Age matters in the prevalence and clinical significance of ultra‐high‐risk for psychosis symptoms and criteria in the general population: Findings from the BEAR and BEARS‐kid studies

Early detection of psychosis is an important topic in psychiatry. Yet, there is limited information on the prevalence and clinical significance of high‐risk symptoms in children and adolescents as compared to adults. We examined ultra‐high‐risk (UHR) symptoms and criteria in a sample of individuals aged 8‐40 years from the general population of Canton Bern, Switzerland, enrolled from June 2011 to May 2014. The current presence of attenuated psychotic symptoms (APS) and brief intermittent psychotic symptoms (BLIPS) and the fulfillment of onset/worsening and frequency requirements for these symptoms in UHR criteria were assessed using the Structured Interview for Psychosis Risk Syndromes. Additionally, perceptive and non‐perceptive APS were differentiated. Psychosocial functioning and current non‐psychotic DSM‐IV axis I disorders were also surveyed. Well‐trained psychologists performed assessments. Altogether, 9.9% of subjects reported APS and none BLIPS, and 1.3% met all the UHR requirements for APS. APS were related to more current axis I disorders and impaired psychosocial functioning, indicating some clinical significance. A strong age effect was detected around age 16: compared to older individuals, 8‐15‐year olds reported more perceptive APS, that is, unusual perceptual experiences and attenuated hallucinations. Perceptive APS were generally less related to functional impairment, regardless of age. Conversely, non‐perceptive APS were related to low functioning, although this relationship was weaker in those below age 16. Future studies should address the differential effects of perceptive and non‐perceptive APS, and their interaction with age, also in terms of conversion to psychosis.     

Paravertebral Catheter for Three-Level Injection in Radical Mastectomy: A Randomised Controlled Study

Introduction

Paravertebral block (PVB) is an alternative to general anaesthesia (GA) for breast surgery. However, for extensive surgery multiple punctures are needed increasing the immanent risk of the method. The purpose of this study was to evaluate PVB via catheter and injections at three different levels. Primary outcome was the quality of postoperative analgesia, in particular, the number of patients requiring additional morphine.

Methods

In a randomised single blinded clinical study patients scheduled for breast surgery including axillary approach, were randomly allocated to different anaesthetic techniques, n = 35 each. Patients received either GA with sevoflurane or PVB with catheter at level Th 4. In PVB-patients a 1:2 mixture of bupivacaine 0.5% and lidocaine 2% with adrenaline was injected sequentially 10 ml each at three different levels.

Results

Complication-free catheter insertion was possible in all 35 scheduled patients. The need for postoperative analgesics was higher after GA compared to PVB (22 vs.14 patients); p = 0.056. Postoperative morphine consumption was 1.55 (GA) and 0.26 mg (PVB) respectively (p < 0.001). Visual rating score (VRS) for pain at rest and at movement was higher in GA patients on post anaesthesia care unit (PACU) as well as on the ward at 1 - 6h and 6 - 12h. Readiness for discharge was earlier after PVB (4.96 and 6.52 hours respectively). After GA the incidence and severity of postoperative nausea and vomiting (PONV) was higher, though not significantly. Patients’ satisfaction was comparable in both groups.

Conclusions

Three-level injection PVB via catheter for extensive mastectomy was efficient and well accepted. Using a catheter may enhance safety by avoiding multiple paravertebral punctures when extended spread of analgesia is required.

Trial Registration

www.ClinicalTrial.gov NCT02065947     

Footwear Decreases Gait Asymmetry during Running

Previous research on elderly people has suggested that footwear may improve neuromuscular control of motion. If footwear does in fact improve neuromuscular control, then such an influence might already be present in young, healthy adults. A feature that is often used to assess neuromuscular control of motion is the level of gait asymmetry. The objectives of the study were (a) to develop a comprehensive asymmetry index (CAI) that is capable of detecting gait asymmetry changes caused by external boundary conditions such as footwear, and (b) to use the CAI to investigate whether footwear influences gait asymmetry during running in a healthy, young cohort. Kinematic and kinetic data were collected for both legs of 15 subjects performing five barefoot and five shod over-ground running trials. Thirty continuous gait variables including ground reaction forces and variables of the hip, knee, and ankle joints were computed for each leg. For each individual, the differences between the variables for the right and left leg were calculated. Using this data, a principal component analysis was conducted to obtain the CAI. This study had two main outcomes. First, a sensitivity analysis suggested that the CAI had an improved sensitivity for detecting changes in gait asymmetry caused by external boundary conditions. The CAI may, therefore, have important clinical applications such as monitoring the progress of neuromuscular diseases (e.g. stroke or cerebral palsy). Second, the mean CAI for shod running (131.2 ± 48.5; mean ± standard deviation) was significantly lower (p = 0.041) than the CAI for barefoot running (155.7 ± 39.5). This finding suggests that in healthy, young adults gait asymmetry is reduced when running in shoes compared to running barefoot, which may be a result of improved neuromuscular control caused by changes in the afferent sensory feedback.     

Regeneration of the visual system in gastropods (Mollusca)

Abstract. The topic of tissue and organ regeneration has been of interest to life scientists ever since the phenomenon was noticed. The reason for this is obvious: if one can learn what drives and controls regeneration, i.e., how lost or damaged structures can be replaced, one not only has a better chance to understand an animal's embryogenesis and evolutionary relationship with other taxa, but one would also be in a better position to treat organ loss or tissue damage in humans. In this context, the possible restitution of individual sensory neurons or nerve projections has been of special interest to us. We identified central visual projections in several gastropod species and found that: (1) projections are very extensive across the brain and (2) they have connections with other systems and organs (including, most likely, non-ocular skin photoreceptors) that may be involved in the integration of signals from different sensors. Investigations of afferent and efferent visual elements at a morphological level should help reveal the neuronal basis of a gastropod's behavioral reactions.     

Carotenoids in ripe green and in autumn senescing leaves of apple tree: I - Qualitative composition of free carotenoids,xanthophyll esters and fatty acids of esters

Abstract

By different chemical, spectral and chromatographic procedures seven carotenoids, two carotenes (α- and β-carotene) and five free xanthophylls (violaxanthin, lutein, antheraxanthin, zeaxanthin and neoxanthin) have been isolated and identified in green apple leaves. In autumn senescing leaves, besides the above seven carotenoids, the occurrence of at least seven xanthophyll esters has also been proved. Four esters, violaxanthin mono- and diester and lutein mono- and diester, (≥90% of total esters) and a minor component, neoxanthin triester, have been identified. Another minor component is most probably a monoester of antheraxanthin; the seventh, present in traces, has not been identified.

The fatty acids combined with the above xanthophyll esters have been analysed by gas-chromatography. The unusual presence of low molecular weight fatty acids, C7-C11, has been registered (1,5-8% of the total); caprilic and capric acids have been identified. Lauric acid with three minor homologous (2-7% and myristic acid (9-15%) are also present. The major component, palmitic acid, with palmitoleic and two other minor components, reaches 36-44%. In addition a remarkable presence of oleic acid (12-26%) has been observed together with stearic (8-10%), linolenic (5-6%), arachidic (0,7-2,5%) and linolenic-gadoleic acids (2,5-9,3%).     

Rapid detection and quantification of five periodontopathic bacteria by real-time PCR

The quantity of periodontopathic bacteria in plaque samples is an important determinant for understanding the etiologic role of bacteria. The real-time PCR method was used to detect and quantify periodontopathic bacteria, such as Actinobacillus actinomycetemcomitans, Bacteroides forsythus, Porphyromonas gingivalis, Treponema denticola, and Treponema socranskii, in saliva and subgingival plaque samples. There was good agreement between the results of conventional PCR and real-time PCR methods. Using the LightCycler system we were able to determine the amount of periodontopathic bacteria within an hour. The real-time PCR method was linear for samples containing from 10(3) to more than 10(8) cells (r2 = 0.999). The application of the real-time PCR method should be useful in the rapid detection and quantification of periodontopathic bacteria in clinical samples.