Movement Disorders After Exposure to Antipsychotic Drugs in Patients With Depressive Disorders.

OBJECTIVES: The aims of the study were to explore the frequency of movement disorders (MDs) in depressive patients exposed to antipsychotic drugs (APDs) and to compare it with nonexposed depressive patients and APDs-treated schizophrenic patients. METHODS: Four hundred fifty-two depressive patients not exposed to APDs (group A), 156 depressives exposed to APDs (group B), and 75 patients with schizophrenia on APDs (group C) were recruited. Presence of MDs was explored by the Simpson-Angus and UKU scales (Registration: NCT02409823). RESULTS: Movement disorders were observed in 5%, 9%, and 13% of patients in groups A to C, respectively (P < 0.001, χ for linear trend). A logistic multivariate analysis revealed that male sex (odds ratio = 2.26, 95% confidence interval = 1.13-4.49, P < 0.01), exposure to first-generation (vs second-generation) APDs (odds ratio = 5.71, 95% confidence interval = 2.08-15.66, P < 0.01), and exposure to lithium (odds ratio = 3.99, 95% confidence interval = 1.74-9.14, P < 0.01) were independently and significantly associated with MDs. CONCLUSIONS: Male sex, use first-generation APDs, and exposure to lithium were associated with MDs in depression. Therefore, caution is advised with the use of these drugs in depressive patients. Prospective studies are needed to confirm these results.

Factors Related to Early Clinical Effects of Quetiapine Extended-Release: A Multinational, Prospective, Observational Study.

BACKGROUND AND OBJECTIVES: The first weeks of treatment with antipsychotics are important for the development of their long-term efficacy. The objective of this study was to identify factors related to early clinical effects and quality of life (QoL) improvements with quetiapine extended-release (XR). METHODS: Six hundred and sixty-five patients starting with quetiapine XR were followed up for 8 weeks (schizophrenia = 153, major depression = 200, bipolar depression = 252, other psychiatric conditions = 60). Clinical effects were assessed by the Clinical Global Impression of Change scale (CGI-C), QoL by the visual analog scale (VAS) of the EQ-5D (QoL-VAS), and adherence by the Moriksy scale. Adverse events were explored: movement disorders by the UKU and Simpson-Angus scales, weight gain by calibrated balances, and diurnal somnolence by the Epworth Somnolence Scale (ESS). RESULTS: The mean dose of quetiapine XR during follow-up was 195.6 ± 154.8 mg/day. CGI and QoL-VAS scores improved significantly at week 8 by 2.7 ± 0.1 points and 25.1 ± 0.9 points. Adverse events were observed in 34 and 26 % of patients at weeks 4 and 8, respectively. A significant reduction in ESS score was also observed at week 8. Factors independently associated with change in QoL-VAS ≥20 points (n = 292, 43 %) were female gender, more severe disease at baseline, higher antipsychotic dose during follow-up, and improvements in somnolence. Factors independently associated with clinically significant improvement (CGI-C ≥5, n = 610, 93 %) were greater change in QoL-VAS, less frequent movement disorders at baseline, and lack of adverse events during follow-up, especially somnolence. CONCLUSIONS: Results from this real-setting, large observational study in Central America suggest that disease severity at baseline, gender, antipsychotic dose, and occurrence of adverse reactions has a significant impact on the early clinical effects of quetiapine XR. Clinicaltrials.gov registration number NCT02409823.

Serum testosterone and electroencephalography spectra in developmental male rhesus Macaca mulatta monkeys.

BACKGROUND: The main objectives in this work were to determine whether the relationship between serum testosterone concentration and electroencephalography (EEG) develop mental change observed in human males is also present in Macaca mulatta and, if so, to determine which frequency bands are involved and which regions change in pre-pubertal monkeys as a function of serum testosterone concentration. METHODS: Nine healthy monkeys were divided into three groups according to age. Serum testosterone was measured using immunoenzymatic chemiluminescent assay. EEG results were processed using Fast Fourier transform; average relative spectral power analysis was calculated and separated into delta and theta bands. RESULTS: The main findings were higher delta relative power in temporal area of the youngest group. Significant positive correlations were observed between serum testosterone levels and theta relative power across the entire scalp, and between theta relative power at frontal and temporal locations and in negative direction between delta relative power in temporal areas. Partial correlations controlling for cephalic perimeter remained significant between testosterone and total theta relative power and theta relative power in temporal areas. Partial correlations remained significant for theta relative power controlling for age at temporal locations. CONCLUSIONS: Our data show that testosterone may be a significant covariate in EEG development in Macaca mulatta males.

Tumor miofibroblástico inflamatorio de cavidad nasal: localización infrecuente / Inflammatory myofibroblastic tumor of the nasal cavity: an infrequent localization

Se refiere espectro clínico e histológico de un tumor miofibroblástico inflamatorio (TMI) o pseudotumor inflamatorio en nariz, localiza-ción nunca antes descrita, el cual al principio fue diagnosticado como neoplasia por el crecimiento súbito y sus características radiográficas y tomográficas. Se trató de una paciente de 48 años de edad, con antecedente de traumatismo nasal de repetición. Su padecimiento lo inició 10 años antes con obstrucción nasal derecha que paulatinamente se acentuó acompañada de epistaxis ocasional, otalgia bilateral de predominio derecho e hipoacusia derecha. La rinoscopia anterior mostró tumoración que obstruía totalmente el vestíbulo derecho. El estudio citológico demostró estroma escleró-tico hipocelular e infiltrado heterogéneo. Después de la resección quirúrgica la paciente se encontró asintomática; hasta el momento de este informe el seguimiento con tomografía axial computarizada señala que continúa libre de lesión nasal.

Adenocarcinoma bronquioloalveolar con arquitectura quística / Bronchioloalveolar adenocarcinoma with cystic architecture

Se presenta el caso de carcinoma bronquioloalveolar con arquitectura quística, en lóbulo pulmonar superior derecho de una paciente de 42 años de edad, cuyo esposo era positivo a tabaquismo acentuado. La formación histopatológica hallada es infrecuente y en la literatura existen escasos reportes al respecto. Desde el punto de vista radiográfico, es más común que el carcinoma se presente como un nódulo solitario periférico, múltiples nódulos periféricos o consolidación difusa. El diagnóstico diferencial incluye malformación adenomatoide quística, quistes broncogénicos, bronquiectasias y enfisema, principalmente. Dentro del variado espectro del cáncer pulmonar el carcinoma bronquioloalveolar predomina en las mujeres y, según algunos estudios recientes, la frecuencia va en aumento.

Punción biopsia pulmonar guiada por tomografía computada / Strategic alliance, general approaches and perspectives for the future

Entre el 1§ de marzo de 1995 y el 30 de marzo de 1996, se efectuaron 21 biopsias pulmonares a igual número de pacientes con nódulos y neoformaciones pulmonares sospechosas de malignidad, por datos clínicos y de la imagen radiológica. Los pacientes del sexo masculino fueron los más afectados por neoplasias (72 por ciento) y la sexta década de la vida fue la mas frecuente, el diagnóstico citológico mas numeroso fue el carcinoma epidermoide en 12 pacientes. Veinte lesiones fueron periféricas y en un sólo paciente fue de tipo central, cercana al mediastino. En 19 pacientes (90.4 por ciento), obtuvimos un diagnóstico citológico, en dos (9.52 por ciento el procedimiento fue fallido, ambos por tener lesiones pequeñas (1.8 cm). Dos pacientes tuvieron como complicación del procedimiento, neuromotórax, que requirió manejo con sello de agua (9.52 por ciento). Este procedimiento fue eficaz para dar el diagnóstico citológico en 19 pacientes