HIV-assoziierte tuberkulöse Meningoenzephalitis als Ursache abnormen Verhaltens in Haft

Zusammenfassung: Über Art und Häufigkeit psychoorganischer Syndrome bei Inhaftierten ist wenig bekannt. Wir berichten über einen 20-jährigen, HIV-I-positiven Asylbewerber aus Schwarzafrika mit bisher unauffälliger psychiatrischer Anamnese, der in Ausschaffungshaft ein zunehmend bizarres Verhalten entwickelte. Die paranoid-halluzinatorische Verwirrtheit mit tageszeitabhängiger Ausprägung und Desorientierung führte zur Diagnose Delir. Als Ursache hierfür fand sich eine AIDS-definierende tuberkulöse Meningoenzephalitis, die spezifisch und symptomatisch behandelt wurde. Dieser Fall illustriert die Schwierigkeiten der Diagnostik und die Bedeutung der Verhaltensbeobachtung bei eingeschränkten sprachlichen Verständigungsmöglichkeiten. Bei Häftlingen mit Verhaltensauffälligkeiten sollten stets auch somatische Differenzialdiagnosen in Betracht gezogen werden. Pathogenese und Diagnostik der tuberkulösen Meningoenzephalitis werden diskutier

Einstellungen zu alten Menschen zu Beginn und am Ende des Medizinstudiums

Zusammenfassung: In der vorliegenden Studie wurden 188 Medizinstudenten des ersten und 120 des sechsten Studienjahres der Universität Zürich hinsichtlich ihrer Einstellungen zum Alter, ihrem Wissen zu alterspezifischen Vorgängen, ihren Erfahrungen mit alten Menschen und ihren eigenen Erwartungen an das Alter befragt. Eingesetzt wurden voll strukturierte, standardisierte Fragebögen. Die Auswertung erfolgte mittels uni- und multivariater statistischer Methoden. Die Ergebnisse zeigen, weitgehend unabhängig von Geschlecht und Studienjahr, ein positives Altersbild der Studierenden. Ihre positiven Erfahrungen mit alten Menschen und ihre positiven Erwartungen an das eigene Alter betreffen vor allem die eigene psychische Gesundheit. Für die Vermittlung von gerontologischem und geriatrischem Wissen in der Ausbildung von Medizinstudenten sollte diesen überwiegend positiven Einstellungen gegenüber älteren Menschen Rechnung getragen werden und sowohl auf Risiko- als auch auf protektive Faktoren für die Entstehung und Behandlung alterstypischer gesundheitlicher Störungen hingewiesen werde

Einstellungen zu alten Menschen zu Beginn und am Ende des Medizinstudiums

In der vorliegenden Studie wurden 188 Medizinstudenten des ersten und 120 des sechsten Studienjahres der Universität Zürich hinsichtlich ihrer Einstellungen zum Alter, ihrem Wissen zu alterspezifischen Vorgängen, ihren Erfahrungen mit alten Menschen und ihren eigenen Erwartungen an das Alter befragt. Eingesetzt wurden voll strukturierte, standardisierte Fragebögen. Die Auswertung erfolgte mittels uni- und multivariater statistischer Methoden. Die Ergebnisse zeigen, weitgehend unabhängig von Geschlecht und Studienjahr, ein positives Altersbild der Studierenden. Ihre positiven Erfahrungen mit alten Menschen und ihre positiven Erwartungen an das eigene Alter betreffen vor allem die eigene psychische Gesundheit. Für die Vermittlung von gerontologischem und geriatrischem Wissen in der Ausbildung von Medizinstudenten sollte diesen überwiegend positiven Einstellungen gegenüber älteren Menschen Rechnung getragen werden und sowohl auf Risiko- als auch auf protektive Faktoren für die Entstehung und Behandlung alterstypischer gesundheitlicher Störungen hingewiesen werden. = In the present study, 188 first year and 120 sixth year students of the University of Zurich were questioned about their attitudes towards older people, their knowledge concerning aging specific developments, their experiences with older people and their own expectations concerning old age. Structured and standardized questionnaires were used. The data were analyzed using univariate and multivariate statistical methods. The results show a positive image of old age independent of gender and point in time of education. Their positive experiences with older people and their positive expectations concern their own aging refer, above all, to their own mental health. For the transfer of gerontological and geriatric knowledge in the education of medical students, these mainly positive attitudes towards older people should be taken into account. Risk factors as well as protective factors concerning the development and treatment of diseases which are characteristic for old age should be pointed out

Suicide prevention for youth - a mental health awareness program: lessons learned from the Saving and Empowering Young Lives in Europe (SEYLE) intervention study.

ABSTRACT: BACKGROUND: The Awareness program was designed as a part of the EU-funded Saving and Empowering Young Lives in Europe (SEYLE) intervention study to promote mental health of adolescents in 11 European countries by helping them to develop problem-solving skills and encouraging them to self-recognize the need for help as well as how to help peers in need. METHODS: For this descriptive study all coordinators of the SEYLE Awareness program answered an open-ended evaluation questionnaire at the end of the project implementation. Their answers were synthesized and analyzed and are presented here. RESULTS: The results show that the program cultivated peer understanding and support. Adolescents not only learned about mental health by participating in the Awareness program, but the majority of them also greatly enjoyed the experience. CONCLUSIONS: Recommendations for enhancing the successes of mental health awareness programs are presented. Help and cooperation from schools, teachers, local politicians and other stakeholders will lead to more efficacious future programs

Neurophysiology

Contains research objectives and reports on nine research projects.The Teagle Foundation, Inc.U.S. Air Force (Aeronautical Systems Division) under Contract AF33(616)-7783Bell Telephone Laboratories, Inc.National Institutes of Health [Grant M-4235-(C1)]National Institutes of Health (Grant B-1865-(C3))National Institutes of Health (Grant MP-4737)National Institutes of Health (Grant B-2480(C1)

Psychosocial stress and brain function in adolescent psychopathology

Objective: To explore how conduct, hyperactivity/inattention, and emotional symptoms are associated with neural reactivity to social-emotional stimuli, and the extent to which psychosocial stress modulates these relationships. Method: Participants were community adolescents recruited as part of the European IMAGEN study. Bilateral amygdala regions of interest were used to assess the relationship between the three symptom domains with fMRI neural reactivity during passive viewing of dynamic angry and neutral facial expressions. Exploratory functional connectivity and whole-brain multiple regression approaches were used to analyze how the symptoms and psychosocial stress relate to other brain regions. Results: In response to the social-emotional stimuli, adolescents with high levels of conduct or hyperactivity/inattention symptoms showed hyperactivity of the amygdala, and several regions across the brain, when they experienced a greater number of stressful life events. This effect was not observed with emotional symptoms. A cluster in the mid-cingulate was found to be common to both conduct problems and hyperactivity symptoms. Exploratory functional connectivity analyses suggested amygdala-precuneus connectivity is associated with hyperactivity/inattention symptoms. Conclusions: The results link hyperactive amygdala responses, and regions critical for top-down emotional processing, with high levels of psychosocial stress in individuals with greater conduct and hyperactivity/inattention symptoms. This work highlights the importance of studying how psychosocial stress impacts functional brain responses to social-emotional stimuli, particularly in adolescents with externalizing symptoms

Transient Receptor Potential Channel Polymorphisms Are Associated with the Somatosensory Function in Neuropathic Pain Patients

Transient receptor potential channels are important mediators of thermal and mechanical stimuli and play an important role in neuropathic pain. The contribution of hereditary variants in the genes of transient receptor potential channels to neuropathic pain is unknown. We investigated the frequency of transient receptor potential ankyrin 1, transient receptor potential melastin 8 and transient receptor potential vanilloid 1 single nucleotide polymorphisms and their impact on somatosensory abnormalities in neuropathic pain patients. Within the German Research Network on Neuropathic Pain (Deutscher Forscbungsverbund Neuropathischer Schmerz) 371 neuropathic pain patients were phenotypically characterized using standardized quantitative sensory testing. Pyrosequencing was employed to determine a total of eleven single nucleotide polymorphisms in transient receptor potential channel genes of the neuropathic pain patients and a cohort of 253 German healthy volunteers. Associations of quantitative sensory testing parameters and single nucleotide polymorphisms between and within groups and subgroups, based on sensory phenotypes, were analyzed. Single nucleotide polymorphisms frequencies did not differ between both the cohorts. However, in neuropathic pain patients transient receptor potential ankyrin 1 710G>A (rs920829, E179K) was associated with the presence of paradoxical heat sensation (p = 0.03), and transient receptor potential vanilloid 1 1911A>G (rs8065080, I585V) with cold hypoalgesia (p = 0.0035). Two main subgroups characterized by preserved (1) and impaired (2) sensory function were identified. In subgroup 1 transient receptor potential vanilloid 1 1911A>G led to significantly less heat hyperalgesia, pinprick hyperalgesia and mechanical hypaesthesia (p = 0.006, p = 0.005 and p<0.001) and transient receptor potential vanilloid 1 1103C>G (rs222747, M315I) to cold hypaesthesia (p = 0.002), but there was absence of associations in subgroup 2. In this study we found no evidence that genetic variants of transient receptor potential channels are involved in the expression of neuropathic pain, but transient receptor potential channel polymorphisms contributed significantly to the somatosensory abnormalities of neuropathic pain patients

Human subcortical brain asymmetries in 15,847 people worldwide reveal effects of age and sex

The two hemispheres of the human brain differ functionally and structurally. Despite over a century of research, the extent to which brain asymmetry is influenced by sex, handedness, age, and genetic factors is still controversial. Here we present the largest ever analysis of subcortical brain asymmetries, in a harmonized multi-site study using meta-analysis methods. Volumetric asymmetry of seven subcortical structures was assessed in 15,847 MRI scans from 52 datasets worldwide. There were sex differences in the asymmetry of the globus pallidus and putamen. Heritability estimates, derived from 1170 subjects belonging to 71 extended pedigrees, revealed that additive genetic factors influenced the asymmetry of these two structures and that of the hippocampus and thalamus. Handedness had no detectable effect on subcortical asymmetries, even in this unprecedented sample size, but the asymmetry of the putamen varied with age. Genetic drivers of asymmetry in the hippocampus, thalamus and basal ganglia may affect variability in human cognition, including susceptibility to psychiatric disorders

Suicide prevention for youth - a mental health awareness program: lessons learned from the Saving and Empowering Young Lives in Europe (SEYLE) intervention study

Background: The Awareness program was designed as a part of the EU-funded Saving and Empowering Young Lives in Europe (SEYLE) intervention study to promote mental health of adolescents in 11 European countries by helping them to develop problem-solving skills and encouraging them to self-recognize the need for help as well as how to help peers in need. Methods: For this descriptive study all coordinators of the SEYLE Awareness program answered an open-ended evaluation questionnaire at the end of the project implementation. Their answers were synthesized and analyzed and are presented here. Results: The results show that the program cultivated peer understanding and support. Adolescents not only learned about mental health by participating in the Awareness program, but the majority of them also greatly enjoyed the experience. Conclusions: Recommendations for enhancing the successes of mental health awareness programs are presented. Help and cooperation from schools, teachers, local politicians and other stakeholders will lead to more efficacious future programs

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder