scholarly journals How Did COVID-19 Affect Suicidality? Data from a Multicentric Study in Lombardy

2021 ◽  
Vol 10 (11) ◽  
pp. 2410
Author(s):  
Camilla Gesi ◽  
Federico Grasso ◽  
Filippo Dragogna ◽  
Marco Vercesi ◽  
Silvia Paletta ◽  
...  
Keyword(s):  
Psychiatric Treatment ◽  
Retrospective Chart Review ◽  
Time Frame ◽  
Emergency Rooms ◽  
Multicentric Study ◽  
Priority Level ◽  
History Of ◽  
To Receive ◽  
Free Women ◽  
Drug Free

The aim of the study was to describe the characteristics of subjects accessing the emergency rooms for suicidal behavior during the first epidemic wave of COVID-19 in three Emergency Departments (EDs) in Lombardy (Italy). A retrospective chart review was conducted for the period 8 March–3 June 2020, and during the same time frame in 2019. For all subjects accessing for suicidality, socio-demographic and clinical data were collected and compared between the two years. The proportion of subjects accessing for suicidality was significantly higher in 2020 than in 2019 (13.0 vs. 17.2%, p = 0.03). No differences between the two years were found for sex, triage priority level, history of substance abuse, factor triggering suicidality and discharge diagnosis. During 2020 a greater proportion of subjects did not show any mental disorders and were psychotropic drug-free. Women were more likely than men to receive inpatient psychiatric treatment, while men were more likely to be discharged with a diagnosis of acute alcohol/drug intoxication. Our study provides hints for managing suicidal behaviors during the still ongoing emergency and may be primary ground for further studies on suicidality in the course of or after massive infectious outbreaks.

Administration of Comfort Medication at End of Life in Neonates: Effects of Weight

2008 ◽  
Vol 27 (4) ◽  
pp. 223-227 ◽  
Author(s):  
Angela Lee Matthews ◽  
Susan O’Conner-Von
Keyword(s):  
End Of Life ◽  
Chart Review ◽  
Ventilatory Support ◽  
Retrospective Chart Review ◽  
Time Frame ◽  
To Receive

Purpose: To examine whether a relationship exists between a neonate’s weight and the neonate’s receipt of comfort medication between four hours prior to elective ventilator withdrawal and death. It was hypothesized that the greater the neonate’s weight, the more likely the neonate was to receive comfort medication at end of life.Design: A retrospective chart review.Sample: One hundred seventy-one neonates in a midwestern Level III NICU who died after withdrawal of ventilatory support.Results: Of the 171 neonates in the sample, 27.5 percent (n = 47) did not receive comfort medication within the designated time frame; neonates who weighed <800 g were significantly less likely to receive comfort medication than were their heavier cohorts.Conclusion: In this sample, smaller neonates were given comfort medication less often while they were dying than were their larger counterparts.

Presenting international prognostic scoring system affects time to treatment: A retrospective single center review.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e20058-e20058
Author(s):  
Sierra Sutcliffe ◽  
Indryas Woldie ◽  
Caroline M. Hamm
Keyword(s):  
Retrospective Chart Review ◽  
B Cell Lymphoma ◽  
International Prognostic Scoring System ◽  
Cancer Center ◽  
Wait Times ◽  
Time To Treatment ◽  
Lower Stage ◽  
History Of ◽  
Receive Treatment ◽  
To Receive

e20058 Background: Diffuse large B cell lymphoma (DLBCL) is an aggressive form of non-Hodgkin’s lymphoma, which requires prompt initiation of chemotherapy to cure, as any delays can result in worse outcomes. A recent study in Japan found that patients with an IPI score ≥3 had a worse prognosis if their diagnosis was delayed, whereas with an IPI score < 3, there was no effect. Methods: This study investigated how long Windsor patients wait to receive chemotherapy after diagnosis, and how this affects relapse status. A retrospective chart review was conducted, looking at all patients diagnosed with DLBCL who underwent treatment at the Windsor Regional Cancer Center from 2007 to 2018 (N = 317). Each chart was reviewed for variables relating to treatment and outcomes. Results: Overall survival within the studied time period was 71% with the median survival time of 11.99 years. The overall relapse rate was 19.24% with a mean relapse-free interval of 4.87 years. A longer time to initial treatment resulted in a decreased risk of relapse (p = 0.038); however, these patients tended to have a lower stage (p = 0.002), no family history of cancer (p < 0.001), and lower IPI scores (p = 0.004). When broken down by IPI score, the mean times to treatment after diagnosis were: IPI 0 = 40 days; IPI 1 = 35 days; IPI 2 = 38 days; IPI 3 = 29 days; IPI 4 = 22 days; IPI 5 = 29 days. Conclusions: These results show that while DLBCL patients with worse prognostic measures are prioritized to receive treatment quicker, there is a large discrepancy in time to treatment between IPI scores. There was an 11-day delay between early and late IPI scores, likely driven by patient symptoms, rather than evidence of safety. The natural history of DLBCL is known to be aggressive, but more granular information is necessary to determine appropriate wait times for presenting IPI score. Further research should focus on identifying delays in the process, and if it can be streamlined to improve wait times for all patients, regardless of IPI score.

scholarly journals Cotard Syndrome in recurrent depressive disorder: case report

2021 ◽  
Vol 21 (4) ◽  
pp. 837-842
Author(s):  
Héctor Ocampo Ramos ◽  
Richard Jeremy Febres Ramos ◽  
Sheron Arestegui Saavedra ◽  
Rosa Bravo Torres ◽  
Danitza Cardenas Peralta
Keyword(s):  
Social Life ◽  
Scientific Literature ◽  
Psychiatric Treatment ◽  
The Body ◽  
Medical Progress ◽  
Symptoms Of Depression ◽  
Affective Symptoms ◽  
Suicidal Attempts ◽  
History Of ◽  
To Receive

The Cotard Syndrome, also known as delirium of negation or nihilistic delirium, was described by the French neurologist, Julius Cotard, on June 1880. From that time until the end of the 20th century, in scientific literature, approximately 100 cases were reported that presented symptoms of depression, anxiety, nihilist delusions concerning the body and existence, hypochondriacal and immortality delusions, as well as auditory and visual hallucinations. We present the case of a female patient, 73-years old, from Ayacucho, with a history of sexual assault at the age of 12 and suicidal attempts on 2 occasions, diagnosed with depression at 40 years of age, received treatment with quetiapine, trazadone and clonazepam. She remained with fluctuating medical progress, with symptoms worsening with stressors such as the death of her mother and husband and when she underwent surgeries. Currently, she presents sad and anxious mood, daily crying, ideas of guilt, disability and death, insomnia of conciliation, nihilistic delusive ideas concerning the body, referring that her stomach and bladder do not work, reason why she doesn’t want to eat or drink water. Due to the total refusal of food intake and persistent suicidal ideation, she was hospitalized to receive psychiatric treatment and nutritional support. It is concluded that there are few cases reported on the use of psychotherapy in Cotard's syndrome. Therefore, this case in which psychotherapy was indicated to reduce anxious-affective symptoms, to avoid isolation of the person and to redirect his personal and social life, is important.

EVALUATION OF THE EFFECTIVENESS OF COMPREHENSIVE AND CONTINUOUS PEDIATRIC CARE

PEDIATRICS ◽  
1971 ◽  
Vol 48 (5) ◽  
pp. 766-776
Author(s):  
Leon Gordis ◽  
P. H. ◽  
Milton Markowitz
Keyword(s):  
Medical Care ◽  
Public Health Nurse ◽  
Pediatric Care ◽  
Emergency Rooms ◽  
Continuous Care ◽  
History Of ◽  
Traditional Care ◽  
One Year ◽  
To Receive ◽  
Penicillin Prophylaxis

Two controlled studies were undertaken to evaluate the effectiveness of comprehensive and continuous pediatric care. In the first study, 220 infants of primiparous adolescents were randomly allocated to either a comprehensive care (CC) or traditional care (TC) group. CC infants received all medical care, preventive and therapeutic, in a hospital-based program staffed by a pediatrician, public health nurse, and social worker. Mothers of TC infants were left to obtain care from emergency rooms, well-baby and outpatient clinics. One year after delivery, each mother was interviewed and her infant's medical records abstracted. No differences were found between CC and TC infants in completeness of immunization, utilization of medical resources, morbidity, or mortality. In a second study, it was hypothesized that patient compliance with physicians' recommendations would be favorably influenced by continuous care. Seventy-seven children on daily oral penicillin prophylaxis for history of rheumatic fever (RF) were studied. For one year, compliance was determined by periodic urine tests for penicillin. Patients were then stratified for age, sex, and compliance and randomly allocated to continuous care (CC) or traditional care (TC) groups. CC patients received all medical care, even for problems unrelated to RF, from the same two physicians for 15 months. TC patients continued to receive specialty clinic care, were seen at the RF clinic by different physicians and referred elsewhere for all problems unrelated to RF. Urine specimens were tested periodically for penicillin. After 15 months, no differences were observed between CC and TC groups in proportion of noncompliers or in internal shifts in compliance which had occurred during the study. Thus, neither of these studies was able to demonstrate that comprehensive and continuous care was more effective than conventional ambulatory care for children.

The Antiaggressive Action of Combined Haloperidol-Propranolol Treatment in Schizophrenia

2000 ◽  
Vol 5 (4) ◽  
pp. 312-325 ◽  
Author(s):  
Gadi Maoz ◽  
Daniel Stein ◽  
Sorin Meged ◽  
Larisa Kurzman ◽  
Joseph Levine ◽  
...  
Keyword(s):  
Rating Scales ◽  
Double Blind ◽  
Propranolol Group ◽  
Schizophrenic Patients ◽  
Propranolol Treatment ◽  
Simultaneous Decrease ◽  
The Mean ◽  
Haloperidol Treatment ◽  
To Receive ◽  
Drug Free

Psychopharmacological interventions for managing aggression in schizophrenia have thus far yielded inconsistent results. This study evaluates the antiaggressive efficacy of combined haloperidol-propranolol treatment. Thirty-four newly admitted schizophrenic patients were studied in a controlled double-blind trial. Following a 3-day drug-free period and 7 days of haloperidol treatment, patients were randomly assigned to receive either haloperidol-propranolol or haloperidol-placebo for eight consecutive weeks. Doses of medications were adjusted as necessary; biperiden was administered if required. Rating scales were applied to assess aggression, anger, psychosis, depression, anxiety and extrapyramidal symptoms. The mean daily dose of haloperidol was 21 mg (SD = 6.4) in the research group and 29 mg (SD = 6.9) in the controls. Mean and maximal daily doses of propranolol were 159 mg (SD = 61) and 192 mg (SD = 83), and of placebo, 145 mg (SD = 50) and 180 mg (SD = 70), respectively. Compared with the controls, the scores for the research patients decreased significantly from baseline, particularly after 4 weeks of treatment, for some dimensions of anger, psychosis, anxiety, and neuroleptic-induced parkinsonism. A tendency for reduced aggression was shown in the combined haloperidol-propranolol group for some dimensions but not others. These patients also required significantly less biperiden. The tendency toward elevated antiaggressive effect of combined haloperidol-propranolol treatment compared to haloperidol alone may be explained by a simultaneous decrease in aggression, psychotic symptomatology, and anxiety.

The perils and dangers of these knights (and undead peasants): Interpreting English and Scottish Extent Rolls of 1297–1305

2016 ◽  
Vol 36 (1) ◽  
pp. 13-39 ◽  
Author(s):  
J. Donnelly
Keyword(s):  
Social History ◽  
Economic History ◽  
Time Frame ◽  
Compte Rendu ◽  
History Of ◽  
Different Sources

Medieval Scottish economic and social history has held little interest for a unionist establishment but, just when a recovery of historic independence begins to seem possible, this paper tackles a (perhaps the) key pre-1424 source. It is compared with a Rutland text, in a context of foreign history, both English and continental. The Berwickshire text is not, as was suggested in 2014, a ‘compte rendu’ but rather an ‘extent’, intended to cross-check such accounts. Read alongside the Rutland roll, it is not even a single ‘compte’ but rather a palimpsest of different sources and times: a possibility beyond earlier editorial imaginings. With content falling (largely) within the time-frame of the PoMS project (although not actually included), when the economic history of Scotland in Europe is properly explored, the sources discussed here will be key and will offer an interesting challenge to interpretation. And some surprises about their nature and date.

Component resolved diagnostics in peanut sensitized children with and without a history of clinical reaction

2020 ◽  
Vol 41 (5) ◽  
pp. 336-340
Author(s):  
Yasmin Hamzavi Abedi ◽  
Cristina P. Sison ◽  
Punita Ponda
Keyword(s):  
Retrospective Chart Review ◽  
Clinical History ◽  
Specific Ige ◽  
Exact Test ◽  
Ara H 1 ◽  
Sige Level ◽  
History Of ◽  
Laboratory Procedures ◽  
Ige Mediated ◽  
The Relationship

Background: Serum Peanut-specific-IgE (PN-sIgE) and peanut-component-resolved-diagnostics (CRD) are often ordered simultaneously in the evaluation for peanut allergy. Results often guide the plans for peanut oral challenge. However, the clinical utility of CRD at different total PN-sIgE levels is unclear. A commonly used predefined CRD Ara h2 cutoff value in the literature predicting probability of peanut challenge outcomes is 0.35kUA/L. Objective: To examine the utility of CRD in patients with and without a history of clinical reactivity to peanut (PN). Methods: This was a retrospective chart review of 196 children with PN-sIgE and CRD testing, of which, 98 patients had a clinical history of an IgE-mediated reaction when exposed to PN and 98 did not. The Fisher's exact test was used to assess the relationship between CRD and PN-sIgE at different cutoff levels, McNemar test and Gwet’s approach (AC1 statistic) were used to examine agreement between CRD and PN-sIgE, and logistic regression was used to assess differences in the findings between patients with and without reaction history. Results: Ara h 1, 2, 3, or 9 (ARAH) levels ≤0.35 kUA/L were significantly associated with PN-sIgE levels <2 kUA/L rather than ≥2 kUA/L (p < 0.0001). When the ARAH threshold was increased to 1 kUA/L and 2 kUA/L, these thresholds were still significantly associated with PN-sIgE levels of <2, <5, and <14 kUA/L. These findings were not significantly different in patients with and without a history of clinical reactivity. Conclusion: ARAH values correlated with PN-sIgE. Regardless of clinical history, ARAH levels are unlikely to be below 0.35, 1, or 2 kUA/L if the PN-sIgE level is >2 kUA/L. Thus, if possible, practitioners should consider PN-sIgE rather than automatically ordering CRD with PN-sIgE every time. Laboratory procedures that allow automatically and reflexively adding CRD when the PN-sIgE level is ≤5 kUA/L can be helpful. However, further studies are needed in subjects with challenge-proven PN allergy.

The Aristocracy in England and Tuscany, 1000 - 1250

2019 ◽  
Author(s):  
Peter Coss
Keyword(s):  
Time Frame ◽  
Grand Narrative ◽  
English History ◽  
Internal Dynamics ◽  
Italian Experience ◽  
English Society ◽  
History Of ◽  
External Stimuli ◽  
The Relationship ◽  
Interpretative Framework

Part I of this book is an in-depth examination of the characteristics of the Tuscan aristocracy across the first two and a half centuries of the second millennium, as studied by Italian historians and others working within the Italian tradition: their origins, interests, strategies for survival and exercise of power; the structure and the several levels of aristocracy and how these interrelated; the internal dynamics and perceptions that governed aristocratic life; and the relationship to non-aristocratic sectors of society. It will look at how aristocratic society changed across this period and how far changes were internally generated as opposed to responses from external stimuli. The relationship between the aristocracy and public authority will also be examined. Part II of the book deals with England. The aim here is not a comparative study but to bring insights drawn from Tuscan history and Tuscan historiography into play in understanding the evolution of English society from around the year 1000 to around 1250. This part of the book draws on the breadth of English historiography but is also guided by the Italian experience. The book challenges the interpretative framework within which much English history of this period tends to be written—that is to say the grand narrative which revolves around Magna Carta and English exceptionalism—and seeks to avoid dangers of teleology, of idealism, and of essentialism. By offering a study of the aristocracy across a wide time-frame and with themes drawn from Italian historiography, I hope to obviate these tendencies and to appreciate the aristocracy firmly within its own contexts.

The Oxford Handbook of American Women's and Gender History

2018 ◽  
Keyword(s):  
Women Of Color ◽  
Historical Record ◽  
Historical Evidence ◽  
Gender History ◽  
Artistic Production ◽  
The Past ◽  
History Of ◽  
Cultural Power ◽  
And Gender ◽  
Free Women

The Oxford Handbook of American Women’s and Gender History boldly interprets the history of diverse women and how ideas about gender shaped their access to political and cultural power in North America over six centuries. In twenty-nine chapters, the Handbook showcases women’s and gender history as an integrated field with its own interpretation of the past, focused on how gender influenced people’s lives as they participated in migration, colonialism, trade, warfare, artistic production, and community building. Organized chronologically and thematically, the Handbook’s six sections allow readers to consider historical continuities of gendered power as well as individual innovations and ruptures in gender systems. Theoretically cutting edge, each chapter bursts with fascinating historical characters, from young Chicanas transforming urban culture, to free women of color forging abolitionist doctrines, to Asian migrant women defending the legitimacy of their marriages, to working-class activists mobilizing international movements, to transwomen fleeing incarceration. Together, their lives constitute the history of a continent. Leading scholars from multiple generations demonstrate the power of innovative research to excavate a history hidden in plain sight. Scrutinizing silences in the historical record, from the inattention to enslaved women’s opinions to the suppression of Indian women’s involvement in border diplomacy, the authors challenge the nature of historical evidence and remap what counts in our interpretation of the past. They demonstrate a way to extend this more capacious vision of history forward, setting an intellectual agenda informed by intersectionality and transnationalism, and new understandings of sexuality.

Pseudo-Parkinson Disease Secondary to Ritonavir–Buspirone Interaction

2003 ◽  
Vol 37 (2) ◽  
pp. 202-205 ◽  
Author(s):  
Patrick G Clay ◽  
Molly M Adams
Keyword(s):  
Drug Interaction ◽  
Inhibitory Effect ◽  
Hiv Positive ◽  
High Dose ◽  
Resting Tremor ◽  
Case Summary ◽  
History Of ◽  
Drug Drug Interaction ◽  
To Receive

OBJECTIVE: To report a case of Parkinson-like symptoms appearing in a patient after introduction of ritonavir to buspirone therapy. CASE SUMMARY: A 54-year-old HIV-positive white man presented to the clinic with a 2-week history of ataxia, shuffling gait, cogwheel rigidity, resting tremor, and sad affect with masked features. This patient had been receiving high-dose buspirone (40 mg every morning and 30 mg every evening) for 2 years prior to the introduction of ritonavir/indinavir combination therapy (400 mg/400 mg twice daily) 6 weeks prior to initiation of the above symptoms. Buspirone was decreased to 15 mg 3 times daily, ritonavir/indinavir was discontinued, and amprenavir 1200 mg twice daily was added. The patient's symptoms began to subside after 1 week, with complete resolution after about 2 weeks. The patient continued to receive buspirone for an additional 12 months without recurrence of symptoms. DISCUSSION: This is the first reported interaction of buspirone and antiretrovirals. Buspirone, extensively metabolized by CYP3A4, was likely at supratherapeutic levels due to the inhibitory effect of ritonavir and, secondarily, indinavir. The Parkinson-like symptoms developed rapidly and severely, impacted this patient's quality of life, and necessitated significant clinic expenditures to identify this drug–drug interaction. CONCLUSIONS: This case demonstrates a severe drug–drug interaction between buspirone and ritonavir and further demonstrates the need for awareness of the metabolic profile for all agents an HIV-infected patient is receiving.

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