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Lanthanum aluminate-lanthanum zirconate composite was synthesized by using coprecipitation and powders were dried by spray-drying. Pseudoboehmite was used as a precursor of lanthanum aluminate during the precipitation process. Highly crystalline phases were obtained. Lanthanum zirconate exhibits a pyrochlore structure at lower synthesis temperature (>1500°C). Due drying technique lanthanum aluminate particles appear surrounded by lanthanum zirconate. No other remaining phases were observed and the phase distribution in the composite was homogeneous.
Residual strain in electrodeposited Li films may affect safety and performance in Li metal battery anodes, so it is important to understand how to detect residual strain in electrodeposited Li and the conditions under which it arises. To explore this Li films, electrodeposited onto Cu metal substrates, were prepared under an applied pressure of either 10 or 1000 kPa and subsequently tested for the presence or absence of residual strain via sin2(ψ) analysis. X-ray diffraction (XRD) analysis of Li films required preparation and examination within an inert environment; hence, a Be-dome sample holder was employed during XRD characterization. Results show that the Li film grown under 1000 kPa displayed a detectable presence of in-plane compressive strain (−0.066%), whereas the Li film grown under 10 kPa displayed no detectable in-plane strain. The underlying Cu substrate revealed an in-plane residual strain near zero. Texture analysis via pole figure determination was also performed for both Li and Cu and revealed a mild fiber texture for Li metal and a strong bi-axial texture of the Cu substrate. Experimental details concerning sample preparation, alignment, and analysis of the particularly air-sensitive Li films have also been detailed. This work shows that Li metal exhibits residual strain when electrodeposited under compressive stress and that XRD can be used to quantify that strain.
In the present study, a new method for a decision-support system for fungicide administration against the pathogen Botrytis cinerea in vineyards was developed based on Integrated Pest Management principles which identified an infection risk before the appearance of disease symptoms. The proposed method is based on the combination of (i) the phenological observations of the main susceptible stages to infection, (ii) the airborne spores monitoring, (iii) the forecasting of the suitable meteorological conditions for B. cinerea spore germination during the subsequent 4–6 days after the spore detection. Aerobiological, phenological and meteorological analyses were carried out using data from 2008 to 2015 in a vineyard of Northwestern Spain. Aerobiological spore data were obtained using a Lanzoni VPPS-2000 pollen-spore trap. Phenological observations were conducted on 22 plants of Treixadura cultivar following the BBCH (Biologische Bundesanstalt für Land und Forstwirtschaft, Bundessortenamt und CHemische Industrie) scale. The Magarey generic fungal model was applied for the identification of the main meteorological suitable periods for infection within the susceptible phenological stages of flowering and ripening of berries. Our results showed that climatic conditions favoured fungal development during flowering, although a higher incidence of B. cinerea infection risk-periods occurred during the prior-to-harvest stage of ripening of berries, the most susceptible phenological stage to B. cinerea infection obtained by the proposed methodology. This approach enables more precise targeting in pesticide spraying and reduction in pesticide application from 4–5 to 2–3 times per year at our commercial study. It also illustrates the real-world benefits of integrated disease risk modelling.
There are 80.000 patients undergoing replacement opiate programs in Spain, mainly methadone. Gender differences and the ratio of dual diagnosis in this population are unknown.
To describe gender differences in the current therapeutic management of opiate-dependent patients undergoing a replacement therapy program in Spain.
624 patients from 74 centers in Spain were included between September 2008 and February 2009 in an observational, cross-sectional, multicenter study. Patients were ≥ 18 years, had a diagnosis of opiate dependence according to DSM-IV-TR criteria, were currently scheduled in a replacement therapy program in Spain and were given written informed consent.
Only 16% of patients were female. Methadone average doses were significantly higher in man (57,59mg ± (SD 46,77) vs 52,81mg ± (SD 50,81) (p< 0.05)). Most women were caretaken by their partner (56.8% vs 34,2%) and man by their parents (61,6% vs 37,8) p< 0,05.Women were found to have significantly more sexual disorders than men (6% versus 2%; p=0.0316); but less delirium, dementia, amnesic and other cognitive disorders (none versus 6%; p=0.0486); schizophrenia and other psychotic disorders (3% versus 13%; p=0.0226); and adaptive disorders (2% versus 9%; 0.0427). No significant differences were found between sexes for other psychiatric comorbidities.
The ratio between men and women was close to 5/1, being bigger than that in the general opiate dependent Spanish population. Dual diagnosis rates vary by gender, but not in the number of diagnosis in Axis I or II. Gender differences must be considered when planning dependence services as women.
The predictD study is a pioneering international study whose main objective was to develop a risk index for the onset of major depression in general practice attendees.
The aim of this exploratory study was to determine the opinion of primary care attendees and their general practitioners about how to implement primary prevention of major depression. The intervention consisted of informing primary care attendees about their risk level and risk profile for the onset of major depression.
The study participants were primary care attendees and general practitioners in urban health centres of 7 Spanish provinces. The methodology used was qualitative: there were 14 in-depth interviews (two from each province), 7 DAFO groups and 7 focus groups.
The results showed that attendees generally welcomed this precautionary measure. Some even proposed potential changes in their lifestyles to prevent depression, such as improving social relationships, taking things more calmly or doing more leisure activities, while others asked their GP for advice. The GPs were more resistant about informing primary care attendees, raising doubts about the validity-reliability of the instrument, their lack of education about what they should or should not advise their attendees, the danger of creating excessive fear in their attendees, or the barrier of lack of time in the office to do these activities.
Primary care attendees welcome this preventive measure more than their general practitioners.
Two studies to date have been published regarding the prevalence of the metabolic syndrome in bipolar patients. The unadjusted prevalence rates reported were 30% and 32%. The aim of this study was to evaluate the prevalence of the metabolic syndrome in a group of 142 bipolar patients from Spain.
Bipolar patients (ICD-10 criteria) from 11 centres in Spain were assessed cross-sectionally for metabolic syndrome according to the NCEP ATP III criteria.
The mean age was 47.3 (SD 14.5), 51.1% were male. On average, patients were receiving 2.8 (SD 1.3) drugs for the treatment of their bipolar disorder. Ninety-one percent were receiving mood stabilizers, 63.4% antipsychotics and 29.6 antidepressants. Eighty-seven percent of the antipsychotics prescribed were atypicals. The overall prevalence of metabolic syndrome in our sample was 24.6% Fifty-seven percent of the sample met the criterion for abdominal obesity, 37.4% for met the criterion for hypertriglyceridemia, 36.4% for low HDL-cholesterol, 25.2% for high blood pressure and 12.5% for high fasting glucose. No statistically significant difference was found between with and without the metabolic syndrome for gender, illness status (acute versus in remission), CGI-S-BP scores and number of medications used. Patients taking tow mood stabilizers had significantly higher metabolic syndrome rates than patients taking one mood stabilizer and than patients without mood stabilizer treatment (40% versus 17.8% and 11.1% respectively, p .02).
The prevalence of the metabolic syndrome in bipolar patients is high. It appears to be higher than that estimated for the Spanish general population.
Assess clinical and functioning treatment outcomes of risperidone long-acting injection (RLAI) versus oral antipsychotics for patients participating in the electronic Schizophrenia Treatment Adherence Registry (e-STAR) in Spain.
e-STAR is a 2-year, multi-national, prospective, observational study of patients with schizophrenia who were initiated on RLAI or an oral antipsychotic. Data were collected retrospectively (1-year) and prospectively every three months (2 years). Outcomes included clinical effectiveness measured by Clinical Global Impression of Illness Severity (CGI-S) and patient functioning assessed by Global Assessment of Functioning (GAF) scale. Clinical and functional outcomes are analyzed using a linear mixed model controlling for age, gender, disease duration, baseline hospitalization status and antipsychotic treatment patterns. Results presented are based on the complete e-STAR data from Spain.
1,622 patients (63.6% male, mean age 38.4±11.2 years) participated in e-STAR from Spain, 1,345 were initiated on RLAI and 277 on oral antipsychotics. RLAI treated patients had significantly longer disease duration (12.6±9.5 years vs. 10.9±9.7, p<0.01) than those treated with oral antipsychotics. During the 2-year study, clinical symptoms and functioning improved in both groups. As revealed by the mixed-model regression, RLAI patients, compared to oral patients, had significantly greater improvement on CGI-S scores (-1.10 vs. -0.88, p<0.02) and GAF scores (16.4 vs. 14.6, p<0.03). Baseline hospitalization status and disease duration were significant explanatory variables in the mixed model regression.
This 2-year, prospective, observational study showed that compared to oral antipsychotics, RLAI treatment was associated with greater improvement in clinical symptoms and functioning in patients with schizophrenia.
To know prevalence of depression in Spanish nursing home(NH) by analysing the clinical profile of residents from RESYDEM study (Identification of patients with cognitive deterioration and dementia in NH).
A multicentral, transversal, observational study was carried out in April 2005. 71 geriatrician from 54 NH representing the Spanish state participated. Depression was analysed in patient´s history and determined by NPI of Cummings, NH version.
1037 residents were randomized, 1020 were used by clinical data analysis. 941 were used to determine depression prevalence. Median age 83,4yo, 66.6% were women, 70.9% with basic educational level, 57.4% widows, 25.7% single, 41.5% had some degree of functional deterioration, 22.1% had delirium. In 26.4% were documented Stroke(17,9% TIA). 61.7% had dementia.
Depression appears in 31.4% of elderly institutionalized with the only diagnosis of depression or independent of others. There were no significant differences in age groups. However, was most frequent in women. 95.7% of patients with diagnosis of dementia had at least one drug for depression. Most used anti-depressants were trazadone (23%), citalopram (20.9%), sertraline (15.8%), fluoxetine (10.1%). No tricyclical anti-depressant reached 1% of consumption.
Depression affects practically one in three institutionalized elderly in Spain
Institutionalized elderly with depression are largely treated with ISRS. It is believed that the use of trazadone is linked with the effects on sleep and anxiety.
The high prevalence of depression, its overlapping with other processes and the comorbility of residents requires a careful search and approach in NH which implies a challenge for professionals in order to treat it.
We set up a study to analyze quality of life and social adaptation in a group of women suffering from fibromyalgia.
Patient inclusion from 1st March to 30th June 2010. An especially designed questionnaire was used for the study, together with Short-Form-36 Health Survey (SF36), Family Apgar questionnaire, Duke-UNC Functional Social Support (Duke-UNC 11) questionnaire, and Social Adaptation Self-evaluation Scale (SASS). SPSS was used for statistical analysis.
Following explanation of purpose of our study and confidentiality agreement, 35 women voluntarily joined our study. Mean age was 52.2 years standard deviation (SD) 7.17. 82,9% had children (mean 2.03 and SD 0.94); 85.7% of patients acknowledged coping with fibromyalgia “badly” or “very badly”; 60% acknowledged that their illness affected their families “severely” or “critically”; 94.3% acknowledged their quality of life affected “much” or “very much”; and 85.7% of patients had their social relationships “much” or “very much” affected. 82.9% of our group of patients was under psychiatric treatment. SF36 scored an average of 27.85 on the physical functioning subscale (SD 19.93); physical role 6.42 (SD 18.53); pain 16.64 (SD 13.7); social functioning 32.14 (SD 21.92); mental health 33.14 (SD 19.0); emotional role 15.23 (SD 30.61); vitality 16.28 (SD 18.60) and general health perception 16.71 (SD 14.54). Family Apgar scored 7.34 (SD 2.53). Duke-UNC 11 scored 35.17 (SD 11.34). Finally, SASS scored 31.32 (SD 7.59).
In view of the results, women suffering from fibromyalgia showed severe changes in all parameters analyzed, social adaptation being very much impaired.
Investigation of the occurrence of psychotic symptoms in non-psychiatric population may help to identify population at risk of psychosis. The aim of our study was to find out lifetime and current prevalence of psychotic symptoms in the general population of the Czech Republic. Study sample consisted of a stratified population. All participants were administered the Psychosis Screening Questionnaire and the data on psychiatric treatment and diagnosis according to the M.I.N.I. were recorded. In total, 3244 subjects responded (48.1% males and 51.9% females). The most frequently reported symptom was paranoia (7.7%), followed by hypomania (6.2%), strange experiences (5.2%), thought insertion (3.8%), and hallucinations (1.7%). Lifetime prevalence of minimum 1 psychotic symptom was 17.9%. The highest proportion of responders reported only one symptom (13.5%). Significantly more males than females experienced paranoia (p=0.002). In the subset of individuals with a history of at least one psychotic symptom, 70.6% never visited a psychiatrist, 78.9% did not meet diagnostic criteria of psychotic disorder according to the M.I.N.I., and 67.0% failed to have any psychiatric diagnosis at all. The results suggest a high frequency of psychotic experience among the ethnically homogeneous Czech population. Only the longitudinal follow-up could confirm whether the symptomatic subjects are at risk of development of psychotic disorder. More likely, our findings support a hypothesis of the presence of psychiatric symptoms in the general population as a continuum of psychotic spectrum, from normality and sanity through unique psychotic experiences to fully expressed illness.
Prevalence of obsessive-compulsive disorder (OCD) in general population is 2–3%. This high prevalence is not often reflected in number of assitances to Emergency Department. There are few studies that analyze the characteristics of OCD patients assisting to psychiatric emergency services.
To establish the profile of these patients, determining aswell their type of emergency assistance, time distribution and why they relapse. We used the SPSS 17 package.
A retrospective and descriptive study of attendances at the Psychiatry Emergency Department of Hospital Clínico Universitario de Santiago de Compostela in a sample of patients fitting the ICD-10 criteria for OCD diagnosis (n = 45). Time period: from 9TH July 2007 to 26TH September 2010.
From 5091 attendances at the Psychiatry Emergency Department, 45 patients had an OCD diagnosis (57.8% women), with a mean age of 33.31 ± 11.58 years. 68.9% came from rural areas. 44.4% had comorbid psychiatric disorders.68.9% came by own initiative. In 28.9% the consultation was anxiety, 15.6% obsessive symptoms and 11% affective symptoms. 13.3% were admitted to a psychiatric ward.There was lower attendance between 0:00–08:00 AM and on Fridays. The months with more attendance were August and September.12% had more than one assitance, 85.7% were women with anxiety symptoms (38%) and with personality disorder as the most frequent comorbid diagnosis.
Patient's profile: “33 years old female from countryside, presenting anxiety symptoms, who comes only once and by own initiative. Doesn’t have comorbid psychiatric disorders. After the psychiatric evaluation she is discharged to outpatient's psychiatric follow-up”.
We aimed to study the relationship between impulsivity and the addiction severity in 3 groups of outpatients attending our clinic, through the Barrat Impulsivity Scale (BIS-11) and the standarized, semistructured interview EuropAsi.
174 outpatients were analized (82.6% men, 113 cocaine-dependent as main drug (mean age 32.71 y.o. (31.45–33.96)), 43 cocaine and heroin-dependent (mean age 36.68 y.o. (33.52–39.85)) and 18 heroin dependent (mean age 37.94 (32.71–41.50)). 26.3% were cannabis-dependent and 10.9% abused of Cannabis. Statistical analysis used was the Kruskal-Wallis Test.
Differences in motor impulsivity were found between the 2 groups with cocaine dependency and the only heroin-dependent (mean = 20.59, ST ± 7.7 and mean = 17.11, ST ± 7.3, respectively; W: .019). EuropASI, showed intergroup differences in the medical, use of alcohol and legal areas. In the medical area the most affected were the heroin dependent group (mean score = .40), followed by cocaine and heroin group (mean score = .27) and the cocaine-dependent (Mean = .10). In the use of alcohol area the most affected were the cocaine group (Mean = .16) followed by the cocaine and heroin-dependent (mean = .11) and heroin dependent (Mean = .06). In the legal area the most affected were the the cocaine and heroin-dependent (Mean =.22) followed by heroin-dependent (Mean = .09) and cocaine-dependent (Mean = .07).
Patients suffering from stimulant dependency alone or together with heroin dependency show different impulsivity levels. The addiction severity varies depending on the substance of abuse. Treatment programs should be designed attending patients’ needs.
Toxoplasma is considered as one of the most promising candidates of infectious agent that might trigger psychotic disorder in predisposed subjects or modulate the course of the disease. A clinical pattern has not been established yet in Toxoplasma infected schizophrenia patients. Psychopathological, cognitive and treatment response features of Toxoplasma seropositive and seronegative individuals suffering from schizophrenia spectrum disorder has been studied in China, Czech Republic, Ethiopia, Germany, Turkey, United States and other countries to determine whether schizophrenia and Toxoplasma infection co-morbidity modifies clinical presentation and illness course. Prague Psychiatric Centre project consisted of 251 patients with schizophrenia spectrum disorder consecutively admitted to between 2000 and 2010. Toxoplasma-infected patients spent more days in hospital during their last admission compared to Toxoplasma-free patients (p = 0.003; mean difference 32.9 days). Schizophrenia started approximately one year earlier in Toxoplasma-infected men and about 3 years later in Toxoplasma-infected women than in Toxoplasma-free patients, which corresponds to gender related toxoplasmosis incidence curves in the Czech Republic. All infected patients scored higher in the Positive Subscale of Positive and Negative Symptom Scale (PANSS). The PANSS scores and composite PANSS scores also correlated negatively with the concentration of anti-Toxoplasma antibodies indicating the increase of psychopathology with infection duration. Our findings support the hypothesis that toxoplasmosis may represent a risk factor for schizophrenia spectrum disorders.
Clozapine is an atypical dibenzodiazepine antipsychotic used for resistant schizophrenia. Myocarditis and cardiomyopathy are rarely reported complications of clozapine treatment. The incidence of clozapine-related myocarditis has been variably reported at between 0.03% and 0.19% Myocarditis is a potentially life-threatening complication of clozapine.
We reported a case of a 30-year-old female patient who developed reversible myocarditis a few weeks after we began the treatment with clozapine for chronic resistant schizophrenia (as specified in DSM-IVTR), characterized by severe left ventricular systolic dysfunction that resulted in congestive heart failure.
After the immediate discontinuation of the clozapine, along with aggressive supportive care, resulted in almost complete recovery to baseline.
Patients taking clozapine who develop dyspnoea, fatigue, chest pain or collapse should be screened for myocarditis, especially during the first weeks of treatment. Health professionals should be aware of this uncommon but serious side effect of clozapine since failure to recognize the association may result in adverse clinical outcome. Myocarditis should be suspected when cardiac dysfunction appears suddenly, and appropriate diagnostic and therapeutic strategies must be undertaken promptly.
Fibromyalgia seems to be associated with various forms of psychopathology, particularly major affective disorders.
To evaluate associated psychopathology in a series of women with diagnosis of fibromyalgia.
Patient inclusion from 1st March to 30th June 2010. Symptom Checklist (SCL-90-R) was used for evaluation. SPSS was used for statistical analysis of data and results.
A total of 34 women voluntarily joined our study. Mean age was 52.2 years (standard deviation (SD) 7.17). 11.4% were singled, 74.3% married or unmarried couples, 8.6% were divorced, and 5.7% were widowers. 74.3% of women lived with their couple and/or children whereas 8.6% lived by their own, and 8.6% with their parents. Results obtained with SCL-90-R showed:
Our patients with fibromyalgia scored higher in somatization, obsession-compulsion, depression, and anxiety. In view of the results, there is an important association between fibromyalgia and various forms of psychopathology.
Self-perceived health is a well-recognised predictor of later health outcomes and mortality, but its relationship to incident dementia has been scarcely explored.
To analyze self- perceived health as a risk factor for dementia and Alzheimer disease (AD) in a population- based survey of the elderly (NEDICES) Study.
Participants were evaluated at baseline (1994-1995) with a standardized questionnaire that included subjective and objective (chronic disorders) health status and screening questions for depression and neurologic disorders. At follow-up (a median of 3.2 years later in 1997-1998) an analogous protocol and neurological assessment were performed.
Of 5,278 participants evaluated at baseline there were 306 prevalent dementia cases, and 161 incident dementia cases were identified among 3,891 individuals assessed at follow-up (D: 115).
Cox hazard ratio analyses showed that age, stroke and illiteracy were independent risk factors for dementia and AD. Aggregation of vascular risk factors was related to a higher risk of both dementia and AD. Good (and very good) versus less than good (fair, bad and very bad) self-perceived health was an independent risk factor for dementia (CI 95% 1.13- 2.16; p= .006) and AD (CI 95% 1.02- 2.18; p= .038) after adjusting by age, sex education and vascular risk factors.
Self-perceived health increased the risk for incident dementia and AD in the NEDICES cohort as it was previously described in the United Kindom MRC- CFA Study of dementia incidence. Global health measurements (self-perceived health, quality of life) needs farther studies as risk for dementia and AD.
The TaqIA polymorphism linked to the DRD2 gene has been associated with alcoholism. The aim of this work is to study attention and inhibitory control as per the continuous performance test and the stop task in a sample of 50 Spanish male alcoholic patients split into two groups according to the presence of the TaqIA1 allele in their genotype. Our results show that alcoholics carrying the TaqIA1 allele present lower sustained attention and less inhibitory control than those patients without such allele.
Computer programs are used in rehabilitation of cognitive deficit in schizophrenia. Repetitive transcranial magnetic stimulation (rTMS) can directly affect cortical excitability and metabolism of prefrontal lobe and subsequently affect cognition. The objective of our study was to investigate augmentation of cognitive rehabilitation in schizophrenia with rTMS. Study subjects were stabilized patients with DSM-IV diagnosis of schizophrenia, treated with second-generation antipsychotics, except for clozapine (total N=34). Study with rTMS was double-blind, randomized, placebo-controlled, with 2 parallel arms. All subjects participated in eight-week computer-assisted cognitive training, during first 2 weeks Group 1 (N=8) received rTMS and Group 2 (N=8) inactive sham stimulation. Patients who refused stimulation participated in rehabilitation program only. Data were assessed fo the totatl study sample and for each group separately. The results showed that computer-assisted cognitive training significantly improved severity of cognitive deficit in schizophrenia in many domains, especially executive functions: attention shift – flexibility, attention control, and working memory. The output was faster, more precise, and more reliable. We did not detect to effect of rTMS on the change of cognition, there was no significant difference between active and sham stimulation. This finding can be explained by a significantly lower initial score in Raven test found in actively stimulated group or by a smaller sample size in a double-blind study. The study confirmed efficacy of computer-assisted rehabilitation in remediation of cognitive deficit in schizophrenia.
Supported by the projects IGA MZ CR NF7571-3 and MSMT CR CNS 1M0517