Platelet-derived growth factor (PDGF) BB acts as achemoattractant for human malignant mesotheliomacells via PDGF receptor b - integrin a3b1 interaction

Platelet-derived growth factor BB (PDGF BB) and the PDGF receptor b are expressed on mesotheliomacells, but their biological function has not yet been defined. In the present study we used Boyden chambersfitted with filters coated with the adhesive matrix proteins fibronectin, laminin, collagen type IV or the non-matrixadhesive molecule poly-L-lysine (PLL). Mesothelioma cells migrated towards PDGF BB at concen-trationsranging from 0.78 to 12.5 ng/ml if matrix proteins were present as adhesive substrates. This migrationwas integrin dependent since the same cells failed to migrate if the adhesive interactions necessary for migra-tionwere provided by molecules other than integrins. Migration of mesothelioma cells on fibronectin, lamininor collagen-type IV in response to PDGF BB was inhibited if the cells were pretreated with blocking anti-bodiesto a3b1 integrin. These findings describe for the first time PDGF BB as a chemoattractant for malig-nantmesothelioma cells and that collaboration between PDGF receptor b and integrin a3b1 is necessaryfor the motile response of these cells to PDGF BB.©Kluwer Academic Publishers     

Strength of Different Krackow Stitch Configurations Using High-strength Suture

The purpose of the present study concerning high-strength sutures was to determine whether increasing the number of locking loops with different size sutures or decreasing the suture size with increased suture strands would have any influence on the strength of Achilles tendon repair. A total of 32 fresh bovine Achilles tendon specimens were randomly assigned to 4 groups. For 3 of the groups, 1 suture was used (no. 2 or no. 5 FiberWire? with 2 or 4 Krackow locking loops). For the fourth group, 2 sutures (2-0 FiberWire?) with 2 locking loops were used. After repair, the study groups underwent cyclic loading (0 to 200 N, 200 cycles) and then underwent tension to failure in a testing machine. Cyclic elongation, peak to peak displacement, ultimate load, stiffness, and failure mode were recorded for each specimen. The tendon width and thickness were measured in all specimens. The mean width, thickness, cyclic displacement, load to failure, and pull-out stiffness showed no differences among the 4 groups. The cyclic peak to peak displacements (0.01 ± 0.01 mm) were smallest with the no. 5 suture with 4 locking loops (p < .05), with no failure during cyclic loading, unlike in the other groups. In the group with 2-0 suture with 4 strands and 2 locking loops, 6 failed during cyclic loading. The number of locking loops used might have had an influence on the strength of the Krackow suture configuration using the larger diameter, high-strength sutures. However, decreasing the suture diameter, with a simultaneous increase in the number of strands, failed to improve the initial strength of the repair.     

Enthesopathy in patients with familial Mediterranean fever: increased prevalence in M694 V variant

Enthesopathy is pathology of bony insertions of tendons, ligaments or joint capsules. It is a frequent finding in rheumatic diseases, like ankylosing spondylitis (AS) and Behçet’s disease. Musculoskeletal complaints are common in patients with familial Mediterranean fever (FMF), and these could be a clinical manifestation of enthesopathy. Hence, we investigated the possible association between FMF and enthesopathy. Fifty-six patients with FMF and 11 patients with FMF-associated spondyloarthropathy (FMFS) were enrolled. Forty-seven healthy individuals and 36 patients with AS formed the healthy and diseased control groups. Musculoskeletal complaints were meticulously questioned, and all patients underwent a detailed physical and ultrasonographic (US) examination of the lower limbs. US scorings of enthesopathy was performed according to the Glasgow Ultrasound Enthesitis Scoring System (GUESS). Demographic data, disease characteristics, MEFV genotypes and HLA B27 results were retrieved from the medical records. Patient-reported pain and physical examination findings consistent with enthesopathy were frequent in all groups with the highest prevalence in the FMFS group. Heel was the most common region affected in all patient groups. FMF patients harboring M694 V variant had higher GUESS scores compared to patients with other variants (2.78 ± 2.43 vs. 1.37 ± 1.67, p = 0.026). There was no statistically significant difference in the mean ± SD GUESS scores between healthy subjects and those FMF patients with genetic variants other than M694 V (1.38 ± 1.42 vs. 1.37 ± 1.67, p > 0.05). Enthesopathy may not be a feature of general FMF population; rather, it might be specifically associated with the presence of M694 V variant. Our results further support the previous evidence regarding M694 V mutation and spondyloarthropathy association.     

Beliefs about Causes of Schizophrenia among Police Officers Before and After Crisis Intervention Team Training

This study examined the ways in which beliefs about the causes of schizophrenia change after crisis intervention team (CIT) training of police officers. Comparisons of pre- and post-training scores from 159 officers revealed a decrease in endorsement of items pertaining to personal/family/social stressors and items inconsistent with contemporary conceptions of risk, as well as an increase in endorsement of items consistent with modern biological conceptions of the causation of schizophrenia. Changes in causal beliefs were associated with personal and family history of psychiatric treatment among officers. Findings indicate a need for further research in this area, and suggest that some characteristics of officers may be associated with an increased capacity for knowledge/attitudinal change during CIT training.     

Use of Force Preferences and Perceived Effectiveness of Actions Among Crisis Intervention Team (CIT) Police Officers and Non-CIT Officers in an Escalating Psychiatric Crisis Involving a Subject With Schizophrenia

Background: Few studies have examined police officers’ use of force toward individuals with schizophrenia, despite the widely disseminated Crisis Intervention Team (CIT) model of partnership between mental health and law enforcement that seeks to reduce use of force and enhance safety of officers and individuals with mental illnesses. This study tested the hypotheses that CIT-trained officers would select a lower level of force, identify nonphysical actions as more effective, and perceive physical force as less effective in an escalating psychiatric crisis, compared with non–CIT-trained officers. Methods: Police officers (n = 135)—48 CIT trained and 87 non–CIT trained—completed a survey containing 3 scenario-based vignettes depicting an escalating situation involving a subject with psychosis. Data were analyzed using repeated-measures analyses of variance. Results: Officers escalated their preferred actions across the scenarios. A significant scenario by group interaction indicated that CIT-trained officers chose less escalation (ie, opting for less force at the third scenario) than non–CIT-trained officers. Officers reported decreasing perceived effectiveness of nonphysical action across the 3 scenarios. A significant scenario by group interaction indicated that CIT-trained officers reported a lesser decline in perceived effectiveness of nonphysical actions at the third scenario. CIT-trained officers consistently endorsed lower perceived effectiveness of physical force. Conclusions: Efforts are needed to reduce use of force toward individuals with psychotic disorders. These findings suggest that CIT may be an effective approach. In addition to clinical and programmatic implications, such findings demonstrate a role for clinicians, advocates, and schizophrenia researchers in promoting social justice through partnerships with diverse social sectors.     

Characteristics of Patients Referred to Psychiatric Emergency Services by Crisis Intervention Team Police Officers

The Crisis Intervention Team (CIT) program trains police officers in crisis intervention skills and local psychiatric resources. Because the safety and appropriateness of any new intervention is a crucial consideration, it is necessary to ensure that CIT training does not result in excessive or inappropriate referrals to psychiatric emergency services (PES). Yet, aside from one prior report by Strauss et al. (2005) in Louisville, Kentucky, little is known about the comparability of patients referred to PES by CIT-trained officers in relation to other modes of referral. The research questions driving this retrospective chart review of patients referred to PES were: (1) What types of patients do CIT-trained officers refer to PES?, and (2) Do meaningful differences exist between patients referred by family members, non-CIT officers, and CIT-trained officers? Select sociodemographic and clinical variables were abstracted from the medical records of 300 patients during an eight-month period and compared by mode of referral. Differences across the three groups were found regarding: race, whether or not the patient was held on the locked observation unit, severe agitation, recent substance abuse, global functioning, and unkempt or bizarre appearance. However, there were virtually no differences between patients referred by CIT-trained and non-CIT officers. Thus, while there were some expected differences between patients referred by law enforcement and those referred by family members, CIT-trained officers appear to refer individuals appropriately to PES, as evidenced by such patients differing little from those referred by traditional, non-CIT police officers. Trained officers do not have a narrower view of people in need of emergency services (i.e., bringing in more severely ill individuals), and they do not have a broader view (i.e., bringing in those not in need of emergency services). Although CIT training does not appear to affect the type of individuals referred to PES, future research should examine the effect of CIT training on the frequency of referrals or proportion of subjects encountered that are referred, which may be expected to differ between CIT-trained and non-CIT officers.