bluuebunny/crossref_metadata_2025 huggingface dataset:
Supporting lay carers in end of life care: current gaps and future priorities
Authors: Grande G , Stajduhar K , Aoun S , Toye C , Funk L , Addington-Hall J , Payne S , Todd C
Published: March 2009

Informal carers are central to the achievement of end of life care and death at home and to policy aims of enabling patient choice towards end of life. They provide a substantial, yet hidden contribution to our economy. This entails considerable personal cost to carers, and it is recognised that their needs should be assessed and addressed. However, we lack good research evidence on how best to do this. The present position paper gives an overview of the current state of carer research, its gaps and weaknesses, and outlines future priorities. It draws on a comprehensive review of the carer literature and a consensus meeting by experts in the field. Carers’ needs and adverse effects of caregiving have been extensively researched. In contrast, we lack both empirical longitudinal research and conceptual models to establish how adverse effects may be prevented through appropriate support. A reactive, “repair” approach predominates. Evaluations of existing interventions provide limited information, due to limited rigour in design and the wide variety in types of intervention evaluated. Further research is required into the particular challenges that the dual role of carers as both clients and providers pose for intervention design, suggesting a need for future emphasis on positive aspects of caregiving and empowerment. We require more longitudinal research and user involvement to aid development of interventions and more experimental and quasi-experimental research to evaluate them, with better utilisation of the natural experiments afforded by intra- and international differences in service provision.
An unusual cause of insomnia
Authors: Dando N , England S , Ford-Dunn S
Published: March 2009

We report the case of a patient with tonsillar carcinoma, presenting with insomnia and symptoms of obstructive sleep apnoea/hypopnea syndrome (OSAHS), which were exacerbated following an increase in benzodiazepine dose. There is a growing body of evidence describing OSAHS in patients treated for head and neck cancer. However, to our knowledge, there are no reports relating to the population of patients with progressive disease, whose management is palliative. We would advise consideration be given to the possibility of OSAHS in a patient presenting with an oropharyngeal tumour and sleep disturbance and would also suggest caution in the prescription of benzodiazepines and other sedative medication to this group of patients.
An investigation of bupropion substitution for the interoceptive stimulus effects of nicotine
Authors: Wilkinson JL , Carroll FI , Bevins RA
Published: March 2009

Although the exact mechanism that makes bupropion hydrochloride (Zyban®) effective as a smoking cessation aid has not been fully elucidated, studies have found that bupropion and nicotine share behavioural and neurophysiological properties suggesting that bupropion might serve as a substitute for nicotine. In fact, bupropion prompts nicotine-appropriate responding in operant and Pavlovian drug discrimination studies with rats. A majority of the literature examining this substitution pattern has been done with an operant paradigm. The present research extended this literature by further characterising the behavioural and neuropharmacological properties underlying the substitution for a nicotine conditioned stimulus (CS). Examination of the dose—effect function and temporal dynamics of this substitution pattern showed that bupropion (20 mg/kg) produced conditioned responding similar to nicotine (0.4 mg base/kg) (ED50= 9.9 mg/kg) at 15 and 30 min after injection and partially substituted 5 and 60 min post-injection. Bupropion produced a pattern of conditioned responding similar to nicotine during a 60-min extinction test. Additionally, it has been hypothesised that bupropion and nicotine have an overlapping dopaminergic mechanism. We tested the effects of bupropion pretreatment, the nicotine dose—effect function and the ability of dopamine antagonist to block the substitution of bupropion for nicotine. Pretreatment with doses of bupropion that did not substitute for the nicotine stimulus (5 and 10 mg/kg) did not affect nicotine-conditioned responding; pretreatment with 20 mg/kg attenuated nicotine-evoked responding. Pretreatment with the dopamine antagonists SCH-23390 and eticlopride blocked the substitution. Finally, S,S-hydroxybupropion, the major metabolite of bupropion in humans, did not substitute for the nicotine CS.
mCPP: an undesired addition to the ecstasy market
Authors: Bossong MG , Brunt TM , Van Dijk JP , Rigter SM , Hoek J. , Goldschmidt HMJ , Niesink RJM
Published: March 2009

A new ecstasy-like substance, meta-chlorophenylpiperazine (mCPP), has been detected in street drugs in the Netherlands. Theoretically, mCPP possesses the potential to become a non-neurotoxic alternative for methylenedioxymethamphetamine (MDMA), the regular psychoactive substance of ecstasy. Since its introduction on the Dutch market of synthetic drugs, the percentage of mCPP-containing tablets has increased, including both tablets that contain only mCPP and tablets containing a combination of mCPP and MDMA. These tablets occur in many different colours, shapes and sizes and with various logos, making it impossible to distinguish mCPP-containing tablets from regular MDMA tablets. In addition, the reports of users concerning the effects of mCPP are predominantly negative. All these aspects together lead to the conclusion that mCPP is an undesired addition to the ecstasy market from the user’s perspective.
A single high dose of escitalopram increases mismatch negativity without affecting processing negativity or P300 amplitude in healthy volunteers
Authors: Wienberg M. , Glenthoj BY , Jensen KS , Oranje B.
Published: March 2009

Information processing deficits are commonly found in psychiatric illnesses, while at the biochemical level serotonin seems to play a role in nearly all psychiatric disorders. Processing negativity (PN), mismatch negativity (MMN) and P300 amplitude are electrophysiological measures of information processing. The present study was designed to replicate and further extent the results of our initial study on the effects of a low dose of escitalopram (10 mg) on MMN, PN and P300 amplitude. In a randomised, double-blind, cross-over experiment, 20 healthy male volunteers received either a single, orally administered dose of 15 mg escitalopram (a highly selective serotonin reuptake inhibitor (SSRI)) or placebo, after which their PN, MMN and P300 amplitude were assessed. Similar to our initial study with 10 mg escitalopram, 15 mg escitalopram significantly increased MMN, while it did not affect P300 amplitude. In contrast to our initial study, however, the currently higher dose of escitalopram did not increase PN. Results support the view that a broad range of increased serotonergic activity enhances MMN, while the relationship between serotonin and PN seems more complex. The current study does not support a serotonergic involvement in P300 amplitude.
The prevalence of undiagnosed metabolic abnormalities in people with serious mental illness
Authors: Holt RIG , Abdelrahman T. , Hirsch M. , Dhesi Z. , George T. , Blincoe T. , Peveler RC
Published: March 2009

The prevalence of metabolic syndrome is increased 2—3-fold in people with serious mental illness (SMI). Monitoring of physical health in these individuals is poor, despite clear guidance from the National Institute of Health and Clinical Excellence. The aim of this study was to assess the proportion of people with SMI who had been screened for metabolic abnormalities within the previous year and in a further study to assess the prevalence of undiagnosed metabolic abnormalities in people who had not been screened. The notes and computer records of 100 patients with SMI from community and in-patient settings were evaluated. In a subsequent study, the prevalence of metabolic syndrome was assessed in 71 previously unscreened patients. The study was carried out at the psychiatric in-patient and out-patient units in Southampton and Winchester. The frequency of screening and prevalence of the metabolic syndrome as defined by the International Diabetes Federation (IDF) were assessed. There was documented evidence that the following cardiovascular risk factors had been measured in the previous year: blood pressure (32%), glucose (16%), lipids (9%) and weight (2%). In the metabolic abnormalities study, 41 of 71 (58%) patients were found to fulfil the IDF criteria for the metabolic syndrome. Two had previously undiagnosed diabetes. Twelve percent of patients had a greater than 20% risk of a cardiovascular event within the next 10 years. Despite clear guidance and a high prevalence of undiagnosed metabolic syndrome, screening rates for metabolic abnormalities in people with SMI remain low. Improved screening of metabolic complications should lead to better identification and treatment of this clinical problem.
Activation of the JAK-STAT pathway by olanzapine is necessary for desensitization of serotonin2A receptor-stimulated phospholipase C signaling in rat frontal cortex but not serotonin2A receptor-stimulated hormone release
Authors: Singh RK , Jia C. , Garcia F. , Carrasco GA , Battaglia G. , Muma NA
Published: March 2009

Chronic treatment with olanzapine causes desensitization of serotonin 2A receptor signaling. The purpose of the current study was to further understand the mechanisms underlying this desensitization response of serotonin 2A receptor signaling in vivo. We report that desensitization of serotonin 2A receptor stimulated-phospholipase C activity in rat frontal cortex induced by olanzapine is dependent on the activation of the JAK-STAT pathway. Olanzapine treatment for 7 days significantly increased the levels of the regulator of G protein signaling (RGS7) protein, RGS7 mRNA levels, and activation of JAK2 in rat frontal cortex. Pre-treatment with a JAK2 inhibitor AG490, significantly attenuated the olanzapine-induced reductions in serotonin 2A receptor—stimulated phospholipase C activity and prevented the olanzapine-induced increases in RGS7 mRNA and protein levels. In contrast, inhibition of the JAK-STAT pathway with AG490 did not reverse the olanzapine-induced desensitization of the serotonin 2A receptor pathway in the hypothalamic paraventricular nucleus mediating increases in plasma hormone levels. AG490 dose-dependently inhibited serotonin 2A receptor—stimulated oxytocin and corticosterone release. These results suggest that the olanzapine-induced increase in RGS7 expression is mediated by the activation of JAK-STAT and is necessary for olanzapine-induced desensitization of serotonin 2A receptor—stimulated phospholipase C activity in the frontal cortex but not serotonin 2A receptor—stimulated hormone release.
Are depot antipsychotics more coercive than tablets?
Authors: Patel MX , de Zoysa N. , Bernadt M. , Bindman J. , David AS
Published: March 2009

Some clinicians consider depot antipsychotics to be stigmatising, coercive and unacceptable to patients. This cross-sectional study investigated patients’ perspectives of coercion for depot and oral antipsychotics. In all, 72 participants with chronic mental illness on voluntary maintenance antipsychotic medication were interviewed for their views on oral and depot medication and experiences of coercion. The MacArthur Admission Experience (short form) was adapted to explore coercion regarding medication. Mean total coercion levels were higher for those on depot (depot: mean 4.39; oral: 2.80, P = 0.027), as were perceived coercion (2.52 vs 1.73, P = 0.041) and negative pressures subscales (1.17 vs 0.33, P = 0.009). No significant differences were found for the ‘voice’ subscale and affective reactions. Specifically, more participants on depot felt that people try to force them to take medication (30% vs 2%, P< 0.001). Depots were perceived as more coercive than oral antipsychotics. Greater perceived coercion may explain why some consider depots to be a more stigmatising form of treatment. Although forced medication is sometimes required, the experience of coercion should be minimised by giving patients a fair say in treatment decisions, regardless of formulation.
MDMA (ecstasy) use is associated with reduced BOLD signal change during semantic recognition in abstinent human polydrug users: a preliminary fMRI study
Authors: Raj V. , Liang HC , Woodward ND , Bauernfeind AL , Lee J. , Dietrich MS , Park S. , Cowan RL
Published: March 2009

3,4-methylenedioxymethamphetamine (MDMA) users have impaired verbal memory, and voxel-based morphometry has shown decreased grey matter in Brodmann area (BA) 18, 21 and 45. Because these regions play a role in verbal memory, we hypothesized that MDMA users would show altered brain activation in these areas during performance of a functional magnetic resonance imaging (fMRI) task that probed semantic verbal memory. Polysubstance users enriched for MDMA exposure participated in a semantic memory encoding and recognition fMRI task that activated left BA 9, 18, 21/22 and 45. Primary outcomes were percent blood oxygen level-dependent signal change in left BA 9, 18, 21/22 and 45, accuracy and response time. During semantic recognition, lifetime MDMA use was associated with decreased activation in left BA 9, 18 and 21/22 but not 45. This was partly influenced by contributions from cannabis and cocaine use. MDMA exposure was not associated with accuracy or response time during the semantic recognition task. During semantic recognition, MDMA exposure was associated with reduced regional brain activation in regions mediating verbal memory. These findings partially overlap with previous structural evidence for reduced grey matter in MDMA users and may, in part, explain the consistent verbal memory impairments observed in other studies of MDMA users.
Neuronal correlates of visual and auditory alertness in the DMT and ketamine model of psychosis
Authors: Daumann J. , Wagner D. , Heekeren K. , Neukirch A. , Thiel CM , Gouzoulis-Mayfrank E.
Published: March 2009

Deficits in attentional functions belong to the core cognitive symptoms in schizophrenic patients. Alertness is a nonselective attention component that refers to a state of general readiness that improves stimulus processing and response initiation. The main goal of the present study was to investigate cerebral correlates of alertness in the human 5HT2A agonist and N-methyl-D-aspartic acid (NMDA) antagonist model of psychosis. Fourteen healthy volunteers participated in a randomized double-blind, cross-over event-related functional magnetic resonance imaging (fMRI) study with dimethyltryptamine (DMT) and S-ketamine. A target detection task with cued and uncued trials in both the visual and the auditory modality was used. Administration of DMT led to decreased blood oxygenation level-dependent response during performance of an alertness task, particularly in extrastriate regions during visual alerting and in temporal regions during auditory alerting. In general, the effects for the visual modality were more pronounced. In contrast, administration of S-ketamine led to increased cortical activation in the left insula and precentral gyrus in the auditory modality. The results of the present study might deliver more insight into potential differences and overlapping pathomechanisms in schizophrenia. These conclusions must remain preliminary and should be explored by further fMRI studies with schizophrenic patients performing modality-specific alertness tasks.
Acute tryptophan depletion selectively attenuates cardiac slowing in an Eriksen flanker task
Authors: Van der Veen FM , Evers EAT , Mies GW , Vuurman EFPM , Jolles J.
Published: March 2009

In the present study, the effects of transiently lowering central serotonin levels by means of acute tryptophan depletion on measures of cognitive flexibility were examined. Flexible behaviour was measured in an Eriksen flanker task, and cardiac and electro-cortical responses to errors and congruent and incongruent stimuli were measured. The depletion was successful in lowering tryptophan levels and, as expected, it did not affect subjective mood. Depletion did not affect performance and electro-cortical measures and selectively affected cardiac measures. Depletion attenuated cardiac slowing to incongruent flanker stimuli but did not affect cardiac responses to congruent stimuli and errors. The selective effect on cardiac responses as compared to performance and electro-cortical measures was in accordance with earlier findings, as well as the attenuation of cardiac slowing. The selective effect on the cardiac response to incongruent stimuli was unexpected. Detailed analyses showed a close connection to the earlier reported attenuation of the cardiac response to negative feedback, and the effect is explained in terms of reduced anticipation of the feedback stimulus due to enhanced punishment prediction.
Differential Item Functioning Analysis of the Preschool Language Scale—4 Between English-Speaking Hispanic and European American Children From Low-Income Families
Authors: Huaqing Qi Cathy , Marley Scott C.
Published: March 2009

The study examined whether item bias is present in the Preschool Language Scale—4 (PLS-4). Participants were 440 children (3—5 years old; 86% English-speaking Hispanic and 14% European American) who were enrolled in Head Start programs. The PLS-4 items were analyzed for differential item functioning (DIF) using logistic regression and a one-parameter item response theory (IRT) model. The logistic regression analysis identified Auditory Comprehension (AC) Item 35 as having non-uniform DIF. Using IRT, AC Item 55 and Expressive Communication (EC) Items 30 and 31 displayed statistical evidence of DIF. AC Item 55 and EC Item 30 were more difficult for Hispanic children than for European American children, whereas the opposite was true for EC Item 31. These findings did not find strong evidence of cultural bias for the PLS-4 against English-speaking Hispanic children from low-income families.
Addressing Early Learning Standards for All Children Within Blended Preschool Classrooms
Authors: Grisham-Brown Jennifer , Pretti-Frontczak Kristie , Hawkins Sarah R. , Winchell Brooke N.
Published: March 2009

Preschool teachers working in blended classrooms are faced with identifying which children need intensive instruction as well as being responsible for directly linking individualized learning outcomes with state or federal early learning standards. The series of studies presented were designed to illustrate how teachers working in blended preschool programs provided intensive instruction on individual skills that were related to a common early learning standard (i.e., prewriting). Results suggest that embedding intensive instruction during daily activities is not only effective but also efficient given the relatively short amount of time it took for children to acquire individualized skills. Future research should examine interventions that produce effective and efficient results given the constraints imposed by the schedule of publicly funded blended preschools.
How Long Should Acute Anterior Dislocations of the Shoulder be Immobilized in External Rotation?
Authors: Scheibel Markus , Kuke Anika , Nikulka Constanze , Magosch Petra , Ziesler Ottfried , Schroeder Ralf Juergen
Published: March 2009

Background

Immobilization of the shoulder in external rotation has been shown to reduce the risk of recurrence after traumatic anteroinferior shoulder dislocation. It remains unclear how duration of immobilization affects labral coaptation.

Hypothesis

Immobilization of the shoulder in 30° of external rotation for 5 weeks allows better coaptation of the anteroinferior labrum than does an immobilization period of 3 weeks.

Study Design

Cohort study; Level of evidence, 2.

Methods

Twenty-two patients with traumatic anteroinferior dislocation of the glenohumeral joint were included in this study. Patients were divided into 2 groups. Group 1 consisted of the initial 11 patients (mean age, 37.4 years) immobilized for 3 weeks; group 2 consisted of the subsequent 11 patients (mean age, 29.7 years) immobilized for 5 weeks in 30° of external rotation. With use of magnetic resonance imaging, displacement and separation of the glenoid labrum and anterior joint effusion were assessed in different arm positions (internal rotation, neutral rotation, 30° of external rotation, maximum external rotation) within 3 days, 3 weeks, and 5 weeks after reduction.

Results

Displacement and separation of the labrum and anterior joint effusion were significantly less, particularly with maximum external rotation compared with neutral and internal rotation, during the acute magnetic resonance imaging evaluation in both groups (P < .05). No statistically significant differences were found in all parameters comparing internal rotation with neutral rotation, 30° of external rotation, and maximum external rotation in both groups after 5 weeks (P > .05). No statistically significant differences were found between both groups comparing the results of the measured variables during the acute, 3-week, and 5-week magnetic resonance imaging examinations (P > .05).

Conclusion

Immobilization of the shoulder in 30° of external rotation seems to allow a similar coaptation of the glenoid labrum, regardless of duration of immobilization (3 vs 5 weeks). Clinical trials are needed to evaluate the effect of these results on recurrence rates. The optimum position of immobilization in external rotation has yet to be determined.
Anterior Cruciate Ligament—Injured Subjects Have Smaller Anterior Cruciate Ligaments than Matched Controls
Authors: Chaudhari Ajit M.W. , Zelman Eric A. , Flanigan David C. , Kaeding Christopher C. , Nagaraja Haikady N.
Published: March 2009

Background

Very few studies examining the predisposing anatomical factors leading to anterior cruciate ligament (ACL) injuries have examined the ACL itself, and none of these directly examined the difference in ACL properties between injured and matched control subjects.

Hypothesis

The ACL total volume in people who have experienced a noncontact ACL injury is smaller than that of matched controls.

Study Design

Case control study; Level of evidence, 3.

Methods

Contours of the ACL were manually identified in sagittal magnetic resonance images, and volumes were calculated for 27 contralateral, healthy knees of individuals after noncontact ACL injury and for 27 control subjects matched for gender, height, age, and weight. Validation of this method was performed on 5 porcine knees. Stepwise multiple regression was used to determine the difference in ACL volume between injured and control subjects while considering gender, height, weight, and age as potential covariates.

Results

Contralateral ACL volume for injured subjects was significantly smaller than for noninjured subjects (P = .0208) by 231 mm3 after adjusting for weight, which was also a significant contributor to ACL volume (P < .0001). At the average body mass of 72.7 kg, subjects with a noncontact ACL injury had an average contralateral ACL volume of 1921 mm3, while the corresponding control group had an average volume of 2151 mm3. Gender, height, and age were not significant when weight was included in the regression model.

Conclusion

This study shows that there are anthropometric differences between the knees of subjects with a noncontact ACL injury and those without an ACL injury, suggesting that ACL volume may play a direct role in noncontact ACL injury.
Nonoperative Treatment for Proximal Avulsion of the Rectus Femoris in Professional American Football
Authors: Gamradt Seth C. , Brophy Robert H. , Barnes Ronnie , Warren Russell F. , Byrd J. W. Thomas , Kelly Bryan T.
Published: March 2009

Background

Avulsion of the rectus femoris origin is a rare injury. The only previous report of this injury in professional American football has been limited to the kicking athlete.

Purpose

To describe the incidence and treatment of proximal rectus femoris avulsion in the National Football League (NFL).

Study Design

Case series; Level of evidence, 4.

Methods

The NFL Injury Surveillance System (NFLISS) was reviewed for any proximal rectus femoris avulsion injuries from 1986 to 2006, including the type and mechanism of injury, player demographics, method of treatment, and time to return to play. The NFL team physicians and trainers were surveyed as to their experience with these injuries as well.

Results

A total of 11 cases of proximal rectus femoris avulsion were identified starting in 1997. These injuries occurred in athletes in a variety of positions. All of these were treated nonoperatively, and the mean return to play was 69.2 days.

Conclusion

Rectus femoris avulsions are uncommon injuries in the NFL, occurring about once a year in the entire league (once magnetic resonance imaging facilitated correct diagnosis of these injuries). Conservative treatment of these injuries usually results in return to play after 6 to 12 weeks.

Clinical Relevance

Proximal avulsions of the rectus femoris can be treated nonoperatively with a high degree of predictability for return to full, unrestricted participation in professional American football.
Analysis of Physical and Solvent Transport Behavior of Poly(Ethylene-co-Vinyl Acetate)/Silica Composites
Authors: Priya Dasan K. , Purushothaman E. , Unnikrishnan G.
Published: March 2009

This article deals with the effect of nano silica on the cure, mechanical, solvent transport, dielectric, and thermal behavior of poly(ethylene-co-vinyl acetate) (EVA). X-ray diffraction is used to analyze the composite morphology. The cure time and scorch time of the composite was found to be decreasing with filler content. The mechanical properties of the composites such as tensile strength, hardness, and abrasion resistance increased with filler incorporation. The mechanical properties of the composites have been compared with some of the other EVA composites. The solvent resistance of the composite has also been tremendously improved with filler loading. The overall thermal stability of the composite has been found to be improved with filler loading.
Effects of subchronic methyl tert-butyl ether ether exposure on male Sprague-Dawley rats
Authors: Dong-mei L , Yi G , Chun-tao Y , Yu-feng H , Xiao-dong H
Published: March 2009

Methyl tert-butyl ether (MTBE) is an additive used to oxygenate gasoline to improve air quality by reducing tailpipe emissions of carbon monoxide and ozone precursors. Although several toxicity studies in rats have been conducted to examine the acute, subchronic, and chronic toxicities by employing various routes of exposure to MTBE, few data were available on the effects of MTBE exposure on blood. In this study, MTBE was administered to rats at dose levels of 0, 400, 800, and 1600 mg/kg/day, respectively. After 2- or 4-weeks treatment period, rats were euthanized and blood was collected for the assay of hematological indicators and blood biochemistry indicators. Some organs, including brain, heart, liver, spleen, lung, kidneys, testes, epididymis, thymus, and prostate, were immediately removed and weighed. Possible subchronic health effects of MTBE exposure by gavage were evaluated on mortality, body weight, relative organ weight, hematology, and blood biochemistry indicators in male Sprague-Dawley rats. The results indicated that MTBE did not disrupt the growth rate of rats. Relative organ weight showed change in heart, liver, kidney, testes, thymus, and prostate. In the 2-week treatment, MTBE exerted toxicity on white blood cell count, including lymphocyte, granulocyte, and eosinophil. This finding was especially strong at 1600 mg/kg/day MTBE. In the 4-week treatment, hemoglobin at high dose MTBE significantly increased. The results of the assay for the biochemistry indicators and relative organ weight indicated that MTBE could impair liver and kidney functions and also have adverse effects on lipid metabolism and immune system. It was conducted that subchronic MTBE exposure induced the adverse effects occurring in the relative organ weight, the hematological indicators, and the biochemistry indicators under high MTBE dose.
Pyrethroid and organophosphate insecticide exposure in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine mouse model of Parkinson’s disease: an immunohistochemical analysis of tyrosine hydroxylase and glial fibrillary acidic protein in dorsolateral striatum
Authors: Dodd CA , Klein BG
Published: March 2009

The pyrethroid insecticide permethrin and the organophosphate insecticide chlorpyrifos can experimentally produce Parkinson’s disease (PD)-associated changes in the dopaminergic nigrostriatal pathway, short of frank degeneration, although at doses considerably higher than from a likely environmental exposure. The ability of permethrin (200 mg/kg), chlorpyrifos (50 mg/kg), or combined permethrin + chlorpyrifos to facilitate nigrostriatal damage in the 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP) (30 mg/kg) C57BL/6 mouse model of PD was investigated in three separate experiments. Tyrosine hydroxylase (TH) and glial fibrillary acidic protein (GFAP) immunohistochemistry assessed nigrostriatal degeneration or nigrostriatal damage more subtle than frank degeneration. Four fields in the dorsolateral caudate-putamen were examined at two rostrocaudal locations. The dopaminergic neurotoxin MPTP decreased striatal TH immunopositive neuropil and increased GFAP immunopositive neuropil. Neither permethrin nor chlorpyrifos, alone or in combination, altered the effects of MPTP upon TH or GFAP immunostaining. Permethrin alone increased striatal GFAP immunopositive neuropil but not when combined with chlorpyrifos treatment. Therefore, combined administration of the two insecticides appeared to protect against an increase in a neuropathological indicator of striatal damage seen with permethrin treatment alone. Differences compared with analysis of entire striatum emphasize the value of varying the topographic focus used to assess nigrostriatal degeneration in studies of insecticides in PD.
Effects of subchronic exposure to carbendazim on spermatogenesis and fertility in male rats
Authors: Yu G , Guo Q , Xie L , Liu Y , Wang X
Published: March 2009

The aim of this study is to investigate the effects of subchronic exposure to carbendazim on spermatogenesis and fertility in male rats. Ninety-eight healthy male rats were divided into four groups: three exposure groups and a control group. Carbendazim was administered orally to male rats at 0, 20, 100 and 200 mg/kg for 80 days prior to mating. Each male was cohabited with an unexposed female for a maximum of 5 days. In 100 and 200 mg/kg groups, the mating index was relatively increased, the fertility index was decreased, and the testis weight, the sperm counts and motility were also decreased. The levels of luteinizing hormone (LH) showed a decreasing tendency and there was a statistical difference between the 200 mg/kg group and the control group. There were no obvious effects on the levels of follicle stimulating hormone (FSH) and testosterone (T). Histopathological evaluation showed atrophic seminiferous tubules, decreased germ cells, and increased sloughing of germ cells. Flow cytometric analysis of the testicular tissue revealed that carbendazim inhibited meiotic transformation and interfered with the spermatogenic process. These results suggest that carbendazim has adverse effects on spermatogenesis, resulting in reduced fertility in male rats.
Genotoxicity studies of a desealant solvent mixture, SR-51®
Authors: Oakes DJ , Ritchie HE , Woodman PDC , Narup E , Moscova M , Picker K , Webster WS
Published: March 2009

The Royal Australian Air Force (RAAF) has reported that personnel involved in F-111 fuel tank maintenance were concerned that exposure to a range of chemicals during the period 1977 to mid-1990s was the cause of health problems, including cancer. Particular concern was directed at SR-51®, a desealant chemical mixture containing the following four solvents: aromatic 150 solvent (Aro150), dimethylacetamide, thiophenol (TP), and triethylphosphate. The present study examined the mutagenic potential of SR-51® using a range of well-known mutagen and genotoxin assays. The tests used were i) a modified version of the Ames test, ii) the mouse lymphoma assay, iii) the comet assay (a single-cell gel electrophoresis assay), and iv) a mouse micronucleus test. The modified Ames test used mixed bacterial strains in liquid suspension media. The Ames test results showed that SR-51® (tested up to the cytotoxic concentration of 36 μg/ml, 30 min incubation) in the presence and absence of S9 metabolic activation was not mutagenic. The mouse lymphoma assay used cultured mouse lymphoma cells in a microwell suspension method. The mouse lymphoma assay was also negative with SR-51® (tested up to the cytotoxic concentration of 22.5 μg/ml, 3 h incubation) in the presence and absence of S9 metabolic activation. The Comet assay, using cultured mouse lymphoma cells, showed no evidence of DNA damage in cells exposed up to the cytotoxic concentration of SR-51® at 11.25 μg/ml. The in-vivo mouse micronucleus test was undertaken in wild-type C57Bl6J male mice dosed orally with SR-51® for 14 days with a single daily dose up to 360 mg/kg/day (the maximum-tolerated dose). No increases were observed in micronuclei (MN) frequency in bone marrow collected (24 h after final dose) from SR-51®-treated mice compared to the number of MN observed in bone marrow collected from untreated mice. Tissues collected from treated mice at necropsy demonstrated a significant increase in spleen weights in the high dose mice. Gas chromatography analysis of SR-51® identified more than 40 individual components and an oxidation product, diphenyldisulfide derived from TP under conditions of mild heating. In conclusion, there was no evidence that SR-51® is mutagenic.
Angiocentric Glioma—Induced Seizures in a 2-Year-Old Child
Authors: Fulton Stephen P. , Clarke Dave F. , Wheless James W. , Ellison David W. , Ogg Robert , Boop Frederick A.
Published: March 2009

A 2-year-old child presented with medically refractory seizures and was found to have a right frontoparietal parasagittal angiocentric glioma. Depth electrodes were used to document ictal onset from within the tumor rather than from the surrounding tissues. Ictal activity then spread to a wide area on the cortical surface, including the region around the tumor and hand motor cortex. Lesionectomy permitted sparing of adjacent areas of eloquent cortex, and the child is now seizure-free on monotherapy.
Incidence of Mild Cognitive Impairment and Alzheimer Disease in Southern Brazil
Authors: Lorena Chaves Márcia , Luiza Camozzato Ana , Godinho Cláudia , Piazenski Isabel , Kaye Jeffrey
Published: March 2009

The objective of the study was to evaluate incident cases of Alzheimer disease (AD) and mild cognitive impairment (MCI) in an elderly community cohort in a major city of southern Brazil and to determine the variables associated with the development of cognitive dysfunction. Data were drawn from a cohort to investigate healthy aging among community elderly (N = 345) and were derived from the follow-up for a maximum of 8 years. Sociodemographic, psychiatric and medical information, the Mini-Mental State Examination (MMSE), and the Clinical Dementia Rating scale were obtained in each assessment. The Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition; DSM-IV), NINCDS-ADRDA (National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer’s Disease and related Disorders Association), and the Mayo Clinic criteria were applied to ascertain diagnoses of AD and MCI. The incidence rate per 1000 persons-year for MCI was 13.2 (95% confidence interval [CI] 7.79-20.91) and for AD was 14.8 (95% CI 9.04-22.94). Cognitive dysfunction was associated with education (odds ratio [OR] = 0.86; confidence limit [CL] 0.76-0.97 95%) and baseline MMSE (OR = 0.81; CL 0.70-0.94 95%). The AD incidence in this sample was higher than those reported in a previous Brazilian study. The study filled the epidemiological gap in the evaluation of MCI in Brazil.
Preparing Future Pharmacists for Diabetes Management
Authors: Thurmon Tara B. , Schwartz Lorie L.
Published: March 2009

The Integrated Pharmacy Skills laboratory is a laboratory-based approach to many different aspects of pharmacy education. As diabetes is one of the most common disease states in the United States, it is a primary focus of the educational experience at South University School of Pharmacy. The laboratory experience at South University School of Pharmacy includes the application of diabetes management in a hospital setting, a community setting, and a clinic setting. The class has been developed for the first professional year of a 3-year professional curriculum. Laboratory exercises include calculations, case studies, intravenous preparation, assessment tools, and patient-counseling exercises. The Integrated Pharmacy Skills laboratory provides a practical experience for teaching our future pharmacists about diabetes and diabetes management.
Diabetic Kidney Disease: A Renin-Angiotensin-Aldosterone System Focused Review
Authors: Hite Pamela F. , DeBellis Heather F.
Published: March 2009

Diabetic nephropathy, also referred to as diabetic kidney disease, is a multifaceted complication of one of the largest epidemics in the United States. Diabetic patients currently represent approximately 8% of the US population. Aggressive screening and control of diabetes, hypertension, and dyslipidemia as well as dietary protein restriction are vital to the prevention and management of diabetic kidney disease. Because there are no direct pharmacologic options for diabetic kidney disease, treatment is focused on controlling comorbidities that exacerbate the development and progression of diabetic kidney disease. This article will provide an overview of structural renal alterations during the progression of diabetic kidney disease as well as a concise review of current diabetic kidney disease management guidelines with a focus on agents that affect the renin-angiotensin-aldosterone system. At this point in time, the mainstays of therapy are angiotensin-converting enzyme inhibitors and angiotensin receptor blockers. More research is currently needed to determine if renin inhibitors will have an active role in the management of diabetic kidney disease.
Case Report of SIADH Associated With Escitalopram Use
Authors: Koski Renee R. , Covyeou Jill A. , Morissette Michelle
Published: March 2009

The authors report a case of syndrome of inappropriate antidiuretic hormone (SIADH) associated with the use of escitalopram in an elderly female patient. A 97-year-old white female was admitted to the hospital for a suspected vertebral fracture and hyponatremia. Her serum sodium concentration was 113 mEq/L (113 mmol/L) at admission. She was started on escitalopram 5 mg daily 1 week prior to admission for anxiety. During admission, her laboratory tests revealed serum hyponatremia and hypo-osmolality and urine hyperosmolality and hypernatremia. Her escitalopram was stopped, and she was diagnosed with syndrome of inappropriate antidiuretic hormone. She was treated with hypertonic (3%) saline. She was discharged 1 week later with a serum sodium concentration of 121 mEq/L (121 mmol/L). There have been hundreds of case reports of SIADH associated with selective serotonin reuptake inhibitors (SSRIs), including 5 cases associating escitalopram with syndrome of inappropriate antidiuretic hormone. The median time to onset of SIADH after initiating SSRIs is approximately 2 weeks. Risk factors include advanced age, concomitant diuretic use, low baseline sodium, and low body mass index. Treatment options include fluid restriction, normal saline, diuretics, hypertonic saline, and discontinuing the SSRI. The authors conclude that elderly patients receiving escitalopram or other SSRIs should be monitored carefully for SIADH in the first couple of weeks of treatment and with dose increases, especially if other risk factors are present.
The Relationship of Neighborhood Climate to Perceived Social Support and Mental Health in Older Hispanic Immigrants in Miami, Florida
Authors: Brown Scott C. , Mason Craig A. , Spokane Arnold R. , Cruza-Guet Maria Cristina , Lopez Barbara , Szapocznik José
Published: March 2009

Objective: This study examines the relationship of neighborhood climate (i.e., neighborhood social environment) to perceived social support and mental health outcomes in older Hispanic immigrants. Method: A population-based sample of 273 community-dwelling older Hispanic immigrants (aged 70 to 100) in Miami, Florida, completed self-report measures of neighborhood climate, social support, and psychological distress and performance-based measures of cognitive functioning. Structural equation modeling was used to model the relationship of neighborhood climate to elders' perceived social support and mental health outcomes (i.e., cognitive functioning, psychological distress). Results: Neighborhood climate had a significant direct relationship to cognitive functioning, after controlling for demographics. By contrast, neighborhood climate had a significant indirect relationship to psychological distress, through its relationship to perceived social support. Moreover, social support mediated the relationship between neighborhood climate and psychological distress. Discussion: Findings suggest that a more positive neighborhood social environment may be associated with better mental health outcomes in urban, older Hispanic immigrants.
Activity Restriction Related to Fear of Falling Among Older People in the Colombian Andes Mountains
Authors: Curcio Carmen-Lucia , Gomez Fernando , Reyes-Ortiz Carlos A.
Published: March 2009

Objective: This study examines the associations between activity restriction related to fear of falling and sociodemographic and health factors among people aged 60 and older living in the Colombian Andes mountains. Method: The sample includes 1,668 community-living participants. Outcomes included no fear of falling, fear of falling alone, or activity restriction related to fear of falling. Results: Fear of falling was reported by 83.3%, and of these 52.2% reported activity restriction. Independent factors for activity restriction (vs. fear of falling alone) were low income, functional difficulty, falling or decreasing physical activity, polypharmacy, poor self-perceived health, and depression. Discussion: The prevalence of overall fear of falling and related activity restriction was surprisingly high because this is a physically active population. Participants with activity restriction related to fear of falling have decreased physical activity or functional status, poor self-perceived health, and worse depressive symptoms than those who have fear of falling alone.
Eosinophilic enteritis in association with systemic lupus erythematosus
Authors: Jaimes-Hernandez J , Aranda-Peirera P , Melendez-Mercado CI
Published: March 2009

Eosinophilic gastroenteritis (EGE) is an uncommon disease and has rarely been reported in association with connective tissue diseases as systemic lupus erythematosus. We report a 36-year-old woman who developed recurrent episodes of abdominal pain, nausea, vomiting and melena. Complete blood counts showed elevated eosinophil counts. Ultrasound and CT-scan images studies were significant for bowel wall thickening and ascites. The patient underwent an exploratory laparotomy with a mesenteric biopsy and appendectomy that showed eosinophil infiltration in the muscularis propria, establishing the diagnosis of EGE. The patient developed pleural effusions, with laboratory studies showing haemolytic anaemia, thrombocytopenia, positive antinuclear antibody and anticardiolipin antibodies. The patient was treated with high-dose systemic corticosteroid therapy, with successful resolution of symptoms. Three months later, she developed a new episode of abdominal pain defined as intestinal pseudo-obstruction that was resolved without complications.
Exposure to maternal smoking and incident SLE in a prospective cohort study
Authors: Simard JF , Costenbader KH , Liang MH , Karlson EW , Mittleman MA
Published: March 2009

Current cigarette smoking is a risk factor for SLE, and recent work has demonstrated that early-life smoke exposure was related to the risk of related rheumatic conditions in female children. Therefore, we sought to investigate whether early-life cigarette smoke exposure might be associated with incidence of SLE in adult women. We studied 93,054 Nurses’ Health Study (NHS) and 95,554 NHSII participants free of SLE at baseline who provided information on perinatal exposures. By medical record review, 236 incident SLE cases were confirmed (142 NHS and 94 NHSII) among these women using American College of Rheumatology criteria. We used stratified Cox models to estimate the association of smoke exposure with SLE adjusting for race, birth weight, preterm birth and parents’ occupation. Combined estimates were computed using random effects meta-analytic techniques. Maternal cigarette smoking did not increase the risk of SLE (relative risk (RR) = 0.9, 95%CI: 0.6 to 1.4) nor did paternal smoking during the participant’s childhood (RR = 1.0, 95% CI: 0.8 to 1.3) in combined analyses. Early-life exposure to cigarette smoke due to mothers’ or fathers’ smoking was not associated with increased risk of adult-onset SLE in women.
Systemic lupus erythematosus presenting as hypoglycaemia with insulin receptor antibodies and insulin autoantibodies
Authors: Qing Y , Zhou J-G , Yuan G
Published: March 2009

A 37-year-old man presented with sweating, confusion, palpitations, hunger and tremor of 3 months duration. The symptoms disappeared after ingestion of food. After 3 months, he suffered from irregular fever, arthritis, rash, photosensitivity, and was admitted to the hospital. His antinuclear antibody, anti–double stranded DNA antibody, anti-smith antibody and lupus erythematosus cell phenomenon were all positive. Urine analysis showed albuminuria; his 24-h urine protein was 4.7 g. During hospitalisation, the patient presented with loss of consciousness three times because of hypoglycaemia. His serum insulin level during the hypoglycaemic episode was high at 490–1080 mmol/L (normal range: 6.00–27.00 mmol/L). He had never received an insulin rejection. Both insulin autoantibody and insulin receptor antibody were positive. Investigations confirmed systemic lupus erythematosus (SLE) with autoimmune hypoglycaemia. High-dose of corticosteroids, chloroquine and cyclophosphamide therapy had resulted in remission of hypoglycaemia associated with resolution of circulating antibodies to insulin and insulin receptor, and improvement in clinical and laboratory features of SLE.