The "neurofi bromatoses" (NFs) are a group of distinct genetic disorders that are commonly associated with the appearance of nerve tumours. They include NF1, NF2 and schwannomatosis, with the NF1 or von Recklinghausen disease being the most common form. All these disorders are dominantly inherited with a high rate of new mutation and variable expression. It is typically regarded as a cancer predisposition syndrome; however the most common complication of NF1 in childhood is impairment in academic achievement and cognition with att entional, executive, language and visuospatial functions frequently aff ected. This paper therefore, att empts to emphasize the existence and importance of psychological disorders and diffi culties in people with NF1. Early detection of existing psychiatric disorders in NF1 patients opens the possibility of early treatment and bett er quality of life. In this study an overview of the latest fi ndings regarding mental disorders in NF1 patients is given. The majority of studies to date have based their investigation on cognitive impairments whose frequency is high in NF1 patients. Other investigations describe the problems of socialization, quality of life and the possibility of medical treatment. It is important that specialists of diff erent areas of expertise have a clear overview of all mental disorders and diffi culties that may occur in people aff ected by this disease. The importance of a multidisciplinary approach to treatment is also emphasized, which will lead to more successful forms of treatment and improve the quality of life of patients with NF1.
The best way to prevent unplanned downtime of production machines is certainly adherence to the principles of preventive maintenance. In case of extremely difficult working conditions and the contaminated working environment of the machine, a major maintenance intervention is required. This involves not only the replacement of worn parts, but also design changes, the use of other materials or shapes, such as hydraulic cylinder seals. Such a major intervention often also presents a major logistical and organizational challenge. As such an example, the paper presents the reconstruction of an older special press for the production of molds for casting and is still of key importance for the production of the company. The challenge was to renovate a special hydraulic block with 63 hydraulic rollers mounted in a 9 x 7 matrix, which, in addition to the appropriate force for sand compaction in all molds, must also ensure flawless compression parallelism.
IntroductionDry eye disease (DED) is a multifactorial disease of the tear film and ocular surface representing one of the most common problems in ophthalmological practice and significant public health problem. Characteristic symptoms of DED include gritty, sandy foreign body sensation as well as visual disturbances that have a negative impact on the patient’s daily activities and also affecting patient’s quality of life (QOL).ObjectivesThe objective of this research is to point out the importance of transdisciplinary approach to treatment of dry eye disease in patients with psychiatric disorders.MethodsWe reviewed all current available literature in Pubmed dealing with the topic of connection of dry eye disease and psychiatric disorders.ResultsIn recent years, the relationship between DED and psychiatric disorders has been gaining attention. A number of epidemiological studies have reported a possible association between dry eye and psychiatric disorders showing that the subjective symptoms of dry eye can be affected not only by changes of the tear film and ocular surface but also psychological factors such as anxiety, depression, schizophrenia, post-traumatic stress disorder (PTSP) and subjective happiness. Apart from psychiatric disorders, psychiatric medications are also considered as risk factors for DED due to their influence on the tear film status. The incidence of ocular side effects increases rapidly with the use of polypharmacy, a very common form of treatment used in psychiatry.Mental health disorders may be one of considerable contributing factors for dry eye symptoms and undiagnosed mental health conditions can be an influencing element for unexplained levels of DED symptoms. Depression, anxiety, stress, hypochondriasis, neuroticism, sleep and mood disorders may be associated with the exacerbation of symptoms to degrees that are not consistent with the objective signs related to tear dysfunction as well as changes in the anterior surface of the eye.There is often inconsistency between signs and symptoms of DED, where symptoms often are more related to non-ocular conditions including psychiatric disorders than to tear film parameters. Consequently, in many cases DED may be considered as a psychiatric as well as ophthalmological problem. Psychiatrists and ophthalmologists need to be aware of the potential influence of psychiatric disorders and medications on tear film stability.ConclusionsA detailed medical history, thorough ophthalmological examination and referral to a psychologist or psychiatrist may be essential in the treatment of those patients. In treatment of psychiatric patients, an integrative and transdisciplinary approach will result in better functioning and higher QOL.Disclosure of InterestNone Declared
Cilj: Utvrditi i analizirati određene karakteristike kliničkog uzorka djece i adolescenata sa suicidalnim ponašanjima tijekom 2019. i 2020. godine te pojavnost suicidalnog ponašanja tijekom određenih mjeseci u objema godinama. Metode: Provedeno je presječno, retrogradno, deskriptivno istraživanje na kliničkom uzorku 2428 djece/adolescenata pregledanih u jednoj hitnoj psihijatrijskoj ambulanti. Od navedenog uzorka 447 je izvještavalo o suicidalnom ponašanju. Rezultati: Zabilježeno je postojanje većeg udjela suicidalnih ideja, suicidalnih pripremnih aktivnosti i suicidalnih pokušaja kod djece i mladih u 2020. u odnosu na 2019. godinu. Tijekom svibnja (32,8 % naspram 10,4 %), kolovoza (30,6 % naspram 15,1 %) i rujna 2020. (38,0 % naspram 7,8 %) ta je razlika istatistički značajna za suicidalne ideje (svi p < 0,05). Bilježi se porast suicidalnih pripremnih aktivnosti u 2020. godini čiji je udio statistički značajno viši tijekom svibnja (25,0 % naspram 8,1 %), rujna (17,7 % naspram 6,8 %) i studenog (20,6 % naspram 9,5 %) u odnosu na iste mjesece u 2019. godini (svi p < 0,05). Tijekom svibnja (15,6 % naspram 4,4 %) i kolovoza (6,5 % naspram 0,0 %) značajno je viši udio pokušaja suicida u 2020. u odnosu na 2019. godinu (svi p < 0,05). Medijan dobi pacijenata je 15 godina (8-19). Rezultati pokazuju da je suicidalno ponašanje zastupljenije među pacijenticama, najčešća metoda pokušaja suicida je intoksikacija lijekovima, uz statistički značajne spolne razlike u metodama pokušaja suicida. Kod djevojčica/adolescentica zastupljeniji su emocionalni poremećaji, a kod dječaka/adolescenata mješoviti poremećaj ophođenja i emocija. Zaključci: Rezultate istraživanja treba razmotriti u kontekstu ograničenja te ih ne možemo generalizirati. Potrebno je u budućim istraživanjima razmatrati faktore koji mogu pridonijeti složenom fenomenu suicidalnog ponašanja djece i adolescenata, prepoznavati pravodobno djecu i mlade u riziku te jačati preventivne programe.
IntroductionThe paper discusses the problem of psychiatric treatment of rare diseases and “diagnostic screening” of certain psychic symptoms that affect people with intellectual disabilities. Prader–Willi (PWS) is a genetic syndrome that belongs to a group of rare diseases and is caused by deficiency or loss of function of genes on chromosome 15 inherited from the father. This disease affects both sexes and its main characteristics are: obesity, hyperphagia, mental retardation and hypogonadism. Chronical feeling of insatiable hunger and slow metabolism leads to excessive body weight which is, according to existing date sources and monitoring studies, the primary cause of premature death of patients with PWS. Anxiety, psychomotor agitation, behavioral problems, difficulties with short-term memory, frequent skin injury in the form of wounds and bruises are the symptoms of this disease that hinder diagnosis and treatment. Research suggests that patients with PWS have unusual reactions to the standard drug dosages, specifically anxiolytics.AimWe shall present a multidisciplinary approach of pharmacological and psychotherapeutic treatment of a 16-year-old female patient with PWS.ResultThis patient responded well to a small dosage of quetiapine, at the same time monitoring other physical parametres. Pharmacotherapy, combined with psychotherapy, along with providing counseling and support for parents resulted in decreased psychomotor restlessness and, subsequently, better control of food intake and prevention of weight gain.ConclusionThis paper has emphasis on the importance of a multidisciplinary approach, as well as experience from clinical practice in the treatment of complex and rare syndrome diseases.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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