Postepy psychiatrii neurologii最新文献

Purpose: A survey of epilepsy patients' experiences of and attitudes towards the pharmacy switching of anti-epileptic medications.

Methods: A structured questionnaire was administered to a group of epilepsy patients treated at the Institute of Psychiatry and Neurology and the Medical University of Silesia, Poland. Two hundred and eleven patients (mean [± SD] age: 41.0 ± 15.6 years) were recruited; 60.6% were women. 68.2% had been treated for over 10 years.

Results: Most individuals (63%) claimed that they had never bought a generic substitute medication. Among the patients who declared that a switch had been proposed to them at a pharmacy (~40%), only 68.7% received any explanation at all from a pharmacist. Some reported positive emotions mostly related to a lower price of the new drug but also to the explanations received. Most respondents who accepted the pharmacy switch (67.4%) did not notice any significant changes in the efficacy or tolerability of treatment, while the remaining subjects reported an increase in seizure frequency (23.2%) and deterioration in treatment tolerance (9%).

Conclusions: Around 40% of Polish epilepsy patients have been confronted with a proposal to switch their anti-epileptic medications at a pharmacy. More of them report negative attitudes towards the pharmacist's proposal than do not. It is possible that one of the major reasons for this is the insufficient information provided by pharmacists. It remains to be established whether the reported decrease in seizure control could be accounted for by a low concentration of the anti-epileptic drug in the blood after the switch.

Purpose: This article provides an overview of current treatment options for adults and adolescents suffering from eating disorders (ED).

Views: ED are prevalent public health problems that considerably impair physical health and disrupt psychosocial functioning. In primary care settings, anorexia nervosa, bulimia nervosa, and binge eating disorder represent the most frequently seen types of eating disorders, in both adults and adolescents. To address these maladaptive eating-related behaviors and concurrent psychiatric symptoms, various pharmacological interventions and specialized psychological treatments have been evaluated and received support to varying degrees by controlled research.

Conclusions: The current literature regarding children and adolescents with eating disorders mainly supports the use of psychological interventions, such as family-based treatment and cognitive behavioral therapy. Due to the lack of robust evidence, the use of psychotropic medications is neither recommended nor approved in this population. For adults with eating disorders, an array of behaviorally focused psychotherapies, along with integrative and interpersonal approaches, can lead to the improvement of symptoms and the achievement of a healthy weight. Moreover, aside from psychotherapy, several pharmacological agents can contribute to the alleviation of eating disorders' clinical characteristics in the adult population. At the moment, the recommended psychotropic medication for eating disorders is represented by fluoxetine for bulimia nervosa and lisdexamfetamine for binge eating disorder.

Purpose: In patients with epilepsy (PWE), cognitive and behavioural dysfunctions are associated with abnormalities in various brain areas. The aim of the study was to compare the volume of the hippocampus (VHIP), amygdala (VAMG) and parahippocampal gyrus (VPHG) with the results of neuropsychological assessment in patients with temporal lobe epilepsy (TLE) and genetic generalized epilepsy (GGE).

Methods: 33 PWE were enrolled in the study (mean age 37.3), 10 with TLE and 23 GGE (12 with GGE with tonic-clonic seizure [GGE-GTCS], and 11 with juvenile myoclonic epilepsy). 19 healthy persons (mean age 32.2) were enrolled as the control group (CG). Measurements of VHIP, VAMG and VPHG were made with 3D completely balanced steady state (CBASS) and 3D T1-weighted sequence. All participants underwent a neuropsychological assessment using a multi-domain cognitive battery and emotional state questionnaires.

Results: The left hippocampus was significantly smaller in patients with left TLE (LTLE) and with GGE-GTCS, compared to the CG (p = 0.0069). In LTLE a significant enlargement of the right amygdala in comparison to the CG and other types of epilepsy were found (p = 0.0015). Among patients with LTLE and GGE-GTCS, impairment of attention and executive functions was statistically more common than in the CG. VHIP right (r = 0.25 p < 0.01) and VHIP left (r = 0.26 p < 0.04) were positively correlated with phonetic verbal fluency.

Conclusions: PWE showed changes in the volume of selected medial temporal lobe (MTL) structures. Selective impairment of attention and executive functions was found. Some neuropsychological findings correlate with volume changes in MTL structures. Antiseizure medications therapy could have an impact on the severity of neuropsychological dysfunctions.

Purpose: Healthcare workers (HCWs) are more than others likely to be exposed to a viral overload regardless of the protective equipment and systems. Recent studies have reported that quarantine time is stressful for healthcare workers. We explored the impact of quarantine time as an external stressor on distress, sleep, healthy lifestyle behaviors, and familial relations among HCWs during the COVID-19 pandemic.

Methods: A surgery team (n = 12) were working on a patient with confirmed thyroid cancer. This team was quarantined for 14 days as per the criteria of the local health government after the patient tested positive for COVID-19. We included and interviewed this team through a purposive technique in this qualitative study in Iraqi Kurdistan in 2020. Using the Graneheim and Lundman method, we analyzed the data via thematic content analysis with a deductive approach.

Results: The participants experienced distress with mental health burdens during these difficult times. Some of them had to stay away from their families and friends for the first time. The first and last days were stressful for them due to fear of infection. The HCWs attempted to maintain their healthy lifestyles, including getting sufficient sleep, reducing stress levels, and creating a positive relationship with their families. The HCWs used the following coping strategies to alleviate the effects of COVID-19: beliefs, habits, and familial support. Familial and social support were their main strategies for maintaining a healthy lifestyle. The intensity level of familial and social relations was found to be a positive experience for HCWs during this stressful period.

Conclusions: This study showed that HCWs experienced psychological stress during the quarantine time of the COVID-19 outbreak. The HCWs' quality of sleep was affected adversely along with negative effects on their lifestyles. However, the level of support from familial and social relations increased during the COVID-19 outbreak. This was the major means for them to deal with stress during this difficult time of their lives.

Purpose: Artificial neural networks, "artificial intelligence" or machine learning now dominate a number of areas, making many activities automatic and thus affecting the safety and comfort of life. Neural networks might provide intelligent decisions with limited human assistance. Medicine also uses artificial intelligence, also in models designed to support the therapeutic process. The aim of this article is to define the main directions of development of machine learning applications in supporting the therapeutic processes.

Views: Currently, the literature distinguishes at least a few applications of new technologies of varying degrees of advancement, with machine learning at the forefront [6]. It seems that the researchers are most interested in personalizing notifications of therapeutic applications, modifying therapeutic programs in a manner adapted to the patient's problems, and conducting "intelligent" conversations with them.

Conclusions: There are dangers in using machine learning methods to support the therapeutic process. Particular attention should be paid to ensuring the full privacy of the implemented applications; moreover, selling user data of this type to third parties, such as those that sell certain medications or dietary supplements, would be ethically questionable. There are no legal regulations (or a system of recommendations of relevant scientific societies) that would limit proven applications to support the therapeutic process of a given disorder in the future, and which were created solely for the financial purpose of authors who did not conduct substantive consultations.

Purpose: Varicella-zoster virus (VZV) belongs to the human neurotropic alpha-herpes virus group. VZV reactivation can lead to neurological complications, including transverse myelitis. However, transverse myelitis caused by VZV reactivation is rare in immunocompetent patients. A case of transverse myelitis caused by VZV in an immunocompromised patient is presented in this paper.

Case description: A 64-year-old female patient was admitted to our outpatient clinic with complaints of pain, numbness and loss of strength in her right arm, and decreased sensation of warmth, after suffering from zona zoster infection two weeks before. At that time the patient had shingles in the area covering the C4-T1 dermatomes on her right side and was treated with acyclovir.

Comment: Consequently, patients presenting with similar symptoms after shingles should undergo appropriate imaging and tests, and treatment should be given for shingles-related transverse myelitis.

Purpose: This case report of Tourette syndrome with intellectual disability as a comorbid condition may help us learn more about neuropsychiatric disorders as a comorbid condition. Increased knowledge and a better understanding of the pathophysiology of the disease may help with the management of it.

Case description: We report on a 12-year-old male patient with motor and vocal tics that have been present since the age of 1 and have worsened over time - this is typical for patients with comorbid intellectual disability and behavioral impairment. An MRI of the head showed decreased hippocampal volume. The patient was diagnosed with Tourette syndrome on the basis of his history and a physical exa mination.

Comment: As many as 86-90% of patients with Tourette syndrome have at least one comorbid condition or coexisting neuropsychological problems. Tourette syndrome is diagnosed on the basis of physical symptoms, especially the presence of multiple motor and vocal tics that began before the person was 21 years old. The diagnosis must also be supported by the presence of a comorbid behavioral disorder.

Purpose: Neural networks might be an appropriate solution for the categorization of child sexual abuse materials (CSAM) in forensic cases. The aim of this study was to present a neural network model that may be able to categorize objects and behaviors, which are visible in CSAM, using pictures visually similar to CSAM (AB/DL), involving persons who have paraphilic preferences for watching adult women or men dressed like children or involved in activities typical for children, such as playing.

Methods: The dataset consisted of 2251 photos divided into five classes. 1914 photos were randomly used for the training of the neural network, while 337 photos were used for its later validation. The Fast.ai and PyTorch libraries were used for the training of the neural network using the ResNet152 model. We used five classes, two of which were imported from the sexACT dataset, and three of which that were collected for this study.

Results: The model was able to classify selected classes with a relatively high accuracy (95%); on the other hand, further improvement of the network is needed, considering the fact that the final validation loss was moderate (0.17).

Conclusions: The model presented might be effective in the classification of several objects and behaviors presented in a number of pornography categories ("paraphilic infantilism", "sexual activity", "nude women", "dressed women", "sexual activity - spanking"). As the results are promising, further research on real CSAM is justified.

Purpose: Multiple sclerosis (MS) is a chronic demyelinating disease of the central nervous system in which multifocal damage to the brain and spinal cord occurs. The etiology of MS remains unclear but it is often recognized by researchers as a multifactorial disease that involves autoimmune and genetic predisposition combined with environmental influences (e.g., low vitamin D levels, smoking, obesity). An adequate and balanced diet can be extremely helpful in improving the condition of MS patients, effectively supporting pharmacological therapy. The purpose of the study was to investigate whether, and if so, to what extent, the intake of macronutrients, vitamins, and microelements may affect the course of MS.

Views: The review presents data from studies published between 2017 and 2022.

Conclusions: There are numerous studies on the role of specific dietary components in the treatment of MS, but the results are still limited. More work is needed to define the tools required for the assessment of patients' eating habits because dietary factors can affect the functioning and quality of life of MS patients and should therefore be evaluated to assist in comprehensive treatment and recovery.

Purpose: Menopause is associated with complications that may affect quality of life, such as hot flashes, night sweats, and mood swings. This study aimed to compare the effects of phone versus face-to-face counseling based on cognitive-behavioral therapy (CBT) for vasomotor symptoms in postmenopausal women.

Methods: In this study, 40 eligible postmenopausal women were randomly assigned to face-to-face (n = 20) and phone counseling methods (n = 20). Six counseling sessions were held weekly for each person, and the women were requested to record their hot flashes (HF) and night sweats (NS) in a diary. HF and NS were measured at baseline, and 6 and 8 weeks after the completion of intervention. Data were analyzed using χ2, repeated measures ANCOVA, and independent t-test.

Results: Means of weekly hot flashes and night sweats decreased after intervention in both groups (face-to-face group: HF frequency from 31.92 ± 7.98 to 18.83 ± 7.35, HF severity from 2.24 ± 0.28 to 1.21 ± 0.23, HF duration from 4.22 ± 1.17 min to 2.79 ± 0.91 min, NS frequency from 2.34 ± 0.31 to 1.21 ± 0.24 and NS severity from 1.70 ± 0.34 to 1.03 ± 0.29; and also in the phone counseling group: HF frequency from 33.32 ± 7.77 to 19.53 ± 7.7, HF severity from 2.23 ± 0.24 to 1.20 ± 0.18, HF duration from 4.29 ± 1.23 min to 2.68 ± 0.95 min, NS frequency from 2.33 ± 0.31 to 1.14 ± 0.16 and NS severity from 1.59 ± 0.34 to 1.01 ± 0.30). Although the differences within each group were significant (p < 0.001), there was no significant difference between the groups after the intervention in terms of HF frequency, severity, and duration, as well as NS frequency and severity (p > 0.05).

Conclusions: Face-to-face and phone counseling methods based on CBT had a similar effect on reducing hot flashes and night sweats. Both methods can be used for women with postmenopausal complications such as hot flashes and night sweats.