Sample records for schizophrenic patients treated

  1. A massive neglected giant basal cell carcinoma in a schizophrenic patient treated successfully with vismodegib

    DEFF Research Database (Denmark)

    Andersen, Rosa Marie; Lei, Ulrikke


    The small molecule vismodegib is a great treatment alternative to patients challenged, e.g. psychiatric disorders, suffering from severe basal cell carcinoma of the skin in which surgery or other treatment modalities is not possible because of patient's wish or condition. We present a case of a 73......-year-old schizophrenic patient with a 15-year history of a neglected tumour located at the forehead and scalp, admitted to hospital in a state of inanition because of tumour expansion to the meninges and severe anaemia caused by bleeding, treated successfully with vismodegib....

  2. A 12-month follow-up study of treating overweight schizophrenic patients with aripiprazole

    NARCIS (Netherlands)

    Schorr, S. G.; Slooff, C. J.; Postema, R.; Van Oven, W.; Schilthuis, M.; Bruggeman, R.; Taxis, K.

    Objective: To investigate the feasibility of switching overweight schizophrenic patients to aripiprazole and to assess the impact of 12 months of aripiprazole treatment on weight in routine practice. Method: This was a non-controlled cohort study in overweight schizophrenic patients. Data were


    Directory of Open Access Journals (Sweden)

    Oscar Rodríguez-Mayoral


    Full Text Available Objective: tobacco smoking is the most commonly substance abused in psychiatric patients; among them, patients with schizophrenia are the highest abusers. Smoking is related to a decrease in the quality life and life expectancy, as well as interacting with psychotropic drugs. In Mexico, there is not basic descriptive knowledge about the main variables related to cigarette smoking in psychiatric population. The aim of this study was to know the relation among variables (beginning and course of the disease, use of other drugs and times of hospitalization among others and cigarette smoking in a Mexican population of hospitalized schizophrenic patients. Method: The relation between the main variables and smoking were evaluated in a Mexican population of schizophrenic patients while hospitalized. A casuistic sampling was performed in 96 patients diagnosed with schizophrenia and they were divided into three groups: 1 non-smokers, 2 ex-smokers and 3 smokers; according to their score on the Fagerström Test for Nicotine Dependence. Results: The results showed that hospitalized schizophrenic patients smoke 2.7 times more than the general population. Most of these patients showed moderate to high dependence of nicotine, as well as a higher risk for other drugs abuse (marihuana mainly. Most patients started smoking before the first positive symptoms of schizophrenia appeared, and their symptoms started at an earlier age than in patients without a smoking background. Conclusions: Similar studies will allow deepening into specific aspects that modify and or improve the prescribed treatments for each psychiatric patient in hospital settings.

  4. Somatotypic characteristic of schizophrenic patients. (United States)

    Sivkov, Stefan; Akabaliev, Valentin; Nikolova, Yulia


    Introduction of quantitative metric methods of somatotype assessment in schizophrenic patients to make clinical diagnosis more objective, the diagnosis being otherwise based exclusively on the clinical interview and assessment of the mental status of patients and thus involving certain subjectivity. The study included 67 schizophrenic inpatients (38 men, 29 women) consecutively admitted to the Clinic of Psychiatry in Plovdiv. Their mean age was 31.47 years (SD = 9.43, range 16-56), mean duration of illness 6.86 (SD = 6.09, range 1-27), mean number of hospitalizations 4.22 (SD = 4.08, range 1-19). The patients satisfied DSM-IV criteria for a diagnosis of schizophrenia (American Psychiatric Association, 1994). The control group comprised 69 subjects (36 men, 33 women) with a mean age 39.24 years (SD = 10.18, range 22-68) and socioeconomic background matching that of the patients. The data showed statistically significant differences in the three somatotype component and in almost all somatotypological variables between male schizophrenic patients and control subjects. The somatotype categories were more extensively presented in the schizophrenic patients. There was a tendency to higher frequency of the ectomorphic categories (ectomorphic mesomorph, mesomorphic ectomorph and endomorph-ectomorph). No statistically significant differences were found in the somatotype components and somatotypological variables between the female schizophrenic patients and control subjects. The data of the examination of the somatotype of schizophrenic patients and control subjects evince a definite sexually related body constitution characteristic that differentiates the groups. Schizophrenic patients and control subjects are clearly determined somatotypically only in the group of males.

  5. Association between the blood concentrations of ammonia and carnitine/amino acid of schizophrenic patients treated with valproic acid. (United States)

    Ando, Masazumi; Amayasu, Hideaki; Itai, Takahiro; Yoshida, Hisahiro


    Administration of valproic acid (VPA) is complicated with approximately 0.9% of patients developing hyperammonemia, but the pathogenesis of this adverse effect remains to be clarified. The aim of the present study was to search for mechanisms associated with VPA-induced hyperammonemia in the light of changes in serum amino acids concentrations associated with the urea cycle of schizophrenic patients. Blood samples (10 mL) were obtained from 37 schizophrenic patients receiving VPA for the prevention of violent behaviors in the morning after overnight fast. Blood concentrations of ammonia, VPA, free carnitine, acyl-carnitine, and 40 amino acids including glutamate and citrulline were measured for each patient. Univariate and multivariate regression analyses were performed to identify amino acids or concomitantly administered drugs that were associated with variability in the blood concentrations of ammonia. The blood ammonia level was positively correlated with the serum glutamate concentration ( r  = 0.44, p  blonanserin ( p  < 0.01) was positively associated with the elevation of the blood ammonia level. We hypothisized that VPA would elevate the blood ammonia level of schizophrenic patients. The observed changes in serum amino acids are compatible with urea cycle dysfunction, possibly due to reduced carbamoyl-phosphate synthase 1 (CPS1) activity. We conclude that VPA should be prudently prescribed to schizophrenic patients, particularly those receiving mood stabilizers or certain antipsychotics.



    Oscar Rodríguez-Mayoral; Julio César Flores-Lázaro; Nuria Lanzagorta; Fernando Corona-Hernández; Humberto Nicolini


    Objective: tobacco smoking is the most commonly substance abused in psychiatric patients; among them, patients with schizophrenia are the highest abusers. Smoking is related to a decrease in the quality life and life expectancy, as well as interacting with psychotropic drugs. In Mexico, there is not basic descriptive knowledge about the main variables related to cigarette smoking in psychiatric population. The aim of this study was to know the relation among variables (beginning and course of...

  7. Psychopharmacological treatment of aggression in schizophrenic patients. (United States)

    Brieden, T; Ujeyl, M; Naber, D


    Aggressive behavior is frequently observed in schizophrenic patients. More than 50 % of all psychiatric patients and 10 % of schizophrenic patients show aggressive symptoms varying from threatening behavior and agitation to assault. The pharmacological treatment of acute, persisting and repetitive aggression is a serious problem for other patients and staff members. Not only is violent behavior from mentally ill patients the most detrimental factor in their stigmatization, aggression is also a considerable direct source of danger for the patients themselves. Based on rather limited evidence, a wide variety of medications for the pharmacological treatment of aggression has been recommended: typical and atypical antipsychotics, benzodiazepines, mood stabilizers, beta-blockers and selective serotonin reuptake inhibitors (SSRIs). Most clinical information on treating aggression has been collected for atypical neuroleptics, particularly for clozapine. Several retrospective and open studies indicate its efficacy. Treatment duration of 6 months is recommended to induce a stable reduction of physical and verbal aggression. Severe side effects have very rarely been seen. At the moment, clozapine seems to be the first choice in aggression treatment. Within the last few years, about 10 articles were published showing that this is the most effective antiaggressive agent in the treatment of aggression and agitation in psychiatric patients, independent of psychiatric diagnosis. However, clozapine, like all the other substances used, does not have an established indication for the treatment of aggressive symptoms. Noncompliance with medication makes it difficult to choose the right preparation for the medication: tablets, liquids, intramuscular injections and readily soluble "FDDFs" are available. Ethical, juridical and methodological problems prevent controlled studies from establishing a reference in the treatment of aggression in mentally ill patients. This review summarizes

  8. Altered balance in the autonomic nervous system in schizophrenic patients

    DEFF Research Database (Denmark)

    Nielsen, B M; Mehlsen, J; Behnke, K


    .05). Heart-rate response to inspiration was greater in non-medicated schizophrenics compared to normal subjects (P less than 0.05), whereas no difference was found between medicated and non-medicated schizophrenics. The results show that the balance in the autonomic nervous system is altered in schizophrenic...... patients with a hyperexcitability in both the sympathetic and the parasympathetic division. Our study has thus indicated a dysfunction in the autonomic nervous system per se and the previous interpretations of attentional orienting responses in schizophrenia is questioned. Medication with neuroleptics......The aim of the present study was to evaluate the autonomic nervous function in schizophrenic patients. Twenty-eight patients (29 +/- 6 years) diagnosed as schizophrenics and in stable medication were included, together with ten schizophrenic patients (25 +/- 5 years) who were unmedicated. Eleven...

  9. Conditional Reasoning in Schizophrenic Patients. (United States)

    Kornreich, Charles; Delle-Vigne, Dyna; Brevers, Damien; Tecco, Juan; Campanella, Salvatore; Noël, Xavier; Verbanck, Paul; Ermer, Elsa


    Conditional reasoning (if p then q) is used very frequently in everyday situations. Conditional reasoning is impaired in brain-lesion patients, psychopathy, alcoholism, and polydrug dependence. Many neurocognitive deficits have also been described in schizophrenia. We assessed conditional reasoning in 25 patients with schizophrenia, 25 depressive patients, and 25 controls, using the Wason selection task in three different domains: social contracts, precautionary rules, and descriptive rules. Control measures included depression, anxiety, and severity of schizophrenia measures as a Verbal Intelligence Scale. Patients with schizophrenia were significantly impaired on all conditional reasoning tasks compared to depressives and controls. However, the social contract and precautions tasks yielded better results than the descriptive tasks. Differences between groups disappeared for social contract but remained for precautions and descriptive tasks when verbal intelligence was used as a covariate. These results suggest that domain-specific reasoning mechanisms, proposed by evolutionary psychologists, are relatively resilient in the face of brain network disruptions that impair more general reasoning abilities. Nevertheless, patients with schizophrenia could encounter difficulties understanding precaution rules and social contracts in real-life situations resulting in unwise risk-taking and misunderstandings in the social world.

  10. Reported Childhood Trauma and Suicide Attempts in Schizophrenic Patients (United States)

    Roy, Alec


    Childhood traumas are associated with suicidal behavior but this aspect has not been examined in relation to schizophrenia. In this study, 50 chronic schizophrenic patients who had attempted suicide were compared with 50 chronic schizophrenic patients who had never attempted suicide for their scores on the 34-item Childhood Trauma Questionnaire…

  11. [Neurological soft signs in schizophrenic patients and their nonaffected siblings]. (United States)

    Mechri, A; Slama, H; Bourdel, M-C; Chebel, S; Mandhouj, O; Krebs, M-O; Gaha, L


    Neurological soft signs (NSS) are subtle neurological signs indicating non specific cerebral dysfunction. Several studies have found an excess of NSS in schizophrenic patients compared to healthy subjects. Although NSS have been consistently reported in schizophrenic patients, their clinical relevance and their relation to functional impairment and severity of this disease are not well-clarified. In addition, the presence of NSS in schizophrenic patient's relatives suggests that they could be associated with the genetic liability. To determine the prevalence and scores of NSS in schizophrenic patients and their nonaffected siblings and to examine the clinical correlates of NSS in the schizophrenic patients. Sixty-six schizophrenic patients (50 males and 16 females, mean age=31.16+/-7.17 years), were compared to 31 of their nonaffected siblings (22 males and nine females, mean age=32.19+/-5.88 years) and to 60 controls subjects (40 males and 20 females, mean age=30.70+/-6.54 years) without family psychiatric history. NSS were assessed with Krebs et al.'s neurological soft signs scale. It is a comprehensive and standardized scale consisting of 23 items comporting five factors: motor coordination, motor integration, sensory integration, quality of lateralization and involuntary movements or posture. The Simpson and Angus scale for extrapyramidal symptoms was also rated. Clinical assessment of the schizophrenic patients was conducted using the positive and negative syndrome scale (PANSS), clinical global impressions (CGI) and global functioning evaluation (GAF). Psychiatric disorders were ruled out among siblings of schizophrenic patients and control subjects by psychiatric review evaluation, according to the DSM-IV check list. When the total NSS score of 11.5 was considered the cut-off point, the prevalence of NSS was 96.9% in the schizophrenic patients versus 35.5% in the nonaffected siblings (ptotal score and subscores than the siblings and control groups. The NSS

  12. schizophrenics

    African Journals Online (AJOL)


    Jul 30, 2006 ... A risk for diabetes is being overweight and the potential for psychotropic agents to increase weight would therefore impact on this health factor.1 Following the introduction of phenothiazine's in. 1956 the prevalence rates of type 2 diabetes mellitus in patients with schizophrenia showed a marked increase.


    NARCIS (Netherlands)



    The feasibility of day treatment with community care for schizophrenic patients was tested by means of a longitudinal randomized experiment with 34 experimentals and 16 controls: 38 percent could be treated satisfactorily in a day program that included a very active ambulatory service. The new

  14. [Psychopathology of poetry writing of schizophrenic patients while ill]. (United States)

    Miliavskiĭ, V M


    On the basis of a psychopathological analysis of over 300 poems written by 29 schizophrenics in the state of the defect some characteristic features associated with the disturbances in the sphere of thought were revealed. The verses written by the patients showed a strange interpretation of the events being described, an unnecessary accentuation of minor details, a striving for formal novelty, peculiar plays on words, various abbreviations underlinings, as well as an amorphous character, absence of key points, inconsistency of the plot. In a number of cases the poverty of the content was combined with grandiloquent pathetics. Characteristic of the verses written by the schizophrenics was emotional inadequacy. In the author's opinion, verses of schizophrenic patients in the state of the defect can serve as a differential diagnostic criterion of the defective states.



    T.murali; John, C. J.; Ramakrishnan, N.; Gopinath, P.S.


    SUMMARY Sexual behaviour in forty mile schizophrenics on maintenance medication were studied. Authors observed that thirteen patients reported decrease in frequency of sexual thoughts, fifteen in frequency of intercourse. Eight patients reported decline in enjoyment of intercourse and six avoided sex.

  16. Expressed emotion among schizophrenic patients in Lagos, Nigeria ...

    African Journals Online (AJOL)

    MO. Emotional reactions of relatives to schizophrenic patients in Lagos,. Nigeria. African Journal of Medical Sciences 2003; 32(1):7-11. 7. Vaughn CE, Leff JP. The measurement of expressed emotions in the families of psychiatric patients. British Journal of Social and Clinical. Psychology. 1976b; 15:157-165. 8. Jablensky A ...

  17. Refraction and eye anterior segment parameters in schizophrenic patients

    Directory of Open Access Journals (Sweden)

    Tongabay Cumurcu


    Full Text Available ABSTRACT Purpose: To evaluate the difference in terms of refractive errors and anterior segment parameters between schizophrenic patients and healthy volunteers. Methods: This study compared 70 patients (48 men who were diagnosed with schizophrenia with a control group of 60 (35 men who were similar in terms of age, gender, education, and socioeconomic level. Anterior segment examination was performed using a Scheimflug system. Axial length and lens thickness (LT were measured using optic biometry. The following tests were administered to the psychiatric patient group: Brief Psychiatric Rating Scale (BPRS, Scale for the Assessment of Negative Symptoms (SANS, and Scale for the Assessment of Positive Symptoms (SAPS. Results: Mild myopia was detected in both the schizophrenic and control groups, with no statistically significant difference (p>0.005. Corneal volume (CV, anterior chamber volume (ACV, anterior chamber depth (ACD, and central corneal thickness (CCT values were lower in the schizophrenic group, and there was a statistically significant between-group difference (p=0.026, p=0.014, p=0.048, and p=0.005, respectively. LT was greater in schizophrenics, and the difference was found to be statistically significant (p=0.006. A statistically significant negative correlation was found between SAPS and cylinder values (p=0.008. The axial eye length, cylinder value, pupil diameter, mean keratometric value, and anterior chamber angle revealed no statistically significant difference between the groups (p>0.05. Conclusion: No statistically significant difference was detected in terms of refraction disorders between schizophrenics and the healthy control group, while some differences in anterior chamber parameters were present. These results demonstrate that schizophrenics may exhibit clinical and structural differences in the eye.

  18. Sexual self-perception in schizophrenic and depressive patients. (United States)

    Vučić-Peitl, Marija; Peitl, Vjekoslav; Pavlović, Eduard


    Sexual self-perception is just one of the items of the complex system of self, which has rarely been researched in the population of mental health patients. Our goal was to establish whether the differences in sexual self-perception exist between schizophrenic and depressive patients compared with the healthy control group. This research was performed on 100 schizophrenic patients, 100 depressive patients and 100 phenotypically healthy volunteers. In order to diagnose schizophrenia and depression, DSM-IV classification was used. Bezinovic's questionnaire for sexual self-perception was used in order to assess seven aspects of sexual self-perception. Results revealed that schizophrenic and depressive patients, compared with healthy individuals, scored significantly higher on the aspects of negative emotionality and sexual incompetence, and significantly lower on the aspect of sexual satisfaction. No statistically significant differences were established between schizophrenic and depressive patients. We can conclude that patients suffering from schizophrenia or depression differ from healthy individuals in all of the aspects of sexual self-perception.

  19. Concentrations in plasma clozapine levels in schizophrenic and schizoaffective patients. (United States)

    Iglesias García, Celso; Iglesias Alonso, Ana; Bobes, Julio

    There is great variability in plasma levels of clozapine. The objective of this study is to know the characteristics of patients treated with clozapine and the relationship between them and the variability of plasma levels. Descriptive, cross-sectional study of all patients currently treated with clozapine in a Psychiatric Service with a diagnosis of schizophrenic psychosis or schizoaffective disorder. The present study assessed physical situation, psychopathology and functionality of the patients and explored the associations and correlations between clinical variables and plasma levels. We studied 39 patients, predominantly men, with negative and depressive symptoms and cardiovascular risk factors (metabolic syndrome and smoking). Significant variability in dose and even greater in clozapine levels were observed. The levels of clozapine at equal doses/kg of body weight were higher in non-smokers, they had positive correlation with BMI and negative correlation with systolic BP, disruptive behaviors and number of cigarettes consumed. Plasma level monitoring clozapine is an important tool to avoid clozapine plasma levels monitoring and minimize undesirable clinical situations (metabolic syndrome, sedation, negative symptoms and functional impairment). It is also important to control the effects of a smoking habit for optimum drug bioavailability. Copyright © 2017 SEP y SEPB. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Working memory capacity predicts language comprehension in schizophrenic patients. (United States)

    Condray, R; Steinhauer, S R; van Kammen, D P; Kasparek, A


    The association between language comprehension and working memory capacity was evaluated in 25 male DSM-III-R schizophrenic patients (14 inpatients; 11 outpatients), and in 11 male normal controls (no lifetime DSM-III-R disorder). Patients and controls did not differ significantly on age and education. Language comprehension was examined as a function of two types of processing demand: grammatical complexity (complex versus simple sentences) and presentation rate (accelerated versus conversational). Schizophrenic patients showed significantly reduced language comprehension and decreased working memory capacity for language, compared with controls. Patients showed general difficulty in comprehending accurately, rather than exhibiting problems with specific grammatical structures. Subject groups were highly accurate and did not differ in their ability to perceive the individual words in sentences presented at the accelerated rate (intelligibility). Presentation rate and grammatical complexity affected comprehension accuracy in all groups, however, with increases in rate and complexity producing decreases in understanding. Of most importance, theoretically, is the finding that working memory capacity predicted language comprehension accuracy in both schizophrenic patients and normal controls. Results suggest that language comprehension deficits in schizophrenic patients may involve a general dysfunction that is associated with working memory capacity for language.

  1. The Comprehension of Idiomatic Expressions in Schizophrenic Patients (United States)

    Schettino, Antonio; Lauro, Leonor Romero; Crippa, Franca; Anselmetti, Simona; Cavallaro, Roberto; Papagno, Costanza


    Recent fMRI and TMS studies on idiom comprehension have shown that the prefrontal cortex is involved in idiom processing. Since schizophrenic patients exhibit prefrontal "structural" changes and dysexecutive "behavioural" deficits, we hypothesised an impairment in idiom comprehension, correlating with performance on executive…

  2. affective, schizophrenic and mood disorders in patients admitted at ...

    African Journals Online (AJOL)

    Findings from clinical, genetic, neuropsychological and neurophysiological studies have failed to highlight a clear demarcation between the two main psychotic syndromes i.e.. MD and SCZ12, while evidence from brain imaging,. The relationship between schizo- affective, schizophrenic and mood disorders in patients ...

  3. Assessment of Living Skills in Schizophrenic Patients by Kohlman Evaluation

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    Leila Kazazi


    Full Text Available Background: The living skills of schizophrenic patients are disrupted due to cognitive, perceptual, sensory-motor, psychological, and psychosocial problems. Therefore, the identification of some aspects of living skills that require medical intervention is essential in these patients. Accordingly, in this study, the living skills of schizophrenic patients were investigated with the Kohlman Evaluation of Living Skills.Materials and Methods: This study was conducted by using the cross-sectional descriptive and analytic approach in which 35 hospitalized and 51 outpatient schizophrenic patients and 35 healthy individuals were compared and the areas of living skills that needed help were determined.Results: According to the Kruskal-Wallis test, there was a significant difference between the mean scores of healthy, hospitalized and outpatients subjects, whereas the difference in the means scores was not significant between the two groups of patients (p=0.693. Schizophrenic patients showed more than 50% requirement for help in the following subscales; appearance, awareness of dangerous household situations, appropriate action for sickness and accidents, obtaining and maintaining a source of income, budgeting their monthly income, and leisure activities. Employment had a direct effect on the living skills of the subjects and the test mean scores of employed people (2.409 was better than unemployed persons (7.083.Conclusion: The living skills of schizophrenic patients are damaged in some areas through the course of the disease and its symptoms. Based on the Kohlman Evaluation of Living Skills, these people require most help in self-care, safety health, money management, and leisure activities.

  4. [The information of the schizophrenic patient: actuality]. (United States)

    Palazzolo, J; Brousse, G; Favre, P; Llorca, P-M


    schizophrenia can come alive talking about things in the past before they became ill. It's as if their life grinded to halt when they became sick. I'm stuck in the mid seventies, and that's the music I like. Everybody I know with schizophrenia is quite isolated socially and I don't really know why. That is especially true for the older people in my age group. Younger people seem to be doing much better. Many still live with their parents. Most older people live alone. There is also the odd person who recovers well, returns to a career, and marries someone without schizophrenia. In cases where marriage predates the onset of schizophrenia, the outcome is often divorce although women are more likely to stick with their husbands with schizophrenia than vice versa, especially if there are already children. I hope the next generation who appears to be less disabled survives better than people of my age with schizophrenia. The goal of community integration is one that requires: more effective treatments and/or more financial support and/or a compassionate non-discriminating community. The combination of early diagnosis and atypical medications will change the face of schizophrenia. I'm not expecting more financial support from the government, but many more people with schizophrenia will start working again instead. Their social networks will develop but social networks are probably the hardest hit in schizophrenia. It's better that you never lose your friends in the first place". This testimony shows how the information of the schizophrenic patient is necessary, and underlines the importance of the relationships between the patient and his family. Our article insists on this theme, rarely developed in the literature.

  5. Stroop interference effect in schizophrenic patients: an electrophysiological approach. (United States)

    Markela-Lerenc, Jaana; Schmidt-Kraepelin, Christian; Roesch-Ely, Daniela; Mundt, Christoph; Weisbrod, Matthias; Kaiser, Stefan


    Schizophrenic patients present deficits in executive control functions. The Stroop test requires executive control functions, in particular response inhibition. So far only one study has employed the high temporal resolution of electrophysiological methods to investigate the neural correlates of the Stroop effect in schizophrenia. This study investigated medicated patients with schizophrenia or schizoaffective disorder (n=15) and healthy controls (n=15) using event-related potentials. The analyses of the P1 and N1 components revealed no differences between the groups indicating intact sensory processing in schizophrenia during the Stroop test. We found greater negativity in the incongruent as compared to the congruent and neutral conditions between 350 and 450 ms over prefrontal scalp areas in healthy subjects but not in schizophrenic patients. Later on, a sustained positivity was observed over parietal scalp regions in healthy subjects. This later sustained potential was attenuated in patients but only in the first block. This suggests that following practice patients show similar parietal effects as healthy subjects. The total errors in the incongruent condition in patients correlated negatively with the difference in mean activity between incongruent and congruent conditions over the left parietal area (time window 600-1000 ms). In other words the more errors were made by patients, the more attenuated was the Stroop related electrophysiological effect. This suggests that the parietal activity is related to successful resolution of the Stroop conflict in schizophrenic patients. Furthermore, the absence of the frontal deflection in patients reflects dysfunctional neural processes associated with executive control.

  6. Unsuccessful Self-Enucleation in a Schizophrenic Patient

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    Noam Bar-Yaakov


    Full Text Available Self-enucleation is a very unusual form of self-mutilation directly linked to mental illness. In this case we present a 26-year-old schizophrenic patient who attempted to enucleate his eye with a rollerball pen. Antipsychotic therapy and emergency surgery saved the patient eye and emphasize the importance of quick response and good collaboration between psychiatric and ophthalmic teams.

  7. [History of treatment of schizophrenic forensic patients prior to admission: a comparison with schizophrenic general psychiatric patients]. (United States)

    Piontek, K; Kutscher, S-U; König, A; Leygraf, N


    The number of schizophrenic patients admitted to forensic hospitals according to section 63 of the German Criminal Code has increased continuously over the past years. Prior to admission to a forensic ward, two thirds of schizophrenic patients have been admitted to a general psychiatric institution at least once. Among other factors, forensic admission is seen as a consequence of insufficient pretreatment in general psychiatry. This study aims to identify differences regarding the history of treatment of forensic and general psychiatric patients diagnosed with schizophrenia. The matched samples include 72 male patients from forensic wards and 72 male patients from general psychiatry diagnosed with schizophrenia. The history of psychiatric treatment was reconstructed by interviewing the patients as well as the outpatient psychiatrists and by analyzing these patients' medical records. Both groups showed similar risk factors, however, forensic patients had a higher number of previous convictions and were convicted more often for violent offences. Furthermore, the data indicate that forensic patients are less integrated into psychiatric care and showed a lower rate of treatment compliance prior to admission to a forensic ward. The results provide support for the arrangement of an intensive outpatient aftercare, especially for schizophrenic patients with comorbid substance abuse disorders and previous convictions for violent offences.

  8. Mortality and causes of death in first admitted schizophrenic patients

    DEFF Research Database (Denmark)

    Mortensen, P B; Juel, K


    Although many studies have shown an increased mortality in schizophrenic patients, the literature provides little information about mortality from specific causes in relation to age, gender, and duration of illness. This study examined mortality and causes of death in a total national sample...... of 9156 first admitted schizophrenic patients. Suicide accounted for 50% of deaths in men and 35% of deaths in women. Suicide risk was particularly increased during the first year of follow-up. Death from natural causes, with the exception of cancer and cerebrovascular diseases, was increased. Suicide...... risk during the first year of follow-up increased by 56%, with a 50% reduction on psychiatric in-patient facilities. The study confirms that mortality in schizophrenia is still markedly elevated, and the finding of an increasing suicide risk may be an indicator of some adverse effects...

  9. Chronic pain and quality of life in schizophrenic patients

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    Jouce Gabriela de Almeida


    Full Text Available OBJECTIVE: To identify the prevalence and characteristics of chronic pain in schizophrenic patients and to compare the quality of life in patients with and without chronic pain. METHODS: Crossover design with a probablistic sample of 205 adult schizophrenic outpatients (80% paranoid schizophrenia. Socio-demographic, psychiatric disorder, pain and quality of life (WHOQOL- brief data were collected between June and September 2008. RESULTS: Mean age was 37 years, 65% were men, and the mean time spent in school was 9 years; 87% were single, 65% lived with parents and 25% had a job. Among patients with chronic pain, 70% did not receive treatment for pain. Regarding quality of life, patients with pain had more physical disabilities compared to those without pain (p < .001. There were no differences in other domains. Comparisons between patients with and without pain did not show any differences in how much they felt their mental health problems disabled them. Conclusion: Chronic pain was common in schizophrenic patients (similar to the general population of a similar age and decreased their quality of life. It is necessary to pay more attention to this co-morbidity.

  10. Neurocognitive performance in first-episode and chronic schizophrenic patients. (United States)

    Moritz, Steffen; Andresen, Burghard; Perro, Christian; Schickel, Marc; Krausz, Micheal; Naber, Dieter


    Previous research on neuropsychological disturbances in first-episode and chronic schizophrenic patients has provided mixed results which can be partially attributed to methodological inconsistencies. For the present study, 70 schizophrenic patients (40 with chronic and 30 with first-episode schizophrenia) were compared to 30 healthy controls on a large battery of neuropsychological tests. Special attention was paid to potential confounds such as differences in psychopathology, age and educational level between the schizophrenic sub-samples. Healthy controls performed better than both first-episode and chronic patients in almost all cognitive domains (P < 0.01), while the patient samples did not differ in any of the tasks. Results were confirmed in a second series of analyses in which patient subgroups were equated for sociodemographic background variables. The present results confirm recent data collected in longitudinal studies, thus, lending further support for a neurodevelopmental model of schizophrenia. It is suggested that neuropsychological disturbances occur early in schizophrenia and do not worsen in the course beyond age-related decrement. Possible reasons why previous research has produced contradictory findings are discussed.

  11. Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient


    Morgado, Pedro; Ribeiro, Ricardo; Cerqueira, João J.


    Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient Introduction . Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method . We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Res...

  12. Intraocular pressure in schizophrenic patients treated with psychiatric medications Pressão intra-ocular em pacientes esquizofrênicos tratados com medicações psiquiátricas

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    Valéria Barreto Novais e Souza


    Full Text Available PURPOSE: In order to assess the occurrence of adverse ocular effects of antipsychotic drugs, we sought to evaluate intraocular pressure of schizophrenic patients treated with psychiatric medications. METHODS: Twenty-eight outpatients with DSM-IV diagnosis of schizophrenia who met both the inclusion and exclusion criteria were submitted to an ophthalmic evaluation for ocular abnormalities which included intraocular pressure measurement with Goldmann applanation tonometry. RESULTS: Raised intraocular pressure was found in three patients (11%. Abnormality in cup-disc ratio was seen in only one patient with cup-disc ratio asymmetry of 0.4. All these four patients were taking only ziprasidone. CONCLUSIONS: Patients using ziprasidone were found to have abnormalities in both intraocular pressure and cup-disc ratio.OBJETIVO: Para avaliar a ocorrência de efeitos adversos oculares dos antipsicóticos, buscamos avaliar a pressão intra-ocular em pacientes esquizofrênicos tratados com medicações psiquiátricas. MÉTODOS: Vinte e oito pacientes tratados ambulatorialmente com diagnóstico de esquizofrenia segundo o DSM-IV que preencheram os critérios de inclusão e exclusão foram submetidos a uma avaliação oftalmológica para pesquisa de alterações oculares que incluiu a medida da pressão intra-ocular com tonometria de aplanação de Goldmann. RESULTADOS: Pressão intra-ocular aumentada foi encontrada em 3 pacientes (11%. Anormalidade na escavação do disco óptico foi observada em apenas um paciente com assimetria de escavação de 0,4. Todos esses quatro pacientes estavam usando apenas ziprasidona. CONCLUSÕES: Pacientes em uso de ziprasidona apresentaram anormalidades na pressão intra-ocular e na escavação do disco óptico.

  13. Abnormal electroretinography in schizophrenic patients with a history of sun gazing. (United States)

    Gerbaldo, H; Thaker, G; Tittel, P G; Layne-Gedge, J; Moran, M; Demisch, L


    Electroretinographic (ERG) measurements were performed in 9 schizophrenic patients and in 13 control subjects. The measurements of schizophrenic patients as a group did not differ from those of normals. However, 6 schizophrenic patients who had a past history of sun gazing showed a decrease in retinal responsiveness under conditions of light adaptation. These results suggest that a subgroup of schizophrenic patients, who show deviant light-related behavior, have abnormal ERG. We postulate that an abnormality in retinal dopaminergic neurons, which are known to reduce light responsiveness of horizontal and ganglion cells, is the underlying pathophysiology of this clinical finding.

  14. Faux Pas Test in schizophrenic patients

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    Juliana Negrão


    Full Text Available ABSTRACT Objective The aim of this study is to validate the adult version of “Faux Pas Recognition Test” created by Stone and colleagues (1998 as a reliable instrument assess and discriminate social cognition among schizophrenia patients and healthy controls. Methods This is a cross-sectional study with a total of 196 participants (mean age = 26.45; CI (95% [25.10; 27.83] 51% male. From those, 44 (22.4% patients with schizophrenia and 152 (77.6% healthy controls. The participants answered a short version of the Faux Pas Recognition Test, composed by 10 stories. Results Significant differences were found between both groups regarding their scores on Faux Pas Recognition Test (p = 0.003. Patients with schizophrenia had lower score, compared to healthy controls. Story 14 was the best to distinguish both groups, and Story 16, the worst. Among the questions of Faux Pas stories, the one related to intuition presented the most significant difference between the groups (p = 0.001, followed by the one related to understanding (p = 0.003. Conclusion The Brazilian version of the Faux Pas Recognition Test is a valid test to assess social cognition in schizophrenia and can be an important instrument to be used on the clinical practice.

  15. [Associations between stigma perception and stigma coping behavior and quality of life in schizophrenic patients treated at a community rehabilitation center]. (United States)

    Tseng, Chiu-Jung; Chiou, Jeng-Yuan; Yen, Wen-Jiuan; Su, Hui-Chen; Hsiao, Chiu-Yueh


    Quality of life (QOL) is a critical issue in mental health care. The associations between quality of life and schizophrenia patients' stigma perception and stigma coping behavior are not well understood. This study investigated quality of life in schizophrenia patients. We used a cross-sectional, correlational research design; enrolled 119 individuals diagnosed with schizophrenia as participants; and used instruments including a demographics datasheet, perceived stigma scale, stigma coping behavior scale, and the World Health Organization quality of life scale, brief version to collect data. Data were analyzed using SPSS 12.0 for Windows software. (1) Participants had an average QOL index score of 62.40, indicating moderate quality of life; (2) Long working hours, holding rehabilitation-related employment, and receiving social welfare support correlated with lower QOL; (3) Marital issues had the greatest impact on quality of life, with participants who chose secrecy ÷ concealment reporting generally better QOL; (4) Social welfare support, number of working hours, stigma perception, stigma coping, level of job satisfaction, and level of salary satisfaction together accounted for 48.8% of total QOL variance. Findings increase our understanding of the influence of socio-demographics, stigma perception, and stigma coping behavior on quality of life in individuals with schizophrenia. Greater community involvement in schizophrenia treatment programs can enhance patient satisfaction with their jobs and lives.

  16. Mortality and causes of death in schizophrenic patients in Denmark

    DEFF Research Database (Denmark)

    Mortensen, P B; Juel, K


    A cohort consisting of 6178 people that were psychiatric inpatients with a clinical schizophrenia diagnosis in 1957 were followed up from 1957 through 1986, and their cause-specific mortality was determined. Mortality from cardiovascular diseases, lung diseases, gastrointestinal and urogenital...... disorders, accidents and suicide was increased, whereas mortality from cerebrovascular disorders was reduced. In the male patients cancer mortality was reduced whereas cancer mortality in the female patients was increased. Mortality from a number of causes that theoretically could be associated with side...... effects from neuroleptics was increased. Mortality from some causes of death used as a measurement of the quality of medical care was found to be slightly increased. Further studies of the quality of the medical care provided to schizophrenic patients and of the association between neuroleptic medication...

  17. Patterns of Dysfunction in Schizophrenic Patients on an Aphasia Test Battery (United States)

    DiSimoni, Frank G.; And Others


    In a study comparing schizophrenic language performance with the language performance profiles characteristic of aphasia, apraxia of speech, generalized intellectual impairment, and confused language, 27 schizophrenic patients (20 to 67 years old) were tested with an aphasia test battery. (Author/IM)

  18. The meaning of pharmacological treatment for schizophrenic patients

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    Kelly Graziani Giacchero Vedana


    Full Text Available OBJECTIVE: to understand the meaning of medication therapy for schizophrenic patients and formulate a theoretical model about the study phenomenon.METHOD: a qualitative approach was employed, using Symbolic Interactionism as the theoretical and Grounded Theory as the methodological framework. The research was developed between 2008 and 2010 at three community mental health services in the interior of the State of São Paulo - Brazil. Thirty-six patients and thirty-six family members were selected through theoretical sampling. The data were mainly collected through open interviews and observation and simultaneously analyzed through open, axial and selective coding.RESULTS: the meaning of the pharmacotherapy is centered on the phenomenon "Living with a help that bothers", which expresses the patients' ambivalence towards the medication and determines their decision making. The insight, access, limitations for self-administration of the drugs and interactions with family members and the health team influenced the patient's medication-related behavior.CONCLUSION: the theory presented in this study provides a comprehensive, contextualized, motivational and dynamic understanding of the relation the patient experiences and indicates potentials and barriers to follow the medication treatment.

  19. The meaning of pharmacological treatment for schizophrenic patients1 (United States)

    Vedana, Kelly Graziani Giacchero; Miasso, Adriana Inocenti


    OBJECTIVE: to understand the meaning of medication therapy for schizophrenic patients and formulate a theoretical model about the study phenomenon. METHOD: a qualitative approach was employed, using Symbolic Interactionism as the theoretical and Grounded Theory as the methodological framework. The research was developed between 2008 and 2010 at three community mental health services in the interior of the State of São Paulo - Brazil. Thirty-six patients and thirty-six family members were selected through theoretical sampling. The data were mainly collected through open interviews and observation and simultaneously analyzed through open, axial and selective coding. RESULTS: the meaning of the pharmacotherapy is centered on the phenomenon "Living with a help that bothers", which expresses the patients' ambivalence towards the medication and determines their decision making. The insight, access, limitations for self-administration of the drugs and interactions with family members and the health team influenced the patient's medication-related behavior. CONCLUSION: the theory presented in this study provides a comprehensive, contextualized, motivational and dynamic understanding of the relation the patient experiences and indicates potentials and barriers to follow the medication treatment. PMID:25296152

  20. Extent of Burden and coping among family Caregivers living with schizophrenic patients in Nepal


    kali kumari pun; Gouping He; Xiu Hua Wang


    Caring for schizophrenic patient is an enduring affect among family caregivers and gives substantial amount of burden. None any research has carried out to know the extent of burden among family caregivers of schizophrenia in Nepal. The aim of this study was to explore the extent of burden and identify coping strategies adopted by family caregivers living with schizophrenic patient. A descriptive cross sectional study was undertaken to assess the extent of burden and coping, using purposive s...

  1. [Nursing experience with a schizophrenic breast cancer patient after mastectomy]. (United States)

    Lin, Jia-Rong; Lin, Mei-Ling


    This case study used cognitive therapy to improve the life quality of a 46-year-old woman with chronic schizophrenia who had undergone a mastectomy for breast cancer. This case had suffered from schizophrenia for over 24 years and was hospitalized in the chronic ward of our hospital. Breast cancer was revealed during an annual comprehensive physical checkup. In May 2012, this case received a right mastectomy at a local hospital. After the surgery, she was readmitted to the psychiatric acute ward for further care from May 30th to August 28th, 2012. A holistic nursing assessment was conducted that addressed five major aspects. The major nursing problems found during hospitalization were: acute pain, body image disturbance, and low self-esteem. A decline in pain score from 10 to 4 was achieved by developing rapport with the patient, empathizing with her distress, and providing active care to the wound. Her body image changed because of loosing her breast. Her acceptance of the loss improved through helping her to explore her feelings of change. To improve her self-esteem, we offered cognitive therapy to change her negative thinking process. She became more sanguine and cheerful. Moreover, her dependence in terms of activities of daily living decreased. This individualized intervention contributed to the recovery of a post-mastectomy, schizophrenic patient from low self-esteem.

  2. Altered Adipocytokine Levels and Heart Rate Variability in Schizophrenic Patients with Risk of Metabolic Syndrome. (United States)

    Musa, Zulifeiya; Shabiti, Asikaer; Aizezi, Zainuremu; Yi, Peng


    The aim of this study was to investigate changes in the levels of high-sensitivity C-reactive protein (Hs-CRP), tumor necrosis factor α (TNF-α), myocardial fibrosis, and long-term heart rate variability (HRV) in schizophrenic patients at risk of developing metabolic syndrome (MS). 45 subjects without schizophrenia or MS were recruited into the control group (group A), 45 schizophrenic patients not at risk for developing MS constituted group B, and 45 schizophrenic patients at risk of MS constituted group C. Serum levels of TNF-α and Hs-CRP were examined by enzyme linked immunosorbent assay (ELISA). Ultrasonic acoustic densitometry (AD) analysis was performed to assess myocardial fibrosis, and 24 hours dynamic electrocardiography was conducted to determine HRV time-domain index. Compared with the control group, schizophrenic patients at risk of MS displayed a reduced HRV (p 0.05). Moreover, serum levels of TNF-α and Hs-CRP in the schizophrenic patients with MS risk were elevated compared with the control group (p levels, hypertension and obesity, schizophrenic patients at risk of MS exhibited elevated levels of TNF-α and Hs-CRP, enhanced ventricular myocardial fibrosis, and reduced HRV, which might have resulted from structural changes and autonomic nervous dysfunction in cardiac tissues.

  3. [Are schizophrenic patients being told their diagnosis today in France? (United States)

    Villani, M; Kovess-Masféty, V


    The progressive shifts in the legal and social contexts, along with major changes in information seeking habits with the development of the Internet, have placed patients' information at the core of medical practice. This has to be applied to the psychiatric fields as well, and to questions about how schizophrenic patients are being told their diagnosis nowadays in France. This paper is a national and international literature review about schizophrenia diagnosis disclosure practices, from 1972 to 2014, using French and English languages and various psychology and medical databases. The used key words were "diagnosis", "disclosure", "communication", "breaking bad news", "information", "schizophrenia" and "psychosis". Proportions of diagnosis announcement: our results show that the proportion of psychiatrists delivering schizophrenia diagnosis to their patients varies between countries. Although we must acknowledge that the questionnaires and samples are diverse, we have found that psychiatrists are in general less prone to deliver diagnosis information in France (from 13,5% to 39% given the studies), Germany (28%), Italy (30%), and Japan (30%), than in Anglo-Saxon countries. Thus, 70% of the psychiatrists in North America and 56% in Australia claim that they disclose their diagnosis to schizophrenic patients. In the United-Kingdom, a study targeting psychotic patients themselves has shown that 47% of them had been told their diagnosis by their doctor. Even in the countries where the proportion of diagnosis disclosure is the highest, there remains a substantial difference with other mental illnesses such as affective or anxiety disorders, which are almost always labeled as such in the information communicated to the patient (90% in North America). Diagnostic information about schizophrenia continues therefore to appear problematic for health professionals, which can seem a paradox given the recent social and legal evolutions, the therapeutic progress, the proved

  4. Ancient schwannoma of thoracic spine in a schizophrenic patient with somatic delusion

    Directory of Open Access Journals (Sweden)

    Ya-Ting Wen


    Full Text Available Ancient schwannoma is a rare variant of schwannoma characterized by histopathologic degenerative changes, which are thought to be the result of long-term tumor growth and aging. However, ancient schwannoma in the spinal canal is particularly rare. We report a case of thoracic spine intradural extramedullary ancient schwannoma in a schizophrenic patient, who kept saying that “something in his back was giving him electric shock” for a long time. Unfortunately, this complaint was misinterpreted as somatic delusion symptoms. A spinal cord tumor was taken into consideration only after paraparesis developed. We have highlighted this case to remind every clinician to remain alert about the possibility of organic disease while treating patients with psychotic disorder history. Thorough neurological examination is required to avoid misdiagnosis. Spinal canal schwannoma can be totally removed successfully with good functional outcome and prognosis.

  5. A Rasch analysis between schizophrenic patients and the general population

    Directory of Open Access Journals (Sweden)

    Denis Frederic


    Full Text Available The aim of this study was to test the General Oral Health Assessment Index Questionnaire (GOHAI items for differential item functioning (DIF according to demographic characteristics (gender, age and mental health status (schizophrenic disorders versus general population using Rasch analysis.

  6. P2-26: Comparison between Normal People and Schizophrenic Patients on Face Recognition

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    Yl-Woo Lee


    Full Text Available This research was tested to compare face recognition of normal people and schizophrenic patients. Frontal male faces were used as stimuli, which were Northeast Asian and Southeast Asian. Normal people and patients with positive/negative symptom of schizophrenia participated in this research, and all participants were Korean. Participants were instructed to memorize a stimulus (target presented briefly, and recognize it later among another stimuli (fillers. In recognition task, five faces were presented with a target or without as fillers. The results showed that while schizophrenic patients had difficulty recognizing targets, all participants performed best in the condition of other ethnic target-own ethnic fillers. These results suggest that own ethnicity effect could not be observed, and imply that face processing of schizophrenic patients might be disrupted by perception level rather than memory level.

  7. Increased concentration of. cap alpha. - and. gamma. -endorphin in post mortem hypothalamic tissue of schizophrenic patients

    Energy Technology Data Exchange (ETDEWEB)

    Wiegant, V.M.; Verhoef, C.J.; Burbach, J.P.H.; de Wied, D.


    The concentrations of ..cap alpha..-, ..beta..- and ..gamma..-endorphin were determined by radioimmunoassay in HPLC fractionated extracts of post mortem hypothalamic tissue obtained from schizophrenic patients and controls. The hypothalamic concentration of ..cap alpha..- and ..gamma..-endorphin was significantly higher in patients than in controls. No difference was found in the concentration of ..beta..-endorphin, the putative precursor of ..cap alpha..- and ..gamma..-endorphins. These results suggest a deviant metabolism of ..beta..-endorphin in the brain of schizophrenic patients. Whether this phenomenon is related to the psychopathology, or is a consequence of ante mortem farmacotherapy, remains to be established.

  8. Written but not oral verbal production is preserved in young schizophrenic patients. (United States)

    Salomé, Franck; Boyer, Patrice; Fayol, Michel


    The aim of this study is to discover whether the language capabilities of young schizophrenic patients are more affected in speaking than in writing or whether the disorders are equivalent in the two modes. To do this, we compared spoken and written descriptions of pictures obtained from 10 schizophrenic patients with those produced by 10 control subjects. These productions were analysed on the basis of objective indices. The syntax and coherence of the productions were evaluated by judges. The comparison of the performances of the controls and schizophrenic patients supports the hypothesis that the latter suffer from a language disorder affecting the oral mode but impacting less frequently and less severely on the written mode. These results are discussed in the light of the cognitive mechanisms which may provide an explanation of these language disorders.

  9. Facial, vocal and musical emotion recognition is altered in paranoid schizophrenic patients. (United States)

    Weisgerber, Anne; Vermeulen, Nicolas; Peretz, Isabelle; Samson, Séverine; Philippot, Pierre; Maurage, Pierre; De Graeuwe D'Aoust, Catherine; De Jaegere, Aline; Delatte, Benoît; Gillain, Benoît; De Longueville, Xavier; Constant, Eric


    Disturbed processing of emotional faces and voices is typically observed in schizophrenia. This deficit leads to impaired social cognition and interactions. In this study, we investigated whether impaired processing of emotions also affects musical stimuli, which are widely present in daily life and known for their emotional impact. Thirty schizophrenic patients and 30 matched healthy controls evaluated the emotional content of musical, vocal and facial stimuli. Schizophrenic patients are less accurate than healthy controls in recognizing emotion in music, voices and faces. Our results confirm impaired recognition of emotion in voice and face stimuli in schizophrenic patients and extend this observation to the recognition of emotion in musical stimuli. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Group art therapy as adjunct therapy for the treatment of schizophrenic patients in day hospital. (United States)

    Gajić, Gordana Mandić


    The schizophrenics are frequently disinterested and resistant to standard care. We presented clinical observations of group art therapy of two schizophrenic patients during integrative therapy in Day Hospital. We modified the original "Synallactic collective image technique" (Vassiliou G, Vassiliou V.). The group is open, heterogeneous, meets once a week and discusses on exhibited drawings, drawn by free associations. The patients' drawings and group protocols showed clinical improvement by lowering depressive themes, more human figures and self-confidence. The obvious severity of markedly impairment on Clinical Global Impression (CGI) and Global Assessment of Functioning (GAF) scales on admission with minimal improvement at discharge was rated. Group art therapy enables visual expression of emotions, perceptions and cognitions, develops creative potentials and support within the group, thus facilitating the integrative therapeutic process of schizophrenics. It may be useful adjunctive therapy for schizoprenic patients.

  11. Group art therapy as adjunct therapy for the treatment of schizophrenic patients in day hospital

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    Mandić-Gajić Gordana


    Full Text Available Introduction. The schizophrenics are frequently disinterested and resistant to standard care. Case report. We presented clinical observations of group art therapy of two schizophrenic patients during integrative therapy in Day Hospital. We modified the original “Synallactic collective image technique” (Vassiliou G, Vassiliou V.. The group is open, heterogeneous, meets once a week and discusses on exhibited drawings, drawn by free associations. The patients' drawings and group protocols showed clinical improvement by lowering depressive themes, more human figures and self-confidence. The obvious severity of markedly impairment on Clinical Global Impression (CGI and Global Assessment of Functioning (GAF scales on admission with minimal improvement at discharge was rated. Conclusion. Group art therapy enables visual expression of emotions, perceptions and cognitions, develops creative potentials and support within the group, thus facilitating the integrative therapeutic process of schizophrenics. It may be useful adjunctive therapy for schizoprenic patients.

  12. Internalized Stigma of Mental Illness among Schizophrenic Patients and Their Families (Comparative Study) (United States)

    Mahmoud, Sahar; Zaki, Rania A.


    This study was a comparative study aiming to assess the extent of internalized stigma of mental illness among patients with schizophrenia & identify stigma as perceived by family members caring schizophrenic patients. The study was conducted in two settings 1st clinic was outpatient clinic for psychiatric patient affiliated to Abbasia…

  13. Driving skills in unmedicated first- and recurrent-episode schizophrenic patients. (United States)

    Segmiller, Felix M; Buschert, Verena; Laux, Gerd; Nedopil, N; Palm, Ulrich; Furjanic, Katharina; Zwanzger, Peter; Brunnauer, Alexander


    The present study was designed to examine driving skills according to regulations of the German guidelines for road and traffic safety in unmedicated schizophrenic inpatients. A total of 13 first-episode (FES) and 13 recurrent-episode (RES) schizophrenic inpatients were included in the analysis and compared with a group of 20 healthy controls (HC). Data were collected with the computerised Wiener Testsystem measuring visual perception, reactivity and stress tolerance, concentration and vigilance. Analysis of data indicates that a great proportion (58 %) of schizophrenic patients were impaired in psychomotor functions related to driving skills. FES and RES significantly differed with respect to driving ability with a greater proportion in the FES (38 %) showing severe impairments when compared with RES (25 %). Differences with respect to HC performance were most pronounced in concentration and for the FES additionally in visual perception. Analysis of our data indicates that a great proportion of schizophrenic patients are impaired in psychomotor functions related to driving skills that cannot be attributed to adverse side effects of psychopharmacological treatment. Besides, we cannot confirm a chronical decline of psychomotor functions related to driving skills at least in the early course of schizophrenic illness.

  14. Dopamine transporter gene polymorphism and psychiatric symptoms seen in schizophrenic patients at their first episode

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    Inada, Toshiya; Sugita, Tetsuyoshi; Dobashi, Izumi [National Institute of Mental Health, Chiba (Japan)] [and others


    To investigate the possible role of the dopamine transporter (DAT) gene in determining the phenotype in human subjects, allele frequencies for the 40-bp variable number of tandem repeats (VNTR) polymorphism at this site were compared between 117 Japanese normal controls and 118 schizophrenic patients, including six subgroups: early-onset, those with a family history, and those suffering from one of the following psychiatric symptoms at their first episode: delusion and hallucination; disorganization; bizarre behavior; and negative symptoms. No significant differences were observed between the group as a whole or any subgroup of schizophrenic patients and controls. The results indicate that VNTR polymorphism in the DAT gene is unlikely to be a major contributor to any of the psychiatric parameters examined in the present population of schizophrenic subjects. 12 refs., 1 fig., 2 tabs.

  15. Association of erythrocyte sedimentation rate and fibrinogen concentration with metabolic syndrome in schizophrenic patients. (United States)

    Pavlović, Marko; Babić, Dragan; Rastović, Pejana; Ljevak, Ivona


    Inflammation can be a process significant to the development of schizophrenia and metabolic disorders that are frequently found in patients suffering from schizophrenia. The aim of this study was to determine the values of erythrocyte sedimentation rate and fibrinogen concentration and to establish their possible association with MS and its components in schizophrenic patients. A cross-sectional study was conducted on 200 subjects who were divided into two groups. The study group consisted of schizophrenic patients from the University Clinical Hospital Mostar (n=100), while the control group consisted of healthy subjects who came for systematic medical examinations at the infirmary of the Health Center Mostar (n=100). The diagnosis of MS was made according to NCEP-ATP III criteria, and on that basis subjects from both groups were divided into two subgroups, one with and one without MS. Inflammatory indicators that were determinated were erythrocyte sedimentation rate and fibrinogen concentration. Statistically, MS was significantly more frequent in schizophrenic subjects (46.0%) compared to the control group (29.0%) (p=0.013). Schizophrenic subjects with MS had statistically higher sedimentation rate and fibrinogen concentration compared to the schizophrenic subjects without MS, as well as compared to the control subgroup without MS. The most significant correlations discovered were for the relation of sedimentation rate with systolic (r=0.41) and diastolic (r=0.34) blood pressures. Routine monitoring of erythrocyte sedimentation rate and fibrinogen concentration might have an important role in forecasting MS development and consequent adverse cardiovascular events which are the leading cause of mortality in schizophrenic patients.

  16. Niacin skin flushing in schizophrenic and depressed patients and healthy controls

    NARCIS (Netherlands)

    Bosveld-van Haandel, Linda; Knegtering, Rikus; Kluiter, Herman; van den Bosch, Robert J.


    This study compares the skin reactions to the niacin flushing test of 16 schizophrenic patients with those of 17, depressed patients and 16 healthy controls. Methyl nicotinate (niacin) in a concentration of 0.1 M was applied to the forearm for 5 min. Significant differences could be observed between

  17. Simultaneous determination of amino acids and neurotransmitters in plasma samples from schizophrenic patients by hydrophilic interaction liquid chromatography with tandem mass spectrometry. (United States)

    Domingues, Diego Soares; Crevelin, Eduardo José; de Moraes, Luiz Alberto Beraldo; Cecilio Hallak, Jaime Eduardo; de Souza Crippa, José Alexandre; Costa Queiroz, Maria Eugênia


    A sensitive, reproducible, and rapid method was developed for the simultaneous determination of underivatized amino acids (aspartate, serine, glycine, alanine, methionine, leucine, tyrosine, and tryptophan) and neurotransmitters (glutamate and γ-aminobutyric acid) in plasma samples using hydrophilic interaction liquid chromatography coupled to triple quadrupole tandem mass spectrometry. The plasma concentrations of amino acids and neurotransmitters obtained from 35 schizophrenic patients in treatment with clozapine (27 patients) and olanzapine (eight patients) were compared with those obtained from 38 healthy volunteers to monitor the effectiveness of treatment. The chromatographic conditions separated ten target compounds within 3 min. This method presented linear ranges that varied from (lower limit of quantification: 9.7-13.3 nmol/mL) to (upper limit of quantification: 19.4-800 nmol/mL), intra- and interassay precision with coefficients of variation lower than 10%, and relative standard error values of the accuracy ranged from -2.1 to 9.9%. The proposed method appropriately determines amino acids and neurotransmitters in plasma from schizophrenic patients. Compared with the control group (healthy volunteers), the plasma levels of methionine in schizophrenic patients treated with olanzapine are statistically significantly higher. Moreover, schizophrenic patients treated with clozapine tend to have increased plasma levels of glutamate. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Effectiveness of gratitude disposition promotion program on depression and quality of life of chronic schizophrenic patients. (United States)

    Jung, Miran; Han, Kuemsun


    Gratitude intervention is expectedly an effective intervention to reduce depression and improve the quality of life in schizophrenic patients, but there is a lack of literature on it. We attempted to develop and test the effectiveness of the gratitude disposition promotion program for chronic schizophrenic patients in Korea. Nonequivalent control group pre- and post-test design was used in two mental health centers located at Gyeonggi-do in South Korea. This paper was a quasi-experimental study and the participants who took part in the gratitude disposition promotion program were 17 of experimental group and 15 of control group. Gratitude disposition (the short gratitude, resentment, and appreciation test), depression (Beck Depression Inventory), and quality of life (developed by Kook) of chronic schizophrenic patients were measured before and after an intervention, as compared to the control. Chi-square test, Fisher's exact test, and t -test were performed for prehomogeneity testing for variables related to the general characteristics. Testing for the effectiveness of gratitude disposition promotion program and hypothesis testing for its effect on depression and quality of life were by ANCOVA and t -test, as verified to significance level of P gratitude disposition promotion program showed significant improvements in gratitude disposition ( F = 18.740, P gratitude disposition promotion program was an effective clinical intervention program for enhancing gratitude disposition and quality of life of chronic schizophrenic patients in community.

  19. Genital Self-Mutilation in Schizophrenic Patients. A Report of Two ...

    African Journals Online (AJOL)


    GENITAL SELF-MUTILATION IN SCHIZOPHRENIC PATIENTS both ICD-10 and DSM-IV11,12. The ICD-. 10 diagnostic criteria for schizophrenia require the presence of bizarre delusions, hallucinations and overall behavioral changes lasting up to one month in the absence of general medical conditions that could explain.

  20. Genital self-mutilation in schizophrenic patients. a report of two cases

    African Journals Online (AJOL)

    Schizophrenia is a serious psychiatric disorder that requires long-term treatment. Poor adherence to medication can lead to serious and possibly life-threatening complications. Genital selfmutilation has been reported in some schizophrenic patients in response to delusions or command auditory hallucination. We report two ...

  1. Metabolic syndrome in Thai schizophrenic patients: a naturalistic one-year follow-up study

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    Charnsilp Chawanun


    Full Text Available Abstract Background Not only the prevalence, but also the progress of metabolic abnormalities in schizophrenic patients is of importance for treatment planning and policy making. However, there have been very few prospective studies of metabolic disturbance in schizophrenic patients. This study aimed to assess the progress of metabolic abnormalities in Thai individuals with schizophrenia by estimating their one-year incidence rate of metabolic syndrome (MetS. Methods We screened all schizophrenic patients who visited our psychiatric clinic. After the exclusion of participants with MetS at baseline, each subject was reassessed at 6 and 12 months to determine the occurrence of MetS. The definition of MetS, as proposed by the International Diabetes Federation (IDF, was applied. Results Fifty-seven participants (24 males and 33 females had a mean of age and duration of antipsychotic treatment of 37.5 years old and 8.4 years, respectively. At baseline, 13 subjects met the MetS definition. Of 44 subjects who had no MetS at baseline, 35 could be followed up. Seven of these 35 subjects (20.0% had developed MetS at the 6- or 12-month visit, after already having 2 MetS components at baseline. The demographic data and characteristics of those developing and not developing MetS were not different in any respect. Conclusion Thai schizophrenic patients are likely to develop MetS. Their metabolic abnormalities may progress rapidly and fulfill the MetS definition within a year of follow-up. These findings support the importance of assessing and monitoring metabolic syndrome in schizophrenic patients.

  2. Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient. (United States)

    Morgado, Pedro; Ribeiro, Ricardo; Cerqueira, João J


    Introduction. Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method. We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Results. Although there are few descriptions of this syndrome in schizophrenia, patients usually present depressive mood and psychomotor retardation, features not seen in our patient. Loss of the sense of the inner self, present in schizophrenia, could explain patient's symptomatology but neurobiological bases of this syndrome remain unclear. Conclusion. Despite not being considered in actual classifications, Cotard syndrome is still relevant and psychiatric evaluation is critical to diagnosing and treating this condition in psychiatric patients.

  3. Auditory hallucinations in schizophrenic and affective disorder Nigerian patients: phenomenological comparison. (United States)

    Okulate, G T; Jones, O B E


    Although auditory hallucinations are universal phenomena, they show cultural and ethnic variation. We set out to study some differences between auditory hallucinations in Nigerian patients and their foreign counterparts. We also investigated the usefulness of auditory hallucinations in distinguishing between schizophrenia and affective disorders. A semi-structured interview was used to obtain information from 89 patients with auditory hallucinations who met ICD-10 criteria for either schizophrenia or affective psychoses and 10 others with organic mental disorders. Responses were compared with respect to the frequency, form and content of the hallucinatory voices as well as the languages spoken. In this sample, voices speaking exclusively in a foreign language were uncommon. Voices commanding and those discussing patients in the third person were the commonest in schizophrenic patients but not as frequent as in a similar group of patients in the UK studied by other authors. In patients with schizophrenia, voices were more likely to discuss the patient, whereas in affective disorders, voices were more likely to evoke fear, and patients were more likely to carry out commands. In conclusion, only three features of auditory hallucinations distinguished between schizophrenic and affective psychoses patients. Auditory hallucinations may be less harassing in Nigerian schizophrenic patients than in their UK counterparts. These hallucinations are most often perceived in the individual's mother tongue, with or without additional use of English, even when the patients have been 'westernized' through education and religion.


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    Full Text Available Introduction: It is assumed that the process of schizophrenia effect on patient"s cognitive functions. The aim of this study was to examine and to compare cognitive profile of patients with that of control group. Methods: 40 patients with schizophrenia were selected from Isfahan Noor Hospital. 40 non-patients as control group were selected and matched on the base of age, sex, education, economic status. Cognitive functions of two groups were assessed by WAlS-R. Results: Results show that schizophrenic patients appear at a lower level of IQ than control group. Nonverbal IQ was more impaired than the other kind of IQ in patients. Cognitive profile analysis reveals that patients had low scores on all of the WAlS-R subscles except information and word subscales. Discussion: These findings show that schizophrenic patients in the first episode of theire illness reveal a remarkable impairment on inteligence performance. Cognitive profile analysis indicates that schizophrenic patients performer significatly at a lower level in comparison with control group, in: abstraction, visual - special perception, verbal and non-verbal conceptualization, social judgment, attention, motor-visual organization and mental flexibility.

  5. Cotard Syndrome without Depressive Symptoms in a Schizophrenic Patient

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    Pedro Morgado


    Full Text Available Introduction. Cotard syndrome is a rare condition characterized by nihilistic delusions concerning body or life that can be found in several neuropsychiatry conditions. It is typically associated with depressive symptoms. Method. We present a case of Cotard syndrome without depressive symptoms in the context of known paranoid schizophrenia. A literature review of Cotard syndrome in schizophrenia was performed. Results. Although there are few descriptions of this syndrome in schizophrenia, patients usually present depressive mood and psychomotor retardation, features not seen in our patient. Loss of the sense of the inner self, present in schizophrenia, could explain patient’s symptomatology but neurobiological bases of this syndrome remain unclear. Conclusion. Despite not being considered in actual classifications, Cotard syndrome is still relevant and psychiatric evaluation is critical to diagnosing and treating this condition in psychiatric patients.

  6. Neuropsychology, Social Cognition and Global Functioning Among Bipolar, Schizophrenic Patients and Healthy Controls: Preliminary Data

    Directory of Open Access Journals (Sweden)

    Elisabetta eCaletti


    Full Text Available This study aimed to determine the extent of impairment in social and non-social cognitive domains in an ecological context comparing bipolar (BD, schizophrenic patients (SKZ and healthy controls (HC. The sample was enrolled at the Department of Psychiatry of Policlinico Hospital, University of Milan, it includes stabilized schizophrenic patients (n = 30, euthymic bipolar patients (n = 18 and healthy controls (n = 18. Patients and controls completed psychiatric assessment rating scales, the Brief Assessment of Cognition in Schizophrenia (BACS and the Executive and Social Cognition Battery (ESCB that contains both ecological tests of executive function and social cognition, in order to better detect cognitive deficits in patients with normal results in standard executive batteries. The three groups differed significantly for gender and substance abuse, however the differences did not influence the results. Bipolar patients showed less impairment on cognitive performance compared to schizophrenic patients, even in ecological tests that mimic real life scenarios. In particular, BD performed better than SKZ in verbal memory (p

  7. Animal-assisted therapy for elderly schizophrenic patients: a one-year controlled trial. (United States)

    Barak, Y; Savorai, O; Mavashev, S; Beni, A


    Animal-assisted therapy (AAT) has been used as a therapeutic tool in various psychiatric populations, but there have been no published studies with elderly schizophrenic patients. The authors evaluated, in a blinded, controlled manner, the effects of AAT in a closed psychogeriatric ward over 12 months. Subjects were 10 elderly schizophrenic patients and 10 matched patients (mean age: 79.1+/-6.7 years). The outcome measure was the Scale for Social Adaptive Functioning Evaluation (SAFE). AAT was conducted in weekly 4-hour sessions. Treatment encouraged mobility, interpersonal contact, and communication and reinforced activities of daily living (ADLs), including personal hygiene and independent self-care, through the use of cats and dogs as "modeling companions." The SAFE scores at termination showed significant improvement compared with baseline scores and were significantly more positive for the AAT group on both Total SAFE score and on the Social Functions subscale. AAT proved a successful tool for enhancing socialization, ADLs, and general well-being.

  8. The role of cognitive-developmental tests in differential diagnosis of borderline and schizophrenic patients

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    Vulević Gordana


    Full Text Available The aim of our research was to find out whether cognitive-developmental tests such as Nominal Realism Test and Vygotsky Concept Formation Test could contribute to the process of diagnosing borderline and schizophrenic patients. The specific aim of this study was to assess the diagnostic power of subtests (such as Vocabulary, Comprehension, Similarities and Picture Arrangement Test on Wechsler Adult Intelligence Scale (VITI in the differential diagnosis of the two groups of patients. The study included 90 subjects, 30 of whom were diagnosed with borderline personality disorder (BPD, 30 had the diagnosis of schizophrenic psychosis (SCH, while 30, who had no psychiatric diagnosis, represented the control group. The findings indicate that the patients with BPD, and particularly those diagnosed with SCH, had both quantitative and qualitative cognitive impairment. The findings show that cognitive developmental tests represent valuable tools in the differential diagnosis of borderline personality disorder and schizophrenia.

  9. A comparison between effectiveness of three types of music on memory activity and sustained attention in schizophrenic patients


    Narges bahmany; Karamatollah Zandi ghashghaee; Sadrollah Khosravi


    Background: schizophrenia is a psychiatric disorder in which a lot of cognitive functions including memory, attention, motor skills, executive functions and intelligence are compromised. Numerous empirical studies showed that schizophrenic patients have problem in sustain retention and memory activity. The objective of this study was a comparison between effectiveness of three types of music on memory activity and sustain retention in schizophrenic patients. Material and Methods: A total of 6...

  10. [Risk factors for delinquent behavior in schizophrenic patients -- a survey from Krafft-Ebing till today]. (United States)

    Rous, F


    The dangerousness of psychotic, especially schizophrenic patients has always been a matter for controversial discussion. On the one side psychiatrists got under suspicion to show too much understanding for deviant and aggressive acts of their patients and to forget the public need for security. On the other side experts disagreed in their opinion on the risk of aggressive behaviour. The following paper reviews the development in evaluation of risk factors from Krafft-Ebing to the presence. On this way the studies of Böker are a milestone in forensic psychiatry. The doctrine "schizophrenic = irresponsible = dangerous" was not valid any more. He showed that the risk for violence depends on much more than the diagnosis of mental illness. Based on the outcome of his study and his differentiated descriptions of subtypes of schizophrenia and their individual risk of violence modern psychological prognostic instruments were developed.

  11. The Self Representation in Schizophrenic patients: Considerations on the Draw a Tree Test

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    Salvatore Settineri


    Full Text Available Abstract   Objective: The tree is the archetypal symbol of the identification in the growing life. The objective of this study is to evaluate the representation of the self in schizophrenic patients through the tree drawing. Methods: Were identified 36 patients, 22 women and 14 (M-age=53, suffering from schizophrenic disorder. Through the Scale for the Assessment of Negative Symptoms (SANS and the Scale for the Assessment of Positive Symptoms (SAPS positive and negative symptoms, and the reactive tree representation of the self were assessed.   Results: In the group with negative symptoms archetypal figures are more frequent, such as images that are part of the collective unconscious, or thought more archaic. In patients in which emerges the delirium, that is part of the most evolved thinking, near to the secondary process, the reality testing is better preserved. In cases where there are symptoms mixed the tree structure leads to an archetypal image. Conclusions: This study shows that in the draw of the tree trunk-to-crown ratio in schizophrenic patients was significantly higher than that of healthy individuals. The usefulness of the study insert itself in the Jungian analytic thought, for which psychotic thought corresponds to an abbaissement of the self activity.   Keyword: Representation of Self; Schizophrenia; Draw a Tree Test.

  12. Smoking in schizophrenic patients: A critique of the self-medication hypothesis


    Manzella, Francesca; Maloney, Susan E; Taylor, George T


    A common remark among laypeople, and notably also among mental health workers, is that individuals with mental illnesses use drugs as self-medication to allay clinical symptoms and the side effects of drug treatments. Roots of the self-medication concept in psychiatry date back at least to the 1980s. Observations that rates of smokers in schizophrenic patients are multiple times the rates for regular smoking in the general population, as well as those with other disorders, proved particularly...

  13. Affective reactivity of speech in patients with schizophrenia and their non-schizophrenic relatives. (United States)

    Mohagheghi, Arash; Farnam, Alireza; Farhang, Sara; Bakhshipoor, Abbas


    Studies about cognitive functioning of patients with schizophrenia (language problems in particular) are very limited in Iran. This study aims at evaluating the affective reactivity of speech in Turkish-speaking schizophrenic patients and their non-schizophrenic relatives. In a cross-sectional setting, 30 outpatients with schizophrenia were compared with 30 first-degree non-schizophrenic family members and 30 non-clinical controls. The audio-taped speech samples (10 min each) were analyzed blindly for frequencies of referential communication failure. Levels of referential communication disturbance in speech samples (Communication Disturbance Index, CDI) during two separate sessions were compared in affectively positive versus affectively negative conditions. All three groups showed significantly higher frequencies of communication disturbances in the affectively negative condition. The affective reactivity of speech was significant in patients with schizophrenia compared with the controls but not the unaffected relatives. The severity of positive or negative symptoms was not correlated with CDI or level of affective reactivity. This study was carried out in a Turkish-speaking sample and supports the idea that referential communication disturbances may be linked to vulnerability to schizophrenia while affective reactivity is associated with manifest illness. Language differences may affect the observed impact of symptom severity on communication failures.

  14. Interpretation of ambiguous idiomatic statements in schizophrenic and depressive patients. Evidence for common and differential cognitive patterns. (United States)

    Iakimova, Galina; Passerieux, Christine; Hardy-Baylé, Marie-Christine


    This study is concerned with the comprehension of ambiguous idiomatic statements in schizophrenic and depressive patients. Using a multiple-choice procedure, we simultaneously tested the presence of concrete and literal elements in the understanding of idiomatic statements. Fourteen schizophrenic and 10 patients undergoing a major depressive episode as well as 14 control subjects completed a questionnaire with 10 idiomatic expressions with two possible interpretations (figurative and literal) of equivalent prominence. The participants had to choose one word linked with the different interpretations of these idioms (figurative, literal, concrete or inappropriate meaning). The main results show that, in all the subjects, the contextual characteristics of the task induced a bias in favor of figurative interpretations despite the equivalent prominence of the literal interpretations of the idioms. The selection of responses relating to the concrete meaning of a single word in the idiom constituted a response mode common to both the schizophrenic and depressed patients. Despite the contextual constraints of the task, the schizophrenics opted for the literal responses more often than the other participants. The descriptive analysis argues in favor of a cognitive and clinical heterogeneity of schizophrenic patients. Results support the idea that literality and concreteness in idiomatic interpretation are possibly due to distinct cognitive impairments, though only some are specific to schizophrenic patients. Copyright (c) 2006 S. Karger AG, Basel.

  15. Development and validation of a skin fibroblast biomarker profile for schizophrenic patients

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    Marianthi Logotheti


    Full Text Available Gene expression profiles of non-neural tissues through microarray technology could be used in schizophrenia studies, adding more information to the results from similar studies on postmortem brain tissue. The ultimate goal of such studies is to develop accessible biomarkers. Supervised machine learning methodologies were used, in order to examine if the gene expression from skin fibroblast cells could be exploited for the classification of schizophrenic subjects. A dataset of skin fibroblasts gene expression of schizophrenia patients was obtained from Gene Expression Omnibus database. After applying statistical criteria, we concluded to genes that present a differential expression between the schizophrenic patients and the healthy controls. Based on those genes, functional profiling was performed with the BioInfoMiner web tool. After the statistical analysis, 63 genes were identified as differentially expressed. The functional profiling revealed interesting terms and pathways, such as mitogen activated protein kinase and cyclic adenosine monophosphate signaling pathways, as well as immune-related mechanisms. A subset of 16 differentially expressed genes from fibroblast gene expression profiling that occurred after Support Vector Machines Recursive Feature Elimination could efficiently separate schizophrenic from healthy controls subjects. These findings suggest that through the analysis of fibroblast based gene expression signature and with the application of machine learning methodologies we might conclude to a diagnostic classification model in schizophrenia.

  16. [Visuospatial context processing in untreated schizophrenic patients and relation to disorganization syndrome]. (United States)

    Longevialle-Hénin, R; Bourdel, M-C; Willard, D; Lôo, H; Olié, J-P; Poirier, M-F; Krebs, M-O; Amado, I


    Previous studies on schizophrenia have suggested that context-processing disturbances were one of the core cognitive deficits present in schizophrenia. Schizophrenic patients have a failure either of inhibition strategy and maintenance of visuospatial information (25) in condition of contextual interference. In the present study, we explored the performances of untreated schizophrenic patients with 2 tasks exploring detection and long term retention of complex visual features and field dependence-independence tasks were selected. These abilities involve temporary maintenance of visuospatial information and executive functioning of visual working memory system. Several studies have shown that cognitive deficit may depend on schizophrenic symptomatology. However results remain controversial in determining the specific influence of negative and positive symptomatologies as well as clinical disorganization. Our goal was to explore the processing of spatial context and its relation to disorganized syndrome. This study was approved by the local ethic committee. Thirty-six schizophrenic patients were included according to DSM IV criteria (19 neuroleptic naïve, 17 unmedicated patients during more than 3 months). Thirty-six healthy controls were matched to patients for age, gender and level of education. Absence of axis 1 pathology was attested for controls with SCID-NP. Current symptomatology was evaluated by the Positive and Negative Syndrome Scale (PANSS) (14). Clinical disorganisation was evaluated with the disorganisation score established upon a factorial analysis of PANSS by Lepine and Lançon. Items selected to distinguish the disorganised group were abstraction, disorganization, orientation, and attention. Two tasks of embedded figures were administered individually to patients and controls. The Faverge task (Research of Figures-RF) (10) evaluates the ability to recognize the target from spatial complex geometrical figures. The Group Embedded Figure Task (GEFT

  17. [Psychotherapy of a schizophrenic patient in a large psychiatric hospital--therapeutic option or naive idealism]. (United States)

    Branik, E


    The psychotherapy of a schizophrenic points, as it is depicted, at some characteristics of the interactions with these patients. In this context also the weight and the restrictions of the institutional framing conditions are indicated. Despite all still open questions, difficulties and limitations the author pleads for the furthering of psychotherapeutic efforts with psychotic patients, as in a considerable number of cases they mitigate their suffering, lead to a better understanding of the psychological aspects of the illness, which are important to the patient, and finally afford insight to the therapist into a sphere at the limit of human experience and, by this means, add to his fundamentally competence.

  18. Clinical correlates of decreased anteroposterior metabolic gradients in positron emission tomography (PET) of schizophrenic patients

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    DeLisi, L.E.; Buchsbaum, M.S.; Holcomb, H.H.; Dowling-Zimmerman, S.; Pickar, D.; Boronow, J.; Morihisa, J.M.; van Kammen, D.P.; Carpenter, W.; Kessler, R.


    The finding in schizophrenic patients of a reversal of the normal frontal to posterior pattern of brain metabolic activity with positron emission tomography (PET) is of interest, but its relevance to psychopathology is unknown. Using PET, the authors studied 21 patients with chronic schizophrenia and 21 age- and sex-matched control subjects. Although eight of the 21 patients and only one of the control subjects showed a relatively lower anteroposterior metabolic gradient, no clinical correlates of this finding were noted. In addition, cerebral atrophy, as determined by CAT scan, was not associated with this aberrant metabolic pattern.

  19. [Subjective quality of life in severely disabled long-stay schizophrenic patients]. (United States)

    Franz, Michael; Meyer, Thorsten; Gallhofer, Bernd


    In the controversy about severely chronic mental patients, who still reside in the psychiatric hospital after decades of deinstitutionalization, their quality of life (QoL) has become a main topic. On the basis of a critique of the dominant, mere standardized approach to QoL this method is compared with a qualitative approach in such a schizophrenic "residual" patient group (n = 144). While in the standardized approach a high level of subjective QoL could be found that correlated positively with the duration of hospitalisation, the open interviews yielded specific experiences of deficiencies. The appraisal of the quality of life especially of chronic or hospitalized patients is reconsidered.

  20. A sobrecarga de cuidadores de pacientes com esquizofrenia The burden in caregivers of schizophrenic patients

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    Marcelo Machado de Almeida


    Full Text Available INTRODUÇÃO: A reforma psiquiátrica brasileira conduziu a novas práticas de assistência à saúde mental, associadas ao processo de desospitalização. Deixando os hospitais, os pacientes portadores de esquizofrenia passaram a ser tratados dentro da comunidade, e um novo sujeito passou a ganhar força nessa modalidade de tratamento: o cuidador. OBJETIVO: Avaliar os fatores de sobrecarga em cuidadores de pacientes esquizofrênicos. MÉTODO: Os fatores de sobrecarga foram avaliados utilizando metodologia qualitativa, apropriada para analisar o mundo dos significados, motivos, crenças, aspirações, valores e atitudes dos cuidadores. O estudo foi realizado num Centro de Atenção Psicossocial do interior de Minas Gerais. Foram entrevistados um total de 15 cuidadores, selecionados com base nos critérios de saturação e singularidade das falas. As entrevistas foram analisadas na perspectiva do método fenomenológico. RESULTADOS: Nos discursos dos cuidadores é possível identificar que as atividades da vida diária, as mudanças na rotina, a diminuição do lazer, os problemas de saúde, as preocupações, o medo de adoecer, a obrigatoriedade do cuidado, o custo do tratamento, aspectos financeiros e expectativas em relação ao futuro são importantes fatores de sobrecarga. Foram identificados quatro fatores de redução da sobrecarga: apoio social e família, presença de espaços para aliviar as tensões, afastamento físico do paciente e valorização do tratamento farmacológico. CONCLUSÃO: Fazem-se necessários programas de atendimento específicos para essa parcela da população, já que o discurso dos cuidadores apontou que o cuidado de pacientes com esquizofrenia pode impactar negativa e permanentemente as suas vidas.INTRODUCTION: The Brazilian psychiatric reform has led to new mental health care practices associated with the de-hospitalization process. Previously treated at hospitals, patients suffering from schizophrenia now

  1. Evaluation and Socio-occupational Intervention in Bipolar and Schizophrenic Patients within a Multimodal Intervention Program- PRISMA. (United States)

    Díaz Zuluaga, Ana M; Duica, Kelly; Ruiz Galeano, Carlos; Vargas, Cristian; Agudelo Berruecos, Yuli; Ospina, Sigifredo; López-Jaramillo, Carlos

    Functional improvement in bipolar and schizophrenic patients is one of the main aims of treatment. Nevertheless, there is no evidence about the effect of socio-occupational intervention within a multimodal intervention (MI) programme. To describe the socio-occupational profile and to evaluate the functional effect of a MI in bipolar I and schizophrenic patients. A prospective, longitudinal, therapeutic-comparative study was performed including 302 subjects (104 schizophrenic and 198 Bipolar Disorder I [BDI] patients), who were randomised into two groups, multimodal (psychiatry, psychology, medicine, occupational therapy, neuropsychology, and family therapy), or traditional intervention (psychiatry and medicine only). Several scales were applied to assess assertiveness, free time management, social abilities, general anxiety, self-care and performance in home, work and community tasks. After performing the longitudinal analysis, it was shown that the multimodal intervention was more effective than traditional intervention in general anxiety scores (P=.026) and development in home tasks (P=.03) in schizophrenic patients. No statistical differences were found in bipolar patients. The other variables showed improvement, however, their effect was similar in both intervention groups. Our study identified functional improvement in home tasks in schizophrenic patients after receiving multimodal intervention. Other variables also showed improvement for both interventions groups. Future studies, applying longer rehabilitation programs and other ecological strategies should be performed to identify the most effective interventions. Copyright © 2017 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  2. [The medical social aspects of life quality of schizophrenic patients]. (United States)


    The issue of life quality of patients with mental disorders is considered. The results of study of life quality of group of patients with schizophrenia and schizotipical disorders are presented. The sampling was made in the clinical psychiatric hospital of Ryazan oblast. The survey was implemented with specially designed questionnaire. The assessment of indicators of main areas and sub-areas of respondents life was made. The importance of assessment of indicators of patients life quality in optimizing the treatment and rehabilitation is emphasized.

  3. Serum iron levels in schizophrenic patients with or without akathisia. (United States)

    Kuloglu, Murat; Atmaca, Murad; Ustündag, Bilal; Canatan, Halit; Gecici, Omer; Tezcan, Ertan


    The pathophysiology of akathisia still remains controversial. Iron deficiency was proposed to be an important factor in the development of akathisia. In the present study, it was aimed to compare levels of serum iron and linked variables in chronic akathisic (n=30), and non-akathisic patients (n=30) with schizophrenia and healthy controls (n=30) because of the controversy in the association of iron and akathisia. The Barnes Akathisia Scale for akathisia and Simpson-Angus Rating Scale for extrapyramidal side effects were used. Serum iron and linked variables and hematological profile of the patients and control subjects were determined. Serum iron levels were significantly lower both in akathisic and non-akathisic groups compared to the control group (Piron levels than non-akathisic patients (Piron binding capacity was significantly higher in patients with akathisia compared to the control group (Piron binding capacity, it was not statistically significant compared to the control group (P>0.05). Ferritin levels were determined to be significantly lower in both groups compared to the control group (Piron metabolism exists.

  4. affective, schizophrenic and mood disorders in patients admitted at ...

    African Journals Online (AJOL)

    SCZ, SAD and MD regarding: affective and core symptoms of schizophrenia (with the exception of core symptoms of schizophrenia between SCZ and SAD); presence of past trauma; a past suicide attempt; and comorbidity with alcohol and drug abuse disorders. SAD and MD patients took significantly more mood stabilizers ...

  5. Foreign body ingestions in a schizophrenic patient | Alao | West ...

    African Journals Online (AJOL)

    Here, we report a case of ingestion of a rolled, metal tuna can lid in a male prison inmate previously diagnosed with depression and paranoid schizophrenia. Following evaluation by the surgical team, the foreign body was removed by laparotomy and the patient was discharged back to the prison without complication.

  6. Quality of life assessment of patients with schizophrenic spectrum disorders from Psychosocial Care Centers

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    Tatiana Fernandes Carpinteiro da Silva


    Full Text Available OBJECTIVE: Assessing the quality of life and the clinical and social-demographic factors associated in schizophrenic spectrum patients (ICD-10 F20-F29 attending CAPS at the programmatic area 3.0. METHODS: A cross-sectional study was carried out in a sample of schizophrenic spectrum patients who have been enrolled in 2008 in CAPS in programmatic area (AP 3 at Rio de Janeiro city, using MINIPLUS to assess schizophrenia spectrum disorder and use of psychoactive substances, Positive and Negative Symptoms Scale (PANSS to assess psychiatric symptoms and Quality of Life Scale (QLS-BR to assess the quality of life. RESULTS: Seventy nine patients were included, of whom 74 (93.7% presented some impairment in quality of life. The most frequently affected area was occupational performance. Variables that showed a significant association with severe impairment of quality of life were: marital status, race, occupation, who patients lived with, homelessness, having children, previous psychiatric hospitalization, negative symptoms and symptoms designated as not applicable (being characterized by a lack of typical positive and negative symptoms. CONCLUSION: The knowledge of these factors should be crucial to implement health policies and psychosocial rehabilitation programs focused on improving the quality of life of these patients.

  7. [Treatment of Adult Schizophrenic Patients With Depot Antipsychotics]. (United States)

    Jaramillo González, Luis Eduardo; Gómez Restrepo, Carlos; García Valencia, Jenny; de la Hoz Bradford, Ana María; Ávila-Guerra, Mauricio; Bohórquez Peñaranda, Adriana


    To determine the indications of long-acting antipsychotic injection and what its effectiveness and safety in adult patients with schizophrenia during the treatment maintenance phase. A clinical practice guideline was elaborated under the parameters of the Methodological Guide of the Ministerio de Salud y Protección Social to identify, synthesize and evaluate the evidence and make recommendations about the treatment and follow-up of adult patients with schizophrenia. The evidence of NICE guide 82 was adopted and updated. The evidence was presented to the Guideline Developing Group and recommendations, employing the GRADE system, were produced. The literature review shows that the evidence has moderate to low quality. 8 articles were used. The risk of relapse was lower with depot risperidone and paliperidone palmitate when compared with placebo. For the risk of hospitalizations comparing depot antipsychotics (APD) versus oral AP, the result is inconclusive. Globally the second-generation APD had a lower risk of discontinuation when compared with placebo. The second generation AP had higher risk of extrapyramidal syndromes than placebo, as in the use of antiparkinsonian. The comparison of second-generation AP injections versus placebo showed an increased risk of early weight gain. The use of depot antipsychotics in the maintenance phase of adult patients diagnosed with schizophrenia is recommended if there is no adherence to oral antipsychotics as the patient's preference. It is not recommended depot antipsychotics in the acute phase of schizophrenia in adults. Copyright © 2014 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  8. Treatment of Social Phobia in Rezidual Schizophrenic Patients

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    Full Text Available Having negative symptoms is the basic feature of residual-type schizophrenia and there is a direct proportion between the neurocognitive impairments associated with negative symptoms. Among the approaches used for the treatment of patients with schizophrenia, cognitive behaviour therapy is the one with the most evidence of efficacy. Cognitive behaviour therapy is considered to be beneficial for the residual symptoms after drug treatment. The social phobia leads among the anxiety disorders accompanying schizophrenia. According to the cognitive model, the impairment of social performance increases the severity of social phobia. The leading factor of this vicious circle is that the patients pay attention selectively to such cases in order to find evidence for their thoughts and beliefs that they are going to be evaluated negatively. In this paper, the cognitive behavioural therapy and formulation carried out with a patient, who has been followed for a long time with the diagnosis of residual-type schizophrenia and social phobia is reported. The purpose of the treatment is to interfere with the impaired functionality of the patient through cognitive and behavioural techniques by dealing with the medical treatment-resistant symptoms. To this end, firstly coping mechanisms are examined through the identification of avoidance and security providers, and then, the patient’s automatic thoughts and false beliefs are discussed depending on the cognitive perspective. The main part of the treatment has been completed by carrying out various investigations in order to increase the patients’ social performance via applying behavioural techniques. As a result, false beliefs are the indicators of the relationship between cognitive inability and negative symptoms and related to social functioning. By addressing these beliefs through cognitive behavioural therapy, the necessity of increasing the patient’s social activities and the relationship between social

  9. Regional cerebral blood flow in schizophrenic patients; In relation to the subtypes of the disease

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    Sagawa, Katsuo; Sibuya, Isoo; Oiji, Arata; Kawakatsu, Sinobu; Morinobu, Shigeru; Totsuka, Shiro (Yamagata Univ. (Japan). School of Medicine); Kinoshita, Osami; Yazaki, Mitsuyasu


    Seventy-six schizophrenic patients were examined by a Xe-133 inhalation method to determine regional cerebral blood flow. A decreased blood flow was observed in the frontal lobe, especially in the right inferior part. In a study on the relationship between disease subtypes and regional cerebral blood flow, negative symptoms were found more predominantly associated with dissolution type than delusion type. In the group of dissolution type, a decreased blood flow was observed in both the right inferior frontal lobe and the right upper hemisphere, in comparison to the group of delution type. Patients presenting with auditory hallucination had a significantly higher incidence of both negative and positive symptoms, as compared with those not presenting with it. In such patients, a significantly decreased blood flow was also seen in the left upper frontal lobe and the bilateral parietal lobe. Xe-133 inhalation method should assist in evaluating brain function in schizophrenic patients, thus leading to the likelihood of developing a new treatment modality. (N.K.).

  10. Functional analysis of the deficit in semantic context processes in schizophrenic patients: an event-related potentials study. (United States)

    Kostova, M; Passerieux, C; Laurent, J P; Saint-Georges, C; Hardy-Baylé, M C


    Schizophrenic patients exhibit a deficit in the semantic context processing strategies which might be responsible for the language and communication disorders that are characteristic of this condition. The aim of our study was to identify the nature of the contextualization processes which are lacking in schizophrenic patients, by distinguishing between processes for the generation of expectations and processes of semantic integration. Thirteen schizophrenic patients and 12 healthy controls performed two tasks: (a) a lexical decision task (LDT) with a highly structured sentence context and whose experimental characteristics made it possible to call strongly on predictive strategies, and (b) a LDT with classic semantic priming (the context being reduced to a single word). In this latter task, the small number of related words did not prompt the generation of expectations but instead called on the postlexical integration process. The event-related potentials (ERP) were recorded during the administration of the task. In the sentence task, we observed a modulation in the N400 amplitude due to the presence of expectations both in the schizophrenic and control participants: predictable words evoked a small N400 amplitude compared to the non-predictable words. In contrast, in the simple (priming) task, the semantic link evoked an N400 amplitude modulation in the control group exclusively. Our results indicate that schizophrenics could be able to use context to activate expectations for the most highly predictable item, and that their deficit appears when the processing strategy is based on the integration of the context stored in working memory.

  11. Effects of hormones on cognition in schizophrenic male patients--preliminary results. (United States)

    Bratek, Agnieszka; Koźmin-Burzyńska, Agnieszka; Krysta, Krzysztof; Cierpka-Wiszniewska, Katarzyna; Krupka-Matuszczyk, Irena


    Schizophrenia is a prevalent neurodevelopmental disorder of an unknown etiology and a variable phenotypic expression. In the recent years, the impact of hormones on the course of schizophrenia has been investigated. This study is aimed at assessing the level of correlating serum levels of hormones in schizophrenic male patients with their cognitive functioning measured with neuropsychological tests. In the index group there were 15 medicated male schizophrenic patients. In the control group there were 15 age and education matched healthy men. All subjects underwent analysis of serum hormones level (TSH, testosterone, estradiol, FSH, LH, progesterone and prolactin) and a battery of tests (Trail Making Test A and B, Stroop Test, Verbal and Semantic Fluency Test). The mean serum levels of the following hormones were higher in the index group than in the control group: TSH (1.76 mIU/L vs 1.58 mIU/L; p=0.66), progesterone (0.85 ng/ml vs 0.69 ng/ml; p=0.22) and prolactin (558.71 uIU/ml vs 181 uIU/ml; p=0.025). The mean levels of estradiol (24.36 pg/ml vs 25.40 ng/ml; p=0.64), FSH (3.17 mIU/ml vs 5.72 mIU/ml; p=0.019), LH (3.85 mIU/ml vs 5.77 mIU/ml; p=0.056) and testosterone (2.90 ng/ml vs 5.38 ng/ml; p=0.003) were higher in the control group. In the index group there were significant negative correlations between FSH and semantic fluency (ρ=-0.678606), progesterone and: TMT B (ρ=-0.586763), Stroop 1 (ρ=-0.701880) and Stroop 2 (ρ=-0.601074) and prolactin and TMT A (ρ=-0.579607). The preliminary results of our study show that serum levels of FSH and testosterone are significantly lower, whereas the level of prolactin is markedly higher, in schizophrenic male patients than in healthy men. There is an inverse correlation between serum levels of progesterone, FSH and prolactin and the results of certain cognitive functioning tests in schizophrenic men.

  12. A schizophrenic patient with cerebral infarctions after hemorrhagic shock

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    Youichi Yanagawa


    Full Text Available We herein report the fourth case of cerebral infarction, concomitant with hemorrhagic shock, in English literature. A 33-year-old male, who had been diagnosed with schizophrenia and given a prescription for Olanzapine, was discovered with multiple self-inflicted bleeding cuts on his wrist. On arrival, he was in hemorrhagic shock without verbal responsiveness, but his vital signs were normalized following infusion of Lactate Ringer′s solution. The neuroradiological studies revealed multiple cerebral ischemic lesions without any vascular abnormality. He was diagnosed with speech apraxia, motor aphasia, and dysgraphia, due to multiple cerebral infarctions. As there was no obvious causative factor with regard to the occurrence of cerebral infarction in the patient, the hypoperfusion due to hemorrhagic shock, and the thromboembolic tendency due to Olanzapine, might have acted together to lead to the patient′s cerebral ischemia.

  13. The effect of antipsychotic medication on sexual function and serum prolactin levels in community-treated schizophrenic patients: results from the Schizophrenia Trial of Aripiprazole (STAR study (NCT00237913

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    Pans Miranda


    Full Text Available Abstract Background The aim of this paper is to evaluate the effect of antipsychotics for the treatment of schizophrenia in a community based study on sexual function and prolactin levels comparing the use of aripiprazole and standard of care (SOC, which was a limited choice of three widely used and available antipsychotics (olanzapine, quetiapine or risperidone (The Schizophrenia Trial of Aripiprazole [STAR] study [NCT00237913]. Method This open-label, 26-week, multi-centre, randomised study compared aripiprazole to SOC (olanzapine, quetiapine or risperidone in patients with schizophrenia (DSM-IV-TR criteria. The primary effectiveness variable was the mean total score of the Investigator Assessment Questionnaire (IAQ at Week 26. The outcome research variables included the Arizona Sexual Experience scale (ASEX. This along with the data collected on serum prolactin levels at week 4, 8, 12, 18 and 26 will be the focus of this paper. Results A total of 555 patients were randomised to receive aripiprazole (n = 284 or SOC (n = 271. Both treatment groups experienced improvements in sexual function from baseline ASEX assessments. However at 8 weeks the aripiprazole treatment group reported significantly greater improvement compared with the SOC group (p = 0.007; OC. Although baseline mean serum prolactin levels were similar in the two treatment groups (43.4 mg/dL in the aripiprazole group and 42.3 mg/dL in the SOC group, p = NS at Week 26 OC, mean decreases in serum prolactin were 34.2 mg/dL in the aripiprazole group, compared with 13.3 mg/dL in the SOC group (p Conclusion The study findings suggest that aripiprazole has the potential to reduce sexual dysfunction, which in turn might improve patient compliance.

  14. [The role of the self-consciousness of schizophrenic patients in the socio-vocational readaptation]. (United States)

    Nosenko, N F


    Using clinical and special medico-psychological methods, the authors studied 154 patients with schizophrenia with different rates of the disease progression and at different stages of the disease. The authors studied the condition of the patients' self-consciousness in relation to the possibilities of their social and occupational readaptation. It has been established that the working ability of patients depends on a number of factors, including their profession and working conditions, the influence of the family, the degree of progression of the schizophrenic process and the severity of negative symptoms. At the same time the level of patients' self-consciousness exerts a considerable influence on their social and occupational readaptation which should be taken into account in developing rehabilitative measures and in the course of expert medical examination of working capacity in such patients.

  15. Decreased serum levels of brain-derived neurotrophic factor in schizophrenic patients with deficit syndrome

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    Akyol ES


    Full Text Available Esra Soydas Akyol,1 Yakup Albayrak,2 Murat Beyazyüz,3 Nurkan Aksoy,4 Murat Kuloglu,5 Kenji Hashimoto6 1Deparment of Psychiatry, Yenimahalle Education and Research Hospital, Ankara, Turkey; 2Department of Psychiatry, Faculty of Medicine, Namik Kemal University, Tekirdag, Turkey; 3Department of Psychiatry, Biga State Hospital, Çanakkale, Turkey; 4Department of Biochemistry, Yenimahalle Education and Research Hospital, Ankara, Turkey; 5Department of Psychiatry, Faculty of Medicine, Akdeniz University, Antalya, Turkey; 6Division of Clinical Neuroscience, Chiba University Center for Forensic Mental Health, Chiba, Japan Background: Brain-derived neurotrophic factor (BDNF is a well-established neurotrophin that plays a role in the pathophysiology of numerous psychiatric disorders. Many studies have investigated the serum BDNF levels in patients with schizophrenia. However, there are restricted data in the literature that compare the serum BDNF levels in patients with deficit and nondeficit syndromes. In this study, we aimed to compare the serum BDNF levels between schizophrenic patients with deficit or nondeficit syndrome and healthy controls.Methods: After fulfilling the inclusion and exclusion criteria, 58 patients with schizophrenia and 36 healthy controls were included in the study. The patients were grouped as deficit syndrome (N=23 and nondeficit syndrome (N=35 according to the Schedule for the Deficit Syndrome. Three groups were compared in terms of the sociodemographic and clinical variants and serum BDNF levels.Results: The groups were similar in terms of age, sex, body mass index, and smoking status. The serum BDNF levels in patients with deficit syndrome were significantly lower than those in healthy controls. In contrast, the serum BDNF levels in patients with nondeficit syndrome were similar to those in healthy controls.Conclusion: This study suggests that decreased BDNF levels may play a role in the pathophysio­logy of schizophrenic

  16. Laughter in a psychiatric ward. Somatic, emotional, social, and clinical influences on schizophrenic patients. (United States)

    Gelkopf, M; Kreitler, S; Sigal, M


    The study was designed to explore the potential therapeutic effects of humor on hospitalized schizophrenics. For this purpose, in the first stage, we conducted a review of findings in regard to physical health, emotions, psychiatric state, and social behavior. In the second stage, we carried out an experiment with 34 resident patients in two chronic schizophrenic wards who were exposed to 70 movies during 3 months. The experimental group was exposed to humorous movies only, and the control group to different kinds of movies. Before and after the exposure to films for 3 months, both groups were tested on different health, emotional, social, and clinical measures using the Cognitive Orientation of Health Questionnaire, the Shalvata Symptom Rating Scale, blood pressure, heart rate, Perceived Verbal and Motor Aggression (rated by nurses), the Multiple Affect Adjective Check List, the Social Support Questionnaire 6, and the Brief Psychiatric Rating Scale (BPRS; rated by psychiatrists). Covariance analyses yielded significant reductions in Perceived Verbal Hostility, BPRS scales (total score, anxiety/depression), and significant increases in BPRS (activation) and degree of staff support experienced by the patients. The results indicate that the effects of exposure to humor may be mediated by the effects on the staff of the incidental exposure to humorous films.

  17. Adherence to depot versus oral antipsychotic medication in schizophrenic patients during the long-term therapy

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    Stanković Žana


    Full Text Available Background/Aim. There is a high rate of schizophrenic patients who do not adhere to their prescribed therapy, despite the implementation of antipsychotic long-acting injections and the introduction of atypical antipsychotics. The aim of this study was to investigate the differences in sociodemographic, clinical and medication adherence variables between the two groups of schizophrenic patients on maintenance therapy with depot antipsychotic fluphenazine decanoate and oral antipsychotics only as well as a correlation between the medication adherence and other examined variables. Methods. A total of 56 patients of both genders, aged < 60 years, with the diagnosis of schizophrenia (F20 (ICD-10, 1992 clinically stable for at least 6 months were introduced in this cross-sectional study. The patients from the depot group (n = 19 were on classical depot antipsychotic fluphenazine decanoate administering intramuscularly every 4 weeks (with or without oral antipsychotic augmentation and the patients from the oral group (n = 37 were on oral therapy alone with classical or atypical antipsychotics, either as monotherapy or combined. The Positive and Negative Syndrome Scale (PANSS was used to assess symptom severity. Item G12 of the PANSS was used to assess insight into the illness. The patients completed the Medical Adherence Rating Scale (MARS was used to assess adherence to the therapy. A higher MARS score indicates behavior [Medical Adherence Questionnaire (MAQ subscale] and attitudes toward medication [Drug Attitude Inventory (DAI subscale] that are more consistent with treatment adherence. The exclusion criteria were determined. The Pearson's χ2 test was used to compare categorical variables, Student's t-test to compare continuous variables and Pearson's correlation to test the correlation significance; p = 0.05. Results. Significant betweengroup differences in age, illness duration, chlorpromazine equivalents, PANSS score and DAI subscore were found

  18. Origins of a Jungian-oriented therapeutic community for schizophrenic patients. (United States)

    Wilmer, H A


    The author believes that rapid hospital turnover of psychiatric patients and heavy reliance on psychotropic drugs often interfere with recovery, especially for many psychotic patients who need a retreat where they might be helped to heal themselves. He describes the origins and operation of a Jungian-oriented therapeutic community for schizophrenic patients in a Veterans Administration hospital, the community is based parly on his earlier work with therapeutic communities and his belief that clear lines of authority must be maintained as well as his experiences with videotherapy and art therapy. The community relies heavily on art therapy in which patients are encouraged to make abstract paintings of their delusions, visions, hallucinations, dreams, and fantasies and to interpret the paintings themselves.

  19. The Application of Drawing and Painting to Decrease the Anixiety of the Schizophrenic Patients

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    Farbod Fadaei


    Full Text Available Objective: People with schizophrenia continuous type (previously labeled as chronic, constitute the majority of inpatients in rehabilitation wards. These patients, apart from the characteristic signs and symptoms of schizophrenia, suffer from anxiety. This anxiety, not influenced by antipsychotic medications, can be a part of the schizophrenia per se, but it may be due to the unfavorable frame and quality of life in mental hospital wards. Every attempt in decreasing the anxiety of these patients, can be regarded as a step toward a more perfect treatment and rehabilitation plan, and elevating the quality of their lives. In this research the application of drawing and painting as a method to decrease the anxiety of these patients was evaluated. Materials & Methods: 100 schizophrenic patients (according to DSM-IV criteria who were hospitalized in long stay rehabilitation wards of Razi psychiatric center for at least 2 years, entered the research procedure. Their anxiety level was measured by the Cattel anxiety questionnaire. 50 patients, who were selected as experimental group, had 15 one hour sessions of drawing and painting. For the remainder 50 patients who were the control group, various neutral activities (as placebo were performed, during those hours. Medications were unchanged during the research. After the 15th session the anxiety levels of patients were evaluated for the second time. The scores obtained in the first and second evaluations in each group and between two groups were analyzed by appropriate statistical methods. Results: In comparing the mean scores obtained from the first and second measurements in experimental group by applying the t-test (in correlated groups, the difference was statistically significant (t=67.5, P<0.0l. Conclusion: Sessions of drawing and painting with appropriate duration and frequency can significantly diminish the anxiety in long stay schizophrenic patients in rehabilitation wards.

  20. Successful microsurgical penile replantation following self amputation in a schizophrenic patient

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    Saurabh Gyan


    Full Text Available Amputation of the penis is a rare condition reported from various parts of the world as isolated cases or small series of patients; the common etiology is self-mutilating sharp amputation or an avulsion or crush injury in an industrial accident. A complete reconstruction of all penile structures should be attempted in one stage which provides the best chance for full rehabilitation of the patient. We report here a single case of total amputation of the penis in an acute paranoid schizophrenic patient .The penis was successfully reattached using a microsurgical technique. After surgery, near-normal appearance and function including a good urine flow and absence of urethral stricture, capabilities of erection and near normal sensitivity were observed.

  1. Pharmacotherapy of schizophrenic patients: preponderance of off-label drug use.

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    David Pickar

    Full Text Available Multiple drug class combinations are often prescribed for the treatment of schizophrenia, although antipsychotic monotherapy reflects FDA labeling and scientific justification for combinations is highly variable. This study was performed to gain current data regarding drug treatment of schizophrenia as practiced in the community and to assess the frequencies of off-label drug class combinations. 200 DSM IV-diagnosed schizophrenic patients recruited from community treatment sources participated in this cross-sectional study of community based schizophrenic patients. Drug class categories include First and Second Generation Antipsychotic drugs (FGA and SGA, respectively, mood stabilizers, antidepressants and anti-anxiety drugs. 25.5% of patients received antipsychotic monotherapy; 70% of patients received an antipsychotic and another drug class. A total of 42.5% of patients received more than one antipsychotic drug. The most common drug class combination was antipsychotic and a mood stabilizer. Stepwise linear discriminant function analysis identified the diagnosis of schizoaffective schizophrenia, history of having physically hurt someone and high scores on the General Portion of the PANSS rating scale predicted the combined use of an antipsychotic drug and a mood stabilizer. "Real world" pharmacotherapy of schizophrenia has developed its own established practice that is predominantly off-label and may have outstripped current data support. The economic implications for public sector payers are substantial as well as for the revenue of the pharmaceutical industry, whose promotion of off-label drug use is an increasingly problematic. These data are consistent with the recognition of the therapeutic limitations of both first and second generation antipsychotic drugs.

  2. Urinary tract infection complicated by urine retention presenting as pseudocyesis in a schizophrenic patient. (United States)

    Yeh, Yi-Wei; Kuo, Shin-Chang; Chen, Chun-Yen


    Pseudocyesis is a rare condition wherein a nonpregnant woman shows signs and symptoms of pregnancy, such as abdominal enlargement, breast enlargement, pigmentation, cessation of menses, subjective sensation of fetal movement and labor pains at the expected delivery date. In the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, it is classified as a somatoform disorder, characterized by a false belief of being pregnant that is associated with objective signs of pregnancy. We report the case of a middle-aged female schizophrenic patient who developed pseudocyesis secondary to a urinary tract infection complicated by acute urine retention. The patient accepted that she had pseudocyesis after the causative medical condition resolved. Copyright © 2012 Elsevier Inc. All rights reserved.

  3. Identification of a missense mutation and several polymorphisms in the proenkephalin A gene of schizophrenic patients

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    Mikesell, M.J.; Sommer, S.S.; McMurray, C.T. [Mayo Foundation and Mayo Graduate School, Rochester, MN (United States)] [and others


    Schizophrenia is a complex and severe disorder of unknown cause and pathophysiology. In this study, we examined the opioid hypothesis for schizophrenia at the molecular level, focusing on the dopamine-regulated proenkephalin A gene (chromosome 8q11.23-q12). We have screened 150 schizophrenic patients for sequence variations within the promoter region, entire coding sequence, and 3{prime}-untranslated region. We find one sequence change in a conserved amino acid that may be of functional significance. This mutation was found in a single schizophrenia patient but not in controls. Although several new, race-specific polymorphisms were identified, all other sequence changes appeared to be common polymorphisms, unlikely to contribute to the etiology of schizophrenia. 38 refs., 3 figs., 2 tabs.

  4. Catha edulis chewing effects on treatment of paranoid schizophrenic patients

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    Kotb El-Sayed MI


    Full Text Available Mohamed-I Kotb El-Sayed, Hatem-K Amin Department of Biochemistry and Molecular Biology, Faculty of Pharmacy, Helwan University, Ain Helwan, Helwan, Cairo, Egypt Background: The current study’s aim is to evaluate the possible interaction effects of khat chewing on treatment of paranoid schizophrenic patients.Patients and methods: In the study group, 42 male subjects suffered from paranoid schizophrenia and were classified according to their khat chewing habits into two subgroups: either khat-chewer subgroup (SKc; n=21; r=11, h=10 or non-khat-chewer subgroup (SNKc; n=21, r=11, h=10. Each subgroup was further subdivided according to type of treatment into r (risperidone and h (haloperidol. Healthy male subjects (37 were subdivided into healthy khat-chewer as positive controls (HKc, n=17 and healthy non-khat-chewer as negative controls (HNKc, n=20. Plasma dopamine, 3,4-dihydroxyphenylacetic acid (DOPAC, homovanillic acid, 5-hydroxytryptamine (serotonin, 5-hydroxyindoleacetic acid, epinephrine, and norepinephrine were estimated.Results: ANOVA and post hoc analysis showed that dopamine was illustrating significant elevation in all khat chewing groups. DOPAC was illustrating significant decrease in all khat chewing groups with an interesting outcome showing significant increase in DOPAC in SNKcr group due to risperidone effect. Homovanillic acid, serotonin, hydroxyindoleacetic acid, and norepinephrine were illustrating significant elevations in all khat chewing groups. Epinephrine was illustrating significant elevation in all chewers than non-chewers groups. Unexpected significant decrease in epinephrine in the SNKcr group indicated that risperidone drug is decreasing epinephrine through indirect mechanism involving calcium.Conclusion: Khat chewing in schizophrenic patients is contraindicated because it aggravates the disease symptoms, attenuates all used treatment medications, and deteriorates all biochemical markers of the patients. Keywords

  5. A comparison between effectiveness of three types of music on memory activity and sustained attention in schizophrenic patients

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    Narges bahmany


    Full Text Available Background: schizophrenia is a psychiatric disorder in which a lot of cognitive functions including memory, attention, motor skills, executive functions and intelligence are compromised. Numerous empirical studies showed that schizophrenic patients have problem in sustain retention and memory activity. The objective of this study was a comparison between effectiveness of three types of music on memory activity and sustain retention in schizophrenic patients. Material and Methods: A total of 60 schizophrenic patients (30 males , 30 females 18-48 years old were selected from available sampling frame. Participants were otherwise healthy except for schizophrenia. Wechsler Memory Scale and cognitive diagnostic battery Kay test were taken from all subjects. Then patients were randomly divided into three experimental groups (Iranian classic, western classic and pop music and three control groups. There were 10 participants (5 male, 5 female in each group. After taking these tests, music therapy course was performed on experimental groups. After music therapy sessions were completed, tests were taken again from groups. Results: Covariance analysis results indicated that music therapy is overall effective on memory activity. But type of music had no effect in improving memory activity. There wasn’t significant difference between groups considering type of music. Furthermore, covariance analysis showed that music therapy is totally effective on sustain retention and type of music is effective in this intervention. Pop music had the most effectiveness on schizophrenic patients in improving sustain retention. Conclusion: Performing music therapy improves memory and retention. More over, using pop music particularly has the most effect in improving sustain retention in schizophrenic patients.

  6. Measurement of methionine level with the LC-ESI-MS/MS method in schizophrenic patients

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    S. Kulaksizoglu


    Full Text Available The purpose of this study was to evaluate plasma methionine levels by using liquid chromatography electrospray ionization-tandem mass spectroscopy (LC-ESI-MS/MS in schizophrenic patients. A twelve-point standard graph was drawn, and the recovery rate, the intra-day and inter-day coefficients of variation (CV, the limit of detection (LOD, and the limit of quantification (LOQ were evaluated. The y and R2 values of the standard graph equation were determined as 0.011x + 0.0179 and 0.9989, respectively, and the graph remained linear until the 200 µmol/l level. The intra-day coefficients of variation of the samples (n = 10 containing 8, 28, and 58 µmol/l methionine were determined as 2.68, 3.10, and 3.79%, respectively; while their inter-day coefficients of variation were determined as 2.98, 3.19, and 3.84%. The LOD and LOQ values were determined as 0.04 and 0.1 µmol/l, respectively, while the mean recovery rates were determined as 101.7 and 99.3%. Plasma methionine values were measured as 21.5 (19.5-24,6 µmol/l for the patient group, 17.8 (16.3-20.1 µmol/l for the control group, and the difference between the two groups was statistically significant (p = 0.03. LC-ESI-MS/MS method represents a fairly sensitive, economic, and rapid analysis that requires very little sample and is suitable for measuring methionine levels in schizophrenic patients.

  7. Virtual reality testing of multi-modal integration in schizophrenic patients. (United States)

    Sorkin, Anna; Peled, Avi; Weinshall, Daphna


    Our goal is to develop a new family of automatic tools for the diagnosis of schizophrenia, using Virtual Reality Technology (VRT). VRT is specifically suitable for this purpose, because it allows for multi-modal stimulation in a complex setup, and the simultaneous measurement of multiple parameters. In this work we studied sensory integration within working memory, in a navigation task through a VR maze. Along the way subjects pass through multiple rooms that include three doors each, only one of which can be used to legally exit the room. Specifically, each door is characterized by three features (color, shape and sound), and only one combination of features -- as determined by a transient opening rule -- is legal. The opening rule changes over time. Subjects must learn the rule and use it for successful navigation throughout the maze. 39 schizophrenic patients and 21 healthy controls participated in this study. Upon completion, each subject was assigned a performance profile, including various error scores, response time, navigation ability and strategy. We developed a classification procedure based on the subjects' performance profile, which correctly predicted 85% of the schizophrenic patients (and all the controls). We observed that a number of parameters showed significant correlation with standard diagnosis scores (PANSS), suggesting the potential use of our measurements for future diagnosis of schizophrenia. On the other hand, our patients did not show unusual repetition of response despite stimulus cessation (called perseveration in classical studies of schizophrenia), which is usually considered a robust marker of the disease. Interestingly, this deficit only appeared in our study when subjects did not receive proper explanation of the task.

  8. Self-mutilation of the nose in a schizophrenic patient with Cotard syndrome. (United States)

    Ghaffari-Nejad, Alireza; Kerdegari, Mohammad; Reihani-Kermani, Hamed


    Cotard syndrome is a rare condition, which its main symptom is nihilistic delusion. Self-mutilation of the nose is also a rare condition, which has not been seen in schizophrenic patients with Cotard syndrome. A single case is presented here. A 32-year-old woman who was diagnosed as having schizophrenia and believed that she was dead, cut the tip of her nose. She had no guilt feeling and described her act as a cosmetic surgery. We try to explain how various symptoms that seem to be very far from each other could exist side by side. Misinterpretation of her face is suggested to be the starting point in her complex symptoms.

  9. Symptom changes in chronic schizophrenic patients on a token economy: a controlled experiment. (United States)

    Baker, R; Hall, J N; Hutchinson, K; Bridge, G


    An 18-month controlled experiment was conducted into the effects of a token economy programme on the ward behaviour and symptoms of chronic schizophrenic patients. An experimental group received tokens dependent upon appropriate behaviour, while a matched control group on the same ward received every aspect of the ward programme similarly except that tokens were not dependent upon their behaviour. Regular assessment showed that both groups improved substantially in social withdrawal. Over twelve months of treatment the experimental group improved no more than the control group. There were no symptomatic changes. The conclusions were that token economy is a treatment affecting withdrawl and social behaviour rather than symptomatology, and that factors other than reinforcement by tokens were responsible for the main changes.

  10. Serum cortisol and dehydroepiandrosterone-sulfate levels in schizophrenic patients and their first-degree relatives. (United States)

    Yıldırım, Osman; Dogan, Orhan; Semiz, Murat; Kilicli, Fatih


    Alterations in cortisol and dehydroepiandrosterone sulfate (DHEA-S) levels are thought to play a role in the pathophysiology of neuropsychiatric disorders, including schizophrenia. The aim of this study was to investigate the role of serum cortisol and DHEA-S in the pathophysiology of schizophrenia. Sixty schizophrenic patients, 70 healthy first-degree relatives, and 60 healthy volunteers were included. Sociodemographic characteristics, data regarding disease duration and severity, as well as ongoing and previous drug use were recorded. Serum cortisol and DHEA-S levels were measured. Serum cortisol and DHEA-S levels were significantly higher in the schizophrenia group compared with the first-degree relatives and controls (P cortisol levels in the first-degree relatives were significantly higher than in the healthy controls (P DHEA-S levels and between the three groups in terms of serum cortisol/DHEA-S ratios. Elevated serum cortisol levels in schizophrenic patients might be associated with the role of cortisol in the pathophysiology of schizophrenia. Also, the elevation of serum cortisol levels in first-degree relatives compared to controls suggests that similar pathophysiological processes might have a role in individuals without any disease symptoms, but with a genetic predisposition for schizophrenia. Elevated serum DHEA-S levels might be the result of a compensatory response to elevated cortisol levels. Serum cortisol and DHEA-S levels may be used as a biological marker for the diagnosis of schizophrenia; however, further studies with larger sample sizes are warranted to support this finding. © 2011 The Authors. Psychiatry and Clinical Neurosciences © 2011 Japanese Society of Psychiatry and Neurology.

  11. Neuropsychology, social cognition and global functioning among bipolar, schizophrenic patients and healthy controls: preliminary data. (United States)

    Caletti, Elisabetta; Paoli, Riccardo A; Fiorentini, Alessio; Cigliobianco, Michela; Zugno, Elisa; Serati, Marta; Orsenigo, Giulia; Grillo, Paolo; Zago, Stefano; Caldiroli, Alice; Prunas, Cecilia; Giusti, Francesca; Consonni, Dario; Altamura, A Carlo


    This study aimed to determine the extent of impairment in social and non-social cognitive domains in an ecological context comparing bipolar (BD), schizophrenic (SKZ) patients and healthy controls (HC). The sample was enrolled at the Department of Psychiatry of Policlinico Hospital, University of Milan; it includes stabilized SKZ patients (n = 30), euthymic bipolar patients (n = 18) and HC (n = 18). Patients and controls completed psychiatric assessment rating scales, the Brief Assessment of Cognition in Schizophrenia (BACS) and the Executive and Social Cognition Battery (ESCB) that contains both ecological tests of executive function and social cognition, in order to better detect cognitive deficits in patients with normal results in standard executive batteries. The three groups differed significantly for gender and substance abuse, however, the differences did not influence the results. BD patients showed less impairment on cognitive performance compared to SKZ patients, even in "ecological" tests that mimic real life scenarios. In particular, BD performed better than SKZ in verbal memory (p Hotel task SKZ patients completed significantly less tasks (p differences were found between the two groups in GAF scores, being greater among BD subjects (p < 0.001). GAF was correlated with BACS and ESCB scores showing the crucial role of cognitive and ecological performances in patients' global functioning.

  12. Sex and Laterality Differences in Parkinsonian Impairment and Transcranial Ultrasound in Never-Treated Schizophrenics and Their First Degree Relatives in an Andean population (United States)

    Kamis, Danielle; Stratton, Lee; Calvó, María; Padilla, Eduardo; Florenzano, Néstor; Guerrero, Gonzalo; Rangeon, Beatriz Molina; Molina, Juan; de Erausquin, Gabriel A.


    We tested the hypothesis that loss of substantia nigra neurons in subjects at risk of schizophrenia (1), as reflected by midbrain hyperechogenicity (2) and parkinsonian motor impairment (3), is asymmetric and influenced by sex. We evaluated 62 subjects with never-treated chronic schizophrenia, 80 of their adult, unaffected first degree relatives and 62 healthy controls (matched by sex and age to the cases), part of an Andean population of Northern Argentina. Parkinsonism was scored blindly using UPDRS-3 (Unified Parkinson's Disease Rating Scale) on videotaped exams by 2 independent raters. Trancranial ultrasound was performed by an expert sonographist blind to subject condition with a 2.5 MHz transducer through a temporal bone window. Quantification of echogenic area was carried out on saved images by a different evaluator. We found a significant difference in parkinsonian motor impairment between patients, their relatives as well as controls. All three groups showed worse parkinsonism on the left side than the right, corresponding with increased echogenicity on the right substantia nigra compared with the left. Females had significantly more right echogenicity than males, and patients and unaffected relatives were significantly more echogenic than controls on that side. On the left, only female patients had significant echogenicity. Our data supports the notion that unaffected relatives of schizophrenic subjects have increased parkinsonism and concomitant brainstem abnormalities which may represent a vulnerability to the disease. Both motor and brainstem abnormalities are asymmetric and influenced by sex. PMID:25735637

  13. A virtual environment for investigating schizophrenic patients' characteristics: assessment of cognitive and navigation ability. (United States)

    Ku, Jeonghun; Cho, Wongeun; Kim, Jae-Jin; Peled, Avi; Wiederhold, Brenda K; Wiederhold, Mark D; Kim, In Y; Lee, Jang Han; Kim, Sun I


    Patients with schizophrenia have thinking disorders such as delusions or hallucinations because they have a deficit in the ability to systematize and integrate information. Therefore, they cannot integrate or systematize visual, auditory, and tactile stimuli. The multimodal integration model of the brain can provide a theoretical background from which one can approach multimodal stimulus integration. In this study, we suggest a virtual reality system for the multi-modal assessment of cognitive ability of schizophrenia patients. The virtual reality system can provide multimodal stimuli, such as visual and auditory stimuli, to the patient and can evaluate the patient's multimodal integration and working memory integration abilities by making the patient interpret and react to multimodal stimuli, which must be remembered for a given period of time. The clinical study showed that the virtual reality program developed is comparable to those of the Wisconsin Card Sorting Test (WCST) and the Standard Progressive Matrices (SPM), and it provides some information related to the schizophrenic patients' behavior in 3D virtual environment.

  14. The discontinuance of maintenance neuroleptic therapy in chronic schizophrenic patients: drug and social consequences. (United States)

    Johnson, D A; Pasterski, G; Ludlow, J M; Street, K; Taylor, R D


    In a prospective follow-up the outcome of 60 chronic schizophrenic patients who discontinued neuroleptic therapy after remaining stable 12-48 months was compared with controls continuing medication. Not only did the drug-discontinued patients have more relapses (P less than 0.001), but the form of relapse was both more severe and acute, resulting in differences of self-injury (P less than 0.05), anti-social behaviour (P less than 0.01), inpatient admissions (P less than 0.001), and the use of compulsory powers (P less than 0.01). In patients who relapsed, both social and work function was affected adversely for some months. Patients who remained relapse-free without drugs (20%) had a level of work and social function similar to medicated patients. At the end of 18 months the patients who discontinued depot maintenance therapy were found to have been prescribed one-third more neuroleptic drugs than controls, with a possible increase in the risk of long-term tardive dyskinesia.

  15. Serum cortisol and DHEA-S levels in schizophrenic patients with different response to antipsychotic therapy: association with psychopathology


    Babinkostova, Zoja; Stefanovski, Branko; Janikevik Ivanovska, Danijela; Samardziska, Valentina; Stojanovska, Lila


    Background: Previous studies suggested that alterations in serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Imbalance in serum cortisol and DHEA-S levels may be related to responsivity to antipsychotic treatment. Aim: To compare serum cortisol and DHEA-S levels between patients with schizophrenia and healthy controls and to evaluate their association with psychopathology in schizophrenic patients with different response to antipsychotic treatment. ...

  16. A literature critique using outcomes model and substruction in nursing science - Psychoeducational therapy for schizophrenic patients


    松田, 光信


    The purposes of this article are (1) to introduce the outline of the outcomes model and substruction, and (2) to introduce the example of synthesis and critique of literature about psychoeducational therapy for schizophrenic patients. Recently, psychiatrists or psychologists are providing patients with education for medication using cognitive therapy, social skills training and psychoeducational therapy in Japan. Psychiatrists and psychologists are doing evaluation research of these structure...

  17. Recognition of visual stimuli and memory for spatial context in schizophrenic patients and healthy volunteers. (United States)

    Brébion, Gildas; David, Anthony S; Pilowsky, Lyn S; Jones, Hugh


    Verbal and visual recognition tasks were administered to 40 patients with schizophrenia and 40 healthy comparison subjects. The verbal recognition task consisted of discriminating between 16 target words and 16 new words. The visual recognition task consisted of discriminating between 16 target pictures (8 black-and-white and 8 color) and 16 new pictures (8 black-and-white and 8 color). Visual recognition was followed by a spatial context discrimination task in which subjects were required to remember the spatial location of the target pictures at encoding. Results showed that recognition deficit in patients was similar for verbal and visual material. In both schizophrenic and healthy groups, men, but not women, obtained better recognition scores for the colored than for the black-and-white pictures. However, men and women similarly benefited from color to reduce spatial context discrimination errors. Patients showed a significant deficit in remembering the spatial location of the pictures, independently of accuracy in remembering the pictures themselves. These data suggest that patients are impaired in the amount of visual information that they can encode. With regards to the perceptual attributes of the stimuli, memory for spatial information appears to be affected, but not processing of color information.


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    Stefan Todorov


    Full Text Available The achievements of the contemporary psychopharmacology enable the out-patient treatment of schizophrenic patients, thus let them living in their usual social environment- family, relatives, neighbors, friends.In this connection, the real conditions of patients’ micro-social environment play an important role- either stimulating their compensatory mechanisms, or exercising negative impact on their adaptation and behavior.We examined 30 schizophrenic patients (22 males, 8 females, who have committed aggressive acts, triggered by psycho-traumatic situations with different sensible content, originating from their micro-social environment.Dominant were family conflicts, followed by conflicts with the neighbors. The aggressive acts were directed to concrete persons, from the close neighborhood, involved into the psycho-traumatic situations.Studying and evaluation of the aggressive acts, triggered by psycho-traumatic factors play an important role for their prevention.

  19. [Guideline compliance in the treatment of schizophrenic patients. Introduction of a computer-assisted treatment pathway]. (United States)

    Godemann, F; Blittersdorf, K; Poschenrieder, M; Klimitz, H; Hauth, I; Gutzmann, H


    The goal of S3 Guidelines for the Treatment of Schizophrenia was to improve the care of patients with schizophrenic psychoses. However, the publication of guidelines alone does not ensure their consistent implementation. The use of treatment pathways represents one possible approach to help implement the complex treatment recommendations contained in the S3 Guidelines. The first computer-assisted treatment pathway for patients with schizophrenic psychoses was successfully incorporated into the everyday routine of psychiatric hospitals. The aim of the present study was to systematically analyse the impact of this measure on guideline compliance. Based on the S3 Guidelines for the Treatment of Schizophrenia developed by the German Association of Psychiatry, Psychotherapy and Neurology (Deutsche Gesellschaft für Psychiatrie, Psychotherapie und Nervenheilkunde; DGPPN), diagnostic and treatment procedures were defined by a multiprofessional working group with members from five different hospitals and subsequently incorporated into an existing hospital information system. In one of the five hospitals, the impact of this measure was analysed in a pilot study in a systematic manner. In the year 2007, approximately 100 patients in each of two wards in the hospital received in a parallel group design either standard care or care based on a computer-assisted treatment pathway. Based on their place of residence, patients were assigned to the two units consecutively. Both groups were analysed to determine the extent to which the care they received conformed to treatment guidelines. Data available from the years 2004 and 2005 served as a historical comparison to the present results. The differences in guideline compliance between the two wards were heterogeneous and, in certain respects, counterintuitive. As expected, the treatment pathway group showed an increased number of laboratory tests, more frequent drug screening at hospital admission and more appropriate dosing of

  20. [Cost-effectiveness analysis of schizophrenic patient care settings: impact of an atypical antipsychotic under long-acting injection formulation]. (United States)

    Llorca, P M; Miadi-Fargier, H; Lançon, C; Jasso Mosqueda, G; Casadebaig, F; Philippe, A; Guillon, P; Mehnert, A; Omnès, L F; Chicoye, A; Durand-Zaleski, I


    pharmaceutical formulation of antipsychotics. Hospitalization and relapse risks are lower in compliant than in non-compliant patients. The main objective of this pharmacoeconomic analysis is to evaluate the impact in terms of medical benefits and costs of the following strategies: 1. Risperidone long-acting injection: first long-acting injectable atypical antipsychotic; 2. Haloperidol depot: long-acting injectable conventional neuroleptic; 3. Olanzapine: atypical antipsychotic available commercially in oral formulation. The target population defined for the study are young schizophrenic patients treated for at least 1 year and whose disorder has not been diagnosed for longer than 5 years. The time horizon is 2 years. A cost-effectiveness analysis is performed. The perspective adopted is the French Health System. The main hypothesis of the model is that an increase in compliance linked to the use of long-acting injectable formulation could lead to an increased efficacy and a modification of the cost-effectiveness ratio. A decision tree was built. Six periods of follow-up are identified with a duration of 4-months per period. The tree contains 3 principal arms, each one corresponding to a specific treatment: risperidone LA injection, haloperidol decanoate and olanzapine. For each arm, at the chance node, two health states are identified: either the patient responds favourably to the treatment or does not respond favourably and requires a switch to another drug treatment. After a period of response, the patient can either remain in the same state or experiences a clinical deterioration. If the patient presents a clinical deterioration, he can either go back to a positive response state after a period of intensive follow-up or remain in an insufficient response state; in this case, a change of antipsychotic treatment is necessary. In the model, a patient should receive four different treatments before a long-term hospitalization takes put in place. According to the market

  1. Significant treatment effect of adjunct music therapy to standard treatment on the positive, negative, and mood symptoms of schizophrenic patients: a meta-analysis

    National Research Council Canada - National Science Library

    Tseng, Ping-Tao; Chen, Yen-Wen; Lin, Pao-Yen; Tu, Kun-Yu; Wang, Hung-Yu; Cheng, Yu-Shian; Chang, Yi-Chung; Chang, Chih-Hua; Chung, Weilun; Wu, Ching-Kuan


    .... However, its role is still inconclusive. A recent meta-analysis demonstrated that MT for schizophrenic patients only significantly benefits negative symptoms and mood symptoms rather than positive symptoms...

  2. [Expressed Emotions, Burden and Family Functioning in Schizophrenic and Bipolar I Patients of a Multimodal Intervention Program: PRISMA]. (United States)

    Ramírez, Alexandra; Palacio, Juan David; Vargas, Cristian; Díaz-Zuluaga, Ana María; Duica, Kelly; Agudelo Berruecos, Yuli; Ospina, Sigifredo; López-Jaramillo, Carlos

    Bipolar disorder and schizophrenia are causes of major suffering in patients. Nevertheless, they also affect family and caregiver functioning. This is important because the participation and involvement of families and caregivers is essential to achieve an optimal treatment. To describe the level of expressed emotions, burden, and family functioning of bipolar and schizophrenic patients and, to evaluate the efficacy of the multimodal intervention (MI) versus traditional intervention (TI) in family functioning and its perception by patients and caregivers. A prospective, longitudinal, therapeutic-comparative study was conducted with 302 patients (104 schizophrenic and 198 bipolar patients) who were randomly assigned to a MI or TI groups of a multimodal intervention program PRISMA. MI group received care from psychiatry, general medicine, neuropsychology, family therapy, and occupational therapy. TI group received care from psychiatry and general medicine. Hamilton, Young and SANS, SAPS scales were applied to bipolar and schizophrenic patients, respectively. The EEAG, FEICS, FACES III and ECF were also applied at the initial and final time. There were statistically significant differences in socio- demographic and clinical variables in schizophrenia vs bipolar group: 83% vs 32.2% were male, 37 vs 43 mean age, 96% vs 59% were single, 50% vs 20% unemployed, and 20% vs 40% had college studies. In addition, 2 vs 2.5 numbers of hospitalisations, 18 vs 16 mean age of substance abuse onset and, 55 vs 80 points in EEAG. There were no statistically significant differences in family scales after conducting a multivariate analysis on thr initial and final time in both groups. This study did not show changes in variables of burden and family functioning between bipolar and schizophrenic groups that were under TI vs MI. Copyright © 2016 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

  3. [Impact of a Multimodal Intervention on the Psychological Profile of Schizophrenic and Bipolar I Patients: A Study of PRISMA Program]. (United States)

    Díaz-Zuluaga, Ana María; Vargas, Cristian; Duica, Kelly; Richard, Shanel; Palacio, Juan David; Agudelo Berruecos, Yuli; Ospina, Sigifredo; López-Jaramillo, Carlos

    Bipolar Disorder (BD) and schizophrenia are included in the group of severe mental illness and are main causes of disability and morbidity in the local population due to the bio-psycho-social implications in patients. In the last 20 years or so, adjunctive psychological interventions been studied with the purpose of decreasing recurrences, stabilising the course of the disease, and improving the functionality in these patients. To analyse the psychological effect of a multimodal intervention (MI) vs a traditional intervention (TI) program in BD I and schizophrenic patients. A prospective, longitudinal, therapeutic-comparative study was conducted with 302 patients (104 schizophrenic and 198 bipolar patients) who were randomly assigned to the MI or TI groups of a multimodal intervention program PRISMA. The MI group received care from psychiatry, general medicine, neuropsychology, family therapy, and occupational therapy. The TI group received care from psychiatry and general medicine. The Hamilton and Young scales, and the Scales for the Assessment of Negative Symptoms (SANS) and Postive Symptoms (SAPS) were used on bipolar and schizophrenic patients, respectively. The scales AQ-12, TEMPS-A, FAST, Zuckerman sensation seeking scale, BIS-11, SAI-E and EEAG were applied to measure the psychological variables. The scales were performed before and after the interventions. The psychotherapy used in this study was cognitive behavioural therapy. There were statistically significant differences in socio-demographic and clinical variables in the schizophrenia and bipolar disorder group. There were no statistically significant differences in the psychological scales after conducting a multivariate analysis between the intervention groups and for both times (initial and final). This study did not show any changes in variables of psychological functioning variables between bipolar and schizophrenic groups, who were subjected to TI vs MI (who received cognitive behavioural therapy

  4. Neural correlates of eye tracking deficits in first-degree relatives of schizophrenic patients: a positron emission tomography study. (United States)

    O'Driscoll, G A; Benkelfat, C; Florencio, P S; Wolff, A L; Joober, R; Lal, S; Evans, A C


    Schizophrenia is thought to arise from the interaction of genetically mediated and environmentally triggered abnormalities in brain function. Reduced frontal activation, reported in schizophrenic patients, may be one expression of genetic risk. The present study investigated whether frontal activation in relatives of schizophrenic patients would be related to eye tracking deficits (ETD), which are considered a behavioral marker of risk for schizophrenia. Subjects were first-degree relatives of schizophrenic patients (n = 17) and controls (n = 11). Relatives were divided into those with normal and abnormal pursuit based on qualitative ratings. Subjects were scanned using positron emission tomography and the H(2)15O bolus subtraction technique while performing smooth pursuit and fixation. Brain areas more active in pursuit than fixation were identified in the 3 groups. Correlations were used to investigate the relationship between activation of pursuit regions and pursuit gain in the relatives. Controls significantly activated frontal eye fields (FEFs) and posterior areas, including the motion processing area, V5, and cuneus. The 2 groups of relatives activated the same posterior regions as controls, but differed from each other in activation of FEFs. Relatives with normal tracking activated right dorsal FEFs while relatives with ETD did not. Individual subtractions revealed that 90% of controls and 100% of the relatives with normal tracking activated FEFs during pursuit compared with 42% of relatives with ETD (P = .009). Pursuit gain was significantly and selectively associated with percent activation of right dorsal FEFs (r = 0.74). Subtle frontal dysfunction seems to be a pathophysiological substrate of ETD in relatives of schizophrenic patients, and may be one aspect of genetically mediated differences in brain function relevant to schizophrenia.

  5. Seasonal variations of schizophrenic patients in emergency departments in Sofia, Bulgaria

    Directory of Open Access Journals (Sweden)

    Zornitsa Spasova


    Full Text Available Aim: The purpose of this study was to reveal the seasonal distribution of emergency department visits of schizophrenic patients in Sofia, Bulgaria. Methods: We collected daily data for visits of patients with schizophrenia, schizotypal and delusional disorders in the emergency center of the regional dispenser for mental disorders in the city of Sofia for the period 1998-2003. The total number of emergency visits was 5723 (mean daily visits: 5.04±2.4. T-test was used to compare the monthly and seasonal distribution of visits. Results: The season with the highest levels of emergency visits was summer, and the lowest levels were observed in winter (P<0.0001. Spring and autumn had intermediate values close to the mean value, and significantly differentiated from winter values. The month with the highest admission rates was September, followed by May and the three summer’s months. The lowest levels were observed in December, October and January, with statistically significant differences observed between the values of all the three months. Differences between July values compared with December and October values were significant, but not with January values. Conclusion: The study showed significant seasonal and monthly differences in emergency schizophrenics’ visits. The data confirm the outcome of similar studies conducted in countries with temperate climate in the Northern Hemisphere. These results could prove useful for psychiatrists, public health specialists, and governmental authorities dealing with team planning and prevention programs in the field of psychiatry.

  6. A combined cICA-EEMD analysis of EEG recordings from depressed or schizophrenic patients during olfactory stimulation (United States)

    Götz, Th; Stadler, L.; Fraunhofer, G.; Tomé, A. M.; Hausner, H.; Lang, E. W.


    Objective. We propose a combination of a constrained independent component analysis (cICA) with an ensemble empirical mode decomposition (EEMD) to analyze electroencephalographic recordings from depressed or schizophrenic subjects during olfactory stimulation. Approach. EEMD serves to extract intrinsic modes (IMFs) underlying the recorded EEG time. The latter then serve as reference signals to extract the most similar underlying independent component within a constrained ICA. The extracted modes are further analyzed considering their power spectra. Main results. The analysis of the extracted modes reveals clear differences in the related power spectra between the disease characteristics of depressed and schizophrenic patients. Such differences appear in the high frequency γ-band in the intrinsic modes, but also in much more detail in the low frequency range in the α-, θ- and δ-bands. Significance. The proposed method provides various means to discriminate both disease pictures in a clinical environment.

  7. An epidemiological study of concomitant use of Chinese medicine and antipsychotics in schizophrenic patients: implication for herb-drug interaction.

    Directory of Open Access Journals (Sweden)

    Zhang-Jin Zhang

    Full Text Available BACKGROUND: Herb-drug interactions are an important issue in drug safety and clinical practice. The aim of this epidemiological study was to characterize associations of clinical outcomes with concomitant herbal and antipsychotic use in patients with schizophrenia. METHODS AND FINDINGS: In this retrospective, cross-sectional study, 1795 patients with schizophrenia who were randomly selected from 17 psychiatric hospitals in China were interviewed face-to-face using a structured questionnaire. Association analyses were conducted to examine correlates between Chinese medicine (CM use and demographic, clinical variables, antipsychotic medication mode, and clinical outcomes. The prevalence of concomitant CM and antipsychotic treatment was 36.4% [95% confidence interval (95% CI 34.2%-38.6%]. Patients using concomitant CM had a significantly greater chance of improved outcomes than non-CM use (61.1% vs. 34.3%, OR = 3.44, 95% CI 2.80-4.24. However, a small but significant number of patients treated concomitantly with CM had a greater risk of developing worse outcomes (7.2% vs. 4.4%, OR = 2.06, 95% CI 2.06-4.83. Significant predictors for concomitant CM treatment-associated outcomes were residence in urban areas, paranoid psychosis, and exceeding 3 months of CM use. Herbal medicine regimens containing Radix Bupleuri, Fructus Gardenia, Fructus Schisandrae, Radix Rehmanniae, Akebia Caulis, and Semen Plantaginis in concomitant use with quetiapine, clozapine, and olanzepine were associated with nearly 60% of the risk of adverse outcomes. CONCLUSIONS: Concomitant herbal and antipsychotic treatment could produce either beneficial or adverse clinical effects in schizophrenic population. Potential herb-drug pharmacokinetic interactions need to be further evaluated.

  8. The effects of psychoactive drugs and neuroleptics on language in normal subjects and schizophrenic patients: a review. (United States)

    Salomé, F; Boyer, P; Fayol, M


    The aim of this survey is to present an overview of research into psychopharmacology as regards the effects of different psychoactive drugs and neuroleptics (NL) on language in normal subjects and schizophrenic patients. Eighteen studies that have investigated the effects of different drugs (alcohol, amphetamines, secobarbital, L-dopa, psilocybin, ketamine, fenfluramine) and neuroleptics (conventional and atypical) on language are reviewed. There are no studies concerning the effects of neuroleptics on language in healthy subjects. The results of the effects of other molecules indicate that language production can be increased (alcohol, amphetamine, secobarbital), rendered more complex (d-amphetamine), more focused (L-dopa) or more unfocused (psilocybin) and clearly impaired (ketamine). For schizophrenic patients, most studies show that conventional neuroleptic treatments, at a therapeutic dosage and in acute or chronic mode, reduce language disorders at all levels (clinic, linguistic, psycholinguistic). In conjunction with other molecules, the classical NL, when administered at a moderate dosage and in chronic mode, modify language in schizophrenia, either by improving the verbal flow and reducing pauses and positive thought disorder (NL + amphetamine) or by inducing an impairment in the language measurements (NL + fenfluramine). Clinical, methodological and theoretical considerations of results are debated in the framework of schizophrenic language disorders.

  9. Double-Decision Lexical Tasks in Thought-Disordered Schizophrenic Patients: A Path Towards Cognitive Remediation? (United States)

    Besche-Richard, Chrystel; Passerieux, Christine; Hardy-Bayle, Marie-Christine


    It has been shown that schizophrenics have certain difficulties in the processing of semantic context. These difficulties have usually been evaluated using lexical decision tasks with semantic priming. In this study, we chose to examine the idea of an abnormality in the early stages of semantic context processing in thought-disordered…

  10. Validation of the French version of the BACS (the brief assessment of cognition in schizophrenia) among 50 French schizophrenic patients. (United States)

    Bralet, Marie-Cécile; Falissard, Bruno; Neveu, Xavier; Lucas-Ross, Margaret; Eskenazi, Anne-Marie; Keefe, Richard S E


    Schizophrenic patients demonstrate impairments in several key dimensions of cognition. These impairments are correlated with important aspects of functional outcome. While assessment of these cognition disorders is increasingly becoming a part of clinical and research practice in schizophrenia, there is no standard and easily administered test battery. The BACS (Brief Assessment of Cognition in Schizophrenia) has been validated in English language [Keefe RSE, Golberg TE, Harvey PD, Gold JM, Poe MP, Coughenour L. The Brief Assessment of Cognition in Schizophrenia: reliability, sensibility, and comparison with a standard neurocognitive battery. Schizophr. Res 2004;68:283-97], and was found to be as sensitive to cognitive dysfunction as a standard battery of tests, with the advantage of requiring less than 35 min to complete. We developed a French adaptation of the BACS and this study tested its ease of administration and concurrent validity. Correlation analyses between the BACS (version A) and a standard battery were performed. A sample of 50 stable schizophrenic patients received the French Version A of the BACS in a first session, and in a second session a standard battery. All the patients completed each of the subtests of the French BACS . The mean duration of completion for the BACS French version was 36 min (S.D.=5.56). A correlation analysis between the BACS (version A) global score and the standard battery global score showed a significant result (r=0.81, pschizophrenic patients compared to a standard battery (administration shorter and completion rate better) and its good psychometric properties suggest that the French Version of the BACS may be a useful tool for assessing cognition in schizophrenic patients with French as their primary language.

  11. Significant treatment effect of adjunct music therapy to standard treatment on the positive, negative, and mood symptoms of schizophrenic patients: a meta-analysis. (United States)

    Tseng, Ping-Tao; Chen, Yen-Wen; Lin, Pao-Yen; Tu, Kun-Yu; Wang, Hung-Yu; Cheng, Yu-Shian; Chang, Yi-Chung; Chang, Chih-Hua; Chung, Weilun; Wu, Ching-Kuan


    Music therapy (MT) has been used as adjunct therapy for schizophrenia for decades. However, its role is still inconclusive. A recent meta-analysis demonstrated that MT for schizophrenic patients only significantly benefits negative symptoms and mood symptoms rather than positive symptoms. In addition, the association between specific characteristics of MT and the treatment effect remains unclear. The aim of this study was to update the published data and to explore the role of music therapy in adjunct treatment in schizophrenia with a thorough meta-analysis. We compared the treatment effect in schizophrenic patients with standard treatment who did and did not receive adjunct MT through a meta-analysis, and investigated the clinical characteristics of MT through meta-regression. The main finding was that the treatment effect was significantly better in the patients who received adjunct MT than in those who did not, in negative symptoms, mood symptoms, and also positive symptoms (all p positively associated with the whole duration of illness, indicating that MT would be beneficial for schizophrenic patients with a chronic course. Our meta-analysis highlights a significantly better treatment effect in schizophrenic patients who received MT than in those who did not, especially in those with a chronic course, regardless of the duration, frequency, or amounts of sessions of MT. These findings provide evidence that clinicians should apply MT for schizophrenic patients to alleviate disease severity.

  12. Functional MRI in schizophrenia. Diagnostics and therapy monitoring of cognitive deficits of schizophrenic patients by functional MRI; Funktionelle MRT bei Schizophreniepatienten. Diagnostik und Therapiemonitoring kognitiver Defizite schizophrener Patienten mittels funktioneller MRT

    Energy Technology Data Exchange (ETDEWEB)

    Furtner, J.; Prayer, D. [Medizinische Universitaet Wien, Univ.-Klinik fuer Radiodiagnostik, Wien (Austria); Sachs, G. [Medizinische Universitaet Wien, Univ.-Klinik fuer Psychiatrie und Psychotherapie, Wien (Austria)


    Cognitive impairments are core psychopathological components of the symptomatic of schizophrenic patients. These dysfunctions are generally related to attention, executive functions and memory. This report provides information on the importance of using functional magnetic resonance imaging (fMRI) for the diagnostics and therapy monitoring of the different subtypes of cognitive dysfunctions. Furthermore, it describes the typical differences in the activation of individual brain regions between schizophrenic patients and healthy control persons. This information should be helpful in identifying the deficit profile of each patient and create an individual therapy plan. (orig.) [German] Kognitive Defizite sind ein zentraler Bestandteil der Symptomatik schizophrener Patienten. Diese Defizite betreffen v. a. die Aufmerksamkeit, exekutive Funktionen sowie das Gedaechtnis. Der vorliegende Beitrag zeigt den Stellenwert der funktionellen Magnetresonanztomographie (fMRT) in Hinblick auf Diagnostik und Therapiemonitoring der unterschiedlichen kognitiven Teilbereiche auf. Darueber hinaus werden die Unterschiede in Bezug auf die Aktivierung der einzelnen Gehirnareale zwischen schizophrenen Patienten und gesunden Kontrollpersonen dargestellt. Diese Informationen sollen helfen, in der Praxis ein Profil der kognitiven Leistungsreduktionen sowie ein darauf angepasstes Therapiekonzept zu erstellen. (orig.)

  13. Frontal dopamine D(2/3) receptor binding in drug-naive first-episode schizophrenic patients correlates with positive psychotic symptoms and gender

    DEFF Research Database (Denmark)

    Glenthoj, Birte Y; Mackeprang, Torben; Svarer, Claus


    with single-photon emission computerized tomography (SPECT) using the D(2/3)-receptor ligand [123I]epidepride. RESULTS: In the hitherto largest study on extrastriatal D(2/3) receptors we detected a significant correlation between frontal D(2/3) BP values and positive schizophrenic symptoms in the larger group...... of male schizophrenic patients, higher frontal BP values in male (n = 17) compared to female (n = 8) patients, and - in accordance with this - significantly fewer positive schizophrenic symptoms in the female patients. No significant differences in BP values were observed between patients and controls......; the patients, however, had significantly higher BP in the right compared to the left thalamus, whereas no significant hemispheric imbalances were observed in the healthy subjects. CONCLUSIONS: The present data are the first to confirm a significant correlation between frontal D(2/3) receptor BP values...

  14. Schizophrenia and the paranormal: more psi belief and superstition, and less déjà vu in medicated schizophrenic patients. (United States)

    Shiah, Yung-Jong; Wu, Yi-Zhen; Chen, Yueh-Hua; Chiang, Shih-Kuang


    The present study examined the relation between déjà vu experiences and paranormal beliefs in schizophrenic patients. A total of 522 participants (54.5% female; mean age=33.3, SD=16.02) were recruited, including 422 healthy adults (60.9% female; mean age=29.48, SD=15.07) and 100 medicated adult schizophrenic patients (27.3% female; mean age=48.98, SD=8.57). The Chinese version of the Inventory of Déjà-vu Experiences Assessment was created via back translation. Chinese versions of the Revised Paranormal Belief Scale (CRPB), Beck Anxiety Inventory (CBAI), and Perceived Stress Scale (CPSS) were also used. After controlling for age, gender, education, and anxiety, the results supported the following three hypotheses. Schizophrenic persons have fewer déjà vu experiences than normal persons. These experiences are positively related to paranormal beliefs in healthy adults but not in schizophrenic patients. Schizophrenic patients have higher scores than healthy adults on the psi and superstitious subscales of the CRPB. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. An association study of the Hermansky-Pudlak syndrome type 4 gene in schizophrenic patients. (United States)

    Saito, Atsushi; Kuratomi, Go; Ito, Chihiro; Matsuoka, Hiroo; Suzuki, Tamio; Ozeki, Yuji; Watanabe, Takashi; Fujii, Kumiko; Shimoda, Kazutaka; Fukushima, Yasutsugu; Inukai, Toshihiko; Ohmori, Kenichi; Akiyama, Kazufumi


    We encountered two Japanese siblings who had Hermansky-Pudlak syndrome (HPS) and major mental disorders (schizophrenia and major depression) as well. As it is known that HPS is caused by a local mutation in one of the human genes, named HPS1 to HPS8 and PLDN (HPS9), encoding subunit proteins involved in endosomal trafficking pathways, here, we report the mutation causing the siblings disease and a case-control association study of schizophrenia using polymorphisms of a gene to be screened in the mutation analysis. We analyzed three HPS-causing genes, HPS1, HPS4, and HPS7, to identify a genetic mutation involved in the siblings. A case-control association study of nine tagging single-nucleotide polymorphisms of the entire genetic region of the HPS4 gene resulting from the screening in the siblings was carried out for schizophrenic patients (n=422) and controls (n=578). The two patients with HPS were homozygous for nonsense mutation (T/T) for the c.541C>T (rs119471022) in the HPS4 gene, which is mapped to human chromosome 22q12.1. The same nonsense mutation existed in the heterozygous state (C/T) in their mother and in two other siblings. The genotypic distribution of rs9608491 (C/T) in intron 4 showed a trend toward an association with schizophrenia as indicated by a corrected P-value of 0.053 controlling for multiple testing. Haplotype analyses showed that two of two-locus haplotypes, and all of three-locus, four-locus, and five-locus haplotypes, as they share rs9608491, yielded significant evidence for association with schizophrenia as shown by the following omnibus P-values. When rs4822724, rs61276843, rs9608491, rs713998, and rs2014410, five haplotype tagging single-nucleotide polymorphisms, are assigned serial numerals (1, 2, 3, 4, and 5), the omnibus P-values for the resulting haplotypes were P=0.0039 for 2-3, P=0.0142 for 3-4, P=0.0083 for 1-2-3, P=0.0187 for 2-3-4, P=0.0191 for 3-4-5, P=0.0270 for 1-2-3-4, P=0.0246 for 2-3-4-5, and 0.0261 for 1

  16. Correlation of regional cerebral blood flow and positive/negative symptoms in schizophrenic patients: covariate SPM analysis

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Ki Chun; Kim, J. S.; Kim, C. Y.; Lee, H. K.; Moon, D. H. [Ulsan University, Seoul (Korea, Republic of)


    We investigated the relations between rCBF and psychopathology in schizophrenic patients using a SPM99. Thirty-two patients(M/F:22/10, 25{+-}5,6yr) with active symptoms of schizophrenia and 15 age matched normal controls underwent Tc-99m ECD brain perfusion SPECT. Psychopathology of all patients were also assessed according to PANSS (positive and negative syndrome scale in schizophrenia). By covariate SPM analysis, specific areas where rCBF correlated with sum scores of positive/negative synptoms were identified. Regional CBF of schizophrenics was different in several cortical regions from normal controls. Sum scores of positive symptoms were positively correlated with rCBF of both rectal and inferior frontal gyri and right transverse temporal gyrus, and negatively correlated with rCBF of left lingual and right middle temporal gyri (p<0.01). Sum scores of negative symptoms were positively correlated with rCBF of both middle temporal gyri and negatively correlated with rCBF of right superior parietal lobule and medial frontal gyrus (p<0.01). Positive and negative symptoms of schizophrenia were correlated with rCBF change in different regions of cerebral association cortex.

  17. Serum cortisol and DHEA-S levels in schizophrenic patients with different response to antipsychotic therapy: association with psychopathology. (United States)

    Babinkostova, Z; Stefanovski, B; Janicevic-Ivanovska, D; Samardziska, V; Stojanovska, L


    Previous studies suggested that alterations in serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Imbalance in serum cortisol and DHEA-S levels may be related to responsivity to antipsychotic treatment. To compare serum cortisol and DHEA-S levels between patients with schizophrenia and healthy controls and to evaluate their association with psychopathology in schizophrenic patients with different response to antipsychotic treatment. This clinical prospective study included 60 patients with schizophrenia and 40 healthy age and sex matched controls. All patients experienced an acute exacerbation of the illness (PANSS: P1 and P3 ≥ 4). Clinical evaluation of patients was performed using the Positive and Negative Symptom Scale. A questionnaire for socio-demographic and clinical data collection was used. For the purposes of the study, the examined group was divided in two subgroups: responders and nonresponders. Serum cortisol and DHEA-S levels were measuredat baseline in all participants and after 3 and 6 weeks of the antipsychotic treatment in patients with schizophrenia. Patients with schizophrenia had significantly higher serum cortisol and DHEA-S levels comparedwith control group. Responders had significantly higher serum cortisol and DHEA-S levels compared with nonresponders. Responders group had significant correlation between serum cortisol and PANSS positive scale score as well as between hostility and serum DHEA-S. Elevated serum cortisol and DHEA-S levels may play a role in the pathophysiology of schizophrenia. Serum cortisol and DHEA-S are associated with psychopathology in schizophrenic patients with different response to antipsychotic therapy.

  18. The effect of verbalization strategy on wisconsin card sorting test performance in schizophrenic patients receiving classical or atypical antipsychotics

    Directory of Open Access Journals (Sweden)

    Cavallaro Roberto


    Full Text Available Abstract Background A number of reports showed en encouraging remediation in some patients' executive deficits thanks to the use of 'information processing strategies'. Moreover the impact of antipsychotics on cognitive functions of the schizophrenics is an important issue, especially if an integrated psychosocial treatment is needed. The aim of this paper is to evaluate different executive performance and response to verbalization, a strategy of the Wisconsin Card Sorting Test (WCST remediation, in subjects on classical vs atypical antipsychotic (AP treatment. Methods Sixty-three schizophrenic subjects undertook the WCST under standard and modified (verbalization administration. Subjects were stratified by the kind of WCST response (i.e. good, poor and remediable and AP treatment (i.e. atypical vs. classical. Results Subjects on atypical APs showed a better performance than those on classical ones. More poor performers who did not remediate were seen in the sample with classical Aps while subjects who remediated the performance were seen in the subgroup with atypical APs only. An increase of perseverative and total errors was seen in poor performers subjects on classical APs. Conclusion Subjects on atypicals showed a better cognitive pattern in terms of WCST performance. Since the naturalistic assignment of medication we cannot draw conclusions about its effect on cognitive performance and its interaction with cognitive remediation potential. However the data lead us to hypothesize that subjects with potential room for remediation did so with the atypical APs.

  19. Relational Control Patterns in Families of Schizophrenics. (United States)

    McCarrick, Anne; And Others


    Examined patterning of relational control in families of schizophrenic patients, and relationship between control in the family and the course of the illness. Transcripts of conversations among 17 schizophrenic outpatients and their families were coded into Relational Control Coding System. Found rigid, one-up messages from family members to…

  20. Repetition in Schizophrenic Speech. (United States)

    Manschreck, Theo C.; And Others


    Describes an investigation into the relationship of schizophrenic thought disorder to measures of repetition that include phrase units, proximity of repetitions, and word frequencies to determine whether such measures distinguish schizophrenics from non-schizophrenics and to what extent they are associated with certain attributes of schizophrenia,…

  1. [The schizophrenic disorder]. (United States)

    Bellomo, L E


    The author makes both a historical and up-to-date review of the "schizophrenic defect" concept (S.D.). He comes to the conclusion that this is the "morbid residual" or balance left as "ideo-affective" capital after every productive psychotic outbreak. The S.D. is studied in a "Medium and Long Term" Ward with prevailing statistics amounting to 33% D.E. patients plus 9% active schizophrenic patients over a total average of 100 chronic hospitalized patients. It was found out that 33% of that universe had some scattered family whereas 19% of these patients had no family at all. The latter showed strong tendency towards isolation, slovenliness and "hospitalism". They became "passive-dependent" patients. The situational framework is analyzed. Medical staff relation ships with patients, type of treatment and the illusion created by "fictitious discharge" of E.D. under no favorable psycho-environmental conditions are taken into account. Methods to improve the situation are then outlined and discussed. The following topics are considered: correct therapeutics, family therapy, sectorization, therapeutic community, transition homes (foyers), and current legislation.

  2. [Clinical features of the Kandinsky-Clerambault syndrome in schizophrenic patients and prognosis]. (United States)

    Tsirkin, S Iu


    The paper deals with the typology of conditions with a delusional variant of the Kandinsky-Clerambault syndrome in schizophrenia. At the basis of the differentiation there lie different types of delusional disturbances in the structure of which the syndrome is formed. Accordingly, 4 types of conditions have been distinguished: 1. developing in combination with interpretative systematized delusions; 2. interpretative non-systematized delusions; 3. acute fantastic paraphrenic delusions; 4. acute sensual delusions. Certain correlations were demonstrated between these types of delusional disturbances and the indices of the gravity of the schizophrenic process (the form of disease development, quality of negative disturbances, the depths of process intensification, following each of the types of conditions, index of working capacity, duration of attacks). The typology presented is discussed in the light of prognosis of the severity of the development of schizophrenias and its treatment.

  3. Dor crônica em pacientes esquizofrênicos: prevalência e características Chronic pain in schizophrenic patients: prevalence and characteristics

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    Jouce Gabriela de Almeida


    Full Text Available A prevalência de dor crônica entre pacientes com transtornos psiquiátricos é, possivelmente, no mínimo igual à encontrada entre a população geral. Para estimar a prevalência de dor crônica em pacientes com esquizofrenia, comparar os grupos com e sem dor crônica e caracterizar a dor foi realizado um estudo transversal, com uma amostra probabilística de 205 pacientes adultos, com diagnóstico de esquizofrenia (idade média 37 anos; 65% homens; média de escolaridade de nove anos; 87% sem companheiro(a; 65% residentes com os pais, atendidos em hospital público do Município de São Paulo, Brasil. A prevalência de dor foi de 36,6%; a dor foi mais presente no abdômen (30,7%, seguida da dor de cabeça, face e boca (24% e região lombar, sacra e cóccix (14,7%. Com relação à freqüência, 24% dos entrevistados referiram ter dor todos os dias. O tempo médio de dor foi de 41 meses, com intensidade moderada. A prevalência de dor crônica em pacientes esquizofrênicos foi semelhante à encontrada para a população geral, e o quadro álgico foi significativo em termos de duração, intensidade e freqüência dos episódios dolorosos.Chronic pain may be at least as prevalent in psychiatric patients as in the general population. To estimate the prevalence of chronic pain in schizophrenic patients, compare the groups with and without chronic pain, and characterize the pain, a cross-sectional study was performed on a probabilistic sample of 205 adult patients with a diagnosis of schizophrenia (mean age 37 years; 65% men; mean schooling nine years; 87% single; 65% living with parents, treated at a public hospital in the city of São Paulo, Brazil. Prevalence of pain was 36.6%, and the most frequent sites were abdomen (30.7%, head, face, and mouth (24%, and lower back (14.7%. Twenty-four percent of patients reported feeling pain every day. Mean duration of pain was 41 months, with moderate intensity. Prevalence of chronic pain in

  4. Correlation between neuropsychological and social cognition measures and symptom dimensions in schizophrenic patients. (United States)

    Altamura, A Carlo; Caletti, Elisabetta; Paoli, Riccardo Augusto; Cigliobianco, Michela; Zugno, Elisa; Grillo, Paolo; Prunas, Cecilia; Caldiroli, Alice; Zago, Stefano


    Neurocognitive and social cognition deficits have been largely reported in Schizophrenia (SKZ) but their association with psychopathology remains uncertain. Our purpose was to explore the relationship between symptom dimensions and neuropsychological performances. We enrolled 35 stabilized schizophrenic outpatients of the Department of Psychiatry of Policlinico Hospital, University of Milan, who completed psychiatric Rating Scales, the Brief Assessment of Cognition in Schizophrenia (BACS) and the Executive and Social Cognition Battery (ESCB). Disorganized dimension seems to have the most significant impact on cognition, being associated with performance in several BACS subtests (verbal memory, working memory, motor speed, symbol coding, Tower of London) and ESCB tasks (MET and Hotel task number of tasks attempted, number of broken MET rules, sum of deviations in Hotel Task). Positive dimension correlated with performance in verbal fluency, negative dimension with IOWA Test results, cognitive dimension with MET number of inefficiencies and Eyes test score. Impulsive-aggressive and depressive dimensions weakly correlated only with Faux Pas test. Our study supports the existence of a specific disorganized dimension in SKZ, separated from cognitive dimension evaluated through clinical instruments (e.g. PANSS), but capable of influencing cognitive abilities. Furthermore, it strengthens the validity of ecological tasks in evaluating cognition in SKZ. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. The interactions between religion, religiosity, religious delusion/hallucination, and treatment-seeking behavior among schizophrenic patients in Taiwan. (United States)

    Huang, Charles Lung-Cheng; Shang, Chi-Yung; Shieh, Ming-Shien; Lin, Hsin-Nan; Su, Jin Chung-Jen


    Religion could influence the psychopathology, treatment-seeking behavior, and treatment outcome in schizophrenia, but the associations between these factors have never been explored thoroughly, and the data in Han-Chinese society are scarcer still. The current study recruited 55 schizophrenic patients to explore the relationship between religion, psychopathology with religious content, treatment-seeking behavior, and outcome. Subjects with religious delusions/hallucinations had lower scores on functioning and higher scores on religiosity. The higher religiosity scores were correlated with older age, longer duration of illness, religious affiliation, lower preference of psychiatric treatment, lower functioning score, and delusion/hallucination. As to treatment-seeking behavior, patients with religious affiliation showed less preference toward psychiatric treatment. Individuals with religious delusion/hallucination were more likely to receive magico-religious healing and not to be satisfied with psychiatric treatment. A more positive view of psychiatric treatment was predicted by lower religiosity score, higher satisfaction with psychiatric treatment, and lower years of education. The religiosity level seems not directly related to clinical severity, but it seems to be a better predictor of religious delusions/hallucinations than religious affiliation status. Patients with religious delusions/hallucinations did not necessarily have more severe psychopathology. There are different profiles associated with religious affiliation/religiosity and religious delusions/hallucinations in relation to treatment-seeking behavior among schizophrenia patients in Han-Chinese society. Copyright © 2010 Elsevier Ltd. All rights reserved.

  6. Opposite effective connectivity in the posterior cingulate and medial prefrontal cortex between first-episode schizophrenic patients with suicide risk and healthy controls.

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    Huiran Zhang

    Full Text Available OBJECTIVE: The schizophrenic patients with high suicide risk are characterized by depression, better cognitive function, and prominent positive symptoms. However, the neurobiological basis of suicide attempts in schizophrenia is not clear. The suicide in schizophrenia is implicated in the defects in emotional process and decision-making, which are associated with prefrontal-cingulate circuit. In order to explore the possible neurobiological basis of suicide in schizophrenia, we investigated the correlation of prefrontal-cingulate circuit with suicide risk in schizophrenia via dynamic casual modelling. METHOD: Participants were 33 first-episode schizophrenic patients comprising of a high suicide risk group (N = 14 and a low suicide risk group (N = 19. A comparison group of healthy controls (N = 15 were matched for age, gender and education. N-back tasking functional magnetic resonance imaging data was collected. RESULTS: Compared with healthy controls group, the two patients groups showed decreased task-related suppression during 2-back task state versus baseline state in the left posterior cingulate and medial prefrontal cortex; the hyper-connectivity from the left posterior cingulate cortex to the left medial prefrontal cortex existed in both schizophrenic patients groups, but hypo-connectivity in the opposite direction only existed in the schizophrenic patients group with high suicide risk. CONCLUSIONS: The hyper-connectivity from the left posterior cingulate cortex to the left medial prefrontal cortex may suggest that the abnormal effective connectivity was associated with risk for schizophrenia. The hypo-connectivity in the opposite direction may represent a possible correlate of increased vulnerability to suicide attempt.

  7. Switch from neuroleptics to clozapine does not influence pituitary-gonadal axis hormone levels in male schizophrenic patients. (United States)

    Markianos, M; Hatzimanolis, J; Lykouras, L


    Hypothalamic dopaminergic and serotonergic inputs participate in the regulation of pituitary hormones, and drugs that block central dopamine and serotonin receptors are expected to influence the hypothalamus-pituitary-gonadal (HPG) and -adrenal (HPA) axes. In schizophrenic patients, the switch from neuroleptics to clozapine influences prolactin and cortisol secretion, but there is no information on possible changes on HPG-axis hormones. We measured the plasma levels of testosterone (TST), LH, FSH, as well as of prolactin (PRL) and cortisol (CORT), in a group of male patients with schizophrenia during treatment with classical neuroleptics with no satisfactory therapeutic response (31 pts, age 30.3+/-8.5, range 18-50), and 6 weeks later, after switch to treatment with clozapine (CLZ) in doses from 100 to 600 mg daily (mean 328 mg). Psychopathology was assessed using the Brief Psychiatric Rating Scale. The hormone levels were also compared to those of a control group of 38 healthy males. Treatment with CLZ resulted in a reduction in the BPRS score by 30% in the mean. Plasma PRL was reduced from 39.9+/-26.1 to 8.3+/-5.0 ng/ml (PHPG-axis hormone plasma levels, although it reduces substantially the levels of prolactin and cortisol.

  8. The effect of neuroleptics on prolactinoma growth in a Jordanian schizophrenic girl. (United States)

    Daradkeh, T K; Ajlouni, K M


    We describe a case of a schizophrenic girl who developed prolactinoma while being treated with neuroleptics. The clinical history and special investigations of the pituitary tumor suggest that neuroleptic medications may have enhanced the growth of the tumor in our patient. The author suggests that the relationship between the occurrence of prolactinoma and neuroleptic medications ought to be investigated in a large controlled study.

  9. Effects of typical antipsychotic, haloperidol on regional cerebral blood flow in drug-naive schizophrenic patients-study with 99mTc-HMPAO SPECT

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    Kamoya, Masatoshi [Kanazawa Medical Univ., Ishikawa (Japan)


    For the purpose of examining antipsychotic action of haloperidol (HPD), effects of chronic perioral administration of HPD 4.5 mg/day on regional cerebral blood flow (rCBF) with 99mTc-HMPAO SPECT were investigated in 12 drug-naive schizophrenic patients with acute hallucinatory and delusional state. Further, the SPECT examinations were performed on 20 normal adult volunteers to investigate differences in rCBFs between schizophrenics and the normal subjects. Results are itemized as follows. The rCBF values were significantly increased in the bilateral superior and middle frontal, cingulate, middle temporal, pre-and post-central gyri, the left superior temporal gyrus, the bilateral inferior parietal lobule, and the bilateral hippocampal and thalamic cortices in comparison between normal subjects and before the HPD dose in schizophrenics. However, the rCBF values after the HPD dose showed significant increases only in the bilateral pre-and post-central gyri in comparison with the normal subjects. The rCBF values were significantly decreased in the bilateral superior, middle and inferior frontal, superior and middle temporal gyri, and the left insular gyrus after the HPD dose in comparison with before the HPD dose. The psychiatric assessment with PANSS showed an improvement of positive symptoms consisting of auditory hallucination and delusions after the HPD dose. Statistical analyses on relationships between the rCBF values and PANSS scores before and after the HPD dose showed positive correlations between the right inferior frontal gyrus and auditory hallucination or positive symptoms, between the right superior temporal gyrus, left thalamus and delusions, and between the left thalamus, insular gyrus and negative symptoms. These results suggest that acute drug-naive schizophrenic patients have widespread cortico-subcortical energic hypermetabolism and HPD reduces the hypermetabolism, leading to whole normalized brain metabolism, in particular with the larger region

  10. Drug Treated Schizophrenia, Schizoaffective and Bipolar Disorder Patients Evaluated by qEEG Absolute Spectral Power and Mean Frequency Analysis. (United States)

    Wix-Ramos, Richard; Moreno, Xiomara; Capote, Eduardo; González, Gilbert; Uribe, Ezequiel; Eblen-Zajjur, Antonio


    Research of electroencephalograph (EEG) power spectrum and mean frequency has shown inconsistent results in patients with schizophrenic, schizoaffective and bipolar disorders during medication when compared to normal subjects thus; the characterization of these parameters is an important task. We applied quantitative EEG (qEEG) to investigate 38 control, 15 schizophrenic, 7 schizoaffective and 11 bipolar disorder subjects which remaine under the administration of psychotropic drugs (except control group). Absolute spectral power (ASP), mean frequency and hemispheric electrical asymmetry were measured by 19 derivation qEEG. Group mean values were compared with non parametrical Mann-Whitney test and spectral EEG maps with z-score method at p Schizoaffective patients received neuroleptic+benzodiazepine (71.4%) and for bipolar disorder patients neuroleptic+antiepileptic (81.8%). Schizophrenic (at all derivations except for Fp1, Fp2, F8 and T6) and schizoaffective (only at C3) show higher values of ASP (+57.7% and +86.1% respectively) compared to control group. ASP of bipolar disorder patients did not show differences against control group. The mean frequency was higher at Fp1 (+14.2%) and Fp2 (+17.4%) in bipolar disorder patients than control group, but no differences were found in frequencies between schizophrenic or schizoaffective patients against the control group. Majority of spectral differences were found at the left hemisphere in schizophrenic and schizoaffective but not in bipolar disorder subjects. The present report contributes to characterize quantitatively the qEEG in drug treated schizophrenic, schizoaffective or bipolar disorder patients.

  11. Sensation seeking behavior among schizophrenics. (United States)

    Farhady, Yadollah; Fadai, Farbod; Mazinani, Robabeh; Ashtari, Zabih; Alawijeh, Morteza


    To compare sensation seeking between schizophrenic patients (and clinical subtypes of schizophrenia) according to criteria of DSM-IV-TR; and a healthy control group. Two hypotheses were assumed: 1. Sensation seeking in the control group is higher than schizophrenic patients. 2. The levels of sensation seeking are different among clinical subtypes of schizophrenia. The sample comprised a study group of 69 schizophrenic inpatients at Raazy Psychiatric Center, Tehran, Iran in 2005 (10 males and 10 females for each of paranoid, undifferentiated and residual subtypes, and 9 males from disorganized subtype), and 50 randomly selected healthy people, the control group. To measure sensation seeking, the Zuckermann Sensation Seeking Scale, a 41-item questionnaire form, was used after evaluating its validity and reliability. After obtaining a weak or negative correlation, we omitted 9 questions, so that finally a 32-item questionnaire with highest reliability (Cronbach`s alpha = 0.64), remained and was utilized. We used descriptive statistical methods and calculation of statistical indices, and Student t-test for independent groups to evaluate the research hypotheses. The first hypothesis was confirmed at a 99% significance level. The second hypothesis was rejected at a 95% significance level. We found a definite correlation between schizophrenia and a low level of sensation seeking. Accordingly, and since sensation seeking (as a part of temperament) has a strong genetic component, a low level of sensation seeking is probably an existing feature of schizophrenia. Assessing sensation seeking in high-risk populations (children or the siblings of schizophrenics) could be a practical attempt at prevention or immediate treatment of schizophrenia.

  12. If drugs are not taken - How different antipsychotics influence compliance of schizophrenic patients

    NARCIS (Netherlands)

    Schorr, S. G.; Brouwers, J. R. B. J.; Taxis, K.

    The effectiveness of pharmacotherapy partly depends on patients' compliance. However noncompliance with pharmacotherapy occurs frequently. It is particularly a problem in diseases requiring long-term treatment. On average chronically ill patients only take about half of their medication as

  13. Common variants in MAGI2 gene are associated with increased risk for cognitive impairment in schizophrenic patients.

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    Takayoshi Koide

    Full Text Available Schizophrenia is a complex psychiatric disorder characterized by positive symptoms, negative symptoms, and cognitive impairment. MAGI2, a relatively large gene (∼1.5 Mbps that maps to chromosome 7q21, is involved in recruitment of neurotransmitter receptors such as AMPA- and NMDA-type glutamate receptors. A genetic association study designed to evaluate the association between MAGI2 and cognitive performance or schizophrenia has not been conducted. In this case-control study, we examined the relationship of single nucleotide polymorphism (SNP variations in MAGI2 and risk for schizophrenia in a large Japanese sample and explored the potential relationships between variations in MAGI2 and aspects of human cognitive function related to glutamate activity. Based on the result of first schizophrenia genome-wide association study in a Japanese population (JGWAS, we selected four independent SNPs and performed an association study using a large independent Japanese sample set (cases 1624, controls 1621. Wisconsin Card Sorting Test (WCST was used to evaluate executive function in 114 cases and 91 controls. We found suggestive evidence for genetic association of common SNPs within MAGI2 locus and schizophrenia in Japanese population. Furthermore in terms of association between MAGI2 and cognitive performance, we observed that genotype effect of rs2190665 on WCST score was significant (p = 0.034 and rs4729938 trended toward significance (p = 0.08. In conclusion, although we could not detect strong genetic evidence for association of common variants in MAGI2 and increased schizophrenia risk in a Japanese population, these SNPs may increase risk of cognitive impairment in schizophrenic patients.

  14. Ensaio com sulpiride em esquizofrênicos hospitalizados Clinical trial with sulpiride on schizophrenic in-patients

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    Clóvis Martins


    Full Text Available Um ensaio terapêutico é feito com sulpiride, substância psicotrópica dada como muito ativa e cujas propriedades permitem enquadrá-la entre os neurolépticos e os timoanalépticos. Foram tratados 24 pacientes internados, com idades que variavam entre 17 e 48 anos, de ambos os sexos (17 masculinos e 7 femininos, todos com o diagnóstico clínico de esquizofrenia e internados em hospital psiquiátrico. O tempo de doença variava de 30 dias a 18 anos. O sulpiride foi aplicado em doses diárias em torno de 1200 mg, predominantemente por via oral. O tratamento durou em média 6 semanas permanecendo a maioria dos casos em observação por alguns meses, sob tratamento de manutenção. Os resultados foram em geral favoráveis, principalmente no que tange aos fenômenos psicóticos sensoperceptivos e delirantes. Não foram assinalados efeitos colaterais ou manifestações colaterais molestas.A therapeutic trial with sulpiride was made, submiting to treatment 24 in-patients of a mental hospital, diagnosed as schizophrenics. The ages are from 17 to 48 years old, 17 males and 7 females. The time of disease was from 30 dayes to 18 years. The drug was given mainly orally on about 1200 mg/die, in a treament of 6 weeks followed in some cases, by several months of observation. The best results were obtained in the sensoperceptive and delusional symptoms. No side effects of importance were detected.

  15. Presenting a Spatial-Geometric EEG Feature to Classify BMD and Schizophrenic Patients

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    Fatemeh AliMardani


    Full Text Available Schizophrenia (SZ and bipolar mood disorder (BMD patients demonstrate some similar signs and symptoms; therefore, distinguishing those using qualitative criteria is not an easy task especially when these patients experience manic or hallucination phases. This study is aimed at classifying these patients by spatial analysis of their electroencephalogram (EEG signals. In this way, 22-channels EEG signals were recorded from 52 patients (26 patients with SZ and 26 patients with BMD. No stimulus has been used during the signal recording in order to investigate whether background EEGs of these patients in the idle state contain discriminative information or not. The EEG signals of all channels were segmented into stationary intervals called “frame” and the covariance matrix of each frame is separately represented in manifold space. Exploiting Riemannian metrics in the manifold space, the classification of sample covariance matrices is carried out by a simple nearest neighbor classifier. To evaluate our method, leave one patient out cross validation approach has been used. The achieved results imply that the difference in the spatial information between the patients along with control subjects is meaningful. Nevertheless, to enhance the diagnosis rate, a new algorithm is introduced in the manifold space to select those frames which are less deviated around the mean as the most probable noise free frames. The classification accuracy is highly improved up to 98.95% compared to the conventional methods. The achieved result is promising and the computational complexity is also suitable for real time processing.

  16. The facial expression of schizophrenic patients applied with infrared thermal facial image sequence

    National Research Council Canada - National Science Library

    Bo-Lin Jian; Chieh-Li Chen; Wen-Lin Chu; Min-Wei Huang


    .... Thus, this study used non-contact infrared thermal facial images (ITFIs) to analyze facial temperature changes evoked by different emotions in moderately and markedly ill schizophrenia patients...

  17. Relationship between Drug Attitudes of Schizophrenic Patients on Discharge and Re-hospitalization

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    Hannaneh Taghizadeh


    Full Text Available "n "nObjective: Non-compliance is one of the major problems in treatment of patients with schizophrenia. It is also the most significant risk factor for relapse and re-hospitalization. Previous studies showed that 25-70% of all patients with schizophrenia have negative attitudes to drugs. Therefore, the present study aimed to identify the relationship between drug attitude and discharge and the rate of re-hospitalization in patients with schizophrenia. "nMethod: This cohort study was carried out on 200 hospitalized patients with schizophrenia. Drug Attitude Inventory (DAI was completed for all the patients at the time of discharge. All patients were followed-up for one year for ehospitalization. Logistic regression was used to examine the association between drug attitude and specific risk factors. "nResults: The Mean age of patients was 37.34±10.74 years. Positive and negative drug attitudes were 68%.5 and 27% respectively. The rate of rehospitalization was 41.5% during the one year follow-up. The rate of negative attitude was not significantly different between the two groups with and without re-hospitalization. However, the mean DAI score was significantly lower in the re-hospitalized patients. Multivariate analysis showed that lower DAI score and being female were significant and independent risk factors for re-hospitalization. "n "nConclusion: The more negative attitude the patients with schizophrenia had towards drugs, the more rate of re-hospitalization they had. Moreover, female patients are at higher risk for re-hospitalization.

  18. God's eyes and the schizophrenic hands: listening to a psychiatric patient

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    Luciane Loss Jardim


    Full Text Available This article describes the intriguing case of a young female patient first seen in the emergency room and then followed up at the psychiatric outpatient facility of the General Hospital at UNICAMP, Brazil. The cooperation that ensued between psychiatrists and a psychoanalyst to reach a psychopathological diagnosis is also presented here. The differential diagnosis is discussed within a psychiatric framework and then contributions from listening to the patient's free associations related to the clarification of her psychopathology are described. The clinical collaboration between psychiatry and psychoanalysis proved effective in this case as a clinical method for approaching the patient.

  19. Detecting potential adverse reactions of sulpiride in schizophrenic patients by prescription sequence symmetry analysis

    National Research Council Canada - National Science Library

    Lai, Edward Chia-Cheng; Hsieh, Cheng-Yang; Kao Yang, Yea-Huei; Lin, Swu-Jane


    .... Patients with schizophrenia aged 18 and older, newly prescribed with a single antipsychotic medication from the National Health Insurance Research Database of Taiwan in the period from 2003 to 2010 were included...

  20. Abnormal laboratory values during the acute and recovery phases in schizophrenic patients: a retrospective study

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    Takahiko Nagamine


    Full Text Available Takahiko NagamineDivision of Psychiatric Internal Medicine, Seiwakai-Kitsunan Hospital, Suzenji, JapanAbstract: During treatment of acute-phase schizophrenia, attention needs to be given to physical as well as psychological symptoms. It is often difficult, however, to obtain information on physical symptoms from patients with psychomotor excitation, and only laboratory examinations can provide objective data. The results of laboratory parameters measured in 68 patients with schizophrenia during psychomotor excitation and approximately 1 month later during the medicated recovery phase have been analyzed retrospectively. Abnormal laboratory values during psychomotor excitation were frequent. The most frequent (≥35% of patients were increased white blood cell count, low serum potassium levels, high levels of fasting blood sugar, lactate dehydrogenase and uric acid. There were fewer abnormal values during the medicated recovery phase. The most frequent (≥25% of patients were high serum levels of triglycerides, amylase, creatinine kinase, and low-density lipoprotein cholesterol. Abnormal triglyceride levels were found significantly more frequently in patients receiving olanzapine than those receiving risperidone. Abnormal values during the acute phase may be the result of excitation such as increased sympathetic tone and dehydration. Abnormal values during the recovery phase appeared to be related to the adverse metabolic effects of antipsychotic drugs. The frequency of these abnormal values was particularly high in patients receiving olanzapine alone or in combination with other medications.Keywords: schizophrenia, laboratory test values, acute phase, recovery phase, risperidone, olanzapine

  1. A Web-based Game for Teaching Facial Expressions to Schizophrenic Patients. (United States)

    Gülkesen, Kemal Hakan; Isleyen, Filiz; Cinemre, Buket; Samur, Mehmet Kemal; Sen Kaya, Semiha; Zayim, Nese


    Recognizing facial expressions is an important social skill. In some psychological disorders such as schizophrenia, loss of this skill may complicate the patient's daily life. Prior research has shown that information technology may help to develop facial expression recognition skills through educational software and games. To examine if a computer game designed for teaching facial expressions would improve facial expression recognition skills of patients with schizophrenia. We developed a website composed of eight serious games. Thirty-two patients were given a pre-test composed of 21 facial expression photographs. Eighteen patients were in the study group while 14 were in the control group. Patients in the study group were asked to play the games on the website. After a period of one month, we performed a post-test for all patients. The median score of the correct answers was 17.5 in the control group whereas it was 16.5 in the study group (of 21) in pretest. The median post-test score was 18 in the control group (p=0.052) whereas it was 20 in the study group (pgames may be used for the purpose of educating people who have difficulty in recognizing facial expressions.

  2. Clozapine Use Presenting with Pseudopheochromocytoma in a Schizophrenic Patient: A Case Report

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    Jaskanwal Sara


    Full Text Available Introduction. There have been six previous cases that reported pseudopheochromocytoma in patients taking clozapine. Our case showed the direct link of clozapine to serum levels of certain markers. Case. This is a case of a 49-year-old obese Caucasian female who was referred to endocrinology for investigation of Cushing’s syndrome, based on raised blood pressure and Cushingoid facies. The patient had underlying schizophrenia and was stable on clozapine. Her blood pressure was 150/99 mmHg on bendroflumethiazide and candesartan. We measured her 24-hour urinary-free cortisol, which was normal but 24-hour urinary-free noradrenaline was elevated at 835 nmol (76–561 with normal adrenaline 36 nmol (7–82 and dopamine 2679 nmol (366–2879, as the patient had history of palpitations and sweating. Two sets of 24-hour urinary-free cortisol measurements were normal and serum cortisol suppressed to <50 nmol/l after a 1 mg overnight dexamethasone. Two further 24-hour urinary-free catecholamines showed a raised level of noradrenaline. MRI demonstrated normal adrenals and MIBG scan did not show any abnormal uptake at adrenal glands. Conclusion. Pseudopheochromocytoma has been reported in patients taking clozapine. A number of different mechanisms for raised plasma noradrenaline levels with clozapine have been postulated. The above case highlights an unusual but known side effect of clozapine.

  3. The facial expression of schizophrenic patients applied with infrared thermal facial image sequence. (United States)

    Jian, Bo-Lin; Chen, Chieh-Li; Chu, Wen-Lin; Huang, Min-Wei


    Schizophrenia is a neurological disease characterized by alterations to patients' cognitive functions and emotional expressions. Relevant studies often use magnetic resonance imaging (MRI) of the brain to explore structural differences and responsiveness within brain regions. However, as this technique is expensive and commonly induces claustrophobia, it is frequently refused by patients. Thus, this study used non-contact infrared thermal facial images (ITFIs) to analyze facial temperature changes evoked by different emotions in moderately and markedly ill schizophrenia patients. Schizophrenia is an emotion-related disorder, and images eliciting different types of emotions were selected from the international affective picture system (IAPS) and presented to subjects during ITFI collection. ITFIs were aligned using affine registration, and the changes induced by small irregular head movements were corrected. The average temperatures from the forehead, nose, mouth, left cheek, and right cheek were calculated, and continuous temperature changes were used as features. After performing dimensionality reduction and noise removal using the component analysis method, multivariate analysis of variance and the Support Vector Machine (SVM) classification algorithm were used to identify moderately and markedly ill schizophrenia patients. Analysis of five facial areas indicated significant temperature changes in the forehead and nose upon exposure to various emotional stimuli and in the right cheek upon evocation of high valence low arousal (HVLA) stimuli. The most significant P-value (lower than 0.001) was obtained in the forehead area upon evocation of disgust. Finally, when the features of forehead temperature changes in response to low valence high arousal (LVHA) were reduced to 9 using dimensionality reduction and noise removal, the identification rate was as high as 94.3%. Our results show that features obtained in the forehead, nose, and right cheek significantly

  4. [Promoting recovery of schizophrenic patients: discrepancy between routine practice and evidence. The SIEP-DIRECT'S Project]. (United States)

    Semisa, Domenico; Casacchia, Massimo; Di Munzio, Walter; Neri, Giovanni; Buscaglia, Giacinto; Burti, Lorenzo; Pucci, Cristina; Corlito, Giuseppe; Bacigalupi, Maurizio; Parravani, Roberto; Roncone, Rita; Cristofalo, Doriana; Lora, Antonio; Ruggeri, Mirella


    The aim of this work is to present the main discrepancies, as evidenced by the SIEP-DIRECT'S Project, between the evidence-based NICE guidelines for schizophrenia and the usual practices of the Italian mental health services in order to promote the recovery of patients with schizophrenia. Starting from the main NICE recommendations on recovery promotion, 41 indicators were developed. These were experimented in 19 participating Italian Mental Health Departments (MHD) or Psychiatric Services through self-evaluation of the activities carried out to promote patient recovery with the aim of assessing the level of adherence to the recommendations. The data required by most of the indicators were obtained from the psychiatric informative system or from the Direction of the MHD. Moreover, specific research was carried out on the clinical records and on representative patient samples. Furthermore, for 14 indicators, there was requested an assessment by the part of "multidisciplinary" or "specialistic" focus groups who then attributed a score according to a defined "ad hoc" scale. According to the data obtained, although the mental health services seem to care about the physical condition of their patients, they do not routinely examine principle parameters such as blood pressure, glycaemia etc., and collaboration with general practitioners is often complex or not uniformly practiced. Most psychiatrists and psychologists possess the basic communication skills but not enough competences in cognitive-behavioural treatments; such treatments, and every other form of structured individual psychotherapy, are seldom carried out and seem to have become marginal activities within the Services. Also family psycho-educational interventions are under-used. The Services are very active in the care of multi-problem schizophrenia patients, who make up a large percentage (almost a quarter, on average) of the patients in their care. These patients are offered specific and integrated



    Snežana Manojlović; Julijana Nikolić-Popović


    The group and analytically-oriented psychotherapy of schizoid patients shows some peculiarities springing from the characteristics of the schizoid process itself that necessarily impose certain modifications of the therapeutic goals in techniques.The aim of the paper is to determine precisely the specific effect of the illness process upon the group psychotherapy process, that is, implications upon the therapeutic engagement.The verbal therapeutic interventions in a small psycho therapeutic g...

  6. Traditional Chinese religious beliefs and superstitions in delusions and hallucinations of Chinese schizophrenic patients. (United States)

    Yip, Kam-Shing


    Religious beliefs and superstitions have an important impact on the psychopathology of psychiatric patients. Traditional Chinese religious beliefs and superstitions, such as fortune telling, Buddhist gods, Taoist gods, historical heroic gods and ancestor worship, have important influence on subjective psychotic experiences, in particular delusions and hallucinations. By means of empirical phenomenological case narration, the writer shows that all these traditional Chinese religious beliefs and superstitions tend to affect the contents, manifestation and meaningfulness of delusion and hallucination. They also serve as a means to replace clients' self-identity. They appear in the form of a supernatural force to resolve all difficulties, cause of troubles and misfortune, stress and coping mechanisms.

  7. Paralinguistic characteristics of speech in schizophrenics and depressives. (United States)

    Mandal, M K; Srivastava, P; Singh, S K


    Schizophrenics, depressives, patients with anxiety neurosis and normal controls were asked to comment freely for 2 min on photographs depicting seven facial emotional expressions. Schizophrenics commented for the shortest duration of time with characteristic vocalization; depressives' speech was characterized by low initiative time latency, greater duration of utterance but fewer word-counts.

  8. [Family experiences of living with chronic schizophrenic patients - application of Parse's human becoming research methodology]. (United States)

    Lee, Ok Ja; Choi, Young Sook


    This study was aimed at understanding the nature of the suffering of families with patients in mental health nursing homes and hoped to contribute to the rehabilitation process of those with a chronic mental disorder. Research methodology was based upon Parse's human becoming research methodology. a) Despite the despair the family feels by the violence caused by their now-institutionalized relative, they also realize anew the importance of their role as protectors b) Although they fear social stigmatization they also try to be supportive, out of guilt feelings; c) They regret their severe rearing style and wish to be more sympathetic, d) They find courage and hope through family therapy, which leads to a better understanding of the illness, e) With hopes of rehabilitation, the family members feel happy and go through an emotional release, by sharing the pain with each other. Families of nursing home residents share a focus on the process of human-health-universe. This is a positive, 'human-becoming' process with which, based on past feelings of despair, fear, resignation, and pain, one can render meaning into his or her experiences in the present in the pursuit of love, conquest, hope, liberty and success.

  9. Brain structure differences among male schizophrenic patients with history of serious violent acts: an MRI voxel-based morphometric study

    National Research Council Canada - National Science Library

    Noriomi Kuroki; Hiroko Kashiwagi; Miho Ota; Masanori Ishikawa; Hiroshi Kunugi; Noriko Sato; Naotsugu Hirabayashi; Toshio Ota


    .... The aim of this study was to identify the characteristics of brain morphometry in patients with schizophrenia and a history of serious violent acts, who were being treated under relatively new...

  10. Comparative dynamics of self-consciousness of schizophrenic patients and patients with acute and transient psychotic disorders in the process of compulsory treatment

    Directory of Open Access Journals (Sweden)

    Yur’yeva L.N.


    Full Text Available Article presents the materials of empirical research of life sense orientations, self-relation and level of claims of schizophrenic patients and patients with acute and transient psychotic disorders, who have committed socially hazardous actions and to whom forced measures of medical character are temporarily applied. Changes in the self- consciousness of patients with schizophrenia in dynamics were examined: in comparing the results obtained at first and fourth stages of patients' stay in mental hospital with strict supervision (the first stage – adaptation and diagnostics, the fourth stage – the consolidation of treatment results and preparation of patient to be discharged. Research was done by D. Leontiev’s test of life sense orientations (LSO, by S. Pantileyev – V. Stolin’s techniques and by Shwarzlander’s “Motor test”. Statistical processing of the obtained results of differences by indices of life sense orientations, of selfattitude and level of claims between the group under study with Student's t-criterion was used.

  11. Altered Expression Profile of IgLON Family of Neural Cell Adhesion Molecules in the Dorsolateral Prefrontal Cortex of Schizophrenic Patients

    Directory of Open Access Journals (Sweden)

    Karina Karis


    Full Text Available Neural adhesion proteins are crucial in the development and maintenance of functional neural connectivity. Growing evidence suggests that the IgLON family of neural adhesion molecules LSAMP, NTM, NEGR1, and OPCML are important candidates in forming the susceptibility to schizophrenia (SCZ. IgLON proteins have been shown to be involved in neurite outgrowth, synaptic plasticity and neuronal connectivity, all of which have been shown to be altered in the brains of patients with the diagnosis of schizophrenia. Here we optimized custom 5′-isoform-specific TaqMan gene-expression analysis for the transcripts of human IgLON genes to study the expression of IgLONs in the dorsolateral prefrontal cortex (DLPFC of schizophrenic patients (n = 36 and control subjects (n = 36. Uniform 5′-region and a single promoter was confirmed for the human NEGR1 gene by in silico analysis. IgLON5, a recently described family member, was also included in the study. We detected significantly elevated levels of the NEGR1 transcript (1.33-fold increase and the NTM 1b isoform transcript (1.47-fold increase in the DLPFC of schizophrenia patients compared to healthy controls. Consequent protein analysis performed in male subjects confirmed the increase in NEGR1 protein content both in patients with the paranoid subtype and in patients with other subtypes. In-group analysis of patients revealed that lower expression of certain IgLON transcripts, mostly LSAMP 1a and 1b, could be related with concurrent depressive endophenotype in schizophrenic patients. Additionally, our study cohort provides further evidence that cannabis use may be a relevant risk factor associated with suicidal behaviors in psychotic patients. In conclusion, we provide clinical evidence of increased expression levels of particular IgLON family members in the DLPFC of schizophrenic patients. We propose that alterations in the expression profile of IgLON neural adhesion molecules are associated with brain

  12. [Clinical-chemical studies in schizophrenic out-patients under neuroleptic long-term treatment with particular consideration of the hepatic metabolism (author's transl)]. (United States)

    Gonçalves, N; Grüneberg, F


    A series of clinical-chemical tests was conducted in 68 schizophrenic out-patients under long-term neuroleptic medication, with particular consideration of the hepatic metabolism, i.e.: Erythrocyte sedimentation rate, alpha 1-glycoprotein, ceruloplasmin, fibrinogen, GPT, GOT, gamma-GT, total protein and serum-protein-electrophoresis. Furthermore, the glucose tolerance tests was carried out. In 44% of the patients an increased erythrocyte sedimentation rate and positive correlations with increased fibrinogen values were found. Increased gamma-GT-values were proven in 33% of the patients; they correlated positively with the increased GPT-and/or GOT-values as well as with pathological glucose tolerance values. Overweight of more than 10 kilos was found in 46% of the patients. A significant correlation between overweight and pathological glucose tolerance values existed. The results were interpreted as consequence of a light fatty liver.

  13. Bizarreness in dream reports and waking fantasies of psychotic schizophrenic and manic patients: empirical evidences and theoretical consequences. (United States)

    Limosani, Ivan; D'Agostino, Armando; Manzone, Maria Laura; Scarone, Silvio


    Several overlapping features have frequently been described between psychosis and the subjective experience of dreaming from the neurobiological to the phenomenological level, but whether this similarity reflects the cognitive organization of schizophrenic thought or rather that of psychotic mentation independent of diagnostic categories is still unclear. In this study, 40 actively psychotic inpatients were equally divided in two age- and education-matched groups according to their diagnosis (Schizophrenia and Bipolar Disorder). Participants were asked to report their dreams upon awakening and the Thematic Apperception Test (TAT) was administered to elicit waking fantasies; the same procedure was used in a control group of 20 non-psychiatric subjects. Two highly trained judges scored the collected material according to a Dream Bizarreness scale. The same level of cognitive bizarreness was found in TAT and dream reports of schizophrenic and manic subjects but was almost completely absent in the TAT stories of the control group. Two-way analysis of variance for repeated measures assessed the effect of diagnosis and experimental conditions (TAT stories and dream reports) on bizarreness yielding a significant interaction. Cognitive bizarreness seems to be a shared feature of dreaming and psychotic mentation, beyond diagnostic categorizations. Although these findings must be considered preliminary, this experimental measure of the cognitive architecture of thought processes seems to support the view that dreaming could be a useful model for the psychoses. Copyright © 2011 Elsevier Ltd. All rights reserved.

  14. Prevalence of Metabolic Syndrome in Schizophrenics on ...

    African Journals Online (AJOL)

    Aim: To determine the prevalence of the metabolic syndrome among outpatients with schizophrenia. Methods: A cross sectional survey of schizophrenics attending out-patient clinics in a Nigerian hospital was undertaken. Anthropometric measures, clinical variables and lifestyle patterns of respondents were assessed.

  15. Receptor imaging of schizophrenic patients under treatment with typical and atypical neuroleptics; Nuklearmedizinische Rezeptordiagnostik bei schizophrenen Patienten unter Therapie mit typischen und atypischen Neuroleptika

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    Dresel, S.; Tatsch, K. [Klinik und Poliklinik fuer Nuklearmedizin der Ludwig-Maximilians-Univ. Muenchen (Germany); Meisenzahl, E. [Psychiatrische Klinik der Ludwig-Maximilians-Univ. Muenchen (Germany); Scherer, J. [Bezirkskrankenhaus Haar (Germany)


    Schizophrenic psychosis is typically treated by typical and atypical neuroleptics. Both groups of drugs differ with regard to induction of extrapyramidal side effects. The occupancy of postsynaptic dopaminergic D2 receptors is considered to be an essential aspect of their antipsychotic properties. The dopamine D2 receptor status can be assessed by means of [I-123]IBZM SPECT. Studies on the typical neuroleptic haloperidol revealed an exponential dose response relationship measured by IBZM. Extrapyramidal side effects were presented by all patients below a threshold of the specific binding of IBZM below 0.4 (with one exception, norm value: >0.95). Also under treatment with the atypical neuroleptic clozapine an exponential dose response relationship was found. However, none of these patients showed extrapyramidal side effects. Recently introduced, new atypical neuroleptics such as risperidone and olanzapine again presented with an exponential relationship between daily dose and IBZM binding. The curves of the latter were in between the curves of haloperidol and clozapine. Extrapyramidal side effects were documented in a less number of patients treated with risperidone as compared to haloperidol, for olanzapine only one patient revealed these findings in our own patient group. The pharmacological profile of atypical neuroleptics shows - in addition to their binding to dopamine receptors - also high affinities to the receptors of other neurotransmitter systems, particularly the serotonergic system. Therefore, the lower incidence of extrapyramidal side effects seen by atypical in comparison to typical neuroleptics is at least in part most likely due to a complex interaction on a variety of neurotransmitter systems. (orig.) [German] Die pharmakologische Therapie von Erkrankungen aus dem schizophrenen Formenkreis erfolgt durch typische und atypische Neuroleptika. Beide Gruppen unterscheiden sich klinsich im Wesentlichen durch die Eigenschaft, extrapyramidal

  16. Differing lateralized perceptual-motor patterns in schizophrenic and non-psychotic children. (United States)

    Krynicki, V E; Nahas, A D


    A neuropsychological assessment stressing lateralized perceptual-motor and cognitive abilities was administered to two groups of hospitalized child and adolescent psychiatric patients, 25 schizophrenics and 25 non-psychotics. The findings included an increased incidence of crossed eye-hand dominance in schizophrenics, poorer tactile sensory function in the right hands of schizophrenics than in the left hands, and lower Vocabulary and Similarities WISC subtest scores than Block Design and Object Assembly scores for schizophrenics. Right-left confusion was associated with finger agnosia for schizophrenics. The results supported the hypothesis that there may be left-hemisphere dysfunction in schizophrenia; however, no single pattern of dysfunction was apparent.

  17. Oxidative stress and level of antioxidant enzymes in drug-naive schizophrenics. (United States)

    Reyazuddin, Mohammed; Azmi, Suhail A; Islam, Najmul; Rizvi, Abid


    Schizophrenia is a chronic illness having varied etiology which affects cognition, emotion, perception, and other aspects of behavior. There are data which show possible role of oxidative stress and disturbance in antioxidant mechanisms in various neurological and neuropsychiatric disorders. Fifty drug-naive schizophrenic patients, who attended psychiatry outpatient department/inpatient department for the 1(st) time, were selected and compared with 50 age-sex matched healthy controls. The erythrocyte level of malondialdehyde (MDA) - a lipid peroxidation product and marker of oxidative stress, antioxidant enzymes - superoxide dismutase (SOD), glutathione peroxidase (GPX) was estimated. We also correlated the sociodemographic parameters and severity of illness (positive and negative syndrome scale score) with oxidative stress (MDA) and level of antioxidant enzymes (SOD, GPX). The level of oxidative stress (MDA) was increased, and the levels of antioxidative enzymes (GPX and SOD) were decreased in schizophrenic patients as compared to normal healthy controls and the difference was statistically significant. No significant relationships of age, sex, educational status, marital status, and PANNS score with oxidative stress (MDA) and antioxidative enzymes (GPX and SOD) level in schizophrenic patients was found; but there was significant relationship of locality with oxidative stress (MDA) and antioxidative enzymes (GPX and SOD) level in schizophrenic patients was found. Urban population have a higher level of MDA, GPX, and SOD than the rural population. Our findings put great emphasis on the weak pro/antioxidant defense mechanisms and its role in the pathophysiology of schizophrenia. We can make recommendations of dietary nutritional supplementation and adjunct antioxidants therapy with antipsychotics to treat schizophrenics.

  18. Schizophrenic performance on form E of Cattell's 16PF test. (United States)

    Serban, G; Katz, G


    Form E of Cattell's 16PF test was administered to 515 hospitalized schizophrenics. This sample was compared to Cattell's standardization population for both raw scores and sten scores. Comparisons were made between males and females, acute patients and chronic patients, and amongst three categories of schizophrenia (paranoid, undifferentiated, schizo-affectives). The results indicate that the "schizophrenic profile," reported in previous research with Form A, did not obtain expected differentiations among schizophrenic categories. The question of the usefulness of Form E in diagnosing schizophrenia was raised.

  19. Cannabis use and dependence among French schizophrenic inpatients

    Directory of Open Access Journals (Sweden)

    Michel eLejoyeux


    Full Text Available Background: To assess the prevalence of cannabis use and dependence in a population of schizophrenic inpatients and to compare schizophrenics with and without cannabis consumption. Methods: 101 schizophrenic patients were examined during their first week of hospitalization. They answered the PANNS scale of schizophrenia, the CAGE and the Fagerström questionnaire and the DSM-IV-TR criteria for cannabis, alcohol, opiates and nicotine use dependence were checked. We also assessed socio-demographic characteristics, the motive of cannabis consumption and the number of cannabis joints and alcoholic drinks taken.Results: The prevalence of cannabis consumption was 33.6% among schizophrenic inpatients. Schizophrenics consuming cannabis were younger than non-schizophrenics (33.3 vs 44.7 years pConclusion: 33.6 % of the schizophrenic patients hospitalized in psychiatry consume cannabis and most of them are dependent on cannabis and alcohol. Hospitalization in psychiatry may provide an opportunity to systematically identify a dependence disorder and to offer appropriate information and treatment

  20. Quantitative studies of schizophrenic behavior. (United States)

    Reynolds, T D


    Behavioral data from eight psychiatric patients were collected and formed into 14 time series of 100 weekly rates (percentages of positive entries for frequent behaviors such as pacing, talking, hand-movement, etc.). A variety of methods of time-series analysis were applied to determine optimal predictive schemes in an effort to develop an inductive approach to input-output behavioral modelling. Some attempts at numerical prediction into new data were successful, and the results suggested that the best overall approach is likely to be nonlinear modification of auto-regressive schemes. Nonlinearity and nonstationarity of such time series are prominent features, but deterministic trends appear strong enough to justify extensive work. Application of artificial inputs to some of the models suggests that protracted oscillatory responses to stimulation may be characteristic for some schizophrenic patients. Copyright © 1976. Published by Elsevier B.V.

  1. Effects of handedness (left vs right) and cannabis abuse on intermanual coordination and negative symptoms in schizophrenic patients of the paranoid type. (United States)

    Gorynia, Inge; Schwaiger, Markus


    Intermanual coordination as an index of interhemispheric transfer and negative symptoms were investigated in 50 left- and 42 right-handed schizophrenic inpatients of the paranoid type, also including drug abusers. The primary objective was to show that there were higher values in intermanual coordination and fewer manifestations of negative symptoms in the left-handed compared to the right-handed patients. This assumption was based on previous studies. Most importantly, right- and left-handed patients showed a different behaviour in intermanual coordination, when the duration of illness was taken into consideration. Thus, long-term left-handed paranoid patients performed better in intermanual coordination and showed fewer manifestations of negative symptoms than did long-term right-handed patients. These results were true for the large group of all patients, and among them for the subgroup of patients without drug abuse. Consequently, higher scores in intermanual coordination in left-handed patients may be related to a better interhemispheric crosstalk resulting in less pronounced negative symptoms. Secondary objectives assessed by explorative data analysis included the effects of cannabis abuse. While cannabis abuse may be more prevalent in left-handed patients, its effects may be more pronounced in right-handed patients, scoring higher in intermanual coordination and lower in manifestations of negative symptoms.

  2. P600 alteration of syntactic language processing in patients with bipolar mania: Comparison to schizophrenic patients and healthy subjects. (United States)

    Lee, Chang Woo; Kim, Sung Hwa; Shim, Miseon; Ryu, Vin; Ha, Ra Yeon; Lee, Su Jin; Cho, Hyun-Sang


    Disturbances in thought, speech, and linguistic processing are frequently observed in bipolar manic patients, but the underlying neurophysiological mechanisms are not well understood. P600 is a distinct, positive event-related potential component elicited by syntactic violations. Using the P600 ERP, we examined neural processing of syntactic language comprehension in patients with bipolar mania compared to patients with schizophrenia and healthy people. P600s were recorded from 21 manic patients with bipolar disorder, 26 patients with schizophrenia, and 29 healthy subjects during the presentation of 120 auditory sentences with syntactic violations or non-violations. Subjects were asked to judge whether each sentence was correct or incorrect. Patients with mania and schizophrenia had significantly smaller P600 amplitudes associated with syntactic violations compared with healthy subjects. There was no difference in P600 amplitude between patient groups. For behavioral performance, patients with schizophrenia had significantly less accurate rates and longer reaction times compared with healthy subjects, whereas manic patients exhibited no significant differences in accuracy and only showed increased reaction times in comparison with healthy subjects. Psychotropic drug usage and small sample size. Patients with bipolar mania have reduced P600 amplitude, comparable to patients with schizophrenia. Our findings may represent the first neurophysiological evidence of abnormal syntactic linguistic processing in bipolar mania. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. The usefulness of monitored therapy using Clozapine concentration in the blood serum for determining drug dose in Polish schizophrenic patients. (United States)

    Piwowarska, Jadwiga; Radziwoń-Zaleska, Maria; Dmochowska, Martyna; Szepietowska, Ewa; Matsumoto, Halina; Sygitowicz, Grażyna; Pilc, Andrzej; Łukaszkiewicz, Jacek


    The aim of the study is to evaluate the advisability of systematic monitoring of clozapine (CLO) concentration in serum during treatment of schizophrenia in Polish psychiatric patients. The concentration of CLO and its metabolites: norclozapine (NCLO) and clozapine N-oxide (CLO-NO) in serum obtained from 107 patients suffering from schizophrenia was determined by high performance liquid chromatography (HPLC) method. There were two groups of patients. In the first group of patients (n=95) the concentration of drug and its metabolites was determined by one-time testing. Correlations were tested using the test statistics. In the second group of patients (n=12), 51 samples of serum were provided by the same patient in different time spans (from 6days to 14 months after the beginning of the treatment). Concentrations of CLO and its metabolites in blood serum do not always show a linear dependence on the applied dose for individual patients. The high volatility of CLO concentrations in blood serum of patients treated with identical doses of the drug confirmed the validity of the monitored therapy. Copyright © 2016. Published by Elsevier Urban & Partner Sp. z o.o.

  4. [A psychopathological study on three-dimensional computer graphics (3DCGs): special reference to pictures made by a schizophrenic patient before and after the onset]. (United States)

    Ashizawa, Yuko; Tachikawa, Hirokazu; Hori, Masashi; Hori, Takafumi; Mizukami, Katsuyoshi; Asada, Takashi


    A patient with catatonic type schizophrenia drawing 3-dimensional computer graphics (3DCGs) before and after the onset is reported. His 3DCGs are discussed from the view of psychopathology. A 21-year-old male was admitted to our hospital. He was an art student. For three months before admission, he had been absorbed in drawing 3DCGs. When he was asked to draw handmade pictures by his teacher, he experienced a bizarre mood and took an overdose of aspirin. At the time of admission, he was in a stupor state, and was diagnosed with catatonic type schizophrenia. After admission, he exhibited excitement and disorganized speech. These symptoms disappeared after administration of neuroleptics, and he was discharged. The 3DCGs he drew before and after the onset revealed several special characteristics. First, the compositions of his pictures were too geometric and too precise. Secondly, the themes of his pictures changed from romantic before the onset to symbolic after it, and the styles changed from realistic to abstractive after the onset. Finally, histograms of the 3DCGs revealed many colors before onset, which converged to simple colors after. Therefore, it was suggested that the latent pathological process at the beginning of schizophrenia might be reflected in his 3DCGs. 3DCGs are a new type of fine art. They can express beautiful and cool images more simply than handmade pictures. Due to these features, artists can create images of their innerworld, with less effort and talent than picture drawings, by computer assistance. This case suggests that the geometric working space, change-free viewpoints, and computer assistance, which are characteristics of the methods in making 3DCGs may be suitable for schizophrenic artists to create images of their innerworld. However, being absorbed in making 3DCGs could also promote the latent schizophrenic process to the onset.

  5. Continuing clozapine treatment with lithium in schizophrenic patients with neutropenia or leukopenia: brief review of literature with case reports. (United States)

    Aydin, Memduha; Ilhan, Bilge Cetin; Calisir, Saliha; Yildirim, Seda; Eren, Ibrahim


    Clozapine is a second-generation antipsychotic used for treatment-resistant schizophrenia. Despite its effectiveness, clozapine is largely underused due to serious side effects such as leukopenia or neutropenia. We aimed to review whether to continue, discontinue or rechallenge clozapine treatment after such haematological side effects. We reviewed and summarized the literature on the use of clozapine, how to deal with its side effects, and suitable options in case of any haematological problems. Then, we described several cases successfully treated with clozapine and lithium after development of neutropenia or leukopenia. We present three patients with treatment-resistant schizophrenia. While they had demonstrated poor response to multiple antipsychotic trials, clozapine was started. Clozapine induced neutropenia; or leukopenia developed in some cases that was successfully reversed after lithium onset. Increased serious side effects related with coprescription of lithium and clozapine were not observed. Lithium increases neutrophil and total white blood cell count as a side effect that may be useful in patients who develop neutropenia or leukopenia while being treated with clozapine.

  6. BDNF serum concentrations in first psychotic episode drug-naïve schizophrenic patients: associations with personality and BDNF Val66Met polymorphism. (United States)

    Sotiropoulou, Marianthi; Mantas, Christos; Bozidis, Petros; Marselos, Marios; Mavreas, Venetsanos; Hyphantis, Thomas; Antoniou, Katerina


    To investigate the relationship among brain derived neurotrophic factor (BDNF) serum concentrations, BDNF Val66Met polymorphism and personality profile in drug-naïve schizophrenic patients with first-episode psychosis (FEP) and healthy participants. This cross-sectional study included fifty FEP patients and fifty healthy participants who served as controls. To study their personality profile the standardized Greek version of the Alternative Five-Factor Zuckerman-Kuhlman Personality Questionnaire (ZKPQ) was administered. Serum BDNF levels were measured and genotyping of BDNF Val66Met polymorphism was performed in patients and healthy subjects. FEP patients presented lower BDNF serum concentrations (P=0.002) and higher scores in ZKPQ Neuroticism (P=0.001) and Aggression-Hostility (P=0.002) scales while lower scores in the ZKPQ Sociability scale (Ppersonality traits, BDNF Val66Met polymorphism, and psychotic symptomatology has been arisen but further investigation is needed to better clarify the observed associations. Copyright © 2012 Elsevier Inc. All rights reserved.

  7. Brain structure differences among male schizophrenic patients with history of serious violent acts: an MRI voxel-based morphometric study. (United States)

    Kuroki, Noriomi; Kashiwagi, Hiroko; Ota, Miho; Ishikawa, Masanori; Kunugi, Hiroshi; Sato, Noriko; Hirabayashi, Naotsugu; Ota, Toshio


    The biological underpinnings of serious violent behaviors in patients with schizophrenia remain unclear. The aim of this study was to identify the characteristics of brain morphometry in patients with schizophrenia and a history of serious violent acts, who were being treated under relatively new legislation for offenders with mental illness in Japan where their relevant action should be strongly associated with their mental illness. We also investigated whether morphometric changes would depend on types of serious violent actions or not. Thirty-four male patients with schizophrenia who were hospitalized after committing serious violent acts were compared with 23 male outpatients or inpatients with schizophrenia and no history of violent acts. T1-weighted magnetic resonance imaging (MRI) with voxel-based morphometry was used to assess gray matter volume. Additionally, patients with violent acts were divided based on whether their relevant actions were premeditated or not. The regional volumes of these two groups were compared to those of the control patient group. Patients with schizophrenia and a history of serious violent acts showed significantly smaller regional volumes of the right inferior temporal area expanded to the middle temporal gyrus and the temporal pole, and the right insular area compared to patients without a history of violence. Patients with premeditated violent acts showed significantly smaller regional volumes of the right inferior temporal area, the right insular area, the left planum polare area including the insula, and the bilateral precuneus area including the posterior cingulate gyrus than those without a history of violence, whereas patients with impulsive violent acts showed significantly smaller volumes of only the right inferior temporal area compared to those without a history of violence. Patients with schizophrenia and a history of serious violent acts showed structural differences in some brain regions compared to those with

  8. A five-year longitudinal study of the regional cerebral metabolic changes of a schizophrenic patient from the first episode using Tc-99m HMPAO SPECT. (United States)

    Chen, R Y; Chen, E; Ho, W Y


    This is a naturalistic study of the relationship between cerebral metabolic activity, clinical symptoms and treatment response in a schizophrenic patient for 5 years from the onset of her illness. Serial technetium-99m-HMPAO brain SPECT was used to measure regional cerebral metabolism. The Cambridge Neurological Inventory and neuropsychological tests (WAIS-R verbal subscales, Wisconsin Card Sorting Test, semantic verbal fluency, logical memory in Weschler Memory Scale) were used for neurocognitive assessment. Under-activity of the left temporal area was observed in the course of patient illness despite remission of the psychotic symptoms. Bilateral prefrontal metabolic under-activity was noted at the emergence of negative symptoms, executive neurocognitive dysfunction and the treatment-resistant state. After response to clozapine, the right prefrontal activity returned to a normal level. Our findings suggested that persistent left temporal underactivity detected by SPECT despite clinical remission may indicate a vulnerability for further relapses and development of a treatment-resistant state. Treatment-resistant state, negative symptoms and executive neurocognitive deficit may involve abnormal prefrontal metabolic activity and can be alleviated in clozapine-responsive patients.

  9. Word Associations of Schizophrenic Children (United States)

    Johnston, Mary Hollis


    A study of word associations in normal and disturbed children integrated two methods of word association research: pathological features of adult schizophrenic language and psycholinguistic features of developmental changes in children's associations. (Author/KM)

  10. [Prodromal symptoms in schizophrenic relapse: A descriptive and comparative study]. (United States)

    Bouhlel, S; Jones, Y; Khelifa, E; Msolly, M; Melki, W; El-Hechmi, Z


    Schizophrenia is a severe, chronic psychiatric disorder. After recovery from a first psychotic episode, 70% of patients have exacerbations. These exacerbations are preceded in 66 to 100% of cases by early signs. Prevention of relapses is the main object of dealing with schizophrenia. In fact, after a psychotic relapse, 17% of patients develop residual symptoms which did not exist before the relapse. Moreover, symptoms resistant to antipsychotics appear in 35% of patients after a relapse. Each relapse increases the risk of future relapses. Finally, the cost of treating patients with relapses is four times higher than in patients without relapses. Prevention of relapses is possible if we detect early signs. In fact, when specific interventions are applied in time, relapses can be avoided. Surprisingly, there is a scarcity of data on prodromal symptoms of schizophrenic relapses in the literature. In this study, we aimed to describe early signs of schizophrenic relapses, which are comparatively more frequent than those in stabilized outpatients. We conducted a retrospective, descriptive and comparative trial. We included 30 patients with schizophrenia who had recently experienced a psychotic relapse and a member of their families. We also included a control group of 30 stabilized outpatients with schizophrenia. All of the patients were diagnosed schizophrenic according to the DSM IV and had no secondary diagnosis. Only patients aged from 18 to 55 years and having an illness with an episodic evolution were included. The relapse group must have had a period off illness of more than one year and duration of the last remission greater than 3 months. We built a structured interview based on the data of the literature on early symptoms of relapses and on our clinical experience. It contained 93 items describing symptoms and feelings relevant to the period of relapse. The interview lasted about 1h. We collected demographic information from both groups. The relapse group was

  11. Treatment, expressed emotion and relapse in recent onset schizophrenic disorders

    NARCIS (Netherlands)

    Linszen, D.; Dingemans, P.; van der Does, J. W.; Nugter, A.; Scholte, P.; Lenior, R.; Goldstein, M. J.


    The effect of in-patient and individual orientated psychosocial intervention (IPI) and in-patient and individual and family orientated intervention (IPFI) across levels of expressed emotion (EE) on relapse was compared in a group of patients with recent onset schizophrenic disorders. Patients were

  12. Automutilação de dedos e lábio em paciente esquizofrênico Self-mutilation of fingers and lips in a schizophrenic patient

    Directory of Open Access Journals (Sweden)

    Breno Satler de Oliveira Diniz


    Full Text Available CONTEXTO: Episódios de automutilação grave são raramente observados na prática psiquiá­trica. Ocorrem principalmente em pacientes psicóticos, sendo o principal diagnóstico a esquizofrenia. As regiões mais comumente automutiladas são o pênis e os olhos. RELATO DE CASO: Relatamos o caso de um paciente portador de esquizofrenia paranóide que desenvolveu quadro de auto-amputação de lábios e falanges secundário a alucinações auditivas de comando e delírios místico-religiosos. CONCLUSÃO: Episódios de automutilação são eventos raros em pacientes esquizofrênicos. Deve-se nestes casos identificar pródromos ou fatores desencadeantes destes episódios para se instituir rapidamente abordagens para prevenir ou diminuir o risco de sua ocorrência nestes pacientes.CONTEXT: Severe self-mutilation episodes are rare in psychiatric practice. Most patients are psychotic during such acts and the main diagnosis is schizophrenia. The regions most commonly self-mutilated are the penis and the eyes. CASE REPORT: A patient previously diagnosed with schizophrenia started self-mutilating his lip and phalanxes secondary to command auditory hallucinations and influenced by mystic-religious delusions. CONCLUSION: Self-mutilation episodes are rare in schizophrenic patients. In such case, it should be identified prodrome symptoms or provoking situations in order to promptly institute strategies to prevent or lessen the risk of new episodes.

  13. Heart failure in patients treated with bisphosphonates

    DEFF Research Database (Denmark)

    Grove, E L; Abrahamsen, B; Vestergaard, P


    The aim of this study was to investigate the occurrence of heart failure in patients treated with bisphosphonates.......The aim of this study was to investigate the occurrence of heart failure in patients treated with bisphosphonates....

  14. Prevalence of diabetes mellitus in chronic schizophrenic inpatients in relation to long-term neuroleptic treatment.

    NARCIS (Netherlands)

    Cohen, D.; Dekker, J.J.M.; Peen, J.; de Wied, C.


    Background: Many reports indicate that the incidence and prevalence of diabetes mellitus is increased in schizophrenic patients and related to antipsychotic treatment. In an exploratory cross-sectional study we assessed the prevalence of type 2 diabetes mellitus in 266 chronic schizophrenic and

  15. Dynamical quantification of schizophrenic speech. (United States)

    Leroy, Fabrice; Pezard, Laurent; Nandrino, Jean-Louis; Beaune, Daniel


    Schizophrenic speech has been studied both at the clinical and linguistic level. Nevertheless, the statistical methods used in these studies do not specifically take into account the dynamical aspects of language. In the present study, we quantify the dynamical properties of linguistic production in schizophrenic and control subjects. Subjects' recall of a short story was encoded according to the succession of macro- and micro-propositions, and symbolic dynamical methods were used to analyze these data. Our results show the presence of a significant temporal organization in subjects' speech. Taking this structure into account, we show that schizophrenics connect micro-propositions significantly more often than controls. This impairment in accessing language at the highest level supports the hypothesis of a deficit in maintaining a discourse plan in schizophrenia.

  16. Recognition and Repair of Communicative Failures: The Interaction between Theory of Mind and Cognitive Complexity in Schizophrenic Patients (United States)

    Bosco, Francesca M.; Bono, Adele; Bara, Bruno G.


    The aim of the present research is to perform a detailed and empirical investigation of schizophrenia patients' deficits in recognizing and recovering a communicative failure. In particular, this paper investigates the role of Theory of Mind (ToM) and of the complexity of the mental representations involved in explaining patients' deficits in…

  17. The incidence of metabolic syndrome and its reversal in a cohort of schizophrenic patients followed for one year

    NARCIS (Netherlands)

    Schorr, S. G.; Slooff, C. J.; Bruggeman, R.; Taxis, K.

    Cross-sectional studies showed a high prevalence of metabolic syndrome in patients with schizophrenia. This study aimed to identify the incidence of metabolic syndrome and its reversal in a non-preselected cohort of chronic psychotic patients in routine practice in one year follow-up and to find

  18. Do Surgeons Treat Their Patients Like They Would Treat Themselves?

    NARCIS (Netherlands)

    Janssen, S.J.; Teunis, T.; Guitton, T.G.; Ring, D.; Biert, J.


    BACKGROUND: There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences. QUESTIONS/PURPOSES: (1) Are surgeons more likely to

  19. Do Surgeons Treat Their Patients Like They Would Treat Themselves?

    NARCIS (Netherlands)

    Janssen, Stein J.; Teunis, Teun; Guitton, Thierry G.; Ring, David; Spoor, Andy B.; Chauhan, Aakash; Shafritz, Adam B.; Wasterlain, Amy; Terrono, Andrew L.; Neviaser, Andrew S.; Schmidt, Andrew; Nelson, Andy; Miller, Anna N.; Kristan, Anze; Apard, Thomas; Berner, Arne; Ilyas, Asif; Jubel, Axel; Jost, Bernhard; Babis, George; Watkins, Barry; Kreis, Barbara; Nolan, Betsy M.; Crist, Brett D.; Cross, Brian J.; Wills, Brian P. D.; Barreto, Camilo Jose Romero; Ekholm, Carl; Swigart, Carrie; Spath, Catherine; Zalavras, Charalampos; Cassidy, Charles; Garnavos, Christos; Moreno-Serrano, Constanza L.; Rodner, Craig; Klostermann, Cyrus; Osei, Daniel A.; Rikli, Daniel A.; Haverkamp, Daniel; Polatsch, Daniel; Drosdowech, Darren; Edelstein, David M.; Eygendaal, Denise; McKee, Desirae M.; van Deurzen, Derek; Verbeek, Diederik O. F.; Patel, Minoo; Brilej, Drago; Walbeehm, Erik T.; Pemovska, Emilija Stojkovska; Hofmeister, Eric; Twiss, Eric L. L.; Hammerberg, Eric Mark; Schumer, Evan D.; Kaplan, F. Thomas D.; Suarez, Fabio; Fernandes, Carlos H.; Lopez-Gonzalez, Francisco; Walter, Frank L.; Seibert, Franz Josef; Frihagen, Frede; Kraan, Gerald; Gadbled, Guillaume; Huemer, Georg M.; Kohut, Georges; Porcellini, Giuseppe; Garrigues, Grant; Bayne, Grant J.; DeSilva, Gregory; Bamberger, H. Brent; Grunwald, H. W.; Goost, Hans; Broekhuyse, Henry; Durchholz, Holger; Routman, Howard D.; Kodde, F.; McGraw, Iain; Harris, Ian; Lin, Ines C.; Choueka, Jack; Kazanjian, Jack Elias; Gillespie, James A.; Biert, Jan; Greenberg, Jeffrey A.; Abrams, Jeffrey; Wint, Jeffrey; Giuffre, Jennifer L.; Wolf, Jennifer Moriatis; Overbeck, Joachim P.; Doornberg, Job N.; Scheer, Johan H.; Itamura, John; Erickson, John M.; McAuliffe, John; Capo, John T.; Taras, John; Braman, Jonathan; Rubio, Jorge; Filho, Jose Eduardo Grandi Ribeiro; Abboud, Joseph; Conflitti, Joseph M.; Abzug, Joshua M.; Roiz, Juan Miguel Rodriguez; Adams, Julie; Bishop, Julius; Kabir, Karoush; Zyto, Karol; Lee, Kendrick; Eng, Kevin; Rumball, Kevin M.; Erol, Konul; Dickson, Kyle; Jeray, Kyle; Bainbridge, Chris; Poelhekke, Lodewijk; van Minnen, Paul; Mica, Ladislav; Borris, Lars C.; Adolfsson, Lars E.; Weiss, Lawrence; Schulte, Leah M.; Lane, Lewis B.; Paz, Lior; Taitsman, Lisa; Guenter, Lob; Catalano, Louis; Campinhos, Luiz Aaugusto B.; Austin, Luke S.; Lygdas, Panagiotis; Waseem, Mohammad; Palmer, M. Jason; Krijnen, Matthijs R.; Abdel-Ghany, Mahmoud I.; Swiontkowski, Marc; Rizzo, Marco; Oidtmann, Marijke; Pirpiris, Marinis; Loebenberg, Mark I.; Boyer, Martin; Richardson, Martin; Mormino, Matt; Menon, Matthew; Calcagni, Maurizio; Beaumont-Courteau, Maxime; Soong, Maximillian; Wood, Megan M.; Meylaerts, Sven A.; Darowish, Michael; Nancollas, Michael; Prayson, Michael; Quinn, Michael; Grafe, Michael W.; Kessler, Michael W.; van den Bekerom, Michel P. J.; Ruiz-Suarez, Michell; Pirela-Cruz, Miguel A.; Mckee, Mike; Merchant, Milind; Tyllianakis, Minos; Shafi, Mohamed; Felipe, Naquira Escobar Luis; Parnes, Nata; Chen, Neal C.; Wilson, Neil; Elias, Nelson; Akabudike, Ngozi M.; Horangic, Nicholas J.; Shortt, Nicholas L.; Schep, Niels; Rossiter, Nigel; Kanakaris, Nikolaos K.; van Eerten, Percy V.; Paladini, Paolo; Melvanki, Parag; Althausen, Peter; Giannoudis, Peter; Hahn, Peter; Evans, Peter J.; Jebson, Peter; Kloen, Peter; Krause, Peter; Brink, Peter R. G.; Schandelmaier, Peter; Peters, Anil; Dantuluri, Phani; Blazar, Philip; Muhl, Philipp; Andreas, Platz; Choudhari, Pradeep; Inna, Prashanth; Gaston, R. Glenn; Haverlag, Robert; Ramli, Radzeli Mohd; Costanzo, Ralph M.; de Bedout, Ramon; Ranade, Ashish; Hauck, Randy; Smith, Raymond Malcolm; Babst, Reto H.; Jenkinson, Richard; Hutchison, Richard L.; GIlbert, Richard S.; Page, Richard S.; Wallensten, Richard; Papandrea, Rick; Zura, Robert D.; Slater, Robert R.; Gray, Robert R. L.; Wagenmakers, Robert; Pesantez, Rodrigo; Hackney, Roger G.; van Riet, Roger; Calfee, Ryan P.; Mehta, Samir; Bouaicha, Samy; Spruijt, Sander; Kakar, Sanjeev; Kaplan, Saul; Duncan, Scott F.; Kaar, Scott G.; Mitchell, Scott; Rowinski, Sergio; van Helden, Svenhjalmar; Jacoby, Sidney M.; Kennedy, Stephen A.; Westly, Stephen K.; Beldner, Steven; Morgan, Steven J.; Sulkers, George; Schepers, Tim; Baxamusa, Taizoon; Tosounidis, Theodoros; Wyrick, Theresa; Begue, Thierry; DeCoster, Thomas; Dienstknecht, Thomas; Varecka, Thomas F.; Higgins, Thomas; Fischer, Thomas J.; Mittlmeier, Thomas; Wright, Thomas; Chesser, Tim; Omara, Timothy; Siff, Todd; Havlifc, Tomo; Neuhaus, Valentin; Sabesan, Vani J.; Nikolaou, Vasileios S.; Verhofstad, Michael; Giordano, Vincenzo; Iyer, Vishwanath M.; Vochteloo, Anne; Batson, W. Arnnold; Hammert, Warren C.; Belangero, William Dias; Satora, Wojciech; Weil, Yoram; Balogh, Zsolt


    There is substantial unexplained geographical and surgeon-to-surgeon variation in rates of surgery. One would expect surgeons to treat patients and themselves similarly based on best evidence and accounting for patient preferences. (1) Are surgeons more likely to recommend surgery when choosing for

  20. Adult Medication-Free Schizophrenic Patients Exhibit Long-Chain Omega-3 Fatty Acid Deficiency: Implications for Cardiovascular Disease Risk (United States)

    McNamara, Robert K.; Jandacek, Ronald; Rider, Therese; Tso, Patrick; Dwivedi, Yogesh; Pandey, Ghanshyam N.


    Deficiency in long-chain omega-3 (LCn − 3) fatty acids, eicosapentaenoic acid (EPA, 20:5n − 3) and docosahexaenoic acid (DHA, 22:6n − 3), has been implicated in the pathoetiology of cardiovascular disease, a primary cause of excess premature mortality in patients with schizophrenia (SZ). In the present study, we determined erythrocyte EPA + DHA levels in adult medication-free patients SZ (n = 20) and age-matched healthy controls (n = 24). Erythrocyte EPA + DHA composition exhibited by SZ patients (3.5%) was significantly lower than healthy controls (4.5%, −22%, P = 0.007). The majority of SZ patients (72%) exhibited EPA+DHA levels ≤4.0% compared with 37% of controls (Chi-square, P = 0.001). In contrast, the omega-6 fatty acid arachidonic acid (AA, 20:4n − 6) (+9%, P = 0.02) and the AA:EPA + DHA ratio (+28%, P = 0.0004) were significantly greater in SZ patients. Linoleic acid (18:2n − 6) was significantly lower (−12%, P = 0.009) and the erythrocyte 20:3/18:2 ratio (an index of delta6-desaturase activity) was significantly elevated in SZ patients. Compared with same-gender controls, EPA + DHA composition was significantly lower in male (−19%, P = 0.04) but not female (−13%, P = 0.33) SZ patients, whereas the 20:3/18:2 ratio was significantly elevated in both male (+22%, P = 0.008) and female (+22%, P = 0.04) SZ patients. These results suggest that the majority of SZ patients exhibit low LCn − 3 fatty acid levels which may place them at increased risk for cardiovascular morbidity and mortality. PMID:23533712

  1. The influence of impaired processing speed on cognition in first-episode antipsychotic-naïve schizophrenic patients

    DEFF Research Database (Denmark)

    Andersen, Rune; Fagerlund, B; Rasmussen, Hans


    of neuropsychological tests to assess domains of cognitive impairments in schizophrenia. Composite scores were calculated, grouping tests into cognitive domains. RESULTS: There were significant differences between patients and healthy controls on global cognition and all cognitive domains, including verbal intelligence...

  2. Social cognition in schizophrenic patients: the effect of semantic content and emotional prosody in the comprehension of emotional discourse. (United States)

    Brazo, Perrine; Beaucousin, Virginie; Lecardeur, Laurent; Razafimandimby, Annick; Dollfus, Sonia


    The recognition of the emotion expressed during conversation relies on the integration of both semantic processing and decoding of emotional prosody. The integration of both types of elements is necessary for social interaction. No study has investigated how these processes are impaired in patients with schizophrenia during the comprehension of an emotional speech. Since patients with schizophrenia have difficulty in daily interactions, it would be of great interest to investigate how these processes are impaired. We tested the hypothesis that patients present lesser performances regarding both semantic and emotional prosodic processes during emotional speech comprehension compared with healthy participants. The paradigm is based on sentences built with emotional (anger, happiness, or sadness) semantic content uttered with or without congruent emotional prosody. The study participants had to decide with which of the emotional categories each sentence corresponded. Patients performed significantly worse than their matched controls, even in the presence of emotional prosody, showing that their ability to understand emotional semantic content was impaired. Although prosody improved performances in both groups, it benefited the patients more than the controls. Patients exhibited both impaired semantic and emotional prosodic comprehensions. However, they took greater advantage of emotional prosody adjunction than healthy participants. Consequently, focusing on emotional prosody during carrying may improve social communication.

  3. Development and validation of a Thai stressful life events rating scale for patients with a diagnosis of schizophrenic methamphetamine abuse

    Directory of Open Access Journals (Sweden)

    Ek-uma Imkome


    Full Text Available This study aimed to psychometrically test a Thai Stressful Life Events Rating Scale (TSLERS. Factor analysis was done on data collected from 313 patients with schizophrenia and methamphetamine abuse in Thailand from April to May, 2015. Results identified the following problems impacting physical and mental health: social relationship and social concerns, money, family life, life security, and career. Evaluation of the psychometric scale properties demonstrated acceptable validity and reliability. TSLERS provided scientific and empirical data about stressful life events of patients with schizophrenia and methamphetamine abuse, and was suitable for stress detection and suggesting further innovations.

  4. [MODen: Psychoeducationnal therapeutic group program for schizophrenic patients, based on nutritional balance and pleasure, using cognitive functions: A pilot study]. (United States)

    Farhat, S L; Hochard, C; Orens, S; Gautier, C; Lambert, T; Geret, L; Bralet, M C


    Schizophrenia causes psychological difficulties (with positive and/or negative symptoms) as well as cognitive disabilities (attention, memory, executive functions and social cognition). Moreover, 40 to 60% of patients suffer from an excess of weight or obesity (due to bad eating habits, eating disorders or medication). All these difficulties impair their autonomy and their insertion into the society. In this context, setting-up a therapeutic tool, which may have cognitive benefits seems relevant. Thus, MODen is a therapeutic educational tool whose aim is to improve cognitive functions and the symptoms by using "nutritional balance" as an aid. In this treatment program, two therapists lead a group of 5 to 8 patients which group meets once a week during two to four hours for 16 weeks, divided in 4 cycles. The first three weeks of each cycle consists of theoretical instruction: patients talk about their eating habits, information is given about nutritional balance and preparation of meals. In the different cycles, flexibility, planning, memory and attention are trained. For instance, the work on categorisation of foods and nutritional balance allow enhancing flexibility abilities. Writing down the lists of different ingredients needed for one week's meals and preparation of meals train planning abilities. MODen also takes into account ecological issues such as the limited budget of patients to do their shopping (this budget is around 4 euros per meal in France). The budget is also linked to planning abilities and reasoning. Finally, during the last session of each cycle the group prepares a meal (from the shopping to cooking). This last session is all about sharing and social cognition abilities. By the end of the program, patients will have prepared four meals together. Also "homework" has to be done each week in order to facilitate memorisation of what has been learned during the last session and to prepare the beginning of the next session. In a pilot study with 8

  5. Evaluation of Factors Affecting Continuous Performance Test Identical Pairs Version Score of Schizophrenic Patients in a Japanese Clinical Sample

    Directory of Open Access Journals (Sweden)

    Takayoshi Koide


    Full Text Available Aim. Cognitive impairment in schizophrenia strongly relates to social outcome and is a good candidate for endophenotypes. When we accurately measure drug efficacy or effects of genes or variants relevant to schizophrenia on cognitive impairment, clinical factors that can affect scores on cognitive tests, such as age and severity of symptoms, should be considered. To elucidate the effect of clinical factors, we conducted multiple regression analysis using scores of the Continuous Performance Test Identical Pairs Version (CPT-IP, which is often used to measure attention/vigilance in schizophrenia. Methods. We conducted the CPT-IP (4-4 digit and examined clinical information (sex, age, education years, onset age, duration of illness, chlorpromazine-equivalent dose, and Positive and Negative Symptom Scale (PANSS scores in 126 schizophrenia patients in Japanese population. Multiple regression analysis was used to evaluate the effect of clinical factors. Results. Age, chlorpromazine-equivalent dose, and PANSS-negative symptom score were associated with mean d′ score in patients. These three clinical factors explained about 28% of the variance in mean d′ score. Conclusions. As conclusion, CPT-IP score in schizophrenia patients is influenced by age, chlorpromazine-equivalent dose and PANSS negative symptom score.

  6. [Pro- and antioxidant processes in schizophrenics with tardive dyskinesia]. (United States)

    Gałecki, Piotr; Pietras, Tadeusz; Florkowki, Antoni


    Central nervous system diseases are connected with the production of an increased amount of reactive oxygen species. Decreased antioxidant activity is considered as one of the causes of tardive dyskinesia (TD) in schizophrenic patients in a prolonged neuroleptic treatment course. Evaluation of superoxide dismutase, catalase, glutathione peroxidase activity as well as lipid peroxidation by TBARS saturation in blood platelets in schizophrenic patients with or without tardive dyskinesia symptoms. 84 paranoid schizophrenic patients took part in the study, 40 of them with TD symptoms. The groups were comparative in clinical and demographic terms. Indication of TBARS in blood platelets was performed by the Placed and coop method. GSH-Px activity was indicated by the Little and O'Brien method. CAT activity was indicated according to the Beers and coop method. CuZnSOD activity in blood platelets was indicated by the Mirsa and Fridovich method. CuZnSOD activity in schizophrenic patients without TD is 820.23 and accordingly 710.75 U/g in TD symptoms patients and it is statistical essential. TBARS for patients with TD is 1.06 and accordingly without TD it is 0.92 micromol/10(9)), the difference is statistically essential. For groups with and without TD CAT activity is accordingly 19.87 and 17.93 Ub/g. For groups with and without TD GSH-Px is accordingly 32.30 and 30.48 U/g. schizophrenic patients with TD symptoms have lower CuZnSOD activity and higher concentration of TBARS in platelets than patients without TD. CAT activity is higher in patients with TD symptoms. CuZnSOD activity and concentration of TBARS are in correlation with age in both studied groups.

  7. Two Spectrophotometric Assays for Dopamine Derivatives in Pharmaceutical Products and in Biological Samples of Schizophrenic Patients Using Copper Tetramine Complex and Tri-iodide Reagent

    Directory of Open Access Journals (Sweden)

    F. A. Nour El-Dien


    Full Text Available Two simple, rapid, and sensitive spectrophotometric methods are proposed for the determination of levodopa (LD. The first method is based on coupling of 4-aminoantipyrine (4-AAP with one of the dopamine derivatives (LD, CD to give a new ligand that reacts with copper tetramine complex to give intensely colored chelates. The colored products are quantified spectrophotometrically at 525 and 520 nm for LD and CD, respectively. The optimization of the experimental conditions is described. The method has been used for the determination of 19.7–69.0 and 18.1–54.3μg mL−1 of LD and CD, respectively. The accuracy of the method is achieved by the values of recovery (100±0.2% and the precision is supported by the low standard deviation (SD =0.17–0.59 and relative standard deviation (CV =0.4%–1.54% values. The second method is based on the formation of ion-pair iodinated inner sphere or outer sphere colored complexes between the LD and triiodide ions at pH 5 and room temperature (23±3°C. This method has been used for the determination of LD within the concentration range 39.44–78.88μg mL−1 with SD =0.22–0.24 and recovery percent =100±0.3%. The sensitivity of the two methods is indicated by Sandell's sensitivity of 0.014–0.019 g cm−2. The results of the two methods are compared with those of the official method. The interference of common drug additives, degradation products, and excipients was also studied. The proposed methods were applied successfully to the determination of the LD-CD synthetic mixture and Levocare drug. The determination of LD in urine of some schizophrenic patients was applied with good precision and accuracy. The reliability of the methods was established by parallel determinations against the official British pharmacopoeia method.

  8. Two Spectrophotometric Assays for Dopamine Derivatives in Pharmaceutical Products and in Biological Samples of Schizophrenic Patients Using Copper Tetramine Complex and Triiodide Reagent (United States)


    Two simple, rapid, and sensitive spectrophotometric methods are proposed for the determination of levodopa (LD). The first method is based on coupling of 4-aminoantipyrine (4-AAP) with one of the dopamine derivatives (LD, CD) to give a new ligand that reacts with copper tetramine complex to give intensely colored chelates. The colored products are quantified spectrophotometrically at 525 and 520 nm for LD and CD, respectively. The optimization of the experimental conditions is described. The method has been used for the determination of 19.7–69.0 and 18.1–54.3 μg mL−1 of LD and CD, respectively. The accuracy of the method is achieved by the values of recovery (100 ± 0.2%) and the precision is supported by the low standard deviation (SD = 0.17–0.59) and relative standard deviation (CV = 0.4%–1.54%) values. The second method is based on the formation of ion-pair iodinated inner sphere or outer sphere colored complexes between the LD and triiodide ions at pH 5 and room temperature (23 ± 3°C). This method has been used for the determination of LD within the concentration range 39.44–78.88 μg mL−1 with SD = 0.22–0.24 and recovery percent = 100 ± 0.3%. The sensitivity of the two methods is indicated by Sandell's sensitivity of 0.014–0.019 g cm−2. The results of the two methods are compared with those of the official method. The interference of common drug additives, degradation products, and excipients was also studied. The proposed methods were applied successfully to the determination of the LD-CD synthetic mixture and Levocare drug. The determination of LD in urine of some schizophrenic patients was applied with good precision and accuracy. The reliability of the methods was established by parallel determinations against the official British pharmacopoeia method. PMID:15689633

  9. Neural correlates of working memory deficits in schizophrenic patients. Ways to establish neurocognitive endophenotypes of psychiatric disorders; Neuronale Korrelate gestoerter Arbeitsgedaechtnisfunktionen bei schizophrenen Patienten. Ansaetze zur Etablierung neurokognitiver Endophaenotypen psychiatrischer Erkrankungen

    Energy Technology Data Exchange (ETDEWEB)

    Gruber, O. [Universitaet des Saarlandes, Klinik fuer Psychiatrie und Psychotherapie, Homburg (Saar) (Germany); Max-Planck-Institut fuer Kognitions- und Neurowissenschaften, Leipzig (Germany); Gruber, E.; Falkai, P. [Universitaet des Saarlandes, Klinik fuer Psychiatrie und Psychotherapie, Homburg (Saar) (Germany)


    This article briefly reviews some methodological limitations of functional neuroimaging studies in psychiatric patients. We argue that the investigation of the neural substrates of cognitive deficits in psychiatric disorders requires a combination of functional neuroimaging studies in healthy subjects with corresponding behavioral experiments in patients. In order to exemplify this methodological approach we review recent findings regarding the functional neuroanatomy of distinct components of human working memory and provide evidence for selective dysfunctions of cortical networks that underlie specific working memory deficits in schizophrenia. This identification of subgroups of schizophrenic patients according to neurocognitive parameters may facilitate the establishment of behavioral and neurophysiological endophenotypes and the development of a neurobiological classification of psychiatric disorders. (orig.) [German] Dieser Beitrag befasst sich mit einigen methodischen Problemen funktionell-bildgebender Studien mit psychiatrischen Patienten, aufgrund derer die Untersuchung der neuronalen Korrelate kognitiver Defizite bei psychiatrischen Erkrankungen einer Kombination funktionell-bildgebender Studien bei gesunden Normalprobanden mit Verhaltensuntersuchungen bei Patienten bedarf. Dieser methodische Ansatz wird am Beispiel von Arbeitsgedaechtnisfunktionen erlaeutert, wobei zunaechst neuere Erkenntnisse zur funktionellen Neuroanatomie verschiedener Komponenten des menschlichen Arbeitsgedaechtnisses referiert werden. Anschliessend werden bei schizophrenen Patienten erhobene Befunde vorgestellt, die auf spezifische Stoerungen der funktionellen Integritaet neuronaler Netzwerke mit Arbeitsgedaechtnisfunktionen hinweisen. Die damit verbundene Identifikation von Subgruppen schizophrener Patienten koennte zur Etablierung verhaltensneurophysiologisch definierter Endophaenotypen psychiatrischer Stoerungsbilder fuehren und die Entwicklung einer neurowissenschaftlich

  10. Economic cost and quality of life of family caregivers of schizophrenic patients attending psychiatric hospitals in Ghana. (United States)

    Opoku-Boateng, Yaw Nyarko; Kretchy, Irene A; Aryeetey, Genevieve Cecilia; Dwomoh, Duah; Decker, Sybil; Agyemang, Samuel Agyei; Tozan, Yesim; Aikins, Moses; Nonvignon, Justice


    Low and middle income countries face many challenges in meeting their populations' mental health care needs. Though family caregiving is crucial to the management of severe mental health disabilities, such as schizophrenia, the economic costs borne by family caregivers often go unnoticed. In this study, we estimated the household economic costs of schizophrenia and quality of life of family caregivers in Ghana. We used a cost of illness analysis approach. Quality of life (QoL) was assessed using the abridged WHO Quality of Life (WHOQOL-BREF) tool. Cross-sectional data were collected from 442 caregivers of patients diagnosed with schizophrenia at least six months prior to the study and who received consultation in any of the three psychiatric hospitals in Ghana. Economic costs were categorized as direct costs (including medical and non-medical costs of seeking care), indirect costs (productivity losses to caregivers) and intangible costs (non-monetary costs such as stigma and pain). Direct costs included costs of medical supplies, consultations, and travel. Indirect costs were estimated as value of productive time lost (in hours) to primary caregivers. Intangible costs were assessed using the Zarit Burden Interview (ZBI). We employed multiple regression models to assess the covariates of costs, caregiver burden, and QoL. Total monthly cost to caregivers was US$ 273.28, on average. Key drivers of direct costs were medications (50%) and transportation (27%). Direct costs per caregiver represented 31% of the reported monthly earnings. Mean caregiver burden (measured by the ZBI) was 16.95 on a scale of 0-48, with 49% of caregivers reporting high burden. Mean QoL of caregivers was 28.2 (range: 19.6-34.8) out of 100. Better educated caregivers reported lower indirect costs and better QoL. Caregivers with higher severity of depression, anxiety and stress reported higher caregiver burden and lower QoL. Males reported better QoL. These findings highlight the high household

  11. Higher incidence of hip fracture in newly diagnosed schizophrenic ...

    African Journals Online (AJOL)

    Higher incidence of hip fracture in newly diagnosed schizophrenic patients in Taiwan. Hip fracture is a major public health concern due to its poor outcome and serious socioeconomic burden in older people (1). Evidence has shown that many factors are related to increased risk of hip fracture, but psychiatric diseases are ...

  12. Sobrepeso e obesidade em pacientes esquizofrênicos em uso de clozapina comparado com o uso de outros antipsicóticos Overweight and obesity in schizophrenic patients taking clozapine compared to the use of other antipsychotics

    Directory of Open Access Journals (Sweden)

    Carmen Lúcia Leitão-Azevedo


    Full Text Available INTRODUÇÃO: O uso de antipsicóticos tem sido fundamental no tratamento de portadores de esquizofrenia. Entretanto, tanto a clozapina quanto a maior parte dos antipsicóticos atípicos podem induzir um maior ganho de peso corporal e alterações metabólicas. OBJETIVO: Comparar a freqüência de sobrepeso e obesidade em pacientes esquizofrênicos expostos à clozapina com a dos expostos a demais antipsicóticos. MÉTODO: Foram estudados 121 pacientes esquizofrênicos, com idade de 18 anos ou mais, de ambos os sexos, atendidos no Ambulatório de Esquizofrenia e Demências do Hospital de Clínicas de Porto Alegre, encaminhados de forma consecutiva. Foram avaliadas medidas antropométricas de 53 pacientes em uso de clozapina e de 68 usando outros antipsicóticos, e todos preencheram os critérios diagnósticos de esquizofrenia do DSM-IV e CID-10. RESULTADOS: Não houve diferença significativa na freqüência do IMC entre os esquizofrênicos em uso de clozapina, quando comparado com o dos que usam os demais antipsicóticos. As análises mostraram uma elevada prevalência de pacientes (72,7% com excesso de peso (sobrepeso + obesidade. DISCUSSÃO: Devido à maior freqüência de excesso de peso na população esquizofrênica, pode-se evidenciar na amostra um indicativo de maior risco para transtornos vasculares e metabólicos. A ausência de diferença significativa em relação ao uso de clozapina, comparada com os demais antipsicóticos, demonstra a necessidade da montagem de estudos prospectivos determinando a magnitude de ganho de peso e o aumento de risco relativo à exposição específica de cada antipsicótico.BACKGROUND: The use of antipsychotics has been crucial in the treatment of schizophrenic patients. However, clozapine, as well as most atypical antipsychotics, may lead to higher weight gain and metabolic changes. OBJECTIVE: To compare the frequency of overweight and obesity between schizophrenic patients exposed to clozapine to the

  13. Prolactin gene polymorphism (-1149 G/T) is associated with hyperprolactinemia in patients with schizophrenia treated with antipsychotics

    NARCIS (Netherlands)

    Ivanova, Svetlana A.; Osmanova, Diana Z.; Boiko, Anastasia S.; Pozhidaev, Ivan V.; Freidin, Maxim B.; Fedorenko, Olga Yu.; Semke, Arkadiy V.; Bokhan, Nikolay A.; Kornetova, Elena G.; Rakhmazova, Lubov D.; Wilffert, Bob; Loonen, Anton J. M.

    Background: Antipsychotic drugs can cause hyperprolactinemia. However, hyperprolactinemia was also observed in treatment-naive patients with a first schizophrenic episode. This phenomenon might be related to the role of prolactin as a cytokine in autoimmune diseases. Extrapituitary prolactin

  14. Opisodic memory orientation in schizophrenics, their relatives and normal people

    Directory of Open Access Journals (Sweden)

    Gholamali Nikpour


    Full Text Available Introduction: Memory is what creates perseverance and continuity in human and everyone's idea about himself depends on the memory. Among different psychological ideas, cognitive psychology is only one which investigated and recognized the memory. It seems mental and spiritual statuses have effects on memory and lead to memory orientation toward specific systems. According to research findings, there are spatial distortions in schizophrenics patients which are equal with main signs of schizophrenia i.e. disorders in the thoughts of these patients. Orientation has basic role to create and process the data same as thoughts in schizophrenics and normal people. Assessing such memory orientation in selecting the direction against pleasant, unpleasant and neutral stimulants is the purpose of current research Methods:   Used data in current study is related to patients and normal people reactions against pleasant, unpleasant and neutral materials of William’s test. After gathering the data, mean, variance and standard deviation were firstly, estimated and were analyzed statistically by independent T test. Results: Findings showed that there was a meaningful relationship between two mean of patients and normal people in reaction against pleasant, unpleasant and neutral stimulants of William’s test. It meaned normal people selected more pleasant stimulants than schizophrenics. Indeed, normal people selected neutral stimulants with slightly more different than schizophrenics. There was not any meaningful difference between normal people and schizophrenics only in unpleasant stimulants. Conclusion: Ability and intellectual coherence lead to mental appropriate performance and will result those people remind all memories particularly unpleasant ones with more details. Therefore it seems that memory orientation process leads to psychological status controlled the individual.

  15. In vivo effects of olanzapine on striatal dopamine D{sub 2}/D{sub 3} receptor binding in schizophrenic patients: an iodine-123 iodobenzamide single-photon emission tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Dresel, S.; Rossmueller, B.; Hahn, K.; Tatsch, K. [Department of Nuclear Medicine, University of Munich (Germany); Mager, T.; Meisenzahl, E.; Moeller, H.J. [Department of Psychiatry, University of Munich (Germany)


    Olanzapine is a new atypical antipsychotic agent that belongs to the same chemical class as clozapine. The pharmacological efficacy of olanzapine (in contrast to that of risperidone) has been shown to be comparable to that of clozapine, but olanzapine has the advantage of producing a less pronounced bone marrow depressing effect than clozapine. The specific aims of this study were (a) to assess dopamine D{sub 2}/D{sub 3} receptor availability in patients treated with olanzapine by means of iodine-123 iodobenzamide [{sup 123}I]IBZM single-photon emission tomography (SPET), (b) to compare the results with findings of [{sup 123}I]IBZM SPET in patients under treatment with risperidone and (c) to correlate the results with the occurrance of extrapyramidal side-effects (EPMS). Brain SPET scans were performed in 20 schizophrenic patients (DSM III R) at 2 h after i.v. administration of 185 MBq [{sup 123}I]IBZM. Images were acquired using a triple-head gamma camera (Picker Prism 3000 XP). For semiquantitative evaluation of D{sub 2}/D{sub 3} receptor binding, transverse slices corrected for attenuation were used to calculate specific uptake values [STR-BKG]/BKG (STR=striatum; BKG=background). The mean daily dose of olanzapine ranged from 0.05 to 0.6 mg/kg body weight. The dopamine D{sub 2}/D{sub 3} receptor binding was reduced in all patients treated with olanzapine. Specific IBZM binding [STR-BKG]/BKG ranged from 0.13 to 0.61 (normal controls >0.95). The decreased D{sub 2}/D{sub 3} receptor availability revealed an exponential dose-response relationship (r=-0.85, P<0.001). The slope of the curve was similar to that of risperidone and considerably higher than that of clozapine as compared with the results of a previously published study. EPMS were observed in only one patient, presenting with the lowest D{sub 2}/D{sub 3} availability. The frequency of EPMS induced by olanzapine (5%) was considerably lower than the frequency under risperidone treatment (40%). Our findings

  16. In vivo effects of olanzapine on striatal dopamine D[sub 2]/D[sub 3] receptor binding in schizophrenic patients: an iodine-123 iodobenzamide single-photon emission tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Dresel, S.; Rossmueller, B.; Hahn, K.; Tatsch, K. (Department of Nuclear Medicine, University of Munich (Germany)); Mager, T.; Meisenzahl, E.; Moeller, H.J. (Department of Psychiatry, University of Munich (Germany))


    Olanzapine is a new atypical antipsychotic agent that belongs to the same chemical class as clozapine. The pharmacological efficacy of olanzapine (in contrast to that of risperidone) has been shown to be comparable to that of clozapine, but olanzapine has the advantage of producing a less pronounced bone marrow depressing effect than clozapine. The specific aims of this study were (a) to assess dopamine D[sub 2]/D[sub 3] receptor availability in patients treated with olanzapine by means of iodine-123 iodobenzamide [[sup 123]I]IBZM single-photon emission tomography (SPET), (b) to compare the results with findings of [[sup 123]I]IBZM SPET in patients under treatment with risperidone and (c) to correlate the results with the occurrance of extrapyramidal side-effects (EPMS). Brain SPET scans were performed in 20 schizophrenic patients (DSM III R) at 2 h after i.v. administration of 185 MBq [[sup 123]I]IBZM. Images were acquired using a triple-head gamma camera (Picker Prism 3000 XP). For semiquantitative evaluation of D[sub 2]/D[sub 3] receptor binding, transverse slices corrected for attenuation were used to calculate specific uptake values [STR-BKG]/BKG (STR=striatum; BKG=background). The mean daily dose of olanzapine ranged from 0.05 to 0.6 mg/kg body weight. The dopamine D[sub 2]/D[sub 3] receptor binding was reduced in all patients treated with olanzapine. Specific IBZM binding [STR-BKG]/BKG ranged from 0.13 to 0.61 (normal controls >0.95). The decreased D[sub 2]/D[sub 3] receptor availability revealed an exponential dose-response relationship (r=-0.85, P<0.001). The slope of the curve was similar to that of risperidone and considerably higher than that of clozapine as compared with the results of a previously published study. EPMS were observed in only one patient, presenting with the lowest D[sub 2]/D[sub 3] availability. The frequency of EPMS induced by olanzapine (5%) was considerably lower than the frequency under risperidone treatment (40%). Our findings

  17. [Effectiveness of acupuncture in treating schizophrenia: a clinical randomized trial of 31 patients]. (United States)

    Bouhlel, Saoussen; El-Hechmi, Safouene; Ghanmi, Latifa; Ghaouar, Mabrouk; Besbes, Chokri; Khaled, Mehrez; Melki, Wahid; El-Hechmi, Zouhaier


    Acupuncture is one of the most popular types of complementary/alternative medicine in the world. It is sometimes used as a treatment for schizophrenia mainly in China. To assess the contribution of acupuncture in the treatment of patients treated for schizophrenia in Tunisian population. Our study is a clinical randomized trial about 31 hospitalized patients with schizophrenia or schizo-affectif disorder (DSM IV). They were evaluated by the Positive and Negative Syndrome Scale (PANSS), the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS) the first and 23nd day of the study. Manual acupuncture was used for 10 sessions at the rate of three sessions per week. All patients were under drug therapy. Among them, 15 were treated by acupuncture and 16 by sham acupuncture. Scores of the PANSS, SAPS and SANS were similar in the two groups at the end of the study. Our study did not provide any evidence for the effectiveness of acupuncture in treating schizophrenic symptoms.

  18. Hypoacusia in a Patient Treated by Isotretinoin

    Directory of Open Access Journals (Sweden)

    L. Rosende


    Full Text Available Isotretinoin is the most effective treatment for severe acne, but there are several adverse effects associated with its use, some of them very exceptional (<1/10000. We report one case of hypoacusia and tinnitus in a 15-year-old boy treated with isotretinoin during 6 weeks, who quickly improved after isotretinoin withdrawal. Also, we comment other publications about hearing alterations in patients treated with isotretinoin and other retinoids.

  19. schizophrenics

    African Journals Online (AJOL)


    Jul 30, 2006 ... of the use of atypical antipsychotic agents with the development of ... development of diabetes when compared to a general population ..... Diazepam 2mg bid. Sodium Valproate controlled release 500mg bid. 4. Zuclopenthixol depot 200mg IMI 4 weekly. 56. Chlorpromazine 100mg am and 200mg pm. 5.

  20. Avaliação antropométrica e bioquímica em pacientes com esquizofrenia usuários de clozapina Anthropometric and biochemical assessment of schizophrenic patients taking clozapine

    Directory of Open Access Journals (Sweden)

    Karine Zortéa


    Full Text Available OBJETIVO: Avaliar a proporção de sobrepeso/obesidade e alterações em parâmetros bioquímicos sangüíneos em pacientes com esquizofrenia do sexo masculino, usuários de medicação antipsicótica (clozapina. MÉTODOS: Estudo transversal com 40 pacientes do sexo masculino, diagnosticados com esquizofrenia, em uso de clozapina, atendidos no Hospital de Clínicas de Porto Alegre. Foram verificadas as relações entre o índice de massa corporal, a circunferência abdominal, o percentual de gordura corporal, o perfil lipídico e o exame de glicose de jejum e a dosagem da medicação, o acompanhamento dietoterápico e a monoterapia de clozapina. RESULTADOS: Os pacientes apresentaram freqüências de 71,8% de sobrepeso/obesidade, 76,9% de circunferência abdominal aumentada e 94,1% de percentual de gordura elevada. Foram encontrados 56,8% de pacientes com lipoproteína de baixa densidade-colesterol acima do normal e 64,1% com triglicerídeos elevados. Quanto maior a dosagem de clozapina utilizada maiores foram os níveis de lipoproteína de baixa densidade-colesterol (p=0,01. CONCLUSÃO: Pacientes tratados com clozapina apresentam aumento de peso e significante anormalidade lipídica, necessitando de monitoramento freqüente dos níveis plasmáticos e intervenção nutricional precoce, visando à otimização do tratamento.OBJECTIVE: The objective was to access the overweight/obesity rates and variations of biochemical blood parameters in male schizophrenic outpatients taking antipsychotic medication (clozapine, treated at the Schizophrenia and Dementia First Aid Station of the Clinics Hospital in Porto Alegre. METHODS: This is a cross-sectional study with 40 male outpatients diagnosed with schizophrenia and taking clozapine, from the Clinics Hospital in Porto Alegre. Associations between body mass index, waist circumference, body fat percentage, lipid levels and fasting glucose and medication dosage, diet therapy and clozapine monotherapy were

  1. [Language disorders and cognitive functions in persons with schizophrenic disorders]. (United States)

    Waszkiewicz, Justyna; Wciórka, Jacek; Anczewska, Marta; Chrostek, Anna; Switaj, Piotr


    The aim of this study is to evaluate the relationship between clinical and neuropsychological measures of language disorders as well as characteristics of the mental condition of patients diagnosed as having schizophrenic disorders. There were 45 persons with schizophrenic disorder (acc. ICD-10) examined with The Positive and Negative Syndrome Scale (PANSS), the side effect rating scale (UKU), Wisconsin Cards Storting Test (WCST), verbal fluency task, Ruff's Test, "Similarities" --WAIS-R subtest, 10 graphics of The Thematic Apperception Test (TAT). Patient's speech was evaluated independently by two diagnosticians using Thought, Language and Communication Scale (TLCS). Time since the onset of illness and the number of hospitalisations were associated with total TLCS scores and with most of the WCST indicators. Total amount and most of the particular language disorders correlated positively with total PANSS scores. Total amount of language disorders was connected with the number of trials, which were necessary to complete the first category and also with the global scores obtained in "Similarities". There were also many correlations between particular language phenomenons and results of several neuropsychological tests. Correlation between psychopathological evaluation of language disorders according to TLCS and evaluation of the schizophrenic syndrome score is found to be significant. The psychopathological rating of general and particular language disorders shows significant correlations with some indicators of executive function, verbal and nonverbal fluency and the ability for abstract thinking.

  2. Life Expectancy in Patients Treated for Osteoporosis

    DEFF Research Database (Denmark)

    Abrahamsen, Bo; Osmond, Clive; Cooper, Cyrus


    Osteoporosis is a chronic disease, carrying an elevated risk of fractures, morbidity, and death. Long-term treatment may be required, but the long-term risks with osteoporosis drugs remain incompletely understood. The competing risk of death may be a barrier to treating the oldest, yet this may...... not be rational if the risk of death is reduced by treatment. It is difficult to devise goal-directed long-term strategies for managing osteoporosis without firm information about residual life expectancy in treated patients. We conducted an observational study in Danish national registries tracking prescriptions...... for osteoporosis drugs, comorbid conditions, and deaths. We included 58,637 patients and 225,084 age- and sex-matched control subjects. Information on deaths until the end of 2013 was retrieved, providing a follow-up period of 10 to 17 years. In men younger than 80 years and women younger than 60 years...

  3. [The Cotard syndrome in schizophrenic disorders]. (United States)

    Stompe, Thomas; Schanda, Hans


    The Cotard-Syndrome (CS), the belief of being dead, was described for the first time in 1880. Since then it met the interest not only of psychopathologists but also of philosophers. With a few exceptions, the literature is mainly restricted to case reports of anxious-depressive, demented or paranoid patients. It was the aim of our study to investigate the prevalence and the psychopathological context of the CS. We analyzed the Austrian data (N = 346) of the International Study of Psychotic Symptoms in Schizophrenia. A CS could be diagnosed in three cases (0.87%). In all of them, CS developed on the basis of nihilistic-hypochondriac delusions and a progressive loss of energy. Two patients bridged the logical inconsistencies between obviously being alive and the belief of being dead by visual illusions, the third patient, however, by locating himself in an intermediate region between this world and the afterworld. On the one hand the CS can be considered as a special manifestation of the topic of death in schizophrenic delusions, on the other as a nihilistic delusional identity. Without doubt, this uncommon and bizarre psychotic phenomenon will be an object of interest for general psychopathology as well as for the philosophy of mind also in future.

  4. The neurobehavioural evaluation in schizophrenics: a comparative study. (United States)

    Ilamkar, Kamini Ramdas


    The simple reaction time task assesses the ability of the subject to respond to an external cue and to retrieve a reward. The reaction time provides an indirect index of the processing capability of the central nervous system and a simple means to the determined sensory and the motor performances, which is a neurobehavioural evaluation. A general slowness in the latency in the reaction time tasks and a disengagement deficit in the visual and the hearing oriented tasks were seen in schizophrenics. In order to clarify the feature of the attention disorders in schizophrenia, a simple reaction time task was given to schizophrenics. Schizophrenics (34 males and 20 females, n=54) and healthy controls (40 males and 21 females, n=61) with a mean age of 35±7, who were individually matched for gender and age, were included in the study, by using a response analyser to evaluate the reaction time. The performances were expressed in mean ± standard deviation of the reaction time by using the unpaired 't' test. The schizophrenic patients performed poorer than the healthy controls, which indicated a difficulty in sustaining attention and this was statistically very highly significant (pdisturbance in interpersonal situations. The increased reaction time as compared to that in healthy controls, might be due to the impairment of the psychomotor poverty, disorganization and reality distortion which were associated with the deficits in the cortical neurological functions, such as planning, coordination and sequencing of the motor acts, which showed a greater involvement of the frontal lobe and temporal lobe dysfunction.

  5. O impacto dos agentes antipsicóticos na densidade mineral óssea de pacientes esquizofrênicos Impact of antipsychotic agents in bone mineral density of schizophrenic patients

    Directory of Open Access Journals (Sweden)

    Lísia Rejane Guimarães


    Full Text Available Estudos têm evidenciado o alto risco de osteoporose em pacientes esquizofrênicos. Alguns estudos têm demonstrado que os neurolépticos típicos e a risperidona podem induzir a osteoporose ou reduzir a densidade mineral óssea. Isso pode ser atribuído ao fato de estas drogas, em uso prolongado, induzirem a hiperprolactinemia a níveis acima do normal, em ambos os sexos, e a baixa dos níveis de estrogênio e de testosterona, aumentando o risco para osteopenia/osteoporose. Neste relato, será apresentado um caso de osteopenia em uma paciente mulher de 53 anos, em uso de antipsicóticos há 30 anos, sendo comentados os procedimentos recomendados para detecção dessa ocorrência e as diretrizes existentes para seu manejo.Studies have shown a high risk of osteoporosis in schizophrenic patients. Some studies have demonstrated that typical neuroleptics and risperidone may induce osteoporosis or reduce bone mineral density. This can be due to the fact that prolonged use of those drugs induces hyperprolactinemia to levels above normal in both genders, and reduces the levels of estrogen and testosterone, thus increasing the risk of osteopenia/osteoporosis. We report on a case of osteopenia in a 53-year-old female patient using antipsychotics for 30 years. We comment on the recommended procedures to detect osteopenia and on the existing guidelines for its management.

  6. Neurocortical electrical activity tomography in chronic schizophrenics

    Directory of Open Access Journals (Sweden)

    Veiga Heloisa


    Full Text Available Functional imaging of brain electrical activity was performed in 25 chronic medicated schizophrenics and 40 controls, analyzing the classical frequency bands (delta, theta, alpha, and beta of 19-channel EEG during resting state to identify brain regions with deviant activity of different functional significances, using LORETA (Low Resolution Tomography and SPM99 (Statistical Parametric Mapping. Patients differed from controls due to an excess of slow activity comprising delta + theta frequency bands (inhibitory pattern located at the right middle frontal gyrus, right inferior frontal gyrus, and right insula, as well as at the bilateral anterior cingulum with a left preponderance. The high temporal resolution of EEG enables the specification of the deviations not only as an excess or a deficit of brain electrical activity, but also as inhibitory (delta, theta, normal (alpha, and excitatory (beta activities. These deviations point out to an impaired functional brain state consisting of inhibited frontal and prefrontal areas that may result in inadequate treatment of externally or internally generated information.

  7. Are there schizophrenics for whom drugs may be unnecessary or contraindicated? (United States)

    Rappaport, M; Hopkins, H K; Hall, K; Belleza, T; Silverman, J


    This study reports that there are schizophrenics who do relatively well long term without the routine or continuous use of antipsychotic medication. Specially selected young males undergoing an acute schizophrenic episode were followed, after hospitalization, for up to three years. While hospitalized they were assigned randomly to either placebo or chlorpromazine treatment. Many unmedicated-while-in-hospital patients showed greater long-term improvement, less pathology at follow-up, fewer rehospitalizations and better overall function in the community than patients who were given chlorpromazine while in the hospital. Factors related to post-hospital outcome were good premorbid history and short-lived paranoid characteristics. Considerations which may have an effect on the successful management of acute schizophrenic patients not on medication are mentioned. The findings underline the need for further study of how to utilize antipsychotic medication more selectively in the treatment of schizophrenia.

  8. Studies of the correlations between morphological brain changes on MRI and computerized EEG changes in schizophrenics

    Energy Technology Data Exchange (ETDEWEB)

    Takeuchi, Kouzou (Kagoshima Univ. (Japan). Faculty of Medicine)


    Twenty eight schizophrenic patients, who ranged in age from 21 to 39 years with a mean of 30.2, and 21 age- and sex-matched normal volunteers were studied by magnetic resonance (MR) imaging and electroencephalography (EEG). ALl subjects were given informed consent prior to the present study. They were all right-handed. Schizophrenic patients showed a significantly larger ventricular brain ratio (VBR) on the axial and coronal planes as compared with the control. The bilateral anterior horns, left body, left posterior horn of the lateral ventricle and the third ventricle were significantly larger in schizophrenic patients than the control. The middle half of the corpus callosum was smaller in schizophrenic patients than the control. Schizophrenia was more likely associated not only with delta and theta activities in the centro-parieto-occipital regions but also with beta 1 and beta 2 activities in the front-central regions. In schizophrenic patients, however, alpha 2 activity was markedly decreased in all regions. There were significant positive correlations between the total scores for brief psychiatric rating scale (BPRS) and the areas of the left anterior and posterior horns of the lateral ventricle. The total BPRS scores positively correlated with the area of the third ventricle. In addition, positive correlations were significant between delata activity and the area of the left anterior horn of the lateral ventricle, between delta activity and the area of the third ventricle, and between beta 1 activity and the area of left posteior horn of the lateral ventricle. These results suggest that a dilated third ventricle is associated with electrophysiological brain pathology and psychopathology in schizophrenic patients. (N.K.) 76 refs.

  9. Schizophrenic and Sibling: A Comparison of Parental Relationships. (United States)

    Summers, Frank; Walsh, Froma


    Schizophrenics were differentiated from their siblings in tendencies to see themselves as symbiotically attached to their mothers and failing to be accommodated to by their fathers. Schizophrenics tend to be aligned with the same sex parent. Findings may help explain the psychosexual identification difficulties of schizophrenics. (Author)

  10. Monitoring multiple myeloma patients treated with daratumumab

    DEFF Research Database (Denmark)

    McCudden, Christopher; Axel, Amy E; Slaets, Dominique


    and IFE can confound the use of these tests for response assessment in clinical trials and disease monitoring. METHODS: To discriminate between endogenous myeloma protein and daratumumab, a daratumumab-specific immunofixation electrophoresis reflex assay (DIRA) was developed using a mouse anti......-daratumumab antibody. To evaluate whether anti-daratumumab bound to and shifted the migration pattern of daratumumab, it was spiked into daratumumab-containing serum and resolved by IFE/SPE. The presence (DIRA positive) or absence (DIRA negative) of residual M-protein in daratumumab-treated patient samples...... was evaluated using predetermined assessment criteria. DIRA was evaluated for specificity, limit of sensitivity, and reproducibility. RESULTS: In all of the tested samples, DIRA distinguished between daratumumab and residual M-protein in commercial serum samples spiked with daratumumab and in daratumumab...


    NARCIS (Netherlands)


    Background. A randomised controlled trial of day treatment with community care for patients with schizophrenic and affective disorders, referred for in-patient psychiatric treatment, was conducted to evaluate patterns of treatment and the course of illness with its psychosocial consequences over a

  12. Phenothiazine effects on cerebral-evoked potentials and eye movements in acute schizophrenics. (United States)

    Rappaport, M; Hopkins, H K; Hall, K; Belleza, T


    An investigation was made of the effects of phenothiazine medication on the averaged visual-evoked potentials (AVEP) and on eye movements in hospitalized, young, acute schizophrenic patients. These results were compared with those of normal subjects who were not given medication. AVEP measures included maximum amplitude (Am), frequency of peaks (FOP'S), variability (V) and peak latencies for an early negative peak (N1) and a later positive peak (P6). Eye movement measures included percent of time looking at a stimulus slide, percent of time looking at a figure on the slide, the number of fixations and the percent of cells entered in which fixations occurred. For schizophrenics off and on phenothiazine medication, there were no consistently significant drug effects on any measure except frequency of peaks. Schizophrenics compared to normals had lower amplitudes, greater frequency of peaks, greater variability and lower eye movement scores.

  13. Increased amygdala and parahippocampal gyrus activation in schizophrenic patients with auditory hallucinations : An fMRI study using independent component analysis

    NARCIS (Netherlands)

    Jose Escarti, Maria; de la Iglesia-Vaya, Maria; Marti-Bonmati, Luis; Robles, Montserrat; Carbonell, Jose; Jose Lull, Juan; Garcia-Marti, Gracian; Vicente Manjon, Jose; Jesus Aguilar, Eduardo; Aleman, Andre; Sanjuan, Julio

    Objective: Hallucinations in patients with schizophrenia have strong emotional connotations. Functional neuroimaging techniques have been widely used to study brain activity in patients with schizophrenia with hallucinations or emotional impairments. However, few of these Studies have investigated

  14. Identification of single nucleotide polymorphisms (SNPs) and other sequence changes and estimation of nucleotide diversity in coding and flanking regions of the NMDAR1 receptor gene in schizophrenic patients. (United States)

    Rice, S R; Niu, N; Berman, D B; Heston, L L; Sobell, J L


    Glutamatergic dysregulation has been hypothesized to play a role in schizophrenia. The N-methyl-D-aspartate (NMDA) type of glutamate receptor especially is of interest because, in addition to binding sites for glutamate and glycine, a necessary co-agonist, this receptor also contains noncompetitive binding sites for the psychotomimetics phencyclidine (PCP), MK-801, and ketamine. PCP-induced psychosis has been a useful disease model in that both the positive as well as the negative symptomatologies seen in schizophrenia are observed. Recently, a mouse deficient in expression of the NR1 subunit gene (NMDAR1) of the heteromeric receptor has been developed and shown to display aberrant behaviors, with reduced social and sexual interactions as well as increased stereotypic motor activity. In an extensive examination of the NMDAR1 gene in our laboratory in approximately 100 chronic schizophrenic patients, 28 unique sequence changes were identified, including eight single nucleotide polymorphisms (SNPs) in the 5' untranslated region (5'UTR), six SNPs in coding regions (cSNPs), eleven intronic SNPs, two intronic deletions of 7 and 30 bp, and an intronic microinsertion/deletion. With the exception of one previously reported cSNP, all of the identified changes were novel. The frequency of polymorphisms differed significantly by ethnicity and several appeared to be in linkage disequilibrium. None of the changes appeared likely to be of functional significance, thus suggesting that changes in the genomic NMDAR1 are unlikely to contribute to the etiology of schizophrenia. Estimates of nucleotide diversity are comparable to those observed in studies of other genes.

  15. Disordered semantic representation in schizophrenic temporal cortex revealed by neuromagnetic response patterns

    Directory of Open Access Journals (Sweden)

    Silberman Yaron


    Full Text Available Abstract Background Loosening of associations and thought disruption are key features of schizophrenic psychopathology. Alterations in neural networks underlying this basic abnormality have not yet been sufficiently identified. Previously, we demonstrated that spatio-temporal clustering of magnetic brain responses to pictorial stimuli map categorical representations in temporal cortex. This result has opened the possibility to quantify associative strength within and across semantic categories in schizophrenic patients. We hypothesized that in contrast to controls, schizophrenic patients exhibit disordered representations of semantic categories. Methods The spatio-temporal clusters of brain magnetic activities elicited by object pictures related to super-ordinate (flowers, animals, furniture, clothes and base-level (e.g. tulip, rose, orchid, sunflower categories were analysed in the source space for the time epochs 170–210 and 210–450 ms following stimulus onset and were compared between 10 schizophrenic patients and 10 control subjects. Results Spatio-temporal correlations of responses elicited by base-level concepts and the difference of within vs. across super-ordinate categories were distinctly lower in patients than in controls. Additionally, in contrast to the well-defined categorical representation in control subjects, unsupervised clustering indicated poorly defined representation of semantic categories in patients. Within the patient group, distinctiveness of categorical representation in the temporal cortex was positively related to negative symptoms and tended to be inversely related to positive symptoms. Conclusion Schizophrenic patients show a less organized representation of semantic categories in clusters of magnetic brain responses than healthy adults. This atypical neural network architecture may be a correlate of loosening of associations, promoting positive symptoms.

  16. Thalidomide in Treating Patients With Myelodysplastic Syndrome (United States)


    Chronic Myelomonocytic Leukemia; de Novo Myelodysplastic Syndromes; Previously Treated Myelodysplastic Syndromes; Refractory Anemia; Refractory Anemia With Excess Blasts; Refractory Anemia With Excess Blasts in Transformation; Refractory Anemia With Ringed Sideroblasts; Secondary Myelodysplastic Syndromes

  17. Copper and ceruloplasmin concentrations in the blood serum oe schizophrenic patients Concentrações do cobre e da ceruloplasmina no plasma de pacientes com esquizofrenia

    Directory of Open Access Journals (Sweden)

    Luis Marques-Assis


    Full Text Available The serum copper (26 cases and ceruloplasmin (20 cases are studied in 45 patients with schizophrenia. The following conclusions were drawn from this study: 1 the blood copper is significantly higher in patients with schizophrenia; 2 the variations of ceruloplasmin are not significant. The slightly amounts of copper in schizophrenia may have not a diagnostic value.É estudado o comportamento do cobre total do soro (26 casos e da ceruloplasmina (20 casos em 45 pacientes portadores de esquizofrenia. A análise estatística dos resultados permitiu aos autores chegarem às seguintes conclusões: 1 o cobre total do soro está aumentado nos pacientes esquizofrênicos; 2 os níveis de ceruloplasmina não variaram de maneira significativa. Os autores julgam que os achados podem não ter valor diagnóstico.

  18. Interaction between paliperidone extended release and TS-1(®), an oral anticancer drug containing a 5-fluorouracil derivative, in a schizophrenic patient. (United States)

    Yasui-Furukori, Norio; Hashimoto, Kojiro; Kubo, Kazutoshi; Tomita, Tetsu


    Until now there has been no information available on drug interaction between paliperidone and TS-1(®), an oral anticancer drug containing a 5-fluorouracil derivative. The patient in the case presented here was a 39-year-old man with a 15-year history of schizophrenia. The patient's usual treatment of 2 mg/day of risperidone was changed to 3 mg/day of paliperidone extended release. He experienced worsening psychotic symptoms after switching from risperidone to paliperidone while he was also receiving TS-1. Retrospective analyses showed plasma concentration of paliperidone was consistently lower during the treatment with TS-1 than without TS-1. This case suggests there is drug interaction between paliperidone extended-release tablets and TS-1.

  19. Schizophrenic outpatient perceptions of psychiatric treatment and psychotic symptomatology: an investigation using structural equation modeling. (United States)

    Hayashi, N; Yamashina, M; Taguchi, H; Ishige, N; Igarashi, Y


    Schizophrenic patient perceptions of treatment have clinical value and deserve detailed psychiatric investigation. The present study sought a model indicating statistically estimated cause-effect relationships of perceptions and psychotic symptomatology of outpatients with schizophrenia by applying a method of structural equation modeling. The perceptions included in this model were patient satisfaction with treatment, perceptions of their treating psychiatrists, and patient-role perception. Scores of Positive and Negative Syndrome Scale and poor insight measures were added to the model as possible influential factors. The constructed model revealed that the poor insight exerted a major influence on the patient-role perception that had small effects on the reliable therapist perception and the satisfaction. It was also shown that satisfaction was chiefly determined by the reliable therapist perception that was formed in the treatment relationship, rather independently of the other construct. These findings were valuable in terms of their implications for understanding the makeup of the perceptions and the strategy for interventions to improve them.


    Ananthanarayanan, C.V.; Janakiramaiah, N.; Gangadhar, B.N.; Vittal, S.; Andade, C.; Kumaraiah, V.


    SUMMARY Twenty four remitted schizophrenics and twenty four neurotic depressives were studied on three measures of visual information processing, viz., simple reaction time, choice reaction time, and a forced choice span of apprehension test. The groups were matched for age, sex, and educational status. The remitted schizophrenics performed poorly on these measures compared to neurotic depressives. The findings suggest that information processing deficits are present in outpatient schizophrenics even during clinical remission. PMID:21776163

  1. Reversal of imbalance between kynurenic acid and 3-hydroxykynurenine by antipsychotics in medication-naïve and medication-free schizophrenic patients. (United States)

    Myint, A M; Schwarz, M J; Verkerk, R; Mueller, H H; Zach, J; Scharpé, S; Steinbusch, H W M; Leonard, B E; Kim, Y K


    The association between the pro-inflammatory state of schizophrenia and increased tryptophan degradation into kynurenine has been reported. However, the relationship between metabolites from subdivisions of the kynurenine pathway, kynurenic acid and 3-hydroxykynurenine, remains unknown. The present study tested the relationship between these kynurenine metabolites in the plasma of medication-naïve (n=35) or medication-free (n=18) patients with schizophrenia at admission and following 6-week antipsychotic treatment compared to healthy controls (n=48). The plasma concentrations of kynurenic acid (nmol/l) were lower (difference=-8.44 (-13.22 to -3.65); p=0.001) and of 3-hydroxykynurenine (nmol/l) were higher (difference=11.24 (8.11-14.37); p<0.001) in the patients compared with the healthy controls. The kynurenic acid/kynurenine (difference=-2.75 (-5.115 to -0.336); p=0.026) and kynurenic acid/3-hydroxykynurenine (difference=-1.08 (-1.431 to -0.729); p<0.001) ratios were also lower in the patients. After the 6-week treatment, the patients' plasma kynurenic acid levels (difference=3.85 (-0.23 to 7.94); p=0.064) showed a trend towards an increase, whereas plasma 3-hydroxykynurenine levels (difference=22.41 (19.76-25.07); p<0.001) decreased. As a consequence, the kynurenic acid/3-hydroxykynurenine ratio (difference=-4.41 (-5.51 to -3.3); p<0.001) increased. Higher initial plasma kynurenic acid levels on admission or increased kynurenic acid/kynurenine ratio after treatment were associated with reduction of clinical symptoms scores upon discharge although higher kynurenic acid/kynurenine on admission may induce higher positive symptoms score. In contrast, higher 3-hydroxykynurenine is associated with lower positive symptoms score. These results indicate that there is an imbalance in the kynurenine pathway in schizophrenia. The 6-week antipsychotic treatment may partially reverse the imbalance in kynurenine metabolism and that in turn induces clinical response. Copyright

  2. Prolactin gene polymorphism (-1149 G/T) is associated with hyperprolactinemia in patients with schizophrenia treated with antipsychotics. (United States)

    Ivanova, Svetlana A; Osmanova, Diana Z; Boiko, Anastasia S; Pozhidaev, Ivan V; Freidin, Maxim B; Fedorenko, Olga Yu; Semke, Arkadiy V; Bokhan, Nikolay A; Kornetova, Elena G; Rakhmazova, Lubov D; Wilffert, Bob; Loonen, Anton J M


    Antipsychotic drugs can cause hyperprolactinemia. However, hyperprolactinemia was also observed in treatment-naive patients with a first schizophrenic episode. This phenomenon might be related to the role of prolactin as a cytokine in autoimmune diseases. Extrapituitary prolactin production is regulated by an alternative promoter, which contains the functional single nucleotide polymorphism -1149 G/T (rs1341239). We examined whether this polymorphism was associated with hyperprolactinemia in patients with schizophrenia. We recruited 443 patients with schizophrenia and 126 healthy controls. The functional polymorphism -1149 G/T (rs1341239) in the prolactin gene was genotyped with multiplexed primer extension, combined with MALDI-TOF mass spectrometry. Genotype and allele frequencies were compared between groups with the χ2 test and logistic regression models adjusting for covariates. The frequency of genotypes and alleles in patients with schizophrenia did not differ from those in control subjects. A comparison between patients with schizophrenia with and without hyperprolactinemia revealed significantly higher frequency of the G allele in patients with hyperprolactinemia than in patients without it (χ2=7.25; p=0.007; OR=1.44 [1.10-1.89]). Accordingly, patients with hyperprolactinemia carried the GG genotype more frequently than patients without hyperprolactinemia (χ2=9.49; p=0.009). This association remained significant after adjusting the estimates for such covariates as sex, age, duration of the diseases and the dose of chlorpromazine equivalents. This study revealed a significant association between the polymorphic variant rs1341239 and the development of hyperprolactinemia in patients with schizophrenia. The serum prolactin concentration in patients with schizophrenia treated with antipsychotics may provide an indication of the activity of the gene that regulates extrapituitary prolactin production which is believed to play a role in the immune system

  3. High mortality among heart failure patients treated with antidepressants

    DEFF Research Database (Denmark)

    Veien, Karsten T; Videbæk, Lars; Schou, Morten


    BACKGROUND: This study was designed to assess whether pharmacologically treated depression was associated with increased mortality risk in systolic heart failure (SHF) patients. METHODS: Patients (n=3346) with SHF (left ventricular ejection fraction......BACKGROUND: This study was designed to assess whether pharmacologically treated depression was associated with increased mortality risk in systolic heart failure (SHF) patients. METHODS: Patients (n=3346) with SHF (left ventricular ejection fraction...

  4. Treating the elderly diabetic patient: special considerations

    Directory of Open Access Journals (Sweden)

    Kezerle L


    Full Text Available Louise Kezerle, Leah Shalev, Leonid Barski Department of Internal Medicine F, Soroka University Medical Center, Beer-Sheva, Israel Abstract: The prevalence of diabetes is rising in the >65 year-old group. The challenge of defining the goals of therapy arises from the heterogeneity of the aging process and the sparse clinical data in this patient population. In light of these challenges, the clinician should be aware of the pitfalls of caring for the older diabetic patient and prioritize an individualized treatment plan to ensure an optimal glycemic control, without placing the patient at unnecessary risk. We present a review of the current guidelines and literature that deal specifically with the treatment of the older diabetic patient in order to establish the principles of treatment in this age group and help the clinician make decisions regarding the care of these patients. Keywords: diabetes treatment, elderly, review

  5. High mortality among heart failure patients treated with antidepressants

    DEFF Research Database (Denmark)

    Veien, Karsten Tang; Videbæk, Lars; Schou, Morten


    This study was designed to assess whether pharmacologically treated depression was associated with increased mortality risk in systolic heart failure (SHF) patients.......This study was designed to assess whether pharmacologically treated depression was associated with increased mortality risk in systolic heart failure (SHF) patients....

  6. The recognition of facial affect in autistic and schizophrenic subjects and their first-degree relatives. (United States)

    Bölte, Sven; Poustka, Fritz


    Autism and schizophrenia are considered to be substantially influenced by genetic factors. The endophenotype of both disorders probably also includes deficits in affect perception. The objective of this study was to examine the capacity to detect facially expressed emotion in autistic and schizophrenic subjects, their parents and siblings. Thirty-five subjects with autism and 102 of their relatives, 21 schizophrenic subjects and 46 relatives from simplex (one child affected) and multiplex (more than one child affected) families, as well as an unaffected control sample consisting of 22 probands completed a 50-item computer-based test to assess the ability to recognize basic emotions. The autistic subjects showed a poorer performance on the facial recognition test than did the schizophrenic and the unaffected individuals. In addition, there was a tendency for subjects from multiplex families with autistic loading to score lower on the test than individuals from simplex families with autistic loading. Schizophrenic subjects and their relatives as well as siblings and parents of autistic subjects did not differ from the sample of unaffected subjects in their ability to judge facial affect. Findings corroborate the assumption that emotion detection deficits are part of the endophenotype of autism. In families with autistic children, the extent of facial recognition deficits probably indexes an elevation in familial burden. It seems unlikely that problems in emotion perception form a consistent part of the endophenotype of schizophrenia or the broader phenotype in relatives of patients with psychosis or autism.

  7. Foreign patients in ER: receiving, understanding, treating

    Directory of Open Access Journals (Sweden)

    Alberto Dal Molin


    Full Text Available In the last years the presence of foreign patients inside Emergency Departments is increased, this means many problems, like misunderstanding, communication difficulties and more problematic situations when, our work or our expectations meet the values sideboards and life style of our patients. This article purpose is to describe this phenomenon inside Biella Emergency Departments, because if you know a situation you can solve it better.

  8. God of the hinge: treating LGBTQIA patients. (United States)

    Boland, Annie


    This paper looks at systems of gender within the context of analysis. It explores the unique challenges of individuation faced by transsexual, transgender, gender queer, gender non-conforming, cross-dressing and intersex patients. To receive patients generously we need to learn how a binary culture produces profound and chronic trauma. These patients wrestle with being who they are whilst simultaneously receiving negative projections and feeling invisible. While often presenting with the struggles of gender conforming individuals, understanding the specifically gendered aspect of their identity is imperative. An analyst's unconscious bias may lead to iatrogenic shaming. The author argues that rigorous, humble inquiry into the analyst's transphobia can be transformative for patient, analyst, and the work itself. Analysis may, then, provide gender-variant patients with their first remembered and numinous experience of authentic connection to self. Conjuring the image of a hinge, securely placed in the neutral region of a third space, creates a transpositive analytic temenos. Invoking the spirit of the Trickster in the construction of this matrix supports the full inclusion of gender-variant patients. Nuanced attunement scaffolds mirroring and the possibility of play. Being mindful that gender is sturdy and delicate as well as mercurial and defined enriches the analyst's listening. © 2017, The Society of Analytical Psychology.

  9. Family expectation, social adjustment and gender differences in a sample of schizophrenic patients Expectativa familiar, ajustamento social e diferenças entre os gêneros numa amostra de pacientes esquizofrênicos

    Directory of Open Access Journals (Sweden)

    Itiro Shirakawa


    Full Text Available A case series to study factors related to family expectation regarding schizophrenic patients was conducted in an out-patient setting in the city of S. Paulo, Brazil. Patients diagnosed as presenting schizophrenia by the ICD 9th Edition and having had the disease for more than four years were included in the study. Family Expectation was measured by the difference between the Katz Adjustment Scale (R2 and R3 scores based on the relative's expectation and the socially expected activities of the patient (Discrepancy Score, and social adjustment was given by the DSM-III-R Global Assessment Scale (GAS . Outcome assessments were made independently, and 44 patients comprised the sample (25 males and 19 females. The Discrepancy mean score was twice as high for males as for females (p Foi realizado estudo de corte transversal para estudar fatores associados às expectativas familiares com familiares ambulatoriais esquizofrênicos pela Classificação Internacional de Doenças, 9ª edição e que tivessem mais de 4 anos de duração da doença foram incluídos no estudo. A expectativa familiar foi medida pela diferença dos escores da Escala de Ajustamento Katz (R2 e R3, que são baseados nas expectativas dos familiares e no nível atual de desempenho das atividades socialmente esperadas (Escore de Discrepância . O ajustamento social foi medido através da Escala de Avaliação Global (GAS do DSM-III-R. As avaliações dos desfechos clínicos foram realizadas independentemente, e a amostra foi constituída por 44 pacientes (25 homens e 19 mulheres. A média do Escore de Discrepância foi duas vezes maior para os homens do que para as mulheres (p < 0,02, e houve uma associação inversa entre o escore de discrepância, quando idade atual e idade de início da doença, e número de admissões psiquiátricas foram controladas através de uma técnica de análise de regressão múltipla. Houve interação entre sexo e ajustamento social, uma rela

  10. A twelve-week randomized controlled study of the cognitive-behavioral Integrated Psychological Therapy program: positive effect on the social functioning of schizophrenic patients Estudo controlado randomizado de 12 semanas do programa cognitivo-comportamental IPT (Terapia Psicológica Integrada com efeito positivo sobre o funcionamento social em pacientes com esquizofrenia

    Directory of Open Access Journals (Sweden)

    Marilene Zimmer


    Full Text Available OBJECTIVES: The present study was designed to evaluate the effect of twelve weekly sessions of the cognitive-behavioral program originally known as the Integriertes Psychologisches Therapieprogramm für Schizophrene Patienten, designated the Integrated Psychological Therapy (IPT program in English, on cognition, social adjustment and quality of life in schizophrenic outpatients, comparing it to the effect of treating such patients as usual. METHOD: Fifty-six adult outpatients (from 18 to 65 years of age with ICD-10-based diagnoses of schizophrenia were randomly assigned to two different groups: active intervention (IPT group; and treatment as usual (control group. Outcome measures were quality of life (as determined using the WHOQOL-Bref, cognition (Mini-Mental State Examination and Word Recall Test, global functioning (DSM-IV Global Assessment of Functioning Scale, social functioning (Social and Occupational Functioning Assessment Scale and social adjustment (Social Adjustment Scale. RESULTS: The findings suggest that, in comparison with treatment as usual (control group, the twelve-session IPT program had a positive effect on several outcome measures: cognition in the domains of spatiotemporal orientation (p = 0.051 and memory (p = 0.031; overall social adjustment (p = 0.037, leisure/social life (p = 0.051 and family relations (p = 0.008; overall functioning (p = 0.000; social-occupational functioning (p = 0.000; and quality of life in the psychological domain (p = 0.021. CONCLUSIONS: The twelve-session cognitive-behavioral IPT intervention demonstrated superiority over treatment as usual in its effects on cognition, social adjustment and quality of life. Studies involving larger samples, longer follow-up periods and additional outcome measures are needed in order to assess the specific effects on dimensions of social functioning, cognitive functioning and quality of life in patients with schizophrenia.OBJETIVOS: O presente estudo foi

  11. Pseudoproteinuria in tolmetin-treated patients. (United States)

    Ehrlich, G E; Wortham, G F


    In a clinical study of the new nonsteroidal anti-inflammatory drug tolmetin, the urines of 5 patients reacted positively when tested for protein by the standard sulfosalicylic acid method. Pseudoproteinuria, due to the precipitation by acid of the major metabolite of tolmetin, was suspected. The urines were subsequently tested for protein by the following alternate methods: solubility of acid precipitate test, heat coagulation test, Upjohn modification of the sulfosalicylic acid test, biuret test, Albustix, and electrophoresis. All were negative for protein. These results confirmed that the reactions with the sulfosalicylic acid test did not indicate true proteinuria but pseudoproteinuria. It is suggested that patients who receive tolmetin be tested for proteinuria by methods other than those involving acid precipitation.

  12. The Cognitive Orientation of Expressive Communicability in Schizophrenics and Normals. (United States)

    Kreitler, Shulamith; And Others


    The study examined the expressive communicability (i.e., the amount, fluency, elaboration, clarity, and veracity of voluntarily transmitted information about oneself) and belief systems of 30 hospitalized adult schizophrenics and 30 matched normals. Schizophrenics differed from normals on all measures and the different beliefs predicted expressed…

  13. Functionally aberrant electrophysiological cortical connectivities in first episode medication-naive schizophrenics from three psychiatry centers

    Directory of Open Access Journals (Sweden)

    Dietrich eLehmann‡


    Full Text Available Functional dissociation between brain processes is widely hypothesized to account for aberrations of thought and emotions in schizophrenic patients. The typically small groups of analyzed schizophrenic patients yielded different neurophysiological findings, probably because small patient groups are likely to comprise different schizophrenia subtypes. We analyzed multichannel eyes-closed resting EEG from three small groups of acutely ill, first episode productive schizophrenic patients before start of medication (from three centers: Bern N=9; Osaka N=9; Berlin N=12 and their controls. Low resolution brain electromagnetic tomography (LORETA was used to compute intracortical source model-based lagged functional connectivity not biased by volume conduction effects between 19 cortical regions of interest (ROIs. The connectivities were compared between controls and patients of each group. Conjunction analysis determined six aberrant cortical functional connectivities that were the same in the three patient groups. Four of these six concerned the facilitating EEG alpha 1 frequency activity; they were decreased in the patients. Another two of these six connectivities concerned the inhibiting EEG delta frequency activity; they were increased in the patients. The principal orientation of the six aberrant cortical functional connectivities was sagittal; five of them involved both hemispheres. In sum, activity in the posterior brain areas of preprocessing functions and the anterior brain areas of evaluation and behavior control functions were compromised by either decreased coupled activation or increased coupled inhibition, common across schizophrenia subtypes in the three patient groups. These results of the analyzed three independent groups of schizophrenics support the concept of functional dissociation.

  14. Communicating with the schizophrenic superego. (United States)

    Levin, R


    The procedure reported here, which I have called "conversations with superegos," raises a number of important questions, both about ordinary versus psychopathological psychic structure, and about technique. There is no space to enter into a lengthy discussion, but a few brief points may be in order. First, let us consider the issue of psychic structure. I have argued that the superego is a hostile agency within the mind whose operations are essentially inimical to the patient's growth and well-being. (As an element of psychic structure, the superego can be distinguished from the ego ideal on the basis of the associated affect, that is, guilt rather than shame. Similarly, it is possible that the superego may be constructed on the basis of identifications that are different than those that may form the basis of the ego ideal). Further, I have argued that the superego is neither a force for true moral development nor a platform for the voice of the patient's "better" nature, (although it purports to be until challenged). A structure that lies, manipulates, threatens, and appears to be motivated in the end solely by its own continued existence, must certainly be considered suspect as an authority on morality. On the contrary, I see true morality originating in the patient's ego, because in that structure lies the ability to identify with others. One could object, however, that this way of viewing the matter is an artifact of working with a particular patient population. That is to say, it might be the case that in psychotic and borderline psychotic conditions, the superego does function this way, whereas in healthy or neurotic conditions it does not. In a similar vein, it could be argued that a pattern of development that was sufficiently skewed so as to result in psychosis would be more than likely to have been peopled by hostile, punitive, and essentially destructive identification figures, such as could form the basis for a pathological superego, whereas in normal

  15. Is non-pharmacological treatment an option for certain schizophrenia patients? (United States)

    Matei, Valentin P; Mihailescu, Alexandra I; Davidson, Michael


    Schizophrenia treatment has been debated at length and presently pharmacological treatment is being advocated as the most beneficial for patients. However, research has shown contradictory results regarding the suitability of pharmacological treatment for certain groups of schizophrenia patients. The present review discusses results from the literature indicating good outcomes only for patients who adhered to prescribed pharmacological treatments. It also describes studies favoring non-drug treatments in certain schizophrenic patients. The authors described two groups of patients where the long-term use of neuroleptics may be useless, if not harmful. The first group comprised schizophrenic people with a single psychotic episode and therefore very good prognosis. In their case, the prolonged use of antipsychotics would not be beneficial due to pharmacological and social (stigma) side effects. Further research is warranted to identify and investigate biological, environmental, and psychological factors associated with single-episode schizophrenia. The second group comprised ultra-resistant schizophrenic patients. In their case, in the absence of a therapeutic response in acute episodes or aggressive behavior, clinicians should use short episodes of treatment with benzodiazepines or other sedative medications such as mood stabilizers. The present paper attempted to answer the important question as to whether all schizophrenic people should be treated with antipsychotics for the same good prognosis. The authors have provided solutions for better outcomes in a greater number of patients using alternative treatment after identifying schizophrenic patients who should not receive neuroleptic treatment. Suggestions for future research are also discussed.

  16. Qualidade de vida de familiares cuidadores do doente esquizofrênico Calidad de vida de familiares que cuidan de pacientes esquisofrenicos Life quality of family caregivers of schizophrenic patient

    Directory of Open Access Journals (Sweden)

    Marina Borges Teixeira


    Full Text Available Objetivou-se verificar o conceito de qualidade de vida (QV de familiares cuidadores de pacientes esquizofrênicos e identificar fatores que interferem em sua qualidade de vidas. Para tanto, foi realizada uma pesquisa exploratório-descritiva, transversal, de campo com 52 familiares cuidadores que residiam com o paciente. Concluiu-se que os familiares definiram qualidade de vida como: "ter saúde, poder trabalhar e sustentar a família" (35; "ter saúde"(9; "ter saúde, ter bons hospitais e morar em um bairro melhor"(3; "ter saúde e continuar tratando deles" (2; "ter saúde e casa própria" (2;"ter dinheiro para tratar melhor dele"(1. Entre os fatores que interferiram em suas vidas o "deixar de ir a igreja"; "não sair com amigos"; "deixar de trabalhar " e "não ter mais tempo para si mesmo" foram os que sobressaíram.Se apuntó a verificar el concepto de calidad de vida (CV de familiares que cuidam de pacientes esquisofrenicos y identificar factores que interfieren en su calidad de vida. Así, una investigación exploratorio-descriptiva y transversal fue cumplida con 52 de conserjes familiares que moram con el paciente. Se concluye que los parientes definieron la calidad de vida como: "tener la salud, trabajar y sostener a la familia" (35; "tener la salud (9; "tener la salud, tener buenos hospitales y vivir en un barrio bueno" (3; "tener la salud y continuar cuidan de ellos" (2; "tener salud y casa propia" (2; "tener el dinero para tratar bien de él" (1. Entre los factores que interfirieron en sus vidas "no ir a la iglesia"; "no salir con los amigos"; "no salir para trabajar" y "no tener más tiempo por su cuidado" fueran los más evidentes.It was aimed to verify the concept of life quality (LQ of family caregivers of schizophrenic patient bearers and to identify the factors that interfere in their quality lives. For that an exploratory-descriptive, and traverse research was accomplished with 52 family caregivers that live with the patient. It

  17. Metallic taste in cancer patients treated with chemotherapy

    NARCIS (Netherlands)

    Ijpma, I.; Renken, R. J.; ter Horst, G. J.; Reyners, A. K. L.

    Background: Metallic taste is a taste alteration frequently reported by cancer patients treated with chemotherapy. Attention to this side effect of chemotherapy is limited. This review addresses the definition, assessment methods, prevalence, duration, etiology, and management strategies of metallic

  18. Treatment Related Cardiac Toxicity in Patients Treated for Breast Cancer

    National Research Council Canada - National Science Library

    Marks, Lawrence B


    To determine the incidence, dose/time-dependence, and functional significance of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT...

  19. Treatment Related Cardiac Toxicity in Patients Treated for Breast Cancer

    National Research Council Canada - National Science Library

    Marks, Lawrence B


    Purpose: To determine the incidence dose/time-dependence and functional significance of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT...

  20. Treatment Related Cardiac Toxicity in Patients Treated for Breast Cancer

    National Research Council Canada - National Science Library

    Marks, Lawrence


    To determine the incidence, dose/time-dependence, and functional significance of regional cardiac perfusion abnormalities in patients with left-sided breast cancer treated with radiation therapy (RT...

  1. One-Year Follow-Up of Serum Prolactin Level in Schizophrenia Patients Treated with Blonanserin: A Case Series


    Takahashi, Sakae; Suzuki, Masahiro; Uchiyama, Makoto


    In our previous study, a prolactin elevation was more frequently in risperidone than in blonanserin; however, it was more often in blonanserin than in olanzapine. Therefore, while a rate of PRL rising is low to moderate, hyperprolactinemia is a considerable adverse effect in the blonanserin treatment. In this study, to examine detailed characteristics of hyperprolactinemia of blonanserin, we analyzed the prolactin data in six schizophrenic patients who were switched to blonanserin from other ...

  2. Multiple Gastrointestinal Polyps in Patients Treated with BRAF Inhibitors. (United States)

    Amaravadi, Ravi K; Hamilton, Kathryn E; Ma, Xiaohong; Piao, Shengfu; Portillo, Armando Del; Nathanson, Katherine L; Carlino, Matteo S; Long, Georgina V; Puzanov, Igor; Xu, Xiaowei; Morrissette, Jennifer J D; Tsai, Kenneth Y; Flaherty, Keith T; Sosman, Jeffrey A; Goodman, Grant R; McArthur, Grant A; Rustgi, Anil K; Metz, David C; Schuchter, Lynn M; Chapman, Paul B; Sepulveda, Antonia R


    BRAF inhibitors (BRAFi) extend survival in BRAF-mutant melanoma but can promote the growth of Ras-mutant neoplasms. This study determined if gastrointestinal polyps found in BRAFi-treated patients harbored Ras mutations. Colonic and gastric polyps were identified and resected from BRAFi-treated melanoma patients. Next-generation sequencing (NGS) was performed on polyps. The ability of BRAFi to promote polyp formation was functionally characterized in Apc Min(+/-) mice. MAPK and β-catenin pathway activity was assessed by immunohistochemistry in mouse and human polyps. Fourteen patients treated with BRAFi underwent endoscopy to assess for polyps. Seven out of 7 patients >40 years of age and treated for >2 years were found to have colonic tubular adenomas with 4 out of the 7 patients having 5 or more polyps. One patient presented with bleeding from hyperplastic gastric polyps that recurred 6 months after BRAFi rechallenge. NGS performed on polyps found no mutations in MAPK pathway genes, but found APC mutations in all tubular adenomas. A significant increase in the number of polyps was observed in BRAFi-treated compared with control-treated Apc Min(+/-) mice (20.8 ± 9.2 vs 12.8 ± 0.1; P = 0.016). No polyps were observed in BRAFi-treated wild-type mice. BRAFi may increase the risk of developing hyperplastic gastric polyps and colonic adenomatous polyps. Due to the risk of gastrointestinal bleeding and the possibility of malignant transformation, further studies are needed to determine whether or not endoscopic surveillance should be recommended for patients treated with BRAFi. ©2015 American Association for Cancer Research.

  3. Characterization of the CPAP-treated patient population in Catalonia. (United States)

    Turino, Cecilia; Bertran, Sandra; Gavaldá, Ricard; Teixidó, Ivan; Woehrle, Holger; Rué, Montserrat; Solsona, Francesc; Escarrabill, Joan; Colls, Cristina; García-Altés, Anna; de Batlle, Jordi; Sánchez de-la-Torre, Manuel; Barbé, Ferran


    There are different phenotypes of obstructive sleep apnoea (OSA), many of which have not been characterised. Identification of these different phenotypes is important in defining prognosis and guiding the therapeutic strategy. The aim of this study was to characterise the entire population of continuous positive airway pressure (CPAP)-treated patients in Catalonia and identify specific patient profiles using cluster analysis. A total of 72,217 CPAP-treated patients who contacted the Catalan Health System (CatSalut) during the years 2012 and 2013 were included. Six clusters were identified, classified as "Neoplastic patients" (Cluster 1, 10.4%), "Metabolic syndrome patients" (Cluster 2, 27.7%), "Asthmatic patients" (Cluster 3, 5.8%), "Musculoskeletal and joint disorder patients" (Cluster 4, 10.3%), "Patients with few comorbidities" (Cluster 5, 35.6%) and "Oldest and cardiac disease patients" (Cluster 6, 10.2%). Healthcare facility use and mortality were highest in patients from Cluster 1 and 6. Conversely, patients in Clusters 2 and 4 had low morbidity, mortality and healthcare resource use. Our findings highlight the heterogeneity of CPAP-treated patients, and suggest that OSA is associated with a different prognosis in the clusters identified. These results suggest the need for a comprehensive and individualised approach to CPAP treatment of OSA.

  4. Subverting Space: An Exploration of a Dance Therapy Workshop Apparatus for Schizophrenics. (United States)

    Lippi, Silvia; Petit, Laetitia


    The authors created a dance workshop for schizophrenic patients designed to address their singular experience of space, in which the categories of interior and exterior do not function as limits. The space of the workshop, which, paradoxically, is thought in terms of the psychic space of schizophrenic patients by playing on its borderless quality, creates a continuity between the psychiatric hospital and the external world, and thus helps to prevent the segregation and isolation of such patients. This continuity is established on the basis of both the physical architecture of the workshop setting and the practice of dancing itself. The authors explore the hypothesis that, inside the particular space made possible by the apparatus of the workshop, schizophrenic patients benefit from the experience of movement, beginning with the pulse of rhythm, which establishes a consistency in time. By means of its repetitive character, the beat of music, like movement, accompanies and promotes the experience of continuity, which is the condition for any possible form of symbolizing. Two brief clinical illustrations show how this approach to dance therapy allows a moribund jouissance to be overturned and transformed into the aesthetic jouissance that characterizes the experience of dance.

  5. Influencing and moderating factors analyzed in the group art therapy of two schizophrenic inpatients. (United States)

    Hung, Chung-Chieh; Ku, Yung-Wen


    Art therapy has been considered a guideline treatment for schizophrenia. Due to difficulty in the outcome measurement, the research is difficult and controversial. Here, we presented two schizophrenic patients receiving the regular art group therapy. We compared their characteristics and different outcome. Art therapy is difficult to quantify. However, we could qualify the improvement from the individual case. Further study might be focus on how to make appropriate qualification of art therapy and individualized difference instead of enrollment of huge data bank.

  6. Cognitive function in patients with chronic pain treated with opioids

    DEFF Research Database (Denmark)

    Kurita, G P; de Mattos Pimenta, C A; Braga, P E


    The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated...... with opioids....

  7. Health status in patients treated with cardiac resynchronization therapy

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Denollet, Johan; Pedersen, Susanne S.


    Cardiac resynchronization therapy (CRT) is a promising treatment in chronic heart failure (CHF). However, a subgroup of patients still report impaired health status, cardiac symptoms, and feelings of disability following CRT. The aims of this study were to examine (1) whether CHF patients treated...

  8. Atrial fibrillation in fracture patients treated with oral bisphosphonates

    DEFF Research Database (Denmark)

    Abrahamsen, B; Eiken, P; Brixen, K


    increased even in patients who stopped therapy after the first packet and (ii) risks were not increased by high adherence. Bisphosphonate-exposed patients were at increased risk of hospital-treated AF [adjusted HR: 1.13 (1.01-1.26)], but the risk amongst bisphosphonate users was inversely proportional...

  9. Metabolic control of type 2 diabetic patients commonly treated with ...

    African Journals Online (AJOL)

    Fasting insulin and glucose concentrations were used to assess insulin resistance and sensitivity (%S) using Homeostasis model assessment (HOMA) method. Results: Of the 179 patients studied, 87% of male and 92% of female patients were treated with sulphonylurea drugs whereas 13% and 9% of male and female ...

  10. Treating depression in HIV-positive patients affects adherence

    African Journals Online (AJOL)


    Sep 2, 2012 ... ART adherence in a group of HIV-positive patients with depression at Chris Hani Baragwanath Academic Hospital. Treating depression in HIV-positive patients affects adherence. M Y H Moosa, F Y Jeenah. Division of Psychiatry, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg.

  11. The morbidity and mortality of surgically treated urological patients ...

    African Journals Online (AJOL)

    Objective: To determine the morbidity and mortality of surgically treated urological patients at Moi Teaching and Referral Hospital (MTRH) and compare them with those of other tertiary centres. Design: A fi ve year hospital based, retrospective study reviewing files of patients who underwent surgery for urological problems in ...

  12. Hypereosinophilia in patients with multiple sclerosis treated with natalizumab. (United States)

    Abbas, M; Lalive, P H; Chofflon, M; Simon, H-U; Chizzolini, C; Ribi, C


    To report asymptomatic hypereosinophilia as a potential side effect in patients treated with natalizumab, an α-4 integrin blocking agent. A case series of 3 patients treated with natalizumab for relapsing-remitting multiple sclerosis including functional and phenotypic characterization of their peripheral blood lymphocytes and eosinophils is presented. Marked peripheral blood eosinophilia with more than 2,000 cells/mm(3) emerged in all 3 patients after the fourth natalizumab infusion and was asymptomatic. Hypereosinophilia was associated with enhanced Th2 activity, ceased with drug discontinuation, and in 2 of 3 patients recurred with drug resumption. Despite persistently high eosinophil counts, there were no signs of end-organ damage. Hypereosinophilia may occur during treatment with natalizumab. It seems to reflect enhanced Th2 activity and recedes with systemic corticosteroids. If the patient is asymptomatic, natalizumab may be continued, provided that other causes of eosinophilia are excluded and the patient is carefully monitored.

  13. A systematic review of implant outcomes in treated periodontitis patients. (United States)

    Sousa, Vanessa; Mardas, Nikos; Farias, Bruna; Petrie, Aviva; Needleman, Ian; Spratt, David; Donos, Nikolaos


    To investigate the effect of treated periodontitis on implant outcomes in partially edentulous individuals compared with periodontally healthy patients. Longitudinal studies reporting on implant survival, success, incidence of peri-implantitis, bone loss and periodontal status, and on partially dentate patients with a history of treated periodontitis were included. The search yielded 14,917 citations. Twenty-seven publications met the inclusion criteria for qualitative data synthesis. Implant success and survival were higher in periodontally healthy patients, whilst bone loss and incidence of peri-implantitis was increased in patients with history of treated periodontitis. There was a higher tendency for implant loss and biological complications in patients previously presenting with severe forms of periodontitis. The strength of the evidence was limited by the heterogeneity of the included studies in terms of study design, population, therapy, unit of analysis, inconsistent definition of baselines and outcomes, as well as by the inadequate reporting of statistical analysis and accounting for confounding factors; thus, meta-analysis could not be performed. Implants placed in patients treated for periodontal disease are associated with higher incidence of biological complications and lower success and survival rates than those placed in periodontally healthy patients. Severe forms of periodontal disease are associated with higher rates of implant loss. However, it is critical to develop well-designed, long-term prospective studies to provide further substantive evidence on the association of these outcomes. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  14. Treatment of patients with first-episode psychosis: two-year outcome data from the Danish National Schizophrenia Project

    DEFF Research Database (Denmark)

    Rosenbaum, Bent; Valbak, Kristian; Harder, Susanne


    First episode psychosis interventions have been in focus in the last two decades in an attempt to improve the course and outcome of schizophrenic disorders. The Danish National Schizophrenia Project began in 1997 its intake of patients, aged 16-35, with a first psychotic episode of a schizophrenic...... patients in the treatment-as-usual group. Improvement in the intervention groups continued into the second year. Patients receiving integrated assertive treatment faired better than those being treated with the less intensive method of supportive psychodynamic psychotherapy, and the latter group improved...

  15. Intrahepatic Flow Redistribution in Patients Treated with Radioembolization

    Energy Technology Data Exchange (ETDEWEB)

    Spreafico, Carlo, E-mail:; Morosi, Carlo, E-mail: [Fondazione Istituto Tumori, Department of Radiology (Italy); Maccauro, Marco, E-mail: [Fondazione Istituto Tumori, Department of Nuclear Medicine (Italy); Romito, Raffaele, E-mail: [Fondazione Istituto Tumori, Department of Liver Surgery and Transplant (Italy); Lanocita, Rodolfo, E-mail:; Civelli, Enrico M., E-mail: [Fondazione Istituto Tumori, Department of Radiology (Italy); Sposito, Carlo, E-mail:; Bhoori, Sherrie, E-mail: [Fondazione Istituto Tumori, Department of Liver Surgery and Transplant (Italy); Chiesa, Carlo, E-mail: [Fondazione Istituto Tumori, Department of Nuclear Medicine (Italy); Frigerio, Laura F., E-mail: [Fondazione Istituto Tumori, Department of Radiology (Italy); Lorenzoni, Alice, E-mail: [Fondazione Istituto Tumori, Department of Nuclear Medicine (Italy); Cascella, Tommaso, E-mail:; Marchianò, Alfonso, E-mail: [Fondazione Istituto Tumori, Department of Radiology (Italy); Mazzaferro, Vincenzo, E-mail: [Fondazione Istituto Tumori, Department of Liver Surgery and Transplant (Italy)


    IntroductionIn planning Yttrium-90 ({sup 90}Y)-radioembolizations, strategy problems arise in tumours with multiple arterial supplies. We aim to demonstrate that tumours can be treated via one main feeding artery achieving flow redistribution by embolizing accessory vessels.MethodsOne hundred {sup 90}Y-radioembolizations were performed on 90 patients using glass microspheres. In 19 lesions/17 patients, accessory branches were found feeding a minor tumour portion and embolized. In all 17 patients, the assessment of the complete perfusion was obtained by angiography and single photon emission computerized tomography–computerized tomography (SPECT–CT). Dosimetry, toxicity, and tumor response rate of the patients treated after flow redistribution were compared with the 83 standard-treated patients. Seventeen lesions in 15 patients with flow redistribution were chosen as target lesions and evaluated according to mRECIST criteria.ResultsIn all patients, the complete tumor perfusion was assessed immediately before radioembolization by angiography in all patients and after the {sup 90}Y-infusion by SPECT–CT in 15 of 17 patients. In the 15 assessable patients, the response rate in their 17 lesions was 3 CR, 8 PR, and 6 SD. Dosimetric and toxicity data, as well tumour response rate, were comparable with the 83 patients with regular vasculature.ConclusionsAll embolization procedures were performed successfully with no complications, and the flow redistribution was obtained in all cases. Results in term of toxicity, median dose administered, and radiological response were comparable with standard radioembolizations. Our findings confirmed the intratumoral flow redistribution after embolizing the accessory arteries, which makes it possible to treat the tumour through its single main feeding artery.

  16. Lower frequency of the low activity adenosine deaminase allelic variant (ADA1*2 in schizophrenic patients Diminuição da frequência da variante alélica de baixa atividade da adenosina desaminase (ADA1*2 em pacientes esquizofrênicos

    Directory of Open Access Journals (Sweden)

    Gustavo Pimentel Dutra


    Full Text Available OBJECTIVE: Adenosine may play a role in the pathophysiology of schizophrenia, since it modulates the release of several neurotransmitters such as glutamate, dopamine, serotonin and acetylcholine, decreases neuronal activity by pos-synaptic hyperpolarization and inhibits dopaminergic activity. Adenosine deaminase participates in purine metabolism by converting adenosine into inosine. The most frequent functional polymorphism of adenosine deaminase (22G→A (ADA1*2 exhibits 20-30% lower enzymatic activity in individuals with the G/A genotype than individuals with the G/G genotype. The aim of this study was to evaluate the ADA polymorphism 22G→A (ADA1*2 in schizophrenic patients and healthy controls. METHOD: The genotypes of the ADA 22G→A were identified with allele-specific PCR strategy in 152 schizophrenic patients and 111 healthy individuals. RESULTS: A significant decrease in the frequency of the G/A genotype was seen in schizophrenic patients (7/152 - 4.6% relative to controls (13/111 - 11.7%, p = 0.032, OR = 2.6. CONCLUSION: These results suggest that the G/A genotype associated with low adenosine deaminase activity and, supposingly, with higher adenosine levels is less frequent among schizophrenic patients.OBJETIVO: A adenosina pode ter um papel importante na fisiopatologia da esquizofrenia, uma vez que modula a liberação de vários neurotransmissores, tais como glutamato, dopamina, serotonina e acetilcolina, diminui a atividade neuronal por hiperpolarização pós-sináptica e inibe a atividade dopaminérgica. A adenosina desaminase participa do metabolismo das purinas pela conversão de adenosina em inosina. O mais frequente polimorfismo funcional da adenosina desaminase (22G →A (ADA1*2 exibe uma diminuição de 20-30% da atividade funcional em indivíduos com genótipo G/A quando comparados com indivíduos com o genótipo G/G. O objetivo deste estudo foi avaliar o polimorfismo 22G→A (ADA1*2 em pacientes esquizofrênicos e em

  17. Early information processing deficit in schizophrenia. New findings using schizophrenic subgroups and manic control subjects. (United States)

    Saccuzzo, D P; Braff, D L


    In recent years, the idea that schizophrenia involves a primary disturbance of the higher cognitive (ie, cortical) thinking processes has been challenged by investigators who have shown that there may be a primary disturbance in schizophrenia in the early stages of information processing that occurs during the first few hundred milliseconds after the stimulus reaches the sense organs. Among the hypothesized early information processing deficits are deficiencies in iconic storage (a brief peripheral memory store) and slowness of processing from iconic storage to a more permanent memory system. Three experiments were conducted using tachistoscopically presented stimuli in order to evaluate these two stages of information processing (iconic storage and speed of processing) in schizophrenic and control subjects. Results converged in supporting the hypothesis, that independent of iconic storage and sensory registration, slow information processing is a relatively stable deficit of schizophrenic patients with a poor prognosis. The schizophrenic patients with a good prognosis had a similar deficit, which was reversible. Results are discussed as they relate to the early information processing deficit theories of schizophrenia.

  18. Metallic taste in cancer patients treated with chemotherapy. (United States)

    IJpma, I; Renken, R J; Ter Horst, G J; Reyners, A K L


    Metallic taste is a taste alteration frequently reported by cancer patients treated with chemotherapy. Attention to this side effect of chemotherapy is limited. This review addresses the definition, assessment methods, prevalence, duration, etiology, and management strategies of metallic taste in chemotherapy treated cancer patients. Literature search for metallic taste and chemotherapy was performed in PubMed up to September 2014, resulting in 184 articles of which 13 articles fulfilled the inclusion criteria: English publications addressing metallic taste in cancer patients treated with FDA-approved chemotherapy. An additional search in Google Scholar, in related articles of both search engines, and subsequent in the reference lists, resulted in 13 additional articles included in this review. Cancer patient forums were visited to explore management strategies. Prevalence of metallic taste ranged from 9.7% to 78% among patients with various cancers, chemotherapy treatments, and treatment phases. No studies have been performed to investigate the influence of metallic taste on dietary intake, body weight, and quality of life. Several management strategies can be recommended for cancer patients: using plastic utensils, eating cold or frozen foods, adding strong herbs, spices, sweetener or acid to foods, eating sweet and sour foods, using 'miracle fruit' supplements, and rinsing with chelating agents. Although metallic taste is a frequent side effect of chemotherapy and a much discussed topic on cancer patient forums, literature regarding metallic taste among chemotherapy treated cancer patients is scarce. More awareness for this side effect can improve the support for these patients. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Hair cortisol measurement in mitotane-treated adrenocortical cancer patients. (United States)

    Manenschijn, L; Quinkler, M; van Rossum, E F C


    The only approved drug for the treatment of adrenocortical cancer (ACC) is mitotane. Mitotane is adrenolytic and therefore, hydrocortisone replacement therapy is necessary. Since mitotane increases cortisol binding globulin (CBG) and induces CYP3A4 activity, high doses of hydrocortisone are thought to be required. Evaluation of hydrocortisone therapy in mitotane-treated patients has been difficult since there is no good marker to evaluate hydrocortisone therapy. Measurement of cortisol in scalp hair is a novel method that offers the opportunity to measure long-term cortisol levels. Our aim was to evaluate whether hair cortisol measurements could be useful in evaluating recent hydrocortisone treatment in mitotane-treated ACC patients. Hair cortisol levels were measured in 15 mitotane-treated ACC patients on hydrocortisone substitution and 96 healthy individuals. Cortisol levels were measured in 3 cm hair segments, corresponding to a period of 3 months. Hair cortisol levels were higher in ACC patients compared to healthy individuals (pcortisol levels above the reference range. None of the patients had hair cortisol levels below normal. In contrast to hydrocortisone doses (β=0.03, p=0.93), hair cortisol levels were associated with BMI (β=0.53, p=0.042). There was no correlation between hair cortisol levels and hydrocortisone doses (β=0.41, p=0.13). Almost half of the ACC patients had high hair cortisol levels, suggesting long-term over-substitution of hydrocortisone in some of the patients, whereas none of the patients was under-substituted. Hair cortisol measurements might be useful in long-term monitoring hydrocortisone treatment in mitotane-treated ACC patients. © Georg Thieme Verlag KG Stuttgart · New York.

  20. [The successfully treated patients - are they the satisfied ones?]. (United States)

    Brinkers, Michael; Gerth, Nico; Pfau, Giselher; Hachenberg, Thomas


    The current scientific opinion on the success of a therapy is that patients having undergone a successful therapy are satisfied. However, in reality, it is possible that patients with poor living conditions are satisfied (well-being paradox) whereas patients treated successfully are not (dissonance). The higher the psychological distress, the more rare is the assumption that successful therapy is an equivalent of satisfaction. Satisfaction depends more on fulfillment of patient expectations and involvement of the physicians. © Georg Thieme Verlag Stuttgart · New York.

  1. The changing face of HIV/AIDS in treated patients. (United States)

    Llibre, Josep M; Falco, Vicenç; Tural, Cristina; Negredo, Eugenia; Pineda, Juan A; Muñoz, Jose; Ortega, Enrique; Videla, Sebastia; Sirera, Guillem; Martinez, Esteban; Miralles, Celia; Iribarren, Josean; Galindo, Maria J; Domingo, Pere; d'Arminio-Monforte, Antonella; Miro, Jose M; Clotet, Bonaventura


    The spectrum of complications emerging in successfully treated HIV-infected patients has dramatically changed since the advent of HAART. Typical AIDS-defining illnesses have been substituted by new comorbid conditions that threaten even those patients who maintain virologic suppression. Proper management of cardiovascular risk, and early diagnosis of AIDS-related and, particularly, non-AIDS-related malignancies (including papilomavirus-related neoplasms) must be introduced into the routine of care. Hot areas of investigation include HIV-associated neurocognitive disorders, hepatitis B and C coinfection, non-alcoholic fatty liver disease, progressive multifocal leukoencephalopathy and tuberculosis. Bone and kidney long-term toxicities and lipoatrophy remain as issues of paramount importance. The identification and early treatment of immune reconstitution disease is also of major interest, specially in those patients starting their antiretroviral treatment with severe CD4 cell depletion. The present review focuses on these twelve areas of increasing interest for physicians currently facing successfully treated HIV+ patients.

  2. Polyarthritis flare in patient with ankylosing spondylitis treated with infliximab

    Directory of Open Access Journals (Sweden)

    E. Filippucci


    Full Text Available Over the last ten years, the treatment of seronegative spondyloarthropathies has changed dramatically with the introduction of the anti-tumor necrosis factor alpha (TNFα agents. Nevertheless, there is a growing number of studies describing several adverse reactions in patients treated with biological agents. In the present report we describe the case of a 22-year-old male patient with ankylosing spondylitis who developed a “paradoxic” adverse reaction, while receiving infliximab.

  3. Severe hyponatraemia in an amiloride/hydrochlorothiazide-treated patient

    NARCIS (Netherlands)

    Van Assen, S.; Mudde, A.H.


    A 85-year-old woman treated with, among other drugs, a thiazide diuretic presented with a severe hyponatraemia. She met several of the criteria for SIADH and, besides drugs, no cause for SIADH was found. After stopping the thiazide diuretic and restricting fluid intake the patient recovered fully.

  4. metabolic control of type-2 diabetic patients commonly treated with ...

    African Journals Online (AJOL)



    Apr 4, 2003 ... Objective: To assess metabolic control in type 2 diabetic patients predominantly treated with sulphonylurea ... shown that the disorder has a hereditary background(1,2) and often .... of fasting plasma glucose, HbA1c, triglycerides and LDL- ..... Weir, G.C. Non-insulin dependent diabetes mellitus: interplay.

  5. Haematological alteration in Leprosy patients treated with dapsone ...

    African Journals Online (AJOL)

    Objective: To evaluate the haemoglobin concentration (Hb); total white blood cell count (WBC), differential WBC count; platelet count and reticulocyte count in leprosy patients already treated with dapsone. Design: A case-control study. Setting: Specialist Hospital Ossiomo, which is a Leprosarium and Haematology ...

  6. A 3- Year Review of Patients with Chronic Empyema Treated ...

    African Journals Online (AJOL)

    Background: Empyema thoracic is one of the main causes of morbidity and mortality in developing countries. This study was aimed at determining the causes, clinical presentation, outcomes of surgical intervention and variables associated with adverse outcomes in patients with chronic empyema treated surgically.

  7. Risperidone versus zuclopenthixol in the treatment of acute schizophrenic episodes: a double-blind parallel-group trial. (United States)

    Huttunen, M O; Piepponen, T; Rantanen, H; Larmo, I; Nyholm, R; Raitasuo, V


    A double-blind, randomized, multi-center, parallel-group study was conducted in Finland to compare the efficacy and safety of risperidone with zuclopenthixol in patients with acute exacerbations of schizophrenia or schizophreniform disorder. Ninety-eight patients were randomly assigned to treatment with risperidone (n = 48) or zuclopenthixol (n = 50), in variable doses, for 6 weeks. The mean daily doses of risperidone and zuclopenthixol at the end of the trial were 8 mg and 38 mg respectively. Efficacy was assessed throughout by the Positive and Negative Syndrome Scale for schizophrenia and Clinical Global Impression. Safety assessments included the Extrapyramidal Symptom Rating Scale, UKU Side-Effect Rating Scale, vital signs, body weight and laboratory screening. The results indicate that risperidone is at least as effective as zuclopenthixol for the treatment of acute schizophrenic episodes, with a trend towards greater improvement in the overall severity of symptoms. The onset of action was significantly shorter with risperidone than with zuclopenthixol. Although the general tolerability of the two drugs was comparable, fewer patients experienced extrapyramidal symptoms with risperidone, so that significantly fewer risperidone-treated patients required antiparkinsonian medication.

  8. Physical Activity in Patients Treated With Peritoneal Dialysis

    Directory of Open Access Journals (Sweden)

    Tharshika Thangarasa


    Full Text Available Background: Patients with chronic diseases are known to benefit from exercise. Despite a lack of compelling evidence, patients with end-stage kidney disease treated with peritoneal dialysis are often discouraged from participating in exercise programs that include resistance training due to concerns about the development of hernias and leaks. The actual effects of physical activity with or without structured exercise programs for these patients remain unclear. The purpose of this study is to more completely define the risks and benefits of physical activity in the end-stage kidney disease population treated with peritoneal dialysis. Methods/design: We will conduct a systematic review examining the effects of physical activity on end-stage kidney disease patients treated with peritoneal dialysis. For the purposes of this review, exercise will be considered a purposive subcategory of physical activity. The primary objective is to determine if physical activity in this patient population is associated with improvements in mental health, physical functioning, fatigue and quality of life and if there is an increase in adverse outcomes. With the help of a skilled librarian, we will search MEDLINE, EMBASE, CINAHL, and Cochrane Central Register of Controlled Trials for randomized trials and observational studies. We will include adult end-stage kidney disease patients treated with peritoneal dialysis that have participated in an exercise training program or had their level of physical activity assessed directly or by self-report. The study must include an assessment of the association between physical activity and one of our primary or secondary outcomes measures. We will report study quality using the Cochrane Risk of Bias Assessment Tool for randomized controlled trials and the Newcastle–Ottawa Scale for observational studies. Quality across studies will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE

  9. Addison disease in patients treated with glucocorticoid therapy.

    LENUS (Irish Health Repository)

    Cronin, C C


    Acute adrenal crisis in patients with unrecognized chronic adrenocortical failure is difficult to diagnose and potentially fatal. We describe 2 patients with acute adrenal crisis whose diagnoses were hindered because of concomitant glucocorticoid treatment. Acute adrenal insufficiency is primarily a state of mineralocorticoid deficiency. Prednisolone and prednisone, the most frequently prescribed anti-inflammatory corticosteroid agents, have minimal mineralocorticoid activity. Several conditions that may be treated with pharmacological glucocorticoids are associated with an increased risk of Addison disease. An acute adrenal crisis, against which concurrent glucocorticoid therapy does not confer adequate protection, may develop in such patients.

  10. Implant therapy on patients treated with oral bisphosphonates

    Directory of Open Access Journals (Sweden)

    Aris Petros Tripodakis


    Full Text Available Aim: Bisphosphonates represent a group of drugs with a significant effect on bone structure preventing bone remodelling. They can be administered for the treatment of osteoporosis, Paget’s disease, osteogenesis imperfecta, osteopenia and bone metastases. The aim of this study was to discuss the necessary precautions for successful implant therapy on patients treated with per os bisphosphonates. Case reports: Two female patients, both in the seventh decade of life, requested implant therapy. Their medical history was significant for osteoporosis, managed with per os bisphosphonates (Risedronate and Alendronate, respectively, without other risk factors for osteonecrosis. The duration of bisphosphonate administration was 4 years and 2 months respectively. After consultation with the treating physician, the patients stopped the bisphosphonates 3 months before and 3 months after the placement of the implants. The patients received antibiotic coverage for the surgical interventions. The treatment plan was completed uneventfully with placement of fixed prostheses without complications during a 2-year follow-up period. Conclusion: The greatest dental treatment-related risk for patients on bisphosphonate therapy is bisphosphonate-associated osteonecrosis, which presents with exposure of avascular bone of the jaws and, according to the clinical stage, pain, inflammation, fractures and/or extensive osteolysis. Most of reported cases of bisphosphonate-associated osteonecrosis consist of patients on intravenous drug therapy who had undergone dentoalveolar surgery. Patients on per os bisphosphonates may undergo all types of dentoalveolar surgery, including implant placement, as long as the necessary precautions (bisphosphonate discontinuation, antibiotic coverage, meticulous oral hygiene are taken.

  11. Ventricular arrhythmias in patients treated with methadone for opioid dependence. (United States)

    Hanon, Sam; Seewald, Randy M; Yang, Felix; Schweitzer, Paul; Rosman, Jonathan


    Over the last decade, there has been a significant rise in reported cases of methadone induced QT prolongation (QTP) and Torsades de Pointes (TdP) in patients treated for opioid dependence. Optimal management of these patients is challenging. We report a case series of 12 consecutive patients admitted to our institution with methadone-induced QTP and ventricular arrhythmias. All patients survived the presenting arrhythmia. Successful transition to buprenorphine was accomplished in three patients. QT interval normalized and none of these patients had recurrent arrhythmias. Methadone dose was reduced in five patients with improvement of QT interval and resolution of arrhythmia. Four patients, including two with ICDs, refused or did not tolerate a reduction in their methadone dose. Ventricular arrhythmias in patients on methadone are an uncommon but important problem. Buprenorphine, a partial micro-opiate-receptor agonist and a kappa-opiate-receptor antagonist does not cause QTP or TdP. Buprenorphine is a useful and effective alternative to methadone in a select group of patients, including those with documented ventricular arrhythmias on methadone. Pacemakers or defibrillators should be reserved for patients who have failed buprenorphine or a reduced methadone dose.

  12. Practical Management Guide for Clinicians Who Treat Patients with Amiodarone. (United States)

    Epstein, Andrew E; Olshansky, Brian; Naccarelli, Gerald V; Kennedy, John I; Murphy, Elizabeth J; Goldschlager, Nora


    Amiodarone, an iodinated benzofuran derivative with Class I, II, III, and IV antiarrhythmic properties, is the most commonly used antiarrhythmic drug used to treat supraventricular and ventricular arrhythmias. Appropriate use of this drug, with its severe and potentially life-threatening adverse effects, requires an essential understanding of its risk-benefit properties in order to ensure safety. The objective of this review is to afford clinicians who treat patients receiving amiodarone an appropriate management strategy for its safe use. The authors of this consensus management guide have thoroughly reviewed and evaluated the existing literature on amiodarone and apply this information, along with the collective experience of the authors, in its development. Provided are management guides on the intravenous and oral dosing of amiodarone, appropriate outpatient follow-up of patients taking the drug, its recognized adverse effects, and recommendations on when to consult specialists to help in patient management. All clinicians must be cognizant of the appropriate use, follow-up, and adverse reactions of amiodarone. The responsibility incurred by those treating such patients cannot be overemphasized. Published by Elsevier Inc.

  13. [Circulating endothelial progenitor cell levels in treated hypertensive patients]. (United States)

    Maroun-Eid, C; Ortega-Hernández, A; Abad, M; García-Donaire, J A; Barbero, A; Reinares, L; Martell-Claros, N; Gómez-Garre, D


    Most optimally treated hypertensive patients still have an around 50% increased risk of any cardiovascular event, suggesting the possible existence of unidentified risk factors. In the last years there has been evidence of the essential role of circulating endothelial progenitor cells (EPCs) in the maintenance of endothelial integrity and function, increasing the interest in their involvement in cardiovascular disease. In this study, the circulating levels of EPCs and vascular endothelial growth factor (VEGF) are investigated in treated hypertensive patients with adequate control of blood pressure (BP). Blood samples were collected from treated hypertensive patients with controlled BP. Plasma levels of EPCs CD34+/KDR+ and CD34+/VE-cadherin+ were quantified by flow cytometry. Plasma concentration of VEGF was determined by ELISA. A group of healthy subjects without cardiovascular risk factors was included as controls. A total of 108 hypertensive patients were included (61±12 years, 47.2% men) of which 82.4% showed BP<140/90 mmHg, 91.7% and 81.5% controlled diabetes (HbA1c <7%) and cLDL (<130 or 100 mg/dL), respectively, and 85.2% were non-smokers. Around 45% of them were obese. Although patients had cardiovascular parameters within normal ranges, they showed significantly lower levels of CD34+/KDR+ and CD34+/VE-cadherin+ compared with healthy control group, although plasma VEGF concentration was higher in patients than in controls. Despite an optimal treatment, hypertensive patients show a decreased number of circulating EPCs that could be, at least in part, responsible for their residual cardiovascular risk, suggesting that these cells could be a therapeutic target. Copyright © 2015 SEHLELHA. Published by Elsevier España, S.L.U. All rights reserved.

  14. Work activity in patients treated with cochlear implants. (United States)

    Huarte, Alicia; Martínez-López, Marta; Manrique-Huarte, Raquel; Erviti, Sandra; Calavia, Diego; Alonso, Cora; Manrique, Manuel

    The aim of this study was to determine the impact that the cochlear implant (CI) had in the working life of individuals implanted, using the first version of a questionnaire developed in the cochlear implant program at the University Clinic of Navarre. Its purpose was to demonstrate that the CI significantly affected the working lives of these patients. This was a retrospection study on a population of 60 patients (mean age, 48 years old) with bilateral profound sensorineural hearing loss treated with CI and to whom a questionnaire on working life satisfaction was given. Of the patients completing the questionnaire, 94.23% were currently satisfied at work. Almost all of them (93.05%) were more motivated to go to work after the implantation. The majority (79.31%) considered themselves more competent after surgery and device activation. Social relations at work were considered to have improved after cochlear implantation by 67.23% of patients. The CI provided positive support in the professional sphere as well as in social abilities by improving communication skills of implanted patients. The development of tools to assess the degree of job satisfaction of patients treated with a CI is of great interest. Copyright © 2016 Elsevier España, S.L.U. and Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  15. Targets, attitudes, and goals of psychiatrists treating patients with schizophrenia: key outcome drivers, role of quality of life, and place of long-acting antipsychotics

    Directory of Open Access Journals (Sweden)

    de Bartolomeis A


    Full Text Available Andrea de Bartolomeis,1 Andrea Fagiolini,2 Marco Vaggi,3 Claudio Vampini4 1Section of Psychiatry and Treatment Resistant Psychosis, Department of Neuroscience, University of Naples Federico II, Naples, Italy; 2Department of Molecular and Developmental Medicine, School of Medicine, University of Siena, Siena, Italy; 3Mental Health and Drug Addiction Department, Genovese, Genoa, Italy; 4Department of Mental Health, Ospedale Civile Maggiore and ULSS 20, Verona, Italy Purpose: This survey of Italian psychiatrists was conducted to better define drivers of schizophrenia treatment choice in real-life practice, particularly for use of long-acting injectable (LAI antipsychotics.Methods: Between October 15 and December 15, 2014, 1,000 surveys were sent to psychiatrists who treat schizophrenic patients; 709 completed questionnaires were analyzed (71% response rate.Results: The two most important factors determining therapy success were efficacy (75% of responses and tolerability (45% followed by global functioning (24% and quality of life (17%. LAI antipsychotics were most often used to facilitate regular treatment monitoring (49%, and 41% of psychiatrists thought that patients with low adherence who had failed oral therapy were well-suited for LAI antipsychotics. Only 4% of respondents saw LAI antipsychotics as appropriate for patients without other therapeutic options.Conclusion: Although efficacy and tolerability were the most common factors used to evaluate treatment success in schizophrenia, psychiatrists also consider QoL and global functioning to be important. Keywords: quality of life, long-acting injectable antipsychotics, schizophrenia, survey

  16. Asymptomatic reactivation of JC virus in patients treated with natalizumab. (United States)

    Chen, Yiping; Bord, Evelyn; Tompkins, Troy; Miller, Janice; Tan, Chen S; Kinkel, R Philip; Stein, Marion C; Viscidi, Raphael P; Ngo, Long H; Koralnik, Igor J


    Progressive multifocal leukoencephalopathy (PML) occurs in a fraction of patients with multiple sclerosis who were treated with natalizumab. Most adults who are infected with the JC virus, the etiologic agent in PML, do not have symptoms. We sought to determine whether exposure to natalizumab causes subclinical reactivation and neurotropic transformation of JC virus. We followed 19 consecutive patients with multiple sclerosis who were treated with natalizumab over an 18-month period, performing quantitative polymerase-chain-reaction assays in blood and urine for JC virus reactivation; BK virus, a JC virus-related polyomavirus, was used as a control. We determined JC virus-specific T-cell responses by means of an enzyme-linked immunospot assay and antibody responses by means of an enzyme-linked immunosorbent assay and analyzed JC virus regulatory-region sequences. After 12 months of natalizumab therapy, the prevalence of JC virus in the urine of the 19 patients increased from a baseline value of 19% to 63% (P=0.02). After 18 months of treatment, JC virus was detectable in 3 of 15 available plasma samples (20%) and in 9 of 15 available samples of peripheral-blood mononuclear cells (60%) (P=0.02). JC virus regulatory-region sequences in blood samples and in most of the urine samples were similar to those usually found in PML. Conversely, BK virus remained stable in urine and was undetectable in blood. The JC virus-specific cellular immune response dropped significantly between 6 and 12 months of treatment, and variations in the cellular immune response over time tended to be greater in patients in whom JC viremia developed. None of the patients had clinical or radiologic signs of PML. Subclinical reactivation of JC virus occurs frequently in natalizumab-treated patients with multiple sclerosis. Viral shedding is associated with a transient drop in the JC virus-specific cellular immune response. 2009 Massachusetts Medical Society

  17. Leishmania infantum leishmaniasis in corticosteroid – treated patients


    Pittalis, Silvia; Nicastri, Emanuele; Spinazzola, Francesco; Ghirga, Piero; De Marco, Michele; Paglia, Maria Grazia; Narciso, Pasquale


    Abstract Background The number of leishmaniasis cases associated with immunosuppression has increased regularly over the past 20 years. Immunosuppression related to HIV infection, immunosuppressive treatment, organ transplantation, and neoplastic diseases increases the risk for Leishmania-infected people to develop visceral illness. Case presentation Three cases of Leishmania infantum leishmaniasis in corticosteroid (CS)-treated patients are reported: an isolated lingual leishmaniasis in a fa...

  18. Ofuji's disease in an immunocompetent patient successfully treated with dapsone

    Directory of Open Access Journals (Sweden)

    Gopikrishnan Anjaneyan


    Full Text Available Eosinophilic pustular folliculitis or Ofuji's disease is a non-infectious eosinophilic infiltration of hair follicles, which usually presents with itchy papules and pustules in a circinate configuration. We report this case of an immunocompetent patient with erythematous papules and plaques without macropustules diagnosed as eosinophilic pustular folliculitis—a rarely reported entity outside Japan. He was successfully treated with oral dapsone.

  19. metabolic control of type-2 diabetic patients commonly treated with ...

    African Journals Online (AJOL)



    Apr 1, 2003 ... of type 2 diabetes do not sustain glycaemic control. Objective: To assess metabolic control in type 2 diabetic patients predominantly treated with .... 1 (3.2). 5 (5.1). Alcohol consumption: • Yes (%). 23 (37.1)**. 5(21.7). 18 (46.2)a. 17(14.5). 2 (6.5). 15(17.4). Treatment. • Diet & exercise. 8(12.9). 2(8.7). 6(15.4).

  20. Dyspnoea management in acute coronary syndrome patients treated with ticagrelor (United States)

    Parodi, Guido; Storey, Robert F


    The occurrence of dyspnoea in acute coronary syndrome (ACS) patients has always been considered a challenging diagnostic and therapeutic clinical scenario. P2Y12 platelet receptor inhibitors (i.e., clopidogrel, prasugrel and ticagrelor) are currently the cornerstone of treatment of ACS patients. Thus, in the last few years, the potential association between ACS and dyspnoea has also become more challenging with the increasing use of ticagrelor in these patients due to its beneficial effects on ischaemic event prevention and mortality, since ticagrelor can induce dyspnoea as a side effect. The present article is intended to review the current literature regarding dyspnoea occurrence in ACS patients, especially those treated with ticagrelor, and to propose ticagrelor-associated dyspnoea management recommendations based on current knowledge. PMID:25267878

  1. Dyspnoea management in acute coronary syndrome patients treated with ticagrelor. (United States)

    Parodi, Guido; Storey, Robert F


    The occurrence of dyspnoea in acute coronary syndrome (ACS) patients has always been considered a challenging diagnostic and therapeutic clinical scenario. P2Y12 platelet receptor inhibitors (i.e., clopidogrel, prasugrel and ticagrelor) are currently the cornerstone of treatment of ACS patients. Thus, in the last few years, the potential association between ACS and dyspnoea has also become more challenging with the increasing use of ticagrelor in these patients due to its beneficial effects on ischaemic event prevention and mortality, since ticagrelor can induce dyspnoea as a side effect. The present article is intended to review the current literature regarding dyspnoea occurrence in ACS patients, especially those treated with ticagrelor, and to propose ticagrelor-associated dyspnoea management recommendations based on current knowledge. © The European Society of Cardiology 2014.

  2. [Tranexamic acid gel in patients treated with oral anticoagulants]. (United States)

    Ripollés-de Ramón, Jorge; Muñoz-Corcuera, Marta; Bravo-Llatas, Carmen; Bascones-Martínez, Antonio


    Patients treated with oral anticoagulants have increased susceptibility to bleeding, and therefore any surgical medical procedure and especially oral surgery requires a therapeutic approach that minimizes bleeding effects in these patients. The working hypothesis was based on studies of local application of tranexamic acid after maxillofacial interventions as effective therapeutic alternative for the prevention and control of bleeding. The aim was to assess the effectiveness of the application of a gel solution tranexamic acid after tooth extraction in anticoagulated patients in terms of healing time and degree of healing. The results indicate that application of tranexamic acid gel is very effective for consistency and maintenance in the place of action and shows its efficacy as a procoagulant material. The application of a gel solution of tranexamic acid in oral anticoagulants patients ameliorates healing time and the bleeding time within the first 48-72 h. Copyright © 2013 Elsevier España, S.L.U. All rights reserved.

  3. Monitoring guidance for patients with hypophosphatasia treated with asfotase alfa. (United States)

    Kishnani, Priya S; Rush, Eric T; Arundel, Paul; Bishop, Nick; Dahir, Kathryn; Fraser, William; Harmatz, Paul; Linglart, Agnès; Munns, Craig F; Nunes, Mark E; Saal, Howard M; Seefried, Lothar; Ozono, Keiichi


    Hypophosphatasia (HPP) is a rare, inherited, systemic, metabolic disorder caused by autosomal recessive mutations or a single dominant-negative mutation in the gene encoding tissue-nonspecific alkaline phosphatase (TNSALP). The disease is associated with a broad range of signs, symptoms, and complications, including impaired skeletal mineralization, altered calcium and phosphate metabolism, recurrent fractures, pain, respiratory problems, impaired growth and mobility, premature tooth loss, developmental delay, and seizures. Asfotase alfa is a human, recombinant enzyme replacement therapy that is approved in many countries for the treatment of patients with HPP. To address the unmet need for guidance in the monitoring of patients receiving asfotase alfa, an international panel of physicians with experience in diagnosing and managing HPP convened in May 2016 to discuss treatment monitoring parameters. The panel discussions focused on recommendations for assessing and monitoring patients after the decision to treat with asfotase alfa had been made and did not include recommendations for whom to treat. Based on the consensus of panel members, this review provides guidance on the monitoring of patients with HPP during treatment with asfotase alfa, including recommendations for laboratory, efficacy, and safety assessments and the frequency with which these should be performed during the course of treatment. Recommended assessments are based on patient age and include regular monitoring of biochemistry, skeletal radiographs, respiratory function, growth, pain, mobility and motor function, and quality of life. Because of the systemic presentation of HPP, a coordinated, multidisciplinary, team-based, patient-focused approach is recommended in the management of patients receiving asfotase alfa. Monitoring of efficacy and safety outcomes must be tailored to the individual patient, depending on medical history, clinical manifestations, availability of resources in the clinical

  4. Different outcomes of never-treated and treated patients with schizophrenia: 14-year follow-up study in rural China. (United States)

    Ran, Mao-Sheng; Weng, Xue; Chan, Cecilia Lai-Wan; Chen, Eric Yu-Hai; Tang, Cui-Ping; Lin, Fu-Rong; Mao, Wen-Jun; Hu, Shi-Hui; Huang, Yue-Qin; Xiang, Meng-Ze


    The long-term outcome of never-treated patients with schizophrenia is unclear. To compare the 14-year outcomes of never-treated and treated patients with schizophrenia and to establish predictors for never being treated. All participants with schizophrenia (n = 510) in Xinjin, Chengdu, China were identified in an epidemiological investigation of 123 572 people and followed up from 1994 to 2008. The results showed that there were 30.6%, 25.0% and 20.4% of patients who received no antipsychotic medication in 1994, 2004 and 2008 respectively. Compared with treated patients, those who were never treated in 2008 were significantly older, had significantly fewer family members, had higher rates of homelessness, death from other causes, being unmarried, living alone, being without a caregiver and poor family attitudes. Partial and complete remission in treated patients (57.3%) was significantly higher than that in the never-treated group (29.8%). Predictors of being in the never-treated group in 2008 encompassed baseline never-treated status, being without a caregiver and poor mental health status in 1994. Many patients with schizophrenia still do not receive antipsychotic medication in rural areas of China. The 14-year follow-up showed that outcomes for the untreated group were worse. Community-based mental healthcare, health insurance and family intervention are crucial for earlier diagnosis, treatment and rehabilitation in the community. © The Royal College of Psychiatrists 2015.

  5. Case Study of Cancer Patients Treated with Herbal Acupuncture Therapy

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    Hwa-Seung Yoo


    Full Text Available Objective : This study was aimed to validate the Herbal Acupuncture Therapies(HAT for cancer patients. Patients and methods : This retrospective study was performed on 8 patients who were diagnosed as cancer in Korea and treated with HAT in the oriental hospital of Daejeon University, from January 2003 to January 2004. We retrospectively analyzed the medical records of 8 patients for improvement of symptoms, toxic effects of liver and kidney, myelosupression and changes of Quality of Life(QOL. Results : Analysis of change of chief complaints showed that 75% patients replied moderate relief and 25% replied complete relief in Likert scale. Analysis of Liver Function Test(LFT, Renal Function Test(RFT level showed that HAT does not have toxic effects on liver and kidney. Analysis of Complete Blood Count(CBC level showed that HAT does not have myelosuppression effects on bone marrow. Analysis of QOL showed that 100% patients replied improvement in Eastern Cooperative Oncology Group status(ECOG status. Conclusion : Our findings suggest that HAT offer potential benefits for cancer patients.

  6. Erectile dysfunction in patients with chronic pain treated with opioids. (United States)

    Ajo, Raquel; Segura, Ana; Inda, María-Del-Mar; Margarit, César; Ballester, Pura; Martínez, Emi; Ferrández, Guillermina; Sánchez-Barbie, Ángel; Peiró, Ana M


    Chronic pain is associated with comorbidities that have an impact on the quality of life of patients and, among others, affect their sexual functioning. One of the most relevant side effects of opioid analgesics is erectile dysfunction (ED), due in part to the inhibition of the gonadal-pituitary-hypothalamic axis and the decline in testosterone levels. To evaluate ED and effectiveness of treatment in men with chronic pain treated with long-term opioids. Prospective observational study lasting 3 years, where the intensity of pain (visual analogue scale, 0-10cm), erectile function (IIEF-EF, range 1-30 points), quality of life (EQ-VAS, 0-100mm), quality of sexual life (MSLQ-QOL, 0-100 points), anxiety/depression (HAD, 0-21 points) and testosterone levels, was assessed in patients who reported sexual dysfunction (ED or libido modification). A 6-month follow-up was applied to each patient after administering the usual treatment in the Andrology Unit. The study was approved by the Clinical Research Ethics Committee and data were statistically analyzed with the GraphPad Prism 5 software. ED was observed in 27.6% of patients (n=105, 57±12.2 years, mean dose of morphine equivalent=107.1±107.9mg/day, 84.3% adjuvant analgesics). After 6 months, 42% of patients showed a significant improvement after being treated with iPDE5 (48.5%) and/or testosterone gel (81.8%), with a resolution rate of 31% (p=0.000). A positive correlation was observed between the improvement of IIEF and quality of sexual life (55.5±25.7 points, p=0.000), as well as anxiety (7.4±4.3 points, p=0.048). No significant changes were observed in the levels of testosterone, in the levels of pain nor in the quality of life, which remained moderate. Erectile function and quality of sexual life, as well as anxiety, improved in patients treated chronically with opioids after administering andrological treatment. The management of patients with pain should include a review of their sexual health history given the

  7. An investigation of factors increasing the risk of aggressive behaviour among schizophrenic inpatients

    Directory of Open Access Journals (Sweden)

    Michel eLejoyeux


    Full Text Available Aim of the studyThis study tried to identify risk factors of aggressive behavior in a population of schizophrenic inpatients. We tested the association between aggressive behavior and socio-demographic characteristics, addictive disorders, history of suicide attempt and sexual violence, impulsivity and sensation seeking.MethodsAll consecutive schizophrenic inpatients (100 were assessed during six months. Aggressive behavior was quantified with a standardized scale, the Overt Aggression Scale (OAS. We studied socio-demographic characteristics and the history of suicide attempt and sexual violence with a specific standardized questionnaire. Addictive disorders were identified with the Fagerström and CAGE questionnaires and with the DSM-IV-R diagnostic criteria for nicotine, alcohol, cannabis opiates, and cocaine abuse and dependence disorders. Lastly, we studied sensation-seeking with the Zuckerman scale and impulsivity with the Barratt scale. ResultsLinear regression identified four factors associated with aggressive behaviour: male gender (odd ratio =12.8, history of sexual violence (odd ratio = 3.6, Fagerström score (odd ratio= 1.3, number of cigarettes smoked each day (odd ratio=1.16. Patients with nicotine use or dependence had significantly higher levels of OAS scores. This difference was not observed between patients with or without alcohol dependence. OAS scores were correlated to the number of cigarettes smoked each day and to Fagerström scores. Patients with a higher level of sensation seeking and impulsivity also had higher OAS scores. ConclusionA Typical schizophrenic patient at risk of showing aggressive behavior is a man, who smokes and presents a history of sexual violence.

  8. Ethical issues in treating gay and lesbian patients. (United States)

    Drescher, Jack


    Since the 1973 decision to remove homosexuality from the list of mental disorders, most mental health practitioners have shifted their clinical focus from "the cure" of homosexuality to treating the concerns of gay and lesbian patients. Some clinicians, however, reject the mental health mainstream's view and continue to conceptualize homosexuality as a mental disorder. Their clinical theories have been incorporated into wider societal debates regarding the status of gay and lesbian people. The sexual conversion or reparative therapies they practice, however, may include routine ethical violations in the realm of improper pressure, confidentiality, informed consent, and fiduciary responsibility to the patient's best interest. On the other hand, a normal/identity approach to treatment, particularly in its most reductionistic forms, may involve ethical lapses in the areas of informed consent and fiduciary responsibility to the patient's best interests as well.

  9. [Evaluation of patients with polytrauma treated in the emergency department]. (United States)

    Karwan, Krzysztof


    Polytrauma care is a very important diagnostic and therapeutic problem. The clinical profile of patients with multiorgan injuries admitted to the emergency department (ED) is different, similarly to severity of injuries. An evaluation of patients with polytrauma treated in ED and proposition of diagnostic and therapeutic algorithm in initial management in patients with multiply injuries. The analysis of medical data was performed in 72 polytraumized patients. Their age, sex, time of admission to ED, influence of alcohol and drugs, vital parameters, etiological factors, severity of injuries and the therapy after initial management in ED were studied. The majority of patients were admitted to ED in the morning. There were 25 females and 47 males. Their mean age was 41 years. Patients between 21-40 years of age represented half of all victims. There were 10 patients under influence of alcohol or drugs. Vital signs like Glasgow Coma Scale (GCS), systolic blood pressure (SBP), and respiratory rate (RR) evaluated at the initial examination and counted as a values of Revised Trauma Score (RTS) in most cases were 7.841. The traffic accidents were the most frequent ethiologic factors. Head injuries, chest injuries and fractures were the most frequently. After initial treatment in ED, 22 patients were discharged home and 23 were hospitalized, because they had been needed surgical treatment, and 8 because of threat of life. 6 patients died in ED. Multiorgan injuries were diagnosed mainly in young men after traffic accidents in the morning. Head injuries, chest injuries and fractures were the most frequent. Author propose the diagnostic and therapeutic algorithm for initial management in ED in patients with multiply injuries.

  10. Comparison of Healthcare Utilization Among Patients Treated With Alcoholism Medications (United States)

    Mark, Tami L.; Montejano, Leslie B.; Kranzler, Henry R.; Chalk, Mady; Gastfriend, David R.


    Objectives To determine in a large claims database the healthcare utilization and costs associated with treatment of alcohol dependence with medications vs no medication and across 4 US Food and Drug Administration (FDA)–approved medications. Study Design Claims database analysis. Methods Eligible adults with alcohol dependence claims (n = 27,135) were identified in a commercial database (MarketScan; Thomson Reuters Inc, Chicago, Illinois). Following propensity score–based matching and inverse probability weighting on demographic, clinical, and healthcare utilization variables, patients who had used an FDA-approved medication for alcohol dependence (n = 2977) were compared with patients who had not (n = 2977). Patients treated with oral naltrexone hydrochloride (n = 2064), oral disulfiram (n = 2076), oral acamprosate calcium (n = 5068), or extended-release injectable naltrexone (naltrexone XR) (n = 295) were also compared for 6-month utilization rates of alcoholism medication, inpatient detoxification days, alcoholism-related inpatient days, and outpatient services, as well as inpatient charges. Results Patients who received alcoholism medications had fewer inpatient detoxification days (706 vs 1163 days per 1000 patients, P alcoholism-related inpatient days (650 vs 1086 days, P alcoholism-related emergency department visits (127 vs 171, P = .005). Among 4 medications, the use of naltrexone XR was associated with fewer inpatient detoxification days (224 days per 1000 patients) than the use of oral naltrexone (552 days, P = .001), disulfiram (403 days, P = .049), or acamprosate (525 days, P alcoholism-related inpatient days than the groups receiving disulfiram or acamprosate. More patients in the naltrexone XR group had an outpatient substance abuse visit compared with patients in the oral alcoholism medication groups. Conclusion Patients who received an alcoholism medication had lower healthcare utilization than patients who did not. Naltrexone XR showed an

  11. Infectious complications in paediatric patients treated with extracorporeal membrane oxygenation. (United States)

    Santiago-Lozano, Maria José; Barquín-Conde, Marta Lucía; Fuentes-Moreno, Lucía; León-Vela, Roberto Manuel; Madrid-Vázquez, Lucas; Sánchez-Galindo, Amelia; López-Herce Cid, Jesús


    The aim of this study was to analyse the incidence, treatment and evolution of infections in children treated with ECMO. A retrospective study based on a prospective database was performed. Children under the age of 18 years treated with ECMO from September 2006 to November 2015 were included. The patients' clinical characteristics were collected, together with ECMO technique, cultures and treatment of infection. One hundred patients with a median age of 11 months were analysed. Heart disease was diagnosed in 94 patients. An infection was suspected and antibiotic treatment was initiated in 51 patients, although only 22 of them were microbiologically confirmed. The most common infection was sepsis (49%), followed by pneumonia (35.3%) and urinary tract infection (9.8%). There were no differences in haematological parameters and acute phase reactants between children with infection and those without. Children who died had a higher incidence of infection during ECMO (60.4%) than the survivors (40.3%), but the difference did not reach statistical significance (P=.07). The duration of admission in the PICU was 57 days in patients with infection vs 37 days in patients without infection but the difference was not statistically significant (P=.067). Infection in children with ECMO is common. There are no specific infection parameters and less than half of the clinical infections are confirmed microbiologically. There was no statistically significant correlation between infection and mortality or duration of PICU stay. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  12. Treating diabetes mellitus in older and oldest old patients. (United States)

    Abbatecola, A M; Paolisso, G; Sinclair, A J


    There is a rapidly growing number of persons reaching extreme age limits. Indeed, the fastest growth is found in those over the age of 80 years or octogenarians. Along with this continuous rise, there is a significant increase in type 2 diabetes in this population. Unfortunately, individuals living past 80 years of age are often accompanied by numerous comorbidities and geriatric conditions, all which render anti-diabetic treatment options challenging. Indeed the principles of managing type 2 diabetes are similar to younger patients. Special considerations in this delicate group are essential due to the increased prevalence of comorbidities and relative inability to tolerate adverse effects of medication and severe hypoglycemia. It is important to recall that octogenarians have shown to have a greater prevalence for cognitive impairment, physical disability, ren al and hepatic dysfunction, and syndromes, such as frailty compared to younger elders. The frailty syndrome is considered one of the most important limitations when treating octogenarians with type 2 diabetes in polypharmacy. Due to the lack of evidence for specific targets of glucose and glycated hemoglobin (A1C) levels in the elderly, available treatment guidelines are based on data extrapolation from younger adults and expert opinion citing reliable evidence. Overall, the most important conclusion emerging from these groups is to accomplish a moderate glycemic control (A1C levels between 7 -8%) in complex elderly patients. However, the risk of hypoglycemia from some treatments may present the greatest significant barrier to optimal glycemic control for the very old. The present review discusses the highlights from the latest guidelines for treating older persons and underlines the need for specific considerations when treating the very old in order to maintain a balance between treating comorbidities and maintaining quality of life.

  13. Outcome analysis of colistin-treated burn center patients. (United States)

    Wilkinson, Rachel E; Hill, David M; Hickerson, William L


    Intravenous colistimethate sodium (CMS) use in burn center patients is increasing due to the emergence of multidrug-resistant gram-negative bacteria. However, optimal dosing strategies and factors that may contribute to treatment failure are limited. The purpose of this study was to determine factors that may contribute to treatment failure in colistin-treated burn center patients. This retrospective, observational study included burn center patients that received ≥48h of intravenous CMS between June 1, 2009 and June 30, 2014. Data was collected utilizing the institution's electronic medical record system. Statistical analysis included demographic, univariable, and multivariable analysis to determine factors that may predict clinical failure of burn center patients requiring intravenous CMS. Eighty-one patients were included in this study, with 55 patients (68%) achieving clinical success. A total daily dose (TDD) of >5mg/kg ideal body weight (IBW) was associated with significantly less clinical failure (odds ratio=0.21; 95% CI, 0.05, 0.91). Additionally, clinical failure was significantly higher in patients with wounds as the primary source of infection, creatinine clearances of 91-120mL/min, and those receiving renal replacement therapy. No difference was observed in nephrotoxicity when comparing TDD >5mg/kg IBW and TDD ≤5mg/kg IBW. Clinical success was significantly higher with larger intravenous CMS doses in burn center patients. Higher CMS doses were not found to be associated with increased nephrotoxicity within this patient group. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  14. Mortality in elderly dementia patients treated with risperidone. (United States)

    Haupt, Martin; Cruz-Jentoft, Alfonso; Jeste, Dilip


    Agitation, aggression, and psychosis are among the most troublesome behavioral and psychological symptoms of dementia (BPSD) and impair the lives of dementia patients and their caregivers. Atypical antipsychotics have been widely prescribed to improve these BPSD. However, in a number of trials with atypical antipsychotics, a consistent increase in overall mortality has been observed. The US Food and Drug Administration issued a warning for all atypical antipsychotics as a result of a meta-analysis of 17 placebo-controlled clinical trials using various atypical antipsychotics for the treatment of BSPD. To evaluate this mortality risk specifically for risperidone, 6 phase-2/3 double-blind trials comparing risperidone with placebo were analyzed. Data were obtained from Johnson & Johnson Pharmaceutical Research and Development. Hazard ratios with 95% confidence intervals were calculated to compare the relative mortality risk between patients treated with risperidone and those treated with placebo. In this meta-analysis, 1721 patients were included. In the pooled sample, the mortality was 4.0% with risperidone versus 3.1% with placebo (relative risk, 1.21; 95% confidence interval, 0.71-2.06) during treatment or within 30 days after treatment discontinuation. The most common adverse events associated with death were pneumonia, cardiac failure or arrest, or cerebrovascular disorder. No relationship was found between risperidone dose and mortality. In conclusion, this meta-analysis found a nonsignificant increase in mortality during treatment with risperidone in dementia patients. Larger studies would be needed to rule out a small increase in mortality in these patients. Careful assessments of potential benefits and risks should be made before prescribing risperidone for the treatment of BPSD.

  15. Thyroglobulin value in patients surgically treated for differentiated thyroid carcinoma

    Directory of Open Access Journals (Sweden)

    Mikač Gostimir


    Full Text Available Introduction. Thyroglobulin is composed glycoprotein, and it is synthesized by follicular cells of the thyroid gland. Treatment of differentiated thyroid carcinomas involves total thyroidectomy followed by radioiodine ablation of a potential remaining tissue. The measurement of thyroglobulin in the postoperative follow-up can serve as an indicator of tumor growth or recurrence of the disease. Objective. The aim of this paper is to examine the value of thyroglobulin in patients surgically treated for differentiated thyroid cancer who had metastases in the lymph nodes of the neck, as well as in operated on patients without any evident metastasis. Methods. Thyroglobulin values in the serum of 58 patients were analyzed. Two groups were formed. The thyroglobulin value was established with the use of IRMA-hTg (125I system. Normal levels of thyroglobulin were from 2 ng/ml to 65 ng/ml. For all of 58 patients, thyroglobulin was determined three times. The first, so-called pre-ablation thyroglobulin was determined immediately before the application of 131I ablation dose. The second and the third measurements were conducted six to eight months and one year, respectively, after the application of the ablation dose respectively. Results. The first group consisted of 14 patients with histologically proven metastases in the lymph nodes of the neck, while the second group consisted of 44 patients without any evident metastases. The average thyroglobulin value of pre-ablation in the patients from the first group was 43.45 ng/ml, while in the second was 7.57 ng/ml. Levene’s test (with p = 0.00, i.e p < 0.05, demonstrated a statistically significant difference. Furthermore, in both groups, there was statistically significant difference between pre-ablation and post-ablation thyroglobulin values (Student’s t-test with p < 0.05. Conclusion It can be concluded that the average value of thyroglobulin was significantly higher in patients with lymph node metastases

  16. Severe infections in patients with autoimmune diseases treated with cyclophosphamide. (United States)

    Cavallasca, Javier A; Costa, Cecilia A; Maliandi, Maria Del Rosario; Contini, Liliana E; Fernandez de Carrera, Elena; Musuruana, Jorge L


    Infectious diseases are a significant cause of morbidity and mortality in patients with connective tissue diseases. Corticosteroids and immunosuppressive drugs, such as cyclophosphamide (CYC), increases the risk of infections. The objective of this study was to estimate the incidence rates of severe infections in patients who received treatment with CYC. The records of 60 patients with systemic autoimmune diseases who received treatment with CYC were retrospectively reviewed. We evaluated the rate of severe infections that occurred during CYC therapy and the 3 subsequent months. Systemic lupus erythematosus was the most common disease, and diffuse proliferative glomerulonephritis the most frequent indication. Severe infection occurred in 9 patients (15%). Community acquired pneumonia was the most frequent infection with 3 cases (33%) followed by Herpes Zoster with 2 reports (22%). The cumulative dose of corticosteroid was the only significant risk factor for infection 32.8±16.7 vs. 20.1±15.3 P=.007. The use of lower doses of corticosteroids and an aggressive management of infectious complications, allows for an acceptable safety profile in patients treated with CYC. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  17. Intubation of Profoundly Agitated Patients Treated with Prehospital Ketamine. (United States)

    Olives, Travis D; Nystrom, Paul C; Cole, Jon B; Dodd, Kenneth W; Ho, Jeffrey D


    Profound agitation in the prehospital setting confers substantial risk to patients and providers. Optimal chemical sedation in this setting remains unclear. The goal of this study was to describe intubation rates among profoundly agitated patients treated with prehospital ketamine and to characterize clinically significant outcomes of a prehospital ketamine protocol. This was a retrospective cohort study of all patients who received prehospital ketamine, per a predefined protocol, for control of profound agitation and who subsequently were transported to an urban Level 1 trauma center from May 1, 2010 through August 31, 2013. Identified records were reviewed for basic ambulance run information, subject characteristics, ketamine dosing, and rate of intubation. Emergency Medical Services (EMS) ambulance run data were matched to hospital-based electronic medical records. Clinically significant outcomes are characterized, including unadjusted and adjusted rates of intubation. Overall, ketamine was administered 227 times in the prehospital setting with 135 cases meeting study criteria of use of ketamine for treatment of agitation. Endotracheal intubation was undertaken for 63% (85/135) of patients, including attempted prehospital intubation in four cases. Male gender and late night arrival were associated with intubation in univariate analyses (χ2=12.02; P=.001 and χ2=5.34; P=.021, respectively). Neither ketamine dose, co-administration of additional sedating medications, nor evidence of ethanol (ETOH) or sympathomimetic ingestion was associated with intubation. The association between intubation and both male gender and late night emergency department (ED) arrival persisted in multivariate analysis. Neither higher dose (>5mg/kg) ketamine nor co-administration of midazolam or haloperidol was associated with intubation in logistic regression modeling of the 120 subjects with weights recorded. Two deaths were observed. Post-hoc analysis of intubation rates suggested a

  18. A case of progeria syndrome treated as VIP patient

    Directory of Open Access Journals (Sweden)

    Seema Mahant, Mahant PD, C.M. Reddy


    Full Text Available Progeria is rare autosomal recessive genetic disease with an incidence of about one in eight million. He was 16 years old boy lying on the couch. He was short stature thin with minimal subcutaneous tissue, skin was thin and fragile with loss of hair over scalp, eyebrows and eyelashes, and his face was dismorphic with prominent eyes, beaked nose, small jaw and large cranium with visible veins over it. His voice was thin and high pitched. Overall, this gives them an extremely aged nearly 70 -80 years old man look. The patient was a known case of progeria syndrome and he was treated as a VIP patient by all faculty members and staff, though he belongs low socioeconomic status, no political issue with them. But still he was a VIP.

  19. Fluctuating anaemia in treated HIV patients: could be a PICA? (United States)

    Ajana, Faiza; Pasquet, Armelle; Auffret, Marine; Gautier, Sophie


    HIV infected patients are frequently exposed to anaemia, due to antiretroviral agents and/or prophylactic treatment of opportunistic infections. Anemia due to PICA, unusually evoked in our western countries, could be a more frequent situation than imagined. We report two cases of fluctuating anemia with no HIV or iatrogenic origin, observed in two HIV infected women, 47 years old and 33 years old respectively, coming from Africa and treated with antiretroviral agents. The anemia was explained by a culturally sanctioned practice of kaolin ingestion, in the broader context of PICA and resolved after the withdrawal of kaolin ingestion. PICA, and in particular kaolin ingestion, must be investigated when HIV infected patients came from Africa and presented significative unexplained anemia. © 2013 Société Française de Pharmacologie et de Thérapeutique.

  20. Ultrasound elastography in patients with rectal cancer treated with chemoradiation

    DEFF Research Database (Denmark)

    Rafaelsen, S R; Vagn-Hansen, C; Sørensen, T


    OBJECTIVE: The current literature has described several predictive markers in rectal cancer patients treated with chemoradiation, but so far none of them have been validated for clinical use. The purpose of the present study was to compare quantitative elastography based on ultrasound measurements...... in the course of chemoradiation with tumor response based on T stage classification and the Mandard tumor regression grading (TRG). MATERIALS AND METHODS: We prospectively examined 31 patients with rectal cancer planned for high dose radiochemotherapy. The tumor and the mesorectal fat elasticity were measured...... using the Acoustic Radiation Force Impulse to generate information on the mechanical properties of the tissue. The objective quantitative elastography shear wave velocity was compared to the T stage classification and TRG. RESULTS: The baseline mean tumor elasticity was 3.13m/s. Two and six weeks after...

  1. Suicidality in clozapine-treated patients with schizophrenia: role of obsessive-compulsive symptoms. (United States)

    Szmulewicz, Alejandro G; Smith, José M; Valerio, Marina P


    Patients with schizophrenia have an increased lifetime risk of comorbid obsessive-compulsive symptoms. Up to 30% of these patients experience such symptoms and 12% may be diagnosed with obsessive-compulsive disorder. The presence of these symptoms in schizophrenia seems to be associated with poor outcomes including a greater suicidal risk. A subgroup of patients develops this symptomatology after the initiation with Second Generation Antipsychotics (SGA). Also, there is evidence of a causal relationship for this association, particularly for clozapine. The primary aim of this study was to investigate the association of this comorbidity with suicidality in a population of clozapine-medicated schizophrenic and schizoaffective patients (N=65). The prevalence of obsessive-compulsive symptoms in our sample was 29.2% (N=19) and the prevalence of obsessive-compulsive disorder was 13.8% (N=9). Significant positive correlations between suicidality and total Y-BOCS score and between Y- BOCS score and depressive symptoms were found. Further analysis indicated that a Y-BOCS score greater or equal than 8 was an independent predictor of suicide attempt during clozapine treatment. Routine screening for this adverse event should be warranted for this population. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  2. Audiological profile of patients treated for childhood cancer. (United States)

    Liberman, Patricia Helena Pecora; Goffi-Gomez, Maria Valéria Schmidt; Schultz, Christiane; Novaes, Paulo Eduardo; Lopes, Luiz Fernando

    To characterize the hearing loss after cancer treatment, according to the type of treatment, with identification of predictive factors. Two hundred patients who had cancer in childhood were prospectively evaluated. The mean age at diagnosis was 6 years, and at the audiometric assessment, 21 years. The treatment of the participants included chemotherapy without using platinum derivatives or head and neck radiotherapy in 51 patients; chemotherapy using cisplatin without radiotherapy in 64 patients; head and neck radiotherapy without cisplatin in 75 patients; and a combined treatment of head and neck radiotherapy and chemotherapy with cisplatin in ten patients. Patients underwent audiological assessment, including pure tone audiometry, speech audiometry, and immittancemetry. The treatment involving chemotherapy with cisplatin caused 41.9% and 47.3% hearing loss in the right and left ear, respectively, with a 11.7-fold higher risk of hearing loss in the right ear and 17.6-fold higher in the left ear versus patients not treated with cisplatin (p<0.001 and p<0.001, respectively). Children whose cancer diagnosis occurred after the age of 6 have shown an increased risk of hearing loss vs. children whose diagnosis occurred under 6 years of age (p=0.02). The auditory feature found after the cancer treatment was a symmetrical bilateral sensorineural hearing loss. Chemotherapy with cisplatin proved to be a risk factor, while head and neck radiotherapy was not critical for the occurrence of hearing loss. Copyright © 2016 Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda. All rights reserved.

  3. Young Children of Schizophrenic Mothers: Difficulties of Intervention

    DEFF Research Database (Denmark)

    Grünbaum, Liselotte; Gammeltoft, Marie


    Casework by Danish local social agencies on behalf of 11 children og chronically ill schizophrenic mothers is retrospectively analyzed, along with documentation from psychiatric hospitals, consulting child specialists, and other health professionals. Findings point to a need for earlier and more ...... precise assessment of the mother's parenting abilities as measured against the severity of her illness and the vulnerability of the child...

  4. Towards Understanding and Studying Cohesion in Schizophrenic Speech. (United States)

    Fine, Jonathan


    Cohesion analysis has been used to investigate the language of schizophrenics and that associated with other psychiatric syndromes. Cohesion, one means of creating text, cannot account for all aspects of the pretheoretical notion of coherence. As a research tool, cohesion meets the dual criteria of an analysis of language in context and…

  5. Discourse Analysis of Schizophrenic Speech: A Critique and Proposal. (United States)

    Alverson, H.; Rosenberg, S.


    Attempts to give a clearer picture of discourse analysis and the assumptions behind it, focusing on its use in the domain of schizophrenic speech, to provide a better indication of both the promise and the procedures of a discourse-analytic approach to the speech productions of psychiatric populations. (Author/CB)

  6. The Role of Third Person Hallucination in Schizophrenic Suicide ...

    African Journals Online (AJOL)

    Background: Suicide is among the most common causes of mortality among individuals with schizophrenia. Efforts at determining risk factors have been fruitful as some specific factors for schizophrenic suicide have been reported. However, there are few studies on the role of third person auditory hallucination in such ...

  7. Young children of schizophrenic mothers: difficulties of intervention

    DEFF Research Database (Denmark)

    Grünbaum, Liselotte Tang; Gammeltoft, Michele


    Casework by Danish local social agencies on behalf of 11 children of chronically ill schizophrenic mothers is retrospectively analyzed, along with documentation from psychiatric hospitals, consulting child specialists, and other health professionals. Findings point to a need for earlier and more...

  8. Validity of Draw-A-Person Test as a measure of Anxiety and Aggression Indices among Schizophrenics of Hospicio de San Juan de Dios

    Directory of Open Access Journals (Sweden)



    Full Text Available The present study sought to determine the validity of Draw-A-Person Test as a measure of Anxiety and Aggression Indices among Schizophrenics of Hospicio de San Juan de Dios in Bocaue, Bulacan. The Draw a Person Test as a psychological tool took an integral part in revealing the anxiety and aggression indices as showed through the details of the parts of the drawing. It showed that most of the Male Schizophrenics have high aggression indices compare to anxiety indices. The researcher also comes up with an Action Plan for an intervention program for patients with Schizophrenia which includes Art Therapy, Interactive Group Activities and Psychotherapy which is very beneficial for them to achieve continuous stability. This study also serves as awareness and provides understanding to situations of schizophrenics which are sometimes, have not been prioritize by the society. It also serves as a guide to the future researchers who will develop a related study.

  9. Application of cryoprecipitate in patients treated by portaazygous devascularization

    Directory of Open Access Journals (Sweden)

    YANG Zhaoxu


    Full Text Available ObjectiveTo evaluate the effect of cryoprecipitate-based blood component therapy on reducing perioperative risk in patients treated with portaazygous devascularization and to assess its influence on risk of post-operative complications. MethodsSixty-eight patients with portal hypertension who were scheduled for portaazygous devascularization were randomly assigned to receive either the standard surgery (control group, n=34 or surgery combined with perioperative transfusion of 10U cryoprecipitate (treatment group, n=34. Data recorded for inter-group comparative analysis (t-test included postoperative blood loss, prothrombin time, and recovery time, as well as incidences of re-hemorrhage in the gastrointestinal tract and of portal vein thrombosis. ResultsCompared with the control group, the cryoprecipitate-transfused patients showed significantly lower amount of blood loss after surgery and significantly lower incidence of postoperative bleeding and of re-hemorrhage in the gastrointestinal tract. The cryoprecipitate-transfused patients also experienced a shorter duration recovery period, with less days of in-hospital stay. There was no increase in the incidence of portal vein thrombosis after the use of cryoprecipitate. ConclusionApplication of cryoprecipitate during portaazygous devascularization surgery is safe and can improve coagulation function and reduce the risk of perioperative bleeding. Perioperative cryoprecipitate administration also benefits postoperative recovery and does not increase the incidence of portal vein thrombosis.

  10. PCSK9 Inhibitors: Treating the Right Patients in Daily Practice. (United States)

    King, Peta; Nicholls, Stephen J


    Monoclonal antibodies that inhibit proprotein convertase subtilisin/kexin type 9 (PCSK9) have emerged as a novel approach to low-density lipoprotein cholesterol (LDL-C) lowering. The potential role of PCSK9 inhibitors in clinical practice will be reviewed. Clinical trials have demonstrated that PCSK9 inhibitors produce robust LDL-C lowering when administered either as monotherapy or in combination with statins. This provides the opportunity to achieve effective lipid lowering in familial hypercholesterolemia, patients with either established atherosclerotic cardiovascular disease or high risk primary prevention and an important opportunity to treat patients with statin intolerance. The findings from plaque imaging and patients with established atherosclerotic cardiovascular disease suggest that PCSK9 inhibition has favorable outcomes beyond improving lipid profiles, which has the opportunity to expand their use. PCSK9 inhibitors represent a new approach to achieving effective cardiovascular risk reduction in a broader number of patients. How these agents will be taken up in clinical practice remains to be determined.

  11. Bone densitometry in pediatric patients treated with pamidronate

    Energy Technology Data Exchange (ETDEWEB)

    Grissom, Leslie E.; Kecskemethy, Heidi H.; Harcke, H.Theodore [Alfred I. duPont Hospital for Children, Nemours Children' s Clinic, Department of Medical Imaging, P.O. Box 269, Wilmington, DE (United States); Bachrach, Steven J. [Alfred I. duPont Hospital for Children, Nemours Children' s Clinic, Division of General Pediatrics, P.O. Box 269, Wilmington, DE (United States); McKay, Charles [Alfred I. duPont Hospital for Children, Nemours Children' s Clinic, Division of Nephrology, P.O. Box 269, Wilmington, DE (United States)


    To determine the effect of intravenous pamidronate on the bone mineral density of children with osteogenesis imperfecta and spastic quadriplegic cerebral palsy. Charts of 38 children with osteogenesis imperfecta (n=20) and spastic quadriplegic cerebral palsy (n=18) treated with pamidronate were retrospectively reviewed. Patients were selected for treatment because of prior fracture and/or abnormally low bone mineral density. All received intravenous pamidronate at two-month to eight-month intervals and were periodically examined using dual energy X-ray absorptiometry. All patients had abnormally low bone mineral density prior to treatment. Lumbar spine bone mineral density and z-scores showed serial improvement in 31 of 32 patients. Spine bone mineral density increased 78{+-}38.1% in OI and 47.4{+-}39.0% in children with cerebral palsy. The area of greatest lateral distal femur bone mineral density improvement was in the metaphysis adjacent to the growth plate, with a 96{+-}87.8% improvement in the osteogenesis imperfecta group and 65.7{+-}55.2% improvement in the cerebral palsy group. Increases in bone mineral density exceeded that expected for age-specific growth. This was demonstrated by improvement in both spine and femur z-scores for both groups. No children with spastic quadriplegic cerebral palsy experienced fractures after the first week of treatment, whereas patients with osteogenesis imperfecta continued to have fractures but at a decreased rate. (orig.)

  12. Malignancy rates in patients with rheumatoid arthritis treated with tocilizumab. (United States)

    Rubbert-Roth, Andrea; Sebba, Anthony; Brockwell, Laura; Kelman, Ariella; Porter-Brown, Benjamin; Pulley, Jennifer; Napalkov, Pavel; van Vollenhoven, Ronald F


    To analyse malignancy rates in patients with rheumatoid arthritis (RA) treated with tocilizumab. Patients who received tocilizumab or placebo+methotrexate/disease-modifying antirheumatic drugs in the double-blind phases of 5-phase three trials or who received at least 1 dose of tocilizumab in the long-term extension studies were analysed up to the 2 May 2012 cut-off date. Malignancies were monitored throughout the studies, analysed and adjudicated as malignant by medical review. Risk was compared with that in the general population using standardised incidence ratios (SIRs) based on data from the Surveillance Epidemiology and End Results SEER (US general population) and GLOBOCAN (non-US general population) databases. In total, 4009 patients in the tocilizumab all-exposure population were included. Mean treatment duration was 4.0 years (mean 5.1 (range 0.0-6.8); total observation time was 16 120.1 patient-years (PY). The adjudicated malignancy rate (95% CI) was 1.26/100 PY (1.09 to 1.44) and remained constant over time. The SIR (95% CI) for all malignancies combined, excluding non-melanoma skin cancer, was 1.36 (1.01 to 1.80) for US and 1.81 (1.44 to 2.23) for non-US populations, driven primarily by higher rates in lung and bronchus (US/non-US) malignancies and prostate cancer and non-Hodgkin lymphoma (non-US), in contrast to those for the general populations; these higher rates are in line with those expected in patients with RA or in the geographic regions studied. Malignancy rates remained stable with long-term tocilizumab treatment, and malignancy types and rates were consistent with those expected in patients with RA.

  13. Malignancies in patients treated with high doses of radium-224

    Energy Technology Data Exchange (ETDEWEB)

    Nekolla, E.A. [Federal Office for Radiation Protection (BfS), Neuherberg (Germany); Walsh, L. [Radiobiological Inst., Univ. of Munich (Germany); Schottenhammer, G.; Spiess, H. [Children' s Hospital, Univ. of Munich (Germany)


    Several thousand German patients suffering from ankylosing spondylitis, tuberculosis and some other diseases, received multiple injections of the short-lived {alpha}-emitter {sup 224}Ra. The ''Spiess study'' was initiated in the early 1950s to follow the health of 899 persons (278 female, 621 male) who were treated mainly between 1945 and 1955. Most of the high dose patients and nearly all of those treated as children or juveniles (n=217) were included in the study. In June 2003, 152 persons were still alive. The most striking observed health effect, following {sup 224}Ra injections, was a temporal wave of 56 malignant bone tumours with a maximum at about 8 years after exposure which has already been described in several publications. In 2000, a new analysis was performed because an improved dosimetry resulted in modified bone surface doses. The estimated risk coefficient, averaged over all ages at exposure, was found to be in agreement with earlier analyses. However, a statistically significant increase of bone tumour risk with decreasing age at exposure was found. The earlier results, which indicated a reversed protraction factor, were confirmed. A significant excess of non-skeletal solid malignancies has also appeared during the most recent observation decade. In 2004, significant increases of cancer rates were observed for several sites: for breast cancer (31 cases observed vs. 9.1 cases expected), soft tissue malignancies (11 vs. 1.0), thyroid carcinomas (7 vs. 0.9), liver (8 vs. 2.3), kidney (13 vs. 4.6), pancreas (8 vs. 3.9), and bladder cancer (14 vs. 7.7). The 8-fold excess relative risk of mammary cancers in those women exposed as children or juveniles is particularly striking; moreover, 2 cases of breast cancer occurred in men. In 1993, a control group of tuberculosis patients not treated with {sup 224}Ra was established to rule out potential confounding factors - such as chest fluoroscopy - which might bias the breast cancer excess

  14. Modern approach to treating mental patients in colonial chosun. (United States)

    Lee, Bang Hyun


    them or who posed a threat to others, or else commissioned them to the government hospital. Thus, the final responsibility for mental patients was imposed on the modern Western medical team, because the district commissioners sent them to the police and the police sent them to the government mental hospital. Most educated people and government personnel in the colonial era thought modern Western psychiatry circles were responsible for mental patient management, and the Japanese empire enacted mental-healthrelated laws and made efforts to secure funds for the establishment of mental hospitals. As the literature at that time also show the position of the modern Western medical circle, their ambivalent attitude to mental patients must also be clarified to interpret the modern approach to treating mental patients in colonial Chosun. In this context, a research on historical figures in Japanese psychiatry, a study on the specific treatment methods used by the modern Western psychiatric team in the colonial era and their effects, and the extension of the subject period for such researches are suggested.

  15. Effect of clinical improvement of schizophrenic symptoms on {sup 99m}Tc-HMPAO brain SPECT

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Chul Jin; Koong, Sung Soo; Chung, In Won [College of Medicine, Chungbuk National Univ., Cheongju (Korea, Republic of)


    This study investigated regional blood flow changes of frontal, temporal, and basal ganglia in eleven schizophrenic patients on DSM-IV criteria to examine the relationship between rCBF and clinical improvement of symptoms. Single-photon emission computed tomography imaging with {sup 99m}Tc-HMPAO was performed in baseline and sixth weeks after the treatment, and concurrently psychopathology was assessed by PANSS. Antipsychotics wash-out period was more than 2 weeks, and three patient were drug naive. All patients were finally divided into two groups, the improved or not improved. We examined the difference of the amount of rCBF changes between two groups. Finally, frontal activity shows no significant difference between two groups but both groups show decreased frontal blood flow after antipsychotic treatment. However, the change of right temporal rCBF had positive correlation with the change of the total PANSS score, and the change of left temporal lobe activity was greater in the improved group than in the not improved group. Our results suggest that the temporal lobe activity has relation to the underlying schizophrenic symptoms.

  16. Tissue biomarkers in melanoma patients treated with TIL.

    Directory of Open Access Journals (Sweden)

    Anne-Chantal Knol

    Full Text Available While treating stage III melanoma patients with autologous therapeutic TIL in an adjuvant setting, we previously reported a significant benefit of treatment on both progression-free survival and overall survival in patients with only one invaded lymph node (early stage III compared to patients with more than one invaded lymph nodes (advanced stage III. In this context, in order to understand the difference of activity of TIL therapy according to the progression of the illness at stage III, the first objective of the present study was to determine potential differences in the characteristics of TIL populations obtained from an early stage III and a more advanced stage III when tumor burden is more important. The second objective was to determine possible differences in tissue expression level of several molecules involved in interactions between tumor cells and T cells between early and advanced stage III considering that the tumor microenvironment of invaded lymph nodes could become more tolerant with the progression of the disease. A total of 47 samples of melanoma invaded LN from stage IIIb (AJCC 2007 melanoma patients treated with TIL plus IL-2 were included in this study. We confirmed that both PFS and OS were significantly associated to the presence of tumor-reactive T-cells among TIL injected to the patients and that these tumor reactive T cells were more frequently observed at the early stage III. Moreover, while analyzing the expression of 17 markers on 34/47 tumor specimens using immunohistochemistry, we identified that 3 tissue markers involved in interactions between melanoma cells and T cells have a significant difference of expression between early and advanced stage III: MHC class I, adhesion molecule ICAM-1 and the co-stimulation molecule LFA-3 had a significantly weaker expression in melanoma tissue specimens from advanced stage III. In addition, the expression of the alpha chain of the IL-2 receptor (CD25 and the nuclear

  17. Neuropathic pain in cancer patients treated with bortezomib. (United States)

    Expósito Vizcaíno, S; Casanova-Mollà, J; Escoda, L; Galán, S; Miró, J

    The neuropathic pain is the most habitual problem in the neuropathy induced by chemotherapy (NIQ) and the one that more interferes in the quality of life of the patients. His precocious detection turns out to be fundamental to reduce or to eliminate the problems that from this one stem. The aims of this study were: 1) determine the incident and NIQ's characteristics and neuropathic pain in patients with mieloma multiple (MM) treated with bortezomib, and 2) to evaluate the impact of the neuropathic pain in the activities of the daily life (AVD). All the patients diagnosed of MM candidates for treatment with bortezomib attended in the Hospital Joan XXIII during 2013, took part. The participants were interviewed individually and were reporting on the presence, the characteristics and the impact of the pain, as well as of the adverse effects of the bortezomib. There took part 22 persons, of which NIQ presented the half, being the degree 2 the predominant one. The most habitual location of the neuropathic pain was hands and feet; it was appearing in a spontaneous and progressive way deteriorating in rest and during the night, with predominance of positive symptoms. The impact of the pain was reflected in all the AVD. The principal limitation was the disability to enjoy the life. The peripheral neuropathy occupied the first place in order of subjective importance for the patient followed by the fatigue and the constipation. A proper assessment and early detection of neuropathic pain is critical to minimizing its impact on the quality of life of patients. Copyright © 2016 Sociedad Española de Neurología. Publicado por Elsevier España, S.L.U. All rights reserved.

  18. Controversial issues in treating the dental patient with autism. (United States)

    Rada, Robert E


    The author conducted a literature review to investigate concerns that parents of a child with an autism spectrum disorder may have when oral health care is provided to the child. The author conducted a search of PubMed using the terms "mercury," "fluoride," "nitrous oxide," "antibiotics," "gluten," "casein," "acetaminophen" and "dentistry" each with the term "autism." He identified controlled studies and literature reviews in both medical and alternative medical literature that were related to areas of importance to oral health care workers. The use of mercury, fluoride, nitrous oxide, antibiotic agents and acetaminophen all are sources of controversy between dentistry and the parents of children who have autism. The author found that patients who have autism frequently also have allergies, immune system problems, gastrointestinal disturbances and seizures. Dental health care workers must be aware of these comorbid conditions so they can provide optimal care to the children with autism spectrum disorders. The author found two distinct theories as to what causes autism: one that focuses on genetic causes, and one that focuses on the impact of the environment. He found that the interpretation of these theories might affect parents' concerns about various dental treatments. Dentists treating patients who have autism may need to provide more than standard patient care, as the use of time-tested dental treatment and prevention modalities may be questioned or refused by parents.

  19. Bone mineral density in patients with treated Addison's disease. (United States)

    Braatvedt, G D; Joyce, M; Evans, M; Clearwater, J; Reid, I R


    Some studies have reported low bone mineral density (BMD) in patients with Addison's disease, whereas others have found BMD to be normal. It is possible that over-replacement of corticosteroids and adrenal androgen deficiency may contribute to a reduction in BMD in these patients. The aims of this study were to examine BMD using dual-energy X-ray absorptiometry in patients with treated Addison's disease at multiple skeletal sites and to investigate the relationships between these measurements and corticosteroid dose. Nineteen men, 3 premenopausal and 7 postmenopausal women with Addison's disease were studied and data from these patients were analyzed separately and as a group. The mean SEM age and duration of Addison's disease of the men were 44 +/- 3.8 years and 15 +/- 2.2 years, in the premenopausal women 40 +/- 2 years and 5 +/- 2.4 years, and in the postmenopausal women 68 +/- 4 years and 20 +/- 5 years, respectively. Eight men were unexpectedly hypogonadal (serum testosterone <13 nmol/l). BMD was expressed as a percent of values in normal controls (n = 418) adjusted for age, sex, ethnic origin, menopausal status and body weight. In the whole group (n = 29), mean BMD of the patients with Addison's disease was not different from normal at any site [mean (+/- SEM) lumbar spine 99.5% +/- 2.9%; femoral neck 99.3% +/- 2.5%; Ward's triangle 96.2% +/- 3.5%; trochanter 99.2% +/- 2.9%; radius 99.8% +/- 2.1%; total body 98.5% +/- 1.4%]. However, there was a wide range of bone densities, with some patients having a low BMD at multiple sites. Bone density was negatively correlated with current and cumulative corticosteroid dose per kilogram body weight and duration of Addison's disease. In conclusion, BMD in patients with Addison's disease is little different from normal, but may be lower in patients with disease of long duration and a high cumulative corticosteroid dose. Unexpected hypogonadism in men with Addison's disease is common.

  20. Comparison of weight changes in patients treated with different antidepressants: clinical experiences in Taiwanese patients. (United States)

    Su, Jian-An; Tsang, Hin-Yeung


    Psychiatric patients are more likely to gain weight when prescribed antipsychotics or antidepressants. Studies on these issues in Taiwan are scarce. This study compared weight changes in patients treated with NaSSA (Noradrenergic and Specific Serotonergic Antidepressant) and SSRIs (Selective Serotonin Reuptake Inhibitors), and investigated possible associated factors. An observational, non-randomized study was conducted on all patients diagnosed with depression attending the out-patient's clinic at a general hospital. Patients treated with NaSSA or SSRIs were monitored for 24 weeks. Forty-Seven patients (27 patients on NaSSA and 20 on SSRIs) completed the study. Patients taking NaSSA gained an average of 1.87 kg (SD: 4.14, median: 1.0, range: -3.5 to 11.0) at the end of the study, compared to 1.83 kg (SD: 3.78; median: 1.5, range: -7.0 to 8.0) for the SSRIs group. No statistically significant difference existed between the two groups. However, patients who had never previously been treated with either SSRIs or NaSSA exhibited significantly greater weight gain (4.84 kg, SD: 3.20, median: 4.75, range: 0 to 11.0) than those who had previously been treated (-0.78 kg, SD: 2.36, median: -0.5, range: -7.0 to 3.5). Low initial body mass index and concomitant medications also seemed to be linked to weight gain. Significant weight gain occurred in those patients who had not been previously treated with NaSSA or SSRIs. Patients should be informed of this possibility before initiating treatment, especially those with low body mass index and those prescribed co-medications. Furthermore, the treatment program should include weight monitoring, nutritional assessment and counseling.

  1. Severe hypercalcemia and hypernatremia in a patient treated with canagliflozin. (United States)

    Kaur, Arshpreet; Winters, Stephen J


    Drugs that inhibit the sodium-glucose co-transporter-2 (SGLT2) are an exciting novel, insulin-independent treatment for diabetes that block glucose reabsorption from the proximal tubules of the kidney, leading to increased glucose excretion and lower blood glucose levels. Inhibition of SGLT2 activity also reduces sodium reabsorption, which together with glycosuria produces a mild diuretic effect with the potential for dehydration and hyperkalemia. We report on a 60-year-old man with uncontrolled type 2 diabetes treated with insulin, glimepiride, metformin and canagliflozin, who was admitted with altered mental status after a syncopal episode. He had a 1-week history of ingestion of Tums for heartburn followed by poor appetite and lethargy. Laboratory work-up showed acute kidney injury, diabetic ketoacidosis (DKA), and parathyroid hormone-independent severe hypercalcemia of 17.4 mg/dl. DKA resolved with insulin treatment, and saline hydration led to improvement in hypercalcemia and renal function over 48 h, but was accompanied by a rapid increase in the serum sodium concentration from 129 to 162 mmol/l despite changing fluids to 0.45% saline. Urine studies were consistent with osmotic diuresis. Hypernatremia was slowly corrected with hypotonic fluids, with improvement in his mental status over the next 2 days. This is the first report of hypercalcemia associated with the use of a SLGT2 inhibitor. Although the exact mechanism is unknown, canagliflozin may predispose to hypercalcemia in patients ingesting excessive calcium because of dehydration from osmotic diuresis, with reduced calcium excretion and possible increased intestinal calcium absorption. Saline therapy and osmotic diuresis may lead to hypernatremia from electrolyte-free water loss. Canagliflozin, an SGLT2 inhibitor, may cause hypercalcemia in susceptible patients.Although the exact mechanisms are unknown, dehydration from osmotic diuresis and increased intestinal calcium absorption play a role

  2. Dental Student, Resident, and Faculty Attitudes Toward Treating Medicaid Patients. (United States)

    Behar-Horenstein, Linda S; Feng, Xiaoying


    Failure to receive proper oral health care including both prevention and maintenance is influenced by myriad and complex social, economic, and dental factors, including access to care. Reducing oral health disparities requires changes in the preparation of future dentists as well as measuring and influencing the attitudes and knowledge of practicing dentists. The aim of this study was to determine the likelihood that future dentists (students and residents) and faculty members at one U.S. dental school would treat Medicaid participants. Attitudes were measured using the Deamonte Driver scenario survey, which assesses factors affecting dentists' participation in Medicaid. In October 2012, all 113 full-time faculty members were invited to participate, and 60 completed the survey, for a response rate of 53.1%. In January and February 2013, all 18 residents in the dental clinics and university hospital were invited to participate, and 16 completed the survey, for a response rate of 88.9%. From 2013 to 2015, all 267 students in three classes were invited to participate: first-year students in the Classes of 2017 and 2018 and fourth-year students in the Class of 2015. A total of 255 students completed the survey, for an overall student response rate of 95.5%. The results showed that the students were more likely to participate in caring for Medicaid patients than the faculty and residents. The white and male students had stronger negative stereotypes about Medicaid patients than the females and underrepresented minority students, while residents had stronger negative stereotypes about Medicaid patients than the students and faculty. Overall, the cultural competency skills, beliefs, and attitudes of these faculty members and residents were less developed than those of their students, signaling a need for broad educational and faculty development programs to fully prepare the future dental workforce to care for these patients.

  3. Estimation of localization and dipole moment of alpha- and theta-rhythm sources by cluster analysis in healthy subjects and schizophrenics

    NARCIS (Netherlands)

    Verkhlyutov, VM; Shchuchkin, YV; Ushakov, VL; Strelets, VB; Pirogov, YA


    In 12 healthy subjects and 9 schizophrenic patients in the background conditions (with eyes closed) EEG was recorded from 16 standard derivations (10-20 system) during 3 min. The record underwent the spectral analysis detecting alpha- and theta-frequency bands. After the preliminary narrow band

  4. [New-onset pulmonary tuberculosis patients with schizophrenia: course and efficiency of treatment]. (United States)

    Mishin, V Iu; Shevchuk, E Iu; Tsygankov, B D; Losev, L V


    To investigate the specific features of the course and efficiency of treatment, the authors examined 72 patients with new-onset pulmonary tuberculosis and schizophrenia versus 68 new-onset pulmonary tuberculosis patients without mental diseases. Tuberculosis has been found to be identified in 66.7% of schizophrenics by lung fluorography made at a mental hospital or specialized dispensary. This mainly diagnoses the circumscribed forms of the disease with a low bacterial discharge, drug resistance, and cavitation while in nonschizophrenics, pulmonary tuberculosis is detected in 33.3% of cases in general health care network facilities. Following 9 months, complex treatment of pulmonary tuberculosis in schizophrenics succeeded in ceasing bacterial discharge, as shown by microscopy and sputum cultures, in 94.4 and 84.5% of cases, respectively. However, in schizophrenics receiving chemotherapy for tuberculosis, adverse reactions are revealed in 63.9% of cases, with this the incidence of these reactions depends not only on antituberculosis drugs, but also on drugs taken by patients for schizophrenia. Schizophrenic patients with pulmonary tuberculosis need an individual approach to treating the patient, longer treatment, intermittent use of antituberculosis agents, regular clinical and laboratory monitoring of the development of side effects, and complex pathogenetic treatment.

  5. Increased automatic spreading activation in healthy subjects with elevated scores in a scale assessing schizophrenic language disturbances. (United States)

    Moritz, S; Andresen, B; Domin, F; Martin, T; Probsthein, E; Kretschmer, G; Krausz, M; Naber, D; Spitzer, M


    Previous studies on semantic priming have suggested that schizophrenic patients with language disturbances demonstrate enhanced semantic and indirect semantic priming effects relative to controls. However, the interpretation of semantic priming studies in schizophrenic patients is obscured by methological problems and several artefacts (such as length of illness). We, therefore, used a psychometric high-risk approach to test whether healthy subjects reporting language disturbances resembling those of schizophrenics (as measured by the Frankfurt Complaint Questionnaire subscale 'language') display increased priming effects. In addition, the Schizotypal Personality Questionnaire was used to cover symptoms of schizotypal personality. Enhanced priming was expected to occur under conditions favouring automatic processes. One hundred and sixty healthy subjects performed a lexical decision semantic priming task containing two different stimulus onset asynchronicities (200 ms and 700 ms) with two experimental conditions (semantic priming and indirect semantic priming) each. Analyses of variance revealed that the Frankfurt Complaint Questionnaire-' language' high scorers significantly differed from low scorers in three of the four priming conditions indicating increased automatic spreading activation. No significant results were obtained for the Schizotypal Personality Questionnaire total and subscales scores. In line with Maher and Spitzer it is suggested that increased automatic spreading activation underlies schizophrenia-typical language disturbances which in our study cannot be attributed to confounding variables such as different reaction time baselines, medication or length of illness. Finally, results confirm that the psychometric high-risk approach is an important tool for investigating issues relevant to schizophrenia.

  6. Performance of schizophrenic patients in the Stroop Color Word Test and electrodermal responsiveness after acute administration of cannabidiol (CBD Desempenho de pacientes esquizofrênicos no Stroop Color Word Test e responsividade eletrodérmica após administração aguda de canabidiol (CBD

    Directory of Open Access Journals (Sweden)

    Jaime E. C. Hallak


    Full Text Available OBJECTIVE: The last decade has seen increasing evidence of dysfunctions in the endogenous cannabinoid system in schizophrenia and of its relationship with the typical cognitive impairment of the disorder. Studies in animal models, healthy volunteers, and psychotic patients clearly suggest an antipsychotic-like effect of cannabidiol. This study investigated the effects of cannabidiol on selective attention in 28 schizophrenic patients using the Stroop Color Word Test and on these patients' electrodermal responsiveness to auditive stimuli. METHOD: The subjects attended two experimental sessions, the first one without the administration of drugs. In the second session the subjects were divided into three groups that received either a single dose of cannabidiol 300mg or cannabidiol 600mg or placebo. RESULTS: The three groups did not differ significantly with respect to electrodermal measures in the two experimental sessions. When the first and second sessions were compared improved performance was found in all three groups, with patients who received placebo and cannabidiol 300mg performing better than those who received cannabidiol 600mg. CONCLUSION: The single, acute administration of cannabidiol seems to have no beneficial effects on the performance of schizophrenic patients in the Stroop Color Word Test, although the hypothesis that chronic administration may lead to improvement cannot be disregarded.OBJETIVO: Descobertas relativas a possíveis disfunções do sistema canabinóide endógeno na esquizofrenia e sua relação com o prejuízo cognitivo característico da doença têm aumentado durante a última década. Estudos com modelos animais, voluntários saudáveis e pacientes psicóticos sugerem claramente que o canabidiol possui efeitos antipsicóticos. Este estudo investigou os efeitos do canabidiol sobre a atenção seletiva por meio do Stroop Color Word Test e a responsividade eletrodérmica a estímulos auditivos em 28 pacientes com

  7. [The effect of family nursing on the lived experience of children living with schizophrenic fathers]. (United States)

    Chang, Hsiu-Ju; Chang, Chun-Ju; Lin, Ching-Rong; Chan, Tan-Hsuan; Shiau, Shu-Jen


    The purpose of this study was to explore by means of the phenomenological method the effect of family nursing on the experience of six adolescent offspring living with schizophrenic fathers. Data were collected by family intervention with low structured interview. Three themes of the lived experience of adolescents were identified: stalemate, coping and transcendence. The sub-dimensions of stalemate included encounter with "sick father" and unstable emotion, which resulted from the negative impacts of the father's illness. The sub-dimensions of coping included "sick father" or "my father", being with "sick father", trying to take care of "sick father", identification and differentiation, and the reformulation of "my father". These sub-dimensions emerged after family intervention and included coping in cognition, emotion, and behaviors. The sub-dimensions of transcendence included positive attitude toward psychiatric patients, caring for father's disease and medications, and family life restructuring. The findings from this study could help psychiatric mental health nurses to apply family interventions in order to gain a better understanding of the lived experience of children living with schizophrenic fathers and to enable them to cope positively with the father's disease.

  8. A comparison of new and revised Rorschach measures of schizophrenic functioning in a Serbian clinical sample. (United States)

    Dzamonja-Ignjatovic, Tamara; Smith, Bruce L; Djuric Jocic, Dragana; Milanovic, Marko


    We empirically evaluated indexes derived from the Rorschach Comprehensive System (CS) and the Rorschach Performance Assessment System (R-PAS) that are used for the assessment of psychotic functioning in schizophrenia. We compared the Perceptual Thinking Index (PTI) and the Ego Impairment Index (EII-2) with their revised versions: Thought and Perception Composite (TP-Comp) and EII-3. We evaluated their predictive validity for differentiating schizophrenic from nonschizophrenic patients in a Serbian sample. The sample consisted of 211 (109 men and 102 women, 18-50 years old) inpatients in Serbia who were divided into 2 groups: schizophrenic (100) and nonschizophrenic (111). Test administration, coding, and form quality classification followed CS guidelines. Logistic regression analysis indicated that the new indexes TP-Comp and EII-3 have slightly better predictive power than their counterparts, PTI and EII-2, in identification of schizophrenia, and that TP-Comp performed better than other indexes, although all 4 indexes were successful in differentiating these groups. The results supported the use of TP-Comp in diagnosis of schizophrenia and generally provided evidence for the utility of the Rorschach in evaluating psychosis and for its use in a cross-national context.

  9. Schizophrenic, alcoholic, felon and management factor compositions of social status. (United States)

    Pishkin, V; Thorne, F C


    Administered the Social Status Study scale to four different groups: 174 incarcerated felons, 125 alcoholics, 278 management consultants, and 388 chronic undifferentiated schizophrenics. Five factors were derived fro each of the four populations. Major finding is that factorial composition of the groups is dependent upon specific population characteristics, and the overall factors are not sufficient for clinical judgment of individuals from different subgroups. The resulting factors were clearly unique in depicting social adjustment maladjustment styles in each of the clinical groups.

  10. [Stigma as perceived by schizophrenics and depressives]. (United States)

    Holzinger, Anita; Beck, Michael; Munk, Ingrid; Weithaas, Sandra; Angermeyer, Matthias C


    The goal of this study is to investigate the stigma of mental illness from the perspective of the persons directly affected by it. 210 patients with schizophrenia or major depression were questioned about anticipated and concrete stigmatization experiences, using a questionnaire especially developed for this study. Most of the patients expected negative reactions from the environment. Three quarters were convinced that their job application would be rejected when it became known that they are mentally ill. Almost two thirds felt apprehensive that others would avoid them due to their illness. There is hardly any difference between schizophrenia and depressive patients' assessment of stigmatization of mentally ill people. Concrete stigmatization experiences were most frequently reported in the domain of interpersonal interaction. Second comes the distorted picture of mentally ill people that is depicted in the media and experienced as hurtful by the patients. The obstacles to access social roles (partnership, work, etc.) perceived by the patients come third. Participants least frequently mentioned structural discrimination, i. e. disadvantages regarding psychiatric treatment or rehabilitation measures. Contrary to anticipated stigmatization, there are differences between the two diagnostic groups when it comes to concrete stigmatization experiences. Schizophrenia patients more frequently report that others would avoid contact with them and that the access to social roles was especially complicated for them. They also seemed to be more exposed to structural discrimination than depressive patients. Based on the results of this study, ways are discussed of how stigmatization and discrimination of mentally ill people can be reduced.

  11. Intent-to-treat analysis of health care expenditures of patients treated with atypical antipsychotics as adjunctive therapy in depression. (United States)

    Jing, Yonghua; Kalsekar, Iftekhar; Curkendall, Suellen M; Carls, Ginger S; Bagalman, Erin; Forbes, Robert A; Hebden, Tony; Thase, Michael E


    To compare health care utilization and expenditures in patients with depression whose initial antidepressant (AD) treatment was augmented with a second-generation antipsychotic. Claims data from January 1, 2001, through June 30, 2009, were used to select patients aged 18 to 64 years with depression treated with ADs augmented with aripiprazole, olanzapine, or quetiapine. Patients were required to have 6 months of continuous eligibility before the first AD prescription and 6 months after the second-generation antipsychotic augmentation (index) date. Utilization and expenditures were assessed for 6 months after the index date. Multivariate regression was used to estimate adjusted expenditures and risks for hospitalizations and emergency department visits. A total of 483 patients treated with aripiprazole, 978 with olanzapine, and 2471 with quetiapine were selected. Mean adjusted expenditures for aripiprazole were significantly lower than those for olanzapine for each service category (all-cause, all-cause medical care, mental health-related, and mental health-related medical care) and were significantly lower than those for quetiapine for each category with the exception of mental health-related. The adjusted risks for hospitalization and emergency department visits were significantly higher for quetiapine than for aripiprazole. Compared with patients treated with ADs and aripiprazole, those treated with ADs and olanzapine or quetiapine had greater utilization and higher expenditures. Copyright © 2011 Elsevier HS Journals, Inc. All rights reserved.

  12. Inter-patient variability of platelet reactivity in patients treated with prasugrel and ticagrelor. (United States)

    Siller-Matula, Jolanta M; Akca, Betül; Neunteufl, Thomas; Maurer, Gerald; Lang, Irene M; Kreiner, Gerhard; Berger, Rudolf; Delle-Karth, Georg


    The aim of this study was to evaluate the distribution of platelet reactivity values in patients treated with prasugrel and ticagrelor. This prospective observational study enrolled 200 patients treated with prasugrel or ticagrelor. Platelet aggregation was determined by multiple electrode aggregometry after stimulation with adenosine diphosphate (ADP) in the maintenance phase of treatment with prasugrel or ticagrelor. Only 3% of patients in the prasugrel group and 2% of study participants in the ticagrelor group had high on treatment platelet reactivity (HTPR). The majority of patients displayed low on treatment platelet reactivity (LTPR; prasugrel: 69%; ticagrelor: 64%). The pharmacodynamic effect was similar in patients treated with prasugrel and ticagrelor: the median level of ADP-induced platelet aggregation was 15U (interquartile range IQR 9-21U) under prasugrel treatment and 17U (IQR 8-24U) under ticagrelor treatment (p=0.370). In conclusion, our study suggests that there is some degree of variability in ADP-induced platelet aggregation under treatment with prasugrel and ticagrelor.

  13. [Social integration and contacts to reference persons of the normal social environment in inpatient treatment in the psychiatric hospital. A prospective catamnestic study of patients admitted for the first time with schizophrenic and cyclothymic psychoses]. (United States)

    Böcker, F M


    Fifty first-admission inpatients (27 women, 23 men; mean age 35.1 years) with schizophrenia (n = 35) or affective disorders (n = 15) participated in a standardized, half-open interview about contact with people outside the hospital. The frequency of contact was compared with outcome, as based on a 1-year follow-up. Nearly all patients (48 of 50) had "direct" contact with relatives and friends during the week (means = 3/week): 45 patients had visitors, 13 went home on weekends. Thirty-five patients had contact with the outside by telephone, and 21 by letter; only 12 patients indicated no "indirect" contact. The frequency of contact had no relationship to sex, age or diagnosis. The significant factors were: structure of the patient's family, his/her educational and occupational level, social network, means of admission, conditions of hospitalization, and length of stay. The distance between the patient's residence and the hospital markedly influenced the frequency of visits and weekend holidays. The importance of frequent interaction with the usual social environment was verified by follow-up: 11 patients with rare or only average contact had unfavorable results (readmission or suicide by 1 year after discharge or long-term hospitalization); on the other hand, none of the patients with frequent direct contact outside the hospital showed poor results. There is no reason for indiscriminate criticism of the relatives of psychiatric inpatients according to etiological hypotheses of "family research"; above all, patients without relationships with a family or friends have to be regarded as at risk.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Personality Disorders in Substance Abusers: A Comparison of Patients Treated in a Prison Unit and Patients Treated in Inpatient Treatment (United States)

    Stefansson, Ragnar; Hesse, Morten


    A large body of literature has shown a high prevalence of personality disorders in substance abusers. We compared a sample of substance abusers treated in a prison setting with substance abusers treated in a non-prison inpatient setting rated with the Millon Clinical Multiaxial Inventory-III. Base-rate scores indicated a prevalence of 95% of…

  15. One-Year Follow-Up of Serum Prolactin Level in Schizophrenia Patients Treated with Blonanserin: A Case Series. (United States)

    Takahashi, Sakae; Suzuki, Masahiro; Uchiyama, Makoto


    In our previous study, a prolactin elevation was more frequently in risperidone than in blonanserin; however, it was more often in blonanserin than in olanzapine. Therefore, while a rate of PRL rising is low to moderate, hyperprolactinemia is a considerable adverse effect in the blonanserin treatment. In this study, to examine detailed characteristics of hyperprolactinemia of blonanserin, we analyzed the prolactin data in six schizophrenic patients who were switched to blonanserin from other antipsychotics and followed for one year. As a result, blonanserin dose was clearly associated with serum prolactin level. The average prolactin level was almost normal when the mean blonanserin dosage was 8.0 mg/day. Regardless of the dose decrease of blonanserin, there were no remarkable changes in symptoms and social functions. Based on our findings, we conclude that low dose blonanserin medication may be useful for schizophrenia maintenance treatment without hyperprolactinemia and a high rate of relapse.

  16. The relation of serotonin-related gene and COMT gene polymorphisms with criminal behavior in schizophrenic disorder. (United States)

    Koh, Kyung Bong; Choi, Eun Hee; Lee, Young-joon; Han, Mooyoung; Choi, Sang-Sup; Kim, So Won; Lee, Min Goo


    It has been suggested that patients with schizophrenia might be involved in criminal behavior, such as homicidal and violent behavior. However, the relationship between criminal behavior and genes in patients with schizophrenia has not been clearly elucidated. The objective of this study was to examine the relation between criminal behavior and serotonin-related gene or catechol-O-methyltransferase (COMT) gene polymorphisms in patients with schizophrenia. Serotonin-related and COMT polymorphic markers were assessed by using single nucleotide polymorphism (SNP) genotyping. Ninety-nine crime-related inpatients with schizophrenia (57 homicidal and 42 nonhomicidal violent) and 133 healthy subjects were enrolled between October 2005 and May 2008. Diagnoses were made according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. The genotype frequencies of tryptophan hydroxylase-1 (TPH1) A218C and COMT V158M were compared between groups. The TPH1 CC genotype had 2.7-fold higher odds of crime-related schizophrenia compared with A-carrier genotype after the analysis was controlled for sex and age (OR, 2.69; 95% CI, 1.22 - 5.91; P = .01). In addition, the TPH1 CC genotype had 3.4-fold higher odds of homicidal schizophrenia compared with A-carrier genotype after the analysis was controlled for sex and age (OR, 3.38; 95% CI, 1.40 - 8.18; P = .007). However, no significant differences were found in the frequencies of genotype of COMT polymorphism between criminal schizophrenics and healthy subjects, nor were any significant differences found between nonhomicidal schizophrenics and healthy subjects. These results indicate that the TPH1 CC recessive genotype is likely to be a genetic risk factor for criminal behavior, especially homicidal behavior in patients with schizophrenia. However, COMT gene polymorphisms were not associated with criminal behavior in schizophrenic patients. © Copyright 2012 Physicians Postgraduate Press, Inc.

  17. Revisiting the Association of Aggression and Suicidal Behavior in Schizophrenic Inpatients (United States)

    Neuner, Tanja; Hubner-Liebermann, Bettina; Hausner, Helmut; Hajak, Goran; Wolfersdorf, Manfred; Spiessl, Hermann


    Our study investigated the association of aggression and suicidal behavior in schizophrenic inpatients. Eight thousand nine hundred one admissions for schizophrenia (1998-2007) to a psychiatric university hospital were included. Schizophrenic suicides (n = 7)/suicide attempters (n = 40) were compared to suicides (n = 30)/suicide attempters (n =…

  18. Pragmatic assessment of schizophrenic bilinguals' L1 and L2 use ...

    African Journals Online (AJOL)

    This paper reports on a study investigating the pragmatic skills and deficits of schizophrenic bilinguals in their spontaneous first language (L1) and second language (L2) speech. Smit (2009) (see also Smit et al., this volume) argues that the locus of deficits in schizophrenic speech is semantics and suggests that a next step ...

  19. [Peculiarities of schizophrenic diseases in prelingually deaf persons]. (United States)

    Engmann, B


    Diagnostic criteria of schizophrenia, according to Kurt Schneider's first and second range symptoms appear in spoken language. This raises the question of how symptoms of schizophrenia are manifested in prelingually deaf people who mainly communicate with sign language. The article shows that acoustic hallucinations of normal hearing schizophrenic people correspond to visual and tactile hallucinations of the prelingually deaf. An additional similarity is found in a disorder of the structure of the language. These similarities show that schizophrenia does not depend on the acoustic part of language or the acquisition of spoken language.

  20. Treating Infertility (United States)

    ... Education & Events Advocacy For Patients About ACOG Treating Infertility Home For Patients Search FAQs Treating Infertility Page ... Treating Infertility FAQ137, October 2017 PDF Format Treating Infertility Gynecologic Problems What is infertility? What causes infertility ...

  1. Treatment responses in adult depressive patients treated with ...

    African Journals Online (AJOL)

    INTRODUCTION. Depression is a severe psychiatric disorder involving multiple etiological factors such as the surrounding environment and genetics [1]. The main precipitating factor in depression is stress, which can be treated with antidepressants [2-5]. Many researchers have reported clear evidence of altered endocrine ...

  2. Medico-social characteristics of patients treated in rehabilitation centres

    Directory of Open Access Journals (Sweden)

    Shapovalenko T.V.


    Full Text Available Aim: analysis of the medical social characteristics of patients of rehabilitation center. Material and methods. The data that had been got by extracting from medical records of patients of the Center of restorative medicine and rehabilitation «Medical rehabilitation center» MOH of Russia on a specially developed «Patient card» were analyzed. Results. Among the majority of patients (who got treatment in the center with diseases of the musculoskeletal system and connective tissue (44,9%, almost 1/3 (29,2% were patients with diseases of the circulatory system, in the third place — patients with injuries (14,1 %. Conclusion. As a result of the peculiarities of a patient health condition of different age and social position had been revealed.

  3. Portal biliopathy: a study of 39 surgically treated patients. (United States)

    Agarwal, Anil Kumar; Sharma, Dharamanjai; Singh, Shivendra; Agarwal, Shaleen; Girish, S P


    Portal biliopathy (PBP) denotes intra- and extrahepatic biliary duct abnormalities that occur as a result of portal hypertension and is commonly seen in extrahepatic portal vein obstruction (EHPVO). The management of symptomatic PBP is still controversial. Prospectively collected data for surgically managed PBP patients from 1996 to 2007 were retrospectively analysed for presentation, clinical features, imaging and the results of surgery. All patients were assessed with a view to performing decompressive shunt surgery as a first-stage procedure and biliary drainage as a second stage-procedure if required, based on evaluation at 6 weeks after shunt surgery. A total of 39 patients (27 males, mean age 29.56 years) with symptomatic PBP were managed surgically. Jaundice was the most common symptom. Two patients in whom shunt surgery was unsuitable underwent a biliary drainage procedure. A total of 37 patients required a proximal splenorenal shunt as first-stage surgery. Of these, only 13 patients required second-stage surgery. Biliary drainage procedures (hepaticojejunostomy [n= 11], choledochoduodenostomy [n= 1]) were performed in 12 patients with dominant strictures and choledocholithiasis. One patient had successful endoscopic clearance of common bile duct (CBD) stones after first-stage surgery and required only cholecystectomy as a second-stage procedure. The average perioperative blood product transfusion requirement in second-stage surgery was 0.9 units and postoperative complications were minimal with no mortality. Over a mean follow-up of 32.2 months, all patients were asymptomatic. Decompressive shunt surgery alone relieved biliary obstruction in 24 of 37 patients (64.9%) and facilitated a safe second-stage biliary decompressive procedure in the remaining 13 patients (35.1%). Decompressive shunt surgery alone relieves biliary obstruction in the majority of patients with symptomatic PBP and facilitates endoscopic or surgical management in patients who require

  4. Dyspnoea management in acute coronary syndrome patients treated with ticagrelor


    Parodi, Guido; Storey, Robert F


    The occurrence of dyspnoea in acute coronary syndrome (ACS) patients has always been considered a challenging diagnostic and therapeutic clinical scenario. P2Y12 platelet receptor inhibitors (i.e., clopidogrel, prasugrel and ticagrelor) are currently the cornerstone of treatment of ACS patients. Thus, in the last few years, the potential association between ACS and dyspnoea has also become more challenging with the increasing use of ticagrelor in these patients due to its beneficial effects o...

  5. Regional cerebral blood flow measurements in schizophrenics by /sup 133/Xe inhalation and intra-venous injection method

    Energy Technology Data Exchange (ETDEWEB)

    Matsuda, Hiroshi; Seki, Hiroyasu; Sumiya, Hisashi; Ishida, Hiroko; Taki, Junichi; Hisada, Kinichi; Kurachi, Masayoshi; Kobayashi, Katsuji; Yamaguchi, Nariyoshi (Kanazawa Univ. (Japan). School of Medicine)


    Regional cerebral blood flow measurements were performed in 25 schizophrenic patients and 25 healthy volunteers by /sup 133/Xe inhalation and intra-venous injection method. Schizophrenic patients were classified into the following three groups. Group I: 8 patients without auditory hallucination measured by 2-dimensional /sup 133/Xe inhalation method. Group II: 6 patients with auditory hallucination measured by the same method as in Group I. Group III: 11 patients, including 2 patients with auditory hallucination measured by 3-dimensional /sup 133/Xe intra-venous injection method at the level of OM+5 cm. Bilateral regional percent values, which were obtained by dividing regional values by hemispheric mean or sectional mean values, for frontal lobes in Group I and II were significantly lower than those in the controls. In addition, bilateral regional percent values for bilateral temporal lobes in Group II were significantly higher than those in the controls. In Group III, regional percent values for right frontal lobes and those for posterior part of central gray matter showed significant decrease and increase, respectively. These findings would suggest that the negative symptoms of schizophrenia are related to the hypofrontal and positive ones to the hypertemporoparietal activity.

  6. Nutrition and lifestyle in patients pharmacologically treated due to hypertensionally treated due to hypertension. (United States)

    Jarosz, Mirosław; Wolańska, Diana; Stolińska, Hanna; Respondek, Wioleta; Kłosiewicz-Latoszek, Longina


    Proper nutrition and physical activity are together an important way of non-pharmacological treatment of arterial hypertension. The aim of the study was to answer the question whether patients with hypertension use non-pharmacological methods of hypertension treatment. The study included a group of 280 patients aged 18-85, suffering from hypertension. In the study, 10 nutritional and non-nutritional factors affecting the treatment of hypertension were analyzed. Data regarding the diet were collected by a method of 24-h recall. Basic anthropometric measurements (body weight, body height, waist and hip circumference) were taken, as well as threefold measurement of blood pressure. The data were statistically analyzed. The average value of blood pressure was 131.2 ± 15.5/82.9 ± 10.5 mm Hg. Approximately 90% of the respondents had abnormal body weight, i.e. excessive weight or obesity. Abdominal obesity according to waist hip ratio (WHR) assessment was diagnosed in 87% of women and 66% of men; according to the measurement of waist circumference, it was diagnosed in 140 (81%) women and 88 (81%) men. Among the ingredients with antihypertensive effect, the sodium intake was 4,417.8 ± 2,052.7 mg/d, which when converted to salt is on average 11 g/d, potassium: 3,808.5 ± 1,265.7 mg/d, calcium: 724.6 ± 413.7 mg/d, and magnesium: 383.9 ± 139.3 mg/d. One in 5 (18%) people declared smoking. Only 5% of subjects reported high level of physical activity. In persons with diagnosed hypertension, vast majority of patients did not implement non-pharmacological hypertension treatment.

  7. Pulmonary artery dissection in a patient with Eisenmenger syndrome treated with heart and lung transplantation

    DEFF Research Database (Denmark)

    Tønder, Niels; Køber, Lars; Hassager, Christian


    We report the case of a patient with known Eisenmenger syndrome due to congenital ventricular septal defect, who developed pulmonary artery dissection. The patient was successfully treated with heart and lung transplantation.......We report the case of a patient with known Eisenmenger syndrome due to congenital ventricular septal defect, who developed pulmonary artery dissection. The patient was successfully treated with heart and lung transplantation....

  8. Diabetic patients treated with dialysis: complications and quality of life

    DEFF Research Database (Denmark)

    Sørensen, V R; Mathiesen, E R; Watt, T


    AIMS/HYPOTHESIS: The aim of this study was to describe the prevalence of complications, health-related quality of life (HRQOL) and the influence of beliefs about control over health in diabetic dialysis patients. METHODS: Of 53 eligible diabetic patients on chronic dialysis during January 2004...... in our clinic, 38 (76%) completed a kidney-specific (Kidney Disease Quality of Life) and a generic (SF-36) questionnaire and were characterised in terms of cardiovascular diseases and diabetic complications. Matched groups of non-diabetic dialysis patients (n = 40) and diabetic patients with a long...... population (47 +/- 19). The diabetic dialysis patients had similar levels of kidney-specific quality of life and mental health compared with the control groups. Reduced physical health was predicted by the presence of end-stage renal disease, diabetes and short time spent in education. Among the diabetic...

  9. LASIK and surface ablation in patients treated with amiodarone. (United States)

    Ortega-Usobiaga, J; Llovet-Osuna, F; Reza Djodeyre, M; Cobo-Soriano, R; Llovet-Rausell, A; Baviera-Sabater, J


    To determine the anatomical and functional outcomes of corneal refractive surgery in patients on amiodarone, a drug listed as being contraindicated in patients undergoing this procedure. A retrospective observational study was conducted on all consecutive patients who took amiodarone and who underwent LASIK or surface ablation from January 2003 to December 2014. Functional (visual and refractive) outcomes are described. A total of 20 patients (33 eyes) were included. No significant intraoperative or postoperative complications were found. In our experience, LASIK and surface ablation did not produce significant clinical complications in selected patients taking amiodarone. The absolute exclusion of certain systemic medications should be reconsidered. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  10. Qualidade de vida de pacientes com esquizofrenia internados em hospital de custódia An evaluation of the quality of life of schizophrenic patients admitted to a forensic hospital

    Directory of Open Access Journals (Sweden)

    Ana Flávia Ferreira de Almeida Santana


    Full Text Available OBJETIVO: Investigar a qualidade de vida (QV de pacientes com o diagnóstico de esquizofrenia que cumprem medida de segurança em regime fechado. MÉTODOS: Estudo epidemiológico com delineamento transversal, realizado com pacientes de um hospital de custódia. As entrevistas foram conduzidas utilizando questionário sociodemográfico e a escala de qualidade de vida Quality of Life Scale (QLS-BR, específica para pacientes com diagnóstico de esquizofrenia. Foi realizada análise descritiva e multivariada. A associação entre os escores de QV e as características clínicas, sociodemográficas e do delito foi obtida por análise multivariada, através da árvore de decisão, por meio do algoritmo Chi-squared Automatic Interaction Detector (CHAID. RESULTADOS: Participaram deste estudo 54 pacientes, sendo 90,7% do sexo masculino, com a média de idade de 40 anos. Todos os domínios de qualidade de vida, inclusive o global, apresentaram escores compatíveis com uma QV muito baixa. O domínio ocupacional apresentou-se como o mais comprometido. Maior duração da doença, ter cometido homicídio e estar com idade superior a 40 anos foram as variáveis associadas a uma baixa qualidade de vida pela análise multivariada. CONCLUSÃO: Evidenciou-se uma baixa QV dos pacientes que cumprem medida de segurança em regime fechado, realidade que precisa ser modificada a partir da viabilização de mudanças nas políticas brasileiras.OBJECTIVE: To investigate the quality of life (QOL in patients diagnosed with schizophrenia that are under involuntary commitment. METHODS: A cross-sectional epidemiological study was carried out on patients from a penitentiary hospital. The survey was conductid by a social-demographic questionnaire and the Quality of Life Scale (QLS-BR, specific for patients diagnosed with schizophrenia. A descriptive and multivariate analysis was performed. The association between the scores of QOL and the clinical, social-demographic and

  11. Willingness of Health-Professions Students to Treat Patients with AIDS. (United States)

    Currey, Charles J.; And Others


    This 1988-89 survey of 319 students in the medical, dental, nursing, and allied health-care professions revealed that over one-third had reservations about treating AIDS (Acquired Immune Deficiency Syndrome) patients. Unwillingness to treat AIDS patients was strongly associated with homophobic attitudes. Education should emphasize methods for the…

  12. Incidence of cancer in adolescent idiopathic scoliosis patients treated 25 years previously

    DEFF Research Database (Denmark)

    Simony, Ane; Hansen, Emil Jesper; Christensen, Steen Bach


    PURPOSE: To report the incidence of cancer in a cohort of adolescent idiopathic scoliosis (AIS) patients treated 25 years previously. METHODS: 215 consecutive AIS patients treated between 1983 and 1990 were identified and requested to return for clinical and radiographic examination. The incidence...

  13. Target lesion revascularisation in patients treated with a sirolimus-eluting or paclitaxel-eluting stent

    DEFF Research Database (Denmark)

    Maeng, Michael; Okkels Jensen, Lisette; Rasmussen, Klaus


    OBJECTIVE: To identify risk factors for clinical-driven target lesion revascularisation (TLR) in patients treated with sirolimus-eluting (Cypher) or paclitaxel-eluting (Taxus) stents in a real-world scenario. DESIGN: From 1 January 2003 to 18 May 2005, all patients treated with a Cypher or Taxus...

  14. Hearing status of thalassemic patients treated with dessfroxamin

    Directory of Open Access Journals (Sweden)

    Majid Ashrafi


    Full Text Available Background: Major beta thalassemia is the most common inherited anemia with high prevalence in Iran and hearing loss is one of its side effects. The present study aimed to determine the hearing status of patients with major thalassemia and its relationship with serum ferritin level, period of blood transfusion and Dessfroxamin administration.Methods: This descriptive-analytic study was performed on 80 thalassemia major patients (36 Male and 44 Female aged 4-32 (14.2 ±2.3 who were referred to Bou Ali Hospital for two years. The studied variables include age, gender, serum ferritin level, amount and duration of Desferal injection and hearing level. All subjects went under evaluation for their otologic and audiometric status. The collected data were analyzed using t-test and ANOVA with SPSS software.Results: The findings of the study indicated that 38 patients (47% had entirely hearing loss. Among these 38 patients, 17 patients had sensory neural type f hearing loss 12 patients had conductive and 7 patients had mixed type of hearing problems. The results showed a significant relationship (p<0.05 between hearing loss and serum ferritin level and the dosage and duration of Desferal administration. Conclusion: Hearing impairment may develop with increasing dosage of Dessfroxamin. Periodic follow up and physical examination is recommended to prevent hearing impairment in major thalassemia.

  15. American brain tumor patients treated with BNCT in Japan

    Energy Technology Data Exchange (ETDEWEB)

    Laramore, G.E.; Griffin, B.R.; Spence, A.


    The purpose of this work is to establish and maintain a database for patients from the United States who have received BNCT in Japan for malignant gliomas of the brain. This database will serve as a resource for the DOE to aid in decisions relating to BNCT research in the United States, as well as assisting the design and implementation of clinical trials of BNCT for brain cancer patients in this country. The database will also serve as an information resource for patients with brain tumors and their families who are considering this form of therapy.

  16. [Effectiveness of treating periodontitis in patients with thyroid dysfunction]. (United States)

    Moskvina, T S


    Efficiency of some drugs in the treatment of periodontitis in combination with corrective treatment of thyroid function was evaluated in 70 patients with hypo- and hyperthyrosis with different initial level of nonspecific resistance. The therapeutic complex including drugs commonly used in the treatment of periodontitis and irrigation of the periodontium with lithium chloride and chlorohexidine solutions was highly effective in patients with thyroid dysfunction and relatively favorable status of nonspecific resistance of the organism. In patients with hypo- and hyperthyrosis with poor nonspecific resistance the best effect in the treatment of periodontitis was attained with potassium orotate as an immunomodulator and lithium chloride.

  17. Color vision loss in patients treated with chloroquine

    Directory of Open Access Journals (Sweden)

    Ventura Dora F.


    Full Text Available Patients that make use of chloroquine or hydroxychloroquine, drugs which are frequently administered for treatment of rheumatoid arthritis, lupus erithromatosus or malaria, may suffer alterations in color vision and in contrast sensitivity. The present work evaluates the visual function of these patients in a joint study of the University of São Paulo (USP, in São Paulo, and of the Federal University of Pará (UFPA, in Belém. Thirty two chloroquine user patients without alterations in the eye fundus exam were evaluated in São Paulo (n=10; aged 38 to 71 years; mean=55,8 years and in Belém (n=22; aged 20 to 67; mean=40 years. The prescribed accumulated chloroquine dose was 45 to 430 g (mean=213 g; sd = 152 g for the São Paulo group, and 36 to 540 g (mean=174 g; sd=183 g for the Belém group. Tests were performed monocularly with corrected eye refractive state. Color discrimination was evaluated using the Cambridge Colour Test (CCT: the color discrimination threshold was measured first in the protan, deutan and tritan axes and, in succession, three MacAdam's ellipses were determined. The patient's color vision was also evaluated with color arrangement tests: the Farnsworth-Munsell 100 Hue (FM100, the Farnsworth-Munsell D15, and the Lanthony Desaturated (D15d tests. We also measured the contrast sensitivity for black-and-white sine wave grating of twenty two patients. The results were compared with controls without ophthalmologic or neuro-ophthalmologic pathologies. Twenty four patients presented acquired dyschromatopsia. There were cases of selective loss (11 patients and of diffuse loss (13 patients. Although losses were present in the FM100 there was no correlation between the FM100 error score and the ellipse area measured by the CCT. Moreover, three patients that scored normal in the FM100, failed to reach normal threshold in the CCT. The Lanthony test was less sensitive than the other two tests, since it failed to indicate loss in about

  18. Breast cancer patients treated with chemotherapy reports more unmet supportive care needs in the early treatment phase, than patients treated only with radiotherapy

    DEFF Research Database (Denmark)

    Jensen-Johansen, Mikael Birkelund; Meldgaard, Anette; Henriksen, Jette


    Breast Cancer Patients Treated with Chemo-therapy Reports More Unmet Supportive Care Needs in the Early Treatment Phase, than Patients Treated Only with Radio-therapy Jensen-Johansen, Mikael Birkelund, Meldgaard, Anette, Henriksen, Jette, Villadsen, Ingrid VIA University College, Holstebro, Denmark...... Aims: The purpose was to identify unmet supportive care needs in the early treatment phase of women treated for breast cancer and to investigate differences in needs between groups treated with chemo-therapy and radiationtherapy. If it is possible to identify early unmet needs, it may be possible...... of a large battery of selfadministered questionnaires, the women filled out at home, the Supportive Care Needs Survey (SCNS-SF34) together with demographic items (socioeconomic status, working hours, marital status etc.). The SCNS-SF34 includes 5 different domains of needs: Psychological-, Health system...

  19. Preventing Fatigue in Patients With Breast Cancer Treated with Chemotherapy

    National Research Council Canada - National Science Library

    Marrow, Gary


    ... or alleviate the development of treatment-induced fatigue. We conducted a randomized, double-blind, placebo-controlled clinical trial with 124 breast cancer patients who were studied for up to four successive chemotherapy treatments...

  20. Nephrogenic diabetes insipidus in a lethargic lithium-treated patient

    NARCIS (Netherlands)

    Meinardi, [No Value; Donders, SHJ

    We report on a patient who developed severe lithium-induced nephrogenic diabetes insipidus (NDI) and neurotoxicity, despite recommended serum lithium levels. Hydrochlorothiazide and indomethacin appeared effective antipolyuric drugs, which led to a normalization of serum osmolality. After

  1. Treating depression in HIV-positive patients affects adherence ...

    African Journals Online (AJOL)

    positive patients with depression, following treatment with an antidepressant or psychotherapy. Methods. The study was prospective, randomised and controlled. Consenting volunteers aged .18 years and stable on ART for .6 months were ...

  2. Baseline Biomarkers for Outcome of Melanoma Patients Treated with Pembrolizumab

    NARCIS (Netherlands)

    Weide, Benjamin; Martens, Alexander; Hassel, Jessica C.; Berking, Carola; Postow, Michael A.; Bisschop, Kees; Simeone, Ester; Mangana, Johanna; Schilling, Bastian; Di Giacomo, Anna Maria; Brenner, Nicole; Kaehler, Katharina; Heinzerling, Lucie; Gutzmer, Ralf; Bender, Armin; Gebhardt, Christoffer; Romano, Emanuela; Meier, Friedegund; Martus, Peter; Maio, Michele; Blank, Christian; Schadendorf, Dirk; Dummer, Reinhard; Ascierto, Paolo A.; Hospers, Geke; Garbe, Claus; Wolchok, Jedd D.


    Purpose: Biomarkers for outcome after immune-checkpoint blockade are strongly needed as these may influence individual treatment selection or sequence. We aimed to identify baseline factors associated with overall survival (OS) after pembrolizumab treatment in melanoma patients. Experimental Design:

  3. Treating Patients with High-Risk Smoldering Myeloma (United States)

    In this phase III clinical trial, patients with smoldering myeloma classified as high risk for progression will be randomly assigned to undergo standard observation or six 4-week courses of treatment with the drug lenalidomide.

  4. Pain in neurosurgically treated patients: A prospective observational study

    NARCIS (Netherlands)

    M. Klimek (Markus); J.F. Ubben (Johannes); J. Ammann (Jan); K. Borner (Katy); J. Klein (Jan); S.J.C. Verbrugge (Serge)


    textabstractObject. This is the first observational study to compare perioperative pain character and intensity in patients undergoing different types of elective neurosurgical procedures. Methods. A structured questionnaire was used to inquire about pain intensity, character, and management during

  5. Osteonecrosis in patients with testicular tumours treated with chemotherapy.


    Berkmortel, F. van den; Wit, R.; Rooy, J.W.J. de; De Mulder, P. H. M.


    The role of antiemetics is invaluable in allowing cancer patients to complete, otherwise possibly intolerable, chemotherapy. In the Perugia Consensus Conference it was decided that the recommended antiemetic regimen in the prevention of acute emesis induced by a single high, low and repeated doses of cisplatin is a serotonin receptor antagonist plus dexamethasone. We describe three testicular cancer patients who were cured with chemotherapy but developed bilateral osteonecrosis of the femoral...

  6. [Illness Concepts of Patients with Schizophrenia: A Triangulation Study]. (United States)

    Wigand, Moritz E; Reichhardt, Lea; Lang, Fabian U; Krumm, Silvia; Jäger, Markus


    Objective Therapists' and patients' concepts of illness often show severe discrepancies. This study explores the illness concepts of patients with schizophrenic disorders (n = 40). Methods Two German scales were used, the "Causal Belief Questionnaire" and the "Illness Concept Scale for Schizophrenic Patients". We compared our data with data published previously. A semi structured interview was performed in a convenience sample (n = 7). Results The domains "trust in medication" and "trust in the treating physician" yielded high scores, yet in comparison with data published 30 years ago, trust in medication is unaltered, while trust in psychiatrists is even slightly lower. Recent psychosocial factors scored high as a possible cause of mental illness. Several patients felt responsible for being mentally ill. No patient in the interview mentioned the neurotransmitter hypothesis of schizophrenia. Conclusion Illness concepts of patients with schizophrenic disorders are a complex phenomenon. Triangulation of quantitative and qualitative methods proves to be a promising approach for future studies. © Georg Thieme Verlag KG Stuttgart · New York.

  7. Analysis of neural sources of p300 event-related potential in normal and schizophrenic participants. (United States)

    Sabeti, Malihe; Moradi, Ehsan; Katebi, Serajeddin


    The P300 event-related potential (ERP) is associated with attention and memory operations of the brain. P300 is changed in many cognitive disorders such as dementia, Alzheimer, schizophrenia, and major depression disorder. Therefore, investigation on basis of this component can help to improve our understanding of pathophysiology of such disorders and fundamentals of memory and attention mechanism. In this study, electroencephalography (EEG) signals of 20 schizophrenic patients and 20 age-matched normal subjects are analyzed. The oddball paradigm has been used to record the P300, where two stimuli including target and standard are presented with different probabilities in a random order. Data analysis is carried out using conventional averaging techniques as well as P300 source localization with low-resolution brain electromagnetic tomography (LORETA). The results show that the P300 components stem from a wide cerebral cortex network and defining a small definite cortical zone as its generator is impossible. In normal group, cingulate gyrus, one of the essential components of working memory circuit that was reported by Papez, is found to be the most activated area and it can be in line with the hypothesis that at least a part of the P300 is elicited by working-memory circuit. In schizophrenic group, frontal lobe is the most activated area that was responsible for P300 sources. Our results show that the cingulate gyrus is not activated in comparison with normal group, which is in line with previous results that dysfunction of the anterior cingulate cortex plays a prominent role in the schizophrenia disorder.

  8. Treating depression in HIV-positive patients affects adherence

    Directory of Open Access Journals (Sweden)

    M Y H Moosa


    Full Text Available Aim. To determine changes in adherence to antiretroviral therapy (ART in HIV-positive patients with depression, following treatment with an antidepressant or psychotherapy. Methods. The study was prospective, randomised and controlled. Consenting volunteers aged ≥18 years and stable on ART for ≥6 months were included in the study. Sociodemographic data were obtained, and a clinical diagnostic evaluation and the Hamilton Depression rating scale (HAMD were performed on all subjects at entry to and at the end of the study. Participants found to be depressed were randomly assigned antidepressant treatment (20 mg citalopram or interpersonal psychotherapy (IPT (5 sessions. Medication was dispensed at each visit and patients were asked to return all unused medication to determine ART adherence. The study was approved by the University of the Witwatersrand. Results. Sixty-two HIV-positive persons receiving ART participated; 30 were not depressed (control group and 32 were depressed (patient group. No significant differences in demographic characteristics existed between the control and patient groups. Mean ART adherence at the start of the study was 99.5% (standard error (SE ±0.46 and 92.1% (SE ±1.69 in the control and patients groups, respectively. Mean ART adherence at the end of the study changed marginally in the control group (99.7%; SE ±0.46 and increased significantly in the patient group (99.5%; SE± 0.13 (p>0.05. The mean ART adherence rate of patients who received pharmacotherapy increased from 92.8% to 99.5%, and of those who received psychotherapy increased from 91.1% to 99.6% (p>0.05. There was no significant association between the increased adherence in the patient group and baseline demographic and clinical characteristics, irrespective of antidepressant therapy or IPT (p>0.05. Conclusion. Successful treatment of depression with an antidepressant or psychotherapy was associated with improved ART adherence, independent of the type

  9. Update on scar management: guidelines for treating Asian patients. (United States)

    Kim, Sukwha; Choi, Tae Hyun; Liu, Wei; Ogawa, Rei; Suh, Jeong Seok; Mustoe, Thomas A


    Following injury, Asian skin has a tendency towards hyper-pigmentation and scar formation, and therefore the prevention of scarring is particularly important in Asian patients. Since publication of an International Clinical Recommendation on Scar Management in 2002, there have been numerous publications in the field of scar management. Advances in understanding scar formation have also led to the introduction of new treatments as well as a better understanding of established therapeutic options. A literature search for abstracts, clinical trials and meta-analyses evaluating scar prevention and treatment was performed using PubMed and the Cochrane Database of Systematic Reviews. Based on this data a panel of experts formulated treatment recommendations for Asian patients. Following surgery, scar prevention should be initiated in all Asian patients due to the high risk of poor scars. There is strong evidence for the efficacy of silicone based products, and due to their ease of use, they can be considered first-line therapy. Silicone gel (versus silicone gel sheets) products have demonstrated efficacy. For patients who fail to respond to first-line therapy, intralesional steroid injections, radiation therapy, and intralesional 5-flourouracil injections have achieved widespread acceptance. Laser treatments have been increasingly used, although the evidence remains largely anecdotal without a clear consensus on optimal wavelength, or amount of energy. Surgical approaches have increased in sophistication with recognition of the impact that tension has on scar formation. Updated scar management recommendations will benefit practitioners making decisions regarding optimal, evidence-based treatment strategies for their patients.

  10. Treating vertigo with vestibular rehabilitation: results in 155 patients. (United States)

    Bittar, R S M; Pedalini, M E B; Lorenzi, M C; Formigoni, L G


    Balance is fundamental to our daily activities and the vestibular system, together with vision and proprioceptive functions, are the main structures involved in this process. Dizziness is the main clinical manifestation of malfunction of these systems. The mechanisms of vestibular compensation are one of the most studied aspects since they play an important role in the patient's everyday activities. In this retrospective description of a series of cases the authors present their results in 155 patients that underwent a program of vestibular rehabilitation (VR). The program, first described by Cawthorne and Coosey, is based on mechanisms of potentiation of the cervico-ocular reflex and substitution of the lost vestibular cues for visual and somatosensory cues. The results were satisfactory (remission or partial cure) in 75.5% of the patients, with an average treatment time of up to 2 months and 5 or fewer sessions performed in most of the cases. The results were somewhat inferior in those cases in which a central vestibular lesion or more than one etiologic factor was present. The results of a subgroup of elderly patients (age > 65 years) were similar to those of the total number of studied subjects. Vestibular rehabilitation, associated to the specific etiological treatment, appears to be a very useful tool in the management of patients suffering from dizziness of all ages, although different clinical responses to the therapy may vary according to the presence of a central or a peripheral vestibular lesion or multiple etiological factors.

  11. Retrospective study of advanced melanoma patients treated with ipilimumab after nivolumab: Analysis of 60 Japanese patients. (United States)

    Fujisawa, Yasuhiro; Yoshino, Koji; Otsuka, Atsushi; Funakoshi, Takeru; Uchi, Hiroshi; Fujimura, Taku; Matsushita, Shigeto; Hata, Hiroo; Okuhira, Hisako; Tanaka, Ryota; Nagai, Kojiro; Ishida, Yoshihiro; Nakamura, Yoshio; Furudate, Sadanori; Yamamura, Kentaro; Imafuku, Keisuke; Yamamoto, Yuki


    Due to resistance and immune-related adverse events (irAE) some melanoma patients require ipilimumab after nivolumab therapy. However, little is known about the result of this switching. Investigate the outcome of ipilimumab switching in Japanese patients. We retrospectively collected 60 patients who were treated with ipilimumab after nivolumab from 9 institutes in Japan. Information of the primary tumor, treatment, response, irAE), and survival was collected. In our cohort, acral lentiginous and mucosal melanoma accounted for 53% of the cases. The most common reason for initiating ipilimumab was disease progression (93%). Median interval from the last nivolumab administration to first ipilimumab administration was 29days. Only 38% of patients completed 4 injections of ipilimumab. The best overall response was 3.6%. IrAE occurred in 78% of patients and 70% of those were of grade 3/4 (G3/4) and 31% of patients experienced 2 or more irAEs. An within interval of 28days or less between the last nivolumab administration and ipilimumab administration was correlated with the development of G3/4 pyrexia and 3 or more irAEs, but irAE occurrence did not affect survival. Multivariate analysis showed that endocrine irAE (relative risk=0.22, P=0.015) and skin irAE (relative risk=2.78, P=0.048) were significant factors associated with survival. In our study, the response ratio to ipilimumab after nivolumab was unsatisfactory and associated with a high frequency of severe irAEs. As there are few second-line treatment options for patients with BRAF wild-type advanced melanoma after nivolumab failure, patients should be closely monitored if ipilimumab is initiated. Copyright © 2017 Japanese Society for Investigative Dermatology. Published by Elsevier B.V. All rights reserved.

  12. Options for Treating Pain in Cancer Patients with Dysphagia. (United States)

    Mercadante, Sebastiano


    Patients with chronic pain often develop dysphagia during the course of an advanced disease such as cancer. Opioids are the cornerstone of the management of cancer pain and are commonly administered orally. However, the oral route does not suit patients with dysphagia, who require alternative methods to administer analgesic drugs. Opioids given by parenteral or transdermal routes provide adequate pain control, being at least as efficacious as the oral route, but knowledge and experience in conversion ratios are mandatory when using these routes of administration. For breakthrough pain, transmucosal fentanyl preparations should be the preferred option and these can be given as needed due to the route of absorption. In addition, a new class of opioid formulations has been developed for use in dysphagic patients that are administered via nasogastric or enteral tubes while maintaining their sustained-release properties.

  13. Effects of smoking in patients treated with cardiac resynchronization therapy. (United States)

    Perrotta, Laura; Xhaferi, Brunilda; Chiostri, Marco; Pieragnoli, Paolo; Ricciardi, Giuseppe; Di Biase, Luigi; Natale, Andrea; Ricceri, Ilaria; Biria, Mazda; Lakkireddy, Dhanunjay; Valleggi, Alessandro; Emdin, Michele; Michelotti, Federica; Mascioli, Giosuè; Pandozi, Angela; Santini, Massimo; Padeletti, Luigi


    Smoking is associated with increased morbidity and mortality in cardiac patients. However, data on the prognostic impact of smoking in heart failure (HF) patients on cardiac resynchronization therapy with defibrillator (CRT-D) are absent. We investigated the effects of smoking on all-cause mortality and on a composite endpoint (all-cause death/appropriate device therapy), appropriate and inappropriate device therapy, in 649 patients with HF who underwent CRT-D between January 2003 and October 2011 in 6 Centers (4 in Italy and 2 in USA). 68 patients were current smokers, 396 previous-smokers (patients who had smoked in the past but who had quit before the CRT-D implant), and 185 had never smoked. The risk of each endpoint by smoking status was evaluated with both Kaplan-Meier and Cox proportional-hazard analysis. After adjusting for age, left ventricular ejection fraction, QRS width and ischemic etiology, both current and previous smoking were independent predictors of all-cause death [HR = 5.07 (95 % CI 2.68-9.58), p therapy compared to never smokers [HR = 21.74 (4.53-104.25), p = 0.005]. Our study indicates that in patients with HF who received a CRT-D device, current and previous smoking increase the event rate per person-time of death and of appropriate and inappropriate ICD therapy more than other known negative prognostic factors such as age, left ventricular dysfunction, prolonged QRS duration and ischemic etiology.

  14. Treating malignant glioma in Chinese patients: update on temozolomide

    Directory of Open Access Journals (Sweden)

    Chang L


    Full Text Available Liang Chang,1 Jun Su,1 Xiuzhi Jia,2,3 Huan Ren2,3 1Department of Neurosurgery, The Tumor Hospital of Harbin Medical University, 2Department of Immunology, Harbin Medical University, 3Key Lab Infection and Immunity, Heilongjiang Province, Harbin, People's Republic of China Abstract: Malignant glioma, ie, anaplastic astrocytoma and glioblastoma, is the most common type of primary malignant brain tumor in the People's Republic of China, and is particularly aggressive. The median survival of patients with newly diagnosed glioblastoma is only 12–14 months despite advanced therapeutic strategies. Treatment of malignant glioma consists mainly of surgical resection followed by adjuvant radiation and chemotherapy. Temozolomide (TMZ, a second-generation oral alkylating agent, is playing an increasingly important role in the treatment of malignant glioma in Chinese patients. Since the publication of a study by Stupp et al in 2005, which used a protocol of conventional fractionated irradiation with concomitant TMZ followed by standard TMZ for six cycles, many clinical studies in the People's Republic of China have demonstrated that such a treatment strategy has significantly improved efficacy with limited side effects for newly diagnosed glioblastoma after surgery as compared with strategies that do not contain TMZ. However, as a relatively new agent, the history and development of TMZ for malignant glioma is not well documented in Chinese patients. Multicenter, randomized controlled trials including appropriately sized patient populations investigating multiple aspects of TMZ therapy and related combination therapies are warranted in patients with malignant glioma. This review provides an update on the efficacy, mechanism of action, adverse reactions, and clinical role of TMZ in the treatment of malignant glioma in Chinese patients. Keywords: malignant glioma, chemotherapy, temozolomide, efficacy, side effect, People's Republic of China

  15. Limited success in patients treated with transanal haemorrhoidal dearterialisation

    DEFF Research Database (Denmark)

    Kjær, Søren; Lund, Henrik Hemmert; Schulze, Svend


    INTRODUCTION: Transanal haemorrhoidal dearterialisation (THD) is a novel non-excisional technique based on suture closure of the haemorrhoidal arterial flow feeding the haemorrhoidal plexus. The primary objective of this study was to report the first Danish experience with THD. METHODS: The study...... was a single-centre, non-controlled retrospective study that comprised consecutive patients from a two-year period. Prior to the study start, THD was introduced in our surgical department as the standard treatment of Grade III-IV haemorrhoids. All patients were clinically examined 4-6 weeks post...

  16. Patient with intractable delirium successfully treated with electroconvulsive therapy

    DEFF Research Database (Denmark)

    Lindgren, Eske; Hageman, Ida


    Delirium is a frequent and serious condition often seen in hospitalized patients, especially the elderly. Treatment of the somatic illness causing the delirium, and antipsychotic medication will usually resolve the condition. Sometimes, however, the condition is refractory towards medical treatment...... and in this situation electroconvulsive therapy (ECT) can be a quick and efficient treatment. In this case report of a 26-year-old man a post-operative intractable delirium persisting for three weeks was efficiently and swiftly relieved by three consecutive ECTs. The patient was discharged without need for further...

  17. Transient anisocoria in a patient treated with nebulized ipratropium bromide

    Directory of Open Access Journals (Sweden)

    Renato Pejic


    Conclusions and importance: Presence of anisocoria may be a concerning neurological sign. If there are no other neurological or ophthalmological signs and symptoms and a recent ipratropium bromide inhalation treatment exists in the patient's history, we should consider iatrogenic side-effect of drugs as a possible reason of anisocoria and possibly spare the patient extensive and invasive diagnostic procedures that can also raise costs of treatment significantly. Observing neurological status and testing with 1% pilocarpine solution may be necessary to determine the etiology of this condition.

  18. Immune response to vaccines is maintained in patients treated with dimethyl fumarate. (United States)

    von Hehn, Christian; Howard, Jonathan; Liu, Shifang; Meka, Ven; Pultz, Joe; Mehta, Devangi; Prada, Claudia; Ray, Soma; Edwards, Michael R; Sheikh, Sarah I


    To investigate the immune response to vaccinations in patients with relapsing forms of MS treated with delayed-release dimethyl fumarate (DMF) vs nonpegylated interferon (IFN). In this open-label, multicenter study, patients received 3 vaccinations: (1) tetanus-diphtheria toxoid (Td) to test T-cell-dependent recall response, (2) pneumococcal vaccine polyvalent to test T-cell-independent humoral response, and (3) meningococcal (groups A, C, W-135, and Y) oligosaccharide CRM 197 conjugate to test T-cell-dependent neoantigen response. Eligible patients were aged 18-55 years, diagnosed with relapsing-remitting MS (RRMS), and either treated for ≥6 months with an approved dose of DMF or for ≥3 months with an approved dose of nonpegylated IFN. Primary end point was the proportion of patients with ≥2-fold rise in antitetanus serum IgG levels from prevaccination to 4 weeks after vaccination. Seventy-one patients (DMF treated, 38; IFN treated, 33) were enrolled. The mean age was 45.3 years (range 27-55); 86% were women. Responder rates (≥2-fold rise) to Td vaccination were comparable between DMF- and IFN-treated groups (68% vs 73%). Responder rates (≥2-fold rise) were also similar between DMF- and IFN-treated groups for diphtheria antitoxoid (58% vs 61%), pneumococcal serotype 3 (66% vs 79%), pneumococcal serotype 8 (95% vs 88%), and meningococcal serogroup C (53% vs 53%), all p > 0.05. In a post hoc analysis, no meaningful differences were observed between groups in the proportion of responders when stratified by age category or lymphocyte count. DMF-treated patients mount an immune response to recall, neoantigens, and T-cell-independent antigens, which was comparable with that of IFN-treated patients and provided adequate seroprotection. NCT02097849. This study provides Class II evidence that patients with RRMS treated with DMF respond to vaccinations comparably with IFN-treated patients.

  19. Patient with intractable delirium successfully treated with electroconvulsive therapy

    DEFF Research Database (Denmark)

    Lindgren, Eske; Hageman, Ida


    and in this situation electroconvulsive therapy (ECT) can be a quick and efficient treatment. In this case report of a 26-year-old man a post-operative intractable delirium persisting for three weeks was efficiently and swiftly relieved by three consecutive ECTs. The patient was discharged without need for further...

  20. Development of labial gingival recessions in orthodontically treated patients

    NARCIS (Netherlands)

    Renkema, A.M.; Fudalej, P.S.; Kiekens, R.M.A.; Katsaros, C.


    INTRODUCTION: Our aim was to assess the prevalence of gingival recessions in patients before, immediately after, and 2 and 5 years after orthodontic treatment. METHODS: Labial gingival recessions in all teeth were scored (yes or no) by 2 raters on initial, end-of-treatment, and posttreatment (2 and

  1. Development of labial gingival recessions in orthodontically treated patients

    NARCIS (Netherlands)

    Renkema, Anne Marie; Fudalej, Piotr S.; Renkema, Alianne; Kiekens, Rosemie; Katsaros, Christos

    Introduction: Our aim was to assess the prevalence of gingival recessions in patients before, immediately after, and 2 and 5 years after orthodontic treatment. Methods: Labial gingival recessions in all teeth were scored (yes or no) by 2 raters on initial, end-of-treatment, and posttreatment (2 and

  2. Administering ziconotide and monitoring patients treated with ziconotide: expert opinions. (United States)

    Mitchell, Alisia A; Sapienza-Crawford, Anne J; Hanley, Kari L; Lokey, Kristi J; Wells, Linda; McDowell, Gladstone C; Stanton-Hicks, Michael


    Some patients with chronic pain who are intolerant of or refractory to treatment with systemic analgesics may benefit from intrathecal therapy. Ziconotide is the first nonopioid analgesic approved by the United States Food and Drug Administration for intrathecal administration. Several randomized, double-blind, placebo-controlled clinical trials have demonstrated the efficacy and safety of ziconotide. However, the maximum recommended dosing and titration schedule provided in the prescribing information may be too aggressive for some patients, and experience has demonstrated that ziconotide is better tolerated with slower titration to a lower maximum dose. Efficacy can be assessed by an evaluation of changes in pain, functionality, and quality of life. Cognitive adverse events may be subtle; therefore, it is important that health care professionals not only monitor patients for signs and symptoms of cognitive adverse events, but also teach family members how to do the same. Careful patient assessment and monitoring can help optimize the potential benefit from treatment with ziconotide. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  3. Risk factors for hypothermia in EMS-treated burn patients. (United States)

    Weaver, Matthew D; Rittenberger, Jon C; Patterson, P Daniel; McEntire, Serina J; Corcos, Alain C; Ziembicki, Jenny A; Hostler, David


    Hypothermia has been associated with increased mortality in burn patients. We sought to characterize the body temperature of burn patients transported directly to a burn center by emergency medical services (EMS) personnel and identify the factors independently associated with hypothermia. We utilized prospective data collected by a statewide trauma registry to carry out a nested case-control study of burn patients transported by EMS directly to an accredited burn center between 2000 and 2011. Temperature at hospital admission ≤36.5°C was defined as hypothermia. We utilized registry data abstracted from prehospital care reports and hospital records in building a multivariable regression model to identify the factors associated with hypothermia. Forty-two percent of the sample was hypothermic. Burns of 20-39% total body surface area (TBSA) (OR 1.44; 1.17-1.79) and ≥40% TBSA (OR 2.39; 1.57-3.64) were associated with hypothermia. Hypothermia was also associated with age > 60 (OR 1.50; 1.30-1.74), polytrauma (OR 1.58; 1.19-2.09), prehospital Glasgow Coma Scale burn patients demonstrate hypothermia at hospital arrival. Risk factors for hypothermia are readily identifiable by prehospital providers. Maintenance of normothermia should be stressed during prehospital care.

  4. Persistence with osteoporosis medication among newly-treated osteoporotic patients

    NARCIS (Netherlands)

    van Boven, Job F. M.; de Boer, Pieter T.; Postma, Maarten J.; Vegter, Stefan

    Low persistence with osteoporosis medication is associated with higher fracture risk. Previous studies estimated that 1-year persistence with osteoporosis medication is low. Our aim was to study persistence with osteoporosis medication among patients with long-term follow-up (to 5 years). The

  5. Orbital Cellulitis in a Psoriatic Patient Treated With Adalimumab. (United States)

    Katana, Vienna G; Carpenter, Robert J; Trafeli, John P; Kwan, Julia M


    Psoriatic patients on tumor necrosis factor alpha inhibitors (TNFi) may be at increased risk for upper respiratory tract infections, including chronic rhino-sinusitis (CRS). Rarely, CRS can progress to orbital cellulitis (OC), an emergent ophthalmic complication wherein respiratory flora from paranasal sinus disease intrude the retro-orbital space. Single case report. We report the first case, to our knowledge, of an invasive sinusitis that rapidly evolved into OC in a patient receiving adalimumab treatment for plaque psoriasis and psoriatic arthritis. After TNFi withdrawal and appropriate medical and surgical intervention, the patient fully recovered. However, on resumption of TNFi therapy, symptoms of recalcitrant CRS returned. More investigation is needed to explore how TNFi might predispose to chronic, refractory rhino-sinusitis and subsequent progression to OC. Military physicians and other medical providers should be aware of this proposed new disease entity and the potential for rapidly evolving and invasive infections in immunocompromised patients. Screening and monitoring for chronic infectious disease, such as CRS before initiating and during TNFi therapy is warranted. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

  6. Vascular Lesions Seen among Patients Treated at Muhimbili ...

    African Journals Online (AJOL)

    Background: Birthmarks sometimes represent significant vascular anomalies that require diagnosis and treatment. This study was aimed at determining the demographic and clinical pattern of vascular lesions seen among patients attending The Oral and Maxillofacial Surgical Clinic at Muhimbili National Hospital. Methods: ...

  7. Quality of life in treated adult craniopharyngioma patients

    NARCIS (Netherlands)

    Dekkers, O. M.; Biermasz, N. R.; Smit, J. W. A.; Groot, L. E.; Roelfsema, F.; Romijn, J. A.; Pereira, A. M.


    Quality of life (QoL) has become increasingly important in the evaluation of treatment of pituitary and hormonal diseases. A reduced QoL has been reported in childhood-onset craniopharyngioma; however, reports of QoL in adult craniopharyngioma patients are scarce. In the present study, we assessed

  8. Mortality in patients treated for tuberculous pericarditis in sub ...

    African Journals Online (AJOL)

    Objective: To determine the mortality rate and its predictors in patients with a presumptive diagnosis of tuberculous pericarditis in sub-Saharan Africa. ... diagnosis of pericardial effusion and treatment of concomitant HIV infection may reduce the high mortality associated with the disease. SAMJ Vol. 98 (1) 2008: pp. 36-40 ...

  9. Reperfusion delay in patients treated with primary percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Schoos, Mikkel M; Sejersten, Maria; Hvelplund, Anders


    -hospital organization with tele-transmitted electrocardiograms, field triage and direct transfer to a 24/7 primary percutaneous coronary intervention (PPCI) center. METHODS AND RESULTS: This was a single center cohort study with long-term follow-up in 472 patients. The PPCI center registry was linked by person...

  10. Treatment responses in adult depressive patients treated with ...

    African Journals Online (AJOL)

    DEX/CRH levels were analyzed. Adrenocorticotrophic hormone and cortisol levels in the blood were analysed by immuno-radiometric assay. Cortisol levels were also analysed by kinetic assay method. Results: In group I, among the 59 patients that received sertraline 50-100 mg/day for 5 weeks with a low dose of 30 mg T3, ...

  11. Osteonecrosis in patients with testicular tumours treated with chemotherapy. (United States)

    van den Berkmortel, F; de Wit, R; de Rooy, J; DeMulder, P


    The role of antiemetics is invaluable in allowing cancer patients to complete, otherwise possibly intolerable, chemotherapy. In the Perugia Consensus Conference it was decided that the recommended antiemetic regimen in the prevention of acute emesis induced by a single high, low and repeated doses of cisplatin is a serotonin receptor antagonist plus dexamethasone. We describe three testicular cancer patients who were cured with chemotherapy but developed bilateral osteonecrosis of the femoral head 17, 22 and 55 months after chemotherapy. It is very likely that the dexamethasone used in the antiemetic drug regimen contributed to the development of osteonecrosis in these patients. Osteonecrosis is a serious side effect of antiemetic treatment with dexamethasone and this serious complication should be incorporated in the current guidelines. Patients should be informed about the risk of osteonecrosis when taking dexamethasone as an antiemetic drug. A recommendation to add corticosteroids to serotonin receptor antagonists only after demonstrated nausea in chemotherapy regimes with low-dose cisplatin (20 mg/m2) for five days seems justified.

  12. Osteonecrosis in patients with testicular tumours treated with chemotherapy.

    NARCIS (Netherlands)

    Berkmortel, F. van den; Wit, R. de; Rooy, J.W.J. de; Mulder, P.H.M. de


    The role of antiemetics is invaluable in allowing cancer patients to complete, otherwise possibly intolerable, chemotherapy. In the Perugia Consensus Conference it was decided that the recommended antiemetic regimen in the prevention of acute emesis induced by a single high, low and repeated doses

  13. Cancer risk in patients with spondyloarthritis treated with TNF inhibitors

    DEFF Research Database (Denmark)

    Hellgren, Karin; Dreyer, Lene; Arkema, Elizabeth V.


    Background Safety data on cancer risks following tumour necrosis factor a inhibitors (TNFi) in patients with spondyloarthritis (SpA) (here defined as ankylosing spondylitis (AS), undifferentiated spondarthropaties (SpA UNS), psoriatic arthritis (PsA)) are scarce. Our objective was to assess risks...

  14. Herpes zoster in psoriasis patients treated with tofacitinib

    DEFF Research Database (Denmark)

    Winthrop, Kevin L; Lebwohl, Mark; Cohen, Arnon D


    BACKGROUND: Tofacitinib is an oral Janus kinase (JAK) inhibitor. Immunomodulatory therapies can increase the risk for herpes zoster (HZ) in patients with psoriasis. OBJECTIVE: To evaluate the relationship between tofacitinib use and HZ risk. METHODS: We used phases 2 and 3 and long-term extension...

  15. Development of labial gingival recessions in orthodontically treated patients. (United States)

    Renkema, Anne Marie; Fudalej, Piotr S; Renkema, Alianne; Kiekens, Rosemie; Katsaros, Christos


    Our aim was to assess the prevalence of gingival recessions in patients before, immediately after, and 2 and 5 years after orthodontic treatment. Labial gingival recessions in all teeth were scored (yes or no) by 2 raters on initial, end-of-treatment, and posttreatment (2 and 5 years) plaster models of 302 orthodontic patients (38.7% male; 61.3% female) selected from a posttreatment archive. Their mean ages were 13.6 years (SD, 3.6; range, 9.5-32.7 years) at the initial assessment, 16.2 years (SD, 3.5; range, 11.7-35.1 years) at the end of treatment, 18.6 years (SD, 3.6; range, 13.7-37.2 years) at 2 years posttreatment, and 21.6 (SD, 3.5; range, 16.6-40.2 years) at 5 years posttreatment. A recession was noted (scored "yes") if the labial cementoenamel junction was exposed. All patients had a fixed retainer bonded to either the mandibular canines only (type I) or all 6 mandibular front teeth (type II). There was a continuous increase in gingival recessions after treatment from 7% at end of treatment to 20% at 2 years posttreatment and to 38% at 5 years posttreatment. Patients less than 16 years of age at the end of treatment were less likely to develop recessions than patients more than 16 years at the end of treatment (P = 0.013). The prevalence of recessions was not associated with sex (P = 0.462) or extraction treatment (P = 0.32). The type of fixed retainer did not influence the development of recessions in the mandibular front region (P = 0.231). The prevalence of gingival recessions steadily increases after orthodontic treatment. The recessions are more prevalent in older than in younger patients. No variable, except for age at the end of treatment, seems to be associated with the development of gingival recessions. Copyright © 2013 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

  16. CNS Involvement in AML Patient Treated with 5-Azacytidine

    Directory of Open Access Journals (Sweden)

    Diamantina Vasilatou


    Full Text Available Central nervous system (CNS involvement in acute myeloid leukemia (AML is a rare complication of the disease and is associated with poor prognosis. Sometimes the clinical presentation can be unspecific and the diagnosis can be very challenging. Here we report a case of CNS infiltration in a patient suffering from AML who presented with normal complete blood count and altered mental status.

  17. Managing Transition in Patients Treated with Growth Hormone

    Directory of Open Access Journals (Sweden)

    Berthold P. Hauffa


    Full Text Available Growth hormone (GH promotes growth in children, but is also essential for bone strength, body composition, metabolic factors, such as lipid profile, and maintenance of quality of life. The Merck KGaA (Germany funded “360° GH in Europe” meeting, held in Lisbon, Portugal, in June 2016, comprised three sessions entitled “Short Stature Diagnosis and Referral,” “Optimizing Patient Management and Adherence,” and “Managing Transition.” The scientific program covered all stages of pediatric GH treatment, and reported here are the outcomes of the third session of the meeting, which considered transition from pediatric GH treatment to teenage and young adult GH therapy. A large number of patients with chronic diseases, including GH deficiency, drop out of therapy during the transition period. Multiple factors are associated with this, such as lack of understanding of the disease process, insufficient knowledge of treatment options, the patient becoming more independent, and requirement for interaction with a new set of health-care workers. Education regarding disease management and treatment options should be provided from an early age and right through the transition period. However, endocrine specialists will view the transition period differently, depending on whether they are pediatric endocrinologists who mainly deal with congenital diseases, in which auxology is important, or adult endocrinologists who are more concerned with body composition and metabolic factors. View points of both a pediatric and an adult endocrine specialist are presented, together with a case study outlining practical aspects of transition. It was noted in the meeting discussion that having one person to guide a patient through transition from an early age is important, but may be constrained by various factors such as finances, and options will differ by country.

  18. Urgency to treat patients with chronic hepatitis C in Asia. (United States)

    Kao, Jia-Horng; Ahn, Sang Hoon; Chien, Rong-Nan; Cho, Mong; Chuang, Wan-Long; Jeong, Sook-Hyang; Liu, Chen-Hua; Paik, Seung-Woon


    Chronic hepatitis C (CHC) infection poses a global healthcare burden, being associated with serious complications if untreated. The prevalence of hepatitis C virus (HCV) infection is highest in areas of Central, South, and East Asia; over 50% of HCV patients worldwide live in the region, where HCV genotypes 1b, 2, 3, and 6 are the most prevalent. Treatment outcomes for chronic hepatitis C vary by ethnicity, and Asian patients achieve higher sustained virologic response rates following interferon (IFN)-based therapy than non-Asians. However, low efficacy, poor safety profile, and subcutaneous administration limit the use of IFN-based therapies. Superior virologic outcomes have been observed with different classes of direct-acting antivirals (DAAs) alone or in combination, and several all-oral DAA regimens are available in Asia. These regimens have shown excellent efficacy and favorable tolerability in clinical trials, yet there is a need for further studies of DAAs in a real world context, particularly in Asia. Furthermore, IFN-free treatment may not be accessible for many patients in the region, and IFN-based regimens remain an option in some countries. There is a need to improve current clinical practices for HCV management in Asia, including effective screening, disease awareness, and prevention programs, and to further understand the cost-effectiveness of IFN-free regimens. The evolution of potent treatments makes HCV eradication a possibility that should be available to all patients. However, access to these therapies in Asian countries has been slow, primarily because of economic barriers that continue to present a hurdle to optimal treatment. © 2016 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.

  19. Primary CNS lymphoma in a patient treated with azathioprine

    DEFF Research Database (Denmark)

    Glesner, Matilde Kanstrup; Ocias, Lukas Frans; Larsen, Thomas Stauffer


    with surrounding oedema. There was cerebrospinal fluid pleocytosis, and Epstein-Barr virus (EBV) DNA was detected in the spinal fluid by PCR. A brain biopsy confirmed the suspicion of primary brain lymphoma. EBV-associated primary brain lymphoma is a relevant differential diagnosis in patients with long......-standing immune suppression presenting with neurological symptoms. Detection of EBV DNA in the spinal fluid together with characteristic radiological findings may serve as a diagnostic clue for a quick diagnosis....

  20. A patient with endobronchial BALT lymphoma successfully treated with radiotherapy. (United States)

    Hashemi, Sayed M S; Heitbrink, Martin A; Jiwa, Mehdi; Boersma, Wim G


    Low-grade bronchus-associated lymphoid tissue (BALT) lymphoma is a rare tumour originating from the marginal zone of lymphoid tissue. It is a subgroup of B-cell extranodal non-Hodgkin's lymphoma with an indolent course. We report a case of this tumour with characteristic histologic feature. The patient had non-specific respiratory complaints. The tumour occluded the right bronchus intermedius. He received radiation therapy alone, resulting in complete remission of the tumour and disappearance of symptoms.

  1. Blonanserin, a novel antipsychotic, is suitable for treating schizophrenia associated with hyperprolactinemia: a case series. (United States)

    Kawabe, Kentaro; Horiuchi, Fumie; Ueno, Shu-ichi


    Recently, atypical antipsychotic agents have primarily been used in pharmacological treatment of schizophrenia because of the fewer associated adverse effects. Blonanserin is a novel atypical antipsychotic recently introduced to treat patients with schizophrenia in Japan and South Korea. In this study, we examined the efficacy of switching antipsychotic medications to blonanserin monotherapy in patients with chronic schizophrenia with associated hyperprolactinemia. Ten schizophrenic patients (5 males and 5 females) with hyperprolactinemia were recruited. Clinical data before (baseline) and 12 weeks after (end point) switching to blonanserin monotherapy were assessed using the Brief Psychiatric Rating Scale score, Drug-Induced Extrapyramidal Symptoms Scale, and serum prolactin levels. The mean (SD) blonanserin dosage was 14.8 (3.8) mg/d. After switching to blonanserin, there were significant improvements in the Brief Psychiatric Rating Scale in the patients from both sexes. Moreover, serum prolactin levels in the female patients significantly decreased to within reference range. There were no additional adverse effects observed with the blonanserin treatment. Switching to blonanserin can reverse medication-induced prolactin elevations found in female patients- and blonanserin is a suitable antipsychotic for schizophrenic patients.

  2. [Outcome of acute kidney injury in critically ill patients treated with intermittent hemodialysis versus CRRT]. (United States)

    Ávalos-López, Mariana; Pérez-López, María Juana; Aguilar-Martínez, Carolina; Díaz-Franco, Ana María Del Carmen; Esquivel-Chávez, Alejandro; Baltazar-Torres, José Angel


    Acute kidney injury (AKI) is common in critically ill patients and it is associated with poor outcome. Some patients require renal replacement therapy (RRT), and the most frequently used are intermittent hemodialysis (IHD) and continuous renal replacement therapies (CRRT). Current evidence is insufficient to conclude which modality is most appropriate to treat critically ill patients with AKI. We reviewed the clinical records of critically ill patients with stage 3 AKI treated with RRT. We recorded demographic and clinical data and serum creatinine. We compared the evolution and prognosis of patients treated with IHD versus those treated with CRRT by Student's t test, chi squared, Kaplan-Meier curves, and Cox regression. Logistic regression was performed to determine the association between RRT and mortality. We analyzed 221 patients; the mean age was 49.8 years, and 55.2% were men. Mortality was 36.7%. IHD was used in 73.8% and CRRT in 26.2% of cases. In the group treated with CRRT, the severity of disease was higher, the recovery of renal function less frequent, the need for long-term RRT less frequent, and mortality higher, compared with those treated with IHD. CRRTs had an odds ratio (OR) of 8.64 for mortality (p = 0.063). IHD is the RRT most frequently used. Mortality is higher in patients treated with CRRT. CRRTs are not an independent risk factor for death.

  3. Celecoxib effectively treats patients with acute shoulder tendinitis/bursitis. (United States)

    Petri, Michelle; Hufman, Stephen L; Waser, Gregory; Cui, Harry; Snabes, Michael C; Verburg, Kenneth M


    Shoulder tendinitis and subacromial bursitis are acute, painful inflammatory musculoskeletal conditions that may recur as a result of overuse. We investigated the efficacy of celecoxib in managing patients with acute shoulder tendinitis/bursitis. In this double blind, placebo controlled, parallel group study, patients with acute onset shoulder tendinitis and/or subacromial bursitis were randomized to receive one of: celecoxib 400 mg followed by 200 mg bid, naproxen 500 mg bid, or placebo bid for 14 days. The primary measure of efficacy was the mean reduction in Maximum Pain Intensity at Rest, measured using a 100 mm visual analog scale, from baseline to Days 7 and 14. Of the 306 patients randomized to treatment, 254 completed the study. On Day 7, the mean reduction from baseline in Maximum Pain Intensity at Rest was significantly greater in the celecoxib group compared with the placebo group (-27.7 +/- 2.75 mm vs -18.4 +/- 2.63 mm, respectively; p subacromial bursitis.

  4. Harvey Cushing Treated the First Known Patient With Carney Complex. (United States)

    Tsay, Cynthia J; Stratakis, Constantine A; Faucz, Fabio Rueda; London, Edra; Stathopoulou, Chaido; Allgauer, Michael; Quezado, Martha; Dagradi, Terry; Spencer, Dennis D; Lodish, Maya


    Carney complex (CNC) is a syndrome characterized by hyperplasia of endocrine organs and may present with clinical features of Cushing syndrome and acromegaly due to functional adrenal and pituitary gland tumors. CNC has been linked to mutations in the regulatory subunit of protein kinase A type I-alpha ( PRKAR1A ) gene. Tissue samples were taken from the hypothalamus or thalamus or tumors of patients with pituitary adenomas seen and operated on by neurosurgeon Harvey Cushing between 1913 and 1932. Following DNA extraction, sequencing for genes of interest was attempted, including PRKAR1A , AIP , USP8 , GNAS1 , and GPR101 , to explore the possibility that these mutations associated with acromegaly, CNC, and Cushing syndrome have been conserved over time. We report a patient described by Dr. Cushing in 1914 with a clinical presentation and postmortem findings suggestive of CNC. Genetic sequencing of the hypothalamus and pituitary adenoma revealed a germline heterozygous p.Arg74His mutation in the PRKAR1A gene, a codon previously described as mutated in CNC, but with a novel amino acid change. This patient is, to our knowledge, the first molecularly confirmed individual with CNC. This case demonstrates the power of modern genetics in studying archived tissues and the importance of recording detailed clinical notes in the diagnosis of disease.

  5. PET studies of parkinsonian patients treated with autologous adrenal implants. (United States)

    Guttman, M; Burns, R S; Martin, W R; Peppard, R F; Adam, M J; Ruth, T J; Allen, G; Parker, R A; Tulipan, N B; Calne, D B


    Transplantation of autologous adrenal medulla tissue into the striatum has recently been proposed as a treatment for Parkinson's disease. We report the use of positron emission tomography (PET) to evaluate patients who had adrenal implants placed into the right caudate. 6-[18F] fluoro-L-dopa (6-FD) scans were performed to study the integrity and activity of the implant, and the nigrostriatal dopamine system before and six weeks after transplantation surgery. [68Ga] Gallium-ethylenediaminetetraacetate (Ga) scans were also performed to assess the blood brain barrier. The Ga scans performed on two patients showed increased permeability of the blood brain barrier at the surgical site. 6-FD PET scans in five patients did not show a consistent change in striatal uptake following adrenal medullary implantation after six weeks. Further assessment of implant viability with 6-FD PET scans after longer follow up may provide useful information if the blood-brain barrier becomes re-established with the passage of time.

  6. Options for treating postherpetic neuralgia in the medically complicated patient

    Directory of Open Access Journals (Sweden)

    Bruckenthal P


    Full Text Available Patricia Bruckenthal,1 Robert L Barkin2,31Department of Graduate Studies in Advanced Practice Nursing, Stony Brook University School of Nursing, Stony Brook, NY, USA; 2Department of Anesthesiology, Family Medicine, and Pharmacology, Rush University Medical College, Chicago, IL, USA; 3Department of Anesthesiology, Northshore University Health System Pain Centers, Skokie and Evanston Hospitals, Skokie and Evanston, IL, USAAbstract: Patients with postherpetic neuralgia (PHN are often of advanced age or immunocompromised and likely to have ≥1 comorbid medical condition for which they receive ≥1 medication (polypharmacy. Comorbidities affecting renal or hepatic function can alter pharmacokinetics, thereby impacting the efficacy or tolerability of PHN analgesic therapies. Cardiovascular, cerebrovascular, or psychiatric comorbidities may increase patient vulnerability to potential adverse events associated with some PHN analgesic therapies. Because PHN is a localized condition, localized therapy with a topical analgesic (lidocaine patch 5% and capsaicin 8% patch or cream may provide adequate efficacy while mitigating the risk of systemic adverse events compared with oral analgesics (eg, tricyclic antidepressants, anticonvulsants, opioids. However, combined therapy with a topical and an oral analgesic or with >1 oral analgesic may be needed for optimal pain management in some patients. This review summarizes how comorbidities and concomitant medications should be taken into account when selecting among available pharmacotherapies for PHN and provides recommendations for the selection of therapies that will provide analgesia while minimizing the risk of adverse events.Keywords: calcium channel α2-δ ligand, comorbidities, lidocaine patch, polypharmacy, postherpetic neuralgia, TCA

  7. Why all migraine patients should be treated with magnesium. (United States)

    Mauskop, Alexander; Varughese, Jasmine


    Magnesium, the second most abundant intracellular cation, is essential in many intracellular processes and appears to play an important role in migraine pathogenesis. Routine blood tests do not reflect true body magnesium stores since Migraine sufferers may develop magnesium deficiency due to genetic inability to absorb magnesium, inherited renal magnesium wasting, excretion of excessive amounts of magnesium due to stress, low nutritional intake, and several other reasons. There is strong evidence that magnesium deficiency is much more prevalent in migraine sufferers than in healthy controls. Double-blind, placebo-controlled trials have produced mixed results, most likely because both magnesium deficient and non-deficient patients were included in these trials. This is akin to giving cyanocobalamine in a blinded fashion to a group of people with peripheral neuropathy without regard to their cyanocobalamine levels. Both oral and intravenous magnesium are widely available, extremely safe, very inexpensive and for patients who are magnesium deficient can be highly effective. Considering these features of magnesium, the fact that magnesium deficiency may be present in up to half of migraine patients, and that routine blood tests are not indicative of magnesium status, empiric treatment with at least oral magnesium is warranted in all migraine sufferers. © Springer-Verlag 2011

  8. [Pharmacosurveillance regarding Colombian patients being treated with stavudine]. (United States)

    Machado-Alba, Jorge E


    Reducing the occurrence of negative stavudine use-associated outcomes by reporting such risk to doctors responsible for the care of HIV/AIDS patients in Colombia as stavudine has been associated with cumulative and irreversible toxicity. All stavudine users were identified from Audifarma S.A. (drug suppliers) databases (covering about 4.5 million people). The risk was then reported to health service providers and the substitution of stavudine for zidovudine or tenofovir was recommended. It was found that 1,410 patients registered in the afore mentioned databases were receiving antiretroviral therapy during 2010, of whom 109 (7.5 %) were receiving stavudine; these patients were living in 20 cities and being attended by 19 institutions. Stavudine use became reduced by 94.6 % during the 28 months following the intervention. Zidovudine was the most commonly used replacement drug. Stavudine was successfully replaced following World Health Organization recommendations aimed at preventing the occurrence of lipodystrophy and the peripheral neuropathy associated with its use.

  9. Expressed emotion among schizophrenic patients in Lagos, Nigeria ...

    African Journals Online (AJOL)

    Journal references should appear as follows: a. Peter S, Jones A, Smith B. Acute hamstring injuries. Am J Sports Med 1994;. 12(7):395-400. Book references should be set out as follows: a. Williams G. Textbook of Sports Medicine. 2nd Edition: Butterworth, 1989: 101-104. b. Vandermere P, Russel P. Biomechanics of the hip ...


    Directory of Open Access Journals (Sweden)

    Luis Maia


    Full Text Available Se analizan los resultados de un estudio descriptivo y exploratorio, con el propósito de comprender los resultados de 21 pacientes esquizofrenicos varones, evaluados con pruebas neuropsicológicas, internados en un centro portugués de salud mental. Se busca relacionar estas pruebas a variables tales como escolaridad, contacto familiar o duración de la internación. Los instrumentos del evaluación fueron: serie de dígitos y vocabulario del WAIS, las matrices progresivas de Raven, las figuras complejas de Rey, La serie gráfica neuropsicológica del screening de Luria, el Test del reloj y el test de búsqueda visual y atención. Los resultados de las pruebas sugieren que no hay un déficit de atención clínicamente significativo, aunque sugieren un defecto ligero de la atención. Las variables como contacto familiar y escolaridad aparecen como los factores protectores de memoria y también parecen ser significativos para las funciones de ejecutivas del cerebro como son la planificación y organización.

  11. Functional brain imaging alterations in acne patients treated with isotretinoin. (United States)

    Bremner, J Douglas; Fani, Negar; Ashraf, Ali; Votaw, John R; Brummer, Marijn E; Cummins, Thomas; Vaccarino, Viola; Goodman, Mark M; Reed, Lai; Siddiq, Sajid; Nemeroff, Charles B


    Although there have been case reports suggesting a relationship between treatment with the acne medication isotretinoin and the development of depression and suicide, this topic remains controversial. In order for isotretinoin to cause depression, it must have an effect on the brain; however, the effects of isotretinoin on brain functioning in acne patients have not been established. The purpose of this study was to assess the effects of isotretinoin on brain functioning in acne patients. Brain functioning in adults was measured with [(18)F]fluorodeoxyglucose positron emission tomography before and after 4 months of treatment with isotretinoin (N=13) or an antibiotic (N=15). Isotretinoin but not antibiotic treatment was associated with decreased brain metabolism in the orbitofrontal cortex (-21% change versus 2% change for antibiotic), a brain area known to mediate symptoms of depression. There were no differences in the severity of depressive symptoms between the isotretinoin and antibiotic treatment groups before or after treatment. This study suggests that isotretinoin treatment is associated with changes in brain functioning.

  12. Neuropsychological deficits in chronic schizophrenics. Relationship with symptoms and behavior. (United States)

    Dickerson, F B; Ringel, N B; Boronow, J J


    Thirty-nine hospitalized chronic schizophrenics were administered the Luria-Nebraska Neuropsychological Battery (LNNB) and the Weschler Adult Intelligence Scale-Revised when they were clinically stable. Test variables were related to Brief Psychiatric Rating Scale ratings and two behavioral measures of ward functioning, points and activities. Spearman correlations of test variables with the symptom and behavioral measures were entered into a series of median polish analyses. There was an overall significant relationship between the two sets of variables. Neuropsychological test variables that were most highly correlated with symptom/behavioral measures were LNNB Left Frontal, Memory, and Intellectual Processes scales. The positive symptoms of thought disorder and hallucinations were most consistently related to neuropsychological variables. In contrast with other findings in the literature, negative symptoms were not significantly correlated with neuropsychological performance.

  13. Osteonecrosis detected by whole body magnetic resonance in patients with Hodgkin Lymphoma treated by BEACOPP. (United States)

    Albano, Domenico; Patti, Caterina; La Grutta, Ludovico; Grassedonio, Emanuele; Mulè, Antonino; Brancatelli, Giuseppe; Lagalla, Roberto; Midiri, Massimo; Galia, Massimo


    The purpose of our retrospective review of prospectively acquired Whole Body Magnetic Resonance (WB-MRI) scans was to assess the incidence of osteonecrosis in patients who received different chemotherapies. We evaluated the WB-MRI scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6ABVD, 2ABVD + 4BEACOPP, 2ABVD + 8BEACOPP), excluding patients with the main risk factors for osteonecrosis. Six out of seven patients (86 %) who received eight BEACOPP and one out of five patients (20 %) treated by four BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p osteonecrosis were detected in six out of seven patients (86 %). The development of osteonecrosis is strictly related to the chemotherapy protocol adopted and the number of cycles received, with a strong correlation between the dose of corticosteroids included in the BEACOPP scheme and this complication. WB-MRI can be considered as a helpful tool that allows detecting earlier osteonecrotic lesions in patients treated with corticosteroids. • Osteonecrosis is a possible complication of patients with Lymphoma treated by chemotherapy. • Osteonecrosis is related to the corticosteroids included within the BEACOPP protocol. • WB-MRI allows detecting osteonecrotic lesions in patients treated with corticosteroids.

  14. Prevalence of nocturnal hypoglycemia in first trimester of pregnancy in patients with insulin treated diabetes mellitus

    DEFF Research Database (Denmark)

    Hellmuth, Ellinor Adelheid; Damm, P; Mølsted-Pedersen, L


    BACKGROUND: Excellent metabolic control before conception and during diabetic pregnancies is the aim in order to avoid malformations and perinatal morbidity. Since an inverse correlation between median blood glucose concentration (BG) and hypoglycemia as well as a high prevalence of nocturnal...... hypoglycemia have been described, we investigated the frequency of nocturnal hypoglycemia and the predictive value of bedtime blood glucose concentration for development of this condition in insulin treated diabetic patients. METHODS: During hospitalization, with no other changes in the patients' normal...... of pregnancy in insulin treated patients. Only one patient registered the hypoglycemia. Nocturnal hypoglycemia could be predicted in the majority of patients by measurements of BG before bedtime....

  15. Grupo de acompanhamento de portadores de Esquizofrenia em uso de Clozapina e de seus familiares: percepção dos participantes Grupo de seguimiento de portadores de Esquizofrenía con uso de Clozapina y de sús familiares: percepción de los participantes Follow-up group for Schizophrenic patients using Clozapine and their relatives: the participants' perception

    Directory of Open Access Journals (Sweden)

    Ana Maria Sertori Durão


    Full Text Available Este estudo descreveu a visão do portador de Esquizofrenia e de seu familiar sobre o acompanhamento em grupo. A população constou de 11 pacientes que participam do grupo e 11 familiares que os acompanham com maior freqüência ao mesmo. Para coleta de dados foram utilizadas entrevistas. Estas foram gravadas e, posteriormente, transcritas na íntegra. Obteve-se que o grupo: constituiu espaço oportuno para conversar e ouvir sobre a doença, trocar experiências; proporcionou maior segurança e auto-estima para seus integrantes e melhora nos relacionamentos dos pacientes e, constituiu ajuda terapêutica para os familiares. Tais resultados apontam a necessidade de um novo olhar para o portador de transtorno mental, no sentido de buscar atitudes terapêuticas mais adequadas que atuem na produção de vida.Este estudio tuvo como objetivo describir la visión del portador de esquizofrenia y de su familia sobre el seguimiento en grupo. La población en estudio constó de 11 pacientes, que participaron del grupo y 11 familiares, que los acompañaban con mayor frecuencia. Para la recopilación de los datos se utilizaron entrevistas, las cuales fueron grabadas y, posteriormente, transcritas por entero. Como resultado se obtuvo que el grupo: crea un espacio adecuado y oportuno para conversar y oir sobre la enfermedad, intercambiar experiencias, proporciona más seguridad y auto-estima a sus integrantes, mejora las relaciones de los pacientes y otorga un ayuda terapéutica para los familiares. Tales resultados apuntan hacia la necesidad de una nueva visión sobre el portador de transtornos mentales, en el sentido de buscar actitudes terapéuticas más adecuadas que mejoren su calidad de vida.This study described the views of Schizophrenic patients as well as those of their relatives concerning the group follow-up. The population consisted of 11 patients participating in the group and of 11 relatives who most often accompanied them to group meetings

  16. Mortality in patients treated for Cushing's disease is increased, compared with patients treated for nonfunctioning pituitary macroadenoma

    NARCIS (Netherlands)

    Dekkers, O. M.; Biermasz, N. R.; Pereira, A. M.; Roelfsema, F.; van Aken, M. O.; Voormolen, J. H. C.; Romijn, J. A.


    Increased mortality in patients with pituitary tumors after surgical treatment has been reported. However, it is unknown to what extent excess mortality is caused by pituitary tumors and their treatment in general and to what extent by previous exposure to hormonal overproduction. The aim of the

  17. Safety and Efficacy of Nivolumab in Patients With Metastatic Renal Cell Carcinoma Treated Beyond Progression (United States)

    George, Saby; Motzer, Robert J.; Hammers, Hans J.; Redman, Bruce G.; Kuzel, Timothy M.; Tykodi, Scott S.; Plimack, Elizabeth R.; Jiang, Joel; Waxman, Ian M.; Rini, Brian I.


    IMPORTANCE Response patterns with immunotherapy may differ from those of other treatments. This warrants further investigation because some patients may benefit from continued immunotherapy beyond Response Evaluation Criteria in Solid Tumors (RECIST)-defined first progression. OBJECTIVE To evaluate the safety and potential benefit of treatment with nivolumab, a programmed cell death 1 immune checkpoint inhibitor, beyond investigator-assessed first progression in patients with metastatic renal cell carcinoma (mRCC). DESIGN, SETTING, AND PARTICIPANTS Subgroup analysis of a blinded, randomized, multicenter, phase 2 dose-ranging trial initiated May 31, 2011, including patients with clear-cell mRCC previously treated with antiangiogenic therapy. Data cutoffs for this subgroup analysis were May 15, 2013, for progression-free survival and objective response rate and March 5, 2014, for overall survival and duration of response. In this analysis, patients treated beyond first progression received their last dose of nivolumab more than 6 weeks after RECIST-defined progression, and patients not treated beyond first progression discontinued nivolumab before or at RECIST-defined progression. INTERVENTIONS Nivolumab 0.3, 2, or 10 mg/kg intravenously every 3 weeks. MAIN OUTCOMES AND MEASURES Safety and efficacy of nivolumab treatment. RESULTS Of 168 patients (median [range] age, 61 [37–81] years; 72% male) randomized to nivolumab, 154 experienced progression (36 were treated beyond first progression, 26 were treated beyond first progression for ≤ 6 weeks, and 92 were not treated beyond first progression), 13 were treated and did not experience progression, and 1 was not treated. Prior to first progression, the RECIST-defined objective response rate was 14% (5 patients) and 16% (15 patients), and median progression-free survival was 4.2 (95% CI, 2.8–5.5) and 2.6 (95% CI, 1.5–3.9) months in patients treated and not treated beyond progression, respectively. Following initial

  18. Changes in pressure-flow parameters in patients treated with transurethral microwave thermotherapy

    NARCIS (Netherlands)

    de la Rosette, J. J.; Tubaro, A.; Trucchi, A.; Carter, S. S.; Höfner, K.


    We document changes in pressure-flow study parameters in patients treated by transurethral microwave thermotherapy. Pressure-flow study tracings before and after therapy from 75 patients with benign prostatic hyperplasia were analyzed. Patients were stratified according to the predominant type of

  19. A novel technique to treat ruptured umbilical hernias in patients with liver cirrhosis and severe ascites. (United States)

    Melcher, Marc L; Lobato, Robert L; Wren, Sherry M


    The full-thickness skin erosion (rupture) of an umbilical hernia in a patient with end-stage liver disease can lead to significant morbidity and mortality. Here, we present a case report of the use of a novel technique to treat a patient with this condition. The use of a fibrin-based tissue adhesive provides a means of managing such patients medically.

  20. Survival and hospitalization in heart failure patients with or without diabetes treated with beta-blockers. (United States)

    Bobbio, Marco; Ferrua, Stefania; Opasich, Cristina; Porcu, Maurizio; Lucci, Donata; Scherillo, Marino; Tavazzi, Luigi; Maggioni, Aldo Pietro


    Physicians are still concerned about prescribing beta-blockers in diabetic patients with heart failure. In the outcome research study (the Beta-Blockers in Patients With Congestive Heart Failure: Guided Use in Clinical Practice [BRING-UP] study), the responsible clinicians could decide whether to start beta-blocker treatment and which agent to use. A total of 3091 patients were enrolled by 202 cardiologic centers: 25% of the recruited patients were already on beta-blockers, 28% started treatment at the enrollment visit, and 47% were not started on beta-blockers. The 1-year mortality, hospitalization rate, and the combined end point of mortality or hospitalization were higher in diabetic patients (15.8% versus 10.9%; relative risk [RR] = 1.44; 95% confidence intervals [CI] 1.16-1.78, P =.001) (31.0% versus 24.0%; RR = 1.28; 95% CI 1.11-1.49; P =.0009) (40.5% versus 30.1%; RR = 1.35; 95% CI 1.19-1.51; P =.0001). The event-free analysis of the 4 groups (diabetic patients not treated with beta-blockers, diabetic patients treated with beta-blockers, nondiabetic patients not treated with beta-blockers, nondiabetic patients treated with beta-blockers) showed that patients treated with beta-blockers had a higher event-free probability than patients not treated with beta-blockers regardless the presence of diabetes (P <.0001). On the basis of post hoc analysis, diabetic patients with chronic heart failure benefit from beta-blockers even if at a lower degree. Thus, there are no justifications to avoid beta-blockers in heart failure patients in the presence of diabetes.

  1. [The combined use of traditional acupuncture and microacupuncture therapy in treating bronchial asthma patients]. (United States)

    Oĭvin, V I; Gaponiuk, P Ia


    The attacks of bacterial asthma in 100 patients were treated by standard acupuncture, microacupuncture and by combined use of the modalities. The comparative analysis revealed the highest efficiency for the combined treatment, the less for microacupuncture. The disease of moderate severity, light severity and that free of attacks should be treated, as the authors believe, with acupuncture plus microacupuncture, standard acupuncture, and microacupuncture, respectively.

  2. Bone mineral density in adult patients treated with various antiepileptic drugs

    DEFF Research Database (Denmark)

    Beniczky, Simona Alexandra; Viken, Janina; Jensen, Lars Thorbjørn


    adult consecutive outpatients treated with AEDs for more than 2 years, and who underwent measurement of the BMD. We compared the incidence of decreased BMD among the patients treated with 6 different AEDs: carbamazepine (CBZ), oxcarbazepine (OXC), valproic acid (VPA), lamotrigine (LTG), topiramate (TPM...

  3. [Respiratory depression in delirium tremens patients treated with phenobarbital. A retrospective study

    DEFF Research Database (Denmark)

    Lutzen, L.; Poulsen, L.M.; Ulrichsen, J.


    in DT patients treated with phenobarbital. MATERIALS AND METHODS: We examined the medical records of patients who were treated as inpatients in 1998-2006 and discharged with the ICD-10 diagnoses F10.4 (alcohol withdrawal delirium) or F10.5 (alcohol induced psychotic disorder). Patients with pre......-DT and full blown DT were included in the study. RESULTS: While we did not detect any respiratory problems among patients with pre-DT, we found 9 cases among 73 patients with full blown DT, 5 of which were considered serious. In two of these the frequency of respiration (FR) was decreased (5-6 per min). Both...... cases occurred in the same patient at two different admissions. It was not considered necessary to move the patient to the Intensive Care Unit (ICU). Three patients developed pneumonia and were moved to the ICU, one of whom developed a life-threatening sepsis. One patient with chronic emphysema died due...

  4. The art of treating Parkinson disease in the older patient. (United States)

    Chan, Daniel Kam Yin


    Parkinson disease (PD) is a neurodegenerative disorder that increases sharply after the sixth decade. There are many disorders in the elderly that exhibit some parkinsonian signs that can be confused with PD. This article discusses the diagnostic and management issues of PD in the elderly patient. Levo-dopa (L-dopa) therapy is the cornerstone of treatment for PD in the elderly. After 5-8 years of treatment, monitor complications such as fluctuations and dyskinesia usually occur and adjunct therapy may be required. Dopamine agonists can be used to smooth out motor fluctuations and amantadine is sometimes useful for dyskinesia. However, the adverse drug effects of adjunct therapy in the elderly are more common than with L-dopa alone, and risks need to be weighed up against benefits. Nonmotor complications including dementia, psychosis, depression, autonomic dysfunction and somnolence are common and require special attention. Late stage problems such as aspiration, difficulties with activities of daily living or recurrent falls require a multidisciplinary approach. Anticholinergic drugs such as benztropine and benzhexol are best avoided because of the high risk of major side effects.

  5. [Developmental conditions and subjective experiences of children with a schizophrenic parent--qualitative and quantitative studies from the Mannheim Study of Children at Risk]. (United States)

    Könnecke, Regina; Wening, Ursula; Ropeter, Daniel; Heiden, Wolfram an der; Maurer, Kurt; Häfner, Heinz


    35 children 12-42 years of age of patients with schizophrenia (ABC-Cohort-12-year-follow-up) were interviewed for studying objective and subjective effects of growing up with a schizophrenic parent. Social development and childhood experiences were assessed and quantitatively and qualitatively evaluated. The majority of probands had to take on early responsibilities in their family. Experienced deficits in parental care and problems with poor communication within the family were also mentioned. Compared with controls they showed only light disadvantages in the level of education and vocational training. Even if early independence could be a positive resource for children with a schizophrenic parent the restrictions in the child's life and development should not be overlooked. Information on the illness and support in dealing with stressful situations are frequently needed.

  6. Dental caries prevalence in patients treated by dentistry students at a university dental clinic

    National Research Council Canada - National Science Library

    Mosa Alrifai; Ahmed Alhadi; Mohammed Alhadi; Ahmed Aldarweesh; Abdulaziz Aleid; Fatimah Alshehri; Renata Chałas


    ... of Conservative Dentistry and Endodontics of the Medical University of Lublin. The authors collected and analyzed the dental history of patients who had been treated at the university dental clinic in Lublin throughout 2013 and 2014...

  7. High prevalence of metabolic syndrome features in patients previously treated for nonfunctioning pituitary macroadenoma

    NARCIS (Netherlands)

    Joustra, Sjoerd D.; Claessen, Kim M. J. A.; Dekkers, Olaf M.; van Beek, Andre P.; Wolffenbuttel, Bruce H. R.; Pereira, Alberto M.; Biermasz, Nienke R.


    Objective: Patients treated for nonfunctioning pituitary macroadenoma (NFMA) with suprasellar extension show disturbed sleep characteristics, possibly related to hypothalamic dysfunction. In addition to hypopituitarism, both structural hypothalamic damage and sleep restriction per se are associated

  8. Outcomes of patients with microscopic colitis treated with corticosteroids: a population-based study. (United States)

    Gentile, Nicole M; Abdalla, Adil A; Khanna, Sahil; Smyrk, Thomas C; Tremaine, William J; Faubion, William A; Kammer, Patricia P; Sandborn, William J; Loftus, Edward V; Pardi, Darrell S


    To evaluate the outcomes of corticosteroid-treated microscopic colitis (MC) in a population-based cohort, and to compare these outcomes in patients treated with prednisone or budesonide. A historical cohort study of Olmsted County, Minnesota residents diagnosed with collagenous or lymphocytic colitis (LC) between 1986 and 2010 was performed using the Rochester Epidemiology Project. Of 315 patients with MC, 80 (25.4%) were treated with corticosteroids. The median age at colitis diagnosis was 66.5 years (range: 16-95) and 78.7% were female. Forty patients (50%) had LC and 40 (50%) had collagenous colitis. Prednisone was used in 17 patients (21.2%) and budesonide in 63 (78.8%); 56 (75.6%) had complete response and 15 (20.3%) had partial response. Patients treated with budesonide had a higher rate of complete response than those treated with prednisone (82.5 vs. 52.9%; odds ratio, 4.18; 95% CI, 1.3-13.5). Six patients were lost to follow-up. The remaining 74 had a median follow-up of 4 years (range 0.2-14). Fifty patients out of the 71 who responded (70.4%) had a recurrence after corticosteroid discontinuation. Patients treated with budesonide were less likely to recur than those treated with prednisone (hazard ratio, 0.38; 95% CI, 0.18-0.85; P=0.02). After 397 person years of follow-up in the 73 patients with long-term data, 47 (64.4%) required maintenance with corticosteroids. Patients with MC often respond to corticosteroid therapy, but with a high relapse rate. Budesonide had a higher response rate and a lower risk of recurrence than prednisone.

  9. Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated with Radiotherapy (United States)


    AWARD NUMBER: W81XWH-15-1-0680 TITLE: Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated with Radiotherapy PRINCIPAL... Genetic Modeling of Radiation Injury in Prostate Cancer Patients Treated with Radiotherapy 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) Barry S...achieve this goal has been the identification of genetic markers, primarily single nucleotide polymorphisms (SNPs), which are associated with the

  10. (/sup 3/H)muscimol binding sites increased in autopsied brains of chronic schizophrenics

    Energy Technology Data Exchange (ETDEWEB)

    Hanada, S.; Mita, T.; Nishino, N.; Tanaka, C.


    (/sup 3/H)muscimol binding and glutamic acid decarboxylase (GAD) activity in the prefrontal cortex and caudate nucleus of autopsied brains from 19 chronic schizophrenics and 17 control subjects were investigated. In the schizophrenics, saturation analysis with varying concentrations of (/sup 3/H)muscimol revealed an increase in the number GABA/sub A/ receptors, but there was no significant difference in the affinity. In addition, the enhancement of (/sup 3/H)muscimol binding by diazepam was significantly greater in schizophrenics than in controls. GAD activity did not differ between controls and schizophrenics. The possibility that GABAergic mechanisms might play a role in case of chronic schizophrenia should be given further attention.

  11. Dual hydrophilic and salt responsive schizophrenic block copolymers – synthesis and study of self-assembly

    NARCIS (Netherlands)

    Vasantha, Vivek Arjunan; Jana, Satyasankar; Lee, Serina Siew Chen; Lim, Chin-Sing; Teo, Serena Lay Ming; Parthiban, Anbanandam; Vancso, Gyula J.


    A new class of dual hydrophilic diblock copolymers (BCPs) possessing poly(ethylene glycol) (PEG) and zwitterionic polysulfabetaine (PSB) was synthesized by reversible addition–fragmentation chain transfer (RAFT) polymerization. These BCPs formed schizophrenic micelles undergoing core–shell

  12. Development of the caregivers attitude scale on home care of schizophrenics (CASHS)

    National Research Council Canada - National Science Library

    Balasubramanian, N; Sathyanarayana Rao, T S; D'Sa, Juliana Linnette


    .... This article describes the development of a Likert scale, the Caregivers Attitude Scale on Home Care of Schizophrenics CASHS, which is a 31-item self-reported instrument that quantifies three aspects...

  13. [Schizophrenic psychoses with affect-dominant symptoms : Contribution to a system-specific approach]. (United States)

    Lang, F U; Stegmayer, K; Becker, T; Jäger, M


    In order to reduce heterogeneity in schizophrenia a system-specific approach consisting of the domains 'language', 'affect' and 'motor behavior' was proposed namely the Bern psychopathology scale (BPS). Using the example of the affective domain we examined this system-specific approach for its applicability to clinical practice using a qualitative-casuistic method. Moreover, we examined the possibility to identify a homogeneous subgroup of patients applying this approach. From a sample of 100 patients with schizophrenia a total of six patients was selected and described following a traditional psychopathological case approach. To expand this qualitative-casuistic method we included the results of standardized psychopathological assessments using the BPS and the positive and negative syndrome scale of schizophrenia (PANSS). Schizophrenic psychoses with affect-dominant symptoms could be characterized better using a system-specific approach than the positive-negative-concept. Ensuing from the cross-sectional psychopathological patterns only limited statements regarding the prospective course were possible. The concept of an affect-dominant subtype of schizophrenia was not entirely convincing with respect of the heterogeneous course of the patients described. Nevertheless, the system-specific approach may hold promise for the future regarding further neurobiological research.

  14. A clinical contrast: physical therapists with low back pain treating patients with low back pain. (United States)

    Louw, Adriaan; Puentedura, Emilio J; Zimney, Kory


    Patients with low back pain (LBP) often display faulty beliefs and cognitions regarding their pain experience. Pain neuroscience education (PNE) aims to alter the pain experience by targeting these faulty beliefs and cognitions. One PNE strategy aims specifically to reframe commonly held beliefs about tissues by patients with LBP as the single source of pain. In line with this reasoning, it is hypothesized that physical therapists (PT) treating patients with LBP may indeed experience similar, if not worse, pain experiences while treating a patient with LBP. To date, this assumption has never been studied. A PT LBP questionnaire was developed, validated and distributed to a convenience sample of attendees of an international PT conference. One-hundred and ten PTs completed the questionnaire for a 71% response rate. Ninety percent of the PTs reported having experienced LBP, with 27% at the conference experiencing LBP at the time. Of the PTs that have experienced LBP 75% reported not having received any imaging; 81% no formal diagnoses, 58% no treatment and 86% not having missed work due to LBP. Eighty-six percent of therapists reported having experienced LBP while treating a patient with LBP, with 50% convinced their LBP was higher than the LBP experienced by the patient they were treating. The results from this study indicate PTs often treat patients with LBP while suffering LBP. It is suggested that this knowledge may potentially help patients with LBP reconceptualize their LBP experience leading to expedited recovery.

  15. Lymph Node Failure Pattern and Treatment Results of Esophageal Cancer Patients Treated with Definitive Radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Sun Young; Kwon, Hyoung Cheol; Kim, Jung Soo [Chonbuk National University Hospital, Jeonju (Korea, Republic of); Lee, Heui Kwan [The Catholic University of Korea, Seoul (Korea, Republic of); Kim, Soo Geon [Jesushospital, Jeonju (Korea, Republic of)


    We evaluated the failure pattern of the celiac axis, gastric lymph node, and treatment outcome in the upper and mid-esophageal region of cancer patients treated by definitive radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, retrospectively. Materials and Methods: The study constituted the evaluation 108 patients with locally advanced esophageal cancer receiving radiotherapy or a combination of radiotherapy and chemotherapy at Chonbuk National University Hospital from January 1986 to December 2006. In total, 82 patients treated by planned radiotherapy, except when treating the celiac axis and gastric lymph node for treatment volume, were analysed retrospectively. The study population consisted of 78 men and 2 women (mean age of 63.2 years). In addition, 51 patients received radiotherapy alone, whereas 31 patients received a combination of radiation therapy and chemotherapy. The primary cancer sites were located in the upper portion (17 patients), and mid portion (65 patients), respectively. Further, the patients were in various clinical stages including T1N0-1M0 (7 patients), T2N0-1M0 (18 patients), T3N0-1M0 (44 patients) and T4N0-1M0 (13 patients). The mean follow up period was 15 months. Results: The various treatment outcomes included complete response (48 patients), partial response (31 patients) and no response (3 patients). The failure patterns of the lymph node were comprised of the regional lymph node (23 patients) and the distance lymph node which included celiac axis and gastric lymph node (13 patients). However, metastasis was not observed in the regional and distant lymph node in 10 patients, whereas 36 patients were not evaluated. Furthermore, of the 13 patients who developed celiac axis and gastric lymph node metastases, 3 were in stage T1N0-1M0 and 10 were in stage T2-4N0-1M0. A complete response appeared in 12 patients, whereas a partial response appeared in 1 patient. The mean survival time of the

  16. Sexual function in prostatic cancer patients treated with radiotherapy, orchiectomy or oestrogens

    Energy Technology Data Exchange (ETDEWEB)

    Bergman, B.; Damber, J.E.; Littbrand, B.; Sjoegren, K.; Tomic, R. (Umeaa Univ. (Sweden))


    Sexual function in prostatic carcinoma patients was studied in 12 patients from each of three treatment groups: radiotherapy, orchiectomy and oestrogen treatment. Significant deterioration occurred in all groups. Although erectile potency was preserved in 9 of 12 patients treated with radiotherapy, 7 of these had a marked reduction in the frequency of sexual activity. Men subjected to orchiectomy or oestrogen treatment were seldom capable of having intercourse or of experiencing orgasm. However, oestrogen-treated men continued sexual activity with their partner more often than orchiectomised subjects. Patients receiving oestrogen treatment scored significantly higher for mental depression than those in the other two treatment groups.

  17. Reduced Acute Bowel Toxicity in Patients Treated With Intensity-Modulated Radiotherapy for Rectal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Samuelian, Jason M. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States); Callister, Matthew D., E-mail: [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States); Ashman, Jonathan B. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States); Young-Fadok, Tonia M. [Division of Colorectal Surgery, Mayo Clinic, Scottsdale, AZ (United States); Borad, Mitesh J. [Division of Hematology-Oncology, Mayo Clinic, Scottsdale, AZ (United States); Gunderson, Leonard L. [Department of Radiation Oncology, Mayo Clinic, Scottsdale, AZ (United States)


    Purpose: We have previously shown that intensity-modulated radiotherapy (IMRT) can reduce dose to small bowel, bladder, and bone marrow compared with three-field conventional radiotherapy (CRT) technique in the treatment of rectal cancer. The purpose of this study was to review our experience using IMRT to treat rectal cancer and report patient clinical outcomes. Methods and Materials: A retrospective review was conducted of patients with rectal cancer who were treated at Mayo Clinic Arizona with pelvic radiotherapy (RT). Data regarding patient and tumor characteristics, treatment, acute toxicity according to the Common Terminology Criteria for Adverse Events v 3.0, tumor response, and perioperative morbidity were collected. Results: From 2004 to August 2009, 92 consecutive patients were treated. Sixty-one (66%) patients were treated with CRT, and 31 (34%) patients were treated with IMRT. All but 2 patients received concurrent chemotherapy. There was no significant difference in median dose (50.4 Gy, CRT; 50 Gy, IMRT), preoperative vs. postoperative treatment, type of concurrent chemotherapy, or history of previous pelvic RT between the CRT and IMRT patient groups. Patients who received IMRT had significantly less gastrointestinal (GI) toxicity. Sixty-two percent of patients undergoing CRT experienced {>=}Grade 2 acute GI side effects, compared with 32% among IMRT patients (p = 0.006). The reduction in overall GI toxicity was attributable to fewer symptoms from the lower GI tract. Among CRT patients, {>=}Grade 2 diarrhea and enteritis was experienced among 48% and 30% of patients, respectively, compared with 23% (p = 0.02) and 10% (p = 0.015) among IMRT patients. There was no significant difference in hematologic or genitourinary acute toxicity between groups. In addition, pathologic complete response rates and postoperative morbidity between treatment groups did not differ significantly. Conclusions: In the management of rectal cancer, IMRT is associated with a


    Directory of Open Access Journals (Sweden)

    L. N. Korichkina


    Full Text Available Aim. To study changes of intercellular cooperation in peripheral blood induced by treatment in patients with arterial hypertension (HT, ischemic heart disease (IHD and chronic heart failure (CHF.Material and methods. 610 patients were involved into the study, including 250 patients with HT of stages I-III (50 untreated patients, 150 patients with IHD and 210 patients with CHF of stages I-III. All patients were treated except 50 hypertensive ones. 80 healthy patients (40 men, 40 women were included into control group. Blood smears of patients were evaluated (Romanovsky's stain. A number of leukocyte, autorosettes and autorosettes with erythrocyte lysis was calculated. The cellular association consisting of a neutrophil, monocyte or eosinocyte with 3 or more erythrocytes skintight to their surface defined as autorosettes. Erythrocytes number and hemoglobin level determined in peripheral blood.Results. Single autorosettes in peripheral blood were observed in patients of control group and in untreated patients with HT. Treated patients with HT, IHD and CHF had increased number of autorossets and autorosettes with erythrocytes lysis. This phenomenon resulted in reduction of erythrocytes number and hemoglobin level in peripheral blood.Conclusion. Treated patients with cardiologic diseases had changes in intercellular cooperation. It should be considered at intensive and long term therapy.

  19. Outcome of patients treated with automated peritoneal dialysis: Effects of selection of patients

    Directory of Open Access Journals (Sweden)

    Ayman Karkar


    Full Text Available To determine the effect of selection of peritoneal dialysis patients who used auto-mated PD (APD as a first renal replacement therapy (RRT option, we studied two groups of adult chronic kidney disease (CKD patients treated with APD over a period of 4 years: group 1 included 30 patients in whom APD was the first choice for RRT and group 2 included 40 patients transferred from failed hemodialysis (HD treatment. Both groups were matched for the original causes of CKD and comorbid conditions. However, group 1 had significantly higher residual renal function (RRF than group 2 [glomerular filtration rate (GFR 11.85 ± 4 mL/min and urine output 995 ± 465 mL/day vs. 3.69 ± 3.7 mL/min and 340 ± 447 mL/day, respectively, P = 0.0001] and Kt/v (2.7 ± 0.7 vs. 1.9 ± 0.4, respectively, P = 0.006. Most of the patients were compliant with their APD prescription, performed ideal PD techniques, achieved adequate dialysis and fluid ultra-filtration, and experienced much less than average infectious and non-infectious complications. However, group 1 achieved better clinical outcome than group 2, including relatively higher sur-vival rate and kidney transplantation, significantly fewer episodes of peritonitis per year (0.09 vs. 0.14, respectively, P = 0.0001, higher serum albumin (2.95 ± 0.3 vs. 2.7 ± 0.27 g/dL, respectively, P = 0.035, hemoglobin (11.5 ± 0.9 vs. 10.6 ± 0.7 g/dL, respectively, P = 0.022 and lower para-thormone levels (283 ± 117 vs. 389 ± 269 pg/mL, respectively, P = 0.02. They also maintained significantly higher total fluid removal compared to group 2 (1120 ± 330 vs. 560 ± 300 mL/day, respectively, P = 0.004, higher RRF (GFR 8 ± 2.6 mL/min vs. 1.8 ± 2.4 mL/min, respectively, P = 0.0001, and urine output (556 ± 447 mL/day vs. 240 ± 347 mL/day, respectively, P = 0.004, and significantly higher Kt/v (2.8 ± 0.7 vs. 1.9 ± 0.4, respectively, P = 0.2. In conclusion, in CKD patients, PD is a viable initial modality of RRT, and with better

  20. Electroconvulsive therapy for treating schizophrenia: a chart review of patients from two catchment areas

    DEFF Research Database (Denmark)

    Kristensen, Diana; Bauer, Jeanett; Pedersen, Ida Hageman


    To examine disease and treatment characteristics of patients with schizophrenia treated with electroconvulsive therapy (ECT). We examined charts from 79 patients diagnosed with schizophrenia (n = 55), persistent delusional disorders (n = 7), and schizoaffective disorders (n = 17) between 2003...... schizophrenia. Rather, it reflects the degree of relief from psychosis and disruptive behaviour, as described in the patient charts. The treatment was often offered to patients after considerable disease durations....

  1. Survival of metastatic colorectal cancer patients treated with chemotherapy in Alberta (1995?2004)


    Chen, Yiqun; Qiu, Zhenguo; Kamruzzaman, Anmmd; Snodgrass, Tom; Scarfe, Andrew; Bryant, Heather E.


    Goals of work Clinical trials have suggested that advances in chemotherapy significantly improve the survival of patients with metastatic colorectal cancer. Comparable evidence from clinical practice is scarce. This study aims to investigate the survival of patients with metastatic colorectal cancer treated with chemotherapy in Alberta, Canada. Patients and methods Trends of relative survival of patients diagnosed in 1994?2003 were assessed using Alberta Cancer Registry (ACR) data. The median...

  2. Tumor-stroma ratio predicts recurrence in patients with colon cancer treated with neoadjuvant chemotherapy

    DEFF Research Database (Denmark)

    Hansen, Torben Frøstrup; Kjær-Frifeldt, Sanne; Lindebjerg, Jan


    BACKGROUND: Neoadjuvant chemotherapy represents a new treatment approach to locally advanced colon cancer. The aim of this study was to analyze the ability of tumor-stroma ratio (TSR) to predict disease recurrence in patients with locally advanced colon cancer treated with neoadjuvant chemotherapy....... MATERIAL AND METHODS: This study included 65 patients with colon cancer treated with neoadjuvant chemotherapy in a phase II trial. All patients were planned for three cycles of capecitabine and oxaliplatin before surgery. Hematoxylin and eosin stained tissue sections from surgically resected primary tumors...... was 55%, compared to 94% in the group of patients with a high TSR. CONCLUSIONS: TSR assessed in the surgically resected primary tumor from patients with locally advanced colon cancer treated with neoadjuvant chemotherapy provides prognostic value and may serve as a relevant parameter in selecting...

  3. Risk factors in the development of schizophrenia: contributions from a study of children of schizophrenic mothers. (United States)

    Parnas, J


    The development of and the results from a prospective longitudinal study of children of schizophrenic mothers are presented. The presented studies have been guided by a diathesis-stress model of psychopathology and data analyses relied on the paradigm that schizophrenics and schizotypes share genetic liability to schizophrenia, but that the former, in addition, suffer from environmental insult. This paradigm, hypothetically formulated by Paul Meehl (21) proved especially fruitful in the etiological inferences made in this study. The results indicate that schizophrenia is, to some degree, genetically transmitted and that schizotypes share this genetic vulnerability with schizophrenics. Schizophrenia may be conceptualized as an environmentally complicated schizotypal personality disorder. Deleterious environmental influences identified in this study are obstetric complications probably resulting in central brain atrophy as measured by the CT-scans. In addition, future schizophrenics experienced disrupted childhood conditions as measured here by the amount of institutional rearing during the first five years of life. Fathers of the high risk children were more frequently mentally disturbed than fathers of the low risk children. The presence of a schizophrenia spectrum disorder in the father significantly increased a risk for such disorder in the high risk offspring. Continuity of psychopathological deviance in the form of subtle formal thought disorder and defective emotional contact was demonstrated for the schizophrenics and schizotypes from childhood into adulthood. This suggests that such symptoms are central to schizophrenic psychopathology and that schizophrenia is a development and not a disease which affects people without forewarning.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation

    DEFF Research Database (Denmark)

    Thrane, Jens F; Sunde, Niels A; Bergholt, Bo


    Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation......Increasing infection rate in multiple implanted pulse generator changes in movement disorder patients treated with deep brain stimulation...

  5. Prevalence of esophageal candidiasis among patients treated with inhaled fluticasone propionate. (United States)

    Kanda, Naoki; Yasuba, Hirotaka; Takahashi, Teruko; Mizuhara, Yuka; Yamazaki, Syuji; Imada, Yuko; Izumi, Yoshio; Kobayashi, Yoshiki; Yamashita, Kenzo; Kita, Hideo; Tamada, Takashi; Chiba, Tsutomu


    Development of oropharyngeal candidiasis is a frequently reported adverse effect of inhaled corticosteroid use, but the prevalence of esophageal candidiasis is unknown. The aim of this study was to estimate the prevalence of esophageal candidiasis among patients treated with an inhaled corticosteroid, fluticasone propionate. Upper GI endoscopy was performed on 49 patients treated with inhaled fluticasone propionate to examine the prevalence of esophageal candidiasis. Of the patients, 36 had bronchial asthma and 13 had chronic obstructive pulmonary disease. To compare the prevalence with control patients, upper GI endoscopy was performed on 700 consecutive patients without malignancy or immunosuppression. The prevalence of esophageal candidiasis was 37% among patients treated with inhaled fluticasone propionate, whereas only 0.3% of the control patients had the infection. The prevalence was especially high among patients with diabetes mellitus or those who were treated with a high dose of inhaled fluticasone propionate. Moreover, a reduction in the daily dose of inhaled fluticasone propionate eliminated the infection in four of five patients. Esophageal candidiasis is a common complication of inhaled corticosteroid use.

  6. Osteonecrosis detected by whole body magnetic resonance in patients with Hodgkin Lymphoma treated by BEACOPP

    Energy Technology Data Exchange (ETDEWEB)

    Albano, Domenico; La Grutta, Ludovico; Grassedonio, Emanuele; Brancatelli, Giuseppe; Lagalla, Roberto; Midiri, Massimo; Galia, Massimo [University of Palermo, Department of Radiology, DIBIMED, Palermo (Italy); Patti, Caterina; Mule, Antonino [Azienda Ospedali Riuniti Villa Sofia-Cervello, Department of Hematology I, Palermo (Italy)


    The purpose of our retrospective review of prospectively acquired Whole Body Magnetic Resonance (WB-MRI) scans was to assess the incidence of osteonecrosis in patients who received different chemotherapies. We evaluated the WB-MRI scans performed on 42 patients with Hodgkin Lymphoma treated by three chemotherapy regimens (6ABVD, 2ABVD + 4BEACOPP, 2ABVD + 8BEACOPP), excluding patients with the main risk factors for osteonecrosis. Six out of seven patients (86 %) who received eight BEACOPP and one out of five patients (20 %) treated by four BEACOPP presented osteonecrosis, with a statistically significant difference of frequency between the two groups of patients (p < 0.05); no injury has been reported in patients treated by only ABVD. Among a total of 48 osteonecrotic lesions observed, 48 % were detected in the knee; multifocal osteonecrosis were detected in six out of seven patients (86 %). The development of osteonecrosis is strictly related to the chemotherapy protocol adopted and the number of cycles received, with a strong correlation between the dose of corticosteroids included in the BEACOPP scheme and this complication. WB-MRI can be considered as a helpful tool that allows detecting earlier osteonecrotic lesions in patients treated with corticosteroids. (orig.)

  7. Osteonecrosis of the jaw in patients with multiple myeloma treated with bisphosphanates. (United States)

    Pavkovic, M; Petrushevska, G; Jovanovic, R; Karanfilski, O; Cevreska, L; Stankovic, S; Stojanovic, A


    Bisphosphonates are pyrophosphate analogues which inhibit osteoclastic activity. Long term use of bisphosphonates has recently been associated with osteonecrosis of the jaw (ONJ) defined as a three month non-healing defect in the jaw. ONJ is commonly precipitated by a tooth extraction or other stomatological procedure in patients treated with long-term, potent, high dose intravenous bisphosphonates for the management of myeloma, breast or prostate cancer. The aim of this study was to evaluate the incidence of ONJ in patients with MM treated with bisphosphonates during the last 8 years in our institution and to pre-sent the first two cases. We have analysed 247 myeloma patients diagnosed in our institution in the period 2002-09. Only 190/247 patients (76.9%) were treated with bisphosphonates. The incidence of ONJ in our group of patients treated with bisphosphonates was 2/190 (1%). The most commonly used bisphosponate was i.v. pamidronate (17.8%) and 46.6% were treated with two or more types of bisphosphonates. Sixty-five patients (34.2%) received oral forms of bisphosphonates; 42.1% patients were treated with i.v. forms of pamidronate, ibondronate or clodronate, and 45 patients (23.7%) received a combination of oral and i.v. forms of bisphosphonates. The mean duration of bisphosphonates therapy was 24.7±17.7 months. The low incidence of ONJ in our institution could be explained by the rare use of zolendronate, which is the most commonly referred bisphosphonate causing ONJ, and by a relatively shorter duration of bisphosphonates treatment in patients with MM. Despite the fact that ONJ is a rare complication in our institution, preventive measures must be considered.

  8. [Clinical features of foreign-born tuberculosis patients treated at our hospital]. (United States)

    Takikawa, Shuichi; Sugisaki, Katsunori; Inoue, Soichi; Yoshimatsu, Tetsuyuki; Otsu, Tatsuya


    There has been an increase in the number of foreign-born tuberculosis (TB) patients residing in Japan. The purpose of this study is to clarify the clinical features of the foreign-born TB patients treated at our hospital. This study included foreign-born TB patients treated at our hospital between 2000 and 2009. A comparison was performed with Japanese TB patients in the same age group who were treated in the same period. There were 44 patients (17 males and 27 females; mean age: 23.6 +/- 5.1). These patients originated from 13 different countries, 12 of which were Asian countries such as China and the Philippines, and 8 of which were WHO-designated high-burden TB countries. The period between the patient's entry into Japan and the onset of TB was less than a year for half of the cases. As compared with the Japanese patients group, the foreign patients group included a significantly higher proportion of students and a significantly large number of cases found by periodic health examination. In terms of clinical findings, no significant difference was observed in the proportion of cavitary cases (37.5%) and of smear positive cases (37.5%); however, the frequency of drug-resistant cases (30.4%) was significantly higher among the foreign patients than the Japanese patients. The cure rate was 75% among foreign-born patients, and there were no defaulters. Compared with Japanese patients with the same ages, the foreign-born TB patients treated at our hospital included a high proportion of students from high-burden TB countries who were detected by periodic health examination and a higher proportion of drug-resistant cases. The treatment outcome was satisfactory without any defaulters. Periodic mass health examinations and drug susceptibility tests are important, and careful health examination is necessary for all individuals from high-burden TB countries when they enter Japan.

  9. Determinants of post-intensive care mortality in high-level treated critically ill patients

    NARCIS (Netherlands)

    Iapichino, G; Morabito, A; Mistraletti, G; Ferla, L; Radrizzani, D; Miranda, DR


    Objective. To assess the predictive ability of preillness and illness variables, impact of care, and discharge variables on the post-intensive care mortality. Setting and patients. 5,805 patients treated with high intensity of care in 89 ICUs in 12 European countries (EURICUS-I study) surviving ICU

  10. Correlation between quality of life and voiding variables in patients treated with percutaneous tibial nerve stimulation.

    NARCIS (Netherlands)

    Pal, F. van der; Balken, M.R. van; Heesakkers, J.P.; Debruyne, F.M.J.; Kiemeney, L.A.L.M.; Bemelmans, B.L.H.


    OBJECTIVE: To investigate the relationship between quality of life (QoL) and voiding variables in patients with lower urinary tract dysfunction treated with percutaneous tibial nerve stimulation (PTNS), as it is assumed that improvements in voiding will lead to a better QoL in such patients.

  11. Acute exercise in treated phenylketonuria patients: Physical activity and biochemical response

    Directory of Open Access Journals (Sweden)

    Priscila Nicolao Mazzola


    Conclusions: Acute aerobic exercise followed by a Phe-restricted breakfast did not change Phe concentrations in treated phenylketonuria patients, but it was associated with decreased Phe/Tyr only in controls. Further studies are necessary to confirm our results in a higher number of patients.

  12. Outcomes of Patients With Burkitt Lymphoma Older Than Age 40 Treated With Intensive Chemotherapeutic Regimens

    NARCIS (Netherlands)

    Kelly, Jennifer L.; Toothaker, Stephen R.; Ciminello, Lauren; Hoelzer, Dieter; Holte, Harald; LaCasce, Ann S.; Mead, Graham; Thomas, Deborah; Van Imhoff, Gustaaf W.; Kahl, Brad S.; Cheson, Bruce D.; Magrath, Ian T.; Fisher, Richard I.; Friedberg, Jonathan W.

    Burkitt lymphoma is a highly curable disorder when treated with modern intensive chemotherapy regimens. The majority of adult patients with Burkitt lymphoma in the United States are over age 40 years. Older patients have historically been underrepresented in published clinical trials of modern

  13. Pharmacokinetics of cefetaxime in ICU-patients treated with continuous renal replacement : A pilot study

    NARCIS (Netherlands)

    Valk-Swinkels, C.G.H.; Rijpstra, T.A.; Van Der Meer, B.J.M.; Touw, D.J.; van't Veer, N.E.


    Introduction: Data on the optimal dosage of cefotaxime (CTX) in patients receiving continuous renal replacement therapy (CRRT) is sparse and equivocal [1]. We conducted a trial investigating the concentrations of CTX in general ICU and post-cardiac surgery ICU patients who were treated with CRRT

  14. Risk of second malignant neoplasm and mortality in patients with rheumatoid arthritis treated with biological DMARDs

    DEFF Research Database (Denmark)

    Dreyer, Lene; Cordtz, René L; Hansen, Inger Marie J


    OBJECTIVE: To study the risk of a second malignant neoplasm (SMN) and mortality in patients with rheumatoid arthritis (RA) with a history of a primary cancer diagnosis and treated with biological disease-modifying antirheumatic drugs (bDMARD). METHODS: Among patients with RA (n=15 286) registered...

  15. Metallic Taste in Cancer Patients Treated with Systemic Therapy : A Questionnaire-based Study

    NARCIS (Netherlands)

    IJpma, Irene; Timmermans, Erik R.; Renken, Remco J.; Horst, ter Gert; Reyners, Anna K. L.


    A metallic taste is reported by cancer patients as a side effect of systemic therapy. Despite the high prevalence, this taste alteration has received limited attention. The present study investigated: 1) the prevalence of metallic taste in cancer patients treated with systemic therapy; 2) possible

  16. Are Nigerian dentists willing to treat patients with HIV infection ? | Uti ...

    African Journals Online (AJOL)

    Objective: HIV/AIDS is a modern day plague, which is a challenge to dentistry. The willingness of dentists to treat HIV positive patients is crucial in the provision of oral health care to this increasing population of patients. The purpose of this study was to assess the willingness of dentists and factors that influence willingness ...

  17. Closed mallet thumb injury: Our experience of 10 patients treated with surgery and a systematic review. (United States)

    Abe, Yoshihiro; Rokkaku, Tomoyuki; Tokunaga, Susumu; Yamada, Toshiyuki; Okamoto, Seiji


    This retrospective study reports 10 patients with closed mallet thumb injury treated with surgery and compares the clinical outcomes achieved with those of previously described patients who were treated with either conservative therapy or surgery. We report the outcomes of a series of 10 patients who received surgical treatment at our institutions. Due to the rarity of closed mallet thumb, a systematic review was conducted, and the results of a literature search were compared with our case series to strengthen our conclusions. The previously described patients were categorized into two groups: the surgically treated group (16 patients) and the conservatively treated group (10 patients). The following patient and injury characteristics were documented: age, gender, injured side, time from injury to treatment, mechanism of injury, extension lag at first visit, postoperative range of motion (ROM) of the interphalangeal joint, immobilization period, and follow-up period. Statistical analyses showed no significant differences in the clinical results, except for shorter immobilization periods between our series and the previously described patients involving conservative treatment (4.9 ± 0.9 vs. 9.5 ± 2.3 weeks, respectively; P = 0.0053). This study suggests that surgery may result in more rapid recovery. Copyright © 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  18. Cytologic follow-up of patients with invasive cervical carcinoma treated by radiotherapy

    Energy Technology Data Exchange (ETDEWEB)

    Muram, D. (Univ. of Ottawa, Ontario); Curry, R.H.; Drouin, P.


    In an 11-year study done at the Ottawa Civic Hospital, cytologic assessment of 323 patients treated by radiotherapy for invasive cervical carcinoma was reviewed. The value and limitations of gynecologic cytology in the follow-up of these patients are discussed.

  19. Neuropsychological assessment of chronic non-malignant pain patients treated in a multidisciplinary pain centre

    DEFF Research Database (Denmark)

    Sjøgren, Per; Christrup, Lona Louring; Petersen, Morten Aa


    The aim of the study was to investigate the influence of pain, sedation, pain medications and socio-demographics on cognitive functioning in chronic non-malignant pain patients. Chronic non-malignant pain patients (N=91) treated in a multidisciplinary pain centre were compared with age and sex ma...

  20. Three-year followup of patients treated with lower energy microwave thermotherapy

    NARCIS (Netherlands)

    de Wildt, M. J.; D'Ancona, F. C.; Hubregtse, M.; Carter, S. S.; Debruyne, F. M.; de la Rosette, J. J.


    A retrospective study was done to investigate the long-term outcome of patients treated with lower energy transurethral microwave thermotherapy. A total of 305 patients with lower urinary tract symptoms and benign prostatic hypertrophy underwent transurethral microwave thermotherapy according to a

  1. Long-Term Survival in Patients with Metastatic Melanoma Treated with DTIC or Temozolomide


    Kim, Christina; Lee, Christopher W; Kovacic, Laurel; Shah, Amil; Klasa, Richard; Savage, Kerry J.


    The study examined long-term survivors from among metastatic melanoma patients treated with either dacarbazine or temozolomide to relate long-term survival to sensitivity to chemotherapy. Patients achieving a complete response to chemotherapy were more likely to attain long-term survival.

  2. More complications in patients with septic shock treated with dextran compared with crystalloids

    DEFF Research Database (Denmark)

    Rasmussen, Anders Mølgaard; Peter Jakobsen, Rasmus; Strøm, Thomas


    of patients admitted to our intensive care unit with septic shock and treated with dextran-70 in the period from 1 January 2009 to 31 December 2009. The controls were included from 1 March 2012 to 28 February 2013 when dextran-70 was replaced with crystalloids. RESULTS: There were 91 patients in the dextran...

  3. Metastatic melanoma patients treated with dendritic cell vaccination, Interleukin-2 and metronomic cyclophosphamide

    DEFF Research Database (Denmark)

    Ellebaek, Eva; Engell-Noerregaard, Lotte; Iversen, Trine Zeeberg


    have been added to a DC vaccine with the intend to dampen immunosuppressive mechanisms. Twenty-eight patients with progressive metastatic melanoma were treated with autologous DCs pulsed with survivin, hTERT, and p53-derived peptides (HLA-A2(+)) or tumor lysate (HLA-A2(-)). Concomitantly the patients...

  4. Depression is independently associated with 7-year mortality in patients treated with percutaneous coronary intervention

    DEFF Research Database (Denmark)

    Damen, Nikki L; Versteeg, Henneke; Boersma, Eric


    Depression has been associated with poor prognosis in patients with coronary artery disease (CAD), but little is known about the impact of depression on long-term mortality. We examined whether depression was associated with 7-year mortality in patients treated with percutaneous coronary interven...... intervention (PCI), after adjusting for socio-demographic and clinical characteristics, anxiety, and the distressed (Type D) personality....

  5. Functional and clinical results achieved in congenital clubfoot patients treated by Ponseti's technique

    Directory of Open Access Journals (Sweden)

    Pedro Augusto Jaqueto

    Full Text Available ABSTRACT OBJECTIVES: To analyze and evaluate functional and clinical results in patients with congenital clubfoot treated with Ponseti's technique. METHODS: This study evaluated 31 patients diagnosed with 51 congenital clubfeet, treated between April 2006 and September 2011 with Ponseti's technique. The patients who did not achieve an equinus correction with manipulation were treated with Achilles tenotomy. An anterior tibial tendon transfer was performed in patients who maintained residual adduction. All plasters were made by fellows and supervised by Ankle and Foot Chiefs. The technique was performed without the need for physical therapists, orthotics, and plaster technicians. Patients were submitted to pre- and post-treatment examination and evaluated under Pirani's classification. RESULTS: Male patients had an increased incidence and the right side was more affected, while bilateral involvement was observed in 64.5% of the cases. The mean number of cast changes was 5.8, and Achilles tenotomy was necessary in 26 patients. There were significant deformity improvements in 46 of the 51 treated feet (90.2%; Pirani's mean score improved from 5.5 to 3.6 after treatment. CONCLUSION: The Ponseti method was effective in both functional and clinical evaluation of patients, with significant statistical relevance (p = 0.0001, with a success rate of 90.2% and mean improvement in the Pirani's index of 65.5%.

  6. Follow-up study of late effects in /sup 224/Ra treated ankylosing spondylitis patients

    Energy Technology Data Exchange (ETDEWEB)

    Wick, R.R.; Goessner, W.


    Fifteen hundred thirty-one patients treated with /sup 224/Ra from 14 hospitals in the F.R.G. and 267 control patients with ankylosing spondylitis not treated with any form of ionizing radiation are being followed. Since 1970 three cases of malignant tumour in the skeleton have been found among /sup 224/Ra-treated patients with skeletal doses below 90 rad compared with 0.4-0.6 expected. Two of these three cases were tumours of the bone marrow. An effect of /sup 224/Ra on the haematopoietic system cannot be excluded. Also, seven cases of cataract were found among 274 /sup 224/Ra patients. The mean time since /sup 224/Ra treatment was 26 yr. The mean age at diagnosis was 66 yr. The cataract incidence was not unusual for people of this age.

  7. Metastatic deaths in retinoblastoma patients treated with intraarterial chemotherapy (ophthalmic artery chemosurgery) worldwide. (United States)

    Abramson, David H; Shields, Carol L; Jabbour, Pascal; Teixeira, Luiz Fernando; Fonseca, José Roberto Falco; Marques, Marcio Chaves Pedro; Munier, Francis L; Puccinelli, Francesco; Hadjistilianou, Theodora; Bracco, Sandra; Chantada, Guillermo; Ceciliano, Alejandro; Gobin, Y Pierre


    Ophthalmic artery chemosurgery [OAC, intra-arterial chemotherapy (IAC)] was introduced in 2006 as treatment modality for intraocular retinoblastoma. The purpose of this commentary is to retrospectively review the incidence of metastatic deaths in retinoblastoma patients treated with OAC worldwide over a 10 year period. Retrospective data regarding metastatic deaths was collected from six international retinoblastoma centers (New York City USA, Philadelphia USA, Sao Paulo Brazil, Siena Italy, Lausanne Switzerland and Buenos Aires Argentina). All retinoblastoma patients from these centers (naive and recurrent, unilateral and bilateral) treated with OAC/IAC since 2006 have been included in this study. Data regarding number of patients, number of OAC/IAC infusions, number unilateral and bilateral, number treated for naive disease or salvage and number of metastatic deaths have been assessed. Over a 10-year period of time 1139 patients received OAC/IAC for 4396 infusions. At last follow-up there were only three metastatic deaths (all treated in Buenos Aires). The current survey assessed the recorded risk of metastatic deaths in six retinoblastoma centers worldwide in children with retinoblastoma (unilateral or bilateral) treated with OAC/IAC as primary or secondary therapy. Overall, the observed risk for metastatic deaths from retinoblastoma was <1% in OAC/IAC treated children.

  8. Active tuberculosis in psoriasis patients treated with TNF antagonists: a French nationwide retrospective study. (United States)

    Guinard, E; Bulai Livideanu, C; Barthélémy, H; Viguier, M; Reguiai, Z; Richard, M A; Jullien, D; Beneton, N; Bara, C; Vabres, P; Grandvuillemin, A; Marguery, M C; Amelot, F; Konstantinou, M P; Bagheri, H; Paul, C


    There is limited information about active tuberculosis (TB) occurring in psoriasis patients treated with Tumor necrosis factor (TNF) antagonists. To describe the clinical characteristics of TB in psoriasis patients treated with TNF antagonists. Nationwide retrospective study of psoriasis patients having experienced TB. Cases of TB were collected via three methods: search in the national pharmacosurveillance database, questionnaire to members of the French psoriasis research group, the college of French dermatology professors. We collected demographic data, TNF antagonist used, screening for latent tuberculosis infection, median time between TNF antagonists introduction and first symptoms, tests used for diagnosing TB infection, clinical features of tuberculosis and outcome. Eight centres reported 12 cases of TB between 2006 and 2014. They were nine men and three women with mean age of 49 years. All patients had adequate screening for latent tuberculosis. Three patients had stayed in endemic areas, three reported contact with a patient with TB. Tuberculosis presentation was extrapulmonary in 10 patients. Seven patients were treated with infliximab, four with adalimumab and one with certolizumab. The median time between TNF antagonist introduction and first symptoms of tuberculosis was 23.4 weeks (2-176). Six of the 12 patients had a positive direct examination and/or positive culture for Mycobacterium tuberculosis. Histological samples of affected organs taken from seven patients showed granulomatous inflammation in six, with caseating necrosis in five. Two of the 12 patients died of disseminated TB. This study shows tuberculosis in patients treated with TNF antagonists still occurs despite adherence to tuberculosis prevention guidelines. Prophylactic measures do not fully prevent the occurrence of tuberculosis. Rapid initiation of effective anti-tuberculosis treatment is important even in patients with negative mycobacteriological examination presenting with

  9. Patient characteristics do not predict poor glycaemic control in type 2 diabetes patients treated in primary care

    NARCIS (Netherlands)

    Goudswaard, AN; Stolk, RP; Zuithoff, P; Rutten, GEHM

    Many diabetic patients in general practice do not achieve good glycaemic control. The aim of this study was to assess which characteristics of type 2 diabetes patients treated in primary care predict poor glycaemic control (HbA(1c) greater than or equal to7%). Data were collected from the medical

  10. Hyperemia-associated costs of medication changes in glaucoma patients treated initially with prostaglandin analogs. (United States)

    Schwartz, Gail F; Tan, Jason; Kotak, Sameer


    To develop a model to estimate and compare the cost of changing therapy due to hyperemia in glaucoma patients treated initially either with latanoprost, bimatoprost, or travoprost monotherapy. Data collected from the HealthCore Integrated Research Database, as part of the Glaucoma Adherence and Persistency Study (GAPS), were used to populate the model. Patients with a documented diagnosis of glaucoma who were newly treated (no ocular hypotensive medication and no glaucoma-related procedure during 6 months before first prescription) with latanoprost, bimatoprost, or travoprost monotherapy were identified. The time horizon for the base-case model was the duration of chart abstraction (mean = 4.1 years); a 3-month model also was developed. Physician-reported rates of hyperemia were obtained from chart reviews of 300 patients. Transition rates reflected events related to reports of hyperemia where a physician-driven change (switch or discontinuation) in therapy was documented. The per-patient direct cost (2008) due to hyperemia-driven change in therapy was calculated as the sum of the cost of the initial prescription plus the cost of the office visit where the patient was evaluated and the decision to change therapy was made. Costs were stratified by whether patients were hyperemia free or discontinued the initial therapy due to hyperemia. From the sample of 13,977 newly treated patients, 8,743 patients were started on a prostaglandin monotherapy only. Of these, 5,726 received latanoprost, 1,633 were treated with bimatoprost, and 1,384 received travoprost index monotherapy. Across all treatment groups, costs among hyperemia-free patients were US$73.67 versus US$140.02 for those who discontinued the initial prostaglandin due to hyperemia. Per-patient costs were lowest in the group treated initially with latanoprost. For the base-case model, with latanoprost as the reference, total per-patient incremental costs due to hyperemia-driven change in therapy were US$5.92 for

  11. Pioglitazone metabolic effect in metformin-intolerant obese patients treated with sibutramine. (United States)

    Derosa, Giuseppe; Mereu, Roberto; Salvadeo, Sibilla A T; D'Angelo, Angela; Ciccarelli, Leonardina; Piccinni, Mario N; Ferrari, Ilaria; Gravina, Alessia; Maffioli, Pamela; Cicero, Arrigo F G


    Metformin is the drug of choice to treat obese type 2 diabetes patients because it reduces either insulin-resistance and body weight. We aimed to comparatively test the efficacy and tolerability of pioglitazone and sibutramine in metformin-intolerant obese type 2 diabetic patients treated with sibutramine. Five hundred and seventy-six consecutive Caucasian obese type 2 diabetic patients were evaluated during a 12-months period and fifty-two patients were resulted intolerant to metformin at maximum dosage (3,000 mg/day). All intolerant patients to metformin received a treatment with pioglitazone (45 mg/day) and sibutramine (10 mg/day) and they were compared with fifty-three patients treated with metformin (3,000 mg/day) and sibutramine (10 mg/day) for 6 months in a single-blind controlled trial. We assessed body mass index, waist circumference, glycated hemoglobin, Fasting Plasma glucose, postprandial plasma glucose, fasting plasma insulin, postprandial plasma insulin, lipid profile, systolic blood pressure, diastolic blood pressure and heart rate at baseline and after 3, and 6 months. No body mass index change was observed at 3, and 6 months in pioglitazone + sibutramine group, while a significant reduction of body mass index and waist circumference was observed after 6 months in metformin + sibutramine group (pPioglitazone and sibutramine combination appears to be a short-term equally efficacious and well-tolerated therapeutic alternative respect to metformin-intolerant obese type 2 diabetic patients treated with sibutramine.

  12. Muscle mitochondrial metabolism and calcium signaling impairment in patients treated with statins

    Energy Technology Data Exchange (ETDEWEB)

    Sirvent, P., E-mail: [U1046, INSERM, Université Montpellier 1 and Université Montpellier 2, 34295 Montpellier (France); CHRU Montpellier, 34295 Montpellier (France); Clermont Université, Université Blaise Pascal, EA 3533, Laboratoire des Adaptations Métaboliques à l' Exercice en conditions Physiologiques et Pathologiques (AME2P), BP 80026, F-63171 Aubière cedex (France); Fabre, O.; Bordenave, S. [U1046, INSERM, Université Montpellier 1 and Université Montpellier 2, 34295 Montpellier (France); CHRU Montpellier, 34295 Montpellier (France); Hillaire-Buys, D. [CHRU Montpellier, 34295 Montpellier (France); Raynaud De Mauverger, E.; Lacampagne, A.; Mercier, J. [U1046, INSERM, Université Montpellier 1 and Université Montpellier 2, 34295 Montpellier (France); CHRU Montpellier, 34295 Montpellier (France)


    The most common and problematic side effect of statins is myopathy. To date, the patho-physiological mechanisms of statin myotoxicity are still not clearly understood. In previous studies, we showed that acute application in vitro of simvastatin caused impairment of mitochondrial function and dysfunction of calcium homeostasis in human and rat healthy muscle samples. We thus evaluated in the present study, mitochondrial function and calcium signaling in muscles of patients treated with statins, who present or not muscle symptoms, by oxygraphy and recording of calcium sparks, respectively. Patients treated with statins showed impairment of mitochondrial respiration that involved mainly the complex I of the respiratory chain and altered frequency and amplitude of calcium sparks. The muscle problems observed in statin-treated patients appear thus to be related to impairment of mitochondrial function and muscle calcium homeostasis, confirming the results we previously reported in vitro. -- Highlights: ► The most common and problematic side effect of statins is myopathy. ► Patients treated with statins showed impairment of mitochondrial respiration. ► Statins-treated patients showed altered frequency and amplitude of calcium sparks.

  13. Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab

    DEFF Research Database (Denmark)

    Nguyen, Mai; Pødenphant, Jan; Ravn, Pernille


    We report three cases of severe disseminated Staphylococcus aureus infection in patients with rheumatoid arthritis (RA) treated with tocilizumab. Tocilizumab is a new drug, unknown to most internists, and injections given weeks before admission may not be considered by the patient as part of thei...... infections and that patients are taught to inform health staff about their medication history and their increased risk of infection....

  14. Sideroblastic anemia as a preleukemic event in patients treated for Hodgkin's disease

    Energy Technology Data Exchange (ETDEWEB)

    Kitahara, M.; Cosgriff, T.M.; Eyre, H.J.


    Sideroblastic anemia after treatment for Hodgkin's disease was seen in two patients 3 years after completion of radiation therapy and chemotherapy. This was followed in both by the development of myelomonoblastic leukemia. No evidence of recurrent Hodgkin's disease was present in either patient. Our observation suggests that development of sideroblastic anemia in patients previously treated for Hodgkin's disease is probably secondary to the treatment and is a preleukemic event.

  15. Endurance and resistance training in radically treated respiratory cancer patients: a pilot study


    Salhi, B.; Demedts, I; Simpelaere, A.; Decraene, S.; Vermaelen, K.; Surmont, V.; van Meerbeeck, J. P.; Derom, E.


    Introduction. Respiratory cancer and its treatment are known to contribute to muscle weakness and functional impairment. Aim. To assess the effects of rehabilitation in patients with respiratory cancer. Methods. Radically treated respiratory cancer patients were included in a 12-week multidisciplinary rehabilitation program. Results. 16 patients (age: 61 ± 7 years; FEV1: 57 ± 16% pred.) showed a reduced exercise tolerance (VO2max: 56 ± 15% pred.; 6 MWD: 67 ± 11% pred.), muscle force (PImax: 5...

  16. Nitric oxide mediates abnormal responsiveness of thyroid arteries in methimazole-treated patients


    Ortega Serrano, Joaquín; Vila Salinas, José María; Mauricio Aviñó, María Dolores; Segarra Irles, Gloria Vicenta; Medina Bessó, Pascual; Martínez León, Juan Bautista; Lluch, Salvador


    Objective: We studied the intervention of nitric oxide (NO), prostacyclin (PGI2) and endothelium-derived hyperpolarizing factor (EDHF) in mediating responses to acetylcholine in thyroid arteries from euthyroid (E) and methimazole-treated (MT) patients. Design and methods: Branches of the superior thyroid artery were obtained from 19 E patients and 17 MT patients (euthyroid at the time of surgery) undergoing total thyroidectomy or hemithyroidectomy. Artery rings were suspended in organ baths f...

  17. Longitudinal Changes in Active Bone Marrow for Cervical Cancer Patients Treated With Concurrent Chemoradiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Noticewala, Sonal S.; Li, Nan; Williamson, Casey W. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Hoh, Carl K. [Division of Nuclear Medicine, Department of Radiology, University of California San Diego, La Jolla, California (United States); Shen, Hanjie [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); McHale, Michael T.; Saenz, Cheryl C. [Division of Gynecologic Oncology, Department of Reproductive Medicine, University of California San Diego, La Jolla, California (United States); Einck, John [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Plaxe, Steven [Division of Gynecologic Oncology, Department of Reproductive Medicine, University of California San Diego, La Jolla, California (United States); Vaida, Florin [Division of Biostatistics and Bioinformatics, Department of Family Medicine and Public Health, University of California San Diego, La Jolla, California (United States); Yashar, Catheryn M. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States); Mell, Loren K., E-mail: [Department of Radiation Medicine and Applied Sciences, University of California San Diego, La Jolla, California (United States)


    Purpose: To quantify longitudinal changes in active bone marrow (ABM) distributions within unirradiated (extrapelvic) and irradiated (pelvic) bone marrow (BM) in cervical cancer patients treated with concurrent chemoradiation therapy (CRT). Methods and Materials: We sampled 39 cervical cancer patients treated with CRT, of whom 25 were treated with concurrent cisplatin (40 mg/m{sup 2}) and 14 were treated with cisplatin (40 mg/m{sup 2}) plus gemcitabine (50-125 mg/m{sup 2}) (C/G). Patients underwent {sup 18}F-fluorodeoxyglucose positron emission tomographic/computed tomographic imaging at baseline and 1.5 to 6.0 months after treatment. ABM was defined as the subvolume of bone with standardized uptake value (SUV) above the mean SUV of the total bone. The primary aim was to measure the compensatory response, defined as the change in the log of the ratio of extrapelvic versus pelvic ABM percentage from baseline to after treatment. We also quantified the change in the proportion of ABM and mean SUV in pelvic and extrapelvic BM using a 2-sided paired t test. Results: We observed a significant increase in the overall extrapelvic compensatory response after CRT (0.381; 95% confidence interval [CI]: 0.312, 0.449) and separately in patients treated with cisplatin (0.429; 95% CI: 0.340, 0.517) and C/G (0.294; 95% CI: 0.186, 0.402). We observed a trend toward higher compensatory response in patients treated with cisplatin compared with C/G (P=.057). Pelvic ABM percentage was reduced after CRT both in patients receiving cisplatin (P<.001) and in those receiving C/G (P<.001), whereas extrapelvic ABM percentage was increased in patients receiving cisplatin (P<.001) and C/G (P<.001). The mean SUV in pelvic structures was lower after CRT with both cisplatin (P<.001) and C/G (P<.001). The mean SUV appeared lower in extrapelvic structures after CRT in patients treated with C/G (P=.076) but not with cisplatin (P=.942). We also observed that older age and more intense chemotherapy

  18. Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians (United States)

    Tsugawa, Yusuke; Jena, Anupam B.; Figueroa, Jose F.; Orav, E. John; Blumenthal, Daniel M.; Jha, Ashish K.


    IMPORTANCE Studies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice. However, whether patient outcomes differ between male and female physicians is largely unknown. OBJECTIVE To determine whether mortality and readmission rates differ between patients treated by male or female physicians. DESIGN, SETTING, AND PARTICIPANTS We analyzed a 20% random sample of Medicare fee-for-service beneficiaries 65 years or older hospitalized with a medical condition and treated by general internists from January 1, 2011, to December 31, 2014. We examined the association between physician sex and 30-day mortality and readmission rates, adjusted for patient and physician characteristics and hospital fixed effects (effectively comparing female and male physicians within the same hospital). As a sensitivity analysis, we examined only physicians focusing on hospital care (hospitalists), among whom patients are plausibly quasi-randomized to physicians based on the physician’s specific work schedules. We also investigated whether differences in patient outcomes varied by specific condition or by underlying severity of illness. MAIN OUTCOMES AND MEASURES Patients’ 30-day mortality and readmission rates. RESULTS A total of 1 583 028 hospitalizations were used for analyses of 30-day mortality (mean [SD] patient age, 80.2 [8.5] years; 621 412 men and 961 616 women) and 1 540 797 were used for analyses of readmission (mean [SD] patient age, 80.1 [8.5] years; 602 115 men and 938 682 women).