scholarly journals Treatment of Delirium in Older Persons: What We Should Not Do!

2020 ◽  
Vol 21 (7) ◽  
pp. 2397 ◽  
Author(s):  
Fulvio Lauretani ◽  
Giuseppe Bellelli ◽  
Giovanna Pelà ◽  
Simonetta Morganti ◽  
Sara Tagliaferri ◽  
...  
Keyword(s):  
Side Effects ◽  
Older Persons ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Cost Effective ◽  
Correct Choice ◽  
Point Of View ◽  
The Body ◽  
Geriatric Syndrome ◽  
Visual Spatial

The presentation of common acute diseases in older age is often referred to as “atypical”. Frequently, the symptoms are neither single nor tissue related. In most cases, the onset of symptoms and diseases is the expression of a diminished reserve with a failure of the body system and imbalance of brain function. Delirium is one of the main devastating and prevalent atypical symptoms and could be considered as a geriatric syndrome. It encompasses an array of neuropsychiatric symptoms and represents a disarrangement of the cerebral function in response to one or more stressors. The most recent definition, reported in the DSM-V, depicts delirium as a clear disturbance in attention and awareness. The deficit is to be developed in a relatively short time period (usually hours or days). The attention disorder must be associated with another cognitive impairment in memory, orientation, language, visual-spatial or perception abilities. For the treatment, it is imperative to remove the potential causes of delirium before prescribing drugs. Even a non-pharmacological approach to reducing the precipitating causes should be identified and planned. When we are forced to approach the pharmacological treatment of hyperactive delirium in older persons, we should select highly cost-effective drugs. High attention should be devoted to the correct balance between improvement of psychiatric symptoms and occurrence of side effects. Clinicians should be guided in the correct choice of drugs following cluster symptoms presentation, excluding drugs that could potentially produce complications rather than advantages. In this brief point-of-view, we propose a novel pharmacological flow-chart of treatment in relation to the basic clusters of diseases of an older patient acutely admitted to the hospital and, in particular, we emphasize “What We Should Not Do!”, with the intention of avoiding possible side effects of drugs used.

ASSESSMENT OF ECONOMIC EFFICIENCY AT THE DESIGN STAGES OF FLEXIBLE MANUFACTURE SYSTEMS

2021 ◽  
pp. 26-32
Author(s):  
J. F. Mammadov ◽  
G. S. Abdullayev ◽  
I. L. Korshunov ◽  
I. R. Aliyev
Keyword(s):  
Economic Efficiency ◽  
Hydraulic System ◽  
High Performance ◽  
Cost Effective ◽  
Correct Choice ◽  
Point Of View ◽  
Active Elements ◽  
Economic Justification ◽  
Flexible Manufacture ◽  
Selection Of

Based on the analysis of economic and technical indicators of the efficiency of the flexible manufacture system (FMS), the criteria for choosing a cost-effective project of the hydraulic system were determined, taking into account the minimization of automated technical systems, technological equipment and increasing the productivity of the designed enterprise. The ranking method is used to decide the correct choice of the most effective FMS project. An algorithm is proposed to substantiate economic efficiency by minimizing the costs of the selected active elements and increasing the productivity of the investigated production. On the basis of a sequential, parallel and parallel-circular layout diagram of the production modules of the FMS, a study is carried out on their choice and economic justification. To determine specific comparative economic indicators from the point of view of minimizing the number of active elements and their temporal indicators of technological operations, an algorithm for choosing a layout diagram of a FMS production module is proposed. The developed algorithm makes it possible to evaluate the economic efficiency taking into account the number of active elements, their types and types of technological operations. The process of selection of the parallel-circular layout scheme of FMS depending on the number of finished products has been substantiated which ensures high performance of the parallel-circular layout scheme of FMS.

scholarly journals Characterizing the features and course of psychiatric symptoms in children and adolescents with autoimmune encephalitis

2021 ◽  
Author(s):  
R Rosello ◽  
B Girela-Serrano ◽  
S Gómez ◽  
B Baig ◽  
M Lim ◽  
...  
Keyword(s):  
Side Effects ◽  
Psychiatric Disorder ◽  
Children And Adolescents ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Autoimmune Encephalitis ◽  
Emotional Lability ◽  
Liaison Psychiatry ◽  
Paediatric Cohort ◽  
Psychiatric Manifestations

AbstractAutoimmune encephalitis (AE) can present like a psychiatric disorder. We aimed to illustrate the psychiatric manifestations, course and management of AE in a paediatric cohort. Neuropsychiatric symptoms, investigations and treatment were retrospectively retrieved in 16 patients (mean age 11.31, SD 2.98) with an AE diagnosis at the liaison psychiatry services in two UK tertiary paediatric centres. Psychiatric presentation was characterised by an acute polysymptomatic (predominantly agitation, anger outbursts/aggressiveness, hallucinations, and emotional lability) onset. Antipsychotics produced side effects and significant worsening of symptoms in four cases, and benzodiazepines were commonly used. This psychiatric phenotype should make clinicians suspect the diagnosis of AE and carefully consider use of treatments.

Second generation direct-acting antiviral (DAAs) Treatment on HCV+ patients: Patient reported outcomes (PROs) and psychiatric symptoms in a real world setting sample

2017 ◽  
Vol 41 (S1) ◽  
pp. S316-S317
Author(s):  
M. Moneglia ◽  
A. Santangelo ◽  
I. Burian ◽  
L. Gragnani ◽  
F. Elisa ◽  
...  
Keyword(s):  
Side Effects ◽  
Real World ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Multivariate Logistic Regression Analysis ◽  
Psychiatric History ◽  
Sample Mean ◽  
Sf 36 ◽  
Significant Difference ◽  
Patient Reported

IntroductionAnti-HCV treatments are moving away from interferon-alpha towards DAAs, associated with fewer side effects, better tolerability, and better PROs.AimsTo describe neuropsychiatric symptoms and PROs during DAAs treatment in a group of HCV+ patients.MethodsForty outpatients, scheduled for DAAs treatment, were assessed at enrolment (T0), 4 weeks (T1), at the end of treatment (EOT) and after 12 weeks of follow up (F-UP), by means of MDRS, HAM-D, HAM-A, MRS, Y-BOCS and SF-36. Afterwards the sample was divided into two groups as a function of a positive psychiatric history (19) and compared with each other.ResultsTotal sample mean scores between W0 and F-UP were compared and an improving trend was observed in all administered scales. An SF-36 items analysis showed a statistically significant difference in emotional role functioning between W0 vs EOT and EOT vs F-UP, in change in overall health status between W0 vs EOT and W0 vs F-UP.A multivariate logistic regression analysis showed that a positive psychiatric history was not associated with an improvement in vitality of 4.3 (minimal clinically important difference). Comparing the two groups, no significant fluctuations in SF-36 scores were founded and major deviations score increases were recorded in patients with a psychiatric history in all scales.ConclusionsOur real world data shows that new regimens do not seem to be associated with psychiatric side effects and conversely a clinical improvement compared to baseline was found, suggesting an immediate gain in PROs over the treatment period, particularly the psychiatric subgroup.Disclosure of interestThe authors have not supplied their declaration of competing interest.

DESTRUCTION OF CARBOHYDRATES IN THE PROCESS OF DIRECTED FERMENTATION OF PROTEIN CABBAGE WITH A CHANGED CARBOHYDRATE COMPONENT OF THE ENVIRONMENT

2021 ◽  
Author(s):  
В.В. КОНДРАТЕНКО ◽  
Н.Е. ПОСОКИНА ◽  
А.И. ЗАХАРОВА ◽  
М.В. ТРИШКАНЕВА
Keyword(s):  
Lactic Acid ◽  
Food Production ◽  
Raw Materials ◽  
Cost Effective ◽  
Point Of View ◽  
The Body ◽  
Biologically Active ◽  
Main Stage ◽  
White Cabbage ◽  
Vegetable Raw Materials

Польза для здоровья от ферментированных функциональных продуктов выражается непосредственно, через взаимодействие живых микроорганизмов, поступивших в организм вместе с пищевыми продуктами или с биологически активными добавками (пробиотический эффект), или косвенно, в результате потребления микробных метаболитов, синтезируемых в процессе ферментирования (биогенный эффект). Целый ряд исследований посвящен потенциалу процесса ферментирования для создания экономически эффективного производства пищевых продуктов с новыми функциональными и потребительскими свойствами. Присутствие в составе субстрата достаточного количества нутриентов (преимущественно сахаров) играет решающую роль в развитии молочнокислых микроорганизмов в процессе ферментирования. В этой связи были исследованы динамики концентрации глюкозы и фруктозы в результате направленной углеводной корректировки субстрата, приготовленного из белокочанной капусты сорта Парус. Установлено, что оптимальным, с точки зрения деструкции сахаров, является консорциум молочнокислых микроорганизмов видов L. casei и L. plantarum. Экспериментально установлено, что только этот консорциум удовлетворяет условие устойчивого синергизма между входящими в него видами микроорганизмов во время основного этапа ферментирования при условии углеводной корректировки сырья. Процесс углеводной корректировки целесообразно использовать при разработке технологии направленной ферментации овощного сырья. The health benefits of fermented functional products are expressed directly, through the interaction of living microorganisms that have entered the body together with food or biologically active additives (probiotic effect), or indirectly, as a result of consumption of microbial metabolites synthesized during fermentation (biogenic effect). A number of studies are devoted to the potential of the fermentation process to create cost-effective food production with new functional and consumer properties. The presence of a sufficient amount of nutrients (mainly sugars) in the substrate plays a crucial role in the development of lactic acid microorganisms during fermentation. In this regard, the dynamics of glucose and fructose concentrations were investigated as a result of directed carbohydrate adjustment of the substrate prepared from white cabbage of the Parus variety. It has been established that the consortium of lactic acid microorganisms of the species L. casei and L. plantarum is optimal from the point of view of the destruction of sugars. It has been experimentally established that only this consortium satisfies the condition of stable synergy between the species of microorganisms included in it during the main stage of fermentation, subject to carbohydrate adjustment of raw materials. It is advisable to use the process of carbohydrate correction in the development of technology for directed fermentation of vegetable raw materials.

Neuropsychiatric Side-Effects of Lidocaine: Examples from the Treatment of Headache and a Review

Cephalalgia ◽  
2009 ◽  
Vol 29 (5) ◽  
pp. 496-508 ◽  
Author(s):  
R Gil-Gouveia ◽  
PJ Goadsby
Keyword(s):  
Side Effects ◽  
Clinical Presentation ◽  
Psychiatric Symptoms ◽  
Case Reports ◽  
Neuropsychiatric Symptoms ◽  
Alternative Therapy ◽  
Intravenous Lidocaine ◽  
Refractory Headache ◽  
Neuropsychiatric Toxicity ◽  
Neuropsychiatric Side Effects

Lidocaine has been used in treatment of patients with refractory headache. Personal observations of neuropsychiatric toxicity in these patients led us to review our cases and the literature systematically for lidocaine side-effects, especially neuropsychiatric symptoms. In our series of 20 patients, side-effects were observed in all, the most frequent being neuropsychiatric (75%) and cardiological (50%). When reviewing published series on intravenous lidocaine use, reports of side-effects range from 0 to 100%, with neuropsychiatric symptoms being reported in 1.8–100%. Thirty-six case reports of lidocaine-induced psychiatric symptoms were also analysed. Psychiatric symptoms of toxicity were similar in most patients, despite their differing ages, pathologies, co-therapies and lidocaine dosages. In conclusion, lidocaine neuropsychiatric toxicity has a well-recognized stereotypical clinical presentation that is probably unrecognized in headache series. As lidocaine represents an emerging alternative therapy in headache, particularly in short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing, clinicians and patients should be aware of the extent of this problem.

scholarly journals The neuro-inflammasome in Alzheimer’s disease and cerebral stroke

2020 ◽  
Author(s):  
Jong-hoon Lee
Keyword(s):  
Alzheimer’S Disease ◽  
Alzheimer's Disease ◽  
Side Effects ◽  
Psychiatric Symptoms ◽  
Neuropsychiatric Symptoms ◽  
Clinical Staging ◽  
Cerebral Stroke ◽  
Study Results ◽  
Before And After ◽  
Neuro Inflammation

Aim/Background: This study investigated patients with Alzheimer’s disease (AD) who were treated with 4,4’-diaminodiphenyl sulfone (DDS) as a neuro-inflammasome competitor according to the 2018 'NIA-AA Research Framework' to differentiate neuro-psychiatric symptoms from drug side effects. Methods: According to the diagnostic criteria of AD, the Seoul study analysed AD and anti-AD drugs (AADs) in the EDI database of the Sorokdo National Hospital archived from January 2005 to June 2020 and searched using the ICD-9 and 10 codes. Numeric clinical staging (NCS) was determined by managing the AD symptoms and neuropsychiatric symptoms caused by AADs with a new biomarker, (D). We report related cases of cerebral infarction and the function of DDS as a neuro-inflammasome competitor in the Seoul study. Results: DDS acts as a neuro-inflammasome competitor; this effect can be inferred by comparing the prevalence of AD in patients who have been prescribed DDS and those who have not. By the introduction of (D), the progression of AD was monitored through NCS staging; AAD side effects and neuropsychiatric symptoms were distinguished and treated with DDS. AD can occasionally be exacerbated by AADs, and mild cognitive impairment can be alleviated by DDS. We clinically confirmed the role of DDS as a neuro-inflammasome competitor before and after cerebral infarcts in the Seoul study. Conclusions: DDS acts as a blocker of canonical/non-canonical ubiquitylation; NLRP3 inflammasome formation; Higgins’ cascade; and iron-rich, strongly magnetic nanoparticles released by the splitting of red blood cells. (D) can be used to guide the prevention and treatment of AD with DDS. This study demonstrates the use of NCS and neuro-inflammation treatment as a preventive and therapeutic method for AD.

RE-AUTHORING THE LOSSES AND CHALLENGES OF AGING: OLDER INDIVIDUALS’ EXPERIENCES OF LONGTERM GROUP WORK

2015 ◽  
Vol 27 (1) ◽  
pp. 3-19
Author(s):  
Cecile Frankel ◽  
Brenda Solarsh ◽  
Eleanor Ross
Keyword(s):  
Life Expectancy ◽  
Group Work ◽  
Narrative Therapy ◽  
Older Persons ◽  
Senior Citizens ◽  
Cost Effective ◽  
Life Transitions ◽  
Older Individuals ◽  
Documentary Analysis ◽  
Social Group Work

The increase in life expectancy has highlighted the value of group work interventions as a cost-effective way of helping older persons to deal with life transitions. This article describes a group for senior citizens that continued for 18 years. The aim of the study was to undertake a documentary analysis of the facilitator’s process notes and participans’ reflections to ascertain possible reasons for the group’s longevity. These were attributed to the skill of the facilitator and her creative use of programme material and narrative therapy. Recurring themes included loneliness, the fear of dying, and dilemmas about relinquishing control and independence. Findings have implications for the practice of social group work with older persons.

Role of Rasayana in Prevention of COVID-19 - A Review

2020 ◽  
Vol 11 (SPL1) ◽  
pp. 716-722
Author(s):  
Sneha Dhakite ◽  
Sadhana Misar Wajpeyi
Keyword(s):  
Immune System ◽  
Respiratory System ◽  
Viral Infections ◽  
Cost Effective ◽  
The Body ◽  
Healthy Life ◽  
Vital Functions ◽  
Healthy Life Style ◽  
And Control

The “Coronavirus disease 19 (COVID-19)” is caused by “Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)”, a newly discovered member of the Coronaviridae family of viruses which is a highly communicable. There is no effective medical treatment till date for Coronavirus disease hence prevention is the best way to keep disease away. Rasayana proved to be highly efficacious and cost effective for the Prevention and Control of viral infections when vaccines and standard therapies are lacking. Rasayana Chikitsa is one of the eight branches of Ashtanga Ayurveda which helps to maintain healthy life style. Rasayana improves immunity and performs many vital functions of human body. Vyadhikshamatva that is immune mechanism of the body is involved in Prevention of the occurrence of a new disease and it also decreases the virulence and progression of an existing disease. In COVID-19 the Respiratory system mainly get affected which is evident from its symptoms like cold, cough and breathlessness. Here the drugs help in enhancing immune system and strengthening functions of Respiratory system can be useful. For this purpose, the Rasayana like Chyavanprasha, Agastya Haritaki, Pippali Rasayana, Guduchi, Yashtimadhu, Haridra, Ashwagandha, Tulsi are used. Rasayana working on Respiratory system are best for Prevention of Coronavirus and boosting immune system. Rasayana Chikitsa can be effective in the Prevention as well as reducing symptoms of COVID-19.

Integrating Focusing and Differentiation: A Therapeutic Path for Couples in Intimate Relationships

2018 ◽  
Vol 3 ◽  
Author(s):  
Evi Zohar
Keyword(s):  
Couples Therapy ◽  
Therapeutic Potential ◽  
Well Being ◽  
Point Of View ◽  
The Body ◽  
Self Awareness ◽  
Emotional Healing ◽  
Felt Sense ◽  
Inner World

Continuing the workshop I've given in the WPC Paris (2017), this article elaborates my discussion of the way I interlace Focusing with Differentiation Based Couples Therapy (Megged, 2017) under the systemic view, in order to facilitate processes of change and healing in working with intimate couples. This article presents the theory and rationale of integrating Differentiation (Bowen, 1978; Schnarch, 2009; Megged, 2017) and Focusing (Gendlin, 1981) approaches, and its therapeutic potential in couple's therapy. It is written from the point of view of a practicing professional in order to illustrate the experiential nature and dynamics of the suggested therapeutic path. Differentiation is a key to mutuality. It offers a solution to the central struggle of any long term intimate relationship: balancing two basic life forces - the drive for individuality and the drive for togetherness (Schnarch, 2009). Focusing is a body-oriented process of self-awareness and emotional healing, in which one learns to pay attention to the body and the ‘Felt Sense’, in order to unfold the implicit, keep it in motion at the precise pace it needs for carrying the next step forward (Gendlin, 1996). Combining Focusing and Differentiation perspectives can cultivate the kind of relationship where a conflict can be constructively and successfully held in the inner world of each partner, while taking into consideration the others' well-being. This creates the possibility for two people to build a mutual emotional field, open to changes, permeable and resilient.

Biocompatible Polymers and their Potential Biomedical Applications: A Review

2019 ◽  
Vol 25 (34) ◽  
pp. 3608-3619 ◽  
Author(s):  
Uzma Arif ◽  
Sajjad Haider ◽  
Adnan Haider ◽  
Naeem Khan ◽  
Abdulaziz A. Alghyamah ◽  
...  
Keyword(s):  
Drug Delivery ◽  
Side Effects ◽  
Biomedical Applications ◽  
Living System ◽  
Health Condition ◽  
The Body ◽  
Biocompatible Polymers ◽  
Nano Technology ◽  
Artificial Grafts ◽  
Immunological Reactions

Background: Biocompatible polymers are gaining great interest in the field of biomedical applications. The term biocompatibility refers to the suitability of a polymer to body and body fluids exposure. Biocompatible polymers are both synthetic (man-made) and natural and aid in the close vicinity of a living system or work in intimacy with living cells. These are used to gauge, treat, boost, or substitute any tissue, organ or function of the body. A biocompatible polymer improves body functions without altering its normal functioning and triggering allergies or other side effects. It encompasses advances in tissue culture, tissue scaffolds, implantation, artificial grafts, wound fabrication, controlled drug delivery, bone filler material, etc. Objectives: This review provides an insight into the remarkable contribution made by some well-known biopolymers such as polylactic-co-glycolic acid, poly(ε-caprolactone) (PCL), polyLactic Acid, poly(3- hydroxybutyrate-co-3-hydroxyvalerate) (PHBV), Chitosan and Cellulose in the therapeutic measure for many biomedical applications. Methods: : Various techniques and methods have made biopolymers more significant in the biomedical fields such as augmentation (replaced petroleum based polymers), film processing, injection modeling, blow molding techniques, controlled / implantable drug delivery devices, biological grafting, nano technology, tissue engineering etc. Results: The fore mentioned techniques and other advanced techniques have resulted in improved biocompatibility, nontoxicity, renewability, mild processing conditions, health condition, reduced immunological reactions and minimized side effects that would occur if synthetic polymers are used in a host cell. Conclusion: Biopolymers have brought effective and attainable targets in pharmaceutics and therapeutics. There are huge numbers of biopolymers reported in the literature that has been used effectively and extensively.

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