Do psychosis prodrome onset negative symptoms predict first presentation negative symptoms?

BACKGROUND: Negative symptoms have been previously reported during the psychosis prodrome, however our understanding of their relationship with treatment-phase negative symptoms remains unclear. OBJECTIVES: We report the prevalence of psychosis prodrome onset negative symptoms (PONS) and ascertain whether these predict negative symptoms at first presentation for treatment. METHODS: Presence of expressivity or experiential negative symptom domains was established at first presentation for treatment using the Scale for Assessment of Negative Symptoms (SANS) in 373 individuals with a first episode psychosis. PONS were established using the Beiser Scale. The relationship between PONS and negative symptoms at first presentation was ascertained and regression analyses determined the relationship independent of confounding. RESULTS: PONS prevalence was 50.3% in the schizophrenia spectrum group (n=155) and 31.2% in the non-schizophrenia spectrum group (n=218). In the schizophrenia spectrum group, PONS had a significant unadjusted (χ(2)=10.41, P<0.001) and adjusted (OR=2.40, 95% CI=1.11-5.22, P=0.027) association with first presentation experiential symptoms, however this relationship was not evident in the non-schizophrenia spectrum group. PONS did not predict expressivity symptoms in either diagnostic group. CONCLUSION: PONS are common in schizophrenia spectrum diagnoses, and predict experiential symptoms at first presentation. Further prospective research is needed to examine whether negative symptoms commence during the psychosis prodrome.

Neurocysticercosis: a rare cause of seizure.

Neurocysticercosis is endemic in certain parts of the world, is rare in Europe and has never previously been described in the Irish healthcare setting. We report the case of a healthy male, originally from Guatemala, who presented to our hospital with a generalized tonic-clonic seizure presumed secondary to neurocysticercosis.

Bile duct adenomas in heterozygous (MZ) deficiency of alpha 1-protease inhibitor.

A case of bile duct adenomas in association with heterozygous (MZ) deficiency of alpha 1-proteinase inhibitor (API) is presented. The salient features were the presence of large API-containing globules in the adenomatous tissue and only minimally, in granular form, in hepatocytes. alpha 1-Proteinase inhibitor was not demonstrated in portal bile ducts entrapped in the adenomatous tissue or in bile ducts present in the liver parenchyma. Bile duct markers such as cytokeratin and carcinoembryonic antigens were present in the adenomatous tissue and also in the normal bile ducts, but not in the hepatocytes, suggesting that the adenomatous structures are ductular in origin, and probably not from ductular metaplasia of liver cells. Accumulation of API is postulated to be a triggering factor in neoplastic transformation.

T-cell morphology in nodular follicular center cell lymphomas.

T cells are known to be frequently numerous in follicular lymphomas but are generally considered to be a homogeneous population of small, round, "resting" lymphocytes. Although immunologic studies have suggested the presence of some "activated" T cells in these B-cell neoplasms, virtually no attention has been paid to the T-cell morphology. Wright-stained cytocentrifuged sheep erythrocyte (SRBC) rosette preparations from 20 cases of nodular follicular center cell lymphomas were therefore examined and the morphologic appearance of the SRBC rosetting cells was categorized. A mean of 19% (range 11-33%) of the SRBC-positive cells present were medium or large in size (diameter greater than two SRBCs, approximately 10 micron). A mean of 62% of SRBC-positive cells had round nuclei; 18% had indented nuclei and 20% had irregularly shaped nuclei. These data provide supportive morphologic evidence for some T-cell "activation" in certain follicular lymphomas. In addition to having possible functional and biologic implications, the previously undescribed presence of enlarged and sometimes "atypical" T cells in uncomplicated follicular lymphomas has implications for interpreting the histopathology of these B-cell neoplasms and the reported occurrence of composite T-cell/follicular center-cell lymphomas.