Orofacial dyskinesia, frontal lobe dysfunction, and coping in older people with psychosis.

OBJECTIVE: To investigate whether orofacial tardive dyskinesia (OTD) is associated with frontal lobe dysfunction and whether either are related to the coping abilities independent of psychiatric symptoms in older people with psychotic disorders. METHODS: A total of 52 patients, aged over 65 years or over, who satisfied International Classification of Diseases, Tenth Revision criteria for psychotic disorders (F20-F29) were recruited into the study. OTD was measured using the Abnormal Involuntary Movements Scale and Waddington et al.'s (1993) criteria. Neuropsychological measures were specifically selected to assess different aspects of frontal function and coping was measured using a semistructured interview. Psychiatric symptoms were assessed using the Positive and Negative Syndrome Scale (PANSS). RESULTS: Patients with OTD showed more severe global cognitive impairment compared to patients without OTD. Group differences on measures of frontal lobe dysfunction were not maintained following adjustment for global cognitive impairment. Patients with OTD did not differ from patients without OTD on coping measures. Scores on the general psychopathology subscale of the PANSS, which includes symptoms associated with depression and anxiety, consistently predicted patients' negative perceptions of stressors and appraisals of coping, but cognitive impairment did not predict coping independent of symptoms. CONCLUSION: The association between coping and general psychopathology in older patients with psychosis warrants further investigation as both variables may be amenable to psychological interventions.     

Clinical Concept-Based Radiology Reports Classification Pipeline for Lung Carcinoma

Rising incidence and mortality of cancer have led to an incremental amount of research in the field. To learn from preexisting data, it has become important to capture maximum information related to disease type, stage, treatment, and outcomes. Medical imaging reports are rich in this kind of information but are only present as free text. The extraction of information from such unstructured text reports is labor-intensive. The use of Natural Language Processing (NLP) tools to extract information from radiology reports can make it less time-consuming as well as more effective. In this study, we have developed and compared different models for the classification of lung carcinoma reports using clinical concepts. This study was approved by the institutional ethics committee as a retrospective study with a waiver of informed consent. A clinical concept-based classification pipeline for lung carcinoma radiology reports was developed using rule-based as well as machine learning models and compared. The machine learning models used were XGBoost and two more deep learning model architectures with bidirectional long short-term neural networks. A corpus consisting of 1700 radiology reports including computed tomography (CT) and positron emission tomography/computed tomography (PET/CT) reports were used for development and testing. Five hundred one radiology reports from MIMIC-III Clinical Database version 1.4 was used for external validation. The pipeline achieved an overall F1 score of 0.94 on the internal set and 0.74 on external validation with the rule-based algorithm using expert input giving the best performance. Among the machine learning models, the Bi-LSTM_dropout model performed better than the ML model using XGBoost and the Bi-LSTM_simple model on internal set, whereas on external validation, the Bi-LSTM_simple model performed relatively better than other 2. This pipeline can be used for clinical concept-based classification of radiology reports related to lung carcinoma from a huge corpus and also for automated annotation of these reports.

     

Bioequivalence evaluation of two marketed brands of stavudine 40 mg capsules in healthy human South African volunteers.

Stavudine (d4T), a thymidine nucleoside analogue has been effectively used for treatment of patients infected with HIV. A randomized, two-way, crossover study was conducted in 24 fasting, healthy, Caucasian male volunteers to compare plasma pharmacokinetic (PK) profile and single-dose tolerability of a new d4T formulation (Stavir, Cipla Ltd, India; 40 mg capsule, test, T) with that of reference (R) formulation (Zerit), Bristol-Myers Squib, NJ, USA; capsule, 40 mg). Each volunteer received T and R formulation separated by at least 10 days of drug free wash-out period. Plasma concentrations of d4T, determined upto 24h post-dose by a validated LC-MS/MS assay were utilized to assess PK parameters such as maximum observed plasma concentration (Cmax), time to Cmax (tmax), and area under plasma concentration curve (AUC(infinity)). The primary plasma PK parameters, Cmax, and AUC(infinity), of anti-retroviral were comparable for either of the formulations. tmax was achieved within an hour suggesting rapid absorption of d4T from both formulations. Geometric mean ratios (GMR) (percentage reference) of AUC(infinity) and Cmax, and their 90% confidence intervals (CI) were 106.32 [102.52-110.26] and 102.32 [90.25-116.00], respectively. As the 90% CI of GMR were entirely within 80-125% for log-transformed parameters, two formulations were considered bioequivalent, in the extent and rate of absorption. Both formulations exhibited similar tolerability under fasting conditions.     

Immunohistochemical localization of FSH and LH in rat pituitary

Antisera to ovine FSH, LH and their β-subunits were used to localize the cell types producing these hormones in the rat pituitary. With a single section dual immunoperoxidase staining technique, two separate cell types were observed for FSH and LH. 10% of the immunohistochemically identified gonadotropic cells were found to stain for FSH. The results obtained with anti-LH and anti-FSH correspond well with those obtained with anti-β-LH and anti-β-FSH. Two separate cell types could be demonstrated for β-LH and β-TSH, although these two hormones partially cross-reacted with each other.     

Correction to: Epilepsy related multimorbidity,polypharmacy and risks in adults with intellectual disabilities: a national study

Journal of Neurology -     

The effect of anticholinesterases on personality changes in Alzheimer's disease

Anticholinesterases are known to be effective against cognitive and non-cognitive symptoms of Alzheimer's disease (AD) but their effect on the personality changes in the disease is not known. This study examines the effect of anticholinesterase treatment on personality changes in AD. It involved the carers of patients with mild to moderate AD who were currently receiving anticholinesterases in south Manchester. The personality change was measured using the Brooks and McKinlay Personality Inventory. The carers were asked to complete the inventory for each of three periods in the patients' lives: before the onset of AD, after the diagnosis of AD but before starting anticholinesterases, and currently on anticholinesterases. Fifty-eight carers participated in the study. Personality became more negative (total score on the personality inventory became less) following the onset of AD (p < 0.001). Following anticholinesterase treatment, the total score on the personality inventory remained the same or increased in 23 (39%) patients. Scores on individual personality traits remained the same or increased in the majority of patients. In approximately one fifth of the patients, the traits 'does things himself', 'happy', 'calm' and 'cautious' showed improvement on anticholinesterases. The study confirms that personality changes are almost universal and negative in AD and suggests that anticholinesterases may have a positive effect. Further double blind prospective studies are needed to understand natural progression of personality changes in AD and to validate the findings of this study.