Patients' perception of their experience of primary percutaneous intervention for ST segment elevation myocardial infarction

Many patients experiencing ST segment elevation myocardial infarction (STEMI) are currently treated with primary percutaneous intervention (PCI). This relatively new procedure has reduced the time patients with the diagnosis of STEMI spend in hospital. In this literature review we explore patients' perceptions of their experience of receiving primary percutaneous intervention (PCI) as a treatment for STEMI. We critiqued and graded for relevance 10 papers that included original research and other sources. Key findings indicate that there is considerable variability in how patients treated for STEMI perceive the experience of PCI. Further, there is a misalignment between some patients' perceptions and health professionals' perceptions of this experience related to the event as well as the language used to speak of it. Thus, we recommend that nurses assess patients' perception of the experience and patients' health literacy level, then tailor the content and language of patient and family education to ensure an effective educative intervention.     

Visual phonetic processing localized using speech and nonspeech face gestures in video and point‐light displays

The talking face affords multiple types of information. To isolate cortical sites with responsibility for integrating linguistically relevant visual speech cues, speech and nonspeech face gestures were presented in natural video and point‐light displays during fMRI scanning at 3.0T. Participants with normal hearing viewed the stimuli and also viewed localizers for the fusiform face area (FFA), the lateral occipital complex (LOC), and the visual motion (V5/MT) regions of interest (ROIs). The FFA, the LOC, and V5/MT were significantly less activated for speech relative to nonspeech and control stimuli. Distinct activation of the posterior superior temporal sulcus and the adjacent middle temporal gyrus to speech, independent of media, was obtained in group analyses. Individual analyses showed that speech and nonspeech stimuli were associated with adjacent but different activations, with the speech activations more anterior. We suggest that the speech activation area is the temporal visual speech area (TVSA), and that it can be localized with the combination of stimuli used in this study. Hum Brain Mapp, 2010. © 2010 Wiley‐Liss, Inc.     

Biofeedback therapy for symptoms of bowel dysfunction following surgery for colorectal cancer

Background  

Following colorectal cancer (CRC) surgery, up to 60% of patients experience post-surgery bowel dysfunction (PSBD). This retrospective review aimed to evaluate biofeedback therapy with regard to patients’ symptoms of fecal incontinence (FI) and stool frequency.     

Tetrahydrobiopterin as a novel therapeutic intervention for autism

Tetrahydrobiopterin (BH₄) is an essential cofactor for several critical metabolic pathways that have been reported to be abnormal in autism spectrum disorder (ASD). In addition, the cerebrospinal fluid concentration of BH₄ is reported to be depressed in children with ASD. Over the past 25 years, several clinical trials have suggested that treatment with BH₄ improves ASD symptomatology in some individuals. Two ongoing clinical protocols may help further define the efficacy of BH₄ treatment in children with ASD. First, children with ASD who had low concentrations of cerebrospinal fluid or urine pterins were treated in an open-label manner with 20 mg/kg per day of BH₄. The majority of children (63%) responded positively to treatment, with minimal adverse events (AEs). Second, a double-blind placebo-controlled study examining the efficacy of 20 mg/kg per day of BH₄ treatment in children with ASD is currently underway. Safety studies from the commercially available forms of BH₄ document the low incidence of AEs, particularly serious AEs. Studies have also documented the ability of BH₄ to cross the blood-brain barrier. Based on the importance of BH₄ in neurodevelopmental metabolic pathways, the safety of BH₄ treatment, and the evidence for a therapeutic benefit of BH₄ treatment in children with ASD, we conclude that BH₄ represents a novel therapy for ASD, one that may gain wider use after further clinical studies have established efficacy and treatment guidelines.     

A novel X‐linked four‐repeat tauopathy with Parkinsonism and spasticity

The parkinsonian syndromes comprise a highly heterogeneous group of disorders. Although 15 loci are linked to predominantly familial Parkinson's disease (PD), additional PD loci are likely to exist. We recently identified a multigenerational family of Danish and German descent in which five males in three generations presented with a unique syndrome characterized by parkinsonian features and variably penetrant spasticity for which X‐linked disease transmission was strongly suggested (XPDS). Autopsy in one individual failed to reveal synucleinopathy; however, there was a significant four‐repeat tauopathy in the striatum. Our objective was to identify the locus responsible for this unique parkinsonian disorder. Members of the XPDS family were genotyped for markers spanning the X chromosome. Two‐point and multipoint linkage analyses were performed and the candidate region refined by analyzing additional markers. A multipoint LOD_max score of 2.068 was obtained between markers DXS991 and DXS993. Haplotype examination revealed an ～20 cM region bounded by markers DXS8042 and DXS1216 that segregated with disease in all affected males and obligate carrier females and was not carried by unaffected at‐risk males. To reduce the possibility of a false‐positive linkage result, multiple loci and genes associated with other parkinsonian or spasticity syndromes were excluded. In conclusion, we have identified a unique X‐linked parkinsonian syndrome with variable spasticity and four‐repeat tau pathology, and defined a novel candidate gene locus spanning ～28 Mb from Xp11.2–Xq13.3. © 2010 Movement Disorder Society