A cross-sectional study on the sleep quality and excessive daytime sleepiness of Filipino medical students in a state-run university during the coronavirus disease (COVID-19) pandemic

Introduction@#Movement restrictions and changes in medical education around the world due to the Coronavirus 2019 pandemic have been sources of stress, which affect sleep and compound the demands of medical education. In the Philippines, stay-at-home orders were implemented in the National Capital Region on 15 March 2020, and despite various readjustments and re-definitions, remain in effect to date, March 2022. Objectives. This cross-sectional study aims to determine the sleep quality and daytime sleepiness of Filipino medical students during prolonged stay-at-home orders, to compare them with pre-pandemic evaluations, and to explore associations between scores and participant characteristics.@*Methods@#The medical student population of a state-run university in the City of Manila was included, while those on a leave of absence were excluded. The Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index which measure excessive daytime sleepiness and sleep quality, respectively, were disseminated via Google Forms from April to May 2021. @*Results@#Response rate was 87.75% (n=709) with a mean age of 22.9 ± 2.0 years and a 1:1.09 male-to-female ratio. Among the respondents, 41.18% had excessive daytime sleepiness, and was significantly higher for first-year premedicine students. Compared to pre-pandemic scores, daytime sleepiness decreased during the pandemic. On the other hand, 62.34% of the respondents had poor sleep quality, with global scores being significantly higher for the first-year pre-medicine students. Relationships between participants' characteristics and their scores were extremely weak, while a moderately significant correlation existed between global daytime sleepiness and sleep quality scores.@*Conclusion@#Both excessive daytime sleepiness and poor sleep quality remain prevalent during prolonged stay-athome orders. These reflect the effect of the pandemic on stress inherent to medical education, and may be additional facets to be regarded in evaluating the general well-being of medical students.

Mechanisms of mid-thoracic spine fracture/dislocation due to falls during horse racing: A report of two cases / 中华创伤杂志(英文版)

We reported two cases of jockeys who sustained fracture/dislocation of the mid-thoracic spine due to traumatic falls during horse racing. We examined the injury mechanism based upon the patients' diagnostic images and video footage of races, in which the accidents occurred. Admission imaging of patient 1 (a 42 years old male) revealed T5 burst fracture with bony retropulsion of 7 mm causing complete paralysis below T5/6. There existed 22° focal kyphosis at T5/6, anterolisthesis of T5 relative to T6, T5/6 disc herniation, cord edema and epidural hemorrhage from T4 through T6, and cord injury from C3 through C6. Admission imaging of patient 2 (a 23 years old male) revealed T4/5 fracture/dislocation causing incomplete paralysis below spinal level. There existed compression fractures at T5, T6, and T7; 4 mm anterior subluxation of T4 on T5; diffuse cord swelling from T3 through T5; comminuted fracture of the C1 right lateral mass; right frontal traumatic subarachnoid hemorrhage; and extensive diffuse axonal injury. The injuries were caused by high energy flexion-compression of the mid-thoracic spine with a flexed posture upon impact. Our results suggest that substantially greater cord compression occurred transiently during trauma as compared to that documented from admission imaging. Video footage of the accidents indicated that the spine buckled and failed due to abrupt pocketing and deceleration of the head, neck and shoulders upon impact with the ground combined with continued forward and downward momentum of the torso and lower extremities. While a similar mechanism is well known to cause fracture/dislocation of the cervical spine, it is less common and less understood for mid-thoracic spine injuries. Our study provides insight into the etiology of fracture/dislocation patterns of the mid-thoracic spine due to falls during horse racing.

Open-angle glaucoma in a rural and urban population in Eastern India—the Hooghly river glaucoma study

Purpose: Glaucoma is the leading cause of irreversible blindness in the world. The current study aims to estimate prevalence, features, and associations of open angle glaucoma (OAG) in a rural and urban East Indian population. Methods: This is a population based cross sectional study with two arms, rural (28 contiguous villages from 13 Gram Panchayats in Balagarh Police Station, Hooghly district) and urban (Kolkata). Individuals residing in the study area aged 40 years and above were included using multistage random cluster sampling. All subjects underwent a detailed ophthalmic examination at our base hospitals including applanation tonometry, ultrasound pachymetry, gonioscopy, and frequency doubling technology perimetry. The primary outcome was the prevalence of POAG (95% CI). Age and gender specific prevalence estimates were calculated. Multiple logistic regressions were used to analyze the risk factors. Results: Data from 7128 and 6964 subjects aged 40 years or older from Kolkata city and Hooghly district, respectively were analyzed. In the urban population, 2.10% (95% CI: 1.99–2.21%) had POAG and 0.15% (95% CI: 0.13–0.17%) had secondary OAG. In the rural population, 1.45% (95% CI: 0.59–2.31%) had POAG and 0.10 ± 0.03% (95% CI: 0.07–0.13%) had secondary OAG. Conclusion: The study concludes that higher age, higher vertical cup disc ratio (VCDR), and lower central corneal thickness (CCT) are important independent predictors of OAG and emphasizes that increased intraocular pressure (IOP) is not POAG. Gonioscopy, disc evaluation, and screening perimetry need to be incorporated in the detection protocol for glaucoma if we intend to lighten the burden of blindness due to glaucoma.

A cross-sectional study on the sleep quality and excessive daytime sleepiness of Filipino medical students in a state-run university during the Coronavirus Disease (COVID-19) Pandemic

Introduction@#Movement restrictions and changes in medical education around the world due to the Coronavirus 2019 pandemic have been sources of stress, which affect sleep and compound the demands of medical education. In the Philippines, stay-at-home orders were implemented in the National Capital Region on 15 March 2020, and despite various readjustments and re-definitions, remain in effect to date, March 2022. Objectives. This cross-sectional study aims to determine the sleep quality and daytime sleepiness of Filipino medical students during prolonged stay-at-home orders, to compare them with pre-pandemic evaluations, and to explore associations between scores and participant characteristics. @*Methods@#The medical student population of a state-run university in the City of Manila was included, while those on a leave of absence were excluded. The Epworth Sleepiness Scale and the Pittsburgh Sleep Quality Index which measure excessive daytime sleepiness and sleep quality, respectively, were disseminated via Google Forms from April to May 2021. @*Results@#Response rate was 87.75% (n=709) with a mean age of 22.9 ± 2.0 years and a 1:1.09 male-to-female ratio. Among the respondents, 41.18% had excessive daytime sleepiness, and was significantly higher for first-year premedicine students. Compared to pre-pandemic scores, daytime sleepiness decreased during the pandemic. On the other hand, 62.34% of the respondents had poor sleep quality, with global scores being significantly higher for the first-year pre-medicine students. Relationships between participants' characteristics and their scores were extremely weak, while a moderately significant correlation existed between global daytime sleepiness and sleep quality scores. @*Conclusion@#Both excessive daytime sleepiness and poor sleep quality remain prevalent during prolonged stay-athome orders. These reflect the effect of the pandemic on stress inherent to medical education, and may be additional facets to be regarded in evaluating the general well-being of medical students.

A descriptive study on the sleeping habits and correlation of sleepiness with academic performance in a State University-run Medical School in the Philippines

Background and Significance@#Sleep is a vital facet of human existence that is vital to learning and memory; lack of sleep is associated with significant impairment in learning. Medical students are a special population because of the demands of medical school. They are very prone to sleep deprivation and poor quality of sleep, hence academic performance might be affected.@*Objectives@#We determined the different sleeping habits of medical students using a descriptive tool, with variables chosen specifically for this study. The level of sleepiness was then correlated with the academic performance (using the general weighted average) among students in a state university run-medical school in the Philippines.@*Methods@#The study is a prospective cross-sectional survey among medical students in a state university-run medical school enrolled for the academic year 2016-2017. The questionnaires used were the Epworth Sleepiness Score and specific questions about sleeping habits. The General Weighted Average (GWA) of those who participated were obtained from the student records section of the college. Descriptive statistics were used to describe the results on different sleeping habits, while the chi-squared test was used to determine any significant differences in the GWA versus level of sleepiness across all year levels.@*Results@#A total of 426 medical students (or 60% of the total student population of the college) participated. However, of the 426, only 326 had complete GWAs and were therefore included in the final analysis for correlation. The average medical student is “sleep-deprived”, sleeping two hours less (six hours) than the recommended daily minimum duration of sleep (eight to 10 hours). For the correlation of sleepiness and academic performance, we found out that there is no significant difference in academic performance among those who are excessively sleepy (ESS greater than 10) versus those who are not, p-value = 0.892.@*Conclusion@#Increased level of sleepiness does not correlate with poorer academic performance among these medical students, despite them sleeping less than the general recommendation for adults. The study is limited however by the use of the GWA as the sole tool to measure academic performance, which is affected by many other factors. We recommend the performance of this study in a broader population and use more validated tools to measure sleepiness and academic performance.

Angle closure glaucoma in rural and urban populations in eastern India—The Hooghly River Glaucoma Study

Purpose: To estimate the prevalence, features, and associations of primary angle closure disease (PACD) in rural and urban populations from West Bengal in eastern India. Methods: This was a population-based cross-sectional study with two arms, rural and urban. The rural study area consisted of 28 contiguous villages from 13 gram panchayats in Balagarh Police Station, with rural base hospital at Dhobapara, Balagarh Police Station, in the village Kuliapara of Hooghly district. A tertiary eye hospital in central Kolkata was the urban study center. Individuals residing in the study area aged 40 years and above were included in this study using multistage random cluster sampling. All subjects underwent a detailed ophthalmic examination at our base hospitals including applanation tonometry, ultrasound pachymetry, gonioscopy, and frequency doubling technology perimetry. Data collected were analyzed using SPSS 13. Multiple logistic regressions were used to analyze risk factors for PACD. Results: A total of 7,408 and 7,248 subjects aged 40 years or older were enumerated from Hooghly district and Kolkata city, respectively. PACD was detected in 1.9% subjects in rural arm and 1.54% subjects in the urban arm (P < 0.001). In rural arm, 0.3% had PACS, 0.56% had PAC, and 1.03% had PACG. In urban arm, 0.22% had PACS, 0.35% had PAC, and 0.97% had PACG. Conclusion: The study concludes that higher age, higher CCT, and shorter axial length/presence of hyperopia are important independent predictors of ACD. ACD is more common in eastern India than previous estimates.

Comparative Study of Risk Factors for Cancer Cervix among Women of Reproductive Age Women in Rural and Urban Area

Background: Awareness of risk factors is not at the desired levels among the women in the age group of 15-49 years. The level of awareness regarding identification of risk factors, symptoms of disease, the importance of early treatment which are important for control and prevention of disease. The present study is conducted in urban and rural areas in and around Kurnool district with the intention to know the level of awareness present and to measure the prevalence of risk factors for occurrence of cervical cancer. Methods: A total of 1400 women (700 urban and 700 rural women) in the reproductive age group of 15 – 49 years were interviewed at their residence. Interview done by investigator, during interview study pattern was explained to study population, later the data was collected. Results: Prevalence of two or more life time sexual partners was found to be high (4.2%) among rural women compared to urban women (1.33%). Prevalence of poor genital hygiene was 37.42% in rural women as compared to 8.28% in urban women. Prevalence of RTI among women of rural area was 34.57% and in urban area was 12.58%. History of husband having STI was more in rural areas (18%) when compared to urban area (14%). Status of screening by Pap smear was significantly high in urban (5.14%) than in rural (1.72%) population. Conclusion: Health care worker should be trained to identify and prevent risk factors causing cancer cervix in both urban and rural areas.

Post-partum depression, anxiety and marital satisfaction: A perspective from Southeastern Nigeria

Background: Many studies have noted the high prevalence of post-partum depression (PPD) and anxiety associated with poor marital satisfaction, albeit amidst a dearth of literature on comorbid PPD and anxiety among women in Nigeria. Objective: The study was aimed to assess the prevalence of PPD and anxiety, and to investigate their relationship with marital satisfaction in low-risk women in Enugu, Southeastern Nigeria. Method: A cross-sectional study of 309 randomly selected nursing mothers at two tertiary health institutions. Socio-demographic Questionnaire, Hospital Anxiety and Depression Scale, and Index of Marital Satisfaction (IMS) were used to collect data on demography, anxiety and depression and marital relationship respectively. All statistical tests were performed at a significant level of 0.05. Results: The age range of the respondents was 20­46 years; mean and s.d. was 29.65 and ±4.87, respectively, and most of them were graduates of tertiary educational institutions (74.1%). The prevalence of post-partum anxiety was 31.1% and of PPD was 33.3%. Marital dissatisfaction was observed in 39.5% (122) of the respondents who were mothers. Those with co-morbid depression and anxiety (22.0%) had worse marital dissatisfaction. The strongest correlation with depression and anxiety was item 12 of IMS ('feel that my partner doesn't confide in me').Conclusion: There was a high prevalence of marital dissatisfaction, PPD and anxiety among nursing mothers in Enugu, but with low detection rate. The effects of PPD and anxiety on the mother, her marital relationship and her infant make them essential conditions for early diagnosis, prevention and treatments

Level of awareness and treatment of anxiety and depression during pregnancy in southeast Nigeria

Background: Anxiety and depressive disorders are somewhat masked by features of pregnancy; hence many women are ignorant of them and are untreated. Aim: To determine the level of awareness and treatment of anxiety and depression in pregnancy. Setting: The study was carried out at the antenatal clinic of Enugu State University Teaching Hospital, Enugu, Nigeria. Method: This was a cross-sectional and descriptive study of 200 pregnant women in consecutive attendance of the antenatal clinic using the Hospital Anxiety and Depression Scale (HADS) and a sociodemographic questionnaire. Results: Of the participants, 23.5% had anxiety and/or depression, 7.5% of them were aware of their condition and only 0.5% of all the participants or 6.7% of those who were aware of their problem received treatment. Conclusion: Anxiety and depression are prevalent among pregnant women. Because of overlap of symptoms of anxiety and depression with those of pregnancy, the awareness is very low; hence many of them suffer immensely without treatment

Functional measurement in the field of Ethics in Politics / Medición funcional en el campo de la Ética en Política

We present, in a synthetic way, some of the main findings from ten studies that were conducted in the field of ethics in politics, using the Functional Measurement framework. These studies were about (a) Angolan and Mozambican people's views about the legitimacy of military-humanitarian interventions, (b) French people's perspectives regarding the government's responsibility for the health of consumers of illicit substances, (c) Togolese people's views about the acceptability of political amnesties in a time of political transition, (d) the perspective of victims of the genocide of the Tutsis in Rwanda regarding the attribution of guilt by association to offspring of perpetrators, (e) slave descendants' views about the acceptability of national policies on reparations for slavery, (f) Colombian people's willingness to forgive perpetrators of violence who harmed family members during the civil war, (g) the attitudes of French and Colombian people about national drug control policies, (h) Indian students' views about the appropriateness of the death penalty for murder or rape, (i) Colombian people's perspectives regarding corruption, and finally (j) Venezuelan people's conceptualization of human rights. The main findings are discussed in reference to six of the foundations of Moral Foundations Theory.

Este texto presenta, de forma resumida, algunos de los principales resultados de diez estudios que se realizaron en el campo de la ética y la política, en el marco de la Medición Funcional. Estos estudios trataron de: (a) los puntos de vista de la gente de Angola y Mozambique sobre la legitimidad de las intervenciones militares-humanitaria; (b) las perspectivas de los franceses con respecto a la responsabilidad del gobierno con la salud de los consumidores de sustancias ilícitas; (c) las perspectivas de las personas de Togo acerca de la aceptabilidad de amnistías políticas en un momento de transición política; (d) las perspectivas de las víctimas del genocidio de los Tutsis en Ruanda en cuanto a la atribución de culpabilidad a los descendientes de los perpetradores de violencia; (e) los puntos de vista de los descendientes de esclavos acerca de la aceptabilidad de las políticas nacionales de reparaciones por la esclavitud; (f) la disposición de los colombianos a perdonar autores de la violencia que causaron daño a miembros de la familia durante el conflicto armado interno; (g) las actitudes de los franceses y colombianos acerca de las políticas nacionales de control de drogas; (h) los puntos de vista de los estudiantes indios acerca de la idoneidad de la pena de muerte por asesinato o violación; (i) las perspectivas de los colombianos con respecto a la corrupción, y, finalmente, (j) la conceptualización de los derechos humanos en la población venezolana. Los principales resultados se discuten en relación con seis de los fundamentos de la Teoría de los Fundamentos Morales.

Association between carotid intima media thickness and measurements of adiposity among residents and interns of a tertiary hospital in the Philippines

INTRODUCTION: Atherosclerotic diseases wherein obesity is a risk factor was shown to be the leading causes of mortality according to statistics. Body mass index (BMI), waist hip ratio (WHR) and waist circumference (WC), measurements of adiposity, were consistently identified as good measures of cardio-metabolic health risks. High-resolution B-mode ultrasound measurements of carotid intima-media thickness (CIMT) have also been used as a reliable and reproducible method to detect preclinical atherosclerosis, a precursor of cardiovascular disease. OBJECTIVE: This study aims to investigate which of the measurements of adiposity would best correlate with early vascular changes primarily noted in the CIMT among non-high risk clinicians of Victor R. Potenciano Medical Center (VRPMC). METHODS: A total of 38 subjects out of 42 residents and interns of VRPMC volunteered to participate in the study from August to November 2010. They had no evidence of cardiac or vascular disease. The weight, height, WC, and hip circumference of each subject were measured. High-resolution B-mode ultrasonography of the right and left common carotid arteries was then performed.  RESULTS: A weak correlation between BMI with CMIT was found. There is no association between WC and WHR and thickness of CIMT. CONCLUSION: WC, BMI, and WHR are insignificantly associated with CIMT in this study. 

A comparison of stretching with ice vs stretching with heat on hamstring flexibility among physical therapy students / The Health Sciences Journal

Introduction@#This study aimed to compare the effectiveness of stretching with ice and stretching with heat and their long term effect on the hamstring muscle flexibility among college students.@*Methods@#This was a quasi-experimental study where students who were determined to have tightness of the hamstring muscle were randomized to receive hot or cold packs thrice weekly for four weeks prior to stretching the muscle. The range of motion of knee extension with 90º hip flexion (active knee extension) was measured at baseline, week 1, week 2 and at the end of the treatment period. The post-treatment range of motion was compared with the baseline within and between the two study groups.@*Results @#Both modalities resulted in an increase in the range of motion from the initial to the week 4 determination. The final range of motion assessment was similar for the cold and hot groups. The difference between the final and initial assessment was larger in the cold group compared with the heat group (13.5º vs 9.5º) but when the mean difference was compared between the two groups, an unpaired t-test showed that the difference was significant.@*Conclusion@#Cold therapy prior to stretching appears to be a more effective option than heat in addressing hamstring muscle extensibility problems.

Effects of Live Infectious Bursal Disease Vaccines, on Immune Response of Vaccinated Chicks.

Aim: Relationship between virus titers of live Infectious Bursal disease (IBD) vaccines and their serum-conversion abilities was studied. Study design and Methodology: Five batches of each, of five IBD vaccine brands used in Nigeria, were tested for virus titers. Each of the vaccine brands was also used to vaccinate a group of fifteen 12-days old chicks to study their serum-conversion abilities. Mean antibody titers of the groups of chicks were plotted, on a graph, against virus titers of the vaccine brands used to vaccinate them. Results: Mean Modified Passive Haemagglutination titers of IBD virus in the vaccines,were:1,065.60±780.03,1,472.00±748.55,2,112.00±1984.00,2,176.00±1920. 00 and 2,585.00±926.92 while mean antibody titers they elicited were, 1,356.80±241.51, 1,280.00±174.88, 448.00±79.25, 998.40±196.27 and 332.80±51.20, respectively. Line of best fit of graph of antibody titers of vaccinated chicks on vaccine titers, showed that reducing titers of the live IBD vaccines improved their immunogenicity. Conclusions: The inverse relationship between virus titers of the vaccines and their serum conversion abilities, suggests that, if viral titers of live IBD vaccines are too high, immune-suppression instead of enhancement of immune response may occur.

A voyage to the twilight: Exploring death preparation among the elderly

@#<p style="text-align: justify;">What if the angel of death suddenly came knocking on your door? Death and aging are inevitable. However, since investigations usually assume that death unanimously provokes anxiety, death is often termed the last taboo which makes it painful for most people to talk about, think about, or even plan for it. This study was conducted to determine the philosophies and attitudes of the elderly in terms of the physical, psychosocial, and spiritual aspects of death preparation. The study also sought to determine importance of a support system for the elderly faced or are facing neardeath experiences and/or terminal illnesses. The study utilized phenomenology as its research design. Eight informants from the different cities and municipalities of Pangasinan were chosen through purposive sampling. All of them have been involved in a near-death experience and/or are in a dying state. Data was gathered in the form of a semi-structured interview. The study found that the informants' respective concepts of death, the grieving process, their cultivated philosophies, and support system played major roles in helping them prepare for death.</p> <p> </p>

Testes sanguíneos de biomarcadores para diagnóstico e tratamento de desordens mentais: foco em esquizofrenia / Biomarker blood tests for diagnosis and management of mental disorders: focus on schizophrenia

A descoberta e a aplicação clínica de biomarcadores para desordens mentais são confrontadas com muitos desafios. Em geral, os atuais métodos de descoberta e validação de biomarcadores não produziram os resultados que foram inicialmente aguardados depois da finalização do Projeto Genoma Humano. Isso se deve principalmente à falta de processos padronizados conectando a descoberta de marcadores com tecnologias para a validação e a tradução para uma plataforma que ofereça precisão e fácil uso em clínica. Como consequência, a maior parte dos psiquiatras e praticantes em geral são relutantes em aceitar que testes de biomarcadores pode suplementar ou substituir os métodos de diagnóstico utilizados baseados em entrevista. Apesar disso, agências regulatórias concordam agora que melhoras nos correntes métodos são essenciais. Além disso, essas agências estipularam que biomarcadores são importantes para o desenvolvimento de futuras drogas e iniciaram esforços no sentido de modernizar métodos e técnicas para suportar esses esforços. Aqui revisamos os desafios encontrados por essa tentativa do ponto de vista de psiquiatras, praticantes em geral, agências reguladoras e cientistas de biomarcadores. Também descrevemos o desenvolvimento de um novo teste sanguíneo molecular para esquizofrenia como um primeiro passo a esse objetivo

The discovery and clinical application of biomarkers for mental disorders is faced with many challenges. In general, the current methods for discovery and validation of biomarkers have not produced the results which were first anticipated after completion of the human genome project. This is mostly due to the lack of a standardized pipeline connecting marker discovery with technologies for validation and translation to a platform that offers accuracy and ease of use in a clinical setting. As a consequence, most psychiatrists and general practitioners are still reluctant to accept that biomarker tests can supplement or replace the long standing interview-based methods for diagnosis. Despite this, the regulatory agencies now agree that improvements over the current methods are essential. Furthermore, these agencies stipulate that biomarkers are important for future drug development and have initiated efforts to modernize methods and techniques to support these efforts. Here, we review the challenges faced by this endeavour from the point of view of psychiatrists, general practitioners, the regulatory agencies and biomarker scientists. We also describe the development of a novel molecular blood-test for schizophrenia as a first promising step towards achieving this goal

Os efeitos do estresse na função do eixo hipotalâmico-pituitário-adrenal em indivíduos com esquizofrenia / The effects of stress on hypothalamic-pituitary-adrenal (HPA) axis function in subjects with schizophrenia

Nas últimas décadas, têm surgido evidências sugerindo que a patogênese de desordens psiquiátricas, tais como a esquizofrenia, pode envolver perturbações no eixo hipotalâmico-pituitário-adrenal (HPA). Variações na manifestação desses efeitos poderiam estar relacionadas a diferenças em sintomas clínicos entre os indivíduos afetados, assim como a diferenças na resposta ao tratamento. Tais efeitos podem também ser originados de complexas interações entre genes e fatores ambientais. Aqui, revisamos os efeitos do estresse maternal em anormalidades na regulação do eixo HPA e desenvolvimento de desordens psiquiátricas, incluindo a esquizofrenia. Estudos nessa área podem gerar o aumento do nosso entendimento da natureza multidimensional da esquizofrenia. Posterior pesquisa nesse campo poderia, em última instância, levar ao desenvolvimento de melhores diagnósticos e novas abordagens terapêuticas para essa debilitante condição psiquiátrica

Over the last few decades, evidence has been emerging that the pathogenesis of psychiatric disorders such as schizophrenia can involve perturbations of the hypothalamic-pituitary-adrenal (HPA) axis. Variations in the manifestation of these effects could be related to the differences in clinical symptoms between affected individuals as well as to differences in treatment response. Such effects can also arise from the complex interaction between genes and environmental factors. Here, we review the effects of maternal stress on abnormalities in HPA axis regulation and the development of psychiatric disorders including schizophrenia. Studies in this area may prove critical for increasing our understanding of the multi-dimensional nature of schizophrenia. Further research in this area could ultimately lead to the development of improved diagnostics and novel therapeutic approaches for treating this debilitating psychiatric condition

Explorando o componente inflamatório da esquizofrenia / Targeting the inflammatory component of schizophrenia

A esquizofrenia é uma doença heterogênea caracterizada por um conjunto de manifestações clínicas. Um grande número de estudos ao longo dos últimos 20 anos apontou para anormalidades no sistema imune em pacientes que sofrem dessa condição. Em adição, tem sido mostrado que a psicose e a disfunção cognitiva associadas com a esquizofrenia estão ligadas a doenças autoimunes. Aqui, revisamos a evidência que sugere que um status pró-inflamatório do sistema imune induz sintomas psicopatológicos e pode estar envolvido na fisiopatologia dessa principal doença mental. Também propomos que futuros estudos pré-clínicos e clínicos deveriam levar em conta tais causas predefinidas e o status do componente inflamatório. Estratificação de pacientes e estratégias de medicina personalizadas baseadas no direcionamento ao componente inflamatório da doença poderiam ajudar na redução de sintomas e da progressão da doença. Por fim, isso poderia levar a novos conceitos na identificação de alvos moleculares em esquizofrenia e estratégias de descoberta de drogas

Schizophrenia is a heterogeneous disease characterised by an array of clinical manifestations. A large number of studies over the last 20 years have pointed towards immune system abnormalities in patients suffering from this condition. In addition, the psychosis and cognitive dysfunction associated with schizophrenia have been shown to be linked with autoimmune diseases. Here, we review the evidence, which suggests that a pro-inflammatory status of the immune system induces psychopathologic symptoms and may be involved in the pathophysiology of this major mental illness. We also propose that future preclinical and clinical studies should take such pre-defined causes and the dynamic status of the inflammatory component into account. Patient stratification and personalised medicine strategies based on targeting the inflammatory component of the disease could help in alleviation of symptoms and slowing disease progression. Ultimately, this could also lead to novel concepts in schizophrenia target/molecular identification and drug discovery strategies

Estudos traducionais de neuropsiquiatria e esquizofrenia: modelos animais genéticos e de neurodesenvolvimento / Translational neuropsychiatry of genetic and neurodevelopmental animal models of schizophrenia

Sintomas psiquiátricos são subjetivos por natureza e tendem a se sobrepor entre diferentes desordens. Sendo assim, a criação de modelos de uma desordem neuropsiquiátrica encontra desafios pela falta de conhecimento dos fundamentos da fisiopatologia e diagnósticos precisos. Modelos animais são usados para testar hipóteses de etiologia e para representar a condição humana tão próximo quanto possível para aumentar nosso entendimento da doença e avaliar novos alvos para a descoberta de drogas. Nesta revisão, modelos animais genéticos e de neurodesenvolvimento de esquizofrenia são discutidos com respeito a achados comportamentais e neurofisiológicos e sua associação com a condição clínica. Somente modelos animais específicos de esquizofrenia podem, em último caso, levar a novas abordagens diagnósticas e descoberta de drogas. Argumentamos que biomarcadores moleculares são importantes para aumentar a tradução de animais a humanos, já que faltam a especificidade e a fidelidade necessárias às leituras comportamentais para avaliar sintomas psiquiátricos humanos

Psychiatric symptoms are subjective by nature and tend to overlap between different disorders. The modelling of a neuropsychiatric disorder therefore faces challenges because of missing knowledge of the fundamental pathophysiology and a lack of accurate diagnostics. Animal models are used to test hypotheses of aetiology and to represent the human condition as close as possible to increase our understanding of the disease and to evaluate new targets for drug discovery. In this review, genetic and neurodevelopmental animal models of schizophrenia are discussed with respect to behavioural and neurophysiological findings and their association with the clinical condition. Only specific animal models of schizophrenia may ultimately lead to novel diagnostic approaches and drug discovery. We argue that molecular biomarkers are important to improve animal to human translation since behavioural readouts lack the necessary specificity and reliability to assess human psychiatric symptoms

Prevalence & correlates of primary infertility among young women in Mysore, India.

Background & objectives: There are sparse data on the prevalence of primary infertility in India and almost none from Southern India. This study describes the correlates and prevalence of primary infertility among young women in Mysore, India. Methods: The baseline data were collected between November 2005 through March 2006, among 897 sexually active women, aged 15-30 yr, for a study investigating the relationship of bacterial vaginosis and acquisition of herpes simplex virus type-2 (HSV-2) infection. A secondary data analysis of the baseline data was undertaken. Primary infertility was defined as having been married for longer than two years, not using contraception and without a child. Logistic regression was used to examine factors associated with primary infertility. Results: The mean age of the women was 25.9 yr (range: 16-30 yr) and the prevalence of primary infertility was 12.6 per cent [95% Confidence Interval (CI): 10.5-15.0%]. The main factor associated with primary infertility was HSV-2 seropositivity (adjusted odds ratio: 3.41; CI: 1.86, 6.26). Interpretation & conclusions: The estimated prevalence of primary infertility among women in the study was within the range reported by the WHO and similar to other estimates from India. Further research is needed to examine the role of HSV-2 in primary infertility.