Neuropsychological performance and regional cerebral blood flow in obsessive-compulsive disorder

Convergent findings from neuropsychological and neuroimaging studies have suggested that neural dysfunction in frontal-subcortical circuits may play a central role in the pathophysiology of obsessive-compulsive disorder (OCD). To further examine the relationship between these two sets of findings we investigated both neuropsychological functions and regional cerebral blood flow (rCBF) in a combined study. Fourteen unmedicated patients fulfilling DSM-IV criteria for OCD and 14 healthy controls matched for age, gender, handedness, and education were assessed on neuropsychological tests that included Trail Making Test (TMT), Rey Complex Figure Test (RCF) (copy and 5-min recall), Verbal Fluency Test (VFT), and Wisconsin Card Sorting Test (WCST). rCBF was studied with 99 mTc-hexamethyl-propyleneamine-oxime (HMPAO) single photon emission computed tomography (SPECT). Patients performed more poorly than controls (P<.05) on RCF (copy), VFT, and WCST (perseverative errors). Spearman's correlations indicated that severity of OCD correlated inversely with performance on the RCF (copy and recall scores) and positively with rCBF in the right thalamus. Positive correlations were observed between nonperseverative errors (WCST) and rCBF in frontal areas and anterior cingulate. Perseverative errors (WCST) correlated negatively with rCBF in the right thalamus. These findings are consistent with most previously published studies and suggest neural dysfunctions in the frontal-subcortical circuits probably more pronounced in the right hemisphere. They also extend the existing research, showing associations between deficits in cortical-subcortical circuitry and performance on neuropsychological tests of controlled attention and visuospatial functions.     

Prognostic Value of Proliferation Index and Expression of the RNA Component of Human Telomerase (hTR) in Papillary Meningiomas

Papillary meningioma is a rare subtype of meningioma that often behaves aggressively. In order to characterize factors that may influence this behavior, we chose to compare MIB-1 labeling index (LI) and telomerase RNA localization (hTR) in papillary meningiomas, meningiomas, and atypical meningiomas. LI is now often used to supplement histologic grade in the evaluation of these lesions. More recent studies indicate that increased expression of hTR is detected in many neoplastic cells, and may play an essential role in cell immortalization. The study group consisted of five papillary meningiomas (and a recurrence in one case), 11 conventional meningiomas, and eight atypical meningiomas. Conventional meningiomas showed either negative or 1+ hTR. Atypical meningiomas showed 1+ hTR. Papillary meningiomas showed the highest hTR (five of six, including recurrence, 2–3+ and one 1+). Generally, the LI was very low for conventional meningiomas (<2%). The LI of atypical meningiomas ranged from 3–19%, mean 12%, and from 5.5–17.5%, mean 11.75% for papillary meningiomas. LI differentiated between meningiomas, and papillary or atypical meningiomas. hTR further delineated papillary (moderate to high) from atypical meningiomas (low). The combined variable of LI and hTR expression could be a useful independent prognostic indicator in patients with papillary meningioma.     

Tn5090-like class 1 integron carrying blaVIM-2 in a Pseudomonas putida strain from Portugal

Three Pseudomonas putida strains containing bla_VIM-2 were isolated from an inanimate surface of a female ward sanitary facility in the Hospital Infante D. Pedro, Aveiro. A novel class 1 integron was found in strain Pp2 (aacA41bla_VIM-2/aac6'-IIc disrupted by an insertion sequence IS1382), and strain PpI was found to carry a class 1 integron (aacA7/bla_VIM-2/aacCl/aacA4), which is described for the first time in this species. Strain PFI carries a class 1 integron associated with a Tn5090-like transposon, constituting the first finding of this type of arrangement in a strain from Portugal. This association highlights further dissemination of bla_VIM-2 in environmental hospital isolates.     

Outcome of orthotopic liver transplantation in autoimmune hepatitis according to subtypes

The relevance of autoimmune hepatitis (AIH) classification for clinical purposes is controversial. We analyzed the outcome after orthotopic liver transplantation (OLT) of nine type I and seven type II AIH patients. Type II patients had a significantly higher incidence of cirrhosis at the time of diagnosis, more resistance to steroid therapy, and a higher Child-Pugh score at the time of OLT. OLT was performed in emergency in three type II patients and electively in all type I patients. Four type II and one type I patients died in the postoperative period. There was no difference regarding the incidence of post-OLT infection and rejection between the two types. No recurrence of AIH was observed. The 6-year actuarial survival rates for type I and type II patients were 76% and 43%, respectively. Type II AIH patients who have a poor response to medical therapy should be considered for OLT with a shortened delay.     

Exposure to Family Violence and Temperament Factors as Predictors of Adult Psychopathology and Substance Use Outcomes

This study examines the potential for a negative psychological impact as a result of childhood exposure to family violence. Psychopathological outcomes in adulthood, such as alcohol problems and depression, are examined in light of reports of childhood physical abuse and exposure to parental violence. A national household probability sample of over 3,000 respondents were asked whether they had, as children, observed violence or threats of violence between their parents or whether they had directly experienced violence from one or both parents. Observed threats of violence was the most potent predictor of depression and current heavy drinking in women. Among men, observed threats of violence predicted current heavy drinking, and alcohol dependence symptoms; personal experience of violence predicted depression. Impulsivity was a main effect predictor of virtually all outcome variables for men and women, but typically did not interact with experience or observation of violence. Findings suggest that individuals who remember childhood experiences of indirect violence from parental conflicts have higher rates of pathological adult outcomes. Impulsivity and sensation seeking are highly related to these outcomes over and above violence history. Family conflict variables and temperament variables are highly correlated with one another but make independent contributions.     

Pain evaluation and management: a survey of Italian radiotherapists

Goals The objective of this study was to assess the knowledge possessed and the attitudes held by Italian radiotherapists regarding evaluation and treatment of pain.Methods One hundred and twenty-six radiotherapists completed a 16-item questionnaire that was specifically designed to investigate three main topics: the attention paid to pain, the use of analgesics, and pain in children. Chi-square or Fishers exact text was employed to evaluate differences based on position (staff/resident), age (<35/>35 years old), availability of consultants in pain therapy and/or palliative care, colleagues with main interest in palliative care among their own staff, and region of residence (north/center/south of Italy).Results Overall percentage of correct answers was 76.6% (range 34.9–94.4%). Correct answers by groups of items were: attention paid to pain 77.3%, use of analgesics 81.5%, and pain in children 63.7%.Conclusion Results of the survey demonstrate that knowledge and attitudes of Italian radiotherapists towards the approach to and treatment of pain can be considered satisfactory.     

Predictive value of common genetic variants in idiopathic pulmonary fibrosis survival

Journal of Molecular Medicine - Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, fibrosing interstitial pneumonia of unknown etiology. The role of genetic risk factors has been the...