Sample Of Outpatients Research Articles

The Frequency of Topically Applied Corticosteroid Abuse Among Outpatients with Dermatology-Related Conditions

Topically applied corticosteroids are commonly prescribed medications for the treatment of various dermatology-related conditions. However, their misuse and abuse have become a growing concern. This study aims to determine the frequency of topically applied corticosteroid abuse among outpatients with dermatology-related conditions. A cross-sectional study design was employed, and data were collected from a sample of outpatients attending dermatology clinics. The participants were assessed for the presence of corticosteroid abuse based on clinical presentation, medical history, and examination findings. The frequency of abuse was determined, and factors associated with abuse were analyzed using statistical methods. The results of this study will contribute to a better understanding of corticosteroid abuse and provide insights for improving prescribing practices and patient education.

Psychometric Properties of the Persian Version of the Revised Temperament and Character Inventory (TCI-140) in a Psychiatric Outpatient Sample in Iran

Background: Cloninger first proposed the personality theory, considering both normal and abnormal personality traits. Later, different complementary versions of the Temperament and Character Inventory (TCI) found their way into the academic milieu to enhance their psychometric properties and efficiency in both experimental and clinical settings. Objectives: The main objective of the current research was to investigate the principal psychometric properties of the Persian version of the Temperament and Character Inventory (TCI-140). Methods: This research is a cross-sectional study. The data included information on psychiatric outpatients visiting Roozbeh psychiatric hospital in 9 months in 2021. Purposive sampling was performed on volunteers. A total of 471 outpatients filled out the TCI-140, 150 of whom also filled out the Personality Inventory for the DSM-5 (PID-5). Exploratory factor analysis (EFA) was performed using principal component analysis (PCA) by Promax rotation. Results: The internal consistency of all dimensions (Cronbach's alpha: Above 0.70, except for reward dependence) was proved to be satisfactory, but that of some subscales (NS1, NS4, RD4, CO3, and CO5) was quite poor. Test-retest reliability confirmed that for all dimensions, ICC > 0.70, indicating a high reliability. The findings of the PCA revealed that all dimensions were loaded in accordance with the theoretical expectations. At the facet level, all the facets were loaded on their factors except for sentimentality and dependence. According to the correlation findings, the concurrent validity of TCI-140 was acceptable for PID-5. The results showed that HA had relatively high positive correlations with detachment (r = 0.55) and negative affect (r = 0.48). Conclusions: The results confirmed the satisfactory reliability and validity of the Persian version of TCI-140 despite its drawbacks. Hence, it can be employed to examine personality traits.

2020–2021 rhinovirus genetic diversity in Saint Petersburg

Introduction. Rhinoviruses represent one of the most common respiratory viruses and belong to the Picornoviridae family, genus Enterovirus, being divided into three types: A, B, C, which account for 169 types. Rhinoviruses predominate in autumn and spring periods, although they circulate throughout almost entire epidemic season. The rhinovirus genome is represented by a single-stranded 7.2 thousand base-long +RNA. According to the publications, the most common rhinovirus species is rhinovirus A (HRV-A), followed by rhinoviruses C (HRV-C) and finally rhinovirus B (HRV-B). The aim of our study was to define rhinovirus genetic diversity in Saint Petersburg . Materials and methods. The study was conducted at the Laboratory of Molecular Virology, Smorodintsev Research Institute of Influenza. Samples (smears from the nasopharynx and oropharynx) were delivered from the S.P. Botkin Clinical Infectious Diseases Hospital, St. Olga’s Children's City Hospital, N.F. Filatov Children's City Clinical Hospital No. 5. Outpatient samples were used as well. Samples received from December 2020 to October 2021 were analyzed. Detection of rhinoviruses was carried out by real-time PCR, typing — by Sanger sequencing, with primers developed by da Costa Souza L. et al. (2021). Results. According to total specimen testing, rhinoviruses comprise 3.2% total number of specimens tested. Of these, 71 rhinoviruses were typed, representing 17.03% total number of rhinovirus-positive specimens. The most common was HRV-A (55%), among which 21 types were found (the most common HRV-A46 is 13%, n = 5). HRV-B and HRV-C were found in equal numbers — 23% (n = 16) of each species out of total number of typed rhinoviruses. Among HRV-B, 8 types were found; the most common HRV-B06 comprised 33% (n = 5). Among HRV-C, 7 types were found (the most common types are HRV-C42, HRV-C32 and HRV-C15 — 19% each, n = 3). HRV-A was detected mainly in patients aged 18 to 65 years (57.5%, n = 23). HRV-B was detected only in adult patients (100%, n = 16). HRV-C was detected in children under 2 years of age (43.75%, n = 7) and adults aged 18–65 years (31.25%, n = 5). In some cases, HRV-A and HRV-C were associated with various respiratory tract syndromes such as acute nasopharyngitis, laryngotracheitis, obstructive bronchitis, and pneumonia. HRV-B was related to clinical manifestations of pneumonia in seven cases. Conclusion. Rhinovirus type A prevails in Saint Petersburg . Rhinoviruses can be associated with diverse respiratory tract syndromes.

Mental health disorders, functioning and health-related quality of life among extensively hospitalized patients due to severe self-harm - results from the Extreme Challenges project.

Severe self-harm leading to extensive hospitalization generates extreme challenges for patients, families, and health services. Controversies regarding diagnoses and health care often follow. Most evidence-based treatments targeting self-harm are designed for borderline personality disorder (BPD). However, current knowledge about mental health status among individuals with severe self-harm is limited. To investigate psychopathology among patients extensively hospitalized due to severe or frequent self-harming behaviors. A cross sectional study (period 2019-2021) targeting psychiatric inpatients (>18 years) with frequent (>5) or long (>4 weeks) admissions last year due to self-harm. The target sample (N = 42, from 12 hospitals across all Norwegian health regions) was compared to individuals admitted to outpatient personality disorder (PD) treatment within specialist mental health services in the same period (N = 389). Clinicians performed interviews on self-harm and psychopathology, supplemented by self-report. The target sample were young adults, mainly female, with considerable hospitalization and self-harming behaviors, both significantly more extensive than the comparison group. The majority in both groups reported self-harm onset <18 years. The target sample reported increasing severity of self-harm acts and suicidal intention over time. Both samples had high levels of childhood trauma, impaired personality functioning, and a majority fulfilled criteria for PD. In the target sample, comorbid depression, PTSD, anxiety disorders, and substance use occurred more frequently and in 50%, psychosis/dissociative disorder/autism spectrum disorder/ADHD was reported (outpatient comparison sample: 9%). 35% in the target sample screened over cut-off for possible intellectual disability. The target sample reported poor psychosocial functioning and health-related quality of life - greater impairment than the outpatient comparison sample. The study reveals that severe self-harm inpatients have complex psychopathology and highlights the importance of individualized and thorough assessment among patients with severe and/or repetitive self-harm.

Case Report: Adenoid cystic oral carcinoma of the buccal mucosa: a case report study

Adenoid cystic carcinoma is a rare tumor with epithelial cells origin in the jaw and face area. Here, we reported a case of this malignancy in the palate of a 43-years-old man. In this case report study, a 43-years-old man came to Shohada Qaen Hospital in January 2022 with a complaint of a sore in his mouth. An adenoid cystic based hypo-echo lesion was reported in the ultrasound. The pathological examination of the biopsy obtained by outpatient sampling method showed malignant neoplastic tissue with proliferation, hyperchromatic nucleus with false cyst appearance and cribriform glands, and the diagnosis of oral adenoid cystic carcinoma was confirmed. The patient was treated surgically. The prognosis of this tumor is different depend on the tissue of the mass, the clinical stage of the tumor, the site of involvement and the presence of vascular or perineural invasion.

Narcissistic dimensions and depressive symptoms in patients across mental disorders in cognitive behavioural therapy and in psychoanalytic interactional therapy in Germany: a prospective cohort study

Narcissistic personality traits have been theorised to negatively affect depressive symptoms, therapeutic alliance, and treatment outcome, even in the absence of narcissistic personality disorder. We aimed to examine how the dimensional narcissistic facets of admiration and rivalry affect depressive symptoms across treatment modalities in two transdiagnostic samples. We did a naturalistic, observational prospective cohort study in two independent adult samples in Germany: one sample pooled from an inpatient psychiatric clinic and an outpatient treatment service offering cognitive behavioural treatment (CBT), and one sample from an inpatient clinic providing psychoanalytic interactional therapy (PIT). Inpatients treated with CBT had an affective or psychotic disorder. For the other two sites, data from all service users were collected. We examined the effect of core narcissism and its facets admiration and rivalry, measured by Narcissistic Admiration and Rivalry Questionnaire-short version, on depressive symptoms, measured by Beck's Depression Inventory and Patient Health Questionnaire-Depression Scale, at baseline and after treatment in patients treated with CBT and PIT. Primary analyses were regression models, predicting baseline and post-treatment depression severity from core narcissism and its facets. Mediation analysis was done in the outpatient CBT group for the effect of the therapeutic alliance on the association between narcissism and depression severity after treatment. The sample included 2371 patients (1423 [60·0%] female and 948 [40·0%] male; mean age 33·13 years [SD 13·19; range 18-81), with 517 inpatients and 1052 outpatients in the CBT group, and 802 inpatients in the PIT group. Ethnicity data were not collected. Mean treatment duration was 300 days (SD 319) for CBT and 67 days (SD 26) for PIT. Core narcissism did not predict depression severity before treatment in either group, but narcissistic rivalry was associated with higher depressive symptom load at baseline (β 2·47 [95% CI 1·78 to 3·12] for CBT and 1·05 [0·54 to 1·55] for PIT) and narcissistic admiration showed the opposite effect (-2·02 [-2·62 to -1·41] for CBT and -0·64 [-1·11 to -0·17] for PIT). Poorer treatment response was predicted by core narcissism (β 0·79 [0·10 to 1·47]) and narcissistic rivalry (0·89 [0·19 to 1·58]) in CBT, whereas admiration showed no effect. No effect of narcissism on treatment outcome was discernible in PIT. Therapeutic alliance mediated the effect of narcissism on post-treatment depression severity in the outpatient CBT sample. As narcissism affects depression severity before and after treatment with CBT across psychiatric disorders, even in the absence of narcissistic personality disorder, the inclusion of dimensional assessments of narcissism should be considered in future research and clinical routines. The relevance of the therapeutic alliance and therapeutic strategy could be used to guide treatment approaches. IZKF Münster. For the German translation of the abstract see Supplementary Materials section.

A - 176 The MIL Test: Validation of a Web-Based Performance Validity Test.

Establish validity of a web-based performance validity test (PVT) in a mixed-clinical sample of outpatients referred for a neuropsychological evaluation using a known-effort design. Participants were 110 adults (75.4% female, 89% white) classified as valid (i.e., /= 2 PVT failures; M age = 50.75, SD = 12.51, n = 16) based on five well-established PVTs. The MIL Test is a web-based PVT designed to identify noncredible memory performance on a 50-word recognition test that was also administered. ROC curve analyses yielded a significant area under the curve (AUC) of 0.86 (95% confidence interval: 0.78-0.92, p 0.05). Initial support for the validity of the MIL Test was promising in terms of psychometric properties (i.e., classification accuracy, strong convergent and discriminant validity). Future research may benefit from exploring further psychometric development (e.g., item analysis) and validation in larger, more diverse demographic and clinical populations.

Trauma symptom patterns in a large sample of military personnel outpatients: Differential relations to trauma exposure, depression, and anxiety symptoms.

Posttraumatic stress disorder (PTSD) results from experiencing or witnessing a traumatic event and is the most common clinical syndrome seen in military personnel. However, each patient experiences the impact of trauma differently exhibiting individual patterns of trauma symptoms. The current study endeavors to investigate individual patterns of trauma symptoms in military personnel and specifically analyze potential linkage and/or relation between blast exposure, anxiety, and depression. We employed a person-centered approach of latent class analysis (LCA) to stratify 594 military personnel outpatients based on their response patterns in the Trauma Symptom Inventory (TSI). Then, we related the resulting clusters to the number of blasts to which they were exposed, as well as to depression (Zung Self-Rating Depression Scale) and anxiety symptom severity (Beck Anxiety Inventory) using one-way analyses of variance with Bonferroni pairwise comparisons. We found three distinct clusters of traumatic symptoms: (a) Atypical response with low overall symptom burden, (b) increased response level and arousal, and (c) severe trauma symptom burden with tension-reduction behaviors. Individuals in Cluster 2 were exposed to significantly more blasts than in Cluster 1. Moreover, individuals in Cluster 3 reported the highest depression and anxiety symptom severities, followed by Cluster 2, followed by Cluster 1. These results suggest heterogeneity among military personnel suffering from trauma and reveal their distinct relations to clinical comorbidities-emphasizing the role of person-centered, tailored approaches in clinical practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The psychobiology of child and parental stress and the subjective perception of parental stress in a clinical sample of children

Parental stress may influence the assimilation of treatment strategies and affect a child's recovery trajectory. Thus, assessing parental stress is crucial for children requiring psychiatric care. The Parenting Stress Index (PSI) is widely utilized to gauge perceived parental stress. However, since the PSI does not quantify cortisol concentration (i.e., a biological marker for stress), it is vital to ascertain the alignment between these indicators. Moreover, understanding the correlation in cortisol concentrations between parents and children in clinical contexts can refine assessment and diagnostic methodologies. In an outpatient sample [mean age (Mage) = 9.68 years], we examined the correlation between hair cortisol concentration (HCC) in 60 pairs of parents and children, analyzed the relationship between PSI scores and parent HCC (n = 65), and used a regression model to probe the influence of child HCC and PSI scores on parent HCC (n = 63). The results showed a significant relationship between parent and child HCC (p &amp;lt; 0.001). The “Distraction and Hyperactivity” PSI subscale correlated significantly with parent HCC (p = 0.02). None of the PSI scores correlated with child HCC (p ≥ 0.07). The regression model, accounting for 44% of the variance, demonstrated that only child HCC significantly predicted parent HCC (p &amp;lt; 0.001), while the “Distraction and Hyperactivity” subscale did not.

Prevalence and correlates of frailty in older hypertensive outpatients according to different tools: the HYPER-FRAIL pilot study.

To date, few studies have investigated frailty in hypertensive individuals. This study aimed at identifying the prevalence of frailty in a sample of hypertensive older outpatients using six different identification tools. Clinical correlates of frailty and agreement between different frailty definitions were also investigated. The HYPER-FRAIL pilot study recruited hypertensive patients aged at least 75 years from two geriatric outpatient clinics of Careggi Hospital, Florence, Italy. Four frailty scales [Fried Frailty Phenotype, Frailty Index, Clinical Frailty Scale (CFS), Frailty Postal Score] and two physical performance tests [Short Physical Performance Battery (SPPB) and usual gait speed] were applied. The Cohen's kappa coefficient was calculated to assess agreement between measures. Multiple logistic regression was used to identify clinical features independently associated with frailty. Among 121 participants (mean age 81, 60% women), frailty prevalence varied between 33 and 50% according to the tool used. Moderate agreement was observed between Fried Frailty Phenotype, Frailty Index and SPPB, and between Frailty Index and CFS. Agreement was minimal or weak between the remaining measures (K < 0.60). Use of walking aids and depressive symptoms were independently associated with frailty, regardless of the definition used. Frailty correlates also included dementia, disability and comorbidity burden, but not office and 24-h blood pressure values. Frailty is highly prevalent among older hypertensive outpatients, but agreement between different frailty tools was moderate-to-weak. Longitudinal studies are needed to assess the prognostic role of different frailty tools and their clinical utility in the choice of antihypertensive treatment.

The change of antibiotic resistance rates over the years in Enterococcus spp. isolated from clinical specimens

Aims: The aim of this study was to retrospectively evaluate the change in antibiotic resistance rates of Enterococcus species isolated from various clinical samples of outpatients and inpatients in our hospital over the years.&#x0D; Methods: Between January 2018 and December 2021, various clinical samples sent to Tekirdağ Namık Kemal University Hospital Microbiology Laboratory from outpatients, inpatients and intensive care patients were retrospectively examined. The samples were inoculated on 5% sheep blood agar, chocolate agar and EMB agar media according to their types and incubated at 37°C. The blood cultures were performed by BACTEC 1280 System (Becton Dickinson, MA, USA). Bacterial identification and antimicrobial sensitivity tests were made using conventional methods and automated systems.&#x0D; Results: A total of 417 Enterococcus strains were isolated in our laboratory at four years and included in the study. Of the 417 isolates, 204 (48.9%) were isolated from male patients and 213 (51.1%) from female patients. The mean age of the patients was 57.79±22.9 years (0-96 years). It was determined that 36.9% of the isolates belonged to outpatients, 33.4% to inpatients and 29.7% to intensive care unit patients. Of the 122 enterococci isolates identified as species, 49.2% were typed as Enterococcus faecalis (E. faecalis) and 40.2% as Enterococcus faecium (E. faecium). Of the 417 isolates, 60.4% were isolated from urine samples, 24.2% from blood samples, and 8.9% from wound samples. Considering the total antibiotic resistance rates; ampicillin was 34.9%, ciprofloxacin was 46.4%, vancomycin was 8.4%, tigecline was 3.2%, high-level gentamicin was 49.0%. Linezolid and nitrofurantoin resistance were not detected. Ampicillin and vancomycin resistance rates were determined to have a statistically significant increase within four years. Ampicillin, ciprofloxacin, vancomycin and high-level gentamicin resistance rates were found to be significantly higher in isolates obtained from inpatients and intensive care patients compared to enterococcal isolates obtained from outpatients.&#x0D; Conclusion: In our study, it was determined that antibiotic resistance in enterococcal isolates, which are the causative agents of infection in our hospital, increased over the years. In this way, determining the change in antibiotic resistance rates is beneficial in determining appropriate antibiotic use policies. It is thought that conducting surveillance studies on antibiotic resistance periodically and taking new measures according to changing antibiotic resistance rates will be beneficial in terms of treatment.

Outpatients satisfaction and perceptions toward pharmaceutical services in public and private hospitals in Palestine: a cross-sectional study

BackgroundPharmaceutical care is an essential component of healthcare services, and patient satisfaction with these services is crucial for improving overall health outcomes. We aimed to evaluate patient satisfaction and perception with pharmaceutical care services provided at public and private hospitals for outpatient pharmacies. This study can provide insights into the quality of pharmaceutical services provided in both settings and identify areas for improvement.Materials and methodsA cross-sectional 1-month study was conducted in three hospitals in Nablus city in the Northern District of West Bank, Palestine. Participants were a convenience sample of outpatients who attended the study-selected hospitals (two public and one private). A sample of 30 patients from each hospital was selected with a total of 90 patients. A self-administered questionnaire was used to assess socio-demographics pharmacist-related issues, waiting and working time, and medication availability.ResultsA total of 90 patients were recruited. The overall level of patient satisfaction with pharmaceutical health services was moderate with a mean of 3.24 out of 5. Females represented 58.9%. The most prevalent age was (30–39) years (30%). There was a statistically significant difference in patient satisfaction with pharmaceutical services regarding working time between the morning and evening shifts (p value = 0.009) in favor of morning shift. No statistically significant differences in satisfaction with pharmaceutical treatments based on socio-demographics (age, gender, marital status, education level, family income, employment status, and living place), were found. Nearly, 70% of patients indicated having problems getting the medicine on their last visit to the hospital pharmacy. Only 66.7% of patients expressed satisfaction with the pharmacies’ operating (working) hours.ConclusionsPatient satisfaction with pharmaceutical care services could be enhanced by involving pharmacists in patient-oriented training and informing patients about the role of pharmacists. Patient satisfaction in the evening shift might be improved by establishing a system for continuous evaluation and improvement of pharmaceutical care services in hospitals to ensure the highest quality of care for patients in addition to implementing technology such as electronic prescribing and medication management systems that can improve the accuracy and efficiency of pharmaceutical services in hospitals.

B-125 Artificial Intelligence Application to Improve the Algorithm for Autoverification of Results of Biochemical Markers that Assess Thyroid Function

Abstract Background The results verification process is the most important control step of the post-analytical phase. It can be done in two ways, manually by a professional, or using autoverification systems. Appropriate results are verified and submitted to the Laboratory Information System (LIS). Corrective actions are initiated for discordant results prior to their submission to the LIS. Autoverification is a process where the laboratory tests results are published without any professional’s intervention. It is recommended that each laboratory creates the necessary cut-off values for autoverification, according to its population and its biochemical-medical criteria. In our laboratory, an autoverification algorithm is applied to evaluate thyroid function, which involves the measurement of 2 parameters: Thyrotropin (TSH) and Free Thyroxine (FT4). These parameters were chosen because they are the most used for characterizing thyroid function. The autoverification algorithm was defined for euthyroid, hypothyroid and hyperthyroid patients. Our professionals proposed a “safe range” for both parameters and we relate those parameters results for autoverification. We study the usefulness of artificial intelligence models by clustering non-supervised machine learning algorithms, to find behavioral patterns of not autoverified sample results, to support and even broaden the “safe ranges” established by our professionals. The goal was to improve the current autoverification algorithm by using artificial intelligence for thyroid function test results and to increase the autoverification percentage. Methods The autoverification process was carried out at TURNER Laboratories, Rosario, Argentina. The autoverification algorithm was designed according to the Laboratory and Clinical Standards Institute Guide AUTO10-A. The Atellica Data Manager (ADM) middleware was used to provide the connection between the Atellica Solution Immunoassay &amp; Clinical Chemistry Analyzers and the LIS. ADM receives the results from the analyzers and processes them in consideration of the pre-analytical (age, sex, etc.), analytical (QC, flags, etc.) and post-analytical (Delta Check, etc.) conditions. It then applies the autoverification algorithm to send the results to the LIS. In the first semester of 2022, we used the autoverification algorithm with the existing “safe ranges” in 18 626 samples of outpatients between the ages of 16 and 60. On the other hand, we applied different Clustering algorithms to the samples that were not autoverified, to find behavior patterns. The ones we used are: KMeans, Fuzzy C-Means, DBSCAN, Agglomerative Clustering, Dendrogram and Affinity Propagation. We chose KMeans with k = 4. Our professionals thoroughly analyzed each of the clusters and defined “new safe ranges” for autoverification. In the second semester of 2022, 18 947 samples were analyzed and the autoverification algorithm was applied with the “safe ranges” and the “new safe ranges”. Results In the first semester of 2022, by applying the existing “safe ranges” we obtained an autoverification of 19.0%. We then simulated an autoverification with “safe ranges” and “new safe ranges” and obtained an autoverification of 71.5%. In the second semester, we applied autoverification with “safe ranges” and “new safe ranges” obtaining an autoverification of 72.7%. Conclusion The application of machine learning algorithms has significantly improved the level of autoverification of biochemical markers that evaluate thyroid function.

A-193 Effects of Delayed Centrifugation and Delayed Testing on the Stability of Comprehensive Metabolic Profile Analytes

Abstract Background The centralization of clinical laboratory testing has become increasingly common in recent years. While centralization allows for consolidation of resources, expanded test menus, procedural standardization, and improved efficiencies, central laboratories can face significant logistical challenges related to sample transport. In particular, problems may arise when samples are received from distant sites or if the courier services used to transport samples are infrequent or unreliable. Policies aimed to mitigate pre-analytical issues such as the time-to-centrifugation, the time-to-testing, and storage temperature, are best devised when driven by empiric data. Objective In this study, we provide stability studies for the Comprehensive Metabolic Panel (CMP) analytes in paired serum and lithium heparin (LiHep) plasma samples. Our findings not only complement preexisting literature data but also help guide the current sample acceptance criteria and policy for receiving satellite clinic samples in our laboratory. Methods Serum and LiHep plasma were collected from healthy volunteers in gel separator tubes. In one set of experiments, samples of both specimen types were all centrifuged within 30 min of collection and tested at pre-determined time intervals (2, 4, 6, 12, and 24 h post collection) using Roche Cobas 8000 system. In a second set of experiments, samples of both specimen types collected from another set of volunteers were kept at room temperature and only centrifuged prior to testing at pre-determined time intervals (2, 4, 6, 12, and 24 h post collection). Sample storage prior to testing was at room temperature. The percent recovery of each result was calculated relative to the first sample of the series. The CMP includes the following analytes: glucose, sodium, potassium, chloride, carbon dioxide, urea nitrogen, creatinine, calcium, total bilirubin, total protein, albumin, alkaline phosphatase, aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Results Glucose in promptly centrifuged (i.e., within 30 min of collection) LiHep plasma samples showed acceptable recovery (≥90%) when tested within 12 h of collection in LiHep gel separator tubes, whereas glucose stability in serum stored at room temperature exceeded 24 h. In contrast, delayed centrifugation beyond 3 h led to unacceptably low recoveries in both LiHep plasma and serum sample types. All other analytes included in the CMP were stable beyond 24 h irrespective of whether the sample type is LiHep plasma or serum, or even if the time-to-centrifugation was up to 24 h. Conclusions Based on the study, our laboratory has updated our policy to accept pre-centrifuged (i.e., within 30 min of collection) LiHep plasma from satellite clinics up to 8 h from blood collection, which is a 2-hour increase as compared to our prior cut-off acceptability. Given the location of our satellite clinics and unpredictability of sample transport, this increase represents a positive change in reducing outpatient sample rejections while ensuring reliable laboratory results.

Psychometric Comparison of EQ-5D-Y, CHU-9D, and PedsQL 4.0 in Chinese Children and Adolescents With Functional Dyspepsia: A Multicenter Study

ObjectivesThis study aimed to assess and compare psychometric properties of the 3 health-related quality of life (HRQOL) instruments EQ-5D Youth version (EQ-5D-Y), Child Health Utility 9D (CHU-9D), and Pediatric Quality of Life Inventory 4.0 (PedsQL 4.0) in children and adolescents with functional dyspepsia (FD) in China. MethodsA consecutive sample of FD outpatients were recruited from 6 tertiary medical centers in Hangzhou. The patients self-completed the 3 instruments in random order. Their feasibility, acceptability, construct validity (convergent, divergent, and known-group validity), and sensitivity were assessed. Multiple linear regression was used for identifying HRQOL-associated factors. ResultsA total of 1100 patients (mean age, 9.2 years; girl, 56.8%) completed the survey with no missing responses. Ceiling effect was quite higher in EQ-5D-Y (60.9%) than CHU-9D (33.8%) and PedsQL 4.0 (1.0%). The EQ-5D-Y and CHU-9D utility scores and PedsQL 4.0 total score were highly correlated (|r| = 0.593-0.661), except for the EuroQol visual analog scale score (EQ-VAS). The intraclass correlation coefficient between the 2 utility scores was fair (0.542). Most conceptually similar dimensions among the 3 instruments showed moderate to high correlations (|r| > 0.3) as hypothesized. The difference was statistically significant for the 2 utility scores and PedsQL 4.0 total score in varied severity groups (P < .001), and PedsQL 4.0 total score had higher relative efficiency and effect size values. The child’s age, severity of FD symptoms, and their guardian’s education had significant impact on HRQOL (P < .001). ConclusionsEQ-5D-Y, CHU-9D, and PedsQL 4.0 demonstrated acceptable psychometric properties in Chinese children with FD. PedsQL 4.0 showed superior sensitivity and is recommended. EQ-5D-Y and CHU-9D utility scores were not interchangeable. The measurement properties of EQ-VAS need to be further explored.

COMPARISON OF ANTIBIOTIC SENSITIVITY OF MRSA WITH MSSA AMONG STAPHYLOCOCCUS AUREUS ISOLATES FROM PATIENTS IN THE 48 MILITARY HOSPITAL IN SANA'A CITY, YEMEN

Background and objectives: A number of infectious disorders can be opportunistically brought on by Staphylococcus aureus ( S. aureus), which colonizes human skin and mucous membranes. Methicillin (MRSA) resistance is a frequent occurrence, as are resistances to a number of clinically useful antibiotics. Though MRSA affects healthcare systems and society all throughout the world, it is most severe in underdeveloped countries. The Clinical and Laboratory Standards Institute (CLSI) advises that cumulative antibiotic data for S. aureus be analyzed and reported on an annual basis to help clinicians choose the best preliminary empirical antimicrobial therapy. The most recent report from our center on this subject, however, was more than 7 years ago. Subjects and methods: Well-proven S. aureus data were gathered from inpatient and outpatient clinical samples at the 48th Military Hospital, Sana'a, Yemen, from January 1, 2022, through December 2022, using a retrospective cross-sectional design. Using Kirby-Bauer disk diffusion, antimicrobial susceptibility testing (AST) was carried out. Calculations were made on the rate of antibiotic resistance between MRSA and MSSA as well as the correlation between MRSA. Results: Among the 265 unique isolates, the overall prevalence of MRSA was 37.4%. Inpatients had a greater risk factor for MRSA with an OR of 2.7 (p&lt;0.001). A risk factor was also found with the catheter sample, and devices with an OR=3.7 (p=0.003). Methicillin resistance was predictive of resistance to most antibiotics. Zero resistance rate to linezolid, and vancomycin was observed for the MRSA and MSSA strains. The prevalence of multidrug resistant (MDR) isolates was 60.4%. Significantly higher in MRSA (68.7%) versus 55.4% for MSSA. Conclusion: This study's MRSA prevalence was higher than that of earlier research from the same hospital; it is a progressive issue and much below the desired rates. Additionally, there was notable resistance to erythromycin, imipenem, and clindamycin. Vancomycin and linezolid are currently the top two options for the empiric treatment of MRSA. In order to stop the emergence of MDR species, it is suggested against giving newer antibacterial medications while the older ones are still effective. Peer Review History: Received: 24 June 2023; Revised: 19 July; Accepted: 29 August, Available online: 15 September 2023 Academic Editor: Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg Received file: Reviewer's Comments: Average Peer review marks at initial stage: 5.5/10 Average Peer review marks at publication stage: 7.0/10 Reviewers: Dr. Rola Jadallah, Arab American University, Palestine, rola@aauj.edu Dr. Tamer Elhabibi, Suez Canal University, Egypt, tamer_hassan@pharm.suez.edu.eg

Beliefs about emotions predict psychological stress related to somatic symptoms.

Previous research has shown that the more people believe their emotions are controllable and useful (BECU), the less they generally report psychological distress. Psychological distress, in turn, impacts health outcomes, and is among the most frequently reported complaints in psychotherapeutic and psychosomatic practice. We aimed to examine how BECU predicts psychological distress related to somatic symptoms in a prospective sample from the general population and to replicate this association in two cross-sectional samples of psychosomatic patients. We applied a panel design with an interval of 2 weeks between T1 and T2 in general-population panel-participants (N = 310), assessing BECU and psychological distress related to somatic symptoms via validated self-report measures. Moreover, we cross-sectionally replicated the relationship between BECU and psychological distress in a clinical sample of psychosomatic outpatients diagnosed with somatoform disorders (n = 101) or without somatoform disorders (n = 628). BECU predicted over and above the lagged criterion panel-participants' psychological distress related to somatic symptoms, β = -.18, p < .001. BECU was also cross-sectionally related to psychological distress in our clinical replication-sample of psychosomatic outpatients diagnosed with somatoform disorders, rS (87) = -.33, p = .002 and in those without, rS (557) = -.21, p < .001. BECU as a malleable way of thinking about emotions predicted psychological distress related to somatic symptoms in general-population panel-participants and correlated with the same in two clinical replication samples. BECU thus becomes a promising treatment target in psychotherapeutic approaches.

Influenza Vaccine Effectiveness in Preventing Laboratory-Confirmed Influenza Cases and Hospitalizations in Navarre, Spain, 2022-2023.

We estimated influenza vaccine effectiveness (IVE) in preventing outpatient and hospitalized cases in the 2022-2023 season. A test-negative design included a representative sample of outpatients and all hospitalized patients with influenza-like illness (ILI) from October 2022 to May 2023 in Navarre, Spain. ILI patients were tested by PCR for influenza virus. Influenza vaccination status was compared between confirmed influenza cases and test-negative controls. Among 3321 ILI patients tested, IVE to prevent influenza cases was 34% (95% confidence interval (CI): 16 to 48) overall, 85% (95%CI: 63 to 94) against influenza B, and 28% (95%CI: 3 to 46) against A(H3N2). Among 558 outpatients, 222 (40%) were confirmed for influenza: 55% A(H3N2), 11% A(H1N1), and 31% B. Overall, IVE to prevent outpatient cases was 48% (95%CI: 8 to 70), 88% (95%CI: 3 to 98) against influenza B, and 50% (95%CI: -4 to 76) against A(H3N2). Of 2763 hospitalized patients, 349 (13%) were positive for influenza: 64% A(H3N2), 17% A(H1N1), and 8% B. IVE to prevent hospitalization was 24% (95%CI: -1 to 42) overall, 82% (95%CI: 49 to 93) against influenza B, and 16% (95%CI: -17 to 40) against A(H3N2). No IVE was observed in preventing influenza A(H1N1). IVE was high to prevent influenza B, moderate against A(H3N2) and null against A(H1N1). A lower proportion of influenza B cases may explain the smaller IVE in hospitalized patients than in outpatients. The null IVE against A(H1N1) was consistent with the observed antigenic drift and supports the new composition of the 2023-2024 influenza vaccine.

Mapping the Path to Cognitive Balance: Applying the States of Mind Model and Network Analysis to Eating Disorder Patients.

Background: In eating disorders (EDs), cognitive-behavioral therapy (CBT) represents one of the first-line treatment options albeit with sub-optimal results. The assessment of cognitive balance through an index measuring increased adaptive thinking and reduced maladaptive thinking, the desired outcomes, and the ultimate goal of CBT treatments warrants attention. The states of mind model (SOM) provides a framework through which a cognitive balance index can be defined. The current cross-sectional controlled study tested the clinical utility of the SOM model in a sample of ED outpatients. Methods: ED outpatients (n = 199) were assessed at baseline with the attitudes and beliefs scale-2 (ABS-2) for rational beliefs (RBs) and irrational beliefs (IBs), from which a SOM ratio score index (RBs/(RBs + IBs)) was calculated, the eating disorder inventory-3 (EDI-3) for ED symptoms and ED-related psychopathological features, the psychological well-being scales (PWB) for positive psychological functioning. A matched control sample (n = 95) was also assessed with the ABS-2. Results: ED patients exhibited significantly lower SOM and RB scores compared to controls. Network analysis results highlighted the centrality of the SOM-cognitive balance index, PWB-self-acceptance, and EDI-3-general psychological maladjustment, as well as the importance of the influence that cognitive balance and general psychological maladjustment exert on each other. Conclusions: The findings support the clinical utility of the SOM ratio applied to cognitions in EDs. This demonstrates its ability to differentiate such patients from controls and in capturing worse ED-related general psychopathology as well as compromised aspects of psychological well-being, in particular self-acceptance and environmental mastery. It thus might be considered in CBT treatment of EDs a potential cognitive clinimetric and clinical index of ED severity indicating key difficulties in counteracting maladaptive thinking with adaptive thinking.

Towards an integrative hope-dysfunctional beliefs perspective to personal recovery in schizophrenia: a path analysis

BackgroundEvidence shows that negative symptoms of schizophrenia and underlying dysfunctional cognition are related to persistently low functioning and quality of life. However, despite the abundance of existing recovery programs for people with schizophrenia, few have examined whether and how the widely-adopted hope-motivation recovery pathway and the deficit-oriented cognitive pathway might converge to influence functioning and quality of life.MethodsA cross-sectional, quantative survey recruited a convenient sample of adult outpatients with DSM-5 schizophrenia spectrum disorders and low social functioning (n = 124). Self-reported measurements included personal recovery (30-item Mental Health Recovery Measure), social functioning (8-item Social Functioning Questionnaire), hope (12-item Hope Scale), quality of life (28-item World Health Organization Quality of Life Scale-Abbreviated Version-Hong Kong), defeatist beliefs (15-item extracted from Dysfunctional Attitude Scale), and asocial beliefs (15-item extracted from Revised Social Anhedonia Scale). Correlation analysis and structural equation modelling was applied to investigate how the two pathways intertwined to predict social functioning and quality of life.ResultsAsocial beliefs and hope separately mediated two partial mediation pathways from defeatist beliefs to recovery outcomes (social functioning and personal recovery). Meanwhile, defeatist beliefs, social functioning, and personal recovery further predicted quality of life.ConclusionsThis is one of the very few studies that provides empirical evidence of a deficit-strength linkage in the recovery from schizophrenia. Remediation of dysfunctional beliefs and the injection of hope and successful experiences should be undertaken concurrently in recovery as they are associated with differential effects on enhancing social functioning and personal recovery, which then converge and contribute to a better quality of life.