Sleep or sedation Price Lowering of Paediatric Kidney Nuclear Medicine Tests: Consequences of a Precise Audit.
The scores of four CBCL subscales (social problems, thought problems, delinquent behavior and aggressive behavior) were significantly higher in PWS patients. Higher scores of the CBCL-thought problems were associated with significantly higher levels of insulin as well as HOMA-IR. Conclusion Patients with PWS seem to be more prone to develop subclinical metabolic dysregulation, in terms of elevated non-HDL levels and insulin levels, compared to DGS patients. Altered insulin sensitivity, present in both groups, even though it is not a specific risk factor, might be related to thought problems associated with psychosis. © 2020 Krefft et al.Objective Referrals to neurology in emergency departments (ED) are continuously increasing, currently representing 15% of all admissions. Existing triage systems were developed for general medical populations and have not been validated for patients with neurological symptoms. Methods To characterize neurological emergencies, we first retrospectively analyzed symptoms, service times and resources of the cohort of neurological referrals to a German interdisciplinary ED (IED) during 2017 according to urgency determined by final IED diagnosis. In a second step, we performed a retrospective assignment of consecutive patients presenting in April 2017 according to internal guidelines as either acute (requiring diagnostic/therapeutic procedures within 24 hrs) or non-acute neurological conditions as well as a retrospective classification according to the Emergency Severity Index (ESI). Both assessments were compared with the urgency according to the final ER diagnosis. Results In a 12-month period, 36.4% of 5340 patients were rated as having an urgent neurological condition; this correlated with age, door-to-doctor time, imaging resource use and admission (p less then 0.001, respectively). In a subset of 275 patients, 59% were retrospectively triaged as acute according to neurological expertise and 48% according to ESI categories 1 and 2. Neurological triage identified urgency with a significantly higher sensitivity (94.8, p less then 0.01) but showed a significantly lower specificity (55.1, p less then 0.05) when compared to ESI (80.5 and 65.2, respectively). Conclusion The ESI may not take specific aspects of neurological emergency (eg, time-sensitivity) sufficiently into account. Refinements of existing systems or supplementation with dedicated neurological triage tools based on neurological expertise and experience may improve the triage of patients with neurological symptoms. © 2020 Hoyer et al.Introduction Although ATP-binding cassette sub-family A member 7 gene (ABCA7) is known to be associated with Alzheimer's disease, the relationship between ABCA7 and schizophrenia has been unknown. Methods Schizophrenia patients (n = 50; 24 males, 62.1 ± 0.50 years old) and age- and sex-matched healthy controls (n = 50) were recruited for the mRNA analysis. Additionally, a case-control study for the rs3764650 genotypes was performed with 1308 samples (control subjects; n = 527, schizophrenia patients; n = 781). All participants were Japanese, unrelated to each other, and living in the same area. Results The distributions of the rs3764650 genotypes in schizophrenia patients were not different from that of controls. However, the ABCA7 mRNA expression levels in schizophrenia patients were significantly higher than those in controls by a logistic regression analysis. Additionally, the ABCA7 mRNA expression levels in schizophrenia patients were correlated with the rs3764650 genotypes in a dose-dependent manner. Discussion The ABCA7 mRNA expression levels in peripheral blood with the rs3764650 genotypes may be related to pathological mechanisms in schizophrenia and may be a biological marker for schizophrenia. © 2020 Yamazaki et al.Background Even though a large number of patients live with epilepsy, few of them receive effective treatment. Most people with epilepsy, particularly those from rural communities, do not seek medical care as they are convinced that solutions lie only with traditional healers (traditional leaders, prophets and community elders). Therefore, studying treatment-seeking behavior regarding this major neurological problem would provide additional knowledge and help to identify a gap which needs to be addressed when tackling related problems. Participants and Methods This rural community-based cross-sectional study was conducted in Gedeo zone, Ethiopia, among 755 participants. Data were collected using face-to-face interview-based questionnaires. Collected data were entered into EpiData version 3.01 and analyzed using SPSS version 20. Bivariate and multivariate logistic regression analysis was conducted to identify associated factors. The strengths of associations were presented as adjusted odds ratios with 95% confidence intervals. https://www.selleckchem.com/products/fr180204.html'>https://www.selleckchem.com/products/fr180204.html Results The prevalence of poor treatment-seeking behavior was 54.6% (95% CI 51.4, 58.2). Poor knowledge (adjusted odds ratio [AOR]=3.21, 95% CI 2.14, 4.81), poor social support (AOR=2.48, 95% CI 1.12, 5.53), unfavorable attitude (AOR=1.84, 95% CI 1.34, 2.54) and having no history of experiencing others' seizures (AOR=2.17, 95% CI 1.47, 3.2) were variables strongly associated with poor help-seeking behavior towards epilepsy. Conclusion The study showed that more than half of the participants had poor treatment-seeking behavior towards epilepsy. This indicates the need to implement measures to raise community awareness regarding treatment options for epilepsy. © 2020 Molla et al.Introduction Clozapine (CLZ) is the gold standard drug for treatment-refractory schizophrenia (TRS). However, approximately 30% of patients partially respond to CLZ, defining this subset with super refractory schizophrenia (SRS). https://www.selleckchem.com/products/fr180204.html'>https://www.selleckchem.com/products/fr180204.html Alterations in enzyme activity may affect CLZ responses; the CYP3A4, CYP1A2 and CYP2C19 genes are primarily responsible for CLZ metabolism. Objective The aim of this study was to assess if CYP2C19 variants were associated with TRS or SRS. Methods CYP2C19*2 loss-of-function and CYP2C19*17 gain-of-function polymorphism genotype testing were performed in 108 individuals undergoing pharmacological treatment for TRS or SRS. DNA was extracted and polymorphisms were analyzed by polymerase chain reaction (PCR) and sequencing. Results CYP2C19*17 had positive correlations with SRS and lower Brief Psychiatric Rating Scale (BPRS) scores for TRS. In addition, CYP2C19*2 was associated with lower CLZ dosages for TRS. Conclusion These results show that CYP2C19*2 and CYP2C19*17 polymorphisms influence CLZ responses during schizophrenia treatment.