Assessment of Clinical Information: Comparison of the Validity of a Structured Clinical Interview (the Scid) and the Clinical Diagnostic Interview

Adaptive functioning is a key aspect of psychiatric diagnosis and assessment in research and practice. This study compared adaptive functioning validity ratings from Structured Clinical Interviews (SCIDs, symptom-focused structured diagnostic interviews), and Clinical Diagnostic Interviews (CDIs, systematic diagnostic interviews modeling naturalistic clinical interactions focusing on relational narratives). Two hundred forty-five patients (interviewed by two independent interviewers) and their interviewers completed the Clinical Data Form which assesses adaptive functioning and clinical information. Both interviews converged strongly with patient-reports, with no significant differences in validity of the interviews in measuring global and specific domains of adaptive functioning variables. Findings suggest that CDIs provide adaptive functioning data comparable to SCIDs (often considered gold standard for assessment but difficult to use in practice) and have important implications for bridging the research-practice gap. By incorporating clinicians\u27 everyday methods, CDIs yield information that is psychometrically sound for empirical investigation, diagnostically practical, and clinically meaningful and valid

Agreement Between Clinician and Patient Ratings of Adaptive Functioning and Developmental History

Objective: Psychiatric researchers rely heavily on patient report data for clinical research. However, patient reports are prone to defensive and self-presentation biases. Recent research using practice networks has relied on clinician reports, and both forensic and personality disorder researchers have recently turned to quantified data from clinically expert observers as well. However, critics have raised legitimate concerns about the reliability and validity of data from clinician informants. The aim of this study was to assess the validity and diagnostic efficiency of clinician reports of their patients\u27 adaptive functioning and developmental histories, using patient reports as the comparative standard traditionally used in psychiatric research. Method: Eighty-four clinicians and their patients completed a clinical data form designed to assess a range of patient functioning, clinical history, and developmental relationship variables used in multiple clinician report studies. The authors correlated clinician and patient reports across a number of clinically relevant adaptive functioning variables and calculated diagnostic efficiency statistics for a range of clinical history variables, including suicide attempts, hospitalizations, arrests, interpersonal conflicts affecting employment, and childhood physical and sexual abuse. Results: Across variables, patient-therapist correlations (0.40-0.66) and overall correct classification statistics (0.74-0.96) were high. Conclusions: The data demonstrate that clinicians\u27 judgments about their patients\u27 functioning and histories agree with patients\u27 self-reports and that in areas of discrepancy, clinicians tend to make appropriately conservative judgments in the absence of clear data. These findings suggest that quantified clinical judgment provides a vast untapped potential for large-sample research on psychopathology and treatment

Perceived stress and depression in stroke patients with and without aphasia

Therefore, the purpose of the current study is to determine whether perceived stress, neurological functioning, and depressive symptoms are associated in a sample of left hemisphere stroke patients with aphasia (LH) and right hemisphere stroke patients without aphasia (RH). We also explore change over time in these measures

Prototype personality diagnosis in clinical practice: A viable alternative for DSM–5 and ICD–11

Several studies suggest that a prototype-matching approach yields diagnoses of comparable validity to the more complex diagnostic algorithms outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Furthermore, clinicians prefer prototype diagnosis of personality disorders to the current categorical diagnostic system or alternative dimensional methods. An important extension of this work was to investigate the degree to which clinicians are able to make prototype diagnoses reliably. The aim of this study was to assess the interrater reliability of a prototype-matching approach to personality diagnosis in clinical practice. Using prototypes derived empirically in prior research, outpatient clinicians diagnosed patients' personality after an initial evaluation period. External evaluators independently diagnosed the same patients after watching videotapes of the same clinical hours. Interrater reliability for prototype diagnosis was high, with a median r ϭ .72. Cross-correlations between disorders were low, with a median r ϭ .01. Clinicians and clinically trained independent observers can assess complex personality constellations with high reliability using a simple prototype-matching procedure, even with prototypes that are relatively unfamiliar to them. In light of its demonstrated reliability, efficiency, and versatility, prototype diagnosis appears to be a viable system for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders and the 11th edition of the International Classification of Diseases, with exceptional utility for research and clinical practice

Cytokine secretion from mononuclear cells cultured in vitro with starch-based polymers and poly-L-lactide

The cytokine network is one of the major controlling systems of the inflammatory process, driving the magnitude and duration of the host response against invading microorganisms, foreign materials, or altered internal stimuli. Pro- and antiinflammatory cytokines were quantified after in vitro culture of a mixed population of monocytes/macrophages and lymphocytes with biodegradable polymers. Different blends of starch-based polymers and their composites filled with hydroxyapatite were studied and compared with poly-L-lactide. Interleukin (IL)-1, IL-6, and tumour necrosis factor- were investigated as the markers of immunological reactivity because they are known to act at the early stages of injury/invasion. Interferon-, recognized as a proinflammatory cytokine, although not present during early responses was also investigated. Contrarily, IL-4 derived from T lymphocytes, was investigated because it is an immunoregulator that counteracts some aspects of inflammation. T lymphocyte activation was also determined by quantifying IL-2. The results support the hypothesis that different biodegradable polymers can affect mononuclear cell activation and the production of several cytokines associated with the inflammatory process. No IL-2 or interferon- was found in the culture supernatants after 3, 7, and 14 days in the presence of any of the materials. IL-6 was detected in the highest amounts, for all the conditions, followed by tumour necrosis factor-. IL-1 was produced in very low amounts, being undetectable with some of the starch-based materials. IL-4 was the only cytokine that did not demonstrate any significant difference within this group of materials. Starch-based polymers and composites induced lower production of proinflammatory cytokines in comparison to poly-L-lactide.Fundação para a Ciência e a Tecnologia (FCT

Interaction and uptake of exosomes by ovarian cancer cells

<p>Abstract</p> <p>Background</p> <p>Exosomes consist of membrane vesicles that are secreted by several cell types, including tumors and have been found in biological fluids. Exosomes interact with other cells and may serve as vehicles for the transfer of protein and RNA among cells.</p> <p>Methods</p> <p>SKOV3 exosomes were labelled with carboxyfluoresceine diacetate succinimidyl-ester and collected by ultracentrifugation. Uptake of these vesicles, under different conditions, by the same cells from where they originated was monitored by immunofluorescence microscopy and flow cytometry analysis. Lectin analysis was performed to investigate the glycosylation properties of proteins from exosomes and cellular extracts.</p> <p>Results</p> <p>In this work, the ovarian carcinoma SKOV3 cell line has been shown to internalize exosomes from the same cells via several endocytic pathways that were strongly inhibited at 4°C, indicating their energy dependence. Partial colocalization with the endosome marker EEA1 and inhibition by chlorpromazine suggested the involvement of clathrin-dependent endocytosis. Furthermore, uptake inhibition in the presence of 5-ethyl-N-isopropyl amiloride, cytochalasin D and methyl-beta-cyclodextrin suggested the involvement of additional endocytic pathways. The uptake required proteins from the exosomes and from the cells since it was inhibited after proteinase K treatments. The exosomes were found to be enriched in specific mannose- and sialic acid-containing glycoproteins. Sialic acid removal caused a small but non-significant increase in uptake. Furthermore, the monosaccharides D-galactose, α-L-fucose, α-D-mannose, D-N-acetylglucosamine and the disaccharide β-lactose reduced exosomes uptake to a comparable extent as the control D-glucose.</p> <p>Conclusions</p> <p>In conclusion, exosomes are internalized by ovarian tumor cells via various endocytic pathways and proteins from exosomes and cells are required for uptake. On the other hand, exosomes are enriched in specific glycoproteins that may constitute exosome markers. This work contributes to the knowledge about the properties and dynamics of exosomes in cancer.</p

Использование симуляционных технологий при изучении клинических дисциплин в Витебском государственном медицинском университете

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