Symptoms Of Different Severity Research Articles

Genetic and acquired sucrase-isomaltase deficiency: A clinical review.

Genetic sucrase-isomaltase deficiency (GSID) is an inherited deficiency in the ability to digest sucrose and potentially starch due to mutations in the sucrase-isomaltase (SI) gene. Congenital sucrase-isomaltase deficiency is historically considered to be a rare condition affecting infants with chronic diarrhea as exposure to dietary sucrose begins. Growing evidence suggests that individuals with SI variants may present later in life, with symptoms overlapping with those of irritable bowel syndrome. The presence of SI genetic variants may, either alone or in combination, affect enzyme activity and lead to symptoms of different severity. As such, a more appropriate term for this inherited condition is GSID, with a recognition of a spectrum of severity and onset of presentation. Currently, disaccharidase assay on duodenal mucosal tissue homogenates is the gold standard in diagnosing SI deficiency. A deficiency in the SI enzyme can be present at birth (genetic) or acquired later, often in association with damage to the enteric brush-border membrane. Other noninvasive diagnostic alternatives such as sucrose breath tests may be useful but require further validation. Management of GSID is based on sucrose and potentially starch restriction tailored to the individual patients' tolerance and symptoms. As this approach may be challenging, additional treatment with commercially available sacrosidase is available. However, some patients may require continued starch restriction. Further research is needed to clarify the true prevalence of SI deficiency, the pathobiology of single SI heterozygous mutations, and to define optimal diagnostic and treatment algorithms in the pediatric population.

The patient journey in Chronic Obstructive Pulmonary Disease (COPD): a human factors qualitative international study to understand the needs of people living with COPD

BackgroundChronic obstructive pulmonary disease (COPD) is a common condition that causes irreversible airway obstruction. Fatigue and exertional dyspnoea, for example, have a detrimental impact on the patient’s daily life. Current research has revealed the need to empower the patient, which can result in not only educated and effective decision-making, but also a considerable improvement in patient satisfaction and treatment compliance.The current study aimed to investigate the perspectives and requirements of people living with COPD to possibly explore new ways to manage their disease.MethodsAdults with COPD from 8 European countries were interviewed by human factor experts to evaluate their disease journey through the gathering of information on the age, performance, length, and impact of diagnosis, symptoms progression, and family and friends' reactions. The assessment of present symptoms, services, and challenges was performed through a 90-min semi-structured interview. To identify possible unmet needs of participants, a generic thematic method was used to explore patterns, themes, linkages, and sequences within the data collected. Flow charts and diagrams were created to communicate the primary findings. Following analysis, the data was consolidated into cohesive insights and conversation themes relevant to determining the patient's unmet needs.ResultsThe 62, who voluntarily accepted to be interviewed, were patients (61% females, aged 32–70 years) with a COPD diagnosis for at least 6 months with stable symptoms of different severity. The main challenges expressed by the patients were the impact on their lifestyle, reduced physical activity, and issues with their mobility. About one-fourth had challenges with their symptoms or medication including difficulty in breathing. Beyond finding a cure for COPD was the primary goal for patients, their main needs were to receive adequate information on the disease and treatments, and to have adequate support to improve physical activity and mobility, helpful both for patients and their families.ConclusionsThese results could aid in the creation of new ideas and concepts to improve our patient’s quality of life, encouraging a holistic approach to people living with COPD and reinforcing the commitment to understanding their needs.

Prevalence of Depressive Symptoms in the Whole Spectrum of Cognitive Aging: Findings from the HELIAD Community Study

AbstractBackgroundDepressive symptoms embody a risk factor for developing age‐related cognitive impairment, while they belong to the most common non‐cognitive symptoms of dementia. The conundrum of the prevalence of depressive symptoms in older adults in the Mediterranean region, but also worldwide is vividly reflected in reported prevalence rates ranging from 7.7% in a study from Malaysia and Australia to 81.1% in India. The present study aimed to shed light on the prevalence of mild, moderate and severe depressive symptoms in the entire spectrum of cognitive aging based on a cohort of randomly selected older adults from municipal rosters of two locations in Attica and central Greece.MethodsBased on a thorough neurological and neuropsychological assessment, the diagnoses of mild cognitive impairment, Alzheimer’s dementia (AD) or dementia caused by other diseases (non‐AD) were established in participants of the Hellenic Epidemiological Longitudinal Investigation of Aging and Diet (HELIAD). The presence of depressive symptoms was tapped with the 15‐item Geriatric Depression Scale (GDS). Scores between 0‐4 point to the absence of depression, while scores between 5‐8, 9‐11, 12‐15 are compatible with mild, moderate and severe depressive symptoms, respectively. Statistical analyses were based on Pearson’s Chi‐squared test and pairwise proportions tests.ResultsThe prevalence of depressive symptoms in the total sample (n = 1937 participants; mean age 73,84 SD: 5,427, females: 1148) was 19.5% (mild 13.1%, moderate 3.8%, severe 2.5%). The prevalence of depressive symptoms in older adults without cognitive impairment was 18%, in patients with MCI 27%, in AD 25% and in non‐AD 23.5%. The differences in the distribution of depressive symptoms of different severity across the four groups reached statistical significance (chi‐squared = 28.957, df = 9, p‐value<0.001). The prevalence of moderate to severe depressive symptoms reached its maximum in AD (11.3%) and its lowest in people without cognitive impairment (5.4%).ConclusionsAlmost one out of five older adults suffered from depressive symptoms, with the prevalence and severity increasing significantly in cases of cognitively impaired individuals. These observations highlight the urgent need for raising awareness regarding the presence of depressive symptoms in older adults and improving primary, secondary and tertiary preventive strategies.

The occurrence of depressive symptoms in rheumatoid arthritis: A cross-sectional study

Background/Aim. Depression, as a common comorbidity in patients with rheumatoid arthritis (RA), has been found to affect the disease diagnosis and treatment response. Accordingly, the aim of the study was to investigate the occurrence of depressive symptoms among patients with RA and the association between RA and depression. Methods. The cross-sectional study included 69 patients with RA. The depressive symptoms in patients with RA were assessed using the Beck Depression Inventory (BDI), and RA activity was measured by Disease Activity Score-28 for RA with erythrocyte sedimentation rate (DAS28-ESR) and Clinical Dis-ease Activity Index (CDAI). Results. It was found that 42% of respondents reported having depressive symptoms of different severity, among which the majority (23.2%) presented with mild symptoms. A mild positive correlation was found between the BDI and the DAS28-ESR (r = 0.39 p = 0.001), as well as between the BDI and the CDAI (r = 0.40 p = 0.001). Place of residence (t = -2.14 p = 0.03) and employment status (t = -2.81 p = 0.00) associated with depressive symptoms were also found to have statistically significant differences within the group of respondents. In addition, age had a positive correlation with the disease activity, as well as the place of residence and employment status. Conclusion. It has been observed that depressive symptoms in patients with RA were associated with disease activity, employment status, and place of residence. Therefore, there is an important need for integrating rheumatologic and mental health services for future research toward a better understanding of both depression and RA.

Prediagnosis Depression Rather Than Anxiety Symptoms Is Associated with Decreased Ovarian Cancer Survival: Findings from the Ovarian Cancer Follow-Up Study (OOPS).

The relationship between prediagnosis depression, anxiety symptoms, and ovarian cancer (OC) survival is unknown. We aimed to explore these associations to provide further epidemiological evidence. We investigated the relationship between prediagnosis depression, anxiety symptoms, and OC survival in a prospective cohort study of newly diagnosed OC patients aged 18-79 years. Depression and anxiety symptoms were assessed using the Patient Health Questionnaire 9 and Generalized Anxiety Disorder 7 at diagnosis, respectively. Deaths were ascertained until 31 March 2021 via medical records and active follow-up. Multivariable-adjusted Cox proportional hazards regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) with prediagnosis depression and anxiety symptoms and all-cause mortality of OC. We found 56 (9.4%) and 235 (39.3%) OC patients with depression and anxiety symptoms, respectively. During a median follow-up of 37.2 months (interquartile range 24.7-50.2 months), 130 deaths were confirmed. Compared with non-depression symptoms, patients with prediagnosis depressive symptoms showed a significantly increased risk of OC mortality (HR = 2.10, 95% CI: 1.20-3.70). Of note, the association was still robust when focusing on the OC patients with severe depressive symptoms (HR = 2.10, 95% CI: 1.07-4.12). However, we observed no association between prediagnosis anxiety symptoms of different severity and OC mortality. Interestingly, OC patients with combined moderate depression and anxiety symptoms had a significantly increased risk of OC mortality (HR = 3.23, 95% CI: 1.14-9.11) compared to those with no symptoms of depression and anxiety. Notably, Wilms's tumor 1 was significantly associated with depression and anxiety symptoms (p < 0.05). Prediagnosis depression increases the risk of OC mortality. Large multicenter studies are required to confirm this finding.

Seizure Phenotype and Underlying Cellular Defects in Drosophila Knock-In Models of DS (R1648C) and GEFS+ (R1648H) SCN1A Epilepsy.

Mutations in the voltage-gated sodium channel gene SCN1A are associated with human epilepsy disorders, but how most of these mutations alter channel properties and result in seizures is unknown. This study focuses on two different mutations occurring at one position within SCN1A. R1648C (R-C) is associated with the severe disorder Dravet syndrome, and R1648H (R-H), with the milder disorder GEFS+. To explore how these different mutations contribute to distinct seizure disorders, Drosophila lines with the R-C or R-H mutation, or R1648R (R-R) control substitution in the fly sodium channel gene para were generated by CRISPR-Cas9 gene editing. The R-C and R-H mutations are homozygous lethal. Animals heterozygous for R-C or R-H mutations displayed reduced life spans and spontaneous and temperature-induced seizures not observed in R-R controls. Electrophysiological recordings from adult GABAergic neurons in R-C and R-H mutants revealed the appearance of sustained neuronal depolarizations and altered firing frequency that were exacerbated at elevated temperature. The only significant change observed in underlying sodium currents in both R-C and R-H mutants was a hyperpolarized deactivation threshold at room and elevated temperature compared with R-R controls. Since this change is constitutive, it is likely to interact with heat-induced changes in other cellular properties to result in the heat-induced increase in sustained depolarizations and seizure activity. Further, the similarity of the behavioral and cellular phenotypes in the R-C and R-H fly lines, suggests that disease symptoms of different severity associated with these mutations in humans could be due in large part to differences in genetic background.

Smiling, Yawning, Jaw Functional Limitations and Oral Behaviors With Respect to General Health Status in Patients With Temporomandibular Disorder-Myofascial Pain With Referral.

Background: The temporomandibular joint is the one of the most important joints in the human body. It enables numerous orofacial functions such as mastication, swallowing, breathing, speech, emotional communication, and facial expressions. The aim of the study was to evaluate the prevalence of jaw functional limitations and oral behaviors with respect to general health status in patients with temporomandibular joint disorders—myofascial pain with referral.Materials and methods: The study group consisted of 50 individuals (37 females and 13 males) with complete natural dentition. The average age was 23.36 years with ± 0.30 as a standard error. All subjects underwent clinical examination and were diagnosed with myofascial pain with referral according to the Diagnostic Criteria for Temporomandibular Disorders. The survey was conducted in connection with the Jaw Functional Limitation Scale-8 (JFLS-8), Jaw Functional Limitation Scale-20 (JFLS-20), Patient Health Questionnaire-4 (PHQ-4), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-15 (PHQ-15), and Oral Behaviors Checklist (OBC).Results: The most common functional problems in the entire study group were chewing tough food and yawning. In terms of gender, statistically significant differences were noted for chewing tough food and smiling (p = 0.015451; p = 0.035978, respectively). With respect to Bonferroni correction and Benjamini-Hochberg procedure, the observed differences were not statistically significant. There were no statistically considerable differences in mastication, mandibular mobility, verbal and emotional communication, or global limitations (p > 0.05). Over half (56%) of the respondents had depression of varying severity. Somatic symptoms of different severity were found in 78% of the patients, and 44% of the respondents declared anxiety disorders. The score of the Oral Behavior Checklist (OBC = 27.18) highlighted a high tendency for developing craniomandibular disorders.Conclusion: Patients with myofascial pain with referral, demonstrated a disturbed biopsychosocial profile. The restrictions in yawning and smiling as well as limitations in mastication, mobility, verbal and emotional communication, and global limitations appear to be significant predictors of craniomandibular dysfunction. Depression, stress, and somatic disorders are important factors predisposing patients to the occurrence of myofascial pain with referral. The progression of oral behaviors may indicate the role of somatosensory amplification.

What is important for doctor’s drug decision-making for the patient with acute schizophrenia?

IntroductionIn spite of the long history of antipsychotic treatment there are still no clear criteria, which can be robust support for drug decision-making.ObjectivesTo determine the important hallmarks of patient’s current state, life span and history of illness defining the doctor’s decision about the type of antipsychotic to be chosen.MethodsThe data from the case charts of 275 patients with episodic schizophrenia and rather benign course of the disease were analyzed.ResultsThe group included: male 62%, mean age 33 (SD 11), education 10 years 23%, 13 years 27%, 16 years 29%, disability - 51%, number of hospitalizations due to psychotic episodes in the past 7 (SD 6). The symptoms of the current episode varied from patient to patient: delusions and hallucinations, symptoms of disorganization, negative symptoms of different severity were registered Atypical antipsychotics were more often than typical prescribed to the patients with developmental problems: traumatic obstetric complications (p=0,009), poor somatic health in the childhood (p= 0,02), cognitive dysfunction during school years (p=0,04), and quality of first remission – presence of residual symptoms in the first remission (p=0.005). Good compliance in the past was one more important factor for choosing a atypical antipsychotic for a patient (p=0.05). It appeared that the most important for the decision-making was the specific features of the patient’s development and early period of the disease, but not the specific signs of current psychotic state.ConclusionsDoctor’s decision upon the type of antipsychotics in this category of patients is most probably based on other than current clinical symptoms signs.

Psychological Impact among COVID-19 Positive Patients in a Tertiary Care Hospital: A Cross-sectional Study

Introduction: Coronavirus Disease (COVID-19) outbreak is one of the biggest medical challenges to humankind in recent times, started from China in December 2019, and had spread to almost all the countries of the world. The social, psychological and economic fissures exposed by the pandemic resulted in mass disruption in human behaviour population. This is pushing them towards more stress. Aim: To analyse the anxiety and depressive symptoms in COVID-19 positive patients. Materials and Methods: A cross-sectional study was conducted on 325 COVID positive patients who were admitted in isolation ward in Tertiary Care Centre and were enrolled in this study, out of which 18 subjects refused to give the consent and 5 were already taking psychiatric medications and were excluded. Telephonic contact was not established with rest of the 5 patients. After ethical clearance, the anxiety and depressive symptoms were assessed by using Hamilton Anxiety Rating Scale (HAM-A) and Hamilton Depression Rating Scale (HAM-D). Results: Maximum patients belonged to age group of 21-40 years (54.9%). Maximum patients were males (70%). Almost 3/4th of the population 64% had depressive symptoms of different severity and 61% had anxiety symptoms. Significant association of anxiety symptoms was seen with gender (p=0.001) and marital status (p=0.002). No association with depressive symptoms was seen with gender (p=0.087) and marital status (p=0.399). Conclusion: COVID-19 had significant impact on the patients. More than half of the population had showed the psychological issues in the form of anxiety and depression. Males and married patients were affected more with both anxiety and depressive symptoms.

Correlation of Tc-99 m ethyl cysteinate dimer single-photon emission computed tomography and clinical presentations in patients with low cobalamin status.

BackgroundCobalamin (Cbl) deficiency has been associated with various neuropsychiatric symptoms of different severities. While some studies dedicated in structural neuroimaging credibly address negative impact of low Cbl status, functional imaging reports are limited. We herein retrospectively review the correlation of Tc-99 m ethyl cysteinate dimer single-photon emission computed tomography (Tc-99 m-ECD SPECT) and clinical presentations among patients with low serum cobalamin (Cbl) status (<250 pg/ml).MethodsTwelve symptomatic patients with low serum Cbl status were enrolled. Clinical presentations, Tc-99 m-ECD SPECT, and neuropsychological tests were reviewed.ResultsDysexecutive syndrome (67 %), forgetfulness (50 %), attention deficits (42 %), and sleep disorders (33 %) constituted the major clinical presentations. All patients (100 %) had temporal hypoperfusion on the Tc-99 m-ECD SPECT. Five patients (42 %) had hypoperfusion restricted within temporal regions and deep nuclei; seven patients (58 %) had additional frontal hypoperfusion. In patients with hypoperfusion restricted within temporal regions and deep nuclei, psychiatric symptoms with spared cognition were their main presentations. Among patients with additional frontal hypoperfusion, six of seven patients (86 %) showed impaired cognitive performances (two of them were diagnosed as having dementia). Among ten patients who finished neuropsychological tests, abstract thinking (70 %) was the most commonly affected, followed by verbal fluency (60 %), short-term memory (50 %), and attention (50 %). Anxiety and sleep problems were the major clinically remarkable psychiatric features (33 % both). Four Tc-99 m-ECD SPECT follow-up studies were available; the degree and extent of signal reversal correlated with cognitive changes after Cbl replacement therapy.ConclusionsOur TC-99 m-ECD SPECT observations provide pivotal information of neurobiological changes within basal ganglia and fronto-temporal regions in conjunction with disease severity among patients with Cbl deficiency. Hypoperfusion within thalamus/basal ganglia and temporal regions may be seen in the earlier state of Cbl deficiency, when psychiatric symptoms predominate. Hypoperfusion beyond thalamus/basal ganglia and involving frontal regions appears when cognitive problems, mostly dysexecutive syndrome, are manifested. Symmetric hypofrontality of SPECT in the context of dysexcutive syndrome serves as a distinguishing feature of non-amnestic mild cognitive impairment attributed to Cbl deficiency. Concordant with TC-99 m-ECD SPECT findings, the psychiatric symptoms and dysexcutive syndrome undergird impaired limbic and dorsolateral prefrontal circuits originating from basal ganglia respectively.

Frequency of the p.Gly262Asp mutation in congenital Factor X deficiency.

Congenital factor X (FX) deficiency is a rare bleeding disorder inherited as an autosomal recessive trait with an incidence of 1:500000-1000000. A total or partial deficiency of FX causes an impairment of clot formation, leading to a haemorrhagic disease, which manifests with bleeding symptoms of different severity, also unprovoked. We analysed the clinical manifestations, laboratory phenotype and genotype in 12 patients from Turkey affected with severe FX deficiency. Prothrombin time (PT), activated partial thromboplastin time (APTT), FX activity (FX:C) and FX antigen level (FX:Ag) were measured, and mutation analysis was performed for all patients. The most frequent bleeding episodes in patients were epistaxis and easy bruising (11/12, 91%), followed by haemarthroses (10/12, 83%). FX:C was <1% in 11 patients, and 4% in one. FX:Ag was reduced in all patients, consistent with type II deficiency. Direct sequencing of the factor X gene (F10) identified two different mutations: the novel 33bp in-frame deletion p.Thr176_Gln186, c.526_558del, which seems to be associated with milder bleeding symptoms and the c.785G>A, p.Gly262Asp missense mutation (previously reported as Gly222Asp), which is associated with severe bleeding symptoms. The p.Gly262Asp missense mutation was identified in 11 of the 12 patients in this study. Previously published cases on the same p.Gly262Asp mutation were Iranian patients originating from the border between Turkey and Iran suggesting that this mutation may be candidate as a good tool for mutational screening analysis in this area.

Influence of different doses of trospium and solifenacin on manageability of OAB symptoms with different severity in elderly men and women

Objective: We studied the rationale for using standard and increased dosages of solifenacin and trospium against overactive bladder (OAB) symptoms of different severity among elderly patients. Methods: A total of 327 patients took part in the study: 199 women and 128 men older than 65 years (median age 69.1). The state of the lower urinary tracts was estimated by cystometry, ICIQ-SF and bladder diaries. Frequency of urgency urinary incontinence (UUI) was taken as a criterion of OAB symptom severity. Result: Administration of double-dosed trospium and solifenacin leads to decrease of frequency of UUI both in the group with severe symptoms (B1: 6.1 (0.5) →2.4 (0.9), p ⩽ 0.05), and in the group with moderate symptoms of OAB (A1: 2.8 (0.8) →0.5 (0.4), p ⩽ 0.001). Under a combination of trospium and solifenacin in doses recommended by manufacturers, UUI decreased authentically in the group with moderate symptoms (A2: 2.9 (0.5) →0.9 (0.5), p ⩽ 0.05) and unauthentically in the group with severe symptoms of detrusor dysfunction (B2: 7.0 (1.2) → 4.3 (1.5), p ⩾ 0.05). During the experiment six patients (1.8%) elected not to participate because of intolerable adverse events. Forty-seven more individuals (14.4%) felt adverse effects, among which the most frequent were: xerostomia (15 patients or 4.6%), faintness (nine patients or 3.8%), dryness of integuments (six patients or 1.8%). Conclusion: A standard-dose combination of solifenacin and trospium in older patients with moderate symptoms of OAB enables a good therapeutic effect in a short time without increasing risk of side effects. High therapeutic doses of antimuscarinic drugs are reasonable for older men and women with severe symptoms of OAB. Increasing the dose of simultaneous use of solifenacin and trospium yields a good therapeutic effect to correct UUI; however, it raises the hazard of appearance of adverse effects. The number of side effects in the group of elderly individuals who were taking the combination of increased and standard dosages of solifenacin and trospium does not significantly differ.

Begomoviruses Infecting Tomato Crops in Panama

AbstractThe key regions in Panama involved in open field‐ and greenhouse‐grown commercial tomato production, including the Chiriquí, Veraguas, Herrera, Los Santos, Coclé and Panama Oeste provinces, were surveyed for the incidence and distribution of begomoviruses in the growing seasons of 2011 and 2012. The surveys took place in 14 of the 51 districts of the above‐mentioned provinces and comprised all relevant tomato production areas of the provinces. A total of 28 tomato plots were surveyed. The exact location of each plot was geo‐referenced using a hand‐held Global Positioning System unit. In total, 319 individual tomato plants (181 in 2011 and 138 in 2012) were sampled. Plants displayed diverse combinations of virus‐like symptoms of different severity, including necrosis, yellowing, mosaic, mottling, rolling, curling, distortion and puckering of leaves, reduced leaf size, and stunted growth. DNA was extracted from each plant for a subsequent polymerase chain reaction (PCR) analysis, using two sets of degenerate primers able to detect members of the genus Begomovirus. The samples displaying a positive reaction were subsequently analysed with specific primer pairs to identify the affecting begomoviruses. A total of 42.3% of all collected samples showed a positive signal to PCRs. Three begomovirus species were detected with the species‐specific set of primers; in particular, in the samples obtained in 2011, Potato yellow mosaic Panama virus (PYMPV), Tomato leaf curl Sinaloa virus (ToLCSiV) and Tomato yellow mottle virus (TYMoV) were detected, while in the 2012 samples, only PYMPV and ToLCSiV were found. To our knowledge, this is the first reported incidence of ToLCSiV and TYMoV in Panamanian tomato crops.

The 5HTT and MAO-A polymorphisms associate with depressive mood and climacteric symptoms in postmenopausal women

The aim of this study was to assess the influence of the 44-bp polymorphism in the 5HTTLPR (SLC 6A4) (serotonin-transporter-linked polymorphic region, solute carrier family 6 member 4) promoter region and the 30-bpVNTR (variable number of tandem repeats) polymorphism in the MAO-A (monoamine oxidase A) promoter region on the prevalence of depressive mood and the severity of climacteric symptoms in postmenopausal women. The study involved 630 women from northern Poland who had their last menstrual period at least one year before the study. The women did not abuse alcohol or cigarettes, had not been diagnosed as having endocrinological, cancerous or mental diseases, and had not received psychiatric treatment by the time. This survey-based study was performed using the following research instruments: the Beck Depression Inventory (BDI), to evaluate depressive symptoms, and the Blatt-Kupperman Menopausal Index, to measure the severity of climacteric symptoms. The average age of the women was 57.5 ± 6.4 years. Depressive symptoms of different severity according to the BDI were diagnosed in 29.2% of the women (minor-18.6%, moderate-7.1%, severe-3.5%) and according to the Blatt-Kupperman Menopausal Index were diagnosed in 42% of the women (minor-24.1%, moderate-9.2%, severe-8.7%). Allele 'l' was significantly more common in the women without climacteric symptoms than those with minor, moderate or severe climacteric complaints (p ≤ 0.05). There was a significant correlation between the severity of climacteric and depressive symptoms (p ≤ 0.05). The women who had severe climacteric symptoms also had more severe depressive symptoms. 1. The 5HTTLPR gene polymorphism contributes to climacteric symptoms in postmenopausal women. 2. The Blatt-Kupperman Menopausal Index is an instrument which can not only be used for the measurement of the severity of climacteric symptoms but also the early detection of perimenopausal women at the risk of developing depressive symptoms.

Pharmacological Therapy of Parkinsons Disease: Current Options and New Avenues

Parkinson's disease is a neurodegenerative pathology which affects the dopaminergic neurons in the mesencephalon, leading to a progressive and relentless motor disability and to non-motor symptoms of different severity. The aim of this review is to summarize the features of drugs currently used in the pharmacotherapy of Parkinson's disease, with a look at their beneficial effects and limitations. Drugs acting on dopamine transmission, as L-DOPA, direct dopaminergic agonists, inhibitors for either the MAO or COMT enzymes and drugs acting on neurotransmitters other than dopamine (e.g. acetylcholine, glutamate) will be covered. Investigational drugs currently under examination for their therapeutic potential in Parkinson's disease and recent patents which may be relevant to the field will be also discussed.

Bioecology and chemical diversity of abdominal glands in the iranian samsum ant Pachycondyla sennaarensis (Formicidae: Ponerinae)

The genus Pachycondyla is a large group of ants in the Ponerini tribe, known mostly from tropical and subtropical regions. Pachycondyla sennaarensis, the so-called Samsum ant in the Middle East, is distributed throughout the African tropics, Arabian Peninsula and Iran, where it is responsible for many cases of insect-induced dermal lesions and systemic reactions in humans. Populations of P. sennaarensis were studied in two regions of Iran and some aspects of their biology, ecology and medical importance are herein presented. Colonies of P. sennaarensis contain less than 850 workers that live in complicated underground galleries approximately one meter deep. Because of the harsh weather conditions of southern Iran, they can survive only in human disturbed habitats with higher humidity. Neither a real queen (without reproductive division of labor) nor a caste system is found in a P. sennaarensis colony. Observations indicated that P. sennaarensis is omnivorous, feeding on seeds of various plants, dead ants of other species, the larvae of dipterans and a few other invertebrates. The effect of the P. sennaarensis sting is usually mild, resulting in papule formation, erythema and dermal itching. The abdominal gland secretion of P. sennaarensis is a complex mixture of saturated and unsaturated hydrocarbons and small amounts of terpenoids, ketones, pyrazines and phenolic compounds that are accompanied by straight-chain hydrocarbons. So far, no case of anaphylaxis has been reported in Iran, a fact probably due to the lack of proteins in P. sennaarensis venom. It appears that P. sennaarensis populations vary considerably in their toxin composition according to their geographic range, which may ultimately explain symptoms of different severity among local residents.

Fitness consequences of infection of Arabidopsis thaliana with its natural bacterial pathogen Pseudomonas viridiflava

Variation in plant resistance to pathogen infection is commonly observed in interactions between wild plants and their foliar pathogens. Models of host-pathogen interactions indicate that a large cost of infection is generally necessary to maintain this variation, yet there is limited evidence that foliar pathogens cause detectable fitness reductions in wild host plants. Most published work has focused on fungal pathogens. Pseudomonas viridiflava, a common bacterial pathogen of the annual weed Arabidopsis thaliana across its range, comprises two distinct genetic clades that cause disease symptoms of different severity. Here we measured the extent of infection of wild A. thaliana populations in the Midwest, USA, and examined the effect on seed production, in field and growth-chamber experiments, of experimental inoculation with isolates from the two clades. We found infection with P. viridiflava varied from 0 to 56% in Midwest A. thaliana populations, with the possibility of several leaves per plant infected later in the growing season. In the growth chambers, experimental inoculation reduced seed set by averages of 15 and 11% for clades A and B, respectively. In the field experiment, only clade A affected plant fitness significantly, reducing seed set by an average of 38%. Underlying these average effects we observed both negative and positive effects of infection, and variation in both fitness among plant genotypes and sensitivity to environmental conditions.

The Correlation between Severity of Disease Symptoms and the Accumulation of Viral Antigen and Acidic Pathogenesis‐related Proteins in the Leaves of Thorn‐apple Plants Infected with Different Isolates of Potato Virus X

AbstractThe isolates of potato virus X causing disease symptoms of different severity in thorn‐apple plants (Datura stramonium L.) can be categorized in terms of the increase in antigen accumulation, as follows: strong, medium and weak. Extracts from leaves of healthy plants and of those infected with separate virus isolate did not differ in set of acidic pathogenesis‐related (PR) proteins as shown by discontinuous non‐denaturating polyacrylamide gel electrophoresis. Within 2 weeks after inoculation the total content of PR‐proteins in leaves of plants infected with weak or medium isolates was higher than in the healthy ones but after 3 weeks these differences became negligible. The plants infected with the strong isolate had higher total content of PR‐proteins than healthy plants and plants infected with weak or medium isolates during 3 weeks. It is proposed that the greater the damage to the plant caused by virus infection, the more PR‐proteins are accumulated.

A note on phytotoxicity of homodestruxin B – a compound produced by Alternaria brassicae

Homodestruxin B, a compound produced by Alternaria brassicae, the causal organism of the blackspot disease of rapeseed, is known to be phytotoxic to the leaves of Brassica napus. In this study we found that its phytotoxicity was comparable to that of destruxin B, another toxin produced by the pathogen when tested on B. napus. Homodestruxin B caused symptoms of different severities in leaves of various non-host plants. The results suggestthat homodestruxin B is a non-host-specific toxin.

Relationship between X-inactivation and clinical involvement in Fabry heterozygotes. Eleven novel mutations in the α-galactosidase A gene in the Czech and Slovak population

We have identified 21 different alpha-galactosidase A gene (GLA) mutations in 22 unrelated Czech and Slovak families with Fabry disease. Eleven of these mutations were novel (point mutations D93N, A135V, D155H, G171R, Q280K, G360S, Q330X, splicing errors c.194ins14, c.801ins36 and deletions c.674_732del59, g.3405_6021del2617). Genotyping of family members for family-specific mutations revealed 55 heterozygotes that manifested clinical symptoms of different severity. To examine the contribution of X-inactivation skewing to disease manifestation in Fabry heterozygotes, we have adopted the Mainz severity scoring scheme and compared the score values with the X-inactivation status in 39 carriers in an age-dependent manner. The age-score trendline of Fabry females who had a predominantly inactivated X-chromosome bearing a wild-type GLA allele (10 of 38 females) was markedly steeper than in the rest of the cohort. One female carrier with an inactivated mutated allele had a low score value when compared to the other heterozygotes of the same age. These data suggest that X-inactivation is indeed a major factor determining the severity of clinical involvement in Fabry heterozygotes. There was a statistically significant difference between the severity score values of heterozygotes with random and non-random X-chromosome inactivation at the 5% level of significance. Further studies will show if the degree of the wildtype allele inactivation will be useful as a predictive marker of severity of phenotype in Fabry heterozygotes. Although the correlation between X-inactivation skewing and presentation of the disease in Fabry heterozygotes has previously been suggested in the literature, this report is among the first attempts to examine this relationship systematically.