Measurement of total water and bound water contents in human stratum corneum by in vitro proton nuclear magnetic resonance spectroscopy

The reliability of in vitro proton nuclear magnetic resonance (NMR) spectroscopy to specifically measure the water content of rehydrated human stratum corneum samples was assessed by comparison with the previously validated thermal desorption-mass spectrometry technique. The interest of proton NMR is that it can determine, in the same sample, both the amount of total water by recording the spectra at ambient temperature, and that of bound water (non-freezing water) by recording the spectra below 0 degrees C. Provided that enough samples of stratum corneum are analysed to average out the observed and well-known sample-to-sample variation, proton NMR may be of value in the evaluation of hygroscopic properties of raw materials for moisturizer formulations.

Coalescence cascade of dissipative solitons in parametrically driven systems

Parametrically driven spatially extended systems exhibit uniform oscillations which are modulationally unstable. The resulting periodic state evolves to the creation of a gas of dissipative solitons. Driven by the interaction of dissipative solitons, the multisoliton state undergoes a cascade of coalescence processes, where the average soliton separation distance obeys a temporal self-similar law. Starting from the soliton pair interaction law, we have derived analytically and characterized the law of this multisoliton coarsening process. A comparison of numerical results obtained with different models such as the parametrically driven damped nonlinear Schrödinger equation, a vertically driven chain of pendula, and a parametrically forced magnetic wire, shows remarkable agreement. Both phenomena, the pair interaction law and the coarsening process, are also observed experimentally in a quasi-one-dimensional layer of Newtonian fluid which is oscillated vertically.

Toxicity and neuropharmacological effects of elenine

Elenine is the aglycone of elenoside, a cytotoxic arylnaphthalene lignan (NSC 644013-W/1) derived from Justicia hyssopifolia. (Family: Acanthaceae). Elenoside is a β-D-glucoside, with a similar chemical structure to etoposide, exhibiting central depressant activity. In the present study, elenine was given to mice and rats at doses of 10, 20, and 40 mg/kg. Acute toxicity (24 h) and general behaviour in mice was studied as well as its effects on muscular relaxant activity, locomotor activity (Varimex test), and the open-field test and were compared with 10 mg/kg of chlorpromazine. Elenine produced a reduction in the permanence time in muscular relaxant activity (traction test). Spontaneous activity was lower in the Varimex test. The ambulation and rearing were lower compared with the control group, and an increase in boluses was observed in the open-field test. Thus, it can be concluded that elenine has central sedative effects at lower doses than those used with elenoside and has a possible application in conditions of anxiety.

The role of a computed tomography-based image registered navigation system for natural orifice transluminal endoscopic surgery: a comparative study in a porcine model

BACKGROUND AND STUDY AIMS

Most natural orifice transluminal endoscopic surgery (NOTES) procedures have been performed in animal models through the anterior stomach wall, but this approach does not provide efficient access to all anatomic areas of interest. Moreover, injury of the adjacent structures has been reported when using a blind access. The aim of the current study was to assess the utility of a CT-based (CT: computed tomography) image registered navigation system in identifying safe gastrointestinal access sites for NOTES and identifying intraperitoneal structures.

METHODS

A total of 30 access procedures were performed in 30 pigs: anterior gastric wall (n = 10), posterior gastric wall (n = 10), and anterior rectal wall (n = 10). Of these, 15 procedures used image registered guidance (IR-NOTES) and 15 procedures used a blind access (NOTES only). Timed abdominal exploration was performed with identification of 11 organs. The location of the endoscopic tip was tracked using an electromagnetic tracking system and was recorded for each case. Necropsy was performed immediately after the procedure. The primary outcome was the rate of complications; secondary outcome variables were number of organs identified and kinematic measurements.

RESULTS

A total of 30 animals weighting a mean (± SD) of 30.2 ± 6.8 kg were included in the study. The incision point was correctly placed in 11 out of 15 animals in each group (73.3 %). The mean peritoneoscopy time and the number of properly identified organs were equivalent in the two groups. There were eight minor complications (26.7 %), two (13.3 %) in the IR-NOTES group and six (40.0 %) in the NOTES only group ( P = n. s.). Characteristics of the endoscope tip path showed a statistically significant improvement in trajectory smoothness of motion for all organs in the IR-NOTES group.

CONCLUSION

The image registered system appears to be feasible in NOTES procedures and results from this study suggest that image registered guidance might be useful for supporting navigation with an increased smoothness of motion.

Psychosis secondary to traumatic brain injury

BACKGROUND

Traumatic brain injury (TBI) can result in serious and disabling neuropsychiatric disorders.

METHOD

The authors report a case of a 51-year old male, admitted to the psychiatric ward for acute psychosis and suicidal ideation, probably associated with TBI. After a temporal head trauma he initiated auditory/verbal hallucinations and subsequently developed paranoid delusions. The electroencephalography showed slow bilateral temporal activity and the neuropsychological testing showed several impairments. The patient improved with olanzapine at a dosage of 20 mg daily.

RESULTS

This case shows the difficulty of differential diagnosis between schizophrenia and psychotic disorder due to traumatic brain injury.

CONCLUSIONS

The authors conducted a revision of literature about the diagnosis, epidemiology, clinical aspects, laboratory and structural investigations and the treatment of this condition. Based on this revision work, the authors sketch some recommendations about the work-up that should be done when faced with this diagnostic hypothesis.

[Diagnosis of valve dysfunction in the paediatric age: the predictive value of the clinical signs and symptoms]

INTRODUCTION

Cerebrospinal fluid shunt valves are the preferred treatment in many cases of childhood hydrocephalus. Cerebrospinal fluid shunt valve dysfunctions usually present in an unspecific manner, which delays their diagnosis and, consequently, can increase the morbidity and mortality rates in these patients.

AIM

To determine the signs and symptoms that are most suggestive of valve dysfunction in the childhood population.

PATIENTS AND METHODS

We conducted a retrospective study of the reports of patients who visited the emergency department of a tertiary care paediatric hospital with a clinical picture that suggested valve dysfunction. In each case the clinical manifestations were determined, and also whether there had been a diagnosis of valve dysfunction or not. A univariate analysis and later a logistic regression study were performed.

RESULTS

In all, 183 visits were included. Valve dysfunction was confirmed in 28.5% of them. The most frequent complication was obstruction of the proximal drainage catheter. The univariate analysis showed a significant relation between the presence of irritability, sleepiness, abdominal pain, paresis of the cranial nerves and increased perimeter of the skull, and the existence of valve dysfunction. The logistic regression analysis revealed that sleepiness, irritability and abdominal pain could predict valve dysfunction.

CONCLUSIONS

Sleepiness and irritability are the clinical manifestations that best predict valve dysfunction, which means that they are almost undoubtedly candidates for an urgent neuroimaging study. In most cases the abdominal pain is related to abdominal pseudocysts. Headaches, vomiting and a high temperature are less predictive of valve dysfunction.

Soliton pair interaction law in parametrically driven Newtonian fluid

An experimental and theoretical study of the motion and interaction of the localized excitations in a vertically driven small rectangular water container is reported. Close to the Faraday instability, the parametrically driven damped nonlinear Schrödinger equation models this system. This model allows one to characterize the pair interaction law between localized excitations. Experimentally we have a good agreement with the pair interaction law.

Cytological vitreous findings in a patient with infantile neurological cutaneous and articular (CINCA) syndrome

The CINCA syndrome is an inflammatory disease characterised by persistent rash and chronic aseptic meningitis, with extensive infiltration of polymorphonuclear and macrophage cells at the sites of inflammation. The CINCA syndrome belongs to the group of systemic autoinflammatory diseases characterised by episodic or fluctuating degrees of inflammation, without evidence of high-titre autoantibodies or antigen-specific T cells. The disease is caused by mutations in the CIAS1 gene that encodes a protein cryopyrin, NALP3 or PYPAF1. Mutations in cryopyrin have a profound pro-inflammatory effect. Cryopyrin is a caspase 1 activator, which in turn causes the activation of interleukin (IL)1ß. The activating mutations of cryopyrin induce an excessive activation of IL1ß, which causes an influx of macrophages and polymorphonuclear cells to the site of inflammation, in our patient, in his eye.

Regards Through Adolescence: Comparison Between an Adolescent’s Suicidal Behaviour Consultation and an Adolescence Consultation

The aim of this study is a comparison between two different adolescents’ consultations: NES Consultation, which assists youngsters from 11 to 21 years old with self-destructive behaviours and Adolescence Consultation, which assists adolescents from 13 to 21 years old, without any specific diagnose or psychopathology.

Our sample it is composed of 100 youngsters, 15 males and 35 females from NES C (average age 15.5) and 14 males and 36 females from AC group (average age 15.6).

Data was collected from semi-structure interviews (at the assessment moment) and clinical documentation forms, analysed with SPSS program, through qui-square test (nominal variables).

Major findings: absence of significant differences between youngsters who cut themselves in the two consultations; in reported difficulties category, the hypothesis that there would be significant differences between the two groups was not fully confirm, it figured to be only true for school difficulties sub-category; significant differences found on depressive syndromatic diagnose sub-category; the results on source of reference category showed a significant difference between the groups we studied; the number of adolescents from the AC who have previously had suicidal ideation, although significantly different from NES C, can't be disregard. Inquiring about suicidal ideas and thoughts whenever attending an adolescent in difficulties should be the standard, not the exception, recognizing that we will not be able to bring to an end suicide but listening and understanding the suffering adolescent, we can win some time, and at the meantime, plenty of things can change.

Psychiatric Inpatient Readmission in a General Hospital: Preliminary Report of a Two Years Observational Study

Introduction:

Studying inpatient clinical population's features allows a better understanding of readmissions. Factors associated with higher levels of readmission may give clues concerning better treatment planning and follow-up.

Objectives:

To detect psychosocial and clinic factors associated with readmissions in an inpatient general psychiatric population.

Method:

107 patients consecutively admitted to an inpatient unit were characterized in terms of psychosocial, clinical, treatment and discharge plan features. Readmission was defined as the number of previous admittances in the last two years.

Results:

Patients characteristics: Average age 44 (SD: 16); 58% female; 10 (SD:5) years of education; average disease duration of 128 (SD:115) months. Main diagnosis: 30,8% schizophrenia; 14% bipolar I disorder; 13,1% major depression; 11,2% recurrent major depression; 5,6% cluster B personality; 3,8% bipolar II disorder and 2,9% schizoaffective disorder. From more to less frequent diagnosis implicated in readmissions were schizophrenia, schizoaffective disorder, recurrent major depression, bipolar I, bipolar II and major depression episode. Readmissions were not associated with inpatient treatment or disease duration, nor toxics or axis II diagnosis. Nonetheless, beginning a depot antipsychotic medication was related to an increase in previous admissions.

Conclusion:

These are preliminary results of a small sample, but they point towards the usefulness of a systematic evaluation of inpatient populations, mainly in what concerns complex clinical situations like major pathology readmissions.

Metabolic Syndrome in Bipolar Illness: Patient Concepts and Screening Effectivity

Introduction:

Metabolic Syndrome (MS) is constituted by a set of specific metabolic alterations being postulated that the main dysfunction is insulin resistance. Estimates point to higher prevalence of MS in bipolar patients, between 30 to 35%. Cost-effective screening methods, not recurring to blood test, have been researched.

Objectives:

Analyse knowledge and importance given to MS in bipolar patients. Test the viability of MS screening without blood tests.

Methodology:

Observational, cross-sectional study. Random sample of 15 adult bipolar patients, in euthymic phase. Semi-structured interview, YMRS, HAMD were applied. MS diagnosis investigated according to the International Diabetes Federation (IDF) criteria. MS screening was defined positive if blood pressure ≥ 130/85 or anti-hypertensive medication and abdominal perimeter > 90 in males or > 80 in females. A questionnaire about knowledge, attitudes and concerns on MS was applied.

Main results:

14 patients completed the investigation protocol. Five (36%) met IDF criteria for metabolic syndrome. Screening sensitivity was 80% and specificity 78%. Twelve patients (80%) were overweigh or obese. Mean IMC in patients that met IDF criteria for MS was 30 while in the other group mean IMC was 26. Only 3 (20%) have ever heard about MS, but the majority of the patients were concerned, in decreasing order, about weight gain, blood pressure cholesterol and hyperglycemia control.

Conclusions:

Although limited by small sample size, this study strengthens the idea that MS screening can be effective in clinical practice, it also indicates the need to educate BP patients about MS and to prevent overweight.

[Forestier-Rotes-Querol's disease. Ossification of the anterior cervical longitudinal ligament as a cause of dysphagia]

Forestier's disease or diffuse idiophatic skeletal hyperostosis is a systemic reumathological abnormality of unknown etiology. It produces calcificationossification of the anterior longitudinal ligament. The low dorsal region is the most affected in the raquis. These patients are tipically asymptomatic or with few symptoms (minimal joint pain, spinal pain, stiffness). Dysphagia is the most common symptom when the disease affects the cervical spine; less frequent is dyspnea, both secondary to extrinsic compression of the esophagus and trachea. Neurological complaints are quite rare. In the 1970s Resnick described specific radiological criteria for the diagnosis of Forestier's disease that are still used today. It affects men more frequently than women (2:1); the peak occurrence is in patients in their 60s. We present two cases diagnosed by severe difficulty with deglution, a 84 years-old woman and a 54 years-old man; we operated on them for surgical decompression of the esophagus with resection of osteophytes C3-C4 and C5-C6 respectively through a conventional anterolateral neck approach. Relief of difficulty in swallowing was immediately ensued.