Assessing the Trajectory of Bipolar Disorder Effectively in Order to Treat Effectively.

Accurate diagnosis of mood disorders, particularly depression and bipolar disorder, is essential for effective treatment planning and patient management. This article emphasizes the need for systematic symptom assessment and longitudinal analysis in facilitating the precise diagnosis and planning appropriate treatment interventions. By meticulously evaluating the symptomatology and delineating the longitudinal trajectory of the illness, clinicians can distinguish between unipolar depression and bipolar disorder, and therefore optimise patient outcomes. The article describes the inherent complexities in diagnosing mood disorders. It describes the overlapping symptomatology and diagnostic challenges. Through a comprehensive review of literature and clinical insights, it argues for a structured approach to symptom assessment, focusing on both the current presentation and also retrospective evaluation of illness progression. By elucidating the longitudinal trajectory of the illness, including the presence of episodes of high mood suggestive of bipolar disorder, clinicians can differentiate between mood disorders accurately. The article discusses the implications of accurate diagnosis on treatment planning and patient prognosis. A precise diagnosis enables clinicians to plan treatment strategies to the specific needs of the individual, including pharmacotherapy, psychotherapy, or both. By addressing the underlying mechanisms and trajectory of the illness, clinicians can implement targeted interventions which reduce the risk of misdiagnosis and which optimize therapeutic outcomes.

Rapid Decision Algorithm for Patient Triage during Ebola Outbreaks.

The low specificity of Ebola virus disease clinical signs increases the risk for nosocomial transmission to patients and healthcare workers during outbreaks. Reducing this risk requires identifying patients with a high likelihood of Ebola virus infection. Analyses of retrospective data from patients suspected of having Ebola virus infection identified 13 strong predictors and time from disease onset as constituents of a prediction score for Ebola virus disease. We also noted 4 highly predictive variables that could distinguish patients at high risk for infection, independent of their scores. External validation of this algorithm on retrospective data revealed the probability of infection continuously increased with the score.

Comparison of tear Matrix Metalloproteinase 9 (MMP-9) estimation with Schirmer's test in Ocular Surface Disorders.

Background: Ocular surface disorder (OSD) is a vexed eye problem and a diagnostic conundrum. Diagnosis has traditionally depended upon symptoms and tests like Schirmer's, TBUT, staining with dyes, and tear meniscus height. Schirmer's test is the most popular. However, the test strips irritate with reflex tearing - producing false high results. Matrix Metalloproteinase 9 (MMP) in the tear is believed to be expressed by stressed epithelial cells of the corneal surface - a key pathology in dry eye disease. This study attempts to compare the results of Schirmer's test and MMP-9 so that the test can individually or severally add to a more definite diagnosis of dry eye disease. Materials and methods: 100 eyes of 50 symptomatic patients underwent MMP-9 estimation and were divided into two groups (MMP-9+ve and MMP-9-ve). They were then sub-grouped as per DEWS-2007 based on Schirmer test levels and Ocular Symptomatology Score (OSS). The two groups were compared for severity of dry eye based on Schirmer's test and OSS. Results: Mean Schirmer's value was 12.85 (SD 7.07) for MMP-9+ve and 19.18 (SD 8.94) for MMP-9-ve patients. 80% of patients with severe dry eye and 55.6% of moderate dry eye patients were positive for MMP-9. 85% of the MMP-9 patients had OSS values of 2 or 3. Discussion: A higher OSDI and positive MMP-9 were shown to be correlated in a statistically remarkable way (p<0.001). The OSDI values of 0-12 for 3/44 (6.8%) positive results, 13-22 for 2/8 (25%) positive results, 23-32 for 4/14 (28.6%) positive results, and 33-100 for 13/35 (37.1%) positive results all showed an increase in MMP-9 positivity along with a rise in the subjective severity of the illness. Conclusion: MMP-9 compares well with Schirmer's values and DED categories based on Schirmer's. The result pointed towards the usefulness of this test in diagnosing patients who may have not yet manifested symptoms.

Capgras Syndrome in Dementia: A Systematic Review of Case Studies.

BACKGROUND: In an ageing population, dementia has become an imminent healthcare emergency. Capgras syndrome, the most common delusion of misidentification (DMS), is frequently found alongside dementia. Previous research showed that Capgras syndrome has significant negative effects on people living with dementia and their carers due to its complex presentation and impact on their lives. This qualitative systematic review explores the evidence base of the effective management and treatment of Capgras syndrome in dementia. AIMS: As per our knowledge, this is the first systematic review exploring the symptomatology of Capgras syndrome across different types of dementia. Additionally, it aims to identify the treatments used and their efficacy. METHODS: Four databases (EMBASE, MEDLINE, PsycINFO, and CINHAL) were screened in March, 2023. Twenty-six studies met the inclusion criteria and were included in the review. Thematic analysis was performed to explore and synthesise the qualitative findings of the studies. RESULTS: Three conceptual themes were identified: diagnostic tools, Capgras syndrome symptomatology, and Capgras syndrome treatment. Results showed that Capgras syndrome in dementia is not diagnosed and treated in a standardised manner. Following the pharmacological intervention, 28% of cases showed resolution of symptoms, and another 28% experienced improvement. However, 7% of cases reported worsening symptoms, and 10.7% experienced no change. While some patients had positive outcomes with specific medications, others either did not respond or experienced a deterioration of their condition. CONCLUSION: The results highlight that there is no single treatment approach for Capgras syndrome in people living with dementia. This underscores the need for person-centred care, where treatment is tailored to individual needs. The review also reveals a heavy reliance on antipsychotic medications and a noticeable lack of psychosocial interventions. Given the limited benefits and significant risks associated with antipsychotics, future research should prioritise developing and testing psychosocial approaches. Additionally, establishing standardised diagnostic criteria and consistent outcome measures for Capgras syndrome in dementia is crucial for evaluating treatment effectiveness and improving care.

Which comes first? Comorbidity of depression and anxiety symptoms: A cross-lagged network analysis.

Depression and anxiety significantly impact college students, leading to various negative outcomes. While numerous studies have investigated the relationship between these two conditions, their temporal sequence remains unresolved. Many previous studies have concentrated on broad latent variables, often neglecting the nuanced symptomatology perspective, which may offer deeper insight into the clinical characteristics of these disorders. In this study, we collected questionnaire data from a college in South China using a cluster random sampling method. Data collection occurred over two time points, with the first round completed in November 2022 and May 2023, with a six-month interval. A total of 689 participants successfully completed the questionnaires during both rounds. Employing cross-lagged network analysis from a symptom-focused perspective, this research examines the interactions and predictive relationships between symptoms of depression and anxiety. The findings identified key symptoms-specifically "Irritability", "Guilty" and "Sad mood"- as critical bridging nodes of connection within the depression and anxiety symptom network. Our analysis revealed both bidirectional predictive relationships between certain symptoms nodes of depression and anxiety, as well as unidirectional ones. By highlighting these core nodes and their directional relationships, this study offers valuable insights that can inform targeted intervention and treatment strategies for enhancing mental health among college students.

Differentiating the Structural and Functional Instability of the Craniocervical Junction.

This paper presents the anatomical and biomechanical aspects of chronic instability of the craniocervical junction (CCJ) with a discussion on clinical diagnostics based on mobility tests and provocative tests related to ligamentous system injuries, as well as radiological criteria for CCJ instability. In addition to the structural instability of the CCJ, the hypothesis of its functional form resulting from cervical proprioceptive system (CPS) damage is discussed. Clinical and neurophysiological studies have shown that functional disorders or organic changes in the CPS cause symptoms similar to those of vestibular system diseases: dizziness, nystagmus, and balance disorders. The underlying cause of the functional form of CCJ instability may be the increased activity of mechanoreceptors, leading to "informational noise" which causes vestibular system disorientation. Due to the disharmony of mutual stimulation and the inhibition of impulses between the centers controlling eye movements, the cerebellum, spinal motoneurons, and the vestibular system, inadequate vestibulospinal and vestibulo-ocular reactions occur, manifesting as postural instability, dizziness, and nystagmus. The hyperactivity of craniocervical mechanoreceptors also leads to disturbances in the reflex regulation of postural muscle tone, manifesting as "general instability". Understanding this form of CCJ instability as a distinct clinical entity is important both diagnostically and therapeutically as it requires different management strategies compared to true instability. Chronic CCJ instability significantly impacts the quality of life (QOL) of affected patients, contributing to chronic pain, psychological distress, and functional impairments. Addressing both structural and functional instability is essential for improving patient outcomes and enhancing their overall QOL.

Myocarditis - A silent killer in athletes: Comparative analysis on the evidence before and after COVID-19 pandemic.

Myocarditis is a rare cardiomyocyte inflammatory process, typically caused by viruses, with potentially devastating cardiac sequalae in both competitive athletes and in the general population. Investigation into myocarditis prevalence in the Coronavirus disease 2019 (COVID-19) era suggests that infection with Severe acute respiratory syndrome coronavirus (SARS-CoV-2) is an independent risk factor for myocarditis, which is confirmed mainly through cardiovascular magnetic resonance imaging. Recent studies indicated that athletes have a decreased risk of myocarditis after recent COVID-19 infection compared to the general population. However, given the unique nature of competitive athletics with their frequent participation in high-intensity exercise, athletes possess distinct factors of susceptibility for the development of myocarditis and its subsequent severe cardiac complications (e.g., sudden cardiac death, fulminant heart failure, etc.). Under this context, this review focuses on comparing myocarditis in athletes versus non-athletes, owing special attention to the distinct clinical presentations and outcomes of myocarditis caused by different viral pathogens such as cytomegalovirus, Epstein-Barr virus, human herpesvirus-6, human immunodeficiency virus, and Parvovirus B19, both before and after the COVID-19 pandemic, as compared with SARS-CoV-2. By illustrating distinct clinical presentations and outcomes of myocarditis in athletes versus non-athletes, we also highlight the critical importance of early detection, vigilant monitoring, and effective management of viral and non-viral myocarditis in athletes and the necessity for further optimization of the return-to-play guidelines for athletes in the COVID-19 era, in order to minimize the risks for the rare but devastating cardiac fatality.

A cross-sectional study on the quality of life of women with endometriosis in Trinidad and Tobago.

Introduction: Endometriosis is a chronic gynecological condition that lacks a definitive cure and adversely impacts the quality of life (QoL) of those affected. This study delves into the experiences of individuals with endometriosis in Trinidad and Tobago, focusing on their quality of life, pain severity, and acceptance of illness. Methods: Surveys were distributed among 160 members of the Trinidad and Tobago Endometriosis Association. The survey instrument utilized was the WHOQOL-BREF, which measures QoL, pain severity, and acceptance of illness [the Acceptance of Illness Scale (AIS)]. Results: The average age of respondents was 38.65 years. Quality of life scores averaged 3.41, with the "environment" aspect scoring highest (12.84) and "social relationships" scoring lowest (11.88). Cronbach's alpha indicated excellent internal consistency for "environment" (ɑ = 0.909) and the "AIS" (ɑ = 0.882). The independent samples t-test revealed lower mean QoL scores for unemployed participants. Analysis of variance revealed significant differences in mean QoL scores for "health status" and "years since endometriosis diagnosis." All the QoL domains were positively correlated with each other. There were moderate positive correlations between the physical health and social relationships domains (ρ = 0.558). All other domains were strongly correlated with each other (0.6 < ρ < 0.8). Pain intensity and acceptance of illness had mean scores of 24.15 and 6.57, respectively. Variations in quality of life were observed for health status and duration since diagnosis, impacting mostly on the domain of physical health. Acceptance of illness emerged as a significant influencer of overall quality of life, assisting individuals in navigating the challenges posed by endometriosis. Discussion: The findings underscore the importance of understanding determinants, such as pain severity to improve care and support for those with endometriosis. Exploring acceptance of illness is critical in improving the quality of life of these individuals, highlighting the need for tailored interventions that encompass psychological and social support alongside medical treatment. This study demonstrates the pivotal role of acceptance of illness in the overall quality of life of endometriosis patients. Improving the quality of care requires a comprehensive understanding of the factors influencing quality of life, particularly pain severity and the need for a holistic approach to support individuals grappling with endometriosis.

Short-term and Long-term Stability of the Autism Diagnostic Observation Schedule (ADOS-2) Calibrated Comparison Scores (CCS) and Classification Scores in Youth with Down Syndrome or Fragile X Syndrome with Intellectual Disability.

Autism diagnosis in individuals with fragile X syndrome (FXS) or Down syndrome (DS) with co-occurring intellectual disability is complex since clinicians often must consider other co-occurring behavioral features. Understanding how best to assess the features of autism in individuals with these conditions is crucial. In this study, we consider the short-term and long-term psychometric consistency of the Autism Diagnostic Observation Schedule-2 (ADOS-2) calibrated comparison scores (CCSs) and ASD classifications in individuals with FXS or DS. 76 individuals with DS (39 males; Mage = 15.27) and 90 individuals with FXS (71 males; Mage = 14.52 years) completed an assessment battery (ADOS-2, abbreviated IQ assessment and semi-structured language sample) at three timepoints (initial visit, short-term stability visit, long-term stability visit). All CCSs were found to have short-and long-term consistency for both groups, with lowest reliability scores for the repetitive behaviors (RRB) CCSs. Decreased reliability of RRB CCSs was found in the DS group than the FXS group. Variable short- and long-term ASD classifications were observed in both groups, with significantly higher variability in the DS group. Across groups, participants with variable classifications had lower ADOS-2 CCSs and higher language scores than those with stable ASD classifications. In the FXS group, those with variable classifications earned higher cognitive scores than did participants with stable ASD classifications. These findings highlight the high incidence of autism symptomatology in individuals with DS or FXS and co-occurring intellectual disability, while elucidating the short- and long-term variability of symptom expression in the context of structured observational tasks such as the ADOS-2.

Physical and Psychological Symptomatology, Co-Parenting, and Emotion Socialization in High-Conflict Divorces: A Profile Analysis.

Although the consequences of divorce and conflict have been extensively studied, most research has focused on children rather than ex-spouses, although variables such as parental health or co-parenting may have an influence on children's development through processes such as emotion socialization. In addition, the relationship between these variables has never been considered in high-conflict divorces. Therefore, the present study aimed to analyze the impact of physical and psychological symptomatology and co-parenting on the emotion socialization patterns of parents experiencing high-conflict divorces. Furthermore, the moderating role of resilience was considered, as it has been highly studied as a coping mechanism in adverse situations but barely in divorce at the parental level. For this purpose, a Latent Profile Analysis was carried out with Mplus 8.10, using a sample of 239 parents from Family Visitation Centers. Results revealed, on the one hand, that parents with fewer physical and psychological symptoms sowed more emotion socialization behaviors than those with more symptomatology. On the other hand, in situations of high interparental conflict, the role of co-parenting and resilience seems less relevant than that of physical and psychological symptomatology when analyzing parental skills like emotion socialization.

The multiple mediation model of social support and postpartum anxiety symptomatology: the role of resilience, postpartum stress, and sleep problems.

OBJECTIVE: This study aimed to assess the prevalence of postpartum anxiety and the factors influencing it, while also exploring the multiple mediating roles of related factors between social support and postpartum anxiety symptomatology among postpartum women in China. METHODS: Between April and August 2023, we recruited a total of 824 postpartum women through a convenience sampling method. These participants completed a series of general survey questionnaires and were evaluated using the depression anxiety stress scale, perceived social support scale, 10-item Connor-Davidson resilience scale, maternal postpartum stress scale, and Pittsburgh sleep quality index. Additionally, we employed a hierarchical multiple regression model to investigate the relevant factors and mediators of postpartum anxiety symptomatology. A structural equation model was used to examine the mediating role of resilience, postpartum stress, and sleep problems in the relationship between social support and postpartum anxiety symptomatology. RESULTS: Our study found a postpartum anxiety symptomatology prevalence rate of 18.40%. The factors influencing postpartum anxiety symptomatology included age, education of their husband, mastitis, social support, resilience, postpartum stress, and sleep problems. Through a multiple mediation analysis, we found that resilience, postpartum stress, and sleep problems completely mediated the effects of social support on postpartum anxiety symptomatology, with the mediating effect accounting for 83.57% of the total effect. CONCLUSION: The multiple mediation analysis revealed that among postpartum women, the impact of social support on postpartum anxiety symptomatology is channeled through resilience, postpartum stress, and sleep problems. Therefore, enhancing social support, resilience, postpartum stress, and sleep problems might alleviate postpartum anxiety symptomatology.

Head and neck paragangliomas: Recent advances in translational and clinical research and guidelines for patient care.

Head and neck paragangliomas (HNPGLs), rare neuroendocrine tumors that mainly arise from parasympathetic ganglia along the cranial nerves, are challenging due to anatomic origin, tendency to aggressive neurovascular and skull base infiltration, unpredictable metastatic potential, radio-chemoresistance, and risk of multiplicity. Symptoms range from mild to life threatening depending on location/size, but rarely relate to catecholamine excess. Risk factors include female sex and pathogenic germline variants in genes affecting hypoxia signaling (foremost succinate dehydrogenase genes). Diagnostic work-up relies on imaging, measurements of plasma free metanephrines/methoxytyramine, genetic testing, and pathology/immunohistochemistry. Management is tailored to patient/tumor characteristics and encompasses wait-scan, upfront surgery, debulking surgery, and radiotherapy. Presurgical embolization is recommended, except for small tympanic and tympanomasoid tumors. Presurgical stenting is required for internal carotid artery involvement, and two-stage surgery for intradural extension. Current treatments for metastatic/inoperable HNPGL are non-curative, and long-term follow-up should be recommended for all patients to monitor local recurrence and new tumors.

Lawyer-client relationship in divorce proceedings: development and validation of a new instrument.

Introduction: This study is based on the paradigm of collaborative law and the current absence of instruments that evaluate the lawyer-client relationship as a function of the needs of the family system. The objective was to construct and validate an instrument, conceptualizing the lawyer-client relationship as a helping relationship. Method: Two groups of experts and 239 parents (58% mothers and 42% fathers), users of Family Visitation Centers, participated in the study. The content, construct, and criterion validity of the instrument, as well as its invariance for both parents, were analyzed. Results: The resulting 12-item instrument has been shown to have a two-dimensional structure, invariant for both parents, with high psychometric solidity. Discussion: The LCR scale seems to be a valuable and effective measure for use in a legal context, with important correlations with the parents' psychological well-being, leading to a promising and relevant instrument for the holistic approach to the divorce process.

Subjective and objective measures of cognitive function are correlated in persons with Post-COVID-19 Condition: a secondary analysis of a Randomized Controlled Trial.

BACKGROUND: It remains unclear whether subjective and objective measures of cognitive function in Post COVID-19 Condition (PCC) are correlated. The extent of correlation has mechanistic and clinical implications. METHODS: This post-hoc analysis of a randomized, double-blind, placebo-controlled clinical trial contains baseline data of subjective and objective measures of cognition in a rigorously characterized cohort living with PCC. Herein, we evaluated the association between subjective and objective condition function, as measured by the Perceived Deficits Questionnaire, 20-item (PDQ-20) and the Digit Symbol Substitution Test (DSST) and Trails Making Test (TMT)-A/B, respectively. RESULTS: A total of 152 participants comprised the baseline sample. Due to missing data, our statistical analyses included 150 for self-reported PDQ-20, 147 individuals for combined DSST-measured cognitive function (composite z-score of the Pen/Paper plus Online CogState Version, NcombinedDSST), 71 for in-person DSST-measured cognitive function (Pen/Paper Version), 70 for TMT-A-measured cognitive function, and 70 for TMT-B-measured cognitive function. After adjusting for age, sex, and education, PDQ-20 was significantly correlated with pen-and-paper DSST (ß = -0.003, p = 0.002) and TMT-B (ß = 0.003, p = 0.008) scores, but not with TMT-A scores (ß = -0.001, p = 0.751). CONCLUSIONS: Overall, a statistically significant correlation was observed between subjective and objective cognitive functions. Clinicians providing care for individuals with PCC who have subjective cognitive function complaints may consider taking a measurement-based approach to cognition at the point of care that focuses exclusively on patient-reported measures.

Symptoms of Post-Traumatic Stress and Mental Health in a Sample of University Students: The Mediating Role of Resilience and Psychological Well-Being.

The COVID-19 pandemic has been one of the most stressful events in recent times across the world. The long-term effect of these experiences raises several concerns, including the development of post-traumatic stress symptomatology. However, little is known about the psychological processes that mediate this association. The aim of this study was to explore the association of emotional exhaustion and anxiety in post-traumatic stress symptomatology, and the mediating role of resilience and psychological well-being in university students. A total of 526 university students of both sexes participated in this study, and they were aged between 17 and 62 years old. Symptoms of anxiety and emotional exhaustion were significantly higher in females, in contrast, males showed on average more resilience and psychological well-being. Additionally, participants with COVID-19 infection had higher levels of emotional exhaustion, anxiety, and PTSD. The results indicated that the variables were correlated with each other (p < 0.001). A conceptual model was confirmed that describes anxiety and emotional exhaustion as predictors, post-traumatic stress symptomatology as an outcome variable, and resilience and psychological well-being as mediators. Resilience and psychological well-being can be important protective factors for adaptive responses in stressful situations. The findings obtained in this study will provide a theoretical basis for designing targeted interventions to improve psychological health, whether for crisis intervention, the process of adapting to higher education, or for recovery plans from psychological trauma.

Effects of a Brief Safe Drinking Intervention on Depressive and Anxiety Symptomatology: Examining Potential Side Effects of Deviance Regulation Theory Interventions.

College students are at a heightened risk of experiencing depression and anxiety symptomatology and engaging in maladaptive alcohol use. Understanding how alcohol interventions impact emotional functioning is essential. One such intervention uses Deviance Regulation Theory (DRT), which posits that behavior can be modified using targeted messaging as a function of perceived norms. DRT has been shown to be effective at increasing responsible drinking behaviors and decreasing alcohol-related consequences. However, it is unclear if this intervention influences emotional functioning. The current examines the impact of a DRT intervention on emotional functioning. Participants (n = 147) were recruited from a large Southeastern university. The study included a screening phase, intervention, and six-week follow-up. Participants were randomly assigned to one of three conditions: a positive message condition about people who drink responsibly, a negative message condition about people who do not drink responsibly, and an active control condition. During the study, all participants reported on depression/anxiety symptoms, alcohol use, responsible drinking, and alcohol-related consequences. Mixed-effects regression was used to analyze the data. Results suggest an overall reduction of depressive and anxiety symptomatology in the intervention conditions but not in the control condition. In the positive condition, there was a decrease in depressive and anxiety symptomatology. The messaging was not moderated by normative beliefs. The negative condition also led to decreases in depression and anxiety symptomatology over time. In addition, perceived norms moderated the negative message in the first week after the intervention, an effect consistent with DRT. Prior research indicates this intervention is efficacious for the reduction of adverse alcohol outcomes; these data show that the intervention may also have positive effects on downstream mental health outcomes.

Implications of Butyrate Signaling Pathways on the Motor Symptomatology of Parkinson's Disease and Neuroprotective Effects-Therapeutic Approaches: A Systematic Review.

Parkinson's Disease (PD) is a prevalent neurodegenerative disorder characterized by motor and non-motor symptoms. Emerging evidence suggests that gut microbiota alterations, specifically involving short-chain fatty acids (SCFAs) like butyrate, may influence PD pathogenesis and symptomatology. This Systematic Review aims to synthesize current research on the role of butyrate in modulating motor symptoms and its neuroprotective effects in PD, providing insights into potential therapeutic approaches. A systematic literature search was conducted in April 2024 across databases, including ScienceDirect, Scopus, Wiley, and Web of Science, for studies published between 2000 and 2024. Keywords used were "neuroprotective effects AND butyrate AND (Parkinson disease OR motor symptoms)". Four authors independently screened titles, abstracts, and full texts, applying inclusion criteria focused on studies investigating butyrate regulation and PD motor symptoms. A total of 1377 articles were identified, with 40 selected for full-text review and 14 studies meeting the inclusion criteria. Data extraction was performed on the study population, PD models, methodology, intervention details, and outcomes. Quality assessment using the SYRCLE RoB tool highlighted variability in study quality, with some biases noted in allocation concealment and blinding. Findings indicate that butyrate regulation has a significant impact on improving motor symptoms and offers neuroprotective benefits in PD models. The therapeutic modulation of gut microbiota to enhance butyrate levels presents a promising strategy for PD symptom management.

Substance use and adolescent mental health during the COVID-19 pandemic in Brazil: a longitudinal approach

Abstract Objective: To describe the changes in alcohol and drug use by Brazilian adolescents during the COVID-19 pandemic (April-August 2021), and to analyze the relationship between alcohol use changes and psychiatric symptomatology. Methods: A secondary analysis with a longitudinal approach was performed with data from a cluster-randomized controlled trial, conductedin73publicmiddleschoolsinthreeBrazilian cities, to evaluate the effectiveness of a drug use prevention program. The sample included 535 students (61% girls; Mage = 15.2 years). Data were collected pre-intervention (February-March 2019), after 9 months (November-December 2019), and after 26 months (April-August 2021), when the students were in their first year of high school. The authors analyzed drug use prevalence (alcohol, binge drinking, tobacco, inhalants, marijuana, cocaine, and crack) in a lifetime, past year, and past month periods, and the association between alcohol use change subsamples with psychiatric symptoms. Logistic regressions were adjusted by sex, age, socioeconomic status, city, and group (control and intervention). Results: The present findings suggest that the COVID-19 pandemic led to a decrease in past-year substance use and in past-month substance use frequency, despite the gradually increased (but decelerating) prevalence of lifetime use. However, some adolescents initiated, maintained, or increased the frequency of their alcohol use. Mainly, they were more likely to present behavioral problems, as well as symptoms of inattentive hyperactivity, and peer and emotional problems. Conclusions: Despite the extensive decline in substance use during the pandemic period, these results suggest an association between previous mental health conditions and behavioral risk factors, leading to increased alcohol consumption and behavioral disorders manifestations.

Deslizamiento en céntrica y la prevalencia de ruido y/o sintomatología mioarticular de las ATM. Estudio descriptivo

Introducción. El deslizamiento en céntrica (DC) y su incidencia en la sintomatología mioarticular ha sido un tema ampliamente estudiado, sin embargo, aún no está clara la relación entre ambos fenómenos. Objetivo. Evaluar la relación entre el DC y la prevalencia de ruido y/o sintomatología mioarticular de las articulaciones temporomandibulares en una muestra de pacientes. Material y Método. Se analizó una muestra de 183 modelos de estudio con dentición permanente completa excluyendo terceros molares. Se midió el DC en sentido sagital, vertical y transversal. Se recopilaron los datos del examen funcional de cada paciente para registrar las variables ruido y sintomatología mioarticular. Resultados. La magnitud del DC en los sentidos sagital, vertical y transversal está relacionada significativamente (p<0,05) con la presencia de ruido articular. El DC como variable dicotómica está relacionado significativamente, en sentido vertical, con la presencia de sintomatología mioarticular de las articulaciones temporomandibulares. El DC como magnitud y como variable dicotómica, en los sentidos sagital y transversal, están relacionados significativamente con la presencia de ruido y sintomatología mioarticular. Conclusión. Los pacientes que presentan DC con valores superiores a los normales presentan algún tipo de ruido y/o sintomatología mioarticular.

Introduction. Centric slide (CS) and its incidence in myoarticular symptoms have been widely studied: However, the relationship between both phenomena is still unclear. Objective. To evaluate the relationship between CS and the prevalence of noise and/or myoarticular symptoms of the temporomandibular joints in a sample of patients. Material and method. A sample of 183 study models with complete permanent dentition, excluding third molars, was analyzed. CS was measured in the sagittal, vertical, and transverse directions. Data from the functional examination of each patient were collected to record the "noise" and "myoarticular symptoms" variables. Results. The magnitude of CS in the sagittal, vertical, and transverse directions is significantly (p<0.05) related to the presence of joint noise. CS as a dichotomous variable is significantly related, vertically, to the presence of myoarticular symptoms of the temporomandibular joints. As a magnitude and as a dichotomous variable in the sagittal and transverse directions, CS is significantly related to the presence of noise and myoarticular symptoms. Conclusion. Patients with CS values ​​higher than normal present some type of noise and/or myoarticular symptoms.

The influence of body image on psychological symptomatology in breast cancer women undergoing intervention: a pre-post study.

Introduction: Body image concerns related to breast cancer surgery may challenge patients' quality of life and their treatment outcomes, thus representing a key aspect to be assessed in the psycho-oncological settings. The present longitudinal study is aimed to (1) investigate the association between preoperative body image and postoperative psychological symptoms in breast cancer patients; (2) explore the impact of pre-/post-surgery variation in body image on psychological symptomatology. Methods: N = 72 women undergoing breast cancer surgery were preoperatively screened (T1) using the Body Uneasiness Test (BUT) and were assessed postoperatively (T2) using the Symptom Checklist-90 Revised (SCL-90-R) and re-administered the BUT. Spearman's correlation was used to investigate the relationship between age, preoperative body image and postoperative psychological symptoms, and variation in body image. To predict post-surgical psychological symptomatology, two separated multiple regression models were used to evaluate preoperative body image and its variation after surgery controlling for covariates (i.e., education; intervention type). P significance was set as 0.05 for all analyses and adjusted for multiple comparisons. Results: At T1, anxiety in relation to body image scores emerged as the most frequently experienced psychological symptomatology after surgery (all adjusted p < 0.05). Significant correlations were observed between all SCL-90-R scores at T2 and avoidance behaviors and depersonalization scores at T1. The associations were most significantly strong for somatization, depression, anxiety, and hostility (all adjusted p < 0.05). However, change in body image between pre- and post-intervention was not associated with psychological symptomatology at T2 (all adjusted p > 0.05). Pre-surgery body avoidance was significantly associated with post-intervention psychological symptoms (SOMß = 0.453, p = 0.0001; DEPß = 0.507, p = 0.0001; AXß = 0.459, p = 0.0001; HOSß = 0.410, p=. 0001). However, increased weight phobia between pre- and post-surgery was statistically associated with increased somatization, anxiety, depression and hostility at T2 (ßSOM = 0.439, p = 0.0001; ßDEP = 0.454, p = 0.0001; ßANX = 0.471, p = 0.0001). Discussion: Overall, pre-/post-intervention body concerns were significantly associated with primary psychological symptoms in breast cancer patients undergoing surgery. Higher levels of body avoidance and weight phobia were significantly associated with the primary psychological dimensions assessed. As body concerns might act as quality-of-life predictors, their evaluation is crucial in fostering patients' well-being and treatment adherence.