Changes in triglyceride levels in ultra-high risk for psychosis individuals treated with omega-3 fatty acids.

AIM: The aim of this analysis was to assess changes in lipid parameters, specifically in triglyceride (TG) levels, in a population at ultra-high risk (UHR) for psychosis treated with ω-3 polyunsaturated fatty acids (PUFAs) versus placebo. METHODS: Data were derived from a randomized, double-blind, placebo-controlled trial conducted at an early psychosis unit. Eighty-one individuals, aged 13-25 years, at UHR for psychosis participated in a 12-week intervention trial of 1.2 g/day of ω-3 PUFAs (n = 41) versus placebo (n = 40). Lipid and C-reactive protein levels were collected at baseline and after 12 weeks. RESULTS: Between-group comparisons showed no significant difference in TG levels after the intervention. However, in individuals with baseline TG levels above 150 mg dL-1 there was a significant mean TG reduction of 67.29 (SD 42.54; P = 0.006) in the ω-3 group (n = 7). CONCLUSION: In this sample of UHR individuals, a 12-week intervention with ω-3 PUFAs was effective in reducing previously elevated TG levels. This might introduce the possibility of altering the lipid profile and thus the risk of cardiovascular morbidity of UHR individuals.

Topical Plasminogen as Adjunctive Treatment in Recurrent Ligneous Conjunctivitis.

Ligneous conjunctivitis is a rare, autosomal recessive, membranous conjunctivitis characterized by a deficiency in type 1 plasminogen. The absence of normal plasmin activity results in the formation of fibrin-rich, membranous material that typically manifests on the palpebral conjunctiva. Surgical treatment often causes irritation of the conjunctiva and accelerated recurrence of pseudomembranes. In this interventional case report, the authors document the results of treatment with topical plasminogen following conjunctival pseudomembrane excision in a 32-year-old woman. The patient underwent pseudomembrane excision in the OS followed immediately by hourly topical application of plasminogen eye drops. The plasminogen was prepared from pooled human plasma purchased under Food and Drug Administration approval from DiaPharma. Follow-up evaluation at 1 week, 1 month, and 5 months showed no evidence of recurrent pseudomembranous change. Adjunctive topical plasminogen application appears to be an effective and safe method of controlling pseudomembrane recurrence in patients with ligneous conjunctivitis.

[Early detection of psychotic disorders]. / Früherkennung psychotischer Störungen.

UNLABELLED: Over the last decade there has been considerable interest in early intervention in schizophrenia and other psychotic disorders, driven by observations that early intervention might favorably alter the course of illness. New clinical and research programs have been established around the globe aiming to reduce treatment delays in psychosis and, more recently, to identify and possibly treat individuals in the pre-psychotic phase who are at imminent risk of developing psychosis. Since May 2004, a service for individuals at high risk (HR) for psychosis has been established at Vienna General Hospital. Individuals are offered comprehensive assessment and treatment which includes participation in a RCT investigating the effects of Omega-3 fatty acids versus placebo in addition to standard care. The aim of this article is to describe (1) classification of psychotic symptoms in incipient psychosis and (2) findings of the screening process as well as baseline characteristics in individuals with and without transition to psychosis. INCLUSION CRITERIA: 1. Age 13 to 24 years 2. High Risk (HR) as classified by Yung et al. (1998) HR criteria: one or more of following characteristics occurred within the last 12 months: 1. Frank psychotic symptoms < 1 week 2. Attenuated psychotic symptoms > 1 week, several times per week 3. Drop in GAF of > 30% (>1 months) plus family history of psychosis or individual has schizotypal personality disorder Other psychiatric measures: SCID for DSM-IV, PANSS, MADRS, and the UKU side effect rating scale. Between May 2004 and June 2005, 140 individuals were referred to our service for suspected psychosis. 69 individuals (49,3%) met HR criteria, 21 (15%) were detected with first-episode psychosis at initial presentation; 50 (35,7%) individuals did not meet criteria for HR or DSM-IV psychotic disorder. 42 (60,9%) of 69 individuals with HR agreed to participate in the proposed EPA/DHA treatment trial. Co-morbidity of axis-I disorders was high in the HR group: 54,3% affective disorders, 40% anxiety/obsessive-compulsive disorders, 14,3 substance related disorders, 11,4% eating disorders and 2,9% somatoform disorders. To date 6 (14,3%) individuals have made a transition to psychotic disorder. These subjects scored significantly higher at the negative and at the general psychopathology scale ofPANSS and at the MADRS at time of randomization. Early detection and intervention in psychotic disorders seems to be a feasible goal which can be achieved in an outpatient setting. Individuals with HR can be detected and already show a substantial loss of functioning. In the process of screening for individuals with HR a high number of undiscovered cases of psychosis can be found. Given their high prevalence, treatment of comorbid axis-I conditions should be carefully addressed in HR and studied in relation to the risk of progression to psychosis. In contrast to antipsychotics, Omega-3 fatty acids have a high acceptance among youth and parents. At this stage the role of Omega-3 fatty acids remains unclear because the trial is not finished yet.