Hormone profile in acute psychotic disorders: A cross-sectional comparison of serum hormone concentrations in treated and untreated male patients with schizophrenia

Background: Antipsychotic drugs for the treatment of schizophrenia provide effective treatment of psychotic symptoms but might lead to neuroendocrine abnormalities.Objective: the aim of this study was to assess hypothalamic-pituitary-gonadal (HPG) axis function by comparing serum hormone profiles of newly admitted patients with psychotic disorders who were receiving antipsychotic drugs with those who were antipsychotic-drug-free during the preceding 6 months.Methods: Adult male patients admitted during a 1-year period (December 1999 to December 2000) to I of 2 Brazilian public psychiatric inpatient units that provide care for severely ill patients were eligible for this cross-sectional study if they had a diagnosis of schizophrenia based on the criteria given in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and a score > 24 on the Brief Psychiatric Rating Scale. On the morning after admission, serum concentrations of follicle-stimulating hormone (FSH), luteinizing hormone (LH), sex hormone-binding globulin (SHBG), prolactin, free testosterone (FT), and total testosterone (TT) were determined. A commercial laboratory provided the normal serum hormone concentrations of healthy Brazilian men in the same age range as that of the study patients.Results: Sixty-three adult male patients, aged 18 to 55, were included in the study. Forty-eight (76.2%) patients (mean [SD] age, 30.6 [8.9] years) were receiving antipsychotic drugs (treated). Fifteen (23.8%) patients (mean [SD] age, 36.5 [9.8] years) were antipsychotic-drug-free for 6 months before admission (untreated). the only significant between-group difference was for disease duration (treated, 7.6 [8.1] years vs untreated, 12.3 [9.7] years; P = 0.044). Treated patients were more likely to have higher dispersed serum hormone concentrations than the untreated patients. Serum concentration of FSH was numerically higher in the treated patients than in the untreated patients, although the difference was not statistically significant. Compared with the control group (1436 men and women for prolactin; 226 men for LH; 207 for FSH; 128 for TT; 128 for FT; and 128 for SHBG), patients in the treated group had significantly different mean [SD] serum concentrations of all hormones (treated vs control: prolactin, 24.3 [23.7] mu g/L vs 6.8 [0.12] mu g/L, P < 0.001; LH, 4.9 [3.4] U/L vs 3.3 [0.13] U/L, P = 0.001; FSH, 4.4 [3.9] U/L vs 3.0 [0.06] U/L, P = 0.025; TT, 17.5 [7.8] nmol/L vs 20.1 [1.64] nmol/L, P = 0.004; FT, 0.056 [0.08] nmol/L vs 0.06 [0.003] nmol/L, P < 0.001; and SHBG, 33.3 [18.9] nmol/L vs 48.4 [1.45] nmol/L, P = 0.002). Compared with the control group, patients in the untreated group had significantly different mean (SD) serum concentrations of all hormones except FSH and TT (untreated vs control: prolactin, 19.9 [12.8] mu g/L vs 6.8 [0.12] mu g/L, P = 0.001; LH, 6.0 [1.9] U/L vs 3.3 [0.13] U/L, P = 0.002; FT, 0.08 [0.04] nmol/L vs 0.06 [0.003] nmol/L, P = 0.001; and SHBG, 26.6 [11.6] nmol/L vs 48.4 [1.45] nmol/L, P < 0.001). No differences were found between the TT distribution curve of the control group and that of the untreated patients.Conclusion: This study supports further investigation of a potential difference in the HPG axis among treated and untreated patients with schizophrenia and those who do not have that condition.Universidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilBristol Myers Squibb Co, São Paulo, BrazilFed Univ Pelotas, Dept Psychiat, Pelotas, BrazilEli Lilly Brazil, São Paulo, BrazilPax Clin Psiquiatrica, Goiania, Go, BrazilUniv Fed Bahia, Dept Psychiat & Neurol, Salvador, BA, BrazilUniv Fed Bahia, Dept Pharmacol, Salvador, BA, BrazilUniversidade Federal de São Paulo, Dept Psychiat, São Paulo, BrazilWeb of Scienc

Clinical Study on the Efficacy and Safety of Arginine Administered Orally in Association with Other Active Ingredients for the Prevention and Treatment of Sarcopenia in Patients with COVID-19-Related Pneumonia, Hospitalized in a Sub-Intensive Care Unit

In order to evaluate the efficacy of oral supplementation with 3 g of arginine per day associated with creatine, L-carnitine, aspartic acid, magnesium, selenium and vitamins C and E (Argivit&copy; Aesculapius Farmaceutici) in the prevention and treatment of sarcopenia in patients with COVID-19-related pneumonia, we conducted a parallel randomized study comparing it with standard therapy alone. Forty patients on standard therapy plus supplementation were compared with a control group of 40 patients, all hospitalized at the sub-intensive care unit of the Del Mare Hospital in Naples, with a clinical diagnosis of SARS-CoV-2 infection and COVID-19 pneumonia. Muscle strength was assessed with the handgrip test and muscle ultrasound. Arginine-supplemented patients had an average grip strength of 23.5 at the end of hospitalization compared with 22.5 in the untreated group with less reduction, showing statistical significance (p &lt; 0.001). In the same way, the thickness of the vastus lateralis quadriceps femoris muscle measured at the end of hospitalization showed less reduction on ultrasound, with a higher average value in the group receiving treatment than in the group of patients without supplementation (p &lt; 0.001). Upon discharge there was a 58.40% reduction in ventilation days in patients with arginine supplementation compared with the control group

Efficacy of Prolonged-Release Melatonin 2 mg (PRM 2 mg) Prescribed for Insomnia in Hospitalized Patients for COVID-19: A Retrospective Observational Study

Background: we have observed the effect of insomnia treatment in clinical and prognostic differences of patients admitted for COVID-19 pneumonia in respiratory sub-intensive units that were administered a prolonged-release melatonin 2 mg (PRM 2 mg) therapy versus a group of patients out of therapy. Materials and Methods: We evaluated 40 patients on prolonged-release melatonin 2 mg (PRM 2 mg) therapy versus a control group of 40 patients out of therapy. Results: patients in the PRM 2 mg group had a shorter duration of therapy with non-invasive ventilation (5.2 &plusmn; 3.0 vs. 12.5 &plusmn; 4.2; p &lt; 0.001), with a shorter stay in sub-intensive care (12.3 &plusmn; 3.2 vs. 20.1 &plusmn; 6.1; p &lt; 0.001), and, therefore, a shorter overall duration of hospitalization (31.3 &plusmn; 6.8 vs. 34.3 &plusmn; 6.9 p = 0.03). In addition, a lower incidence of delirium was found (2.2 &plusmn; 1.1 vs. 3.3 &plusmn; 1.3; p &lt; 0.001). Conclusions: A significant increase in sleep hours and a reduction in delirium episodes occurs in hospitalized insomniac patients treated with PRM 2 mg, compared to untreated patients. Based on these preliminary results, we can assume that there are benefits of prolonged-release melatonin 2 mg in COVID-19 therapy

Pneumomediastinum and Pneumothorax as Relevant Complications of Sub-Intensive Care of Patients with COVID-19: Description of a Case Series

Lung failure has been the most common cause of hospitalization for COVID-19. Yet, bilateral interstitial pneumonia has not been the only cause of lung failure of these inpatients, and frequently they develop other illnesses associated with COVID-19. Pulmonary embolism has been the most looked for in the world, but rarely other pneumological diseases, such as pneumothorax and pneumomediastinum, have been described and associated with a worsening prognosis. We here report our clinical experience associated with the occurrence of pneumothorax and pneumomediastinum in a cohort of inpatients hospitalized in our division of medicine in a regular ward or in a sub-intensive ward

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was <1.1 kg m–2 in the vast majority of countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified