Objectives: To determine the prevalence and correlates of treatment-resistant schizophrenia (TRS) through a systematic review and meta-analysis. Methods: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, an electronic search was performed in PubMed and Embase through May 17, 2022. All study designs that assessed a minimum of 20 schizophrenia-spectrum patients and provided data on TRS prevalence or allowed its calculation were included. Estimates were produced using a random-effects model meta-analysis. Results: The TRS prevalence across 50 studies (n = 29,390) was 36.7% (95%CI 33.1-40.5, p < 0.0001). The prevalence ranged from 22% (95%CI 18.4-25.8) in first-episode to 39.5% (95%CI 32.2-47.0) in multiple-episode samples (Q = 18.27, p < 0.0001). Primary treatment resistance, defined as no response from the first episode, was 23.6% (95%CI 20.5-26.8) vs. 9.3% (95%CI 6.8-12.2) for later-onset/secondary (≥ 6 months after initial treatment response). Longer illness duration and recruitment from long-term hospitals or clozapine clinics were associated with higher prevalence estimates. In meta-regression analyses, older age and poor functioning predicted greater TRS. When including only studies with lower bias risk, the TRS prevalence was 28.4%. Conclusion: Different study designs and recruitment strategies accounted for most of the observed heterogeneity in TRS prevalence rates. The results point to early-onset and later-onset TRS as two separate disease pathways requiring clinical attention. Registration number: PROSPERO CRD42018092033.

Resumen Reportamos el primer caso de depredación de la Culebra Ojo de Gato (Leptodeira polysticta) por la Tarántula Veracruzana (Tliltocatl kahlenbergi) en el bosque tropical de la región de los Tuxtlas, Veracruz, México. La documentación de este evento proporciona una interacción ecológica para L. polysticta, lo cual contribuye al conocimiento de la red trófica en este ecosistema a través de la documentación de historia natural.

Abstract We report the first case of predation of the Small-spotted Cat-eyed Snake (Leptodeira polysticta) by the Veracruzan Tarantula (Tliltocatl kahlenbergi) in the tropical forest of the Tuxtlas region, Veracruz, Mexico. The documentation of this event provides an ecological interaction for L. polysticta, which provides insights on knowledge of the food web in this ecosystem through natural history documentation.

Objective: German psychiatrist Kurt Schneider proposed the concept of first-rank symptoms (FRS) of schizophrenia in 1959. However, their relevance for diagnosis and prediction of treatment response are still unclear. Most studies have investigated FRS in chronic or medicated patients. The present study sought to evaluate whether FRS predict remission, response, or improvement in functionality in antipsychotic-naive first-episode psychosis. Methods: Follow-up study of 100 patients at first episode of psychosis (FEP), with no previous treatment, assessed at baseline and after 2 months of treatment. The participants were evaluated with the standardized Positive and Negative Syndrome Scale (PANSS) and Global Assessment of Functioning (GAF) and for presence of FRS. Results: Logistic regression analysis showed that, in this sample, up to three individual FRS predicted remission: voices arguing, voices commenting on one’s actions, and thought broadcasting. Conclusion: Specific FRS may predict remission after treatment in FEP patients. This finding could give new importance to Kurt Schneider’s classic work by contributing to future updates of diagnostic protocols and improving estimation of prognosis.

Objectives: The Positive and Negative Syndrome Scale (PANSS) was developed to assess the symptoms of schizophrenia dimensionally. Although it is widely used in clinical trials in Brazil, it is not fully validated. The aim of this study is to assess the factor structure of the Brazilian PANSS and generate validation data for its current version. Methods: A total of 292 patients diagnosed with schizophrenia were enrolled. Results: Principal component analysis suggested a forced five-factor final model that accounted for 58.44% of the total variance, composed of negative, disorganization/cognition, excitement, positive, and depression/anxiety. Conclusion: The Brazilian PANSS has a similar factor structure and internal consistency compared to its other country versions.

Objective: To investigate whether inpatients with disorganized schizophrenia are more resistant to treatment. Method: Eighty-five inpatients were assessed at admission and at discharge for schizophrenia subtype, symptom severity, and treatment resistance criteria. Results: Disorganized patients were significantly more treatment-resistant than paranoid patients (60%, p = 0.001), and presented worse scores on the Positive and Negative Syndrome Scale (PANSS), the Clinical Global Impression Scale (CGI-S), and the Global Assessment of Functioning Scale (GAF) (p < 0.001). Although the difference was not significant, 80% of treatment-resistant patients with disorganized schizophrenia responded to clozapine. Conclusion: Patients with the disorganized subtype of schizophrenia should benefit from clozapine as a second-line agent.

Chemical recycling can turn plastic wastes into a potential source of valuable organic chemicals. This work studied the depolymerization of three plastics commonly found in plastic waste: poly (ethylene terephthalate), polycarbonate and Nylon-6, a polyamide. Different reaction conditions were evaluated for each type of polymer. For each plastic, the yield was determined and the product was characterized by spectroscopic techniques. Good yields of bis (2-hydroxyethylene) terephthalate were obtained after treating PET with conventional and microwave heating. 90% of bisphenol-A was obtained from polycarbonate waste, while 80% of ε-caprolactam was formed from Nylon-6. These results show that plastic wastes can become an interesting source of chemicals.

Mediante el reciclaje químico, los desechos plásticos son una potencial fuente de materia prima de compuestos orgánicos valiosos. En este trabajo se ha estudiado la despolimerización de tres plásticos comúnmente presentes en desechos domésticos: el poli (tereftalato de etileno), el policarbonato y la poliamida Nylon-6. Para cada tipo de polímero se estudió las condiciones para su despolimerización y se cuantificó e identificó el monómero formado utilizando técnicas espectroscópicas. En el caso del PET, se obtuvo el tereftalato de bis (2hidroxietileno), utilizando el calentamiento convencional o microondas. Del policarbonato se obtuvo el bisfenol-A con un rendimiento del 90% y la ε-caprolactama se obtuvo del nylon-6 con un 80% de rendimiento. Los resultados obtenidos demuestran que los desechos plαsticos son una potencial fuente de materia prima.

OBJETIVOS: Avaliar diferentes estudos que analisam o grau de eficácia da resposta antidepressiva entre a associação de estimulação magnética transcraniana de repetição (EMTr) com antidepressivos em pacientes deprimidos graves. MÉTODOS: Os autores revisaram vários estudos em que a EMTr foi usada concomitantemente a antidepressivos em pacientes deprimidos graves. Adicionalmente, relatou-se um estudo feito no Instituto de Psiquiatria do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo. Estudo duplo-cego, randomizado, unicêntrico, placebo-controlado com 46 pacientes atendendo aos critérios diagnósticos da DSM-IV para episódio depressivo severo. Os pacientes estavam em uso de amitriptilina. RESULTADOS: De forma geral, a maioria dos estudos mostra que a EMTr apresenta boa eficácia antidepressiva quando associada a antidepressivos. Há grande diversidade de parâmetros técnicos utilizados, tipos de bobina, diferentes técnicas de placebo e uso de diferentes antidepressivos. O estudo realizado no Instituto de Psiquiatria mostrou que o emprego da EMTr de alta freqüência aumentou a resposta antidepressiva à amitriptilina e diminuiu o tempo para o início da resposta antidepressiva em relação ao grupo placebo. CONCLUSÕES: EMTr é um método novo, promissor e com grande potencial para o tratamento da depressão. Apesar disso, observa-se que não há ainda uniformidade no emprego dos parâmetros técnicos, nem tampouco das técnicas de placebo. O estudo realizado no Instituto de Psiquiatria do HC- FMUSP mostrou grandes taxas de resposta e remissão em relação ao grupo com estimulação sham e amitriptilna.

OBJECTIVE: Transcranial magnetic stimulation has been developed as a noninvasive method to stimulate the cortex, and the treatment of depression is one of its potential therapeutic applications. This report makes a review about add-on trials (hf-rTMS plus antidepressants) discuss whether rTMS does accelerate the onset of action, and increase the therapeutic effects of antidepressants. METHOD: The authors review controlled studies of nonconvulsive rTMS therapy for depression associated with antidepressants. In addition, the authors presented a randomized, double-blind, unicentric trial performed at Institute of Psychiatry of Faculty of Medicine of University of São Paulo with patients meeting DSM-IV criteria for non-psychotic severe depressive episode in order to assess if hf-rTMS augments and accelerates the onset of action of amytriptiline. RESULTS: Most data support an antidepressant effect of high-frequency repetitive TMS administered to the left prefrontal cortex. The absence of psychosis might predict treatment success. Technical parameters possibly affecting treatment success include intensity and duration of treatment, but these suggestions require systematic testing. CONCLUSIONS: rTMS shows promise as a novel antidepressant treatment. Systematic and large-scale studies are needed to identify patient populations most likely to benefit and treatment parameters most likely to produce success. In addition to its potential clinical role, TMS promises to provide insights into the pathophysiology of depression through research designs in which the ability of rTMS to alter brain activity is coupled with functional neuroimaging.