Tobacco use in first-episode psychosis, a multinational EU-GEI study.

BACKGROUND: Tobacco is a highly prevalent substance of abuse in patients with psychosis. Previous studies have reported an association between tobacco use and schizophrenia. The aim of this study was to analyze the relationship between tobacco use and first-episode psychosis (FEP), age at onset of psychosis, and specific diagnosis of psychosis. METHODS: The sample consisted of 1105 FEP patients and 1355 controls from the European Network of National Schizophrenia Networks Studying Gene-Environment Interactions (EU-GEI) study. We assessed substance use with the Tobacco and Alcohol Questionnaire and performed a series of regression analyses using case-control status, age of onset of psychosis, and diagnosis as outcomes and tobacco use and frequency of tobacco use as predictors. Analyses were adjusted for sociodemographic characteristics, alcohol, and cannabis use. RESULTS: After controlling for cannabis use, FEP patients were 2.6 times more likely to use tobacco [p ⩽ 0.001; adjusted odds ratio (AOR) 2.6; 95% confidence interval (CI) [2.1-3.2]] and 1.7 times more likely to smoke 20 or more cigarettes a day (p = 0.003; AOR 1.7; 95% CI [1.2-2.4]) than controls. Tobacco use was associated with an earlier age at psychosis onset (ß = -2.3; p ⩽ 0.001; 95% CI [-3.7 to -0.9]) and was 1.3 times more frequent in FEP patients with a diagnosis of schizophrenia than in other diagnoses of psychosis (AOR 1.3; 95% CI [1.0-1.8]); however, these results were no longer significant after controlling for cannabis use. CONCLUSIONS: Tobacco and heavy-tobacco use are associated with increased odds of FEP. These findings further support the relevance of tobacco prevention in young populations.

Effect of marker dosage frequency and spot fecal sampling frequency in the prediction accuracy of fecal output using chromic oxide and titanium dioxide in grazing BON steers.

This study aimed to evaluate the effect of two marker dosage frequencies and two spot fecal sampling frequencies on the variability of fecal output estimation and fecal recovery rate in grazing Blanco Orejinegro (BON) steers with chromium (Cr) or titanium (Ti) as external markers. Four steers (230.5 ± 14.4 kg BW) were used in a 4 × 4 Latin square design in a split-plot arrangement with two markers: Cr or Ti, two marker dosage frequencies: 10.0 g Cr2O3 or TiO2/steer once daily (DF1) or 5.0 g Cr2O3 or TiO2/steer twice daily (DF2), and two fecal sampling frequencies: spot sampling once daily (SF1) or spot sampling twice daily (SF2). Steers were equipped with fecal collection bags to evaluate the actual fecal output (FOR). Fecal marker concentration (FMC) was affected by marker dosage frequency × fecal sampling frequency interaction (P = 0.032): SF1DF1 allowed higher FMC (2.26 g/kg DM) than SF2DF1 (1.95 g/kg DM). Chromium marker allowed higher estimated fecal output (FOe) values when compared to FOR (P < 0.001). Both Ti mean and SD bias (+ 0.074 ± 0.160 kg) were lower than Cr mean and SD bias (+ 0.312 ± 0.272 kg). The Ti fecal output prediction showed lower both RSR (0.586 vs 1.401) and MSPE (0.029 vs 0.167) than Cr prediction. The titanium external marker allowed fecal output estimation with more accuracy in grazing beef cattle trials. A protocol including a once-daily marker dosage associated with a once-daily fecal sampling is plausible, allowing good fecal recovery rates and accurate fecal output estimation.

Timing of ondansetron administration to prevent postoperative nausea and vomiting

BACKGROUND: The original guidelines for using ondansetron recommending its administration prior to induction of anesthesia have been questioned. METHOD: In an effort to determine the most effective timing of ondansetron administration to prevent postoperative nausea and vomiting (PONV), a prospective, randomized, double-blind study was performed. Patients undergoing ambulatory plastic surgery procedures estimated to last two hours or more and who had at least two risk factors for PONV (female gender, non-smoker, previous history of PONV and postoperative opioids) participated in the study. General anesthesia for all patients followed the same standard institutional protocol and all patients received dexamethasone 4 mg intravenously at the start of surgery. The control group (n = 188) received 4 mg of ondansetron intravenously prior to the induction of anesthesia. The study group (n = 184) received 4 mg of ondansetron intravenously 30 minutes prior to completion of the surgery. The incidence of PONV during the early (0-2 hours) and delayed (2-24 hours) postoperative periods was recorded. RESULTS: No significant difference was found between the groups regarding early postoperative nausea or vomiting (p > 0.05). However, a significant difference (p < 0.05) was noted in both late postoperative nausea (control: 30% vs. study group: 20%) and late postoperative vomiting (control: 17% vs. study group: 8%). CONCLUSION: This clinical study indicates that when performing prolonged surgical procedures, late administration of ondansetron (within 30 minutes prior to completing the surgery) is significantly more effective in the prevention of late PONV than when administered prior to the induction of anesthesia.

Topiramate in the treatment of highly refractory patients with Dravet syndrome.

The purpose of this study was to assess the effectiveness and tolerability of topiramate (TPM) as add-on therapy in children with Dravet syndrome and considered unsatisfactorily controlled using stiripentol. All the 36 patients having been treated with TPM in our centre in 2001 were retrospectively evaluated. Seventy percent of them still received stiripentol when TPM was introduced. The association of both drugs did not need any particular adaptation of dosages. The mean TPM follow-up was 13.3 months (4-25 months) and the mean optimal TPM dose was 3.2 mg/kg/d (0.6-9.2 mg/kg/d). Twenty eight children (78 %) showed more than 50 % reduction in the frequency of generalized tonic-clonic seizures and status epilepticus (SE), whereas 8 % had more than 50 % increase. Six patients (17 %) remained seizure-free for at least 4 months. The most frequently reported side-effects were gastrointestinal and behavioural disturbances. TPM had to be stopped in 17 % of patients, because of poor tolerability and/or lack of efficacy. Topiramate seems therefore to be helpful in Dravet syndrome, even in patients not satisfactorily controlled by stiripentol. Both drugs can be easily and safely associated.

Quality of life measures in schizophrenia.

The recognition of the importance of evaluating the quality of life of patients with schizophrenia highlighted the importance of developing appropriate instruments. In this paper we review the available quality of life instruments focusing on their conceptual framework, structure, administration and psychometric properties. First, we address the generic instruments that have been validated for schizophrenic populations, namely the World Health Organization Quality of Life Assessment (WHOQOL), the Medical Outcome Study (MOS) 36-Item Short-Form Health Survey (SF-36) and the EuroQoL-5 Dimensions (EQ-5D). Then, we focus on instruments that have been specifically developed for patients with schizophrenia and other or severe mentally illness such as the Quality of Life Scale (QLS), the Quality of Life Interview (QoLI), the Lancashire Quality of Life Profile (LQoLP), the Sevilla Quality of Life Questionnaire (SQLQ), the Personal Evaluation of Transitions in Treatment (PETIT), and the Quality of Life Questionnaire in Schizophrenia (S-QoL).

[SPECT-identified hypoperfusion of the left temporomesial structures in a Kleine-Levin syndrome]. / Hypoperfusion temporomésiale gauche en TEMP dans un syndrome de Kleine-Levin.

A 13-year-old boy developed typical features of Kleine-Levin syndrome. Routine investigations and MRI were normal. SPECT, performed both during an attack and during a symptom-fee period, demonstrated clear hypoperfusion of the left mesiotemporal structures. The possible implications of this finding are discussed.

Trends in suicide in the elderly in Asturias (Spain).

Data from elderly suicides was obtained from two previous studies of community suicides in two localities of Northern Spain, namely, Oviedo between 1983 and 1990, and Gijón between 1975 and 1986. Data from the two localities were obtained by the revision of court register cases. A retrospective study on elderly suicide (over 60 years of age) was carried out. Mean annual specific rates for the elderly in Oviedo for 1982-1991 were 37.7 (58.1 for men and 23.3 for women) and for those in Gijón for the period 1975-1986, 23.4 (40 for men and 11.5 for women). A marked increase was seen in the rates for Gijón from the first (1975-1978) to the last period (1983-1986). This was particularly marked in men. The greatest increase in the rate was seen in men over 75 from Gijón and in those between 1970-1974 from Oviedo. In contrast a decrease was seen in the 65-69 age group rates for both men and women. A tendency for the rates to increase was seen but no important increase for elderly suicides was evident.

[Sleep, organic deterioration and general health in the aging population. Study in a basic health zone of Oviedo]. / Sueño, deterioro orgánico y salud general en población involutiva. Estudio en una zona básica de salud de Oviedo.

An epidemiologic approach to the involutive general population was made to detect patients and risk group of insomnia. The survey was carried out in one health area of Oviedo, during the winter of 1990. A total of 329 elderly persons were interviewed, and three questionnaires were used: the G.H.Q., MMSE and a questionnaire "ad hoc". In the study, sleep disorders were correlated with level of general health (Golberg) and cognitive impairment (MMSE).

[Thematic Apperception Test: psychodiagnosis in heroin-dependent patients]. / T.A.T.: psicodiagnóstico en pacientes heroinómanos.

The aim of our work is the search of some differential psychopathologic features or categories in the personality of the heroin addict, through the application of Murray TAT. Which, we try to contrast with another contributions carried out until the present time. On the other hand, other parameters of sociolaboral and demographic character have been valued. We do not detect a structure of uniform personality, through we observe clear differences with respect to people who are not dependent on drugs. According to the results we have found, there are a larger number of psychopathologic elements in the whole of the heroin addict personality, as a greater low self-esteem, a suicidal inclination, a problematic with authority models, an evasión of aggressiveness, feelings of anxiety and quiltiness, without being a universal pattern.

[Psychopathologic traits of patients addicted to heroin]. / Rasgos psicopatológicos en pacientes heroinómanos.

The aim of our work is the search for some differential psychopathologic features in the heroin addict personality, through the 16 PF of Cattell (A form), which we try to contrast with other contributions from studies carried out up to the present. Moreover, other parameters of demographic and socioeconomic interest have been evaluated. Through the results we have gotten, it seems that there is a larger number of psychopathologic elements in the personality of the heroin addict, such as greater introversion, frustration, culpability, radicalism, self-sufficiency, anxiety, over-excitement, actions influenced by their feelings, and a minor acceptance of the rules of the group, though these features do not constitute a standard structure of personality.