Indicators of Complex Care During the Consultation-Liaison Psychiatry Activity at the Transplant Center of the Policlinico Hospital, Modena.

OBJECTIVE: The objective of this study was to identify possible biopsychosocial predictors of organizational complexity in patients referred to the consultant psychiatrist for assessment before liver transplantation. METHODS: This was a case-control study. All psychiatric consultations performed before and after liver transplantation from January 1, 2008 to December 31, 2013 were included. Complexity was operationalized as "undergoing two or more psychiatric consultations". Controls were defined as patients who were assessed only once by the consultant. Cases were represented by patients who underwent two or more consultations. Statistical analysis was performed with STATA 13.1, using logistic regressions. RESULTS: In this study, 515 consultations were requested for 309 patients potentially eligible for liver transplantation. Controls were 209 (67.6%); cases were 100 (32.4%). Positive psychiatric history (odds ratio [OR] = 2.44; 95% confidence interval [CI], 1.43-4.16), viral or toxic (alcohol- or drug-related) liver disease (OR = 1.93; 95% CI, 1.09-3.42), use of psychotropic medications at the baseline (OR = 2.15; 95% CI, 1.14-4.07), and female gender (OR = 1.77; 95% CI, 1.01-3.11) were significantly associated with an increased probability of being cases. CONCLUSIONS: Positive psychiatric history, viral or toxic liver disease, use of psychotropic medications at the index referral, and female gender are possible biopsychosocial predictors of complexity in patients eligible for liver transplantation.

Characterization of a PET detector head based on continuous LYSO crystals and monolithic, 64-pixel silicon photomultiplier matrices.

The characterization of a PET detector head based on continuous LYSO crystals and silicon photomultiplier (SiPM) arrays as photodetectors has been carried out for its use in the development of a small animal PET prototype. The detector heads are composed of a continuous crystal and a SiPM matrix with 64 pixels in a common substrate, fabricated specifically for this project. Three crystals of 12 mm × 12 mm × 5 mm size with different types of painting have been tested: white, black and black on the sides but white on the back of the crystal. The best energy resolution, obtained with the white crystal, is 16% FWHM. The detector response is linear up to 1275 keV. Tests with different position determination algorithms have been carried out with the three crystals. The spatial resolution obtained with the center of gravity algorithm is around 0.9 mm FWHM for the three crystals. As expected, the use of this algorithm results in the displacement of the reconstructed position toward the center of the crystal, more pronounced in the case of the white crystal. A maximum likelihood algorithm has been tested that can reconstruct correctly the interaction position of the photons also in the case of the white crystal.