Introduction Mild cognitive impairment (MCI) is regarded as a prodrome to dementia. Various cognitive tests can help with diagnosis; meta‐analysis of diagnostic accuracy studies would assist clinicians in choosing optimal tests. Methods We searched online databases for “mild cognitive impairment” and “diagnosis” or “screening” from 01/01/1999 to 01/07/2017. Articles assessing the diagnostic accuracy of a cognitive test compared with standard diagnostic criteria were extracted. Risk of bias was assessed. Bivariate random‐effects meta‐analysis was used to evaluate sensitivity and specificity. Results Eight cognitive tests (ACE‐R, CERAD, CDT‐Sunderland, IQCODE, Memory Alteration Test, MMSE, MoCA, and Qmci) were considered for meta‐analysis. ACE‐R, CERAD, MoCA, and Qmci were found to have similar diagnostic accuracy, while the MMSE had lower sensitivity. Memory Alteration Test had the highest sensitivity and equivalent specificity to the other tests. Discussion Multiple cognitive tests have comparable diagnostic accuracy. The Memory Alteration Test is short and has the highest sensitivity. New cognitive tests for MCI diagnosis should not be compared with the MMSE.

Background and Objectives: Hallucinations are sensory perceptions which occur without external stimuli. There are associated with psychiatric disease but also can be related to organic disease and drug or toxic exposure. The purpose of our study was to investigate the association between exposure to medications and the reporting of hallucinations using data from the spontaneous-reporting French Pharmacovigilance Database (FPVD). Methods: We used the case/noncase method in the FPVD. Cases were all the observations of hallucination with the LLT term "perception disturbances", registered into the FPVD from January 1985 to Jan 2013. Data were expressed as odds ratio (OR) with their 95% confidence intervals. Results: Among the 469,181 reports of adverse effects recorded between 1985 and 2013, 4,086 are hallucinations. For about 50% of these hallucinations were experimented by patient older than 65 years old. A statistically significant OR was found with several medications included rasagiline (OR 17.6 [95%CI 10.4-29.8]), zolpidem (OR 12.9 [95%CI 11.3-14.8]), methylphenidate (OR 9.3 [95%CI 5.9-14.6]) and baclofene (OR 5.4 [95%CI 3.7-7.8]). An increased risk of hallucinations was also observed with non central nervous system drugs, including ertapenem (OR 24.0 [95%CI 14.2-40.5]), voriconazole (OR 12.9[95%CI 10.2-16.5]) and valacyclovir (OR 9.1 [95%CI 6.9-11. 9]). Conclusions: This pharmacoepidemiological study describes an association between drugs and hallucinations. This relationship involves not only some already suspected drugs but also other drugs less known to induce such an adverse reaction. Despite the mandatory limits of this kind of study, these data should lead to special precautions in patient at risk.

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Development of excised coremia of Doratomyces purpureofuscus (Fries) Morton and Smith requires the presence of living mycelium at the coremium base. Relations between the vegetative hyphae and the synnema are established by means of anastomosis. Coremial development is controlled by an intramycelial factor which is one or several small thermostable molecules.

AimsAntipsychotic use is associated with cardiovascular and metabolic side-effects, which may contribute to increase mortality and morbidity in this patient group. This highlights the importance of physical health monitoring. We aimed to assess our compliance with the more stringent NICE guidelines, updated in September 2021.MethodsHalf of BEIS team's caseload was audited (n = 67) during October 2021 for compliance with NICE's monitoring guidelines for patients initiated on antipsychotic medication. These included initial and, if indicated, repeat monitoring of body mass index (BMI), pulse, blood pressure (BP), blood results, electrocardiogram, and adverse effects. Patients who were not on antipsychotics were excluded. 61% of patients were initiated on antipsychotics as inpatients, and 39% were outpatients. These patients have been started on antipsychotics within the last three years. Data were collected via electronic record systems. 80% compliance was set as the standard, in line with National Clinical Audit of Psychosis standards.ResultsIn the first three months of antipsychotic initiation (61% as inpatients, 39% in the community) six out of nine parameters met standards (ranging from 2% to 100%), with BMI measurement (weekly), pulse and BP measurements and one month repeat haemoglobin A1C (HbA1c) failing. When only accounting for patients who were started on antipsychotics in outpatient settings (BEIS or crisis team), compliance was only met on two parameters.Three months post initiation, when patients were mainly monitored in the community, only three of the nine parameters met compliance (lipids, HBA1c, and side-effects).ConclusionAdherence to the NICE standards for physical health monitoring in the community poses significant challenges. Possible barriers include reduced patient contact during the pandemic, lack of awareness of monitoring requirements, poor documentation (particularly of declined screening) and a lack of time and resources. There is also a possibility of unnecessarily stringent and impractical guidelines which are difficult to achieve in outpatient settings – such as weekly BMI. We plan to implement interventions including providing a checklist for medical and nursing staff and encouraging patients to monitor their own blood pressure and weight at home. We will reaudit the same parameters in 6 months’ time.