Fatal encephalitis in a patient with refractory celiac disease presenting with myorhythmia and carpal spasm.

We report the case of a woman with refractory celiac disease who developed abnormal spontaneous movements of the extremities and face consistent with myorhythmia. Investigation led to a diagnosis of encephalitis, confirmed by postmortem examination. The movements were likely caused by nonparaneoplastic encephalitis associated with refractory celiac disease. Etiologic and diagnostic considerations and treatment options are discussed.     

Gender differences in facial reactions to facial expressions

This study explored whether males and females differ in facial muscle reactivity when exposed to facial expressions. The study also examined whether the sex of the stimulus faces differentially influences the response patterns to facial stimuli. Thus, the sex was manipulated in a 2 x 2 factorial design by exposing males and females to slides of angry and happy faces displayed by both sexes. Facial electromyographic (EMG) activity was measured from the corrugator and zygomatic muscle regions. The subjects were also required to rate the stimuli on different dimensions. The results showed that angry faces evoked increased corrugator activity whereas happy faces evoked increased zygomatic activity. As predicted, these effects were more pronounced for females, particularly for the response to happy faces. Interestingly, there were no facial EMG effects for gender of stimulus. It was further found that males and females perceived the stimuli similarly. The results are consistent with previous findings indicating that females are more facially reactive than are males.     

Anti-inflammatory effect by exclusive enteral nutrition (EEN) in a patient with juvenile idiopathic arthritis (JIA): brief report

There is extensive evidence for influence of gut microbiota on health. Exclusive enteral nutrition (EEN) possibly changes gut microbiota, but the exact pathophysiological role is unknown. EEN has been shown to have an anti-inflammatory effect in children with Mb Crohn, an inflammatory bowel disease. The intestinal tract is very scarcely studied in children with juvenile idiopathic arthritis (JIA), but data points to an immunologically important role. The aim of this study was to explore if EEN had any anti-inflammatory effect in children with JIA. The first patient enrolled in the study was followed for 1 year. She had onset of severe polyarticular disease at 3.2 years of age, negative in RF, anti-CCP, ANA, and HLA-B27. She was included in the study at 7.4 years of age. Exclusive enteral nutrition was given in two periods of almost 7 weeks each, several months apart, during the year of the study. Clinical and laboratory status were assessed before, during, and after treatment periods. In this patient, EEN had remarkable anti-inflammatory effect that was sustained for months after each of two separate treatment periods. Exclusive enteral nutrition is a possible anti-inflammatory treatment in patients with JIA, but to what extent EEN is effective in other children with JIA needs to be explored, as well as the possible pathophysiological role of EEN in those children.     

Dental auscultation for nursing personnel as a model of oral health care education: development,baseline, and 6-month follow-up assessments

Oral health care has been shown to have low priority in nursing and has been only partly successful. To create more positive effects than those achieved through traditional oral health care education, this project tested an educational model for nursing staff personnel. In addition to traditional oral health care education, some of the nursing staff members passed an additional dental auscultation period and served as oral care aides. The aides were responsible for the oral health care of the residents at their nursing facilities (intervention group). The intervention nursing facilities were compared with facilities where nursing personnel only received a traditional oral health care education program. Assessments were made at baseline and at a 6-month follow-up. At follow-up it was shown that the nursing staff in the intervention group gave higher priority to the oral health care work than the nursing staff in the control group.     

K-ras and B-raf gene mutations are not associated with gastrin- and CCK2-receptor mRNA expression in human colorectal tumour tissues

BACKGROUND: Colorectal cancer is a multistep process caused by genetic alterations in cell growth regulatory genes such as K-ras and B-raf. It has been assumed that mutations in the K-ras gene induce gastrin gene expression and that gastrin stimulates the growth of colorectal cancer in an autocrine fashion by coexpressing gastrin and cholecystokinin (CCK)2 receptors. The aim of this study was to examine a possible association of K-ras and B-raf gene mutations with gastrin and CCK2 receptor mRNA expression in human colon and rectum tumour biopsy specimens. METHODS: K-ras and B-raf gene mutations as well as gastrin and CCK2 receptor mRNA expression in 50 colon and 46 rectum biopsies, respectively, were determined using molecular biology methods. RESULTS: K-ras mutations occurred in 44% colon and 30% rectum and B-raf mutations in 16% colon and 4% rectum tumours, respectively. Gastrin mRNA was expressed in 64% colon and 61% rectum tumours, whereas CCK2 receptor mRNAs was expressed in 32% colon and 13% rectum tumours. K-ras or B-raf gene mutations and simultaneous gastrin mRNA expression was observed in 40% colon and 17% rectum tumours, respectively. Co-expression of gastrin and CCK2 receptor mRNA occurred in 20% colon and 9% rectal tumours. CONCLUSIONS: The results do not support the hypothesis that K-ras and B-raf gene mutations have an impact on gastrin- and CCK-receptor mRNA expression in colorectal tumour tissues.