Trends of legacy and emerging organic contaminants in a sediment core from Cienfuegos Bay, Cuba, from 1990 to 2015

Legacy and emerging organic pollutants pose an ever-expanding challenge for the marine environment. This study analysed a dated sediment core from Cienfuegos Bay, Cuba, to assess the occurrence of polychlorinated biphenyls (PCBs), organochlorine pesticides (OCPs), polybrominated diphenyl ethers (PBDEs), alternative halogenated flame retardants (aHFRs), organophosphate esters (OPEs), and phthalates (PAEs) from 1990 to 2015. The results evidence the continuing presence of historical regulated contaminants (PCBs, OCPs, and PBDEs) in the southern basin of Cienfuegos Bay. PCB contamination declined since 2007, likely in response to the gradual global phasing out of PCB containing materials. There have been relatively consistent low accumulation rates for OCPs and PBDEs at this location (in 2015 approximately 1.9 and 0.26ng/cm²/year, respectively, with 2.8ng/cm²/year for Σ₆PCBs), with indications of recent local DDT use in response to public health emergencies. In contrast, sharp increases are observed between 2012 and 2015 for the contaminants of emerging concern (PAEs, OPEs, and aHFRs), and in the case of two PAEs (DEHP and DnBP) the concentrations were above the established environmental effect limits for sediment dwelling organisms. These increasing trends reflect the growing global usage of both alternative flame retardants and plasticizer additives. Local drivers for these trends include nearby industrial sources such as a plastic recycling plant, multiple urban waste outfalls, and a cement factory. The limited capacity for solid waste management may also contribute to the high concentrations of emerging contaminants, especially plastic additives. For the most recent year (2015), the accumulation rates for Σ₁₇aHFRs, Σ₁₉PAEs, and Σ₁₇OPEs into sediment at this location were estimated to be 10, 46 000, and 750ng/cm²/year, respectively. This data provides an initial survey of emerging organic contaminants within this understudied region of the world. The increasing temporal trends observed for aHFRs, OPEs, and PAEs highlights the need for further research concerning the rapid influx of these emerging contaminants.

A comprehensive evaluation of two sample treatment procedures for the determination of emerging and historical halogenated flame retardants in biota

Two different sample preparation protocols for the determination of 37 emerging and historical halogenated flame retardants (HFRs) in marine tissues were compared with regards to extraction recovery, lipid removal efficiency, repeatability, reproducibility, and ability to measure sub-ng g^-1 (dry weight) concentrations in marine biota. One method involved a purification step using gel permeation chromatography (GPC) followed by a HPLC fractionation step on a Partisil amino-cyano normal phase (GPC-Partisil procedure) and the other more traditional method was based on sulphuric acid treatment followed by silica column fractionation (H₂SO₄-silica procedure). The samples were analysed by gas chromatography (GC) and liquid chromatography (LC) tandem mass spectrometry (MS/MS). Sample fractionation in both methods enabled unique sample preparation procedures to isolate the GC from the LC amenable compounds. Both methods could remove > 99% of the lipids which was necessary prior to GC- and LC-MS/MS analyses. The majority of the target compounds (70%) had acceptable recoveries between 60-120% for both methods. However, the sulphuric acid treatment resulted in the degradation of the TBP-AE and the silica column fractionation resulted in the loss of BEH-TEBP and the elution of PBB-Acr and TBBPA-BME in the unsuitable fraction. High recoveries of DBE-DBCH (α+β), EHTBB, BTBPE, BEH-TEBP, and PBB-Acr were attributed to matrix effects, suggesting the need to use isotope-labelled surrogate standards of the target compounds. The optimisation of the silica column chromatography, GPC, and Partisil fractionation is described and discussed to afford easy implementation of the method. The method using GPC followed by Partisil fractionation is more efficient and more reproducible than the sulphuric acid-silica procedure. The application of this method to marine biota reference materials revealed the presence of relatively high concentrations of DBE-DBCH isomers and BDE-47 in fish samples. The method detection limits comply with the recommendations of the European Commission.

A new marine sediment certified reference material (CRM) for the determination of persistent organic contaminants: IAEA-459

A new marine sediment certified reference material (IAEA 459) with very low concentrations (μg kg^-1) for a variety of persistent organic contaminants (POPs) listed by the Stockholm Convention, as well as other POPs and priority substances (PSs) listed in many environmental monitoring programs was developed by the IAEA. The sediment material was collected from the Ham River estuary in South Korea, and the assigned final values were derived from robust statistics on the results provided by selected laboratories which demonstrated technical and quality competence, following the guidance given in ISO Guide 35. The robust mean of the laboratory means was assigned as certified values, for those compounds where the assigned value was derived from at least five datasets and its relative expanded uncertainty was less than 40% of the assigned value (most of the values ranging from 8 to 20%). All the datasets were derived from at least two different analytical techniques which have allowed the assignment of certified concentrations for 22 polychlorinated biphenyl (PCB) congeners, 6 organochlorinated (OC) pesticides, 5 polybrominated diphenyl ethers (PBDEs), and 18 polycyclic aromatic hydrocarbon (PAHs). Mass fractions of compounds that did not fulfill the criteria of certification are considered information values, which include 29 PAHs, 11 PCBs, 16 OC pesticides, and 5 PBDEs. The extensive characterization and associated uncertainties at concentration levels close to the marine sediment quality guidelines will make CRM 459 a valuable matrix reference material for use in marine environmental monitoring programs.

The combined use of chemical and biochemical markers in Rutilus rutilus to assess the effect of dredging in the lower course of the Ebro River

The lower course of the Ebro River is polluted with high concentrations of organochlorine compounds dumped by a chloro-alkali plant during the last century. A remediation plan, including building of a protective wall, removal and disposal of polluted sediments started in 2012. With the aim of assessing the effects of dredging of contaminated sediments and potential alterations of water quality, areas located upstream (RR) and downstream (BE, A) the chemical plant (FL) were monitored prior (October 2012) and during dredging (June 2013) using roach (Rutilus rutilus) as sentinel organisms. Concentrations of organochlorine compounds (OCs) in fish muscle and biliary levels of polycyclic aromatic hydrocarbons (PAHs), galaxolide (HHCB) and alkyphenols (APEs) were determined together with selected enzymatic activities (7-ethoxyresorufin-O-deethylase (EROD), 7-benzyloxy-4-trifluoromethyl-coumarin O-debenzyloxylase (BFCOD) and UDP-glucuronyltransferase (UGT)) in the liver. The obtained results proved the effectiveness of the wall retaining suspended particles and avoiding further contamination of downstream sites as fish sampled at downstream sites showed up to 9-fold higher concentrations of OCs in muscle during wall construction than during dredging. EROD and UGT activities were induced in fish from downstream sites; however, no clear response to the observed pollution gradient was detected.

Influence of diet in the accumulation of organochlorine compounds in herons breeding in remote riverine environments

The composition of organochlorine compounds (OCs), pentachlorobenzene (PeCB), hexachlorobenzene (HCB), hexachlorocyclohexanes (HCHs), DDTs and polychlorobiphenyls (PCBs), has been analyzed in eggs from cattle egret (Bubulcus ibis) and little egret (Egretta garzetta), two species of herons (family Ardeidae), nesting at the same remote riverine environment (Aiguabarreig, Ebro River). These two species were selected to evaluate the importance of diet in the accumulation of OCs. Cattle egret essentially feeds on dry grassy habitats and follow cattle or other large animals whereas little egret feeds on fish, amphibians and crustaceans captured in shallow waters. The δ(15)N and δ(13)C isotopic composition of the sampled eggs was studied and the results were consistent with these species feeding habits. In both species, the compounds accumulated the most were the less volatile and more lipophilic, e.g. PCB congeners of higher chlorination, DDT and metabolites. The distinct foraging species preferences were reflected in significant higher concentrations in little egret than cattle egret of all pollutant groups analysed. These differences were statistically significant for DDTs and PCBs (p < 0.015 and p < 0.047, respectively), e.g. the p,p'-DDE and PCB concentrations were 6 and 4.5 times higher, respectively, in the former than the latter. This strong contrast indicates that in remote environments aquatic riverine ecosystems are more efficient OC reservoirs than the terrestrial ecosystem.

Organochlorine compounds in European catfish (Silurus glanis) living in river areas under the influence of a chlor-alkali plant (Ebro River basin)

European catfish, Silurus glanis, were used as sentinel organisms of the influence of recent and past discharges of organochlorine compounds (OCs) from a chlor-alkali plant located in the Ebro River. The fish concentrations of hexachlorobenzene (HCB), polychlorobiphenyls (PCBs) and DDTs were very high along the last 100 km of the river, including the irrigation channels, e.g. 1.2-27 ng/g wet weight of HCB, 6.3-100 ng/g ww of PCBs and 1-270 ng/g ww of total DDT compounds. These concentrations were much higher than those found upstream from the chlor-alkali discharge site, 0.2 ng/g ww for HCB, 5.6 ng/g ww for PCBs and 7.5 ng/g for DDT compounds. These concentrations were also standing out among those previously described in this fish species. The European catfish collected in sites under lower water flows, Ribarroja reservoir and irrigation channels, showed higher muscle lipid content, 1.09-7.2%, than those from sites of higher current intensities, river bed, 0.27%-0.67%. In these lower water current areas catfish exhibited OC ww concentrations that were correlated to % lipids. These differences suggest that normalization to lipid content is necessary for comparison of the OC accumulation in specimens from riverine systems living under different flow intensities. Accordingly, OC concentrations referred to lipid content showed more uniform downriver distribution which was consistent with a single focal point as main source of these compounds for the European catfish collected in the last 100 km of river stretch. This geographic distribution was also consistent with the uniform composition of PCB congeners in the studied European catfish. The distribution of DDT compounds was predominated by 4,4'-DDE which is common in most currently examined fish from aquatic environments. However, it included a high proportion of 4,4'-DDD and 2,4'-DDD which was consistent with the high contribution of benthic organisms from anoxic environments in the diet of these fish.

Differential diagnosis by EEG of dissociative status versus nonconvulsive status epilepticus

INTRODUCTION

Nonconvulsive status epilepticus (NCSE) has different clinical presentations, from minimal confusion to bizarre behavioral manifestations, psychosis or coma. As a result, patients can sometimes be misdiagnosed and labeled as psychiatric cases.

CLINICAL CASE

The patient was alert and disoriented in time, with disconnection episodes, generalized slowness, slow mental response, faltering language and slow answers. A differential diagnosis between dissociative status and NCSE was proposed. The physical and neurological examinations were normal. The cranial CT scan findings were normal. Only the EEG provided the definitive diagnostic data, consisting of generalized spike and wave discharges of 2-3 Hz against a desynchronized background.

CONCLUSIONS

Diagnosis of NCSE requires the availability of an EEG. Often patients are on the border between medical conditions and mental disorders. Observation of the disease evolution and an open-minded attitude of physicians are necessary for the correct diagnosis and treatment.

Antitumor activity of a small-molecule inhibitor of the histone kinase Haspin

The approval of histone deacetylase inhibitors for treatment of lymphoma subtypes has positioned histone modifications as potential targets for the development of new classes of anticancer drugs. Histones also undergo phosphorylation events, and Haspin is a protein kinase the only known target of which is phosphorylation of histone H3 at Thr3 residue (H3T3ph), which is necessary for mitosis progression. Mitotic kinases can be blocked by small drugs and several clinical trials are underway with these agents. As occurs with Aurora kinase inhibitors, Haspin might be an optimal candidate for the pharmacological development of these compounds. A high-throughput screening for Haspin inhibitors identified the CHR-6494 compound as being one promising such agent. We demonstrate that CHR-6494 reduces H3T3ph levels in a dose-dependent manner and causes a mitotic catastrophe characterized by metaphase misalignment, spindle abnormalities and centrosome amplification. From the cellular standpoint, the identified small-molecule Haspin inhibitor causes arrest in G2/M and subsequently apoptosis. Importantly, ex vivo assays also demonstrate its anti-angiogenetic features; in vivo, it shows antitumor potential in xenografted nude mice without any observed toxicity. Thus, CHR-6494 is a first-in-class Haspin inhibitor with a wide spectrum of anticancer effects that merits further preclinical research as a new member of the family of mitotic kinase inhibitors.

Blood biomarkers and contaminant levels in feathers and eggs to assess environmental hazards in heron nestlings from impacted sites in Ebro basin (NE Spain)

Blood biomarkers and levels of major pollutants in eggs and feathers were used to determine pollution effects in nestlings of the Purple Heron Ardea purpurea and the Little Egret Egretta garzetta, sampled on three Ebro River (NE Spain) areas: a reference site, a site affected by the effluents of a chlor-alkali industry and the river Delta. The two impacted heron populations showed mutually different pollutant and response patterns, suggesting different sources of contamination. In the population nesting near the chlor-alkali plant, elevated levels of hexachlorobenzene (HCB) and polychlorobiphenyls (PCBs) in eggs, and mercury in feathers in A. purpurea chicks were related with reduced blood antioxidant defenses and increased levels of micronuclei. In Ebro Delta, high levels of plasmatic lactate dehydrogenase in A. purpurea chicks and high frequency of micronuclei in blood of both species were tentatively associated with intensive agricultural activities taking place in the area. These results provide the first evidence of a biological response in heron chicks to the release of pollutants at a chlor-alkali plant.

Contaminant accumulation and multi-biomarker responses in field collected zebra mussels (Dreissena polymorpha) and crayfish (Procambarus clarkii), to evaluate toxicological effects of industrial hazardous dumps in the Ebro river (NE Spain)

Large amounts of industrial waste containing high concentrations of mercury, cadmium and organochlorine residues were dumped in a reservoir adjacent to a chlorine-alkali plant in the village of Flix(Catalonia, Spain), situated at the shore of the lower Ebro river. Effects of these contaminants to aquatic river invertebrates were assessed by integrating analyses of metals and organochlorine residues in field collected zebra mussels and crayfish with a wide range of biomarkers. Biological responses included levels of metallothioneins, activities of ethoxyresorufin-O-deethylase, oxidative stress biomarkers (glutathione content, enzymatic activities of superoxide dismutase, catalase, glutathione s-transferase, glutathione peroxidise and glutathione reductase), levels of lipid peroxidation and of DNA strand breaks. The results obtained evidenced similar response patterns in mussels and crayfish with increasing toxic stress levels from upper parts of the river towards the meander located immediately downstream from the most polluted site, close to the waste dumps. The aforementioned stress levels could be related with concentrations of mercury, cadmium, hexachlorobenzene, polychlorobiphenyls and dichlorodiphenyltrichloroethanes from 4- to 195-fold greater than local background levels. The response of biomarkers to these pollutant concentrations differences was reflected in high activities and levels of antioxidant enzymes, metallothioneins, lipid peroxidation and DNA strand breaks and decreased levels of glutathione.

Muscular and hepatic pollution biomarkers in the fishes Phycis blennoides and Micromesistius poutassou and the crustacean Aristeus antennatus in the Blanes Submarine Canyon (NW Mediterranean)

Submarine canyons are regarded as a sink for pollutants. In order to determine if this theory applied to deep-sea species from an important fishing ground (the Blanes submarine canyon) located in the NW Mediterranean, we sampled the commercial fish Phycis blennoides and Micromesistius poutassou and the crustacean Aristeus antennatus. Specimens were sampled inside and outside (in the open continental slope) the submarine canyon; both are regarded as potentially affected by exposure to different anthropogenic chemicals. Several pollution biomarkers in muscle (activity of cholinesterases) and liver/hepatopancreas (catalase, glutathione S-transferases, carboxylesterases, ethoxyresorufin O-deethylase in fish or mixed function oxygenase (MFO)-related reductases in crustacean, and lipid peroxidation levels) were measured. Chemical analysis of the persistent organic pollutants, namely polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethanes (DDTs) and hexachlorocyclohexanes (HCHs) was also performed on the fish and crustacean muscle. Biomarker activities and levels were discussed in relation to pollutant exposure, habitat, and parameters including sex, size, and species. Biochemical responses and chemical analysis of PCBs evidenced interspecies differences as well as sex and size-related ones, mainly in A. antennatus. An indication of higher exposure to pollutants inside the canyon was observed, which was more clearly reflected in the fish than in the crustacean. However, further research is required to confirm this observation.

Intellectual capacity measurement in schizophrenia

INTRODUCTION

The measurement of the intellectual capacity (IC) in schizophrenic patients has been found to be of clinical relevance. A user-friendly tool such as the Cattell's intelligence test might facilitate this measurement in daily clinical practice.

METHOD

In this study, we measured the intelligence quotient (IQ) using Cattell's test in 35 schizophrenic patients before and after treatment with risperidone.

RESULTS

At baseline, the sample showed an average intelligence of 78.3 points (standard deviation [SD]: 14.3), in the low-medium range. After 1 year on risperidone, the IQ significantly improved (mean: 84.8; SD: 17.0; p = 0.028). This IQ elevation was positively correlated with the improvement in the psychotic symptoms rated with the PANSS.

CONCLUSIONS

Cattell's intelligence test could be a valid instrument to measure cognitive performance in schizophrenic patients. Antipsychotic therapy with risperidone could be effective to improve cognitive functioning in these subjects.

Antiaggressive effect of cyproterone versus haloperidol in Alzheimer's disease: a randomized double-blind pilot study

OBJECTIVE

Alzheimer's disease (AD) is commonly accompanied by aggressive behavior. In the elderly, effective and safe antiaggressive treatment is lacking. Risks of antipsychotics in this population demand therapeutic alternatives. This randomized, double-blind, pilot trial examined the efficacy and safety of cyproterone in the treatment of agitated AD.

METHOD

The subjects were 27 elderly patients referred to the University Hospital of Guadalajara Psychogeriatric Clinic diagnosed with AD and associated aggressive behavior (mean Staff Observation Aggression Scale [SOAS] score >or=2). Each patient underwent a 15-day washout for psychotropics and then was randomly assigned to receive stable doses of either cyproterone (100 mg/day) or haloperidol (2 mg/day) for 90 days. The primary outcome measure was the SOAS score. This trial was conducted between October 27, 1993, and March 24, 1998.

RESULTS

Of the 27 patients, 19 (70.4%) were women, and the mean age was 80.7 years. The trial was completed by 24 (88.9%) of the subjects (13 in the cyproterone group and 11 in the haloperidol group for 90 days). Three patients (11.1%) dropped out, all after adverse effects in the haloperidol group. Baseline aggression level in the sample was mild (mean SOAS score of 4.48 [SD = 2.04]). Efficacy analyses for all intent-to-treat patients showed that 9 (69.2%) in the cyproterone group achieved complete elimination of aggression at endpoint, in contrast to 2 patients (14.2%) in the haloperidol group (p = .012). Ten patients (71.4%) taking haloperidol had adverse events, compared with 4 (30.7%) taking cyproterone (p = .035).

CONCLUSION

Cyproterone showed significantly better efficacy and safety than haloperidol in controlling mild aggression associated with AD. Additional research is needed to confirm if these results can be ratified in a larger study and generalized to patients whose aggression is more severe.

Update on the biological treatment of aggression

This review is focused on aggressive behavior in adult patients with major mental disorders. Aggression, agitation, and hostility are defined. The roles of intramuscular forms of ziprasidone and olanzapine in the treatment of acute agitation and aggression are discussed. We review general considerations pertaining to persistent aggression in inpatients and outpatients, including comorbidity of major mental disorders with substance use disorders and personality disorders. The role of clozapine as an antiaggressive agent is well established, particularly in inpatients. Evidence also exists for the efficacy of risperidone, olanzapine, quetiapine, and aripiprazole. Anticonvulsants and lithium are widely used with the intent to control aggression, but their efficacy lacks strong evidential support. Benzodiazepines have a role in controlling acute agitation, but their long-term use for persistent aggression is not recommended. There is evidence for antiaggressive effects of SSRIs and hormonal agents with antiandrogenic properties. Beta-adrenergic blockers and electroconvulstive treatment are rarely used in clinical practice to control aggression, but they may be effective. The heterogeneity of aggressive behavior is a challenge for developing rational treatments. Emerging genetic findings hold a promise of future treatments of aggressive behavior developed on the basis of individual patients' genotypes.

Nefazodone in the treatment of elderly patients with depressive disorders: a prospective, observational study

OBJECTIVES

The aim of this study was to evaluate the clinical effectiveness and tolerability of nefazodone for the treatment of depression in elderly patients in clinical routine practice.

PATIENTS AND STUDY DESIGN

Seventy-nine patients with a mean age of 72.81 years, who had major depression or dysthymia according to DSM-IV criteria, were enrolled into this open label study. Patients were prescribed nefazodone starting at 50 mg/day, increasing every 4 days until a dosage of 200 mg/day was attained, and subsequently upward to 600 mg/day if no dose-limiting adverse effects appeared. Effectiveness was evaluated at the end of weeks 2, 4, 8 and 12 by completion of the Hamilton Depression Rating Scale (HAM-D), the Geriatric Depression Scale (GDS) and the Clinical Global Impressions scale. The Hamilton Anxiety Rating Scale (HAM-A), the sleep satisfaction item of the Oviedo Sleep Questionnaire (OSQ) and the Short Portable Mental Status Questionnaire (SPMSQ) were used to assess the patients at the end of week 12. Primary efficacy analysis was based on an intention-to-treat, last-observation-carried-forward data set.

RESULTS

HAM-D scores decreased progressively from a baseline mean of 22.3 to 14.2 at the study endpoint; although this was a significant reduction, the endpoint score indicates that a significant residual symptomatology remained in the patients. Similarly, the GDS and HAM-A scores had decreased significantly by week 12. Response and remission rates were 47 and 37.5%, respectively. The percentage of patients who were satisfied, much satisfied or very much satisfied with their sleep according to the OSQ increased from 4.2% at baseline up to 62.2% at the study endpoint. A significant reduction in the SPMSQ total score was observed at the study endpoint, although the clinical relevance of this finding is doubtful. Forty-two (53.2%) patients completed the study. The most common reasons for withdrawal from the study were a lack of efficacy and adverse effects. Most adverse reactions were mild to moderate in severity and included dizziness, dry mouth, gastrointestinal distress, sedation, anxiety and malaise.

CONCLUSION

Our results suggest that nefazodone may be a well tolerated and effective alternative for treating elderly patients with depression. Although the HAM-D score at study endpoint indicated significant residual symptomatology, a similar finding has been described in several meta-analyses of antidepressant treatment in the elderly. Further research is needed to evaluate a different nefazodone dose regimen, especially a slower dose titration rate, which could result in a reduced discontinuation rate and thus a better treatment outcome.

New posteroanterior cephalometric norms: a comparison with craniofacial measures of children treated with palatal expansion

The aim of the study was to evaluate posteroanterior (PA) cephalometric characteristics in a normal longitudinal database and compare these measurements with corresponding measures in a group of patients treated with rapid maxillary expansion. Posteroanterior cephalographs of 16 girls and 14 boys from the Bolton-Brush growth study, taken at ages 10 and 18 years, were used to track growth in children with normal occlusion. Pretreatment PA cephalograms of 24 patients who had palatal distraction around age 10 were compared with the 10-year-old normal patients. Digitized landmarks included right and left jugale (J, at intersection of maxillary tuberosity and zygomatic buttress) and antegonion (AG, at notch of antegonial protuberance). Mandibular width (AG-AG) was similar in boys and girls at age 10 but not 18, when the difference between gender groups was statistically significant (P < .05). Maxillary width (J-J) was greater in boys than girls at both ages. The increase in AG-AG (5.5 mm, boys; 3.9 mm, girls) was more than twice that of J-J (2.4 mm, boys; 1.2 mm, girls). Arch width (at first molar) was nearly stable with age, indicating compensatory occlusal adaptation to differential changes between maxillary and mandibular widths. At age 18, the distance between the centers of the orbits, a surrogate measure of cranial width, was almost equal to J-J in girls and significantly correlated with AG-AG in boys (r = .71, P < .002) and girls (r = .77, P < .0001). The majority of treated children had both skeletal and dentoalveolar widths narrower than control values. Linear regressions between J-J and AG-AG revealed almost parallel slopes for control and treated groups in both genders, but the treated group was at a lower level, which is consistent with smaller maxillary widths.

[The use of electroconvulsive therapy in acute services at the general hospital]

GOAL

The aim of the investigation focused on a retrospective analysis of the clinical use of ECT in the Acute Psychiatric Unit of The University Hospital of Guadalajara.

METHOD

All patients admitted to our psychiatric unit from 1993 to 1998 and who underwent ECT along their hospitalization, were included in the analysis. Age of the sample ranged from 17 to 79. Several variables were controlled, including technical parameters of ETC application.

RESULTS

All patients with a diagnosis of bipolar disorder or schizoaffective disorder showed full remission after ECT. Among patients diagnosed of schizophrenia, 60% experimented full remission and 40% partial remission. In the group of subjects with depression, 66.6% showed full remission, 27.7% partial remission and 5.7% no response. Besides, ETC appeared to be more effective in subjects without psychiatric comorbidity.

CONCLUSION

The present retrospective analysis support that ECT still must be considered an effective, useful and safe therapeutic technique. In our review, adverse reactions to ECT have been limited and rare, and mostly reversible.

Expression of the human CFTR gene from episomal oriP-EBNA1-YACs in mouse cells

Plasmids carrying the origin of plasmid replication ( oriP ) and expressing the EBNA-1 protein from the Epstein-Barr virus replicate and segregate in human cells and are thus potentially useful vectors for gene therapy. As very large circular molecules, up to 660 kb in size, can be maintained episomally using this system, it is possible to include intact human genes with all their long-range controlling elements which might give high levels of tissue-specific and controlled gene expression. We have shown previously that a 320 kb yeast artificial chromosome (YAC) carrying the intact human CFTR gene can complement the Cambridge null cystic fibrosis mice as a transgene. We have now modified this YAC to a circular molecule carrying both oriP and the EBNA-1 gene. We show that this oriP-EBNA1-YAC can be stably maintained as unrearranged episomes in mouse LA-9 cells, which do not express endogenous cftr, and in mouse CMT-93 cells, which do express endogenous cftr. The human CFTR gene is expressed in some of the cell lines, but the level of expression is very variable between cell lines and is not related to the copy number of the elements.

[Subsyndromal depressive semiology in severe alcoholism]

INTRODUCTION

Several investigations have communicated frequent association between alcohol dependence and depression.

METHOD

21 subjects with DSM-IV criteria for alcohol dependence were included in an open label trial for alcohol withdrawal. At inclusion and along the follow-up none of the probands met DSM-IV criteria for mood disorder. Follow-up included a 15-day detoxification period and 195 days of withdrawal program, including treatment with 20 mg/d of fluoxetine. Occurrence of depressive semiology was measured using the Beck Depression Inventory (BDI) on day 15 (after detoxification), day 75 and day 210 (after withdrawal from ethanol of 195 days).

RESULTS

67% of the sample showed a positive basal BDI (after-detoxification-BDI> 9). Global retention rate after 210 days of follow-up was 57%. All patients who dropped out the investigation before completing the protocol showed a basal BDI in the depressive rank (BDI= 10-63), and maintained depressive scores in this instrument until their abandonment.

CONCLUSIONS

Prevalence of <<subsyndromal depressive semiology>> in this population appears to be high. This clinical feature is frequently ignored because most of the patients do not meet standardized diagnostic criteria for mood disorders. Post-detoxification BDI could be used as a predictive factor of therapeutic result in long-term alcohol withdrawal programs. In addition, in our study fluoxetine showed efficacy in maintaining long-term alcohol abstinence.

DDP1, a single-stranded nucleic acid-binding protein of Drosophila, associates with pericentric heterochromatin and is functionally homologous to the yeast Scp160p, which is involved in the control of cell ploidy

The centromeric dodeca-satellite of Drosophila forms altered DNA structures in vitro in which its purine-rich strand (G-strand) forms stable fold-back structures, while the complementary C-strand remains unstructured. In this paper, the purification and characterization of DDP1, a single-stranded DNA-binding protein of high molecular mass (160 kDa) that specifically binds the unstructured dodeca-satellite C-strand, is presented. In polytene chromosomes, DDP1 is found located at the chromocentre associated with the pericentric heterochromatin but its distribution is not constrained to the dodeca-satellite sequences. DDP1 also localizes to heterochromatin in interphase nuclei of larval neuroblasts. During embryo development, DDP1 becomes nuclear after cellularization, when heterochromatin is fully organized, being also associated with the condensed mitotic chromosomes. In addition to its localization at the chromocentre, in polytene chromosomes, DDP1 is also detected at several sites in the euchromatic arms co-localizing with the heterochromatin protein HP1. DDP1 is a multi-KH domain protein homologous to the yeast Scp160 protein that is involved in the control of cell ploidy. Expression of DDP1 complements a Deltascp160 deletion in yeast. These results are discussed in view of the possible contribution of DNA structure to the structural organization of pericentric heterochromatin.

Tandem 5'-GA:GA-3' mismatches account for the high stability of the fold-back structures formed by the centromeric Drosophila dodeca-satellite

The centromeric dodeca-satellite of Drosophila forms unusual DNA structures in which its purine-rich strand (GTACGGGACCGA)n folds into very stable intramolecular hairpins. These intramolecular hairpins contain groups of tandem 5'-GA:GA-3' mismatches that, as judged by gel electrophoresis analysis and UV-melting studies, have a determinant contribution to their stability. Duplexes of the dodeca-satellite purine-rich strand, carrying tandem 5'-GA:GA-3' mismatches, are as stable as equivalent fully Watson-Crick duplexes containing tandem 5'-TA:TA-3' Watson-Crick pairs in place of the non-Watson-Crick G.A pairs. On the other hand, duplexes carrying any of the other three possible tandem combinations of purine.purine mismatches, including G.A pairs on the opposite orientation 5'-AG:AG-3', are very unstable. The high stability of the dodeca-satellite hairplus suggests that the tandem G.A pairs are on the sheared configuration although they are found within the less favourable 5'-G-(G-A)-C-3' sequence context. Other centromeres DNA sequences, including the AAGAG satellite of Drosophila and the mammalian CENP-B box sequence, have the potential of forming intramolecular hairpins stabilised by similar purine.purine interactions.

[Delirium in delusions of negations of Cotard: syndrome versus disorder]

This article constitutes the first of a series directed to review fundamental disorders in clinical psychogeriatrics. This sort of publication is intended to retrieve clinical practice as the cornerstone for research and teaching in psychiatry. Besides, and particularly in geriatry, we try to expand the strategy of liaison work with primary physicians. In this case, a nosological review of the so called "delusion of negations" is presented. The Jules Cotard's original concept of subtype of delusional melancholia is contrasted to the view of numerous authors in this century who have described it as a form of non-specific delusional syndrome.

Structural polymorphism of homopurine DNA sequences. d(GGA)n and d(GGGA)n repeats form intramolecular hairpins stabilized by different base-pairing interactions

DNA sequences containing homopurine d(G1-3A)n tracts are known to be capable of adopting non-B-DNA conformations. The structural polymorphism of these sequences is a direct consequence of the structural properties of the homopurine d(G1-3A)n tracts. Depending on the conditions, d(GA)n DNA sequences can form antiparallel-and parallel-stranded homoduplexes, multistranded complexes, and ordered single-stranded conformations. On the other hand, much less is known about the structural properties of d(GGA)n and d(GGGA)n sequences. In this paper, we show that d(GGA)n and d(GGGA)n repeats form antiparallel-stranded, intramolecular hairpins. Under physiological salt and pH conditions, the thermal stability of these hairpin forms is high, showing, at 50 mM NaCl, melting temperatures in the range of 40-50 degrees C. The base-pairing interactions involved in the formation of the d(GGA)n and d(GGGA)n hairpins are different. G.A pairs importantly contribute to the stability of the d(GGA)n hairpins. On the other hand, the d(GGGA)n hairpins are stabilized by the formation of G.G and A.A, but not G.A pairs. Homopurine d(G1-3A)n tracts are frequently found at genomic locations performing specialized chromosomal functions (i.e. telomeres, centromeres, and recombination "hot-spots"). The molecular interactions described here are relevant for the understanding of the peculiar structural and biological properties of DNA sequences containing homopurine tracts.

Intramolecular TAT triplex in (dA)58.(dT)58. influence of ions

Supercoil-stabilized intramolecular triplexes have been described under various conditions in different polypurine.polypyrimidine sequences such as (dG)n.(dC)n and mixed sequences including d(GA)n.d(CT)n while information about the triplexes in (dA)n.(dT)n is scarce. Using osmium tetroxide complexes and diethyl pyrocarbonate as structural probes, we show a pyrimidine.purine.pyrimidine (TAT) triplex in (dA)58.(dT)58 sequence in a supercoiled plasmid pE19. Strong modification of approximately six central thymines and approximately six T's at the 3'-end of the (dT)58 stretch as well as the DEPC modification of the 5'-half of the (dA)58 strand suggested the prevalence of the H-y3 triplex conformer. At native superhelix density, optimum conditions for the triplex formation were close to 1 mM MgCl2, pH 8.5. At room temperature and MgCl2 concentrations below 0.5 and above 5 mM, almost no triplex was formed. It is suggested that the absence of the triplex at higher MgCl2 concentrations is due to the stabilization of the duplex by Mg2+ ions which prevents the duplex opening necessary for the triplex formation. At higher temperatures, favorable for duplex opening (e.g. 55 degrees C), the TAT triplex is formed even in the presence of 10 mM MgCl2. Among Ca2+, Sr2+, Ba2+, Cd2+, Zn2+ and Ni2+, only Ca2+ and Sr2+ yielded a modification pattern similar to that obtained with Mg2+; the modification pattern produced in the presence of Sr2+ was, however, much less intense. In the presence of 1 mM MgCl2, a decrease in pH from 8.5 to 7.7 resulted in a strong decrease of the triplex content. At highly negative superhelix density, the conditions for triplex formation were less stringent, and the triplex was observed even in the absence of MgCl2.

Characterization of the structural conformation adopted by (TTAGGG)n telomeric DNA repeats of different length in closed circular DNA

Telomeric DNA sequences are known to adopt unusual DNA structures upon protonation when contained into negatively supercoiled DNA. In this paper, the structural properties of (T2AG3)n telomeric sequences of different length is analyzed in detail. Transition to the protonated form is observed at very low pH for (T2AG3)n > or = 8 sequences. Formation of the protonated form is facilitated by negative supercoiling. The patterns of chemical modification obtained with different chemical reagents indicate that protonation induces denaturation of the (T2AG3)n telomeric sequences. Upon denaturation, the "C-rich" strand becomes structured forming, most likely, hairpin-like conformations stabilized by the formation of C+.C pairs and, probably, of A+.A pairs. The "G-rich" strand of the (T2AG3)8 sequence shows also signs of becoming structured giving rise to various structural conformers which might include triple- and tetra-stranded conformations. However, in the case of shorter sequences, the "G-rich" strand remains basically single-stranded.

Structural polymorphism of d(GA.TC)n DNA sequences. Intramolecular and intermolecular associations of the individual strands

Alternating d(GA.TC)n sequences are highly structurally polymorphic. Most of their conformational flexibility is likely to reside in the structural properties of the individual strands themselves. In this paper the conformational behaviour of the d(GA)20 and d(TC)20 oligonucleotides was analysed. Formation of d(GA)20 intramolecular duplexes is observed at any pH value, from 8.3 to 4.6. On the other hand, intramolecular d(TC)20 duplexes are formed only under acidic conditions. The acid d(TC)20 intramolecular duplex is likely to be stabilized through the formation of C+C pairs, the thymine residues remaining unpaired. The d(GA)20 oligonucleotide also forms intermolecular duplexes which coexist with the intramolecular forms at any pH, from 8.3 to 4.6. The structural conformation adopted by the d(TC)20 oligonucleotide at neutral pH is uncertain. Under these conditions, this oligonucleotide shows an electrophoretic apparent molecular weight consistent with the formation of a bimolecular complex. However, no hydrogen bonding was observed to occur under these conditions. Implications of these results for an understanding of the molecular principles behind the conformational flexibility of alternating d(GA.TC)n sequences are discussed. The possible biological significance of these results is also discussed.

Alternating d(GA)n DNA sequences form antiparallel stranded homoduplexes stabilized by the formation of G.A base pairs

Alternating d(GA)n DNA sequences form antiparallel stranded homoduplexes which are stabilized by the formation of G.A pairs. Three base pairings are known to occur between adenine and guanine: AH+ (anti).G(syn), A(anti).G(anti) and A(syn).G(anti). Protonation of the adenine residues is not involved in the stabilization of this structure, since it is observed at any pH value from 8.3 to 4.5; at pH < or = 4.0 antiparallel stranded d(GA.GA) DNA is destabilized. The results reported in this paper strongly suggest that antiparallel stranded d(GA.GA) homoduplexes are stabilized by the formation of alternating A(anti).G(anti) and G(anti).A(syn) pairs. In this structure, all guanine residues are in the anti conformation with their N7 position freely accessible to DMS methylation. On the other hand, adenines in one strand adopt the anti conformation, with their N7 position also free for reaction, while those of the opposite strand are in the syn conformation, with their N7 position hydrogen bonded to the guanine N1 group of the opposite strand. A regular right-handed helix can be generated using alternating G(anti).A(syn) and A(anti).G(anti) pairs.

The problem of coping as a reason for psychiatric consultation

To examine those patients referred to psychiatry for the "problem of coping," a structured clinical databased management system--MICRO-CARES--was employed to identify the frequency, demographic characteristics, psychiatric diagnoses, psychosocial interventions, use of psychopharmacology, number of follow-up visits, and discharge placement of these referrals. Consultations totaling 1,157 from July 1, 1988 through January 1, 1990 were divided into two groups and compared: "Not coping" (N = 456, 28.5%) and "others" (N = 701, 61%). Those with a "problem in coping" more often had no Axis I diagnosis (p = 0.001), or were described as adjustment disorders (p = 0.0001). Fewer recommendations were made for those with a coping problem, although lag time (admission date to request for consultation), number of follow-ups, and discharge placement were not significantly different between the two groups. Stepwise logistic regression analyses revealed that the aged had lesser risk for being referred with a coping problem; those who were white, had their own income, experienced greater stress prior to hospitalization (Axis IV), and had higher functioning during the last year (Axis V) were at greater risk.

Psychiatric care of coronary artery disease in a cardiac rehabilitation unit

The present work describes the psychiatric intervention in the Ramón y Cajal Hospital (Madrid) Cardiac Rehabilitation Program for Coronary Disease patients. The psychopathological concepts in relation to coronary heart disease are reviewed and studied in the foregoing acute and rehabilitation phases. The evaluation and therapeutic intervention methods are related in detail. Finally, results obtained in 90 patients who were treated in the past 3 years are analyzed. We mainly focused on the psychological risk factors and the psychosocial aspects.

Pharmacokinetics of 2-methyl-9-hydroxyellipticinium acetate (NSC-264137) in cancer patients (phase I study)

In 12 cancer patients we studied the pharmacokinetics of a new antitumor compound, elliptinium, which is a quaternary ammonium derivative of ellipticine, after i.v. infusion. The main parameters were calculated by means of the ADAPT program based upon plasma concentrations and urinary elimination determined by a high performance liquid chromatographic assay and fluorescence detection. The mean apparent volume of distribution for the central compartment, V1, is 2.8 l, the total plasma clearance is 971 ml/min, with a renal clearance of 127 ml/min. The mean elimination half-life, t1/2, z, is 23.7 hr, but shows a large interindividual variation. Urinary elimination is quite low (16%), with the main part (12%) excreted in the first 24 hr. In vitro plasma protein binding (78%) was found to be independent of the concentration (0.1-5.0 micrograms/ml).

[N-Methyl-9 hydroxy-ellipticine (NSC 264-137) in the treatment of malignant metastases. Preliminary results (author's transl)]

In a phase II trial 2 N-Methyl-9-Hydroxy-Ellipticine (NMHE) was administered in weekly infusions of 100mg/m2 over 1 hour to patients with malignant metastases. Prior to injection, the drug was dissolved in 250 ml isotonic glucose. The results were evaluated in 67 patients. Objective regression was observed in 23 (34%) and was superior to 50% in 10 cases. Patients showing signs of regression under treatment were mostly those with breast cancer (10/24 cases), soft tissue sarcoma (3/9 cases) and renal cancer (2/8 cases). The main toxic effect was haemolysis (2 cases), probably due to an immunoallergic mechanism. Attention is drawn to the lack of bone marrow toxicity.