Switching to Vortioxetine in Patients with Poorly Tolerated Antidepressant-Related Sexual Dysfunction in Clinical Practice: A 3-Month Prospective Real-Life Study.

Treatment-emergent sexual dysfunction (TESD) is one of the most frequent and persistent adverse effects of antidepressant medication. Sexual dysfunction (SD) secondary to SSRIs occurs in >60% of sexually active patients and >80% of healthy volunteers, with this causing treatment discontinuation in >35% of patients. However, this factor is rarely addressed in routine examinations, and only 15-30% of these events are spontaneously reported. A strategy of switching to a different non-serotonergic antidepressant could involve a risk of relapse or clinical worsening due to a lack of serotonergic activity. Vortioxetine appears to have less impact on sexual function due to its multimodal mechanism of action. No studies have been published on the effectiveness of switching to vortioxetine in patients with poorly tolerated long-term antidepressant-related SD in naturalistic settings. STUDY OBJECTIVES: To determine the effectiveness of switching to vortioxetine due to SD in a routine clinical practice setting. METHODOLOGY: observational pragmatic and naturalistic study to determine the effectiveness of the switch to vortioxetine (mean dosage 13.11 ± 4.03) in 74 patients aged 43.1 ± 12.65 (54% males) at risk of discontinuing treatment due to sexual dysfunction. The PRSexDQ*- SALSEX scale (* Psychotropic-Related Sexual Dysfunction Questionnaire) was applied at two moments: baseline visit and after 3 months of follow-up. RESULTS: global Sexual Dysfunction (SD) measured with the SALSEX scale decreased significantly between the baseline visit (10.32; SD 2.73) and the follow-up visit (3.78; SD 3.68), p < 0.001. There was a significant improvement (p < 0.001) at the endpoint including decreased libido, delay of orgasm, anorgasmia and arousal difficulties in both sexes. After switching to vortioxetine, 83.81% of patients experienced an improvement in sexual function (43.2% felt greatly improved). Most patients (83.3%) who switched to vortioxetine continued treatment after the follow-up visit. A total of 58.1% of patients showed an improvement in depressive symptoms from the baseline visit. CONCLUSION: switching to vortioxetine is an effective and reliable strategy to treat patients with poorly tolerated previous antidepressant-related sexual dysfunction in real-life clinical settings.

[Seroprevalence of Toxoplasma gondii in students with occupational risk]. / Seroprevalencia de Toxoplasma gondii en estudiantes con riesgo ocupacional.

BACKGROUND: Toxoplasmosis is a disease that results from infection with the Toxoplasma gondii parasite, one of the world's most common parasites. The zoonotic infection usually occurs by eating undercooked contaminated meat or by contact with contaminated cat feces. A few studies of toxoplasmosis in healthy and immuno-compromised persons were done in Chile, but investigations related to occupational risk groups, such as Veterinary Medicine students were not studied. AIM: Determine the seroprevalence for T. gondii in Veterinary Medicine students at a university located in the center-south of the country, and evaluated to association with intrinsic variables. METHODS: Peripheral blood samples were taken from 74 veterinary students from a university in south-central Chile. Immunoassay with sequential chemiluminescent was used as diagnostic technique. RESULTS: Of the total number of students, 16 were seropositive, which is equivalent to 21.6%, the largest number of seropositive students was female (75%), they were in the age range between 24 and 26 years of age (43.7%), all consumed meat and vegetables (100%) and collected pet cat feces without protection 50 (68,7%). CONCLUSIONS: The results obtained show the presence of antibodies against T. gondii in Veterinary Medicine students. To the authors' knowledge, it is the first serological study for toxoplasmosis performed in university students of Veterinary Medicine in Chile.

Seroprevalencia de Toxoplasma gondii en estudiantes con riesgo ocupacional / Seroprevalence of Toxoplasma gondii in students with occupational risk

INTRODUCCIÓN: La toxoplasmosis es una enfermedad zoonótica cuyo contagio se produce por vía oral por ingestión de quistes al consumir carne contaminada o al tener contacto con heces de felinos contaminadas con ooquistes. Con menor frecuencia, se adquiere por transmisión vertical o por trasplante de órganos infectados. En Chile, existen estudios serológicos en personas sanas e inmunodeprimidas, pero no en grupos de riesgo ocupacional, como son los estudiantes de Medicina Veterinaria. OBJETIVO: Determinar la seroprevalencia para T. gondii en estudiantes de Medicina Veterinaria de una universidad ubicada en el centro-sur del país, y ver su asociación con variable intrínsecas. MÉTODOS. Se tomaron muestras de sangre a 74 estudiantes de una universidad del centro-sur de Chile. Se determinó la presencia de anticuerpos específicos clase IgG contra Toxoplasma gondii mediante la técnica de inmunoanálisis por quimioluminiscencia en fase solida secuencial. RESULTADOS. Del total de alumnos, 16 fueron seropositivos lo que equivale a 21,6%, el mayor número de estudiantes seropositivos fue de sexo femenino (75%), se encontraban en el rango etario entre 24 y 26 años de edad (43,7%), todos consumían carne y verduras (100%) y realizaban la recolección de heces de gatos sin protección 50 (68,7%). CONCLUSIONES. Los resultados obtenidos demuestran la presencia de anticuerpos contra T. gondii en alumnos de Medicina Veterinaria. Según el conocimiento de los autores, es el primer estudio serológico para toxoplasmosis realizado en estudiantes universitarios de Medicina Veterinaria en Chile.

BACKGROUND: Toxoplasmosis is a disease that results from infection with the Toxoplasma gondii parasite, one of the world's most common parasites. The zoonotic infection usually occurs by eating undercooked contaminated meat or by contact with contaminated cat feces. A few studies of toxoplasmosis in healthy and immuno-compromised persons were done in Chile, but investigations related to occupational risk groups, such as Veterinary Medicine students were not studied. AIM: Determine the seroprevalence for T. gondii in Veterinary Medicine students at a university located in the center-south of the country, and evaluated to association with intrinsic variables. METHODS: Peripheral blood samples were taken from 74 veterinary students from a university in south-central Chile. Immunoassay with sequential chemiluminescent was used as diagnostic technique. RESULTS. Of the total number of students, 16 were seropositive, which is equivalent to 21.6%, the largest number of seropositive students was female (75%), they were in the age range between 24 and 26 years of age (43.7%), all consumed meat and vegetables (100%) and collected pet cat feces without protection 50 (68,7%). CONCLUSIONS: The results obtained show the presence of antibodies against T. gondii in Veterinary Medicine students. To the authors' knowledge, it is the first serological study for toxoplasmosis performed in university students of Veterinary Medicine in Chile.

Contribution of baseline body mass index and leptin serum level to the prediction of early weight gain with atypical antipsychotics in schizophrenia.

AIM: This study investigated whether biochemical parameters add predictive information concerning risk for weight gain associated with treatment with atypical antipsychotics (AP) to that provided by baseline weight. METHODS: Weight changes were assessed in 25 patients with schizophrenia after 3-6 months of treatment. These patients were started on AP monotherapy owing to a first psychotic episode or resumed treatment after at least a 6-month period of abandonment. Anthropometric and biochemical data were collected and analyzed as predictors of early weight change. RESULTS: The baseline biochemical and anthropometric data were not significantly higher in the patients than in the healthy participants. During follow up, the patients had significant increases in body mass index and total cholesterol and apolipoprotein B level. The baseline weight and leptin level were predictive of weight gain during follow up, with an inverse association in both cases. CONCLUSION: Baseline weight and leptin level may help to assess the risk of early weight gain with AP.

Different gray matter patterns in chronic schizophrenia and chronic bipolar disorder patients identified using voxel-based morphometry.

Gray matter (GM) volume deficits have been described in patients with schizophrenia (Sz) and bipolar disorder (BD), but to date, few studies have directly compared GM volumes between these syndromes with methods allowing for whole-brain comparisons. We have used structural magnetic resonance imaging (MRI) and voxel-based morphometry (VBM) to compare GM volumes between 38 Sz and 19 BD chronic patients. We also included 24 healthy controls. The results revealed a widespread cortical (dorsolateral and medial prefrontal and precentral) and cerebellar deficit as well as GM deficits in putamen and thalamus in Sz when compared to BD patients. Besides, a subcortical GM deficit was shown by Sz and BD groups when compared to the healthy controls, although a putaminal reduction was only evident in the Sz patients. In this comparison, the BD patients showed a limited cortical and subcortical GM deficit. These results support a partly different pattern of GM deficits associated to chronic Sz and chronic BD, with some degree of overlapping.

No association between prepulse inhibition of the startle reflex and neuropsychological deficit in chronic schizophrenia.

Sensorimotor gating deficits are relevant in schizophrenia and can be measured using prepulse inhibition (PPI) of the startle reflex. It is conceivable that such deficits may hinder the cognitive functions in schizophrenia patients. In this study, using PPI and a neuropsychological battery, we studied this possibility in a group of 23 acute, neuroleptic-free schizophrenia patients and 16 controls. A non-significant decrease in PPI was found in the patients as compared to the controls, as well as significant differences in the performance of Trail A and B in Wisconsin Card Sorting and Digit/Symbol Tests. No statistically significant correlations between PPI and neuropsychological performance were found after the correction for multiple comparisons in any group. Our results suggest that PPI deficits in schizophrenia patients may not contribute to the cognitive deficits typical of that illness, at least in patients with a non-significant PPI decrease.