Preventing the recurrence of depression with a Mediterranean diet supplemented with extra-virgin olive oil. The PREDI-DEP trial: study protocol.

BACKGROUND: The role of dietary patterns in the prevention of unipolar depression has been analyzed in several epidemiological studies. The primary aims of this study are to determine the effectiveness of an extra-olive oil-enriched Mediterranean diet in reducing the recurrence of depression and improving the symptoms of this condition. METHODS: Multicenter, two-arm, parallel-group clinical trial. Arm 1, extra-virgin olive oil Mediterranean diet; Arm 2, control group without nutritional intervention. Dieticians are in charge of the nutritional intervention and regular contact with the participants. Contacts are made through our web platform ( https://predidep.es/participantes/ ) or by phone. Recurrence of depression is assessed by psychiatrists and clinical psychologists through clinical evaluations (semi-structured clinical interviews: Spanish SCID-I). Depressive symptoms are assessed with the Beck Depression Inventory. Information on quality of life, level of physical activity, dietary habits, and blood, urine and stool samples are collected after the subject has agreed to participate in the study and once a year. DISCUSSION: To the best of our knowledge, the PREDI-DEP trial is the first ongoing randomized clinical trial designed to assess the role of the Mediterranean diet in the prevention of recurrent depression. It could be a cost-effective approach to avoid recurrence and improve the quality of life of these patients. TRIAL REGISTRATION: The study has been prospectively registered in the U.S. National Library of Medicine ( https://clinicaltrials.gov ) with NCT number: NCT03081065.

[Neurosyphilis: forms of presentation and clinical management]. / Neurosífilis: formas de presentación y manejo clínico.

INTRODUCTION AND AIMS: Neurosyphilis results from the infection of the central nervous system by Treponema pallidum. It causes diverse clinical pictures which are occasionally similar to other, better known neurological diseases. In this paper our aim is to offer a global clinical vision of this entity by reviewing the different forms it can take and its diagnostic and therapeutic management. DEVELOPMENT: The forms of presentation of neurosyphilis can be grouped in two categories: early (asymptomatic, meningeal and meningovascular neurosyphilis) and late (progressive general paralysis and tabes dorsalis). Other less important forms, such as gummas, ocular forms, syphilitic amyotrophy or hypoacusis, have also been described. Diagnosis is complex and is based on the study of the cerebrospinal fluid. Given the difficulty involved in performing an accurate diagnosis, different criteria have been developed in which T. pallidum serology plays a key role. The most effective treatment is penicillin, although on occasions it may have no effect and we therefore recommend clinical and fluid analysis follow ups. Lastly, we describe the changes in incidence and clinical presentation, and the complications that may arise in diagnosis when HIV carrying patients also suffer from this disease. CONCLUSIONS: Neurosyphilis is a disease that still occurs nowadays and, due to its clinical polymorphism, must be borne in mind as a differential diagnosis in a number of neurological and psychiatric illnesses. This, together with the fact the serological tests are difficult to interpret and its irregular response to the usual treatment, makes it difficult to manage and means that the neurologist must have a thorough knowledge of the disorder.

Prevalence of the metabolic syndrome among schizophrenic patients hospitalized in the Canary Islands.

INTRODUCTION: Schizophrenic patients have a higher standardized mortality rate than that expected for the rest of the population. The prevalence of the metabolic syndrome is high among them, this increase coronary risk twofold to fourfold. This study aims to find out the prevalence of the metabolic syndrome among patients with schizophrenia and schizoaffective disorder who have been admitted to an acute psychiatric ward and the sociodemographic, evolutive and psychopharmaceutical variables related to it. We also hope to establish the extent of coronary risk and its relationship with the metabolic syndrome. METHOD: Cross-sectional observational study including 136 adult patients over 18 years of age. They were admitted in the year 2004 to the Hospital Universitario de Gran Canaria Dr Negrín, with the diagnosis of schizophrenia or SCID-I validated schizoaffective disorder. The metabolic syndrome and coronary risk were defined according to NCEP-ATP III criteria. RESULTS: The prevalence of the metabolic syndrome in the population studied is 36 % (95 % CI: 29.4 to 45.6). The metabolic syndrome is associated to an older age (p<0.05). Abdominal obesity is more prevalent among women (p<0.05). Coronary risk in the next 10 years is moderate in 52.3% of cases and high in 2.9 %. Increase in risk is associated to antipsychotic intake and to suffering metabolic syndrome (p<0.05). CONCLUSIONS: The prevalence of the metabolic syndrome among schizophrenic patients is high and it entails moderate to high coronary risk.

[Psychiatric pathology after extracorporeal cardiac surgery: a case report of tardive postoperative cognitive dysfunction]. / Patología psiquiátrica tras cirugía extracorporea: a propósito de un caso de disfunción cognitiva postoperatoria tardía.

CLINICAL OBSERVATION: A 67-year-old female patient operated of a severe aortic esthenosis with extracorporeal circulation during cardiac surgery, developed psychiatric disturbances with excitement and delirium, being necessary internamtient in a psychiatric ward, a month later. The evolution was right after neuroleptic treatment and nowdays she's assimptomatic. We review what is wrote about posteparative cognitive dysfunction (POCD), being this a tardive presentation case. We analize the definition, prevalence, etiology, pathofisiology, treatment and prevention since it is a reversible surgery complication but if it isn't early diagnosed and treated, its morbidity and mortality can be high.