Avoidant personality disorder is a separable schizophrenia-spectrum personality disorder even when controlling for the presence of paranoid and schizotypal personality disorders The UCLA family study.

It is unresolved whether avoidant personality disorder (APD) is an independent schizophrenia (Sz)-spectrum personality disorder (PD). Some studies find APD and social anxiety symptoms (Sxs) to be separable dimensions of psychopathology in relatives (Rels) of schizophrenics while other studies find avoidant Sxs to be correlated with schizotypal and paranoid Sxs. Rates of APD among first-degree Rels of Sz probands, attention-deficit/hyperactivity disorder (ADHD) probands, and community control (CC) probands were examined. Further analyses examined rates when controlling for the presence of schizotypal (SPD) and paranoid (PPD) personality disorders, differences in APD Sxs between relative groups, and whether APD in Rels of Szs reflects a near miss for another Sz-spectrum PD. Three hundred sixty-two first-degree Rels of Sz probands, 201 relatives of ADHD probands, and 245 Rels of CC probands were interviewed for the presence of DSM-III-R Axis I and II disorders. Diagnoses, integrating family history, interview information, and medical records, were determined. APD occurred more frequently in Rels of Sz probands compared to CC probands (p<0.001) and also when controlling for SPD and PPD (p<0.005). Two Sxs of APD were most characteristic of the Rels of Sz probands: "avoids social or occupational activities..." and "exaggerates the potential difficulties..." 65% of the Rels of Sz probands who had diagnoses of APD were more than one criterion short of a DSM-III-R diagnosis of either SPD or PPD. This indicates that APD is a separate Sz-spectrum disorder, and not merely a sub-clinical form of SPD or PPD.

Randomized prospective comparison of non-contrast enhanced helical computed tomography and intravenous urography in the diagnosis of acute ureteric colic.

Non-contrast enhanced helical CT has become an accepted technique for evaluating acute ureteric colic. The results of a randomized prospective comparison of the accuracy, cost and radiation dose of CT and intravenous urography (IVU) are presented. All patients presenting to the Emergency Department with symptoms and signs suggestive of ureteric colic over a 16-month period (n = 242) were randomized to CT or IVU. Follow up was obtained for 228 patients (94%), with 14 patients (6%) lost to follow up. One hundred and twenty-three patients (54%) underwent CT and 105 (46%) had an IVU. At follow up the sensitivity and specificity of CT were each 100%, while those of IVU were 99% and 100%, respectively. Computed tomography demonstrated seven of 26 (27%) potential alternative diagnoses, whereas IVU suggested one of 23 (4%). Estimates of the average effective dose were calculated for CT (4.95 mSv) and IVU (1.48 mSv, 95% confidence interval (CI) 0.7-2.27). Radiation dose and intravenous contrast material safety are discussed and the relative costs are considered. Computed tomography is as accurate as IVU in the diagnosis of acute ureteric colic. It confers certain major diagnostic benefits, and is a fast, well-tolerated technique. Its accompanying higher effective radiation dose is recognized.

Uptake and retention in suckling rats of 51chromium fed with human milk or infant formulas.

Optimum concentration of Cr for infant formulas has not been established. Such components as soy protein or supplemental Fe could influence absorption and retention. Suckling rat pups were used to evaluate the influence of three commercial formulas and human milk, all of which had been incubated with 51CrCl3 for 1 h, on the uptake and retention of the added 51Cr. After fasting 3 h, the pups were intubated with a single dose of 25 microCi 51CrCl3 in either a cow's milk-based formula, an Fe-supplemented cow's milk-based formula, a soy-based formula, or human milk. Six hours later, 51Cr was counted in five organs, thymus, blood, and total urine. Absorption of 51Cr was low. At 6 h, percent 51Cr in blood was < 0.2% of the dose, and total 51Cr excretion in urine was < 1.8%. The uptake and retention of 51Cr and its concentration in any of the organs, thymus, blood, and urine were not influenced by different types of formula or by human milk.

Histological comparison of autogenous canine fascia lata, Gore-Tex, lyophilized human fascia lata, and autogenous canine vein for vascular patch graft material in a canine arteriotomy model.

Autogenous fascia lata has found little clinical use as a vascular patch graft material. Previous experience, however, suggests that it possesses attributes that might make it useful in this regard. To assess its efficacy as a vascular patch graft, nine adult mongrel dogs each underwent four arteriotomies with placements of patch grafts. The four sites included both carotid arteries and both femoral arteries. In each animal, one of four patch graft materials (autogenous canine fascia lata, Gore-Tex, lyophilized human fascia lata, and autogenous canine vein) were placed as patch material at the arteriotomy site utilizing 7-0 running sutures and loop magnification. The site for placement of each graft material was rotated serially in the animals so that each site would have equal numbers of all four graft materials applied. The animals were killed at either 6 to 8 weeks or 11 to 12 weeks after angiography of all four vessels. The specimens were then evaluated histologically. No difference was observed among any of the patch graft materials with regard to myofibroblast plaque formation. Inflammatory responses were noted to be substantially less in the canine fascia lata group than in the other three groups. Granuloma formation, however, appeared to be most significant in the autogenous canine vein group. Only one vessel was occluded. Aneurysm or pseudoaneurysm formation was not noted in any specimen. It appears from the above results that autogenous fascia lata may be an appropriate alternative to currently utilized arterial patch graft materials and that it should be evaluated further for this purpose.

Breath hydrogen (H2) response to carbohydrate malabsorption after exercise.

Ten subjects were studied in order to determine whether mild exercise after an overnight fast would influence the baseline breath H2 concentration or breath H2 response to the nonabsorbable disaccharide, lactulose. Breath H2 concentrations immediately after exercise were significantly lowered (p less than 0.0001) but rapidly returned to baseline values. Exercise did cause a significant change in the overall response after oral lactulose and must be considered when sequential breath H2 tests are undertaken.

Effectiveness of milk products in dietary management of lactose malabsorption.

Eleven lactose malabsorbers were studied to compare the effectiveness of commercially available products recommended for dietary treatment of lactose malabsorption. One product, a commercial lactase preparation, is added to milk for lactose hydrolysis before consumption. The other is a commercial milk product containing lactose-hydrolyzing, nonpathogenic bacteria, Lactobacillus acidophilus. Both of these products are presently recommended for management of lactose malabsorption, although such recommendations have not been validated by controlled studies. Lactose malabsorption was determined by breath H2 analyses after subjects drank four different test doses on 4 different days. The first test dose was 480 ml of low fat milk; the second was 480 ml of milk treated with a commercial lactase preparation; the third was 480 ml of a commercial L. acidophilus-containing milk; and the fourth was 480 ml of the L. acidophilus-containing milk after 1 wk of gastrointestinal exposure to this commercial bacteria-containing milk. The mean breath H2 response to the lactase-treated milk was significantly lower (p less than 0.001) than the mean response to regular milk. However, the mean breath H2 response to either of the test doses of the L. acidophilus-containing milk were not significantly different than responses to regular milk. It is concluded that the lactase-treated milk reduces breath H2 responses and symptomatic discomfort from malabsorption while the L. acidophilus-containing milk does not.

Interval sampling of breath hydrogen (H2) as an index of lactose malabsorption in lactase-deficient subjects.

Interval sampling of breath hydrogen content was used in lactose malabsorbers: (1) to compare hydrogen responses following increasing oral doses of lactose in milk and aqueous solutions; (2) to determine the reproducibility of interval breath sampling, and (3) to compare carbohydrate malabsorption following ingestion of either regular milk or milk containing Lactobacillus acidophilus. Significant differences in breath hydrogen responses due to increasing amounts of lactose in milk and aqueous solutions were observed. The individual breath hydrogen responses were reproducible using the same lactose dose on different days. There was no significant difference in breath hydrogen responses or symptoms following administration of either regular milk or milk containing Lactobacillus acidophilus. Breath hydrogen sampling at intervals, as performed in these studies, provides a sensitive and reproducible index of lactose malabsorption.