Trastornos de personalidad en la adolescencia: características clínicas y vías asistenciales desde la infancia a la adultez / Personality disorders in adolescence: Clinical characteristics and therapeutic paths from infancy to adulthood

El trastorno de la personalidad en la infancia representa una realidad clínica presente y, a menudo, dramáticamente relevante en la adolescencia, mientras que desde el punto de vista nosográfico la codificación de la OMS (ICD-10) no prevé su utilización hasta después de los 16-17 años. La primera parte del trabajo presenta el concepto de trastorno de la personalidad haciendo hincapié en su uso en la infancia. En la parte experimental se analiza una muestra de pacientes con trastornos de la personalidad (TP) ingresados en nuestro servicio. Se comenta, básicamente, la evolución clínico-nosográfica, el recorrido asistencial incluso después de su mayoría de edad, el peso de los factores de riesgo (AU)

This paper studies the concept of personality disorders paying special attention to its use in childhood and adolescence. Personality disorders in childhood constitute a clinical reality that often becomes dramatically relevant in adolescence. However, from a nosological point of view, the World Health Organization’s diagnostic classification (ICD-10) does not consider its usage until after 16 or 17 years of age. The paper presents a sample of patients with personality disorders attended in our Center and analyses their clinical and diagnostic development, their treatment history into adulthood and the weight of risk factors (AU)

Autolesión como señal transcultural entre malestar y comunicación: comparación de una muestra italiana y una extracomunitaria / Self-aggression as a trans-cultural signal, between mental suffering and communication: A comparison between italian and immigrant patients

Se presenta una muestra de 13 pacientes (6 varones y 7 mujeres, edad media 16 años) agrupados por actos de autolisis sin tentativa de suicidio en urgencias psiquiátricas infantiles un de hospital de día. El análisis estadístico diferencia dos poblaciones clínicas con distinta composición de género, en las cuales el acto de autolesión tiene funciones diferentes.: una población “clásica”, de tipo occidental, con prevalencia femenina para la cual cortarse provoca alivio, y una población constituida sobre todo por varones, extracomunitarios, para la cual “ el corte” tiene la función de expresas rabia y protesta (AU)

The clinical population (13 patients: 7 females and 6 males) addressed to the Day Hospital of the Child and Adolescent Psychiatry and Psychotherapy Unit after self-aggressive acting (cutting, in the majority of the cases) without suicidal intention, is presented. Statistical analysis allowed us to detect two different subgroups: self-aggressive acting prevailed amongst girls in the Italian group, whilst this type of patients where nearly all male in the immigrant group. The mental suffering is both in the Italian and the immigrant group the basis for the self-aggressive acting, but it assumes a different meaning from a simbolic viewpoint. In the Ialian group this kind of acting can be read as a reassuring manoeuvre against anxiety or depressive feelings, whilst in the immigrant group theses acts are often a an expression of rage and protest against adults (AU)

Polarization of caveolins and caveolae during migration of immortalized neurons.

During CNS development neurons undergo directional migration to achieve their adult localizations. To study neuronal migration, we used a model cell line of immortalized murine neurons (gonadotropin-releasing hormone expressing neurons; GN11), enriched with caveolins and caveolae invaginations that show in vitro chemotaxis upon serum exposure. Cholesterol depletion with methyl-beta-cyclodextrin induced the loss of caveolae and the inhibition of chemotaxis, thus suggesting that GN11 migration depends upon the structural integrity of caveolae. Polarization of proteins and organelles is a hallmark of cell migration. Accordingly, GN11 cells transmigrating through filter pores exhibited a polarized distribution of caveolin-1 isoform (cav-1) in the leading processes. In contrast, during two-dimensional migration cav-1 and caveolae polarized at the trailing edge. As caveolae are enriched with signaling molecules, we suggest that asymmetrical localization of caveolae may spatially orient GN11 neurons to incoming migratory signals thereby transducing them into directional migration.

Human platelets express the synaptic markers VGLUT1 and 2 and release glutamate following aggregation.

Vesicular glutamate transporters (VGLUTs) are involved in storing glutamate for secretion at the level of glutamatergic axon terminals, and for this reason they have been extensively used as markers to identify glutamate-releasing cells. Platelets have been considered as a suitable model for studying glutamatergic dysfunction because they perform glutamate uptake and express both external transporters, and NMDA-like receptors. Here, we show that platelets express the pre-synaptic markers VGLUT1 and VGLUT2 and release glutamate following aggregation, implying a possible contributory role in the pathophysiology of stroke, migraine, and other excitotoxic disorders.

Restoration of bacterial killing activity of human respiratory cystic fibrosis cells through cationic vector-mediated cystic fibrosis transmembrane conductance regulator gene transfer.

In vitro and in vivo studies have demonstrated that gene transfer of the CFTR (cystic fibrosis transmembrane conductance regulator) cDNA into human respiratory cells through nonviral vectors can occur safely and can be done repeatedly. Although functional evaluation of CFTR in cystic fibrosis (CF) patients enrolled in phase I clinical trials using cationic liposomes has shown a partial correction of nasal potential difference, a biological assay indicating a therapeutic relevance of CFTR gene transfer is still missing. Our aims were to study the induction of killing activity toward Pseudomonas aeruginosa (PA) in CF cells by cationic vector-mediated CFTR gene transfer and to use this assay as a therapeutic end point. Luciferase expression and GFP FACS analysis were used to evaluate the optimal vector and the efficiency of gene transfer into non-CF human respiratory cells growing from nasal polyp explants at the air-liquid interface. To prove that transgenic CFTR was expressed in CF cell cultures under the same experimental conditions, a specific RT-PCR was performed. Challenge of the outgrowths with a known amount of PA showed a bacterial clearance activity by non-CF respiratory cells, while in the case of CF cells it even resulted in bacterial growth. Cationic vector-mediated CFTR cDNA determined the recovery of bacterial clearance activity only under those conditions yielding 5% or more of GFP-positive cells. The results shown in this study might be helpful in considering cationic vectors as therapeutic nonviral vectors for transferring CFTR into human CF respiratory cells, as well as for restoring the bacterial killing activity defective in cystic fibrosis.

The parafascicular thalamic nucleus but not the prefrontal cortex facilitates the nitric oxide/cyclic GMP pathway in rat striatum.

We investigated whether the parafascicular thalamic nucleus and the prefrontal cortex, the two major excitatory inputs to the striatum, modulate the nitric oxide/cyclic GMP pathway in rat striatum. Electrical stimulation (10 pulses of 0.5 ms, 10 V applied at 10 Hz, 140 microA) delivered bilaterally to the parafascicular thalamic nucleus for a total of 4, 10 and 20 min, time-dependently facilitated cyclic GMP output in the dorsal striatum of freely moving rats, assessed by trans-striatal microdialysis. Electrical stimulation to the prefrontal cortex for a total duration of 20 min did not affect striatal cyclic GMP levels. The facilitatory effect observed after electrical stimulation of the parafascicular thalamic nucleus was blocked by co-perfusion with tetrodotoxin, suggesting that the effect is mediated by neuronal process(es). The non-competitive N-methyl-D-aspartate receptor antagonist, dizocilpine maleate (30 microM infused into the dorsal striatum), and the competitive one, 3-[(R)-carboxypiperazin-4-yl]-propyl-phosphonic acid (50 microM infused), but not local perfusion of the alpha-amino-3-hydroxy-5-methyl-isoxazole-4-propionic acid antagonist, 6-nitro-7-sulphamoylbenzo(f)quinoxaline-2,3-dione (15 microM perfused locally), abolished the cyclic GMP response in the striatum. The nitric oxide synthase inhibitor, 7-nitroindazole, applied locally (1 mM), blocked the electrically evoked increase in striatal extracellular cyclic GMP. This increase was also prevented by local application (100 and 300 microM) of 1H-(1,2,4)-oxadiazolo-(4,3a)-quinoxalin-1-one, a selective inhibitor of soluble guanylyl cyclase. The results provide direct functional evidence of selective thalamic facilitation of the nitric oxide/cyclic GMP pathway in the dorsal striatum, through activation of N-methyl-D-aspartate receptors.