Social cognition in people with schizophrenia: A cluster-analytic approach

Background The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. Method A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. Results We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI <10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. Conclusions If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person

Social cognition in people with schizophrenia: A cluster-analytic approach

Background The study aimed to subtype patients with schizophrenia on the basis of social cognition (SC), and to identify cut-offs that best discriminate among subtypes in 809 out-patients recruited in the context of the Italian Network for Research on Psychoses. Method A two-step cluster analysis of The Awareness of Social Inference Test (TASIT), the Facial Emotion Identification Test and Mayer-Salovey-Caruso Emotional Intelligence Test scores was performed. Classification and regression tree analysis was used to identify the cut-offs of variables that best discriminated among clusters. Results We identified three clusters, characterized by unimpaired (42%), impaired (50.4%) and very impaired (7.5%) SC. Three theory-of-mind domains were more important for the cluster definition as compared with emotion perception and emotional intelligence. Patients more able to understand simple sarcasm (14 for TASIT-SS) were very likely to belong to the unimpaired SC cluster. Compared with patients in the impaired SC cluster, those in the very impaired SC cluster performed significantly worse in lie scenes (TASIT-LI <10), but not in simple sarcasm. Moreover, functioning, neurocognition, disorganization and SC had a linear relationship across the three clusters, while positive symptoms were significantly lower in patients with unimpaired SC as compared with patients with impaired and very impaired SC. On the other hand, negative symptoms were highest in patients with impaired levels of SC. Conclusions If replicated, the identification of such subtypes in clinical practice may help in tailoring rehabilitation efforts to the person's strengths to gain more benefit to the person

Estimation of Colloid Osmotic Pressure During Hemodilutional Cardiopulmonary Bypass

Patients undergoing cardiopulmonary bypass (CPB) using hemodilution are subjected to large reductions in colloid osmotic pressure (COP). The purpose of this investigation was to determine the course of COP during CPB and to compare these values to critical ranges for COP as cited in the literature. The prime consisted of a mixture of the crystalloid (Lactated Ringer’s) and a variety of colloids. Samples were taken of the prime, and blood drawn prior to, during, and after CPB. The COP of each sample was measured, and also estimated by three (3) different techniques. During CPB, patient’s COP were reduced by 30–60%, placing them within the published critical ranges for COP. Since patients did not suffer the predicted consequences of large reductions in COP, it is apparent the previously accepted critical ranges for COP must be re-evaluated for the CPB patient. In the process of this investigation, a simple pumpside method for COP estimations was developed

Activated Clotting Time and Cardiopulmonary Bypass, III. Effect of High Platelet Count on Heparin Management

Although standard methods of heparin management have proven adequate in routine cardiopulmonary bypass procedures there are, occasionally, extraordinary cases in which special management is necessary. When a patient's blood is introduced to the extracorporeal circuit the non-endothelial surface precipitates platelet adhesion and aggregation. One of the factors released at this time is Platelet Factor IV which acts to neutralize the anticoagulant effect of the heparinantithrombin III complex. The purpose of this investigation was to relate platelet count to heparin requirement. Patients with thrombocytosis were studied. Heparin was managed as per usual except that additional heparin had to be given either before initiating bypass (after the three mg/kg loading dose failed to safely prolong the activated clotting time) or immediately after initiation of bypass due to a dangerously shortened coagulation time. Based upon the results of this study it is recommended that careful monitoring is necessary in thrombocytotic patients