Acute Mania in a Patient With Primary Adrenal Insufficiency Due to Autoimmune Adrenalitis: A Case Report.

We describe a rare case of acute mania in the setting of autoimmune adrenalitis. A 41-year-old male with no previous psychiatric diagnoses presented with impulsivity, grandiosity, delusions of telepathy, and hyperreligiosity following a previous hospitalization for an acute adrenal crisis and 2 subsequent days of low-dose corticosteroid treatment. Workups for encephalopathy and lupus cerebritis were negative, raising concern that this presentation might represent steroid-induced psychosis.

Effectiveness and response differences of a multidisciplinary workplace health promotion program for healthcare workers.

Background: Workplace health promotion (WHP) in the healthcare industry is an important yet challenging issue to address, given the high workload, heterogeneity of work activities, and long work hours of healthcare workers (HCWs). This study aimed to investigate the effectiveness and response differences of a multidisciplinary WHP program conducted in HCWs.

Methods: This retrospective cohort study included HCWs participating in a multidisciplinary WHP program in five healthcare facilities.

Psychiatric Clinics: Computer-Based Teaching.

Learning is no longer constrained to the classroom or lecture hall. Today's students expect teaching to be available 24/7 and on whatever device they own and to be interactive and engaging. Educators need to become familiar with computer-based teaching tools and learn how to implement them or risk losing their audience.

Depression.

Most psychiatric care is delivered in primary care settings, where depression is the most common presenting psychiatric symptom. Given the high prevalence of depression worldwide and the well-established consequences of untreated depression, the ability of primary care clinicians to effectively diagnose and treat it is critically important. This article offers up-to-date guidance for the diagnosis and treatment of major depressive disorder, including practical considerations for delivering optimal and efficient care for these patients.

A randomized controlled trial of cognitive remediation and long-acting injectable risperidone after a first episode of schizophrenia: improving cognition and work/school functioning.

Background: Cognitive deficits at the first episode of schizophrenia are predictive of functional outcome. Interventions that improve cognitive functioning early in schizophrenia are critical if we hope to prevent or limit long-term disability in this disorder.

Methods: We completed a 12-month randomized controlled trial of cognitive remediation and of long-acting injectable (LAI) risperidone with 60 patients with a recent first episode of schizophrenia.

A Framework for Competencies for the Use of Mobile Technologies in Psychiatry and Medicine: Scoping Review.

Background: To ensure quality care, clinicians need skills, knowledge, and attitudes related to technology that can be measured.

Objective: This paper sought out competencies for mobile technologies and/or an approach to define them.

Methods: A scoping review was conducted to answer the following research question, "What skills are needed for clinicians and trainees to provide quality care via mHealth, have they been published, and how can they be made measurable and reproducible to teach and assess them?" The review was conducted in accordance with the 6-stage scoping review process starting with a keyword search in PubMed/Medical Literature Analysis and Retrieval System Online, APA PsycNET, Cochrane, EMBASE, PsycINFO, Web of Science, and Scopus.

A Guide for the 21st Century Psychiatrist to Managing Your Online Reputation, Your Privacy, and Professional Use of Social Media.

The Internet is a vast expanse of information; however, search engines have made finding the proverbial needle in a haystack a simple matter. Although insurance provider databases and referrals may dominate how patients find their doctor today, one's online reputation and reviews on physician ratings sites will increasingly play a role in how prospective patients find their next provider. Social media plays a dominant role as the medium where people place and find information, blurring the boundary of professional and personal use.

Mobile Health, Smartphone/Device, and Apps for Psychiatry and Medicine: Competencies, Training, and Faculty Development Issues.

Faculty and trainees need clinical skills, knowledge, and attitudes to ensure quality care using technology. Clinical faculty teach, supervise, and role model skills for trainees and interprofessional team members. Mobile health, smartphone/device, and app competencies may be situated within the graduate medical education milestone domains.

A Hierarchical Framework for Evaluation and Informed Decision Making Regarding Smartphone Apps for Clinical Care.

With thousands of smartphone apps targeting mental health, it is difficult to ignore the rapidly expanding use of apps in the treatment of psychiatric disorders. Patients with psychiatric conditions are interested in mental health apps and have begun to use them. That does not mean that clinicians must support, endorse, or even adopt the use of apps, but they should be prepared to answer patients' questions about apps and facilitate shared decision making around app use.

Stem cell-derived exosomes: a novel vector for tissue repair and diabetic therapy.

Exosomes are extracellular vesicles (EVs) secreted from a majority of cell types. Exosomes play a role in healthy and pathogenic intercellular interactions via the transfer of proteins, lipids and RNA. The contents and effects of exosomes vary depending on the properties of the originating cell.

Effects of bone marrow on the microenvironment of the human pancreatic islet: A Protein Profile Approach.

Stem cells are a new therapeutic modality that may support the viability and function of human organs and tissue. Our previous studies have revealed that human allogeneic bone marrow (BM) sustains pancreatic β cell function and survival. This paper examines whether BM creates a microenvironment that supports human pancreatic islets in vitro by evaluating 107 proteins in culture media from BM, islet, and islet/bone marrow (IB) with mass spectrometry.

EFFECTS OF GINSENG AND ITS FOUR PURIFED GINSENOSIDES (Rb2, Re, Rg1, Rd) ON HUMAN PANCREATIC ISLET β CELL IN VITRO.

Ginseng has attracted interest because of its potential therapeutic role in diabetes therapy. No direct evidence has shown the effects of ginseng and its components, ginsenosides, on human islet β cell. In this study, we evaluated ginseng extract and ginsenosides (Rb2, Re, Rg1, Rd) on human pancreatic β cell function.

The Biochemical Cascades of the Human Pancreatic -Cells: The Role of MicroRNAs.

Diabetes mellitus is a disease that poses a burden to the health care system due to its prevalence and chronic nature. Understanding β cell pathophysiology may lead to future therapeutic options for diabetes mellitus type 1 and 2. MicroRNAs (MiR) fine-tune β cell biochemical cascades through specific protein targets.

A framework for telepsychiatric training and e-health: Competency-based education, evaluation and implications.

Telepsychiatry (TP; video; synchronous) is effective, well received and a standard way to practice. Best practices in TP education, but not its desired outcomes, have been published. This paper proposes competencies for trainees and clinicians, with TP situated within the broader landscape of e-mental health (e-MH) care.

Anti-apoptotic Effects of Bone Marrow on Human Islets: A Preliminary Report.

Apoptosis is one of the major factors contributing to the failure of human islet transplantation. Contributors to islet apoptosis exist in both the pre-transplantation and post transplantation stages. Factors include the islet isolation process, deterioration in vitro prior to transplantation, and immune rejection post transplantation.

Long-Acting Injectable Risperidone for Relapse Prevention and Control of Breakthrough Symptoms After a Recent First Episode of Schizophrenia. A Randomized Clinical Trial.

Importance: Long-acting, injectable, second-generation antipsychotic medication has tremendous potential to bring clinical stability to persons with schizophrenia. However, long-acting medications are rarely used following a first episode of schizophrenia.

Objective: To compare the clinical efficacy of the long-acting injectable formulation of risperidone with the oral formulation in the early course of schizophrenia.

Human Bone Marrow Subpopulations Sustain Human Islet Function and Viability .

Aims: Allogeneic bone marrow (BM) has been shown to support human islet survival and function in long-term culture by initiating human islet vascularization and β-cell regeneration. Various BM subpopulations may play different roles in human islet functions and survival. In this paper we investigated the effects of BM and its subpopulations, endothelial progenitor cells (E) and mesenchymal (M) cells on human islet's β-cell function and regeneration.

The impact of second-generation antipsychotic adherence on positive and negative symptoms in recent-onset schizophrenia.

Objective: The aim of the study was to explore the extent to which initial severity of positive or negative symptoms in patients with recent-onset schizophrenia is related to medication nonadherence during the first outpatient year.

Methods: The study involved 64 first-episode schizophrenia patients treated with the second-generation oral antipsychotic medication, risperidone, for 12 months. Symptoms were evaluated using the SANS and SAPS completed every 3 months.

Tripeptide amide L-pyroglutamyl-histidyl-L-prolineamide (L-PHP-thyrotropin-releasing hormone, TRH) promotes insulin-producing cell proliferation.

A very small tripeptide amide L-pyroglutamyl-L-histidyl-L-prolineamide (L-PHP, Thyrotropin-Releasing Hormone, TRH), was first identified in the brain hypothalamus area. Further studies found that L-PHP was expressed in pancreas. The biological role of pancreatic L-PHP is still not clear.

Allogeneic bone marrow cocultured with human islets significantly improves islet survival and function in vivo.

Background: A significant barrier to islet transplantation is the rapid loss of human islet function in vivo. The present study evaluates whether bone marrow (BM) could be used to support human islet survival and function in vivo.

Methods: We cocultured human islets and BM for 3 weeks before transplantation into the left subrenal capsule of diabetic severe combined immunodeficient mice.

Impact on intracortical myelination trajectory of long acting injection versus oral risperidone in first-episode schizophrenia.

Context: Imaging and post-mortem studies suggest that frontal lobe intracortical myelination is dysregulated in schizophrenia (SZ). Prior MRI studies suggested that early in the treatment of SZ, antipsychotic medications initially increase frontal lobe intracortical myelin (ICM) volume, which subsequently declines prematurely in chronic stages of the disease. Insofar as the trajectory of ICM decline in chronic SZ is due to medication non-adherence or pharmacokinetics, it may be modifiable by long acting injection (LAI) formulations.

Long acting injection versus oral risperidone in first-episode schizophrenia: differential impact on white matter myelination trajectory.

Context: Imaging and post-mortem studies provide converging evidence that subjects with schizophrenia (SZ) have a dysregulated trajectory of frontal lobe myelination. Prior MRI studies suggested that early in treatment of SZ, antipsychotic medications initially increase frontal lobe white matter (WM) volume, which subsequently declines prematurely in chronic stages of the disease. Insofar as the trajectory of WM decline associated with chronic disease may be due to medication non-adherence, it may be modifiable by long acting injection (LAI) formulations.

Emergency medicine and psychiatry agreement on diagnosis and disposition of emergency department patients with behavioral emergencies.

Objectives: The objective was to determine the level of agreement between emergency physicians (EPs) and consulting psychiatrists in their diagnosis and disposition of emergency department (ED) patients with behavioral emergencies.

Methods: The authors conducted a prospective study at a university teaching hospital ED with an annual census of approximately 45,000 patients. During study hours, each time a psychiatric consultation was requested, the emergency medicine (EM) and consulting psychiatry residents were asked to fill out similar short questionnaires concerning their diagnoses and disposition decisions after they consulted with their attending physicians.