Immune and oxidative stress biomarkers in pediatric psychosis and psychosis-risk: Meta-analyses and systematic review.

OBJECTIVE: While genetic and cohort studies suggest immune and reduction/oxidation (redox) alterations occur in psychosis, less is known about potential alterations in children and adolescents. METHODS: We conducted a systematic review to identify immune and redox biomarker studies in children and adolescents (mean age ≤ 18 years old) across the psychosis spectrum: from psychotic like experiences, which are common in children, to threshold psychotic disorders like schizophrenia. We conducted meta-analyses when at least three studies measured the same biomarker. RESULTS: The systematic review includes 38 pediatric psychosis studies. The meta-analyses found that youth with threshold psychotic disorders had higher neutrophil/lymphocyte ratio (Hedge's g = 0.40, 95 % CI 0.17 - 0.64), tumor necrosis factor (Hedge's g = 0.38, 95 % CI 0.06 - 0.69), C-reactive protein (Hedge's g = 0.38, 95 % CI 0.05 - 0.70), interleukin-6 (Hedge's g = 0.35; 95 % CI 0.11 - 0.64), and total white blood cell count (Hedge's g = 0.29, 95 % CI 0.12 - 0.46) compared to youth without psychosis. Other immune and oxidative stress meta-analytic findings were very heterogeneous. CONCLUSION: Results from several studies are consistent with the hypothesis that signals often classified as "proinflammatory" are elevated in threshold pediatric psychotic disorders. Data are less clear for immune markers in subthreshold psychosis and redox markers across the subthreshold and threshold psychosis spectrum. Immune and redox biomarker intervention studies are lacking, and research investigating interventions targeting the immune system in threshold pediatric psychosis is especially warranted.

After a disaster: Validation of PTSD checklist for DSM-5 and the four- and eight-item abbreviated versions in mental health service users.

Posttraumatic stress disorder (PTSD) is a common and disabling condition developing in one of four survivors after an earthquake. Brief and self-reported validated measures for assessing PTSD symptom severity are necessary to improve care access and assess disorder progress and treatment response. Therefore, we evaluated the psychometric properties of the PTSD-Checklist for the DSM-5 (PCL-5) of 20-, 8- and 4-item in patients that sought specialized mental health services after a catastrophic earthquake that stroke Mexico on September 19th, 2017. The internal consistency of 20-, 8- and 4-item PCL-5 was adequate (≥.7). Using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5) as a reference, signal detection analyses revealed a PCL-5 score of 27 as optimal (sensitivity = .96, specificity = .73) for identifying probable PTSD cases. The shortened versions highly correlated with the full PCL-5 and had comparable diagnostic utility. Our results indicate that the 20-item PCL-5 and the abridged versions can effectively identify possible PTSD cases. The 8-item version has better psychometric properties and more consistent diagnostic utility across time and civil populations. These measures must be evaluated in independent samples to corroborate their utility in different populations and regarding diverse traumatic events.

[Adult Grisel Syndrome and Cervical Skull instability. Transnasal endoscopic odontoidectomy and occipito-cervical fusion. Case report and literature review]. / Síndrome de Grisel en el adulto e inestabilidad cráneo cervical. Odontoidectomía endoscópica transnasal y fijación occípito-cervical. Reporte de caso y revisión de literatura.

BACKGROUND: Craniocervical junction pathology is infrequent in daily neurosurgical practice. In general, most of these lesions are of traumatic or rheumatic origin. Atlantoaxial instability of inflammatory origin (Grisel syndrome) is a rare entity of which only 16 adult cases have been reported in the literature. This pathology is characterized by the development of an osteolytic lesion at the level of the atlantoaxial joint after an infectious event, usually of the upper airways. CASE DESCRIPTION: We present the case of a 76-year-old patient who attended our office for clinical symptoms of spinal instability secondary to an osteolytic lesion, with involvement of C1 and C2. The symptomatology began after an infectious respiratory process. A posterior cervical occiput fixation and an endoscopic transnasal odontoidectomy with anterior decompression were performed. The patient evolved with complete resolution of symptoms. The cultures were negative, and the pathological anatomy study concluded nonspecific inflammatory changes. CONCLUSION: Until a few years ago, the only option to address this pathology was the transoral pathway with microsurgical technique. Nowadays, endoscopy offers many technical advantages. This is an option to be considered when planning approaches to craniocervical junction.

[Relation of red cell distribution width and mean platelet volume with the severity of preeclampsia]. / Severidad de la preeclampsia y su relacion con volumen plaquetario y ancho de distribucion eritrocitaria.

BACKGROUND: It has been established a strong association between the red cell distribution width (RDW) and mean platelet volume (MPV) with hypertension in non-pregnant patients. However, few studies have been performed in patients with preeclampsia, yielding inconsistent results. Our aim is to evaluate the relationship between RDW and MPV with the severity of preeclampsia. METHODS: Analytic cross-sectional study. We include 64 patients with preeclampsia (26 mild, 38 severe) and 70 patients with normotensive pregnancy. Clinical data, sociodemographic characteristics and laboratory measures, including RDW and MPV, were recorded for each patient. RESULTS: Hemoglobin and platelet count measures were similar between groups. Preeclamptic patients had levels of RDW (14.7 ± 1.4 vs. 13.4 ± 0.7, p = 0.0001) and MPV (11.8 ± 2.4 vs. 11.0 ± 1.4, p = 0.03) more elevated than control group. Moreover, severe preeclamptic subgroup had more elevated levels of RDW (15.0 ± 1.6 vs. 14.0 ± 0.6, p = 0.001) and MPV (12.7 ± 2.8 vs. 10.8 ± 1.8, p = 0.01) in comparison with mild preeclamptic patients. CONCLUSIONS: We demonstrate that RDW and MPV are accessible and inexpensive measures associated with the severity of preeclampsia.

Introducción: se ha establecido fuertemente la asociación entre el ancho de distribución eritrocitario (ADE) y el volumen plaquetario medio (VPM) con la hipertensión arterial sistémica. Sin embargo, se han realizado pocos estudios en pacientes con preeclampsia, obteniéndose resultados inconsistentes. Nuestro objetivo es evaluar la relación entre el ADE y el VPM con la severidad de la preeclampsia. Métodos: incluimos 64 pacientes con preeclampsia (26 leve, 38 severa) y 70 pacientes con embarazo normotenso. Los datos clínicos, características sociodemográficas y valores de laboratorio, incluyendo ADE y VPM, fueron registrados en cada paciente. Resultados: las medidas de hemoglobina y conteo plaquetario fueron similares entre ambos grupos. Las pacientes con preeclampsia tuvieron niveles de ADE (14.7 ± 1.4 frente a 13.4 ± 0.7, p = 0.0001) y VPM (11.8 ± 2.4 frente a 11.0 ± 1.4, p = 0.03) más elevados que el grupo control. El subgrupo de preeclampsia severa tuvo niveles más elevados de ADE (15.0 ± 1.6 frente a 14.0 ± 0.6, p = 0.001) y VPM (12.7 ± 2.8 frente a 10.8 ± 1.8, p = 0.01) que las pacientes con preeclampsia leve. Conclusiones: se demuestra que el ADE y el VPM son medidas accesibles asociadas a la severidad de la preeclampsia.

Combinacion de taping con escuela de columna en pacientes con lumbalgia cronica: ensayo clinico controlado aleatorizado / Combination of taping with back school in patients with chronic low back pain: a randomized controlled clinical trial

Introducción: El 70-85% de la poblacion general sufre dolor lumbar. Se ha demostrado que los programas de Escuela de Columna son eficaces para el tratamiento de la lumbalgia cronica. El taping podria ser util para disminuir el dolor y normalizar la funcion muscular. El objetivo de este estudio fue evaluar la eficacia a corto y a largo plazo del taping combinado con la Escuela de Columna en el tratamiento de la lumbalgia cronica. Materiales y Métodos: Ensayo clinico controlado aleatorizado. El grupo experimental utilizo cinta (tape) y realizo Escuela de Columna, y el grupo de control solo realizo Escuela de Columna. Al comienzo y al final del tratamiento, se registraron el dolor con la escala analogica visual, la flexibilidad con el Modified Finger Tip-to-Floor Test y la funcionalidad con el Roland Morris Disability Questionnaire. Solo al inicio se midio la depresion con el Beck Depression Inventory. Resultados: Se incluyeron 220 pacientes, solo 42 del grupo experimental y 33 del grupo de control completaron el tratamiento. El delta de dolor entre la primera y la quinta sesion no mostro diferencias entre los grupos, independientemente del tiempo (p = 0,329). Tampoco hubo diferencias entre los grupos en las determinaciones de depresion, funcionalidad (p = 0,75) y flexibilidad (p = 0,20). Conclusión: El taping combinado con Escuela de Columna comparado con el tratamiento exclusivo de Escuela de Columna no resulto mas eficaz para disminuir el dolor, aumentar la funcionalidad y la flexibilidad en los pacientes con lumbalgia cronica.

Introduction: From 70% to 85% of the general population suffers from back pain. Back School programs have been effective in the treatment of chronic low back pain. Taping may be useful in reducing pain and normalizing muscle function. The objective of this study was to evaluate the short- and long-term effectiveness of combining taping with Back School. Methods: Randomized controlled clinical trial. The experimental group used tape and made Back School and the control group only made Back School. At the beginning and the end of treatment, pain was evaluated with a visual analogue scale, the flexibility was determined with the Modified Finger Tip-to-Floor Test and functionality was calculated with the Roland Morris Disability Questionnaire. Depression was recorded with the Depression Beck Inventory just at the beginning. Results: Two hundred and twenty patients were enrolled, only 42 in the experimental group and 33 in the control group completed the treatment. Pain variation between the first and the fifth session showed no differences between groups regardless of time (p = 0.329). There were no differences between groups in functionality (p = 0.75), flexibility (p = 0.20) and depression. Conclusion: The combination of taping and Back School compared with only Back School was not more effective in reducing pain, increasing functionality and flexibility in patients with chronic low back pain.