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P03-292 - Suicidal Behavior In Psychotic Patients
- R. Gómez Martínez, M.D. Ortega García, C. Martinez Martínez, A. Rodríguez Campos, M.A. Alonso de la Torre, L. Gómez Martínez, A. Agúndez Modino, I. Alvarez Silva
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- Journal:
- European Psychiatry / Volume 25 / Issue S1 / 2010
- Published online by Cambridge University Press:
- 17 April 2020, 25-E1346
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Introduction
Suicide is one of the most frequent causes of death. In 1993, Bleuler emphasized its importance in his “Suicidal behavior is the most serious symptom of schizophrenia”. Since then, various studies have confirmed importance of suicide in schizophrenia, and today it's clear that his research and knowledge is one of the great challenges of psychiatry.
Objectives- Establish clinical-socio-demographic profile and risk factors for psychotic people with autolytic behaviors.
- Determine frequency of suicides in psychotic disorders in our area of care.
Material and methodsRetrospective study(3 years evolution) that includes psychotic patients(diagnosed according DSM IV-TR) admitted to the HCU of Valladolid. With data provided by hospital medical records, analyzed socio-demographic variables and clinics. Study consists of two groups:group of cases(those patients who have suicidal behavior) and control group (those that haven't autolytic gesture during the study period). Statistical evaluation was performed with SPSS.
Results- The sample includes 191 patients:41(21%) have attempted suicide.
- Of them:73% are males;88% singles;51% have basic studies;61% we re unemployed;37% were 31-40 aged;54% started disease 21-30 aged and 63.5% are schizophrenic.
- Considering statistical study we find that suicidal patient profile is male(p = 0.039),diagnosed with schizophrenia(p = 0.033),with previous suicide attempts(p = 0.009)and lack of social support(p = 0.007).
Conclusions:
- 21% of hospitalized psychotic patients have presented some autolytic attempt.
- Profile of suicidal psychotic patient is a male, single, 21-40 aged, primary education, unemployed, with a primary diagnosis of schizophrenia, particularly paranoid, with ten years evolution,without acceptable social support, number of revenues higher than non-suicidal psychotic and a personal history of previous autolytic attempts.
Use of anticonvulsant agents in the management of alcohol dependence
- M. Marin Mayor, J. Lopez Alvarez, M.D. Riaza Perez, A. Quintana Perez, G. Rubio Valladolid
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- Journal:
- European Psychiatry / Volume 26 / Issue S2 / March 2011
- Published online by Cambridge University Press:
- 16 April 2020, p. 78
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Background
Alcoholism is a chronic relapsing disorder characterized by compulsive drinking, alcohol seeking, loss of control over alcohol consumption, and impaired social and occupational functioning. Treatment of Alcohol Dependence (AD) comprises two steps, detoxification and relapse prevention (RP). Traditionally, long half-life benzodiazepines have been the most widely used agents for alcohol detoxification. On the other hand, disulfiram, naltrexone and acamprosate are the three drugs that have been approved for relapse prevention. In the last decades, nevertheless, there is a growing interest in the use of anticonvulsant drugs in the management of both, detoxification and relapse prevention of alcohol.
AimsTo review the different pharmacological strategies in which an anticonvulsant was used in the management of AD.
MethodWe searched in MEDLINE and in the Cochrane Database System Review, selecting all studies from 1980 until present, in which a pharmacological intervention with anticonvulsant agents was made for alcohol detoxification or RP.
ResultsThe most tested anticonvulsant drugs are the classical Carbamazepine and Valproate. Both have demonstrated to be efficacious in Alcohol Withdrawal Syndrome and RP. However, the use of these agents has been limited by their hepatic and hematologic toxicity. Novel anticonvulsants such as Gabapentin, Pregabalin, Topiramate, Oxcarbazepine and Zonisamide have also been found to be effective, with the advantage of rapid onset of action, lower toxicity and fewer side effects.
ConclusionsAnticonvulsants are efficacious and safe agents in the management of AD. Further randomized, double-blind, placebo-controlled trials are warranted to increase the evidence of the use of these agents.
P0312 - Application of electroconvulsive therapy in a psychiatric ward
- M. Martin, M.F. Pando, E. Benitez, T. Alvarez, M.D. Crespo, M. Vega, A. Chinchilla
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- Journal:
- European Psychiatry / Volume 23 / Issue S2 / April 2008
- Published online by Cambridge University Press:
- 16 April 2020, p. S284
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We have studied electroconvulsive therapy application in a 24 patient psychiatric ward during the period between 2000 and 2007.
In our sample, consistent on 70 electroconvulsive cycles applicated in 53 patients applications, the measured variables were: gender, age, diagnosis, previous processes, previous administration of ECT, duration of the present episode, previous treatment before ECT including drugs used and treatment compliance, average number of ECT applications, response to the administration, treatment at discharge and evidence of the appearance of subsequent psichoorganic deficit.
Average age of patients treated with ECT was 55, 81 years, being mostly women (67, 14%). Diagnosis in our sample were melancholy, psychotic or non psychotic (41, 42%), and manic depressive psychosis or schizoaffective psychosis, most frecuently in a depressive episode, although also during manic o mixed episodes. Schizophrenic psychosis only takes up a discreet percentage of the sample (11, 42%).
Average of applied sessions was 5, 52 sessions per patient, obtaining very successful results in most cases (92, 86 %). Globally, the ECT was well tolerated specially in those cases in which the process that justified ECT were not associated to previous persistent intellectual deficit. From these patients just five of them had post- ECT administration confusional symptoms. We found manic symptoms in five cases.
Electroconvulsive therapy was administrated as prophylactic intervention in several melancholic patients and as maintenance therapy.
29 - Tyrosinemia
- from SECTION IV - METABOLIC LIVER DISEASE
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- By Grant A. Mitchell, M.D., Professor, Department of Pediatrics, CHU Sainte-Justine and Université de Montréal, Montréal, Québec, Canada, Pierre A. Russo, M.D., Professor of Pathology and Pediatrics, Department of Pathology and Laboratory Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, Josée Dubois, M.D., F.R.C.P., Professor of Radiology, Department of Radiology, CHU Sainte-Justine and Université de Montréal, Montréal, Québec, Canada, Fernando Alvarez, M.D., Professor of Pediatrics, Department of Pediatric Gastroenterology, CHU Sainte-Justine and Université de Montréal, Montréal, Québec, Canada
- Edited by Frederick J. Suchy, Mount Sinai School of Medicine, New York, Ronald J. Sokol, University of Colorado, Denver, William F. Balistreri, University of Cincinnati
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- Book:
- Liver Disease in Children
- Published online:
- 18 December 2009
- Print publication:
- 07 May 2007, pp 694-713
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Summary
Hepatorenal tyrosinemia is a fascinating inborn error of metabolism that can affect numerous organs, particularly the liver, kidneys, and peripheral nerves. The first report of a patient with elevated blood tyrosine was by Medes in 1932 [1]. Patients with a more typical clinical and biochemical picture of tyrosinemia were then described in the late 1950s [2–5]. Since then, more than 500 patients have been reported in the literature [6–8] or enrolled in the International NTBC [2-(2-nitro-4-trifluoromethyl benzoyl)-1,3-cyclohexanedione] Trial. Previously, almost all patients died in infancy and early childhood, and only isolated case reports described affected adults. In the 50 years since the description of tyrosinemia [3], the course of the disease has been improved successively by the introduction of diet therapy, neonatal screening, and hepatic transplantation. The advent of liver and kidney transplantation as a definitive treatment [7–11] revolutionized the outcome. Recently, the availability of NTBC, a chemical now designated as nitisinone and commercialized as Orfadin (Swedish Orphan International AB), has provided hope for a nonsurgical solution for some patients. On a fundamental level, tyrosinemia raises questions in hepatology, biochemical and population genetics, cell biology, oncology, and public health.
PATHOPHYSIOLOGY
Tyrosinemia is caused by a deficiency of fumarylacetoacetate hydrolase (FAH; enzyme [EC] 3.7.1.2), the last enzyme of tyrosine degradation (Figure 29.1A). The site of the primary metabolic block in tyrosinemia was elegantly deduced by Lindblad et al. in 1977 [12] and subsequently confirmed enzymatically by several investigators [13–15].
Foreword
- Edited by Adrian O. Alvarez
- Edited in association with Jay B. Brodsky, Stanford University School of Medicine, California, Martin A. Alpert, George S. M. Cowan
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- Book:
- Morbid Obesity
- Published online:
- 17 August 2009
- Print publication:
- 04 November 2004, pp xi-xii
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Summary
In the last 25 years, overweight (body mass index, BMI > 25 kg/m2) and obesity (BMI >30 kg/m2) have developed into a global epidemic. This increase in obesity cannot be attributed to genetics alone; rather, complex fast-food and nutritional causes, lifestyle changes and physical inactivity have become important factors.
The severe form of obesity, called morbid obesity, occurs in patients with BMI > 40 (or >35kg/m2 with severe co-morbidities) and is associated with serious, debilitating and progressive sequelae.
Morbid obesity and super-obesity (BMI > 50kg/m2) have significant co-morbidities — type 2 diabetes, cardiovascular disease, hypertension, deep vein thromboses and pulmonary embolism, debilitating arthritis of weightbearing joints and low back, an increased incidence of certain cancers, alveolar hypoventilation (Pickwickian) and/or obstructive sleep apnea, foul intertrigos under skin folds, abdominal and hiatal hernias, gastroesophageal reflux disease, stasis leg ulcers, accident proneness, plethora and diaphoresis, immobility, gallbladder disease, amenorrhea, increased incidence of Caesarian section, urinary stress incontinence in females, psychosocial and economic problems, etc.
These patients require medical assistance by multiple allied health fields — internal medicine, endocrinology, pulmonology, psychiatry and psychology, eating disorder specialists, nutritionists and dietitians, specialized nursing care, plastic surgery, intensive care specialists, social workers and governmental assistance for disability, among others.
Up Close: Centra Nacional de Microelectrónica
- E. Lora-Tamayo, M.D. Alvarez
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- Journal:
- MRS Bulletin / Volume 17 / Issue 3 / March 1992
- Published online by Cambridge University Press:
- 29 November 2013, pp. 60-61
- Print publication:
- March 1992
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The Spanish National Microelectronics Center (Centra Nacional de Microelectrónica or CNM), a nonprofit R&D institute, was established in 1985 through the joint efforts of the General Directorate of Science (Ministry of Education) and the General Directorate of Electronics and Computer Science (Ministry of Industry and Energy).
As a scientific research center, the CNM belongs to the Spanish Science Research Council (Consejo Superior de Investigaciones Cientifícas, CSIC), but differs from other CSIC centers in two ways. CNM is a direct spinoff of a nationwide scientific and technological research program (Programa Nacional de Microelectrónica), and it has its own board of trustees with representatives from different ministries (Education, Industry and Energy, Defense, and Communications); from the local governments of Catalonia, Andalusia, and Madrid; and from microelectronics-related industries.
CNM's activities are channeled toward promoting microelectronics in Spain through scientific and technological research on the design and fabrication of integrated circuits, electronic devices, and related materials, while providing technological support for industry and university research groups. The global objectives are as follows:
∎ Establishment of stable quasi-industrial technologies in technological niches that permit good interaction between CNM and industry. Among those niches, fixed by Spain's national industrial policy, are application-specific integrated circuits (ASICs), power devices, semiconductor sensors, and molecular beam epitaxy (MBE) technologies and associated devices.
∎ Startup of precise technological processes or new IC design techniques through cooperative research projects with industry and/or university groups that involve carrying out research and technology development tasks, renewing established technologies, and the continuing training of researchers.