To kill two birds with a stone

2021 ◽  
pp. 1-3
Author(s):  
Saara Ahmad ◽  
Asra Khan ◽  
Prashant Tikmani ◽  
Hamna Rafiq
Keyword(s):  
Viral Infections ◽  
Anxiety And Depression ◽  
Vicious Cycle ◽  
Herbal Tea ◽  
Neuroprotective Effects ◽  
Traditional Remedies ◽  
Pleasant Surprise ◽  
Cytokine Cascade ◽  
The Uk ◽  
End Stage

Novel Corona virus 2019, its infectivity and pandemic around the world has earnestly garnered much panic, especially, with its new strain spreading across the UK and possibly its spread across borders. This has increased anxiety and stress levels to many folds mainly due to its robustness and resistance to treatment (1). The panic and paranoia of testing COVID-19 positive, restraining into isolation and being shunned by the society often lead to a vicious cycle of heightened stress, anxiety and depression levels in individuals that at times lead to the ugly consequences of COVID-19 rendering end stage in affected with admissions in the intensive care or even death upon arriving hospitals. China, the first ever country in world to announce COVID-19 infection, has successfully controlled and contained the infection (2). There the new cases are negligible and has shown its capacity of treatment of COVID-19 through utility of medicinal herbs and old traditional remedies that are long ago forgotten by the other nations. The commonest treatment modality against COVID-19 in China, Thailand and other Buddhist countries are through mere inhaling of steam and intake of herbal teas (3). Many studies have shown that any form of tea especially chamomile tea is beneficial in the treatment of COVID 19. We have also currently run a clinical trial at the Aga Khan University where chamomile and saffron tea was given in twice a day dose for a month to the depressed patients to treat their depression. To our pleasant surprise many participants of the trial knew that chamomile is also effective against viral infections. Our research has shown that saffron and chamomile in combination at reduced doses has synergistic antioxidant and anti-inflammatory and neuroprotective effects through modulation of neurotransmitters in brain (4,5). It is suggested that this synergism may benefit individuals against cytokine cascade, oxidant activity and inflammatory effects of the COVID 19 as well as alleviate neuropsychological deficits like anxiety, stress and depression that are associated with the fear of catching this communicable infection. This herbal tea may indeed help to kill two birds COVID-19 and neuropsychological illness with a stone. Continuous...

scholarly journals Family caregiver emotional distress in advanced cancer: the DME-C scale psychometric properties

2020 ◽  
pp. bmjspcare-2020-002608
Author(s):  
Joaquín T Limonero ◽  
Jorge Maté-Méndez ◽  
María José Gómez-Romero ◽  
Dolors Mateo-Ortega ◽  
Jesús González-Barboteo ◽  
...  
Keyword(s):  
Psychometric Properties ◽  
End Of Life ◽  
Family Caregivers ◽  
Advanced Cancer ◽  
Emotional Distress ◽  
Family Caregiver ◽  
Screening Tools ◽  
Anxiety And Depression ◽  
The Family ◽  
End Stage

BackgroundFamily caregivers of patients with advanced illness at end of life often report high levels of emotional distress. To address this emotional distress is necessary to have adequate and reliable screening tools.AimThis study analyses the psychometric properties and clinical utility of the Family Caregiver Emotional Detection Scale for caregivers of patients with end-stage cancer (DME-C, Spanish acronym) who are receiving palliative care (PC).DesignMulticentre, cross-sectional study.Settings/participantsFamily caregivers of patients with advanced cancer at end of life receiving palliative treatment were interviewed to explore their emotional distress through the DME-C scale and other instruments measuring anxiety and depression (Hospital Anxiety and Depression Scale (HADS)), distress thermometer (DT) and overload (B), as well as a clinical psychological assessment (CPA).Results138 family caregivers, 85 (61.6%) female and 53 (38.4%) male, with an average age of 59.69±13.3 participated in the study. The reliability of the scale, as measured by Cronbach’s alpha, was 0.76, and its stability over time was 0.734. Positive, significant correlations were found between the DME-C and the scores for anxiety and depression registered on the HADS scale, as well as with the total result of this latter scale and the results for B, the DT and the CPA. A statistical analysis of the receiver-operating characteristic curves showed that the scale has a sensitivity and specificity of 75%, and that the cut-off point for the detection of emotional distress was a score ≥11. Fifty-four per cent of the caregivers displayed emotional distress according to this scale.ConclusionsThe DME-C displays good psychometric properties. It is simple, short, reliable and easy to administer. We believe that the instrument is useful for the detection of emotional distress in the family caregivers of hospitalised patients suffering from end-stage illnesses and receiving PC.

scholarly journals Diarylureas: Repositioning from Antitumor to Antimicrobials or Multi-Target Agents against New Pandemics

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 92 ◽  
Author(s):  
Alessia Catalano ◽  
Domenico Iacopetta ◽  
Michele Pellegrino ◽  
Stefano Aquaro ◽  
Carlo Franchini ◽  
...  
Keyword(s):  
Anticancer Agents ◽  
Kinase Inhibitors ◽  
Viral Infections ◽  
Drug Repositioning ◽  
Biological Activities ◽  
Antiviral Treatment ◽  
Far East ◽  
Mild Disease ◽  
To Come ◽  
The Uk

Antimicrobials have allowed medical advancements over several decades. However, the continuous emergence of antimicrobial resistance restricts efficacy in treating infectious diseases. In this context, the drug repositioning of already known biological active compounds to antimicrobials could represent a useful strategy. In 2002 and 2003, the SARS-CoV pandemic immobilized the Far East regions. However, the drug discovery attempts to study the virus have stopped after the crisis declined. Today’s COVID-19 pandemic could probably have been avoided if those efforts against SARS-CoV had continued. Recently, a new coronavirus variant was identified in the UK. Because of this, the search for safe and potent antimicrobials and antivirals is urgent. Apart from antiviral treatment for severe cases of COVID-19, many patients with mild disease without pneumonia or moderate disease with pneumonia have received different classes of antibiotics. Diarylureas are tyrosine kinase inhibitors well known in the art as anticancer agents, which might be useful tools for a reposition as antimicrobials. The first to come onto the market as anticancer was sorafenib, followed by some other active molecules. For this interesting class of organic compounds antimicrobial, antiviral, antithrombotic, antimalarial, and anti-inflammatory properties have been reported in the literature. These numerous properties make these compounds interesting for a new possible pandemic considering that, as well as for other viral infections also for CoVID-19, a multitarget therapeutic strategy could be favorable. This review is meant to be an overview on diarylureas, focusing on their biological activities, not dwelling on the already known antitumor activity. Quite a lot of papers present in the literature underline and highlight the importance of these molecules as versatile scaffolds for the development of new and promising antimicrobials and multitarget agents against new pandemic events.

scholarly journals 841 The psychological impact of Foundation Interim Year 1 Placements on Final Year UK Medical Students Transitioning to Foundation Year One During the COVID Era

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
M Durand-Hill ◽  
D I Ike ◽  
A N Nijhawan ◽  
A B Shah ◽  
A Dawson ◽  
...  
Keyword(s):  
Medical Students ◽  
Perceived Stress ◽  
Psychological Impact ◽  
Depression Scale ◽  
Anxiety And Depression ◽  
Hospital Anxiety ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Stress Scale ◽  
The Uk

Abstract Introduction During the COVID pandemic, the 2019-2020 cohort of final year students were invited to participate in Foundation interim Year 1 placements (FiY1). FiY1 aimed to ease transition to Foundation Year 1 doctor (FY1). We assessed the psychological impact of FiY1 on final year medical students. Method A cross-sectional survey was distributed to final year medical students in the UK between June 4th and July 4th, 2020. The survey contained the following domains: participant demographics, rationale for FiY1 participation, a checklist of the key safety principles for FiY1s, the Hospital Anxiety and Depression Scale and the Perceived Stress scale-4. Results 107 final years responded to the survey. 72.0% (n = 77) of final year students surveyed were working as FiY1s. Final year students participating in FiY1 postings had reduced rates of anxiety (29.9% vs 43.4%, P = 0.186), depression (5.2% vs 20.0%, P = 0.018) and lower perceived stress levels (5.0 vs 7.2, P < 0.001). 19.5% (15/77) FiY1s reported working beyond their competency, 27.3% (22/77) felt unsupervised, but 94.8% (73/77) of FiY1s felt the post prepared them for FY1. Conclusions Students participating in FiY1 postings felt less stressed and depressed than those not participating in the scheme and the majority felt it was preparing them for FY1.

scholarly journals Viral hepatitis and liver cancer

2017 ◽  
Vol 372 (1732) ◽  
pp. 20160274 ◽  
Author(s):  
Marc Ringehan ◽  
Jane A. McKeating ◽  
Ulrike Protzer
Keyword(s):  
Liver Cirrhosis ◽  
Liver Cancer ◽  
Hepatitis B ◽  
Viral Infections ◽  
Current Knowledge ◽  
Primary Liver Cancer ◽  
Oncogenic Viruses ◽  
Chronic Infections ◽  
Future Design ◽  
End Stage

Hepatitis B and C viruses are a global health problem causing acute and chronic infections that can lead to liver cirrhosis and hepatocellular carcinoma (HCC). These infections are the leading cause for HCC worldwide and are associated with significant mortality, accounting for more than 1.3 million deaths per year. Owing to its high incidence and resistance to treatment, liver cancer is the second leading cause of cancer-related death worldwide, with HCC representing approximately 90% of all primary liver cancer cases. The majority of viral-associated HCC cases develop in subjects with liver cirrhosis; however, hepatitis B virus infection can promote HCC development without prior end-stage liver disease. Thus, understanding the role of hepatitis B and C viral infections in HCC development is essential for the future design of treatments and therapies for this cancer. In this review, we summarize the current knowledge on hepatitis B and C virus hepatocarcinogenesis and highlight direct and indirect risk factors. This article is part of the themed issue ‘Human oncogenic viruses’.

scholarly journals Epigenetic dysregulation of ACE2 and interferon-regulated genes might suggest increased COVID-19 susceptibility and severity in lupus patients

2020 ◽  
Author(s):  
Amr H. Sawalha ◽  
Ming Zhao ◽  
Patrick Coit ◽  
Qianjin Lu
Keyword(s):  
Oxidative Stress ◽  
Immune Response ◽  
Viral Entry ◽  
Viral Infections ◽  
Severe Disease ◽  
Disease Course ◽  
Vicious Cycle ◽  
Respiratory Complications ◽  
Disease Remission ◽  
Functional Receptor

SummaryInfection caused by SARS-CoV-2 can result in severe respiratory complications and death. Patients with a compromised immune system are expected to be more susceptible to a severe disease course. In this report we suggest that patients with systemic lupus erythematous might be especially prone to severe COVID-19 independent of their immunosuppressed state from lupus treatment. Specially, we provide evidence in lupus to suggest hypomethylation and overexpression of ACE2, which is located on the X chromosome and encodes a functional receptor for the SARS-CoV-2 spike glycoprotein. Oxidative stress induced by viral infections exacerbates the DNA methylation defect in lupus, possibly resulting in further ACE2 hypomethylation and enhanced viremia. In addition, demethylation of interferon-regulated genes, NFκB, and key cytokine genes in lupus patients might exacerbate the immune response to SARS-CoV-2 and increase the likelihood of cytokine storm. These arguments suggest that inherent epigenetic dysregulation in lupus might facilitate viral entry, viremia, and an excessive immune response to SARS-CoV-2. Further, maintaining disease remission in lupus patients is critical to prevent a vicious cycle of demethylation and increased oxidative stress, which will exacerbate susceptibility to SARS-CoV-2 infection during the current pandemic. Epigenetic control of the ACE2 gene might be a target for prevention and therapy in COVID-19.

Abstract TMP48: Effect of Pre-Morbid Antianxiety and Antidepressant Medications on Ischemic Stroke Functional Outcome

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Cecilia Peterson ◽  
Ka-Ho Wong ◽  
Michael Dela Cruz ◽  
Kirby Taylor ◽  
Jennifer J Majersik ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Acute Ischemic Stroke ◽  
Regression Models ◽  
Primary Outcome ◽  
Negative Impact ◽  
Secondary Analysis ◽  
Anxiety And Depression ◽  
Neuroprotective Effects ◽  
Logistic Regression Models ◽  
Antidepressant Medications

Introduction: Antianxiety and antidepressant medications have shown some neuroprotective effects following stroke. However, the effect of premorbid use of these medications remains unclear. Hypothesis: Pre-morbid exposure to antianxiety or antidepressant medications will negatively impact recovery from acute ischemic stroke, measured by modified Rankin scale (mRS) at 90 days after stroke onset. Methods: This is a secondary analysis of the Albumin in Acute Ischemic Stroke (ALIAS) 2 trial. The primary outcome is 90-day mRS 0-1. The exposure is premorbid antidepressant or antianxiety medication. We fit univariate and multivariate logistic regression models to our outcome, with covariates chosen using a stepwise backwards interactive selection. Results: We included 806 patients with a mean (SD) age of 64.4 (12.8) years. The median (IQR) NIH Stroke Scale was 11 (8, 17) and 54.3% were male, 75.6% were Caucasian, 88.8% received tPA, 72.5% had hypertension, and 20.3% had diabetes. A total of 140/806 (17.4%) of patients took either an antidepressant or antianxiety medication, of which 91 took an antidepressant, 34 took an antianxiety medication, and 15 took both. The median (IQR) mRS Scale was one point higher in patients on antidepressant or antianxiety medication pre-stroke (3 vs. 2, p=0.019). The primary outcome of mRS 0-1 was seen in 37.7% of all patients. Taking an antidepressant or antianxiety medication was associated with lower odds of a good outcome in univariate (OR 0.61, 95% CI 0.41-0.91, p=0.015) and multivariate models (aOR 0.62, 95% CI 0.40-0.95, p=0.027) (Table 1). Conclusion: Pre-morbid exposure to antianxiety or antidepressant medications is associated with a worse outcome after acute ischemic stroke. This may be due to a negative impact of pre-stroke anxiety and depression that outweigh any neuroprotective factors of these medications.

A novel multidisciplinary approach to the management of end-stage macular disease

2021 ◽  
pp. 026461962110326
Author(s):  
Su Ling Young ◽  
Nathan Ng ◽  
Ngee Jin Yap ◽  
Zain Hussain ◽  
Peter D Cackett
Keyword(s):  
Low Vision ◽  
Holistic Approach ◽  
Depression Score ◽  
Anxiety And Depression ◽  
Macular Disease ◽  
Global Pandemic ◽  
Patient Reported ◽  
One Stop ◽  
End Stage ◽  
Endothelial Growth Factor

Introduction: In 2017, the Royal College of Ophthalmologists UK published ‘The Way Forward’ describing the effects of the ageing UK population on clinical demand for macular conditions. Although one-stop clinics have become accepted standard practice for combined assessment and injections, there is little guidance regarding eventual discharge of patients, and practice varies between clinicians. In 2018, NHS Lothian started a multidisciplinary one-stop clinic involving an Ophthalmologist, a Medical Photographer, a specialist Low Vision Optometrist, and a Low Vision Counsellor. We aimed to detail our experiences of this novel multidisciplinary discharge clinic for advanced macular disease patients. We also aimed to assess patient-reported anxiety and depression outcomes following this clinic. Retrospective data on 60 patients who attended the clinic from August 2018 to January 2019 were collected and included in analysis. Average age at presentation to the clinic was 85.76 ± 8.18 years old and patients had been followed up in the macula clinic for a mean of 4.80 ± 2.43 years prior to attending the clinic. In all, 31 patients responded to a survey on anxiety and depression using the Hospital Anxiety and Depression score (HADS). Three (10%) of the patients reported scores abnormal for anxiety, and there were no abnormal scores for depression. The clinic provides a holistic approach for end-stage macular disease patients and reduces unnecessary macular anti–vascular endothelial growth factor treatments and clinic review appointments. This is especially important now during the coronavirus SARS-CoV-2 global pandemic. This provides significant benefits to capacity for delivery of clinical services and facilitates a safe and supported discharge for patients.

PP147 Physician And Patient Reported Anxiety And Depression In Hemophilia

2017 ◽  
Vol 33 (S1) ◽  
pp. 138-139 ◽  
Author(s):  
Ian Jacob ◽  
Charlotte Camp ◽  
Jamie O'Hara ◽  
Mark Skinner ◽  
Shaun Walsh
Keyword(s):  
Mental Health ◽  
Point Of Care ◽  
Anxiety And Depression ◽  
Health State ◽  
Severe Hemophilia ◽  
Severe Condition ◽  
Patient Reported ◽  
Illness Study ◽  
Related Quality ◽  
The Uk

INTRODUCTION:Anxiety and depression are major drivers of health-related quality of life, adherence to therapy, and motivation to self-manage chronic conditions. A number of studies have shown rates of anxiety and depression to be higher among individuals with hemophilia compared to that of the general population (1). As the primary point of care for persons with hemophilia, hematologists are well-placed to assess the mental health state of their patients (2). The aim of this study is to explore physician- and patient-reported rates of anxiety and depression among a cohort with severe hemophilia.METHODS:Data were drawn from the Cost of Haemophilia across Europe – a Socioeconomic Survey (CHESS), a cost-of-illness study in severe hemophilia A and B across five European countries (France, Germany, Italy, Spain, and the UK) (3). Physicians provided clinical and sociodemographic information for 1,285 adult patients, 551 of whom completed corresponding questionnaires, including EuroQol EQ-5D-3L. We compared the self-reported EQ-5D with physician reports of anxiety and depression.RESULTS:Across the five countries, physicians recorded a diagnosis of anxiety disorder in 189 patients (15 percent; range 4 percent-28 percent) and depression in 178 patients (14 percent; range 10 percent-28 percent). Seventy-three patients (6 percent) recorded comorbid anxiety and depression. Forty-six percent of patients with anxiety and 58 percent of patients with depression were receiving some form of treatment for their condition.Within the EQ-5D measure, 42 percent of individuals recorded problems with anxiety or depression, with 6 percent of patients reporting “extreme” anxiety or depression. Twenty-two percent of individuals with a self-reported problem were not recorded with a corresponding diagnosis by their hematologist; 39 percent of patients reporting “extreme” anxiety or depression were absent of any physician-reported diagnosis.CONCLUSIONS:Anxiety and depression are notable conditions within the hemophilia community, particularly so among those with severe condition. The mental health of individuals with hemophilia is an important aspect in ensuring therapy adherence and overall wellbeing and should be considered as part of a multidisciplinary approach to management of the condition.

scholarly journals Anxiety and depression in end-stage COPD

2008 ◽  
Vol 31 (3) ◽  
pp. 667-677 ◽  
Author(s):  
K. Hill ◽  
R. Geist ◽  
R. S. Goldstein ◽  
Y. Lacasse
Keyword(s):  
Anxiety And Depression ◽  
End Stage
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