Determination of the minimal clinically significant difference on a patient visual analog sleep quality scale

The amount of change in quality of sleep (QOS), as measured by a 100-mm visual analog scale (VAS), that constitutes a minimum clinically significant difference was determined. A total of 428 patients with insomnia aged 55 years and older received placebo (2 weeks), prolonged release melatonin 2 mg (3 weeks) and then placebo (2 weeks). Sleep quality was assessed by the end of each period using the Leeds Sleep Evaluation Questionnaire (LSEQ) QOS variable and a five-point severity-rating scale. The mean difference between current and preceding VAS scores in patients improving or worsening by 1 point was 13 mm (95% CI 11-16). Correlation analysis indicated that a change of 1 point was associated with a mean change of 10.3 mm on the VAS. In conclusion, a change of 10 mm change in the 100-mm VAS QOS variable of the LSEQ, signifies an important change in patients' sleep quality.     

Melanocortins applied intravitreally delay retinal dystrophy in Royal College of Surgeons rats

Background -Melanocyte-stimulating hormone (MSH) is a neurotrophic agent. In Royal College of Surgeons (RCS) rats, the effects of an MSH analog (MA) were investigated on: (1) the preservation of photoreceptors in vivo following MA intravitreal injection; (2) whether MA is a mitogenic factor.Methods The study comprised five RCS rat groups, two injected with different doses of MA, one injected with PBS , and two non-injected groups. A single injection of MA or PBS was applied intravitreally to RCS rats on postnatal day 20 (20p). Photoreceptor preservation on 40p was studied using light microscopy. Considering the mitogenic effect of MA, it was studied whether cell proliferation was induced by MA in cultured retinal pigment epithelium (RPE) using the thymidine uptake technique.Results In degenerating untreated RCS retinae the number of photoreceptor rows on 40p was 60–70% lower than on 20p. Retinae treated with higher doses of MA revealed on 40p a localized significant photoreceptor rescue in the retinal hemisphere which had been injected. However, only a small area of photoreceptor preservation was noted in the injected hemisphere in retinae treated with the lower MA dose. MA showed no mitogenic effect in endothelial or RPE cell culture in vitro.Conclusions This study is the first to demonstrate that: (1) intravitreally injected MA promotes a dose-related localized rescue of photoreceptors in RCS retinae which may be related to the hormones neurotrophic activity; (2) MA has no mitogenic or angiogenic properties; (3) MA, as a neuroprotective agent, might be considered for future treatment of retinal dystrophy.     

Effects of polarizing solution on glucose uptake of rat oxygenated or hypoxic ventricular myocytes

1. Although adult cardiac metabolism depends on fatty acids rather than on carbohydrates, hypoxic hearts consume glucose and infusion with a glucose-insulin-potassium solution (GIK) helps in the recovery of the pressure register, the heart rate and electrocardiogram of rat hypoxic whole hearts. 2. Rat myocytes obtained by enzymatic disaggregation captured significant amounts of glucose in Tyrode's solution (9.8 +/- 2.05% during oxygenation and 16.26 +/- 2.76% during hypoxia) after 60 min incubation. Cells incubated with GIK showed a significantly increased glucose uptake (to 30.04 +/- 1.99% during oxygenation and to 37.06 +/- 1.97% during hypoxia). 3. Glucose was the component of the Tyrode's solution that most enhanced its own entry, increasing glucose entry to 45.42 +/- 2.64% with oxygen and 41.42 +/- 2.69% under hypoxia. 4. Antibodies against glucose transporters 1 and 4 (GLUT-1 and -4, respectively) decreased glucose transport during GIK treatment under hypoxia. 5. We conclude that GIK has beneficial effects mediated by GLUT-1 and -4 during hypoxia, inducing recovery of the damaged tissue.     

Cross-cultural validation of the Leeds sleep evaluation questionnaire (LSEQ) in insomnia patients

The Leeds sleep evaluation questionnaire (LSEQ) is a standardized self-reporting instrument comprising ten 100 mm visual analogue scales that pertain to the ease of getting to sleep (GTS), quality of sleep (QOS), ease of awakening from sleep (AFS) and alertness and behaviour following wakefulness (BFW). Although the LSEQ has been used in a variety of populations, published psychometric data on insomnia patients are limited. The LSEQ reliability and construct validity was evaluated in 396 French insomnia patients aged 55 years and over, who were treated with placebo (2 weeks) and melatonin (3 weeks). The results supported LSEQ internal consistency, reliability and construct validity with minor differences from those of the original English version. Then the internal consistency of the LSEQ was evaluated in 257 insomnia patients (age 20-80 years) in France and Israel who, following a 1 week placebo baseline, were randomized to placebo or melatonin treatment for 3 weeks. Cronbach's alpha and Pearson's r correlation coefficients for placebo and drug treatment conditions (p<0.001 for all) supported LSEQ internal consistency in different treatment and age groups and in different languages. It is concluded that the consistency, reliability and validity of the four LSEQ domains allows them to be singled out as independent outcome variables in cross cultural sleep research and clinical practice in adult and elderly patients with insomnia.     

Comparing treatments of alcoholism on craving and biochemical measures of alcohol consumptionst

An open randomized study was conducted to compare different treatments of alcoholism on ethanol intake, craving, and on biochemical measures of alcohol consumptions. Eighty-six alcoholics were abstinent for a mean of two weeks prior to random assignment to g-hydroxybutyrate (GHB, 50 mg/kg of body weight t.i.d), naltrexone (NTX, 50 mg/day) or disulfiram (DSF, 200 mg/ day) treatment for 12 months. All treatments were equally effective in reducing alcohol intake and in maintaining abstinence. In all patients, the treatments were able to reduce both craving and the altered biological markers of alcohol abuse. The maximum effects were observed in GHB-treated patients. The results of the present study suggest that GHB might act both as anticraving and cellular protector agent.     

Fatal paroxysmal supraventricular tachycardia in an infant

A 37-day-old infant, without associated congenital anomalies, died following a 48-hour episode of supraventricular tachycardia. The histopathologic findings of nodoventricular and fasciculoventricular Mahaim's fibers in a setting of persistent fetal dispersion were consistent with an anatomic substrate for a reentry circuit at the specialized A-V junction.