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Epilepsy is one of the most common serious brain illness, with symptoms influenced by multiple risk factors and a strong genetic predisposition, rather than having a single expression and cause¹. Neuropsychiatric symptoms in epilepsy can encompass manifestations such as mood alterations, anxiety, sleep disturbances, psychosis, and behavioral disorders. While the motor and sensory manifestations of epileptic seizures are widely recognized, neuropsychiatric symptoms accompanying epilepsy are often underestimated. Therefore, it is essential to understand the most prevalent epidemiological profile of these patients to improve the diagnosis and management of these symptoms.
Objectives
Our goal was to evaluate the neuropsychiatric behavior of epilepsy patients in Brazilian over the past 3 years through hospitalization data in order to outline an epidemiological and behavioral profile.
Methods
A cross-sectional, descriptive, retrospective, and quantitative study was conducted on hospitalizations of individuals simultaneously diagnosed with epilepsy, schizotypal and delusional disorders, and mood disorders in all five regions of Brazil (South, Southeast, Midwest, North, and Northeast) between February 2020 and December 2022. Data from January 2020 were not available. The data used were collected through the Department of Health Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, gathering information regarding the nature of care, age range, gender, and ethnicity of the patients.
Results
The analysis covers the years 2020 to 2022, totaling 503,045 hospitalizations. In 2022, the highest number of cases occurred (≈ 37.55%), followed by 2021 (≈ 33.62%) and 2020 (≈ 28.81%). Urgent hospitalizations represented ≈ 90.85% of the total. The most affected age group was 30 to 39 years old (≈ 18.30%). Men were more affected than women (≈ 52.03% and ≈ 47.96%, respectively), and Caucasians accounted for ≈ 36.07% of the hospitalizations. The average length of stay was 19.1 days, and the mortality rate was 1.4%.
Conclusions
Thus, there is a gradual and annual increase in the number of hospitalizations during the observed period. While there is a minimal disparity between the affected genders, it is evident that the profile of male, caucasian, and adult patients is the most prevalent. Moreover, the predominantly urgent nature of hospitalizations points to an alarming scenario regarding this issue. From the analysis of the data obtained in the study, there is a clear need for interventions capable of reducing the prevalence of hospitalizations for neuropsychiatric symptoms in epilepsy patients in Brazil.
Neuropsychiatric disorders are the leading cause of disability worldwide, as seen in cases such as depression, anxiety, bipolar mood disorder and schizophrenia, which can be developed or exacerbated by the use of psychoactive substances. Most mental disorders have an early onset, often leading to early and/or permanent disability, increasing the need and cost of healthcare. Therefore, it is necessary to improve the identification of the epidemiological profile of these cases in the South of Brazil in order to enhance the diagnosis and reduce the costs associated with managing these disorders.
Objectives
The present study aimed to analyze statistical data regarding hospitalizations related to mental disorders caused by the use of psychoactive substances and alcohol in the southern region of Brazil, highlighting the pathological scenario and identifying the most prevalent profiles of these disorders in this region.
Methods
A cross-sectional, descriptive, retrospective, and quantitative study was conducted on hospitalizations of individuals diagnosed with mental and behavioral disorders due to the use of psychoactive substances and alcohol in the states of the Southern region of Brazil (Paraná, Santa Catarina, and Rio Grande do Sul) between February 2020 and December 2022. Data of January 2020 were not available. The data used were collected through the Department of Health Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, gathering information regarding the nature of the care, age range, gender, and ethnicity of the patients.
Results
The study covers the years 2020 to 2022, indicating a total of 81,608 hospitalizations, with the year 2022 having the highest number of cases (≈ 37.13%), followed by 2021 (≈ 33.30%) and 2020 (≈ 29.55%). The states with the highest number of hospitalizations were Rio Grande do Sul (≈ 54.90%), Paraná (≈ 29.29%), and Santa Catarina (≈ 15.79%). Urgent hospitalizations accounted for ≈ 87.29% of the total. The most affected age group was 30 to 39 years old (≈ 25.61%). Men were more affected than women (≈ 81.70% and ≈ 18.28%, respectively). Caucasians accounted for ≈ 64.29% of the hospitalizations. The average length of stay was 20.8 days, and the mortality rate was 0.32%.
Conclusions
There is a clear increase in the number of hospitalizations related to mental disorders caused by the use of psychoactive substances in the period from 2020 to 2022 in the southern region of Brazil, with the highest number of cases in the state of Rio Grande do Sul. The most affected population consisted of Caucasian men aged 30 to 39 years old. Furthermore, these results may be related to the increasing trend of psychoactive substance use among the Brazilian population and also the COVID-19 pandemic, which led to a period of underreporting due to social isolation.
In recent years, mental health has gained prominence in public health, prompting thorough investigations into psychiatric condition trends. This study conducts a comprehensive epidemiological analysis of hospitalizations for Schizophrenia, Schizotypal, and Delirium Disorders in Rio Grande do Sul (RS) over the past five years. By revealing these patterns, it enhances our understanding of regional mental health dynamics and offers insights for intervention strategies, resource planning, and improved mental healthcare. The ultimate goal is to advance more effective and accessible mental healthcare in RS and beyond.
Objectives
This study aims to analyze the prevalence and epidemiological profile of hospitalizations due to psychiatric disorders to assist in the diagnosis and outcome of affected patients.
Methods
A cross-sectional, descriptive, retrospective, and quantitative study was conducted regarding hospitalizations for Schizophrenia, Schizotypal Disorders, and Delirium in the state of RS between January 2018 and November 2022. Data were collected from the Department of Informatics of the Brazilian Unified Health System (DATASUS) in the “Hospital Information System of SUS” section, focusing on the nature of care, age group, gender, and ethnicity of the patients. The information was aggregated over the five-year period based on the four mentioned descriptors and subsequently analyzed to establish a profile of hospitalizations during that period.
Results
The analysis spans from 2018 to 2022, encompassing a total of 28,345 hospitalizations. In 2019, there was the highest number of cases (22.21%), followed by 2018 (21.08%). Urgent care admissions constituted 85.34% of the total. The age group most affected was 35 to 39 years (11.8%). Men were more affected than women (60.18%), and the majority of hospitalizations were among the Caucasian ethnicity (75.12%). The average length of stay was 23.7 days, and the mortality rate stood at 0.26%.
Conclusions
The increasing trend in hospitalizations, peaking in 2019, highlights the need for preventive measures. Urgent admissions (85.34%) underscore the demand for accessible mental health resources. Men in the 35 to 39 age group are disproportionately affected, suggesting specific risk factors. The predominance of Caucasian ethnicity emphasizes the need for culturally sensitive care. A longer average length of stay (23.7 days) underscores treatment complexity, while a low mortality rate (0.26%) signals effective medical care. In essence, these findings inform tailored mental health policies to enhance service quality and prioritize patient-centered approaches.
In tropical regions, water stress is one of the main causes of the reduction in forage productivity, and irrigation strategies can mitigate the problem, especially for highly productive species. The objective of this study was to evaluate the effects of irrigation, genotype and plant size on productive responses and water use efficiency (WUE) of elephant grass (Cenchrus purpureus [Schumach.] Morrone), in the rainy and dry season. The experimental design was randomized in blocks, arranged in split plots, the main plots were established based on the use of irrigation and the subplots were the tall-sized genotypes (IRI 381 and Elephant B) and dwarfs (Taiwan A-146 2.37 and Mott). The genotypes were evaluated for two years and harvested every 60 days. Water use efficiency, total forage accumulation per year and harvest, forage accumulation rate and forage density were evaluated. There was a significant difference between the genotypes in terms of total forage accumulated (P < 0.05). The most productive genotype was IRI 381, which showed the greatest total forage accumulation (42 168 kg of DM/ha in two years) in the irrigated plots. During the rainy seasons, IRI 381 stood out in terms of forage accumulated (24 667 kg of DM/ha). Irrigation favoured increases in forage accumulation around 60%, in both years of evaluation. Irrigation and plant size influenced the productivity and WUE of elephant grass harvested in 60-day intervals. Tall genotypes and Taiwan A-146 2.37 (dwarf size) stood out in most of the productive traits analysed, while Mott was highlighted by its forage density.
Sleep related sexual behaviors or sexsomnias are unconscious behavioral activities that occur during sleep (e.g. parasomnias). Behaviors could range from sexual vocalizations, orgasms, sexualized movements, masturbation, or full sexual intercourse with a subsequent amnesia. Early epidemiological studies showed a prevalence of 7.1%, with a male predominance. While intended as a rare condition, leads to important physical and psychological consequences for both the patient and their bed partner. For our knowledge this is the first case of sexsomnia reported in Portugal.
Objectives
To report the clinical and psychosocial impact of a Sexsomnia case in a young woman which was misdiagnosed with depression.
Methods
Patient´s clinical files consultation and literature review using Pubmedâ and the keywords: sexsomnia.
Results
A 18-year-old female referred to a psychiatric consultation to be assessed and treated from a diagnostic of depressive disorder. This was a young woman with a previous history of sleepwalking during childhood, with no recurrent episodes since adolescence. A familiar positive history for sleepwalking was confirmed (mother). She reported the beginning of her sleep related sexual behavior six months before the consultation, conflicting with the moment in which she started pharmacological therapy for Chron Disease, diagnosed at that time.
After she slept with her boyfriend, she was told by him about the recurrence of masturbatory activity during sleep. These episodes were told to occur as often as 1 to 2 times a night, shortly after falling asleep, with posterior amnesia for the event.
As for medical or psychiatric history, only Chron’s disease is highlighted, being under control with azathioprine. Likewise, he took 1mg of melatonin/night.
Pittsburgh Sleep Quality Index at presentation was 7/21 and the STOP-Bang questionnaire revealed a low risk of Obstructive Sleep Apnea.
A Type I Polysomnographic study was performed revealing decreased sleep efficiency and fragmented sleep presenting an alternating cyclic pattern. The existence of significant respiratory events during sleep, as well as periodic movements, was excluded.
Cognitive behavioral therapy by means of highlighting the need of improvement on sleep hygiene measures was prescribed and the dose of melatonin was increased up to 3mg. Despite the good clinical response, the patient discontinued the melatonin treatment mainly due to familiar and personal reasons and failed to comply with the prescribed hygienic measures, with a further worsening of the clinical condition.
Conclusions
This particularly challenging case representing the emerging medicolegal issues and psychosocial aspects related with the still poorly understood sleep disorders like sexomnia, shows up how much awareness is required from psychiatric team members to better assist and refer patients, promoting both an assertive diagnostic and an effective management.
Sleep is a complex physiological process present in all living beings, performing essential functions for various biological functions. The prevalence of sleep disorders has increased exponentially, as well as studies relating to sleep patterns of the general population.
University students are especially vulnerable to a decrease in sleep quality, particularly medical students. Even so, the literature on sleep quality in medical students is scarce, especially when referring to Portugal, where studies are almost non-existent.
Objectives
To evaluate sleep quality in medical students and to analyze the differences in sleep quality according to age, sex, cohabitation and physical activity. It is also intended to compare the sleep quality of medical students throughout the various phases of the medical course.
Methods
This is a cross-sectional study involving medical students at the University of Beira Interior, Covilhã, Portugal. All medical students were invited to complete the Pittsburgh Sleep Quality Index (PSQI), which has been validated for the portuguese population. First, the scores obtained in each of the components of the PSQI and the global PSQI score were analyzed for the global population. Lastly, the global PSQI score was correlated with each of the sociodemographic variables to verify the existence of a statistically significant relationship.
Results
296 students completed the instrument. Of these, 62.2% classify their sleep quality as good; 42.4% scored 2 in the sleep latency component; 50% reported sleeping 6 to 7 hours; 73.9% stated an adequate sleep efficiency; 85.5% mentioned few or no sleep disturbances; 83,8% said they never used sleep medication; and 60.8% had low or no sleepiness or daytime dysfunction.
As for the overall PSQI score, 72.6% of the students had a score greater than 5, indicating a poor quality of sleep. 74.7% of female respondents have a low quality of sleep, as well as 67.7% of male respondents. Likewise, 91.3% of students who live alone have poor sleep quality, as well as 76.8% of those living with family members and 69.8% of those living with colleagues.
Regarding the course year, 82.4% of the first-year students report a poor quality of sleep, as well as 77.5% of the second-year students, 72.1% of the third-year students, 77.8% of the fourth-year, 65.8% of the fifth-year students and 71.4% of the sixth-year students.
Conclusions
Medical students seem to be more likely to have poor sleep quality, especially when compared to other university students. Thus, further studies are needed to prove this susceptibility as well as therapeutic interventions aimed at improving sleep parameters.
Cancer is a major public health problem worldwide and the risk of death from cancer has decreased continuously since 1991, therefore, This translates into an increasing number of cancer survivors (CS) worldwide.
During the survivorship seasons, CS face several short-term, long-term, persistent, and late-emerging health and psychosocial problems, including cancer-related pain, fatigue, menopausal symptoms, anxiety, depression, distress associated with the risk of cancer recurrence, chronic uncertainty, social disruption, alterations of sleep, sexual and cognitive dysfunctions.
Since 2002 that some researchers and clinicians argued that it is important to de-velop and implement rehabilitation programs for cancer patients that integrate both psychosocial and physical rehabilitation.
Objectives
With the scarcity of studies on the effectiveness of combined interventions in this population, despite the strong recommendation to perform and study it, and aiming to contribute to a greater knowledge on the theme, the present work aims to build, implement, and evaluate a combined intervention program, which integrates psychoeducational intervention with physical exercise to cancer survivors and relatives, through the following indicators: psychopathological symptoms (anxiety and depression), self-concept, coping strategies, personal growth and QoL.
Methods
A non-probabilistic convenience sample of 70 cancer survivors was assigned to: control (without intervention: n=32), combined intervention (n=21) and psychoedu-cation intervention (n=17) groups. Both intervention groups were 9 consecutive weeks duration. The combined intervention group benefited from 2 weekly exercise sessions additionally. It was administered before and after intervention the following questionnaires: demographic; Hospital Anxiety and Depression Scale (HADS); Clinical Self-concept Inventory (ICAC); Cancer Coping Questionnaire (CCQ); sub-scale of Personal Growth of the Psychological Well-being Scale (EBEP) and the World Health Organization Quality of Life Questionnaire (WHOQOL-Bref).
Results
It was observed a statistically significant reduction of anxiety and depression symptoms from the beginning to the end of the intervention, as well as a significative improvement of overall and all do-mains of self-concept and personal growth. It was not observed a significative difference on quality of life.
Conclusions
The findings of this study contribute to support of the beneficial effect of combined intervention on psychological functioning of cancer survivors. Positive effects of the psychological program were observed but not into the same extent as in the combined intervention.
Preantral to early antral follicles transition is a complex process regulated by endocrine and paracrine factors, as well as by a precise interaction among oocyte, granulosa cells and theca cells. Understanding the mechanisms that regulate this step of folliculogenesis is important to improve in vitro culture systems, and opens new perspectives to use oocytes from preantral follicles for assisted reproductive technologies. Therefore, this review aims to discuss the endocrine and paracrine mechanisms that control granulosa cell proliferation and differentiation, formation of the antral cavity, estradiol production, atresia, and follicular fluid production during the transition from preantral to early antral follicles. The strategies that promote in vitro growth of preantral follicles are also discussed.
The objective of this study was to evaluate the radiation use efficiency (RUE) and canopy structure of elephant grass varieties (Cenchrus purpureus Schum.) of contrasting statures, under monocropping or intercropped with butterfly pea (Clitoria ternatea L.) in cut-and-carry systems. Two tall varieties (elephant B and IRI-381), and two dwarf ones (Mott and Taiwan A-146 2.37), were evaluated as monocrops or binary intercrops with the legume in a 2-year trial with eight harvests. Greater annual leaf biomass accumulation was observed in the monocrops of the tall variety elephant B (7.76 t/ha per year) and dwarf Mott (8.08 t/ha per year). Greater herbage bulk density (59 kg/ha per cm) and leaf area index (3.83) were recorded in canopies of dwarf Mott than in those composed of IRI-381 (37 kg/ha per cm and 3.48, respectively). In the first year, dwarf varieties Mott and Taiwan A-146 2.37 showed less RUE (0.89 and 0.84 g dry matter (DM)/MJ, respectively) than the elephant B (1.46 g DM/MJ). Higher non-fibre carbohydrate (NFC) contents were found in dwarf Mott under monocrop (180 g/kg) and in the intercrop systems. Tall varieties elephant B and IRI-381 showed greater efficiency in intercepting the radiation to accumulate herbage via stem accumulation. Dwarf Mott variety exhibited short stems and great leaf biomass accumulation that favoured denser canopies with higher content of NFCs in vegetal tissue. Planting butterfly pea into rows of elephant grass varieties can be adopted with no significant losses in RUE caused by light extinction, regardless of the grass stature.
The objective of this study was to describe and explain the effect of adding corn meal (CM) on losses, fermentation characteristics and nutritional value of silages from two elephant grass [Cenchrus purpureus (Schumach.) Morrone] genotypes (Taiwan A-146 2.37 and IRI-381) mixed with butterfly pea (Clitoria ternatea L.) legume. The forage was harvested at 75 days of regrowth from elephant grass plots intercropped with butterfly pea legume and ensiled with or without CM at 5% of dry matter (DM) content. Greater gas losses (12 g/kg) and pH (4.2) were observed in the Taiwan A-146 2.37 + butterfly pea silages. The greatest crude protein content was observed in the ‘Taiwan A-146 2.37’ + butterfly pea silage added with CM (116 g/kg). Silages with additive and those containing IRI-381 had a greater acid detergent fibre content (367 and 366 g/kg, respectively). CM increased the silage DM (221 g/kg), remaining water-soluble carbohydrates contents (26 g/kg) and in vitro digestibility of DM. The aerobic stability was maintained until 45 h after opening the silos. All silages presented a good fermentative profile and were not affected by the relatively large proportion of butterfly pea (>34%) in the ensiled mass as indicated by the reduced contents of butyric acid and ammonia nitrogen. CM reduces total losses, increases DM recovery and improves the nutritional value of silages from mixed elephant grass–butterfly pea legume.
The objective of this study was to evaluate the effect of different intercropping and spacing arrangements of corn (Zea mays L) and crotalaria (Crotalaria spp) on the agronomic characteristics, chemical composition and forage digestibility. The experiment was distributed in a randomized complete block design with a 2 × 2 + 1 factorial scheme. The treatments were two cultivation systems (corn + Crotalaria juncea (CCJ) intercropping, and corn + Crotalaria ochroleuca (CCO) intercropping), in two spacing arrangements (A1 (corn and crotalaria sown in the same row) and A2 (corn and crotalaria sown in alternate rows)) plus control (single corn monocropping (CSC)), with six replicates per treatment, for 2 years. Forage plants were harvested when the corn grain reached the doughy-farinaceous phenological stage. Forage mass (total and of each species), morphological composition, chemical composition and in vitro digestibility were evaluated. The forage accumulation was higher for the A1 spatial arrangement. In the second year, the highest total forage mass was verified in the CCO intercropping (11 140 kg/ha). The highest corn mass (9402 kg/ha) was observed for CSC. The highest crotalaria mass was observed in the CCJ intercropping in both years. Regarding the chemical composition, CCJ and CCO intercropping had the highest crude protein concentration. The lowest acid detergent fibre concentration was observed in CSC and CCO intercropping, directly reflecting the in vitro dry matter digestibility coefficients. It is concluded that C. ochroleuca, sown between corn rows, had higher forage accumulation and nutritive value among the treatments tested in this experiment.
The Coronavirus Disease 2019 (COVID-19) can affect mental health in different ways. There is little research about psychiatric complications in hospitalized patients with COVID-19.
Objectives
The aim of the study was to describe the psychiatric clinical profile and pharmacological interactions in COVID-19 inpatients referred to a Consultation-Liaison Psychiatry (CLP) unit.
Methods
This is a cross-sectional retrospective study, carried out at a tertiary hospital in Spain, in inpatients admitted because of COVID-19 and referred to our CLP Unit from March 17,2020 to April 28,2020. Clinical data were extracted from electronic medical records. The patients were divided in three groups depending on psychiatric diagnosis: delirium, severe mental illness (SMI) and non-severe mental illness (NSMI).
Results
Of 71 patients included (median [ICR] age 64 [54-73] years; 70.4% male), 35.2% had a delirium, 18.3% had a SMI, and 46.5% had a NSMI. Compared to patients with delirium and NSMI, patients with SMI were younger, more likely to be institutionalized and were administered less anti-COVID19 drugs. Mortality was higher among patients with delirium (21.7%) than those with SMI (0%) or NSMI (9.45%). The rate of side effects due to interactions between anti-COVID19 and psychiatric drugs was low, mainly drowsiness (4.3%) and borderline QTc prolongation (1.5%).
Conclusions
Patients affected by SMI were more often undertreated for COVID-19. However, the rate of interactions was very low, and avoidable with a proper evaluation and drug-dose adjustment. Half of the patients with SMI were institutionalized, suggesting that living conditions in residential facilities could make them more vulnerable to infection.
Characterizing neuroanatomical markers of different stages of schizophrenia (SZ) to assess of how the disorder develops is extremely important for the clinical practice. It still remains uncertain how abnormalities are formed as SZ progresses.
Objectives
We reviewed and analyzed 113 voxel based morphometry studies on people at risk of or with schizophrenia to assess GM alterations at different stages of the disorder and to functionally characterize these GM variations.
Methods
We performed a meta-analysis of voxel-based morphometry studies of genetic and clinical high-risk subjects (g-/c-HR), recently diagnosed (RDSZ) and chronic SZ patients (ChSZ). We quantified gray matter (GM) changes associated with these four conditions and compared them with contrast and conjunctional data. We performed the behavioral analysis and networks decomposition of alterations to obtain their functional characterization.
Results
Compared to previous investigations, results reveal a robust cortical-subcortical, left-to-right homotopic progression of GM loss. The right anterior cingulate is the only altered region in all conditions. Contrast analyses show left-lateralized insular, amygdalar and parahippocampal GM reduction in RDSZ, which appears bilateral in ChSZ. An overlap between RDSZ and ChSZ is observed in the left insula, amygdala, precentral and inferior frontal gyri. Functional decomposition shows involvement of the salience network, with an enlargement of the sensorimotor network in RDSZ and the thalamus-basal nuclei network in ChSZ.
Conclusions
These results can help the research on diagnostic and neuroimaging biomarkers of SZ staging, as well as on the identification of new therapeutics neuroanotomic targets that could be addressed with focused magnetic or non-invasive electric stimulation.
The main purpose of the present study was to evaluate whether complications related to surgery for exostoses are associated with a decrease in patients’ quality of life.
Methods
This was a retrospective study for which the following information was collected: sex, age, pre- and post-operative symptoms, pre- and post-operative audiological evaluation results, surgical approach, instruments used, complications, and Glasgow Benefit Inventory score.
Results
The study included 67 patients (94 ears). The three main complaints reported were wax retention, otitis externa and hearing loss. Surgical complications occurred in 14.9 per cent of patients. Patients experienced a significant benefit from surgery, especially in relation to somatic state, with a global Glasgow Benefit Inventory score of + 44.3. No significant difference was found between the global Glasgow Benefit Inventory changes and surgery-related complications (p = 0.093).
Conclusion
After surgery for exostoses, the vast majority of patients showed improvement. Complications related to surgery in general do not seem to influence patients’ satisfaction with surgery.
Studies evaluating the occurrence of enteropathogenic bacteria in urban rats (Rattus spp.) are scarce worldwide, specifically in the urban environments of tropical countries. This study aims to estimate the prevalence of diarrhoeagenic Escherichia coli (DEC) and Salmonella spp. with zoonotic potential in urban slum environments. We trapped rats between April and June 2018 in Salvador, Brazil. We collected rectal swabs from Rattus spp., and cultured for E. coli and Salmonella spp., and screened E. coli isolates by polymerase chain reaction to identify pathotypes. E. coli were found in 70% of Rattus norvegicus and were found in four Rattus rattus. DEC were isolated in 31.3% of the 67 brown rats (R. norvegicus). The pathotypes detected more frequently were shiga toxin E. coli in 11.9%, followed by atypical enteropathogenic E. coli in 10.4% and enteroinvasive E. coli in 4.5%. From the five black rats (R. rattus), two presented DEC. Salmonella enterica was found in only one (1.4%) of 67 R. norvegicus. Our findings indicate that both R. norvegicus and R. rattus are host of DEC and, at lower prevalence, S. enterica, highlighting the importance of rodents as potential sources of pathogenic agents for humans.
Pearl millet (Pennisetum glaucum (L.) R.) is an important crop for rainfed production systems and can play a significant role as a feed source for ruminants owing to its high yield and drought tolerance. It is well-established that the maturity stage can influence the chemical composition as well as the nutritional value of crops traditionally used for silage production, although quantitative evidence that this occurs with pearl millet under rainfed conditions is lacking. The current research assessed the agronomic characteristics, ensilability, intake and digestibility of a Brazilian pearl millet cultivar (IPA BULK1-BF) harvested at four different growth stages. Forage was harvested at 35, 50, 65 and 80 days after sowing and ensiled under laboratory and farm conditions. Apparent digestibility of the silages was determined using 24 male lambs. The results showed that dry matter (DM) and panicle and stem proportions increased with the advancement maturity. The silage evaluations showed that DM, total and non-fibrous carbohydrates and lignin concentrations increased, while crude protein, ADF and in vitro DM digestibility decreased with the increase in plant maturity. Additionally, the fermentation characteristics were improved with the increasing maturity. The digestion study showed that intake of DM and N as well as digestibility of DM and fibre fractions decreased, while lignin intake increased. The results obtained for the production of dry and digestible DM, the ratio of plant fractions and fermentation parameters indicate the possibility of harvesting pearl millet forage after 50 days after sowing for silage production in the Brazilian semi-arid region.
The Attention Deficit Disorder and Hyperactivity (ADDH) is now, a frequent diagnosis in Paediatrics Psychiatry. This real neurobiological syndrome has a variable incidence (3-12%), an early beginning (before 7 years) and an important permanency in adult age (15-20% keep diagnosis and 65% residual symptoms). It represents a risk factor for posterior psychiatric diseases, antisocial behaviour and relation problems. This makes the early diagnosis and treatment necessary. The 70-90% of the patients responds to simpatico mimetic treatment and the methylphenidate is the most used. Patients must carry out the clinical criteria and nowadays there is not any recognized helpful test for the diagnoses except the clinical one. The medium latency auditory evoked response (MLAER) appears 10-70 ms after the cochlear receptor activation and it has cortical and subcortical generators.
We studied MLAER in ADDH: their morphology, changes with treatment and relation between morphology changes and clinical response to treatment.
Patients (53) had ADDH clinical criteria, methylphenidate treatment chosed, not comorbidity neither hearing loss. First phase without treatment and second with it where we did MLAER and tronco-encephalic auditory evoked response during wakefulness and sleep.
Without treatment 76% responses were asymmetric (51% of them with a specific type). The rest 23% were normal. With treatment 63% changed the morphology and 70% had a good response to treatment. Only 11% of patients without alterations had a good clinical development.
An ADDH diagnosis has different physiopathologic mechanism. The MLAER in ADDH could predict the treatment response.
In the last decades, psychiatric training has undergone a major transformation due to the contribution of recent scientific developments in psychiatry. Nowadays, the information acquired during the Psychiatric training seems considerably variable in content and quality between different countries. However, data concerning access to information and also about the educational resources available to the trainees in Europe is very limited.
Objectives and aims
The ATIIPT survey aimed to evaluate Psychiatric trainees’ access to published, online, senior's or industry's information in Europe.
Methods
A short paper questionnaire constituted of 7 questions (Appendix 1) was created by the members of the EFPT Research Working Group and passed to each delegate of the 32 countries represented at the 19th EFPT Forum in Prague, Czech Republic, on the 2nd of July 2011.
Results
According to the ATIIPT results, access to information among Psychiatric trainees in Europe is heterogeneous. The most available resources are books and websites, and the most preferable resource is journals. Most of the trainees find their resources sufficient, with the main obstacles being related to low availability of journals and books, lack of time and help from seniors.
Conclusions
Better access to information and more evidence in practice is warranted, since the introduction of novel approaches to access to information may create better psychiatrists in the future, encourage medical students to consider psychiatry as a potential career, and help reduce negative attitudes towards mental illness.
Dr. Jules Cotard (1840–1889) was a Parisian neurologist who first described the délire des négations. Cotard's syndrome or Cotard's delusion comprises any one of a series of delusions ranging from the fixed and unshakable belief that one has lost organs, blood, or body parts to believing that one has lost one's soul or is dead. in its most profound form, the delusion takes the form of a professed belief that one does not exist. Nihilistic delusions were described by Cotard to refer to a special type of hypochondriacal delusion associated to melancholia. Although Cotard himself and other XIX and XX centuries' psychiatrists have considered it from different approaches a specific clinical entity, most of the authors estimate that nihilistic delusion is either a syndrome or a symptom which can appear in different psychiatric disorders.
Objectives/aims:
To describe a case study of a patient diagnosed with Cotard's Syndrome and make a revision of the literature.
Methods:
Search in the PubMed/MedLine and Medscape databases with the following key words: Cotard; depression; delusion; nihilism.
Results/conclusions:
The same symptoms still persist and are shown the same way in our clinical practice as they were in the remote Cotard's times.
It is known that the level of dietary protein modulates the enzymatic activity of the digestive tract of fish; however, its effect at the molecular level on these enzymes and the hormones regulating appetite has not been well characterised. The objective of this study was to evaluate the effect of CP on the activity of proteases and the expression of genes related to the ingestion and protein digestion of juveniles of red tilapia (Oreochromis sp.), as well as the effects on performance, protein retention and body composition of tilapia. A total of 240 juveniles (29.32 ± 5.19 g) were used, distributed across 20 tanks of 100 l in a closed recirculation system. The fish were fed to apparent satiety for 42 days using four isoenergetic diets with different CP levels (24%, 30%, 36% and 42%). The results indicate that fish fed the 30% CP diet exhibited a higher growth performance compared to those on the 42% CP diet (P < 0.05). Feed intake in fish fed 24% and 30% CP diets was significantly higher than that in fish fed 36% and 42% CP diets (P < 0.05). A significant elevation of protein retention was observed in fish fed with 24% and 30% CP diets. Fish fed with 24% CP exhibited a significant increase in lipid deposition in the whole body. The diet with 42% CP was associated with the highest expression of pepsinogen and the lowest activity of acid protease (P < 0.05). The expression of hepatopancreatic trypsinogen increased as CP levels in the diet increased (P < 0.05) up to 36%, whereas trypsin activity showed a significant reduction with 42% CP (P < 0.05). The diet with 42% CP was associated with the lowest intestinal chymotrypsinogen expression and the lowest chymotrypsin activity (P < 0.05). α-amylase expression decreased with increasing (P < 0.05) CP levels up to 36%. No significant differences were observed in the expression of procarboxypeptidase, lipase or leptin among all the groups (P > 0.05). In addition, the diet with 42% CP resulted in a decrease (P < 0.05) in the expression of ghrelin and insulin and an increase (P < 0.05) in the expression of cholecystokinin and peptide yy. It is concluded that variation in dietary protein promoted changes in the metabolism of the red tilapia, which was reflected in proteolytic activity and expression of digestion and appetite-regulating genes.