HYPOTHESIS | doi:10.20944/preprints202309.0196.v1
Subject: Biology And Life Sciences, Biochemistry And Molecular Biology Keywords: Neurodegenerative disorders; schizophremia; PDK1 inhibitors; Lipid replacement therapy; Aryl hydrocarbon receptor antagonists
Online: 4 September 2023 (14:29:13 CEST)
Abstract Forensic institutions throughout the country house patients with severe psychiatric illness and history of criminal violations. Improved medical care, hygiene, and nutrition led to unmatched longevity in this population which previously lived on average 15 to 20 years shorter than the public at large. On the other hand, longevity has contributed to increased prevalence of age-related diseases, including neurodegenerative disorders, which complicate clinical management. Forensic institutions, originally intended for the treatment of younger individuals, are ill-equipped for the growing number of older offenders. Moreover, as antipsychotic drugs became available in 1950s and 1960s, we are observing the first generation of forensic detainees who had aged on dopamine blockers. Although the consequences of long-term treatment with these agents are unclear, schizophrenia-associated gray matter loss, may contribute to the development of early dementia. Taken together, increased lifespan and subsequent cognitive deficit observed in long-term psychiatric institutions brought forth questions and dilemmas unencountered by the previous generations of clinicians, such as: 1. Does the presence of neurocognitive dysfunction justify antipsychotic dose reduction or discontinuation despite a lifelong history of schizophrenia and violent behavior? 2. Should neurolipidomic interventions become the standard of care in elderly individuals with lifelong schizophrenia and dementia? 3. Can patients with schizophrenia and dementia meet the Dusky standard and stand trial? 4. Should neurocognitive disorders in elderly with lifelong schizophrenia be treated differently than age-related neurodegeneration? In this article, we describe strategies for potentially slowing the development of neurocognitive disorders in forensic patients with chronic mental illness by adopting a three-prong strategy: 1. Approaching lifelong psychosis from microbial and immunological perspective. 2. Identify modifiable risk factors for age-related diseases in forensic institutions. 3. Utilizing novel receptor-independent treatments for chronic psychosis.
ARTICLE | doi:10.20944/preprints202209.0343.v1
Subject: Medicine And Pharmacology, Tropical Medicine Keywords: Lymphatic Filariasis; Indonesia; National Surveillance; Registry; BELKAGA
Online: 22 September 2022 (10:41:18 CEST)
Lymphatic filariasis (LF) is a vector-borne disease caused by parasitic helminths and constitutes a serious public health issue in tropical regions. According to the World Health Organization (WHO), infected cases in Southeast Asia constitute 50% of the estimated 120 million infections globally. In Indonesia, LF is caused by all filarial species, and in 2018, 236 districts from a total of 514 districts in the entire country were declared as endemic areas. The global program to eliminate filariasis has been running for the last 19 years and has been conducted as a full national initiative for the last 8 years in Indonesia. The study describes the surveillance of LF cases and prevalence in Indonesia for the past 17 years (2001-2017) – during the global and national LF elimination programs-, using national registry-based data. The data demonstrates that the national program has been largely effective in the areas it has been active the longest, while there are provinces lagging behind in the successful suppression of LF. The high geographical fragmentation of the country with the associated ecological parameters relating to LF incidence, likely play an important role in maintaining the highly varied incidence rate across Indonesia.