Preferential attention to animals and people is independent of the amygdala

The amygdala is thought to play a critical role in detecting salient stimuli. Several studies have taken ecological approaches to investigating such saliency, and argue for domain-specific effects for processing certain natural stimulus categories, in particular faces and animals. Linking this to the amygdala, neurons in the human amygdala have been found to respond strongly to faces and also to animals. However, the amygdala’s necessary role for such category-specific effects at the behavioral level remains untested. Here we tested four rare patients with bilateral amygdala lesions on an established change-detection protocol. Consistent with prior published studies, healthy controls showed reliably faster and more accurate detection of people and animals, as compared with artifacts and plants. So did all four amygdala patients: there were no differences in phenomenal change blindness, in behavioral reaction time to detect changes or in eye-tracking measures. The findings provide decisive evidence against a critical participation of the amygdala in rapid initial processing of attention to animate stimuli, suggesting that the necessary neural substrates for this phenomenon arise either in other subcortical structures (such as the pulvinar) or within the cortex itself.     

Effectiveness of therapeutic massage for generalized anxiety disorder: a randomized controlled trial

Background: Although massage is one of the most popular complementary and alternative medical (CAM) treatments for anxiety, its effectiveness has never been rigorously evaluated for a diagnosed anxiety disorder. This study evaluates the effectiveness of therapeutic massage for persons with generalized anxiety disorder (GAD). Methods: Sixty‐eight persons with GAD were randomized to therapeutic massage (n=23), thermotherapy (n=22), or relaxing room therapy (n=23) for a total of 10 sessions over 12 weeks. Mean reduction in anxiety was measured by the Hamilton Anxiety Rating Scale (HARS). Secondary outcomes included 50% reduction in HARS and symptom resolution of GAD, changes in depressive symptoms (Patient Health Questionnaire (PHQ‐8)), worry and GAD‐related disability. We compared changes in these outcomes in the massage and control groups posttreatment and at 6 months using generalized estimating equation (GEE) regression. Results: All groups had improved by the end of treatment (adjusted mean change scores for the HARS ranged from −10.0 to −13.0; P<.001) and maintained their gains at the 26‐week followup. No differences were seen between groups (P=.39). Symptom reduction and resolution of GAD, depressive symptoms, worry and disability showed similar patterns. Conclusions: Massage was not superior to the control treatments, and all showed some clinically important improvements, likely due to some beneficial but generalized relaxation response. Because the relaxing room treatment is substantially less expensive than the other treatments, a similar treatment packaged in a clinically credible manner might be the most cost effective option for persons with GAD who want to try relaxation‐oriented CAM therapies. Depression and Anxiety, 2010. © 2010 Wiley‐Liss, Inc.     

Regaining Tolerance to a Self-antigen by the Modified Vaccination Technique

Autoimmune diseases are initiated and maintained by complex immunopathological processes in environmental and genetic factor predisposed patients. In certain autoimmune diseases, the etiologies and pathogenesis of the conditions are quite well understood; yet in others, controversy surrounds as to why and how auto-injurious processes start. Clinical and laboratory examinations reasonably well define the state of progression/remission of an autoimmune disease and allow treatment according to observed findings. However, none of the presently employed treatment options are specific. In fact, they are all nonspecific in their actions and have undesirable side effects. Over the years, experiments carried out in animals have shed light on the complex immunopathological processes which contribute to disease development and progression. At least one experimental autoimmune kidney disease—which we shall describe—helps to understand how pathogenic autoimmune responses can be terminated specifically, without side effects. Since the new vaccination method—that we call modified vaccination technique—was successfully implemented in an experimental autoimmune disease model called slowly progressive Heymann nephritis for the termination of pathogenic immune responses by a target antigen-specific treatment modality, we shall highlight its use in providing insight to physicians and autoimmunologists for its future implementation in human autoimmune diseases.     

Prognostic impact of anastomotic leakage after elective colon resection for cancer – A propensity score matched analysis of 628 patients

Background

There is limited information regarding the impact of anastomotic leakage on oncologic outcome in exclusively colon cancer patients.

The place of liver transplantation in Caroli''s disease and syndrome

Caroli's disease (CD) or syndrome (CS) are rare inherited disorders which may cause severe, life-threatening, cholangitis or which may lead to hepatobiliary degeneration. The typical cystic biliary anomalies are often associated to congenital hepatic fibrosis (CHF) and, less frequently, to cystic renal disease especially autosomic recessive polycystic kidney disease (ARPKD). The place of liver transplantation (LT) in the treatment of CD or CS is evaluated based on our own experience of three successfully transplanted patients, the literature review of 19 patients and the European experience with 110 patients collected in the European Liver Transplant Registry. LT should be proposed as a definitive therapeutic option once severe cholangitis or (suspicion of) malignant transformation is present. The frequently used radiological, endoscopical or surgical biliary drainage procedures carry a high morbidity and mortality rate. In case of concomitant symptomatic CHF and renal failure, combined or sequential hepatorenal transplantation should be carried out, dependent on the evolution of the hepatic and renal disease. In case of associated ARPKD, renal transplantation is often indicated early on because of the more rapid progression of the renal component of the disease.