ObjectiveTo demonstrate the therapeutic efficacy of aripiprazole LP by a case of difficult clinical management and that we often find in our daily practice.MethodsDescription of a clinical case of a 21-year-old man, recently diagnosed with paranoid schizophrenia with no awareness of disease neither treatment adherence and harmful use of THC and cocaine that are identified as precipitating factors for multiple hospital admissions.ResultsInjectable medication with objective clinical improvement is significant, cessation of readmissions, achieving improvement in all parameters measured functionality and proper adherence to treatment as well as outpatient mental health of both devices as of drug dependence.ConclusionPsychiatry is facing the great challenge of modifying the natural history to the deterioration of schizophrenia, a disease considered one of the leading causes of years lived with disability. The objectives medium and long-term treatment of this disease are centered on the delay-avoidance disability and improving the functioning and quality of life of people with this disease.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Introduction:Suicide is a public health problem of the first magnitude for both its costs and its implications for the population. The attention to suicide attempts is itself one of the first reasons for psychiatric consultation, if not the first, in hospitals. Among the risk factors for suicide is the presence of mental disorders on Axis I and II, and the existence of previous attempts.Objectives:Studying the behavior of some of the risk factors for suicide known (psychiatric history and previous attempts) in a sample from service Emergency Hospital Juan Ramón JiménezMethods:Performed a retrospective analysis (for a period of 6 months of 2013) of the risk factors associated with suicidal behavior of patients seen in the emergency department of our hospital for attempted suicide.Results:In an interim analysis found that up to 50% of patients treated for attempted suicide had made ??previous attempts. Most of them had any axis I disorder (> 75%) and were or had been in outpatient psychiatric follow. Extensive treatment with psychotropic drugs performed most (> 80%)Conclusions:The high number of cases with previous attempts provides a clear example of the problem of suicidal behavior relapse. The importance of this is increased when you consider that most were receiving or had received psychiatric treatment, reflecting the limitations in our daily clinical practice we have to control this pubic health problem.
Background Background:Rheumatoid arthritis (RA) cause sarcopenia (SCP). The European Working Group on Sarcopenia in Older People (EWGSOP)1,2 defined primary and secondary SCP cut-off values. Studies have reported prevalence (PV) of SCP in RA whit the previous criteria, it was between 21.4% and 33.3%. The SCP is considered a disability cause in patients with RA Objectives Objective: To estimate prevalence of secondary SCP in patients with RA using new EWGSOP criteria; associate joint function, quality of life and physical activity with the presence of SCP. Methods Methods: An observational, cross-sectional study. Inclusion criteria: Patients with RA that fulfilling ACR criteria/EULAR 2010, 18-59 years. Exclusion Criteria: Patients with previous arthroplasty, unstable chronic illness, stroke with motor deficits. Demographics, clinimetric (DAS28, CDAI, HAQ-DI and EuroQol) were collected. The measurement of body composition was performed by multifrequency bioimpedance (InBody 720®), physical performance (walking speed), muscle strength (Handgrip strength). Descriptive and inferential statistical analysis was used according to the variable type and distribution using Stata12®. Results Results: 46 patients were studied, 86.9% female, mean age 44.9±10.6 years; family history of RA in 45.6%; duration of RA 9.9±6.8 years, time of diagnosis of RA 7.8±6.5 years, comorbidities found: diabetes 4.8%, hypertension 10.8%, history of non prosthetic orthopedic surgery 17.4% and 19.6% previous fracture. We found a DAS28 3.64 (1.74-6.38), CDAI 7.5 (0-32). Anthropometric measures: weight 67±10.2 kg, height 1.56±0.007 m, BMI 27.4±3.6, body fat mass 25.7±8.3 kg (reference population 11.4-18.2 kg), percent body fat 37.9±8.5 (reference 18-28%), waist hip ratio 0.96±0.07 (reference 0.75-0.85), muscle mass (MM) in women median 8.88 (6.8-10.4) kg/m2 (reference >6.76kg/m2), men MM median 10.2 (6.7-12.5) kg/m2 (reference >10.76 kg/m2), handgrip strength in women of 14.9 kg (2.6-27 kg) (reference >20 kg) in men and 25.7 kg (18-38) (reference >30 kg), walking speed 0.96±0.23 m/s (reference >1 m/s). We found prevalence of 6.5% pre-SCP, SCP 2.1% and did not find patient with severe SCP. Comparing the quality of life, joint function between groups with and without SCP, we found no statistically significant differences. Conclusions Conclusions: We found less PV of SCP with respect to previously published, although our population probably does not represent all patients with RA. Our population had more overweight and percent body fat. We found no difference between these groups in quality of life, joint function and activity. Applying new EWGSOP criteria we obtain accurate data for diagnosed secondary SCP in RA patients. References Cruz-Jentoft AJ, Baeyens JP, Bauer JM, et al. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in Older People. Age Ageing 2010;39(4):412–23. Janssen I, Baumgartner R, Ross R et al. Skeletal muscle cutpoints associated with elevated physical disabi...
IntroductionAlthough psychoactive substances has a long history in recreational settings, research on its composition has focused only on tablets, crystal and powder, even though new formulation for new psychoactive substances are readily available for users.ObjectivesTo describe the presence of psychoactive substances and its characteristics in new formulations which had not previously been found in samples delivered to Energy Control from 2014 to 2015 in Spain.MethodsA total of 8324 samples were analysed from June 2014 to December 2015. Only those samples in gummy formulation were studied (n = 9). Samples were analyzed by energy control, a Spanish harm-reduction NGO that offers analysis of substances to users. Analysis was done by gas chromatography-mass spectrometry.ResultsFrom 9 samples of psychoactive substances in gummy formulation, the analysis detected that 55.5% contained multiple psychoactive substances: 6 samples contained 25N-NBOMe (66.7%), 1 2C-E (11.1%), 1 2C-D (11.1%). Two allylescaline (20%), 1 cocaine (11.1%), 1 THC (11.1%), 1 canabinol (11.1%), 1 ketamine (11.1%), 1 caffeine (11.1%), 1 MDMA (11.1%), 1 N-acetyl-MDMA (11.1%), 1 metoxetamine (11.1%), 1 N-acetyl-MDMA), 1 2C-N (11.1%). The only substance found in active dosage was 25N-NBOMe. Six samples (66.67%) did not contain the substance expected by the consumer.DiscussionIncipient presence of gummies as new psychoactive formulation was found. The most prevalent drug was 25N-NBOMe; 66.7% did not contain the substance expected. This may pose a risk for potential harmful effects. All the gummies were known to be drug-carriers when bought. This could represent the presence of new formulations from June 2014 in the Spanish recreational market.Disclosure of interestThe authors have not supplied their declaration of competing interest.
IntroductionThe use of antipsychotics in children is controversial, one of the considerations to take into account is the possible effect on the values of fasting glucose, prolactin or weight gain are very important.ObjectivesTo study the effect of these drugs on metabolic rate in children.MethodsWe measured the weight, waist circumference, fasting glucose and basal prolactin in 6 children at Children's Hospital in the province of Huelva, diagnosed with bipolar disorder and early schizophrenia, atypical antipsychotics before starting treatment and 6 months later.ResultsIn the provisional results it is found that a there is not a significant weight gain (less than 3%), no impairment of glucose and only in one case basal prolactin was elevated.ConclusionsThe use of atypical antipsychotics in children should be reserved when strictly necessary. Once established, keep tight control of metabolic parameters, although the data of our study coincide with the literature, do not produce significant alterations.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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