Prevalence of Circadian Rhythm Sleep-Wake Disorder in Outpatients with Schizophrenia and Its Association with Psychopathological Characteristics and Psychosocial Functioning

The prevalence of circadian rhythm sleep-wake disorder (CRSWD) among patients with schizophrenia is not clear. The effect of comorbid CRSWD on such patients has also not been fully evaluated yet. Outpatients with schizophrenia in the maintenance phase who visited Tokyo Women’s Medical University Hospital between April 2018 and March 2019 participated in this study. The Brief Psychiatric Rating Scale (BPRS), the Clinical Global Impressions–Severity Illness Scale (CGI-S), Global Assessment of Functioning (GAF), World Health Organization Disability Assessment Schedule II, Insomnia Severity Index (ISI), and Morningness–Eveningness Questionnaire (MEQ) were administered, and the patient responses with and without CRSWD were compared. Of the 105 patients with schizophrenia, 19 (18.1%) had CRSWD. There were trends toward higher BPRS and lower GAF scores in the CRSWD group than in the non-CRSWD group, although these did not reach statistical significance following a false discovery rate correction. Among the BPRS subitems, the anxiety scores were significantly higher in the CRSWD group than in the non-CRSWD group (p < 0.01). CRSWD was highly prevalent among patients with schizophrenia in the maintenance phase. Comorbidities of CRSWD may affect psychopathological characteristics and psychosocial functioning.

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Time trends in socio-economic, urban-rural and regional disparities in prevalence of obesity among non-pregnant women in Lesotho: evidence from Lesotho demographic and health surveys (2004–2014)

BMC Public Health ◽

10.1186/s12889-021-10571-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Betregiorgis Zegeye ◽

Gebretsadik Shibre ◽

Gashaw Garedew Woldeamanuel

Keyword(s):

Pregnant Women ◽

Health Surveys ◽

Educational Inequality ◽

Statistical Significance ◽

World Health ◽

Demographic And Health Surveys ◽

Obesity Prevalence ◽

Urban Rural ◽

Prevalence Of Obesity ◽

Health Organization

Abstract Background The growing rates of obesity in developing countries are alarming. There is a paucity of evidence about disparities of obesity in Lesotho. This study examined socioeconomic and area-based inequalities in obesity among non-pregnant women in Lesotho. Methods Data were extracted from the 2004, 2009 and 2014 Lesotho Demographic and Health Surveys (LDHS) and analyzed through the recently updated Health Equity Assessment Toolkit (HEAT) of the World Health Organization. Obesity prevalence was disaggregated by four equity stratifiers, namely education, wealth, residence and sub-national region. For each equity stratifier, simple and complex as well as relative and absolute summary measures were calculated. A 95% confidence interval was used to measure statistical significance of findings. Results We noticed substantial wealth-driven (D = -21.10, 95% CI; − 25.94, − 16.26), subnational region (PAR = -11.82, 95%CI; − 16.09, − 7.55) and urban-rural (− 9.82, 95% CI; − 13.65, − 5.99) inequalities in obesity prevalence without the inequalities improved over time in all the studied years. However, we did not identify educational inequality in obesity. Conclusions Wealth-driven and geographical inequalities was identified in Lesotho in all the studied time periods while education related inequalities did not appear during the same time period. All population groups in the country need to be reached with interventions to reduce the burden of obesity in the country.

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Cryopreservation of sperm before gonadotoxic treatment at the University Hospital Brno in the years 1995–2020

Česká gynekologie ◽

10.48095/cccg2021156 ◽

2021 ◽

Vol 86 (3) ◽

pp. 156-162

Author(s):

Pavel Ventruba ◽

◽

Jana Žáková ◽

Michal Ješeta ◽

Igor Crha ◽

...

Keyword(s):

Testicular Cancer ◽

Assisted Reproduction ◽

University Hospital ◽

World Health ◽

Hematopoietic Tissue ◽

Severe Oligozoospermia ◽

Sperm Bank ◽

Long Term Storage ◽

Health Organization ◽

Hodgkin's Lymphomas

Summary Objective: Sperm cryopreservation before gonadotoxic treatment is the basic and mos teffective method of preserving reproduction, which can be used during adolescence. The communication summarizes 26 years of experience in the operation of an oncological sperm bank, analyzes spermiograms of oncological patients, assesses the relationship between sperm pathology and diagnosis, and determines the number of deaths and the use of frozen sperm. Methods: During the existence of CAR 01 (assisted reproduction center), more than 50,000 spermiograms were performed. From January 1995 to December 2020, a total of 24,729 men were examined within the sperm bank, of which 1,448 (5.9%) had an oncological diagnosis. The spermiograms were evaluated according to current WHO (World Health Organization) manuals. Cryopreservation of sperm has undergone a major development. The rules for the storage of frozen cells have been laid down by Act No. 296/2008 Coll. since 2008. In 2019, the methodology „Cryopreservation of reproductive cells and tissues in patients before cancer treatment“ was updated. In all cases, the standard thawing technique was used. The sperms were processed by the swim-up method. As part of the treatment with assisted reproduction methods, oocytes were fertilized by the ICSI (intracytoplasmatic sperm injection) micromanipulation technique. Results: Out of 1,448 examined spermiograms in men with oncological diagnoses, testicular cancer was present in 43.7% of patients and malignant diseases of lymphatic and hematopoietic tissue were found in 24.1%, of which 70,1% included Hodgkin‘s lymphomas and 29,9% were non-Hodgkin‘s lymphomas. Leukemia was found in 7.9%, bone and cartilage cancers in 6.8%. The age of the clients of the whole group ranged from 13 to 64 years (27.2 ± 6.8 years). A total of 38.3% of men had normozoospermia, 54.2% of spermiograms showed pathological findings in 1 to 3 evaluated parameters and 7.5% of patients had azoospermia. Severe asthenozoospermia (mobility ≤ 10%) was detected in 57.2% of men and severe oligozoospermia (concentration ≤ 1 × 106 mm3) in 22.3% of patients. The lowest values of the spermiogram were found in men with testicular cancer; the best values were seen in CNS (central nervous system) cancers. The cryopreservation of sperm was performed in 1,340 cases (92.5%). So far, a total of 160 men (11.9%) have used frozen sperm, of which 6.2% in our center. In these 83 cases, the ICSI technique was always used, 38 clinical pregnancies (45.8%) and 32 births were achieved. We have registered 424 completed storages of semen (31.6%), of which 148 (11.0% of all oncology patients) were made due to death and the others at patients’ request. Using the sperm of the dead is a specific issue. Conclusion: In cancer patients, sperm pathologies occur in high percentage. The lowest spermiogram values were found in men with testicular cancer. It is necessary to take into account long-term storage and fertilization by micromanipulation methods. The number of men who die is significantly higher than the number of those who use sperm to treat infertility. Cryopreservation of sperm should be offered to each patient prior to the therapy leading to the destruction of spermatogenesis.

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A Bittersweet Memoir

Asian Medicine ◽

10.1163/15734218-12341486 ◽

2021 ◽

Vol 16 (1) ◽

pp. 128-135

Author(s):

Anita Y. N. Lim

Keyword(s):

Video Clip ◽

Early Period ◽

General Medicine ◽

University Hospital ◽

World Health ◽

Public Healthcare ◽

The Novel ◽

National University ◽

Novel Coronavirus ◽

Health Organization

Abstract I wrote this journal in March 2020 prior to the World Health Organization declaring the COVID-19 infection as a worldwide pandemic on March 11. The situation in Singapore was unfolding even as public healthcare institutions were tasked to lead the charge to contain the novel coronavirus as it was then called. This journal describes my experiences and impressions during my work in an isolation ward at the National University Hospital during this early period. I was to be catapulted into Pandemic Team 3 in the second and third weeks of February 2020. The urgency of hospital measures to respond to the novel coronavirus meant that the general medicine consultant roster which I was on was hijacked to support the pandemic wards. I thought wryly to myself that it was a stroke of genius to commandeer the ready-made roster of senior physicians; it would have been difficult for the roster monster to solicit senior physicians to volunteer when there were still so many unknowns about this virus. Graphic images of the dire situation in Wuhan, China, were circulating widely on social media. It was heart-wrenching to read of Dr. Li Wen Liang’s death. He had highlighted the mysterious pneumonia-causing virus. The video clip of him singing at a karaoke session that went viral underscored the tragedy of a young life cut short. Questions raced in my mind. “Are we helpless to prevent the spread of this virus?” “Is the situation in China to be replicated here in Singapore?” This seemed incredulous, yet, might it be possible? The immediate responses that jumped up within me was “yes, it’s possible, but let’s pray not. Whatever has to be done, must be done.”

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Attribution of non-ClinicalTrials.gov registries among WHO International Clinical Trials Registry Platform-registered trials from 2014 to 2018: A protocol for a meta-epidemiological study

10.7287/peerj.preprints.27298v1 ◽

2018 ◽

Author(s):

Masahiro Banno ◽

Yasushi Tsujimoto ◽

Yuki Kataoka

Keyword(s):

Clinical Trials ◽

Epidemiological Study ◽

Medical Information ◽

University Hospital ◽

World Health ◽

Study Phase ◽

Target Sample Size ◽

Registration Number ◽

Health Organization ◽

Clinical Trials Registry

Background. The attribution of non-ClinicalTrials.gov registries among registered trials of the World Health Organization (WHO) International Clinical Trials Registry Platform (ICTRP) had increased until 2013. However, the attribution after 2013 is unknown. Moreover, no study has investigated the usage of non-ClinicalTrials.gov registries after 2015 or compared the characteristics of trials under non-ClinicalTrials.gov and ClinicalTrials.gov registries. Methods. This will be a meta-epidemiological study. It will include all trials registered on the ICTRP from January 1, 2014, to December 31, 2018. First, we will describe the total attribution of non-ClinicalTrials.gov registries among the ICTRP-registered trials for each year and each registry worldwide. Second, we will compare the recruitment status, target sample size, study type, study design, countries, prospective registration, funding, and study phase of the trials on ClinicalTrials.gov and other registries from 2014 to 2018. Third, we will report on the distribution of primary registries of trials from the top five countries in order of the quantity of registered trials on the ICTRP. Ethics & Dissemination. Ethics approval is not required for this study. This protocol has been registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR). The findings will be published in a peer-reviewed journal and may be presented at conferences. Trial Registration Number. UMIN000034401

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Estado nutricional e desfechos clínicos em pacientes críticos internados em hospital universitário

Abr-Jun - Braspen Journal ◽

10.37111/braspenj.2019344009 ◽

2020 ◽

Vol 34 (4) ◽

pp. 361-366

Author(s):

Edcleide Oliveira dos Santos Olinto ◽

Gina Araújo Martins Feitosa ◽

Izaura Odir Lima Gomes da Costa ◽

Janine Maciel Barbosa ◽

Ericka Vilar Bôtto Targino ◽

...

Keyword(s):

Body Mass ◽

Statistical Significance ◽

Strong Relationship ◽

The Body ◽

University Hospital ◽

Nutritional Risk ◽

World Health ◽

P Value ◽

Chi Square ◽

Length Of Hospitalization

Introduction: There is a strong relationship between malnutrition and increased length of hospitalization and morbidity and mortality. Studies have shown that malnourished patients can have up to twenty times more complications than eutrophic ones. In critically ill patients, there is a tendency to catabolism, resulting in the loss of lean body mass, which when it reaches 40% is usually lethal. Methods: A quantitative, descriptive study was conducted on adults from both genders, admitted to the intensive care unit (ICU) of a university hospital, from March to December 2018. The following variables were collected from the evaluation and nutritional records: length of hospitalization in the ICU, date of discharge or death, nutritional risk through specific screening, height, weight and arm circumference (AC). For the screening, the Nutric score was used. For the nutritional evaluation, the body mass index (BMI) and AC indicators and the classifications recommended by the World Health Organization (2004) and Blackburn and Thornton (1979) were used. After collecting the data, they were analyzed in the Statistical Package for Social Sciences (SPSS) 13.0 and for the association of the variables the Chi-square test was used, considering statistical difference when the p value <0.05. Results: The sample consisted of 116 patients, mostly female (53.4%) whose median age was 46 years (interquartile range IQR 31-53). Regarding the frequency of nutritional risk, most patients (61.5%) had a low score. There was an important frequency of malnutrition, according to the AC indicator (73%), although BMI (43.5%) showed eutrophy. Even though most patients had low nutritional risk, those with high nutritional risk (38.5%) had a higher tendency to mortality, however, not statistically confirmed (p> 0.05). There was also a tendency of association between death and malnutrition, although no statistical significance was shown(p> 0.05). Conclusion: Patients at nutritional risk and/or malnutrition appear to be vulnerable to worse clinical outcomes.

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Epidemiology and burden

Depression ◽

10.1093/med/9780198804147.003.0002 ◽

2018 ◽

pp. 3-10

Author(s):

Raymond W. Lam

Keyword(s):

Psychosocial Functioning ◽

Indirect Costs ◽

World Health ◽

Medical Illness ◽

Middle Income ◽

Middle Income Countries ◽

Increased Risk ◽

Significant Impairment ◽

Health Organization ◽

Years Lived With Disability

Depression is a common condition with a lifetime prevalence of about 15%. People with depression experience significant impairment in psychosocial functioning, particularly in those with a recurrent or chronic course. Depression is now the leading cause of years lived with disability worldwide. Depression is also associated with increased risk of developing a medical illness and an increased risk of overall mortality, even when deaths from suicide are excluded. The economic costs of depression are staggering, largely owing to indirect costs associated with occupational impairment leading to work absence and reduced productivity. Depression remains undertreated, particularly in lower- and middle-income countries, but the World Health Organization has estimated that scaling up of depression treatment returns US$5 for every US$1 spent.

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Diuretic Drug Utilization Study

Journal of Pharmacy Technology ◽

10.1177/875512259601200412 ◽

1996 ◽

Vol 12 (4) ◽

pp. 169-176

Author(s):

Jaime Torelló ◽

José A Durán ◽

María I Serrano

Keyword(s):

Adverse Drug Reactions ◽

Diuretic Therapy ◽

University Hospital ◽

World Health ◽

Drug Reactions ◽

Cardiac Symptoms ◽

Medicine Service ◽

Combined Use ◽

Health Organization ◽

The University

Objective: To evaluate the present use of diuretics in our institution, and determine the appropriateness of that use and the incidence of adverse reactions and interactions. Design: This retrospective study describes the indications for use of an identified drug or combination of drugs. By the time the data were collected, some patients had been discharged or had died. Setting: The study was carried out in a referral center, the University Hospital “Virgen Macarena,” Seville, Spain. Patients: All patients receiving diuretic therapy. Those undergoing hemodialysis or receiving home care were excluded from the study. Intervention: A therapeutic audit was performed using specific standards of reference. Two models were used — one for each of the most frequent indications, ascites and congestive heart failure (CHF). Main Outcome Measures: A structured protocol gathered data on (1) demographic characteristics, (2) causes of admission and pathologic antecedents, (3) diuretic treatment, (4) basic controls (24-h diuresis and daily basal weight), (5) clinical evolution, and (6) concurrent complementary studies. The protocol included a checklist of the most frequent adverse drug reactions and interactions whose degree of causality was determined by applying the modified algorithm of Karch-Lasagna, used in the World Health Organization voluntary reporting system of adverse drug reactions. Results: One hundred twenty-six patients (16% of total admissions) received diuretic therapy. Of these, 71% were analyzed; information in the medical records was incomplete for the rest (29%). Fifty-one percent of the patients were more than 60 years old. The most frequent admission diagnoses were cardiovascular (51.5%), followed by digestive (16.7%) diseases. A total of 134 cardiac symptoms was seen in 50 patients. The most notable were acute pulmonary edema (26%), ischemic cardiopathy (12%), and cardiogenic shock (8%). Most patients receiving diuretic therapy (47.3%) were admitted to the internal medicine service. The most-prescribed diuretic was furosemide (59%), followed by spironolactone (27%). The combined use of furosemide and spironolactone occurred in all but 1 of the patients with hepatic ascites (92%), whereas in those with CHF the figure for the combined use of furosemide and spironolactone fell to 38% (p = 0.001). In 63% of the patients with ascites, the spironolactone dosage was changed in the first 48 hours of treatment. There was a high percentage of deaths (21%) in the study patients. Conclusions: Therapeutic strategy often does not follow the guidelines laid down in the standards of reference on diuretic use in serious CHF and/or ascites in this institution.

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11th Geneva Conference on Person Centered Medicine: Summary Report

The International Journal of Person Centered Medicine ◽

10.5750/ijpcm.v8i1.730 ◽

2019 ◽

Author(s):

C Ruth Wilson ◽

Juan E. Mezzich

Keyword(s):

Medical Association ◽

World Health Organization ◽

University Hospital ◽

World Health ◽

Annual Conference ◽

World Medical Association ◽

Family Doctors ◽

The World ◽

Health Organization ◽

World Organization

For the 11th time, the International College for Person-Centered Medicine (ICPCM) held its annual conference on Person-Centered Medicine in Geneva, Switzerland. As in previous years, the conference was supported by the World Health Organization, the World Medical Association, the World Organization of Family Doctors, the International Council of Nurses, the International Alliance of Patients’ Organizations and 30 other global health professional and academic institutions. The organizing committee was composed of the ICPCM Board members, with Ruth Wilson as program director. Material support was provided by the World Medical Association, the World Health Organization, the Geneva University Hospital, and the Paul Tournier Association.

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Quantitative risk assessment of accidental points in the area of Shahid Beheshti field to Abuzar Square in Yazd with the method of accidents rate - severity index

Occupational Medicine ◽

10.18502/tkj.v12i4.5878 ◽

2021 ◽

Author(s):

A TavakoliMehr ◽

Gh Halvani ◽

R Soltani Gerdfaramarzi ◽

H Moradi ◽

H Hobubati

Keyword(s):

Traffic Accidents ◽

Good Health ◽

Severity Index ◽

Quantitative Risk Assessment ◽

World Health ◽

Organization Studies ◽

Index Method ◽

Intensity Index ◽

Pedestrian Bridges ◽

Health Organization

Introduction: Accidents are one of the biggest public health problems in the world. At the same time, most young victims are in good health before the accident. World Health Organization studies indicate that in 2020 road accidents will be one of three of the three leading causes of death globally. Materials and Methods: Due to selecting the inner-city route, this study identified the accident hot zones by the number-accident intensity index method in one year. The table of coefficients proposed by the state of Georgia was used to weigh the severity of the accidents (injuries, deaths, and damages). Results: In this study, six spatial units were identified as hot zones ( 9/1% ), and 19 spatial units were identified as yellow zones ( 28/8% ); as. Finally, 41 spatial units ( 4100 meters from 6600 meters ) were identified as cold zones ( 62/1% ). Conclusion: The most important ways to reduce traffic accidents include the review of traffic signs in terms of the number, size, location, height, and the installation of the speed breaker in the spatial units as hot zones, the construction of an underpass, and the structure of pedestrian bridges with embedding the escalator in some important routs ( hot zones ), developing a comprehensive and long– term training program for improving the driving culture, etc.

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Endometriosis and Infertility: Impact on Sexuality

Klinička psihologija ◽

10.21465/2016-kp-op-0042 ◽

2016 ◽

Vol 9 (1) ◽

pp. 65-65

Author(s):

V. Rossi ◽

◽

E. Viozzi ◽

F. M. Nimbi ◽

F. Tripodi ◽

...

Keyword(s):

Quality Of Life ◽

Relationship Satisfaction ◽

Sexual Functioning ◽

Female Sexuality ◽

Rating Scale ◽

Clinical Profile ◽

World Health ◽

World Health Organization Quality ◽

Health Organization

Objective: Endometriosis is a condition that has a great impact on women’s life. One of the most important consequences of the disease is infertility that may exacerbate the psychological, relational and sexual consequences on patients. The aim of the present study was to examine quality of life, anxiety, sexual functioning and relationship satisfaction of women with endometriosis and infertility. Infertility is supposed to be associated with a worse clinical profile. Design and Method: Data were collected on 71 patients (39 women with endometriosis and 32 with endometriosis and infertility) aged between 20 and 50 (M=34.21, SD=8.38), recruited in the Gynecological and Obstetrics department of Policlinico Umberto I, Rome. Participants completed: a socio-demographic questionnaire, the World Health Organization Quality of Life (WHOQOL)-Bref for quality of life, the McCoy Female Sexuality Questionnaire (MFS-Q) for sexual and relationship satisfaction, the Female Sexual Functioning Index (FSFI) for sexual functioning and the Hamilton Anxiety Rating Scale (HAM-A) for anxiety symptoms. Results: Women without infertility obtained worse scores: sexual functioning (F(1,69)=10.97 p<.01), sexual (F(1,69)=17.44 p<.001) and relationship satisfaction (F(1,69)=10.18 p<.001) and quality of life (F(1,69)=13.56 p<.001). Conclusions: Contrary to our hypothesis, endometriosis, with or without fertility impairment, has an impact on patients’ relationship, sexuality and quality of life. Therefore, infertility is not the main factor that explains a negative clinical profile. The present study suggests the importance of psychosexual counseling during medical treatment of the disease, and the need of involving partners in the assessment and in the health care decision making.

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