Nonlinear parameters of surface EMG in schizophrenia patients depend on kind of antipsychotic therapy

ArticleWe compared a set of surface EMG (sEMG) parameters in several groups of schizophrenia (SZ, n = 74) patients and healthy controls (n = 11) and coupled them with the clinical data. sEMG records were quantified with spectral, mutual information (MI) based and recurrence quantification analysis (RQA) parameters, and with approximate and sample entropies (ApEn and SampEn). Psychotic deterioration was estimated with Positive and Negative Syndrome Scale (PANSS) and with the positive subscale of PANSS. Neuroleptic-induced parkinsonism (NIP) motor symptoms were estimated with Simpson-Angus Scale (SAS). Dyskinesia was measured with Abnormal Involuntary Movement Scale (AIMS). We found that there was no difference in values of sEMG parameters between healthy controls and drug-naïve SZ patients. The most specific group was formed of SZ patients who were administered both typical and atypical antipsychotics (AP). Their sEMG parameters were significantly different from those of SZ patients taking either typical or atypical AP or taking no AP. This may represent a kind of synergistic effect of these two classes of AP. For the clinical data we found that PANSS, SAS, and AIMS were not correlated to any of the sEMG parameters. Conclusion: with nonlinear parameters of sEMG it is possible to reveal NIP in SZ patients, and it may help to discriminate between different clinical groups of SZ patients. Combined typical and atypical AP therapy has stronger effect on sEMG than a therapy with AP of only one class.Publisher's pdfhttp://purl.org/eprint/status/PeerReviewe

Trematodes from Antarctic teleost fishes off Argentine Islands, West Antarctica: molecular and morphological data

In 2014–2015 and 2019–2021, teleost fishes off Galindez Island (Antarctic Peninsula) were examined for trematodes. Combined morphological and molecular analyses revealed the presence of eight trematode species of four families (Hemiuridae, Lecithasteridae, Opecoelidae, Lepidapedidae) from five fish species. Only adult trematodes were found and all of them are Antarctic endemics with their congeners occurring on other continents. The hemiuroids, Elytrophalloides oatesi (Leiper & Atkinson, 1914), Genolinea bowersi (Leiper & Atkinson, 1914), and Lecithaster macrocotyle Szidat & Graefe, 1967 belong to the most common Antarctic species and together with Lepidapedon garrardi (Leiper & Atkinson, 1914) and Neolebouria georgiensis Gibson, 1976 they were recorded as the least host-specific parasites. The originally sub-Antarctic Neolepidapedon macquariensis Zdzitowiecki, 1993 is a new record for the Antarctic Peninsula and Parachaenichthys charcoti (Vaillant), is a new host record. Neolebouria terranovaensis Zdzitowiecki, Pisano & Vacchi, 1993 is considered a synonym of N. georgiensis because of identical morphology and dimensions. The currently known phylogenetic relationships within the studied families are supported, including the polyphyly of Macvicaria Gibson & Bray, 1982 with the future need to accommodate its Antarctic species in a new genus. The validity of M. georgiana (Kovaleva & Gaevskaja, 1974) and M. magellanica Laskowski, Jezewski & Zdzitowiecki, 2013 needs to be confirmed by further analyses. Genetic sequence data are still scarce from Antarctica, and more studies applying integrative taxonomic approaches and large-scale parasitological examinations of benthic invertebrates are needed to match sequences of larval stages to those of well-characterised adults and to elucidate trematode life-cycles

Fate of Poly-3-Hydroxybutyrate-co3-Hydroxyvalerate on Skin

Трансдермальные системы доставки лекарственных средств становятся всё более совершенными. Однако самым большим препятствием для разработки систем доставки лекарственных средств является наличие практически непроницаемого верхнего рогового слоя эпидермиса. Материалы, проникающие через кожу, должны иметь низкий молекулярный вес и быть липофильными. Существует много способов преодолеть барьер рогового слоя, и один из перспективных методов – использование микро- и наночастиц. Это исследование было направлено на разработку трёх различных микро- и наноразмерных носителей, изучение их проникновения в кожу и оценку их эффективности в коже. Были сконструированы полимерные микро/нанокапсулы из поли(3-гидроксибутирата/3-гидроксивалерата) (ПГБВ) (ГВ 5 мол. %) с флуоресцентным красителем Nile Red. Трансдермальное проникновение микро/нанокапсул из ПГБВ было изучено in vivo, на мышах. Согласно анализу размера частиц, проведённому с помощью анализатора Master Sizer и системы измерения дзета-потенциала, микро/ нанокапсулы имели диаметр 1,9 мкм, 426 нм и 166 нм. Частицы наносили на здоровую кожу спины мышей линии BALB/c. Чтобы оценить проникновение частиц, определяли присутствие ПГБВ на коже методом хромато-масс-спектрометрии. Морфология исследовалась с помощью растрового электронного микроскопа. Результаты хромато-масс-спектрометрии показали, что проникновение капсул через кожу зависело от размера частиц, несмотря на труднопроницаемый верхний слой кожи. Однако гистологический поперечный разрез показал, что частицы не могли проникнуть через неповреждённую кожу; роговой слой эпидермиса явно препятствовал переносу полимерных частиц. Данное исследование продемонстрировало, что, изменяя размер наночастиц, несущих лекарственные средства, можно регулировать глубину проникновения частиц и, следовательно, осуществлять целевую доставку лекарственных средств.Transdermal drug delivery systems have become increasingly sophisticated over time. However, the greatest limitation for developing an effective drug delivery system is the highly impermeable outermost layer of the skin called the stratum corneum. Therefore, materials penetrating the skin must be of low molecular weight, and lipophilic. There are many techniques to safely pass the stratum corneum and one of the promising method of transdermal drug delivery is the use of micro and nano sized particles. The aim of this study was to develop three different micro and nano sized carriers to study their skin penetration and to judge their effectiveness within the skin. Polymeric micro/ nanocapsules carrying a fluorescent dye Nile Red, were prepared using poly(3-hydroxybutyrate-co 3-hydroxyvalerate) (PHBV) (5 %mol. hydroxyvalerate). The in vivo transdermal permeation of PHBV micro/nanoparticles were studied using a mouse model. According to the particle size analysis with Master Sizer and Zeta Potential Measurement System, the PHBV micro/nanocapsules were 1.9 µm, 426 nm and 166 nm in diameter. The particles were applied to healthy skin of the dorsal region of BALB/c mice. Penetration of the particles was determined by GC-MS analysis of the skin for PHBV. Scanning electron microscope (SEM) imaging was used to study their morphology. GC-MS results showed that the capsules penetrated into the skin in relation with their particle size, despite the highly impermeable outer skin layer. However, histology cross-section revealed that uncompromised skin could not penetrate; the transport of the polymeric particle was clearly impeded by the stratum corneum. It was thus shown in this study that control of penetration depth, and therefore, the target size within into the skin is possible by varying the size of the drug carrying nanocapsules

Fate of Poly-3-Hydroxybutyrate-co3-Hydroxyvalerate on Skin

Трансдермальные системы доставки лекарственных средств становятся всё более совершенными. Однако самым большим препятствием для разработки систем доставки лекарственных средств является наличие практически непроницаемого верхнего рогового слоя эпидермиса. Материалы, проникающие через кожу, должны иметь низкий молекулярный вес и быть липофильными. Существует много способов преодолеть барьер рогового слоя, и один из перспективных методов – использование микро- и наночастиц. Это исследование было направлено на разработку трёх различных микро- и наноразмерных носителей, изучение их проникновения в кожу и оценку их эффективности в коже. Были сконструированы полимерные микро/нанокапсулы из поли(3-гидроксибутирата/3-гидроксивалерата) (ПГБВ) (ГВ 5 мол. %) с флуоресцентным красителем Nile Red. Трансдермальное проникновение микро/нанокапсул из ПГБВ было изучено in vivo, на мышах. Согласно анализу размера частиц, проведённому с помощью анализатора Master Sizer и системы измерения дзета-потенциала, микро/ нанокапсулы имели диаметр 1,9 мкм, 426 нм и 166 нм. Частицы наносили на здоровую кожу спины мышей линии BALB/c. Чтобы оценить проникновение частиц, определяли присутствие ПГБВ на коже методом хромато-масс-спектрометрии. Морфология исследовалась с помощью растрового электронного микроскопа. Результаты хромато-масс-спектрометрии показали, что проникновение капсул через кожу зависело от размера частиц, несмотря на труднопроницаемый верхний слой кожи. Однако гистологический поперечный разрез показал, что частицы не могли проникнуть через неповреждённую кожу; роговой слой эпидермиса явно препятствовал переносу полимерных частиц. Данное исследование продемонстрировало, что, изменяя размер наночастиц, несущих лекарственные средства, можно регулировать глубину проникновения частиц и, следовательно, осуществлять целевую доставку лекарственных средств.Transdermal drug delivery systems have become increasingly sophisticated over time. However, the greatest limitation for developing an effective drug delivery system is the highly impermeable outermost layer of the skin called the stratum corneum. Therefore, materials penetrating the skin must be of low molecular weight, and lipophilic. There are many techniques to safely pass the stratum corneum and one of the promising method of transdermal drug delivery is the use of micro and nano sized particles. The aim of this study was to develop three different micro and nano sized carriers to study their skin penetration and to judge their effectiveness within the skin. Polymeric micro/ nanocapsules carrying a fluorescent dye Nile Red, were prepared using poly(3-hydroxybutyrate-co 3-hydroxyvalerate) (PHBV) (5 %mol. hydroxyvalerate). The in vivo transdermal permeation of PHBV micro/nanoparticles were studied using a mouse model. According to the particle size analysis with Master Sizer and Zeta Potential Measurement System, the PHBV micro/nanocapsules were 1.9 µm, 426 nm and 166 nm in diameter. The particles were applied to healthy skin of the dorsal region of BALB/c mice. Penetration of the particles was determined by GC-MS analysis of the skin for PHBV. Scanning electron microscope (SEM) imaging was used to study their morphology. GC-MS results showed that the capsules penetrated into the skin in relation with their particle size, despite the highly impermeable outer skin layer. However, histology cross-section revealed that uncompromised skin could not penetrate; the transport of the polymeric particle was clearly impeded by the stratum corneum. It was thus shown in this study that control of penetration depth, and therefore, the target size within into the skin is possible by varying the size of the drug carrying nanocapsules

Management of coronary disease in patients with advanced kidney disease

BACKGROUND Clinical trials that have assessed the effect of revascularization in patients with stable coronary disease have routinely excluded those with advanced chronic kidney disease. METHODS We randomly assigned 777 patients with advanced kidney disease and moderate or severe ischemia on stress testing to be treated with an initial invasive strategy consisting of coronary angiography and revascularization (if appropriate) added to medical therapy or an initial conservative strategy consisting of medical therapy alone and angiography reserved for those in whom medical therapy had failed. The primary outcome was a composite of death or nonfatal myocardial infarction. A key secondary outcome was a composite of death, nonfatal myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. RESULTS At a median follow-up of 2.2 years, a primary outcome event had occurred in 123 patients in the invasive-strategy group and in 129 patients in the conservative-strategy group (estimated 3-year event rate, 36.4% vs. 36.7%; adjusted hazard ratio, 1.01; 95% confidence interval [CI], 0.79 to 1.29; P=0.95). Results for the key secondary outcome were similar (38.5% vs. 39.7%; hazard ratio, 1.01; 95% CI, 0.79 to 1.29). The invasive strategy was associated with a higher incidence of stroke than the conservative strategy (hazard ratio, 3.76; 95% CI, 1.52 to 9.32; P=0.004) and with a higher incidence of death or initiation of dialysis (hazard ratio, 1.48; 95% CI, 1.04 to 2.11; P=0.03). CONCLUSIONS Among patients with stable coronary disease, advanced chronic kidney disease, and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of death or nonfatal myocardial infarction

Health status after invasive or conservative care in coronary and advanced kidney disease

BACKGROUND In the ISCHEMIA-CKD trial, the primary analysis showed no significant difference in the risk of death or myocardial infarction with initial angiography and revascularization plus guideline-based medical therapy (invasive strategy) as compared with guideline-based medical therapy alone (conservative strategy) in participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease (an estimated glomerular filtration rate of <30 ml per minute per 1.73 m2 or receipt of dialysis). A secondary objective of the trial was to assess angina-related health status. METHODS We assessed health status with the Seattle Angina Questionnaire (SAQ) before randomization and at 1.5, 3, and 6 months and every 6 months thereafter. The primary outcome of this analysis was the SAQ Summary score (ranging from 0 to 100, with higher scores indicating less frequent angina and better function and quality of life). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate the treatment effect with the invasive strategy. RESULTS Health status was assessed in 705 of 777 participants. Nearly half the participants (49%) had had no angina during the month before randomization. At 3 months, the estimated mean difference between the invasive-strategy group and the conservative-strategy group in the SAQ Summary score was 2.1 points (95% credible interval, 120.4 to 4.6), a result that favored the invasive strategy. The mean difference in score at 3 months was largest among participants with daily or weekly angina at baseline (10.1 points; 95% credible interval, 0.0 to 19.9), smaller among those with monthly angina at baseline (2.2 points; 95% credible interval, 122.0 to 6.2), and nearly absent among those without angina at baseline (0.6 points; 95% credible interval, 121.9 to 3.3). By 6 months, the between-group difference in the overall trial population was attenuated (0.5 points; 95% credible interval, 122.2 to 3.4). CONCLUSIONS Participants with stable ischemic heart disease, moderate or severe ischemia, and advanced chronic kidney disease did not have substantial or sustained benefits with regard to angina-related health status with an initially invasive strategy as compared with a conservative strategy

Initial invasive or conservative strategy for stable coronary disease

BACKGROUND Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain. METHODS We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction. RESULTS Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, 121.8 percentage points; 95% CI, 124.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32). CONCLUSIONS Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used

Health-status outcomes with invasive or conservative care in coronary disease

BACKGROUND In the ISCHEMIA trial, an invasive strategy with angiographic assessment and revascularization did not reduce clinical events among patients with stable ischemic heart disease and moderate or severe ischemia. A secondary objective of the trial was to assess angina-related health status among these patients. METHODS We assessed angina-related symptoms, function, and quality of life with the Seattle Angina Questionnaire (SAQ) at randomization, at months 1.5, 3, and 6, and every 6 months thereafter in participants who had been randomly assigned to an invasive treatment strategy (2295 participants) or a conservative strategy (2322). Mixed-effects cumulative probability models within a Bayesian framework were used to estimate differences between the treatment groups. The primary outcome of this health-status analysis was the SAQ summary score (scores range from 0 to 100, with higher scores indicating better health status). All analyses were performed in the overall population and according to baseline angina frequency. RESULTS At baseline, 35% of patients reported having no angina in the previous month. SAQ summary scores increased in both treatment groups, with increases at 3, 12, and 36 months that were 4.1 points (95% credible interval, 3.2 to 5.0), 4.2 points (95% credible interval, 3.3 to 5.1), and 2.9 points (95% credible interval, 2.2 to 3.7) higher with the invasive strategy than with the conservative strategy. Differences were larger among participants who had more frequent angina at baseline (8.5 vs. 0.1 points at 3 months and 5.3 vs. 1.2 points at 36 months among participants with daily or weekly angina as compared with no angina). CONCLUSIONS In the overall trial population with moderate or severe ischemia, which included 35% of participants without angina at baseline, patients randomly assigned to the invasive strategy had greater improvement in angina-related health status than those assigned to the conservative strategy. The modest mean differences favoring the invasive strategy in the overall group reflected minimal differences among asymptomatic patients and larger differences among patients who had had angina at baseline