Characterization of acute and long-term sulfur mustard-induced skin injuries in hairless guinea-pigs using non-invasive methods

Background/purpose: Skin exposure to sulfur mustard (HD) results in erythema, edema and severe injury, which take long time to heal and might impose a heavy burden on the health system. Despite many years of research, there is no treatment that prevents the development of the cytotoxic effects of HD causing acute and prolonged damage to the skin. Therefore, it is of great importance to develop treatments that will ameliorate the extent of injury and improve as well as shorten the healing process. The aim of the present study was to establish a small animal model for a long‐term HD‐induced skin injury using the hairless guinea‐pig (HGP) and to further test the efficacy of anti‐inflammatories in ameliorating the pathology. Methods: HGPs were exposed to HD vapor on four sites for various time durations (1, 5, 10, 15 and 30 min). Clinical evaluation was conducted using reflectance colorimetry, transepidermal water loss and wound‐area measurements. Biochemical [prostaglandin (PGE) content and metalloproteinase‐9 (MMP‐9) activity] and histopathological evaluations were conducted up to 2 weeks post‐exposure. Results: Typical symptoms of HD skin injury developed including erythema and edema and the extent of injury was closely related to the exposure duration. Histological evaluation revealed severe edema, infiltration of inflammatory cells, damage to basal cells and vesication. By 2 weeks, healing was not completed, impaired basement membrane and epithelial hyperplasia were observed. PGE content and MMP‐9 activity increased at 2 h post‐exposure; however, while PGE returned to baseline levels within 24 h, MMP‐9 remained elevated at least up to 48 h. Furthermore, a short‐term, topical, anti‐inflammatory post‐exposure treatment was effective in reducing the extent of the acute injury. Conclusion: These results indicate that the effects of HD on HGP skin are similar to previously shown effects in the pig model and in humans and therefore support the use of the HGP as an animal model for long‐term effects of HD on skin injury and for studying the efficacy of anti‐inflammatory treatments.     

The effect of reboxetine co-administration with olanzapine on metabolic and endocrine profile in schizophrenia patients

Rationale

We previously demonstrated that the addition of the selective norepinephrine reuptake inhibitor reboxetine attenuates olanzapine-induced weight gain. Using the same study sample, we also sought to determine whether reboxetine’s weight-attenuating effect was accompanied by a beneficial effect on metabolic and endocrine parameters relevant to antipsychotic-induced weight gain and obesity.

Method

Blood samples at baseline and at the end of the 6-week trial were available for 54 participants who participated in previous double-blind, placebo-controlled studies of reboxetine (4 mg BID) addition to olanzapine-treated schizophrenia patients. Fasting glucose, lipid profile, insulin, leptin, cortisol, dehydroepiandrosterone (DHEA), prolactin, and thyroid-stimulating hormone (TSH) were analyzed.

Results

In contrast to the olanzapine/placebo group, the olanzapine/reboxetine group exhibited a reduction in blood triglyceride (p?<?0.05) and leptin (p?<?0.05) levels, and elevation in cortisol (p?<?0.05) and DHEA (p?<?0.008) levels. No significant between-group differences were detected in the changes in cholesterol, glucose, insulin, TSH, and prolactin.

Conclusions

Reboxetine addition resulted in meaningful improvement of some metabolic and endocrine measures associated with olanzapine-induced weight gain. The potential role of reboxetine in the prevention of olanzapine-induced weight gain and cardio–metabolic morbidity merits further large-scale, long-term investigation.     

The bacterial species associated with aspirated foreign bodies in children

Objective

Inhaled foreign bodies in children are common and may be complicated by secondary airway tract infection. The inhaled foreign body may act as carrier of infectious material and the aim of this study was to explore the bacterial species associated with aspirated foreign bodies in a cohort of children.

Occupational identity of adolescents with ADHD: A mixed methods study

Background: Occupational identity (OI) is shaped by occupational experiences over time and has been studied among individuals with a variety of health conditions. Adolescents with ADHD face numerous challenges in their occupational performance that may threaten their OI.

Objective: This study sought to compare the occupational identities of adolescents with and without ADHD and to gain a deeper understanding of the characteristics of OI among adolescents with ADHD.

Methods: Sixty-four adolescents with (n?=?21) and without ADHD (n?=?43) were interviewed using the Occupational Performance History Interview (OPHI-II). A mixed methodology was applied, using quantitative and subsequent qualitative content analyses of 10 interviews, with a directed approach.

Results: OPHI-II OI interval scores and 7/11 items of the OI scale were significantly lower in the ADHD group compared to controls. In the qualitative content analyses, three major themes were found: (i) the meaning of success in academic participation, (ii) the consequences of not succeeding in academic participation and (iii) self-explanations for not succeeding in academic participation.

Conclusion: Findings demonstrate the presence of OI challenges among adolescents with ADHD. Occupational therapy intervention may be needed in order to promote occupational adaptation.     

Stress hormones and emotion-regulation in two genetic animal models of depression

Children of depressed parents often exhibit emotion-regulation deficits, characterized by either excessive withdrawal or approach strategies toward the mother. The current study examined behavioral and physiological emotion-regulation in preweanling pups (postnatal day 17-19) belonging to two different genetic animal models of depression, Wistar-Kyoto (WKY) and Flinders Sensitive-Line (FSL) rats. The study also examined the effects of stress on the two animal models, hypothesizing an interactive effect of hereditary vulnerability and exposure to stress. Chronic-stress was simulated by providing limited bedding to the dam and litter for a week, in the early postnatal period. Acute-stress was generated by exposure to an adult male rat, an ethologically valid stressor. Emotion-regulation of the pups was examined using a Y-maze preference test and radioimmunoassay of Hypothalamic-Pituitary-Adrenal (HPA) axis hormones (corticosterone & adreno-corticotropin/ACTH). WKY and FSL pups exhibited reduced approach-behavior toward the dam, an emotion-regulation profile reminiscent of avoidant attachment evident in many children of depressed parents. In contrast, the two animal models did not show similar HPA axis activity. FSL pups exhibited markedly lower ACTH levels compared to controls, while WKY pups did not differ from controls. With regard to the stress manipulations, the limited-bedding condition had no effect, while the acute-stressor induced overall effects on all groups, with more pronounced reactivity evident in the WKY and FSL pups. Taken together, the experiments indicate a similar behavioral profile of the two strains at the preweanling period, while suggesting HPA dysfunction in only one of the strains.     

Risk factors associated with failure of syndromic treatment of sexually transmitted diseases among women seeking primary care in Addis Ababa

OBJECTIVE: To determine risk factors associated with the failure of syndromic management of sexually transmitted diseases (STDs) among women seeking treatment in primary healthcare centre in Addis Ababa, Ethiopia. METHODS: Women with symptomatic STDs seeking care in a health centre were prospectively enrolled. A total of 259 women were interviewed and underwent clinical examination; 106 were enrolled and received syndromic STD treatment and 91% returned for follow up. Logistic regression analysis was used to identify risk factors associated with treatment failure. RESULTS: Of the 106 women enrolled and presenting with symptomatic STDs 67% were HIV seropositive. Syndromic STD treatment did not result in clinical improvement in 30% of the women. Having genital ulcer disease, genital ulcer disease with genital discharge, genital warts, bacterial vaginosis and plasma HIV-1 load >10,000 copies RNA/ml or being HIV seropositive were all significantly associated with treatment failure. In multivariate analysis, however, only genital ulcer disease was significantly associated with treatment failure. CONCLUSION: In our setting, the association between HIV and genital ulcer disease caused by herpes may, therefore, be the reason for the failure of treatment.     

Stereotactic radiosurgery for vestibular schwannomas in neurofibromatosis type 2 patients: a systematic review and meta-analysis

Journal of Neuro-Oncology - Neurofibromatosis type 2 (NF2) is characterized by often bilateral vestibular schwannomas (VS) that result in progressive hearing loss and compression of nearby...