bluuebunny/crossref_metadata_2025 huggingface dataset:
Quadriceps force generation in patients with osteoarthritis of the knee and asymptomatic participants during patellar tendon reflex reactions: an exploratory cross-sectional study
Authors: Dixon John , Howe Tracey E
Published: September 2005

Background

It has been postulated that muscle contraction is slower in patients with osteoarthritis of the knee than asymptomatic individuals, a factor that could theoretically impair joint protection mechanisms. This study investigated whether patients with osteoarthritis of the knee took longer than asymptomatic participants to generate force during reflex quadriceps muscle contraction. This was an exploratory study to inform sample size for future studies.

Methods

An exploratory observational cross sectional study was carried out. Two subject groups were tested, asymptomatic participants (n = 17), mean (SD) 56.7 (8.6) years, and patients with osteoarthritis of the knee, diagnosed by an orthopaedic surgeon, (n = 16), age 65.9 (7.8) years. Patellar tendon reflex responses were elicited from participants and measured with a load cell. Force latency, contraction time, and force of the reflex response were determined from digitally stored data. The Mann-Whitney U test was used for the between group comparisons in these variables. Bland and Altman within-subject standard deviation values were calculated to evaluate the measurement error or precision of force latency and contraction time.

Results

No significant differences were found between the groups for force latency (p = 0.47), contraction time (p = 0.91), or force (p = 0.72). The two standard deviation measurement error values for force latency were 27.9 ms for asymptomatic participants and 16.4 ms for OA knee patients. For contraction time, these values were 29.3 ms for asymptomatic participants and 28.1 ms for OA knee patients. Post hoc calculations revealed that the study was adequately powered (80%) to detect a difference between the groups of 30 ms in force latency. However it was inadequately powered (59%) to detect this same difference in contraction time, and 28 participants would be required in each group to reach 80% power.

Conclusion

Patients with osteoarthritis of the knee do not appear to have compromised temporal parameters or magnitude of force generation during patellar tendon reflex reactions when compared to a group of asymptomatic participants. However, these results suggest that larger studies are carried out to investigate this area further.
Description of a PCR-based technique for DNA splicing and mutagenesis by producing 5' overhangs with run through stop DNA synthesis utilizing Ara-C
Authors: Ailenberg Menachem , Goldenberg Neil M , Silverman Mel
Published: September 2005

Background

Splicing of DNA molecules is an important task in molecular biology that facilitates cloning, mutagenesis and creation of chimeric genes. Mutagenesis and DNA splicing techniques exist, some requiring restriction enzymes, and others utilize staggered reannealing approaches.

Results

A method for DNA splicing and mutagenesis without restriction enzymes is described. The method is based on mild template-dependent polymerization arrest with two molecules of cytosine arabinose (Ara-C) incorporated into PCR primers. Two rounds of PCR are employed: the first PCR produces 5' overhangs that are utilized for DNA splicing. The second PCR is based on polymerization running through the Ara-C molecules to produce the desired final product. To illustrate application of the run through stop mutagenesis and DNA splicing technique, we have carried out splicing of two segments of the human cofilin 1 gene and introduced a mutational deletion into the product.

Conclusion

We have demonstrated the utility of a new PCR-based method for carrying out DNA splicing and mutagenesis by incorporating Ara-C into the PCR primers.
Biofilm reactors for industrial bioconversion processes: employing potential of enhanced reaction rates
Authors: Qureshi Nasib , Annous Bassam A , Ezeji Thaddeus C , Karcher Patrick , Maddox Ian S
Published: August 2005

This article describes the use of biofilm reactors for the production of various chemicals by fermentation and wastewater treatment. Biofilm formation is a natural process where microbial cells attach to the support (adsorbent) or form flocs/aggregates (also called granules) without use of chemicals and form thick layers of cells known as "biofilms." As a result of biofilm formation, cell densities in the reactor increase and cell concentrations as high as 74 gL-1 can be achieved. The reactor configurations can be as simple as a batch reactor, continuous stirred tank reactor (CSTR), packed bed reactor (PBR), fluidized bed reactor (FBR), airlift reactor (ALR), upflow anaerobic sludge blanket (UASB) reactor, or any other suitable configuration. In UASB granular biofilm particles are used. This article demonstrates that reactor productivities in these reactors have been superior to any other reactor types. This article describes production of ethanol, butanol, lactic acid, acetic acid/vinegar, succinic acid, and fumaric acid in addition to wastewater treatment in the biofilm reactors. As the title suggests, biofilm reactors have high potential to be employed in biotechnology/bioconversion industry for viable economic reasons. In this article, various reactor types have been compared for the above bioconversion processes.
Malaria during pregnancy and foetal haematological status in Blantyre, Malawi
Authors: Abrams Elizabeth T , Kwiek Jesse J , Mwapasa Victor , Kamwendo Deborah D , Tadesse Eyob , Lema Valentino M , Molyneux Malcolm E , Rogerson Stephen J , Meshnick Steven R
Published: August 2005

Background

Although maternal anaemia often stems from malaria infection during pregnancy, its effects on foetal haemoglobin levels are not straightforward. Lower-than-expected cord haemoglobin values in malarious versus non-malarious regions were noted by one review, which hypothesized they resulted from foetal immune activation to maternal malaria. This study addressed this idea by examining cord haemoglobin levels in relation to maternal malaria, anaemia, and markers of foetal immune activation.

Methods

Cord haemoglobin levels were examined in 32 malaria-infected and 58 uninfected women in Blantyre, Malawi, in relation to maternal haemoglobin levels, malaria status, and markers of foetal haematological status, hypoxia, and inflammation, including TNF-α, TGF-β, and ferritin. All women were HIV-negative.

Results

Although malaria was associated with a reduction in maternal haemoglobin (10.8 g/dL vs. 12.1 g/dL, p < 0.001), no reduction in cord haemoglobin and no significant relationship between maternal and cord haemoglobin levels were found. Cord blood markers of haematological and hypoxic statuses did not differ between malaria-infected and uninfected women. Maternal malaria was associated with decreased TGF-β and increased cord ferritin, the latter of which was positively correlated with parasitaemia (r = 0.474, p = 0.009). Increased cord ferritin was associated with significantly decreased birth weight and gestational length, although maternal and cord haemoglobin levels and malaria status had no effect on birth outcome.

Conclusion

In this population, cord haemoglobin levels were protected from the effect of maternal malaria. However, decreased TGF-β and elevated ferritin levels in cord blood suggest foetal immune activation to maternal malaria, which may help explain poor birth outcomes.
Pancreatic metastasis of Merkel cell carcinoma and concomitant insulinoma: Case report and literature review
Authors: Bachmann Jeannine , Kleeff Jorg , Bergmann Frank , Shrikhande Shailesh V , Hartschuh Wolfgang , Büchler Markus W , Friess Helmut
Published: September 2005

Background

Merkel cell carcinomas are rare neoplasm of neuroendocrine origin, usually observed in elderly people in areas with abundant sunlight, and predominantly located on the head and neck, extremities, and trunk. In many patients, a local recurrence after resection of the primary tumour and even distant metastases can be found.

Case presentation

We report an unusual occurrence of pancreatic metastases from a previously diagnosed Merkel cell carcinoma with the discovery of a concomitant insulinoma. An 82-year old lady suffered from recurrent attacks of hypoglycemia and presented with an abdominal mass, 2 years prior she had an excision done on her eyebrow that was reported as Merkel cell carcinoma. An extended distal pancreatectomy and splenectomy along with resection of the left flexure of the colon for her abdominal mass was carried out. Final histopathology of the mass was a poorly differentiated endocrine carcinoma in the pancreatic tail, in the peripancreatic tissue and in the surrounding soft tissue consistent with metastatic Merkel cell carcinoma in addition to an insulinoma of the pancreatic body.

Conclusion

This is the first documented case of a metastatic Merkel cell carcinoma and a concomitant insulinoma, suggesting either a mere coincidence or an unknown neuroendocrine tumor syndrome.
Nucleic acid chaperons: a theory of an RNA-assisted protein folding
Authors: Biro Jan C
Published: September 2005

Background

Proteins are assumed to contain all the information necessary for unambiguous folding (Anfinsen's principle). However, ab initio structure prediction is often not successful because the amino acid sequence itself is not sufficient to guide between endless folding possibilities. It seems to be a logical to try to find the "missing" information in nucleic acids, in the redundant codon base.

Results

mRNA energy dot plots and protein residue contact maps were found to be rather similar. The structure of mRNA is also conserved if the protein structure is conserved, even if the sequence similarity is low. These observations led me to suppose that some similarity might exist between nucleic acid and protein folding. I found that amino acid pairs, which are co-located in the protein structure, are preferentially coded by complementary codons. This codon complementarity is not perfect; it is suboptimal where the 1st and 3rd codon residues are complementary to each other in reverse orientation, while the 2nd codon letters may be, but are not necessarily, complementary.

Conclusion

Partial complementary coding of co-locating amino acids in protein structures suggests that mRNA assists in protein folding and functions not only as a template but even as a chaperon during translation. This function explains the role of wobble bases and answers the mystery of why we have a redundant codon base.
Human enterovirus 71 subgenotype B3 lacks coxsackievirus A16-like neurovirulence in mice infection
Authors: Chan Yoke-Fun , AbuBakar Sazaly
Published: August 2005

Background

At least three different EV-71 subgenotypes were identified from an outbreak in Malaysia in 1998. The subgenotypes C2 and B4 were associated with the severe and fatal infections, whereas the B3 virus was associated with mild to subclinical infections. The B3 virus genome sequences had ≥85% similarity at the 3' end to CV-A16. This offers opportunities to examine if there are characteristic similarities and differences in virulence between CV-A16, EV-71 B3 and EV-71 B4 and to determine if the presence of the CV-A16-liked genes in EV-71 B3 would also confer the virus with a CV-A16-liked neurovirulence in mice model infection.

Results

Analysis of human enterovirus 71 (EV-71) subgenotype B3 genome sequences revealed that the 3D RNA polymerase and domain Z of the 3'-untranslating region RNA secondary structure had high similarity to CV-A16. Intracerebral inoculation of one-day old mice with the virus resulted in 16% of the mice showing swollen hind limbs and significantly lower weight gain in comparison to EV-71 B4-infected mice. None of the mice presented with hind leg paralysis typical in all the CV-A16 infected mice. CV-A16 genome sequences were amplified from the CV-A16-infected mice brain but no amplification was obtained from all the EV-71-inoculated mice suggesting that no replication had taken place in the suckling mice brain.

Conclusion

The findings presented here suggest that EV-71 B3 viruses had CV-A16-liked non-structural gene features at the 3'-end of the genome. Their presence could have affected virulence by affecting the mice general health but was insufficient to confer the EV-71 B3 virus a CV-A16-liked neurovirulence in mice model infection.
Constitutive expression of Atlantic salmon Mx1 protein in CHSE-214 cells confers resistance to Infectious Salmon Anaemia virus
Authors: Kibenge Molly JT , Munir Khalid , Kibenge Frederick SB
Published: August 2005

Infectious salmon anaemia (ISA) is a highly fatal viral disease affecting marine-farmed Atlantic salmon which is caused by ISA virus (ISAV), a fish orthomyxovirus that has recently been assigned to the new genus Isavirus within the family Orthomyxoviridae. Mx proteins are among the interferon (IFN)-induced proteins responsible for the development of an antiviral state in vertebrate cells. We used real-time reverse transcription-polymerase chain reaction (RT-PCR) and Chinook salmon embryo (CHSE-214) cells constitutively expressing Atlantic salmon Mx1 protein (ASMx1) to examine the antiviral properties of ASMx1 against two ISAV strains, NBISA01 and HKS-36, having phenotypically different growth properties (cytopathic vs non-cytopathic) in the CHSE-214 cell line. We present evidence that ISAV is sensitive to ASMx1. CHSE-214 cells constitutively expressing ASMx1 showed increased resistance to infection with the cytopathic ISAV strain NBISA01, manifested as delayed development of cytopathic effects (CPE) and significant reduction in the severity of CPE, as well as a 10-fold reduction in virus yield. However, by real-time RT-PCR we observed no significant difference in the mean threshold cycle (Ct) values of ISAV RNA levels, suggesting that the ASMx1 activity on ISAV occurs at the post-transcription steps of virus replication, possibly in the cytoplasm.
Varicella zoster virus acute retinal necrosis following eye contusion: case report
Authors: Svozílková Petra , Říhová Eva , Diblík Pavel , Kuthan Pavel , Kovařík Zdeněk , Kalvodová Bohdana
Published: September 2005

Background

Acute retinal necrosis is a sight-threatening disease caused by the group of herpesviruses. The aim of this paper is to report a case of acute retinal necrosis following ocular trauma in a patient initially treated with vaso-active drugs and corticosteroids for presumed ocular ischemic syndrome.

Case presentation

A 51-years-old otherwise healthy man, who suffered from sudden visual loss in the left eye following contusion, was commenced on vaso-active drugs and systemic corticosteroids for suspected ocular ischemic syndrome with extensive swelling of the optic disc and macular edema. Subsequently, vision in the initially uninvolved right eye decreased. Polymerase chain reaction of vitreous samples and retinal biopsy confirmed varicella zoster virus. Despite intensive treatment with intravenous antiviral medication, the patient became completely blind in both eyes.

Conclusion

Initial treatment of acute, unexplained visual decrease with systemic corticosteroids may lead to visual loss in patients with developing acute retinal necrosis. Ocular trauma could have induced and corticosteroid treatment promoted reactivation of a latent viral infection in our patient.
Effects of dietary curcumin or N-acetylcysteine on NF-κB activity and contractile performance in ambulatory and unloaded murine soleus
Authors: Farid Mehran , Reid Michael B , Li Yi-Ping , Gerken Eric , Durham William J
Published: August 2005

Background

Unloading of skeletal muscle causes atrophy and loss of contractile function. In part, this response is believed to be mediated by the transcription factor nuclear factor-kappa B (NF-κB). Both curcumin, a component of the spice turmeric, and N-acetylcysteine (NAC), an antioxidant, inhibit activation of NF-κB by inflammatory stimuli, albeit by different mechanisms. In the present study, we tested the hypothesis that dietary curcumin or NAC supplementation would inhibit unloading-induced NF-κB activity in skeletal muscle and thereby protect muscles against loss of mass and function caused by prolonged unloading.

Methods

We used hindlimb suspension to unload the hindlimb muscles of adult mice. Animals had free access to drinking water or drinking water supplemented with 1% NAC and to standard laboratory diet or diet supplemented with 1% curcumin. For 11 days, half the animals in each dietary group were suspended by the tail (unloaded) and half were allowed to ambulate freely.

Results

Unloading caused a 51–53% loss of soleus muscle weight and cross-sectional area relative to freely-ambulating controls. Unloading also decreased total force and force per cross-sectional area developed by soleus. Curcumin supplementation decreased NF-κB activity measured in peripheral tissues of ambulatory mice by gel shift analysis. In unloaded animals, curcumin supplementation did not inhibit NF-κB activity or blunt the loss of muscle mass in soleus. In contrast, NAC prevented the increase in NF-κB activity induced by unloading but did not prevent losses of muscle mass or function.

Conclusion

In conclusion, neither dietary curcumin nor dietary NAC prevents unloading-induced skeletal muscle dysfunction and atrophy, although dietary NAC does prevent unloading induced NF-κB activation.
The use of cystatin C to inhibit epithelial–mesenchymal transition and morphological transformation stimulated by transforming growth factor-β
Authors: Sokol Jonathan P , Neil Jason R , Schiemann Barbara J , Schiemann William P
Published: August 2005

Introduction

Transforming growth factor-β (TGF-β) is a potent suppressor of mammary epithelial cell (MEC) proliferation and is thus an inhibitor of mammary tumor formation. Malignant MECs typically evolve resistance to TGF-β-mediated growth arrest, enhancing their proliferation, invasion, and metastasis when stimulated by TGF-β. Recent findings suggest that therapeutics designed to antagonize TGF-β signaling may alleviate breast cancer progression, thereby improving the prognosis and treatment of breast cancer patients. We identified the cysteine protease inhibitor cystatin C (CystC) as a novel TGF-β type II receptor antagonist that inhibits TGF-β binding and signaling in normal and cancer cells. We hypothesized that the oncogenic activities of TGF-β, particularly its stimulation of mammary epithelial–mesenchymal transition (EMT), can be prevented by CystC.

Method

Retroviral infection was used to constitutively express CystC or a CystC mutant impaired in its ability to inhibit cathepsin protease activity (namely Δ14CystC) in murine NMuMG MECs and in normal rat kidney (NRK) fibroblasts. The effect of recombinant CystC administration or CystC expression on TGF-β stimulation of NMuMG cell EMT in vitro was determined with immunofluorescence to monitor rearrangements of actin cytoskeletal architecture and E-cadherin expression. Soft-agar growth assays were performed to determine the effectiveness of CystC in preventing TGF-β stimulation of morphological transformation and anchorage-independent growth in NRK fibroblasts. Matrigel invasion assays were performed to determine the ability of CystC to inhibit NMuMG and NRK motility stimulated by TGF-β.

Results

CystC and Δ14CystC both inhibited NMuMG cell EMT and invasion stimulated by TGF-β by preventing actin cytoskeletal rearrangements and E-cadherin downregulation. Moreover, both CystC molecules completely antagonized TGF-β-mediated morphological transformation and anchorage-independent growth of NRK cells, and inhibited their invasion through synthetic basement membranes. Both CystC and Δ14CystC also inhibited TGF-β signaling in two tumorigenic human breast cancer cell lines.

Conclusion

Our findings show that TGF-β stimulation of initiating metastatic events, including decreased cell polarization, reduced cell–cell contact, and elevated cell invasion and migration, are prevented by CystC treatment. Our findings also suggest that the future development of CystC or its peptide mimetics hold the potential to improve the therapeutic response of human breast cancers regulated by TGF-β.
Urinary bladder partial carbon dioxide tension during hemorrhagic shock and reperfusion: an observational study
Authors: Dubin Arnaldo , Pozo Mario O , Edul Vanina S Kanoore , Murias Gastón , Canales Héctor S , Barán Marcelo , Maskin Bernardo , Ferrara Gonzalo , Laporte Mercedes , Estenssoro Elisa
Published: August 2005

Introduction

Continuous monitoring of bladder partial carbon dioxide tension (PCO2) using fibreoptic sensor technology may represent a useful means by which tissue perfusion may be monitored. In addition, its changes might parallel tonometric gut PCO2. Our hypothesis was that bladder PCO2, measured using saline tonometry, will be similar to ileal PCO2 during ischaemia and reperfusion.

Method

Six anaesthetized and mechanically ventilated sheep were bled to a mean arterial blood pressure of 40 mmHg for 30 min (ischaemia). Then, blood was reinfused and measurements were repeated at 30 and 60 min (reperfusion). We measured systemic and gut oxygen delivery and consumption, lactate and various PCO2 gradients (urinary bladder–arterial, ileal–arterial, mixed venous–arterial and mesenteric venous–arterial). Both bladder and ileal PCO2 were measured using saline tonometry.

Results

After bleeding systemic and intestinal oxygen supply dependency and lactic acidosis ensued, along with elevations in PCO2 gradients when compared with baseline values (all values in mmHg; bladder ΔPCO2 3 ± 3 versus 12 ± 5, ileal ΔPCO2 9 ± 5 versus 29 ± 16, mixed venous–arterial PCO2 5 ± 1 versus 13 ± 4, and mesenteric venous–arterial PCO2 4 ± 2 versus 14 ± 4; P < 0.05 versus basal for all). After blood reinfusion, PCO2 gradients returned to basal values except for bladder ΔPCO2, which remained at ischaemic levels (13 ± 7 mmHg).

Conclusion

Tissue and venous hypercapnia are ubiquitous events during low flow states. Tonometric bladder PCO2 might be a useful indicator of tissue hypoperfusion. In addition, the observed persistence of bladder hypercapnia after blood reinfusion may identify a territory that is more susceptible to reperfusion injury. The greatest increase in PCO2 gradients occurred in gut mucosa. Moreover, the fact that ileal ΔPCO2 was greater than the mesenteric venous–arterial PCO2 suggests that tonometrically measured PCO2 reflects mucosal rather than transmural PCO2. Ileal ΔPCO2 appears to be the more sensitive marker of ischaemia.
A molecular map of mesenchymal tumors
Authors: Henderson Stephen R , Guiliano David , Presneau Nadege , McLean Sean , Frow Richard , Vujovic Sonja , Anderson John , Sebire Neil , Whelan Jeremy , Athanasou Nick , Flanagan Adrienne M , Boshoff Chris
Published: August 2005

Background

Bone and soft tissue tumors represent a diverse group of neoplasms thought to derive from cells of the mesenchyme or neural crest. Histological diagnosis is challenging due to the poor or heterogenous differentiation of many tumors, resulting in uncertainty over prognosis and appropriate therapy.

Results

We have undertaken a broad and comprehensive study of the gene expression profile of 96 tumors with representatives of all mesenchymal tissues, including several problem diagnostic groups. Using machine learning methods adapted to this problem we identify molecular fingerprints for most tumors, which are pathognomonic (decisive) and biologically revealing.

Conclusion

We demonstrate the utility of gene expression profiles and machine learning for a complex clinical problem, and identify putative origins for certain mesenchymal tumors.
Studying suicide from the life course perspective: Implications for prevention
Authors: Gunnell D. , Lewis G.
Published: September 2005

Suicide is an important contributor to premature mortality accounting for over 800 000 deaths worldwide every year Environmental and genetic factors acting from before birth to old age affect an individual's risk of suicide. Risk is influenced not only by psychiatric illness and impulsive behaviour but also by factors such as the cultural acceptability of suicide, the ease of availability of lethal suicide methods, help-seeking behaviours in times of crisis and access to effective treatments following self-harm. Suicide prevention programmes might usefully focus on two discrete areas: the prevention of the psychiatric illnesses that precede suicide and tackling those risk factors particular to suicide such as media influences, help-seeking, the availability of methods and the medical management of self-harm.

Delcaration of interest

None.
Substance use disorders and the orbitofrontal cortex
Authors: Dom G. , Sabbe B. , Hulstijn W. , van Den Brink W.
Published: September 2005

Background

Orbitofrontal cortex dysfunctions have been frequently documented in people with substance use disorders. The exact role of this cortical region, however, remains unspecified.

Aims

To assess the functionality of the orbitofrontal cortex in people with substance use disorders.

Method

Reports of studies using behavioural decision-making tasks and/or neuroimaging techniques to investigate orbitofrontal cortex functioning in cases of substance misuse were reviewed. Studies focusing exclusively on tobacco-smoking and gambling were excluded.

Results

Fifty-two research articles were evaluated. Most studies showed significant deficits in decision-making in people with substance use disorders. A consistent finding in the neuroimaging studies was hypoactivity of the orbitofrontal cortex after detoxification. The association between hyperactivity of this region and craving or cue reactivity was not consistent across studies.

Conclusions

The orbitofrontal cortex has an important role in addictive behaviours. Further studies are needed to elucidate the underlying neuronal substrates of cue reactivity, craving and decision-making, and the implications for treatment and relapse prevention.
Laterality phenotypes in patients with schizophrenia, their siblings and controls: Associations with clinical and cognitive variables
Authors: Dragovic Milan , Hammond Geoff , Badcock Johanna C. , Jablensky Assen
Published: September 2005

Background

Various behavioural indices of brain lateralisation significantly intercorrelate, but current research in this area still focuses on single behavioural asymmetries, such as handedness.

Aims

To describe a novel approach, which simultaneously integrates various laterality indices and delineates complex phenotypes.

Method

Grade of membership analysis was used to describe latent, complex lateralisation phenotypes in patients with schizophrenia (n=157), their siblings (n=74) and controls (n=77). The indices used were asymmetries of eye, foot and hand; hand motor proficiency; and handedness of patient's first-degree relatives.

Results

Three distinct pure types of lateralisation (‘right’, ‘left’ and ‘mixed’) were evident in patients compared with two (‘right’ and ‘left’) in siblings and controls. The ‘mixed’ type in patients featured absence of eye and foot lateralisation and presence of familial sinistrality, despite a right-hand dominance for writing. Patients with schizophrenia expressing the ‘left’ phenotype had a more severe course of illness, significantly increased scores on two schizotypy factors and poorer neurocognitive performance. The pure types in the siblings were similar to those in healthy controls.

Conclusions

The findings suggest that a leftward reversal, rather than a reduction in lateralisation, is associated with clinical severity and neurocognitive deficits in patients with schizophrenia.
Risperidone in the treatment of acute mania
Authors: Khanna Sumant , Vieta Eduard , Lyons Benjamin , Grossman Fred , Eerdekens Mariëlle , Kramer Michelle
Published: September 2005

Background

Severe mania is life-threatening, carries an increased risk of suicide and has a serious impact on patients and their families. Efficient and rapid control of episodes of acute mania is needed.

Aims

To evaluate the safety and efficacy of risperidone monotherapy for acute mania.

Method

In a 3-week, randomised, double-blind trial, 290 in-patients with bipolar l disorder with current manic or mixed episode and a baseline Young Mania Rating Scale (YMRS) score of 20 or more received flexible doses of risperidone (1–6 mg per day) or placebo.

Results

Risperidone was received by 146 patients and placebo by 144. Their mean baselineYMRS score was 37. 2 (s. e. =0. 5). Significantly greater improvements were observed with risperidone than with placebo at weeks l and 2 and at end-point (total YMRS:P<0. 01). Extrapyramidal symptoms were the most frequently reported adverse events in the risperidone group.

Conclusions

In patients with severe manic symptoms, risperidone produced significant improvements in YMRS scores as early as week 1 and substantial changes at end-point. Treatment was well tolerated.
Schizophrenia practice guidelines: International survey and comparison
Authors: Gaebel Wolfgang , Weinmann Stefan , Sartorius Norman , Rutz Wolfgang , McIntyre John S.
Published: September 2005

Background

Schizophrenia guidelines differ considerably in methodology and content.

Aims

To systematically compare national schizophrenia guidelines from different countries.

Method

An international survey was conducted on guideline development and a methodological comparison was made using a validated guideline appraisal instrument (the Appraisal Guideline Research and Evaluation Europe).

Results

The methodological quality of many schizophrenia guidelines was at best moderate. Few guidelines had included key stakeholders in their development process. Although pharmacotherapy recommendations were similar, there were strong variations in the type of psychosocial interventions recommended.

Conclusions

The methodological quality of guidelines has a strong influence on their applicability However, the lack of financial means to develop and implement guidelines is a serious problem. Independent international organisations could contribute to defining a core set of unbiased schizophrenia treatment recommendations. In countries with a shortage of resources, this could be a basis for adaptation to different cultural and economic backgrounds in collaboration with stakeholders.
Patient-rated mental health needs and quality of life improvement
Authors: Slade Mike , Leese Morven , Cahill Sharon , Thornicroft Graham , Kuipers Elizabeth
Published: September 2005

Background

Patient-rated unmet need is cross-sectionally associated with quality of life. Its longitudinal relationship has not been established.

Aims

To test the hypotheses that: (a) higher patient-rated unmet need is associated with lower individual quality of life assessments by apatientover time; and (b) reduction in patient-rated unmet need precedes improvement in quality of life.

Method

One hundred and one individuals using adult mental health services were asked to complete 6-monthly questionnaires, comprising quality of life (Manchester Short Assessment of Quality of Life, MANSA) and unmet need (Camberwell Assessment of Need Short Appraisal Schedule, CANSAS) assessments.

Results

Seventy-three participants provided 240 separate pairs of consecutive assessments. Random effects regression models indicated an impact on current quality of life for both average level of unmet need (B= −0.23, 95% CI −0.29 to −0.17) and change in unmet need over the past month (B= −0.04, 95% CI −0.02).

Conclusions

Changes in patient-rated unmet needs may cause changes in quality of life.
General practitioners and schizophrenia: Results from a Swiss survey
Authors: Simon Andor E. , Lauber Christoph , Ludewig Katja , Braun-Scharm Hellmuth , Umbricht Daniel S.
Published: September 2005

Background

General practitioners (GPs) have an important role in the care of patients with chronic schizophrenia and of those in the early phases of this disorder.

Aims

To obtain information about the number of patients in the early and chronic stages of schizophrenia seen in general practice; the needs and attitudes of GPs, their diagnostic knowledge concerning early phases of schizophrenia and their knowledge and practice concerning treatment of patients with first-episode and multi-episode schizophrenia.

Method

Apostal survey was conducted among randomly selected GPs in Switzerland.

Results

Atotal of 1089 GPs responded to the survey. Early psychosis had a low prevalence in general practice, and GPs expressed a wish for specialised, low-threshold referral services. Diagnostic and treatment knowledge showed inconsistencies. Most GPs said they would treat first-episode schizophrenia with antipsychotics, but only a third recommended maintenance treatment after a first episode of schizophrenia that would conform with international recommendations.

Conclusions

Easily accessible, low-threshold referral services are pivotal in supporting GPs in the management and treatment of emerging schizophrenia in primary healthcare patients.
Fronto-parietal activation in attention-deficit hyperactivity disorder, combined type: Functional magnetic resonance imaging study
Authors: Silk T. , Vance A. , Rinehart N. , Egan G. , O'Boyle M. , Bradshaw J. L. , Cunnington R.
Published: September 2005

Afunctional magnetic resonance imaging mental rotation paradigm was used to investigate the patterns of activation of fronto-parietal brain areas in male adolescents with attention-deficit hyperactivity disorder, combined type (ADHD–CT) compared with age-, gender-, handedness- and performance IQ-matched healthy controls. The ADHD-CT group had (a) decreased activation of the ‘action-atttentional’ system (including Brodmann's areas (BA) 46, 39, 40) and the superior parietal (BA7) and middle frontal (BA10) areas and (b) increased activation of the posterior midline attentional system. These different neuroactivation patterns indicate widespread frontal, striatal and parietal dysfunction in adolescents with ADHD-CT.
Cognitive performance in presumed obligate carriers for psychosis
Authors: Toulopoulou Timothea , Mapua-Filbey Francesca , Quraishi Seema , Kravariti Eugenia , Morris Robin G. , McDonald Colm , Walshe Muriel , Bramon Elvira , Murray Robin M.
Published: September 2005

We report cognitive performance of a group of individuals who are likely to have transmitted liability to psychosis to their offspring. Out of 230 relatives of patients with psychosis, 27 met our criteria for a presumed obligate carrier, that is a non-psychotic individual who had a parent or a sibling as well as an offspring with psychosis. The presumed obligate carriers showed impairments in verbal memory and in visuospatial manipulations, suggesting that these individuals transmit vulnerability for psychosis to their offspring in terms of a disability to recall verbal information and an impaired capacity to perceive spatial relations.
Longitudinal follow-up in acute and transient psychotic disorders and schizophrenia
Authors: Pillmann Frank , Marneros Andreas
Published: September 2005

We prospectively studied the long-term course of individuals with acute and transient psychotic disorders and a control group with positive schizophrenia matched for age and gender. Follow-up investigations using standardised instruments were performed at three time-points covering 7 years after the index episode or 12 years after the first episode. During follow-up, those with positive schizophrenia experienced a deterioration in their general functioning whereas those with acute and transient psychotic disorders retained their high level of functioning. At the end of the observation period, 12 out of 39 (31%) of those with acute and transient psychotic disorders were functioning well without medication compared with 0 out of 38 with positive schizophrenia.
Sharing letters with patients and their carers: problems and outcomes in elderly and dementia care
Authors: Treloar Adrian , Adamis Dimitrios
Published: September 2005

Aims and Method

In a cross-sectional survey, we assessed the attitudes of older patients and their carers towards receiving copies of letters about them and the effects upon outcomes of sharing letters. We also studied the opinions of consultants on letter-sharing.

Results

Few old age psychiatrists shared letters with patients or carers, and many had concerns about this practice. In contrast, letters were considered ‘very welcome’ by 87% of patients and carers who received them, and 81% of those who did not would be ‘very pleased’ to receive them. Patients and carers who had received letters had significantly better knowledge of their care plan, whom to contact and ways of making contact with services.

Clinical Implications

Despite concerns expressed by psychiatrists, our findings support the sharing of letters with patients and carers of patients with dementia in old age psychiatry services.
Logbook for specialist registrars in general adult psychiatry: development and peer evaluation
Authors: George Sanju , Jorsh Mike , Johnson Joe
Published: September 2005

Aims and Method

Despite the Royal College of Psychiatrists' recommendation that higher specialist trainees in general adult psychiatry should use logbooks to record their training-related activities, none is currently available. We developed a logbook and conducted a postal survey of specialist registrars in general adult psychiatry in the West Midlands and Merseyside Training Schemes to elicit their perceptions of its usefulness and feasibility.

Results

All of the 35 specialist registrars who completed the questionnaire felt that there was scope for a logbook and that this format was easy to use. Three-quarters of the respondents suggested that their training curriculum should be incorporated into the logbook and 71% felt that the use of logbooks ought to be mandatory. Despite all acknowledging the need for a logbook, only 14% were currently using one.

Clinical Implications

Logbooks would greatly help higher specialist trainees to organise (identify, record and review learning objectives) the multifaceted aspects of their training. They would also help immensely in preparing for the Record of In-Training Assessment, appraisal and revalidation. There is clearly scope for a more ‘centrally’ produced (College) logbook for specialist registrars in general adult psychiatry, as indicated by the results of this survey. For logbooks to work in practice, they need to be simple and easy to use.
Is liaison psychiatry a separate specialty? Comparison of referrals to a liaison psychiatry service and a community mental health team
Authors: Molodynski Andrew , Bolton Jim , Guest Louise
Published: September 2005

Aims and Method

The aim of the study was to compare referrals to a liaison psychiatry service and a neighbouring community mental health team (CMHT). Demographic and clinical information were compared for 100 consecutive referrals to each service.

Results

The liaison psychiatry service had a smaller ongoing case-load and a higher referral rate than the CMHT. Larger proportions of patients referred to liaison psychiatry had comorbid physical illness (49 v. 10%) or had harmed themselves (41 v. 10%). More patients referred to the CMHT had a primary diagnosis of a mood disorder (49 v. 28%), but fewer had organic disorders.

Clinical Implications

The differences in service delivery and clinical problems referred imply that different expertise is required by those working in each service. This supports the view that community and liaison psychiatry are separate specialties, with implications for higher specialist training.
From specialist registrar to consultant: permission to land?
Authors: Naeem Asim , Rutherford Joan , Kenn Chris
Published: September 2005

After many years of hard work and training, the transition from trainee to consultant is potentially challenging. Having successfully negotiated the hurdles of preregistration training, the MRCPsych examination and the specialist registrar (SpR) interview, trainees have to pass one final signpost to mark the end of their formal training – securing their first substantive consultant psychiatrist post. Despite overall vacancy rates of about 12% for consultant psychiatrists in the UK (Royal College of Psychiatrists, 2002), competition can be intense for some posts.
Optimierte Neuro-Fuzzy-Modelle für Auslegungsprozesse und Simulation im Automotive-Bereich (Improved Neuro-Fuzzy Models for Design Processes and Simulation in Automotive Applications)
Authors: Jakubek Stefan , Keuth Nikolaus
Published: September 2005

Dieser Artikel beschreibt einen neuen iterativen Partitionierungsalgorithmus für lokale Neuro-Fuzzy-Modelle. Der Algorithmus zielt darauf ab, datenbasierte Modelle aus dünnbesetzten Eingangsräumen, wie sie im Automotive-Bereich häufig auftreten, zu generieren. Der Gültigkeitsbereich jedes lokalen Neuro-Fuzzy-Modells wird dabei unter Anwendung statistischer Kriterien und Regularisierung an die vorhandenen Daten angepasst. Ausdehnung und Orientierung jedes lokalen Modells orientieren sich auch derart an den vorhandenen Trainingsdaten, dass die Bestimmung der Regressionsparameter ein gut konditioniertes Problem darstellt. Die Regularisierung des Modells kann durch den Benutzer mittels eines Parameters gut konditioniert werden.

Um die Qualität und Sicherheit des erstellten Modells beurteilen zu können, wird zusätzlich eine Modellstatistik berechnet. Mehrere Beispiele aus der Praxiserprobung bzw. aus einem Pilotprojekt beschreiben die Effizienz des vorgestellten Algorithmus.
Analyse und Synthese frequenzadaptiver Herzschrittmacher (Analysis and Design of Rate-responsive Pacemakers)
Authors: Hexamer Martin
Published: September 2005

Chronotrop inkompetente Patienten werden mit einem frequenzadaptiven Herzschrittmacher therapiert. Dieser stimuliert das Herz mit einer Frequenz, die von einem belastungskorrelierten Sensorsignal abgeleitet wird. Eine bestimmte Klasse von Sensoren erzeugt eine geschlossene Rückkopplung, sodass regelungstechnische Methoden beim Entwurf angesetzt werden müssen. Dieser Beitrag präsentiert ein methodisches Gerüst für einen solchen Entwurf.
Modellierung und Regelung des arteriellen Blutflusses während der extrakorporalen Zirkulation (Modelling and Control of the Arterial Blood Flow During Extracorporeal Circulation)
Authors: Misgeld Berno J. E. , Hexamer Martin
Published: September 2005

Zum Entwurf einer Regelung für den arteriellen Blutfluss während der extrakorporalen Zirkulation (EKZ) wird ein Modell entwickelt, welches sich in die Teilmodelle Herz-Lungen-Maschine (HLM) und vaskuläres System unterteilen lässt. Zwei vaskuläre Kompartimentenmodelle unterschiedlicher Komplexität werden mit den linearisierten Navier–Stokes-Gleichungen beschrieben und miteinander verglichen. Als Stellglied für den Blutfluss wird eine Kreiselpumpe modelliert. Ein diskreter PI-Regler wird im Hinblick auf Parameterunsicherheiten robust entworfen. Der PI-Regler beweist sowohl in Simulationsstudien (MATLAB/SIMULINK) als auch im Test an einem hydrodynamischen Kreislaufsimulator Stabilität und eine hohe Güte.
Comprehensive Primary Care for Children With Special Health Care Needs in Rural Areas
Authors: Farmer Janet E. , Clark Mary J. , Sherman Ashley , Marien Wendi E. , Selva Thomas J.
Published: September 2005

Objective. Most research on comprehensive primary care interventions for children with chronic health conditions has been conducted in large urban areas, where child health and related services are readily available. The purpose of this study was to evaluate the feasibility and impact of a medical home demonstration project in a more rural part of the country.

Methods. Fifty-one parents of children with special health care needs participated in a pre-/posttreatment assessment of a program designed to enhance comprehensive and coordinated care. Participants were recruited from 3 primary care practices in a central Midwest state and remained in the program for ∼12 months.

Results. Parents reported significant increases in satisfaction with care coordination and access to mental health services after the intervention. They also noted decreases in family needs, caregiver strain, parents’ missed work days, children’s school absences, and utilization of ambulatory services. Satisfaction with primary care declined slightly but remained in the “very good” range. Families of children with more complex conditions were more likely to report a decrease in needs after intervention, but other factors, such as geographic location or socioeconomic status, were not related to key outcome variables.

Conclusions. Comprehensive care has a positive effect on children with chronic health conditions and their families, including those who live in more rural areas. Additional study is needed to learn more about rural service delivery strategies that promote implementation of this approach in general practice.
Breastfeeding Rates in US Baby-Friendly Hospitals: Results of a National Survey
Authors: Merewood Anne , Mehta Supriya D. , Chamberlain Laura Beth , Philipp Barbara L. , Bauchner Howard
Published: September 2005

Objectives. The objectives of this study were to analyze all available breastfeeding data from US Baby-Friendly hospitals in 2001 to determine whether breastfeeding rates at Baby-Friendly designated hospitals differed from average US national, regional, and state rates in the same year and to determine prime barriers to implementation of the Baby-Friendly Hospital Initiative.

Methods. In 2001, 32 US hospitals had Baby-Friendly designation. Using a cross-sectional design with focused interviews, this study surveyed all 29 hospitals that retained that designation in 2003. Demographic data, breastfeeding rates, and information on barriers to becoming Baby-Friendly were also collected. Simple linear regression was used to assess factors associated with breastfeeding initiation.

Results. Twenty-eight of 29 hospitals provided breastfeeding initiation rates: 2 from birth certificate data and 26 from the medical record. Sixteen provided in-hospital, exclusive breastfeeding rates. The mean breastfeeding initiation rate for the 28 Baby-Friendly hospitals in 2001 was 83.8%, compared with a US breastfeeding initiation rate of 69.5% in 2001. The mean rate of exclusive breastfeeding during the hospital stay (16 of 29 hospitals) was 78.4%, compared with a national mean of 46.3%. In simple linear regression analysis, breastfeeding rates were not associated with number of births per institution or with the proportion of black or low-income patients. Of the Ten Steps to Successful Breastfeeding the 3 described as most difficult to meet were Steps 6, 2, and 7. The reason cited for the problem with meeting Step 6 was the requirement that the hospital pay for infant formula.

Conclusion. Baby-Friendly designated hospitals in the United States have elevated rates of breastfeeding initiation and exclusivity. Elevated rates persist regardless of demographic factors that are traditionally linked with low breastfeeding rates.