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OBJECTIVES: The neurobiological basis and nosological status of schizoaffective disorder remains elusive and controversial. This study provides a systematic review of neurocognitive and neuroimaging findings in the disorder. METHODS: A comprehensive literature search was conducted via PubMed, ScienceDirect, Scopus and Web of Knowledge (from 1949 to 31st March 2015) using the keyword 'schizoaffective disorder' and any of the following terms: 'neuropsychology', 'cognition', 'structural neuroimaging', 'functional neuroimaging', 'multimodal', 'DTI' and 'VBM'. Only studies that explicitly examined a well defined sample, or subsample, of patients with schizoaffective disorder were included. RESULTS: Twenty-two of 43 neuropsychological and 19 of 51 neuroimaging articles fulfilled inclusion criteria. We found a general trend towards schizophrenia and schizoaffective disorder being related to worse cognitive performance than bipolar disorder. Grey matter volume loss in schizoaffective disorder is also more comparable to schizophrenia than to bipolar disorder which seems consistent across further neuroimaging techniques. CONCLUSIONS: Neurocognitive and neuroimaging abnormalities in schizoaffective disorder resemble more schizophrenia than bipolar disorder. This is suggestive for schizoaffective disorder being a subtype of schizophrenia or being part of the continuum spectrum model of psychosis, with schizoaffective disorder being more skewed towards schizophrenia than bipolar disorder.
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Neuroimagen/métodos , Trastornos Psicóticos/diagnóstico por imagen , Trastornos Psicóticos/psicología , Mapeo Encefálico/métodos , Imagen de Difusión por Resonancia Magnética/métodos , Sustancia Gris/diagnóstico por imagen , Sustancia Gris/patología , Humanos , Trastornos Psicóticos/patologíaRESUMEN
OBJECTIVE: Brain structural changes in schizoaffective disorder, and how far they resemble those seen in schizophrenia and bipolar disorder, have only been studied to a limited extent. METHOD: Forty-five patients meeting DSM-IV and RDC criteria for schizoaffective disorder, groups of patients with 45 matched schizophrenia and bipolar disorder, and 45 matched healthy controls were examined using voxel-based morphometry (VBM). RESULTS: Analyses comparing each patient group with the healthy control subjects found that the patients with schizoaffective disorder and the patients with schizophrenia showed widespread and overlapping areas of significant volume reduction, but the patients with bipolar disorder did not. A subsequent analysis compared the combined group of patients with the controls followed by extraction of clusters. In regions where the patients differed significantly from the controls, no significant differences in mean volume between patients with schizoaffective disorder and patients with schizophrenia in any of five regions of volume reduction were found, but mean volumes in the patients with bipolar disorder were significantly smaller in three of five. CONCLUSION: The findings provide evidence that, in terms of structural gray matter brain abnormality, schizoaffective disorder resembles schizophrenia more than bipolar disorder.
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Trastorno Bipolar/patología , Encéfalo/patología , Sustancia Gris/patología , Trastornos Psicóticos/patología , Esquizofrenia/patología , Adulto , Mapeo Encefálico/métodos , Estudios de Casos y Controles , Imagen de Difusión por Resonancia Magnética/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Neuroimagen/métodosRESUMEN
BACKGROUND: Schizo-affective disorder has not been studied to any significant extent using functional imaging. The aim of this study was to examine patterns of brain activation and deactivation in patients meeting strict diagnostic criteria for the disorder. METHOD: Thirty-two patients meeting research diagnostic criteria (RDC) for schizo-affective disorder (16 schizomanic and 16 schizodepressive) and 32 matched healthy controls underwent functional magnetic resonance imaging (fMRI) during performance of the n-back task. Linear models were used to obtain maps of activations and deactivations in the groups. RESULTS: Controls showed activation in a network of frontal and other areas and also deactivation in the medial frontal cortex, the precuneus and the parietal cortex. Schizo-affective patients activated significantly less in prefrontal, parietal and temporal regions than the controls, and also showed failure of deactivation in the medial frontal cortex. When task performance was controlled for, the reduced activation in the dorsolateral prefrontal cortex (DLPFC) and the failure of deactivation of the medial frontal cortex remained significant. CONCLUSIONS: Schizo-affective disorder shows a similar pattern of reduced frontal activation to schizophrenia. The disorder is also characterized by failure of deactivation suggestive of default mode network dysfunction.
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Encéfalo/fisiopatología , Imagen por Resonancia Magnética/métodos , Memoria a Corto Plazo/fisiología , Trastornos Psicóticos/fisiopatología , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética/instrumentación , Masculino , Persona de Mediana Edad , Red Nerviosa/fisiopatología , Pruebas NeuropsicológicasRESUMEN
BACKGROUND: Deficits in memory and executive performance are well-established features of bipolar disorder and schizophrenia. By contrast, data on cognitive impairment in schizoaffective disorder are scarce and the findings are conflicting. METHOD: We used the Wechsler Memory Scale (WMS-III) and the Behavioural Assessment of the Dysexecutive Syndrome (BADS) to test memory and executive function in 45 schizophrenic patients, 26 schizomanic patients and 51 manic bipolar patients in comparison to 65 healthy controls. The patients were tested when acutely ill. RESULTS: All three patient groups performed significantly more poorly than the controls on global measures of memory and executive functioning, but there were no differences among the patient groups. There were few differences in memory and executive function subtest scores within the patient groups. There were no differences in any test scores between manic patients with and without psychotic symptoms. CONCLUSIONS: Schizophrenic, schizomanic and manic patients show a broadly similar degree of executive and memory deficits in the acute phase of illness. Our results do not support a categorical differentiation across different psychotic categories with regard to neuropsychological deficits.
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Trastorno Bipolar/fisiopatología , Trastornos del Conocimiento/fisiopatología , Función Ejecutiva , Trastornos de la Memoria/fisiopatología , Trastornos Psicóticos/fisiopatología , Esquizofrenia/fisiopatología , Adulto , Análisis de Varianza , Trastorno Bipolar/epidemiología , Trastorno Bipolar/psicología , Trastornos del Conocimiento/epidemiología , Trastornos del Conocimiento/psicología , Comorbilidad , Femenino , Humanos , Masculino , Trastornos de la Memoria/epidemiología , Trastornos de la Memoria/psicología , Pruebas Neuropsicológicas/estadística & datos numéricos , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/psicología , Esquizofrenia/epidemiología , Psicología del Esquizofrénico , España/epidemiologíaRESUMEN
INTRODUCTION: The organ and tissue donation interview is a vital step in obtaining the donation. Therefore, it is important to obtain as much information as possible regarding the relatives of the potential donor prior to this interview and know if there is a health care professional among the relatives who may act as an interlocutor. OBJECTIVE: The objective of this study is to assess the influence that relatives who are health care professionals may have if present at the interview for the organ and tissue donation request. METHODS: This is a descriptive study of all the organ donations from 1996 to 2019. Variables of the interview record form were completed by the Regional Transplant Coordination Office. Quantitative variables are expressed as mean (standard deviation) or median (interquartile range), and qualitative variables are expressed in percentage. The χ2 test was used for inferential statistics. RESULTS: Health care professionals were present as interlocutors in 8.4% of the total interviews conducted (9279). Organ donation was accepted in 86% of these interviews, while the relative who was a health care professional gave a 93.8% (729) positive response to the donation. Having a health care professional as an interlocutor favors the acceptance of the donation (odds ratio 9.325, 95% confidence interval: 5.054-17.205; P < .001). CONCLUSION: Health care professionals have a very positive attitude toward donation. This attitude positively impacts other relatives' acceptance of the donation.
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Familia/psicología , Personal de Salud/psicología , Trasplante de Órganos/psicología , Rol Profesional/psicología , Obtención de Tejidos y Órganos , Adulto , Actitud del Personal de Salud , Femenino , Humanos , Masculino , Aceptación de la Atención de Salud/psicología , Donantes de Tejidos/psicologíaRESUMEN
The bifunctionally reactive nucleoside and distant nucleoside analogs adenosine (Ado), S-[(adenine-9-yl)methoxyethyl]-L-cysteine (Na-salt) (cysA) and 9-vinyladenine (vA) in aqueous solutions assemble on complementary polyuridylic acid templates to form complex lyomesophases. The systems are investigated by polarizing microscopy, differential scanning calorimetry (DSC) and 1H- and 31P-nmr spectroscopies, assisted by molecular modeling studies. The results indicate the importance of biomesogenic (pre)ordering in nucleic acid native and artificial matrix reactions.
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Polirribonucleótidos/química , Adenina/análogos & derivados , Adenina/química , Adenosina/química , Rastreo Diferencial de Calorimetría , Sustancias Macromoleculares , Espectroscopía de Resonancia Magnética , Microscopía de Polarización , Modelos Moleculares , Conformación de Ácido Nucleico , Poli U/química , TermodinámicaRESUMEN
Amphiphilic complementary nucleobase derivatives, containing n-octadecyloxymethyl substituents at the N1 position of pyrimidine and N9 of purine, dissolved in chloroform form non-specific lyotropic mesophases, which were analyzed by optical polarizing microscopy. Molecular modeling studies visualize hypothetical horizontal and vertical nucleobase hydrogen-bonding and stacking arrangements, as well as aliphatic long-chain interstrand interaction.
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ADN/química , ADN/síntesis química , Nucleósidos/síntesis química , Cloroformo/química , Enlace de Hidrógeno , Microscopía de Polarización , Modelos Moleculares , Conformación de Ácido NucleicoRESUMEN
The objective is to determine the blood lead levels of the children (7-8 years of age) living in some of Madrid's satellite towns, and to establish links between these levels and different socioeconomic items, life styles and environmental factors, among other variables. A cross-sectional study using a sample based on 205 schoolchildren of Second Grade Primary Education, was under taken during 1995. Venous blood samples were analysed through atomic absorption spectrophotometry. Parents answered a questionnaire with items used in this study. The average blood lead level found was 3.9 mud/dl (CI 95% 3.7-4.1), with higher levels among the children of the Northern zone of Madrid. Between the associated factors to blood lead level was found to be the habit of nail biting, mother's studies and some variables associated with habitual dwelling. We reached the conclusion that the blood lead levels of Madrid's suburban children are low.
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Intoxicación por Plomo/sangre , Salud Suburbana , Niño , Femenino , Humanos , Masculino , Factores Socioeconómicos , EspañaRESUMEN
A series of new acycloguanosine O-alkoxyalkyl derivatives have been obtained by the reaction of 9-(2-hydroxyethoxymethyl)- and 8-bromo-9-(2-hydroxyethoxymethyl)-N2-acetylguanines with cyclic and acyclic alpha-vinyl ethers. 9-[2-(Alkoxyalkyl)oxyethoxymethyl]-N2-acetylguanines are better soluble in water and low-polar organic solvents as compared with acycloguanosine. The compounds have the pronounced antiviral activity against HSV-I in the experiments in vivo and can be applied as acycloguanosine prodrugs.
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Aciclovir/química , Antivirales/química , Nucleósidos de Purina/química , Aciclovir/farmacología , Antivirales/farmacología , Espectroscopía de Resonancia Magnética , Nucleósidos de Purina/farmacología , Simplexvirus/efectos de los fármacosRESUMEN
Agitation is relatively common among Borderline Personality Disorder (BPD) patients in Psychiatric Emergency Services (PES). New injectable atypical antipsychotics are indicated for treatment in agitated psychotic or maniac patients but not for agitated BDP patients. Twenty agitated BPD patients were treated with intramuscular atypical antipsychotics (olanzapine or ziprasidone). Results suggest intramuscular atypical antipsychotics may be effective, fast and safe for treating acute BPD patients.
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Antipsicóticos/administración & dosificación , Trastorno de Personalidad Limítrofe/tratamiento farmacológico , Piperazinas/administración & dosificación , Agitación Psicomotora/tratamiento farmacológico , Tiazoles/administración & dosificación , Adulto , Benzodiazepinas/administración & dosificación , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/tratamiento farmacológico , Comorbilidad , Servicios de Urgencia Psiquiátrica , Femenino , Humanos , Inyecciones Intramusculares , Masculino , Persona de Mediana Edad , Olanzapina , Escalas de Valoración Psiquiátrica , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/tratamiento farmacológico , Esquizofrenia/diagnóstico , Esquizofrenia/tratamiento farmacológico , Resultado del TratamientoRESUMEN
INTRODUCTION: Psychomotor agitation is a common event in psychiatric emergency services (PES) with a prevalence of approximately 10 %. There is no general consensus on to how to manage psychomotor agitation; benzodiazepines, typical antipsychotics and now atypical antipsychotics have demonstrated similar efficacy. The aim of our study was to describe the epidemiology and clinical management of agitation in "real-life" in a psychiatric emergency service. METHODS: A naturalistic study was performed in acutely agitated patients recruited consecutively in a psychiatric emergency service. Demographics, clinical and therapeutic characteristics were analyzed. Efficacy was assessed by the Excitement Component of the Positive and Negative Syndrome Scale (PANSS-EC) and the Agitation-Calmness Evaluation Scale (ACES). Pragmatic variables such as the need for second pharmacological intervention and the need for physical restraints were assessed. RESULTS: The study included 100 patients with psychomotor agitation. Mean age was 36.2 % and 54% were women. The most prevalent diagnoses were psychotic disorder (48 %) and personality disorder (24 %). Physical restraint was required in 39 % of patients and 52 % accepted oral treatment. Haloperidol was the most frequent oral treatment and olanzapine was the most frequent intramuscular treatment. CONCLUSIONS: A naturalistic approach provides data based on clinical reality in psychiatric emergency services. Strict research designs of clinical trials of efficacy imply sample selection biases and are generally distanced from the clinical reality. Atypical antipsychotics have become the first-line treatment in acute agitation
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Servicios de Urgencia Psiquiátrica , Agitación Psicomotora/rehabilitación , Adulto , Femenino , Hospitalización , Hospitales Psiquiátricos , Humanos , Masculino , Agitación Psicomotora/diagnóstico , Agitación Psicomotora/epidemiología , Encuestas y CuestionariosRESUMEN
In this study we investigated the effects of two guanine derivatives, 9-benzyl- (I) and 7-benzyl-8-bromoguanines (II) on the proliferation of human T-cell leukemia and T-cell lymphoma, normal human peripheral blood mononuclear cells (PBMC), and mouse Th1 (pGL10) and Th2 (D10.G4.1) clones. We also assessed their effects on cytokine production (IL-3, IL-10 and IFN-gamma) in PBMC, T-cell lymphoma, HUT78 (IL-2), and murine Th1 (IL-2) and Th2 (IL-4 and IL-5) clones. These compounds were synthesize as analog of known inhibitors of purine nucleoside phosphorylase (PNP) 8-amino-9-benzylguanine. These compounds suppressed proliferation of human leukemia MOLT-4 cells, human cutaneous lymphoma HUT78 cells and normal PMBC. Compound II was a significantly more potent inhibitor than compound I. Exogenous recombinant human IL-2 reversed the anti-proliferative effects of both compounds on HUT78 cells. These compounds had low toxicity to human EBV-transformed B-lymphocytes. Both compounds suppressed the production of IL-2 by activated human HUT78 cells, IFN-gamma by PBMC and did not affect IL-3 and IL-10 production in PBMC. Compound I inhibited anti-CD3-activated IL-2 secretion from the murine Th1 clone. The murine Th2 clone was less sensitive to both compounds as compared with Thl. The production of IL-4 and IL-5 by this clone was not suppressed. Thus, it has been shown that not only 9-substituted guanines but also their 7-isomers selectively inhibit T-cell functions and both selectively inhibit Th1-related cytokines secretion.
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Compuestos de Bencilo/farmacología , Guanina/farmacología , Interleucina-2/metabolismo , Leucocitos Mononucleares/efectos de los fármacos , Linfoma de Células T/metabolismo , Animales , División Celular/efectos de los fármacos , Línea Celular Transformada/efectos de los fármacos , Humanos , Interleucina-2/farmacología , Leucemia de Células T/metabolismo , Ratones , Linfocitos T Colaboradores-Inductores/efectos de los fármacos , Linfocitos T Colaboradores-Inductores/metabolismo , Células Tumorales Cultivadas/efectos de los fármacos , Células Tumorales Cultivadas/metabolismoRESUMEN
This investigation was carried out to show the possible association between groups of children with extreme values of copper and zinc concentrations and cardiovascular risk indicators. Serum copper and zinc concentrations were analysed in a group of 3887 children from Navarra, Spain (both sexes. aged 4-17 years). Hypertension, unfavourable serum lipid profile (total cholesterol, high density lipoprotein cholesterol, low density lipoprotein cholesterol, triglycerides, and cholesterol/HDL and LDL/HDL ratios), and degree of adiposity (weight, height, subcutaneous skinfolds, Quetelet's index and mean of subcutaneous skinfolds) were evaluated. Positive correlation was found between several lipid parameters and copper and zinc concentrations, i.e. degree of correlation related with age, except for copper/HDL and triglycerides/zinc ratios, where correlation remained negative at all points. Copper levels were correlated with adiposity parameters in an age-dependent fashion (Quetelet's index: r = 0.01 for ages 4-7 years to r = 0.10, p < 0.01 for ages 14-17 years; mean skinfold thickness: r = 0.05 for ages 4-7 years up to r = 0.18, p < 0.01 for ages 14-17 years). Most correlations between lipid parameters and copper and zinc are markedly amplified if adiposity parameters are taken into account. However, the only significant association was the established relation between high copper concentrations (> x + 2SD) and unfavourable serum lipid profile (LDL/HDL > 2.2).