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Iulian Iancu,* Nimrod Pick,* Orit Seener-Lorsh, Pinhas Dannon Be’er Ya’akov Mental Health Center, affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel *These authors share first authorship of this paper Background: While electroconvulsive therapy (ECT) has been used for many years, there is insufficient research regarding the indications for continuation/maintenance (C/M)-ECT, its safety and efficacy, and the characteristics of patients with schizophrenia or schizoaffective disorder who receive multiple ECT sessions. The aims of this study were to characterize a series of patients who received 30 ECT sessions or more, to describe treatment regimens in actual practice, and to examine the results of C/M-ECT in terms of safety and efficacy, especially the effect on aggression and functioning.Methods: We performed a retrospective chart review of 20 consecutive patients (mean age 64.6 years) with schizophrenia (n=16) or schizoaffective disorder (n=4) who received at least 30 ECT sessions at our ECT unit, and also interviewed the treating physician and filled out the Clinical Global Impression-Severity, Global Assessment of Functioning, and the Staff Observation Aggression Scale-Revised.Results: Patients received a mean of 91.3 ECT sessions at a mean interval of 2.6 weeks. All had been hospitalized for most or all of the previous 3 years. There were no major adverse effects, and cognitive side effects were relatively minimal (cognitive deficit present for several hours after treatment). We found that ECT significantly reduced scores on the Staff Observation Aggression Scale-Revised subscales for verbal aggression and self-harm, and improved Global Assessment of Functioning scores. There were reductions in total aggression scores, subscale scores for harm to objects and to others, and Clinical Global Impression-Severity scores, these were not statistically significant.Conclusion: C/M-ECT is safe and effective for chronically hospitalized patients. It improves general functioning and reduces verbal aggression and self-harm. More research using other aggression tools is needed to determine its effects and to reproduce our findings in prospective and controlled studies. Keywords: electroconvulsive therapy, schizophrenia, maintenance, multiple sessions

E6 oncogene of the high-risk human papillomavirus (hrHPV) 16 was found to bind to and inhibit IRF3 (Interferon regulatory factor 3) that is involved in the regulation of innate immune response. On the other hand, IRF members are suggested to be modulated by epigenetic mechanisms. The aim of this study was to evaluate the methylation status of IRF3 gene promoter and IRF3 and IFN-β expression levels in hrHPV cervical lesions and cancer. Materials and methods: Cervical hrHPV positive and negative (control) samples were selected from the department biobank. Nucleic acids (DNA and RNA) were isolated from cervical specimens and cDNA synthesis was performed. Unmethylated C residue conversion was done via bisulfite treatment and direct quantitative methylation-specific PCR of genomic DNA was used to assess the degree of methylation of the samples. Expression levels of IRF3 and IFN-β were quantified by qRT-PCR using β-actin gene as reference. Statistical analysis was performed using GraphPad Prism 6.0. Results: Compared with the control group, a significant increase of IRF3 promoter methylation was noted in all hrHPV positive samples (p = 0.0026). However, except a single SCC (Squamous Cervical Cancer) case, no hypermethylation of the IRF3 gene promoter is noted in any group. Moreover, IRF3 expression levels were found increased in precursor lesions and cervical cancer groups, the SCC group showing the highest expression levels. In LGSIL (Low Grade Squamous Intraepithelial Lesion) group a significantly negative correlation between IFN-β expression level and IRF3 promoter methylation was found (r = -0.8929; p = 0.0123). No significant differences in IRF3 and IFN-β expression levels were observed when samples were stratified by HPV type (HPV16 vs other hrHPV). Conclusions: Obtained data suggest that hrHPV infection might contribute to IRF3 promoter methylation. [ABSTRACT FROM AUTHOR]