Validity and reliability of the Spanish versions of the Bech-Rafaelsen's mania and melancholia scales for bipolar disorders

OBJECTIVE

To assess classical psychometric properties of the Spanish versions of the Bech-Rafaelsen's mania (MAS) and melancholia (MES) scales.

METHOD

Observational, prospective, and multicentric study in bipolar out-patients. Convergent validity was assessed against the Young Mania Rating Scale and the Montgomery-Asberg Depression Rating Scale. Discriminant validity, reliability, and sensitivity to change, were also assessed.

RESULTS

One hundred and thirteen bipolar patients with a manic episode and 102 bipolar patients with a depressive episode were included. Both the MAS and the MES showed appropriate convergent validity (r > 0.90), discriminant validity (P < 0.0001), internal consistency (Cronbach's alpha >0.80), test-retest reliability [intraclass correlation coefficient (ICC) = 0.69 for the MAS and 0.94 for the MES], inter-rater reliability (ICC > 0.80), and sensitivity to change at 4 weeks since inception (P < 0.0001; within-group effect size >or=1.8).

CONCLUSION

The Spanish versions of both scales present appropriate psychometric estimates in bipolar patients treated in ambulatory care.

[The effect of a fibre enriched dietary milk product in chronic primary idiopatic constipation]

BACKGROUND

fibre is effective in some types of constipation. Our objective was to determine if the administration of an enriched dairy preparation with a supplement of soluble fibre (Naturfibra) [inulin and digestion resistant maltodextrin (Fibersol 2)], improves primary chronic constipation.

METHODS

Prospective, randomized, double blind clinical trial randomized with dietary intervention in 32 subjects with constipation according to the Rome II criteria. Thirty two subjects (men 4; women 28) with an average age of 47 +/- 15 years were randomly divided in two homogeneous groups. A type of milk (A or B) was assigned to each group. Group A received fibre enriched semi-skimmed milk; Group B received semi skimmed milk. The subjects drank half a litre of milk per day during 20 days, meaning that those who drank the enriched milk ingested 20 grams of fibre a day.

RESULTS

The subjects that presented straining at defecation (p < 0.001), sensation of incomplete evacuation (p < 0.001), sensation of obstruction in the evacuation (p < 0.001) and days between bowel movements, diminished significantly after the intake of milk supplemented with fibre.

CONCLUSION

The intake of a dairy preparation with a supplement of fibre containing 20 grams of soluble fibre (inulin and digestion resistant maltodextrin), improves the situation of idiopathic primary chronic constipation based on the Rome II criteria.

Leukaemia inhibitory factor is over-expressed by ischaemic brain tissue concomitant with reduced plasma expression following acute stroke

Leukaemia inhibitory factor (LIF) is a glycoprotein of the interleukin-6 family, which has potent pro-inflammatory properties and is involved in regulation of neuronal differentiation. We have previously identified its upregulation in gene microarrays following acute ischaemic stroke in man. LIF expression and localization was measured in human ischaemic stroke autopsy specimens, in a rat model of middle cerebral artery occlusion (MCAO) and in human foetal neural cell cultures following oxygen-glucose deprivation (OGD) by Western blotting and immunohistochemistry. Circulating LIF was determined in the plasma of patients in the hyper-acute stroke phase using a multiplex enzyme-linked-immunosorbent serologic assay system. Patients demonstrated an increase in LIF expression in peri-infarcted regions with localization in neurons and endothelial cells of microvessels surrounding the infarcted core. The rat MCAO model showed similar upregulation in neurons with a peak increase at 90 min. Circulating serum LIF expression was significantly decreased in the hyper-acute phase of stroke. Brain-derived neurons and glia cultured in vitro demonstrated an increase in gene/protein and protein expression respectively following exposure to OGD. Increased LIF expression in peri-infarcted regions and sequestration from the peripheral circulation in acute stroke patients are characteristic of the pathobiological response to ischaemia and tissue damage.

Contribution of marginal donors to liver transplantation for hepatitis C virus infection

The use of marginal liver donors can affect the outcomes of liver transplantation in patients with hepatitis C virus (HCV) infection. There are no firm conclusions about which donor criteria are important for allocation of high-risk grafts to recipients with HCV cirrhosis. We performed 120 consecutive liver transplantations for HCV infection between 1995 and 2005. Marginal donor criteria were considered to be: age >70 years, macrovesicular steatosis >30%, moderate-to-severe liver preservation injury, high inotropic drug dose (dopamine >15 microg/kg/min; epinephrine, norepinephrine, or dobutamine at any doses), peak serum sodium >155 mEq/L, any hypotensive episode <60 mm Hg and >1 hour, cold ischemia time >12 hours, ICU hospitalization >4 days, bilirubin >2 mg/dL, AST and/or ALT >200 UI/dL. Graft survival with donors showing these marginal criteria was compared with optimal donors using Kaplan-Meier analysis and the log-rank test. Independent predictors of survival were computed with the Cox proportional hazards model. Fifty-six grafts (46%) were lost during follow-up irrespective of the Model for End-Stage Liver Disease (MELD) scores of the recipients in each category. Upon univariate analysis, grafts with moderate-to-severe steatosis (P = .012), those with severe liver preservation injury (P = .007) and prolonged cold ischemia time (P = .0001) showed a dismal prognosis at 1, 3, and 5 years. Upon multivariate analysis, fat content (P = .0076; OR = 4.2) and cold ischemia time >12 hours (P = .034; OR = 7.001) were independent predictors of graft survival. Among HCV recipients, marginal liver donors worked similar to those from "good" donors, except for those with fatty livers >30%, especially when combined with a prolonged cold ischemia time.

Assessment of adverse events associated with antiretroviral regimens for postexposure prophylaxis for occupational and nonoccupational exposures to prevent transmission of human immunodeficiency virus

OBJECTIVE

To assess adverse events associated with antiretroviral regimens for human immunodeficiency virus (HIV) postexposure prophylaxis (PEP), with a particular focus on the treatment combination of zidovudine, lamivudine, and tenofovir (ZDV-3TC-TDF).

METHODS

Retrospective chart review for individuals who received HIV PEP for occupational and nonoccupational exposure, and multivariate analyses to identify risk factors for noncompletion of PEP and adverse events associated with PEP.

SETTING

University of Rochester Health Service Occupational Health Program and University of Rochester AIDS Center.

PARTICIPANTS

Healthcare workers who received HIV PEP for occupational exposure from January 1, 1999, to December 31, 2004, and individuals who received HIV PEP for nonoccupational exposure from January 1, 2002, to December 31, 2004.Results. We found increased rates of nausea among subjects who received treatment with ZDV-3TC-TDF and subjects who received treatment with zidovudine, lamivudine, and indinavir (ZDV-3TC-IDV). Analyses showed that female sex was a risk factor for nausea. Compared with subjects who received treatment with ZDV-3TC-TDF, subjects who received treatment with ZDV-3TC-IDV were less likely to not complete the HIV PEP for occupational exposure.

CONCLUSION

Preventive treatment of adverse events may be necessary to ensure completion of HIV PEP.

The sufficiency of the HAM-D6 as an outcome instrument in the acute therapy of antidepressants in the outpatient setting

Objective. To re-analyse the Spanish outpatient study on the various versions of the Hamilton Depression Scale (HAM-D) by using item-response theory models for measuring unidimensionality. Methods. The Mokken analysis, based on the coefficient of homogeneity, was used. A coefficient of 0.40 or higher was accepted for unidimensionality. The three HAM-D versions were compared: HAM-D6 (core items of depression), HAM-D17 and HAM-D21. Results. In total, 113 of the 116 patients included in the study completed the planned treatment period of 6 weeks. As the Mokken analysis depends as much on the sample of patients under examination (dispersion of scores on the item) as on the scale itself, the endpoint was used. For HAM-D6, but not for HAM-D17 or HAM-D21, the coefficient of homogeneity was acceptable (0.44). Conclusion. The HAM-D6 is a valid version of the Hamilton Scale to be recommended for monitoring depressed patients in antidepressant therapy in the outpatient setting.

Production of photocurrent due to intermediate-to-conduction-band transitions: a demonstration of a key operating principle of the intermediate-band solar cell

We present intermediate-band solar cells manufactured using quantum dot technology that show for the first time the production of photocurrent when two sub-band-gap energy photons are absorbed simultaneously. One photon produces an optical transition from the intermediate-band to the conduction band while the second pumps an electron from the valence band to the intermediate-band. The detection of this two-photon absorption process is essential to verify the principles of operation of the intermediate-band solar cell. The phenomenon is the cornerstone physical principle that ultimately allows the production of photocurrent in a solar cell by below band gap photon absorption, without degradation of its output voltage.

Recent Outbreak of Soybean Sudden Death Syndrome Caused by Fusarium virguliforme and F. tucumaniae in Argentina

Sudden death syndrome (SDS) of soybean was detected initially in Argentina during 1991-1992 in the Pampas Region and 1992-1993 in the Northwest Region. The first report of the fulfillment of Koch's postulates of SDS caused by Fusarium solani f. sp. glycines in Argentina was published in 2003 (3). Subsequently, analyses have shown that F. solani f. sp. glycines represents several morphologically and phylogenetically distinct species, including F. tucumaniae in Argentina and F. virguliforme in the United States (1). Isolations were made from plants that exhibited typical SDS symptoms (interveinal foliar chlorosis and necrosis leading to defoliation of the leaflets but not the petioles) from fields in Santa Fe and Buenos Aires provinces in 2001, 2002, and 2003. To determine which species are responsible for SDS in Argentina, cultures of eight slow growing isolates that developed bluish pigmentation and produced abundant macroconidia in sporodochia on potato dextrose agar were subjected to morphological and molecular phylogenetic analyses and pathogenicity tests. Morphological analyses demonstrated that three of the isolates were F. virguliforme and five were F. tucumaniae. Isolates of F. tucumaniae produced long and narrow sporodochial conidia while F. virguliforme produced diagnostic comma-shaped conidia. Molecular phylogenetic analyses of DNA sequences from multiple loci confirmed morphology-based identifications and showed that the soybean SDS pathogen in the United States, F. virguliforme, was also present in Argentina. To our knowledge, this is the first report of F. virguliforme in Argentina and of this pathogen outside the United States. Five isolates of F. tucumaniae and three isolates of F. virguliforme were used for pathogenicity tests. F. virguliforme isolate 171 provided by J. Rupe (University of Arkansas, Fayetteville) was used as a positive control. Soybean cultivars Ripley, RA 702, Pioneer 9492RR, Spencer, and A-6445RG were inoculated with each of the isolates tested in a greenhouse assay using soil infestation and toothpick methods (2). All eight isolates produced typical foliar SDS symptoms 15 to 25 days after inoculation. Severity of foliar symptoms averaged 3.3 for F. virguliforme, 2.6 for F. tucumaniae, and 3.3 for the positive control using a disease severity scale in which 1 = no symptoms and 5 = severely infected or dead plants. Under these conditions, F. virguliforme appeared to be more virulent than F tucumaniae. Noninoculated plants remained symptomless. Koch's postulates were confirmed with soybean cultivars RA 702 and A6445RG. Isolates recovered from symptomatic plants inoculated by the soil infestation and toothpick methods were identical to those used to inoculate the plant. Strains were recovered at frequencies of 100 and 60% from plants inoculated by the toothpick and soil infestation methods, respectively. To our knowledge, this is the first report of the fulfillment of Koch's postulates for F. tucumaniae and F. virguliforme in Argentina. References: (1) T. Aoki et al. Mycologia 95:660, 2003. (2) K. W. Roy et al. Plant Dis. 81:1100, 1997 (3) M. Scandiani et al. Plant Dis. 87:447, 2003.

First Report of Koch's Postulates Completion of Sudden Death Syndrome of Soybean in Argentina

Foliage symptoms on soybean resembling those of sudden death syndrome were detected in Argentina during 1991 and 1992 in the Pampas Region and during 1992 and 1993 in the Northwest Region. Isolations were made in 1999, 2000, and 2001 from soybean plants (Glycine max (L.) Merr.) showing these symptoms. Five isolates of fungi obtained from taproot tissue and blue sporulation on taproot exteriors were selected for further evaluation. These isolates were plated on potato dextrose agar supplemented with streptomycin (PDAS). Based on the spore morphology, colony growth rate, morphology and pigmentation on PDAS, and lack of microconidia (1) five isolates were identified as Fusarium solani f. sp. glycines. Soybean cvs. Ripley, Spencer, Pioneer 9492RR, and A6445 RG were inoculated in greenhouse tests with each of the isolates using toothpick and soil infestation methods for a total of six experiments. Isolate 171 provided by J. Rupe (University of Arkansas, Fayetteville) was tested as a positive control. Foliar symptoms typical of sudden death syndrome and similar to those in the field were observed 14 and 25 days, respectively, after inoculations using the toothpick and soil infestation methods. Lesions produced on leaves averaged 3.6 for all five isolates and 4 for the reference strain using a disease severity scale where: 1 = no symptoms; 2 = slight symptom development with mottling and mosaic on leaves (1 to 20% foliage affected); 3 = moderate symptom development with interveinal chlorosis and necrosis on foliage (21 to 50% foliage affected); 4 = heavy symptom development with interveinal chlorosis and necrosis (51 to 80% foliage affected); and 5 = severe interveinal chlorosis and necrosis (81 to 100% foliage affected). Noninoculated controls were symptomless. Differences in virulence were observed among the isolates. Based on disease symptoms in the greenhouse and cultural morphology on PDAS, the isolates were classified as Fusarium solani f. sp. glycines. Isolates recovered from symptomatic plants resembled Fusarium solani f. sp. glycines on PDAS and peptone/p-chloro-nitrobenzene agar amended with streptomycin, confirming Koch's postulates. Fusarium solani f. sp. glycines was recovered from 60% of inoculated plants. Reference: (1) K. W. Roy et al. Plant Dis. 81:1100,1997.

Recent Outbreak of Soybean Stem Canker Caused by Diaporthe phaseolorum var. caulivora in the Main Soybean-Producing Region of Argentina

The first report of soybean stem canker (SSC) caused by Diaporthe phaseolorum var. caulivora in South America was published in 2001, and was based on an isolate obtained in 1999 at Oliveros, Santa Fe (32°33'S, 60°51'W), Argentina (2). During the 2001 to 2002 growing season, isolates of D. phaseolorum var. caulivora were obtained from stems of field-grown soybeans (Glycine max L.) exhibiting SSC symptoms. Isolates were collected in three localities of the main soybean-producing region of Argentina: Marcos Juárez, Córdoba (32°66'S, 62°10'W); Salto, Buenos Aires (34°20'S, 60°33'W); and Diego de Alvear, Santa Fe (34°21'S, 62°10'W), and disease incidence in the fields was 10 to 60%, 5 to 15%, and 10 to 20%, respectively. The pathogen was isolated on potato glucose agar acidified with 0.2% lactic acid cultured in the dark at 25 ± 1°C. White colonies with compact and tufted mycelium were produced and turned yellow and light tan after 6 days. Appressed and fluffy mycelia were observed in old cultures. Stromata (2 mm diameter) were produced but pycnidia were not detected. After 20 days in culture at 25 ± 1°C under a 12-h light and 12-h dark regime, clustered perithecia developed on stem segments. For each isolate, 10 perithecia, 90 asci, and 30 bicellular, biguttulate ascospores were measured. Averages of asci length and width were 28.3 ± 2.3 and 5.9 ± 0.7 μm, respectively. Averages of ascospores mean length and width were 8.4 ± 0.6 and 2.5 ± 0.4 μm, respectively. These measures were similar to the measures obtained previously (2). Based on these features, the new isolates were classified as D. phaseolorum var. caulivora (Athow & Caldwell). Clustered perithecia, smaller asci and ascospores, and the development of fluffy mycelia with age were the main characteristics that distinguished D. phaseolorum var. caulivora from D. phaseolorum var. meridionalis (1). Pathogenicity trials were performed on cvs. Tracy M, Crockett, Hutchenson, and RA 702 in the greenhouse by placing a small amount of mycelium in soybean seedling hypocotyls wounds made with a scalpel. The pathogen was reisolated from stem portions of the symptomatic plants. Control plants remained healthy. The results reported here show that D. phaseolorum var. caulivora is widely disseminated in the main soybean-producing region of Argentina, where it coexists with D. phaseolorum var. meridionalis (2). The coexistence of both varieties indicates pathogen variability in the region is higher than previously recognized. References: (1) R. N. Pioli et al. Plant Dis. 83:1071, 1999. (2) R. N. Pioli et al. Plant Dis. 85:95, 2001.

HLA polymorphism in a Majorcan population of Jewish descent: comparison with Majorca, Minorca, Ibiza (Balearic Islands) and other Jewish communities

'Chueta' was the name given to the Catholic descendants of Jewish victims of the last Spanish Inquisition process in Majorca Island in the western Mediterranean. We have studied the allele distribution of HLA-A, -B, -Cw, -DRB1 and -DQB1 loci of 103 random, healthy, unrelated individuals belonging to the ancient Majorcan Jewish community, known locally as Chuetas, and 589 individuals from the Balearic population selected because of their typical Balearic - Majorca, Minorca or Ibiza - lineages and according to their ancestor's place of birth. Our aim was to establish the genetic relationship between Majorcan Chuetas, and Balearic and other Jewish and Mediterranean populations. Our results have shown that, to a remarkable extent, they have retained their biological identity, with a unique pattern, in terms of gene and haplotype frequencies, separate from the other populations of Majorca. The Chuetas were found to be more related to Moroccan and Libyan Jews than other Majorcans. Characteristic Jewish haplotypes, A26-B38-DRB1*13, A24-B38-DRB1*11, A1-B52-DRB1*15/16, were found in our study. Some peculiarities were observed in the distribution of common haplotypes among the three main Balearic Islands. The Ibizan population was genetically different from the other Balearic populations, with a high frequency of some haplotypes, for example, A29-Cw*16-B44-DRB1*07-DQB1*03; A1-Cw*07-B8-DRB1*03-DQB1*02. We also found a new haplotype, A25-Cw*12-B39-DRB1*11-DQB1*03(3.5%), in Ibizans and a more limited variability in the HLA alleles that were expressed, perhaps because of genetic isolation. The genetic diversity of the populations from Majorca and Minorca were similar and more related to the mainland Spanish population.

Irritable bowel syndrome: attrition rates of patients identified at primary care centers during a 50-week period versus those identified in hospitals in a phase II clinical trial

Although most irritable bowel syndrome (IBS) patients are managed in primary care centers, most trials are performed in the hospital setting. A successful recruitment strategy is important for trial completeness and its external validity. To this end, it was important to assess the attrition rates of patients identified at primary care centers and hospitals in this phase II trial conducted in the outpatient clinics of 16 hospitals. IBS patients were identified through review of the centers' files (prescreening). After a 2-week single-blind placebo screening phase, the patients were randomized to receive an investigational drug or a matched placebo for 24 weeks (dose-ranging study). Thereafter, the patients were invited to participate in a 24-week, double-blind extension study. The attrition rates among patients identified at hospitals (group A) and at primary care centers (group B) were compared in each study phase and during the 50-week period by bivariate and multivariate regression analyses. Group A and B patients were identified in 13 hospitals and 51 primary care centers, respectively. Of 1,001 prescreened patients, 302 started the screening phase with attrition rates of 35% (of 132 patients) and 25% (of 170) for groups A and B, respectively (p = 0.054). The attrition rate during the double-blind phase was 14%. Of the 184 patients who completed the dose-ranging study, 39 (group A: 32%; group B: 14%; p = 0.005) did not wish to participate in the extension study. The attrition rate in the extension study was 15%. The overall attrition rates during the 50-week period were 67% and 53% (p = 0.016) for groups A and B, respectively. The multivariate regression analysis showed that the screening phases (p = 0.000) and unwillingness to participate in the extension study (p = 0.007) had the highest impact on attrition rates. We conclude that referring patients identified in primary care centers to hospitals seems appropriate to ensure potentially eligible patients for IBS trials. Patients identified in primary care centers are more likely than those identified in hospitals to participate in a 24-week extension study, which may be due to their positive feelings about being treated in a hospital rather than being referred back to their original primary care center. This strategy may be considered in future trials since, with a reasonably low attrition rate, it would enhance the external validity of the results obtained.

Syntheses, crystal structures, and magnetic properties of one-dimensional oxalato-bridged Co(II), Ni(II), and Cu(II) complexes with n-aminopyridine (n = 2-4) as terminal ligand

The reaction of M(ox) x 2H(2)O (M = Co(II), Ni(II)) or K(2)(Cu(ox)(2)) x 2H(2)O (ox = oxalate dianion) with n-ampy (n = 2, 3, 4; n-ampy = n-aminopyridine) and potassium oxalate monohydrate yields one-dimensional oxalato-bridged metal(II) complexes which have been characterized by FT-IR spectroscopy, variable-temperature magnetic measurements, and X-ray diffraction methods. The complexes M(mu-ox)(2-ampy)(2) (M = Co (1), Ni (2), Cu (3)) are isomorphous and crystallize in the monoclinic space group C2/c (No. 15), Z = 4, with unit cell parameters for 1 of a = 13.885(2) A, b = 11.010(2) A, c = 8.755(1) A, and beta = 94.21(2) degrees. The compounds M(mu-ox)(3-ampy)(2).1.5H(2)O (M = Co (4), Ni (5), Cu (6)) are also isomorphous and crystallize in the orthorhombic space group Pcnn (No. 52), Z = 8, with unit cell parameters for 6 of a = 12.387(1), b = 12.935(3), and c = 18.632(2) A. Compound Co(mu-ox)(4-ampy)(2) (7) crystallizes in the space group C2/c (No. 15), Z = 4, with unit cell parameters of a = 16.478(3) A, b = 5.484(1) A, c = 16.592(2) A, and beta = 117.76(1) degrees. Complexes M(mu-ox)(4-ampy)(2) (M = Ni (8), Cu (9)) crystallize in the orthorhombic space group Fddd (No. 70), Z = 8, with unit cell parameters for 8 of a = 5.342(1), b = 17.078(3), and c = 29.469(4) A. All compounds are comprised of one-dimensional chains in which M(n-ampy)(2)(2+) units are sequentially bridged by bis-bidentate oxalato ligands with M.M intrachain distances in the range of 5.34-5.66 A. In all cases, the metal atoms are six-coordinated to four oxygen atoms, belonging to two bridging oxalato ligands, and the endo-cyclic nitrogen atoms, from two n-ampy ligands, building distorted octahedral surroundings. The aromatic bases are bound to the metal atom in cis (1-6) or trans (7-9) positions. Magnetic susceptibility measurements in the temperature range of 2-300 K show the occurrence of antiferromagnetic intrachain interactions except for the compound 3 in which a weak ferromagnetic coupling is observed. Compound 7 shows spontaneous magnetization below 8 K, which corresponds to the presence of spin canted antiferromagnetism.

Polarization and interaction of adhesion molecules P-selectin glycoprotein ligand 1 and intercellular adhesion molecule 3 with moesin and ezrin in myeloid cells

In response to the chemoattractants interleukin 8, C5a, N-formyl-methionyl-leucyl-phenylalanine, and interleukin 15, adhesion molecules P-selectin glycoprotein ligand 1 (PSGL-1), intercellular adhesion molecule 3 (ICAM-3), CD43, and CD44 are redistributed to a newly formed uropod in human neutrophils. The adhesion molecules PSGL-1 and ICAM-3 were found to colocalize with the cytoskeletal protein moesin in the uropod of stimulated neutrophils. Interaction of PSGL-1 with moesin was shown in HL-60 cell lysates by isolating a complex with glutathione S-transferase fusions of the cytoplasmic domain of PSGL-1. Bands of 78- and 81-kd were identified as moesin and ezrin by Western blot analysis. ICAM-3 and moesin also coeluted from neutrophil lysates with an anti-ICAM-3 immunoaffinity assay. Direct interaction of the cytoplasmic domains of ICAM-3 and PSGL-1 with the amino-terminal domain of recombinant moesin was demonstrated by protein-protein binding assays. These results suggest that the redistribution of PSGL-1 and its association with intracellular molecules, including the ezrin-radixin-moesin actin-binding proteins, regulate functions mediated by PSGL-1 in leukocytes stimulated by chemoattractants.

The effect of grazing Lotus corniculatus during late summer - autumn on reproductive efficiency and wool production in ewes

A grazing experiment was conducted at Massey University (Palmerston North, New Zealand) over 80 days in the late summer–autumn of 1998 (9 February–29 April). Reproductive performance and wool growth of ewes grazing on Lotus corniculatus (birdsfoot trefoil) were compared with those of ewes grazing perennial ryegrass–white clover pasture. A rotational grazing system with 210 mixed-age dry ewes (59.80.9 kg/ewe) was used, with 80 ewes grazing pasture [1 g of condensed tannin (CT) per kg dry matter (DM)] and 130 ewes grazing L. corniculatus (24 g CT/kg DM). Half of the ewes grazing L. corniculatus were supplemented orally, twice daily, with polyethylene glycol (PEG; MW, 3500) to inactivate the CTs. The effect of forage species and PEG supplementation on voluntary feed intake (VFI), reproductive performance (as measured by ovulation rate), and wool production was measured during 4 synchronised oestrous cycles. The ewes were restricted to maintenance feeding during the first 10 days of each oestrous cycle and then increased to ad libitum for the 6 days leading up to and including ovulation. In vitro organic matter digestibility in the selected diet was higher for lotus than for pasture (0.80 v. 0.76), with L. corniculatus containing less nitrogen than pasture (36.5 v. 40.8 g/kg organic matter). Ewes grazing on L. corniculatus produced 11% more wool and had an ovulation rate up to 14% higher than ewes grazing pasture, with neither parameter being affected by PEG supplementation. Higher mean ovulation rates of ewes grazing L. corniculatus were due to increases in fecundity (multiple ovulations/ovulating ewe; P < 0.05), with no effect on ewes cycling/ewes mated. Three cycles of grazing on L. corniculatus were required to achieve the maximum response in multiple ovulation, but most of this was achieved after 2 cycles. As the VFI of ewes grazing on L. corniculatus was not greater than that of ewes grazing pasture, the greater wool production and higher ovulation rate of ewes grazing this forage was due to improved efficiency of feed utilisation. It was concluded that feeding ewes L. corniculatus increased the efficiency of both reproduction and wool production without increasing VFI.

The interaction of activated integrin lymphocyte function-associated antigen 1 with ligand intercellular adhesion molecule 1 induces activation and redistribution of focal adhesion kinase and proline-rich tyrosine kinase 2 in T lymphocytes

Integrin receptors play a central role in the biology of lymphocytes, mediating crucial functional aspects of these cells, including adhesion, activation, polarization, migration, and signaling. Here we report that induction of activation of the beta2-integrin lymphocyte function-associated antigen 1 (LFA-1) in T lymphocytes with divalent cations, phorbol esters, or stimulatory antibodies is followed by a dramatic polarization, resulting in a characteristic elongated morphology of the cells and the arrest of migrating lymphoblasts. This cellular polarization was prevented by treatment of cells with the specific tyrosine kinase inhibitor genistein. Furthermore, the interaction of the activated integrin LFA-1 with its ligand intercellular adhesion molecule 1 induced the activation of the cytoplasmic tyrosine kinases focal adhesion kinase (FAK) and proline-rich tyrosine kinase 2 (PYK-2). FAK activation reached a maximum after 45 min of stimulation; in contrast, PYK-2 activation peaked at 30 min, declining after 60 min. Upon polarization of lymphoblasts, FAK and PYK-2 redistributed from a diffuse localization in the cytoplasm to a region close to the microtubule-organizing center in these cells. FAK and PYK-2 activation was blocked when lymphoblasts were pretreated with actin and tubulin cytoskeleton-interfering agents, indicating its cytoskeletal dependence. Our results demonstrate that interaction of the beta2-integrin LFA-1 with its ligand intercellular adhesion molecule 1 induces remodeling of T lymphocyte morphology and activation and redistribution of the cytoplasmic tyrosine kinases FAK and PYK-2.

[Validation of the Spanish version of the Liebowitz social anxiety scale, social anxiety and distress scale and Sheehan disability inventory for the evaluation of social phobia]

BACKGROUND

Social phobia is an anxiety disorder of increasing interest in clinical psychiatric practice and research. The questionnaires most widely used in the psychometric evaluation of these patients are: Liebowitz Social Anxiety Scale (LSAS), Social Anxiety and Distress Scale (SADS) and Sheehan Disability Inventory (SDI). The objective of this study was to evaluate the validity and reproducibility of the Spanish versions.

SUBJECTS AND METHODS

Convergent validity was analysed by correlating patients' scores on the LSAS, SADS and SDI with scores on the Global Activity Evaluation Scale (GAES), the Hamilton Anxiety Scale (HAM-A) and the Visual Analogue Scale (VAS) of the EuroQol. Validity of the internal structure was examined by analysing the correlations between the different sub-escales of the questionnaires. Internal consistency was analysed using Cronbach's alpha and Kuder-Richardson coefficients. Discriminative capability was analysed by comparing LSAS, SADS and SDI scores of patients with social phobia with scores from healthy subjects, and with that obtained on the HAM-A and the EuroQol VAS. Reproducibility was analysed by re-testing patients after 15 days.

RESULTS

57 patients and 57 healthy subjects were recruited in 4 psychiatric centres. The three questionnaires showed an adequate convergent validity with the GAES, the HAM-A and the EuroQol VAS (r = -0.24-0.40 and r = 0.29-0.52). The LSAS and SDI questionnaires showed a homogenous internal structure in terms of correlation between sub-scales (r = -0.61-0.93 for LSAS, and r = -0.04-0.61 for SDI). All the sub-scales of the questionnaires showed an adequate internal consistency (with coefficients between 0.72 and 0.88). The questionnaires discriminated between groups of patients with different levels of symptom severity and self-perceived overall health. They also discriminated between patients with social phobia and healthy subjects (area under the Receiver's Operating Characteristics curves = 0.95-0.99). All sub-scales from the questionnaires showed adequate reproducibility (with intraclass correlation coefficients between 0.63 and 0.88).

CONCLUSIONS

The Spanish versions of the LSAS, SADS and SDI questionnaires have shown adequate validity and reproducibility for use in clinical research and the clinical assessment of patients with social phobia in Spain.