bluuebunny/crossref_metadata_2025 huggingface dataset:
The Pathology of Lupinosis of Sheep
Authors: Gardiner M. R.
Published: July 2017

The gross- and histo-pathology in relation to the main clinical features of inappetence, loss of body weight and jaundice, of some 500 sheep in various stages of lupinosis is described. The gross changes occurring in the liver, the principal organ affected, of pen trial sheep receiving pure diets of toxic lupins were classified as (a) early, (b) subacute, and (c) chronic. The corresponding histological features were found to be (a) eosinophilic and nuclear degeneration of hepatocytes with or without granular formation in the cytoplasm, (b) accumulation of granular degenerated hepatocytes in centrilobular areas with proximate fibrosis, and (c) portal tract fibrosis, bile duct cell and Kupffer cell proliferations, and cirrhosis.

The granular degenerated hepatocytes were found to be composed mainly of lipofuscins and haemosiderin with small admixtures of other cell decomposition products. Their probable derivation is by cellular peroxidation mechanisms under the influence of increased serum and liver iron and copper in association with toxins forming at times on lupin roughage. Haemosiderosis of liver, spleen and kidney was correlated along with nutritional deficits in the pathogenesis of lupinosis.
Pathology of Skull, Radius and Rib in Hypervitaminosis A of Young Calves
Authors: Grey R. M. , Nielsen S. W. , Rousseau J. E. , Calhoun M. C. , Eaton H. D.
Published: July 2017

In an experiment to produce hypervitaminosis A, twenty-two Holstein calves, 3 months of age and with a plasma vitamin A of 10 μg/100 ml or less, were fed vitamin A levels of 18, 54, 4000, 12,000 or 16,000 μg/lb of body weight per day for a 12-week period, except for the 16,000 μg group which was terminated in 8 weeks. The long bones and skulls were examined by X-rays and histologically.

The roentgenologic changes were a slowing of growth and remodeling processes in all calves on the 3 highest levels resulting in diminution of the overall size, thinning of the cortical bone and a marked decrease in the amount of spongious bone. Serial radiographs at weekly intervals of the radii of the calves on the highest level of vitamin A demonstrated changes as early as 2 weeks after administration of the vitamin supplement was begun.

The gross pathologic changes correlated well with the radiographic findings, except that failure of the internal bony plates of the frontal sinuses to form was not detected in the radiographs. The lack of bony separation of the brain from the frontal sinuses and the expansion of the cerebrum into these sinuses may explain the decreased cerebrospinal fluid pressure which accompanied the dilated cerebral ventricles.

Histologically, the essential change was retarded osteogenesis with poor differentiation of the mesenchymal cells into osteoblasts. As a result, the compacta was thin, osteoporotic and, at the 2 higher levels of vitamin A administration, contained large amounts of fibrous bone. As demonstrated in calves, the effect of excessive vitamin A on bone appears to be retardation of bone growth due to a defect in osteoid production resulting in osteoporosis.
Anomalous Origin of the Coronary Arteries in Animals
Authors: van Nie C. J.
Published: July 2017

Twelve different cases of anomalous origin of the coronary arteries in animals are reported, 10 from cattle, 1 from a pig, and 1 from a deer. The etiology of these anomalies is not yet clear. The hypothesis of abnormal potential of development of the bulbus-truncus cushions may be right, though it has not been proved.
Hepatic Hemangioendothelioma in a Rhesus Monkey
Authors: Woodruff J. M. , Johnson D. K.
Published: July 2017

A case of hemangioendothelioma of the liver of a rhesus monkey is described. Histologically, the growth was benign, but demonstrated a diffuse pattern more commonly seen with the adult, malignant form of hepatic hemangioendothelioma. Comparison with tissue changes seen in 4 other monkeys 20 months after exposure at similar dose levels to 55 Mev protons suggests that the tumor was not caused by the prior radiation.
Pathologic Effects of Aflatoxin in Pigs
Authors: Wilfred E. Gagné , Dungworth Donald L. , Moulton Jack E.
Published: July 2017

Rations containing up to 810 ppb aflatoxin B1 were fed to 3-month-old pigs for 107 to 117 days. Biochemical abnormalities indicative of hepatocellular damage occurred in pigs receiving 233 ppb or more aflatoxin B1. Slightly decreased gain in weight was detected in pigs fed 615 ppb aflatoxin B1, and 810 ppb resulted in reduction in efficiency of feed conversion and greatly decreased gain in weight. The livers of some pigs in the 615 and 810 ppb groups were pale yellow to tan, with increased resistance to cutting and a fine superficial granularity. Histologic lesions occurred in livers of some pigs in the 450 ppb group and in most livers of pigs in higher dosage groups. Mild changes included karyomegaly, cytoplasmic degeneration, and proliferation of bile ductules and fibrous tissue. Hepatocellular alignment into tubular structures and development of centrilobular vascular plexuses occurred in a few livers of the 810 ppb group. Only the most severely affected livers had lipidosis. There was no neoplasia.
A Case of Protothecosis in a Dog
Authors: Povey R. C. , Austwick P. K. C. , Pearson H. , Smith K. C.
Published: July 2017

Cells closely resembling those of a Prototheca sp. were found in lesions of the rectal wall, kidney, and myocardium of a 31/2-year-old springer spaniel dog which died after a short illness characterised by colitis, emesis, and polydypsia.
Adenocarcinomas of the Intestine Induced in Syrian Hamsters by N-methyl-N-nitrosourea
Authors: Herrold Katherine McD.
Published: July 2017

The adenocarcinomas of the intestine induced in Syrian hamsters by N-methyl-N-nitrosourea (NMU) were of two histological types, superficial and intestinal. These types had distinctive characteristics regarding pattern, cytological features, secretion of mucus, and mode of growth. The histological changes induced by NMU in the mucosa of the small intestine differed from what has been described in enzootic intestinal adenocarcinoma and proliferative ileitis of Syrian hamsters. NMU produced alteration in the villous architecture and cytological change in the absorptive cells. There was marked shortening of the villi and reduced thickness of the mucosa. The villous absorptive cells were large and cuboidal with centrally placed nuclei.
Transverse Fracture of the Proximal Humeral Articular Cartilage in Dogs (So-called Osteochondritis Dissecans)
Authors: Cordy D. R. , Wind Alida P.
Published: July 2017

A disease in young, predominantly male dogs of heavier breeds, commonly called osteochondritis dissecans of the shoulder, was found to be a transverse fracture of humeral articular cartilage along the ‘tidemark’ (the junction of uncalcified and calcified cartilage) rather than through necrotic subchondral bone. The lesion was characterized by a profile of plaques of remnant calcified cartilage in the floor of the defect, with variable proliferation of fibrous tissue, fibrocartilage, primitive cartilage, and bone derived from the underlying tissue. The sequestral fragment was composed of viable hyaline cartilage with small areas of calcified cartilage in the deep surface.
Congenital Cardiac Rhabdomyoma in a Pig
Authors: Omar A. R.
Published: July 2017

A case of congenital cardiac rhabdomyoma is described in a 5-month-old female pig. Multiple nodules of various sizes in the wall of the ventricles were made up of large myoblastic cells containing glycogen and cytoplasmic vacuoles. Typical ‘spider cells’ occurred.
Headache Temporal Patterns: Towards a Chronobiological Model
Authors: Nappi Giuseppe , Micieli Giuseppe , Sandrini Giorgio , Martignoni Emilia , Lottici Patrizia , Bono Giorgio
Published: July 2017

Rhythmical changes in terrain susceptibility and trigger occurrence can induce periodic temporal patterns in headache patients, with readily foreseeable frequency cycles of attacks. The impaired ability of biological functions to adjust to cyclic environmental changes represents the minus, the handicap, the increased risk of clinical symptomatology (headache); attacks occur when the precarious systems of these patients are forced by cyclical environmental stimuli towards phase shiftings or to cope with new levels of performance. A dyschronic hypothesis of primary headache must be based upon observations demonstrating that along with dysfunctions of the pain control systems there is also a vulnerability of the rhythmic physiological organization of CNS.

On sait que les fluctuations de la “susceptibilité du terrain” et la succession rythmique d'évènements trigger différents sont à même de conditionner des profils céphalalgiques périodiques, tout à fait prévisibles dans leur caractère séquentiel. La perte de la capacité des fonctions biologiques de s'adapter aux oscillations ambiantes de nature cyclique représente le “minus”, le “handicap”, le risque accru d'une véritable symptomatologie (céphalée); les crises se manifestent au moment où les stimuli ambients périodiques contraignent les systèmes neuronals précaires de ces patients à un glissement de phase ou à faire face à de nouveaux niveaux critiques d'activité. Une hypothèse dyschronique des céphalées primaires doit se fonder sur des observations démontrant qu'il existe aussi, dans ces patients, à côté du trouble des systèmes préposés au contrôle et à la perception des stimuli nociceptifs, une vulnérabilité de l'organisation physiologique rythmique du SNC.

E’ di rilievo comune come fluttuazioni della “suscettibilità di terreno” ed il succedersi ritmico di vari eventi trigger siano in grado di condizionare profili cefalalgici periodici, ampiamente prevedibili nella loro sequenzialità. La perdita della capacità delle funzioni biologiche di adattarsi alle oscillazioni ambientali di natura ciclica costituisce il “minus”, l’ “handicap”, l'aumentato rischio di sintomatologia vera e propria (cefalea); le crisi si manifestano nel momento in cui stimoli ambientali periodici sollecitano i precari sistemi neuronali di questi pazienti a slittare di fase o far fronte a nuovi livelli critici di attività. Un'ipotesi discronica delle cefalee primarie deve fondarsi su osservazioni che dimostrino come in questi pazienti, a lato della disfunzione dei sistemi preposti al controllo ed alla percezione degli stimoli nocicettivi, una vulnerabilità anche esista della fisiologica organizazione ritmica del SNC.
Evaluation of central opioid tonus in menstrual migraine
Authors: Petraglia F. , Martignoni E. , Sola D. , Cicoli C. , Facchinetti F. , Nappi G. , Genazzani A. R.
Published: July 2017

The aim of this study is to make an evaluation of the activity of endogenous opioid tonus in patients affected by menstrual migraine. We tested the LH response to naloxone injection, an opiate receptor antagonist, in 18 migraineurs in the early and late luteal periods going towards the attacks. The lack of any response in the latter group demonstrates an opioid disregulation in this kind of pathology.

Notre but a été l'études des eventuelles variation du systèm opioide chez des patientes souffrantes de maladie migraineuse en phase premenstruelle. On a mesurés la reponse de la LH a la stimulation par le Naloxone, antagoniste des recepteurs aux opiates, chez 18 femmes souffrantes de maladie migraineuse, en phase luteale moyenne et tardive. Pendants les jours immediatements precedents les règles, cette réponse a totalment fallu etant condictionnée positivement par l'augmentation du rapport Progesterone/Estradiole. Ces donnés demontrent l'existence, chez ces patientes, d'une alteration du tonus opioides.

Scopo della presente ricerca è la valutazione delle modificazioni del tono oppioide centrale nel corso del ciclo mestruale di pazienti affette da cefalea catameniale. E stata valutata la risposta dei tassi plasmatici di LH alla stimolazione endovenosa con Naloxone, antagonista dei recettori per gli oppioidi, in 18 pazienti nel corso della fase luteale media e tardive del ciclo mestruale. In fase premestruale questa risposta neuroendocrina è totalmente assente e sembra essere modulata dal rapporto Progesteron/Estradiolo, sostenedo l'esistenza di una sregolazione del tono oppioide nelle cefalee catameniali.
Chronobiological aspects of headache syndromes due to sellar or pituitary pathology
Authors: Bossolo Pierangelo , Canepari Claudio , Daguati Mimma Maria , Cozzi Alberto , Fioravanti Marisa , Ferrari Ettore
Published: July 2017

A chronobiological study was carried out in headache syndromes due to empty sella or to pituitary G.H.- and PRL-secreting adenomas. In the empty sella syndrome only the chrono-organization of G.H. secretion was disturbed, whereas pl. PRL exhibited the usual circadian pattern. The circadian rhythms of pl. G.H. and pl. PRL were abolished in G.H.-and PRL-secreting pituitary tumors, respectively, and were again detectable when patients were cured by selective transsphenoidal adenomectomy. A normal circadian rhythmicity of pl. cortisol was demonstrable in the empty sella syndrome and in pituitary adenomas, both before and after surgery.

On a étudié les aspects rhythmométriques de certains cas de céphalée secondaire à un atteinte sellaire ou bien hypophysaire, tels la syndrome de la selle vide et les adénomes GH- ou PRL-secrétants. Au cours du syndrome de la selle vide on observe un trouble de la rhythmicité circadienne du GHpl., tandis que les autres rhythmes (PRL et cortisol pl., température orale) sont normaux. Dans les adénomes GH- ou PRL-secrétants on observe une altération sélective du rhythme circadien de l'hormone spécifiquement secrétée par l'adénome. Après l'exérèse chirurgicale de l'adénome par voie transphénoidale, la normalization des niveaux plasmatiques hormonaux s'accompagne à la réapparition du rhythme circadien habituel. Le rhythme circadien du cortisol plasmatique ne semble pas être affecté par la présence d'une selle vide ou bien d'un adénome GH- ou PRL-secrétant ni par l'adenomectomie par voie transphénoidale.

E’ stata attuata una indagine cronobiologica in corso di cefalea secondaria a patologie sellario ipofisarie, quali la sindrome della sella vuota e gli adenomi GH- o PRL-secernenti, con sindrome cefalalgica. In presenza di empty sella si riscontra un'alterazione della cronoorganizzazione circadiana solo per la secrezione di G.H., mentre la PRL pl. presenta il normale ritmo circadiano. Negli adenomi ipofisari si rileva la scomparsa della normale ritmicità circadiana dell'ormone specificamente ipersecreto e la completa rimozione dell'adenoma per via trans-nasosfenoidale è seguita dal ripristino del ritmo circadiano dell'ormone stesso. Il ritmo circadiano del cortisolo pl. non risulta alterato nell'empty sella nè in presenza di adenoma ipofisario GH o PRL-secernente e non viene significativamente modificato dall'intervento neurochirurgico.
Progress in migraine: treatment with dihydroergotamine-retard
Authors: Mastrosimone Filippo , Iaccarino Carmine
Published: July 2017

A group of 40 patients suffering from migraine underwent dihydroergotamine-retard therapy for a period of five months after a 30-day pre-treatment period. They had previously been treated with other medications but results were not relevant. Drug effectiveness was evaluated by means of Pain Total Index, number of attacks, analgesic consumption and number of awakenings with headache. The results show a significant difference between the observation period and the treatment phase, with relevant therapeutic success. Only moderate side-effects were observed.

La dihydroergotamine à libération programmée a été administrée pendant cinq mois à quarante patients souffrants de céphalée qui avaient déjà été traités avec d'autres médicaments sans obtenir un résultat appréciable. Le commencement de la thérapie était précédé par une période d'observation de trente jours. L'éfficacité du traitement a été évaluée au moyen du Pain Total Index, de la fréquence des crises, de la consommation des analgésiques et du nombre de réveils avec la céphalée. Les résultats indiquent des différences significatives du point de vue de la statistique par rapport à la période d'observation. La thérapie a permis des succès thérapeutiques remarquables, vue aussi la mancance d'effets collatéraux qui auraient conseiller la suspension du traitement ou bien la réduction de la posologie.

A quaranta pazienti affetti da cefalea emicranica e già trattati con scarsi risultati con altri farmaci, è stata somministrata diidroergotamina a cessione programmata per cinque mesi. Un periodo di osservazione di trenta giorni precedeva l'inizio della terapia. L'efficacia del trattamento è stata valutata per mezzo del Pain Total Index, della frequenza delle crisi, del consumo degli analgesici e del numero di risvegli con cefalea. I risultati mostrano differenze statisticamente significative rispetto al periodo di osservazione. La terapia ha permesso rilevanti successi terapeutici, in assenza di effetti collaterali tali da indurre la sospensione del trattamento o la riduzione della posologia.
Timed-release dihydroergotamine in the prophylaxis of mixed headache. A study versus amitriptyline
Authors: Bonuso Salvatore , Stasio Emanuela Di , Barone Paolo , Steardo Luca
Published: July 2017

A pharmacological trial has been carried out on 41 out-patients suffering from mixed headache. The prophylactic effect of a timed-release dihydroergotamine formulation was tested versus amitriptyline. Patients reported daily, on appropriate cards, the hours of headache and the degree of pain during the month before therapy and on the following two months of treatment. Whereas amitriptyline was found to be more effective than dihydroergotamine in reducing headache intensity, timed-release dihydroergotamine was found significantly more effective than amitriptyline in reducing attacks of “migraine” type.

Les auteurs ont conduit une étude pharmacologique sur 41 patients souffrant de céphalée mixte. L'effet préventif de la dihydroergotamine à libération programmée a été comparé à celui de l'amitriptiline. Les patients ont quotidiennement enregistré, sur des fiches spéciales, les heures de céphalée et le degré d'intensité de la douleur au cours du mois précédant la thérapie et durant les deux mois de traitement. La dihydroergotamine à libération programmée s'est avérée de façon significative plus efficace que l'amitriptiline dans la réduction de la fréquence des attaques de type hémialgique.

Gli autori hanno condotto uno studio farmacologico su 41 pazienti sofferenti di cefalea mista. L'effetto preventivo della diidroergotamina a liberazione programmata è stato paragonato a quello della amitriptilina. I pazienti hanno riportato, quotidianamente, su apposite schede, le ore di cefalea ed il grado di intensità del dolore nel mese precedente la terapia e durante i due mesi di trattamento. La diidroergotamina a liberazione programmata è risultata significativamente più efficace dell'amitriptilina nel ridurre la frequenza degli attacchi ti tipo emicranico.
β Blockers and the Central Nervous System
Authors: Schoenen J
Published: July 2017

The exact mechanism of action of β blockers in migraine remains undetermined. An effect on the central nervous system (CNS) might be a factor. The evidence from the literature indicates that the anatomical and chemical targets for these drugs are present in the mammalian brain, that they readily penetrate the brain, and that they may modify CNS functions. The present study shows that psychomotor tests and contingent negative variation (CNV), an event related slow cerebral potential, both of which are abnormal in untreated migraineurs, tend to normalize after treatment with the β blocker metoprolol. Moreover, a strong positive correlation was found between the amplitude of CNV and the clinical efficacy of β blockers in migraineurs. One might hypothesize that a hyperactive central catecholaminergic state in migraine might be the common denominator between reduced performance on psychomotor testing and enhanced CNV. It remains to be determined whether this is due to hyperactivity of catecholaminergic neurons or to hypersensitivity of catecholamine receptors.
Clinical Aspects of β-Blockade
Authors: Smith Ulf
Published: July 2017

β-Blocking drugs have no or only a partial β-agonistic activity (ISA). Since they all bind to β receptors, they act as competitive inhibitors of the endogenous catecholamines. In addition to this common effect, the β-blocking drugs also have other properties that may be clinically important, such as extent of β, selectivity, ISA, and lipophilicity. The importance of these properties in the clinical setting is reviewed.
Onset of Action of Various Migraine Prophylactics
Authors: Amery Willem K
Published: July 2017

Four studies were pooled to study the onset of action of three pharmacologically different migraine prophylactics: flunarizine, pizotifen and propranolol. Inter-drug differences in reduction of baseline attack frequency were subjected to analysis of variance. At months 1, 2, and 3 the inter-drug differences in number of patients showing a first 50% decrease in attack rate were subjected to the Chi-square test. Both tests showed that there were no significant differences in onset of action between the three drugs. It is concluded that migraine responds to flunarizine and to other commonly used prophylactics in a similar way and with similar kinetics.
Flunarizine I.V. in the Acute Treatment of the Migraine Attack. A Double-Blind Placebo-Controlled Study
Authors: Soyka Dieter , Taneri Ziya , Oestreich Wolfgang , Schmidt Rainer
Published: July 2017

Flunarizine, 20 mg by slow intravenous injection, was studied in the acute treatment of migraine attacks in a multicentre, double-blind, placebo-controlled study. At the end of the 60 min observation period, 23 of the 31 (74.2%) patients treated with flunarizine reported complete relief, or a pain reduction of more than 50%, vs. 8 of 29 (27.6%) placebo patients ( p < 0.017). Accompanying symptoms also improved significantly better in the flunarizine than in the placebo group. The investigators evaluated the therapy as good or excellent in 77.4% of the flunarizine and in 27.6% of the placebo patients, respectively. Tolerance of the therapy was good and comparable in the two groups. Somnolence was the only flunarizinerelated adverse reaction. Blood pressure and heart rate were not affected. Flunarizine i.v. deserves further study in the acute treatment of a migraine attack.
Development of diagnostic criteria for headache syndromes: Lessons from psychiatry
Authors: Merikangas Kathleen Ries , Frances Allen
Published: July 2017

This paper reviews the development of diagnostic criteria for the psychiatric disorders in order to provide a model for the development of classification of headache. The strengths and weaknesses of the current psychiatric classification system, and procedures that have been instituted to strengthen the next version of the classification are described. The problems that characterized the successive versions of the criteria are highlighted in order to stimulate future developments of diagnostic criteria for headache syndromes. Recommendations for application of these principles to headache classification are presented.
Evaluation of the nosology of chronic tension-type headache
Authors: Pfaffenrath Volker , Isler Hansruedi
Published: July 2017

Tension-type headache is one of the problematic classes of the IHS classification of headache. Based on the data of 211 cases of chronic tension-type headache modified criteria are proposed for the diagnosis of chronic tension-type headache. In order to provide optimal discrimination between migraine and tension-type headache it is recommended that the severity of characteristic migraine symptoms, which also frequently occur at a mild level of intensity among patients with tension-type headache, be incorporated into the diagnostic criteria for this headache. Specifically, mild photophobia and phonophobia, and headache aggravation by physical activity should not be used as exclusion criteria for tension-type headache.
A headache clinic-based approach to field trials of the International Headache Society criteria
Authors: Solomon Seymour , Lipton Richard B
Published: July 2017

Criteria for the diagnosis of headache disorders have recently been developed but require empirical validation. We present an approach to the evaluation of headache criteria in a headache clinic: define the group of headache sufferers to be studied, obtain data used in establishing the diagnosis, apply the diagnostic criteria and assess their usefulness. In applying this method to a group of patients with chronic daily headache, we found that approximately one-third would not fit the current criteria for chronic tension-type headache. We conclude that empiric validation of headache criteria based on subjective data is a complex and iterative process. Operational criteria for headache diagnosis to be used by primary care physicians should be validated in that setting and ideally should be relatively simple.
A personal view of the classification and definition of drug dependence headache
Authors: Diener H-C
Published: July 2017

A review of the literature indicates that drug-induced headache exists. The criteria of the International Headache Society proposed for the diagnosis of “headache induced by chronic substance use or exposure”, however, need to be modified in order to identify all patients with this headache form.
Cardiovascular response to cognitive stress in subjects with menstrually related disorders
Authors: Tarabusi M , Caputo As , Volpe A , Facchinetti F
Published: July 2017

We measured reactivity to a stress paradigm during the premenstrual period in 19 women affected by Menstrually Related Disorders (MRD) and in 11 normal controls. Eight had premenstrual syndrome diagnosed by the Menstrual Distress Questionnaire and 11 suffered menstrual migraine, diagnosed according to International Headache Society criteria. Subjects were observed during two menstrual cycles and submitted to a psychocognitive test (Stroop Color Word) during the luteal phase. In both groups the stimulation by Stroop C-W was present for systolic blood pressure (SBP) (F = 18.14, p = 0.000), diastolic blood pressure (DBP) (F = 9.56, p = 0.000), and heart rate (F = 12.80, p = 0.000). Moreover, an interaction of response by group was present for DBP (2.58, p = 0.04); DBP values were higher in MRD subjects. Also baseline DBP values were higher in MRD with respect to controls. Area under the curve (AUC) subtracted from baseline for the SBP, DBP and heart rate did not differ between groups. In conclusion, MRD subjects facing a cognitive stress had normal cardiovascular response. However, patients had increased arousal of cardiovascular measures before and after testing. The significant differences during stress of testing were dissociated from those of experimental stress stimulation. MRD subjects may have less ability to cope with novelty than healthy volunteers.
Migraine and ovarian steroid hormones
Authors: Welch Kma
Published: July 2017

This chapter reviews clinical and epidemiological data that support a role for ovarian steroid hormones in the migraine syndrome. Changes in the clinical presentation of migraine are discussed on the basis of current knowledge of biochemistry and pharmacology of ovarian steroids. Finally, special treatment considerations of ovarian hormone-sensitive migraine are discussed.
Treatment of menstrual migraine
Authors: Granella F , Sances G , Messa G , De Marinis M , Manzoni Gc
Published: July 2017

Because of its pathophysiological and clinical peculiarities, true menstrual migraine (MM) (i.e. migraine starting exclusively between the days immediately before and immediately after the first day of the menstrual cycle) requires an ad hoc management different from that of other migraines. The paucity of well-conducted, controlled clinical trials and the lack of a universally accepted definition of MM have meant that the treatment of MM is still largely empirical. In our clinical practice, we adopt a sequential therapeutic approach, including the following steps: (i) acute attack drugs (sumatriptan, ergot derivatives, NSAIDs); (ii) intermittent prophylaxis with ergot derivatives or NSAIDs; (iii) oestrogen supplementation with percutaneous or transdermal oestradiol (100 Lig patches); (iv) antioestrogen agents (danazol, tamoxifen).
Catamenial epilepsy, progesterone and its metabolites
Authors: Murri L , Galli R
Published: July 2017

This study was undertaken to determine plasma allopregnanolone (3alpha-hydroxy-5alpha-pregnan-20-one, A-PREG) and pregnanolone (3alpha-hydroxy-5beta-pregnan-20-one, PREG) concentrations in the luteal phase (22nd to 24th day of the ovarian cycle) in 15 women with partial epilepsy and catamenial exacerbation of the seizures in the intercritical phase and in 15 healthy women matched for age in order to determine if an impaired metabolism of 3alpha-hydroxymetabolites of progesterone (P) occurs in this convulsive disorder. No significant differences between the two groups were found with respect to the mean plasmatic A-PREG and PREG levels. A significant correlation was found instead between P and A-PREG or PREG concentrations.
The Neurobiology, Neuropharmacology, and Pharmacological Treatment of the Paraphilias and Compulsive Sexual Behaviour
Authors: Brad ford John MW
Published: July 2017

There has been in creas ing in ter est in the treat ment of sex ual dis or ders in re cent years. Sex ual dis or ders are clas si fied in DSM-IV as sex ual dysfunctions, paraphilias, and gen der iden tity dis or ders. The sex ual dysfunctions are nondeviant or nonparaphillic.

The sex ual dys func tion dis or ders should in clude “hy per ac tive sex ual de sire dis or der” un der sex ual de sire dis or ders. Fur ther, there should be a speci fier for paraphilias of “with hypersexuality” or “with out hypersexuality.” There is still in com plete un derstand ing of the neurobiology of sex ual dis or ders al though func tional neuroanatomy and neoropharmcological re search has e xposed the neurotransmitters, receptors, and hormones that are in volved in sex ual de sire. Vari ous pharmacological agents in clud ing se ro to nin reuptake in hib i tors, antiandrogens, LHRH agonists, and oth ers have been doc u mented as re duc ing sex ual de sire. An al go rithm for the use of these drugs in the treat ment of the paraphilias as well nonparaphilic hypersexuality is out lined. The modes of ac tion, dos ages, aims of treat ment, and usual meth ods of pre scrib ing these agent s is re viewed in this ar ti cle. Some fu ture di rec tions of re search in phar ma co log i cal treat ment is also dis cussed.
Is Schizophrenia on the Decline in Canada?
Authors: Woogh Car o lyn
Published: July 2017

Objective:

To ex am ine changes in prev a lence rates of treated schizo phre nia over 10 years in a small urban teach ing cen tre us ing data from the Kingston Psy chi at ric Re cord Link age Sys tem (KPRLS).

Method:

The KPRLS, a psy chi at ric case reg is ter es tab lished in 1984, col lects and links de mo graphic, di ag nos tic, and ser vice use in for ma tion for all psy chi at ric in pa tients, out pa tients and emer gency con tacts at the 3 hos pi tals in Kingston, On tario. A pre lim inary com par i son of first ad mis sions for schizophrenia used chart review (1976–1978) and KPR LS data (1996–1998). The KPRLS data were used to cal cu late pop u la tion-based prev a lence rates of treated schizo phre n ia in 3 cen sus years (1986, 1991, 1996) for pa tients in the 2 coun ties clos est to Kingston.

Results:

The pre lim i nary com par i son showed a 42% de crease in the num ber of first-admission schizo phre nia cases over 20 years. In the main study, the an nual in pa tient prev a lence rates de creased sig nif i cantly (52%) from 1986 to 1996 with no cor re spond ing change in out pa tient rates, re gard less of sex. Al though to tal ma jor af fec tive dis or ders in creased, this was due to an in crease in m ajor de pres sion, not bi po lar dis or der.

Conclusions:

This is the first Ca na dian case-register study to sup port the widely re ported fall ing rates of schizo phre nia in other parts of the world over the last 40 years. Since this is a geo graph i cally lim ited prev a lence study based on only 10 years of data, further re search over lon ger pe ri ods of time in other re gions of the coun try is re quired to sup port or re fute these find ings.
Serum Lipid Concentrations in Patients with Comorbid Generalized Anxiety Disorder and Major Depressive Disorder
Authors: Sevincok Levent , Buyukozturk Aslihan , Dereboy Ferhan
Published: July 2017

Objective:

To ex am ine the lipid lev els in a sam ple of pa tients with comorbid gen er al ized anx i ety dis or der (GAD) and ma jor d epres sive dis or der (MDD).

Methods:

Se rum lipid con cen tra tions were ex am ined in 40 pa tients with both GAD and MDD, in 27 pa tients with MDD only, in 26 pa tients with GAD only, and in 24 healthy con trol sub jects.

Results:

All mean se rum cho les terol con cen tra tions are pre sented in Ta ble 1. The mean se rum to tal cho les terol con cen tra tion in pa tients with both GAD and MDD was sig nif i cantly higher than in MDD-only pa tients, GAD-only pa tients, and con trol sub jects. The triglyceride con cen tra tion was also sig nif i cantly higher in pa tients with both GAD and M DD than in MDD-only pa tients, GAD-only pa tients, and con trol sub jects. Pa tients with both GAD and MDD had a lower mean high-density li po pro tein cho lesterol (HDL-C) con cen tra tion than did pa tients with GAD only and con trol sub jects. The se rumcon cen tra tion of low-density li p opro tein cho les terol (LDL-C) was higher in pa tients with both GAD and MDD than in pa tients with MDD only and GAD only and healthy con trol sub jects.

Conclusions:

Our find ings in di cate that the pa tients with both GAD and MDD have in creased se rum cho les t erol, triglyceride, and LDL-C and re duced HDL-C lev els. These pa tients may have a greater risk of mor tal ity from cor o nary ar tery dis ease (CAD) than do pa tients with ei ther de pres sion or anx i ety dis or der.
Validation of French- and English-Canadian Versions of the Social Cue Recognition Test
Authors: Beaupré Mar tin G , King Su zanne , Bauer Isabelle , Hess Ursula , Debruille Jacques-Bruno , Cor ri gan Pat rick W
Published: July 2017

Objective:

Our pri mary ob jec tive was to cre ate and vali date the So cial Cue Rec og ni tion Test-C (SCRT-C), a Ca na dian test com pa ra ble with the origi nal SCRT.

Method:

We ad min is tered the SCRT-C and the origi nal SCRT to 111 nor mal un der graduate stu dents.

Results:

In our sam ple, the re li abil ity and va lid ity of the SCRT-C were mod er ately high and simi lar to those found with Cor rigan's SCRT. The re sults also sug gest that the Eng lish and French ver sions of the Ca na dian SCRT are equiva lent.

Conclusions:

The SCRT-C is an ap pro pri ate in stru ment for as sess ing so cial cue rec og n ition in emo tional con texts.
“Cade's Disease” and Beyond: Misdiagnosis, Antidepressant Use, and a Proposed Definition for Bipolar Spectrum Disorder
Authors: Ghaemi S Nassir , Ko James Y , Goodwin Fred er ick K
Published: July 2017

The diagnosis and treatment of bipolar disorder (BD) has been in con sis tent and frequently mis under stood in re cent years. To identify the causes of this problem and suggest possible solutions, we under took a critical review of studies concerning the nosology of BD and the effects of antidepressant agents.

Both the under diagnosis of BD and its frequent mis diagnosis as unipolar major depressive dis order (MDD) appear to be problems in patients with BD. Under diagnosis results from clinicians' in adequate under standing of manic symptoms, from patients' im paired in sight into mania, and especially from failure to involve family members or third parties in the di agnostic process.

Some, but by no means all, of the under diagnosis problem may also result from lack of agreement about the breadth of the bipolar spectrum, beyond classic type I manic-depressive illness (what Ketter has termed “Cade's Dis ease”). To alleviate confusion about the less classic varieties of bipolar illness, we propose a heuristic definition, “bipolar spectrum disorder.” This diagnosis would give greater weight to family history and antidepressant-induced manic symptoms and would apply to non-type I or II bipolar illness, in which depressive symptom, course, and treatment response character is tics are more typical of bipolar than unipolar illness.

The role of antidepressants is also controversial. Our review of the evidence leads us to conclude that there should be less emphasis on using antidepressants to treat per sons with this illness.
The Neurobiology of Bipolar Disorder: Focus on Signal Transduction Pathways and the Regulation of Gene Expression
Authors: Bezchlibnyk Yarema , Young L Trevor
Published: July 2017

Objective:

This article presents an overview of signal transduction path ways and re views the re search under taken to study these systems in clinically relevant samples from patients with bipolar disorder (BD).

Method:

We re viewed the published findings from studies of post mortem brain tissue and blood samples from patients with BD.

Results:

Al though the ex act biochemical abnormalities have yet to be identified, the presented findings strongly suggest that BD may be due, at least in part, to abnormalities in signal transduction mechanisms. In particular, altered levels or function, or both, of G-protein a subunits and effector molecules such as protein kinase A (PKA) and protein kinase C (PKC) have consistently been associated with BD both in peripheral cells and in post mortem braintis sue, while more re cent studies implicate disruption in novel second-messenger cascades, such as the ERK/MAPK path way.

Conclusions:

De spite the difficulties inherent in biochemical studies of clinically relevant tissue samples, numerous investigations have illuminated the signal transduction mechanisms in patients with BD. These studies also suggest that BD may be due to the interaction of many abnormalities. In this con text, novel techniques enabling the study of gene expression promise to assist in untangling these complex interactions, through visualizing the end result of these changes at the level of gene transcription.
Major Depression and its Association with Long-Term Medical Conditions
Authors: Gagnon Lisa M , Pat ten Scott B
Published: July 2017

Objective:

To replicate previously re ported as sociations between major depressive episodes (MDEs) and long-term medical conditions in a Canadian community sample.

Methods:

A sample of 2542 house hold residents was selected using random digit dialing (RDD). Data were collected by tele phone in ter view. The Composite International Diagnostic In ter view (CIDI)-Short Form for major depression (CIDI-SFMD) was used to identify MDEs occurring in the previous 12 months. Long-term medical conditions were identified by self-report.

Results:

The prevalence of MDE was elevated in those subjects who re ported 1 or more long-term medical conditions. The association was not due to con founding by age, sex, social support, or stressful recent life events.

Conclusion:

This study replicates a previously re ported as sociation between depressive disorders and long-term medical conditions. These cross-sectional associations suggest that medical conditions may increase the risk of major depression or that major depression may in crease the risk of medical conditions. Alternatively, comorbid medical conditions may influence the duration of depressive episodes, or vice versa. These explanations are not mutually exclusive.
Advances in Psychotherapy Education
Authors: Ravitz Paula , Silver Ivan
Published: July 2017

Acquiring expertise in psychotherapy is central to the professional development of psychiatrists able to employ a broad therapeutic repertoire in their clinical practice. This article reviews how postgraduate psychiatry programs address this important aspect of training. We present the results of a national survey of psychotherapy education in Canadian psychiatry residency programs. The results highlight significant advances over the past decade in curriculum, in teaching methods, and in evaluation. These include training in evidence-based, manualized, time-limited therapies such as cognitive-behavioural and interpersonal therapy, greater attention to evaluating competence, and integrating electronic technology. Trends and advances in postgraduate and continuing medical psychotherapy education programs are considered in association with principles of adult learning. Health education research endorses the provision of longitudinal training programs that integrate learning and practice. We discuss issues related to the development of expertise, the importance of educational communities of practitioners, and the importance of attending to both educational process and outcomes, with a view to more effectively translating psychotherapy practice guidelines into sustained improvements in practice behaviours.
Comparisons between the South Oaks Gambling Screen and a DSM-IV—Based Interview in a Community Survey of Problem Gambling
Authors: Cox Brian J , Enns Murray W , Michaud Valerie
Published: July 2017

Objective:

To directly compare 2 forms of assessment for determining gambling problems in a community survey, and to examine the characteristics of respondents who endorsed DSM-IV symptoms but who scored below the formal DSM-IV diagnostic cut-off for pathological gambling.

Method:

We interviewed 1489 Winnipeg adults by phone (response rate 70.5%) using the South Oaks Gambling Screen (SOGS), a DSM-IV–based instrument, and several gambling-related variables.

Results:

The lifetime prevalence of “probable pathological gambling” (according to the SOGS, having a score of ≥ 5) was 2.6%. The SOGS items and DSM-IV symptoms were highly correlated ( r = 0.80), but a score of 5 or more symptoms for a DSM-IV diagnosis produced lower prevalence figures. Comparisons between recreational gamblers (those with no DSM-IV symptoms), subthreshold pathological gamblers (those with 1 to 4 DSM-IV symptoms), and pathological gamblers (those with ≥ 5 DSM-IV symptoms) on a series of gambling-related variables (for example, high use of video lottery terminals) revealed that subthreshold individuals significantly differed from recreational gamblers and more closely approximated the characteristics displayed by pathological gamblers.

Conclusions:

SOGS items show a high degree of association with the DSM-IV clinical symptoms of pathological gambling, but the DSM-IV cut-off of 5 symptoms is more conservative in defining gambling problems. Results support a continuum view of gambling problems in the community. DSM-IV scores of 3 or 4 represent the higher end of the group officially considered diagnostically “subthreshold” and may be important from both a clinical and public health perspective.
Clinical Case Discussion: The Elderly Patient with Psychosis
Authors: Thorpe Lilian , Campbell Barry , Primeau François J
Published: July 2017

Objective:

To present a clinical case of an elderly person with psychosis and to discuss associated diagnostic and treatment issues.

Methods:

A case from 1 of the authors' clinical practices was presented in English and French to several groups of Canadian psychiatrists attending a teaching day on psychosis. Three geriatric psychiatrists acted as facilitators, soliciting the clinical experiences of the participants in the discussion. The authors integrated clinical content from these sessions with results of a Medline search on psychosis in elderly persons.

Results:

The assessment of elderly patients with psychosis is more often than in younger patients by overlying organicity, including delirium due to illness or medication use, dementia, or sensory deficits. Treatment might further worsen cognitive, affective, and functional impairment through adverse effects such as extrapyramidal symptoms (leading to decreased mobility and general functioning), anticholinergic effects (predisposing to delirium), and hypotension (predisposing to falls). Newer antipsychotics with less hazardous side effect profiles have an increasing role, but they must be coupled with psychosocial support to maximize the patient's independent functioning and quality of life after discharge.

Conclusions:

Assessment and treatment of the elderly person with psychosis must consider a wide variety of biopsychosocial variables, seeking to minimize further treatment-related deterioration. Controlled studies of antipsychotics in elderly people must be conducted in a variety of diagnostic situations that reflect their actual use in the community, and information must be propagated effectively among general psychiatrists, family physicians, and geriatric psychiatrists. The role of nonpharmacologic interventions in elderly persons with psychosis is even less well understood and deserves further study.
Assessment and Management of Antipsychotic-Induced Adverse Events
Authors: Cortese Leonardo , Pourcher-Bouchard Emmanuelle , Williams Richard
Published: July 2017

Objective:

To review and discuss the spectrum of adverse events caused by antipsychotic agents that can directly influence the outcome of treatment by interfering with patient acceptance of and adherence to therapy.

Method:

The adverse effects of traditional and second-generation antipsychotic medications were discussed during a series of clinical workshops attended by psychiatrists from across Canada. The various adverse effects of antipsychotic drugs as well as their assessment and management are reviewed.

Results:

Simple techniques for assessing adverse effects such as extrapyrimidal symptoms (EPS) are described. In some cases, adverse effects can be managed by dosage reduction and/or the use of adjunctive therapies such as antiparkinsonian agents and benzodiazepines. However, in some patients dose reduction carries the risk of symptom reemergence, while the commonly used adjunctive medications are associated with adverse effects of their own.

Conclusions:

Treatment-related side effects often require a reduction in dosage or a change in medication. Proper management can help encourage patient compliance and improve the outcome of antipsychotic treatment. The availability of the newer atypical antipsychotics offers another alternative, because they are associated with a much lower incidence of antipsychotic-induced side effects.
Effects of Processing Temperature and Layup on Matrix Cracking
Authors: Brinkman Marco R. , Sarrazin Hugo
Published: July 2017

Tests were performed to assess the effects of processing temperature and laminate layup on matrix cracking. Twelve inches long and one inch wide cross-ply and angle ply coupons made of Fiberite T300/976 graphite/epoxy were tested. Coupons of different layup were cured and postcured at different temperatures. The number of cracks was determined from X-ray pictures. The results showed that the number of cracks depends directly on the maximum temperature reached during processing, and is minimized when the 900 plies are dispersed (not stacked together) in the laminate.
Distribution of Body Stresses in an n-Phase Composite Body: Prior to Outside Loading
Authors: Sharma Rajesh , Parihar K. S.
Published: July 2017

A mathematical analysis is presented to describe the state of stress-strain transmission among the constituents of a composite reinforced with one or more inclusions, prior to outside loading, so as to have an in-depth view of the work proposed in References [1-3] for the investigation of elastic behaviour under external loading. A result for the distribution of surface forces is derived from the analysis which eventually helps in predicting the Young's modulus of a composite reinforced with (n-1) different and discontinuous inclusions.