Neurocognitive correlates of the varied domains of outcomes at 20 year follow-up of first-episode psychosis.

Little is known about long-term outcomes of the first episode of psychosis (FEP) other than in the symptomatic domain. We hypothesised that cognitive impairment is associated with poorer multi-domain outcomes at a long-term follow-up of FEP patients. We followed-up 172 FEP patients for a mean of 20.3 years. Ten outcome dimensions were assessed (symptomatic, functional and personal recovery, social disadvantage, physical health, suicide attempts, number of episodes, current drug use, chlorpromazine equivalent doses (CPZ), and schizophrenia/schizoaffective disorder final diagnosis). Cognition was assessed at follow-up. Processing speed and verbal memory deficits showed significant associations with poor outcomes on symptomatic, social functioning, social disadvantage, higher number of episodes, and higher CPZ. Significant associations were found between visual memory impairments were significantly associated with low symptomatic and functional recovery, between attentional deficits and a final diagnosis of schizophrenia/schizoaffective disorder, and between social cognition deficits and poor personal recovery.Lower cognitive global scores were significantly associated with all outcome dimensions except for drug abuse and physical status. Using multiple outcome dimensions allowed for the inclusion of the patients' perspective and other commonly neglected outcome measures. Taken together, cognitive impairment in FEP patients is strongly related to poor performance on several outcome dimensions beyond symptomatic remission.

Perspectivas de una producción sostenible en acuicultura multitrófica integrada (IMTA): una revisión / Prospects for sustainable production in integrated multitrophic aquaculture (IMTA): a review

RESUMEN La acuicultura tradicional se enfrenta a serios problemas medioambientales, particularmente por el uso de grandes volúmenes de agua, con las consecuentes descargas de efluentes ricos en nutrientes inorgánicos y partículas orgánicas. Un ejemplo claro de esto está en que del 20 al 30% del nitrógeno presente en la proteína del alimento suministrado es aprovechado por los peces, el restante 70-80% es desechado en el cuerpo de agua producto de la excreción y el alimento no consumido, lo que favorece la eutrofización de aguas receptoras y su entorno. Por lo anterior, se requiere el desarrollo de tecnologías y prácticas de producción innovadoras, responsables, sostenibles y rentables. Una de las alternativas que está generando interés, debido a sus implicaciones ambientales, económicas y sociales, es la producción en sistemas de acuicultura multitrófica integrada (IMTA). Este concepto se basa en la integración de diferentes niveles tróficos en un mismo sistema, lo que resulta en una conversión de los residuos de cultivo de unas especies en alimentos o fertilización para otras especies. Aplicada, la producción IMTA puede mejorar la sostenibilidad de la acuicultura al reducir el impacto de los efluentes y generar mayor rentabilidad económica, debido a la producción simultanea de dos o más productos finales y al uso mínimo de fertilizantes. El objetivo de la presente revisión es presentar los fundamentos básicos de los sistemas de IMTA, como una alternativa a los sistemas de producción en piscicultura.

ABSTRACT Traditional aquaculture faces serious environmental problems, particularly due to the use of large volumes of water, with the consequent discharge of effluents rich in inorganic nutrients and organic particles. A clear example of this is that only 20 to 30% of the nitrogen present in the protein of the supplied food is used by the fish. The remaining 70 to 80% is disposed of in the water body as a result of excretion and unconsumed food, favoring the eutrophication of receiving waters and their environment. Therefore, the development of innovative, responsible, sustainable, and profitable technologies and production practices is required. One of the alternatives that is generating interest due to its environmental, economic, and social implications is the production in integrated multitrophic aquaculture systems (IMTA). This concept is based on the integration of different trophic levels in the same system, which results in a conversion of the culture residues of some species into food or fertilization for other species. Applicated, the IMTA systems can improve the sustainability of aquaculture by reducing the impact of effluents, generating greater economic profitability due to the simultaneous production of two or more end products and minimal use of fertilizers. The objective of this review is to present fundamentals basic aspects of IMTA systems, as an alternative to fish farming production systems.

[Sentinel node biopsy after neoadjuvant chemotherapy in breast cancer. Its relation with molecular subtypes]. / La biopsia del ganglio centinela después de quimioterapia neoadyuvante en el cáncer de mama. Relación con los subtipos moleculares.

OBJECTIVE: To evaluate the influence of the molecular subtype (MS) in the Sentinel Node Biopsy (SNB) technique after neoadjuvant chemotherapy (NAC) in women with locally advanced breast cancer (BC) and a complete axillary response (CR). MATERIAL AND METHODS: A prospective study involving 70 patients with BC treated with NAC was carried out. An axillary lymph node dissection was performed in the first 48 patients (validation group: VG), and in case of micro- or macrometastases in the therapeutic application phase (therapy group:TG). Classified according to MS: 14 luminal A; 16 luminal B HER2-, 13 luminal B HER2+, 10HER2+ non-luminal, 17 triple-negative. RESULTS: SNB was carried out in 98.6% of the cases, with only one false negative result in the VG (FN=2%). Molecular subtype did not affect SN detection. Despite the existence of axillary CR, statistically significant differences were found in the proportion of macrometastasis (16.7% vs. 35.7%, p=0.043) on comparing the pre-NAC cN0 and cN+. Breast tumor response to NAC varied among the different MS, this being lowest in luminal A (21.5%) and highest in non-luminal HER2+ group (80%). HER2+ and triple-negative were the groups with the best axillary histological response both when there was prior clinical involvement and when there was not. CONCLUSIONS: Molecular subtype is a predictive factor of the degree of tumor response to NAC in breast cancer. However, it does not affect SNB detection and efficiency. SNB can also be used safely in women with prior node involvement as long as a complete clinical and radiological assessment is made of the node response to NAC.

Acute venous thrombosis as complication and clue to diagnose a SAPHO syndrome case. A case report.

This report concerns a male adult admitted for sternal and left arm pain, who was diagnosed and treated for acute deep venous thrombosis in the left subclavian and axillary veins. X-ray and a hybrid single photon emission tomography and computed tomography (SPECT-CT) scintigraphy scan revealed high intensity uptake in both sternoclavicular joints, which corresponded to hyperostosis, thereby suggesting a SAPHO syndrome. Upon reviewing the patient's medical history, we found dermatological pustulosis disease and an intermittent sternal chest pain untreated since 10 years ago. In the biochemical study we found erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) elevation, hyperglobulinemia, and mild anaemia. Initial treatment included nonsteroidal anti-inflammatory drugs (NSAIDs) with low response, which then changed to methotrexate, sulfasalazine, and prednisone. The patient's pain was controlled almost completely in 10 months. A control bone scan revealed a marked decrease in intensity of bone deposits according to clinical response. To our knowledge, there are only a few cases of SAPHO and thrombosis and none are followed up with a bone SPECT-CT scan.