Assessment of a self-contained solid phase enzyme linked immunoassay (ImmunoComb) for the determination of serum total IgE

A semiquantitative method (ImmunoComb) for measuring total serum IgE is described and compared with a standard radioimmunoassay (PRIST). ImmunoComb, based on a solid-phase enzyme-linked immunoassay, is self-sufficient and does not require any expensive laboratory equipment. Comparison of these two assays revealed an almost absolute agreement between them (correlation coefficient = 0.95). Furthermore, the ImmunoComb assay also demonstrated its rapidity and temperature independence while maintaining a recovery of 90% to 102%.     

COMPRI--an instrument to detect patients with complex care needs: results from a European study

The authors developed a screening instrument to detect patients in need of complex care coordination at admission to a general hospital. On the basis of a series of risk factors for care complexity, the authors constructed a short, care complexity prediction instrument (COMPRI) and assessed its qualities. The COMPRI is an easily administered screening instrument that detects patients at risk for complex care needs for whom care coordination is indicated. COMPRI's predictive power exceeds all currently available case-mix instruments.     

Convulsive therapy: a review of the first 55 years

Convulsive therapy was introduced to psychiatric practice in 1934. It was widely hailed as an effective treatment for schizophrenia and quickly recognized as equally effective for the affective disorders. Like other somatic treatments, it was replaced by psychotropic drugs introduced in the 1950s and 1960s. But two decades later, ECT was recalled to treat pharmacotherapy-resistant cases. Avid searches to optimize seizure induction and treatment courses, to reduce risks and fears, to broaden the indications for its use, and to understand its mechanism of action followed. Unlike other medical treatments, however, these searches were severely impeded by a vigorous antipsychiatry movement among the public and within the profession. ECT is effective in the treatment of patients with major depression, delusional depression, bipolar disorder, schizophrenia, catatonia, neuroleptic malignant syndrome, and parkinsonism, and this breadth of action is both remarkable and unique. ECT is a safe treatment. No age or systemic condition bars its use. Its major limitations are the high relapse rates and the occasional profound effects on memory and recall that mar its success. Experiments to sustain its benefits with medications and with continuation ECT are underway. Its mode of action remains a mystery and this puzzle is an unappreciated challenge. The full impact of this intervention is yet to be felt.     

Physical disorders associated with mental illness. A register investigation

On the basis of nationwide patient register data the diagnostic pattern of the medical admissions of a general population (17-49 year-olds; N = 30427) during an 8-year period was studied by comparing those individuals who had been admitted to the psychiatric department (i.e. psychiatric patients) with those individuals who had not. The results suggest that the high utilization of medical admissions by psychiatric patients could not be explained simply by coincident chronic physical illness or particular types of physical disease including the somatic complications of mental disorders. It is more likely to be attributable to other factors such as an increased general susceptibility to physical illness, different forms of illness behaviour, and the process of somatization.     

Septins: a ring to part mother and daughter

The septins are well conserved GTPases found in animals and fungi. In yeast, they are required for the formation of 10-nm filaments, with which they co-localize at the bud neck. Therefore, septins have been proposed to be components of the neck filaments and to have polymerization properties. In support of this hypothesis, septin complexes purified from yeast and flies form filaments in vitro. However, recent studies have questioned the relevance of septin filament formation for septin function. Particularly, septin polymerization may not be required for their function in cytokinesis. New septin functions have also been recently uncovered: in budding yeast, the septin ring is required for the maintenance of cell polarity. It forms a cortical barrier that prevents lateral diffusion of membrane-associated proteins through the bud neck. Here, we review the most recent functional and biochemical data, to discuss whether there is a link between septin polymerization properties and septin function.     

Differential effect of nerve fiber structure on block by local anesthetic

The incidence of conduction block by lidocaine 0.3 mmol/l (8.1 mg/dl) in several successive lengths of individual afferent axons of rabbit was compared. The conduction velocity of the axons was either "slow," "intermediate" (1.3-4 m/s), or "fast." The "intermediate" group showed a higher incidence of proximal acceleration of conduction (P less than 0.001) and a greater incidence of block (P less than 0.001) than the "slow" and "fast" fiber groups. The results were interpreted as indicating that the fibers of the "intermediate" group had an unmyelinated peripheral and a myelinated proximal length, with a junctional heminodal region that was the seat of the high sensitivity to block. The potential clinical significance of the observation is discussed in terms of the known distribution of heminodes in the peripheral nervous system.     

Serial Dexamethasone Suppression Tests and Clinical Outcome in ECT

Serial dexamethasone suppression tests (DST), obtained during a course of electroconvulsive therapy in 43 severely depressed patients, did not exhibit relationships between the initial DST, final DST, or the change in DST with clinical outcome measures at the time of discharge. In 37 patients reviewed six months after discharge, no relationship with the continuation of improvement, rehospitalization, or suicide was found. We are unable to confirm a clinical application for the DST in the management of patients during a course of convulsive therapy.