Social disability in different mental disorders.

ObjectiveTo assess the social disability of people with different psychiatric disorders.MethodsCross-site survey in five psychiatric hospitals (Dresden, Wrocław, London, Michalovce and Prague). Working-aged patients diagnosed (ICD-10) with schizophrenia and related disorders (F2), affective disorders (F3), anxiety disorders (F4), eating disorders (F5) and personality disorders (F6), were assessed at admission (n = 969) and 3 months after discharge (n = 753) using the Brief Psychiatric Rating Scale and the Groningen Social Disability Schedule. The main outcome measure was Interviewer-rated social disability.ResultsDuring acute episodes patients with personality, eating and schizophrenic disorders functioned less effectively than those with affective or anxiety disorders. After controlling for age and severity of psychopathology, there was no significant effect of the diagnosis (during remission), sex, education and history of disorder on disability. Site, employment and partnership were significant factors for the level of social disability in both measure points.ConclusionSeverity of psychopathological symptoms, not the diagnosis of a mental disorder, was the most significant factor in determining the level of social functioning, particularly during the remission period. Site, employment and partnership appeared as significant factors influencing the level of social disability.     

Validation of analytical parameters of a competitive direct ELISA for aflatoxin B1 in peanuts

Analytical validation of a competitive direct SUNQuik ELISA with a reference High Performance Liquid Chromatography (HPLC) method and other methods including a minicolumn method and the VICAM Aflatest® system for aflatoxin in peanuts was conducted. Both the ELISA and the VICAM Aflatest® system, using the same peanut extracts were analytically comparable with the HPLC method (R=0.998, p<0.000). The minicolumn method was also found to be acceptable as a low cost rapid semi-quantitative test. Despite the large variation in sampling, the correlation between the SUNQuik ELISA and HPLC using the different peanut sub-samples was considered acceptable over the range of 0–1200 µg kg^?1 (R=0.938). No false negatives were found using the SUNQuik ELISA and false positives were either nil or negligible in all the studies conducted. The repeatability of the SUNQuik ELISA run on the same day was good with only±10% deviation. The reproducibility of the SUNQuik ELISA between days was also acceptable, but with a higher deviation. Applying the SUNQuik ELISA for aflatoxin surveys of peanuts in Indonesia proved that the method can deliver high quality, cost- and time-effective analysis with very little establishment capital and maintenance.     

Feeding preferences and attitudes to breastfeeding and its promotion among teenagers in Northern Ireland.

Northern Ireland has one of the lowest breastfeeding initiation rates in the world. Given that attitudes toward infant feeding are formed at an early age and a high rate of teenage pregnancy, it has become necessary to survey attitudes to infant feeding and breastfeeding promotion preferences in teenagers in Northern Ireland. Questionnaires were distributed to teenagers aged 14 to 18 years (n = 419) based in 7 schools selected by type and location throughout Northern Ireland. Attitudes to breastfeeding in public reflected preferred infant-feeding method and were positively influenced by prior exposure to breastfeeding (P = .024). Females were more positive than males both in relation to breastfeeding in public (P = .002) and breastfeeding promotion (P = .003). Recommendations for breastfeeding promotion include specific targeting of young people (both male and female) and enabling contact between teenagers and nursing mothers as much as possible.     

Salivary gland malignancy with divergent differentiation: is it a teratocarcinosarcoma?

Four poorly differentiated malignant lesions occurred in a 60-year-old Chinese male in the nasal cavity, submandibular gland, a lymph node in the neck, and the mandible. These malignant lesions developed within an 8-year period and each showed distinctive histological features. Among these malignant lesions, the neoplasm in the submandibular gland presented variegated histological and immunohistochemical (IHC) features and posed a diagnostic challenge in interpretation. Based on microscopic and IHC findings, we believe the diagnosis of teratocarcinosarcoma is justified for the submandibular neoplasm and the metastasis in the lymph node. The pathological features and diagnoses of these malignant lesions are discussed.     

Molecular modeling and metabolic studies of the interaction of catechol-O-methyltransferase and a new nitrocatechol inhibitor.

Catechol-O-methyltransferase (COMT, EC 2.1.1.6) plays a central role in the metabolic inactivation of neurotransmitters and neuroactive xenobiotics possessing a catechol motif. 1-(3,4-Dihydroxy-5-nitrophenyl)-2-phenyl-ethanone (BIA 3-202) is a novel nitrocatechol-type inhibitor of COMT, the potential clinical benefit of which is currently being evaluated in the treatment of Parkinson's disease. In the present work we characterize the molecular interactions of BIA 3-202 within the active site of COMT and discuss their implication on the regioselectivity of metabolic O-methylation. Unrestrained flexible-docking simulations suggest that the solution structure of this complex is better described as an ensemble of alternative binding modes, in contrast to the well defined bound configuration revealed by the X-ray structures of related nitrocatechol inhibitors, co-crystallized with COMT. The docking results wherein presented are well supported by experimental evidence, where the pattern of in vitro enzymatic O-methylation and O-demethylation reactions are analyzed. We propose a plausible explanation for the paradoxical in vivo regioselectivity of O-methylation of BIA 3-202, as well as of its related COMT inhibitor tolcapone. Both compounds undergo in vivo O-methylation by COMT at either meta or para catechol hydroxyl groups. However, results herein presented suggest that, in a subsequent step, the p-O-methyl derivatives are selectively demethylated by a microsomal enzyme system. The overall balance is the accumulation of the m-O-methylated metabolites over the para-regioisomers. The implications for the general recognition of nitrocatechol-type inhibitors by COMT and the regioselectivity of their metabolic O-methylation are discussed.     

Geriatric hypertension therapy: a guide to cost-effectiveness

The traditional, stepped-care approach to the treatment of hypertension has been challenged by the introduction of new and more expensive medications. Because hypertensive patients include those who can least afford high-priced medication, such prescribing patterns may result in noncompliance and, further, may cause patients to switch to physicians or managed-care systems more considerate of their economic needs. Physicians should therefore consider cost-effectiveness in treatment of hypertensive patients.     

Resource management in community residential facilities for adults with learning disabilities.

The trend towards community living for people with learning disabilities puts pressure on traditional hierarchical lines of resource management. A sample of 150 community residential facilities is surveyed in order to describe the systems used to manage resources in the community and to assess the impact they have on the quality of service provided. There are marked differences amongst provider agencies in the degree to which responsibility for resource management is devolved to facility managers and this has a direct effect on the quality of care. Residential homes which operate under centralised management systems are more institutional in their care practices and less responsive to individual clients' needs. In contrast, homes in which responsibility is delegated to the facility manager provide a service more in keeping with current philosophies of care. The results of this survey suggest that more responsibility for resource management can be delegated to facility managers without losing control of expenditure and with improvements in the efficiency and effectiveness of care.     

Closed neural tube defects: neurologic, orthopedic, and gait outcomes.

PURPOSE: The purpose of our study was to obtain a clear understanding of the various diagnoses within the closed neural tube defect (NTD) groups included in the large database of clients in our Spina Bifida Clinic and a clear picture of the outcomes for the various NTD groups. METHODS: One hundred and four clients with closed NTD were categorized using a classification system devised by Tortori-Donati et al. Various clinical markers were investigated, including ambulation and the need for orthoses and wheelchairs. RESULTS: Most clients are ambulatory, requiring an orthoses, but not a wheelchair, despite the high incidence of ankle/foot abnormalities. CONCLUSIONS: This classification system has enhanced our knowledge of this group of clients, provided a greater understanding of the varied outcomes of these children and clinical management required.