Fatty acid composition of the blood serum and erythrocyte membrane lipids in patients with hypothyroidism and left ventricular diastolic dysfunction

Fatty acid composition in blood serum and erythrocyte membrane lipids was studied in 38 patients with hypothyroidism treated in the Department of Endocrinology of Chita Regional Clinical Hospital; left ventricular diastolic dysfunction was revealed in 16 patients. The total content of saturated fatty acids (FA) in serum, mostly at the account of myristic and palmitic acids, was found to be increased. The total content of unsaturated FA was decreased. The level of arachidonate in blood serum and erythrocyte membrane lipids was found to be significantly decreased both before the treatment and within the course of replacing hormonal therapy. The content of omega-3 FA in erythrocyte membrane lipids decreased in the course of conventional therapy, which suggests that omega-3 FA preparations should be administered as a part of complex therapy of hypothyroidism.     

Training and career development for comparative effectiveness research workforce development: CTSA Consortium Strategic Goal Committee on comparative effectiveness research workgroup on workforce development

As comparative effectiveness research (CER) increasingly becomes a national priority, there are increased needs for training and workforce development in this area. Particularly important CER competencies include clinical epidemiology, biomedical informatics, economic analyses, systematic reviews, clinical practice guideline development, use of large databases and electronic health records for research, practice-based research, implementation and dissemination, health services research, and decision analysis. Institutions funded by Clinical and Translational Science Awards (CTSAs) should be one of the central stakeholders in providing training and career development in CER. Survey results regarding the current CER capacity and needs of CTSAs are presented, and recommendations are provided. Volume 5: 258-262.     

Alcohol and acute myocardial infarction

A number of studies from different countries and several large-scale meta-analyses have reported reduced coronary heart disease rates among those regularly consuming mild to moderate amounts of alcohol compared with those abstaining from alcohol. In contrast, various studies have also reported that heavy alcohol consumption promotes the progression of atherosclerosis and that binge drinking might trigger embolic stroke and acute myocardial infarction. We discuss the association between alcohol consumption and acute myocardial infarction on the basis of evidence from literature published recently. Alcohol consumption has both favourable and unfavourable effects on metabolism, lipid profile, blood coagulation and fibrinolysis, blood pressure and vascular tone depending on the amount of alcohol consumed and the way that it is drunk (i.e. drinking habits). We conclude that it is extremely important to warn people of the risks associated with binge drinking and to encourage them to remain within the recommended safe limits for alcohol consumption.     

Predictors of diagnosis of child psychiatric disorder in adult–infant social-communicative interaction at 12 months

To establish which social interactive behaviours predict later psychiatric diagnosis, we examined 180 videos of a parent–infant interaction when children were aged one year, from within the Avon Longitudinal Study of Parents and Children (ALSPAC) cohort. Sixty of the videos involved infants who were later diagnosed with a psychiatric disorder at seven years, and 120 were a randomly selected sex-matched control group. Interactive behaviours for both the caregiver and the one year old infant were coded from the videos according to eight holistic categories of interpersonal engagement: Well-being, Contingent Responsiveness, Cooperativeness, Involvement, Activity, Playfulness, Fussiness, and Speech. Lower levels of adult activity and speech in interaction at one year significantly predicted overall diagnosis of child psychiatric disorder.     

Cannabis use and premorbid functioning as predictors of poorer neurocognition in schizophrenia spectrum disorder

BackgroundEvidence of associations between neurocognitive function and cannabis use in schizophrenia is inconclusive. However, direct measures of cannabis intake and premorbid function are rarely explored in this context. We investigated the relation between cannabis use, determined by its presence in urine, and neurocognitive functioning in schizophrenia controlling for the potential bias of premorbid functioning.MethodsNaturalistic study of 364 patients with schizophrenia spectrum disorder from catchment areas in Oslo, Norway. Hierarchical multiple regression analyses were used to assess the relationship between cannabis in urine and measures of neurocognitive functioning, with adjustment for confounders, including premorbid functioning.ResultsCannabis was detected in the urine of 21 patients, who had significant dysfunction in several neurocognitive domains independent of a current diagnosis of cannabis abuse. However, level of premorbid functioning explained the associations for all measures.ConclusionDifferences in premorbid functioning may explain apparent differences in neurocognitive function between schizophrenia spectrum patients using cannabis or not. The findings suggest that illness-related traits present early in life can affect both later cannabis use and neurocognition, probably by complex mechanisms.     

Clinical management of hydatid disease of the urinary tract

This study reviews urinary hydatid disease in seven males and three females (mean age, 32.1 +/- 17.7 years; range, 7-67 years). Cysts were located in the kidney in six cases (one also involved the liver), the paravesical and retrovesical region in two cases (one coexisted with a bladder tumour), the adrenal gland (one case) and in the right parapelvic region (one case). Investigations included urinalysis, eosinophil count, Casoni skin test, indirect haemagglutination test (IHA), abdominal ultrasonography, intravenous urography and computed tomography (CT). All patients underwent surgery and were followed for an average of 5.6 years. Lumbar or abdominal pain was the most common symptom. Eosinophilia was seen in five patients (50%), IHA positivity occurred in four patients (40%) and the Casoni skin test was positive in four patients (40%). Abdominal CT was the most useful diagnostic method of radiological investigation (100%). No complications or recurrences were seen on follow-up. Urinary hydatid disease is uncommon and is likely to cause considerable diagnostic difficulties, and should therefore be considered in the differential diagnosis of space-occupying lesions of the urinary tract.     

Mechanistic aspects of the release of levamisole hydrochloride from biodegradable polymers.

The release of levamisole hydrochloride from poly-DL-lactide-co-glycolide compacts prepared at 5, 10 and 20% drug loading using two different particle size fractions of drug (90-125 and 125-250 microm) was investigated. Release profiles were significantly different from those previously reported for compacts prepared using the base form of the drug. Release was found to occur in a biphasic manner, with an initial fast release phase followed by a slower polymer degradation controlled release phase. The drug release profiles were successfully described by a model combining contributions from a first-order initial release phase and a polymer degradation controlled drug release phase. The fraction of drug released in the initial burst phase (F(B)) was attributed to the dissolution of drug domains situated at the surface of the polymer-drug compact and this fraction tended to increase with increasing drug particle size, as expected from the model. The increase in F(B) with increased loading was attributed to the clumping of dispersed drug particles which effectively increased the proportion of drug linked to the compact surface.     

La sciatalgie neuropathique post-opératoire: prise en charge diagnostique et thérapeutique

Résumé  La sciatalgie neuropathique est l’une des douleurs résiduelles rencontrées dans les suites de la chirurgie discale lombaire. Elle est toujours liée à la notion de souffrance radiculaire prolongée. Son diagnostic est essentiellement clinique, conforté ensuite par les données anatomiques et neurophysiologiques. L’évaluation précise de son intensité permet d’orienter correctement le traitement au sein d’un programme thérapeutique plus global en raison d’autres douleurs, de la déficience physique et du handicap résiduel. Les différents traitements sont rappelés en précisant notamment la place, la sélection des indications et les résultats de la stimulation cordonale postérieure à propos d’une série de 250 patients avec un recul moyen d’observation de 75 mois.

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Summary  Neuropathic sciatalgia is a frequent clinical eventuality in the follow-up of lumbar disc surgery. It mainly accurs related with a long story of radicular suffering. Its diagnosis is essentially based upon clinical data and conformed by anatomical and electrophysiological explorations. The precise evaluation of pain intensity allows well definition of the treatment in a global therapeutic approach, often due to other pain, physical deficiency and residual social disadvantage. The different medical treatments are reported with special place to spinal cord stimulation proposed in 250 patients with a mean follow up of 75 month: the place, the selection of the indications, the results and the complications are precised.

     

A self-adjusting randomization plan for allocation of patients into two treatment groups.

This paper presents a self-adjusting randomization plan which is thought to be useful in controlled stratified randomized clinical trials. The method assures an optimal balance of treatments within each subgroup of patients. An imbalance caused by a high number of dropouts in one treatment group will be counteracted by the self-adjusting nature of the method. The method has been tested in computer-simulated trials and has been shown to produce better results than conventional plans for stratified randomized clinical trials. The method does not involve any complicated calculations and its use in a running clinical trial has shown that it is easy to handle.