Real-Time Changes in Connectivities During Neurofeedback

Introduction. Changes in quantitative EEG during and in response to neurofeedback (NF) training was explored in patients with traumatic brain injury (TBI). Data from 19 adults with a TBI of moderate mechanical nature, non-drug-related, and without severe posttraumatic stress disorder or seizure disorder were analyzed (14 male and 5 female).

Methods. EEG was evaluated before, during, and after ROSHI NF training. Data were collected as duplicate samples of 6 min each during eyes open and eyes closed conditions, but only the eyes closed condition was analyzed.

Results. Significant changes in connectivity occurred during and in response to NF training.

Conclusion. Results showed significant changes in real-time QEEG connectivity. An evaluation of a larger subject population will clarify gender differences in connectivity responses to NF training.     

Specificity of fear and disgust experienced during traumatic interpersonal victimization in predicting posttraumatic stress and contamination-based obsessive-compulsive symptoms

Emerging evidence has documented comorbidity between posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) among individuals with a history of traumatic events. There is growing recognition of the importance of disgust in each of these conditions independently. No study, however, has examined the potential role of disgust in these conditions following traumatic event exposure. The current study examined the unique role of peritraumatic fear, self-focused disgust, and other-focused disgust in predicting posttraumatic stress symptoms and contamination-based OC symptoms among 49 adult women (M(age)=28.37, SD=13.86) with a history of traumatic interpersonal victimization. Results demonstrated that intensity of peritraumatic self-focused disgust was significantly related to contamination-based OC symptoms while peritraumatic fear and other-focused disgust were related to posttraumatic stress symptoms. These results highlight the need for future research aimed at elucidating the nature of the association between disgust experienced during traumatic events and subsequent psychopathology.     

Genetic contributions of the serotonin transporter to social learning of fear and economic decision making

Serotonin (5-HT) modulates emotional and cognitive functions such as fear conditioning (FC) and decision making. This study investigated the effects of a functional polymorphism in the regulatory region (5-HTTLPR) of the human 5-HT transporter (5-HTT) gene on observational FC, risk taking and susceptibility to framing in decision making under uncertainty, as well as multidimensional anxiety and autonomic control of the heart in healthy volunteers. The present results indicate that in comparison to the homozygotes for the long (l) version of 5-HTTLPR, the carriers of the short (s) version display enhanced observational FC, reduced financial risk taking and increased susceptibility to framing in economic decision making. We also found that s-carriers have increased trait anxiety due to threat in social evaluation, and ambiguous threat perception. In addition, s-carriers also show reduced autonomic control over the heart, and a pattern of reduced vagal tone and increased sympathetic activity in comparison to l-homozygotes. This is the first genetic study that identifies the association of a functional polymorphism in a key neurotransmitter-related gene with complex social–emotional and cognitive processes. The present set of results suggests an endophenotype of anxiety disorders, characterized by enhanced social learning of fear, impaired decision making and dysfunctional autonomic activity.     

Interactive Roles of Pubertal Timing and Peer Relations in Predicting Social Anxiety Symptoms Among Youth

The interaction between early maturation and problematic peer relations in relation to social anxiety symptoms was examined among 167 adolescents aged 10–17 years. Results indicated that early-maturing youth with problematic peer relations evidenced elevated social anxiety symptoms. Findings are discussed in terms of theoretical implications for adolescent social anxiety development.     

Cytotoxic T-cell immunity against telomerase reverse transcriptase in colorectal cancer patients

The catalytic subunit of telomerase (hTERT) has recently been proposed as a potential tumour-associated antigen capable of inducing T-cell mediated immunity in cancer patients. Before any attempts at vaccination with hTERT antigens can be made, one should establish if cancer patients possess cytotoxic T-lymphocytes (CTL) that can recognise hTERT epitopes. The T-cell response against two HLA-A2-specific epitopes of hTERT in 37 colorectal cancer patients and 12 normal controls was analysed using an interferon gamma (IFN-gamma) ELISPOT assay. For comparison the response to HLA-A2-restricted epitopes of CEA and influenza A matrix protein was also measured. CTL that recognised either of the two hTERT epitopes studied were found in 7 (19%) of colorectal cancer patients, with 2 (5%) possessing T-cells that recognised both these peptides. Four (11%) colorectal cancer patients had CTL that reacted to the CEA epitope. No relationship between cancer stage and the presence of specific CTL against hTERT or CEA was observed. None of the normal controls possessed T-cells capable of recognising either the hTERT or the CEA epitopes. However, a similar proportion of patients and normal controls had CTL reactive with the influenza A peptide. The results of this study demonstrate that CTL active against hTERT are present in approximately 20% of colorectal cancer patients irrespective of disease stage. Moreover, these cells are functional, able to secrete IFN-gamma when stimulated with the relevant peptide.     

A study of antioxidant activity in patients with schizophrenia taking atypical antipsychotics

Introduction

Atypical antipsychotics have significantly improved the quality of life for schizophrenic patients. Despite their beneficial effects, these antipsychotics induce weight gain, diabetes, and dyslipidemia. The aims of this study were to investigate the antioxidative activity of paraoxonase and assess lipid profile as a cardiovascular risk factor in patients with schizophrenia under long-term clozapine or risperidone treatment.

Methods

The study included 66 patients with schizophrenia under clozapine or risperidone treatment and 19 healthy control subjects. Serum paraoxonase activities against paraoxon (PON(PO)), phenylacetate (PON(PA)), dihydrocoumarin (PON(DHC)), serum Trolox equivalent antioxidant activity (TEAC), antioxidant gap (GAP), and lipid profile were determined.

Results

PON(DHC) activity was reduced in both antipsychotic drug-treated groups (clozapine 43.46?±?1.06 U/ml, p?p?Conclusions In patients with schizophrenia, clozapine or risperidone treatment had different effects on various paraoxonase activities. The results of the present study suggest that patients with schizophrenia might be at increased risk for metabolic and cardiovascular disease related to reduced PON(DHC), TEAC, and GAP.     

An audit of operative notes: facts and ways to improve

Background: Accurate operation record keeping is an important element of risk management. Handwritten surgical notes are often produced as evidence in medico‐legal malpractice cases and incomplete and illegible notes may be a source of weakness in a surgeon’s defence. Therefore, we audited the surgical notes in a teaching hospital surgical department. Methods: During 1 week 190 operative notes were audited for patient identity details, preoperative diagnosis, operation title and details, CMB code, postoperative instruction and author of the note. The operative notes were assessed by a medico‐legal lawyer and a medical expert to establish level of legibility and usefulness in a virtual court case. Results: Several operative notes were found incomplete (51.57%) missing important information as CMB code (13.68%), patient details (6.8%) preoperative diagnosis (6.31%), operation title (6.31%) and postoperative instruction (14.73%). Overall, only 92 notes were complete. Conclusion: This audit suggests that handwritten surgical notes generate several errors that could lead to confusion when notes are reviewed for further follow up or are produced as evidence in medico‐legal disputes.     

Bovine papillomavirus type-2 DNA and expression of E5 and E7 oncoproteins in vascular tumours of the urinary bladder in cattle

Cattles suffering from chronic enzootic haematuria frequently develop urinary bladder tumours of both epithelial and mesenchymal origin mainly haemangioma and its malignant counterpart. The role of the bovine papillomavirus type-2 (BPV-2) and of its major transforming oncoprotein in naturally occurring urothelial carcinogenesis has been recently clarified. E5 interacts in vivo as in vitro with the beta receptor for the platelet-derived growth factor (PDGF). However, studies regarding tumours of mesenchymal origin such as those arising from blood vessels are lacking. We show that the BPV-2 is present in 100% of the vascular tumours of the urinary bladder examined. Twenty-six out of twenty-seven tumour samples (96%) expressed E5 while 20 out of 27 (74%) tumour samples expressed E7. The two viral oncoproteins were not expressed in normal endothelial cells. Additionally, they co-localize in neoplastic endothelial cells as demonstrated by confocal immunofluorescence. PDGFbeta receptor was also shown to be expressed and co-localizes with E5 in neoplastic blood vessels. Our results demonstrate, for the first time, that the BPV-2 is present in high percentage in tumours of mesenchymal origin arising in its natural host. Furthermore, the expression of the two viral oncoproteins confirm that the virus may have a causative role in the neoplastic process.     

Is chronic ulcerative stomatitis a variant of lichen planus,or a distinct disease?

Chronic ulcerative stomatitis is an immune‐mediated mucocutaneous disorder characterized clinically by erosions or ulcers. Most cases are limited to the mouth. The histopathological features are non‐specific or mimic those of oral lichen planus, and studies by immunofluorescent microscopy are essential for definitive diagnosis. The defining immunopathogenic mechanism is the binding of IgG to the nuclear protein deltaNp63alpha of keratinocytes in the basal and parabasal cell layers of the oral stratified epithelium. DeltaNp63alpha functions as a regulator of epithelial stem cell activity and as an antiapoptotic agent and regulates the expression of cell‐to‐cell and cell‐to‐basement membrane adhesion molecules. The autoimmune IgG‐deltaNp63alpha interaction is thought to result in damage to the structural attachment of keratinocytes to one another and to the epithelial basement membrane zone and in dysregulation of the cell cycle and apoptosis of basal keratinocytes with the development of erosions or ulcers. The aims of treatment are to suppress the pathogenic immunoinflammatory responses, to prevent local infection and to promote healing. The purpose of this article is to provide a succinct review of the diagnostic, clinical and etiopathogenic features of, and treatment guidelines for chronic ulcerative stomatitis, and to argue that this disease should be regarded as a variant of oral lichen planus, rather than as a distinct entity.