The Reactivity of Psychosis Rating Form (RPRF): background,development and psychometrics

The ICD-10 and DSM-IV classifications have both given low priority to “reactivity” to acute stress as a classificatory principle for functional psychoses. In Scandinavia, reactivity is still considered an important factor in the development of such psychoses. Reactivity is a complex concept, and its various components are historically examined. The Reactivity of Psychosis Rating Form (RPRF) was developed in order to operationalize reactivity. Seven of the 10 elements of RPRF can be rated reliably. Factor analysis of the RPRF yields three factors: stressor, onset and change, that also show high interrater reliability. Our results indicate that RPRF has both construct and discriminant validity. Further studies with the RPRF may elucidate the true status of reactivity in functional psychoses.     

PET examination of [11C]NNC 687 and [11C]NNC 756 as new radioligands for the D1-dopamine receptor

The benzazepines NNC 687 and NNC 756 have in animal studies been described as selective D₁-dopamine receptor antagonists. Both compounds have been labeled with¹¹C for examination by positron emission tomography (PET). In the present study central receptor binding was studied in monkeys and healthy men. After IV injection of both radioligands in Cynomolgus monkeys radioactivity accumulated markedly in the striatum, a region with a high density of D₁-dopamine receptors. This striatal uptake was displaced by high doses of the selective D₁-antagonist SCH 23390 (2 mg/kg) but not by the 5HT₂-antagonist ketanserin (1.5 mg/kg) or the selective D₂-antagonist raclopride (3 mg/kg). The cortical uptake after injection of [¹¹C]NNC 687 was not reduced in displacement experiments with ketanserin. The cortical uptake of [¹¹C]NNC 756 was reduced in displacement and protection experiments with ketanserin by 24–28% (1.5 mg/kg), whereas no reduction could be demonstrated on striatal uptake. In healthy males both compounds accumulated markedly in the striatum. For [¹¹C]NNC 687 the ratio of radioactivity in the putamen to cerebellum was about 1.5. For [¹¹C]NNC 756 the ratio was about 5. This ratio of 5 for [¹¹C]NNC 756 is the highest obtained so far for PET radioligands for the D₁-dopamine receptor.     

Need for bilateral arthroplasty for coxarthrosis 1, 477 replacements in 1, 199 patients followed for 0-14 years

During the 10-year period 1981-1990, 1, 199 patients in the county of South Jutland, Denmark, had 1, 477 primary total hip arthroplasties (THA) performed because of primary arthrosis (OA).

The patients were followed until the end of 1994, with a mean follow-up of 5.6 (0-14) years. Bilateral operations were performed on 356 patients, whereas 248 patients had died with only 1 THA.

The cumulated risk of replacement of the contralateral hip was approximately 0.15 1 year after replacement of the first hip, 0.20 after 2 years, 0.29 after 5 years and 0.47 after 10 years, respectively.

During the follow-up period, the demand for a THA of the contralateral hip continued to be approximately 15 times higher than in the general population.     

Spontaneous remission in a patient with therapy-related myelodysplastic syndrome (t-MDS) with monosomy 7

We describe a case of spontaneously reversible refractory anaemia, a subtype of myelodysplastic syndrome (MDS), with monosomy 7 secondary to chronic treatment with azathioprine (AZA) in a young renal transplant recipient. AZA was stopped after that conventional cytogenetics and fluorescence in situ hybridization (FISH) had demonstrated the existence of a monosomy 7 clone. 4 months later, haematological values had considerably improved and the karyotypic examination as well as the FISH analysis were normal. The spontaneous remission of this MDS with monosomy 7, which is usually associated with a particularly poor prognosis, could be due to the recovery of a better immunosurveillance following the withdrawal of AZA.     

Dentin hypersensitivity treated with a fluoride-containing varnish or a light-cured glass-ionomer liner.

Dentin hypersensitivity in 112 teeth was randomly treated with Duraphat or Vitrabond. No patients were included unless they, without being asked, complained about daily pain for a long period of time caused by cold, warm, sweet, sour, touch or any combination of these five variables. Patients were excluded if the dentin hypersensitivity could have been caused by cervical abrasion/erosion lesions deeper than 1 mm, cracked-tooth syndrome, caries lesions, operative caries treatment, and/or periodontal surgery or root scaling within the last 6 months. The pain was registered on a binary scale: 1) pain before the treatment; and 2) pain/no pain after the treatment. With Duraphat, 22% of the treatments failed within 1 wk and the cumulative 1-yr success rate was 41%. With Vitrabond, 2% failed within the first week and the 1-yr success rate was 79%. The difference between the two treatments was highly significant. Patients in whom Duraphat failed were treated with Vitrabond and vice versa; the 1-yr success rate for the retreated teeth was 68% when "Duraphat-failures" were treated with Vitrabond and 42% when "Vitrabond-failures" were treated with Duraphat.     

Effects of flurazepam on disturbed sleep in patients with AIDS

Polysomnograms were recorded of twelve patients with acquired immune deficiency syndrome (AIDS) during different stages in an open design. During the first night no hypnotics were administered, during the second night 30 mg flurazepam per os were given. Flurazepam affected mainly the NREM parameters. The times "awake" during the night were reduced, sleep stage 2 showed an increase, and the effective sleep time was also increased. The increase in sleep spindle density was remarkable, however, delta sleep and generation of K-complexes were not affected. Flurazepam did not affect REM sleep at all. The amount of REM sleep showed a slight increase. REM distribution during the night did not show the "bell shaped" increase and the decrease in the morning; the degree of the illness correlated with a flattening of REM distribution.     

Distribution of cerebral blood flow during deep isoflurane vs. pentobarbital anesthesia in rats with middle cerebral artery occlusion

While previous studies have identified a protective effect for barbiturate anesthesia during focal cerebral ischemia, no such effect has been demonstrated for isoflurane. To better understand the effects of these anesthetics on cerebral blood flow and metabolism that might have relevance to their respective potential for cerebral protection, fasted physiologically stable rats underwent autoradiographic determination of CBF and CMRglu during deep isoflurane or pentobarbital anesthesia (burst suppression of EEG). As expected, cerebral blood flow was significantly greater during isoflurane anesthesia (isoflurane = 157 +/- 18 and pentobarbital = 54 +/- 12 ml/100 g/min) while CMRglu values were nearly identical (isoflurane = 35 +/- 5 and pentobarbital = 33 +/- 4 mumol/100 g/min). Additional identically anesthetized rats underwent middle cerebral artery occlusion with CBF autoradiographically determined 1 h later. While the insult resulted in a significant reduction in the ipsilateral hemispheric and cortical blood flow in both anesthetic groups, flow remained at least twofold greater in isoflurane as opposed to pentobarbital-anesthetized rats. When regional flow was assessed, no difference between groups was observed with respect to the area of tissue with flow values falling between 0-10 ml/100 g/min. In contrast, isoflurane-anesthetized rats had significantly less hemispheric and cortical area with flow values in the ranges of 10-20 and 20-30 ml/100 g/min, respectively. These data, therefore, do not support the contention that isoflurane causes maldistribution of CBF during focal ischemia.     

Activity involvement, risk-taking, demographic variables, and other drug use: prediction of trying smokeless tobacco

Four activity participation variables (clubs, sports, church, and parties); two indices of "risk-taking" (preference for risk-taking, getting into trouble at school); three demographic variables (sex, ethnic group, socioeconomic status); and two drug use variables (trial of cigarettes and alcohol) were examined as correlates and prospective predictors of trial of smokeless tobacco in two cohorts of seventh graders in urban Los Angeles. The data were analyzed separately for males and females. Cross-sectional logistic regression analyses indicated that correlates of trying smokeless tobacco among the seventh-grade cohorts or among these same cohorts in the eighth grade (considering those persons who had not tried smokeless tobacco in seventh grade) generally included being white, trying cigarettes, risk-taking, and attending parties. Prospective logistic regression analyses with data from subjects who had not tried smokeless tobacco in the seventh grade indicated that predictors of subsequent trial of it generally included only being white and having tried cigarettes. Sports participation predicted onset only in one cohort of female subjects but not in males. Some activities that have been proposed as being predictive of smokeless tobacco use (e.g., sports participation) are generally irrelevant for a large sample of young adolescents in urban Los Angeles. White male cigarette smokers, regardless of the activities they have engaged in, are most likely to try smokeless tobacco.