Adjunctive Use of Nonsteroidal Anti-inflammatory Drugs for Schizophrenia: A Meta-analytic Investigation of Randomized Controlled Trials

Objective: To meta-analytically assess the efficacy and tolerability of nonsteroidal anti-inflammatory drugs (NSAIDs) vs placebo in schizophrenia. Method: Searching PubMed, PsycINFO, ISI Web of Science, and the US National Institute of Mental Health clinical trials registry from database inception to December 31, 2012, we conducted a systematic review/meta-analysis of randomized placebo-controlled studies assessing the efficacy of adjunctive NSAIDs. Primary outcome was the change in Positive and Negative Syndrome Scale (PANSS) total score. Secondary outcomes included change in PANSS positive and negative subscores, all-cause discontinuation, and tolerability outcomes. Random effects, pooled, standardized mean changes (Hedges’ g) and risk ratios were calculated. Results: Across 8 studies, including 3 unpublished reports (n = 774), the mean effect size for PANSS total score was −0.236 (95% CI: −0.484 to 0.012, P = .063, I² = 60.6%), showing only trend-level superiority for NSAIDs over placebo. The mean effect sizes for the PANSS positive and negative scores were −0.189 (95% CI: −0.373 to −0.005, P = .044) and −0.026 (95% CI: −0.169 to 0.117, P = .72), respectively. The relative risk for all-cause discontinuation was 1.13 (95% CI: 0.794 to 1.599, P = .503). Significant superiority of NSAIDs over placebo regarding PANSS total scores was moderated by aspirin treatment (N = 2, P = .017), inpatient status (N = 4, P = .029), first-episode status (N = 2, P = .048), and (in meta-regression analyses) lower PANSS negative subscores (N = 6, P = .026). Interpretation: These results indicate that adjunctive NSAIDs for schizophrenia may not benefit patients treated with first-line antipsychotics judged by PANSS total score change. NSAIDs may have benefits for positive symptoms, but the effect was minimal/small. However, due to a limited database, further controlled studies are needed, especially in first-episode patients.Key words: schizophrenia, inflammation, treatment resistance, augmentation, concomitant, nonsteroidal anti-inflammatory     

Early effect of thrombolysis on structural brain network organisation after anterior‐circulation stroke in the randomized WAKE‐UP trial

The symptoms of acute ischemic stroke can be attributed to disruption of the brain network architecture. Systemic thrombolysis is an effective treatment that preserves structural connectivity in the first days after the event. Its effect on the evolution of global network organisation is, however, not well understood. We present a secondary analysis of 269 patients from the randomized WAKE‐UP trial, comparing 127 imaging‐selected patients treated with alteplase with 142 controls who received placebo. We used indirect network mapping to quantify the impact of ischemic lesions on structural brain network organisation in terms of both global parameters of segregation and integration, and local disruption of individual connections. Network damage was estimated before randomization and again 22 to 36 h after administration of either alteplase or placebo. Evolution of structural network organisation was characterised by a loss in integration and gain in segregation, and this trajectory was attenuated by the administration of alteplase. Preserved brain network organization was associated with excellent functional outcome. Furthermore, the protective effect of alteplase was spatio‐topologically nonuniform, concentrating on a subnetwork of high centrality supported in the salvageable white matter surrounding the ischemic cores. This interplay between the location of the lesion, the pathophysiology of the ischemic penumbra, and the spatial embedding of the brain network explains the observed potential of thrombolysis to attenuate topological network damage early after stroke. Our findings might, in the future, lead to new brain network‐informed imaging biomarkers and improved prognostication in ischemic stroke.     

Personality Traits and Coping Strategies Relevant to Posttraumatic Growth in Patients with Cancer and Survivors: A Systematic Literature Review

The possibility of positive psychological changes after cancer, namely, posttraumatic growth, is a growing field of research. Identifying personality traits and coping strategies related to posttraumatic growth may help find vulnerable individuals as well as promote helpful coping strategies to help more patients make positive changes at an early stage. The aim of this systematic literature review is to provide an overview of the quantitative data on coping strategies and personality traits associated with posttraumatic growth in patients with cancer and cancer survivors as well as the methods used in included studies. A systematic literature search was conducted using five databases (PubMed, PubPsych, PsycInfo, Web of Science, and PSYNDEXplus). The 70 reports of included studies assessed posttraumatic growth using questionnaires in a sample of patients with cancer or survivors. In addition, associations with a personality trait or coping strategy had to be examined cross-sectionally or longitudinally. All 1698 articles were screened for titles and abstracts by two authors, after which disputed articles were reviewed by a third author. Afterwards, articles were screened for full texts. Most studies had a cross-sectional design and used a sample of patients with breast cancer. Coping strategies have been researched more than personality factors. The personality traits of resilience, hardiness, dispositional positive affectivity, and dispositional gratitude seem to be related to posttraumatic growth, while the Big Five personality traits (openness to experience, conscientiousness, extraversion, agreeableness, neuroticism) have been less researched and/or seem to be unrelated. The use of social support, religious coping, positive reframing, and reflection during illness as coping strategies seems to be related to posttraumatic growth. The findings can be used for the development of interventions. Future studies should investigate associations longitudinally.     

Laser Surface Alloying of Sintered Stainless Steel

A characteristic feature of sintered stainless steel (SSS) is its porosity. Porosity results in a lower density of steel, making attractive components for producing lightweight structures and materials used in industry (e.g., the automotive industry or aerospace). Scientists also observe that porosity adversely affects steel’s properties, especially its strength properties. One of the proposals for improving the discussed properties is the use of surface treatment of sintered stainless steels, e.g., with the use of concentrated energy sources such as plasma beams or laser beams. However, this proposal is an incidental subject of research, which is not justified from the point of view of the obtained research results presented by a few research groups. In this study, the surface modification (surface treatment) of sintered stainless steel was presented. The authors proposed the use of two surface treatments in order to compare them and obtain the best results. The first treatment was the deposit of Cr₃C₂–NiCr coatings on SSS surfaces using the atmospheric plasma spraying (APS) method. The second treatment was to create surface layers on SSSs by laser alloying the surface with a CO₂ laser. Due to high precision and ease of automation, the most common methods in surface alloying treatment are laser technologies. This research’s main aim was to analyze the microstructure and strength properties of the SSS surface layer. The research confirms that applying the Cr₃C₂–NiCr coating and modifying the surface layer through the laser alloying method improves the mechanical properties of SSSs.     

SARS-CoV-2 and West Nile Virus Prevalence Studies in Raccoons and Raccoon Dogs from Germany

Unlike farm animals, wild animals are not subject to continuous health surveillance. Individual projects designed to screen wildlife populations for specific pathogens are, therefore, also of great importance for human health. In this context, the possible formation of a reservoir for highly pathogenic zoonotic pathogens is a focus of research. Two of these pathogens that have received particular attention during the last years are the novel severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), due to its fast global spread and high impact to the human health, and, since its introduction into Germany, the flavivirus West Nile virus (WNV). Especially in combination with invasive vertebrate species (e.g., raccoons (Procyon lotor) and raccoon dogs (Nyctereutes procyonoides) in Germany), risk analysis must be done to enable health authorities to assess the potential for the establishment of new wild life reservoirs for pathogens. Therefore, samples were collected from raccoons and raccoon dogs and analyzed for the presence of SARS-CoV-2 and WNV infections in these populations. Molecular biological and serological data obtained imply that no SARS-CoV-2 nor WNV reservoir has been established in these two wild life species yet. Future investigations need to keep an eye on these invasive carnivore populations, especially since the close contact of these animals to humans, mainly in urban areas, would make animal–human transmission a challenge for human health.     

Die Erzeugung von Leberkrebs durch den Farbstoff 4-Dimethylamino-azobenzol

Zusammenfassung In Nachprüfung früherer Untersuchungen vonKinosita wurden 83 Ratten bis zur Dauer von 2 Jahren mit Buttergelb gefüttert. Dabei entstand in 12 Fällen ein primärer Leberkrebs. Während aberKinosita Krebs immer schon zwischen dem 70. und 130. Fütterungstag erhielt, traten in unseren Versuchen die Krebse erst zwischen dem 360. und 600. Tag auf, und zwar nicht bei allen Tieren.Auch der Ablauf der Leberveränderungen, die dem Krebs vorausgehen, ist gegenüber den VersuchenKinositas ein anderer: Zunächst findet sich eine Kern-und Zellschädigung, die von Gangwucherungen in denGlissonschen Scheiden gefolgt ist. Diese nehmen immer mehr überhand, werden gelegentlich cystisch, während das ursprüngliche Lebergewebe mehr und mehr zugrunde geht. Dann entstehen hepatocelluläre Adenome und schließlich Krebs, als dessen Ausgangspunkt, nach seiner Bauart zu urteilen, die Leberzellen angesehen werden müssen (hepatocellulärer Krebs).Die Kostform (Semmel-oder Reisfütterung) oder das Lebensalter der Tiere hatten keinen entscheidenden Einfluß auf den Ablauf der Leberveränderungen.Schließlich wird auf die theoretische und praktische Bedeutung der Feststellung hingewiesen, daß die Schädigung des Zellkerns die erste gestaltlich faßbare Besonderheit in der Reihe der Veränderungen ist, die zum Krebs führen.Mit 9 Textabbildungen.Die Arbeiten wurden von der Deutschen Forschungsgemeinschaft wesentlich gefördert.     

Über ein Neues Oesophagoskop für den Gebrauch der Inneren Klinik

Ohne Zusammenfassung     

Zur Kenntnis der Paraffin- und Stearinfremdkörper in mÄnnlichen Blasen

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