[Detection of disorders of the chemical senses-assessment of state of health by those affected]. / Erfassung von Störungen der chemischen Sinne ­ Einschätzung des Gesundheitszustands durch Betroffene.

Although hundreds of thousands of people seek medical help every year because of smell and taste disorders, the burden on patients is often underestimated by health care professionals. Numerous studies have demonstrated the impact of disorders of the chemical senses on quality of life. In clinical practice, the Questionnaire of Olfactory Disorders (QOD) has proven to be a good measure of the impact of olfactory loss on everyday life. Patient-reported outcome measures (PROMs) should therefore be used more frequently for better recording and assessing the needs of patients. In addition to education and treatment by specialized clinics, the provision and optimization of information platforms, support groups, and organizations should be promoted in Germany.

Incidence of diabetes in HIV-infected patients treated with first-line integrase strand transfer inhibitors: a French multicentre retrospective study.

BACKGROUND: Integrase strand transfer inhibitors (INSTIs) are increasingly used in patients living with HIV due to their safety, effectiveness and high genetic barrier. However, an association with weight gain has recently been suggested and several cases of diabetes mellitus have been reported with raltegravir and dolutegravir. The long-time metabolic impact of these recent molecules remains unclear. OBJECTIVES: To assess if an INSTI as a third agent is statistically associated with new-onset diabetes mellitus compared with an NNRTI or a PI. PATIENTS AND METHODS: Patients undergoing first-line combined ART (cART) without diabetes at baseline were retrospectively included from the Dat'AIDS French cohort study (ClinicalTrials.gov NCT02898987). Incident diabetes mellitus was defined as a notification of new diabetes in the medical history, a glycated haemoglobin (HbA1c) level superior to 7.5% or the start of a diabetes therapy following the initiation of ART. RESULTS: From 2009 to 2017, 19 462 patients were included, among which 265 cases of diabetes mellitus occurred. Multivariate and survival analyses did not highlight an increase in new-onset diabetes in patients undergoing cART with an INSTI as a third agent compared with an NNRTI or a PI. BMI >30 kg/m2, age >37 years old (in survival analysis), black race or Hispanic ethnicity, arterial hypertension and AIDS were associated with a higher proportion of incident diabetes. CONCLUSIONS: INSTIs were not statistically associated with new-onset diabetes. However, clinicians should remain aware of this possible metabolic comorbidity, particularly in patients with a high BMI and older patients.

Pharmacological profile, phase I metabolism, and excretion time profile of the new synthetic cathinone 3,4-Pr-PipVP.

1-(2,3-Dihydro-1H-inden-5-yl)-2-(piperidin-1-yl)pentan-1-one (3,4-Pr-PipVP), a novel synthetic cathinone (SCat), was first identified in 2022 in Germany. The product was marketed as 1-(bicyclo[4.2.0]octa-1,3,5-trien-3-yl)-2-(pyrrolidin-1-yl)pentan-1-one (3,4-EtPV), a substance not covered by the German New Psychoactive Substances Act (NpSG). Although originally intended to be an exploratory new synthetic cathinone containing the novel bicyclo[4.2.0]octatrienyl function, the compound was subsequently confirmed to contain an indanyl ring system scheduled under generic legislation like the NpSG. However, it is one of only a few marketed SCats carrying a piperidine ring. Inhibition experiments involving norepinephrine, dopamine, and serotonin transporters showed that 3,4-Pr-PipVP was a low potency blocker at all three monoamine transporters compared to related substances such as MDPV. Additionally, pharmacokinetic data were collected from pooled human liver microsomes incubations and from the analysis of authentic urine samples received after oral administration of 5 mg 3,4-Pr-PipVP hydrochloride. Phase I metabolites were tentatively identified in vitro and in vivo using liquid chromatography-time-of-flight mass spectrometry. Main metabolites were formed by metabolic reduction of the carbonyl function with and without additional hydroxylations at the propylene bridge of the molecule. Keto-reduced H2 -3,4-Pr-PipVP and H2 -piperidine-OH-3,4-Pr-PipVP as well as aryl-OH-3,4-Pr-PipVP, and indanyl-OH-piperidine-OH-3,4-Pr-PipVP are suggested as most suitable biomarkers for the detection of 3,4-Pr-PipVP since they were detected for much longer than the parent compound. 3,4-Pr-PipVP could be detected for up to 21 h whereas its metabolites were detectable for up to about 4 days.

Symptoms of depression and post-traumatic stress in a group of lightning strike victims.

INTRODUCTION: Lightning strike victims often suffer repercussions. Although a lightning strike constitutes a severe traumatic event, there is a lack of data about potential psychological sequelae. This is precisely the context in which we assessed the prevalence of Post-Traumatic Stress Disorder (PTSD) and Major Depressive Episode (MDE) in a group of lightning strike victims. METHODS: The symptoms of peritraumatic dissociation were evaluated on the basis of the Peritraumatic Dissociative Experiences Questionnaire (PDEQ) whilst the Peritraumatic Distress Inventory (PDI) was used to assess symptoms of distress. PTSD and MDE diagnoses were evaluated using the MINI (Mini International Neuropsychiatric Interview). Symptom intensity was assessed using the self-report PTSD Checklist-Specific (PCLS) and the Beck Depression Inventory II (BDI II), respectively. RESULTS: Forty-nine patients were enrolled in the study. As regards symptoms of depression, 28 patients (57.1%) reported a major depressive episode (MINI) including 10 (20.4%) of moderate intensity and 5 (10.2%) of severe intensity (BDI). In terms of PTSD symptoms, 13 patients (26.5%) reported probable PTSD (MINI) with a PCL-S score ≥ 45. A significant correlation was established between PDEQ and BDI II (Spearman correlation coefficient = 0.36, p = .012). A significant correlation was also found between PDI and PCLS (Spearman correlation coefficient = 0.43, p = .002). A further significant correlation was noted between PDEQ and PCLS (Spearman correlation coefficient = 0.31, p = .028). DISCUSSION: This study highlights the need for a multidisciplinary evaluation of lightning strike victims. Indeed, the prevalence of psychiatric disorders such as PTSD and MDE appears to be significant.