Self-monitoring dysfunction and the schizophrenic symptoms of alien control

BACKGROUND: Frith & Done (1988) have proposed that the experience of alien control symptoms in schizophrenia is related to a failure by such individuals to monitor effectively their own willed intentions, actions and thoughts. METHOD: To examine this hypothesis, a heterogeneous group of 35 patients, all carrying a DSM-III-R diagnosis of schizophrenia (or schizophreniform psychosis) and 24 non-patient controls, completed a battery of neuropsychological and cognitive tests, which inter alia, included four putative measures of self-monitoring. Patients took part in a detailed clinical interview to assess current levels of symptomatology. RESULTS: Patients generally performed at a lower level on most components of the test battery, including the four self-monitoring tests. Moreover, patients currently experiencing symptoms of alien control tended to experience greater difficulty with each of the self-monitoring tests; an effect that was relatively independent of neuropsychological or general cognitive function. CONCLUSIONS: The relationship between poor self-monitoring and the presence of alien control symptoms provides support for Frith & Done's account of the origins of these symptoms in schizophrenia.     

Are frequent short gastro-oesophageal reflux episodes the cause of symptoms in patients with non-ulcer dyspepsia responding to treatment with ranitidine?

BACKGROUND: Patients with non-ulcer dyspepsia (NUD) responding to treatment with H2-receptor antagonists have no clinically useful characteristics. This trial compares the gastro-oesophageal reflux pattern as measured by 24-h oesophageal pH monitoring in patients responding to ranitidine with that of non-responders. METHODS: Thirty-one patients with NUD were randomized to 6 weeks' double-blind alternating treatment with 150 mg ranitidine twice daily or placebo and classified as responders or non-responders. RESULTS: Pathologic gastro-oesophageal reflux was seen in 3 of the 13 responders and 4 of the 18 no-responders (NS). The responders had frequent short reflux episodes (< 1 min in duration). When 4 patients with > or = 5 reflux episodes longer than 5 min were excluded, the number of short reflux episodes (median) in responders and non-responders was 32 and 14, respectively. The difference is statistically significant (p = 0.025). There were no other differences between the groups. CONCLUSIONS: In this study patients with NUD responding to ranitidine were characterized by frequent short reflux episodes in the absence of numerous long reflux episodes.     

Heart rate and workload variations in actual and simulated flight

The monitoring of heart rate in aviation research provides a global index of pilot workload. Heart rate variability is a promising measure but more complex to assess and therefore less often used, especially in dynamic task environments. The application of spectral analysis techniques of heart rate for workload assessment in aviation is illustrated and discussed. Ideally, workload assessment includes real-time or continuous measures to reveal variations in workload as pilots accomplish their tasks. Four studies are discussed that used heart rate measures for the assessment of: (1) training effectiveness; (2) stress of flight instruction; (3) simulator realism; and (4) flight task difficulty. Results indicate that cardiovascular measures are well suited to index different mental states of pilots as well as their dynamic responses to variations in workload.     

Analysis of immunoglobulin genes in splenic marginal zone lymphoma suggests ongoing mutation

BACKGROUND: The incidence of venous thromboembolism has not been well described, and there are no studies of long-term trends in the incidence of venous thromboembolism. OBJECTIVES: To estimate the incidence of deep vein thrombosis and pulmonary embolism and to describe trends in incidence. METHODS: We performed a retrospective review of the complete medical records from a population-based inception cohort of 2218 patients who resided within Olmsted County, Minnesota, and had an incident deep vein thrombosis or pulmonary embolism during the 25-year period from 1966 through 1990. RESULTS: The overall average age- and sex-adjusted annual incidence of venous thromboembolism was 117 per 100000 (deep vein thrombosis, 48 per 100000; pulmonary embolism, 69 per 100000), with higher age-adjusted rates among males than females (130 vs 110 per 100000, respectively). The incidence of venous thromboembolism rose markedly with increasing age for both sexes, with pulmonary embolism accounting for most of the increase. The incidence of pulmonary embolism was approximately 45% lower during the last 15 years of the study for both sexes and all age strata, while the incidence of deep vein thrombosis remained constant for males across all age strata, decreased for females younger than 55 years, and increased for women older than 60 years. CONCLUSIONS: Venous thromboembolism is a major national health problem, especially among the elderly. While the incidence of pulmonary embolism has decreased over time, the incidence of deep vein thrombosis remains unchanged for men and is increasing for older women. These findings emphasize the need for more accurate identification of patients at risk for venous thromboembolism, as well as a safe and effective prophylaxis.     

The expression of voltage-dependent calcium channel beta subunits in human cerebellum

The beta subunits of voltage-dependent calcium channels, exert marked regulatory effects on the biophysical and pharmacological properties of this diverse group of ion channels. However, little is known about the comparative neuronal expression of the four classes of beta genes in the CNS. In the current investigation we have closely mapped the distribution of beta1, beta2, beta3 and beta4 subunits in the human cerebellum by both in situ messenger RNA hybridization and protein immunohistochemistry. To our knowledge, these studies represent the first experiments in any species in which the detailed localization of each beta protein has been comparatively mapped in a neuroanatomically-based investigation. The data indicate that all four classes of beta subunits are found in the cerebellum and suggest that in certain neuronal populations they may each be expressed within the same cell. Novel immunohistochemical results further exemplify that the beta voltage-dependent calcium channel subunits are regionally distributed in a highly specific manner and studies of Purkinje cells indicate that this may occur at the subcellular level. Preliminary indication of the subunit composition of certain native voltage-dependent calcium channels is suggested by the observation that the distribution of the beta3 subunit in the cerebellar cortex is identical to that of alpha(1E). Our cumulative data are consistent with the emerging view that different native alpha1/beta subunit associations occur in the CNS.