The aim of this study was to determine the prevalence of impulse control disorders (ICDs) in morbidly obese individuals. One hundred bariatric surgery candidates were examined using a module of the Structured Clinical Interview for DSM-IV that has been developed for ICDs. Nineteen per cent suffered from at least one current ICD and 27% met the criteria for any lifetime ICD, most frequently skin picking (current, 8%; lifetime, 9%), compulsive buying (current 6%, lifetime 8%), and intermittent explosive disorder (current, 5%; lifetime, 10%). Patients with regular binge eating (N = 25) reported significantly more often a history of at least one ICD compared with those without binge eating. The results indicate a high prevalence of ICDs among morbidly obese prebariatric surgery patients that are related to regular binge eating.
Protein B2 from Nodamura virus (NMV B2), a member of the Nodavirus family, acts as a suppressor of RNA interference (RNAi). The N-terminal domain of NMV B2, consisting of residues 1-79, recognizes double-stranded RNA (dsRNA). The 2.5 A crystal structure of the RNA-binding domain of NMV B2 shows a dimeric, helical bundle structure. The structure shows a conserved set of RNA-binding residues compared with flock house virus B2, despite limited sequence identity. The crystal packing places the RNA-binding residues along one face of symmetry-related molecules, suggesting a potential platform for recognition of dsRNA.
The current DSM-5 proposal with regard to somatic symptom disorder recommends using psychological factors as diagnostic criteria for medically unexplained symptoms while placing less emphasis on the criterion of lack of somatic causation. In this study, an association between pain characteristics and cognitive-perceptual factors was found both for patients with NCCP and for patients with CCP. We found no evidence for a specific profile of psychological characteristics distinguishing patients with NCCP from patients with CCP, except for somatic amplification.
ZusammenfassungEine Dysfibrinogenämie kann zu Blutungen oder Thrombosen sowie zu Geburtskomplikationen führen. Letztere beinhalten frühzeitige Schwangerschaftsverluste, Blutungen, vorzeitige Plazentaablösung und Thrombosen. Es gibt nur wenige Fallberichte mit Behandlungsempfehlungen für Schwangerschaften bei betroffenen Frauen. Wir berichten über eine inzwischen 34-jährige Frau, bei der es zwischen 2013 und 2015 zu 4 aufeinanderfolgenden Frühaborten kam. Bei der Vorstellung in unserer Ambulanz berichtete die Patientin von einer Neigung zu Blutergüssen, aber keine weiteren Blutungen und keine thromboembolischen Ereignisse. Laboruntersuchungen ergaben einen verminderten Quick-Wert, eine verlängerte Thrombinzeit, eine stark verlängerte Reptilasezeit und Fibrinogenkonzentrationen von 67 mg/dl (Clauss-Methode) und 387 mg/dl (Immunturbidimetrie). Bei der Patientin wurde eine Dysfibrinogenämie diagnostiziert. Die molekularbiologische Untersuchung ergab die Mutation c.103C>T (p.Arg35Cys) im Exon 2 des FGA-Gens (Synonym Aα 16Arg→Cys-Substitution). Während der 5. und 6. Schwangerschaft wurde die Patientin mit einem niedermolekularen Heparin unter Verwendung der empfohlenen Prophylaxedosis für erhöhtes Thromboserisiko behandelt. Gleichzeitig erhielt die Patientin 3 × wöchentlich Fibrinogenkonzentrat (3 × 2 g pro Woche). Darunter verliefen beide Schwangerschaften ereignislos. Schwangerschaftskomplikationen wurden in vielen Fällen berichtet, wenn der funktionell aktive Fibrinogenspiegel unter 0,6 g/l lag (Clauss-Methode). Nach der erstmaligen Feststellung einer Dysfibrinogenämie bei einer Frau ohne offensichtliche Blutungsneigung und ohne thromboembolische Ereignisse in der Anamnese erscheint aus unserer Sicht die empfehlenswerte Vorgehensweise, Fibrinogen zu substituieren und gleichzeitig niedermolekulare Heparine zu geben, um sowohl Blutungen als auch Thrombosen und Schwangerschaftsverluste zu verhindern.
Over the past years, next-generation sequencing (NGS) technologies revolutionized the possibilities in a broad range of application areas. Also in the field of forensic genetics, NGS continuously gained in importance and attentiveness. A significant number of sudden cardiac deaths (SCD) in the young is due to heritable arrhythmia syndromes emphasizing the need of examining the genetic basis in these cases also with regard to the identification of relatives and/or patients being at risk. As a result, highthroughput methods became of increasing value in molecular autopsy investigations enabling the analysis of a broad spectrum of genes.Most standard protocols are optimized for high-quality samples and frequently not directly applicable to challenging forensic sample material. In the present study, we intended to examine a comprehensive gene panel associated with SCD and inherited arrhythmogenic disorders. We compared three different hybridization-based library preparation technologies in order to implement a suitable NGS workflow for heterogeneous, forensic as well as diagnostic sample material.The results obtained indicated, that the Illumina technologies Nextera DNA Flex and TruSeq were compatible with samples exhibiting varying levels of degradation. In comparison, the TruSight method also resulted in good sequencing data, but seemed to be more dependent on DNA integrity. The preparation protocols evaluated in our study are not restricted to molecular autopsy investigations and might be helpful for and transferrable to further forensic research applications.
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