Video EEG diagnosis of repetitive behavior in early childhood and its relationship to seizures

Differentiating seizures from pseudoseizures frequently is challenging in very young children manifesting repetitive, stereotypic behavior. Using video electroencephalographic recording, we evaluated 60 patients, younger than 10 years of age, with episodic signs and symptoms believed to be seizures despite repeatedly normal routine electroencephalograms. Nine patients (15%) had simple partial and atypical absence seizures. Twenty-four patients (40%) had pseudoseizures presenting as rhythmic movements or staring. Pseudoseizure frequency was greater than the frequency of true seizures; brief staring episodes were common. Motor pseudoseizures usually were of longer duration than true seizures and could be brought on with verbal encouragement. Furthermore, the stereotypic motor presentations were quite different from those of true motor seizures but were difficult to recognize from historic, clinical, and routine electroencephalographic data. Symptomatic patients can be clinically diagnosed by analyzing confirmed episodes with video electroencephalography.     

In vitro synthesis of oviductal proteins associated with estrus and 17 beta-estradiol-treated ovariectomized ewes

The objectives of this study were: 1) to identify and characterize ewe oviductal secretory proteins (OSP) de novo synthesized during the estrous cycle; 2) to examine the effect of estrogen (E) and progesterone (P) on synthesis of OSP; and 3) to determine synthesis of OSP by ampulla (A) and isthmus (I). Oviducts were collected from cyclic ewes on days 1, 8, and 16 and ovariectomized (OVX) ewes after treatment with corn oil (CO), E, P, and E + P. Tissue was incubated in the presence of 3H-leucine or 3H-glucosamine. Rates of 3H-leucine incorporation into nondialyzable macromolecules by explants was greater (P less than 0.05) on day 1 than days 8 and 16, greater (P = 0.01) in OVX E-treated ewes, greater in A than I regardless of treatment and greater (P less than 0.05) in A than I with E. Culture medium was analyzed by one- and two-dimensional polyacrylamide gel electrophoresis and fluorography. Two major basic proteins (Mr 90-92,000) and three minor proteins were only present on day 1 of estrus. E treatment demonstrated these same proteins which were not found with CO or P treatment. Two-dimensional analysis of medium from A and I cultured separately indicated that A synthesized the two major basic and three minor E-dependent proteins. Of three protein complexes present regardless of treatment or cycle day, two were dominant in the A and one was dominant in the I suggesting a synthetic gradient. Tunicamycin did not inhibit incorporation of 3H-glucosamine into E-dependent proteins. Gel filtration revealed a high Mr fraction (2 x 10(6] 2.5-fold greater on day 1 than day 8 and 2.2-fold greater with E than CO treatment. This study clearly demonstrates: 1) that the oviduct from estrus and E-treated ewes synthesizes two major basic and three minor glycoproteins not detectable on other cycle days or with OVX or P treatment; 2) the E-dependent glycoproteins are synthesized by the A; and 3) a high Mr fraction is induced or amplified by E.     

Isoenzymes of carbohydrate metabolism in primary cultures of hepatocytes from thioacetamide-induced rat liver necrosis: responses to growth factors.

Hepatocytes isolated from the liver of rats after a necrotizing dose of thioacetamide (6.6 mmol/kg) were used to study the postnecrotic process of liver regeneration. Flow cytometry analysis revealed populations of dedifferentiated hepatocytes exhibiting physical properties (size and fluorescence emission at 530 nm) similar to those found in fetal (22 days old) liver cells. The percentage of these cells increased progressively from 24 to 48 and 72 hr after thioacetamide administration. In primary cultures of hepatocytes the effects of phorbol 12-myristate 13-acetate, bombesin and insulin were investigated on the 6-phosphofructo 2-kinase/fructose 2,6 bisphosphate system. Bombesin and insulin stimulated 6-phosphofructo 2-kinase activity and fructose 2,6-bisphosphate content both in control and in thioacetamide-treated hepatocytes. However, phorbol 12-myristate 13-acetate stimulated 6-phosphofructo 2-kinase activity and increased fructose 2,6-bisphosphate concentration in thioacetamide-treated liver cells, whereas no similar response was found in hepatocytes from control rats. The response of postnecrotic thioacetamide-treated hepatocytes to phorbol 12-myristate 13-acetate was similar to that obtained from 22-day-old fetal liver cells, which reveals that different methods might control fructose 2,6-bisphosphate content and therefore the mechanisms of glycolysis and gluconeogenesis at this regulatory step. The lack of response to glucagon of glycogen phosphorylase a and 6-phosphofructo 2-kinase from thioacetamide-treated hepatocytes may indicate that the expression of specific enzymes of carbohydrate metabolism undergoes transitions to less-differentiated isoenzymatic forms. Moreover, the isoenzyme pattern of hexokinases elicits a complete disturbance in glucokinase and hexokinases activities.(ABSTRACT TRUNCATED AT 250 WORDS)     

Course of depressive symptoms and medication adherence after acute coronary syndromes: an electronic medication monitoring study.

OBJECTIVES: We tested whether improvements in depressive symptoms precede improved adherence to aspirin in patients with acute coronary syndromes (ACS). BACKGROUND: Depression is associated with medication nonadherence in patients with ACS, but it is unclear whether changes in depression impact on adherence. METHODS: Electronic medication monitoring was used to measure adherence to aspirin during a 3-month period in a consecutive cohort of 172 patients (25 to 85 years) recruited within 1 week of hospitalization for ACS. Depressive symptom severity was assessed using the Beck Depression Inventory (BDI) during hospitalization and at 1 and 3 months after hospitalization. Adherence was defined as the percentage of days aspirin was taken as prescribed. RESULTS: Depression severity in hospital was associated with nonadherence in a gradient fashion: 15% of non-depressed patients (BDI score 0 to 4), 29% of mildly depressed patients (BDI score 10 to 16), and 37% of patients with moderately-to-severely depressive symptoms (BDI score >16) took aspirin less than 80% of the time (p = 0.03). A cross-lagged path analytic model revealed that improvements in depressive symptoms in the first month after the ACS were associated with improvements in adherence rates in the subsequent 2 months (standardized direct effect -0.32, p = 0.016). CONCLUSIONS: Diagnosis and treatment of depressive symptoms may improve medication adherence in patients after ACS.     

Dentoskeletal treatment changes in Class II subdivision malocclusions in submentovertex and posteroanterior radiographs.

The objective of this study was to evaluate the dentoskeletal changes consequent to orthodontic treatment in subjects with Class II subdivision malocclusions, treated with asymmetric extractions, compared with a normal-occlusion control group. The sample consisted of 3 groups, with 30 subjects in each: normal-occlusion subjects (group 1), untreated Class II subdivision subjects (group 2), and Class II subdivision patients treated with asymmetric extractions (group 3). All subjects had a full complement of permanent teeth at the beginning of treatment. The average ages of the subjects were 22.42, 15.76, and 18.57 years, respectively, in groups 1, 2, and 3. Measurements of relative differences in the spatial position of dental and skeletal bilateral landmarks were obtained from the submentovertex and posteroanterior cephalometric (PA) radiographs. The t test for independent samples was used to compare group 1 with groups 2 and 3 at different times. Results from the submentovertex radiograph showed that asymmetric extractions in Class II subdivision malocclusions will maintain the differences in the anteroposterior positions of right and left, maxillary and mandibular first molars, as would be expected with the treatment protocols used. There were no significant skeletal changes that could be attributed to the treatment approaches investigated or transverse collateral effects with the asymmetric mechanics used. It was also demonstrated that treatment of Class II subdivision malocclusions with asymmetric extractions produced corrections of maxillary and mandibular dental midline deviations with the midsagittal plane, without canting the occlusal plane or any other investigated horizontal plane, as seen in the PA radiograph. Treatment of Class II subdivision malocclusions with asymmetric extractions constitutes a beneficial approach to this problem.     

Postretention relapse of mandibular anterior crowding in patients treated without mandibular premolar extraction.

Treatment stability is one of the most important objectives in orthodontics, but, despite decades of research, it is still agreed that the stability of aligned teeth is variable and largely unpredictable. This study aimed to evaluate the relapse of mandibular anterior crowding in patients treated without mandibular premolar extraction. The sample comprised 40 patients of both sexes with Class I or II malocclusions who received nonextraction treatment in the mandibular arch with edgewise mechanics. Lateral cephalograms and dental casts of each patient were obtained at pretreament, posttreatment, and 5 years postretention. Relapse of mandibular anterior crowding was assessed, and associations between this relapse and other clinical factors were also investigated. Mandibular anterior crowding was measured by the Little irregularity index, and the data were evaluated by the Mann-Whitney test. The mean relapse of mandibular anterior crowding was 1.95 mm (26.54%) over the long term. No clinical factor studied was predictive of crowding relapse in the long term.     

Identifying the special needs of children with Type 1 diabetes in the school setting. An overview of parents' perceptions.

AIMS: The aims of this observational study were to identify the special needs of children with Type 1 diabetes in schools from the parents' point of view and the difficulties experienced with full integration, and to define a series of interventions which may improve the situation. METHODS: Parents of children aged 3-18 years with Type 1 diabetes were eligible. Those who agreed to participate completed a self-reporting questionnaire which determined the effects of the disease on children, parents and school personnel, and addressed aspects including children's integration, glycaemic control, insulin administration, meals, sports, trips and attitudes of teachers and school colleagues to their disease. RESULTS: A total of 499 questionnaires were completed and validated. Median age of children was 11.5 years (95% CI 7.8-15.2). Only 34% of parents believed that teachers could recognize the symptoms of a mild hypoglycaemic episode. Seventeen per cent of parents experienced problems at their schools when they informed staff about their children's disease, 5% were finally not accepted and 8% were forced to change school. In some cases, they had to modify glucose monitoring (9%) and treatment administration (16%) because of a lack of cooperation from the school. CONCLUSIONS: Training sessions on Type 1 diabetes, an increase in the number of nurses, better availability of resources from diabetic associations to schools and improved communication between school personnel and parents were identified as key factors that may improve the full integration of the diabetic child in this setting.     

Why do some overweight children experience psychological problems? The role of weight and shape concern.

OBJECTIVE: To examine the associations between weight status, weight and shape concern, self-esteem, body dissatisfaction and depression in children. METHODS: Interviews were conducted with 7- to 13-year-old overweight (n = 89) and healthy weight (n = 118) children, using the Child Eating Disorder Examination, Self-Perception Profile for Children, Children's Body Image Scale and Child Depression Inventory. RESULTS: Overweight children were more concerned about weight and shape than healthy weight children. After controlling for BMI z-score, children with high weight and shape concern reported lower self-esteem, higher body dissatisfaction and higher depression than children with low weight and shape concern. Concern about weight and shape mediated the relationships between BMI z-score and low self-esteem, body dissatisfaction and depression. CONCLUSIONS: Results support the hypothesis that differences in weight and shape concern, within samples of overweight and healthy weight children, can account for differences in degree of psychological distress. Findings have implications for the prevention and treatment of psychological problems in overweight children.     

Axons grow in the aging rat but fast transport and acetylcholinesterase content remain unchanged

Caliber and microtubular density of myelinated fibers, acetylcholinesterase (AChE) content and its accumulation at a ligature were studied in the phrenic nerve of mature (3-4 months) and aging (2-year-old) rats. The number of axons remained constant. The cross-sectional area of the nerve was 67% greater in the older group; the axoplasm, though, constituted about 20% of the nerve tissue irrespective of age. The mean cross-sectional area of myelinated axons was twice as big in aging compared to mature rats. All axons grew in the same proportion irrespective of their original caliber. The microtubular density of 3-microns axons was about 22 microtubules/micron2 in mature and aging rats. The AChE activity of aging rats was half as much as that of mature rats if it was expressed per wet weight of nerve tissue but did not change if it was expressed per nerve fiber. Twenty-four hours after ligation of the nerve, total AChE activity rose in mature and aging rats by ca. 168%; the molecular forms--asymmetric and globular--accumulated in the same proportion in both age groups. We conclude that myelinated axons grow in the adult stage of life but the structure of axoplasm, content of AChE per axon, and rate of fast transport remain lifelong features of nerve fibers.