Long-acting antipsychotic drugs for the treatment of schizophrenia: use in daily practice from naturalistic observations

BACKGROUND: Current guidelines suggest specific criteria for oral or long-acting injectable antipsychotic drugs (LAIs). This review aims to describe the demographic and clinical characteristics of the ideal profile of the patient with schizophrenia treated with LAIs, through the analysis of nonrandomized studies. METHODS: A systematic review of nonrandomized studies in English was performed attempting to analyze the factors related to the choice and use of LAIs in daily practice. The contents were outlined using the Cochrane methods for nonrandomized studies and the variables included demographic as well as clinical characteristics. The available literature did not allow any statistical analysis that could be used to identify the ideal profile of patients with schizophrenia to be treated with LAIs. RESULTS: Eighty publications were selected and reviewed. Prevalence of LAI use ranged from 4.8% to 66%. The only demographic characteristics that were consistently assessed through retrieved studies were age (38.5 years in the 1970’s, 35.8 years in the 1980’s, 39.3 years in the 1990’s, to 39.5 years in the 2000’s) and gender (male > female). Efficacy was assessed through the use of various symptom scales and other indirect measurements; safety was assessed through extrapyramidal symptoms and the use of anticholinergic drugs, but these data were inconsistent and impossible to pool. Efficacy and safety results reported in the different studies yielded a good therapeutic profile with a maximum of 74% decrease in hospital admissions and the prevalence of extrapyramidal symptoms with LAIs consistently increased at 6, 12, 18, and 24 months (35.4%, 37.1%, 36.9%, and 41.3%, respectively). CONCLUSIONS: This analysis of the available literature strongly suggests that further observational studies on patients with schizophrenia treated with LAIs are needed to systematically assess their demographic and clinical characteristics and the relationships between them and patient outcome. Besides the good efficacy and safety profile of LAIs, health care staff must also take into account the importance of establishing a therapeutic alliance with the patient and his/her relatives when selecting the most appropriate treatment. LAIs seem to be a good choice not only because of their good safety and efficacy profile, but also because they improve compliance, a key factor to improving adherence and to establishing a therapeutic alliance between patients with schizophrenia, their relatives, and their health care providers

Metabolomics driven analysis by UAEGC-MS and antioxidant activity of Chia (<i>Salvia hispanica </i>L.) commercial and mutant seeds

Chia is a food plant producing seeds which have seen increasing interest owing to their health benefits. This work is the first report on the metabolite profile, total polyphenols and antioxidant activity of chia seeds, determined by ultrasound-assisted extraction, coupled with gas chromatography-mass spectrometry (UAE GC-MS). Different chia sources were compared: two commercial (black and white) and three early flowering (G3, G8 and G17) mutant genotypes. Organic extracts were mainly composed of mono- and polyunsaturated fatty acids with alpha-linolenic being the most abundant. Polar extracts contained sucrose, methylgalactoside and glucose as main sugars. Antioxidant activity and total polyphenolic content were correlated. Chemical composition and yield potential of early flowering genotypes were different from commercial chia, and while white chia showed the highest content of omega-3 fatty acids, the high content of nutraceuticals in G17 and G8 suggests them as a potential source of raw materials for the food/feed industry

A double nellix and chimney covered stents: challenging treatment of pararenal aortic aneurysm

A 77-year-old male patient presented with a symptomatic, 66-mm pararenal aortic aneurysm. The patient was classified as unsuitable for open surgery due to significant comorbidities. Fenestrated or branched endografts were contraindicated due to the poor iliac access (6 mm diameter). A double Nellix with chimney endovascular aneurysm sealing (ChEVAS) technique was selected to exclude the pararenal aortic aneurysm and to preserve renal arteries and the superior mesenteric artery. Technical preplanning considered the ideal proximal landing zone to be close to the origin of the almost occluded celiac trunk and the distal common iliac arteries as the ideal distal landing zone. The total length of the aorta to cover was estimated as >180 mm, requiring 2 aortic EVAS systems, bilaterally overlapped. Technical success was achieved, and the patient was discharged on postoperative day 8 in good general condition. Successful aneurysm exclusion and target vessel patency without endoleak or stent-graft kinking or migration were confirmed at angio-computed tomography at 6 months

Bayesian Measurement Error Correction in Structured Additive Distributional Regression with an Application to the Analysis of Sensor Data on Soil-Plant Variability

The flexibility of the Bayesian approach to account for covariates with measurement error is combined with semiparametric regression models for a class of continuous, discrete and mixed univariate response distributions with potentially all parameters depending on a structured additive predictor. Markov chain Monte Carlo enables a modular and numerically efficient implementation of Bayesian measurement error correction based on the imputation of unobserved error-free covariate values. We allow for very general measurement errors, including correlated replicates with heterogeneous variances. The proposal is first assessed by a simulation trial, then it is applied to the assessment of a soil-plant relationship crucial for implementing efficient agricultural management practices. Observations on multi-depth soil information forage ground-cover for a seven hectares Alfalfa stand in South Italy were obtained using sensors with very refined spatial resolution. Estimating a functional relation between ground-cover and soil with these data involves addressing issues linked to the spatial and temporal misalignment and the large data size. We propose a preliminary spatial interpolation on a lattice covering the field and subsequent analysis by a structured additive distributional regression model accounting for measurement error in the soil covariate. Results are interpreted and commented in connection to possible Alfalfa management strategies

IGF-I influences everolimus activity in medullary thyroid carcinoma

Context: Medullary thyroid carcinoma (MTC) is a rare tumor originating from thyroid parafollicular C cells. It has been previously demonstrated that insulin-like growth factor I (IGF-I) protects MTC from the effects of antiproliferative drugs. Everolimus, an mTOR inhibitor, has shown potent antiproliferative effects in a human MTC cell line, TT, and in two human MTC primary cultures. Objective: To verify whether IGF-I may influence the effects of everolimus in a group of human MTC primary cultures. Design: We collected 18 MTCs that were dispersed in primary cultures, treated without or with 10 nM-1 mu M everolimus and/or 50 nM IGF-I. Cell viability was evaluated after 48 h, and calcitonin (CT) secretion was assessed after a 6 h incubation. IGF-I receptor downstream signaling protein expression profile was also investigated. Results: Everolimus significantly reduced cell viability in eight MTC [by similar to 20%; P < 0.01 vs. control; everolimus-responders (E-R) MTCs], while cell viability did not change in 10 MTCs [everolimus-non-responders (E-NR) MTCs]. In E-R MTCs, IGF-I blocked the antiproliferative effects of everolimus that did not affect CT secretion, but blocked the stimulatory effects of IGF-I on this parameter. IGF-I receptor downstream signaling proteins were expressed at higher levels in E-NR MTC as compared to E-R MTCs. Conclusion: IGF-I protects a subset of MTC primary cultures from the antiproliferative effects of everolimus and stimulates CT secretion by an mTOR mediated pathway that, in turn, may represent a therapeutic target in the treatment of aggressive MTCs

Extraversion and neuroticism in sexually dysfunctional men suffering from erectile dysfunction and premature ejaculation: a cross-sectional study

The role of personality traits in sexual complaints and dysfunctions is ever more evident. However, the literature is very scarce as to the possible relationships between such personality traits and specific sexual dysfunctions like ED, PE or both, their subtypes as to time of onset and severity levels. The main aim of the present study was to investigate if Neuroticism and Extraversion have different roles and trends in men suffering from PE and/or ED, both lifelong and acquired. Moreover, we verified if, by adopting DSM-IV-TR and DSM-5 criteria for diagnosing PE, some differences emerged in percentages of diagnosed cases. The sample consisted of 222 patients aged 18-70. The International Index of Erectile Function (IIEF-15) was used to assess erectile function, and the Premature Ejaculation Severity Index (PESI) was used to assess the severity of PE dysfunction. Neuroticism and Extraversion were measured with the Eysenck Personality Questionnaire-Revised (EPQ-R). In our results, Neuroticism and Extraversion were dependent on the kind of sexual dysfunction and its severity. These results suggest that type, time of onset and severity of sexual dysfunctions should be considered as related to specific personality characteristics and vice versa

Testing the Conjugative Properties of Benzodithiophene and Benzotrithiophene in Charge Transfer Multi(ferrocenyl) Systems

The charge transfer properties of the mono-, di-, and tricationic derivatives of bis(ferrocenyl)benzodithiophene and tris- (ferrocenyl)benzotrithiophene were investigated. The cations were generated by chemical oxidation using ferrocenium(BF4) and acetylferrocenium(BF4) as the oxidative agents and monitored in the visible and NIR regions. By changing the supporting electrolyte from [nBu4N][PF6] to [nBu4][B(C6F5)4], we were able to selectively generate the monocationic species of bis- and triferrocenyl complexes. The redox and optical properties of the cationic derivatives were rationalized by an in-depth electrochemical and optical study. The comparison with the results previously obtained for the structurally related bis(ferrocenyl)-s-indacene and tris(ferrocenyl)-trindene allowed for the evaluation of the huge influence of thiolation on the metal 12metal electronic coupling

QUALIDADE NA CADEIA DE PRODUÇÃO DE LEITE: DIAGNÓSTICO E PROPOSIÇÃO DE MELHORIAS

São Paulo state is one of the major milk producer region in Brazil and in this aspect until last decade the municipality of Tupã was most prominent. This city had a decrease in the milk production of around 20%, from 2002 to 2005. There are many facts which might have restrained that milk production chain as a whole to have prevented it to become more competitive. One of the main restraining factors for its development is the quality of the product offered to the final consumer. Considering that this work aims to make a diagnose of the agents which compound that milk production chain in the region of Tupã, SP, aiming to observe whether there are management tools being used for quality management and describe what they are, and identify possible lacks and propose solutions. The method selected for the empirical part is the case study which was made viable by means of interviews with the agent’s participants and researcher observations. This study indicates that the agents in this production chain have different interests. The milk producers are not aware of quality management tools whilst supermarkets are not committed to contribute for building and preserving the quality of milk products. Finally, a model to improve the coordination of the agents in this production chain in order to improve the quality of the product was proposed.milk production chain, quality management and quality product.,