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Diaz DR, Urrutia S, Gutierrez G, Cuevas F. Clinical presentation and outcomes of hospitalized children with COVID-19 in Mexico City. Pediatr Pulmonol 2022; 57:3044-3049. [PMID: 36039829 PMCID: PMC9538333 DOI: 10.1002/ppul.26132] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Revised: 05/22/2022] [Accepted: 08/06/2022] [Indexed: 01/11/2023]
Abstract
We describe the demographic, clinical, radiological, and laboratory findings relating them also to the severity and clinical outcome of 129 children (0-18 years) who were admitted to a tertiary care pediatric hospital in Mexico City due to severe acute respiratory syndrome coronavirus 2 infection between April 1, 2020 and March 31, 2021. The infection was confirmed using reverse transcription-polymerase chain reaction Fever (82.2%), tachypnea (72.1%), and cough (71.3%) were the most reported signs at the moment of hospitalization. The most frequent radiological pattern that stood out was the interstitial pattern (66.7%). History of oncologic pathology (25.6%) was the most frequent past medical history. Non-steroidal anti-inflammatory drugs (93%), antibiotics (57.4%), and steroids (40.3%) were the most common medication given. The average hospitalization stay was 14.2 days, and 21.7% of the total patients required transfer to the intensive care unit. At discharge, 20.2% required oxygen on an outpatient basis, and unfortunately, 7.0% of the patients who were admitted to the institute for COVID-19 died. Our findings confirm that COVID-19 in children has a mild presentation except for patients with hematologic/oncologic comorbidities who had severe presentations.
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Affiliation(s)
- David R Diaz
- Department of Pediatric Pulmonology, Instituto Nacional de Pediatría, Coyoacan, Mexico
| | - Samuel Urrutia
- The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Gabriel Gutierrez
- Department of Pediatric Pulmonology, Instituto Nacional de Pediatría, Coyoacan, Mexico
| | - Francisco Cuevas
- Department of Pediatric Pulmonology, Instituto Nacional de Pediatría, Coyoacan, Mexico
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Mathos KK, Landsberger SA, Diaz DR, Barnett S. Experiences in Psychiatric Residency Training: Teaching About the Mental Health of Persons Who Are Deaf or Hard of Hearing. Acad Psychiatry 2018; 42:869-870. [PMID: 30171493 DOI: 10.1007/s40596-018-0975-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Accepted: 08/15/2018] [Indexed: 06/08/2023]
Affiliation(s)
| | | | - David R Diaz
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Steven Barnett
- University of Rochester Medical Center, Rochester, NY, USA
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Hunt HB, Pearl JC, Diaz DR, King KB, Donnelly E. Bone Tissue Collagen Maturity and Mineral Content Increase With Sustained Hyperglycemia in the KK-Ay Murine Model of Type 2 Diabetes. J Bone Miner Res 2018; 33:921-929. [PMID: 29281127 PMCID: PMC5935591 DOI: 10.1002/jbmr.3365] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 12/01/2017] [Accepted: 12/13/2017] [Indexed: 11/11/2022]
Abstract
Type 2 diabetes mellitus (T2DM) increases fracture risk for a given bone mineral density (BMD), which suggests that T2DM changes bone tissue properties independently of bone mass. In this study, we assessed the effects of hyperglycemia on bone tissue compositional properties, enzymatic collagen crosslinks, and advanced glycation end-products (AGEs) in the KK-Ay murine model of T2DM using Fourier transform infrared (FTIR) imaging and high-performance liquid chromatography (HPLC). Compared to KK-aa littermate controls (n = 8), proximal femoral bone tissue of KK-Ay mice (n = 14) exhibited increased collagen maturity, increased mineral content, and less heterogeneous mineral properties. AGE accumulation assessed by the concentration of pentosidine, as well as the concentrations of the nonenzymatic crosslinks hydroxylysylpyridinoline (HP) and lysyl pyridinoline (LP), did not differ in the proximal femurs of KK-Ay mice compared to controls. The observed differences in tissue-level compositional properties in the KK-Ay mice are consistent with bone that is older and echo observations of reduced remodeling in T2DM. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Heather B Hunt
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Jared C Pearl
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - David R Diaz
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA
| | - Karen B King
- Department of Orthopedics, University of Colorado School of Medicine, Aurora, CO, USA.,Surgical Service/Orthopaedic Service, Veterans Affairs Eastern Colorado Health Care System, Denver, CO, USA
| | - Eve Donnelly
- Department of Materials Science and Engineering, Cornell University, Ithaca, NY, USA.,Research Division, Hospital for Special Surgery, New York, NY, USA
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Landsberger SA, Diaz DR, Spring NZ, Sheward J, Sculley C. Psychiatric diagnoses and psychosocial needs of outpatient deaf children and adolescents. Child Psychiatry Hum Dev 2014; 45:42-51. [PMID: 23504290 DOI: 10.1007/s10578-013-0375-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Deaf youth may be more vulnerable to psychiatric disorders but very little research data is available. The current study identified prevalence rates of psychiatric disorders and examined the psychosocial needs and strengths of deaf youth aged 4-17 receiving specialized outpatient mental health services for the deaf. Compared to hearing peers, deaf youth had greater rates of attention deficit hyperactivity disorder, conduct, autism-spectrum and bipolar disorders and spent three times longer in treatment than their hearing peers. In the deaf subsample, moderate-severe risk was found in social functioning (33.3 %) and suicidal behavior (14 %). Deaf youth had moderate to severe impairment in social relationships (54.8 %), school functioning (42.9 %). Over one-third of deaf youth had impaired family relationships, living situation, communication, judgment and physical health. Deaf youth present with higher rates of certain clinical disorders and have deficits in multiple life domains that may impact functioning and create a longer treatment course.
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Affiliation(s)
- Sarah A Landsberger
- Department of Psychiatry, IU Health Neuroscience Center, Indiana University School of Medicine, Goodman Hall, 355 W. 16th Street, 2nd Floor, Indianapolis, IN, USA,
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Diaz DR, Landsberger SA, Povlinski J, Sheward J, Sculley C. Psychiatric disorder prevalence among deaf and hard-of-hearing outpatients. Compr Psychiatry 2013; 54:991-5. [PMID: 23688857 DOI: 10.1016/j.comppsych.2013.04.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Revised: 03/26/2013] [Accepted: 04/01/2013] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To contribute to the dearth of literature on the prevalence rates of psychiatric disorders in deaf adults, this study examined the diagnostic and clinical characteristics of deaf psychiatric outpatients in comparison to hearing psychiatric outpatients. METHODS Archival clinical data for deaf adults (N=241), treated at a specialized, linguistically and culturally affirmative outpatient community mental health program from 2002 to 2010, was compared to data from a random sample of hearing adult outpatients (N=345) who were treated at the same community mental health center. RESULTS In various diagnostic categories, significant differences were seen between the deaf and hearing groups: bipolar disorders (3.7% versus 14.2%), impulse control disorders (15.8% versus 5.2%), anxiety disorders (18.7% versus 30.1%), attention deficit hyperactivity disorder (11.2% versus 4.9%), pervasive developmental disorders (3.3% versus 0.3%), substance use disorders (27.8% versus 48.4%), and intellectual disabilities (10.4% versus 2.9%). CONCLUSIONS The deaf outpatient group evidenced a different diagnostic profile than the hearing sample. It is suggested that the use of culturally competent and fluent ASL-signing clinicians provides more diagnostic clarity and is encouraged as a best practice for the care of deaf individuals.
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Affiliation(s)
- David R Diaz
- Indiana University School of Medicine, Department of Psychiatry, Indianapolis, Indiana.
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Landsberger SA, Scott EL, Hulvershorn LA, Chapleau KM, Diaz DR, McDougle CJ. Mentorship of clinical-track junior faculty: impact of a facilitated peer-mentoring program to promote scholarly productivity. Acad Psychiatry 2013; 37:288-289. [PMID: 23820920 DOI: 10.1176/appi.ap.12100177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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Abstract
This case report demonstrates challenges diagnosing psychosis in language dysfluent deaf patients. Treatment of a 34-year-old deaf man on an inpatient psychiatric unit is described. He had a history of physical aggression and possible symptoms of paranoia and thought disorganization, in addition to learning difficulties and minimal language skills. The patient was placed on a combined hearing/deaf inpatient unit, received specialized programming for deaf patients and was prescribed risperidone and divalproex sodium to treat his aggressive behavior and possible psychosis. Uncertainty if the patient were having psychotic symptoms remained throughout his hospitalization, although he improved behaviorally and was discharged after 13 months of treatment. The patient's pre-existing language deficits made accurate diagnosis and appropriate treatment challenging. It is important for clinicians to be aware of the frequency of language dysfluency in the deaf inpatient population and have a strategy for evaluating and treating this complex subgroup of deaf people.
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Chapleau KM, Landsberger SA, Povlinski J, Diaz DR. Using paradoxical intention therapy to treat refractory nonepileptic events. Psychosomatics 2013; 54:398-401. [PMID: 23380672 DOI: 10.1016/j.psym.2012.12.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2012] [Revised: 12/14/2012] [Accepted: 12/17/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Kristine M Chapleau
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202-7176, USA.
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Abstract
This article reviews recent research in the area of psychotic disorders in deaf psychiatric patients. Comparisons of the rates of psychotic disorders in the deaf and hearing populations suggest that psychotic disorders occur equally as often or even somewhat less often in the deaf population as in the hearing population. Consideration is given to the limitations of this small body of research, and recommendations for future research are provided. The contradictory literature on hallucinations in the deaf is also reviewed, and current theory about the manner in which hallucinations are manifested and experienced based on audiological history is presented. The challenges encountered by clinicians in accurately assessing symptoms of thought disorganization in deaf people are reviewed. Specifically, the etiology of deafness, language dysfluency, and the skill and training of American Sign Language interpreters are considered as factors impacting accurate diagnosis. Recommendations from the current literature are also provided.
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Affiliation(s)
- Sarah A Landsberger
- Department of Psychiatry, Indiana University School of Medicine, 1111 West 10th Street, Indianapolis, IN 46202, USA.
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Abstract
OBJECTIVE This study examined the diagnostic and clinical features of deaf psychiatric inpatients. METHODS Archival clinical data for deaf and hard-of-hearing adults (N=30) were compared with data for a random sample of hearing adults (N=60) admitted to a state psychiatric hospital from 1998 to 2008. RESULTS Significant differences were found between deaf and hearing inpatient groups in the frequency of impulse control disorders (23% versus 2%), pervasive developmental disorders (10% versus 0%), substance use disorders (20% versus 45%), mild mental retardation (33% versus 3%), and personality disorders (17% versus 43%). The deaf group had a larger proportion with diagnoses of psychotic disorder not otherwise specified (17% versus 2%). Deaf inpatients had longer hospitalizations than hearing inpatients (17 months versus ten months). CONCLUSIONS Clinicians working with the underserved, understudied population of deaf and hard-of-hearing psychiatric inpatients should be aware of the cultural and linguistic differences in assessment and treatment and make efforts to modify their approach.
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Affiliation(s)
- Sarah A Landsberger
- Department of Psychiatry, Indiana University School of Medicine, 1111 W. 10th St., Psychiatry Building, Indianapolis, IN 46202, USA.
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Diaz DR, Fleming DE, Rhees RW. The hormone-sensitive early postnatal periods for sexual differentiation of feminine behavior and luteinizing hormone secretion in male and female rats. Brain Res Dev Brain Res 1995; 86:227-32. [PMID: 7656415 DOI: 10.1016/0165-3806(95)00029-d] [Citation(s) in RCA: 37] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
The purpose of this study was to determine the duration of the hormone-sensitive postnatal period during which a single injection of testosterone propionate (TP) influences feminine behavior and luteinizing hormone (LH) secretion in male and female rats. Male pups were castrated on the day of birth (day 1) between 6 and 12 h postpartum. On postnatal day 3, 4, 5, 6, 7, 8, or 9 female pups and castrated males (fales) were injected subcutaneously with testosterone propionate (TP-500 micrograms). The females were laparotomized at 60 days of age, and ovarian tissue was removed for histological analysis. Female behavior was evaluated at 100 days of age. At 150 days of age, the ability of steroids to facilitate LH secretion was determined. Tests for lordosis indicated a diminished lordotic quotient (LQ) with both females and fales treated with TP on postnatal day 3, 4, 5, 6, or 7. On day 8 or 9, however, the lordotic response was at control levels. Females in all TP treated groups had significantly reduced number of corpora lutea. Females and fales treated with TP on postnatal day 3, 4, 5, 6, 7, 8, or 9 failed to exhibit an LH surge as adults. The results indicate that the neural control of feminine behavior (LQ) is hormone-sensitive to a single injection of TP up through the 7th day of postnatal life, whereas the neural substrate regulating LH secretion was sensitive in the present study at least up through day 9 in both fales and females.
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Affiliation(s)
- D R Diaz
- Department of Zoology, Brigham Young University, Provo, UT 84602, USA
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