Outcome and clinical course in inpatient bulimic women: a 2- to 9-year follow-up study

BACKGROUND: One previous follow-up study suggested that inpatient bulimic women do quite poorly; after an interval of 2 to 5 years, only 13% were recovered. To examine the course and outcome of a sample of patients with bulimia nervosa that was severe enough to require inpatient hospitalization, the authors conducted the following study. METHOD: Women (N = 52) with DSM-III-R bulimia nervosa were sought 2 to 9 years after hospitalization. Prior to contact, a retrospective chart review was conducted to determine global functioning and admission diagnoses. At follow-up, patients participated in a 4 to 6 hour interview that assessed current and lifetime Axis I disorders (SCID-I), current Axis II disorders (PDE), eating behaviors (EAT, BSQ, EDI, PSR), global functioning (GAF), social adjustment (SAS-SR), and treatment and medical problems experienced since discharge. To assess the significance of differences between the recovered and the currently bulimic women, Yates-corrected chi-square tests and two-tailed t tests were used. RESULTS: Of the 52 women, 46 were interviewed, 1 had died, and 5 could not be located. Of the 46 interviewed women, 39% had fully recovered, 20% had partially recovered, and 41% were currently bulimic. The likelihood of recovery increased with length of time since discharge. While medical problems related to the bulimia were few, treatment with phenelzine was associated with three reports of serious hypertensive episodes, one of which led to death. Global functioning before hospitalization, lifetime DSM-III-R Axis I diagnoses, and current Axis II diagnoses were not associated with outcome. CONCLUSIONS: These findings suggest that even severely ill bulimic patients have a significant chance of achieving full recovery.     

Adiponectin is an independent determinant of insulin resistance in women with polycystic ovary syndrome.

OBJECTIVE: Polycystic ovary syndrome (PCOS) is frequently associated with insulin resistance and a consequent increased risk of metabolic diseases. The aim of the present study was to investigate the role of adiponectin in insulin resistance in PCOS women. MATERIALS AND METHODS: Forty-seven patients with PCOS and 23 control subjects, matched for age and body mass index (BMI), were enrolled in the study. Clinical, metabolic and hormonal parameters and adiponectin levels were measured, and HOMA-IR score (homeostasis model assessment-insulin resistance index) was calculated for each subject. RESULTS: There was no difference in adiponectin levels between PCOS patients and the control group. However, adiponectin levels were negatively correlated with obesity-associated parameters and HOMA-IR score in PCOS patients and controls. As adiponectin is modulated by BMI we adjusted for BMI among the PCOS patients, and found a negative correlation between adiponectin levels and HOMA-IR score (r = -0.51, p < 0.001). Adiponectin and BMI were independent determinants of insulin resistance in PCOS patients (adjusted R2 = 0.66, p < 0.001). CONCLUSION: Adiponectin did not seem to be actively involved in the pathogenesis of PCOS. However, adiponectin levels were independently associated with insulin resistance in PCOS patients, suggesting that adiponectin might play a role in the complicated metabolic abnormalities of PCOS.     

Incidence of the retroaortic left renal vein in patients with varicocele.

OBJECTIVE: The purpose of this study was to investigate the incidence of the retroaortic left renal vein (RLRV) in patients with varicocele. METHODS: The left renal vein was ultrasonographically investigated for the presence of the RLRV in 140 patients with varicocele and a control group of 137 age-matched patients. The main diagnostic criteria for varicocele were the presence of a varicose vein with a diameter of 3 mm or larger at rest and with a reflux lasting more than 2 seconds during the Valsalva maneuver. The RLRV was defined as a posterior course of the left renal vein to the aorta at the level of the origin of the superior mesenteric artery. RESULTS: The RLRV was observed in 13 (9.3%) of the 140 patients with varicocele and 3 (2.2%) of the control patients. The incidence of the RLRV was found to be significantly higher in patients with varicocele compared with the control patients (P = .018, Fisher exact test). In 13 patients with the RLRV, left varicocele and bilateral varicocele were detected in 10 and 3 cases, respectively. CONCLUSIONS: In this study, the incidence of the RLRV was found to be significantly higher in patients with varicocele compared with control patients. Thus, we suggest that the presence of the RLRV may be considered one of the etiologic factors in the development of varicocele.     

Optical Manipulation of Objects and Biological Cells in Microfluidic Devices

In this paper, we review optical techniques used for micro-manipulation of small particles and cells in microfluidic devices. These techniques are based on the object's interaction with focused laser light (consequential forces of scattering and gradient). Inorganic objects including polystyrene spheres and organic objects including biological cells were manipulated and switched in and between fluidic channels using these forces that can typically be generated by vertical cavity surface emitting laser (VCSEL) arrays, with only a few mW optical powers. T-, Y-, and multi-layered X fluidic channel devices were fabricated by polydimethylsiloxane (PDMS) elastomer molding of channel structures over photolithographically defined patterns using a thick negative photoresist. We have also shown that this optical manipulation technique can be extended to smaller multiple objects by using an optically trapped particle as a handle, or an optical handle. Ultimately, optical manipulation of small particles and biological cells could have applications in biomedical devices for drug discovery, cytometry and cell biology research.     

MR imaging of posteromedial and posterolateral stabilisers of the knee: anatomic basis and patterns of lesions in knee injuries

Summary The angular points are the ligamentous and tendinous structures that reinforce the posteromedial and posterolateral capsule of the knee and share in fixation of the posterior horns of the menisci. They are often damaged in acute injuries and this is usually associated with ruptures of the cruciate and collateral ligaments and may add to the degree of laxity. We describe the normal appearance of these structures in terms of the sectional anatomy, correlated with the lesional appearances of complete and incomplete ruptures and associated meniscal detachments as shown by clinical testing and arthrotomy findings.

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IRM des points d'angle du genou : bases anatomiques et applications aux genoux traumatiques

Résumé Les points d'angle sont des structures ligamentaires et tendineuses qui renforcent la capsule postéro-médiale et postéro-latérale et participent à la fixation des cornes postérieures des ménisques. Leurs lésions, fréquentes au cours des traumatismes aigus, sont généralement associées à des ruptures des ligaments croisés et des ligaments collatéraux et peuvent être source d'une aggravation de la laxité. Nous rapportons, en corrélation avec l'anatomie en coupe, l'aspect normal de ces structures, et en corrélation avec les données de l'arthrotomie et du testing les aspects lésionnels observés au cours des traumatismes : ruptures complètes, incomplètes et désinsertions méniscales associées.

     

Bulimia and depression

In recent years several lines of evidence have emerged suggesting that eating disorders in general, and bulimia in particular, are in some way linked to affective illness. However, there are few data on the frequency of affective syndromes among patients who have anorexia nervosa or bulimia. This report describes the results of semistructured interviews using the Schedule for Affective Disorders and Schizophrenia (SADS) to evaluate the frequency of the current and lifetime diagnoses of affective illness among 50 female patients meeting DSM-III criteria for bulimia. Seventy percent of the patients had, at some time during their lives, met Research Diagnostic Criteria (RDC) for an episode of major depression and 88% had met RDC at some time during their lives for some affective disturbance. The implications of this high frequency of affective disturbance among patients with bulimia are discussed.     

Effects of Different Doses of Caffeinated Coffee on Muscular Endurance,Cognitive Performance,and Cardiac Autonomic Modulation in Caffeine Naive Female Athletes

Caffeine is widely consumed among elite athletes for its well-known ergogenic properties, and its ability to increase exercise performance. However, studies to date have predominantly focused on the anhydrous form of caffeine in male participants. The aim of the study was to investigate the effect of caffeinated coffee ingestion on lower-upper body muscular endurance, cognitive performance, and heart rate variability (HRV) in female athletes. A total of 17 participants (mean ± standard deviation (SD): age = 23 ± 2 years, body mass = 64 ± 4 kg, height = 168 ± 3 cm) in a randomized cross-over design completed three testing sessions, following the ingestion of 3 mg/kg/bm of caffeine (3COF), 6 mg/kg/bm of caffeine (6COF) provided from coffee or decaffeinated coffee (PLA) in 600 mL of hot water. The testing results included: (1) repetition number for muscular endurance performance; (2): reaction time and response accuracy for cognitive performance; (3): HRV parameters, such as standard deviation of normal-to-normal (NN) intervals (SDNN), standard deviation of successive differences (SDSD), root mean square of successive differences (RMSSD), total power (TP), the ratio of low- and high-frequency powers (LF/HF), high-frequency power (HF), normalized HF (HFnu), low-frequency power (LF), and normalized LF (LFnu). A one-way repeated measures ANOVA revealed that 3COF (p = 0.024) and 6COF (p = 0.036) improved lower body muscular endurance in the first set as well as cognitive performance (p = 0.025, p = 0.035 in the post-test, respectively) compared to PLA. However, no differences were detected between trials for upper body muscular endurance (p = 0.07). Lastly, all HRV parameters did not change between trials (p > 0.05). In conclusion, ingesting caffeinated coffee improved lower body muscular endurance and cognitive performance, while not adversely affecting cardiac autonomic function.     

Intra-Arterial Infusion Chemotherapy in the Treatment of Locally Advanced Breast Cancer

The efficacy of intra-arterial infusion chemotherapy (IACT) as the first step in a combined modality therapy in the treatment of locally advanced breast cancer was evaluated in a prospective clinical study consisting of 18 patients, 15 with stage IIIB, and three with stage IV breast cancer. A combined chemotherapy using adriamycin, mitomycin C and 5-Fluorouracil were administered at 3-week intervals until sufficient regression was achieved. Objective response rate was 66.6%. Among the 14 patients who received IACT for induction, plus surgery, simultaneous adjuvant chemotherapy and radiotherapy, 7 were disease-free at a mean of 19.5 (range 4-42) months. Six patients developed various relapses at a mean of 20.6 (range 12-28) months. IACT was found to be quite effective in local control. The early systemic relapse continues to be a serious problem that needs further intervention.