Age-at-first-admission of schizophrenia, bipolar disorder and major depression: Implications of heterogeneity

Age of onset is an important variable when considering the cause and course of mental illnesses. Given the debate about the relationship between psychotic disorders it would be useful to compare age-at-first-admission for ICD schizophrenia and for affective psychoses when the latter is differentiated into 'major depression' and 'bipolar disorder'. Data on age-at-first-admission for Australian-born individuals diagnosed with schizophrenia (ICD 295) or affective psychosis (ICD 296) were extracted from the Queensland Mental Health Statistics System -- a comprehensive, namelinked mental health register. Because the ICD 9 category 296.1 was used to code what is now called "major depressive episode', this group was differentiated from other 296 categorieswhich were considered bipolar disorders. Those receiving more than one diagnoses within these categories were excluded. All distributions show a wide age range of onset from early adolescence into the seventies and eighties. However the modal age-group for major depression ('60-69' for both sexes) is clearly different from bipolar disorder ('20-29' for males; '30- 39' for females), the latter distribution being more similar to the SCZ distribution (which had a model age-group of '20-29' for both sexes). While these distributions were similar for males and females, there were sex differences in the proportions within each diagnostic group: more males with schizophrenia, and more females with bipolar disorder and with major depression. Our results suggest heterogeneity within the affective psychoses as categorised by ICD 9, with bipolar disorder having an age-at-first-admission distribution more similar to schizophrenia than major depression. The Stanley Foundation supported this project.

Azana atlantica, n.sp., with reduced mouthparts and two ocelli: first record of Azana for the Neotropical region (Diptera : Mycetophilidae : Sciophilinae)

A new Sciophilinae-Azana atlantica, sp. n. - is described from the Atlantic Forest in southeastern Brazil. The species has a number of distinctive apomorphic features, including loss of the mid ocellus, reduced mouthparts, Sc short and incomplete, first section of Rs missing, r-m elongated, longitudinal in position, aligned with the second section of Rs ( R(5)), unforked medial and cubital veins, R(4) missing, M(4) entirely absent, gonostyle triangular, with an inner row of elongated spines and a basal, digitiform inner projection. Some of these features are shared with other genera of the Azana-group of Sciophilinae. The shape of the scutum and the strong spines on the gonostyle make it clear that the species belongs in Azana, despite the features that are distinctive from the remaining species in the genus. There are ten species described in Azana to date, from United States, Europe, Sri Lanka, Canary Islands, tropical Africa and Baltic amber. This is the first Neotropical species belonging to the genus. The complete loss of M(4) and the separated gonocoxites suggest that Azana atlantica, sp. n. forms a monophyletic group with the Afrotropical species of the genus. Azana, Morganiella, Neoaphelomera, Neotrizygia, and Trizygia are shown to compose a small clade within the Azana-group of genera. The division of the genus into two subgenera - A. ( Azana) and A. ( Jugazana) - most probably renders A. ( Azana) paraphyletic and it is suggested that this should be for the time being abandoned.

Revision of the larval morphology (Zoea I) of the family Hippolytidae (Decapoda, Caridea), with a description of the first stage of the shrimp Hippolyte obliquimanus Dana, 1852

The aim of this study was to summarize the available data on larval morphology of the first zoea of the family Hippolytidae and describe the first zoeal stage of H. obliquimanus from two geographically distinct populations, Brazilian and Caribbean in order to discuss inter- and intraspecific variability. Ovigerous females of Hippolyte obliquimanus were collected at Cahuita (Limon, Costa Rica) and at Ubatuba (Sao Paulo, Brazil). We compiled the published descriptions of all available hippolytid Zoea I (66 spp., 21%), and all zoeae share several characteristics. However, such morphological features cannot be used to distinguish the first zoeae of Hippolytidae from other caridean larvae. Historically, the presence of an exopodal seta at the maxillule and the absence of the anal spine/papilla have been considered as characteristic for the Zoea I of the genus Hippolyte. The results of our revision, however, did not support these conclusions: although H. obliquimanus showed an exopodal seta at the maxillule, four congeners did not bear such structure; moreover, H. obliquimanus as well as one other congener have an anal spine/papilla. All morphological characters observed in the first zoeal stage of H. obliquimanus are shared with others species of the family Hippolytidae. Intraspecific variability in Hippolyte obliquimanus was detected in one morphological aspect: the first zoea had four denticles on the ventral margin of the carapace in the Brazilian population, while specimens from the Costa Rican population had three.

Triphora uniflora AC Ferreira, Baptista & Pansarin (Orchidaceae: Triphorcae): a new species and the first record of the genus Triphora Nutt. for Sao Paulo state, Brazil

(Triphora uniflora A.C. Ferreira, Baptista & Pansarin (Orchidaccae: Triphorcae): a new species and the first record of the genus Triphora Nutt. for Sao Paulo state, Brazil). Triphora uniflora A. C. Ferreira, Baptista & Pansarin, a new species of Orchidaceae, is described and illustrated. Furthermore, this is the first report of the genus Triphora for Sao Paulo state, Brazil. The relationship of this new species to other taxa of the genus and the need to preserve the natural habitat of this Triphora species are discussed.

From anatomy to angioscopy: 164 years of crocodilian cardiovascular research, recent advances, and speculations

This paper present: a synthesis of current research on the crocodilian cardiovascular system with a view to encourage discussion and debate about the intricacies of this unique system and to provide ideas and suggestions for future studies. Innovative experimental approaches combined with new technologies have helped to resolve the complex flow and pressure patterns observed during non-shunting conditions that predominate in resting instrumented animals and during pulmonary to systemic shunting, which has been observed to occur spontaneously and during diving. The mechanisms and structures that may induce and regulate shunting are presented and the functional significance of a pulmonary to systemic shunt is discussed. (C) 1997 Elsevier Science Inc.

Children's cooperative behavior and interactions in trained and untrained work groups in regular classrooms

This study examined group and individual factors that facilitate changes in cooperation and learning outcomes in trained and untrained work groups of elementary school-age children. The study had two foci. The first was to determine if the cooperative behaviors and interactions of children in classroom groups who were trained in cooperative learning skins were different from those of children who were given no training, and the second was to investigate small group interactions and achievement in these groups over time. The results showed that there were observable differences between student interactions in the two conditions and these differences were maintained over time. Compared with children in the untrained groups, those in the trained groups were consistently more cooperative and helpful to each other; they actively tried to involve each other in the learning task by using language which was more inclusive (e.g., frequent use of ''we''), and they gave more explanations to assist each other as they worked together. It appeared that as the children worked together over time, they became more responsive to the learning needs of each other. Furthermore, the children in the trained groups performed significantly better on the learning outcomes questionnaire than those in the untrained groups. (C) 1997 Society for the Study of School Psychology. Published by Elsevier Science Ltd.

Calcium intake and metabolic bone disease after eight years of Roux-en-Y gastric bypass

Background Roux-en-Y gastric bypass (RYGBP) has been found to be the most efficient way to lose weight and maintain the weight loss in morbid obesity. However, with the formation of a new stomach and the modification of intestinal anatomy, there are significant changes on physiological properties of these organs that lead to nutrient deficiency, including calcium. The objectives of this study were to evaluate calcium intake, bone metabolism, and prevalence of metabolic bone disease in women subjected to RYGBP after 8 years. Methods Food frequency questionnaire and 3-day dietary recall, laboratory tests of bone metabolism and bone mineral density were accessed. Results Calcium intake was below the recommendation in all women. Serum PTH and alkaline phosphatase were elevated, whereas vitamin D and urinary calcium were significantly lower. Also, a higher prevalence of metabolic bone disease than the one expected for the normal population at the same age was noted. Conclusion These data suggest that metabolic bone disease could be a complication of this type of surgery.

Ultrasound detection rate of single umbilical artery in the first trimester of pregnancy

Objective To determine accuracy of first trimester detection of single umbilical artery (SUA). Methods The number of vessels in the umbilical cord was examined in a prospective cohort of 779 singleton, low-risk, unselected pregnancies, in the first (11-13 weeks) and second (17-24 weeks) trimesters, using both power and color Doppler and after delivery, by placental histopathologic exam. Concordance between first and second trimester findings to postnatal diagnoses was compared by calculating kappa coefficients. Results There was medium concordance between the findings in the first trimester and the postnatal diagnoses (kappa = 0.52) and high concordance (kappa = 0.89) for the second trimester scan. Sensitivity, specificity, positive and negative predictive values for the findings in the first trimester were 57.1, 98.9, 50.0 and 99.2% and for the second trimester were 86.6, 99.9, 92.9 and 99.7%. Conclusion Sensitivity and positive predictive value of first trimester scan to identify an isolated SUA in a prospective unselected population was poor. Diagnosis of isolated SUA as well as a definitive judgment about the presence of associated anomalies would still require a scan in the second trimester. Copyright (C) 2011 John Wiley & Sons, Ltd.

Intrauterine Growth Restriction and Zinc Concentrations in Term Infants during the First Month of Life

Objective: We analyzed the influence of IUGR on the concentrations of plasma (Znpl) and erythrocyte (Zne) zinc and on the ratios of Zne to Znpl (Zne:Znpl) and Zne to hemoglobin (Zne:Hb) in term infants during the first month of life. Design: Cohort study. Setting: Tertiary Care Neonatal Unit. Subjects: Exclusively breastfed term newborns (n = 84) were divided into 3 groups: group 1, without IUGR (n = 41), group II. with mild to moderate IUGR (n = 12). and group III, with severe IUGR (n = 31). IUGR was defined as birth weight under the 5th percentile of the Alexander et at curve and as a Kramer Index (KI: ratio of birth weight to estimated weight for each gestational age) <0.85. Severe IUGR was defined as a KI <0.75. Znpl, Zne. and Hb were measured at birth. 3 days, and 1 month of life. Results: Znpl tended to decrease (P = 0.073), Zne and Zne:Znpl increased (P < 0.001), and Hb decreased (P < 0.001) during the first month of life. There was not Znpl, Zne and Zne:Znpl time by group interaction. Zne:Hb increased (P < 0.001) during the first month of life and was lower in Group II at I month of age. Differences between Groups I and If (P = 0.017) and Groups II and III at I month of age (P = 0.011) were detected. Conclusions: Our results suggest that IUGR did not have association with erythrocyte zinc and Zne:Hb ratio at birth. However. neonatal nutrition could have influenced zinc incorporation during this period, through Zne increase.

Chronic polyarthritis as the first manifestation of juvenile systemic lupus erythematosus patients

Objective: To evaluate the prevalence of chronic polyarthritis in juvenile systemic lupus erythematosus (JSLE) and to describe the manifestations, treatments, and outcomes in these patients. Methods: From January 1983 to July 2010, 5419 patients were followed up at the Pediatric Rheumatology Unit of the University Hospital and 271 (5%) of them had JSLE (American College of Rheumatology [ACR] criteria). `Rhupus` was classified as the overlap of juvenile idiopathic arthritis (International League of Associations for Rheumatology [ILAR] criteria) and JSLE. We evaluated demographic data, polyarthritis and other clinical manifestations, disease activity and damage, laboratory exams, radiographic findings, treatments, and outcomes. Results: The prevalence of chronic polyarthritis in this JSLE population was 2.6% (7/271). This articular involvement was the initial manifestation in all seven JSLE patients. The median duration of chronic polyarthritis was 11 months (range 2-15 months). Interestingly, rhupus with chronic polyarthritis and limitation of movement, presence of rheumatoid factor, autoantibodies, and/or radiographic abnormalities (juxtaarticular osteopenia, joint-space narrowing, or erosions) was evidenced in three patients. No patient had deformities of hands and feet associated with Jaccoud`s arthropathy or osteonecrosis. All patients were treated with nonsteroidal anti-inflammatory drugs (NSAIDs, naproxen 10-15 mg/kg/day) when polyarthritis diagnosis was established. Prednisone and antimalarials were administered at JSLE diagnosis. The three non-responsive rhupus patients were treated in conjunction with immunosuppressive drugs (methotrexate, azathioprine, and/or cyclosporine). Conclusions: Chronic polyarthritis was a rare lupus manifestation in active pediatric patients. The interesting overlap between chronic arthritis and lupus, called rhupus suggests a new entity with a different clinical profile and a poor response to treatment with NSAIDs alone. In addition, the occurrence of this association in JSLE patients could be classified as a clinical sub-group of JSLE with possible specific genetic determinants. Lupus (2011) 20, 960-964.