Dose- and time-dependent formation of biliary benzo[a]pyrene metabolites in the marine flatfish dab (Limanda limanda)

Polycyclic aromatic hydrocarbons (PAHs) are abundant pollutants, and many PAHs are carcinogenic, but only after metabolic activation. Benzo[a]pyrene (BaP) is among the most carcinogenic PAHs. The dose and time response of two enzymes involved in BaP metabolism and the amounts of BaP metabolites excreted into the bile were evaluated in an experiment with dab (Limanda limanda). Ninety dab were exposed orally to one of five doses of BaP (0, 0.08, 0.4, 2, or 10 mg/kg) and sampled at 3, 6, or 12 d after exposure. None of the doses studied caused significant induction of either microsomal ethoxyresorufin-O-deethylase (EROD). which reflects cytochrome P450 1A (CYP1A) activity, or cytosolic glutathione-S-transferase activity (GST). Concentrations of biliary BaP metabolites significantly increased with dose and significantly decreased with time after exposure. It is concluded that biliary BaP metabolites provide a much more sensitive method than EROD (CYP1A) or GST activity to monitor recent exposure to PAHs in dab.     

Severity of injury does not have any impact on posttraumatic stress symptoms in severely injured patients

Background

Due to improved surgical techniques and more efficient decision making in treating severely injured patients, survival rates have increased over the years. This study was initiated to evaluate the incidence and identify risk factors for developing posttraumatic stress symptoms, using both extensive trauma-related data and data assessing the psychological trauma, in a population of severely injured patients.

Patients and methods

79 patients admitted to the Department of Multitrauma and Spinal Cord Injury at Sunnaas Rehabilitation Hospital from 2003 to 2005, prospectively completed semistructured psychological interviews and questionnaires, such as Impact of Event Scale-Revised. In addition, extensive injury-related data, such as injury severity score (ISS), new injury severity score (NISS), and probability of survival (PS) were collected.

Results

39% had multiple trauma, 34% had multiple injuries including spinal cord injuries, and 27% had isolated spinal cord injuries. Mean NISS was 31.5 (S.D. 13.7). 6% met diagnostic criteria for posttraumatic stress disorder (PTSD) and 9% met the criteria for subsyndromal PTSD. Injury-related data did not influence the prevalence of posttraumatic stress symptoms, however, some psychosocial variables did have a significant impact.

Conclusions

We found a low incidence of PTSD and subsyndromal PTSD. No significant differences were found between the patients suffering from posttraumatic stress symptoms and the non-symptoms group in relation to injury-related data such as ISS/NISS, PS, or multiple trauma versus spinal cord injury. The most evident risk factors for developing posttraumatic stress symptoms were symptoms of anxiety, female gender and negative attitudes toward emotional expression.     

The effect of trichlorfon and methylazoxymethanol on the development of guinea pig cerebellum

The pesticide trichlorfon (125 mg/kg on days 42-44 in gestation) gives hypoplasia of the brain of the offspring without any significant reduction in their body weights. The hypoplasia may be caused by trichlorfon itself or by its metabolite dichlorvos. This period of development coincides with the growth spurt period of guinea pig brain. The largest changes occurred in the cerebellum. Electron microscopic examination of the cerebellar cortex showed increased apoptotic death of cells in the granule cell layer after trichlorfon treatment. A reduction in thickness of the external germinal layer of the cerebellar cortex and an elevated amount of pyknotic and karyorrhexic cells in the granule cell layer was found. There was a significant reduction in choline esterase, choline acetyltransferase and glutamate decarboxylase activities in the cerebellum. Methylazoxymethanol (15 mg/kg body weight, day 43) was examined for comparison and caused similar hypoplasia of the guinea pig cerebellum, but did also induce a reduction in body weight. Trichloroethanol, the main metabolite of trichlorfon, did not give brain hypoplasia.     

Indicators of salivary gland inflammation in primary Sjögren's syndrome

The aim of this study was to establish additional indicators in saliva and plasma which are associated with salivary gland inflammation in patients with primary Sjögren's syndrome (SS). ELISA assays were used to determine the concentrations of sICAM-1, sVCAM-1, sIL-2Rz, IgA, IgG, calprotectin and albumin in parotid saliva, whole saliva and plasma samples. Soluble ICAM-1 was present in whole and parotid saliva samples from primary SS patients. Soluble VCAM-1 and sIL-IRx could not be detected in salivary samples from either primary SS or control subjects. IgA, IgG, calprotectin and albumin concentrations were higher in both whole and parotid saliva in the patient group compared with the control group. The results showed increased levels of calprotectin in all saliva samples compared to plasma, suggesting that calprotectin may be locally produced. Increased plasma values of sICAM-1. sVCAM-1, SIL-2Rα, IgA, IgG and calprotectin were detected in primary SS patients when compared to controls. The output/min of IgA. IgG, calprotectin and albumin was decreased in SS patients. Plasma levels of various proteins could offer information concerning glandular and extraglandular inflammatory processes. However, salivary levels of these proteins (particularly sICAM-1) tend to reflect more the local inflammatory activity, providing a convenient and non-invasive tool for diagnosis.     

Description of a multifaceted intervention programme for fatigue after acquired brain injury: a pilot study

The purpose of this pilot study was to describe and explore a group-based multifaceted intervention for patients with fatigue after acquired brain injury (ABI). We hypothesised that post-intervention changes would result in reduced fatigue, in addition to improved emotional health, sleep and attentional control. Eight subjects with traumatic brain injury (n?=?3) and cerebrovascular insults (n?=?5) were included. Inclusion was based upon the presence of fatigue complaints. The participants received 36 hours of intervention. Changes related to fatigue, emotional health and sleep was assessed with self-rating measures. Additionally, a neuropsychological test (Conners’ Continuous Performance Test II) was included as a measure of attentional control. All subjects were assessed at baseline, post-intervention, and at 3 and 9 months follow-up. Findings indicated reduced fatigue levels (post-intervention and 3 months follow-up), anxiety (9 months follow-up), and daytime sleepiness (3 and 9 months follow-up). Pilot results suggest that multifaceted group-based interventions may have the potential to alleviate symptoms of fatigue, anxiety and sleepiness after ABI. At an individual level, a low load of psychological distress, insomnia symptoms, dysexecutive symptoms, in addition to a strong sense of self-efficacy, may be central in order to reduce levels of fatigue.     

Moderators,mediators and nonspecific predictors of outcome after cognitive rehabilitation of executive functions in a randomised controlled trial

Moderators, mediators and nonspecific predictors of treatment after cognitive rehabilitation of executive functions in a randomised controlled trial

Objective: To explore moderators, mediators and nonspecific predictors of executive functioning after cognitive rehabilitation in a randomised controlled trial, comparing Goal Management Training (GMT) with an active psycho-educative control-intervention, in patients with chronic acquired brain injury.

Methods: Seventy patients with executive dysfunction were randomly allocated to GMT (n?=?33) or control (n?=?37). Outcome measures were established by factor-analysis and included cognitive executive complaints, emotional dysregulation and psychological distress.

Results: Higher age and IQ emerged as nonspecific predictors. Verbal memory and planning ability at baseline moderated cognitive executive complaints, while planning ability at six-month follow-up mediated all three outcome measures. Inhibitory cognitive control emerged as a unique GMT specific mediator. A general pattern regardless of intervention was identified; higher levels of self-reported cognitive—and executive–symptoms of emotional dysregulation and psychological distress at six-month follow-up mediated less improvement across outcome factors.

Conclusions: The majority of treatment effects were nonspecific to intervention, probably underscoring the variables’ general contribution to outcome of cognitive rehabilitation interventions. Interventions targeting specific cognitive domains, such as attention or working memory, need to take into account the patients’ overall cognitive and emotional self-perceived functioning. Future studies should investigate the identified predictors further, and also consider other predictor candidates.     

The Norwegian Polio Study 1994 part II: early experiences of polio and later psychosocial well-being.

STUDY DESIGN: The Norwegian Polio Study 1994 was a nation-wide survey of the medical and psychosocial situation of polio survivors. METHOD: A questionnaire, consisting of 133 questions with sub-questions, was sent to a total of 2392 polio victims, most of them registered in 'The National Society of Polio Victims' in Norway. 1449 (61%) answered. OBJECTIVES: To investigate the relationship between early polio experiences, such as duration of hospitalization and perceived support, and later psychosocial well-being. RESULTS: Three hundred and ninety-one persons (27%) reported they had been psychologically harmed by the treatment received at the time they contracted polio (Harmed group), while 1053 persons (73%) did not (Non-Harmed group). Persons in the Harmed group were significantly younger at polio onset, were hospitalized for a longer period and had less parental visit and support. Today they use more medication, report more pain, general fatigue, sleep disturbance and concentration problems, more psychosocial distress, less satisfaction with life and less social support than persons in the Non-Harmed group. CONCLUSIONS: The results demonstrate that a subgroup of polio survivors has been vulnerable from childhood, with possible consequences for their physical, psychological and social wellbeing later in life. Recommendations for long-life treatment of children with similar diseases should include follow-up not only of their physical disabilities, but also on psychological and psychosocial needs.