Subclinical Features Research Articles

Association of subclinical psychosis with suicidal ideation: A twin study

Subclinical psychosis, including schizotypal indicators and psychotic experiences, predicts future suicidal ideation. This relationship may reflect unmeasured confounding from environmental factors, genetic factors, or both. We used a genetically-informative twin design to understand if the association between subclinical psychosis and suicidal ideation is independent of shared genetic and environmental factors. We analysed cross-sectional associations of age-22 self-reported subclinical psychosis (positive, negative, and disorganised features) with suicidal ideation in twins participating in the FinnTwin12 study (maximum n = 1213). Then, we analysed the reverse association of age-14 suicidal ideation with age-22 subclinical psychosis. Associations were studied first among individuals and then within monozygotic (MZ) and dizygotic (DZ) pairs. Individual-level analyses showed that all subclinical psychosis factors were associated with suicidal ideation. In within-pair analyses, estimates of associations were lower for MZ pairs than DZ pairs, except for the negative schizotypy–suicidal ideation association where estimates were consistent across individual-level and within-pair analyses. Findings provide evidence that the association between negative features and suicide ideation is not explained by familial factors and may be causal, though the possibility of confounding by individual-specific environmental factors and reverse causation cannot be ruled out. The relationships of positive and disorganised subclinical psychosis features with suicidal ideation cannot be explained by confounding due to environmental factors shared between siblings, but their associations may be due to shared genetic factors.

Abstract A68: Optical coherence tomography improves subclinical retinoblastoma management

Abstract Purpose: Optical coherence tomography (OCT) improved retinal assessment that is comparable to histopathologic sections. In retinoblastoma, OCT was reported to detect fovea-tumor relation, diagnose subclinical (new, residual and recurrent tumors), and suspect tumor spread into the optic nerve. We hypothesized that strategic incorporation of OCT into retinoblastoma management will improve outcomes and managing retinoblastoma at the subclinical level (clinically undetectable) provides means for less treatment burden. Methods: A single-center, noncomparative retrospective review of all eyes with subclinical retinoblastoma was conducted. Any eye that had an OCT-guided procedure, whether diagnostic or therapeutic, utilizing OCT software was included. OCT-guided management included projecting embedded OCT software tools (scan cube size and direction, multiple scan frames, localizing and measuring vertical and horizontal calipers, enhanced depth imaging frames, and/or red free fundus photograph) on a separate colored fundus image to guide management to improve visual, life, and eye salvage outcomes. Results: We used OCT-guided strategies in 83 children (114 eyes). Diagnostic strategies included posterior pole screening for invisible retinoblastoma (37 eyes), topographic localization of invisible tumors (15 eyes) or subclinical recurrence (29 tumors), topographic localization of fovea-tumor relation (31 eyes), and mapping of potential choroidal or optic nerve invasion to determine subsequent management (2 eyes each). Therapeutic strategies included laser photocoagulation for perifoveal residual (26) and invisible (11) tumors and verification of photocoagulation adequacy for invisible (11) new and recurrent (11) tumors. These procedures were scored for their influence to changed therapy. Conclusion: Detailed OCT assessment improves retinoblastoma management and facilitates precision therapy to preserve vital visual structures (e.g., the center of vision), detect subtle subclinical tumors (new or recurrent), allow administration and adequacy of laser treatment, and map subclinical high-risk features. Developing OCT-guided strategies with full technical description facilitates reproducibility and allows precision therapy to be a reality. Citation Format: Sameh E. Soliman, Cynthia VandenHooven, Leslie MacKeen, Brenda Gallie. Optical coherence tomography improves subclinical retinoblastoma management [abstract]. In: Proceedings of the AACR Special Conference on the Advances in Pediatric Cancer Research; 2019 Sep 17-20; Montreal, QC, Canada. Philadelphia (PA): AACR; Cancer Res 2020;80(14 Suppl):Abstract nr A68.

The Clinical and Subclinical Features of Patients with Airway Foreign Body at the Endoscopy Department, National Otorhinolaryngology Hospital of Vietnam from 08/2018 to 02/2020

This study describes clinical and subclinical features of 30 patients with airway foreign body at the Endoscopy Department, National Otorhinolaryngology Hospital of Vietnam from August 2018 to February 2020. The study results show that airway foreign body was commonly found in patients aged over 18 (43.33%); male-female ratio was 1.7:1; cough and shortness of breath were two common symptoms with 96.67% and 73.33%, respectively; penetration syndrome was the common clinical symptom with 93.33%; 20% of the airway foreign body cases were detected by X-ray; 100% of the airway foreign body cases were diagnosed by endoscopy; 53.33% of the cases were cured in one day; and 93.33% of the cases showed good treatment results. The study concludes that airway foreign bodies can be detected in all ages with more men than women; penetration syndrome with cough and shortness of breath suggests symptoms of airway foreign bodies; and endoscopy of bronchial airways is the leading method to diagnose and remove airway foreign bodies.
 Keywords
 Airway foreign body, clinical, subclinical.
 References
 [1] V.T. Quang, Otorhinorarynology Textbook, Vietnam National University Press, Hanoi, 2017 (in Vietnamese).[2] A.M. Salih, M. Alfaki and D.M. Alam-Elhuda, Airway foreign bodies: A critical review for a common pediatric emergency, National Central for Biotechnology Information, 2016, 7: 5-12. http://doi.org/10.5847/wjem.j.1920 8642.2016.01.001 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4786499/[3] D.D. Tuoc, Forgotten airway foreign body, The Second Degree Specialist Graduation Thesis, Hanoi Medical University, 1978 (in Vietnamese).[4] N.D. Khang, N.N. Lien, Airway foreign body cases in National Otorhinolarygology Hospital of Vietnam from 1998 to 2001, The Second Degree Specialist Graduation Thesis, Hanoi Medical University, 2001 (in Vietnamese).[5] V.L. Phuoc, Airway foreign bodies in Otorhinorarygology Department at Hue Central Hospital, The Second Degree Specialist Graduation Thesis, Hue University of Medicine and Pharmacy, 2003 (in Vietnamese). [6] L.S. Can, P.K. Hoa, Airway foreign body, in: L.S. Can, Otorhinorarynology Emergency, Medical Publishing House, Hanoi, 1991, pp 32-38 (in Vietnamese).[7] C.Y. Chiu, K.S. Wong, S.H. Lai, S.H. Hsia, C.T.Wu. Factors predicting early diagnosis of foreign body aspiration in children. Polish Journal of Otolaryngology 21 (2005) 161–164. https://doi.org/10.5604/00306657.1184544
 
 

M141. INDIVIDUALS WITH SCHIZOTYPAL TRAITS SHOW A UNIQUE PATTERN OF CAUDATE ACTIVATION IN PROSPECTION OF POSITIVE EMOTION COMPARED TO HEALTHY CONTROLS

BackgroundProspection, the ability to simulate future scenarios and pre-experience future feelings, plays a fundamental role in anhedonia and motivation. Empirical findings have suggested that a wide range of patients who experience anhedonia, with schizophrenia, autism and major depression, exhibit prospection impairment. Altered brain responses while envisioning future events have also been observed in these clinical samples. However, it remains unclear whether similar abnormalities are exhibited by individuals with schizotypal traits (ST), autistic traits (AT) and subsyndromal depressive symptoms (SD).MethodsThe Schizotypal Personality Questionnaire, Autism-Spectrum Quotient, and Patient Health Questionnaire-9 were administered to a group of 2904 college students. Based on the cut-off points of each scale, a final sample of 27 individuals with ST, 34 with AT, 31 with SD, and 35 with low levels of all subclinical features (controls) were recruited. Participants performed a Prospection Task in a 3T MRI scanner and completed the Temporal Experience of Pleasure Scale (TEPS) after the brain scan. The Prospection task included three conditions: positive prospection, neutral prospection, and control imagination. Contrasts examining general prospection [positive prospection + neutral prospection – control imagination], positive prospection [positive prospection- control imagination], neutral prospection [neutral prospection-control imagination], and positive emotion [positive prospection – neutral prospection] were defined. Group comparisons were conducted to measure brain activation in all contrasts using a threshold of p<0.001, Familywise error corrected.ResultsIncreased activation of the task-positive network, including regions of the bilateral inferior parietal gyrus, the middle frontal gyrus, and the inferior frontal gyrus, was observed in individuals with ST, AT and SD, for the general prospection contrast, compared to controls. Both individuals with ST and AT exhibited reduced activation of the medial frontal gyrus, the posterior cingulate cortex, the precuneus, and the hippocampus (the “core network”/default mode network) for the general prospection contrast, compared to controls. However, only individuals with ST exhibited increased activation of the bilateral caudate for the positive emotion contrast. Moreover, activation of the bilateral caudate in ST individuals was negatively correlated with the contextual anticipatory pleasure subscale of the TEPS (r=-0.215, p=0.019).DiscussionOur findings showed that individuals with ST, AT and SD exhibited increased activation of the task-positive network, suggesting that these individuals might mobilize more cognitive effort to envision future events compared with controls. Moreover, the findings of decreased activation in the “core network” observed in individuals with ST and AT further suggests that only these individuals, but not those with SD, have prospection impairment. On the other hand, only individuals with ST exhibited hyper-activation of the caudate, thalamus, and claustrum for the positive emotion contrast. These findings suggest that individuals with ST demonstrate a distinct pattern of brain activation while prospecting future events.

Nghiên cứu đặc điểm lâm sàng và cận lâm sàng bệnh schonlein-henoch ở trẻ em

Study clinical and subclinical features of Henoch-Schönlein purpura in children Objective: Describe clinical and subclinical characteristics of Henoch-Schönlein purpura in children. Find the relationship between kidney lesion and clinical and subclinical manifestations. Methods: Cross-sectional descriptive study, including 51 children &lt;15 years of age diagnosed with Schonlein-Henoch purpura being treated at Hue Central Hospital and Hue University Hospital from April 2016 - May 2018. Results: 51 children entered the study: Male:Female =1.3:1; mean age 7.5  3.4 years. At onset, purpura was present in all cases, gastrointestinal manifestations in 66.7%, arthritis/arthralgias in 54.9%, , renal lesion in 19.6%. The most frequent laboratory abnormalities were Leukocytosis (WBC &gt;10 x 109/L) in 60,8%, high-erythrocyte sedimentation rate (ESR) in 80.4%, microscopic hematuria in 15.7%, proteinuria in 13.7%. Renal lesion were correlated with age of onset. The age group&gt; 10 years old has 6.1 times more kidney lesion than the group ≤ 10 years (OR: 6.1; 95% CI (1.5-26). Conclusion: Clinical and subclinical findings of Schonlein-Henoch purpura in our study are similar to those in the literature. There is an relationship between the age of onset with kidney lesion. Key words: Henoch-Schönlein purpura, kidney lesion

Metaphyseal Chondrodysplasia Schmid type - widening the phenotype: Significant variable expression in two familial cases with heterozygous COL10A1 variants

Metaphyseal Chondrodysplasia Schmid Type (SMCD) is a rare dominant form of skeletal dysplasia, caused by heterozygous mutations in the COL10A1 (Collagen Type X alpha 1) gene which codes for α1 chains in type X collagen, and typically results in disproportionate short stature. We report two families with the clinical and radiological diagnosis of SMCD seen in our unit over 4 years. In the first family (A), the proband had a possible pathogenic COL10A1 variant (c.133C&gt;T, p.Pro45Ser). However, his father had the same variant without any obvious signs of SMCD, causing uncertainty whether this mutation was pathogenic. In the second family (B), the proband and her affected father had the same variant. Almost at the same time, a large consanguineous family was reported to have segregation of the variant with SMCD phenotypes in that the homozygosity was related to severer phenotypes and the heterozygosity to milder phenotypes. Hence, we were convinced that the variant was pathogenic. The pathogenic variant (p.Pro45Ser) causes a wide phenotypic spectrum of SMCD and even subclinical features. In this report, we highlight attenuated phenotypes of SMCD, and also discuss the latest therapeutic advances in SMCD and its mechanism of action.

CLINICAL, SUBCLINICAL FEATURES AND THE RISK FACTORS OF GESTATIONAL TROPHOBLASTIC NEOPLASIA AT HUE CENTRAL HOSPITAL

Aim: To determine clinical and subclinical features and the risk factors of gestational trophoblastic neoplasia at Hue Central Hospital. Medthods: A cross-sectional study was conducted from 01/2018 -12/2019 in the Obstetrics and Gynecology Deparment of Hue Central Hospital. This study included 54 women who were diagnosed gestational trophoblastic neoplasia (FIGO 2002) and 54 molar pregnancy women monitored and treated in a stable condition. Results: In gestational trophoblastic neoplasia (GTN) group, age group with women who were ≥ 40 was 4.5 times higher at risk factors of GTN (p &lt; 0.05), the history of stillbirth had 5.2 times higher at risk (p &lt; 0.05). History of molar pregnancy accounted for 20.4% with OR = 4.3 (95% CI = 1.2 - 16.3). The risk in the number of births ≥ 3 was 5.1 times higher (p &lt; 0.05). The rate of toxemia in GTN group was 66.7% with OR = 8.6; 95%CI =3.3-21.4 (p &lt; 0.05). The women with hyperthyroidism were 3.1 times higher at risk of GTN. The risk of bilateral theca-lutein cyst in GTN group was 12.6 times more than that of control group. The percentage of beta hCG level &gt; 100.000 mUI/ml before treatment in GTN group was 75.9% with 6.8 times higher at risk of GTN (p &lt; 0.05). Conclusion: A history of molar pregnancy, birth multiple times,a history of stillbirth, presence of hyperthyroidism, the bilateral theca-lutein cyst &gt; 4 weeks, the percentage of beta hCG level &gt; 100.000 mUI/ml before treatment, are risk factors found to be associated with the gestational trophoblastic neoplasia. Key words: Molar pregnancy, gestational trophoblastic neoplasia, risk factors

Exploring the effect of hypertension on retinal microvasculature using deep learning on East Asian population.

Hypertension is the leading risk factor of cardiovascular disease and has profound effects on both the structure and function of the microvasculature. Abnormalities of the retinal vasculature may reflect the degree of microvascular damage due to hypertension, and these changes can be detected with fundus photographs. This study aimed to use deep learning technique that can detect subclinical features appearing below the threshold of a human observer to explore the effect of hypertension on morphological features of retinal microvasculature. We collected 2012 retinal photographs which included 1007 from patients with a diagnosis of hypertension and 1005 from normotensive control. By method of vessel segmentation, we removed interference information other than retinal vasculature and contained only morphological information about blood vessels. Using these segmented images, we trained a small convolutional neural networks (CNN) classification model and used a deep learning technique called Gradient-weighted Class Activation Mapping (Grad-CAM) to generate heat maps for the class "hypertension". Our model achieved an accuracy of 60.94%, a specificity of 51.54%, a precision of 59.27%, and a recall of 70.48%. The AUC was 0.6506. In the heat maps for the class "hypertension", red patchy areas were mainly distributed on or around arterial/venous bifurcations. This indicated that the model has identified these regions as being the most important for predicting hypertension. Our study suggested that the effect of hypertension on retinal microvascular morphology mainly occurred at branching of vessels. The change of the branching pattern of retinal vessels was probably the most significant in response to elevated blood pressure.

Pregnancy outcomes in women with idiopathic inflammatory myopathy, before and after diagnosis-a population-based study.

ObjectivesTo examine pregnancy outcomes among births to women with idiopathic inflammatory myopathy (IIM) in relation to time of IIM diagnosis using population-based data.MethodsThis study used Swedish nationwide registers to identify all singleton births that occurred between 1973 and 2016 among women diagnosed with IIM between 1998 and 2016 and among women unexposed to IIM. We classified births according to the IIM status of the mother at time of delivery: post-IIM (n = 68), 1–3 years pre-IIM (n = 23), >3 years pre-IIM (n = 710) and unexposed to IIM (n = 4101). Multivariate regression models were used to estimate relative risks of adverse pregnancy outcomes in post-IIM births and pre-IIM births separately, in comparison with their non-IIM comparators.ResultsWe found that post-IIM births had increased risks of caesarean section [adjusted relative risk (aRR) = 1.98; 95% CI: 1.08, 3.64], preterm birth (aRR = 3.35; 95% CI: 1.28, 8.73) and low birth weight (aRR = 5.69; 95% CI: 1.84, 17.55) compared with non-IIM comparators. We also noticed higher frequencies of caesarean section and instrumental delivery in 1–3 years pre-IIM births than in the non-IIM comparators.ConclusionWomen who gave birth after IIM diagnosis had higher risks of caesarean section, preterm birth and low birth weight. These results further underline the importance of special care and close monitoring of women with IIM. Higher frequencies of caesarean section and instrumental delivery in pre-IIM births highlight the need for future research on the influence of subclinical features of IIM on pregnancy outcomes.

Subclinical features of atherosclerotic remodeling of arteries in patients with rheumatoid arthritis

The aim of the research – to study the structural-functional state of artery walls in patients with rheumatoid arthritis depending of disease duration, seropositivity for rheumatoid factor/ cyclic citrullinated peptide antibodies, disease activity. Materials and methods. 82 patients with rheumatoid arthritis were investigated: 19 men (23.1 %) and 63 women (76.9 %), the average age of whom was (37.6 ± 5.1) years old. The control group consisted of 30 apparently healthy persons. In all the patients measurements of diameter and thickness of intima-media complex of common carotid arteries were carried out, the stiffness index was calculated. Results. 47.5 % (n = 39) of patients had rheumatoid arthritis with the present illness duration less than 3 years, in 47.5 % of patients (n = 39) the duration of rheumatoid arthritis was more than 3 years. In 48 (58.5 %) of patients rheumatoid factor/cyclic citrullinated peptide antibodies were present – seropositive variant of rheumatoid arthritis, in 34 (41.5 %) patients – rheumatoid factor/cyclic citrullinated peptide antibodies seronegative variant of the disease. Within all investigated patients with rheumatoid arthritis the highest rates of intima-media thickness complex of common carotid arteries were detected in patients with longer-term (more than 3 years) present illness rheumatoid factor/cyclic citrullinated peptide antibodies of seropositive rheumatoid arthritis; in patients of this group higher stiffness index of common carotid arteries was also detected that characterizes the local (carotid) rigidity of artery wall. Correlation analysis showed the existence of direct relationship between DAS28 and intima-media complex of common carotid arteries, the duration of rheumatoid arthritis and stiffness index of intima-media complex of common carotid arteries, and also between their size and the level of rheumatoid factor, cyclic citrullinated peptide antibodies, which shows the substantial contribution of activity and duration of autoimmune inflammation course in rheumatoid arthritis to changes of common carotid arteries architectonics. Conclusions. The data obtained demonstrate the existence of subclinical lesion of common carotid arteries in patients with rheumatoid arthritis and absence of cardiovascular diseases, more significant in long-term course (more than 3 years) of seropositive for rheumatoid factor/ cyclic citrullinated peptide antibodies disease variant.

Intra articular methylprednisolone acetate injection efficacy in the treatment of primary knee osteoarthritis at Hue Central Hospital and Hospital of Hue University of Medicine and Pharmacy

Introduction/Background: Osteoarthritis is still an incurable disease, the current treatment is to reduce clinical symptoms. The intra articular glucocorticoid injection in knee osteoarthritis makes the inflammatory process self-limiting and improves pain symptom. Objectives: To evaluate the efficacy and safety of intra articular methylprednisolone acetate injection in treatment of primary knee osteoarthritis. Materials and Methods: Prospective descriptive study of 88 knee joints (34 joints in study group, 54 joints in control group) was diagnosed with primary osteoarthritis according to the American College of Rheumatology (ACR) classification criteria and in Kellgen &amp; Lawrence grade II, III. The patient was assessed about clinical features, subclinical features and the VAS score, Lequesne index at the initial of the study and 7 days later. Results: The analgesic effect was higher in the group of intra articular methylprednisolon injection with statistically significant difference (∆VAS of the study group and the control group were 38.65 ± 9.25; 25.11 ± 9.26, respectively, with p &lt; 0.05). The improving of knee function was higher in the group of intra articular methylprednisolon injection with statistically significant difference (∆Lequesne of the study group and the control group were 7.00 (5.00 – 8.00); 4.00 (3.00 – 5.00), respectively, with p &lt; 0.05). The incidence of complications in the study group was 1/34 (2.94%) with post – injection pain. The improvement of VAS is better in patient with severe pain than those with moderate pain (p &lt; 0.05) and correlated to the initial value of Lequesne (r2 = 0,162, respectively, with p &lt; 0.05). The improvement of Lequesne correlated to the joint fluid thickness in ultrasound (r2 = 0.102, p &lt; 0.05). There is no relation between efficacy of treatment and site of knee joint, radiology stage and synovial membrane thickness (p &gt; 0.05). Conclusions: The intra articular methylprednisolone acetate injection in treatment of primary knee osteoarthritis is a safe treatment and has significant, clearly effect in pain relief and physical function improving after 7 days. The improvement of VAS is better in the patient with higher initial value of VAS, Lequesne and the improvement of Lequesne is better in the patients with more synovial thickness in ultrasound. Key words: Knee osteoarthritis, intraarticular injection, methylprednisolon acetate

Familiality of behavioral flexibility and response inhibition deficits in autism spectrum disorder (ASD)

BackgroundDiminished cognitive control, including reduced behavioral flexibility and behavioral response inhibition, has been repeatedly documented in autism spectrum disorder (ASD). We evaluated behavioral flexibility and response inhibition in probands and their parents using a family trio design to determine the extent to which these cognitive control impairments represent familial traits associated with ASD.MethodsWe examined 66 individuals with ASD (probands), 135 unaffected biological parents, and 76 typically developing controls. Participants completed a probabilistic reversal learning task (PRL) and a stop-signal task (SST) to assess behavioral flexibility and response inhibition respectively. Rates of PRL and SST errors were examined across groups, within families, and in relation to clinical and subclinical traits of ASD. Based on prior findings that subclinical broader autism phenotypic (BAP) traits may co-segregate within families and reflect heritable risk factors, we also examined whether cognitive control deficits were more prominent in families in which parents showed BAP features (BAP+).ResultsProbands and parents each showed increased rates of PRL and SST errors relative to controls. Error rates across tasks were not related. SST error rates inter-correlated among probands and their parents. PRL errors were more severe in BAP+ parents and their children relative to BAP− parents and their children. For probands of BAP+ parents, PRL and SST error rates were associated with more severe social-communication abnormalities and repetitive behaviors, respectively.ConclusionReduced behavioral flexibility and response inhibition are present among probands and their unaffected parents, but represent unique familial deficits associated with ASD that track with separate clinical issues. Specifically, behavioral response inhibition impairments are familial in ASD and manifest independently from parental subclinical features. In contrast, behavioral flexibility deficits are selectively present in families with BAP characteristics, suggesting they co-segregate in families with parental subclinical social, communication, and rigid personality traits. Together, these findings provide evidence that behavioral flexibility and response inhibition impairments track differentially with ASD risk mechanisms and related behavioral traits.

Dermatoscopy in life-threatening and severe acute rashes

A prompt recognition of life-threatening and severe acute rashes is of utmost importance to start an appropriate therapy as soon as possible. Consequently, clinicians often must rely only on clinical data to make a diagnosis because some diagnostic procedures may take a relatively long time to be performed (eg, histologic examination, microbiologic tests). In this scenario, dermatoscopy may be useful as an auxiliary tool to support the diagnosis by highlighting subclinical features. We have provided an up-to-date overview on the use of dermatoscopic assessment in life-threatening and severe acute dermatoses, including erythroderma (due to psoriasis, eczema, pityriasis rubra pilaris, mycosis fungoides, and drugs), pustular eruptions (pustular psoriasis and acute generalized exanthematous pustulosis), bullous eruptions (staphylococcal scalded skin syndrome, toxic epidermal necrolysis, and pemphigus vulgaris), hemorrhagic eruptions (necrotizing vasculitis and calciphylaxis), and erythematous eruptions (erythema multiforme major, Sweet syndrome, and DRESS syndrome).

Network analysis of schizotypal personality traits and their association with other subclinical psychiatric features.

Schizotypal personality (SP) traits have been found to be correlated with autistic traits, obsessive-compulsive traits, depressive symptoms and anxiety symptoms. However, the overall pattern of the relationship remains unclear. The purpose of this study was to investigate the network structure between SP traits and other subclinical features (symptoms or traits) and test the replicability of these relationships. A total of 2204 college students completed measurements for SP traits, autistic traits, obsessive-compulsive traits, depressive symptoms and anxiety symptoms, and a validated subsample of 814 completed the same questionnaires again three months later. Using network analysis, we constructed the network structure of subclinical features and then tested its replicability. We found that interpersonal features were the bridge node connecting SP traits and autistic traits (social skill: r = 0.50; attention switching: r = 0.14; communication: r = 0.12), while cognitive-perceptual (obsessing: r = 0.05; neutralizing: r = 0.06) and disorganization (obsessing: r = 0.11) features were the SP traits associated with obsessive-compulsive traits. In addition to interpersonal features (r = 0.10), disorganization (r = 0.12) and cognitive-perceptual (r = 0.05) features were also the overlap between depressive symptoms and SP traits. Anxiety symptoms only connected with interpersonal (r = 0.05) but not cognitive-perceptual features of SP traits. The network showed high predictability (43%) and interpersonal features of SP traits had the highest expected influence (1.67) among all nodes, which may be a potential target for intervention. High similarities were found on network structure (r = 0.86) and expected influence (r = 0.96), and no significant difference on global connectivity was found between these two networks (difference value = 0.45, p = 0.135), suggesting the replicability of the network structure.

Effects of bariatric surgery on telomere length and T-cell aging

BackgroundObesity adversely affects health and is associated with subclinical systemic inflammation and features of accelerated aging, including the T-cell immune system. The presence of metabolic syndrome (MetS) may accelerate, while bariatric surgery might reverse these phenomena. To examine the effects of MetS and bariatric surgery on T-cell aging, we measured relative telomere length (RTL) and T-cell differentiation status in obese patients before and after bariatric surgery.MethodsWHO II/III classified obese patients scheduled for bariatric surgery were included: 41 without MetS and 67 with MetS. RTL and T-cell differentiation status were measured in circulating CD4+ and CD8+ T cells via flow cytometry. T-cell characteristics were compared between patients with and without MetS prior to and at 3, 6, and 12 months after surgery considering effects of age, cytomegalovirus-serostatus, and weight loss.ResultsThymic output, represented by numbers of CD31-expressing naive T cells, showed an age-related decline in patients with MetS. MetS significantly enhanced CD8+ T-cell differentiation. Patients with MetS had significant lower CD4+ RTL than patients without MetS. Within the first 6 months after bariatric surgery, RTL increased in CD4+ T cells after which it decreased at month 12. A decline in both thymic output and more differentiated T cells was seen following bariatric surgery, more pronounced in the MetS group and showing an association with percentage of body weight loss.ConclusionsIn obese patients, MetS results in attrition of RTL and accelerated T-cell differentiation. Bariatric surgery temporarily reverses these effects. These data suggest that MetS is a risk factor for accelerated aging of T cells and that MetS should be a more prominent factor in the decision making for eligibility for bariatric surgery.

When Trust Does Not Come Easily: Negative Emotional Information Unduly Influences Trustworthiness Appraisals for Individuals With Borderline Personality Features.

Individuals with borderline personality disorder and subclinical borderline features perceive others as untrustworthy (e.g., Fertuck, Grinband, & Stanley, 2013). Trust difficulties may be influenced by emotional state and are formally articulated in the diagnostic criteria for the disorder as temporary state-dependent paranoia. The current study examines the influence of emotional information on trustworthiness appraisals. Seventy-seven community adults, ranging in age from 18 to 70 (M = 31.53, SD = 14.01), with three or more borderline personality disorder symptoms (n = 30) or two or fewer symptoms (n = 47), completed an affective priming paradigm. They were exposed to negative, neutral, or positive information before rating the trustworthiness of unfamiliar faces. Individuals with borderline pathology made more untrusting appraisals regardless of prime, and they were more greatly influenced by negative primes relative to the control group. Findings suggest that biased trustworthiness appraisal is a replicable and consistent finding for individuals with borderline pathology, and that emotional context, even if unrelated to the appraisal at hand, has undue influence.

Cardiac Manifestations in Systemic Lupus Erythematosus: Clinical Correlates of Subclinical Echocardiographic Features.

Objectives This study aims to correlate subclinical echocardiographic features with the clinical, laboratory, and therapeutic profiles of the patients to characterize risks for systemic lupus erythematosus (SLE) cardiac diseases. Methods The study included 59 SLE patients. Demographic data, disease characteristics, and current therapies were recorded, and the anthropometric measurements and routine laboratory tests were performed. The disease activity by the SLE Disease Activity Index-2K (SLEDAI2K) and the presence of metabolic syndrome (MetS) were assessed. Two-dimensional echocardiography was performed. Results The mean age of the patients was 31.3 ± 10.5 years, and the disease duration was 5.18 ± 4.1 years. 86.4% of the patients were females. Cardiac presentations by echocardiography were mainly mitral regurgitation (33.9%), tricuspid regurgitation (32.2%), mitral thickening (18.6%), aortic thickening (13.6%), pericardial effusion (13.6%), and pulmonary hypertension (8.5%) in order of frequency. The frequency of different echocardiographic findings with respect to other clinical phenotypes showed peaks with renal disease, MetS, and leukopenia. Components of MetS (triglycerides, high systolic blood pressure) and avascular necrosis were significant predictors for pericardial diseases (OR=1.011 CI 95% 1-1.022, p=0.046, OR=1.157 CI 95% 1.025-1.307, p=0.018, and OR=74.78 CI 95% 2.52-2215.76, p=0.013, respectively), and it is likely that hydroxychloroquine was protective against them. Age of the patients was a significant predictor for tricuspid regurgitation (OR=1.063 CI 95% 1.004-1.126, p=0.036). Mucosal ulcers were negative predictors for mitral thickening and regurgitation (OR=0.2 CI 95% 0.059-0.673, p=0.009). The use of corticosteroids appeared to protect against a number of valve lesions especially tricuspid regurgitation (OR=0.299 CI 95% 0.088-1.019, p=0.054). Conclusion This study highlighted different echocardiographic features and identified clinical predictors of different cardiac pathologies aiming to determine patients at risk and improve the prognosis of SLE cardiac diseases.

Dyadic interactions in children exhibiting the broader autism phenotype: Is the broader autism phenotype distinguishable from typical development?

In families raising a child with an autism spectrum disorder (ASD), infant siblings are at elevated risk for ASD and other developmental concerns, including elements of the broader autism phenotype (BAP). Typically, the BAP is indexed using standardized developmental assessments; however, these measures do not capture a number of social difficulties commonly associated with the BAP. The present study aims to expand our developmental understanding of the BAP by comparing children exhibiting the BAP to their typically developing peers on, (a) standardized measures of development, and (b) social behaviors exhibited during dyadic play interactions. As part of a prospective study, dyads were recruited from families with at least one older child with ASD (high-risk, n = 36), and families with no history of ASD (low-risk, n = 38). During laboratory visits at 12, 15, 18, and 24 months of age, infants completed a series of standardized assessments and a mother-child play interaction. Dyadic play interactions were micro-analytically coded for gaze, positive affect, and vocalizations to create theory-driven composites to index dyadic synchrony and responsiveness. Videos were also coded with an existing rating scheme for joint engagement and child responsiveness. Multilevel models revealed significant group differences on select constructs within the first 2 years. Language and cognitive differences emerged by 24 months of age, whereas dyadic differences were evident as early as 15 months. Recognizing the increasing demand for elevated-risk interventions, these findings highlight several social constructs through which interventions may identify risk and promote optimal development. Autism Res 2019, 12: 469-481 © 2019 International Society for Autism Research, Wiley Periodicals, Inc. LAY SUMMARY: In families raising children with an autism spectrum disorder (ASD), younger siblings are at an increased risk for social and developmental difficulties that characterize a "broader autism phenotype." The present study explored the emergence of social, language, and cognitive differences in the first 2 years of life. Social differences were evident as early as 15 months of age for several play-based measures, and language and cognitive differences emerged by 24 months of age. For infant siblings of children with ASD, some of the earliest behavioral marks for subclinical features of ASD are evident within the first 2 years of life.

Endothelial dysfunction and subclinical atheromatosis in gout: A Spanish multicenter cross-sectional study

Objectives: To assess subclinical vascular features in gout patients using carotid ultrasound and flow mediated vasodilation as measures of cardiovascular risk. Methods: Cross-sectional study over a cohort of 150 patients diagnosed with gout, on whom a vascular study was performed to assess angiodynamic parameters measured by flow mediated vasodilation in brachial artery and pathological findings in carotid ultrasound: carotid intima-media thickness and atherosclerotic plaques. Classical cardiovascular risk factors were also assessed, as well as main features of gout in terms of joint involvement and inflammation parameters. Results: 150 patients with gout were recruited. 81% of patients had endothelial dysfunction, being severe in 51%. Carotid intima-media thickness was pathological in 66% and atherosclerotic plaques were present in 38%. 73% of patients had low vitamin D levels and elevation of homocysteine was present in 38% of the sample. A negative correlation between vitamin D levels and endothelial dysfunction was obtained (OR= 0.27; CI 95% 0.09-0.83). No other features related to gout (serum uric acid levels, joint involvement, inflammatory parameters or treatments) were associated to vascular damage in this cohort. Conclusions: Patients with gout have a great prevalence of subclinical vascular involvement, mainly endothelial dysfunction. So a correct characterization of vascular damage is important in these patients to better assessment and management of cardiovascular risk.

Beyond the tip of the iceberg: Adolescent weight development of women and men with features of binge eating disorder

ObjectiveBinge eating disorder (BED) is a clinical eating disorder that is strongly and bidirectionally related to overweight and obesity. Little is known about how subclinical features of BED relate to weight development in adolescence and young adulthood. MethodWomen (n = 2825) and men (n = 2423) from the community-based longitudinal FinnTwin16 cohort participated. Seven eating-related cognitions and behaviors similar to the defining features of BED were extracted from the Eating Disorder Inventory-2 and were assessed at a mean age of 24. We used linear mixed models to assess the association of features of BED with BMI trajectories across four waves of data collection (mean ages 16, 17, 18, and 24). ResultsThe number of features of BED at wave 4 (age 24) was significantly associated with BMI from age 16 years onwards. Those reporting more features of BED had gained more weight throughout adolescence and into their twenties. ConclusionsFeatures of BED in young adulthood were preceded by steeper BMI trajectories in adolescence. A higher number of features were consistently associated with higher BMI and more weight gain.