Reduction of nightmares and other PTSD symptoms in combat veterans by prazosin: a placebo-controlled study

OBJECTIVE: Prazosin is a centrally active alpha(1) adrenergic antagonist. The authors' goal was to evaluate prazosin efficacy for nightmares, sleep disturbance, and overall posttraumatic stress disorder (PTSD) in combat veterans. METHOD: Ten Vietnam combat veterans with chronic PTSD and severe trauma-related nightmares each received prazosin and placebo in a 20-week double-blind crossover protocol. RESULTS: Prazosin (mean dose=9.5 mg/day at bedtime, SD=0.5) was superior to placebo for the three primary outcome measures: scores on the 1) recurrent distressing dreams item and the 2) difficulty falling/staying asleep item of the Clinician-Administered PTSD Scale and 3) change in overall PTSD severity and functional status according to the Clinical Global Impression of change. Total score and symptom cluster scores for reexperiencing, avoidance/numbing, and hyperarousal on the Clinician-Administered PTSD Scale also were significantly more improved in the prazosin condition, and prazosin was well tolerated. CONCLUSIONS: These data support the efficacy of prazosin for nightmares, sleep disturbance, and other PTSD symptoms.     

Nestin expression after experimental intracerebral hemorrhage

The current study examines nestin expression after intracerebral hemorrhage (ICH), the role of different blood components in nestin upregulation, and the possibility that low doses of thrombin that induce tolerance to brain injury (thrombin preconditioning) might also induce nestin expression. Adult male Sprague-Dawley rats received an intracaudate injection of either whole blood, thrombin (1 or 5 U) or red blood cells (RBCs). Animals were sacrificed for single and double labeling immunohistochemistry to identify which cells express nestin, and for Western blotting to quantify nestin expression. By immunohistochemistry, nestin immunoreactivity was present in large numbers of astrocytes, surrounding the hematoma from day 3 to 1 week after ICH. After 2 weeks, nestin immunoreactivity was co-localized with a neuronal marker (neuronal specific enolase). By Western blot analysis, nestin was strongly expressed at day 3 (P<0.01) and 1 week (P<0.01), and expression persisted for at least 1 month (P<0.05). Intracerebral injection of thrombin or lysed RBCs resulted in a marked increase in nestin expression. Interestingly, injection of a low dose of thrombin that induces brain tolerance also upregulated nestin. The ICH-induced nestin expression in astrocytes may reflect an early response of these cells to injury, while the delayed expression in neurons might be a part of the adaptative response to injury perhaps leading to recovery of function. Nestin induction by a low dose of thrombin suggests that specific receptor-mediated pathways are involved in inducing nestin expression and that nestin may play a role in thrombin preconditioning.     

Quality control in colorectal cancer screening: Systematic microbiological investigation of endoscopes used in the NORCCAP (Norwegian Colorectal Cancer Prevention) trial

Background  

Endoscopic colorectal cancer (CRC) screening is currently implemented in many countries. Since endoscopes cannot be sterilised, the transmission of infectious agents through endoscopes has been a matter of concern. We report on a continuous quality control programme in a large-scale randomised controlled trial on flexible sigmoidoscopy screening of an average-risk population. Continuously, throughout a two-year screening period, series of microbiological samples were taken from cleaned ready-to-use endoscopes and cultured for bacterial growth.     

"Stalking"--a popular conceptualisation of disturbing behaviour with limited practicability for forensic psychiatry

Aspects of "stalking" behaviour have been discussed predominantly in the Anglo-American psychiatric literature. However following new legal regulations, "stalking" is expected to gain relevance for the German forensic psychiatry. "Stalkers" are a heterogeneous group presenting with a wide range of relational or even psychotic motives for their behaviour. Therefore careful diagnostics are required. Legal responsibility can be estimated by assessing the capacity of the offender to understand (cognitive functioning) and to control his behaviour (volitional functioning). The severity of possible restrictions can be assessed by comparing them to the known impairments in cases of erotomania.     

Intelligence in preterm children at four years of age as a predictor of school function: a longitudinal controlled study

The aim of the study was to examine whether school performance was reduced in children with very-low birthweight beyond what could be explained by the deficit in intelligence-score at 4 years of age. Participants (n=333) examined at 4 years of age included three subgroups on the basis of birthweight: very-low birthweight (VLBW < 1501 g; n=102), low birthweight (LBW 1500-2300 g; n=139), and normal birthweight (NBW > or = 2500 g; n=92). The general cognitive index index (CGI) from the McCarthy Scales of Children's Abilities was used as an intelligence measurement at this assessment. At 18 to 20 years of age a telephone interview concerning school performance was conducted. Two hundred and fifty-seven participants (53% male, 47% female) entered the analysis. A model with School Performance score after the last year of compulsory school as the outcome variable, and McCarthy GCI and birthweight group as predicting variables, was used in linear regression analyses. Twenty-four per cent of the variance was explained. Birthweight had no influence in this model. In conclusion, the study did not find that birthweight influenced school performance beyond that represented by the McCarthy GCI found at age 4 years.     

Soccer specific aerobic endurance training

BACKGROUND: In professional soccer, a significant amount of training time is used to improve players' aerobic capacity. However, it is not known whether soccer specific training fulfils the criterion of effective endurance training to improve maximal oxygen uptake, namely an exercise intensity of 90-95% of maximal heart rate in periods of three to eight minutes. OBJECTIVE: To determine whether ball dribbling and small group play are appropriate activities for interval training, and whether heart rate in soccer specific training is a valid measure of actual work intensity. METHODS: Six well trained first division soccer players took part in the study. To test whether soccer specific training was effective interval training, players ran in a specially designed dribbling track, as well as participating in small group play (five a side). Laboratory tests were carried out to establish the relation between heart rate and oxygen uptake while running on a treadmill. Corresponding measurements were made on the soccer field using a portable system for measuring oxygen uptake. RESULTS: Exercise intensity during small group play was 91.3% of maximal heart rate or 84.5% of maximal oxygen uptake. Corresponding values using a dribbling track were 93.5% and 91.7%. No higher heart rate was observed during soccer training. CONCLUSIONS: Soccer specific exercise using ball dribbling or small group play may be performed as aerobic interval training. Heart rate monitoring during soccer specific exercise is a valid indicator of actual exercise intensity.