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10 results

  • A systematic review of COVID-19 and the presentation of avoidant/restrictive food intake disorder and avoidant/restrictive food intake disorder-like symptoms

  • Kristen Maunder, Oscar Markey, Rachel Batchelor, Fiona McNicholas
  • Journal:
    BJPsych Open / Volume 10 / Issue 2 / March 2024
    Published online by Cambridge University Press:
    04 March 2024, e56
    • Article
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  • Background

    The adverse effects of COVID-19 and the associated restrictions on eating disorder populations have been discussed in recent literature. However, little is known about the presentation of cases with avoidant/restrictive food intake disorder (ARFID) during this period.

    Aims

    To explore the extent of the literature on the presentation of ARFID, and ARFID-like cases, during the COVID-19 pandemic.

    Method

    Cochrane Library, CINAHL (EBSCO), PsycINFO (EBSCO), EMBASE (Ovid) and Medline (Ovid) were searched for publications between March 2020 and May 2023. Google Scholar and reference lists were hand searched. At least two reviewers independently screened each paper. Narrative synthesis was used.

    Results

    Seven papers were included: four case reports and three cohort studies (total ARFID sample of 46). Included papers were assessed as having high (n = 3) or moderate (n = 4) quality. Findings did not suggest an increase in ARFID cases during the COVID-19 pandemic, although it is unclear if this is because of a lack of impact or underrecognition of ARFID. A need for a multidisciplinary approach to differentiate between ARFID and organic causes of ARFID-like presentations (e.g. gastrointestinal effects of COVID-19) was highlighted.

    Conclusions

    Publications specifically pertaining to ARFID presentations during the COVID-19 pandemic have been few. Papers found have been of small sample sizes and lack subanalyses for ARFID within broader eating disorder samples. Continued surveillance is needed to evaluate any COVID-19-specific effects on the development, identification, treatment and outcomes of ARFID.

  • Chapter 72 - Adnexal Mass in Pregnancy

  • from Section 12 - Malignant Conditions in Pregnancy
  • Edited by Amira El-Messidi, McGill University, Montréal, Alan D. Cameron, University of Glasgow
  • Book:
    OSCEs in Obstetrics and Maternal-Fetal Medicine
    Published online:
    23 February 2023
    Print publication:
    16 February 2023, pp 909-921

  • Summary

    You are seeing a patient referred by her primary care provider for consultation at your tertiary center’s high-risk obstetrics unit. She is a 37-year-old primigravida currently at 13+2 weeks’ gestation with an incidental 7-cm complex right adnexal mass detected last week on routine first-trimester sonography performed at an external center. Although the ultrasound report is not yet available to you, the consultation note confirms a singleton intrauterine pregnancy with normal fetal morphology and low risk of aneuploidy using sonographic markers. Routine serum prenatal investigations are only significant for iron-deficiency anemia.

  • Chapter 71 - Cervical Cancer in Pregnancy

  • from Section 12 - Malignant Conditions in Pregnancy
  • Edited by Amira El-Messidi, McGill University, Montréal, Alan D. Cameron, University of Glasgow
  • Book:
    OSCEs in Obstetrics and Maternal-Fetal Medicine
    Published online:
    23 February 2023
    Print publication:
    16 February 2023, pp 898-908

  • Summary

    You are covering an obstetrics clinic for your colleague, who left for vacation last week. A healthy 32-year-old primigravida at 13+4 weeks’ gestation called for an emergency appointment after experiencing two episodes of postcoital bleeding over the past week. She met your colleague last week at her first prenatal visit, which was unremarkable. Sonographic dating was appropriate for menstrual age, and first-trimester fetal anatomy was normal. You note that all routine prenatal serum laboratory investigations are normal with low-risk screening tests for fetal aneuploidy. Without a cervical smear in over two years, cytology was performed, and results are expected shortly.

  • Chapter 73 - Lymphoma and Leukemia in Pregnancy

  • from Section 12 - Malignant Conditions in Pregnancy
  • Edited by Amira El-Messidi, McGill University, Montréal, Alan D. Cameron, University of Glasgow
  • Book:
    OSCEs in Obstetrics and Maternal-Fetal Medicine
    Published online:
    23 February 2023
    Print publication:
    16 February 2023, pp 922-936

  • Summary

    You are seeing a patient referred by her primary care provider for consultation at your tertiary center’s high-risk obstetrics unit. She is a 27-year-old primigravida at 16+3 weeks’ gestation with intermittent swelling of her arms and face that appears within several minutes of brushing her hair and resolves upon lowering her arms. First-trimester dating sonography was concordant with menstrual dates, and fetal morphology appeared normal, with a low risk of aneuploidy; apart from HIV-negative status, results of other routine baseline prenatal investigations are not yet available to you. She has not experienced abdominal cramps or vaginal bleeding. Her medications include only routine prenatal vitamins.

  • Acute rheumatic fever in south-east of Turkey: clinical features and epidemiological evaluation of the patients over the last 25 years

  • Sevcan Erdem, Fadli Demir, Mustafa Ayana, Oguz Canan, Yankı Kaan Okuducu, Alev Arslan, Osman Kucukosmanoglu, Nazan Özbarlas
  • Journal:
    Cardiology in the Young / Volume 30 / Issue 8 / August 2020
    Published online by Cambridge University Press:
    02 July 2020, pp. 1086-1094

  • This study evaluates clinical and epidemiological features of acute rheumatic fever using the data of last 25 years in our hospital in south-east of Turkey. The medical records of 377 patients with acute rheumatic fever admitted to Pediatric Cardiology Department of Çukurova University during 1993–2017 were retrospectively analysed. Two hundred and six patients were admitted between 1993 and 2000, 91 between 2001 and 2008, and 80 between 2009 and 2017. The largest age group (52%) were between 9 to 12 years of age and approximately two-thirds of the patients presented in the spring and winter seasons (62.8%). Among the major findings, the most common included carditis 83.6% (n = 315), arthritis at 74% (n = 279), Sydenham’s chorea at 13.5% (n = 51), and only two patients (0.5%) had erythema marginatum and two patients (0.5%) had subcutaneous nodule. Carditis was the most common manifestation observed in 315 patients (83.6%). The most commonly affected valve was the mitral valve alone (54.9%), followed by a combined mitral and aortic valves (34%) and aortic valve alone (5.7%). Of the patients with carditis, 48.6% (n = 153) had mild carditis, of which 45 had a subclinical. Sixty-two patients (19.7%) had moderate and 100 patients (31.7%) had severe carditis. At the follow-up, 2 patients died and 16 patients underwent valve surgery. Twenty-eight (7.4%) patients’ valve lesions were completely resolved. Conclusion: Although the incidence of acute rheumatic fever decreased, it still is an important disease that can cause serious increases in morbidity and mortality rates in our country.

  • Detecting delirium in elderly outpatients with cognitive impairment

  • Anne J. M. Stroomer-van Wijk, Barbara W. Jonker, Rob M. Kok, Roos C. van der Mast, Hendrika J. Luijendijk
  • Journal:
    International Psychogeriatrics / Volume 28 / Issue 8 / August 2016
    Published online by Cambridge University Press:
    15 April 2016, pp. 1303-1311
  • Background:

    Delirium may be more prevalent in elderly outpatients than has long been assumed. However, it may be easily missed due to overlap with dementia. Our aim was to study delirium symptoms and underlying somatic disorders in psycho-geriatric outpatients.

    Methods:

    We performed a case-control study among outpatients that were referred to a psychiatric institution between January 1st and July 1st 2010 for cognitive evaluation. We compared 44 cases with DSM-IV delirium (24 with and 20 without dementia) to 44 controls with dementia only. All participants were aged 70 years or older. We extracted from the medical files (1) referral characteristics including demographics, medical history, medication use, and referral reasons, (2) delirium symptoms, scored with the Delirium Rating Scale-Revised-98, and (3) underlying disorders categorized as: drugs/intoxication, infection, metabolic/endocrine disturbances, cardiovascular disorders, central nervous system disorders, and other health problems.

    Results:

    At referral, delirium patients had significantly higher numbers of chronic diseases and medications, and more often a history of delirium and a recent hospital admission than controls. Most study participants, including those with delirium, were referred for evaluation of (suspected) dementia. The symptoms that occurred more frequently in cases were: sleep disturbances, perceptual abnormalities, delusions, affect lability, agitation, attention deficits, acute onset, and fluctuations. Drug related (68%), infectious (61%), and metabolic-endocrine (50%) disturbances were often involved.

    Conclusions:

    Detection of delirium and distinction from dementia in older outpatients was feasible but required detailed caregiver information about the presence, onset, and course of symptoms. Most underlying disorders could be managed at home.

  • Chapter 17 - Animal models and experimental treatments of intracerebral hemorrhage

  • from Section 7 - Advances in pathogenesis and treatment of intracerebral hemorrhage: experimental
  • Edited by J. Ricardo Carhuapoma, Stephan A. Mayer, Columbia University, New York, Daniel F. Hanley
  • Book:
    Intracerebral Hemorrhage
    Published online:
    04 May 2010
    Print publication:
    12 November 2009, pp 193-205

  • Summary

    Intracerebral hemorrhage (ICH) presents clinically in a variety of ways, depending primarily on the location and size of the hematoma. Several studies have correlated the anatomical location of putaminal hemorrhages with their clinical presentation. Caudate hemorrhage presents with sudden onset of headache, vomiting, and altered level of consciousness, resembling subarachnoid hemorrhage (SAH) from ruptured cerebral aneurysm. Behavioral and neuropsychological abnormalities can be a prominent part of the clinical picture of caudate hemorrhage. Lobar ICHs occur in any of the cerebral lobes, generally favoring the parietal and occipital areas although some series have reported a predominance of frontal or temporal locations. Primary hemorrhage into the medulla oblongata is the least common of all brain hemorrhages. The most consistent clinical profile in medullary hemorrhage has been with sudden onset of headache, vertigo, dysphagia, dysphonia or dysarthria, and limb incoordination.

  • 5 - Posttraumatic stress disorder in women

    • By Mark Creamer, Australian Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne, Victoria, Australia, Jessica Carty, Australian Centre for Posttraumatic Mental Health, University of Melbourne, Melbourne, Victoria, Australia
  • Edited by David Castle, University of Melbourne, Jayashri Kulkarni, Monash University, Victoria, Kathryn M. Abel
  • Foreword by Jill Goldstein
  • Book:
    Mood and Anxiety Disorders in Women
    Published online:
    13 August 2009
    Print publication:
    23 February 2006, pp 75-91

  • Summary

    This chapter discusses posttraumatic stress disorder (PTSD) in women. The clinical presentation in both men and women is often complex, with high levels of depression, anxiety, and substance use. Several epidemiological studies have indicated that, while men are more likely than women to be exposed to traumatic events, the prevalence of PTSD within the community is approximately twice as high for women. Few studies have investigated psycho physiological differences between men and women in acute reactions to threat that may serve as potential mediators for PTSD vulnerability. A mounting body of empirical research has supported the efficacy of certain types of psychotropic medication in the treatment of PTSD. Finally, while women may be at greater risk for the development of psychiatric sequelae following trauma, preliminary findings from treatment outcome studies indicate that they may benefit from PTSD interventions to a greater extent than men.