Do aluminum (Al)-hyperaccumulator and phosphorus (P)-solubilising species assist neighbouring plants sensitive to Al toxicity and P deficiency?

We aimed to evaluate the facilitation effects of an aluminum (Al) hyperaccumulator species bearing cluster roots, Gevuina avellana, on the seedling growth and performance of an Al-intolerant and phosphorus (P)-deficient-sensitive plant, Vaccinium corymbosum. For this, seedlings of G. avellana and V. corymbosum were grown alone or together as follows: i) two G. avellana seedlings, ii) one G. avellana + one V. corymbosum and iii) two V. corymbosum, in soil supplemented with Al (as Al2(SO4)3) and in the control (without Al supplementation). We determined relative growth rate (RGR), photosynthetic rate, chlorophyll concentration, lipid peroxidation and Al and nutrient concentration [Nitrogen (N), P, potassium (K), calcium (Ca), magnesium (Mg), sodium (Na), manganese (Mn), iron (Fe), copper (Cu), zinc (Zn), and sulfur (S)] in leaves and roots of both species. The results showed that, in general, G. avellana did not assist V. corymbosum to enhance its RGR nor reduce its Al uptake. However, G. avellana assisted V. corymbosum in enhanced N acquisition and, consequently, to increase its chlorophyll concentration and photosynthetic rate. Besides, V. corymbosum had lower lipid peroxidation in leaves when grown in the soil with high Al supplementation in association with G. avellana. Our results suggest a facilitating effect of G. avellana to V. corymbosum when grown in soils with high Al concentration, by enhancing chlorophyll concentrations and photosynthetic rate, and decreasing the oxidative damage to lipids.

'Brain Disorders', by Henry Calderwood (1879).

Henry Calderwood, a nineteenth-century Scottish philosopher interested in madness, published in 1879 an important work on the interaction between philosophy of mind, the nascent neurosciences and mental disease. Holding a spiritual view of the mind, he considered the phrase 'mental disease' (as Feuchtersleben had in 1845) to be but a misleading metaphor. His analysis of the research work of Ferrier, Clouston, Crichton-Browne, Maudsley, Tuke, Sankey, etc., is detailed, and his views are correct on the very limited explanatory power that their findings had for the understanding of madness. Calderwood's conceptual contribution deserves to be added to the growing list of nineteenth-century writers who started the construction of a veritable 'philosophy of alienism' (now called 'philosophy of psychiatry').

Caracterización epidemiológica del tipo de urgencias urológicas en el hospital barros luco trudeau (HBLT) período 2008-2012 / Epidemiological characterization of types of urological emergencies at barros luco trudeau hospital, analysis of the 2008-2012 period

INTRODUCCIÓN: En la mayoría de servicios de urgencia estatales no cuentan con un Urólogo de llamado, por lo que la mayoría de los pacientes que acuden al Servicio de Urgencia (SU) son evaluados por cirujanos generales. MATERIALES Y MÉTODO: Estudio observacional retrospectivo de corte transversal de la totalidad de ingresos al SU de nuestro centro entre enero de 2008 y diciembre de 2012, de los cuales se analizaron los pacientes con diagnósticos urológicos. Las variables estudiadas fueron: edad, sexo, diagnóstico determinado según la CIE-10 y si se realizó cirugía de urgencia. RESULTADOS: Media de edad: 48,5 años (D.E.:27,07), Sexo: Masculino 74 por ciento, Media de Consultas totales en SU: 142.138pacientes anuales, Media de consultas Urológicas en SU: 4.837 pacientes anuales, correspondientes al 3,4 por ciento del total. Las consultas más frecuentes fueron: ITU baja: 33,5 por ciento, Cólico Renal: 33,1 por ciento , ITU alta 15,6 por ciento, de los cuales un 0,6 por ciento correspondena Pionefrosis, Patología Genital Infecciosa: 4,7 por ciento, de los cuales un 76 por ciento, corresponden a Orquiepididimitis, Retención Aguda de Orina: 3,7 por ciento, Hematuria Persistente: 2,4 por ciento,, Trauma Urogenital: 1,86 por ciento,, Urgencias Genitales: 0,37 por ciento,. Pacientes que requirieron Cirugía de Urgencia: 1.02 por ciento, CONCLUSIONES: Si bien, el porcentaje de pacientes a los que se realizó una intervención quirúrgica de urgencia es bajo,sería importante implementar en los servicios de urgencia estatales Urólogos de llamado, ya que patologías altamente prevalentes, como la litiásica, podrían tener una mejor resolución. (AU)

Most of the public emergency services do not count with urologist and these patients are evaluated by general surgeons. MATERIALS AND METHODS: cross-section, retrospective study of all admissions in Emergency Services (ES) at our center between January 2008 and December 2012, of patients with urological diagnoses were analyzed. The variables studied were: age, sex, diagnosis determined according to the International Classification Diseases, 10th version and if emergency surgery was performed. RESULTS: Average age: 48.5 years (SD: 27.07), Gender: Male 74 pertcent Average Total consultations in ES: 142,138 patients annually, Media of urological evaluations at ES: 4,837 patients annually, corresponding to 3.4 pertcent of the total. The most frequent diagnosis were: low UTI: 33.5 pertcent,Renal pain: 33.1 pertcent, 15.6 pertcent high UTI, of which 0.6 pertcent are to Pyonephrosis, Infectious Genital Pathology 4.7 pertcent, of which 76 pertcent are Epydidimo- Orchitis, Acute Urinary Retention: 3.7 pertcent, Persistent Hematuria 2.4 pertcent, Genitourinary Trauma: 1.86 pertcent Genital Emergencies: 0.37 pertcent. Patients requiring urgent surgery: 1.02 pertcent CONCLUSIONS: While the percentage of patients who performed an emergency surgical intervention is low, it would be important to implement Urologists in public Emergency Services as highly prevalent diseases such as urolithiasis, could have a better resolution.(AU)

The 'Preliminary Discourse' to Methodical Nosology, by François Boissier de Sauvages (1772).

The eighteenth century witnessed an intense drive to classify diseases as natural kinds. Together with Linné, Macbride, Cullen, Sagar and Vogel, François Boissier de Sauvages, Professor of Medicine at Montpellier, was an important player in this process. In his monumental Nosologie Méthodique, Sauvages based his nosological system on the more botanico view proposed by Thomas Sydenham, namely, that human diseases (including mental ailments) should be classified in the same way as were plants. Classic Text No. 104 is an abridged translation of the Preliminary Discourse to the Nosologie Méthodique.

David Hartley's views on Madness: With an introduction by GE Berrios.

The psychiatric aspects of David Hartley's writings have received less attention than the rest of his work. This Classic Text deals with Section VI of his Observations on Man …, namely, the 'Imperfections of the rational Faculty'. Hartley defines madness as an imperfection of reason that can be temporary or enduring. He makes use of his model of mental functioning to differentiate between eight clinical categories of madness, each representing a different pattern of vibrations of the nerves. Hartley developed this model based on Newton's theory of vibrations and, to explain the complexity of mental acts and entities, he combined it with his own version of the mechanism of Association of Ideas borrowed from John Locke. Much work needs to be done to identify the provenance of Hartley's nosology and nosography.

J.H. Pons on 'Sympathetic insanity': With an introduction by GE Berrios.

The ancient concept of 'sympathy' originally referred to a putative affinity or force that linked all natural objects together. This notion was later used to explain the manner in which human beings related and felt for each other. A large literature exists on both the physical and psychological definitions of sympathy. Until the nineteenth century the conceptual apparatus of medicine preserved the view that the organs of the human body had a sympathetic affinity for each other. In addition to these 'physiological' (normal) sympathies there were morbid ones which explained the existence of various diseases. A morbid sympathy link also explained the fact that insanity followed the development of pathological changes in the liver, spleen, stomach and other bodily organs. These cases were classified as 'sympathetic insanities'. After the 1880s, the sympathy narrative was gradually replaced by physiological, endocrinological and psychodynamic explanations. The clinical states involved, however, are often observed in hospital practice and constitute the metier of 'consultation-liaison psychiatry'. Hence, it is surprising that historical work on the development of this discipline has persistently ignored the concept of 'sympathetic insanity'.

Evolución inusual de fibroadenomas mamarios múltiples en adolescente con metrorragia disfuncional / Unusual evolution of multiple breast fibroadenomas in adolescent with dysfunctional uterine bleeding

Se describe la inusual evolución de fibroadenomas (FA) mamarios múltiples en una adolescente de 11 años en tratamiento con progestinas cíclicas por metrorragia disfuncional. Inicialmente la ecografía mamaria mostró más de 10 lesiones sólidas en cada mama de hasta 2,6 cm, compatibles con fibroadenomas. Al cabo de 13 meses las lesiones se redujeron en número y tamaño. Se discute la historia natural de los FA, la influencia hormonal en la etiología de los FA y finalmente el diagnóstico ecográfico y manejo de este cuadro en la adolescencia. Se plantea, a modo de hipótesis, que existe un desbalance estrógeno-progesterona (E-P) dado por ciclos anovulatorios en el periodo posmenárquico, que se manifestó con metrorragia disfuncional y la presencia de FA. Al administrar progesterona cíclica se reequilibra la relación E-P explicando el control del ciclo y la involución de las lesiones mamarias.

We describe the unusual evolution of multiple fibroadenomas (FA) in a 11-years old adolescent during treatment of an abnormal uterine bleeding with cyclic progestins. Inicially ultrasound demonstrated more than 10 masses in each breast, up to 2,6 cm diameter, compatible with fibroadenomas. After 13 month follow up lesions decreased in number and size. We discuss the natural history of FA, the hormonal influence in FA etiology, the ultrasound diagnosis and the managment of this pathology in adolescents. We hypothesized that there is an estrogen/progestin imbalance, due to the anovulatory cycles of the post menarche period that caused the AUB and FA. Cyclic progesterone balanced the E/P relation, thus managing both AUB and causing regression of the breast masses.

'Febrile anxiety', by Robert James (1745): with an introduction by.

The current class of psychiatric conditions called 'Anxiety Disorders' was constructed during the 20th century. Before 1900, its clinical components were conceptualized differently: some were not considered as diseases at all and others were looked after by physicians (not alienists). Whether it can be claimed that the complaints included under the 'Anxiety Disorders' have always existed, that is, constitute a form of 'natural kind', is a moot point that needs further historical investigation. This is because psychiatric complaints (mental symptoms) are no more than culturally configured segments of biological or symbolic information. Therefore, symptom-invariance or -perdurance can be explained by either biological or cultural factors. This can only be resolved by studying symptoms individually. Classic Text No. 97 shows how 'Anxiety' was conceptualized during the 18th century.

Ecologically valid cognitive tests and everyday functioning in euthymic bipolar disorder patients.

BACKGROUND: In euthymic bipolar disorder patients, scores on the Mini-Mental State Examination (MMSE) are not abnormal but general functioning remains impaired. Recent studies provide ample evidence that euthymic patients show significant impairment on more comprehensive neuropsychological test batteries. There is no definitive relationship between performance on neuropsychological test batteries and the ability to cope in everyday life. Ecologically valid tests of cognitive function aim to bridge this gap as they use everyday tasks to explore cognitive function. The aims of the study were to examine if euthymic bipolar disorder patients were impaired on ecologically valid tests of cognitive function and measures of general, social and occupational function. We examined the relationships between cognitive impairment and residual symptoms, clinical history, general functioning and employment. METHOD: Cognitive tasks, functional assessments and mood scales were administered to 29 euthymic bipolar disorder patients and 29 matched controls. RESULTS: Patients were impaired on ecologically valid tests of attention, memory and executive function. Patients showed impairment in general, social and occupational functioning. Unemployment was associated with impairment in attention. Memory impairment correlated with number of previous manic episodes. LIMITATIONS: All patients were on psychotropic medication, which may affect cognition. Traditional neuropsychological tests were not performed concurrently with ecologically valid tests. CONCLUSIONS: Ecologically valid tests of cognitive function are sensitive in detecting cognitive impairment in euthymic bipolar disorder. Clinicians should consider using these tests in the recovery phase of bipolar illness, as they may be particularly helpful in showing where rehabilitation should focus.

Reducción neumática de invaginación intestinal en niños: experiencia clínica y técnica / Intussusception pneumatic reduction in children: clinical and technical experience

Objetivo: Evaluar la facilidad y efectividad de la reducción neumática de la invaginación intestinal en niños. Materiales y métodos: El grupo de estudio estuvo conformado por 14 niños y 6 niñas, entre un mes y tres años de edad, a quienes se les realizaron 21 reducciones neumáticas desde enero de 2006 a abril de 2009. La invaginación intestinal fue diagnosticada en todos los pacientes por los criterios ecográficos conocidos y a todos se les realizó la reducción bajo control fluoroscópico. Se mantuvo una presión de 120 mm Hg durante 30 segundos con guía fluoroscópica. Resultados: El índice de éxito fue del 95% (20 reducciones de 21), sin recurrencia inmediata. En un paciente no se logró la reducción por encontrársele un divertículo de Meckel, que requirió cirugía. No se presentaron perforaciones intestinales y un paciente tuvo una invaginación recurrente tardía. Conclusión: La reducción neumática de la invaginación intestinal es un método seguro y muy efectivo, con una alta tasa de éxito.

Objective: To assess the feasibility and effectiveness of pneumatic reduction as a non surgical treatment of intussusception in children. Materials and Methods: We studied retrospectively 20 consecutive patients (aged 1 month to 3 years; 14 boys, 6 girls) who underwent pneumatic reduction of intussusception from January 2006 to April 2009. Previous abdominal sonography was performedand confirmed the diagnosis of intussusception in all of them. All patients underwent pneumaticreduction under fluoroscopic guidance using the standard technique. Results: The overall success rate of pneumatic reduction in intussusception was of 95% (20 of 21 reductions), with no cases of immediate recurrence. In a patient who had a Meckel’s diverticulum, the intussusception could not be reduced. There were no cases of intestinal perforation or other complications and recurrence of intussusception occurred only in one patient. Conclusion: Pneumatic reduction is a safe, feasible and highly effective method for treatment of intussusception in children.

A review of the natural course of bipolar disorders (manic-depressive psychosis) in the pre-drug era: review of studies prior to 1950.

A review of the most important original studies describing the natural course of bipolar disorder (manic-depressive psychosis) published in the pre-drug era - before 1950 - is conducted. Discrepancies among studies are detected, most of which are likely explained by methodological differences. However, some conclusions from these old studies remain perfectly valid nowadays: mania is a chronic brain disorder, inherited in most cases, decompensation being more frequent between March and August. It is more common in males, and in some cases, is secondary to other somatic problems. Mixed states are more frequent in the elderly. The review of this type of historical studies is aimed at underscoring the importance that should be attached to the careful study of psychopathology and its recording, both in clinical practice and in psychiatry research.

'The varieties of effects resulting from such morbific causes as are capable of rendering more vivid the feelings of the mind' by S. Hibbert (1825).

The transformation of the old notion of apparition into the new concept of hallucination started in earnest at the beginning of the 19th century. Apparitions were naturalized on the argument that in no case were they a response to an external stimulus; and were secularized by challenging the very existence of external spirits or forces. Both arguments are clearly stated in the work on 'Apparitions' by Samuel Hibbert (a chapter of which has been included below as Classic Text No. 69). Although the debate on the ontology and meaning of the 'phantasms of the living' has continued to this day, it has had no influence on the medical concept of hallucination. It is likely that the latter has suffered as a result.

Confabulation in schizophrenia and its relationship to clinical and neuropsychological features of the disorder.

BACKGROUND: A form of confabulation has been documented in schizophrenia and appears to be related to the symptom of thought disorder. It is unclear whether it is associated with the same pattern of neuropsychological deficits as confabulation in neurological patients. METHOD: Thirty-four patients with chronic schizophrenia, including those with and without thought disorder, and 17 healthy controls were given a fable recall task to elicit confabulation. They were also examined on a range of executive, episodic and semantic memory tests. RESULTS: Confabulation was seen at a significantly higher rate in the schizophrenic patients than the controls, and predominated in those with thought disorder. Neuropsychologically, it was not a function of general intellectual impairment, and was not clearly related to episodic memory or executive impairment. However, there were indications of an association with semantic memory impairment. CONCLUSIONS: The findings support the existence of a form of confabulation in schizophrenia that is related to thought disorder and has a different neuropsychological signature to the neurological form of the symptom.

'The clinico-diagnostic perspective in psychopathology' by K Kahlbaum.

Karl Kahlbaum (1828-99) introduced the concept of time into European psychiatric nosology. In 1863 he first expressed the view that disease definition should take into account the course of the disease, the extension to which psychological functions were compromised, the relevance of the period of life when the mental disorder first appeared, and its primary or secondary nature. Via E. Kraepelin these ideas have moulded the way in which mental disorder has been conceived ever since. And yet Kahlbaum never made it into academic psychiatry. For reasons which remain obscure, he did not obtain a university teaching position and had to spend the rest of his life in private psychiatry. Whether the novelty of his ideas irked contemporary psychiatric officialdom needs further study.

[Cross-cultural adaptation and validation of the Cambridge Depersonalisation Scale]. / Adaptación y validación al castellano de la Escala de Despersonalización de Cambridge.

INTRODUCTION: The Cambridge Depersonalisation Scale (CDS) is a self-rating questionnaire constructed to capture the frequency and duration of depersonalization symptoms over the last six months. The instrument has proved to be valid and reliable and can be useful in both clinical and neurobiological research. METHODS: This paper presents the Spanish adaptation and validation of the CDS. The study was carried out in two stages. First, we developed the Spanish version of the CDS by means of a cross-cultural adaptation methodology. Second, the CDS was tried on a sample of 130 subjects: 77 patients meeting DSM-IV-TR criteria for schizophrenia, 35 with depression disorders and 18 with anxiety disorders. Scores were compared against clinical diagnoses (gold standard). Furthermore, all the subjects of the study were administered the following: Dissociation Experiences Scale (DES), Positive and Negative Syndrome Scale (PANSS), Beck's Depression Inventory (BDI), and the Hamilton Anxiety Rating Scale (HARS). RESULTS: 38 patients (29.2 %) had depersonalization symptoms. The scale showed high internal consistency (Cronbach's alpha > 0.9 and split-half reliability > 0.8) and a test-retest reliability of 0.391. Convergent validity was 0.65 (p < 0.001) and discriminant validity was 0.308 (p < 0.05). The area under the ROC curve was 0.94. A cut-off of 71 appears to be most useful (sensitivity and specificity were 76.3 % and 89.1 %, respectively). CONCLUSION: The Spanish version of the CDS has good reliability and validity, similar to the original instrument.