The relevance of analogue studies for understanding obsessions and compulsions

Analogue samples are often used to study obsessive–compulsive (OC) symptoms and related phenomena. This approach is based on the hypothesis that results derived from such samples are relevant to understanding OC symptoms in individuals with a diagnosis of obsessive–compulsive disorder (OCD). Two decades ago, Gibbs (1996) reviewed the available literature and found initial support for this hypothesis. Since then there have been many important advances addressing this issue. The purpose of the present review was to synthesize various lines of research examining the assumptions of using analogue samples to draw inferences about people with OCD. We reviewed research on the prevalence of OC symptoms in non-clinical populations, the dimensional (vs. categorical) nature of these symptoms, phenomenology, etiology, and studies on developmental and maintenance factors in clinical and analogue samples. We also considered the relevance of analogue samples in OCD treatment research. The available evidence suggests research with analogue samples is highly relevant for understanding OC symptoms. Guidelines for the appropriate use of analogue designs and samples are suggested.     

AudioGene: Predicting Hearing Loss Genotypes from Phenotypes to Guide Genetic Screening

Autosomal dominant nonsyndromic hearing loss (ADNSHL) is a common and often progressive sensory deficit. ADNSHL displays a high degree of genetic heterogeneity and varying rates of progression. Accurate, comprehensive, and cost‐effective genetic testing facilitates genetic counseling and provides valuable prognostic information to affected individuals. In this article, we describe the algorithm underlying AudioGene, a software system employing machine‐learning techniques that utilizes phenotypic information derived from audiograms to predict the genetic cause of hearing loss in persons segregating ADNSHL. Our data show that AudioGene has an accuracy of 68% in predicting the causative gene within its top three predictions, as compared with 44% for a majority classifier. We also show that AudioGene remains effective for audiograms with high levels of clinical measurement noise. We identify audiometric outliers for each genetic locus and hypothesize that outliers may reflect modifying genetic effects. As personalized genomic medicine becomes more common, AudioGene will be increasingly useful as a phenotypic filter to assess pathogenicity of variants identified by massively parallel sequencing.     

Symmetrical bronchial pattern with normal atrial morphology

An infant with trisomy 21 and tracheostenosis is described. Postmortem findings included symmetrical bronchi, normal atrial arrangement (“situs”) and anomalous thoracic vessels. The lack of concordance between the bronchial morphology and atrial arrangement supports the premise that atrial morphology is a more accurate predictor of the presence or absence of the isomerism syndromes.     

The interaction of antibody/dna immune complexes with complement

In 28 serum and plasma samples from patients with systemic lupus erythematosus, we examined the importance of antibody class with respect to complement-mediated binding to human red blood cells (RBC) of antibody/DNA immune complexes (IC) prepared with anti-DNA antibodies. We used both ³H–double-stranded DNA and ³H–single-stranded DNA (ssDNA). Generally, double-stranded DNA IC showed considerably higher binding than did ssDNA IC in the RBC binding assay. Further analysis indicated that although ssDNA IC fix complement, it is necessary that these IC contain IgM anti-DNA antibodies in order for them to bind to RBC. The results suggest that the mechanisms of clearance and pathogenic potential of these IC may depend upon both the DNA conformation and antibody class. In particular, complement-fixing IC which contain IgG anti-DNA antibodies and ssDNA may not be cleared via the erythrocyte clearance mechanism, and therefore, could be more likely to deposit in certain tissues and initiate inflammatory reactions.     

Evidence for an alcohol-stress link among normal weight adolescents reporting purging behavior

A survey of 1728 tenth grade students was conducted to assess the prevalence of purging behavior, alcohol and drug use, and reported physical and psychological distress. Thirteen percent reported purging behavior. Female purgers outnumbered males 2 to 1. Male purgers were significantly heavier than male nonpurgers. The prevalence of drunkenness and daytime drinking among female purgers was significantly higher than for female nonpurgers. Female purgers were more likely to report using alcohol to reduce stress than nonpurging female peers. Female purgers reported a higher level of psychological distress when perceived situational control is low than female nonpurgers. Significant differences were not found between male purgers and male nonpurgers on variables assessing alcohol use and psychological distress. Educational programs aimed at prevention of eating disorders may need to be developed.     

Analysis of the Origin and Dissemination of HIV-1 Subtype C in Bulgaria

HIV-1 subtype C is the most abundant strain of HIV-1 infections worldwide and was found in the first known patients diagnosed with HIV/AIDS in Bulgaria in 1986. However, there is limited information on the molecular-epidemiological characteristics of this strain in the epidemic of the country. In this study, we analyze the evolutionary history of the introduction and dissemination of HIV-1 subtype C in Bulgaria using global phylogenetic analysis, Bayesian coalescent-based approach, and molecular clock methods. All available samples with HIV-1 subtype C from individuals diagnosed with HIV/AIDS between 1986 and 2017 were analyzed. Men and women were equally represented, and 24.3% of patients reported being infected abroad. The global phylogenetic analysis indicated multiple introductions of HIV-1 subtype C from various countries of the world. The reconstruction of a Bayesian time-scaled phylogenies showed that several Bulgarian strains segregated together in clusters, while others were intermixed in larger clades containing strains isolated from both European and non-European countries. The time-scale of HIV-1 subtype C introductions in Bulgaria demonstrates the early introduction of these viruses in the country. Our in-depth phylogenetic and phylogeographic analyses are compatible with a scenario of multiple early introductions in the country followed by limited local distribution in the subsequent years. HIV-1 subtype C was introduced in the early years of the epidemic, originating from different countries of the world. Due to the comprehensive measures for prevention and control in the early years of the epidemic in Bulgaria, HIV-1 subtype C was not widely disseminated among the general population of the country.     

The Prevalence and Impact of Dental Anxiety Among Adult New Zealanders

ObjectiveTo describe the prevalence and impact of dental anxiety in the New Zealand adult population.MethodsSecondary analysis of data from the 2009 New Zealand national oral health survey. Dental anxiety was measured using the Dental Anxiety Scale (DAS).ResultsThe prevalence of dental anxiety was 13.3% (95% CI = 11.4, 15.6). On average, DAS scores were higher by 14% among females, lower among those in the oldest age group (55+), higher by 10% among those in the European/Other ethnic category, and higher by 10% among those residing in the most deprived neighbourhoods. Those who were dentally anxious had greater oral disease experience and were less likely to have visited a dentist within the previous 12 months. They also had poorer oral health-related quality of life, with the highest prevalence of OHIP-14 impacts observed in dentally anxious 35- to 54-year-olds.ConclusionsDental anxiety is a dental public health problem. It is an important contributor to poor oral health and care avoidance among New Zealanders. There is a need to develop both clinical and population-level interventions aimed at reducing the condition''s prevalence and impact.Key words: Dental anxiety, New Zealand, Quality of life, Dental utilisation     

Interscalene anesthesia for shoulder arthroscopy in a community-sized military hospital

The first 100 consecutive shoulder arthroscopic procedures performed under interscalene anesthesia at a small community-sized military hospital are the basis of this report. This method of anesthesia was compared with 100 shoulder arthroscopies performed in a previous 2-year time period under general anesthesia. A variety of arthroscopic and subsequent open reconstructive procedures about the shoulder were performed using both techniques. Using the interscalene method, 87 regional blocks were entirely successful. Thirteen patients required conversion to general anesthesia for adequate pain control; however, 4 of these had a complete block in the recovery room and required no postoperative narcotics. Seven patients required supplementation with local anesthetic when an open procedure became necessary. There were no major complications. Minor complications included 5 patients with transient Horner's syndrome, 4 patients who experienced anxiety, which was controlled with sedation, and 3 with nausea or pruritus. Interscalene anesthesia provided excellent intraoperative and postoperative analgesia with low morbidity. On a subsequent questionnaire, all patients with a successful block reported that they were extremely satisfied with their experience. Ten patients who had previous shoulder surgery under general anesthesia preferred the interscalene method. In summary, interscalene anesthesia proved to be an excellent method of anesthesia for shoulder arthroscopy. The technique is reproducible within the resources available in most community-level hospitals.