Can we predict a "tsunami"? Symptomatic and syndromal density, mood instability and treatment intensity in people with bipolar disorders under a strict and long lockdown

BACKGROUND

Converging evidence supports the involvement of circadian rhythm disturbances in the course and morbidity of bipolar disorders (BD). During 2020, lockdown measures were introduced worldwide to contain the health crisis caused by the COVID-19 pandemic. As a result, chronobiological rhythms were critically disrupted and illness outcomes were expected to worsen. The current study aimed to explore changes in morbidity among BD patients living under lockdown.

METHODS

Ninety BD outpatients under naturalistic treatment conditions were followed from March to September 2020 using a mood chart technique. Different treatment and illness variables, including mood instability, were assessed and compared with the outcomes obtained during the same 28-week period in 2019.

RESULTS

For most clinical variables, no significant differences were observed between time periods. A slight decrease was found in symptom intensity (from 15.19 ± 20.62 to 10.34 ± 15.79, FDR-adjusted p = 0.04) and in the number of depressive episodes (from 0.39 ± 0.74 to 0.22 ± 0.63, FDR-adjusted p = 0.03), whereas the intensity of pharmacological treatment remained unchanged. Previous illness course predicted mood outcomes during the confinement.

LIMITATIONS

Follow-up periods were relatively short. Further, actigraphy or other methods capable of ensuring significant changes in physical activity were not used.

CONCLUSIONS

In line with other studies, our findings show no worsening in the clinical morbidity of BD patients during lockdown. This conspicuous contrast between our initial predictions and the observed findings highlights the fact that we are still far from being able to provide accurate predictive models for BD.

[Adaptation of psychiatric practice in public and private mental health institutions of the City of Buenos Aires during the COVID-19 pandemic]

BACKGROUND

One of the most significant indirect impacts of the COVID-19 pandemic will be seen on the mental health of the population. On this study, we will take into account the adapting capacity that the most representative mental health services (MHS) of Buenos Aires (BA) City have had as to this new situation.

METHODS

We designed an online survey including 10 self-administered closed questions, strictly anonymous. It has been sent to targeted professionals who work in public and private MHS of BA after 2 months of the beginning of the lockdown.

RESULTS

We got 38 answers. 2 professionals rejected to answer. 34% belonged to private institutions and 66% to public ones. 81% of the total were able to implement online assistance but only 24% had been trained on how to treat patients in this context. 69% of the private and 12% of the public sector professionals informed to have been trained on telemedicine tools. 69% of the private and 36% of the public sector professionals informed to have prepared materials for the users on telemedicine resources. 68% mentioned that their service was properly organized. 40% of the public sector professionals may have been reassigned to work on tasks related to the pandemic. 40% of the total informed a reduced capacity of assistance.

CONCLUSIONS

The MHS of BA may have been able to migrate their assistance to telemedicine, however we have noticed differences in the training levels. A better capacity of training on this modality might be needed.

The course of the nasolacrimal duct in brachycephalic cats

Casts of the nasolacrimal duct system were obtained from 50 euthanised cats including brachy-, meso- and dolichocephalic breeds. The course of the nasolacrimal duct, which was assessed radiographically and gross-anatomically, was strongly related to the shape of the skull. In meso- and dolichocephalic cats the nasolacrimal duct formed a dorsally opened arch with the descending part being directed rostroventrally. The main part of the duct passed the nasal cavity in a rather horizontal course parallel to the hard palate and was located ventrally to the lacrimal foramen. However, foreshortening of the face was associated with a right-angled or even acute-angled alignment of the duct. In higher degrees of brachycephaly the main part of the duct ascended beyond the level of the lacrimal foramen and passed the nasal cavity dorsal to the level of the lacrimal foramen. This specific course of the nasolacrimal duct in brachycephalic cats was consistent with a steeper alignment and attachment of the maxilloturbinate. Accessory orifices of the nasolacrimal duct opening into the nasal cavity had never been observed. The present results strongly suggest that the specific course of the nasolacrimal duct in brachycephalic cats might hinder the drainage of the lacrimal fluid irrespective of the diameter of the lumen of the nasolacrimal duct system.

Morphometric investigations of breed-specific features in feline skulls and considerations on their functional implications

A total of 17 parameters (nine lengths, four heights, four widths) was used to characterize the shape of the skull in a sample of 69 pure bred cats. Results of the discriminant analysis confirmed three phenotypically different skull formations, i.e. the round-shaped, the triangular and the cuneiform. Further statistical analyses revealed that the appearance of the skull was especially variable in the case of a round shape and that the lengths had been especially affected by these characteristics. The round shape of the brachycephalic skull was attributed to a reduction in length of the face and braincase as well. In many cases, this condition was associated with disproportional increase in height and width of the braincase and an increase in convexity of the calvaria. The decrease in length of the face was more pronounced at the dorsal surface of the nose than at the palate. Therefore, the inclination of the bony nasal aperture became flatter and the inclination of the maxilloturbinate became steeper. As a result, the ventral nasal meatus changed its direction twice. This condition might predispose to dyspnoea by restricting the air passageways within the nasal cavity. Round-shaped skulls were also associated with a decrease in facial width. Morphological variants that were frequently seen in round-shaped skulls include almost rectangular inclination of the nasal bone and more distant extension of the foramen magnum between the occipital condyles.

Chemical Reactions in Ionic Molecular Aggregates. An ab initio and R2PI-Study of the Halogenbenzene/Ammonia System

The structure, charge distribution and intermolecular binding energy of stable neutral and ionic aggregates of m-difluorobenzene and m-fluorochlorobenzene with one and two ammonia molecules are calculated on the MP2/6-31 G** level. The R2PI spectra of m-difluorobenzene/ammonia aggregates are reported. The origin of the size dependence of chemical reactions observed in the ionic aggregates is discussed.