Epidemiology and course of schizophrenia

Author(s):  
Assen Jablensky

Epidemiological research into schizophrenia has a long and productive history over many decades, since the formulation of the disease concept by Emil Kraepelin in 1896. As a critical counterpart to clinical and biological research, its focus is on the population frequency and distribution of incidence, prevalence, course, and outcome, and the associated risk factors. This chapter presents an overview of the historical landmarks of the epidemiology of schizophrenia, its progress over the years, and the state of current knowledge. It highlights the challenges for its future directions of this research, including the question of whether primary or secondary prevention of the disorder will eventually be possible. The unprecedented growth of basic knowledge about the brain and the human genome opens up novel perspectives in the study of complex disorders, such as schizophrenia, which integrate concepts and tools of genetics, neuroscience, and epidemiology.

Author(s):  
Kristel K. Leung ◽  
Maya Deeb ◽  
Sandra E. Fischer ◽  
Aliya Gulamhusein

AbstractPatients with primary sclerosing cholangitis (PSC) constitute 5 to 15% of patients listed for liver transplantation worldwide. Although post-transplant outcomes are favorable, recurrent PSC (rPSC) occurs in an important subset of patients, with higher prevalence rates reported with increasing time from transplant. Given its association with poor graft outcomes and risk of retransplant, effort has been made to understand rPSC, its pathophysiology, and risk factors. This review covers these facets of rPSC and focuses on implicated risk factors including pretransplant recipient characteristics, inflammatory bowel-disease-related factors, and donor-specific and transplant-specific factors. Confirming a diagnosis of rPSC requires thoughtful consideration of alternative etiologies so as to ensure confidence in diagnosis, management, subsequent risk assessment, and counseling for patients. Unfortunately, no cure exists for rPSC; however, future large-scale efforts are underway to better characterize the natural history of rPSC and its associated risk factors with hopes of identifying potential key targets for novel therapies.


2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Annalisa Scimemi

Two decades into the two thousands, intracerebral hemorrhagic stroke (ICH) continues to reap lives across the globe. In the US, nearly 12,000 people suffer from ICH every year. Half of them survive, but many are left with permanent physical and cognitive disabilities, the severity of which depends on the location and broadness of the brain region affected by the hemorrhage. The ongoing efforts to identify risk factors for hemorrhagic stroke have been instrumental for the development of new medical practices to prevent, aid the recovery and reduce the risk of recurring ICH. Recent efforts approach the study of ICH from a different angle, providing information on how we can limit brain damage by manipulating astrocyte receptors. These results provide a novel understanding of how astrocytes contribute to brain injury and recovery from small ICH. Here, we discuss current knowledge on the risk factors and molecular pathology of ICH and the functional properties of astrocytes and their role in ICH. Last, we discuss candidate astrocyte receptors that may prove to be valuable therapeutic targets to treat ICH. Together, these findings provide basic and clinical scientists useful information for the future development of strategies to improve the detection of small ICH, limit brain damage, and prevent the onset of more severe episodes of brain hemorrhage.


2021 ◽  
Vol 22 (23) ◽  
pp. 12795
Author(s):  
Wojciech Grodzicki ◽  
Katarzyna Dziendzikowska ◽  
Joanna Gromadzka-Ostrowska ◽  
Marcin Kruszewski

The widespread usage of plastic places a significant burden on the environment and impacts numerous aquatic and terrestrial species. Humans in particular can be affected by plastic pollution, predominantly via inhalation and ingestion, as well as trophic transfer along the food chain. Under natural conditions synthetic materials undergo degradation into micro- and nanoparticles, especially prone to interact with biological systems. Organisms exposed to nanoplastic accumulate it in multiple tissues, including the gut and the brain. This phenomenon raises a question about the impact of nanoparticulate plastics on the communication pathways between these organs. The aim of this review is to explore an unsettling possibility of the influence of nanoplastic on the gut-brain axis and provide a comprehensive summary of available data regarding this subject. The scarce but consistent evidence shows that exposure to plastic nanoparticles can indeed affect both the digestive and the nervous system. Reported outcomes include microbiota alterations, intestinal barrier permeability, oxidative stress, inflammation, neurotoxicity and behavioral disturbances. Taking into consideration these alarming observations and the ubiquitous presence of plastics in human environment, more research is urgently needed in order to identify any potential threats that nanoplastic exposure can pose to the functioning of the gut-brain axis.


Author(s):  
Berhane Worku ◽  
Leonard Girardi

Thoracic aortic disease most commonly presents in the form of aneurysmal dilation or dissection of the ascending or descending thoracic aorta, most commonly secondary to degenerative disease and hypertension. Several genetic connective tissue disorders are commonly associated as well. Treatment is focused on blood pressure control and surgical repair. Surgical repair of thoracic aortic disease presents unique risks, including neurologic injury involving the brain or spinal cord, and several adjuncts are available to mitigate against this risk. This chapter discusses commonly associated risk factors, preoperative testing, surgical repair, and postoperative management of thoracic aortic disease along with strategies for minimizing neurologic injury.


2018 ◽  
Vol 34 (6) ◽  
pp. 490-494
Author(s):  
Rymma Dudar

Sonographic evaluation is the gold standard in diagnosing of testicular microlithiasis, the nature of which has raised controversy in opinions regarding its premalignant or benign tendency. Testicular microlithiasis is often an incidental finding on sonographic examination with indications for other disease processes, and it may or may not require additional follow-up. This pathology has raised equal interest among domestic and foreign researchers, and studies have been performed on both adult and pediatric populations, yet there is no standard recommendation for follow-up care of testicular microlithiasis. Isolated testicular microlithiasis and that with additional risk factors may require different approaches to testing and care. In this publication, a case study is reviewed and two approaches to follow-up care of testicular microlithiasis based on the associated risk factors or a lack of thereof are discussed.


1960 ◽  
Vol 106 (443) ◽  
pp. 531-536 ◽  
Author(s):  
J. R. Smythies ◽  
C. K. Levy

There are, in the main, two principal methods of biological research into the problem of causation of schizophrenia. In the first, or direct method, studies are made of the body fluids and of the metabolism of schizophrenics in the hope of turning up some toxic factor or error of metabolism. Such studies are currently under way in a number of centres and, although many claims as to positive findings have been made, none of these has as yet been substantiated and the majority have actually been refuted by subsequent analysis. These studies have been directed by two main hypotheses of the causation of the illness described in a previous communication (14). Now it is clear that one great difficulty entailed in using this approach is that our basic knowledge of neuro-chemistry and neuropharmacology is still extremely limited. The very complexity of the neurochemical processes of the brain would seem to offer a large number of possible loci of metabolic disturbance, any of which might be responsible for the onset of schizophrenia. Thus, we can say that the probable results of all such investigations at present will be purely negative, i.e. we will discover that the given metabolism of injected adrenaline, serotonin, etc., is normal in the illness. Thus, the second, or indirect, method becomes increasingly important. This consists of two parts. The first is implied merely by the general statement that the advance of neurochemistry and neuropharmacology may disclose other areas of function in which specific hypotheses of the causation of the illness may be constructed. The second consists of a detailed study of the precise mode of action of known psychotomimetic agents. Knowledge of the mode of action of mescaline and LSD-25 in detail would pinpoint areas for research in the metabolism of schizophrenics. Unfortunately, however, very little seems to be known at present of the mode of action of these drugs. Most of the work that has been done has been carried out on LSD-25 (see e.g. the annotated bibliography put out by Sandoz Inc., Hanover, New Jersey, 1958). However, the important field of the structure-activity relationships (SAR) of mescaline seems to have been strangely neglected. The research programme here would include the synthesis of a number of analogues of mescaline according to systematic principles to determine the role the details of its molecular structure play in the mode of action. These analogues would be subjected to a number of tests—psychopharmacological, neurophysiological and neurochemical—comparison between the results of which would give important information not only of the SAR of mescaline but also of the details of its mode of action and the interrelationships between behavioural, neurophysiological and neurochemical factors involved that would help us explain the former effects in terms of the latter, which reduction is the main aim of biological science. The present paper reviews the little that is known at present about the SAR of mescaline and then reports some new studies in the psychopharmacology of this field.


Author(s):  
Berhane Worku ◽  
Leonard Girardi

Thoracic aortic disease most commonly presents in the form of aneurysmal dilation or dissection of the ascending or descending thoracic aorta, most commonly secondary to degenerative disease and hypertension. Several genetic connective tissue disorders are commonly associated as well. Treatment is focused on blood pressure control and surgical repair. Surgical repair of thoracic aortic disease presents unique risks, including neurologic injury involving the brain or spinal cord, and several adjuncts are available to mitigate against this risk. This chapter discusses commonly associated risk factors, preoperative testing, surgical repair, and postoperative management of thoracic aortic disease along with strategies for minimizing neurologic injury.


2018 ◽  
Vol 9 (1) ◽  
pp. 17-22
Author(s):  
Konstantin A. Shemerovskii ◽  
Petr D. Shabanov ◽  
Vladimir Ph. Mitreikin ◽  
Pavel V. Seliverstov ◽  
Andrei Yu. Iurov

The major advantages of primary prevention of colorectal cancer in young adults (around 20 years) compared with se condary prevention in adults (after 50 years). Primary prevention is aimed at screening and eliminating one of the major proven risk factors for colon cancer – chronic constipation and its predecessor – colorectal bradyarrhythmia – as slower circadian rhythm of defecation. The main advantages of primary prevention of colorectal cancer are: non-invasiveness, safety, efficiency and timeliness. Screening of colorectal bradyarrhythmia at 2501 operating physician is allowed to diagnose this arrhythmia in 44% of the surveyed entities. There is discovered the new fundamental dependence between the regularity of circadian rhythm of defecation and an acrophase of this rhythm. The implementation of the morning acrophase of the circadian rhythm of defecation is the key mechanism of the regularity of this rhythm. Repeated screening of colorectal bradyarrhythmia in individuals around the age of 20 years (a month after informing students about the law of circadian rhythm in the brain and intestine) showed that 53% of the students began to observe the morning routine of bowel movements. This led to a transition of moderate stage of colorectal bradyarrhythmia severity (3-4 times a week) in an easy stage (5-6 times a week). It’s proved the possibility of primary (behavioral) prevention of colorectal bradyarrhythmia (colorectal coprostasis) as a risk factor for colorectal cancer. Secondary prevention of colon cancer is associated with the invasiveness of colonoscopy, its possible complications (bleeding, perforation of bowel and fatal outcomes), the high cost of special equipment and late in the approach to screening for colorectal cancer (after the appearance of blood in the stool or after 50 years).


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