Microenvironment Eradication of Hepatitis C: A Novel Treatment Paradigm.

OBJECTIVES: Prisons are major reservoirs of hepatitis C virus (HCV) in which a therapeutic approach has been particularly difficult so far. Our aim was to create a permanent program of HCV elimination in a prison based on a "test and treat" strategy. METHODS: This open-label clinical trial was conducted in the Spanish prison "El Dueso" between May 2016 and July 2017. Viremic patients were treated with a ledipasvir-sofosbuvir regimen (8-12 weeks) according to the 2015 Spanish Guidelines. A teleconsultation program was established to follow-up patients from the hospital. Non-responders were submitted for a phylogenetic analysis and offered retreatment. An evaluation of new cases of HCV infection was performed every 6 months and upon release in all inmates. RESULTS: 847 (99.5%) inmates accepted to participate. HCV antibodies were present in 110 (13.0%) and 86 (10.2%) had detectable viremia. Most of them were genotype 1 or 3 (82.6%) and had

Dysbindin gene variability is associated with cognitive abnormalities in first-episode non-affective psychosis.

INTRODUCTION: Dystrobrevin-binding protein 1 gene (dysbindin or DTNBP1) has been associated with schizophrenia and cognitive performance. Its expression in areas implicated in cognition such as the dorsolateral prefrontal cortex, as well as its role in dopaminergic and glutamatergic system, has been replicated by several studies. The main aim of this study was to examine the association between DTNBP1 variability and cognitive performance in a sample of 238 patients with a first episode of a non-affective psychosis. METHODS: Patients, and a comparison sample of 47 healthy subjects, completed an extensive neuropsychological battery. Five single nucleotide polymorphisms (SNPs) within DTNBP1 (rs2619528, rs2619538, rs3213207, rs2619539 and rs760761) and three haplotypes (GACAC, GAGAC and GTGAC) were analysed. RESULTS: In the group of patients, we found a significant association between two of the DTNBP1 SNPs and one of the haplotypes (rs2619539, rs3213207 and GACAC) and a measure of premorbid IQ [Wechsler Adult Intelligence Scale-3rd Edition (WAIS-III) Vocabulary subtest]. Moreover, one of these SNPs, rs2619539, was also associated with our measure of working memory (WAIS-III Backward digits subtest) and two haplotypes, GAGAC and GTGAC, with our measure of verbal memory (Rey Auditory Verbal Learning Test), of visual memory (Rey Complex Figure Test) in the case of GAGAC, and of speed of processing (WAIS-III Digit Symbol-coding) in the case of GTGAC. CONCLUSIONS: Our findings add further evidence suggesting an association between dysbindin gene variability and cognitive abnormalities in schizophrenia, providing preliminary evidence of this association since the time of illness onset among minimally medicated patients.

Board game-based intervention to improve executive functions and academic skills in rural schools: A randomized controlled trial.

INTRODUCTION: This research intends to increase the knowledge about the use of board games in the classroom to train executive functions and academic skills. 99 children from rural schools were assessed in executive functions and academic skills. METHODS: Through a randomized controlled trial, they were assigned to a playing group (n = 51) and an active control group (regular classes without games, n = 48). Play program consisted of 12 sessions for 6 weeks with eight commercial board games. RESULTS: In flexibility, the playing group was significantly faster after the program (p= = .01, d = 0.76), but not the control group (p = .23; d = 0.35). Both groups improved in the academic tasks, but the significance in calculus was greater in the playing group (p = .00; d = 2.19) than in the control group (p = .01; d = 0.97). DISCUSION: The use of board games during school hours could be as good or better methodology for cognitive training and learning academic skills than regular classes.

Insular cortex thinning in first episode schizophrenia patients.

Overall and regional cortical thinning has been observed at the first break of schizophrenia. Due to the fact that structural abnormalities in the insular cortex have been described in schizophrenia, we investigated insular thickness anomalies in first episode schizophrenia. Participants comprised 118 schizophrenia patients and 83 healthy subjects. Magnetic resonance imaging brain scans (1.5T) were obtained, and images were analyzed by using BRAINS2. The contribution of sociodemographic, cognitive and clinical characterictics was controlled. Schizophrenia patients demonstrated a significant right insular thinning, and a significant group by gender interaction was found for left insular thickness. Post-hoc comparisons revealed that male schizophrenia patients had a significant left insular thinning compared with healthy male subjects. There were no significant associations between insular thickness, the severity of symptoms at baseline and cognitive measurements and premorbid variables. The fact that insular thinning is already present at early phases of the illness and is independent of intervening variables offers evidence for the potential of these changes to be a biological marker of the illness.

Neurocognitive effectiveness of haloperidol, risperidone, and olanzapine in first-episode psychosis: a randomized, controlled 1-year follow-up comparison.

OBJECTIVE: To investigate the neurocognitive effectiveness of haloperidol, risperidone, and olanzapine in first-episode schizophrenia-spectrum disorders. METHOD: This prospective, randomized, open-label study was conducted from February 2001 to February 2005. Data for the present investigation were obtained from a large epidemiologic and 3-year longitudinal intervention program of first-episode psychosis (DSM-IV criteria) conducted at the outpatient clinic and the inpatient unit at the University Hospital Marques de Valdecilla, Santander, Spain. One hundred four patients randomly assigned to haloperidol (N = 35), olanzapine (N = 30), or risperidone (N = 39) who completed clinical and cognitive evaluations at baseline, 6 months, and 1 year were included in the final analysis. Thirty-seven healthy individuals were also longitudinally assessed. A neuropsychological battery that comprised 9 cognitive domains was used. The contribution of clinical changes, concomitant medications, and the severity of motor side effects to cognitive changes was controlled. The main outcome measure was cognitive changes at 1-year follow-up. RESULTS: The 3 treatment groups showed a significant improvement in cognitive scores after 1 year. The differential cognitive effectiveness between antipsychotics was insignificant. The magnitude of cognitive changes was similar in the 3 treatment groups and controls, although a greater improvement on the Finger Tapping Test, Trail Making Test B, and Rey Complex Figure Test was found in the treatment groups. Clinical changes, use of concomitant medications, and the emergence of motor side effects did not significantly account for cognitive changes over time. CONCLUSION: Haloperidol, olanzapine, and risperidone were equally effective in treating cognitive deficits of psychosis. The effect of practice clearly contributes to cognitive score improvements after treatment with antipsychotics. Our results provide important information regarding the practical utility of antipsychotic treatments to improve cognition and could have implications for developing novel approaches for cognitive pharmacotherapy in schizophrenia.