Partner symptom accommodation in generalized anxiety disorder: a preliminary examination of correlates with symptoms and cognitive behavioural therapy outcome.

BACKGROUND: Symptom accommodation is suggested to maintain anxiety pathology and interfere with treatment effectiveness for anxiety and related disorders. However, little is known about symptom accommodation in generalized anxiety disorder (GAD). AIM: This study investigated the associations between romantic partner symptom accommodation, GAD symptoms, intolerance of uncertainty (IU), relationship satisfaction, and cognitive behavioural therapy (CBT) outcomes from the perspective of the person with GAD. METHOD: One hundred and twelve people with GAD participated in group CBT and completed measures at pre- and post-treatment. RESULTS: All participants endorsed that their partner engaged in symptom accommodation to some extent, and the most commonly endorsed type was providing reassurance. Greater self-reported partner symptom accommodation was associated with greater GAD symptoms, chronic worry severity, IU, and relationship satisfaction at baseline. Partner symptom accommodation was found to significantly decrease over treatment; however, less improvement in symptom accommodation from pre- to post-treatment was associated with worse treatment outcomes. DISCUSSION: This study is the first to show that partner symptom accommodation is prevalent in adults with GAD and to elucidate the presentation and frequency of behaviours. The findings provide preliminary evidence that targeting partner symptom accommodation in treatment may improve CBT outcomes.

Synthesis and characterization of fluorinated anatase nanoparticles and subsequent N-doping for efficient visible light activated photocatalysis.

Fluorinated-titanium dioxide (TiO2-F) nanoparticles in a pure anatase polymorph was precipitated from solution by hydrolysis of titanium oxychloride, using urea and ammonia as precipitation agents and potassium fluoride as a source of fluorine anion. A further wet attrition milling in presence of glycine completed by a heat treatment allowed an additional nitrogen doping of TiO2 (TiO2-F&N-HT). The morphology and crystalline structure of the as-synthesized powder was determined by transmission electron microscopy (TEM) and X-ray diffraction (XRD) and showed that TiO2 powder was composed of nanoparticles with narrow size distribution which crystallized in the anatase phase. X-ray photoelectron spectroscopy (XPS) revealed that fluorine and nitrogen are present in TiO2 as surface fluorination and interstitial doping, respectively. UV-vis diffuse reflectance spectroscopy (DRS) showed an increased optical absorption in the visible for TiO2-F&N-HT sample. Under visible light irradiation, TiO2-F nanoparticles showed a high photocatalytic performance, showing the high potential of an improved surface fluorination for Escherichia coli (E. coli) disinfection in suspension. These results show the importance of anatase-TiO2 nanoparticles synthesis and modification by using a wet chemical approach leading to low aggregation and high specific surface area for effective bacterial inactivation. The co-doped TiO2-F&N-HT powder showed slightly improved performance compared to the fluorinated sample. The significant degree of aggregation after the heat treatment is postulated as being a limiting factor in its photocatalytic activity.

Prospective study on diagnostic and prognostic significance of postoperative FDG PET/CT in recurrent colorectal carcinoma patients: comparison with MRI and tumor markers.

Current guidelines for follow-up after resection of colorectal cancer (CRC) recommend regular measurements of carcinoembryogenic antigen (CEA) and imaging tests. Multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI) are currently primary imaging modalities, while the role of fluorine-18-fluoro-deoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT), which is recommended in patients with negative MDCT and increased CEA, is still uncertain. Our aim was to compare diagnostic performance and prognostic significance of 18F-FDG PET/CT with MRI and tumor markers CEA and carbohydrate antigen 19-9 (CA 19-9) in detection of recurrent CRC. This prospective study included 35 patients with resected CRC, referred to 18F-FDG PET/CT examination for suspected recurrence. During median follow-up of 24.4±1.5 months 18F-FDG PET/CT and MRI results and tumor marker levels were compared with findings of histopathological examination or with results of clinical and imaging follow-up. Management plan before the 18F-FDG PET/CT scan was considered and compared to the final treatment decision. The sensitivity, specificity, positive and negative predictive value and accuracy of 18F-FDG PET/CT and MRI in detection of recurrent colorectal cancer in patient-based analysis were 92.6%, 75%, 92.6%, 75% and 88.6%, and 65.4%, 66.7%, 85%, 40% and 65.7%, respectively. In lesion-based analysis the sensitivity of 18F-FDG PET/CT and MRI was 83.1% and 68.2%, respectively. The overall accuracy of CEA and CA 19-9 in recurrence detection was 48.6% and 54.3%, respectively. PET/CT induced therapy alterations in 13/35 (37.1%) patients. Progression was observed in 16/35 patients during follow-up, with significantly lower risk of progression in patients with treatment changes based on PET findings (Multivariate Cox regression; p=0.017). In addition, elevated CA 19-9 levels in time of PET scan and male gender carried significantly higher risk of progression (p=0.007 and p=0.016, respectively). Kaplan-Meier Log rank test showed significantly longer progression-free survival time in patients who had treatment plan changed based on PET/CT (p=0.046). We can conclude that 18F-FDG PET/CT showed better sensitivity and accuracy compared to MRI in detection of recurrent colorectal cancer, with much better sensitivity compared to CEA and CA 19-9. Patients with treatment changes based on 18F-FDG PET/CT had significantly better prognosis and longer progression-free survival, while elevated values of CA 19-9 and male gender were associated with worse prognosis.

[PECULIARITIES OF CARE FOR PATIENTS WITH TRANSPLANTED SOLID ORGAN IN FAMILY MEDICINE].

Transplantation is sometimes the only therapeutic option to treat acute or chronic organ failure. In the care of transplant patients, there are numerous complications that are caused by powerful immunosuppressive drugs, cardiovascular, metabolic, and neoplastic diseases. These diseases are associated with significant morbidity and mortality in patients after transplantation, which will become an important part for supporting the transplant patient care. In the first year after transplantation, patients have regular contact with transplant center, and family doctor acts as a contact connecting patients with specialized centers, while also detecting and managing health problems and issues that are not related only to transplantation. After that, the role of family physicians is becoming ever more important and active in the prevention of morbidity and mortality in transplant patients by appropriate and timely intervention in detection of side effects of immunosuppressive therapy and threatening metabolic disorders. The aim of this article is to show the role of family physician in tracking the welfare of organ transplant patient.

The comparison of chronic hepatitis C treatment outcome between intravenous drug users and non-intravenous drug users.

UNLABELLED: Despite the fact that the majority of prevalent and incident cases of HCV are associated with intravenous drug use (IVDU), these patients have largely been excluded from HCV care. The aim of this study was to examine the treatment outcome of chronic hepatitis C in IVDUs compared to non-IVDUs. PATIENTS AND METHODS: Patients with chronic hepatitis C (CHC) who initiated and completed combination antiviral therapy with pegilated interferon and ribavirin, at the Hepatology Department of the University Hospital for Infectious and Tropical Diseases in Belgrade, were retrospectively analyzed. The study included a series of 254 patients of which 100 (39.4%) were former IVDU. RESULTS: Sustained virological response (SVR) was recorded in a total of 172 patients (67.7%). The analyses of the favorable treatment outcome, regarding particular viral genotypes, revealed that among those with genotype 1 and/or 4, including patients with genotype 1 recombinants with genotype 3, SVR was achieved in 114 (63.3%), while it was almost equally distributed between subgroups of former IVDU and all others (P=0.079). Among patients infected with HCV genotypes 2 and/or 3 the SVR rate was as high as 86.6%. CONCLUSION: IVDU with CHC infection should be treated with standard combination antiviral therapy for CHC, since the success rate is equal or even better than in non-IVDU patients.

Mechanical coupling in homogeneously deformed single-wall carbon nanotubes.

We developed a full symmetry implementing method, based on classical molecular dynamics with the Brenner-Tersoff potential, for determining the optimal configuration of homogeneously deformed infinitely long single-wall carbon nanotubes. All nanotubes with diameter less than 1.3 nm are studied. Systematic analysis of the coupling between different types of deformation shows that, in the tubes with chiral angle close to zero and 30°, the torsion-induced circumferential strain is opposite to the induced axial strain. Also, torsion in zigzag tubes induces larger circumferential strain, but in armchair tubes it yields a larger axial strain. The influence of diameter on axial-stretching-induced torsion becomes significant only for narrow tubes. Finally, significant deviation from the linear dependence of axial-strain-induced radial deformation is found for zigzag tubes. The presented results are important for the calculation of electro-optical properties of nanotubes under strain.

Natural torsion in chiral single-wall carbon nanotubes.

Optimizations performed with two geometrical, molecular mechanical and density functional models show that the configuration of single-wall carbon nanotubes is slightly twisted with respect to that predicted by conventional techniques. Geometrical models are used to explain the effect by breaking of local symmetry of the equally distant neighbors in graphene in the course of rolling, which is minimized by torsion. The torsion angle is small, and decreases with nanotube diameter, being less than 1° Å(-1) for ultrathin tubes. Therefore this effect can be hard to observe in experiments. Still, we single out features in diffraction patterns which can distinguish between twisted and non-twisted configurations. In addition, torsion makes a blue shift in the radial breathing mode, which for thin tubes can be seen by Raman measurement. The effect is slightly strengthened at room temperature.

The challenge of osteo-articular tuberculosis in the twenty-first century: a 15-year population-based study.

SETTING: Serbia, an intermediate tuberculosis (TB) incidence country in socio-economic transition. OBJECTIVE: To examine the epidemiological and clinical pattern of osteo-articular TB (OATB) in Serbia over 15 years. DESIGN: This retrospective observational study included OATB cases diagnosed between 1 January 1993 and 31 December 2007, according to the National Referral Institute of Lung Diseases and TB in Belgrade and the Central TB Register. Population estimates with extrapolations were based on 1991 and 2002 census data. RESULTS: The 295 OATB cases represented 10.9% (range 5.3-20.2) of all extra-pulmonary TB cases notified in Serbia over the period. One tenth of these were relapses. The incidence rate showed a significant increasing trend (y = 0.1167 + 0.0175x, R(2) = 0.3196), with an average age-specific incidence rate of 0.26 per 100 000 population. The peak number of cases was in the 45-64 year age group for both men and women. The average male:female ratio was 0.85. The outcome was favourable for 279 of the 295 patients (94.6%). In addition to a standardised chemotherapy regimen, 25.4% patients underwent surgery. CONCLUSION: The increasing time trend of OATB is caused by increased morbidity, a higher TB detection rate and better notification. Although rare in children, OATB remains a challenge in clinical practice.

[Quality of life in patients with surgical treatment of hip fractures, preliminary study].

INTRODUCTION: Fractures of the proximal segment of the femur occurring most commonly in elderly patients are a serious, both medical (orthopaedic) and socioeconomic, problem. MATERIAL AND METHODS: 46 patients (14 male and 32 female) operated for hip fracture in the January-June 2008 period, who were available for analysis (as 24 patients were not) were investigated. In addition to descriptive analysis, general health status-quality of life was assessed by means of SF-36 questionnaire comprising eight groups of questions determining the physical, psychological and social status of the patients within the 0 to 100 (problem) points range. RESULTS: The findings were that the average patient age was 74 years (76.9 for male patients and 74.06 fro female ones). The values of all eight parameters were lower by up to 89% in comparison to the pre-injury values, but improved by as much as 50% after six months (for physical functioning and the role of physical functioning) or by 30% for the role of emotions. The values never return to their pre-injury levels. In foreign studies, the parameters are higher, especially post-treatment values for vitality and role of emotions. CONCLUSION: In patients treated for hip fractures, it is necessary to carry out an assessment of general, physical, mental and social functioning of the patient in addition to the assessment of their clinical and radiological findings, so as to get a more realistic insight in the status of the treated and operated patients. The SF-36 questionnaire is widely used in such investigations along with other questionnaires. It is also necessary to investigate the general health status-quality of life of the entire healthy population in our country.

Epidemiology and diagnostics of visceral leishmaniasis in Serbia.

A retrospective epidemiological and diagnostic study of visceral leishmaniasis (VL) was carried out during the period 2001-2007 and included patients suspected of VL who had been diagnosed at the Parasitological Laboratory at the Institute for Infectious and Tropical Diseases, Belgrade. Diagnosis of VL was confirmed by microscopic examination of Giemsa-stained bone marrow (BM) smears. BM smears from 134 patients were examined; 22 cases of VL were diagnosed, the majority of which involved individuals who had been on holiday at the Montenegrian sea coast. The sensitivity of the initial BM smears was inadequate; this required the application of a serological test, adapted for routine use, for the diagnosis of VL.

Symmetry of single-wall nanotubes.

Nanotubes have become attractive subjects in solid-state physics owing to their potential applications in nanotechnology. Their symmetry is one of the important tools in theoretical investigations. Here a review is presented of the symmetry groups of the single-wall nano- and microtubes considered in literature: BN, GaN, MS2, C, BC3, BC2N.

[The action of tiazofurin on the development of sea urchin embryos and larvae]. / Deistvie tiazofurina na razvitie zarodyshei i lichinok morskikh ezhei.

The effects of the antitumor drug tiazofurin on development of sea urchins Sphaerechinus granularis, Paracentrotus lividus, Strongylocentrotus intermedius, and Arbacia lixula were studied. When 0.01-200 microM tiazofurin (TAF) was introduced in the incubation medium (artificial sea water) just after fertilization or at the midblastula stage, the development proceeded quite normally until the beginning of gastrulation. But later TAF blocked gastrulation and induced formation of mobile ball-shaped larvae with normal pigment cells but devoid of the nervous system, skeletal spicules and digestive tract. The threshold TAF concentrations varied from 0.05 microM (S. granularis) to 2-5 microM (all other species). When TAF was introduced during gastrulation and just after gastrulation, the larvae had defective nervous system and skeleton and suppressed expression of gangliosides. The nonhydrolyzable analog of GTP, GTP-gamma-S (5-20 microM), introduced in artificial sea water no later than at the midblastula stage prevented all above mentioned developmental defects.

Monoamine-containing neurons in the Aplysia brain.

The localization of monoamine-containing neurons in the CNS of Aplysia depilans has been studied by fluorescent histochemistry (the glyoxylic acid condensation method) and microspectrofluorimetry. Yellow fluorescent nerve cells and fibers show the emission maximum at 515-520 nm which corresponds to that of serotonin fluorophore in a model system. Green fluorescent nerve cells have the emission maximum at 485 nm which corresponds to that of catecholamine. Central catecholamine-containing neurons were found in cerebral, buccal, pedal and unpaired abdominal ganglia. The majority of them were revealed in cerebral ganglia (about 40). Serotonin-containing neurons are abundant in cerebral and pedal ganglia. More than 30 serotonin-containing nerve cells were localized in cerebral ganglia. In the right pedal ganglion approximately 100 neurons were revealed; in the left one about 150. In the abdominal ganglion all nerve cells of this chemical type (except one) are located in the right hemiganglion. The results are summarized in corresponding schemes.

Catecholamine-containing neurons in the peripheral nervous system of Aplysia.

Numerous green-fluorescent neurons have been revealed by means of the glyoxylic acid histochemical method in cryostat sections of several organs of two Adriatic aplysiid gastropods, Aplysia depilans and A. fasciata. Catecholamine-containing perikarya and their processes have been found to be especially abundant in the vaginal portion of the large hermaphrodite duct, in the penis and its sheath, and in the gill. In the reproductive organs, two subpopulations of catecholamine-containing neurons could be distinguished according to their size and location. Axons of larger neurons formed bundles which seemed to project at the CNS.