scholarly journals Psychiatric Assistance at Cataract Juvenile

2019 ◽  
Vol 3 (11) ◽  
pp. 501-504
Author(s):  
I Gusti Ayu Indah Ardani ◽  
Yunias Setiawati ◽  
Joni Wahyuhadi
Keyword(s):  
Metabolic Diseases ◽  
Management Plan ◽  
City Government ◽  
Global Developmental Delay ◽  
Child Psychiatrist ◽  
Physical And Mental Health ◽  
Liaison Psychiatry ◽  
Blurred Vision ◽  
Psychological Assistance ◽  
Child Disorders

Background: Psychiatric assistance is required in the integrated handling of physical health disorders in the field of other disciplines known as CLP. A collaborative approach to the field of psychiatry with other scientific disciplines in accordance with WHO health criteria that includes physical and mental health for improving health and quality of life. Case presentation: A boy, 8 years, was consulted from the Ophthalmology Department with Right eye cataract juvenile, and left eye ptisis bulbi to give pre-operative psychological assistance for eye assessment and diagnostics. Patient also complained the blurred vision since last year and cannot see anything since 10 months ago. The current condition represents the patient cannot speak, often screams, likes to injure his head and scratch his face. Patients treated in the pediatric’s ward with global developmental delay. Patients were also consulted to the child psychiatry section with childhood autism, audiology, nutrition and metabolic diseases of children, pediatric neurology, and finally collaboration with the Surabaya City Health Office for a follow-up management plan. Conclusions: Child psychiatrist as a liaison, interacting with multidisciplinary medical or rehabilitation teams, families, schools, community and local city government are beneficial in the management of child disorders and improving family wellbeing. Keywords: cataract juvenile; autism; psychiatric assistance; consultation liaison psychiatry (CLP)

scholarly journals Multidisciplinary team management of 46,XY 17α-hydroxylase deficiency: a case report and literature review

2021 ◽  
Vol 49 (3) ◽  
pp. 030006052199396
Author(s):  
Yang Zhou ◽  
Xue Xue ◽  
Panpan Shi ◽  
Qinrui Lu ◽  
Shulan Lv
Keyword(s):  
Multidisciplinary Team ◽  
Relevant Literature ◽  
Management Plan ◽  
Laboratory Evaluation ◽  
Primary Amenorrhea ◽  
Physical And Mental Health ◽  
Hydroxylase Deficiency ◽  
Holistic Management ◽  
Sexual Characteristics ◽  
Set Up

Background We report here a case study of 17α-hydroxylase deficiency in a phenotypic girl with male karyotype (46,XY). We also review the relevant literature to deepen our understanding of the disease, reduce the rate of missed diagnosis, and emphasize that holistic management of this disease requires collaborative multidisciplinary teamwork. Case presentation A 14-year-old patient with a female phenotype visited the endocrinology department because of hypertension. The patient had primary amenorrhea and lacked secondary sexual characteristics. Initial laboratory evaluation revealed normal levels of electrolytes, a hypergonadotropic hypogonadal state with high progesterone and low testosterone levels, and a 46,XY karyotype. She was referred to the urology department for gonadectomy and transferred to the gynecological endocrine clinic. On the basis of the patient’s medical history and genetic testing results, a diagnosis of 46,XY 17α-hydroxylase deficiency was made. The patient was provided with glucocorticoids, estrogens, metformin, and psychological support. Conclusions Patients with 17α-hydroxylase deficiency, a rare cause of congenital adrenal hyperplasia, should be treated by a multidisciplinary team. Relevant experts from different disciplines should set up a systematic and comprehensive individualized management plan to optimize the physical and mental health and quality of life of affected patients.

scholarly journals “Lost between the interface of physical and mental health”: focus groups exploring liaison psychiatry staff's perception about working during the first wave of the COVID-19 pandemic in Birmingham and Solihull Mental Health Foundation Trust

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S329-S329
Author(s):  
Saima Jehanzeb ◽  
Muhammad Suleman ◽  
Ella Tumelty ◽  
Joanne Okusanya ◽  
Laxsan Karunanithy ◽  
...  
Keyword(s):  
Mental Health ◽  
Mental Health Services ◽  
Community Mental Health ◽  
Health Services ◽  
Focus Groups ◽  
Working Conditions ◽  
Community Mental Health Services ◽  
Physical And Mental Health ◽  
Liaison Psychiatry ◽  
Mental Health Foundation

AimsAs the COVID-19 pandemic continues, increasing attention is being drawn to the welfare of healthcare providers who have endured many months of sustained exposure to the virus, disrupted working conditions and psychological stress. This project aimed to explore the subjective experiences of staff working in Liaison Psychiatry (LP) in the Birmingham and Solihull Mental Health Foundation Trust, (BSMHFT) during the first wave of the COVID-19 pandemic. These findings have been used to devise recommendations for subsequent waves.MethodData collection occurred as part of a mixed method service evaluation project. We invited all clinical and non-clinical staff from LP departments across BSMHFT to participate in focus groups conducted via Microsoft Teams. The focus groups were video-recorded and facilitated by a moderator and an observer. Subsequent anonymised transcripts were coded and themes were generated by at least two evaluators, using thematic analysis.ResultThe focus groups, which ranged from 21 to 69 minutes, involved consultants, junior doctors and nurses from four hospitals within BSMHFT. Six major themes emerged including an initial reduction in number yet increase in acuity of patients seen by LP, with some perception that this resulted from reduced face-to-face contact with community mental health services. A feeling that LP was lost at the interface between the physical and mental health trusts emerged as another theme. Uncertainty in adapting to unprecedented working conditions, for example, unclear guidance concerning the use of personal protective equipment, was also described alongside anxiety about contracting and transmitting SARS-Cov-2. Additionally, increased pressure was felt due to staff shortages and inadequate inter-departmental communication. Participants reported differential uptake of remote working, as well as conflicting views regarding the feasibility of remote assessments in LP.ConclusionLiaison psychiatry staff within BSMHFT continued to provide a crucial service during the COVID-19 pandemic. Focus groups with thes staff indicate several recommendations for implementation within the Trust and provoke questions for future research. Due to the unique role that LP plays in providing mental health care within general hospitals, clear guidance for LP staff is key for effective service provision and supporting LP staff. Although used widely across community mental health services, the role of remote working in LP is contentious and requires further exploration. However, there are limitations to the use of focus groups and these findings may not fully represent the experiences of LP staff throughout BSMHFT. Different themes may have emerged through the use of anonymous questionnaires.

scholarly journals London's liaison psychiatry services: survey of service provision

2015 ◽  
Vol 39 (2) ◽  
pp. 65-69 ◽  
Author(s):  
Smitha Naidu ◽  
Jim Bolton ◽  
Jared Smith
Keyword(s):  
Service Provision ◽  
Service Development ◽  
Clinical Implications ◽  
Physical And Mental Health ◽  
Liaison Psychiatry ◽  
General Hospitals ◽  
Staffing Levels ◽  
Similar Survey ◽  
Service Policy ◽  
The Cost

Aims and methodTo describe the liaison psychiatry services of all 30 general hospitals in Greater London and to determine whether services met national recommendations. The results were compared with a similar survey conducted 8 years previously to determine whether there had been significant service development.ResultsWe identified wide variations in service provision across London. Fifteen hospitals (50%) had 24-hour services and one had no service. There had been a significant increase in services that assessed older adults. Increases in the size of teams and consultant psychiatry staff were not significant.Clinical implicationsDespite an increasing emphasis on the effectiveness of liaison psychiatry services, no London hospital had staffing levels consistent with national recommendations. Recent evidence for the cost-effectiveness of liaison psychiatry and an emphasis on parity between physical and mental health in National Health Service policy may provide further impetus for growth.

Liaison old age psychiatry

2020 ◽  
pp. 347-360
Author(s):  
Fiona Thompson ◽  
Elena Baker-Glenn
Keyword(s):  
Old Age ◽  
Older Adult ◽  
Screening Tools ◽  
Physical And Mental Health ◽  
Liaison Psychiatry ◽  
General Hospitals ◽  
Old Age Psychiatry ◽  
The Uk ◽  
Hospital Team

Liaison psychiatry is a sub-specialty of psychiatry that specializes in the interface between physical and mental health, and involves treating patients who are attending general hospitals. This chapter provides an overview of the development of old age liaison psychiatry with consideration of the commissioning and funding of services. It discusses the importance of liaison psychiatry services being integrated within the general hospital team. It outlines different models of liaison psychiatry and provides examples of different services in the UK. It describes common conditions seen within older adult liaison psychiatry and considers screening tools and outcomes. Finally, it covers other aspects of the role of liaison psychiatry, such as teaching, training, governance and accreditation of services and considers interfaces with other services and the future of liaison psychiatry.

scholarly journals Dysmorphic Facial Features and Other Clinical Characteristics in Two Patients with PEX1 Gene Mutations

2016 ◽  
Vol 2016 ◽  
pp. 1-5
Author(s):  
Mehmet Gunduz ◽  
Ozlem Unal
Keyword(s):  
Gene Mutation ◽  
Clinical Characteristics ◽  
Metabolic Diseases ◽  
Molecular Genetic ◽  
Molecular Genetic Analysis ◽  
Global Developmental Delay ◽  
Facial Features ◽  
Peroxisomal Disorders ◽  
Elevated Liver Enzymes ◽  
Ophthalmologic Examination

Peroxisomal disorders are a group of genetically heterogeneous metabolic diseases related to dysfunction of peroxisomes. Dysmorphic features, neurological abnormalities, and hepatic dysfunction can be presenting signs of peroxisomal disorders. Here we presented dysmorphic facial features and other clinical characteristics in two patients with PEX1 gene mutation. Follow-up periods were 3.5 years and 1 year in the patients. Case I was one-year-old girl that presented with neurodevelopmental delay, hepatomegaly, bilateral hearing loss, and visual problems. Ophthalmologic examination suggested septooptic dysplasia. Cranial magnetic resonance imaging (MRI) showed nonspecific gliosis at subcortical and periventricular deep white matter. Case II was 2.5-year-old girl referred for investigation of global developmental delay and elevated liver enzymes. Ophthalmologic examination findings were consistent with bilateral nystagmus and retinitis pigmentosa. Cranial MRI was normal. Dysmorphic facial features including broad nasal root, low set ears, downward slanting eyes, downward slanting eyebrows, and epichantal folds were common findings in two patients. Molecular genetic analysis indicated homozygous novel IVS1-2A>G mutation in Case I and homozygous p.G843D (c.2528G>A) mutation in Case II in the PEX1 gene. Clinical findings and developmental prognosis vary in PEX1 gene mutation. Kabuki-like phenotype associated with liver pathology may indicate Zellweger spectrum disorders (ZSD).

Implementation of the CLiP database

2019 ◽  
Vol 33 (1) ◽  
pp. 27-35
Author(s):  
Kenneth Ken Siong Lee ◽  
Umi Adzlin Silim
Keyword(s):  
Depressive Disorders ◽  
Management Plan ◽  
Care Plan ◽  
Liaison Psychiatry ◽  
Content Type ◽  
Audit Data ◽  
Common Diagnosis ◽  
Consultation Liaison Psychiatry ◽  
Working Day ◽  
Audit Standards

Purpose The purpose of this paper is to review the findings from an audit of the implementation of a consultation-liaison psychiatry (CLiP) database in all inpatients referred to a CLiP service at the largest hospital in Malaysia with the aim of improving the quality CLiP services. Design/methodology/approach All inpatient referrals to the CLiP team were recorded over a three-month period and compared to previous audit data from 2017. Four audit standards were assessed: the reporting of referrals, timeliness of response indication of reason for referral and presence of a management plan. Findings The compliance of reporting using the CLiP form was 70.1 per cent compared to 28 per cent in the audit data from 2017 after interventions were conducted. Analysis of the completed CLiP form reveals that 89 per cent of referrals were seen within the same working day. All referrals included the reason for referral. The most common reason for referral was for depressive disorders, but post-assessment, delirium was the most common diagnosis. In total, 87.8 per cent satisfied the audit criteria for a completed written care plan. Originality/value Specialised CLiP services are relatively new in Malaysia and this is the first paper to examine the quality of such services in the country. Interventions were effective in improving the compliance of reporting using the CLiP database. The findings suggest that the CLiP services are on par with international audit standards. Furthermore, data from this clinical audit can serve as a benchmark for the development of national operating policies in similar settings.

scholarly journals Implementing out of hours MDT safety huddles at the Ladywell Unit, Lewisham, South London and the Maudsley (SLAM) NHS Foundation Trust

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S229-S230
Author(s):  
Su Yeoh ◽  
Natavan Babayeva ◽  
Hugh Williams ◽  
Emma Jones
Keyword(s):  
Mental Health ◽  
Physical Health ◽  
Best Practice ◽  
Management Plan ◽  
Slight Reduction ◽  
List Type ◽  
Physical And Mental Health ◽  
Out Of Hours ◽  
Team Cohesiveness ◽  
Mental And Physical Health

Aims•For 100% of patients admitted OOH (Friday 5pm – Sunday 9am) to have a multi-disciplinary review of their treatment•For 100% of patients with deteriorating physical and mental health to be discussed•To improve multi-disciplinary team (MDT) morale, working relationships and team cohesiveness OOHBackgroundIn most specialties, the standard of best practice is that patients admitted to the ward out of hours (OOH) receive a senior review over the weekend. However this does not usually take place in Psychiatry, and patients routinely wait until Monday to be seen by the ward team. This has been highlighted as problematic in cases where patients are agitated and not receiving any treatment for > 24 hours.We trialled a weekend teleconference safety huddle in Lewisham involving the on call consultant, registrar (SpR), core trainee (CT) and duty senior nurse (DSN).MethodThe weekend huddles were through a teleconference line, with participants dialling in at 9.45am.Issues discussed: 1)Management plan for newly admitted patients OOH.2)Plan for patients with deteriorating mental health or escalating level of aggression.3)Plan for patients with deteriorating physical health.Feedback was collected from CTs, SpRs and consultants focusing on whether the huddle made any difference to the speed of care, cohesiveness of the OOH team, and whether it was generally helpful or not.Result54% of CTs (n = 11) felt that patients admitted OOH had an MDT review, and 90% felt that patients with deteriorating mental and physical health were discussed and a plan put in place. 80% of CTs, 63% of SpRs (n = 8) and 67% of consultants (n = 6) agreed it improved team cohesiveness. 90% of DSNs felt safer and more supported in decision-making OOH.80% of CTs, 63% of SpRs and 83% of consultants found weekend huddles helpful.Data were also collected on violent incidents OOH, and there was a slight reduction in the number of violent incidents in the weeks following introduction of the huddle.ConclusionIntroducing safety huddles in Lewisham has facilitated the prompt discussion of the management of patients admitted OOH, and of those with deteriorating mental and physical health. It has also fostered a greater sense of cohesiveness in the MDT team.In light of this feedback, safety huddles have now been established as part of the weekend schedule in Lewisham, and are being rolled out to other boroughs within SLaM.

scholarly journals Therapy Management of Metabolic Disorder Comorbidity With Depression

2021 ◽  
Vol 12 ◽  
Author(s):  
Hua Luo ◽  
Zheng-Li Jiang ◽  
Yu Ren
Keyword(s):  
Effective Treatment ◽  
Metabolic Disorder ◽  
Metabolic Disorders ◽  
Metabolic Diseases ◽  
Research Progress ◽  
Common Disease ◽  
Human Beings ◽  
Physical And Mental Health ◽  
Psychological Burden ◽  
Prevention And Cure

Depression is a common disease that seriously endangers the physical and mental health of human beings, and it often coexists with other metabolic disorders such as diabetes and cancer. There have been endless reports on the mechanism, prevention, and cure of comorbidity because of its high incidence and poor prognosis and the increased burden on the family and society. There may be a specific comorbid basis and causal relationship between depression and metabolic diseases. Depression in patients with metabolic disorders can be effectively alleviated through psychotherapy and medication. The timely and effective treatment of depression can significantly improve the quality of life of patients with metabolic disorders, reduce their psychological burden, and promote the effective treatment of metabolic diseases. This study reorganized the research progress on the management of metabolic disorder comorbidity with depression.

Mitochondria microcrystals deposition in some inherited diseases of lipid metabolism.

1978 ◽  
Vol 36 (2) ◽  
pp. 256-257
Author(s):  
S. Laoussadi ◽  
A. Kahan ◽  
G. Aubouy ◽  
F. Delbarre
Keyword(s):  
Synovial Tissue ◽  
Storage Disease ◽  
Metabolic Diseases ◽  
Uranyl Acetate ◽  
List Type ◽  
Type Ii ◽  
Type Number ◽  
Lipid Storage Disease ◽  
Thin Sections ◽  
Mean Size

Several patients with Fabry's, Gaucher's diseases and hyperlipoproteinemia type II and with arthropatic manifestations were observed.As no histological explanation for these symptoms was available,an ultrastructural study of synovial tissue was done to establish an anatomoclinical relation.Material and Methods :synovial membrane samples were obtained by needle biopsies of the knee from three patients with arthropatic manifestations of each disease.They were fixed in 5% glutaraldehyde, postfixed in 1% osmium tetraoxyde and embedded in Epon 812. Thin sections coloured by uranyl acetate and lead citrate were observed with an Elmiskop I Siemens electron microscope.Two important phenomena were observed in synovial tissue:Specific patterns of each lipid storage disease,which are now well known.In all the three metabolic diseases, hydroxyapatite-like crystals were found. They are characterized by their intramitochondrial localization, without any relation with cristae,an anarchic disposition and a mean size of 550 A.Crystals may be found also free in the cytoplasm of synoviocytes Some micrographs suggest an evolution in four steps :a. mitochondria with only a few microcrystalsb. mitochondria stuffed with these structuresc. disruption of mitochondria membranesd. microcrystals appear free in the cytoplasm

Investigation analysis of metabolic diseases-associated indexes in Chongqing children

2010 ◽  
Vol 34 (8) ◽  
pp. S70-S70
Author(s):  
Xiaoping WEI ◽  
Lan LIU ◽  
Jie CHEN ◽  
Youxue LIU ◽  
Yang BI ◽  
...  
Keyword(s):  
Metabolic Diseases
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