Testing four diagnostic systems for schizophrenia

Four diagnostic systems for schizophrenia--New Haven, Feighner et al, Research Diagnostic Criteria, and DSM-III--were tested for reliability, comprehensiveness, concordance with established clinical use, specificity, and predictive validity. The sample consisted of 400 patients admitted to Chestnut Lodge, Rockville, Md, 330 of whom received long-term follow-up assessment by interview an average of 15 years after discharge. Diagnostic system criteria were applied retrospectively to abstracted medical records. Findings replicated recent studies on schizophrenia diagnosis and extended the generalizability of current nosologic systems to chronically ill patients. Results also indirectly supported the validity of applying these systems to medical records. This study demonstrated advantages and disadvantages of each system.     

In-111-labeled leukocyte scintigraphy in suspected orthopedic prosthesis infection: comparison with other imaging modalities

When infection of prosthetic orthopedic implants is suspected, optimal management requires accurate confirmation or exclusion of infection. The authors retrospectively studied 98 patients with possible infection who underwent scanning with indium-111-labeled white blood cells (WBCs) and subsequently underwent surgery within 14 days. At surgery, 50 patients had infections, as determined by means of culture or histologic results. The diagnostic accuracy of In-111 scanning was compared with that of plain radiography, arthrography, three-phase bone scanning, and various clinical and laboratory findings classically associated with infection. Positive findings on In-111 WBC scans and elevated erythrocyte sedimentation rates were found to be the most predictive variables in the diagnosis of septic prostheses (P less than or equal to .001 and P less than or equal to .002, respectively). Likelihood ratio analysis more clearly demonstrated the superiority of In-111 WBC scanning, with positive and negative scans yielding likelihood ratios of 5.0 and 0.16, respectively.     

A LIGHT AND ELECTRON MICROSCOPIC HISTOCHEMICAL STUDY ON THE MECHANISM OF DFP-INDUCED ACUTE AND SUBACUTE MYOPATHY

Tóth L., Karcsú S., Poberai M. & Sávay Gy. (1981) Neuropathology and Applied Neurobiology 7, 399–410
A light and electron microscopic histochemical study on the mechanism of DFP-induced acute and subacute myopathy
The histochemical changes occuring in association with the development of acute and subacute myopathy have been studied in the rat diaphragm 30 min-48 h after a single i.p. injection of 1–82 mg/kg of the irreversible cholinesterase inhibitor organophosphate, diisopropylfluorophosphate (DFP). In addition to a considerable inhibition of the AChE activity of the motor end-plates, accumulation of ionic Ca²⁺ and an increase in neutral protease activity in the subjunctional sarcoplasm have been demonstrated. A temporal and causal relationship has been established between the histochemical changes and the development of the ultrastructural signs of myopathy.     

A comparison of DSM-III and DSM-III-R schizophrenia

The authors compared DSM-III and DSM-III-R definitions of schizophrenia among 532 inpatients treated in a long-term residential setting and reevaluated an average of 15 years later. Largely by excluding those with nonbizarre delusions (somatic, grandiose, or religious) without hallucinations, DSM-III-R reduced the number of patients diagnosed with schizophrenia by 10%. With the exception of the sign and symptom variables used to define them, the DSM-III schizophrenic patients included (N = 164) and excluded (N = 18) by DSM-III-R did not differ with respect to demographic, premorbid, or long-term outcome characteristics. The authors argue that frequent changes in diagnostic schemes in the absence of evidence of improved validity are likely to impede progress in research.     

Treatment of Alcoholic Patients in a Psychiatric Hospital

This study was undertaken on 50 male patients chosen at random among the 188 who came in the last 6 months.     

Autoantibodies and immunoglobulin allotypes in healthy North American Blacks of different age groups

A population of 291 healthy North American Black subjects of different ages was studied for immunoglobulin (Ig) allotypes and the prevalence of autoantibodies, to determine possible associations between Ig allotypes and age, autoantibodies and age, and Ig allotypes and autoantibodies. Indirect immunofluorescence was used to detect anti-gastric parietal cell, anti-smooth muscle, anti-thyroid microsomal, anti-nuclear, and anti-mitochondrial antibodies. The sera were typed for the Ig allotypes Gm(1, 2, 3, 5, 6, 13, 14, 17, and 21) and Km(1) with a hemagglutination-inhibition assay. A significant association between advanced age and an increased prevalence of anti-nuclear antibodies was observed in females. There was no significant association between Ig allotypes and the autoantibodies tested. The results suggest that Ig allotypes are not involved in the development of autoantibodies in healthy Blacks.