The potential ameliorating effect of vitamin E on bleomycin - induced lung fibrosis in adult albino rats.

Lung fibrosis is a critical interstitial lung disease with poor prognosis. There is an urgent need to develop a proper and cost-effective therapeutic modality that can reverse and/or ameliorate lung fibrosis. Vitamin E is one of the widely investigated dietary antioxidants which has been linked to improvement of many health problems. The current study was conducted to evaluate the possible roles of vitamin E in prevention and treatment of bleomycin (BLM) induced lung fibrosis. Physiological, anatomical, histopathological and immunohistochemical studies were done to assess and compare between the structure and function of the lung tissue in lung fibrosis model, early and late treated groups with vitamin E. Furthermore, measurement of transforming growth factor-ß(TGF-ß), E-cadherin, Smad-3, BAX, BCL2, malondialdehyde (MDA), and superoxide dismutase (SOD) were done. The study revealed that administration of vitamin E helped to improve signs of lung fibrosis, as reflected by amelioration of structure and functions of lungs as well as the decrease in TGF-ß levels and inhibition of α-SMA/collagen I profibrotic pathway. These findings highlight the importance of administration of vitamin E as a prophylactic agent prior to BLM therapy and as an adjuvant treatment in cases of lung fibrosis.

Human Pose Estimation for Clinical Analysis of Gait Pathologies.

Gait analysis serves as a critical diagnostic tool for identifying neurologic and musculoskeletal damage. Traditional manual analysis of motion data, however, is labor-intensive and heavily reliant on the expertise and judgment of the therapist. This study introduces a binary classification method for the quantitative assessment of gait impairments, specifically focusing on Duchenne muscular dystrophy (DMD), a prevalent and fatal neuromuscular genetic disorder. The research compares spatiotemporal and sagittal kinematic gait features derived from 2D and 3D human pose estimation trajectories against concurrently recorded 3D motion capture (MoCap) data from healthy children. The proposed model leverages a novel benchmark dataset, collected from YouTube and publicly available datasets of their typically developed peers, to extract time-distance variables (e.g. speed, step length, stride time, and cadence) and sagittal joint angles of the lower extremity (e.g. hip, knee, and knee flexion angles). Machine learning and deep learning techniques are employed to discern patterns that can identify children exhibiting DMD gait disturbances. While the current model is capable of distinguishing between healthy subjects and those with DMD, it does not specifically differentiate between DMD patients and patients with other gait impairments. Experimental results validate the efficacy of our cost-effective method, which relies on recorded RGB video, in detecting gait abnormalities, achieving a prediction accuracy of 96.2% for Support Vector Machine (SVM) and 97% for the deep network.

Risk as catalyst for positive change: lessons learnt from public health readiness for cholera in Jordan.

This case study highlights how a looming health crisis was leveraged as drivers for positive change for the health sector, in line with the health security agenda. In Jordan, several authorities are mandated by law to manage health emergencies. Following the declaration of outbreaks of cholera in Iraq, Lebanon and Syria, health authorities in Jordan called for a series of emergency meetings during September 2022 to discuss implications around travel and trade as well as shared waters. WHO was part of the consultations and provided guidance on the application of the International Health Regulations 2005. As the risk for cholera importation persisted, the Ministry of Health assumed its leadership role for the overall health sector response while the Jordanian Center for Disease Control assumed a coordinating function. Roles and responsibilities were enshrined in the National Cholera Preparedness and Response Plan. In consideration of the vulnerability of refugee camps and settlements towards Cholera, the existing Jordan humanitarian coordination platforms such as the Health Sector Working Group were used to share information and to coordinate activities. A whole-of-government risk assessment during December 2022 was complemented by a field visit at Zaatari refugee camp. This helped assess the risk and readiness for a cholera outbreak in Jordan and informed priority activities, such as the establishment of a national risk communication and community engagement working group as well as training on case management.

Microbiological quality of some packed and unpacked bread products in Alexandria, Egypt.

BACKGROUND: Bakery products are important food snacks consumed by people of all ages and economic groups. The growth of unwanted microorganisms that deteriorate products such as bacteria, moulds, and fungi in these foodstuffs may offer risks to consumers' health and generate considerable economic losses. This work aimed to assess the microbiological quality of some packed and unpacked bread products in Alexandria, Egypt. METHODS: This cross-sectional comparative study involved 168 local and branded bakery products that were collected randomly from 2 districts in Alexandria. Hygienic practices such as covering of the bread and wearing gloves during handling were observed and recorded. All bread samples were tested to determine the total plate count (TPC), presence/absence of Staphylococcus aureus (S. aureus), total yeasts and moulds in CFU/g and total coliform count (TC) in MPN/g. RESULTS: The mean of the total yeasts and moulds and TC in the packed bread was lower than that of the unpacked bread (3.40 × 103 CFU/g and 3.25 MPN/g versus 6.37 × 103 CFU/g and 31.61 MPN/g, respectively). However, the mean of TPC in the packed bread was higher than that of the unpacked bread (1.39 × 106 versus 2.07 × 105 CFU/g, respectively). The mean TPC, total yeasts and moulds and TC was higher in the studied flatbread than Fino bread and toast (3.4 × 106, 1.14 × 104 CFU/g and 24.6 MPN/g, respectively). The presence of S. aureus was higher in flat, unpacked bread, bread displayed outside the shop and handled without gloves. CONCLUSION: Bread produced by local bakeries showed lower standards in packaging and microbial quality. Better manufacturing, packaging, storage, and handling initiatives should be introduced to avoid related food safety concerns in the future. The formal authorities should define and clarify standards and rules on bread safety.

Acute Severe Heart Failure in Paediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2: A Case Report.

A 17-year-old boy presented during the COVID-19 pandemic in late 2021 with intractable fevers and hemodynamic instability with early gastrointestinal disturbances, resembling features of the pediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2. Our patient required intensive unit care for persistently worsening signs of cardiac failure; initial admission echocardiography demonstrated severe left ventricular dysfunction with an estimated ejection fraction of 27%. Treatment with intravenous IgG and corticosteroids showed a rapid improvement in symptoms, but further specialist cardiological input was required for heart failure in the coronary care unit. Substantial improvement in cardiac function was shown on echocardiography before discharge, initially to left ventricular ejection fraction (LVEF) 51% two days after the commencement of treatment and then to >55% four days later, and on cardiac MRI. An echocardiogram one month post-discharge was normal, and the patient reported complete resolution of heart failure symptoms by four months in addition to full restoration of functional status.

Are we seeing the unseen of human trafficking? A retrospective analysis of the CTDC k-anonymized global victim of trafficking data pool in the period 2010-2020.

BACKGROUND: Human trafficking is considered a hidden global crime with unsubstantiated numbers. Despite the challenges in counting or measuring this crime, reports revealed the presence of around 40.3 million victims worldwide. Human trafficking results in severe detrimental impacts on both mental and physical health. Given the sensitivity and negative consequences of human trafficking on the global system and victims, and considering the scarce research in this area, our current study aimed at describing the (i) Sociodemographic profiles of anonymized victims, (ii) Means of control, and (iii) Purpose of trafficking, utilizing the largest anonymized and publicly available dataset on victims of human trafficking. METHODS: This is a retrospective secondary analysis of the Counter-Trafficking Data Collaborative (CTDC) data pool in the period from 2010 to 2020. The utilized dataset is called the k-anonymized global victim of trafficking dataset, and it is considered the largest global dataset on victims of human trafficking. Data from the k-anonymized data pool were extracted and exported to Statistical Package for Social Sciences, SPSS® version 27.0 for Windows (IBM Corp. Version 27.0. Armonk, NY) for quality check and analysis using descriptive statistics. RESULTS: A total of 87003 victims of human trafficking were identified in the period from 2010 to 2020. The most age category encountered among victims was 9-17 years with 10326 victims (11.9%), followed by 30-38 years with 8562 victims (9.8%). Females comprised 70% of the sample with 60938 victims. The United States (n = 51611), Russia (n = 4570), and the Philippines (n = 1988) comprised the most countries of exploitation/trafficking. Additionally, the year 2019 witnessed the greatest number of victims registered for assistance by anti-trafficking agencies with around 21312 victims (24.5%). Concerning means of control, threats, psychological abuse, restriction of the victim's movement, taking the victim's earnings, and physical abuse were the most reported means. 42685 victims (49.1%) reported sexual exploitation as the purpose of their trafficking, followed by forced labor with 18176 victims (20.9%). CONCLUSION: Various means and methods can be used by traffickers to control the victims to be trafficked for many purposes, with sexual exploitation and forced labor being the most common ones. Global anti-trafficking efforts should be brought together in solidarity through utilizing the paradigm of protection of victims, prosecution of traffickers, prevention of trafficking, and inter-sectoral partnerships. Despite being a global concern with various reports that tried to capture the number of trafficked victims worldwide, human trafficking still has many unseen aspects that impose a significant challenge and adds to the global burden in combatting this threat.

Bacteriological profile and antibiotic resistance in newborn infants with possible community-acquired neonatal sepsis in Khartoum State, Sudan.

Neonatal sepsis is a leading cause of morbidity and mortality, and knowledge of bacterial patterns and susceptibility to antibiotics is essential to design therapeutic guidelines. To determine the bacterial aetiology and antibiotic resistance patterns in neonatal sepsis, a prospective, cross-sectional, hospital-based study was conducted in a large paediatric emergency hospital in Khartoum State, Sudan, over a 6-month period. All newborn infants with a clinical diagnosis of sepsis were included in the study and had a blood sample collected for culture and sensitivity. The World Health Organization case definition of neonatal sepsis in conjunction with the Integrated Management of Childhood Illnesses criteria was used to select patients. A total of 170 newborn infants fulfilled the study inclusion criteria. The median age at presentation was 4-7 days and blood culture was positive in 31%. Early-onset neonatal sepsis was present in 30% of cases, while 70% were late-onset. Gram-positive organisms accounted for 58% of the total isolates, and 38% were Gram-negative organisms. Staphylococcus aureus was the most prevalent organism (55% of all isolates) and 72% of these were methicillin-resistant which showed 100% sensitivity to vancomycin and 90% to gentamycin. Pseudomonas aeruginosa was the commonest Gram-negative organism in both early and late-onset sepsis and the second commonest isolated organism, accounting for 19% of cases. All Gram-negative organisms were 100% sensitive to imipenem, meropenem and ciprofloxacin. Both Gram-positive and Gram-negative organisms were highly resistant to benzylpenicillin and cefotaxime, the commonly used empiric antibiotics in neonatal sepsis.

Circulating miR-181a and miR-223 expression with the potential value of biomarkers for the diagnosis of systemic lupus erythematosus and predicting lupus nephritis.

BACKGROUND: MicroRNAs (miRNAs) contribute to the development and progression of systemic lupus erythematosus (SLE) by affecting a wide range of targeted genes and facilitating the development of lupus nephritis (LN). The present study aimed to analyze the serum expression of miR-181a and miR-223 in SLE patients and to assess whether they could serve as novel biomarkers for SLE diagnosis and to distinguish LN. METHODS: The study included 70 control subjects and 116 patients with SLE (67 non-LN and 49 LN groups). Circulating miR-181a and miR-223 expression levels were analyzed among the Egyptian population using a real-time polymerase chain reaction. RESULTS: Up-regulation of miR-181a was detected among SLE patients compared to healthy controls and higher values were reported among the LN group compared to the non-LN group. Down-regulation of miR-223 was reported among SLE patients compared to controls and lower values were reported among the LN group compared to the non-LN group. The higher miR-181a expression and the lower miR-223 expression were associated with higher stages of LN. SLE disease activity index, proteinuria and serum creatinine were independently correlated with miR-181a and miR-223 among SLE patients by linear regression analysis. Receiver-operating characteristic curve analysis revealed that combined miR-181a and miR-223 expression increased the sensitivity and specificity for the diagnosis of SLE and further distinguished LN from non-LN patients. CONCLUSIONS: miR-181a and miR-223 could play a role in evaluating SLE disease progression and prognosis. Combined miR-181a and miR-223 expression analysis could serve as novel serum-based biomarkers in the diagnosis of SLE and predicting LN among Egyptians.

Unraveling the capability of graphene nanosheets and γ-Fe2O3 nanoparticles to stimulate anammox granular sludge.

In this study, we investigated the potentials of nanomaterials to enhance anaerobic ammonium oxidation (anammox) process, in terms of nitrogen removal, microbial enrichment, and activity of key enzymes. Graphene nanosheets (GNs) and γ-Fe2O3 nanoparticles (NPs) were selected due to their catalytic functions as conductive material and electron shuttles, respectively. The obtained results revealed that the optimum dosage of GNs (10 mg/L) boosted the nitrogen removal rate (NRR) by 46 ± 3.1% compared to the control, with maximum NH4+-N and NO2--N removal of 86.5 ± 2.7% and 97.1 ± 0.5%, respectively. Moreover, hydrazine dehydrogenase (HDH) enzyme activity was augmented by 1.1-fold when using 10 mg/L GNs. The presence of GNs promoted the anammox granulation via enhancement of hydrophobic interaction of extracellular polymeric substances (EPS). Regarding the use of γ-Fe2O3 NPs, 100 mg/L dose increased NRR by 55 ± 3.8%; however, no contribution to HDH enzyme activity and a decrease in EPS compositions were observed. Given that the abiotic use of γ-Fe2O3 NPs further resulted in high adsorption efficiency (~92%), we conclude that the observed promotion due to γ-Fe2O3 NPs was mainly abiotic. Moreover, the 16S rRNA analysis revealed that the relative abundance of genus C. Jettenia (anammox related bacteria) increased from 11.9% to 12.3% when using 10 mg/L GNs, while declined to 8.3% at 100 mg/L γ-Fe2O3 NPs. Eventually, nanomaterials could stimulate the efficiency of anammox process, and this promotion and associated mechanism depend on their dose and composition.

Reward and punishment learning in schizophrenia and bipolar disorder.

Prior studies on reward learning deficits in psychiatric disorders have used probabilistic learning tasks, making it unclear whether impairment is due to the probabilistic nature of the task rather than reward processing. In this study, we tested probabilistic vs. deterministic reward and punishment learning in healthy controls and three patient groups: schizophrenia (SZ), psychotic bipolar disorder (BD), and nonpsychotic BD. Experimental results show that reward learning was impaired in patients with SZ and patients with psychotic BD in the probabilistic learning task compared to patients with nonpsychotic BD and healthy controls. In contrast, punishment learning in the probabilistic task was impaired in patients with nonpsychotic BD compared to the other patient groups and healthy controls. There were no significant differences among all groups in the deterministic learning task scores. We also found that Hamilton Depression Scale scores negatively correlated with probabilistic learning performance. Our data may suggest that reward learning impairment may be due to the nature of the task as well as subtype of BD.

Regulating acidogenesis and methanogenesis for the separated bio-generation of hydrogen and methane from saline-to-hypersaline industrial wastewater.

Given the limitations of acidogens and methanogens activities under saline environments, this work aims to optimize the main operational parameters affecting hydrogen and methane production from saline-to-hypersaline wastewater containing mono-ethylene glycol (MEG). MEG is the main contaminant in several saline industrial effluents. Anaerobic baffled reactor (ABR), as a multi-stage system, was used at different temperatures (i.e., 19-31 °C [ambient] and 35 °C), organic loading rates (OLRs) of 0.6-2.2 gCOD/L/d, and salinity of 5-35 gNaCl/L. Mesophilic conditions of 35 °C substantially promoted MEG biodegradability (92-98%) and hydrogen/methane productivity, even at elevated salinity. Hydrogen yield (HY) and methane yield (MY) peaked to 258 and 140 mL/gCODadd, respectively, at OLR 0.64 gCOD/L/d and salinity up to 20-25 gNaCl/L. An immobilized sludge ABR (ISABR), packed with polyurethane media, was further compared with classical ABR, resulting in 1.8-fold higher MY, at 35 gNaCl/L. Microbial analysis showed that introducing attached growth system (ISABR) substantially promoted methanogens abundance, which was dominated by genus Methanosarcina. Among bacterial genera, Acetobacterium was dominant, particularly in 1st compartment, representing MEG-degrading/salt-tolerant genus. At high salinity up to 35 gNaCl/L, the multi-phase and attached growth configuration can efficiently reduce the induced salt stress, particularly on methanogens, towards balanced and separated acidogenesis/methanogenesis. Overall, producing hydrogen and methane from anaerobic treatment of MEG-based saline wastewater is feasible at optimized parameters and configuration.

Testing baby bottles for the presence of residual and migrated bisphenol A.

Plastic made with bisphenol A (BPA) produces trans-generational changes in genes and behavior. It has been positively linked to obesity and thyroid dysfunction. This study aimed to detect the presence of BPA in polycarbonate plastic (PC) baby bottles. Fifteen PC baby bottles with a clear indication of BPA free/safe/clear were randomly selected. High-performance liquid chromatography (HPLC) tests were used to detect residual or migrating BPA post three stress tests. An estimated intake of BPA among children was calculated then compared to the universal tolerable daily intake (TDI). Around 27% of bottles had detectable amounts of residual BPA in the first test, 100% released migrating BPA in the second and third tests. A significant positive linear trend in migrated BPA levels was observed over the three consecutive tests P < 0.0001. Approximately 73.5% of the accounted variability in BPA levels was due to these stress tests P < 0.0001. Babies from 0 to 3 months are expected to consume 0.8 to 23.8% of their safe TDI of BPA just by using plastic bottles between the first time of usage and after 60 washes (estimated 15 to 20 days of usage). Although no bottles have shown a risk of BPA intake exceeding TDI, the combined use of BPA bottles with other plastic utensils might result in reaching it. It is advisable to refrain from using BPA-containing plastic bottles or be cautious about usage duration. Manufacturers should indicate a clear margin of usage duration. Four baby bottle brands showed the least BPA leaking (Baby King, Camera, Sweet Baby, and Farlin).

Characterization of Pathogenic Bacteria Isolated from Sudanese Banknotes and Determination of Their Resistance Profile.

BACKGROUND: Banknotes are one of the most exchangeable items in communities and always subject to contamination by pathogenic bacteria and hence could serve as vehicle for transmission of infectious diseases. This study was conducted to assess the prevalence of contamination by pathogenic bacteria in Sudanese banknotes, determine the susceptibility of the isolated organisms towards commonly used antibiotics, and detect some antibiotic resistance genes. METHODS: This study was carried out using 135 samples of Sudanese banknotes of five different denominations (2, 5, 10, 20, and 50 Sudanese pounds), which were collected randomly from hospitals, food sellers, and transporters in all three districts of Khartoum, Bahri, and Omdurman. Bacterial prevalence was determined using culture-based techniques, and their sensitivity patterns were determined using the Kirby-Bauer disk diffusion method. Genotypic identification was carried out using PCR and 16S rDNA sequencing. Antibiotic resistance genes of some isolates were detected using PCR technique. RESULTS: All Sudanese banknotes were found to be contaminated with pathogenic bacteria. Klebsiella pneumoniae was found to be the most frequent isolate (23%), whereas Bacillus mycoides (15%) was the most abundant Gram-positive isolate. There was a significant relationship between the number of isolates and the banknote denomination with p value <0.05 (the lower denomination showed higher contamination level). Our study has isolated bacteria that are resistant to penicillins and cephalosporins. Multidrug-resistant strains harboring resistant genes (mecA, blaCTX-M, and blaTEM) were also detected. CONCLUSION: All studied Sudanese banknotes were contaminated with pathogenic bacteria, including multidrug-resistant strains, and may play a significant role in the transmission of bacterial infections.

An ex vivo comparison of working length determination by three electronic root canal length measurement devices integrated into endodontic rotary motors.

AIM: The objective of this study was to compare the accuracy of working length (WL) determination by X-Smart Dual, ENDOAce, and Gold Reciproc motor, in manual mode and mechanical preparation set to auto apical reverse (AAR) mode. MATERIALS AND METHODS: Forty-five anterior teeth were included in the study. The canal length was determined by introducing #10 file into the canal until it emerged at the apical foramen. The incisal edges were adjusted to obtain 18 mm standard length. The teeth were embedded in Plexiglas tubes, filled with alginate, and measured in manual and AAR modes. RESULTS: Within and between the groups, there was no significant difference in WL measurements, both in manual and AAR modes. In the X-Smart Dual group, all manual measurements were within root canal limits, while 13 % of AAR mode measurements were recorded when the file tip passed the apical foramen. In the ENDOAce group, 13 and 7 % of the measurements, in manual and AAR modes respectively, were recorded when the file tip passed the foramen. In the Gold Reciproc motor group, 27 and 33 % of the measurements, in manual and AAR modes respectively, were recorded when the file tip passed the foramen. CONCLUSION: With the limitation of this ex vivo study, the tested devices presented no significant differences in length measurements and were within the clinical accepted margin of error. CLINICAL RELEVANCE: Mechanical preparation must be confined to the root canal system. The adverse results of overinstrumentation emphasize the need to reconsider the ±0.50 mm margin of error that is clinically acceptable for WL measurements.

Plasmacytoid variant of urothelial carcinoma: Diagnostic challenges and role of immunohistochemistry.

Plasmacytoid carcinoma of the urinary bladder or plasmacytoid urothelial carcinoma (PUC) is rare and only recently described a histological variant of transitional cell carcinoma. The morphological resemblance of PUC to other malignancies is a source of diagnostic dilemmas and often misdiagnosis. Immunohistochemistry plays a pivotal role in narrowing the differential diagnosis and reaching to a conclusive diagnosis. A diagnosis of PUC usually carries a dismal prognosis. Hence, correct diagnosis is important. We report here a 52-year-old male with a plasmacytoid variant of urothelial carcinoma.

Identifying the Basal Ganglia network model markers for medication-induced impulsivity in Parkinson's disease patients.

Impulsivity, i.e. irresistibility in the execution of actions, may be prominent in Parkinson's disease (PD) patients who are treated with dopamine precursors or dopamine receptor agonists. In this study, we combine clinical investigations with computational modeling to explore whether impulsivity in PD patients on medication may arise as a result of abnormalities in risk, reward and punishment learning. In order to empirically assess learning outcomes involving risk, reward and punishment, four subject groups were examined: healthy controls, ON medication PD patients with impulse control disorder (PD-ON ICD) or without ICD (PD-ON non-ICD), and OFF medication PD patients (PD-OFF). A neural network model of the Basal Ganglia (BG) that has the capacity to predict the dysfunction of both the dopaminergic (DA) and the serotonergic (5HT) neuromodulator systems was developed and used to facilitate the interpretation of experimental results. In the model, the BG action selection dynamics were mimicked using a utility function based decision making framework, with DA controlling reward prediction and 5HT controlling punishment and risk predictions. The striatal model included three pools of Medium Spiny Neurons (MSNs), with D1 receptor (R) alone, D2R alone and co-expressing D1R-D2R. Empirical studies showed that reward optimality was increased in PD-ON ICD patients while punishment optimality was increased in PD-OFF patients. Empirical studies also revealed that PD-ON ICD subjects had lower reaction times (RT) compared to that of the PD-ON non-ICD patients. Computational modeling suggested that PD-OFF patients have higher punishment sensitivity, while healthy controls showed comparatively higher risk sensitivity. A significant decrease in sensitivity to punishment and risk was crucial for explaining behavioral changes observed in PD-ON ICD patients. Our results highlight the power of computational modelling for identifying neuronal circuitry implicated in learning, and its impairment in PD. The results presented here not only show that computational modelling can be used as a valuable tool for understanding and interpreting clinical data, but they also show that computational modeling has the potential to become an invaluable tool to predict the onset of behavioral changes during disease progression.

Impairments of working memory in schizophrenia and bipolar disorder: the effect of history of psychotic symptoms and different aspects of cognitive task demands.

Comparisons of cognitive impairments between schizophrenia (SZ) and bipolar disorder (BPD) have produced mixed results. We applied different working memory (WM) measures (Digit Span Forward and Backward, Short-delay and Long-delay CPT-AX, N-back) to patients with SZ (n = 23), psychotic BPD (n = 19) and non-psychotic BPD (n = 24), as well as to healthy controls (HC) (n = 18) in order to compare the level of WM impairments across the groups. With respect to the less demanding WM measures (Digit Span Forward and Backward, Short-delay CPT-AX), there were no between group differences in cognitive performance; however, with respect to the more demanding WM measures (Long-delay CPT-AX, N-back), we observed that the groups with psychosis (SZ, psychotic BPD) did not differ from one another, but performed poorer than the group without a history of psychosis (non-psychotic BPD). A history of psychotic symptoms may influence cognitive performance with respect to WM delay and load effects as measured by Long-delay CPT-AX and N-back tests, respectively. We observed a positive correlation of WM performance with antipsychotic treatment and a negative correlation with depressive symptoms in BPD and with negative symptoms in SZ subgroup. Our study suggests that WM dysfunctions are more closely related to a history of psychosis than to the diagnostic categories of SZ and BPD described by psychiatric classification systems.

Effects of combined MAO-B inhibitors and levodopa vs. monotherapy in Parkinson's disease.

BACKGROUND: Prior studies report that monoamine oxidases inhibitors (MAO-I) when used as an adjunct to levodopa ameliorate motor symptoms in Parkinson's disease (PD), but this was not tested in relation to cognitive or psychiatric measures. OBJECTIVE: Here, we tested the effects of MAO-I as an adjunct to levodopa, in comparison to levodopa or dopamine (DA) agonists alone, on various cognitive, affective and quality of life measures. METHODS: We studied three groups of subjects: healthy controls, PD patients on combined levodopa and MAO-I, and PD patients on levodopa or DA agonists only. RESULTS: We found that compared to monotherapy, combined MAO-I and levodopa seemed to improve cognition, including probabilistic learning, working memory and executive functions. There were no differences between the different medication regimes on deterministic learning, attention or memory recall. It was also found that MAO-I as an adjunct to levodopa improves affective measures such as depression, apathy, anxiety and quality of life. Interestingly, this enhancing effect of combined levodopa and MAO-I was more pronounced in PD patients with severe akinesia, compared to patients with severe tremor. CONCLUSION: Our data are in agreement with (a) the Continuous Dopaminergic Stimulation (CDS) theory which states that continuous stimulation of the basal ganglia enhances motor, psychiatric and cognitive functions in PD patients; and/or (b) findings that MAO-I increase the bioavailability of monoamines that have beneficial effects on motor and behavioral dysfunction in PD.