Personality functioning and self-disorders in individuals at ultra-high risk for psychosis, with first-episode psychosis and with borderline personality disorder.

BACKGROUND: Assessment of personality functioning in different stages of psychotic disorders could provide valuable information on psychopathology, course of illness and treatment planning, but empirical data are sparse. AIMS: To investigate personality functioning and sense of self in individuals at ultra-high risk (UHR) for psychosis and with first-episode psychosis (FEP) in comparison with a clinical control group of individuals with borderline personality disorder (BPD) and healthy controls. METHOD: In a cross-sectional design, we investigated personality functioning (Structured Interview of Personality Organization, STIPO; Level of Personality Functioning Scale, LPFS) and disturbances of the basic self (Examination of Anomalous Self-Experience, EASE) in 107 participants, comprising 24 individuals at UHR, 29 individuals with FEP, 27 individuals with BPD and 27 healthy controls. RESULTS: The UHR, FEP and BPD groups had moderate to severe deficits in personality organisation (STIPO) compared with the healthy control group. Self-functioning with its subdomain (facet) 'self-direction' (LPFS) was significantly worse in participants with manifest psychosis (FEP) compared with those at-risk for psychosis (UHR). The FEP group showed significantly worse overall personality functioning than the UHR group and significantly higher levels of self-disturbance (EASE) than the BPD group, with the UHR group lying between these diagnostic groups. Hierarchical cluster analysis based on the seven STIPO domains yielded three clusters differing in level of personality functioning and self-disturbances. CONCLUSIONS: Our data demonstrate that psychotic disorders are associated with impaired personality functioning and self-disturbances. Assessment of personality functioning can inform treatment planning for patients at different stages of psychotic disorder.

["Psychiatry Takes its Time  " Why Does One Become a Psychiatrist? - A Qualitative Study]. / "Die Psychiatrie nimmt sich Zeit  " Warum Psychiater*in werden? ­ Eine qualitative Studie.

OBJECTIVE: Identification of intrinsic motivators involved in choosing psychiatry as a career path. METHODS: 14 qualitative in-depth interviews were analysed systematically using coding frames. RESULTS: Positive findings were the interpersonal focus and the holistic approach of psychiatry. Negative dimensions were the unfavorable image among colleagues, the lack of precision, prejudices and stigmatization. To interest more medical students, cases should be presented weighing psychiatric aspects as equally important to other medical aspects. CONCLUSIONS: To increase the popularity of psychiatry, the prejudices inherent in the medical system need urgent addressing. Teaching should be conducted in case presentations. Psychiatric conditions, which are highly prevalent across all medical fields, need to be adequately represented.

Determinants of quality of life improvements in anxiety and depressive disorders-A longitudinal study of inpatient psychotherapy.

Background: Quality of life (QoL) is substantially impaired in patients with anxiety disorders (AD) and depressive disorders (DD) and improvements in symptom burden after psychotherapy are not always paralleled by similar improvements in QoL. So far, little is known about treatment outcome in terms of QoL and predictors of QoL improvements following inpatient psychotherapy with a focus on cognitive behavior therapy (CBT). The current study aimed at investigating the relationship between changes in symptoms and QoL across different life domains. Additionally, predictors of a positive treatment outcome were evaluated. Methods: 122 patients with AD and/or DD undergoing an 8-weeks inpatient CBT program completed self-report measures of psychopathological symptoms and QoL at pre- and post-treatment. Mixed effects models were used to investigate changes, a confirmatory factor analysis was applied to analyze the latent factor structure of the anxiety sensitivity index and binary logistic regression analyses were performed for predictors of QoL improvements. Results: Patients showed moderate to strong decreases in anxious and depressive symptoms and moderate to strong improvements in general QoL, particularly in the psychological and physical QoL subdomains. Changes in symptom burden correlated most strongly with psychological and physical QoL. In addition, poor QoL before treatment and low levels of specific anxiety sensitivity symptoms (items 1 and 5) significantly predicted improvement in QoL. Conclusion: Patients with poor QoL who are not as inhibited to openly express their anxious feelings particularly benefit from inpatient psychotherapy (individual and group) to improve their QoL. In contrast, our research suggests that patients who are too anxious to openly express their nervousness should receive additional social skills training, more focused treatment to build sufficient self-confidence to better engage in the treatment program.

Hazardous alcohol consumption among older adults: A comprehensive and multi-national analysis of predictive factors in 13,351 individuals.

BACKGROUND: Older adults exhibit heightened vulnerability for alcohol-related health impairments. Increases in the proportion of older adults within the European Union's total population and prevalence rates of alcohol use disorders in this age group are being observed. This large scale international study was conducted to identify those older adults with an increased risk to engage in hazardous drinking behaviour. METHODS: Socio-demographic, socio-economic, personality characteristics (Big Five Inventory, BFI-10), and alcohol consumption patterns of 13,351 individuals from 12 different European countries, collected by the Survey of Health, Aging, and Retirement in Europe, were analyzed using regression models. RESULTS: Age, nationality, years of education, as well as personality traits, were significantly associated with alcohol intake. For males, extraversion predicted increased alcohol intake (RR = 1.11, CI = 1.07-1.16), whereas conscientiousness (RR = 0.93, CI = 0.89-0.97), and agreeableness (RR = 0.94, CI = 0.90-0.99), were associated with a reduction. For females, openness to new experiences (RR = 1.11, CI = 1.04-1.18) predicted increased alcohol intake. Concerning excessive drinking, personality traits, nationality, and age-predicted consumption patterns for both sexes: Extraversion was identified as a risk factor for excessive drinking (OR = 1.15; CI = 1.09-1.21), whereas conscientiousness was identified as a protective factor (OR = 0.87; CI = 0.823-0.93). CONCLUSION: Hazardous alcohol consumption in the elderly was associated with specific personality characteristics. Preventative measures, crucial in reducing deleterious health consequences, should focus on translating the knowledge of the association of certain personality traits and alcohol consumption into improved prevention and treatment.

Parental feeding practices and the relationship with parents in female adolescents and young adults with eating disorders: A case control study.

OBJECTIVE: Perceived parental influence on diet in early adolescence in the context of the parental relationship had previously not been studied in a clinical sample. The aim of this study was to investigate a possible association between eating disorders and characteristics of the relationship with parents and the parental feeding practices in early adolescence. METHODS: 21 female adolescents and young adults with an eating disorder (ED)-bulimia nervosa or anorexia nervosa-and 22 females without eating disorder (healthy control; HC), aged between 16 and 26, were assessed via self-report questionnaires for problematic eating behaviour, relationship with parents, perceptions of parent's feeding practices at the age of 10-13 years and personality. Statistical evaluation was performed by means of group comparisons, effect sizes, regression analyses and mediator analyses. RESULTS: Adolescent and young adult females with ED reported more fears/overprotection and rejection/neglect by their mothers and less self-responsibility in terms of eating behaviour during adolescence than did the HC. The relationship with the fathers did not differ significantly. Females who perceived more cohesion, rejection/neglect and fears/overprotection by the mother were more likely to suffer from an ED. Rejection/neglect by both parents were associated with less self-acceptance of the young females with even stronger effect sizes for the fathers than the mothers. Harm prevention in the young females was a partial mediator between fears/overprotection and the drive for thinness. CONCLUSIONS: The parental relationship is partly reflected in the self-acceptance and self-responsibility in eating of the adolescent and young females, both of them are particularly affected in EDs. Stressors in the parent-child relationship should be targeted in treatment of eating disorders. Nutritional counselling for parents might be useful in early adolescence.

Association between malnutrition, clinical parameters and health-related quality of life in elderly hospitalized patients with Parkinson's disease: A cross-sectional study.

OBJECTIVE: This study aimed to explore the association between malnutrition, clinical parameters, and health-related quality of life in elderly hospitalized patients with Parkinson's disease (PD). METHODS: Cross-sectional study of 92 hospitalized elderly patients with PD (mean age 73.6 ± 6.7 years) without dementia. The Mini Nutritional Assessment (MNA) was used to evaluate nutritional status. Motor impairment and non-motor symptoms burden (Movement Disorder Society-sponsored revision of the Unified Parkinson's Disease Rating Scale [MDS-UPDRS], Non-Motor Symptoms Questionnaire, and Hoehn & Yahr staging), depression (Becks Depression Inventory-II), and health-related quality of life (PD quality of life Questionnaire-39) were assessed. RESULTS: Every second patient was malnourished or at risk of malnutrition. In the multivariable analysis, male gender, longer disease duration, higher Hoehn & Yahr and depression were associated with total MNA score. Besides non-motor symptoms and motor impairment, malnutrition was an independent predictor of poor health-related quality of life. In the multivariate analysis, malnutrition had a statistically significant effect on emotional well-being, mobility, social support, stigmatization, and cognition. The strongest association was found between malnutrition and emotional well-being. CONCLUSION: Elderly male persons with longer PD duration and higher disease stages are more likely to be malnourished or at risk for malnutrition. Malnutrition was mainly associated with poor emotional well-being, suggesting that treatment of depression and anxiety beside diet and physical activity can help improving nutrition status in these subjects. The MNA should not be used independent of other measures of cognition and depression in people with advanced PD.

Personality functioning in anxiety disorders.

PURPOSE OF REVIEW: The alternative model for personality disorders in DSM-5 and the upcoming ICD-11 stimulated an increased interest in the concept of personality functioning for the diagnosis of personality disorders. Furthermore, the impact of personality functioning on other mental disorders has become the focus of recent research efforts. The purpose of this review is to provide a comprehensive and critical study of the empirical literature on the relationship between personality functioning and anxiety disorders. RECENT FINDINGS: Recent studies predominantly show a positive association of anxiety symptoms and disorders with an impairment in personality functioning. However, no evidence was found for different levels of personality functioning according to the type of anxiety disorder. Anxiety disorders can occur at all levels of personality organization. SUMMARY: Anxiety disorders are associated with significant impairment in personality functioning. As the underlying personality structure is known to play a crucial role for treatment outcome, the evaluation of personality functioning should be a central part of a comprehensive diagnostic process and treatment planning in patients with anxiety disorders.

Personality functioning in anxiety disorders.

BACKGROUND: The Alternative DSM-5 Model for Personality Disorders as well as the upcoming IDC-11 have established a new focus on diagnosing personality disorders (PD): personality functioning. An impairment of self and interpersonal functioning in these models represents a general diagnostic criterion for a personality disorder. Little is known so far about the impairment of personality functioning in patients with other mental disorders than PD. This study aims to assess personality functioning in patients with anxiety disorders. METHODS: Ninety-seven patients with the diagnosis of generalized anxiety disorder, panic disorder, or phobia, and 16 healthy control persons were diagnosed using the Structured Clinical Interview for DSM-IV (SCID-I and -II) and were assessed by means of the Structured Interview for Personality Organization (STIPO) to determine the level of personality functioning. RESULTS: While all three patient groups showed significant impairment in personality functioning compared to the control group, no significant differences were observed between the different patient groups. In all three groups of anxiety disorders patients with comorbid PD showed significantly worse personality functioning than patients without. Patients without comorbid PD also yielded a significant impairment in their personality functioning when compared to the control group. CONCLUSIONS: Anxiety disorders are associated with a significant impairment in personality functioning, which is significantly increased by comorbid PD. There are no differences in terms of personality functioning between patients with different anxiety disorders.

Psychotic-like experiences in esoterism: A twilight zone?

BACKGROUND: Over the past decades, research has suggested the existence of a psychosis continuum ranging from psychotic-like experiences (PLEs) in the general population to psychotic symptoms in patients with affective and schizophrenia spectrum disorders. Especially individuals interested in esoterism were more often reported having experienced PLEs. However, there is little information on the extent of PLEs in this subculture. The aim of this study was to assess the extent of PLEs in a non-clinical population with interest in esoterism by means of an anonymized clinically used screening questionnaire. PARTICIPANTS AND METHODS: The 16-item version of the Prodromal Questionnaire (PQ-16), a self-report screening questionnaire assessing the presence of PLEs was administered to individuals with interest in esoterism (IE) and a control group without interest in esoterism (NI). RESULTS: The sample included 402 individuals. 224 subjects (55.7%) reported interest in esoterism and 178 subjects (44.3%) showed no such interest. In an ANCOVA, interest in esoterism was shown to have a significant impact on the PQ-16 score (<0.001). Also, age (p=0.022) and the interaction between age and interest in esoterism had a significant impact on the PQ-16 score (p=0.004). Specifically, younger individuals interested in esoterism showed increased PQ-16 scores, whereas scores decreased with increasing age. In individuals without interest in esoterism, age had no relevant impact on the score. CONCLUSION: Younger individuals interested in esoterism seem to be more prone to reporting psychotic-like experiences compared to individuals without interest in esoterism and compared to their older counterparts.

['Barbie Doll Syndrome'. A case report of body dysmorphic disorder]. / "Das Barbie Syndrom". Ein Fallbericht über die Körperdysmorphe Störung.

BACKGROUND: This case report aims to present a 37-year-old women striving to shape her body like a Barbie doll of which she has been fascinated since childhood. She could hardly tolerate any deviation from this beauty ideal. She has been admitted to the psychosomatic ward due to an eating disorder. METHODS: The ICD-10 and DSM-5 criteria were established for axis I disorders and the German version of the SCID II interview (for DSM-4) was applied for axis II disorders. Additionally, the "modified Yale-Brown Obsessive Compulsive Scale for body dysmorphic disorder" was carried out. RESULTS: The diagnosis of dysmorphophobia (ICD-10: F45.21) or body dysmorphic disorder (DSM-5: 300.7) and bulimia nervosa (ICD-10: F50.2; DSM-5: 307.51) was confirmed. The patient fulfilled criteria of an avoidant, depressive and histrionic personality disorder. Psychopharmacological treatment with Fluoxetine was started and the patient participated in an intensive inpatient psychosomatic program. The body image, self-concept and the sense of shame were therapeutic key topics. CONCLUSION: The present case report focuses on body dysmorphic disorder as a distinctive entity with high prevalence. Diagnostic criteria of different classification systems were contrasted and comorbidity with eating disorders was discussed. In clinical praxis, body dysmorphic disorder remains underdiagnosed, especially when cooccurring with an eating disorder. However, the correct diagnosis could be relevant for therapy planning.

Drinking with a very long proboscis: Functional morphology of orchid bee mouthparts (Euglossini, Apidae, Hymenoptera).

Neotropical orchid bees (Euglossini) possess the longest proboscides among bees. In this study, we compared the feeding behavior and functional morphology of mouthparts in two similarly large-sized species of Euglossa that differ greatly in proboscis length. Feeding observations and experiments conducted under semi-natural conditions were combined with micro-morphological examination using LM, SEM and micro CT techniques. The morphometric comparison showed that only the components of the mouthparts that form the food tube differ in length, while the proximal components, which are responsible for proboscis movements, are similar in size. This study represents the first documentation of lapping behaviour in Euglossini. We demonstrate that Euglossa bees use a lapping-sucking mode of feeding to take up small amounts of fluid, and a purely suctorial technique for larger fluid quantities. The mouthpart movements are largely similar to that in other long-tongued bees, except that the postmentum in Euglossa can be extended, greatly enhancing the protraction of the glossa. This results in a maximal functional length that is about 50% longer than the length of the food canal composing parts of the proboscis. The nectar uptake and the sensory equipment of the proboscis are discussed in context to flower probing.

Content Analysis by the Crowd: Assessing the Usability of Crowdsourcing for Coding Latent Constructs.

Crowdsourcing platforms are commonly used for research in the humanities, social sciences and informatics, including the use of crowdworkers to annotate textual material or visuals. Utilizing two empirical studies, this article systematically assesses the potential of crowdcoding for less manifest contents of news texts, here focusing on political actor evaluations. Specifically, Study 1 compares the reliability and validity of crowdcoded data to that of manual content analyses; Study 2 proceeds to investigate the effects of material presentation, different types of coding instructions and answer option formats on data quality. We find that the performance of the crowd recommends crowdcoded data as a reliable and valid alternative to manually coded data, also for less manifest contents. While scale manipulations affected the results, minor modifications of the coding instructions or material presentation did not significantly influence data quality. In sum, crowdcoding appears a robust instrument to collect quantitative content data.

The risk of HCV RNA contamination in serology screening instruments with a fixed needle for sample transfer.

BACKGROUND: Hepatitis C diagnostics involve antibody screening and confirmation of current infection by detection of HCV RNA positivity. In screening instruments with fixed pipetting needle, there is a risk of sample carry-over contamination. OBJECTIVES: The aim of this study was to evaluate the risk of such contamination in a proposed clinical setting. STUDY DESIGN: In the present study, known HCV RNA positive (n=149) and negative (n=149) samples were analysed by anti-HCV Abbott in an Architect instrument in an alternating fashion in order to test for contamination. RESULTS: In subsequent retesting of the previously HCV RNA-negative samples, six samples (4%) were positive by the Cobas Taqman assay with a maximum level of 33 IU/mL. The results show that there is a risk for transfer of HCV in the Architect instrument but they also show that the levels of HCV RNA observed are low. CONCLUSIONS: We conclude that complementary HCV RNA testing on samples identified as anti-HCV positive by screening can be recommended because the complementary results are reliable in the majority of cases when either HCV RNA is negative or HCV RNA is positive with a level >1000 IU/mL. In a minority of cases, with low HCV RNA after anti-HCV antibody screening, cross-contamination should be suspected and a new sample requested for HCV RNA testing. This strategy would reduce the need for obtaining a new sample from the vast majority of patients with a newly discovered HCV antibody positivity.

Activity of selected phytochemicals against Plasmodium falciparum.

According to the WHO, in 2008, there were 247 million reported cases of malaria and nearly one million deaths from the disease. Parasite resistance against first-line drugs, including artemisinin and mefloquine, is increasing. In this study the plant-derived compounds aglafolin, rocaglamid, kokusaginine, arborine, arborinine and tuberostemonine were investigated for their anti-plasmodial activity in vitro. Fresh Plasmodium falciparum isolates were taken from patients in the area of Mae Sot, north-western Thailand in 2008 and the inhibition of schizont maturation was determined for the respective compounds. With inhibitory concentrations effecting 50%, 90% and 99% inhibition (IC(50), IC(90) and IC(99)) of 60.95 nM, 854.41 nM and 7351.49 nM, respectively, rocaglamid was the most active of the substances, closely followed by aglafoline with 53.49 nM, 864.55 nM and 8354.20 nM. The activity was significantly below that of artemisinin, but moderately higher than that of quinine. Arborine, arborinine, tuberostemonine and kokusaginine showed only marginal activity against P. falciparum characterized by IC(50) and IC(99) values higher than 350 nM and 180 µM, respectively, and regressions with relatively shallow slopes S>14.38. Analogues of rocaglamid and aglafoline merit further exploration of their anti-plasmodial activity.

Clustering and local magnification effects in atom probe tomography: a statistical approach.

Local magnification effects and trajectory overlaps related to the presence of a second phase (clusters) are key problems and still open issues in the assessment of quantitative composition data in three-dimensional atom probe tomography (APT) particularly for tiny solute-enriched clusters. A model based on the distribution of distance of first nearest neighbor atoms has been developed to exhibit the variations in the apparent atomic density in reconstructed volumes and to correct compositions that are biased by local magnification effects. This model was applied to both simulated APT reconstructions and real experimental data and shows an excellent agreement with the expected composition of clusters.

Asociación de la Infección por el Virus de Inmunodeficiencia Humana con Osteopenia y Osteoporosis / Association of Infection with Human Immunodeficiency Virus Osteopenia and Osteoporosis

La infección por el Virus de Inmunodeficiencia Humana (SIDA) es una pandemia, que con el advenimiento de la terapia antirretroviral de alta eficacia (TARAE), ha presentado un marcado control de la morbimortalidad; sin embargo, surgen problemáticas asociadas a dicho tratamiento, como los trastornos de la densidad mineral ósea. Encontrar la posible relación entre la infección por el VIH con la presencia de osteopenia y osteoporosis, en pacientes que reciben o no TARAE y su relación con la carga viral ARN para VIH, contaje linfocitario T CD4 y el empleo de TARAE. Se estudiaron tres grupos, Grupo 1: 28 pacientes SIDA en TARAE; Grupo 2: 22 pacientes VIH-positivo sin TARAE y Grupo 3: 30 pacientes seronegativos controles. Se analizaron 80 individuos. De los 50 pacientes VIH-positivos, 34 presentaron alteración de la densidad mineral ósea, 16 (32%) con osteopenia y 18 (36%) osteoporosis, en comparación con 4 (13.3%) y 2 (6,7%) del grupo control que presentaron osteopenia y osteoporosis respectivamente; observándose una relación estadísticamente significativa (p= 0.001) entre la infección por VIH y la alteración de la densidad mineral ósea. No hubo asociación significativa con el empleo o tipo de TARAE, carga viral o nivel de T CD4. Existe relación estadísticamente significativa entre la infección por VIH y el riesgo de padecer osteopenia y osteoporosis (p=0,001) independiente del empleo de TARAE...

HIV infection is a pandemic, but the morbidity and mortality have been controlled with the arrival of HAART. This treatment has brought other problems, like changes in bone density. To find a possible relationship between HIV infection, osteoporosis and osteopenia in patients under HAART, and the relation with CD4+ and viral load. The sample was divided in three groups: 1. 28 HIV patients treated with HAART; group 2: 22 patients HIV+ without treatment and group 3: 30 HIV negative, subjects. The total were 80 subjects. In the group with AIDS, 34 had an abnormal bone density: 16 (32%) osteopenic and 18 (36%) osteoporosis, compared with only 4 (13,3%) and 2 (7,7% ) of the control subjects. This was statistically significant (p= 0,001), but we found no association when HAART, viral load or CD4+. There is a significant association of the risk for low bone density ant AIDS...

Pharmacodynamic interaction between mefloquine and retinol in Plasmodium falciparum in vitro.

Mefloquine, a 4-quinolinemethanol derivative, was introduced in Thailand after Plasmodium falciparum had acquired almost universal resistance to the 4-aminoquinolines and antifols. However, also resistance to mefloquine has become an increasing problem, but artemisinin-based combination therapy (ACT) with mefloquine and artesunate remained until recently sufficiently effective. Since synergistic interaction between quinine, another 4-quinolinemethanol, with retinol was observed earlier, the investigations were expanded to mefloquine. The interaction between mefloquine and retinol at concentrations equal to the 50(th), 65(th) and 80(th) percentile of the physiological retinol levels in healthy adults was determined in 37 fresh isolates of P. falciparum. The mean IC(50), IC(90) and IC(99) values for mefloquine were 1.76, 9.81 and 39.78 microM, those for mefloquine + retinol "low" 0.33, 1.37 and 4.33 microM, those for mefloquine + retinol "medium" 0.29, 1.15 and 3.48 microM, and those for mefloquine + retinol "high" 0.20, 0.85 and 2.70 microM. Evidence for strong synergism between mefloquine and retinol in P. falciparum was highly significant.

Glicemia e insulinemia en pacientes con síndrome de inmunodeficiencia adquirida del adulto / Glucose and insulin in patients with acquired immunodeficiency syndrome adult

Las alteraciones del metabolismo de los carbohidratos son frecuentes en personas infectadas con VIH, como consecuencia de cambios inflamatorios crónicos inducidos por el virus, efecto de la HAART y factores de riesgo clásicos como sobrepeso, obesidad, obesidad abdominal y predisposición genética. Describir las alteraciones en la glicemia e insulinemia a través de 2 mediciones consecutivas en un período de 6 meses, en pacientes con infección por VIH provenientes de la consulta del Instituto de Inmunología del IVSS de Caracas, Venezuela y establecer si existe relación entre dichas alteraciones y el tiempo de diagnóstico de infección por VIH, el esquema de tratamiento antirretroviral recibido, tiempo de su uso y con variables antropométricas como índice de masa corporal, circunferencia abdominal y porcentaje masa grasa. Estudio observacional, analítico y prospectivo, realizado entre febrero y octubre de 2007. Se midió la glicemia e insulina, se calculó el índice HOMA y se tomaron medidas antropométricas, se estadió a los pacientes por contaje de linfocitos CD4+ y se obtuvieron los antecedentes familiares de diabetes, en 2 oportunidades con intervalo de 6 meses. Se incluyeron 77 pacientes que completaron las 2 etapas del estudio, la mayoría recibiendo HAART. Se observó hiperglicemia en ayunas en 10,38%, y DM en 1,3%, siendo estas alteraciones más frecuentes entre usuarios de INTR + INNTR, aún cuando no pudo demostrarse significancia estadística. Se identificó insulinoresistencia en 20% de los sujetos

Carbohydrate metabolism abnormalities are frequent in AIDS patients as a consequence of chronic inflamatory changes caused or induced by the virus, the efect of HAART and the classic risk factors such as overweight, obesity, central obesity and genetic predisposition. To describe the alterations of glycemia and insulinemia by 2 consecutive determinations in a period of 6 months in patients infected by HIV who consulted at the ambulatory setting of the Instituto de Inmunología IVSS, Caracas, Venezuela. We wanted to determine if there was a relation between these changes and the following variables: type and duration of antiretroviral treatment, body mass index, abdominal circunference and percentage of lean body fat. This was an observational, analytic and prospective study done between february and october 2007. On two occasions the following measurements were performed: blood sugar and insulin, Home Model Assessment (HOMA) index and the above mentioned anthropometric evaluations were done; CD4+ was also measured and family history of diabetes was obtained. We included the 77 patients who completed both stages of the study; most of them were under HAART. Fasting hyperlycemia was found in 10,38% and DM in 1,3 % , more frequentely in users of INTR+INNTR, although without statistical significance. Insulinresistance was identified in 20% of the subjects

Deletions account for 17% of pathogenic germline alterations in MLH1 and MSH2 in hereditary nonpolyposis colorectal cancer (HNPCC) families.

Hereditary nonpolyposis colorectal cancer (HNPCC) is due to defects in DNA mismatch repair (MMR) genes MSH2, MLH1, MSH6, and to a lesser extent PMS2. Of 466 suspected HNPCC families, we defined 54 index patients with either tumors of high microsatellite instability (MSI-H) and/or loss of expression for either MLH1, MSH2, and/or MSH6, but without a detectable pathogenic point mutation in these genes. This study cohort was augmented to 64 patients by 10 mutation-negative index patients from Amsterdam families where no tumors were available. Deletion/duplication screening using the multiplex ligation-dependent probe amplification (MLPA) revealed 12 deletions in MSH2 and two deletions in MLH1. These deletions constitute 17% of pathogenic germline alterations but elucidate the susceptibility to HNPCC in only 22% of the mutation-negative study cohort, pointing towards other mutation mechanisms for an inherited inactivation of MLH1 or MSH2. We describe here four novel deletions. One novel and one known type of deletion were found for three and two unrelated families, respectively. MLPA analysis proved a reliable method for the detection of genomic deletions in MLH1 and MSH2; however, sequence variations in the ligation-probe binding site can mimic single exon deletions.

Tratamiento médico del absceso esplénico: presentación de un caso / Splenic abscess medical treatment: presentation of a case

Presentamos un caso de absceso esplénico demostrado por ultrasonografía y tomografía axial computarizada, el cual fue satisfactoriamente tratado con antibióticos solamente. La resolución del absceso fue confirmada posteriormente por tomografía. Se revisa la literatura y se comparan los hallazgos clínicos y posibilidades terapéuticas de este caso con los descritos en otras series