Human urocortin 2, a corticotropin-releasing factor (CRF)2 agonist, and ovine CRF, a CRF1 agonist, differentially alter feeding and motor activity

Two corticotropin-releasing factor (CRF) receptor families have been identified (CRF1 and CRF2). Whereas anxiogenic-like roles for the CRF1 receptor have been identified, behavioral functions of the CRF2 receptor remain obscure. Urocortin 2 (Ucn 2), a CRF-related peptide that selectively binds CRF2 receptors, was recently identified and recognized for its central anorectic properties. The present study tested the hypothesis that the anorexigenic mode of action of Ucn 2 differed from that of ovine CRF (oCRF), a preferential CRF1 receptor agonist. The behavioral effects of intracerebroventricular administration of Ucn 2 were compared with those of oCRF in nondeprived male Wistar rats (n=102). Ucn 2 reduced 6-h food and water intake at doses that did not induce visceral illness (0.1, 1, and 10 microg), as indicated by kaolin intake. Ucn 2 retained its potent anorectic activity in rats receiving a highly palatable cafeteria diet, preferentially reducing intake of carbohydrate (CHO)-rich items while sparing intake of mixed-fat/CHO items. In contrast to Ucn 2, oCRF (10 microg) suppressed 6-h intake of cafeteria diet-fed rats without regard to macronutrient composition. Rather, oCRF most potently suppressed intake of preferred food items. Whereas oCRF had short-onset motor-activating effects, Ucn 2 had nondose-dependent, delayed-onset motor-suppressing effects. Thus, central infusion of a CRF2 receptor agonist suppressed intake of both bland and palatable diets without inducing behavioral arousal or malaise, and the profile of anorexigenic effects qualitatively differed from those of a CRF1 receptor agonist. The results suggest the existence of distinct forms of CRF1- and CRF2-mediated anorexia.     

A prospective study of assault against staff by youths in a state psychiatric hospital

OBJECTIVE: This study examined the frequency and nature of violence directed at staff in a state inpatient psychiatric hospital for children and adolescents. METHODS: A total of 215 assaults that occurred over a two-month period were examined by using information obtained from staff at the time of the assault and from the hospital database. Assaults were analyzed for situational characteristics of the incidents as well as the characteristics that best differentiated between assaultive and nonassaultive patients. RESULTS: Thirty-three percent of all hospitalized patients were involved in an assaultive incident. A majority of the patients who assaulted staff were neither involved in the juvenile justice system nor psychotic. Although youths who were involved in repeat assaults were more likely to be male, gender did not differentiate between those who were assaultive toward staff and those who were not. Some type of verbal direction or redirection (typically minor) on the part of the staff preceded a majority (68 percent) of the assaults. CONCLUSION: Preconceived notions about why youths assault staff at psychiatric hospitals do not appear to be validated by these data, which suggest a more complex picture.     

Prevalence of reported migraine headaches in Canadian adolescents

OBJECTIVE: To examine self-reported prevalence data for migraine among adolescent Canadians and to explore how reported migraine treatment varies by age. METHODS: We analyzed the microdata files of the Canadian National Population Health Survey (1996-1997). Respondents reported whether they had "migraine headaches diagnosed by a health professional". They also reported whether they received "any treatment or medication for migraine headaches", with treatments subdivided into drug, diet or "other". RESULTS: 99.9% of 173,216 eligible respondents reported whether they had migraine headaches. Migraine was reported by 2.4% of Canadian youth aged 12-14 years and by 5.0% of 15-19 year-olds compared to 7.2% of adults aged > or = 20 years of age (p< 0.0001, chi-square). Active treatment was used by 51.0% - higher by females (53.1%) than males (44.7%) (p<0.0001 chi-square). Treatment was used by 45.1% of 12-14 year-olds, by 45.7% of 15-19 year-olds and by 51.5% of those > or = 20 years (p=0.0027). The nature of the active treatment choice (drug, diet or other) did not significantly vary within the age groups studied. CONCLUSIONS: We present robust estimates of self-report diagnosed migraine prevalence, derived from a large nationally representative population survey. Estimates of the prevalence of active treatment for migraine provide insight into the burden of migraine within this population.     

Aberrant cellular differentiation and migration in renal and pulmonary tuberous sclerosis complex

This review is focused on pathways and mechanisms that might provide molecular links between the pathogenesis of renal and pulmonary disease in tuberous sclerosis complex and the pathogenesis of the neurologic manifestations of tuberous sclerosis complex. Tuberous sclerosis complex is an autosomal dominant disorder in which the manifestations can include seizures; mental retardation; autism; benign tumors of the brain, retina, skin, and kidneys; and pulmonary lymphangiomyomatosis. Lymphangiomyomatosis is a life-threatening lung disease affecting almost exclusively young women. Genetic data have demonstrated that the cells giving rise to renal angiomyolipomas, the most frequent tumor type in patients with tuberous sclerosis complex, exhibit differentiation plasticity. Genetic studies have also shown that the benign smooth muscle cells of angiomyolipomas and pulmonary lymphangiomyomatosis have the ability to migrate or metastasize to other organs. These findings indicate that hamartin and tuberin play functional roles in the regulation of cell migration and differentiation. The biochemical pathways responsible for these effects are not yet fully understood but might involve dysregulation of the small guanosine triphosphatase Rho. Similar pathways might contribute to aberrant neuronal differentiation and migration in tuberous sclerosis complex.     

AACAP 2002 research forum: placebo and alternatives to placebo in randomized controlled trials in pediatric psychopharmacology

OBJECTIVE: The use of placebo in the pediatric age group has come under increasing scrutiny. At the 2002 Annual Meeting of the American Academy of Child and Adolescent Psychiatry, the Academy's Workgroup on Research conducted a research forum. The purpose was to identify challenges and their solutions regarding the use of placebo in randomized controlled trials in pediatric psychopharmacology. METHOD: Workgroups focused on problems and solutions in five areas: ethics and human subjects, research design and statistics, partnering with consumers, U.S. Food and Drug Administration and pharmaceutical industry perspectives, and psychosocial treatments. RESULTS: In many but not all circumstances, inclusion of a placebo control is essential to meet the scientific goals of treatment outcome research. Innovative research designs; involvement of consumers in planning and implementing research; flexibility by industry, academia, the National Institutes of Health, and regulatory agencies acting in partnership; and concomitant use of evidence-based psychosocial services can and should assist in making placebo-controlled trials acceptable. CONCLUSIONS: Properly designed placebo-controlled trials remain necessary, ethical, and feasible.     

Diagnosis of Rickettsia prowazekii disease at the final stage of its elimination

Diagnosis of Rickettsia prowazekii forms at the final stage of its elimination. 30 cases of petechial typhus occurred in Russian Federation during the period from 1973 to 1996 were subjected to retrospective analysis. On the base of this analysis the false registration of disease "epidemic" form was revealed. Indeed it appeared to be the recurrences, i.e. the Brill's disease. The authors propose to use the table of differential diagnostic signs of both forms of Rickettsia prowazekii based on their clinical-and-epidemiological special features. It will help to avoid the false reports.     

An outbreak of campylobacteriosis amongst directing staff and students at the Infantry Training Centre, Brecon, Wales, March 2004

A cohort study was undertaken to determine the source of an outbreak of gastrointestinal illness affecting a number of military personnel at ITC, Brecon during the period 19--30 March 2004. Of 105 soldiers on a field training exercise over the period 15--19 March 2004, 36 subsequently developed symptoms. Nine patients had Campylobacter sp identified in their stool. Water was provided from a single source. This water was used for washing, shaving, drinking and the preparation of rations. Although not statistically significant, epidemiological investigation suggests that the water may have been the vehicle of infection.