Salivary lactoferrin levels, disease severity and correlates in patients with chronic periodontitis presenting to a tertiary health facility in Nigeria

Objective: This study compared the concentration of salivary lactoferrin in patients with and without chronic periodontitis and investigated correlations with clinical variables of the disease. Methods: The study included 102 participants (51 cases and 51 controls) who presented at the Periodontology Clinic of University of Benin Teaching Hospital and met the selection criteria of '4mm and above' periodontal probing depths (PPD) and positive bleeding on probing (BOP) using community periodontal index (CPI) probe. Healthy participants (controls) were patients that had PPD less than or equal to 3mm, absence of BOP and simplified oral hygiene index (OHI-S) not more than 1.2. Baseline OHI-S and CPI scores were recorded. Saliva samples were collected and analyzed using enzyme-linked immunosorbent assay. All data were analyzed with the Statistical Package for Social Sciences (SPSS) version 22.0. Results: There was a statistically significant difference between the mean (SD) lactoferrin concentration of control participants 5.27(0.59) mg/l and case participants 6.74(0.61) mg/l (p<0.001). Participants with probing pocket depths (PPD) of 6mm or more had a significantly higher mean concentration [6.85(0.06) mg/l] than that of those with PPD 4-5mm [6.71(0.67) mg/l] (p< 0.001)Lactoferrin levels were highest in participants with 'poor' oral hygiene [6.85(0.60) mg/l] and lowest in those with 'good' oral hygiene [6.65(0.83) mg/l]. Conclusion: Salivary lactoferrin levels were higher among participants with chronic periodontitis than those without chronic periodontitis and correlates positively with the main clinical characteristics of the disease

Socio-demographic and Clinical Correlates of Community Reintegration of Stroke Survivors in Nigeria

Background:Low level of community reintegration among stroke survivors is a major obstacle to rehabilitation services post discharge from acute care. Few studies have assessed the impact of community reintegration on stroke survivors in Nigeria. This study investigates community reintegration and associated factors among stroke survivors in Maiduguri, Nigeria.Methodology:Purposive sampling technique was used to recruit 55 stroke survivors attending rehabilitation services from two public hospitals in Maiduguri. Community reintegration was assessed with the Reintegration to Normal Living Index (RNLI) questionnaire, while information on sociodemographics (e.g., age group, gender, employment status, educational status) and clinical characteristics (e.g., post stroke duration, types of stroke, side of affectation) was obtained using the data form. Logistic regression analyses with odd ratios were used to test the associations between community reintegration and sociodemographic and clinical characteristics Results:The mean age and post stroke duration of the participants were 44.69±13.06 years and 17.25±24.90 months respectively. The participants’ community reintegration scores showed that 60%, 38.2% and 1.8% have no integration, mild to moderate reintegration and complete reintegration respectively. The results indicated that stroke survivors with a stroke duration greater than 8 months (OR=3.32, C.I=1.08-10.27) and those with haemorrhagic stroke (OR=4.67, C.I=1.05-20.66) were more likely to be reintegrated into the community than their counterparts with 6-8 months post stroke duration and ischaemic stroke, respectively. There was significant association between community reintegration and sociodemographic characteristics such as post stroke duration and type of stroke.Conclusions: Rehabilitation strategies should focus on clinical characteristics of the stroke survivors when planning and delivering effective community reintegration interventions

Antidepressants Use in Schizophrenia: Clinical Correlates and Prescription Profiles / 신경정신의학

OBJECTIVES: To identify recent prescription patterns, as well as the demographic and clinical correlates of antidepressants (ADs) usage in schizophrenic patients. METHODS: A total of 297 patients diagnosed with schizophrenia enrolled at Seoul National Hospital in 2013. Brief Psychiatric Rating Scale (BPRS) was used to evaluate current psychiatric symptoms. Bivariate comparisons were used to assess the usage of concomitant psychotropics, demographic and clinical characteristics of ADs users compared with non-users. Multivariate analysis of covariance was performed consecutively. RESULTS: The rate of ADs usage was 26.3% and the most commonly used ADs were selective serotonin reuptake inhibitors. ADs users more often took benzodiazepine than ADs non-users (p=0.005), whereas there were no significant demographic and other clinical difference between the two groups. Regarding BPRS, somatic concern (p=0.022), anxiety (p=0.001) and depressive mood (p=0.009) scores were higher, and excitement (p=0.006) and hostility (p=0.04) scores were lower among ADs users compared to non-users, although there was no significant difference in the other scores of BPRS between the two groups. Moreover, among 5 components of BPRS, scores of affective symptoms (p < 0.001) were significantly higher, and scores of activation symptoms (p=0.014) were significantly lower in ADs users compared to non-users. CONCLUSION: This study suggests that the usage of ADs could be related to affective symptoms regardless of positive and negative symptoms of schizophrenia. Further studies are required in order to confirm the clinical correlates of ADs usage and the interactions between affective symptoms and psychotic symptoms.

Socio-Demographic and Clinical Variables Associated with Chronic Homelessness among the Street Homeless People / 신경정신의학

OBJECTIVES: This exploratory study was designed to estimate the socio-demographic characteristics, course of homelessness, adverse childhood experiences, and prevalence of mental disorders among the street homeless people in Seoul, Korea. In addition, we examined the associations between chronic homelessness and study variables. METHODS: The study subjects were 75 homeless people dwelling in the street around Seoul Station. Questionnaires related to socio-demographic data and the course of homelessness were provided to each subject. The subjects' Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) mental disorder diagnoses were made by using Mini International Neuropsychiatric Interview-Plus interviews. RESULTS: Most subjects exhibited chronic homelessness and the prevalence of DSM-IV mental disorders among the homeless subjects was higher than that among the Korean general population. There was a statistically significant association between chronic homelessness and adverse childhood experiences. Compared to those with no history of childhood adversity, homeless people with a history of childhood adversity had a younger age of first homeless episode and a higher prevalence of DSM-IV major mental disorders. The association between DSM-IV diagnosis and chronic homelessness was not significant, but the group with mental disorders had more prevalent re-housing and homeless recurrent histories. CONCLUSION: Street homeless people were often involved in chronic homelessness. Results of this study suggest that homeless people who were never married and had adverse childhood experiences were more vulnerable to chronic homelessness. In addition, we detected a possible relationship between the recurrence of homelessness and the presence of mental disorders.

Clinical Correlates and Description Profiles of Antipsychotic Polypharmacy for Patients with Schizophrenia / 신경정신의학

OBJECTIVES: Despite increasing use of antipsychotic polypharmacy (APP), few studies have investigated APP for Korean patients with schizophrenia. The aim of this study was to identify the sociodemographic and clinical correlates and recent prescription profiles of APP in schizophrenia patients. METHODS: A total of 297 schizophrenia patients were recruited and interviewed using standardized assessment instruments in Seoul National Hospital. Differences in demographic and clinical characteristics between APP and antipsychotic monopharmacy (APM) groups were analyzed. The prescriptions of psychotropic drugs were collected by a review of medical records. RESULTS: In comparison with the APM group, the APP group showed association with earlier onset, lower employment rate, and higher scores for Clinical Global Impression-Severity and Brief Psychiatric Rating Scale (BPRS) (p<0.001). In particular, the BPRS positive (p<0.001) and affective symptom scores (p<0.001) of the APP group were higher those of the APM group. The most frequent combination pattern of APP was second generation antipsychotics (SGA)+SGA, followed by SGA+first generation antipsychotics (FGA), and SGA+SGA+FGA. For antipsychotics, it was risperidone+quetiapine, followed by clozapine+risperidone, risperidone+sulpiride, and risperidone+haloperidol. CONCLUSION: The current study suggests that the usage of APP for schizophrenia could be related to symptom severity affected by positive and affective symptoms. The prescription profile reflects that the proportion of atypical antipsychotics on APP has increased.