Single-level anterior cervical discectomy and interbody fusion using PEEK anatomical cervical cage and allograft bone

Background  

In an effort to avoid the morbidity associated with autogenous bone graft harvesting, cervical cages in combination with allograft bone are used to achieve fusion. The goal of the current study was to assess the reliability and efficacy of anterior cervical discectomy and interbody fusion (ACDF) using a PEEK anatomical cervical cage in the treatment of patients affected by single-level cervical degenerative disease.     

Forced expiratory volume in 1 second and cognitive aging in men

OBJECTIVES: To evaluate forced expiratory volume in 1 second (FEV₁, a measure of overall lung function), long‐term average FEV₁, and rate of decline in FEV₁ in relation to cognition and cognitive decline in older men. DESIGN: Prospective observational study. SETTING: Community‐based population. PARTICIPANTS: Eight hundred sixty‐four older men from the Normative Aging Study. MEASUREMENTS: Starting in 1984, participants underwent triennial clinical evaluations. Lung function assessments provided estimates of FEV₁. Cognitive assessments entailing tests of several cognitive abilities began in 1993. FEV₁ measured approximately 12 years before baseline cognitive testing, average FEV₁ over the 12‐year period, and rate of change in FEV₁ were all evaluated in relation to baseline and change in performance on the cognitive tests. RESULTS: In multivariable‐adjusted analyses, associations between FEV₁ and baseline cognitive scores were mixed, although average FEV₁ predicted significantly better performance on tests of visuospatial ability (P=.04) and general cognition (P=.03). Higher FEV₁ was more consistently associated with slower cognitive decline, but only the association between historical FEV₁ and attention was significant (difference per standard deviation in FEV₁=0.056, P=.05). Rate of FEV₁ decline was not consistently associated with cognitive function or decline. Findings were generally similar or stronger in men who had never smoked. To account for potential bias due to selective attrition, inverse probability of censoring weights were applied to the cognitive decline analyses, yielding slightly larger estimates; the inadequate prognostic power of the censoring models limited this approach. CONCLUSION: Overall, the data provide limited evidence of an inverse association between FEV₁ and cognitive aging.     

Mutations in insulin-like growth factor receptor 1 gene (IGF1R) resulting in intrauterine and postnatal growth retardation

Approximately 10% of children born small-for-gestational age (SGA) do not show spontaneous growth catch-up. The causes of this deficit in prenatal growth and its maintenance after birth are not completely known, in most cases. Over the past eight years, several heterozygous inactivating mutations and deletions in IGF1R gene have been reported, indicating the role of defects in the IGFs/IGF1R axis as a cause of growth deficit. It has been hypothesized that at least 2.5% of children born SGA may have IGF1R gene defects. The clinical presentation of these patients is highly variable in the severity of growth retardation and hormonal parameters. In the most evident cases, patients have microcephaly, mild cognitive impairment and high levels of IGF-1, associated with short stature of prenatal onset. This review will describe the clinical, molecular and treatment of short stature with hrGH of children with mutations in the IGF1R gene.     

Peripheral biomarkers and illness activity in bipolar disorder

Recent evidence suggests that peripheral markers related to oxidative stress, inflammation and neurotrophins may be altered during mood episodes in bipolar disorder. These can be seen as proxies of peripheral toxicity or markers of illness activity. Here we report an en bloc assessment of a set of previously described biomarkers in different mood states (n = 60) as well as in healthy subjects (n = 80). To make the point that these are ominous changes, we obtained the same measures from a group of septic patients (n = 15) as a “positive” control group. In this sample, we measured serum levels of brain derived neurotrophic factor, neurotrophin 3, tumor necrosis factor α, interleukin 6, interleukin 10, total reactive antioxidant potential, thiobarbituric acid reactive substances and protein carbonyl content. Several of the markers discriminated between the bipolar and control groups, especially when patients were in acute episodes. In some cases, toxicity was as high in bipolar disorder as that seen in patients with sepsis. We believe these findings highlight the potential of using biomarkers to assess illness activity in bipolar disorder.     

Increased dopamine transporter density in Parkinson's disease patients with Social Anxiety Disorder

Social Anxiety Disorder (SAD) is more common among PD patients than in the general population. This association may be explained by psychosocial mechanisms but it is also possible that neurobiological mechanism underlying PD can predispose to SAD. The aim of this study was to investigate a possible dopaminergic mechanism involved in PD patients with SAD, by correlating striatal dopamine transporter binding potential (DAT-BP) with intensity of social anxiety symptoms in PD patients using SPECT with TRODAT-1 as the radiopharmaceutical. Eleven PD patients with generalized SAD and 21 PD patients without SAD were included in this study; groups were matched for age, gender, disease duration and disease severity. SAD diagnosis was determined according to DSM IV criteria assessed with SCID-I and social anxiety symptom severity with the Brief Social Phobia Scale (BSPS). Demographic and clinical data were also collected. DAT-BP was significantly correlated to scores on BSPS for right putamen (r=0.37, p=0.04), left putamen (r=0.43, p=0.02) and left caudate (r=0.39, p=0.03). No significant correlation was found for the right caudate (r=0.23, p=0.21). This finding may reinforce the hypothesis that dopaminergic dysfunction might be implicated in the pathogenesis of social anxiety in PD.