Psychiatry in Europe.
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Cross-Cultural Comparison↗
Biomedical subjects
P Power
Publications and source records attributed to P Power.
Cognitively oriented psychotherapy for early psychosis (COPE): a 1-year follow-up.
OBJECTIVES: Cognitively oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode. DESIGN: A total of 80 people participated in the initial trial and completed assessments on a range of outcome measures. Post-treatment assessment results from a non-randomized controlled trial of COPE have been previously reported. The present paper describes the results obtained from 51 patients who attended a follow-up assessment 1 year subsequent to the end-of-treatment assessment. METHOD: The 51 patients formed three groups: (1) those who were offered and accepted COPE; (2) those who were offered COPE but refused it, and continued to receive other services from the Early Psychosis Prevention and Intervention Centre (EPPIC) (refusal subjects); and (3) those who were offered neither COPE nor any other continuing treatment from EPPIC (control subjects). RESULTS: At 1-year follow-up, there was only one significant difference and this was between the COPE and refusal groups on the Integration/Sealing Over (I/SO) measure (p = .008). End-of-treatment differences were mostly sustained over the 1-year follow-up period. When the complete sample of 80 was considered, there were no differences between the three groups in terms of hospital admissions, community episodes, or time taken to first in-patient re-admission. CONCLUSIONS: The study was weakened by the poor follow-up rates in the two control groups. This reduced power to detect differences between groups on the seven major measures. However, the relapse data gathered on the complete set of 80 patients were discouraging and suggest that the present formulation of COPE does not confer any advantage to those patients receiving the therapy over those not receiving the therapy.
Adolescent↗
Cefotaxime-hydrolysing beta lactamases in Morganella morganii.
The frequency of enterobacterial isolates with high resistance to expanded-spectrum beta-lactam antibiotics (mainly cefotaxime or ceftriaxone) has increased notoriously in Argentina, mainly because of the spread of extended-spectrum beta-lactamases. The aim of this work was the study of extended-spectrum beta-lactamases in several Morganella morganii isolates with unusually high resistance to ceftriaxone. These strains produced at least two beta-lactamases, of apparent pIs of 5.4 and 8.2, molecular weight 23 000, well inhibited by clavulanate, compatible with a broad-spectrum beta-lactamase - perhaps TEM-1 - and an extended-spectrum beta-lactamase, respectively. The extended-spectrum beta-lactamase was identified as a CTX-M-type beta-lactamase - probably CTX-M-2 - by polymerase chain reaction, restriction profile analysis and DNA-DNA hybridisation. The remaining isolates studied produced either the broad-spectrum beta-lactamase plus the ubiquitous AmpC beta-lactamase (13 strains), or the AmpC beta-lactamase only (10 strains).
Anti-Bacterial Agents↗
Work-related respiratory symptoms and lung function in New Zealand mussel openers.
Our objectives were to measure the prevalence of work-related and nonwork-related respiratory symptoms in a group of New Zealand mussel openers who open green-lipped mussels, and to relate these to demographic factors, work history, smoking history, and pulmonary function measurements. A cross-section study of respiratory symptoms and lung function was performed on 224 New Zealand mussel openers (99.6% of the study population) at nine work sites. In addition, peak expiratory flow (PEF) change across-shift was measured at one work site in 19 workers. The mean age of all mussel openers was 33.4 years and the mean duration of mussel opening was 5.0 years; 25% were male, 54.7% were current smokers, and 13.9% were ex-smokers. The reported symptom prevalences were: any wheeze, 35%; work-related wheeze, 23%; any chest tightness, 30.5%; work-related chest tightness, 20.2% (work-related symptoms were defined as symptoms improving on rest days or worse at work). Seventy-two mussel openers (32.3%) answered positively to at least 1 of 4 questions concerning work-related symptoms. The mean predicted FEV1 (SD) for this group was 74.3% (14.5), and the mean predicted FVC (SD) was 79.2 (16.0). Nineteen workers completed serial PEF, and the mean percentage change was +1.5% at 7 hr, but 8 workers had falls ranging between 1.1-14% after either 1 or 7 hr of work. Duration of mussel opening of greater than 2 years, but less than 7 years (OR = 2.29; 95% CI, 1.07-4.91), and duration of mussel opening greater than 7 years (OR = 3.72; 95% CI, 1.52-9.11), were significant predictors of work-related respiratory symptoms. Female sex (OR = 1.73; 95% CI, 0.83-3.60) was also associated with the presence of work-related symptoms. No relationship was found with measured hygiene parameters of cleaning agents used. In conclusions, duration of work as a mussel opener was associated with the present of work-related respiratory symptoms, after adjustment of age, sex, and smoking habit. There were marked abnormalities in mean FEV1 and FVC, although no consistent changes across working shift were noted.
Adult↗
Comparative in-vitro activities of GD-40 and other beta-lactamase inhibitors against TEM-1 and SHV-2 beta-lactamases.
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Clavulanic Acid↗
Analysis of the initial treatment phase in first-episode psychosis.
BACKGROUND: The Early Psychosis Prevention and Intervention Centre (EPPIC) commenced operation in Melbourne, Australia, in 1992. It offers a model for management of first-episode psychosis, utilising principles of early detection, low-dose medication and comprehensive psychosocial interventions within the least restrictive setting. METHOD: Data were examined from the first three months of treatment for all consecutive people with first-episode psychosis (n = 231) accepted in the programme in 1995-1996. A subsample of patients (n = 120) was assessed comparing clinical ratings with variables of gender, diagnosis, hospitalisation, and medication. RESULTS: Hospitalisations were brief, and avoided for a third of the people. Low-dose antipsychotic medication was maintained in both in-patient and community settings. Those people with manic psychosis were more likely to be hospitalised. Hospitalised people received higher antipsychotic dosages, and had a greater rate of reduction in Brief Psychiatric Rating Scale psychotic subscale scores at three months follow-up. Eighty per cent of a representative subsample had responded to treatment and 63% were in remission by the end of the three months. CONCLUSION: This naturalistic study suggests that the feasibility of implementing the EPPIC model in a range of clinical settings is promising and applicable in practice.
Adult↗
Cognitively-oriented psychotherapy for early psychosis (COPE). Preliminary results.
BACKGROUND: The present study describes the results of the pilot testing of a therapy we have developed for people with first-episode psychosis. Cognitively-oriented psychotherapy for early psychosis (COPE) is aimed at facilitating the adjustment of the person, and at preventing or alleviating secondary morbidity in the wake of the first psychotic episode. METHOD: Eighty people formed three groups: those who were offered and accepted COPE (COPE subjects); those who refused COPE (refusal subjects); and those who were offered neither COPE nor any other continuing treatment from our service (control subjects). The individuals were assessed prior to, and at the end of, COPE treatment (a 12-month period) on the Integration/Sealing Over, Explanatory Model, Scale for the Assessment of Negative Symptoms, Brief Psychiatric Rating Scale, Quality of Life, SCL-90-R, and Beck Depression Inventory measures. RESULTS: People who received COPE obtained significantly superior scores (P < 0.05) to the control group on four of the seven measures but only significantly out-performed the refusal group on one of the seven measures (P < 0.05). The COPE group performed significantly worse on the BDI than the refusal group (P < 0.05). Effect sizes are also provided for each measure. CONCLUSIONS: There seems to be a place for psychological therapy in this group of people but our results need to be replicated in a more definitive randomised controlled trial and such a study is now in progress.
Adult↗
Binding of O-alkyl derivatives of serotonin at human 5-HT1D beta receptors.
In humans, 5-HT1D serotonin receptors represent terminal autoreceptors, and there is some evidence that 5-HT1D ligands may be useful in the treatment of migraine. The most widely used 5-HT1D agonist is sumatriptan; however, this agent reportedly displays little selectivity for 5-HT1D versus 5-HT1A receptors. To identify novel serotonergic agents with enhanced 5-HT1D versus 5-HT1A selectivity, we attempted to take advantage of possible differences in the regions of bulk tolerance associated with the 5-position of the 5-HT binding sites for these two populations of receptors. Examination of a series of 5-(alkyloxy)tryptamine derivatives demonstrated that compounds with unbranched alkyl groups of up to eight carbon atoms bind with high affinity at human 5-HT1D beta receptors (Ki < 5 nM) but demonstrate less than 50-fold selectivity relative to 5-HT1A receptors. Alkyl groups longer than eight carbon atoms impart reduced affinity for 5-HT1A receptors whereas groups longer than nine carbon atoms lead to compounds with reduced affinity at 5-HT1D beta receptors. 5-(Nonyloxy)tryptamine (10) represents a compound with optimal 5-HT1D beta affinity (Ki = 1 nM) and selectivity (> 300-fold). Branching of the alkyl chain, to 5-[(7,7-dimethylheptyl)oxy]tryptamine (15), results in an agent with somewhat lower affinity (5-HT1D beta Ki = 2.3 nM) but with greater (i.e, 400-fold) 5-HT1D versus 5-HT1A selectivity. Replacement of the oxygen atom of 10 with a methylene group (i.e., 20), replacement of the O-proximate methylene with a carbonyl group (i.e., ester 26), or cyclization of the aminoethyl moiety to a carbazole (e.g., 34, 36) or beta-carboline (i.e., 37), result in reduced affinity and/or selectivity. None of the compounds examined displayed significant selectivity for 5-HT1D beta versus 5-HT1D alpha sites; nevertheless, compounds 10 (recently shown to have as a 5-HT1D agonist) and 15 represent the most 5-HT1D versus 5-HT1A selective agents reported to date.
Animals↗
An evaluation of currently available methods for plasma fibrinogen.
Fibrinogen levels in a variety of clinical plasma samples were assessed concurrently by several methods. Technics that appeared to provide the best improvements over the basic varieties of methods for fibrinogen assay were used. Results were correlated against a reference method based on Ancrod clottable fibrinogen and calibrated by ultraviolet absorbance with alkaline solutions of carefully dried fibrin standard. The best correlations with the reference method were achieved by an immunologic method using the Centrifichem principle and by heat precipitation with quantitation by packing in microhematocrit tubes. A modified clot opacity method also gave acceptable results. The turbidimetric ammonium sulfate and sodium sulfite precipitation methods correlated less well with the reference method, and in particular, the sodium sulfite technic gave high apparent fibrinogen levels with jaundiced plasmas. Neither of the turbidimetric methods were useful for fibrinogen levels below 50 mg/dl. The thrombin time method showed excellent sensitivity to fibrinogen, even at very low fibrinogen levels, but did not correlate well with the reference method.
Ammonium Sulfate↗
Third-generation cephalosporin resistance in Shigella sonnei, Argentina.
Shigella sonnei resistant to cefotaxime (but not to ceftazidime) was isolated for the first time in stool samples from a pediatric patient with vomiting and bloody diarrhea in northern Argentina. Microbiologic and biochemical tests confirmed the presence of an extended spectrum beta-lactamase displaying an apparent isoelectric point value of 8.2.
Argentina↗
[Genetic environment of CTX-M-2 in Klebsiella pneumoniae isolates from hospitalized patients in Uruguay].
We studied two CTX-M-2-producing Klebsiella pneumoniae clinical strains, K96005 and K13, isolated from hospitalized patients in Uruguay, during 1996 and 2003, respectively. The genomic surroundings of bla(CTX-M-2) were characterized by PCR-mapping and DNA sequencing. Our results show that blaCTX-M-2 is included in a complex class-1 integron (InK13), associated with an orf513 in both isolates. The genetic array of the integron, aac(6')-lb, bla(OxA,2), orfD (gene cassette region), associated with an orf513-bla(CTX-M-2), seems to be widely disseminated over the Rio de la Plata region.
Base Sequence↗