Familial aggregation of MATRICS Consensus Cognitive Battery scores in a large sample of outpatients with schizophrenia and their unaffected relatives.

BACKGROUND: The increased use of the MATRICS Consensus Cognitive Battery (MCCB) to investigate cognitive dysfunctions in schizophrenia fostered interest in its sensitivity in the context of family studies. As various measures of the same cognitive domains may have different power to distinguish between unaffected relatives of patients and controls, the relative sensitivity of MCCB tests for relative-control differences has to be established. We compared MCCB scores of 852 outpatients with schizophrenia (SCZ) with those of 342 unaffected relatives (REL) and a normative Italian sample of 774 healthy subjects (HCS). We examined familial aggregation of cognitive impairment by investigating within-family prediction of MCCB scores based on probands' scores. METHODS: Multivariate analysis of variance was used to analyze group differences in adjusted MCCB scores. Weighted least-squares analysis was used to investigate whether probands' MCCB scores predicted REL neurocognitive performance. RESULTS: SCZ were significantly impaired on all MCCB domains. REL had intermediate scores between SCZ and HCS, showing a similar pattern of impairment, except for social cognition. Proband's scores significantly predicted REL MCCB scores on all domains except for visual learning. CONCLUSIONS: In a large sample of stable patients with schizophrenia, living in the community, and in their unaffected relatives, MCCB demonstrated sensitivity to cognitive deficits in both groups. Our findings of significant within-family prediction of MCCB scores might reflect disease-related genetic or environmental factors.

Impact of Mood Spectrum Spirituality and Mysticism Symptoms on Suicidality in Earthquake Survivors with PTSD.

The aim of the present study was to explore the correlations between Spirituality/Mysticism/Psychoticism symptoms and suicidality in young adult survivors of the L'Aquila earthquake. The sample included 475 subjects recruited among high school seniors who had experienced the April 6, 2009, earthquake. Assessments included: Trauma and Loss Spectrum-Self Report and Mood Spectrum-Self Report (MOODS-SR). Mysticism/Spirituality dimension and suicidality were evaluated by means of some specific items of the MOOD-SR. The Spirituality/Mysticism/Psychoticism MOODS-SR factor score was significantly higher among subjects with PTSD diagnosis with respect to those without. Similarly, subjects with suicidal ideation, as well as those who committed a suicide attempt, reported significantly higher scores than those without.

A Comparison of Humiliation Measurement in a Depressive Versus Non-clinical Sample: A Possible Clinical Utility.

OBJECTIVE: We aimed to deepen the clinical utility of humiliation assessment in the study of depression. METHOD: We performed a correlational analysis of the relationship between humiliation, depression, resilience, and negative primary familial environment in 80 clinically depressed subjects (41 men and 39 women; mean age = 40.71, standard deviation SD = 9.94) and a strictly matched sample of 80 non-clinical subjects (41 men and 39 women; mean age = 40.64, SD = 10.24). We also implemented a hierarchical multiple regression analysis for each sample, to test the prediction of these variables on depression. RESULTS: Humiliation showed positive correlations with depressive factors, while negative correlations emerged with resilience in both samples. The hierarchical multiple regression analysis showed humiliation to be the most predictive factor of depression in the clinical sample only. CONCLUSION: This study improves the understanding of the relationship of humiliation and depression in both clinical and non-clinical populations.

Immune function assay (immunknow) drop over first 6 months after renal transplant: a predictor of opportunistic viral infections?

BACKGROUND: The Immuknow assay (IKA; Cylex) is a T-cell immune function assay that evaluates immunoreactivity in immunocompromised patients. The aim of this study was to analyze IKA values in a cohort of kidney transplantation (KT) recipients to investigate correlations between single-time point low IKA values and their trend over time with cytomegalovirus (CMV) or BK virus (BKV) reactivation. METHODS: A total of 118 adult patients receiving deceased-donor KT were enrolled (55.6±11.9 years old; 79 [66.9%] male). IKA CMV and BKV viremia determinations and were performed at months 1, 3, and 6 after surgery. RESULTS: Overall, 272 IKA determinations were performed: IKA values significantly decreased from month 1 (422±184 ng/mL) to month 3 (330±159 ng/mL; P<.001) and from month 3 to month 6 (300±128 ng/mL; P=.030). IKA values did not correlate with renal function or viral reactivation at any time. However, patients with either CMV or BKV viremia had a trend to higher IKA values at month 1 and lower IKA values at month 6, even if the difference did not reach a statistical significance (P=.115). CONCLUSIONS: Our study suggests that presence of low immunologic reactivity (IKA<225 ng/mL) is not associated with an increased risk of CMV and BKV reactivation over the 1st 6 months after KT. However, a trend to a more pronounced drop in IKA values over time was observed in patients with viral reactivation. These preliminary results suggests that drop in IKA values within the 1st post-KT months, unlike single-time point immune function assay, may predict the risk of opportunistic viral infections.

Gender differences in DSM-5 versus DSM-IV-TR PTSD prevalence and criteria comparison among 512 survivors to the L'Aquila earthquake.

BACKGROUND: Post-traumatic Stress Disorder (PTSD) has demonstrated gender-specific prevalence and expressions across the different DSM definitions, since its first introduction in DSM-III. The DSM-5 recently introduced important revisions to PTSD symptomatological criteria. Aim of the present study is to explore whether gender moderates rates of DSM-5 PTSD expression in a non-clinical sample of survivors to a massive earthquake in Italy. METHODS: 512 survivors of the L'Aquila 2009 earthquake, previously investigated for the presence DSM-IV-TR PTSD, were reassessed according to DSM-5 criteria in order to explore gender differences. All subjects completed the Trauma and Loss Spectrum-Self Report (TALS-SR). RESULTS: Females showed significantly higher DSM-5 PTSD rates and rates of endorsement of almost all DSM-5 PTSD criteria. Significant gender differences emerged in almost half of PTSD symptomatological criteria with women reporting higher rates in 8 of them, while men in only one (a new symptom in DSM-5: reckless or self-destructive behavior). Considering the impact of the three new DSM-5 symptoms on the diagnosis, significant gender differences emerged with these being crucial in almost half of the PTSD diagnoses in males but in about one-fourth in females. By using ROC curves, DSM-5 criteria E and D showed the highest AUC values in males (.876) and females (.837), respectively. LIMITATIONS: The use of self-report instrument; no information on comorbidity; homogeneity of study sample; lack of assessment on functional impairment. CONCLUSIONS: This study provides a contribution to the ongoing need for reassessment on how gender moderates rates of expression of particular disorders such as PTSD.

Emotional reactivity in bipolar depressed patients.

OBJECTIVE: Emotional reactivity in bipolar affective disorders has received increased attention as a relevant issue with regard to the ability to respond to emotional external stimuli for individual real world adaptation. We investigated emotional reactivity using the International Affective Picture System (IAPS) paradigm in bipolar patients during the depressive phase compared to healthy controls. METHOD: Twenty-three bipolar patients with a major depressive episode without manic symptoms and 27 healthy control subjects were recruited. They were asked to judge their emotional reactivity while viewing 90 pictures selected from the IAPS. Their ratings were categorized according to the emotional valence and arousal in response to pleasant, neutral, and unpleasant stimuli. RESULTS: The patients showed lower valence ratings for neutral pictures compared to healthy subjects. No significant between-group differences were found for the pleasant and unpleasant pictures. Higher activation for patients to all emotional stimuli was seen. CONCLUSION: Patients during the depressive phase gave more negative valence to neutral images. This can suggest that they are more pessimistic in the way they perceive the environment as more reactive to emotional cues.

Post-traumatic stress disorder in DSM-5: estimates of prevalence and criteria comparison versus DSM-IV-TR in a non-clinical sample of earthquake survivors.

BACKGROUND: The latest edition of DSM (DSM-5) introduced important revisions to PTSD symptomatological criteria, such as a four-factor model and the inclusion of new symptoms. To date, only a few studies have investigated the impact that the proposed DSM-5 criteria will have on prevalence rates of PTSD. METHODS: An overall sample of 512 adolescents who survived the L'Aquila 2009 earthquake and were previously investigated for the presence of full and partial PTSD, using DSM-IV-TR criteria, were reassessed according to DSM-5 criteria. All subjects completed the Trauma and Loss Spectrum-Self Report (TALS-SR). RESULTS: A DSM-5 PTSD diagnosis emerged in 39.8% of subjects, with a significant difference between the two sexes (p<0.001), and an overall 87.1% consistency with DSM-IV-TR. Most of the inconsistent diagnoses that fulfilled DSM-IV-TR criteria but not DSM-5 criteria can be attributed to the subjects not fulfilling the new criterion C (active avoidance). Each DSM-5 symptom was more highly correlated with its corresponding symptom cluster than with other symptom clusters, but two of the new symptoms showed moderate to weak item-cluster correlations. Among DSM-5 PTSD cases: 7 (3.4%) endorsed symptom D3; 151 (74%) D4; 28 (13.7%) both D3 and D4; 75 (36.8%) E2. LIMITATIONS: The use of a self-report instrument; no information on comorbidity; homogeneity of study sample; lack of assessment on functional impairment; the rates of DSM-IV-TR qualified PTSD in the sample was only 37.5%. CONCLUSIONS: This study provides an inside look at the empirical performance of the DSM-5 PTSD criteria in a population exposed to a natural disaster, which suggests the need for replication in larger epidemiological samples.

Middle and long-term outcomes of dual kidney transplant: a multicenter experience.

INTRODUCTION: Dual kidney transplantation (DKTx) to reduce the disparity between demand and supply of organs was evaluated in two Italian centers (Bari and Novara). MATERIALS AND METHODS: Between October 2000 and October 2011, we performed 97 DKT (26 ipsilateral/71 bilateral) following routine biopsy of all kidneys obtained from expanded criteria donors by Remuzzi-Karpinsky scores. The reference group was 379 single grafts from donors older than 60 years single kidney transplantation ([SKT] × > 60). RESULTS: Good postoperative renal function was observed in 56 DKTx (57.7%); whereas acute tubular necrosis requiring dialysis was observed in 41 (42.3%) patients. After a mean follow-up of 60 months, DKTx graft survivals were 96%, 93%, and 90% and patient survivals, 96%, 91%, and 91% at 1, 3, and 5 years, respectively. Complications in expanded criteria donor kidney transplantations included a high rate of cytomegalovirus (CMV) disease especially dual kidney cases. DKTx represented the only independent risk factor for CMV disease upon multivariate analysis (odds ratio [OR] 2.33, 95% confidence interval [CI] 1.28-4.2; P = .006). We did not observe any significant difference in graft or patient survival between DKTx and SKTx > 60 years. CONCLUSIONS: We observed good outcomes up to 5 years after transplantation in terms of graft and patient survival despite the use of inferior grafts. Comparing DKTx and SKT > 60, we noted that the mean Karpinski score for SKTx was significantly better than DKTx, although patient and graft survivals were similar. This trend confirms that the use of a biopsy to allocate expanded criteria donor kidneys may be too protective; therefore, the criteria to select DKTx require further refinement.

Anti-IFI16 antibodies and their relation to disease characteristics in systemic lupus erythematosus.

OBJECTIVE: Several studies have shown the presence of anti-IFI16 antibodies in systemic lupus erythematosus (SLE), Sjögren Syndrome (SjS), systemic sclerosis (SSc) and other autoimmune diseases. However, the significance of anti-IFI16 antibodies in SLE has not been fully characterized. The aim of this study was to investigate associations between anti-IFI16 antibodies and clinical and serologic parameters of SLE. METHODS: An enzyme-linked immunosorbent assay (ELISA) kit was used to measure anti-IFI16 antibodies in the sera of 168 SLE patients, 46 patients with any type of primary glomerulonephritis (GN) and 182 healthy controls (HCs). Associations between anti-IFI16 antibodies and clinical and serologic parameters of SLE were statistically evaluated using both univariate and multivariate analysis. RESULTS: Significantly higher anti-IFI16 titres were observed in SLE patients compared to both non-SLE GN and HCs (median levels: 270.1 U/ml vs 132.1 U/ml, p = 0.001, and 52.9 U/ml, p < 0.0001, respectively). With cut-off levels corresponding to the 95th percentile of the control population (113 U/ml), 63% of the SLE patients tested positive for anti-IFI16 autoantibodies, compared to just 24% of patients with primary non-SLE GN and 5% of HCs. The presence of anti-IFI16 antibodies inversely correlated with proteinuria (univariate analysis) and C3 hypocomplementaemia (univariate and multivariate analyses). CONCLUSIONS: The inverse correlations observed between anti-IFI16 positivity, proteinuria and C3 hypocomplementaemia suggest that anti-IFI16 antibodies do not contribute to renal inflammation in SLE; indeed they may even prevent complement consumption. Anti-IFI16 antibodies hold the potential to serve as a new biomarker of disease activity in SLE.

Severe acute nephrotoxicity in a kidney transplant patient despite low tacrolimus levels: a possible interaction between donor and recipient genetic polymorphisms.

WHAT IS KNOWN AND OBJECTIVE: Tacrolimus has a narrow therapeutic index and shows large interindividual variations in pharmacokinetics, which may be partly explained by genetic variability in metabolic enzymes of the cytochrome P450 (mainly CYP3A4 and CYP3A5) and transport P-glycoprotein (encoded by the ABCB1 gene). Genetic variability in the expression of biotransformation enzymes and drug transporters may also predispose individuals to tacrolimus-induced nephrotoxicity. CASE SUMMARY: We report a case of severe biopsy-proven Tacrolimus (TAC) nephrotoxicity that occurred 1 month after renal transplantation despite persistently low TAC levels. The donor genotype was CYP3A5*3/*3 (loss-of-function genotype), whereas that of the recipient was CYP3A5*1/*3. The donor and recipient genotypes did not differ with respect to either CYP3A4 rs35599367C>T (both were CC homozygotes) or ABCB1 gene polymorphisms (both TT homozygotes for the 1236C>T polymorphism and CT heterozygotes for the 3435C>T polymorphism). WHAT IS NEW AND CONCLUSION: This case study suggests that donor/recipient genetic mismatch in metabolic enzymes may have an important role in modulating tacrolimus nephrotoxicity. It provides a possible explanation for the intriguing observation that for a subset of patients, cumulative TAC doses appear to correlate better with nephrotoxicity than trough levels.

Age, gender and epicenter proximity effects on post-traumatic stress symptoms in L'Aquila 2009 earthquake survivors.

BACKGROUND: Earthquakes are among the most frequently occurring natural disasters affecting the general population and inducing Post-Traumatic Stress Disorder (PTSD). Thus, increasing effort has been devoted to explore risk factors for PTSD onset after exposure. The aim of the present study was to investigate the impact of gender, degree of exposure and age on PTSD and post-traumatic stress symptoms in the general population exposed to the L'Aquila 2009 earthquake (Richter Magnitude 6.3). METHODS: A total sample of 1488 subjects (721 women and 767 men) was assessed by means of the Trauma and Loss Spectrum Self Report (TALS-SR): 939 subjects have been directly and 549 not-directly exposed to the earthquake. We performed a random extraction of units from the population in order to have 8 homogenous comparable subgroups. RESULTS: A main significant effect of exposure (exposed>non exposed subjects) and gender (women>men) emerged on the TALS-SR domain scores. Further significant interaction effects of exposure(⁎)age and gender(⁎)age emerged with significantly more TALS-SR symptoms being reported in younger with respect to older non-exposed subjects and in younger with respect to older women. LIMITATIONS: Social support was not examined systematically as well as major depression. Further limitations are the relatively small sample size and the use of lifetime instruments. CONCLUSIONS: Our results corroborate literature on female gender and proximity to the epicenter being correlated to PTSD after earthquake exposure and suggest a possible secondary effect of age.

Endovascular treatment of transplanted renal artery stenosis with PTA/stenting.

PURPOSE: We evaluated the effectiveness of endovascular treatment with percutaneous transluminal balloon angioplasty (PTA)/stenting of transplanted renal artery stenosis (TRAS). MATERIALS AND METHODS: Between January 2005 and December 2010, 17 patients (4 women, 13 men; mean age 60.9 years) with TRAS underwent PTA/stenting. The parameters analysed were: technical success, pre- and post-treatment serum creatinine (SCr) and blood pressure (BP), average number of antihypertensive drugs administered before and after treatment and vessel patency on colour Doppler ultrasound (CDUS) at 1, 3, 6 and 12 months and once a year thereafter. RESULTS: Technical success was 100%. During a mean follow-up of 28.3±18.7 months, there was a statistically significant reduction in SCr and BP values. In 18 % of cases, moderate (<60%) restenosis was observed on CDUS without renal failure and not requiring new treatment. There was a reduction in antihypertensive drugs from an average of 3.5±0.5 to 1.5±0.5. CONCLUSIONS: Consistent with the literature data, our experience shows that endovascular treatment with PTA/stenting is a safe and effective option for managing TRAS and can thus be considered the method of choice.

The interactions of age, sex, body mass index, genetics, and steroid weight-based doses on tacrolimus dosing requirement after adult kidney transplantation.

PURPOSE: The aim of this study was to evaluate the effect of different clinical covariates on tacrolimus dose requirements in adult kidney transplant patients with a specific focus on drug interactions. PATIENTS: Tacrolimus dosing requirement, normalized by drug levels and expressed as the concentration/dose (C/D) ratio as a surrogate index of tacrolimus bioavailability, was employed to identify four categories of tacrolimus dosing requirement, namely, very high, high, small, and very-small, in very fast, fast, slow, and very slow metabolizers, respectively. Steroid weight-based doses were analyzed instead of fixed doses, and genetic analysis of cytochrome P450 (CYP) 3A5*1/*3 and multi-drug resistance 1 (MDR1) C3435T and C1236T polymorphisms were performed RESULTS: Multivariate analysis on 450 adult transplant patients identified six risk factors for being slow metabolizers and therefore requiring small tacrolimus doses: male sex (OR 1.615, p = 0.020); age >60 years (OR 2.456, p = 0.0005); body mass index ≥ 25 (OR 1.546, p = 0.046), hepatitis C virus positivity (OR 2.800, p = 0.0004); low steroid dose <0.06 mg/kg (OR 3.101, p < 0.0001). Patients with a small tacrolimus requirement were at increased risk for multiple infections (OR 1.533, p = 0.0008) and higher systolic blood pressure (OR 1.385, p = 0.022) and showed a significant association with the CYP3A5*3/*3 genotype adjusted by MDR1 polymorphisms C3435T and C1236T (OR 8.104, p = 0.0001). CONCLUSIONS: Our results demonstrate the importance of the interaction among genetic and clinical factors in conditioning tacrolimus disposition, with corticosteroid weight-based dose being the only modifiable risk factor for tacrolimus requirement. As the tacrolimus dosing requirement increases with increasing tacrolimus clearance through concomitant steroid use, undesirable changes in tacrolimus levels may occur when steroid doses are tapered, predominantly in slow metabolizers. This often neglected drug interaction has to be monitored to optimize tacrolimus exposure in kidney transplant patients.

Structure-function relationships of iodinated contrast media and risk of nephrotoxicity.

Characteristics of CM have greatly changed over time. First-generation ionic CM have many-fold (5-7) greater osmolalities than plasma. Subsequently non ionic CM generations were looked for to reduce osmolality, and encompass nonionic monomers and nonionic dimers reaching osmolality as low as that of plasma (iso-osmolar CM) but paying however dear, as viscosity is considerably increased. Intrarenal microcirculation has its "Achilles" heel in the outer medulla, where the smallness of capillary lumen and the slackness of the capillary mesh render regular blood flow at high risk, mainly because it is the same area in which the only renal work needing oxygen is made and? Iodinated CM may exert their nephrotoxic effects in three different ways: by interfering with vascular hemodynamics, by interfering with intratubular fluid volume and composition, and by producing direct cytotoxic effects to glomerular and tubular cells due to iodine by-itself. Furthermore, effects of oxygen free radical can damage glomerular cells by increasing the permeability and tubular cells impairing specific function and leading to apoptosis. Although clinical nephrotoxicity has considerably improved over time, there is no evidence for an a priori superiority of a specific CM. In general, low-osmolar (2-3 times blood) and iso-osmolar (the same as blood) CM are recommended, keeping in mind that within last generation CM dimeric iso-somolar compounds reach viscosity values higher than monomeric low-osmolar compounds and hyperviscosity is a neglected mechanisms of nephrotoxicity. We suggest that CM should be classified not only by osmolality, but also by viscosity.

Impact of traumatic loss on post-traumatic spectrum symptoms in high school students after the L'Aquila 2009 earthquake in Italy.

BACKGROUND: On April 6th 2009, the town of L'Aquila, Italy, was struck by an earthquake (6.3 on the Richter scale) that lead large parts of the town to be destroyed and the death of 309 people. Significant losses in the framework of earthquakes have been reported as a major risk factor for PTSD development. Aim of this study was to investigate post-traumatic spectrum symptoms in a sample of adolescents exposed to the L'Aquila 2009 earthquake 21 months earlier, with particular attention to the impact of loss. METHODS: 475 students (203 women and 272 men), attending the last year of High School in L'Aquila, were assessed by: Trauma and Loss Spectrum-Self Report (TALS-SR) and Impact of Event Scale (IES). The presence of full and partial PTSD was also assessed. RESULTS: 72 students (15.2%) reported the loss of a close friend or relative in the framework of the earthquake. Full PTSD was reported by 146 (30.7%) students and partial PTSD by 149 (31.4%) students. There was a significant difference reported in PTSD between bereaved and non bereaved subjects. Significantly higher post-traumatic symptom levels were reported by bereaved subjects. LIMITATIONS: The lack of information on the relationship with the deceased and the number of losses experienced, besides the use of self report instruments are the limitations of this study. CONCLUSIONS: Our results show high rates of post-traumatic spectrum symptoms in adolescents who survived the L'Aquila earthquake. Having experienced the loss of a close friend or a relative in the framework of the earthquake seems to be related to higher PTSD rates and more severe symptomatology. These results highlight the need to carefully explore adolescents exposed to a significant loss as consequence of an earthquake.

Decision-making impairment in schizophrenia: relationships with positive symptomatology.

Abnormal decision-making (DM) performance has been reported in several neurobehavioral disorders such as schizophrenia, addiction, and obsessive compulsive disorders. The exploration of DM correlates in terms of symptom formation may add more knowledge about the meanings of DM performance in schizophrenia. We examined the Iowa Gambling Task (IGT) and its relationship with clinical symptoms, evaluated by Positive and Negative Symptom Scale (PANSS), in 40 schizophrenic patients and 20 controls. Schizophrenic patients did worse on IGT performance with a significant difference between the two groups in Net Score. PANSS positive symptoms were negatively correlated with Net Score and advantageous choices and directly with disadvantageous choices. Results suggest that persons with schizophrenia display a pattern of compromised DM related to positive symptoms.

The contraceptive vaginal ring in women with renal and liver transplantation: analysis of preliminary results.

INTRODUCTION: Vaginal administration seems to be the best route to achieve steady and precise doses of contraceptive hormones, resulting in stable serum concentrations and low exposure. The aim of this study was to evaluate the contraceptive efficacy, cycle control, tolerability and acceptability of a contraceptive vaginal ring (NuvaRing) in renal and liver transplant recipients. MATERIAL AND METHODS: Renal or liver transplant recipients, asking for contraception, were enrolled into the study. The duration of treatment was 12 cycles, with each vaginal ring releasing an average of 120 mg etonogestrel and 15 mg ethinylestradiol daily. Study visits were scheduled at screening, in the first week following cycles 3, 6, and 12 (172 cycles). RESULTS: Among 17 females included into the study: were 9 renal (mean age, 30 +/- 7.2 years) and 8 liver transplant recipients (mean age, 32.6 +/- 6.6 years). At the onset of therapy all patients showed at least 6 months of stable graft function with no signs of allograft rejection. The mean posttransplant follow-up was 4 +/- 3.6 and 5.3 +/- 2.1 years for women with renal and hepatic transplantations respectively (P = NS). The immunosuppressive therapy was not changed for any patient. We demonstrated good cycle control: 162 cycles did not exhibit any bleeding; 7 cycles, only spotting episodes, whereas 2 cycles had 1 bleeding episode during the ring period. The estrogen-related adverse events (nausea and breast tenderness) were reported in 2 patients. One patient experienced significant bleeding related to thrombocytopenia. DISCUSSION: Nuvaring, in our preliminary findings, may be considered to be an highly effective contraceptive method for female transplant recipients that additionally regulate menstrual bleeding and seems to positively influence well-being. Vaginal administration may diminish the chance of drug interactions and therefore be safer for patients.

Prevalence and clinical relevance of occult hepatitis B virus infection in patients on the waiting list for kidney transplantation.

BACKGROUND: Occult hepatitis B virus (HBV) infection can be defined as the long-lasting persistence of viral genomes in the liver tissue, and sometimes also in the serum at low levels of viremia in individuals with undetectable HBV surface antigen (HBsAg). Viral replication can be reactivated by immunosuppressive therapies or immunologic diseases, leading to the development of typical hepatitis B. METHODS: All patients on the waiting list for renal transplantation at the only 2 transplant centers in our region (Piemonte, Italy) were checked for the presence of occult HBV infection by an highly sensitive quantitative HBV-DNA polymerase chain reaction (PCR) assay (nested PCR); the only exclusion criterion was HBsAg-positivity. The enrollment lasted from October 1, 2006, to May 31, 2007. The prospective follow-up will continue for 5 years. RESULTS: HBV-DNA sequences were detected in blood samples from 10 of 300 cases examined (3.3%), being more frequent among Asian (1/3; 33.3%) and African (1/16; 6.25%) subjects as compared with the Caucasians (8/281; 2.8%; P = .011), among anti-hepatitis C virus (HCV) positive versus HCV negative patients (3/32 [9.3%] vs 7/268 [2.6%]; P = .004) and mainly among patients with a previous history of overt liver diseases (3/22 [14%] vs 7/278 [2.5%]; P = .019). HBV-DNA sequences became undetectable at 1 month after renal transplantation in 3 patients; the follow-up is in progress for these and the other patients. CONCLUSION: Occult HBV infection occurs in patients undergoing renal transplantation. Longer observation and prospective studies will clarify the clinical impact of this occult infection on transplant outcomes and the possibility of viral reactivation related to immunosuppressive therapy.

Dimensional, non-taxonic latent structure of psychotic symptoms in a student sample.

INTRODUCTION: We examined the construct of psychosis using the self-report instrument CAPE (Community Assessment of Psychic Experiences) in a sample of 1,323 students. MATERIALS AND METHODS: Taxometric analysis was carried out using Taxometric Programs for the R Computing Environment. The MAXCOV CCFI was 0.34, indicating a dimensional latent structure. All other taxometric analysis yielded very similar results indicative of dimensional structure. CONCLUSION: In this study, using powerful analytic techniques designed expressly for the purpose, i.e. taxometric analysis, the latent construct of psychosis in a sample of young students appeared to be consistent with a dimensional, non-taxonic latent structure.