Decisions about sectioning and medicating of schizophrenic patients in Germany and England--results of a comparative study

Questionnaires with three case summaries have been presented to 143 psychiatrists in Germany and 27 in England. All three case summaries regard patients with schizophrenia who either show risk to themselves or others. The psychiatrists were asked whether they would recommend sectioning and furthermore whether they would recommend treatment against the patient's will. In the case regarding a risk to others there was widespread approval of sectioning and treatment (Germany 85 %, England 93 %) against the patient's will. Significant differences were seen in the cases of risk to the patients themselves with regards to treatment against the patient's will. This was the case with a scenario involving a young man with his first presentation of schizophrenia as well as in the case of a middle aged man presenting with chronic psychotic symptoms and self-neglect (approval in England: 96 % and 93 % respectively, in Germany: 63 % and 59 % respectively, p < 0.001 for both). When a logistic regression was performed the country of work was the most important predictive factor in deciding whether or not to treat a patient against his will.     

Erhöhter postoperativer Schmerz nach orthopädischen Operationen

The aim of this study was to examine whether depression is a strong predictor of elevated postoperative pain levels following orthopedic surgery and whether the implementation of standardized pain management is more beneficial for patients with depression. We performed a non-randomized, prospective study with two different groups of patients who underwent orthopedic surgery. Group 1 (n=249) received non-standardized pain therapy whereas group 2 (n = 243) was treated with a standardized pain management concept. Effects of the treatment were monitored with a VAS-based pain assessment protocol. Depression was measured preoperatively with the self-reported Patient Health Questionnaire (PHQ-9). Patients with the probable diagnosis of a current episode of major depression showed significantly higher postoperative pain than patients without a depressive episode. On the other hand, patients with depression benefited from the implementation of standardized pain management. Our data suggest a predictive value of depression for severe postoperative pain. Patients with depression benefited from standardized postoperative pain therapy, but were still suffering from significantly higher postoperative pain.     

Age‐related changes in skin mechanical properties: a quantitative evaluation of 120 female subjects

Background/purpose: The most commonly used method to determine the mechanical ability of skin is the creep test using suction chamber devices. Until now, there is no scientific consensus upon which skin deformation parameters and which body sites are particularly suitable to describe age‐related changes in human skin mechanics. The aim of this study was to find those mechanical skin parameters best representing influence of aging at five different body sites. Methods: A total of 120 healthy women aged 18–65, divided into four similar age groups, were included in this study. The biomechanical properties of the skin were measured using the Cutometer^® MPA 580 on five body sites: cheek, neck, cleavage, volar forearm and back of the hand. In order to analyze parameters referred to 1 mm skin thickness, we also used 20 MHz sonography (DUB 20). Results: A high average correlation with age was found for the parameters U_a/U_f, U_r/U_e, U_r, U_r/U_f and U_a. Only low correlation with age was found for the parameters U_v/U_e, U_f‐U_a, U_f5/U_f, U_d/U_f and U_a5. The localizations cheek, forearm and neck showed the highest correlation with age, while cleavage showed only low correlation. Conclusion: According to the results of our study, we recommend the parameter ratio of elastic recovery to distensibility (U_r/U_f) as well as the gross elasticity (U_a/U_f) for evaluation of aging effects on the mechanical properties of skin. Their high correlation with age makes them particularly applicable to represent the influence of aging onto skin mechanical properties. Most suitable localizations to evaluate skin aging are cheek, forearm and neck.     

Phylogenetic relationships and new records of Asterinaceae (Dothideomycetes) from Panama

Asterinaceae are small obligately biotrophic pathogens growing superficially on living leaves of higher plants in tropical and subtropical regions worldwide. The species-rich but rarely studied ascomycete group has an uncertain placement within the Dothideomycetes because molecular data are missing completely up to now. Based on nuclear DNA from fresh material of five Asterina spp. and a related anamorphic stage from Panama, we present the first molecular phylogenetic hypothesis of the Asterinaceae within the Dothideomycetes. A combined SSU and LSU rDNA phylogenetic analysis shows that species of Asterina and its anamorphs form a well supported monophyletic clade within the Dothideomycetes with Venturiaceae as sistergroup. Three Asterina spp. included in the molecular study are new records for Panama and Central America with new records of host plant species: A. cestricola on Cestrum rugulosum (Solanaceae), A. weinmanniae on Weinmannia pinnata (Cunoniaceae) and A. zanthoxyli on Zanthoxylum scheryi (Rutaceae). A. cestricola and A. weinmanniae are illustrated here for the first time.     

A novel function for transglutaminase 1: Attachment of long-chain ω-hydroxyceramides to involucrin by ester bond formation

Transglutaminases (TGases) are defined as enzymes capable of forming isopeptide bonds by transfer of an amine onto glutaminyl residues of a protein. Here we show that the membrane-bound form of the TGase 1 enzyme can also form ester bonds between specific glutaminyl residues of human involucrin and a synthetic analog of epidermal specific omega-hydroxyceramides. The formation of a approximately 5-nm-thick lipid envelope on the surface of epidermal keratinocytes is an important component of normal barrier function. The lipid envelope consists of omega-hydroxyceramides covalently linked by ester bonds to cornified envelope proteins, most abundantly to involucrin. We synthesized an analog of natural omega-hydroxyceramides N-[16-(16-hydroxyhexadecyl)oxypalmitoyl]sphingosine (lipid Z). When recombinant human TGase 1 and involucrin were reacted on the surface of synthetic lipid vesicles containing lipid Z, lipid Z was attached to involucrin and formed saponifiable protein-lipid adducts. By mass spectroscopy and sequencing of tryptic lipopeptides, the ester linkage formation used involucrin glutamine residues 107, 118, 122, 133, and 496 by converting the gamma-carboxamido groups to lipid esters. Several of these residues have been found previously to be attached to ceramides in vivo. Mass spectrometric analysis after acetonide derivatization also revealed that ester formation involved primarily the omega-hydroxyl group of lipid Z. Our data reveal a dual role for TGase 1 in epidermal barrier formation and provide insights into the pathophysiology of lamellar ichthyosis resulting from defects of TGase 1 enzyme.