Coronary bypass graft patency cannot be determined by multidetector spiral computed tomography

Objectives. Angiography by selective catheterization is the reference standard for coronary bypass graft patency assessment but carries a risk of serious complications. We have investigated whether 16-slice multidetector spiral computed tomography (MDCT) can substitute for selective angiography. Design. Two to three years after coronary artery bypass grafting, 45 patients with a total of 156 bypasses (100 single and 28 sequential grafts) were examined with both MDCT and conventional selective angiography on the same day. The bypasses were classified as patent, stenotic or occluded. Results. The likelihood ratio for MDCT-detected occlusion was 40, reflecting a fairly high combined sensitivity and specificity. However, 24% of the distal anastomoses could not be evaluated by MDCT, mainly because of respiratory movements, artifacts due to metal clips, and small vessel dimensions. Moreover, seven out of 117 bypasses (6%) deemed evaluable by MDCT were wrongly classified by this method. Conclusions. At present, 16-slice MDCT cannot replace selective angiography for assessment of coronary bypass graft patency since 24% of bypasses could not be evaluated by this method, and an error rate of 6% is unacceptable.     

Temperament profiles in personality disorders among a young adult population

The objective of this study was to describe the temperament dimension profiles assessed by the Temperament and Character Inventory (TCI) among young adults with the DSM-III-R personality disorder (PD). Our hypothesis was that PD clusters and separate PDs can be distinguished from one another by their specific temperament profiles. As a part of the 31-year follow-up survey of the prospective Northern Finland 1966 Birth Cohort, the cohort members living in the city of Oulu at the age of 31 years (n=1609) were invited to participate in a two-phase field study. The Structured Clinical Interview for DSM-III-R for PDs (SCID–II) was used as diagnostic instrument. The final study sample consisted of the 1311 subjects who had completed the Hopkins Symptom Check List-25 questionnaire for screening and had given a written informed consent. Of the 321 SCID interviewed subjects, 74 met the criteria for at least one PD and had completed the TCI. The mean TCI scores of subjects with PD and control subjects without PD (n=910) were compared. Low Novelty Seeking, high Harm Avoidance and low Reward Dependence characterized cluster A and C PDs. Subjects with a cluster B PD did not differ from controls, except for Novelty Seeking, which was high. The temperament dimensions could not distinguish different PDs very well, with the only exception of persons with obsessive–compulsive PD. PD clusters were associated with different profiles of temperament, lending some support for Cloninger's typology.     

Group-based Cognitive Behavioural Therapy for Anxiety Disorder in Children with Autism Spectrum Disorder: a feasibility study

Abstract

Purpose: Autism spectrum disorder (ASD) includes core symptoms that affect general and social development. High risk of developing comorbid disorders such as anxiety is prominent. Up to 60% of children with ASD suffer from anxiety disorders which can negatively influence educational, social and general development together with quality of life. This study is the first to investigate the feasibility of the manualised cognitive behavioural therapy (CBT) group programme 'Cool Kids ASD' for anxiety adapted for children with ASD in a general hospital setting.

Methods: Nine children, aged 9–13 years, with ASD and anxiety recruited from a public child psychiatric health clinic were enrolled in the study. Outcome measures were collected from both child and parent pre- and post-treatment and at 3-month follow-up and included scores from a semi-structured anxiety interview, together with questionnaires on anxiety symptoms, life interference, children's automatic thoughts and satisfaction with the programme.

Results: Eight out of nine families found the programme useful and would recommend it to other families in a similar situation. Six families attended all 12 sessions in the programme, two missed one session and one family only managed to attend eight sessions. At follow-up, five children were free of all anxiety diagnoses and a further two out of the nine children no longer met the criteria for their primary anxiety diagnosis.

Conclusions: This study suggests that the transition of the group programme 'Cool Kids ASD' from University Clinics to standard child psychiatric clinical settings is feasible. Further randomised studies are needed to confirm the efficacy of the programme in a larger sample.     

Ionic conductivity enhancement in solid polymer electrolytes by electrochemical in situ formation of an interpenetrating network

Various overoxidized poly(1H-pyrrole) (PPy), poly(N-methylpyrrole) (PMePy) or poly(3,4-ethylenedioxythiophene) (PEDOT) membranes incorporated into an acrylate-based solid polymer electrolyte matrix (SPE) were directly electrosynthesized by a two-step in situ procedure. The aim was to extend and improve fundamental properties of pure SPE materials. The polymer matrix is based on the cross-linking of glycerol propoxylate (1PO/OH) triacrylate (GPTA) with poly(ethylene glycol) diacrylate (PEGDA) and lithium bis(trifluoromethanesulfonyl)imide (LiTFSI) as a conducting salt. A self-standing and flexible polymer electrolyte film is formed during the UV-induced photopolymerization of the acrylate precursors, followed by an electrochemical polymerization of the conducting polymers to form a 3D-IPN. The electrical conductivity of the conducting polymer is destroyed by electrochemical overoxidation in order to convert the conducting polymer into an ion-exchange membrane by introduction of electron-rich groups onto polymer units. The resulting polymer films were characterized by scanning electron microscopy, cyclic voltammetry, electrochemical impedance spectroscopy, differential scanning calorimetry, thermal analysis and infrared spectroscopy. The results of this study show that the combination of a polyacrylate-matrix with ion selective properties of overoxidized CPs leads to new 3D materials with higher ionic conductivity than SPEs and separator or selective ion-exchange membrane properties with good stability by facile fabrication.

Conductive polymers were encapsulated and subsequently overoxidized in an acrylate polymer matrix as potential separator materials via the combination of UV-induced and electrochemical polymerization.     

In‐season adaptations to intense intermittent training and sprint interval training in sub‐elite football players

This study investigated the in‐season effect of intensified training comparing the efficacy of duration‐matched intense intermittent exercise training with sprint interval training in increasing intermittent running performance, sprint ability, and muscle content of proteins related to ion handling and metabolism in football players. After the first two weeks in the season, 22 sub‐elite football players completed either 10 weeks of intense intermittent training using the 10‐20‐30 training concept (10‐20‐30, n = 12) or sprint interval training (SIT, n = 10; work/rest ratio: 6‐s/54‐s) three times weekly, with a ~20% reduction in weekly training time. Before and after the intervention, players performed a Yo‐Yo intermittent recovery test level 1 (Yo‐Yo IR1) and a 30‐m sprint test. Furthermore, players had a muscle biopsy taken from the vastus lateralis. Yo‐Yo IR1 performance increased by 330 m (95%CI: 178‐482, P ≤ 0.01) in 10‐20‐30, whereas no change was observed in SIT. Sprint time did not change in 10‐20‐30 but decreased by 0.04 second (95%CI: 0.00‐0.09, P ≤ 0.05) in SIT. Muscle content of HADHA (24%, P ≤ 0.01), PDH‐E1α (40%, P ≤ 0.01), complex I‐V of the electron transport chain (ETC) (51%, P ≤ 0.01) and Na⁺, K⁺‐ATPase subunits α₂ (33%, P ≤ 0.05) and β₁ (27%, P ≤ 0.05) increased in 10‐20‐30, whereas content of DHPR (27%, P ≤ 0.01) and complex I‐V of the ETC (31%, P ≤ 0.05) increased in SIT. Intense intermittent training, combining short sprints and a high aerobic load, is superior to regular sprint interval training in increasing intense intermittent running performance during a Yo‐Yo IR1 test and muscle content of PDH‐E1α and HADHA in sub‐elite football players.     

Negotiating the social and medical dangers of abortion in Addis Ababa: An exploration of young,unmarried women's abortion-seeking journeys

Unmarried, young women constitute a significant proportion of women who undergo unsafe abortion in Ethiopia. Based on material from an ethnographic study, the experiences of young, unmarried women who had been admitted to the hospital in the aftermath of an unsafe, clandestine abortion are explored in this article. The routes the young women followed in their search of abortion services and the concerns and realities they had to negotiate and navigate are at the fore. Despite their awareness of the dangers involved in clandestine and illegal abortion, the young women felt they had no choice but to use medically unsafe abortion services. Two reasons for this are highlighted: such services were affordable and, significantly, they were considered socially safe in that the abortion remained unknown to others and the stigma of abortion and its consequences could hence be avoided. In situations in which choices had to be made, social safety trumped medical safety. This indicates a need for abortion services that address both the medical and social safety concerns of young women in need of such services.     

Activation of phosphoinositide 3-kinase delta by antipsychotic drugs: Preliminary results

Background

Catalytic subunit delta of phosphoinositide 3-kinase, p110δ, encoded by the PIK3CD gene, was recently proposed as a target for pharmacological treatment of schizophrenia. Current antipsychotic drugs were found to decrease the mRNA expression of PIK3CD, but the mechanism of this process is not known. The aim of the study was to elucidate the mechanism by which antipsychotic drugs affect the mRNA expression of PIK3CD.