Función ejecutiva, lenguaje pragmático y perfiles psicopatológicos según la CBCL en niños con trastornos del neurodesarrollo y antecedentes familiares de esquizofrenia / Executive function, pragmatic language and CBCL psychopathological profiles in children with neurodevelopmental disorders and family history of schizophrenia

INTRODUCCIÓN: La escala CBCL de Achenbach completada por padres evalúa un amplio rango de problemas conductuales y emocionales de inicio en la infancia. Sus subescalas "retraimiento-depresión" y principalmente "problemas de pensamiento" se han propuesto como medida de detección de riesgo de psicosis en adolescentes. Dentro de los posibles endofenotipos de la esquizofrenia se plantean la disfunción ejecutiva y la alteración en el lenguaje pragmático. OBJETIVOS: Identificar mediante ambas subescalas de la CBCL un subgrupo de niños y adolescentes con puntuaciones elevadas entre los pacientes que consultan en psiquiatría infantil por trastornos del neurodesarrollo y que tienen antecedentes familiares de esquizofrenia. MATERIAL Y MÉTODOS: Los padres completan la escala CBCL de Achenbach, CCC-Childrens Communication Checklist- (evaluación del lenguaje pragmático) y BRIEF-2 (evaluación conductual de la función ejecutiva). RESULTADOS: Se incluyeron 21 niños (16 niños: 5 niñas). Edad media 11,4 años. Los diagnósticos principales fueron TDAH (66,7%), trastorno de aprendizaje (9,5%) y TEA (9,5%). Las dos subescalas de la CBCL "retraimiento-depresión" y "problemas de pensamiento" discriminan dos grupos, uno con afectación (n=11) con puntuaciones por encima del Pc70 y otro sin afectación (n=10) con puntuaciones inferiores al Pc70. Los casos con afectación mostraron más dificultades en el lenguaje pragmático y función ejecutiva que los del grupo sin afectación. CONCLUSIONES: Realizar una evaluación dimensional más completa de la psicopatología, como la que ofrece la CBCL, en niños con trastornos del neurodesarrollo y antecedentes familiares de esquizofrenia puede ayudar a describir mejor las dificultades premórbidas e identificar casos susceptibles de seguimiento longitudinal e intervención precoz

INTRODUCTION: The CBCL is a standardized form that parents fill out to describe their children ́s behavioral and emotional problems. Previous studies have suggested that two subscales, "withdrawal-depressed" and mainly "thought problems" may have utility as a psychosis risk screening measure in youth. Executive function and higher-order language dysfunctions have been postulated as potential endophenotypes for schizophrenia. OBJECTIVES: To identify by means of the two CBCL subscales mentioned above, a group of children and adolescents with higher ratings amongst those patients attending an outpatient psychiatric clinic, who present a neurodevelopmental disorder and a family history of schizophrenia MATERIAL AND METHODS: Parents filled out CBCL, CCC-Childrens Communication Checklist- (evaluates pragmatic language) and BRIEF-2 (Behavior Rating Inventory of Executive Function). RESULTS: Twenty-one children were included (16 males; 5 females). Mean age 11,4 y/o. Main diagnoses were ADHD (66,7%), Learning Disorder (9,5%) and ASD (9,5%). CBCL subscales "withdrawn-depressed" and "thought problems" discriminated two groups. One with higher ratings (above Pc70) showing the presence of symptoms (n=11) and the other with lower ratings (below Pc70) indicating symptom absence (n=10). The first group showed more pragmatic language difficulties as well as poorer executive function. CONCLUSIONS: A more comprehensive dimensional evaluation of the psychopathology of children with neurodevelopmental disorders and family history of schizophrenia, by means of CBCL, may provide a better description of premorbid difficulties, helping to identify more vulnerable cases for long term follow up and early intervention

A new method for phenotyping red blood cells using microplates.

BACKGROUND AND OBJECTIVES: The supply of phenotyped red blood cells (RBC) for patients with several RBC antibodies presents a difficult task to hospital blood banks and regional blood centers. The aim of this study was to establish a low-cost typing system to allow extensive phenotyping of regular blood donors for clinically significant RBC antigens. MATERIALS AND METHODS: We developed a new buffer that greatly intensifies the antigen-antibody reaction and thus reduces the quantity of serum needed for phenotyping. The procedure was carried out on microplates. RESULTS: A total of 20,435 regular blood donors have been typed to date. For 752 units required for transfusion, 3,584 phenotyping tests were performed, validating the results by tube or gel typing methods; agreement was achieved in all cases. CONCLUSION: This technique seems adequate for phenotyping a large number of RBC units at very low cost, thus facilitating the availability of phenotyped blood.