Classification strategies for a single-trial binary Brain Computer Interface based on remembering unpleasant odors.

A Brain Computer Interface (BCI) is a useful instrument to support human communication. In recent years, BCI systems have been frequently implemented by using EEG. Regarding the communication paradigm used, there exists a very large number of strategies and, recently, the remembering of unpleasant odors has been also defined. However, the quality of the signals collected by this last paradigm is very poor, due to the absence of a real stimulus (the stimulus consists in remembering a disgusting situation). For this reason, a crucial node is the choice of a very efficient classification algorithm to improve the accuracy of the BCI. The present paper describes a and compares classification strategies for such type of BCI systems. The proposed methods and the experimental setup are described and experimental measurements are presented and discussed.

Prognostic value of circulating tumor cells in nonmuscle invasive bladder cancer: a CellSearch analysis.

BACKGROUND: Circulating tumor cells (CTCs) provide prognostic information in patients with metastatic tumors. Recent studies have shown that CTCs are released in circulation in an early phase of cancer disease so that their presence is under investigation in the adjuvant setting. Few studies investigated the prognostic significance of CTCs enumeration in patients with metastatic and advanced bladder cancer. The current study has analyzed the presence of CTC in patients with nonmuscle-invasive bladder cancer (NMIBC). PATIENTS AND METHODS: Forty-four NMIBC patients were enrolled and included in a 24-month follow-up program. Blood drawings were carried out in all patients at the first diagnosis. CellSearch system (Veridex; LLC, Raritan, NJ) was used for CTCs enumeration. RESULTS: CTC were detectable in 8/44 patients (18%). Presence of CTC was found significantly associated to shorter time to first recurrence (6.5 versus 21.7 months, P < 0.001). Median time to progression was not reached, due to the short follow-up period. CTC presence was found associated to concomitant carcinoma in situ and higher T category. CONCLUSION: The detection of CTC in this setting of disease may allow to distinguish patients with high risk of recurrence from those with high risk of progression, as well as to early identify patients candidate for adjuvant treatment.

Psychosensorial and related phenomena in panic disorder and in temporal lobe epilepsy.

Since Cullen coined the term "neurosis" in the 18th century, medical investigators have searched the neural substrates of conditions we now classify as anxiety disorders. Harper and Roth in 1962 hypothesized that the temporal lobes might represent one such substrate for phobic-anxious patients with depersonalization-derealization (DD); the association between the presumed temporal lobe feature and phobic anxiety was so compelling that Roth (in 1959) described the condition as "phobic-anxiety-depersonalization" syndrome. Introduced into our current nosology as panic disorder-agoraphobia (PDA), this seemingly neuropsychiatric condition is nonetheless distinct from complex partial epilepsy (CPE), from which it is conventionally differentiated through clinical and anamnestic evaluation. Yet increasingly there are clinical-and laboratory-hints of certain overlap between manifestations of the two disorders, hitherto based largely on evaluation of psychosensorial phenomena in PDA or affective phenomena in CPE. We located only one systematic study that monitored 24-hour electroencephalogram (EEG) abnormalities in PDA. Finally, recent epidemiologic data suggest a significantly greater than chance association between PDA and a history of seizures. To further explore these intriguing links, the present study directly compared a group of 91 PDA outpatients with a group of 41 CPE outpatients with respect to DD and other psychosensorial symptoms. The broad similarities discovered between psychosensorial and related phenomena provide further support for the hypothesis that there may be a common neurophysiological substrate linking CPE phenomena with PDA.

A randomized, double-blind study of alpidem vs placebo in the prevention and treatment of benzodiazepine withdrawal syndrome.

The aim of the trial was to assess alpidem efficacy in preventing and treating the benzodiazepine (BZ) withdrawal syndrome (WS). A multicentre, double-blind, randomized versus placebo, parallel group study of six-week duration was carried out in outpatients suffering from generalized anxiety or adjustment disorder with an anxious mood and taking non-hypnotic BZ as continuous course of therapy of at least one-year duration. At the entry, the patients abruptly discontinued BZs and were treated with 50 mg/bid/tid of alpidem or placebo. Withdrawal syndrome diagnosis was (regarding treatment allocation) formulated by an independent psychiatrist, according to DSM-III-R and an appropriate scale, the SESSB. One hundred seventy-three patients were randomized and 148 completed the study. Withdrawal syndrome occurred in 27 patients of the alpidem group (31.0%) and in 38 patients of the placebo group (44.2%). A severe WS was diagnosed in 11.1% of the patients in the alpidem group and in 31.6% of the placebo group. If not having been withdrawn from the market, alpidem could have been useful for the prevention of BZ withdrawal syndrome.

Adverse effects associated with the short-term treatment of panic disorder with imipramine, alprazolam or placebo.

Side effects play a significant role in the selection of drugs to be used in panic disorder/agoraphobia whose polyphobic symptomatology often includes a suspiciousness about taking drugs and a fear of undesired side effects which may lead to the refusal of treatment. The safety, side effects and patients' acceptance of alprazolam and imipramine versus placebo were evaluated in 1168 subjects with panic disorder/agoraphobia who had been enrolled in the second phase of the Upjohn World Wide Panic Study. Side effects that worsened over baseline to a greater extent with alprazolam than with imipramine and placebo were sedation, fatigue/weakness, memory problems, ataxia and slurred speech. In the imipramine group blurred vision, tachycardia/palpitations, insomnia, sleep disturbance, excitement/nervousness, malaise, dizziness/faintness, headache, nausea/vomiting and decrease in appetite were worse than in the other groups. In the placebo group the anxious symptoms were most prominent. The highest level of compliance was shown in the alprazolam-treated group and the lowest in the placebo-treated group. Strong predictors of side effects were not observed. If a side effect profile is known, it will be easier for a clinician to choose the right drug and the appropriate management by taking into account compliance, safety and efficacy in each patient under treatment. Further information about side effects in long-term maintenance treatment would be of great clinical pertinence in ensuring safety and enhancing patients' quality of life.

[Benzodiazepine withdrawal syndrome. Problems of differential diagnosis against depression, panic attacks and generalized anxiety]. / La sindrome da astinenza da benzodiazepine. Problemi di diagnosi differenziale con depressione, attacchi di panico e ansia generalizzata.

Anxiety and mood disorders are among the psychic afflictions which tend to lead to prolonged benzodiazepine intake. This is also one of the reasons why doctors are faced with a difficult task when having to differentiate between these phenomena and the anxiolytic withdrawal syndrome. Since preexisting psychiatric pathology may modify withdrawal symptoms, thus making differential diagnosis between withdrawal syndrome and recrudescence of the previous disorder even more difficult, it is necessary carefully to assess clinical phenomenology both in relation to its course and to its variability with possible emergence of new symptoms. In addition to drawing attention to the diagnostic elements that can be most useful for identifying the withdrawal syndrome in mood disturbances and panic attack disorder, the authors also report the data of an experimental study of benzodiazepine withdrawal in patients suffering from generalized anxiety.

[Benzodiazepine withdrawal syndrome]. / Sindrome da astinenza da benzodiazepine.

Benzodiazepines (BDZ) are widely prescribed in clinical practice for many pathological conditions, because of their anxiolytic, sedative, myorelaxant and anticonvulsant properties. The effectiveness, specificity and rapidity of action, the few side effects and the virtual absence of toxicity, have contributed to the widespread use of these compounds. In the last decade, however, the attitude towards BDZ has greatly changed, due to growing awareness and concern about dependence liability, withdrawal phenomena, and long-term side effects. Withdrawal symptoms have been singled out and specified in the contest of a well-defined syndrome with foreseeable onset, duration and remission. Psychic and physical symptoms and disorders of sensory perception can be observed. These manifestations can be suppressed by resuming treatment. The symptomatic and developmental aspects of BDZ withdrawal syndrome are discussed, according to the available literature, with particular reference to clinical features of patients suffering from anxiety and mood disorders.

[Omega benzodiazepine receptor subtypes and new ligands]. / Sottotipi recettoriali omega per le benzodiazepine e nuovi ligandi.

Pharmacological and biochemical studies indicate that for many receptors, distinct subtypes exist; the multiplicity and diversity of signal reception proteins increase the information-handling capacity of neurons, thus contributing to neural plasticity. This is also the case for the allosteric modulatory-centre omega of the GABA-A receptor. Binding studies suggest the presence of at least two pharmacologically distinct omega receptors in the human brain; furthermore, molecular biological studies have confirmed the existence of genes encoding different omega subtypes. As omega receptors are the site of action of benzodiazepines and other anxiolytic compounds, this knowledge may be useful for developing new subtype-specific drugs, with more selective therapeutic effects.

Delimitation of generalized anxiety disorder: clinical comparisons with panic and major depressive disorders.

We compared 40 outpatients with "pure" generalized anxiety disorder (GAD) with 152 panic disordered patients with varying degrees of phobic avoidance, and 241 primary major depressives with single and recurrent episodic patterns. Despite sociodemographic and symptomatologic overlaps with these comparison groups, GAD emerged as a relatively distinct disorder, characterized by chronic low-grade symptomatology with observed anxiety at interview, as well as nausea, headache, tension, and insomnia. These anxious "traits," which appear to be part of the habitual self of the patient, are subject to fluctuation over time, and may form the temperamental substrate or precursor of panic and other anxiety and depressive disorders.

Treatment of generalized anxiety disorder: preliminary clinical experience with buspirone.

The authors reviewed pharmacologic treatment of generalized anxiety disorder (GAD), particularly treatment with benzodiazepine agents, and compared the antianxiety effects and dependence risks of these agents with those of nonGABAergic compounds such as buspirone--a new psychotropic drug--in the treatment of chronic anxiety. Forty outpatients who met DSM-III criteria for GAD were randomly assigned to double-blind treatment with buspirone or lorazepam. After 8 weeks, treatment was abruptly stopped and withdrawal reactions were evaluated at Weeks 9 and 10. After 3 to 4 weeks, buspirone's efficacy in treating GAD symptomatology was found to be comparable with lorazepam's, except for sleep disturbances, which were minimally affected by buspirone. After treatment was discontinued, buspirone-treated patients were free from withdrawal symptoms, while the symptoms of lorazepam-treated patients worsened at Week 9.

Derealization and panic attacks: a clinical evaluation on 150 patients with panic disorder/agoraphobia.

One hundred fifty patients with Panic Disorder (PD) with or without Phobic Avoidance were subdivided into two groups on the basis of presence/absence of derealization and/or depersonalization (D-D) during panic attacks. D-D was found in 34.7% of the sample. By comparing the two groups, the patients with D-D were found to be younger and had an earlier onset of the disorder; they had a higher prevalence of avoidance behavior and a higher severity of the agoraphobic spectrum phobias. They were also more frequently subject to concomitant disorders such as Generalized Anxiety, Obsessive-Compulsive, and depressive symptomatology. The authors have hypothesized a correlation between the presence of D-D during panic attacks and a more frequent clinical evolution toward agoraphobia. This view is supported by finding that D-D in panic attacks corresponds to severer forms of PD, both in terms of the earlier onset of PD, and because PD shows higher levels of anxiety, depression, and disability.

Clomipramine for panic disorder: I. The first 10 weeks of a long-term comparison with imipramine.

Clomipramine and imipramine treatments were compared in a sample of 152 panic disorders. Diagnosis was according to the positive criteria of DSM-III-R, but without exclusion of comorbid affective or personality disorders. The 2-year design provides non-blind treatment under typical clinical practice conditions, and it includes random assignment, periodic assessment with standardized measures, and comparable, flexible drug dosages. Findings on six outcome measures in the first 59 cases to complete 10 weeks showed both tricyclics to be markedly and equally effective for blocking panic attacks, alleviating phobic avoidance, and reducing nonspecific aspects of anxiety. Clomipramine's predominantly serotonergic action seemed not to determine a different action spectrum. During the first 2 weeks, clomipramine was significantly and unexpectedly superior to imipramine in both antipanic and antiphobic actions. These results require replication under double-blind conditions.

[Preparation of reactants for the detection of proteins from different animal species by immunodiffusion]. / Preparación de reactivos para la detección de proteínas de diferentes especies animales por inmunodifusión.

Qualitative identification of fresh ground meat samples of beef, sheep, pork, horse and rabbit has been made by the double agar gel diffusion test (method of Ouchterlony) and by immunoelectrophoresis. The reagents used were: 1) Antigens: saline meat extracts from different animal species, saline meat mixture extracts and whole sera from the different animal species. Meat extracts and sera were controlled by electrophoresis and the amounts of protein were estimated by the method of Lowry; 2) Antibodies: multivalent antisera anti-bovine, anti-ovine, anti-porcine and anti-equine, were obtained by immunization of rabbits with an emulsion of 1 vol of whole serum and 1 vol of Freund complete adjuvant; anti-rabbit serum was obtained by immunization of rats; antisera were controlled by the double agar gel diffusion test and by immunoelectrophoresis. To remove cross-reacting antibodies, when it was necessary, antisera were adsorbed.

Preparación de reactivos para la detección de proteínas de diferentes especies animales por inmunodifusión. / [Preparation of reactants for the detection of proteins from different animal species by immunodiffusion]

Qualitative identification of fresh ground meat samples of beef, sheep, pork, horse and rabbit has been made by the double agar gel diffusion test (method of Ouchterlony) and by immunoelectrophoresis. The reagents used were: 1) Antigens: saline meat extracts from different animal species, saline meat mixture extracts and whole sera from the different animal species. Meat extracts and sera were controlled by electrophoresis and the amounts of protein were estimated by the method of Lowry; 2) Antibodies: multivalent antisera anti-bovine, anti-ovine, anti-porcine and anti-equine, were obtained by immunization of rabbits with an emulsion of 1 vol of whole serum and 1 vol of Freund complete adjuvant; anti-rabbit serum was obtained by immunization of rats; antisera were controlled by the double agar gel diffusion test and by immunoelectrophoresis. To remove cross-reacting antibodies, when it was necessary, antisera were adsorbed.

Preparación de reactivos para la detección de proteínas de diferentes especies animales por inmunodifusión / [Preparation of reactants for the detection of proteins from different animal species by immunodiffusion]

Qualitative identification of fresh ground meat samples of beef, sheep, pork, horse and rabbit has been made by the double agar gel diffusion test (method of Ouchterlony) and by immunoelectrophoresis. The reagents used were: 1) Antigens: saline meat extracts from different animal species, saline meat mixture extracts and whole sera from the different animal species. Meat extracts and sera were controlled by electrophoresis and the amounts of protein were estimated by the method of Lowry; 2) Antibodies: multivalent antisera anti-bovine, anti-ovine, anti-porcine and anti-equine, were obtained by immunization of rabbits with an emulsion of 1 vol of whole serum and 1 vol of Freund complete adjuvant; anti-rabbit serum was obtained by immunization of rats; antisera were controlled by the double agar gel diffusion test and by immunoelectrophoresis. To remove cross-reacting antibodies, when it was necessary, antisera were adsorbed.