Endemic psychosis in western Ireland

For over 200 years parts of Ireland have been thought to have a high prevalence of psychosis, and recent hospital and community studies have confirmed this impression. In an intensive study of a rural area, the authors found that 4% of the population over age 40 was actively psychotic, with diagnoses of schizophrenia, schizoaffective disorder, and bipolar disorder. Psychosis seems to be endemic in some rural, lower socioeconomic areas in Ireland. Possible etiological explanations are discussed.     

The Parsons visual acuity test for screening children 18 to 48 months old

The Parsons visual acuity test (PVAT) uses modified Allen test targets for visual acuity assessment in young children and persons who are difficult to test. Using this method, we were able to obtain a visual acuity threshold in 44% of 18- to 24-month-old children and in 90% of children aged 25 to 36 months. At all ages tested, the mode for visual acuity was 20/30; however, the percentage of those with 20/20 increased with age. The decision whether to refer was correctly made by means of the PVAT criterion 83% of the time.     

Oral contraceptives, smoking and nodular hyperplasia of the liver

Case studies of 4 women (aged 21, 40, 44, and 45) who smoked, had used oral contraceptives, and had nodular hyperplasia of the liver are reviewed, with an emphasis on vascular changes. It is suggested that the natural history of focal nodular hyperplasia is a progressive occlusion of hepatic lobular arteries as a result of either recurrent thrombosis or stimulation of intimal proliferation by contraceptive steroids. Ischemia, infarction, and hemorrhage may occur, followed by rapid development of collateral vessels and nodular regeneration about a central scar. The process is not primarily neoplastic, when contraceptive steroids are withdrawn the lesions will regress. Women with the condition who smoke are urged to stop.     

Modification of immunological potential by ultraviolet radiation. I. Immune status of short-term UV-irradiated mice.

C3Hf/HeN mice support the progressive growth of most transplanted syngeneic ultraviolet (UV) light-induced tumors following short-term UV exposure whereas nonexposed mice reject these tumors. Because an immunosuppressive role in UV-mediated tumor susceptibility might be suggested by these observations, a comparison of several immunological parameters has been conducted. These include antibody production, proliferation in response to antigenic and mitogenic stimulation, and the generation of cytotoxic effector cells by normal or short-term UV-exposed mice. The results indicate that short-term UV irradiation of mice does not result in any readily detectable alterations of the host's immune system other than the consistent loss of the antitumor response mediating rejection of the transplanted UV-induced tumor.     

Should all diabetic patients receive statins?

Diabetes is known to play a causal role in promoting both microvascular and macrovascular complications. Reducing rates of end-organ damage has been a key objective of multiple clinical trials. In addition to the roles of glycemic and blood pressure control, it is evident that lipid reduction via statin therapy independently helps to reduce the risk of primary and secondary vascular events. This effect seems to remain intact across a broad range of lipid levels, suggesting additional mechanisms for efficacy of statin medications beyond cholesterol reduction. The demonstrated safety and data from recent trials lend support to the argument that all people with diabetes should be started on statin therapy regardless of their cholesterol level. It is also plausible that treating the underlying mechanisms of vascular dysfunction, inflammation, and injury so prevalent in diabetic patients would have similar implications for the patient identified as having insulin resistance or metabolic syndrome.