Cotard’s Syndrome: Clinical Case Presentation and Literature Review

In 1880 French neurologist Jules Cotard described a condition characterized by delusion of negation (nihilistic delusion) in a melancholia context. Recently, there has been a resurgence of interest in Cotard’s syndrome. The most prominent symptoms of Cotard’s Syndrome are depressive mood, nihilistic delusions concerning one’s own body and one’s own existence, delusions of guilt, immortality and hypochondria. The aim of the present paper is to review literature evidences concerning Cotard’s syndrome and to describe a clinical case keeping in the background the recent trends on its psychopathological implications. In the clinical study, the following sequence of stages emerged: the dissociative side, expressed as a loss of body-mind cohesion; the ‘mixed’ mood disorder, with depressive-manic episodes, and a persecutory background, all coexisting in the anguish of the idea of a body falling apart, the anguish of a descent towards the abyss of melancholia and/or an ascent to unlimited euphoria, characteristic of an “uncommon alarm” for loss of Self cohesion

Predicting needlestick and sharps injuries in nursing students: Development of the SNNIP scale

© 2020 The Authors. Nursing Open published by John Wiley & Sons Ltd. Aim: To develop an instrument to investigate knowledge and predictive factors of needlestick and sharps injuries (NSIs) in nursing students during clinical placements. Design: Instrument development and cross-sectional study for psychometric testing. Methods: A self-administered instrument including demographic data, injury epidemiology and predictive factors of NSIs was developed between October 2018–January 2019. Content validity was assessed by a panel of experts. The instrument's factor structure and discriminant validity were explored using principal components analysis. The STROBE guidelines were followed. Results: Evidence of content validity was found (S-CVI 0.75; I-CVI 0.50–1.00). A three-factor structure was shown by exploratory factor analysis. Of the 238 participants, 39% had been injured at least once, of which 67.3% in the second year. Higher perceptions of “personal exposure” (4.06, SD 3.78) were reported by third-year students. Higher scores for “perceived benefits” of preventive behaviours (13.6, SD 1.46) were reported by second-year students

Marino Ortolani: "Does That Baby's Hip Go Click?"

Marino Ortolani (1904-1983), a pediatrician from Ferrara, in northeastern Italy, was an outstanding pioneer in the early diagnosis and treatment of hip dysplasia. In 1935, while examining hip abduction-adduction in a six-month-old baby, Ortolani noted that a clearly audible and palpable "click" was sufficient to reveal congenital pre-dislocation of the hip, a condition he confirmed by an X-ray of the pelvis. This discovery suggested that the sound alone could be used for early diagnosis and treatment of the condition. Ortolani's test is now a widespread diagnostic technique, described in all pediatric and orthopedic textbooks. To confirm his conjecture, Ortolani dissected many hip specimens in very young babies who had died of unrelated causes. He also collected excellent specimens of congenital hip pathology in fetuses at all stages of intrauterine development, proving that hip dysplasia may already occur in utero. After his death, his entire collection was donated to the Institute of Anatomy of the University of Padua, where it is now exhibited in a special showcase. This collection, very impressive for both the number and high anatomical quality of its specimens, is famous worldwide because it demonstrates the etiopathology of hip dysplasia so clearly

EFFECT OF WRIST WRAP IN HANDGRIP STRENGTH IN CROSSFIT

ABSTRACT Objectives: Analyze wrist wrap influence on the values of maximum handgrip strength and dynamic resistance. Methods: A controlled randomized cross-over trial including 54 Crossfit participants randomly assigned to two groups. Group 1 began the series of tests with control wrapping, and Group 2 started with functional wrapping. Alternate series of four dynamic grip strength resistance tests were performed, and the resistance and fatigue values were calculated. Results: The values obtained from the grip tests did not indicate any effect from the wrist wrap for an increase in maximum grip strength (35.7 vs. 35.6 kg; p=0.737) or greater endurance (78.2 vs. 77.8%; p=0.549). Fatigue was also equal in both groups (mean differences between the groups: 0.1 kg, CI= -0.7–0.8; p=0.779). Conclusion: The hypothesis that using a wrist wrap increases maximum strength and dynamic handgrip endurance was rejected in this study. Evidence Level I; Randomized control trial

ENVELHECIMENTO E INTERDISCIPLINARIDADE: ANÁLISE DA PRODUÇÃO CIENTÍFICA DA REVISTA ESTUDOS INTERDISCIPLINARES SOBRE O ENVELHECIMENTO

O processo de envelhecimento humano no Brasil atualmente representa uma pauta de extrema relevância no cenário de planejamento de políticas públicas voltadas a idosos, uma vez que dados oficiais confirmam o aumento da expectativa de vida de forma acelerada e favorecida por investimentos em saneamento básico, diminuição das taxas de mortalidade infantil e fecundidade, amparadas pelo crescente avanço e acesso à evolução dos conhecimentos da medicina. O objetivo deste estudo é verificar, por meio de uma revisão de caráter descritivo e quantitativo na revista Estudos Interdisciplinares sobre o Envelhecimento, as produções científicas publicadas de 2010 a 2013. Foram inclusos somente artigos de reflexão teórica e os de pesquisas descritivas e experimentais. Após a seleção, foram lidos e analisados 83 artigos, 42 dissertações e 17 teses. Uma vez que, em relação às teses e aos artigos, foram disponibilizados apenas resumos, o presente estudo restringiu-se à análise completa dos artigos. Em referência ao tipo de pesquisa, houve predomínio da técnica descritiva associada ao delineamento de levantamento. De acordo com a análise da formação profissional dos autores, observou-se influência preponderante, respectivamente, das áreas de Educação Física, Enfermagem e Psicologia. O maior número de produções no que tange às temáticas versou sobre questões relacionadas à atividade física no envelhecimento e ao perfil de idosos. Com exceção da Universidade Federal do Rio Grande do Norte, as instituições mais frequentemente associadas às linhas de pesquisa sobre o envelhecimento humano localizam-se no Sul do Brasil, nos estados do Rio Grande do Sul e de Santa Catarina

Atypical cystic echinococcosis in a young child

An almost four year old Argentinian girl had abdominal pain and daily fevers of 38.5°C for 5 days. She appeared to be in good general condition except for petechial lesions on the anterior trunk. She also had a painful and tense abdomen on light palpation. Abdominal ultrasonography revealed a large intraperitoneal cystic lesion measuring 11.56 cm × 10.5 cm x 4.18 cm with thin walls and liquid in the cavity (See Figure, Supplemental Digital Content 1). Laboratory tests showed slight eosinophilia. Preoperative diagnosis was a congenital cystic mass of the mesenterium. Laparotomy showed liquid in the cavity and a flaccid cyst of very thin walls surrounded by the small intestine, the stomach and the omentum. During removal it was damaged and it resembled a hydatid membrane. The abdominal cavity was washed with physiologic solution and hypertonic saline solution-soaked pads were used. The patient had an uneventful recovery and received albendazoletreatment (15 mg/kg/day). She was discharged after the 3rd postoperative day when abdominal ultrasonography and chest radiography were normal. Outpatient follow-up included abdominal ultrasonography bimonthly and albendazole treatment. Histopathological examination confirmed hydatid cyst showing laminated and germinal layers with abundant eosinophils, multinucleated giantcells and scoleces (See Figure, Supplemental Digital Content 2, which shows a histophatological section of hydatic cyst. Laminal layer, germinal layer and vesicle with two scoleces are seen. HE stain).Intraperitoneal hydatid cysts usually develop secondary to spontaneous or iatrogenic rupture of  hepatic, splenic, or mesenteric cysts. Rarely an isolated primary cyst can develop in the peritoneum without evidence of cysts in other intra-abdominal organs 1. The growth rate of a hydatid cyst has been variably reported at 1-16 cm per year in abdomen 2. Abdominal cystic echinococcosis had been infrequently reported and only in adults 3. If the girl ingested the oncosphere in the first semester of life, an estimated minimum growth rate of the cyst was 2.5-3 cm per year.Canine coproparasitological research in the environment where the family was living showed a dog with Taenia sp. These findings confirm the persistence of the habit of feeding dogs with raw offal and the existence of hosts involved in the parasite life cycle, which represent risk factors to develop cystic echinococcosis or other parasitic diseases.Fil: Lavallén, Carla Mariela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Departamento de Biologia. Laboratorio de Zoonosis Parasitarias; ArgentinaFil: Pons, Mauricio. Hospital Interzonal Especializado Materno Infantil “Victorio Tetamanti”; ArgentinaFil: Mercuri, Enrique. Hospital Interzonal Especializado Materno Infantil “Victorio Tetamanti”; ArgentinaFil: Ortolani, Viviana. Hospital Interzonal Especializado Materno Infantil “Victorio Tetamanti”; ArgentinaFil: Scioscia, Nathalia Paula. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Departamento de Biologia. Laboratorio de Zoonosis Parasitarias; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Hollmann, Patricia. Centro Municipal de Zoonosis, Secretaría de Salud, Partido de General Pueyrredon ; ArgentinaFil: Denegri, Guillermo Maria. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Departamento de Biologia. Laboratorio de Zoonosis Parasitarias; ArgentinaFil: Dopchiz, Marcela Cecilia. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Departamento de Biologia. Laboratorio de Zoonosis Parasitarias; Argentin

Association between hospitalization-related outcomes, dynapenia and body mass index: The Glisten Study

Objective: To compare the prognostic value of dynapenia, as evaluated by handgrip, and body mass index (BMI) on length of stay (LOS), days of bed rest, and other hospitalization-related outcomes in a population of older adults admitted to 12 italian acute care divisions. Methods: Data on age, weight, BMI, comorbidities, ADL, physical activity level, muscle strength, were recorded at hospital admission. LOS, days of bed rest, intrahospital falls, and discharge destination were also recorded during the hospitalization. Subjects with BMI <18.5 kg/m2were classified as underweight, subjects with BMI 18.5–24.9 as normal weight, subjects with BMI ≥25 as overweight-obese. Results: A total of 634 patients, mean age 80.8 ± 6.7 years and 49.4% women, were included in the analysis. Overall dynapenic subjects (D) showed a longer period of LOS and bed rest compared with non-dynapenic (ND). When the study population was divided according to BMI categories, underweight (UW), normal weight (NW), and overweight-obese (OW-OB), no significant differences were observed in hospital LOS and days of bed rest. When analysis of covariance was used to determine the difference of LOS across handgrip/BMI groups, D/OW-OB and D/UW subjects showed significantly longer LOS (11.32 and 10.96 days, both p 0.05) compared to ND/NW subjects (7.69 days), even when controlling for age, gender, baseline ADL, cause of hospitalization and comorbidity. After controlling for the same confounding factors, D/OW-OB, D/NW and D/UW subjects showed significantly longer bed rest (4.7, 4.56, and 4.05 days, respectively, all p 0.05, but D/OW-OB p 0.01) compared to ND/NW subjects (1.59 days). Conclusion: In our study population, LOS is longer in D/UW and D/OW-OB compared to ND/NW subjects and days of bed rest are mainly influenced by dynapenia, and not by BMI class

Polypharmacy and sarcopenia in hospitalized older patients: results of the GLISTEN study

Background: Recently the Berlin Aging Study II (BASE-II) showed that polypharmacy is associated with clinically relevant sarcopenia among community-dwelling older persons. Here we report findings from the GLISTEN study about the association of polypharmacy with sarcopenia among older medical in-patients. Methods: The GLISTEN study investigated prevalence and clinical correlates of sarcopenia in older patients admitted to geriatric and internal medicine acute care wards of 12 Italian hospitals. Results: In this sample of older medical in-patients with high prevalence of sarcopenia (34.7%) and polypharmacy (70.2%) we did not observe a significant association of polypharmacy with sarcopenia. Conclusions: Present findings demonstrate that the association of polypharmacy with sarcopenia, observed in the BASE-II study, is not evident in the GLISTEN sample, being our patients significantly older, more multi-morbid, with high prevalence of sarcopenia and polypharmacy, suggesting that this association might vary according to the heterogeneous health, functional, and nutritional characteristics of older people