Admission Rate of Patients With Major Psychiatric Disorders to the Intensive Care Unit.

BACKGROUND: Major psychiatric disorders such as major depression and schizophrenia interfere with patients' life activities and ability to function. These disorders correlate with a higher prevalence of medical and psychiatric comorbidities. OBJECTIVE: To compare the admission rate of patients with major psychiatric disorders between the intensive care unit and other departments in a tertiary care center. METHODS: In a retrospective study of records of 238 721 patients, data were collected from admission files and the intensive care unit computer system. The study group was 245 patients with psychiatric disorders admitted to the intensive care unit. Control groups were 9226 psychiatric patients in other hospital departments and 3032 nonpsychiatric patients in the intensive care unit. RESULTS: A major psychiatric disorder was diagnosed twice as often in the 3277 patients admitted to the intensive care unit as in patients admitted to other departments (7.5% vs 3.8%, P < .001). The study group had fewer male patients than did the nonpsychiatric intensive care unit group (52% vs 66%, P < .001); the age distribution was similar. Patients with a psychiatric disorder required longer stays than other intensive care unit patients. However, their mortality rate was significantly lower (8.57% vs 17.1%, P = .001). A direct correlation between the admission and a psychiatric condition was found in one-third of admissions in the study group. CONCLUSIONS: Psychiatric patients' admission rate to the intensive care unit was significantly higher than their admission rate to other departments. Their intensive care unit stays were also longer, which may increase resource use.

Chromosomal aberrations and gene expression profiles in non-small cell lung cancer.

Alterations in genomic content and changes in gene expression levels are central characteristics of tumors and pivotal to the tumorigenic process. We analyzed 23 non-small cell lung cancer (NSCLC) tumors by array comparative genomic hybridization (array CGH). Aberrant regions identified included well-characterized chromosomal aberrations such as amplifications of 3q and 8q and deletions of 3p21.31. Less frequently identified aberrations such as amplifications of 7q22.3-31.31 and 12p11.23-13.2, and previously unidentified aberrations such as deletion of 11q12.3-13.3 were also detected. To enhance our ability to identify key acting genes residing in these regions, we combined array CGH results with gene expression profiling performed on the same tumor samples. We identified a set of genes with concordant changes in DNA copy number and expression levels, i.e. overexpressed genes located in amplified regions and underexpressed genes located in deleted regions. This set included members of the Wnt/beta-catenin pathway, genes involved in DNA replication, and matrix metalloproteases (MMPs). Functional enrichment analysis of the genes both overexpressed and amplified revealed a significant enrichment for DNA replication and repair, and extracellular matrix component gene ontology annotations. We verified the changes in expressions of MCM2, MCM6, RUVBL1, MMP1, MMP12 by real-time quantitative PCR. Our results provide a high resolution map of copy number changes in non-small cell lung cancer. The joint analysis of array CGH and gene expression analysis highlights genes with concordant changes in expression and copy number that may be critical to lung cancer development and progression.

Absence of p53 mutations in malignant mesotheliomas.

Mutations in the p53 gene are the most common genetic alterations found in human malignancies. In this study, a search was done for mutations in the conserved regions of the p53 gene in malignant mesotheliomas. Thirteen malignant mesotheliomas collected over the preceding 12 yr and maintained in paraffin blocks were examined by polymerase chain reaction (PCR) followed by both single-strand conformation polymorphism (SSCP) and denaturing gradient-gel electrophoresis (DGGE). Direct sequence analysis was performed in cases suspected for mutations. No mutations in exons 5 to 8 of the p53 gene were detected. Our results suggest that malignant transformation of human mesothelioma cells does not require inactivation of p53 by point mutations in the conserved regions of the gene.

Antibodies to inhalant fungal antigens in patients with asthma in Israel.

Thirty-eight of 97 asthmatic patients, seven of 26 normal subjects and two of 39 patients with chronic obstructive pulmonary disease (COPD) were found to have antibodies to one or more of the inhalant fungi and candida antigens assayed by both immunodiffusion and counterimmune electrophoresis. Atopy was demonstrated in 33 of the 38 asthmatic patients with antibodies. Eleven asthmatics had anti-alternaria antibodies while only two reacted to aspergillus.