Systematic review of the treatment of cancer-associated anorexia and weight loss.

PURPOSE: We systematically assessed the efficacy and safety of appetite stimulants in the management of cancer-related anorexia. Literature databases were searched for randomized controlled trials of appetite stimulants in the treatment of cancer anorexia. MATERIALS AND METHODS: Studies were graded according to quality. Fifty-five studies met inclusion criteria. RESULTS: Only two drugs have evidence to support their use for anorexia (progestins and corticosteroids). There is strong evidence against the use of hydrazine sulfate. The outcomes of these trials have been mixed and patient population heterogeneous. CONCLUSION: The optimal dose, time to start, and duration of treatment for many appetite stimulants for cancer anorexia is still unknown. A more systematic approach to research methodology with universal outcome measure and prospective randomized studies are need. Combination regimens are needed but this cannot at the present time be supported by the data presented.     

Effects of amyotrophic lateral sclerosis serum on cultured chick spinal neurons

We used a quantitative immunoassay to examine the effects of human serum and immunoglobulins on neurofilament protein expression in cultures of chick spinal neurons. Compared with cultures grown in the presence of serum from healthy controls or patients with other neurologic disorders, ALS serum lowered the level of neurofilament proteins. Effects were similar with or without muscle-derived neurotrophic factors; there was no specificity for motor neurons. No neurotoxic activity was found in immunoglobulin fractions, and there was no evidence of circulating antibodies that might neutralize muscle-derived neurotrophic factors or induce cytolysis of spinal neurons.     

The relation between syntactic and morphological recovery in agrammatic aphasia: A case study

BACKGROUND: Production of grammatical morphology is typically impaired in agrammatic aphasic individuals, as is their capacity to produce the syntactic structure responsible for licensing that morphology. Whether these two impairments are causally related has been an issue of long-standing debate. If morphological deficits are a side-effect of underlying syntactic ones, as has been claimed (Friedmann & Grodzinsky, 1997; Izvorski & Ullman, 1999), therapy which improves the syntactic deficit should remediate the morphological deficit as well. This paper reports a case study of one individual with such co-occurring impairments and describes their recovery in response to linguistically-motivated treatment targeting his syntactic deficits. METHODS #ENTITYSTARTX00026; PROCEDURES: MD is a 56 year-old male diagnosed with non-fluent Broca's aphasia subsequent to a left-hemisphere CVA, with limited capacity to produce syntactically complex utterances and grammatical morphology. He was enrolled in therapy using Treatment of Underlying Forms (TUF; Thompson & Shapiro, 2005), targeting production of sentences involving Wh-movement (object relative clauses). MD participated in twice-weekly treatment sessions for approximately two months, with daily probes assessing his production of treated and untreated sentence types. In addition, probes assessing his grammatical morphology and sentence production were administered pre- and post-treatment. OUTCOMES #ENTITYSTARTX00026; RESULTS: Pre-treatment scores in tests of grammatical morphology and sentence production indicated deficits in both domains. During treatment, MD successfully acquired production of a variety of sentence with Wh-movement, though this did not generalize to sentences involving a grammatically distinct movement operation (NP-movement). Post-treatment scores also indicated a lack of improvement in production of grammatical morphology. CONCLUSIONS: The dissociation between MD's morphological and syntactic recovery indicates that the recovery of syntactic and morphological processes in aphasia may occur independently. This result is thus surprising under approaches in which morphological and syntactic impairments are strongly and causally related in aphasia, such as the Tree-Pruning Hypothesis (Friedmann, 2001; Friedmann & Grodzinsky, 1997). Further, these results reinforce the conclusion that aphasia treatment can lead to generalization, but only to linguistic material which is in a subset relation to trained structures (Thompson, Shapiro, Kiran & Sobecks, 2003).     

Characterisation of black-pigmented anaerobes isolated from diseased and healthy periodontal sites

Prevotella intermedia has recently been re-defined and a new species, Prevotella nigrescens has been proposed. However, there is little data available on the incidence of these new species in periodontal health or disease. Black-pigmented anaerobes isolated from diseased and healthy subgingival sites were identified by serotyping, SDS-PAGE and physiological tests. In adult periodontitis subjects, 64% of active sites, 35.7% of inactive sites and 38.5% of healthy sites yielded black-pigmented anaerobes. Of these, Porphyromonas gingivalis was found in 11% of active and 5% of healthy sites in diseased patients, Prevotella intermedia in 15.5% of active and 20.5% of healthy sites, Prevotella nigrescens in 37.7% of active and 11.5% of healthy sites and Prevotella denticola in 3% of active and 1% of healthy sites. In healthy subjects, 50% of sites yielded black-pigmented anaerobes. P. gingivalis was not found in healthy subjects but P. intermedia was found in 18% and P. nigrescens in 31% of sites. SDS-PAGE proved to be a useful method for routinely differentiating P. intermedia and P. nigrescens and two sub-types of the latter species were detected on the basis of band pattern. Only one P. nigrescens sub-type was found in any given individual and one type, typified by ATCC 25261, was more commonly found in deep pockets. However, overall both P. nigrescens and P. intermedia as species were just as frequently found at healthy sites as diseased sites. Thus, these species, in contrast to P. gingivalis , appear to be common commensals but they may act as opportunistic pathogens.     

Mycotic aneurysm of the aorta: MRI and MRA features

Mycotic aneurysms of the abdominal aorta are potentially fatal but uncommon. We report the MRI and MRA features of an abdominal aortic mycotic aneurysm in a patient who presented with nonspecific low back pain. By delineating the saccular nature of the aneurysm and identifying the coexistence of vertebral enhancement, MRI was crucial for the final diagnosis. A potential pitfall of contrast-enhanced MRA is also demonstrated.