Morphea affecting a father and son

Morphea, also known as localized scleroderma, is characterized by firm plaques that can occur anywhere on the body. Reports of familial morphea are rare, and we report an unusual case of morphea affecting both a father and a son.     

Nuciferine stimulates insulin secretion from beta cells-an in vitro comparison with glibenclamide

Ethnopharmacological relevance

Several Asian plants are known for their anti-diabetic properties and produce alkaloids and flavonoids that may stimulate insulin secretion.

Materials and methods

Using Vietnamese plants (Nelumbo nucifera, Gynostemma pentaphyllum, Smilax glabra, and Stemona tuberosa), we extracted two alkaloids (neotuberostemonine, nuciferine) and four flavonoids (astilbin, engeletin, smitilbin, and 3,5,3′-trihydroxy-7,4′-dimethoxyflavone), and studied their insulin stimulatory effects.

Results

Nuciferine, extracted from Nelumbo nucifera, stimulated both phases of insulin secretion in isolated islets, whereas the other compounds had no effect. The effect of nuciferine was totally abolished by diazoxide and nimodipine, and diminished by protein kinase A and protein kinase C inhibition. Nuciferine and potassium had additive effects on insulin secretion. Nuciferine also stimulated insulin secretion in INS-1E cells at both 3.3 and 16.7 mM glucose concentrations. Compared with glibenclamide, nuciferine had a stronger effect on insulin secretion and less beta-cell toxicity. However, nuciferine did not compete with glibenclamide for binding to the sulfonylurea receptor.

Conclusions

Among several compounds extracted from anti-diabetic plants, nuciferine was found to stimulate insulin secretion by closing potassium-adenosine triphosphate channels, explaining anti-diabetic effects of Nelumbo nucifera.     

利福昔明：有效维持肝性脑病缓解

肝性脑病是的一种慢性消耗性的肝硬化并发症。利福昔明（rifaximin）,一种口服的抗生素,治疗急性肝性脑病的疗效已有报道,但其预防此病疗效未知。     

Racial and Ethnic Differences in the Mental Health Needs and Access to Care of Older Adults in California

Little is known about the unmet mental health needs of minority older adults. Racial and ethnic differences in the prevalence rates of psychological distress and reported need and use of mental health services were examined in a population‐based sample of older adults using the 2005 California Health Interview Survey. The sample comprised 16,974 people aged 55 and older, with 13,974 non‐Hispanic whites, 719 African Americans, 1,215 Asians, and 1,066 Latinos. Respondents were compared in terms of prevalence of symptoms of mental distress and serious mental illness, reported need for help, and access to mental health services. African Americans, Asians, and Latinos were more likely to have mental distress than whites (21.2–24.2% vs 14.4%, P<.001) and a higher prevalence of serious mental illness (4.1–7.7% vs 2.5%, P<.001). After adjustment for age, sex, birthplace, marital status, education, limited English proficiency, chronic health conditions, and insurance status, older African‐American (adjusted odds ratio (aOR)=1.37, 95% confidence interval (CI)=1.04–1.81) and Asian (aOR=1.50, CI=1.13–2.00) adults still had greater odds of mental distress than whites. Furthermore, all three groups had worse access to mental health services than whites (African American aOR=0.64, 95% CI=0.43–0.96; Asian aOR=0.32, CI=0.16–0.63; Latino aOR=0.35, CI=0.17–0.70). Clinicians caring for older individuals should be aware of their high risk for mental health needs. Given that minorities' access to mental health services is worse than whites', even after adjusting for health insurance status, providing insurance alone will not eliminate this disparity. Innovative clinical and systemic strategies are needed to better identify individuals at risk and to provide needed services.     

Massage therapy after heart surgery: possibly pleasant,but not effective

Albert NM, Gillinov AM, Lytle BW, Feng J, Cwynar R, Blackstone EH. A randomized trial of massage therapy after heart surgery. Heart Lung 2009; 38: 480–90.     

Psychopathology predicts the outcome of medial branch blocks with corticosteroid for chronic axial low back or cervical pain: a prospective cohort study

Background  

Comorbid psychopathology is an important predictor of poor outcome for many types of treatments for back or neck pain. But it is unknown if this applies to the results of medial branch blocks (MBBs) for chronic low back or neck pain, which involves injecting the medial branch of the dorsal ramus nerves that innervate the facet joints. The objective of this study was to determine whether high levels of psychopathology are predictive of pain relief after MBB injections in the lumbar or cervical spine.     

Intervention study of exercise program for oral function in healthy elderly people

In Japan, one of the duties of the long-term care insurance system is the prevention of oral function degradation. Although various exercise programs for oral function have been developed and practiced in Japan, to date, no study has reported their effects. In the present study, we examined the effects of an exercise program on oral functions in healthy elderly people. Healthy elderly people participated in the study and were randomly divided into intervention and control groups (39 subjects/group). The exercise program consisted of four exercises: exercise for expression muscles, tongue, salivary glands, and swallowing. Before and after a six-month intervention period, we evaluated changes in oral functions, namely bite force, swallowing ability, and salivary flow rate. Fifty-four subjects completed the study protocol: 26 and 28 subjects from intervention and control groups, respectively. A significant improvement in all oral functions, including bite force, swallowing ability, as well as unstimulated and stimulated salivary flow rate, was observed in the intervention group after six months, whereas no improvement was observed in the control group. Further, among the intervention group, a significant improvement in oral functions was observed in 17 subjects with 20 or more remaining teeth, whereas no improvement was observed in the other nine with less than 20 teeth. Our results suggest that oral functions significantly improve after conducting a six-month exercise program for oral function. Further, this improvement appears to be influenced by the number of remaining teeth.