بررسی میزان عوارض متابولیک دارو های آنتی سایکوتیک نسل جدید در بیماران مبتلا به کم توانی ذهنی در مقایسه با گروه شاهد در بیماران مراجعه کننده به مرکز اموزشی درمانی بیست و دو بهمن در سال 1400

چکیده زمینه و هدف:یکی از عوارض اصلی داروهای انتی سایکوتیک نسل جدید عوارض متابولیک می باشد. افراد مبتلا به کم توانی ذهنی به علت مشکلات رفتاری و بیماری های جسمی همراه تحت درمان با داروهای انتی سایکوتیک نسل جدید قرار می گیرند. هدف از این مطالعه بررسی عوارض متابولیک داروهای انتی سایکوتیک نسل جدید در افراد مبتلا به کم توانی ذهنی در مقایسه با افراد با ضریب هوشی نرمال می باشد. مواد و روش ها: افراد شرکت کننده در این مطالعه، بیماران مبتلا به کم توانی ذهنی می باشند که درمان با یک داروی انتی سایکوتیک نسل جدید برای انها شروع شده بود. گروه شاهد در این مطالعه از بیماران بستری در بیمارستان 22 بهمن قزوین انتخاب شدند که ضریب هوشی نرمال داشتند و از نظر سن و جنسیت همسان با گروه مورد بودند و درمان با یک داروی انتی سایکوتیک نسل جدید برای انها شروع شده بود. وزن، فشار خون و BMI افراد در شروع مطالعه، 2 ماه، 4 ماه و 6ماه پس از مطالعه بررسی و بین دو گروه مقایسه شد. از نرم افزار SPSS نسخه 20 برای آنالیز داده ها استفاده شد. سطح معنی داری کمتر از ۰۵/۰ در نظر گرفته شد. یافته ها: در نهایت 80 بیمار که در این مطالعه مورد بررسی قرار گرفتند. وزن و BMI بیماران در گروه افراد با کم توانی ذهنی 2ماه، 4 ماه و6 ماه بعد از شروع درمان نسبت به زمان شروع مطالعه افزایش معنی داری از نظر اماری در مقایسه با افراد با ضریب هوشی نرمال را نشان داد (05/0> p value). نتیجه گیری: با توجه به نتایج این مطالعه به نظر می رسد درمان با داروهای انتی سایکوتیک نسل جدید با افزایش وزن بیشتری در افراد با کم توانی ذهنی در مقایسه با افراد با ضریب هوشی نرمال همراه باشد که لازم است این نتایج در مطالعات بعدی مورد تایید قرار گیرد. کلید واژه ها: عوارض متابولیک، دارو های آنتی سایکوتیک نسل جدید، بیماران کم توان ذهن

Depression, Anxiety and Suicidal Ideation Among Patients With Chronic Kidney Disease Undergoing Hemodialysis in Qazvin, Iran

Background Patients undergoing hemodialysis are prone to psychiatric symptoms due to considerable changes in their individual, social and occupational life which can influence the course and prognosis of renal diseases. Objective The aim of the present study is to evaluate the prevalence of depression, anxiety, and suicidal ideation among patients with chronic kidney disease undergoing hemodialysis in Qazvin, Iran. Methods This descriptive cross- sectional study was performed on 120 patients with chronic kidney disease undergoing hemodialysis in Qazvin, Iran. Prior to study, their demographic and laboratory data were recorded. Dialysis adequacy was assessed using urea reduction ratio (URR) and KT/V formula. Data collection tools were Beck’s Depression Inventory, Beck’s Anxiety Inventory and Beck Scale for Suicidal Ideation. Collected data were analyzed using Pearson correlation test and t-test. Findings The mean level of depression in patients was 13.72 where 79 (65.8%) had depressive symptoms. The severity of symptoms was mild in 47 (39.2%), moderate in 21 (17.5%), and severe in 11 (9.2%). Moreover, the mean level of anxiety was 9.73 where 16 (13.3%) had anxiety symptoms. Of 120 patients, only 8 (6.7%) had suicidal ideation. There was a significant negative association between dialysis adequacy and the severity of depression, anxiety and suicidal ideation. Anxiety symptoms were more frequent among unemployed patients, and the increase in age was associated with the increase in suicidal ideations (P<0.05). Conclusion Regarding the high prevalence of depressive symptoms and existence of anxiety symptoms in patients undergoing hemodialysis in Qazvin, assessment of these psychiatric disorders along with effective therapeutic interventions should be considered

The Effect of transcranial Direct Current Stimulation (tDCS) on Opioid Craving: Effect of tDCS on Opioid Craving

Introduction: Nowadays, substance use disorder is one of the most serious health problems in the world. Craving is one of the leading causes of substance use relapse. The purpose of this study was to evaluate the effect of transcranial Direct Current Stimulation (tDCS) on participants with opioid substance use disorder. Materials and Methods:&nbsp; A randomized, sham-controlled trial was carried out to evaluate the effect of dorsolateral prefrontal cortex stimulation (right anodal and left cathodal) on craving among participants with opioid use disorder. Eighteen men were categorized into sham tDCS and active tDCS groups. Interventions were performed for seven consecutive days. In both groups, the instantaneous and periodic craving was evaluated by the Desire for Drug Questionnaire (DDQ) and Obsessive Compulsive Drug Use Scale (OCDUS) before and a week after the interventions. The differences between the two groups were evaluated by paired samples t-test and student's t-test. Results: The results indicated that tDCS significantly reduced the scores on DDQ and OCDUS in the active tDCS group compared to the sham tDCS group (P&lt;.05). Conclusions: Our findings provide support for applying tDCS in controlling opioid craving. Therefore, this method can be considered to be a new therapeutic approach in treatment of opioid use disorder

Coronary artery disease and plasma apolipoprotein E4 in mild cognitive impairment

BACKGROUND: Atherosclerosis and apolipoprotein E4 (APOE4) are known risks for Dementia. We sought to evaluate the relationship between coronary atherosclerosis and APOE4 with mild cognitive impairment (MCI). METHODS: In a case-control study, subjects with age more than 60 years and recent coronary angiography were evaluated by mini-mental state examination and neuropsychiatry Unit Cognitive Assessment Tool (NUCOG) to find the patients with MCI (n = 40) and the controls with normal cognition (n = 40). Coronary angiography records were re-assessed to find the severity of coronary artery disease by the Gensini scores. Plasma levels of APOE4 were measured. RESULTS: There were no-significant difference between the 2 groups regarding the plasma APOE4 levels (P = 0.706) and the Gensini scores (P = 0.236). Associations between the Gensini scores and the NUCOG scores in the MCI group (r = &minus;0.196, P = 0.225) and the control group (r = 0.189, P = 0.243) were not significant. However, the interaction effect between the Gensini and the NUCOG scores based on allocation to the control or the patient groups showed statistically significant difference (F(1,67) = 4.84, P = 0.031). CONCLUSION: Although atherosclerosis has been considered as known risk factor for dementia and MCI, this study could not reveal that coronary atherosclerosis-related to declining in cognitive functioning. There was no significant association between plasma APOE4 levels and MCI. &nbsp; Keywords: Mild Cognitive Impairment, Coronary Artery, Angiography, Apolipoprotein E4 Normal 0 false false false EN-US X-NONE FA <!--[endif] --

The relationship between regional brain volumes and the extent of coronary artery disease in mild cognitive impairment

Background: There are conflicting reports regarding the association between coronary artery disease (CAD) and mild cognitive impairment (MCI). Volumetric Magnetic resonance imaging (MRI) investigations have been considered as an objective biomarker for MCI. In this study, we determined the relationship between the regional brain volumes and the extent of CAD in MCI patients and cognitively normal controls. Materials and Methods: In a case-control study a subset of MCI patients (n = 20) and cognitively normal controls (n = 20), aged 66.4 ± 4.6 and 65.3 ± 3.9 respectively, from subjects who were recently admitted to cardiac catheterization facilities in two general hospitals were selected. All subjects underwent a clinical interview, biochemical measures, neuropsychological testing and Neuropsychiatry Unit COGnitive assessment tool. Video records of coronary angiography were scored with the Gensini method. For volumetric evaluation of regions of interest, brain MRI scans was processed using the FreeSurfer software package the relationship between the regional brain volumes and the extent of CAD in MCI patients and cognitively normal controls were compared. Results: We have found that, there were significant differences between the two groups in volumes of left fusiform (P = 0.039), left pars triangularis (P = 0.003) and left superior temporal gyrus (P = 0.009), after controlling for intracranial volumes. Higher Gensini scores were associated with reduced volumes of total cortical volume (P = 0.047, R = −0.4), left precuneus (P = 0.022, R = −0.5), right inferior parietal lobule (P = 0.011, R = −0.5) and left supra marginal gyrus (P = 0.035, R = −0.04) in MCI. Conclusion: In MCI, a greater degree of coronary stenosis correlates with greater loss of gray matter in specific brain regions relevant to cognitive function. This, however, was not the case for cognitively normal subjects