[Depression and anxiety in Turkish and Moroccan minorities in the Netherlands: prevalence, symptoms, risk factors and protective factors A systematic review]. / Depressie en angst bij Turkse en Marokkaanse minderheidsgroepen in Nederland: prevalentie, symptomen, risico- en beschermende factoren in de algemene bevolking Een systematische review.

.

[Hyperactive behavior in adults; possibly attention deficit/hyperactivity disorder (ADHD)]. / Druk gedrag bij volwassenen; mogelijk aandachtstekort-hyperactiviteitstoornis (ADHD).

Two men aged 34 and 41 years, respectively, displayed hyperactive and chaotic behaviour. On the basis of the symptoms and their effect on the patients' functioning during childhood and adulthood, the diagnosis of attention deficit/hyperactivity disorder (ADHD) was made. The patients became calmer with methylphenidate treatment, but a few months later they chose to stop taking the medication and to accept their hyperactive behaviour. To establish the diagnosis of ADHD in adults, it is essential that some of the symptoms started before seven years of age and that the symptoms and resulting impairment persist over time from childhood into adulthood. To investigate this, it is necessary to obtain heteroanamnestic information from the parents or other people who knew the patient at that age. Treatment with medication and psychoeducation is effective and can prevent further suffering.

Point prevalence of schizophrenia in immigrant groups in Rotterdam: data from outpatient facilities.

OBJECTIVE: Reports of an increased incidence of schizophrenia in some immigrant groups to The Netherlands are based exclusively on hospital data. THE AIMS OF OUR STUDY WERE: 1) to determine the treated point prevalence of schizophrenia at outpatient mental health services in Rotterdam and to compare the results for immigrants to those for natives; and 2) to compare groups born in The Netherlands and immigrant groups in terms of the proportions of patients with a previous hospital admission. METHOD: We included all patients aged between 20 and 64 who were treated for a non-affective psychosis at any of the outpatient mental health services in Rotterdam on October 1, 1994. The mental health professionals responsible reported on the socio-demographic and clinical characteristics of each patient. RESULTS: Seven hundred and thirteen patients with a diagnosis of schizophrenia (DSM-III-R) were identified (rate: 2.1 per 1000). The (treated) prevalence of schizophrenia in male immigrants from Surinam and Morocco and in female immigrants from Surinam, the Netherlands Antilles and Cape Verde was significantly higher than that in their native-born counterparts (odds ratios between 2 and 3). The (treated) prevalence was not significantly higher in immigrants from Turkey, female immigrants from Morocco or male immigrants from the Antilles. Proportions of patients with a previous hospital admission were similar in each ethnic group (81-93%). CONCLUSION: These findings are generally in line with earlier studies, based on the Dutch psychiatric registry, which has reported an increase in the (treated) incidence of schizophrenia in immigrants from Surinam and the Netherlands Antilles and in male immigrants from Morocco, and no increase in the (treated) incidence in immigrants from Turkey or female immigrants from Morocco.

alpha1H T-type Ca2+ channel is the predominant subtype expressed in bovine and rat zona glomerulosa.

The low voltage-activated (T-type) Ca2+ channel has been implicated in the regulation of aldosterone secretion from the adrenal zona glomerulosa by extracellular K+ levels, angiotensin II, and ACTH. However, the identity of the specific subtype mediating this regulation has not been determined. We utilized in situ hybridization to examine the distribution of three newly cloned members of the T-type Ca2+ channel family, alpha1G, alpha1H, and alpha1I, in the rat and bovine adrenal gland. Substantial expression of only the mRNA transcript for the alpha1H-subunit was detected in the zona glomerulosa of both rat and bovine. A much weaker expression signal was detected for the alpha1H transcript in the zona fasciculata of bovine. Whole cell recordings of isolated bovine adrenal zona glomerulosa cells showed the native low voltage-activated current to be inhibited by NiCl2 with an IC50 of 6.4 +/- 0.2 microM. Because the alpha1H subtype exhibits similar NiCl2 sensitivity, we propose that the alpha1H subtype is the predominant T-type Ca2+ channel present in the adrenal zona glomerulosa.

Activation and inhibition of G protein-coupled inwardly rectifying potassium (Kir3) channels by G protein beta gamma subunits.

G protein-coupled inwardly rectifying potassium (GIRK) channels can be activated or inhibited by different classes of receptors, suggesting a role for G proteins in determining signaling specificity. Because G protein betagamma subunits containing either beta1 or beta2 with multiple Ggamma subunits activate GIRK channels, we hypothesized that specificity might be imparted by beta3, beta4, or beta5 subunits. We used a transfection assay in cell lines expressing GIRK channels to examine effects of dimers containing these Gbeta subunits. Inwardly rectifying K(+) currents were increased in cells expressing beta3 or beta4, with either gamma2 or gamma11. Purified, recombinant beta3gamma2 and beta4gamma2 bound directly to glutathione-S-transferase fusion proteins containing N- or C-terminal cytoplasmic domains of GIRK1 and GIRK4, indicating that beta3 and beta4, like beta1, form dimers that bind to and activate GIRK channels. By contrast, beta5-containing dimers inhibited GIRK channel currents. This inhibitory effect was obtained with either beta5gamma2 or beta5gamma11, was observed with either GIRK1,4 or GIRK1,2 channels, and was evident in the context of either basal or agonist-induced currents, both of which were mediated by endogenous Gbetagamma subunits. In cotransfection assays, beta5gamma2 suppressed beta1gamma2-activated GIRK currents in a dose-dependent manner consistent with competitive inhibition. Moreover, we found that beta5gamma2 could bind to the same GIRK channel cytoplasmic domains as other, activating Gbetagamma subunits. Thus, beta5-containing dimers inhibit Gbetagamma-stimulated GIRK channels, perhaps by directly binding to the channels. This suggests that beta5-containing dimers could act as competitive antagonists of other Gbetagamma dimers on GIRK channels.

Infectious keratitis with corneal perforation associated with corneal hydrops and contact lens wear in keratoconus.

BACKGROUND: Corneal perforation is an uncommon complication associated with keratoconus. The first cases of infectious keratitis and corneal perforation associated with corneal hydrops and contact lens wear are reported in two keratoconus patients. METHODS: A retrospective chart review and histopathological examination were carried out. RESULTS: Both patients progressed to corneal perforation and emergency penetrating keratoplasty. One patient cultured Fusarium and the second patient Serratia marcesens. Both patients wore contact lenses against medical advice. CONCLUSIONS: The tear in Descement's membrane, stromal oedema, and epithelial bedewing associated with corneal hydrops results in loss of the epithelial-endothelial barrier of the cornea, creating a conduit for infectious organisms through the cornea. Acute hydrops associated with epithelial keratitis, stromal swelling, and a Descement's membrane tear may be a significant risk factor for infectious keratitis and corneal perforation. Contact lenses should not be worn during an active corneal hydrops owing to the increased risk for severe infectious keratitis and corneal perforation.

Penetration of topically applied ciprofloxacin, norfloxacin, and ofloxacin into the aqueous humor.

PURPOSE: To determine the intraocular penetration of topically applied fluoroquinolone antibiotics into aqueous humor. METHODS: Thirty-two patients undergoing cataract extraction received either 0.3% ciprofloxacin, 0.3% norfloxacin, or 0.3% ofloxacin topical drops. The patients were given two drops 90 minutes preoperatively and two drops 30 minutes preoperatively. At the time of surgery, 0.1 ml aqueous fluid was aspirated from the anterior chamber and immediately stored at -70 degrees C. RESULTS: Concentrations of ciprofloxacin, norfloxacin, and ofloxacin were determined using a broth dilution bioassay. Morganella morganii with a known minimal inhibitory concentration was used to assay ciprofloxacin and norfloxacin levels. Salmonella enteritidis with a known minimal inhibitory concentration was used to assay ofloxacin levels. Topically applied ciprofloxacin achieved a mean aqueous level of 0.072 microgram/ml (range, 0.02-0.153 microgram/ml). One sample was below the sensitivity of the bioassay. Topical norfloxacin achieved a mean aqueous level of 0.0570 microgram/ml (range, 0.046-0.10 microgram/ml). Seven samples did not reach the sensitivity of the bioassay. Topical ofloxacin achieved a mean level in the aqueous humor of 0.338 microgram/ml (range, 0.078-0.625 microgram/ml). There was no statistically significant difference in intraocular aqueous humor levels of ciprofloxacin versus norfloxacin (P > 0.05). Topical ofloxacin achieved aqueous humor levels significantly higher than either ciprofloxacin or norfloxacin (P < 0.004). CONCLUSION: Of the currently available topical fluoroquinolone antibiotics, ofloxacin achieves the highest aqueous humor concentrations.

Lid imbrication syndrome. Diagnosis with rose bengal staining.

BACKGROUND: Lid imbrication syndrome is an abnormality of lid apposition in which the upper lid overlies the lower lid. Patients often complain of irritation, tearing, and foreign body sensation. The condition may be difficult to diagnose. METHOD: Twenty-one patients with suspected lid imbrication syndrome were compared with 21 age-matched controls. All patients were given 0.5% topical rose bengal. RESULTS: The diagnosis of lid imbrication syndrome was confirmed by the presence of rose bengal staining of the tarsal conjunctiva of the upper lid margin. The amount of rose bengal staining correlated with the severity of lid imbrication. Eighteen of 21 patients had received a diagnosis previously of dry eye syndrome. Four patients had persistent epithelial defects. CONCLUSIONS: Rose bengal staining of the superior lid margin tarsal conjunctiva offers an extremely reliable aid for diagnosing lid imbrication syndrome. The condition commonly presents as a dry eye or persistent epithelial defect. Treatment ranges from viscous tear substitutes to horizontal lid shortening of the upper lid.

Validity of peak expiratory flow measurement in assessing reversibility of airflow obstruction.

BACKGROUND: Assessing the reversibility of airflow obstruction by peak expiratory (PEF) measurements would be practicable in general practice, but its usefulness has not been investigated. METHODS: PEF measurements were performed (miniWright peak flow meter) in 73 general practice patients (aged 40 to 84) with a history of asthma or chronic obstructive lung disease before and after 400 micrograms inhaled sulbutamol. The change in PEF was compared with the change in forced expiratory volume in one second (FEV1). Reversible airflow obstruction was analysed in two ways according to previous criteria. When defined as a 9% or greater increase in FEV1 expressed as a percentage of predicted values reversibility was observed in 42% of patients. Relative operating characteristic analysis showed that an absolute improvement in PEF of 60 l/min or more gave optimal discrimination between patients with reversible and irreversible airflow obstruction (the sensitivity and specificity of an increase of 60 l/min in detecting a 9% or more increase in FEV1 as a percentage of predicted values were 68% and 93% respectively, with a positive predictive value of 87%). When defined as an increase of 190 ml or more in FEV1, reversible airflow obstruction was observed in 53% of patients. Again an absolute improvement in PEF of 60 l/min or more gave optimal discrimination between patients with reversible and irreversible airflow obstruction (sensitivity 56%, specificity 94%, and positive predictive value 92%). CONCLUSION: Absolute changes in PEF can be used as a simple technique to diagnose reversible airflow obstruction in patients from general practice.

Quality of life in elderly patients with chronic nonspecific lung disease seen in family practice.

We studied the quality of life of elderly patients with chronic nonspecific lung disease (CNSLD) in family practice. We also investigated the relationship between patients' somatic condition and their quality of life. Seventy patients, aged 40 years or older, with a diagnosis or symptoms of CNSLD completed the Sickness Impact Profile (SIP) and the list of daily activities (DAL). Pulmonary function (FEV1, IVC) and respiratory symptoms were assessed. The results indicated that patients were more impaired in their physical and psychosocial functioning than healthy control subjects. Most lung function parameters showed no correlation with the SIP scores. The respiratory symptoms of wheezing and dyspnea were related to patients' quality of life. Patients with chronic obstructive pulmonary disease (COPD) were more restricted in their daily functioning than patients with asthma. Since the relationship between patients' somatic condition and their quality of life is weak, we recommend comprehensive care that encompasses psychosocial as well as somatic interventions.

Categorization of natural stimuli by monkeys (Macaca mulatta): effects of stimulus set size and modification of exemplars.

The concept humans was studied in two experiments on rhesus monkeys, in each of which a two-choice simultaneous discrimination procedure was used. In Experiment 1, the choice was between scenes with humans and scenes without humans, with the slide set sizable enough that a large number of trials could be given without repeating any individual slide. Speed of categorization learning was faster and final level of performance was higher than in prior research in this laboratory involving a much smaller slide set. Experiment 2 was an attempt to obtain some information about the basis for the categorization by means of a series of probe trials. Probe trials involved slides of humans that were modified in one of several ways and slides in which monkeys or apes were present instead of humans. When paired with slides with humans, probe slides were seldom chosen, except when they showed a human rightside up in an upside down scene. In the latter case, choices were at the chance level. When paired with a slide with no humans in the scene, probe slides were usually chosen, except when they showed monkeys or apes or silhouettes of humans, in which case choices were again at the chance level. Possible reasons for the differences in results of category learning tests with pigeons and monkeys are discussed as are the implications of the probe tests for a concept interpretation of these results.

Biological and behavioural assessments of young rhesus monkeys after intrauterine exposure to high phenylalanine concentrations.

Nineteen pregnant Macaca mulatta were fed a special diet throughout the gestational period in an attempt to render them hyperphenylalaninaemic. Group C (control group) received a regular diet, group Lo was given a 'low' phenylalanine diet, group Me a 'median' phenylalanine diet, and group Hi a 'high' phenylalanine diet. Nearly all monkeys had an uncomplicated pregnancy and an uneventful delivery. Biological measurements were obtained shortly after the birth of the infants and behavioural assessments were done when the offspring were between 6 and 18 months of age. The results of the biological and behavioural evaluations revealed that there was no statistically significant difference among the respective study groups. We concluded that a combination of factors inherent in an imperfect animal model may account for the negative results of this study.

Eye movements of monkeys during discrimination learning: role of visual scanning.

Four experiments were conducted on stumptailed monkeys (Macaca arctoides) to determine whether the high levels of visual scanning (shifts in fixation from one discriminative stimulus to the other) seen during discrimination learning play a necessary role in this learning. In Experiments 1 and 2, the monkeys were given a series of two-choice, dot-pattern discrimination reversal problems. Normal visual scanning before a choice response was allowed during all but the reversal trials of half of the problems. On these latter trials, the discriminative stimuli were replaced by an uninformative stimulus after the animals made more than one visual fixation on each discriminative stimulus. Thus, on these trials, the animals were limited, in terms of the information received, to the empirically determined minimum number of scans necessary to maintain high levels of performance on such problems. In both experiments, which differed primarily in the number and type of uninformative stimuli used, the rate of reversal learning was markedly retarded by the experimental condition, with the effect persisting over a long series of problems. The magnitude of the effect was unrelated to the similarity of the uninformative stimulus to the discriminative stimuli. In Experiment 3, the monkeys were given a series of discrimination problems without reversals, during half of which the experimental condition was in effect. The results were similar to those of the first two experiments. Experiment 4 was similar to the preceding experiment except that, under the experimental condition, each trial began with the uninformative stimuli, which were replaced by the discriminative stimuli when visual scanning occurred. The uninformative stimuli had no clear-cut effect on discrimination learning in this experiment. These experiments indicate that the information provided by above-minimum levels of scanning is not necessary for discrimination learning per se, but it dose appear necessary for efficient discrimination learning.

Conditional discrimination learning: a critique and amplification.

Carter and Werner recently reviewed the literature on conditional discrimination learning by pigeons, which consists of studies of matching-to-sample and oddity-from-sample. They also discussed three models of such learning: the "multiple-rule" model (learning of stimulus-specific relations), the "configuration" model, and the "single-rule" model (concept learning). Although their treatment of the multiple-rule model, which seems most applicable to the pigeon data, is generally excellent, their discussion of the other two models is incomplete and sometimes inaccurate. Potential problems of terminology are discussed in the present paper, as are additional lines of research that deserve consideration by those interested in further work in this area. The issue of response versus stimulus selection (configuration versus compound-cue learning) is discussed in connection with the configuration model. Particular attention is given to Carter and Werner's criticism of the application, in studies with other species, of the learning set procedure in testing for single-rule learning. Some of the important related issues are: the bias for improvement on new problems in a series, the adequacy of a multiple-rule model to explain learning set formation, and evidence in favor of the single-rule model, at least in primates. Consideration of these additional contributions to the study of conditional discrimination learning emphasizes the usefulness of this task in the comparative study of cognitive processes.

Eye movements of monkeys during learning-set formation.

Eye movements of stump-tailed monkeys were measured during learning of a long series of two-choice pattern discrimination problems. The amount of scanning per trial (shifts in visual fixation from one pattern to the other) and the duration of individual fixations on the patterns increased during the course of learning-set formation and (except for the amount of scanning by some animals) remained high during the prolonged training following learning-set formation. Some of the changes in eye movements were different from those seen during the learning of single discrimination problems, a difference that possibly reflects cognitive processes specific to the learning-set task.