Synthetic cannabinoid use in a case series of patients with psychosis presenting to acute psychiatric settings : Clinical presentation and management issues

Background: Novel Psychoactive Substances (NPS) are a heterogeneous class of synthetic molecules including synthetic cannabinoid receptor agonists (SCRAs). Psychosis is associated with SCRAs use. There is limited knowledge regarding the structured assessment and psychometric evaluation of clinical presentations, analytical toxicology and clinical management plans of patients presenting with psychosis and SCRAs misuse. Methods: We gathered information regarding the clinical presentations, toxicology and care plans of patients with psychosis and SCRAs misuse admitted to inpatients services. Clinical presentations were assessed using the PANSS scale. Vital signs data were collected using the National Early Warning Signs tool. Analytic chemistry data were collected using urine drug screening tests for traditional psychoactive substances and NPS. Results: We described the clinical presentation and management plan of four patients with psychosis and misuse of SCRAs. Conclusion: The formulation of an informed clinical management plan requires a structured assessment, identification of the index NPS, pharmacological interventions, increases in nursing observations, changes to leave status and monitoring of the vital signs. The objective from using these interventions is to maintain stable physical health whilst rapidly improving the altered mental state.Peer reviewedFinal Published versio

Modelling reaction time distribution of fast decision tasks in schizophrenia: Evidence for novel candidate endophenotypes

Increased reaction time (RT) and variability of RT in fast decision tasks is observed in patients with schizophrenia and their first degree relatives. This study used modelling of the RT distribution with the aim of identifying novel candidate endophenotypes for schizophrenia. 20 patients with schizophrenia, 15 siblings of patients and 25 healthy controls performed an oddball task of varying working memory load. Increases in mean and standard deviation (SD) of RT were observed for both patients and siblings compared to controls and they were again independent of working memory load. Ex-Gaussian modelling of the RT distribution confirmed that parameters mu, sigma and tau increased significantly in patients and siblings compared to controls. The Drift Diffusion Model was applied on RT distributions. A decrease in the diffusion drift rate (v) modeling the accumulation of evidence for reaching the decision to choose one stimulus over the other, was observed in patients and siblings compared to controls. The mean time of the non-decisional sensorimotor processes (t0) and it's variance (st0) was also increased in patients and siblings compared to controls. In conclusion modeling of the RT distribution revealed novel potential cognitive endophenotypes in the quest of heritable risk factors for schizophrenia

Excessive weight gain after remission of depression in a schizophrenic patient treated with risperidone: case report

BACKGROUND: The use of atypical antipsychotics in schizophrenic patients has been associated with a risk of weight gain. Similarly, recovery from depression is often followed by improved appetite, greater food intake and potential increase in weight. CASE PRESENTATION: A Caucasian 33-year-old schizophrenic female patient was being treated with 6 mg/day of risperidone and 15 mg/day of clorazepate. She developed depressive symptomatology and 40 mg/day of fluoxetine was gradually added to her treatment regimen for about 9 months. After the remission of depression, and the discontinuation of fluoxetine, she experienced an increase in appetite and subsequently excessive weight gain of 52 kg. Re-administration of fluoxetine did not reverse the situation. The patient developed diabetes mellitus, which was successfully controlled with metformin 1700 mg/day. The addition at first of orlistat 360 mg/day and later of topiramate 200 mg/day has helped her to lose a significant part of the weight gained (30 kg). CONCLUSION: The case suggests a probable association between the remission of depressive symptomatology and weight gain in a schizophrenic patient

Insomnia and its correlates in a representative sample of the Greek population

<p>Abstract</p> <p>Background</p> <p>Insomnia is a major public health concern affecting about 10% of the general population in its chronic form. Furthermore, epidemiological surveys demonstrate that poor sleep and sleep dissatisfaction are even more frequent problems (10-48%) in the community. This is the first report on the prevalence of insomnia in Greece, a southeastern European country which differs in several socio-cultural and climatic aspects from the rest of European Community members. Data obtained from a national household survey (n = 1005) were used to assess the relationship between insomnia symptoms and a variety of sociodemographic variables, life habits, and health-related factors.</p> <p>Methods</p> <p>A self-administered questionnaire with questions pertaining to general health and related issues was given to the participants. The Short Form-36 (Mental Health subscale), the Athens Insomnia Scale (AIS) as a measure of insomnia-related symptoms, and the International Physical Activity Questionnaire (IPAQ) were also used for the assessment.</p> <p>Results</p> <p>The prevalence of insomnia in the total sample was 25.3% (n = 254); insomnia was more frequent in women than men (30.7% vs. 19.5%) and increased with age. Multiple regression analysis revealed a significant association of insomnia with low socio-economical status and educational level, physical inactivity, existence of a chronic physical or mental disease and increased number of hospitalizations in the previous year.</p> <p>Conclusions</p> <p>The present study confirms most findings reported from other developed countries around the world regarding the high prevalence of insomnia problems in the general population and their association with several sociodemographic and health-related predisposing factors. These results further indicate the need for more active interventions on the part of physicians who should suspect and specifically ask about such symptoms.</p

Short term low voltage load forecast of supplier

Εθνικό Μετσόβιο Πολυτεχνείο--Μεταπτυχιακή Εργασία. Διεπιστημονικό-Διατμηματικό Πρόγραμμα Μεταπτυχιακών Σπουδών (Δ.Π.Μ.Σ.) “Τεχνο-οικονομικά συστήματα

Memantine and NMDA antagonism for chronic migraine: A potentially novel therapeutic approach?

We present the case of a woman with chronic migraine who unexpectedly reported full remission of headache after memantine, an NMDA receptor antagonist, was administered for treating concomitant mild cognitive impairment. An underlying dose-dependent effect of memantine on headache symptoms in chronic daily headache and chronic migraine could be assumed

Electrochemical promotion of catalysis in hydrogenation and hydrodesulfurization processes

Electrochemical Promotion of Catalysis (EPOC or Non-Faradaic Electrochemical Modification of Catalytic Activity, NEMCA effect) is a phenomenon where the application of small currents or potentials (±1V) between a catalyst electrode, which is in contact with a solid electrolyte support, and a counter or reference electrode, causes a significant change in catalytic activity in a predictable, reversible and to some extend controllable manner. As have been shown by numerous surface science and electrochemical techniques, electrochemical promotion is due to electrochemically controlled migration (backspillover) of promoting or poisoning ionic species between the ionic or mixed ionic-electronic conductor support and the gas exposed catalytic surface. Τhe phenomenon has been studied extensively in a variety of catalytic systems (>70) during the last 30 years, while it has been successfully applied in a pilot scale reactor, the monolithic electrochemically promoted reactor (MEPR) in environmental important reactions. In the first chapter, an extended analysis is given of the properties of solid electrolytes, and focused on the yttria-stabilized zirconia (YSZ). Moreover, the concepts of spillover and backspillover, which are used to describe the phenomenon of electrochemical promotion and the metal-support interactions, are discussed in detail. In the second chapter, the fundamentals of Electrochemical Promotion of Catalysis are discussed in the basis of classical promotion, reaction kinetics and the rules of Electrochemical Promotion of Catalysis. In the third chapter, the effect of the electrochemical promotion of catalysis on the hydrodesulfurization (HDS) reaction of sulfur containing model compounds (thiophene) has been investigated, using ion conducting solid electrolytes (BCN18, CZI or YSZ) and state-of-the-art catalysts, e.g. RuS₂, MoS₂, MoS₂-CoS₂ and the unsupported state-of-the-art catalyst Nebula (NiMoW). In this study thiophene, was used under atmospheric pressure in the temperature range of 250°C-550°C. Significant Electrochemical Promotion was achieved with 10 different CoMo based catalyst-electrodes. Values of rate enhancement up to 20% and faradaic efficiency values up to ~600 were achieved, denoting the strongly non-faradaic behavior and high energy efficiency at T<300°C. In the case of oxygen ion conductors (YSZ) an increase of 300% on the catalytic rate and a faradaic efficiency value of 0.2 was recorded at 500°C. The results show the strong potential of Electrochemical Promotion of Catalysis on improving the efficiency of industrial and/or environmental processes. In the last chapter, the electrochemical promotion of the CO₂ hydrogenation reaction was also examined, towards methane production using Ru/YSZ/Au type electrochemical catalytic elements. It was found that the reaction rates and similarly as well as the selectivity to CH₄ can be enhanced under anodic polarizations.Η ηλεκτροχημική ενίσχυση της κατάλυσης (EPOC ή αλλιώς μη-φαρανταïκή τροποποίηση της καταλυτικής ενεργότητας, φαινόμενο NEMCA) είναι ένα φαινόμενο όπου εφαρμογή μικρών ρευμάτων ή δυναμικών (±2V) σε ένα καταλύτη που είναι υποστηριγμένος σε ένα ηλεκτρολύτη, ιοντικό ή μικτό ιοντικό-ηλεκτρονιακό αγωγό, μπορεί να επιφέρει σημαντική τροποποίηση της καταλυτικής ενεργότητας αλλά και εκλεκτικότητας της αντίδρασης που γίνεται στην αέρια φάση, με τρόπο ελεγχόμενο, αντιστρεπτό και έως ένα βαθμό προβλέψιμο. Η ηλεκτροχημική ενίσχυση έχει βρεθεί με χρήση διαφόρων τεχνικών ότι πηγάζει από την ηλεκτροχημικά ελεγχόμενη διάχυση ενισχυτικών ιοντικών ειδών ανάμεσα στο φορέα-ηλεκτρολύτη και στα καταλυτικά σωματίδια. Το φαινόμενο έχει εφαρμοστεί σε πληθώρα καταλυτικών συστημάτων (πάνω από 70) τα τελευταία 30 χρόνια ενώ έχει πραγματοποιηθεί και επιτυχής εφαρμογή του σε πιλοτική κλίμακα χάρη στον μονολιθικό ηλεκτροχημικά ενισχυόμενο αντιδραστήρα. Στο πρώτο κεφάλαιο της παρούσας διατριβής γίνεται εκτεταμένη αναφορά στους στερεούς ηλεκτρολύτες, στις ιδιότητες τους καθώς και τους τομείς στους οποίους χρησιμοποιούνται με ιδιαίτερη σημασία στη σταθεροποιημένη με οξείδιο του υττρίου ζιρκονία (YSZ), που αποτελεί ένα πολύ συχνά χρησιμοποιούμενο αγωγό ιόντων οξυγόνου. Επιπρόσθετα, εισάγονται οι έννοιες της μετανάστευσης (spillover) και της αντίστροφης μετανάστευσης (backspillover), οι οποίες χρησιμοποιούνται στην ερμηνεία και την κατανόηση του φαινομένου της ηλεκτροχημικής ενίσχυσης και των αλληλεπιδράσεων μετάλλου-φορέα (MSI). Στο δεύτερο κεφάλαιο γίνεται μια εισαγωγή στις αρχές του φαινομένου της Ηλεκτροχημικής Ενίσχυσης της Κατάλυσης όπου συζητούνται αρκετά παραδείγματα εφαρμογής του και γίνεται ανασκόπηση όλων των εργασιών που υπάρχουν στην βιβλιογραφία και αφορούν στο συγκεκριμένο φαινόμενο. Παρουσιάζονται επίσης, πλήθος πειραματικών τεχνικών, όπως ηλεκτροκινητικών πειραμάτων δυναμικής απόκρισης, μετρήσεων έργου εξόδου, κυκλικής βολταμμετρίας, XPS, TPD και STM, καθώς και θεωρητικών μελετών, με στόχο την κατανόηση της αρχής του φαινομένου σε ατομικό επίπεδο. Στο τρίτο κεφάλαιο παρουσιάζονται τα πειραματικά αποτελέσματα από την εφαρμογή του φαινομένου της ηλεκτροχημικής ενίσχυσης της κατάλυσης στην αντίδραση βιομηχανικής σημασίας της υδρογονοαποθείωσης (HDS). Στην παρούσα μελέτη χρησιμοποιήθηκε η πρότυπη ένωση του θειοφαινίου, χρησιμοποιώντας στερεούς ηλεκτρολύτες αγωγούς ιόντων (BCN18, CZI ή YSZ) σε συνδυασμό καταλύτες, όπως RuS₂, MoS₂, FeSₓ και MoS₂-CoS₂ καθώς και μη-στηριγμένους όπως ο Nebula (NiMoW). Η μελέτη επικεντρώθηκε στην επίτευξη ηλεκτροχημικής ενίσχυσης στην HDS του θειοφαινίου υπό συνθήκες ατμοσφαιρικής πίεσης στο θερμοκρασιακό εύρος 250°C-550°C. Ηλεκτροχημική Ενίσχυση επιτεύχθηκε σε συνολικά 10 καταλυτικά ηλεκτρόδια. Στην περίπτωση χρήσης πρωτονιακών αγωγών, τιμές προσαύξησης ρυθμού έως 20% και φαρανταϊκής απόδοσης έως ~600 καταγράφησαν, αναδεικνύοντας την ισχυρά μη-φαρανταϊκή συμπεριφορά και το υψηλό ενεργειακό όφελος σε Τ<300°C. Στην περίπτωση των αγωγών ιόντων οξυγόνου (YSZ) προσαύξηση ρυθμού έως και 300% καταγράφηκε με τιμές φαρανταϊκής απόδοσης έως και 0.2 στους 500°C. Στο τέταρτο κεφάλαιο παρουσιάζεται η ηλεκτροχημική ενίσχυση της αντίδρασης υδρογόνωσης του CO₂ χρησιμοποιώντας καταλυτικά υμένια Ru εναποτεθειμένα σε στερεούς ηλεκτρολύτες YSZ με στόχο την παραγωγή μεθανίου. Βρέθηκε ότι η αντίδραση μπορεί να ενισχυθεί σε μεγάλο βαθμό και επιπλέον να τροποποιηθεί και η εκλεκτικότητά της σε CΗ₄ που είναι και το επιθυμητό προϊόν