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Cystic echinococcosis is a zoonosis caused by Echinococcus granulosus sensu lato, which leads to serious public health problems. Considerable phenotypic variation has been described between parasites depending on the intermediate host and genotype. Knowledge of species/genotypes present in an endemic region is clue for control programs. Although DNA sequencing is the most accurate tool for this purpose, its high cost makes it less affordable. A multivariate study of the morphometric parameters of rostellar hooks of E. granulosus sensu lato of human origin from Neuquén was carried out using Principal Components Analysis and classification trees. A valid classification criterion to differentiate E. granulosus species using morphometry of rostellar hooks in human hydatid cysts was determined. Seventy-six human fertile hydatid cysts (48 E. granulosus sensu stricto G1 and G3, and 28 E. canadensis G6) were included. Overall, 2,280 hooks were measured. The rostellar hooks belonging to E. granulosus sensu stricto were significantly smaller than those of E. canadensis. The Large Total Length (LTL) was sufficient to classify a new isolate into the 2 species: if LTL < 25.3 μm, then it corresponds to E. granulosus sensu stricto, and if LTL ≥ 25.3 μm to E. canadensis. This is the first multivariate study that establishes a morphometric cut-off value to discriminate between 2 species of E. granulosus sensu lato from human patients, using a significant number of cysts of both species identified by sequencing of mitochondrial genes. It constitutes a useful predictive tool in endemic areas where both human infective species overlap.
Evidence supports plant-based dietary patterns for preventing cardiovascular diseases (CVD)(1). Fat mass is a strong predictor of CVD(2), however it’s unclear whether this mediates the relationship between plant-based dietary patterns and CVD. Hence, the aim of this study was to determine if longitudinal associations between plant-based dietary patterns and incidence of CVD events, CVD mortality and all-cause mortality are mediated by fat mass in mid-life. Dietary data (Oxford WebQ) from 14,247 adults (median 56 years [IQR 49–61]) in the UK Biobank cohort study were used to derive diet quality index scores for an overall plant-based diet (PDI), a healthy plant-based diet (hPDI), and a less healthy plant-based diet (uPDI). Health registries and national records provided CVD event and mortality data. Percentage fat mass was measured by dual X-ray absorptiometry. Cox proportional hazard ratios (95% CI) identified associations between each diet quality index and CVD events, CVD mortality or all-cause mortality. Regression-based mediation analysis was used to identify the direct effect (plant-based diet quality indices on CVD mortality, CVD events, or all-cause mortality), and the indirect effect, which was mediated by fat mass. New CVD events (n = 364), CVD mortality (n = 52) and all-cause mortality (n = 220) were identified with mean follow up of 11.6 (SD ± 0.4) years for CVD events, and 11.5 (SD ± 0.7) years for mortality. The mean score for PDI was 50.5 (SD ± 5.9), hPDI 52.8 (SD ± 7.2), and uPDI 54.0 (SD ± 6.8). The PDI and hPDI were inversely associated with fat mass, and the uPDI was positively associated with fat mass (p < 0.001). There was no association between the diet quality indices and health outcomes, with (direct effect) or without (total effect) the fat mass mediator for males and females (p ≥ 0.1). Fat mass was associated with risk of mortality in some models, after controlling for the indices, such as a lower risk of all-cause mortality after controlling for the hPDI (p < 0.1). There was a significant negative indirect effect of hPDI on CVD mortality via fat mass for females only (observed coefficient 0.81; 95% CI 0.60–0.99). Overall, there was limited evidence of a mediating effect from fat mass in the association between plant-based dietary patterns and incidence of CVD events, CVD mortality and all-cause mortality. Studies with larger samples and longer follow up are needed to determine whether the mediating effect of fat mass on hPDI and CVD mortality in females is reproducible.
In this article, a genetic algorithm (GA) is proposed as a solution for the path planning of unmanned aerial vehicles (UAVs) in 3D, both static and dynamic environments. In most cases, genetic algorithms are utilised for optimisation in offline applications; however, this work proposes an approach that performs real-time path planning with the capability to avoid dynamic obstacles. The proposed method is based on applying a genetic algorithm to find optimised trajectories in changing static and dynamic environments. The genetic algorithm considers genetic operators that are employed for path planning, along with high mutation criteria, the population of convergence, repopulation criteria and the incorporation of the destination point within the population. The effectiveness of this approach is validated through results obtained from both simulations and experiments, demonstrating that the genetic algorithm ensures efficient path planning and the ability to effectively avoid static and dynamic obstacles. A genetic algorithm for path planning of UAVs is proposed, achieving optimised paths in both static and dynamic environments for real-time tasks. In addition, this path planning algorithm has the properties to avoid static and moving obstacles in real-time environments.
Consumer interest in plant-based diets has increased, alongside significant growth in the availability of plant-based meat and dairy alternatives in supermarkets(1). The nutritional profile of these products is likely to vary due to the broad range of ingredients used(2). Food composition databases, such as the Australian Food Composition Database (AFCD), are used extensively in research, practice, and policy, including by nutrition and dietetics researchers and health professionals to identify the nutrient content of foods. However, it is unclear if, and to what extent, the AFCD data on plant-based alternatives reflects the current food supply. This study aimed to examine the range and composition of plant-based meat and dairy alternatives available in Australian supermarkets and compare this with the AFCD. Data on core plant-based meat and dairy alternatives were collected from eight Melbourne supermarkets between June and October 2022 using the CSIRO FoodTrackTM database methodology(3). Products were included if they were i) meat or dairy substitutes outlined in the AFCD; or ii) plant-based alternatives for core meat and dairy included in the Australian Dietary Guidelines. Product images were taken, and data was transcribed. Products collected in supermarkets were then ‘matched’ to the most appropriate reference item in the AFCD. In total, 455 meat alternatives (n = 219 legumes/pulses; n = 178 meat substitutes; n = 38 tofu/tempeh; n = 20 sausages) and 249 dairy alternatives (n = 157 milk; n = 52 cheese; n = 40 yoghurt) were identified. Over half of the plant-based meat substitutes (n = 102; 57%) were made from a soy/wheat/pea base protein. Of the dairy alternatives, just over half of the cheese substitutes had coconut as their main ingredient (n = 28; 54%), and almost two-thirds of yoghurts were coconut-based (n = 28; 70%). The majority of the 157 milks were oat-based (n = 57; 37%), followed by almond (n = 45; 29%), and soy (n = 27; 17%). Many supermarket products were not reflected in the AFCD, including over two-thirds of dairy alternatives (n = 159; 67%), and one-third of meat alternatives (n = 150; 33%). This was due to more product options within categories, such as the variety of canned beans/legumes (n = 96) and flavoured milk substitutes (n = 34) available in supermarkets, and a greater variety of main ingredients used, most notably for cheese substitutes (n = 52). This study highlights that the range of plant-based meat and dairy alternatives available in Australian supermarkets is diverse, with many different base ingredients used, and a great range of products available in-store than in the AFCD. Findings highlight the challenges of food composition databases in keeping up to date with the fast-growing plant-based sector. Outcomes from this study have implications for the monitoring of the food supply and population level dietary data.
Within rural Australia, only 47% and 9% of adults meet recommendations for fruit and vegetable intake, respectively, which is a leading contributor to the increased risk of non-communicable disease. Previous literature has identified barriers and facilitators to increasing fruit and vegetable intake in rural Australian settings, such as having greater access to fresh produce(1). However, this literature is limited by observing fruit and vegetables as a single food group and small sample sizes. This study aimed to determine the barriers and facilitators to meeting fruit and vegetable recommendations (as separate food groups) in rural Australian adults. It was hypothesised that barriers and facilitators to consumption of fruits and vegetables would be identified at the individual, social-environmental and physical-environmental levels of a socio-ecological framework and these would differ between fruit and vegetables(2). Data from the 2019 Active Living Census were used, completed in the Loddon Campaspe region of north-west Victoria, Australia. Data were available at the level of the individual (socio-demographic characteristics, health behaviours, education level, financial stability), social-environment (household size), and physical-environment (use of community gardens). Information on fruit and vegetable consumption was collected using two open-ended questions asking how many serves were consumed each day. Survey weighting was used to account for the survey design. Descriptive statistics were reported for continuous (mean and standard errors [SE]) and categorical (frequencies) data. Multivariate logistic regression analyses were used to determine odds ratios (OR) and 95% confidence intervals (CI) for meeting fruit and vegetables recommendations according to barriers and facilitators at the individual, social-environmental and physical-environmental level. A total of 13,464 adults with complete data were included in the analysis (51% female; mean age 48 (0.17) years). Mean fruit intake was 2.85 (0.02) serves per day and mean vegetable intake was 1.56 (0.01) serves per day. A total of 48% of participants consumed the recommended two serves of fruit daily, while 19% consumed the recommended five serves for vegetables. Multivariate analyses determined distinct barriers and facilitators to consumption between fruit and vegetables. For example, a larger household size facilitated meeting vegetable recommendations (OR: 1.41; 95% CI: 1.22, 1.63), but not fruit, and greater alcohol consumption was a barrier to meeting fruit recommendations (OR: 1.47; 95% CI: 1.31, 1.64), but not vegetables. Common facilitators across both fruit and vegetables included higher age, lower BMI, being a non-smoker, and engaging in more vigorous activity. The results of this research will help inform future policies to increase both fruit and vegetable intake in rural communities, therefore contributing to efforts to improve the health of rural Australians.
Populations of Egyptian spiny mice (Acomys cahirinus dimidiatus) in a fragmented montane wadi system in the Sinai showed significant differences in the abundance of gut helminths. Differences in parasite load between populations were positively associated with measures of androgen activity but showed no significant relationship with glucocorticoid activity. Social discrimination tests with adult males from different wadis showed that those from sites with greater helminth abundance were less likely to investigate odours from other males and were less aggressive when subsequently interacting with the odour donors. Subjects showed markedly more investigation towards the odours of males from distant wadis compared with those from their own or immediately neighbouring wadi, but were less aggressive when confronted with odour donors from distant wadis. Despite this, there was a positive relationship between the amount of investigation towards distant male odour and subsequent aggression towards the male. While aggressiveness was positively associated with measures of androgen and glucocorticoid activity, no significant relationship emerged with individual helminth infection. Thus aggressiveness appeared to relate to overall local population levels of infection rather than individual challenge.
Climate change is expected to affect parasitic nematodes and hence possibly parasite–host dynamics and may have far-reaching consequences for animal health, livestock production, and ecosystem functioning. However, there has been no recent overview of current knowledge to identify how studies could contribute to a better understanding of terrestrial parasitic nematodes under changing climates. Here we screened almost 1,400 papers to review 57 experimental studies on the effects of temperature and moisture on hatching, development, survival, and behaviour of the free-living stages of terrestrial parasitic nematodes with a direct life cycle in birds and terrestrial mammals. Two major knowledge gaps are apparent. First, research should study the temperature dependency curves for hatching, development, and survival under various moisture treatments to test the interactive effect of temperature and moisture. Second, we specifically advocate for more studies that investigate how temperature, and its interaction with moisture, affect both vertical and horizontal movement of parasitic nematodes to understand infection risks. Overall, we advocate for more field experiments that test environmental effects on life-history traits and behaviour of parasitic nematodes in their free-living stages under natural and realistic circumstances. We also encourage studies to expand the range of used hosts and parasitic nematodes because 66% of results described in the available studies use sheep and cattle as hosts and 32% involve just three nematode species. This new comprehension brings attention to understudied abiotic impacts on terrestrial parasitic nematodes and will have broader implications for livestock management, wildlife conservation, and ecosystem functioning in a rapidly warming climate.
In South America, the knowledge of trematode diversity parasitizing freshwater fishes is still scarce, as less than 5% of the freshwater fish fauna has been examined for parasites. A similar situation applies to studies on digenean life cycles, which have become increasingly rare. Among the digenean families parasitizing freshwater fishes in the region, Haploporidae is considered the richest in species diversity. However, information about the developmental stages of haploporid life cycles remains fragmentary. Particularly, in Argentina, nine cercariae attributed to the family Haploporidae have been described using morphological analysis, and only two life cycles of this family have been completely elucidated. In this study a new type of cercaria, morphologically assigned to the family Haploporidae and collected from the snail Heleobia parchappii (Cochliopidae) in Los Padres shallow lake, Buenos Aires province, was identified using morphological and molecular techniques. The molecular analysis, based on 28S and ITS2 sequences, revealed that the cercariae were 100% identical to adult specimens of Saccocoelioides nanii (Haploporidae) parasitizing the fish Prochilodus lineatus (Prochilodontidae) from Los Talas, Buenos Aires province. Our results not only provide information about the life cycle of S.nanii but also show that a molecular and morphological approach can be extremely useful in identifying the developmental stages of digeneans and elucidating their life cycles.
Concerns have been raised about Europe facing a reinstitutionalization process. Thus, research and policy interest in prevalence and determinants of involuntary hospitalizations has recently rekindled. In Greece, heightened rates of compulsory admissions have been partly ascribed to the incomplete psychiatric reform. Psychiatric hospitals remain the mainstay of inpatient care, as opposed to the more community-oriented psychiatric departments of general hospitals.
Objectives
To investigate differences between a psychiatric and a general hospital with respect to rates and determinants of involuntary hospitalizations in Athens.
Methods
All admissions in one psychiatric and one general hospital between May – September 2020 were considered. Information about patients’ socio-demographic characteristics and mental health status was garnered through clinical records and patient and physician interviews. Symptom severity was assessed with the Health of Nations Outcome Scale and diagnosis was assigned in accordance with the ICD-10 criteria.
Results
A total of 600 admissions were analysed. In the general hospital, 52.5% of admissions were involuntary, as opposed to 63.1% in the psychiatric hospital (OR = 0.65, 95%CI = 0.43 – 0.97). In the general hospital, the sole risk factor for compulsory admission was aggression (OR= 3.23, 95%CI = 1.24-8.4). Interestingly, in the psychiatric hospital, sex, age, nationality, education, diagnosis and the severity of symptoms tapped by HoNOS were not found to predict involuntary status.
Conclusions
In psychiatric hospitals, no patient subgroups appear to be at elevated risk of civil detention. Therefore, further research is warranted as to what drives the decision there.
Stigma is omnipresent in human societies, both globally and historically; while it is also discerned in other primates. On these grounds, it has been suggested to be the product of natural selection and therefore to protect against threats to effective group functioning. Nonetheless, in contemporary society, stigma raises fundamental ethical concerns, while it actually impinges on public health
Objectives
To explore prejudicial attitudes and desired social distance from recovered COVID-19 patients, people with mental illness and refugees in Athens region.
Methods
A convenience sample of 360 residents of Athens region participated in the study, after being recruited from social media. The questionnaire was distributed online and encompassed: i) the Prejudicial Attitudes Survey, (ii) the Social Distance scale, (iii) the Interpersonal Reactivity Index and information about respondents’ socio-demographic characteristics and personal experience with the three population subgroups. The stigma measures were included three times, one for each out-group.
Results
Repeated ANOVA revealed that negative attitudes were predominantly expressed for refugees. On the contrary, positive attitudes were predominantly expressed for people with mental illness. Interestingly, desired social distance was greater from people with mental illness (mean = 32.37) compared to refugees (mean = 25.47) and recovered COVID-19 patients (mean = 24.17).
Conclusions
Stigma towards people with mental illness and refugees is still prevalent in Greece. Anti-stigma efforts should target prejudices in the case of refugees and social distance in the case of mental illness. To date, no stigma attached to COVID-19 has been discerned in the country
The illusion of invulnerability has been linked to lower perceived risk and increased engagement in risky behaviors among youth. Therefore, it has been purported to influence young people’s poor adherence to public health measures aiming to contain the COVID-19 pandemic. Concomitantly, beliefs about the virus and mental health may also shape public health behaviours.
Objectives
To investigate the role of beliefs, perceived invincibility and mental health status in explaining frequency of hand-washing and hours outside the house among youth in Greece
Methods
A total of 1.899 students, aged between 18-29 years old, were recruited from the main universities of the country. An online questionnaire entailing: (i) popular beliefs about COVID-19, (ii) the DASS-21, (iii) the Adolescent Invincibility Tool and (iv) queries about health behaviours, was distributed during the lockdown period.
Results
Most participants reported washing their hands rarely/never within a day (78.6%) and spending 2-6 hours outside the house (68.1%). Handwashing was largely influenced by mental health [OR = 0.94, 95%CI= 0.91 – 0.98 for stress; OR = 0.96, 95%CI = 0.93-0.99 for anxiety and OR = 1.05, 95%CI= 1.02-1.08 for depression]; while hours outside the house by perceptions that the virus is out of control [OR=0.76, 95%CI = 0.61-0.95], manufactured [OR=1.21, 95%CI = 1.53, 95%CI =1.21 – 1.93] and airborne [OR= 0.78, 95%CI = 0.64-0.95].
Conclusions
Addressing stress and anxiety as well as health education interventions should be prioritized to foster young people’s adherence to public health measures amid the pandemic.
Converging evidence substantiates a negative impact of the COVID-19 pandemic on the mental health of frontline workers. Nonetheless, there is paucity of research on paramedics.
Objectives
To estimate the prevalence of stress, anxiety and depression in frontline paramedics in the Athens region, Greece, and to investigate the coping skills that are associated with less favourable mental health outcomes
Methods
A total of 100 ambulance paramedics participated in the study. The online questionnaire encompassed the DASS-21 for assessing mental health outcomes and the Brief-COPE for measuring coping skills. Information about socio-demographic characteristics and personal/relatives’ vulnerability to COVID-19 was also gleaned.
Results
The prevalence for moderate to severe cases was found to be 7.2% for stress, 9.4% for anxiety and 11.3% for depression. Multiple linear regression analysis indicated that men demonstrated significantly higher stress [B = -2.28, 95%CI = -3.88 - -0.68] and depression compared to women [B = -1.69, 95%CI = -3.19 - -0.19]. Similarly, the use of denial was found to be associated with higher stress [B = 0.69, 95%CI = 0.11 -1.37] and anxiety [B= 0.55, 95%CI = 0.13 – 0.98]. Moreover, emotional support was linked to heightened anxiety [B= 0.71, 95%CI = 0.36 – 1.06] and self-distraction to depression [B = 0.60, 95%CI = 0.16 – 1.04]. Personal or relatives’ vulnerability to COVID-19 did not impinge on mental health outcomes.
Conclusions
Healthcare initiatives should be tailored at the mental health needs of frontline paramedics, especially men. Psychosocial interventions should target maladaptive coping, especially the use of denial.
Lee waves generated by stratified flow over rough bottom topography in the ocean extract momentum and energy from the geostrophic flow, causing drag and enhancing turbulence and mixing in the interior ocean when they break. Inviscid linear theory is generally used to predict the generation rate of lee waves, but the location and mechanism of wave breaking leading to eventual dissipation of energy and irreversible mixing are poorly constrained. In this study, a linear model with viscosity, diffusivity and an upper boundary is used to demonstrate the potential importance of the surface in reflecting lee wave energy back into the interior, making the case for treating lee waves as a full water-column process. In the absence of critical levels, it is shown that lee waves can be expected to interact with the upper ocean, resulting in enhanced vertical velocities and dissipation and mixing near the surface. The impact of the typical oceanic conditions of increasing background velocity and stratification with height above bottom are investigated and shown to contribute to enhanced upper ocean vertical velocities and mixing.
This paper describes the application of low-order models to the prediction of the steady performance of axial compressors at sub-idle conditions. An Euler body-force method employing sub-idle performance correlations is developed and presented alongside a mean-line approach employing the same set of correlations. The low-order tools are used to generate the characteristic lines of the compressor in the locked-rotor and zero-torque windmilling conditions. The results are compared against steady-state operating points from three-dimensional (3D) Reynolds-averaged Navier–Stokes (RANS) computational fluid dynamics (CFD) simulations. The accuracy of the low-order tools in reproducing the results from high-fidelity CFD is analysed, and the trade-off with the computational cost of each method is discussed. The low-order tools presented are shown to offer a fast alternative to traditional CFD which can be used to predict the performance in sub-idle conditions of a new compressor design during early development stages.
The conventional approach in measuring treatment persistence tended to use only the first prescription episode even though some patients received multiple prescriptions of the same medication. In this study, we assessed the extent to which patients received multiple prescriptions and levels of treatment persistence associated with each prescription episode.
Methods:
Using 2000-2004 data from the Veterans Health Administration in the United States, we identified patients with schizophrenia using ICD-9-CM codes and defined initiation of the target agent as 6-month "clean" period of no target drugs prior to initiation and reserved one year following the initiation to calculate treatment persistence, or time to discontinuation, as defined by a gap of >15 or > 30 days.
Results:
The study found that about 25% of the patients had two or more treatment episodes, and that the levels of treatment persistence exhibited variation for patients with one, two, or three prescriptions. Generally speaking, among patients with one prescription, initiators of typical agents tended to fare worst in the level of treatment persistence. This finding suggests that conventional approach in calculating treatment persistence tends to underestimate the gap between typical and atypical agents.
Conclusion:
Considering that patients with different number of treatment episodes might differ in disease profiles, this treatment episode-specific approach offered a fair comparison of the levels of treatment persistence across patients with different number of treatment episodes.
This study is a retrospective analysis of the clinical use of ECT at a county hospital in Norway. Our aim was to determine the ECT- parameters, effect and side effects of patients that received ECT and compare standards of ECT practice with similar studies conducted elsewhere.
Methods:
The study is based on data collected from specific ECT journals and the patients’ hospital journals. We investigated treatment characteristics, side effects (headache, memory problems and others), and effect which was measured as either present or not present. The number of necessary sessions before effect was achieved was also registered.
Results:
210 patients received ECT in the study period. The mean number of ECT treatments was 7.9. Bilateral electrode placement was used for 63.3%. The analyses suggest that a unilateral placing of electrodes tended to increase the average number of treatments compared to the bilateral placing of electrodes. The level of energy compared to the placement of electrodes seemed to indicate that unilateral treated received higher energy than those who had the bilateral placing of electrodes. We found that high stimulus dosage required shorter cramps. Common side effects included headache (N=86), retrograde amnesia (N=31) and others (N=17), no side effects (N=28), missing data (N=65).
82.2% of patients improved with treatment, 51.1% experienced improvement between treatment 4 and 7, 17.8% patients did not respond to the treatment, missing data 35.7%.
Conclusions:
Our findings are mainly in concordance with previous reports of ECT use in public funded hospitals.
This paper reviews the presence of catatonia in neurodevelopmental disorders, with emphasis on autism spectrum disorders. Clinical presentations are reviewed, followed by catatonia treatment algorithms including lorazepam and ECT.
Method:
A literature review of catatonia in autistic, developmentally disabled and neurologically impaired populations was conducted. This was combined with the author's experience with patients with autism as well as traumatic, infectious and congenital brain injuries, all of whom developed frank catatonia.
Results:
Catatonia is a unique neurobiological syndrome with multiple psychiatric, neurological, medical and drug-related etiologies. Most commonly associated with bipolar affective illness, catatonia has also been found in 12-17% of patients with autism. Other neurodevelopmental disorders may similarly present with catatonia. Blueprints for treatment of catatonia include lorazepam and electroconvulsive therapy. While current literature supports the appropriateness, safety and efficacy of ECT for catatonia in autistic and developmentally disabled populations, treatment barriers may persist. The following cases are presented:
Pt 1: A 14 year-old female with encephalitis of unknown origin and profound catatonia. Cultural barriers prevented treatment.
Pt 2: A 20 year-old male with high-functioning autism and catatonia characterized by alternating stupor and extreme psychomotor agitation with self-injury.
Pt 3: A 15 year-old male with congenital agenesis of the cerebellum and vermis in frank catatonic stupor mistakenly attributed to his disability.
Conclusion:
Catatonia is readily diagnosed in a variety of neurodevelopmental conditions including autism, and is eminently treatable with lorazepam and/or ECT in this population. Treatment barriers should be recognized and remedied.
This paper reviews electroconvulsive therapy (ECT) in children and adults with autism and concomitant psychopathology, including affective illness, catatonia and self-injury. Case examples are highlighted.
Method:
A review of the English-language literature on ECT in pediatric, adult, autistic and mentally retarded populations was conducted, with focus on catatonia, drug-resistant psychiatric illness and self-injury. This was combined with the author's experience with two autistic adolescents in catatonic stupor, and an autistic child and young adult with severe affective disturbance and self-injury. All four patients underwent ECT with excellent symptom resolution.
Results:
ECT is an effective and safe treatment modality across the lifespan for a wide range of psychopathology. Current literature supports the appropriateness, safety and efficacy of ECT in autistic and intellectually disabled populations, where patients suffer from an increased incidence of psychiatric and behavioral disturbances. The following cases are presented:
Pt 1: An 18-year-old female with autism, MR and self-injury in classic catatonic stupor.
Pt 2: A 15 year-old male with autism and MR in catatonic stupor confounded by bradycardia and arrhythmias.
Pt 3: A 19-year-old male with autism, MR, profound depression, tics, compulsions and catatonic symptoms accompanied by self-injury.
Pt 4: An 8-year-old boy with autism, MR, cyclical mood disturbance and intractable self-injury confined to full-body protective equipment.
Conclusion:
Electroconvulsive therapy affords excellent symptom remission in autistic individuals with affective illnesses and catatonia, which may be complicated by dangerous self-injury. Prompt diagnosis and pursuit of ECT significantly improve clinical outcome in this patient population.