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1. Electroretinographic dysfunction, insulin resistance, and childhood trauma in early-course psychosis: A case-control exploratory study

Author

Erik Velez-Perez, Nicolas Raymond, Chelsea Kiely, Willa Molho, Rebekah Trotti, Caroline Harris, Deepthi Bannai, Rachal Hegde, Sarah Herold, Matcheri Keshavan, Steven Silverstein, and Paulo Lizano

Subjects
Early-course psychosis, Retinal dysfunction, Flash electroretinography, Insulin resistance, Childhood trauma, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

Background: Electroretinographic dysfunction is observed in psychosis, with a-wave and b-wave amplitudes potentially serving as biomarkers. Insulin resistance (IR) and childhood trauma (CT) have also been associated with psychosis-spectrum disorders, particularly schizophrenia. Electroretinographic dysfunction in early-course psychosis (EP) lacks exploration. This case-control exploratory study aimed to understand electroretinographic dysfunction in EP and its relationship with IR and CT. Methods: The study involved healthy controls (n=13) and EP individuals (n=14) and included photopic and scotopic flash-electroretinography (fERG), blood collection for IR assessment, and the Childhood Trauma Questionnaire (CTQ). Data were analyzed using SPSS v.29.0. Case-control differences across fERG conditions were explored using repeated-measures ANCOVA (3 flash conditions X 2 groups) adjusted for gender and age. Sub-analyses included Fisher’s, Mann-Whitney, partial correlations, and logistic and linear regressions. Results: Compared to controls, EP participants showed (1) lower photopic a-wave and b-wave amplitudes, specifically in the left eye and under the P1 condition, (2) greater odds for IR, and (3) higher CTQ scores. IR was associated with a higher CTQ score and a lower P2b amplitude. A higher CTQ score was associated with lower P2b amplitude in the left eye when adjusting for its interacting effect with IR. Conclusion: These findings suggest lower photopic a-wave and b-wave amplitudes, IR, and CT are explanatory markers in EP. CT may dysregulate the hypothalamic-pituitary-adrenal axis, increasing the risk of experiencing later-life psychosis. IR might be a biomarker in psychosis, contributing to electroretinographic dysfunction and neurodegeneration of cone post-synaptic cells. Further investigations are needed.

Published
2024
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2. Complications After Arthroscopic Knee Surgery

Author

Christopher D. Harner, James J. Irrgang, Sarah Herold, Chealon D. Miller, Matthew J. Salzler, and Albert Lin

Subjects
Male, medicine.medical_specialty, Certification, Knee Joint, Sports medicine, Anterior cruciate ligament reconstruction, medicine.medical_treatment, Chondroplasty, Physical Therapy, Sports Therapy and Rehabilitation, Knee Injuries, Sports Medicine, Arthroscopy, Humans, Medicine, Orthopedic Procedures, Orthopedics and Sports Medicine, business.industry, Posterior Cruciate Ligament Reconstruction, Evidence-based medicine, United States, Surgery, Cross-Sectional Studies, Knee surgery, Orthopedic surgery, Female, business, Complication
Abstract

Background: Knee arthroscopies are among the most common procedures performed by orthopaedic surgeons, yet little is known about the associated complications and complication rates. Purpose: To examine the nature and frequency of complications after the most common arthroscopic knee procedures, with particular attention to fellowship training, geographic location of practice, and age and sex of the patient. Study Design: Cross-sectional study; Level of evidence, 3. Methods: Data were obtained from the American Board of Orthopaedic Surgery database for orthopaedic surgeons who sat for the part II examination from 2003 to 2009. The database was queried to determine the type and frequency of complications for patients who underwent knee arthroscopy and for those who underwent sports medicine knee arthroscopy, including arthroscopic partial meniscectomy, meniscal repair, chondroplasty, microfracture, anterior cruciate ligament reconstruction, or posterior cruciate ligament reconstruction. Factors affecting complication rates that were investigated included type of procedure, fellowship training status, geographic location of practice, and age and sex of the patient. Results: There were 4305 complications out of 92,565 knee arthroscopic procedures obtained from the American Board of Orthopaedic Surgery database for an overall candidate-reported complication rate of 4.7%. The complication rates were highest for posterior cruciate ligament reconstruction (20.1%) and anterior cruciate ligament reconstruction (9.0%); complication rates for meniscectomy, meniscal repair, and chondroplasty were 2.8%, 7.6%, and 3.6%, respectively. The complication rate for sports fellowship–trained candidates was higher than for non–sports trained candidates (5.1% sports, 4.1% no sports; P < .0001) and for male patients (4.9% male vs 4.3% female; P < .0001). Younger patients (Conclusion: The overall self-reported complication rate for arthroscopic knee procedures was 4.7%. Knee arthroscopy is not a benign procedure, and patients should be aware of the risk of complications.

Published
2013
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3. Hepatitis C Virus and Schizophrenia: Expanding the Role of the Community Psychiatrist

Author

Oliver Freudenreich and Sarah Herold

Subjects
Male, medicine.medical_specialty, Nurses, Community Health, Antiviral Agents, 03 medical and health sciences, 0302 clinical medicine, Arts and Humanities (miscellaneous), Medicine, Humans, General hospital, Psychiatry, Community Psychiatry, Physician's Role, Clozapine, Applied Psychology, Fluorenes, business.industry, Medical school, Disease Management, Hepatitis C, Chronic, Middle Aged, Mental health, 030227 psychiatry, Psychiatry and Mental health, Schizophrenia, 030211 gastroenterology & hepatology, Benzimidazoles, Sofosbuvir, business, Uridine Monophosphate, Delivery of Health Care, Antipsychotic Agents
Abstract

Received March 30, 2016; revised May 17, 2016; accepted May 20, 2016. From Department of Psychiatry, Massachusetts General Hospital, Boston, MA (SH, OF); Erich LindemannMental Health Center, Boston, MA (SH, OF); Harvard Medical School, Boston, MA (OF). Send correspondence and reprint requests to Sarah Herold, M.D., Erich Lindemann Mental Health Center, 25 Staniford St, Boston, MA 02114; e-mail: sherold@partners.org & 2016TheAcademy of PsychosomaticMedicine. Published by Elsevier Inc. All rights reserved. Introduction

Published
2016

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