Major depression in young girls is related to altered cortisol awakening response

Background

There is evidence that clinical depression is associated with elevated basal cortisol levels in adult patients.

Objective

The present investigation tries to find out, whether this relationship also holds true in adolescents with major depression.

Methods

For 131 female subjects (63 MDD, 68 controls) the cortisol awakening response (CAR) was measured at 0, 30, 45, and 60 min after awakening. All subjects provided saliva cortisol.

Results

A significantly higher CAR was found in patients. The global mean difference was due to differences 60 and 45 min after awakening.

Limitations

A causal interpretation of the data is restricted, because of its cross-sectional nature. The effect size of the mean differences is rather small.

Conclusion

The observed HPA hyperactivity may be a cause as well as a consequence of depression in childhood.     

Central hyperthermia, brain hyperthermia and low hypothalamus temperature

Introduction, Patients and Methods

We measured brain temperature in a case of central hyperthermia.

Results

Brain temperature was increased except for hypothalamus that was colder.

Conclusion

We suppose that central hyperthermia is driven by cold hypothalamus.     

Transcerebellar biopsy of diffuse pontine gliomas in children: a technical note

Introduction

The need for a surgical biopsy for diffuse pontine glioma (DPG) is increasing, and a safer and less invasive procedure is required.

Methods

We describe a transcerebellar stereotactic biopsy procedure that can be safely performed in young children. Four pediatric patients with DPG underwent transcerebellar stereotactic biopsies.

Results

All of the patients were diagnosed with gliomas, and one patient had a transient numbness of the lip margin after the procedure.

Discussion

Transcerebellar stereotactic biopsy is a relatively safe way to obtain a tissue diagnosis for children with DPG.     

An Indirect Approach to the Measurement of Nutrient-Specific Perceptions of Food Healthiness

Background

Enhancing our understanding of food-related perceptions is critical to assist those with eating- and weight-related problems.

Purpose

This study investigated normative and person-specific aspects of perceived food healthiness in terms of nutritional characteristics and the relevance of nutritional knowledge to perceived healthiness.

Methods

Two hundred sixty-three undergraduate women judged the healthiness of 104 foods and completed nutrient knowledge tasks. Multilevel modeling estimated average and person-specific reliance on and knowledge about nutrients.

Results

Participants relied substantially on fat and fiber, moderately on sugar, and minimally on protein. Disordered eating symptoms moderately predicted greater reliance on fat. Nutritional knowledge was highest for sugar and lowest for fiber. Nutritional knowledge and utilization were unrelated.

Conclusions

Public health campaigns should educate college-aged women further on the health consequences of sugar and protein consumption. Explicit knowledge of nutrients may not be prioritized when judging food healthiness.     

Perimesencephalic Subarachnoid Hemorrhage Triggered by Hypoxic Training During Swimming

Introduction

Perimesencephalic subarachnoid hemorrhage is a rare neurologic condition of unclear etiology. Multiple mechanisms have been postulated as potential triggers, but none are universally accepted.

Methods

Single observational case report and review of the literature.

Results

We describe a patient who developed perimesencephalic subarachnoid hemorrhage in the setting of “hypoxic training” (breath-holding while swimming). We describe the plausible pathophysiologic events that caused the hemorrhage.

Conclusion

The occurrence of perimesencephalic subarachnoid hemorrhage during hypoxic training suggests that acute venous congestion may be a triggering factor. The increasing popularity of hypoxic training demands vigilance from health care providers.     

Neurologist Versus Machine: Is the Pupillometer Better than the Naked Eye in Detecting Pupillary Reactivity

Background

A 62-year-old man with severe traumatic brain injury developed postsurgical anisocoria in which there was a discrepancy between pupillometer and manual testing.

Methods

Case report.

Results

The patient’s larger pupil was read as unreactive by the pupillometer but constricted 1 mm over 7–9 s of continuous light stimulation.

Conclusions

While pupillometry assessment is a valuable adjunct to the manual pupillary assessment, this case demonstrates that nonreactive pupils read on the pupillometer should be confirmed with the manual examination because it can miss very slowly reacting pupils.     

The Impact of Incentives on Exercise Behavior: A Systematic Review of Randomized Controlled Trials

Background

The effectiveness of reinforcing exercise behavior with material incentives is unclear.

Purpose

This study aims to conduct a systematic review of existing research on material incentives for exercise, organized by incentive strategy.

Methods

Ten studies conducted between January 1965 and June 2013 assessed the impact of incentivizing exercise compared to a non-incentivized control.

Results

There was significant heterogeneity between studies regarding reinforcement procedures and outcomes. Incentives tended to improve behavior during the intervention while findings were mixed regarding sustained behavior after incentives were removed.

Conclusions

The most effective incentive procedure is unclear given the limitations of existing research. The effectiveness of various incentive procedures in promoting initial behavior change and habit formation, as well as the use of sustainable incentive procedures should be explored in future research.     

Elevated levels of exhaled nitric oxide in patients with anorexia nervosa

Background

Nitric oxide (NO) is involved in eating behavior and inflammatory response. Moreover, there is evidence that NO production is altered in patients with anorexia nervosa (AN).

Aim

To assess whether the overproduction of NO in AN can affect NO level in exhaled air.

Materials and methods

Exhaled NO level was studied in 23 girls with AN and compared with that of healthy age- and gender-matched nonatopic controls.

Results

Exhaled NO levels were significantly higher in girls with AN compared with healthy age-matched controls.

Conclusions

It appears that anorexia nervosa was accompanied by a higher level of exhaled NO, likely resulting from a systemic increase in NO production because of the severe catabolic state.     

Reassurance and Distress Behavior in Preschool Children Undergoing Dental Preventive Care Procedures in a Community Setting: a Multilevel Observational Study

Background

The effect of reassurance in managing distress among children who receive procedures of a less aversive nature has not been fully investigated.

Purpose

This study aimed to investigate the relationship between reassurance by dental staff and distress behavior of preschool children receiving preventive procedures in a community setting.

Methods

Nurse–child interactions (n?=?270) during fluoride varnish application were video recorded and coded. Multilevel logistic regression modeled the probability of the occurrence of child distress behavior as a function of reassurance provision, controlling for child-level and nurse-level variables.

Results

Child distress behavior was positively related to nurse verbal reassurance but negatively linked to the time that this reassurance occurred. Both child initial anxiety and nurse nonprocedural training increased the probability of observable distress behavior.

Conclusions

The use of verbal reassurance to promote reception of mild invasive procedures was counterindicated, especially when offered early in the intervention (ClinicalTrials.gov number: NCT00881790).     

Adoption, family relations and psychotic symptoms among Palauan adolescents who are genetically at risk for developing schizophrenia

Purpose

This paper focuses on the role of adoption and family relations as moderators of genetic risk for psychotic disorders.

Methods

Participants included 184 adolescents in the Republic of Palau identified to be at genetic risk for schizophrenia and other psychotic disorders. Palau is an island nation in Micronesia with a lifetime prevalence of 1.99% for schizophrenia and 2.67% for psychotic disorders more broadly defined [24]. In Palauan culture, kinship adoption is a common cultural practice; 47 of the 184 participants had been adopted at an early age. The current study was designed to test the hypothesis that adoption would function as a protective factor among Palauan youth at genetic risk for the development of psychotic symptoms. Participants were evaluated for psychotic and other psychiatric symptoms using KSADS-PL [16]. Concurrently, the Youth Self Report [1] was used to assess the perceived quality of family relationships.

Results

Results indicated that adopted adolescents were more likely to develop psychotic symptoms than non-adopted adolescents. However, perceived family relations moderated the association between adoption status and psychotic symptoms, such that adopted adolescents with poorer family relations reported disproportionately higher rates of psychotic symptoms. Family relations also moderated the association between level of genetic risk and psychotic symptoms, independently of adoption status.

Conclusion

Consistent with previous research, adolescents at high genetic risk who reported more positive family relations also reported fewer psychotic symptoms [4, 29].     

Increasing Screening Intentions for Oral and Pharyngeal Cancer

Background

Oral and pharyngeal cancer is a serious health threat that goes unnoticed by most people. Increasing screenings for oral and pharyngeal cancer is essential to achieving early detection when the disease is most treatable.

Purpose

We tested the effectiveness of a media campaign designed to increase intentions to seek an oral and pharyngeal cancer screening. We further examined whether concern and knowledge of oral and pharyngeal cancer mediated screening intentions.

Methods

Participants in the intervention condition received messages on posters, handheld fans, pamphlets, and magnets displayed on the sides of cars or trucks. Participants in the intervention and comparison conditions (N?=?1,790) were surveyed prior to and after the intervention.

Results

Intervention participants reported greater intentions to seek free oral and pharyngeal cancer screenings. Concern about oral and pharyngeal cancer partially mediated the effect whereas knowledge did not.

Conclusions

Our media campaign successfully increased screening intentions by heightening concerns.     

Internalized Stigma, Social Distance, and Disclosure of HIV Seropositivity in Rural Uganda

Background

HIV is highly stigmatized, compromising both treatment and prevention in resource-limited settings.

Purpose

We sought to study the relationship between internalized HIV-related stigma and serostatus disclosure and to determine the extent to which this association varies with the degree of social distance.

Methods

We fit multivariable Poisson regression models, with cluster-correlated robust estimates of variance, to data from 259 persons with HIV enrolled in an ongoing cohort study in rural Uganda.

Results

Persons with more internalized stigma were less likely to disclose their seropositivity. The magnitude of association increased with social distance such that the largest association was observed for public disclosures and the smallest association was observed for disclosures to sexual partners.

Conclusions

Among persons with HIV in rural Uganda, internalized stigma was negatively associated with serostatus disclosure. The inhibiting effect of stigma was greatest for the most socially distant ties.     

History of Major Depressive Disorder Prospectively Predicts Worse Quality of Life in Women with Breast Cancer

Background

Data are scarce about whether past history of major depressive disorder in the absence of current depression places breast cancer patients at risk for worse quality of life.

Purpose

The current study prospectively examined quality of life during chemotherapy in breast cancer patients with a history of resolved major depressive disorder (n?=?29) and no history of depression (n?=?144).

Methods

Women with Stages 0?CII breast cancer were assessed prior to and at the completion of chemotherapy. Major depressive disorder was assessed via structured interview and quality of life with the SF-36.

Results

Patients with past major depressive disorder displayed greater declines in physical functioning relative to patients with no history of depression (p????0.01).

Conclusions

Findings suggest that breast cancer patients with a history of resolved major depressive disorder are at increased risk for declines in physical functioning during chemotherapy relative to patients with no history of depression.     

Wealth, Health, and the Moderating Role of Implicit Social Class Bias

Background

Subjective social status (captured by the MacArthur Scale of Subjective Social Status) is in many cases a stronger predictor of health outcomes than objective socioeconomic status (SES).

Purpose

The study aims to test whether implicit beliefs about social class moderate the relationship between subjective social status and inflammation.

Methods

We measured implicit social class bias, subjective social status, SES, and baseline levels of interleukin-6 (IL-6), a marker of inflammation, in 209 healthy adults.

Results

Implicit social class bias significantly moderated the relationship between subjective social status and levels of IL-6, with a stronger implicit association between the concepts “lower class” and “bad” predicting greater levels of IL-6.

Conclusions

Implicit social class bias moderates the relationship between subjective social status and health outcomes via regulation of levels of the inflammatory cytokine IL-6. High implicit social class bias, particularly when one perceives oneself as having low social standing, may increase vulnerability to inflammatory processes.     

Childhood Abuse and Inflammatory Responses to Daily Stressors

Background

Childhood abuse leads to greater morbidity and mortality in adulthood. Dysregulated physiological stress responses may underlie the greater health risk among abused individuals.

Purpose

This study evaluated the impact of childhood abuse on inflammatory responses to naturalistically occurring daily stressors.

Methods

In this cross-sectional study of 130 older adults, recent daily stressors and childhood abuse history were evaluated using the Daily Inventory of Stressful Events and the Childhood Trauma Questionnaire. Blood samples provided data on circulating interleukin-6 (IL-6), tumor necrosis factor-?? (TNF-??), and C-reactive protein (CRP).

Results

Childhood abuse history moderated IL-6 levels but not TNF-?? and CRP responses to daily stressors. Individuals with a childhood abuse history who experienced multiple stressors in the past 24?h had IL-6 levels 2.35 times greater than those of participants who reported multiple daily stressors but no early abuse history.

Conclusion

Childhood abuse substantially enhances IL-6 responses to daily stressors in adulthood.     

The foramen of Monro: a review of its anatomy,history, pathology,and surgery

Introduction

The foramen of Monro lies at the junction between the paired lateral ventricles and the third ventricle of the brain.

Methods

A comprehensive review of the literature was performed focusing on the foramen of Monro.

Conclusions

A good understanding of the anatomy of the foramen of Monro is essential for the neurosurgeon, especially with the increasing use of intraventricular endoscopy.     

The Dynamic Relationship Between Social Support and HIV-Related Stigma in Rural Uganda

Background

Cross-sectional studies show that human immunodeficiency virus (HIV) stigma is negatively correlated with social support.

Purpose

The purpose of this study is to examine the bidirectional relationship between social support and HIV stigma.

Methods

We collected quarterly data from a cohort of 422 people living with HIV in Uganda, followed for a median of 2.1 years. We used multilevel regression to model the contemporaneous and 3-month-lagged associations between social support and both enacted and internalized stigma.

Results

Lagged enacted stigma was negatively correlated with emotional and instrumental social support, and lagged instrumental social support was negatively correlated with enacted stigma. Internalized stigma and emotional social support had reciprocal lagged associations.

Conclusions

Interventions to reduce enacted stigma may strengthen social support for people living with HIV. Improved social support may in turn have a protective influence against future enacted and internalized stigma.     

Combining Self-Affirmation and Implementation Intentions: Evidence of Detrimental Effects on Behavioral Outcomes

Background

There is limited evidence that self-affirmation manipulations can promote health behavior change.

Purpose

The purpose of this study was to explore whether the efficacy of a self-affirmation manipulation at promoting exercise could be enhanced by an implementation intention intervention.

Methods

Participants (Study 1?N?=?120, Study 2?N?=?116) were allocated to one of four conditions resulting from the two (self-affirmation manipulation: no affirmation, affirmation) by two (implementation intention manipulation: no implementation intention, implementation intention) experimental design. Exercise behavior was assessed 1 week post-intervention.

Results

Contrary to prediction, those participants receiving both manipulations were significantly less likely to increase the amount they exercised compared to those receiving only the self-affirmation manipulation.

Conclusion

Incorporating an implementation intention manipulation alongside a self-affirmation manipulation had a detrimental effect on exercise behavior; participants receiving both manipulations exercised significantly less in the week following the intervention.     

Pathways Linking Socioeconomic Status and Postpartum Smoking Relapse

Background

Low socioeconomic status (SES) exacerbates the high rate of smoking relapse in women following childbirth.

Purpose

This study examined multiple models of potential mechanisms linking SES and postpartum smoking relapse among women who quit smoking due to pregnancy.

Methods

Participants were 251 women enrolled in a randomized clinical trial of a new postpartum smoking relapse prevention intervention. Four models of the prepartum mechanisms linking SES and postpartum smoking relapse were evaluated using a latent variable modeling approach.

Results

Each of the hypothesized models were a good fit for the data. As hypothesized, SES indirectly influenced postpartum smoking relapse through increased prepartum negative affect/stress, reduced sense of agency, and increased craving for cigarettes. However, the model that included craving as the sole final pathway between SES and relapse demonstrated superior fit when compared with all other models.

Conclusions

Findings have implications for future interventions that aim to reduce postpartum relapse.     

Divergent Associations of Antecedent- and Response-Focused Emotion Regulation Strategies with Midlife Cardiovascular Disease Risk

Background

It is not known whether various forms of emotion regulation are differentially related to cardiovascular disease risk.

Purpose

The purpose of this study is to assess whether antecedent and response-focused emotion regulation would have divergent associations with likelihood of developing cardiovascular disease.

Methods

Two emotion regulation strategies were examined: reappraisal (antecedent-focused) and suppression (response-focused). Cardiovascular disease risk was assessed with a validated Framingham algorithm that estimates the likelihood of developing CVD in 10 years. Associations were assessed among 373 adults via multiple linear regression. Pathways and gender-specific associations were also considered.

Results

One standard deviation increases in reappraisal and suppression were associated with 5.9 % lower and 10.0 % higher 10-year cardiovascular disease risk, respectively, in adjusted analyses.

Conclusions

Divergent associations of antecedent and response-focused emotion regulation with cardiovascular disease risk were observed. Effective emotion regulation may promote cardiovascular health.