Biological and Clinical Aspects on the Treatment of Schizophrenia and Related Disorders : New Challenges

For several decades, it has been postulated that dopaminergic pathways explain the neurobiology of schizophrenia, the biological underpinnings of treatment responses and the main mechanisms of action of antipsychotics [...

Late allocation and early release of physical registers

The register file is one of the critical components of current processors in terms of access time and power consumption. Among other things, the potential to exploit instruction-level parallelism is closely related to the size and number of ports of the register file. In conventional register renaming schemes, both register allocation and releasing are conservatively done, the former at the rename stage, before registers are loaded with values, and the latter at the commit stage of the instruction redefining the same register, once registers are not used any more. We introduce VP-LAER, a renaming scheme that allocates registers later and releases them earlier than conventional schemes. Specifically, physical registers are allocated at the end of the execution stage and released as soon as the processor realizes that there will be no further use of them. VP-LAER enhances register utilization, that is, the fraction of allocated registers having a value to be read in the future. Detailed cycle-level simulations show either a significant speedup for a given register file size or a reduction in the register file size for a given performance level, especially for floating-point codes, where the register file pressure is usually high.Peer ReviewedPostprint (published version

Seventy Years of Treating Delusional Disorder with Antipsychotics : A Historical Perspective

For many decades, delusional disorder (DD) has been considered a treatment-resistant disorder, with antipsychotics acknowledged as the best, though imperfect, treatment. It is possible that the discovery of the right drug could turn treatment resistance into treatment response. The goal of this narrative review is to provide a historical perspective of the treatment of DD since the introduction of antipsychotics 70 years ago. The following search terms were used to scan the literature: antipsychotics AND "delusional disorder". Findings were that therapy for DD symptoms has changed over time. Initial reports suggested that the drug of choice was the antipsychotic pimozide, and that this drug was especially effective for the somatic subtype of DD. Subsequent studies demonstrated that other antipsychotics, for instance, risperidone and olanzapine, were also highly effective. Treatment response may vary according to the presence or absence of specific symptoms, such as cognitive defect and depression. Clozapine, partial D2 agonists, and long-acting injectable drugs may be more effective than other drugs, but the evidence is not yet in. Because of the absence of robust evidence, treatment guidelines for the optimal management of DD are not yet available

Virtual registers

The number of physical registers is one of the critical issues of current superscalar out-of-order processors. Conventional architectures allocate, in the decoding stage, a new storage location (e.g. a physical register) for each operation that has a destination register. When an instruction is committed, it frees the physical register allocated to the previous instruction that had the same destination logical register. Thus, an additional register (i.e. in addition to the number of logical registers) is used for each instruction with a destination register from the time it is decoded until it is committed. In this paper, we propose a novel register organization that allocates physical registers when instructions complete their execution. In this way, the register pressure is significantly reduced, since the additional register is only used from the time execution completes until the instruction is committed. For some long-latency instructions (e.g. load with a cache miss) and for parts of the code with a small amount of parallelism, the savings could be very high. We have evaluated the new scheme for a superscalar processor and obtained a significant speedup.Peer ReviewedPostprint (published version

The influence of the organizational capabilities on the export behavior of the firm

Este trabajo, con base en la teoría de los recursos y capacidades, analiza el comportamiento exportador de la empresa española. Con este fin, se estudian las capacidades de 1197 empresas exportadoras del sector manufacturero. Los resultados muestran que el control directivo de las operaciones de exportación, la actividad de I+D, la calidad del producto y la tecnología de fabricación son capacidades que influyen positivamente en la actividad exportadora de la empresa. El alto poder explicativo del modelo planteado nos lleva a concluir la gran importancia de las capacidades en el desempeño exportador de la empresa.This paper, based on the resources and capabilities theory, analyzes the export behavior of the Spanish firm. To this end, the capabilities of 1197 manufacturing exporters are studied. The results show that several capabilities -export operations management control, R+D activity, product quality and manufacturing technology- positively influence the export behavior of the firm. The high explanatory power of the raised model takes to us to conclude the great importance of the capabilities when determining the export performance of the firm

Hormone Targets for the Treatment of Sleep Disorders in Postmenopausal Women with Schizophrenia: A Narrative Review

While the early identification of insomnia in patients with schizophrenia is of clinical relevance, the use of specific compounds to treat insomnia has been studied less in postmenopausal women with schizophrenia. We aimed to explore the effects of melatonin, sex hormones, and raloxifene for the treatment of insomnia in these populations. Although melatonin treatment improved the quality and efficiency of the sleep of patients with schizophrenia, few studies have explored its use in postmenopausal women with schizophrenia. The estrogen and progesterone pathways are dysregulated in major psychiatric disorders, such as in schizophrenia. While, in the context of menopause, a high testosterone-to-estradiol ratio is associated with higher frequencies of depressive symptoms, the effects of estradiol and other sex hormones on sleep disorders in postmenopausal women with schizophrenia has not been sufficiently investigated. Raloxifene, a selective estrogen receptor modulator, has shown positive effects on sleep disorders in postmenopausal women. Future studies should investigate the effectiveness of hormonal compounds on insomnia in postmenopausal women with schizophrenia

Diferencias de género en cognición y cognición social en pacientes afectos de psicosis en proceso de rehabilitación psicosocial

Objectives: The objectives of our study were to explore gender differences in Cognition and Social Cognition in patients affected by Psychosis in process of psychosocial rehabilitation and to establish a model of the relationship between Psychopathology, Cognition and Social Cognition in function of the gender, and attending to relevant clinical, sociodemographics and outcome factors.Methodology: Cross-sectional observational study with 124 Non-Affective Schizophrenia Spectrum patients included consecutively in Community Rehabilitation Program at XXXXXXXXXXXXXXX (XXXXX, XXXXXXXXX), assessed through PANSS (using Wallwork's factors) and Matrics Cognitive Consensus Battery.Results: Participants had a mean age of 40.2 years, 57.3% men and mainly Schizophrenia (71.0%). We found gender differences favour to men in attention (p=0.045), working memory (p=0.013) and reasoning/problem solving (p=0.002) domains. No differences in Social Cognition was founded. Linear regression model shows different participations for different domains, with a predominance of the influence of the Cognitive/Disorganized Wallwork's factor and patient's age. In the subsample of men, the model were quite similar to that of total sample, but the influence of the Disorganized factor decreases and that of age remains. In women subsample, the model had even less influence of Disorganized factor or age. In general, women's models explain less variance.Objetivos: Explorar diferencias de género en cognición y cognición social en pacientes afectos de psicosis en proceso de rehabilitación psicosocial y establecer un modelo de relación entre psicopatología, cognición y cognición social en función del género y de factores clínicos, sociodemográficos y evolutivos relevantes. Metodología: Estudio observacional transversal con 124 pacientes del espectro de la esquizofrenia incluidos en el Programa de Rehabilitación Comunitaria de la Corporaciò Sanitària Parc Tauí (Sabadell, Barcelona), evaluados mediante PANSS (factores de Wallwork) y la batería cognitiva MATRICS. Resultados: Edad media 40.2 años, 57.3% hombres, principalmente esquizofrenia (71.0%). Encontramos diferencias de género a favor de los hombres en la atención (p = 0.045), memoria de trabajo (p = 0.013) y razonamiento/resolución de problemas (p = 0.002). No se encontraron diferencias en la cognición social. El modelo de regresión lineal muestra diferentes participaciones para diferentes dominios, con un predominio de la influencia del factor de Wallwork cognitivo/desorganizado y la edad del paciente. En la submuestra de hombres, el modelo fue bastante similar al de la muestra total, pero la influencia del factor desorganizado disminuye y la de la edad permanece. En la submuestra femenina, el modelo tuvo, incluso, menos influencia del factor desorganizado o la edad. En general, los modelos de mujeres explican menos varianza. Conclusión: Los hombres afectos de esquizofrenia e incluidos en el Programa de Rehabilitación Comunitaria de nuestra muestra presentan mejor atención, memoria de trabajo y razonamiento/resolución de problemas que las mujeres, sin diferencias en la cognición social. En general, los modelos explican menos varianza en las mujeres.

Community resilience and Chagas disease in a rural region of Mexico

OBJETIVO Explorar los pilares de la resiliencia comunitaria en una región en la que la enfermedad de Chagas es endémica, con la finalidad de partir de la resiliencia de la población para impulsar procesos participativos para enfrentar este padecimiento. MÉTODOS Estudio cualitativo que utilizó registro etnográfico y seis entrevistas de grupos focales con jóvenes, mujeres y hombres adultos. La investigación se efectúo en una localidad rural del Estado de Morelos, México, entre 2006 y 2007. Se efectuaron sesiones educativas con la población en general, para que los habitantes identificaran la relación entre el vector Triatoma pallidipennis, el parásito (Trypanosoma cruzi), la sintomatología y acciones preventivas para la enfermedad de Chagas. El registro etnográfico y los grupos fueron analizados con base en una modificación de Taylor y Bogdan, y el foco fue comprender los significados socioculturales que guían los discursos y actividades de los pobladores en relación a los pilares de la resiliencia comunitaria. RESULTADOS La población se sentía orgullosa de pertenecer a esa localidad y se identificaron con claridad tres pilares de la resiliencia comunitaria: autoestima colectiva, identidad cultural y honestidad social. Tomando como base estos pilares, se impulsó la participación de la población en torno a la enfermedad de Chagas, y se formó un Grupo de Acción Comunitaria con jóvenes, hombres y mujeres adultos, y líderes sociales. Este Grupo inició acciones de vigilancia epidemiológica y entomológica en la comunidad para hacer frente a esta problemática. CONCLUSIONES Es necesario generar más experiencias que profundicen en la comprensión de los pilares de resiliencia comunitaria, y en la manera en que estos contribuyen a potenciar la participación en salud para enfrentar la enfermedad de Chagas.OBJECTIVE To explore the pillars of community resilience in a region where Chagas disease is endemic, with the aim of promoting participatory processes to deal with this condition from the resilience of the population. METHODS Qualitative study using ethnographic record and six interviews of focus groups with young people, women and men. The research was carried out in a rural area of the state of Morelos, Mexico, between 2006 and 2007. We carried out educational sessions with the population in general, so that residents could identify the relationship between the vector Triatoma pallidipennis, the parasite (Trypanosoma cruzi), symptoms, and preventive actions for Chagas disease. The ethnographic record and groups were analyzed based on Taylor and Bogdan’s modification, and the focus was to understand the socio-cultural meanings that guide the speeches and activities of residents in relation to the pillars of community resilience. RESULTS The population felt proud of belonging to that location and three pillars of community resilience were clearly identified: collective self-esteem, cultural identity, and social honesty. Having these pillars as bases, we promoted the participation of the population concerning Chagas disease, and a Community Action Group was formed with young people, adult men and women, and social leaders. This Group initiated actions of epidemiological and entomological surveillance in the community to deal with this problem. CONCLUSIONS It is necessary to create more experiences that deepen the understanding of the pillars of community resilience, and how they contribute to enhance participation in health to deal with Chagas disease

Natural history of patients with venous thromboembolism and hereditary hemorrhagic telangiectasia. Findings from the RIETE registry

Background: Limited data exist about the clinical presentation, ideal therapy and outcomes of patients with hereditary hemorrhagic telangiectasia (HHT) who develop venous thromboembolism (VTE). Methods: We used the data in the RIETE Registry to assess the clinical characteristics, therapeutic approaches and clinical outcomes during the course of anticoagulant therapy in patients with HHT according to initial presentation as pulmonary embolism (PE) or deep venous thrombosis (DVT). Results: Of 51,375 patients with acute VTE enrolled in RIETE from February 2009 to January 2019, 23 (0.04%) had HHT: 14 (61%) initially presented with PE and 9 (39%) with DVT alone. Almost half (47.8%) of the patients with VTE had a risk factor for VTE. Most PE and DVT patients received low-molecular-weight heparin for initial (71 and 100%, respectively) and long-term therapy (54 and 67%, respectively). During anticoagulation for VTE, the rate of bleeding events (major 2, non-major 6) far outweighed the rate of VTE recurrences (recurrent DVT 1): 50.1 bleeds per 100 patient-years (95%CI: 21.6-98.7) vs. 6.26 recurrences (95%CI: 0.31-30.9; p = 0.020). One major and three non-major bleeding were epistaxis. No patient died of bleeding. One patient died shortly after being diagnosed with acute PE. Conclusions: During anticoagulation for VTE in HHT patients, there were more bleeding events than VTE recurrences. Most bleeding episodes were non-major epistaxis

Retroflexão de bexiga. Relato de caso em Blastocerus dichotomus (Cervo-do-Pantanal)

A bladder retroflexion was reported in Blastocerus dichotomus at The Veterinary Hospital of FCAV Jaboticabal-SP. A pregnat female from University breeder showed a retal and bladder prolapse. A cesarean were applied but not sucsseful for both. Then, the female was euthanized because the bladder had no conditions to be back again.A retroflexão de bexiga foi objeto de estudo em cervídeo atendido no Hospital Veterinário da FCAV-Unesp-Jaboticabal-SP. Uma fêmea gestante do criatório da Faculdade apresentou prolapso de bexiga e de reto. A cesariana foi efetuada, porém sem sucesso para ambos. Após esse procedimento, o animal foi sacrificado devido ao comprometimento total da bexiga