scholarly journals M194. THE USE OF NOVEL PSYCHOACTIVE SUBSTANCES IN THE PRODROMAL PHASE OF SCHIZOPHRENIA- A CASE SERIES

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S210-S210
Author(s):  
Octavian Vasiliu
Keyword(s):  
Personality Disorders ◽  
Case Reports ◽  
Case Series ◽  
Antipsychotic Treatment ◽  
Novel Psychoactive Substances ◽  
Psychoactive Substances ◽  
Prodromal Phase ◽  
Psychological Counselling ◽  
Axis I ◽  
The Impact

Abstract Background The so-called “novel psychoactive substances” (NPS) or “legal highs” have been highly used by adolescent and young population in the last decade, reaching a level at which they became a challenge for policy makers and public health [1]. Drugs like synthetic cannabinoids, synthetic cathinones, Salvia divinorum, phenylethylamines, synthetic cocaine substitutes and Mitragyna speciosa have been included in the NPS category and patients diagnosed with bipolar disorder, personality disorders or schizophrenia and related disorders were the most frequently associated disorders with NPD use (between 11.6 and 23.1%) [2]. Case reports of the NPS-induced relapses among patients with schizophrenia exist, and a toxicology screening rarely detect these substances [3]. The impact of NPS in the prodromal phase of schizophrenia is associated with several important questions, like “is there a common predisposition for both NPS abuse and schizophrenia spectrum disorders?”, or “how can the early treatment of the NPS abuse may interfere with the risk for the development of schizophrenia?”. Methods A number of three patients who presented NPS use and attenuated psychotic syndrome (according to the DSM-5 criteria for conditions for further study) were monitored for 3 months during their detox treatment and after that period, during which they received a maintenance treatment with moodstabilizers (carbamazepine 600–900 mg daily or sodium valproate 500–1000 mg daily) and naltrexone (50 mg daily). Two patients accepted also low-dose antipsychotic treatment with olanzapine (5 mg/daily). Psychological counselling was offered and accepted by all three patients. These patients were evaluated every 4 weeks using Positive and Negative Syndrome Scale (PANSS), Global Assessment of Functioning (GAF), Clinical Global Impressions – Severity (CGI-S), and Inventary for Drug Taking Situations (IDTS). No other axis I or III diagnoses were detected in any of these patients. However, two patients presented features of cluster A personality disorders, without reaching the threshold for a clear-cut axis II diagnosis. Results All three patients reached the week 12 visit, and they presented improvements in the PANSS scores, including the patient who refused antipsychotic treatment (mean PANSS reduction was 23.7 points compared to baseline). GAF increased with 29.9 points, and CGI-S decreased with 1.9 points. IDTS had a more fluctuating course, with final values being modestly reduced to baseline (-10.7, p=0.127). One patient remained abstinent from NPS for 2 months, while the other two admitted a continuation of the drugs use during the 3 months of their monitoring period. No discontinuation of the treatment was reported during to the low tolerability. Discussion The initiation of pharmacological treatment and psychological counselling could improve the evolution of patients diagnosed with both NPS abuse and attenuated psychotic syndrome, as reflected at least by the PANSS scores, even if patients did not significantly improve their drug consumption. References

scholarly journals Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19)

2021 ◽  
Author(s):  
Biyan Nathanael Harapan ◽  
Hyeon Joo Yoo
Keyword(s):  
Severe Acute Respiratory Syndrome ◽  
Case Reports ◽  
Case Series ◽  
Altered Mental Status ◽  
Neurological Complications ◽  
Neurological Symptoms ◽  
Neurological Manifestations ◽  
Fisher Syndrome ◽  
Novel Coronavirus ◽  
The Impact

AbstractSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and was first identified in Wuhan, China in December 2019. It is evident that the COVID-19 pandemic has become a challenging world issue. Although most COVID-19 patients primarily develop respiratory symptoms, an increasing number of neurological symptoms and manifestations associated with COVID-19 have been observed. In this narrative review, we elaborate on proposed neurotropic mechanisms and various neurological symptoms, manifestations, and complications of COVID-19 reported in the present literature. For this purpose, a review of all current published literature (studies, case reports, case series, reviews, editorials, and other articles) was conducted and neurological sequelae of COVID-19 were summarized. Essential and common neurological symptoms including gustatory and olfactory dysfunctions, myalgia, headache, altered mental status, confusion, delirium, and dizziness are presented separately in sections. Moreover, neurological manifestations and complications that are of great concern such as stroke, cerebral (sinus) venous thrombosis, seizures, meningoencephalitis, Guillain–Barré syndrome, Miller Fisher syndrome, acute myelitis, and posterior reversible encephalopathy syndrome (PRES) are also addressed systematically. Future studies that examine the impact of neurological symptoms and manifestations on the course of the disease are needed to further clarify and assess the link between neurological complications and the clinical outcome of patients with COVID-19. To limit long-term consequences, it is crucial that healthcare professionals can early detect possible neurological symptoms and are well versed in the increasingly common neurological manifestations and complications of COVID-19.

Real-world Experience of Fluocinolone Acetonide (0.2 μg/day) Intravitreal Implant in the Treatment of Diabetic Macular Oedema

2015 ◽  
Vol 09 (01) ◽  
pp. 42 ◽  
Author(s):  
Fahd Quhill ◽  
Keyword(s):  
Real World ◽  
Macular Oedema ◽  
Clinical Studies ◽  
Case Reports ◽  
Case Series ◽  
Diabetic Macular Oedema ◽  
Fluocinolone Acetonide ◽  
Functional Benefit ◽  
Intravitreal Implant ◽  
The Impact

Fluocinolone acetonide intravitreal implant (ILUVIENR, FAc intravitreal implant) is approved for clinical use in Europe and US for the treatment of diabetic macular oedema (DMO). In Europe, the implant is indicated for chronic DMO patients who are insufficiently responsive to available therapies. The use of FAc intravitreal implants has been shown to be effective in pivotal clinical trial studies. Case reports and case series of FAc intravitreal implants in chronic DMO are now emerging and combined analysis of these reveals interesting findings that complement the findings in the clinical studies. Visual improvement and central retinal thickness reductions are similar to those of the clinical trials, which is surprising given that treatments often perform less well in the real-world. In addition, the incidence of intraocular pressure (IOP) elevations is lower than reported in the clinical studies. However, further follow-up is ongoing and this needs to be confirmed in a larger population of subjects. This article reviews some of these important real-world data and their likely impact on future chronic DMO treatment practice as well as the impact in terms of the functional benefit to patients with impaired vision.

scholarly journals Coronavirus infection in neonates: a systematic review

2020 ◽  
pp. fetalneonatal-2020-319837
Author(s):  
Daniele Trevisanuto ◽  
Francesco Cavallin ◽  
Maria Elena Cavicchiolo ◽  
Martina Borellini ◽  
Serena Calgaro ◽  
...  
Keyword(s):  
Systematic Review ◽  
Spontaneous Breathing ◽  
Respiratory Infections ◽  
Case Reports ◽  
Gastrointestinal Symptoms ◽  
Case Series ◽  
Final Analysis ◽  
Good Prognosis ◽  
Cochrane Database ◽  
The Impact

ObjectiveTo summarise currently reported neonatal cases of SARS-CoV-2 infection.MethodsA search strategy was designed to retrieve all articles published from 1 December 2019 to 12 May 2020, by combining the terms ‘coronavirus’ OR ‘covid’ OR ‘SARS-CoV-2’) AND (‘neonat*’ OR ‘newborn’) in the following electronic databases: MEDLINE/Pubmed, Scopus, Web of Science, MedRxiv, the Cochrane Database of Systematic Review and the WHO COVID-19 database, with no language restrictions. Quality of studies was evaluated by using a specific tool for assessment of case reports and/or case series.ResultsTwenty-six observational studies (18 case reports and 8 case series) with 44 newborns with confirmed SARS-CoV-2 infection were included in the final analysis. Studies were mainly from China and Italy. Half of neonates had a documented contact with the infected mother and one out of three infected neonates was admitted from home. Median age at diagnosis was 5 days. One out of four neonates was asymptomatic, and the remaining showed mild symptoms typical of acute respiratory infections and/or gastrointestinal symptoms. The majority of neonates were left in spontaneous breathing (room air) and had good prognosis after a median duration of hospitalisation of 10 days.ConclusionsMost neonates with SARS-CoV-2 infection were asymptomatic or presented mild symptoms, generally were left in spontaneous breathing and had a good prognosis after median 10 days of hospitalisation. Large epidemiological and clinical cohort studies, as well as the implementation of collaborative networks, are needed to improve the understanding of the impact of SARS-CoV-2 infection in neonates.

scholarly journals Intranasal corticosteroids do not affect intraocular pressure or lens opacity: a systematic review of controlled trials

2015 ◽  
Vol 53 (4) ◽  
pp. 290-302
Author(s):  
N. Ahmadi ◽  
K. Snidvongs ◽  
L. Kalish ◽  
R. Sacks ◽  
K. Tumuluri ◽  
...  
Keyword(s):  
Systematic Review ◽  
Intraocular Pressure ◽  
Case Reports ◽  
Case Series ◽  
Upper Airway ◽  
Lens Opacity ◽  
Systemic Absorption ◽  
Intranasal Corticosteroids ◽  
Reported Data ◽  
The Impact

Background: Intranasal corticosteroids (INCS) are prescribed for the long-term prophylactic treatment of inflammatory upper airway conditions. Although some systemic absorption can occur via topical routes, the clinical relevance is controversial. The effects of orally administered corticosteroids on intraocular pressure (IOP) and lens opacity (LO) are well established, but the impact of the INCS is less well defined. This study aims to systematically review the literature for evidence of adverse occular events with INCS use. Methodology: A systematic review of literature from Medline and Embase databases (January 1974 to 21st of November 2013) was performed. Using the PRISMA guidelines, all controlled clinical trials of patients using INCS, that reported original measures of IOP, LO, glaucoma or cataract incidences were included. Studies with adjuvant administration of oral, inhaled and intravenous steroids were excluded. Results: 665 articles were retrieved with 137 were considered for full-text review. Of these, 116 (85%) were literature reviews and two were case reports. 19 studies (10 RCTs, 1 case-control, 8 case series) were included for the qualitative review, of which 18 reported data on IOP and 10 on cataract/LO. None (n=0) of the 10 RCT reporting data on glaucoma or IOP demonstrated changes in IOP compared to control. Also none (n=0) of the 6 RCTs reporting cataract or lens opacity demonstrated changes compared to control. Conclusion: Data from studies with low levels of bias, do not demonstrate a clinically relevant impact of INCS on neither ocular pressure, glaucoma, lens opacity nor cataract formation.

Impact of pharmacists in mental health over the past decade

2012 ◽  
Vol 1 (10) ◽  
pp. 252-260 ◽  
Author(s):  
Jennifer E. Thomas ◽  
Joshua Caballero
Keyword(s):  
Health Care Providers ◽  
Case Reports ◽  
Case Series ◽  
Cost Savings ◽  
Interdisciplinary Approach ◽  
Controlled Trials ◽  
Care Providers ◽  
The Past ◽  
Significant Difference ◽  
The Impact

Purpose: As healthcare moves towards an interdisciplinary approach to improve clinical outcomes, it has become increasingly important for health care providers to collaboratively work together. Pharmacists have been working with psychiatrists for several decades to improve patient outcomes. However, their utility in psychiatry has not been recently elucidated. The purpose of this article is to describe and evaluate the impact of pharmacists in psychiatric settings over the past ten years. Methods: A literature search was conducted using PubMed and CINAHL Plus with Full Text. Studies published between 2002 and 2011 were included. Additional studies were identified through references contained within the studies. Case reports and case series were excluded. Results: Seventeen studies met the inclusion criteria: 15 studies in outpatient settings, two in inpatient settings. Outcomes measured included: patient symptoms, economic outcomes, medication adherence, and patient satisfaction. The majority of studies found improvements (e.g., resolution of symptoms, cost savings). However, controlled trials found no significant difference in clinical improvement from pharmacists' interventions. Conclusion: Although the majority of studies suggest pharmacists provide positive outcomes, the trials vary widely in quality and measured outcomes. Additional controlled trials with more standardized methods are recommended to support the role of pharmacists in psychiatric settings.

The Impact of Personality Disorders on Alcohol-Use Outcomes in a Pharmacotherapy Trial for Alcohol Dependence and Comorbid Axis I Disorders

2007 ◽  
Vol 16 (6) ◽  
pp. 443-449 ◽  
Author(s):  
Elizabeth Ralevski ◽  
Samuel Ball ◽  
Charla Nich ◽  
Diana Limoncelli ◽  
Ismene Petrakis
Keyword(s):  
Alcohol Use ◽  
Alcohol Dependence ◽  
Personality Disorders ◽  
Axis I Disorders ◽  
Axis I ◽  
The Impact

scholarly journals OP0024 USE OF HYDROXYCHLOROQUINE AND RISK OF HEART FAILURE IN PATIENTS WITH RHEUMATOID ARTHRITIS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 18.1-18
Author(s):  
A. Sorour ◽  
Y. Shahin ◽  
C. S. Crowson ◽  
R. Kurmann ◽  
S. Achenbach ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Heart Failure ◽  
Confidence Interval ◽  
Cumulative Dose ◽  
Index Date ◽  
Smoking Status ◽  
Case Reports ◽  
Case Series ◽  
Long Term Treatment ◽  
The Impact

Background:Hydroxychloroquine (HCQ) is a disease-modifying anti-rheumatic drug (DMARD) used as a long-term treatment for rheumatoid arthritis (RA) patients. Cardiotoxicity is a rare but potentially life-threatening side effect of HCQ and may present as conduction disorders, cardiomyopathy, and resulting heart failure (HF). The evidence of cardiotoxicity associated with the use of HCQ largely relies on case reports and case series while large cohort studies on the subject are lacking.Objectives:To examine the relationship between the use of HCQ and risk of developing HF in RA.Methods:In this nested case-control study, cases were Olmsted county, Minnesota residents with incident RA (based on 1987 ACR criteria) in 1980-2013 who developed HF after RA incidence. Each case was matched on year of birth, sex and year of RA incidence with an RA control who did not develop HF. Each non-HF control was assigned an index date corresponding to the HF diagnosis date of the case. Controls were allowed to later become cases to avoid bias. HF was defined using the Framingham criteria. Data on HCQ use including start and stop dates and dose changes was manually abstracted via medical record review, and used to calculate HCQ duration and cumulative dose. Age-adjusted logistic regression models were used to examine the association between HCQ and HF.Results:From a cohort of 1078 subjects, the study identified 143 RA cases diagnosed with HF (mean age 65.8, 62% females) and 143 non-HF RA controls (mean age 64.5, 62% female). Cases and controls had similar RA duration, proportion of patients positive for rheumatoid factor (RF) and/ or cyclic citrullinated antibody (CCP), body mass index, and smoking status (Table). The duration of HCQ use prior to the diagnosis of HF was 2.8 years in cases and 2.6 years in controls. A total of 71 cases and 69 controls used HCQ at some time before index date. Among these, the median (interquartile range) duration of HCQ use was 2.8 (0.6, 10.0) years for cases and 2.5 (0.7, 8.2) for controls. The median cumulative dose of HCQ was 371 g and 302 g in cases and controls, respectively, with 55% of cases receiving a cumulative dose of ≥ 300 g compared to 54% in controls. HCQ cumulative dose was not associated with HF (Odds Ratio [OR]: 0.96 per 100g increase in cumulative dose, 95% confidence interval [95% CI]: 0.90-1.03). Likewise, no association was found for patients with a cumulative dose ≥300g (OR 0.92, 95% CI 0.41-2.08). The duration of use of HCQ prior to index was not associated with HF (OR 0.98, 95% CI 0.91-1.05). Retinal toxicity rates were similar in cases and controls.Table 1.Characteristics of patients with rheumatoid arthritis with and without heart failure.VariableHFnon-HFAge at RA diagnosis (years)65.8 ± 12.364.5 ± 12.5Female62%62%RA duration at baseline (years)11.3 ± 8.510.3 ± 8.2RF positive66%65%CCP positive46%53%RF/ CCP positive68%66%BMI (at RA diagnosis)28.6 ± 6.527.7 ± 5.4Smoking status at RA incidenceFormer45%41%Current22%22%Conclusion:Use of HCQ was not associated with development of HF in patients with RA in this study. While there was no statistically significant association between the cumulative dose of HCQ and HF, the confidence interval for HCQ dose ≥300 g was wide suggesting that more studies are needed to understand the impact of higher doses of HCQ on development of HF in RA.Disclosure of Interests:Ahmed Sorour: None declared, Youssef Shahin: None declared, Cynthia S. Crowson Grant/research support from: Pfizer research grant, Reto Kurmann: None declared, Sara Achenbach: None declared, Rekha Mankad: None declared, Elena Myasoedova: None declared

scholarly journals COVID-19 in pregnancy: What do we really know?

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 362
Author(s):  
Jerome Bouaziz ◽  
Marc Even ◽  
Frederique Isnard-Bogillot ◽  
Eli Vesale ◽  
Mariam Nikpayam ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Pregnant Women ◽  
Current Knowledge ◽  
Case Reports ◽  
Case Series ◽  
Adverse Outcomes ◽  
Health Concern ◽  
Case Control Studies ◽  
Increased Risk ◽  
The Impact

Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to escalate worldwide and has become a pressing global health concern. This article comprehensively reviews the current knowledge on the impact of COVID-19 over pregnant women and neonates, as well as current recommendations for their management. We also analyse previous evidences from viral respiratory diseases such as SARS, Middle East respiratory syndrome, and influenza that may help to guide clinical practice during the current pandemic. We collected 23 case reports, case series, and case-control studies (18 from China) comprising 174 pregnant women with COVID-19. The majority of mothers showed a clinical presentation of the disease similar to that of non-infected adults. Preliminary evidences point towards a potentially increased risk of pregnancy adverse outcomes in women with COVID-19, with preterm delivery the most frequently observed (16.7%) followed by fetal distress (9.77%). The most commonly reported adverse neonatal outcomes included respiratory symptoms (7.95%) and low birth weight (6.81%). A few studies reported other maternal comorbidities that can influence these outcomes. Mothers with other comorbidities may be at higher risk of infection. Mother-to-child transmission of SARS-CoV-2 appears unlikely, with no study observing intrauterine transmission, and a few cases of neonatal infection reported a few hours after birth. Although the WHO and other health authorities have published interim recommendations for care and management of pregnant women and infants during COVID-19 pandemic, many questions remain open. Pregnant women should be considered in prevention and control efforts, including the development of drugs and vaccines against SARS-CoV-2. Further research is needed to confirm the exact impact of COVID-19 infection during pregnancy. To fully quantify this impact, we urgently need to integrate the current knowledge about viral characteristics, epidemiology, disease immunopathology, and potential therapeutic strategies with data from the clinical practice.

scholarly journals A systematic review of the neglect of non-COVID patients amidst COVID pandemic

2021 ◽  
Vol 2 (6) ◽  
Author(s):  
Priyanka Mishra ◽  
◽  
Amborish Nath ◽  
Surbhi Sharma ◽  
Ajit Kumar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Case Reports ◽  
Case Series ◽  
Communicable Diseases ◽  
Health Concern ◽  
Health Priorities ◽  
P Value ◽  
Non Communicable Diseases ◽  
Adverse Pregnancy ◽  
The Impact

The rapidly evolving health concern for COVID-19 has considerably overshadowed the non-COVID ailments. Ranging from delays in diagnosis and treatment, neglect of mild-moderate diseases resulting into their progression, adverse pregnancy outcomes and many others, an array of the collateral damage of this pandemic is still evolving. We have performed this systematic review about the impact of COVID pandemic on patients suffering from other ailments. Our search was conducted through PubMed, Cochrane and Google scholar databases. We included systematic reviews and meta- analysis, and randomized controlled trials, observational studies, case series and case reports to ensure comprehensiveness of our search. We excluded abstract only articles, news articles, the non-scientific commentaries and reports from the review. Primary outcome was assessment of the impact of COVID pandemic on non-COVID diseases and management strategies for tackling the same. This review showed that this crisis has resulted into a significant delay in routine diagnostic procedures and workup with p value < 0.00001 (OR of 0.36; 95% CI, 0.24 to 0.55). The highest impacts will be seen with preexisting major health priorities like HIV, tuberculosis, malignancy, various non-communicable diseases, reproductive and child health. The chief culprits for this include inadequate supplies of medicines, healthcare staff, diagnostics and other technologies. Expansion of the health care workforce, enhanced health financing and supply chain resilience can help us override this pandemic. Hence, the intersection of COVID-19 with other non- COVID ailments can have drastic effects. To minimize this surplus morbidity and mortality, we need to adopt comprehensive strategies and maintain the momentum even after this pandemic is surpassed. Keywords: COVID-19; neglect; non-COVID; non-communicable diseases; communicable diseases; management.

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