bluuebunny/crossref_metadata_2025 huggingface dataset:
20 Electrogastrography is of limited value in the diagnosis of motility disorders
Authors: ABID S , LINDBERG G
Published: May 2006

Background:  Electrogastrography (EGG) is a technique for recording gastric myoelectric activity. Conflicting results were obtained in previous studies when EGG was applied in motility disorders of the stomach associated with various systemic diseases.

Aim:  To investigate whether the underlying diagnosis could be predicted from EGG parameters.

Material and methods:  This is a retrospective analysis of patients with motility disorders who underwent EGG as part of their clinical work‐up. A single bipolar channel measured the EGG. The ability of EGG to identify diagnostic groups was tested by comparing 21 EGG parameters for each diagnostic group or symptom against all other patients in the sample.

Results:  A total of 151 patients, 125 (83%) females, and mean age 45 ± 14 years were analysed. There were 52 patients with irritable bowel syndrome (IBS), 22 with enteric dysmotility, 26 with slow transit constipation (STC), 11 with chronic intestinal pseudo‐obstruction (CIP), 13 with gastroparesis or functional dyspepsia, three post‐surgical, and 24 patients with other diagnoses. In general, the discriminatory power of EGG for underlying motility disorder was low. Only those with STC showed a reasonable number of differences in EGG parameters compared to all other groups (Table). Patients with IBS had lower fasting and postprandial variability of the dominant frequency (DF) and a higher percentage of postprandial time with normogastric DF.

Conclusion:  The ability of EGG to identify motility disorders as well as symptoms in general was poor. EGG findings in patients with STC require validation.

 Significant EGG variables in slow transit constipation (STC)

EGG parameter
STC (n = 26)
Other diagnosis (125)

Postprandial normal power (Log)
3.7 ± 0.4
4.0 ± 0.5

Postprandial tachygastria power (Log)
3.5 ± 0.4
3.7 ± 0.4

Postprandial bradygastria% median and range
 2 (0–20)
 0 (0–17)

Postprandial normal% median and range
87 (56–100)
96 (0–100)

Postprandial tachygastria% median and range
 9 (0–33)
 3 (0–100)

Postprandial DFIC% median and range
26 (8–72)
18 (2–77)

Postprandial period dominant power PDP (Log)
2.1 ± 0.6
2.4 ± 0.5

Power Ratio (Log)
0.2 ± 0.5
0.4 ± 0.5
29 Burn‐induced GI dysmotility in severe burn injury
Authors: SALLAM H , OLIVEIRA H , CHEN JDZ
Published: May 2006

Introduction:  Severe burn injury is known to delay gastric emptying in both animals and humans; however no data are available on its effect on gastric myoelectrical activity (GMA). We aimed at studying the effect of burn injury on GMA as it might contribute to burn‐induced delayed gastric emptying.

Methods:  Surgical implantation of a pair of cardiac pacemaker wires onto the stomach serosa was carried out in 20 adult male Sprague‐Dawley rats. Following recovery, GMA was recorded for 30 min in both fasting and fed conditions. The following day, rats received a sham or a 3rd degree scald burn injury under anesthesia. Proper fluid resuscitation and analgesia were given to all animals. Six hours after sham/burn injury, GMA was recorded for 30 min again in both fasting and fed conditions. A methylcellulose meal was mixed with phenol red (marker), so that the percentage of gastric emptying could be calculated based on the amount of phenol red recovered from the stomach. GMA parameters were computed using previously validated spectral analysis software developed in our laboratory, including dominant frequency/power and percentages of normal slow waves, bradygastria, tachygastria and arrhythmia. The normal slow wave frequency range was 4–6 cycles per min (cpm) in rats, while ≤4 cpm and ≥6 cpm were considered bradygastria and tachygastria respectively. Arrhythmia was established if the slow wave frequency had no specific range.

Results:  1) None of GMA parameters showed any statistical differences in the fasting condition after burn (p > 0.05). 2) Significant changes in GMA with burn were only observed postprandially, including: a decrease in dominant frequency (4.5 ± 0.2 vs. 5.1 ± 0.2, p = 0.002) and in the percentage of normal slow waves (67.2 ± 7.3 vs. 84.5 ± 4.1, p = 0.02) and an increase in the percentage of bradygastria (24.7 ± 6.8 vs. 9 ± 3.9, p = 0.02). 3) The percentage of gastric emptying was decreased after burn to 40.3 ± 6.5 vs. 77 ± 3.2 in previously obtained controls (p = 0.0003); however, it did not correlate significantly to any of GMA parameters before or after burn, whether in fasting or in fed conditions (p > 0.05).

Conclusion:  Severe burn injury impairs both GMA and gastric emptying in rats. However, these alterations are not correlated with each other, suggesting that gastric dysrhythmia is a manifestation of burn rather than the cause of burn‐induced delayed gastric emptying.
31 Effects of test meal on multi‐channel Electrogastrography and autonomic nervous system function in different subtypes of patients with functional dyspepsia
Authors: XU X , SONG Z , DING Z , WANG Z , CHEN X , KE M
Published: May 2006

Previous studies have shown that patients with functional dyspepsia (FD) had significantly lower percentage of slow wave coupling (%SWC) in fasting state. The aim of this study was to utilize MEGG and ANS test to investigate the difference of MEGG parameters and ANS parameters between different subtypes of FD patients and healthy subjects (HS).

Methods:  Sixty‐two patients with the diagnosis of FD were enrolled in this study (16 M, 46 F, mean age: 43 years) and divided into dysmotility‐like FD group (15 M, 35 F, mean age: 42 years) and ulcer‐like FD group (1 M, 11 F, mean age: 46 years) based on Rome II criteria. 50 HS were recruited as control (25 M, 25 F, mean age: 44 years). MEGG were recorded simultaneously with the electrocardiogram (ECG) recording for 30 min in the fasting state and 60 min after a standard 450 Kcal test meal. MEGG parameters included dominant frequency (DF), normal percentage of 2–4 cpm gastric slow waves (%N) and %SWC. ANS parameters included sympathovagal balance LF/HF Ratio, mainly sympathetic activity LF and vagal activity HF.

Results:  (1) Compared with HS, %SWC was significantly lower in ulcer‐like FD group in fasting state (P < 0.05) but not in fed state. No significant difference of %SWC was shown between dysmotility‐like FD group and HS either in fasting state or in fed state. There was no significant difference between the two FD groups and HS in DF and %N neither in fasting state nor in fed state. (2) Compared with HS, LF/HF ratio and LF were significantly lower and HF was significantly higher in fasting state in dysmotility‐like FD group (P < 0.05), this difference was abolished by test meal in the 1st 30 min fed state and the lower LF and higher HF were present in the 2nd 30 min fed state again in dysmotility‐like FD group. There was no significant difference between ulcer‐like FD group and HS in any of those ANS parameters either in fasting state or in fed state.

Conclusions:  Gastric slow wave coupling was abnormal in patients with ulcer‐like FD. Patients with dysmotility‐like FD had abnormal ANS function in fasting state and test meal could only correct the abnormal ANS for short time, which suggest that different subtypes of FD may have different patterns in ANS test.
32 How common is rapid gastric emptying in gastroparesis? Comparison of area under the curve, total gastric emptying and 1‐hour values in patients and normal volunteers
Authors: ABELL TL , STARKEBAUM W , ABIDI N
Published: May 2006

Introduction:  Rapid gastric emptying has been described not only in patients with nausea and vomiting and gastroparesis but also in obesity and dyspepsia. We investigated the use of three measures of rapid gastric emptying in a large group of patients with gastroparesis as compared to normal controls.

Patients:  From a pool of 214 consecutive patients with the symptoms of gastroparesis we reviewed the results of standardized solid gastric emptying tests and compared the results to a group of normal controls as previously described (AJG 95: 1456‐14622000). Patients were 39 males, 175 females mean age 42 years, with diagnosis of 42 Diabetes Mellitus, 26 Post Surgical and 146 Idiopathic diseases.

Methods:  Gastric emptying was compared by three models: Area under the emptying curve (AUC, rapid < 0.257), total gastric emptying (TGE: the sum of 1, 2 and 4 hours; rapid < 47), and percentage remaining at 1 hour (<37%) for rapid and/or at 4 hours (>10%) for delayed emptying, using data and techniques previously described (AGJ2004; 99: S45 and NGM 2005; 17: 470).

Results:  Measurable gastric emptying could be determined for 4 hours emptying in 146 patients; 87 patients had complete 1, 2 and 4 hours emptying. 44 patients had delayed emptying by 4 hour% >10%, seven patients (8%) had rapid gastric emptying by AUC and eight pts (9%) had rapid emptying by the TGE values; and 16 (18%) pts had rapid emptying by the 1 hour value alone.

Conclusion:  Rapid gastric emptying of a solid meal is not uncommon in patients with the symptoms of gastroparesis. The AUC and TGE models identified approximately the same number of patients with rapid emptying, while the 1‐hour model identified approximately twice as many patients. Using the three techniques described to determine rapid gastric emptying awaits prospective use in other patients, including dyspepsia and obesity. Standardized measure for rapid gastric emptying may be useful in evaluating therapeutic outcomes for these disorders.
37 Autonomic nervous system response to a solid meal in healthy children: its relation to gastric myoelectrical activity
Authors: LIN Z , FRIESEN CA , SCHURMAN JV , ANDRE L , ZHO B , MCCALLUM RW
Published: May 2006

Electrogastrogram (EGG) is a measurement of gastric electrical activity using cutaneous electrodes. Autonomic nervous function is an important modulator of gastric activity, but little is known regarding its relation with the EGG parameters. The aims of this study were to investigate the patterns of myoelectrical and autonomic activities both in the fasting and in the fed state and their correlation in healthy children.

Methods:  Simultaneous recordings of EGG and electrocardiogram were performed in 28 healthy children (13 M, 15 F, mean age: 12.4 years, range: 8–17) for 30 min in the fasting state and 60 min after a solid test meal. Spectral analysis was performed to compute EGG parameters and their postprandial changes. The autonomic activity was assessed based on spectral analysis of the heart rate variability (HRV) signal which was derived from the electrocardiogram. Data are presented as mean ± SE.

Results:  The solid meal resulted in a postprandial increase in the EGG dominant frequency (2.92 ± 0.08 cpm vs. 3.16 ± 0.07 cpm, P < 0.05), dominant power (46.9 ± 0.8 dB vs. 53.7 ± 1.5 dB, P < 0.05), and percentage of normal slow waves (81.9 ± 2.0% vs. 89.0 ± 2.0%, P < 0.05). Spectral analysis of HRV revealed that sympathetic activity primarily associated with power in the low‐frequency band of HRV (LF) was increased in the postprandial state (0.34 ± 0.02 vs. 0.43 ± 0.03, P < 0.05). The parasympathetic activity primarily associated with power in high‐frequency band of HRV (HF) was significantly higher in the fasting state (0.66 ± 0.02 vs. 0.58 ± 0.03, P < 0.05). The sympathovagal balance associated with the LF‐to‐HF ratio was much higher in the postprandial state (0.56 ± 0.05 vs. 0.90 ± 0.13, P < 0.05). Moreover postprandial LF was positively and HF was negatively correlated with the postprandial increase in EGG dominant power (r = 0.39; P = 0.04, respectively).

Conclusions:  The solid meal resulted in a significant increase in EGG dominant frequency, dominant power and percentage of normal slow waves as well as sympathovagal balance in healthy children, suggesting that both vagal and sympathetic pathways are involved in modulation of gastric myoelectrical activity.
40 Gastric electrical stimulation for adolescents with intractable nausea and gastroparesis
Authors: ISLAM S , GOSCHE JR , ABELL TL
Published: May 2006

Purpose:  Gastric electrical stimulation (GES) has been performed in adults as a treatment for refractory nausea and vomiting, in patients who have failed medical treatment. It has not been systematically applied to individuals less than 18 years old with this problem.

Methods:  Six patients, one male, five female with chronic nausea and vomiting with a mean age of 15 years (range 13–18), were evaluated with gastric emptying studies and cutaneous electrogastrograms (EGG) for temporary GES. All patients had idiopathic gastroparesis. Five patients subsequently underwent placement of a permanent GES device ‐ four were done laparoscopically and one was open. Each patient had an intra operative EGG and in three patients, seromuscular biopsies from the stomach or jejunum were obtained as well. Symptoms were recorded at baseline, after temporary pacing and then after permanent pacing using a Likert scale (0–4 for each symptom with a total of 5 symptoms). Statistical analysis was performed using a paired student's t test and a value of <0.05 was considered significant.

Results:  At baseline, all patients were symptomatic and most had delayed solid gastric emptying and abnormal EGG. As a group, there was a significant improvement in nausea (3.4 ± 0.4–1.7 ± 0.3, p = 0.005), and combined symptoms score (11.3 ± 2.0–5.0 ± 1.5, p = 0.02). Gastric emptying and EGG values also improved. Biopsy was abnormal in 2 of 3 patients, showing diminished and abnormal Cajal cells in the two patients who had less improvement long term. Follow up ranged from 1–20 month, with an average of 9 month.

Conclusions:  GES can be successfully applied to adolescents with intractable nausea and gastroparesis symptoms. The role of the cells of Cajal in enteric motility needs investigation. Long term efficacy of this therapy in children needs to be established.
41 Temporary gastric electrical stimulation and the EGG: the SENSA phenomenon.
Authors: ABELL TL , MINOCHA A , ABIDI N
Published: May 2006

Introduction:  We previously reported that temporary gastric electrical stimulation (GES) is associated with an increase in EGG frequency (IEGGS 2005). We now report further on this phenomenon, which we have labeled Submucosal Enteric Nervous System Activation or SENSA.

Patients:  We studied 121 patients (18 m, 103 f, mean age 39 years with dx: 71 Idiopathic, 37 diabetes mellitus and 13 post‐surgical disorders) who underwent temporary endoscopic GES. All patients had complete data for baseline cutaneous EGG (Base) and a repeat cutaneous EGG (Temp) after 3 day of temporary GES.

Methods:  Patients had cutaneous EGGs at baseline and again after temporary GES, performed with high‐frequency, low‐energy stimulation parameters, as previously described (GIE, 2005). Temporary GES mucosal electrode placement was near the submucosal plexus, confirmed by endoscopy. EGGs, performed at a standard time in relation to a low‐fat meal, were reported as average frequency (F, in cpm), were compared by t‐tests with baseline, reported as mean ± SE.

Results:  For the whole group EGG done with Temporary GES revealed a slight increase in frequency over baseline, but the results were not statistically significant. However, when stratified at baseline as Low (average F < 3.3) or High (≥3.3) a number of differences were present: the patients with Low EEG increased significantly (2.7 (0.1) at Base to 4.5 (0.2) with Temp , p = 0.001) but not for high EGG (4.7 (0.1) to 4.4 (0.1), p = 0.67). See the results detailed in the table below.

Conclusion:  The occurrence of the phenomena of Submucosal Enteric Nervous System Activation (SENSA) appears dependent on the characteristics of the baseline EGG. As with gastric emptying, careful characterization of baseline values is important when reporting the effects of GES on the EGG. The SENSA phenomena, when occurring, may give important clues to the mechanisms involved in the beneficial effects of temporary gastric electrical stimulation.

Group
All
Low
DM Low
ID Low
PS Low
High
DM High
ID High
PS High

Base
4.3 (0.1)
2.8 (0.1)
2.8 (0.1)
2.8 (0.1)
2.1 (0.7)
4.7 (0.1)
4.4 (0.2)
4.8 (0.2)
4.7 (0.3)

Temp
4.4 (0.1)
4.5 (0.2)
3.8 (0.3)
5.3 (0.6)
6.0 (0.1)
4.3 (0.1)
4.4 (0.4)
4.9 (0.3)
4.9 (1.7)

p value
>0.05
0.001
<0.05
<0.05
<0.05
0.67
>0.05
>0.05
>0.05
43 Gastric Electrical Stimulation in Severe Gastroparesis – The Scottish Experience
Authors: GRAY J , FULLARTON GM
Published: May 2006

Introduction:  Gastroparesis (GP) is a common complication of type 1 and 2 diabetes affecting up to 50% of the diabetic population. In severe cases diabetic gastroparesis (DGP) may be profoundly disabling with severe GI symptoms, prolonged hospital stay and potentially life‐threatening metabolic upset. Standard management of DGP with dietary changes or drug treatment is unsatisfactory in many patients. The development of gastric electrical stimulation (GES) in drug refractory DGP has been shown to be beneficial in this difficult group of patients. In Scotland GES has only recently been available as a treatment option and we report here our initial experience in both diabetic and idiopathic gastroparesis patients. We have treated 7 patients (5 female), age 30 (21–73) (median, range) over a 3 years period. Of the 7 patients 5 were type 1 diabetics and 2 had idiopathic gastroparesis. All had severe drug refractory GP and 6/7 had required enteral feeding prior to GES implantation. All 7 patients had GES initiated with the Enterra (Medtronic) neural stimulator placed at mini‐laparotomy. No peri‐operative complications were noted. One patient died of unrelated sepsis 6 month post‐implant. GES was initiated with standard parameters (frequency 14 Hz, intensity 5 mA, pulse width 330 μs; cycle on 0.1 s; cycle off 5 s).

All 6 patients who had required enteral feeding pre‐GES had their feeding tubes removed at surgery and have had normal nutritional intake without supplemental feeding after GES [follow‐up 24 month (11–34)].Gastric emptying as assessed by dual phase solid/liquid labeled meals improved in 50% of our patients.

Conclusions:  GES significantly improves the weekly vomiting frequency in patients with GP and avoids the need for enteral feeding. Long‐term GES should be considered as a treatment option in all drug refractory GP patients.

Results (6 months)
PRE
POST
GES

Median (range)

Weekly vomiting frequency
25 (15–35)
4 (1–6)
*p < 0.001

Weight (kg)
49 (44–70)
54 (50–89)
p = ns
6 Effect of a water load test on gastric myoelectrical activity and upper gastrointestinal symptoms in patients with nausea and vomiting of pregnancy
Authors: KOCH KL , GOODWIN TM , ROMERO RJ , LEVINE ME , TISON H
Published: May 2006

Nausea and vomiting of pregnancy (NVP) is a common syndrome in which symptoms predominate in the first trimester of pregnancy. Symptoms range from mild to severe and afflict up to 80% of pregnant women. The underlying mechanisms of NVP remain poorly understood. Provocative gastric function testing has not been performed in these patients.

Aims:  The aim of this study were to determine the effects of the water load test (WLT) on gastric myoelectrical activity, nausea, and other upper gastrointestinal symptoms in pregnant women.

Method:  46 women with NVP were studied prospectively. Gastric myoelectrical activity was recorded throughout the study by electrogastrography (EGG). A 15 min baseline period was followed by a WLT during which patients ingested water until full over a 5 min period. After the WLT, an additional 30 min of EGG was recorded. EGG responses were categorized into four groups: normal (2.5–3.7 cpm), bradygastria (1.0–2.5 cpm), tachygastria (3.7–10.0 cpm), and mixed gastric dysrhythmia (tachygastria and bradygastria). Nausea, bloating, stomach fullness, and abdominal discomfort were recorded before, and 10, 20, and 30 minutes after the WLT on 100 mm visual analogue scales.

Results:  In response to the WLT, 14% of the women exhibited normal EGG responses, while significantly more (86%) exhibited gastric dysrhythmias (p < 0.01). Of the dysrhythmic EGG responses, 57% were tachygastria, 11% were bradygastria, and 18% were mixed gastric dysrhythmia. Patients with tachygastria ingested less water (338 ml) than patients with normal (371 ml), bradygastria (415 ml), or mixed gastric dysrhythmia (394 ml) patterns, but the differences were not statistically significant. 46% of the women reported nausea at baseline; significantly more women (72%) reported nausea after the WLT (p < 0.05). At 20 min after the WLT, a significant, direct relationship was observed between nausea severity and tachygastria (p < 0.05). The other upper gastrointestinal symptoms were not significantly increased by the WLT.

Conclusions:  (1) 86% of the pregnant women in this sample developed gastric dysrhythmias in response to the WLT. (2) Tachygastria was the most common dysrhythmia, and increased tachygastria was correlated with increased nausea. Gastric dysrhythmias are evoked by the WLT in women with NVP, suggesting these dysrhythmias have a pathophysiological role in the mechanism of NVP, and are a target for future therapies.
7 Characteristics of the electrogastrogram in patients with cyclic vomiting syndrome
Authors: NAMIN F , LIN Z , FORAN P , MCCALLUM RW
Published: May 2006

Cyclic vomiting syndrome (CVS) is an unexplained disorder characterized by recurrent attacks of nausea and vomiting. The aim of this study was to investigate the characteristics of gastric myoelectrical activity in patients meeting Rome II criteria for CVS and studied between cycles using cutaneous electrogastrography (EGG).

Methods:  11 patients (6M, 5F, mean age: 31 years, range: 16–60) with CVS (5 symptomatic and 6 asymptomatic at the time of the study) underwent EGG between acute CVS attacks. EGG recordings were made for 30 minutes in the fasting state and for 60 minutes after ingestion of a caloric liquid meal (Boost, 360 kcal). Power spectral analysis methods were used to extract quantitative EGG parameters: EGG dominant frequency/power, change in postprandial EGG power, percentages of normal slow waves (2 to 4 cpm) and dysrythmias including tachygastria (slow‐wave frequency >4 cpm) and bradygastria (slow‐wave frequency <2 cpm) in each recording session. Patients were asked to score their symptoms of nausea, vomiting and abdominal pain (0 = none, 4 = constant) during both pre‐ and postprandial periods. Data are expressed as mean ± SE.

Results:  7/11 demonstrated an abnormal EGG (dysrhythmia >30% in 4 patients and a decrease in postprandial EGG power in 6 patients). 5/11 patients had symptoms (nausea) during EGG recording and all had an abnormal EGG. The major abnormalities of EGG were tachygastria and a decrease in EGG postprandial power change. In comparison with asymptomatic patients at the time of the study, symptomatic patients had significantly more tachgastria (20.4 ± 3.9% vs. 6.7 ± 2.7%, P = 0.01) and significantly less normal slow waves (67.6 ± 2.0% vs. 86.7 ± 2.8%, P < 0.05) in the fed state. The increase in EGG postptandial power in symptomatic patients was also significantly less than asymptomatic patients (­2.55 ± 1.01 dB vs. 1.14 ± 0.54 dB, P < 0.05).

Conclusions:  1) Abnormalities of EGG are presented in CVS between acute episodes and could explain some of the symptoms present; 2) Abnormal gastric myoelectrical activity is part of the spectrum of the CVS patients.
Serum calcium‐independent phospholipase A2 activity in bipolar affective disorder
Authors: Ross Brian M , Hughes Bronwen , Kish Stephen J , Warsh Jerry J
Published: May 2006

Objective:  Phospholipases A2 (PLA2) are a family of enzymes involved in membrane phospholipid metabolism and cell signalling. The gene encoding one form, type VI calcium‐independent phospholipase A2, is located in a region of DNA that may contain a gene important in the aetiology of psychosis. Moreover, the activity of calcium‐independent PLA2 is reported to be elevated in the blood and brain of patients with schizophrenia. In this study we determined whether a similar change takes place in patients with bipolar disorder with and without a history of psychosis.

Methods:  Serum calcium‐independent and ‐dependent PLA2 activities were determined in 24 patients with bipolar I disorder.

Results:  Serum calcium‐independent and ‐dependent PLA2 activities in bipolar cases did not differ significantly from that in healthy volunteers (HVs). However, calcium‐independent PLA2 activity was significantly (p < 0.05) higher in patients with a history of psychosis compared with those with no history of psychosis (by 55%) or to HVs (by 31%).

Conclusions:  Our data suggest that a subset of bipolar I disorder patients with a history of psychosis have elevated calcium‐independent PLA2 activity. Given that this enzyme activity is also increased in schizophrenia, elevated rates of phospholipid turnover mediated by the enzyme could represent a common biochemical feature of psychotic illness.
Maintenance electroconvulsive therapy for recurrent refractory mania
Authors: Nascimento Antonio Leandro , Appolinario José Carlos , Segenreich Daniel , Cavalcanti Maria Tavares , Brasil Marco Antonio Alves
Published: May 2006

Background:  Although there are some reports on the efficacy of maintenance electroconvulsive therapy (mECT) in rapid cycling bipolar disorder there is scant data about the use of mECT in the non‐rapid cycling form of this condition.

Patient and methods:  We report the case of a 45‐year‐old man diagnosed with bipolar affective disorder at the age of 32 who had 5 manic episodes in 6 years. These episodes were severe, required hospitalization and had poor response to lithium carbonate, sodium valproate, carbamazepine, haloperidol and chlorpromazine (either alone or in combination). The patient was treated with electroconvulsive therapy (ECT) during his last hospitalization and since then his treatment has included mECT and chlorpromazine (400 mg/day) and he has remained euthymic during the past 21 months.

Conclusion:  This case describes the utility of mECT in medication refractory bipolar disorder.
Treatment adherence with antipsychotic medications in bipolar disorder
Authors: Sajatovic Martha , Valenstein Marcia , Blow Frederic C , Ganoczy Dara , Ignacio Rosalinda V
Published: May 2006

Objectives:  Atypical antipsychotic medications are a relatively new, increasingly prominent component of the treatment armamentarium for bipolar disorder. Information on adherence with antipsychotics among individuals with bipolar disorder in general, and atypical antipsychotics in particular, is currently quite limited. Using data from the VA National Psychosis Registry, we examined adherence with antipsychotic medications among patients with bipolar disorder (n = 73,964).

Methods:  Antipsychotic medication adherence among veterans with bipolar disorder was evaluated using the medication possession ratio and categorizing patients into three groups: fully adherent, partially adherent and non‐adherent. We compared characteristics of bipolar patients who received versus those who did not receive antipsychotic medication, and also identified predictors of poor adherence with antipsychotic medications.

Results:  Approximately 45% (n = 32,993) of all individuals with bipolar disorder were prescribed antipsychotic medication. Individuals who were prescribed antipsychotic medications were younger and more often had comorbid substance abuse or post‐traumatic stress disorder compared to individuals with bipolar disorder who were not prescribed antipsychotic medication. Just over half (51.9%) of individuals appear to be fully adherent with antipsychotic medications, while 48.1% of individuals are either partially adherent or non‐adherent with antipsychotic medications. Factors associated with treatment non‐adherence were younger age, minority ethnicity, comorbid substance abuse and homelessness.

Conclusions:  Treatment non‐adherence is a major issue for close to half of individuals with bipolar disorder prescribed antipsychotic medication. Additional studies are needed to better understand treatment adherence within the full range of pharmacologic therapies among individuals with bipolar disorder.
Early maternal, genetic and environmental components of antioxidant protection, morphology and immunity of yellow-legged gull (Larus michahellis) chicks
Authors: Rubolini D. , Romano M. , Bonisoli Alquati A. , Saino N.
Published: May 2006

Maternal effects mediated by egg quality are important sources of offspring phenotypic variation and can influence the course of evolutionary processes. Mothers allocate to the eggs diverse antioxidants that protect the embryo from oxidative stress. In the yellow-legged gull (Larus michahellis), yolk antioxidant capacity varied markedly among clutches and declined considerably with egg laying date. Analysis of bioptic yolk samples from clutches that were subsequently partially cross-fostered revealed a positive effect of yolk antioxidant capacity on embryonic development and chick growth, but not on immunity and begging behaviour, while controlling for parentage and common environment effects. Chick plasma antioxidant capacity varied according to rearing environment, after statistically partitioning out maternal influences mediated by egg quality. Thus, the results of this study indicate that egg antioxidants are important mediators of maternal effects also in wild bird populations, especially during the critical early post-hatching phase.
Cultural and PCR‐based detection of Septoria musiva in inoculated hybrid poplar stems
Authors: Weiland J. E. , Stanosz G. R.
Published: May 2006

The fungal pathogen Septoria musiva can be difficult to isolate from cankers that result from its colonization of poplar stems, and its persistence in these cankers has not been well studied. In order to compare cultural and polymerase chain reaction (PCR)‐based assays for detection of S. musiva in cankers, stems of susceptible hybrid poplar clone NC11505 were wounded and inoculated in August 2003. At 8, 16, 24 and 32 weeks after inoculation (October and December 2003, February and April 2004, respectively), 110 inoculated stems (plus controls) were harvested and a semiselective culture medium was used in attempts to detect the pathogen in bark and wood. Six chips of bark and six chips of underlying wood from one half of each canker were incubated on the semiselective medium for 2 weeks until pycnidia and conidia of S. musiva could be identified. The number of positive cankers and positive chips (out of six attempts per tissue per canker) was recorded. The remaining halves of cankers from subsets of 70 inoculated stems (plus controls) of those harvested in October 2003 and April 2004 were tested using a PCR‐based assay. Three chips of bark and three chips of underlying wood were ground, and DNA was extracted and then amplified using S. musiva‐specific primers designed from the internal transcribed spacer (ITS) region of nuclear rDNA repeats. The number of positive cankers and positive chips (out of three attempts per tissue per canker) was recorded. For both assays, the number of positive cankers and the number of positive chips per canker decreased with time. Using either assay, however, the pathogen was still detected from at least 49% of cankers at 32 weeks after inoculation.
Increasing dietary crude protein does not increase the essential amino acid requirements of kittens*
Authors: Strieker M. J. , Morris J. G. , Rogers Q. R.
Published: May 2006

Essential amino acid (EAA) requirements of omnivores and herbivores (e.g. chicks, lambs, pigs and rats) are directly related to the concentration of dietary crude protein (CP). When an EAA is limiting in the diet, addition of a mixture of EAA lacking the limiting one (which increases dietary CP) results in a decrease in food intake and weight gain. This interaction has been referred to as an AA imbalance and has not been studied in depth in strict carnivores. The objectives of these experiments were to examine the effects on growing kittens (2‐week periods) of the addition to diets of a mixture of AA lacking the limiting one. The control diets were at the requirement of the respective limiting EAA (or about 85% of the 1986 National Research Council requirement). In experiment 1, with the dietary EAAs at the minimally determined requirements, the concentration of the essential or dispensable amino acids was increased to determine if CP or an EAA was limiting. Results of growth rates (n = 12) and plasma AA concentrations indicated that tryptophan was limiting, but increased body weight gain also occurred when the concentration of CP was increased as dispensable amino acids without additional tryptophan. Experiment 1 was repeated in experiment 2 using a crossover design. Again, when tryptophan was limiting additional concentrations of dispensable AAs increased body weight gain. This response is the opposite of that in herbivores and omnivores. Experiment 3 consisted of 10 separate crossover trials, one for each of the 10 EAA and examined the effect of two concentrations of dietary CP (200 and 300 g CP/kg diet) on body weight gain of kittens (n = 8) offered diets limiting in each respective EAA. Body weight gain was numerically greater when diets contained 300 g CP/kg than 200 g CP/kg for eight of 10 EAAs (p < 0.05 for only isoleucine and threonine) when each amino acid was limiting. This response is the reverse of that which occurs in chicks, lambs, pigs and rats when an EAA is limiting and dietary CP lacking the limiting EAA is increased. These results indicate that the EAA requirements of kittens are not positively correlated with dietary CP concentrations.
Investigation on the growth of coprophagy‐prevented rats with supplemented vitamin B12
Authors: Sukemori S. , Kurosawa A. , Ikeda S. , Kurihara Y.
Published: May 2006

The growth of coprophagy‐prevented rats was compared under administration of normal levels of vitamin B12 and supplemented amounts. Two experiments in which supplemented amounts of vitamin B12 were administered were conducted under different conditions. Six rats per group were fed under coprophagy‐allowed (conventional feeding) and coprophagy‐prevented conditions respectively. In the first experiment, coprophagy‐prevented rats were fed only feed containing recommended vitamin B12 level and forced fed hydrous faeces, vitamin B12 and folic acid respectively. In the second experiment, coprophagy‐prevented rats were fed AIN‐93G at the recommended vitamin B12 level (25 μg/kg diet), at 100 times the level and at 1000 times the level respectively. Body weight, feed consumption and amounts of each faeces type were determined in both experiments. In a comparison of body weight gain, we learned that coprophagy prevention reduced the values, but that there was no significant difference in the forced feeding group in the first experiment. Similar results were recognized in the second experiment. Vitamin B12 supplementation was not able to raise feed intake significantly and hence it obviously was not a severely limiting factor under the respective experimental condition which depressed feed intake.
Effects of L‐carnitine supplementation in pregnant sows on plasma concentrations of insulin‐like growth factors, various hormones and metabolites and chorion characteristics
Authors: Doberenz J. , Birkenfeld C. , Kluge H. , Eder K.
Published: May 2006

Previous studies have shown that supplementation of sow diets with l‐carnitine increases the body weight of piglets at birth. This study was conducted to elucidate the reasons for this phenomenon. Three experiments with 24 (experiment 1), 40 (experiment 2) and 12 (experiment 3) sows were conducted. In all three experiments, sows were allotted to two groups which had free access to a nutritionally adequate diet. Sows of one group were supplemented with 125 mg l‐carnitine/day during pregnancy; sows of the other group (control group) did not receive l‐carnitine. In experiment 1, plasma samples were collected at day 95 of pregnancy, in experiment 2 plasma samples were collected at days 80 and 100 of pregnancy. In experiment 3, chorions of the sows were collected at parturition. l‐carnitine‐treated sows had higher plasma concentrations of total l‐carnitine than control sows (p < 0.05). The number of piglets born and weights of litter and individual piglets at birth were not different between both groups in all three experiments. l‐carnitine‐treated sows had higher plasma concentrations of insulin‐like growth factor‐I (IGF‐I) on day 80 of pregnancy (experiment 2, p < 0.05) and on day 95 (experiment 1, p < 0.10), and a higher plasma concentration of IGF‐II on day 80 (experiment 2, p < 0.05) than control sows. Moreover, sows supplemented with l‐carnitine had heavier chorions (+22%, p =0.10) with greater amounts of protein (+45%, p < 0.05) and DNA (+38%, p < 0.10) and a higher protein concentration of glucose transporter‐1 (+62%, p < 0.05). Plasma concentrations of 17β‐oestradiol, progesterone and thyroid hormones as well as concentrations of urea and total free amino acids were not different between both groups of sows. Plasma concentrations of non‐esterified fatty acids, ketone bodies, triacylglycerols and cholesterol were also largely indifferent between both groups of sows. In conclusion, this study shows that l‐carnitine has less influence on lipid metabolism and utilization of nitrogen in pregnant sows but increases their plasma concentrations of IGFs. This in turn may enhance development of the placentae and the intrauterine nutrition of the fetuses. This may be the reason for increased birth weights observed in recent studies in sows supplemented with l‐carnitine.
The Bologna Process and the Lisbon Research Agenda: the European Commission’s expanding role in higher education discourse
Authors: KEELING RUTH
Published: May 2006

This article examines the role of the European Union’s Commission in weaving together the Bologna Process and the Lisbon research strategy with its existing educational initiatives to define and disseminate an influential vision of European higher education. The article begins by outlining the Commission’s activities in relation to EU education programmes, the Lisbon research agenda and the Bologna Process. It goes on to examine, in a variety of policy texts, the discourse of European higher education that is supported by, and supporting, these large‐scale policy developments. Whilst the overall coherence and cohesiveness of this emerging discourse can be queried, the article argues that the Commission is drawing effectively on both Bologna and Lisbon to firmly constitute — and reconstitute — higher education as a European policy domain. The article concludes with an analysis of how different educational stakeholders are supported and restricted by the Commission’s views of higher education, as articulated through its ‘hybrid’ Bologna/Lisbon agenda.
The Rise of Global Science and the Emerging Political Economy of International Research Collaborations1
Authors: PETERS MICHAEL A.
Published: May 2006

This article charts the rise of global science and a global science infrastructure as part of the emerging international knowledge system exemplifying a geography of knowledge and the importance of new info‐communications networks. The article theorises the rise of global science, which still strongly reflects a Western bias and is highly nationalistic, in terms of an historical account that sketches three ‘moments’— classical science, colonial science, ‘big’ science. The historical sketch is a basis against which to raise questions about the emerging political economy of international research collaborations.
Involving Users in Social Science Research — A New European Paradigm?
Authors: WICKHAM JAMES , COLLINS GRÁINNE
Published: May 2006

Recent EU social science research programmes have stressed the importance of the ‘user’. Using a study of EU funded social science projects, the article develops a typology of the different forms of user involvement. A case study of a ‘cluster’ of research projects shows that user involvement within projects has significant national variations. This new user involvement could be taken as exemplifying a shift from ‘Mode 1’ to ‘Mode 2’ knowledge production, but this would be exaggerated. Users remain distinct from researchers, the pressure for involvement came from the European Commission and not the users. User involvement can best be understood as an attempt to strengthen the relationship between academic research and civil society through networks rather than through market relations — a move that is now being rolled back by new developments in EU research policy.
The Rise and Fall of the Neo‐liberal University
Authors: DAVIES BRONWYN , GOTTSCHE MICHAEL , BANSEL PETER
Published: May 2006

The rise of neo‐liberal universities over the last 15–20 years has been characterised as an inevitable effect both of globalisation and the associated dominance of capital. In this article we will analyse that rise, seeking to understand how it has come about and its impact on intellectual work. In the final pages of the article we turn towards its fall.
Social support, locus of control, and depressive symptoms in hemodialysis patients
Authors: GENÇÖZ TÜLİN , ASTAN GÜLENDAM
Published: May 2006

This study aimed to reveal how social support and psychological well‐being association might differ with locus of control orientation for chronically ill patients receiving a restrictive and unpleasant medical treatment (i.e., hemodialysis). Data were collected from 104 hemodialysis patients. After controlling for the variance accounted for by gender and duration of dialysis, for patients with internal locus of control, lack of “perceived social support” was found to be associated with depressive symptoms. On the other hand, for patients with external locus of control, the same analysis revealed that lack of “satisfaction from the received social support” was associated with depressive symptoms. Thus, for hemodialysis patients the variables associated with depressive symptoms varied with their locus of control orientations. Furthermore, the present study underlined the importance of considering different aspects of social support while studying with chronically ill patients.
Poverty, Social Exclusion and Social Policy in the Czech Republic
Authors: Sirovátka Tomáš , Mareš Petr
Published: May 2006

This article analyses the pattern of poverty and social exclusion in the Czech Republic and the impact of social policy on this pattern. The analysis is mostly based on data from the Czech Survey on Social Conditions of Households (2001; 27,000 respondents); Eurostat data provide a benchmark for making international comparisons. The poverty rate in the Czech Republic is among the lowest in Europe. On the other hand, material deprivation, as well as concentration of poverty within specific population groups, is high, with the unemployed facing the highest risk of poverty. Social policy measures in effect reinforce this pattern: while the benefit system is highly redistributive and effectively eliminates income poverty among households of employed persons and among pensioners, incomes of persons outside paid employment are protected less effectively. Labour market policy measures are insufficient in scope and inadequate in targeting groups which are facing the highest risk of labour market exclusion and poverty. We argue that although this practice is effective at present, it is not sustainable in the long term.
Density‐dependent foraging behaviour of sheep on alpine pastures: effects of scale
Authors: Kausrud K. , Mysterud A. , Rekdal Y. , Holand Ø. , Austrheim G.
Published: May 2006

Foraging patterns of large herbivores may give important clues as to why their life history varies depending on population density. In this landscape‐scale experiment, domestic sheep Ovis aries were kept at high (80 sheep km−2) and low (25 sheep km−2) population densities during summer in high mountain pastures in Hol, Norway. We predicted an increasing use of less preferred plant species or habitat types with increasing sheep population density. Foraging behaviour was investigated by direct observations of individually marked sheep on different spatial scales, and diet composition was also assessed with microhistological analysis of faecal samples from known individuals. We found that the effects of density on foraging behaviour depended on scale and were only detected at the scale of diet choice. Use of the common grass species Deschampsia flexuosa, which provided the bulk forage (10–65% of the diet), remained constant throughout the season at low densities, but increased significantly over time at high densities. On a coarser spatial scale, neither within vegetation type nor between vegetation types, selection was affected by density, but vegetation type selection differed depending on whether the sheep were grazing or resting. Our study provides evidence of density dependence in foraging behaviour, but only at the finest spatial scale (diet choice).
Interaction between ephrins/Eph receptors and excitatory amino acid receptors: possible relevance in the regulation of synaptic plasticity and in the pathophysiology of neuronal degeneration
Authors: Calò Laura , Cinque Carlo , Patanè Monica , Schillaci Danilo , Battaglia Giuseppe , Melchiorri Daniela , Nicoletti Ferdinando , Bruno Valeria
Published: May 2006

There is increasing evidence that Eph receptors and their transmembrane ligands, named ephrins, interact with glutamate receptors in both developing and adult neurons. EphB receptors interact with proteins that regulate the membrane trafficking of α‐amino‐3‐hydroxy‐5‐methylisoxazole‐4‐propionate (AMPA) receptor subunits, and both ephrins and EphB receptors have been found to co‐localize with N‐methyl‐d‐aspartate (NMDA) receptors and to positively modulate NMDA receptor function. Moreover, pharmacologic activation of ephrin‐Bs amplifies group‐I metabotropic glutamate receptor signaling through mechanisms that involve NMDA receptors. The interaction with ionotropic or metabotropic glutamate receptors provides a substrate for the emerging role of ephrins and Eph receptors in the regulation of activity‐dependent forms of synaptic plasticity, such as long‐term potentiation and long‐term depression, which are established electrophysiologic models of associative learning. In addition, these interactions explain the involvement of ephrins/Eph receptors in the regulation of pain threshold and epileptogenesis, as well as their potential implication in processes of neuronal degeneration. This may stimulate the search for new drugs that might modulate excitatory synaptic transmission by interacting with the ephrin/Eph receptor system.
A novel tricyclic pyrone compound ameliorates cell death associated with intracellular amyloid‐β oligomeric complexes
Authors: Maezawa Izumi , Hong Hyun‐Seok , Wu Hui‐Chuan , Battina Srinivas K. , Rana Sandeep , Iwamoto Takeo , Radke Gary A. , Pettersson Erik , Martin George M. , Hua Duy H. , Jin Lee‐Way
Published: May 2006

The neurotoxicity of amyloid‐β protein (Aβ) is widely regarded as one of the fundamental causes of neurodegeneration in Alzheimer's disease (AD). This toxicity is related to Aβ aggregation into oligomers, protofibrils and fibrils. Recent studies suggest that intracellular Aβ, which causes profound toxicity, could be one of the primary therapeutic targets in AD. So far, no compounds targeting intracellular Aβ have been identified. We have investigated the toxicity induced by intracellular Aβ in a neuroblastoma MC65 line and found that it was closely related to intracellular accumulation of oligomeric complexes of Aβ (Aβ‐OCs). We further identified a cell‐permeable tricyclic pyrone named CP2 that ameliorates this toxicity and significantly reduces the levels of Aβ‐OCs. In aqueous solution, CP2 attenuates Aβ oligomerization and prevents the oligomer‐induced death of primary cortical neurons. CP2 analogs represent a new class of promising compounds for the amelioration of Aβ toxicities within both intracellular and extracellular sites.