Dehydroepiandrosterone augmentation in the management of negative,depressive, and anxiety symptoms in schizophrenia

CONTEXT: Negative symptoms of schizophrenia are a prominent feature of the illness, and frequently remain refractory to treatment. Dehydroepiandrosterone (DHEA), along with its sulfated form, DHEA-S, is an important circulating neurosteroid with several vital neurophysiological functions, including the regulation of neuronal excitability and function. OBJECTIVE: Since the administration of DHEA has demonstrated improvement in mood, sense of well-being, interest, activity, and energy in several subpopulations, we investigate the efficacy of DHEA in the management of the negative symptoms of schizophrenia. DESIGN: Thirty DSM-IV-diagnosed schizophrenic patients with prominent negative symptoms (inpatients in a large referral state hospital) were randomized to receive either DHEA or placebo in double-blind fashion, in addition to regular antipsychotic medication, dose-stabilized prior to study entry. The DHEA was titrated up to a dose of 100 mg in divided doses during 6 weeks. RESULTS: Results indicated significant improvement in negative symptoms (P<.001), as well as in depressive (P<.05) and anxiety (P<.001) symptoms in individuals receiving DHEA. This effect was especially noted in women. The improvement in negative symptoms was independent of improvement in depression. No differences were noted on the positive symptom subscale of the Positive and Negative Syndrome Scale (PANSS) or on the total PANSS score as compared with placebo. Subjects receiving DHEA demonstrated a significant increase in DHEA (P<.05) and DHEA-S (P<.01) plasma levels, without changes in cortisol levels. Increases in DHEA and plasma DHEA-S levels were correlated with improvement in negative symptoms (P<.05), but not with improvement in depressive and anxiety symptoms. No obvious adverse effects were experienced by participating subjects. CONCLUSIONS: Our preliminary observations report for the first time in double-blind fashion the efficacy of DHEA augmentation in the management of negative, depressive, and anxiety symptoms of schizophrenia. The findings from this study raise important issues regarding the role of neurosteroids in general, and DHEA in particular, in the ongoing symptomatology and pharmacotherapy of schizophrenia.     

Ileal duplication in adults

Alimentary tract duplications are rare anomalies usually present in childhood. They are most common in the ileum, but can occur anywhere along the alimentary tract from the mouth to the anus. We report a case of a 23-year-old female presented with severe epigastric and lower abdominal pain of one day duration, and was found to have perforated tubular ileal duplication communicating with the ileum on surgery.     

Abnormal cardiac function in the streptozotocin-diabetic rat. Changes in active and passive properties of the left ventricle.

To provide an integrated assessment of changes in systolic and diastolic function in diabetic rats, we measured conscious hemodynamics and performed ex vivo analysis of left ventricular passive-elastic properties. Rats given streptozotocin (STZ) 65 mg/kg i.v. (n = 14) were compared with untreated age-matched controls (n = 15) and rats treated with insulin after administration of STZ (n = 11). After 7 d, diabetic rats exhibited decreases in heart rate and peak developed left ventricular (LV) pressure during aortic occlusion. After 26 d of diabetes there were significant decreases in resting LV systolic pressure, developed pressure, and maximal +dP/dt, whereas LV end-diastolic pressure increased and the time constant of LV relaxation was prolonged. The passive LV pressure-volume relationship was progressively shifted away from the pressure axis, and the overall chamber stiffness constant was decreased. However, "operating chamber stiffness" calculated at end-diastolic pressure was increased at 7 d, and unchanged at 26 d. LV cavity/wall volume and end-diastolic volume were increased after 26 d of diabetes. Myocardial stiffness was unchanged at both time intervals. All of the above abnormalities were reversed by the administration of insulin. We conclude that the hemodynamic and passive-elastic changes that occur in diabetic rats represent an early dilated cardiomyopathy which is reversible with insulin.     

Comparison of a 28-channel receive array coil and quadrature volume coil for morphologic imaging and T2 mapping of knee cartilage at 7T

Purpose:

To compare a new birdcage‐transmit, 28‐channel receive array (28‐Ch) coil and a quadrature volume coil for 7T morphologic MRI and T2 mapping of knee cartilage.

Materials and Methods:

The right knees of 10 healthy subjects were imaged on a 7T whole body magnetic resonance (MR) scanner using both coils. 3D fast low‐angle shot (3D‐FLASH) and multiecho spin‐echo (MESE) sequences were implemented. Cartilage signal‐to‐noise ratio (SNR), contrast‐to‐noise ratio (CNR), thickness, and T2 values were assessed.

Results:

SNR/CNR was 17%–400% greater for the 28‐Ch compared to the quadrature coil (P ≤ 0.005). Bland–Altman plots show mean differences between measurements of tibial/femoral cartilage thickness and T2 values obtained with each coil to be small (?0.002 ± 0.009 cm / 0.003 ± 0.011 cm) and large (?6.8 ± 6.7 msec/?8.2 ± 9.7 msec), respectively. For the 28‐Ch coil, when parallel imaging with acceleration factors (AF) 2, 3, and 4 was performed SNR retained was: 62%–69%, 51%–55%, and 39%–45%.

Conclusion:

A 28‐Ch knee coil provides increased SNR/CNR for 7T cartilage morphologic imaging and T2 mapping. Coils should be switched with caution during clinical studies because T2 values may differ. The greater SNR of the 28‐Ch coil could be used to perform parallel imaging with AF2 and obtain similar SNR as the quadrature coil. J. Magn. Reson. Imaging 2012;441‐448. © 2011 Wiley Periodicals, Inc.

     

Catalytic filtration: efficient C-C cross-coupling using Pd(II)-salen complex-embedded cellulose filter paper as a portable catalyst

A new approach has been developed for environmentally friendly C-C cross-coupling reactions using bi-functional Pd(ii)-salen complex-embedded cellulose filter paper (FP@Si-Pd^II-Salen-[IM]OH). A Pd(ii)-salen complex bearing imidazolium [OH]⁻moieties was covalently embedded into a plain filter paper, then used as an efficient portable catalyst for the Heck, Suzuki, and Sonogashira cross-coupling reactions under environmentally friendly conditions via the filtration method. The catalytic filter paper properties were studied by EDX, XPS, TGA, ATR, XRD, and FESEM analyses. The reactions were catalyzed during reactants'' filtration over the catalytic filter paper. The modified filter paper was set up over a funnel and the reactants were passed through the catalytic filter paper several times. The effect of reaction parameters including loading of Pd(ii)-salen complex, temperature, solvent, and contact time were carefully studied and also the optimal model of conditions was presented by the design expert software. High to excellent yields were obtained for all C–C coupling types with 5 to 8 filtration times. Under optimal conditions, all coupling reactions showed high selectivity and efficiency. Another advantage of the modified filter paper was its stability and reusability for several times with preservation of catalytic activity and swellability.

A new platform has been developed for environmentally friendly C–C cross-coupling reactions via filtration of reactants through a portable Pd^(II)-salen complex-embedded filter paper.