Serum cholesterol concentrations in suicidal and non-suicidal male patients suffering from persistent delusional disorder

Suicidal behavior is a major health risk in psychiatric disorders, especially in affective and psychotic disorders. The neurobiology of suicidal behavior is still unclear. Suicidality has been related to a reduced cholesterol levels. The aim of this study was to evaluate serum cholesterol concentrations in suicidal and non-suicidal men suffering from persistent delusional disorder and in healthy volunteers. Results showed that serum cholesterol concentrations were significantly lower in suicidal than in non-suicidal patients and healthy controls. Also, level of psychopathology (measured by Brief Psychiatric Rating Scale) is significantly marked in the group of suicidal patients, which indicates the importance of detecting some clinical symptoms in patients with persistent delusional disorder in order to prevent suicidal behavior.     

Dermatoglyphic analysis in borderline personality disorder and schizophrenia--results of a Croatian study

Dermatoglyphic features of 52 male patients with borderline personality disorder (BPD) were compared with those of 200 male controls (control group-CG) and 195 males with schizophrenia (SCH). Quantitative analysis showed statistically significant differences between BPD-CG and between BPD-SCH, mainly regarding the palmar traits, but also the 5th, the 4th and the 1st finger of the right hand as well as the 5th and the 4th finger of the left hand between BPD and SCH patients. The canonical discriminant analysis permitted correct classification with 69.84% probability between the BPD and CG and with 76.11% probability between the BPD and the SCH group. Qualitative finger and palmar traits analysis showed differences between the BPD and SCH groups on the 3rd finger of the left hand, total frequency for all fingers and in the III interdigital space. Significant differences between the BPD and CG were found on the 3rd finger of the left hand. Our results show that the dermatoglyphic features of BPD differ from those of schizophrenia and from those of control subjects. The possible significance of these findings is discussed.     

Serum cholesterol concentration and death from suicide in men: Paris prospective study I.

OBJECTIVE: To investigate whether low serum cholesterol concentration or changing serum cholesterol concentration is associated with risk of suicide in men. DESIGN: Cohort study with annual repeat measurements of serum cholesterol concentration (for up to four years). SETTING: Paris, France. SUBJECTS: 6393 working men, aged 43-52 in 1967-72, who had at least three measurements of serum cholesterol concentration. MAIN OUTCOME MEASURES: Individual change over time in serum cholesterol concentration (estimated using within person linear regression method); death from suicide during average of 17 years'' follow up after last examination. RESULTS: 32 men committed suicide during follow up. After adjustment for age and other factors, relative risk of suicide for men with low average serum cholesterol concentration (< 4.78 mmol/l) compared with those with average serum cholesterol concentration of 4.78-6.21 mmol/l was 3.16 (95% confidence interval 1.38 to 7.22, P = 0.007). Men whose serum cholesterol concentration decreased by more than 0.13 mmol/l a year had multivariate adjusted relative risk of 2.17 (0.97 to 4.84, P = 0.056) compared with those whose cholesterol remained stable (change of < or = 0.13 mmol/l a year). CONCLUSION: Both low serum cholesterol concentration and declining cholesterol concentration were associated with increased risk of death from suicide in men. Although there is some evidence in favour of a concomitant rather than a causal effect for interpreting these associations, long term surveillance of subjects included in trials of lipid lowering treatments seems warranted.     

Serum cholesterol concentration and mortality from accidents,suicide, and other violent causes.

OBJECTIVE--To study the association of mortality from accidents, suicides, and other violent deaths with serum cholesterol concentration. DESIGN--Baseline measurements in two randomly chosen independent cohorts were carried out in 1972 and 1977. Mortality was monitored over 10-15 years through the national death registry. SETTING--Eastern Finland. SUBJECTS--The two cohorts comprised men (n = 10,898) and women (n = 11,534) born between 1913 and 1947. There were 193 deaths due to accidents, suicides, and violence among men and 43 among women. MAIN OUTCOME MEASURE--Mortality from accidents, suicides, and other violent deaths was used as the end point. Deaths from these causes were pooled together in the analyses. RESULTS--Serum cholesterol concentration was not associated with mortality from accidents, suicides, and other violent deaths in the univariate analyses or in the proportional hazards regression analyses including smoking, systolic blood pressure, alcohol drinking, and education. In both genders smoking was more prevalent among those who died from accidents, suicides, and other violent causes than from other causes. Frequent use of alcohol increased mortality from these causes. CONCLUSION--The risk of accidents, suicides, and other violent deaths was not related to serum cholesterol concentration, whereas such deaths were more prevalent in smokers and alcohol drinkers.     

Analytically oriented psychotherapy in schizotypal and borderline patients: at the border of treatability

Analytically oriented psychotherapy (AOP) has been considered the treatment of choice for borderline patients and a useful technique in the treatment of schizotypal patients. There are many exceptions, however, in addition to a number of borderline and schizotypal patients who are just barely amenable to this modality: they are at the border of treatability by AOP. Limitations relating to time, cost, and the availability of therapists trained in this discipline render it important to delineate the factors which conduce either to the success or failure of AOP. From the author's clinical impressions about borderline and schizotypal patients at the border of treatability by AOP, a number of such factors emerge. On the positive side: likeableness, autoplastic defenses, high motivation, psychological-mindedness, genuine concern, good moral sense, self-discipline, and low impulsivity. Negative factors include, beside the opposites to the aforementioned, vengefulness and parental abusiveness or exploitation. A scale for measuring the balance between these positive and negative factors is proposed. Its use may, it is hoped, improve forecast, during initial consultation, as to which borderline and schizotypal patients will respond favorably to AOP.     

5-HT1A receptor gene C -1019 G polymorphism and amygdala volume in borderline personality disorder

Alterations of amygdala structure and function have been repeatedly described in patients with borderline personality disorder (BPD). The aim of our study was to determine whether a functional polymorphism of the 5-hydroxytryptamine_1A receptor (5-HTR_1A) gene C −1019 G (identity number: rs6295 G/C) is associated with structural changes of the amygdala in patients with BPD. Twenty-five right-handed female inpatients with BPD according to DSM IV and 25 healthy controls matched for age, sex, handedness and educational status were enrolled. Brain volumetry of the amygdala was performed with a 1.5-T Magnetom Vision apparatus (Siemens, Erlangen, Germany) and analyzed by the software program ' brains '. Patients who have the 5-HTR_1A gene G allele had significantly smaller amygdala volumes than C/C genotype carriers ( P  = 0.02). While no difference of allelic distribution between patients and controls was detected, the described effect of 5-HTR_1A genotype on amygdala volume was found for the whole group of patients, as well as in the subgroup of patients with comorbid major depression ( P  = 0.004) but not in controls. In contrast to these subgroups of BPD patients who had significant amygdala volume differences, the mean amygdala volume of the whole group of BPD patients was not significantly different from that of controls. In summary, our study provides first evidence that 5-HTR_1A gene C −1019 G polymorphism is associated with structural changes in the limbic system of BPD patients, a finding that might be disease related and might contribute to explanation of previous discrepant results regarding amygdala volume changes in BPD. Future research is recommended to clarify possible interactions between this functional polymorphism and symptoms, course and treatment responses in this disorder.     

Serum high density lipoprotein cholesterol,alcohol, and coronary mortality in male smokers.

OBJECTIVE--To determine whether the increase in mortality from coronary heart disease with high concentration (> 1.75 mmol/l) of high density lipoprotein cholesterol could be due to alcohol intake. DESIGN--Cohort study. SETTING--Placebo group of the alpha tocopherol, beta carotene cancer prevention (ATBC) study of south western population in Finland. PARTICIPANTS--7052 male smokers aged 50-69 years enrolled to the ATBC study in the 1980s. MAIN OUTCOME MEASURES--The relative and absolute rates adjusted for risk factors for clinically or pathologically verified deaths from coronary heart disease for different concentrations of high density lipoprotein cholesterol with and without stratification for alcohol intake. Similar rates were also calculated for different alcohol consumption groups. RESULTS--During the average follow up period of 6.7 years 258 men died from verified coronary heart disease. Coronary death rate steadily decreased with increasing concentration of high density lipoprotein cholesterol until a high concentration. An increase in the rate was observed above 1.75 mmol/l. This increase occurred among those who reported alcohol intake. Mortality was associated with alcohol intake in a J shaped dose response, and those who reported consuming more than five drinks a day (heavy drinkers) had the highest death rate. Mortality was higher in heavy drinkers than in non-drinkers or light or moderate drinkers in all high density lipoprotein categories from 0.91 mmol/l upward. CONCLUSIONS--Mortality from coronary heart disease increases at concentrations of high density lipoprotein cholesterol over 1.75 mmol/l. The mortality was highest among heavy drinkers, but an increase was found among light drinkers also.     

Serum antibodies reacting with Escherichia coli heat-labile enterotoxin in sera of patients suffering from Campylobacter jejuni infection

Abstract Using an enzyme-linked immunosorbent assay (ELISA) with purified Escherichia coli heat-labile enterotoxin (LT), an increase in serum antibody against LT was demonstrated in 49% of patients infected with Campylobacter jejuni tested. The antibody titers, however, were not as high as those in patients with cholera. This finding suggests that some strains of C. jejuni in patients with diseases due to C. jejuni produce a toxin (or substance) immunologically related to LT in the intestine.     

Serum concentration of nine hormones in aging male population and association with potency and libido problems

Aim was to determine if a serum levels of free testosterone and selected eight hormones are in correlation with potency and libido problems in aging male. Male population older then 45 years of two Slavonian villages was called for voluntary examination. Every patient filled a questionnaire concerning medical history, operations and potency and libido problems. Based on answers we formed six groups of patients, but only three were analyzed further. Population with potency and libido problems is on average older. In group of patients with normal potency and libido (PNLN group) average levels of free testosterone are 46.01 pmol/L, LH 4.62 IU/L and FSH 6.20 IU/L. In group of patients with mild-damaged potency and normal libido (PMLN group) average levels of free testosterone are 44.61 pmol/L, LH 6.19 IU/L and FSH 8.18 IU/L. In PALA group of patients with absent potency and libido (PALA group) average levels of free testosterone are 41,89 pmol/L, LH 8.07 IU/L and FSH 11.27 IU/L. Significant higher levels of FSH and LH were found compared with the control group (for FSH p<0.001 and p < 0.003, and for LH p <0.003 and p < 0.021). No significant difference in serum levels of free or binned testosterone were found between three groups. Even if average serum levels of free testosterone is found lower in patients with libido and potency problems, this difference is not significant and testosterone deficiency itself can not explain potency and libido problems in aging male.     

Serum cortisol concentration and testosterone to cortisol ratio in elite prepubescent male gymnasts during training.

Serum cortisol concentrations and testosterone:cortisol concentration ratios of eight prepubescent elite male gymnasts (mean age 10 years 11 months) and 11 controls (mean age 11 years 1 month) were examined during 5 consecutive training days. During this period, the gymnasts trained 3 h each day with moderate intensity mobility, strength and skill exercises while the controls were relatively sedentary. Blood samples were taken from all the boys in both groups before (1630 hours) and 30 min after (2000 hours) training on 4 days. Serum cortisol concentrations of the gymnasts were not significantly different from those of the controls throughout the experiment. Serum cortisol concentrations of both groups were significantly larger (P < 0.05) at 1630 hours than at 2000 hours, indicating that cortisol secretion followed the typical adult circadian change, seemingly unaltered by training. However, there was a significant decrease (P < 0.05) in the testosterone:cortisol ratio of the gymnasts when compared with controls from day 1 to day 3. After a rest on day 4 the testosterone: cortisol ratio of the gymnasts significantly increased (P < 0.05) but the ratio of the control group also increased indicating that there may have been some day-to-day change by factor(s) other than training. The most obvious factor which may have accounted for the unresponsiveness of serum cortisol concentration to the gymnastics training was that the exercise intensity was too low. However, several days of the training seemed to reduce the anabolic to catabolic balance but further experiments are needed to confirm this finding.     

Plasma concentration of intestinal- and liver-FABP in neonates suffering from necrotizing enterocolitis and in healthy preterm neonates

Both early diagnostic and prognostic assessment of the acute abdomen in preterm infants are hampered by the lack of a sensitive and specific parameter for intestinal injury. In this prospective clinical study we wanted to estimate the value of intestinal (I-) and liver (L-) fatty acid binding protein (FABP) in diagnosing necrotizing enterocolitis (NEC). Using highly sensitive and specific sandwich ELISAs which employ recombinant human I- and L-FABP as standard proteins (limit of detection 0.1 ng/ml plasma), the L-FABP concentration (median 7.6 ng/ml) was determined to be about 3 fold that of I-FABP (median 2.52 ng/ml) in plasma of healthy preterm infants. I- and L-FABP concentrations significantly increased with birth weight (1.6 and 5.0 ng/ml per kg, respectively). At onset of symptoms, I-FABP concentration was significantly higher in infants who later developed severe NEC compared to healthy infants and those, whose illness remained confined to stage I or II. L-FABP was significantly elevated compared to the control group at onset of symptoms regardless of the further course of NEC. In conclusion, I-FABP appears to be a specific parameter for early detection of intestinal injury leading to severe NEC stage III. L-FABP, however, is a promising sensitive marker even for stage I of NEC.     

Serum concentration of pancreatic polypeptide in normal subjects and in peptic ulcer patients

The present study evaluates the serum concentration of pancreatic polypeptide (PP) in normal male and female subjects of different ages (ranging from 20 to 69) and also in patients with peptic ulcers. The PP level rose with age and was higher in the male subjects (from the age of 30). Serum levels of the peptide in patients with gastric or duodenal ulcers were not significantly different from the normal subjects (age and sex matched with the diseased groups).     

Serum aluminium concentration and aluminium deposits in bone in patients receiving haemodialysis.

Serum aluminium concentrations and biopsy specimens of bone were examined in 56 patients with end stage chronic renal failure receiving maintenance haemodialysis. Deposits of aluminium in bone specimens were often associated with low bone formation with or without osteomalacia. Serum aluminium concentrations of greater than 3.7 mumol/l (10 micrograms/100 ml) indicated a high probability of deposits of aluminium in bone specimens, although high serum concentrations did not predict the type of renal bone disease. Biopsy of the bone is the best method of detecting aluminium intoxication of bone. A serum aluminium concentration of 3.7 mumol/l should be the threshold beyond which bone biopsy should be performed to confirm an overload of aluminium and identify histological bone changes induced by aluminium.     

Evaluation of the efficacy and effectiveness of a structured disorder tailored psychotherapy in ADHD in adults: study protocol of a randomized controlled multicentre trial

ADHD is a serious risk factor for co-occurring psychiatric disorders and negative psychosocial consequences in adulthood. Previous trials on psychotherapeutic concepts for adult ADHD are based on behavioural (cognitive behavioural and dialectical behavioural) psychotherapeutic approaches and showed significant effects. The aim of our study group (COMPAS) is to carry out a first randomized and controlled multicentre study to evaluate the effects of a disorder tailored psychotherapy in adult ADHD compared to clinical management in combination with psychopharmacological treatment or placebo. A total of 448 adults with ADHD according to DSM-IV will be treated at seven university sites in Germany. In a four-arm design, patients are randomized to a manualized dialectical behavioural therapy (DBT) based group programme plus methylphenidate or placebo or clinical management plus methylphenidate or placebo with weekly sessions in the first 12 weeks and monthly sessions thereafter. Therapists are graduated psychologists or physicians. Treatment integrity is established by independent supervision. Primary endpoint (ADHD symptoms measured by the Conners Adult Rating Scale) is rated by interviewers blind to the treatment allocation. Intention-to-treat analysis will be performed within a linear regression model (Current Controlled Trials ISRCTN54096201). The trial is funded by the German Federal Ministry of Research and Education (01GV0606) and is part of the German network for the treatment of ADHD in children and adults (ADHD-NET).     

Comparative analysis of cholesterol transport in bile from patients with and without cholesterol gallstones

Aggregation of cholesterol-phospholipid vesicles in supersaturated biles precedes cholesterol crystal formation. In this study we examined the relationship between the percentage of cholesterol carried by vesicles and/or their composition and the propensity to form cholesterol crystals (nucleation time). Bile (common bile duct, gallbladder and T-tube) was obtained from patients with and without gallstones. Gel filtration chromatography resolved three peaks, a void volume vesicle, a smaller vesicle (identified by electron microscopy and of distinct composition compared to the larger void volume vesicle), and the mixed micelle. The void volume vesicle was present in 11 of 28 abnormal gallbladder biles, but in none of the 10 normal gallbladder biles. Despite this difference, no correlation between the nucleation time of whole bile with either the percentage of cholesterol carried by or cholesterol/phospholipid ratio of the void volume vesicle was found. Nucleation time was, however, found to correlate with the composition of the small-vesicular transport form. No significant difference in the composition or percentage of the small-vesicular form or the combined vesicular forms was found between normal and abnormal gallbladder biles, although the latter nucleated significantly more rapidly. Our results confirm the importance of vesicles in the nucleation process but suggest that other factors, not yet identified, appear to be responsible for the more rapid nucleation seen in abnormal gallbladder biles.     

Serum antithrombin III and alpha-2-antiplasmin concentration in patients with lung carcinoma

Serum antithrombin III and alpha-2-plasmin inhibitor concentrations has been evaluated in 26 patients with lung carcinoma. We observed a twofold decrease in antithrombin III level and no differences between test and control groups in alpha-2-plasmin inhibitor concentrations. Evidently, the decreased antithrombin III level may reflect its consumption because of enhanced plasma thrombin activity, whereas normal alpha-2-plasmin inhibitor may result in no induction of secondary fibrinolysis followed by the stimulation of the coagulation system or no conditions for primary increased fibrinolysis. It seems possible, that the antithrombin III level in the serum may at least partly reflect the tendency for hypercoagulability and spreading of cancer.