Enterococcus avium is an extremely rare aetiological agent of brain abscess, with only a limited number of cases reported to date. Early diagnosis and timely antimicrobial therapy are essential because of the potential for significant morbidity and neurological sequelae.

We present a case series of patients diagnosed with E. avium brain abscess following neurosurgical evaluation for progressive neurological symptoms. Clinical, radiological, microbiological, antimicrobial susceptibility, treatment, and outcome data were reviewed.

All patients had radiological evidence of focal intracranial abscess formation, with microbiological confirmation of E. avium from abscess specimens. In most cases, empirical antimicrobial therapy did not result in an adequate clinical response, highlighting the importance of targeted antibiotic selection based on culture and antimicrobial susceptibility testing. Surgical drainage combined with appropriate antimicrobial therapy resulted in a favourable outcome in the majority of patients.

Accurate species-level identification and antimicrobial susceptibility testing are important when E. avium is isolated from brain abscess specimens. These investigations facilitate appropriate antimicrobial selection and may contribute to improved clinical management and outcomes.

Marginalisation has been proposed as a risk factor for the development of opioid use disorder (OUD), an important element of Canada's ongoing opioid epidemic. In this study, we examined the relationship between neighbourhood-level dimensions of marginalisation and risk of OUD in Ontario, Canada.

We conducted a retrospective cohort study from 1 January 2016 to 31 December 2022 using population-level administrative data. Neighbourhood-level marginalisation was measured by three dimensions of the Ontario Marginalisation Index (households and dwellings, material resources and age and labour force). Incident OUD diagnoses were extracted using International Classification of Diseases, 10th Revision (ICD-10), Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), Ontario Health Insurance Programme fee codes and drug identification numbers for opioid agonist therapy. Modified (robust) Poisson regression using generalised estimating equations produced risk ratios (RRs) to assess the association between neighbourhood-level marginalisation and OUD in multivariate analyses.

A random sample of 221 267 individuals was taken from all eligible Ontarians (n=10 806 807). A total of 1222 incident OUD diagnoses were made, indicating a rate of 844.38 diagnoses per 1 000 000 person-years. In multivariate models comparing the lowest and highest marginalisation quintiles, neighbourhood households and dwellings (RR=1.60, 95% CI 1.33 to 1.92), material resources (RR=2.03, 95% CI 1.68 to 2.45) and age and labour force (RR=1.48, 95% CI 1.27 to 1.72) were significantly associated with risk of incident OUD.

Risk of incident OUD is associated with neighbourhood-level marginalisation, a relationship that occurred with and without adjusting for relevant demographic and clinical factors. Addressing social disadvantage should be prioritised in research and public health interventions amidst the ongoing opioid crisis.

In medical-psychological centers, care is provided through a multidisciplinary team comprising nurses, advanced practice nurses specializing in psychiatry and mental health, psychologists, and psychiatrists. These care approaches work in a complementary manner - particularly between nursing care and psychotherapy - enabling support for both symptoms and psychological development. Ms. C.'s situation illustrates this integrative care approach.

Whether affective and non-affective psychoses reflect a severity continuum or distinct neurobiological mechanisms remains unresolved. We compared whole-brain and subnetwork efficiency across this spectrum.

Resting-state functional magnetic resonance imaging data were analyzed from 78 patients with affective psychosis, 197 with non-affective psychosis, 164 with non-psychotic primary affective disorders, and 165 healthy controls. Graph analysis quantified whole-brain and subnetwork global and local efficiency. We tested symptom and cognitive associations and performed sensitivity analyses stratifying schizophrenia by depressive-symptom status and affective psychosis by diagnosis.

Non-affective psychosis showed lower whole-brain efficiency than controls and both affective groups, and lower sensory/somatomotor efficiency than controls. Conversely, whole-brain efficiency was preserved in both affective groups; affective psychosis showed higher cingulo-opercular, dorsal attention, and salience network efficiency, whereas the non-psychotic affective group showed higher dorsal attention and salience network efficiency. Sensitivity analyses identified shared increases in dorsal attention global efficiency and salience network local efficiency across psychotic major depression and psychotic bipolar disorder, and reduced sensory/somatomotor efficiency in schizophrenia regardless of depressive-symptom status. After false discovery rate correction, higher default mode network efficiency was associated with Positive Symptoms, while higher whole-brain, cingulo-opercular, salience, and sensory/somatomotor efficiency was associated with Activation symptoms; no cognitive associations survived correction.

These opposing, subgroup-robust patterns favor a dichotomous-mechanism framework comprising an affective axis of increased control-network efficiency and a psychosis axis of whole-brain and sensorimotor inefficiency. Affective psychosis predominantly expressed the affective axis with a partial shift toward the psychosis-axis profile.

Perfluoroalkyl substances (PFAS) are endocrine disrupting chemicals that may interfere with steroid hormone synthesis. Aldosterone is an essential steroid hormone during pregnancy and an independent determinant of placental and birth weight.

To investigate associations between PFAS exposure in early pregnancy and 24hour urine (U-) and plasma (P-) aldosterone concentrations in late pregnancy.

In 467 pregnant women from Odense Child Cohort, serum concentrations of five PFAS - perfluorohexane sulfonic acid (PFHxS), perfluorooctane sulfonic acid (PFOS), perfluorooctanoic acid (PFOA), perfluorononanoic acid (PFNA), and perfluorodecanoic acid (PFDA) - were measured at a median gestational week (GW) 12 (25^th, 75^th percentile: 10, 15). PFAS associations with 24h U- and P- aldosterone measured at a median GW 29 (25^th, 75^th percentile: 28, 29) were assessed using multiple linear regression models.

A doubling of PFOS, PFOA, and PFNA concentrations was associated with a -4.8 % (95% CI: -8.4%, -1.0%), -5.9% (95% CI: -9.1%, -2.7%), and -6.2% (95% CI: -9.9%, -2.4%) change in 24h U-aldosterone concentrations, respectively. Compared with the lowest exposure tertile, higher tertiles of PFOS, PFOA, and PFNA were associated with lower 24h U-aldosterone concentrations. Significant linear trends across exposure tertiles were observed for PFOS, PFOA, and PFNA. No significant associations were observed between PFAS and P-aldosterone.

Higher PFOS, PFOA, and PFNA concentrations in early pregnancy were associated with lower 24h U-aldosterone concentrations in late pregnancy. These findings suggest that altered aldosterone regulation may represent one potential pathway linking PFAS exposure with fetoplacental development.

Inflammation and structural brain alterations are implicated in psychosis risk, yet it remains unknown whether epigenetic C-reactive protein (CRP), a DNA methylation-based estimator of cumulative inflammatory burden, is associated with brain structure in youth at clinical high risk for psychosis (CHR-P).

We examined associations between epigenetic and plasma CRP, regional gray matter volume (GMV), and positive symptom severity in 165 participants (108 CHR-P, 57 healthy comparisons (HC)) from the North American Prodrome Longitudinal Study Phase 2. Epigenetic CRP was derived from the Illumina 450 k array; plasma CRP was quantified in a subset of 81 participants via multiplex immunoassay. GMVs of the medial prefrontal cortex, anterior cingulate cortex (ACC), and hippocampus were extracted from 3-Tesla MRI scans; positive symptoms were assessed with the Scale of Prodromal Symptoms.

Epigenetic and plasma CRP were weakly correlated (r = 0.19). Higher epigenetic CRP was associated with lower GMV in several corticolimbic regions, including the left caudal ACC (β =  - 0.08, p = 0.011), and lower cACC volume was associated with greater positive symptom severity (β =  - 0.26, p = 0.001). Plasma CRP showed no significant associations in the primary combined-sample model.

To our knowledge, this study is the first to show that epigenetic CRP is associated with corticolimbic structural differences in CHR-P and HC youth. Epigenetic CRP may capture inflammation-related neurostructural variation relevant to psychosis risk.

Serotonergic psychedelics are promising treatments for neuropsychiatric disorders, and their immunomodulatory effects may contribute to their clinical efficacy. However, we lack a systematic review and meta-analysis of these effects across in vitro, in vivo non-human, and human studies. We systematically searched PubMed, EMBASE, Web of Science, PsycINFO, LILACS and ClinicalTrials.gov for all studies, published from database inception through February 9th, 2026, examining changes in immune markers after serotonergic psychedelic exposure, and meta-analyzed eligible studies. Of 9,195 studies screened, 61 studies met eligibility criteria for systematic review including 24 in vitro studies, 30 non-human in vivo studies, and seven human studies including data from 10 separate human trials. Results of the systematic review indicated that most in vitro (19/24) and non-human in vivo (25/30) studies reported anti-inflammatory effects of psychedelics. Human results were mixed with anti-inflammatory effects observed in 3/10 trials. Results of the meta-analysis of 18 eligible in vivo murine studies showed a significant decrease in proinflammatory cytokines in inflammatory models (standardized mean difference (SMD = -1.23, 95% CI [-1.54, -0.92]), but no significant effects in healthy murines (SMD = -0.06, 95% CI [-0.54, 0.43]), following treatment with a serotonergic psychedelic. Four human studies were eligible for meta-analysis; however, the small number of studies resulted in imprecise estimates and limited interpretability. Thus, while serotonergic psychedelics reduce proinflammatory cytokines in preclinical models of increased baseline inflammation, limited human evidence precludes conclusions about their translational potential.

ObjectiveTo estimate lifetime and current panic disorder (PD) prevalence and examine medical and current psychiatric burden and treatment coverage among adults attending family medicine health centers in central Türkiye.MethodA district-wide cross-sectional survey recruited adult attendees systematically from 28 randomly selected family health centers. Two psychiatrists assessed 1807 participants using the Structured Clinical Interview for DSM-5 Disorders, Clinician Version. Medical conditions were recorded using a checklist and available records. Prevalence estimates and hierarchical logistic regression were used to examine center-level clustering.ResultsLifetime PD was identified in 102 participants (5.6%; 95% CI = 4.4%-6.9%) and current PD in 52 (2.9%; 95% CI = 2.0%-3.8%). In the fully adjusted model, lifetime PD was associated with female sex (adjusted odds ratio [aOR] = 1.87; 95% CI = 1.20-2.93), family psychiatric history (aOR = 2.05; 95% CI = 1.31-3.21), one (aOR = 1.94; 95% CI = 1.11-3.38) or at least two medical conditions (aOR = 2.50; 95% CI = 1.25-5.02), and one (aOR = 1.68; 95% CI = 1.16-2.45) or at least two current non-PD psychiatric disorders (aOR = 3.79; 95% CI = 1.72-8.35). Only 14 of 52 participants with current PD (26.9%) were receiving psychiatric treatment.ConclusionsPD was identified in a clinically important proportion of family health center attendees and accompanied by substantial medical and current psychiatric burden. Better recognition, comprehensive assessment, and referral in primary health care may improve treatment coverage in Türkiye.

Schizophrenia exhibits high heterogeneity, with early-onset (EOS) and adult-onset (AOS) potentially involving distinct pathophysiological mechanisms. We investigated the patterns of putative glymphatic function in first-episode schizophrenia across different onset types to explore this heterogeneity, with a focus on differences in glymphatic-related perivascular diffusion characteristics.

This study enrolled 195 first-episode schizophrenia patients (EOS, n = 103; AOS, n = 92) and 191 matched healthy controls (younger controls [yHC], n = 62; older controls [oHC], n = 129). Diffusion tensor imaging indices along the perivascular space (DTI-ALPS) were computed as indirect markers of putative glymphatic-related fluid dynamics. We first explored the interaction effects of disease and onset-age on bilateral and mean ALPS. Further analyses included multiple linear regression models adjusting for confounding factors of illness duration and antipsychotic dosage, and partial correlation analyses with symptom subdimensions and cognitive function.

Significant disease and onset-age interaction effects were observed in the right and mean ALPS indices. Simple effect analysis revealed that the interactions were primarily driven by the significant differences between AOS and both oHC and EOS. Specifically, AOS patients exhibited significantly lower right and mean ALPS indices compared to both oHC and EOS groups. Notably, lower right ALPS in AOS patients were associated with greater hallucination severity, whereas no significant associations between DTI-ALPS indices and cognitive measures survived multiple comparison correction.

Differences in DTI-ALPS indices in first-episode schizophrenia varied by onset-age, with more pronounced alterations occurring in AOS patients, particularly within the right hemisphere, partly explaining the onset-age heterogeneity of schizophrenia.

Previous studies have observed a correlation between plasma gelatinase-associated lipocalin (NGAL) levels and cognitive function in drug-naïve patients with schizophrenia (DNS), but the mechanism is unclear. Basic research suggests that the neuroprotective effect of NGAL may be related to the regulation of growth factors. So, we hypothesized that growth factors such as brain-derived neurotrophic factor (BDNF) mediated the effect between NGAL and cognitive function in DNS. This study recruited 137 DNS patients and divided the patients into severe cognitive impairment group (SCI-DNS, n = 58) and non-SCI group (non-SCI-DNS, n = 79) according to the MATRICS Consensus Cognitive Battery (MCCB), with SCI defined as MCCB composite T-score < 25. Sociodemographic characteristics, cognitive function, psychotic symptoms and peripheral blood samples were collected from all participants. Plasma levels of NGAL, BDNF, epidermal growth factor (EGF) and vascular endothelial growth factor (VEGF) were measured using enzyme-linked immunosorbent assay (ELISA). (1) SCI was observed in 42.3% of DNS. (2) Plasma levels of NGAL, BDNF, and EGF were significantly lower in the SCI-DNS group compared with the non-SCI-DNS group. (3) Plasma NGAL exhibited significant positive correlations with all three growth factors (BDNF, EGF, VEGF). (4) Plasma NGAL, BDNF, and EGF levels were positively associated with cognitive function. (5) Plasma BDNF demonstrated a significant mediating effect in the relationship between plasma NGAL and cognitive function. In patients with DNS, those with SCI exhibited lower plasma levels of NGAL, BDNF and EGF. Notably, a significant BDNF-mediated pathway was identified in the association between NGAL and cognitive function.