1,354,230 research outputs found
Ruolo dei polimorfismi del CYP450 1A2 negli eventi avversi da clozapina: uno studio osservazionale.
No full textObjectives: The genetically polymorphic enzyme cytochrome P450 (CYP) 1A2
contributes to the biotransformation of the antipsychotic drug clozapine (CLO). Two
polymorphisms are known to affect significantly 1A2 activity: 1A2*1F which increase
metabolism and 1A2*1C which decrease it. These SNPs, located in the promoter region
of the gene, may be responsible of a different CYP1A2 mRNA expression and could
help to explain interindividual differences in enzyme activity. Aim of these research
was to evaluate the impact of these polymorphisms on CLO pharmacokinetics and on
the occurrence of adverse reactions (ADRs).
Methods: All enrolled subjects were patients treated with CLO in our department
during the period 2008-2009. Inclusion criteria for case-group were: diagnosis of
psychotic disorder, normal liver and renal function, absence of concomitant diseases,
occurrence of significant CLO-induced ADRs. Patients who assumed CYP1A2 inducer
or inhibitory drugs, except smoking, were excluded. We considered significant CLOinduced
ADRs all reactions which led to CLO discontinuation or a permanent dose
reduction, and were related to CLO according to the clinical evaluation of the clinicians
confirmed by a “certain” or “probable” result at WHO-Uppsala criteria (WHO Uppsala
Monitoring Centre-UMC: http://www.who-umc.org). In the control-group we enrolled
patients treated for at least 1 year with CLO without showing ADRs, with the same
clinical features, matched for age, sex, CLO doses and smoking habits. Clinical
parameters were correlated with the CYP1A2 genotype and allelic combinations and
with CYP1A2 mRNA expression levels.
Results: The ratings for side effects, like sedation, constipation, scialorrea, were
significantly higher in CYP1A2 poor metabolizers genotypes.
Conclusions: Treatment with clozapine could be dangerous in extremely slow
metabolizers and ineffective in extremely rapid. Although genotyping explained only a
fraction of the adverse events, it could be a good predictor of adverse events
A SINGLE CASE REPORT OF RECURRENT SURGERY FOR CHRONIC BACK PAIN AND ITS IMPLICATION CONCERNING A DIAGNOSIS OF MUNCHAUSEN SYNDROME.
No full textWhile undergoing treatment in the psychiatric depart-
ment,4.C., a 40-year-old white male, who had arrived in
the casualty department complaining of an uncontrol-
lable anxiety attack and in a state of fluctuating con-
sciousness, was found to be suffering from a psy-
chopathological condition characterized by pathologi-
cal lying, gambling, compulsive restlessness, a long
clinical history of chronic back pain, with multiple inva-
sive diagnostic investigations and repeated surgery for
disc hernia with relative complications, culminating in
the fitment of a fixed neurostimulator, a slowdischarge
morphine pump and the patient being granted a full dis-
ability pension. The continual increases in the doses of
morphine suggested a tendency towards drug addic-
tion.
After providing a brief overview of lhe historical back-
ground and current concepts relating to the relation-
ship between factitious disorders, malingering and
hysteria, the authors discuss the differential diagnosis
of the case, suggesting a diagnosis of Mùnchausen
syndrome (the hypothesis best supported by the clini-
cal evidence). This diagnosis, although the subject of
much academic debate, is, unfortunately, still not fre-
quently encountered in the medical literature, with the
result that even today it has a strong clinical, relational
and social impact
Psichiatria e dermatoligia: 6 casi clinici di pazientiaffetti da schizofrenia e psoriasi.
No full textI vantaggi della rapidità d'azione di escitalopram: benessere soggettivo e funzionamento globale. Un caso clinico.
No full textA single case report of current surgery for chronic back pain and its implications concerning a diagnosis of Munchausen syndrome
No full textSearching for adherence in minor mental disorders: ethical warnings and clinical precations
No full textEvaluation of positive and negative symptoms in chronic schizophrenia: An interrelationship study among SANS/SAPS, PANSS and InSka rating scales
No full textAim. The aim of the study was to evaluate the degree of statistic correlation of some of the best known instruments used for the assessment of the positive and negative symptomatology of schizophrenic patients. Methods. The evaluation rating scales PANSS, SAPS/SANS and InSka in the Italian version have been used. The scales have been submitted, through the joined interview method, to 28 DSM-IV schizophrenic patients living in some community units of our department, with at least 5 year illness. We have used the scores resulting from the submission of each rating scale to get to the definition of the syndrome diagnosis following the rules stated by each author. We have then compared these diagnosis (syndromic diagnosis interrelation), the simple scores of each subscale (subscale interrelation) and the subscales of PANSS and SAPS/SANS for the structure correlation evaluation. Results. A substantial positive correlation among the tools used has been noticed. This correlation was higher for the negative syndrome diagnosis (Spearman's p=0.503; P<0.01) and for the correlation between the subscales evaluating the negative symptoms (Pearson's r=0.668; P<0.01). The correlation between very different instruments such as the scale of evaluation of the apathy syndrome and the scale of evaluation of the PANSS general psychophatology has proved statistically significant (Pearson's r=0.689; P<0.01). Conclusion. Even if based on a poor sample, the results seem to support the research hypothesis and to confirm the litterature data. On the basis of our experience we can confirm the validity of the support given by these instruments both in research and in clinical practice
Going Beyond Counting First Authors in Author Co-citation Analysis
No full textThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Variations on the Author
No full text“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
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