Motor activity and depression severity in adolescent outpatients.

OBJECTIVES: The present study investigated the association between motor activity and severity of depression in 6 depressed adolescent outpatients. METHOD: Motor activity was assessed by actigraphy and the severity of depression was assessed weekly using the CDRS-R. The levels of motor activity were analyzed by considering activity parameters. RESULTS: Among the parameters of motor activity studied, the mean total activity, the mean 24-hour activity levels, the mean waking activity, and the mean activity level between 12:00 and 18:00 h were inversely correlated with severity of depression. The means of the 10 most active hours tended toward a negative correlation with the depressive severity score. CONCLUSION: The results seem to suggest an association between motor activity level and severity of depression in adolescents. Nevertheless, in order to reach a more conclusive understanding, it would be necessary to replicate this study using a larger number of individuals as well as a longer observation period.

Transmission of light through a single rectangular hole.

We show that a single rectangular hole in a metallic film exhibits transmission resonances that appear near the cutoff wavelength of the hole waveguide. For light polarized with the electric field pointing along the hole's short axis, it is shown that the normalized-to-area transmittance at resonance is proportional to the ratio between the long and short sides, and to the dielectric constant inside the hole. Importantly, this resonant transmission process is accompanied by a huge enhancement of the electric field at both entrance and exit interfaces of the hole.

Comorbidity of obsessive-compulsive disorder and personality disorders. A Brazilian controlled study.

The aim of this study was to evaluate the presence of personality disorders (PDs) in 40 patients with obsessive-compulsive disorder (DSM-III-R criteria) from the Medical School of Botucatu (UNESP), São Paulo, Brazil. It is a case-control study. Patients were 24 women and 16 men, 16-68 years old, referred to our outpatient psychiatric service for treatment. Controls were 40 nonpsychiatric outpatients matched to the cases by sex, age and marital status. The instrument used was the Portuguese version of the Structured Interview for DSM-III-R Personality Disorders (SIDP-R). All interviews (n = 80) were made simultaneously by 2 raters, with independent scoring, so that the interrater reliability of the instrument could also be assessed (kappa statistics). The consensual axis II diagnoses in the OCD group were: avoidant (52.5%, kappa = 0.80), dependent (40%, kappa = 0.84), histrionic (20%, kappa = 0.83), paranoid (20%, kappa = 0.74), obsessive-compulsive (17.5%, kappa = 0.86), narcissistic (7.5%, kappa = 1.00), schizotypal (5%, kappa = 0.65), passive-aggressive (5%, kappa = 0.79) and self-defeating (5%, kappa = 0.55). At least one PD diagnosis was made in 70% of the patients, while only 6 controls had a PD diagnosis (p < 0.01). A great deal of diagnostic overlap was found in the OCD group (57.5% had two or more PDs), especially between avoidant and dependent PDs. The features of these two PDs may be secondary to the OCD. The study also suggests that there is not a close relationship between OCD and obsessive-compulsive personality disorder (OCPD). Patients with OCPD or even 3 or 4 O-C traits had significantly less insight into their obsessions and compulsions (p < 0.01).

Applicability and reliability of a portuguese version of the structured interview for DSM-III-R personality disorders

The importance of personality psychopathology has been recently recognized, since it may influence the manifestation and prognosis of the other psychiatric conditions. The systematic evaluation of patients for personality disorders (PD) has been favored by some structure instruments developed in the past few years. The aim of this study was to translate into Portuguese and evaluate the applicability and interrater reliability of the "Structure Interview for DSM-III-R Personality Disorders" (SIDP-R). The subjects were 40 patients with DSM-III-R obsessive-compulsive disorder (OCD) and 40 nonpsychiatric patients from a university outpatient service. All 80 interviews were made simultaneously by two raters, with independent scoring. The coefficient of agreement (Kappa) was calculated for nine individual PDs and ranged from 0.55 to 1.00. The OCD patients had significantly (p <0.01) more PDs (70 percent) than the nonpsychiatric group (15 percent). No significant sex differences were found in the prevalence of PDs. There was much diagnostic overlap, specially between avoidant and dependent PDs. The Portuguese version of the SIDP-R had good applicability and satisfactory interrater reliability and may be a useful instrument to assess axis II disorders

[Amebic liver abscess and amebic colitis in a couple]. / Absceso amebiano hepático y colitis amebiana en una pareja.

Amebiasis is a disease commonly extended all around the world, its prevalence depending on the population under study. In Spain, most cases published are of exotic acquisition. We present the case of a married couple from Venezuela presenting two different forms of invasive amebiasis: acute colitis and hepatic abscess. In our environment, once the diagnosis of amebiasis is established, a close follow-up of the patients must be made, including the evaluation of the closest contacts. Regarding the treatment, we think that the asymptomatic forms must be treated with a luminal amebicidal and the symptomatic forms, with hystic amebicidal followed by luminal amebicidal.

Effect of cutaneous cell-mediated immune response to rIFN gamma on Mycobacterium leprae viability in the lesions of lepromatous leprosy.

1. Studies were carried out to determine the effect of intra-dermal injections of recombinant human interferon-gamma (rIFN gamma) on the viability of Mycobacterium leprae. Twenty-three untreated and 4 treated multibacillary patients, 12 with lepromatous leprosy (LL) and 15 with borderline lepromatous leprosy (BL), were selected for intradermal administration of rIFN gamma or PPD. Treated patients (LL and BL) had received multi-drug therapy according to the recommendations of the World Health Organization, i.e., rifampicin (600 mg/month), dapsone (100 mg/day) and clofazimine (50 mg/day and 300 mg/month) for 1-4 months. Three daily doses of 10 or 30 micrograms rIFN gamma induced local induration and mononuclear leucocyte accumulation. Bacteria isolated from a punch biopsy of the site 21 days after lymphokine administration were injected into mouse foot pads and evaluated for viability and growth. 2. The local response to rIFN gamma (specific activity 2 x 10(7) units/mg protein) induced a delay or total inhibition of M. leprae growth in the mouse foot pad, indicating that the cellular response to the antigen reduced local M. leprae viability. The extent of reduction in viability depended on the dose of rIFN gamma injected and the extent of local induration induced by the lymphokine. With a vigorous cell-mediated immune response growth was fully inhibited. 3. A similar but less extensive effect on M. leprae viability was observed in response to the local injection of 5 units in 0.1 ml of purified protein derivative of tuberculin (PPD).

Effect of cutaneous cell-mediated immune response to rIFNy on mycobacterium leprae viability in the lesions of lepromatous leprosy / Efeito da célula cutanea - resposta imune intermediária para rIFNy sobre viabilidade de Mycobacterium leprae nas lesöes de lepra lepromatosa

Studies were caried out to determine the effect of intra-dermal injections of recombinant human interferon-gamma (rIFNy) on the viability of Mycobacterium leprae. Twenty-three untreated and 4 treated multibacillary patients, 12 with lepromatous leprosy (LL) and 15 with bordeline lepromatous leprosy (BL), were selected for intradermal administration of rIFNy or PPD. Treated patients (LL and BL) had received multi-drug therapy according to the recommendations of the World Health Organization, i. e., rifampicxin (600 mg/month), dapsone (100 mg/day) and clofazimine (50 mg/day and 300 mg/month) for 1-4 months. Three daily doses of 10 or 30 ug rIFNy induced local induration and mononuclear leucocyte accumulation. Bacteria isolated from a punch biopsy of the site 21 days after lymphokine administration were injected into mouse foot pads and evaluated for viability and growth. The local response to rIFN (specific activity 2 x 10 7 units/mg protein) induced a delay or total inhibition of M. leprae growth in the mouse foot pad, ,indicating that the cellular response to the antigen reduced local M. leprae viability. The extent of reduction in viability depended on the dose of rIFNy injected and the extent of local induration induced by the lymphokine. With a vigorous cell-mediated immune response growth was fully inhibited. A similar but less extensive effect on M. leprae viability was observed in resapo0nse to the local injection of 5 units in 0.1 ml of purified protein derivative of tuberculin (PPD)

[Sternoclavicular staphylococcal arthritis in non-immunodepressed patients. Study of 4 cases]. / Artritis estafilocócica esternoclavicular en pacientes no inmunodeprimidos. Estudio de 4 casos.

We report four patients (3 males and one female) suffering a sternoclavicular staphylococcal arthritis in whom risk factors such as parenteral drug addiction, alcoholism, diabetes, or immunosuppression were not observed. The etiopathogenesis, clinical picture, and diagnosis of this uncommon septic arthritis in reviewed.

Enemas de 5-ASA no tratamento de retocolite ulcerativa aguda: ensaio clínico controlado / 5-aminisalicylic acid (5-ASA) enemas in the treatment of acute ulcerative colitis: a clinical controlled study

Säo relatados os resultados de um estudo duplo-cego, aleatório, elaborado com o objetivo de verificar a eficácia terapêutica do ácido 5-aminossalicílico (5-ASA), em comparaçäo com a hidrocortisona, no tratamento da fase aguda da retocolite ulcerativa. Ambas as drogas foram administradas sob a forma de enemas de 100ml, contendo 3g de 5-ASA ou 0,1 g de hidrocortisona. Participaram voluntariamente do trabalho 15 pacientes. Oito doentes foram tratados com 5-ASA e sete com hidrocortisona por um período de 28 dias. Durante as primeiras duas semanas os pacientes foram tratados com dois enemas diários, reduzindo-se para um enema nas duas semanas seguintes. Seis dos oito pacientes tratados com 5-ASA e cinco dos sete tratados com hidrocortisona foram considerados em remissäo, utilizando-se critérios clínicos e retossigmoidoscópicos ao término da terapêtica. Dois pacientes tratados com 5-ASA abandonaram o tratamento com queixas de ardência no reto. Ao término do tratamento observou-se acentuada melhora quanto à sintomatologia clínica, à retossigmoidoscopia e à histopatologia nos pacientes de ambos os sexos, comparando-se com os valores observados no início da terapêutica. Näo se constatou, entretanto, diferença significativa entre os dois tratamentos instituídos. Os autores concluem que os enemas de 5-ASA e os de hidrocortisona säo igualmente efetivos para producir remissäo da retocolite ulcerativa quando em fase aguda

[Malignant histiocytosis. Apropos of a case]. / Histiocitose maligna. A propósito de um caso.

The authors report a case of malignant histiocytosis occurring in a 39 year old female patient who presented an ulcerated cutaneous lesion which was the only clinical manifestation for one year and then widespread systemic involvement took place and death ensued. They emphasize the rarity of the condition and point out that erythrophagocytosis in the histopathological examination may be a valuable finding for the diagnosis of malignant histiocytosis.

[Ashy dermatosis. Review of the literature and report of a case]. / Dermatose cinzenta. Revisão e relato de um caso.

The authors make a review of the epidemiologic, etiopathogenic, clinical, laboratory and therapeutic aspects of ashy dermatosis, described in 1957 by Ramírez in El Salvador, of which more than 150 cases have been described up to now in different continents. The disease is exclusively cutaneous, presents peculiar clinical features with a lichenoid tissue reaction, and has no specific treatment or known etiology. The authors report a case in a Brasilian man, followed up for three years. The treatment of a T. trichiura infestation did not change the cutaneous features, as opposed to what has been reported.

[Correlation of skin tests and the production of gamma-interferon in leprosy patients]. / Correlação entre testes cutâneos e produção de Y-IFN en pacientes com hanseníase.

The responsiveness of 25 leprosy patients to an in vitro correlate of cell-mediated immunity to M. leprae antigen, (the production of Y-IFN by peripheral blood mononuclear cells) was compared to their response to skin tests routinely used to evaluate cell-mediated immunity to a number of antigens including M. leprae. The results indicate that among the polar lepromatous patients (LL) there was a clear correlation between low responses in the in vitro assay (Y-IFN production), negative skin test to the specific antigen (Mitsuda reaction) and low responses to skin tests to a related antigen (PPD). There was no correlation in the other clinical groups with skin tests to other unrelated antigens.

Cord serum gamma glutamyltransferase in newborns.

This article reports correlations among gamma-glutamyltransferase (GGT), fetal haemoglobin (fH), alpha-fetoprotein, 5'-nucleotidase, ceruloplasmin, and direct, indirect, and total bilirubin in the serum of blood taken from the umbilical cords of 128 newborns delivered after 37-42 weeks of gestation. GGT was significantly correlated with alpha-fetoprotein, but not with direct bilirubin, indirect bilirubin, total bilirubin, fH, or %fH. Neither fH nor %fH were correlated with alpha-fetoprotein, but there was highly significant negative correlation between both fH and %fH on the one hand, and gestational age and weight at birth on the other. The %fH was also correlated negatively with ceruloplasmin, which in turn exhibited negative correlation with alpha-fetoprotein. The predominant forms of GGT in umbilical cord and adult sera were, respectively, those with alpha 1 and alpha 2 mobility. In cord sera, delipidation with n-butanol brought about loss of GGT activity and a shift from an alpha 1 to an alpha 2 position, whereas no significant effect of this kind was observed in adult sera. Affinity chromatography through Concanavalin A-Sepharose showed cord sera to contain a proportion of bound-GGT (68.5 +/- 5.5%) that was significantly greater (p less than 0.001) than that found in adult sera (59.8 +/- 10.2%). It is concluded that the high GGT activity of cord sera is probably due to hepatic immaturity rather than maternal sources, enzymatic induction or microsomal lesions; that the predominant form of GGT in cord serum may be a complex with HDL and less sialized than the adult enzyme; and that, of the factors examined, the best indicator of neonatal maturity is fetal haemoglobin.

Cellular responses to the intradermal injection of recombinant human gamma-interferon in lepromatous leprosy patients.

The local response to a single intradermal injection of 10 micrograms recombinant gamma-interferon (rIFN gamma) has been studied in 17 patients with lepromatous leprosy. Of these, 2 patients additionally received two intradermal injections of 10 micrograms rIFN gamma at another site. The results were compared with those of 3 patients who received three injections of the same dose at a single site in an earlier study. One to 7 days after lymphokine administration 4-mm punch biopsies were obtained and examined for cellular alterations in the dermis and epidermis. This allowed a kinetic analysis of mononuclear cell infiltration, keratinocyte proliferation and differentiation, and Langerhans cell redistribution. At 24 hours, the migration of large numbers of helper T cells and monocytes was already prominent and associated with induration. Mononuclear cell accumulation peaked at 72 hours but then persisted for 5-7 days. Only small numbers (one-third or less of total T cells) of suppressor/cytotoxic T cells were present at any time, and granulocytes were absent. Two daily injections of rIFN gamma led to a more intense accumulation of cells. Ten micrograms of rIFN gamma resulted in enhanced keratinocyte proliferation, Ia expression, and thickening of the epidermis. At 24-48 hours major histocompatibility Class II (Ia) antigen was first noted on the dividing cells of the basal layer. By 72-96 hours the entire epidermis exhibited strong expression of Ia antigen on cell surfaces. Repeated doses of lymphokine accentuated these changes and resulted in a more prompt keratinization and sloughing of this layer. Whereas a single dose of rIFN gamma resulted in the upward movement of T6+ Langerhans cells (LCs) in the epidermis, two injections led to a 50% reduction in their numbers and three doses were associated with an almost total loss of detectable T6+ LCs from the epidermis. These are probably sloughed along with keratinocytes. In contrast to the situation with a delayed immune response in the skin (purified protein derivative), no LCs accumulated in the dermis in association with helper T cells.

Uma formulaçäo oral para liberaçäo de ácido 5-aminossalicílico no cólon / An oral preparation for release of 5-aminosalicylic acid in the colon

Estudou-se uma preparaçäo oral de ácido 5-aminossalicílico de liberaçäo pH dependente. Participaram do estudo 11 indivíduos com idades variando entre 20 e 63 anos, dos quais três eram voluntários sadios, seis apresentavam retocolite ulcerativa e dois doença de Crohn. Através de um acompanhamento radiológico efetuado na 6ª, 12ª e 24ª hora, constatou-se que a desintegraçäo dos comprimidos se realiza somente na regiäo ileocecal e cólon. Finalmente, com base nos resultados, destaca-se a potencialidade da formulaçäo no controle das doenças inflamatórias intestinais

Reversal of abnormal dexamethasone suppression test in alcoholics abstinent for four weeks.

Fourteen of 64 alcoholic inpatients (22%) showed a nonsuppression postdexamethasone response when tested between the second and fifth days of admission. No association with alterations of hepatic enzymes (GGT, SGOT, SGPT) was observed. At retest (in the fourth week of abstinence), no abnormal response to the Dexamethasone Suppression Test (DST) was detected. The nonsuppressor alcoholics did not meet the criteria for major depression according to the Research Diagnostic Criteria (RDC). The data indicate a lack of specificity of the DST for the diagnosis of depression in alcoholics during the first days of withdrawal.