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Determinants of mechanical restraint in an acute psychiatric care unit

World Journal of Psychiatry 2021年第10期11卷 854-863页

作者： Khadija El-Abidi antonio r moreno-poyato Alba Toll Privat David Corcoles Martinez rosa Acena-Dominguez Victor Perez-Sola Anna Mane Department of Psychiatry Institut de Neuropsiquiatria i AddiccionsParc de Salut MarBarcelona 08003Spain Public Health Mental and Maternal and Child HealthSchool of NursingFaculty of Medicine and Health SciencesUniversity of BarcelonaBarcelona 08907Spain Biomedical research Institut Hospital del Mar d'Investigacions MediquesBarcelona 08003Spain Biomedical research Center for Biomedical Research in Mental Health NetworkBarcelona 08003Spain Department of Psychiatry Institut de Neuropsiquiatria i AddiccionsCentre FòrumBarcelona 08019Spain

BACKGrOUND Despite numerous attempts to reduce the use of mechanical restraint(Mr),this technique continues to be widely applied in many acute psychiatric care *** order to reduce Mr,a better understanding of the variables associated with its use and duration in different clinical environments is *** To determine the proportion of patients subjected to Mr and the duration thereof in two acute care psychiatric units;and to identify the variables associated with the use and duration of *** Descriptive study of all patients admitted to the acute psychiatric units at the Parc de Salut Mar(Barcelona,Spain)in the year *** number and percentage of patients subjected to Mr,as well as the duration of each episode were *** following data were also registered:sociodemographic characteristics,psychiatric diagnosis,and presence of cultural and/or language *** analyses were performed to assess determinants of Mr and its *** Of the 464 patients,119(25.6%)required Mr,with a median of 16.4 h per *** factors-a diagnosis of psychotic disorder[Odds ratios(Or)=0.22;95%CI:0.06-0.62;P=0.005]and the presence of a language barrier(Or=2.13;95%CI:1.2-3.7;P=0.007)-were associated with a significantly higher risk of *** sex was associated with a longer duration of Mr(B=-19.03;95%CI:-38.06-0.008;P=0.05).CONCLUSION The presence of a language barrier and a psychotic disorder diagnosis are associated with a significantly higher risk of ***,male sex is associated with a longer duration of *** restraint protocols that include the required tools are necessary to ultimately limit the use of mechanical restraint.

关键词： Mechanical restraint Prolonged restraint Determining factors Psychiatric acute unit

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Dendritic cell deficiencies persist seven months after SArS-CoV-2 infection

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Cellular & Molecular Immunology 2021年第9期18卷 2128-2139页

作者： Alberto Pérez-Gómez Joana Vitallé Carmen Gasca-Capote Alicia Gutierrez-Valencia María Trujillo-rodriguez Ana Serna-Gallego Esperanza Muñoz-Muela María de los reyes Jiménez-Leon Mohamed rafii-El-Idrissi Benhnia Inmaculada rivas-Jeremias Cesar Sotomayor Cristina roca-Oporto Nuria Espinosa Carmen Infante-Domínguez Juan Carlos Crespo-rivas Alberto Fernández-Villar Alexandre Pérez-González Luis Fernando López-Cortés Eva Poveda Ezequiel ruiz-Mateos JoséMiguel Cisneros Sonsoles Salto-Alejandre Judith Berastegui-Cabrera Pedro Camacho-Martínez Carmen Infante-Domínguez Marta Carretero-Ledesma Juan Carlos Crespo-rivas Eduardo Márquez JoséManuel Lomas Claudio Bueno rosario Amaya Joséantonio Lepe Jerónimo Pachón Elisa Cordero Javier Sánchez-Céspedes Manuela Aguilar-Guisado Almudena Aguilera Clara Aguilera Teresa Aldabo-Pallas Verónica Alfaro-Lara Cristina Amodeo Javier Ampuero María Dolores Avilés Maribel Asensio Bosco Barón-Franco Lydia Barrera-Pulido rafael Bellido-Alba Máximo Bernabeu-Wittel Candela Caballero-Eraso Macarena Cabrera Enrique Calderón Jesús Carbajal-Guerrero Manuela Cid-Cumplido Yael Corcia-Palomo Juan Delgado antonio Domínguez-Petit Alejandro Deniz reginal Dusseck-Brutus Ana Escoresca-Ortega Fátima Espinosa Nuria Espinosa Michelle Espinoza Carmen Ferrándiz-Millón Marta Ferrer Teresa Ferrer Ignacio Gallego-Texeira rosa Gámez-Mancera Emilio García Horacio García-Delgado Manuel García-Gutiérrez María Luisa Gascón-Castillo Aurora González-Estrada Demetrio González Carmen Gómez-González rocío González-León Carmen Grande-Cabrerizo Sonia Gutiérrez Carlos Hernández-Quiles Inmaculada Concepción Herrera-Melero Marta Herrero-romero Luis Jara Carlos Jiménez-Juan Silvia Jiménez-Jorge Mercedes Jiménez-Sánchez Julia Lanseros-Tenllado Carmina López Isabel López Álvaro López-Barrios Luis F.López-Cortés rafael Luque-Márquez Daniel Macías-García Guillermo Martín-Gutiérrez Luis Martín-Villén JoséMolina Aurora Morillo María Dolores Navarro-Amuedo Dolores Nieto-Martín Francisco Ortega María Paniagua-García Amelia Peña-rodríguez E Clinical Unit of Infectious Diseases Microbiology and Preventive MedicineInstitute of Biomedicine of Seville(IBiS)Virgen del Rocío University HospitalCSICUniversity of SevilleSevilleSpain Department of Medical Biochemistry Molecular Biologyand ImmunologySchool of MedicineUniversity of SevilleSevilleSpain Pneumology Service Galicia Sur Health Research Instituto(IIS Galicia Sur)SERGAS-UVigoVigoSpain Infectious Diseases Unit Department of Internal MedicineComplexo HospitalarioUniversitario de VigoIIS Galicia SurSERGAS-UVigoVigoSpain Group of Virology and Pathogenesis Galicia Sur Health Research Institute(IIS Galicia Sur)-Complexo Hospitalario Universitario de VigoSERGAS-UVigoVigoSpain Unit of Infectious Diseases Microbiologyand Preventive MedicineVirgen del Rocío University HospitalSevilleSpain Institute of Biomedicine of Seville(IBiS) Virgen del Rocío University Hospital/CSIC/University of SevilleSevilleSpain Medico-Surgical Unit of respiratory Diseases Virgen del Rocío University HospitalSevilleSpain Unit of Emergencies Virgen del Rocío University HospitalSevilleSpain Intensive Care Unit Virgen del Rocío University HospitalSevilleSpain Department of Medicine University of SevilleSevilleSpain Cardiology and Cardiovascular Surgery Unit Virgen del Rocío University HospitalSevilleSpain rheumatology Unit Virgen del Rocío University HospitalSevilleSpain Internal Medicine Unit Virgen del Rocío University HospitalSevilleSpain Digestive and Hepatobiliary Unit Virgen del Rocío University HospitalSevilleSpain Neurology and Clinical Neurophysiology Unit Virgen del Rocío University HospitalSevilleSpain Endocrinology and Nutrition Unit Virgen del Rocío University HospitalSevilleSpain Urology and Nephrology Unit Virgen del Rocío University HospitalSevilleSpain Unit of Clinical Investigation and Clinical Trials Virgen del Rocío University HospitalSevilleSpain

Severe Acute respiratory Syndrome Coronavirus(SArS-CoV)-2 infection induces an exacerbated inflammation driven by innate immunity *** cells(DCs)play a key role in the defense against viral infections,for instance plasmacytoid DCs(pDCs),have the capacity to produce vast amounts of interferon-alpha(IFN-α).In COVID-19 there is a deficit in DC numbers and IFN-αproduction,which has been associated with disease *** this work,we described that in addition to the DC deficiency,several DC activation and homing markers were altered in acute COVID-19 patients,which were associated with multiple inflammatory ***,previously hospitalized and nonhospitalized patients remained with decreased numbers of CD1c+myeloid DCs and pDCs seven months after SArS-CoV-2 ***,the expression of DC markers such as CD86 and CD4 were only restored in previously nonhospitalized patients,while no restoration of integrinβ7 and indoleamine 2,3-dyoxigenase(IDO)levels were *** findings contribute to a better understanding of the immunological sequelae of COVID-19.

关键词： SArS-CoV-2 COVID-19 Dendritic cell Long-COVID

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