Studying the relationship between intelligence quotient and schizophrenia polygenic scores in a family design with first-episode psychosis population.

BACKGROUND: The intelligence quotient (IQ) of patients with first-episode psychosis (FEP) and their unaffected relatives may be related to the genetic burden of schizophrenia (SCZ). The polygenic score approach can be useful for testing this question. AIM: To assess the contribution of the polygenic risk scores for SCZ (PGS-SCZ) and polygenic scores for IQ (PGS-IQ) to the individual IQ and its difference from the mean IQ of the family (named family-IQ) through a family-based design in an FEP sample. METHODS: The PAFIP-FAMILIES sample (Spain) consists of 122 FEP patients, 131 parents, 94 siblings, and 176 controls. They all completed the WAIS Vocabulary subtest for IQ estimation and provided a DNA sample. We calculated PGS-SCZ and PGS-IQ using the continuous shrinkage method. To account for relatedness in our sample, we performed linear mixed models. We controlled for covariates potentially related to IQ, including age, years of education, sex, and ancestry principal components. RESULTS: FEP patients significantly deviated from their family-IQ. FEP patients had higher PGS-SCZ than other groups, whereas the relatives had intermediate scores between patients and controls. PGS-IQ did not differ between groups. PGS-SCZ significantly predicted the deviation from family-IQ, whereas PGS-IQ significantly predicted individual IQ. CONCLUSIONS: PGS-SCZ discriminated between different levels of genetic risk for the disorder and was specifically related to patients' lower IQ in relation to family-IQ. The genetic background of the disorder may affect neurocognition through complex pathological processes interacting with environmental factors that prevent the individual from reaching their familial cognitive potential.

Coping with the hospital environment during the COVID-19 pandemic: A qualitative study of the survivors' perspective during their stay at the ICU and inpatient ward.

The COVID-19 pandemic has significantly affected the clinical practice of healthcare professionals. This study aimed to explore the perspectives of COVID-19 survivors regarding the healthcare they received during their stay in the Intensive Care Unit (ICU) and the inpatient COVID-19 ward. A qualitative case-study approach was implemented. Participants were recruited using non-probabilistic purposeful sampling strategy. Inclusion criteria included patients aged ≥18 years who received follow-up from the Pulmonology service at a Hospital in de North of Spain, were diagnosed with COVID-19 and bilateral pneumonia, and were admitted to the ICU before being transferred to a COVID-19 inpatient ward. Data was collected through in-depth interviews and researchers' field notes, and thematic analysis was performed. Techniques such as credibility, transferability, dependability, and confirmability were employed to ensure the trustworthiness of the data. A total of 25 individuals (six women) were included in the study. Three main themes emerged from the analysis: common challenges faced in both units, coping with the hospital stay, and developing strategies. Findings highlighted the need to improve information dissemination, individualize care, and enhance direct patient interaction. Moreover, the study shed light on the psychological impact of hospitalization and ICU experience, including feelings of loneliness, confinement, and the lack of memories from the ICU stay, as well as the influence of care and healthcare language. Finally, strategies such as keeping the mind occupied and maintaining self-discipline were identified as crucial during hospitalization. These findings provide valuable insights for healthcare professionals in delivering care to individuals with COVID-19 in the ICU and hospital ward settings.

Processing speed in first episode of psychosis and first-degree relatives: A candidate endophenotype of spectrum schizophrenia disorders.

OBJECTIVE: The processing speed (PS) is highly impacted in individuals experiencing their first episode of psychosis (FEP). Conducting family studies can help to determine whether PS can serve as an endophenotype of schizophrenia spectrum disorders (SSDs), offering valuable insights into the prevention and diagnosis of SSDs. METHOD: A comprehensive cognitive battery, encompassing tests for PS, verbal memory, visual memory, working memory, executive functions, motor dexterity, and attention, was administered to a sample consisting of 133 FEP patients, 146 parents, 98 siblings, and 202 healthy controls (HCs). Univariate analyses (analysis of covariance [ANCOVA]) were conducted to compare the different cognitive domains between groups, utilizing sex, age, and years of education as covariates and Bonferroni corrections. Effect sizes (ESs) were calculated for estimating the magnitude of differences between groups. RESULTS: Group comparisons revealed significant differences in all cognitive domains. PS was the most impaired function in patients. Parents and siblings had intermediate PS performance between FEP patients and HC. Large ES were observed in PS between FEP versus siblings, FEP versus controls, parents versus controls, and parents versus siblings. CONCLUSIONS: Despite not meeting all the necessary criteria, the PS observed in FEP patients and their first-degree relatives suggests its potential as a promising endophenotype of SSDs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Surgical vs. transcatheter aortic valve replacement in patients over 75 years with aortic stenosis: sociodemographic profile, clinical characteristics, quality of life and functionality.

Background: Aortic valve stenosis (AVS) affects 25% of the population over 65 years. At present, there is no curative medical treatment for AVS and therefore the surgical approach, consisting of transcatheter aortic valve replacement (TAVR) or surgical aortic valve replacement (SAVR), is the treatment of choice. Methodology: The aim of this study was to analyze the sociodemographic and clinical characteristics, quality of life and functionality of a sample of patients with AVS over 75 years of age, who underwent TAVR or SAVR, applying standard clinical practice. A prospective multicenter observational study was conducted in two hospitals of the Spanish National Health System. Data were collected at baseline, 1, 6 months and 1 year. Results: In total, 227 participants were included, with a mean age of 80.6 [SD 4.1]. Statistically significant differences were found in terms of quality of life, which was higher at 1 year in patients who underwent SAVR. In terms of functionality, SAVR patients obtained a better score (p < 0.01). However, patients who underwent TAVR began with a worse baseline situation and managed to increase their quality of life and functionality after 1 year of follow-up. Conclusion: The individualized choice of TAVR or SAVR in patients with AVS improves patients' quality of life and function. Moreover, the TAVR procedure in patients with a worse baseline situation and a high surgical risk achieved a similar increase in quality of life and functionality compared to patients undergoing SAVR with a better baseline situation.

A family study on first episode of psychosis patients: Exploring neuropsychological performance as an endophenotype.

INTRODUCTION: Family studies provide a suitable approach to analyzing candidate endophenotypes of schizophrenia, including cognitive features. OBJECTIVE: To characterize different neurocognitive functions in a group of patients with first episode of psychosis (FEP), their first-degree relatives (parents and siblings), and healthy controls (HC), in order to identify potential endophenotypes for schizophrenia spectrum disorders (SSD). METHODS: Participants were assessed in the context of a national project in Spain called PAFIP-FAMILIAS. They completed the same neuropsychological battery, which included tests of verbal memory, visual memory, processing speed, working memory, executive functions, motor dexterity, attention, and theory of mind. Group comparisons were performed using one-way ANOVA, followed by tests of multiple comparisons when appropriate. RESULTS: One hundred thirty-three FEP patients were included, as well as 244 of their first-degree relatives (146 parents and 98 siblings) and 202 HC. In general, relatives showed an intermediate performance between the HC and the FEP patients in all neurocognitive domains. However, the domains of executive functions and attention stood out, as relatives (especially parents) showed similar performance to FEP patients. This was replicated when selecting patients subsequently diagnosed with schizophrenia and their relatives. CONCLUSION: These findings suggest that executive and attention dysfunctions might have a family aggregation and could be relevant cognitive endophenotypes for psychotic disorders. The study shows the potential of exploring intra-family neuropsychological performance supporting neurobiological and genetic research in SSD.

Health Education Intervention for Patients Undergoing Placement of Percutaneous Nephrostomy Tube: A Randomized Controlled Trial.

PURPOSE: The purpose of this study was to compare the economic impact (cost) of percutaneous nephrostomy (PCN) tube care in patients following an educational intervention to no intervention. DESIGN: A randomized controlled trial. SUBJECTS AND SETTING: The sample comprised 178 patients recruited between May 2017 and April 2019. The study setting was the Marqués de Valdecilla University Hospital located in Cantabria on the northern coast of Spain. Data were collected in the hospital's radiology department. METHODS: Participants were randomly allocated to 2 groups: an intervention group received an educational intervention that specifically addressed living with a PCN tube and a control group that received standard instruction. The intervention group received the educational intervention twice, before placement of the nephrostomy and at first tube change (6 weeks later). The main outcome variable was economic impact of the PCN, operationally defined as unscheduled or urgent visits and health care costs related to PCN tube placement. RESULTS: When compared to control group subjects, participants who received the educational intervention had fewer urgent (unscheduled) visits (1.9 vs 4.0; P = .004) and lower direct and indirect health care costs reflecting a savings of €5277 (approximately US $6257). CONCLUSIONS: The health education intervention reduced costs associated with these additional visits when compared to patients receiving standard postprocedural education.

Covid-19: As a Fear Factor in Response to Stroke Code and Other Interventional Radiology Emergencies?

The COVID-19 coronavirus crisis has posed an international challenge for all health systems. The first patient registered in Spain with the COVID-19 coronavirus was known on January 31, and the state of alarm was declared on March 14, 2020. The advance of the infection worldwide has caused a modification of the usual pattern in hospital emergency responses. This study describes the incidence of emergencies in the interventional radiology section of the Marqués de Valdecilla University Hospital and analyzes whether the presence of COVID-19 caused a decrease in the number of patients treated especially for ischemic strokes. A descriptive cross-sectional study was carried out on a sample of 236 patients treated at the interventional radiology on call between June 1, 2019 and May 10, 2020, at the Marqués de Valdecilla University Hospital. No specific results were found that indicate a decrease in the incidence of urgent procedures, especially mechanical thrombectomies in patients with ischemic strokes performed by the interventional radiology team since the establishment of the alarm state by COVID-19 in Cantabria. Patients' fear of contracting COVID-19 infection in the hospital environment has not led to a decrease in urgent procedures, especially for ischemic strokes.

Quality of life, pain and anxiety in patients with nephrostomy tubes.

OBJECTIVE: to evaluate the impact on the quality of life as well as anxiety and pain in patients with nephrostomy tubes. METHOD: this is a longitudinal descriptive study performed on a sample of n=150 patients. To evaluate the quality of life, the EuroQol-5D questionnaire was used; anxiety was quantified by the Beck Anxiety Inventory; to study pain, a visual analogue scale was employed. RESULTS: statistically significant differences were found in the quality of life, with its worsening (r = 0.51; p <0.01) when evaluated at the first tube replacement. Patients presented mild to moderate anxiety before the procedure, which was reduced at the first tube replacement, although this difference was not significant (r = 0.028, p = 0.393). Finally, the degree of pain was also significantly reduced (r = 0.13, p<0.01) after six weeks. As for gender, women presented the worst values ​​in the three variables studied (worse quality of life and greater anxiety and pain). CONCLUSIONS: nephrostomy tubes have a negative impact on the patient's quality of life. During the time they live with these tubes, patients have mild to moderate pain and anxiety.

Quality of life, pain and anxiety in patients with nephrostomy tubes / Qualidade de vida, dor e ansiedade em pacientes com sondas de nefrostomia / Calidad de vida, dolor y ansiedad en pacientes con sondas de nefrostomía

Objective: to evaluate the impact on the quality of life as well as anxiety and pain in patients with nephrostomy tubes. Method: this is a longitudinal descriptive study performed on a sample of n=150 patients. To evaluate the quality of life, the EuroQol-5D questionnaire was used; anxiety was quantified by the Beck Anxiety Inventory; to study pain, a visual analogue scale was employed. Results: statistically significant differences were found in the quality of life, with its worsening (r = 0.51; p <0.01) when evaluated at the first tube replacement. Patients presented mild to moderate anxiety before the procedure, which was reduced at the first tube replacement, although this difference was not significant (r = 0.028, p = 0.393). Finally, the degree of pain was also significantly reduced (r = 0.13, p<0.01) after six weeks. As for gender, women presented the worst values ​​in the three variables studied (worse quality of life and greater anxiety and pain). Conclusions: nephrostomy tubes have a negative impact on the patient's quality of life. During the time they live with these tubes, patients have mild to moderate pain and anxiety.

Objetivo: avaliar o impacto na qualidade de vida, bem como a ansiedade e dor em pacientes com sondas de nefrostomia. Método: estudo descritivo longitudinal realizado em uma amostra de n=150 pacientes. Para avaliar a qualidade de vida, utilizou-se o questionário EuroQol-5D; a ansiedade foi quantificada pelo Inventário de Ansiedade de Beck; para estudar a dor, foi utilizada uma escala visual analógica. Resultados: foram encontradas diferenças estatisticamente significativas na qualidade de vida, com sua piora (r = 0,51; p <0,01) quando avaliada na primeira troca da sonda. Os pacientes apresentaram ansiedade leve a moderada antes do procedimento, que foi reduzida na primeira troca da sonda, embora esta diferença não tenha sido significativa (r = 0,028; p = 0,393). Finalmente, o grau de dor também foi significativamente reduzido (r = 0,13; p<0,01) após seis semanas. Quanto ao sexo, as mulheres apresentaram os piores valores nas três variáveis ​​estudadas (pior qualidade de vida e maior ansiedade e dor). Conclusões: Sondas de nefrostomia têm um impacto negativo na qualidade de vida do paciente. Durante o tempo que convivem com estas sondas, os pacientes têm dor e ansiedade leve a moderada.

Objetivo: valorar el impacto en la calidad de vida, así como la ansiedad y el dolor que presentan los pacientes portadores de sondas de nefrostomía. Método: estudio descriptivo longitudinal que se llevó a cabo sobre una muestra de n=150 pacientes. Para valorar la calidad de vida se empleó el cuestionario EuroQol-5D; la ansiedad fue cuantificada mediante el Inventario de Ansiedad de Beck; para estudiar el dolor se empleó una escala visual analógica. Resultados: encontramos diferencias estadísticamente significativas en la calidad de vida, produciéndose su empeoramiento (r=0.51; p<0.01) cuando fue valorada en el primer cambio de sonda. Los pacientes presentaron una ansiedad leve a moderada previa al procedimiento, que se vio reducida en el primer cambio de sonda, si bien esta diferencia no resultó significativa (r=0.028; p=0.393). Por último, el grado de dolor también se vio disminuido de forma significativa (r=0.13; p<0.01) al cabo de seis semanas. Por sexos, las mujeres presentaron peores valores en las tres variables estudiadas (peor calidad de vida, y mayor ansiedad y dolor). Conclusiones: las sondas de nefrostomía suponen un impacto negativo en la calidad de vida del paciente. Durante el tiempo que conviven con dichas sondas, los pacientes presentan dolor y ansiedad leve a moderada.