Outdoor adventure for young people with a mental illness

Aim: The study aims to evaluate the efficacy of an Outdoor Adventure Group (OAG) for young people with a mental illness. It was hypothesized that participating in OAG would result in an increase in self‐esteem, sense of mastery and social connectedness, compared with those who attended other Psychosocial Recovery Group Program groups based at Orygen Youth Health. In addition, those in the OAG would show an improved performance of personal goals. Methods: Twenty‐one youths (aged 15 to 25) participated in the OAG and 12 participated in other Psychosocial Recovery Group Program groups and served as the comparison group. Pre‐ and post‐evaluation measures included (i) Rosenberg Self Esteem Scale; (ii) Mastery Scale; (iii) Social Connectedness Scale; and (iv) personal goals for attending the OAG, rated 1–10 on current performance. The groups were based at Orygen Youth Health, Melbourne, Australia and run over an 8 to 10‐week period. Results: Participants of the OAG experienced an improvement in self‐esteem (P = 0.001) and mastery (P = 0.001); these changes were not observed in the controls. There were a total of 80 personal goals for the OAG, with an average of 3.81 per person, and performance significantly improved in 66 (82.5%) goals. There were 10 categories of goals; the most common goals were related to self‐improvement and social skills development. Conclusions: Increased self‐esteem and mastery, and achievement of personal goals gained through the OAG, may facilitate, or be a precursor to, a young person's psychosocial recovery.     

CD28-independent,TRAF2-dependent Costimulation of Resting T Cells by 4-1BB Ligand

4-1BB ligand (4-1BBL) is a member of the tumor necrosis factor (TNF) family expressed on activated antigen-presenting cells. Its receptor, 4-1BB, is a member of the TNF receptor family expressed on activated CD4 and CD8 T cells. We have produced a soluble form of 4-1BBL using the baculovirus expression system. When coimmobilized on plastic with anti-CD3, soluble 4-1BBL induces interleukin (IL)-2 production by resting CD28⁺ or CD28⁻ T cells, indicating that 4-1BBL can function independently of other cell surface molecules, including CD28, in costimulation of resting T cell activation. At low concentrations of anti-CD3, 4-1BBL is inferior to anti-CD28 in T cell activation. However, when 4-1BB ligand is provided together with strong TCR signals, then 4-1BBL and anti-CD28 are equally potent in stimulation of IL-2 production by resting T cells. We find that TNF receptor–associated factor (TRAF)1 or TRAF2 associate with a glutathione S-transferase–4-1BB cytoplasmic domain fusion protein in vitro. In T cells, we find that association of TRAF1 and TRAF2 with 4-1BB requires 4-1BB cross-linking. In support of a functional role for TRAF2 in 4-1BB signaling, we find that resting T cells isolated from TRAF2-deficient mice or from mice expressing a dominant negative form of TRAF2 fail to augment IL-2 production in response to soluble 4-1BBL. Thus 4-1BB, via the TRAF2 molecule, can provide CD28-independent costimulatory signals to resting T cells.     

The apex cardiogram in normal aged subjects

In 25 healthy subjects aged 60-88 years (mean 74.5) and in 20 healthy subjects aged 16-32 years (mean 23.6) apexcardiographic indices were studied as a function of age. The apex cardiograms (ACG) were obtained using a non-calibrated displacement transducer. With the help of an interactive computer program, 17 ACG indices of systolic and diastolic function were computed. The indices were divided into 2 groups (according to the nomenclature proposed by their Authors): a) systolic indices: electromechanical ventricular interval q-C, systolic upstroke time C-E, time from the beginning of ventricular depolarization to the peak of the first ACG derivative q-dA/dt, time from the onset of systolic slope to the peak of first ACG derivative C-dA/dt, ejection fraction according to Antani et al. 1979 E.F.; b) diastolic indices: electromechanical atrial interval P-a, atrial wave length d.a., height of atrial wave as percent of total ACG deflection a/H, height of atrial wave as percent of total diastolic deflection a/D, ratio of the diastolic wave to the total ACG height D/H, total rapid filling cR, early filling period EFP, rapid filling period RFP, total apexcardiographic relaxation time TART, duration of diastolic period A2-C, total apexcardiographic relaxation time index TARTI and diastolic amplitude time index DATI. Several diastolic indices (a/D, a/H, TART, electromechanical atrial time) were markedly higher (p less than 0.001) or lower (TART and DATI, p less than 0.001) in the older group. Systolic indices showed less significant differences: the electromechanical interval lengthened in the older group (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)     

Magnetic Resonance Imaging of the Central Nervous System in Diabetic Neuropathy

Diabetic ‘peripheral’ neuropathy (DPN) is one of the common sequelae to the development of both type-1 and type-2 diabetes mellitus. Neuropathy has a major negative impact on quality of life. Abnormalities in both peripheral vasculature and nerve function are well documented and, in addition, evidence is emerging regarding changes within the central nervous system (CNS) that are concomitant with the presence of DPN. The often-resistant nature of DPN to medical treatment highlights the need to understand the role of the CNS in neuropathic symptomatology and progression, as this may modulate therapeutic approaches. Advanced neuroimaging techniques, especially those that can provide quantitative measures of structure and function, can provide objective markers of CNS status. With that comes great potential for not only furthering our understanding of involvement of the CNS in neuropathic etiology but also most importantly aiding the development of new and more effective, targeted, analgesic interventions.     

The anti-ischemic drugs defibrotide and oligotide analogously inhibit leukocyte-endothelial cell adhesion in vitro

Abstract  Defibrotide (a polydeox-yribonucleotide) and oligotide (an oligodeoxyribonucleotide) obtained from mammalian single-stranded DNA, have been demonstrated to have anti-ischemic activity in some experimental models of ischemia/ reperfusion of kidney in rats. We hypothesized that their anti-is chemic activity could be related to an inhibition of leukocyte-endothe lial cell adhesion and also the con sequent generation of oxygen free radicals by leukocytes. We studied the in vitro adhesion of neutrophils to human umbilical vein endothelial cells under basal conditions and following neutrophil or endothelial cell activation (using 10^--⁷ fMLP and SO0 U/ml TNF-α, respectively). De fibrotide and oligotide significantly inhibited neutrophil adhesion to endothelial cells (after only 1 min of drug treatment). When the anti-LFA-1 70H12 F(ab)₂ monoclonal antibody was used, the drugs exerted only slight additional inhibition of the adhesion of fMLP-acti-vated neutrophils to endothelium. These results, confirmed in NIH/ 3T3–ICAM-l-transfected cells, demonstrate that defibrotide and oligo tide interfere with leukocyte adhesion to endothelial cells by an LFA-1–dependent mechanism.     

Photodynamic therapy with verteporfin in the treatment of exudative idiopathic polypoidal choroidal vasculopathy

PURPOSE: To determine the safety and efficacy of photodynamic therapy with verteporfin (V-PDT) in the treatment of exudative idiopathic polypoidal choroidal vasculopathy (IPCV) lesions that were not suitable for laser photocoagulation. METHODS: This was a prospective, open label study in two centers involving 30 consecutive patients (31 eyes) diagnosed with exudative IPCV using fluorescein angiography (FA), indocyanine green angiography (ICGA), and optical coherence tomography (OCT). All patients underwent complete ophthalmologic examination including best-corrected visual acuity (VA) measurement, contrast sensitivity (CS) testing, FA, ICGA, and OCT. OCT was used to assess the stage of the polypoidal dilations (active or scarred) and the evolution of the signs associated with exudation. Study patients were treated with V-PDT and followed up at 6 weeks and 3, 6, and 12 months. Re-treatment was applied, at an interval of 3 months, until there was an absence of leakage on FA and hyperfluorescence on ICGA. RESULTS: Thirty eyes (29 patients) completed the 12 months post-treatment visit and were retained for further analysis. The mean number of V-PDT treatments was 2.5 (SD 1.1). At 12 months post-treatment, the mean foveal thickness had significantly (p<0.03) decreased to 224 (SD 104) microm from the baseline 292 (SD 124) microm while the mean VA had significantly (p<0.02) improved to 0.50 (SD O.38) from the baseline 0.38 (SD 0.24). Serous detachment of the macula completely resolved in 83.3% of the eyes while 73.3% of the polypoidal dilations were occluded at 12 months. CONCLUSIONS: The results suggest that V-PDT is effective and relatively safe in treating exudative IPCV.