Hypercalcemia with elevation of parathormone in lymphocytic lymphoma. Efficacy of ethanehydroxydiphosphonate by mouth

Acute hypercalcaemia was observed in a 54 year old woman followed up over a five year period for a lymphocytic non-Hodgkin lymphoma, a complication which is rare in chronic lymphoproliferative disorders except multiple myeloma. This case is of interest from 3 points of view: haematological: the simultaneous occurrence of hypercalcaemia (4.80 mmol/l) and of a leukaemic phase (19,300 lymphocytes/mm3) with no signs of "transformation" of the haemopathy; physiopathological: increased osteoclastic bone resorption and a rise in serum parathormone (0.21 to 4.82 ng/ml); therapeutic: efficacy of oral ethane 1, hydroxy 1, 1 diphosphonate (20 mg/kg/day) in treating the hypercalcaemia.     

Continuation Therapy After ECT for Delusional Depression: A Naturalistic Study of Prophylactic Treatments and Relapse

The study examines the naturalistic clinical course of 21 patients with delusional depression following their acute response to ECT. Their course is contrasted with that of 31 patients with delusional depression who acutely responded to medication treatment. They were treated for a minimum of 6 months (mean 3.5 years) with various continuation medications. Delusional depression is associated with a high rate of relapse, and some form of continuation therapy is clearly required. Akin to the acute treatment studies of delusional depression, prophylaxis with antidepressants alone is inadequate in preventing relapse in delusional depression patients.     

Computerized evaluation of the effectiveness of subgingival scaling in jaw models

The purpose of the present study was to improve the quality and the effectiveness of subgingival scaling managed by dental students. A training program was developed and the scaling was performed in jaw models. The teeth of these models were modified in order to ensure a quick inspection of the scaled root surfaces. Artificial "calculus", consisting of a mixture of shellac, umbra, pumice and plaster dissolved in ethanol, was painted on the root surfaces. Following the completion of the scaling test, remaining "calculus" was evaluated by adoption of a grading system. This system had scores from 0 to 3 and was defined by illustrated and described criteria. A menu-directed computer program was developed in order to ensure a rapid transformation of surface scores into clinically-related variables. The output from this program gave valuable information about the proficiency of individual students, as well as about the whole class of students as one body. Other advantages and potentials of this system are described.     

Psychiatric morbidity in three primary medical care clinics in the city of Sao Paulo

Summary The aim of this study was to assess the prevalence of psychiatric disturbance in three primary medical care settings (Brasilandia, Servidor and Barra Funda) in a large city of a developing country and the effect of relevant sociodemographic factors (sex, age, marital status, occupation, migration, colour of skin and housing) on minor psychiatric morbidity.The prevalence rates of psychiatric morbidity were estimated at two levels: for minor and for severe psychiatric disturbance. The extent of minor psychiatric morbidity was found to be very high in the three primary medical care clinics (Brasilandia 56%, Servidor 50% and Barra Funda 47%) and about one-quarter of persons attending each clinic presented a severe psychiatric disturbance.Two factors were found to be associated with minor psychiatric morbidity (sex and family income per capita) when the joint effects of the sociodemographic variables were investigated. Women were more likely than men to present a minor psychiatric disturbance and the lower the family income the higher the risk of minor psychiatric morbidity. These findings are discussed in the light of the mental health of the urban poor living in the large cities of developing countries.     

Facilitators and Barriers to the Sustainability of a School-Based Bullying Prevention Program

Prevention Science - The long-term sustainment of bullying prevention programs has rarely been investigated. This study addresses this gap by identifying facilitators and barriers to the systematic...     

Communication Patterns Among Male Couples with Open and Monogamous Agreements

Archives of Sexual Behavior - Male couples in open relationships tend to have as equally fulfilling relationships as monogamous male couples; however, less is known about communication differences...     

What is the impact of day care on older people with long-term conditions: A systematic review

There is a lack of robust evidence regarding outcomes for day care use among older people living with long-term conditions (LTCs). Day care is provided by independent, private and voluntary and charitable sectors. This systematic review aims to establish current evidence of outcomes for older people with LTCs attending day care services and outcomes on carers, across all service models. Narrative synthesis of quantitative and qualitative data was undertaken. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A systematic literature search was carried out across eight electronic databases and reference lists of key journals between 2004 and October 2020 were searched. Searches returned 1,202 unique titles. Forty-five articles from 16 countries met the criteria on review of title, abstract and full article. There is limited evidence suggesting improved levels of perceived psychological health, quality of life, perceived general health, physical health and functioning for older people attending day care who have LTCs. The respite function of day care resulted in positive outcomes for carers. Studies evaluating outcomes for participants or carers were limited in quantity and quality. There is limited information regarding outcomes for day care attendance for older people with multiple LTCs from existing literature. Further research focusing on LTCs and day care attendance would benefit this field.     

IgE to cross-reactive carbohydrate determinants: analysis of the distribution and appraisal of the in vivo and in vitro reactivity

BACKGROUND: IgE to cross-reacting carbohydrate determinants has already been described by several authors, but their function and distribution are still a matter of debate. In previous studies we showed how the presence of IgE to bromelain could be a useful and simple marker of the presence of IgE to carbohydrate epitopes. METHODS: A survey of 1,831 subjects with a suspected allergic respiratory disease has been carried out by detecting IgE to bromelain. Data were analysed on the basis of demographical and allergological parameters. To find out whether a glycoprotein is capable of triggering an allergic reaction, 1,076 subjects were also skin tested with several purified molecules bearing carbohydrate side chains differing in number, composition and complexity. RESULTS: An overall prevalence of 23% of positive IgE to cross-reacting carbohydrate determinants was recorded. Prevalence varied when subsets of non-allergic (5%), non-pollen-allergic (10%), and pollen-allergic (31%) subjects were considered. Prevalence further increased in subsets with multiple pollen sensitization (71%), and with a previous pollen immunotherapy course (46%), whereas minor differences were found in gender and age distribution. Almost all the allergenic extracts recorded negative in the skin test gave a positive IgE test in vitro. A higher correlation was found mainly with plant-derived allergenic extracts, whereas a lower one was recorded with mites and fungi. Horseradish peroxidase was the only glycoprotein capable of exerting a positive skin test in 21% of the subjects with IgE to cross-reacting carbohydrate determinants, 80% of them having IgE to the HRP molecule. CONCLUSIONS: IgE to cross-reacting carbohydrate determinants are common among the allergic population and the binding to skin test negative allergenic extracts further confirms their poor biological activity. Further studies on horseradish peroxidase should be carried out to define the role of the glycan side chains in its allergenic activity.     

Triplications of chromosome 1p36.3, including the genes GABRD and SKI,are associated with a developmental disorder and a facial gestalt

Triplication of chromosomal region 1p36.3 is a rare genomic rearrangement. In this report, we delineate the phenotypic spectrum associated with 1p36.3 triplications. We describe four patients with microtriplications of variable size, but with a strong phenotypic overlap, and compare them to previously described patients with an isolated triplication or duplication of this region. The 1p36.3 triplication syndrome is associated with a distinct phenotype, characterized by global developmental delay, moderate intellectual disability, seizures, behavioral problems, and specific facial dysmorphic features, including ptosis, hypertelorism, and arched eyebrows. The de novo occurrence of these microtriplications demonstrates the reduced reproductive fitness associated with this genotype, in contrast to 1p36.3 duplications which are mostly inherited and can be associated with similar facial features but with a less severe developmental phenotype. The shared triplicated region encompasses four disease-related genes of which GABRD and SKI are most likely to contribute to the phenotype.