Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings

Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ. Patients showed medium to large deficits across all functions (ES range = –0.45 to –0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = –0.14 to –0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = –0.88 to –0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically significant, albeit reduced by half (ES range = –0.13 to –0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = –0.21 to –0.43, p < 0.01). Deficits in verbal knowledge, and working memory may specifically index familial, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders

Cognitive functioning throughout adulthood and illness stages in individuals with psychotic disorders and their unaffected siblings.

Important questions remain about the profile of cognitive impairment in psychotic disorders across adulthood and illness stages. The age-associated profile of familial impairments also remains unclear, as well as the effect of factors, such as symptoms, functioning, and medication. Using cross-sectional data from the EU-GEI and GROUP studies, comprising 8455 participants aged 18 to 65, we examined cognitive functioning across adulthood in patients with psychotic disorders (n = 2883), and their unaffected siblings (n = 2271), compared to controls (n = 3301). An abbreviated WAIS-III measured verbal knowledge, working memory, visuospatial processing, processing speed, and IQ. Patients showed medium to large deficits across all functions (ES range = -0.45 to -0.73, p < 0.001), while siblings showed small deficits on IQ, verbal knowledge, and working memory (ES = -0.14 to -0.33, p < 0.001). Magnitude of impairment was not associated with participant age, such that the size of impairment in older and younger patients did not significantly differ. However, first-episode patients performed worse than prodromal patients (ES range = -0.88 to -0.60, p < 0.001). Adjusting for cannabis use, symptom severity, and global functioning attenuated impairments in siblings, while deficits in patients remained statistically significant, albeit reduced by half (ES range = -0.13 to -0.38, p < 0.01). Antipsychotic medication also accounted for around half of the impairment in patients (ES range = -0.21 to -0.43, p < 0.01). Deficits in verbal knowledge, and working memory may specifically index familial, i.e., shared genetic and/or shared environmental, liability for psychotic disorders. Nevertheless, potentially modifiable illness-related factors account for a significant portion of the cognitive impairment in psychotic disorders.The European Community’s Seventh Framework Programme under grant agreement No. HEALTH-F2-2010-241909 (EU-GEI)

Hyponatremia: Analysis of cases in the hospital setting in Costa Rica

Objetivo: Analizar el manejo de los pacientes con hiponatremia durante su estancia en un hospital privado de Costa Rica así como las razones específicas generadoras de dicha enfermedad, para mejorar el manejo de esta patología y sus complicaciones. Método: Estudio observacional, restrospectivo realizado en un hospital de 80 camas en el periodo entre enero 2014 y enero 2017. Se incluyeron todos los pacientes que al ingreso o durante su estancia presentaron valores de sodio menor o igual a 125 mEq/L. Los datos clínicos obtenidos se agruparon en cinco clasificaciones: tiempo de desarrollo de la hiponatremia, concentración plasmática de sodio, gravedad de los síntomas, osmolalidad plasmática y estado de volumen. Resultados: En el estudio se incluyeron 102 pacientes de los cuales un 96% presentaron hiponatremia previa a su ingreso al hospital. Los síntomas neurológicos estaban presentes en un 36% de los casos. La hipertensión arterial (HTA) y la diabetes fueron las comorbilidades más frecuentes (96% de los pacientes). Con respecto al manejo farmacoterapéutico ninguno de los pacientes recibió la cantidad de mEq sodio requerida y solamente dos de los pacientes recibieron una monitorización de los valores plasmáticos de sodio tal y como lo establecen las guías. Conclusiones: Se debe educar al personal hospitalario sobre la importancia de un manejo adecuado de la hiponatremia, sus posibles efectos adversos y la importancia de instaurar un tratamiento precoz con el fin de evitar daños irreversibles.Objective: To analyze the management of patients with hiponatremia during their stay in a private hospital in Costa Rica, as well as the specific reasons for This disease, to improve the management of this disease and its complications. Method: Obsevational, retrospective study performed in a hospital with 80 beds in the period between Januany 2014 and January 2017. All patients were included who, on admission or during their stay, had sodium values less than or equal to 125 mEq/L. The clinical data obtained were grouped into five classifications: time of development of hyponatremia, plasma concentration of sodium, severity of symptoms, plasma osmolality and volume status. Results: 102 patients were included in the study, of which 96% had hyponatremia prior to hospital admission. Neurological symptoms were present in 36% of cases. High blood pressure (HBP) and diabetes were the most frequent comorbidities (96% of patients). None of the patients received the amount of mEq sodium required and only two of the patients received a monitoring of plasma sodium values as established by the guidelines. Conclusions: Hospital staff should be educated on the importance of proper management of hiponatremia, its possible adverse effects and the importance of establishing early treatment in order to avoid irreversible damage.UCR::Vicerrectoría de Docencia::Salud::Facultad de Farmaci

Spatial Scientometrics and Scholarly Impact: A Review of Recent Studies, Tools, and Methods

Previously, we proposed a research program to analyze spatial aspects of the science system which we called “spatial scientometrics” (Frenken, Hardeman, & Hoekman, 2009). The aim of this chapter is to systematically review recent (post-2008) contributions to spatial scientometrics on the basis of a standardized literature search. We focus our review on contributions addressing spatial aspects of scholarly impact, particularly, the spatial distribution of publication and citation impact, and the effect of spatial biases in collaboration and mobility on citation impact. We also discuss recent dedicated tools and methods for analysis and visualization of spatial scientometric data. We end with reflections about future research avenues

A randomized clinical trial of lipid metabolism modulation with fenofibrate for acute coronavirus disease 2019

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) cytotoxicity may involve inhibition of peroxisome proliferator-activated receptor alpha. Fenofibrate activates peroxisome proliferator-activated receptor alpha and inhibits SARS-CoV-2 replication in vitro. Whether fenofibrate can be used to treat coronavirus disease 2019 (COVID-19) infection in humans remains unknown. Here, we randomly assigned inpatients and outpatients with COVID-19 within 14 d of symptom onset to 145 mg of oral fenofibrate nanocrystal formulation versus placebo for 10 d, in a double-blinded fashion. The primary endpoint was a severity score whereby participants were ranked across hierarchical tiers incorporating time to death, mechanical ventilation duration, oxygenation, hospitalization and symptom severity and duration. In total, 701 participants were randomized to fenofibrate (n = 351) or placebo (n = 350). The mean age of participants was 49 ± 16 years, 330 (47%) were female, mean body mass index was 28 ± 6 kg/m2 and 102 (15%) had diabetes. Death occurred in 41 participants. Compared with placebo, fenofibrate had no effect on the primary endpoint. The median (interquartile range) rank in the placebo arm was 347 (172, 453) versus 345 (175, 453) in the fenofibrate arm (P = 0.819). There was no difference in secondary and exploratory endpoints, including all-cause death, across arms. There were 61 (17%) adverse events in the placebo arm compared with 46 (13%) in the fenofibrate arm, with slightly higher incidence of gastrointestinal side effects in the fenofibrate group. Overall, among patients with COVID-19, fenofibrate has no significant effect on various clinically relevant outcomes (NCT04517396). © 2022, The Author(s), under exclusive licence to Springer Nature Limited