Sleep and memory complaints in long COVID: an insight into clustered psychological phenotypes.

This study evaluated clinical features of individuals with long COVID (5-8 months after diagnosis) who reported sleep and memory problems (62 cases) compared to those without (52 controls). Both groups had a similar mean age (41 vs. 39 years). Around 86% of the participants were non-hospitalized at the time of infection, and none of them were vaccinated at that point. Subsequently, both cases and controls received the vaccine; however, the vaccination rates differed significantly between the groups (30.7% vs. 51.0%). Cases and controls had similar rates of symptoms at acute COVID phase. However, cases were more likely to experience coryza, dyspnea, headache, and nausea/vomiting during long COVID. Regarding new-onset symptoms in long COVID, 12.9% of cases had dyspnea, and 14.5% experienced nausea/vomiting, whereas in the control group there were only 1.9% and 0.0%, respectively. Cases also had a significantly higher prevalence of persistent headache (22.6% vs. 7.7%), and dyspnea (12.9% vs. 0.0). In addition, cases also showed an increased rate of mental health complaints: disability in daily activities (45.2% vs. 9.6%; P < 0.001); concentration/sustained attention difficulties (74.2% vs. 9.6%; P < 0.001); anxiety-Generalized Anxiety Disorder 2-item scale (GAD-2) ≥ 3 (66.1% vs. 34.6%; P = 0.0013); and "post-COVID sadness" (82.3% vs. 40.4%; P < 0.001). We observed a significant correlation between sadness and anxiety in cases, which was not observed in controls (P=0.0212; Spearman correlation test). Furthermore, the frequency of concomitant sadness and anxiety was markedly higher in cases compared to controls (59.7% vs. 19.2%) (P < 0.0001; Mann-Whitney test). These findings highlight a noteworthy association between sadness and anxiety specifically in cases. In conclusion, our data identified concurrent psychological phenotypes in individuals experiencing sleep and memory disturbances during long COVID. This strengthens the existing evidence that SARS-CoV-2 causes widespread brain pathology with interconnected phenotypic clusters. This finding highlights the need for comprehensive medical attention to address these complex issues, as well as major investments in testing strategies capable of preventing the development of long COVID sequelae, such as vaccination.

The Potential of Crude and Partially Purified Black Rice Bran Extracts Obtained by Ultrasound-Assisted Extraction: Anti-Glycemic, Cytotoxicity, Cytoprotective, and Antitumoral Effects.

Recovering anthocyanins from black rice bran is a way of valuing this byproduct, by obtaining an extract with biological potential. The objective of this study was to recover anthocyanins using ultrasound-assisted extraction. Some of the extract was partially purified, and both (crude and partially purified) extracts were evaluated for their anthocyanin content, antioxidant activity, antidiabetic and antitumoral activities, cytotoxicity, and oxidative stress. An increase in the laboratory scale was also achieved, making possible to increase the extraction volume up to 20 times without significantly changing the content of anthocyanins (1.85 mg C3G/g DW). It was found that the purified sample presented a 4.2 times higher value of total anthocyanins compared to the crude sample. The best IC50 values for the purified sample were verified by DPPH and ABTS (0.76 and 0.33 mg/mL). The best results for antidiabetic activity were obtained for the partially purified sample: 0.82 µM C3G for α-glucosidase and 12.5 µM C3G for α-amylase. The extracts demonstrated protection (~70%) when subjected to the oxidative stress of L929 cells. An antitumoral effect of 25-30% for both extracts was found in A459 cells. The crude and partially purified extracts of black rice have antidiabetic and anticancer effects and more studies are needed to explore their potential.

Proposal for an implicit stigma measure in mental illness: A multigroup study.

An Implicit Association Test was developed to assess the mental illness stigma in people from the general population, mental health professionals, people with a diagnosis, and family members. No differences were found between groups. Implicit stigma was found throughout the sample, with lower scores in the younger age group.

Study of the relationship between implicit and explicit stigmas associated with mental illness.

The emergence of the Implicit Association Test (IAT) has encouraged the study of the implicit stigma associated with mental illness in recent years, although further research is still needed in this area. A sample (n = 102) composed of psychology students and people from the general population completed explicit stigma tests: Attribution Questionnaire-9 (AQ-9), Social Distance Scale (DS) and a Spanish version of the IAT. A statistical analysis of sociodemographic measures and variables, and the relationships between explicit and implicit evidence, was carried out. The presence of implicit and explicit stigma was observed throughout the sample. Significantly lower AQ-9 scores were found in the student group. A greater desire for social distance was related to older age, belonging to the general population group and not having a diagnosed relative. In contrast, greater implicit stigma was found in people who had a family member with a diagnosis. No relationship was observed between explicit tests and IAT. An analysis of the main components revealed one implicit component and other explicit. Our study supports the existence of a stigma model with two different dimensions. These findings highlight the need to consider explicit and also implicit stigma, in future theoretical models and applied studies.

Confirmatory factor analysis of the Revised UCLA Loneliness Scale (UCLA LS-R) in individuals over 65.

GOALS: The UCLA LS-R is the most extensively used scale to assess loneliness. However, few studies examine the scale's use on older individuals. The goal of the study is to analyse the suitability of the scale´s structure for assessing older individuals. METHOD: The UCLA LS-R scale was administered to a random sample of 409 community-dwelling residents of Madrid (53% women) aged 65-84 years (obtained from the MentDis_ICF65+ study). Confirmatory factor analysis was used to assess the factor structure of the UCLA LS-R. RESULTS: The internal consistency of the scale obtained a Cronbach's alpha of .85. All the analysed models of factor structure of the UCLA LS-R achieved a fairly good fit and RMSEA values over .80. The models that best fit the empirical data are those of Hojat (1982) and Borges et al. (2008). CONCLUSION: The data suggest an equivalent effectiveness of UCLA LS-R in adults under 65 and over 65, which may indicate a similar structure of the loneliness construct in both populations. This outcome is consistent with the idea that loneliness has two dimensions: emotional loneliness and social loneliness. The use of short measures that are easy to apply and interpret should help primary care professionals identify loneliness problems in older individuals sooner and more accurately.

Age-related self-stigma of people over 65 years old: adaptation of the Internalized Stigma of Mental Illness scale (ISMI) for use in age-related self-stigma (IS65+) in a Spanish sample.

OBJECTIVES: To adapt the Internalized Stigma of Mental Illness scale (ISMI) to examine self-stigma associated with aging and to study the psychometric properties of this adapted version (IS65+). Finally, self-stigma associated with age in older people is studied. METHOD: The IS65+ was administered to a random sample of 419 people over 65 years from Madrid (Spain) to study the psychometric properties of this adapted version. A regression model was estimated to identify the variables that best predict self-stigma associated with old age. RESULTS: The IS65+ showed good internal consistency (α = .89) and a factorial structure of five factors. The data showed lower levels of self-stigma related to age in the sample than the levels of mental illness self-stigma in people with mental illness. The variables associated with age-related self-stigma are: high levels of perceived loneliness, low levels of coping strategies, gender (female), mental disorder, major depressive disorder, low levels of optimism and quality of life, and high levels of functional impairment. CONCLUSION: A new version of ISMI (IS65+) with acceptable psychometric criteria has been developed for use in people over 65 years old.

Prevalence of Mental Disorders in the Elderly in the Community of Madrid: Results of the Mentdis_ICF65+ Study.

The MentDis_ICF65+ Project is an epidemiological study of mental disorders in people 65 to 85 years old in several European cities, including Madrid. Its aim is to determine the lifetime, 12-month, and 1-month prevalence of the main mental disorders in the elderly. The relationship of age and sex with each mental disorder was examined. The sample was collected through random sampling of people over 65 in Madrid, and consisted of 555 persons between 65 and 85 years old. The CIDI65+ was administered. Estimates of prevalence and odds ratios (OR) were made using sample frequencies and according to sex and age. Excluding nicotine dependence, 40.12% of the sample was found to have suffered a mental disorder at some time in their lives, 29.89% in the past year, and 17.70% were currently suffering from a mental disorder. The disorders with the highest prevalence rates were anxiety disorders, alcohol-related disorders, and mood disorders. Elderly women had a higher risk of suffering an anxiety disorder (OR men/women 0.42; CI 0.25-0.68) with a significance level of p < .001, while elderly men were more affected by any substance-related disorder (OR men/women 3.96; CI 1.62-11.07) with a significance level of p < .001. Each disorder's prevalence decreased with age (OR 65-74/75-85, 1.85; CI 1.25-2.75) with a significance level of p < .01. Results show higher prevalence rates than previous studies reported. The main implications of this study, and the need to adapt mental health services for people over 65, are highlighted.

Prevalence of mental disorders in the elderly in the community

The MentDis_ICF65+ Project is an epidemiological study of mental disorders in people 65 to 85 years old in several European cities, including Madrid. Its aim is to determine the lifetime, 12-month, and 1-month prevalence of the main mental disorders in the elderly. The relationship of age and sex with each mental disorder was examined. The sample was collected through random sampling of people over 65 in Madrid, and consisted of 555 persons between 65 and 85 years old. The CIDI65+ was administered. Estimates of prevalence and odds ratios (OR) were made using sample frequencies and according to sex and age. Excluding nicotine dependence, 40.12% of the sample was found to have suffered a mental disorder at some time in their lives, 29.89% in the past year, and 17.70% were currently suffering from a mental disorder. The disorders with the highest prevalence rates were anxiety disorders, alcoholrelated disorders, and mood disorders. Elderly women had a higher risk of suffering an anxiety disorder (OR men/ women 0.42; CI 0.25-0.68) with a significance level of p < .001, while elderly men were more affected by any substancerelated disorder (OR men/women 3.96; CI 1.62-11.07) with a significance level of p < .001. Each disorder’s prevalence decreased with age (OR 65-74/75-85, 1.85; CI 1.25-2.75) with a significance level of p < .01. Results show higher prevalence rates than previous studies reported. The main implications of this study, and the need to adapt mental health services for people over 65, are highlighted (AU)

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Physician-initiated daily verbal reminders decrease the duration of indwelling urinary catheter use compared with nurse-initiated reminders.

We compared the effectiveness of physician-initiated daily verbal reminders to primary care providers with nurse-initiated daily verbal reminders in decreasing the duration of inappropriate indwelling urinary catheter use in hospitalized patients. Catheter use duration was significantly decreased in the physician-initiated intervention group compared with the nurse-initiated intervention group (0.5 ± 0.8 vs 1.7 ± 2.7 days, respectively; P = .03).

A structural equation modeling study of the Spanish Mental Illness Stigma Attribution Questionnaire (AQ-27-E).

The main purpose of this study was the translation and analysis of psychometric properties of the Attribution Questionnaire for use in Spanish-speaking populations (AQ-27-E) and to test the dangerousness and responsibility models of mental illness stigma in a Spanish sample. The sample consisted of 439 adults from the general population of the community of Madrid (Spain). The questionnaire was translated using the translation/back-translation method. Cronbach's alpha was used to carry out the reliability analysis, and structural equations were used to test the dangerousness and the responsibility models of stigma. Internal reliability of AQ-27-E was .855, which can be interpreted as good. However, some factors (Pity, Responsibility, and Coercion) showed limited internal consistency. Results suggest that the AQ-27-E is a standardized instrument with acceptable psychometric properties comparable to previous versions, which can be used to assess stigma in Spanish-speaking populations.

Increasing the efficiency and yield of a tuberculosis contact investigation through electronic data systems matching.

BACKGROUND: Electronic health data may improve the timeliness and accuracy of resource-intense contact investigations (CIs) in healthcare settings. METHODS: In September 2013, we initiated a CI around a healthcare worker (HCW) with infectious tuberculosis (TB) who worked in a maternity ward. Two sources of electronic health data were employed: hospital-based electronic medical records (EMRs), to identify patients exposed to the HCW, and an electronic immunization registry, to obtain contact information for exposed infants and their providers at two points during follow-up. RESULTS: Among 954 patients cared for in the maternity ward during the HCW's infectious period, the review of EMRs identified 285 patients (30%) who interacted with the HCW and were, thus, exposed to TB. Matching infants to the immunization registry offered new provider information for 52% and 30% of the infants in the first and second matches. Providers reported evaluation results for the majority of patients (66%). CONCLUSION: Data matching improved the efficiency and yield of this CI, thereby demonstrating the usefulness of enhancing CIs with electronic health data.

Valoración mediante resonancia magnética cerebral de embolias clínicamente silentes en pacientes con fibrilación auricular sometidos a cardioversión eléctrica / Assessment of silent microembolism by magnetic resonance imaging after cardioversion in atrial fibrillation

Introducción y objetivos. Estudiar si la cardioversión eléctrica en pacientes con fibrilación auricular puede causar lesiones cerebrales isquémicas agudas clínicamente silentes. Métodos. Se realizó un análisis prospectivo de 62 pacientes consecutivos (media de edad, 62±10 años; 16 mujeres). Todos ellos fueron anticoagulados durante al menos 3 semanas con acenocumarol, manteniendo una media de razón internacional normalizada=2,69±0,66. En todos los casos se realizó una resonancia magnética cerebral antes y 24 h después de la cardioversión, incluidas las secuencias potenciadas en difusión. Se realizó también una exploración neurológica antes y después del procedimiento, utilizando las escalas de ictus National Institute of Health Stroke Scale y de Rankin modificada. Se obtuvo el consentimiento informado por escrito en todos los casos. Resultados. De los 62 pacientes, en 51 (85%) se revirtió a ritmo sinusal. La exploración neurológica no mostró cambios después de la cardioversión. La resonancia magnética realizada antes del procedimiento mostró enfermedad de pequeño vaso en 35 pacientes (56%); de ellos, 2 presentaban enfermedad cerebrovascular previa conocida. La resonancia magnética tras la cardioversión no mostró nuevas áreas de isquemia en ningún caso. Conclusiones. Después de la cardioversión, no encontramos cambios en la exploración neurológica ni áreas de isquemia aguda en la resonancia magnética de ningún paciente de nuestra serie. Sin embargo, en nuestro estudio, la resonancia magnética basal mostró lesiones isquémicas clínicamente silentes en 35 pacientes (56%) con fibrilación auricular persistente (AU)

Introduction and objectives. To study electrical cardioversion in patients with atrial fibrillation as a potential cause of acute ischemic brain lesions. Methods. We performed prospective analysis of 62 consecutive patients (62 [10] years, 16 female). All of them were anticoagulated for at least 3 weeks with an international normalized tatio of 2.69 (0.66). In all cases a magnetic resonance imaging of the brain was performed before and 24h after the cardioversion, including diffusion-weighted sequences. A neurological exploration was also performed before and after the procedure, using the modified Ictus on the National Institute of Health Stroke Scale and the modified Rankin scale. Written informed consent was obtained in all cases. Results. Of the 62 patients, 51 (85%) reverted to sinus rhythm. The neurological examination showed no changes after cardioversion. The pre-procedure magnetic resonance imaging showed microvascular disease in 35 (56%), including 2 patients with known cerebrovascular disease, and did not depict new clinically silent ischemic areas after cardioversion. Conclusions. After electrical cardioversion no acute ischemic lesions in the brain nor alteration in the neurological scales were found. Nevertheless, in 35 patients (56%) with persistent atrial fibrillation, the magnetic resonance imaging showed clinically silent ischemic lesions (AU)

Assessment of silent microembolism by magnetic resonance imaging after cardioversion in atrial fibrillation.

INTRODUCTION AND OBJECTIVES: To study electrical cardioversion in patients with atrial fibrillation as a potential cause of acute ischemic brain lesions. METHODS: We performed prospective analysis of 62 consecutive patients (62 [10] years, 16 female). All of them were anticoagulated for at least 3 weeks with an international normalized ratio of 2.69 (0.66). In all cases a magnetic resonance imaging of the brain was performed before and 24h after the cardioversion, including diffusion-weighted sequences. A neurological exploration was also performed before and after the procedure, using the modified Ictus on the National Institute of Health Stroke Scale and the modified Rankin scale. Written informed consent was obtained in all cases. RESULTS: Of the 62 patients, 51 (85%) reverted to sinus rhythm. The neurological examination showed no changes after cardioversion. The pre-procedure magnetic resonance imaging showed microvascular disease in 35 (56%), including 2 patients with known cerebrovascular disease, and did not depict new clinically silent ischemic areas after cardioversion. CONCLUSIONS: After electrical cardioversion no acute ischemic lesions in the brain nor alteration in the neurological scales were found. Nevertheless, in 35 patients (56%) with persistent atrial fibrillation, the magnetic resonance imaging showed clinically silent ischemic lesions.

La Enfermedad Mental en los Medios de Comunicación: Un Estudio Empírico en Prensa Escrita, Radio y Televisión / Mental Illness in the Media: An Empirical Study in Press, Radio and Television

La percepción social de la enfermedad mental está teñida de una serie de estereotipos negativos y prejuicios que conducen a la discriminación y aumentan el sufrimiento de las personas que padecen un trastorno mental. En repetidas ocasiones se ha señalado el papel de los medios de comunicación como agentes estigmatizadores de gran repercusión y difusión social. El presente estudio pretende cubrir la escasez de trabajos que analizan las posibles tendencias estigmatizantes en los principales medios de comunicación españoles. Los resultados muestran una utilización abusiva e incorrecta de terminología relacionada con los trastornos mentales en los contenidos informativos de prensa, radio y televisión, mientras que el seguimiento real del tema es escaso y se aleja de un tratamiento informativo óptimo. De hecho, una cuarta parte de las noticias analizadas incluían contenidos estigmatizadores, siendo los estereotipos con mayor frecuencia de aparición el de peligrosidad e impredecibilidad. Todo ello hace necesaria la puesta en marcha de iniciativas de sensibilización social y erradicación del estigma, con el fin de favorecer la integración y el bienestar de las personas que sufren algún trastorno mental (AU)

The social perception of mental illness is characterised by a wide range of negative stereotypes and prejudices which lead to discrimination and increase the suffering of people with a mental disorder. The media have been repeatedly described as important stigmatizing agents with enormous social influence and repercussion. This study intends to compensate for the lack of investigations about possible stigmatizing trends in the main Spanish media. The results have shown an abusive and improper use of terminology related to mental disorders in the radio, television and press news reports, which contrasts with a lack of news stories which really dealt with the subject and offered high quality information. In fact, a quarter of the analyzed news stories included stigmatizing contents, and a significant presence of stereotypes concerning danger and unpredictability. This reality requires the setting up of social sensitization and stigma eradication campaigns, aimed at promoting the integration and well-being of those people suffering from a mental disorder (AU)

Proposal of a socio-cognitive-behavioral structural equation model of internalized stigma in people with severe and persistent mental illness.

The social stigma of mental illness has received much attention in recent years and its effects on diverse variables such as psychiatric symptoms, social functioning, self-esteem, self-efficacy, quality of life, and social integration are well established. However, internalized stigma in people with severe and persistent mental illness has not received the same attention. The aim of the present work was to study the relationships between the principal variables involved in the functioning of internalized stigma (sociodemographic and clinical variables, social stigma, psychosocial functioning, recovery expectations, empowerment, and discrimination experiences) in a sample of people with severe and persistent mental illness (N=108). The main characteristics of the sample and the differences between groups with high and low internalized stigma were analyzed, a correlation analysis of the variables was performed, and a structural equation model, integrating variables of social, cognitive, and behavioral content, was proposed and tested. The results indicate the relationships among social stigma, discrimination experiences, recovery expectation, and internalized stigma and their role in the psychosocial and behavioral outcomes in schizophrenia spectrum disorders.

Associação do RIFLE com letalidade e tempo de internação em pacientes críticos com lesão renal aguda / RIFLE: association with mortality and length of stay in critically ill acute kidney injury patients

OBJETIVO: Correlacionar a classificação do RIFLE com a letalidade e tempo de internação na unidade de terapia intensiva e no hospital. MÉTODOS: Estudo de coorte prospectivo, observacional e longitudinal aprovado pelo Comitê de Ética da Instituição. Foram coletados os dados de todos os pacientes internados por mais de 24 horas na unidade de terapia intensiva do Hospital Universitário Polydoro Ernani de São Thiago da Universidade Federal de Santa Catarina de setembro de 2007 a março de 2008 e com seguimento até a alta ou óbito. Os pacientes foram divididos em dois grupos: com lesão renal aguda e sem lesão renal aguda. O grupo com lesão renal aguda foi classificado conforme o RIFLE e subdividido de acordo com a classe máxima alcançada: risco, injúria ou falência. Não foram incluídas as classes loss e end-stage no estudo. Analisou-se também APACHE II e SOFA. Utilizaram-se os testes t Student e Qui-Quadrado, principalmente. Um p<0,05 foi estatisticamente significativo. RESULTADOS: A amostra foi composta por 129 pacientes. Desses, 52 (40,3 por cento) apresentaram lesão renal aguda segundo o RIFLE. Nesse grupo, os doentes foram considerados mais graves obtendo médias maiores de APACHE II e SOFA (p<0,05). Em comparação ao grupo sem dano renal, a gravidade da lesão renal aguda proporcionou maior letalidade na unidade de terapia intensiva (risco-25 por cento; injúria-37,5 por cento; falência-62,5 por cento) e hospitalar (risco-50 por cento; injúria-37,5 por cento; falência-62,5 por cento) e maior tempo de internação na unidade de terapia intensiva (p<0,05). CONCLUSÃO: O sistema RIFLE, conforme a classe de gravidade, foi marcador de risco para maior letalidade na unidade de terapia intensiva e no hospital e maior tempo de internação na unidade de terapia intensiva. Não se encontrou relação para o tempo de internação hospitalar.

OBJECTIVE: To correlate the RIFLE classification with mortality and length of stay both in the intensive care unit and hospital. METHODS: A prospective, observational, longitudinal cohort study, approved by the Institution's Ethics Committee. Data were collected for all patients staying longer than 24 hours in the intensive care unit of Hospital Universitário Polydoro Ernani de São Thiago - Universidade Federal de Santa Catarina from September 2007 to March 2008, followed-up either until discharge or death. Patients were divided in two groups: with or without acute kidney injury. The acute kidney injury group was additionally divided according to the RIFLE and sub-divided according to the maximal score in Risk, Injury of Failure. Loss and End-stage classes were not included in the study. APACHE II and SOFA were also evaluated. The t Student and Chi-Square tests were used. A P<0.05 was considered statistically significant. RESULTS: The sample included 129 patients, 52 (40.3 percent) with acute kidney injury according to RIFLE. Patients were more severely ill in this group, with higher APACHE and SOFA scores (P<0.05). Compared to the without kidney injury group, the kidney injury severity caused increased intensive care unity (Risk 25 percent; Injury 37.5 percent; Failure 62.5 percent) and in-hospital (Risk 50 percent; Injury 37.5 percent; Failure 62.5 percent) mortality, and longer intensive care unit stay (P<0.05). CONCLUSION: The RIFLE system, according to the severity class, was a marker for risk of increased intensive care unit and in-hospital mortality, and longer intensive care unit stay. No relationship with in-hospital length of stay was found.

Evaluación de la Atención a las Personas con Enfermedad Mental Grave y Persistente: la Experiencia de Madrid / Evaluation of the Care Program for People with Chronic and Severe Mental Illiness: the Madrid Experience

En este artículo se presenta una experiencia de evaluación de programas de atención a las personas con enfermedad mental grave y persistente llevada a cabo en la Comunidad de Madrid: la evaluación del Plan de atención social para personas con enfermedad mental grave y crónica 2003-2007, de la Consejería de Familia y Asuntos Sociales. En este caso se aborda la evaluación de una forma global, abarcando los distintos aspectos del Plan, aunque prestando una atención especial a la red de recursos que se incluyen en el mismo. Se describe el proceso de evaluación global explicando los objetivos, metodología y procedimientos seguidos, así como las fases del proceso, las tareas y actividades desarrolladas, los instrumentos aplicados y los procedimientos de evaluación establecidos. Se presentan también algunos de los resultados obtenidos mediante dicha evaluación durante el año 2006 (AU)

This paper presents the experience of a program evaluation in Madrid –the evaluation of a social care program for people with chronic and severe mental illness. It is a global evaluation, including different aspects of the program –although a special attention is paid to the resources network. The evaluation process is described, including goals, methodology, phases, activities, instruments and procedures. Finally, some results are shown concerning evaluation in 2006 (AU)