A latent class analysis of DSM-IV criteria for pathological gambling: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

With rapid increases in gambling opportunities over the past decade, gambling has emerged as an important social and public health concern. The pending revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM) has prompted a flurry of empirical research evaluating the extant diagnostic classification scheme; however few studies have evaluated the pathological gambling criteria. This paper utilized latent class analysis (LCA) to empirically derive and validate a typology of gamblers. LCA was applied to the 10 DSM-IV pathological gambling criteria utilizing data from the 2001-2002 National Epidemiologic Survey on Alcohol and Related Conditions (n=11,104). LCA identified three latent classes which largely differed according to severity. The majority of respondents were assigned to the no gambling problems class (93.3%). Gamblers in the moderate gambling problems class (6.1%) primarily endorsed the preoccupation, tolerance, and chasing criteria. The pervasive gambling problems class (0.6%) endorsed the majority of the criteria. A number of significant differences between the classes emerged as a function of demographic, psychiatric and substance use disorders. The findings offer a heuristic and clinically useful typology of gamblers. Support for a continuum of gambling-related problems reiterate the need for assessment, prevention, and treatment strategies that reflect this more nuanced understanding of gambling.     

Inhibition of murine γδ lymphocyte expansion and effector function by regulatory αβ T cells is cell‐contact‐dependent and sensitive to GITR modulation

γδ T cells are highly cytolytic lymphocytes that produce large amounts of pro‐inflammatory cytokines during immune responses to multiple pathogens. Furthermore, their ability to kill tumor cells has fueled the development of γδ‐T‐cell‐based cancer therapies. Thus, the regulation of γδ‐T‐cell activity is of great biological and clinical relevance. Here, we show that murine CD4⁺CD25⁺ αβ T cells, the vast majority of which express the Treg marker, Foxp3, abolish key effector functions of γδ T cells, namely the production of the pro‐inflammatory cytokines, IFN‐γ and IL‐17, cytotoxicity, and lymphocyte proliferation in vitro and in vivo. We further show that suppression is dependent on cellular contact between Treg and γδ T cells, results in the induction of an anergic state in γδ lymphocytes, and can be partially reversed by manipulating glucocorticoid‐induced TNF receptor‐related protein (GITR) signals. Our data collectively dissect a novel mechanism by which the expansion and pro‐inflammatory functions of γδ T cells are regulated.     

Do medulloblastoma tumors meet the food and drug administration criteria for anti‐erbB2 therapy with trastuzumab?

Several publications have recently focused on the erbB2 receptor in pediatric medulloblastomas (MBs) and its prognostic consequence. We determined erbB2 expression in 23 MBs at diagnosis. After DNA extraction, quantitative PCR targeting the erbB2 gene was performed and correlated with FISH analysis and immunohistochemistry. The samples were representative of the spectrum of the disease apart from the absence of large cell MBs. Using the tools validated for breast cancers by the FDA, we did not observe any expression or amplification of erbB2 and hence we speculate that MBs are not a good target for treatment with anti-erbB2 antibodies.     

Coinfections of Rickettsia slovaca and Rickettsia helvetica with Borrelia lusitaniae in ticks collected in a Safari Park,Portugal

Borrelia and Rickettsia bacteria are the most important tick-borne agents causing disease in Portugal. Identification and characterization of these circulating agents, mainly in recreational areas, is crucial for the development of preventive measures in response to the gradually increasing exposure of humans to tick vectors. A total of 677 questing ticks including Dermacentor marginatus, Rhipicephalus sanguineus, Ixodes ricinus, Hyalomma lusitanicum, H. marginatum, and Haemaphysalis punctata were collected in a Safari Park in Alentejo, Portugal, to investigate the prevalences of infection and characterize Borrelia and Rickettsia species. From a total of 371 ticks tested by PCR for Borrelia burgdorferi sensu lato (s.l.), of which 247 were tested for Rickettsia, an infection prevalence of 18.3% was found for B. lusitaniae and 55.1% for Rickettsia spp. Sequence analysis of positive amplicons identified the presence of B. lusitaniae (18.3%), R. monacensis strain IRS3 (51.7%), and R. helvetica (48.3%) in I. ricinus. R. slovaca (41.5%), R. raoultii (58.5%), and also B. lusitaniae (21%) were identified in D. marginatus ticks. One (5.9%) H. lusitanicum was infected with B. lusitaniae, and R. massiliae was found in one Rhipicephalus sanguineus. Coinfection was found in 7 (20%) I. ricinus and 34 (23.3%) D. marginatus ticks. We report, for the first time, simultaneous infection with R. helvetica and B. lusitaniae and also R. slovaca, the agent of TIBOLA/DEBONEL, with B. lusitaniae. Additionally, 6 isolates of B. lusitaniae were established, and isolates of Rickettsia were also obtained for the detected species using tick macerates cultured in mammalian and mosquito cell lines. This report describes the detection and isolation of tick-borne agents from a Portuguese Safari Park, highlighting the increased likelihood of infection with multiple agents to potential visitors or staff.     

Renal function and histology in children after small bowel transplantation

Boyer O, Noto C, Patey‐Mariaud De Serre N, Gubler M‐C, Dechaux M, Goulet O, Niaudet P, Lacaille F. Renal function and histology in children after small bowel transplantation. Abstract: CKD is a frequent long‐term complication after SBTx. CNIs are a well‐known factor, but probably not the only cause. We assessed the incidence, risk factors, and severity of CKD in 27 children with SBTx (15 combined liver/SBTx) and prednisone/TAC‐based maintenance immunosuppression. Median follow‐up was seven yr (3–21). A renal biopsy was performed in 14 patients, 1–18 yr post‐SBTx. A reduced GFR was observed in 17 children (63%) during the follow‐up with none requiring dialysis. CNI toxicity was observed in 11/14 biopsies, as early as two yr post‐transplant, and could occur with a normal mGFR. The dose of TAC was reduced by 50% in 13 patients with CKD and/or significant kidney histological lesions, and six were also given MMF. This led to a significant improvement in renal function: mGFR normalized in eight patients and improved or stabilized in five. No rejection occurred. At last follow‐up, 37% had CKD stage 2 and 15% had CKD stage 3. In conclusion, CKD is frequent in children after SBTx and probably multifactorial. Less nephrotoxic immunosuppressive protocols may improve mGFR and should be further considered. The kidney histology helps in designing personalized immunosuppression strategies for patients.     

Soft tissue myoepithelioma of the scalp in a 11-year-old girl: a challenging diagnosis

Myoepithelioma is a well-known tumor in the salivary glands and breasts in adults. It is exceptionally rare in soft tissue and in children. We present a case of subcutaneous scalp myoepithelioma in an 11-year-old girl. On clinical examination, it appeared as a dermoid cyst. Myoepithelioma is uncommon in the subcutaneous tissue. Clinically, the neoplasm is nonspecific. Because of the variable appearance of myoepithelial cells and their phenotype, the pathological diagnosis is challenging. We report a case of subcutaneous myoepithelioma in a child and discuss the literature.