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Background and purpose: There are few population-based surveys on multiple sclerosis (MS) survival. To investigate MS survival in MS patients recruited during surveys conducted in Sicily. Methods: Multiple sclerosis patients identified during previous surveys were randomly matched to two referent subjects by residence, year of birth, and gender. Living status was obtained by municipality records (end of follow-up June, 30th 2007) and, for the deceased, date and causes of death were searched. Kaplan-Meier plots were used to calculate differences in mortality between MS patients and referent subjects. MS risks for mortality with 95% confidence intervals (CI) were also calculated. Results: We included 194 MS patients and 388 matched persons. Thirty MS patients (15.5%) and 28 referents (7.2%) had died until the end of follow-up. Mean survival from onset of the disease to death was 20.6 years. Mean age at death was 55.5 for MS patients and 64.8 for the referents. Adjusted Hazard Ratios for mortality in MS was 1.81 (95% CI 1.36–2.40). Kaplan-Meier estimates showed a higher mortality amongst patients compared to referent subjects ( P < 0.001). Conclusions: The present study confirms the higher mortality risk in MS patients with no significant gender difference. Causes of death are related to complications of high disability and to increasing age. [ABSTRACT FROM AUTHOR]

Background and purpose: Previous studies on the association between Parkinson’s disease (PD) and body mass index (BMI) have reported conflicting results. We investigated the relationship between PD and BMI by a case–control study. Methods: PD patients were randomly matched to healthy individuals by sex and age. BMI distribution in cases has been compared with BMI of controls and odd ratios (ORs) with 95% CI were calculated. Results: We included 318 PD patients and 318 controls. We observed no association between PD and BMI. BMI distribution in cases and controls was similar also when we adjusted for diabetes, hypercholesterolemia and the time elapsed between PD onset and the interview (OR = 0.99; CI = 0.94–1.03; P = 0.51). Conclusions: These results did not confirm the previously reported association between PD and BMI. Population characteristics and methodological issues may partially account for the differences observed between the present study and the others. [ABSTRACT FROM AUTHOR]

Background and Objectives: Despite the overwhelming need for tobacco use disorder (TUD) treatment in behavioral health settings, few models have emerged for training psychiatry residents. One barrier may be a lack of curricula or faculty expertize in this area. The goal of this project was to develop and evaluate a 3 hour online webinar-based course for teaching psychiatry residents about TUD., Methods: Residents from 42 participating general psychiatry residency programs were emailed a unique link to course materials. Participation was voluntary., Results: Two-hundred and seven residents completed the pretest measuring baseline knowledge and 199 completed the survey measuring attitudes toward treatment of tobacco use. Mean pretest scores were 53.0% correct (SD 19.6), showing low levels of baseline knowledge. Pretest knowledge scores differed by residency year, suggesting no gain in knowledge during residency training. About 80% of participants completed the entire course and posttest evaluations. Paired t tests for 150 individuals who completed both a pretest and posttest indicated a significant increase in knowledge, with a mean gain in score of 35 points., Discussion and Conclusions: Many residents reported feeling not well prepared to treat TUD from prior education. The vast majority (98%) felt the program enhanced their professional experience somewhat or substantially or would recommend the program to others (82%)., Scientific Significance: Online training for residents is a viable option to address knowledge deficits in TUD. (Am J Addict 2019;28:277-284)., (© 2019 American Academy of Addiction Psychiatry.)

Study Objective: To investigate patient recall of therapeutic paralysis (TP) in a surgical critical care unit., Design: Prospectively applied structured interview of patients undergoing TP over 18 months., Setting: Surgical critical care unit with 27 beds at a tertiary care university teaching hospital., Patients: Forty patients admitted for postoperative care after coronary artery bypass graft surgery, trauma, or gastrointestinal surgery., Interventions: Patients received TP and concurrent sedation with benzodiazepines, propofol, and narcotics., Measurements and Main Results: After the end of TP patients were asked to recall the experience, and their responses were ranked on a four-point ordinal scale. Four of 11 patients recalled mostly negative events and experiences with TP, such as sleeplessness, discomfort, pain, anxiety, and inconsistent caregiver communication. All patients with recall experienced fear, anxiety, and sleeplessness. Single-drug therapy with propofol and inadequate benzodiazepine dosing were linked to patient recall., Conclusions: Patient recollection from TP may be more common than appreciated and is generally unpleasant. Adequate dosing with benzodiazepines and narcotics is warranted to prevent recall and discomfort.