Drug monitoring in child and adolescent psychiatry for improved efficacy and safety of psychopharmacotherapy

Most psychotropic drugs used in the treatment of children and adolescents are applied "off label" with a direct risk of under- or overdosing and a delayed risk of long-term side effects. The selection of doses in paediatric psychiatric patients requires a consideration of pharmacokinetic parameters and the development of central nervous system, and warrants specific studies in children and adolescents. Because these are lacking for most of the psychotropic drugs applied in the Child and Adolescent and Psychiatry, therapeutic drug monitoring (TDM) is a valid tool to optimise pharmacotherapy and to enable to adjust the dosage of drugs according to the characteristics of the individual patient. Multi-centre TDM studies enable the identification of age- and development-dependent therapeutic ranges of blood concentrations and facilitate a highly qualified standardized documentation in the child and adolescent health care system. In addition, they will provide data for future research on psychopharmacological treatment in children and adolescents, as a baseline for example for clinically relevant interactions with various co-medications. Therefore, a German-Austrian-Swiss "Competence Network on Therapeutic Drug Monitoring in Child and Adolescent Psychiatry" was founded [1] introducing a comprehensive internet data base for the collection of demographic, safety and efficacy data as well as blood concentrations of psychotropic drugs in children and adolescents

Analysis of the construction of the hightemperature gas infrared radiator with the use of virtual prototyping

Method of virtual prototyping with the following mathematical modeling was used to simulate the heat-mass exchange and combustion during the operation of high-temperature gas infrared radiators, and to find optimal technical solutions for its design. The most authoritative and approved software product Ansys Multiphysics was used. The results of the mathematical modeling of heat and mass transfer in a turbulent reaction medium with combustion reproduce the experimental data produced by a measurement in real operating conditions of the gas-fired infrared heat emitter. The temperature distribution along the height of the ceramic nozzle was established. Obtained results enable estimation of the ignition and combustion zones

Expression analyses of the mitochondrial complex I 75-kDa subunit in early onset schizophrenia and autism spectrum disorder: increased levels as a potential biomarker for early onset schizophrenia

Searching for a peripheral biological marker for schizophrenia, we previously reported on elevated mitochondrial complex I 75-kDa subunit mRNA-blood concentrations in early onset schizophrenia (EOS). The aim of this study was to further evaluate the utility of this gene as a potential marker for schizophrenia. Both—schizophrenia and autism—are suggested to be neuronal maldevelopmental disorders with reports of mitochondrial dysfunction and increased oxidative stress. Therefore we have investigated the expression levels of mitochondrial complex I 75-kDa subunit mRNA in whole blood of children with autistic spectrum disorder (ASD) and a group of adolescent acute first-episode EOS patients in comparison to matched controls. We have found that compared to the respective controls only the group of EOS patients—and not the ASD group—showed a significantly altered expression of the complex I 75-kDa subunit mRNA. Although further studies are necessary to test for the specificity of this marker, our findings point to the potential use of the mitochondrial complex I as a biomarker for schizophrenia

The psychopathological and psychosocial outcome of early-onset schizophrenia: Preliminary data of a 13-year follow-up

<p>Abstract</p> <p>Background</p> <p>Relatively little is known about the long-term psychopathological and psychosocial outcome of early-onset schizophrenia. The existing literature describes more severe courses of illness in these patients compared with adult-onset schizophrenia. This article reports preliminary data of a study exploring the outcome of early-onset schizophrenia 13.4 years (mean) after first admission. Predictors for interindividual outcomes were investigated.</p> <p>Methods</p> <p>We retrospectively assessed 27 former patients (mean age at first admission 15.5 years, SD = 2.0) that were consecutively admitted to the Department of Child and Adolescent Psychiatry at the University of Wuerzburg between 1990 and 2000. A multidimensional approach was chosen to assess the outcome consisting of a mail survey including different questions about psychopathological symptoms, psychosocial parameters, and standardized self-reports (ESI and ADS).</p> <p>Results</p> <p>Concerning the psychopathological outcome, 22.2% reported having acute schizophrenic symptoms. Almost one third (30.8%) described symptoms of depression and 37.0% reported having tried to commit suicide or seriously thought about it. 77.8% of the former patients were still in outpatient treatment. Compared to the general population, the number of patients without a school graduation was relatively high (18.5%). Almost half of participants still live with their parents (48.1%) or in assisted or semi-assisted living conditions (33.3%). Only 18.5% were working in the open market.</p> <p>Conclusion</p> <p>Schizophrenia with an early onset has an unfavourable prognosis. Our retrospective study of the psychopathological and psychosocial outcome concludes with a generally poor rating.</p

Bone mineral density in partially recovered early onset anorexic patients - a follow-up investigation

<p>Abstract</p> <p>Background and aims</p> <p>There still is a lack of prospective studies on bone mineral development in patients with a history of early onset Anorexia nervosa (AN). Therefore we assessed associations between bone mass accrual and clinical outcomes in a former clinical sample. In addition to an expected influence of regular physical activity and hormone replacement therapy, we explored correlations with nutritionally dependent hormones.</p> <p>Methods</p> <p>3-9 years (mean 5.2 ± 1.7) after hospital discharge, we re-investigated 52 female subjects with a history of early onset AN. By means of a standardized approach, we evaluated the general outcome of AN. Moreover, bone mineral content (BMC) and bone mineral density (BMD) as well as lean and fat mass were measured by dual-energy x-ray absorptiometry (DXA). In a substudy, we measured the serum concentrations of leptin and insulin-like growth factor-I (IGF-I).</p> <p>Results</p> <p>The general outcome of anorexia nervosa was good in 50% of the subjects (BMI ≥ 17.5 kg/m², resumption of menses). Clinical improvement was correlated with BMC and BMD accrual (χ²= 5.62/χ²= 6.65, p = 0.06 / p = 0.036). The duration of amenorrhea had a negative correlation with BMD (r = -.362; p < 0.01), but not with BMC. Regular physical activity tended to show a positive effect on bone recovery, but the effect of hormone replacement therapy was not significant. Using age-related standards, the post-discharge sample for the substudy presented IGF-I levels below the 5^thpercentile. IGF-I serum concentrations corresponded to the general outcome of AN. By contrast, leptin serum concentrations showed great variability. They correlated with BMC and current body composition parameters.</p> <p>Conclusions</p> <p>Our results from the main study indicate a certain adaptability of bone mineral accrual which is dependent on a speedy and ongoing recovery. While leptin levels in the substudy tended to respond immediately to current nutritional status, IGF-I serum concentrations corresponded to the individual's age and general outcome of AN.</p

Molecular structure of chemically carbonized poly (vinylidene fluoride) films (IR-spectroscopy data)

Актуальность исследования обусловлена важностью разработки и совершенствования методов синтеза наноматериалов на основе углерода. Синтез и исследование свойств цепочечного углерода представляет фундаментальный интерес для экспериментальной проверки соответствия многочисленных моделей одномерных структур реальному физическому объекту. Химическая обработка поливинилиденфторида в жидкой дегидрофторирующей среде позволяет получить на поверхности полимера обогащённый углеродом слой. В нём имеются цепи различной протяжённости, состоящие из атомов углерода, связанных либо двойными, либо чередованием одинарных и тройных связей. Теоретические расчеты предсказывают полупроводниковый тип проводимости такого материала, что делает его интересным для использования в области микро- и наноэлектроники. Цель исследования: выявить изменения молекулярного состава поливинилиденфторида в результате химического дегидрофторированияи и последующего хранения при обычном и пониженном давлении воздуха. Объект: химически дегидрофторированная пленка поливинилиденфторида. Методы: инфракрасная спектроскопия. Результаты. При химическом дегидрофторировании поливинилиденфторида происходит формирование фторзамещённых полиеновых фрагментов, а также сопряженных двойных и тройных углерод-углеродных связей. Присоединение к углеродной цепи гидроксильных групп, содержащихся в воде, компонентах дегидрофторирующей смеси и атмосферном воздухе, препятствует образованию сопряженных углерод/углеродных связей. Сушка при пониженном давлении образцов, дегидрофторированных в жидкой среде, способствует образованию более протяжённых фрагментов цепей, в которых атомы углерода соединены между собой кратными связями. Наблюдаемый при этом рост ИК поглощения тройных углерод/углеродных связей в области 2050-2100 см{-1} наиболее очевидно демонстрирует возникновение карбиноподобного атомного упорядочения полиинового типа.The relevance of the research is caused by the importance of elaboration and improvement of the carbon-based nanomaterials synthesis technique. Synthesis of a chain-like carbon and study of its properties are of fundamental interest for experimental check of compliance of numerous models of one-dimensional structures to a real physical object. Chemical treatment of poly (vinylidene fluoride) in a liquid dehydrofluorinating medium allows obtaining a carbon/rich layer on the polymer surface containing chains of various lengths in which carbon atoms are connected to each other with either double bonds or alternating single and triple ones. Theoretical calculations predict a semiconductor-type conductivity of the material, which makes it interesting for use in the field of micro- and nanoelectronics. The main aim is to reveal changes in the molecular composition of polyvinylidene fluoride as a result of chemical dehydrofluorination and subsequent storage at normal and reduced air pressure. Object of the research is a chemically dehydrofluorinated poly (vinylidene fluoride) film. Method of research is infrared spectroscopy. Results. During chemical dehydrofluorination of poly (vinylidene fluoride) the fluorine-substituted polyene fragments, as well as conjugated double and triple carbon-carbon bonds are formed. Hydroxyl groups, contained in water, in the components of dehydrofluorinating mixture and in the atmospheric air, attach to the carbon chains thus preventing conjugated carbon-carbon bonds generation. Drying of the samples, dehydrofluorinated in a liquid medium, under reduced pressure promotes the formation of longer chain fragments, in which the carbon atoms are interconnected by multiple bonds. The observed increase in triple carbon-carbon bonds IR absorption band at 2050-2100 cm-1most obviously shows occurrence of the carbine-like atomic arrangement of polyyne type

Expression analyses of the mitochondrial complex I 75-kDa subunit in early onset schizophrenia and autism spectrum disorder: increased levels as a potential biomarker for early onset schizophrenia

International audienceSearching for a peripheral biological marker for schizophrenia, we previously reported on elevated mitochondrial complex I 75-kDa subunit mRNA-blood concentrations in early onset schizophrenia (EOS). The aim of this study was to further evaluate the utility of this gene as a potential marker for schizophrenia. Both--schizophrenia and autism--are suggested to be neuronal maldevelopmental disorders with reports of mitochondrial dysfunction and increased oxidative stress. Therefore we have investigated the expression levels of mitochondrial complex I 75-kDa subunit mRNA in whole blood of children with autistic spectrum disorder (ASD) and a group of adolescent acute first-episode EOS patients in comparison to matched controls. We have found that compared to the respective controls only the group of EOS patients--and not the ASD group--showed a significantly altered expression of the complex I 75-kDa subunit mRNA. Although further studies are necessary to test for the specificity of this marker, our findings point to the potential use of the mitochondrial complex I as a biomarker for schizophrenia