Reduced levels of E-cadherin correlate with progression of corticotroph pituitary tumours

Objectives Loss of E‐cadherin is an important marker of epithelial tumour progression. The aims of this study were to explore whether E‐cadherin expression and localization correlate to corticotroph tumour progression, relate the expression of the E‐cadherin gene (CDH1) to immunohistochemical E‐cadherin staining pattern, and study whether the E‐cadherin levels were correlated to methylation status of the CDH1 promoter region. Design Immunohistochemical analyses of E‐cadherin protein were performed, as was RT‐qPCR of the CDH1 and the POMC genes. Methylation pattern of the promoter region of CDH1 was measured using pyrosequencing of bisulfite‐treated DNA. Patients Forty‐five patients operated at a tertiary referral centre in Oslo, Norway. Adenoma tissue sections and RNA samples from patients with verified Cushing’s disease or Nelson’s syndrome were collected. Measurements Expression of E‐cadherin mRNA and protein in pituitary corticotroph adenomas and average percentage of methylated cytosines in a cytosine‐phosphate‐guanosine island of the CDH1 promoter. Results Correlations were observed between tumour progression and both nuclear expression of E‐cadherin and reduced CDH1 mRNA. The E‐cadherin expression was not determined by the methylation pattern of the CDH1 promoter. Conclusions Corticotroph tumour progression was associated with reduced expression of the epithelial marker E‐cadherin.     

Is there a correlation between vaginal chlamydia infection and cervical smear abnormalities? A community-based study in the Al-Ain district, United Arab Emirates

AIM: The purpose of this study was to determine the correlation between vaginal chlamydia infection and cervical abnormalities. The data on the prevalence of chlamydia infection and cervical abnormalities have been presented elsewhere and in this article we provide the results of a correlation analysis. METHODS: In this cross-sectional, community-based survey, women attending primary and secondary care in the Al-Ain medical district, United Arab Emirates, were offered cervical screening using the Papanicolaou smear, and chlamydia testing. A total of 793 women underwent cervical screening and 728 were tested for chlamydia. A commercially available kit was used to determine the prevalence of chlamydia. The correlation between cervical abnormalities and chlamydia infection was tested using the chi-squared test or Fisher's exact test, as appropriate. RESULTS: The prevalence of abnormal smears was 1.51% (95% confidence interval [CI], 0.66-2.4). Twelve subjects had abnormal smears, including smears showing atypical squamous cells of undetermined significance. The prevalence of chlamydia infection in this population was 2.5% (95% CI, 1.2-3.3). Statistical analysis showed no association (chi2 0.6, P = 0.4) between the prevalence of chlamydia infection and cervical abnormalities. CONCLUSION: Although there have been earlier reports of an association between vaginal chlamydia and cervical abnormalities, our study does not provide evidence to support this association.     

Highly discrepant proportions of female and male Scandinavian and British Isles ancestry within the isolated population of the Faroe Islands

The Faroe Islands in the North Atlantic Ocean are inhabited by a small population, whose origin is thought to date back to the Viking Age. Historical, archaeological and linguistic evidence indicates that the present population of the Faroe Islands may have a mixture of Scandinavian and British Isles ancestry. In the present study we used 122 new and 19 previously published hypervariable region I sequences of the mitochondrial control region to analyse the genetic diversity of the Faroese population and compare it with other populations in the North Atlantic region. The analyses suggested that the Faroese mtDNA pool has been affected by genetic drift, and is among the most homogenous and isolated in the North Atlantic region. This will have implications for attempts to locate genes for complex disorders. To obtain estimates of Scandinavian vs British Isles ancestry proportions, we applied a frequency-based admixture approach taking private haplotypes into account by the use of phylogenetic information. While previous studies have suggested an excess of Scandinavian ancestry among the male settlers of the Faroe Islands, the current study indicates an excess of British Isles ancestry among the female settlers of the Faroe Islands. Compared to other admixed populations of the North Atlantic region, the population of the Faroe Islands appears to have the highest level of asymmetry in Scandinavian vs British Isles ancestry proportions among female and male settlers of the archipelago.     

Relatives' view on collaboration with nurses in acute wards: development and testing of a new measure

BACKGROUND: Collaboration between relatives and nurses in acute care settings is sparsely investigated, and that mostly from nurses' point of view. Feasible and valid instruments are needed for assessing collaboration, its prerequisites and outcome. OBJECTIVES: To develop and test an instrument to assess, from the relatives' perspective, collaboration between relatives of frail elderly patients and nurses in acute hospital wards, as well as prerequisites for, and outcome of, collaboration. DESIGN: Instrument development and psychometric testing. SETTING: Acute medical and geriatric wards. PARTICIPANTS: One hundred fifty-six relatives. Women constituted 74.8%, offspring 63.9% and spouses 20%, respectively. METHODS: A model for collaboration was developed and underpinned the development and construction of the instrument. Face and content validity was examined by relatives and an expert panel, before testing it among 156 relatives. Construct validity was assessed by principal component analysis and test for correlation between factors. Predictive validity was assessed by comparing factor scores with scores in outcome measures. Internal consistency was assessed by Cronbach's alpha for factors, item-to-total correlation and item-to-item correlation. Systematic internal dropout was investigated. RESULTS: A five-factor solution labelled "influence on decisions", "quality of contact with nurses", "trust and its prerequisites", "achieved information level" and "influence on discharge" showed Cronbach's alpha values between .83 and .94. Correlation between factors showed coefficients between .16 and .60. Item-to-total correlation values ranged between .34 and .83 and mean inter-item-correlation coefficients between .40 and .56. Predictive validity was indicated. Systematic internal dropout was related to higher age and lower educational level. CONCLUSION: The instrument was mainly valid and reliable. The instrument is, to our knowledge, the first of its kind and should be tested on larger samples in various cultural contexts. The feasibility of the instrument may benefit from a reduction of number of items.     

Different development of general beliefs about medicines during undergraduate studies in medicine,nursing and pharmacy

Objective

To analyze differences in general beliefs about medicines between healthcare students and to see if health education was of importance to general beliefs about medicines.

Method

The participants were students of medicine, pharmacy, pharmaceutical bioscience, dispensing pharmacy, nursing and economics (comparison group) at the University of Gothenburg. Data were collected twice in 2003 and 2005. A questionnaire was used comprising background questions and the general part of Beliefs about Medicines Questionnaire.

Results

The questionnaire was completed by 460 of 642 (71.7%) first-year and 293 of 398 (73.6%) third-year students. Over 70% were women and two-thirds were under 25 years of age. Medical and pharmacy students saw medicines as less harmful than nursing students did. Stage of education was also important: third-year medical and pharmacy students saw medicines as more beneficial and less harmful than first-year students did. Experience of medicine use was relevant to general beliefs about medicines.

Conclusion

Different beliefs exist between healthcare professions owing to different types and stages of education, which could result in different messages being given to the patient.

Practice implications

It is important to educate future healthcare professionals about the potential effect of beliefs on communication.     

Is autism spectrum disorder common in schizophrenia?

A century ago, Kraepelin and Bleuler observed that schizophrenia is often antedated by "premorbid" abnormalities. In this study we explore how the childhood neurodevelopmental problems found in patients with schizophrenia relate to the current concept of autism spectrum disorder (ASD). Forty-six young adult individuals with clinical diagnoses of schizophrenic psychotic disorders were assessed. The Structured Clinical Interview for DSM Disorders (SCID-I) was used in face-to-face psychiatric examination of each individual. In 32 of the 46 cases (70%), collateral information was provided by one or both parents. The Diagnostic Interview for Social and Communication Disorders - eleventh version (DISCO-11) was used when interviewing these relatives. This instrument covers, in considerable depth, childhood development, adaptive functioning, and symptoms of ASD - current and lifetime. There is a strict algorithm for ASD diagnosis. About half of the cases with schizophrenic psychosis had ASD according to the results of the parental interview. The rate of ASD was strikingly high (60%) in the group with a SCID-I diagnosis of schizophrenia paranoid type. The findings underscore the need to revisit the DSM's "either or" stance between ASD and schizophrenia.     

The effects of the ketogenic diet on behavior and cognition

Multiple forms of the ketogenic diet (KD) have been successfully used to treat drug-resistant epilepsy, however its mainstream use as a first-line therapy is still limited. Further investigation into its clinical efficacy as well as the molecular basis of activity is likely to assist in the reversal of any resistance to its implementation. In this review we shall attempt to elucidate the current state of experimental and clinical data concerning the neuroprotective and cognitive effects of the KD in both humans and animals. Generally, it has been shown by many research groups that effective implementation of KD exerts strong neuroprotective effects with respect to social behavior and cognition. We will also elucidate the role of KD in the interesting relationship between sleep, epilepsy and memory. Currently available evidence also indicates that, under appropriate control, and with further studies investigating any potential long-term side effects, the KD is also a relatively safe intervention, especially when compared to traditional anti-epileptic pharmacotherapeutics. In addition, due to its neuroprotective capacity, the KD may also hold potential benefit for the treatment of other neurological or neurodegenerative disorders.