Hematological differences between patients with different subtypes of sickle cell disease on hydroxyurea treatment

OBJECTIVE: Sickle cell anemia and the interaction S/Beta thalassemia differ in hematological values due to microcytosis and hypochromia caused by the thalassemic mutation. The clinical benefit of long-term hydroxyurea treatment is undeniable in sickle cell disease with monitoring of the biological action of the drug being by the complete blood count. The objective of this work is to compare changes in some of the erythrocytic indexes between S/Beta thalassemia and sickle cell anemia patients on long-term hydroxyurea treatment. METHODS: The values of erythrocyte indexes (mean corpuscular volume and mean corpuscular hemoglobin) were compared in a retrospective study of two groups of patients (Sickle cell anemia and S/Beta thalassemia) on hydroxyurea treatment over a mean of six years. RESULTS: The quantitative values of the two parameters differed between the groups. Increases in mean corpuscular volume and reductions in mean corpuscular hemoglobin delay longer in S/Beta thalassemia patients (p-value = 0.018). CONCLUSION: Hematological changes are some of the beneficial effects of hydroxyurea in sickle cell disease as cellular hydration increases and the hemoglobin S concentration is reduced. The complete blood count is the best test to monitor changes, but the interpretation of the results in S/Beta thalassemia should be different.

Specific PET-ligands for selected 5-HT and GABA A-receptor subtypes = PET-Liganden mit Spezifität für definierte 5-HT und GABA A-Rezeptor-Subtypen

Für diese Arbeit wurden sechs neue Benzodiazepinderivate, TC07, TC08, TC09, TC10, TC11 und TC12, hergestellt. Diese wurden mittels Radioligandenbindungsassay sowohl auf ihre Bindungseigenschaften für Membranen des Cerebellum, des Hippo-campus und des Cortex der Ratte hin untersucht, als auch für Membranen von HEK293 Zellen, die transient rekombinante GABAA Rezeptoren exprimierten. Zusätz-lich wurden kompetitive in situ Rezeptorautoradiographien an Rattenhirnschnitten mit den Liganden [3H]Ro15-4513 und [3H]R015-1788 durchgeführt. Zusammen ergaben sich aus diesen Experimenten deutliche Hinweise auf eine Selektivität der Verbindun-gen TC07, TC11 und TC12 für a5-Untereinheiten enthaltende GABAA Rezeptoren mit a5-Affinitäten im niedrigen nanomolaren Bereich. In vivo Bindungsexperimente in Ratten, mit [3H]Ro15-1788 als Tracer und TC07 als Kompetitor, ergaben, dass TC07 mehr [3H]Ro15-1788 im Vorderhirn als im Cerebellum verdrängt. Bezog man die regionale Verteilung der a5-Untereinheit des GABAA Rezep-tors im Rattenhirn mit ein – sehr wenige a5-Untereinheiten im Cerebellum, etwa 20 % der GABAA Rezeptor-Untereinheiten im Hippocampus – untermauerten diese Ergeb-nisse die Vermutung, TC07 könne a5-selektiv sein. Diese Daten bestätigten darü-berhinaus, dass TC07 die Blut-Hirn-Schranke passieren kann. Für elektrophysiologische Messungen mit TC07 und TC12 wurden die oben erwähnten transient transfizierten HEK293 Zellen verwendet, welche die GABAA Rezeptor Unte-reinheitenkombination a5b3g2 exprimierten. Das Dosis-Antwort Verhalten ergab keinen signifikanten Effekt für TC12. Die Daten von TC07 dagegen lassen auf einen schwach negativ modulatorischen Effekt schließen, was, zumindest theoretisch, die Möglichkeit eröffnet, TC07 auch als sogenannten cognitive enhancer einzusetzen. Der errechnete Ki-Wert lag in derselben Größenordnung wie der Ki-Wert, der anhand der Bindungsas-saydaten errechnet wurde. Insgesamt rechtfertigen die bisherigen Ergebnisse die radiochemische Markierung mit 18F von drei der sechs getesteten Verbindungen in der Reihenfolge TC07, TC12 und TC11. Des Weiteren wurde [18F]MHMZ, ein potentiell 5-HT2A selektiver Ligand und PET-Tracer einschließlich Vorläufer und Referenzverbindungen, mit hohen Ausbeuten syn-thetisiert (Herth, Debus et al. 2008). Autoradiographieexperimente mit Rattenhirn-schnitten zeigten hervorragende in situ Bindungseigenschaften der neuen Verbindung. Die Daten wiesen eine hohe Selektivität für 5-HT2A Rezeptoren in Verbindung mit einer niedrigen unspezifischen Bindung auf. [18F]MHMZ erfährt in vivo eine schnelle Metabo-lisierung, wobei ein polarer aktiver Metabolit entsteht, welcher vermutlich nicht die Blut-Hirn-Schranke passieren kann. Transversale, sagittale und coronale Kleintier-PET-Bilder des Rattenhirns zeigten eine hohe Anreicherung im frontalen Cortex und im Striatum, während im Cerebellum so gut wie keine Anreicherung festzustellen war. Diese Verteilung deckt sich mit der bekann-ten Verteilung der 5-HT2A Rezeptoren. Die in vivo Anreicherung scheint sich ebenfalls gut mit der Verteilung der in den Autoradiographieexperimenten gemessenen Bindung zu decken. Nach Berechnungen mit dem 4-Parameter Referenzgewebe Modell beträgt das Bindungspotential (BP) für den frontalen Cortex 1,45. Das Cortex zu Cerebellum Verhältnis wurde auf 2,7 nach 30 Minuten Messzeit bestimmt, was bemerkenswert nah an den von Lundkvist et al. für [11C]MDL 100907 publizierten Daten liegt. Abgesehen von der etwas niedrigeren Affinität waren die gemessenen in vitro, in situ und in vivo Daten denen von [3H]MDL 100907 und [11C]MDL 100907 sehr ähnlich, so dass wir ein [18F]Analogon in der Hand haben, das die bessere Selektivität von MDL 100907 verglichen mit Altanserin mit der längeren Halbwertszeit und den besse-ren Eigenschaften für die klinische Routine von 18F verglichen mit 11C verbindet. Die Ergebnisse von [18F]MHMZ rechtfertigenden weitere Experimente, um diesen Liganden für die klinische Routine am Menschen nutzbar zu machen.

Proposta di traduzione dall'italiano al francese di un prodotto multimediale: Adhd - disturbo da deficit di attenzione e iperattività

La presente tesi di laurea verte sulla traduzione dall'italiano al francese della presentazione multimediale (centoquattro diapositive power point) dal titolo “ADHD – Il Disturbo da Deficit di Attenzione ed Iperattività”. Nello specifico, tale presentazione, redatta dagli operatori preposti dell'Unità Operativa di Neuropsichiatria dell’Infanzia e dell’Adolescenza degli “Spedali Civili di Brescia”, costituisce una sorta di supporto informativo e breve guida al comportamento per i docenti che si relazionano con studenti affetti da ADHD. La mia scelta è stata dettata da un interesse per la materia, ma anche da aspetti rilevanti dal punto di vista traduttivo, quali la tipologia del testo di partenza e la traduzione attiva. Il testo di partenza è, infatti, di tipo misto, a metà tra tecnico/scientifico, istruttivo e divulgativo, e presenta una struttura adeguata al genere di supporto utilizzato, vale a dire un supporto multimediale. Alle problematicità sul piano testuale sono, infine, da aggiungere quelle in ambito terminologico, essendo la traduzione attiva una sfida notevole qualunque sia l'argomento affrontato. L’elaborato si compone di cinque capitoli. Il primo capitolo funge da introduzione alla presentazione originale, fornendo una base teorica relativa alle lingue speciali e al linguaggio della divulgazione scientifica. Il secondo capitolo è costituito dalla presentazione multimediale in lingua originale. Oggetto del terzo capitolo è, invece, l'analisi macro e microlinguistica del testo di partenza. Il quarto e il quinto capitolo rappresentano il fulcro della mia tesi proponendo rispettivamente la traduzione in lingua francese della presentazione powerpoint, dal titolo “TDAH – Le Trouble du Déficit de l'Attention avec Hyperactivité”, e il commento alla traduzione. Il quinto capitolo, più nel dettaglio, si focalizza sulla metodologia adottata nel corso della stesura dell'elaborato, sulle strategie traduttive di cui mi sono servita per redigere la traduzione e sui problemi riscontrati. Infine, il capitolo conclusivo riprende i punti cardine del mio lavoro in una valutazione a posteriori.

Attention-deficit hyperactivity disorder (ADHD) and glial integrity: an exploration of associations of cytokines and kynurenine metabolites with symptoms and attention

In contrast to studies of depression and psychosis, the first part of this study showed no major differences in serum levels of cytokines and tryptophan metabolites between healthy children and those with attention-deficit/hyperactivity disorder of the combined type (ADHD). Yet, small decreases of potentially toxic kynurenine metabolites and increases of cytokines were evident in subgroups. Therefore we examined predictions of biochemical associations with the major symptom clusters, measures of attention and response variability.

Attention-deficit hyperactivity disorder (ADHD) and glial integrity: S100B, cytokines and kynurenine metabolism--effects of medication

Children with attention-deficit/hyperactivity disorder (ADHD) show a marked temporal variability in their display of symptoms and neuropsychological performance. This could be explained in terms of an impaired glial supply of energy to support neuronal activity.

Social cognition in attention-deficit hyperactivity disorder (ADHD)

Attention-deficit hyperactivity disorder (ADHD) is associated with a range of cognitive deficits and social cognition impairments, which might be interpreted in the context of fronto-striatal dysfunction. So far only few studies have addressed the issue of social cognition deficits in ADHD.

German validation of the Conners Adult ADHD Rating Scales–self-report (CAARS-S) I: Factor structure and normative data

Attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood. Instruments for diagnosing ADHD in childhood are well validated and reliable, but diagnosis of ADHD in adults remains problematic. Attempts have been made to develop criteria specific for adult ADHD, resulting in the development of self-report and observer-rated questionnaires. To date, the Conners Adult ADHD Rating Scales (CAARS) are the international standard for questionnaire assessment of ADHD. The current study evaluates a German version of the CAARS self-report (CAARS-S).

The role of migration and domestic transmission in the spread of HIV-1 non-B subtypes in Switzerland

By analyzing human immunodeficiency virus type 1 (HIV-1) pol sequences from the Swiss HIV Cohort Study (SHCS), we explored whether the prevalence of non-B subtypes reflects domestic transmission or migration patterns.

Improved virological outcome in White patients infected with HIV-1 non-B subtypes compared to subtype B

Antiretroviral compounds have been predominantly studied in human immunodeficiency virus type 1 (HIV-1) subtype B, but only ~10% of infections worldwide are caused by this subtype. The analysis of the impact of different HIV subtypes on treatment outcome is important.

Neurophysiological correlates of delinquent behaviour in adult subjects with ADHD

The attention deficit/hyperactivity disorder (ADHD) shows an increased prevalence in arrested offenders compared to the normal population. The aim of the present study was to investigate whether ADHD symptoms are a major risk factor for criminal behaviour, or whether further deficits, mainly abnormalities in emotion-processing, have to be considered as important additional factors that promote delinquency in the presence of ADHD symptomatology. Event related potentials (ERPs) of 13 non-delinquent and 13 delinquent subjects with ADHD and 13 controls were compared using a modified visual Go/Nogo continuous performance task (VCPT) and a newly developed version of the visual CPT that additionally requires emotional evaluation (ECPT). ERPs were analyzed regarding their topographies and Global Field Power (GFP). Offenders with ADHD differed from non-delinquent subjects with ADHD in the ERPs representing higher-order visual processing of objects and faces (N170) and facial affect (P200), and in late monitoring and evaluative functions (LPC) of behavioural response inhibition. Concerning neural activity thought to reflect the allocation of neural resources and cognitive processing capability (P300 Go), response inhibition (P300 Nogo), and attention/expectancy (CNV), deviances were observable in both ADHD groups and may thus be attributed to ADHD rather than to delinquency. In conclusion, ADHD symptomatology may be a risk factor for delinquency, since some neural information processing deficits found in ADHD seemed to be even more pronounced in offenders with ADHD. However, our results suggest additional risk factors consisting of deviant higher-order visual processing, especially of facial affect, as well as abnormalities in monitoring and evaluative functions of response inhibition.

Behavioral Assessment of Core ADHD Symptoms Using the QbTest

Objective: Hyperactivity, one of the core symptoms of ADHD, has been mostly neglected in neuropsychological assessment of childhood ADHD. The neuropsychological Quantified behavior Test (QbTest) separately assesses all three core symptoms of ADHD on a behavioral level. Factor structure of the QbTest and its concurrent and discriminant validity are presented. Method: An exploratory factor analysis (n = 828 children) was performed. In a second sample (n = 102 children) a Multi-Trait-Multi-Method (MTMM) approach was used for validity analyses. Results: A three factorial model explained 76 % of the total variance, with the resulting QbTest factors significantly influenced by age and gender. The MTMM approach yielded promising results for discriminant, yet inconsistent findings for concurrent validity between the QbTest and another attention test as well as for Conners' Parent and Teacher Rating Scales. Conclusion: Results indicate that the QbTest may be helpful for the behavioral assessment of childhood ADHD, yet further studies on its psychometric quality and clinical utility are needed. (J. of Att. Dis. 2012; XX(X) 1-XX).

German Validation of the Conners Adult ADHD Rating Scale-Self-Report: Confirmation of Factor Structure in a Large Sample of Participants With ADHD

Objective: The Conners Adult ADHD Rating Scales (CAARS) assess symptoms specific to adults that are frequently used and have been translated into German. The current study tests the factor structure of the CAARS in a large sample of German adults with ADHD and compares the means of the CAARS subscales with those of healthy German controls. Method: CAARS were completed by 466 participants with ADHD and 851 healthy control participants. Confirmatory factor analysis was used to establish model fit with the American original. Comparisons between participants with ADHD and healthy controls and influences of gender, age, and degree of education were analyzed. Results: Confirmatory factor analysis showed a very good fit with the model for the American original. Differences between ADHD participants and healthy controls on all Conners Adult ADHD Rating Scales-Self-Report (CAARS-S) subscales were substantial and significant. Conclusion: The factor structure of the original American model was successfully replicated in this sample of adult German ADHD participants. (J. of Att. Dis. 2012; XX(X) 1-XX).