Association analyses suggest GPR24 as a shared susceptibility gene for bipolar affective disorder and schizophrenia.

Linkage analyses suggest that chromosome 22q12-13 may harbor a shared susceptibility locus for bipolar affective disorder (BPD) and schizophrenia (SZ). In a study of a sample from the Faeroe Islands we have previously reported association between both disorders and microsatellite markers in a 3.6 cM segment on 22q13. The present study investigated three candidate genes located in this segment: GPR24, ADSL, and ST13. Nine SNPs located in these genes and one microsatellite marker (D22S279) were applied in an association analysis of two samples: an extension of the previously analyzed Faeroese sample comprising 28 distantly related cases (17 BPD, 11 SZ subjects) and 44 controls, and a Scottish sample including 162 patients with BPD, 103 with SZ, and 200 controls. In both samples significant associations were observed in both disorders with predominantly GPR24 SNPs and haplotypes. In the Faeroese sample overall P-values of 0.0009, 0.0054, and 0.0023 were found for haplotypes in BPD, SZ, and combined cases, respectively, and in the Scottish sample overall P-values of 0.0003, 0.0005, and 0.016 were observed for similar groupings. Specific haplotypes showed associations with lowest P-values of 7 x 10(-5) and 0.0006 in the combined group of cases from the Faeroe Islands and Scotland, respectively. The G protein-coupled receptor 24 encoded by GPR24 binds melanin-concentrating hormone (MCH) and has been implicated with feeding behavior, energy metabolism, and regulation of stress and mood. To our knowledge this is the first study reporting association between GPR24 and BPD and SZ, suggesting that GPR24 variants may confer susceptibility to both disorders.     

Are disease duration and degree of functional impairment determinants of bone loss in rheumatoid arthritis?

One hundred and five patients with rheumatoid arthritis treated with a variety of antirheumatic drugs, excepting glucocorticoids, were stratified according to the degree of functional impairment (functional classes I to IV) and duration of the disease (0-3 years; 4-8 years; and greater than 8 years). The variables investigated were distal forearm bone mineral content (BMC), biochemical markers of bone formation: serum alkaline phosphatase and serum bone gamma-carboxyglutamic acid containing protein (BGP) and biochemical markers of bone resorption: fasting urinary calcium and fasting urinary hydroxyproline. Significant relationships were found between BMC and functional impairment and duration of the disease. Indices of bone formation and bone resorption rose with increasing functional impairment, particularly those of bone resorption. It is concluded that disability induces osteopenia in rheumatoid arthritis by increasing the bone turnover with a more marked increased in resorption than in the formation processes. The effect of the disease duration is merely that of adding more years of functional impairment.     

Pain drawings and concepts of pain among patients with "half-body" complaints

OBJECTIVE: To explore main features of pain drawings and concepts about illness in patients seeking help for "half-body" complaints at two primary health care centres in different parts of Sweden. METHODS: A qualitative study of pain-drawings and tape-recorded semi-structured interviews analysed by qualitative methods in 20 patients (4 men, 16 women, aged 37-68 years) from five health centers. Three of them were native Swedes and 17 were foreign-born. RESULTS: All complained of pain in a left (three-fourth) or right (one-fourth) body-half, mainly in front. Some had general pain with a "worse side". Many said they had pain only on the "edges" and outlined the margins on the side of pain, but excluded the "face". Posterior drawings often received a line in the middle dividing the body in lateral halves. Pain was referred to as a "growing" thing - ("It") - that could spread ("jump") to the other side, grow and eventually paralyse them. "It" was believed as caused by body imbalance, natural factors or supernatural forces. CONCLUSION: "Half-body" pain was an expression that in main was used by middle-aged patients to denote an initially superficial and frontal one-sided pain that could spread and become dangerous to their health. PRACTICE IMPLICATIONS: Patients with half-body complaints should be taken seriously and met with respect by doctors and other health care personnel, particularly in cross-cultural consultations.     

Prevalence of decreased bone mass in rheumatoid arthritis. Relation to anti-inflammatory treatment

Summary The bone mineral content (BMC) in both forearms (highly correlated to total body calcium) was measured by photon absorptiometry in a representative sample of rheumatoid arthritis outpatients comprising 129 patients treated with either gold salts (n=29), penicillamine (n=61), prednisone (n=24), or other anti-RA drugs (n=15). The mean BMC value was 84% of normal (p<0.001) with the lowest mean value in the group treated with prednisone (73% of normal). The patients as a group had hypocalcaemia (p<0.001), raised serum alkaline phosphatase (p<0.001), and normal urinary excretion rates of calcium and hydroxyproline. These results indicate that RA patients have disturbances in their calcium and bone metabolism.     

Self-poisonings with drugs by adolescents in the Lund catchment area

Our objective was to investigate which drugs young people who attempt suicide use in the Lund catchment area eight municipalities in Skåne, southern Sweden. All patients aged up to 18 years admitted to Lund University Hospital after deliberate or probably deliberate self-poisoning from 1 January 1991 until 31 December 1995 were included. Forty-nine (58%) had used a single drug; 20 (24%) had used 3 or more drugs. Fifty-two (61%) used analgesics paracetamol was used by 38 (45%) and propoxyphene by 17 (20%). Thirty-one (36%) had ingested psychotropics 13 used benzodiazepines, 10 antidepressants, and 8 antipsychotics. Eleven (15%) had used drugs in combination with alcohol. We conclude that it is important to follow changes in self-poisoning patterns, to monitor the effects of preventive work and discover new trends in drug use.     

Displacement of brain regions in preterm infants with non-synostotic dolichocephaly investigated by MRI

Regional investigations of newborn MRI are important to understand the appearance and consequences of early brain injury. Previously, regionalization in neonates has been achieved with a Talairach parcellation, using internal landmarks of the brain. Non-synostotic dolichocephaly defines a bi-temporal narrowing of the preterm infant's head caused by pressure on the immature skull. The impact of dolichocephaly on brain shape and regional brain shift, which may compromise the validity of the parcellation scheme, has not yet been investigated. Twenty-four preterm and 20 fullterm infants were scanned at term equivalent. Skull shapes were investigated by cephalometric measurements and population registration. Brain tissue volumes were calculated to rule out brain injury underlying skull shape differences. The position of Talairach landmarks was evaluated. Cortical structures were segmented to determine a positional shift between both groups. The preterm group displayed dolichocephalic head shapes and had similar brain volumes compared to the mesocephalic fullterm group. In preterm infants, Talairach landmarks were consistently positioned relative to each other and to the skull base, but were displaced with regard to the calvarium. The frontal and superior region was enlarged; central and temporal gyri and sulci were shifted comparing preterm and fullterm infants. We found that, in healthy preterm infants, dolichocephaly led to a shift of cortical structures, but did not influence deep brain structures. We concluded that the validity of a Talairach parcellation scheme is compromised and may lead to a miscalculation of regional brain volumes and inconsistent parcel contents when comparing infant populations with divergent head shapes.