Paraspinal muscle pathology in experimental scoliosis

Summary Paraspinal muscle biopsies from ten rabbits with experimentally induced scoliosis and from four healthy controls were analyzed histologically and histochemically. Scoliosis was induced by two different methods: six animals underwent unilateral damage of the dorsal column of the spinal cord (mean curve: 22°) and four costotransversectomy (mean curve: 47°). In eight scoliotic animals myopathic changes were detected on the muscles of the concave side. Only those animals which underwent costotransversectomy showed a neuropathic pattern with cronic denervation changes on the convex side. As regards the fiber type distribution, the control group showed a higher percentage of type-I fibers, which were similar on both sides of the spinal cord. No fiber proportion asymmetry could be detected in the muscles on the concave side in normal or scoliotic rabbits. There was a tendency to depart from normal values, in two different ways, on the convex side of scoliotic animals. Thus, in contrast to the medullary damage group, the muscles of the costotransversectomized rabbits showed an increased proportion of type-I fibers. Taken together, our findings support the hypothesis that myopathic changes as observed in human idiopathic scoliosis are a consequence of the postural deformity. Fiber type distribution does not appear to be related to the curvature in the same way.     

Effects of estradiol treatment on voluntary and forced alcohol consumption in male rats.

Estrogens have been related to alcohol as a dependent variable, but scarcely as a causal variable, that affects the alcohol consumption. The scope of the present work was to study the effect of estrogens on both the amount and the pattern of alcohol consumption. Male Wistar rats were individually exposed to forced alcohol consumption (FAC) and voluntary alcohol consumption (VAC) in each of the following four periods: precastration (PreC), postcastration (PosC) or post-sham castration, estradiol (E) treatment (5 microg of estradiol benzoate/day/rat) and postestradiol (PosE). Estrogenic treatment reduced significantly the alcohol consumption with respect to the PreC and PosE periods in castrated (C) males during VAC. E treatment showed the lowest value of alcohol intake in FAC, but differences were significant only with respect to PreC regardless of the male gonadal condition. E treatment decreased food intake regardless of the male gonadal condition in both FAC and VAC. Castration and E treatment modified differentially the patterns of alcohol consumption depending on the volitive characteristics of alcohol intake. Castration reduced the size of the licking rates without affecting the number of drinking bouts in FAC. This pattern was maintained in the E and PosE periods of C males. Castration did not affect the pattern of alcohol consumption in VAC, but estrogen reduced both the bout size and the number of bouts during the day, which gave an additional support to the inhibitory effect of estrogens on VAC. Results are discussed in terms of a possible inhibitory action of estrogens on the opioid system, which possibly reduces the rewarding properties of alcohol.     

Identification of problems in the functioning of individuals with schizophrenia from the expert perspective: an Internet-based survey

Purpose: The purpose of the study was to identify aspects of functioning and related environmental factors that are relevant to schizophrenia from the perspective of health professionals experienced in treating individuals with this disorder using the International Classification of Functioning, Disability and Health (ICF).

Method: An international pool of experts from diverse health care disciplines was surveyed to identify problems in functioning experienced by individuals with schizophrenia and the environmental factors that impact their functioning. On the basis of established rules, all answers were translated to the ICF by two independent researchers.

Results: One-hundred and eighty-nine experts from all six World Health Organization regions identified 4776 meaningful concepts, of which 92% were linked to 347 different ICF categories. Of the 347 categories, 194 were second-level categories, 151 were third-level categories and 2 were fourth-level categories. Ninety-five second-level ICF categories, 43 third-level categories and 1 fourth-level category reached percentage frequency of at least 5%. The majority of the categories were attributed to body functions, activities and participation, and environmental factors.

Conclusions: Health professionals identified a wide range of problems in functioning that reflect the complexity and breadth of schizophrenia, specifically activity limitations and participation restrictions that are particularly relevant for individuals with schizophrenia. Knowing these functioning problems can guide the design of patient-oriented rehabilitation programmes.

• Implications for rehabilitation

• Schizophrenia may result in impaired functioning in multiple daily life activities. The International Classification of Functioning, Disability and Health (ICF) can help in identifying the needs and problems of these individuals.

• The reported list of ICF categories can facilitate a systematic application of the ICF in schizophrenia and can help to design and implement coordinated and patient oriented rehabilitation programmes with a biopsychosocial approach.

• According to health professionals surveyed, activity limitations and participation restrictions are broadly affected in this population and are highly influenced by neurocognitive and social cognitive deficits and environmental factors.

     

Stability and Predictive Validity of the Parent–Child Sleep Interactions Scale: A Longitudinal Study Among Preschoolers

Little research has examined the processes underlying children’s persistent sleep problems and links with later psychopathology. The current study examined the stability of parent–child sleep interactions as assessed with the parent-reported Parent–Child Sleep Interactions Scale (PSIS) and examined whether sleep interactions in preschool-age children predict sleep problems and psychiatric symptoms later in childhood. Participants included 108 preschool-age children (50% female) and their parents. Parents completed the PSIS when children were 3–5 years (T1) and again when they were 6–9 years (T2). The PSIS includes three subscales—Sleep Reinforcement (reassurance of child sleep behaviors), Sleep Conflict (parent–child conflict at bedtime), Sleep Dependence (difficulty going to sleep without parent)—and a total score. Higher scores indicate more problematic bedtime interactions. Children’s sleep problems and psychiatric symptoms at T1 and T2 were assessed with a clinical interview. PSIS scores were moderately stable from T1 to T2, and the factor structure of the PSIS remained relatively consistent over time. Higher total PSIS scores at T1 predicted increases in children’s sleep problems at T2. Higher PSIS Sleep Conflict scores at T1 predicted increases in oppositional defiant disorder symptoms at T2. Children with more sleep problems and higher PSIS Sleep Reinforcement scores at T1 showed increases in attention deficit/hyperactivity disorder, depressive, and anxiety symptoms at T2. These findings provide evidence for the predictive validity of the PSIS and highlight the importance of early parent–child sleep interactions in the development of sleep and psychiatric symptoms in childhood. Parent–child sleep interactions may serve as a useful target for interventions.     

Mutación del gen BRAF V600E en el cáncer papilar de tiroides y su efecto en la terapia con yodo radiactivo (131I) posquirúrgica: ¿deberíamos modificar nuestra estrategia terapéutica?

Introduction

The BRAF V600E mutation in papillary thyroid cancer (PTC) has been associated with resistance to ¹³¹I. Our aim was to quantify the response to ¹³¹I after surgery in patients who had the mutation (BRAF+) and those who did not have the mutated gene (BRAF?).

Long-term Prognosis After Lung Transplantation: A Monocentric Study in 510 Patients

Introduction

Lung transplantation is the final treatment option in patients with respiratory failure. Morbidity and mortality rates associated with the management of complications is high despite advances. Postoperative complications include acute transplant rejection, bronchiolitis obliterans, and infections. Because of that, the success of this treatment option depends on the correct choice of donor and candidates to receive a transplant.

Motor cortical hyperexcitability in idiopathic scoliosis: could focal dystonia be a subclinical etiological factor?

The aetiology of idiopathic scoliosis (IS) remains unknown; however, there is a growing body of evidence suggesting that the spine deformity could be the expression of a subclinical nervous system disorder. A defective sensory input or an anomalous sensorimotor integration may lead to an abnormal postural tone and therefore the development of a spine deformity. Inhibition of the motor cortico-cortical excitability is abnormal in dystonia. Therefore, the study of cortico-cortical inhibition may shed some insight into the dystonia hypothesis regarding the pathophysiology of IS. Paired pulse transcranial magnetic stimulation was used to study cortico-cortical inhibition and facilitation in nine adolescents with IS, five teenagers with congenital scoliosis (CS) and eight healthy age-matched controls. The effect of a previous conditioning stimulus (80% intensity of resting motor threshold) on the amplitude of the motor-evoked potential induced by the test stimulus (120% of resting motor threshold) was examined at various interstimulus intervals (ISIs) in both abductor pollicis brevis muscles. The results of healthy adolescents and those with CS showed a marked inhibitory effect of the conditioning stimulus on the response to the test stimulus at interstimulus intervals shorter than 6 ms. These findings do not differ from those reported for normal adults. However, children with IS revealed an abnormally reduced cortico-cortical inhibition at the short ISIs. Cortico-cortical inhibition was practically normal on the side of the scoliotic convexity while it was significantly reduced on the side of the scoliotic concavity. In conclusion, these findings support the hypothesis that a dystonic dysfunction underlies in IS. Asymmetrical cortical hyperexcitability may play an important role in the pathogenesis of IS and represents an objective neurophysiological finding that could be used clinically.