Virtual Kitchen Test. Assessing frontal lobe functions in patients with alcohol dependence syndrome

INTRODUCTION

This article is part of the Focus Theme of Methods of Information in Medicine on "New Methodologies for Patients Rehabilitation".

BACKGROUND

The ecological validity of paper-and-pencil neuropsychological tests is currently a matter of debate. Arguments in favor of alternatives indicate that paper-and-pencil forms are unable to account for both mental and functional aspects of cognitive functioning.

OBJECTIVES

In this study we developed a new neuropsychological evaluation test - the Virtual Kitchen Test (VKT) - devised to evaluate frontal brain functioning in cognitively impaired individuals. We designed this test according to the rationale of the Trail Making Test (TMT), in order to capture frontal lobe abilities during a more ecologically valid task.

METHODS

Forty-nine participants, 25 from a clinical sample of patients diagnosed with Alcohol Dependence Syndrome, plus 24 healthy participants.

RESULTS

Execution errors and task completion time were significantly higher in the clinical sample. Also, scores on the new VKT showed moderate to high positive correlations with scores on the TMT. Furthermore, the overall discriminant performance of the VKT was high for both of its indicators.

CONCLUSIONS

Overall results support the ability of the VKT to evaluate frontal lobe functions. The best cut-off scores based on this sample are discussed.

The "psychomicrobiotic": Targeting microbiota in major psychiatric disorders: A systematic review

The gut microbiota is increasingly considered as a symbiotic partner in the maintenance of good health. Metagenomic approaches could help to discover how the complex gut microbial ecosystem participates in the control of the host's brain development and function, and could be relevant for future therapeutic developments, such as probiotics, prebiotics and nutritional approaches for psychiatric disorders. Previous reviews focused on the effects of microbiota on the central nervous system in in vitro and animal studies. The aim of the present review is to synthetize the current data on the association between microbiota dysbiosis and onset and/or maintenance of major psychiatric disorders, and to explore potential therapeutic opportunities targeting microbiota dysbiosis in psychiatric patients.

Prevention of ventilator-associated pneumonia

Invasive mechanical ventilation (IMV) represents a risk factor for the development of ventilator-associated pneumonia (VAP), which develops at least 48h after admission in patients ventilated through tracheostomy or endotracheal intubation. VAP is the most frequent intensive-care-unit (ICU)-acquired infection among patients receiving IMV. It contributes to an increase in hospital mortality, duration of MV and ICU and length of hospital stay. Therefore, it worsens the condition of the critical patient and increases the total cost of hospitalization. The introduction of preventive measures has become imperative, to ensure control and to reduce the incidence of VAP. Preventive measures focus on modifiable risk factors, mediated by non-pharmacological and pharmacological evidence based strategies recommended by guidelines. These measures are intended to reduce the risk associated with endotracheal intubation and to prevent microaspiration of pathogens to the lower airways.

Effectiveness and tolerance of anti-inflammatory drugs' add-on therapy in major mental disorders: a systematic qualitative review

OBJECTIVE

To provide a systematic review of the literature regarding the efficacy of anti-inflammatory drugs in three major mental disorders [major depressive disorder (MDD), schizophrenia and bipolar disorders].

METHOD

Four databases were explored, without any year or language restrictions. The baseline search paradigm was limited to open-labelled clinical and randomized controlled trials (RCTs).

RESULTS

Four major classes of anti-inflammatory drugs were identified, namely polyunsaturated fatty acids (PUFAs), cyclooxygenase (COX) inhibitors, anti-TNFalpha and minocycline. Effectiveness and benefit/risk ratio of each class in MDD, bipolar disorders and schizophrenia was detailed when data were available. Several meta-analyses indicated effectiveness of PUFAs in MDD with a good tolerance profile. One meta-analysis indicated that COX-2 specific inhibitors showed effectiveness in schizophrenia. Anti-TNFalpha showed important effectiveness in resistant MDD with blood inflammatory abnormalities. Minocycline showed effectiveness in schizophrenia.

CONCLUSION

Polyunsaturated fatty acids seem to have the best benefit/risk ratio profile but proved their effectiveness only in MDD. A number of anti-inflammatory drugs are available as adjunct treatment for treatment-resistant patients with MDD, schizophrenia and bipolar disorder. If used with caution regarding their possible side-effects, they may be reasonable therapeutic alternatives for resistant symptomatology.

Système HLA et gènes de l’immunité dans le trouble bipolaire

Résumé non reçu.

MicroRNA profile: a promising ancillary tool for accurate renal cell tumour diagnosis

Background:

Renal cell tumours (RCTs) are clinically, morphologically and genetically heterogeneous. Accurate identification of renal cell carcinomas (RCCs) and its discrimination from normal tissue and benign tumours is mandatory. We, thus, aimed to define a panel of microRNAs that might aid in the diagnostic workup of RCTs.

Methods:

Fresh-frozen tissues from 120 RCTs (clear-cell RCC, papillary RCC, chromophobe RCC (chRCC) and oncocytomas: 30 cases each), 10 normal renal tissues and 60 cases of ex-vivo fine-needle aspiration biopsies from RCTs (15 of each subtype validation set) were collected. Expression levels of miR-21, miR-141, miR-155, miR-183 and miR-200b were assessed by quantitative reverse transcription–PCR. Receiver operator characteristic curves were constructed and the areas under the curve were calculated to assess diagnostic performance. Disease-specific survival curves and a Cox regression model comprising all significant variables were computed.

Results:

Renal cell tumours displayed significantly lower expression levels of miR-21, miR-141 and miR-200b compared with that of normal tissues, and expression levels of all miRs differed significantly between malignant and benign RCTs. Expression analysis of miR-141 or miR-200b accurately distinguished RCTs from normal renal tissues, oncocytoma from RCC and chRCC from oncocytoma. The diagnostic performance was confirmed in the validation set. Interestingly, miR-21, miR-141 and miR-155 expression levels showed prognostic significance in a univariate analysis.

Conclusion:

The miR-141 or miR-200b panel accurately distinguishes RCC from normal kidney and oncocytoma in tissue samples, discriminating from normal kidney and oncocytoma, whereas miR-21, miR-141 and miR-155 convey prognostic information. This approach is feasible in fine-needle aspiration biopsies and might provide an ancillary tool for routine diagnosis.

Substituição de monensina sódica por bicarbonato de sódio em dietas de novilhas confinadas

Avaliaram-se os efeitos da substituição da monensina sódica pelo bicarbonato de sódio em dietas de novilhas em confinamento em relação ao desempenho animal, à conversão alimentar e ao parâmetro de fermentação ruminal. Foram utilizadas 56 novilhas mestiças, confinadas por 112 dias, submetidas a dietas com duas porcentagens de concentrado, 50% e 80% da matéria seca, com adição de monensina sódica ou bicarbonato de sódio, em fatorial 2x2. O volumoso utilizado para compor as dietas testadas foi composto de silagem de milho e cana-de-açúcar na proporção de 60:40, respectivamente. O nitrogênio amoniacal foi maior nos animais alimentos com dietas com alto grão. A monensina, na dieta 80:20, proporcionou maiores valores de nitrogênio amoniacal, uma e nove horas após o consumo da ração. O uso de bicarbonato promoveu os maiores valores de pH ruminal na dieta com 50% de concentrado, de seis a 18 horas após o consumo. Não houve efeito do aditivo sobre o desempenho animal. A alta inclusão de grãos na dieta propiciou aumento do desempenho animal e da eficiência alimentar. Conclui-se que o uso de bicarbonato de sódio em dietas para terminação de animais em confinamento é uma opção viável em substituição à monensina sódica para a manipulação da fermentação ruminal.

Competing exchanges and spin-phonon coupling in Eu(1-x)R(x)MnO3 (R=Y, Lu)

This work is focused on the phase diagrams and physical properties of Y-doped and Lu-doped EuMnO3. The differences in the corresponding phase boundaries in the (x,T) phase diagram could be overcome by considering a scaling of the Y(3+) and Lu(3+) concentrations to the tolerance factor. This outcome evidences that the tolerance factor is in fact a more reliable representative of the lattice deformation induced by doping. The normalization of the phase boundaries using the tolerance factor corroborates previous theoretical outcomes regarding the key role of competitive FM and AFM exchanges in determining the phase diagrams of manganite perovskites. However, significant differences in the nature and number of phases at low temperatures and concentrations could not be explained by just considering the normalization to the tolerance factor. The vertical phase boundary observed just for Lu-doped EuMnO3, close to 10% Lu, is understood by considering a low temperature Peierls-type spin-phonon coupling, which stabilizes the AFM-4 phase in Lu-doped EuMnO3.

Cardiorespiratory fitness associates with metabolic risk independent of central adiposity

This study sought to analyze the associations between cardiorespiratory fitness (CRF), waist circumference (WC) and metabolic risk in children and adolescents. Participants were 633 subjects (58.7% girls) ages 10-18 years. Metabolic risk score (MRS) was calculated from HDL-cholesterol, triglycerides, fasting glucose and mean arterial pressure. MRS was dichotomized into low and high metabolic risk (HMRS). CRF was defined as the maximal oxygen uptake (VO₂max) estimated from the 20 m Shuttle Run Test. The first quartile of CRF was set as the low fitness group. The fourth quartile of WC was defined as high central adiposity. With adjustments for age, sex and WC, CRF was correlated with MRS (r=-0.095; p<0.05). WC was correlated with MRS (r=0.150; p<0.001) after adjustments for age, sex and CRF. Participants who had low fitness levels, presented higher levels of MRS (p<0.001) compared to those who were fit, even after adjustment for age, sex and WC. In comparison with subjects who were fit with normal central adiposity, an increased odds ratio (OR) for being at HMRS was found for participants who were of low fitness level with high central adiposity (OR=2.934; 95%CI= 1.690-5.092) and for those who were of low fitness with normal central adiposity (OR=2.234; 95%CI=1.116-4.279). Results suggest that CRF relates to MRS independently of central adiposity.

Lisina digestível em dietas de baixa proteína para frangos de corte tipo caipira de um aos 28 dias

Avaliou-se a inclusão de diferentes porcentagens de lisina digestível em dietas de baixa proteína para frangos de corte tipo caipira, machos e fêmeas, com idade entre um e 28 dias. Utilizaram-se 792 machos e 792 fêmeas de linhagem comercial, de um dia de idade, distribuídos em delineamento inteiramente ao acaso, em esquema fatorial 2x6 (sexo x porcentagem de lisina digestível: 0,85; 0,90; 0,95; 1,00; 1,05 e 1,10%) com seis repetições de 22 aves. Não foi constatada interação (P>0,05) de sexo versus inclusão de lisina. Observou-se superioridade (P<0,05) dos machos em relação às fêmeas para todas as variáveis avaliadas. O ganho de peso dos frangos diminuiu linearmente (P<0,05) em função do aumento da porcentagem de lisina digestível na dieta e observou-se redução linear (P<0,01) nos consumos de ração e de proteína. O consumo de lisina digestível aumentou linearmente (P<0,01) em função do aumento de sua concentração na dieta. Não houve diferença (P>0,05) para conversão alimentar. Da composição centesimal da carcaça, apenas o percentual de matéria mineral foi influenciada (P<0,05) pela porcentagem de lisina digestível. Conclui-se que 0,85% de lisina para frangos tipo caipira de pescoço pelado atende à exigência nutricional de lisina digestível em dietas com baixa concentração proteica.