Alpha rhythm in classical migraine (migraine with aura): abnormalities in the headache-free interval

The alpha rhythm of 18 patients with classical migraine (migraine with aura) was studied by EEG spectrum analysis for evidence of neural abnormalities during the asymptomatic period. The temporal relationship of the findings to attacks was studied by serial records in 11 cases. Increased frequency dispersion and frequency asymmetries of the alpha rhythm were found. The records were, however, mostly normal when separated from attacks by at least 10 asymptomatic days. The abnormalities increased significantly before the onset of prodromal symptoms and clearly outlasted the headache phase. The results give evidence of a fluctuating asymmetric neural disorder in classical migraine.     

Expression of CD11b/CD18 adhesion molecules on circulating phagocytes—a novel aid to diagnose infection in patients with cancer

Goals of work  No blood marker available to date is useful for distinguishing infection-related from neoplasm-related fever. We evaluated the expression of the peripheral blood phagocyte CD11b/CD18 adhesion molecule complex for this purpose. Materials and methods  Neutrophil and monocyte CD11b/CD18 expression was assessed in two cohorts of patients with advanced solid cancer (n = 120) and in healthy controls (n = 63). The cancer series included 89 patients with verified infection, 23 without infection, and eight with neoplastic fever. CD11b/CD18 expression was measured using flow cytometry, and serum C-reactive protein (CRP) concentration was determined with immunoturbidimetric assay. Results  Cancer patients with infection had higher blood neutrophil and monocyte CD11b/CD18 expression levels than patients with neoplastic fever, those with advanced cancer without infection, or healthy controls (p < 0.01 for all analyses). High CD11b/CD18 values were measured exclusively in individuals diagnosed with infection. Receiver-operating characteristic area under the curve (AUC) for neutrophil and monocyte CD11b/CD18 expression for the discrimination of infection from neoplastic fever was 0.80 (95% CI, 0.70 to 0.88), which was superior (p = 0.039 and p = 0.049, respectively) to serum CRP on admission (AUC 0.51, 0.40 to 0.62). Conclusions  Peripheral blood phagocytic cell CD11b/CD18 expression is useful for making a differential diagnosis between infection and neoplasm-related fever in cancer patients. R. Kallio and H. Aalto equally contributed to the present study.     

Effect of physician-staffed helicopter emergency medical service on blunt trauma patient survival and prehospital care.

OBJECTIVE: The aim of the study was to assess the immediate and long-term effect of a helicopter emergency physician giving advanced life support on-scene compared with conventional load and go principle in urban and rural settings in treating blunt trauma patients. METHODS: In a retrospective study, 81 blunt trauma patients treated prehospitally by a physician-staffed helicopter emergency medical service were compared with 77 patients treated before the era of the helicopter emergency medical service. The data were collected in the prehospital and hospital files and a questionnaire was sent to the survivors 3 years after the trauma. RESULTS: The physicians treated the patients more aggressively (gave drugs, intubated and cannulated) and had the patients transported directly to a university hospital. The given treatment did not delay arrival at the hospital. No statistically significant difference was found, but a trend (P = 0.065) to lower survival in the helicopter emergency medical service group. Almost half of the deaths in the helicopter emergency medical service group and none in the control group, however, occurred in the emergency department. No difference was found 3 years later between the groups in the health-related quality of life or decrease in the income owing to the accident. CONCLUSION: The physicians treated the patients more aggressively, but it did not delay the arrival at the hospital. A beneficial effect of this aggressive treatment or direct transport to a university hospital could not be seen in the immediate physiological parameters or later health-related quality of life. The physician-staffed helicopter emergency medical service was not beneficial to blunt trauma patients in this setting.     

Metabolomics of Synovial Fluid and Infrapatellar Fat Pad in Patients with Osteoarthritis or Rheumatoid Arthritis

Inflammation - Osteoarthritis (OA) and autoimmune-driven rheumatoid arthritis (RA) are inflammatory joint diseases with complex and insufficiently understood pathogeneses. Our objective was to...     

Neck muscles cross-sectional area in adolescents with and without headache – MRI study

Background: Cervical musculature may play an important role in the genesis of tension‐type headache. However, there are no reports on a possible association between the morphometrical features of the neck flexion and extension muscles and adolescence headache. Aim: To examine differences in neck flexion and extension muscles cross‐sectional area (CSA) in adolescents with and without headache. Methods: A population‐based sample of 17‐year‐old adolescents with migraine (N=19), tension‐type headache (N=24) and healthy controls without headache (N=22) was examined. CSA of the neck muscles was measured from axial T1‐weighted magnetic resonance images (MRI). Results: Boys with tension‐type headache showed significantly smaller CSA of right sternocleidomastoid muscle than boys with migraine and girls with tension‐type headache showed significantly smaller CSA of combined right sternocleidomastoid and scalenus muscles than girls with migraine. In addition, boys with migraine had significantly larger CSA of both right sternocleidomastoid and combined right sternocleidomastoid and scalenus muscles, and left semispinalis capitis muscle and combined left semispinalis and splenius muscles than boys without headache. In boys and girls no other significant differences were observed in the CSA of neck flexion or extension muscles. Conclusions: This preliminary work demonstrates that both girls and boys with tension‐type headache and migraine have differences in the size of neck flexion muscles, especially unilaterally. In boys, unilaterally increased size of neck flexion and extension muscles is associated with migraine. These findings, if confirmed in further studies, may have important diagnostic and therapeutic implications for rehabilitation of adolescents with headache.     

Factors Associated With Radiographers' Intravenous Pharmacotherapy Theoretical Competence: A Comparative Repeated-Measures Study

Introduction

There are concerns that the high incidence of medicine-related adverse events is compromising patient safety. System errors and human factors, particularly inadequate knowledge of pharmacotherapy, are significant causes of medication errors. Little has been published on the continuing professional education of radiographers. We report on a study undertaken in Finland between 2012 and 2014.

A locus on 2p12 containing the co-regulated MRPL19 and C2ORF3 genes is associated to dyslexia

DYX3, a locus for dyslexia, resides on chromosome 2p11-p15. We have refined its location on 2p12 to a 157 kb region in two rounds of linkage disequilibrium (LD) mapping in a set of Finnish families. The observed association was replicated in an independent set of 251 German families. Two overlapping risk haplotypes spanning 16 kb were identified in both sample sets separately as well as in a joint analysis. In the German sample set, the odds ratio for the most significantly associated haplotype increased with dyslexia severity from 2.2 to 5.2. The risk haplotypes are located in an intergenic region between FLJ13391 and MRPL19/C2ORF3. As no novel genes could be cloned from this region, we hypothesized that the risk haplotypes might affect long-distance regulatory elements and characterized the three known genes. MRPL19 and C2ORF3 are in strong LD and were highly co-expressed across a panel of tissues from regions of adult human brain. The expression of MRPL19 and C2ORF3, but not FLJ13391, were also correlated with the four dyslexia candidate genes identified so far (DYX1C1, ROBO1, DCDC2 and KIAA0319). Although several non-synonymous changes were identified in MRPL19 and C2ORF3, none of them significantly associated with dyslexia. However, heterozygous carriers of the risk haplotype showed significantly attenuated expression of both MRPL19 and C2ORF3, as compared with non-carriers. Analysis of C2ORF3 orthologues in four non-human primates suggested different evolutionary rates for primates when compared with the out-group. In conclusion, our data support MRPL19 and C2ORF3 as candidate susceptibility genes for DYX3.     

Loading and gait symmetry during level and stair walking in asymptomatic subjects with knee osteoarthritis: Importance of quadriceps femoris in reducing impact force during heel strike?

Repetitive impulsive forces during walking are claimed to result in joint osteoarthritis (OA). The aim of this study was to investigate impact loading and gait symmetry during level and stair walking in asymptomatic elderly subjects with knee OA. It was hypothesised that pre-activity of the quadriceps femoris muscle (QF) would be an important factor reducing impulsive loading when walking on level ground. Subjects [21 female, six men, 66.2 (7.6) years] were studied. The subjects had no knee pain or diminished functional capacity, but showed radiographically light or moderate bilateral knee OA changes. Ground reaction forces (GRFs), plantar pressure distribution, muscle activation pattern [vastus medialis (VM), vastus lateralis, biceps femoris and gastrocnemius medialis] and asymmetry during level walking and stair walking were evaluated. Almost 20% of subjects had a distinct heel-strike transient at maximal speed with lower pre-activity of VM (P<0.05). The most forceful maximum vertical GRF in the braking phase occurred in stair descent [1.52 (0.21) BW]. This was 32.5% (P<0.001) higher than seen when walking on the level at normal speed. The loading rate of stair descent [10.87 (2.96) BW/s] was significantly stronger (P<0.05) than in level walking at normal speed [8.55 (1.93) BW/s]. There was no asymmetry in kinematic or kinetic variables in level walking. However, asymmetry increased during stair walking. The control of quadriceps femoris prior to heel-strike is possibly an important factor that reduces impulsive loading during walking in asymptomatic OA subjects. Stair walking is a demanding motor task and the musculoskeletal system is loaded more during stair descent than level walking at normal speed.     

Does mismatch negativity show differences in reading-disabled children compared to normal children and children with attention deficit?

An auditory event-related potential (ERP) component called mismatch negativity (MMN) was examined in three groups of children (n = 63) aged 8-14 years. A control group comprised healthy children in second or sixth grade of comprehensive school (n = 21). The two clinical groups included children with reading disability (RD) (n = 21) and children with attention deficit (AD) (n = 21). MMN was elicited in a passive oddball paradigm by duration changes in a continuous sound, consisting of two alternating (600 and 800 Hz) 100 msec tones. The deviant tones were either 30 or 50 msec in duration. Both deviants elicited a clear MMN in all groups. Statistical analyses showed no systematic difference in the MMN peak latencies or amplitudes between the groups. A significant difference between the RD group and the control group was observed in the lateralization of the MMN peak amplitudes.