Twenty patients meeting DSM-III criteria for Schizophrenic Disorder, Paranoid Type were studied. After a 30 day drug-free period the patients were randomized in two groups. During a year, patients in Group 1 received intramuscular injections of a placebo while Group 2 received recombinant IFN alpha-2b. Both groups took anti-psychotic medication (APM) as needed on an individual basis, depending on their psychiatric symptomatology. Double blind evaluations, were performed at the beginning and at the end of the trial, using the Brief Psychiatric Rating Scale (BPRS) and the Reyes Scale for Social Evolution (RSSE). Information about relapses was gathered such as months without relapse, number and duration of the relapses and maximum dosages of APM given for relapse control. The statistical analysis of the results was performed with a matched pairs sign or Student's t tests for comparisons of each group before and after treatment. Groups were compared between them using the Fisher's exact test for frequencies and Student's t test for continuous variables. In Group 1: only one patient improved on the BPRS score; two had improved ratings on the RSSE; 2 patients got worse; and there were no changes in the rest of the group; three patients had no relapses and one increased in relapse frequency. These changes were not significant. The rate of relapses per year and their duration were not significantly modified in Group 1. The maximum dose of APM required for their relapse control was larger than before treatment although not significantly. All these patients required continuous APM. In Group 2 (IFN treated): 6 patients had improved BPRS scores (N = 6, K = 6, p < 0.01) and 5 improved their RSSE scores (n = 5, K = 5, p < 0.05). In 5 patients there were no relapses on their frequency decreased. There was significant reduction in the duration of the relapses (37.8 +/- 14.6 to 20.7 +/- 12.5 days; t = 4.83; d.f. = 9; p = 0.0009) after treatment. Only 3 patients in Group 2 needed continuous APM after a relapse and the maximum dose required for control was significantly less (1281 +/- 527 to 687 +/- 552 chlorpromazine-equivalent mg. per day; t = 5.56, p < 0.001). Comparisons between groups showed advantage for the IFN treated group in the BPRS change, proportion of patients needing continuous APM and integral evaluation. These results indicate that alpha IFN may be useful in the treatment of Schizophrenic Disorder, Paranoid Type.

Introduction Our objective was to compare the in vitro efficacy of electrothermal bipolar [EB] vessel sealing and ultrasonic harmonic scalpel [HS] versus mechanical interruption, with conventional ties or surgical clips (SC), in sealing saphenous vein (SV) collaterals, during its eventual preparation for bypass surgery. Methods Experimental in vitro study on 30 segments of SV. Each fragment included two collaterals at least 2 mm in diameter. One of them was sealed by ligation with 3/0 silk ties (control) and the other one with EB (n = 10), HS (n = 10) or medium-6 mm SC (n = 10). After incorporation in a closed circuit with pulsatile flow, the pressure was progressively increased until causing rupture. Collateral diameter, burst pressure, leak point, and histological study were recorded. Results Burst pressure was higher for SC (1320.20 ± 373.847 mmHg) as compared with EB (942.2 ± 344.9 mmHg, p = 0.065), and especially with HS (637.00 ± 320.61 mmHg, p = 0.0001). No statistically significant difference between EB and HS was found, and bursting always happened at supraphysiological pressures. The leak point for HS was always detected in the sealing zone (10/10), while for EB and SC, it occurred in the sealing zone only in 6/10(60%) and 4/10(40%), respectively (p = 0.015). Conclusions Energy delivery devices showed similar efficacy and safety in sealing of SV side branches. Although bursting pressure was lower than with tie ligature or SC, non-inferiority efficacy was shown at the range of physiological pressures in both, EB and HS. Due to their speed and easy handling, they may be useful in the preparation of the venous graft during revascularization surgery. However, remaining questions about healing process, potential spread of tissue damage and sealing durability, will require further analysis.

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