Nandrolone decanoate administration dose-dependently affects the density of kappa opioid peptide receptors in the rat brain determined by autoradiography

The kappa opioid receptor ligand [³H]CI-977 was used to autoradiographically determine the density of kappa opioid receptors in the male rat brain following chronic treatment with the anabolic androgenic steroid nandrolone decanoate at two different doses. As compared to controls, significantly lower densities of the kappa opioid receptor were encountered after two weeks of high dose nandrolone decanoate (15 mg/kg) in the nucleus accumbens shell (16%), lateral hypothalamic area (36%), ventromedial hypothalamic nucleus (37%), dorsomedial hypothalamic nucleus (49%), central amygdaloid nucleus, capsular part (28%), lateral globus pallidus (35%) and in the stria terminalis (24%). Furthermore, an up-regulation of the receptor level was observed in the caudate putamen (18%) and in the dorsal endopiriform nucleus (23%). These alterations in the kappa opioid receptor expression are possibly attributed to a previously observed pronounced impact of nandrolone decanoate on the dynorphinergic system and could also include involvement of the dopaminergic reward system.     

Diagnostic stability over 3 years in a total group of first-episode psychosis patients

First-episode psychosis (FEP) patients are often given diagnoses that later have to be changed. The aim of this study was to measure the diagnostic stability in a total group of FEP patients; 146 FEP patients were followed longitudinally and prospectively. Their revised baseline diagnoses were compared with their 3-year follow-up diagnoses. The schizophrenic spectrum disorders showed a high diagnostic stability as a group, but there was a great flow of patients between the different schizophrenic spectrum diagnoses. Also schizophrenia was a stable diagnosis. The affective psychosis group was homogenous without interaction of other psychosis groups. The other psychosis diagnoses, both regarded as a group and individually, turned out to be quite heterogeneous, with low stability values and a split course, often ending up in the schizophrenic spectrum. Fifty one per cent did not fulfil the criteria for DSM-IV axis 1 psychosis diagnosis at follow-up. In conclusion, our findings suggest that in the early phase of psychosis. Only three different diagnostic categories would be sufficient; "schizophrenic spectrum type", "affective psychosis," and for the rest "psychotic disorder NOS."     

Increase in [11C]vorozole binding to aromatase in the hypothalamus in rats treated with anabolic androgenic steroids

In the present study, we investigated the alteration of aromatase expression in the brain by anabolic androgenic steroid treatment in male rats. The rats were given nandrolone decanoate (15 mg/kg/day) for 14 days, and the brains were used for autoradiography with [C]vorozole, which has been developed as a positron emission tomography tracer for aromatase by our group. The results indicated a significant increase of [C]vorozole binding by anabolic androgenic steroids in the bed nucleus of the stria terminalis and preoptic area. In contrast, no significant change of [C]vorozole binding was observed in the medial amygdala. Our results suggest that aromatase is significantly upregulated in the bed nucleus of the stria terminalis and preoptic area by anabolic androgenic steroids and also suggest that androgens regulate aromatase differently in these structures compared with the medial amygdala.     

Feeling hindered by health problems and functional capacity at 60 years and above

It is common to use activities of daily living (ADL) rating scales to identify the impact of health problems such as diseases, impaired eyesight or hearing on daily life. However, for various reasons people with health problems might feel hindered in daily life before limitations in ability to perform ADL have occurred. In addition, there is sparse knowledge of what makes people feel hindered by health problems in relation to their ADL capacity. The aim was to investigate feeling hindered by health problems among 1297 people aged 60-89 living at home in relation to ADL capacity, health problems, life satisfaction, self-esteem, and social and financial resources, using a self-reported questionnaire, including questions from Older Americans' Resources and Services schedule (OARS), Rosenberg's self-esteem and Life Satisfaction Index Z (LSIZ). People feeling greatly hindered by health problems rarely had anyone who could help when they needed support, had lower life satisfaction and self-esteem than those not feeling hindered. Feeling hindered by health problems appeared to take on a different meaning depending on ADL capacity, knowledge that seems essential to include when accomplishing health promotion and rehabilitation interventions, especially at the early stages of reduced ADL capacity.     

Eye movements and visuospatial problem solving: Identifying separable phases of complex cognition

Identifying overtly observable indicators of cognitive processes should provide a promising basis for a more precise tracking of the associated cognitive and neural events. In the current study we used recordings of eye movements to gain deeper insight into the time course of visuospatial problem solving as measured by the Tower of London. Single-trial, saccade-locked analyses revealed that, despite the complexity of the implemented task, gaze alternations between start and goal state followed a highly regular pattern. Consistent with the buildup of an internal representation, the first two fixations were of constant duration and unaffected by experimental variations of planning demands. Instead, planning manipulations exclusively influenced the duration of the very last fixation before problem execution. Our results demonstrate that different phases of complex cognition can be identified on a single-trial level using eye movement analyses.     

A randomized controlled trial of guided Internet-delivered cognitive behavioral therapy for erectile dysfunction

IntroductionMen with erectile dysfunction are often worried about their condition, have interpersonal difficulties, and have a reduced quality of life. Internet‐delivered cognitive behavior therapy (ICBT) has been shown effective for a number of health problems but evidence is limited concerning the treatment of erectile dysfunction.AimThe study investigated the effects of ICBT for erectile dysfunction.MethodsSeventy‐eight men were included in the study and randomized to either ICBT or to a control group, which was an online discussion group. Treatment consisted of a 7‐week Web‐based program with e‐mail‐based therapist support. Each therapist spent an average of 55 minutes per participant.Main Outcome MeasureThe International Index of Erectile Functioning five‐item version was administered via the telephone at pretreatment, post‐treatment, and 6 months after receiving ICBT.ResultsAt post‐treatment, the treatment group had significantly greater improvements with regard to erectile performance compared with the control group. Between‐group differences at post‐treatment were small (d = 0.1), but increased at the 6‐month follow‐up (d = 0.88).ConclusionsThis study provides support for the use of ICBT as a possible treatment format for erectile dysfunction. Andersson E, Walén C, Hallberg J, Paxling B, Dahlin M, Almlöv J, Källström R, Wijma K, Carlbring P, and Andersson G. A randomized controlled trial of guided Internet‐delivered cognitive behavioral therapy for erectile dysfunction. J Sex Med 2011;8:2800–2809.     

Pelvic inflammatory disease in patients infected with Chlamydia trachomatis: in vitro cell mediated immune response to chlamydial antigens.

Blood samples were obtained from 11 women with laparoscopically confirmed acute salpingitis who yielded positive cultures of Chlamydia trachomatis from the cervix. Four patients also had perihepatitis. Lymphocyte transformation assays, using C trachomatis serovars I and L2 as antigens, showed that the patients' lymphocytes responded to antigenic stimulation more strongly than the lymphocytes of age matched controls. Responses to the I and L2 antigens correlated strongly, but greater responses were obtained to the L2 antigen. No correlation was found between the response in the lymphocyte transformation assay and the degree of the inflammatory changes of the fallopian tubes, the presence of perihepatitis, or the titres of humoral antibodies to C trachomatis as measured by microimmunofluorescence. Sequential transformation assays, however, showed that patients with perihepatitis tended to have a more sustained response.     

Women with low-energy fracture should be investigated for osteoporosis

Introduction Treatment of osteoporosis is becoming more effective, but methods to identify patients who are most suitable for investigation and treatment are still being debated. Should any type of fracture have higher priority for investigation of osteoporosis than any other? Is the number of previous fractures useful information?

Material and methods We investigated 303 consecutive women patients between 55 and 75 years of age who had a newly diagnosed low-energy fracture. They answered a questionnaire on previous fractures which also dealt with risk factors. Bone mineral density (BMD) was measured at the hip, lumbar spine, and forearm.

Results The distribution of fracture location was: distal forearm 56%, proximal humerus 12%, vertebra 18%, and hip 13%, all with similar age. Half of the subjects had had at least one previous fracture before the index fracture, 19% had had two previous fractures, and 6% had had three or more previous fractures. Patients with vertebral or hip fracture had lower BMD and had had more previous fractures than patients with forearm or humerus fractures. There was an inverse correlation between number of fractures and BMD. Osteoporosis was present in one-third of patients with forearm fracture, in one-half of those with hip or humerus fracture, and in two-thirds of those with vertebral fracture.

Interpretation Vertebral fractures were the strongest marker of low BMD and forearm fractures the weakest. The number of previous fractures is helpful information for finding the most osteoporotic patient in terms of severity. Investigation of osteoporosis therefore seems warranted in every woman between the ages of 55 and 75 with a recent low-energy fracture, with highest priority being given to those with vertebral, hip, or multiple fractures.     

Case managers for frail older people: a randomised controlled pilot study

Scand J Caring Sci; 2010; 24; 755–763
Case managers for frail older people; a randomised controlled pilot study Aim: The aim was to test sampling and explore sample characteristics in a pilot study using a case management intervention for older people with functional dependency and repeated contact with the healthcare services as well as to investigate the effects of the intervention on perceived health and depressed mood after 3 months. The aim was also to explore internal consistency in the life satisfaction index Z, activities of daily living‐staircase and Geriatric Depression Scale‐20. Method: This pilot study was carried out in a randomised controlled design with repeated follow‐ups. In all, 46 people were consecutively and randomly assigned to either an intervention (n = 23) or a control (n = 23) group. Two nurses worked as case managers and carried out the intervention, which consisted of four parts. Result: No differences were found between the groups at baseline. The results showed the participants had low life satisfaction (median 14 vs. 12), several health complaints (median 11) and a high score on the Geriatric Depression Scale (median 6) at baseline, indicating the risk of depression. No significant effects were observed regarding depressed mood or perceived health between or within groups at follow‐up after 3 months. Cronbach′s alpha showed satisfactory internal consistency for group comparisons. Conclusions: The sampling procedure led to similar groups. The life satisfaction, functional dependency and symptoms of depression measures were reliable to use. No changes in perceived health and symptoms of depression were found after 3 months, indicating that it may be too early to expect effects. The low depression score is noteworthy and requires further research.