Breaking down long-term chronic aggression within a forensic hospital system

CNS Spectrums ◽  
2020 ◽  
Vol 25 (2) ◽  
pp. 216-222
Author(s):  
Benjamin Rose ◽  
Charles Broderick ◽  
Darci Delgado ◽  
Rebekah Kornbluh ◽  
Stephen M. Stahl
Keyword(s):  
Physical Aggression ◽  
Cognitive Rehabilitation ◽  
Cognitive Disorder ◽  
Treatment Programs ◽  
Cognitively Impaired ◽  
Hospital System ◽  
Forensic Hospital ◽  
Data Collection And Analysis ◽  
History Of

Objective.Historically, patients with multiple acts of aggression, or chronic aggressors, have been studied as one large group. It was our objective to subdivide this group into those patients who engage in physical aggression consistently over multiple years and see if common characteristics of chronic aggressors could classify patients into an aggressive or nonaggressive group.Method.Within a forensic hospital system, patients who had committed 5 acts of physical aggression, per year, for 3 years (2010 and 2015) were reviewed. Data was collected on clinical and demographic characteristics that have shown to be associated with chronically aggressive patients and compared to nonaggressive matched controls. Data collection and analysis were completed to determine if the variables could classify patients into an aggressive or nonaggressive group.Results.Analysis showed that 2 variables, the presence of a cognitive disorder and a history of suicidal behaviors were significant in the univariate and multivariate analyses. The 2 variables were able to correctly classify 76.7% of the cases.Conclusion.A cognitive disorder, a history of suicidal behavior, and increased age were factors associated with this subgroup of aggressive patients. Clinicians may want to explore treatment programs aimed at these clinical factors including cognitive rehabilitation and social cognition treatments, which have been shown to reduce aggression in cognitively impaired populations.

Atypical Femoral Fracture in McCune-Albright Syndrome

2020 ◽  
Vol 7 (3) ◽  
pp. 147-152
Author(s):  
Salman Ghaffari ◽  
◽  
Mehran Razavipour ◽  
Parastoo Mohammad Amini ◽  
◽  
...  
Keyword(s):  
Femoral Fracture ◽  
Dynamic Compression ◽  
Plate Fixation ◽  
Medullary Canal ◽  
Mccune Albright Syndrome ◽  
Café Au Lait Spots ◽  
History Of ◽  
Albright Syndrome ◽  
Mccune Albright

McCune-Albright Syndrome (MAS) is characterized by endocrinopathies, café-au-lait spots, and fibrous dysplasia. Bisphosphonates are the most prescribed treatment for reducing the pain but their long-term use has been associated with atypical fractures of cortical bones like femur in patients. We present a 23-year-old girl diagnosed with MAS. She had an atypical mid-shaft left femoral fracture that happened during simple walking. She also had a history of long-term use of alendronate. Because of the narrow medullary canal, we used 14 holes hybrid locking plate for the lateral aspect of the thigh to fix the fracture and 5 holes dynamic compression plate (instead of the intramedullary nail) in the anterior surface to double fix it, reducing the probability of device failure. With double plate fixation and discontinuation of alendronate, the complete union was achieved five months after surgery

European Integration

2020 ◽  
Author(s):  
Johann P. Arnason
Keyword(s):  
European Integration ◽  
Eastern European ◽  
The European Union ◽  
Historical Processes ◽  
History Of ◽  
External Conditions ◽  
Eastern European Countries ◽  
Totalitarian Regimes ◽  
The Eu

Different understandings of European integration, its background and present problems are represented in this book, but they share an emphasis on historical processes, geopolitical dynamics and regional diversity. The introduction surveys approaches to the question of European continuities and discontinuities, before going on to an overview of chapters. The following three contributions deal with long-term perspectives, including the question of Europe as a civilisational entity, the civilisational crisis of the twentieth century, marked by wars and totalitarian regimes, and a comparison of the European Union with the Habsburg Empire, with particular emphasis on similar crisis symptoms. The next three chapters discuss various aspects and contexts of the present crisis. Reflections on the Brexit controversy throw light on a longer history of intra-Union rivalry, enduring disputes and changing external conditions. An analysis of efforts to strengthen the EU’s legal and constitutional framework, and of resistances to them, highlights the unfinished agenda of integration. A closer look at the much-disputed Islamic presence in Europe suggests that an interdependent radicalization of Islamism and the European extreme right is a major factor in current political developments. Three concluding chapters adopt specific regional perspectives. Central and Eastern European countries, especially Poland, are following a path that leads to conflicts with dominant orientations of the EU, but this also raises questions about Europe’s future. The record of Scandinavian policies in relation to Europe exemplifies more general problems faced by peripheral regions. Finally, growing dissonances and divergences within the EU may strengthen the case for Eurasian perspectives.

The natural history of pituitary apoplexy: long term follow-up study

2019 ◽  
Author(s):  
Ayesha Shaikh ◽  
Natasha Shrikrishnapalasuriyar ◽  
Giselle Sharaf ◽  
David Price ◽  
Maneesh Udiawar ◽  
...  
Keyword(s):  
Natural History ◽  
Pituitary Apoplexy ◽  
Follow Up Study ◽  
Long Term Follow Up ◽  
History Of

1386-P: Long-Term Weight Change after Pregnancy and Type 2 Diabetes Risk in Women with a History of Gestational Diabetes

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1386-P
Author(s):  
SYLVIA E. BADON ◽  
FEI XU ◽  
CHARLES QUESENBERRY ◽  
ASSIAMIRA FERRARA ◽  
MONIQUE M. HEDDERSON
Keyword(s):  
Type 2 Diabetes ◽  
Gestational Diabetes ◽  
Weight Change ◽  
Diabetes Risk ◽  
History Of

Update on the Boundaries of the Curly Birch Range

2020 ◽  
pp. 9-21
Author(s):  
L.V. Vetchinnikova ◽  
◽  
A.F. Titov ◽  
◽  
Keyword(s):  
Population Size ◽  
Natural Populations ◽  
Forest Tree ◽  
Published Data ◽  
Population Approach ◽  
Key Factors ◽  
History Of ◽  
Individual Trees ◽  
Karelian Birch

The article reports on the application of the best known principles for mapping natural populations of curly (Karelian) birch Betula pendula Roth var. carelica (Mercklin) Hämet-Ahti – one of the most appealing representatives of the forest tree flora. Relying on the synthesis and analysis of the published data amassed over nearly 100 years and the data from own full-scale studies done in the past few decades almost throughout the area where curly birch has grown naturally, it is concluded that its range outlined in the middle of the 20th century and since then hardly revised is outdated. The key factors and reasons necessitating its revision are specified. Herewith it is suggested that the range is delineated using the population approach, and the key element will be the critical population size below which the population is no longer viable in the long term. This approach implies that the boundaries of the taxon range depend on the boundaries of local populations (rather than the locations of individual trees or small clumps of trees), the size of which should not be lower than the critical value, which is supposed to be around 100–500 trees for curly birch. A schematic map of the curly birch range delineated using this approach is provided. We specially address the problem of determining the minimum population size to secure genetic diversity maintenance. The advantages of the population approach to delineating the distribution range of curly birch with regard to its biological features are highlighted. The authors argue that it enables a more accurate delineation of the range; shows the natural evolutionary history of the taxon (although it is not yet officially recognized as a species) and its range; can be relatively easily updated (e.g. depending on the scope of reintroduction); should be taken into account when working on the strategy of conservation and other actions designed to maintain and regenerate this unique representative of the forest tree flora.

Long Term Monitoring of the Macrobenthos of the Upper Clyde Estuary

1984 ◽  
Vol 16 (5-7) ◽  
pp. 359-373 ◽  
Author(s):  
Anne R Henderson
Keyword(s):  
Water Quality ◽  
Seasonal Variation ◽  
Organic Pollution ◽  
Long Term Changes ◽  
Pollution Loading ◽  
Faunal Density ◽  
History Of ◽  
Long Term Monitoring ◽  
Term Monitoring

The sublittoral macrobenthic invertebrate populations of the Upper Clyde Estuary are described. The estuary has a long history of organic pollution. The long term changes in species composition, faunal density and dominance patterns between 1974 and 1980 are presented. The fauna is dominated by brackish, pollution tolerant oligochaetes and polychaetes. Fluctuations in populations can be related to both seasonal variation in environmental conditions and long term improvements in water quality through a reduction in pollution loading to the estuary.

Premature Adrenarche and its Association with Cardiovascular Risk in Females

2020 ◽  
Vol 26 (43) ◽  
pp. 5609-5616
Author(s):  
Sarantis Livadas ◽  
Christina Bothou ◽  
Djuro Macut
Keyword(s):  
Polycystic Ovary ◽  
Dehydroepiandrosterone Sulfate ◽  
Adrenal Androgen ◽  
Premature Adrenarche ◽  
Adrenal Hyperandrogenism ◽  
Long Term Follow Up ◽  
History Of ◽  
Hormonal Milieu ◽  
The Impact

Early activation of the adrenal zona reticularis, leading to adrenal androgen secretion, mainly dehydroepiandrosterone sulfate (DHEAS), is called premature adrenarche (PA). The fact that adrenal hyperandrogenism in females has been linked to a cluster of cardiovascular (CV) risk factors, even in prepubertal children, warrants investigation. Controversial results have been obtained in this field, probably due to genetic, constitutional, and environmental factors or differences in the characteristics of participants. In an attempt to understand, in depth, the impact of PA as a potential activator of CV risk, we critically present available data stratified according to pubertal status. It seems that prepubertally, CV risk is increased in these girls, but is somewhat attenuated during their second decade of life. Furthermore, different entities associated with PA, such as polycystic ovary syndrome, non-classical congenital adrenal hyperplasia, heterozygosity of CYP21A2 mutations, and the impact of DHEAS on CV risk, are reviewed. At present, firm and definitive conclusions cannot be drawn. However, it may be speculated that girls with a history of PA display a hyperandrogenic hormonal milieu that may lead to increased CV risk. Accordingly, appropriate long-term follow-up and early intervention employing a patient-oriented approach are recommended.

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