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Introduction: Individuals who strive autonomously for their goals, and who perceive autonomy supportive environments are more successful during goal pursuit. What dispositional factors predict autonomy flourishing during goal pursuit? Methods: Four longitudinal studies were conducted over an 8‐month academic year, and university students (Ntotal = 1,544) completed surveys on motivation, support, and personality. Structural equation models were created using Mplus software to test whether collaborative personality factors were related to growth in autonomous motivation and autonomy support. Results: All three distinct collaborative personality factors, trait Agreeableness, assisted autonomy striving, and secure parental attachment, were related to increases in autonomous motivation over the academic year. Conscientiousness, assisted autonomy, and secure attachment were related to increases in perceived autonomy support. A higher order latent collaborative traits factor, composed of Agreeableness, assisted autonomy, and secure attachment was found to be related to increased autonomous motivation and support over the academic year and resulted in increased goal progress. Conclusion: These results suggest that individuals higher in collaborative personality factors experience growth in personal autonomy during goal pursuit. Future research is needed to determine how to promote collaboration in goal pursuit to further help individuals successfully strive for their goals. [ABSTRACT FROM AUTHOR]

Objectives: To determine the feasibility and tissue yield of a perinatal incisionless ultrasound-guided biopsy procedure, the INcisionless Targeted Core Tissue (INTACT) technique, in the context of minimally invasive autopsy.Methods: Cases of perinatal death in which the parents consented for minimally invasive autopsy underwent postmortem magnetic resonance imaging and an INTACT biopsy procedure, defined as needle biopsy of organs via the umbilical cord, performed under ultrasound guidance. In each case, three cores of tissue were obtained from seven target organs (both lungs, both kidneys, heart, spleen and liver). Biopsy success was predefined as an adequate volume of the intended target organ for pathological analysis, as judged by a pathologist blinded to the case and biopsy procedure.Results: Thirty fetuses underwent organ sampling. Mean gestational age was 30 weeks (range, 18-40 weeks) and mean delivery-to-biopsy interval was 12 days (range, 6-22 days). The overall biopsy success rate was 153/201 (76.1%) samples, with the success rates in individual organs being highest for the heart and lungs (93% and 91%, respectively) and lowest for the spleen (11%). Excluding splenic samples, the biopsy success rate was 150/173 (86.7%). Histological abnormalities were found in 4/201 (2%) samples, all of which occurred in the lungs and kidneys of a fetus with pulmonary hypoplasia and multicystic kidney disease.Conclusions: Incisionless ultrasound-guided organ biopsy using the INTACT procedure is feasible, with an overall biopsy success rate of over 75%. This novel technique offers the ideal combination of an imaging-led autopsy with organ sampling for parents who decline the conventional invasive approach. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Objective : The role of baseline severity as effect modifier in various psychiatric disorders is a topic of controversy and of clinical import. This study aims to examine whether baseline severity modifies the efficacy of various antidepressants for major depression through individual participant data (IPD) meta‐analysis. Method: We identified all placebo‐controlled, double‐blind randomised trials of new generation antidepressants in the acute phase treatment of major depression conducted in Japan and requested their IPD through the public–private partnerships (PPPs) between the relevant academic societies and the pharmaceutical companies. The effect modification by baseline depression severity was examined through six increasingly complex competing mixed‐effects models for repeated measures. Results: We identified eleven eligible trials and obtained IPD from six, which compared duloxetine, escitalopram, mirtazapine, paroxetine or bupropion against placebo (total n = 2464). The best‐fitting model revealed that the interaction between baseline severity and treatment was not statistically significant (coefficient = −0.04, 95% confidence interval: −0.16 to 0.08, P = 0.49). Several sensitivity analyses confirmed the robustness of the findings. Conclusion: We may expect as much benefit from antidepressant treatments for mild, moderate or severe major depression. Clinical practice guidelines will need to take these findings into consideration. [ABSTRACT FROM AUTHOR]

Copyright of Ultrasound in Obstetrics & Gynecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives Guidelines for the investigation of intrauterine death and sudden unexpected death in infancy (SUDI) recommend, based on expert opinion, autopsy procedures and tissue sampling strategies for histological analysis. Although stillbirth is much more common than SUDI, there have been no large-scale studies published which evaluate the usefulness of histological evaluation of specific organs in stillbirth for determining cause of death. Our aim was to evaluate the use of macroscopic and microscopic assessment of internal organs to determine cause of intrauterine death. Methods As part of a larger study evaluating several aspects of autopsy findings in intrauterine death, a dedicated database was used to collate antenatal and postmortem examination details for cases of intrauterine death examined between 2005 and 2013 at two tertiary specialist centers in London, UK. Histological findings for all organs were examined in relation to the final cause of death, as determined by objective criteria. Results Among 1064 intrauterine deaths, the majority (>80%) of cases had internal organs that were normal on both macroscopic and microscopic examination. There was no case in which histological cardiac examination provided the cause of death when the macroscopic appearance of the heart was normal. Microscopic examination of lung tissue revealed 13 (1%) cases with histological abnormalities that provided the cause of death when the macroscopic appearance was normal, but there was only one (0.1%) case in which the diagnosis would not have been apparent on placental examination: a case of congenital cytomegalovirus infection. There was no case in which microscopic examination of macroscopically normal liver, kidneys, adrenals, spleen, thymus, intestines, pancreas, brain or thyroid provided the cause of death. Conclusion In this large series of autopsies in cases of intrauterine death, only around 1% of cases demonstrated histological abnormalities which provided the cause of death when the internal organs appeared normal macroscopically. There was no case in which routine histological examination of most tissues provided diagnostically useful information that was not apparent from other examinations, such as placental pathology. There is little benefit, purely in terms of determining cause of death, in obtaining tissue from most macroscopically normal organs for routine histological examination. [ABSTRACT FROM AUTHOR]

Copyright of Ultrasound in Obstetrics & Gynecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ultrasound in Obstetrics & Gynecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Ultrasound in Obstetrics & Gynecology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Guidelines for the investigation of intrauterine death and sudden unexpected death in infancy (SUDI) recommend, based on expert opinion, autopsy procedures and tissue sampling strategies for histological analysis. Although stillbirth is much more common than SUDI, there have been no large-scale studies published which evaluate the usefulness of histological evaluation of specific organs in stillbirth for determining cause of death. Our aim was to evaluate the use of macroscopic and microscopic assessment of internal organs to determine cause of intrauterine death.Methods: As part of a larger study evaluating several aspects of autopsy findings in intrauterine death, a dedicated database was used to collate antenatal and postmortem examination details for cases of intrauterine death examined between 2005 and 2013 at two tertiary specialist centers in London, UK. Histological findings for all organs were examined in relation to the final cause of death, as determined by objective criteria.Results: Among 1064 intrauterine deaths, the majority (> 80%) of cases had internal organs that were normal on both macroscopic and microscopic examination. There was no case in which histological cardiac examination provided the cause of death when the macroscopic appearance of the heart was normal. Microscopic examination of lung tissue revealed 13 (1%) cases with histological abnormalities that provided the cause of death when the macroscopic appearance was normal, but there was only one (0.1%) case in which the diagnosis would not have been apparent on placental examination: a case of congenital cytomegalovirus infection. There was no case in which microscopic examination of macroscopically normal liver, kidneys, adrenals, spleen, thymus, intestines, pancreas, brain or thyroid provided the cause of death.Conclusion: In this large series of autopsies in cases of intrauterine death, only around 1% of cases demonstrated histological abnormalities which provided the cause of death when the internal organs appeared normal macroscopically. There was no case in which routine histological examination of most tissues provided diagnostically useful information that was not apparent from other examinations, such as placental pathology. There is little benefit, purely in terms of determining cause of death, in obtaining tissue from most macroscopically normal organs for routine histological examination. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

Eastern Shore of Virginia red, round tomatoes contaminated with Salmonella serotype Newport pattern JJPX01.0061 have been a source of several multistate outbreaks within the last 10 years. No source of the contamination has yet been identified. The goal of this study was to evaluate wildlife as a potential source of contamination. Faecal samples from deer, turtles and birds were collected between November 2010 and July 2011 from seventeen locations on the Eastern Shore of Virginia. A total of 262 samples were tested for the presence of Salmonella using an enzyme-linked immunosorbent assay ( ELISA). A total of 23 (8.8%) samples tested positive for Salmonella spp. and were further characterized by serotyping and pulsed-field gel electrophoresis ( PFGE) subtyping. Overall, twelve serotypes were identified, including Salmonella serotype Javiana, another common serotype associated with tomato-related outbreaks. Only one avian sample collected in July 2011 was determined to be positive for S. Newport pattern 61. This sample was collected from the ground at a site where birds, mostly gulls, were congregating. Although many of the avian samples from this site were dry, the site yielded eleven positive Salmonella samples. This suggests that certain Salmonella serotypes may persist in the environment despite extreme conditions. The recovery of one Newport pattern 61 isolate alone does not yield much information regarding the environmental reservoirs of this pathogen, but when combined with other data including the recovery of several isolates of Javiana from birds, it suggests that birds might be a potential source of Salmonella contamination for tomatoes on the Eastern Shore. [ABSTRACT FROM AUTHOR]

Outbreaks of human salmonellosis associated with live poultry contact have been reported since 1955. Multiple Salmonella serotypes have been associated with these outbreaks, and specific outbreak strains have been repeatedly linked to single hatcheries over multiple years. During 2009, four multistate outbreaks of human Salmonella infections associated with direct and indirect exposure to live poultry purchased from mail-order hatcheries and agricultural feed stores were identified, resulting in 165 culture-confirmed cases in 30 states. This report describes the epidemiologic, environmental and laboratory investigations conducted by state and local health departments, state departments of agriculture, the U.S. Department of Agriculture (USDA), Animal and Plant Health Inspection Service (APHIS), National Poultry Improvement Plan (NPIP) and National Veterinary Services Laboratories (NVSL), and the Centers for Disease Control and Prevention (CDC). Case-patients were identified through PulseNet, the national molecular subtyping network for foodborne disease surveillance, and interviewed using the CDC standard live poultry contact questionnaire that asks about poultry-related exposures during the 7 days before illness onset. These outbreaks highlight the need to focus efforts on strategies to decrease and prevent human illness associated with live poultry contact through comprehensive interventions at the mail-order hatchery, agricultural feed store and consumer levels. Additional consumer education and interventions at mail-order hatcheries and venues where live poultry are sold, including agricultural feed stores, are necessary to prevent transmission of Salmonella from poultry to humans. [ABSTRACT FROM AUTHOR]

Background Little is known about the degree to which baboons, an important animal model in skeletal research, spontaneously experience age-related osteopenia and osteoporosis. Methods We measured bone mineral density (BMD) in 667 baboons, assigned T-scores to older animals based on sex-specific young adult reference groups, and compared reproductive history in older females with low BMD to those with normal BMD. Results Approximately 25% of older baboon females were osteopenic. No females or males were osteoporotic. Neither parity nor interbirth interval spine clearly distinguished low vs. normal BMD groups. Intersite correspondence in low BMD was highest between sites in the same region rather than sites of the same bone type. Conclusion As with humans, osteopenia is common among older females. The absence of osteoporotic animals may be due to colony maintenance resulting in truncation of the aged population and selection for healthier animals in the oldest ranges. [ABSTRACT FROM AUTHOR]

Discussion boards have the unique capacity to support higher-order constructivist learning and the development of a learning community, This chapter provides ten conditions that support the effective use of an online discussion. [ABSTRACT FROM AUTHOR]

The postnatal development of the mouse is characterised by a period of hypo-responsiveness of the hypothalamic-pituitary-adrenal (HPA) axis to moderate stressors. Maternal separation disinhibits this blockade of the HPA axis, but the mechanism responsible is not clear. The present study examined the influence of metabolic signals on the central and peripheral components of the HPA axis in neonatal mice aged 8 days in absence or presence of the mother. Reductions in plasma glucose and leptin as well as rapid increases in plasma ghrelin were apparent in the neonate 4 h following maternal deprivation and maximal at 8 h. In addition, maternal separation induced an increase of neuropeptide Y (NPY) mRNA expression in the arcuate nucleus, a decrease of corticotrophin-releasing hormone (CRH) mRNA expression in the paraventricular nucleus and a rise in serum corticosterone. Pharmacological manipulation of the metabolic signals attenuated the HPA response to maternal separation. Thus, the rise in plasma corticosterone induced by maternal separation was ameliorated by prevention of reduction in blood glucose or blockade of the ghrelin signalling pathway, as were the hypothalamic changes in NPY and CRH mRNAs. By contrast, leptin treatment did not affect the HPA axis response to maternal separation. Together these results suggest that metabolic signals play an important role in triggering the HPA response of the neonate to maternal separation. [ABSTRACT FROM AUTHOR]

In the adult, corticotropin-releasing hormone (CRH) is the key mediator for the behavioural and neuroendocrine response to stress. It has also been hypothesized that, during postnatal development of the stress system, CRH controls the activity of the HPA axis and mediates the effects of early disturbances, e.g. 24 h of maternal deprivation. In the current study we investigated the function of specific brain corticotropin-releasing hormone receptor type 1 (CRHR1) subpopulations in the control of the HPA axis during postnatal development under basal conditions as well as after 24 h of maternal deprivation. We used two conditional CRHR1-deficient mouse lines which lack this receptor, either specifically in forebrain and limbic structures (Cam-CRHR1) or in all neurons (Nes-CRHR1). Basal circulating corticosterone was increased in Nes-CRHR1 mice compared to controls. Corticosterone response to maternal deprivation was significantly increased in both CRHR1-deficient lines. In the paraventricular nucleus, Cam-CRHR1 animals displayed enhanced CRH and decreased vasopressin expression levels. In contrast, gene expression in Nes-CRHR1 pups was strikingly similar to that in maternally deprived control pups. Furthermore, maternal deprivation resulted in an enhanced response of Cam-CRHR1 pups in the brain, while expression levels in Nes-CRHR1 mouse pups were mostly unchanged. Our results demonstrate that brainstem and/or hypothalamic CRHR1 contribute to the suppression of basal corticosterone secretion in the neonate, while limbic and/or forebrain CRHR1 dampen the activation of the neonatal HPA axis induced by maternal deprivation. [ABSTRACT FROM AUTHOR]

Aims : To describe the spectrum of histopathological features encountered in children with chronic granulomatous disease (CGD) at a specialist centre. Methods and results : The histopathological findings of 88 surgical pathology requests from a range of organ systems including upper and lower gastrointestinal tract biopsy series, liver, bladder, bone, lung, skin, soft tissue, bone marrow and lymph node biopsy specimens, in 32 patients aged 4 months to 18 years (median 7 years) with CGD were reviewed. In most tissues the features were those of active chronic inflammation, with or without abscess or granuloma formation, often associated with fungal infection. In some tissues, more characteristic findings were identified, including the presence of pigmented macrophages, especially in hepatic sinusoids and colonic mucosa, where active chronic eosinophil predominant colitis was also observed. Conclusions : Chronic granulomatous disease may present to histopathologists in a wide range of tissue specimens most often demonstrating features of active chronic inflammation with or without granuloma formation. The presence of numerous pigmented macrophages in association with such inflammation should raise suspicion of the diagnosis. In addition, diffuse granulomatous inflammation of the lung and hepatic abscess formation should be regarded as suggestive of the diagnosis. [ABSTRACT FROM AUTHOR]

1. The sources of nitrogen for phytoplankton were determined for a bloom-prone lake as a means of assessing the hypothesis that cyanobacteria dominate in eutrophic lakes because of their ability to fix nitrogen when the nitrogen : phosphorous (N : P) supply ratio is low and nitrogen a limiting resource. 2. Nitrogen fixation rates, estimated through acetylene reduction with 15N calibration, were compared with 15N-tracer estimates of ammonium and nitrate uptake monthly during the ice-free season of 1999. In addition, the natural N stable isotope composition of phytoplankton, nitrate and ammonium were measured biweekly and the contribution of N2 to the phytoplankton signature estimated with a mixing model. 3. Although cyanobacteria made up 81–98% of phytoplankton biomass during summer and autumn, both assays suggested minimal N acquisition through fixation (<9% for the in-situ incubations; <2% for stable isotope analysis). Phytoplankton acquired N primarily as ammonium (82–98%), and secondarily as nitrate (15–18% in spring and autumn, but <5% in summer). Heterocyst densities of <3 per 100 fixer cells confirmed low reliance on fixation. 4. The lake showed symptoms of both light and nitrogen limitation. Cyanobacteria may have dominated by monopolizing benthic sources of ammonium, or by forming surface scums that shaded other algae. [ABSTRACT FROM AUTHOR]

A close contact between the dam and the litter is essential for the normal development of the hypothalamic-pituitary-adrenal (HPA) axis in rats and mice. Maternal signals, as licking and feeding, have been shown to sustain the HPA axis of the pups in a hypo-responsive state. Disruption of this mother–pup interaction by 24 h of maternal deprivation activates the otherwise quiescent stress system of the neonates, resulting in an enhanced adrenal sensitivity to adrenocorticotropic hormone (ACTH) and a decreased expression of central HPA markers, such as corticotropin-releasing hormone (CRH). However, the dynamics of these central and peripheral changes over the 24h period are largely unknown. In this study, we examined the time course of some of the central and peripheral indices of HPA activity during 24 h of maternal deprivation. We measured corticosterone and ACTH in the blood as well as CRH, mineralocorticoid and glucocorticoid receptor expression in the brain. Our results demonstrate that each of the components of the HPA axis responds to maternal deprivation at different time points following removal of the mother and with a very specific time course. The main activation of the HPA axis occurred between 4 h and 8 h of maternal absence. By contrast, during the second half of the deprivation period, negativefeedback mechanisms restrained the further increase in ACTH and corticosterone release. We conclude that maternal deprivation triggers a cascade of sequential changes at the various levels of the stress system, and that measuring only one aspect of the system at one time point does not accurately reflect the dynamic alterations of the HPA axis. [ABSTRACT FROM AUTHOR]

The main characteristic of the postnatal development of the stress system in the rat is the so-called stress hypo-responsive period (SHRP). Lasting from postnatal day (pnd) 4 to pnd 14, this period is characterized by very low basal corticosterone levels and an inability of mild stressors to induce an enhanced ACTH and corticosterone release. During the last years, the mouse has become a generally used animal in stress research, also due to the wide availability of genetically modified mouse strains. However, very few data are available on the ontogeny of the stress system in the mouse. This study therefore describes the postnatal ontogeny of peripheral and central aspects of the hypothalamic–pituitary–adrenal (HPA) axis in the mouse. We measured ACTH and corticosterone in blood and CRH, urocortin 3 (UCN3), mineralocorticoid receptor (MR) and glucocorticoid receptor (GR) transcripts in the brain at postnatal days 1, 2, 4, 6, 9, 12, 14 and 16. Our results show that we can subdivide the postnatal development of the HPA axis in the mouse in two phases. The first phase corresponds to the SHRP in the rat and lasts from right after birth (pnd 1) until pnd 12. Basal corticosterone levels were low and novelty exposure did not enhance corticosterone or ACTH levels. This period is further characterized by a high expression of CRH in the paraventricular nucleus (PVN) of the hypothalamus. Expression levels of GR in the hippocampus and UCN3 in the perifornical area are low at birth but increase significantly during the SHRP, both reaching the highest expression level at pnd 12. In the second phase, the mice have developed past the SHRP and were now exhibiting enhanced corticosterone basal levels and a response of ACTH and corticosterone to mild novelty stress. CRH expression was decreased significantly, while expression of UCN3 and GR remained high, with a small decrease at pnd 16. The expression of MR in the hippocampus was very dynamic throughout the postnatal development of the HPA axis and changed in a time and subregion specific manner. These results demonstrate for the first time the correlation between the postnatal endocrine development of the mouse and gene expression changes of central regulators of HPA axis function. [Copyright &y& Elsevier]

Rats dehydrated by 6 days of water deprivation had a low level of mitotic activity in the astrocytes ('pituicytes') of the neural lobe of the pituitary. Mitotic activity in the pituicytes was greatly increased when isotonic lithium was administered in the last 3 days of water deprivation. Rehydration on the last day of the experiment produced a further increase in mitoses. Isotonic solutions of sodium, potassium or rubidium chloride did not increase mitoses. This model of cell proliferation is of interest because the mitotic activity is related to a physiological attempt to maintain homeostasis rather than a response to injury or the development of neoplasia. [ABSTRACT FROM AUTHOR]

Abstract There is a large body of evidence that the development of the hypothalamic-pituitary-adrenal (HPA) system in the rat is under maternal regulation. One method used to study the influence of the dam–pup interaction in neonates and weanlings is the separation of mother and litter for 24 h. Previous studies showed that, even at the time of weaning, maternal deprivation results in a dysregulation of the HPA axis at multiple levels. However, the maternal deprivation paradigm usually includes deprivation of food and water, and it was not clear to which extent the observed effects are due to either maternal cues or dehydration and fasting. The primary purpose of the present study was to determine the role of fasting and/or maternal separation on the HPA axis at the time of weaning. Pups at 20 days after parturition are capable of self-feeding and no longer require tactile stimulation to induce eliminative functions. The results indicated that 24 h of fasting led to increased basal levels and further increases in stress induced corticosterone secretion. Fasting also appeared to contribute to the down regulation of basal glucocorticoid receptor mRNA in the hippocampus. In contrast, abrupt weaning irrespective of fasting or dehydration resulted in a suppressed adrenocorticotropin hormone response to an injection of isotonic saline. Although there was an effect of maternal separation on corticotropin-releasing factor mRNA in the paraventricular nucleus, this effect was further exacerbated by the absence of food. Finally, all rats that were separated from their dams showed more efficient negative-feedback. Thus, different aspects of the HPA system appear to respond differentially to either the absence of food or the absence of the mother or both. [ABSTRACT FROM AUTHOR]

Investigates the presence of mitotic figures in the neural lobe of the rat pituitary in the United States. Influence of lithium on cell proliferation; Examination on the effect of lithium chloride on the central nervous system of nephrectomized rats; Establishment of morphologic criteria.

Filamentous fungal infections are associated with high morbidity and mortality in solid organ transplant patients, and prevention is warranted whenever possible. An increase in invasive aspergillosis was detected among solid organ transplant recipients in our institution during 1991–92. Rates of Aspergillus infection (18.2%) and infection or colonization (42%) were particularly high among lung transplant recipients. Epidemiologic investigation revealed cases to be both nosocomial and community-acquired, and preventative efforts were directed at both sources. Environmental controls were implemented in the hospital, and itraconazole prophylaxis was given in the early period after lung transplantation. The rate of Aspergillus infection in solid organ transplant recipients decreased from 9.4% to 1.5%, and mortality associated with this disease decreased from 8.2% to 1.8%. The rate of Aspergillus infection or colonization among lung transplant recipients decreased from 42% to 22.5%; nosocomial Aspergillus infection decreased from 9% to 3.2%. Cases of aspergillosis in lung transplant recipients were more likely to be early infections in the pre-intervention period. Early mortality in lung transplant recipients decreased from 15% to 3.2%. Two cases of dematiaceous fungal infection were detected, and no further cases occurred after environmental controls. The use of environmental measures that resulted in a decrease in airborne fungal spores, as well as antifungal prophylaxis, was associated with a decrease in aspergillosis and associated mortality in these patients. Ongoing surveillance and continuing intervention is needed for prevention of infection in high-risk solid organ transplant patients. [ABSTRACT FROM AUTHOR]

A multicentre parallel group study was carried out to compare the efficacy and safety of remoxipride, a new antipsychotic drug, with haloperidol in the treatment of acute schizophrenia. Patients were randomly assigned to the two groups and assessments were made under double-blind conditions. Treatment was preceded by a washout period and lasted 6 weeks. Eighty-nine consecutively admitted men and women meeting the Research Diagnostic Criteria for schizophrenia in an acute phase of the illness were treated with remoxipride 75-300mgb.d. or haloperidol 5 -20 mg b.d. The main assessments were changes in scores on the Brief Psychiatric Rating Scale, Krawieeka Rating Scale and Clinical Global Impression. Both neuroleptics produced clinical improvement but there were no significant differences in overall efficacy measurements between the two drugs. There were relatively few unwanted side-effects. There were significantly less extra-pyramidal symptoms and blurred vision with remoxipride, and less constipation with haloperidol. The results indicate that remoxipride is an effective antipsychotic drug with a low incidence of extrapyramidal side-effects. [ABSTRACT FROM AUTHOR]

Litters from donor mothers received differential treatments (handling or shocking) and were then placed in wire-mesh baskets affixed to the cage tops of test mothers. Pup-produced cues from donor litters elicited different patterns of maternal behavior from test mothers that interacted with their own litters. In addition to these differences in maternal behavior, cues from the donor litters elicited a differential pattern of pituitary-adrenal activity. Shocked pups elicited larger corticosterone elevations than handled pups. These data suggest that the elimination of differential pituitary-adrenal responsiveness evidenced when mothers interact directly with pups subsequent to pup treatment results from the termination of pup-produced cues that normally accompany active mother-infant interactions. [ABSTRACT FROM AUTHOR]

The first 100 patients in a series of 616 cerebellopontine angle tumors were compared to the most recent 100 patients. All of the first 100 patients were evaluated prior to the common use of CT or ABR. Recently, improved diagnostic studies have resulted in the discovery of significantly smaller tumors. The later group of patients was also found to have their symptoms for a shorter period of time and had better overall hearing at the time of diagnosis. Reductions in the rates of various complications were also observed. These trends are felt to be the direct result of improved audiologic and radiologic diagnostic studies. A heightened awareness of all otolaryngologists to seek the diagnosis of acoustic neuroma also improved early diagnosis. [ABSTRACT FROM AUTHOR]

Tinnitus is a frequent presenting symptom. Tinnitus that is rhythmic and synchronous with the patient's heartbeat is rare. Pulsatile tinnitus may be the only symptom of life-threatening and treatable diseases. The presence of hearing loss or vertigo focuses the diagnostic evaluation. The cause of pulsatile tinnitus may be found on otoscopic examination. Audiologic assessment and enhanced computed tomography often contribute to the diagnosis. Increased intracranial pressure should be excluded with a fundoscopic examination. Arteriography is required to diagnose life-threatening and treatable lesions in the presence of normal otoscopy, audiologic assessment, and enhanced computed tomography. [ABSTRACT FROM AUTHOR]

Reconstruction of large laryngotracheal defects may require simultaneous application of more than one surgical technique. This paper reports the advantages gained by combining epiglottic laryngoplasty with the myocutaneous sternohyoid muscle rotary door flap. The two procedures complement each other in achieving structural and functional rehabilitation of extensive defects in the larynx and trachea. Avoidance of intraluminal stents and use of a tracheostomy procedure that does not require an indwelling cannula have yielded improved results. [ABSTRACT FROM AUTHOR]

Effective utilization of blood and blood products is an important consideration in elective surgical procedures. A cost-effective process will maintain availability to the general population while supplying reasonable surgical needs. Removing stored blood from the general pool strains these resources and drastically increases cost. To establish the first clinical model of study and to better predict blood requirements for elective surgery of the larynx and neck, medical records of 137 consecutive patients who underwent laryngeal surgery from January 1, 1981 to June 30, 1984 were reviewed. All patients had one or a combination of one of the following: radical neck dissection, total laryngectomy, hemilaryngectomy, and/or supra-glottic laryngectomy. Data analyzed included estimated allowable blood loss, estimated intraoperative blood loss, as well as preoperative and postoperative blood hemoglobin concentrations. Actual blood utilization was adjusted for individual patient need, and recommendations for appropriate blood screen and crossmatch were derived for each of the above surgical procedures. It was concluded that blood availability for the individual patient is best assessed by the surgeon. [ABSTRACT FROM AUTHOR]

Contemporary otomicrosurgical techniques have made total removal of acoustic tumor with preservation of the seventh and sometimes the eighth cranial nerves possible. The four approaches currently used in acoustic tumor surgery are the middle cranial fossa, the translabyrinthine, the suboccipital, and the combined translabyrinthine-suboccipital. This review examines the surgical results in the removal of more than 600 acoustic tumors and outlines a rationale for the choice of approach. Tumor size on computed tomographic scan and auditory reserve establish the parameters used in planning the surgical procedure. The translabyrinthine exposure is used most frequently followed by the combined translabyrinthine-suboccipital. The middle fossa and suboccipital approaches are used when preservation of hearing is attempted. Total removal of tumor was accomplished in more than 99% of patients with a mortality rate of less than 1%. Anatomic preservation of the facial nerve, which is directly related to tumor size, was achieved in more than 80% of patients. Preservation of hearing is unlikely when the tumor is larger than 2 cm; anatomic preservation of the cochlear nerve was successful in 73% of hearing preservation procedures. [ABSTRACT FROM AUTHOR]