Mycobacterium smegmatis in Skin Biopsy Specimens from Patients with Suppurative Granulomatous Inflammation

Formalin-fixed, paraffin-embedded skin biopsy specimens, including 72 suppurative granulomatous inflammation (SGI) and 47 non-SGI controls, were tested for mycobacteria by using a broad-range PCR and a suspension array identification system. Mycobacterium smegmatis was detected in 13 (18.1%) of the SGI skin biopsy specimens, which was significantly more than 2 (4.3%) in the controls (odds ratio, 5.73; 95% confidence interval, 1.21 to 27.06; P = 0.028).     

A systematic review comparing clinical features in early age at onset and late age at onset late-life depression

Background

Although evidence suggests that there are neurobiological differences between unipolar depression in younger versus older adults, conflicting evidence exists about whether these manifest as clinically identifiable differences.

Method

We conducted a systematic review of aetiological, phenomenological and outcome studies to examine the evidence for a distinction between early onset (EOD) and late onset (LOD) depression. A literature search was completed using the computer databases MEDLINE, EMBASE, PSYCHINFO and PUBMED for papers published between January 1982 and December 2012 which compared groups with EOD and LOD. Studies were included if they were of older people and compared symptoms, aetiological factors or outcomes. We conducted a quality assessment of included articles.

Results

We identified 23 articles which met entry criteria. The only clinical feature which was different between the groups was a higher frequency of a family history of mood disorders in EOD.

Limitations

The number of studies identified was low and their quality was generally poor.

Conclusions

Although neurobiological studies have reported differences between EOD and LOD, generally these do not appear to translate into identifiable distinguishing clinical features.     

Mental Health Service Users’ Perceptions of Stigma,From the General Population and From Mental Health Professionals in Mexico: A Qualitative Study

Community Mental Health Journal - Negative attitudes towards people with mental health disorders have been widely studied and identified in the general population, and even within health care...     

The Role of NK Cells in Autoimmune Disease

NK cells are a subset of mononuclear cells which have long been suspected of playing an immuno-regulatory role in the prevention of autoimmune diseases. Here, we briefly discuss the characteristics of NK cells--particularly what is known of their functional capabilities--and summarise the major findings from studies of NK cells in human and animals susceptible to three major autoimmune diseases: multiple sclerosis, systemic lupus erythematosus and type 1 (autoimmune) diabetes mellitus. In each case, we present the evidence for an association between disease and deficiencies in NK cells. The prospect of clinical interventions that stimulate NK cell activity are discussed and the current status described.     

Dysregulated mTORC1 renders cells critically dependent on desaturated lipids for survival under tumor-like stress

Solid tumors exhibit heterogeneous microenvironments, often characterized by limiting concentrations of oxygen (O₂), glucose, and other nutrients. How oncogenic mutations alter stress response pathways, metabolism, and cell survival in the face of these challenges is incompletely understood. Here we report that constitutive mammalian target of rapamycin complex 1 (mTORC1) activity renders hypoxic cells dependent on exogenous desaturated lipids, as levels of de novo synthesized unsaturated fatty acids are reduced under low O₂. Specifically, we demonstrate that hypoxic Tsc2^−/− (tuberous sclerosis complex 2^−/−) cells deprived of serum lipids exhibit a magnified unfolded protein response (UPR) but fail to appropriately expand their endoplasmic reticulum (ER), leading to inositol-requiring protein-1 (IRE1)-dependent cell death that can be reversed by the addition of unsaturated lipids. UPR activation and apoptosis were also detected in Tsc2-deficient kidney tumors. Importantly, we observed this phenotype in multiple human cancer cell lines and suggest that cells committed to unregulated growth within ischemic tumor microenvironments are unable to balance lipid and protein synthesis due to a critical limitation in desaturated lipids.     

Quetiapine augmentation of prolonged exposure therapy in veterans with PTSD and a history of mild traumatic brain injury:design and methodology of a pilot study

Background:Selective serotonergic reuptake inhibitors(SSRIs)are first-line pharmacologic treatments for patients with posttraumatic stress disorder(PTSD),but must be given over extended period of time before the onset of action.The use of SSRIs in PTSD patients with mild traumatic brain injury(mTBI)is problematic since SSRIs could exacerbate post-concussion syndrome(PCS)symptoms.VA/DOD guidelines identify trauma-focused psychotherapy as the best evidence-based treatment for PTSD,but overall effectiveness is limited by reduced levels of patient engagement and retention.A previous study from this research group suggested that quetiapine monotherapy,but not risperidone or valproate,could increase engagement in trauma-focused psychotherapy.Methods:We report the study protocol of a pilot study funded under the South-Central Mental Illness Research,Education,and Clinical Center pilot study program from the U.S.Department of Veterans Affairs.This randomized,open-label study was designed to evaluate the feasibility of completing a randomized trial of quetiapine vs.treatment as usual to promote patient engagement in PTSD patients with a history of mTBI.Discussion:We expect that the success of this ongoing study should provide us with the preliminary data necessary to design a full-scale randomized trial.Positive efficacy results in a full-scale trial should inform new VA guidelines for clinical practice by showing that quetiapine-related improvements in patient engagement and retention may be the most effective approach to assure that VA resources achieve the best possible outcome for veterans.