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The patient was considered to have pouch outlet obstruction and was successfully managed using bedside evacuation anoscopy. After 3days, oral nutrition was re-established, and appropriate stool evacuation and fecal continence were achieved.
Proctocolectomy with ileal pouch-anal anastomosis still carries a considerable complication rate. Proper identification of causative factors is mandatory for appropriate treatment. Pouch outlet obstruction can present as acute abdomen after diverting ileostomy closure. In this case, outlet obstruction was identified and treated by pouch evacuation, avoiding morbidity of a new surgical procedure.
We presented an unusual case of acute intestinal obstruction due to pouch outlet obstruction that was managed nonoperatively with bedside pouch evacuation.
We presented an unusual case of acute intestinal obstruction due to pouch outlet obstruction that was managed nonoperatively with bedside pouch evacuation.The high prevalence of somatic symptom disorder (SSD) led to cumulative burdens to the medical system. However, the pathogenesis of this disease still remains unclear. Graph theoretical analysis discovered altered network topology across various psychiatric disorders, yet alteration in the topological structure of brain functional network in SSD patients is still unexplored. selleck chemicals Catastrophizing is a common cognitive distortion in SSD. We hypothesize that the network topological metrics of SSD should be altered, and should correlate with catastrophizing scales. 32 medication-naïve, first-episode SSD patients and 30 age, gender matched HCs were recruited. The 17-item Hamilton Depression Rating Scale (HAMD-17), Hamilton Anxiety Rating Scale (HAMA) and Cognitive Emotion Regulation Questionnaire (CERQ) were accessed. Functional MRI were scanned and brain functional networks were constructed based on 166 anatomically cerebrum regions from the automated anatomical labeling 3 (AAL3) template. Network topological metrics were calculated and compared between the two groups. Correlation between these metrics and clinical scales were also calculated. Network global efficiency of SSD was significantly lower than that of HC. Nodal global efficiency of the left subgenual anterior cingulate cortex (sgACC) of SSD was significantly lower than that of HC. FCs between the left sgACC and other 21 seed nodes were significantly declined in SSD in comparison with HC. In SSD group, HAMD total score was significantly negatively correlated with the connection between the left medial superior frontal gyrus and the left sgACC. CERQ catastrophizing score was significantly negatively correlated with nodal global efficiency of left sgACC and with the FCs between the left sgACC and other 13 seed nodes. Catastrophizing could reflect the specific sgACC-centered dysfunction of brain network global efficiency of SSD. The left sgACC may be a future treatment target of dealing with catastrophizing, which is a core cognitive distortion of SSD.Gaming is popular among youth and gaming disorders have been introduced recently into psychiatric nomenclature systems. Motivations underlying gaming may include involvement to reduce negative emotional states and thus may link to psychiatric and overall health. Thus, the extent to which adolescents engage in gaming to relieve anxiety warrants additional investigation. Data from 2005 Connecticut high-school students were used to examine how adolescents who reported gaming to relieve tension or anxiety differed from those who reported gaming but not to relieve tension or anxiety on measures of demographics, academic performance, general health, extracurricular activities, dysphoria/depression symptoms, substance use, and aggressive or violent behaviors. Chi-square analyses and binomial and multinomial logistic regression models were conducted. Gaming to relieve anxiety was more prevalent in boys and Hispanic and Asian adolescents and associated with less extracurricular involvement, poorer academic performance, increased cigarette and other drug use, problematic internet use, and depression. Participants with gaming to relieve tension or anxiety were also more likely to report weapon-carrying, missing school because they felt unsafe, having been threatened with a weapon, having engaged in physical fights, and having experienced injuries from fights. As gaming to relieve anxiety was related to mental-health- and functioning-related measures, additional research is needed to examine the precise natures of these relationships and to translate the information into improved intervention strategies.
Non-invasive brain stimulation (NIBS) techniques have been suggested as alternative treatments to decrease depression symptoms during the perinatal period. These include brain stimulation techniques that do not require surgery and that are nonpharmacological and non-psychotherapeutic. NIBS with evidence of antidepressant effects include repetitive transcranial magnetic stimulation (rTMS), transcranial electric stimulation (TES) and electroconvulsive therapy (ECT).
This systematic review aims to summarize evidence on NIBS efficacy, safety and acceptability in treating peripartum depression (PPD).
We included randomized, non-randomized and case reports, that used NIBS during pregnancy and the postpartum. The reduction of depressive symptoms and neonatal safety were the primary and co-primary outcomes, respectively.
rTMS shows promising results for the treatment of PPD, with clinically significant decreases in depressive symptoms between baseline and end of treatment and overall good acceptability. Althoughits from the most robust research, future multicenter randomized clinical trials are needed to determine the position of each NIBS strategy within the pathways of care.People with schizophrenia (SCZ) and bipolar disorder (BD) have challenges in self-evaluation of their cognitive and functional performance (introspective accuracy). They also manifest response biases, with tendencies toward overestimation. This study aimed to examine objective test performance, momentary judgments of performance, momentary confidence, and subsequent global judgments of performance on a metacognitive version of the Wisconsin Card Sorting Test (WCST). This sample included 99 participants with SCZ and 67 with BD. After each of the 64 WCST trials, participants reported whether they believed their sort was correct and how confident they were in that judgment, they then received performance feedback. After completion of the entire task, participants generated a global performance judgment. On average, the SCZ group got 31 sorts correct, reporting being correct on 49 whereas the BD group got 37 trials correct but reported being correct on 53. For participants with BD, sorting performance correlated with trial x trial accuracy judgments, confidence, and predicted global judgments.
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