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Deficits in social functioning are a core feature of schizophrenia and are influenced by both symptomatic and neurocognitive variables.
In the present study we aimed to determine the reliability and validity of the Portuguese version of the Personal and Social Performance (PSP) scale, and possible correlations with measures of cognitive functioning.
One-hundred and four community and inpatients with schizophrenia were assessed using measures of social functioning and symptom severity alongside measures of executive function, processing speed and verbal memory.
The reliability of the PSP was found to be satisfactory, with a Cronbach's alpha coefficient of 0.789. Inter-rater reliability in the four domains of the PSP varied from 0.430 to 0.954. Low-functioning patients (PSP < 70) were older, had longer duration of illness, were more symptomatic and had worse cognitive performances, as compared to high-functioning patients (PSP ≥ 70). In a regression model, deficits in social functioning were strongly predicted both by symptomatic and neurocognitive variables; these together accounted for up to 62% of the variance.
The present study supports the reliability and validity of the Portuguese language version of the PSP and further supports the original measure. The co-administration of brief cognitive assessments with measures of functioning may lead to more focused interventions, possibly improving outcomes in this group.
Hyperprolactinemia is a common adverse effect of typical and some atypical antipsychotics and can induce side effects associated with decreased quality of life and poor adherence to treatment.
Management options are limited and can lead to decompensation of the patient.
Aripiprazole is a recent antipsychotic with partial agonist activity over the dopamine D2 receptors which can be effective in reducing hyperprolactinemia in patients treated with antipsychotics.
Review the existing literature about the effect of adjunctive treatment with low doses of aripiprazole on antipsychotic-induced hyperprolactinemia.
Search for literature about the topic in PubMed and Goocle Scholar databases using “hyperprolactinemia” and “aripiprazole” as keywords.
We found 6 case reports with 8 patients treated with risperidone, paliperidone, zuclopenthixol and fluphenazine that, with 2,5-10mg of aripiprazole, showed a decrease in serum levels of prolactin. 4 open label studies, with a total of 69 patients, all treated with risperidone, also showed a decrease in prolactin levels for adjunctive treatment with 3-10mg of aripiprazole. Two double-blind and two single-blind RCT vs placebo was found, with a sample of 297 patients treated with risperidone or sulpiride and 5-10mg of aripiprazole, and showed decrease in serum levels of prolactin. In all studies treatment with aripiprazole was not significantly associated with an increase in adverse effects or worsening of clinical symptoms.
The antipsychotic-induced hyperprolactinemia could be partially or totally reversed after adding low doses of aripiprazole to current treatment. It seems to be an effective, safe and well tolerated option.
Previous epidemiological studies clearly demonstrated gender differences in the patterns of mental illness. as a matter of fact, female suffer more from depressive and anxiety disorders, while male suffer more from addictive behaviour and psychotic disorders.
The present study was elaborated by the Psychiatric Department Quality Commission of the Coimbra University Hospital in order to identify gender differences in socio-demographic and clinical characteristics of patients that were hospitalized from January to June 2011.
We analyzed 417 clinical files and gathered socio-demographic information (gender, age, marital status and job) and clinical information (diagnosis and hospitalization's length).
Statistical analysis was performed with SPSS program, using the chi-square's and Mann-Whitney's tests.
53% of the inpatients were women.
It was also observed that women were older (p = 0.021), more frequently married and widowed (p < 0.001), were less associated with compulsory admission (p < 0.001), had shorter hospitalizations (p = 0.024) and were more often diagnosed with adjustment reaction and bipolar disorder (p < 0.001), while men were younger (p < 0.001), more frequently single (p < 0.001), more frequently unemployed (p < 0.001), were more subject to compulsory admission (p < 0.001) and were more often diagnosed with addictive disorders and schizophrenia.
These results are consistent with the existing literature and enable us to organize the services’conditions according to the needs of our psychiatric inpatient population.
Eating disorders are characterized by a persistent disturbance of eating behaviour that results in altered consumption of food and that significantly impairs physical health or psychosocial functioning. Treatment of eating disorders is complex and challenging and sometimes patient's hospitalization is needed. The Santa Maria Hospital's Eating Disorders Unit is a specialized multidisciplinary team with long experience in the treatment of such disorders.
To present and discuss the results of the inpatient treatment program for patients with eating disorders held at the Santa Maria Hospital's Eating Disorders Unit.
review of clinical files of all patients hospitalised at Santa Maria Hospital's Eating Disorders Unit during a twelve month period and statistical analysis of data collected using SPSS program.
The sample included mainly female patients with anorexia nervosa with a significantly low body weight. In this presentation we show the results of the statistical analysis performed for sample characterization (both demographic and clinical variables), evaluation of patient's clinical outcome and features associated with good or poor prognosis.
The results of this study show the importance of inpatient care especially for patients with anorexia nervosa with a significantly low body weight.
Cognitive deficits are a core feature of the first psychotic episode patients and could be an obstacle to functional ability. Cognitive stimulation could be a promising method to surpass neuropsychological deficits.
–to implement an online training protocol to stable first psychotic episode outpatients;
–to assess adherence to the intervention;
–to measure neurocognitive, psychopathological and functional outcomes pre- and post-training.
To investigate the feasibility of an online-based resource for cognitive stimulation (COGWEB®) and explore possible benefits in different domains.
Fifteen patients were enrolled from the Early Psychosis Intervention Program (PROFIP) at the Department of Psychiatry of Santa Maria Hospital, Lisbon. The training consisted on 30-40-minute online sessions performed every weekday during 6 months at home. Assessments were performed at baseline and after program completion and included: psychopathological scores; personal and social functioning scores; Clinical Global Impression and a neuropsychological battery.
Every participant had some kind of impairment on baseline. Mean training time was 36 h. Six patients left the program before completion (half of them because they got employed). The program showed overall good feasibility and safety with no reported significant psychiatric occurrences or hospitalizations. Results regarding final neuropsychological, psychopathological and functioning showed a tendency for stability or improvement on an individual case analysis.
Our results show that cognitive training using an online-based stimulation software is a feasible intervention for first-episode psychosis patients with possible benefits for this population. However, results should be analyzed very carefully because of different participant trajectories and of study limitations.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The scientific community assumes that rigorous methodology research is more likely to be published in high impact psychiatry journals (HIJ). We aimed to test which methodological variables could predict publication in HIJ.
We conducted a systematic review of the MEDLINE and EMBASE databases from 2013, January 1st to 2015, June 15th. Inclusion criteria were studies that were RCTs whose at least one arm of the study should be fluoxetine regarding adult patients (> 18 years old) with MDD. We performed logistic regression regarding the number of participants, intention-to-treat analysis, blinding, multicenter study, sample losses, positive result, sponsorship of pharmacy's industry, and h-index of the last author. A HIJ was considered if journal impact factor was above the median or 3rd quartile of our sample.
Forty-two studies were considered for the final analysis. The results of the univariate logistic regression found no differences between HIJ and low impact psychiatry journals for all methodological variables, except the h-index of the last author. By considering HIJ when impact factor was above the mean, h-index had an odds ratio = 1.09 (1.01–1.17), P = 0.02; considering HIJ when impact factor was above the 3rd quartile, h-index had an odds ratio = 1.07 (1.01–1.14), P = 0.02.
Our results indicate that the author productivity may be a relevant predictor for publication in a HIJ in the psychiatry/psychology field. Our study proposes that journals focus on identifying what are the relevant criteria for publication approval in the peer-review process.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
The impact of educational public policies in developing countries such as Brazil is determinant in the improvement of socioeconomic outcomes as well as in the increase of individual's well-being.
This research aimed to study the effects of early detection and intervention in language and behavioral difficulties among 3–4-year-old preschoolers in Brazil. It was designed as a pretest–posttest model with a total of 178 subjects, 90 girls and 88 boys, divided in control (n = 94) and experimental groups (n = 84), with average age of 3.7 y. Children were evaluated in receptive and expressive vocabulary, central auditory processing and behavior. Subjects of the experimental group were engaged in intervention for three months for the development and refinement of language and behavior through activities developed in software used in tablets and orientation provided to their parents and teachers by a professional team composed by speech therapists, psychologists and psycho-pedagogues. The subjects improved their performance in all tests. There was a significant difference in the performance of behavioral and language tests in posttest, indicating that improvement was due to the intervention proposed. This research was supported by the Foundation for Research Support of the State of São Paulo (FAPESP) and Maria Cecilia Souto Vidigal Foundation (FMCSV) whose agreement aims to develop and support projects with potential application in society. These results are meant to guide the design of a project, which will allow the early identification of communication disorders and behavioral difficulties and the development of continuing education actions for the teachers.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
Background: Challenges in predicting risk of recurrence for individual patients with meningioma limits appropriate selection of patients who may benefit from adjuvant radiation therapy to delay recurrence. Here, we aimed to develop and validate a combined clinicomolecular predictor of early recurrence for individual patients with meningiomas. Methods: A methylation-based predictor of 5-year recurrence-free-survival (RFS) was developed using DNA-methylation profiles from a training cohort of 228 patients. Model performance was compared to a standard-of-care histological-based model using three independent cohorts (N=54 ;N=140; N=64 patients). Subsequently, a nomogram that integrated the methylome-based predictor with prognostic clinical factors was developed and validated. Results: The methylome-based predictor of 5-year RFS performed favorably compared to a grade-based predictor when tested using the three validation cohorts (ΔAUC=0.10, 95%CI 0.03 – 0.018) and was independently associated with RFS on multivariable Cox regression analysis (HR=3.6, 95%CI 1.8–7.2, P<0.001). A nomogram combining the methylome-predictor with clinical factors demonstrated greater discrimination for recurrence than a nomogram using clinical factors alone (ΔAUC=0.25, 95%CI 0.22–0.27) and resulted in two risk groups with distinct recurrence patterns (HR=7.7, 95%CI 5.3–11.1, P<0.001) and clinical implications. Conclusions: Our validated models provide important novel prognostic information that could be used to individualize decisions regarding post-operative therapeutic interventions in meningioma.
Glyphosate-resistant (GR) goosegrass [Eleusine indica (L.) Gaertn.] was recently identified in Brazil, but its resistance mechanism was unknown. This study elucidated the resistance mechanism in this species and developed a molecular marker for rapid detection of this target-site resistance trait. The resistance factor for the resistant biotype was 4.4-fold compared with the glyphosate-susceptible (GS) in greenhouse dose–response experiments. This was accompanied by a similar (4-fold) difference in the levels of in vitro and in planta shikimate accumulation in these biotypes. However, there was no difference in uptake, translocation, or metabolism of glyphosate between the GS and GR biotypes. Moreover, both biotypes showed similar values for 5-enolpyruvylshikimate-3-phosphate synthase (EPSPS) copy number and transcription. Sequencing of a 330-bp fragment of the EPSPS gene identified a single-nucleotide polymorphism that led to a Pro-106-Ser amino acid substitution in the enzyme from the GR biotype. This mutation imparted a 3.8-fold increase in the amount of glyphosate required to inhibit 50% of EPSPS activity, confirming the role of this amino acid substitution in resistance to glyphosate. A quantitative PCR–based genotyping assay was developed for the rapid detection of resistant plants containing this Pro-106-Ser mutation.
The Total Solar Irradiance (TSI), which is the total radiation arriving at Earth's atmosphere from the Sun, is one of the most important forcing of the Earths climate. Measurements of the TSI have been made employing instruments on board several space-based platforms during the last four solar cycles. However, combining these measurements is still challenging due to the degradation of the sensor elements and the long-term stability of the electronics. Here we describe the preliminary efforts to design an absolute radiometer based on the principle of electrical substitution that is under development at Brazilian's National Institute for Space Research (INPE).
We describe the preliminary design of a magnetograph and visible-light imager instrument to study the solar dynamo processes through observations of the solar surface magnetic field distribution. The instrument will provide measurements of the vector magnetic field and of the line-of-sight velocity in the solar photosphere. As the magnetic field anchored at the solar surface produces most of the structures and energetic events in the upper solar atmosphere and significantly influences the heliosphere, the development of this instrument plays an important role in reaching the scientific goals of The Atmospheric and Space Science Coordination (CEA) at the Brazilian National Institute for Space Research (INPE). In particular, the CEA's space weather program will benefit most from the development of this technology. We expect that this project will be the starting point to establish a strong research program on Solar Physics in Brazil. Our main aim is acquiring progressively the know-how to build state-of-the-art solar vector magnetograph and visible-light imagers for space-based platforms to contribute to the efforts of the solar-terrestrial physics community to address the main unanswered questions on how our nearby Star works.
Intestinal mucositis is an important toxic side effect of 5-fluorouracil (5-FU) treatment. Saccharomyces boulardii is known to protect from intestinal injury via an effect on the gastrointestinal microbiota. The objective of the present study was to evaluate the effect of S. boulardii on intestinal mucositis induced by 5-FU in a murine model. Mice were divided into saline, saline (control)+5-FU or 5-FU+S. boulardii (16 × 109 colony-forming units/kg) treatment groups, and the jejunum and ileum were removed after killing of mice for the evaluation of histopathology, myeloperoxidase (MPO) activity, and non-protein sulfhydryl group (mainly reduced glutathione; GSH), nitrite and cytokine concentrations. To determine gastric emptying, phenol red was administered orally, mice were killed 20 min after administration, and the absorbance of samples collected from the mice was measured by spectrophotometry. Intestinal permeability was measured by the urinary excretion rate of lactulose and mannitol following oral administration. S. boulardii significantly reversed the histopathological changes in intestinal mucositis induced by 5-FU and reduced the inflammatory parameters: neutrophil infiltration (control 1·73 (sem 0·37) ultrastructural MPO (UMPO)/mg, 5-FU 7·37 (sem 1·77) UMPO/mg and 5-FU+S. boulardii 4·15 (sem 0·73) UMPO/mg); nitrite concentration (control 37·00 (sem 2·39) μm, 5-FU 59·04 (sem 11·41) μm and 5-FU+S. boulardii 37·90 (sem 5·78) μm); GSH concentration (control 477·60 (sem 25·25) μg/mg, 5-FU 270·90 (sem 38·50) μg/mg and 5-FU+S. boulardii 514·00 (sem 38·64) μg/mg). Treatment with S. Boulardii significantly reduced the concentrations of TNF-α and IL-1β by 48·92 and 32·21 % in the jejunum and 38·92 and 61·79 % in the ileum. In addition, S. boulardii decreased the concentrations of chemokine (C–X–C motif) ligand 1 by 5-fold in the jejunum and 3-fold in the ileum. Interestingly, S. boulardii reduced the delay in gastric emptying (control 25·21 (sem 2·55) %, 5-FU 54·91 (sem 3·43) % and 5-FU+S. boulardii 31·38 (sem 2·80) %) and induced the recovery of intestinal permeability (lactulose:mannitol ratio: control 0·52 (sem 0·03), 5-FU 1·38 (sem 0·24) and 5-FU+S. boulardii 0·62 (sem 0·03)). In conclusion, S. boulardii reduces the inflammation and dysfunction of the gastrointestinal tract in intestinal mucositis induced by 5-FU.
To determine whether multidrug-resistant (MDR) gram-negative organisms are present in Afghanistan or Iraq soil samples, contaminate standard deployed hospital or modular operating rooms (ORs), or aerosolize during surgical procedures.
US military hospitals in the United States, Afghanistan, and Iraq.
Soil samples were collected from sites throughout Afghanistan and Iraq and analyzed for presence of MDR bacteria. Environmental sampling of selected newly established modular and deployed OR high-touch surfaces and equipment was performed to determine the presence of bacterial contamination. Gram-negative bacteria aerosolization during OR surgical procedures was determined by microbiological analysis of settle plate growth.
Subsurface soil sample isolates recovered in Afghanistan and Iraq included various pansusceptible members of Enterobacteriaceae, Vibrio species, Pseudomonas species, Acinetobacter Iwojfii, and coagulase-negative Staphylococcus (CNS). OR contamination studies in Afghanistan revealed 1 surface with a Micrococcus luteus. Newly established US-based modular ORs and the colocated fixed-facility ORs revealed no gram-negative bacterial contamination prior to the opening of the modular OR and 5 weeks later. Bacterial aerosolization during surgery in a deployed fixed hospital revealed a mean gram-negative bacteria colony count of 12.8 colony-forming units (CFU)/dm2/h (standard deviation [SD], 17.0) during surgeries and 6.5 CFU/dm2/h (SD, 7.5; P = .14) when the OR was not in use.
This study demonstrates no significant gram-negative bacilli colonization of modular and fixed-facility ORs or dirt and no significant aerosolization of these bacilli during surgical procedures. These results lend additional support to the role of nosocomial transmission of MDR pathogens or the colonization of the patient themselves prior to injury.
Calculi in salivary glands and ducts (sialoliths) can be found in about 1% of the general population. Typically sialolithiasis causes long-term obstruction of salivary secretions, leading to atrophy of the gland with concomitant ceasing of the secretory function and ultimately fibrosis. Although some theories have been put forward regarding the etiology and pathogenesis of salivary calculi, the exact nucleation and growth mechanisms remain elusive. An exhaustive characterization of salivary calculi and systematic evaluation of the existing etiologic theories is therefore required.
We used UV-to-IR archival data to investigate the nature of the giant spiral galaxy, NGC 6872, 65 Mpc away. It belongs to the southern Pavo group and is interacting with a small lenticular galaxy, IC4970. GALEX UV images show a very large part of the galaxy not seen before, making it one of the largest spiral galaxies known, with a physical size greater than 150 kpc. The SED of 17 regions (10 kpc of diameter) across the two arms show a remarkable spatial distribution, as if they were mirror images with respect to their stellar population. However, the last 40 kpc of the northeastern arm are much bluer than any other region of the southwestern one. There is a strong spatial correlation between the NUV luminosity and the distance to the nucleus. The UV data supports the scenario of an interaction at 130 Myr which triggered star formation all over the disk of NGC 6872. The tip of the northeastern arm resembles a tidal dwarf galaxy in the process of formation.