Clozapine prescription trends in Brazil in the last decade

Objective: Clozapine is a second-generation antipsychotic indicated for treatment-resistant schizophrenia. Studies in several countries have shown a low rate of clozapine use despite the fact that approximately 30% of schizophrenia cases are treatment-resistant. In Brazil, few studies have addressed the frequency and variety of antipsychotic use in individuals diagnosed with schizophrenia (ICD F20). The objective of this study was to measure the rates of clozapine use in this population in the last decade using Brazilian Ministry of Health data. Methods: Prescriptions made between 2010 and 2020 in all 26 states and the Federal District registered at the Outpatient Information System Database from the Brazilian Health System (SIASUS) were evaluated. Results: A total of 25,143,524 prescriptions were recorded in this period, with clozapine representing 8.86% of all antipsychotics. The most frequently prescribed antipsychotic for patients with schizophrenia was olanzapine (35.8%), followed by quetiapine (27.5%). From 2010 to 2020, the rate of clozapine prescriptions in Brazil increased from 7.2% to 10.9%. Conclusions: Despite a slight increase in prescriptions in the last decade, clozapine is still underutilized in Brazil

Factor structure of the Positive and Negative Syndrome Scale (PANSS) in Brazil: convergent validation of the Brazilian version

Objectives: The Positive and Negative Syndrome Scale (PANSS) was developed to assess the symptoms of schizophrenia dimensionally. Although it is widely used in clinical trials in Brazil, it is not fully validated. The aim of this study is to assess the factor structure of the Brazilian PANSS and generate validation data for its current version. Methods: A total of 292 patients diagnosed with schizophrenia were enrolled. Results: Principal component analysis suggested a forced five-factor final model that accounted for 58.44% of the total variance, composed of negative, disorganization/cognition, excitement, positive, and depression/anxiety. Conclusion: The Brazilian PANSS has a similar factor structure and internal consistency compared to its other country versions.Universidade Federal de São Paulo (UNIFESP) Department of Psychiatry Interdisciplinary Laboratory in Clinical Neuroscience (LiNC)UNIFESP Schizophrenia Program (PROESQ)Faculdade de Ciências Médicas da Santa Casa de São Paulo Center for Integrated Mental HealthUniversidade Federal de São Paulo (UNIFESP) Department of PsychiatryUNIFESP Genetics Division, Department of Morphology and GeneticsUNIFESP, Department of Psychiatry Interdisciplinary Laboratory in Clinical Neuroscience (LiNC)UNIFESP, Schizophrenia Program (PROESQ)UNIFESP, Department of PsychiatryUNIFESP, Genetics Division, Department of Morphology and GeneticsSciEL

Effects of Risperidone on Cytokine Profile in Drug-Naive First-Episode Psychosis

Background: There is robust evidence that schizophrenia is characterized by immune-inflammatory abnormalities, including variations on cytokine levels. the results of previous studies, however, are heterogeneous due to several confounding factors, such as the effects of antipsychotic drugs. Therefore, research on drug-naive first-episode psychosis (FEP) patients is essential to elucidate the role of immune processes in that disorder.Methods: the aim of this study is to compare cytokine levels (IL-2, IL-10, IL-4, IL-6, IFN-gamma, TNF-alpha, and IL-17) in drug-naive FEP patients both before and after treatment with risperidone for 10 weeks, and to investigate possible associations between cytokine levels and clinical responses to treatment and presence of depressive symptoms. It this study, we included 55 drug-naive FEP patients who had repeated measurements of cytokine levels and 57 healthy controls.Results: We found that FEP patients had significantly higher IL-6, IL-10 and TNF-alpha levels than healthy controls. After risperidone treatment, these three cytokines and additionally IL-4 decreased significantly. No significant difference was found between the post-treatment cytokine levels in FEP patients and in healthy controls, suggesting that these alterations in cytokine profiles are a state marker of FEP. No significant association was found between risperidone-induced changes in cytokines and the clinical response to treatment or the presence of depression. There was a significant inverse association between the risperidone-induced changes in IL-10 and the negative symptoms.Conclusions: in conclusion, our results show a specific cytokine profile in FEP patients (monocytic and regulatory T-cell activation) and suggest immunoregulatory effects of risperidone treatment, characterized by suppressant effects on monocytic, Th2, and T-regulatory functions.Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Fundacao SafraFundacao ABADSJanssenEli LillyLundbeckNovartisRocheUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilFac Ciencias Med Santa Casa São Paulo, Episode Psychosis Program 1, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Morphol & Genet, Div Genet, São Paulo, BrazilDeakin Univ, Dept Psychiat, Geelong, Vic 3217, AustraliaChulalongkorn Univ, Dept Psychiat, Bangkok, ThailandUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilUniversidade Federal de São Paulo, Dept Morphol & Genet, Div Genet, São Paulo, BrazilWeb of Scienc

Catechol-O-methyltransferase (COMT) polymorphisms modulate working memory in individuals with schizophrenia and healthy controls

Objective: Cognitive impairment is a core feature of schizophrenia, related to dopaminergic dysfunction in the prefrontal cortex (PFC). It is hypothesized that functional single nucleotide polymorphism (SNP) rs4680 of the catechol-O-methyltransferase (COMT) gene could mediate the relationship between cognition and dopamine activity in the PFC. Other COMT SNPs could also play a role. Methods: We evaluated the role of three COMT SNPs (rs737865, rs165599, and rs4680) in schizophrenia and their impact on three working memory tasks. For genetic association analyses, 212 individuals with schizophrenia and 257 healthy controls (HCs) were selected. The Visual Working Memory (VWM) Task, Keep Track Task, and Letter Memory Task were administered to 133 schizophrenics and 93 HCs. Results: We found a significant association of rs737865, with the GG genotype exerting a protective effect and the GA haplotype (rs4680/rs165599) exerting a risk effect for schizophrenia. COMT rs4680 AA carriers and rs737865 AA carriers scored lowest on the Keep Track Task. When the genotype* group interaction effect was evaluated, rs165599 exerted opposite effects for VWM and Keep Track task performance in patients and controls, with AA carriers scoring lowest on both tests among controls, but highest among patients. Conclusion: These data support the hypothesis that COMT polymorphisms may be associated with schizophrenia and modulate cognition in patients and controls.Fundacao de Amparo a Pesquisa do Estado de Sao Paulo (FAPESP), BrazilUniv Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilFMABC, Dept Saude Colet, Santo Andre, SP, BrazilUniv Fed Sao Paulo, Lab Interdisciplinar Neurociencias Clin LiNC, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Morfol & Genet, Disciplina Genet, Sao Paulo, SP, BrazilCtr Univ Fundcao Inst Ensino Osasco UNIFIEO, Dept Psicol Educ, Osasco, SP, BrazilUniv Fed Sao Paulo, Dept Psicobiol, Sao Paulo, SP, BrazilUniv Fed Sao Paulo UNIFESP, Dept Psiquiatria, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Lab Interdisciplinar Neurociencias Clin LiNC, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Morfol & Genet, Disciplina Genet, Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Psicobiol, Sao Paulo, SP, BrazilFAPESP: 2007/58736-1FAPESP: 2011/50740-5Web of Scienc

PRODH Polymorphisms, Cortical Volumes and Thickness in Schizophrenia

Schizophrenia is a neurodevelopmental disorder with high heritability. Several lines of evidence indicate that the PRODH gene may be related to the disorder. Therefore, our study investigates the effects of 12 polymorphisms of PRODH on schizophrenia and its phenotypes. To further evaluate the roles of the associated variants in the disorder, we have conducted magnetic resonance imaging (MRI) scans to assess cortical volumes and thicknesses. A total of 192 patients were evaluated using the Structured Clinical Interview for DSM-IV (SCID), Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale, Global Assessment of Functioning (GAF) and Clinical Global Impression (CGI) instruments. the study included 179 controls paired by age and gender. the samples were genotyped using the real-time polymerase chain reaction (PCR), restriction fragment length polymorphism (RFLP)-PCR and Sanger sequencing methods. A sample of 138 patients and 34 healthy controls underwent MRI scans. One polymorphism was associated with schizophrenia (rs2904552), with the G-allele more frequent in patients than in controls. This polymorphism is likely functional, as predicted by PolyPhen and SIFT, but it was not associated with brain morphology in our study. in summary, we report a functional PRODH variant associated with schizophrenia that may have a neurochemical impact, altering brain function, but is not responsible for the cortical reductions found in the disorder.Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Universidade Federal de São Paulo UNIFESP, Disciplina Genet, Dept Morfol & Genet, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, LiNC, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Psiquiatria, São Paulo, BrazilFac Med ABC FMABC, Dept Ginecol & Obstet, Disciplina Genet & Reprod Humana, São Paulo, BrazilFed Univ Para, Lab Genet Humana & Med, BR-66059 Belem, Para, BrazilUniv Fed ABC, Ctr Math Computat & Cognit, Santo Andre, BrazilUniversidade Federal de São Paulo UNIFESP, Disciplina Genet, Dept Morfol & Genet, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, LiNC, São Paulo, BrazilUniversidade Federal de São Paulo UNIFESP, Dept Psiquiatria, São Paulo, BrazilFAPESP: 2011/50740-5FAPESP: 2007/58736-1Web of Scienc

Tetti verdi multistrato per lo sviluppo sostenibile di città resilienti: quattro casi studio italiani

Negli ultimi anni le inondazioni in ambito urbano sono state sempre più frequenti, provocando notevoli danni sia livello sociale che a livello economico. Questo fenomeno è in parte determinato da un aumento di urbanizzazione causato dalla crescita della popolazione, che tende sempre più a spostarsi dalle zone rurali alle aree urbane, che si espandono molto velocemente, spesso con infrastrutture idrauliche inadeguate. Inoltre, a causa di cambiamenti climatici, soprattutto nelle aree mediterranee, si può osservare un aumento di lunghi periodi di siccità, intervallati da piogge di breve durata, ma di sempre più forte intensità e frequenza. La presenza di questi fenomeni di pioggia intensa, in un ambiente altamente urbanizzato, determina un forte rischio di inondazione urbana. I tetti verdi, detti anche tetti giardino, sono stati ampiamente studiati come possibile soluzione di ingegneria naturalistica per ridurre il deflusso superficiale generato dalla presenza di tetti, trattenendo una frazione della precipitazione nello strato di terreno. Oltre alla significativa capacità di mitigazione del deflusso urbano, i tetti verdi presentano molteplici vantaggi in diversi ambiti: per esempio la presenza di queste strutture garantisce una riduzione della temperatura media dell’ambiente circostante, riducendo così l’effetto di isola di calore, che caratterizza le grandi città moderne. I tetti verdi, inoltre, garantiscono un isolamento termico per gli edifici sottostanti, favorendo il risparmio di energia per il funzionamento di impianti di climatizzazione e riscaldamento. Da un punto di vista ecologico, i tetti verdi riproducono parzialmente un ambiente naturale: assorbono CO2 e attraggono diverse specie di insetti e piccoli animali, facilitando così l’aumento della biodiversità. Infine, aumentano il valore estetico della città e possono essere utilizzate per attività ricreative, migliorando il benessere della comunità. Tra le varie tipologie di tetti verdi, quelli multistrato presentano uno strato aggiuntivo che permette di raccogliere l’acqua che percola dallo strato di terreno, stoccarla e utilizzarla in un secondo momento per diversi usi in cui non viene richiesta acqua potabile (come ad esempio l’irrigazione di giardini domestici o il lavaggio delle strade). Il presente lavoro illustra i risultati preliminari del progetto “the Polder Roof field lab”, nell’ambito del quale alcuni prototipi di tetti verdi multistrato proposti dalla compagnia olandese MetroPolder Company sono stati installati in 4 città italiane (Fig.1, Cagliari, Palermo, Perugia e Viterbo) al fine di valutare le potenzialità di questa “nature-based solution” in un clima Mediterraneo, soprattutto in termini di riduzione del deflusso superficiale durante eventi intensi di pioggia e di isolamento termico per l’edificio sottostante.Nello specifico, questo contributo ha, dunque, l’obiettivo di presentare le caratteristiche dei quattro casi studio, discutendo, sulla base dei risultati preliminari, le possibili linee di ricerca future. Le analisi preliminari, condotte studiando le misure di deflusso e di temperatura durante il periodo invernale da dicembre 2020 a marzo 2021, sottolineano l’elevata capacità di ritenzione durante eventi di pioggia intensi e la capacità di mitigazione dell’escursione termica giornaliera ottenibili con l’utilizzo di queste tecnologie

Spectroscopy of geo-neutrinos from 2056 days of Borexino data

We report an improved geo-neutrino measurement with Borexino from 2056 days of data taking. The present exposure is $(5.5\pm0.3)\times10^{31}$ proton$\times$yr. Assuming a chondritic Th/U mass ratio of 3.9, we obtain $23.7 ^{+6.5}_{-5.7} (stat) ^{+0.9}_{-0.6} (sys)$ geo-neutrino events. The null observation of geo-neutrinos with Borexino alone has a probability of $3.6 \times 10^{-9}$ (5.9$\sigma$). A geo-neutrino signal from the mantle is obtained at 98\% C.L. The radiogenic heat production for U and Th from the present best-fit result is restricted to the range 23-36 TW, taking into account the uncertainty on the distribution of heat producing elements inside the Earth.Comment: 4 pages, 4 figure

Measurement of neutrino flux from the primary proton--proton fusion process in the Sun with Borexino detector

Neutrino produced in a chain of nuclear reactions in the Sun starting from the fusion of two protons, for the first time has been detected in a real-time detector in spectrometric mode. The unique properties of the Borexino detector provided an oppurtunity to disentangle pp-neutrino spectrum from the background components. A comparison of the total neutrino flux from the Sun with Solar luminosity in photons provides a test of the stability of the Sun on the 10$^{5}$ years time scale, and sets a strong limit on the power production in the unknown energy sources in the Sun of no more than 4\% of the total energy production at 90\% C.L.Comment: 15 pages, 2 tables, 3 figure