Factors affecting survival and dispersal of the comma butterfly in a high mountain deciduous forest habitat

Population and community dynamics of butterflies are relatively well known in Europe thanks to citizen science and academic efforts to cover large spatio–temporal scales. However, there are still gaps of knowledge about which life–history traits have a large influence on the dynamics of particular species and the ecological factors that influence those traits. We conducted a capture–recapture demographic study on the comma butterfly Polygonia c–album in a high mountain deciduous forest. We estimated daily survival in breeding adults caught while foraging on thistles and we calculated the probability of dispersal between two close sites. Thistle growth was enhanced by nitrification in cattle grazing in the study area. Local survival was higher for males (0.920, 95 % CI: 0.851–0.959) than for females (0.869, 95 % CI: 0.799–0.917). Short–range dispersal mostly occurred in absence of wind. Light winds and high levels of solar radiation likely enhanced foraging activity. In contrast with findings in most butterfly demographic studies, recapture rates were significantly higher in females than in males, likely due to the latter moving each afternoon to establish territories along sunny forest edges away from the foraging habitat. Further demographic studies are needed to assess the effects of climate stochasticity and habitat transformation caused by changes in extensive cattle grazing on the population dynamics of the comma butterfly.

Changing the Antipsychotic in Early Nonimprovers to Amisulpride or Olanzapine: Randomized, Double-Blind Trial in Patients With Schizophrenia

BACKGROUND AND HYPOTHESIS

Meta-analyses have shown that the majority of patients with schizophrenia who have not improved after 2 weeks of treatment with an antipsychotic drug are unlikely to fully respond later. We hypothesized that switching to another antipsychotic with a different receptor binding profile is an effective strategy in such a situation.

STUDY DESIGN

In total, 327 inpatients with an acute exacerbation of schizophrenia were randomized to double-blind treatment with either olanzapine (5-20 mg/day) or amisulpride (200-800 mg/day). Those patients who had not reached at least 25% Positive-and-Negative-Syndrome-Scale (PANSS) total score reduction from baseline after 2 weeks (the "non-improvers") were rerandomized double-blind to either staying on the same compound ("stayers") or to switching to the other antipsychotic ("switchers") for another 6 weeks. The primary outcome was the difference in the number of patients in symptomatic remission between the combined "switchers" and the "stayers" after 8 weeks of treatment, analyzed by logistic regression.

STUDY RESULTS

A total of 142 nonimprovers were rerandomized at week two. 25 (45.5 %) of the 'stayers' compared to 41 (68.3 %) of the "switchers" reached remission at endpoint (p = .006). Differences in secondary efficacy outcomes were not significant, except for the PANSS negative subscore and the Clinical-Global-Impression-Scale. "Switchers" and "stayers" did not differ in safety outcomes.

CONCLUSIONS

Switching "non-improvers" from amisulpride to olanzapine or vice-versa increased remission rates and was safe. The superiority in the primary outcome was, however, not paralleled by significant differences in most secondary efficacy outcomes and the effect was only apparent at the last visit making replications of longer duration necessary.

New Metabolic, Digestive, and Oxidative Stress-Related Manifestations Associated with Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) represents a pressing and generally invalidating syndrome that is triggered by a terrifying or stressful experience, relying on recurrently reliving the traumatic event feelings associated to it, which is subsequently linked to ongoing activations of stress-related neurobiological pathways and is often associated with neurodegeneration. In this paper, we examine what lies beneath this disorder, reviewing evidence that connects PTSD with a wide array of mechanisms and its intertwined pathways that can lead to the decompensation of different pathologies, such as cardiovascular disease, gastrointestinal ailments, autoimmune disorders, and endocrine diseases. Also, the significance of the oxidative stress in this frame of reference is debated. Thus, knowing and identifying the main features of the distressing experience, the circumstances around it, as well as the neuropsychological and emotional characteristics of people prone to develop PTSD after going through disturbing incidents can offer an opportunity to anticipate the development of potential destructive consequences in several psychological dimensions: cognitive, affective, relational, behavioral, and somatic. We can also observe more closely the intricate connections of the disorder to other pathologies and their underlying mechanisms such as inflammation, oxidative stress, bacterial overgrowth syndrome, irritable bowel syndrome, metabolic disorders, oxytocin, and cortisol in order to understand it better and to optimize the course of treatment and its management. The complex foundation PTSD possesses is supported by the existing clinical, preclinical, and experimental data encompassed in the current review. Different biological systems and processes such as the hypothalamic-pituitary-adrenal axis, sympathetic nervous system, oxidative stress, inflammation, and microbiome suffer modifications and changes when it comes to PTSD; that is why targeted therapies exert tremendous alleviations of symptoms in patients diagnosed with this disorder. Therefore, this implies that PTSD is not restricted to the psychiatric domain and should be viewed as a systemic condition.

Personalized nuclear imaging protocol in cases with nodular goiter and parathyroid adenoma

A 62 years old woman was diagnosed with multinodular toxic goiter and primary hyperparathyroidism/left parathyroid adenoma by hormonal assessment, ultrasound and nuclear thyroid/parathyroid scans. Cervical ultrasound illustrated a multinodular aspect of the thyroid with solid nodules and cystic-component nodules; the larger one represented a multinodular complex with necrosis areas in the left thyroid lobe, ACR TI-RADS score 4 (moderately suspicious). Functional nuclear imaging was performed for accurate differential diagnosis between thyroid vs. parathyroid localization, between cold vs. hot nodules, and eventually, for guiding the choice of a subsequent Fine-Needle Aspiration Biopsy (FNAB). Scans described an early intense ^99mTc-sestaMIBI uptake with no ^99mTc-pertechnetate uptake in the left thyroid lobe larger nodule. Due to the suspicion of malignancy for this nodule, we performed an additional scan (1 hour before the classical 2 hours parathyroid delayed scan). The intense uptake persists in both delayed scans suggesting no malignant phenotype and which was confirmed after surgery by benign histology. In conclusion, using a ^99mTc-sestaMIBI personalized protocol, related to the radiotracer cellular uptake mechanisms: 1 hour scan (supplementary image, corresponding to the maximum uptake pattern of ^99mTc-sestaMIBI for cancer cells) and 2 hours scan (for parathyroid washout evaluation) may avoid unnecessary extensive thyroid surgery.

Impact of an Education Programme on IBD Patients' Skills: Results of a Randomised Controlled Multicentre Study [ECIPE]

BACKGROUND

Better patient knowledge on inflammatory bowel disease [IBD] could improve outcome and quality of life. The aim of this study was to assess if an education programme improves IBD patients' skills as regards their disease.

METHODS

The GETAID group conducted a prospective multicentre randomised controlled study. IBD patients were included at diagnosis, or after a significant event in the disease course. Patients were randomised between 'educated' or control groups for 6 months. Education was performed by trained health care professionals. A psycho-pedagogic score [ECIPE] was evaluated by a 'blinded' physician at baseline and after 6 and 12 months [M6 and M12]. The primary endpoint was the increase of ECIPE score at M6 of more than 20%.

RESULTS

A total of 263 patients were included in 19 centres (male:40%; median age:30.8; Crohn's disease [CD]:73%). Of these, 133 patients were randomised into the educated group and 130 into the control group. The median relative increase in ECIPE score at M6 was higher in the educated group as compared with the control group (16.7% [0-42.1%] vs 7% [0-18.8%], respectively, p = 0.0008). The primary endpoint was met in 46% vs 24% of the patients in the educated and control groups, respectively [p = 0.0003]. A total of 92 patients met the primary endpoint. In multivariate analysis, predictors of an increase of at least 20% of the ECIPE score were randomisation in the educated group (odds ratio [OR] = 2.59) and no previous surgery [OR = 1.92].

CONCLUSIONS

These findings support the set-up of education programmes in centres involved in the management of IBD patients.

Effects of Natura 2000 on nontarget bird and butterfly species based on citizen science data

The European Union's Natura 2000 (N2000) is among the largest international networks of protected areas. One of its aims is to secure the status of a predetermined set of (targeted) bird and butterfly species. However, nontarget species may also benefit from N2000. We evaluated how the terrestrial component of this network affects the abundance of nontargeted, more common bird and butterfly species based on data from long-term volunteer-based monitoring programs in 9602 sites for birds and 2001 sites for butterflies. In almost half of the 155 bird species assessed, and particularly among woodland specialists, abundance increased (slope estimates ranged from 0.101 [SD 0.042] to 3.51 [SD 1.30]) as the proportion of landscape covered by N2000 sites increased. This positive relationship existed for 27 of the 104 butterfly species (estimates ranged from 0.382 [SD 0.163] to 4.28 [SD 0.768]), although most butterflies were generalists. For most species, when land-cover covariates were accounted for these positive relationships were not evident, meaning land cover may be a determinant of positive effects of the N2000 network. The increase in abundance as N2000 coverage increased correlated with the specialization index for birds, but not for butterflies. Although the N2000 network supports high abundance of a large spectrum of species, the low number of specialist butterflies with a positive association with the N2000 network shows the need to improve the habitat quality of N2000 sites that could harbor open-land butterfly specialists. For a better understanding of the processes involved, we advocate for standardized collection of data at N2000 sites.

The Modulation of Oxytocin and Cortisol Levels in Major Depression Disorder and Irritable Bowel Syndrome

There is a progressive trend in the current literature in understanding the central effects of oxytocin, which besides its classical roles in parturition and lactation, seems to exert some facilitatory effects in most of the neuropsychiatric disorders. Thus, it seems that oxytocin is mainly linked to the neuropsychiatric disorders where the social component is more or less affected and it has also strong correlations with the stress-related mechanisms and hypothalamic�pituitary�adrenal (HPA) axis. In addition, the connections between oxytocin and the digestive system were previously suggested, including by some of our preliminary results, in the context of irritable bowel syndrome (IBS) pathology. Also, the relations between depression and stress in the context of cortisol implications are quite well described, although various modifications of cortisol (increased, decreased or non-modified) were described in the major depression pathology. Thus, by using two research cohorts: one with major depression disorder (n = 15) and another one having both diagnosis of major depression disorder and irritable bowel syndrome in the same time (n = 15), we are showing in this report significantly increased levels of cortisol in patients with MDD and IBS, when compared with patients with MDD without IBS, while an opposite pattern was obtained by measuring the plasma level of oxytocin, where the patients with MDD and IBS had a significantly decreased concentration of oxytocin, as compared with those with MDD but without IBS.

Effects of Roluperidone (MIN-101) on two dimensions of the negative symptoms factor score: Reduced emotional experience and reduced emotional expression

BACKGROUND

Recent research has suggested that negative symptoms (NS) can be considered in terms of two different dimensions: reduced expression (expressive deficit) and reduced experience (experiential deficit). Roluperidone, a compound with high affinities for 5 HT2A and sigma2 receptors, has previously shown superiority over placebo on improving NS in a prospective study in patients with schizophrenia. The objective here is to explore the effect of roluperidone compared to placebo, on the 2 domains of the Negative Symptoms.

METHODS

This was a multi-national Phase 2b trial that enrolled 244 symptomatically stable patients with schizophrenia who had baseline scores ≥20 on the NS subscale of the PANSS. Patients were randomized to daily monotherapy with roluperidone 32 mg, roluperidone 64 mg, or placebo in a 1:1:1 ratio. All enrolled patients were Caucasian, and 137 (56%) were male. The 3 treatment groups were balanced on all demographic and illness-related baseline characteristics.

RESULTS

Both doses of roluperidone were superior to placebo on both domains: Reduced Experience (p ≤ .006 for the 32 mg; p ≤ .001 for the 64 mg) with persistent superiority from Week 2 for the 64 mg dose and Week 8 for the 32 mg dose; Reduced Expression (p ≤ .003 for 32 mg; p ≤ .001 for 64 mg) with similar persistence.

IMPLICATIONS

Both doses of roluperidone previously improved PANSS negative symptoms in general and demonstrated tolerability in stable schizophrenia patients. The post hoc analysis reported here found the drug to work on both the reduced emotional experience and reduced emotional expression sub-scales empirically derived from the PANSS.

Serum Cortisol Levels Modifications in Patients with Depression and Irritable Bowel Syndrome

The correlations between depression and stress are quite accepted nowadays, as well as the fact that cortisol levels could also represent fundamental risk factors for major depressive disorder. However, when it comes to the modifications of cortisol levels in depression, the results are controversial. Same goes for the cortisol modifications in irritable bowel syndrome (IBS), which is a functional digestive disorder characterized by a strong biopsychological component, being highly influenced or exacerbated by stressful stimuli. Thus, in the present report we were interested in seeing if there are any serum cortisol levels variations in patients with depression and irritable bowel syndrome, by looking at cortisol modifications in two different groups of patients: a control group with major depression disorder and another study group composed by major depression disorder + IBS patients. Thus, our data presented here are suggesting that there is a significant increase in cortisol levels in the morning serum of the patients with major depression disorder + IBS, as compared to the group having only depression. The results presented here could have an important relevance in the context of managing the stress-related factors in the pathological entities described above.

Preliminary Study on the Correlations Between Oxytocin Levels and Irritable Bowel Syndrome in Patients with Depression

Lately there are increased evidences that oxytocin may be an important mediator in several psychiatric disorders including depression and anxiety. Oxytocin system seems to be linked with several neurotransmitters important in psychiatric disorder, but also with the hypothalamic�pituitary�adrenal (HPA) axis and is also a key factor in stress regulation mechanisms. Considering the oxytocin receptor pattern of distribution both central and peripherally and the growing data concerning the disbalance of oxytocin in psychiatric disorders we may speculate that oxytocin system may be at the core of psychosomatic disturbances. Also, recent data brought to attention that oxytocin receptor is distributed throughout gastrointestinal tract. Our hypothesis of the present study was that oxytocin system is disbalanced in irritable bowel syndrome considering also the psychological component of this digestive disorder. We preliminary report here a significant decrease of serum oxytocin levels in patients with major depression disorder and irritable bowel syndrome, as compared with those with major depression disorder alone.

Survival Rates and Complications for Zirconia-Based Fixed Dental Prostheses in a Period up to 10 Years: A Systematic Review

AIMS

The purpose of this study was to methodically review the literature concerning the success and survival rates of zirconia fixed dental prostheses (FDPs).

METHODS

A systematic search was conducted of MEDLINE, Elsevier and the Cochrane Library to identify relevant articles about zirconia FDPs. In order to obtain suitable articles, rigorous criteria were applied. The minimum follow-up period was five years.

RESULTS

From a total of 986 articles identified in the first electronic search, only 10 matched the inclusion criteria. A total of 368 patients with 430 zirconia FDPs were included in this systematic review. The survival rate was 89.43% ± 10.01% and chipping of the veneering ceramic occurred in 16.97% of the cases.

CONCLUSION

Zirconia-based fixed dental prostheses perform reasonably well and can serve as an alternative to metal-ceramic fixed dental prostheses.

Impact of vedolizumab therapy on extra-intestinal manifestations in patients with inflammatory bowel disease: a multicentre cohort study nested in the OBSERV-IBD cohort

BACKGROUND

The effectiveness of vedolizumab as a treatment for extraintestinal manifestations (EIM) is questionable due to its gut-specificity.

AIM

To assess effectiveness of vedolizumab for EIM in patients with inflammatory bowel disease (IBD) in a large real-life experience cohort.

METHODS

Between June and December 2014, 173 patients with Crohn's disease and 121 with ulcerative colitis were treated with vedolizumab. Patients were followed until week 54. EIM activity was assessed at weeks 0, 6, 14, 22, 30 and 54 by using a 3-step scale: complete remission, partial response and no response.

RESULTS

At baseline, 49 (16.7%) patients had EIMs of which 47 had inflammatory arthralgia/arthritis, four had cutaneous lesions and two had both rheumatologic and skin EIM. At week 54, 21 (44.7%) patients had complete remission for inflammatory arthralgia/arthritis and three (75%) for cutaneous EIM. In multivariate analysis, complete remission of inflammatory arthralgia/arthritis was associated with clinical remission of IBD (OR = 1.89, IC95% [1.05-3.41], P = .03) and recent onset of inflammatory arthralgia/arthritis (OR = 1.99, IC95% [1.12-3.52], P = .02). During the follow-up period, 34 (13.8%) patients without any EIM at baseline, developed incident cases of inflammatory arthralgia/arthritis consisting mostly of peripheral arthralgia without evidence of arthritis and 14 (4.8%) incident cases of paradoxical skin manifestation.

CONCLUSION

Vedolizumab therapy is commonly associated with improvement in EIM. This was associated with quiescent IBD and recent EIM. However, paradoxical skin manifestation and inflammatory arthralgia/arthritis may occur upon vedolizumab therapy.

One-year effectiveness and safety of vedolizumab therapy for inflammatory bowel disease: a prospective multicentre cohort study

BACKGROUND

We recently showed that vedolizumab is effective in patients with Crohn's disease (CD) and ulcerative colitis (UC) with prior anti-TNF failure in a multicentre compassionate early-access programme before marketing authorisation was granted to vedolizumab.

AIMS

To assess effectiveness and safety of vedolizumab at week 54 in patients UC and CD.

METHODS

Between June and December 2014, 173 patients with Crohn's disease (CD) and 121 with ulcerative colitis (UC) were treated with vedolizumab induction therapy. Among those 294 patients, 272 completed the induction period and were evaluated at the week 14 visit (161 patients with CD and 111 with UC). Disease activity was assessed using the Harvey-Bradshaw Index for CD and the partial Mayo Clinic score for UC. The primary outcome was steroid-free clinical remission at week 54.

RESULTS

At week 54, steroid-free clinical remission rates at week 54 were 27.2% and 40.5% in patients with CD and UC respectively. In addition, the sustained steroid-free clinical remission (from week 14 to week 54) rates were 8.1% and 19.0% respectively. No deaths were observed. Severe adverse events occurred in 17 (7.2%) patients, including six (2.5%) leading to vedolizumab discontinuation.

CONCLUSION

Vedolizumab is able to maintain steroid-free clinical remission in up to one-third of patients with UC and CD at week 54 with a reasonable safety profile. A significant number of patients experienced loss of response during the first year of treatment, particularly in patients with CD.

Is abdominal CT useful for the management of patients with severe acute colitis complicating inflammatory bowel disease? A study in 54 consecutive patients

AIM

To evaluate the contribution of CT for the management of patients with severe acute exacerbation of colitis (SAC) complicating inflammatory bowel disease (IBD); in particular, its contribution to surgical decision making.

METHOD

All patients who were admitted to our institution for SAC complicating IBD were divided into two groups: group A (those who received surgical treatment); and group B (those who received medical treatment). Admission CT results were compared between groups.

RESULTS

From 2006 to 2015, 54 patients [26 male; median age 39 (17-71) years] presenting with SAC were placed in either group A (n = 41; 76%) or group B (n = 13; 24%). Surgical patients in group A more frequently had altered general status (50 vs 17%; P = 0.01). Physical examination, Lichtiger score, endoscopic findings and laboratory results were similar between the groups. There was no significant difference in CT data between the groups with respect to extent of the colitis (pan-colitis in 54 and 69%, respectively, P = 0.35), median colonic thickness [10 (4-16) vs 8 (6-11) mm, P = 0.15], target enhancement (88 vs 77%, P = 0.38) and occurrence of toxic megacolon (2 vs 0%).

CONCLUSION

Admission CT is not helpful in surgical decision making in SAC.

Endoscopic Detection of Small Bowel Dysplasia and Adenocarcinoma in Crohn's Disease: A Prospective Cohort-Study in High-Risk Patients

BACKGROUND AND AIMS

Crohn's disease [CD] is associated with an increased risk of small bowel adenocarcinoma [SBA]. There are no recommendations on endoscopic screening of SBA in CD patients. The aim of this study was to evaluate the feasibility and value of endoscopic screening for SBA in CD patients at high-risk of SBA.

METHODS

We performed an exploratory multi-centre study in a prospective cohort of CD patients at high-risk of SBA defined as long-term small bowel disease without bowel resection for the past 10 years. Depending on the location of the disease, baseline upper and/or lower enteroscopies were performed. Random and targeted biopsies using chromoendoscopy were taken. Patients were followed-up for at least 1 year after inclusion.

RESULTS

In total, 101 patients [62 men; median age: 48 years; median duration of disease: 19 years] were recruited in ten centres. The endoscopic procedure was incomplete in 47 cases because of impassable strictures and dilation was performed in four patients. Indeterminate small bowel dysplasia was identified in two patients at endoscopic screening; SBA was confirmed in one after surgical resection. With an at least 1-year follow-up duration, two additional cases of SBA were identified in patients who underwent surgery for obstruction, resulting in a 33% sensitivity rate for SBA endoscopic screening.

CONCLUSION

In a cohort of high-risk patients, the prevalence of dysplasia and SBA on CD was 4%. Because of its low sensitivity, endoscopic screening cannot be recommended for surveillance in CD patients at high-risk of SBA.

The Importance of Ultrasound Monitoring of the Normal and Lesional Cervical Ectropion Treatment

OBJECTIVE

to investigate the importance of various ultrasound prognosis features in the assessment of the cervical ectropion treatment monitoring.

METHOD

The inclusion criteria was the presence of ectropion and the selection was based on clinical examination performed during routine consultations in specialized clinics, later confirmed by colposcopic evaluation of cervix. The evaluation protocol included: clinical evaluation completed with colposcopy, guided biopsy when lesions were suspected, serological assay of day 21 progesteronemy, presence of Chlamydia, Mycoplasma, Ureaplasma, HVS type II, HPV and bacterial infections, transvaginal ultrasound serial evaluation at the 7th, 14th and 21st day before and after tretment concerning: cervical volumetric calculations and velocimetric measurements of uterine arteries flows. Progestative treatment was prescribed, and antiinfectious specific treatment when needed. Patients were reevaluated after 3 months.

RESULTS

The prospective study included 45 patients between 2013-2014. 28 presented serum progesterone levels below the reference range or borderline. We noted a moderate reduction of the ectropion area in 42 % and a marked reduction in 58% of the cases. No statistically significant differences were found between the size of the cervix before or after treatment, except certain evaluations (the 7th and the 14th day) in the presence of bacterial coinfections. Evaluation of pulsed Doppler velocimetric indices of uterine arteries flows showed generally minor variations with no constant positive or negative trend.

CONCLUSION

Based on the data obtained in our study, we conclude that ultrasound monitoring of ectropion treatment do not provide reliable prognosis data regarding the evolution of cervical lesion.

Short Review on the Aggressive Behaviour: Genetical, Biological Aspects and Oxytocin Relevance

In this mini-review we were interested in describing the main genetic, biological and mechanistic aspects of the aggressive behaviour in human patients and animal models. It seems that violent behaviour and impulsive traits present a multifactorial substrate, which is determined by genetic and non-genetic factors. Thus, aggressivity is regulated by brain regions such as the amygdala, which controls neural circuits for triggering defensive, aggressive or avoidant behaviour. Moreover, other brain structures such as the anterior cingulate cortex and prefrontal cortex regions could modulate circuits involved in aggression. Regarding the genetic aspects, we could mention the mutations in the monoamine oxidase or the polymorphisms of the genes involved in the metabolism of serotonin, such as tryptophan hydroxylase. Also, besides the low levels of serotonin metabolites, which seem to be associated with impulsive and aggressive traits, there are good evidences that deficiencies in glutamate transmission, as well as testosterone, vasopressin, hypochloesterolemia or oxytocin modifications could be related to the aggressive behaviour. Regarding oxytocin we present here in the last chapter the controversial results from the current literature regarding the various effects exhibited by oxytocin administration on the aggressive behavior, considering the increased interest in understanding the role of oxytocin on the main neuropsychiatric disorders.

Short Review on the Aggressive Behaviour: Genetical, Biological Aspects and Oxytocin Relevance

In this mini-review we were interested in describing the main genetic, biological and mechanistic aspects of the aggressive behaviour in human patients and animal models. It seems that violent behaviour and impulsive traits present a multifactorial substrate, which is determined by genetic and non-genetic factors. Thus, aggressivity is regulated by brain regions such as the amygdala, which controls neural circuits for triggering defensive, aggressive or avoidant behaviour. Moreover, other brain structures such as the anterior cingulate cortex and prefrontal cortex regions could modulate circuits involved in aggression. Regarding the genetic aspects, we could mention the mutations in the monoamine oxidase or the polymorphisms of the genes involved in the metabolism of serotonin, such as tryptophan hydroxylase. Also, besides the low levels of serotonin metabolites, which seem to be associated with impulsive and aggressive traits, there are good evidences that deficiencies in glutamate transmission, as well as testosterone, vasopressin, hypochloesterolemia or oxytocin modifications could be related to the aggressive behaviour. Regarding oxytocin we present here in the last chapter the controversial results from the current literature regarding the various effects exhibited by oxytocin administration on the aggressive behavior, considering the increased interest in understanding the role of oxytocin on the main neuropsychiatric disorders.

Fistula Plug in Fistulising Ano-Perineal Crohn's Disease: a Randomised Controlled Trial

BACKGROUND AND AIMS

Anal fistula plug [AFP] is a bioabsorbable bioprosthesis used in ano-perineal fistula treatment. We aimed to assess efficacy and safety of AFP in fistulising ano-perineal Crohn's disease [FAP-CD].

METHODS

In a multicentre, open-label, randomised controlled trial we compared seton removal alone [control group] with AFP insertion [AFP group] in 106 Crohn's disease patients with non- or mildly active disease having at least one ano-perineal fistula tract drained for more than 1 month. Patients with abscess [collection ≥ 3mm on magnetic resonance imaging or recto-vaginal fistulas were excluded. Randomisation was stratified in simple or complex fistulas according to AGA classification. Primary end point was fistula closure at Week 12.

RESULTS

In all, 54 patients were randomised to AFP group [control group 52]. Median fistula duration was 23 [10-53] months. Median Crohn's Disease Activity Index at baseline was 81 [45-135]. Fistula closure at Week 12 was achieved in 31.5% patients in the AFP group and in 23.1 % in the control group (relative risk [RR] stratified on AGA classification: 1.31; 95% confidence interval: 0.59-4.02; p = 0.19). No interaction in treatment effect with complexity stratum was found; 33.3% of patients with complex fistula and 30.8% of patients with simple fistula closed the tracts after AFP, as compared with 15.4% and 25.6% in controls, respectively [RR of success = 2.17 in complex fistula vs RR = 1.20 in simple fistula; p = 0.45]. Concerning safety, at Week 12, 17 patients developed at least one adverse event in the AFP group vs 8 in the controls [p = 0.07].

CONCLUSION

AFP is not more effective than seton removal alone to achieve FAP-CD closure.

The outcome of infliximab dose doubling in 157 patients with ulcerative colitis after loss of response to infliximab

BACKGROUND

Optimising infliximab therapy is recommended in inflammatory bowel disease (IBD) patients who lose response to infliximab; however, there are no data on the outcome of ulcerative colitis (UC) patients after doubling the dose.

AIM

To determine the efficacy and safety of infliximab dose doubling in UC patients with a loss of response to infliximab.

METHODS

From January 2006 to May 2013, we retrospectively reviewed the outcome of the consecutive UC patients who were treated with infliximab dose doubling (10 mg/kg) for loss of response in four French academic centres. The clinical response and remission were assessed. A composite event-free survival analysis was performed using the log-rank test and the Cox model.

RESULTS

One hundred and fifty-seven patients [84 males; median age 37. 6 (IQR 28.2-49.4) years] were included. The median follow-up after infliximab dose doubling was 1.8 (1.0-3.1) years. At weeks 8 and 24, 55% and 43% of the patients achieved a clinical response respectively. The probabilities of the event-free survival were 71%, 61% and 55% at 6 months, 1 year and 2 years respectively. In the multivariate analysis, the predictors of infliximab dose doubling failure were the absence of the introduction of an immunomodulator concomitantly to dose doubling, a partial Ulcerative Colitis Disease Activity Index >6, a C-reactive protein level >10 mg/L, a leucocyte count >8000/mm(3) and a haemoglobin level <12.5 g/dL. Adverse events were reported in 12 patients (8%).

CONCLUSIONS

Infliximab dose doubling led to short- and long-term event-free survival in UC patients, who had a loss of response to infliximab, in greater than 50% of the cases. The benefits of such a strategy were significantly improved by adding a concomitant immunomodulator.

Environmental factors influencing butterfly abundance after a severe wildfire in Mediterranean vegetation

Despite the attention given to the ecology of butterflies, little is known about their community response to wildfires in the Mediterranean region. Here, we evaluated the butterfly assemblage two years after a severe, 13,000 ha wildfire in Catalonia (NE Spain) in relation to the surrounding unburned habitat. Using visual transect censuses we assessed community parameters such as abundance, diversity, species richness and equitability in burned and unburned areas. Correspondence analysis was used to analyse specific composition and relative abundance of species in the community. The influence of environmental variables on the abundance of some common species was analysed using generalized linear mixed models, taking spatial effects into account. No significant differences were found between areas for any of the community parameters, and no dominance was detected in the burned area. The structure of the vegetation and the geographical distribution of transects influenced the ordination of species and transects on the correspondence analysis plot. Generalized linear mixed models (GLMM) results underscored the role of nectar availability, fire and vegetation structure on the abundance of most species studied.

Silica nanoparticles: preparation, characterization and in vitro/in vivo biodistribution studies

BACKGROUND

The current progress in pharmaceutical nanotechnology field has been exploited in the design of functionalized radiolabelled nanoparticles that are able to deliver radionuclides in a selective manner to improve the outcome of diagnosis and treatment. Silica nanoparticles (SNPs) have been widely developed for biomedical applications due to their high versatility, excellent functional properties and low cost production, with the possibility to control different topological parameters relevant for multidisciplinary applications.

PURPOSE

The aim of the present study was to characterize and evaluate both in vitro, by microscopy techniques, and in vivo, by scintigraphic imaging, the biodistribution of silica nanostructures derivatives (Cy5.5 conjugated SNPs and (99m)Tc radiolabelled SNPs) to be applied as radiotracers in biomedicine.

METHODS

SNPs were synthesized by hydrolysis and condensation of silicon alkoxides, followed by surface functionalization with amino groups available for fluorescent dye and radiolabelling possibility.

RESULTS

Our data showed the particles size distribution (200-350 nm), the surface charge (negative for bare and fluorescent SNPs and positive for amino SNPs), polydispersity index (broad distribution), the qualitative composition and the toxicity assessments (safe material) that made the obtained SNPs candidates for in vitro/in vivo studies. A high uptake of fluorescent SNPs in all the investigated organs was evidenced by confocal microscopy. The (99m)Tc radiolabelled SNPs biodistribution was quantified in the range of 12-100% counts/g organ using the scintigraphic images.

CONCLUSIONS

The obtained results reveal improved properties, namely, reduced toxicity with a low level of side effects, an improved biodistribution, high labelling efficiency and stability of the radiolabelled SNPs with potential to be applied in biomedical science, particularly in nuclear medicine as a radiotracer.

The oxidative stress hypothesis in Alzheimer's disease

Oxidative stress may be involved in many somatic and psychiatric pathological states including dementia. The hypothesis of oxidative stress involvement in dementia is supported by much scientific data through biochemical, genetic and molecular studies. Thus, there are many reports of an increased level of the markers for oxidative damage, alterations in the specific activity of the antioxidant system, mutations in specific genes, mitochondrial disturbances and also several connections between oxidative stress and amyloid plaques. Despite these evidence and clinical approaches in using antioxidant therapy in dementia treatment, studies have failed to prove a clear benefit for antioxidant treatment in dementia. Hence, there is a need for further research regarding antioxidant therapy in very early stages of dementia.

Inhibition of central angiotensin II enhances memory function and reduces oxidative stress status in rat hippocampus

While it is now well established that the independent brain renin-angiotensin system (RAS) has some important central functions besides the vascular ones, the relevance of its main bioactive peptide angiotensin II (Ang II) on the memory processes, as well as on oxidative stress status is not completely understood. The purpose of the present work was to evaluate the effects of central Ang II administration, as well as the effects of Ang II inhibition with either AT1 and AT 2 receptor specific blockers (losartan and PD-123177, respectively) or an angiotensin-converting enzyme (ACE) inhibitor (captopril). These effects were studied on the short-term memory (assessed through Y-maze) or long-term memory (as determined in passive avoidance) and on the oxidative stress status of the hippocampus. Our results demonstrate memory deficits induced by the administration of Ang II, as showed by the significant decrease of the spontaneous alternation in Y-maze (p=0.015) and latency-time in passive avoidance task (p=0.001) when compared to saline. On the other side, the administration of all the aforementioned Ang II blockers significantly improved the spontaneous alternation in Y-maze task, while losartan also increased the latency time as compared to saline in step-through passive avoidance (p=0.042). Also, increased oxidative stress status was induced in the hippocampus by the administration of Ang II, as demonstrated by increased levels of lipid peroxidation markers (malondialdehyde-MDA concentration) (p<0.0001) and a decrease in both antioxidant enzymes determined: superoxide dismutase-SOD (p<0.0001) and glutathione peroxidase-GPX (p=0.01), as compared to saline. Additionally, the administration of captopril resulted in an increase of both antioxidant enzymes and decreased levels of lipid peroxidation (p=0.001), while PD-123177 significantly decreased MDA concentration (p>0.0001) vs. saline. Moreover, significant correlations were found between all of the memory related behavioral parameters and the main oxidative stress markers from the hippocampus, which is known for its implication in the processes of memory and also where RAS components are well expressed. This could be relevant for the complex interactions between Ang II, behavioral processes and neuronal oxidative stress, and could generate important therapeutic approaches.

The relevance of oxidative stress status in first episode and recurrent depression

Oxidative and nitrosative stress (O&NS) could play an important role in the pathophysiology of major depression (MDD). The aim of the present work was to evaluate the specific activity of the main peripheral antioxidant defences (superoxide dismutase--SOD and glutathione peroxidase--GPX) and the level of malondialdehyde--MDA (a lipid peroxidation maker), in depressed patients, as compared to an age-matched control group. Also, we were interested to see if there are any differences between first episode vs. recurrent depression groups, in terms of oxidative stress markers. Additionally, we want it to investigate the effects of different antidepressant medication (mirtazapine, venlafaxine, tianeptine and escitalopram) on oxidative status of depressed patients. Our results showed an increased oxidative stress status in the serum of patients with MDD, expressed by a significant decrease of both SOD and GPX specific activities and a significant increase of the lipid peroxidation marker MDA, as compared to the control group. When we analyzed the oxidative stress status in depressed patients based on chronicity we observed significant decrease of SOD and GPX specific activities in recurrent depression group, as compared to the first episode group. Moreover, a very significant increase in MDA concentration was observed in recurrent depression patients, as compared to the first episode group. Our work provides additional evidences of increased oxidative stress in MDD, expressed by altered antioxidant enzyme activity and increased levels of lipid peroxidation. Also, it seems that sub-classifying depression into different subtypes, based on chronicity, can predict differences in the levels of some various oxidative stress markers.

Cardiovascular risk factors as potential markers for mild cognitive impairment and Alzheimer's disease

BACKGROUND

Mild cognitive impairment (MCI) is an early stage of cognitive decline that has a significant risk of converting to dementia. Cardiovascular pathology appears to have a major impact in cognitive decline, and it is clear that early identification and correction of cardiovascular morbidity could have a major impact on cognitive functioning.

SUBJECTS AND METHODS

Our study was conducted in order to identify some cardiovascular risk factors among patients with cognitive decline (MCI or Alzheimer disease-AD) and to find if there is any correlation with the degree of cognitive decline. We evaluated the body mass index, total cholesterol, hypertension, history of smoking, alcohol consumption and diabetes mellitus in patients with MCI and AD, compared with an age-matched control group.

RESULTS

Regarding the body mass index, we observed a progressive decrease in patients with MCI and AD, in comparison with the control group. Similar aspects were also observed in the case of cholesterol levels, only that post hoc analysis revealed no significantly statistical differences between MCI and AD groups. The systolic blood pressure was increased in the patients with MCI and AD. Also, as in the case of cholesterol levels, post hoc analysis revealed no significantly statistical differences between MCI and AD groups. Pearson's correlation showed significant connections between the cardiovascular risk factors and the results of the cognitive evaluation.

CONCLUSIONS

Our results constitute additional evidence that cardiovascular risk factors are involved in cognitive regression. This finding could have an important impact on the management of dementia.

Oxidative stress in schizophrenia - focusing on the main markers

Oxidative stress is the condition arising from imbalance between toxic reactive oxygen species and antioxidant systems. It is believed that increased oxidative stress may be relevant to the pathophysiology of schizophrenia. In this way, the main markers of the lipid peroxidation processes include 4-hydroxynonenal and malondialdehyde. On the other side, the potential toxicity of free radicals is counteracted by a number of cytoprotective antioxidant enzymes that limit the damage, such as superoxide dismutase and glutathione peroxidase. However, the reports regarding the status of oxidative stress markers schizophrenia are very inconsistent, with various authors stating both increased and decreased activities of the main antioxidant enzymes, while others did not observe any significant modifications, as compared to control groups. Similar aspects were also reported in the case of the lipid peroxidation markers, although in here the contradictions are much more reduced than in the case of the antioxidant defences. It is generally believed that the equivocal results mentioned above may be due to different tissues studies, different species or the administrated treatment and the duration of the disease/treatment. In this context, in the present paper we were interested to review some studies regarding the oxidative stress status in patients and animal models of schizophrenia, by referring mainly to antioxidant enzymes and lipid peroxidation markers.

Oxidative stress markers in patients treated with typical and atypical antipsychotics

Introduction

Studies performed in schizophrenia patients have generally suggested the presence of a compromised antioxidant system, but this is not always consistent with specific observed parameters, which on the whole, show evidences of dysregulation. There are also controversies regarding the oxidative stress status in patients treated with typical vs. atypical antipsychotics.

Aim

In this context, the aim of the present work was to evaluate the specific activity of some peripheral antioxidant defences like superoxide dismutase (SOD) and glutathione peroxidase (GPX) and the level of a lipid peroxidation maker (malondialdehyde-MDA), in schizophrenic patients treated with typical (haloperidol) or atypical (olanzapine, quetiapine and risperidone) antipsychotics, compared with age-matched healthy subjects.

Methods

The subjects of this study (n = 45), consisted of 35 patients who met DSM-IV criteria for schizophrenia and 10 healthy control age and gender-matched subjects. Patients were of paranoid subtype, with duration of illness for at least 5 years. Nine patients were under haloperidol (1–2 mg daily dose) treatment and 26 (8/10/8) patients were under atypical treatment: quetiapine (300 mg daily dose), olanzapine (20 mg daily dose) or risperidone (2–4 mg daily dose), respectively.

Results

We found a significant decrease in GPX specific activity and also a significant increase of MDA levels in schizophrenic patients, compared to age-matched control group, regardless of their type of treatment. Additionally, an increase in SOD specific activity was observed, mainly in the patients treated with haloperidol and quetiapine.

Conclusions

Further research is necessary in order to elucidate the effects of different antipsychotic agents on antioxidant enzymes.

Changes of some oxidative stress markers in the serum of patients with mild cognitive impairment and Alzheimer's disease

Mild cognitive impairment (MCI) is a nosological entity proposed as an intermediate state between normal aging and dementia. MCI seems to represent an early stage of Alzheimer's disease (AD) and there is a great interest in the relationship between MCI and the progression to AD. Some studies have demonstrated an accumulation of products of free radical damage in the central nervous system and in the peripheral tissues of subjects with AD or mild cognitive impairment. The aim of the present work was to evaluate the serum levels of some enzymatic antioxidant defences like superoxide dismutase (SOD) and glutathione peroxidase (GPX), as well as lipid peroxidation markers like MDA (malondialdehyde), in MCI and AD patients, compared with age-matched healthy controls. The subjects of this study (45 patients) consisted of 15 individuals with mild cognitive impairment (MCI), 15 with Alzheimer's disease (AD) and 15 healthy age-matched controls. Biochemical analyses showed a similar decrease of the main enzymatic antioxidant defences (SOD and GPX) and increased production of lipid peroxidation marker (MDA) in the serum of the MCI and AD patients, compared to age-matched control group. This study clearly demonstrates that oxidative stress damage occurs in patients with MCI and AD. Moreover, some enzymatic markers of oxidative stress are similar in MCI and AD patients, suggesting that oxidative damage could be one important aspect for the onset of AD.

The Comorbidity of Depression and Substance Abuse Disorders in Romanian Patients

Depression appears to be independent from, but frequently co-occurs with, substance abuse disorders, including alcohol and drug abuse. Depression and substance use disorders are highly prevalent in the general population and often co-occur within the same individual. Many people with depression turn to alcohol or drugs, eventually developing a dependence or addiction. Conversely, people who are addicted to alcohol or drugs have a high rate of depression. Alcohol and some drugs are depressants, and depressed mood can be a direct outcome of substance abuse. Use of alcohol by people suffering from depression can increase the severity of their depressive symptoms. Fortunately, it is also treatable and the key to treatment is to recognize the symptoms and to get help. Research shows that one in three depressed people also suffer from some form of substance abuse or dependence.

Children and Computers use: Social, Psychological and Academic Consequences

Numerous surveys have attempted to measure how frequently children use the computer at home. Few studies and inconsistent findings render uncertain whether using the computer has any influence on children's social outcomes. The only available review of this research concluded that there is no evidence that computer use is directly related to any psychological outcomes. Although benefits of computer use have been observed, they typically depend on a variety of factors (e.g., subject matter). The only cognitive outcome for which benefits have been consistently observed is visual-spatial skills. Computer gaming contributes to visual-spatial skills, at least when these skills are assessed immediately following the computer activity.

Objective:

The need for information about the effects of computers on their users also increases. The purpose of this study is to investigate how computers are use by children and adolescents. The second goal is to explore the beneficial and harmful effects of computers use on children's mental and physical health.

Methodology:

The studied group of samples comprised 69 subjects, aged between 13 and 18 years, who answered to a questionnaire. The parents of children answered too another questionnaire whit same subject.

Results and conlusions:

The results were obtained about computers use and identification pathological use. Some the children spend much time to computers, 4% more five hours/day. 41% of the parents believe that the usage computers are favorable to developmental children's mental and physical health and 49% of the parents don't believe that. We find approximately 3,5% of cases with pathological use.

Cystic dystrophy in gastric heterotopic pancreas complicated by intracystic hemorrhage and fistulisation in the stomach - a pediatric case

CONTEXT

Cystic dystrophy of the digestive wall, a rare but well-known complication of heterotopic pancreas when it is located in the duodenum, has been mainly described in adult series. Cystic dystrophy of the heterotopic pancreas within the gastric wall has been reported in only six adult cases. To our knowledge, no pediatric case has been described.

CASE REPORT

We report a 15-year-old boy surgically treated for cystic dystrophy located in the antrum, complicated by an intracystic hemorrhage and fistulisation into the stomach.

CONCLUSION

The diagnosis of heterotopic pancreas must be considered in case of submucosal cystic-gastric lesions, even in pediatric cases. Although the surgical approach is not systematic, it is recommended when cystic dystrophy is symptomatic (e.g., occlusion or hemorrhage).

Genetics of host plant use and life history in the comma butterfly across Europe: varying modes of inheritance as a potential reproductive barrier

Comma butterflies (Nymphalidae: Polygonia c-album L.) from one Belgian site and three Spanish sites were crossed with butterflies from a Swedish population in order to investigate inheritance of female host plant choice, egg mass and larval growth rate. We found three different modes of inheritance for the three investigated traits. In line with earlier results from crosses between Swedish and English populations, the results regarding female oviposition preference (choice between Urtica dioica and Salix caprea) showed X-linked inheritance to be of importance for the variation between Sweden and the other sites. Egg mass and growth rate did not show any sex-linked inheritance. Egg mass differences between populations seem to be controlled mainly by additive autosomal genes, as hybrids showed intermediate values. The growth rates of both hybrid types following reciprocal crossings were similar to each other but consistently higher than for the two source populations, suggesting a nonadditive mode of inheritance which is not sex-linked. The different modes of inheritance for host plant preference vs. important life history traits are likely to result in hybrids with unfit combinations of traits. This type of potential reproductive barrier based on multiple ecologically important traits deserves more attention, as it should be a common situation for instance in the early stages of population divergence in host plant usage, facilitating ecological speciation.