A Case of a Brain Tumor Alexander Pilez (Psychiatr.-Neurolog. W. No. 21.1932)

Alexander Pilez (Psychiatr.-Neurolog. W. No. 21. 1932) reports a case of a brain tumor a metastatic carcinomatous node compressing the left half of the cerebellum whose lifetime diagnosis remained impossible.

Early detection of bipolar disorders and treatment recommendations for help-seeking adolescents and young adults: Findings of the Early Detection and Intervention Center Dresden

Background Early identification and intervention of individuals with risk factors for or subtle prodromal symptoms of bipolar disorders (BD) may improve the illness course and prevent adverse long-term consequences. Methods We examined sociodemographic, clinical and psychopathological characteristics of help-seeking adolescents and young adults who consulted the Early Detection and Intervention Center Dresden at the University of Dresden (Germany) and presented with or without pre-defined at-risk criteria for BD. The standardized diagnostic procedure for all help-seeking youth included a comprehensive psychiatric history and a structured clinical interview. When BD at-risk state was suspected, early detection instruments (EPIbipolar, BPSS-FP) were applied. Treatment recommendations were formulated in multi-professional case conferences. Results Out of 890 help-seeking persons between 05/2009 and 04/2018, 582 (65%) completed the diagnostic process. Of these, 24 (4%) had manifest BD and 125 (21%) fulfilled at-risk BD criteria (age = 23.9 ± 0.6 years, female = 62%). Of the pre-defined main risk factors, family history for BD was reported in 22% of the at-risk persons, (hypo-)mania risk state in 44%, and increasing cyclothymic mood swings with increased activity in 48%. The most common secondary risk factors were decreased psychosocial functioning (78%), lifetime diagnosis of depressive disorder (67%) and specific sleep/circadian rhythm disturbances (59%). Substance use was very common in subjects at-risk for BD (cannabis = 50%, alcohol = 33%) and highest in patients with BD (cannabis = 75%, alcohol = 40%). Psychiatric treatment history, including psychopharmacological therapy, was similar between the groups, while treatment recommendations differed, with more advice for psychotherapy and antidepressants in the at-risk group with a lifetime diagnosis of depression and more advice for specialized BD treatment including mood stabilizers in patients with BD. Conclusion This analysis on the phenomenology of different BD at-risk stages suggests that early detection of individuals presenting with suggested risk factors for the development of BD is feasible in help-seeking young people. Future research should further develop/test stage-specific prevention and early targeted intervention approaches that were described in a naturalistic setting.

UTERINE TORSION- AN OBSTETRICIAN'S NIGHTMARE

Uterine torsion rare in human and has been referred to as an 'obstetrician's once in a lifetime diagnosis'. Uterine torsion is a potentially dangerous complication of pregnancy both to mother and to the fetus. Torsion of less than 45 degrees is considered physiological, but rotation of the uterus of more than 45degrees on its longitudinal axis is considered pathological. Dextro-rotation is more common than levorotatory according to literature. We encountered one case as such which was managed at our institute.

Lifetime diagnosis of carnivore plague

Main problem: Until now the problem of intravital direct diagnosis of canine plague (Kara's disease), aimed at detecting the viral antigen in the secretions and excretions of sick animals, remains urgent. In the case of the disease of carnivorous dogs, the issue of reliable intravital diagnosis is more urgent, since the plague of carnivores in dogs is treated. Lifetime diagnosis of this disease by methods applicable in veterinary clinics is preferable, since in the case of timely and correct diagnosis, therapeutic measures will be more effective. Purpose: To improve the system of antiepizootic measures against canine plague among dogs in terms of prevention, diagnosis and treatment of this disease. Methods: Analysis of data from private veterinary clinics reporting on the incidence of small domestic animals was used. Various serological methods were used. Differential diagnosis from infectious hepatitis in dogs was carried out by means of CBR, DPR, from parvovirus enteritis - by HIR with cat erythrocytes. To check the specificity of reactions and determine the concentration of the test material, excluding false positive results, samples of pathological material obtained from dogs with various infectious diseases, as well as those obtained from healthy intact animals, were examined. Results and their significance: The use of a complex of various diagnostic methods ensures the diagnosis of plague of carnivores in any form of the disease and at any stage, even in the case of mixed infections, as well as differentiate it from parvovirus enteritis, infectious hepatitis and other carnivorous diseases similar to plague. Valuable in the RAM for the detection of the virus-specific antigen of the plague of carnivorous virus is that it can be used to diagnose the disease in vivo by examining fecal samples and swabs from the oral and nasal cavities.

Does Birth-Related Trauma Last? Prevalence and Risk Factors for Posttraumatic Stress in Mothers and Fathers of VLBW Preterm and Term Born Children 5 Years After Birth

Previous research suggests that the birth of a preterm child with very low birth weight (VLBW; <1,500 g) can be traumatic for both parents and lead to short-term consequences like clinical levels of posttraumatic stress symptoms (PTSS) or even to the development of a Posttraumatic Stress Disorder (PTSD). However, little is known about possible mid- and long-term psychological consequences in affected parents. The purpose of this study were (a) to examine the prevalence of parental birth-related PTSS and PTSD in a group of parents with VLBW preterm infants compared to parents of full-term infants 5 years after birth and (b) to investigate potential associations with risk factors for parental PTSS at 5 years postpartum. Perinatal factors (VLBW preterm or term, perceived stress during birth), psychological factors (perceived social support and PTSS 4–6 weeks postpartum, psychiatric lifetime diagnosis) and sociodemographic characteristics (number of children, singleton or multiple birth, socio-economic status), were included in the analysis. The sample consisted of 144 families (77 VLBW, 67 term birth) who participated in the prospective longitudinal cohort study “Hamburg study of VLBW and full-term infant development” (HaFEn-study) and were initially recruited at three perinatal care centers in Hamburg, Germany. PTSD prevalence and PTSS of mothers and fathers were assessed with the Impact of Event Scale-Revised (IES-R), social support with the Questionnaire of Social Support (SOZU-K-22), and lifetime psychiatric diagnoses with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (SCID-I). Data were analyzed by hierarchic multiple regression analyses. Results showed that 5 years after birth none of the parents fulfilled the criteria for a birth-related PTSD diagnosis. For mothers, postnatal PTSS and a VLBW preterm birth significantly predicted PTSS 5 years postpartum. For fathers, psychiatric lifetime diagnosis and postnatal PTSS significantly predicted PTSS 5 years after birth. Early identification of parents with higher risk of PTSS, especially after VLBW preterm birth, and their clinical needs seems beneficial to reduce the risk of long-term consequences. More research is needed on the paternal perspective and on potential effects of preterm birth on both parents and their children's mental health outcomes.

EWING’S SARCOMA

Ewing's sarcomas are rare neoplasms which comprise about 1% of all sarcomas. Сortical bones are usually affected. Cranial bones are rarely involved and are 1-6% of all Ewing's sarcoma cases. The article presents a case of a rare pathology - Ewing’s sarcoma of the temporal bone in a 36-year old woman and describes the morphological changes in the flat bones of the skull and the adjacent soft tissues of the head and their interconnection with data of clinical and laboratory and instrumental methods of investigation. Complexity of the lifetime diagnosis verification without histological and immunohistochemical confirmation has been shown on a concrete example.

Home Remodeling and Food Allergy Interact Synergistically to Increase the Risk of Atopic Dermatitis

Purpose. The purpose of this study was to investigate the effects of home remodeling and food allergy (FA) on the development of atopic dermatitis (AD) in children. Methods. The Modified International Study of Asthma and Allergies in Childhood questionnaire was used to survey 4,111 children recruited from 3 kindergartens and 6 elementary schools from Seongnam, Korea. Participants’ parents agreed for them to participate in physical examinations, skin prick tests, and blood tests. Results. Home remodeling in the past 12 months (adjusted odds ratio [aOR] 3.40, P=0.006), lifetime diagnosis of FA (aOR 3.95, P<0.001), parental history of AD (aOR 2.67, P=0.001), and FA (aOR 2.35, P=0.004) were independent risk factors for lifetime diagnosis of AD ever. When history of home remodeling and FA were combined, the risk for moderate-to-severe AD by scoring atopic dermatitis (SCORAD) score increased (aOR, 7.19, P=0.011, P for interaction = 0.034). Conclusion. Home remodeling, lifetime diagnosis of FA, parental history of AD, and parental history of FA were independent risk factors for AD. In addition, we observed a synergistic interaction between home remodeling and FA in the risk of moderate-to-severe AD.