Follow-up of patients with psychogenic non-epileptic seizures during COVID-19 pandemic in Argentina

Este trabajo investiga si el contexto debido a la pandemia por COVID-19 impactó en la frecuencia y características de las crisis, aspectos emocionales y consultas médicas/psicológicas en las personas que padecen Crisis No Epilépticas Psicógenas atendidas hospitales públicos locales. Se realizó un estudio transversal en 18 pacientes con diagnóstico de CNEP (83.3% mujeres), empleando una entrevista telefónica semiestructurada. La mayoría de los pacientes entrevistados reportaron un aumento del malestar psicológico durante el aislamiento, pero cuando se les consultó a los pacientes sobre la frecuencia de sus convulsiones, estas sólo aumentaron en un tercio de ellos. Los resultados reflejan una similitud con los reportados por investigaciones realizadas en pacientes con síntomas neurológicos funcionales durante el aislamiento por pandemia. La incorporación de actividades placenteras en la vida diaria, el haber mantenido contacto con los seres queridos y familiares, y la búsqueda de ayuda fuera del sistema de salud podrían estar relacionados con una menor o igual frecuencia de crisis y con el no empeoramiento de la enfermedad durante este período.This work investigates whether the context of the COVID-19 pandemic impacted the frequency and characteristics of seizures, emotional aspects, and medical/psychological consultations in people suffering from Psychogenic Non-Epileptic Seizures seen at local public hospitals. A cross-sectional study was carried out in 18 patients (83.3% women) diagnosed with PNES, using a semi-structured telephone interview. Most of the interviewed patients reported an increase in psychological distress during isolation, but when the patients were consulted about the frequency of their seizures these had only increased for a third of them. The results reflect a similarity with those reported by investigations carried out among patients with functional neurological symptoms during the isolation for pandemic. Incorporation of pleasant activities in daily life, having maintained contact with loved ones and family members, and seeking help outside the health system could be related to less or equal PNES frequency seizure and not worsening the disease during this period.Fil: Korman, Guido Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Lanzillotti, Alejandra Inés. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Wolfzun, Camila. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Areco Pico, Maria Marta. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Tenreyro, Cristina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Gonzalez Molina, Lucila. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: Ponieman, Micaela. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; ArgentinaFil: D`alessio, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Sarudiansky, Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología. Instituto de Investigaciones; Argentin

The utility of B-type natriuretic peptide in the diagnosis of heart failure in the emergency department: a systematic review

<p>Abstract</p> <p>Background</p> <p>Dyspnea is a common chief complaint in the emergency department (ED); differentiating heart failure (HF) from other causes can be challenging. Brain Natriuretic Peptide (BNP) is a new diagnostic test for HF for use in dyspneic patients in the ED. The purpose of this study is to systematically review the accuracy of BNP in the emergency diagnosis of HF.</p> <p>Methods</p> <p>We searched MEDLINE (1975–2005) supplemented by reference tracking. We included studies that reported the sensitivity and specificity of BNP for diagnosing HF in ED patients with acute dyspnea. Two reviewers independently assessed study quality. We pooled sensitivities and specificities within five ranges of BNP cutoffs.</p> <p>Results</p> <p>Ten studies including 3,344 participants met inclusion criteria. Quality was variable; possible verification or selection bias was common. No studies eliminated patients with obvious medical causes of dyspnea. Most studies used the Triage BNP assay; all utilized a clinical reference standard. Pooled sensitivity and specificity at a BNP cutoff of 100–105 pg/ml were 90% and 74% with negative likelihood ratio (LR) of 0.14; pooled sensitivity was 81% with specificity of 90% at cutoffs between 300 and 400 pg/ml with positive LR of 7.6.</p> <p>Conclusion</p> <p>Our analysis suggests that BNP has moderate accuracy in detecting HF in the ED. Our results suggest utilizing a BNP of less than 100 pg/ml to rule out HF and a BNP of greater than 400 pg/ml to diagnose HF. Many studies were of marginal quality, and all included patients with varying degrees of diagnostic uncertainty. Further studies focusing on patients with diagnostic uncertainty will clarify the real-world utility of BNP in the emergency management of dyspnea.</p

Site-specific calculation of corn bioethanol carbon footprint with Life Cycle Assessment

The agricultural stage is a hotspot in the carbon footprint (CF) of the production of corn bioethanol and, within this stage, the production and use of nitrogen fertilisers is the subprocess that has the greatest incidence. The current research project aims to incorporate the environmental impacts in the analysis of optimum nitrogen fertiliser rates, in addition to the agricultural and economic outputs that have been widely used in previous studies. We seek to obtain functions that describe the CF at different nitrogen rates, topographic positions and climatic conditions, incorporating them as objective functions in multiobjective optimization procedures. In order to achieve this aim, the first step is to quantify the corn bioethanol CF with Life Cycle Assessment (LCA) methodology, for fertilisation and yield data at a site-specific scale. On-farm research trials were conducted in 18 corn fields where agricultural producers applied up to 6 levels of strip nitrogen fertilisation, through an elevation gradient, in 5 crop seasons distributed over 12 years, in the centre-south region of Córdoba province, Argentina. The corn transportation and its industrial process were considered as fixed subsystems for this research. The LCA methodology follows the ISO 14067:2018 standard and the Intergovernmental Panel on Climate Change (IPCC) guidelines (2019). The R software was used to process the large datasets. A bioethanol corn CF map at a site-specific scale was achieved. As opposed to a single CF value per field, assessing the CF at a site-specific scale allows us to explore the within-field variability caused by different input rates, its interaction with environmental factors and crop yields. Spatial and temporal statistical analysis is needed to understand the relation between nitrogen fertilisation and corn bioethanol CF. Furthermore, we expect to consider the function that best represents this relation in the definition of optimum site-specific nitrogen rate

Psychiatric disorders, depression and quality of life in patients with psychogenic non-epileptic seizures and drug resistant epilepsy living in Argentina

Objectives: Psychiatric disorders are frequently found in both patients with PNES and DRE, making the differential diagnosis even more complex. The aim of this study was to analyze and compare psychiatric aspects and the quality of life in patients with psychogenic non-epileptic seizures (PNES) and drug resistant epilepsy (DRE). Methods: Patients admitted to video-electroencephalograpy (VEEG) unit with confirmed PNES and DRE were included. Demographical characteristics, psychiatric diagnosis according to SCID I and II of DSM IV, pharmacological treatment, general functioning measured with GAF (Global assessment of functionality), quality of life (QoL) using QlesQSF (Quality of Life Enjoyment and Satisfaction Questionnaire Short Form) and depression severity using BDI II (Beck depression inventory), were compared between the groups. Non-parametric tests, chi square test, and logistic regression were used for statistical analysis. Results: 148 patients consecutively admitted to VEEG were included (DRE n = 97; PNES n = 51). Somatization disorder (RR: 13.02, 95% CI: 1.23–137.39, p = 0.03) and a history of trauma (RR: 8.66, 95% CI: 3.21–23.31, p = 0.001) were associated with PNES. The QlesQ score and the GAF score were lower with a higher prevalence of suicide attempts in the PNES group (p < 0.01). A negative correlation was observed between the severity of depression and the quality of life (DRE r = - 0.28, p = 0.013; PNES r = - 0.59, p = 0.001). Conclusions: Higher psychiatric comorbidity with poorer QoL were found in PNES patients compared to DRE. However, depression comorbidity negatively affected the QoL in both groups. Future studies based on illness perception will be orientated to complete this analysis.Fil: Scévola, Maria Laura. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; ArgentinaFil: Wolfzun, Camila. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Sarudiansky, Mercedes. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Centro Argentino de Etnología Americana; Argentina. Universidad de Buenos Aires; ArgentinaFil: Areco Pico, María Marta. Centro Argentino de Etnología Americana; Argentina. Universidad de Buenos Aires; ArgentinaFil: Ponieman, Micaela. Universidad de Buenos Aires; Argentina. Centro Argentino de Etnología Americana; ArgentinaFil: Gonzalez Stivala, Ernesto. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentina. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: Korman, Guido Pablo. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Universidad de Buenos Aires. Facultad de Psicología; ArgentinaFil: Kochen, Sara Silvia. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentina. Universidad Nacional Arturo Jauretche. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Provincia de Buenos Aires. Ministerio de Salud. Hospital Alta Complejidad en Red El Cruce Dr. Néstor Carlos Kirchner Samic. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - La Plata. Unidad Ejecutora de Estudios en Neurociencias y Sistemas Complejos; ArgentinaFil: D`alessio, Luciana. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Houssay. Instituto de Biología Celular y Neurociencia "Prof. Eduardo de Robertis". Universidad de Buenos Aires. Facultad de Medicina. Instituto de Biología Celular y Neurociencia; Argentin