Analysis of the lymphocyte distribution during isopaque-ficoll isolation of mononuclear cells from human peropheral blood

Using chromium-labeled mononuclear cells the movements of lymphocytes in Isopaque-Ficoll (I-F) gradients were analysed. Even small percentages of ox or autologous human erythrocytes mixed with the lymphocytes caused a significant loss of lymphoid cells and this loss was augmented when higher numbers of red cells were added. Such losses could be prevented using I-F gradients of higher densities, but then neutrophils and erythrocytes were found to contaminate the mononuclear suspensions recovered. Purified B and T lymphocytes were found to move identically on the gradients, but when human erythrocytes were added to the lymphocyte suspensions to be separated, a small but significant preferential loss of T cells was observed.     

Disseminated peritoneal leiomyomatosis with malignant change,in a male

Summary Disseminated peritoneal leiomyomatosis (DPL) is a rare disorder, characterized by the occurrence of multiple leiomyomas scattered throughout the peritoneal cavity. Until this report DPL had been observed only in women and there is only one previous case with malignant change. A case of DPL in a male, complicated by sarcomatous transformation is reported. DPL has a definite malignant potential; patients with the disease should be followed closely for signs of progression.     

Widespread higher fractional anisotropy associates to better cognitive functions in individuals at ultra‐high risk for psychosis

In schizophrenia patients, cognitive functions appear linked to widespread alterations in cerebral white matter microstructure. Here we examine patterns of associations between regional white matter and cognitive functions in individuals at ultra‐high risk for psychosis. One hundred and sixteen individuals at ultra‐high risk for psychosis and 49 matched healthy controls underwent 3 T magnetic resonance diffusion‐weighted imaging and cognitive assessments. Group differences on fractional anisotropy were tested using tract‐based spatial statistics. Group differences in cognitive functions, voxel‐wise as well as regional fractional anisotropy were tested using univariate general linear modeling. Multivariate partial least squares correlation analyses tested for associations between patterns of regional fractional anisotropy and cognitive functions. Univariate analyses revealed significant impairments on cognitive functions and lower fractional anisotropy in superior longitudinal fasciculus and cingulate gyrus in individuals at ultra‐high risk for psychosis. Partial least squares correlation analysis revealed different associations between patterns of regional fractional anisotropy and cognitive functions in individuals at ultra‐high risk for psychosis compared to healthy controls. Widespread higher fractional anisotropy was associated with better cognitive functioning for individuals at ultra‐high risk for psychosis, but not for the healthy controls. Furthermore, patterns of cognitive functions were associated with an interaction‐effect on regional fractional anisotropy in fornix, medial lemniscus, uncinate fasciculus, and superior cerebellar peduncle. Aberrant associations between patterns of cognitive functions to white matter may be explained by dysmyelination.     

Suicide risk in first episode psychosis: a selective review of the current literature

Many studies have confirmed that the risk of suicide in patients with first-episode psychosis (FEP) is high, and high rates of premature mortality, particularly from suicide, may occur in the early phases of schizophrenia. However, suicide rates are difficult to measure in FEP patients, even in carefully defined samples, and there is relatively little specific information about the risk of suicide at illness onset or retrospectively concerning the untreated psychotic period. This selected review of the literature investigates suicidal behaviour with particular regard to severe suicidality (plans and attempts) and risk factors associated with suicide in FEP patients. A search was performed to identify all papers and book chapters during the period 1965-2010, and approximately 100 studies met the inclusion criteria. Most of evidence suggests that risk of suicidal behaviour is relatively high in FEP patients. The research reports highlight the need for universal, comprehensive, public mental health interventions aimed, not only toward early detection, but also toward the rapid engagement in treatment of people with psychoses. These interventions should include an adequate assessment of suicidal behaviour in patients with FEP, and an examination of the efficacy of specific components of the interventions.     

Evaluation of a multifaceted intervention to limit excessive antipsychotic co‐prescribing in schizophrenia out‐patients

Baandrup L, Allerup P, Lublin H, Nordentoft M, Peacock L, Glenthoj B. Evaluation of a multifaceted intervention to limit excessive antipsychotic co‐prescribing in schizophrenia out‐patients. Objective: To evaluate the effect of a multifaceted educational intervention on the frequency of antipsychotic co‐prescribing in adult schizophrenia out‐patients. Method: Controlled quasi‐experimental study performed in two Danish municipalities matched for baseline prevalence of antipsychotic polypharmacy, socioeconomic status and functional level of patients. The intervention was aimed at psychiatric healthcare providers and consisted of 1 day of didactic lectures, six 3‐h educational outreach visits and an electronic reminder during drug prescribing. Results: Between‐group use of antipsychotic polypharmacy was compared at baseline (intervention group, N = 232/control group, N = 351) and after 1 year of intervention (intervention group, N = 216/control group, N = 386). The prevalence of antipsychotic polypharmacy at follow‐up was not significantly different between treatment settings when adjusting for differences in case‐mix (P = 0.07). Conclusion: This multifaceted educational intervention failed to reduce the frequency of antipsychotic co‐prescribing, but it suggested that future efforts to improve prescribing practice should address organizational barriers to implementation.