Hypovitaminosis D is associated with depression and anxiety in schizophrenia: results from the national FACE-SZ cohort. Running title: hypovitaminosis D, depression and anxiety in schizophrenia

International audienceBackground. Guidelines have been edited for the treatment of schizophrenia (SZ) and bipola

Assessment of Strangulation in Adhesive Small Bowel Obstruction on the Basis of Combined CT Findings: Implications for Clinical Care

International audiencePurpose To determine which computed tomography (CT) findings or combinations of findings can help to accurately identify strangulation in adhesive small bowel obstruction (SBO). Materials and Methods Contrast agent-enhanced CT findings in a cohort of 256 patients consecutively admitted for adhesive SBO, with a delay of less than 24 hours between CT and surgery for the operated patients, were reviewed independently by two radiologists, with consensus by a third, to assess CT findings commonly associated with strangulation. The reference standard for strangulation was surgery. Univariate and multivariate analyses were performed to identify predictors of strangulation in the entire cohort and to identify predictors of the need for surgical resection in the subgroup of patients with strangulation. A CT score was obtained and diagnostic performances of different combined CT findings were calculated. Results In this study, 105 patients (41.0%; 105 of 256) underwent a surgical procedure, 62 of whom were found to have strangulation (59.0%; 62 of 105), whereas 151 patients (59.0%; 151 of 256) improved with medical care. Three CT findings were significantly associated with strangulation in the multivariate analysis: reduced bowel wall enhancement (odds ratio, 7.8; 95% confidence interval [CI]: 2.6, 23.5), diffuse mesenteric haziness (odds ratio, 6.1; 95% CI: 2.5, 15.2), and a closed-loop mechanism (odds ratio, 6.5; 95% CI: 2.8, 15.5). The model combining these three features had an area under the curve of 0.91 (95% CI: 0.86, 0.96) and a high negative predictive value (97%; 95% CI: 93%, 99%). Positive likelihood ratios were high when two or three of these CT findings were combined (positive likelihood ratios, 14.7 [95% CI: 7.1, 30.4] and 43.8 (95% CI: 14.2, 135.2], respectively). Among the strangulated cases, reduced bowel wall enhancement (odds ratio, 3.9; 95% CI: 1.3, 12) and mesenteric fluid (odds ratio, 3.6; 95% CI: 1.0, 12.8) were predictive of resection. Conclusion A score that combines three CT findings (reduced bowel wall enhancement, a closed-loop mechanism, and diffuse mesenteric haziness) can accurately predict strangulation in adhesive SBO.©RSNA, 2017 Online supplemental material is available for this article

Value of CT to predict surgically important bowel and/or mesenteric injury in blunt trauma: performance of a preliminary scoring system

International audienceTo evaluate the performance of a computed tomography (CT) diagnostic score to predict surgical treatment for blunt bowel and/or mesentery injury (BBMI) in consecutive abdominal trauma

Psychiatric disability as mediator of the neurocognition-functioning link in schizophrenia spectrum disorders: SEM analysis using the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale

International audienceThe functional outcome in schizophrenia spectrum disorders is affected by multiple factors such as cognitive performance and clinical symptoms. Psychiatric disability may be another important determinant of functional outcome. The purpose of this study was to test whether schizophrenia symptoms and psychiatric disability mediated the association between cognition and functioning. Between April 2013 and July 2017, we included 108 community-dwelling adults with stable schizophrenia spectrum disorder in a multicenter study. Psychiatric disability was assessed with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia (ECPDS) scale by relatives of patients. ECPDS focused on the broad array of motivational, neurocognitive, sociocognitive, and metacognitive impairments that result in activity restrictions. We used a battery of tests to assess seven cognition domains (processing speed, attention/vigilance, working, verbal and visual memory, reasoning and problem solving, and executive functioning) and cross-sectional structural equation modeling (SEM) for the mediation analyses. We estimated the one-year temporal stability of ECPDS scores in 45 participants. The model provided showed good fit and explained 43.9% of the variance in functioning. The effect of neurocognition on functioning was fully mediated by symptoms (proportion mediated: 36.5%) and psychiatric disability (proportion mediated: 31.3%). The ECPDS score had acceptable one-year temporal stability. The ECPDS scale has satisfactory psychometric properties, and shows significant convergence with neurocognition and functioning, suggesting a role for this tool in the routine evaluation of cognitive remediation needs. Our model validates psychiatric disability as a crucial step from cognitive impairment to restricted participation in life situations

Screening for cognitive deficits with the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale

International audienceOBJECTIVE::This study aimed to evaluate the validity of the Evaluation of Cognitive Processes involved in Disability in Schizophrenia scale (ECPDS) to discriminate for cognitive impairment in schizophrenia.DESIGN::This multicentre cross-sectional study used a validation design with receiver operating characteristic (ROC) curve analysis.SETTINGS::The study was undertaken in a French network of seven outward referral centres.SUBJECTS::We recruited individuals with clinically stable schizophrenia diagnosed based on the Structured Clinical Interview for assessing Diagnostic and Statistical Manual of Mental Disorders (4th ed., rev.; DSM-IV-R) criteria.MAIN MEASURES::The index test for cognitive impairment was ECPDS (independent variable), a 13-item scale completed by a relative of the participant. The reference standard was a standardized test battery that evaluated seven cognitive domains. Cognitive impairment was the dependent variable and was defined as an average z-score more than 1 SD below the normative mean in two or more cognitive domains.RESULTS::Overall, 97 patients were included (67 with schizophrenia, 28 with schizoaffective disorder, and 2 with schizophreniform disorder). The mean age was 30.2 (SD 7.7) years, and there were 75 men (77.3%). There were 59 (60.8%) patients with cognitive impairment on the neuropsychological battery, and the mean ECPDS score was 27.3 (SD 7.3). The ROC curve analysis showed that the optimal ECPDS cut-off was 29.5. The area under the curve was 0.77, with 76.3% specificity and 71.1% sensitivity to discriminate against cognitive impairment.CONCLUSION::The ECPDS is a valid triage tool for detecting cognitive impairment in schizophrenia, before using an extensive neuropsychological battery, and holds promise for use in everyday clinical practice

Climat et biodiversité : co-construire des problématiques intégrées pour répondre aux enjeux de l’espace marin (Ecole thématique CNRS Horizon 2030-Océan, juin 2021): Notices d'experts - Livrables (version abrégée)

Notices rédigées par les participants aux ateliers de l'EcoleCo-construire une gestion adaptative des socioécosystèmes côtiers : de la pluralité des connaissances à sa mise en oeuvre. Problématique interdisciplinaire La santé humaine est impactée par la pollution diffuse via les réseaux trophiques en raison d'une mauvaise gestion des déchets chimiques contenant des perturbateurs endocriniens

Climat et biodiversité : co-construire des problématiques intégrées pour répondre aux enjeux de l’espace marin (Ecole thématique CNRS Horizon 2030-Océan, juin 2021): Notices d'experts - Livrables (version abrégée)

Notices rédigées par les participants aux ateliers de l'EcoleCo-construire une gestion adaptative des socioécosystèmes côtiers : de la pluralité des connaissances à sa mise en oeuvre. Problématique interdisciplinaire La santé humaine est impactée par la pollution diffuse via les réseaux trophiques en raison d'une mauvaise gestion des déchets chimiques contenant des perturbateurs endocriniens

Climat et biodiversité : co-construire des problématiques intégrées pour répondre aux enjeux de l’espace marin (Ecole thématique CNRS Horizon 2030-Océan, juin 2021): Notices d'experts - Livrables (version abrégée)

Notices rédigées par les participants aux ateliers de l'EcoleCo-construire une gestion adaptative des socioécosystèmes côtiers : de la pluralité des connaissances à sa mise en oeuvre. Problématique interdisciplinaire La santé humaine est impactée par la pollution diffuse via les réseaux trophiques en raison d'une mauvaise gestion des déchets chimiques contenant des perturbateurs endocriniens