Outcome expectancies and ecstasy use in visitors of rave parties in The Netherlands

The aim of this study was to examine the associations between outcome expectancies and ecstasy use in a sample of visitors of raves. The type of expectancies that people endorse were explored, as well as the differences between users and nonusers in expected outcomes of ecstasy use, and the associations between expectancies and quantity of ecstasy use within the group of users. Questionnaires were administered to 844 young visitors of 7 parties in the Netherlands, of which 543 reported to be users. Drug use on these parties was high: 65% reporting ecstasy use. Factor analyses showed 7 factors: negative consequences, enhancement, euphoria, sexiness, dancing, communication and self-insight. These factors strongly discriminated between users and nonusers. In particular those who scored high on self-insight and low on negative effects were most likely to use ecstasy. The expected outcomes of ecstasy are related to ecstasy use and patterns of use providing information for health education directed on long-term negative and positive effects of ecstasy use. Longitudinal research on random samples of visitors of raves is warranted.     

Anogenital distance as a predictor of attractiveness, litter size and sex ratio of rabbit does

In the case of some mammalian species, females with larger anogenital distance (AGD) have smaller litters, where the sex ratio is male-biased. The first aim of the present study was to test whether this phenomenon exists in the Lagomorph group, especially in rabbits. The results revealed that does with large AGD have significantly smaller and lighter litters with a male biased sex ratio; with fewer females but not more males. The second aim of the present study was to test whether males differentiate between females differing in their AGD and are thus capable of choosing the more fertile and fecund does. Males showed a stronger response to the chin marks of females with small AGD than to the marks of females with large AGD. Our results suggest that variation in the prenatal hormonal environment, reflected through variation in AGD, could have long-term consequences on mate choice and population dynamics.     

Clinical outcome after undisplaced femoral neck fractures

Background and purpose

Little attention has been paid to undisplaced femoral neck fractures. By using data from the Norwegian Hip Fracture Register, we investigated the risk of reoperation and the clinical outcome after treatment of these fractures in patients over 60 years of age.

Methods

Data on 4,468 patients with undisplaced femoral neck fractures who were operated with screw osteosynthesis were compared to those from 10,289 patients with displaced femoral neck fractures treated with screw osteosynthesis (n = 3,389) or bipolar hemiarthroplasty (n = 6,900). The evaluation was based on number of reoperations and patient assessment at 4 and 12 months of follow-up.

Results

The 1-year implant survival was 89% after screw fixation for undisplaced fractures, 79% after screw fixation for displaced fractures, and 97% after hemiarthroplasty for displaced fractures. Patients with displaced fractures who were operated with internal fixation had a higher risk of reoperation (RR = 1.9, CI: 1.7–2.2), reported more pain, were less satisfied, and had lower quality of life than patients with undisplaced fractures treated with internal fixation (p < 0.05). Patients with displaced fractures who were operated with hemiarthroplasty had a lower risk of reoperation than patients with undisplaced fractures who were operated with internal fixation (RR = 0.32, CI: 0.27–0.38). Furthermore, they had the lowest degree of pain, were most satisfied, and reported the highest quality of life.

Interpretation

Interpretation The differences in clinical outcome found were less than what is considered to be of clinical importance. The results support the use of screw osteosynthesis for undisplaced femoral neck fractures in elderly patients, although even better results were obtained in the hemiarthroplasty group in patients with displaced fractures.Each year, approximately 9,000 patients are operated for hip fractures in Norway. 19% are undisplaced femoral neck fractures (Garden 1 and 2) and 38% are displaced (Gjertsen et al. 2008). The treatment of displaced fractures has been investigated extensively, and some recent reports have shown better clinical outcome after hemiarthroplasty than after screw fixation (Rogmark et al. 2002, Frihagen et al. 2007, Gjertsen et al. 2010). Less has been published on the treatment of undisplaced fractures. Some authors advocate internal screw fixation as being the best treatment, even though a high rate of reoperations has been reported (Conn and Parker 2004, Bjorgul and Reikeras 2007, Parker et al. 2008). A recent study found poor outcome in many patients after treatment of undisplaced fractures (Rogmark et al. 2009).In Norway, there are no national guidelines for the treatment of hip fractures. The standard treatment for undisplaced fractures has been internal fixation with 2 screws or pins (94% of fractures) (Gjertsen et al. 2008). In the present study, we wanted to investigate the results after undisplaced femoral neck fractures, as reported to the Norwegian Hip Fracture Register. Risk of reoperation, pain, patient satisfaction, and quality of life were used as outcome measures. Since the undisplaced fractures were almost exclusively treated with internal fixation, patients with displaced femoral neck fractures treated with screw osteosynthesis or hemiarthroplasty were used as reference groups when analyzing the results.     

In situ fixation of slipped capital femoral epiphysis with Steinmann pins

Background and purpose

Slipped capital femoral epiphysis (SCFE) is often treated by surgical fixation; however, no agreement exists regarding technique. We analyzed the outcome of in situ fixation with Steinmann pins.

Patients and methods

All 67 subjects operated for slipped capital femoral epiphysis at Haukeland University Hospital during the period 1990–2007 were included. All were treated by in situ fixation with 2 or 3 parallel Steinmann pins (8 mm threads at the medial end). The follow-up evaluation consisted of clinical examination and hip radiographs. Radiographic outcome was based on measurements of slip progression, growth of the femoral neck, leg length discrepancy, and signs of avascular necrosis and chondrolysis.

Results

67 subjects (41 males) were operated due to unilateral slips (n = 47) or bilateral slips (n = 20). Mean age at time of diagnosis was 13 (7.2–16) years. Mean age at follow-up was 19 (14–30) years, with a mean postoperative interval of 6.0 (2–16) years. The operated femoral neck was 9% longer at skeletal maturity than at surgery, indicating continued growth of the femoral neck. At skeletal maturity, 12 subjects had radiographic features suggestive of a previous asymptomatic slip of the contralateral hip. The total number of bilateral cases of SCFE was 32, i.e half of the children had bilateral SCFE. 3 subjects required additional surgery and mild avascular necrosis of the femoral head was seen in 1 patient. None had slip progression or chondrolysis.

Interpretation

In situ pinning of SCFE with partly threaded Steinmann pins appears to be a feasible and safe method, with few complications. The technique allows further growth of the femoral neck.Slipped capital femoral epiphysis (SCFE) is a disease of unknown etiology, but mechanical, biological and hereditary factors are likely to play a role (Barrios et al. 2005, Murray and Wilson 2008). The rationale for treatment of SCFE is to restore hip function, prevent further slip, and to reduce the risk of subsequent degenerative changes. Several surgical techniques have been recommended such as cannulated screws (Chen et al. 2009), hook-pins (Hansson 1982), specially constructed screws (Wensaas and Svenningsen 2005), and most recently surgical hip dislocation with subcapital correction osteotomy (Leunig et al. 2007). However, currently there is no evidence to support the superiority of one particular technique over another.In situ fixation is advocated by most authors (Boyer et al. 1981, Carey et al. 1987, Givon and Bowen 1999) since peroperative reduction may increase the risk of avascular necrosis (Ordeberg et al. 1983, Carney et al. 1991, Lim et al. 2007). Physiodesis to prevent further growth—thus stabilizing the physis—is recommended by some authors (Carey et al. 1987, Aronsson and Karol 1996). Slip of the contralateral hip is reported in more than half of the cases (Hägglund et al. 1988, Castro et al. 2000) and controversies exist regarding prophylactic fixation of the contralateral hip. According to Jerre et al. (1994), more than two-thirds of the contralateral slips are asymptomatic and are therefore only detected at close follow-ups including hip radiographs at short intervals. Immediate prophylactic fixation of the contralateral hip has been advocated by several authors (Hägglund et al. 1988, Schultz et al. 2002, Krauspe et al. 2004).In this paper, we present clinical and radiographic results of a novel, simple technique for in situ fixation of the femoral head with partially threaded Steinmann pins to enable further growth of the femoral neck.     

New considerations on the management of osteoporosis in Central and Eastern Europe (CEE): summary of the ��3rd Summit on Osteoporosis��CEE��, November 2009, Budapest, Hungary

Introduction

In November 2009, the ??3rd Summit on Osteoporosis??Central and Eastern Europe (CEE)?? was held in Budapest, Hungary. The conference aimed to tackle issues regarding osteoporosis management in CEE identified during the second CEE summit in 2008 and to agree on approaches that allow most efficient and cost-effective diagnosis and therapy of osteoporosis in CEE countries in the future.

Discussion

The following topics were covered: past year experience from FRAX? implementation into local diagnostic algorithms; causes of secondary osteoporosis as a FRAX? risk factor; bone turnover markers to estimate bone loss, fracture risk, or monitor therapies; role of quantitative ultrasound in osteoporosis management; compliance and economical aspects of osteoporosis; and osteoporosis and genetics. Consensus and recommendations developed on these topics are summarised in the present progress report.

Conclusion

Lectures on up-to-date data of topical interest, the distinct regional provenances of the participants, a special focus on practical aspects, intense mutual exchange of individual experiences, strong interest in cross-border cooperations, as well as the readiness to learn from each other considerably contributed to the establishment of these recommendations. The ??4th Summit on Osteoporosis??CEE?? held in Prague, Czech Republic, in December 2010 will reveal whether these recommendations prove of value when implemented in the clinical routine or whether further improvements are still required.     

The protective role of bone morphogenetic protein-8 in the glucocorticoid-induced apoptosis on bone cells

One of the side effects associated with glucocorticoid therapy is glucocorticoid-induced bone loss. Glucocorticoids partly detain bone formation via the inhibition of osteoblastic function, however, the exact mechanism of this inhibition remains elusive. In this study, we examined the effect of dexamethasone, an active glucocorticoid analogue, on cell viability and expression of bone remodelling-related genes in primary mouse calvarial and cloned MC3T3-E1 osteoblasts. Using sensitive biochemical assays, we demonstrated the apoptotic effect of dexamethasone on osteoblastic cells. Then, utilizing Taqman probe-based quantitative RT-PCR technology, gene expression profiles of 111 bone metabolism-related genes were determined. As a result of dexamethasone treatment we have detected significant apoptotic cell death, and six genes, including Smad3, type-2 collagen α-1, type-9 collagen α-1, matrix metalloproteinase-2, bone morphogenetic protein-4 and bone morphogenetic protein-8 showed (BMP-8) significant changes in their expression on a time- and concentration-dependent manner. BMP-8, (a novel player in bone-metabolism) exhibited a two orders of magnitude elevation in its mRNA level and highly elevated protein concentration by Western blot in response to dexamethasone treatment. The knockdown of BMP-8 by RNA interference significantly increased dexamethasone-induced cell death, confirming a protective role for BMP-8 in the glucocorticoid-induced apoptosis of osteoblasts. Our results suggest that BMP-8 might be an essential player in bone metabolism, especially in response to glucocorticoids.     

Allosteric interactions within the AT₁ angiotensin receptor homodimer: role of the conserved DRY motif

G protein coupled receptor (GPCR) dimerization has a remarkable impact on the diversity of receptor signaling. Allosteric communication between the protomers of the dimer can alter ligand binding, receptor conformation and interactions with different effector proteins. In this study we investigated the allosteric interactions between wild type and mutant protomers of type 1 angiotensin receptor (AT₁R) dimers transiently expressed in CHO cells. In our experimental setup, one protomer of the dimer was selectively stimulated and the β-arrestin2 binding and conformation alteration of the other protomer was followed. The interaction between β-arrestin2 and the non-stimulated protomer was monitored through a bioluminescence resonance energy transfer (BRET) based method. To measure the conformational alterations in the non-stimulated protomer directly, we also used a BRET based intramolecular receptor biosensor, which was created by inserting yellow fluorescent protein (YFP) into the 3rd intracellular loop of AT₁R and fusing Renilla luciferase (RLuc) to its C terminal region. We have detected β-arrestin2 binding, and altered conformation of the non-stimulated protomer. The cooperative ligand binding of the receptor homodimer was also observed by radioligand dissociation experiments. Mutation of the conserved DRY sequence in the activated protomer, which is also required for G protein activation, abolished all the observed allosteric effects. These data suggest that allosteric interactions in the homodimers of AT₁R significantly affect the function of the non-stimulated protomer, and the conserved DRY motif has a crucial role in these interactions.