Comparing effects of detached mindfulness and cognitive restructuring in obsessive‐compulsive disorder using ecological momentary assessment

Ecological momentary assessment (EMA) has been shown to be a valid and sensitive measure of treatment effects in obsessive‐compulsive disorder (OCD). As part of a clinical trial, this EMA study deals with a comparison of two treatment conditions, that is, cognitive restructuring (CR) and detached mindfulness (DM). EMA data from n = 39 OCD patients were available from a randomized clinical trial on the effectiveness of CR and DM. Smartphone‐based EMA sampling spread over 4 days each before and after treatment, with 10 random prompts per day and a 2‐week intervention of either CR or DM. We tracked CR strategies (e.g., questioning an appraisal by re‐evaluating risk), DM strategies (e.g., allowing one's thoughts to come and go), and application of newly learned strategies during Post‐Treatment EMA. Although there was a trend towards DM strategies being applied more often during Pre‐Treatment EMA than CR strategies, we did not find differences during Post‐Treatment EMA between CR and DM regarding frequency or difficulty of application and experienced relief. As expected, we found a clear pre‐post increase for all CR and DM behaviours except for one DM item. However, we did not find a treatment‐specific increase of CR and DM behaviours; that is, both interventions equally well promoted a seemingly general treatment effect. Despite the ecological validity of EMA, however, social desirability effects cannot be ruled out, so that this conclusion must be handled cautiously. Further research is needed to replicate and generalize our results.     

Toxic and therapeutic effects of Nifurtimox and Benznidazol on Trypanosoma cruzi ex vivo infection of human placental chorionic villi explants

Nifurtimox (Nfx) and Benznidazole (Bnz) are the only available drugs in use for the treatment of Chagas disease. These drugs are recommended but not fully validated in evidence-based medicine and reports about the differential toxicity of both drugs are controversial. Here, we evaluated the toxic and therapeutic effects of Nfx and Bnz on human placental chorionic villi explants (HPCVE) during ex vivo infection of Trypanosoma cruzi, performing histopathological, histochemical, immunohistochemical as well as immunofluorescence analysis of the tissue. Additionally, we determined the effect of both drugs on parasite load by real time PCR. Bnz prevents the parasite induced tissue damage in ex vivo infected HPCVE compared to Nfx, which is toxic per se. The presence of T. cruzi antigens and DNA in infected explants suggests that these drugs do not impair parasite invasion into the HPCVE. Additionally, our results confirm reports suggesting that Bnz is less toxic than Nfx and support the need for the development of more effective and better-tolerated drugs.     

Patterns of punitiveness in women with eating disorders

The level and direction of hostility in patients with bulimia nervosa, anorexia nervosa and a comparison group were measured using the Hostility and Direction of Hostility Questionnaire. A semistructured interview developed by Harris, Brown, and Bifulco (Psychological Medicine, 16, 641-659, 1986) was used to assess childhood care to examine whether a link exists between childhood exposure to aggression or parental neglect and adult hostility. Patients with eating disorders had significantly higher hostility levels and were significantly more intropunitive than the comparison group. Patients with bulimia nervosa were significantly more intropunitive than the comparison group. Patients with bulimia nervosa were significantly more hostile than patients with anorexia nervosa. Anorexia nervosa patients were more likely to direct hostility inwardly, rather than outwardly, when compared with bulimia nervosa patients. Impulsivity was associated with extrapunitiveness whereas intropunitiveness was associated with depression. Although some measures of poor childhood care correlated with adult hostility levels no clear pattern emerged. © 1995 by John Wiley & Sons, Inc.     

Self-treatment of bulimia nervosa: A pilot study

Twenty-eight patients with ICD-10 bulimia nervosa or atypical bulimia nervosa were given a cognitive-behavioral treatment handbook and were reassessed 4-6 weeks later, On a clinician-rated global improvement scale 12 patients had much improved and 8 patients had somewhat improved. Fifteen patients were abstinent of vomiting or laxatives at reassessment as opposed to five patients before treatment. Of the 21 patients who were hinging before treatment, 7 had a 75– 700% reduction of binges and 5 had a 50–75% reduction of binges. Patients' nutritional knowledge increased significantly. A patient-administered handbook may be a useful first intervention in the treatment of patients with bulimia nervosa. © 1993 by John Wiley & Sons, Inc.     

Cancer-related changes and low-to-moderate exposure to welding fumes: A longitudinal study

ObjectiveThis study tested for an association between early cancer-related biomarkers and low-to-moderate exposure to fumes from welding mild steel.MethodsMale, non-smoking participants from southern Sweden were recruited and examined (N=338, 171 welders and 167 controls); of these, 78 welders and 96 controls were examined on two occasions six years apart. Exposure to welding fumes was evaluated by measuring respirable dust, welding years, and cumulative exposure. DNA methylation of CpG sites within the cancer-related genes AHRR, F2RL3, and B3GNTL1 was measured by pyrosequencing and relative mitochondrial DNA copy number and telomere length were measured by qPCR in whole-blood samples. Multivariate models were used for longitudinal analysis.ResultsMedian exposure to respirable dust was 0.7 mg/m³ at both timepoints, adjusted for use of personal protective equipment. Compared with controls, welders showed a significant decrease over time in DNA methylation of B3GNTL1 CpG1 and CpG4 [adjusted for age, body mass index, and smoking: β=-0.66, standard error (SE)=0.28; β=-0.48, SE=0.24, respectively]. In addition, exposure to respirable dust and cumulative exposure was associated with a decrease in methylation of F2RL3 CpG2 among all welders (adjusted β=-0.67, SE=0.23 and β=-0.03, SE=0.02, respectively). No significant associations were found for AHRR, mitochondrial DNA copy number, or telomere length.ConclusionLow-to-moderate exposure to welding fumes was associated with a small effect on selected early epigenetic biomarkers of cancer. The direction of the methylation pattern (lower methylation of specific CpG sites) indicates early lung cancer-related changes associated with mild steel welding.