The mediating role of reflective functioning in the association between childhood trauma and suicide attempt.

BACKGROUND: Childhood trauma is intimately related with suicidal behaviour. Patients who have suffered childhood trauma develop impaired Reflective Functioning (RF), which refers to the capacity to understand ourselves and others in terms of intentional mental states. An improvement in RF has been associated with a reduction in suicidal attempts, but the mediating role of RF between childhood trauma and suicidal behaviour has not been addressed so far. OBJECTIVE: We aim to examine the potential mediating effect of RF among childhood trauma and suicide attempts. METHOD: We included 748 patients who had attempted suicide at least once. They were asked to complete the Reflective Functioning Questionnaire (RFQ-8), the Columbia-Suicide Severity Rating scale (CSSRS), and the Childhood Trauma Questionnaire-Short Form (CTQ-SF). We conducted linear regressions by simple mediating model to examine the role of RF in the indirect association between childhood trauma and the number of suicide attempts. RESULTS: Our results show significant indirect effects through hypo and hypermentalizing between Emotional Abuse (EA) and Sexual Abuse (SA) in childhood and the number of suicide attempts in lifetime. These results indicate that ineffective RF significantly mediates the association between childhood trauma and suicidality. CONCLUSION: This is the first study supporting the mediational role of RF in the relationship between EA and SA, and the number of suicide attempt in lifetime. These findings have important implications for reducing suicide rates and preventing future re-attempts. Further studies analysing this mediating role and focusing efforts on increasing RF-based interventions are required.

[Relationship between standard automated perimetry and retinal nerve fiber layer parameters measured with laser polarimetry]. / Relación entre la perimetría automatizada convencional y los parámetros de la capa de fibras nerviosas de la retina obtenidos con la polarimetría láser.

PURPOSE: To determine the relationship between the structural parameters of the retinal nerve fiber layer (RNFL) obtained by using the scanning laser polarimetry with variable corneal compensation (GDx VCC) and the results of standard automated perimetry (SAP), in normal, ocular hypertensive, preperimetric glaucomas and glaucoma subjects. METHODS: A total of 423 eyes of 423 consecutive subjects were prospectively included in the study and classified depending on the basal intraocular pressure, optic nerve head appearance and SAP results into four groups: 87 normal eyes, 192 ocular hypertensive eyes, 70 preperimetric glaucomas and 74 glaucomatous eyes. Pearson's correlation coefficients, between mean deviation (MD), pattern standard deviation, number of points altered in each quadrant, and number of points altered at different probability levels of SAP and structural parameters of RNFL obtained by using GDx VCC, were calculated in the different diagnostic groups. In the glaucoma group correlations between the 52 points tested by 24- 2 SITA standard and GDx parameters were also calculated. Regression curves were plotted for the strongest correlations. RESULTS: Weak or non-significant correlations were found in the normal, ocular hypertensive and preperimetric glaucoma groups. However, the glaucoma group presented weak to moderate correlations between several GDx VCC parameters and the SAP variables analysed. The strongest correlation was observed between the standard deviation TSNIT and the MD (0.460). CONCLUSIONS: RNFL parameters measured with the GDx VCC presented weak to moderate correlations with the visual field indices and the number of altered points in the glaucoma group.

[Relationship between standard automated perimetry and optic nerve head topography performed with the Heidelberg Retina Tomograph]. / Relación entre la perimetría automatizada convencional y la topografía papilar realizada con el Tomógrafo Heidelberg.

PURPOSE: To determine the correlations between optic nerve head (ONH) parameters measured with the Heidelberg Retina Tomograph (HRT), and the main outcomes of standard automated perimetry (SAP) in normal, ocular hypertensive, glaucoma suspects and glaucomatous subjects. METHODS: Four hundred and twenty-three patients were enrolled in the study and classified into four groups depending on baseline intraocular pressure, optic nerve head morphology, and SAP results: 87 normal eyes, 192 ocular hypertensive eyes, 70 glaucoma suspects and 74 glaucomatous eyes. In the different diagnostic groups, Pearson's correlation coefficients were calculated between ONH parameters and mean deviation, pattern standard deviation (PSD), number of altered points in each quadrant of the visual field (superior-nasal, inferior-nasal, superior-temporal and inferior-temporal), number of points altered at different probability levels, and threshold values at each point of SAP. RESULTS: In the normal and ocular hypertensive groups, only a few weak correlations were found between HRT and SAP parameters. The strength and number of significant correlations increased in the suspected glaucoma group. The glaucoma group had the strongest correlations, particularly between cup/disc ratio and rim/disc ratio with MD (r=0.479) and between rim area and PSD (r=0.444). CONCLUSIONS: Weak to moderate correlations were found between some ONH parameters obtained with the HRT and SAP results in the glaucoma group.

[Relationship between standard automated perimetry and HRT, OCT and GDx in normal, ocular hypertensive and glaucomatous subjects]. / Relación entre perimetría automatizada convencional y HRT, OCT y GDx en sujetos normales, hipertensos oculares y glaucomatosos.

PURPOSE: To determine the correlations between structural parameters of the optic nerve head and the retinal nerve fiber layer (RNFL) obtained by using a Heidelberg Retina Tomograph II (HRT II), optic coherence tomography (OCT), and laser polarimetry (GDX-VCC) and the perimetric indices of standard automated perimetry (SAP) in normal, ocular hypertensive and glaucomatous subjects. METHODS: Three hundred and eighty-nine patients were enrolled in the study and classified into three separate groups: 43 with normal eyes, 274 with ocular hypertensive eyes and 72 with glaucomatous eyes. Subjects were classified according to the basal intraocular pressure and the SAP results. Pearson's correlation coefficients were calculated between the global perimetric indices, mean deviation (MD) and pattern standard deviation (PSD), and structural parameters of the RNFL and optic disc obtained by using HRT II, OCT and GDX-VCC in the different diagnostic groups. RESULTS: Mild to moderate correlations were found between the structural parameters measured by HRT, OCT and GDX and the global perimetric indices, in the glaucoma group. Mild or no significant correlations were found in the normal and ocular hypertensive groups. Correlations were stronger for MD than for PSD. Parameters based on the study of the retinal nerve fiber layer showed stronger correlations than those based on the study of the optic nerve head. CONCLUSIONS: The relationship between structural and functional measurements in glaucoma is weak and therefore the results of these ancillary tests should be interpreted together to increase diagnostic accuracy.

Rosenthal fiber encephalopathy in a dog resembling Alexander disease in humans.

A young male Bernese mountain dog presented with neurologic abnormalities consisting of nonambulatory tetraparesis, generalized tremors, and depressed mental status. At necropsy only a mild enlargement of the lateral ventricles was seen. The histologic examination revealed the presence of eosinophilic deposits consistent with Rosenthal fibers (RFs) throughout the white matter of the central nervous system. There was also a marked proliferation of abnormally large astrocytes and limited myelin changes. RFs were most prominent in perivascular, subpial, and subependymal areas, where they were perpendicularly located, producing a pallisaded arrangement. Immunohistochemically, RFs were strongly positive for glial fibrillary acidic protein (GFAP), and when they were examined ultrastructurally they appeared as electron-dense amorphous masses located within the processes of astrocytes, most particularly in the perivascular feet. The histologic and immunohistochemical findings of this canine case were consistent with the published neuropathologic descriptions of Alexander disease in humans and in a few dogs, a rare condition that in humans has been shown to be caused by dominant mutations in the GFAP gene.

Hemangiomatosis associated with osteolysis of the mandible in a dog resembling Gorham-Stout disease in humans.

A 6-month-old female German Shepherd Dog died as a result of profuse oral bleeding. At postmortem examination, the oral cavity showed visible roots of the right mandibular fourth premolar and first molar teeth and, in addition, they were very mobile and compressible. Radiographs showed a generalized radiolucency in the body of the right mandible, with evidence of resorption of the affected alveolar bone. Histologically, the lesion of the right mandible was characterized by the lysis of bony structures and a non-malignant proliferation of blood-filled vascular spaces lined by a single layer of well-differentiated endothelial cells. The clinical, radiographic, and histologic presentation of this dog is consistent with that associated with Gorham-Stout disease, a rare bone disorder in humans.

Squamous cell carcinoma of the oropharynx and esophagus in a Japanese bantam rooster.

Squamous cell carcinoma of the oropharynx and esophagus was diagnosed in an adult Japanese bantam rooster. Grossly, a cauliflowerlike mass with irregular edges was found involving the ventrolateral surfaces of the caudal portion of the oropharynx and cervical portion of the esophagus. The large volume of the mass almost occluded the lumen of the alimentary passage. Histologically, the tumor consisted of irregular cords of pleomorphic epithelial cells that showed a disorganized pattern of growth and invaded the adjacent tissues. Keratinized epithelial cells and moderate numbers of keratin pearls were readily observed. The mitotic index was low, and, although the tumor was locally invasive, we found no evidence of vascular invasion or metastasis.

Canine distemper in a genet (Gennetta gennetta), associated with endogenous lipid pneumonia.

This report describes the histological and immunohistochemical findings in an adult male genet (Gennetta gennetta) which died a few hours after being found lying in a forest in Lugo (north-western Spain). Subpleural, yellowish, firm foci were found in the lung. Histopathological examination confirmed a diagnosis of endogenous lipid pneumonia. Microscopical lesions that gave rise to a suspicion of canine distemper virus (CDV) infection included lymphoid depletion, non-suppurative encephalitis and demyelination in the central nervous system, and the presence of inclusion bodies in renal tubules. Immunohistochemical examination was performed with the streptavidin-biotin-complex method and a monoclonal antibody against the nucleocapsid protein (NP) of CDV. Antigen was detected in epithelial, nervous and lymphoid cells in several organs. This would appear to be the first report of distemper-like infection in a genet.

Induction and inhibition of apoptosis by pseudorabies virus in the trigeminal ganglion during acute infection of swine.

We examined the ability of pseudorabies virus (PRV) to induce and suppress apoptosis in the trigeminal ganglion during acute infection of its natural host. Eight pigs were intranasally inoculated with a virulent field strain of PRV, and at various early times after inoculation, the trigeminal ganglia were assessed histologically. PRV-infected cells were detected by use of immunohistochemistry and in situ hybridization, and apoptosis was identified by in situ terminal deoxynucleotidyltransferase-mediated dUTP nick end labeling. Light and electron microscopy was also used for morphological studies. Apoptosis was readily detected among infiltrating immune cells that were located surrounding PRV-infected neurons. The majority of PRV-infected neurons did not show morphological or histochemical evidence of apoptosis, even including those neurons that were surrounded by numerous inflammatory cells and exhibited profound pathological changes. However, neuronal virus-induced apoptosis also occurred but at a sporadic low level. These findings suggest that PRV is able to block apoptosis of infected trigeminal ganglionic neurons during acute infection of swine. Furthermore, our results also suggest that apoptosis of infiltrating inflammatory cells may represent an important viral mechanism of immune evasion.

Squamous cell carcinoma in an immature common stork (Ciconia ciconia).

An immature common stork (Ciconia ciconia) was referred from the Wildlife Recovering Center to the Department of Surgery for evaluation. Physical examination revealed a partially ulcerated, necrotic mass on the left surface of the upper beak. The mass was surgically removed and classified histologically as a squamous cell carcinoma. Postsurgically, the bird recovered uneventfully and proceeded to mature normally. During this growth period, no tumor recurrence or metastasis was detected, and no local bone alteration to the beak was found. The stork was ringed and released back into its natural environment.

Distribution of Aujeszky's disease virus in experimentally infected mink (Mustela vison).

Eight Mink (Mustela vison) were inoculated orally with Aujeszky's disease virus (ADV). Three mink were killed at the onset of clinical signs and the other mink died spontaneously after inoculation. The incubation period ranged from 72 to 96 hours and was followed by a short illness characterised by increasing salivation, vomiting and retching, depression and coma. Microscopically, lesions were confined to the brain stem and consisted of a discrete non-suppurative encephalitis. Viral antigen was detected by an immunoperoxidase technique predominantly in association with specific lesions, although sometimes it was found within non-altered areas in the brain stem. Virus isolation confirmed the presence of ADV in the central nervous system. Fibrinoid degeneration of vessel walls was present in pharynx, larynx and myocardium in association with haemorrhages. Microthrombi were observed in heart and brain.

Experimental Aujeszky's disease in blue foxes (Alopex lagopus).

Blue foxes were inoculated orally with Aujeszky's disease virus. Several foxes were killed at the onset of clinical signs and other animals spontaneously died. The incubation period ranged from 3 to 6 days and was followed by a short illness characterized by anorexia, depression and coma. At autopsy, no specific gross findings were observed. Microscopically, lesions included a non-suppurative meningoencephalitis with neuronal necrosis, gliosis, neuronophagia and mononuclear cell cuffing. Viral antigen was detected by immunoperoxidase technique.

Detection of canine distemper viral antigen in foxes (Vulpes vulpes) in northwestern Spain.

We describe the lesions of natural distemper in red foxes (Vulpes vulpes) in Spain. The avidin-biotin-peroxidase complex (ABC) technique and a monoclonal antibody against the nucleocapsid protein of canine distemper virus were successfully used to confirm canine distemper diagnosis.