Mitochondrial Variation of Bottlenose Dolphins (Tursiops truncatus) from the Canary Islands Suggests a Key Population for Conservation with High Connectivity within the North-East Atlantic Ocean.

In recent decades, worldwide cetacean species have been protected, but they are still threatened. The bottlenose dolphin (Tursiops truncatus) is a vulnerable keystone species and a useful bioindicator of the health and balance of marine ecosystems in oceans all over the world. The genetic structure of the species is shaped by their niche specialization (along with other factors), leading to the classification of two ecotypes: coastal and pelagic. In this study, the genetic diversity, population structure, and ecotypes of bottlenose dolphins from the Canary Islands were assessed through the analysis of 49 new samples from biopsies and from stranded animals using the 636 bp portion of the mitochondrial control region and 343 individuals from databases (n = 392). The results reveal high genetic diversity in Canarian bottlenose dolphins (Hd = 0.969 and π = 0.0165) and the apparent lack of population genetic structure within this archipelago. High genetic structure (Fst, Φst) was found between the Canary Islands and coastal populations, while little to no structure was found with the pelagic populations. These results suggest that Canarian bottlenose dolphins are part of pelagic ecotype populations in the North Atlantic. The studied Special Areas of Conservation in the Canary Islands may correspond to a hotspot of genetic diversity of the species and could be a strategic area for the conservation of the oceanic ecotype of bottlenose dolphins.

Use of marine debris as nest material by ospreys.

The use of anthropogenic debris as nest-building materials may affect nest function. We study ospreys (Pandion haliaetus) on an island with scarce vegetation and high availability of beached marine debris. We describe the anthropogenic debris in osprey nests, evaluate the factors affecting its prevalence and abundance, and test its potential effects on breeding parameters. We also quantify plastic entanglements among adults and nestlings. Of the 36 studied nests, 92 % included non-natural items, with plastic being the most frequent material (88.9 %). Nests that were bigger and closer to the coast had more anthropogenic items. The abundance of anthropogenic items in nests did not correlate with osprey breeding parameters. We recorded two live entangled adult females, which represent 3.9 % of the adult population. Monitoring the abundance of anthropogenic debris and its effects on wildlife is necessary to guarantee long-term viability of coastal wildlife.

[Diabetes mellitus and Friedreich´s ataxia in a child: a complicated coexistence]. / Diabetes mellitus y ataxia de Friedreich en un niño: una difícil coexistencia.

Friedreich's ataxia is an autosomal recessive disease caused by trinucleotide repeat expansion, presenting among other systemic complications, diabetes mellitus. The appearance of motor clumsiness, with running and jumping difficulties in a 6-year-old boy prompted the genetic study of Friedreich's ataxia, confirming his diagnosis. After diagnosis, it was evaluated by Pediatric Cardiology, detecting the presence of non-obstructive hypertrophic cardiomyopathy, and by Pediatric Endocrinology, due to overweight. At 9 years of age, he was diagnosed with diabetes mellitus, a regimen of insulin treatment was initiated. During follow-up, he presented significant neurological deterioration, reaching the use of a wheelchair, which hinders adequate metabolic control. This is a report of a pediatric patient with Friedrich ataxia and diabetes mellitus.

La ataxia de Friedreich, de herencia autosómica recesiva causada por una expansión repetida de trinucleótidos se asocia, entre otras complicaciones sistémicas, con diabetes mellitus. La aparición de torpeza motriz, con dificultad en la carrera y el salto en un varón de 6 años motivaron el estudio genético para ataxia de Friedrich y permitieron confirmar el diagnóstico. Tres años más tarde, se diagnosticó diabetes mellitus y se inició el tratamiento con insulina. Durante el seguimiento, presentó un importante deterioro neurológico, con necesidad de usar silla de ruedas, lo que dificultó un adecuado control metabólico. Se presenta el manejo y la evolución de un paciente con ataxia de Friedreich y diabetes mellitus.

Diabetes mellitus y ataxia de Friedreich en un niño: una difícil coexistencia / Diabetes mellitus and Friedreich´s ataxia in a child: a complicated coexistence

La ataxia de Friedreich, de herencia autosómica recesiva causada por una expansión repetida de trinucleótidos se asocia, entre otras complicaciones sistémicas, con diabetes mellitus. La aparición de torpeza motriz, con dificultad en la carrera y el salto en un varón de 6 años motivaron el estudio genético para ataxia de Friedrich y permitieron confirmar el diagnóstico. Tres años más tarde, se diagnosticó diabetes mellitus y se inició el tratamiento con insulina. Durante el seguimiento, presentó un importante deterioro neurológico, con necesidad de usar silla de ruedas, lo que dificultó un adecuado control metabólico. Se presenta el manejo y la evolución de un paciente con ataxia de Friedreich y diabetes mellitus

Friedreich's ataxia is an autosomal recessive disease caused by trinucleotide repeat expansion, presenting among other systemic complications, diabetes mellitus. The appearance of motor clumsiness, with running and jumping difficulties in a 6-year-old boy prompted the genetic study of Friedreich's ataxia, confirming his diagnosis. After diagnosis,it was evaluated by Pediatric Cardiology, detecting the presence of non-obstructive hypertrophic cardiomyopathy, and by Pediatric Endocrinology, due to overweight. At 9 years of age, he was diagnosed with diabetes mellitus, a regimen of insulin treatment was initiated. During follow-up, he presented significant neurological deterioration, reaching the use of a wheelchair,which hinders adequate metabolic control. This is a report of a pediatric patient with Friedrich ataxia and diabetes mellitus.

Volumetric study of brain MRI in a cohort of patients with neurotransmitter disorders.

PURPOSE: Inborn errors of neurotransmitters are rare monogenic diseases. In general, conventional neuroimaging is not useful for diagnosis. Nevertheless, advanced neuroimaging techniques could provide novel diagnosis and prognosis biomarkers. We aim to describe cerebral volumetric findings in a group of Spanish patients with neurotransmitter disorders. METHODS: Fifteen 3D T1-weighted brain images from the International Working Group on Neurotransmitter related Disorders Spanish cohort were assessed (eight with monoamine and seven with amino acid disorders). Volumes of cortical and subcortical brain structures were obtained for each patient and then compared with those of two healthy individuals matched by sex and age. RESULTS: Regardless of the underlying disease, patients showed a smaller total cerebral tissue volume, which was apparently associated with clinical severity. A characteristic volumetric deficit pattern, including the right Heschl gyrus and the bilateral occipital gyrus, was identified. In severe cases, a distinctive pattern comprised the middle and posterior portions of the right cingulate, the left superior motor area and the cerebellum. In succinate semialdehyde dehydrogenase deficiency, volumetric affection seems to worsen over life. CONCLUSION: Despite the heterogeneity and limited size of our cohort, we found novel and relevant data. Total volume deficit appears to be a marker of severity, regardless of the specific neurotransmitter disease and irrespective of the information obtained from conventional neuroimaging. Volumetric assessment of individual brain structures could provide a deeper knowledge about pathophysiology, disease severity and specific clinical traits.

Epilepsia dependiente de piridoxina por deficiencia en el gen PNPO / Pyridoxine-dependent epilepsy due to deficiency in the PNPO gene

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Desarrollo psicomotor en prematuros tardíos a los dos años de edad: comparación con recién nacidos a término mediante dos herramientas diferentes / Psychomotor development in late preterms at two years of age: a comparison with full-term newborn infants using two different instruments

Introducción. Los prematuros tardíos constituyen actualmente el 70% de los nacimientos prematuros. Presentan mayor comorbilidad, incluyendo las alteraciones del neurodesarrollo, que pueden no manifestarse hasta la escolarización. Objetivo. Identificar dificultades en el desarrollo neurológico a los dos años de edad. Sujetos y métodos. Se valoró el desarrollo psicomotor a los dos años de los prematuros tardíos y del grupo control a término nacidos en nuestro centro entre enero y septiembre del año 2014 mediante la escala de Brunet-Lézine revisada y el cuestionario de edades y etapas para la detección de trastornos del neurodesarrollo Ages & Stages Questionnaires (ASQ-3). Resultados. Se incluyó a 88 niños. Los prematuros tardíos presentaron puntuaciones inferiores en el lenguaje y el desarrollo postural. Las niñas obtuvieron resultados superiores en la edad de desarrollo global, la coordinación oculomotriz, el lenguaje y la sociabilidad. El cuestionario ASQ-3 detectó las diferencias en comunicación y socioindividuales. Se identificaron como factores de riesgo para presentar alteración del desarrollo la prematuridad, para alteración del lenguaje, y el sexo masculino, para menor edad de desarrollo y alteración del lenguaje. La correlación entre la valoración del lenguaje con la escala de Brunet-Lézine revisada y el cuestionario ASQ-3 fue buena, con un coeficiente de correlación de Pearson de 0,7 (p < 0,001), lo que nuestra la utilidad del cuestionario. Conclusiones. Los prematuros tardíos presentan menor desarrollo del lenguaje a los dos años. La prematuridad y el sexo masculino son factores de riesgo para presentar alteración. La valoración del lenguaje con el cuestionario ASQ-3 puede ser útil para detectar alteraciones

Introduction. Late preterm infants currently constitute 70% of preterm infant births. They present greater comorbidity, including neurodevelopment disorders, which may not manifest until the school age. Aim. To identify the existence of difficulties in the neurodevelopment at the age of two years. Subjects and methods. The psychomotor development was performed at two years of age in late preterm infants and term control group born at our center between January and September 2014, with Brunet-Lezine Revised test and Ages & Stages Questionnaires (ASQ-3) questionnaire. Results. 88 children were included. Late preterm infants had lower scores in the language area and postural developmental. Girls achieved better results than males at global developmental age, oculo-motor coordination, language area and sociability. The ASQ-3 questionnaire detected differences in communication and socio-individual. Prematurity and male sex were identified as an independent risk factor to present a developmental disorder, prematurity for language impairment and male sex for younger developmental age and language impairment. The correlation between language assessment with the Brunet-Lezine Revised test and the ASQ-3 questionnaire was good, with a Pearson correlation coefficient of 0.7 (p < 0.001), showing the usefulness of the questionnaire. Conclusions. Late preterm infants have a lower developmental age in the language area at two years. Prematurity and male sex are risk factors for developmental disorder. Language assessment with the ASQ-3 questionnaire may be a useful tool to detect disorders and intervene early

Mutación puntual de novo en el gen KCND3 en un paciente con ataxia crónica de inicio precoz / De novo sporadic mutation in the KCND3 gene in a patient with early onset chronic ataxia

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Supplemental feeding and other anthropogenic threats to green turtles (Chelonia mydas) in the Canary Islands.

Green turtles are found in the waters of the Canary Islands but little is known about the ecology and anthropogenic pressures that threaten them. Our results have revealed that juvenile green turtles, ranging in curve carapace length from 26.9-81.0cm, are regularly found in the archipelago and originate from rookeries in both the eastern and western Atlantic. Photo-identification and satellite tracking showed high levels of site fidelity to coastal foraging grounds associated with seagrass meadows, but stable isotope analysis indicated animal-based omnivorous diets after settlement on the continental shelf, with no increase in the consumption of macrophytes as the turtles grew. Most turtles exhibited high levels of some blood biochemical markers associated with a high consumption of proteins and fat. In addition, we determined levels of some organic and inorganic pollutants. Supplemental feeding may also contribute to explain the high prevalence of hooking and boat strikes in the green turtles brought to wildlife rescue centers as compared with loggerhead turtles. Regulatory measures and surveillance should be urgently implemented in order to improve the status of the species in the archipelago.

Comparison of psychodrug prescription patterns in patients diagnosed with bipolar disorder and addiction.

OBJECTIVE: To describe if there are differences in the prescription of psychodrug at discharge between bipolar disorder patients with or without addiction. METHODS: We review all the psychotropic drugs dispensed to inpatients of a brief hospitalization psychiatric unit diagnosed as having bipolar disorder at time of discharge. We recluted 225 patients over 18 years old on their last manic episode, between the year 2000 and 2010. We classify them according to the comorbid presence or not of a substance abuse or dependence disorder. RESULTS: Prevalence of addiction was 24%. We found no differences between groups in the number of psychotropic drugs prescribed at discharge. The prescription pattern of mood stabilizers and benzodiazepines was similar in both groups. We detect differences in the total daily dose of antipsychotic, expressed as risperidone equivalents (5.86 ± 4.62 mg in addictions group versus 4.67 ± 3.20 mg in control group, p=0.042) and in the total daily dose of biperideno (4.80 ± 1.78 mg in addictions group versus 3.20 ± 1.03 mg in the control group, p=0.044). CONCLUSIONS: Contrary to our expectations, both groups were similar in psychopharmacological prescription patterns at discharge. However, those patients with substance abuse disorder had higher doses of antipsychotics and higher dose biperiden at discharge.

Comparación de los patrones de prescripción farmacológica en pacientes diagnosticados de trastorno bipolar y adicción / Comparison of psychodrug prescription patterns in patients diagnosed with bipolar disorder and addiction

Objetivo. Analizar si existen diferencias en la prescripción de psicofármacos en el momento del alta hospitalaria entre los pacientes con trastorno bipolar con o sin adicción. Métodos. Revisamos todos los psicofármacos dispensados en el momento del alta a todos los pacientes con diagnóstico de trastorno bipolar de una unidad psiquiátrica de hospitalización breve. Seleccionamos a 225 pacientes mayores de 18 años en su último episodio maníaco, entre los años 2000 y 2010. Los clasificamos de acuerdo a la presencia o ausencia de un diagnóstico comórbido en adicciones. Resultados. La prevalencia de adicciones fue del 24%. No encontramos diferencias entre grupos en cuanto al número de psicofármacos prescritos al alta. El patrón de prescripción de los estabilizadores del ánimo y las benzodiacepinas fue similar en ambos grupos. Detectamos diferencias en cuanto a la dosis diaria total de antipsicóticos expresada como equivalentes de risperidona (5.86 ± 4.62 mg en el grupo de adicciones frente a 4.67 ± 3.20 mg en el grupo control, p=0.042) y en cuanto a las dosis diaria total de biperideno (4.80 ± 1.78 mg en el grupo de adicciones frente a 3.20 ± 1.03 mg en el grupo control, p=0.044). Conclusiones. Contrariamente a nuestras expectativas, ambos grupos presentaron similares patrones de prescripción psicofarmacológicos al alta. Sin embargo, los pacientes con diagnóstico en adicción tenían dosis más elevadas de antipsicóticos (expresadas como dosis equivalente de risperidona) y dosis superiores de biperideno al alta, respecto a las dosis utilizadas por el grupo control

Objective. To describe if there are differences in the prescription of psychodrug at discharge between bipolar disorder patients with or without addiction. Methods. We review all the psychotropic drugs dispensed to inpatients of a brief hospitalization psychiatric unit diagnosed as having bipolar disorder at time of discharge. We recluted 225 patients over 18 years old on their last manic episode, between the year 2000 and 2010. We classify them according to the comorbid presence or not of a substance abuse or dependence disorder. Results. Prevalence of addiction was 24%. We found no differences between groups in the number of psychotropic drugs prescribed at discharge. The prescription pattern of mood stabilizers and benzodiazepines was similar in both groups. We detect differences in the total daily dose of antipsychotic, expressed as risperidone equivalents (5.86 ± 4.62 mg in addictions group versus 4.67 ± 3.20 mg in control group, p=0.042) and in the total daily dose of biperideno (4.80 ± 1.78 mg in addictions group versus 3.20 ± 1.03 mg in the control group, p=0.044). Conclusions. Contrary to our expectations, both groups were similar in psychopharmacological prescription patterns at discharge. However, those patients with substance abuse disorder had higher doses of antipsychotics and higher dose biperiden at discharge

Determinantes sociales relacionados con el sobrepeso y obesidad, en niños y adolescentes de 10 - 15 años; que residen en Villa Burdeos de Ciudad Versailles, San Juan Opico, La Libertad. Julio a diciembre 2015 / Social determinants related to overweight and obesity, in children and adolescents 10-15 years old; who reside in Villa Burdeos in Versailles City, San Juan Opico, La Libertad. July to December 2015

Propósito: Establecer los determinantes sociales, relacionados con el sobrepeso y obesidad, en niños y adolescentes de 10 ­ 15 años. Métodos y Material: Se realizó un estudio de tipo descriptivo, ya que no existe relación de causa y efecto en el fenómeno estudiado. El Universo: Niños y adolescentes de 10 a 15 años, que residen en vía Burdeos, de Ciudad Versailles, San Juan Opico La Libertad. Resultados: En el grupo estudiado se encontró un índice de sobrepeso de 31.7% y obesidad 22.75% respectivamente. Conclusiones: Los determinantes sociales de la salud, son útiles en el diseño y formulación de intervenciones. Los programas de salud deben incluirlos como factores importantes en su diseño, por la influencia que tienen sobre la conducta alimentaria y el impacto de los programas. Recomendaciones: Por la situación epidemiológica encontrada en la población estudiada, se hace indispensable realizar acciones de promoción de la salud y prevención del sobrepeso y la obesidad.

Distrofia muscular congénita de tipo Ullrich. Utilidad de la resonancia magnética muscular en el diagnóstico / Ullrich congenital muscular dystrophy. The usefulness of muscular magnetic resonance imaging in its diagnosis

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Medidas de inclinación de la trayectoria condílea y delángulo de bennet de lapoblación occidental, actualización y revisió nbibliográfica / Condylar path inclination and bennet angle in western population, update and literature review

Introducción: Actualmente cualquier tratamiento prostodóncico conlleva el uso de articuladores tanto para el diagnóstico como la realización de las prótesis. Aunque lo ideal sería individualizar cada caso hallando la inclinación de la trayectoria con dílea (ITC)y el ángulo de Bennet reales, se tiende a trabajar con los valores estándares establecidos. Dichos valores llevan vigentes desde que fueron instaurados sin ninguna modificación. El objetivo de este estudio fue comprobar que estos valores promedios seguían siendo validos en la actualidad. Material y método: Recopilación de valores reales de ITC y ángulo de Bennet recogidos de la bibliografía entre 1959 y 2011. Fueron seleccionados 34 estudios de grandes muestras poblacionales alcanzando un total de 2.142 valores individualizados de ITC. Resultados: Fueron encontradas grandes diferencias entre los distintos estudios revisados, desde valores medios de ITC de30,1º en 1960 hasta los 57,8º de 2009.Conclusiones: Se observó un incremento gradual de las medias de ITC a lo largo de los años, derivado por una masticación con predominio de los movimientos verticales de apertura-cierre frente a lateralidades. Estos resultados se alejan de los propuestos para los articuladores de guías fijas que son los más empleados en laboratorio. Consideramos que dichos valores estándares deben ser modificados con unas cifras mayores (AU)

Introduction: Currently any prosthodontic treatment involves the use of articulators for diagnosis and prostheses fabrication. The ideal protocol would be to individualizing each case getting the actual condylar path inclination (CPI) and Bennet angle. Although dentists used to work with the stablished standard values. Predeterminated articulator settings have been the same since they were instituted without any change. The aim of this study was to verify that these average values were still valid today. Material and methods: Collection of real CPI and Bennet angle values review from the literature between 1959 and 2011. Thirty four studies were selected from large population samples for a total of 2142 individual condylar values. Results: Large differences between the studies reviewed were found, from average values CPI of 30.1 degrees in 1960 to 57.8 º, 2009.Conclusions: It was observed a gradual increase in average CPI over the years, which indicates vertical chewing movements over lateral ones. These results are far from those proposed for semi-adjustable articulators. Therefore, these standard values must be reinstated with higher figures rather than relying on overage values (AU)

Head to head comparisons as an alternative to placebo-controlled trials.

Head to head trials have been proposed as an alternative to the ethical and methodological concerns related to placebo-controlled trials. While those studies may be particularly informative from the clinical and cost-effectiveness point-of-view, avoiding placebo poses several regulatory concerns: for superiority designs, the choice of the trial population, outcomes, dose and escalation of the comparator, as well as the comparator itself may be an issue; for non-inferiority studies, issues related to uncertain assay sensitivity and exposure of large samples to potentially ineffective or unsafe drugs make them inappropriate, in the absence of a previous positive superiority trial, for regulatory purposes. The inclusion of active comparators in regulatory trials should not be seen as an alternative, but as a useful complement to the information that can be obtained from placebo-controlled studies.

Estudio transversal de hipodoncias no sindrómicas en una muestra de pacientes infantiles / Cross-sectional study of nonsyndromic hypodontia in a sample of pediatric patients

Introducción: Denominamos agenesia la falta de formación o desarrollo de los gérmenes dentales, pudiendo encontrarnos con que uno o más dientes, en dentición temporal o permanente, se encuentran ausentes. Las agenesias en dentición temporal son poco comunes (menos del 1%); sin embargo, en dentición permanente constituyen las alteraciones más frecuentes del desarrollo dentario (1,6-9,6%). El objetivo de este estudio fue determinar la prevalencia de agenesias en dentición permanente no asociadas a síndromes y comprobar si su distribución se cumplía con respecto a otros trabajos de referencia. Métodos: En una muestra de 387 pacientes entre 6,4 y 15,8 años, (189 mujeres y 198 varones) se estudiaron las ortopantomografías de las historias clínicas pertenecientes al Departamento de Estomatología IV de la Facultad de Odontología de la Universidad Complutense de Madrid. Los resultados de frecuencia y porcentaje de agenesia fueron analizados mediante tablas de contingencia, el test chi-cuadrado y el test exacto de Fisher. Para la comparación de dos medias de edad se ha utilizado la t de Student. Resultados: Presentaron algún tipo de ausencia dental un 6,5% (n=25). Los dientes ausentes en un mayor número de casos fueron: segundo premolar inferior derecho de forma aislada 32% (n=8),segundos premolares inferiores bilateralmente 28% (n=7) e incisivos laterales superiores bilateralmente 12% (n=3).Conclusiones: Las agenesias en la muestra fueron más frecuentes en mujeres que en varones. Los dientes ausentes en mayor proporción fueron los segundos premolares inferiores, existiendo mayor frecuencia de ausencia bilateral que unilateral de los mismos (AU)

Introduction: We refer to agenesia as the lack of formation or development of the dental germs, the finding of one or more teeth, in temporary or permanent dentition, being absent. Agenesia in temporary teeth is rather uncommon (less than1%); however, in permanent dentition, this is the most frequent dental development disorder (1.6-9.6%). The objective of this study was to determine the prevalence of agenesia in permanent dentition not associated to syndromes and to verify if their distribution was in line with other works of reference. Methods: In a sample of 387 patients between 6.4 and 15.8 years of age (189 female and 198 male), we studied the or thopantomographs from the clinical histories belonging to the Department of Dentistry IV of the School of Dentistry of the Universidad Complutense de Madrid. The results of frequency and percentage of agenesia were analysed by means of contingency tables , the chi-square test and the Fisher's exact test. For the comparison of the two mean ages Student’s t-test was used. Results: About 6.5% (n=25) presented some type of dental absence. The absent teeth in the majority of the cases were: second lower right premolar, unilaterally 32% (n=8), second lower premolars, bilaterally 28% (n=7) and upper lateral incisors, bilaterally 12% (n=3).Conclusions: The agenesia in the same was more frequent in females than in males. Most of the absent teeth were the second lower premolars, with the greater frequency of bilateral absence than unilateral (AU)

Andrés Piquer-Arrufat (1711-1772): contributions of an eighteenth-century spanish physician to the concept of manic-depressive illness.

Largely unknown in Anglophonic medicine, eighteenth-century Spanish physician-scholar Andrés Piquer-Arrufat was early to coin a name (affectio melancholico-maníaca, or "melancholic-manic illness") for the syndrome that emerged much later as manic-depressive illness and then bipolar disorder. He considered it a single, independent diagnostic entity, distinct from mania and melancholia, with varying manifestations over time. Piquer recognized mixed states, seasonality, and rapid cycling, and hypothesized "mental or cerebral damage" as underlying the disorder. His formulations evolved from clinical observations of patients over time, including his detailed longitudinal clinical description of Spanish King Ferdinand VI (1759), and as presented in his own medical textbook (1764). Piquer anticipated the often cited nineteenth-century works of Jean Falret and Jules Baillarger in Paris, and later, Emil Kraepelin in Heidelberg, by more than a century.

Effects of atypical antipsychotics on neurocognition in euthymic bipolar patients.

BACKGROUND: Different factors may influence cognitive functioning in bipolar disorder such as the effect of subsyndromal symptoms, the history of psychotic symptomatology or substance abuse, negative symptomatology, chronicity, sleep disturbances, and hormonal factors. The effect of pharmacologic treatment on cognition is still uncertain because of an insufficient number of studies examining this issue. OBJECTIVE: The aims of this study were to compare neuropsychologic performance of treated bipolar patients with that of controls, including unmedicated patients and healthy subjects, as well as to evaluate possible neurocognitive differences among 3 different atypical antipsychotics. RESEARCH DESIGN AND METHODS: A total of 119 subjects were included in the study. Of 79 Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition euthymic bipolar patients, 68 were treated with one atypical antipsychotic, quetiapine (n = 12), olanzapine (n = 26), or risperidone (n = 30). Sixteen patients were drug-free. The 4 groups were compared with a sample of drug-naïve patients and a healthy control group (n = 35) on several clinical and neuropsychologic variables, especially on the domains of attention, verbal memory, and executive functions. Euthymia was defined by a score of 6 or less at the Young Mania Rating Scale and a score of 8 or less at the Hamilton Depression Rating Scale for at least 6 months. RESULTS: The 5 groups did not differ in age, years of education, sex distribution, or estimated premorbid IQ. The 4 patients groups did not differ in chronicity, age of onset, total number of episodes, and number of hospitalizations. No differences were found regarding antipsychotic dosages between the groups. Bipolar patients performed poorly on most neuropsychologic measures as compared with healthy controls. After controlling for Hamilton Depression Rating Scale symptoms, no significant change in the results was observed. Because many patients with antipsychotic treatment had a history of psychotic symptoms, we performed multivariate analysis of covariance controlling for this variable. Bipolar patients taking 1 of the 3 antipsychotics presented with dose-independent significant deficits in most cognitive tasks compared with healthy controls. After several head-to-head group comparisons, the patients receiving quetiapine showed a better performance in learning task, short-term memory, and recognition task assessed with the California Verbal Learning Test and verbal fluency (P < .05). CONCLUSIONS: Our results confirm the findings of previous studies of cognitive deficits in bipolar disorder. Untreated euthymic patients showed better cognitive performance than did patients on atypical antipsychotics. Some iatrogenic-pharmacologic effect, therefore, cannot be excluded, but quetiapine seemed to be less associated with impairment in measures of verbal memory than olanzapine or risperidone. We suggest to use drugs in bipolar disorder with a lower risk of cognitive adverse effects. However, randomized controlled trials are urgently needed to give a definite answer to this critical problem.