Carmen M Alonso, M.D.

Anterior Cingulate Cortex {gamma}-Aminobutyric Acid in Depressed Adolescents: Relationship to Anhedonia
Gabbay V; Mao X; Klein RG; Ely BA; Babb JS; Panzer AM; Alonso CM; Shungu DC
2011 Oct 3;:139-149 #, Archives of general psychiatry
CONTEXT: Anhedonia, a core symptom of major depressive disorder (MDD) and highly variable among adolescents with MDD, may involve alterations in the major inhibitory amino acid neurotransmitter system of gamma-aminobutyric acid (GABA). OBJECTIVE: To test whether anterior cingulate cortex (ACC) GABA levels, measured by proton magnetic resonance spectroscopy, are decreased in adolescents with MDD. The associations of GABA alterations with the presence and severity of anhedonia were explored. DESIGN: Case-control, cross-sectional study using single-voxel proton magnetic resonance spectroscopy at 3 T. SETTING: Two clinical research divisions at 2 teaching hospitals. PARTICIPANTS: Twenty psychotropic medication-free adolescents with MDD (10 anhedonic, 12 female, aged 12-19 years) with episode duration of 8 weeks or more and 21 control subjects group matched for sex and age. MAIN OUTCOME MEASURES: Anterior cingulate cortex GABA levels expressed as ratios relative to unsuppressed voxel tissue water (w) and anhedonia scores expressed as a continuous variable. RESULTS: Compared with control subjects, adolescents with MDD had significantly decreased ACC GABA/w (t = 3.2; P < .003). When subjects with MDD were categorized based on the presence of anhedonia, only anhedonic patients had decreased GABA/w levels compared with control subjects (t = 4.08; P < .001; P(Tukey) < .001). Anterior cingulate cortex GABA/w levels were negatively correlated with anhedonia scores for the whole MDD group (r = -0.50; P = .02), as well as for the entire participant sample including the control subjects (r = -0.54; P < .001). Anterior cingulate cortex white matter was also significantly decreased in adolescents with MDD compared with controls (P = .04). CONCLUSIONS: These findings suggest that GABA, the major inhibitory neurotransmitter in the brain, may be implicated in adolescent MDD and, more specifically, in those with anhedonia. In addition, use of a continuous rather than categorical scale of anhedonia, as in the present study, may permit greater specificity in evaluating this important clinical feature
— id: 139542, year: 2011, vol: , page: 139, stat: Journal Article,

International distribution and age estimation of the Portuguese BRCA2 c.156_157insAlu founder mutation
Peixoto, Ana; Santos, Catarina; Pinheiro, Manuela; Pinto, Pedro; Soares, Maria Jose; Rocha, Patricia; Gusmao, Leonor; Amorim, Antonio; van der Hout, Annemarie; Gerdes, Anne-Marie; Thomassen, Mads; Kruse, Torben A; Cruger, Dorthe; Sunde, Lone; Bignon, Yves-Jean; Uhrhammer, Nancy; Cornil, Lucie; Rouleau, Etienne; Lidereau, Rosette; Yannoukakos, Drakoulis; Pertesi, Maroulio; Narod, Steven; Royer, Robert; Costa, Mauricio M; Lazaro, Conxi; Feliubadalo, Lidia; Grana, Begona; Blanco, Ignacio; de la Hoya, Miguel; Caldes, Trinidad; Maillet, Philippe; Benais-Pont, Gaelle; Pardo, Bruno; Laitman, Yael; Friedman, Eitan; Velasco, Eladio A; Duran, Mercedes; Miramar, Maria-Dolores; Valle, Ana Rodriguez; Calvo, Maria-Teresa; Vega, Ana; Blanco, Ana; Diez, Orland; Gutierrez-Enriquez, Sara; Balmana, Judith; Ramon y Cajal, Teresa; Alonso, Carmen; Baiget, Montserrat; Foulkes, William; Tischkowitz, Marc; Kyle, Rachel; Sabbaghian, Nelly; Ashton-Prolla, Patricia; Ewald, Ingrid P; Rajkumar, Thangarajan; Mota-Vieira, Luisa; Giannini, Giuseppe; Gulino, Alberto; Achatz, Maria I; Carraro, Dirce M; de Paillerets, Brigitte Bressac; Remenieras, Audrey; Benson, Cindy; Casadei, Silvia; King, Mary-Claire; Teugels, Erik; Teixeira, Manuel R
2011 Jun;127(3):671-679, Breast cancer research & treatment
The c.156_157insAlu BRCA2 mutation has so far only been reported in hereditary breast/ovarian cancer (HBOC) families of Portuguese origin. Since this mutation is not detectable using the commonly used screening methodologies and must be specifically sought, we screened for this rearrangement in a total of 5,443 suspected HBOC families from several countries. Whereas the c.156_157insAlu BRCA2 mutation was detected in 11 of 149 suspected HBOC families from Portugal, representing 37.9% of all deleterious mutations, in other countries it was detected only in one proband living in France and in four individuals requesting predictive testing living in France and in the USA, all being Portuguese immigrants. After performing an extensive haplotype study in carrier families, we estimate that this founder mutation occurred 558 +/- 215 years ago. We further demonstrate significant quantitative differences regarding the production of the BRCA2 full length RNA and the transcript lacking exon 3 in c.156_157insAlu BRCA2 mutation carriers and in controls. The cumulative incidence of breast cancer in carriers did not differ from that of other BRCA2 and BRCA1 pathogenic mutations. We recommend that all suspected HBOC families from Portugal or with Portuguese ancestry are specifically tested for this rearrangement
— id: 138584, year: 2011, vol: 127, page: 671, stat: Journal Article,

Possible immunomodulatory effects of omega-3 fatty acids and olive oil in a 20-week clinical trial of children and adolescents with tourette's disorder: Relationships to treatment response
Gabbay V.; Coffey B.J.; Katz Y.; Panzer A.; Alonso C.M.; Babb J.S.
2010 ;20(6):532-533, Journal of child & adolescent psychopharmacology
Background: The possible role of immune system dysregulation in Tourette's disorder (TD) has been increasingly recognized. Studies implicate cytokine imbalances in TD, including tumor necrosis factor (TNF)-alpha, interleukin (IL)-2, and IL-12. Omega-3 Fatty Acids (omega-3FA) are widely used as an alternative treatment for TD and are known to have anti-inflammatory properties. The present study is the first double-blind, placebo-controlled trial examining the therapeutic efficacy and cytokine-specific effects of omega-3FA and olive oil (placebo) in children and adolescents with TD. We hypothesized that: (1) improvement of tics and obsessive compulsive disorder (OCD) symptoms would be positively associated with cytokine plasma concentrations in both treatment groups; (2) these associations would be more pronounced in the omega-3FA group. Methods: Thirty-three children and adolescents with TD (28 males), ages six to 18, were enrolled in a 20-week, double-blind, placebo-controlled trial; 17 were randomly assigned to omega-3FA and 16 to olive oil treatment. Clinician-rated measures included the (Table presented) Yale Global Tic Severity Scale (YGTSS) and the Children's Yale- Brown Obsessive Compulsive Scale (CY-BOCS). Blood samples were collected at 8-9 am after a 12-hour fast at baseline, midpoint, and endpoint weeks and analyzed using enzyme-linked immunosorbent assays. Generalized estimating equations (GEE) based on a binary logistic regression model was used to assess cytokine predictability of OCD and Tic symptom improvement (i.e., CY-BOCS and YGTSS tic score), accounting for age and gender. Spearman correlations characterized associations between cytokines and severity scores. Results: Table 1 and Table 2 show GEE predictabilities and Spearman correlations. Conclusions: Findings suggest that IL-6 and TNF-alpha may play a role in TD treatment response, possibly affected by omega-3FA
— id: 120662, year: 2010, vol: 20, page: 532, stat: Journal Article,

The possible role of the kynurenine pathway in adolescent depression with melancholic features
Gabbay, Vilma; Klein, Rachel G; Katz, Yisrael; Mendoza, Sandra; Guttman, Leah E; Alonso, Carmen M; Babb, James S; Hirsch, Glenn S; Liebes, Leonard
2010 Aug;51(8):935-943, Journal of child psychology & psychiatry & allied disciplines
BACKGROUND: Although adolescent major depressive disorder (MDD) is acknowledged to be a heterogeneous disorder, no studies have reported on biological correlates of its clinical subgroups. This study addresses this issue by examining whether adolescent MDD with and without melancholic features (M-MDD and NonM-MDD) have distinct biological features in the kynurenine pathway (KP). The KP is initiated by pro-inflammatory cytokines via induction of the enzyme indoleamine 2,3-dioxygenase (IDO), which degrades tryptophan (TRP) into kynurenine (KYN). KYN is further metabolized into neurotoxins linked to neuronal dysfunction in MDD. Hypotheses were that, compared to healthy controls and to NonM-MDD adolescents, adolescents with M-MDD would exhibit: (i) increased activation of the KP [i.e., increased KYN and KYN/TRP (reflecting IDO activity)]; (ii) greater neurotoxic loads [i.e., increased 3-hydroxyanthranilic acid (3-HAA, neurotoxin) and 3-HAA/KYN (reflecting production of neurotoxins)]; and (iii) decreased TRP. We also examined relationships between severity of MDD and KP metabolites. METHODS: Subjects were 20 adolescents with M-MDD, 30 adolescents with NonM-MDD, and 22 healthy adolescents. MDD episode duration had to be >or= 6 weeks and Children's Depression Rating Scale-Revised (CDRS-R) scores were >or= 36. Blood samples were collected at AM after an overnight fast and analyzed using high-performance liquid chromatography. Group contrasts relied on analysis of covariance based on ranks, adjusted for age, gender, and CDRS-R scores. Analyses were repeated excluding medicated patients. Fisher's protected least significant difference was used for multiple comparisons. RESULTS: As hypothesized, KYN/TRP ratios were elevated and TRP concentrations were reduced in adolescents with M-MDD compared to NonM-MDD adolescents (p = .001 and .006, respectively) and to healthy controls (p = .008 and .022, respectively). These findings remained significant when medicated patients were excluded from the analyses. Significant correlations were obtained exclusively in the M-MDD group between KYN and 3-HAA/KYN and CDRS-R. CONCLUSIONS: Findings support the notion that adolescent M-MDD may represent a biologically distinct clinical syndrome
— id: 111344, year: 2010, vol: 51, page: 935, stat: Journal Article,

Immune system dysregulation in adolescent major depressive disorder
Gabbay, Vilma; Klein, Rachel G; Alonso, Carmen M; Babb, James S; Nishawala, Melissa; De Jesus, Georgette; Hirsch, Glenn S; Hottinger-Blanc, Pauline M Z; Gonzalez, Charles J
2009 May;115(1-2):177-182, Journal of affective disorders
BACKGROUND: A large body of evidence suggests that immune system dysregulation is associated with Major Depressive Disorder (MDD) in adults. This study extends this work to adolescent MDD to examine the hypotheses of immune system dysregulation in adolescents with MDD, as manifested by significantly: (i) elevated plasma levels of cytokines (interferon [IFN]-gamma, tumor necrosis factor-alpha, interleukin [IL]-6, IL-1beta, and IL-4); and (ii) Th1/Th2 cytokine imbalance shifted toward Th1 as indexed by increased IFN-gamma/IL-4. METHOD: Thirty adolescents with MDD (19 females; 13 medication-free/naive; ages 12-19) of at least 6 weeks duration and a minimum severity score of 40 on the Children's Depression Rating Scale-Revised, and 15 healthy comparisons (8 females), group-matched for age, were enrolled. Plasma cytokines were examined using enzyme-linked immunosorbent assay. Mann-Whitney test was used to compare subjects with MDD and controls. RESULTS: Adolescents with MDD had significantly elevated plasma IFN-gamma levels (3.38+/-11.8 pg/ml versus 0.37+/-0.64 pg/ml; p<0.003), and IFN-gamma/IL-4 ratio (16.6+/-56.5 versus 1.76+/-2.28; p=0.007). A trend for IL-6 to be elevated in the MDD group was also observed (1.52+/-2.88 pg/ml versus 0.49+/-0.90 pg/ml; p=0.09). Importantly, findings remained evident when medicated subjects were excluded. CONCLUSIONS: Findings suggest that immune system dysregulation may be associated with adolescent MDD, with an imbalance of Th1/Th2 shifted toward Th1, as documented in adult MDD. Larger studies with medication-free adolescents should follow
— id: 93920, year: 2009, vol: 115, page: 177, stat: Journal Article,

A preliminary study of cytokines in suicidal and nonsuicidal adolescents with major depression
Gabbay, Vilma; Klein, Rachel G; Guttman, Leah E; Babb, James S; Alonso, Carmen M; Nishawala, Melissa; Katz, Yisrael; Gaite, Marta R; Gonzalez, Charles J
2009 Aug;19(4):423-430, Journal of child & adolescent psychopharmacology
BACKGROUND: Increased systemic cytokine levels, modulators of the immune system, have been repeatedly documented in adult and adolescent major depressive disorder (MDD). This preliminary study extends this work to test the role of cytokines in suicidal symptomatology in adolescent MDD. Hypotheses were that acutely suicidal depressed adolescents would have: (1) increased plasma levels of interferon-gamma (IFN-gamma), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and IL-1beta, and (2) a proinflammatory/antiinflammatory cytokine imbalance (indexed by plasma IFN-gamma/IL-4), compared to nonsuicidal depressed adolescents and healthy controls. METHODS: Twelve suicidal adolescents with MDD (7 females [58%]; 5 medication-free/naive), 18 nonsuicidal adolescents with MDD (12 females [67%]; 8 medication-free/naive), and 15 controls (8 females [53%]) were enrolled. MDD had to be of at least 6 weeks duration, with a minimum severity score of 40 on the Children's Depression Rating Scale-Revised. Plasma cytokines were examined using enzyme-linked immunosorbent assays. Nonparametric tests were used to compare subject groups. RESULTS: Unexpectedly, suicidal adolescents with MDD had significantly decreased plasma TNF-alpha concentrations compared to nonsuicidal adolescents with MDD (1.33 +/- 2.95 pg/mL versus 30.9 +/- 110.9 pg/mL; p = 0.03). IFN-gamma was increased in both suicidal and nonsuicidal adolescents with MDD compared to controls (2.14 +/- 6.22 and 4.20 +/- 14.48 versus 0.37 +/- 0.64; p < 0.02, p = 0.005). Findings remained evident when controlled for age and gender. CONCLUSIONS: Our preliminary findings suggest that immune system dysregulation may be associated with suicidal symptomatology in adolescent MDD. These findings should be replicated in larger samples with medication-free adolescents
— id: 101899, year: 2009, vol: 19, page: 423, stat: Journal Article,

Disorders of childhood and adolescence
Alonso, Carmen M; Gosselin, Gary; Teitel, Eric
Psychiatry clerkship guide Philadelphia PA : Mosby/Elsevier, 2007,
— id: 5590, year: 2007, vol: , page: 353, stat: Chapter,

The efficacy of omega-3 fatty acids in Tourette's disorder and the role of cytokines
Gabbay, V; Coffey, BJ; Santucci, L; Alonso, C; Castellanos, FX; Klein, R
2005 DEC ;15(6):855-855, Journal of child & adolescent psychopharmacology
— id: 61455, year: 2005, vol: 15, page: 855, stat: Journal Article,

In the Face of Pain: The Relationship between Psychological Well-Being and Disability in Women with Fibromyalgia
Schleicher, Holly; Alonso, Carmen; Shirtcliff, Elizabeth A; Muller, Daniel; Loevinger, Barbara L; Coe, Christopher L
2005 ;74(4):231-239 Jun, Psychotherapy & psychosomatics
Background: Few studies have examined the potentially beneficial role of positive psychological functioning in individuals with chronic pain. This study examined the relationship of psychological well-being (PWB) to pain and disability in women with fibromyalgia (FM) as compared to women with rheumatoid arthritis (RA) and healthy controls (HC). We targeted several domains of PWB that have been associated with health, and also tested whether PWB was related to the women's social network. Methods: PWB, pain, and disability were assessed in 125 women (57 with FM, 20 with RA, and 48 HC) on two occasions. Results: Women with FM reported lower overall PWB than did RA and HC women. Further, greater PWB was associated with less disability and fatigue, but not pain in women with FM. Self-acceptance, environmental mastery, purpose in life, and positive relations with others emerged as four important constructs in the association between PWB and disability. In addition, PWB mediated the relationship between social network size and disability. Conclusions: This assessment of PWB provides insight into those psychological domains that should be emphasized in treatments aimed at reducing the disabling aspects of FM. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract)
— id: 80776, year: 2005, vol: 74, page: 231, stat: Journal Article,

When to use antidepressant medication in youths
Silva, Raul R; Gabbay, Vilma; Minami, Haruka; Munoz-Silva, Dinohra; Alonso, Carmen
2005 ;12(9):42-50 Sep, Primary Psychiatry
The development of antidepressant agents has been underway since their first use in the 1950s. Types of agents include monoamine oxidase inhibitors, tricyclic antidepressants (TCAs), and selective serotonin reuptake inhibitors (SSRIs). The utility of these agents in adult populations has led to multiple approved indications by the Food and Drug Administration. Although there are only two approved indications in pediatric age groups--major depressive disorder (MDD) and obsessive-compulsive disorder (OCD)--physicians have been prescribing antidepressants to children and adolescents in increasing numbers. In previous years, the TCAs had documented cardiotoxic potential, and there were several sudden unexpected deaths associated with their administration in youths. In December 2003, Great Britain's drug regulatory agency contraindicated the use of four SSRIs in childhood populations. This decision was based on the increased rates of developed suicidal thinking or gestures observed in the pooled data of >4,000 pediatric aged subjects treated with an antidepressant versus placebo. In October 2004, after careful consideration, the FDA placed a black box warning on all antidepressants, alerting clinicians to the potential of developing similar behaviors upon receiving these agents. These findings underscore the importance of using the increasing evidence base of well-designed, double-blind studies to guide the usage of these antidepressants in conditions where efficacy is established. This article reviews that body of literature in conditions such as MDD, OCD, attention-deficit/ hyperactivity disorder, selective mutism, and anxiety disorders. (journal abstract)
— id: 62649, year: 2005, vol: 12, page: 42, stat: Journal Article,

Review of benzodiazepine use in children and adolescents
Witek, Malgorzata W; Rojas, Veronica; Alonso, Carmen; Minami, Haruka; Silva, Raul R
2005 Fall;76(3):283-296, Psychiatric quarterly
Clinically, benzodiazepines are used in adult populations much more frequently than in children and adolescents. There may be a number of reasons for this disparity including a dearth of well controlled clinical studies and the issue of dependence associated with long term use. However, over a ten year span there has been nearly a three fold increase in the use patterns for these agents in the child population. In open studies much of the literature has indicated potentially useful results, but these findings have not been replicated when more refined methodological studies have been conducted. The lack of encouraging results in these later studies may be attributable to a number of factors such as modest sample sizes and less than optimal patient selection. Nonetheless, with increasing prescriptions being written for these agents it is not clear what is compelling clinicians to use them. In this paper we will review the available literature on benzodiazepine use in the child and adolescent population, focusing primarily on psychiatric applications
— id: 58797, year: 2005, vol: 76, page: 283, stat: Journal Article,

Menstrual cycle influences on pain and emotion in women with fibromyalgia
Alonso, Carmen; Loevinger, Barbara L; Muller, Daniel; Coe, Christopher L
2004 Nov;57(5):451-458, Journal of psychosomatic research
OBJECTIVE: This study examined the influence of the menstrual cycle on pain and emotion in women with fibromyalgia (FM) as compared with women with rheumatoid arthritis (RA) and to healthy controls. METHODS: One hundred and twenty-five premenopausal women (21-45 years old) participated in this study (57 with FM, 20 with RA, and 48 controls). Pain and emotion assessments were conducted during the follicular and the luteal phases of the menstrual cycle. RESULTS: Women with FM experienced more pain, menstrual symptoms, and negative affect than did women with RA and the controls. All women reported less positive affect during the luteal phase, although this pattern was more pronounced in women with FM and RA than in controls. CONCLUSION: Although FM pain did not vary across the menstrual cycle, these results point to the importance of considering the lower level and cyclical nature of positive affect when studying women with chronic pain
— id: 140341, year: 2004, vol: 57, page: 451, stat: Journal Article,

Legal Aspects Related to PTSD in Children and Adolescents
Gabbay, Vilma; Alonso, Carmen M
Posttraumatic stress disorders in children and adolescents: Handbook New York, NY, US: W W Norton & Co., 2004,
(from the chapter) Posttraumatic stress disorder (PTSD) has been increasingly introduced to the courts in causes of actions involving minors. It is, therefore, not uncommon for child psychiatrists to be required to deal with the forensic aspects of PTSD and often to be called upon to enter the unfamiliar culture of the legal arena. In this chapter, the authors review the legal issues concerning PTSD in children and adolescents, their application in civil and criminal proceedings, specific litigation rules, and some aspects of a forensic evaluation. The goal is to familiarize child psychiatrists with their possible roles involving minors with PTSD claims.
— id: 3785, year: 2004, vol: , page: 60, stat: Chapter,

Disorders of childhood and adolescence
Alonso, Carmen M
Psychiatry clerkship guide St.Louis MO : Mosby, 2003,
— id: 5624, year: 2003, vol: , page: 301, stat: Chapter,

New onset of body dysmorphic disorder following frontotemporal lesion
Gabbay, V; Asnis, G M; Bello, J A; Alonso, C M; Serras, S J; O'Dowd, M A
2003 Jul 8;61(1):123-125, Neurology
The etiology and pathophysiology of body dysmorphic disorder (BDD) have not been delineated. The authors report a 24-year-old man who developed BDD at age 21 after an inflammatory brain process. Neuroimaging studies showed new atrophy in the frontotemporal region. The authors review cases from the literature with similar clinical features and neuroimaging findings as well as discuss the possible correlation between the neuroanatomic lesion and the clinical presentation of BDD in the patient
— id: 39160, year: 2003, vol: 61, page: 123, stat: Journal Article,

Child and parent response to the 1993 World Trade Center bombing
Koplewicz, Harold S; Vogel, Juliet M; Solanto, Mary V; Morrissey, Richard F; Alonso, Carmen M; Abikoff, Howard; Gallagher, Richard; Novick, Rona M
2002 Feb;15(1):77-85, Journal of traumatic stress
This study evaluated children's symptoms 3 and 9 months after the 1993 bombing of the World Trade Center, and the relationship between parent and child reactions when only the children had been in the building. Nine children who had been trapped in an elevator, 13 who had been on the observation deck, and 27 controls completed the Posttraumatic Stress Reaction Index and a Fear Inventory. Parents completed these measures about the children and comparable measures about themselves. Exposed children reported posttraumatic stress disorder (PTSD) symptoms and disaster-related fears; their parents reported experiencing PTSD symptoms. Only parents rated children's symptoms as decreasing significantly over time. Association between child symptoms and parent symptoms increased over time. Children's initial distress predicted parents' distress 9 months postdisaster
— id: 34328, year: 2002, vol: 15, page: 77, stat: Journal Article,

Disruptions of social relationships accentuate the association between emotional distress and menstrual pain in young women
Alonso, Carmen; Coe, Christopher L
2001 ;20(6):411-416, Health psychology
This study examined the effects of social support on dysmenorrhea and whether social support moderates the relationship between negative emotions and painful symptoms. Women (N=184) completed questionnaires on menstrual symptoms, depression, anxiety, and social networks. Depression and anxiety were strongly associated with menstrual pain. Women who no longer had access to their prior support providers manifested more symptoms than did women with stable social relations. In addition, this disruption in their social networks moderated the relationship between distress and menstrual pain. Results indicate that loss of social support is a significant contributor to menstrual symptoms and point to the importance of considering specific aspects of social support in studying its effect on health. (PsycINFO Database Record (c) 2007 APA, all rights reserved) (journal abstract)
— id: 80775, year: 2001, vol: 20, page: 411, stat: Journal Article,

The role of anxiety and adaptation to illness in the intensity of postchemotherapy nausea in cancer patients
Blasco, Tomas; Pallares, Cinta; Alonso, Carmen; Lopez, Juan Jose Lopez
2000 ;3(1):47-52 May, Spanish Journal of Psychology
Examined postchemotherapy nausea and its relations to cancer patients' anxiety and cancer adaptation. 63 cancer patients (aged 17-70 yrs) were assessed for anxiety and nausea intensity during the period immediately prior to treatment to 2 days subsequently. Additional collected data included symptoms diaries concerning anxiety, nausea, vomiting, and other somatic effects. Results show that Ss with relatively higher levels of nausea reported higher levels of anxiety prior to chemotherapy and lower levels of adaptation to cancer. Findings suggest that psychological factors as well as pharmacological variables are related to nausea intensity. (PsycINFO Database Record (c) 2007 APA, all rights reserved)
— id: 80777, year: 2000, vol: 3, page: 47, stat: Journal Article,

Amniocentesis after multifetal pregnancy reduction: is it safe?
Stephen JA; Timor-Tritsch IE; Lerner JP; Monteagudo A; Alonso CM
2000 Apr;182(4):962-965, American journal of obstetrics & gynecology
OBJECTIVE: This report reviews the obstetric outcomes of women with multifetal pregnancy reductions who subsequently underwent elective amniocentesis. STUDY DESIGN: Five hundred eight patients underwent multifetal pregnancy reduction at our institution. Among these, 91 patients underwent subsequent elective amniocentesis. The obstetric outcomes of all 508 patients were followed up. By means of logistic regression we evaluated several variables to determine any association with loss rate: (1) the finishing number of fetuses, (2) the number of fetuses undergoing reduction (starting number of fetuses minus the finishing number of fetuses), (3) the gestational age at reduction, (4) the maternal age at reduction, and (5) the procedure protocol. We observed that the finishing number of fetuses, the number of fetuses removed, and the procedure protocol were significantly associated with pregnancy loss rate. Women who underwent subsequent amniocentesis were compared with those who did not undergo amniocentesis. By means of multivariate conditional likelihood analysis we stratified the two groups according to the previously mentioned significant variables to compare the pregnancy loss rates. RESULTS: Among patients who subsequently underwent elective amniocentesis the total uncorrected pregnancy loss rate was 9.0% and the early premature delivery rate was 4.5%. The number of fetuses removed, the finishing number of fetuses, and the procedure protocol were statistically significantly associated with the loss rate. The adjusted odds ratio relating amniocentesis to the pregnancy loss rate was 0.7 (95% confidence interval, 0.31.5; P =.3.) CONCLUSIONS:The uncorrected rates of pregnancy loss and of early premature delivery among patients with multifetal pregnancy reduction who underwent subsequent amniocentesis were comparable to those of patients with multifetal pregnancy reduction who did not undergo amniocentesis
— id: 62319, year: 2000, vol: 182, page: 962, stat: Journal Article,

The mother's participation in infant carrying in captive groups of Leontopithecus chrysomelas and Callithrix jacchus
de Oliveira, Marcelina Souza; Lopes, Fivia Araujo; Alonso, Carmen; Yamamoto, Maria Emilia
1999 ;70(3):146-153 May-Jun, Folia primatologica
Callithrix and Leontopithecus exhibit ecological differences that have implications for the patterns of infant care. In C. jacchus, which uses a small home range because it depends mainly on plant exudates, infants can forage independently early in their life. L. chrysomelas, which feeds mainly on fruits and insects, needs larger home ranges and its infants have a more extensive period of dependence. Three families of C. jacchus and 4 families of L. chrysomelas were studied in captivity. The Ss were observed starting from the birth of the infants up to their 8th wk of age. Results show that the pattern of infant transfer in L. chrysomelas occurred much earlier than that reported for L. rosalia . L. chrysomelas infants were carried for about 15% of total time during the 8th wk of life against less than 1% in C. jacchus in the same wk. (PsycINFO Database Record (c) 2007 APA, all rights reserved)
— id: 80778, year: 1999, vol: 70, page: 146, stat: Journal Article,

Risperidone and refusal to eat
Schwam JS; Klass E; Alonso C; Perry R
1998 Jun;37(6):572-573, Journal of the American Academy of Child & Adolescent Psychiatry
— id: 57253, year: 1998, vol: 37, page: 572, stat: Journal Article,