Neurodynamic Techniques Versus “Sham” Therapy in the Treatment of Carpal Tunnel Syndrome: A Randomized Placebo-Controlled Trial

Objective

To evaluate the efficacy of neurodynamic techniques used as the sole therapeutic component compared with sham therapy in the treatment of mild and moderate carpal tunnel syndromes (CTS).

Rho kinase--a new target for pharmacological treatment of an overactive bladder

Rho kinase plays a key role in the regulation of smooth muscles contraction, including those of the urinary bladder detrusor. Rho kinase pathway modulates the level of phosphorylation of the myosin light chain, mainly through the inhibition of myosin phosphatase. Recent experimental data indicate that its role might be exacerbated in local and systemic pathological conditions which affect the bladder. It seems that Rho kinase inhibitors, such as Y27632, may turn out to be an effective group of drugs in pharmacotheraphy of an overactive bladder (OAB), which will influence the storage phase of the micturition cycle, without interfering with the physiological voiding.     

Hepatitis C virus quasispecies in chronically infected children subjected to interferon–ribavirin therapy

Accumulating evidence suggests that certain features of hepatitis C virus (HCV), especially its high genetic variability, might be responsible for the low efficiency of anti-HCV treatment. Here, we present a bioinformatic analysis of HCV-1a populations isolated from 23 children with chronic hepatitis C (CHC) subjected to interferon–ribavirin therapy. The structures of the viral quasispecies were established based on a 132-amino-acid sequence derived from E1/E2 protein, including hypervariable region 1 (HVR1). Two types of HCV populations were identified. The first type, found in non-responders, contained a small number of closely related variants. The second type, characteristic for sustained responders, was composed of a large number of distantly associated equal-rank variants. Comparison of 445 HVR1 sequences showed that a significant number of variants present in non-responding patients are closely related, suggesting that certain, still unidentified properties of the pathogen may be key factors determining the result of CHC treatment.     

Growth hormone therapy and lipid profile in children on chronic peritoneal dialysis

The aim of the study was to assess the effect of recombinant human growth hormone (rhGH) on serum lipids in children treated with chronic peritoneal dialysis. We studied 26 patients aged 5-18 years, including 13 patients treated with rhGH at a dose of 1-1.1 IU/kg per week for 6 months and a control group of 13 patients. Serum total cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C), HDL-C, triglycerides (TG), apolipoproteins A-I and B-100 (apoA and apoB), lipoprotein (a) [Lp(a)], total protein, albumin, urea, and creatinine levels were measured in all children at baseline and at 1, 3, and 6 months of follow-up. We found a significant increase in the TG level after 1 month of administration of rhGH in the treatment group compared with both baseline (218.8+/-49.2 mg/dl vs. 175.9+/-71.9 mg/dl, respectively, P<0.05) and the control group at 1 month of follow-up (146.5+/-44.3 mg/dl, P<0.001). We found no change in TC, LDL-C, HDL-C, apoA, and Lp(a) levels during treatment with rhGH. These data suggest that administration of rhGH to children treated with peritoneal dialysis results in only a transient increase of serum TG level and has no effect on TC, LDL-C, HDL-C, apoA, and Lp(a) levels.     

Antagonism of picrotoxin-induced changes in dopamine and serotonin metabolism by allopregnanolone and midazolam

The effects of allopregnanolone and midazolam, given intracerebroventricularly, on the behavioral and biochemical effects of picrotoxin, were examined in a model of neurotoxin-induced seizures, in mice. After acute injections, midazolam (ED(50)=39.8 nmol) and allopregnanolone (ED(50)=11.0 nmol) produced similar and dose-dependent protection against picrotoxin-induced seizures. Picrotoxin given intraperitoneally at the ED(85) dose decreased significantly the concentration of serotonin (5-HT), dopamine (DA), homovanilic acid (HVA) and 3,4-dihydroxyindolacetic acid (DOPAC), in the mouse striatum and the frontal cortex, in the period of time immediately preceding the onset of seizures. A single injection of allopregnanolone more potently, in comparison to midazolam, antagonized the biochemical action of picrotoxin, abolishing its effects on DA, HVA and 5-HT concentration, in the mouse striatum and the frontal cortex. These results for the first time provide a direct argument for an involvement of central dopaminergic and serotonergic systems in the seizure development. The present data add also to the accumulating evidence suggesting a favorable pharmacological profile for some neurosteroids currently considered to have a future role in the management of epilepsy.     

Rapid desensitization of receptors for pituitary adenylate cyclase-activating polypeptide (PACAP) in chick cerebral cortex

Pituitary adenylate cyclase-activating polypeptide (PACAP38) potently stimulates cyclic AMP formation in slices of chick cerebral cortex. One- to fifteen-minute pretreatment of slices with 30 nM PACAP38 led to a time-dependent attenuation (when compared with values observed in the control tissue) of the cyclic AMP response produced by subsequent re-stimulation with 1 microM PACAP38. Concentration-response curve for restimulation with PACAP38 applied at 0.01-1 microM to tissue slices preincubated for 15 min with 30 nM PACAP38 revealed dose-dependent decreases in subsequent cyclic AMP responses by 16-37%. It is concluded that in chick cerebral cortex, the receptors mediating PACAP-driven cyclic AMP responses (PAC1 receptors) undergo rapid homologous desensitization.     

Intrathecal baclofen in severe spasticity due to multiple sclerosis

Intrathecal administration of baclofen via programmable pump is a highly effective treatment method in severe spasticity resistant to oral medications. The authors describe a case of severe spasticity with tetraplegia and painful (> 10 a day) muscle spasms in the upper and lower limbs and paraspinal muscles, in a patient with clinically definite diagnosis of multiple sclerosis (MS). The 34-year-old female patient with a 15-year history of MS, suffering from lower limb spasticity with pes equinovarus since 1995, was treated with very good results with botulinum toxin injections of calf muscles (14 sessions of Dysport 1500iu till 2002). In the early 2002 she developed tetraplegia with severe, generalized and intractable spasticity. After 4 months of ineffective polytherapy (with high doses of oral baclofen, tizanidine, gabapentine, clonidine, diazepam) and the patient's enormous sufferings (she could neither sit up nor voluntarily change her position in bed), a programmable baclofen pump (Medtronic) was implanted. As soon as a few days after the surgery she could stand, sit and move voluntarily, her painful spasms disappeared, and her bladder catheter was removed. At a 6-month follow-up the effect was stable--she was able to walk a long distance outdoors with the aid of a crutch. The daily dose of the drug is 500 micrograms. No side effects of complications were noted.     

The frequency of diagnosis of catatonic schizophrenia in hospitals in Lubliniec (1894-1932, 1934-1936, 1970-1999) and Boleslawiec (1958-1999)

AIM: The analysis of the data from the psychiatric hospitals in Lubliniec (1894-1932, 1934-1936, 1970-1999) and Boles?awiec (1958-1999) proved a decrease in frequency of diagnosis of catatonic schizophrenia, what could testify to a decrease in morbidity with this form of schizophrenia. METHOD AND RESULTS: Basing on the facts from scientific literature there was ascertained that the decrease in frequency of diagnosis of catatonic schizophrenia is connected with following causes: firstly, with the changes in nozology, secondly, with the introduction of a new form of therapy and finally, with the fact that here psychological and sociological factors exist which eliminate catatonia as the most expressive form of schizophrenia.     

Mumps in Poland in 2000

A total of 17,548 mumps cases were reported in Poland in 2000. A 5-fold decrease in incidence of the disease (from 233.4 to 45.4 per 100,000 population) was noted, when compared with 1999. Approximately 4.8% of mumps cases were hospitalized (849 cases). The majority of the reported cases were children aged 5-9 (51.4% of all cases). In all voivodships the incidence was lower than in previous years. The probable cause of the decline of mumps cases was a marked amelioration of MMR vaccination coverage among 3-year old children. The MMR vaccine is not included into the national program of immunization, the vaccination is recommended for 2-year and 7-year old children.