Structured Approach Therapy for Combat‐Related PTSD in Returning U.S. Veterans: Complementary Mediation by Changes in Emotion Functioning

To address the impact of combat‐related posttraumatic stress disorder (PTSD) on U.S. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans, the investigators developed a 12‐session manualized PTSD treatment for couples called structured approach therapy (SAT). A randomized controlled trial had shown that 29 OEF/OIF veterans with combat‐related PTSD who had participated in SAT showed significantly greater reductions in PTSD compared to 28 veterans receiving a 12‐session PTSD family education intervention (Sautter, Glynn, Cretu, Senturk, & Vaught, 2015). We conducted supplemental follow‐up and mediation analyses, which tested the hypothesis that changes in emotion functioning play a significant role in the decreases in PTSD symptoms primarily observed in veterans who had received SAT. Veterans assigned to the SAT condition showed significantly greater decreases than those assigned to PTSD family education in emotion regulation problems (p < .001, Cohen's f² = .18) and fear of intense emotions (p < .001, Cohen's f² = .152). Decreases in both emotion regulation problems (mediated effect:= .36), and fear of intense emotions (mediated effect: = .24) were found to be complementary mediators of reductions in PTSD symptoms greater with SAT. These findings suggest that SAT may aid veterans in improving their ability to regulate trauma‐related emotions.     

Analgesic effects of acetaminophen,diclofenac and hyoscine N-butylbromide in second trimester pregnancy termination: a prospective randomized study

Objectives: This prospective, randomized study aimed to compare the analgesic effects of acetaminophen, diclofenac and hyoscine-N-butylbromide (HnBB) in cases of second trimester pregnancy termination.

Methods: In 60 women with indications for second trimester pregnancy termination, three analgesic agents were randomized into three groups: group 1, acetaminophen; group 2, diclofenac; and group 3, HnBB. A visual analog scale (VAS) used for the evaluation of pain perception. The primary outcome of the study was mean VAS score during the procedure and last VAS score before the completion of termination. The secondary outcomes were the induction-to-abortion interval, the percentage of aborted cases within the first 24?h and finally the need for parenteral analgesia.

Results: Demographic characteristics were similar among the groups. The mean VAS and last VAS scores before termination did not differ among the groups (p?=?0.3 and 0.2, respectively). The need for parenteral analgesia did not differ among the groups (p?=?0.3). Although a shorter induction-to-abortion interval and greater number of cases with successful termination before 24?h were found in the HnBB group, the differences were not statistically significant (p?=?0.6 and 0.5, respectively).

Conclusions: Our study did not demonstrate a difference in pain perception among second trimester pregnancy termination cases using acetaminophen, diclofenac and HnBB.     

The effect of tibolone versus 17beta-estradiol on climacteric symptoms in women with surgical menopause: a randomized, cross-over study

OBJECTIVE: To compare the effectiveness of tibolone and 17beta-estradiol on climacteric symptoms, in a randomized, single-blind, cross-over study in surgically menopausal women. MATERIAL AND METHODS: Forty surgically menopausal women were divided randomly into two groups. Group A received treatment with tibolone for 6 months, while group B received 17beta-estradiol. After 3 weeks washout period, treatment protocols were exchanged for another 6 months. The climacteric symptoms were assessed with Greene Climacteric Scale at baseline, during washout and after the treatments. Statistical analysis was done with the Wilcoxon's Sign Rank test. RESULTS: Both treatments significantly improved the scores of all subscales with respect to baseline. However, the improvement in psychological, somatic and sexual subscales were significantly superior in the tibolone group compared with 17beta-estradiol group. Both treatments showed comparable improvements in the relief of vasomotor symptoms. CONCLUSION: Our findings suggest that tibolone may improve mood, libido and somatic symptoms in surgically menopausal women to a greater extent than estrogen therapy alone.     

Lymphocyte and monocyte vitamin D receptor expression during paricalcitol or calcitriol treatments in patients with stage 5 chronic kidney disease

International Urology and Nephrology - In this study, we aimed to investigate the effect of paricalcitol and calcitriol usage on vitamin D receptor (VDR) contents of CD8+?,...     

Prospective neurobiological effects of the aerial and root extracts and some pure compounds of randomly selected Scorzonera species

Context: Scorzonera L. species (Asteraceae) are edible and as medicinal plants are used for various purposed in folk medicine.

Objective: The methanol extracts of the aerial parts and roots from 27 Scorzonera taxa were investigated for their possible neurobiological effects.

Materials and methods: Inhibitory potential of the Scorzonera species was tested against acetylcholinesterase (AChE), butyrylcholinesterase (BChE), and tyrosinase (TYRO) at 100?µg?mL^?1 using ELISA microtiter assay. Antioxidant activity of the extracts was tested with radical scavenging activity, metal-chelation capacity, ferric- (FRAP), and phosphomolibdenum-reducing antioxidant power (PRAP) assays. Chlorogenic acid, hyperoside, rutin, and scorzotomentosin-4-O-β-glucoside were also screened in the same manner. Total phenol and flavonoid quantification in the extracts were determined spectrophotometrically.

Results: The aerial parts of Scorzonera pisidica (40.25?±?0.74%) and chlorogenic acid (46.97?±?0.82%) displayed the highest TYRO inhibition, while the remaining samples showed only trivial inhibition against cholinesterases (2.08?±?1.35%–25.32?±?1.37%). The same extract of S. pisidica was revealed to be the most potent in scavenging of all three radicals and FRAP assay.

Discussion and conclusion: Out of 27 taxa, S. pisidica, in particular, may deserve further investigation for its neuroprotective potential.     

Effects of TSH-suppressive therapy on cardiac morphology and function: beneficial effects of the addition of beta-blockade on diastolic dysfunction

OBJECTIVE: To investigate the effects of long-term levothyroxine (LT4) suppressive therapy on the heart and the effects of beta-blockade on cardiac functions. DESIGN: Twelve female patients receiving LT4, selected from a group of patients with TSH levels of 0.1-0.4 microU/ml, were evaluated. The control group consisted of 11 healthy subjects and 12 patients with TSH levels <0.05 microU/ml. METHODS: Cardiac evaluation consisted of a 12-lead electrocardiogram and an echocardiographic study. Left ventricular mass index (LVMI), isovolumetric relaxation time (IVR), left ventricular end systolic (LVESD) and diastolic diameters, early (VE) and late (VA) diastolic flow velocities and fractional shortening were evaluated. Exercise capacity was assessed with a bicycle ergometer. Both work load and maximal exercise time were measured. Atenolol was given to the patient group at a dosage of 50 mg/day for 3 months and evaluations were repeated. RESULTS: On basal evaluations, LVMI (96+/-17 vs 78+/-21 g/m(2)) and IVR (101+/-9 vs 91+/-4 ms) were found to be increased in the patients taking LT4 (P<0.01). LVESD was also lower than controls (P<0.05). A decrease in VE and an increase in VA were also observed in the patients (P<0.01). IVR decreased after atenolol (92+/-10 vs 101+/-9 ms, P<0.05). LVMI decreased and VE and VA improved but did not reach statistical significance after beta-blockade. Baseline work load and maximal exercise duration were significantly lower in the patients and improvements were observed after atenolol treatment. CONCLUSIONS: These results indicated that cardiac dysfunction may occur even when TSH is suppressed to 0.1-0.4 microU/ml with LT4. beta-blockade improved the cardiac functions.     

The Value of P Dispersion on Predicting Atrial Fibrillation After Coronary Artery Bypass Surgery; Effect of Magnesium on P Dispersion

Atrial fibrillation (AF) is a frequent arrhythmia complicating cardiac surgery, and generally occurs within the first week after surgery. Although there are some etiological mechanisms to explain the postoperative AF, the exact mechanisms of AF are not well clarified. In the present study, we would like to show the effect of MgSO₄ infusion on P duration and P dispersion, and its relation with AF complication in patients undergoing coronary artery bypass grafting. The patients were randomly allocated into two groups. Group A consisted of 93 patients to whom 1.5 g/day MgSO₄ infusion in 100 mL 0.9 NaCl solution (25 mL/hr) were applied the day before surgery, just after operation, and once daily for 4 days following surgery. Group B consisted of 55 control patients to whom 100 mL 0.9 NaCl solution (25 mL/hr) were applied at the same time points. Magnesium level was measured before the treatment and daily for the postoperative four days. As a result, AF developed in 2% of cases in group A, and in 36% of cases in group B (p < 0.001). Comparing the patients who developed AF, and who did not, no difference was detected with regard to baseline P max, P min, P dispersion and fourth day P min. But fourth day P max and P dispersion of patients who developed AF were significantly higher than who did not. Baseline Mg level were similar for those who developed AF, and who did not, but fourth day Mg level was significantly lower in AF group. As a result, our opinion that Mg infusion significantly decreased the incidence AF after cardiac bypass surgery was confirmed. And it's also clear that beneficial effect of MgSO₄ is associated with its decreasing effect on P dispersion.