Quality of Depression among Suicidal Inpatient Youth

This study examined the relationship between suicidality and dependent and self-critical depression among adolescents. Ninety-six adolescents participated: 32 suicidal inpatients, 32 nonsuicidal inpatients and 32 healthy controls. The groups were matched for gender, age and education. Participants completed the Depressive Experience Questionnaire for Adolescents (DEQ-A), the Cognition Checklist (CCL), and the Multi-Attitude Suicidal Tendencies Scale (MAST). Results indicated that suicidal adolescents have significantly higher levels of self-critical and dependent depression, compared to nonsuicidal inpatients and healthy controls. The distinctive quality of depression among suicidal adolescents suggests assessment and treatment strategies for these individuals.     

Low-level visible light (LLVL) irradiation promotes proliferation of mesenchymal stem cells

Low-level visible light irradiation was found to stimulate proliferation potential of various types of cells in vitro. Stem cells in general are of significance for implantation in regenerative medicine. The aim of the present study was to investigate the effect of low-level light irradiation on the proliferation of mesenchymal stem cells (MSCs). MSCs were isolated from the bone marrow, and light irradiation was applied at energy densities of 2.4, 4.8, and 7.2 J/cm². Illumination of the MSCs resulted in almost twofold increase in cell number as compared to controls. Elevated reactive oxygen species and nitric oxide production was also observed in MSCs cultures following illumination with broadband visible light. The present study clearly demonstrates the ability of broadband visible light illumination to promote proliferation of MSCs in vitro. These results may have an important impact on wound healing.     

Long waiting period to enter methadone maintenance treatment: relation to patient characteristics and outcome

Methadone maintenance treatment is a chronic treatment for opiate addicts. After having reached full capacity, new admissions to our clinic were delayed (through a waiting list) for all but opiate addicts with HIV and pregnant women. We compared characteristics and outcomes between patients admitted without delay (1993-2002) and those admitted through a waiting list (2003-2009). All 704 patients admitted between June 1993 and June 2009 were followed up until June 2010. There were 470 patients in the early period and 234 in the late period (56 patients were admitted immediately and 178 after 1.1 ± 0.8 years of waiting). Predictors for 1-year retention in treatment (logistic regression model) were if a patient self-referred during the late period, on a waiting list. The waiting list patient group was characterized by older age and self-referral - two known independent predictors of better retention that were attributed to their superior retention rate.     

Secondary splitting of a free deep inferior epigastric perforator flap with pedicled transfer to the contralateral breast for staged reconstruction of two breasts: The split diep flap

Free tissue transfer has become popularized for post‐mastectomy autologous breast reconstruction, particularly with the abdominal wall donor site. However, in the setting of previous autologous breast reconstruction, options for later contralateral reconstruction are limited. We present a case of breast reconstruction with a free deep inferior epigastric artery perforator (DIEP) flap, which was split from the initially reconstructed breast and shared to reconstruct the opposite breast after the occurrence of a metachronous contralateral second primary breast cancer. There were no operative complications, no flap‐related complications, and at two years follow‐up, the patient subjectively described bilateral soft and supple breasts, which were symmetrical in a bra, and with which she has reported high satisfaction. An account of the “split DIEP flap” is provided, highlighting the planning, technique, and vascular rationale. The technique comprises partition of a previously transferred DIEP flap breast reconstruction into two parts based on preoperative computed tomographic angiography, performed to guide surgical planning in avoiding pedicle damage and identifying the portion of the flap to island. The split DIEP flap for staged bilateral autologous breast reconstruction offers two soft‐tissue flaps for the price of one donor site, offering new possibilities in breast reconstruction and the broader field of tissue transplantation. © 2013 Wiley Periodicals, Inc. Microsurgery, 2013.     

Biometric parameters of the hand as an index of schizophrenia—A preliminary study

Since abnormalities in distal upper limb development are among the minor physical anomalies associated with schizophrenia we attempted to determine whether patients with schizophrenia can be identified on the basis of specific morphologic and dermatoglyphic features of the hand. Photographs and prints of the hands of 38 patients with schizophrenia and those of 42 control subjects were evaluated and graded on 13 biometric parameters. Results were statistically evaluated. A combination of three of the parameters was found to have good predicting abilities to distinguish between schizophrenics and controls. Subjects having high values in these three parameters were found to have a higher propensity to be defined as schizophrenics. In order to define a simple rule for classifying subjects we chose a criterion of having a value of 3 (in a scale from 1 to 3) in at least one of these three discriminating variables. This rule yielded an overall accuracy of 81.2%. Among controls, 85.7% of subjects did not fulfill such criteria, while 14.3% were defined as false positives. Among schizophrenics 76.3% achieved this condition while 23.7% were false negatives. The technique's objectivity and ease of application could facilitate the diagnosis of this disease.     

The role of neuroimaging in the evaluation process of children with isolated sixth nerve palsy

Purpose

The purpose of this study was to assess the role of neuroimaging in identifying the etiology of pediatric isolated sixth nerve palsy (SNP).

Methods

A retrospective cohort study was conducted of all patients younger than 18 years of age with an isolated SNP seen at our medical center between 2003 and 2011.

Results

Sixteen children (nine girls; mean age, 4.5 years) with isolated SNP were identified during an 8-year period. Only cases with normal optic disk appearance and otherwise normal neurological examination were included into this study. Thus, 12 other children with SNP were excluded: ten children with papilledema, one child who developed a SNP following a resection of a brain tumor, and one with hydrocephalus and a shunt malfunction. All cases of isolated SNP were unilateral (ten left eyes). The most common cause for the SNP in these children was a tumor that was found in five patients. Other etiologies encountered in decreasing frequencies were: benign recurrent SNP (in four children), postviral or vaccination (in three children), and one case each of post trauma, Chiari malformation, congenital, and undetermined. Children who were found to have a tumor (9.9?±?5.5 years) were significantly older (P?=?0.019) than children who did not have a tumor (2.1?±?1.8 years).

Conclusions

Isolated SNP can be the presentation of a brain tumor in children, and therefore, early neuroimaging of the brain is recommended, especially in older children.     

Fall risk and gait in Parkinson's disease: The role of the LRRK2 G2019S mutation

Patients with Parkinson's disease (PD) who carry the G2019S mutation (a glycine to serine substitution at amino acid 2019) in the leucine‐rich repeat kinase 2 (LRRK2) gene are generally believed to be clinically indistinguishable from patients with sporadic PD. There are, however, conflicting reports on the relationship between the mutation and the motor phenotype. We quantitatively compared gait and mobility in patients with PD carriers of the G2019S mutation to non‐carrier patients with PD to better understand the genotype‐phenotype relationship. Fifty patients with PD carriers of the G2019S LRRK2 mutation and 50 age, disease duration, and disease severity matched PD non‐carriers were studied. An accelerometer quantified gait under three walking conditions: usual‐walking, dual‐tasking, and fast‐walking. The Unified Parkinson's Disease Rating Scale classified patients into PD sub‐types and the Timed Up and Go quantified mobility and fall risk. In all three walking conditions, gait variability was larger and the walking pattern was less consistent among the PD mutation carriers (P < 0.016). The PD carriers also took longer to complete the Timed Up and Go (P = 0.011) and were more likely to report having fallen in the previous year (P = 0.018). 64% of the PD carriers were classified as belonging to the postural‐instability‐gait‐difficulty (PIGD) sub‐type compared to only 17% of the PD non‐carriers (P < 0.0001). Among patients with PD, the G2019S mutation in the LRRK2 gene is apparently associated with increased gait variability, an increased fall risk, and the PIGD sub‐type. Therapeutic approach specifically designed to delay gait disturbances and falls may be justified in patients who carry the G2019S mutation. © 2013 International Parkinson and Movement Disorder Society     

Educational lectures enhance knowledge about the human immunodeficiency virus (HIV) and reduce risky behavior and fear among methadone maintenance treatment patients

Abstract

Background: The aim of this study was to characterize human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS)-related knowledge and stigma among methadone maintenance treatment (MMT) patients and evaluate the contribution of an educational lecture in reducing risky behavior and unjustified overprotective behavior due to fear and stigma among MMT patients. Methods: Patients from an MMT clinic within a tertiary medical center were invited to an educational lecture on HIV/AIDS. Seventy participants (of current 330) were chosen by a random sample (December 2015), plus at-risk patients and HIV patients. Attendee compliance and change in scores of questionnaires on knowledge (modified HIV-K-Q-22) and on sexual and injection behaviors were studied. Results: Forty-six patients (65.7% compliance) attended the lecture, and their knowledge and behavior scores improved 2?weeks post-lecture (knowledge: from 14.2?±?3 to 19.0?±?2.2 [P?<?.0005], sexual behavior: from 12.1?±?2.9 to 8.8?±?3.0 [P?<?.0005], and injection behavior: from 7.3?±?6.2 to 0.2?±?1.3 [P?<?.0005]). The unjustified fear of proximity to HIV carriers reported by 50% attendees fell to 35% post-lecture. Eight months post-lecture, the scores on knowledge and risky behavior of 21 randomly chosen attendees were still better than pre-lecture scores (knowledge: 15.4?±?2.3 vs. 17.2?±?1.8 [paired t test, P?=?.001], sexual behavior: 13.2?±?2.3 vs. 9.7?±?2.9 [P?<?.0005], and injection behavior: 9.3?±?5.6 vs. 2.8?±?3.1 [P?<?.0005]). Drug abuse and treatment adherence were not related to intervention and to risky behavior. Conclusions: More knowledge, less fear, and less risky behavior immediately and at 8?months post-lecture reflect the success and importance of the educational intervention. Future efforts are needed in order to reduce ignorance and fear associated with HIV/AIDS.