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P.026 Success with incrementally faster times to endovascular therapy (SWIFT-EVT): a systematic review and meta-analysis
- B Legere, A Mohamed, S Elsherif, R Saqqur, D Schoenfeld, AM Slebonick, M Mccartin, J Price, K Zachrison, JA Edlow, M Saqqur, A Shuaib, S Thomas
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- Journal:
- Canadian Journal of Neurological Sciences / Volume 51 / Issue s1 / June 2024
- Published online by Cambridge University Press:
- 24 May 2024, pp. S21-S22
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Background: Previous research demonstrates that for acute ischemic stroke (AIS) cases, rapid endovascular therapy (EVT) performance improves outcomes. This study provides updated metrics summarizing estimates for modified Rankin Scale (mRS) gains accrued by streamlining time to EVT. Methods: A systematic review and meta-analysis (MA) was conducted using electronic databases. Eligible studies reported time-benefit slope with times from AIS onset (or time last-seen-normal) to EVT commencement; the predictor was onset-to-groin (OTG) time. Primary and secondary outcomes were 90-day functional independence (mRS 0-2) and 90-day excellent function (mRS 0-1), respectively. Results: The five included studies showed increased chance of good outcome with each hour of pre-EVT time savings for mRS 0-2 for 0-270’ (OR 1.25, 95% CI 1.16-1.35, I2 40%) and 271-360’ time frame (1.22, 95% CI 1.12-1.33, I2 58%). For studies assessing mRS 0-1, pooled effect estimates were appropriate for the 0-270’ time frame (OR 1.34, 95% CI 1.19-1.51, I2 27%) and the 271-360’ time frame (OR 1.20, 95% CI 1.03-1.38, I2 60%). Conclusions: Each hour saved from AIS onset to EVT start is associated with a 22-25% increased odds of functional independence, a useful metric to inform patient-specific and systems planning decisions.
An in vivo appraisal of Punica granatum peel extract’s ultrastructural effect on cystic echinococcosis in mice
- Nashaat E. Nassef, Sawsan S. Shendi, Abdel-Gawad E. Saad, Nancy M. Harba, Engy V.N. Beshay, Asmaa Shams El-Dein Mohamed, Marwa A. Gouda
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- Journal:
- Journal of Helminthology / Volume 98 / 2024
- Published online by Cambridge University Press:
- 13 May 2024, e40
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In the past decade, interest has significantly increased regarding the medicinal and nutritional benefits of pomegranate (Punica granatum) peel. This study examined the effects of using pomegranate peel extract (PGE) alone and in combination with albendazole (ABZ) on ultrastructural and immunological changes in cystic echinococcosis in laboratory-infected mice. Results revealed that the smallest hydatid cyst size and weight (0.48 ± 0.47mm, 0.17 ± 0.18 gm) with the highest drug efficacy (56.2%) was detected in the PGE + ABZ group, which also exhibited marked histopathological improvement. Ultrastructural changes recorded by transmission electron microscopy including fragmentation of the nucleus, glycogen depletion, and multiple lysosomes in vacuolated cytoplasm were more often observed in PGE + ABZ group. IFN-γ levels were significantly increased in the group treated with ABZ, with a notable reduction following PGE treatment, whether administered alone or in combination with ABZ. Thus, PGE enhanced the therapeutic efficiency of ABZ, with improvement in histopathological and ultrastructural changes.
Head and Neck Cancer: United Kingdom National Multidisciplinary Guidelines, Sixth Edition
- Jarrod J Homer, Stuart C Winter, Elizabeth C Abbey, Hiba Aga, Reshma Agrawal, Derfel ap Dafydd, Takhar Arunjit, Patrick Axon, Eleanor Aynsley, Izhar N Bagwan, Arun Batra, Donna Begg, Jonathan M Bernstein, Guy Betts, Colin Bicknell, Brian Bisase, Grainne C Brady, Peter Brennan, Aina Brunet, Val Bryant, Linda Cantwell, Ashish Chandra, Preetha Chengot, Melvin L K Chua, Peter Clarke, Gemma Clunie, Margaret Coffey, Clare Conlon, David I Conway, Florence Cook, Matthew R Cooper, Declan Costello, Ben Cosway, Neil J A Cozens, Grant Creaney, Daljit K Gahir, Stephen Damato, Joe Davies, Katharine S Davies, Alina D Dragan, Yong Du, Mark R D Edmond, Stefano Fedele, Harriet Finze, Jason C Fleming, Bernadette H Foran, Beth Fordham, Mohammed M A S Foridi, Lesley Freeman, Katherine E Frew, Pallavi Gaitonde, Victoria Gallyer, Fraser W Gibb, Sinclair M Gore, Mark Gormley, Roganie Govender, J Greedy, Teresa Guerrero Urbano, Dorothy Gujral, David W Hamilton, John C Hardman, Kevin Harrington, Samantha Holmes, Jarrod J Homer, Deborah Howland, Gerald Humphris, Keith D Hunter, Kate Ingarfield, Richard Irving, Kristina Isand, Yatin Jain, Sachin Jauhar, Sarra Jawad, Glyndwr W Jenkins, Anastasios Kanatas, Stephen Keohane, Cyrus J Kerawala, William Keys, Emma V King, Anthony Kong, Fiona Lalloo, Kirsten Laws, Samuel C Leong, Shane Lester, Miles Levy, Ken Lingley, Gitta Madani, Navin Mani, Paolo L Matteucci, Catriona R Mayland, James McCaul, Lorna K McCaul, Pádraig McDonnell, Andrew McPartlin, Valeria Mercadante, Zoe Merchant, Radu Mihai, Mufaddal T Moonim, John Moore, Paul Nankivell, Sonali Natu, A Nelson, Pablo Nenclares, Kate Newbold, Carrie Newland, Ailsa J Nicol, Iain J Nixon, Rupert Obholzer, James T O'Hara, S Orr, Vinidh Paleri, James Palmer, Rachel S Parry, Claire Paterson, Gillian Patterson, Joanne M Patterson, Miranda Payne, L Pearson, David N Poller, Jonathan Pollock, Stephen Ross Porter, Matthew Potter, Robin J D Prestwich, Ruth Price, Mani Ragbir, Meena S Ranka, Max Robinson, Justin W G Roe, Tom Roques, Aleix Rovira, Sajid Sainuddin, I J Salmon, Ann Sandison, Andy Scarsbrook, Andrew G Schache, A Scott, Diane Sellstrom, Cherith J Semple, Jagrit Shah, Praveen Sharma, Richard J Shaw, Somiah Siddiq, Priyamal Silva, Ricard Simo, Rabin P Singh, Maria Smith, Rebekah Smith, Toby Oliver Smith, Sanjai Sood, Francis W Stafford, Neil Steven, Kay Stewart, Lisa Stoner, Steve Sweeney, Andrew Sykes, Carly L Taylor, Selvam Thavaraj, David J Thomson, Jane Thornton, Neil S Tolley, Nancy Turnbull, Sriram Vaidyanathan, Leandros Vassiliou, John Waas, Kelly Wade-McBane, Donna Wakefield, Amy Ward, Laura Warner, Laura-Jayne Watson, H Watts, Christina Wilson, Stuart C Winter, Winson Wong, Chui-Yan Yip, Kent Yip
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- Journal:
- The Journal of Laryngology & Otology / Volume 138 / Issue S1 / April 2024
- Published online by Cambridge University Press:
- 14 March 2024, pp. S1-S224
- Print publication:
- April 2024
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Exploring Hematological and Biochemical Disparities in Same-Sex and Opposite-Sex Females: A Cross-Sectional Twin Study in a Ghanaian Population
- Moses Banyeh, Benjamin N. Mayeem, Moses Kofi Woli, Augusta S. Kolekang, Clement Binwatin Dagungong, David Bure, Romarick Kofi Wemegah, Mikail Ihsan Azindow, Suleman Yakubu, Musah Seidu, Mohammed Madde Baba, Elisha Essoun, Nancy Owireduwaa
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- Journal:
- Twin Research and Human Genetics / Volume 27 / Issue 1 / February 2024
- Published online by Cambridge University Press:
- 06 March 2024, pp. 50-55
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There are sex-dependent differences in hematological and biochemical variables in adulthood attributed to the predominant effects of testosterone in males and estrogen in females. The Twin Testosterone Transfer (TTT) hypothesis proposes that opposite-sex females may develop male-typical traits due to exposure to relatively higher levels of prenatal testosterone than same-sex females. Additionally, prenatal testosterone exposure has been suggested as a correlate of current circulating testosterone levels. Consequently, opposite-sex females might exhibit male-typical patterns in their hematological and biochemical variables. Despite this hypothesis, routine laboratory investigations assign the same reference range to all females. Our cross-sectional study, conducted in Tamale from January to September 2022, included 40 twins, comprising 10 opposite-sex (OS) males (25%), 10 OS females (25%), and 20 same-sex (SS) females (50%), all aged between 18 and 27 years. Fasting venous blood samples were collected and analyzed using automated hematology and biochemistry laboratory analyzers. Results indicated that levels of hemoglobin, serum creatinine, gamma-glutamyl transferase, total protein, globulins, and total testosterone were significantly higher in OS males than OS females. Conversely, total cholesterol and low-density lipoprotein cholesterol were significantly higher in OS females than OS males. Unexpectedly, levels of low-density lipoprotein cholesterol and total testosterone were significantly higher in SS females than OS females. Contrary to expectations, opposite-sex females did not exhibit male-typical patterns in their hematological and biochemical variables. This suggests that the TTT effect may not occur or may not be strong enough to markedly affect hematological and biochemical variables in OS females.
Elasmobranch diversity around the southern Caribbean island of Tobago: opportunities for conservation in a regional trade hub
- Neil D. Cook, Gina M. Clementi, Kathryn I. Flowers, Lanya Fanovich, Jo Cable, Sarah E. Perkins, Aljoscha Wothke, Ryan S. Mohammed, Demian D. Chapman
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- Journal:
- Journal of the Marine Biological Association of the United Kingdom / Volume 104 / 2024
- Published online by Cambridge University Press:
- 19 February 2024, e8
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Sharks are scarce in much of the Caribbean due to widespread depletion. Trinidad and Tobago, in the southern Caribbean, is a shark meat consumer and international exporter of dried shark fins. Despite limited fisheries management there is a small Marine Protected Area (MPA; 7 km2) in urbanised southwest Tobago, but its effect on sharks and rays (elasmobranchs) is unknown. The rural northeast is a recently designated UNESCO Man and the Biosphere Reserve with a significant marine component and plans for a large MPA, but no baseline data for elasmobranchs exist. Given the local importance of elasmobranchs and a newly drafted Sustainable Shark and Ray Management Plan, we used baited remote underwater video stations within a 40 m depth contour at 270 randomly generated points around Tobago to: (i) establish a baseline of species richness and relative abundance, (ii) investigate the influence of season, habitat relief, depth and water temperature on relative abundance, and (iii) investigate spatial variation in relative abundance. Caribbean reef sharks, nurse sharks, and southern stingrays were observed at all sites, the latter two more frequently in the urbanised southwest. Shark diversity was unexpectedly high in the northeast, driven by rarer species (sharpnose, smoothhound, tiger, scalloped hammerhead, great hammerhead) only observed there. Habitat relief, depth and season likely influence relative abundance of elasmobranchs around Tobago, but research is needed to elucidate species-level effects. Shark species richness in northeast Tobago is high for the Caribbean, warranting research attention, while the larger MPA presents an opportunity to strengthen elasmobranch management.
Somatic multicomorbidity and disability in patients with psychiatric disorders in comparison to the general population: a quasi-epidemiological investigation in 54,826 subjects from 40 countries (COMET-G study)
- Konstantinos N. Fountoulakis, Grigorios N. Karakatsoulis, Seri Abraham, Kristina Adorjan, Helal Uddin Ahmed, Renato D. Alarcón, Kiyomi Arai, Sani Salihu Auwal, Michael Berk, Sarah Bjedov, Julio Bobes, Teresa Bobes-Bascaran, Julie Bourgin-Duchesnay, Cristina Ana Bredicean, Laurynas Bukelskis, Akaki Burkadze, Indira Indiana Cabrera Abud, Ruby Castilla-Puentes, Marcelo Cetkovich, Hector Colon-Rivera, Ricardo Corral, Carla Cortez-Vergara, Piirika Crepin, Domenico De Berardis, Sergio Zamora Delgado, David De Lucena, Avinash De Sousa, Ramona Di Stefano, Seetal Dodd, Livia Priyanka Elek, Anna Elissa, Berta Erdelyi-Hamza, Gamze Erzin, Martin J. Etchevers, Peter Falkai, Adriana Farcas, Ilya Fedotov, Viktoriia Filatova, Nikolaos K. Fountoulakis, Iryna Frankova, Francesco Franza, Pedro Frias, Tatiana Galako, Cristian J. Garay, Leticia Garcia-Álvarez, Maria Paz García-Portilla, Xenia Gonda, Tomasz M. Gondek, Daniela Morera González, Hilary Gould, Paolo Grandinetti, Arturo Grau, Violeta Groudeva, Michal Hagin, Takayuki Harada, Tasdik M. Hasan, Nurul Azreen Hashim, Jan Hilbig, Sahadat Hossain, Rossitza Iakimova, Mona Ibrahim, Felicia Iftene, Yulia Ignatenko, Matias Irarrazaval, Zaliha Ismail, Jamila Ismayilova, Asaf Jakobs, Miro Jakovljević, Nenad Jakšić, Afzal Javed, Helin Yilmaz Kafali, Sagar Karia, Olga Kazakova, Doaa Khalifa, Olena Khaustova, Steve Koh, Svetlana Kopishinskaia, Korneliia Kosenko, Sotirios A. Koupidis, Illes Kovacs, Barbara Kulig, Alisha Lalljee, Justine Liewig, Abdul Majid, Evgeniia Malashonkova, Khamelia Malik, Najma Iqbal Malik, Gulay Mammadzada, Bilvesh Mandalia, Donatella Marazziti, Darko Marčinko, Stephanie Martinez, Eimantas Matiekus, Gabriela Mejia, Roha Saeed Memon, Xarah Elenne Meza Martínez, Dalia Mickevičiūtė, Roumen Milev, Muftau Mohammed, Alejandro Molina-López, Petr Morozov, Nuru Suleiman Muhammad, Filip Mustač, Mika S. Naor, Amira Nassieb, Alvydas Navickas, Tarek Okasha, Milena Pandova, Anca-Livia Panfil, Liliya Panteleeva, Ion Papava, Mikaella E. Patsali, Alexey Pavlichenko, Bojana Pejuskovic, Mariana Pinto Da Costa, Mikhail Popkov, Dina Popovic, Nor Jannah Nasution Raduan, Francisca Vargas Ramírez, Elmars Rancans, Salmi Razali, Federico Rebok, Anna Rewekant, Elena Ninoska Reyes Flores, María Teresa Rivera-Encinas, Pilar Saiz, Manuel Sánchez de Carmona, David Saucedo Martínez, Jo Anne Saw, Görkem Saygili, Patricia Schneidereit, Bhumika Shah, Tomohiro Shirasaka, Ketevan Silagadze, Satti Sitanggang, Oleg Skugarevsky, Anna Spikina, Sridevi Sira Mahalingappa, Maria Stoyanova, Anna Szczegielniak, Simona Claudia Tamasan, Giuseppe Tavormina, Maurilio Giuseppe Maria Tavormina, Pavlos N. Theodorakis, Mauricio Tohen, Eva Maria Tsapakis, Dina Tukhvatullina, Irfan Ullah, Ratnaraj Vaidya, Johann M. Vega-Dienstmaier, Jelena Vrublevska, Olivera Vukovic, Olga Vysotska, Natalia Widiasih, Anna Yashikhina, Panagiotis E. Prezerakos, Daria Smirnova
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- Journal:
- CNS Spectrums / Volume 29 / Issue 2 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 126-149
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Background
The prevalence of medical illnesses is high among patients with psychiatric disorders. The current study aimed to investigate multi-comorbidity in patients with psychiatric disorders in comparison to the general population. Secondary aims were to investigate factors associated with metabolic syndrome and treatment appropriateness of mental disorders.
MethodsThe sample included 54,826 subjects (64.73% females; 34.15% males; 1.11% nonbinary gender) from 40 countries (COMET-G study). The analysis was based on the registration of previous history that could serve as a fair approximation for the lifetime prevalence of various medical conditions.
ResultsAbout 24.5% reported a history of somatic and 26.14% of mental disorders. Mental disorders were by far the most prevalent group of medical conditions. Comorbidity of any somatic with any mental disorder was reported by 8.21%. One-third to almost two-thirds of somatic patients were also suffering from a mental disorder depending on the severity and multicomorbidity. Bipolar and psychotic patients and to a lesser extent depressives, manifested an earlier (15–20 years) manifestation of somatic multicomorbidity, severe disability, and probably earlier death. The overwhelming majority of patients with mental disorders were not receiving treatment or were being treated in a way that was not recommended. Antipsychotics and antidepressants were not related to the development of metabolic syndrome.
ConclusionsThe finding that one-third to almost two-thirds of somatic patients also suffered from a mental disorder strongly suggests that psychiatry is the field with the most trans-specialty and interdisciplinary value and application points to the importance of teaching psychiatry and mental health in medical schools and also to the need for more technocratically oriented training of psychiatric residents.
Diving deep for the needle in the haystack: An outbreak investigation of Burkholderia cenocepacia bacteremia
- Abdul Ghafur, Praveen Balaguru, S. G. Ramanan, Rejiv Rajendranath, Revathi Raj, Mohammed Zehran, T. Raja, Jose M. Easow, Sankar Srinivasan, Dedeepiya Devaprasad, Thilakavathy Sukumar, Praveen Nilgar, K. Sakthivel, Rakkesh M. Nirumal, K. Chandra, Sree V. Lakshmi, Nandini Sethuraman, Yamuna Devi Bakthavatchalam, Balaji Veeraraghavan
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 45 / Issue 5 / May 2024
- Published online by Cambridge University Press:
- 04 January 2024, pp. 677-680
- Print publication:
- May 2024
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In an Indian oncology setting, between August and December 2021, 56 patients, developed Burkholderia cenocepacia bacteremia. An investigation revealed a contaminated batch of the antiemetic drug palonosetron. The outbreak was terminated by withdrawing the culprit batch and the findings were reported promptly to regulatory authorities.
Synthesis and Characterization of Al-Pillared Bentonite for Remediation of Chlorinated Pesticide-Contaminated Water
- Mohamed S. Basiony, Seleem E. Gaber, Hosny Ibrahim, Emad A. Elshehy
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- Journal:
- Clays and Clay Minerals / Volume 68 / Issue 3 / June 2020
- Published online by Cambridge University Press:
- 01 January 2024, pp. 197-210
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The removal of pesticide contaminants from water is a key priority in environmental remediation, and requires intensive effort; this necessitates modification of the properties of pillared clays (PILCs) such as porosity, pore-volume, surface area, and synthesis methods. The purpose of the present study was to test the ability of Al-pillared bentonite (Al-PILB), using [Al13O4(OH)24(H2O)12]7+ and [Al30O8(OH)56(H2O)24]18+ (keggin cations, Al13 and Al30) as pillars, to adsorb chlorinated pesticides from contaminated water. In order to maximize intercalation and uniformity of layer stacking, various ratios of the nitrate forms of the synthesized keggin cations were intercalated into the natural bentonite (BT). The synthesized materials (Al-PILBs) were characterized by various techniques, including X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray analysis (EDX), Fourier-transform infrared (FTIR) spectroscopy, UV-Vis spectroscopy, and N2 adsorption-desorption measurements. Increases in basal spacing, surface area, and pore volume were observed. The adsorption capacity of the Al-PILBs for 17 types of chlorinated pesticides from contaminated water was better than using the BT alone, e.g. for heptachlor epoxide, dieldrin, and endrin at natural pH, the maximum adsorptions obtained at equilibrium solution concentrations of 16, 20, and 20 μg/L, respectively, were 59.2, 59.15, and 60 μg/g, whereas corresponding values using pristine BT were 34.68, 39.45, and 38.9, respectively. The data were best described by the Freundlich adsorption model.
Mineralogy of Egyptian Bentonitic Clays II: Geologic Origin
- Mohamed A. Agha, Ray E. Ferrell, George F. Hart, Mohamed S. Abu El Ghar, A. Abdel-Motelib
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- Clays and Clay Minerals / Volume 61 / Issue 6 / December 2013
- Published online by Cambridge University Press:
- 01 January 2024, pp. 551-565
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Reconstructing the origin of bentonitic clays is often a challenging and rather complicated undertaking, but the analysis of certain predictor clay minerals is proving to be an excellent method to simplify this process. The goal of the present investigation was to use abundance changes of five X-ray diffraction (XRD) predictor minerals to determine the relative contributions of weathering and parent-rock changes to the origin of clay minerals in Egyptian bentonitic clays as the test case. The XRD predictor minerals, selected in an earlier discriminant function analysis of quantitative abundances of 14 minerals, provided a simpler approach to the interpretation of clay-mineral origins because they are the minerals that were most responsible for statistically significant differences among the samples. Changes in mineral composition were basically a function of parent-rock lithology, drainage, and climate interactions. A Paleo-Climate Index (CI; the ratio of coarsely crystalline kaolinite to Fe-rich smectite), and a Parent-Rock Index (PI; the ratio of the illitic phases and quartz abundances to pure smectite) were established to track the paleo-climate and parent-rock changes, respectively. Low CI values indicated that a long, seasonally dry climate prevailed during the Middle Eocene, uppermost Eocene, Lower Miocene, and Upper Pliocene bentonitic clay deposition. Lowermost Upper Eocene and the Middle Miocene bentonitic clays were produced when a wet climate prevailed throughout the year. Moderate to high PI values suggested derivation of the clays from the acidic basement crystalline rocks at Uweinat-Bir Safsaf uplift and Lower Paleogene shales during the Middle Eocene and lowermost Upper Eocene. The youngest Upper Eocene and Lower Miocene materials contained abundant Fe-smectite and low PIs indicating derivation from tholeiitic basalts. Diagenetic and sedimentary segregation modifications were not apparent. Direct evidence for in situ derivation from volcanic precursor materials was lacking in general, but volcanic eruptions were common in the region. The minerals in the Egyptian bentonitic clays formed as weathering products on land and have been transported by north-flowing streams and rivers to the sites of accumulation.
Zirconia-Intercalated Kaolinite: Synthesis, Characterization, and Evaluation of Metal-Ion Removal Activity
- Khaled S. Abou-El-Sherbini, Mohammed A. Wahba, Elsayed A. Drweesh, Adel I. M. Akarish, Seham A. Shaban, Eman A. M. Elzahany
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- Journal:
- Clays and Clay Minerals / Volume 69 / Issue 4 / August 2021
- Published online by Cambridge University Press:
- 01 January 2024, pp. 463-476
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The intercalation of kaolinite through the insertion of ions or molecules amongst the structural aluminosilicate layers is a vital process in numerous clay-based applications and products. Layer neutrality and hydrogen bonding limits direct intercalation into kaolinite, other than for small molecules. Synthesizing zirconia-intercalated kaolinite is not a straightforward matter. To overcome this barrier, raw Egyptian kaolin (UnK) or its acid-activated product (HK) was sonicated and impregnated in aqueous ZrOCl2·8H2O solution followed by thermal treatment at various temperatures (100, 200, 300, and 500°C). The intercalation process was confirmed using various spectroscopic and analytical techniques. The direct intercalation of ZrO2 into the kaolinite layers was observed even through a mild thermal treatment (100, 200, and 300°C). The mechanism of intercalation was suggested to occur by binding ZrO2 to the Si/AlO groups with a preference for the acid-activated HK, causing variable enlargements of the basal spacing and producing very perturbed layers. Interestingly, the surface area increased by 250% as a result of zirconia intercalation. Scanning electron microscopy (SEM) images showed a remarkable improvement in the stacking order of the kaolinite particles. The impact of ZrO2 intercalation into kaolinite also enhanced its adsorption efficiency for Pb2+, Cu2+, and Cd2+ ions. Preliminary investigations showed that the zirconia-intercalated HK demonstrated a removal efficiency, which is three times greater than that of pristine HK. The adsorption tendency toward Pb2+ ions was greater than those of Cu2+ and Cd2+ and followed the order: Pb2+ >> Cu2+ > Cd2+. The study suggests that the chemical modification of kaolin by zirconia via a direct intercalation technique, which greatly improves its functionality as demonstrated by the selective sorption of heavy metal ions, is worthy of further study.
1 Psychometric Characteristics of the Grenada Learning and Memory Scale: An Innovative Tool for Preschool Memory Assessment in Resource-Limited Regions
- Roberta Evans, Lauren Mohammed, Kemi S Burgen, Rashida Isaac, Toni Murray, Patricia Kandle, Mira E Cheng, Randall Waechter, Barbara Landon, Karen Blackmon
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, pp. 209-210
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Objective:
Neuropsychological assessment of preschool children is essential for early detection of delays and referral for intervention prior to school entry. This is especially relevant in low-and middle-income countries (LMICs), which are disproportionately impacted by micronutrient deficiencies and teratogenic exposures. There are limited options for assessment of preschool learning and memory, developed and validated in resource-limited regions. The Grenada Learning and Memory Scale (GLAMS) was created for use in the Caribbean using an indigenous “ground-up” approach, with feedback from regional stakeholders at various stages of development. The GLAMS contains two subtests - a verbal list-learning task, which imagines a trip to the shop to buy culturally familiar items, and a face-name associative learning task using locally-drawn faces of Caribbean children. There are two versions: a 4-item version for 3-year-olds and a 6-item version for 4 and 5-year-olds. Here we present descriptive data and psychometric features for the GLAMS from an initial preschool sample.
Participants and Methods:Participants were recruited from a social-emotional intervention study (SGU IRB#14099) in Grenada between 2019-2021. Children were between 36 and 72 months of age, primarily English-speaking, and had no known history of neurodevelopmental disorders. Trained Early Childhood Assessors administered the GLAMS and NEPSY-II in public preschools and homes across Grenada. Exploratory descriptive statistics characterized participant sociodemographics and test score distributions. Spearman correlations, MannWhitney U, and Kruskal-Wallis tests examined the impact of sociodemographics on test scores. Internal reliability was assessed with coefficient alpha. NEPSY-II subtests were used to assess convergent validity, with the prediction that the highest correlations would be observed for NEPSY-II Sentence Repetition. Test engagement (as reflected by “zero-learning”, “some learning”, and “positive learning curves”) was assessed across each age bracket (in 6-month increments). We assessed and summarized barriers to engagement qualitatively.
Results:The sample consisted of 304 children (152 males,152 females). Participants were predominantly Afro-Caribbean and Indo-Caribbean. Parent education and household income (Mdn=$370-740 USD per month) were consistent with the general population. GLAMS internal consistency was reliable (a=0.713). There were age effects on list-learning (rs=0.51; p<0.001), list recall (rs=0.51; p<0.001), face-name learning (rs=0.30;p<0.001), and face-name recall (rs=0.25; p<0.001). There were gender effects on list-learning (p=0.02) and list recall (p=0.01) but not face-name learning or recall. All GLAMS subtests were correlated with NEPSY Sentence Repetition (rs=0.22-0.34; p<0.001). There was sufficient sampling of males and females across all 6 age brackets. As age increased, a higher proportion of children showed a positive learning curve (and fewer “zero-scores”) on verbal learning (X2 =30.88, p<0.001) and face-name learning (X2=22.19, p=0.014), demonstrating increased task engagement as children mature. There were various qualitative observations of why children showed “zero-scores”, ranging from environmental distractions to anxiety and inattention.
Conclusions:As far as we know, the GLAMS is the first preschool measure of learning and memory developed indigenously from within the Caribbean. It shows reliable internal consistency, expected age and gender effects and convergent validity. These initial results are encouraging and support continued efforts to establish test-retest and inter-rater reliability. Plans include validation in clinical samples, scale-up to other Caribbean countries, and eventual adaptation across global LMICs.
23 Musical Training May Not Enhance Cognitive-Motor Integration in Healthy Young Adults
- Mohammed A. Mudarris, Rebecca S. Schaefer
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- Journal:
- Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
- Published online by Cambridge University Press:
- 21 December 2023, p. 540
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Objective:
Hand and arm functions have been associated with cognition in healthy young and older adults (Vasylenko et al., 2018) and in patients with Parkinson's disease (Bezdicek et al., 2014). Music training has been proposed to integrate motor and cognitive functions by engaging motoric, sensory, perceptual, and various cognitive domains (Wan & Schlaug, 2010). In this study, we examined if performance on fine and gross motor tasks is predicted by cognitive measures of memory, attention, and executive functions, and whether this relationship varies by the extent of musical training in healthy young participants.
Participants and Methods:Forty five healthy young participants were recruited (M = 22.32, SD = 4.10; 78% female). Participants completed fine (Grooved pegboard) and gross motor (Box and Blocks) measures as well as cognitive measures (Rey auditory verbal learning test, Stroop, Trail making, and D2 cancellation), and the musical training subscale of the Goldsmith Musical Sophistication Index. Two multiple regression models were conducted assessing cognitive measures as predictors of fine and gross motor functions, with musical training as a covariate in both models.
Results:Musical training was normally distributed across participants (M = 23.47, SD = 10.28). The results of the first model assessing the role of cognitive measures as predictors of fine motor function indicate a moderate fit (F(5,36) = 3.32, R = 0.55, explaining .32 of variance, p < .05), with memory (B = 2.75, SE = 0.82, p < .005) and sustained attention (B = 0.09, SE = 0.03, p < .01) as moderate predictors. These cognitive measures were also found to predict gross motor function (F(5,36) = 3.06, p < .05, R = 0.55, explaining .30 of the variance), with memory retention (B = 2.49, SE = 0.83, p < .001) and sustained attention (B = 0.07, SE = 0.03, p < .05) as moderate predictors. In both models, musical training was not a significant predictor.
Conclusions:We found that both fine and gross hand motor functions are predicted by cognitive measures of memory retention and sustained attention. Our results support previous findings associating cognition and motor function, with attention being relevant in young adults and memory a predictor in older adults (Vasylenko et al., 2018). We corroborate these findings for hand function, but did not find executive functions to be implicated, which were previously reported as a predictor only for older adults. While musical training has been suggested to enhance the cognitive-motor relationship as it involves motor skills as well as engages various cognitive domains (Wan & Schlaug, 2010), prior musical training was not found to affect this relationship. While music background did not predict better hand motor function, it did account for more interpersonal variance. The results suggest that for most amateur musicians, including those with years of experience, musical training may not affect the association between cognition and both fine and gross hand motor skill. The current findings indicate that while musical training can be an enriching experience, it may not (exclusively) enhance motor-cognitive integration. Different outcomes may be found with more extreme levels of music training, or a different age group.
Schizophrenic with childhood trauma: characterization of a Tunisian sample
- A. Syrine, F. Rim, B. Olfa, G. Imen, S. Najeh, O. Sana, M. B. Manel, Z. Lobna, C. Nada, B. T. Jihen, M. Mohamed
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1040
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Introduction
Schizophrenia is a neurodevelopmental process affecting approximately 1% of the population. Multiple studies have found that Childhood trauma is an important risk factor in the emergence and clinical course of schizophrenia.
ObjectivesThe purpose of this study was to assess the characteristics of schizophrenic inpatients with childhood trauma among a tunisian sample.
MethodsStabilized inpatients with schizophrenia at the Psychiatry C department at University Hospital in Sfax were involved in our study. Sociodemographic and clinical data of patients were collected from medical records.
We used Childhood Trauma Questionnaire-Short Form (CTQ-SF) to evaluate the occurrence of childhood maltreatment.
ResultsWe recruited 33 patients, all men with a mean age of 35 years and 4 months (SD=9.44 years).
They were married in 6.1% and 24.2% of patients had regular work.
The mean age of onset of the disorder was 24.42(3.25).The level of poor psychotropic medication adherence was 72.7%.
According to CTQ-SF, 78.8% of patients had experienced child trauma with a mean score of 35.67 (SD =8.61).
A rate of 39.4% reported having experienced one child trauma, while 60.6% reported having experienced more than one.
We found high rates of emotional neglect (87.8%) while emotional and physical abuse during childhood were experienced by 39.4%, and 6% respectively and physical neglect were found in 30.3% of cases.
Patients with more than one childhood trauma were found to have an earlier onset of psychosis (p=0.004)
The occurrence of childhood trauma was not associated with the socio-demographic characteristics of the respondents or the clinical features of the disease.
ConclusionsThe results point toward childhood emotional neglect being of specific importance to schizophrenia, which may be an area for future prevention and clinical attention.
Disclosure of InterestNone Declared
BORDERLINE PERSONALITY DISORDER: ATTITUDES OF PSYCHIATRY AND FAMILY MEDICINE RESIDENTS
- B. Olfa, O. Sana, A. Syrine, F. Rim, S. Najeh, G. Imen, C. Nada, B. T. Jihen, Z. Lobna, M. B. Manel, M. Mohamed
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S965
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Introduction
Patients with Borderline Personality Disorder (BPD) require a significant amount of time and effort on the part of general practitioners and psychiatrists, resulting in longer visits and complex medical records, with a poor resolution of both physical and mental symptoms.
These patients are likely to express feelings of anger and violence, compared to other patients which makes it difficult to deal with them.
ObjectivesTo determine attitudes toward patients with BPD among psychiatry and family medicine residents in Tunisia. To understand in addition the challenges that these professionals encounter in their everyday practice
MethodsAn online anonymous questionnaires was distributed through social networks to psychiatry residents and family medicine resident.
The attitudes of health professionals towards people with BPD was used to assess clinicians’ attitudes towards people with BPD.
ResultsThirty three clinicians were in the study. A high proportion of respondents (81.8%) were females .The age of the participants ranged from 25 to 34 years, with an average age of 28 years and 3 months (SD = 2.23).In our study 34% reported that they often see patients with borderline personality .The half of the participants (51.5%) reported a feeling being on guard when meeting borderlines while 36.4% were empathetic and neutral. The feeling of anger and frustration was reported with 12.1 % of the participants.
The most frequent cause of these feelings was the difficulty of taking care of patients with BPD.
The majority of the participants (51.5%) reported avoiding working with them. However, only 39.4% reported asking a colleague to replace them in their follow-up.
The results of Attitudes of health professionals towards people with BPD Scale indicate that clinicians generally present a positive attitude towards patient BPD with a mean score 94.94(SD=18.60)
ConclusionsWorking with patients with BPD can be challenging. Professionals’ attitude can create obstacles to effective communication and successful treatment.
Therefore, all clinicians should receive more specific training to be able to deal with this condition.
Disclosure of InterestNone Declared
Toxic encephalopathy after an overdose of cocaine : a case serie
- R. Zouari, F. Nabli, D. Ben Mohamed, M. Z. Saeid, S. Ben Sassi
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S672-S673
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Introduction
cocaine is a widely used illegal drug, known for its fast ability to induce euphoria and arousal. However, cocaine exposure can contribute to several mental and physical effects. Cocaine induced brain damage can be divided into 3 mechanisms: direct effect leading to toxic encephalopathy, secondary to vascular damage causing vasculitis, stroke and vasospasm, and tertiary effect due to hypoxia through a cardiovascular collapse.
ObjectivesHere, we report 2 young men who developed a subacute encephalopathy with different clinical and radiological presentation after a cocaine overdose
Methodsa case serie
Resultswe present two men aged respectively of 28 (P1) and 42 years-old (P2). Both had a history of alcohol consumption and toxicomania (mainly cocaine) during the past year. They manifested, 2 weeks following a cocaine overdose, with gait disorder and confusion. On examination, P1 was apathic and confused. He had a subcortical frontal syndrome with gait apraxia and grasping reflex, along with a quadri-pyramidal syndrome. While patient P2 developed a cognitive decline, parkinsonism with dystonic posture of the trunk and the right limbs, and a pseudobulbar syndrome. Brain MRI was performed in both patients and showed a bilateral multifocal leukoencephalopathy (P1) and the presence of bilateral hyper T2 and FLAIR weighted images affecting basal ganglia, the mesencephalon and the periventricular cerebral white matter. Cerebrospinal fluid (CSF) analysis showed no pleocytosis and normal proteinorrachia. Electroencephalogram was also normal. Infectious differential diagnosis including Human Immunodeficiency Virus (HIV) and syphilis were excluded and metabolic screening including copper analysis, serum and CSF lactate were normal. The urine toxic screening, performed 20 days following the drug overdose, was negative. Both patients were treated with benzodiazepine and fluids without significative improvement. They were discharged with major cognitive and motor impairment.
Conclusionscocaine toxicity is associated with high morbidity and mortality. Usually, cocaine abuse can lead to cardio-vascular, pulmonary and nervous complication. Neuropsychiatric sequelae are uncommon with less recovery potential. To date, there is no drug to prevent or cure cocaine addiction. The key is to educate the patient when he or she presents to the emergency department. Patients should be urged to seek drug counseling.
Disclosure of InterestNone Declared
Characteristics of patient with borderline personality disorder in a sample of Tunisian out patient
- O. Sana, S. Ajmi, B. Olfa, S. Najeh, F. Rim, G. Imen, C. Nada, B. T. Jihen, Z. Lobna, M. Mohamed, M. B. Manel
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S972
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Introduction
Borderline personality disorder (BPD) is a real source of suffering for people affected and for those around them.
ObjectivesThe aim of this study was to describe the socio-demographic and clinical characteristics of out patients with BPD consulting the psychiatry department of Hedi Chaker hospital in sfax tunisia during the period between January 2022 and October 2022.
MethodsIt was a descriptive study. The population study consisted of patients diagnosed with BPD (DSM 5) consulting the psychiatry department of the hospital Hédi Chaker of Sfax tunisia during the period from January 2022 to October 2022.
Sociodemographic and clinical data were collected using a predefined form.
All statistical analyses were performed using the SPSS software package v 18.
ResultsAmong 700 adult patients referred to the psychiatric unit of hedi chaker hospital in sfax from january 2022 to october 2022, 35 patients (5%) were identified as meeting the criteria for BPD.
The average age was about 35 years, 54.3% of the patients were men. They were married in 40% of cases.Only 31.4% of the patients had a regular job.
The presence of a family psychiatric illness was noted in 48.5% of cases and 20% had a childhood psychiatric follow-up .
The rates of sexual abuse, physical abuse, psychological abuse and neglect were 17.1%, 65.7% and 68.6% respectively.
In our sample,48.6% of the patients had attempted suicide and 60% of them had committed self-harm.
The most common means of attempted suicide was phlebotomy.No prior thoughts of suicide were mentioned, all suicide attempts were impulsive. Negative feelings and family conflicts motivated the suicide attempt (37.5% ,56.25%).
Comorbid psychiatric disorder was mentioned in 54.3% and The most frequent comorbid psychiatric disorders was depression (20%).
Pharmacotherapie was used in 88.6% of cases.
ConclusionsThe results emphasize on the comorbidities with mainly depressive episodes and a high proportion of suicide attempts and self-harm. Moreover, this study confirms the impact of family conflicts and abuse in the development of this disorder
Disclosure of InterestNone Declared
N-Hexane neuropathy: from addiction to disability!
- L. Hlioui, R. Zouari, D. Ben Mohamed, M. Z. Saied, J. Ketata, F. Nabli, S. Ben Sassi
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S665
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Introduction
Voluntary poisoning with neurotoxic products in order to achieve euphoria is common especially among young people. Neurological complications are quite likely and can be serious and irreversible.
ObjectivesWe aim to describe the peripheral neuropathies secondary to N-Hexane intoxication in a Tunisian population.
MethodsA retrospective descriptive study was carried out in our department of neurology in the NationalInstitute of Neurology of Tunis including patients diagnosed with N-Hexane neuropathy. All patientshad a history of a N-Hexane exposure. The diagnosis was confirmed after excluding other etiologiesthrough appropriate investigations. Clinical and para-clinical data as well as follow-up were assessed.
ResultsWe selected 38 patients with a mean age of 22.7 years [14-36]. Among them, 37 were glue-sniffer and 1 had a voluntary toxic exposure to paint. An associated cannabis consumption was found in 6 patients. All of them had a low socio-economic background and 17 were unemployed. Time to onset of neurological signs ranged from 5 months to 11 years. The clinical exam showed a quadriparesis (15,7%), a paraparesis (58%), sensory involvement (55,2%) amyotrophy (40%) and abolished tendon reflexes in lower limbs (81,5%). Swallowing disorder and optic neuritis were found in one case. The electroneuromyogram revealed an axono-demyelinating sensory-motor polyneuropathy (PN) in 16 cases and a demyelinating motor PN in 9 cases. Vitamin therapy, motor rehabilitation and psychotherapy sessions have been indicated. Only 6 patients showed slight clinical improvement after withdrawal. The rest of our patients did not quit; 84% of them became bedridden.
ConclusionsGlue-sniffer related neuropathy is very common in our country especially in adolescents and young adults with low socio-economic background. The neurological outcome is serious and usually irreversible if exposure is persistent.
Disclosure of InterestNone Declared
Childhood trauma, psychotic symptoms: which association?
- A. Syrine, F. Rim, G. Imen, S. Najeh, O. Sana, M. B. Manel, Z. Lobna, B. T. Jihen, C. Nada, M. Mohamed
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S1040
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Introduction
Clinical evidence supports the interaction between genetic predisposition and environmental stressors on the emergence of positive psychotic symptoms. Childhood trauma might be a modifiable risk factor among adults with serious mental illness.
ObjectivesThe aim of our study was to investigate associations between childhood trauma (physical abuse, sexual abuse, emotional abuse, emotional neglect, and physical neglect) and symptoms of schizophrenia.
MethodsWe included in our study 33 stabilized inpatients with schizophrenia at the Psychiatry C department at University Hospital in Sfax-Tunisia.
Data on Sociodemographic and clinical variables were collected from medical records.
Psychotic symptoms were evaluated using the Positive and Negative Syndrome Scale (PANSS). We used the Childhood Trauma Questionnaire-Short Form (CTQ-SF) to evaluate childhood trauma experiences.
ResultsOur sample was exclusively composed of men with an average age of 35 years and 4 months.
The majority of patients were unemployed (75.8%). Only 6.1% of them were married.
Among the patients included in the study, 15.2% of our patients were illiterate. The majority of subjects were treated after a period of untreated psychosis (65.5%).
The analysis revealed that 42.4% of our patients experienced childhood adversities with mean CTQ-SF total score 35.48 (SD=9.44)
We found that positive and general psychopathology schizophrenia symptomatology were correlated to Childhood abuse (0.03; 0.004), emotional abuse (0.009; 0.004), physical neglect (0.02; 0.01), and emotional neglect (0.01).
In addition, our analysis showed that only emotional abuse lead to more negative schizophrenia symptomatology (p=0.009).*
ConclusionsSeveral studies have shown an association between childhood trauma and specific symptoms of psychosis. Therefore, Childhood trauma should be considered and inquired about in the course of clinical care of schizophrenia patients.
Disclosure of InterestNone Declared
Recurrence and profile of reconsultants: descriptive study of 162 patients
- S. Brahim, W. BOUALI, K. Mohamed, K. Sabria, B. S. Rim, Y. Samira, Z. Lazhar
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, p. S287
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Introduction
Emergency psychiatric consultation requests present certain specificities both in the situations encountered and in their management, due to a close relationship between the consultant and his environment. They do not only correspond to psychiatric emergencies, in the strict sense of the term, but also to psychological emergencies with their possible social dimension. They require an adapted response that can be decisive for the future
ObjectivesTo determine the epidemiological and clinical characteristics of patients reconsultants in the emergency medical department.
MethodsThis is a cross-sectional study, conducted over a period of 12 months, from 01 April 2020 to 31 March 2021, in the emergency medical department of Mahdia University Hospital.
ResultsDuring the study period, 162 reconsultations for psychiatric emergencies were recorded. the age ranged from 18 to 61 years with an average of 35 years. The level of education was primary or secondary in 78.8% of cases. The majority of reconsultants had single marital status (70%). The absence of professional activity and social security coverage was found in 72.3 and 49% of cases respectively. The presence of family and personal psychiatric history was noted in 29.8% and 91.5% of reconsultants respectively. Heteroaggressiveness followed by instability were the most frequently encountered reasons for consultations with 23.4% and 12.8% of cases respectively. The presence of a triggering factor was found in 63.8% of cases where problems with the main support group followed by those related to the social environment and those related to access to health services were the most reported with 49.23 and 13% respectively. The syndromic psychiatric diagnoses were, in decreasing order of frequency, psychomotor excitement (23.4%), delusional syndrome (17%), dissociative syndrome (12.8%) and somatic conversion (12.8). For reconsultants, relational approach and/or injectable treatment were the most used therapeutic means immediatly (49%). Neuroleptics and benzodiazepines were prescribed in 38% and 13% of cases, respectively. The decision to hospitalize in a psychiatric department concerned 45% of reconsultants.
ConclusionsReferral decisions favored the organization of ambulatory follow-up, with a decrease in the rate of hospitalization. These results make it possible to identify the evolutionary trends of the population consulting in emergency
Disclosure of InterestNone Declared
Predictors of psychosocial functioning in euthymic patients with bipolar disorder
- S. Ajmi, O. Sana, S. Najeh, F. Rim, G. Imen, C. Nada, B. T. Jihen, Z. Lobna, M. Mohamed, M. B. Manel
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- Journal:
- European Psychiatry / Volume 66 / Issue S1 / March 2023
- Published online by Cambridge University Press:
- 19 July 2023, pp. S711-S712
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Introduction
Functional impairment is a major target in the treatment of bipolar disorder (BD), but the magnitude and type of functional difficulties differ across patients.
ObjectivesThe aim of this study was to assess functioning and identify factors associated with global functioning in euthymic patients.
MethodsIt was a descriptive cross-sectional study. The population study consisted of patients diagnosed with BD (DSM 5), who were euthymic and followed up at the psychiatry department of CHU Hedi Chaker.
The Hamilton Depression Scale (HAM-D), the Young Mania Rating Scale (YMRS) and the Functioning Assessment Short Test (FAST) were used to assess depressive, manic symptoms and the functional impairment in bipolar patients respectively. All statistical analyses were performed using the SPSS software package v 18.
ResultsWe collected 40 patients. They had an average age of 36 years and the sex ratio (M/F) was 1.
They had an educational level not exceeding primary studies in 46% of cases.
The average scores of HAM-D and YMRS were 4.57±4.58 and 3.43±2.89 respectively.
The average total functioning score of our patients was 19.13±16.5. Functional impairment was noted in 60% of them. The domains most affected were: occupational activity (62%), cognitive functioning (63%) and autonomy (50%). Fonctional impairement was associated with residual depressive and manic symptoms (p=0.013) and manic/hypomanic or depressive episodes with mixed features (p=0,005).
ConclusionsGreater efforts should be directed toward targeting functioning in patient care, as it constitutes the most meaningful endpoint of response to treatment, especially with occupational and cognitive rehabilitation, thus allowing patients to overcome the course of illness and carry fulfilling lives.
Disclosure of InterestNone Declared