Current Issue : January-March Volume : 2022 Issue Number : 1 Articles : 5 Articles
Background: Acute brain injuries are associated with high mortality rates and poor long-term functional outcomes. Measurement of cerebrospinal fluid (CSF) biomarkers in patients with acute brain injuries may help elucidate some of the pathophysiological pathways involved in the prognosis of these patients. Methods: We performed a systematic search and descriptive review using the MEDLINE database and the PubMed interface from inception up to June 29, 2021, to retrieve observational studies in which the relationship between CSF concentrations of protein biomarkers and neurological outcomes was reported in patients with acute brain injury [traumatic brain injury, subarachnoid hemorrhage, acute ischemic stroke, status epilepticus or post-cardiac arrest]. We classified the studies according to whether or not biomarker concentrations were associated with neurological outcomes. The methodological quality of the studies was evaluated using the Newcastle–Ottawa quality assessment scale. Results: Of the 39 studies that met our criteria, 30 reported that the biomarker concentration was associated with neurological outcome and 9 reported no association. In TBI, increased extracellular concentrations of biomarkers related to neuronal cytoskeletal disruption, apoptosis and inflammation were associated with the severity of acute brain injury, early mortality and worse long-term functional outcome. Reduced concentrations of protein biomarkers related to impaired redox function were associated with increased risk of neurological deficit. In non-traumatic acute brain injury, concentrations of CSF protein biomarkers related to dysregulated inflammation and apoptosis were associated with a greater risk of vasospasm and a larger volume of brain ischemia. There was a high risk of bias across the studies. Conclusion: In patients with acute brain injury, altered CSF concentrations of protein biomarkers related to cytoskeletal damage, inflammation, apoptosis and oxidative stress may be predictive of worse neurological outcomes....
Neutropenia is an adverse effect of various pharmacological therapies, including antipsychotics. Among the second-generation antipsychotic (SGA) medications, clozapine is most notable for neutropenic adverse effect. Risperidone, another SGA drug, is linked mainly with metabolic adverse effects, but rarely, blood dyscrasia adverse reactions have been reported. Hence, we report the case of a 56-year-old African American woman who developed severe neutropenia following two weeks of oral risperidone treatment. Her neutrophil levels returned to normal limits following discontinuation of risperidone and switching to haloperidol....
Schizophrenia is one of the psychotic disorders that is a huge concern with prevalence increasing every year. In this case report, we are discussing the case of a 49-year-old female with no prior history of psychiatric illness and a recent diagnosis of menopause, presenting with signs and symptoms of schizophreniform disorder and menopause. After undergoing treatment with estrogen and risperidone, she experienced complete resolution of her delusions and hallucinations....
Background: Patients with mental disorders have an increased risk of developing somatic disorders, just as they have a higher risk of dying from them. These patients often report feeling devaluated and rejected by health professionals in the somatic health care system, and increasing evidence shows that disparities in health care provision contribute to poor health outcomes. The aim of this review was to map and synthesize literature on somatic health professionals’ stigmatization toward patients with mental disorders. Methods: We conducted a scoping review using Arksey and O’Malley’s framework and carried out a systematic search in three databases: Cinahl, MEDLINE, and PsycINFO in May–June 2019. Peer-reviewed articles published in English or Scandinavian languages during 2008–2019 were reviewed according to title, abstract and full-text reading. We organized and analyzed data using NVivo. Results: A total of 137 articles meeting the eligibility criteria were reviewed and categorized as observational studies (n = 73) and intervention studies (n = 64). A majority of studies (N = 85) focused on patients with an unspecified number of mental disorders, while 52 studies focused on specific diagnoses, primarily schizophrenia (n = 13), self-harm (n = 13), and eating disorders (n = 9). Half of the studies focused on health students (n = 64), primarily nursing students (n = 26) and medical students (n = 25), while (n = 66) focused on health care professionals, primarily emergency staff (n = 16) and general practitioners (n = 13). Additionally, seven studies focused on both health professionals and students. A detailed characterization of the identified intervention studies was conducted, resulting in eight main types of interventions. Conclusions: The large number of studies identified in this review suggests that stigmatizing attitudes and behaviors toward patients with mental disorders is a worldwide challenge within a somatic health care setting. For more targeted interventions, there is a need for further research on underexposed mental diagnoses and knowledge on whether specific health professionals have a more stigmatizing attitude or behavior toward specific mental disorders....
A Traumatic Brain Injury (TBI) is an injury to the brain caused by an external force (vehicle, accidents, violence, sports injuries, industrial accidents, falls). Brain trauma can occur either from an object penetrating the skull or from rapid acceleration (speeding up), or deceleration (slowing down or stopping suddenly) of the brain. Traumatic Brain Injury (TBI) is a major cause of mortality and disability, especially in children and young adults. Based on the Glasgow Coma Scale (GCS), the neurological scale used to measure a person’s level of consciousness after a brain injury, traumatic brain injury is classified as: mild (GCS 13 - 15), moderate (GCS 9 - 12), severe (GCS 8 or less), and evaluates the following functions: Eye Opening (E), Motor Response (M), and Verbal Response (V), to determine a patient’s overall GCS, add together the scores from eye opening, motor response and verbal response. Scores range from 3 to 15. A score of 8 or less signifies coma. Symptoms can vary depending on the severity of the head injury. An individual with a mild traumatic brain injury can remain conscious, or may experience a loss of consciousness for a few seconds or minutes. Other symptoms may include headache, confusion, dizziness, vision changes, ringing in the ears or changes in hearing, fatigue or lethargy, a change in sleep patterns, behavioral or mood changes, and cognitive and/or executive functioning problems. People with a moderate or severe traumatic brain injury may show the same symptoms, but may also have a headache that gets worse, repeated vomiting or nausea, convulsions or seizures, an inability to awaken from sleep, dilation of one or both pupils of the eyes, slurred speech, weakness or numbness in the extremities, loss of coordination, and increased confusion, restlessness, or agitation. Attention-Deficit/Hyperactivity Disorder secondary to Traumatic Brain Injury (TBI) is one of the most common neurobehavioral consequences of Traumatic Brain Injury (TBI), occurring in 20% to 50% of individual’s post-injury (Irastorza, 2011). Some of the most persistent problems include impairment in memory, attention and concentration, language, executive skills, social judgment, social behavior, and impulsiveness. Previous studies have shown that Traumatic Brain Injury (TBI) is a major cause of mental health problems and increases the risk of Attention- Deficit/Hyperactivity Disorder (Schachar et al., 2015). According to studies (Ilie et al., 2015), physical brain injury contributes to the development of Attention-Deficit/Hyperactivity Disorder. Because the risk of Attention-Deficit/ Hyperactivity Disorder development after Traumatic Brain Injury (TBI) remains high over an extended period, and some of the most persistent problems include impairment in memory, attention and concentration, language, executive skills, social judgment, social behavior, and impulsiveness; this master thesis shows the importance of an early prompt intervention after brain injury, and the need to establish a therapeutic plan in order to treat the Attention-Deficit/Hyperactivity Disorder development and evolution. The purpose of the present study is to investigate the association between Traumatic Brain Injury (TBI) and Attention-Deficit/Hyperactivity Disorder, and also to show the importance of prompt intervention and preventive therapy in order to stop the Attention-Deficit/Hyperactivity Disorder development and evolution....
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