Management of alcohol withdrawal in a general hospital: Our experience from an addiction psychiatry unit

Alcohol abuse is a major public health problem. This brief report summarizes our experience from the management of alcohol withdrawal in patients of our hospital. We describe the alcohol withdrawal syndrome and the way we treat these patients. We stress the importance of early recognition and treatment of this syndrome, in order to prevent serious complications, such as delirium tremens and withdrawal seizure

Tako-Tsubo cardiomyopathy in a patient with schizoaffective disorder and severe hyponatremia

We report a case of Tako-Tsubo cardiomyopathy, which causes a reversible malfunction of the left  ventricular apex, diagnosed on a female inpatient in the psychiatric clinic with schizoaffective disorder and severe hyponatriaemia. After the proper treatment in the coronary unit and the psychiatric clinic, the heart function returned to normal and the psychotic episode was remitted. The early diagnosis and the cooperation of psychiatrists and cardiologists is considered necessary

Μηχανισμός προσαρμογής των λιπιδίων του τροφογενούς παθογόνου βακτηρίου Listeria monocytogenes σε αντιοξειδωτικά και σε συνδυασμό με θερμοκρασία, pH και άλλες συνθήκες – Συνέπειες στην ασφάλεια των τροφίμων

Το βακτήριο Listeria monocytogenes εμφανίζεται σε μια ποικιλία τροφίμων και έχει προκαλέσει πολλές ομαδικές τροφολοιμώξεις με υψηλά ποσοστά θνησιμότητας. Η τροποποίηση της σύστασης των μεμβρανικών λιπιδίων του και συνεπώς η μεταβολή της ρευστότητας της κυτταρικής μεμβράνης, είναι ένας μηχανισμός προσαρμογής που του επιτρέπει να αναπτύσσεται σε δυσμενείς συνθήκες, όπως χαμηλή θερμοκρασία, όξινο pH, παρουσία οργανικών οξέων κλπ. Τα αρωματικά φυτά [όπως η ρίγανη (Origanum vulgare L.)] είναι σπουδαίες πηγές αντιοξειδωτικών και αντιμικροβιακών ουσιών και μπορούν να χρησιμοποιηθούν ως φυσικά συντηρητικά στα τρόφιμα. Σκοπός αυτής της διατριβής ήταν να εξεταστεί αν ένα υδατικό εκχύλισμα ρίγανης μπορεί να δράσει ως φυσικό αντιμικροβιακό ενάντια στο βακτήριο L. monocytogenes, καθώς κι οι αλλαγές που πραγματοποιούνται στα λιπίδια της μεμβράνης του, κατά τη προσαρμογή του σε ήπιες συγκεντρώσεις του εκχυλίσματος. Για το σκοπό αυτό, η μελέτη εστιάστηκε σε τρεις κύριες κατευθύνσεις. Η πρώτη κατεύθυνση αφορούσε την μελέτη του εκχυλίσματος της ρίγανης που χρησιμοποιήθηκε στην υπόλοιπη πειραματική πορεία (συνολικό περιεχόμενο φαινολικών συστατικών, αντιοξειδωτική ικανότητα και ταυτοποίηση φαινολικών ενώσεων). Η δεύτερη κατεύθυνση επικεντρώθηκε στην πιθανή επίδραση του εκχυλίσματος στην επιβίωση του βακτηρίου α) σε καλλιέργειες με θρεπτικό ζωμό και συσχέτιση της δράσης του και με άλλες συνθήκες συντήρησης των τροφίμων, όπως χαμηλή θερμοκρασία (5°C) και όξινο pH (pH 5,5, οξικό οξύ) και β) σε ένα μοντέλο πραγματικού τροφίμου, όπως είναι ο τοματοχυμός, σε δύο διαφορετικές θερμοκρασίες αποθήκευσής του (30 και 5°C). Η τρίτη κατεύθυνση ήταν η μελέτη των λιπιδίων της κυτταρικής μεμβράνης του βακτηρίου υπό την επίδραση του εκχυλίσματος ρίγανης, ώστε να διερευνηθεί ένας από τους μηχανισμούς προσαρμογής του (προσδιορισμός του ποσοστού των λιπιδίων, των λιπαρών οξέων και της ρευστότητας της μεμβράνης). Τα αποτελέσματα έδειξαν ότι το υδατικό εκχύλισμα ρίγανης είναι πλούσιο σε φαινολικές ενώσεις (223,86±2,31 mg ισοδύναμα γαλλικού οξέος/100mL) και εμφανίζει υψηλή αντιοξειδωτική ικανότητα (12017,00±201,36 mg ασκορβικού οξέος/100mL). Ταυτοποιήθηκαν ορισμένες φαινολικές ουσίες, όπως λουτεολίνη, απιγενίνη, μεθυλαπιγενίνη, kaempferide, κουμαρικό οξύ σε Ο-γλυκουρονικές μορφές καθώς και ροσμαρινικό οξύ. Το υδατικό εκχύλισμα ρίγανης μείωσε τον πληθυσμό του βακτηρίου σε θρεπτικό μέσο σε πολύ χαμηλά επίπεδα, κυρίως όταν η παρουσία του συνδυάστηκε με θερμοκρασία ψυγείου (5°C) ή/και με οξικό οξύ (pH 5,5). Επίσης μείωσε τον πληθυσμό του βακτηρίου που ενοφθαλμίστηκε σε παστεριωμένο χυμό τομάτας κατά την αποθήκευση σε 5°C, κατά 3,7log κυττάρων/g (65,3%) μετά από 12 ημέρες αποθήκευσης. Το εκχύλισμα της ρίγανης τροποποίησε τη σύσταση των λιπαρών οξέων του βακτηρίου, εισάγοντας περισσότερα λιπαρά οξέα ευθείας αλυσίδας και λιγότερα διακλαδισμένα, κυρίως όταν η παρουσία του συνδυαστεί με οξικό οξύ σε pH 5,5 (303,8% αύξηση και 33,8% μείωση, αντίστοιχα). Οι παραπάνω αλλαγές στα λιπαρά οξέα του βακτηρίου, ερμηνεύουν και την μείωση της ρευστότητας της κυτταρικής μεμβράνης του που παρατηρήθηκε. Τα παραπάνω αποτελέσματα δείχνουν, ότι ένα υδατικό εκχύλισμα ρίγανης θα μπορούσε να χρησιμοποιηθεί ως φυσικό αντιμικροβιακό ενάντια στο βακτήριο L. monocytogenes, ειδικά σε ένα όξινο τρόφιμο, το οποίο θα αποθηκευτεί σε χαμηλή θερμοκρασία.The pathogen Listeria monocytogenes is present in a variety of food products and is a main reason for many outbreaks with high case fatality rates. Modification of its membrane lipid composition, and thus changes in cytoplasmic membrane fluidity, is an adaptation mechanism in L. monocytogenes, which allows it to grow in a stressful environment such as low temperature, low pH, presence of organic acids, etc. Aromatic plants [including oregano (Origanum vulgare L.)] are great sources of antioxidants and antimicrobial compounds for natural food preservation. The aim of this thesis was to determine if a water infusion of oregano is able to act as a natural antimicrobial agent against L. monocytogenes and the changes that will occur in its membrane lipids, during its adaptation of sub-lethal concentration of oregano infusion. For this purpose, this thesis was focused on three main directions. The first direction was concerned about the oregano infusion that was used in the experimental procedure (determination of total phenolic content, antioxidant ability and identification of phenolic compounds). The second direction was focused on the potential impact of this infusion on the survival of the bacterium a) in nutrient broth cultures and correlation of its action in other conditions of food preservation, such as low temperature (5°C) and acid pH (pH 5.5, acetic acid) and b) in a real food model, such as tomato juice, in two different storage temperatures (30 and 5°C). The third guideline was the study of membrane lipids of the bacterium under the influence of the infusion of oregano; in order to be explored one of its adaptation mechanisms (determination of the lipids proportion, fatty acids and membrane fluidity). The results demonstrated that the water infusion of oregano is rich in phenolic compounds (223.86±2.31mg gallic acid equivalents/100mL) and has strong antioxidant activity (12017.00±201.36 mg ascorbic acid equivalents/100mL). Some of the phenolic compounds were identificated such as luteolin, apigenin, methylapigenin, kaempferide, coumaric acid as O-glucuronide forms and rosmarinic acid. The infusion of oregano reduced the cells of L. monocytogenes in broth at very low levels, mainly when its presence was combined with refrigerator temperature or/and acetic acid (pH 5.5). The presence of oregano infusion reduced the inoculated cells of L. monocytogenes in pasteurized tomato juice at 5°C of storage (3.7log decline after 12 days, 65.3% decrease). The infusion of oregano had altered the fatty acid composition of L. monocytogenes by incorporation more straight fatty acids but fewer branched-chain fatty acids into its membrane, mainly when its presence was combined with acetic acid in pH 5.5 (303.8% increase and 33.8% decrease, respectively). The above changes in fatty acids composition of L. monocytogenes interpreted the reduced membrane fluidity, which was measured. The above results indicate that a water infusion of oregano could be used as a natural antimicrobial agent against L. monocytogenes, especially in an acidic food which will be stored at low temperature

Pseudocyesis as a healing mechanism for psychological trauma

Pseudocyesis, a rare condition characterized by clinical signs and symptoms of pregnancy except for the actual existence of a fetus, is a somatic symptom disorder associated with a variety of biological, psychological and social factors. The present report aims to present the case of a 45-year old patient with pseudocyesis from a psychodynamic perspective. According to a psychodynamic perspective and based on patient’s history, pseudocyesis functioned as a mental healing mechanismfor the trauma of long-standing infertility, the trauma of eight unsuccessful and painful in vitro fertilization attempts and above all, the trauma of finally giving birth to a non-healthy child

Fear of COVID-19, anxiety, depression and suicide among elderly patients with chronic physical or mental diseases

Older age renders individuals vulnerable during public emergency crises. Considering that older adults are a highly heterogeneous and continuously growing demographic subgroup, this study aimed to assess the mental health impact of COVID-19 on two groups of older patients: a group of chronic physical disease and a group of chronic mental disease. A total of 102 patients completed the Fear of COVID-19 Scale, the Generalized Anxiety Disorder scale, the Brief Patient Health Questionnaire (PHQ-9) and several questions regarding demographic characteristics. Suicidality was assessed by the 9th item of the PHQ-9. According to the results, older chronic disease patients showed higher levels of fear, whereas anxiety and depressive symptoms were present mainly in the group of older psychiatric patients. Suicidality was reported from a subtotal of 25.4% that was composed of 7.8% chronic disease patients and 17.6% psychiatric patients. Chronic physical disease and higher anxiety predicted more severe COVID-19-related fear

PERITRAUMATIC DISTRESS INVENTORY IN THE COURSE OF THE COVID-19 PANDEMIC

The context of the present study was the COVID-19 pandemic, which has become an unprecedented global health emergency inducing a considerable degree of uncertainty, fear, concern, and worry. Peritraumatic reactions may contribute to the development of Acute Post-traumatic Stress Disorder (PTSD) and the prediction of full PTSD. The aim of this study was to validate the Peritraumatic Distress Inventory (PDI) in a Greek sample during the outbreak of COVID-19 pandemic and explore its association with PTSD as assessed by PTSD-8. A total of 2,827 patients completed the PDI along with validated scales measuring post-traumatic, anxiety and depressive symptoms. CFA confirmed both the unifactorial model, with modest fit, and the bifactorial model of PDI with acceptable fit in the Greek sample. The three- and the four-factor models were not supported. Overall, the scale demonstrated good psychometric properties in the Greek population and can be considered a useful instrument to assess elevated stress during traumatic crises.

Assessing test anxiety and resilience among Greek adolescents during COVID-19 pandemic

The aim of the present study was to explore the impact of school year’s extension due to the coronavirus pandemic (COVID-19) by addressing test anxiety and by studying the coping strategies adolescents used to overcome it. For the majority of the adolescents the final exams can be a powerful source of stress, since the entrance examinations are required for admission into higher education and further reflect the transition to adulthood. The sample consisted of 67 High School students and the data collection was conducted online due to the imposed measures by the Greek government. Results showed normal or average levels of test anxiety with low self-esteem and fear of a family member contracting the virus identified as significant predictors. Students who participated in the research pointed teachers as the main source of pressure in school exams. Gender differences regarding social media engagement and online video gaming were also detected. Resilience was equally as high among genders [t(63) = 858, p =.324] and the correlation between test anxiety and resilience did not produce a statistically significant result (r = -.178, p = .155)

Mental illness through the perspective of undergraduate medical students in Greece: a cross-sectional study at Aristotle University of Thessaloniki

IntroductionNumerous studies reveal that mental health-related stigma, stereotypes, and prejudices negatively affect the patients, jeopardizing their health, prognosis, and social opportunities. Healthcare professionals, who are in the first line of combating mental disease, are expected to play a significant role in drastically changing discriminatory and stigmatizing attitudes toward psychiatric patients and in diminishing the existing healthcare and social disparities. In this study, we aimed to explore and highlight the views of Greek medical students—that is of the future physicians—toward mental illness and people suffering from it.Materials and methodsIt is a cross-sectional, observational study, in which 324 undergraduate students from the most populous Greek medical school of the Aristotle University of Thessaloniki, participated online, during the spring semester of 2022. The tools used were the Opinions about Mental Illness Scale (OMI) that assesses one’s viewpoints about mental illness, the Social Distance Scale (SDS) that captures the desired degree of social distancing from patients with mental disorders, and the Level of Contact Report (LCR-12) that estimates the level of familiarity with them.ResultsParticipants displayed rather positive attitudes regarding the etiology of mental illness, social integration, and discrimination toward psychiatric patients [as evaluated with the respective OMI subscales; Etiology mean score (μ):8.87 ± 4.68, Social Integration (μ):17.79 ± 5.42, Social Discrimination (μ):13.54 ± 11.17], and more clearly favorable opinions concerning the need for social provision or the enactment of restrictive measures [as expressed with the relative OMI subscales; Social Care (μ):22.74 ± 4.56, Social Restriction (μ):13.27 ± 8.98], while claiming to be quite familiar with mental disorders and individuals experiencing them (as assessed with LCR; μ: 8.71 ± 2.16), and relatively willing to interact with them (as measured with SDS; μ:8.95 ± 4.23). Degree of familiarity with mental illness was directly proportional to the desire for contact with patients living with it, while the higher both were, the more improved most of the aforementioned OMI sectors were found to be. Female sex, clinical medical education, previous clinical psychiatric training, and living with or being a person with a mental disorder were the factors that defined a statistically refined profile in many of the aspects above.ConclusionOur findings are in accordance with many prior and recent studies, while showing improved opinions compared to those of previous research in Greek student and healthcare population. They are calling for vigilance, rather than complacency, as well as educational and social interventions, in order to enable current and future healthcare professionals to perform their function to its fullest extent. Implications of our results and further research suggestions are included

Alteration of the phospho- or neutral lipid content and fatty acid composition in Listeria monocytogenes due to acid adaptation mechanisms for hydrochloric, acetic and lactic acids at pH 5.5 or benzoic acid at neutral pH

This study provides a first approach to observe the effects on Listeria monocytogenes of cellular exposure to acid stress at low or neutral pH, notably how phospho- or neutral lipids are involved in this mechanism, besides the fatty acid profile alteration. A thorough investigation of the composition of polar and neutral lipids from L. monocytogenes grown at pH 5.5 in presence of hydrochloric, acetic and lactic acids, or at neutral pH 7.3 in presence of benzoic acid, is described relative to cells grown in acid-free medium. The results showed that only low pH values enhance the antimicrobial activity of an acid. We suggest that, irrespective of pH, the acid adaptation response will lead to a similar alteration in fatty acid composition [decreasing the ratio of branched chain/saturated straight fatty acids of total lipids], mainly originating from the neutral lipid class of adapted cultures. Acid adaptation in L. monocytogenes was correlated with a decrease in total lipid phosphorus and, with the exception of cells adapted to benzoic acid, this change in the amount of phosphorus reflected a higher content of the neutral lipid class. Upon acetic or benzoic acid stress the lipid phosphorus proportion was analysed in the main phospholipids present: cardiolipin, phosphatidylglycerol, phosphoaminolipid and phosphatidylinositol. Interestingly only benzoic acid had a dramatic effect on the relative quantities of these four phospholipids