Toward dysfunctional connectivity: a review of neuroimaging findings in pediatric major depressive disorder

Child and adolescent psychiatric neuroimaging research typically lags behind similar advances in adult disorders. While the pediatric depression imaging literature is less developed, a recent surge in interest has created the need for a synthetic review of this work. Major findings from pediatric volumetric and functional magnetic resonance imaging (fMRI), magnetic resonance spectroscopy (MRS), diffusion tensor imaging (DTI) and resting state functional connectivity studies converge to implicate a corticolimbic network of key areas that work together to mediate the task of emotion regulation. Imaging the brain of children and adolescents with unipolar depression began with volumetric studies of isolated brain regions that served to identify key prefrontal, cingulate and limbic nodes of depression-related circuitry elucidated from more recent advances in DTI and functional connectivity imaging. Systematic review of these studies preliminarily suggests developmental differences between findings in youth and adults, including prodromal neurobiological features, along with some continuity across development.     

Adenosine deaminase in saliva as a diagnostic marker of squamous cell carcinoma of tongue

Tongue cancer is amongst the most common and fatal types of cancers in the world. The abnormalities in purine metabolism are characteristic features of many human tumors. Little is known about the correlation between the activities of key enzymes of purine nucleotide pathway and clinical indicators of tongue cancer invasiveness and aggressiveness. Fifty patients (M: F 25:25; mean age: 55.6 years (range 45-60; SD 1.8)) with diagnosed squamous cell carcinoma of the tongue (test group) and 30 normal subjects (M: F 15:15) without any systemic disease (control group) were recruited after obtaining informed consent. All patients were staged by the TNM classification. Salivary adenosine deaminase (ADA) activity was assessed in cancerous patients (test group) and normal healthy subjects (control group). Statistically significant differences between test and control groups were observed in salivary ADA (P < 0.001). Furthermore, serum ADA levels significantly increased as the disease stage progressed from stage I to stage III of squamous cell carcinoma of the tongue in both genders (P < 0.001). Salivary ADA might be used as a diagnostic tool for early detection of squamous cell carcinoma of tongue.     

Ethnicity and sex affect diabetes incidence and outcomes

OBJECTIVE

Diabetes guidelines recommend aggressive screening for type 2 diabetes in Asian patients because they are considered to have a higher risk of developing diabetes and potentially worse prognosis. We determined incidence of diabetes and risk of death or macrovascular complications by sex among major Asian subgroups, South Asian and Chinese, and white patients with newly diagnosed diabetes.

RESEARCH DESIGN AND METHODS

Using population-based administrative data from British Columbia and Alberta, Canada (1997–1998 to 2006–2007), we identified patients with newly diagnosed diabetes aged ≥35 years and followed them for up to 10 years for death, acute myocardial infarction, stroke, or hospitalization for heart failure. Ethnicity was determined using validated surname algorithms.

RESULTS

There were 15,066 South Asian, 17,754 Chinese, and 244,017 white patients with newly diagnosed diabetes. Chinese women and men had the lowest incidence of diabetes relative to that of white or South Asian patients, who had the highest incidence. Mortality in those with newly diagnosed diabetes was lower in South Asian (hazard ratio 0.69 [95% CI 0.62–0.76], P < 0.001) and Chinese patients (0.69 [0.63–0.74], P < 0.001) then in white patients. Risk of acute myocardial infarction, stroke, or heart failure was similar or lower in the ethnic groups relative to that of white patients and varied by sex.

CONCLUSIONS

The incidence of diagnosed diabetes varies significantly among ethnic groups. Mortality was substantially lower in South Asian and Chinese patients with newly diagnosed diabetes than in white patients.Over the past 20 years, we have seen an explosive increase in the number of cases of diabetes worldwide. The number of individuals with diabetes is expected to more than double by the year 2025. This will have a tremendous public health impact given the high rates of acute myocardial infarction [AMI], heart failure, stroke, and death that follow diabetes.Along with advancing age and increases in obesity prevalence, one putative factor thought to be contributing to this global epidemic is an escalation in the population of nonwhite groups at higher risk for diabetes. The largest increases in diabetes worldwide are occurring in developing countries. The prevalence of diabetes in urban areas of India is as high as 18% (1) and a recent study shows a threefold increase in diabetes prevalence in certain areas of China (2). South Asian and Chinese groups may have a greater susceptibility to developing diabetes due to a predisposition to insulin resistance in the presence of environmental factors including diet and physical inactivity. Differences in health care systems, limited access to health services, and social deprivation can further compound the risk of developing diabetes and its complications.Our current understanding of the incidence and prognosis of diabetes in South Asian and Chinese men and women is limited. There is a paucity of ethnicity- and sex-stratified longitudinal population-based studies. Incidence has only been estimated from prevalence data in cross-sectional studies under various health care systems. General practitioner clinic and general population surveys in Western countries uniformly observe a higher prevalence of diabetes in South Asian respondents compared with that in the general population (3,4). Results among Chinese migrants are inconsistent, with prevalence rates up to 14% (5). Further, it is unclear whether these groups also have a greater susceptibility to developing complications of diabetes. We conducted a large, population-based study in two Canadian provinces to determine the incidence of diabetes and the risk of death and macrovascular complications including AMI, heart failure, and stroke among South Asian, Chinese, and white women and men up to 10 years after a new diagnosis of diabetes.     

Effect of simulated microgravity on salivary and serum oxidants, antioxidants, and periodontal status

Background: Microgravity is associated with an increase in peroxidative damage. The effect is more pronounced after long‐duration space flights and can even last for several weeks after landing. The objective of the study is to determine the influence of simulated microgravity on the periodontal status and salivary and serum oxidant/antioxidant status of the body in simulated microgravity (?6° head‐down‐tilt [HDT) bed rest). Methods: Twenty healthy male volunteers were studied before and after 60 days of simulated microgravity (?6° HDT bed rest). We measured salivary and serum oxidative markers, such as malondialdehyde (MDA), 8‐oxo‐7,8 dihydro‐2 deoxyguanosine (8‐OHdG), and vitamins C and E, and clinical periodontal parameters (probing depth [PD] and clinical attachment level [CAL]). Results: Serum and salivary vitamin C and E concentrations were significantly decreased, whereas MDA and 8‐OHdG levels were significantly increased after 60 days of simulated microgravity. Serum and salivary markers showed a strong and significant correlation. CAL and PD were higher but not statistically significant in simulated microgravity. Conclusions: This study suggests that oxidative stress in the microgravity environment was increased but did not significantly influence periodontal parameters after 2 months. Also, this study indicates the possibility that the findings may have a broader clinical relevance to patients on bed rest or who are physically inactive. Studies on larger patient samples and follow‐up for a longer time are required to verify the relationship between antioxidant status in the space microgravity condition and periodontal health.     

A synopsis of head and neck oncology and related papers published in the British Journal of Oral and Maxillofacial Surgery in 2009/10

This review summarises all head and neck oncology and related papers published in the British Journal of Oral and Maxillofacial Surgery (BJOMS) during the period 2009-2010. A similar review, covering the years 2007-2008 was published in the Journal in 2009 and was well received by readers, as evidenced by the high number of downloads from the BJOMS website. In this article, we include all head and neck oncology-related articles published in the print version of the journal during 2009/10 and concentrate on summarising the full length article papers. Compared to the previous 2-year period, there has been a 25% increase in number of articles published in this sub-specialty.     

Pseudoaneurysm of the right subclavian artery-tracheostomy tube as a causative factor

The subclavian artery pseudoaneurysm developing in a patient of axonal head injury triggered a search for possible causative factor. Intimacy between the aneurysm and the tracheostomy tube suggested possibility of constant irritation of subclavian artery by the tube leading to pseudoaneurysm. The hypothesis is supported by the short neck, long uncuffed tube and constant posture of the neck with absence of any other causative factor. Pseudoaneurysm was repaired without reconstruction of subclavian artery considering well developed collaterals.