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Trichophyton simii is considered to be prevalent only in the Indian subcontinent where it was isolated from soil, as well as from infections of humans and animals. We have investigated a case of onychomycosis caused by this exotic dermatophyte, not traceable to endemic areas. This case, as in others due to this fungus in man or animals, that have been previously and sporadically reported worldwide, suggests infections caused by T. simii might be underestimated, especially outside its primary geographic areas. Indeed, there are isolates that do not show species-specific morphology, as in our case isolate, and as a result may be misidentified by classical methods. By checking the identity of some strains preserved in the collection BCCM/IHEM, we found several that proved to be T. simii, originating from non-endemic areas (Belgium, France and Ivory Coast). Therefore, the natural distribution of T. simii is probably not as restricted as has previously been proposed.

A yeast strain was isolated from the sputum sample of a leukaemia patient in the Spirito Santo Hospital of Pescara, Italy. The fungus produced a pigment that formed a reddish halo around colonies, and was identified and deposited as a Metschnikowia spp. (accession number IHEM 25107-GenBank accession number JQ921016) in the BCCM/IHEM collection of biomedical fungi and yeasts (Bruxelles, Belgium). Although the physiology of the strain was close to that of Metschnikowia sinensis, the D1/D2 sequence did not correspond to any previously described Metschnikowia species. Phylogeny of the genus Metschnikowia is complex and requires far more analysis. We present the first non-M. pulcherrima Metschnikowia spp. isolate recovered from a human, and emphasize the role of man as a transient carrier of environmental yeasts, the pathogenicity of which still needs to be defined.

The European species Lactarius subg. Plinthogalus were subjected to a molecular phylogenetic analysis based on ITS, LSU and rpb2 sequences. Morphological characters of the species are discussed in the light of the phylogenetic results. In addition to a broad sampling within Europe, some Asian and North American taxa also were included in the analysis. Eight European species are confirmed molecularly: L. lignyotus, L. acris, L. azonites, L. pterosporus, L. ruginosus, L. romagnesii, L. fuliginosus and L. picinus. Except the sibling species L. fuliginosus and L. picinus, all are morphologically distinct. Our results suggest that L. fuliginosus is associated exclusively with broadleaf trees and L. picinus with conifers, but this putative difference in host specificity needs to be investigated further. Lactarius subruginosus turns out to be a synonym of either L. pterosporus or L. ruginosus. The position of Lactarius terenopus remains to be clarified. The North American taxa that are closely related to the European L. lignyotus (L. fallax, L. lignyotus var. canadensis, var. nigroviolascens, var. marginatus) are not resolved. Intercontinental conspecificity was demonstrated between Europe and northern Asia but was not found between Europe and southern Asia or between Europe and North America. A taxonomic subdivision of L. subg. Plinthogalus based on the height of the spore ornamentation should be rejected.

Trichophyton quinckeanum, known as the causative agent of mouse favus, has been a subject of controversy since its discovery, 125 years ago. The purpose of this study was to examine the phylogenetic relationships between this fungus and related taxa. To achieve this objective, the ITS rDNA region, as well as actin and β-tubulin gene regions of various isolates were sequenced. Bayesian inference and maximum likelihood analyses were conducted with T. rubrum as outgroup. Our study showed that strains identified as T. quinckeanum and others identified as T. schoenleinii are part of the complex T. mentagrophytes, and that their genotype cannot be confused with any other dermatophytes. Furthermore, this study demonstrates that the choice of the neotype of T. mentagrophytes was inappropriate. The beta-tubulin topology also revealed that isolates of T. interdigitale form a genetically distinct population from the type strains of Arthroderma vanbreuseghemii. Therefore, contrary to what is generally accepted, the anthropophilic species T. interdigitale cannot be considered as the anamorph associated with the latter.

A new milkcap species, Lactarius fuscomarginatus, was found in the subtropical region of central Veracruz (eastern Mexico) associated with two relict populations of Fagus grandifolia var. mexicana. The species is characterized macroscopically by its dark pileus and stipe and by its distant and whitish lamellae with blackish to blackish brown edges. A molecular phylogenetic analyses based on ITS and LSU nucDNA sequences confirms the delimitation of this new taxon and places L. fuscomarginatus in subgenus Gerardii. A detailed morphological comparison is given with similar species.

This paper investigates species delimitation within the Lactarius gerardii species complex and explores its taxonomic and geographical extent. A combined molecular phylogeny based on ITS, LSU and rpb2 gene sequences is constructed and morphological characters are evaluated. While L. gerardii was originally described from North America, it has later been reported from all over Asia. Therefore a worldwide sampling range was aimed at, including species exhibiting morphological affinities with L. gerardii. The phylogenetic analyses indicate that intercontinental conspecificity in L. gerardii is absent. Thirty strongly supported clades are retrieved of which 18 are morphologically identifiable species. The group is elevated to Lactarius subg. Gerardii stat. nov. It includes, apart from L. gerardii s.l., L. atrovelutinus, L. bicolor, L. ochrogalactus, L. petersenii, L. reticulatovenosus, L. sepiaceus, L. subgerardii and L. wirrabara, as well as the pleurotoid L. uyedae. The paraphyletic nature of the genus Lactarius is confirmed. Lactarius subg. Gerardii appears not affiliated with L. subg. Plinthogalus and this can be substantiated morphologically. No representatives are known from Europe, Africa or South America. The high frequency of intercontinental sister relationships observed between America, Asia and the Australian region, suggests multiple migration and speciation events have occurred across continents., (Copyright © 2010 The British Mycological Society. Published by Elsevier Ltd. All rights reserved.)

The mission of medical educators in all fields is to perfect the science and the art of training competent physicians and the next generation of leaders. To do this, outcomes research regarding effective training and supervision techniques and curricula, the optimal educational environment, assessment, and remediation of competency is needed. It is incumbent upon training directors to continue to provide the primary leadership for the field of training. The areas that are ripe for research and development include effective curricula, effective evaluation and remediation of competency, and leadership skill development. As medicine becomes more complex, so does the task of training physicians. Joint monitoring and outcomes research of the training enterprise are the scholarly and academic missions of the present and the future.

In this article we propose developmentally informed remedies to the challenges that face research training. The initiatives described in it have been implemented to various degrees at our institution, and several are already being replicated or expanded through strategic partnerships across the country. We are fortunate to work in an environment in which child and adolescent psychiatry is visible and well represented, but we are aware than many of the settings in which education and recruitment needs are most pressing may not have the range of our resources. We view our different programs as seamlessly interconnected with one another but present them as separate entities to facilitate the incorporation of different components into local realities.

Objective: Residency training programs in all areas of medicine are required to identify core competencies expected of all graduates and develop methods to assess and ensure attainment of these competencies. To assist with this process for residency programs in child and adolescent psychiatry, the Work Group on Training and Education of the American Academy of Child and Adolescent Psychiatry has developed several principles of the assessment process and compiled a variety of assessment methodologies for use in assessing competency. The principles of assessment include 1) residents should share responsibility for assessment; 2) assessment should be an open, ongoing and predictable process; 3) a wide range of evaluators should be utilized in the process; 4) residents should demonstrate competency in a variety of formats; 5) the goal is for 100% of residents to achieve core competencies., Methods: Sample methods of assessment are provided in the report with special attention to how the method could be used in child and adolescent psychiatry., Conclusion: A multi-method, multi-evaluator for process of assessment is recommended.

Objectives: The authors sought to determine the prevalence, patterns, and demographic correlates of multiple psychotropic pharmacotherapy in a statewide sample of low-income children and adolescents in community-based clinical care., Methods: The Medicaid managed care database of the Connecticut Department of Social Services was the source of linked encounter and pharmacy information for the one-year period ending June 30, 1999. Period prevalence was calculated for children and adolescents ranging in age from newborn through 18 years who had any psychotropic drug prescription claims during the study period. For each participant, multiple psychotropic pharmacotherapy was defined as having claims for prescriptions for medications in two or more different psychotropic drug classes during a seven-day period. Age, gender, race, and state custody status were examined across groups, and multiple psychotropic pharmacotherapy patterns were identified., Results: Of the 196,505 youths in Medicaid managed care, 9,447 received at least one psychotropic medication, yielding a period prevalence of 4.8 percent. Among youths who received psychotropics, 13.6 percent had received multiple psychotropic pharmacotherapy. Multivariate logistic regression revealed that participants who received psychotropics, alone or in combination, were significantly more likely to be in state custody, male, and older than other participants and less likely to be African American or Hispanic. Stimulants, antidepressants, and mood stabilizers were the most commonly dispensed agents. The most common drug class combinations were an antidepressant plus an antipsychotic, a stimulant plus an antidepressant, and a stimulant plus an alpha(2) agonist., Conclusions: Our findings revealed sociodemographic differences in psychopharmacological care among young Medicaid managed care enrollees and the common occurrence of multiple psychotropic pharmacotherapy.

Today, the question of the physiological cause of phase transition, the transition from the solitary to the gregarious phase, in locusts remains unanswered. We hereby present a novel approach by which we have attempted to determine whether different phases express or release different peptides in similar physiological conditions. For this purpose, a peptidomic analysis of the corpora cardiaca and hemolymph of crowded and isolated locusts of Schistocerca gregaria was performed using high performance liquid chromatography and matrix-assisted laser desorption ionisation time of flight mass spectrometry. A comparison between the two conditions reveals differences in the number and amount of peptides present in the corpora cardiaca and the hemolymph. Further research will have to identify these phase specific differences and their role in locust phase polymorphism.

Research concerning ADHD and cost-effective and efficacious treatments of the core deficits and concomitant functional impairments is burgeoning. Substantial gains have been made in elucidating effective treatment modalities for the complex neuropsychiatric disorder of ADHD. Much remains to be investigated in order to gain a more thorough understanding of the differential contributions of psychosocial and medication treatments to the long-term outcome of this complex disorder.

There have been "modern" descriptions of ADHD in the medical literature since 1902. Despite the burgeoning growth of information about the cause, pathophysiology, and effective treatments of the disorder, ADHD has been particularly steeped in controversy, especially regarding the use of medication (safety, efficacy, use or overuse, and concerns about medication treatment of preschool children). Changing diagnostic criteria, evolving conceptualizations of the disorder, and international differences in diagnosis, have enhanced and complicated ongoing research and understanding of the disorder. The recent Multimodal Treatment Study of Children with ADHD, a large, multisite study comparing efficacy of behavioral, medication, and combined treatments, and a recent NIH Consensus Conference on ADHD, represent true advances in the scientific understanding of the disorder and its treatment.

There has been recent concern by the public and physicians alike over reports that increasing numbers of young children are being prescribed psychotropic medications. The report by Zito and colleagues addressing this subject that appeared in the 23 February 2000 issue of JAMA sparked enormous controversy and was the impetus for a White House Conference just one month in its wake (20 March 2000). State and federal agencies have considered legislation to regulate the practice of prescribing psychotropic medications to preschool children. Special aspects of the use of psychotropic medication in preschool children are reviewed, with recommendations for evaluation and treatment decisions. The need for data and research in this area is highlighted.

The association between expressed emotion (EE) and psychiatric disorders was investigated in a community survey of 108 preadolescent children. Results indicated that the two components of EE, critical comments and emotional overinvolvement, identified non-overlapping subsets of families and displayed diagnostic specificity. Significantly higher rates of disruptive behavior diagnoses were observed in children of parents who expressed high levels of criticism, while children of parents who expressed high levels of emotional overinvolvement were significantly more likely to have an anxiety disorder when compared to the remaining sample. Findings support the utility of this brief measure of EE in epidemiologic samples.