Motor Cortical Excitability Assessed by Transcranial Magnetic Stimulation in Psychiatric Disorders: A Systematic Review

BackgroundTranscranial magnetic stimulation (TMS) is a popular neurostimulation technique suitable for the investigation of inhibitory and facilitatory networks in the human motor system. In the last 20 years, several studies have used TMS to investigate cortical excitability in various psychiatric disorders, leading to a consequent improvement in pathophysiological understanding. However, little is known about the overlap and specificity of these findings across these conditions.ObjectiveTo provide a systematic review of TMS studies (1985–2013) focusing on motor cortical excitability in dementia, schizophrenia, affective disorders (major depression and bipolar), attention deficit hyperactivity disorder (ADHD), obsessive compulsive disorder (OCD), Tourette Syndrome (TS), substance abuse (alcohol, cocaine, cannabis, nicotine) and other disorders (borderline personality disorder, posttraumatic stress disorder (PTSD)).MethodsSystematic literature-based review.ResultsAcross disorders, patients displayed a general pattern of cortical disinhibition, while the most consistent results of reduced short-interval intracortical inhibition could be found in schizophrenia, OCD and Tourette Syndrome. In dementia, the most frequently reported finding was reduced short-latency afferent inhibition as a marker of cholinergic dysfunction.ConclusionsThe results of this systematic review indicate a general alteration in motor cortical inhibition in mental illness, rather than disease-specific changes. Changes in motor cortical excitability provide insight that can advance understanding of the pathophysiology underlying various psychiatric disorders. Further investigations are needed to improve the diagnostic application of these parameters.     

Compliance with a law to reduce alcoholic beverage sales and service in Zacatecas,Mexico

BackgroundResearch on the effects of restricting bar opening hours and alcohol sales in middle-income countries is very limited. We assessed compliance with and possible effects of a law enacted in Zacatecas, Mexico on December 30, 2017 and implemented in 2018 and 2019 that established a 2 AM bar closing time and 10 PM cut-off for alcohol sales by off-premises stores.MethodsMonthly observations of bars and off-premises stores and alcohol mystery shopping visits from 2018 to early 2020 were conducted to assess compliance with the law. Breath tests were conducted in 2018 and 2019 with samples of pedestrians in the nighttime entertainment districts of Zacatecas and a comparison city (Aguascalientes). Surveys of bar owners/managers and staff, emergency medical personnel (EMP), and police officers were conducted in Zacatecas in 2018 and 2019 to assess awareness and support of the law and possible effects of the law on alcohol-related problems such as violence and injuries.ResultsMonthly observations indicated that a substantial percentage of bars and off-premises package stores did not comply with the law. Pedestrian breath tests in 2018 and 2019 indicated significant reductions in blood alcohol concentration and heavy drinking among pedestrians in Zacatecas from 11 PM to 2 AM compared to Aguascalientes, but not after 2 AM. Surveys of bar owners/managers indicated that most were aware and supportive of the law. EMP surveys indicated reductions in incidents of physical fighting and drunk or injured customers during the annual September fair in Zacatecas.ConclusionsThis study suggests that restricting bar opening hours and alcohol sales may not result in full compliance by bars and off-premises stores, but may help to reduce excessive alcohol use and related harms in a middle-income country. A more rigorous evaluation with pre-intervention data is needed, however, to fully address this latter question.     

一站式复合技术治疗冠状动脉粥样硬化性心脏病进展

一站式复合(one-stop hybrid)技术是外科、内科、影像科、麻醉科等各个学科之间的完美结合,是多学科知识和技术的融合。一站式复合技术充分结合外科治疗和介入治疗技术的优点,以患者为中心,达到创伤、痛苦最小化,疗效最大化。近年来,随着该技术的发展,已经成功用于复杂冠心病的治疗并显示出特有的优势。本文总结一站式复合技术在冠心病中的应用现状,并对其未来发展方向进行讨论。     

Differential verbal working memory effects on linguistic production in children with Specific Language Impairment

Deficits in verbal working memory (vWM) have often been reported in children with Specific Language Impairments (SLIs) and might significantly contribute to their linguistic difficulties. The linguistic and narrative skills of a group of children with diagnosis of SLI were compared to those of a group of children with typical development. The linguistic assessment included a comprehensive analysis of their lexical, grammatical and narrative abilities. Overall, the participants with SLI had difficulties at all three levels of linguistic processing. The effect of vWM was marginal on lexical processing, significant on grammatical structuring, and null on narrative construction.     

An Integrative Review of Adolescent Smoking Cessation Using the Transtheoretical Model of Change

IntroductionThe purpose of this literature review is to report the effectiveness of trials using the Transtheoretical Model of Change for achieving smoking cessation among adolescents.MethodAn integrative literature review was performed. Two reviewers searched the Internet for randomized, controlled trials or observational studies of adolescent smoking cessation trials reported between 1999 and June 2009 that used the Transtheoretical Model of Change.ResultsSix randomized controlled trials remained after all inclusion and exclusion criteria were met. Each study was reviewed qualitatively and odds ratio and quit rates were calculated. Four studies demonstrated an odds ratio of greater than 1.0, and in four studies significantly better quit rates were found in the intervention arm versus the control arm at the endpoint evaluation.DiscussionEvidence exists for the effectiveness of stage-based interventions in promoting smoking cessation in adolescents.     

Colchicine-induced myoneuropathy mimicking polyradiculoneuropathy

We report a patient with colchicine-induced myoneuropathy. Myoneuropathy is an under-recognized complication of colchicine. The weakness seen in our patient improved fairly rapidly after discontinuation of colchicine.     

RCAM: a proposed model of recovery capital for adolescents

Problematic substance use is a challenge worldwide among adolescents. The recovery process requires holistic support addressing multiple and intersecting substance use risk factors; yet, there remains a lack of evidence on how to best understand and support adolescents in recovery. Recovery capital (RC) is a model that can be used to identify areas of assets that could be enhanced and barriers to address in one’s recovery process; however, this construct was generated through a study of adults who achieved natural recovery and it has since been used to frame adult recovery-related literature across the world. The primary aim of this article is to outline the rationale for and present a Recovery Capital for Adolescents Model (RCAM). The article will discuss the original recovery capital model, describe adolescent development, substance use, and recovery, and detail proposed developmental adaptations. Future qualitative and quantitative research should explore the RCAM to assess whether the proposed dimensions are complete as well as to assess its utility in clinical settings for identifying strengths and barriers for adolescents in or seeking recovery.