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1.
ACS Appl Mater Interfaces ; 9(6): 5556-5565, 2017 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-28156089

RESUMO

The engineering of broadband absorbers to harvest white light in thin-film semiconductors is a major challenge in developing renewable materials for energy harvesting. Many solution-processed materials with high manufacturability and low cost, such as semiconductor quantum dots, require the use of film structures with thicknesses on the order of 1 µm to absorb incoming photons completely. The electron transport lengths in these media, however, are 1 order of magnitude smaller than this length, hampering further progress with this platform. Herein, we show that, by engineering suitably disordered nanoplasmonic structures, we have created a new class of dispersionless epsilon-near-zero composite materials that efficiently harness white light. Our nanostructures localize light in the dielectric region outside the epsilon-near-zero material with characteristic lengths of 10-100 nm, resulting in an efficient system for harvesting broadband light when a thin absorptive film is deposited on top of the structure. By using a combination of theory and experiments, we demonstrate that ultrathin layers down to 50 nm of colloidal quantum dots deposited atop the epsilon-near-zero material show an increase in broadband absorption ranging from 200% to 500% compared to a planar structure of the same colloidal quantum-dot-absorber average thickness. When the epsilon-near-zero nanostructures were used in an energy-harvesting module, we observed a spectrally averaged 170% broadband increase in the external quantum efficiency of the device, measured at wavelengths between 400 and 1200 nm. Atomic force microscopy and photoluminescence excitation measurements demonstrate that the properties of these epsilon-near-zero structures apply to general metals and could be used to enhance the near-field absorption of semiconductor structures more widely. We have developed an inexpensive electrochemical deposition process that enables scaled-up production of this nanomaterial for large-scale energy-harvesting applications.

2.
Vet Pathol ; 49(5): 860-9, 2012 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-22156227

RESUMO

Immunohistochemistry is widely utilized in diagnostic laboratories to study neoplastic and nonneoplastic diseases. Knowledge of the immunohistochemical characteristics of normal tissue is essential for interpretation of immunoreactivity in pathologic conditions. In this study, immunohistochemistry was performed with a broad panel of diagnostically relevant antibodies on 4 normal canine globes--namely, vimentin, pan-cytokeratin (AE1/AE3), cytokeratin 7, cytokeratin 8/18, cytokeratin 20, α-smooth muscle actin, muscle specific actin, desmin, Melan-A, microphthalmia transcription factor, S-100, glial fibrillary acidic protein, triple neurofilaments, neuron-specific enolase, chromogranin A, synaptophysin, laminin and CD31. Results include cytokeratin immunoreactivity limited to the conjunctival epithelium, corneal epithelium, and retinal pigment epithelium; distinct patterns of immunopositivity of muscle markers; and widespread immunoreactivity for vimentin and most neural/neuroendocrine markers. These findings in normal eyes provide the basis for interpretation of ocular immunohistochemistry in dogs. Published immunophenotypes of primary ocular neoplasms are also reviewed.


Assuntos
Biomarcadores/metabolismo , Doenças do Cão/diagnóstico , Cães/anatomia & histologia , Oftalmopatias/veterinária , Olho/metabolismo , Imuno-Histoquímica/veterinária , Animais , Biomarcadores/análise , Córnea/citologia , Córnea/metabolismo , Proteínas do Citoesqueleto/análise , Proteínas do Citoesqueleto/metabolismo , Doenças do Cão/imunologia , Doenças do Cão/patologia , Olho/citologia , Oftalmopatias/diagnóstico , Oftalmopatias/imunologia , Imunofenotipagem/veterinária , Masculino , Valores de Referência
3.
Equine Vet J Suppl ; (40): 42-5, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22082445

RESUMO

REASONS FOR PERFORMING STUDY: Neoplasia, for which surgical excision is a frequent treatment, is the most common disease of the equine nictitating membrane. There is little long-term follow-up information available to the practitioner regarding the long-term effects of nictitating membrane excision on ocular health. No information is available to compare recurrence of primary neoplasia of the nictitating membrane after excision with local or general anaesthesia. OBJECTIVES: To evaluate the long-term complications of nictitating membrane resection in horses; recurrence of neoplasia of the nictitating membrane when nictitating membrane resection is performed under local vs. general anaesthesia and if the method of anaesthesia used to permit resection of the affected membrane influences the recurrence of neoplasia of the nictitating membrane after complete nictitating membrane resection. METHODS: Records of 26 horses receiving resection of the nictitating membrane for primary neoplasia of the nictitating membrane 1999-2009 were reviewed. Clinical examination findings, surgical procedure, anaesthesia type, histopathological findings and details of adjunctive treatment were recorded. Owners were contacted via telephone regarding post operative outcomes. Data were analysed using a Fisher's exact test (P<0.05). RESULTS: The most common long-term complication of nictitating membrane excision was mild ocular discharge. Squamous cell carcinoma was the most frequent histopathological diagnosis. Recurrence of neoplasia was uncommon (2/26 horses). No significant difference in the number of horses experiencing recurrence of neoplasia was detected between groups receiving general anaesthesia vs. those receiving local anaesthesia. CONCLUSIONS: Resection of the nictitating membrane in horses following local anaesthesia is not associated with increased risk of recurrence of neoplasia compared with excision under general anaesthesia. Resection of the nictitating membrane is not associated with any long-term ocular side effects and can be an effective modality for cure of primary neoplasia of the nictitating membrane in selected cases.


Assuntos
Anestesia Geral/veterinária , Anestesia Local/veterinária , Neoplasias Palpebrais/veterinária , Doenças dos Cavalos/cirurgia , Membrana Nictitante/cirurgia , Anestesia Geral/efeitos adversos , Anestesia Local/efeitos adversos , Anestésicos Gerais/administração & dosagem , Anestésicos Gerais/efeitos adversos , Anestésicos Gerais/farmacologia , Anestésicos Locais/administração & dosagem , Anestésicos Locais/efeitos adversos , Anestésicos Locais/farmacologia , Animais , Neoplasias Palpebrais/cirurgia , Feminino , Seguimentos , Cavalos , Masculino , Resultado do Tratamento
4.
Equine Vet J ; 43(4): 460-5, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21496078

RESUMO

REASONS FOR PERFORMING STUDY: There is little scientific information available about the ability of ocular disease to cause a systemic inflammatory response. Horses are frequently affected with ocular disease and ensuring their systemic health prior to performing vision saving surgery under anaesthesia is essential for the successful treatment of ophthalmic disease. HYPOTHESIS: Ocular disease will cause elevations in the concentration of the acute phase proteins fibrinogen and serum amyloid A in peripheral blood. METHODS: Whole blood and serum samples were obtained from 38 mature horses with ulcerative keratitis or uveitis and no evidence of systemic disease, 9 mature horses with no evidence of ocular or systemic disease (negative controls) and 10 mature horses with systemic inflammatory disease and no evidence of ocular disease (positive controls). Blood samples were assayed for concentrations of the acute phase proteins fibrinogen and serum amyloid A. RESULTS: Fibrinogen and serum amyloid A were significantly different in the positive control group compared to the negative control, corneal disease and uveitis groups (P<0.126). There was no significant difference between the negative control, corneal disease and uveitis groups (P<0.001). CONCLUSIONS: Ulcerative keratitis and anterior uveitis are not associated with elevated concentrations of the acute phase proteins fibrinogen and serum amyloid A in peripheral blood. POTENTIAL RELEVANCE: When the clinician is presented with a patient with ocular disease and elevated plasma fibrinogen or serum amyloid A concentrations, a nonocular inflammatory focus should be suspected.


Assuntos
Oftalmopatias/veterinária , Fibrinogênio/metabolismo , Doenças dos Cavalos/sangue , Proteína Amiloide A Sérica/metabolismo , Animais , Oftalmopatias/sangue , Feminino , Fibrinogênio/análise , Cavalos , Masculino , Estudos Prospectivos , Proteína Amiloide A Sérica/análise
5.
J Thromb Haemost ; 6(12): 2095-104, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-18826393

RESUMO

BACKGROUND: The development of neutralizing antibodies to factor FVIII (FVIII) represents the most serious complication in the treatment of hemophilia A. OBJECTIVE: We have explored the potential of using immature dendritic cells (iDCs) to present FVIII in a tolerogenic manner to T cells. METHODS: The iDCs were isolated from hemophilic murine bone marrow and pulsed with canine cFVIII (cFVIII-iDCs) in the presence or absence of the NFkappaB pathway blocking compound Andrographolide (Andro-cFVIII-iDCs). Three weekly intravenous infusions of one million cFVIII pulsed-iDCs were administered to a group of five hemophilic Balb/c mice. Anti-FVIII antibody levels were monitored by functional Bethesda assay after four weekly intravenous challenges with 2 IU of cFVIII. RESULTS: We have shown that cFVIII in the presence or absence of Andro is efficiently taken up by iDCs and that this process does not result in the maturation of DCs or the activation of co-cultured T cells. Following repeated infusion of the cFVIII-iDCs and Andro-cFVIII-iDCs into hemophilic mice, which were subsequently challenged with cFVIII, long-term reductions of FVIII inhibitors of 25% and 40%, respectively, were documented. Studies of cytokine release and T-cell phenotypes indicate that the mechanisms responsible for reducing immunologic responsiveness to cFVIII appear to involve an expansion of Foxp3 T regulatory cells in the case of cFVIII-iDC infusion and the elaboration of the immunosuppressive cytokines IL-10 and TGF-beta following andrographolide-treated cFVIII-iDCs. CONCLUSIONS: This study shows that tolerogenic presentation of cFVIII to the immune system can significantly reduce immunogenicity of the protein.


Assuntos
Apresentação de Antígeno , Células Dendríticas/imunologia , Fator VIII/imunologia , Hemofilia A/imunologia , Tolerância Imunológica , Animais , Células Dendríticas/transplante , Cães , Fenômenos do Sistema Imunitário , Interleucina-10 , Camundongos , Camundongos Endogâmicos BALB C , Linfócitos T Reguladores , Fator de Crescimento Transformador beta , Resultado do Tratamento
6.
J Thromb Haemost ; 4(10): 2172-9, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16824190

RESUMO

BACKGROUND: The development of anti-factor VIII (FVIII) neutralizing antibodies (inhibitors) is a significant obstacle to FVIII replacement therapy. OBJECTIVE: As mucosal administration of an antigen may induce immune tolerance we have evaluated the efficacy of mucosal antigen exposure to achieve tolerance to FVIII. METHODS: We investigated the effects of oral and nasal administration of the purified FVIII C2 domain (FVIII-C2) to FVIII-deficient BALB/c mice prior to FVIII protein challenge. Mice received oral or nasal doses of FVIII-C2, followed by a subcutaneous challenge of either FVIII-C2 or FVIII. The development of anti-FVIII inhibitors, cytokine production by splenocytes in vitro, and adoptive transfer assays were analyzed. RESULTS AND CONCLUSIONS: Mucosal administration of FVIII-C2 decreases the titer of anti-FVIII-C2 inhibitors after FVIII-C2 challenge, and decreases the percentage of FVIII-C2 specific antibodies after challenge with full-length FVIII. Tolerance induction to FVIII-C2 is associated with increased IL-10 production by splenocytes in vitro, and can be adoptively transferred to naïve mice. This study is the first to demonstrate that tolerance to the FVIII-C2 domain can be induced via the mucosal route. Based on these results, the potential use of FVIII-specific mucosal tolerance induction as an immunotherapy treatment for anti-FVIII inhibitor development warrants further investigation.


Assuntos
Fator VIII/genética , Fator VIII/metabolismo , Fator VIII/uso terapêutico , Tolerância Imunológica , Mucosa/metabolismo , Administração Intranasal , Animais , Linfócitos T CD4-Positivos/metabolismo , Citocinas/metabolismo , Ensaio de Imunoadsorção Enzimática , Fator VIII/química , Feminino , Hemofilia A/sangue , Hemofilia A/genética , Masculino , Camundongos , Camundongos Endogâmicos BALB C , Camundongos Knockout , Mucosa/patologia , Estrutura Terciária de Proteína , Baço/citologia , Fatores de Tempo
8.
Can J Psychiatry ; 46(6): 534-41, 2001 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-11526810

RESUMO

OBJECTIVE: Given the renewed interest in the role of sex differences in schizophrenia, we undertook a post hoc analysis to determine whether sex differences in treatment response were present among outpatients with schizophrenia who received risperidone in an 8-week, open-label, Phase IV clinical study. METHOD: We evaluated 330 adult patients (232 men, 98 women) with a DSM-III-R diagnosis of schizophrenia for safety and 292 (206 men, 86 women) for efficacy. Antipsychotic and antiparkinsonian medications were discontinued at study entry. Treatment with risperidone was initiated at a dosage of 2 mg daily, increased to the target dosage of 6 mg daily by day 3, and maintained at 6 mg daily until day 14. The dosage was then maintained at 6 mg daily, increased or decreased by 2 mg daily each week, based on the patient's response. Risperidone treatment was given for 8 weeks; the permitted dosage range was 4 mg to 10 mg daily. RESULTS: Both male and female participants responded well to risperidone treatment; by the final assessment day, they had experienced decreases from baseline in their total Positive and Negative Syndrome Scale (PANSS) scores of 41.0% and 36.5%, respectively. Most male (77%) and female (78%) participants were considered to be PANSS responders: risperidone was effective against both the positive and negative symptoms of schizophrenia. Both sexes showed improvements over baseline in the incidence and severity of parkinsonism, dystonia, and dyskinesia. No significant (P > 0.05) sex differences in treatment response were observed for any of the efficacy outcomes or in the incidence and severity of extrapyramidal symptoms (EPS). CONCLUSIONS: In this population of outpatients with chronic schizophrenia, both men and women responded well to flexible doses of risperidone. No significant sex differences were evident either in treatment response or in neurological side effects. The absence of sex differences in response to risperidone treatment may obviate the need for a sex-based differential dosing in schizophrenia management.


Assuntos
Assistência Ambulatorial , Risperidona/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adolescente , Adulto , Idoso , Doença Crônica , Relação Dose-Resposta a Droga , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Risperidona/efeitos adversos , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Fatores Sexuais , Resultado do Tratamento
9.
Schizophr Res ; 50(1-2): 41-53, 2001 May 30.
Artigo em Inglês | MEDLINE | ID: mdl-11378313

RESUMO

Topographic quantitative electroencephalographic (EEG) power and frequency indices were collected in 17 treatment refractory, DSM-III diagnosed schizophrenic patients, before and after acute (single dose) and chronic (six weeks) clozapine treatment, as well as in 17 healthy volunteers. Prior to treatment, patients exhibited greater overall absolute theta power, slower mean alpha frequency and elevated absolute delta and total power in anterior regions. Acute dosing increased total spectrum power globally, slow wave power posteriorally, mean alpha frequency and beta power anteriorally and decreased alpha power posteriorally. Six weeks of clozapine treatment significantly reduced clinical ratings of positive and negative symptoms as well as symptoms of global psychopathology. Chronic treatment resulted in EEG slowing as shown by decreases in relative alpha power, mean beta/total spectrum frequency and by widespread increases in absolute total and delta/theta power. The preliminary findings suggest that brain electric profiling may be a promising tool for assessing and understanding the central impact of pharmacotherapeutic interventions in schizophrenia.


Assuntos
Antipsicóticos/uso terapêutico , Mapeamento Encefálico , Clozapina/uso terapêutico , Eletroencefalografia , Esquizofrenia/diagnóstico , Esquizofrenia/tratamento farmacológico , Doença Aguda , Adolescente , Adulto , Antipsicóticos/administração & dosagem , Clozapina/administração & dosagem , Esquema de Medicação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Psicologia do Esquizofrênico , Índice de Gravidade de Doença , Fatores de Tempo
11.
J Psychiatry Neurosci ; 26(2): 137-49, 2001 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-11291531

RESUMO

OBJECTIVE: To assess the efficacy of quetiapine, a recently introduced second generation antipsychotic medication, in reducing cognitive impairment in patients with schizophrenia. DESIGN: Prospective, randomized, double-blind clinical trial. PATIENTS: 25 patients who met the Diagnostic and Statistical Manual of Mental Disorders, fourth edition, (DSM-IV) criteria for schizophrenia were recruited from 3 Canadian hospitals. INTERVENTION AND OUTCOME MEASURES: After a 48-hour washout period, 25 patients with schizophrenia were randomly assigned to double-blind treatment with quetiapine or haloperidol for 6 months and evaluated with rating scales for psychotic symptoms, mood and extrapyramidal side effects, as well as standardized neuropsychological measures sensitive to 6 cognitive domains: fine motor skill, attention span, verbal reasoning and fluency, visuospatial construction and fluency, executive skills and visuomotor tracking, and immediate recall of verbal and nonverbal materials. The measures were repeated 8 weeks and 6 months after treatment was initiated. RESULTS: Quetiapine improved psychosis and mood without inducing extrapyramidal symptoms. Quetiapine also had beneficial effects on cognitive skills, particularly verbal reasoning and fluency skills and immediate recall, with additional improvements on executive skills and visuomotor tracking and on the average of the 6 cognitive domains with sustained treatment. Patients taking haloperidol showed improvements in general clinical status, but no specific improvements on the positive syndrome, the negative syndrome, depression ratings or cognitive skills. CONCLUSIONS: These preliminary results support the potential value of quetiapine for improving cognitive impairment in patients with schizophrenia and emphasize the importance of further research with this promising atypical antipsychotic.


Assuntos
Antipsicóticos/uso terapêutico , Transtornos Cognitivos/diagnóstico , Dibenzotiazepinas/uso terapêutico , Haloperidol/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Antipsicóticos/administração & dosagem , Antipsicóticos/farmacologia , Transtornos Cognitivos/etiologia , Tomada de Decisões/efeitos dos fármacos , Dibenzotiazepinas/administração & dosagem , Dibenzotiazepinas/farmacologia , Método Duplo-Cego , Feminino , Haloperidol/administração & dosagem , Haloperidol/farmacologia , Humanos , Masculino , Testes Neuropsicológicos , Estudos Prospectivos , Fumarato de Quetiapina , Esquizofrenia/complicações , Índice de Gravidade de Doença , Resultado do Tratamento
12.
Schizophr Res ; 48(1): 57-67, 2001 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-11278154

RESUMO

Neuropsychological change after 6weeks of clozapine treatment was examined in 18 treatment-refractory patients to test anticipated domain-specific cognitive improvements. The first aim of this study was to test the assumption that increased homogeneity of sample and treatment would yield an experimental design with sufficient sensitivity to detect general intellectual changes with clozapine that were not apparent in one previous investigation. The second aim was to test predictions derived from a domain-specific review of all other investigations with clozapine suggesting salient gains on tests sensitive to motor and mental speed, visual spatial manipulation, and new learning of verbal material. The results showed that the comprehensive neuropsychological test battery was sensitive to general cognitive changes with clozapine, and supported the hypothesized domain-specific gains on tests of motor and mental speed, visual spatial manipulation and new verbal learning. Novel gains were also apparent on tests of new learning with nonverbal material. The results are discussed in relation to aspects of experimental design necessary for the evaluation of prospective medication-induced changes in cognitive skill, particularly in future investigations designed to differentiate between second-generation antipsychotic medications.


Assuntos
Antipsicóticos/farmacologia , Clozapina/farmacologia , Cognição/efeitos dos fármacos , Testes Neuropsicológicos , Esquizofrenia/diagnóstico , Esquizofrenia/tratamento farmacológico , Adulto , Feminino , Humanos , Masculino , Projetos de Pesquisa , Sensibilidade e Especificidade
13.
J Psychiatr Res ; 34(4-5): 285-91, 2000.
Artigo em Inglês | MEDLINE | ID: mdl-11104840

RESUMO

OBJECTIVE: To investigate the role of the dopamine receptor 3 (DRD3) and transporter 1 (DAT1) genes in schizophrenia or in modulating its phenotype. METHODS: a Ser9Gly polymorphism in codon 9 of the DRD3 and a VNTR polymorphism in the DAT1genes were examined in two groups of schizophrenic patients, one of excellent neuroleptic responders (N=42) and one of nonresponders (N=64). A group of healthy volunteers screened for major psychiatric disorders was also included (N=89). In addition, age at onset of psychotic symptoms, attention performance and family loading for schizophrenia spectrum disorders were compared between patients with different genotypes in the DRD3 and DAT1 genes. RESULTS: No significant differences in the allelic distribution of the DRD3 and DAT1 polymorphisms were detected between schizophrenic patients and controls. A trend toward an excess of DRD3 genotype Gly/Gly was observed in neuroleptic nonresponder schizophrenic patients compared to controls (chi(2)=3. 30, df=1, p=0.07). No significant differences in age at onset of psychotic symptoms, attention task performance or family loading for schizophrenia spectrum disorders were observed between groups with different DRD3 and DAT1 genotypes. CONCLUSION: These results do not support the role of either of these genes in increasing susceptibility to schizophrenia or in modulating its phenotype in the studied population.


Assuntos
Proteínas de Ligação a DNA/genética , Expressão Gênica/genética , Receptores Dopaminérgicos/genética , Esquizofrenia/genética , Adulto , Alelos , Antipsicóticos/uso terapêutico , Transporte Biológico , Feminino , Predisposição Genética para Doença , Humanos , Masculino , Fenótipo , Polimorfismo Genético/genética , Esquizofrenia/tratamento farmacológico , Resultado do Tratamento
14.
Clin Electroencephalogr ; 31(3): 145-52, 2000 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-10923202

RESUMO

In search of early neuroleptic response predictors in schizophrenia, functional interhemispheric and intrahemispheric asymmetry indices, derived from spectrally analyzed resting electroencephalographic (EEG) activity, were examined in 17 schizophrenic patients prior to open label treatment with the atypical neuroleptic clozapine. Compared to EEG asymmetry indices derived from a normative data bank, patients exhibited significant interhemispheric (left greater than right) and intrahemispheric (anterior greater than posterior) deviations in delta, theta, alpha and beta frequency bands. Intrahemispheric indices were positively correlated with clinical ratings of positive symptoms and global psychopathology. Clozapine-induced improvements in positive and negative symptoms and global psychopathology symptom ratings were related to pretreatment intrahemispheric asymmetry only, with relationships varying with symptom, recording region and frequency band. The results are discussed in relation to the neurobiology of schizophrenia and the utility of EEG as an informative predictor of treatment response.


Assuntos
Clozapina/uso terapêutico , Dominância Cerebral/efeitos dos fármacos , Eletroencefalografia/efeitos dos fármacos , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Adulto , Mapeamento Encefálico , Clozapina/efeitos adversos , Dominância Cerebral/fisiologia , Feminino , Análise de Fourier , Humanos , Masculino , Pessoa de Meia-Idade , Escalas de Graduação Psiquiátrica , Esquizofrenia/fisiopatologia , Processamento de Sinais Assistido por Computador , Resultado do Tratamento
15.
Mol Psychiatry ; 5(3): 323-6, 2000 May.
Artigo em Inglês | MEDLINE | ID: mdl-10889537

RESUMO

The schizophrenia phenotype is heterogeneous with respect to clinical presentation, long-term response to medication, and outcome, possibly reflecting genetic heterogeneity and/or the presence of modifier genes. Compared to non-responders, schizophrenic patients who are responders to neuroleptic medications are characterized by a high female/male ratio, a better long-term outcome and more frequently disturbed dopamine neurotransmission. In this study, we compared two groups of schizophrenic patients selected on the basis of their long-term response to neuroleptics (excellent responders and non-responders) and a group of healthy volunteers, with regard to a missense mutation (677C-->T) in the methylenetetrahydrofolate reductase (MTHFR) gene. This polymorphism was chosen because it is functional and was previously associated with schizophrenia. The present study revealed a significant association between schizophrenia and allele T of this gene. This association was entirely due to an over-representation of allele T in responder patients compared to controls; nonresponder patients did not differ from controls. Genotype TT was more frequent in responder patients compared to controls, thus replicating the findings of Arinami et al. These results strongly suggest that the MTHFR gene is involved in the pathogenesis of schizophrenia characterized by a rapid and sustained therapeutic response to typical neuroleptics and/or a good long-term prognosis/favorable therapeutic outcome.


Assuntos
Mutação de Sentido Incorreto , Oxirredutases atuantes sobre Doadores de Grupo CH-NH/genética , Esquizofrenia/enzimologia , Esquizofrenia/genética , Adulto , Alelos , Antipsicóticos/uso terapêutico , Citosina , Feminino , Genótipo , Humanos , Masculino , Metilenotetra-Hidrofolato Redutase (NADPH2) , Esquizofrenia/tratamento farmacológico , Timina
16.
J Clin Psychopharmacol ; 20(3): 295-304, 2000 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-10831015

RESUMO

This study compared the long-term (12 months) effectiveness of risperidone (RP) with that of conventional neuroleptics (CNs) in a population with chronic schizophrenia who had shown suboptimal response to CNs. A randomized, open, parallel, multicenter design was used. One hundred eighty-four subjects meeting DSM-IV criteria for schizophrenia were randomly assigned to receive either RP or a CN, and 165 of them completed the follow-up. Outcome measures were taken at 3, 6, and 12 months and included the Positive and Negative Syndrome Scale (PANSS) and the Extrapyramidal Symptom Rating Scale. Within this 12-month follow-up, RP was found to be superior to CNs in terms of both the average change in score from baseline on the PANSS (p = 0.006) and the proportion of good responders (as defined by a 20% decrease in total PANSS scores;p = 0.03). For positive symptoms, the effectiveness of the RP treatment tended to increase over time. At 12 months, the percentage of good responders in the RP group was twice as large as that in the CN group (30% vs. 15%;p = 0.03). The superiority of RP over CNs was constant over the three dose categories. In both the RP and the CN groups, the maximum decrease in psychopathology was achieved with the lowest dose range. A worsening of akathisia was less frequent in subjects receiving RP than in those receiving CNs (p = 0.02). In conclusion, this study showed that, compared with CNs, RP is beneficial in the treatment of patients with chronic schizophrenia and that some of these benefits may appear only after longer-term treatment.


Assuntos
Antipsicóticos/uso terapêutico , Risperidona/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Antipsicóticos/efeitos adversos , Doença Crônica , Relação Dose-Resposta a Droga , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Pacientes Desistentes do Tratamento , Escalas de Graduação Psiquiátrica , Risperidona/efeitos adversos , Psicologia do Esquizofrênico
17.
Arch Gen Psychiatry ; 57(3): 249-58, 2000 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10711911

RESUMO

BACKGROUND: The purpose of this investigation was to test the efficacy of novel antipsychotic medications in the treatment of cognitive impairment in early phase schizophrenia. METHODS: Sixty-five patients in this multicenter double-blind study were randomly assigned to olanzapine (5-20 mg), risperidone (4-10 mg), or haloperidol (5-20 mg). Standard measures of clinical and motor syndromes were administered, as well as a comprehensive battery of tests to assess (1) motor skills, (2) attention span, (3) verbal fluency and reasoning, (4) nonverbal fluency and construction, (5) executive skills, and (6) immediate recall at baseline and after 6, 30, and 54 weeks of treatment. RESULTS: The general cognitive index derived from the 6 domain scores revealed a significantly greater benefit from treatment with olanzapine relative to haloperidol and olanzapine relative to risperidone, but no significant difference was shown between risperidone and haloperidol. The improvement related to olanzapine was apparent after 6 weeks and enhanced after 30 and 54 weeks of treatment. Exploratory within-group analyses of the 6 cognitive domains after a conservative Bonferroni adjustment revealed a significant improvement with olanzapine only on the immediate recall domain, and similar analyses of the 17 individual tests revealed a significant improvement with olanzapine only on the Hooper Visual Organization Test. CONCLUSIONS: These data suggest that olanzapine has some superior cognitive benefits relative to haloperidol and risperidone. A larger sample replication study is necessary to confirm and generalize the observations of this study and begin evaluation of the implications of this change to cerebral function and quality of life for people with schizophrenia.


Assuntos
Antipsicóticos/uso terapêutico , Haloperidol/uso terapêutico , Testes Neuropsicológicos , Pirenzepina/análogos & derivados , Risperidona/uso terapêutico , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Adolescente , Adulto , Idoso , Benzodiazepinas , Transtornos Cognitivos/diagnóstico , Transtornos Cognitivos/tratamento farmacológico , Transtornos Cognitivos/psicologia , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Destreza Motora/efeitos dos fármacos , Olanzapina , Pirenzepina/uso terapêutico , Desempenho Psicomotor/efeitos dos fármacos , Esquizofrenia/diagnóstico , Resultado do Tratamento
18.
Am J Med Genet ; 88(6): 694-9, 1999 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-10581491

RESUMO

Recently, it has been suggested that trinucleotide repeat-containing genes may be involved in the etiology of schizophrenia. This study was aimed at investigating putative associations between allelic variants or expansions of CAG repeat-containing genes (CAGrCG) and schizophrenia or its variability with respect to responsiveness to conventional neuroleptics. CAG repeat allelic variants of 14 expressed sequences were compared among three groups of subjects: neuroleptic-responder (R; n = 43) and neuroleptic-nonresponder (NR; n = 63) schizophrenic patients, and a control group (C; n = 122). No CAG expansions, in the range of those observed in neurodegenerative diseases, were identified in these 14 expressed sequences. The sizes of CAG repeat for the hGT1 gene were marginally different among the three groups of subjects (Kruskal-Wallis H (2, 456) = 10.48, Bonferroni corrected P = 0.047). Comparisons among the different groups indicated that neuroleptic responders have shorter alleles compared to controls (Mann-Whitney adjusted Z = -3.23, P = 0.0012). NR patients were not different from controls. These preliminary results suggest that the hGT1 gene, or a gene in its vicinity, may be involved in the etiology of schizophrenia or in modifying the disease phenotype with regard to outcome and/or neuroleptic responsiveness. Am. J. Med. Genet. (Neuropsychiatr. Genet.) 88:694-699, 1999.


Assuntos
Esquizofrenia/genética , Expansão das Repetições de Trinucleotídeos/genética , Repetições de Trinucleotídeos/genética , Adolescente , Adulto , Alelos , Animais , Antipsicóticos/uso terapêutico , Cromossomos Humanos Par 17/genética , Análise Mutacional de DNA , Bases de Dados Factuais , Etiquetas de Sequências Expressas , Feminino , Frequência do Gene/genética , Variação Genética/genética , Humanos , Masculino , Análise por Pareamento , Camundongos , Cadeias Leves de Miosina , Fenótipo , Mapeamento Físico do Cromossomo , Proteínas/genética , Esquizofrenia/tratamento farmacológico , Homologia de Sequência do Ácido Nucleico
19.
Can J Psychiatry ; 44(9): 887-92, 1999 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-10584158

RESUMO

OBJECTIVE: To determine if the inclusion of a placebo control in clinical trials of schizophrenia affects retention rates in the first 35 days of inclusion relative to trials that did not have a placebo control. METHOD: This was a retrospective study of 8 double-blind clinical trials, 5 of which had a placebo control while 3 did not. Using survival analysis, retention rates between the placebo-controlled trials (PCTs) and the nonplacebo-controlled trials (NPCTs) were compared. Screening and percentage improvement on Brief Psychiatric Rating Scale and Positive and Negative Syndrome Scale scores were compared. RESULTS: Significantly more patients were retained in the 35-day period for NPCTs. Also, the PCT group had significantly more psychopathology at screening than did the NPCT group. CONCLUSIONS: Differences in retention rates between PCTs and NPCTs cannot be uniquely attributed to placebo itself.


Assuntos
Antipsicóticos/farmacologia , Antipsicóticos/uso terapêutico , Pirenzepina/análogos & derivados , Remoxiprida/farmacologia , Remoxiprida/uso terapêutico , Retenção Psicológica/efeitos dos fármacos , Risperidona/farmacologia , Risperidona/uso terapêutico , Esquizofrenia/tratamento farmacológico , Adulto , Benzodiazepinas , Escalas de Graduação Psiquiátrica Breve , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , Olanzapina , Pirenzepina/farmacologia , Pirenzepina/uso terapêutico , Estudos Retrospectivos , Esquizofrenia/diagnóstico , Fatores de Tempo
20.
Int Clin Psychopharmacol ; 14(2): 101-12, 1999 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-10220125

RESUMO

The primary objective of this study was to evaluate the efficacy, safety and tolerability of remoxipride (controlled release) versus haloperidol in patients with negative symptoms. The study comprised a multicentre, randomised, double-blind, parallel-group clinical trial. Two hundred and five patients were randomised to either remoxipride or haloperidol. Patients eligible for this study were aged 18-65 years, met the DSM-III-R diagnosis for chronic schizophrenia and the Positive and Negative Symptoms Scale (PANSS) criteria for predominant negative symptoms. There was a statistically significant reduction in the PANSS scores of at least 20% from baseline to last rating for 39 remoxipride (49.4%) and 45 haloperidol (47.6%) treated patients. There were no statistical differences found between the two treatment groups with respect to improvement of negative symptoms and adverse events. The PANSS data suggest that both remoxipride and haloperidol improve the cluster of negative symptoms concerned with social functioning. In addition, the design of the study provides a methodology that is appropriate to the study of primary negative symptoms in schizophrenia.


Assuntos
Haloperidol/uso terapêutico , Remoxiprida/uso terapêutico , Esquizofrenia/tratamento farmacológico , Psicologia do Esquizofrênico , Adulto , Preparações de Ação Retardada/efeitos adversos , Preparações de Ação Retardada/uso terapêutico , Método Duplo-Cego , Feminino , Haloperidol/efeitos adversos , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Remoxiprida/efeitos adversos
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