Hydroxytyrosol recovery from olive pomace: a simple process using olive mill industrial equipment and membrane technology.

In this work, pilot-scale nanofiltration was used to obtain aqueous solutions rich in hydroxytyrosol and tyrosol from olive oil by-products. A large-scale simple process involving olive mill standard machinery (blender and decanter) was used for the olive pomace pre-treatment with water. The aqueous extract was then directly fed to a nanofiltration unit and concentrated by reverse osmosis. Final concentration factors ranged between 7 and 9 for hydroxytyrosol and between 4 and 7 for tyrosol. The final aqueous solution, obtained as retentate stream of reverse osmosis, was highly concentrated in hydroxytyrosol and tyrosol and their concentrations remained stable over at least 14 months.

Pagdahun hin kalinaw (Hope for peace and tranquility)

@#Words cannot fully describe the grotesque experiences of rape survivors. as psychiatry residents, we are faced with the formidable task of trying to understand their inner experiences, so we can journey with them towards healing.

Tissue-engineered human embryonic stem cell-containing cardiac patches: evaluating recellularization of decellularized matrix.

Decellularized cardiac extracellular matrix scaffolds with preserved composition and architecture can be used in tissue engineering to reproduce the complex cardiac extracellular matrix. However, evaluating the extent of cardiomyocyte repopulation of decellularized cardiac extracellular matrix scaffolds after recellularization attempts is challenging. Here, we describe a unique combination of biochemical, biomechanical, histological, and physiological parameters for quantifying recellularization efficiency of tissue-engineered cardiac patches compared with native cardiac tissue. Human embryonic stem cell-derived cardiomyocytes were seeded into rat heart atrial and ventricular decellularized cardiac extracellular matrix patches. Confocal and atomic force microscopy showed cell integration within the extracellular matrix basement membrane that was accompanied by restoration of native cardiac tissue passive mechanical properties. Multi-electrode array and immunostaining (connexin 43) were used to determine synchronous field potentials with electrical coupling. Myoglobin content (~60%) and sarcomere length measurement (>45% vs 2D culture) were used to evaluate cardiomyocyte maturation of integrated cells. The combination of these techniques allowed us to demonstrate that as cellularization efficiency improves, cardiomyocytes mature and synchronize electrical activity, and tissue mechanical/biochemical properties improve toward those of native tissue.

Quantitative and morphologic analysis of lymphocytes and macrophages in the cerebrospinalfluid (CSF) of first onset and chronic schizophrenia

OBJECTIVES: The aim of this study is to compare the White Blood Cell count and morphology in the Cerebrospinal fluid of:1) patients diagnosed with first onset treatment naive schizophrenia; 2) patients with chronic schizophrenia and 3) healthy subjects.METHODOLOGY: CSF samples from 16 chronic schizophrenics, 15 first onset treatment naive schizophrenics and normal controls were collected and analyzed by histopathology.RESULTS: The cytological profile of CSF cells were significantly different from those of the control population. Total cell count was significantly higher in patients with first onset and chronic schizophrenia compared to normal subjects except in neutrophils. There was also a difference in the mean number of cells among groups, with chronic schizophrenics having the most number of large lymphocytes compared to first onset schizophrenia and control groups. The number of macrophages and neutrophils were not statistically significant.CONCLUSION: The finding of atypical lymphocytes in the CSF suggest that immunologic aberration does occur in schizophrenia and point towards a chronic degenerative process.

Awareness and confidence of family physicians in recognition and treatment of psychiatric disorders

OBJECTIVES: This paper aims to evaluate the competence and confidence of the primary care practitioner in the recognition, diagnosis and treatment of mental disorders.METHODOLOGY: A validated 13 point questionnaire which incorporated items from the DSM IV was given to the participants of the annual convention of the Philippine Academy of Family Physician held in Davao City Sept 8-10, 2000.RESULTS: Four hundred eighty five family physicians returned the self administered questionnaire. Fifty one percent (248/ 485) claimed they would immediately refer patients to the psychiatrist while 28% (137/ 485) would initiate treatment on their own. Fourteen percent (68/ 485) and 10.9% (53/ 485) of the respondents indicated that they were familiar with the DSM IV criteria for schizophrenia and depression respectively; however only 11.3 % (55/485)were confident in using the criteria for diagnosis. Fortytwo percent (204/485) described schizophrenic patients as being irritable and aggressive, 30% (146/485) believed that hallucinations were the hallmark symptom, while 18% (88/485) considered bizarre behavior as the most significant indicator of schizophrenia. For depression the subjective feeling of sadness and worthlessness was most indicative of depression for the respondents (63% or 305), while 21% or 102 considered low self esteem or unstable self image as one of the criteria for depression and 16% or 78 thought of diminished interest or pleasure in all activities as the more important symptom to look for when diagnosing depression. Tricyclic antidepressants were still the preferred drug by most family physicians in treating depression (72% or 340) while 62% (301/ 485) prescribed benzodiazepines and 51% (248/ 485) also used the newer selective serotonin reuptake inhibitors. Patients with schizophrenia would be given typical psychotropic drugs like chlorpromazine or haloperidol more commonly (88% or 427), while 46% (224/ 485) had begun to prescribe atypical antipsychotic medications.CONCLUSION:The family physician seems to be hesitant or unsure with their diagnosing or treating psychiatric patients though willing to administer psychotropic medications.

A meta-analysis on the efficacy and safety of risperidone in patients with Behavioral and Psychological Symptoms of Dementia (BPSD)

OBJECTIVE: To determine the efficacy and safety of risperidone compared to placebo and haloperidol in the treatment of behavioral and psychological symptoms of dementia. METHODOLOGY: In a systematic review of literature, all articles published from January 1990 - September 2005 that conducted double-blind, randomized controlled clinical trials evaluating the efficacy and safety of risperidone and haloperidol for the treatment of BPSD were selected. The search was performed by means of MEDLINE, PUBMED, Cochrane Library database limited to studies written in English from 1990 to 2005. Key journals and textbooks were also searched in addition to the electronic database search. References mentioned in these studies were likewise reviewed. Two reviewers independently did validity assessment. Analysis of data was done by statistical packs Revman 4.2.7 from Cochrane Collaboration and SPSS (statistical package for the social sciences) v 9.0. RESULTS: Five trials were included in this study. A total of 964 patients were evaluated. Risperidone was superior to placebo as evidenced by significant reduction in the scores of total BEHAVE-AD score (WMD = 2.97, 95% CI = 1.65 - 4.29), BEHAVE-AD aggression subscale (WMD = 1.40, 95% CI = 1.34 - 1.46), and CMAI total aggression subscale (WMD = 3.82, 95% CI = 3.04 - 4.60). Comparison of risperidone and haloperidol showed significant reduction in the total BEHAVE- AD score in patients receiving risperidone (WMD = 1.80, 95% CI = 0.43 - 3.18). Comparing the odds ratio of having an adverse effect, analysis revealed greater chance of developing somnolence (OR = 1.88, 95% CI = 1.27 - 2.77), peripheral edema (OR = 2.43, 95% CI = 1.29 - 4.59) and extrapyramidal symptoms (OR = 1.93, 95% CI = 1.04 - 3.61) with risperidone. CONCLUSION: Risperidone is effective and relatively safe in the treatment of behavioral and psychological symptoms of dementia. Higher incidence of somnolence, peripheral edema and extrapyramidal symptoms was noted with risperidone compared to placebo. Compared with haloperidol, risperidone was superior in the total BEHAVE- AD scale and showed more favorable results in the total CMAI scale, BEHAVE-AD aggression and CMAI total aggression subscales.

Usefulness of clock drawing test in Filipino patients with schizophrenia

OBJECTIVES: To compare the Clock Drawing Test (CDT) performance of Filipino patients with schizophrenia and normal subjects in detecting cognitive impairment and to determine the correlation of symptom severity using Brief Psychiatric Rating Scale (BPRS) and Positive and Negative Syndrome Scale (PANSS) with the CDT performance among schizophrenic subjects.METHODOLOGY: A descriptive cross-sectional study using convenient sampling. Stable and compliant schizophrenic subjects were recruited at the psychiatry OPD of our institution from July to November 2004. Normal subjects were recruited from the community who were age,sex, and education matched. CDT and MMSE were administered to all the subjects and the scores of the two groups were compared using the two-tailed Student t-test. Symptom severity using BPRS and PANSS were correlated with CDT and Mini Mental Status Exam (MMSE) in schizophrenic subjects using the Pearson;s correlation coefficient.RESULTS: A total of 66 subjects, 33 schizophrenic and 33 normal subjects were included in the study. Schizophrenic subjects performed poorly on CDT and MMSE compared to the normal subjects. The difference between the mean scores was statistically significant. The examination errors on the clock drawing test was more apparent among schizophrenic subjects. There were positive correlations between CDT and MMSE, and BPRS and PANSS. Negative correlations were observed between the cognitive performance and the symptom severity of schizophrenia.CONCLUSION: Schizophrenic subjects performed poorly on CDT compared to the normal subjects, thus it is useful in detecting cognitive impairment. Likewise, CDT performance correlates well with symptom severity. Its availability and simplicity makes it very useful in detecting cognitive impairment in our clinical practice.

A post-marketing surveillance study of risperidone as adjunctive therapy to mood stabilizers in the treatment of manic phase bipolar I disorder

Objectives: The purpose of this study was to assess symptom improvement with, and safety (measured as tolerability) of, risperidone as adjunctive therapy to mood stabilizers in the treatment of bipolar I disorder, manic phase. Methods: Eight hundred sixty seven Filipino patients, recruited from 46 centers across the Philippines and diagnosed according to DSM-IV criteria as having bipolar disorder, current phase manic, completed an 8-week open trial of risperidone as add-on therapy to mood stabilizers. Doses of risperidone were started at 0.5 - 2 mg per day for the first 2 days, and escalated or reduced based on clinical judgment on succeeding days. Treatment was evaluated 1, 2, 4 and 8 weeks after baseline assessment. The Young Mania Rating Scale (YMRS), Hamilton Depression Scale (HAM-D), Clinical Global Impression Scale for Severity (CGI-S) and Clinical Global Impression Scale for Improvement (CGI-I) were used to measure symptom reduction with risperidone use, while the Extrapyramidal Symptoms Rating Scale and incidence of adverse events were employed to determine drug safety. Results: Results showed significant reduction in manic and depressive symptoms throughout the study as measured by statistically significant decreases in mean YMRS and HAM-D scores. CGI scores likewise showed significant improvement from baseline to study end with an increasing percentage of patients who showed steady improvement throughout the trial. There was a low incidence of extrapyramidal symptoms (EPS), majority of which were mild. Only 2 other non-EPS adverse events occurred in the study. Conclusion: This study demonstrated reductions in manic and depressive symptoms with risperidone use and showed that risperidone was safe as adjunct therapy to mood stabilizers for the treatment of manic phase bipolar disorder.

Switching to olanzapine from previous antipsychotics: a regional collaborative multicenter trial assessing 2 switching techniques in Asia Pacific.

BACKGROUND: This open-label, multicenter, randomized study compared the efficacy and safety of switching moderately ill Asian patients with schizophrenia from their current regimen of antipsychotic medication to the atypical antipsychotic olanzapine using either a direct switch method or a start-taper switch method. METHOD: Asian inpatients and outpatients with DSM-IV schizophrenia (N = 108) currently treated with predominantly typical antipsychotics were switched to olanzapine (initial dose of 10 mg/day) for 6 weeks. Patients were randomly assigned to 1 of 2 groups: the direct switch group (N = 54) received only olanzapine, while the start-taper switch group (N = 54) received olanzapine and their usual antipsychotic in decreasing doses for the first 2 weeks. A successful switch was defined as completing 6 weeks of therapy without worsening of symptoms (Clinical Global Impressions-Severity of Illness scale [CGI-S]) or extrapyramidal side effects (Simpson-Angus Scale). Overall efficacy was assessed using the Positive and Negative Syndrome Scale (PANSS), and safety was assessed by recording adverse events and measuring vital signs. RESULTS: Statistically significant (p < .001) improvements from baseline to endpoint occurred in both switch groups in the CGI-S score and the PANSS total score and subscores. However, no significant differences were observed between the switch groups for any efficacy measure. Both techniques had comparable rates of successful switching (direct switch, 74.1% vs. start-taper switch, 67.9%). The frequency of treatment-emergent adverse events was similar between switch groups with no clinically significant differences in any laboratory value or vital sign. Weight gain occurred in both switch groups (p < .001), but the groups were not statistically different from each other. Both switch groups showed statistically significant (p < .01) improvements from baseline to endpoint on the Simpson-Angus Scale and Barnes Akathisia Scale. CONCLUSION: Moderately ill Asian patients with schizophrenia may experience a decrease in symptom severity and improvement in extrapyramidal symptoms when switched from their current medication to olanzapine therapy.

Is there a stigma of psychiatrists among medical colleagues in Tarlac?

Psychiatrists are numerous in urban areas, but are lacking in the provinces. Could there be a discrimination of psychiatrists by physicians in the rural areas? Is there a stigma attached to being a psychiatrist in the province? In an attempt to answer the above questions, a questionnaire survey of physicians in the province of Tarlac was conducted. Internal validity of the questionnaire was tested using Cronbach Alpha. Two pretests were conducted; the actual test consisted of 25 items with 92 points. Stigma was defined in terms of a cutoff value above 50% from the total number of points. In 75% of the respondents, there was a stigma attached to being a psychiatrist in Tarlac. The following were cited as disadvantages if being a psychiatrist in the said province: few patients, inadequate facilities and poor income. Some thought that psychiatrists might identify with their patients and acquire the same symptoms. The presence of stigma caries a negative implication as to the delivery of mental health care. There is a need to re-orient and re-educate physicians in Tarlac and reintegrate psychiatry into general medical practice.