Depression is highly prevalent in children and adolescents. Psychodynamic therapies are only insufficiently evaluated in this field although many children and adolescents suffering from depression ...are treated using this approach. Therefore, the aim of our study was to evaluate the efficacy of psychodynamic short-term psychotherapy (PSTP) for the treatment of depression in children and adolescents. In a waiting-list controlled study, 20 children and adolescents fulfilling diagnosis of major depression or dysthymia were included. The treatment group received 25 sessions of psychodynamic psychotherapy. Main outcome criterion was the Impairment-Score for Children and Adolescents (IS-CA) as well as the Psychic and Social-Communicative Findings Sheet for Children and Adolescents (PSCFS-CA) and the Child Behavior Checklist (CBCL), which were assessed at the beginning and the end of treatment. The statistical and clinical significance of changes in these measures were evaluated. There was a significant advantage of the treatment group compared to the waiting group for the IS-CA. The effect size of the IS-CA total score was 1,3. In contrast to the treatment group, where 20% of the children showed clinically significant and reliable improvement, no subject in the waiting-list control group met this criterion. Comparable results were found for the PSCFS-CA and for the internalising score assessed with the CBCL. The results show that psychodynamic short-term psychotherapy (PSTP) is an effective treatment for depressed children and adolescents. Still, some of the children surely require more intensive treatment.
Anxiety disorders can be regarded as one of the most prevalent disorders in children and adolescents. Although psychodynamic psychotherapies are frequently carried out in this field, the evaluation ...of its efficacy for anxiety disorders is still deficient. Therefore the aim of the study was to evaluate psychodynamic short-term psychotherapy (PSTP) comprising 25 therapy sessions for children and adolescents with anxiety disorders. In a controlled trial PSTP was compared to a waiting list control condition. 26 children and adolescents with anxiety disorders were included in the study. Treatment outcome was measured by the Impairment-Score for Children and Adolescents (IS-CA). Moreover, the Child Behavior Checklist (CBCL) and the Psychic and Social-Communicative Findings Sheet for Children and Adolescents (PSCFS-CA) were administered at the beginning and end of the treatment. The statistical and clinical significance of changes in these measures was evaluated. A significant advantage of the treatment group compared to the waiting control group for the IS-CA was shown. For the IS-CA total score, an effect size of 1.6 was found. Whereas 62% of the patients in the treatment group showed clinically significant and reliable improvement at the end of therapy, this was the case for only 8% of the subjects in the waiting list condition. Effect sizes comparable to the IS-CA were found for the PSCFS-CA. In the CBCL significant improvement could be shown for the treatment and control group. The findings support the evidence that psychodynamic short-term psychotherapy (PSTP) is an effective treatment for children and adolescents with anxiety disorders. However, some of the studied children and adolescents seem to be in need of more intensive treatment.
Behavioral disorders represent one of the most frequent mental disorders in children and adolescents. Even though psychodynamic psychotherapies are often used to treat behavioral disorders, to date, ...its efficacy has rarely been empirically evaluated. The aim of the study therefore was to evaluate psychodynamic short-term psychotherapy (PSTP) for children and adolescents with behavioral disorders. By means of a waiting-list controlled study, 26 children and adolescents fulfilling diagnosis of behavioral disorders were examined. The treatment group received 25 sessions of psychodynamic psychotherapy. Primary criterion of outcome was the Impairment-Score for Children and Adolescents (IS-CA). Furthermore, the Child Behavior Checklist (CBCL) and the Psychic and Social-Communicative Findings Sheet for Children and Adolescents (PSCFS-CA) were administered at the beginning and end of the treatment. The statistical as well as the clinical significance of changes during treatment were analysed. It could be shown, that the treatment group improved significantly more in the Impairment-Score for children and adolescents (IS-CA) compared to the waiting group. The effect size of the IS-CA total score was 0,6. 31% of the children in the treatment group improved clinically significantly or according to the criterion of Reliable Change, whereas that was the case only for 8 % of the subject in the waiting list condition. A significant advantage was found for the therapy group in the PSCFS-CA. Effect sizes were between 0.8 and 1.4. In the CBCL significant improvement could be shown for the treatment and control group however only with small effects. These results substantiate that psychodynamic short-term psychotherapy (PSTP) is an effective intervention for children and adolescents with behavioral disorders. However, the findings also show that some of the children and adolescents are in need of a more intensive or long-term treatment.
From 1995 until June 1998 123 new chemical entities (NCEs) were launched in Switzerland. In this time period 250 reports of adverse reactions (ADRs) involving 56 different NCEs were reported to the ...Swiss Drug Monitoring Center SANZ directly by physicians within the voluntary spontaneous reporting scheme (SRS). No cases from observational or clinical postmarketing studies were included. Of the reports 88% were suspected to be drug-related and 20% of them were serious. In 64% the ADRs were unlabelled and not notified to the health professionals. Disorders of the central nervous system (CNS) were reported in 32% and cardiovascular disorders in 26% of the unlabelled and serious cases. The non-serious cases accounted for 80% of the reported NCE-ADRs and 60% of them were unlabelled. Skin reactions were reported most frequently (18%), followed by psychic (15%), gastrointestinal (10%), cardiovascular and CNS disorders (8% each). In the labelled non-serious cases gastrointestinal and skin reactions were reported in 25% and 24% respectively. The other system organ classes were involved to a much smaller extent (<8%).
(1) Spontaneous reports are of great value in optimizing postmarketing safety information. (2) Early reports give rise to a different ADR profile than expected from premarketing safety information. (3) Spontaneous reports have a strong signalling function especially for drugs used by general practitioners. (4) Sensitive signal detection systems are of great value in detecting non-labelled and serious ADRs in an early phase.
Two related but clearly different cDNA clones corresponding to elongation factor 1 alpha (EF-1 alpha) mRNAs were isolated from a Xenopus laevis gastrula-stage library. Whereas the nucleotide ...sequences of these two cDNAs differ within the coding region at 49 out of 1386 positions (3.5%), the derived amino acid sequences are completely identical, thereby indicating a substantial evolutionary constraint on this translation factor. Southern-blot analysis of genomic DNA suggests that, besides the two closely related EF-1 alpha genes investigated in this study, other more-distantly related genes may exist in the X. laevis genome. Transcription of EF-1 alpha genes during oogenesis and embryonic development was studied by Northern-blot analysis and by in situ hybridizations. A high amount of EF-1 alpha mRNA was detected in previtellogenic oocytes. At later stages of embryonic development, EF-1 alpha mRNA was found to be accumulated in translationally active tissues.
Recent data provide evidence of a systemic inflammatory response in severe acute pancreatitis; in contrast, the exact immune mechanisms underlying chronic pancreatitis remain unclear.
To investigate ...the immune response in the clinical features of chronic pancreatitis, we investigated the gene expression of tumor necrosis factor-alpha (TNF-alpha), tumor necrosis factor receptor (TNFR)-p55 and -p75 and inducible nitric oxide synthase (iNOS) in peripheral blood mononuclear cells (PBMC) of 18 patients with late-stage alcoholic chronic pancreatitis of different disease activity (Balthazar criteria).
Semiquantitative reverse transcriptase-polymerase chain reaction revealed a significantly enhanced gene expression of TNF-alpha (P < 0.05), TNFR-p55 (P < 0.05) and TNFR-p75 (P < 0.01) in unstimulated PBMC of patients with advanced chronic pancreatitis (11/18 with calcifications) compared to healthy controls (n = 8). No significant difference was found between patients with mild acute pancreatitis and patients with an inactive quiescent pancreatitis. Moreover, no expression of inducible nitric oxide synthase was detectable.
The enhanced gene expression of TNFR-p75, TNFR-p55 and TNF-alpha in unstimulated PBMC demonstrates an enhanced leucocyte activation in patients with late-stage chronic pancreatitis and suggests a pathogenetic role of the cytotoxic TNF-alpha pathway in the clinical features of alcoholic chronic pancreatitis. The pathogenetic role of nitric oxide in chronic pancreatitis remains to be fully elucidated.
The function of DnaA protein as a replisome organizer in the initiation of DNA replication is reviewed. A model is presented showing the construction of two basic types of DnaA-dependent replication ...origin. New data demonstrate that the dnaA box-DnaA protein complex is a transcription terminator. Only one orientation of the dnaA box results in termination of transcription. Mutation of the dnaA box within the dnaA reading frame shows that DnaA-mediated transcription termination has a role in the autoregulation of the dnaA gene.
Metastatic stage IV neuroblastoma tumors, as well as cell lines derived from them, are highly malignant and rapidly fatal. To determine whether malignant potential of these cells might be influenced ...by stromal tissue at sites frequently involved in metastasis, we initiated primary cultures from bone marrow of three patients (331, 337, and 91) with stage IV neuroblastoma. All three explants contained two distinct cell populations, malignant neuroblasts (Nb-type) and substrate adherent stromal-like (Str-type) cells. The cell types were separated at the first passage and studied by cytogenetic, molecular, and immunocytochemical methods. Karyotypic analyses after 3–6 passages in vitro revealed the presence of unique chromosomal abnormalities in Nb-type cells of all three lines: (1) der(1)t(1;7)(p32;q11) and der(5)t(5;17)(q35;q21) in pseudodiploid IGR-N-331 neuroblasts; (2) der(1)t(1;17)(p35;q21–22)
×2 and der(7)t(7;7)(p21;q21) in IGR-N-337 hyperdiploid neuroblasts; and (3) more than six rearranged chromosomes in two related subpopulations of hypodiploid IGR-N-91 neuroblasts. Neuroblastic cells from all three tumors amplified MYCN 25- to 50-fold (with amplified genes visible as dmin or, in one IGR-N-91 subline, as an hsr(14)q32) and expressed N-CAM. Str-type cells from tumors 331 and 337 had a normal diploid karyotype, did not express either N-CAM or S-100, and are probably normal bone marrow fibroblasts. By contrast, S-100 negative Str-type IGR-N-91 cells were hypodiploid and shared at least two unbalanced translocations, der(4)t(1;4)(q12;p15) and der(2)t(2;10;17)(p14;q11;q22), with neuroblastic counterparts, indicating that “stromal” cells and malignant neuroblasts had a common tumor cell origin. Thus, the Str-type cells of IGR-N-91 are examples of S-type phenotypic variants frequently described for long-term human neuroblastoma cell lines in vitro, but not previously observed in vivo.
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