Diagnosis of early myocarditis after respiratory or gastrointestinal tract viral infection: insights from cardiovascular magnetic resonance

Background  

The diagnosis of myocarditis continues to be a challenging task in clinical practice. The purpose of our study was to investigate cardiovascular magnetic resonance imaging in the diagnostic workup of ambulatory patients with the suspicion of early myocarditis after respiratory or gastrointestinal tract viral infection. The need for accurate diagnosis of early myocarditis arises from the low diagnostic accuracy of routine clinical tests.     

Recombinant prion protein induces a new transmissible prion disease in wild-type animals

Prion disease is a neurodegenerative malady, which is believed to be transmitted via a prion protein in its abnormal conformation (PrP^Sc). Previous studies have failed to demonstrate that prion disease could be induced in wild-type animals using recombinant prion protein (rPrP) produced in Escherichia coli. Here, we report that prion infectivity was generated in Syrian hamsters after inoculating full-length rPrP that had been converted into the cross-β-sheet amyloid form and subjected to annealing. Serial transmission gave rise to a disease phenotype with highly unique clinical and neuropathological features. Among them were the deposition of large PrP^Sc plaques in subpial and subependymal areas in brain and spinal cord, very minor lesioning of the hippocampus and cerebellum, and a very slow progression of disease after onset of clinical signs despite the accumulation of large amounts of PrP^Sc in the brain. The length of the clinical duration is more typical of human and large animal prion diseases, than those of rodents. Our studies establish that transmissible prion disease can be induced in wild-type animals by inoculation of rPrP and introduce a valuable new model of prion diseases.     

Erratum: Exploring the clinical and social determinants of prescribing anticholinergic medication for Chinese patients with schizophrenia

Human Psychopharmacology 2007; 22 : 173–180 DOI: 10.1002/hup.830 It has come to our attention that there was an error to one of the author names within this published article. The correct author listing and author affiliation is now published below. We apologise for this anomaly. Xiang Yu‐Tao^1,2, Weng Yong‐Zhen², Leung Chi‐Ming¹, Tang Wai‐Kwong¹, Ungvari Gabor Sandor^{1 1}Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China ²Beijing Anding Hospital, Capital Medical University, Beijing, China     

Subjective quality of life in outpatients with schizophrenia in Hong Kong and Beijing: relationship to socio-demographic and clinical factors

Purpose This study compared the subjective quality of life (SQOL) in schizophrenia patients living with their families in Hong Kong (HK) and Beijing (BJ) and explored the relationship between SQOL and basic socio-demographic and clinical factors. Materials and methods Two hundred and sixty-four clinically stable outpatients with schizophrenia were randomly selected in HK and 258 counterparts matched according to age, sex, age at onset, and length of illness in BJ. SQOL and psychiatric status were assessed with standard rating instruments. Results There was no significant difference in any of SQOL domains between the two cohorts after controlling for potentially confounding variables. Positive, depressive and anxiety symptoms and drug-induced extrapyramidal side effects (EPS) were all significantly correlated with SQOL. Multiple regression analysis revealed that only depressive symptoms predicted all SQOL domains in both groups. Having removed depressive symptoms from the model, positive symptoms predicted all domains, anxiety predicted all but social domains, use of benzodiazepines (BZD) predicted all but physical domains, EPS predicted physical domain, and history of suicide predicted social domain in HK; anxiety predicted all domains, positive symptoms predicted all but physical domains, EPS, use of BZD and history of suicide all predicted physical domains, and length of illness predicted environmental domain in BJ. Conclusion Despite considerable differences between the two sites in terms of health care delivery and the economic conditions of the subjects, SQOL did not differ between HK and BJ. The conclusion is in line with previous studies that suggested that patients’ SQOL was independent of their living standard as long as it reached a certain minimum level. SQOL was more strongly related to the severity of depressive symptoms and had weak association with socio-demographic factors.     

Gynaecological and Sexuality Profile of New Patients attending a Family Planning Clinic

2067 first-time attenders (70% of all new patients during the 9-month study period) at a Family Planning Association clinic in Victoria, Australia, completed a questionnaire aimed at obtaining data on the age at onset of sexual activity and contraceptive use patterns. The mean age of study respondents was 23 years; only 13% were married. 86% of the women reported a history of sexual intercourse. The average age at 1st intercourse was 17.4 years, and over 50% were sexually active before 18 years of age. 51% did not use contraception at the time of 1st intercourse, and this rate was lower (37%) among women aged 15 years or less at coitarche. Of those who had used contraception, the most common methods were condoms (52%) and oral contraceptives (37%). When asked to rate the quality of their 1st act of sexual intercourse, 12% indicated the experience was better than they expected, 50% said it was as good as expected, and 38% indicated it was worse than anticipated. 90% claimed that the quality of their sexual experiences has improved since the 1st time. In terms of current frequency of sexual intercourse, 60% reported sexual relations less than twice a week, 26% have sex 2-3 times a week, and 14% have intercourse more than 3 times a week. When asked about their recent contraceptive practice, 47% reported contraception is always used, 26% use contraception most of the time, 10% use contraception sometimes, 5% rarely use such methods, and 12% never use family planning. Since these subjects were either already sexually active or were planning to initiate sexual activity, they are not representative of Australia's female population as a whole. However, they are an important target for family planning education programs.     

Effect of a cytotoxic analog of LH-RH (T-98) on the growth of estrogendependent MXT mouse mammary cancers: Correlations between growth characteristics and EGF receptor content of tumors

Summary Female BDF mice bearing estrogen-dependent MXT mouse mammary cancers were treated for 4 weeks with a cytotoxic analog of luteinizing hormone-releasing hormone (LH-RH), T-98 (agonist [D-Lys⁶]LH-RH linked to glutaryl-2(hydroxymethyl)anthraquinone). The effects of T-98 were compared to those of equimolar amounts of the cytotoxic moiety 2-(hydroxymethyl)anthraquinone hemiglutarate (G-HMAQ) and carrier LH-RH agonist [D-Lys⁶]LH-RH. Both T-98 and [D-Lys⁶]LH-RH significantly inhibited the growth of MXT cancers, but G-HMAQ had only a minor non-significant effect. Cytotoxic analog T-98 and the carrier [D-Lys⁶]LH-RH had similar inhibitory hormonal activities on the pituitary-gonadal axis, but T-98 caused a larger reduction in tumor volume and decreased proliferation characteristics such as mitotic activity and AgNOR numbers in tumor cells to a greater extent than the carrier. Tumor inhibition by T-98, [D-Lys⁶]LH-RH, and ovariectomy was connected with a significant decrease in binding capacity of EGF receptors in tumor cell membranes. The concentration of EGF receptors remained high in tumors that continued to enlarge in spite of treatment and in all control untreated tumors, even those of small size. Thus, the changes in EGF receptors are likely to be the result of the therapy. Treatment with T-98 caused a greater reduction in the binding capacity of EGF receptors in tumors than [D-Lys⁶]LH-RH. This could explain the higher inhibitory effect of the cytotoxic analog on tumor growth. Since radiolabeled T-98 was shown to accumulate in MXT cancers 3 hours after a subcutaneous injection, this indicates that specific targeting might play a role in the antitumor effect exerted by this cytotoxic analog.Abbreviations LH luteinizing hormone - LH-RH LH-releasing hormone - EGF epidermal growth factor - EGF-R EGF receptor - TGF transforming growth factor - NOR nucleolar organizing region - AgNOR argyrophilic NOR - G-HMAQ 2(hydroxymethyl)anthraquinone-hemiglutarate - HPLC high performance liquid chromatography - TNF tumor necrosis factor - 5-FU 5-fluorouracil - PBS phosphate-buffered saline     

Effect of noradrenaline on retinal blood flow in healthy subjects

PURPOSE: To gain insight into the role of circulating catecholamines on retinal blood flow in vivo. DESIGN: Nonrandomized, open, crossover design. PARTICIPANTS: In 10 healthy male subjects, tyramine and noradrenaline were administered in stepwise increasing doses. These doses were selected to induce comparable changes in systemic blood pressure. METHODS: During each infusion step, retinal vessel diameter and retinal venous blood speed were measured with the Zeiss retinal vessel analyzer (Zeiss, Jena, Germany) and laser Doppler velocimetry, respectively. MAIN OUTCOME MEASURES: Retinal blood flow through a major temporal vein was calculated. RESULTS: As expected, tyramine and noradrenaline induced a systemic hypertensive response. Tyramine caused a moderate increase in noradrenaline plasma levels, whereas exogenous noradrenaline increased noradrenaline plasma levels more than 10-fold. Nevertheless, neither tyramine nor noradrenaline induced any effect on retinal hemodynamic parameters. CONCLUSIONS: These data indicate that even high levels of circulating noradrenaline have little impact on retinal vascular tone and retinal blood flow. Hence, the adrenergic system appears not to play a major role in retinal blood flow regulation.