Human amygdala functional network development: A cross-sectional study from 3 months to 5 years of age.

Although the amygdala's role in shaping social behavior is especially important during early post-natal development, very little is known of amygdala functional development before childhood. To address this gap, this study uses resting-state fMRI to examine early amygdalar functional network development in a cross-sectional sample of 80 children from 3-months to 5-years of age. Whole brain functional connectivity with the amygdala, and its laterobasal and superficial sub-regions, were largely similar to those seen in older children and adults. Functional distinctions between sub-region networks were already established. These patterns suggest many amygdala functional circuits are intact from infancy, especially those that are part of motor, visual, auditory and subcortical networks. Developmental changes in connectivity were observed between the laterobasal nucleus and bilateral ventral temporal and motor cortex as well as between the superficial nuclei and medial thalamus, occipital cortex and a different region of motor cortex. These results show amygdala-subcortical and sensory-cortex connectivity begins refinement prior to childhood, though connectivity changes with associative and frontal cortical areas, seen after early childhood, were not evident in this age range. These findings represent early steps in understanding amygdala network dynamics across infancy through early childhood, an important period of emotional and cognitive development.

Viral load strategy: impact on risk behaviour and serocommunication of men who have sex with men in specialized care.

BACKGROUND: Incidence and prevalence of HIV are continuously high in German men, who have sex with men (MSM). Different transmission risk minimizing strategies have been observed. The viral load strategy rates patients unlikely to be sexually infectious if their viral load under effective therapy is stably suppressed during 6 months and no other sexually transmitted infections are present. OBJECTIVES: We aim to objectify the current popularity of the viral load strategy, the adherence to basic conditions and its impact on risk behaviour and serocommunication. Until now, no data on a German sample of HIV-positive MSM in regular specialized outpatient care are available. METHODS: Cross-sectional study with group comparisons between user group and non-user-group of the viral load strategy. Self-report questionnaires were conducted with 269 sexually active German HIV+MSM under effective treatment in specialized outpatient care. Structured interviews gathered additional information about approach to and realization of definite action levels concerning sexual risk behaviour and transmission risk minimizing strategies. RESULTS: Twenty-seven of 269 participants (10%) affirmed knowledge of having an undetectable viral load and stated this to be criteria for unprotected sexual behaviour. This subgroup reported more unprotected insertive (P = 0.018) and receptive anal intercourse (P = 0.042), more anonymous sex partners (P = 0.008) and less consistent safer sex. Analysing serocommunication, less addressing HIV/AIDS in general (P = 0.043) and less disclosing to sex partners (P = 0.023) was found, especially in anonymous settings. Differentiating serocommunication characteristics, a focus on seroguessing was depicted. CONCLUSIONS: The user group of the viral load strategy is small. But a less frequent, more reactive and assumptive serocommunication leads to an imprecise information exchange paired with higher frequency of risky behaviour, especially in anonymous settings, where frank serocommunication is often avoided. The targeted group of the viral load strategy diverges greatly from the user group.

YouTube as a crowd-generated water level archive.

In view of the substantial costs associated with classic monitoring networks, participatory data collection methods can be deemed a promising option to obtain complementary data. An emerging trend in this field is social media mining, i.e., harvesting of pre-existing, crowd-generated data from social media. Although this approach is participatory in a broader sense, the users are mostly not aware of their participation in research. Inspired by this novel development, we demonstrate in this study that it is possible to derive a water level time series from the analysis of multiple YouTube videos. As an example, we studied the recent water level rise in Dahl Hith, a Saudi Arabian cave. To do so, we screened 16 YouTube videos of the cave for suitable reference points (e.g., cave graffiti). Then, we visually estimated the distances between these points and the water level and traced their changes over time. To bridge YouTube hiatuses, we considered own photos taken during two site visits. For the time period 2013-2014, we estimate a rise of 9.5m. The fact that this rise occurred at a somewhat constant rate of roughly 0.4m per month points towards a new and permanent water source, possibly two nearby lakes formed from treated sewage effluent. An anomaly in the rising rate is noted for autumn 2013 (1.3m per month). As this increased pace coincides with a cluster of rain events, we deem rapid groundwater recharge along preferential flow paths a likely cause. Despite the sacrifice in precision, we believe that YouTube harvesting may represent a viable option to gather historical water levels in data-scarce settings and that it could be adapted to other environments (e.g., flood extents). In certain areas, it might provide an additional tool for the monitoring toolbox, thereby possibly delivering hydrological data for water resources management.

Substance use and sexual risk behaviour among HIV-positive men who have sex with men in specialized out-patient clinics.

OBJECTIVES: Unprotected sexual intercourse between men who have sex with men (MSM) is the most common route of HIV infection in Germany. Approximately 70% of newly infected people are MSM. Substance use is a determinant of sexual risk behaviour in the general population, but also in the MSM subpopulation. There are only a few studies, from the USA, on the correlation between substance use and sexual risk behaviour in HIV-infected MSM in specialized care. METHODS: In a German sample of 445 HIV-infected MSM treated in specialized out-patient clinics, the influence of substance use on sexual risk behaviour was investigated. Information was obtained from subjects using self-report questionnaires and a structured interview. RESULTS: Recreational drug use was common. The prevalences of cannabis addiction (4.5%), harmful use of cannabis (4.3%) and harmful use of dissociative anaesthetics (0.4%) were higher than in the general German male population. A substantial proportion of patients reported unprotected insertive (32.9%) and receptive (34.6%) anal intercourse during the last 12 months. Use of cannabis, amyl nitrite, dissociative anaesthetics, cocaine, amphetamines and erectile dysfunction medication was significantly correlated with unprotected sexual contacts. Substance use in the context of sexual activity significantly increased sexual risk behaviour. CONCLUSIONS: Substance use, especially in the context of sexual activity, should be taken into account when developing new prevention and intervention programmes aimed at reducing sexual risk behaviour in HIV-infected MSM currently in specialized care.

Thirty-six novel HLA alleles: 7 HLA-A, 11 HLA-B, 15 HLA-C and 3 HLA-DRB1.

Thirty-six novel human leukocyte antigen (HLA) alleles are described in this article: A*9225N, A*9234, A*030106, A*0337, A*2317, A*2480, A*3023; B*070206, B*0759, B*0761, B*0765, B*150106, B*1827, B*352002, B*3585, B*3943, B*4082, B*5151; Cw*0342, Cw*0343, Cw*0344, Cw*0428, Cw*0430, Cw*0433, Cw*050104, Cw*0519, Cw*060203, Cw*070109, Cw*070202, Cw*0750, Cw*0815, Cw*120306, Cw*1409; DRB1*0336, DRB1*0473 and DRB1*1382.

A scale for predicting nonphysiological contributions to pain.

BACKGROUND: Waddell and colleagues have identified a series of nonorganic signs which may appear in low back pain patients. The occurrence of these signs helps predict nonphysiological factors in the etiology of the pain. This study describes the development of the Waddell Equivalency Scale (WES) which elicits comparable information from patients with pain at other sites. METHODS: One hundred fifty patients presenting to a comprehensive pain clinic with low back pain were evaluated by physicians for Waddell signs and by psychologists using the Pain Presentation Inventory (PPI) developed by Psychometric Designs Inc. From three scales of the PPI, correlation, analysis of variance and multiple regression identified a formula which predicted Waddell signs from the PPI. The study was replicated on a new sample of 150 patients with almost identical results. The two samples were combined, again with highly similar results. An interpretive scheme was devised for use of the WES scale. RESULTS: The WES score derived from three scales of the PPI predicts the number of Waddell signs elicited from low back pain patients. Since it comes from a paper-and-pencil test rather than a physical examination, it can be used with patients whose pain locus is other than the back. CONCLUSIONS: Behavioral expectations and treatment plans, à la Waddell, can now be applied to patients with other than low back pain. Clinical application of the WES information over a variety of pain populations will be required to determine the parameters of its usefulness.

Giardiasis--a simple diagnosis that is often delayed.

In a retrospective study performed on 125 patients with histologically diagnosed giardiasis, it is shown that this disease can lead to a variegated picture involving numerous gastroenterological symptoms. The main symptoms noted were epigastralgia (41%), diarrhoea (32%), nausea and vomiting (23%), and loss of weight (20%). The material for histological diagnosis was obtained in hospitals in 49% of the cases, in the doctor's office in 32%, and in two gastroenterological rehabilitation centres in 19%. The average duration of symptoms before establishment of the diagnosis was 2.01 years (range: 1 week to 30 years). In only 8% of the cases was the disease preceded by a visit to an endemic area. Treatment with nitroamidazole preparations completely relieved symptoms in 78% of the patients and remained unsuccessful in 4%; for the remaining 18% of the patients, no follow-up data were available. On the basis of these results, it is recommended that in patients with upper abdominal pain, diarrhoea, loss of weight, meteorism, flatulence, nausea and vomiting, the possibility of giardiasis should be considered, and that during endoscopy, two or three forceps biopsies should be obtained from macroscopically normally-appearing mucosa of the descending part of the duodenum to enable a histological search for Giardia lamblia.

Localization of phosphoserine residues in the alpha subunit of rabbit skeletal muscle phosphorylase kinase.

The alpha subunit of skeletal muscle phosphorylase kinase, as isolated, carries phosphate at the serine residues 1018, 1020 and 1023. Employing the S-ethyl-cysteine method, these residues are found to be phosphorylated partially, i.e. differently phosphorylated species exist in muscle. Serine 1018 is a site which can be phosphorylated by the cyclic-AMP-dependent protein kinase. The serine residues 972, 985 and 1007 are phosphorylated by phosphorylase kinase itself when its activity is stimulated by micromolar concentrations of Ca2+. These phosphorylation sites are not identical to those found to be phosphorylated already in the enzyme as prepared from freshly excised muscle. A 'multiphosphorylation loop' uniquely present in this but not in the homologous beta subunit contains all the phosphoserine residues so far identified in the alpha subunit.

Reduced tolerance for heat stress environments caused by protective lotions.

There have been complaints of excessive heat after applying skin protective lotions. The purpose of this study was to determine if oil-base or alcohol-base protective lotions interfere with the body's cooling mechanisms during moderate work in heat stress conditions, and if so, then to identify the mechanisms. This was accomplished by evaluating the effect of lotions on thermoregulation as measured by rectal temperatures, local sweat rates, and total water losses during exercise at elevated temperatures. In comparison to the control, after about thirty minutes, the skin lotion tests resulted in a more hyperthermic condition, as measured by rectal temperatures.

[Chemotherapy of the non-small cell carcinoma of the lung with ifosfamide and cisplatin]. / Chemotherapie des nicht-kleinzelligen Karzinoms der Lungen mit Ifosfamid und Cisplatin.

80 patients with inoperable non-small cell bronchial carcinoma were treated, at an interval of 4 weeks between them, with ifosfamide (2 g/m2 on days 1-5) and cisplatin (75 mg/m2, day 1). All diagnoses had been confirmed histologically. The course of 72 patients (36 with squamous carcinoma, 25 with adenocarcinoma, two with alveolar-cell carcinoma and nine with large-cell carcinoma) could be evaluated. There were four complete and 21 partial remissions (response rate 35%). In a further 14 patients temporary arrest of tumor growth was registered. Median survival time of all patients was 8.3 months, for those with complete and partial remission 11.5 months. Patients in whom the tumor progressed lived on average 3.9 months. Age and general state of the patients, as well as histological tumor type, had no influence on the results of treatment. Patients in stage IV lived, at seven months, significantly less long than those with only loco-regional spread (11 months). Main side-effects were vomiting, bone-marrow depression and neuropathy. Urotoxicity was not significant, as a result of treatment with mesna. Remission rate and survival time of these patients corresponded with the results obtained with other cisplatin combinations.

[Diagnostic problems of hyperthyroidism in the older age group (author's transl)]. / Diagnostische Probleme der Hyperthyreose im höheren Lebensalter.

Seventy-seven patients aged more than 60 years from the iodine deficiency area of southern Lower Saxony with hyperthyroidism, diagnosed by assessment of thyroid parameters, showed a nonspecific disease picture with surprising frequency when compared with younger patients. Predominant characteristics were weight loss (86%), general weakness (78%), tachycardia (74%), reduced appetite (66%), exertional dyspnoea (60%), apathy, lack of initiative or depression (48%), and uncharacteristic abdominal complaints (20%). A goitre was not palpable in 30 patients (39%). Laboratory diagnosis was hampered by relative or absolute TBG deficiency and conversion inhibition in the form of a low-T3 syndrome as evidence of non-thyroidal changes in generalised disorders. Neither thyroxine nor triiodothyronine were increased in ten patients (13%). Only by additional routine estimation of the thyroxine-binding index (T3 in vitro test) as indicator of free binding capacity could the diagnosis be ascertained in these cases. The poor prognosis be ascertained in these cases. The poor prognosis of hyperthyroidism in the older age group necessitates generous use of specific diagnostic laboratory investigations in cases with suspicious symptoms.

Metabolic and clinical studies on patients with acromegaly treated with bromocriptine over 22 months.

In twenty-two patients with active acromegaly who were untreated or unsuccessfully operated or irradiated (mean growth hormone (GH) values greater than 4 ng/ml) the following investigations were performed: routine laboratory tests, tomography of pituitary fossa, oral glucose tolerance tests, TRH and other pituitary function tests and GH profiles over 5-10 h before and during bromocriptine treatment with daily doses between 7.5 and 50 mg. In seventeen patients GH was suppressed to less than 50% by bromocriptine, in thirteen of them it was normalized on at least one occasion. A TRH induced GH release was observed in all but two responders to bromocriptine before therapy. This effect of TRH was not blunted during treatment with bromocriptine and also in the two patients with negative tests before therapy a significant GH increase was observed. In no non-responder to bromocriptine was a significant increase of GH after TRH observed. One patient showed a secondary resistance to bromocriptine during a period of treatment with griseofulvin. In the remaining sixteen patients the GH suppression has been consistent for between 3 and 22 months. A single dose of pimozide abolished the bromocriptine effect on GH totally in one patient; in others a slight or no significant effect was observed. Tissue swelling and sweating decreased in all bromocriptine responders and glucose tolerance improved in five patients. In four diabetic patients a partial or full remission of diabetes occurred. Apart from postural hypotension after the first administration in two patients no other severe side effects have been observed. Sella size and the other pituitary functions did not change during the time of the study. It seems that a high percentage of acromegalics may be successfully treated with bromocriptine.

[Therapy of acromegaly using bromocriptine]. / Die Behandlung der Akromegalie mit Brompcriptin

Oral administration of 1.0 or 2.5 mg bromocriptine (CB 154: 2-brom-alpha-ergocryptine) in nine of twelve patients with active acromegaly resulted in a reduction of growth hormone level by 80-90% over 8-10 hours. During treatment for 2-9 months with daily doses of 4.0 to 10.0 mg bromocriptine, there was a sustained reduction of growth hormone levels in these patients. At the same time soft-tissue swellings and tendency towards sweating decreased. In two patients with diabetes mellitus the blood sugar profile improved and in one of them the insulin dose could be markedly reduced. The rise in growth hormone levels after TRH administration also occurred during bromocriptine treatment. In those patients in whom growth hormone levels failed to react to either acute or chronic administration of bromocriptine no rise followed TRH administration. It is possible that in these patients there is a hypophyseal adenoma without hypothalamic control. On gradually increasing dosage bromocriptine was tolerated without side effects.