Does mindfulness improve inhibitory control in psychotic disorders? A randomized controlled clinical trial / ¿Mejora el mindfulness el control inhibitorio en la psicosis? Un ensayo clínico aleatorizado y controlado

BACKGROUND/OBJECTIVE: Impaired Inhibitory Control (IC) is a core feature of psychotic disorders and is related with impaired social functioning in people experiencing psychosis. Despite research showing the benefits of mindfulness over IC in the general population, no study has assessed its effects on IC in psychoses. The aim of our study was to assess the effectiveness of a mindfulness-based intervention combined with integrated rehabilitation treatment in a sample of people diagnosed of psychotic disorders. METHOD: Fifty-six patients diagnosed with psychotic disorder were recruited and randomly allocated either to integrated rehabilitation treatment or integrated rehabilitation treatment enhanced with 26 mindfulness group sessions. Measures comprised PANSS interview, MAAS scale, and Stroop Color Word Test (SCWT). The primary outcome variable was the performance in the non-congruent trials of the SCWT. RESULTS: There were no differences between groups at baseline. At post-treatment patients allocated to mindfulness group increased their scores in non-congruent trials of SCWT and in MAAS. At post-treatment mindfulness group scored higher than integrated rehabilitation treatment in MAAS. CONCLUSIONS: Data suggest that mindfulness added to integrated rehabilitation treatment may improve IC in psychosis. Results are convergent with prior works about the effect of mindfulness over cognitive performance in general population

ANTECEDENTES/OBJETIVO: Los déficits en el control inhibitorio (CI) son una característica central en trastornos psicóticos y se relaciona con funcionamiento social deteriorado en personas con síntomas psicóticos. A pesar de las investigaciones que muestran los beneficios del mindfulness sobre el CI, ningún estudio ha evaluado sus efectos en las psicosis. El objetivo de este estudio fue evaluar la eficacia de una intervención basada en mindfulness combinada con tratamiento rehabilitador integrado en una muestra de personas diagnosticadas con trastorno psicótico. MÉTODO: Cincuenta y seis pacientes diagnosticados con trastorno psicótico fueron reclutados y asignados aleatoriamente a tratamiento rehabilitador integrado o a tratamiento rehabilitador integrado mejorado con 26 sesiones grupales de mindfulness. Las medidas fueron la entrevista PANSS, la escala MAAS, y el Test Stroop de Palabras y Colores (TSPC). La variable resultado principal fue el rendimiento en los ensayos no congruentes del TSPC. RESULTADOS: No hubo diferencias entre grupos antes del tratamiento. En el postratamiento los pacientes del grupo de mindfulness incrementaron sus puntuaciones en TSPC y en MAAS. El grupo de mindfulness puntuó más alto que el de tratamiento rehabilitador integrado en MAAS. CONCLUSIONES: El mindfulness añadido al tratamiento rehabilitador integrado puede mejorar el CI en las psicosis. Los resultados son convergentes con los trabajos previos sobre el efecto del mindfulness en la población general

Does mindfulness improve inhibitory control in psychotic disorders? A randomized controlled clinical trial.

Background/Objective: Impaired Inhibitory Control (IC) is a core feature of psychotic disorders and is related with impaired social functioning in people experiencing psychosis. Despite research showing the benefits of mindfulness over IC in the general population, no study has assessed its effects on IC in psychoses. The aim of our study was to assess the effectiveness of a mindfulness-based intervention combined with integrated rehabilitation treatment in a sample of people diagnosed of psychotic disorders. Method: Fifty-six patients diagnosed with psychotic disorder were recruited and randomly allocated either to integrated rehabilitation treatment or integrated rehabilitation treatment enhanced with 26 mindfulness group sessions. Measures comprised PANSS interview, MAAS scale, and Stroop Color Word Test (SCWT). The primary outcome variable was the performance in the non-congruent trials of the SCWT. Results: There were no differences between groups at baseline. At post-treatment patients allocated to mindfulness group increased their scores in non-congruent trials of SCWT and in MAAS. At post-treatment mindfulness group scored higher than integrated rehabilitation treatment in MAAS. Conclusions: Data suggest that mindfulness added to integrated rehabilitation treatment may improve IC in psychosis. Results are convergent with prior works about the effect of mindfulness over cognitive performance in general population.

Antecedentes/Objetivo: Los déficits en el control inhibitorio (CI) son una característica central en trastornos psicóticos y se relaciona con funcionamiento social deteriorado en personas con síntomas psicóticos. A pesar de las investigaciones que muestran los beneficios del mindfulness sobre el CI, ningún estudio ha evaluado sus efectos en las psicosis. El objetivo de este estudio fue evaluar la eficacia de una intervención basada en mindfulness combinada con tratamiento rehabilitador integrado en una muestra de personas diagnosticadas con trastorno psicótico. Método: Cincuenta y seis pacientes diagnosticados con trastorno psicótico fueron reclutados y asignados aleatoriamente a tratamiento rehabilitador integrado o a tratamiento rehabilitador integrado mejorado con 26 sesiones grupales de mindfulness. Las medidas fueron la entrevista PANSS, la escala MAAS, y el Test Stroop de Palabras y Colores (TSPC). La variable resultado principal fue el rendimiento en los ensayos no congruentes del TSPC. Resultados: No hubo diferencias entre grupos antes del tratamiento. En el postratamiento los pacientes del grupo de mindfulness incrementaron sus puntuaciones en TSPC y en MAAS. El grupo de mindfulness puntuó más alto que el de tratamiento rehabilitador integrado en MAAS. Conclusiones: El mindfulness añadido al tratamiento rehabilitador integrado puede mejorar el CI en las psicosis. Los resultados son convergentes con los trabajos previos sobre el efecto del mindfulness en la población general.

Genetic association study of coronary collateral circulation in patients with coronary artery disease using 22 single nucleotide polymorphisms corresponding to 10 genes involved in postischemic neovascularization.

BACKGROUND: Collateral growth in patients with coronary artery disease (CAD) is highly heterogeneous. Although multiple factors are thought to play a role in collateral development, the contribution of genetic factors to coronary collateral circulation (CCC) is largely unknown. The goal of this study was to assess whether functional single nucleotide polymorphisms (SNPs) in genes involved in vascular growth are associated with CCC. METHODS: 677 consecutive CAD patients were enrolled in the study and their CCC was assessed by the Rentrop method. 22 SNPs corresponding to 10 genes involved in postischemic neovascularization were genotyped and multivariate logistic regression models were adjusted using clinically relevant variables to estimate odds ratios and used to examine associations of allelic variants, genotypes and haplotypes with CCC. RESULTS: Statistical analysis showed that the HIF1A rs11549465 and rs2057482; VEGFA rs2010963, rs1570360, rs699947, rs3025039 and rs833061; KDR rs1870377, rs2305948 and rs2071559; CCL2 rs1024611, rs1024610, rs2857657 and rs2857654; NOS3 rs1799983; ICAM1 rs5498 and rs3093030; TGFB1 rs1800469; CD53 rs6679497; POSTN rs3829365 and rs1028728; and LGALS2 rs7291467 polymorphisms, as well as their haplotype combinations, were not associated with CCC (p < 0.05). CONCLUSIONS: We could not validate in our cohort the association of the NOS3 rs1799983, HIF1A rs11549465, VEGFA rs2010963 and rs699947, and LGALS2 rs7291467 variants with CCC reported by other authors. A validated SNP-based genome-wide association study is required to identify polymorphisms influencing CCC.

The HIF1A C85T single nucleotide polymorphism influences the number of branches of the human coronary tree.

OBJECTIVES: Hypoxia is required for the development of the cardiovascular system. Tissue adaptation to low oxygen is mediated through hypoxia-inducible factor 1. Hypoxia-driven gradients of vascular endothelial growth factor within the heart drive vessel tip sprouting and the angiogenic phase of vasculogenesis. We hypothesized that functional variants of the HIF1A C85T single nucleotide polymorphism (SNP) are associated with the number of coronary artery branches in humans. METHODS: Coronary artery branching in 88 individuals was assessed by dynamic counting of the arterial branches detected in coronary angiograms. Values were classified on the basis of the branches emerging from the right and left coronary arteries. HIF1A C85T genotypes were determined using TaqMan-based assays. A generalized linear model was used to measure the effect of each SNP on the response variables. RESULTS: The presence of the T allele in the HIF1A C85T SNP was associated with few branches of the coronary arteries: 81.03 ± 1.79 for individuals with the CC genotype versus 74.09 ± 2.48 for T-carrying ones (p = 0.042). CONCLUSIONS: The functionality of HIF1A may influence the degree of branching of the human coronary tree. We propose that the HIF1A C85T SNP is a genetic marker that determines interindividual differences in the human coronary artery pattern.

Compliance with guidelines in the treatment of asthma exacerbations in primary care.

OBJECTIVE: To describe the approach to asthma exacerbations in a primary care centre in comparison with current guidelines and to ascertain the resolution of the episodes. METHODS: A cross-sectional, descriptive study was performed in asthmatic patients over 14 years old who were consulting for asthma exacerbations in a primary care centre during a 6-month period. The treatment given and the resolution obtained were evaluated. RESULTS: One hundred and twenty-three asthma exacerbations were registered, corresponding to 96 patients. A total of 74% were mild exacerbations, 24.4% moderate and 1.6% severe. The severity of asthma correlated directly with the severity of exacerbations. The frequency of resolution was 98.4%, with an average duration of medical attention of 30 min (SD 16.5). According to guidelines, 60.2% of the mild exacerbations were well treated, as were 26.7% of the moderate exacerbations and none of the severe episodes. Peak expiratory flow was measured in 54.5% of patients. In 82 cases (66.6%) salbutamol was given with a large-volume spacer chamber. Treatment after discharge was correct in 27.3% of the mild and 23.3% of the moderate exacerbations. A total of 23 (23.9%) patients presented more than one exacerbation during the study period. CONCLUSIONS: Most exacerbations seen in primary care are mild. Administration of salbutamol was sufficient for the resolution of these exacerbations. However, treatment after discharge was not compliant with guidelines in most cases. The primary care team was able to resolve most of the asthma exacerbations.