Manual therapy with or without physical medicine modalities for neck pain: a systematic review

Manual therapy interventions are often used with or without physical medicine modalities to treat neck pain. This review assessed the effect of 1) manipulation and mobilisation, 2) manipulation, mobilisation and soft tissue work, and 3) manual therapy with physical medicine modalities on pain, function, patient satisfaction, quality of life (QoL), and global perceived effect (GPE) in adults with neck pain. A computerised search for randomised trials was performed up to July 2009. Two or more authors independently selected studies, abstracted data, and assessed methodological quality. Pooled relative risk (RR) and standardised mean differences (SMD) were calculated when possible. We included 19 trials, 37% of which had a low risk of bias. Moderate quality evidence (1 trial, 221 participants) suggested mobilisation, manipulation and soft tissue techniques decrease pain and improved satisfaction when compared to short wave diathermy, and that this treatment combination paired with advice and exercise produces greater improvements in GPE and satisfaction than advice and exercise alone for acute neck pain. Low quality evidence suggests a clinically important benefit favouring mobilisation and manipulation in pain relief [1 meta-analysis, 112 participants: SMD ?0.34(95% CI: ?0.71, 0.03), improved function and GPE (1 trial, 94 participants) for participants with chronic cervicogenic headache when compared to a control at intermediate and long term follow-up; but no difference when used with various physical medicine modalities.     

The influence of maternal depression, caregiving, and socioeconomic status in the post-natal year on children's language development

Background   Post-natal depression is common and has been associated with adverse effects on children's later emotional and behavioural development. The evidence for effects on children's cognitive development is unclear but this could potentially be a major public health issue. The aim was to examine whether maternal depression and maternal caregiving during the first year of life are associated with children's subsequent language development.
Methods   One thousand two hundred and one women were recruited from antenatal and post-natal baby clinics in two areas in England, and followed up until their babies were 3 years. Mothers and children were assessed by questionnaire, interview and home observation; 999 children's language was assessed at 36 months, although 55 were excluded principally because they had been exposed to insufficient English.
Results   In bivariate analyses maternal depressive symptomatology in the post-natal year but not at 36 months was associated with poorer child language at 36 months; maternal caregiving, was positively associated with language. Structural Equation Modelling revealed that depression was associated with poorer caregiving but was not independently associated with language. Higher quality caregiving at 10 months was associated with better language. When the sample was split by socioeconomic factors the effects of depression on caregiving were stronger in the less advantaged group. In both groups poorer quality early caregiving predicted lower language outcome.
Conclusions   Post-natal depression had a negative effect on caregiving, which in turn affected language; post-natal depression did not have an additional direct effect on language. Socioeconomic factors moderated the effects of depression on caregiving. When targeting interventions at mothers with post-natal depression, it may be strategic to focus on lower socioeconomic groups at higher risk.     

Beneficial Effects of a Protein Free,High Carbohydrate Meal on Rat Coping Behavior and Neurotransmitter Levels During Heat Stress

Abstract

This study examined effects of a single protein-free (PROT-free), high carbohydrate meal (0% protein, 82% carbohydrate) or control meal (20% protein, 62% carbohydrate) on coping behavior and neurotransmitter levels of male Fischer 344 rats. Meals varying in protein/carbohydrate ratio differentially affect transport of neurotransmitter precursors into the brain and alter neurotransmission. The meals were studied in animals exposed to heat stress and normothermic control animals. Coping behavior was assessed using the Porsolt swim test ( N =39). In other rats, dopamine (DA), epinephrine (EPI), norepinephrine (NE) and serotonin in the striatum were assessed using in vivo microdialysis ( N =35). In control-fed rats, heat stress impaired Porsolt performance in comparison to normothermic controls ( p <0.05). The PROT-free, high carbohydrate meal protected animals from adverse effects of stress on coping performance as it reduced the effect of heat stress more than 90%. Significant changes in striatal DA and EPI efflux were observed as a consequence of the nutritional manipulation and heat exposure. It is concluded a single PROT-free, high carbohydrate meal improves ability to cope with heat stress and alters neurotransmission. The neurochemical basis for these effects may be a change in DA efflux, although other mechanisms cannot be ruled out.     

Penicillin-binding protein 3 is a common adaptive target among Pseudomonas aeruginosa isolates from adult cystic fibrosis patients treated with β-lactams

Objective

Determining the mechanisms that modulate β-lactam resistance in clinical Pseudomonas aeruginosa (P. aeruginosa) isolates can be challenging, as the molecular profiles identified in mutation-based or expression-based resistance determinant screens may not correlate with in vitro phenotypes. One of the lesser studied resistance mechanisms in P. aeruginosa is the modification of penicillin-binding protein 3 (pbpB/ftsI). This study reported that nonsynonymous polymorphisms within pbpB frequently occur among β-lactam resistant sputum isolates, and are associated with unique antibiotic susceptibility patterns.

Transient hyperphosphatasemia in pediatric renal transplant patients – Is there a need for concern and when?

Kutílek ?, Skálová S, Vethamuthu J, Geier P, Feber J. Transient hyperphosphatasemia in pediatric renal transplant patients – Is there a need for concern and when?
Pediatr Transplantation 2012: 16: E5–E9. © 2010 John Wiley & Sons A/S. Abstract: TH of infancy and early childhood is characterized by transiently increased S‐ALP, predominantly its bone or liver isoforms. There are neither signs of metabolic bone disease or hepatopathy corresponding to the increased S‐ALP, nor a common underlying/triggering disease. TH may also occur in children post‐renal Tx, which may raise significant concerns and anxiety. We describe four patients aged 2.8–7 yr in whom the TH occurred at 11–34 (median = 28) months after Tx and lasted from 40 to 105 (median = 63) days. No obvious cause/trigger of TH could be found; the clinical status and bone turnover were not altered. In cases of TH post‐Tx, we recommend the evaluation of basic biochemical indices and wrist X‐ray. If these results are normal, TH is most likely the diagnosis and the S‐ALP can be monitored over the next three months without further testing. In patients with persisting TH for more than three months and/or in children with pre‐existing or suspected metabolic bone disease, further evaluation may be indicated. In conclusion, TH is a benign disorder in patients post‐Tx. Detailed investigation including bone biopsy is only indicated in patients with persisting TH.     

A comparison of father–infant interaction between primary and non-primary care giving fathers

Background This study examined the socio‐demographic characteristics and attitudes of primary care giving fathers and non‐primary care giving fathers and the quality of their interaction with their infants. Method Two groups of fathers of 11.9‐month old infants were compared – 25 primary care giving fathers (20 h per week or more of sole infant care) and 75 non‐primary care giving fathers – with regard to socio‐demographic characteristics, attitudinal differences and father–infant interaction during play and mealtimes. The quality of father–child interaction in relation to the total number of hours of primary care provided by fathers was also examined. Results Primary care giving fathers had lower occupational status and earned a smaller proportion of the family income but did not differ in educational level or attitudes compared with non‐primary care giving fathers. There were no differences between the partners of the two groups of fathers on any variables, and their infants did not differ in temperament. Primary care giving fathers and their infants exhibited more positive emotional tone during play than non‐primary care giving fathers, although fathers did not differ in responsivity. There were no differences between the groups during mealtimes. There was a positive association between total number of child care hours provided by all fathers and infant positive emotional tone. Conclusions Primary and non‐primary care giving fathers were similar in many respects, but primary care giving fathers and their infants were happier during play. This suggests a possible link between the involvement of fathers in the care of their children and their children's emotional state. The finding of a trend towards increased paternal happiness with increased hours of child care suggests that there may also be a gain for fathers who are more involved in the care of their infants. Further research is needed to determine whether these differences ultimately have an effect on children's development.