Association of vitiligo with high-frequency sensorineural hearing loss: a systematic review and meta-analysis.

The association between vitiligo and hearing loss has been noted but the specific frequencies and degrees of hearing impairment remain unclear. The objective of this systematic review was to investigate the relationship between vitiligo and hearing thresholds at various specific frequencies. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We searched MEDLINE and Embase for relevant studies from inception to 10th April 2021. Case-control studies, cross-sectional, or cohort studies that compared the frequency-specific hearing thresholds between vitiligo patients and age-matched non-vitiligo controls were included. There were neither language nor geographic limitations. We used the Newcastle-Ottawa Scale to assess the risk of bias of included studies. The DerSimonian and Laird random-effects model was utilized in meta-analyses due to expected clinical heterogeneity. We included 9 case-control studies with 371 vitiligo patients and 349 controls, which were rated with low or unclear risk. We found neither relevant cross-sectional nor cohort studies. The meta-analysis showed that when compared with controls, vitiligo patients had significantly higher pure-tone hearing thresholds at 2000, 4000, and 8000 Hz. In conclusions, vitiligo patients are prone to high-frequency sensorineural hearing loss.

Impact of country-specific EQ-5D-3L tariffs on the economic value of systemic therapies used in the treatment of metastatic pancreatic cancer.

BACKGROUND: Previous Canadian cost-effectiveness analyses in cancer based on the EQ-5D-3L (EuroQoL, Rotterdam, Netherlands) have commonly used U.K. or U.S. tariffs because the Canadian equivalent only just recently became available. The implications of using non-Canadian tariffs to inform decision-making are unclear. We aimed to reevaluate an earlier cost-effectiveness analysis of therapies for metastatic pancreatic cancer (originally performed using U.S. tariffs) with tariffs from Canada and various other countries to determine the impact of using non-country-specific tariffs. METHODS: We used tariffs from Canada, the United States, the United Kingdom, Denmark, France, Germany, Japan, the Netherlands, and Spain to derive EQ-5D-3L utilities for the 10 health states in the pancreatic cancer model. Quality-adjusted life years (qalys) and incremental cost-effectiveness ratios (icers) were generated, and probabilistic sensitivity analyses (psas) were performed. RESULTS: Canadian utilities are generally lower than the corresponding U.S. utilities and higher than those for the United Kingdom. Compared with the Canadian-valued scenarios, U.S. and U.K. estimates were statistically different for 3 and 9 scenarios respectively. Overall, 35% of the non-Canadian utilities (28 of 80) were significantly different, clinically, from the Canadian values. Canadian qalys were 6% lower than those for the United States and 6% higher than those for the United Kingdom. When comparing the qalys of each treatment with those of gemcitabine alone, the average percent change was +6.8% for a U.S. scenario and -7.5% for a U.K. scenario compared with a Canadian scenario. Consequently, Canadian icers were approximately 5.4% greater than those for the United States and 8.6% lower than those for the United Kingdom. Based on the psas and compared with the Canadian threshold value, the minimum willingness-to-pay threshold at which the combination chemotherapy regimen of gemcitabine-capecitabine is the most cost-effective is $5,239 less than in the United States and $11,986 more than in the United Kingdom. CONCLUSIONS: The use of non-country-specific tariffs leads to significant differences in the derived utilities, icers, and psa results. Past Canadian EQ-5D-3L-based cost-effectiveness analyses and related funding decisions might need to be re-visited using Canadian tariffs.

Assessing vaccine-mediated protection in an ultra-low dose Mycobacterium tuberculosis murine model.

Despite widespread immunization with Bacille-Calmette-Guerin (BCG), the only currently licensed tuberculosis (TB) vaccine, TB remains a leading cause of mortality globally. There are many TB vaccine candidates in the developmental pipeline, but the lack of a robust animal model to assess vaccine efficacy has hindered our ability to prioritize candidates for human clinical trials. Here we use a murine ultra-low dose (ULD) Mycobacterium tuberculosis (Mtb) challenge model to assess protection conferred by BCG vaccination. We show that BCGconfers a reduction in lung bacterial burdens that is more durable than that observed afterconventional dose challenge, curbs Mtb dissemination to the contralateral lung, and, in a smallpercentage of mice, prevents detectable infection. These findings are consistent with the ability of human BCG vaccination to mediate protection, particularly against disseminated disease, in specific human populations and clinical settings. Overall, our findings demonstrate that the ultra-low dose Mtb infection model can measure distinct parameters of immune protection that cannot be assessed in conventional dose murine infection models and could provide an improved platform for TB vaccine testing.

Human mitochondrial RNA turnover caught in flagranti: involvement of hSuv3p helicase in RNA surveillance.

The mechanism of human mitochondrial RNA turnover and surveillance is still a matter of debate. We have obtained a cellular model for studying the role of hSuv3p helicase in human mitochondria. Expression of a dominant-negative mutant of the hSUV3 gene which encodes a protein with no ATPase or helicase activity results in perturbations of mtRNA metabolism and enables to study the processing and degradation intermediates which otherwise are difficult to detect because of their short half-lives. The hSuv3p activity was found to be necessary in the regulation of stability of mature, properly formed mRNAs and for removal of the noncoding processing intermediates transcribed from both H and L-strands, including mirror RNAs which represent antisense RNAs transcribed from the opposite DNA strand. Lack of hSuv3p function also resulted in accumulation of aberrant RNA species, molecules with extended poly(A) tails and degradation intermediates truncated predominantly at their 3'-ends. Moreover, we present data indicating that hSuv3p co-purifies with PNPase; this may suggest participation of both proteins in mtRNA metabolism.

RNA turnover in human mitochondria: more questions than answers?

Protein complexes responsible for RNA degradation play important role in three key aspects of RNA metabolism: they control stability of physiologically functional transcripts, remove the unnecessary RNA processing intermediates and destroy aberrantly formed RNAs. In mitochondria the post-transcriptional events seem to play a major role in regulation of gene expression, therefore RNA turnover is of particular importance. Despite many years of research, the details of this process are still a challenge. This review summarizes emerging landscape of interplay between the Suv3p helicase (SUPV3L1, Suv3), poly(A) polymerase and polynucleotide phosphorylase in controlling RNA degradation in human mitochondria.

Involvement of human ELAC2 gene product in 3' end processing of mitochondrial tRNAs.

Accurate tRNA processing is crucial for human mitochondrial genome expression, but the mechanisms of mt-tRNA cleavage and the key enzymes involved in this process are poorly characterized. At least two activities are required for proper mt-tRNA maturation: RNase P cleaving precursor molecules at the 5' end and tRNase Z at the 3' end. In human mitochondria only RNase P has been identified so far. Using RT-PCR and northern blot analyses we found that silencing of the human ELAC2 gene results in impaired 3' end of mt-tRNAs. We demonstrate this for several mitochondrial tRNAs, encoded on both mtDNA strands, including tRNA (Val) , tRNA (Lys) , tRNA (Arg) , tRNA (Gly) , tRNA (Leu(UUR)) and tRNA (Glu) . The silencing of the MRPP1 gene that encodes a subunit of mtRNase P resulted in inhibition of both 5' and 3' processing. We also demonstrate the double mitochondrial/nuclear localization of the ELAC2 protein using immunofluorescence. Our results indicate that ELAC2 functions as a tRNase Z in human mitochondria and suggest that mt-tRNase Z preferentially cleaves molecules already processed by the proteinaceous mtRNase P.

DGT and selective extractions reveal differences in arsenic and antimony uptake by the white icicle radish (Raphanus sativus).

Increasing soil contamination of arsenic (As) and antimony (Sb) is posing a serious concern to human health. Due to insufficient studies on Sb, the biogeochemical behaviour and plant uptake of Sb are assumed to be similar to that of As. As part of extensive research unravelling As and Sb biogeochemistry and plant uptake, the diffusive gradients in thin films (DGT) technique and sequential extraction procedure (SEP) were applied to evaluate As and Sb uptake by the white icicle radish (Raphanus sativus) cultivated in diluted cattle dip soils contaminated with As only and diluted mining soils contaminated with both As and Sb under agricultural conditions. Labile As and Sb in these soils measured by DGT (CDGT), soil solution (Csol), and SEP (CSEP-labile), were compared with As and Sb bioaccumulation in R. sativus tissues. Regardless of contamination sources and measurement techniques, the results showed that As was consistently more labile than Sb although total As concentrations in two soil types were lower than total Sb. Labile As in cattle dip soils was higher than that in mining soils, although there were no significant differences in soil As concentrations. The analysis of R. sativus tissues revealed that the overall As bioaccumulation was 4.5-fold higher than for Sb, and that As translocation to shoots was limited. In contrast, considerable Sb translocation to shoots was observed. The As and Sb bioaccumulation were strongly correlated with their CSEP-labile, CDGT, and Csol (R2 = 0.87-0.99), demonstrating the effectiveness of these techniques in predicting As and Sb in the white icicle radish. Compared with the cherry bell radish previously studied, the white icicle radish exhibited higher bioaccumulation factors (BAF) for Sb, but lower BAF for As, and lower translocation of As and Sb to shoots, providing understanding of how As and Sb are accumulated by radish cultivars.

Determination of antidepressants in human postmortem blood, brain tissue, and hair using gas chromatography-mass spectrometry.

A gas chromatographic-mass spectrometric (GC-MS) method in positive ion chemical ionization mode in combination with a solid phase extraction was optimized for new-generation antidepressants and their metabolites in postmortem blood, brain tissue, and hair. Twelve antidepressants and their active metabolites (i.e., mirtazapine, viloxazine, venlafaxine, citalopram, mianserin, reboxetine, fluoxetine, fluvoxamine, sertraline, maprotiline, melitracen, paroxetine, desmethylfluoxetine, desmethylmianserin, desmethylmirtazapine, desmethylsertraline, desmethylmaprotiline, desmethylcitalopram, and didesmethylcitalopram) could be quantified. In this article, in addition to the validation of the GC-MS method, four postmortem cases are discussed to demonstrate the usefulness of the described method in forensic toxicology. In these cases, sertraline, fluoxetine, citalopram, and trazodone in combination with their active metabolites were quantified. Blood concentrations ranged from subtherapeutic to toxic concentrations, while brain to plasma ratios ranged from 0.8 to 17. Hair concentrations ranged from 0.4 to 2.5 ng/mg depending on the compound and hair segment.

As and Sb are more labile and toxic to water spinach (Ipomoea aquatica) in recently contaminated soils than historically co-contaminated soils.

Elevated concentrations of As and Sb impact environmental quality and human health. In this study total and bioavailable As and Sb were measured from recently and historically contaminated soils and the phytotoxicity of these soils was evaluated with Ipomoea aquatica (35-d exposure from germination) using biomass, length of plant tissues and photosynthetic efficiency. As and Sb were both present within the soil (co-contaminated). The bioavailable As and Sb in soils were determined by a Sequential Extraction Procedure (SEP) and compared to total soil concentrations and bioaccumulation in the edible parts of I. aquatica. For both As and Sb, bioavailable concentrations increased proportionally with the total soil concentrations and greater bioavailability in recently contaminated soil was observed. Tissue dry mass and length drastically reduced with increasing total and SEP-bioavailable As and Sb soil concentrations. The total soil concentration was a less sensitive measure of the phytotoxicity of As and Sb than the bioavailable fraction. Shoot length was inhibited by 50% (EC50) at bioavailable As concentrations of 80-96 mg kg-1 in both recently and historically contaminated soils; however, bioavailable Sb EC50 for shoot length was achieved at lower bioavailable concentrations, 96 (42-219) and 12 (7-19) mg kg-1 in recently contaminated soils and historically contaminated soils, respectively. Shoot biomass was inhibited by 50% (EC50) at bioavailable As concentrations of 11 (4-30) and 49 (37-65) mg kg-1 in recently and historically contaminated soils, respectively whereas this occurred at much lower bioavailable Sb concentrations, 2-5 mg kg-1 in both recently and historically contaminated soils. Aging is important in contaminated soils, it decreases the lability of As and Sb and hence their bioavailability to agricultural plants, thus posing a lower risk of exposure of these metalloids to humans through agricultural plants grown in contaminated soils.

Radiolocalization of human small cell lung cancer and antigen-positive normal tissues using monoclonal antibody LS2D617.

The murine monoclonal antibody LS2D617, which reacts with an antigen associated with human small cell lung carcinoma (SCLC), was tested in preclinical models to assess its potential for specific targeting of tumors in human SCLC cancer patients. LS2D617 detects a cell antigen on the surface of cultured SCLC and neuroblastoma cell lines. Scatchard analysis of the binding of LS2D617 to NCIH69 SCLC cells indicates an affinity constant of about 1 x 10(8) M-1 and an epitope expression level of approximately 2 x 10(6) antigenic sites/cell. Molecular weight analysis of the target antigen and antibody competition experiments showed that LS2D617 should be classified as a SCLC Cluster 1 antibody (i.e., reacts with the neural cell adhesion molecule). LS2D617 was labeled with 111In and tested for biodistribution (4, 24, 48, 72, and 96 h postinjection) in nude mice bearing the human SCLC NCIH69 tumor. Tumor values peaked at about 35% injected dose/g (Day 3) compared with about 8% injected dose/g for an irrelevant IgG1 antibody while normal tissue accumulation for both antibodies was about 2-8% injected dose/g. Immunohistochemical studies demonstrated that LS2D617 reacts with the central nervous system, peripheral nerves, endocrine tissues, and heart tissue of rabbits as it does in human tissues. The ability of LS2D617 to accumulate in vivo in normal tissues that express the specific target antigen was tested in rabbits. Rabbits given i.v. injections of 111In-LS2D617 or control labeled antibody were sacrificed at 48 h and tissues were examined by gamma well counting, autoradiography, and immunohistochemical staining for murine immunoglobulin. Specific uptake was seen in all sites defined as antigen positive by immunohistology (i.e., heart, liver bile duct, peripheral nerves, pituitary, adrenal), excepting the central nervous system (brain and spinal cord) which was inaccessible to antibody because of the blood brain barrier. The use of preclinical in vivo targeting models to assess tumor as well as antigen-positive normal tissue targeting should aid in the strategy of antibody-based therapeutic intervention of human cancer by providing insight into the potential for tumor targeting and normal tissue toxicity that may be encountered in the clinic.

Assessing the uptake of arsenic and antimony from contaminated soil by radish (Raphanus sativus) using DGT and selective extractions.

The enrichment of soil arsenic (As) and antimony (Sb) is putting increasing pressure on the environment and human health. The biogeochemical behaviour of Sb and its uptake mechanisms by plants are poorly understood and generally assumed to be similar to that of As. In this study, the lability of As and Sb under agricultural conditions in historically contaminated soils was assessed. Soils were prepared by mixing historically As and Sb-contaminated soil with an uncontaminated soil at different ratios. The lability of As and Sb in the soils was assessed using various approaches: the diffusive gradients in thin films technique (DGT) (as CDGT), soil solution analysis, and sequential extraction procedure (SEP). Lability was compared to the bioaccumulation of As and Sb by various compartments of radish (Raphanus sativus) grown in these soils in a pot experiment. Irrespective of the method, all of the labile fractions showed that both As and Sb were firmly bound to the solid phases, and that Sb was less mobile than As, although total soil Sb concentrations were higher than total soil As. The bioassay demonstrated low bioaccumulation of As and Sb into R. sativus due to their low lability of As and Sb in soils and that there are likely to be differences in their mechanisms of uptake. As accumulated in R. sativus roots was much higher (2.5-21 times) than that of Sb, while the Sb translocated from roots to shoots was approximately 2.5 times higher than that of As. As and Sb in R. sativus tissues were strongly correlated with their labile concentrations measured by DGT, soil solution, and SEP. These techniques are useful measures for predicting bioavailable As and Sb in the historically contaminated soil to R. sativus. This is the first study to demonstrate the suitability of DGT to measure labile Sb in soils.

Ileal recovery of nutrients and mucin in humans fed total enteral formulas supplemented with soy fiber.

The objective of this study was to determine whether soy fiber supplementation of total enteral nutrition formulas affected small intestinal recovery of nitrogen, amino acids, and carbohydrates or mucin output in eight human subjects (four males, four females) with ileostomies. The subjects ingested five test diets to provide 1.0-16.5 g soy fiber/L for 2 consecutive days each. The five test diets, each with a different soy fiber content were formulated by varying the relative proportion (1:0, 0.75:0.25, 0.5:0.5, 0.25:0.75, and 0:1) of two commercially available formulas. Effluent dry matter increased with soy fiber intake as a result of the quantitative recovery of soy fiber nonstarch polysaccharide. Nitrogen and amino acid digestibilities were unchanged by the ingestion of soy fiber. Nutrients from the total enteral nutrition formulas were well digested in the small intestine with true nitrogen and amino acid digestibilities in excess of 90% and starch digestibilities approaching 100%. Ileal mucin output was higher in male subjects and was unaffected by soy fiber intake. In summary, soy fiber supplementation does not compromise protein and carbohydrate absorption from the small intestine of humans.

Response of amoeboid and ramified microglial cells to lipopolysaccharide injections in postnatal rats--a lectin and ultrastructural study.

The present study describes the response of amoeboid and ramified microglial cells in the corpus callosum to intraperitoneal lipopolysaccharide injections in postnatal rats as examined by lectin histochemical staining and electron microscopy. In 1 day old rats receiving endotoxin injections and sacrificed at various time intervals, the lectin labelling of amoeboid/ramified microglia was greatly enhanced. The increased labelling persisted in some ramified microglia in rats killed at 14 and 21 days of age; otherwise in normal or control animals of the corresponding stages, the same cells were very weakly stained. In rats killed at 2 days of age after intraperitoneal lipopolysaccharide injection, the number of microglia appeared to increase, but this was reduced at 7 days of age. The lectin-labelled amoeboid/ramified microglia were frequently seen adherent to the outer walls of the callosal blood vessels where infiltrated lymphocytes were also observed. Ultrastructurally, some lectin-labelled microglial cells underwent degeneration and were engulfed by other lectin-positive cells. After endotoxin injections, microglial cells, notably the amoeboid form, showed extensive ruffling at their cell membrane, massive accumulation of lysosomes and increased staining of lectin at their Golgi apparatus. A similar lectin labelling pattern was also observed in ramified microglia of lipopolysaccharide-injected rats. It is concluded that both amoeboid and ramified microglial cells in postnatal rats responded to endotoxin injections as reflected by their enhanced lectin labelling at the surface membrane, lysosomes and Golgi apparatus. It is suggested that such changes may be involved in synthesis and/or modification of galactosyl glycoconjugates probably for the increased production of membranous glycoproteins or lysosomal enzymes.

Evaluation of the 15N-isotope dilution technique for determining the recovery of endogenous protein in ileal digesta of pigs: effect of the pattern of blood sampling, precursor pools, and isotope dilution technique.

The 15N-enrichments (atom percentage excess) were determined in the plasma free amino acids of blood samples taken at the time of feeding and in samples taken hourly and pooled over 12 h, as well as in ileal digesta, crude mucin, and bacteria collected at the distal ileum of pigs fed barley while continuously administered [15N]leucine intravenously. The branched-chain amino acids were the only indispensable amino acids to exhibit incorporation of 15N (P < .05). All dispensable amino acids exhibited some incorporation. Enrichments in free leucine and alanine were higher (P < .02) in blood samples taken at the time of feeding, compared to those in pooled blood samples, resulting in an underestimation of the endogenous ileal recoveries of these amino acids. Enrichments in amino acids in crude mucin were usually similar to those in pooled plasma samples, providing some support for the use of plasma free amino acids to estimate enrichments in endogenous amino acids in ileal digesta. Enrichments in bacteria were not different (P > .05) from those in ileal digesta. The recoveries of endogenous amino acids in ileal digesta determined with the [15N]leucine and 15N-amino acid dilution techniques demonstrate the overestimation of these criteria with the 15N-isotope dilution technique, applied in its current form, and suggest that modifications in the composition of endogenous protein can occur when pigs are fed protein-containing diets. These study supports the use of 15N-isotope dilution techniques, with modifications, for determining the recovery of endogenous protein in ileal digesta of pigs fed protein-containing diets.

15N-leucine and 15N-isoleucine isotope dilution techniques versus the 15N-isotope dilution technique for determining the recovery of endogenous protein and amino acids in digesta collected from the distal ileum in pigs.

Twelve gilts, with an average initial BW of 38 kg, were fitted with simple T-cannulas at the distal ileum and two catheters in the external jugular veins. The animals were fed twice daily (0800 and 2000) 700 g of one of four diets containing either soybean meal, canola meal, wheat, or barley as the sole protein source. 15N-leucine was infused continuously for 9 d at a rate of 40 mg/kg of BW daily via one of the jugular catheters. Blood samples were taken during feeding. Ileal digesta samples were collected continuously for 24 h on d 7 and 9 of the infusion period. 15N-enrichment excess in leucine and isoleucine in the trichloroacetic acid (TCA)-soluble fraction of blood and in digesta were measured using single-ion monitoring gas chromatography-mass spectrometry. Assuming that the 15N-enrichment excess in leucine and isoleucine in the TCA-soluble fraction of the blood is similar to that in endogenous protein secreted into the digestive tract and that the amino acid composition of endogenous protein is constant, the contribution of endogenous to total protein in ileal digesta was calculated using the 15N-isotope dilution technique for leucine and isoleucine, respectively. These contributions were much smaller for the 15N-leucine than for the 15N-isoleucine isotope dilution technique: 7.1 to 11.0 vs 21.8 to 24.9 g of protein/kg of DM intake. The values obtained with the 15N-isoleucine isotope dilution technique were close to those obtained with the 15N-isotope dilution technique as described in a previous publication.

Evaluation of the 15N-isotope dilution technique for determining the recovery of endogenous protein in ileal digestion of pigs: effect of dilution in the precursor pool for endogenous nitrogen secretion.

Three barrows, average initial BW of 35 kg, were fitted with a re-entrant cannula at the distal ileum and catheters in each of the external jugular veins. The barrows were fed twice daily a diet containing barley as the sole source of protein. A 1-d intravenous infusion of saline was followed by an 8-d continuous infusion of [15N]leucine at a rate of 30 mg/(kg BW x d). Blood samples, taken hourly for 9 d, were pooled over the 12-h period between feeding. Ileal digesta were collected hourly on d 3 and 8 of the [15N]leucine infusion and pooled over 12 and 24 h. Enrichments (atom percentage excess 15N) in nitrogen (N), leucine, isoleucine, valine and alanine were measured in the trichloroacetic acid (TCA)-soluble and -insoluble fractions of plasma and in ileal digesta. Although the enrichments in N were similar in all pools, enrichments in amino acids in the TCA-soluble fraction of plasma were at least twice that in the TCA-insoluble fraction and in ileal digesta. The estimated contributions of endogenous N and amino acids to total N and amino acids in ileal digesta were 82.3 +/- 9.38, 39.0 +/- 3.83, 43.8 +/- 6.50, 51.9 +/- 3.24, and 51.9 +/- 9.80 for N, leucine, isoleucine, valine and alanine, respectively. The results from this study indicate that enrichments in total N in the TCA-soluble fraction of plasma may not accurately reflect enrichments in endogenous N secreted into the intestinal lumen. This factor should be considered when using the 15N-isotope dilution technique to estimate the recovery of endogenous protein in ileal digesta of pigs fed protein-containing diets.

Determination of apparent ileal amino acid digestibility in pigs: effect of dietary amino acid level.

Studies were carried out to investigate the effect of dietary amino acid level on apparent ileal amino acid digestibility. Six barrows, average initial BW 35 kg, were fitted with a simple T-cannula at the distal ileum and fed six diets according to a 6 x 6 Latin square design. Six cornstarch-based diets containing six levels of CP from SBM (4, 8, 12, 16, 20, and 24% CP, respectively) were formulated. Chronic oxide was included as a digestibility marker. Each experimental period consisted of 8 d. After a 6-d adaptation period, ileal digesta were collected for 24 h during d 7 and 9 at 2-h intervals. The pigs were fed twice daily, equal amounts, at 0800 and 2000. The dietary allowance was 1,600 g/d during the first period and increased by 100 g each following period. There was a quadratic increase (P < .05) in apparent ileal amino acid digestibility as the dietary CP content was increased from 4 to 24%. Initially, the apparent ileal amino acid digestibilities increased sharply then gradually reached their plateaus, after which there were no further increases and the digestibility values became independent of the dietary amino acid levels. The lower end points of 95% confidence intervals of the plateau ileal digestibility values were defined to be the initial plateau digestibilities. The dietary CP and amino acid contents, corresponding to the initial plateau digestibility values, represent the dietary threshold levels.(ABSTRACT TRUNCATED AT 250 WORDS)

[Psychiatric service in Denmark]. / Psykiatriske tilsyn i Danmark.

The aim of the study was to assess the present psychiatric services in somatic departments in Denmark. A questionnaire was sent to all psychiatric departments in Denmark. All questionnaires were returned. During 1996 11,602 adult psychiatric consultations covering 87% of all beds in general hospitals in Denmark were performed. Mean and SD of the consultancy frequency, i.e. consultations/somatic bed/year, were 0.62 (0.34). The consultancy frequency was significantly higher, when the service included somatic emergency rooms or outpatients, or if the consultant performed the consultation together with a team member. Furthermore, it was significantly higher, when the consultant attended treatment conferences at the somatic departments or yielded supervision. The frequency of the psychiatric consultations performed by the staff from the former State Mental Hospitals was half of the frequency of the psychiatric departments at General Hospitals.

[Dementia and psychiatric service]. / Demens og psykiatrisk service.

The study objective was to describe the service provision in geriatric psychiatry in 1997 and the trends in admission patterns for the elderly to psychiatric hospitals in Denmark from 1988 to 1996. Information concerning admission pattern was obtained from the Danish Psychiatric Case Register. The information on the supply of geriatric psychiatric services was collected by a questionnaire to the individual geriatric psychiatric departments. All geriatric psychiatric departments in Denmark have been identified. The number of demented patients admitted to psychiatric hospitals decreased considerably as did the length of stay for demented patients admitted from 1988 to 1996. For all other diagnoses the number of admissions increased in the same period. Four counties out of 14 did not have a special unit for geriatric psychiatry. There were considerable geographical variations in supply as well as target groups in the counties that supplied geriatric psychiatric service. The unequal access to geriatric psychiatric services and variations in target groups underlines the need for a discussion of future directions for this service provision.