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Biomedical subjects

M Bernardo

Publications and source records attributed to M Bernardo.

71 records · Page 4Linked to original sources

Internal magnetic gradient fields in glass bead packs from numerical simulations and constant time diffusion spin echo measurements.

Internal magnetic field gradients in water saturated glass bead packs were studied by numerical simulations and a constant time spin echo (CTSE) experiment. The CTSE is comprised of two spin echo refocusing periods where each of the two evolution periods, tau1 and tau2, is varied so that the total evolution, 2(tau1 + tau2), is held constant. The experiment is similar to that introduced by Norwood and Quilter and allows the effects of dephasing due to diffusion in a magnetic field gradient to be separated from other relaxation mechanisms. In our experiments, the magnetic susceptibility difference between the pore fluid and glass beads creates the internal field gradient. CTSE measurements were performed at 7 T (300 MHz 1H) for water saturated in 50 microm diameter glass bead pack. We find that the internal gradients in the center of the pore bodies, where free diffusion applies, is in the range of 10 to 100 G/cm. This fluid volume accounts for < or =10% of the total pore volume. From direct numerical simulations of the internal magnetic field based on a first principles calculation, we find that the major fraction, >90%, of the pore volume has internal gradients of order 500 to 5,000 G/cm. Signals from water in these large gradients is not observed in our CTSE measurements.

Glass↗

[Striatal dopamine transporter density decrease in first episode schizophrenic patients treated with risperidone].

UNLABELLED: Extrapyramidal symptoms and Parkinsonism (PS) are side effects commonly observed with antipsychotic treatment. However, about 24% of never-treated schizophrenic patients may suffer from PS, which contrast with that 1% observed from the general population. 123I-FP-CIT SPECT has probe useful to differentiate degenerative from non-degenerative PS, so it could be interesting using it for establishing the functional state of presynaptic dopamine neurons of these patients. AIM: To determine the dopamine transporter binding (DAT) in a homogeneous group of first-episode schizophrenic patients. METHODS: An open, transversal study. Thirty schizophrenic in-patients and 15 healthy subjects were recruited. Patients were treated with similar doses of risperidone and all subjects were scanned with 123I-FP-CIT. Extrapyramidal symptoms and psychopathological status was assessed by Simpson-Angus, CGI and PANSS. Semi-quantitative analyses of SPECT images were performed using ROIs placed in caudate nucleus, anterior, medium and posterior putamen and occipital cortex. RESULTS: Whole striatum 123I-FP-CIT binding ratio was significantly lower in patients than healthy subjects (t = 2.56, p < 0.014). This was observed in whole putamen (t = 2.66, p < 0.011), anterior (t = 2.35, p < 0.023), medium (t = 2.38, p < 0.022) and posterior putamen (t = 2.09, p < 0.042). No differences were observed in caudate nucleus (t = 1.81, p = 0.076). Females obtained higher binding ratios than males (t = -3.13, p < 0.003). No correlation was observed between 123I-FP-CIT binding ratios and clinical scales. CONCLUSION: In our series, first episode schizophrenic patients treated with risperidone have a decrease striatal DAT binding assessed with 123I-FP-CIT SPECT. This alteration could be related to their own schizophrenia disease or be secondary to the antipsychotic treatment.

Adult↗

Psychopathology and wisconsin card sorting test performance in young unmedicated schizophrenic patients.

The relationship between psychopathology and Wisconsin Card Sorting Test (WCST) performance was evaluated in 25 unmedicated young acute schizophrenic female patients (14 neuroleptic-naive and 11 neuroleptic-free) and 15 female controls. The schizophrenic patients (especially the neuroleptic-free) performed more poorly than controls in the WCST. In addition, WCST impairment correlated with both negative and positive symptoms. The results suggest that the neuropsychological dysfunction in schizophrenia is present at the onset of the illness, and is neither secondary to previous neuroleptic treatment nor to chronicity of the illness.

Acute Disease↗

[Neuropsychological alteration in schizophrenia and its modification].

The main experimental works about neuropsychological impairments of schizophrenia are reviewed. The underlying mechanisms of the cognitive deficits are set in a framework of the limited capacity model. In second point, the current status of the modificability of the cognitive deficits and the clinical and psychosocial consequences of this deficits are presented. At least, neuropsychological rehabilitation programs are reviewed from a clinical point of view.

Cognition Disorders↗

[Optimization of electroconvulsive therapy. Strategies for an adequate convulsion: role of caffeine].

The Electroconvulsive Therapy is a widely used technique in psychiatry as a treatment for several mental disorders with particular indications. To produce therapeutic effect it's necessary to induce a convulsion which is considered adequate if its duration lasts more than 20 seconds. Considerations that should be taken in to account and possible enhancement strategies when convulsion is not adequate are revised in the present article. Among these strategies we focus on the specific role of caffeine as convulsion enhancer and on aspects related to its use and administration form.

Caffeine↗

[Functional neuroimaging of emotions and bipolar disorder].

In this review we comment the results of functional neuroimaging works of emotions on normal population and some parallelisms with the emotional changes of bipolar disorder correlated with their functional neuroimaging. Initially we refer the emotional ontogenetical development of human brain based on regional cerebral sanguineous flow evolution (FSC). Secondly we describe the differences of FSC between the externally generated emotions versus internally; between positive versus negative emotions and the correlation between FSC and some facial expressions. When FSC of bipolar disorder is compared with normal emotions on general population, we observe that temporal cortex, the prefrontal medial and insular anterior cortex, change their perfusion with the switch or the change of emotional expression. It is possible to determine if the findings obtained in samples of healthy subjects and bipolar patients converge in a dimensional model, or if on the contrary they support the categorical hypotheses, moving the emotional aspects to a second term on bipolar disorder.

Bipolar Disorder↗

[Selective alteration of the declarative memory systems in patients treated with a high number of electroconvulsive therapy sessions].

INTRODUCTION: The reversible electrochemical effects of electroconvulsive therapy (ECT) on specific areas of the brain enable the neuroanatomical bases of some cognitive functions to be studied. In research carried out on memory systems, a selective alteration of the declarative ones has been observed after treatment with ECT. Little work has been done to explore the differential alteration of the memory subsystems in patients with a high number of ECT sessions. AIM. To study the declarative and non declarative memory system in psychiatric patients submitted to maintenance ECT treatment, with a high number of previous ECT sessions. PATIENTS AND METHODS: 20 patients submitted to treatment with ECT (10 diagnosed as having depression and 10 with schizophrenia) and 20 controls, who were paired by age, sex and psychopathological diagnosis. For the evaluation of the declarative memory system, the Wechsler Memory Scale (WMS) logical memory test was used. The Hanoi Tower procedural test was employed to evaluate the non declarative system. RESULTS: Patients treated with ECT performed worse in the WMS logical memory test, but this was only significant in patients diagnosed as suffering from depression. No significant differences were observed in the Hanoi Tower test. CONCLUSIONS: A selective alteration of the declarative systems was observed in patients who had been treated with a high number of ECT sessions, while the non declarative memory systems remain unaffected.

Adolescent↗

[Functional neuroimaging of auditory hallucinations in schizophrenia].

The neurobiological bases underlying the generation of auditory hallucinations, a distressing and paradigmatic symptom of schizophrenia, are still unknown in spite of in-depth phenomenological descriptions. This work aims to make a critical review of the latest published literature in recent years, focusing on functional neuroimaging studies (PET, SPECT, fMRI) of auditory hallucinations. Thus, the studies are classified according to whether they are sensory activation, trait and state. The two main hypotheses proposed to explain the phenomenon, external speech vs. subvocal or inner speech, are also explained. Finally, the latest unitary theory as well as the limitations the studies published are commented on. The need to continue investigating in this field, that is still underdeveloped, is posed in order to understand better the etiopathogenesis of auditory hallucinations in schizophrenia.

Brain↗

[Venlafaxine titration dosage in depressive in-patients. A series of cases].

This series of patients was gathered to assess the use of last and slow titration dosage of venlafaxine in in-patients with major depression and to evaluate the action onset. An observational open study was performed in 3 centers in 18 in-patients. Nine patients were included in fast titration dosage group (FT) and 9 in slow titration dosage group (ST). As results, it was found that the FT group showed faster improvement than the ST group in HAM-D score. This improvement was sustained to the final visit, with a lower score in the FT group (6.75) than the ST group (10.67). MADRS scores up to the 15th visit were similar; however, the score was lower in the ST group on the 20th visit. Improvement was sustained to the final visit, the FT group score being lower (6.50) than the ST group score (14). CGI - i mprovement and CGI-seve rity scores we re similar to the above mentioned results. The most common events in both groups were considered mild. The data of these patients show faster response to antidepressant therapy with faster titration dosage, with maintenance of the molecule's tolerability profile.

Adolescent↗

[Assessment of frontal functions in psychiatric patients during maintenance electroconvulsive therapy].

INTRODUCTION: Previous studies on adverse cognitive effects of electroconvulsive therapy (ECT) have not found any significant alteration of the frontal functions after an acute treatment course. This study aims to assess frontal executive functions in psychiatric patients during maintenance electroconvulsive therapy (M-ECT). SUBJECTS AND METHODS: Thirty two patients treated with M-ECT and 29 psychiatric patients never treated with ECT were evaluated with neuropsychological tests that assessed the following frontal functions: work memory, planning, cognitive flexibility, attention, visuomotor velocity, verbal abstract reasoning and phonetic verbal fluency. RESULTS: Multivariate global analysis did not detect significant frontal function tests differences between both groups. The M-ECT group only scored significantly lower on the FAS test, a test that measures phonetic verbal fluency. A significant correlation between number of previous ECT sessions and performance in the FAS was found. CONCLUSIONS: The M-ECT patient group presented a phonetic verbal fluency alteration that may also be associated to the previous number of ECT sessions. No significant differences in the other frontal functions were detected.

Bipolar Disorder↗

[Gender differences in mental health: epidemiological study in the general population of the island of Formentera].

The epidemiological data of prevalence of mental disorders according to gender differences are controversial. We analysed the prevalence among men and women via a two-stage epidemiological community study using the GHQ-28 and the SCAN on the island of Formentera (Spain). There are no sex differences in total prevalence; nevertheless some significant differences are detected when data is analysed on specific disorders. Affective disorders, sleep disorders and neurotic and somatoform disorders are more prevalent among women, whereas men have more psychoactive substance use disorders. Comorbidity with medical illness are higher in women but differences are not significant. These findings suggest the need to standardise procedures and instruments in these kinds of studies. This is because one of the bias could be the difference in the number of disorders included in the instrument design used (in our study, sleep disorders and psychoactive substance use disorders were included and personality disorders were excluded.

Adolescent↗

[The management and treatment of severe mental disorders in pregnancy].

The pharmacological treatment of serious mental disorders in the pregnancy, supposes a clinical dare by the possible repercussions on the fetus and the pregnancy: theratogenesis, perinatal syndrome or postnative sequels in the development. The electroconvulsive therapy (ECT) as much takes implicit a minimum risk for the mother as for the fetus and therefore, it must be located in the highest positions of the therapeutic decision trees. In the present article, are reviewed the consequences of the pharmacological treatment and the ECT in the serious mental disorders during the pregnancy. Is referenced to all of the pharmacological groups and with respect to the ECT: their indications, counterindications, complications and technical procedures advisables. Finally is reviewed the guide line for each syndromical group of psychiatric diseases.

Antipsychotic Agents↗