Cannabis use and involuntary admission may mediate long-term adherence in first-episode psychosis patients: a prospective longitudinal study

Background: This study aimed to examine factors associated with treatment adherence in first-episode psychosis (FEP) patients followed up over 8 years, especially involuntary first admission and stopping cannabis use. Methods: This prospective, longitudinal study of FEP patients collected data on symptoms, adherence, functioning,and substance use. Adherence to treatment was the main outcome variable and was categorized as ‘good’ or ‘bad’. Cannabis use during follow-up was stratified as continued use, stopped use, and never used. Bivariate and logistic regression models identified factors significantly associated with adherence and changes in adherence over the 8-year follow-up period. Results: Of the 98 FEP patients analyzed at baseline, 57.1% had involuntary first admission, 74.4% bad adherence,and 52% cannabis use. Good adherence at baseline was associated with Global Assessment of Functioning score (p = 0.019), Hamilton Depression Rating Scale score (p = 0.017) and voluntary admission (p < 0.001). Adherence patterns over 8 years included: 43.4% patients always bad, 26.1% always good, 25% improved from bad to good. Among the improved adherence group, 95.7% had involuntary first admission and 38.9% stopped cannabis use. In the subgroup of patients with bad adherence at baseline, involuntary first admission and quitting cannabis use during follow up were associated with improved adherence. Conclusions: The long-term association between treatment adherence and type of first admission and cannabis use in FEP patients suggest targets for intervention to improve clinical outcomes

Higher COVID-19 pneumonia risk associated with anti-IFN-α than with anti-IFN-ω auto-Abs in children

We found that 19 (10.4%) of 183 unvaccinated children hospitalized for COVID-19 pneumonia had autoantibodies (auto-Abs) neutralizing type I IFNs (IFN-alpha 2 in 10 patients: IFN-alpha 2 only in three, IFN-alpha 2 plus IFN-omega in five, and IFN-alpha 2, IFN-omega plus IFN-beta in two; IFN-omega only in nine patients). Seven children (3.8%) had Abs neutralizing at least 10 ng/ml of one IFN, whereas the other 12 (6.6%) had Abs neutralizing only 100 pg/ml. The auto-Abs neutralized both unglycosylated and glycosylated IFNs. We also detected auto-Abs neutralizing 100 pg/ml IFN-alpha 2 in 4 of 2,267 uninfected children (0.2%) and auto-Abs neutralizing IFN-omega in 45 children (2%). The odds ratios (ORs) for life-threatening COVID-19 pneumonia were, therefore, higher for auto-Abs neutralizing IFN-alpha 2 only (OR [95% CI] = 67.6 [5.7-9,196.6]) than for auto-Abs neutralizing IFN-. only (OR [95% CI] = 2.6 [1.2-5.3]). ORs were also higher for auto-Abs neutralizing high concentrations (OR [95% CI] = 12.9 [4.6-35.9]) than for those neutralizing low concentrations (OR [95% CI] = 5.5 [3.1-9.6]) of IFN-omega and/or IFN-alpha 2

Intoxicación aguda por arsénico con inusual evolución favorable

Describimos un caso de ingesta accidental de arsenito sódico en un joven agricultor. Desarrolló como únicas manifestaciones un cuadro autolimitado de vómitos, dolor abdominal, cólico y alteraciones electrocardiográficas en la repolarización. Pudo darse el alta con recuperación completa. Se detectaron niveles tóxicos de arsénico en sangre y orina

Psicothema

Resumen tomado de la publicaciónVersión española de la escala Perceived Devaluation and Discrimination de Link. Antecedentes: el objetivo de este estudio es traducir, adaptar y validar la “Perceived Devaluation and Discrimination Scale” (PDD) en español en una muestra de personas con esquizofrenia. Método: se incluyeron un total de 130 personas de entre 18 y 65 años con un diagnóstico de esquizofrenia según los criterios del DSM-IV-R de Barcelona y Vitoria. Los pacientes fueron evaluados con la versión traducida de la PDD, la Escala de Funcionamiento Social (SFS), la Evaluación Global de Funcionamiento (GAF), la escala Clinical Global Impresión (CGI-S) y la autopercepción de Estigma Cuestionario para las personas con esquizofrenia (SSQ). Resultados: la consistencia interna del cuestionario, evaluada utilizando a de Cronbach, fue .868. Dos componentes fueron encontrados en el análisis factorial explicando el 40% de la varianza del instrumento (componente 1 asociado a la auto-percepción y el componente 2 individual se refiere más al estigma social). Los valores de estabilidad temporal medidos utilizando el coeficiente de correlación intraclase en ambas ocasiones oscilan entre .415 y .806. Se encontraron correlaciones significativas con SSQ y SFS. Conclusiones: la versión española de PDD parece un buen instrumento para la evaluación del auto-estigma.Universidad de Oviedo. Biblioteca de Psicología; Plaza Feijoo, s/n.; 33003 Oviedo; Tel. +34985104146; Fax +34985104126; [email protected]

Relationship between nutritional treatment compliance and nutritional status improvements in patients with gastrointestinal impairment taking an oral peptide-based supplement.

Compliance in outpatients with gastrointestinal (GI) malabsorption is key in nutritional treatment. The objective of this study was to assess compliance in patients with GI impairment and malnutrition taking a high-calorie, high-protein, peptide-based oral nutritional supplement (ONS-PBD). A prospective, multicenter, observational study was conducted in 19 medical sites in Spain where ONS-PBD were prescribed as standard of care. Patients consumed ONS-PBD daily for 12 wk. Compliance was calculated as the percentage consumed of the prescribed amount of ONS per day. A total of 90 adult patients were included in the study, of whom 64 completed the 12-wk regimine. Mean compliance was 78.8% ± 24.5%. Risk of malnutrition decreased in 56.3% of patients at 12 wk, as measured with the malnutrition universal screening tool. A reduction in abdominal pain was observed and stool consistency improved, with a mean of 54.7% and 27.5%, respectively. Improvements in quality of life and a decrease in percentage of patients with severe functional impairment were observed. These data show that ONS-PBD compliance in malnourished patients with GI symptoms is high, reducing GI symptoms and improving patients' nutritional status