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BackgroundThis analysis evaluated potential differences in subjective well-being (SW) among patients with early-phase schizophrenia (SZ) randomized to treatment with either long-acting injectable (LAI) or oral aripiprazole or paliperidone within the “European Long-acting Antipsychotics in Schizophrenia Trial” (EULAST).MethodsA total of 478 patients were followed for up to 19 months. SW was measured using the Subjective Well-being under Neuroleptic Treatment scale (SWN). Linear mixed-effects models assessed treatment differences. Comprehensive analyses included age, sex, symptomatology (Positive and Negative Syndrome Scale [PANSS]), and side effects (Systematic Monitoring of Adverse Events Related to Treatments [SMARTS] and St. Hans rating scale [SHRS] for extrapyramidal syndromes) on SWN changes.ResultsOverall, SW improved over the course of the study. No significant differences emerged between LAI and oral administration (p = 0.1533) or between aripiprazole and paliperidone (p = 0.2008). Similarly, age and sex were not relevant in this regard. In contrast, negative, positive, and affective symptoms (all p < 0.0001) as well as the overall side effect burden (SMARTS sum-score, p < 0.0001) showed significant inverse associations with SW. Certain SHRS subscales correlated with SW in partial models, but associations disappeared in the fully adjusted model.ConclusionsPatients with SZ initiating LAI or oral treatment with aripiprazole or paliperidone reported comparable SW improvements. Findings emphasize that treatment choice should be guided less by formulation or substance and more by individual patient needs, prioritizing symptom control while minimizing adverse effects. A patient-centered approach remains essential to optimize both clinical outcomes and subjective well-being in early-phase SZ.

BackgroundQuality of life (QOL) is seen as a key outcome variable in schizophrenia. Factors deemed relevant in this context include the severity of symptoms and internalized Stigma.MethodsPatients with schizophrenia (ICD-10) between the ages of 18 and 65 from outpatient mental health services were included into a cross-sectional study. Apart from the registration of demographic data, various rating scales were used: the Positive and Negative Syndrome Scale (PANSS), the Internalized Stigma of Mental Illness (ISMI) Scale, and the German version of the Lancashire Quality of Life Profile, the Berliner Lebensqualitätsprofil (BELP).Results80 patients (47 males, 33 females) with a mean age of 43.0 ± 10.9 years took part in this study. The mean PANSS total score was 71.1 ±25.4, the mean ISMI score was 61.1 ± 14.7 (range: 29–116), and the BELP subscale overall QoL showed a mean score of 4.73 ± 1.17 (range 1–7). Statistical analysis showed a moderate correlation between QoL and internalized stigma (r=-0.468, correlation with general life satisfaction) and a weak correlation with the PANSS total score (r=-0.246, correlation with general life satisfaction). Internalized stigma but not residual symptoms of the disorder negatively predicted QoLDiscussionOur results highlight the complex nature of QoL in individuals suffering from schizophrenia and indicate that outpatients’ quality of life correlates moderately with internalized stigma, whereas residual symptoms of the disorder play a secondary role. Accordingly, psychotherapeutic approaches should be applied to reduce internalized stigma, and, ultimately, to improve quality of life.

Iron deposition in the substantia nigra has been implicated in Parkinson’s disease. Chelation with deferiprone reduced brain iron content but led to worse scores on scales of the movement disorder at 36 weeks.

Short-term thrombotic occlusion and compliance mismatch hamper clinical use of synthetic small-diameter tissue engineered vascular grafts. It is felt that preconditioning of the graft with intimal (endothelial) and medial (vascular smooth muscle) cells contributes to patency of the graft. Autologous, non-vessel-derived cells are preferred because of systemic vascular pathology and immunologic concerns. We tested in a porcine model whether cultured bone marrow–derived mononuclear cells, also referred to as mesenchymal stem cells (MSC), are a potential source of intimal or medial cells in vascular tissue engineering. We show that MSC cultured in endothelial medium do not gain an endothelial phenotype or functional characteristics, even after enrichment for CD31, culturing under flow, treatment with additional growth factors (vascular endothelial growth factor (VEGF), fibroblast growth factor (FGF)-2), or co-culture with microvascular endothelial cells (EC). On the other hand, we show that MSC cultured in MSC medium, but not in smooth muscle cell medium, show phenotypical and functional characteristics of vascular smooth muscle cells. We conclude that bone marrow-derived MSCs can be used as a bona fide source of medial, but not EC in small-diameter vascular tissue engineering.