Wilfred Trotter and the biosociology of peace and war

The distinguished surgeon Wilfred Trotter (1872–1939), in his book Instincts of the Herd in Peace and War, can be regarded as a pioneer of biosociology and its application to the phenomenon of war. In this paper some of Trotter's ideas are discussed and their relevance to the problems of the present day are considered.     

A prospective study on the neurological complications of breast cancer and its treatment: Updated analysis three years after cancer diagnosis

ObjectivesTo quantify the prevalence of neurological complications among breast cancer patients at one and three years after diagnosis, and to identify factors associated with neuropathic pain (NP) and chemotherapy-induced peripheral neuropathy (CIPN).Material and methodsProspective cohort study including 475 patients with newly diagnosed breast cancer, recruited among those proposed for surgical treatment (Portuguese Institute of Oncology, Porto). Patients underwent a neurological evaluation and had their cognitive function assesses with the Montreal Cognitive Assessment, before treatment and at one and three years after enrollment. We estimated the prevalence of each neurological complication, and odds ratios (OR), adjusted for socio-demographic and clinical characteristics, to identify factors associated with NP and CIPN.ResultsMore than half of the patients [54.7%, 95% confidence interval (95%CI): 50.2–59.2] presented at least one neurological complication, at one or at three years after cancer diagnosis. Between the first and the third year of follow-up, there was an increase in the prevalence of NP (from 21.1% to 23.6%), cognitive impairment (from 7.2% to 8.2%), cerebrovascular disease (from 0.6% to 1.5%) and brain metastasis (from 0.0% to 0.6%). The prevalence of CIPN decreased from 14.1% to 12.6%. Axillary lymph node dissection was associated with NP at one year (OR = 2.75, 95%CI: 1.34–5.63) and chemotherapy with NP at three years (OR = 2.10, 95%CI: 1.20–3.67). Taxane-based chemotherapy was strongly associated with prevalence of CIPN at one and three years.ConclusionNeurological complications are frequent even three years after cancer diagnosis and NP remained the major contributor to the burden of these conditions among survivors.     

Cognitive impairment and sedentary behavior predict health-related attrition in a prospective longitudinal Parkinson's disease study

IntroductionIn Parkinson's disease (PD), the high burden of motor and non-motor symptoms, such as cognitive impairment or falls, is associated with rapid disease progression and mortality. This is often reflected by an increased drop-out rate of PD patients in longitudinal studies. Active physical behavior can impact the disease course beneficially and has an overall positive effect on health. Contrarily, sedentary behavior is associated with cognitive impairment in PD. The aim of this study was to investigate whether sedentary physical behavior assessed in the home environment and cognitive impairment can predict health-related study attrition due to sickness and death in PD.MethodsData of 45 PD patients, longitudinally assessed, were analyzed. Of those, 20 patients completed six yearly visits, 16 dropped out due to sickness or death, and nine for other reasons. All patients wore a mobile device to assess physical behavior and completed cognitive testing.ResultsLogistic regression revealed global cognition was the primary predictor for health-related drop-out in varying models (p ≤ .04). In the survival analysis, cognitive impairment (p = .005) and longer sedentary mean bout length (p = .02) were associated with drop-out due to sickness and death. The occurrence of health-related study drop-out or death was highest in patients with both impaired cognition and longer sedentary bouts.ConclusionsCognition was the primary predictor for study drop-out due to sickness and death. However, it seems that sedentary behavior might have a potential negative influence on PD patients’ health, especially those with cognitive impairment.     

地塞米松对老龄大鼠术后认知功能的影响

目的 评价地塞米松对老龄大鼠术后认知功能的影响.方法 雄性SD大鼠180只,18 ～ 20月龄,体重400 ～ 600 g,采用随机数字表法,将大鼠随机分为3组(n=60)∶对照组(C组)、手术组(S组)和地塞米松组(D组).采用大鼠剖腹探查手术模型.D组于麻醉开始时腹腔注射地塞米松10 mg/kg.C组不进行手术,腹腔注射生理盐水2 ml/kg.于术后3h、7d时测定海马OX42(小胶质细胞激活特异性标志物)的表达水平；于术后3h、1d、3d和7d时测定海马IL-1β mRNA和TNF-α mRNA的表达水平.采用Morris水迷宫实验和条件恐怖适应实验检测大鼠术后认知功能.结果 与C组比较,S组和D组逃逸潜伏期延长,穿越原平台次数减少,术后僵直时间缩短,海马OX42表达、IL-1β mR-NA和TNF-α mRNA表达上调(P＜0.05或0.01)；与S组比较,D组逃逸潜伏期缩短,穿越原平台次数增多,术后僵直时间延长,海马OX42、IL-1β mRNA和TNF-α mRNA表达下调(P＜0.05或0.01).结论 地塞米松可抑制海马小胶质细胞过度激活,减轻炎性反应,从而改善老龄大鼠术后认知功能.     

脑微出血危险因素及其与认知功能的相关性研究

目的 探讨脑微出血（cerebral microbleeds，CMBs）患者认知功能损害的临床特征及其相关因素。      

手术创伤对老龄大鼠认知功能及海马铁调素和膜铁转运蛋白1表达的影响

目的 评价手术创伤对老龄大鼠认知功能及海马铁调素和膜铁转运蛋白1(FP1)表达的影响.方法 健康老龄雄性SD大鼠100只,18月龄,体重400～ 500 g,采用随机数字表法,将其分为2组(n=50):对照组(C组)腹腔注射水合氯醛麻醉,但不进行手术；手术创伤组(ST组)腹腔注射水合氯醛麻醉后行改良性剖腹探查术30 min.于术后24h时随机取10只大鼠,行水迷宫实验,测定认知功能,持续6d,分别于水迷宫实验第1、3、5、7天时随机取10只大鼠处死,取脑,分离海马,采用PCR和Western blot法检测海马铁调素和FP1的表达.结果 与C组比较,ST组水迷宫实验第3、4、5天时大鼠逃避潜伏期延长,原平台象限停留时间缩短,穿越原平台次数减少(P＜0.05),各时点海马铁调素表达上调,FP1表达下调(P＜0.05).结论 手术创伤可降低老龄大鼠认知功能,其机制可能与上调海马铁调素表达,下调FP1表达有关.