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1.
J Nerv Ment Dis ; 209(1): 71-75, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-33141781

RESUMO

The purpose of this cross-sectional study was to determine the prevalence of intimate partner violence (IPV) among university students, investigate the potential predictors of IPV in this population, and study the link between IPV and depression. The survey included sociodemographic, relationship quality, and depression-related questions. From 498 respondents, the prevalence of IPV was 4.8%, depression was 30.9%, and suicidal ideation was 20.3%. After adjusting for covariates and confounders, relationship satisfaction (odds ratio [OR], 0.201; 95% confidence interval [CI], 0.101-0.401; p < 0.001) and jealousy (OR, 0.270; 95% CI, 0.094-0.776; p = 0.015) were significant predictors of IPV. Relationship satisfaction predicted depressive disorders (OR, 0.504; 95% CI, 0.365-0.698; p < 0.001). IPV trended toward predicting the presence of a depressive disorder (OR, 0.436; 95% CI, 0.170-1.113; p = 0.083). Relationship satisfaction and jealousy predicted IPV. Although IPV did not predict depression, poor relationship satisfaction increased the odds of depression, implicating the influence of relationship satisfaction on both IPV and depression.


Assuntos
Depressão/epidemiologia , Violência por Parceiro Íntimo/estatística & dados numéricos , Estudantes/estatística & dados numéricos , Universidades , Adulto , Estudos Transversais , Feminino , Humanos , Relações Interpessoais , Masculino , Prevalência , Ideação Suicida , Inquéritos e Questionários , Estados Unidos/epidemiologia , Adulto Jovem
2.
J Nerv Ment Dis ; 208(11): 884-889, 2020 11.
Artigo em Inglês | MEDLINE | ID: mdl-33105442

RESUMO

In the university setting, mental disorders have come under greater scrutiny and more attention has been given toward addressing the social stigmas associated with mental illness in an effort to promote mental well-being and improve mental health care delivery on-campus. Depression has been previously linked to a reduction in quality of life, suicidal ideation, and poor academic performance. However, few studies have directly compared the burden of depression or stigmatized views between multiple universities. As a result, this cross-sectional study of university students from five countries was performed to determine the burden of depressive disorders, the stigmatizations of beliefs related to depression, and international variation. A questionnaire consisting of a sociodemographic survey, Patient Health Questionnaire-9 (PHQ-9), and Depression Stigma Scale (DSS) was distributed via multiple routes to undergraduate and graduate students at institutions in the United States, Taiwan, United Arab Emirates, Egypt, and Czech Republic. The point prevalence of depression was determined by using the algorithm scoring method of the PHQ-9. Depression severity was determined according to the summed-item scoring method of the PHQ-9. The degree of stigmatization of beliefs was determined by continuous scores on the DSS subscales for personal and perceived stigma. Differences in depression severity, personal stigma, and perceived stigma were determined according to analysis of variance and further studied using post hoc Tukey's tests. Responses were collected from students in the United States (n = 593), United Arab Emirates (n = 134), Taiwan (n = 217), Egypt (n = 105), and Czech Republic (n = 238). Of 1287 responses, 30.7% (n = 396) screened positive for a depressive disorder: 18.0% (n = 232) for major depressive disorder and 12.7% (n = 164) for another depressive disorder. Depression severity differed internationally (p < 0.001). Emirati students significantly exhibited most depression followed by Czech, American, and Taiwanese students (all ps < 0.001). There was also a difference between students of different countries in terms of personal stigma (p < 0.001), with Emirati students holding more stigmatized personal views than Czech, American, Egyptian, and Taiwanese students (all ps < 0.001). Students similarly demonstrated differences in terms of personal stigma (p < 0.001). Egyptian students exhibited the most perceived stigma followed by Emirati, Taiwanese, American, and Czech students (all ps < 0.001). These findings suggest a high point prevalence of depression among university students and differences in the severity of depression, which has implications for the delivery of mental health care in this population. There were significant differences in terms of personal and perceived stigma between university students, indicating resource allocation for university-based campaigns to reduce depression stigma may need to be tailored to the population. After implementation of stigma reduction programs, future follow-up surveys can be done to compare degrees of stigma before and after the intervention.


Assuntos
Depressão/psicologia , Transtorno Depressivo Maior/psicologia , Estigma Social , Estudantes/psicologia , Adolescente , Depressão/epidemiologia , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Índice de Gravidade de Doença , Inquéritos e Questionários , Universidades , Adulto Jovem
3.
West J Emerg Med ; 21(4): 737-741, 2020 May 20.
Artigo em Inglês | MEDLINE | ID: mdl-32726230

RESUMO

In March 2020, the World Health Organization declared the spread of SARS-CoV-2 a global pandemic. To date, coronavirus disease-2019 (COVID-19) has spread to over 200 countries, leading to over 1.6 million cases and over 99,000 deaths. Given that there is neither a vaccine nor proven treatment for COVID-19, there is currently an urgent need for effective pharmacotherapy. To address the need for an effective treatment of SARS-CoV-2 during the worldwide pandemic, this systematic review of intravenous (IV) remdesivir was performed. Remdesivir, an anti-viral prodrug originally developed to treat Ebola virus disease, has shown broad spectrum activity against the Coronavirus family. A recent case report reported improvement of clinical symptoms with remdesivir in a patient with COVID-19. After conducting a systematic search of 18 clinical trial registries and three large scientific databases, we identified 86 potentially eligible items. Following removal of duplicates (n = 21), eligible studies were reviewed independently by two authors. After the first round of screening, inter-rater agreement was 98.5% (κ = 0.925). After the second round of full-text screening, inter-rater agreement was 100%. A total of seven ongoing and recruiting clinical trials of remdesivir (100-200 milligrams, intravenous [IV]) were included. We identified the following primary outcomes: patients discharged (n = 2); time to clinical status improvement (n = 2); improved O2 saturation (n = 2); body temperature normalization (n = 2); and clinical status (n = 1). Secondary outcomes in all identified studies included documentation of adverse events. Phase 3 trials are expected to be completed between April 2020-2023. Therefore, despite supportive data from in vitro and in vivo studies, the clinical effectiveness of IV remdesivir for treatment of COVID-19 and potential side effects remain incompletely defined in the human population.


Assuntos
Monofosfato de Adenosina/análogos & derivados , Alanina/análogos & derivados , Antivirais/uso terapêutico , Betacoronavirus/efeitos dos fármacos , Infecções por Coronavirus/tratamento farmacológico , Pneumonia Viral/tratamento farmacológico , Monofosfato de Adenosina/administração & dosagem , Monofosfato de Adenosina/uso terapêutico , Administração Intravenosa , Alanina/administração & dosagem , Alanina/uso terapêutico , Antivirais/administração & dosagem , COVID-19 , Ensaios Clínicos como Assunto , Humanos , Pandemias , SARS-CoV-2 , Resultado do Tratamento , Tratamento Farmacológico da COVID-19
5.
J Vasc Interv Radiol ; 31(2): 336-340.e1, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31353192

RESUMO

PURPOSE: To determine the views and current practice preferences of interventional radiologists and allied healthcare providers regarding management of preprocedural anxiety. MATERIALS AND METHODS: From March to April 2018, members of the Society of Interventional Radiology were surveyed regarding their opinions in the assessment and management of patient anxiety. Degree of responsibility for the management of anxiety was also queried through the use of a scale (1 = no responsibility; 2 = some responsibility; 3 = major responsibility). RESULTS: Of 1163 respondents (23.8% response rate), most described preprocedural anxiety as somewhat to very important in their practice (n = 961, 82.6%), somewhat to very important to the patients (n = 1087, 93.5%), and at least sometimes interfering with delivery of care (n = 815, 70.1%). Most respondents did not measure preprocedural anxiety directly (n = 953, 81.9%), but would address it if raised by the patient (n = 911, 82.9%). Patient education (n = 921, 79.1%), medications (n = 801, 68.8%), and therapeutic or empathetic interactions (n = 665, 56.4%) were most preferred to manage anxiety. Radiologists, nurses, patients, primary care providers, family members, and psychologists or psychiatrists were all allocated responsibility to reduce anxiety. CONCLUSIONS: Interventional radiologists and other providers are aware of the importance of preprocedural anxiety. Despite the notion that most radiologists did not address anxiety directly, most indicated a willingness to discuss the issue if raised by patients. Patient education, medications, and several other techniques are preferred to manage preprocedural anxiety. Responsibility to reduce anxiety is perceived to be shared among radiologists, nurses, patients, family members, and other health care providers.


Assuntos
Ansiedade/prevenção & controle , Atitude do Pessoal de Saúde , Conhecimentos, Atitudes e Prática em Saúde , Radiografia Intervencionista/efeitos adversos , Radiologistas/psicologia , Ansiolíticos/uso terapêutico , Ansiedade/diagnóstico , Ansiedade/etiologia , Ansiedade/psicologia , Pesquisas sobre Atenção à Saúde , Humanos , Enfermeiras e Enfermeiros/psicologia , Equipe de Assistência ao Paciente , Educação de Pacientes como Assunto , Médicos de Atenção Primária/psicologia , Radiografia Intervencionista/psicologia , Fatores de Risco
6.
Neurobiol Learn Mem ; 164: 107042, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31326533

RESUMO

Fragile X Syndrome (FXS) is a leading cause of heritable intellectual disability and autism. Humans with FXS show anxiety, sensory hypersensitivity and impaired learning. The mechanisms of learning impairments can be studied in the mouse model of FXS, the Fmr1 KO mouse, using tone-associated fear memory paradigms. Our previous study reported impaired development of parvalbumin (PV) positive interneurons and perineuronal nets (PNN) in the auditory cortex of Fmr1 KO mice. A recent study suggested PNN dynamics in the auditory cortex following tone-shock association is necessary for fear expression. Together these data suggest that abnormal PNN regulation may underlie tone-fear association learning deficits in Fmr1 KO mice. We tested this hypothesis by quantifying PV and PNN expression in the amygdala, hippocampus and auditory cortex of Fmr1 KO mice following fear conditioning. We found impaired tone-associated memory formation in Fmr1 KO mice. This was paralleled by impaired learning-associated regulation of PNNs in the superficial layers of auditory cortex in Fmr1 KO mice. PV cell density decreased in the auditory cortex in response to fear conditioning in both WT and Fmr1 KO mice. Learning-induced increase of PV expression in the CA3 hippocampus was only observed in WT mice. We also found reduced PNN density in the amygdala and auditory cortex of Fmr1 KO mice in all conditions, as well as reduced PNN intensity in CA2 hippocampus. There was a positive correlation between tone-associated memory and PNN density in the amygdala and auditory cortex, consistent with a tone-association deficit. Altogether our studies suggest a link between impaired PV and PNN regulation within specific regions of the fear conditioning circuit and impaired tone memory formation in Fmr1 KO mice.


Assuntos
Tonsila do Cerebelo/fisiologia , Córtex Auditivo/fisiologia , Medo/fisiologia , Proteína do X Frágil da Deficiência Intelectual/fisiologia , Memória/fisiologia , Neurônios/fisiologia , Animais , Condicionamento Clássico , Proteína do X Frágil da Deficiência Intelectual/genética , Interneurônios/fisiologia , Masculino , Camundongos Knockout , Vias Neurais/fisiologia , Parvalbuminas/metabolismo
7.
Clin Spine Surg ; 32(3): 104-110, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30789492

RESUMO

STUDY DESIGN: Meta-analysis. OBJECTIVE: The objective of this study was to determine whether adjunctive intrathecal morphine (ITM) reduces postoperative analgesic consumption following pediatric spine surgery. SUMMARY OF BACKGROUND DATA: Previous studies that have tested supplemental ITM to manage pain after pediatric spine surgery have been limited by small sample sizes. METHODS: A comprehensive search of PubMed, Web of Science, Clinicaltrials.gov, and the Cochrane Central Register of Controlled Trials was performed for clinical trials and observational studies. Time to first analgesic demand, postoperative analgesic use, pain scores, and complication data were abstracted from each study. Mean difference (MD) and 95% confidence interval (CI) were used to compare continuous outcomes and odds ratios (OR) and 95% CI were used for dichotomous outcomes. RESULTS: A total of 5 studies, including 3 randomized controlled trials and 2 retrospective chart reviews, containing 636 subjects, were incorporated into meta-analysis. Subjects that were administered ITM in addition to postoperative analgesics (ITM group) were compared with those receiving postoperative analgesics only (control group). In the ITM group, time to first analgesic demand was longer (MD, 8.79; 95% CI, 4.20-13.37; P<0.001), cumulative analgesic consumption was reduced at 24 hours (MD, -0.40; 95% CI, -0.56 to -0.24; P<0.001), and cumulative analgesic consumption was reduced at 48 hours (MD, -0.43; 95% CI, -0.59 to -0.27; P<0.001). Neither postoperative pain scores at 24 hours (P=0.16) nor 48 hours (P=0.18) were significantly different between ITM and control groups. Rates of respiratory depression, nausea, vomiting, and pruritus were not different between groups (all Ps>0.05). CONCLUSIONS: Addition of ITM in pediatric spine surgery produced a potent analgesic effect in the immediate postoperative period. Patients administered ITM did not request opiates as early as control and consumed fewer opiates by the second postoperative day. Furthermore, use of ITM did not increase complications such as respiratory depression, nausea, vomiting, or pruritus.


Assuntos
Analgésicos Opioides/uso terapêutico , Laminectomia , Morfina/uso terapêutico , Dor Pós-Operatória/prevenção & controle , Analgésicos Opioides/administração & dosagem , Analgésicos Opioides/efeitos adversos , Criança , Humanos , Injeções Espinhais , Morfina/administração & dosagem , Morfina/efeitos adversos , Ensaios Clínicos Controlados Aleatórios como Assunto
8.
Retina ; 39(5): 860-866, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-29346243

RESUMO

PURPOSE: To compare clinical outcomes of combined pars plana vitrectomy (PPV) with anterior chamber intraocular lens (ACIOL) placement versus scleral fixation of a posterior chamber intraocular lens (PCIOL) using Gore-Tex suture. METHODS: Retrospective, interventional case series of eyes undergoing combined PPV and IOL placement for retained lens material, aphakia, or dislocated IOL. Eyes with history of amblyopia, corneal opacity, retinal, or optic nerve disease were excluded. Outcome measures were change in visual acuity and occurrence of postoperative complications with minimum follow-up of 1 year. RESULTS: Sixty-three eyes of 60 patients were identified. Thirty-three eyes underwent combined PPV and ACIOL placement and 30 eyes underwent combined PPV and scleral fixation of a PCIOL using Gore-Tex suture. Mean follow-up was 502 ± 165 days (median 450, range 365-1,095 days). In the ACIOL group, mean visual acuity improved from 20/914 preoperatively to 20/50 postoperatively (P < 0.001). In the scleral-fixated PCIOL group, mean visual acuity improved from 20/677 preoperatively to 20/46 postoperatively (P < 0.001). No difference in visual acuity was noted between groups at 1-year (P = 0.91) or final follow-up (P = 0.62). Regarding postoperative complications, eyes undergoing ACIOL placement had a significantly higher rate of transient corneal edema (30.3 vs. 6.7%, P = 0.02) compared with eyes undergoing scleral fixation of a PCIOL. CONCLUSION: Combined PPV with ACIOL placement or scleral fixation of a PCIOL with Gore-Tex suture were well tolerated. The techniques resulted in similar visual outcomes at minimum follow-up of 1 year.


Assuntos
Câmara Anterior/cirurgia , Afacia Pós-Catarata/cirurgia , Politetrafluoretileno , Esclera/cirurgia , Técnicas de Sutura/instrumentação , Suturas , Vitrectomia/métodos , Idoso , Feminino , Seguimentos , Humanos , Implante de Lente Intraocular/métodos , Masculino , Estudos Retrospectivos , Fatores de Tempo , Acuidade Visual
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