Temporary results only in electroconvulsive therapy in therapy-resistant depression; retrospective study

OBJECTIVE: To evaluate the use and efficacy of electroconvulsive therapy (ECT) in refractory major depression according to DSM-III-R criteria, and to look for factors predicting response in the acute phase and the occurrence of relapse or recurrence after recovery. DESIGN: Retrospective. SETTING: University Hospital Rotterdam, The Netherlands. METHODS: Of all patients who received ECT between January 1988 and July 1993 data were collected by study of clinical records and of information by treating physicians after discharge. Every patient was visited once, or received an outpatient department appointment, to obtain informed consent, take a follow-up history and evaluate social functioning by scoring Global Assessment of Functioning and Sickness Impact Profile rating scales. RESULTS: 35 patients received ECT. In clinical practice, the guidelines of the Netherlands Psychiatric Association were not violated; most patients had received adequate pharmacological pretreatment before the decision to start ECT was made. Two patients died in hospital (not from ECT). In the acute phase 25 of the 33 patients still alive upon discharge showed good recovery. Seven of these suffered relapse within six months. The number of patients with a return of depressive symptoms rose to 12 by the end of the first year of follow-up. Sociodemographic variables and treatment characteristics did not appear to influence the result of treatment in the acute phase, nor the occurrence of relapse or recurrence. With less intensive pre- and post-ECT drug treatment the chances of relapse were increased. CONCLUSIONS: ECT is an effective treatment in the acute phase of a depression. Results after a longer period of follow-up are less satisfactory.     

Diminished levels of insulin-like growth factor-I in lungs in streptozotocin-induced diabetes: relation to nutritional status and growth

It is yet unknown whether the impaired nutritional status of streptozotocin-induced diabetic rats influences changes in levels of insulin-like growth factor-I (IGF-I) in this experimental model of diabetes. To explore this possibility, simultaneous studies were undertaken of rats made diabetic by streptozotocin (75 mg/kg body wt, intraperitoneally) and undernourished control rats with similar somatic growth rate (determined by body weight gain), in comparison with normal controls. Serum IGF-I levels were diminished in the untreated diabetic and undernourished control animals, but more so in the diabetic group. Lung IGF-I levels (per lung and per lung DNA) and DNA contents were diminished to similar degrees in the untreated diabetic animals and the undernourished control group. Lung dry weights of the diabetic rats were greater than those of the undernourished control group, such that lung IGF-I/100 mg tissue dry wt in the former was significantly lower than in the latter group. Insulin treatment of the diabetic rats restored their body weights, serum and lung IGF-I levels, and DNA contents to normal control values. Lung IGF-I levels in the diabetic rats correlated strongly with serum glucose (r = .75) and body weight (r = .79), and moderately with lung weight (r = .43) and lung DNA (r = .58). These findings suggest that the diminished lung IGF-I levels in streptozotocin-induced diabetes may be related to the impaired nutritional status and/or somatic growth of the experimental animals, and that this relationship may be responsible, at least in part, for the diminished lung cellular proliferation observed in experimental diabetic animals.     

Fibrolamellar carcinoma of the liver: composition of the extracellular matrix and expression of cell-matrix and cell-cell adhesion molecules

We have analyzed the composition of the tumor stroma and the expression of cell-matrix and cell-cell adhesion molecules in 11 cases of fibrolamellar carcinoma of the liver (FLC), in comparison with 34 cases of hepatocellular carcinoma and 8 cases of focal nodular hyperplasia. Fibrolamellar carcinoma was characterized by the presence of large amounts of tenascin in tumor stroma and by the scarce expression of basement membrane components at the contact of neoplastic clusters. Like normal hepatocytes, neoplastic cells constantly expressed the alpha1 integrin chain, lacked the beta4 integrin chain, and coexpressed E-cadherin and the hepatocyte N-related cadherin. Abnormalities in the expression of cell adhesion molecules, including altered cadherin expression, alphaV integrin chain induction, and CD44 expression, were detected in the majority of cases. The composition of the tumor stroma and the pattern of expression of cell adhesion molecules in fibrolamellar carcinoma were reminiscent of those observed in grade III and grade IV hepatocellular carcinomas. Our results therefore show that, despite its slow local growth and good prognosis, fibrolamellar carcinoma expresses many characteristics usually associated with clinically aggressive malignancies. Further studies are needed to identify the factors responsible for the apparent dissociation between clinical behavior and biological characteristics in this tumor.     

A comparison of breeding value predictors for longevity using a linear model and survival analysis

A comparison was made among breeding values of sires for longevity that were obtained by different methods: phenotypic averages of daughters using only uncensored records, BLUP using only uncensored records, survival analysis using only uncensored records, and survival analysis using both censored and uncensored records. Two data files were used: one contained data from small herds, and the other contained data from large herds. The results from both data files were similar. Different methods of predicting breeding values resulted in different rankings of sires. The results obtained using phenotypic averages were weakly correlated (< or = 0.46) with those results obtained using the other methods of prediction. The REML BLUP had strong correlations (< or = -0.91) with the survival analysis predictor if the same data were used, and correlations weakened (< or = -0.60) when censored records were included in the survival analysis. The correlations are negative because the linear method analyzed longevity, and survival analysis measured the risk of being culled, which has an antagonistic relationship with longevity. The results from REML BLUP and survival analysis methods differed mainly because of the different data that were used (uncensored only versus both censored and uncensored).     

Double blind, randomised, placebo controlled study of oral vancomycin in prevention of necrotising enterocolitis in preterm, very low birthweight infants

AIMS: To evaluate the effectiveness of oral vancomycin in the prophylaxis of necrotising enterocolitis in preterm, very low birthweight infants. METHODS: A prospective, double blind, randomised, placebo controlled study in a tertiary referral centre of a university teaching hospital was conducted on 140 very low birthweight infants consecutively admitted to the neonatal unit. The babies were randomly allocated to receive oral vancomycin (15 mg/kg every 8 hours for 7 days) or an equivalent volume of placebo solution. Prophylaxis was started 24 hours before the start of oral feeds. All suspected cases of necrotising enterocolitis were investigated with a full sepsis screen and serial abdominal radiographs. Necrotising enterocolitis was diagnosed and staged according to modified Bell's criteria. RESULTS: Nine of 71 infants receiving oral vancomycin and 19 of 69 infants receiving the placebo solution developed necrotising enterocolitis (p = 0.035). Infants with necrotising enterocolitis were associated with a significant increase in mortality (p = 0.026) and longer duration of hospital stay (p = 0.002). CONCLUSIONS: Prophylactic oral vancomycin conferred protection against necrotising enterocolitis in preterm, very low birthweight infants and was associated with a 50% reduction in the incidence. However, widespread implementation of this preventive measure is not recommended, as it would only be effective in necrotising enterocolitis caused by Gram positive organisms and could increase the danger of the emergence of vancomycin resistant or dependent organisms. Its use should be restricted to a high prevalence nursery for a short and well defined period in a selected group of high risk patients.     

Attentional control within 3-D space

Four experiments investigated whether directing attention to a particular plane in depth enables observers to filter out information from another depth plane. Observers viewed stereoscopic displays and searched for a red line segment among green line segments. The results showed that directing attention to a particular depth plane cannot prevent attentional capture from another depth plane when the colors of the target and distractor are identical. However, it can prevent attentional capture by a singleton from another depth plane when the colors of the target and distractor are different. These results indicate that only when both color and depth information are selective in guiding attention to the target singleton can attentional capture by irrelevant singletons be prevented. The results also suggest that retinal disparity does not have the same special status as location information in two dimensions and should be considered as just another feature along which selection may occur.     

Clinical and functional evaluation of health status of workers exposed to infrasound, noise and general vibration

The article covers complex evaluation of health state in building industry workers engaged into ferro-concrete production in St. Petersburg. The health state was considered under combined action of infrasound, noise and general vibration. Clinical and functional evaluation included medical examination by doctors, blood biochemistry and CBC, ECG, computer integral rheography, voice audiometry. Data for 62 moulders helped to assess acoustic environment at workplace and to reveal the morbidity structure.     

Breed group effects on milk production of Brazilian crossbred dairy cows

Lactation records (n = 2362) of 1402 crossbred cows in 22 cooperating dairy herds in southeastern Brazil were evaluated. Cows were mixtures of Zebu (Gir, Guzera, and unknown) and European breeding (mostly Holstein). Lactation milk yields were expressed as total, 3050-d, or deviated 305-d yields, either adjusted or unadjusted for days in milk (DIM). Mean DIM was 280. Arithmetic means unadjusted for DIM were 1942, 1666, and 5 kg per record. Milk yields of daughters from sires of 6/8 and 7/8 European breeds were higher than yields of daughters from sires of 5/8 European breeds when data were either adjusted or unadjusted for DIM. The differences associated with breed group of sire were only slightly reduced when records were adjusted for DIM. There was no evidence of a decline in milk yield as the fraction of European breeding of the sire increased from 6/8 to 7/8. For a given breed group of sire, whether the grandsire was purebred or crossbred had no detectable effect. These results should be useful in determining strategies for crossbreeding of dairy cows in tropical areas, particularly when crossbred sires are used.