Newcastle disease virus-induced functional impairments and biochemical changes in chicken heterophils

The GB strain of Newcastle disease virus (NDV) is used to infect chicken heterophils in vitro. Heterophils have a decreased ability to phagocytize bacteria 3 h after infection, and those that did engulfed fewer bacteria relative to non-infected heterophils. Infected heterophils have a decreased H2O2 production as shown by flow cytometry, but an increased nitric oxide production, suggesting that NDV can stimulate heterophils to produce and/or utilize nitrogen intermediates but not oxygen intermediates. DNA extracted from the infected heterophils shows a marked fragmentation, suggesting that NDV infection may cause heterophils to undergo apoptosis.     

The relationship between fluoxetine use and suicidal behavior in 654 subjects with anxiety disorders

BACKGROUND: In the past few years, there has been controversy over the relationship between suicidal behavior and fluoxetine use. This report examines the relationship between fluoxetine use and suicidal behavior in the Harvard/Brown Anxiety Disorders Research Program (HARP). METHOD: HARP is a naturalistic, prospective, longitudinal anxiety disorders study. Probabilities of suicidal behavior for 654 subjects were examined using life table analysis for the study group as a whole and stratified by depression status at intake. RESULTS: Subjects not using fluoxetine during follow-up had almost twice the probability of making a suicide attempt or gesture during the follow-up than subjects who were using fluoxetine, although this difference was not statistically significant. Subjects having episodes of major depressive disorder (MDD) at intake were more likely than those not having an episode to receive fluoxetine during follow-up (74/166 [45%] vs. 118/488 [24%], chi squared= 24.85, df= 1, p < .0001). Among those subjects having episodes of MDD at intake, there was a statistically significantly lower probability of suicide attempts/gestures for those taking fluoxetine than for those not using fluoxetine during follow-up (log-rank chi squared= 5.10, df= 1, p= .02). CONCLUSION: We found no evidence that fluoxetine use is associated with increased risk of suicide attempts or gestures. However, we did find that subjects with more suicide risk factors at intake were more likely to use fluoxetine than those without these risk factors.     

The interaction of visual and proprioceptive inputs in pointing to actual and remembered targets

Errors in pointing to actual and remembered targets presented in three-dimensional (3D) space in a dark room were studied under various conditions of visual feedback. During their movements, subjects either had no vision of their arms or of the target, vision of the target but not of their arms, vision of a light-emitting diode (LED) on their moving index fingertip but not of the target, or vision of an LED on their moving index fingertip and of the target. Errors depended critically upon feedback condition. 3D errors were largest for movements to remembered targets without visual feedback, diminished with vision of the moving fingertip, and diminished further with vision of the target and vision of the finger and the target. Moreover, the different conditions differentially influenced the radial distance, azimuth, and elevation errors, indicating that subjects control motion along all three axes relatively independently. The pattern of errors suggest that the neural systems that mediate processing of actual versus remembered targets may have different capacities for integrating visual and proprioceptive information in order to program spatially directed arm movements.     

A psychiatric diagnostic system integrating probabilistic and categorical reasoning

We describe a diagnostic support system for clinical psychiatry and its evaluation results. The system has two inter-related components: a rule-based reasoning part associated with uncertainty, and a deterministic part, that uses heuristics to perform categorical reasoning. The system includes the 30 groups of psychiatric diagnoses which are classified under the categories 290 to 319 of the DSM-III-R and the ICD-9. There are, in fact, 1508 rules relating 208 clinical findings with 257 diagnoses. The reasoning strategy is based on selecting and differentiating diagnostic categories in a hierarchical classification tree. The system is intended to be used for education of medical students, and to help non-specialist clinicians, residents in psychiatry, or experts with few years of experience in decision making. We tested the diagnostic performance of the system using case reports extracted from a specialized journal. In 52.8% of the cases, the correct diagnosis was ranked as the first hypothesis using only the rule-based part. In combination with the deterministic strategy, the correct diagnosis could be made for 73.6% of the analyzed cases.     

Pressure ulcers, self-concept and body image in spinal cord injury patients

The occurrence of pressure ulcers is an important problem for persons with spinal cord injury. Pressure ulcers, though preventable, can engender serious physical and psychological consequences. Living with a spinal cord injury entails the adaptive mechanisms described by Roy (Andrews & Roy, 1991).     

The use of single photon emission computerized tomography in neuropsychiatric SLE: a pilot study

OBJECTIVE: To test the sensitivity of single photon emission computerized tomography (SPECT) in detecting brain abnormalities in cases of definite active neuropsychiatric systemic lupus erythematosus (NPSLE) in a blinded, prospective pilot study. METHODS: Fourteen patients fulfilling at least 4 of the American College of Rheumatology criteria for the classification of SLE plus positive serology manifested by either elevated DNA binding or decreased serum complement and a recent neuropsychiatric event were evaluated with cerebral SPECT using hexa-methyl-propylene-amine-oxime labeled 99Tc. Secondary causes such as infection, uremia, hypertension, drugs, and metabolic abnormalities were excluded. Patients underwent brain scan and electroencephalogram (EEG) for comparison. When clinically indicated, CT scan, magnetic resonance imaging, angiography, and lumbar puncture were performed. RESULTS: SPECT scan abnormalities were noted in 12/14 patients and brain scan was abnormal in 12/14 patients. SPECT and brain scan were in accordance in 12/14 patients (11 patients both positive and 1 both negative) and the combination of SPECT and brain scan yielded 13/14 positive results. In the 3 patients with headache, SPECT scan was negative in 2/3, despite positive EEG and one with a positive brain scan. The positive SPECT in the patient with headache showed an old cerebrovascular accident (CVA), which was confirmed by CT scan. The most consistent CT finding was cortical atrophy; however, SPECT identified a lesion in the occipital cortex in a patient with seizure, and a lesion in the basal ganglia in a patient with ataxia. CONCLUSION: In clinically and serologically active NPSLE, SPECT is a sensitive diagnostic tool. When further stratifying NPSLE into focal (seizure, ataxia, CVA) and diffuse (headache, organic brain syndrome, psychosis), SPECT appeared to be sensitive for focal disease and for most diffuse manifestations, with the exception of headache. The high sensitivity of SPECT in patients with true, positive NPSLE merits further controlled studies in unselected patients with SLE.     

Influence of food on the oral bioavailability of loratadine and pseudoephedrine from extended-release tablets in healthy volunteers

The effect of a high-fat breakfast on the bioavailability of the components of an extended-release tablet containing 10 mg loratadine in the immediate-release coating and 240 mg pseudoephedrine sulfate in the extended-release core was studied in 24 healthy male volunteers in a single-dose, two-way crossover study. The drug was administered after a 10-hour overnight fast or within 5 minutes of consuming a standardized high-fat breakfast. Serial blood samples were collected over a 48-hour period, and plasma was analyzed for loratadine and its active metabolite descarboethoxyloratadine (DCL), and pseudoephedrine. For pseudoephedrine, maximum concentration (Cmax) and area under the concentration-time curve extrapolated to infinity (AUCzero-infinity) were similar after both treatments, indicating no relevant food effect on the bioavailability of pseudoephedrine. Also, the absorption profiles of pseudoephedrine (from Wagner-Nelson analysis) were similar for the fed and fasted treatments, indicating no apparent differences in absorption. Plasma concentration-time profiles and values for Cmax and AUCzero-infinity of DCL were similar for the two treatments, indicating no relevant food effect on the pharmacokinetics of DCL. In contrast, for loratadine, administration with food resulted in a significantly increased mean Cmax (53%) and AUC from time zero to the final quantifiable sample (AUCif) (76%). However, the resultant Cmax and AUC of loratadine under fed conditions were well below those previously obtained at steady-state after multiple-dose administration of loratadine (40 mg/day) that were shown to be safe and well-tolerated in several clinical studies. The effect of food on the bioavailability and pharmacokinetic profiles of the components of a combination loratadine/pseudoephedrine extended-release tablet is not likely to be clinically significant.     

Fatal congenital myopathy with actin filament deposits

We present the clinical and morphological findings in a case of progressive congenital myopathy. The symptoms present at birth included severe general muscular hypotonia, diffuse muscular atrophy, arthrogryposis, absence of spontaneous movements, and left ventricular hypertrophy. A biopsy specimen taken from the gastrocnemius muscle when the patient was 2 weeks old revealed deposits which consisted of actin filaments as shown by electron microscopy. The infant was occasionally respirator dependent but was mostly able to breathe unassisted. At the age of 5 months he died of respiratory failure. The actin filament deposits may explain the clinical findings.