Assessing somatization in urologic chronic pelvic pain syndrome

BACKGROUND: This study examined the prevalence of somatization disorder in Urological Chronic Pelvic Pain Syndrome (UCPPS) and the utility of two self-report symptom screening tools for assessment of somatization in patients with UCPPS. METHODS: The study sample included 65 patients with UCPPS who enrolled in the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Study at Washington University. Patients completed the PolySymptomatic PolySyndromic Questionnaire (PSPS-Q) (n = 64) and the Patient Health Questionnaire-15 Somatic Symptom Severity Scale (PHQ-15) (n = 50). Review of patient medical records found that only 47% (n = 30) contained sufficient documentation to assess Perley-Guze criteria for somatization disorder. RESULTS: Few (only 6.5%) of the UCPPS sample met Perley-Guze criteria for definite somatization disorder. Perley-Guze somatization disorder was predicted by definite PSPS-Q somatization with at least 75% sensitivity and specificity. Perley-Guze somatization disorder was predicted by severe (\u3e 15) PHQ-15 threshold that had \u3e 90% sensitivity and specificity but was met by only 16% of patients. The moderate (\u3e 10) PHQ-15 threshold had higher sensitivity (100%) but lower specificity (52%) and was met by 52% of the sample. CONCLUSIONS: The PHQ-15 is brief, but it measures symptoms constituting only one dimension of somatization. The PSPS-Q uniquely captures two conceptual dimensions inherent in the definition of somatization disorder, both number of symptoms and symptom distribution across multiple organ systems, with relevance for UCPPS as a syndrome that is not just a collection of urological symptoms but a broader syndrome with symptoms extending beyond the urological system

Cultural factors that affected the spatial and temporal epidemiology of kuru

Kuru is a prion disease which became epidemic among the Fore and surrounding linguistic groups in Papua New Guinea, peaking in the late 1950s. It was transmitted during the transumption (endocannibalism) of dead family members at mortuary feasts. In this study, we aimed to explain the historical spread and the changing epidemiological patterns of kuru by analysing factors that affected its transmission. We also examined what cultural group principally determined a family’s behaviour during mortuary rituals. Our investigations showed that differences in mortuary practices were responsible for the initial pattern of the spread of kuru and the ultimate shape of the epidemic, and for subsequent spatio-temporal differences in the epidemiology of kuru. Before transumption stopped altogether, the South Fore continued to eat the bodies of those who had died of kuru, whereas other linguistic groups, sooner or later, stopped doing so. The linguistic group was the primary cultural group that determined behaviour but at linguistic boundaries the neighbouring group’s cultural practices were often adopted. The epidemiological changes were not explained by genetic differences, but genetic studies led to an understanding of genetic susceptibility to kuru and the selection pressure imposed by kuru, and provided new insights into human history and evolution

Motor-Incompatibility of Facial Reactions : The influence of valence and stimulus content on voluntary facial reactions

Emotional cues facilitate motor responses that are associated with approach or avoidance. Previous research has shown that evaluative processing of positive and negative facial expression stimuli is also linked to motor schemata of facial muscles. To further investigate the influence of different types of emotional stimuli on facial reactions, we conducted a study with pictures of emotional facial expressions (KDEF) and scenes (IAPS). Healthy participants were asked to respond to the positive or negative facial expressions (KDEF) and scenes (IAPS) with specific facial muscles in a valence-congruent (stimulus valence matches muscle related valence) or a valence-incongruent condition (stimulus valence is contrary to muscle related valence). Additionally, they were asked to rate pictures in terms of valence and arousal. Muscular response latencies were recorded by an electromyogram. Overall, response latencies were shorter in response to facial expressions than to complex pictures of scenes. For both stimulus categories, response latencies with valence-compatible muscles were shorter compared to reactions with incompatible muscles. Moreover, correlations between picture ratings and facial muscle reactions for happy facial expressions as well as positive scenes reflect a direct relationship between perceived intensity of the subjective emotional experience and physiological responding. Results replicate and extend previous research, indicating that incompatibility effects are reliable across different stimulus types and are not limited to facial mimicry

Mosquito nets for the elderly?

Nine-year follow-up (ending 1999) of survival of 3738 individuals in a malaria-endemic area of Papua New Guinea found that the use of mosquito nets was associated with a large reduction in mortality in people aged ⩾40 years as well as in children aged <5 years. There may be substantial benefits of malaria transmission reduction for older people, that have been overlooked in public health programmes and burden of disease calculation

Geometric reconstruction methods for electron tomography

Electron tomography is becoming an increasingly important tool in materials science for studying the three-dimensional morphologies and chemical compositions of nanostructures. The image quality obtained by many current algorithms is seriously affected by the problems of missing wedge artefacts and nonlinear projection intensities due to diffraction effects. The former refers to the fact that data cannot be acquired over the full $180^\circ$ tilt range; the latter implies that for some orientations, crystalline structures can show strong contrast changes. To overcome these problems we introduce and discuss several algorithms from the mathematical fields of geometric and discrete tomography. The algorithms incorporate geometric prior knowledge (mainly convexity and homogeneity), which also in principle considerably reduces the number of tilt angles required. Results are discussed for the reconstruction of an InAs nanowire

Inhibition of return in fear of spiders: Discrepant eye movement and reaction time data

Inhibition of return (IOR) refers to a bias against returning the attention to a previously attended location. As a foraging facilitator it is thought to facilitate systematic visual search. With respect to neutral stimuli, this is generally thought to be adaptive, but when threatening stimuli appear in our environment, such a bias may be maladaptive. This experiment investigated the influence of phobia-related stimuli on the IOR effect using a discrimination task. A sample of 50 students (25 high, 25 low in spider fear) completed an IOR task including schematic representations of spiders or butterflies as targets. Eye movements were recorded and to assess discrimination among targets, participants indicated with button presses if targets were spiders or butterflies. Reaction time data did not reveal a significant IOR effect but a significant interaction of group and target; spider fearful participants were faster to respond to spider targets than to butterflies. Furthermore, eye-tracking data showed a robust IOR effect independent of stimulus category. These results offer a more comprehensive assessment of the motor and oculomotor factors involved in the IOR effect

Reduced risk of clinical malaria in children infected with multiple clones of Plasmodium falciparum in a highly endemic area: a prospective community study

A prospective community study in a highly malaria endemic area of Papua New Guinea found that infection with multiple Plasmodium falciparum genotypes was an indicator of lowered risk of subsequent clinical attack. The results suggest that concurrent or very recent infections provide protection from superinfecting parasites. The finding of an association between reduced risk of clinical malaria and infection with parasites of merozoite surface protein 1 (MSP-1) type RO33 or MSP-2 type 3D7 further suggests that the concomitant immunity is, at least in part, a consequence of a response to these major merozoite surface protein