A suicidal heavy metal poisoning mimicking corrosive acid poisoning: A rare case report

Ingestion of corrosive substances may cause severe to serious injuries of the upper aero-digestive tractand the poisoning can even result in death. Acute corrosive intoxications pose a major problem in clinical toxicology since the most commonly affected population are the young with psychic disorders, suicidal intent and alcohol addiction. In our case report, a 19-year-old male, 2year engineering student committed suicide by consuming a heavy metal salt available in his chemistry lab after leaving a suicidal note. He got treated in a private hospital for 2 days and later he succumbed due to poisoning. Though the findings of this heavy metal poisoning mimicks corrosive acid poisoning, it has to be viewed through the eye of forensic toxicology for a clear view in clinching the diagnosis in the earlier phase of treatment.

The Impact of Breakdown in Filiation: The Instance of Children Exiled From Reunion Island to Mainland France Between 1962 and 1984

The aim of this article was to show the consequences of breakdowns in filiation among people born between 1950 and 1970 on Reunion Island, who experienced particular traumas during their childhood. The research participants included 2,015 children exiled from Reunion Island to mainland France between 1962 and 1984 as part of a political project. Most of them we adopted, others were placed in foster families, foster homes, or farms. The forced exile was orchestrated by the French social services in charge of child protection (DDASS). Structured interviews were conducted for 13 people exiled when they were between 2 and 15years old. The interviews were transcribed and then analysed. The results show that these children were exposed to abuse in their filiation through a series of traumas. For them, this abuse is still active today as the French government has not yet acknowledged the suffering of these children. The participants displayed numerous psychic disorders linked to their abandonment. They are still experiencing difficulties in assuming their identity, and these difficulties are transmitted to the next generation. Analysis of the impact of these filiation breakdowns leads the present researchers to suggest a specific clinical setting, based on a focus group, in other words a group therapy aiming to generate a group narrative process.

Security Logical Subjectivity of Mental and Behavioral Disorders and their Social and Specialized Correction

The number of people who suffer from various types and forms of mental disorders is growing rapidly every day. The problem definition by the statistical methods only just outlines the quantitative relations between the numbers of registered mental illness cases and the overall number of people suffering from them. However, it doesn’t answer the main questions of the public safety and of the safety of the abovementioned persons as it fails to account for the exogenous factors of the manifestation of the genetically determined and inborn mental disorders that incapacity mostly the children population. In this regard, a necessary condition for public safety is a scientific solution to the problem of the securitylogical subjectivity of the person with mental and behavioral disorders. One of the main reasons for the heavy illnesses of the central nervous system (CNS) and psychic disorders is perinatal cerebrovascular lesions and hypoxic-ischemic cerebrovascular injuries. The problem is, on the one hand, a subject of interest for the psychological, medical and social sciences, and on the other opens the dimensions of both special and social correction. Psychic disorders resulting from the perinatal cerebrovascular lesions and their psychotherapeutic correction are discussed in this article. Clinical investigation of the perinatal cerebrovascular lesions has been conducted using radio diagnostics tools, the mental and behavioural disorders were studied, and the correction methods were presented.

Fibromyalgia and Depression in Women: An 1H-NMR Metabolomic Study

Fibromyalgia is a chronic and systemic syndrome characterized by muscle, bone, and joint pain. It is a gender-specific condition with a 9:1 incidence ratio between women and men. Fibromyalgia is frequently associated with psychic disorders affecting the cognitive and emotional spheres. In the reported work, we compared 31 female fibromyalgia patients to 31 female healthy controls. They were analyzed for biochemical clinical parameters, for autoimmune markers, and were subjected to 1H-NMR metabolomics analysis. To identify a correlation between the metabolomic profile and the psychic condition, a subset of 19 fibromyalgia patients was subjected to HAM-A and HAM-D Hamilton depression tests. Multivariate statistical analysis showed the dysmetabolism of several metabolites involved in energy balance that are associated with systemic inflammatory conditions. The severity of depression worsens dysmetabolic conditions; conversely, glycine and glutamate, known for their critical role as neuromodulators, appear to be potential biomarkers of fibromyalgia and are associated with different severity depression conditions.

The Incidence of Mental Disorders Increases over Time in Patients with Cancer Pain: Data from a Retrospective Cohort Study

Background. It is well known that cancer patients more seldom have a psychiatric disorder than noncancer patients with chronic pain. Conversely, earlier studies have suggested that, at the psychiatric level, long-term cancer survivors (LCSs) have more in common with noncancer patients affected by chronic pain. Materials and Methods. We investigated 89 cancer patients with acute pain (Acute Cancer Pain Patients, ACPPs) treated at a university outpatient chemotherapy department and compared these with 61 LCSs (living >5 yr after the first diagnosis) admitted by general practitioners for the treatment of noncancer pain. Upon administration, each patient was psychiatrically assessed by a liaison-psychiatrist conducting a semistructured interview. In a second step, we compared the LCS patients with hitherto treated noncancer patients suffering from chronic pain and ACPPs with data published by Derogatis in 1983. Results. In a comparison of LCSs with ACPPs, LCSs have more patients with brain organic disorders and more addictions. The largest cancer group within the LCSs is patients with urogenital (Uro) cancer (44.3%), while within the ACPPs, these are patients with cancer of the gastrointestinal (GI) tract (ACPP-GI, 57.2%). As far as the distribution of mental disorders is concerned, long-term cancer survivors show some similarities to noncancer patients. The data of ACPPs are similar to those of cancer patients, published by Derogatis. Discussion. The higher values of addiction and brain organic disorders, in particular, and the slight differences for psychic disorders in general of LCSs vs. ACPPs may result from the different cancer types and a longer survival time for urogenital tract cancer compared to GI cancer. In an additional examination, we compared patients with acute cancer of the GI tract (ACPP-GI, n = 50) with those of the urogenital tract (ACPP-Uro, n = 43). ACPP-Uro had the lowest percentage of patients with psychiatric disorders in general (ACPP-Uro 37.2%, ACPP-GI 50.0%, all LCSs 65.6%, and LCS-Uro 74.1%) and addiction, in particular (ACPP-Uro 2.3%, ACPP-GI 4.0%, and LCSs 13.1%). Conclusion. Cancer patients can develop a process of chronification with an increase in the prevalence of mental disorders. For urogenital cancer, an increase in the probability to develop mental disorders is a function of time.

Vaginismus: Degrees of Expression, Clinical Forms, Family Parental Environment, Characteristics of Patients and Their Sexual Partners, Reactions to the Pathology, Data of Paraclinical Studies

The article deals with and characterizes degrees of vaginismus expression, present in a number of classifications, and contains characteristics of the phobic and hysteric (conversion) forms of vaginismus. It presents a clinical case, which contains a detailed description of psychotraumatic circumstances that resulted in phobic vaginismus and supported its existence, as well as a case of penis captivus in a female patient supervised by the author of this article. Self-perception of the women, suffering from vaginismus, and their family and parental environment are described. In particular it is informed that in many women with vaginismus their fathers were extremely critical, imperious, moralistic and threatening. At the same time, they were sexually seductive with their daughters to an excessive degree. It seemed that in some specific way the daughter substituted for her mother. The fathers behaved like jealous lovers, when their daughters went around with men. On the one hand, they were moralists, but on the other one they extremely concerned themselves with sexuality of their daughters. Also the article points out that half of the patients with vaginismus have alexithymia and discusses the issue of causal relationships between these two conditions. Data about a high rate of comorbid psychic disorders in patients with vaginismus, characteristics of sex partners of women with the above pathology, their responses to the existing disorder as well as information about their sexual dysfunctions are presented. Besides, findings of instrumental physiological examinations (electromyography – EMG) are presented; these demonstrate that women with vaginismus reveal an increased activity of muscles in their pelvic floor both at rest and during induction of vaginismus. The article also contains data, according to which vaginismus is associated with hystrionic-hysterical character traits and sexual distress.

Wiedereingliederung – und dann? Nachhaltigkeitskonflikte um die Rückkehr an den Arbeitsplatz nach psychischer Erkrankung

Zusammenfassung Bei der Betrachtung betrieblicher Wiedereingliederung wird in der Regel der Prozess des betrieblichen Eingliederungsmanagements (BEM) fokussiert. Unberücksichtigt dabei bleibt häufig, dass Wiedereingliederung auch nachhaltig sein soll. Rückfällen und erneuter Erkrankung Betroffener soll vorgebeugt ­werden. Damit rückt die Zeit nach der Rückkehr an den Arbeitsplatz in den Fokus. Am Beispiel psychischer Erkrankungen wird untersucht, welche potenziell aus Arbeitsunfähigkeit und Rückkehrprozess resultierenden Folgekonflikte die Nachhaltigkeit von BEM bedrohen. Anhand problemzentrierter Interviews mit Betroffenen, KollegInnen sowie Führungskräften wird gezeigt, dass es hierbei um soziale Konflikte geht, die aus konkurrierenden Interessenkonstellationen resultieren. Diese sind zugunsten akzeptierter Lösungen auszutarieren, um den langfristigen Reintegrationserfolg nicht zu gefährden. Abstract: Occupational Reintegration – What Comes Next? Sustainability Conflicts Around Return to Work After Psychic Disorder When it comes to return to the workplace, typically the process of the return itself is focused. However, terms of sustainability are often underexposed. Relapses and newly occurring disorders should be avoided. For this reason, subsequent development at the workplace is important. By taking the example of psychic disorders, this paper examines follow-up conflicts resulting from sick leave and the return-process, which are threatening sustainability demands. Problem-centered interviews with returnees, colleagues, and local leaders show the impact of social conflicts, resulting from competing constellations of interests. To promote sustainable reintegration socially accepted solutions are needed.

THE CLINICAL COURSE OF MYOCARDIAL INFARCTION PECULIARITIES IN MEN UNDER 60 YEARS OLD WITH ACUTE KIDNEY INJURY

Relevance. Acute kidneys injury (AKI) negatively affects the prognosis of myocardial infarction (MI). Aim. To evaluate MI clinical features (CF) in men under 60 years old (y.o.) with AKI during MI to improve prevention and outcomes. Material and methods. The study included men aged 19-60 years old with type I MI. Patients are divided into two age-comparable groups: I - the study group, with ACI - 25 patients; II - control, without it - 486 patients. A comparative assessment of the MI CF frequency in selected groups were performed. Results. In patients of the study group more often than in the control group, a combination of MI complications (64.0 and 36.9%; respectively; p = 0.009), psychic disorders (20.0 and 6.9%; p = 0.01), chronic heart failure (CHF) of the second functional class and above (NYHA) at the end of the eighth MI week (72.0 and 43.2%; p = 0.005), with a predominance of newly diagnosed CHF forms (36.0 and 28.0%; p = 0.006). In the study group, less often than in the control group, pulmonary hypertension was noted in the first 48 hours of MI (44.0 and 66.0%; p = 0.02) and at the end of the third MI week (38.1 and 60.3%; p = 0.04). Conclusions. There were no specific clinical signs of AKI in men under 60 y.o. with MI. At the same time, the study group has the worst prognosis during the observation period in terms of the frequency of MI complications combinations and CHF, which requires the start of prophylactic therapy from the moment of AKI verification.

Factors associated with psychic symptomatology in diabetics during the COVID-19 pandemic

Objectives: to determine the frequency and factors associated with severe / extreme signs and symptoms of stress, anxiety and depression in diabetic patients during the COVID-19 pandemic. Methods: cross-sectional study conducted in April /May 2020, which included 162 individuals with diabetes mellitus and over 18 years old. An online questionnaire was applied on social networks, composed of biological, sociodemographic, clinical characteristics and the Stress, Anxiety and Depression Scale (DASS-21). For statistical analysis, a multivariate logistic regression model was applied with a 5% significance level. Results: frequency of 37.7%, 43.3% and 45.1% were found for some symptom of stress, anxiety and depression, respectively. The factors associated with sign and symptoms of severe / extreme psychic disorders were: not having religion (stress, anxiety and depression); be at graduation (stress and anxiety); history of anxiety and depression (anxiety and depression); not practicing or decreasing physical exercises and starting, increased or continue taking sleeping medications (stress); history of contact with a suspected case of COVID-19, absence or decreased leisure (anxiety); female gender, absence of a partner, decreased family income and work or study (depression). Conclusion: the frequency of psychological disorders was higher than described in the literature on diabetic patients, being associated with biological, sociodemographic, clinical factors and aspects related to COVID-19 during the pandemic

A Headset in the Bladder

Foreign objects may be present in the bladder due to deliberate insertion or displacement of the surrounding organs. There have been multiple cases of sharp objects such as nails, hair pins, and screws, as well as large objects such as AAA batteries, toothbrushes, and ballpoint pens found in the urethra and the bladder, which must have been aimed to induce sexual satisfaction associated with mental and psychic disorders. The diagnosis was established by means of radiological examinations, ie thoracic x-ray, KUB, and urethrography. This article reported a 32-year-old man with headset inserted to penile until bladder and could not be pulled out again. The patient complained pain and bleeding out of the urinary tract. We performed vesicotomy and pulling the out headset from bladder. The operation was succesful. In conclusion, the case of a headset in the bladder has been treated successfully with vesicotomy.