Drugs and Psychosis Project: A multi‐centre European study on comorbidity

Introduction and Aims. This paper describes the sociodemographic characteristics of 196 psychotic patients admitted to acute psychiatric wards in the UK, Denmark, Germany and Italy, with the aim of comparing comorbid with non‐comorbid patients. Design and Methods. It is a prospective field study with repeated measures at 1, 6 and 12 months. Patients were recruited from acute psychiatric wards in four European centres. They were grouped as comorbid or not on the basis of urine analysis. The Schedules for Clinical Assessment in Neuropsychiatry was used to provide a psychiatric diagnosis, and the Positive and Negative Symptom Severity Scale for further information on specific symptoms with results from the Fragerstrom test for nicotine dependence also reported. Results. Comorbid patients were younger than those who were not but did not differ significantly in the other sociodemographic measures. Differences in sociodemographic characteristics of patients between centres were apparent. Comorbid patients had higher levels of positive and lower levels of negative symptoms than those who were non‐comorbid. Differences were found in the patterns of drug use between comorbid patients who were using cannabis compared with those who were not. Discussion and Conclusions. Cross‐cultural differences in the sociodemographic characteristics of the comorbid patient population give us a better insight into this heterogenous group.[Baldacchino A, Blair H, Scherbaum N, Grosse‐Vehne E, Riglietta M, Tidone L, Criaco C, Marelli MC, Sommer B, Tan L, Little H, Ghodse H. Drugs and Psychosis Project: A multi‐centre European study on comorbidity. Drug Alcohol Rev 2009;28:379–389]     

Comparative analysis of antibiotic resistance and phylogenetic group patterns in human and porcine urinary tract infectious Escherichia coli

Urinary tract infections (UTIs) are one of the most common infectious diseases in humans and domestic animals such as pigs. The most frequent infectious agent in such infections is Escherichia coli. Virulence characteristics of E. coli UTI strains range from highly virulent pyelonephritis strains to relatively benign asymptomatic bacteriuria strains. Here we analyse a spectrum of porcine and human UTI E. coli strains with respect to their antibiotic resistance patterns and their phylogenetic groups, determined by multiplex PCR. The clonal profiles of the strains differed profoundly; whereas human strains predominantly belonged to clonal types B2 and D, these were not seen among the porcine strains, which all belonged to the E. coli clonal groups A and B1. Contrary to the human strains, the majority of the porcine strains were multidrug resistant. The distinct profiles of the porcine strains suggest selective pressure due to extensive antibiotic use.     

A STUDY OF THE BIPHASIC VENTILATORY EFFECTS OF PROPANIDID

The respiratory effects of propanidid (FBA.1420) were observedwhen used to induce anaesthesia in 100 patients after sedativeor atropine premedication. Premedication had no significantrelation to the length of hyperpnoea or apnoea. Hyperpnoea itselfwas associated with apnoea of variable duration but there wasa tendency for the duration of apnoea to be shorter the longerthe preceding hyperpnoea. The findings suggest that this drugis not only a respiratory stimulant but also a depressant. Inductionside effects included hiccough, involuntary movements, and urinaryincontinence.     

Effect of diet on muscle glycogen and blood glucose utilization during a short-term exercise in man

7 subjects were studied at rest and during a 6 min submaximal exercise (65% of Vo₂, max) on two occasions, the first preceded by a fat rich diet and the second by a carbohydrate rich diet. Oxygen uptake and respiratory exchange ratio (R) were measured at rest and heart rate both at rest and during exercise. Arterial-femoral venous differences for oxygen, glucose, lactate and β-hydroxybutyrate and arterial concentrations of free fatty acids were measured at rest and during exercise. Changes in muscle glycogen (in 6 subjects) and lactate concentration were determined by biopsies from m. quadriceps femoris taken before and immediately after exercise. Muscle glycogen decreased less during exercise after the fat than after the carbohydrate diet in 5 of the 6 subjects, whereas blood glucose extraction by the exercising legs did not change with diet. Muscle lactate accumulation and release were smaller after the fat diet. In conclusion, the muscle glycogen utilization during a short-term exercise appeared to be lower after the fat than after the carbohydrate diet, but not the concomitant blood glucose extraction. These differences between diets were similar to those observed after a more prolonged work at the same load.     

Linkage of Chido and HL-A

Of 156 families who were HL-A typed and Chido-typed, 15 were found to be suitable for linkage analysis. It was calculated that the odds in favour of linkage of Chido and HL-A are 1,450,000:1. The maximum likelihood estimate of the Chido : 1.HL-A recombination fraction is 2½% with 95% confidence limits, obtained graphically, of 0 and 12%; the estimate of the Chido : 2.HL-A recombination fraction is 1½%, with limits of 0 and 9%. Among Chido negative subjects, the antigens HL-A12 and W5 occurred more frequently than in a control population.     

The attitudes to CPAP treatment inventory: development and initial validation of a new tool for measuring attitudes to CPAP treatment

Continuous positive airway pressure (CPAP) is the treatment of choice for obstructive sleep apnoea syndrome (OSAS), but low adherence rates are common. The aim was to develop the attitudes to CPAP treatment inventory (ACTI), and to investigate the validity and reliability of the instrument among patients with OSAS. ACTI was developed on the basis of: (i) in‐depth interviews with 23 patients; (ii) examination of the scientific literature; and (iii) consensus agreement of a multi‐professional expert panel. This yielded five different types of attitudes to CPAP treatment. A prospective longitudinal design was used. Two‐hundred and eighty‐nine patients with OSAS were recruited at three different CPAP centres. Data were collected with ACTI and obtained from medical records. The homogeneity and internal consistency reliability were satisfactorily reflected by the item‐total correlations (0.59–0.81) and Cronbach’s alpha (0.89), respectively. Construct validity was confirmed with factor analysis (principal component analysis with orthogonal rotation; PCF). The PCF based on baseline data resulted in a one single‐factor solution explaining 69% of the total variance. A confirmatory factor analysis was performed 2 weeks after CPAP initiation, resulting in the same factor solution. No indication of uniform differential item functioning was found. The predictive validity was tested with receiver operating characteristic analyses, and a cut‐off of 10 on the ACTI gave a sensitivity of 93% and a specificity of 44% for CPAP termination within 6 months. The satisfactory measurement properties of this new pragmatic instrument are promising and indicate that ACTI can be useful in clinical practice to reliably measure attitudes to CPAP treatment.     

A synthetic peptide corresponding to a sequence in the GTPase activating protein inhibits p21ras stimulation and promotes guanine nucleotide exchange

Amino acid sequence homology between the GTPase Activating Protein (GAP) and the GTP-binding regulatory protein, Gsα, suggests that a specific region of GAP primary structure (residues 891–898) may be involved in its stimulation of p21^ras GTP hydrolytic activity (McCormick, F. [1989] Nature 340 , 678–679). A peptide, designated p891, corresponding to GAP residues 891–906 (M⁸⁹¹RTRVVSGFVFLRLIC⁹⁰⁶) was synthesized and tested for its ability to inhibit GAP-stimulated p21^ras GTPase activity. At a concentration of 25 μm , p891 inhibited GAP activity approximately 50%. Unexpectedly, p891 also stimulated GTP binding to p21^N-ras independent of GAP. This stimulation correlated with an enhancement of p21^N-ras GDP dissociation; an approximate 15-fold increase in the presence of 10 μm p891. In contrast, dissociation of the p21^N-ras GTPγS complex was unaffected by 10μM p891. The p21^N-ras GDP complex was unresponsive to 100μM mastoparan, a peptide toxin shown previously to accelerate GDP dissociation from the guanine nucleotide regulatory proteins, Gi and Go. p21^H-ras, as well as the two p21^H-ras effector mutants, Ala-38, and Ala-35, Leu-36, also exhibited increased rates of GDP dissociation in the presence of p891. Also tested were three ras-related GTP-binding proteins; rap, G25K and rac. The rap GDP complex was unaffected by 10 μm p891. Dissociation of the G25K- and rac GDP complexes were enhanced slightly; approximately 1.3-and 1.8-fold over control, respectively. Thus, the inhibitory effect of p891 on GAP stimulation of p21^ras suggests that amino acids within the region 891–906 of GAP may be essential for interaction with p21^ras. In addition, p891 independently affects the nucleotide exchange properties of p21^ras.     

DOES PRIMARY FIBROMYALGIA EXIST?

Twenty-one of 25 consecutive primary fibromyalgia or fibrositispatients, identified during a 5-year period in a tertiary careday-ward for pain syndromes, were re-examined. Fifteen fulfilledcriteria for fibromyalgia but unexpectedly, all cases had eitherpsychiatric disturbance or thyroid dysfunction. Of the fourpatients not seen at follow-up, two had developed neuro-' logicaldiseases, another rheumatoid arthritis and one other hypothyroidism.Thus, after 5 years no patient fulfilled the criteria for primaryfibromyalgia. Women occupied as manual workers were over-represented.Most patients reported beneficial effects of physiotherapy.None of the patients has been able to return to full time work KEY WORDS: Pain, Thyroid disorders, Psychiatric dysfunction, Occupation, Muscle     

Leukemia in Fanconi's Anemia: Cytogenetic and Tumor Virus Susceptibility Studies

Fanconi’s anemia is an inherited disordercharacterized by multiple congenital abnormalities, chromosome anomalies andirreversible aplastic anemia. Patients,and possibly family members, have beennoted to have an increased incidenceof leukemia and other tumors. A familywith two affected male children, one ofwhom developed acute myelomonocyticleukemia, is described. Chromosomepreparations in both parents showed abnormalities, a previously unreportedfinding. Fibroblast cultures from bothparents and one brother inoculated withSimian Virus 40, a known oncogenicagent, developed increased numbers oftransformed colonies, compared withnormal control cultures similarly inoculated. The presence of chromosome abnormalities and cellular susceptibility tooncogenic agents appear to be relatedto an increased risk of malignancy.

Submitted on October 27, 1969 Revised on February 3, 1970 Accepted on March 24, 1970