Symptoms Moderating the Association between Recent Suicide Attempt and Traumatic Morbidity: Fan-shaped Effects

The present study examines variables affecting the incidence of recent suicide attempt in a large sample of participants who experienced various levels of traumatic morbidity. The sample was drawn from a French nationally representative, general population survey (N= 39,617). In the same line with previous research on the data provided by the survey, five levels of traumatic morbidity were used on the basis of answers to the post-traumatic stress disorder items from the French version of Mini International Neuropsychiatric Interview. Twenty four items, representing Axis I psychopathological symptoms and suicidality indexes, were tested to identify intervening variables moderating the suicide attempt incidence in any given traumatic morbidity level. Seven items yielded a systematic effect: four suicidality items, two major depression items and one panic disorder item. The main findings consist of (i) the suppressing effect of the absence of these symptoms, and (ii) the gradual increasing effect of their presence. These results underline the importance of comorbid symptoms in the association between trauma and suicidality

Evidence-based Ordering of MINI Suicidality Module’s Response Profiles: Application to SMPG Data

Mini International Neuropsychiatric Interview approach to suicidality assessment relies upon a priori ordering of possible response profiles (n-tuples) that describe the presence/absence of five risk factors (‘yes/no’ response format). Conjunctive and disjunctive rules order the MINI’s 5-tuples. Using ‘recent suicide attempt’ as a suicidality criterion, the present study aimed at (i) ordering the 4-tuples in the SMPG (Roelandt, Caria, & Mondière, 2000) sample of 39,617 French adults, and (ii) detecting the items, among 20 screening items used for Axis I diagnosis, that are informative for suicidality assessment. Three suicidality levels were identified. Co-occurrence of suicide ideation, self-harm intention, and lifetime suicide attempt forms a high risk condition: 44% of current month suicide, 95% confidence interval = [0.38, 0.50]. All suicidality levels were systematically moderated by chronic anxiety. This symptom should be included in the set of relevant risk factors for suicidality assessment

Serotonin syndrome in an old man with chronic kidney disease treated with linezolid: Case report

RESUMEN: El síndrome serotoninérgico es una reacción adversa y potencialmente mortal a medicamentos; está caracterizado por cambios en el estado mental, hiperactividad autonómica y anormalidades músculo-esqueléticas causadas por exceso de serotonina a nivel central. Se reporta el caso de un paciente de 71 años con enfermedad renal crónica estadio V y cuadro clínico de infección intraabdominal asociada al catéter. Luego de 33 días de la hospitalización presentó temblor en manos, hiperreflexia y taquicardia. Al día 36 se tornó confuso, desorientado e incoherente, con palpitaciones y disneico. Entre los factores de riesgo para desarrollo de síndrome serotoninérgico se encuentra el uso de linezolid, que en combinación de otros medicamentos con acción serotoninérgica —como los inhibidores selectivos de recaptación de serotonina, el litio, la trazodona, entre otros— se asocia con la presentación de este cuadro. El síndrome serotoninérgico puede ser evitado con una buena educación al personal médico y la modificación de las conductas de prescripción de medicamentos; el pilar del tratamiento se basa en la suspensión de los fármacos que están causando el cuadro y el planteamiento de medidas de soporte.ABSTRACT: Serotonin syndrome is a potentially fatal adverse reaction to medication. It is described as a clinical entity characterized by changes in mental status, autonomic hyperactivity and musculoskeletal abnormalities caused by excess of serotonin at the central nervous system. A 71 years old patient with history of stage V of chronic kidney disease with clinical symptoms of intraabdominal infection associated with catheter is reported. After 33 days of hospitalization the patient began to show hand tremor, tachycardia and hyperreflexia. On day 36, the patient became confused, disoriented and incoherent, dyspneic and with palpitations. Linezolid in combination with others drugs with serotoninergic action —such as selective serotonin reuptake inhibitors, litium, trazodone and others— has been associated with serotonin syndrome presentation. Serotonin syndrome can be avoided through a combination of medical staff education and the modification of prescription drugs behavior. The mainstay of treatment is based on the suspension of drugs that cause the symptoms and the proposal of support measures

Validation of the French Version of the Child Post-Traumatic Stress Reaction Index: Psychometric Properties in French Speaking School-Aged Children

Background: Although the reliable and valid Child Post-Traumatic Stress Reaction Index (CPTS-RI) is a widely used measure of posttraumatic stress disorder (PTSD) symptoms in children, it has not been validated in French-speaking populations. The present study aims to assess the psychometric properties of the CPTS-RI in three samples of French-speaking school-children. Methods: Data was obtained from three samples. Sample 1 was composed of 106 children (mean (SD) age = 11.7(0.7), 50% females) victims of an industrial disaster. Sample 2 was composed of 50 children (mean (SD) age = 10.8(2.6), 44% females) who had received an orthopaedic surgical procedure after an accident. Sample 3 was composed of 106 children (mean (SD) age = 11.7(2.2), 44% females) admitted to an emergency department after a road traffic accident. We tested internal consistency using Cronbach's alpha. We examined test-retest reliability using intraclass correlation coefficient. In order to assess the convergent validity of the French version of the CPTS-RI and the Clinician Administered PTS Scale-Child and Adolescent (CAPS-CA), spearman-correlation coefficient was computed. To verify the validity of the cut-off scores, a ROC curve was constructed which evaluated the sensitivity and specificity of each score compared to the diagnosis with the CAPS-CA. We also used principal components analysis with varimax rotation to study the structure of the French version of the CPTS-RI. Results: Cronbach's alpha coefficient was 0.87 for the French version of the CPTS-RI. Two-week test-retest intraclass correlation coefficient (n = 30) was 0.67. The French version of the CPTS-RI was well correlated with the CAPS-CA (r = 0.76, p24 for the CPTS-RI, the sensitivity and specificities were 100% and 62.6%, respectively. The French version of the CPTS-RI demonstrated a three-factor structure. Conclusions: The CPTS-RI is reliable and valid in French-speaking children

Biotic inactivation of the Pseudomonas aeruginosa quinolone signal molecule

In Pseudomonas aeruginosa, quorum sensing (QS) regulates the production of secondary metabolites, many of which are antimicrobials that impact on polymicrobial community composition. Consequently, quenching QS modulates the environmental impact of P. aeruginosa. To identify bacteria capable of inactivating the QS signal molecule 2-heptyl-3- hydroxy-4(1H)-quinolone (PQS), a minimal medium containing PQS as the sole carbon source was used to enrich a Malaysian rainforest soil sample. This yielded an Achromobacter xylosoxidans strain (Q19) that inactivated PQS, yielding a new fluorescent compound (I-PQS) confirmed as PQS-derived using deuterated PQS. The I-PQS structure was elucidated using mass spectrometry and nuclear magnetic resonance spectroscopy as 2-heptyl-2-hydroxy-1,2-dihydroquinoline- 3,4-dione (HHQD). Achromobacter xylosoxidans Q19 oxidized PQS congeners with alkyl chains ranging from C1 to C5 and also N-methyl PQS, yielding the corresponding 2-hydroxy-1,2-dihydroquinoline-3,4- diones, but was unable to inactivate thePQSprecursor HHQ. This indicates that the hydroxyl group at position 3 in PQS is essential and that A. xylosoxidans inactivates PQS via a pathway involving the incorporation of oxygen at C2 of the heterocyclic ring. The conversion of PQS to HHQD also occurred on incubation with 12/17 A. xylosoxidans strains recovered from cystic fibrosis patients, with P. aeruginosa and with Arthrobacter, suggesting that formation of hydroxylated PQS may be a common mechanism of inactivation

Biotic inactivation of the Pseudomonas aeruginosa quinolone signal molecule

In Pseudomonas aeruginosa, quorum sensing (QS) regulates the production of secondary metabolites, many of which are antimicrobials that impact on polymicrobial community composition. Consequently, quenching QS modulates the environmental impact of P. aeruginosa. To identify bacteria capable of inactivating the QS signal molecule 2-heptyl-3- hydroxy-4(1H)-quinolone (PQS), a minimal medium containing PQS as the sole carbon source was used to enrich a Malaysian rainforest soil sample. This yielded an Achromobacter xylosoxidans strain (Q19) that inactivated PQS, yielding a new fluorescent compound (I-PQS) confirmed as PQS-derived using deuterated PQS. The I-PQS structure was elucidated using mass spectrometry and nuclear magnetic resonance spectroscopy as 2-heptyl-2-hydroxy-1,2-dihydroquinoline- 3,4-dione (HHQD). Achromobacter xylosoxidans Q19 oxidized PQS congeners with alkyl chains ranging from C1 to C5 and also N-methyl PQS, yielding the corresponding 2-hydroxy-1,2-dihydroquinoline-3,4- diones, but was unable to inactivate thePQSprecursor HHQ. This indicates that the hydroxyl group at position 3 in PQS is essential and that A. xylosoxidans inactivates PQS via a pathway involving the incorporation of oxygen at C2 of the heterocyclic ring. The conversion of PQS to HHQD also occurred on incubation with 12/17 A. xylosoxidans strains recovered from cystic fibrosis patients, with P. aeruginosa and with Arthrobacter, suggesting that formation of hydroxylated PQS may be a common mechanism of inactivation

A systematic review of the effects of novel psychoactive substances “legal highs” on people with severe mental illness

Introduction: Novel psychoactive substances (NPS) are synthetic substances that have been developed to produce altered states of consciousness and perceptions. People with severe mental illness (SMI) are more likely to use NPS than people without mental illness, but the short and long-term effects of NPS are largely unknown. Method: We systematically reviewed the literature about the effects of NPS on people with SMI. Results: We included 12 case reports, 1 cross-sectional survey and 1 qualitative study. Participants included mostly males aged between 20 and 35 years. A variety of NPS were used, including synthetic cathinones and herbs such as salvia. The most commonly reported effects of NPS were psychotic symptoms (in some cases novel in form and content to the patients’ usual symptoms) and significant changes in behaviour, including agitation, aggression and violence. Patients’ vital signs; blood pressure, pulse rate and temperature were also commonly affected. Conclusion: NPS potentially have serious effects on people with severe mental illness but our findings have limited generalisability due to a reliance on case studies. There is a paucity of evidence about the long-term effects of these substances. Further research is required to provide a better understanding about how different NPS affect patients’ mental and physical health. PROSPERO Identifier: CRD42015026944 Keywords: legal highs, novel psychoactive substances, psychotic disorders, severe mental illness, schizophrenia, systemati

El autor piensa en público : David Lodge presenta su novela Pensamientos Ocultos'

Obra ressenyada: David LODGE, Pensamiento ocultosapplication/pd