The Role of Negative Affect and Self-Concept Clarity in Predicting Self-Injurious Urges in Borderline Personality Disorder Using Ecological Momentary Assessment.

Deficits in identity as well as negative affect have been shown to predict self-injurious and suicidal behaviors in individuals with borderline personality disorder (BPD). However, less is known about the interactive effects of these two predictors. We examined the moderating effect of a particular component of identity, self-concept, on the relationship between negative affect and self-injurious urges utilizing ecological momentary assessments. Outpatients diagnosed with either BPD (n = 36) or any anxiety disorder but no BPD (n = 18) completed surveys throughout the day over a 21-day period. Higher levels of momentary negative affect predicted greater subsequent urges to self-injure, but only when self-concept clarity was low (z = -3.60, p < .01). This effect did not differ between diagnostic groups. The results suggest that self-concept clarity has a protective effect against self-injurious urges in light of high negative affect, and that this effect may be transdiagnostic.

Transference, transference interpretations, and transference-focused psychotherapies.

The concept of transference and the use of transference interpretations in psychotherapy have been highly controversial topics garnering frequent attention both within psychoanalysis and across multiple orientations of psychotherapy. In this article, we review the empirical evidence as it bears on this controversy and discuss the implications of the evidence for psychoanalysis, psychodynamic psychotherapy, and therapy in general. We provide a brief historical and contextual overview, followed by a discussion of the development of the concept of transference. We then discuss the evidence for the concept of transference from basic psychological research and contend that these findings are not only consistent with a social-cognitive and information processing model, but that they may also indicate conflict and defensive processes suggestive of a dynamic transference process model. We continue with a discussion of the evidence for the concept of transference from psychotherapy research and examine process findings relating to the use of transference interpretations and transference-focused psychotherapies. Finally, we present the implications of this emerging evidence for clinical practice.

Prognostic role of pneumonia in supracricoid and supraglottic laryngectomies.

The goal of this study was to identify host and tumour factors associated with postoperative pneumonia (PP) in a selected population of laryngeal cancer patients, treated by partial laryngectomy in 20 years at our Institution and to assess its potential prognostic impact. Clinical records of 416 consecutive patients were retrospectively reviewed. Tobacco consumption, body mass index (BMI), previous pulmonary disease, age, sex, preoperative blood gas analysis values, tumour stage and type of surgery were tested as potential risk factors for PP. Finally, the prognostic impact of these variables, including PP, in terms of disease-free and actuarial survival by Kaplan-Meier and Cox analyses were evaluated. PP developed in 73 patients (16.8%). We identified two groups of patients: 26 patients experienced an early PP within the first 7-9 days after surgery, whilst 44 experienced an ab ingestis PP following attempts of oral food intake restoration, three patients died for PP related sepsis. At multivariate Cox analysis, age older than 60 years and BMI greater than 30 were statistically associated with early PP; whereas male gender and laryngectomy with neck dissection were statistically related to a higher risk of ab ingestis PP. Interestingly, the occurrence of early PP was a negative independent prognostic factor for 5-years disease-free and actuarial survival (p=0.049 and p=0.001, respectively). The occurrence of early-onset pneumonia in laryngeal cancer patients selected for conservative laryngectomies is predictable and associated with poor clinical outcome.

Evolution of elective neck dissection in N0 laryngeal cancer.

Management of cervical lymph node metastasis is one of the most challenging problems facing clinicians dealing with head and neck cancer. A retrospective evaluation has been made of results in N0 laryngeal cancer patients treated from 1978 to date by comparing historical data reported in related papers previously published by our institution. The medical records of 2207 consecutive patients with cN0 SCC of the larynx were used as the source of data in the present study. Together with primary treatment, 759 (34.4%) received at least unilateral elective neck dissection, while the remaining 1448 (65.6%) were admitted to a wait-and-see protocol. Overall, in the electively dissected patients (ED): 128 (16.9%) cases were submitted to classical radical neck dissection, while 403 (53.1%) cases were submitted to functional neck dissection (FND) and 228 (30.0%) cases to jugular node dissection (JND, removing Level II, III and IV). In 125 of the ED group, a neck procedure on the contralateral N0 neck was associated, of which 15 were RNDs, 35 FNDs and 75 JNDs, respectively. Based on this large series population, the change in the philosophy was evaluated concerning elective neck treatment in N0 laryngeal cancer, from RND through FND towards JND. As far as concerns the reliability as a staging procedure, no statistically significant difference was found between RND, FND and JND (p = 0.794). The 5-year neck recurrence rate, as estimated by the Kaplan Meier, method, for all ED patients, was 7.7%. No significant difference in the rate of 5-year neck recurrence was detected between RND, FND and JND groups (p = 0.178). In the survival curves, no differences, in terms of actuarial survival by Kaplan Meier analysis, were observed, in our series, as far as concerns type of elective neck dissection performed (p = 0.222). In conclusion, following a critical revision of 25 years' experience, at our Institution, in the management of cN0 necks in laryngeal cancer patients, definitive changes were observed in the surgical approach to the treatment of occult disease in cN0 cases. JND, compared to more extensive neck dissections, did not show statistically significant differences in terms of neck control (p = 0.233), in terms of impact on survival (p = 0.122) and in terms of accuracy as staging procedure (p = 0.794).

Effect of protein dose on serum glucose and insulin response to sugars.

To clarify the effects of protein on insulin and glucose response to sugars, 14 healthy normal-weight males and females were fed test meals containing 0, 15.8, 25.1, 33.6, and 49.9 g protein along with approximately 58 g carbohydrate. Serum samples were obtained at fasting time zero and 15, 30, 60, and 120 min postprandial. Mean areas of the glucose curves above fasting decreased with increasing protein dose. Protein-containing meals produced significantly lower (p less than 0.01) areas than the protein-free meal and the relationship between blood glucose area and protein dose was significant (p less than 0.001). Protein-containing meals produced significantly greater (p less than 0.01) insulin areas compared with the protein-free meal. However, no differences in insulin areas among the protein-containing meals were observed. These data support previous studies showing a blood glucose moderating and insulin-enhancing effect of protein ingestion.

Effect of increasing levels of hard wheat fiber on fecal weight, minerals and steroids and gastrointestinal transit time in healthy young women.

Hard red wheat bran (HRWB) baked in a yeast-leavened bread was fed to 36 healthy young college women consuming a basal diet of traditional foods, which contained 15 +/- 3 g/d dietary fiber (DF). Three levels of HRWB were added supplying, respectively, 5.7, 17.1 and 28.5 g/d DF; an additional treatment group did not receive any HRWB. Fecal collections were carried out in the last 5 d of treatment. Fecal wet weight, fecal dry weight and fecal ash increased significantly for each increase in HRWB (P less than 0.05). Fecal dry matter percent changed significantly only at the highest level of HRWB (P less than 0.05). After accounting for the minerals in the HRWB, there was an increased fecal loss of Ca, but not of Zn, Cu, Fe or Mg compared to the women fed no HRWB. HRWB at a level of 17.2 g/d induced faster transit times (TT) than no HRWB and 66 g/d HRWB induced faster TT than either 17.2 or 39.6 g/d HRWB (P less than 0.05). Total daily fecal steroids were not altered by changes in HRWB. Daily total bile acid excretion increased significantly (P less than 0.05) at the two higher levels of HRWB due primarily to higher excretion of chenodeoxycholic acid.

Repletion and depletion of serum alpha and beta carotene in humans with carrots and an algae-derived supplement.

A 10-day low-carotene diet phase (LCD), followed by a 7-day treatment phase (TP) and then another LCD, was adhered to by 32 adult human subjects. Serum alpha carotene (SAC) and serum beta carotene (SBC) levels were examined using HPLC and found to have decreased 44.7% and 35.8% respectively in the first LCD. Alpha and beta carotene, from algae-derived capsules and raw carrots, significantly increased SAC and SBC levels during the TP. Half-lives of SAC and SBC averaged 7.8 days and 12.4 days respectively during the two LCD. Serum vitamin A remained unchanged throughout the study.

Multivitamin-mineral supplementation: effects on blood chemistries of college-age women.

Forty-two female college students, age 18-29 yr. and consuming nutritionally balanced meals in the college cafeteria participated. Subjects discontinued all vitamin-mineral supplements (VMS) for 17 days and were randomly assigned to one of two treatments, either a placebo, or VMS supplying the United States Recommended Daily Allowance (USRDA) of all vitamins, zinc, iron, iodine, copper, and 60% of the USRDA of calcium, 50% of magnesium and 45% of phosphorus. Treatments were consumed for 77 days. Fasting pre-and post-treatment blood chemistries were compared. VMS yielded significant increases (p less than 0.05) in serum vitamin B-12 (+25.05 pg/ml), vitamin C (+0.35 mg/dl) and folate (+7.40 ng/ml). No significant changes (p greater than 0.05) in hematological or other blood chemistries were observed. Significant decreases in the number of below-normal serum indicators of vitamin status (p less than 0.05) and iron status (p less than 0.005) were seen with VMS. No significant changes were seen with placebo (p greater than 0.05).

Skeletal muscle leucine incorporation and testosterone uptake in exercised guinea pigs.

We examined the changes induced by daily treadmill exercise on body weights, plantaris muscle weights, plantaris protein concentrations, and L-leucine-4,5-3H incorporation into plantaris muscles of normal and castrated young male guinea pigs and of castrated animals receiving testosterone replacement therapy, and compared the testosterone-1,2-3H uptake by plantaris muscles of trained normal guinea pigs to that of untrained animals. Trained animals exhibited significantly lower body and muscle weights and greater labeled leucine incorporation into sarcoplasmic and myofibrillar proteins but did not show significant changes in protein concentrations or labeled testosterone uptake. The level of physical activity of the young animals studied appeared to be more important than gonadal endocrine function in altering protein metabolism and muscle and body weights. Because hypertrophy did not occur in the trained plantaris muscles, which had elevated rates of labeled leucine incorporation, it appears that the trained animals had a higher muscle protein turnover rate. It seems unlikely that testosterone plays an important role in these activity-related phenomena.

Digestive Secretion of Dionaea muscipula (Venus's Flytrap).

The digestive fluid of Dionaea muscipula has been studied with respect to its protein content as a function of time after entrapment of protein material and some enzymes of the secretion. Maximum secretion of enzyme occurs within the first 3 days of the digestive cycle and protein reaches its maximum at 4 days. Phosphatase, proteinase, nuclease and amylase have been observed in the secretion. The enzymes have acid pH optima and the proteinase has a molecular weight of about 40,000.