Appropriateness of psychopharmacological therapies to psychiatric diagnoses in persons with autism spectrum disorder with or without intellectual disabilities: a cross-sectional analytic study.

BACKGROUND: Observational studies highlighted high rates of psychotropic medication in persons with autistic spectrum disorder (ASD) with or without intellectual disability, which seems to be associated with the management of problem behaviors more than co-occurrent psychiatric disorders. The purpose of the study is to investigate psychopharmacology use and diagnoses of co-occurrent psychiatric disorder (PD) in persons with ASD attending a public mental health service in Emilia Romagna, Italy. METHODS: The present study is a multicenter, cross-sectional study. RESULTS: 275 persons out of 486 (56.5%) resulted to receive at least one psychotropic drug, compared to 74 persons (15.2%) that were diagnosed with a PD. 63.6% were on poly-pharmacotherapy (2-10 compounds), with 37.8% receiving 3 or more medications. Antipsychotics were the most frequently prescribed class of psychotropic drugs (89%), followed by antiepileptics/mood stabilizers/lithium (42.1%) and anxiolytics (BDZ) (38.5%). Most common psychiatric disorders were psychotic disorders (29.7%), followed by anxiety disorders (17.5%), bipolar disorders (12.2%), and depressive disorders (9.4%). CONCLUSIONS: Our findings support earlier research showing that many individuals with ASD receive pharmacotherapy without being diagnosed with a co-occurring psychiatric disorder, indicating that the main reasons for prescription and the type of compound frequently have little to no link with specific psychopathology.

Very low voltage single drive domain inverted LiNbO(3) integrated electro-optic modulator.

Domain inversion is used in a simple fashion to improve significantly the performance of a waveguide electro-optic modulator in z-cut LiNbO(3). The waveguide arms of the Mach-Zehnder interferometer are placed in opposite domain-oriented regions under the same, narrower and more efficient electrode, so that opposite phase shifts (push-pull effect) can still be achieved despite the arms being subjected to the same electric field. Switching voltages close to 2 V are obtained, which allow 10Gb/s modulation with inexpensive drivers, such as those used for electro-absorption modulators, which deliver driving voltages well below 3V.

Variables associated with the hospitalization of psychiatric emergencies evaluated in the community.

We investigated hospitalization factors in acutely ill patients visited by psychiatrists at home. A series of 100 consecutive calls for psychiatric emergencies of a community mental health centre were investigated with a structured evaluation of psychiatric symptoms and aggressiveness (IEF, GAS, and VSAS). First order interactions were tested, and selected variables were tested with logistic regression analysis. Admission was significantly associated with GAS scores (low scores were found in 92.6% of admitted patients vs. 43.8% of patients not admitted), paranoid delusions (66.7 vs. 39.7%), and lack of social support (70.4 vs. 30.1%). Multivariate analysis confirmed a significant independent effect only for low GAS score and lack of social support. The study replicated some findings from research on hospitalization in emergency wards, while other factors, such as 'diagnosis' and 'suicide risk', were not significant.

Chromogranin-A expression in neoplastic neuroendocrine cells and prognosis in colorectal cancer.

AIMS: Chromogranin-A (CG), a cytoplasmic glycoprotein, is one of the markers most frequently used to identify the presence of neuroendocrine cells in the human gastrointestinal tract. Several authors have identified a subgroup of colorectal cancer patients with a sever prognosis whose tumors contained neuroendocrine CG-positive cells. In the present study, CG expression in 100 patients with colorectal adenocarcinoma treated from January 1983 to December 1988 with potentially curative surgery was analyzed and correlated with other prognostic factors and 5-year survival rate. METHODS: Samples tested immunohistochemically for CG were divided into three groups: I) negative; II) less than 1 CG-positive cell/mm2; III) more than 1 CG-positive cell/mm2. RESULTS: Of 100 patients with primary colorectal adenocarcinoma, 79% had tumors comprised of CG-negative cells, 17% had rare CG-positive cells, and 4% of cases could be classified in group III. No significant relation between CG expression and location of primary tumor, bowel wall infiltration, stage of disease or tumor grade according to Broders and Jass was observed. The 5-year survival was 53% and 52% for CG-positive and CG-negative lesions, respectively. Survival of patients with Dukes-Kirklin stage C and D was comparable in patients with CG-positive (33.3%) and CG-negative (30%) tumors. CONCLUSIONS: CG expression cannot, at present, be recommended as a marker to identify prognostic subgroups in colorectal cancer patients.

Lipoleiomyoma of the uterus.

We report a case of uterine lipoleiomyoma. The tumor contained mature spindled muscle cells connective tissue and mature lipocytes which were positive for vimentin, desmin and myoglobin. This indicated the possibility that the lipoleiomyoma derived from a multipotential undifferentiated mesenchymal cell.

Affective disorders among elderly general practice patients. A two-phase survey in Brescia, Italy.

BACKGROUND: We investigated the prevalence of depression among 255 elderly general practice patients and the practitioners' performance in identifying depression. METHOD: Elderly patients attending 14 general practices entered a screening phase with GHQ-12 and MMSE. Those positive were then interviewed with GMS and HAS. RESULTS: DSM-III-R major depression affected 22.4%, dysthymic disorder 6.3%, not otherwise specified (n.o.s.) depression 7.1%. General practitioners performed fairly well: identification index 88.4%, accuracy 0.49, bias 1.85. CONCLUSIONS: Depression was markedly high. A selective progression of depressed elderly from the community to general practitioners is implied.