Unilateral ultra-brief pulse electroconvulsive therapy for depression in Parkinson's disease.

OBJECTIVES: Electroconvulsive therapy (ECT) has demonstrated efficacy in treating core symptoms of Parkinson's disease (PD); however, widespread use of ECT in PD has been limited due to concern over cognitive burden. We investigated the use of a newer ECT technology known to have fewer cognitive side effects (right unilateral [RUL] ultra-brief pulse [UBP]) for the treatment of medically refractory psychiatric dysfunction in PD. MATERIALS AND METHODS: This open-label pilot study included 6 patients who were assessed in the motoric, cognitive, and neuropsychiatric domains prior to and after RUL UBP ECT. Primary endpoints were changes in total score on the HAM-D-17 and GDS-30 rating scales. RESULTS: Patients were found to improve in motoric and psychiatric domains following RUL UBP ECT without cognitive side effects, both immediately following ECT and at 1-month follow-up. CONCLUSIONS: This study demonstrates that RUL UBP ECT is safe, feasible, and potentially efficacious in treating multiple domains of PD, including motor and mood, without clear cognitive side effects.

Clinical improvement of secondary focal limb dystonia in neurodegenerative disease following a five-day lidocaine infusion: a case report.

Dystonia associated with neurodegenerative disease has minimal effective treatment options and can be devastating to a patient's ability to perform tasks of daily living. We present a case of a 55 year-old man who had progressive symptoms of an atypical asymmetric parkinsonian neurodegenerative disease. This patient presented with a dystonic left upper extremity that was refractory to treatment. In an attempt to treat worsening pain associated with the dystonia, he was given a five-day lidocaine infusion for associated pain and within 24 h had improvement in mobility of his dystonic extremity. Dystonia was measured by the Burke-Fahn-Marsden (BFM) dystonia rating and disability scales on hospital day five and at an eight week follow up visit. These scores were compared with scores derived from his previous pre-treatment neurologic examination. The BFM dystonia scale score was initially 16 and improved to 12 on both immediate post-treatment and eight-week follow-up. The BFM disability score improved from 16 to 6 post treatment and to 8 on follow-up appointment. Most importantly, the patient could feed and dress himself for the first time in several years. No adverse events of treatment were encountered. Treatment effect lasted three months with a slow return to baseline motor function. This case report raises interesting questions regarding the mechanism of dystonia in neurodegenerative disease and suggests the afferent sensory system as a potential target for therapeutics.

[News about cancer in the press]. / Las noticias sobre el cáncer en los medios de comunicación escrita.

BACKGROUND: News on health and health care are increasingly common in the mass media, and cancer is one of the most prominent topic among these news due to its health impact. MATERIAL AND METHODS: All news published in major newspapers in Catalonia, Spain between April to December 1996 were analysed, together with items from science and health supplements general information and science journals. Types of cancer-related topics, sources of information, the importance of cancer in the news item and the theme of the piece were analysed. RESULTS: During the period analysed, 974 news items were published which dealt with cancer. Of these, cancer was the principal topic in 53.5% of the items published in the national press, and 63.4% of the items published in the regional press. Cancer was the subject of an editorial comment on only four occasions. The source of information was mentioned in 64.8% of the items, and mean number of sources was 1.6. Political institutions were the most frequent source of information in newspapers, while science and health supplements and other magazines tended to cite scientific and health care institutions, as well as scientific journals. Basic research was the most common topic for news (30.3%) in science and health supplements while risk and environmental factors (29.6%) were the most common topics in magazines; environmental and technological risk factors (18,6%) and conflicts with health administrative bodies (16%) were the most frequent topics in the newspapers. CONCLUSION: News about risk factors and their prevention as well as technological and environmental factors related to cancer were among the most important topics published in the general press and magazines, together with conflicts with administrative bodies. Informations related to new therapies were a less frequent topic. Scientific journals have an important role as an information source for mass media together with political and scientific institutions.

Las noticias sobre el cáncer en los medios de comunicación escrita / News about cancer in the press

Fundamentos: La publicación de noticias relacionadas con la salud y la sanidad es un hecho cada vez más frecuente en los medios de comunicación social. El cáncer es una de las patologías que por su impacto sanitario es motivo de mayor número de piezas periodísticas. Material y métodos: Se han analizado todas las piezas periodísticas publicadas en los periódicos de mayor difusión en Cataluña entre abril y diciembre de 1996, junto con los suplementos de ciencia/salud y revistas de información general y de divulgación científica. Se evaluaron los tipos de temas tratados dentro del cáncer, las fuentes de información, la importancia del cáncer en la noticia y el perfil temático de la noticia. Resultados: En el período analizado se publicaron 974 piezas periodísticas que trataban del cáncer. El tema del cáncer era abordado como principal motivo de la noticia en el 53,5 por ciento de los textos publicados en la prensa nacional y por un 63,4 por ciento en la prensa comarcal. Sólo cuatro editoriales fueron publicadas con el tema del cáncer como motivo. En el 64,8 por ciento de los casos se citaba la fuente de información con una media de 1,6 fuentes por noticia. Las instituciones políticas fueron la fuente de información más frecuente de las noticias en la prensa mientras que las instituciones científicas, sanitarias y las revistas científicas lo fueron en los suplementos de ciencia/salud, dominicales y otras revistas. La investigación básica fue el perfil temático más frecuente de las piezas publicadas (30,3 por ciento) en los suplementos de ciencia/salud, y los factores de riesgo y ambientales (29,6 por ciento) en las revistas, mientras que en los periódicos los perfiles temáticos más frecuentes fueron los riesgos ambientales y tecnológicos (18,6 por ciento), así como los conflictos con la administración (16 por ciento).Conclusión: Las noticias e informaciones sobre factores de riesgo y su prevención, y riesgos tecnológicos y ambientales relacionados con el cáncer se encuentran entre los principales temas publicados, seguidos por los conflictos con la Administración. Las informaciones relacionadas con nuevos tratamientos tienen menor importancia cuantitativa. Las revistas científicas tienen un papel destacado como fuente de información de los medios de comunicación escrita, así como también los organismos políticos y científicos (AU)

CCR5 chemokine receptor genotype frequencies among Puerto Rican HIV-1-seropositive individuals.

Some individuals remain uninfected by human immunodeficiency virus type 1 (HIV-1), despite multiple sexual contacts with subjects with confirmed HIV-1 infection. Several studies have confirmed that individuals who are homozygous for a 32 base pair (bp) deletion mutation in the chemokine receptor gene CCR5, designated as delta 32/ delta 32, are protected against HIV-1 infection. Heterozygotes of the same chemokine receptor deletion mutation are, however, not protected from acquiring HIV-1 infection but seemingly have slower progression to acquired immunodeficiency syndromes (AIDS). Genotype frequencies of the delta 32 CCR5 mutation vary markedly among different ethnic groups; heterozygosity is found in approximately 15% of Caucasians, about 5-7% of Hispanics and African Americans and 1% or less of Asians. The ethnic background of Puerto Ricans is highly complex and usually includes admixture of Caucasian, Caribbean Indian and African traits to a varying extent. This study was conducted to examine the frequencies of the delta 32 CCR5 mutation among Puerto Ricans who are infected with HIV-1. Samples were received from different geographical regions of the island. Of 377 samples tested, 94.2% were wild type (non-deletion mutant) homozygotes, 5.8% were delta 32 CCR5 heterozygotes, and none were delta 32 CCR5 homozygotes. The incidence of CCR5 delta 32/w heterozygous mutation among Puerto Ricans seems to be somewhat lower than what was reported with US Hispanics. Some age and gender associated bias of the mutation frequency were observed with the study population, the reason for which is unclear at present.

Press releases of science journal articles and subsequent newspaper stories on the same topic.

CONTEXT: Scientific journals issue press releases to disseminate scientific news about articles they publish. OBJECTIVE: To assess whether press releases about journal articles were associated with publication of subsequent newspaper stories. DESIGN: Retrospective content analysis of newspaper stories, journal press releases, and journal tables of contents. From December 1, 1996, to February 28, 1997, press releases and tables of contents were collected from BMJ, Nature, Science, and The Lancet, along with newspaper stories on scientific research published in The New York Times (United States), Le Figaro and Le Monde (France), El País and La Vanguardia (Spain), La Repubblica (Italy), and the International Herald Tribune. MAIN OUTCOME MEASUREMENTS: Number of newspaper stories that contained reference to articles appearing in the 4 scientific journals, number of newspaper stories that referred to journal articles described in press releases, and the order in which journal articles were mentioned in press releases. RESULTS: Of the 1060 newspaper stories analyzed, 142 referred to journal articles; of these, 119 (84%) referred to articles mentioned in press releases and 23 (16%) referred to journal articles not mentioned in press releases (comparison of proportions, P=.03). Articles described first or second were referenced in more newspapers than articles described later in the press release (P=.01 by chi2 analysis). CONCLUSIONS: Journal articles described in press releases, in particular those described first or second in the press release, are associated with the subsequent publication of newspaper stories on the same topic.

CCR5 chemokine receptor genotype frequencies among Puerto Rican HIV-1-seropositive individuals

Some individuals remain uninfected by human immunodeficiency virus type 1 (HIV-1), despite multiple sexual contacts with subjects with confirmed HIV-1 infection. Several studies have confirmed that individuals who are homozygous for a 32 base pair (bp) deletion mutation in the chemokine receptor gene CCR5, designated as delta 32/ delta 32, are protected against HIV-1 infection. Heterozygotes of the same chemokine receptor deletion mutation are, however, not protected from acquiring HIV-1 infection but seemingly have slower progression to acquired immunodeficiency syndromes (AIDS). Genotype frequencies of the delta 32 CCR5 mutation vary markedly among different ethnic groups; heterozygosity is found in approximately 15% of Caucasians, about 5-7% of Hispanics and African Americans and 1% or less of Asians. The ethnic background of Puerto Ricans is highly complex and usually includes admixture of Caucasian, Caribbean Indian and African traits to a varying extent. This study was conducted to examine the frequencies of the delta 32 CCR5 mutation among Puerto Ricans who are infected with HIV-1. Samples were received from different geographical regions of the island. Of 377 samples tested, 94.2% were wild type (non-deletion mutant) homozygotes, 5.8% were delta 32 CCR5 heterozygotes, and none were delta 32 CCR5 homozygotes. The incidence of CCR5 delta 32/w heterozygous mutation among Puerto Ricans seems to be somewhat lower than what was reported with US Hispanics. Some age and gender associated bias of the mutation frequency were observed with the study population, the reason for which is unclear at present