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Medical Sciences	75%

Selected Abstracts

Interaction between caregivers and families expecting a malformed child

JOURNAL OF ADVANCED NURSING, Issue 1 2003
Hanna Maijala MNSc RN
Background. Earlier research has shown that the care of families expecting a malformed child should be intensified and that the topic is understudied. Aim. This study aimed at generating a practical nursing theory of interaction between caregivers and families expecting a malformed child, as experienced by families. Methods. A grounded theory study was undertaken at a university hospital, Finland. Data consisted of semi-structured interviews with 29 mothers and fathers, analysed using the constant comparative method. Findings. The interaction process starts with the confirmation of the diagnosis. It usually comes as a shock to the parents, and gives rise to questions about the nature of the malformation, family members' relationship with themselves, family relationships and relationships with people outside the family. These questions are crucial to the family's coping and form the core of interaction. Families' own coping strategies are either reinforced or undermined by caregivers' actions and are reflected in parents' expectations about caregivers, which in part account for their actions and experiences of interaction. The care system as an interactive environment is part of a process which results in the experiences of being helped or being left without help. The core of the interaction process comprises two dimensions: gaining strength and losing strength in relation to malformation issues. Conclusions. The findings of the study are consistent with earlier research and complement it by providing a detailed delineation of the interaction from the perspective of the family. They can be used to formulate recommendations for improving caregivers' interactive skills and awareness of the topic through training. The care system should be developed to ensure that families receive psychological support and that the family as a whole receives proper care. Consideration of the viewpoint of siblings is a challenge for further research. [source]

Dietary supplementation with melatonin reduces levels of amyloid beta-peptides in the murine cerebral cortex

JOURNAL OF PINEAL RESEARCH, Issue 4 2004
Debomoy K. Lahiri
Abstract:, Melatonin levels decrease with aging in mice. Dietary supplementation with melatonin has recently been shown to result in a significant rise in levels of endogenous melatonin in the serum and all other tissue samples tested. Herein, the effects of dietary melatonin on brain levels of nitric oxide synthase, synaptic proteins and amyloid beta-peptides (A,) were determined in mice. Melatonin supplementation did not significantly change cerebral cortical levels of nitric oxide synthase or synaptic proteins such as synaptophysin and SNAP-25. Increased brain melatonin concentrations however, led to a significant reduction in levels of toxic cortical A, of both short and long forms which are involved in amyloid depositions and plaque formation in Alzheimer's diseases. Thus, melatonin supplementation may retard neurodegenerative changes associated with brain aging. Depletion of melatonin in the brain of aging mice may in part account for this adverse change. [source]

Cerebellar morphology in Tourette syndrome and obsessive-compulsive disorder

ANNALS OF NEUROLOGY, Issue 4 2010
Russell H. Tobe MD
Objective Neuroanatomical and functional imaging studies have identified the cerebellum as an integral component of motor and language control. Few studies, however, have investigated the role of the cerebellum in Tourette syndrome (TS), a condition defined by the presence of semi-involuntary movements and sounds. Methods Magnetic resonance imaging was conducted in 163 persons with TS and 147 control participants. Multivariate linear regression models were used to explore effects on cerebellar surface morphology and underlying volumes for the main diagnosis effects of TS as well as comorbid obsessive-compulsive disorder (OCD) and attention-deficit/hyperactivity disorder. Additionally, the correlations of symptom severity with cerebellar morphology were also assessed. Results The TS group demonstrated reduced volumes of the cerebellar hemispheres bilaterally that derived primarily from reduced gray matter in crus I and lobules VI, VIIB, and VIIIA. These decreased regional volumes accompanied increasing tic symptom severity and motoric disinhibition as demonstrated by a finger tapping test. Males had reduced volumes of these same regions compared with females, irrespective of diagnosis. Comorbid OCD was associated with relative enlargement of these regions in proportion to the increasing severity of OCD symptoms. Interpretation The cerebellum is involved in the pathogenesis of TS and tic-related OCD. Baseline gender differences in cerebellar morphology may in part account for the more prevalent expression of TS in males. ANN NEUROL 2010;67:479,487 [source]

Perioperative plasma active and total ghrelin levels are reduced in acromegaly when compared with in nonfunctioning pituitary tumours even after normalization of serum GH

CLINICAL ENDOCRINOLOGY, Issue 1 2007
Takakazu Kawamata
Summary Objective, Ghrelin is a novel gastric peptide known to stimulate GH secretion, but the relationship between ghrelin and the GH-insulin-like growth factor (IGF)-1 axis in GH excess or deficiency is poorly understood. This study investigated dysregulation of ghrelin secretion in acromegaly and its short-term postoperative recovery. Methods, A prospective study was conducted on eight patients who underwent complete transsphenoidal resection of GH-producing pituitary adenomas (acromegaly group) and 22 for endocrinologically nonfunctioning pituitary tumours (control group). Active and total plasma ghrelin levels were measured serially before and after surgery. Results, Preoperative active and total plasma ghrelin concentrations (mean ± SD; fmol/ml) were significantly reduced in acromegalic patients when compared with those in the controls (9·6 ± 4·3 and 157·4 ± 65·6 vs. 21·8 ± 13·0 and 267·1 ± 111·4; P = 0·023 and P = 0·021, respectively). Both levels were still significantly suppressed on postoperative Day 7 in the acromegaly group when compared with those in the control group (11·7 ± 4·3 and 197·8 ± 68·9 vs. 22·5 ± 12·6 and 302·7 ± 100·0; P = 0·038 and P = 0·018, respectively). The ratios of active to total ghrelin were not significantly different between the two groups before and after operation. In acromegalic patients, active and total ghrelin levels remained significantly suppressed even after normalization of serum GH levels. Conclusions, The putative negative feedback mechanism of GH on ghrelin secretion may in part account for the low ghrelin levels observed in acromegalic patients, and the mechanism may persist even after normalization of serum GH. [source]