Infection with CagA-positive Helicobacter pylori strain containing three EPIYA C phosphorylation sites is associated with more severe gastric lesions in experimentally infected Mongolian gerbils (Meriones unguiculatus).

Infection with Helicobacter pylori strains containing high number of EPIYA-C phosphorylation sites in the CagA is associated with significant gastritis and increased risk of developing pre-malignant gastric lesions and gastric carcinoma. However, these findings have not been reproduced in animal models yet. Therefore, we investigated the effect on the gastric mucosa of Mongolian gerbil (Meriones unguiculatus) infected with CagA-positive H. pylori strains exhibiting one or three EPIYA-C phosphorilation sites. Mongolian gerbils were inoculated with H. pylori clonal isolates containing one or three EPIYA-C phosphorylation sites. Control group was composed by uninfected animals challenged with Brucella broth alone. Gastric fragments were evaluated by the modified Sydney System and digital morphometry. Clonal relatedness between the isolates was considered by the identical RAPD-PCR profiles and sequencing of five housekeeping genes, vacA i/d region and of oipA. The other virulence markers were present in both isolates (vacA s1i1d1m1, iceA2, and intact dupA). CagA of both isolates was translocated and phosphorylated in AGS cells. After 45 days of infection, there was a significant increase in the number of inflammatory cells and in the area of the lamina propria in the infected animals, notably in those infected by the CagA-positive strain with three EPIYA-C phosphorylation sites. After six months of infection, a high number of EPIYA-C phosphorylation sites was associated with progressive increase in the intensity of gastritis and in the area of the lamina propria. Atrophy, intestinal metaplasia, and dysplasia were also observed more frequently in animals infected with the CagA-positive isolate with three EPIYA-C sites.  We conclude that infection with H. pylori strain carrying a high number of CagA EPIYA-C phosphorylation sites is associated with more severe gastric lesions in an animal model of H. pylori infection.

Participation restrictions in patients with psychiatric and/or cognitive disabilities: preliminary results for an ICF-derived assessment tool.

UNLABELLED: Participation in community life is a major challenge for most people with psychiatric and/or cognitive disabilities. Current assessments of participation lack a theoretical basis. However, the new International Classification of Functioning, Disability and Health (ICF) provides a relevant framework. AIMS: The present study used an ICF-derived assessment tool to activity limitations and participation restrictions in two groups of participants with disabilities linked to schizophrenia or traumatic brain injury respectively. METHODS: Twenty-six items (related to six ICF sections) were selected by reviewing the literature and gathering the clinician's opinions and representatives of patient associations. These items, yielded an ordinal rating of activity limitations, participation restrictions and contextual factors (social support, attitudes and, systems & politics). Special attention was paid to contextual and environmental factors. The final checklist (called the Grid for Measurements of Activity and Participation, G-MAP) was administered to 16 participants with traumatic brain injury (the TBI group) and 15 participants with schizophrenic disorders (the SD group). Psychometric assessments of cognition and, neurobehavioural, psychological and psychosocial functioning were also performed. RESULTS: The internal consistencies for activity limitations (Cronbach's alpha coefficient=0.89) and participation restriction (Cronbach's alpha coefficient=0.89) were satisfactory. We did not observe any significant differences between the two groups in terms of the psychometric test results. The G-MAP scores demonstrated that the two groups were confronted with the same limitations in self care, domestic life, leisure and community life (i.e., the intergroup differences were not statistically significant in Mann-Whitney tests). However, interpersonal relationships and economic and social productivity appeared to be more severely limited in the SD group than in the TBI group. Similarly, participation restrictions in domestic life, interpersonal relationships and economic and social productivity were more severe in the SD group than in the TBI group. CONCLUSION: G-MAP is a useful, feasible, relevant tool for performing a detailed, individualized assessment of participation restrictions in people with psychiatric and/or cognitive disabilities.

Association study of 37 genes related to serotonin and dopamine neurotransmission and neurotrophic factors in cocaine dependence.

Cocaine dependence is a neuropsychiatric disorder in which both environmental and genetic factors are involved. Several processes, that include reward and neuroadaptations, mediate the transition from use to dependence. In this regard, dopamine and serotonin neurotransmission systems are clearly involved in reward and other cocaine-related effects, whereas neurotrophic factors may be responsible for neuroadaptations associated with cocaine dependence. We examined the contribution to cocaine dependence of 37 genes related to the dopaminergic and serotoninergic systems, neurotrophic factors and their receptors through a case-control association study with 319 single nucleotide polymorphisms selected according to genetic coverage criteria in 432 cocaine-dependent patients and 482 sex-matched unrelated controls. Single marker analyses provided evidence for association of the serotonin receptor HTR2A with cocaine dependence [rs6561333; nominal P-value adjusted for age = 1.9e-04, odds ratio = 1.72 (1.29-2.30)]. When patients were subdivided according to the presence or absence of psychotic symptoms, we confirmed the association between cocaine dependence and HTR2A in both subgroups of patients. Our data show additional evidence for the involvement of the serotoninergic system in the genetic susceptibility to cocaine dependence.

Comorbilidad psiquiátrica en adolescentes consumidores de cannabis / Psychiatric comorbidity in cannabis users

El cannabis es la droga ilegal más consumida en el mundo. En los últimos años, se ha producido un aumento del consumo experimental, sobre todo en la población adolescente, y a edades cada vez más tempranas. Además del incremento del consumo, se está produciendo, especialmente en la población más joven, la disminución de la percepción de riesgo, que es mucho menor que para otras drogas. El objetivo del trabajo es describir una muestra de pacientes que realizan el seguimiento en un centro ambulatorio de dependencias para tratar un trastorno por dependencia de cannabis, y estudiar la interrelación entre el consumo de cannabis y los problemas psicosociales existentes, sobre todo en la población adolescente. Algunos estudios refieren que es difícil establecer la relación causal entre el consumo de cannabis y la existencia de consecuencias psicopatológicas; pero en lo que sí están de acuerdo varios autores es en que existe una estrecha relación entre ambos hechos. Los consumidores crónicos de cannabis presentan mayores dificultades y problemas psicosociales (AU)

Cannabis is currently the most widely consumed illegal drug. A rise in experimental use has taken place in the last years, mainly in the adolescent population. Meanwhile, the age of first use has decreased. In addition to an increase in cannabis use, a reduction in the perception of risk has been observed, in young populations specially, being much lower than for other drugs. The aim of this study is to describe a sample of outpatients with cannabis dependence disorder and to review the relationship between cannabis use and the existing psychosocial problems, mainly in the teenage population. Some studies report that causal relation between cannabis use and psychopathological consequences is difficult to establish, though many agree on the existence of a close association between both. Chronic cannabis users have greater difficulties and psychosocial problems (AU)

Manejo terapéutico y comorbilidades del paciente con dependencia a opiáceos, en programa de terapia sustitutiva: estudio PROTEUS / Therapeutic management and comorbid psychiatric disorders among opiate dependent patients in replacement therapy programs: The PROTEUS study

Objetivo. Analizar la necesidad de realizar un estudio epidemiológico de pacientes dependientes de opiáceos centrado en conocer más sus tratamientos, comorbilidades médicas y psiquiátricas. Material y métodos. Se examinó la necesidad de tener datos disponibles en nuestro medio sobre el manejo clínico de estos pacientes, el tipo de tratamiento y las posibles comorbilidades. No existen datos completos, representativos de los pacientes españoles. Por ello se seleccionó una muestra representativa a nivel nacional, a partir de la población de pacientes de pendientes de opiáceos en programas de mantenimiento con agonistas opiáceos que acudían a los centros asistenciales de drogodependencias. Resultados. El estudio final incluyó una población representativa de 624 pacientes dependientes a opiáceos en programas de mantenimiento con agonistas, procedentes de 74 centros de asistencia al dependiente de opiáceos de toda España. Conclusiones. Se conocen poco los datos sobre la comorbilidad psicopatológica y médica y los tratamientos farmacológicos en pacientes dependientes de opiáceos. Es necesario realizar un estudio epidemiológico amplio que actualice la realidad de la práctica clínica habitual del paciente dependiente de opiáceos en España (manejo terapéutico, comorbilidades, etc.) valore la gravedad de su adicción, la repercusión sobre el tipo de tratamiento, la presencia de patología dual y las repercusiones médicas (AU)

Background. The purpose of this study was to analyze the need for an epidemiological study of opiate-dependent patients aiming to improve the knowledge about their treatment and medical and psychiatric comorbidities. Matherial and methods. Data on clinical management, treatment type, and comorbidities in Spain were examined. There are no comprehensive data, representative of the Spanish patients. Therefore, a national representative sample was selected from opiate-dependent patients ongoing replacement therapy programs, attending care centers for opiate dependent patients. Results. The representative sample included 624 opiate-dependent patients ongoing opiate replacement therapy programs from 74 drug-dependent rehabilitation centers in Spain. Conclusions. Data on therapeutic management and psychiatric and medical comorbidities in opiate-dependent patients are not well known. There is a need for a comprehensive epidemiological study to update the reality of clinical practice of opioid dependent patients in Spain (therapeutic management, comorbidities, etc.) assessing the severity of their addiction, the impact on the type of treatment, the presence of dual pathology and medical implications (AU)

[Reliability and completeness of an integrated epidemiologic system of acute viral hepatitis]. / Attendibilità e completezza del sistema epidemiologico integrato dell'epatite virale acuta.

An integrated epidemiological system for the surveillance of acute viral hepatitis (Seiva) has been performed in Italy. Aim of the present work is to evaluate diagnostic completeness and reliability of the surveillance system in the Piedmont Region. Results show that 15% of Acute Viral Hepatitis are not reported by the system and that the potential diagnostic errors are 7.3% of the cases.

Legionella pneumophila in a hospital in Torino, Italy. A retrospective one-year study.

Legionella pneumophila serogroup 1 was isolated from post mortem specimens from 13 out of 58 patients with pneumonia diagnosed at autopsy. The results of a study undertaken in the hospital environment showed that the water plumbing system was colonized with L. pneumophila serogroup 1 which could also be isolated from respiratory devices filled with tap water. Control measures instituted are described.

Immune response to anti-HBV vaccination: study of conditioning factors.

The Authors studied the immune responses of 691 health care workers who were given HEVAC B vaccine (455 subjects) and HB Vax vaccine (216 subjects). The immune responses were correlated with data obtained by questionnaires: age, sex, B.M.I., drinking habits, smoking. The results showed correlation between these variables and immune response to vaccine.

[Epidemiology of bronchopulmonary hospital infections]. / Epidemiologia delle infezioni broncopolmonari ospedaliere.

Hospital acquired infections (HAI) represent one of the major problems, due to their elevated frequency and high number of fatal cases, in the control of infectious diseases. With the perspective to evaluate the incidence of bronchopulmonary infections and to determine their role as cause of death of hospitalized patients, as well as to identify the etiology and the associated risk factors, we have studied 105 autopsy cases of patients decreased in hospital. 37 patients had pneumonias, of which 48.6% were of hospital origin. Hospital pneumonia was responsible for death in 12.3% of the cases. The risk factors significantly associated with HAI were recognized to be the following: hospital recovery for a period longer than 10 days, and surgery. Among the etiologic agents isolated in HAI, there was a distinct prevalence in Gram-negative bacteria (55.5% of the samples), such as Pseudomonas aeruginosa, Klebsiella pneumoniae, Legionella pneumophila.

Nosocomial legionellosis associated with use of oxygen bubble humidifiers and underwater chest drains.

In 1 year 12 of 48 patients who developed fatal pneumonia following admission with non-respiratory disorders to the Hospital Molinette, Torino, yielded Legionella pneumophila serogroup 1 from lung at autopsy. Patients were hospitalized on seven different wards for different conditions; only two of the wards had air conditioning but legionellas were not isolated from these. All patients were in poor health or immunocompromised. Some patients had inhaled humidified oxygen from piped supplies and three had undergone surgery. Legionella pneumophila serogroup 1 was detected in the water of oxygen bubble humidifiers and an underwater chest drain. The contaminated devices had been filled with tap or distilled water and the hospital water supply was found to be contaminated with L. pneumophila serogroup 1. Our findings suggest that filling bubble humidifiers or underwater chest drains with tap water is a potential hazard and should be avoided.

[Anaphylactic accidents due to glaphenine. 5 cases]. / Accidents anaphylactiques imputés à la glafénine. Cinq cas

The authors report 5 cases of shock type anaphylactic reactions after the ingestion of glafenine. Up to the present, acute tubulo-interstitial nephritis had chiefly been reported. The existence of allergy to this medication remains to be proved by the wider application of allergological studies.