Altered Serotonin 1B Receptor Binding After Escitalopram for Depression Is Correlated With Treatment Effect.

BACKGROUND: Major depressive disorder (MDD) is commonly treated with selective serotonin reuptake inhibitors (SSRIs). SSRIs inhibit the serotonin transporter (5-HTT), but the downstream antidepressant mechanism of action of these drugs is poorly understood. The serotonin 1B (5-HT1B) receptor is functionally linked to 5-HTT and 5-HT1B receptor binding and 5-HT1B receptor mRNA is reduced in the raphe nuclei after SSRI administration in primates and rodents, respectively. The effect of SSRI treatment on 5-HT1B receptor binding in patients with MDD has not been examined previously. This positron emission tomography (PET) study aimed to quantify brain 5-HT1B receptor binding changes in vivo after SSRI treatment for MDD in relation to treatment effect. METHODS: Eight unmedicated patients with moderate to severe MDD underwent PET with the 5-HT1B receptor radioligand [11C]AZ10419369 before and after 3 to 4 weeks of treatment with the SSRI escitalopram 10 mg daily. Depression severity was assessed at time of PET and after 6 to 7 weeks of treatment with the Montgomery-Åsberg Depression Rating Scale. RESULTS: We observed a significant reduction in [11C]AZ10419369 binding in a dorsal brainstem (DBS) region containing the median and dorsal raphe nuclei after escitalopram treatment (P = .036). Change in DBS [11C]AZ10419369 binding correlated with Montgomery-Åsberg Depression Rating Scale reduction after 3-4 (r = 0.78, P = .021) and 6-7 (r = 0.94, P < .001) weeks' treatment. CONCLUSIONS: Our findings align with the previously reported reduction of 5-HT1B receptor binding in the raphe nuclei after SSRI administration and support future studies testing change in DBS 5-HT1B receptor binding as an SSRI treatment response marker.

Temporal self-imaging effect for periodically modulated trains of pulses.

In this paper, the mathematical description of the temporal self-imaging effect is studied, focusing on the situation in which the train of pulses to be dispersed has been previously periodically modulated in phase and amplitude. It is demonstrated that, for each input pulse and for some specific values of the chromatic dispersion, a subtrain of optical pulses is generated whose envelope is determined by the Discrete Fourier Transform of the modulating coefficients. The mathematical results are confirmed by simulations of various examples and some limits on the realization of the theory are commented.

Increased elective caesarean section rate is not associated with a decreased serious morbidity rate for twins ≥ 32 weeks' gestation.

To assess neonatal and maternal morbidity in twins ≥ 32 weeks' gestation, related to the changes in planned mode of delivery, a retrospective cohort study was performed, including 185 twin births delivered in the Atrium Medical Centre, Heerlen, during the years 2003-2008. The results were compared with those of an earlier study from our department during the period 1999-2002. Compared with the 1999-2002 cohort, the elective caesarean section rate significantly increased from 17.7% to 36.8%. The secondary caesarean rate significantly decreased from 15.9% to 8.8%, but increased from 1.2% to 3.3% for only twin B. No significant differences in serious neonatal morbidity rates for twins A and B were found between both study periods, neither in the elective caesarean group, nor in the planned vaginal birth group. Serious maternal morbidity was not significantly increased in both groups compared with the 1999-2002 cohort.

WDM compatible and electrically tunable SPE-OCDMA system based on the temporal self-imaging effect.

A coding/decoding setup for a spectral phase encoding optical code-division multiple access (SPE-OCDMA) system has been developed. The proposal is based on the temporal self-imaging effect and the use of an easily tunable electro-optic phase modulator to achieve line-by-line coding of the transmitted signal, thus assuring compatibility with WDM techniques. Modulation of the code is performed at the same rate as the data, avoiding the use of high-bandwidth electro-optic modulators. As proof of concept of the technique, experimental results are presented for a back-to-back coder/decoder setup transmitting a 10 GHz unmodulated optical pulse train within an 80 GHz optical window and using 8-chip Hadamard codes.

[Varicella pneumonia in adult population: review of 21 cases]. / Neumonía por varicela en población adulta: revisión de 21 casos.

BACKGROUND: Retrospective study of the varicella pneumonia in adults, in order to know incidence, environmental and clinical characteristics and treatments of patients with this diagnosis during the last 9 years in Toledo. MATERIAL AND METHODS: Twenty-one adult patients with the diagnosis of varicella pneumonia were studied, using the information of clinical histories and codified data. The backgrounds of pregnancy, smoking habit, concomitant diseases, previous contacts with another patients and the season of the year, were evaluated. Diagnosis was established by clinical and radiologic criteria in the course of varicella infection. RESULTS: 21 patients (10 males and 11 females, between 25 and 73 years) were studied. 17 (81%) were smokers, in 15 (71.4%) there was documented contact with varicella infection and 4 (19%) were immunocompromised. In the first 3-7 days after the development of skin lesions (100%), there was fever in 20 cases (95.2%) and dyspnea in 14 (66.7%). There were 4 patients (33,3%) without respiratory symptoms and in 5 (23,8%) there was important hypoxemia. Evolution was satisfactory in 20 cases (95.2%); three others requiring admission to Intensive Care Unit. Chest X-ray revealed an interstitial pattern in 11 cases (52.4%), nodular in 4 (19%) and a mixed pattern in 5 (23.8%). 20 patients were treated with acyclovir and in one case with foscarnet. In 28.57% cases, corticosteroids were needed. CONCLUSIONS: We believe smoking habit could be a risk factor related to an increase of varicella pneumonia. A chest X-ray should be made in every patient, despite the symptoms. Adults with pneumonia have a better prognosis if acyclovir is started early in time. Concomitant treatment with corticosteroids should be used in those cases with respiratory insufficiency.

Neumonía por varicela en población adulta: revisión de 21 casos / Varicella pneumonia in adult population: review of 21 cases

Fundamento. Estudio retrospectivo con el fin de conocer la incidencia de neumonía por varicela en adultos, así como estudiar las características epidemiológicas, clínicas, tratamiento y evolución de los pacientes ingresados en hospital de Toledo en los últimos 9 años. Material y métodos. Se analizó a 21 pacientes adultos ingresados con el diagnóstico de neumonía por varicela mediante estudio retrospectivo de historias clínicas entre enero de 1995 y enero de 2004. Se registraron datos sobre embarazo, sexo, hábito tabáquico, patología subyacente, contacto previo con varicela y época de diagnóstico. Éste se estableció por criterios clinicorradiológicos en el contexto de un episodio de varicela. Resultados. Se han evaluado 21 pacientes (10 varones y 11 mujeres) entre 25 y 73 años, el 81% de los casos presentaba hábito tabáquico, en el 71,4% se había documentado contacto con varicela y en 4 pacientes (19%) existía un trastorno de la inmunidad. La sintomatología aparecida entre 3-7 días tras el desarrollo de lesiones cutáneas (100%), consistió en fiebre, 20 casos (95,2%) y disnea, 14 casos (66,7%) como síntomas más frecuentes. Cuatro pacientes (33,3%) no presentaron clínica respiratoria y en 5 (23,8%) la hipoxemia fue manifiesta. La evolución fue favorable en 20 casos (95,2%), requiriendo ingreso en Unidad de Cuidados Intensivos tres pacientes. La radiología de tórax presentó predominio de patrón intersticial en vidrio deslustrado en 11 casos (52,4%), nodular en 4 casos (19%) y en el 23,8% el patrón fue mixto. En 20 pacientes se usó tratamiento con aciclovir y en un caso foscarnet. Se utilizó coadyuvancia con corticoides en el 28,57% de los casos. Conclusiones. El tabaco podría ser un factor de riesgo que se asociara con un incremento de la incidencia de neumonía por varicela. Es recomendable la realización de radiografía de tórax independientemente de la ausencia de clínica respiratoria. Los adultos con neumonía tienen mejor pronóstico cuando se instaura tratamiento precoz con aciclovir. El uso coadyuvante de corticoides debería emplearse especialmente en aquellos casos con fracaso respiratorio

Background. Retrospective study of the varicella pneumonia in adults, in order to know incidence, environmental and clinical characteristics and treatments of patients with this diagnosis during the last 9 years in Toledo. Material and methods. Twenty-one adult patients with the diagnosis of varicella pneumonia were studied, using the information of clinical histories and codified data. The backgrounds of pregnancy, smoking habit, concomitant diseases, previous contacts with another patients and the season of the year, were evaluated. Diagnosis was established by clinical and radiologic criteria in the course of varicella infection. Results. 21 patients (10 males and 11 females, between 25 and 73 years) were studied. 17 (81%) were smokers, in 15 (71.4%) there was documented contact with varicella infection and 4 (19%) were immunocompromised. In the first 3-7 days after the development of skin lesions (100%), there was fever in 20 cases (95.2%) and dyspnea in 14 (66.7%). There were 4 patients (33,3%) without respiratory symptoms and in 5 (23,8%) there was important hypoxemia. Evolution was satisfactory in 20 cases (95.2%); three others requiring admission to Intensive Care Unit. Chest X-ray revealed an interstitial pattern in 11 cases (52.4%), nodular in 4 (19%) and a mixed pattern in 5 (23.8%). 20 patients were treated with acyclovir and in one case with foscarnet. In 28.57% cases, corticosteroids were needed. Conclusions. We believe smoking habit could be a risk factor related to an increase of varicella pneumonia. A chest X-ray should be made in every patient, despite the symptoms. Adults with pneumonia have a better prognosis if acyclovir is started early in time. Concomitant treatment with corticosteroids should be used in those cases with respiratory insufficiency

Derrame pleural mielomatoso / Myelomatous pleural effusion

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"Deaf hearing": unacknowledged detection of auditory stimuli in a patient with cerebral deafness.

We describe a patient with the rare disorder of total deafness caused by a bilateral lesion in the temporal lobes and lesions in the central pontine area. Although she displayed no voluntary ability to detect or localize or identify sounds and denied hearing them when asked in writing, she retained some ability to respond reflexively to sounds. When attempts were made to restore awareness of sounds and/or voluntary responses to sounds by drawing her attention to her appropriate orienting head movements her performance improved and she began to respond successfully in a "forced-choice" paradigm. However, even when she became confident at detecting and localizing sounds she remained densely agnosic to their meaning. Her condition of deaf-hearing bears many similarities to that of blindsight.

Optical carrier-suppression technique with a Brillouin-erbium fiber laser.

We demonstrate a new concept in optical carrier control that uses a simple arrangement based on a hybrid Brillouin-erbium fiber laser. The system offers precise tunable control of the optical carrier amplitude independently of the characteristics of the transmitter or the optical modulation format. As much as 55 dB of carrier attenuation is demonstrated, which to our knowledge is the highest reported attenuation for a carrier-suppression system.

Optical carrier Brillouin processing of microwave photonic signals.

We introduce a novel concept in Brillouin signal processing based on modification of the optical carrier's magnitude and phase by stimulated Brillouin scattering-induced depletion. The technique offers wideband processing and low noise and requires only low optical power. Application to the enhancement of a 25-km high-frequency analog link is experimentally demonstrated and yields a 6.5-GHz bandwidth extension and a 13-dB reduction in the link insertion loss without intermodulation distortion.

[Detection of liver metastases in colorectal neoplasms: use of intraoperative echography]. / Detección de metástasis hepáticas por neoplasia colorrectal mediante ecografía intraoperatoria.

Fifty patients were consecutively operated on for colorectal cancer. Preoperative ultrasonography and intraoperative palpation were compared to intraoperative ultrasonography to determine their relative capacities in the detection of liver metastases. Preoperative ultrasonography detected metastases in three patients (6%), intraoperative palpation in four (8%) and intraoperative ultrasonography in 5 (10%). The number of metastases detected were 7, 19 and 19 respectively. The comparison failed to yield significant differences. From statistical viewpoint, both preoperative ultrasonography and intraoperative palpation were found to be as effective as intraoperative ultrasonography in detecting liver metastases.

[Urologic manifestations of primary hyperparathyroidism]. / Manifestaciones urológicas del hiperparatiroidismo primario.

We report on 79 patients with primary hyperparathyroidism (PHPT) and analyze the urological manifestations, analytical and histopathological changes commonly encountered in this disease. The importance of repeating calcium studies in patients with recurrent calcium stone formation is underscored. The appropriate metabolic work up should be performed when elevated values are detected.

The self-concepts of regular transcendental meditators, dropout meditators, and nonmeditators.

Regular meditators, dropout meditators, and nonmeditators were administered the Tennessee Self Concept Scale twice over a six month period (N = 32 Australian men and women). Results showed that regular meditators as compared to dropout meditators were found to have significantly fewer of the characteristics associated with psychosis. Nonmeditators as compared to dropout meditators were found to have significantly fewer characteristics associated with psychosis and personality integration. Regular meditators as compared to nonmeditators have a more positive perception of their behavior. The findings provide a personality description of the dropout meditators which may be useful for screening prospective meditators.