bluuebunny/crossref_metadata_2025 huggingface dataset:
Early‐onset psychosis in youth with intellectual disability
Authors: Friedlander R. I. , Donnelly T.
Published: August 2004

Background  Accurate diagnosis of psychotic disorders may be very difficult in youth with intellectual disabilities.

Method  The authors reviewed the assessment, treatment and follow‐up of 21 youths with ID referred because of early onset of psychotic symptoms.

Results  Just over one half of the patients had a diagnosis of schizophrenia or schizoaffective disorder.

One third of the sample carried the diagnosis of psychosis NOS (not otherwise specified). After careful review, five out of seven of these psychotic‐like cases were assessed as non‐psychotic.

Patients with Psychosis NOS associated with moderate or severe ID had the worst outcome.

Conclusion  This clinical review provides important information about the identification, diagnosis and outcome of psychotic symptoms in youth with low verbal abilities.
Schizophrenia‐spectrum psychoses in people with and without intellectual disability
Authors: Bouras N. , Martin G. , Leese M. , Vanstraelen M. , Holt G. , Thomas C. , Hindler C. , Boardman J.
Published: August 2004

Background  Although there is an increased risk of schizophrenia‐spectrum psychoses (SSP) in people with intellectual disability (ID), there is a paucity of research evidence into clinical presentation of the disorder in comparison with research into SSP in people without ID.

Aims  The aims of the study were to compare clinical, functional, and social factors in patients with mild ID (ICD‐10: F70) and SSP (ICD‐10: F20–9) attending a specialist mental health service for people with ID, with a control group of patients without ID but with SSP attending a generic adult mental health (GAMH) outpatient clinic.

Method  A total of 106 patients with SSP (53 with ID and 53 from GAMH) were assessed on psychopathological symptoms, functioning scales and quality of life. They were compared using chi‐squared and regression analysis where appropriate.

Results  People with ID and SSP appear to be more debilitated by the co‐occurring disorder than those with the same disorder but without ID. Increases in observable psychopathology and ‘negative’ schizophrenic symptoms, and decreased functional abilities were observed in the group with ID when compared to the GAMH group. The clinical implications of these findings are discussed.
The association between severity of intellectual disability and psychiatric symptomatology
Authors: Holden B. , Gitlesen J. P.
Published: August 2004

Background  Mental illness is more prevalent in people with intellectual disabilities (ID) than in the normal population. The association between mental illness and severity of ID is also of importance in the understanding and treatment of maladaptive and challenging behaviours. The aim of this study was to investigate the association between severity of ID and prevalence of mental illness.

Methods  Using The Mini PAS‐ADD, an instrument designed to identify psychiatric symptoms in people with ID, informants were interviewed about the presence of symptoms in 96 participants with moderate, severe and profound ID, and asked about the use of psychotropic medication.

Results  Mental illness, particularly anxiety, depression and psychosis, was far more prevalent in participants with moderate ID than in people with severe and profound ID. The use of psychotropic medication was not significantly different between the groups.

Conclusions  The prevalence of psychiatric illness decreases with severity of ID. The usefulness of psychiatric illness models, in explaining maladaptive and challenging behaviours, also decreases with severity of ID. Drug treatment may become more complicated, and behavioural and environmental interventions may become relatively more important, as severity of ID increases.
Longitudinal prescribing patterns for psychoactive medications in community‐based individuals with developmental disabilities: utilization of pharmacy records
Authors: Lott I. T. , McGregor M. , Engelman L. , Touchette P. , Tournay A. , Sandman C. , Fernandez G. , Plon L. , Walsh D.
Published: August 2004

Background  Little is known about longitudinal prescribing practices for psychoactive medications for individuals with intellectual disabilities and developmental disabilities (IDDD) who are living in community settings.

Methods  Computerized pharmacy records were accessed for 2344 community‐based individuals with IDDD for whom a total of 3421 prescriptions were written during a 17‐month period of study. Forty‐two psychoactive medications were rank ordered in terms of prescription frequency.

Results  Fifty‐two per cent (52%) of all prescriptions written during the study period were for psychoactive medications. Anticonvulsant, antipsychotic and antidepressant medications were the most commonly filled prescriptions among psychoactive medications. Sixty per cent (62%) of the study population was given prescriptions for more than one psychoactive medication and 36% received three or more psychoactive medications. During the study period there was a statistically significant increase in prescriptions filled for olanzapine, risperidone, valproic acid, and clonazepam whereas prescriptions filled for thioridazine, haloperidol, and benzotropine showed a significant decline (P < 0.05–0.001). Distribution of psychoactive drug class by age showed that the majority of prescriptions were filled for individuals between 20 and 50 years with the exception of prescriptions for psychostimulants which peaked for individuals prior to 20 years.

Conclusions  (1) Analysis of pharmacy billing records provides a method for assessing prescribing patterns of psychoactive medications in community‐based individuals with IDDD. (2) Polypharmacy for psychoactive medications is prevalent in this setting. (3) The second‐generation antipsychotic medications are prominently represented by an increasing number of filled prescriptions during the study period.
Women with intellectual disability who have offended: characteristics and outcome
Authors: Lindsay W. R. , Smith A. H. W. , Quinn K. , Anderson A. , Smith A. , Allan R. , Law J.
Published: August 2004

Background  There have been a few reports describing the characteristics and outcomes of male offenders with intellectual disability (ID). Therefore, while we are building up a reasonable picture of this client group, there are almost no reports of female offenders with ID. This paper is a preliminary attempt to present information on a small cohort of female offenders.

Methods  Characteristics of female offenders are presented including information on age, IQ, mental illness, referring agents, crimes committed, problems identified, sexual and physical abuse and outcome. Some comparisons are made with corresponding descriptions of male cohorts in Lindsay et al. (2004).

Results  The main result is that females constitute 9% of referrals to the service. Other notable results are that: at 61% sexual abuse in the cohort of female offenders is higher than in male cohorts but at 38.5% physical abuse is no higher than in appropriate comparison groups; as with mainstream female offenders identification of mental illness is high at 67%; and total re‐offending over 5 years was 22% but, excluding prostitution, was only 16.5%.

Conclusions  In some respects, this cohort of female offenders shows similar characteristics to their male counterparts. However, there are higher levels of mental illness, higher levels of sexual abuse and lower levels of re‐offending. It is hypothesized that as females constitute such a low percentage of referrals, it suggests that women with ID do not show the same levels of sexually abusive behaviour or aggressive behaviour – the two most frequent reasons for male referral. Therefore, an intervening variable such as mental illness may indeed be a significant factor. Lower re‐offending rates may indicate the success of interventions directed at psychological problems and mental illness.
Beyond specialist programmes: a study of the needs of offenders with intellectual disability requiring psychiatric attention
Authors: Glaser W. , Florio D.
Published: August 2004

Background  Despite the increased prevalence of psychiatric disorder amongst offenders with an intellectual disability (ID), there is very little known about the characteristics and needs of those with dual disability.

Method  A study of admissions to a new community forensic dual disability clinic during the first 10 months of its operation.

Results  Typically, the offenders are male, are older than other offenders, exhibit long‐standing and continuing serious behavioural disturbance (independent of their psychiatric diagnosis or level of involvement with the criminal justice system) and require supported or custodial accommodation, despite only mild or borderline levels of ID. Although only one‐third have a diagnosable major nonparaphilic psychiatric disorder, three‐quarters have had prior or current contact with psychiatric services and two‐thirds suffer chronic medical illness.

Conclusions  These offenders suffer psychosocial disadvantages far more extensive than those implied by the ‘psychiatric’ or ‘disability’ label. The multiple services provided to this group have been ad hoc, poorly co‐ordinated and sometimes dangerously inappropriate. A service provision model is required which must be integrative and consistent. We suggest the use of multiskilled key workers, who maintain close contact with individual clients. Their role will be to implement management plans from the various specialist agencies who become involved with this group and provide long‐term follow‐up of their recommendations.
Defining the needs of patients with intellectual disabilities in the high security psychiatric hospitals in England
Authors: Thomas S. D. , Dolan M. , Johnston S. , Middleton H. , Harty M. A. , Carlisle J. , Thornicroft G. , Appleby L. , Jones P.
Published: August 2004

Background  Previous studies have suggested that a substantial proportion of the patients with intellectual disabilities (ID) in the high security psychiatric hospitals (HSPHs) should be transferred to more appropriate services to cater for their specific needs in the longer term.

Method  The individual and placement needs of high secure psychiatric patients detained under the legal category of mental impairment or severe mental impairment were assessed in a cross‐sectional survey.

Results  Patients had a large number of needs (on average 10.8), about a third of which were rated as unmet and therefore represented significant continuing problems. Approximately one‐third of the sample could be moved out of HSPHs if appropriate alternatives were available. Factors associated with the continued need for high security included higher treatment and security needs, younger age, recent violent conduct and their index offence profile.

Conclusions  High security services are still required for a number of patients with ID. New and existing services need to be configured to meet specific profiles of need and provide long‐term rehabilitation and specialist care.

Declaration of interest  This was part of a larger project funded by grants from the High Security Psychiatric Services Commissioning Board and Department of Health.
The modified CAMDEX informant interview is a valid and reliable tool for use in the diagnosis of dementia in adults with Down's syndrome
Authors: Ball S. L. , Holland A. J. , Huppert F. A. , Treppner P. , Watson P. , Hon J.
Published: August 2004

Background  Dementia because of Alzheimer's disease (AD) commonly affects older adults with Down's syndrome (DS). Methods are needed, with established concurrent and predictive validity, to facilitate the diagnostic assessment of dementia, when it is complicated by pre‐existing intellectual disabilities (ID). We report on the reliability and validity of a modified version of the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) informant interview, for use when assessing people with DS suspected as having dementia.

Methods  As part of a previous epidemiological study of older people with DS, the CAMDEX informant interview was used to determine the prevalence of dementia. The 74 people with DS included at that time (Time 1) had also completed the Cambridge Cognitive Examination (CAMCOG), the neuropsychological assessment from the CAMDEX schedule. Fifty‐six were assessed again 6 years later (Time 2). Based on the CAMDEX informant interview, nine of the 74 at Time 1, and 11 of the 56 at Time 2, were found to meet clinical criteria for AD. Forty‐one scored above floor on the CAMCOG at Time 1 and were included in the analysis of cognitive decline. Concurrent validity was established by comparing diagnosis at Time 2 with independent evidence of objective decline on cognitive tasks since Time 1. Predictive validity was established by examining how accurately diagnosis at Time 1 predicted both cognitive decline and future diagnosis. Inter‐rater reliability was determined by comparing the level of agreement between two raters.

Results  CAMDEX‐based diagnosis of AD was shown to be consistent with objectively observed cognitive decline (good concurrent validity) and to be a good predictor of future diagnosis. Although numbers are small, some support is also provided for the accuracy with which diagnosis predicts cognitive decline. Inter‐rater reliability was good with Kappa > 0.8 for 91% of items and > 0.6 for all items.

Conclusions  The use of the modified CAMDEX informant interview enables the structured collection of diagnostic information, so that a valid and a reliable diagnosis of dementia can be made in those with pre‐existing ID, using established diagnostic criteria.
Modeling and allometric scaling of s(+)‐ketoprofen pharmacokinetics and pharmacodynamics: a retrospective analysis
Authors: Lepist E.‐I. , Jusko W. J.
Published: August 2004

Interspecies scaling of pharmacokinetic (PK) parameters is commonplace in drug development. However, information about proportionality of pharmacodynamic (PD) parameters in different species is scarce. We investigated the feasibility of allometric scaling of PK and PD parameters of s(+)‐ketoprofen (sKTP) using the literature data from several animal species. Two different indirect response models were proposed to characterize sKTP inhibitory effects on synthesis of thromboxane B2 (TXB2) and prostaglandin E2 (PGE2). Using the traditional allometric approach, the obtained PK and PD parameters were plotted against body weights (BW) on a log‐log scale. For all species, values of systemic clearance (Cl), distribution clearance (ClD), central volume of distribution (Vc), and volume of distribution at steady‐state (Vss) were highly correlated (r2 = 0.89–0.99) with BW. The PD parameters for inhibition of TXB2 synthesis were poorly correlated with BW (r2 = 0.25–0.54) while most of the parameters for inhibition of PGE2 synthesis lacked any correlation (r2 ≈ 0.05). In conclusion, indirect response models adequately described the time course of sKTP inhibitory effects on synthesis of TXB2 and PGE2. Allometrical scaling showed PK parameters to change proportionally to BW, whereas PD parameters had limited ranges and were essentially weight independent.
Intravenous and subcutaneous pharmacokinetics of florfenicol in sheep
Authors: Lane V. M. , Wetzlich S. , Clifford A. , Taylor I. , Craigmill A. L.
Published: August 2004

Pharmacokinetic parameters of florfenicol were determined in 10 adult sheep (five wethers and five ewes) after a single 40 mg/kg intravenous (i.v.) dose, and three daily subcutaneous (s.c.) doses of 40 mg/kg of a commercial preparation (Nuflor®). The concentration of florfenicol in serum samples was assayed using a proprietary HPLC assay method, and pharmacokinetic parameters derived for individual animal data by each route using compartmental and noncompartmental approaches. Two animals (one male and one female) were excluded due to observed i.v. dosing problems, and a biexponential model was found to fit the i.v. data well for six of the other eight animals. Data from two males showed prolonged low concentrations of florfenicol in serum and were better fit by a three‐compartment model. The mean ± SD for the half‐lives of the distribution and elimination phases for the six sheep best fit with a two‐compartment model were 0.069 ± 0.018 and 1.01 ± 0.09 h respectively, and for the Vd(ss) and clearances were 0.503 ± 0.035 L/kg and 366 ± 53 mL/h/kg respectively. The data collected during the s.c. multiple dose study were analyzed using noncompartmental methods only. The bioavailability (F%) after s.c. dosing was calculated in three ways to compare estimation methods as steady‐state had not been reached and single dose s.c. data were not obtained past 24 h. Using the AUC0‐‐24 and AUC0→∞ from the first dose, the F% values averaged 27 and 40% respectively. Using the AUC0→∞ for all doses, the F% was 65%. Calculations of the mean time during which the serum concentration exceeded 0.5 and 1.0 μg/mL were 105 ± 3.9 and 74.7 ± 12.2 h respectively.
The efficacy of bovine lactoferrin in the treatment of cows with experimentally inducedEscherichia colimastitis
Authors: Kutila T. , Suojala L. , Lehtolainen T. , Saloniemi H. , Kaartinen L. , Tähti M. , Seppälä K. , Pyörälä S.
Published: August 2004

The effect of bovine lactoferrin (Lf) was studied in experimentalEscherichia colimastitis, using enrofloxacin as a comparator. Mastitis was induced in six clinically healthy primiparous dairy cows by infusing 1500 colony‐forming units ofE. coliinto a single udder quarter. The challenge was repeated into a contralateral quarter of the same cows 3 weeks later. At the first challenge, three cows were treated with 1.5 g of bovine lactoferrin intramammarily three times (12, 20 and 36 h postchallenge, PC), and the other three cows received 5 mg/kg of enrofloxacin (Baytril®) parenterally (12, 36 and 60 h PC). Flunixin meglumine (2.2 mg/kg) was administered to all cows twice at 24‐h intervals. During the second challenge, the treatments for the two groups were reversed. Intramammary challenge withE. coliproduced clinical mastitis in all cows, but the severity of the disease varied markedly. No statistically significant differences between treatment groups were observed in clinical signs such as rectal temperature, rumen motility and general attitude. Milk somatic cell count, daily milk yield and bacterial counts in cows treated with Lf and those receiving enrofloxacin also did not differ significantly. However, a trend for a more rapid elimination of bacteria was seen in the cows treated with enrofloxacin. Milk NAGase activity also decreased significantly faster in the group treated with enrofloxacin. The concentration of lipopolysaccharide in milk compared with the number of bacteria was significantly lower in Lf than in enrofloxacin‐treated cows (20 h PC).
Metabolism of bromhexine in pig hepatocyte cultures
Authors: Meijer L. A. , Verstegen J. C. M. , Bull S. , Fink‐Gremmels J.
Published: August 2004

The metabolism of bromhexine [N‐cyclohexyl‐N‐methyl‐2‐(2‐amino‐3,5‐di‐bromo‐benzyl)‐amine] was studied using pig hepatocyte cultures and LC/MS/MS techniques. Phase I ‘single‐step’ reactions, i.e. hydroxylation and demethylation occurred the fastest whereas the formation of hydroxylated/demethylated and aminal hydroxylated metabolites, which can be considered as multiple‐step reactions, occurred more slowly. Phase II conjugates were detected for all hydroxylated metabolites. The glucuronides of the hydroxylated/demethylated components tended to accumulate. In addition to metabolites known to be formed in vivo, three unknown components related to bromhexine were detected. Two of these metabolites accumulated during incubation. Based on the fragmentation patterns, a possible molecular structure is proposed for these components.
Frequency of the mutant MDR1 allele associated with multidrug sensitivity in a sample of collies from France
Authors: Hugnet C. , Bentjen S. A. , Mealey K. L.
Published: August 2004

A study was performed to determine the frequency of the mutant MDR1 allele associated with ivermectin sensitivity in a sample of collies living in France. Buccal swab samples were collected from approximately 83 collies for determination of MDR1 genotype. DNA was extracted and the polymerase chain reaction was performed to amplify a 148 bp (wildtype MDR1 genotype) or 144 bp (mutant MDR1 genotype) amplicon containing the MDR1 mutation. Sequence analysis was performed to determine the genotype of each dog. Adequate quantities of DNA for unequivocal genotyping were obtained from only 25 of 83 swabs. Twenty percent (5/25) of the collies studied were homozygous for the normal allele (normal), 32% (8/25) were heterozygous (carrier), and 48% (12/25) were homozygous for the mutant allele (affected). The results of this study indicate that a high percentage of collies presenting to veterinarians in France harbor the MDR1 mutation, thus impacting some therapeutic decisions.
Pharmacokinetics and lung tissue concentrations of tulathromycin in swine
Authors: Benchaoui H. A. , Nowakowski M. , Sherington J. , Rowan T. G. , Sunderland S. J.
Published: August 2004

The absolute bioavailability and lung tissue distribution of the triamilide antimicrobial, tulathromycin, were investigated in swine. Fifty‐six pigs received 2.5 mg/kg of tulathromycin 10% formulation by either intramuscular (i.m.) or intravenous (i.v.) route in two studies: study A (10 pigs, i.m. and 10 pigs, i.v.) and study B (36 pigs, i.m.). After i.m. administration the mean maximum plasma concentration (Cmax) was 616 ng/mL, which was reached by 0.25 h postinjection (tmax). The mean apparent elimination half‐life (t1/2) in plasma was 75.6 h. After i.v. injection plasma clearance (Cl) was 181 mL/kg·h, the volume of distribution at steady‐state (Vss) was 13.2 L/kg and the elimination t1/2 was 67.5 h. The systemic bioavailability following i.m. administration was >87% and the ratio of lung drug concentration for i.m. vs. i.v. injection was ≥0.96. Following i.m. administration, a mean tulathromycin concentration of 2840 ng/g was detected in lung tissue at 12 h postdosing. The mean lung Cmax of 3470 ng/g was reached by 24 h postdose (tmax). Mean lung drug concentrations after 6 and 10 days were 1700 and 1240 ng/g, respectively. The AUCinf was 61.4 times greater for the lung than for plasma. The apparent elimination t1/2 for tulathromycin in the lung was 142 h (6 days). Following i.m. administration to pigs at 2.5 mg/kg body weight, tulathromycin was rapidly absorbed and highly bioavailable. The high distribution to lung and slow elimination following a single dose of tulathromycin, are desirable pharmacokinetic attributes for an antimicrobial drug indicated for the treatment of respiratory disease in swine.
Cyclosporin A pharmacokinetics and efficacy in the treatment of atopic dermatitis in dogs
Authors: Steffan J. , Strehlau G. , Maurer M. , Rohlfs A.
Published: August 2004

A series of experiments was conducted to study cyclosporin A (CsA) pharmacokinetics in dogs and the factors influencing variability of blood concentrations. In a first study, influence of feeding on drug absorption and blood profile was evaluated. Administration of CsA as micro‐emulsion (ME) formulation with food decreased the bioavailability by 22% and increased the individual variability of drug absorption. In a second study, pharmacokinetic profiles from laboratory fasted beagle dogs receiving orally CsA ME formulation were analyzed. CsA was measured in blood samples by high‐performance liquid chromatography (HPLC, 34 profiles) and fluorescent polarization immunoassay (FPIA, 16 profiles). A two‐compartment model with first‐order absorption was used to calculate the pharmacokinetic parameters. Using FPIA, blood concentrations were 1.5 to 1.7 times higher than when using HPLC, but elimination half‐life andMRTwere similar. The coefficient of variation of key pharmacokinetic parameters ranged from 27 to 34% following HPLC assay. The same range of variation was obtained after FPIA assay. In a third study, in a clinical trial evaluating CsA for the treatment of canine atopic dermatitis, a single blood sample was collected in dogs which had received CsA for 28 days. No significant correlation was found between clinical improvement and CsA blood concentrations. Considering the large margin of safety of CsA in dogs, the limited inter‐individual variability and the lack of correlation between blood concentrations and clinical response, routine monitoring of blood CsA does not appear necessary in dogs with atopic dermatitis.
Adrenergic regulation of vascular smooth muscle tone in calf digital artery
Authors: Belloli C. , Badino P. , Arioli F. , Odore R. , Re G.
Published: August 2004

Radioligand binding studies and functional assays on isolated smooth muscle preparations were performed in order to obtain a biochemical and functional characterization of theβ‐adrenoceptor (β‐AR) subtypes involved in regulation of the smooth muscle relaxation of the calf's common digital artery. The results indicate that the common digital artery possesses twoβ‐AR populations (40%β1and 60%β2) and theβ2‐subtype appears to predominate as far as function is concerned. Only theβ2‐AR agonists clenbuterol and fenoterol caused dose‐related relaxant effects, antagonized by propranolol, when tested in preparations precontracted both with PGF2α(1.4 × 10−5 m) and noradrenaline (1.2 × 10−6 m). In noradrenaline precontracted preparations theβ1‐AR selective agonists dobutamine and xamoterol caused vasodilation which was not antagonized by (±)propranolol. While the functional relaxant effects of dobutamine may be attributed to its potent competitiveα‐AR blocking activity, further investigations are required to explain the effect of xamoterol. The vasodilator effect of (±)isoproterenol was irregular. The recorded contractile effects, mainly at dosages greater than 10−6 m, suggest the loss of drug selectivity forβ‐AR andα‐AR activation. Indirect evidence indicates that theα‐adrenoceptor (α‐AR) population in this tissue which produces a strong contraction is functionally dominant over theβ‐AR, suggesting limited therapeutic benefit forβ‐AR drugs to control blood flow disorders in the calf's distal limb.
Papular eosinophilic/mastocytic dermatitis (feline urticaria pigmentosa) in Devon Rex cats: A distinct disease entity or a histopathological reaction pattern?
Authors: NOLI CHIARA , COLOMBO SILVIA , ABRAMO FRANCESCA , SCARAMPELLA FABIA
Published: August 2004

Abstract   A maculopapular eruption with clinical and histological features similar to those previously described in Sphinx cats under the name of urticaria pigmentosa is reported in five unrelated Devon Rex cats. Physical examination revealed erythematous, occasionally crusted papules, with a bilaterally symmetrical linear distribution on the latero‐ventral trunk in two cases and a diffuse distribution on the ventral thorax in the other three cats. One cat also had a greasy seborrhoea on the head and dorsum. Pruritus and pigmented macules were present only in cats affected by secondary bacterial infection. Histological examination of papules in all cats and of the lesional skin of the cat affected by greasy seborrhoea revealed the presence of a perivascular to diffuse mastocytic and eosinophilic infiltrate in the dermis. The mean numbers of nondegranulated and degranulated mast cells per mm2 were 303.2 and 451.6, respectively. The condition waxed and waned in all cats, and exacerbations were controlled with prednisolone or essential fatty acids.
Prolonged remission after immunosuppressive therapy in six dogs with pemphigus foliaceus
Authors: OLIVRY THIERRY , BERGVALL KERSTIN E. , ATLEE BARBARA A.
Published: August 2004

Abstract   Limited information is available on the long‐term outcome of treatment of pemphigus foliaceus in dogs. The purpose of this study is to report that a prolonged remission can occur after discontinuation of immunosuppressive regimens in some animals with this disease. Six dogs were diagnosed with pemphigus foliaceus based on suggestive clinical signs and histopathology. These patients were treated either with immunosuppressive doses of oral glucocorticoids or with a combination of oral glucocorticoids and azathioprine. After clinical signs underwent complete remission, which occurred 1.5–5 months after immunosuppression was initiated, the drugs were tapered progressively and eventually withdrawn. The total duration of immunosuppressive therapy varied between 3 and 22 months. Skin lesions of pemphigus foliaceus did not recur for 1.5–6 years after treatment was stopped. These observations suggest that, in some dogs with pemphigus foliaceus, immunosuppression can lead to long‐term remission of skin lesions, and that discontinuation of treatment is not necessarily followed by a recurrence of clinical signs.
Alopecia areata with lymphocytic mural folliculitis affecting the isthmus in a thoroughbred mare
Authors: COLOMBO SILVIA , KEEN JOHN A. , BROWNSTEIN DAVID G. , RHIND SUSAN M. , MCGORUM BRUCE C. , HILL PETER B.
Published: August 2004

Abstract  A 13‐year‐old, thoroughbred mare was presented with an 8‐year history of multifocal, generalized, noninflammatory alopecia and a 3‐month history of alopecia, erythema and scaling of the white star on the forehead and muzzle. Histopathological examination of biopsy samples from multiple sites on the body (mane, neck, shoulder, flank and gluteal region) showed a subtle lymphocytic inflammatory infiltrate affecting and surrounding the anagen hair bulbs, consistent with a diagnosis of alopecia areata. The biopsy sample from the star on the forehead showed atrophic hair follicles with perifollicular and mural mononuclear folliculitis affecting the isthmus. Immunohistochemical staining with a CD3 marker confirmed the T‐lymphocytic origin of the inflammatory infiltrate in all the samples. The concurrent presence of lymphocytic infiltration at the bulbar and isthmic level of the hair follicles in the same horse is unusual. This finding may represent a variation of the histological appearance of alopecia areata.
Immunopathology of vesicular cutaneous lupus erythematosus in the rough collie and Shetland sheepdog: a canine homologue of subacute cutaneous lupus erythematosus in humans
Authors: JACKSON HILARY A. , OLIVRY THIERRY , BERGET FRÉDÉRIC , DUNSTON STANLEY M. , BONNEFONT CATHERINE , CHABANNE LUC
Published: August 2004

Abstract Clinical and histological features of an erosive disease in the rough collie and Shetland sheepdog are most consistent with a vesicular variant of cutaneous lupus erythematosus (VCLE). This paper reports the immunopathological findings of canine VCLE using samples from 17 affected dogs. Lesional skin sections were stained with monoclonal antibodies specific for CD3 (11 dogs) or a panel of monoclonal antibodies specific for leukocyte antigens (two dogs). Apoptotic cells were detected using the TUNEL method in 12 cases. Direct (14 dogs) and indirect immunofluorescence tests (five dogs) were also performed. Circulating antibodies to extractable nuclear antigens (ENA) were surveyed in 11 dogs by immunoblotting and ELISA. The predominant cells at the dermal–epidermal interface were identified as CD3+T lymphocytes expressing CD4 or CD8 and CD1+dendritic antigen presenting cells. In 7/12 dogs (58%), apoptosis of basal keratinocyte nuclei was present. Up‐regulation of MHCII and ICAM‐1 was observed on basal keratinocytes from the two dogs examined. Direct immunofluorescence revealed deposition of immunoglobulins bound to the cytoplasm of keratinocytes (6/14 dogs; 43%), to the dermal–epidermal junction (7/14 dogs; 50%), or to superficial dermal venules (13/14 dogs; 93%). Circulating IgG auto‐antibodies targeting one or more ENA were detected in nine (82%) and eight (73%) of 11 dogs by immunoblotting and ELISA, respectively. These auto‐antibodies recognized Ro/SSA and/or La/SSB in four (36%) and six (55%) of 11 dogs respectively by these two methods. Altogether, results of these studies provide evidence supporting the hypothesis that canine VCLE is an immunological homologue of subacute cutaneous lupus erythematosus in humans.
Equine congenital papilloma: pathological findings and results of papillomavirus immunohistochemistry in five cases
Authors: WHITE KELLY S. , FUJI REINA N. , VALENTINE BETH A. , BILDFELL ROBERT J.
Published: August 2004

Abstract  Congenital cutaneous papillomas were identified in five foals. Age at diagnosis ranged from 305 days’ gestation to 2 days of age. Breeds were thoroughbred (2), standard‐bred (1), warmblood (1) and paint (1). Two were female, one was male and the gender of two cases was not specified. Masses were pedunculated with a roughened, wart‐like (verrucous) or a smoother, cauliflower‐like surface. Masses occurred as single lesions on the forelimb, lip and face, or as multiple lesions on the trunk. Histological features included relatively uniform epidermal papillary hyperplasia with variable melanin pigment within basal layers and vacuolization of keratinocytes in all layers, but with no evidence of nuclear or cytoplasmic changes (koilocytes) characteristic of viral infection. One case showed epidermal proliferation with proliferation of pilosebaceous units. Results of immunohistochemical studies for the detection of papillomavirus antigens were negative in all cases. These results suggest that equine congenital papilloma may be a hamartomatous lesion (epidermal nevus) and not a viral‐induced growth.
Investigation of killer cell immunoglobulin‐like receptor gene diversity V. KIR3DL2
Authors: Meenagh A. , Williams F. , Sleator C. , Halfpenny I. A. , Middleton D.
Published: August 2004

Abstract:  Allelic definition within the killer cell immunoglobulin‐like receptor gene, KIR3DL2, has been achieved through a sequence‐specific oligonucleotide probe methodology, designed around the specific amplification of the D0 and D1 domains and a section of the cytoplasmic tail of this gene. The system has been applied to a healthy Northern Irish control group, establishing frequencies for this Caucasian population. Additionally, the KIR3DL2 allele status of cell line DNA and Centre d'Etude du Polymorphisme Humain (CEPH) families, both from the 13th International Histocompatibility Workshop, has been established. A high level of KIR3DL2 allelic polymorphism has been identified.
Genetic polymorphism and linkage disequilibrium of the HLA‐DP region in Basques from Navarre (Spain)
Authors: Pérez‐Miranda A.M. , Alfonso‐Sánchez M.A. , Vidales M.C. , Calderón R. , Peña J.A.
Published: August 2004

Abstract:  In this work, a sample of 116 individuals from an autochthonous Basque population (northern Navarre, Spain) was typed at the DNA level for HLA‐DPA1 and HLA‐DPB1 loci, with the aim of analysing the genetic polymorphism and the linkage disequilibrium (LD) of the HLA‐DP region. In this Basque subpopulation, the most frequent alleles were *0103 (0.767) and *0201 (0.185) for DPA1 locus, whereas for DPB1 locus the *0401 allele was predominant (0.307). Accordingly, the most frequent haplotype was DPA1*0103‐DPB1*0401 (0.300), which showed a significant LD. However, the haplotypes that most differentiated the sample of Navarre from other worldwide populations already analysed were DPA1*0105‐DPB1*1901 (0.011) and DPA1*0201‐DPB1*7601 (0.021), both of which showed a strong LD. Analysis of the relationships between populations based on data provided by HLA‐DPA1 and HLA‐DPB1 loci revealed a high genetic affinity between the Basque samples (North Navarre and Guipúzcoa), which, in turn, tend to plot separately from the remaining European populations. Gene frequency clines for DPB1*01, DPB1*04 and DPB1*11 alleles among European populations are reported for the first time. These alleles showed maximum values of FST (0.033, 0.034 and 0.025, respectively). Various evolutionary forces were considered in discussing the origin of the spatial structuring of the gene frequencies: (i) gene flow, argued from the hypotheses of Post‐glacial recolonization from southern Europe or the demic diffusion of farmers from the Near East into Europe, and (ii) the existence of selective pressures that could have generated genetic microdifferentiation.
Description of a new HLA‐DRB1 allele, DRB1*1150
Authors: Crespiatico L. , Frison S. , Andreini E. , Ferrioli G. , Rossi U. , Poli F.
Published: August 2004

Abstract:  We report the identification of a novel HLA‐DRB1*11 using sequence‐based typing. This new allele, officially named DRB1*1150, was detected while performing HLA‐DRB1 high‐resolution typing of a candidate for bone marrow transplantation. DRB1*1150 is identical to DRB1*1143 except at nucleotides 200 and 227, where a T is substituted by a C and a T by an A, respectively. These differences give rise to two amino acid substitutions at codons 38 (Val→Ala) and 47 (Phe→Tyr).
A profile of the caring attributes of Hong Kong and Thailand psychiatric nurses
Authors: Arthur David , Chong Colin , Rujkorakarn Darunee , Wong Doris , Wongpanarak Narisa
Published: August 2004

ABSTRACT:  Despite the unique cultural characteristics of psychiatric nurses in Hong Kong and Thailand little has been written about them or their caring practices. This study set out to examine the caring practices and demographic features of nurses working in these two countries where the development of the nursing education system has distinct similarities, yet where culture, career paths and qualifications differ. The Caring Attributes Questionnaire (CAQ), previously used in general nursing samples, was modified and validated for the study and administered to 275 and 227 psychiatric nurses in Hong Kong and Thailand, respectively. The results showed that more of the Hong Kong nurses were educated at the degree level and they tended to be younger, while both had around the same number of years of experience. The CAQ scores increase significantly with position, age and years of experience in the Hong Kong sample yet not for qualifications, while there were no significant differences detected in the Thai sample. The Thai sample had significantly lower CAQ scores and the results suggest that neither education nor experience modify these qualities of a psychiatric nurse, and it may be that nurses are still learning ‘on the job’ rather than in the school. These findings are discussed in the light of findings from other international studies and recommendations for future studies are made.
Recognition of early warning signs in patients with schizophrenia: A review of the literature
Authors: Van Meijel Berno , Van Der Gaag Mark , Kahn Sylvain René , Grypdonck Maria H.F.
Published: August 2004

ABSTRACT:  This article reviews and discusses the literature on the recognition of the early warning signs of psychosis. The assumption is that nurses, in the everyday exercise of their profession, can contribute to the prevention of psychotic relapse in schizophrenic patients by the early recognition of warning signs. First, the process of psychotic relapse and the factors that influence it are described. Then research on the early signs of psychosis is discussed. This article questions the most common early signs, when they occur, and who can recognize them. Then the predictive value of the early signs is considered: how well can psychotic relapse be predicted with these early signs? Finally, the research on the effects of early recognition and early intervention is discussed, primarily with respect to the question of whether psychotic relapses can actually be prevented by making use of preventive intervention strategies. The conclusion is that the preliminary results are hopeful and invite further research on such matters as the application of this intervention strategy within nursing practice.
Clinical indicators as measures of mental health nursing standards of practice in New Zealand
Authors: O'Brien Anthony P , Boddy Julie M , Hardy Derrylea J , O'Brien Anthony J
Published: August 2004

ABSTRACT: This paper discusses the utility of Consumer Notes Clinical Indicators (CNCI) as a means to monitor mental health nursing clinical practice against the Australian and New Zealand College of Mental Health Nurses’ (ANZCMHN) Standards of Practice for mental health nursing in New Zealand. CNCI are statements describing pivotal mental health nursing behaviours for which evidence can be found in the nurses’ case notes. This paper presents 25 valid and reliable CNCI that can be used to monitor mental health nursing practice against the ANZCMHN's Standards of Practice for mental health nursing in New Zealand. The bicultural clinical indicators were generated in focus groups of Maori and non‐Maori mental health nurses, prioritized in a three‐round reactive Delphi survey of expert mental health nurses and consumers, pilot tested, and applied in a national field study. This paper reports the development and validation of the CNCI, for which achievement is assessed by an audit of the nursing documentation in consumer case notes. The CNCI were tested in a national field study of 327 sets of consumer case notes at 11 District Health Board sites. The results of the national field study show wide variation in occurrence of individual indicators, particularly in the areas of informed consent, information about legal rights, and provision of culturally safe and recovery‐focused care. We discuss the implications of using the CNCI to assess the professional accountability of mental health nurses to provide quality care. Recommendations are made regarding the application of the clinical indicators and future research required, determining appropriate benchmarks for quality practice. The CNCI could be adapted for application in other mental health nursing and other mental health professional clinical settings.
Mental health nursing practice in acute psychiatric close‐observation areas
Authors: O'Brien Louise , Cole Rose
Published: August 2004

Abstract:The provision of evidence‐based therapeutic nursing care in close‐observation units or psychiatric intensive care units, has been identified as a problem internationally. These areas of nursing practice have been the subject of considerable discussion particularly in relation to the management of aggression, violence, involuntary treatment, and seclusion. This study used a participatory action research framework to identify qualitative and quantitative measures of activity in the area. Quantitative data collected included rates of critical incidents, the use of prn medication, and the use of seclusion. These data were used as base‐line data and were predicted as a measure of change. Qualitative data, collected by interview and focus groups, were used to reveal the experience of patients, relatives, and nurses in a close‐observation area.Analysis of this data revealed three main themes: design and environment, lack of activity and structured time, and nursing care. The importance of this study is in demonstrating the multiple problems that exist in the provision of care in close‐observation areas and the corresponding need for fundamental changes.
Shaping mutuality: Nurse−family caregiver interactions in caring for older people with depression
Authors: Jeon Yun‐Hee
Published: August 2004

ABSTRACT:  This paper reports on the research findings derived from a grounded theory study that examined the processes through which community mental health nurses work with families of older people with depression. Data were collected through semistructured, in‐depth interviews with six community mental health nurses and seven family caregivers of older people with depression, and observations of their interactions in natural settings. Data collection and analysis were guided by theoretical sampling and the constant comparative process. The findings indicate that the nurse−­family caregiver relationship involves working towards mutuality, which is shaped by both the nurse and family caregiver. It is through the process of ‘shaping mutuality’ that a nurse and family caregiver learn to collaborate, and achieve their individual goals and desired outcomes, both for the patient and for themselves.
Phytoplankton community and algal growth potential in Taipinghu Reservoir, Anhui Province, China
Authors: Kuang Qijun , Bi Yonghong , Xia Yicheng , Hu Zhenyu
Published: August 2004

An integrated investigation of the community structure and growth potential of algae in Taipinghu Reservoir, Anhui Province, China, was conducted from July 1993 to October 1994. A total of 112 algal species belonging to eight phyla were observed. Green algae were the dominant population, representing 55% of the total recorded taxa. Diatoms and blue‐green algae formed the second and the third largest algal groups, respectively. The total species and population of algae were relatively steady in spring, summer and autumn, but exhibited some variety in winter. Compared to earlier data, the species richness decreased by 36% and the number of genera decreased by 23% over an eight‐year period. The maximum values of the annual mean cell count, biomass and chlorophyll a concentration appeared in summer and the minimum in winter. The algal growth potential of the original water without supplemental nutrients was much lower than that of the control culture, but equal to or a little higher than the control culture which was supplemented with complete nutrients. The study results imply that phosphorus is the limiting nutrient for algal growth and that the trophic status of the reservoir is changing from mesotrophic to eutrophic. Based on these data, some advice on how to manage the reservoir is offered.
Limnological variations of a reservoir during two successive years: One wet, another dry
Authors: Geraldes A. M. , Boavida M. J. L.
Published: August 2004

Changes in environmental variables, as well as in planktonic algae and in crustacean zooplankton abundance, were investigated in a meso‐eutrophic reservoir during two successive years: one wet, another dry. In the wet winter, both total phosphorus and soluble reactive phosphorus reached their maxima, whereas water transparency achieved the minimum during the same period. The obtained data suggest that total phosphorus and soluble reactive phosphorus peaks were related to the increase in nutrient loading as a consequence of the intense rainfall which occurred during this period. Phytoplankton composition was dominated by Cyclotella spp., except during the dry winter when Anabaena became dominant. The dominance of this alga seemed to be related to nitrate depletion. The establishment of more stable environmental conditions (e.g. low water turbulence, longer water retention time) and the increase of irradiance during the dry period (summer 2001 and winter 2001/2002) also favoured growth of this cyanobacterium. Concomitant to Anabaena dominance, Ceriodaphnia abundance decreased while nauplii increased. Although variation between the two years of study seemed to be related to the sequence of a pluvial and a dry year, further research is needed to evaluate whether variations in precipitation intensity influence reservoir ecological processes.