our sample level of acculturation could have been a factor influencing the relationship between TP and speed attention. Future studies using larger representative samples should include measures of acculturation and examine if TP influences other cognitive domains (e.g., executive function) in Hispanic-American monolingual and bilingual speakers.
8 The Dunning-Kruger Effect on a Latinx Population
- Carolina Garza Castaneda, Matthew J. Wright, Raymundo Cervantes, Tara L. Victor, Krissy E. Smith, Chelsea McElwee, Adriana Cuello, Alberto L. Fernandez, Isabel D. C. Munoz, David J. Hardy, Daniel W. Lopez-Hernandez
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 423-424
-
- Article
-
- You have access Access
- Export citation
-
Objective:
Individuals tend to overestimate their abilities in areas where they are less competent. This cognitive bias is known as the Dunning-Krueger effect. Research shows that Dunning-Krueger effect occurs in persons with traumatic brain injury and healthy comparison participants. It was suggested by Walker and colleagues (2017) that the deficits in cognitive awareness may be due to brain injury. Confrontational naming tasks (e.g., Boston Naming Test) are used to evaluate language abilities. The Cordoba Naming Test (CNT) is a 30-item confrontational naming task developed to be administered in multiple languages. Hardy and Wright (2018) conditionally validated a measure of perceived mental workload called the NASA Task Load Index (NASA-TLX). They found that workload ratings on the NASA-TLX increased with increased task demands on a cognitive task. The purpose of the present study was to determine whether the Dunning-Kruger effect occurs in a Latinx population and possible factors driving individuals to overestimate their abilities on the CNT. We predicted the low-performance group would report better CNT performance, but underperform on the CNT compared to the high-performance group.
Participants and Methods:The sample consisted of 129 Latinx participants with a mean age of 21.07 (SD = 4.57). Participants were neurologically and psychologically healthy. Our sample was divided into two groups: the low-performance group and the high-performance group. Participants completed the CNT and the NASA-TLX in English. The NASA-TLX examines perceived workload (e.g., performance) and it was used in the present study to evaluate possible factors driving individuals to overestimate their abilities on the CNT. Participants completed the NASA-TLX after completing the CNT. Moreover, the CNT raw scores were averaged to create the following two groups: low-performance (CNT raw score <17) and high-performance (CNT raw score 18+). A series of ANCOVA's, controlling for gender and years of education completed were used to evaluate CNT performance and CNT perceived workloads.
Results:We found the low-performance group reported better performance on the CNT compared to the high-performance, p = .021, np2 = .04. However, the high-performance group outperformed the low-performance group on the CNT, p = .000, np2 = .53. Additionally, results revealed the low-performance group reported higher temporal demand and effort levels on the CNT compared to the high-performance group, p's < .05, nps2 = .05.
Conclusions:As we predicted, the low-performance group overestimated their CNT performance compared to the high-performance group. The current data suggest that the Dunning-Kruger effect occurs in healthy Latinx participants. We also found that temporal demand and effort may be influencing awareness in the low-performance group CNT performance compared to the high-performance group. The present study suggests subjective features on what may be influencing confrontational naming task performance in low-performance individuals more than highperformance individuals on the CNT. Current literature shows that bilingual speakers underperformed on confrontational naming tasks compared to monolingual speakers. Future studies should investigate if the Dunning-Kruger effects Latinx English monolingual speakers compared to Spanish-English bilingual speakers on the CNT.
25 Exploring Phonemic and Semantic Fluency Ability Across Multiple Generations
- Krithika Sivaramakrishnan, Dorthy Schmidt, Krissy E Smith, Brittany Heuchert, Adriana C Cuello, Natalia L Acosta, Miriam Gomez, Isabel D Munoz, Yvette D Jesus, Daniel W Lopez-Hernandez
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 438-439
-
- Article
-
- You have access Access
- Export citation
-
Objective:
Verbal fluency tasks evaluate executive functioning by requiring a person to provide words within a certain time period that start with a certain letter (phonemic fluency) or category (semantic fluency). Research shows that age impacts test takers’ phonemic and semantic verbal fluency performance. In fact, it has been suggested that phonemic verbal fluency peaks around age 30 to 39 and begins to decline at older ages. In contrast to phonemic fluency, research suggests that semantic fluency increases steadily between test takers until age 12 and begins declining around age 20. A generation is a cohort of people born within a certain period who share age and experiences. Studies show that Generation X individuals (persons born between 1965-1980) outperform Generation Y (persons born between 19811995) and Generation Z individuals (persons born between 1965-1980) on the Cordoba Naming Test. To our knowledge, no study has investigated verbal fluency performance across generational groups. We predicted that Generation X individuals would outperform individuals from Generation Y and Z on both verbal fluency measures.
Participants and Methods:The sample of the present study consisted of 107 participants with a mean age of 27.39 (SD = 9.16). Participants were divided into three groups: Generation X (n = 19), Generation Y (n = 52), and Generation Z (n = 36). The phonemic verbal fluency task consisted of three trials and the semantic verbal fluency task consisted of one trial, one minute each. A series of ANCOVAs with Bonferroni post-hoc tests were used to evaluate verbal fluency performance between generational groups. All participants passed performance validity testing.
Results:We found significant differences between our generational groups on both verbal fluency tasks. Post-hoc tests revealed that the Generation Y group outperformed both Generation X and Z groups on both verbal fluency tasks, p’s <.05, np2 =.11 -.16. No significant differences were found on either verbal fluency task between the Generation X and Z groups.
Conclusions:Contrary to our hypothesis, Generation Y individuals possessed better phonemic and semantic fluency than both Generation X and Z individuals. Meanwhile, Generation X individuals did not significantly differ on any of the verbal fluency tasks compared to Generation Z individuals. Speaking multiple languages has been shown to impact verbal fluency performance. In our sample, the Generation X and Z groups consisted primarily of bilingual speakers compared to the Generation Y group. Examining generational differences is essential to understand the unique characteristics and impact of the times in which various individuals have grown up. Future research, for instance, should evaluate the influence of bilingualism across generational groups on verbal fluency performance.
22 Cordoba Naming Test Performance and Acculturation in a Geriatric Population
- Isabel C.D. Muñoz, Krissy E. Smith, Santiago I. Espinoza, Diana M. R. Maqueda, Adriana C. Cuello, Ana Paula Pena, Carolina Garza, Raymundo Cervantes, Jill Razani, Tara L. Victor, David J. Hardy, Alberto L. Fernandez, Natalia Lozano Acosta, Daniel W. Lopez-Hernandez
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 335-336
-
- Article
-
- You have access Access
- Export citation
-
Objective:
A commonly used confrontation naming task used in the United States is The Boston Naming Test (BNT). Performance differences has been found in Caucasian and ethnic minorities on the BNT. The Cordoba Naming Test (CNT) is a 30-item confrontation naming task developed in Argentina. Past research has shown acculturation levels can influence cognitive performance. Furthermore, one study evaluated geriatric gender differences on CNT performance in Spanish. Researchers reported that older male participants outperformed female participants on the CNT. To our knowledge, researchers have not evaluated ethnic differences on the CNT using a geriatric sample. The purpose of the present study was to examined CNT performance and acculturation in a Latinx and Caucasian geriatric sample. It was predicted the Caucasian group would outperform the Latinx group on the CNT. Moreover, the Caucasian group would report higher acculturation levels on the Abbreviated Multidimensional Acculturation Scale (AMAS) compared to the Latinx group.
Participants and Methods:The sample consisted of 9 Latinx and 11 Caucasian participants with a mean age of 66.80 (SD =6.10), with an average of 14.30 (SD = 2.00) years of education. All participants were neurologically and psychologically healthy and completed the CNT and the AMAS in English. Acculturation was measured via the AMAS English subscales (i.e., English Language, United States. Identity, United States, Competency). A series of ANCOVAs, controlling for years of education completed and gender, was used to evaluate CNT performance and acculturation.
Results:The ethnic groups were not well demographically matched (i.e., years of education and gender).We found that the Caucasian group outperformed the Latinx group on CNT performance p = .012, ηp 2 = .34. Furthermore, the Caucasian group reported higher acculturation levels (i.e., English Language, United States, Identity, United States, Competency) compared to the Latinx group p’s < .05, ηps2 = .42-.64.
Conclusions:To our knowledge, this is the first study to evaluate CNT performance between ethnic groups with a geriatric sample. As expected the Caucasian group outperformed the Latinx group on the CNT. Also, as expected the Caucasian group reported higher English acculturation levels compared to the Latinx group. Our findings are consistent with past studies showing ethnic differences on confrontational naming performance (i.e., The Boston Naming Test), favoring Caucasians. A possible explanation for group differences could have been linguistic factors (e.g., speaking multiple languages) in our Latinx group. Therefore, since our Latinx group reported lower levels of English Language, United States identity, and United States competency the Latinx group assimilation towards United States culture might of influence their CNT performance. Future studies with different ethnic groups (e.g., African-Americans) and a larger sample size should examine if ethnic differences continue to cross-validate in a geriatric sample.
30 Analyzing Spanish Speakers Cordoba Naming Test Performance
- Raymundo Cervantes, Isabel D.C. Munoz, Estefania J. Aguirre, Natalia Lozano Acosta, Mariam Gomez, Adriana C. Cuello, Krissy E. Smith, Diana I. Palacios Mata, Krithika Sivaramakrishnan, Yvette De Jesus, Santiago I. Espinoza, Diana M. R. Maqueda, David J. Hardy, Tara L. Victor, Alberto L. Fernandez, Daniel W. Lopez-Hernandez
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 443-444
-
- Article
-
- You have access Access
- Export citation
-
Objective:
A 30-item confrontation naming test was developed in Argentina for Spanish speakers, The Cordoba Naming Test (CNT). The Boston Naming Test is an established confrontation naming task in the United States. Researchers have used the Boston Naming Test to identify individuals with different clinical pathologies (e.g., Alzheimer’s disease). The current literature on how Spanish speakers across various countries perform on confrontational naming tasks is limited. To our knowledge, one study investigated CNT performance across three Spanish-speaking countries (i.e., Argentina, Mexico, and Guatemala). Investigators found that the Guatemalan group underperformed on the CNT compared to the Argentine and Mexican groups. The purpose of this study was to extend the current literature and investigate CNT performance across five Spanish-speaking countries (i.e., Argentina, Mexico, Guatemala, Colombia, United States). We predicted that the Argentine group would outperform the other Spanish-speaking countries.
Participants and Methods:The present study sample consisted of 502 neurologically and psychologically healthy participants with a mean age of 29.06 (SD = 13.41) with 14.75 years of education completed (SD = 3.01). Participants were divided into five different groups based on their country of birth and current country residency (i.e., United States, Mexico, Guatemala, Argentina, & Colombia). All participants consented to voluntary participation and completed the CNT and a comprehensive background questionnaire in Spanish. The CNT consisted of 30 black and white line drawings, ranging from easy to hard in difficulty. An ANCOVA, controlling for gender, education, and age, was used to evaluate CNT performance between the five Spanish-speaking country groups. Meanwhile, a Bonferroni post-hoc test was utilized to evaluate the significant differences between Spanish-speaking groups. We used a threshold of p < .05 for statistical significance.
Results:Results revealed significant group differences between the five Spanish speaking groups on the CNT, p = .000, np2 = .48. Bonferroni post-hoc test revealed that the United States group significantly underperformed on the CNT compared to all the Spanish-speaking groups. Next, we found the Guatemalan group underperformed on the CNT compared to the Argentinian, Mexican, and Colombian groups. Additionally, we found the Argentinian group outperformed the Mexican, Guatemalan, and United States groups on the CNT. No significant differences were found between the Argentinian group and Colombian group or the Mexican group and Colombian group on the CNT.
Conclusions:As predicted, the Argentinian group outperformed all the Spanish-speaking groups on the CNT except the Colombian group. Additionally, we found that the United States group underperformed on the CNT compared to all the Spanish-speaking groups. A possible explanation is that Spanish is not the official language in the United States compared to the rest of the Spanish-speaking groups. Meanwhile, a possible reason why the Argentinian and Colombian groups demonstrated better CNT performances might have been that it was less culturally sensitive than the United States, Mexican, and Guatemalan groups. Further analysis is needed with bigger sample sizes across other Spanish-speaking countries (e.g., Costa Rica, Chile) to evaluate what variables, if any, are influencing CNT performance.
39 Perceived Workload and Language Order Effects on the Cordoba Naming Test in Spanish-English Bilinguals
- Krissy E. Smith, Isabel D. C. Munoz, Raymundo Cervantes, Andrea R. Preciado, Tara L. Victor, Natalia Garcia, Paula V. Bracho, Enrique Lopez, Alberto L. Fernandez, Yvette De Jesus, Daniel W. Lopez-Hernandez
-
- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 451-452
-
- Article
-
- You have access Access
- Export citation
-
Objective:
The Cordoba Naming Test (CNT) is a 30-item confrontation naming task. The administration of the CNT can be administered in multiple languages. Hardy and Wright (2018) conditionally validated a measure of perceived mental workload called the National Aeronautic Space Administration Task Load Index (NASA-TLX). They found that workload ratings on the NASA-TLX increased with increased demands on a cognitive task. Researchers found interactions in a study examining language proficiency and language (i.e., in which the test was administered) on several tasks of the Golden Stroop Test. Their results revealed that unbalanced bilinguals’ best-spoken language showed significantly better results compared to balanced bilinguals’ where language use did not matter. To our knowledge, no study has examined the order effects of Spanish-English bilingual speakers’ CNT performance and perceived workloads when completed in Spanish first compared to English second and vice-versa. We predicted that persons that completed the CNT in English first would demonstrate better performances and report lower perceived workloads on the CNT compared to completing the CNT in Spanish second. In addition, we predicted that persons that completed the CNT in Spanish first would demonstrate worse performance and higher perceived workloads on the CNT compared to completing the CNT in English second.
Participants and Methods:The sample consisted of 62 Spanish-English healthy and neurologically bilingual speakers with a mean age of 19.94 (SD= 3.36). Thirty-seven participants completed the CNT in English first and then in Spanish (English-to-Spanish) and 25 participants completed the CNT in Spanish first and then in English (Spanish-to-English). The NASA-TLX was used to evaluate CNT perceived workloads. All the participants completed the NASA-TLX in English and Spanish after completing the CNT in the language given, respectfully. A series of paired-samples T-Tests were completed to evaluate groups CNT performance and perceived workload.
Results:We found that the English-to-Spanish group performed better on the CNT in English first than completing it in Spanish second, p = .000. We also found that the English-to-Spanish group reported better performance and less mentally demanding on the CNT when it was completed in English first compared to completing it in Spanish second, p’s < .05. Regarding the Spanish-to-English group, we found participants performed worse when they completed the CNT in Spanish first compared to completing the CNT in English second, p = .000. Finally, the Spanish-to-English group reported worse performance completing the CNT in Spanish first, more temporal demanding, and more frustrating compared to completing the CNT in English second, p’s < .05.
Conclusions:As expected, when participants completed the CNT in English, regardless of the order, they performed better and reported lower perceived workloads compared to completing the CNT in Spanish. Our data suggests that language order effect influenced participants CNT performance possibly due to not knowing specific items in Spanish compared to in English. Future studies using larger sample sizes should evaluate language order effects on the CNT in Spanish-English balanced bilingual speakers compared to unbalanced bilingual speakers.
Increasing rates of ventilator-associated events: Blame it on COVID-19?
- Aditee Dash, Kaila Cooper, Barry Rittmann, Michael Stevens, Gonzalo Bearman, L. Silvia Munoz-Price, Michelle Doll
-
- Journal:
- Antimicrobial Stewardship & Healthcare Epidemiology / Volume 3 / Issue S2 / June 2023
- Published online by Cambridge University Press:
- 29 September 2023, pp. s105-s106
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Background: Rates of ventilator-associated events (VAEs), including infection-related ventilator-associated complications (IVACs) and probable ventilator-associated pneumonia (PVAPs) have increased nationwide since the onset of the COVID-19 pandemic. In December 2021, our health system adopted a new electronic medical record (EMR), which changed the way surveillance for VAEs is performed. We reviewed surveillance criteria, COVID-19 status, and culturing practices in attempts to understand why VAE rates continue to be elevated. Methods: We collected data on VAE type, culture data, COVID-19 status, and surveillance criteria for all patients meeting NHSN definitions for VAE from 2018 through November 2022. For all patients in 2022 (post-EMR transition), 2 physicians (A.D. and M.D.) manually reviewed documented ventilator settings from flow sheets to validate the automated EMR data, and they evaluated culture data for appropriateness. Cultures were defined as appropriate unless they were included in “pancultures” for leukocytosis without concern for pneumonia documented. Rates were compared using an interrupted time series (ITS) analysis before and after the onset of the COVID-19 pandemic and the EMR transition. Patient level data were compared across periods using the χ2 test. All analyses were performed using SAS version 9.4 software. Results: COVID-19 has been implicated in the increasing number of VAEs since the pandemic began: 6% of patients in 2020, 18% in 2021, and 23% in 2022 (P < .001). The percentage of patients meeting criteria for VAE by positive end-expiratory pressure (PEEP) decreased from 2018 to 2022 (92%, 95%, 93%, 85%, 85%, respectively; P = .0004). Patients meeting criteria for VAE by fraction of inspired oxygen (FiO2) increased from 2018 to 2022 (9%, 6%, 11%, 17%, 19%, respectively; P = .0002). Manual review of 2022 data indicated opportunities for test stewardship in 8 of 65 patients with cultures (12%). ITS analysis revealed that IVAC+ rates were climbing prior to the onset of the COVID-19 pandemic (Fig. 1). We observed a marked increase in rates with the implementation of our new EMR and the changes to our surveillance process (0.32 cases per 100 ventilator days). Manual review of records from 2022 revealed 5 patients in which documentation of ventilator settings to meet VAE diagnosis could not be retrieved from flow sheets. Conclusions: COVID-19 continues to affect VAE despite vaccine availability and may partially account for elevated rates nationwide. However, changes in EMR-automated VAE surveillance may also affect rates. Our findings suggest that automated surveillance captures transient or spurious changes in ventilator machine settings that do not accurately represent clinical status. These data may contribute to spurious increases in VAE. More studies are needed to better understand the impact of both COVID-19 and automated surveillance on VAE.
Disclosures: None
Effects of intrahipocampal nmda on re-extinction of an aversive emotional memory task in rats
- E. P. Ruiz Gonzalez, D. M. Gómez Ordoñez, L. F. Cárdenas, M. N. Muñoz Argel
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S613
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
N-Methyl-D-aspartate (NMDA) receptors are involved in learning and memory. It is known that ventral hippocampus is a crucial structure involved in emotional memory formation mainly for fear and anxiety situations. The aim of this research is to identify the effect of the stimulation of ventral hipocampal NMDA receptors on the reextinction of an aversive emotional memory task. NMDA (0.2 ug/μl; 0.2 μl) or saline (0.9 %; 0.2 μl) was bilateral and locally administered in the ventral hippocampus of male Wistar rats, before the re-instatement trial.
The experimental group consisted of 10 animals and the control group by 9 subjects. The results suggest that the activation of ventral hipocampal NMDA receptors induces an increase in the time needed to re-extinguish the conditioned fear, suggesting a possible potentiating effect on re-installation.
ObjectivesTo evaluate the effect of NMDA at the intrahippocampal level, on the reinstatement and re extinction of a conditioned fear response in male Wistar rats.
MethodsThis study is experimental, where two groups of adult male Wistar rats were used. The bilateral cannulas was implanted, the animals were injected intraperitoneally with a mixture of ketamine (Rotexmédica) and xylacin (Bayer; 75 mg/Kg and 5 mg/Kg), respectively, then the animals were placed in a stereotaxic apparatus (Narishige) and injected with veterinary antibiotic.The (21G) caliber cannulas were bilaterally implanted in HPv at the following coordinates: AP = -5.2 mm relative to Bregma; ML = ± 5 mm in relation to the midline and DV = 5.1 mm in relation to the skull and according to the atlas (Paxinos & Watson, 1985).
ResultsIt was observed that in the first phase of extinction there were no statistically significant differences between the two groups, experimental and control, as in the second phase of extinction. The results obtained for the re-extinction phase 1 and 2 showed that there were significant statistical differences between the groups. This difference was only evident in the first three minutes in the two phases of re-extinction.
Image 2:
Image 3:
ConclusionsStatistically significant differences were observed between the two groups, in the phases of re-extinction, seeing a longer time of the freezing response in the experimental group, as an effect of the application of NMDA in the ventral hippocampus (HPv), which suggests that this substance has a memory-enhancing effect, and therefore contributes to increasing the permanence of the fear response. It should be noted that this difference was only evident in the first three minutes in the two re-extinction phases. These results may be related to other studies where it has been shown that LTP is dependent on the N-methyl-D-aspartate receptor in the CA1 region in vivo (Zhong, Cherry, Bies, Florence, & Gerges, 2009)
Disclosure of InterestNone Declared
Analysis of the predictive potential of good clinical response of plasma levels of clozapine in patients with resistant schizophrenia in an area of southern Spain
- L. I. Muñoz-Manchado, F. González-Saiz, J. I. Pérez-Revuelta, N. Laherrán-Cantera, R. J. Pardo-Velasco
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S446
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Resistant schizophrenia is a schizophrenia subtype characterized by a non-ability to respond to an appropriate antipsychotic treatment in dosage and duration by the patients. These patients show a lower prognostic and symptomatology. The unique drug which has shown efficacy for resistant schizophrenia treatment is clozapine, which is effective in suicide and aggressive behaviour prevention too. Whereas clozapine has numerous and serious adverse effects such as agranulocytosis risk. Because of this, and for guaranteeing an accurate diagnosis of resistant schizophrenia, distinguishing this from pseudo-resistance due to a poor tracing of schizophrenia, clozapine’s plasmatic levels monitoring is recommended in Spain by many clinical practise-guidelines.
ObjectivesThis studio has the objective of determining if altered clozapine’s plasmatic levels have predictive potential of therapeutical response and answering what clinical and sociodemographic variables are associated to these anormal plasmatic levels.
MethodsIn this work, a cross-sectional observational study was carried out in which clinical and sociodemographic data obtained by the Mental Health Unit of the Jerez de la Frontera University Hospital were collected within the research project entitled: "Role of social cognition as a factor psychosocial functioning of the schizophrenic patient” (ECOFUN), of all the participating patients (in total the sample was 141 patients, of which 40 are in treatment with clozapine).
ResultsThe sample of patients has a mean age of 44 years and medium-high educational levels. The vast majority are men and do not currently consume substances of abuse, and when this consumption occurs, tobacco and alcohol are the most consumed substances. Their total scores on the PANSS and Markova Barrios scales are generally very disparate, but with average values of 55 and 16. It has been obtained as results that there is no significant statistical correlation between the plasma levels of clozapine and the values of the PANSS scale and its subscales in the patients. On the other hand, patients treated with clozapine would present clinical and sociodemographic characteristics practically identical to those of patients treated with other antipsychotics, especially their values on the PANSS scale. In addition, plasma levels of clozapine are correlated, although not significantly, with an improvement in the positive symptomatology of schizophrenia.
ConclusionsAs a conclusion, unusually higher values of clozapine are correlated significantly with lower values in positive symptomatology in schizophrenia, but plasmatic levels are not correlated significantly with values of PANSS scale.
Disclosure of InterestNone Declared
Predictors of transition from paliperidone palmitate 1 and 3 months (PP1M & PPP3M) to paliperidone palmitate 6 months (PP6M)
- P. J. Escobedo-Aedo, J. Merayo-Cano, S. Sánchez Alonso, S. Ovejero, L. Muñoz Lorenzo, L. Mata Iturralde
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S438
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Schizophrenia is a severe, chronic, mental disease. Its stability relies upon a multidisciplinary treatment, where pharmacological treatment is a key aspect. Long-acting injectable antipsychotics (LAIs) have proved efficacy in improving adherence, reducing hospitalizations and relapses, compared with oral treatment[1,2]. Paliperidone palmitate is a long-acting antipsychotic, approved by FDA in 2009 for acute and chronic treatment in schizophrenia. To date, long evidence exists regarding treatment efficacy of paliperidone palmitate 1 month (PP1M) and paliperidone palmitate 3 month (PP3M)[3]. In September 2021 a new long-acting medication was approved for schizophrenia treatment, that is, paliperidone palmitate 6 months (PP6M). This is the first LAI with 6 months duration of treatment, which means, only 2 administrations per year.
We here analyzed the factors explaining transitioning from PP1M and PP3M to PP6M treatment in a population previously described somewhere else[4].
ObjectivesTo identify the variables explaining the transition from other long-acting formulations (PP1M and PP3M) to the new biannual formulation (PP6M) in our clinical practice.
Methods123 patients, previously diagnosed with psychotic disorders, in follow-up in our clinical center Fundación Jiménez Díaz Hospital, was analyzed. Sociodemographic factors and clinical evolution were compared in order to identify factors predicting transitioning from PP1M and PP3M to PP6M.
ResultsIn the PP1M group, patients transitioning to PP6M had more than 6 years of evolution of disease ans active consummation of drugs, compared with patients who stayed on PP1M. Other sociodemographic were similar in both groups. Only 1 patient was readmitted in hospital since transition to PP6M and no emergency visits were accounted for people transitioned.
In the PP3M group, the majority of people transitioning to PP6M were under polypharmacy of which, 42% were on clozapine treatment. The percentage of people with schizophrenia diagnosis was significantly less than in the no transitioning group, though it remained the principal diagnosis. No other significant difference was found with regard to sociodemographic variables. Additionally, no emergency visits nor readmissions to hospital were accounted in this group.
Finally, the PP3M transitioned to PP6M significantly more than PP1M group. Although no clear variable explained this situation.
ConclusionsWith these results, we conclude that chronicity and drugs consummation were the main variables explaining transitioning from PP1M to PP6M. In the other hand, the main variable explaining transitioning from PP3M to PP6M was polypharmacy.
These results are preliminary and, therefore, should be taken cautiously. We will probably dilucidated future tendency in these treatment use in the upcoming months.
Disclosure of InterestNone Declared
Factors associated with first suicide attempt vs. re-attempt in children and adolescents: A systematic review and meta-analysis
- S. Abascal-Peiró, A. Alacreu-Crespo, I. Peñuelas-Calvo, B. Ezquerra-de la Cruz, L. Jiménez-Muñoz, E. Baca-García, A. Porras-Segovia
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S584
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Suicide among children, adolescents and young adults is a major health problem, as it represents the fourth leading cause of death among people aged 15-29 (WHO, 2022). A recent study showed that the years of potential life lost (YPLL) due to suicide in 2018 were 1,344,552, which is very close to the 1,591,487 YPLL caused by COVID-19 in the year 2020 (Porras-Segovia et al, 2021). In the recent years, there is a growing interest in suicide prevention research in differentiating attempter profiles in terms of lifetime suicide attempts. Specifically, studies suggest that there may be meaningful differences concerning risk factors between patients with a history of one versus multiple suicide attempts. Multiple attempters (MA) show more suicidal ideation, depressive symptoms and hopelessness than single attempters (SA) (Esposito et al, 2003; Goldston et al, 1998).
ObjectivesWe aimed to answer the question ‘What are the factors associated with attempting suicide for the first time and are they different from the factors associated with re-attempting suicide in children and adolescents?’
MethodsWe conducted a systematic literature search in four databases. Article selection and data extraction according to a predefined protocol, including bias risk assessment, were performed by independent peer reviewers. Due to the different way to present data in the studies effect sizes were pre-calculated to standard mean differences (SMD). Random effects model was used to calculate the pooled effect size for all meta-analysis. Publication bias was assessed using funnel plots.
Results14 studies were included in the systematic review, and 13 in the meta-analysis. Original articles used in the meta-analysis included a total of 4286 participants of whom 1579 were multiple suicide-attempters and 2707 single suicide attempters.
MAs showed significantly higher proportion of anxiety disorders (SMD = 0.387, 95%CI [0.09, 0.68], p < 0.022), alcohol abuse disorder (SMD = 0.382, 95%CI [0.07, 0.70], p < 0.036) and substance abuse disorder (SMD = 0.526, 95%CI [0.21, 0.84], p <0.013) than SAs. Mean depression severity was higher among MAs than SAs (SMD = 0.515, 95%CI [0.17, 0.86], p < 0.011). MAs showed higher impulsivity (SMD = 0.28, 95%CI [-0.03, 0.60], p < 0.068) and aggressiveness (SMD = 0.688, 95%CI [0.42, 0.96], p < 0.00) than SAs. Hopelessness (SMD = 0.482, 95%CI [0.06, 0.91], p < 0.03) and suicidal ideation (SMD = 0.399, 95%CI [0.34, 0.46], p < 0.007) was significantly higher in MA.
ConclusionsOn the basis of the current results, multiple attempters may represent a distinct patient population in terms of being a more severe clinical profile. This can provide the basis of stronger suicide prevention and vigilance programs focused in this suicidal phenotype.
Disclosure of InterestNone Declared
Review of a sample of episodes of forced medication in an area of southern Spain
- L. I. Muñoz-Manchado, J. M. Mongil-Sanjuan, J. I. Pérez-Revuelta, C. M. Robledo Casal, J. M. Villagrán-Moreno
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1067
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Forced medication is one of the most frequently used coercive measures in acute mental health units. It is a practice that can lead to physical, psychological and psychopathological consequences. Therefore, it is necessary to implement measures to reduce its use. In this sense, it is interesting to study the variables that can be associated with its use, and thus take measures accordingly.
ObjectivesThis study attempts to identify the number of forced medication episodes between July 2017 and December 2018 treated in the catchment area of the Mental Health Service at Jerez Hospital. As a secondary objective, it pursues to identify the factors that conducted to the use of forced medication with the intention of being able to reduce the use of these measures.
MethodsA descriptive and retrospective study has been developed reviewing the total number of episodes of forced medication. Patients admitted and discharged from hospital between July 2017 and December 2018 treated in the Mental Health Service at Jerez Hospital. Data were extracted from medical records.
ResultsThe total number of episodes of forced medication identified was 330. In these episodes, the average age was 41 years, with a predominance of 74% of the male gender. The most used route in the episodes was intramuscular (94.8%), in addition, more than 50% needed the association of two drugs, the most used were haloperidol and olanzapine. The 32.7% of the episodes also required the use of mechanical restraint and 44.2% required the presence of security service.
Image:
ConclusionsWe present the descriptive analysis of a further study currently been conducted in hour hospital which means to stablish predictive factors for the use of forced medication. We therefore intend to create patient profile, as well as new measures specifically directed to these factors with which to diminish the use of forced medication.
Disclosure of InterestNone Declared
Acute psychosis following corticosteroid administration for COVID-19 and Respiratory Syncytial Virus infection: A case study
- E. Miranda Ruiz, E. Marimon Muñoz, J. Ramirez Gonzalez, M. Fariña, R. G. Troyano, M. I. Arroyo Ucar, S. Ferreiro, I. Fernandez Marquez, C. Hidalgo, A. Quispe, L. Delgado
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S790
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Steroids are a necessary treatment for hypoxic respiratory failure; however there are many side effects that should be taken into account. A 44- year-old-woman with asthma and no past psychiatric history was admitted due to COVID-19 pneumonia and Respiratory syncytial virus (RSV) infection, presenting hypoxic respiratory failure. After two days of intravenous methylprednisolone administration, the patient presented acute psychosis and agitation.
It has been previously described that steroid use can cause effects such as mania, anxiety, agitation, delirium and psychosis amongst other. However they are a necessary treatment in respiratory illnesses and are sometimes unavoidable.
ObjectivesThe aim was to examine the appropriate medical response to steroid induced psychosis in patients with acute hypoxic failure.
MethodsA bibliographical review was done in PubMed database searching recent cases of steroid induced psychosis using the words (“Steroid”, “Psychosis” and “COVID-19”).
ResultsAccording to literature, it has been shown that partial or complete reduction of steroid use and/or use of psychotropic has been successfully used to treat steroid induced psychosis. Following the research it was decided to reduce intravenous methylprednisolone dose from 20mg/ 8h to 20mg/12h and start oral haloperidol 5mg/8h the first 24h and reducing the dose progressively as the patient recovered. After the first 24 hours the patient presented adequate response to steroids as well as partial response to antipsychotic treatment; presenting no further agitation, absence of hallucinations and partial persistence of the persecutory delusion. A couple of days later there was complete remission of the psychotic symptoms and the patient was on the way to recovery from COVID-19 and RSV.
ConclusionsThere is evidence that suggests that medications such as steroids used to treat COVID-19 and other respiratory illnesses can lead to psychotic episodes. It is very important to pay attention to possible side effects when treating with steroids and evaluate the patient history as well as suggest having a follow up visit after the hospital discharge.
Disclosure of InterestNone Declared
Biomarkers of oxidative stress and inflammation in urine samples of extremely preterm newborns and their association with risk for autism at age 6 months
- T. Bollain Muñoz, J. Merchán-Naranjo, B. Almansa, C. Chafer, M. Bento, D. Blanco-Bravo, A. Garcia-Blanco, L. Pina-Camacho
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S585
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Extremely preterm birth (defined as birth before 28 weeks’ gestational age) has been associated with risk of developing autism spectrum disorder (ASD) in infancy. The underlying physiopathological pathways that condition the emergence of ASD on these kids remains unknown, although there is increasing evidence that oxidative stress and inflammation play an important role.
ObjectivesWe investigated the association and the predictive value of marker levels with the primary outcome (risk for ASD at age 6 months, defined as presence of two or more clinical ASD “red flags” at this age), and with other demographic and clinical variables.
MethodsIn a sample of N= 68 extremely preterm newborns, we collected urine samples from birth up to first week of life (T1= birth, T2=24-72 hours, T3=day 7), and analysed levels of biomarkers of oxidative stress and inflammation, and assessed risk for ASD at age 6-months. Through liquid chromatography mass spectrometry, we obtained levels of lipid peroxidation, DNA and protein oxidation metabolites, alongside levels of inflammation markers.
ResultsCompared to those with no risk for ASD, patients at risk for ASD showed significantly higher levels of 14(RS)-14-F4t-NeuroP at 24-72 hours of life (d=1.296, p=.018) and significantly lower levels of total isoprostanes at 24 hours of life (d=1.161, p=.048). In patients at risk for ASD, levels of 14(RS)-14-F4t-NeuroP decreased significantly over time from 24-72 hours (T2) to day 7 of life (T3), p=.032.
ConclusionsIn summary, we obtained a panel of urine biomarkers potentially predictive of early risk for ASD in extremely preterm newborns.
Disclosure of InterestNone Declared
What do we know about lithium associated hypercalcemia?
- N. Laherrán Cantera, R. Palacios - Garrán, A. Sanchez-Guerra Alonso, C. Gutiérrez Santaló, L. I. Muñoz-Manchado
-
- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S577
-
- Article
-
- You have access Access
- Open access
- Export citation
-
Introduction
Lithium associated with hypercalcemia may mimic a psychiatric condition and be confused for a relapse of bipolar disorder. The etiology seems to be due to a reduced sensitivity of the parathyroid cells to calcium, altering the parathyroid hormone (PTH) response. Lithium as an essential monovalent cation has some structural similarity to calcium (Ca) and can interact with protein receptors. This leads to changes in the inhibitory configuration of PTH and increased serum calcium concentrations, rising the threshold necessary to suppress hormone secretion.
Lithium-induced hyperparathyroidism (HIL) is the main cause of hypercalcemia in these patients.
ObjectivesBased on a clinical case of lithium-associated hypercalcemia in a patient with bipolar disorder, review the existing literature and state the needs for periodic monitoring protocols.
MethodsCase report and bibliographical review.
ResultsA 38-year-old woman, diagnosed with bipolar affective disorder at the age of 18, has been treated with lithium during which she developed secondary tubulointerstitial nephropathy as an adverse effect. Recently, she requested medical evaluation for constitutional syndrome associated with deterioration of general condition with loss of strength and difficulty in walking. Analytically, mild hypercalcemia was detected, and the study was extended to include Ca and PTH.
Chronic lithium therapy often develops mild hypercalcemia (approximately 10 to 20 percent of patients taking lithium), most likely due to increased secretion of PTH. Lithium can also unmask previously unrecognized mild hyperparathyroidism in patients with adenomas within a few years of starting therapy or induce parathyroid hyperplasia with a chronic use.
The hypercalcemia usually, but not always, subsides when the lithium is stopped. Normalization of serum calcium is more likely to occur one to four weeks post-lithium withdrawal in patients with a relatively short duration of lithium use. It is less likely in patients receiving lithium for more than 10 years.
Regarding the case to be presented, a review of the literature is carried out and the need to propose periodic calcium monitoring protocols is exposed.
ConclusionsRecommendations include determination of serum calcium every 6 months, urinary calcium and creatinine every 12 months, and bone mineral density monitoring every 1 to 3 years. Regular analytical monitoring including total calcium, PTH and vitamin D, would identify patients with a tendency to hypercalcemia so that appropriate measures could be taken. So as chronic treatment with lithium can develop mild hypercalcemia, I consider it necessary to develop periodic monitoring protocols for this adverse effect.
Disclosure of InterestNone Declared
P.017 Convergent and contrasting modulation of saccade and pupil responses by several neurodegenerative diseases during free viewing of video clips
- HC Riek, BJ White, DC Brien, BC Coe, J Huang, A Abrahao, SE Black, M Borrie, E Finger, CE Fischer, AR Frank, M Freedman, DA Grimes, M Jog, S Kumar, D Kwan, AE Lang, JM Lawrence-Dewar, C Marras, M Masellis, SH Pasternak, BG Pollock, TK Rajji, DP Seitz, C Shoesmith, TD Steeves, B Tan, DF Tang-Wai, C Tartaglia, J Turnbull, L Zinman, ONDRI Investigators DP Munoz
-
- Journal:
- Canadian Journal of Neurological Sciences / Volume 50 / Issue s2 / June 2023
- Published online by Cambridge University Press:
- 05 June 2023, p. S62
-
- Article
-
- You have access Access
- Export citation
-
Background: Saccade and pupil responses are potential neurodegenerative disease biomarkers due to overlap between oculomotor circuitry and disease-affected areas. Instruction-based tasks have previously been examined as biomarker sources, but are arduous for patients with limited cognitive abilities; additionally, few studies have evaluated multiple neurodegenerative pathologies concurrently. Methods: The Ontario Neurodegenerative Disease Research Initiative recruited individuals with Alzheimer’s disease (AD), mild cognitive impairment (MCI), amyotrophic lateral sclerosis (ALS), frontotemporal dementia, progressive supranuclear palsy, or Parkinson’s disease (PD). Patients (n=274, age 40-86) and healthy controls (n=101, age 55-86) viewed 10 minutes of frequently changing video clips without instruction while their eyes were tracked. We evaluated differences in saccade and pupil parameters (e.g. saccade frequency and amplitude, pupil size, responses to clip changes) between groups. Results: Preliminary data indicates low-level behavioural alterations in multiple disease cohorts: increased centre bias, lower overall saccade rate and reduced saccade amplitude. After clip changes, patient groups generally demonstrated lower saccade rate but higher microsaccade rate following clip change to varying degrees. Additionally, pupil responses were blunted (AD, MCI, ALS) or exaggerated (PD). Conclusions: This task may generate behavioural biomarkers even in cognitively impaired populations. Future work should explore the possible effects of factors such as medication and disease stage.