Subungual myiasis in a woman with psychiatric disturbance

WOS: 000260514600016PubMed ID: 18571464Myiasis is caused by the invasion of tissues or organs of men and animals by dipterous larvae. The disease is infrequent in Turkey. A case of a 65-year-old woman having been initially diagnosed with chronic psychosis, and found to have a left big toe nail invaded by the larvae of Calliphora spp., is presented. A total of 17 maggots were removed from the left big toe of the patient, which were then determined as Calliphora spp. The patient has undergone surgical withdrawal of both nails of her big toes, followed by the administration of oral prophylactic antimicrobial treatment. This is the second recorded case of subungual myiasis by Calliphora spp. in Turkey. Myiasis should be considered in patients with lower personal hygiene, especially with chronic psychiatric disturbances. (c) 2008 Elsevier Ireland Ltd. All rights reserved

Treatment Guidelines for Patients with Schizophrenia or Psychotic Disorder who are Hospitalized in a Psychiatry Clinic

In schizophrenia, hospitalization is generally indicated for patients who pose a serious threat to themselves or others, those who are disorganized to the extent of not to being able to look after themselves or who are experiencing delusions/hallucinations. The steps to be taken during the time hospitalization of patients with schizophrenia and psychosis as determined by the Hospital Setting Expert Committee (HSEC), consisting of 19 psychiatrists from Europe, who are specialists in the acute management of schizophrenia patients, have been arranged under 7 topics in the form of algorithms (Algorithm 1- Assessing the acute psychotic episode; Algorithm 2- Defining treatment targets for inpatient treatment; Algorithm 3- Emergency management; Algorithm 4- Defining treatment targets during inpatient treatment; Algorithm 5- Pharmacological treatment at the time of hospitalization; Algorithm 6-Non-pharmacological treatment during inpatient treatment; Algorithm 7- Improvement of well-being. The Turkish version of this guideline, which was revised to meet the conditions in our country, was used and tested in eight psychiatry clinics. Following these algorithms for hospitalized schizophrenia patients may be helpful for doctors in managing the patients and facilitating their participation in social life

A Study on the Frequency of Violence to Healthcare Professionals in a Mental Health Hospital and Related Factors

WOS: 000421440000004A study on the frequency of violence to healthcare professionals in a mental health hospital and related factors Objective: The research was carried out to investigate the violence situations that health staff in a mental health hospital is exposed to and the effective factors regarding those situations. Method: This descriptive study was carried out with 178 healthcare provider working in Manisa Mental Health Hospital, who accepted to participate in the study between March and May 2011. A questionnaire form that was designed by the researchers was used for data collection. Number-percentage distribution and chi-square methods were used for analysis. Results: Among healthcare providers, 73% were exposed to violence in their workplace; 51.1% were exposed to physical violence, 51.1% were exposed to verbal violence, 87.2% were exposed to violence by patients and 39.8% did not react after the act of violence. Conclusion: It was found that a great majority of healthcare providers were exposed to violence. Physical and verbal violence were the most common type of violence, the offenders of violence were mostly patients whereas the victims of the violence were mostly nurses as well as the staff working in contained wards. Investigating violence risk factors in psychiatric work environment, implementing an effective and systematically working security system, training of employees about the management of violence, improving the recording procedures for violence events, and developing written policies were suggested

Formal thought disorder in first-episode psychosis

Formal thought disorder (FTD) is one of the fundamental symptom clusters of schizophrenia and it was found to be the strongest predictor determining conversion from first-episode acute transient psychotic disorder to schizophrenia. Our goal in the present study was to compare a first-episode psychosis (FEP) sample to a healthy control group in relation to subtypes of FTD. Fifty six patients aged between 15 and 45 years with FEP and forty five control subjects were included in the study. All the patients were under medication for less than six weeks or drug-naive. FTD was assessed using the Thought and Language Index (TLI), which is composed of impoverishment of thought and disorganization of thought subscales. FEP patients showed significantly higher scores on the items of poverty of speech, weakening of goal, perseveration, looseness, peculiar word use, peculiar sentence construction and peculiar logic compared to controls. Poverty of speech, perseveration and peculiar word use were the significant factors differentiating FEP patients from controls when controlling for years of education, family history of psychosis and drug abuse. (C) 2016 Elsevier Inc. All rights reserved

Patient adherence and efficacy of quetiapine treatment in schizophrenia: results of a multicentre, naturalistic 6-month follow-up study

The aim of the study was to evaluate the adherence and efficacy of quetiapine treatment in a 6-month, multicentre, noninterventional naturalistic design. Overall, 710 schizophrenia patients using quetiapine or who had switched to quetiapine were included. The continuation rate for quetiapine treatment during 6-month follow-up period was 69%. Adherence improved with each subsequent visit for continued patients, 92.9% at the second visit to 96.1% at the last. Treatment adherence was correlated to improvement of symptoms, though not significantly. Patients having lower clinical global impression severity scores at the beginning were twice as likely to improve compared with patients with higher clinical global impression scores. Schizophrenia patients with antisocial behaviour problems had two and a half times higher drop-out rates. In conclusion, this naturalistic study showed that adherence to quetiapine treatment was high, and treatment was effective in schizophrenia patients during long-term treatment. Remission of symptoms in schizophrenia is much related to severity of symptoms at baseline, treatment adherence and characteristics of patients such as antisocial behavioural patterns. Int Clin Psychopharmacol 25:342-348 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Can Positron Emission Tomography and Computed Tomography Be a Substitute for Bone Marrow Biopsy in Detection of Bone Marrow Involvement in Patients with Hodgkin’s or Non-Hodgkin’s Lymphoma?

Objective: Positron emission tomography and computed tomography (PET/CT) has become an important part of staging and treatment evaluation algorithms of lymphoma. We aimed to compare the results of PET/CT with bone marrow biopsy (BMB) with respect to bone marrow involvement (BMI) in patients with Hodgkin’s lymphoma (HL) and aggressive non-Hodgkin’s lymphoma (aNHL). Materials and Methods: The medical files of a total of 297 patients diagnosed with HL or aNHL and followed at the hematology clinics of 3 major hospitals in İstanbul between 2008 and 2012 were screened retrospectively and 161 patients with classical HL and aNHL were included in the study. The patients were referred for PET/CT and BMB at the initial staging. BMB was performed as the reference standard for the evaluation of BMI. Results: There were 61 (38%) HL and 100 (62%) aNHL patients. Concordant results were revealed between PET/CT and BMB in 126 patients (78%) (52 HL, 74 aNHL), 20 with positive PET/CT and BMB results and 106 with negative PET/CT and BMB results. There were discordant results in 35 patients (9 HL, 26 aNHL), 16 of them with positive BMB and negative PET/CT results and 19 of them with negative BMB and positive PET/CT results. Conclusion: We observed that PET/CT is effective to detect BMI, despite it alone not being sufficient to evaluate BMI in HL and aNHL. Bone marrow trephine biopsy and PET/CT should be considered as mutually complementary methods for detection of BMI in patients with lymphoma. In suspected focal involvement, combining biopsy and PET/CT might improve staging results