Overview on Gastrointestinal Foreign Bodies in Children

Introduction: Greatest percentage of the upper gastro intestinal accidently swallowed foreign bodies in adults are related to food bolus impaction with meat. Most patients who swallow a true foreign body typically are younger, however young children were recorded to accidently swallow other objects rather than food poluses. Males are more often recorded, and often have significant psychiatric illness and/or drug abuse. Foreign body (FB) ingestion is a very common problem in children. FB may pass through gastrointestinal (GI) system silently without any indication, or it may need an intervention to prevent complications. The diagnosis, decision for involvement and management may have some difficulties, and it’s usually decided according to the case, especially in cases with protracted lodgment. Complications caused by lodgment of ingested GI FBs varies according to many factors and are associated with important morbidity and mortality in children. Objectives: to show an overview of gastrointestinal foreign bodies in children, its epidemiology, risk factors, hazards and management.

Psychiatric disorders and offending in an Australian birth cohort: Overrepresentation in the health and criminal justice systems for Indigenous Australians

Objective: Most studies that examine psychiatric illness in people who offend have focused on incarcerated samples, with little known about the larger population of individuals with criminal justice system contact. We examine the overlap between proven offences and psychiatric diagnoses with an emphasis on experiences for Indigenous Australians. Methods: In a population-based birth cohort of 45,141 individuals born in Queensland, Australia, in 1990 (6.3% Indigenous), psychiatric diagnoses were identified from hospital admissions between ages 4/5 and 23/24 years and proven offences were identified from court records (spanning ages 10–24 years). Prevalence rates for offending, psychiatric diagnoses and their overlap were examined for Indigenous and non-Indigenous individuals. Associations between specific psychiatric diagnoses and types of offending were examined using logistic regressions. Results: There were 11,134 (24.7%) individuals with a finalised court appearance, 2937 (6.5%) with a diagnosed psychiatric disorder and 1556 (3.4%) with a proven offence and diagnosed psychiatric disorder, with Indigenous Australians significantly overrepresented across all outcomes. Compared with non-Indigenous Australians, Indigenous Australians were younger at their first court finalisation (Cohen’s d = −0.62, 95% confidence interval = [−0.67, −0.57]), experienced a higher number of finalisations ( d = 0.94, 95% confidence interval = [0.89, 1.00]) and offences ( d = 0.64, 95% confidence interval = [0.59, 0.69]) and were more likely to receive custodial ( d = 0.41, 95% confidence interval = [0.36, 0.46]) or supervised ( d = 0.55, 95% confidence interval = [0.50, 0.60]) sentences. The overlap between offending and psychiatric illness was more pronounced for Indigenous Australians compared with non-Indigenous Australians (14.8% vs 2.7%). Substance use disorders were the most prevalent psychiatric diagnosis among individuals with a court finalisation (9.2%). Conclusions: Indigenous Australians were significantly overrepresented in court finalisations and psychiatric diagnoses. Indigenous Australians with a psychiatric diagnosis were at highest risk of experiencing a court appearance, emphasising the importance of culturally appropriate mental health responses being embedded into the criminal justice system.

Clinical features of UK Biobank subjects carrying protein truncating variants in genes implicated in schizophrenia pathogenesis

The SCHEMA consortium has identified ten genes in which protein truncating variants (PTVs) confer substantial risk of schizophrenia. Exome-sequenced participants in the UK Biobank who carried PTVs in these genes were studied to determine to what extent they demonstrated features of schizophrenia or had neuropsychiatric impairment. Following automated quality control and visual inspection of reads, 251 subjects were identified as having well-supported PTVs in one of these genes. The frequency of PTVs in CACNA1G was higher than had been observed in SCHEMA cases, casting doubt on its role in schizophrenia pathogenesis, but otherwise rates were similar to those observed in SCHEMA controls. Numbers were too small to allow formal statistical analysis but in general carriers of PTVs did not appear to have high rates of psychiatric illness or reduced educational or occupational functioning. One subject with a PTV in SETD1A had a diagnosis of schizophrenia. one with a PTV in HERC1 had psychotic depression and two subjects seemed to have developmental disorders, one with a PTV in GRIN2A and one with a PTV in RBCC1. There seemed to be somewhat increased rates of affective disorders among carriers of PTVs in HERC1 and RB1CC1. Carriers of PTVs did not appear to have subclinical manifestations of schizophrenia. Although PTVs in these genes can substantially increase schizophrenia risk, their effect seems to be dichotomous and most carriers appear psychiatrically well.This research has been conducted using the UK Biobank Resource.

Understanding Psychiatric Illness Through Natural Language Processing (UNDERPIN): Rationale, Design, and Methodology

IntroductionPsychiatric disorders are diagnosed according to diagnostic criteria such as the DSM-5 and ICD-11. Basically, psychiatrists extract symptoms and make a diagnosis by conversing with patients. However, such processes often lack objectivity. In contrast, specific linguistic features can be observed in some psychiatric disorders, such as a loosening of associations in schizophrenia. The purposes of the present study are to quantify the language features of psychiatric disorders and neurocognitive disorders using natural language processing and to identify features that differentiate disorders from one another and from healthy subjects.MethodsThis study will have a multi-center prospective design. Major depressive disorder, bipolar disorder, schizophrenia, anxiety disorder including obsessive compulsive disorder and, major and minor neurocognitive disorders, as well as healthy subjects will be recruited. A psychiatrist or psychologist will conduct 30-to-60-min interviews with each participant and these interviews will be recorded using a microphone headset. In addition, the severity of disorders will be assessed using clinical rating scales. Data will be collected from each participant at least twice during the study period and up to a maximum of five times.DiscussionThe overall goal of this proposed study, the Understanding Psychiatric Illness Through Natural Language Processing (UNDERPIN), is to develop objective and easy-to-use biomarkers for diagnosing and assessing the severity of each psychiatric disorder using natural language processing. As of August 2021, we have collected a total of >900 datasets from >350 participants. To the best of our knowledge, this data sample is one of the largest in this field.Trial registrationUMIN000032141, University Hospital Medical Information Network (UMIN).