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1.
Phys Rev Lett ; 131(9): 091801, 2023 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-37721818

RESUMO

We measured the nuclear-recoil ionization yield in silicon with a cryogenic phonon-sensitive gram-scale detector. Neutrons from a monoenergetic beam scatter off of the silicon nuclei at angles corresponding to energy depositions from 4 keV down to 100 eV, the lowest energy probed so far. The results show no sign of an ionization production threshold above 100 eV. These results call for further investigation of the ionization yield theory and a comprehensive determination of the detector response function at energies below the keV scale.

2.
Radiologia (Engl Ed) ; 65(3): 239-250, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37268366

RESUMO

Low-energy vertebral fractures pose a diagnostic challenge for the radiologist due to their often-inadvertent nature and often subtle imaging semiology. However, the diagnosis of this type of fractures can be decisive, not only because it allows targeted treatment to prevent complications, but also because of the possibility of diagnosing systemic pathologies such as osteoporosis or metastatic disease. Pharmacological treatment in the first case has been shown to prevent the development of other fractures and complications, while percutaneous treatments and various oncological therapies can be an alternative in the second case. Therefore, it is necessary to know the epidemiology and typical imaging findings of this type of fractures. The objective of this work is to review the imaging diagnosis of low-energy fractures, with special emphasis on the characteristics that should be outlined in the radiological report to guide a specific diagnosis that favours and optimizes the treatment of patients suffering of low energy fractures.


Assuntos
Osteoporose , Fraturas da Coluna Vertebral , Humanos , Diagnóstico por Imagem , Osteoporose/complicações , Osteoporose/diagnóstico , Fraturas da Coluna Vertebral/diagnóstico por imagem
3.
Radiología (Madr., Ed. impr.) ; 65(3): 239-250, May-Jun. 2023. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-221004

RESUMO

Las fracturas vertebrales de baja energía suponen un reto diagnóstico para el radiólogo debido a su naturaleza, frecuentemente inadvertida, y a su semiología en imagen, a menudo sutil. Sin embargo, el diagnóstico de este tipo de fracturas puede resultar determinante, no solo por permitir realizar un tratamiento dirigido que evite complicaciones, sino también por la posibilidad de diagnosticar patologías sistémicas como la osteoporosis o la enfermedad metastásica. El tratamiento farmacológico en el primer caso ha demostrado evitar el desarrollo de otras fracturas y complicaciones, mientras que los tratamientos percutáneos y las diversas terapias oncológicas pueden ser una alternativa en el segundo caso. Por lo tanto, es preciso conocer la epidemiología y los hallazgos por imagen de este tipo de fracturas. El objetivo de este trabajo es revisar el diagnóstico por imagen de las fracturas de baja energía, con especial énfasis en las características que deben reseñarse en el informe radiológico para orientar a un diagnóstico específico que favorezca y optimice el tratamiento de los pacientes que padecen este tipo de fracturas.(AU)


Low-energy vertebral fractures pose a diagnostic challenge for the radiologist due to their often-inadvertent nature and often subtle imaging semiology. However, the diagnosis of this type of fractures can be decisive, not only because it allows targeted treatment to prevent complications, but also because of the possibility of diagnosing systemic pathologies such as osteoporosis or metastatic disease. Pharmacological treatment in the first case has been shown to prevent the development of other fractures and complications, while percutaneous treatments and various oncological therapies can be an alternative in the second case. Therefore, it is necessary to know the epidemiology and typical imaging findings of this type of fractures. The objective of this work is to review the imaging diagnosis of low-energy fractures, with special emphasis on the characteristics that should be outlined in the radiological report to guide a specific diagnosis that favours and optimizes the treatment of patients suffering of low energy fractures.(AU)


Assuntos
Humanos , Masculino , Feminino , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/prevenção & controle , Fraturas da Coluna Vertebral/terapia , Osteoporose , Fraturas da Coluna Vertebral/epidemiologia , Radiografia , Radiologia , Tomografia Computadorizada por Raios X , Espectroscopia de Ressonância Magnética
4.
Phys Rev Lett ; 127(8): 081802, 2021 Aug 20.
Artigo em Inglês | MEDLINE | ID: mdl-34477436

RESUMO

The Cryogenic Dark Matter Search low ionization threshold experiment (CDMSlite) achieved efficient detection of very small recoil energies in its germanium target, resulting in sensitivity to lightly ionizing particles (LIPs) in a previously unexplored region of charge, mass, and velocity parameter space. We report first direct-detection limits calculated using the optimum interval method on the vertical intensity of cosmogenically produced LIPs with an electric charge smaller than e/(3×10^{5}), as well as the strongest limits for charge ≤e/160, with a minimum vertical intensity of 1.36×10^{-7} cm^{-2} s^{-1} sr^{-1} at charge e/160. These results apply over a wide range of LIP masses (5 MeV/c^{2} to 100 TeV/c^{2}) and cover a wide range of ßγ values (0.1-10^{6}), thus excluding nonrelativistic LIPs with ßγ as small as 0.1 for the first time.

5.
Phys Rev Lett ; 127(6): 061801, 2021 Aug 06.
Artigo em Inglês | MEDLINE | ID: mdl-34420312

RESUMO

We present limits on spin-independent dark matter-nucleon interactions using a 10.6 g Si athermal phonon detector with a baseline energy resolution of σ_{E}=3.86±0.04(stat)_{-0.00}^{+0.19}(syst) eV. This exclusion analysis sets the most stringent dark matter-nucleon scattering cross-section limits achieved by a cryogenic detector for dark matter particle masses from 93 to 140 MeV/c^{2}, with a raw exposure of 9.9 g d acquired at an above-ground facility. This work illustrates the scientific potential of detectors with athermal phonon sensors with eV-scale energy resolution for future dark matter searches.

6.
Rev. chil. pediatr ; 91(6): 874-880, dic. 2020. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-1508059

RESUMO

INTRODUCCIÓN: La deshidratación hipernatrémica neonatal es una condición grave y su incidencia se ha incre mentado en los últimos años, repercutiendo en complicaciones que llevan a la hospitalización del recién nacido. OBJETIVO: Describir las características clínicas y de laboratorio de recién nacidos a término con diagnóstico de deshidratación hipernatremica. PACIENTES Y MÉTODO: Estudio observacional descriptivo de recién nacidos a término que se hospitalizaron por deshidratación hiperna trémica entre los años 2014 y 2016. Se incluyeron recién nacidos a término mayores de 37 semanas con signos clínicos de deshidratación (mucosas secas, fontanela deprimida, llanto sin lágrimas, signos de pliegue cutáneo) y/o pérdida excesiva de peso mayor de 7% y sodio sérico mayor a 145 mEq/L. Se registraron variables sociodemográficas y bioquímicas para su análisis. RESULTADOS: Se incluyeron 43 neonatos. El 60,5% de sus madres fueron primigestantes, el 90% de los neonatos recibieron lactancia materna exclusiva, las madres reportaron problemas en la lactancia materna en el 76,7%. La pérdida de peso al ingreso con respecto al peso de nacimiento fue de 15,3% en promedio. El 83,3% contaba con seguro de salud público. 65,1% presentó signos clínicos de deshidra tación al ingreso y 83,5% signos neurológicos transitorios. El promedio de sodio fue de 155 mEq/L al ingreso. El descenso de sodio en las primeras 24 horas de manejo fue 7,74 mEq/L (0,32mEq/L por hora). La corrección de la hipernatremia fue en el 55,8% por vía oral y la estancia hospitalaria de 4 días en promedio. CONCLUSIONES: Los problemas de alimentación se presentaron en un (76%) madres primigestantes en un (88,4%). El 90,6% de esta población administraban lactancia materna exclusiva, resultados que pueden contribuir para alertar al profesional de la salud a identificar de forma oportuna, signos de alarma y un control precoz posterior al alta del puerperio y a la toma de medidas preventivas.


INTRODUCTION: The hypernatremic neonatal dehydration is a severe condition whose incidence has increased in recent years resulting in complications leading to the hospitalization of the newborn. OBJECTIVE: Describe the clinical and laboratory characteristics of term-newborns with Hypernatremic Dehy dration diagnosis. PATIENTS AND METHOD: Descriptive observational study of hospitalized term- newborns due to hypernatremic dehydration between a period from 2014 to 2016. Term newborns over 37 weeks with clinical signs of dehydration (dry mucous membranes, depressed fontanel, tear less crying, signs of the cutaneous pleat), and/or excessive weight loss greater than 7% and serum sodium greater than 145 mEq/L were included. Sociodemographic and biochemical variables were recorded for analysis. RESULTS: 43 neonates were included. 60.5 percent of their mothers were pri- miparous, 90 percent of neonates received exclusive breastfeeding, mothers reported breastfeeding problems in 76.7 percent. Incoming neonates reported weight loss compared to birth weight at 15.3% on average. 83.3% had public health insurance. 65.1% had dehydration clinical signs at entry and 83.5% transient neurological signs. The average sodium was 155 mEq/L at revenue. The sodium decrease in the first 24 hours of handling was 7.74 mEq/L (0.32mEq/L per hour). The correction of the hypernatremia was 55.8% by oral intake and 4 days hospital stay on average. CONCLUSIONS: The feeding's problems came up in a (76%), primiparous mothers in an (88.4%). 90.6 percent of this population administered exclusive breastfeeding, results that can help to alert the health professional to timely identification, warning signs, and early post-discharge control and preventive measures.


Assuntos
Humanos , Masculino , Feminino , Recém-Nascido , Adolescente , Adulto , Adulto Jovem , Desidratação/diagnóstico , Hospitalização , Hipernatremia/diagnóstico , Peso ao Nascer , Aleitamento Materno , Redução de Peso , Estudos Retrospectivos , Desidratação/terapia , Desidratação/epidemiologia , Hipernatremia/terapia , Hipernatremia/epidemiologia , Tempo de Internação , Mães
7.
Rev Chil Pediatr ; 91(6): 874-880, 2020 Dec.
Artigo em Espanhol | MEDLINE | ID: mdl-33861823

RESUMO

INTRODUCTION: The hypernatremic neonatal dehydration is a severe condition whose incidence has increased in recent years resulting in complications leading to the hospitalization of the newborn. OBJECTIVE: Describe the clinical and laboratory characteristics of term-newborns with Hypernatremic Dehy dration diagnosis. PATIENTS AND METHOD: Descriptive observational study of hospitalized term- newborns due to hypernatremic dehydration between a period from 2014 to 2016. Term newborns over 37 weeks with clinical signs of dehydration (dry mucous membranes, depressed fontanel, tear less crying, signs of the cutaneous pleat), and/or excessive weight loss greater than 7% and serum sodium greater than 145 mEq/L were included. Sociodemographic and biochemical variables were recorded for analysis. RESULTS: 43 neonates were included. 60.5 percent of their mothers were pri- miparous, 90 percent of neonates received exclusive breastfeeding, mothers reported breastfeeding problems in 76.7 percent. Incoming neonates reported weight loss compared to birth weight at 15.3% on average. 83.3% had public health insurance. 65.1% had dehydration clinical signs at entry and 83.5% transient neurological signs. The average sodium was 155 mEq/L at revenue. The sodium decrease in the first 24 hours of handling was 7.74 mEq/L (0.32mEq/L per hour). The correction of the hypernatremia was 55.8% by oral intake and 4 days hospital stay on average. CONCLUSIONS: The feeding's problems came up in a (76%), primiparous mothers in an (88.4%). 90.6 percent of this population administered exclusive breastfeeding, results that can help to alert the health professional to timely identification, warning signs, and early post-discharge control and preventive measures.


Assuntos
Desidratação/diagnóstico , Hospitalização , Hipernatremia/diagnóstico , Adolescente , Adulto , Peso ao Nascer , Aleitamento Materno/estatística & dados numéricos , Desidratação/epidemiologia , Desidratação/terapia , Feminino , Humanos , Hipernatremia/epidemiologia , Hipernatremia/terapia , Recém-Nascido , Tempo de Internação , Masculino , Mães , Estudos Retrospectivos , Redução de Peso , Adulto Jovem
8.
Acta Psychiatr Scand ; 141(6): 541-552, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-31746462

RESUMO

AIMS: Here, we present a clustering strategy to identify phenotypes of antipsychotic (AP) response by using longitudinal data from patients presenting first-episode psychosis (FEP). METHOD: One hundred and ninety FEP with complete data were selected from the PEPs project. The efficacy was assessed using total PANSS, and adverse effects using total UKU, during one-year follow-up. We used the Klm3D method to cluster longitudinal data. RESULTS: We identified four clusters: cluster A, drug not toxic and beneficial; cluster B, drug beneficial but toxic; cluster C, drug neither toxic nor beneficial; and cluster D, drug toxic and not beneficial. These groups significantly differ in baseline demographics, clinical, and neuropsychological characteristics (PAS, total PANSS, DUP, insight, pIQ, age of onset, cocaine use and family history of mental illness). CONCLUSIONS: The results presented here allow the identification of phenotypes of AP response that differ in well-known simple and classic clinical variables opening the door to clinical prediction and application of personalized medicine.


Assuntos
Antipsicóticos/uso terapêutico , Fenótipo , Medicina de Precisão , Transtornos Psicóticos/tratamento farmacológico , Transtornos Psicóticos/psicologia , Estudos de Coortes , Feminino , Humanos , Masculino
9.
Psychol Med ; 50(16): 2702-2710, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-31637990

RESUMO

BACKGROUND: Social cognition has been associated with functional outcome in patients with first episode psychosis (FEP). Social cognition has also been associated with neurocognition and cognitive reserve. Although cognitive reserve, neurocognitive functioning, social cognition, and functional outcome are related, the direction of their associations is not clear. Therefore, the main aim of this study was to analyze the influence of social cognition as a mediator between cognitive reserve and cognitive domains on functioning in FEP both at baseline and at 2 years. METHODS: The sample of the study was composed of 282 FEP patients followed up for 2 years. To analyze whether social cognition mediates the influence of cognitive reserve and cognitive domains on functioning, a path analysis was performed. The statistical significance of any mediation effects was evaluated by bootstrap analysis. RESULTS: At baseline, as neither cognitive reserve nor the cognitive domains studied were related to functioning, the conditions for mediation were not satisfied. Nevertheless, at 2 years of follow-up, social cognition acted as a mediator between cognitive reserve and functioning. Likewise, social cognition was a mediator between verbal memory and functional outcome. The results of the bootstrap analysis confirmed these significant mediations (95% bootstrapped CI (-10.215 to -0.337) and (-4.731 to -0.605) respectively). CONCLUSIONS: Cognitive reserve and neurocognition are related to functioning, and social cognition mediates in this relationship.


Assuntos
Reserva Cognitiva , Funcionamento Psicossocial , Transtornos Psicóticos/psicologia , Cognição Social , Adolescente , Adulto , Feminino , Humanos , Modelos Lineares , Masculino , Análise de Mediação , Testes Neuropsicológicos , Escalas de Graduação Psiquiátrica , Transtornos Psicóticos/diagnóstico , Adulto Jovem
11.
Eur Child Adolesc Psychiatry ; 28(10): 1395-1405, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30843122

RESUMO

A precise description of the inflammatory response in first-episode psychosis (FEP) by age of onset does not exist. We explored baseline and 6-month follow-up differences in the pro/anti-inflammatory balance in plasma and peripheral blood mononuclear cells in adolescent-onset FEP (≤ 18 y.o., N = 27) and adult-onset FEP (≥ 25 y.o., N = 43) using non-parametric 1-category ANCOVA, with age group as an independent variable and values of pro- and anti-inflammatory markers at baseline and at follow-up as dependent variables. We used a non-parametric repeated-measures mixed-effects model to explore the baseline/6-month change in pro- and anti-inflammatory markers within adolescent- and adult-onset groups, exploring differential trajectories of change by means of the interaction of time by age-of-onset group. Levels of the nuclear transcription factor (NFκB), a master regulator of the inflammatory and oxido/nitrosative status of cells, were higher in adolescent-onset FEP both at baseline and after 6 months. During follow-up, we found further increases in levels of soluble inflammatory markers (PGE2 and NO2-) only in adolescent-onset FEP. In contrast, in adult-onset FEP, the expression of inducible NO synthase (iNOS), which is also pro-inflammatory, tended to decrease, with no further increase in other pro-inflammatory markers. Significant differences in the direction of change by age-of-onset cohort exist only for NFκB (F = 4.165, df = 2, 70.95, p = 0.019). Our results support the existence of changes in the pro/anti-inflammatory balance in FEP depending on the neurodevelopmental stage at illness onset. These results also suggest that inflammation may be a potential therapeutic target in adolescent-onset FEP.


Assuntos
Biomarcadores/sangue , Inflamação/metabolismo , Transtornos Psicóticos/etiologia , Adolescente , Adulto , Criança , Estudos de Coortes , Feminino , Humanos , Masculino , Adulto Jovem
12.
Lupus ; 28(4): 565-568, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30862250

RESUMO

Organizing pneumonia is an inflammatory lung entity that presents with a huge variety of clinical, radiological and pathological patterns. Organizing pneumonia can be idiopathic or secondary to other diseases. Corticosteroid therapy is usually the first-line treatment showing clinical improvement in most cases. This report presents the case of a 56-year-old woman with systemic lupus erythematosus who was diagnosed with an organizing pneumonia and showed a poor response to steroid and azathioprine treatment. We considered the use of belimumab, which resulted in excellent clinical and radiological outcomes.


Assuntos
Anticorpos Monoclonais Humanizados/uso terapêutico , Bronquiolite Obliterante/tratamento farmacológico , Bronquiolite Obliterante/etiologia , Imunossupressores/uso terapêutico , Lúpus Eritematoso Sistêmico/complicações , Anticorpos Antinucleares/sangue , Anticorpos Monoclonais Humanizados/administração & dosagem , Azatioprina/administração & dosagem , Azatioprina/efeitos adversos , Azatioprina/uso terapêutico , Bronquiolite Obliterante/sangue , Progressão da Doença , Tolerância a Medicamentos , Feminino , Seguimentos , Humanos , Imunossupressores/administração & dosagem , Leucocitose/sangue , Pulmão/diagnóstico por imagem , Pulmão/patologia , Lúpus Eritematoso Sistêmico/sangue , Pessoa de Meia-Idade , Prednisolona/administração & dosagem , Prednisolona/uso terapêutico , Testes de Função Respiratória , Tomógrafos Computadorizados , Resultado do Tratamento
14.
Phys Rev Lett ; 121(5): 051301, 2018 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-30118251

RESUMO

We present the first limits on inelastic electron-scattering dark matter and dark photon absorption using a prototype SuperCDMS detector having a charge resolution of 0.1 electron-hole pairs (CDMS HVeV, a 0.93 g CDMS high-voltage device). These electron-recoil limits significantly improve experimental constraints on dark matter particles with masses as low as 1 MeV/c^{2}. We demonstrate a sensitivity to dark photons competitive with other leading approaches but using substantially less exposure (0.49 g d). These results demonstrate the scientific potential of phonon-mediated semiconductor detectors that are sensitive to single electronic excitations.

15.
Acta Psychiatr Scand ; 138(5): 441-455, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30105820

RESUMO

OBJECTIVE: Cognitive reserve (CR) refers to the brain's capacity to cope with pathology in order to minimize the symptoms. CR is associated with different outcomes in severe mental illness. This study aimed to analyze the impact of CR according to the diagnosis of first-episode affective or non-affective psychosis (FEP). METHOD: A total of 247 FEP patients (211 non-affective and 36 affective) and 205 healthy controls were enrolled. To assess CR, common proxies have been integrated (premorbid IQ; education-occupation; leisure activities). The groups were divided into high and low CR. RESULTS: In non-affective patients, those with high CR were older, had higher socioeconomic status (SES), shorter duration of untreated psychosis, and a later age of onset. They also showed greater performance in most cognitive domains. In affective patients, those with a greater CR showed a higher SES, better functioning, and greater verbal memory performance. CONCLUSION: CR plays a differential role in the outcome of psychoses according to the diagnosis. Specifically, in order to address the needs of non-affective patients with low CR, cognitive rehabilitation treatments will need to be 'enriched' by adding pro-cognitive pharmacological agents or using more sophisticated approaches. However, a functional remediation therapy may be of choice for those with an affective psychosis and low CR.


Assuntos
Transtornos Psicóticos Afetivos/fisiopatologia , Disfunção Cognitiva/fisiopatologia , Reserva Cognitiva/fisiologia , Transtornos Psicóticos/fisiopatologia , Esquizofrenia/fisiopatologia , Adulto , Transtornos Psicóticos Afetivos/complicações , Fatores Etários , Idade de Início , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/terapia , Remediação Cognitiva , Feminino , Seguimentos , Humanos , Masculino , Transtornos Psicóticos/complicações , Esquizofrenia/complicações , Classe Social , Adulto Jovem
16.
J Affect Disord ; 238: 297-304, 2018 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-29902733

RESUMO

OBJECTIVE: This study aimed to assess (1) whether there were clinical, neuropsychological and functional differences between and within affective and non-affective psychoses at baseline and two years-follow-up and (2) to explore clinical and neuropsychological predictors of psychosocial functioning in the whole sample. METHOD: This is a subanalysis from a multicentre, naturalistic, longitudinal prospective study ('Phenotype-genotype and environmental interaction. Application of a predictive model in first psychotic episodes'). The sample consisted of 192 patients with a first psychotic episode (FEP): 142 with non-affective psychoses and 50 with affective psychoses. Student t-tests, paired t-tests, Pearson correlations, ANOVAs and regression analyses were performed. RESULTS: At baseline, the groups differed in perseverative errors (WCST), Premorbid Adjustment Scale (PAS), family history of psychiatric disorder, negative (PANSS) and manic symptoms (YMRS). At two years follow-up, the groups differed in all the PANSS subscales and in depressive symptoms assessed by the MADRS. When the whole sample was considered, the regression model which best explained the estimated variance in functioning at follow-up (41%) was composed by PANSS total score and verbal fluency assessed by the FAS (COWAT). CONCLUSIONS: We found clinical and neurocognitive differences at baseline which decreased in the follow-up. Reduced performances at baseline in executive functions in combination with symptom severity (PANSS) were predictors of FEP patients' poor functional outcome.


Assuntos
Afeto , Transtornos Psicóticos/psicologia , Adolescente , Adulto , Análise de Variância , Depressão , Feminino , Seguimentos , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos Prospectivos , Análise de Regressão
17.
Phys Rev Lett ; 120(6): 061802, 2018 Feb 09.
Artigo em Inglês | MEDLINE | ID: mdl-29481237

RESUMO

We report the result of a blinded search for weakly interacting massive particles (WIMPs) using the majority of the SuperCDMS Soudan data set. With an exposure of 1690 kg d, a single candidate event is observed, consistent with expected backgrounds. This analysis (combined with previous Ge results) sets an upper limit on the spin-independent WIMP-nucleon cross section of 1.4×10^{-44} (1.0×10^{-44}) cm^{2} at 46 GeV/c^{2}. These results set the strongest limits for WIMP-germanium-nucleus interactions for masses >12 GeV/c^{2}.

18.
Eur Arch Psychiatry Clin Neurosci ; 268(7): 699-711, 2018 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-29164332

RESUMO

Individual changes over time in cognition in patients with psychotic disorders have been studied very little, especially in the case of first episode psychosis (FEP). We aimed to establish whether change in individual trajectories in cognition over 2 years of a sample of 159 FEP patients was reliable and clinically significant, using the reliable change index (RCI) and clinically significant change (CSC) methods. We also studied a sample of 151 matched healthy controls. Patients and controls were assessed with a set of neuropsychological tests, as well as premorbid, clinical and functionality measures. We analysed the course of cognitive measures over time, using analysis of variance, and the individual trajectories in the cognitive measures with the regression-based RCI (RCISRB) and the CSC. The RCISRB showed that between 5.4 and 31.2% of the patients showed deterioration patterns, and between 0.6 and 8.8% showed improvement patterns in these tests over time. Patients showing better cognitive profiles according to RCISRB (worsening in zero to two cognitive measures) showed better premorbid, clinical and functional profiles than patients showing deterioration patterns in more than three tests. When combining RCISRB and CSC values, we found that less than 10% of patients showed improvement or deterioration patterns in executive function and attention measures. These results support the view that cognitive impairments are stable over the first 2 years of illness, but also that the analysis of individual trajectories could help to identify a subgroup of patients with particular phenotypes, who may require specific interventions.


Assuntos
Atenção/fisiologia , Disfunção Cognitiva/fisiopatologia , Progressão da Doença , Função Executiva/fisiologia , Transtornos Psicóticos/fisiopatologia , Adolescente , Adulto , Disfunção Cognitiva/etiologia , Feminino , Seguimentos , Humanos , Masculino , Testes Neuropsicológicos , Transtornos Psicóticos/complicações , Adulto Jovem
19.
Eur Psychiatry ; 41: 42-46, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28049080

RESUMO

Patients with schizophrenia exhibit a reduced life expectancy. Although unhealthy lifestyle or suicide risk plays a role, the main causes are diverse medical conditions such as cardiovascular diseases, type 2 diabetes mellitus and metabolic syndrome. Albeit pharmacological secondary side effects might also trigger previous conditions, studies in naïve patients reflect diverse anomalies at the onset. Patients with a first episode of psychosis, display a wide scope of metabolic abnormalities, ranging from normality till pathological values depending on the parameters studied. We attempted to evaluate the metabolic syndrome and glycemic homeostasis in a subset of antipsychotic-naïve patients with a first episode of non-affective psychosis. Patients (n=84) showed a similar prevalence of metabolic syndrome compared with a matched control sample (n=98) (6% vs 4%, P=0.562), while glucose homeostasis values differed significantly (14% vs. 5%, P=0.034). Our results suggest that metabolic syndrome is not a useful clinical condition to be evaluated in patients before pharmacological treatment. Abnormal glycemic homeostasis at the onset of the disease requires specific diagnostic tools and preventive measures in order to avoid future cardiovascular events. New strategies must be implemented in order to evaluate the cardiovascular risk and subsequent morbidity in patients at the onset of the disease.


Assuntos
Glicemia , Doenças Cardiovasculares , Síndrome Metabólica , Transtornos Psicóticos , Esquizofrenia , Adulto , Antipsicóticos/uso terapêutico , Glicemia/análise , Glicemia/metabolismo , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/psicologia , Feminino , Humanos , Masculino , Síndrome Metabólica/diagnóstico , Síndrome Metabólica/psicologia , Prevalência , Transtornos Psicóticos/sangue , Transtornos Psicóticos/diagnóstico , Fatores de Risco , Esquizofrenia/metabolismo , Esquizofrenia/fisiopatologia , Espanha/epidemiologia
20.
Eur Psychiatry ; 38: 61-69, 2016 10.
Artigo em Inglês | MEDLINE | ID: mdl-27668551

RESUMO

OBJECTIVE: A functional polymorphism of the brain-derived neurotrophic factor gene (BDNF) Val66Met has been associated with cognitive function and symptom severity in patients with schizophrenia. It has been suggested that the Val66Met polymorphism has a role as a modulator in a range of clinical features of the illness, including symptoms severity, therapeutic responsiveness, age of onset, brain morphology and cognitive function. However, little work has been done in first-episode schizophrenia (FES) spectrum disorders. The objective of this study is to investigate the association of the BDNF Val66Met polymorphism on cognitive function and clinical symptomatology in FES patients. METHODS: Using a cross-sectional design in a cohort of 204 patients with FES or a schizophrenia spectrum disorder and 204 healthy matched controls, we performed BDNF Val66Met genotyping and tested its relationship with cognitive testing (attention, working memory, learning/verbal memory and reasoning/problem-solving) and assessment of clinical symptom severity. RESULTS: There was no significant influence of the BDNF allele frequency on cognitive factor scores in either patients or controls. An augmented severity of negative symptoms was found in FES patients that carried the Met allele. CONCLUSIONS: The results of this study suggest that in patients with a first-episode of schizophrenia or a schizophrenia spectrum disorder, the BDNF Val66Met polymorphism does not exert an influence on cognitive functioning, but is associated with negative symptoms severity. BDNF may serve as suitable marker of negative symptomatology severity in FES patients within the schizophrenia spectrum.


Assuntos
Fator Neurotrófico Derivado do Encéfalo/genética , Polimorfismo Genético , Polimorfismo de Nucleotídeo Único/genética , Esquizofrenia/genética , Adulto , Estudos de Casos e Controles , Cognição , Estudos Transversais , Feminino , Frequência do Gene , Genótipo , Humanos , Masculino , Esquizofrenia/fisiopatologia , Adulto Jovem
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