Mood disorders and circulating levels of inflammatory markers in a longitudinal population-based study.

BACKGROUND: There has been increasing evidence that chronic low-grade inflammation is associated with mood disorders. However, the findings have been inconsistent because of heterogeneity across studies and methodological limitations. Our aim is to prospectively evaluate the bi-directional associations between inflammatory markers including interleukin (IL)-6, tumor necrosis factor (TNF)-α and high sensitivity C-reactive protein (hsCRP) with mood disorders. METHODS: The sample consisted of 3118 participants (53.7% women; mean age: 51.0, s.d. 8.8 years), randomly selected from the general population, who underwent comprehensive somatic and psychiatric evaluations at baseline and follow-up (mean follow-up duration = 5.5 years, s.d. 0.6). Current and remitted mood disorders including bipolar and major depressive disorders (MDD) and its subtypes (atypical, melancholic, combined atypical and melancholic, and unspecified) were based on semi-structured diagnostic interviews. Inflammatory biomarkers were analyzed in fasting blood samples. Associations were tested by multiple linear and logistic regression models. RESULTS: Current combined MDD [ß = 0.29, 95% confidence interval (CI) 0.03-0.55] and current atypical MDD (ß = 0.32, 95% CI 0.10-0.55) at baseline were associated with increased levels of hsCRP at follow-up. There was little evidence for inflammation markers at baseline predicting mood disorders at follow-up. CONCLUSIONS: The prospective unidirectional association between current MDD subtype with atypical features and hsCRP levels at follow-up suggests that inflammation may be a consequence of this condition. The role of inflammation, particularly hsCRP that is critically involved in cardiovascular diseases, warrants further study. Future research that examines potential influences of medications on inflammatory processes is indicated.

Preparation and characterization of polysulfone-polyurethane membranes for recovery of simulated wastewater from industrial textile processes.

Techniques using membranes for the treatment of wastewaters usually promote higher quality of treated water when compared to other processes. Among them, pervaporation has advantages in terms of selectivity in addition to low working pressure, which can prevent clogging problems. Polysulfone and polyurethane have complementary characteristics and are interesting in the context of membranes for industrial applications. In this sense, the aim of this work was to prepare and characterize polysulfone/polyurethane-based membranes and tested them with a simulated wastewater containing the reactive black dye and sodium chloride by pervaporation. In their manufacture, thermal treatment (at 60°C) and photo-radiation treatment (using ultraviolet light) were also applied. The characterizations were performed using different analytical tools. In general, it was possible to verify that all membranes have a dense layer. The thermal analysis allowed to define that the indicated working temperature is below 50°C. With respect to the simulated wastewater treatment, all membranes reached 100% selectivity. Concerning the saline solution, the mean selectivity was around 98.5%. Moreover, the permeate flow values were within the range presented by commercial membranes ranging from 1.6 to 2.4 kg m-2 h-1. Although for the photoirradiated membranes the photo-graft reaction has occurred, among all membranes, the blend without any treatment stood out from the others, presenting the highest permeate flow of the simulated wastewater. Finally, the results reveal that these membranes are capable of recovering wastewater from textile processes, in addition to having the potential to remove salts from water through the pervaporation process.Highlights Polysulfone/polyurethane-based membranes were not yet evaluated for wastewater recovery.Modifications in the membrane characteristics promoted variations in the permeate flow.Changes in physical-chemical properties of membrane as a result of a photoinitiation reaction.Removal efficiency achieved was 100% for reactive black dye and 98.5% for sodium chloride.A new way of performing pervaporation on the recovery of aqueous solutions.

Painful peripheral neuropathies.

Peripheral neuropathies are a heterogeneous group of diseases affecting peripheral nerves. The causes are multiple: hereditary, metabolic, infectious, inflammatory, toxic, traumatic. The temporal profile includes acute, subacute and chronic conditions. The majority of peripheral neuropathies cause mainly muscle weakness and sensory loss, positive sensory symptoms and sometimes pain. When pain is present, however, it is usually extremely intense and among the most disabling symptoms for the patients. In addition, the neurological origin of the pain is often missed and patients receive inadequate or delayed specific treatment. Independently of the disease causing the peripheral nerve injury, pain originating from axonal pathology or ganglionopathy privileges neuropathies affecting smaller fibres, a clinical observation that points towards abnormal activity within nociceptive afferents as a main generator of pain. Natural activation of blood vessels or perineurial nociceptive network by pathology also causes intense pain. Pain of this kind, i.e. nerve trunk pain, is among the heralding symptoms of inflammatory or ischemic mononeuropathy and for its intensity represents itself a medical emergency. Neuropathic pain quality rekindles the psychophysical experience of peripheral nerves intraneural microstimulation i.e. a combination of large and small fibres sensation temporally distorted compared to physiological perception evoked by natural stimuli. Pins and needles, burning, cramping mixed with numbness, and tingling are the wording most used by patients. Nociceptive pain instead is most often described as aching, deep and dull. Good command of peripheral nerve anatomy and pathophysiology allows timely recognition of the different pain components and targeted treatment, selected according to intensity, type and temporal profile of the pain.

Motor neuron dysfunctions in the frontotemporal lobar degeneration spectrum: a clinical and neurophysiological study.

BACKGROUND: Although only a few frontotemporal lobar degeneration (FTLD) patients develop frank amyotrophic lateral sclerosis (ALS), motor neuron dysfunctions (MNDys) occur in a larger proportion of patients. The aim of this study is to evaluate MNDys and ALS in a sample of consecutively enrolled sporadic FTLD patients. METHODS: Clinical and neurophysiological evaluations (i.e. needle electromyography) assessed lower (LMN) and upper (UMN) motor neuron function at the baseline in 70 probable FTLD patients (i.e., 26 behavioural variant-bvFTD, 20 primary progressive aphasias-PPAs and 24 corticobasal syndrome-CBS). To obtain a more accurate estimation, quantitative scales were also applied (i.e. ALSFRS-r and UMN scale). Patients were screened for MAPT, GRN and C9orf72 mutations. A mean clinical follow-up of 27.8±22.4 months assessed MNDys progression and the clinical presentation of ALS. RESULTS: Five genetic cases were identified. Within the sample of sporadic patients, a relative low rate of FTLD patients was diagnosed as probable ALS (5%), while a higher proportion of patients (17%) showed clinical and neurophysiological MNDys. Thirteen patients (20%) presented with isolated clinical signs of LMN and/or UMN dysfunction, and 8 patients (12%) showed neurogenic changes at the electromyography. No differences in FTLD phenotype and disease duration were found between MNDys positive and negative patients. Clinical MNDys were highly associated with positive electromyographic findings. At follow-up, no MNDys positive patient developed ALS. CONCLUSION: Neurophysiological and clinical examinations revealed mild MNDys in FTLD patients not fulfilling criteria for ALS. This condition did not evolve at a mean follow-up of two years. These results, indicating a subclinical degeneration of corticospinal tracts and lower motor neurons, suggest that FTLD patients may be more at risk of MNDys than the general population.

Empathic accuracy in a clinically relevant setting.

This study addressed 3 questions regarding empathic accuracy in a clinically relevant setting. First, does the empathic accuracy of a perceiver improve with increased exposure to a target individual? Second, can empathic accuracy be enhanced by providing the perceiver with feedback about the target's actual thoughts and feelings? Third, are there stable individual differences in empathic accuracy that generalize across different targets? The results indicated that although absolute performance levels varied from 1 target to another, empathic accuracy generally improved with increased exposure to the target. In addition, feedback concerning the target's actual thoughts and feelings accelerated the rate at which the perceivers' empathic accuracy improved. Finally, cross-target consistency in responding (alpha = .86) revealed stable individual differences in the perceivers' empathic ability. Implications of these findings for clinical training and practice are discussed.

Effect of antiinflammatory agents on neutrophil superoxide production in rheumatoid arthritis.

Granulocyte superoxide production by different stimuli was studied in 14 patients suffering from rheumatoid arthritis, and in four cases defective O(2) generation was shown. The effect of two chemically related drugs, such as indomethacin and oxamethacin, was also evaluated, since we have previously investigated the action of antiinflammatory agents on cell locomotion. Indomethacin did not affect O(2) production, whereas oxamethacin reduced significantly superoxide generation in PMNs from all subjects tested. Moreover, the extent of the effect was dependent on the stimulant used, being larger when the activation of O(2) generating system was induced by opsonized zymosan.

Effect on leukocyte locomotion and superoxide production by uremic toxins and polyamines.

We have isolated peak II, which is the peak of the middle molecules containing polyamines, from dialysate of uremic patients in recirculating dialysis. We investigated the effect of total dialysate, chromatographic peaks, I, II, III, IV and commercial polyamines on polymorphonuclear leukocyte chemotaxis and superoxide production (i.e. phagocytic activity) in healthy and uremic patients. Polymorphonuclear chemotaxis was inhibited by total dialysate and peak II but not by polyamines; polyamines, total dialysate and peak II had no activity on polymorphonuclear phagocytosis.

Rol de la TC multicorte con RMP en el diagnóstico de la hernia obturatriz: presentación de un caso / Role of multislice CT with MPR (multi-planar reformation) in the diagnosis of obturator hernia. a case report

La hernia obturatriz (HO) es poco frecuente y representa del 0.05 al 0.4 por ciento del total de hernias. Debido a su rareza y a su presentación inespecífica, el diagnóstico es por lo general tardío y las tasas de mortalidad elevadas (12-70 por ciento). Se presenta un caso típico de HO diagnosticada en el preoperatorio mediante TC Multi-corte con RMP y tratado mediante laparotomía de urgencia con buen resultado. El empleo de TC Multicorte con RMP de abdomen y pelvis, en cuadros de obstrucción intestinal en mujeres añosas, sin antecedente de cirugías previas ni hernias objetivables, tiene gran valor para el diagnóstico preoperatorio precoz de HO y podría contribuir a reducir las elevadas tasas de morbilidad y mortalidad.

Abstract. The obturator hernia (OH) is rare and accounts for 0.05 to 0.4% of all hernias. Because of its rarity and its nonspecific presentation, diagnosis is usually late and has high mortality rates (12-70%). A typical case of OH diagnosed preoperatively by Multislice CT with MPR and treated using emergency laparotomy with good results, is presented. The use of Multislice CT with MPR of the abdomen and pelvis, in symptoms of intestinal obstruction in elderly women with no history of previous surgery or objectified hernias, has great value for early preoperative diagnosis of OH and could help reduce the high rates of morbidity and mortality.

Effect of anti-inflammatory drugs on leukocyte superoxide production by soluble and particulate stimuli.

When polymorphonuclear leukocytes are treated with soluble and particulate substances the cells produce superoxide anion O2-. which plays a role in the activation of the oxidative metabolism. The time-course of O2-. release and the extent to which the anion is produced are related to the nature of the stimulating agents. Anti-inflammatory non steroid drugs, such as indomethacin and oxamethacin, exert a variable depression of the oxidative burst, which does not seem correlated to the inhibition of prostaglandin synthesis.

[Regulation of the functions of human leukocytes by oxametacine]. / Regolazione delle funzioni dei leucociti umani da parte della ossametacina.

Non steroidal anti-inflammatory drugs, such as oxametacine, are generally used in treatment of rheumatoid disease. In an 'in vitro' experimental model, the drug efficacy was tested on leukocyte functions. Locomotion, both random and directional, phagocytic activity and superoxide production of normal and rheumatoid PMNL were tested in the presence of varying concentrations of oxometacine. Locomotion was evaluated by using modified Boyden chambers; phagocytosis was tested by number of yeast particles injested and by NBT reduction; superoxide production was assayed by reduction of ferricytochrome C. In our conditions the drug exhibited a strong anti-inflammatory effect. In fact, chemotaxis and anion production were specifically depressed in a dose-dependent way.

Chemotactic behaviour of peripheral and synovial neutrophils during rifamycin SV therapy in rheumatoid arthritis.

The effect exerted by rifamycin SV, used intra-articularly in the treatment of rheumatoid arthritis, on polymorph function was studied. Random and directional locomotion of synovial fluid neutrophils was compared with that of peripheral blood cells in 10 patients followed up during 5 drug applications. PMNs from the two sources were characterized by different responsiveness to this pharmacological agent: blood cells activated chemotaxis in a dose-response way during rifamycin therapy, whereas synovial polymorphs did not modify their locomotor behaviour. It is proposed that the presence of immune complexes and/or factors produced by cell-cell interactions in the articular space may change the synovial neutrophil response to stimuli.

[Young nurses grow. The pathways and experiences of nurses newly employed in psychiatry]. / Giovani infermieri crescono. Percorsi ed esperienze di infermieri neo-assunti in psichiatria.

Three years after the first interview to a sample of 27 newly employed Registered Nurses in the Department of Mental Health, a second interview was administered to the nurses still working in the psychiatric services (30% of the original sample had already left), to analyze any changes related to their professional education, experiences and expectations. 5 of the nurses still remaining would like to make a change, while the others (14) expressed very high levels of motivation and satisfaction. The structure of the educational curriculum and the policy of internal mobility in the different psychiatric services are seen as main determinants of what has been observed.

Sensory disorder of the chest as presenting symptom of lung cancer.

Four patients with pancoast's syndrome had burning pain in the axilla and abnormal sensation in the intercostobrachial nerve territory. The intercostobrachial nerve is the first component of the brachial plexus to be invaded by lung tumours.

[Indomethacin and oxamethacin as modulators of the production of superoxide anion in human leukocytes]. / Indometacina ed ossametacina come modulatori della produzione di anione superossido dei leucociti umani.

Treatment of human neutrophils with the two chemoattractants formyl-methyonyl-leucyl-phenylalanine and opsonized zymosan or with phorbol myristate acetate induce the production of superoxide anion (O-.2), which plays a role in the inflammatory reaction and microbicidal activity. The time-course of O-.2 release and the extent to which the anion is produced are related to the nature of the stimulating agents. Anti-inflammatory non steroid drugs, such as indomethacin and oxamethacin, exert a variable depression of the oxidative burst, which does not seem correlated to the inhibition of prostaglandin synthesis, but to the lipophilic character of the drug molecule.

[An analog of formyl-met-leu-phe effects the movement of human leukocytes]. / Analogo del formil-met-leu-phe influenza il movimento dei leucociti umani.

Two tripeptides, related to the chemotactic formyl-peptide, are tested for its ability to affect random and directional locomotion and to induce chemotaxis of polymorphonuclear leukocytes. The results indicate that the methyl ester of formyl-methyonyl-leucyl-phenylalanine possesses a biological activity towards human phagocytes, including a chemotactic potency, comparable to that of unmodified peptide. Therefore, the free carboxyl group does not seem essential to generate active leukoattractant. On the contrary, the replacement of the formyl group by the butyloxycarbonyl results in a drastic loss of biological activity. Our data may indicate that the two formyl-peptides interact with the same binding site on the cell membrane.

Phosphate feeding strategy during production phase improves poly(3-hydroxybutyrate-co-3-hydroxyvalerate) storage by Ralstonia eutropha.

The effect of a phosphate feeding strategy and the optimal rate of biomass production ( r(x)) during the production phase of P(3HB-co-3HV) in a 6-l fermentor were determined in cultures of Ralstonia eutropha with the goal of enhancing polymer productivity. Rates of biomass production ( r(x)) between 0.00 and 0.20 gx r l(-1) h(-1) were monitored during the production phase. When a low rate of cell growth was maintained ( r(x) of 0.02 gx r l(-1) h(-1)), polymer production improved, resulting in a final cell mass, P(3HB-co-3HV) mass, and P(3HB-co-3HV) content of 98.2 g, 62.0 g and 63.1 wt%, respectively, after 27.3 h. The maximum polymer productivity obtained during the production phase was 1.36 g l(-1 )h(-1).

Characteristics of violent behaviour in acute psychiatric in-patients: a 5-year Italian study.

OBJECTIVE: In order to examine prospectively the characteristics of violence among psychiatric patients, a 5-year study was carried out in an acute psychiatric unit. METHOD: All assaultive behaviour occurred in the ward during the study period were assessed routinely using the Staff Observation Aggression scale (SOAS). RESULTS: Of 1534 patients admitted to the unit during the study period, 116 were responsible for 329 aggressive episodes (prevalence of violence=7.5%, 2.8 incidents/patient). Most violent patients had an ICD-9 diagnosis of schizophrenia and/or delusional syndromes (55.1%), a history of violence (80.7%) and previous psychiatric admissions (92%). Approximately half of the incidents had no specific cause, occurred during daytime and the first week of admission and, in most cases, were directed towards individuals (77.8%). CONCLUSION: Although confirming the low rate of violence among Italian psychiatric in-patients, the study indicates the need for more attention to the problem of aggression in general hospital psychiatric units.