An evaluation of predictors for success of two-duct ligation for drooling in neurodisabilities

Journal of Neurology - Drooling is dependent on various clinical variables. However, while drooling proves refractory to two-duct ligation in 40% of patients, predictors for treatment success are...     

Transition as a topic in psychiatry training throughout Europe: trainees’ perspectives

European Child & Adolescent Psychiatry - The majority of adolescents with mental health problems do not experience continuity of care when they reach the transition boundary of their child and...     

Preserved calibration of persistence based on delay‐timing distribution during sleep deprivation

We frequently encounter decisions where we have to determine whether to wait for a certain reward delayed for an uncertain duration or to move on. The appropriate decision depends upon the underlying temporal distribution of the delay. With some distributions it is best to be completely persistent, whereas in others it is more appropriate to abandon waiting after a certain period of time. The current study examined whether the ability to form temporal expectations and adjust persistence accordingly is compromised by sleep deprivation. Participants performed a willingness‐to‐wait task either in a well‐rested state or after a night of total sleep deprivation. Participants had to decide either to wait for a larger reward or to abandon waiting in favour of a smaller immediate reward. Delays were drawn from either a uniform distribution, where being persistent yields maximal returns, or from a heavy‐tailed distribution, where occasional long delays render full persistence suboptimal. In spite of increased sleepiness and decreased vigilance, sleep‐deprived participants were able to adjust waiting time appropriate to the experienced timing distribution. Additionally, sleep deprivation did not affect the foreperiod effect, indicating intact perception of conditional probability of temporal events and ability to adjust preparation accordingly.     

From positive emotionality to internalizing problems: the role of executive functioning in preschoolers

Temperament and psychopathology are intimately related; however, research on the prospective associations between positive emotionality, defined as a child’s positive mood states and high engagement with the environment, and psychopathology is inconclusive. We examined the longitudinal relation between positive emotionality and internalizing problems in young children from the general population. Furthermore, we explored whether executive functioning mediates any observed association. Within a population-based Dutch birth cohort, we observed positive emotionality in 802 children using the laboratory temperament assessment battery at age 3 years. Child behavior checklist (CBCL) internalizing problems (consisting of Emotionally Reactive, Anxious/Depressed, and Withdrawn scales) were assessed at age 6 years. Parents rated their children’s executive functioning at ages 4 years. Children with a lower positive emotionality at age 3 had a higher risk of withdrawn problems at age 6 years (OR = 1.20 per SD decrease in positive emotionality score, 95 % CI: 1.01, 1.42). This effect was not explained by preexisting internalizing problems. This association was partly mediated by more problems in the shifting domain of executive functioning (p < 0.001). We did not find any relation between positive emotionality and the CBCL emotionally reactive or anxious/depressed scales. Although the effect sizes were moderate, our results suggest that low levels of positive emotionality at preschool age can result in children’s inflexibility and rigidity later in life. The inflexibility and rigidity are likely to affect the child’s drive to engage with the environment, and thereby lead to withdrawn problems. Further research is needed to replicate these findings.     

Unexplained chronic fatigue and core conflictual relationship themes: A study in a chronically fatigued population

Objective. Unexplained fatigue syndromes are multidimensional phenomena that involve a constellation of symptoms. This paper explores whether typical relationship patterns are associated with self‐reported and clinically rated fatigue symptoms in chronically fatigued patients. Method. Relationship patterns were assessed by means of the core conflictual relationship theme (CCRT) method. This method examines transference patterns, and was applied to interview data collected from chronically fatigued patients (N=30). Chronic fatigue was assessed by means of a self‐report questionnaire and was also rated clinically. Results. Both self‐reported and clinically rated fatigue correlated with relationship themes. The intensity of fatigue related to the perception of others as not respecting and as negatively interfering. The typical reaction of the self to relationships consists of feeling disrespected, anger, passivity, and reduced feelings of self‐consistency. Conclusion. Patients' perception of interpersonal relationships as distressing may be pivotal in understanding these results. Implications for clinical intervention and future research are indicated.     

Accordance and concordance of PCR and NASBA followed by oligochromatography for the molecular diagnosis of Trypanosoma brucei and Leishmania

Objective To evaluate the repeatability and reproducibility of four simplified molecular assays for the diagnosis of Trypanosoma brucei spp. or Leishmania ssp. in a multicentre ring trial with seven participating laboratories. Methods The tests are based on PCR or NASBA amplification of the parasites nucleic acids followed by rapid read‐out by oligochromatographic dipstick (PCR‐OC and NASBA‐OC). Results On purified nucleic acid specimens, the repeatability and reproducibility of the tests were Tryp‐PRC‐OC, 91.7% and 95.5%; Tryp‐NASBA‐OC, 95.8% and 100%; Leish‐PCR‐OC, 95.9% and 98.1%; Leish‐NASBA‐OC, 92.3% and 98.2%. On blood specimens spiked with parasites, the repeatability and reproducibility of the tests were Tryp‐PRC‐OC, 78.4% and 86.6%; Tryp‐NASBA‐OC, 81.5% and 89.0%; Leish‐PCR‐OC, 87.1% and 91.7%; Leish‐NASBA‐OC, 74.8% and 86.2%. Conclusion As repeatability and reproducibility of the tests were satisfactory, further phase II and III evaluations in clinical and population specimens from disease endemic countries are justified.     

Clinical evaluation of Bio-Rad MRSASelect? medium for the detection of livestock-associated methicillin-resistant Staphylococcus aureus

Bio-Rad MRSASelect™ medium was evaluated for its ability to recover methicillin-resistant Staphylococcus aureus (MRSA) from nasal samples of pig farmers and their household members. In total, 257 samples were inoculated on Bio-Rad MRSASelect™ medium with and without broth enrichment and on bioMérieux MRSA ID with broth enrichment. A sample was considered to be positive if at least one of the media grew MRSA. The sensitivity of Bio-Rad MRSASelect™ medium without broth enrichment was 63.9%. With broth enrichment, the sensitivity increased to 98.4%. The specificity was 95.4% both with and without broth enrichment. In conclusion, Bio-Rad MRSASelect™ medium as well as MRSA ID medium are reliable methods to detect MRSA carriage when used in combination with broth enrichment. The directly inoculated MRSASelect™ medium was statistically significantly less sensitive than the two media after broth enrichment.     

Signs of a higher prevalence of autoimmune thyroiditis in female offspring of bipolar parents.

BACKGROUND: Studies are inconsistent as to whether patients with bipolar disorder are more frequently affected by autoimmune thyroiditis. AIM: To study the prevalence of autoimmune thyroiditis in offspring of bipolar patients. METHOD: In 1998 140 children (age 12-21 years) of bipolar parents were evaluated psychiatrically using the K-SADS-PL and blood was drawn to determine thyroperoxidase antibodies (TPO-Abs) and serum TSH. Blood samples of high school students (aged 12-19 years, n=77) and young adults (aged 20-35 years, n=52) were used as comparisons. At follow-up the offspring were psychiatrically evaluated and tested for TPO-Abs and TSH twice (14 months and 55 months after enrollment). RESULTS: TPO-Abs were predominantly found in female bipolar offspring, who had a significantly higher prevalence of positive TPO-Ab titers (9 out of 57 female offspring subjects) as compared to the female high school and young adult comparisons (4 out of 103 female control subjects). In TPO-Ab positive offspring (n=11) a raised prevalence of 55% of thyroid failure (i.e. a raised serum TSH or l-thyroxine treatment) was evident. TPO-Ab positive offspring did not show a raised prevalence of mood disorders (or any psychopathology) as compared to the TPO-Ab negative offspring. CONCLUSION: Our study suggests that bipolar offspring are more vulnerable to develop thyroid autoimmunity independently from the vulnerability to develop psychiatric disorders.