Neuroprotective effect of etomidate on functional recovery in experimental spinal cord injury

OBJECTIVE: Primary impact to the spinal cord causes rapid oxidative stress after injury. To protect neural tissue, it is important to prevent secondary pathophysiological mechanisms. Etomidate, a strong antiexcitotoxic agent, stimulates the gamma aminobutyric acid (GABA) receptors. The purpose of this study was to investigate neurobehavioral and histological recovery and to evaluate the biochemical responses to treatment of experimental spinal cord injury (SCI) in rats with etomidate or methylprednisolone (MP) or both etomidate and MP. MATERIAL AND METHODS: Seventy-two rats were randomly allocated into six groups: a control group (laminectomy alone), a trauma group (laminectomy+trauma), a methylprednisolone group (30 mg/kg MP), an etomidate group (2 mg/kg), a methylprednisolone and etomidate combined treatment group (30 mg/kg MP and 2 mg/kg etomidate) and a vehicle group. Six rats from each group were killed at the 24th hour after the injury. Malondialdehyde, glutathione, nitric oxide and xanthine oxidase levels were measured. Neurological functions of the remaining rats were recorded weekly. Six weeks after injury, all of those rats were killed for histopathological assessment. RESULTS: Etomidate treatment revealed similar neurobehavioral and histopathological recovery to MP treatment 6 weeks after injury. Combined treatment did not provide additional neuroprotection. CONCLUSION: Etomidate treatment immediately after spinal cord injury has similar neuroprotection to MP. In spite of different neuroprotection mechanisms, combined treatment with MP and etomidate does not provide extra protection.     

Handedness, eyedness and nasal cycle in children with autism

OBJECTIVE: Autism is referred to as cerebral lateralization abnormality. In this study, the possible relationships among handedness, eyedness and nasal cycle in autism have been investigated. MATERIALS AND METHODS: Thirty-seven children with autism and 20 controls were included in the study. The patient group included 27 boys and 10 girls who ranged in age from 5 to 20 years. For hand preference, hand used to write and throw a ball was accepted as dominant hand. For eye preference or dominance, eye used to look through keyhole of a door was accepted as dominant eye. Nasal dominance was assessed by a method of measuring the nasal airflow. RESULTS: The rates of left-handedness and left-eyedness were higher in children with autism compared to normal populations. A majority of children with autism had left nasal dominance. CONCLUSION: Autism and early language impairment may be associated with left handedness, eyedness and nasal dominance.     

Mental health of adolescents reared in institutional care in Turkey: challenges and hope in the twenty-first century

The objectives of the study are (i) to describe and compare the epidemiology of emotional/behavioral problems and associated risk/protective factors among nationally representative samples of institutionally reared and similarly aged community-based adolescents brought up in their natural homes by means of youth self-reports, caregiver/parent, and teacher informants; and (ii) to identify mental health service needs and utilization. A cross-sectional survey was conducted between November 2005 through April 2006 using an equal probability cluster sample of 11–18 year old adolescents in institutional care settings (N = 350; 163 males, 187 females) and results were compared with similarly aged community sample of youth living in their natural homes (N = 2,206). The Sociodemographic Information Form, Youth Self Report (YSR), Child Behavior Checklist (CBCL) by caregivers for institutional sample and parents for the community sample, and Teacher’s Report Form (TRF) were used to obtain standardized data on demographic characteristics, emotional/behavioral problems, and risk/protective factors. The prevalence of problems behaviors by YSR, caregiver/parent CBCL, and TRF were: 47, 15.1, 20.5% for the institutional versus 10.1, 7.5 and, 9.5% for the community samples, respectively (p < 0.05). Youth self-reports were fourfold, and all informant reports were twofold higher for institutional versus community comparisons. Furthermore, institutional sample had consistently higher rates, not only of Externalizing, but Internalizing, Social Problems, Attention Problems, and Thought Problems, as well as discrete DSM-oriented scales, suggesting that labeling of institutional youth as simply aggressive and delinquent contributes to their further marginalization and does not comprehensively address their mental health needs. In terms of protective factors, we found that: perceived social support, high competency scores, supportive caregiving, getting along well with peers and relatives (positive relationships), and problem solving skills were significantly protective of mental health. On the other hand fatalistic beliefs, cigarette and alcohol use were significantly associated with increased risk for problem behaviors (p < 0.05). The primary reason for institutional placement was family disruption (68.9%), poverty (15.7%), abandonment (8.4%), and physical or sexual abuse (5.4%). Only 31.2% of the youth were in fact true orphans (loss of one or both parents). It is therefore remarkable that in terms of service use, despite consistently high prevalence of problem behaviors across all informant sources, only 2.4% of the youth had received any speciality mental health services during institutional care. In conclusion, there is a pressing need to transform the social and health care policy and to provide family and community-based alternatives for youth currently in institutional care in Turkey. Before this goal is achieved, it is necessary to address their mental health needs urgently and comprehensively. The highest rates of problems by youth self-report also support the view that the youths’ own voices ought to be heard and need to inform the reform process regarding their future care.