Increased activation of the left hippocampus region in Complex PTSD during encoding and recognition of emotional words: A pilot study

To gain insight into memory disturbances in Complex Posttraumatic Stress Disorder (Complex PTSD), we investigated declarative memory function and medial temporal lobe activity in patients and healthy non-traumatized controls. A case-control study was performed in nine patients with Complex PTSD and nine controls. All respondents performed a declarative memory task with neutral and emotional, negative words during functional magnetic resonance imaging. Memory performance of neutral words was impaired in Complex PTSD with a relative conservation of recall of negative words. Deep encoding of later remembered negative words, as well as correct recognition of negative words and false alarms, was associated with an enhanced Blood Oxygenation Level Dependent (BOLD) response in the left hippocampus extending into the parahippocampal gyrus of Complex PTSD patients compared with controls. Post-hoc volumetric comparisons did not reveal significant anatomical differences in the medial temporal lobe between Complex PTSD patients and controls. We conclude that in Complex PTSD preferential recall of negative words is associated with increased activation in the left hippocampus and parahippocampal gyrus during both successful and false recall. These findings support a model of an abnormally functioning hippocampus in Complex PTSD.     

The Adjuvant Effect of Ambient Particulate Matter Is Closely Reflected by the Particulate Oxidant Potential

Background

It has been demonstrated that ambient particulate matter (PM) can act as an adjuvant for allergic sensitization. Redox-active organic chemicals on the particle surface play an important role in PM adverse health effects and may determine the adjuvant effect of different particle types according to their potential to perturb redox equilibrium in the immune system.

Objectives

We determined whether the adjuvant effect of ambient fine particles versus ultrafine particles (UFPs) is correlated to their prooxidant potential.

Methods

We have established an intranasal sensitization model that uses ambient PM as a potential adjuvant for sensitization to ovalbumin (OVA), which enhances the capacity for secondary OVA challenge to induce allergic airway inflammation.

Results

UFPs with a greater polycyclic aromatic hydrocarbon (PAH) content and higher oxidant potential enhanced OVA sensitization more readily than did fine particles. This manifests as enhanced allergic inflammation upon secondary OVA challenge, leading to eosinophilic inflammation and mucoid hyperplasia starting at the nasal turbinates all the way down to the small pulmonary airways. The thiol antioxidant N-acetyl cysteine was able to suppress some of these sensitization events.

Conclusions

The adjuvant effects of ambient UFP is determined by their oxidant potential, which likely plays a role in changing the redox equilibrium in the mucosal immune system.     

The neuropsychiatry and neuropsychology of lipoid proteinosis

Lipoid proteinosis is a rare hereditary disease which often results in bilateral calcifications in the medial temporal region. Thirty-four adults living with lipoid proteinosis (>10% of the world population) were extensively assessed with standardized neuropsychiatric and neuropsychological measures. Of these, 27 patients representing a homogenous group living in the Northern Cape were matched with 47 controls. Subjects with lipoid proteinosis had a high incidence of neuropsychiatric disorders and performed poorly on facial recognition of positive and negative emotions and on many neuropsychological measures. These findings are consistent with involvement of the medial temporal areas in cognitive and emotive processing.     

Effectiveness of Arndt endobronchial blockers in pediatric scoliosis surgery: a case series

BACKGROUND: Pediatric scoliosis surgery may require single lung ventilation for surgical access. Current methods of lung isolation are inadequate for some or all of these children. The Arndt endobronchial blocker (EBB) has been described for use in pediatric thoracic surgery to enable single lung ventilation (SLV). There are few data on its use in pediatric spinal deformity surgery. We report the successful use of the Arndt EBB in a series of these patients. METHODS: Any patient undergoing surgical correction of scoliosis involving a lateral thoracotomy for an anterior approach was managed with an Arndt EBB (5, 7 and 9 Fr gauge) to facilitate SLV. All cases were undertaken by a pediatric anesthetist trained in pediatric bronchoscopy; a 2.2 or 2.8 mm pediatric fiberoptic scope was used for placement and positional confirmation. RESULTS: Patients' ages and weights ranged from 18 months to 18 years, and from 9.4 to 71 kg. All had idiopathic or congenital scoliosis; one underwent a vertical expansion prosthetic titanium rib (VEPTR) procedure. In all 20 patients, placement was easily and quickly achieved with no incorrect placements. There was one displacement after inflation, quickly corrected. Right upper lobe deflation proved difficult in one patient with high take-off of the right upper lobe bronchus. The surgical field was excellent in all cases. CONCLUSIONS: In our case series, Arndt EBB provided a safe and highly effective means of single lung isolation for children undergoing pediatric scoliosis surgery.     

Occupational exposure and defects of the central nervous system in offspring: review.

A study of published work was carried out in a search for evidence of a causal role for parental occupational exposure in the origin of structural and functional defects of the central nervous system (CNS) in children. Studies that consider this topic are scarce and mostly refer to broad categories of exposures and effects. Non-occupational studies referring to environmental exposure of humans and studies on experimental animals were also reviewed. The studies on animals provided straightforward evidence about morphological and behavioural abnormalities resulting from some agents used occupationally. The studies on humans yielded a scala of defects that could be ascribed to exposure to high doses of various agents in the environment. Evidence for a causal role of occupational exposure has not been found, but a highly probable influence on the developing CNS is hypothesised for lead, methyl mercury, and ionising radiation. Parental occupational exposure to cadmium, organic solvents, anaesthetics, and pesticides may also play a part in causing defects of the CNS. Well designed future research is needed to test the above hypotheses.     

An evidence-based review on the validity of the Kaltenborn rule as applied to the glenohumeral joint

Kaltenborn's convex-concave rule is a familiar concept in joint treatment techniques and arthrokinematics. Recent investigations on the glenohumeral joint appear to question this rule and thus accepted practice guidelines. An evidence-based systematic review was conducted to summarize and interpret the evidence on the direction of the accessory gliding movement of the head of the humerus (HOH) on the glenoid during physiological shoulder movement. Five hundred and eighty-one citations were screened. Data from 30 studies were summarized in five evidence tables with good inter-extracter agreement. The quality of the clinical trials rated a mean score of 51.27% according to the Physiotherapy Evidence Database scale (inter-rater agreement: kappa=-0.6111). Heterogeneity among studies precluded a quantitative meta-analysis. Weighting of the evidence according to Elwood;s classification and the Agency for Health Care Policy and Research classification guidelines indicated that evidence was weak and limited. Poor methodological quality, weak evidence, heterogeneity and inconsistent findings among the reviewed studies regarding the direction of translation of the HOH on the glenoid, precluded the drawing of any firm conclusions from this review. Evidence, however, indicated that not only the passive, but also the active and control subsystems of the shoulder may need to be considered when determining the direction of the translational gliding of the HOH. The indirect method, using Kaltenborn's convex-concave rule as applied to the glenohumeral joint, may therefore need to be reconsidered.     

Lyssaviruses

Lyssaviruses are the etiological agents of rabies, one of the oldest viral diseases known to man and a disease that has persisted over many centuries. Together with sound diagnostic methods and efficacious vaccines--both of which had been available for many decades, an understanding of the epidemiology of the disease have enabled its control and even elimination in some specific reservoir species in North America and Western Europe. However, worldwide rabies still radiates into new host species and geographical domains and has become vastly underestimated throughout the developing world through lack of awareness, apathy and poor surveillance. As a result, this disease is now more of a global public and veterinary health threat than it has ever been.