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Benedict, Alice R., and Michael J. Saks. "The Regulation of Professional Behavior: Electroconvulsive Therapy in Massachusetts." Journal of Psychiatry & Law 15, no. 2 (June 1987): 247–75. http://dx.doi.org/10.1177/009318538701500207.
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This study concerned the regulation of professional behavior. Several sources of regulation were examined to see if and how they succeeded in directing psychiatrists' administration of electroconvulsive therapy (ECT). Archival data from the Massachusetts Department of Mental Health were used to compare professional behavior with scientific evidence and professional consensus in four areas of ECT administration. Results show that approximately 90% of ECT patients received treatment inappropriately, suggesting that the regulation of ECT administration is ineffective. A survey of psychiatrists suggests that some forms of regulation have not been implemented while those regulations which do exist convey little information to inform the behavior of psychiatrists and are, consequently, ineffective. Psychiatrists' behavior was, however, related to their attention to the medical literature.
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Tumpney, Matthew, Betsey John, Nivedha Panneer, R. Paul McClung, Ellsworth M. Campbell, Kathleen Roosevelt, Alfred DeMaria, et al. "Human Immunodeficiency Virus (HIV) Outbreak Investigation Among Persons Who Inject Drugs in Massachusetts Enhanced by HIV Sequence Data." Journal of Infectious Diseases 222, Supplement_5 (September 2, 2020): S259—S267. http://dx.doi.org/10.1093/infdis/jiaa053.
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Abstract Background The Massachusetts Department of Public Health and the Centers for Disease Control and Prevention collaborated to characterize a human immunodeficiency virus (HIV) outbreak in northeastern Massachusetts and prevent further transmission. We determined the contributions of HIV sequence data to defining the outbreak. Methods Human immunodeficiency virus surveillance and partner services data were analyzed to understand social and molecular links within the outbreak. Cases were defined as HIV infections diagnosed during 2015–2018 among people who inject drugs with connections to northeastern Massachusetts or HIV infections among other persons named as partners of a case or whose HIV polymerase sequence linked to another case, regardless of diagnosis date or geography. Results Of 184 cases, 65 (35%) were first identified as part of the outbreak through molecular analysis. Twenty-nine cases outside of northeastern Massachusetts were molecularly linked to the outbreak. Large molecular clusters (75, 28, and 11 persons) were identified. Among 161 named partners, 106 had HIV; of those, 40 (38%) diagnoses occurred through partner services. Conclusions Human immunodeficiency virus sequence data increased the case count by 55% and expanded the geographic scope of the outbreak. Human immunodeficiency virus sequence and partner services data each identified cases that the other method would not have, maximizing prevention and care opportunities for HIV-infected persons and their partners.
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Pearlmutter, Mark D., Kristin H. Dwyer, Laura G. Burke, Niels Rathlev, Louise Maranda, and Greg Volturo. "Analysis of Emergency Department Length of Stay for Mental Health Patients at Ten Massachusetts Emergency Departments." Annals of Emergency Medicine 70, no. 2 (August 2017): 193–202. http://dx.doi.org/10.1016/j.annemergmed.2016.10.005.
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PERUSKI, A. H., P. KLUDT, R. S. PATEL, and A. DeMARIA. "Secular trends in invasive meningococcal disease, Massachusetts, 1988–2011: what happened to invasive disease?" Epidemiology and Infection 142, no. 12 (February 19, 2014): 2483–90. http://dx.doi.org/10.1017/s0950268814000259.
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SUMMARYInvasive meningococcal disease (IMD) reported to the Massachusetts Department of Public Health from 1988 to 2011 was reviewed. The average annual incidence of IMD/100 000 decreased from 1·57 [95% confidence interval (CI) 1·42–1·73] for 1988–1991 to 0·22 (95% CI 0·17–0·29) for 2008–2011. The pattern of decreasing incidence over time differed by age group. There was a decrease in IMD/100 000 in the 0–4 years age group after 1991 from 10·92 (95% CI 8·08–14·70) in 1991 to 5·76 (95% CI 3·78–8·72) in 1992. Incidence in the 0–4 years age group remained below 5/100 000 per year on average thereafter. A substantial reduction in incidence in all age groups was observed between 2000 and 2009, which began before the introduction of conjugate meningococcal vaccine in 2005. Marked reductions in incidence of IMD in Massachusetts, and elsewhere, deserve further investigation with respect to potential factors that go beyond the introduction and deployment of improved meningococcal vaccines.
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Mitra, Monika, Ilhom Akobirshoev, Susan L. Parish, Anne Valentine, Karen M. Clements, and Tiffany A. Moore Simas. "Postpartum emergency department use among women with intellectual and developmental disabilities: a retrospective cohort study." Journal of Epidemiology and Community Health 73, no. 6 (February 22, 2019): 557–63. http://dx.doi.org/10.1136/jech-2018-211589.
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BackgroundAn emerging body of evidence underscores the often-intensive perinatal healthcare needs of women with intellectual and developmental disabilities (IDD). However, population-based research examining postpartum experiences of US women with IDD is sparse. We examined emergency department (ED) use in the postpartum period among Massachusetts mothers with IDD.MethodsWe analysed 2002–2010 Massachusetts Pregnancy to Early Life Longitudinal data to compare any and ≥2 ED visits between mothers with and without IDD: within 1–42 days post partum, 1–90 days post partum and 1–365 days post partum. We also determined whether or not such ED use was non-urgent or primary-care sensitive.ResultsWe identified 776 births in women with IDD and 595 688 births in women without IDD. Across all three postpartum periods, women with IDD were vastly more likely to have any postpartum ED use, to have ≥2 ED visits and to have ED visits for mental health reasons. These findings persisted after controlling for numerous sociodemographic and clinical characteristics. Women with IDD were less likely to have non-urgent ED visits during the three postpartum periods and they were less likely to have primary-care sensitive ED visits during the postpartum period.ConclusionThese findings contribute to the emerging research on perinatal health and healthcare use among women with IDD. Further research examining potential mechanisms behind the observed ED visit use is warranted. High ED use for mental health reasons among women with IDD suggests that their mental health needs are not being adequately met.
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Freudenreich, O., F. Smith, J. Wozniak, M. Fava, and J. Rosenbaum. "The Psychiatric Morbidity and Mortality Teaching Conference to Improve Patient Safety: Lessons Learned at the Massachusetts General Hospital." European Psychiatry 41, S1 (April 2017): S298. http://dx.doi.org/10.1016/j.eurpsy.2017.02.180.
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IntroductionA morbidity and mortality (M&M) conference is a time-honored educational format in surgery and medicine to review bad patient outcomes and learn from mistakes made. However, despite the value of learning together as peers from difficult cases with unexpected outcomes, most psychiatric departments in the United States do not have an M&M conference. Several years ago, the department of psychiatry at Massachusetts's general hospital in Boston began a monthly M&M conference.ObjectivesDescribe our department's experience with the M&M format as an educational vehicle to teach patient safety and improve care in an increasingly complex care environment.AimsIntroduce the M&M format that we have developed at our department and obstacles encountered.MethodsWe reviewed the content of our four years of M&M conferences; the feedback received from participants after each conference; and changes introduced to improve the conference.ResultsOur department has successfully implemented and sustained a monthly psychiatric M&M conference that is well attended and valued. A critical decision was mandatory involvement of residents to prepare cases in conjunction with a dedicated faculty member. A structured presentation using a root cause analysis framework to guide the discussion in order to harness the wisdom of the group allows for a more comprehensive understanding of factors leading to bad outcomes, including systems-based problems.ConclusionsA psychiatric M&M conference can teach individual clinicians about patient safety. Developing a departmental mechanism to apply lessons learned in the conference to improve hospital systems is the next task.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Laramie, Angela K., Vivian C. Pun, Shona C. Fang, David Kriebel, and Letitia Davis. "Sharps Injuries among Employees of Acute Care Hospitals in Massachusetts, 2002–2007." Infection Control & Hospital Epidemiology 32, no. 6 (June 2011): 538–44. http://dx.doi.org/10.1086/660012.
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Objective.Sharps with engineered sharps injury protections (SESIPs) have been found to reduce risk of sharps injuries (Sis). We examined trends in SI rates among employees of acute care hospitals in Massachusetts, including the impact of SESIPs on SI trends during 2002-2007.Design.Prospective surveillance.Setting.Seventy-six acute care hospitals licensed by the Massachusetts Department of Public Health.Participants.Employees of acute care hospitals who reported Sis to their employers.Methods.Data on Sis in acute care hospitals collected by the Massachusetts Sharps Injury Surveillance System were used to examine trends in SI rates over time by occupation, hospital size, and device. Negative binomial regression was used to assess trends.Results.During 2002-2007, 16,158 Sis among employees of 76 acute care hospitals were reported to the surveillance system. The annual SI rate decreased by 22%, with an annual decline of 4.7% (P< .001). Rates declined significantly among nurses (—7.2% per year;P< .001) but not among physicians (—0.9% per year;P= .553). SI rates associated with winged steel needles and hypodermic needles and syringes also declined significantly as the proportion of injuries involving devices with sharps injury prevention features increased during the same time period.Conclusion.SI rates involving devices for which SESIPs are widely available and appear to be increasingly used have declined. The continued use of devices lacking SI protections for which SESIPs are available needs to be addressed. The extent to which injuries involving SESIPs are due to flaws in design or lack of experience and training must be examined.
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Klevens, Monina, Rebecca Roberts, and Melissa Cumming. "Peer Comparison Intervention to Improve Antibiotic Prescribing in Dentistry." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s345—s346. http://dx.doi.org/10.1017/ice.2020.960.
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Background: Dentists prescribe an estimated 13% of outpatient antibiotic courses, many of which may be unnecessary. Health departments are in a unique position to support implementation of antibiotic stewardship across healthcare facilities, including in dental offices. A customized peer comparison message with feedback regarding prescribing frequencies was effective in reducing inappropriate prescribing among primary care physicians in Massachusetts and California. We tested the effect of a peer comparison message for antibiotic prescribing on dentists in the Massachusetts Medicaid program. Methods: We analyzed data from September 2018 to July 2019 for prescriptions of antibiotic courses by dentists to identify the highest prescribing dentists. We used their national provider identifier (NPI) to deduplicate providers and we searched for addresses using the CMS online database. On March 25, 2019, the high prescribers were sent a hard copy letter from the Massachusetts Department of Public Health stating that they were “among the 1% of frequent prescribers.” In addition, the letter provided citations to professional guidelines and prescribing best practices and invited participation in health department–sponsored training for continuing education credits. We tracked the monthly number of antibiotics prescribed by provider before and after the mailing and compared those who received the letter (intervention) to those whose address was either out of state or undeliverable (comparison). Results: Prescribing records for 3,008 dentists were available from September 2018 through July 2019. Most (67%) prescribed <10 antibiotic courses in the 11-month period; the mean monthly antibiotic courses prescribed ranged from 1.2 to 1.6, and the median monthly prescriptions was 0. However, 33% prescribed 10–199 antibiotics, and 1% prescribed >200. Of these 28 comprising the highest 1% , 15 received the intervention letter. The others were either out of state (N = 3) or the letter was returned undelivered (N = 10). The average monthly number of antibiotic courses prescribed before the intervention was similar in the intervention and comparison groups (25.0 and 24.2, respectively). In the 4 months after the intervention, the average did not change in the intervention group but increased slightly in the comparison group (25.2 and 26.2, respectively). The intervention had no significant effect (P = .80). Conclusions: We observed no effect of this peer comparison message among a small sample of dentists in the Massachusetts Medicaid program. This finding may be due to multiple factors, including the small number of the targeted prescribers, the use of a relatively friendly message for communicating with the high prescribers, and the possibility that other forms of communication would be more effective.Funding: NoneDisclosures: None
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Schmiedhofer, Martina, Anna Slagman, Stella Linea Kuhlmann, Andrea Figura, Sarah Oslislo, Anna Schneider, Liane Schenk, Matthias Rose, and Martin Möckel. "Emergency Departments as Care Providers for Patients with Cardiac Ambulatory Care Sensitive and Mental Health Conditions: Qualitative Interview and Focus Group Study with Patients and Physicians." International Journal of Environmental Research and Public Health 19, no. 10 (May 17, 2022): 6098. http://dx.doi.org/10.3390/ijerph19106098.
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Mental health conditions are frequent among patients with somatic illnesses, such as cardiac diseases. They often remain undiagnosed and are related to increased utilization of outpatient services, including emergency department care. The objective of this qualitative study was to investigate the significance of the emergency department in the patients’ course of treatment and from the physicians’ perspective. An improved understanding of the subjective needs of this specific patient group should provide hints for targeted treatment. This study is part of the prospective EMASPOT study, which determined the prevalence of mental health conditions in emergency department patients with cardiac ambulatory care sensitive conditions. The study on hand is the qualitative part, in which 20 semi-structured interviews with patients and a focus group with six ED physicians were conducted. Data material was analyzed using the qualitative content analysis technique, a research method for systematically identifying themes or patterns. For interpretation, we used the “typical case approach”. We identified five “typical patient cases” that differ in their cardiac and mental health burden of disease, frequency and significance of emergency department and outpatient care visits: (1) frequent emergency department users with cardiac diseases and mental health conditions, (2) frequent emergency department users without cardiac diseases but with mental health conditions, (3) needs-based emergency department users with cardiac diseases; (4) targeted emergency department users as an alternative to specialist care and (5) patients surprised by initial diagnose of cardiac disease in the emergency department. While patients often perceived the emergency department visit itself as a therapeutic benefit, emergency department physicians emphasized that frequent examinations of somatic complaints can worsen mental health conditions. To improve care, they proposed close cooperation with the patients’ primary care providers, access to patients’ medical data and early identification of mental health conditions after cardiac diagnoses, e.g., by an examination tool.
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Zhu, Wei, and Weidong Pan. "Strengthening the Ability of General Hospital Neurology Departments to Treat Neuropsychiatric Diseases and Mental Disorders." Integrative Medicine International 4, no. 3-4 (August 23, 2018): 208–14. http://dx.doi.org/10.1159/000491998.
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Due to the “stigma” of neuropsychological and psychogenic disorders in China, patients with psychological and affective disorders mostly prefer to go to general hospitals or integrative medicine hospitals, while the majority of patients with mental disorders in the department of internal medicine are treated in the department of neurology. At present, there are few physicians with the ability to diagnose and treat neuropsychiatric diseases properly in the neurological department of general hospitals in China, and the diagnosis and treatment experience of mental diseases is insufficient. At the same time, the diagnosis and treatment of comorbid patients with internal diseases and mental disorders are more complicated. The psychology departments in general hospitals or mental health centers also have a limited ability to diagnose and treat comorbid diseases relating to internal medicine and mental disorders together. Therefore, this article reviews the current status of diagnosis and treatment of neuropsychiatric and mental disorders in general hospitals or integrative medicine hospitals.
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Walsh, Michelle. "Bridging the Practices of Yoga Therapy and Behavioral Health Service Delivery for Adolescents." International Journal of Yoga Therapy 22, no. 1 (January 1, 2012): 59–60. http://dx.doi.org/10.17761/ijyt.22.1.k14u343483053r49.
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Historically, substance use and mental health disorder interventions for adolescents were derived from adult models, such as Cognitive Behavioral Therapy and 12-step programs, which are rooted in traditional talk therapy. Young people may struggle to benefit from treatments using these models because they may not be developmentally appropriate. A need exists for developmentally attuned interventions that can engage children and adolescents. This article briefly reviews the process of bridging yoga therapy and behavioral health service delivery for adolescents served by the Massachusetts Department of Public Health (DPH).
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Vasilyev, K. K., and Y. K. Vasilyev. "The role of the Kazan university in formation of medical faculty at Novorossiysk university." Kazan medical journal 95, no. 2 (April 15, 2014): 169–74. http://dx.doi.org/10.17816/kmj2056.
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The medical faculty at Novorossiysk University in Odessa (nowadays - Odessa National Medical University) was established in 1900. The aim of the review is to outline the impact of medical scientists from Kazan University on forming the lecturing staff of the medical faculty in Odessa. The article reviews previously published and newly discovered source data. The first head of the department of diagnostic medicine and propaedeutics of the medical faculty was Sergey Vasilyevich Levashov, professor of Kazan University. He took up the position of professor at the department of internal medicine of the teaching hospital of Kazan University in June of 1886. In January of 1903, he was transferred to Novorossiysk University, which was a solid addition for the new faculty. Professor Leontiy Ivanovich Uskov followed professor Levashov on his way from Kazan to Odessa. In 1889 he graduated from gymnasium in Tambov, in 1894 - from medical faculty of Kazan State University magna cum laude, worked as a military doctor, since 1900 - as an ordinary resident of professor Levashov at the department of internal medicine of the teaching hospital of Kazan University. In 1903, Professor Nikolay Mikhaylovich Popov (in 1894-1903 - professor of the department of mental diseases at Kazan University) also transferred to Odessa. Professor Popov was the founder and the first head of the department of neurology and mental diseases in Odessa. Alexey Erastovich Yanishevsky, who was the student of Professor N.M. Popov in Kazan, followed him to Odessa. Another student of Professor Popov, Vladimir Nikolaevich Obraztsov, who graduated from medical faculty of Kazan University in 1898 and was recommended by Professor Popov for extraordinary residency at the department of mental diseases at Kazan University a year after, transferred to Odessa in 1904. Another alumnus of Kazan University, Bronislav Ivanovich Vorotynsky, was teaching at Novorossiysk University. In 1901 he left the position of extraordinary assistant professor of the department of mental diseases at Kazan University after being appointed as a head doctor of the Odessa city mental hospital; since 1905 he was a freelance university lecturer of the department of neurology and mental diseases at Novorossiysk University. Therefore, the lecturing staff of one of the country’s oldest medical schools contributed to establishing the new site of higher medical education in Russia.
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Mitra, Monika, Susan L. Parish, Karen M. Clements, Jianying Zhang, and Tiffany A. Moore Simas. "Antenatal Hospitalization Among U.S. Women With Intellectual and Developmental Disabilities: A Retrospective Cohort Study." American Journal on Intellectual and Developmental Disabilities 123, no. 5 (September 1, 2018): 399–411. http://dx.doi.org/10.1352/1944-7558-123.5.399.
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Abstract This population-based retrospective cohort study examines the prevalence of hospital utilization during pregnancy and the primary reason for antenatal hospital utilization among women with intellectual and developmental disabilities (IDD). Massachusetts residents with in-state deliveries that were ≥ 20 weeks gestational age were included via data from the 2002-2009 Massachusetts Pregnancy to Early Life Longitudinal Data System. Among women with IDD, 54.8% had at least one emergency department (ED) visit during pregnancy, compared to 23% of women without IDD. Women with IDD were more likely to have an antenatal ED visit, observational stays, and non-delivery hospital stays. This study highlights the need for further understanding of the health care needs of women with IDD during pregnancy.
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Jin, Ling, Kai Fan, Shiwang Tan, Shuangxi Liu, Yang Wang, and Shaoqing Yu. "Analysis of the characteristics of outpatient and emergency diseases in the department of otolaryngology during the “COVID-19” pandemic." Science Progress 104, no. 3 (July 2021): 003685042110363. http://dx.doi.org/10.1177/00368504211036319.
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The pandemic of “Corona Virus Disease 2019” (COVID-19) has changed the lives of people. There have been changes in common outpatient and emergency cases in otolaryngology, so an analysis of data pertaining to this was completed. This study is to evaluate the impact of viral infection disease in otolaryngological common disease. This study uses the data of common diseases in the outpatient and emergency department during the “COVID-19” pandemic (from February to April 2020) and the same period in the past 3 years from the Department of Otolaryngology. During the “COVID-19” period compared with the same period last year, the ranking of cases by diseases has changed. Diseases such as chronic pharyngitis, allergic rhinitis, sudden deafness, and tinnitus increased, meanwhile acute pharyngitis and acute laryngopharyngitis decreased ( p < 0.05). The viral infection has impacted the mental behaviors of people, therefore mental-related disease cases of the department of Otolaryngology have increased indirectly. This study provides real data to illustrate mental-related diseases. It also provides experience and shows the importance of keeping and maintaining mental health.
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Petrova, Natalia N. "Mental Disorders and Personal Psychological Characteristics in Patients with Cardiovascular Diseases." Acta Biomedica Scientifica 4, no. 1 (April 4, 2019): 81–86. http://dx.doi.org/10.29413/abs.2019-4.1.12.
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Background.Today the prevalence of mental disorders have grown significantly, so it is urgent to diagnose and correct them as early as possible. Mental disorders in patients with cardiovascular diseases aggravate the course and outcomes of the underlying disease, which necessitates their investigation in clinical practice.Aim:to study the frequency and phenomenology of mental disorders in patients with cardiovascular diseases.Materials and methods.Sixty patients of the Cardiology Department of St. Petersburg Multidisciplinary Hospital became the objects of the study, and comprised 2 groups. The first group included 30 patients with cardiovascular diseases, such as coronary artery disease and hypertension I–III stages, among them 10 men and 20 women aged 43.1 ± 11.7 years. The second group consisted of 30 patients with chronic heart failure in stabilization period (mean age 65.6 ± 10.8 years). The study included clinical and scale assessment.Results.We found that in patients with cardiovascular diseases mild disorders of affective spectrum prevail, with a typical comorbidity of anxiety and depression. Mental disorders and personal features in patients with chronic heart failure are different from those in patients with uncomplicated cardiovascular conditions. Mental disorders are detected in cardiological practice only in one third of patients, which reveals the problem of training internists, who could diagnose the most common mental disorders.Conclusions.Complex clinical and scale assessment in combination with the results of patients’ self-assessment showed a significant prevalence of affective disorders in the patients with cardiovascular diseases, who underwent treatment in the Cardiology Department of St. Petersburg Multidisciplinary Hospital. The results demonstrate that cardiac pa tients have personal risk factors for mental disorders development, predominantly anxiety and depressive disorders of neurotic level, both nosogenic and non-nosogenic, which requires a comprehensive psychological, psychotherapeutic and psychiatric care for these patients.
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Lauer, Emily, Nassira D. Nicola, Kimberley Warsett, and Rodrigo Monterrey. "Contributions of Mental and Behavioral Health Conditions to Health Service Utilization Among People With Intellectual and Developmental Disabilities in Massachusetts." Inclusion 7, no. 3 (September 1, 2019): 188–201. http://dx.doi.org/10.1352/2326-6988-7.3.188.
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Abstract Although existing evidence suggests an increased prevalence mental and behavioral health conditions for people with intellectual and developmental disabilities (IDD), little is known about health service utilization patterns related to these conditions. This study provides population-based data on hospital service utilization. Medicaid claims for people under 65 years of age in Massachusetts were used (years 2008-2013) to identify a cohort of people with IDD. Utilization of inpatient hospitalizations and outpatient Emergency Department (ED) was compared with the U.S. and MA general population through risk ratios. Findings suggest mental and behavioral health conditions were major contributors to increased utilization of inpatient and outpatient ED services and underscore the need for community-based service options that understand how to treat these conditions in people with IDD and address the myriad of related factors to identify, treat, and minimize the potential adverse life impact of these conditions for people with IDD.
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Pliannuom, Suphawita, Kanokporn Pinyopornpanish, Chaisiri Angkurawaranon, Kanokwan Pinyopornpanish, Anawat Wisetborisut, Surinporn Likhitsathian, and Wichuda Jiraporncharoen. "Utilization of Health Care Services and Common Disease Diagnoses among University Students: An Analysis of 35,249 Students from Thailand." International Journal of Environmental Research and Public Health 18, no. 13 (July 4, 2021): 7148. http://dx.doi.org/10.3390/ijerph18137148.
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The health care services for university students are important to improve student health and well-being. Analyzing the database of health conditions in the health service system will identify common health problems, which could be useful in further appropriate and specific health service planning. This study aims to investigate the utilization of health care services and common disease diagnoses among university students enrolled at Chiang Mai University during the academic year of 2018. A retrospective study was carried out using health data from the electronic health records (EHR) database of the university hospital. Ethical procedures were followed. Out of the overall 35,249 students in the academic year 2018, 17,284 students (49.03%) had visited an outpatient department (65,150 outpatient department visits), and 407 students (1.15%) had been admitted to the hospital (458 inpatient department admissions). The proportions of utilization between each field of education and training were similar across both groups. The top five categories of diagnosis, for both outpatient department visits and inpatient department admissions, differed between gender. Some of the most common diseases included trauma and injury conditions, respiratory diseases, and mental health. The conclusion of the study is that integration of a health promotion program with preventive methods, especially regarding traffic injury, transmitted diseases, mental health support, and safe environments are essential for university students. A general overview of utilization and common diseases among university students, which is still lacking in the literature, could be useful as a platform to enhance health care services for common diseases.
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Bushman, Dena, Jency Sekaran, Nancy Jeffery, Caroline Rath, Joel Ackelsberg, Don Weiss, Winfred Wu, et al. "Coronavirus Disease 2019 (COVID-19) Outbreaks at 2 Construction Sites—New York City, October–November 2020." Clinical Infectious Diseases 73, Supplement_1 (July 15, 2021): S81—S83. http://dx.doi.org/10.1093/cid/ciab312.
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Abstract During 23 October–16 November 2020, the New York City Department of Health and Mental Hygiene investigated coronavirus disease 2019 (COVID-19) outbreaks at 2 construction sites. Challenges in adhering to the New York State Department of Health “Interim COVID-19 Guidance for Construction” were reported. To minimize outbreaks, jurisdictions should increase tailored outreach to the construction industry, emphasizing infection prevention.
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Nehir, Sevgi, Cengiz Cengisiz, and Enver Sevinç. "SUICIDE ATTEMPT RATES IN PATIENTS APPLYING TO EMERGENCY DEPARTMENT OF MANİSA MENTAL HEALTH AND DISEASES HOSPITAL." NWSA Academic Journals 17, no. 4 (October 29, 2022): 15–21. http://dx.doi.org/10.12739/nwsa.2022.17.4.1b0123.
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Szigethy, Eva, Sean M. Murphy, Orna G. Ehrlich, Nicole M. Engel-Nitz, Caren A. Heller, Kim Henrichsen, Rachel Lawton, Perry Meadows, and John I. Allen. "Mental Health Costs of Inflammatory Bowel Diseases." Inflammatory Bowel Diseases 27, no. 1 (February 25, 2020): 40–48. http://dx.doi.org/10.1093/ibd/izaa030.
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Abstract Background Mental health diagnoses (MHDs) were identified as significant drivers of inflammatory bowel disease (IBD)-related costs in an analysis titled “Cost of Care Initiative” supported by the Crohn’s & Colitis Foundation. In this subanalysis, we sought to characterize and compare IBD patients with and without MHDs based on insurance claims data in terms of demographic traits, medical utilization, and annualized costs of care. Methods We analyzed the Optum Research Database of administrative claims from years 2007 to 2016 representing commercially insured and Medicare Advantage insured IBD patients in the United States. Inflammatory bowel disease patients with and without an MHD were compared in terms of demographics (age, gender, race), insurance type, IBD-related medical utilization (ambulatory visits, emergency department [ED] visits, and inpatient hospitalizations), and total IBD-related costs. Only patients with costs >$0 in each of the utilization categories were included in the cost estimates. Results Of the total IBD study cohort of 52,782 patients representing 179,314 person-years of data, 22,483 (42.6%) patients had at least 1 MHD coded in their claims data with a total of 46,510 person-years in which a patient had a coded MHD. The most commonly coded diagnostic categories were depressive disorders, anxiety disorders, adjustment disorders, substance use disorders, and bipolar and related disorders. Compared with patients without an MHD, a significantly greater percentage of IBD patients with MHDs were female (61.59% vs 48.63%), older than 75 years of age (9.59% vs 6.32%), white (73.80% vs 70.17%), and significantly less likely to be younger than 25 years of age (9.18% vs 11.39%) compared with those without mental illness (P < 0.001). Patients with MHDs had significantly more ED visits (14.34% vs 7.62%, P < 0.001) and inpatient stays (19.65% vs 8.63%, P < 0.001) compared with those without an MHD. Concomitantly, patients with MHDs had significantly higher ED costs ($970 vs $754, P < 0.001) and inpatient costs ($39,205 vs $29,550, P < 0.001) compared with IBD patients without MHDs. Patients with MHDs also had significantly higher total annual IBD-related surgical costs ($55,693 vs $40,486, P < 0.001) and nonsurgical costs (medical and pharmacy) ($17,220 vs $11,073, P < 0.001), and paid a larger portion of the total out-of-pocket cost for IBD services ($1017 vs $905, P < 0.001). Conclusion Patients whose claims data contained both IBD-related and MHD-related diagnoses generated significantly higher costs compared with IBD patients without an MHD diagnosis. Based on these data, we speculate that health care costs might be reduced and the course of patients IBD might be improved if the IBD-treating provider recognized this link and implemented effective behavioral health screening and intervention as soon as an MHD was suspected during management of IBD patients. Studies investigating best screening and intervention strategies for MHDs are needed.
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Yakhno, N. N., and K. V. Rodionov. "About the history of the Moscow Clinic of Nervous Diseases named after A.Ya. Kozhevnikov." Neurology Bulletin XXXIII, no. 1-2 (May 15, 2001): 99–105. http://dx.doi.org/10.17816/nb79770.
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The history of the development of the Moscow neurological school in the late 19th - early 20th centuries. is, in essence, the history of the clinic of nervous diseases named after A.Ya. Kozhevnikov Moscow Medical Academy named after I.M. Sechenov. The teaching of nervous and mental diseases began at the departments of pathology and therapy of Moscow University, headed by the most prominent clinicians M.Ya. Mudrov, I.E. Dyadkovsky, I.V. Varvinsky, I.T. Glebov and A.I. Polunin long before the creation of a neurological clinic. The new university charter of 1863, among others, provided for the organization of a clinic for nervous and mental diseases, and therefore in the same year the medical faculty recommended A.Ya. Kozhevnikov as a worthy candidate for heading a new department or course of nervous and mental diseases. According to the traditions of A.Ya. Kozhevnikov in 1866 was sent abroad for 3 years. He worked in clinics and laboratories headed by the largest specialists in neuropsychiatry and physiologists (J.-M. Charcot, V. Grisinger, E. Dubois-Raymond, etc.). During this period A.Ya. Kozhevnikov performed several independent histological studies. In 1869, the university council elected A.Ya. Kozhevnikov for the position of Associate Professor of Nervous Diseases and Psychiatry. In the summer of 1869, after returning from an overseas business trip, he headed the independent department of nervous and mental diseases created for the first time in the world and already in December submitted to the dean A.I. Polunin, a curriculum for teaching nervous diseases and psychiatry, began to give a course of lectures on nervous and mental diseases and to conduct practical classes on nervous diseases.
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Robakowska, Marlena, Anna Tyrańska-Fobke, Katarzyna Pogorzelczyk, Joanna Synoweć, Daniel Ślęzak, Piotr Robakowski, Patryk Rzońca, and Paweł Prędkiewicz. "Patient Management in the Emergency Department during a COVID-19 Pandemic." Healthcare 10, no. 8 (August 3, 2022): 1456. http://dx.doi.org/10.3390/healthcare10081456.
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In the wake of the COVID-19 pandemic, international action has been taken to prevent the spread of the disease. The aim of this study is to establish the impact of the COVID-19 pandemic on emergency department utilization patterns in Poland. It was established that age (among COVID-19 positive patients) has a large influence on the occurrence of a mental illness or disorder. It has been proven that the older the person (patients diagnosed with U07.1), the more often mental diseases/disorders are diagnosed (p = 0.009–0.044). Gender decides the course of hospitalization to the disadvantage of men (p = 0.022). Men diagnosed with U07.1 stay much longer in specialized long-term care units. Lower-aged patients have a shorter hospitalization time (up to the age of 29; p = 0.017). The COVID-19 pandemic has placed healthcare systems, their staff, and their patients in an unprecedented situation. Our study showed changes in the number and characteristics of patients visiting the ED during COVID-19. Despite the shift in the center of gravity of health system functioning to the treatment of SARS-CoV-2 infected patients, care must be taken to ensure that uninfected patients have access to treatment for cardiovascular, mental health, oncological, and other diseases.
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Lin, Meei Y., Liisa K. Selin, and Raymond M. Welsh. "Evolution of the CD8 T-cell repertoire during infections11Address for correspondence: Department of Pathology, University of Massachusetts Medical School, 55 Lake Avenue North, Worcester, MA 01655, USA." Microbes and Infection 2, no. 9 (July 2000): 1025–39. http://dx.doi.org/10.1016/s1286-4579(00)01257-0.
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Shakhurova, N. I., V. F. Lebedeva, N. M. Popova, and O. A. Pavlova. "Late-life depression and cerebrovascular diseases." European Psychiatry 26, S2 (March 2011): 856. http://dx.doi.org/10.1016/s0924-9338(11)72561-5.
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IntroductionOne of relevant challenges of psychogeriatric assistance is recognition of depression and cognitive disturbances in elder patients because clinical similarity of their manifestations masks nature of syndrome.ObjectiveTo study of clinical severity and nosological belonging of depressive syndrome against the background of accompanying cerebrovascular pathology with availability of cognitive disorders in elder patients under treatment at the specialized department of affective states.MethodsTotal number of observations has constituted 55 persons (males - 24, females - 31, mean age 66,3 ± 5,8 years). Criteria of inclusion: age older than 60 years, complaints about memory disturbances and decreased background of mood as a basic cause of seeking psychiatric assistance. We excluded patients with mental disorders of psychotic register, presence of substance dependence syndrome, dementia.ResultsAccording to results of clinical-psychopathological investigation along with ICD-10 diagnostic criteria, nosological structure of revealed disorders has been represented by the following rubrics: organic affective disorder (F06.3) was diagnosed in 355 of patients; depressive disorders of rubric F3 were registered in 45% of patients, comorbid with organic asthenic disorder (F06.6) or with mild cognitive disorder (F06.7), in 15% of cases depression was leading syndrome within adjustment disorder also in combination with mild cognitive disorder, in 55 of cases depressive symptoms was regarded as secondary whereas predominating ones were cognitive and behavior disturbances within organic asthenic disorder (F06.6).ConclusionsThus, clinical assessment and nosological belonging of depressive syndrome combined with organic disorders in the elderly are an important factor mainly determining the choice of therapeutic strategy.
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Raidla, Annelie, Katrin Dárro, Tobias Carlson, and Eric Carlström. "Characterising double frequent users in an emergency department." Journal of Hospital Administration 7, no. 3 (April 23, 2018): 35. http://dx.doi.org/10.5430/jha.v7n3p35.
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Visits by frequent users (FUs) has been suggested as one reason for crowding in emergency departments (EDs). In this article, we identified the characteristics of double frequent users (DFUs), ≥ 8 visits during 12 months in an ED during a period of six years, in one ED in Western Sweden. The primary outcome was to characterise DFUs and find common reasons for repeatedly visiting the ED. We conducted a retrospective cohort analysis on register data covering six years of all visits. The DFUs share of all visitors to the ED was not more than 0.03% (144 individuals), but their share of visits was 2.4% (1,017 visits/year). Chest pain and abdominal pain were the most common complaints. A typical DFU is male, around 50-year-old, unemployed, non-immigrant, suffering from alcohol abuse and/or mental health conditions. The results point to the need for changing strategies in ED services towards DFUs suffering from alcohol abuse and/or mental health conditions. The ED prioritises the severely ill but lacks resources and continuity for handling chronic diseases and follow-up routines.
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Sanchez, Sarimer, Eileen Searle, David Rubins, Sayon Dutta, Winston Ware, Paul Biddinger, and Erica Shenoy. "Implementation of an Electronic Travel Navigator to Enable "Identify-Isolate-Inform" for Emerging Infectious Diseases." Infection Control & Hospital Epidemiology 41, S1 (October 2020): s273—s275. http://dx.doi.org/10.1017/ice.2020.843.
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Background: Travel screening can facilitate the identification of patients at risk for emerging infectious diseases, such as Middle East respiratory syndrome (MERS). A travel navigator with associated decision support through a best practice advisory (BPA) was implemented in an electronic health record to build upon the CDC identify-isolate-inform framework. Compliance with documentation of travel history, symptom screening when appropriate, and isolation of suspect MERS patients were assessed. Methods: Adult and pediatric emergency department encounters at the Massachusetts General Hospital, a 1,035-bed, tertiary-care, academic health center in Boston, Massachusetts, from August 2018 to October 2019, were included. We categorized an encounter as adherent to initial travel screening if providers answered foreign, domestic, or no travel to the screen. Encounters were defined as nonadherent if they were recorded as unknown or if an answer was not selected. Adherence to completion of data entry for the subgroup of patients with documented foreign travel was further assessed for region- and country-level specification, completion of symptom screen, and response to the MERS BPA (Fig. 1). Results: In total, 127,866 encounters were included, of which 105,593 (83%) were adherent to initial travel screening. Among 4,498 encounters with documented foreign travel, 2,970 (66%) specified the region of travel, and 710 (16%) selected a country of travel from the listing. Moreover, 214 encounters had documented travel to the Middle East. Selection of Middle East or 1 of the 13 countries identified by the CDC as at risk for MERS triggered symptom screening for fever and cough, which was performed in 139 encounters (65%). Of these, 95 encounters documented absence of fever and cough, 15 documented fever and cough, 12 documented a cough alone, and 17 documented a fever alone through reporting or obtaining vitals. The MERS BPA was triggered in 37 encounters; 10 patients were ordered for isolation using the BPA. Of these, 4 patients met CDC criteria for a MERS patient under investigation and were tested; all were negative. Conclusions: Initial screening to document foreign travel is completed at a high rate; however, use of the travel navigator to specify region and country, key components necessary to prompt clinicians for symptom screening, are documented in a minority of encounters. Future interventions are needed to improve region and country capture and appropriate symptom screening, with isolation when appropriate.Funding: NoneDisclosures: None
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Szyszkowicz, Mieczysław, Roger Zemek, Ian Colman, William Gardner, Termeh Kousha, and Marc Smith-Doiron. "Air Pollution and Emergency Department Visits for Mental Disorders among Youth." International Journal of Environmental Research and Public Health 17, no. 12 (June 12, 2020): 4190. http://dx.doi.org/10.3390/ijerph17124190.
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Although exposure to ambient air pollution has been linked to mental health problems, little is known about its potential effects on youth. This study investigates the association between short-term exposure to air pollutants and emergency department (ED) visits for mental health disorders. The National Ambulatory Care Reporting System database was used to retrieve ED visits for young individuals aged 8–24 years in Toronto, Canada. Daily average concentrations of nitrogen dioxide (NO2), fine particulate matter (PM2.5), and daily maximum 8 h ozone (O3) were calculated using measurement data from seven fixed stations. A case-crossover (CC) design was implemented to estimate the associations between ED visits and air pollution concentrations. Mental health ED visits were identified using International Classification of Diseases 10th Revision (ICD-10) codes, with seven categories considered. Models incorporating air pollutants and ambient temperature (with lags of 0–5 days) using a time-stratified CC technique were applied. Multivariable regression was performed by sex, three age groups, and seven types of mental health disorders to calculate relative risk (RR). The RRs were reported for one interquartile range (IQR) change in the air pollutant concentrations. Between April 2004 and December 2015 (4292 days), there were 83,985 ED visits for mental-health related problems in the target population. Several exposures to air pollutants were shown to have associations with ED visits for mental health including same day exposure to fine particulate matter (IQR = 6.03 μg/m3, RR = 1.01 (95% confidence interval: 1.00–1.02), RR = 1.02 (1.00–1.03)) for all and female-only patients, respectively. One-day lagged exposure was also associated with ED visits for PM2.5 (RR = 1.02 (1.01–1.03)), for nitrogen dioxide (IQR = 9.1 ppb, RR = 1.02 (1.00–1.04)), and ozone (IQR = 16.0 ppb, RR = 1.06 (1.01–1.10)) for males. In this study, urban air pollution concentration—mainly fine particulate matter and nitrogen dioxide—is associated with an increased risk for ED visits for adolescents and young adults with diagnosed mental health disorders.
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Avdibegović, E., A. Delić, Z. Selimbaić, and K. Hadibeganović. "Posttraumatic Stress Disorders and Somatic Disease." European Psychiatry 24, S1 (January 2009): 1. http://dx.doi.org/10.1016/s0924-9338(09)71468-3.
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Numerous studies indicate that the exposure to traumatic vents and psychological trauma is a widespread. Studies also have properly documented and confirmed the presence of relationship between posttraumatic stress disorders (PTSD) and other health conductions. As PTSD might have a devastating effect on physical integrity and general health, the aim of this study was to show the prevalence of physical problems in patients with PTSD. The 217 patients with PTSD treated at the Department for traumatic stress disorders of the Clinic f Psychiatry Tuzla in the period from 2005 to 2008 were analyzed with regard to prevalence and type of physical problems. The PTSD was diagnosed according to DSM IV criteria while somatic diseases were diagnosed to ICD X. In group of patients that were examined there was almost an equal number of male and female. The average age was 49.44±8.85 years. With regard to educational level most patients completed secondary school. Regarding employment 75% patients were employed and exposed to psychological abuse at work. Out of 217 patients the PTSD in 67% was related to war traumatic experiences. With regard to somatic diseases mostly diagnosed were hypertension (45%), diabetes mellitus (43%), cerebrovascular diseases, hyperlipidemia, lumbo-sacral discopathy and thyroid gland diseases. Combination of PTSD and chronic somatic disease was common in patients treated at the department for traumatic stress disorders.
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Helmes, Almut, Lena Krämer, and Jürgen Bengel. "Psycho-social distress in patients with chronic somatic diseases." Zeitschrift für Gesundheitspsychologie 16, no. 3 (July 2008): 104–7. http://dx.doi.org/10.1026/0943-8149.16.3.104.
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Abstract. Research activities of the Department of Rehabilitation Psychology and Psychotherapy, University of Freiburg, mainly focus on psycho-social distress of patients with chronic somatic diseases. Examples of current or recent research projects are: 1. Meta-analysis on quality of life and health care costs in patients with somatic diseases and comorbid mental disorders: Preliminary results indicate a substantial negative effect of comorbid mental disorders on somatic and psychosocial aspects as well as health care costs. 2. Communication in cancer care from the patients’ perspective: Breast cancer patients who were more satisfied with the received information at baseline showed better psychological adjustment after three and six months. 3. Patients’ experiences as empowerment. German version of the website DIPEx with the modules diabetes and chronic pain: it is a free multimedia website with a database of patients’ experiences of their illnesses, linked with evidence-based information on these diseases, treatment options and facilities of support.
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Choo, Carol C., Peter K. H. Chew, and Roger C. Ho. "Controlling Noncommunicable Diseases in Transitional Economies: Mental Illness in Suicide Attempters in Singapore—An Exploratory Analysis." BioMed Research International 2019 (January 15, 2019): 1–8. http://dx.doi.org/10.1155/2019/4652846.
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Background. Mental illness is a pertinent risk factor related to suicide. However, research indicates there might be underdiagnosis of mental illness in Asian suicide attempters; this phenomenon is concerning. This study explored prediction of diagnosis of mental illness in suicide attempters in Singapore using available variables. Methods. Three years of medical records related to suicide attempters (N = 462) who were admitted to the emergency department of a large teaching hospital in Singapore were subjected to analysis. Of the sample, 25% were diagnosed with mental illness; 70.6% were females and 29.4% were males; 62.6% were Chinese, 15.4% Malays, and 16.0% Indians. Their age ranged from 12 to 86 (M = 29.37, SD = 12.89). All available variables were subjected to regression analyses. Findings. The full model was significant in predicting cases with and without diagnosis of mental illness and accurately classified 79% of suicide attempters with diagnosis of mental illness. Conclusions. The findings were discussed in regard to clinical implications in diagnosis and primary prevention.
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Skoromets, A. A., V. M. Kazakov, V. A. Sorokoumov, and E. R. Barantsevich. "100 years of the Department of Nervous and Mental Diseases of the Women's Medical Institute of St. Petersburg State Medical University named after acad. I.P. Pavlov." Neurology Bulletin XXXIII, no. 1-2 (May 15, 2001): 91–99. http://dx.doi.org/10.17816/nb79762.
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In the fall of 2000, jubilee celebrations were held dedicated to the centenary of the Department of Nervous and Mental Diseases at the current St. Petersburg State Medical University named after acad. I.P. Pavlov (until 1994 it was the 1st Leningrad Medical Institute named after Academician I.P. Pavlov).
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Peterson, Alexis, Barbara A. Gabella, Jewell Johnson, Beth Hume, Ann Liu, Julia F. Costich, Jeanne Hathaway, Svetla Slavova, Renee Johnson, and Matt Breiding. "Multisite medical record review of emergency department visits for unspecified injury of head following the ICD-10-CM coding transition." Injury Prevention 27, Suppl 1 (March 2021): i13—i18. http://dx.doi.org/10.1136/injuryprev-2019-043517.
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IntroductionIn 2016, a proposed International Classification of Diseases, Tenth Edition, Clinical Modification surveillance definition for traumatic brain injury (TBI) morbidity was introduced that excluded the unspecified injury of head (S09.90) diagnosis code. This study assessed emergency department (ED) medical records containing S09.90 for evidence of TBI based on medical documentation.MethodsState health department representatives in Maryland, Kentucky, Colorado and Massachusetts reviewed a target of 385 randomly sampled ED records uniquely assigned the S09.90 diagnosis code (without proposed TBI codes), which were initial medical encounters among state residents discharged home during October 2015–December 2018. Using standardised abstraction procedures, reviewers recorded signs and symptoms of TBI, and head imaging results. A tiered case confirmation strategy was applied that assigned a level of certainty (high, medium, low, none) to each record based on the number and type of symptoms and imaging results present in the record. Positive predictive value (PPV) of S09.90 by level of TBI certainty was calculated by state.ResultsWide variation in PPV of sampled ED records assigned S09.90: 36%–52% had medium or high evidence of TBI, while 48%–64% contained low or no evidence of a TBI. Loss of consciousness was mentioned in 8%–24% of sampled medical records.DiscussionExclusion of the S09.90 code in surveillance estimates may result in many missed TBI cases; inclusion may result in counting many false positives. Further, missed TBI cases influenced by incidence estimates, based on the TBI surveillance definition, may lead to inadequate allocation of public health resources.
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Buttera, M., A. Clavenna, E. Maselli, L. Tansini, MP Canevini, and M. Bonati. "P19 Drug use in adolescents attending the emergency department for mental health problems." Archives of Disease in Childhood 104, no. 6 (May 17, 2019): e25.1-e25. http://dx.doi.org/10.1136/archdischild-2019-esdppp.58.
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BackgroundScant evidence is available regarding the pharmacological management of acute episodes of mental disorders in children and adolescents attending emergency departments (ED). In this regard, we performed a retrospective study with the aim to evaluate the pattern of psychotropic drug use in an ED of a large hospital.MethodsA retrospective chart review of adolescents (13–17 years) visited in the ED of San Paolo University Hospital in Milan for a mental disorder between January and June 2018 was conducted. In particular, information concerning age, gender, type of mental disorder, psychotropic drugs administered in the ED and outcome of the visit were extracted and analysed, using an anonymous patient code.ResultsA total of 1,298 adolescents 13–17 years old were visited during the observation period, 56 (4%) of whom had a diagnosis of mental disorder (35 females and 21 males).The most common disorder was predominant psychomotor disturbance (International Classification of Diseases 9 (ICD9) revision code 308.2; 12 patients), followed by anxiety disorder in conditions classified elsewhere (293.84, 8 patients) and anxiety states (300.0, 7 patients).Ten adolescents were hospitalised, while 16 (29%) received a psychotropic drug in the ED: 14 patients received a benzodiapine (8 delorazepam, 3 lorazepam), and 2 an antipsychotic drug (risperidone+olanzapine; promazine). Five out of 12 adolescents with psychomotor disturbance received a psychotropic drug (3 delorazepam, 1 lorazepam, 1 risperidone+olanzapine).Although no randomized controlled trial has evaluated the safety and effectiveness of benzodiazepines in the paediatric population, delorazepam was identified as the first choice pharmacological treatment for agitation in children and adolescents in a local protocol.ConclusionNearly all children received drugs for which no controlled trials have been performed in the paediatric population and for which the appropriateness is debatable. More evidence is needed to guide the pharmacological management of acute episodes of mental disorders.Disclosure(s)Nothing to disclose
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Mimiaga, Matthew J., Sari L. Reisner, Rodney Vanderwarker, Michael J. Gaucher, Catherine A. O'Connor, M. Susana Medeiros, and Steven A. Safren. "Polysubstance Use and HIV/STD Risk Behavior among Massachusetts Men Who Have Sex with Men Accessing Department of Public Health Mobile Van Services: Implications for Intervention Development." AIDS Patient Care and STDs 22, no. 9 (September 2008): 745–51. http://dx.doi.org/10.1089/apc.2007.0243.
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Kornetov, N., O. Molodykh, A. Arzhanik, and N. Zvereva. "Distribution of inpatients with cardiovascular diseases and major depression." European Psychiatry 64, S1 (April 2021): S340. http://dx.doi.org/10.1192/j.eurpsy.2021.911.
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IntroductionMajor depression (MD) and anxiety symptoms (AS) are frequent cardiovascular diseases satellites (CVD).ObjectivesTo examine features of comorbid physical and mental disorders considering age and sex variability.MethodsCross-sectional study 146 patients with СVD were examined in cardiologic department of the Medical Centre. Of these, 51 (60.0%) are women and 34 (40.0%) are men. Patients assessed the intensity of pain or its absence using Visual Analog Scale. Anhedonia was determined by the Snatch-Hamilton Pleasure Scale - SHAPS. A hospital scale, HADS, was used to assess anxiety and depression. The final clinical diagnosis of MD was carried out according to the DSM-V criteria. Quantitative and ordinal signs are presented in the form Me-Median (Q1; Q3) - the first and third quartiles, respectively.ResultsThe degree of MD among male and female p=0,17; in “A” and “B” groups р=0,4912. Among patients of “A” age group is 2 (Q1 1 ; Q3 4) p=0,1777 had no difference. Patients of group “B” scored 3 (Q1 1,0; Q3 5,0) р=0,0019. Anxiety among female is 9 (Q1 6,0; Q3 11,0), among male 7 (Q1 3,5; Q3 9,0) р=0,0006. In the group of patients under 60 years anxiety score is 8 (Q1 4,0; Q3 9,0), group above 60 - 8 (Q1 6,0; Q3 11,0) р=0,0045. Pain intensity scored 3 (Q1 1,0; Q3 5,0) among male, 5 (Q1 3,0; Q3 7,0) among female p=0,0009.ConclusionsDespite invariability of main depression symptoms among sex and partly age, pain and anxiety symptoms prevailed in elderly male and female.
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Maevsky, M. M. "Chronicle and mix." Neurology Bulletin VI, no. 2 (October 29, 2020): 195–200. http://dx.doi.org/10.17816/nb48667.
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The Medical Faculty of the Imperial Kazan University at the end of March 27 of this year honored Doctor of Medicine B.I. Vorotynskiy title of assistant professor in the Department of Nervous and Mental Diseases. For the next academic year, Doctor Vorotynskiy proposes to read a private course in forensic psychopathology for medical students and lawyers.
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Beckerleg, Weiwei, and Joel Hudgins. "Substance Use-related Emergency Department Visits and Resource Utilization." Western Journal of Emergency Medicine 23, no. 2 (February 28, 2022): 166–73. http://dx.doi.org/10.5811/westjem.2022.1.53834.
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Introduction: Substance use-related visits to the emergency department (ED) have been linked to higher service delivery costs, although little is known about the specific services used. Our goal In this study was to describe the recent trends of substance use-related ED visits and assess the association between substance use and specific ED resource utilization. Methods: We performed a retrospective, cross-sectional study using the National Hospital Ambulatory Medical Care Survey (NHAMCS) data from 2013–2018. All ED visits in the United States for patients ≥18 years of age were included. The primary exposure was having substance use included as a chief complaint or diagnosis, which we identified using the International Classification of Diseases, 9th and 10th revisions, codes. The primary outcome was the use of diagnostic services (including laboratory studies and cardiac monitoring) or imaging studies in the ED. Results: The study sample included 95,506 visits in the US, extrapolating to over 619 million ED visits nationwide. The total number of ED visits remained stable during the study period, but substance use-related visits increased by 45%, with these visits making up 2.93% of total ED visits in 2013 and 4.25% in 2018. This increase was primarily driven by stimulant-, sedative- (opioids and benzodiazepines), and hallucinogen-related visits. Mental health-related visits rose in parallel by 66% during the same period. Compared to non-substance use-related visits, substance use-related visits were more likely to undergo any diagnostic study (adjusted odds ratio [aOR] 1.28; 95% confidence interval (CI): 1.11-1.47; P = 0.001), toxicology screening (aOR 10.15; 95% CI: 8.84-11.66), but less likely to have imaging studies (aOR 0.62; 95% CI: 0.56-0.68; P <0.0001). In stratified analyses, substance use-related visits with concurrent mental health disorders were more likely to undergo imaging studies (aOR 1.56; 95% CI: 1.09-2.22), while findings were opposite for those without concurrent mental health disorders (aOR 0.64; 95% CI: 0.51-0.71; P for interaction <0.0001). Conclusion: Substance use- and mental health-related ED visits are rising, and they are associated with increased resource utilization. Further studies are needed to provide more guidance in the approach to acute services in this vulnerable population.
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Дорофейкова, Мария, Mariia Dorofeikova, Сергей Задворьев, Sergey Zadvorev, Наталия Петрова, Nataliya Petrova, Артём Яковлев, and Artyom Yakovlev. "ABOUT THE ALLOCATION OF MENTAL DISORDERS RISK GROUPS IN THE PRACTICE OF CARDIOLOGY DEPARTMENT." Acta biomedica scientifica 2, no. 5 (January 18, 2018): 114–20. http://dx.doi.org/10.12737/article_5a3a0e794aff80.62275471.
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Differential diagnosis of somatic and somatoform pathology is a pressing issue in general practice. The aim of this
study was to develop an algorithm for identification of the patients with indications for psychiatrist’s consultation and
possible psychotropic therapy at the stage of admission to multi-disciplinary hospital.
Material and methods. Regression analysis of data of 1031 patient hospitalized in the cardiology department of a
multiprofile hospital was done with the aim of identifying factors determining the recommendation for receiving
psychotropic therapy at discharge.
Results. An algorithm for allocation among patients of cardiological profile individuals that require a multidisciplinary
approach to treatment involving experts in the field of mental health is proposed. Factors included in the formula were
labile or paroxysmal hypertension, the number of associated (non-cardiological) diagnosis, female gender and heart
rate or heart rhythm disorders with the debut at the age below 55 or 50 years: I = 8 × L + D + 3 × F + 3 (6) × H.
Conclusion. The revealed pattern may be useful in the clinic of internal diseases for screening of patients with a high
contribution of the emotional state the severity of the condition. The doctors of the hospitals of somatic (therapeutic)
profile should pay more attention to the psycho-emotional condition of patients with labile hypertension, early onset of
cardiac arrhythmias, and large number of comorbidities. Patients that meet the criteria are likely to need a consultation
of a psychotherapist or psychiatrist because of the presence of psychosomatic or other mental disorders.
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Thiessen, Michelle, Qi Cui, X. Joan Hu, and Rhonda J. Rosychuk. "Exploring spatio-temporal patterns in mental health related emergency department use from children and adolescents." Spatial and Spatio-temporal Epidemiology 34 (August 2020): 100358. http://dx.doi.org/10.1016/j.sste.2020.100358.
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Alinsky, Rachel, Catherine Silva, Hoover Adger, and Beth McGinty. "5. From Research to Legislation: a Qualitative Case Study of Massachusetts’ 2018 CARE Act Expanding Emergency Department Initiation of Medication for Opioid Use Disorder." Journal of Adolescent Health 70, no. 4 (April 2022): S3. http://dx.doi.org/10.1016/j.jadohealth.2022.01.009.
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Mustafa, Nayab, Dania Al Ayyat, Mazin Awad, Maha Elamin, Entisar Bin Haider, and Samia Alkhoori. "Neuropsychiatric Manifestations of Neurocysticercosis." Dubai Medical Journal 3, no. 1 (February 19, 2020): 37–40. http://dx.doi.org/10.1159/000506365.
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A common scenario in the Emergency Department shows patients presenting with abnormal behavior and agitation. A full workup is performed to rule out organic causes for the patients’ presentation after which they are referred to the Psychiatry Department for further assessment regarding major mental disorders. Similarly, the aforementioned protocol was followed for our patient and he was admitted to the psychiatry ward but was later referred to the Neurology and Infectious Diseases Unit as he developed altered mental status. He was then diagnosed as having neurocysticercosis (NCC), which is a common parasitic infection of the central nervous system. In a multiethnic city like Dubai, NCC should always be considered as a differential diagnosis for abnormal behavior. Symptomatic NCC carries a mortality rate of more than 50%, making early detection and treatment very important. Hence, it is encouraged to screen patients with a high pretest probability using brain CT and MRI.
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Kosslyn, Stephen M. "On Cognitive Neuroscience." Journal of Cognitive Neuroscience 6, no. 3 (July 1994): 297–303. http://dx.doi.org/10.1162/jocn.1994.6.3.297.
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Stephen M. Kosslyn is Professor of Psychology at Harvard University and an Associate Psychologist in the Department of Neurology at the Massachusetts General Hospital. He received his B.A. in 1970 from UCLA and his Ph.D. from Stanford University in 1974, both in psychology, and taught at Johns Hopkins, Harvard, and Brandeis Universities before joining the Harvard Faculty as Professor of Psychology in 1983. His work focuses on the nature of visual mental imagery and high-level vision, as well as applications of psychological principles to visual display design. He has published over 125 papers on these topics, co-edited five books, and authored or co-authored five books. His books include Image and Mind (1980), Ghosts in the Mind's Machine (1983), Wet Mind: The New Cognitive Neuroscience (with 0. Koenig, 1992), Elements of Graph Design (1994), and Image and Brain: The Resolution of the Imagery Debate (1994). Dr. Kosslyn has received numerous honors, including the National Academy of Sciences Initiatives in Research Award, is currently on the editorial boards of many professional journals, and has served on several National Research Council committees to advise the government on new technologies.
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Nehra, Rajiv, Dwijendar Nath, Afreena Nasir, Aamir Hasan, Narottam Aggarwal, and Manju Nehra. "Assessment of copper and zinc in liver diseases." International Journal of Clinical Biochemistry and Research 9, no. 3 (September 15, 2022): 191–94. http://dx.doi.org/10.18231/j.ijcbr.2022.038.
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The liver is a primary storage site for a variety of metabolites. It plays a role in wide variety of metabolic, toxic, excretory, circulatory and defence functions inside the body. Damage to the organ may not evidently affect its activity since the liver has considerable functional reserve. Liver disease is a common term for any damage that reduces the functioning of the liver. Chronic liver disease is identified by gradual destruction of liver cells resulting in fibrosis. It is affected by different conditions including viral hepatitis, excessive alcoholism, genetic, autoimmune and NAFLD. The present study was carried out in Govt. Medical College, Jalaun at Department of Biochemistry. The diagnosis of Liver disease was done by ultrasonographic examination of liver. This study comprised a total of 50 patients, 25 of whom were healthy controls and 25 of whom were Liver Disease patients. After overnight fasting 8-12 hours (under aseptic condition) blood sample (8ml) was drawn from antecubital vein of each subject using a plain vial and was analyzed for serum Cu, Zn & liver profile parameters (serum bilirubin, serum SGOT, serum SGPT and serum ALP done by colorimetric method and calmagnite method, diazo method, IFCC method and assessed by kinetic method respectively. The present study’s findings, indicates that the level of serum copper in liver disease patient was 127.38±28.81µg/dl, which is significantly higher than that of 86.54 ± 15.88µg/dl found is healthy controls (p<0.001). Also, serum copper is strongly linked with biochemical parameters of liver enzyme (SGOT & SGPT). Likewise, the mean value of serum zinc in liver disease were 58.08 ± 13.11µg/dl, which is significantly lower than that of69.88± 6.67µg/dl found in healthy subjects. Further, serum zinc has shown a significant weakly linked with serum SGPT.Therefore, during routine assessments of individuals with liver disease, serum trace elements (Cu and Zn) can be highly effective indicators for detecting the severity of liver damage. Thus, based on the findings of our current investigation, zinc and copper supplementation, as well as a reduction in copper intake, may help to enhance patient survival and preventing the development of hepatitis B to liver cirrhosis.Considering findings of the study, it is recommended that serum trace element concentrations be corrected on a regular basis to help with various problems of liver cirrhosis and maybe to slow the progression of liver disease.
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S., Krishneswari R., Navya Mariam Shaji, and Balakrishna ar S. Maheshkum. "Prevalence of thyroid disorders in an out-patient department setting: a retrospective study." International Journal Of Community Medicine And Public Health 9, no. 5 (April 27, 2022): 2190. http://dx.doi.org/10.18203/2394-6040.ijcmph20221239.
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Background: Disorders of the thyroid gland has become one of the most common endocrine diseases affecting the global population next to Diabetes Mellitus. Data available on the prevalence of thyroid disorders among Indian population is scanty. This study is aimed to investigate the prevalence of thyroid dysfunction in the local population visiting the endocrinology out-patient department of National Homoeopathy Research Institute in Mental Health, Kottayam.Methods: This is a hospital based retrospective descriptive analysis carried out among the patients attended in the endocrinology out-patient department of National Homoeopathy Research Institute in Mental Health (NHRIMH), Kottayam. Patients with Thyroid disorders who seek treatment from the endocrinology OPD for a period of six months (January 2021 to June 2021) were selected for this retrospective analysis.Results: Data were collected from the medical records department of NHRIMH and were analyzed based on the age, sex, different types of thyroid disorders and the medicines prescribed including potency.Conclusions: Females are commonly affected with thyroid disorders and the common age group is between 40 and 49 years. The most common thyroid disorder encountered is hypothyoidism and the most common medicine used is ‘thyroidinum’.
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Giasuddin, Noor Ahmed, and Shazadi Farha Diba. "Pattern of Child and Adolescent Patients Attending Psychiatric Outpatient Department of the Mental Hospital in Bangladesh." Faridpur Medical College Journal 7, no. 2 (January 28, 2013): 67–70. http://dx.doi.org/10.3329/fmcj.v7i2.13501.
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Bangladesh has only one mental hospital which is situated in Pabna district of the country. People from the nearby locality as well as from distant regions of the country come here for psychiatric service. Clinical records of all the children who attended the outpatient department of 'Mental Hospital, Pabna' (MHP) during January, 2009 to June, 2009 were analyzed. Of the 143 children, 125 (88%) were of school going age (i.e., ?6 years of age). The majority (63%) of the patients were male. International Classification of Diseases (ICD) classification revealed that the patients came with mental retardation (F70-F79) (38%), Episodic and paroxysmal disorder (G43-G44) (26%) and Schizophrenia, schizotypal & delusional disorders (F20-F29) (22%). The main comorbid condition was behavioural problem with mental retardation (43% of mentally retarded). Of the 103 patient we had information about the pathway to care, 20 patients (19%) came directly to MHP and the rest 83 (81%) consulted other service provider before reaching here. Among the previous service providers, there were medical graduates (60%), Kobiraj (36%) and indigenous & religious healer (34%). Considering the variety of presentation of child and adolescent patients, we propose to establish a multidisciplinary approach in MHP. DOI: http://dx.doi.org/10.3329/fmcj.v7i2.13501 Faridpur Med. Coll. J. 2012;7(2):67-70
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Slankamenac, Ksenija, Meret Zehnder, Tim Langner, Kathrin Krähenmann, and Dagmar Keller. "Recurrent Emergency Department Users: Two Categories with Different Risk Profiles." Journal of Clinical Medicine 8, no. 3 (March 9, 2019): 333. http://dx.doi.org/10.3390/jcm8030333.
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Recurrent emergency department (ED) visits are responsible for an increasing proportion of overcrowding. Therefore, our aim was to investigate the characteristics and prevalence of recurrent ED visitors as well as to determine risk factors associated with multiple ED visits. ED patients visiting the ED of a tertiary care hospital at least four times consecutively in 2015 were enrolled. Of 33,335 primary ED visits, 1921 ED visits (5.8%) were performed by 372 ED patients who presented in the ED at least four times within the one-year period. Two different categories of recurrent ED patients were identified: repeated ED users presenting always with the same symptoms and frequent ED visitors who were suffering from different symptoms on each ED visit. Repeated ED users had more ED visits (p < 0.001) and needed more hospital admissions (p < 0.010) compared to frequent ED users. Repeated ED users visited the ED more likely due to symptoms from chronic obstructive pulmonary diseases (p < 0.001) and mental disorders (p < 0.001). In contrast, frequent ED patients showed to be at risk for multiple ED visits when being disabled (p = 0.001), had an increased Charlson co-morbidity index (p = 0.004) or suffering from rheumatic diseases (p < 0.001). A small number of recurrent ED visitors determines a relevant number of ED visits with a relevance for and impact on patient centred care and emergency services. There are two categories of recurrent ED users with different risk factors for multiple ED visits: repeated and frequent. Therefore, multi-professional follow-up care models for recurrent ED patients are needed to improve patients’ needs, quality of life as well as emergency services.
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Sanahuja, C., and A. Suarez. "The importance of multiple-family group therapy in treatment of psychosomatic pathology." European Psychiatry 33, S1 (March 2016): S358—S359. http://dx.doi.org/10.1016/j.eurpsy.2016.01.1283.
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IntroductionThe “parental multiple-family school” was developed in Buenos Aires (Argentina) by E. Rotenberg, based on the theory and practice of J. García Badaracco's multiple-family psychoanalysis (which further expands on the classical psychoanalysis’ frame), applying it to the kids and their relatives. We will focus on the therapeutic group treating psychosomatic pathology, with the collaboration of the Dermatology department of the Hospital de Niños Dr. Ricardo Gutiérrez.ObjectiveTo highlight the importance of creating spaces to modify the psychic mechanisms and resources of the psychosomatic patient at an infant age.MethodsWe describe the “multiple-family parents school”, an open, weekly group, coordinated by two psychologists and assisted by a dermatologist, in which the theories of J. García Badaracco's multiple-family group analysis are applied. We also discuss the importance of applying this system in our clinical practice.ResultsWe observed, according to the Dermatology department, very positive and significative changes in every post-group, which could lead to the disappearance of dermatological diseases in different patients without a pharmacological treatment which was previously given as first option. Single-session groups had many advantages, including the removal of waiting lists, a better development of the emotional connection between kids and their families, and a reduction of the therapeutic and professional costs.ConclusionWe think that starting interventions in multiple-family group therapy in Madrid in order to treat psychosomatic diseases in kids and teenagers should be encouraged after the very positive clinical experience in other cities.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Leyden, Jacinta, Diana Back, Tina Lam, and Sejal B. Shah. "2.128 Psychiatric Emergency Department Chief Complaints and Wait Times in Children, Adolescents, and Young Adults During the COVID-19 Pandemic: A Retrospective Review of a Large Massachusetts Hospital System." Journal of the American Academy of Child & Adolescent Psychiatry 61, no. 10 (October 2022): S225. http://dx.doi.org/10.1016/j.jaac.2022.09.272.
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Розанов, V. Rozanov, Карташов, V. Kartashov, Северин, and A. Severin. "Protect the health of students." Journal of New Medical Technologies. eJournal 8, no. 1 (November 5, 2014): 0. http://dx.doi.org/10.12737/7229.
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In this article the authors analyzed the issues of real medical care of the students of the Lomonosov Moscow State University of the municipal polyclinic №202 of Moscow Health Department. Main tasks of medical services for students and professors of the University are stated in the Charter of the polyclinic in accordance with the Federal Law of December 29, 2012 № 273-FZ «On Education in the Russian Federation». Annual physical exam and medical examination of students are carried out in accordance with the requirements of the Ministry of health from 06.12.2012, №1011 and from 3 December 2012 №1006. Identifying diseases increased by 15%. Among the factors influencing the preservation of the health of students, the leading place belongs to the well-organized process of physical education and control over its organization in polyclinic in conjunction with the Department of physical education. The peculiarity of spread of diseases among students is the prevalence of respiratory diseases and, unexpectedly, diseases of the organs of vision. Among the diseases causing academic leave at the 1st place are the mental diseases, on the 2nd - the diseases of the nervous system, on the 3rd - the respiratory diseases. During 3 years of observation, the following results were obtained: 1 group on health has increased from 19,23% to 25,44%, i.e. the state of health hasn’t deteriorated. This confirms the effective work of the section of primary health care and its leading direction - prevention. In conclusion, the authors have identified problems of medical support of students and ways of reducing their negative impact.
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Trela, Wiktor, Cezary Sieńko, Małgorzata Futyma-Jędrzejewska, Sebastian Masternak, and Hanna Karakuła-Juchnowicz. "Mental disorders in neurological diseases. Can symptoms of bipolar disorder be the first manifestation of X-linked adenoleukodystrophy? A case report." Current Problems of Psychiatry 21, no. 2 (June 1, 2020): 109–21. http://dx.doi.org/10.2478/cpp-2020-0011.
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AbstractBackground: X-linked adrenoleukodystrophy (X-ALD) is an inherited metabolic disease which causes demyelination of the white matter of the brain. The symptoms include mental impairment, progressive paresis, impaired motor coordination, and epileptic seizures. Diagnosis is established mainly by genetic testing. Currently, the recommended treatment is haematopoietic stem cell transplantation (HSCT).Goal: The aim of the study was to present the case of a patient suffering from X-ALD, who developed symptoms of bipolar disorder in the initial phase of the disease prior to the onset of characteristic neurological symptoms.Case presentation: In 2015, a 33-year-old patient was admitted to a psychiatric department due to aggressive behaviour he showed towards his wife and other family members. He had been treated for a depressive episode in 2005, and for a manic episode without psychotic symptoms earlier in 2015. During the successive psychiatric hospitalizations, in addition to psychopathological symptoms, the patient had been observed to have neurological symptoms, which included progressive paraparesis and ataxia. In 2018, based on imaging and genetic tests, the patient was diagnosed with X-ALD. The patient’s condition gradually deteriorated; with time, he was unable to move on his own. During a hospital stay in 2019, he was transferred to an internal medicine department due to a progressive urinary tract infection, which, however, could not be controlled, and the patient died.Conclusions:1. X-ALD is a rare metabolic illness. In the early stages of the disease, various psychopathological symptoms, including affective disorders, are observed.2. Early initiation of adequate treatment increases the chances of extending the patient’s life.3. In the present case, the patient did not die due to the underlying disease, but due to causes typical of bed-bound patients, i.e. complications of progressing infection.