bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges Facing Rural Schools: Implications for Gifted Students
Authors: Howley Aimee , Rhodes Megan , Beall Jimmie
Published: July 2017

In this paper, we discuss the implications for gifted students of challenges facing rural schools. We explore 4 challenges with particular relevance to rural schools: (a) declining population, (b) persistent poverty, (c) changing demographics, and (d) ongoing accountability requirements. Recommendations positioned to address these challenges include providing special instruction using distance education, making use of broad definitions of giftedness, making use of various acceleration strategies, and encouraging talented students to plan for meaningful careers in their home communities.
The Meaning of Rural Difference for Bright Rednecks
Authors: Howley Craig B.
Published: July 2017

This essay considers the intellectual engagement of rural people in the context of their schooling. It argues that rural schooling shares the miseducative purposes common to American schooling in general (i.e., purposes associated with sustaining American global economic dominion). It frames rurally appropriate education as an on-the-ground pursuit of rural alternatives in American life, alternatives explained as the engagement of rural ways of being, living, and knowing—alternatives that only a small minority of rural schools currently embraces. The essay applies the insights it develops about intellectual engagement in rural life to school provisions for academically able rural students. Because gifted students demonstrate a high degree of academic aptitude, the recommendations concern engagement with formal literatures about rural ways of being, living, and knowing.
Magnetic Resonance Microscopy of Chemically-Induced Liver Foci
Authors: Johnson G. Allan , Maronpot Robert R.
Published: July 2017

Magnetic resonance imaging (MRI) is a new imaging technique used in clinical diagnosis. This paper describes extension of the technique to basic research applications–specifically detecting and characterizing chemically-induced liver neoplasms and foci of cellular alteration. Two systems have been built that allow spatial microscopic resolution–more than 100,000 x greater than that of earlier efforts. Use of spin-lattice (T1) and spin-spin (T2) relaxation times permits detailed characterization of the tissue.
Use of Rat Liver Altered Focus Models for Testing Chemicals that have Completed Two-Year Carcinogenicity Studies
Authors: Maronpot Robert R. , Pitot Henry C. , Peraino Carl
Published: July 2017

Partial hepatectomy (PH) and neonatal rat short-term liver focus models were used to examine the effects of selected chemicals that had been previously tested in the National Toxicology Program (NTP) 2-yr carcinogenicity studies. C.I. Solvent Yellow 14, monuron, chlorendic acid, and 4-hydroxyacetanilide were tested for initiating and promoting activity in the PH model. Chlorendic acid, 4,4-oxydianiline, 1-amino-2,4-dibromoanthraquinone (ADBAQ), and 4-hydroxyacetanilide were similarly tested in a neonatal rat liver focus model. With the exception of 4-hydroxyacetanilide which was not carcinogenic in the NTP studies, all chemicals tested showed clear evidence of hepatocarcinogenicity. While none of the chemicals showed initiating activity in either the PH or neonatal models, promoting activity, as indicated by increased number, size, or volume fraction of histochemically detected hepatic foci of cellular alteration, was evident for all chemicals with previously demonstrated hepatocarcinogenicity. Liver tumor incidence was documented at 14 months in the PH model and at 300 days in the neonatal model. On the basis of the results obtained from these few chemicals, it is suggested that the use of short-term rat liver focus models may represent a reliable means for identifying chemicals with hepatocarcinogenic potential.
Pathological Implications of Rat Liver Foci and Relevance to Regulatory Decision-Making: Current Status and Future Perspective
Authors: Hayashi Yuzo
Published: July 2017

The purpose of this presentation is to outline regulatory decision-making for carcinogenic chemicals in Japan with special attention to the chemicals found during toxicity testing to cause liver foci in rats.
Hepatocellular Foci–-A Regulator's Gordian
Authors: Moch Ronald W. , O'Neill Timothy P.
Published: July 2017

Recently, the Food and Drug Administration has received several petitions which raise the question of the significance of an increased number of treated rats with foci of hepatocellular alteration. Study pathologists are responsible for defining the diagnostic criteria used in any study to diagnose proliferative changes in the liver. Similarly, study pathologists, based on their observations of the overall liver findings, are responsible for assessing the biological significance of any lesion observed and including their appraisal in the written pathology narrative which should accompany any petition sent to a regulatory agency. Current scientific knowledge regarding the incidence of animals with foci of cellular alteration suggests that the historical control incidence of animals with this change is somewhat less than is currently being observed. While some foci of cellular alteration may progress to neoplastic lesions, it is not possible to unequivocally predict whether carcinogenic activity may be demonstrated, based only on the incidence of animals with foci of cellular alteration. The Food and Drug Administration, for the foreseeable future, will continue to examine the incidence of animals with selected proliferative liver lesions, including foci of cellular alteration, on a case by case basis.
Efficacy of steroids and hyperbaric oxygen on survival of dorsal skin flaps in rats
Authors: Esclamado Ramon M. , Larrabee Wayne F. , Zel Gerald E.
Published: July 2017

This study was designed to determine if steroids improved skin flap survival in rats, and if steroids and hyperbaric oxygen (HBO) showed an additive beneficial effect. Cranially based, 3 × 9 cm dorsal skin flaps were raised in 60 adult rats. All animals received either intramuscular methylprednisolone (30 mg/kg) or an equal volume of intramuscular saline solution placebo 24 hours and 1 hour before, and 24 hours and 48 hours after, flap elevation. Treatment for animals receiving HBO was begun within 5 hours after flap elevation. The regimen consisted of two 90‐minute treatments of 100% oxygen at 2.4 atm separated by 5‐hour intervals of room air per day for 3 consecutive days. The 60 rats were divided equally into four treatment groups, as follows: group A, flap elevation alone (control); group B, flap plus steroids; group C, flap plus HBO; and group D, flap plus steriods plus HBO. Surviving flap length was measured by visual inspection 7 days after flap elevation. The mean surviving flap length for group A was 4.9 cm, for group B it was 6.4 cm, for group C it was 6.7 cm, and for group D it was 6.5 cm. The approximately 30% to 36% improvement in surviving flap length was highly statistically significant (p 0.006) when compared with controls. However, no statistically significant difference was found between the three treatment modalities. These findings indicate that in a rat dorsal skin flap model, perioperative steriods improve skin flap viability, and that steroids alone are as efficacious as HBO and as steroids combined with HBO.
Orbital hemorrhage during ethmoid sinus surgery
Authors: Thompson Robert F. , Gluckman Jack L. , Kulwin Dwight , Savoury Loren
Published: July 2017

Orbital hemorrhage is an unusual complication of ethmoid surgery. A case of intraoperative orbital hemorrhage occurring during a medial maxillectomy and one occurring during a transethmoid sphenoidotomy are presented. The pathogenesis of this potentially serious complication is discussed. A sequential treatment algorithm is presented, consisting of medial orbitotomy, lateral canthotomy and inferior cantholysis, and inferior orbital decompression, along with concomitant medical management with mannitol, acetazolamide, and dexamethasone.
Effect of Klebsiella ozaenae on ciliary activity in vitro: Implications in the pathogenesis of atrophic rhinitis
Authors: Ferguson Jonathan L. , McCaffrey Thomas V. , Kern Eugene B. , Martin William J.
Published: July 2017

Klebsiella ozaenae is a gram‐negative rod that has been isolated with relative frequency from patients with atrophic rhinitis. The relationship of this bacterium to the pathogenesis of atrophic rhinitis is not understood, and whether this bacterium is simply an opportunistic colonizer of the injured nose or the etiologic agent of the disease is unclear. This study was designed to investigate a potential role for bacterially produced cilloinhibition as a mechanism for the pathogenesis of atrophic rhinitis.
The effect of air flow and medial adductory compression on vocal efficiency and glottal vibration
Authors: Berke Gerald S. , Hanson David G. , Gerratt Bruce R. , Trapp Terrence K. , Macagba Carolyn , Natividad Manuel
Published: July 2017

This study used an in vivo canine model to investigate the effects of varying vocal fold resistance by electrically stimulating the recurrent laryngeal nerve while monitoring medial adductory compression of the vocal folds, glottal airflow, and vocal intensity. The effects of increasing airflow on glottal vibration were also examined stroboscopically and by measurement of open quotient. The results indicated that increasing intensity by medial adductory compression was more efficient than by increasing airflow. Increasing airflow produced a significantly greater open quotient and vocal fold vibratory excursion.
Nerve sheath tumors of the paranasal sinuses: Electron microscopy and histopathologic diagnosis
Authors: Hillstrom Robert P. , Zarbo Richard J. , Jacobs John R.
Published: July 2017

Tumors of the nerve sheaths are very unusual. They occur with the highest frequency in the head and neck region, yet only 4% have been found to occur within the paranasal sinuses. Only 40 cases of nerve sheath tumors with direct involvement of the paranasal sinuses have been reported in the world's literature to date. Three new cases of neurofibroma not associated with Recklinghausen's disease and one case of a schwannoma of the frontoethmoid and maxillary sinuses are presented. The clinical, radiographic, and histopathologic features of these lesions will be discussed with emphasis on electron microscopy and immunohistochemical differentiation of these rare and often confusing lesions.
Reduction in the Incidence of Suicide: A Health Gain Objective for the NHS
Authors: Todd Christopher J.
Published: July 2017

Much emphasis is currently being placed on the identification of possible areas of improvement concerning the health of individuals, and therefore, the general population. One health-gain objective under consideration for severe mental illness is the reduction of mortality from suicide. During 1990, 3950 people are known to have taken their own lives in England and Wales and a further 1996 deaths are likely to have been suicides. Although suicide accounts for < 1% of all deaths in the general population, in the 15–44 age group about 10% of deaths are from suicide. It is envisaged that reducing suicide rates will be achieved through the setting of specific national and local targets. This type of approach dictates explicit requirements in outcome, which clearly has implications for the shape of the National Health Service. One problem with using recorded rates of suicide is that suicide is a medico-legal verdict and its use by coroners is influenced by a number of factors. Thus, before rates of suicide can be accepted as indicators of the effectiveness of health services, the validity of the statistics being gathered must be scrutinized. Moreover, the relatively small number of cases that occur each year means that statistical analysis of the data obtained from small areas, such as district health authorities, may be problematic.
Comparison of the relationship between structure and CNS effects for lorazepam, clonazepam and alprazolam
Authors: Ellinwood Everett H. , Nikaido Arlene M. , Gupta Samir K. , Heatherly Douglas G. , Hege Steve
Published: July 2017

Eight healthy young males were administered single doses of lorazepam (4 mg), clonazepam (4 mg), alprazolam (2 mg) or placebo, and their performance on behavioral tasks was monitored for 7 h. Lorazepam and clonazepam impaired performance on subcritical tracking, a primarily neuromotor task, for 2–4 h longer than alprazolam. Although the duration of impairment of the digit symbol substitution task was less discrepant for the three drugs, clonazepam and lorazepam still affected performance for a longer period of time than alprazolam. The rapid development of acute tolerance was indicated by clockwise hysteresis curves for all the drugs on the SCT task and for clonazepam and alprazolam on the DSS task. The maximum effect, effect offset rate and duration of the drug effect are discussed in relation to molecular structure and receptor affinity.
Pre-natal benzodiazepine exposure. III. Lorazepam exposure is associated with a shift toward inverse agonist efficacy
Authors: Byrnes John J. , Miller Lawrence G.
Published: July 2017

Pre-natal exposure to benzodiazepines has been associated with neurobehavioral alterations in human and animal studies. To evaluate effects of pre-natal exposure on subsequent efficacy of benzodiazepine ligands, we exposed mice to lorazepam, 2 mg/kg/day, during days 14–20 of gestation and evaluated offspring at 6 weeks of age using pentylenetetrazol-induced convulsions. Mice exposed to lorazepam were similar to vehicle-exposed and untreated mice in pentylenetetrazol threshold. However, lorazepam-exposed mice had a reduced threshold after an acute dose of lorazepam compared to vehicle-exposed and untreated mice. For the proconvulsant inverse agonist compound FG 7142, threshold was also reduced after pre-natal lorazepam exposure compared to the other treatment groups. These data indicate that pre-natal lorazepam exposure is associated in mature mice with a shift in benzodiazepine efficacy toward the inverse agonist range of the benzodiazepine spectrum.
The discriminative stimulus properties of an ethanol-nicotine mixture in rats
Authors: Gauvin David V. , Holloway Frank A.
Published: July 2017

Sprague-Dawley rats were trained to discriminate between saline (SAL) and an ethanol-nicotine mixture (0.5 g/kg ethanol plus 0.5 mg/kg nicotine) administered 15 min prior to a 15-min drug discrimination training session under a FR-10 schedule of reinforcement. The mixture dose ratio was adjusted after training to obtain a drug mixture with which both individual drugs contributed about equally to the stimulus control (1.0 g/kg ethanol plus 0.3 mg/kg nicotine). The animals were then retrained for 32 sessions using this new mixture. After training, neither nicotine nor ethanol, when tested singly, engendeded > 90% mixture-appropriate responding up to test doses that suppressed responding. Complete generalization occurred when the training doses of either nicotine or ethanol were administered in combination with various doses of the alternate drug element. (+)Nicotine, amphetamine and caffeine engendered dose-dependent increases in responses emitted on the mixture-appropriate lever. Pentobarbital and chloral hydrate only partially generalized to the training mixture. However, depressant/stimulant combinations of chloral hydrate+caffeine and pentobarbital+amphetamine produced complete generalization. The data suggest: (1) drug mixtures are not normally perceived as new entities distinct from their component elements; (2) training dose ratio may influence the characteristics of mixture discriminations; (3) stimulus element saliency may be a factor determining the nature of discriminative control by drug mixture cues; and (4) the ethanol-nicotine cue was most likely based on non-specific depressant/stimulant effects of these drugs.
Intranukleäre und intrazytoplasmatische Glykogenablagerungen in Mastzellentumoren des Hundes
Authors: Weiss E.
Published: July 2017

Intranuclear inclusions of glycogen were detected in 4 of 87 canine mast cell tumours. Intracytoplasmatic accumulations of the same material were found in about 1/3 of all our canine and feline mast cell tumours. Obviously, these inclusions are an expression of the abnormal carbohydrate metabolism of the tumour mast cells. Changes in the permeability of the nuclear membrane are probably necessary for the development of intranuclear glycogen inclusions, whereas the intracytoplasmatic ones obviously can arise on the basis of the disturbed cell metabolism itself, without alteration of the nuclear permeability. The inclusions are not directly related to the viral aetiology of the canine mast cell tumours.
Pathogenesis of Arthritis Induced in Chickens by Mycoplasma gallisepticum
Authors: Da Silva J. M. Lamas , Adler H. E.
Published: July 2017

Gross and microscopic changes of the joint, heart, and brain were studied in chickens infected intravenously with M. gallisepticum (S6 isolate). Synovitis occurred within 3 days, followed by suppurative arthritis at 7 days, and osteomyelitis 5 days later. The pathologic changes were attributed to a severe vasculitis characterized by extensive fibrinoid necrosis and endothelial swelling. Ischemic change was observed in the heart and brain as a result of the acute arteritis.
Pathology of Locoweed Poisoning in Sheep
Authors: Van Kampen Kent R. , James Lynn F.
Published: July 2017

Three locoweeds, Oxytropis sericea, Astragalus pubentissimus, and A. lentigimosus were fed experimentally to yearling wethers for 60 days. Clinical signs were central nervous impairment resulting in diminished control or loss of motor function and proprioception.

Cytoplasmic vacuolar degeneration was a constant finding in the neurons of the central nervous system, and of the plexuses of Auerbach and Miessner. Cytoplasmic vacuoles were also present in reticuloendothelial cells, liver, kidney, and other parenchymatous organs. The contents of the vacuoles was not determined.
Crystals in the Intestinal Epithelium of Neonatal Pigs
Authors: Staley T. E. , Jones E. W. , Corley L. D.
Published: July 2017

Laminated crystalline structures occurred within vacuoles of absorptive intestinal cells in colostrum-fed pigs. They are believed to be bilirubin crystals formed by breakdown of ingested red blood cells, but this could not be substantiated histochemically, and they could not be produced experimentally.
Changes of biological rhythms in primary headache syndromes
Authors: Ferrari Ettore , Canepari Claudio , Bossolo Pier Angelo , Vailati Alberto , Martignoni Emilia , Micieli Giuseppe , Nappi Giuseppe
Published: July 2017

The circadian periodicity of some endocrine (PRL, cortisol, GH) and vegetative (oral temperature, blood pressure) functions has been studied in cluster headache, common migraine, atypical facial pain, and “mixed” headache. Changes in several biological rhythms have been found not only in cluster headache (CH) but also in other kinds of headache. Although a great individual variability of rhythometric changes has been observed, particularly in CH, the dysrhythmic condition seems to be more evident in chronic than in episodic CH. The clinical and chronobiological effects of lithium administration and of a short-term sleep deprivation have been studied in CH.

La périodicité circadienne de plusieurs fonctions biologiques endocriniennes (PRL, cortisol, GH) ou bien végétatives (température orale, tension artérielle) a été étudiée au cours de différents syndrômes de céphalée primaire. Les altérations de plusieurs rythmes biologiques observées soit dans la céphalée en grappe (CH) soit au cours d'autres syndrômes céphalalgiques peuvent être expression de troubles des neuro-médiateurs centrales. On a observé une considérable variabilité individuelle des troubles rythmiques, surtout dans la CH, même si dans la varieté chronique l'on trouve en général un desordre rythmometrique plus important que dans la forme épisodique de la CH. On a étudié aussi dans la CH les effets cliniques et chronobiologiques de l'administration de lithium et de la privation du sommeil pour une nuit.

E’ stato studiato il ritmo circadiano di diverse funzioni endocrine (PRL, cortisolo, GH) e vegetative (temperatura orale, pressione arteriosa) in corso di cefalee primarie. Sia nella cefalea a grappolo (CH) che in altre sindromi cefalalgiche sono state evidenziate diverse alterazioni ritmometriche, probabilmente in rapporto al disordine neurotransmettitoriale cerebrale presente in tali situazioni. I disturbi della ritmicità circadiana di diverse funzioni bio-periodiche presentano una notevole variabilità individuale, soprattutto nella CH. Tuttavia nella forma cronica della CH l'alterazioni disritmica sembra essere più marcata che nella forma episodica. Sono stati infine studiati nella CH gli effetti clinici e cronobiologici del trattamento con lito carbonato e della privazione di sonno per una notte.
On the treatment of migraine. Pharmacokinetic-pharmacodynamic relationships for a programmed release formulation of dihydroergotamine administered orally in the human
Authors: Aylward M. , Davies D. E. , Maddock J. , Robinson P. R. , Jones M.
Published: July 2017

With the combined pharmacokinetic-pharmacodynamic approach, the bioavailability and venoconstrictor effects of two DHE formulations (programmed release capsules and oral solution) have been compared after acute oral dose administrations in the healthy volunteer subjects. The bioavailability of DHE from programmed release capsules has been significantly greater than that shown by the oral solution. DHE capsules formulation has seemed to provide appropriate plasma concentrations for at least 10 h after administration. That may well account for its efficacy in the treatment of morning migraine.

Par les actions pharmacocinétique et pharmacodynamique combinées, la disponibilité biologique et les effets de constricteur veineux de deux formules de DHE (capsules à libération programmée et solution orale) ont été comparé après l'administration d'une dose orale massive sur des sujets volontaires en bonne santé. La disponibilité biologique du DHE des capsules à libération programmée a été plus élevée d'une façon remarquable que celle qui est due à la solution orale. La formule de DHE des capsules parait fournier des concentrations appropriées dans le plasma pendant au moins 10 heures après l'administration. Cela peut mieux expliquer son efficacité dans le traitement de la migraine matinale.

Sono stati confrontati la biodisponibilità e l'effetto venocostrittore di 2 preparazioni di DHE (capsule a liberazione programmata e gocce) dopo una singola dose orale in volontari sani. La biodisponibilità di DHE con le capsule si è mostrata significativamente superiore a quella della preparazione in gocce, formando concentrazioni ematiche adeguate per almeno dieco ore dopo la somministrazione. Ciò spiega l'efficacia di questa preparazione, a liberazione programmata, della DHE nel trattamento dell'emicrania ‘del risveglio’.
Ergot derivatives in the prophylaxis of migraine: a multicentric study with a timed-release dihydroergotamine formulation
Authors: Martucci N. , Manna V. , Mattesi P. , Troiani G. , Manzoni G. C. , Lanfranchi M. , Bono G. , Micieli G.
Published: July 2017

In this multicentric random double-blind study versus placebo, the therapeutic activity of timed-release dihydroergotamine preparation 10 mg/per os/day has been tested in 90 patients affected by common migraine. The drug presented a prophylactic effect on recurrent headache, mainly on night and awakening migraine. A low incidence of side-effects with no weight changes or other effects on physiologic events was registered.

Les résultas obtenus dans cette étude contrôlée, en double aveugle, sur une serie de 90 malades porteurs de ‘migraine commune’, montre que la dihydroergotamine retard est active. Cette substance sembre réellment prévenir les crises du réveil et de la nuit. La tolérance clinique a été exellente.

In questo studio multicentrico in doppio cieco randomizzato versus placebo è stata valutata l'attività terapeutica di una diidroergotamina a liberazione programmata (10 mg/per os/die) in 90 pazienti affetti da emicranie comune. Il farmaco ha dimostrato di possedere un effetto sulle cefalee ricorrenti e soprattutto sulla emicrania notturna e del risveglio. Sono state registrate una bassa incidenza di effetti collaterali e nessuna variazione del peso corporeo e di altri parametri fisiologici.
Long-acting ergot: clinical and neuroendocrinological aspects in migraine patients
Authors: Bussone G. , Boiardi A. , Mantia L. La , Frediani F. , Vescovi A. , Parati E. A.
Published: July 2017

The possible interaction between long-acting ergot and the opiate system has been studied in 12 migraine patients, evaluating the PRL releasing effect of morphine. Our data suggest the integrity of the opiate system in migraine patients and demonstrate that long-acting ergot does not interact with the dopaminergic system. We hypothesize that the effect of ergot on migraine pain may be related to the interaction with non-opiate substances with central analgesic action. Chronic treatment with long-acting ergot significantly reduces the peak of pain intensity of the migraine attack.

Sur un groupe de 12 sujets souffrant de migraine on a étudié l'éventuelle intéraction de ergot à cession programmée sur système opiacé, au moyen d'une série d'études neuro-endocrinologiques, en particulier en prenant comme paramètre l'effect dégageant la PRL d'une stimulation morphinique. Nos donnèes suggèrent l'intégrité du système opiacé chez les patients souffrant de migraine et démontrent que le mécanisme d'action de ergot à cession programmée n'interfère pas avec le système dopaminergique. De cette étude on peut tirer l'hypothèse que l'action de ergot sur le symptòme “douleur” de la migraine est liée à l'interférance avec des substances non opiacées à action analgésique centrale. Du point de vue clinique il a été remarqué un avantage de la thérapie chronique avec ergot encore à cession programmée, avantage tendant à réduire le pic d'intensité douloureuse de l'attaque de la migraine.

E’ stata studiata l'eventuale intearzione dell'ergot a cessione programmata sul sistema oppiaceo su un gruppo di 12 pazienti affetti da emicrania, per mezzo di una serie di studi neuroendocrinologici, in particolare prendendo come parametro l'effetto liberante la PRL della stimolazione morfinica. I nostri dati suggeriscono l'integrità del sistema oppiaceo nei pazienti emicranici e dimostrano che l'ergot a cessione programmata non interagisce con il sistema dopaminergico. Noi ipotizziamo che l'effetto dell'ergot sul sintomo dolore dell'emicrania sia correlato alla interazione con sostanze non oppiacee ad azione analgesica centrale. Da un punto di vista clinico, il trattamento cronico con ergot a cessione programmata riduce in maniera statisticamente significativa il picco d'intensità del dolore nell'attacco emicranico.
Psychological aspects of migraine in childhood
Authors: Lanzi Giovanni , Balottin Umberto , Gamba Nerina , Fazzi Elisa
Published: July 2017

Experimental data indicate that certain unconscious emotions cause modifications of the brain stem neurotransmitters, inducing neurohumoral and vascular changes which underlie the migraine attack in biologically predisposed subjects. The present study investigates, with patient interviews, psychodiagnostic tests (Rorschach, Blacky pictures, Thematic Apperception test, drawings, Wechsler) and parental interviews in 20 pediatric migraine subjects. In 85% of the cases, a condition of repressed anger preceding the attack is seen. In 40% of the subjects, events such as a death in the family, separations, angry quarrels among parents, and scholastic problems, are seen just before onset of the disease. In conclusion, migraine may be considered a psychosomatic disorder, with the phenomenon of pain as a somatic extrinsication of psychological distress.

Les données expérimentales induisent à penser que, chez les sujets biologiquement prédisposés, certains sentiments inconscients causent des modifications des neurotransmetteurs, au niveau du tronc cérébral, telles qu'elles induisent les modifications neuro-humorales et vasculaires qui sous-tendent la crise de migraine. Au cours de cette étude nous avons mené une enquête, au moyen de conversations et de tests psycho-diagnostiques (Rorschach, Blacky Pictures, Thematic Apperception Test, dessins, Wechsler) et d'entretiens avec les parents, sur 20 sujets migraineux en âge évolutif. Dans 85% des cas on découvre une condition de rage réprimée qui pŕecède la crise; dans 40% des sujets, des évènements tels qu'un deuil familial, des disputes graves entre les parents ou leur séparation, des échecs scolaires, etc . . . ont souvent lieu juste avant le début de la maladie. Pour conclure nous pensons que l'on doit considérer la migraine comme une maladie psychosomatique et que le phénomène douleur est un symptôme d'expression somatique de conditions de malaise psychologique.

Dati sperimentali inducono a pensare che, in soggetti biologicamente predisposti, determinati sentimenti inconsci causino modificazioni dei neurotrasmettitori a livello del tronco cerebrale, tali da indurre le modificazioni neuromorali e vascolari che sottendono l'attacco emicranico. Nel presente lavoro si sono indagati con colloqui e tests psicodiagnostici (Rorschach, Blacky Pictures, Thematic Apperception Test, disegni, Wechsler) e coloqui con i genitori, 20 soggetti emicranici in età evolutiva. Nell'85% dei casi si individua una condizione di rabbia repressa che precede l'attacco; nel 40% dei soggetti eventi come un lutto familiare, separazione o gravi litigi fra i genitori, insuccessi scolastici ecc. si verificano appena prima dell'inizio della malattia. In conclusione si ritiene che l'emicrania sia da considerarsi una malattia psicosomatica e che il fenomeno dolore sia un sintomo, ad estrinsecazione somatica, di condizioni di disagio psicologico.
Reliability in headache diagnosis
Authors: Lipton Richard B , Stewart Walter F , Merikangas Kathleen Ries
Published: July 2017

The reliability of headache diagnosis using the criteria of the International Headache Society (IHS) has not been well studied. One definition of reliability refers to the reproducibility of diagnoses assigned to the same individual at different times. Reproducibility of diagnosis should be assessed using different clinicians at different times, with or without specific diagnostic instruments. A diagnosis may be unreliable because of variability in diagnostic criteria, in the clinical information used to assign diagnoses, or in the interpretation and application of clinical information to a given set of diagnostic criteria. Reliable diagnostic methods are essential to the development of valid diagnostic methods, as well as for the identification of headache risk factors, biological markers, and effective treatments. An approach to studying the reliability of the International Headache Society criteria is outlined, modeled after the extensive studies conducted in the area of psychiatric diagnosis.
Migraine headache: Epidemiology and health care utilization
Authors: Stewart Walter F , Lipton Richard B
Published: July 2017

Population-based studies of headache can help inform the development of diagnostic criteria. In population-based studies, migraine has been consistently revealed as a common disabling condition that affects males and females of all ages. From data obtained in a national survey of the United States population, we show that the prevalence of migraine and the frequency of attacks increase as household income decreases. Disability from attacks is not related to income. In contrast, physician diagnosis is more likely as household income increases. Moreover, physician diagnosis is more likely among females, older cases, those more likely to experience disability, and migraine sufferers reporting nausea (males), vomiting, and visual and sensory aura. Analysis of our data leads us to conclude that the symptoms most strongly associated with diagnosis may provide the greatest concern and interest on the part of physicians to make a diagnosis, even though other migraine-related symptoms are more common in the population and in clinical settings. Finally, among migraine sufferers with severe disability, a very large proportion do not receive the benefits of medical diagnosis and treatment. Though most migraine sufferers use OTC medications, given the frequency and associated disability of their migraine attacks, current therapy appears unsatisfactory.
Zolmitriptan (Zomig™, 311C90), a novel dual central and peripheral 5HT1B/1D agonist: An overview of efficacy
Authors: Schoenen J , Sawyer J
Published: July 2017

The efficacy of zolmitriptan (Zomig™, 311C90), a 5-hydroxytryptamine (5HT)1B/1D receptor agonist, in the acute oral treatment of migraine was evaluated in an extensive clinical trial program. Four randomized, placebo-controlled studies (total 2480 patients) were performed; data from two of these trials established that a 2.5 mg dose was on the shoulder of the dose-response curve (2-h headache response rate 64%), showing similar efficacy to the 5 mg dose (67%). In this program, the efficacy of zolmitriptan was not influenced by the pretreatment headache duration; the presence of aura preceding the headache, migraine associated with menses or migraine upon awakening; or by concomitant use of oral contraceptives or antidepressants. In addition, zolmitriptan 5 mg proved consistently effective in the treatment of multiple migraine attacks for up to 1 year. Zolmitriptan reduced the incidence of nausea, photophobia and phonophobia, reduced impairment of normal activity and demonstrated positive effects on patients’ quality of life. Thus, zolmitriptan is a highly effective acute oral antimigraine therapy, with 2.5 mg providing the optimal balance between efficacy and tolerability.
Premenstrual dysphoric disorder and eating disorders
Authors: Verri A , Nappi Re , Vallero E , Galli C , Sances G , Martignoni E
Published: July 2017

Premenstrual Dysphoric Disorder (PMDD) can be differentiated from Premenstrual Syndrome (PMS) by the use of the research criteria provided by the Diagnostic and Statistical Manual (DSM) IV. Indeed, PMS corresponds to mild clinical symptoms, such as breast tenderness, bloating, headache and concomitant minor mood changes, while premenstrual magnification occurs when physical and psychological symptoms of a concurrent axis I disorder get worse during the late luteal phase. Changes in appetite and eating behavior have been documented in women suffering from PMS, with an increased food intake occurring during the luteal phase. Moreover, in women with PMS, a major effect of the phase of the menstrual cycle on appetite has been documented and a high correlation with self-ratings of mood, particularly depression, has been described only in such disturbance. The aim of the present study was to analyse the clinical similarities between PMDD and Eating Disorders (in particular Bulimia Nervosa and Binge Eating Disorder). Thus, we compared the DSM III-R comorbidity, the personality dimensions and the eating attitudes in these patients, attempting to identify any relationship between groups. Twelve PMDD women (mean age 28 years), diagnosed using DSM IV criteria and premenstrual assessor form, were compared with 10 eating disorder (ED) women (6 Bulimia Nervosa, 4 Binge Eating Disorder) (mean age 25 years) and with 10 control women matched for age. The following instruments were used: (i) clinical interview with DSM III-R criteria (SCID); (ii) a psychometric study with TPQ for the evaluation of three personality dimensions (novelty seeking, harm avoidance and reward dependence); (iii) EAT/26 for the evaluation of eating attitudes. Results show that a high comorbidity for mood and anxiety disorders in PMDD and ED is well documented. Our PMDD patients share a 16.6% of comorbidity with ED, whereas such an association is present onlv in 2.3% of the general population. In addition, as a common clue, the personality dimension, harm avoidance, linked to a serotonin mediation is significantly more frequent in PMDD and ED than in normal controls. In conclusion: from the present study it seems clear that a certain degree of similarity exists between the PMDD and ED. However, whether or not these two disorders really share common ground from a physiopathological point of view still has to be clarified by more extensive studies.
Pathophysiological aspects of menstrual migraine
Authors: Benedetto C , Allais G , Ciochetto D , De Lorenzo C
Published: July 2017

We review the role of several biochemical and hormonal factors in menstrual migraine pathogenesis: ovarian hormones, aldosterone circadian rhythm, nocturnal urinary melatonin excretion, sympathetic autonomic system, prolactin levels and dopaminergic function, endogenous opioid tonus, platelet activity and arachidonic acid metabolites. In particular, we focus on certain aspects of platelet function and prostaglandin metabolism, taking into consideration the different behavior of platelet sensitivity to prostacyclin, intraplatelet 5HT, peripheral plasma concentrations of 6-keto-PGF1α and PGE2 in menstrual migraine sufferers and in control subjects during the menstrual cycle. A comprehensive view of the data suggests that a complex impairment of PG and 5HT metabolism, and of platelet function, may play a significant role in the pathogenesis of menstrual migraine. However, it is not yet clear whether these alterations are primary or secondary to neuroendocrine disorders.
The Neuropsychopharmacology of Criminality and Aggression
Authors: Lee Royce , Coccaro Emil
Published: July 2017

Although the idea that aggression has biological components is not a new one, recent research in genetics, neuropsychopharmacology, and neuroimaging has helped clar ify the bi o log i cal con tri bu tions to ag gres sion. Studies to date have fo cused on serotonergic func tion and im pul sive ag gres sion. Re duced lev els of cerebrospinal fluid (CSF) 5-hydroxyindoleacetic acid (5-HIAA) are as so ci ated with im pul sive ag gres sion. Pharmacochallenge stud ies have foun d de creased serotonergic re sponsive ness as so ci ated with im pul sive ag gres sion. Neuroimaging stud ies sug gest a role for the prefrontal cor tex, along with other r egions of the brain, in the ex pres sion of ag gres sion. Se ro to nin is not the only as pect of brain func tion im pli cated in impulsive ag gres sion, and fur ther work is be ing done on other neurotransmitters and neuropeptides.
Managing Schizophrenia during the Stable Phase: Is There Consensus among Practice Guidelines?
Authors: Bhanji Nadeem H , Tempier Ray mond
Published: July 2017

Method:

We per formed a lit era ture search us ing Med line and Psycinfo da ta bases and Goo gle Inter net search en gine.

Results:

We iden ti fied 6 clini cal prac tice guide lines (CPGs). All stress the need for an tipsychotic ther apy and psy cho so cial in ter ven tions. Dif fer ences lie in types of an tipsy chot i cs recom mended, du ra tion of an tipsy chotic trial, man age ment of ex tra py ra mi dal symp toms, and types of psy cho so cial in ter ven tions. Ar eas poorly ad dressed by all guide lines in clude defi n ition of the sta ble phase of schizo phre nia, man age ment of ad verse ef fects with atypi cal agents, man age ment of clo zap ine non re spond ers, and man age ment of per son al ity is sues.

Conclusion:

Pub lished CPGs are help ful in the man age ment of the sta ble phase of schizo phrenia, al though no sin gle CPG se ries ap pears to ad dress all treat ment needs faced by prac tising clinicians.
Seasonal Affective Disorders: Relevance of Icelandic and Icelandic-Canadian Evidence to Etiologic Hypotheses
Authors: Axelsson Jóhann , Stefánsson Jón G , Magnússon Andrés , Sigvaldason Helgi , Karlsson Mikael M
Published: July 2017

Objective:

This study tests the suggestion of earlier studies concerning the importance of genetic factors in the etiology of win ter seasonal affective disorders (SADs) and sub syndromal win ter SAD (S- SAD).

Method:

Two study populations of Winnipeg, Manitoba residents were canvassed: 250 adults of wholly Icelandic de scent and 1000 adults of non-Icelandic de scent. We distributed the Seasonal Pattern Assessment Questionnaire by mail to these 2 populations, yielding 204 and 449 valid responses, respectively.

Results:

Rates of SAD and S- SAD proved markedly lower in the Icelandic population than those in the non-Icelandic population.

Conclusions:

These differences seem unexplained by differences in ambient light or climate, thus indicating that genetic factors contribute to the expression of SADs. Compared with earlier findings from a group of adults of wholly Icelandic de scent living in nearby rural Manitoba, the etiologic importance of as-yet-undetermined environmental factors unrelated to latitude or ambient light is also indicated.
Canadian Psychiatric Inpatient Religious Commitment: An Association with Mental Health
Authors: Baetz Mar i lyn , Larson Da vid B , Marcoux Gene , Bowen Rudy , Grif fin Ron
Published: July 2017

Background:

Research indicates that religion may have a positive effect on coping and possibly enhance clinical outcomes. This study aims to de ter mine the level of religious interest of psychiatric in patients and to assess whether religious commitment has an impact on selected outcome variables.

Methods:

There were 88 consecutive adult patients (50% men) who were admitted to a Canadian tertiary care psychiatry in patient unit and were in ter viewed about their religious beliefs and practices. Patients with a Beck Depression score of 12 or more were included for out come analysis.

Results:

A total of 59% believed in a God who re wards and punishes, 27% had a high frequency of worship at ten dance, and 35% prayed once or more daily. More frequent worship at tenders had less severe depressive symptoms, shorter cur rent length of stay, higher sat is faction with life, and lower rates of cur rent and life time al cohol abuse ( P < 0.05), when com pared with those with less frequent or no worship at ten dance. In contrast, private spirituality was as sociated with lower depressive symptoms and cur rent al co hol use only ( P < 0.05), and prayer frequency had no significant as sociations.

Discussion:

This study indicates that certain religious practices may protect against se verity of symptoms, hospital use, and enhance life sat is faction among psychiatric in patients. This is the first known Canadian study that examines religious commitment among psychiatric in patients.
Antidepressant Side Effects in Depression Patients Treated in a Naturalistic Setting: A Study of Bupropion, Moclobemide, Paroxetine, Sertraline, and Venlafaxine
Authors: Vanderkooy JD , Ken nedy Sid ney H , Bagby R Mi chael
Published: July 2017

Objective:

There is no commonly accepted standard for comparing antidepressant- induced side effects. This study evaluates a clinician- administered scale, the Toronto Side Effect Scale (TSES), in a natural practice clinic.

Method:

We used the TSES to assess side effects in 193 depression patients who completed 8 weeks of treatment with either bupropion, mo clobe mide, paroxetine, ser tra line, or venlafaxine.

Results:

Rates of remission (Hamilton Rating Scale for Depression [HRSD] < 7) did not differ across drugs after 8 weeks of treatment. Paired drug comparisons yielded significant differences in 16 of the 32 side effects. We present differences between pairs of the 5 antidepressants in Central Nervous System (CNS), gastrointestinal (GI), and sexual side effects. A measure of side-effect intensity distinguished paroxetine from the other antidepressants on a measure of sexual dysfunction.

Conclusions:

These results con firm the clinical utility of the TSES as a simple, clinician-administered antidepressant side-effect scale.
Implications of Psychotherapy Research for Psychotherapy Training
Authors: Piper William E
Published: July 2017

This review article considers implications of psychotherapy research for psychotherapy training. It considers 8 themes that characterize the research literature. The themes involve outcome findings, common factors, empirically supported therapies, patient treatment matches, therapy manuals and practice guidelines, brief therapies, combinations of medication and psychotherapy, and group therapies. Each theme represents a controversial issue that has implications for the content of contemporary psychotherapy curricula. To assist trainees in becoming well-informed therapists, themes and implications such as these should be covered as part of their introduction to learning about the psychotherapies. To understand the themes and implications, as well as new findings that continually emerge from the research literature, trainees also need to be familiar with basic research methods and evaluative criteria, subjects that can also be covered as part of their introduction to the psychotherapies. As their training proceeds, research findings can be integrated with the development of their clinical skills in a broad range of psychotherapies.
Improving the Management of Patients with Schizophrenia in Primary Care: Assessing Learning Needs as a First Step
Authors: Toews John , Lockyer Jocelyn , Addington Donald , McDougall Gerald , Ward Richard , Simpson Elizabeth
Published: July 2017

Objective:

To assess family physician learning needs related to the care of patients with schizophrenia.

Methods:

Questionnaires were mailed to all family physicians and general practitioners practising in southern Alberta. Physicians were asked to indicate the number of patients with schizophrenia cared for, their interest in improving the care they provided, their preferred learning methods, and the content they wished to learn.

Results:

A total of 539 surveys were returned for a return rate of 43.8%. Over half of the physicians (53.5%) indicated that they saw 1 to 2 patients with schizophrenia each month. Almost half (48.5%) indicated they were somewhat or very interested in increasing the care provided. Primary learning needs included increasing their knowledge of psychopharmacologic agents and monitoring and adjusting medications. Lectures and half-day workshops were the preferred learning methods.

Conclusion:

Our study was helpful in identifying the types of education that physicians wanted as well as the duration of the programming prior to the development of teaching interventions.
Depressive Symptoms Attributable to Medication Exposure in a Medical Inpatient Population
Authors: Patten Scott B , Williams Jeanne VA , Love Edgar J
Published: July 2017

Objective:

Exposure to certain drugs—angiotensin-converting enzyme inhibitors, β-blockers, calcium channel blockers, corticosteroids, H2 blockers, and sedative hypnotics—may be associated with an increased risk of depression. These drugs are commonly used in inpatient medical therapeutics. Since population attributable risk (PAR) is generally related both to strength of association and to the frequency of exposure to a risk factor, the PAR of depressive symptoms associated with these drug exposures is potentially high. The objective of this study was to estimate the depressive symptoms population attributable risk percent (PAR%) in a medical inpatient population.

Methods:

A prospective cohort design was used in this study. Nondepressed, nondrug-exposed subjects (N = 178) were selected from a series of 369 newly admitted medical inpatients at the Calgary General Hospital. Eighty-six of these 178 subjects were prescribed one of the drugs in question, forming an exposed cohort. The remaining subjects formed a nonexposed cohort. Depressive symptoms and associated psychosocial variables were measured in both subgroups during the hospital stay.

Results:

Seventeen of the 86 exposed subjects and 5 of the 92 nonexposed subjects developed incident depressive symptoms during their stay in hospital. The PAR% associated with drug exposure (56.0%) exceeded that associated with poverty (17.9%) or unemployment (21.7%).

Conclusions:

Drug exposures may have a sizeable impact on the incidence of depressive symptoms in medical inpatient populations.