MARIO RODRIGUES LOUZA NETO
Projetos de Pesquisa
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Instituto Central, Hospital das Clínicas, Faculdade de Medicina
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article 0 Citação(ões) na Scopus Registro Electrónico de Adherencia al Tratamiento de Esquizofrenia en Latinoamérica (e-STAR): Resultados clínicos del uso de risperidona inyectable de liberación prolongada a dos años de seguimiento(2013) APIQUIAN, Rogelio; CORDOBA, Rodrigo; LOUZA, Mario; FRESAN, AnaSchizophrenia is a chronic psychiatric disorder associated to high healthcare costs mainly driven by inpatient care. Lack of adherence to antipsychotic treatment is a common reason for relapse and rehospitalization leading to poor prognosis and global functional impairment of patients. Risperidone long-acting injection (RLAI) has demonstrated its efficacy in treating symptoms of schizophrenia and offers the potential to improve adherence to treatment. Objective To determine clinical and functional efficacy of RLAI and use of health resources (eg., hospitalizations in a 2-year follow up study among patients with schizophrenia from Latin America. Method The electronic Schizophrenia Treatment Adherence Registry (e-STAR) is an Observational study of patients who start treatment with RLAI. Data from patients recruited in Mexico, Colombia and Brazil were collected retrospectively for one year prior to baseline; at baseline and every three months for 24 Months. Hospitalization rates and treatment regime were registered. Efficacy was assessed using the Clinical Global Impression of Illness-Severity Scale (CGI-S), while the Global Assessment of Functioning (GAF) and the Personal and Social Performance (PSP) were used for the evaluation of functioning. Results Seventy-three patients completed the two-year follow-up. The proportion of patients hospitalized declined from 16.4% before treatment to after 2 years of treatment with RLAI. Only 2.7% discontinued the treatment due to lack of efficacy. Significant improvements were reported in illness severity as well-as in global functioning assessed by the CGI.S; GAF and PSP scales, respectively. Discussion Our results give further support of the efficacy of RLAI for the treatment of schizophrenia. Additional to symptom severity reduction and functional recovery, improved treatment adherence and reduced hospitalization rates were observed with the use of RLAI. In a real world clinical setting, RLAI offer an effective long-term treatment for patients with schizophrenia, with a lower use of healthcare resources.- THE KUMON METHOD FOR COGNITIVE REMEDIATION OF INDIVIDUALS WITH SCHIZOPHRENIA: A RANDOMIZED, PLACEBO-CONTROLLED TRIAL(2014) CRIVELARO, Marisa M.; MARTINS, Paula; MUSSKOPFT, Monia; AYUSO, Suely; ARCURY, Silvia; MARTINS, Paula; CELIDONIO, Zilda; BERTINHO, Rosa; LOUZA, Mario
- ANDES NETWORK - STUDYING EARLY PSYCHOSIS IN LATIN AMERICA(2019) CROSSLEY, Nicolas; GUINJOAN, Salvador; RIVERA, Guillermo; JACKOWSKI, Andrea; GADELHA, Ary; ELKIS, Helio; LOUZA, Mario; GAMA, Clarissa; EVANS-LACKO, Sara; CASTANEDA, Carmen Paz; UNDURRAGA, Eduardo; CORDOBA, Rodrigo; LOPEZ-JARAMILLO, Carlos; FUENTE-SANDOVAL, Camilo de la; BRESSAN, Rodrigo
- Lack of Association Between a 3 ' UTR VNTR Polymorphism of Dopamine Transporter Gene (SLC6A3) and ADHD in a Brazilian Sample of Adult Patients(2011) SILVA, Maria Aparecida da; CORDEIRO, Quirino; LOUZA, Mario; VALLADA, HomeroObjective: To investigate a possible association between a 3'UTR VNTR polymorphism of the dopamine transporter gene (SLC6A3) and ADHD in a Brazilian sample of adult patients. Method: Study Case-control with 102 ADHD adult outpatients (DSM-IV criteria) and 479 healthy controls. The primers' sequence used were: 3'UTR-Forward: 5'TGT GGT GAT GGG AAC GGC CTG AG 3' and 3'UTR-Reverse: 5'CTT CCT GGA GGT CAC GGC TCA AGG 3'. Alleles of the 3'UTR were coded according to their number of repeats: 6- repeat 320 bp (allele 6), 8- repeat 400 bp (allele 8), 9-repeat 480 bp (allele 9), 10- repeat 480 bp (allele 10), and 11- repeat 520 bp (allele 11). Results: There were no allelic (chi(2) = 2.67, 5df, p = .75) and genotypic (chi(2) = 7.20, 1df, p = .61) association between adult ADHD and VNTR 3'UTR polymorphism of SLC6A3. Conclusion: Our findings do not support SLC6A3 as marker genetic susceptibility factor in adult ADHD. More comprehensive polymorphism coverage within the SLC6A3 region should be conducted in larger samples, including comparisons in clinical subgroups, and in samples with different ethnic backgrounds. (J. of Att. Dis. 2011; 15(4) 305-309)
- Treatment of Patients with Recently Exacerbated Schizophrenia with Paliperidone Palmitate: A Pilot Study of Efficacy and Tolerability(2020) GATTAZ, Wagner F.; SARACCO-ALVAREZ, Ricardo; DALTIO, Claudiane Salles; BILT, Martinus T. Van de; ORTEGON, Jose Julian; VILLASENOR-BAYARDO, Sergio J.; LOUZA, Mario; ELKIS, Helio; SOARES, Bernardo; JARAMILLO, Patricia Cabrera; LAWSON, Fabio; DIAZ-GALVIS, LeonardoBackground: Paliperidone palmitate is a long-acting, second-generation antipsychotic (SGA) indicated for the treatment of acute exacerbations and maintenance treatment of adults with schizophrenia. This study addressed the response to paliperidone palmitate in Latin American patients with acute symptoms and recently diagnosed schizophrenia. Objective: Explore the efficacy and tolerability of paliperidone palmitate administered once a month for 4 months in patients with acute phase and recent diagnosis (within 1-6 years) of schizophrenia in 3 Latin American countries. Methods: This was a non-randomized, open-label, multicenter study with paliperidone palmitate injected intramuscularly in the deltoid muscle at an initial loading dose of 150 mg eq. (234 mg) on day 1 and 100 mg eq. (156 mg) on day 8 (+/- 4 days). The recommended maintenance dose was 75 mg eq. (117 mg) from day 36 to day 92. Efficacy was evaluated with PANSS and CGI-S. The last observation carried forward (LOCF) was used for efficacy analysis for imputation of missing data; no adjustments were made for multiplicity. Adverse events were evaluated during treatment. Results: The patient retention rate was 84.0% (144 patients received study drug; 121 finished the study). The percentage of patients with a reduction of at least 30% in PANSS total score compared to baseline gradually increased during the study, and at the end, 78.4% of patients showed response. The PANSS total score and CGI-S scores decreased significantly from baseline to LOCF endpoint (P <0.0001 for both); significant reduction in PANSS total score was observed at day 8 and persisted to the end of the study. Most common adverse events were muscle rigidity (11.8%), akathisia (11.1%), injection-site pain (7.6%), weight gain (7.6%), and insomnia (7.6%). Conclusion: Paliperidone palmitate was efficacious in Latin American patients studied with an acute exacerbation and recent diagnosis of schizophrenia, and no new safety signals were identified.
- Effects of socioeconomic status in cognition of people with schizophrenia: results from a Latin American collaboration network with 1175 subjects(2022) CZEPIELEWSKI, Leticia Sanguinetti; ALLIENDE, Luz Maria; CASTANEDA, Carmen Paz; CASTRO, Mariana; GUINJOAN, Salvador M.; MASSUDA, Raffael; BERBERIAN, Arthur A.; FONSECA, Ana Olivia; GADELHA, Ary; BRESSAN, Rodrigo; CRIVELARO, Marisa; LOUZA, Mario; UNDURRAGA, Juan; GONZALEZ-VALDERRAMA, Alfonso; NACHAR, Ruben; NIETO, Rodrigo R.; MONTES, Cristian; SILVA, Hernan; I, Alvaro Langer; SCHMIDT, Carlos; MAYOL-TRONCOSO, Rocio; DIAZ-ZULUAGA, Ana M.; VALENCIA-ECHEVERRY, Johanna; LOPEZ-JARAMILLO, Carlos; SOLIS-VIVANCO, Rodolfo; REYES-MADRIGAL, Francisco; FUENTE-SANDOVAL, Camilo de la; CROSSLEY, Nicolas A.; GAMA, Clarissa S.Background Cognition heavily relies on social determinants and genetic background. Latin America comprises approximately 8% of the global population and faces unique challenges, many derived from specific demographic and socioeconomic variables, such as violence and inequality. While such factors have been described to influence mental health outcomes, no large-scale studies with Latin American population have been carried out. Therefore, we aim to describe the cognitive performance of a representative sample of Latin American individuals with schizophrenia and its relationship to clinical factors. Additionally, we aim to investigate how socioeconomic status (SES) relates to cognitive performance in patients and controls. Methods We included 1175 participants from five Latin American countries (Argentina, Brazil, Chile, Colombia, and Mexico): 864 individuals with schizophrenia and 311 unaffected subjects. All participants were part of projects that included cognitive evaluation with MATRICS Consensus Cognitive Battery and clinical assessments. Results Patients showed worse cognitive performance than controls across all domains. Age and diagnosis were independent predictors, indicating similar trajectories of cognitive aging for both patients and controls. The SES factors of education, parental education, and income were more related to cognition in patients than in controls. Cognition was also influenced by symptomatology. Conclusions Patients did not show evidence of accelerated cognitive aging; however, they were most impacted by a lower SES suggestive of deprived environment than controls. These findings highlight the vulnerability of cognitive capacity in individuals with psychosis in face of demographic and socioeconomic factors in low- and middle-income countries.
- Clinical outcomes of long-acting injectable risperidone in patients with schizophrenia: six-month follow-up from the Electronic Schizophrenia Treatment Adherence Registry in Latin America(2011) APIQUIAN, Rogelio; CORDOBA, Rodrigo; LOUZA, MarioBackground: Risperidone long-acting injection (RLAI) has been shown to be efficacious, improve compliance, and increase long-term retention rate on therapy. The aim of this work was to determine the effect of RLAI on clinical outcome and hospitalization rate in patients with schizophrenia or schizoaffective disorder enrolled in the electronic Schizophrenia Treatment Adherence Registry in Latin America. Methods: Data were collected at baseline, retrospectively for the 12 months prior to baseline, and prospectively every three months for 24 months. Hospitalization prior to therapy was assessed by a retrospective chart review. Efficacy and functioning were evaluated using Clinical Global Impression of Illness Severity (CGI-S), Personal and Social Performance (PSP), and Global Assessment of Functioning (GAF) scores. Relapse and treatment were also registered. Results: Patients were recruited in Mexico (n = 53), Brazil (n = 11), and Colombia (n = 15). Sixty-five percent (n = 52) were male, and mean age was 32.9 years. Patients were classified as having schizophrenia (n = 73) or schizoaffective disorder (n = 6). The mean dose of RLAI at six months was 34.1 mg (standard deviation = 10.2 mg). The percentage of hospitalized patients before treatment was 28.2% and 5.1% at six months after initiating RLAI (P < 0.001). Significant changes were registered on CGI-S, GAF, and PSP scores. Conclusions: RLAI was associated with an improvement in clinical symptoms and functioning, and a greater reduction in hospitalization.
- High IQ May ""Mask"" the Diagnosis of ADHD by Compensating for Deficits in Executive Functions in Treatment-Naive Adults With ADHD(2017) MILIONI, Ana Luiza Vidal; CHAIM, Tiffany Moukbel; CAVALLET, Mikael; OLIVEIRA, Nathalya Moleda de; ANNES, Marco; SANTOS, Bernardo dos; LOUZA, Mario; SILVA, Maria Aparecida da; MIGUEL, Carmen Silvia; SERPA, Mauricio Henriques; ZANETTI, Marcus V.; BUSATTO, Geraldo; CUNHA, Paulo JannuzziObjective: To evaluate and compare the performance of adults with ADHD with high and standard IQ in executive functions (EF) tasks. Method: We investigated the neuropsychological performance of 51 adults with ADHD, compared with 33 healthy controls (HC) while performing a wide battery of neuropsychological tests that measure executive functioning. Adults with clinical diagnosis of ADHD were divided into two groups according to their IQ level (IQ >= 110-ADHD group with more elevated IQ, and IQ < 110-ADHD group with standard IQ). Results: The ADHD group with standard IQ presented a worse executive functioning compared with the HC group in the following measures: Stroop 2 (p = .000) and 3 (p = .000), Trail Making Test (TMT) B (p = .005), Wisconsin Card-Sorting Test (WCST)-perseverative errors (p = .022) and failures to maintain set (p = .020), Continuous Performance Test (CPT)-omission errors (p = .005) and commission errors (p =.000), and Frontal Assessment Battery (FAB)-conceptualization (p = .016). The ADHD group with more elevated IQ presented only impairments in the CPT-commission errors (p = .019) when compared with the control group. Conclusion: Adults with ADHD and more elevated IQ show less evidence of executive functioning deficits compared with those with ADHD and standard IQ, suggesting that a higher degree of intellectual efficiency may compensate deficits in executive functions, leading to problems in establishing a precise clinical diagnosis.