On the relation between a green and bright window view and length of hospital stay in affective disorders

BackgroundThe salutary effect of window views on greenery for inpatients in hospitals on length of stay and recovery rate has been repeatedly shown, however, not for psychiatric inpatients. The study assessed the association between a window view on green trees or man-made objects and brightness of the room on length of stay in a sample of psychiatric inpatients from one clinic.MethodsData records of 244 psychiatric inpatients (mean age in years 41.8; SD = 11.8; 59.8% female, length of stay varying between 7 and 100 days) that were admitted between May 2013 and October 2018 with affective disorders were examined. Window view was assessed with images taken from each room and classified into showing man-made objects or green trees. The percentage of green within each image was also calculated as greenness of the view. Brightness was assessed with a luxmeter.ResultsAlthough no effect was found for the dichotomous measures (man-made objects vs. green trees), a suppression effect emerged for percentage of green and brightness. The results indicate that both greenness of the window view as well as brightness significantly reduce length of stay in psychiatric inpatients with affective disorders.ConclusionsThe suppression effect likely results from the characteristics of the windows; the greenest rooms also being the darkest. Due to the infrastructure of the ward, greenness and brightness came at the expense of each other. The results generally support the importance of a view into greenery and natural sunlight for recovery.     

The bacteriology of hidradenitis suppurativa: a systematic review

Hidradenitis suppurativa (HS) is a chronic inflammatory disabling skin disease consisting of recurrent nodules, sinuses, fistulas and scarring involving the intertriginous regions. HS is often a therapeutic challenge and most treatments are off‐label. A better understanding of aetiology and pathogenesis of HS may facilitate the development of effective treatment. Although the clinical presentation is strongly reminiscent of bacterial infection, the role of bacteria remains controversial. Studies have isolated an array of different bacteria specimens. Consistent findings of Gram‐positive cocci and Gram‐positive rods including Staphylococus aureus, coagulase‐negative staphylococci (CoNS) and Corynebacterium species in deep tissue samples have been demonstrated in HS and may constitute a central target for the immune system. Efficacy of antibiotics, that is rifampicin, clindamycin or tetracycline, supports a microbial role in disease pathogenesis. However, these antibiotics also work as immunomodulators of especially T cells, and the underlying mechanisms may therefore be more complex. We performed a systematic review of previous studies investigating the bacterial flora in hidradenitis suppurativa. We searched PubMed, EMBASE, Royal Danish Library and Cochrane library (search date 11 December 2014). A total of 66 papers were identified and nine papers published between 1988 and 2014 matched our inclusion criteria, yielding bacteriological data of a total of 324 patients with HS (mean age 36.8 years and female/male ratio 215/109). This overview of the bacteriology may aid researchers and physicians exploring the potential role of bacteria in HS. Furthermore, to stimulate a broader debate, we also present different viewpoints on the possible role of bacteria in HS.     

Striatal transplantation for multiple system atrophy — Are grafts affected by α-synucleinopathy?

Multiple system atrophy (MSA), a fatal neurodegenerative disorder, is the second most common cause of parkinsonism and frequently associated with autonomic failure. Previous work from our laboratory has shown that striatal grafts survive and exert functional effects in toxin-induced rodent models of MSA-P, the parkinson variant characterized by levodopa resistance due to loss of striatal medium-sized spiny neurons. It is unknown whether oligodendroglial α-synuclein signature lesions affect graft survival in MSA. Recent reports on neurotransplantation in Parkinson's disease patients suggest a possible host-to-graft disease propagation of α-synuclein pathology which may be relevant to transplantation in MSA as well. We here demonstrate that embryonic E14 striatal allografts show reduced p-zone volume and dopaminergic graft re-innervation accompanied by increased gliosis in a transgenic MSA mouse model featuring α-synuclein oligodendrogliopathy. Oligodendrocytes expressing host-specific α-synuclein migrate into the graft tissue after 3 months of survival. Our data suggest that the presence of MSA-like α-synuclein oligodendrogliopathy and related to it pro-inflammatory microenvironment may compromise the connectivity and neurorestorative outcome of striatal grafts.     

Riluzole therapy in cervical dystonia.

We conducted a 6-week open-label pilot study with blinded video rating of riluzole (50 mg twice a day) in six patients with cervical dystonia (CD) refractory to botulinum toxin A and oral pharmacological treatment. The Tsui rating scale served as primary efficacy measure and improved significantly under riluzole (P = 0.002). In three of six patients, the Tsui score improved by more than 30% with a greater 50% reduction in the head tremor/jerk subscore of the Tsui scale. These data suggest that riluzole may be helpful in a subgroup of patients with disabling CD refractory to other therapies.     

Presence of both odor identification and detection deficits in Alzheimer's disease

Recent studies of Alzheimer's disease patients have demonstrated (a) marked structural and biochemical alterations in brain regions associated with olfactory function (including the olfactory bulb and entorhinal cortex) and (b) decrements in the ability to identify odorants. In light of such findings, we administered the University of Pennsylvania Smell Identification Test (UPSIT) and a forced-choice phenyl ethyl alcohol odor detection threshold test to a relatively large number of patients diagnosed, on the basis of stringent criteria, as having mild to moderately severe Alzheimer's disease. Compared to age-, gender-, and race-matched normal controls, these individuals evidenced consistent and marked decrements on both types of olfactory tests (ps less than 0.001). Surprisingly few of the patients were aware of their disorder, despite its appearance early in the disease process. These findings indicate that both odor identification and odor detection problems are present in dementia of the Alzheimer's type, and raise the possibility that the odor identification problem may be secondary to the odor detection problem.     

Oxytocin attenuates amygdala responses to emotional faces regardless of valence.

BACKGROUND: Oxytocin is known to reduce anxiety and stress in social interactions as well as to modulate approach behavior. Recent studies suggest that the amygdala might be the primary neuronal basis for these effects. METHODS: In a functional magnetic resonance imaging study using a double-blind, placebo-controlled within-subject design, we measured neural responses to fearful, angry, and happy facial expressions after intranasal application of 24 IU oxytocin compared with placebo. RESULTS: Oxytocin reduced right-sided amygdala responses to all three face categories even when the emotional content of the presented face was not evaluated explicitly. Exploratory whole brain analysis revealed modulatory effects in prefrontal and temporal areas as well as in the brainstem. CONCLUSIONS: Results suggest a modulatory role of oxytocin on amygdala responses to facial expressions irrespective of their valence. Reduction of amygdala activity to positive and negative stimuli might reflect reduced uncertainty about the predictive value of a social stimulus and thereby facilitates social approach behavior.