Successful management of lymphangiomatosis and chylothorax in a 7-month-old infant

A 7-month old infant presented with an effusion and multiple lesions in his spleen. A diagnosis of lymphangiomatosis was made based on chylous effusion and an MRI demonstrating numerous enhancing lesions within the spleen on T2-weighed images. Conservative measures, including the withdrawal of feeds and octreotide, did not significantly reduce the rate of chyle production and increasing requirement for respiratory support. Resection of the patient's spleen and partial pleurectomy were associated with a dramatic improvement in his condition. At 27 months the patient was well with no evidence of further lymphangiomas or a recurrence of his chylothoraces.

Substance misuse in first-episode psychosis: 15-month prospective follow-up study

Background Well-designed prospective studies of substance misuse in first-episode psychosis can improve our understanding of the risks associated with comorbid substance misuse and psychosis. Aims To examine the potential effects of substance misuse on in-patient admission and remission and relapse of positive symptoms in first-episode psychosis. Method The study was a prospective 15-month follow-up investigation of 103 patients with first-episode psychosis recruited from three mental health services. Results Substance misuse was independently associated with increased risk of in-patient admission, relapse of positive symptoms and shorter time to relapse of positive symptoms after controlling for potential confounding factors, Substance misuse was not associated with remission or time to remission of positive symptoms. Heavy substance misuse was associated with increased risk of in-patient admission, relapse and shorter time to relapse. Conclusions Substance misuse is an independent risk factor for a problematic recovery from first-episode psychosis.

First-line therapy with latanoprost 0.005% results in improved ocular circulation in newly diagnosed primary open-angle glaucoma patients: a prospective, 6-month, open-label study

Purpose To evaluate the effect of latanoprost 0.005% on the optic nerve head (ONH) and retinal circulation of newly diagnosed and previously untreated primary open-angle glaucoma (POAG) patients. Methods Twenty-two newly diagnosed and previously untreated POAG patients (mean age±SD: 68.38±11.92 years) were included in this longitudinal open-label study. Patients were treated with latanoprost 0.005% once a day. Intraocular pressure (IOP), systemic blood pressure (BP), mean ocular perfusion pressure (MOPP), and ocular perfusion parameters ‘volume’, ‘velocity’, and ‘flow’ measured at the optic nerve head (ONH) and retina by means of Heidelberg Retina Flowmeter system were evaluated during a 6-month follow-up period. Results Treatment with latanoprost 0.005% resulted in a significant decrease in IOP (P<0.0001) and increase in MOPP (P<0.0001). After correcting for changes in MOPP, the blood velocity measured at the ONH level was significantly higher after 6 months of treatment than at baseline (P=0.0310). In addition, blood volume and flow measured at the peripapillary retina level improved after 3 and 6 months of treatment (P=0.0170; P=0.0260, and P=0.0170; P=0.0240 respectively). Conclusion Previously untreated POAG patients exhibit reduced IOP, increased MOPP and improved ocular perfusion at the ONH and retina levels when treated with Latanoprost 0.005%. These effects could be beneficial for glaucoma patients suffering from ocular vascular dysregulation.

Pentoxifylline and the behaviour of 29-month female mice

The dimethyl-xanthine derivative pentoxifylline (PTX) increases blood flow through capillaries. In elderly humans the drug leads to improvement in a number of imapired neuropsychological parameters. We now report that oral administration to 29-month female mice (C57, black and tan) over six days induced four different patterns of behavioural reponse: (1) consistent improvement in grooming behaviour throughout the six day trial; (2) significant improvement in light/dark zone curiosity and curiosity towards a strange object on day three, which declined but remained significantly above pre-treatment levels at day 6; (3) an improvement in general activity which only becomes detectable on day six; (4) a significant improvement in rod-walking, rearing an shuttle-box crosses on day three which returned to pre-treatment levels by day 6. Age-related deficits in general activity, grooming and curiosity were completely eliminated by the drug - the mean group performance levels attained those seen in 9-12 month individuals of this strain.

Ranibizumab 0.5 mg for diabetic macular edema with bimonthly monitoring after a phase of initial treatment:18-month, multicenter, phase IIIB RELIGHT study

Abstract PURPOSE: To evaluate ranibizumab 0.5 mg using bimonthly monitoring and individualized re-treatment after monthly follow-up for 6 months in patients with visual impairment due to diabetic macular edema (DME). DESIGN: A phase IIIb, 18-month, prospective, open-label, multicenter, single-arm study in the United Kingdom. PARTICIPANTS: Participants (N = 109) with visual impairment due to DME. METHODS: Participants received 3 initial monthly ranibizumab 0.5 mg injections (day 0 to month 2), followed by individualized best-corrected visual acuity (BCVA) and optical coherence tomography-guided re-treatment with monthly (months 3-5) and subsequent bimonthly follow-up (months 6-18). Laser was allowed after month 6. MAIN OUTCOME MEASURES: Mean change in BCVA from baseline to month 12 (primary end point), mean change in BCVA and central retinal thickness (CRT) from baseline to month 18, gain of ≥10 and ≥15 letters, treatment exposure, and incidence of adverse events over 18 months. RESULTS: Of 109 participants, 100 (91.7%) and 99 (90.8%) completed the 12 and 18 months of the study, respectively. The mean age was 63.7 years, the mean duration of DME was 40 months, and 77.1% of the participants had received prior laser treatment (study eye). At baseline, mean BCVA was 62.9 letters, 20% of patients had a baseline BCVA of >73 letters, and mean baseline CRT was 418.1 μm, with 32% of patients having a baseline CRT <300 μm. The mean change in BCVA from baseline to month 6 was +6.6 letters (95% confidence interval [CI], 4.9-8.3), and after institution of bimonthly treatment the mean change in BCVA at month 12 was +4.8 letters (95% CI, 2.9-6.7; P < 0.001) and +6.5 letters (95% CI, 4.2-8.8) at month 18. The proportion of participants gaining ≥10 and ≥15 letters was 24.8% and 13.8% at month 12 and 34.9% and 19.3% at month 18, respectively. Participants received a mean of 6.8 and 8.5 injections over 12 and 18 months, respectively. No new ocular or nonocular safety findings were observed during the study. CONCLUSIONS: The BCVA gain achieved in the initial 6-month treatment period was maintained with an additional 12 months of bimonthly ranibizumab PRN treatment.

A validation study of the construct "jealousy" in eleven- to fourteen-month-old infants: Evidence for its divergence from "fear" and "anger"

There has been increasing interest in expanding the scope of the study of the "basic" emotions and their development in infancy to include more of the so-called "complex" emotions like jealousy. This dissertation investigated evidence for the divergence of jealousy in infants from both fear and anger, two of the basic emotions said to be precursors and contributors to the emergence of jealousy in the later part of the first year of life. Participants judged how well eight emotion-denoting terms (including jealousy, anger and fear) described infants' emotionality in fear-, anger-, and jealousy-provoking situations in which the social context of the emotion episodes was either included or excluded. Differences within and between participants' judgments of the eight terms in the two context conditions were examined across the three emotion-provoking conditions. Results suggested that infants' emotional behavior denoting jealousy was not judged differently from behavior denoting anger or fear in the absence of contextual information and, that when contextual information was provided, attributions of infant jealousy, anger, and fear were made "correctly" for their respective target emotion conditions. ^

Mother-Infant Reciprocity and the Development of Joint Attention in 12 Month Old Infants

Social contingency is the ability to connect social stimuli, such as those behaviors performed by oneself and those performed by others. Detecting social contingencies occurs by means of reciprocity through shared experiences with others. Reciprocity denotes a circumstance in which two individuals participate in a collaborative exchange, and is distinguished from an event in which two individuals engage in separate, unrelated activities. Specifically, reciprocity incorporates joint attention (JA), which occurs when two individuals simultaneously and visually attend to the same item. JA is facilitated by gazing and pointing, whereby one individual initiates the action and the second individual follows suit by, for example, gaze-following. However, little is known about the role the mother may play in the development of JA. The purpose of our study was to investigate social contingency between mothers and infants engaging in dyadic interactions. Thirty-three 12-month-old typically developing infants (M = 12.2, SD = .19; N = 19 males) were filmed for 10 minutes during free play with their mothers and toys provided by an experimenter. Reciprocity was measured by coding mother-infant interactions when a precise chain of events occurred: (1) mother initiated a bid by introducing a toy/activity or request to the infant, (2) infant accepted the bid/request by engaging in play with the given toy/activity, and (3) mother persisted by continuing to engage in play with said toy/activity. We computed a Pearson Correlation to assess the relation between the mothers’ initiations of JA and their infants’ responses to JA. We found a moderately positive correlation between the two variables (r= 0.37, p<.05). Our findings suggest that reciprocity, an important component of social relationships, during parent-infant dyads may serve as a scaffold for joint attention abilities, which have been linked to social and language development.

A 34-month sediment trap experiment at the Cape Verde Ocean Observatory (CVOO, December 2009 - October 2012)

Anticyclonic mesoscale eddies (ACME) have been proposed as a mechanism by which new nutrients are episodically delivered into the euphotic zone, thereby enhancing new production as well as shifting phytoplankton community structure. In this paper, we report on a 34-month sediment trap experiment at the Cape Verde Ocean Observatory (CVOO; ca. 18°N, 24°E; December 2009-October 2012), occasionally influenced by ACME passages. The typically oligotrophic, weakly seasonal particle flux pattern at the CVOO is strongly modified by the appearance of a highly productive and low oxygen ACME. Out of four recorded diatom flux maxima at CVOO, three were associated with the passage of ACMEs. The recorded diatom maxima events support the view that local ACME dynamics promotes upward nutrient supply into the euphotic zone leading to a rapid response of diatoms. This response is clearly reflected by the flux seasonality: between 40% and 60% of the total annual diatom flux at the CVOO site was intercepted in a relatively short time interval (<60 days). A highly diverse diatom community characterized the diatom fluxes throughout. Along with the ACME passages, small species of the genus Nitzschia, and Thalassionema nitzschioides var. parva dominated and delivered a major portion of the opal and organic carbon into deeper waters at site CVOO. Several pelagic, warm-water background species became dominant during intervals with low nutrient availability in the euphotic zone. Results of our interannual time-series suggest that ACMEs impact on total diatom production and the species-specific composition of the assemblage north of the Cave Verde Islands, and can strengthen the biological pump in open-ocean, oligotrophic subtropical regions of the world ocean. Our observations are useful for testing biogeochemical ocean models and will also help in improving the knowledge of processes and mechanisms behind interannual time-series of bulk components and microorganisms in pelagic and hemipelagic ocean areas.