OBJECTIVE

Previous studies have suggested that somatoform disorders (SFD) might be associated with changes in the function of the central and autonomic nervous systems. The aim of this study was to examine the possible immunological differences between SFD and healthy controls.

METHODS

Twenty-four patients with SFD and 13 healthy individuals completed the psychological questionnaires to assess symptom reporting [Symptom Checklist-90 Revised (SCL-90-R)] and to diagnose for SFD [Screening for Somatoform Symptoms scale (SOMS-scale)]. Participants also provided a blood sample taken in the morning, which was analysed with an automated cell counter to determine the number of leucocytes per μl and with flow cytometry to determine lymphocyte subsets.

RESULTS

With the exception of a higher T4/T8 ratio in the patient group, which was mainly because of lower CD8 counts, there were no significant differences in the absolute number of lymphocytes (subsets) between patients with SFD and healthy subjects. A positive correlation between B-lymphocyte subsets (CD19+CD22+, CD19+CD5+, CD19+CD3-) to all scales of the SCL-90-R, except somatisation, were found in SFD. Additionally, a positive correlation was found in SFD between CD14+CD16+ monocytes and somatisation (0.573) on the SCL-90-R scale.

CONCLUSIONS

These data indicate that patients with SFD have an enhanced humoral immunity as shown by increased B-cell numbers and furthermore an elevated T4/T8 ratio because of lower CD8 suppressor cells. Further studies will be required to determine whether these alterations in lymphocyte subsets are directly involved in the pathophysiology of SFD.

In this study, 56 patients affected by schizophreniform disorder (SFD), as their first lifetime mental disorder, were re-evaluated 7.9+/-4.7 yrs (2-17 yrs) after their first hospitalization. At follow-up, schizophrenia (SC) was diagnosed in 25 patients (46%), a mood disorder (MD) in 19 (35%), a non-SC psychotic disorder in 10 (18%) and no disorder in 2 (4%). The evolution towards SC was predicted by the presence of blunted affect (OR: 1.88) and by poor pre-morbid functioning (OR: 1.10) at the index hospitalization. Our data suggest that SFD may represent the first psychotic presentation of different disorders and the evolution towards SC or a MD seems to be influenced by the pre-morbid level of functioning and by the presence of blunted affect.

We report an efficient high-power self-frequency-doubling (SFD) Nd:GdCOB laser. The maximum output power is 3.01 W at a wavelength of 545 nm with an optical efficiency of 20.7%, which, to our knowledge, is the highest SFD laser output power and efficiency yet obtained. By optimizing the configuration and cut orientation of the Nd:GdCOB crystals, a SFD laser at a wavelength of about 530 nm was achieved with a maximum output power of 1.32 W. We propose that these SFD lasers will have promise in applications such as laser displays, medical treatment, spectroscopic analysis, etc.

Magnetic dot arrays with perpendicular magnetic anisotropy were fabricated by patterning Co(80)Pt(20)-alloy continuous films by means of laser interference lithography. As commonly seen in large dot arrays, there is a large difference in the switching field between dots. Here we investigate the origin of this large switching field distribution, by using the anomalous Hall effect (AHE). The high sensitivity of the AHE permits us to measure the magnetic reversal of individual dots in an array of 80 dots with a diameter of 180 nm. By taking 1000 hysteresis loops we reveal the thermally induced switching field distribution SFD(T) of individual dots inside the array. The SFD(T) of the first and last switching dots were fitted to an Arrhenius model, and a clear difference in switching volume and magnetic anisotropy was observed between dots switching at low and high fields.

We present a Monte Carlo (MC) method to determine depth-dependent probability distributions of photon visitation and detection for optical reflectance measurements performed in the spatial frequency domain (SFD). These distributions are formed using an MC simulation for radiative transport that utilizes a photon packet weighting procedure consistent with the two-dimensional spatial Fourier transform of the radiative transport equation. This method enables the development of quantitative metrics for SFD optical sampling depth in layered tissue and its dependence on both tissue optical properties and spatial frequency. We validate the computed depth-dependent probability distributions using SFD measurements in a layered phantom system with a highly scattering top layer of variable thickness supported by a highly absorbing base layer. We utilize our method to establish the spatial frequency-dependent optical sampling depth for a number of tissue types and also provide a general tool to determine such depths for tissues of arbitrary optical properties.

Thermal ink-jet spray freeze-drying (TIJ-SFD) was used to produce inhalable particles of terbutaline sulphate, the aerosolisation properties of which were compared to the commercial Bricanyl formulation. Scanning electron micrograph images showed the particles to be spherical, highly porous and suitable for aerosolisation from a simple, capsule-based dry-powder device (Cyclohaler) without the need for additional excipients. Particle size was dependent upon the concentration of solution jetted, as well as the distance between the print head and the surface of the liquid nitrogen. Starting with a 5% (w/v) solution and maintaining this distance at 3cm produced spherical, porous particles of volume median diameter (VMD) 14.1 ± 0.8 μm and mass median aerodynamic diameter (MMAD) 4.0 ± 0.6 μm. The fine particle fraction (proportion of aerosol with MMAD ≤ 4.46 μm) was 22.9 ± 3.3%, which compared favourably with that of the marketed dry powder inhaler formulation of terbutaline (Bricanyl Turbohaler; 25.7 ± 3.8%), tested under the same conditions. These findings show that TIJ-SFD is a useful tool to predict the viability of a DPI formulation during preformulation physicochemical characterisation.

For the first time, sulfanilamide (SFD) was determined in otologic solution, human urine and serum by electroanalytical techniques on glassy carbon electrode (GCE). The cyclic voltammetry (CV) experiments showed an irreversible oxidation peak at +1.06 V in 0.1 mol/L BRBS (pH = 2.0) at 50 mV/s. Different voltammetric scan rates (from 10 to 250 mV/s) suggested that the oxidation of SFD on the GCE was a diffusion-controlled process. Square-wave voltammetry (SWV) method under optimized conditions showed a linear response to SFD from 5.0 to 74.7 μmol/L (R = 0.999) with detection and quantification limits of 0.92 and 3.10 μmol/L, respectively. The developed SWV method showed better results for detection limit and linear range than the chronoamperometry method. It has been successfully applied to determine SFD concentration in pharmaceutical formulation, human urine and serum samples with recovery close to 100%.

To predict the time required for low-birth-weight (LBW) infants to catch-up with standard weight, the growth curves for weight in 156 LBW infants with no medical abnormalities were examined. The proportion of infants who caught-up with standard weight by 1.5 years of age was significantly higher in appropriate-for-dates (AFD) infants than in small-for-dates (SFD) infants (93% vs. 70%). The age of catch-up with standard weight had a significant inverse correlation with birth weight in AFD infants, and not in SFD infants. The age of catch-up standard weight of AFD infants, as predicted by the regression analysis was 4-8 months for 2,000 g of birth weight, 8-12 months for 1,500 g, and 12-15 months for 1,000 g, with about 80% accuracy. This prediction may be valuable in providing health advice to mothers with LBW infants.

Relationships between maternal factors associated with very slow and very fast fetal growth rate, and the postnatal growth patterns within groups of 238 small-for-dates (SFD) and 241 large-for-dates (LFD) children were examined. Within the SFD group significant differences were found in their weight, height, and to a lesser extent head circumference, according to maternal weight, height, parity, social class, and the birthweights of previous siblings. In the LFD group no differences were found according to maternal weight or the birthweights of previous siblings. Maternal height affected only weight and height; first-born were heavier, and children in the upper social classes had larger heads than the rest. After adjustment for sex, the proportion of the variance in size between one and four years accounted for by all these factors was: SFD group 16% for weight and height, and 10% for head circumference; LFD group 6% for all three measures.

The head-for-weight indices of 420 small-for-dates (SFD), 338 average-for-dates (AFD) and 445 large-for-dates (LFD) babies were calculated. The mean values were highest in the SFD group and lowest in the LFD group. Significant differences were found between AFD and LFD groups for girls and both sexes together. Within each group the mean value for boys was significantly higher than for girls. The absolute difference between the sexes was about twice the difference between the SFD and LFD groups. In the SFD group no associations could be found between their proportionality by this measure, and the factors associated with their slow intra-uterine growth rate. 60.8% multiparae in the LFD group had previously given birth to relatively large babies. The mean index of the probands in this subgroup was higher than when previous siblings had been of average birth-weight. In all three groups the mean index was higher for babies delivered instrumentally than for those who had spontaneous vaginal deliveries. No differences were found for other perinatal risk factors.

EC film has improved portal localization images with better contrast and improved distinction of bony structures and air-tissue interfaces. A cassette with slower speed screens was used with EC film to image the treatment portal during the entire course of treatment (verification) instead of taking separate films after treatment. Measurements of film density vs source to film distance (SFD) were made using 15 and 25 cm thick water phantoms with both 6 and 18 MV photons from I to 40 cm past the phantom. A characteristic (H & D) curve was measured in air to compare dose to film density. Results show the reduction in radiation between patient and cassette more closely follows an "inverse cube law" rather than an inverse square law. Formulas to calculate radiation exposure to the film, and the desired SFD were based on patient tumor dose, calculation of the exit dose, and the inverse cube relationship. A table of exposure techniques based on the SFD for a given tumor dose was evaluated and compared to conventional techniques. Although the film has a high contrast, there is enough latitude that excellent films can be achieved using a fixed SFD based simply on the tumor dose and beam energy. Patient diameter has a smaller effect. The benefits of imaging portal films during the entire treatment are more reliability in the accuracy of the portal image, ability to detect patient motion, and reduction in the time it takes to take portal images.

Fifty-five small-for-dates (SFD), 56 average-for-dates (AFD) and 55 large-for-dates (LFD) babies were weighed and measured at regular intervals from birth to 12 months. Within the SFD and AFD groups weight gain was greater for boys than for girls so that by one year there were highly significant differences between the two sexes. Within the LFD group the sex difference was slight at all ages. Gain in length was similar to that for weight within each group; but head circumference showed a different pattern. Absolute increase in head circumference respectively for boys and girls between birth and one year was greatest in the SFD group and least in the LFD group. Within all three groups it was greater for boys than girls. By the age of six months AFD boys had larger heads than LFD girls and SFD boys had larger heads than AFD girls. At 12 months the head-circumference values for LFD girls and SFD boys did not significantly differ.

To find an effective routine screening method for small-for-dates (SFD) infants 500 consecutive patients were recruited at one antenatal clinic. Weight gain during pregnancy, daily fetal movements counts (DFMC) and plasma schwangerschafts protein 1 (Sp1) levels were measured and their efficacy in identifying SFD infant compared. Mothers delivered of SFD infants had a significantly lower weekly weight gain (P less than 0.01) but no significant difference in either DFMC or plasma Sp 1 level. This study shows that epidemiological and clinical data which are inexpensive and easily available at the antenatal clinic are more valuable than more complicated and expensive assays in the prediction of SFD infants.

OBJECTIVE

Somatic causal illness attributions are being considered as potential positive criteria for somatoform disorders (SFDs) in DSM-V. The aim of this study was to investigate whether patients diagnosed with SFDs tend towards a predominantly somatic attribution style.

METHODS

We compared the causal illness attributions of 48 SFD and 149 non-somatoform disorder patients, in a sample of patients presenting for an allergy diagnostic work-up, and those of 47 controls hospitalised for allergen-specific venom immunotherapy. The SFD diagnosis was established by means of the Structured Clinical Interview for DSM-IV. Both spontaneous and prompted causal illness attributions were recorded through interview and by means of the causal dimension of the Revised Illness Perception Questionnaire (IPQ-R), respectively. Patients' spontaneous and prompted responses were assigned to a psychosocial, somatic, or mixed attribution style.

RESULTS

Both in the free-response task and in their responses to the IPQ-R, SFD patients were no more likely than their nonsomatoform counterparts to focus on somatic explanations for their symptoms. They were just as likely to make psychosocial or mixed causal attributions. However, patients with SFDs were significantly more likely to find fault with medical care in the past.

CONCLUSIONS

Our data do not support the use of somatic causal illness attributions as positive criteria for SFDs. They confirm the dynamic and multidimensional nature of causal illness attributions. Clinical implications of these findings are discussed.

Systemic administration of antifungal agents for the treatment of pulmonary aspergillosis is limited by the poor lung deposition and severe adverse effects. In contrast, pulmonary delivery allows a higher amount of drug to be delivered directly to the infection site and therefore a lower dose is required. This study aimed to develop porous and inhalable voriconazole dry powder with good lung deposition by spray freeze drying (SFD), using tert-butyl alcohol (TBA) as a co-solvent. A three-factor two-level full factorial design approach was used to investigate the effect of total solute concentration, drug content and co-solvent composition on the aerosol performance of the SFD powder. In general, the SFD voriconazole powder exhibited porous and spherical structure, and displayed crystalline characteristics. The analysis of factorial design indicated that voriconazole content was the most significant variable that could influence the aerosol performance of the SFD powders. The formulations that contained a high voriconazole content (40% w/w) and high TBA concentration in the feed solution (70% v/v) displayed the highest fine particle fraction of over 40% in the Next Generation Impactor study in which the powder was dispersed with a Breezhaler® at 100 L/min. In addition, the fine particle dose of the SFD powder showed a faster dissolution rate when compared to the unformulated voriconazole. Intratracheal administration of SFD voriconazole powder to mice resulted in a substantially higher drug concentration in the lungs when comparing to the group that received an equivalent dose of liquid voriconazole formulation intravenously, while a clinically relevant plasma drug concentration was maintained for at least two hours. Overall, an inhalable voriconazole dry powder formulation exhibiting good aerosol property and lung deposition was developed with clinical translation potential.

The use of metronidazole in radiation therapy of laryngeal cancer (SFD = 20 Gy) as a radiosensitizer of tumor hypoxic cells resulted in changes of the liver function tests: a decrease in the cholinesterase activity, a decrease in the level of cholesterol and albumin esters in the blood serum that characterize synthetic liver function. Similar though more noticeable in amounts shifts were marked in stomach cancer patients following preoperative irradiation (SFD = 20 Gy). A slight decrease in AP activity and a decrease in LDH activity below the initial level were simultaneously noted in the latter group as opposed to the group of laryngeal cancer patients. The deviations from the initial level of such liver function indices as bilirubin and total protein level, alanine and asparagine aminotransferase activity did not depend on the incorporation of metronidazole in the radiotherapeutic scheme and developed one way in the intervention and control groups of patients disregarding tumor site. The comparison of shifts of the liver tests in stomach and laryngeal cancer patients in whom tumor site was responsible for the incorporation of the liver in the irradiated zone or for the distance from it, made it possible to regard MZ direct toxic effect and its radiosensitizing effect on the hepatic tissue as causes of the observed deviations.

Although there have been a few reports on Ca2+-ATPase and Na+ + K+-ATPase in human placenta, they are still insufficient for getting more detailed information about human placenta. In this study we investigated some characteristics of the Ca2+-ATPase and measured the activity of Ca2+-ATPase and Na+ + K+-ATPase at various gestational periods. Maximum activity of Ca2+-ATPase was seen at 3 mM and pH 9.0. The enzyme was distinguished from ALP (i.e., Alkaline phosphatase) by such tests as adding L-phenylalanine and heat treatment. Our measurement results of Ca2+-ATPase activity (mumoles Pi/mg protein/30 min) in human placental chorion were 21.9 +/- 2.4 (Mean +/- S.D.) at 10-15 gestational weeks, 19.1 +/- 1.4 at 16-27 gestational weeks, 31.4 +/- 7.2 at 28-35 gestational weeks, and at 36-42 gestational weeks, the AFD group showed 25.8 +/- 4.6, the LFD group, 27.9 +/- 2.1, and the SFD group, 21.2 +/- 1.9. Those of Na+ + K+-ATPase activity (mumoles Pi/mg protein/30 min) were 0.98 +/- 0.05 at 10-15 gestational weeks, 0.82 +/- 0.02 at 16-27 gestational weeks, 1.85 +/- 0.42 at 28-35 gestational weeks and at 36-42 gestational weeks, the AFD group showed 1.58 +/- 0.45, the LFD group, 1.49 +/- 0.37, and the SFD group, 1.68 +/- 0.36. As a result, Ca2+-ATPase activity tended to be higher at 28-35 gestational weeks than for other periods, while it showed lower for the SFD group than for the AFD group. As regards to Na+ + K+-ATPase activity, there were not seen any significant differences between the AFD placenta and the LFD placenta as compared with the AFD placenta.

Shape from defocus (SFD) is one of the most popular techniques in monocular 3D vision. While most SFD approaches require two or more images of the same scene captured at a fixed view point, this paper presents an efficient approach to estimate absolute depth from a single defocused image. Instead of directly measuring defocus level of each pixel, we propose to design a sequence of aperture-shape filters to segment a defocused image by defocus level. A boundary-weighted belief propagation algorithm is employed to obtain a smooth depth map. We also give an estimation of depth error. Extensive experiments show that our approach outperforms the state-of-the-art single-image SFD approaches both in precision of the estimated absolute depth and running time.

Fifty newborns, 25 full term SFDs (small for date) and 25 full term AGAs (appropriate for gestational age) were taken up for comparative study of their behavior using BNBAS (Brazelton's neonatal behavior assessment scale). The study revealed that full term SFDs performed significantly poorly on all items under cluster interactive processes compared to their counterparts full term AGAs on day 1. They also showed similar poor performance in clusters of motor processes and organizational processes (State control). Follow up assessment on day 30 revealed significantly better performance in these clusters. However, the performance of SFD babies in all items of cluster of organizational processes (physiological response) was comparable to that of AGA babies in the initial as well as follow up assessments.

The American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD) published a position statement in 2012 on the management of hyperglycaemia in patients with type 2 diabetes. The Société Francophone du Diabète (SFD) adopted it while awaiting future French recommendations. This new care approach individualises the therapeutic choices and objectives for each patient based on their characteristics, through emphasis on the need for mutual cooperation with the patient in decision-making. Glycaemic management should naturally be considered in the context of overall cardiovascular risk reduction, which should remain the primary objective of treatment. The cornerstone of this treatment is based on lifestyle modifications, with the addition of metformin monotherapy if the desired glycaemic control is not attained. There are multiple second- and third-line treatment possibilities, and insulin therapy is an option that can be considered early in the bitherapy stage. On the whole, large published studies at the ADA conference in Philadelphia in June 2012, which are the subject of this article, support this patient-centred position statement.

Aims of this study were: to evaluate changes in lung function in wheezing children with detected MP and CP infection according to treatment; to measure the response to inhaled corticosteroids in children with significant wheezing who were selected as having a high risk of progressing into childhood asthma. 54 children were randomly assigned 2:1 into 2 groups-the main group (36 patients), in which inhaled corticosteroids were administered, and the control group (18 patients), without inhaled corticosteroids. Serum IgE levels were determined using the ELISA (reagents: IBL-Hamburg). Serologic studies were performed by the ELISA for IgM and IgG antibodies to MP and for IgG and IgA antibodies to CP (reagents: ImmunoLISA, Orgenics, Israel) on the Hiperion MRIII (USA). Pulmonary function testing was done with SpiroLab II (DEGO GmbH, Medizin-Elektronik, Germany). The patients of both groups were administered macrolides: azitromycin during five days. Patients of the first group received inhaled fluticasone propionate 125 mg twice daily. The parents were asked to record symptoms. Each symptom (wheezing, cough, and shortness of breath) were scored on a scale of 0 to 3--daily symptom score (DSS). Scores were calculated every 4 weeks for a total treatment period 16 weeks. The days within each period on which the DSS equalled zero were pointed as symptom free days (SFD). It had been shown an significant improvement in DSS, an increase in SFD and significant improvement of the lung functions following the treatment with inhaled fluticasone and macrolide in children with wheezing and documented MP or CP infection, compared to control group treated only with antibiotics. In conclusion, the use of ICS should be seriously considered in children with wheezing and the risk of persisting symptoms.