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The present study aims to describe a new genus and species of microphalloid digenean parasite of two species of bats of the genus Peropteryx from the Mexican Neotropics (in the states of Chiapas and Yucatán). Morphological and molecular data (28s rDNA ribosomal gene sequences) were used to study Digeneans. Sagittatrema zutzi gen. nov. sp., nov., is diagnosed morphologically by having a sagittiform body, a genital pore in the midline of the body, posterior to the ventral sucker, and a cirrus sac running through much of the diameter of the ventral sucker. The nine sequences generated from the 28S rDNA gene were used to examine the phylogenetic affinities of this new taxon within the superfamily Microphalloidea Ward, 1901, using Maximum Likelihood and Bayesian Inference analyses. Both analyses resulted in trees with similar topologies and formed a well-supported clade (Bt = 100; pp = 1) with the Sagittatrema sequences. Because of the new genus’s phylogenetic position and that some sister families to the proposed taxa, like Pleurogenidae and Prosthogonimidae, are polyphyletic, we prefer to consider Sagittatrema as a genus incertae sedis within Microphalloidea. A full systematic review of microphalloids is needed to confirm their phylogenetic position.
Clinostomidae is a diverse family of digenean parasitizing fish-eating birds as adults and fishes as metacercariae. The species composition, within the genus Clinostomum has been steadily increasing in recent years. In Argentina, four named species of Clinostomum have been documented, accompanied by four metacercariae representing distinct genetic lineages whose adults have not been identified. This study focused on examining clinostomids in three fish species – Australoheros scitulus (ASI), Cichlasoma dimerus (CDIM), and Pimelodella laticeps (PLA) – at various localities in Argentina. We conducted both morphological and molecular characterizations of the Clinostomum metacercariae collected from these fish species. Molecular phylogenetic analyses using COI mtDNA were performed to determine the placement of these metacercariae within the clinostomid phylogenetic tree. Clinostomum ASC represents a distinct lineage, morphologically distinguishable from other sequenced metacercariae due to its body shape (widest anteriorly and becoming slender towards the posterior end); this lineage was found to be closely related to C. caffarae. While Clinostomum CDIM and Clinostomum PLA exhibited morphological differences, they clustered together genetically with metacercariae reported in previous studies as Clinostomum L3 and Clinostomum CVI. This outcome, coupled with a low genetic distance (0 to 3%), suggests that they are conspecific with metacercariae found in fish across Mexico, Costa Rica, and Argentina. In light of the extensive diversity of fish species in Argentine freshwater ecosystems (over 500 species), and considering the relatively constrained extent of prior investigations, the anticipation of unearthing additional Clinostomum species or lineages is plausible.
The wavy leading edge (WLE, also known as leading edge protuberances) is a passive flow control device inspired by the humpback whale pectoral flippers. It reduces the flow of three-dimensional effects on wings and increases their aerodynamic performance at high angles of attack. Despite the numerous studies on its aerodynamic benefits, research on its possible applications is still incipient. Therefore, this article addresses an evaluation of the WLE effects on the aerodynamic performance of a winglet. A rectangular wing, a base smooth leading edge winglet, and a winglet with WLE were designed and manufactured for CFD simulations and wind tunnel measurements. The winglet with WLE increased the maximum aerodynamic efficiency, i.e. this configuration reduced the induced drag by increasing wingtip vortex dissipation at a given angle-of-attack. Such results were used in re-evaluations of the aerodynamic performance of an original agricultural aircraft initially configured with a multi-winglet device. The winglet with WLE showed to be effective at increasing the aircraft operational time and range under a simulated actual condition.
Adults may continue suffering AHDH symptoms after this condition is recognized and typified in children. Different works provide evidence that adults have an even more complicated variety of psychiatric disorders than children, as an increased risk of problems stemming from substance abuse, depression, anxiety, increased risk of traffic accidents, and also sexual transmission diseases.
Objectives
There was known that adults could continue suffering symptoms derived from his infantile ADHD. We wonder if the majority of the young males derived to our consultation present compatible symptoms with adult ADHD. This condition promotes the onset of substance use and may lead to latent psychosis onset.
Methods
We analyzed 39 patients derived by suspicion of psychiatric pathology, aged between 17 and 35. They stem to clinical psychology for study of features of personality (Million Questionnaire). Another questionnaire was used also autoapplied for sifted of the ADHD in adults (ASRS_V1:1). According to the criteria DSM-IV TR, the patient had moderate symptoms of ADHD if it was fulfilling 6 or more diagnostic criteria according to their answers in the screening questionnaire.
Results
The results supported the existence of impulsivity, aggression, irritability, problems with compliance and substance abuse.
Conclusions
ADHD is not only a problem of distractibility or worry, but a deeper and extensive alteration caused by the deterioration of a set of cerebral activities. An early treatment in the childhood could prevent devastating consequences for their development, since they include the majority of the functional areas of the patient and it impedes their later social and labor adjustment.
INTRODUCTION Facebook is the world’s leading social network with 2,449 million users. Around 22 million of those users are registered in Spain, and 30% of them are aged between 16 and 31. Pro-Ana and Pro-Mia pages have found a space to promote Eating Disorders (ED) as a ‘lifestyle’ using their own code.
Objectives
OBJECTIVE To study the characteristics of Pro-Ana and Pro-Mia Facebook profiles in Spanish.
Methods
METHODS A non-computerized research of Facebook pages related to ED advocacy was conducted. The opened time, publications, photos, type of profiles (public/private) and link to a WhatsApp group of 58 Facebook pages were analyzed. A qualitative and descriptive analysis was carried out.
Results
RESULTS From Facebook profiles: 62.07% contained ‘Ana’ in their profile name; 18.97% had been opened for more than 3 years; 79.31% had been shared; 48.28% mentioned Whatsapp groups; 91.38% were public profiles; 50% named other social networks; 75.86% added text to their publications; 25.86% had shared more than 20 photos on their profiles.
Conclusions
CONCLUSIONS On platforms like Facebook, people with ED can: advocate for their disease, set up networks, share tips/tricks and encourage other users to become part of their community. Technological developments have made it easier to access to this type of resources. Despite the platform’s policy, there are still these kind of profiles that make a case for ED.
Eating Disorders are a frequent pathology, particularly among teenagers, a group characterized by its vulnerability and body dissatisfaction. Social networks (SN) can be a gateway to ED, mainly with Pro-Ana and Pro-Mia resources. Despite the aforementioned, SN can also be helpful for professionals, either as a tool of approach to vulnerable groups or as a way of interaction in patients already diagnosed.
Objectives
To study the relationship between ED and SN, using the open access evidence available in Pubmed over the last 5 years.
Methods
A single-phase computerised search was carried out in Pubmed. The search terms were: (“Anorexia Nervosa”[Mesh] OR “Bulimia Nervosa”[Mesh] OR “Feeding and Eating Disorders”[Mesh] OR “Eating Disorders”[Tiab] OR “Eating Disorder”[Tiab] OR “Disorder, Eating”[Tiab] OR “Disorders, Eating”[Tiab] OR “Anorexia”[Tiab] OR “Bulimia”[Tiab]) AND (“blogging”[Mesh] OR “social media”[Mesh]). The filters applied were: “free Full Text” and publications for the last 5 years.
Results
36.84% studied SN as a positive tool for ED. 47.37% revealed negative influence, only 44.44% focused on Pro-Ana and Pro-Mia. 15.79% provided both positive and negative arguments. The most studied SN were Twitter and Facebook.
Conclusions
Despite the known negative effect that SN can have on ED, they can also be used as a supportive recovery framework. They can be used to identify dangerous behaviours and intervene or as a prevention tool.
Day care programs have been extensively used to treat people with acute psychiatric disorders. Day hospitals (DH) can act as an alternative to admission in patients with acute symptoms, shorten the duration of admission, be useful for rehabilitation and maintenance care or enhance treatment in patients with poor adherence to outpatient care. Few research has been conducted in delusional disorder (DD).
Objectives
To investigate whether DH care increases adherence with psychiatric appointments in patients with DD. To describe functions of partial hospitalization in DD.
Methods
Comparative study including DD patients who attended a DH (Group 1:n=12) versus patients who did not receive DH care (Group 2;n=7). Patients attending DH were classified into 3 groups according to the program function at referral. Adherence with outpatient follow-up appointments (primary outcome) and pharmacy refill data (secondary outcome) were assessed after discharge over a 6-month period (DH) and compared with group 2. For statistical analyses, non-parametric tests were performed.
Results
Program function (DH): alternative to admission (n=4); shortening of admission (n=5) and enhancing outpatient treatment (n=3). Patients receiving DH care were more frequently referred from the inpatient unit or emergency department compared to those who did not attend DH (commonly referred from primary care services). No statistically significant differences were found between both groups in adherence to psychiatric appointments. Patients who attended DH showed higher compliance with antipsychotics (89.29% vs.72.62, p<0.05).
Conclusions
DH care may be a useful alternative to increase adherence with antipsychotics in DD patients with poor awareness of illness.
Conflict of interest
AGR has received honoraria, registration for congresses and/or travel costs from Janssen, Lundbeck-Otsuka and Angelini.
Eating Disorders (ED) have increased both in number of cases and diagnoses in recent years, partly due to the ease of searching on the Internet. This “community” as they call themselves has a proper language, which makes them easier to connect.
Objectives
To know the search frequency of Pro-Ana and Pro-Mia terms in Spanish in the Google search engine.
Methods
A manual screening was carried out based on the word analysis of Pro-Ana and Pro-Mia blogs to obtain their search frequency in Spanish. Using the Google Trends tool, a total of 19 word combinations related to ED and their advocacy were reviewed in the time period from 01/01/2019 to 01/12/20. Some of them such as: “carrera de kilos” (kilos race), “princesa de cristal” (glass princess), “princesa de porcelana” (porcelain princess) and “dieta ABC” (ABC diet) among other terms.
Results
From 2019 to 2020 there has been an increase in the searches related to Eating Disorders (41.63%), ABC diet (9.72%), porcelain princess (25.52%) and kilos race (38.53%). There has also been a decrease in the search for thinspo ana (30.9%), tips ana (4.15%), blog mia (13.09%) or blog ana (0.79%).
Conclusions
Search trends change over time as they meet the evolving needs. In several media we can find a clear increase in ED during this 2020 due to the confinement related to COVID-19. This is something that we can also relate to this increase in searches for some terms.
Autism spectrum disorder (ASD) is a neurodevelopmental disorder with a biological basis overlapped with obsessive compulsive disorders and body dysmorphic disorder (BDD). The combination of pharmacological treatment and psychological interventions have been considered the gold-standard
Objectives
Our main objective was to present the case of a patient with ASD and comorbid BDD. As a second objective, we reviewed recent works on the common neurobiological substrate and therapeutic options for both conditions.
Methods
(1)Clinical case: Patient with ASD and BDD, treated with fluoxetine 60 mg/day and aripiprazole 30 mg/day. (2)Non-systematic narrative review focused on neurobiological substrate and treatment of ASD and BDD. The electronic search was performed by the PubMed database (1990-2020) using the following key terms: “autism spectrum disorder”, “body dysmorphic disorder”, “dysmorphophobia”, “neurobiology”, “pharmacological treatment”, “psychological treatment” and “treatment”.
Results
Our patient is a 31-year-old single male fulfilling DSM-5 criteria for ASD, diagnosed in childhood, and BDD. He received pharmacological treatment and CBT. He also verbalized having been concerned with his lips and mouth for the last 10 years. This discomfort leads to passive ideas of death. Review: All articles (n=4) supported the use of selective serotonin reuptake inhibitors (SSRIs) and CBT in this comorbidity. None of them reported the use of antipsychotics. Oone article described the use of Repetitive transcranial magnetic stimulation (rTMS) and oxytocin.
Conclusions
ASD and BDD share the basis of corticostriatal circuits. ISRS and CBT may be effective in treatment. Other options (oxytocin or rTMS) should be further investigated. Examining this comorbidity could be useful for discovering possible endophenotypes.
Nowadays Social Networks (SN) are used not only in a playful way but also as a ‘health’ means of communication. The Pro-Ana and Pro-Mia accounts or profiles -whereby Eating Disorders are advocated as a ‘lifestyle’- increased by 300% over the last decade.
Objectives
To analyze Instagram Pro-Ana and Pro-Mia accounts and compare them with Pro-Ana and Pro-Mia Blogs.
Methods
A non-computerized research of Pro-Ana and Pro-Mia Blogs and Instagram profiles was performed. Accepting a risk of Alpha=0.05 and Beta=0.15 in a two-tailed test, 29 subjects were required in each group to detect a difference equal to or greater than 0.2 units. The common standard deviation is assumed to be 0.25. Publication averages, photos, opening years, WhatsApp links and number of followers were analysed and compared. Transversal descriptive study.
Results
Blogs: 100% had no groups in other SN, 33.33% had been opened for more than 3 years, 30% included personal pictures, 16.67% contained Ana in their title, 53.3% named other Blogs. Instagram: 56.67% included personal pictures, 13.33% mentioned WhatsApp groups, 73.33% had a public profile, 43.33% contained ‘Ana’ in their user name and 53.33% had more than one hundred followers.
Conclusions
These tools are constantly adapting to the times in which they coexist. There has also been a current increase in Instagram profiles. This study shows a greater linkage to WhatsApp groups on Instagram than on Blogs, together with a higher number of followers, ease of ownership and difficulty of control.
INTRODUCTION TikTok is a social network (SN) that allows users to share short videos about different issues. Since the COVID-19 lockdown, there has been an increase in Pro-Ana and Pro-Mia videos in this specific SN.
Objectives
OBJECTIVES To know the main characteristics about Pro-Ana and Pro-Mia contents among TikTok users.
Methods
METHODS A search was carried out using uncontrolled language with the term “TCA” (ED in English). The study included only Pro-Ana and Pro-Mia resources in Spanish. Resources under the category “recovery” were excluded. A random sample of 16 TikTok was used, since it is enough to estimate, with a confidence of 95% and an accuracy of +/- 20 percentage units, a population percentage that is expected to be around 20%. The studied variables were images, type of resources, “challenges” and misspelled words.
Results
RESULTS In the sample, 68.75% of the profiles were created upon confinement, 56.25% had more than 500 followers and 68.75% had more than 3000 “likes”. 43.75% included more than 30% of ED advocacy content, 18.75% promoted challenges and 37.5% used misspelled words to avoid SN censorship.
Conclusions
CONCLUSIONS There has been a remarkable increase in ED-related content as a result of lockdown. In turn, the increasing number of users who are part of TikTok reveals that this is a SN that can be associated with ED advocacy.
Research has consistently documented the significance of severe life events for the onset and course of major depression. However, no research has been done on whether social and clinical characteristics differ in depressed primary care attendees who have experienced stressful life events compared to those who have not.
Objectives
We investigated whether social and clinical characteristics differ in depressed primary care attendees who have experienced stressful life events compared to depressed primary care attendees who have not.
Methods
We undertook a prospective cohort study involving 5,442 consecutive primary care attendees with evaluations at baseline and at 6 months. Patients aged 18-75 years were recruited in six Spanish provinces between October 2005 and February 2006. The incidence of major depression was assessed at 6 months with the Depression Section of the Composite International Diagnostic Interview (CIDI). Stressful life events were measured with the List of Threatening Experiences (LTE).
Results
3,804 (70%) were interviewed at 6 months of follow-up. Among 200 attendees with a first episode of major depression, 24.5% had experienced no stressful life events, 30.5% had suffered one, 20.5% had experienced two and 24% had suffered three or more in the 6 months prior to the onset of depression. Depressed primary care attendees who had experienced three or more stressful life events differed from depressed patients with no stressful life events in the following variables: economic difficulties, dissatisfaction with unpaid work, relational variables, psychiatric co-morbidity and family history.
Conclusions
Stress-related major depression differs from non-stress-related depression in primary care.
Comparative studies prove that levetiracetam therapy presents a major frequency of behavioral disturbances, producing problems of impulsive aggressiveness with a relative frequency. Principally if a previous psychiatric history is associated.
Objetives
Report a case of Impulsive homicide aggression in a patient treated with Levetiracetam. Extensive bibliographical review.
Methods
We describe the case of a patient admitted in our Psychiatric acute unit because a major depressive disorder and mild cognitive impairment associated with vascular factors that developed strange impulsive aggressive behavior after the initiation of treatment with levetiracetam, even to try to assassinate his wife. Follow-up visits were performed at 6 and 12 months after discharge to assess aggressive behavior and the change in the Barratt impulsivity scale and the hostility inventory of Buss-Durkee. We conducted a literature review of behavioral and aggression problems associated with treatment with levetiracetam and its possible mechanisms.
Results
After the phasing out of levetiracetam and replacement by oxcarbazepine, aggressive behaviors disappeared. No significant psychopathology was showed in the patient in the follow-up visits, except secondary to preexisting cognitive impairment.
Conclusions
According to studies reviewed a 7-13% of patients treated with levetiracetam may develop behavioral disorders with impulsive aggression that usually resolve after discontinuation of drug.
Comparative studies show that levetiracetam has a greater frequency of such effects, leading to problems of impulsive aggression relatively often, especially if there is a comorbid psychiatric pathology.
To know prevalence of depression in Spanish nursing home(NH) by analysing the clinical profile of residents from RESYDEM study (Identification of patients with cognitive deterioration and dementia in NH).
Design/methods
A multicentral, transversal, observational study was carried out in April 2005. 71 geriatrician from 54 NH representing the Spanish state participated. Depression was analysed in patient´s history and determined by NPI of Cummings, NH version.
Results:
1037 residents were randomized, 1020 were used by clinical data analysis. 941 were used to determine depression prevalence. Median age 83,4yo, 66.6% were women, 70.9% with basic educational level, 57.4% widows, 25.7% single, 41.5% had some degree of functional deterioration, 22.1% had delirium. In 26.4% were documented Stroke(17,9% TIA). 61.7% had dementia.
Depression appears in 31.4% of elderly institutionalized with the only diagnosis of depression or independent of others. There were no significant differences in age groups. However, was most frequent in women. 95.7% of patients with diagnosis of dementia had at least one drug for depression. Most used anti-depressants were trazadone (23%), citalopram (20.9%), sertraline (15.8%), fluoxetine (10.1%). No tricyclical anti-depressant reached 1% of consumption.
Conclusions:
Depression affects practically one in three institutionalized elderly in Spain
Institutionalized elderly with depression are largely treated with ISRS. It is believed that the use of trazadone is linked with the effects on sleep and anxiety.
The high prevalence of depression, its overlapping with other processes and the comorbility of residents requires a careful search and approach in NH which implies a challenge for professionals in order to treat it.
Chronic Fatigue Syndrome (CFS) is characterized by severe fatigue associated with pain, sleep disturbance, attentional impairment and headaches. Evidence points towards a prominent role for Central Nervous System in its pathogenesis, and alterations in serotoninergic and dopaminergic neurotransmission have been described.
Attention-deficit Hyperactivity Disorder (ADHD) courses with inattention, impulsivity, and hyperactivity. It affects children and persists into adulthood in 50% of patients. Dopamine transporter abnormalities lead to impaired neurotransmission of catecholaminergic frontal-subcortical-cerebellar circuits.
Objectives
To describe the prevalence of ADHD in a sample of CFS patients, and the clinical implications of the association.
Aims
To study the relationship between CFS and ADHD.
Methods
The initial sample consisted of 142 patients, of whom 9 were excluded because of severe psychopathology or incomplete evaluation. All the patients (age 49 ± 87; 94,7 women) received CFS diagnoses according to Fukuda criteria. ADHD was assessed with a diagnostic interview (CAADID), ADHD Rating Scale and the scale WURS, for childhood diagnose. The scales FIS-40, HAD, STAI and Pluthik Risk of Suicide (RS) were administrated.
Results
38 patients (28,8%) were diagnosed of childhood ADHD (4 combined, 22 hyperactive-impulsive, 12 inattentive) and persisted into adulthood in 28 (21,1%; 5 combined, 4 hyperactive-impulsive, 19 inattentive). There were no differences in Fukuda criteria profile and FIS-40 between groups. ADHD patients scored higher in HAD-Anxiety (9,88 ± 4,82 vs. 12,57 ± 3,49; p = 0,007), HAD-Depression (9,69 ± 4,84 vs. 12,04 ± 4,53; p = 0,023), STAI-E (30,55 ± 14,53 vs. 38,41 ± 11,35; p = 0,012), and RS (6,13 ± 3,48 vs. 8,49 ± 3,07; p = 0,002).
Conclusions
ADHD is frequent in CFS patients and it is associated with more severe clinical profile.
The graphic papers of Pablo, 14 years, diagnosed of autism of high functioning, serve as a sign of alert when facing what underlies after the specializing professional intervention.
A few letters, a few drawings, and a few words that show the powerlessness, the suffering and the absence of contextual specific adequacy.
In this work we study, from the analysis of a real case, some excellent aspects in the psychosociosanitary attention, such as:
- The need for compilation of pertinent information
- The need for elimination of prejudices
- The need for respect to the family
- The need for specialized formation
- The need for search of a shared communicative code
- The need for search of strategies of social interaction
- The need for empathy
- The need for search of contextual specific adequacy
- The need for rigorous rules in the physical containment.
- The need of a turned over of adapted information
- The need to respect the psychoevolutive situation of the patient
- The need to give priority to the person on the illness.
A testimony that should serve as a warning for those institutions, administrations and professionals who are thinking of having put all the resources to its scope.
A testimony that should serve to contribute information and new challenges to those other professionals who do not stop their determination of conceptual and/or clinical anxious research.