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Munksgaard

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    Selected Abstracts

    The Bech,Rafaelsen Melancholia Scale (MES) in clinical trials of therapies in depressive disorders: a 20-year review of its use as outcome measure

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 4 2002
    P. Bech
    Bech P. The Bech,Rafaelsen Melancholia Scale (MES) in clinical trials of therapies in depressive disorders A 20-year review of its use as outcome measure. Acta Psychiatr Scand 2002: 106: 252,264. © Blackwell Munksgaard 2002. Objective:,To evaluate the psychometric properties of the Bech,Rafaelsen Melancholia Scale (MES) by reviewing clinical trials in which it has been used as outcome measure. Method:,The psychometric analysis included internal validity (total scores being a sufficient statistic), interobserver reliability, and external validity (responsiveness in short-term trials and relapse prevention in long-term trials). Results:,The results showed that the MES is a unidimensional scale, indicating that the total score is a sufficient statistic. The interobserver reliability of the MES has been found adequate both in unipolar and bipolar depression. External validity including both relapse, response and recurrence indicated that the MES has a high responsiveness and sensitivity. Conclusion:,The MES has been found a valid and reliable scale for the measurement of changes in depressive states during short-term as well as long-term treatment. [source]

    Magnetic motor threshold and response to TMS in major depressive disorder

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2002
    O. T. Dolberg
    Dolberg OT, Dannon PN, Schreiber S, Grunhaus L. Magnetic motor threshold and response to TMS in major depressive disorder. Acta Psychiatr Scand 2002: 106: 220,223. © Blackwell Munksgaard 2002. Objective:,The aim of this study was to examine motor threshold (MT) during treatment with transcranial magnetic stimulation (TMS). Method:,The TMS was administered to 46 patients with depression and 13 controls. TMS was performed at 90% power of measured MT. The stimulation frequency was 10 Hz for 6 s, for 20 trains, with 30 s inter-train intervals. The trial included 20 sessions. Patients and controls were assessed on various outcome measures. Results:,The MT values were comparable between patients and controls. Neither demographic nor clinical variables were factors in determining MT. MT was not shown to have any predictive value regarding outcome of treatment. Conclusion:,In this study, MT at baseline or changes in MT during the treatment period were not able to discriminate between patients and controls and were not found to have any predictive value with regard to treatment outcome. [source]

    Relative increase in choline in the occipital cortex in chronic fatigue syndrome

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2002
    B. K. Puri
    Puri BK, Counsell SJ, Zaman R, Main J, Collins AG, Hajnal JV, Davey NJ. Relative increase in choline in the occipital cortex in chronic fatigue syndrome. Acta Psychiatr Scand 2002: 106: 224,226. © Blackwell Munksgaard 2002. Objective:,To test the hypothesis that chronic fatigue syndrome (CFS) is associated with altered cerebral metabolites in the frontal and occipital cortices. Method:,Cerebral proton magnetic resonance spectroscopy (1H MRS) was carried out in eight CFS patients and eight age- and sex-matched healthy control subjects. Spectra were obtained from 20 × 20 × 20 mm3 voxels in the dominant motor and occipital cortices using a point-resolved spectroscopy pulse sequence. Results:,The mean ratio of choline (Cho) to creatine (Cr) in the occipital cortex in CFS (0.97) was significantly higher than in the controls (0.76; P=0.008). No other metabolite ratios were significantly different between the two groups in either the frontal or occipital cortex. In addition, there was a loss of the normal spatial variation of Cho in CFS. Conclusion:,Our results suggest that there may be an abnormality of phospholipid metabolism in the brain in CFS. [source]

    Out-patient behaviour therapy in alcoholism: treatment outcome after 2 years

    ACTA PSYCHIATRICA SCANDINAVICA, Issue 3 2002
    W. Burtscheidt
    Burtscheidt W, Wölwer W, Schwarz R, Strauss W, Gaebel W. Out-patient behaviour therapy in alcoholism: treatment outcome after 2 years. Acta Psychiatr Scand 2002: 106: 227,232. © Blackwell Munksgaard 2002. Objective:,The main aim of the study was the evaluation of out-patient behavioural approaches in alcohol dependence. Additionally, the persistence of treatment effects and the impact of psychiatric comorbidity in long-term follow-up was examined. Method:,A total of 120 patients were randomly assigned to non-specific supportive therapy or to two different behavioural therapy programmes (coping skills training and cognitive therapy) each comprising 26 weekly sessions; the follow-up period lasted 2 years. Results:,Patients undergoing behavioural therapy showed a consistent trend towards higher abstinence rates; significant differences between the two behavioural strategies could not be established. Moreover, the results indicate a reduced ability of cognitive impaired patients to cope with short-time abstinence violations and at a reduced benefit from behavioural techniques for patients with severe personality disorders. Conclusion:,Behavioural treatment yielded long-lasting effects and met high acceptance; yet, still in need of improvement is the development of specific programmes for high-risk patients. [source]

    Announcement of the winner of the 2002 Blackwell Munksgaard and Journal of Cutaneous Pathology Prize

    JOURNAL OF CUTANEOUS PATHOLOGY, Issue 10 2003
    Article first published online: 22 OCT 200
    No abstract is available for this article. [source]

    Porphyromonas gingivalis stimulates the release of nitric oxide by inducing expression of inducible nitric oxide synthases and inhibiting endothelial nitric oxide synthases

    JOURNAL OF PERIODONTAL RESEARCH, Issue 3 2010
    W. Sun
    Sun W, Wu J, Lin L, Huang Y, Chen Q, Ji Y. Porphyromonas gingivalis stimulates the release of nitric oxide by inducing expression of inducible nitric oxide synthases and inhibiting endothelial nitric oxide synthases. J Periodont Res 2010; 45: 381,388. © 2010 The Authors. Journal compilation © 2010 Blackwell Munksgaard Background and Objective:, The purpose of this study was to examine the ability of Porphyromonas gingivalis to invade human umbilical vein endothelial cells (HUVECs) and to study the effects of P. gingivalis ATCC 33277 on the production of nitric oxide (NO) and on the expression of inducible nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) in HUVECs. We attempted to throw light on the pathway of damage to endothelial function induced by P. gingivalis ATCC 33277. Material and Methods:,P. gingivalis ATCC 33277 was cultured anaerobically, and HUVECs were treated with P. gingivalis ATCC 33277 at multiplicities of infection of 1:10 or 1:100 for 4, 8, 12 and 24 h. HUVECs were observed using an inverted microscope and transmission electron microscopy. NO production was assayed through measuring the accumulation of nitrite in culture supernatants. Expression of both iNOS and eNOS proteins was investigated through western blotting. Results:, It was found that P. gingivalis ATCC 33277 can adhere to HUVECs by fimbriae, invade into HUVECs and exist in the cytoplasm and vacuoles. P. gingivalis ATCC 33277 can induce iNOS and inhibit eNOS expression, and stimulate the release of NO without any additional stimulant. Conclusion:, Our study provides evidence that P. gingivalis ATCC 33277 can invade HUVECs, and the ability of P. gingivalis ATCC 33277 to promote the production of NO may be important in endothelial dysfunction, suggesting that P. gingivalis ATCC 33277may be one of the pathogens responsible for atherosclerosis. [source]

    Enhanced monocyte migration and pro-inflammatory cytokine production by Porphyromonas gingivalis infection

    JOURNAL OF PERIODONTAL RESEARCH, Issue 2 2010
    A. Pollreisz
    Pollreisz A, Huang Y, Roth GA, Cheng B, Kebschull M, Papapanou PN, Schmidt AM, Lalla E. Enhanced monocyte migration and pro-inflammatory cytokine production by Porphyromonas gingivalis infection. J Periodont Res 2009; doi: 10.1111/j.1600-0765.2009.01225.x. © 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard Background and Objective:,Porphyromonas gingivalis, a major periodontal pathogen, has been reported to be involved in atherogenesis. In order to further understand this pathogen's link with systemic inflammation and vascular disease, we investigated its influence on murine monocytes and macrophages from three different sources. Material and Methods:, Concanavalin A-elicited peritoneal macrophages, peripheral blood monocyte-derived macrophages and WEHI 274.1 monocytes were infected with either P. gingivalis 381 or its non-invasive fimbriae-deficient mutant, DPG3. Results:, Infection with P. gingivalis 381 markedly induced monocyte migration and significantly enhanced production of the pro-inflammatory cytokines, tumor necrosis factor-, and interleukin-6. Consistent with a role for this pathogen's major fimbriae and/or its invasive capacity, infection with DPG3 had a minimal effect on both monocyte attraction and pro-inflammatory cytokine production. Conclusion:, Since monocyte recruitment and activation are important steps in the development of vascular inflammation and atherosclerosis, these results suggest that P. gingivalis infection may be involved in these processes. [source]

    Effect of cyclic mechanical loading on osteoclast recruitment in periodontal tissue

    JOURNAL OF PERIODONTAL RESEARCH, Issue 1 2010
    K. Nozaki
    Nozaki K, Kaku M, Yamashita Y, Yamauchi M, Miura H. Effect of cyclic mechanical loading on osteoclast recruitment in periodontal tissue. J Periodont Res 2009; doi: 10.1111/j.1600-0765.2008.01193.x. © 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard Background and Objective:, It is well accepted that cyclic mechanical loading induces osteoclastogenesis in periodontal tissue, but its molecular mechanisms are not well understood, in part because of a lack of appropriate models. In this study, we investigated a novel device that allows cyclic mechanical loading to be performed in a well-controlled manner. Furthermore, by employing this model, the effect of cyclic loading on osteoclast recruitment in the periodontal tissue was described. Material and Methods:, By using a newly developed device, the cyclic loading of 20 n (reference loading corresponding to the fracture hardness of dietary pellets) and two excessive loadings (i.e. 30 and 40 n) were applied to maxillary right molars in rats for up to 7 d, and osteoclast recruitment in the periodontal tissue was evaluated by analyzing relevant marker proteins using immunohistochemistry. Results:, Osteoclastogenesis was induced by day 3 within alveolar bone subjected to a compression force of 30 n. With both 30 and 40 n loadings, cells that were positive to for tartrate-resistant acid phosphate, receptor activator of nuclear factor-,B ligand and osteoprotegerin were significantly increased in the alveolar bone/periodontal ligament in a time-dependent manner. Conclusion:, A new device was developed that allows various levels of cyclic mechanical loading to be exerted. By using this device in rats, early events of osteoclast recruitment in the periodontal tissues were observed with excessive loadings in a time-dependent manner, indicating the usefulness of this model. [source]

    Epidermal growth factor released from platelet-rich plasma promotes endothelial cell proliferation in vitro

    JOURNAL OF PERIODONTAL RESEARCH, Issue 1 2010
    M.-P. Bertrand-Duchesne
    Bertrand-Duchesne M-P, Grenier D, Gagnon G. Epidermal growth factor released from platelet-rich plasmapromotes endothelial cell proliferation in vitro. J Periodont Res 2009; doi: 10.1111/j.1600-0765.2009.01205.x. © 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard Background and Objective:, The therapeutic benefits of platelet-rich plasma (PRP) for the promotion of healing and regeneration of periodontal tissues are thought to result from enrichment in growth factors released from platelets. The aim of this study was to evaluate the effects of specific growth factors released from PRP on endothelial cell proliferation. Material and Methods:, The levels of vascular endothelial growth factor (VEGF), platelet-derived growth factor BB (PDGF-BB), basic fibroblast growth factor (bFGF) and epidermal growth factor (EGF) in supernatants of calcium- and thrombin-activated PRP samples from five donors were quantified by enzyme-linked immunosorbent assay. Supernatants were treated with neutralizing antibodies specific to each growth factor, and the effects of these treatments on human umbilical vein endothelial cell (HUVEC) proliferation in vitro were determined. The effect of removing EGF from PRP supernatants with antibody-coated beads on HUVEC proliferation was also tested. Results:, Average concentrations of VEGF, PDGF-BB, bFGF and EGF in PRP supernatants were 189, 27,190, 39.5 and 513 pg/mL, respectively. The addition of EGF neutralizing antibodies to the PRP supernatants significantly reduced HUVEC proliferation (up to 40%), while such an inhibition was not observed following neutralization of the other growth factors. Removal of EGF from PRP supernatants by treatment with antibody-coated beads also resulted in a significant decrease in HUVEC proliferation. Recombinant EGF increased HUVEC proliferation in vitro in a dose-dependent manner. Conclusion:, This study showed that PRP supernatants are highly mitogenic for endothelial cells and provided evidence that this effect may be due, at least in part, to the presence of EGF. In vivo experiments are needed to confirm the roles of specific growth factors released from PRP in the healing of oral surgical and/or periodontal wounds. [source]

    Matrix metalloproteinase-3 gene polymorphism in renal transplant patients with gingival overgrowth

    JOURNAL OF PERIODONTAL RESEARCH, Issue 1 2010
    A. Drozdzik
    Drozdzik A, Kurzawski M, Lener A, Kozak M, Banach J, Drozdzik M. Matrix metalloproteinase-3 gene polymorphism in renal transplant patients with gingival overgrowth. J Periodont Res 2009; doi: 10.1111/j.1600-0765.2009.01221.x. © 2009 The Authors. Journal compilation © 2009 Blackwell Munksgaard Background and Objective:, Gingival enlargement frequently occurs in transplant patients receiving immunosuppressive drugs. It was hypothesized that gingival enlargement associated with cyclosporine use results from reduced degradation of extracellular matrix in the gingiva. Matrix metalloproteinase-3 (MMP-3) is involved in biodegradation of the extracellular matrix, and its inhibition may contribute to an abnormal accumulation of fibronectin and proteoglycans, which are MMP-3 substrates. The aim of this study was to investigate whether an association exists between MMP-3 genotypes and gingival enlargement in kidney transplant patients medicated with cyclosporine A. Material and Methods:, Sixty-four unrelated kidney transplant patients suffering from gingival overgrowth, as well as 111 control transplant patients without gingival overgrowth, were enrolled in the study. Gingival overgrowth was assessed 6 mo after transplantation. During the post-transplant period all patients were given cyclosporine A as a principal immunosuppressive agent. MMP-3 polymorphism was determined using a PCR restriction fragment length polymorphism assay. Results:, In kidney transplant patients suffering from gingival overgrowth the mean gingival overgrowth score was 1.35 ± 0.57, whereas in control subjects the mean gingival overgrowth score was 0.0. The distribution of MMP-3 -1178A/*dupA alleles among all kidney transplant patients, as well as in the two study subgroups, did not differ significantly from Hardy,Weinberg equilibrium. The frequency of the MMP-3-1171*A/*A genotype (28.1% for gingival overgrowth vs. 26.1% for controls) and of the MMP-3-1171*dupA/*dupA genotype (32.8% for gingival overgrowth vs. 22.5% for controls) was similar for both study groups. The risk of gingival overgrowth was lowest among patients carrying the MMP-3-1171*A/*dupA genotype (odds ratio 0.52), but this did not differ markedly from the other genotypes. Conclusion:, No association between MMP-3 gene polymorphism and gingival overgrowth was revealed in kidney transplant patients administered cyclosporine A. [source]

    Non-alcoholic fatty liver disease , a common and benign finding in octogenarian patients

    LIVER INTERNATIONAL, Issue 6 2004
    Nadya Kagansky
    Kagansky N, Levy S, Keter D, Rimon E, Taiba Z, Fridman Z, Berger D, Knobler H, Malnick S. Non-alcoholic fatty liver disease , a common and benign finding in octogenarian patients. Liver International 2004: 24: 588,594. © Blackwell Munksgaard 2004 Abstract: Background: Non-alcoholic fatty liver disease (NAFLD), a common entity in the general population, has been shown to be linked with insulin resistance and metabolic syndrome. Several of the components of the metabolic syndrome are more common in the aged population. The aims of the current study were to determine in the aged, the prevalence and the clinical presentation of NAFLD, as well as the relation to the underlying metabolic abnormalities. Method: In this prospective study, we evaluated 91 octogenarians with a mean age of 85.56±3.76 years, who were admitted to the rehabilitation departments of a geriatric hospital. Clinical evaluation included: abdominal ultrasound (US), fasting glucose and lipid levels, serum liver enzymes, ferritin, iron and transferrin saturation. Elderly patients with NAFLD were compared with 46 young patients with NAFLD. Results: NAFLD diagnosed by US was a common finding in this aged population, is present in 42/91 patients (46.2%). No significant differences were observed between the patients with or without NAFLD in the following: age, gender, chronic illnesses, anthropometric parameters, lipid profile, fasting glucose levels, metabolic syndrome prevalence, serum levels of transaminases, ferritin and iron. Young patients with NAFLD had significantly higher serum levels of triglycerides and a significantly higher prevalence of glucose intolerance, obesity and the metabolic syndrome compared with the elderly patients with NAFLD. Conclusions: NAFLD was a common finding in our group of elderly patients and the prevalence was higher than reported in the general population. In contrast to the well-described association between the metabolic syndrome and NAFLD in the general population, we did not find this association in the aged group. In addition, none of the patients had stigmata of advanced liver disease. These data suggest that NAFLD is a common and benign finding in the elderly population, but is not associated with the metabolic syndrome. [source]

    Induction of IL-10+ CD4+ CD25+ regulatory T cells with decreased NF-,B expression during immunotherapy

    PEDIATRIC ALLERGY AND IMMUNOLOGY, Issue 1-Part-II 2010
    Yi-Giien Tsai
    Tsai Y-G, Chiou Y-L, Chien J-W, Wu H-P, Lin C-Y. Induction of IL-10+ CD4+ CD25+ regulatory T cells with decreased NF-,B expression during immunotherapy. Pediatr Allergy Immunol 2010: 21: e166,e173. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard MyD88 is a major toll-like receptor (TLR) adaptor to activate NF-,B, which acts as a mater switch for allergic inflammation disease. Sterile hust dust extracts have been reported with TLR-dependent immunostimulatory activities. The aim of this study was to evaluate whether Dermatophagoides pteronyssinus (Der p) immunotherapy may increase IL-10+ CD4+ CD25+ T cells with modulating MyD88 signaling proteins, to decrease NF-,B expression. Peripheral blood mononuclear cells were isolated from patients before and after 1 yr of Der p immunotherapy, and also from matched control subjects. After 2 days of Der p-2 stimulation, intracellular IL-10 and Foxp3 expression of CD4+ CD25+ T cells were measured by flow-cytometry. The expression of IL-1 receptor-associated kinase (IRAK)-1 in cytoplasm and IFN-regulator factor-3 (IRF-3) with NF-,B/p65 in nuclei was determined by Western-blot analysis. Patients undergoing immunotherapy produced more soluble CD14, IL-10, and TGF-, that correlated with FEV1improvement (p < 0.05). In the immunotherapy group, the number of Foxp3+ CD4+ Treg cells increased more than the baseline status (25.06 ± 4.19 vs. 16.08 ± 3.54, p < 0.05). Additionally, increased IL-10 production with decreased IRAK-1 and NF-,B/p65 nuclear translocation was observed in sorted-purified Treg cells. IL-10+ CD4+ CD25+ Treg cells may respond to Der p-2 and down-regulate NF-,B/p65 expression to maintain immune tolerance during immunotherapy. [source]

    Pre-ovulatory Granulosa Cells of Infertile Women with Endometriosis are Less Sensitive to Luteinizing Hormone

    AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 2 2003
    David J. Cahill
    Cahill DJ, Harlow CR, Wardle PG. Pre-ovulatory granulosa cells of infertile women with endometriosis are less sensitive to luteinizing hormone. AJRI 2003; 49:66,69 © Blackwell Munksgaard, 2003 PROBLEM: Reduced fertilization rates in women with minor endometriosis may be the result of direct effects on the ovary or to primary dysfunction within the hypothalamic,pituitary,ovarian axis. This controlled study was designed to examine the steroidogenic potential of luteinized granulosa cells in women with minor endometriosis. METHOD OF STUDY: Granulosa cells were harvested at oocyte recovery and incubated for 3 hr in increasing concentrations of luteinizing hormone (LH). The dissociation constant for added concentrations of LH was computed (as Km LH) and the results were compared between women with endometriosis and controls. RESULTS: Women with minor endometriosis had a higher dissociation constant than women with tubal damage [Km 0.98 (0.58,9.24) versus 0.33 (0.28,0.72) ng/mL, P=0.019], indicating reduced sensitivity to LH. CONCLUSIONS: In women with endometriosis, granulosa cells were less sensitive to LH stimulation. This provides further evidence for primary ovarian dysfunction as a significant contributory cause of the associated subfertility. [source]

    Progesterone Regulates IL12 Expression in Pregnancy Lymphocytes by Inhibiting Phospholipase A2

    AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY, Issue 1 2003
    G. Par
    Par G, Geli J, Kozma N, Varga P, Szekeres-Bartho J. Progesterone regulates IL12 expression in pregnancy lymphocytes by inhibiting phospholipase A2. AJRI 2003; 49:1,5 © Blackwell Munksgaard, 2003 PROBLEM: Progesterone-induced blocking factor (PIBF) is one of the pathways that mediate the immunological effects of progesterone. PIBF inhibits natural killer (NK) cytotoxic activity. Recently we showed that neutralization of PIBF results in an increased interleukin (IL)-12 expression, which is corrected by cyclooxygenase inhibitors. As exogenous arachidonic acid (AA) voids the NK blocking effect of PIBF, it is likely that PIBF acts before the level of the cyclooxygenase enzyme. Therefore in this study we investigated the effect of PIBF neutralizing antibody and simultaneous phospholipase A2 inhibitor quinacrine (Q) treatment on IL-12 production. METHODS: Pregnancy lymphocytes were treated with anti-PIBF antibody or lipopolysaccharide (LPS) as a positive control, in the presence or absence of Q. IL-12 expression by PBMC was detected by immunocytochemistry. RESULTS: Neutralization of PIBF as well as LPS treatment resulted in an increased IL-12 expression, which was corrected by simultaneous Q treatment. Pre-treatment of lymphocytes with progesterone prevented the stimulating effect of LPS on IL-12 production. CONCLUSION: Progesterone binding of the lymphocytes is followed by the release of PIBF that inhibits AA release. The subsequent block of prostaglandin synthesis reduces IL-12 production and results in a lowered cytotoxic NK activity, which may contribute to a normal pregnancy outcome. [source]

    A new bipolar spectrum concept: a brief review

    BIPOLAR DISORDERS, Issue 2002
    Jules Angst
    Angst J, Gamma A. A new bipolar spectrum concept: a brief review. Bipolar Disord 2002: 4(Suppl. 1): 11,14. © Blackwell Munksgaard, 2002 Research on the broad bipolar spectrum is dependent on the definition of hypomania. We recently proposed a new, softer syndromal definition with clinical validity. This broadens the diagnosis of bipolar II (BP-II) disorder at the expense of major depressive disorder (MDD). There is evidence for a third group of suspected BP-II manifesting major depression plus hypomanic symptoms. The two bipolar-II groups together are as prevalent as MDD. A new concept of minor bipolar disorder embracing dysthymia, minor and recurrent brief depression with hypomanic syndromes and symptoms is discussed. Some methodological pitfalls of research on drug-induced hypomania as an element of the bipolar spectrum are also summarized. [source]

    Abnormalities of prefrontal cortex SNARE complex proteins in bipolar disorder

    BIPOLAR DISORDERS, Issue 2002
    William G Honer
    Honer WG, Falkai P, Li H-Y, Knable MB, Buslei R, Bayer TA. Abnormalities of prefrontal cortex SNARE complex proteins in bipolar disorder. Bipolar Disord 2002: 4(Suppl. 1): . © Blackwell Munksgaard, 2002 [source]

    Functional correlates of effect: the relevance of regional cerebral brain dysfunction

    BIPOLAR DISORDERS, Issue 2002
    F Schneider
    Schneider F. Functional correlates of effect: the relevance of regional cerebral brain dysfunction. Bipolar Disord 2002: 4(Suppl. 1): 51. © Blackwell Munksgaard, 2002 [source]

    Outcome measures in treatment trials in bipolar disorder

    BIPOLAR DISORDERS, Issue 2002
    WA Nolen
    Nolen WA. Outcome measures in treatment trials in bipolar disorder. Bipolar Disord 2002: 4(Suppl. 1): 64,65. © Blackwell Munksgaard, 2002 [source]

    Limits of the applicability and generalizability of drug trials in mania

    BIPOLAR DISORDERS, Issue 2002
    Rasmus W Licht
    Licht RW. Limits of the applicability and generalizability of drug trials in mania. Bipolar Disord 2002: 4(Suppl. 1): 66,68. ©Blackwell Munksgaard, 2002 During recent years, the majority of drug trials in mania have been conducted for the purpose of drug approval. On this background, this paper addresses to what extent these trials may actually provide the practising clinician with useful information. One major point is that selection prior to the point of randomization in RCTs in mania may limit the applicability of study results to patients seen in ordinary clinical practice. Limitations in study credibility and study design are also discussed. The need for large scale pragmatic studies using broad inclusion criteria, comparing the various treatments, alone or in combination, is emphasized. [source]

    White matter lesions in bipolar disorder

    BIPOLAR DISORDERS, Issue 2002
    IN Ferrier
    Ferrier IN. White matter lesions in bipolar disorder. Bipolar Disord 2002: 4(Suppl. 1): 86. © Blackwell Munksgaard, 2002 [source]

    Structural MRI and MRS abnormalities in bipolar disorder

    BIPOLAR DISORDERS, Issue 2002
    Jair C Soares
    Soares JC. Structural MRI and MRS abnormalities in bipolar disorder. Bipolar Disord 2002: 4(Suppl. 1): 87. © Blackwell Munksgaard, 2002 [source]

    The mechanism of action of psychotherapy

    BIPOLAR DISORDERS, Issue 2002
    F Colom
    Colom F. The mechanism of action of psychotherapy. Bipolar Disord 2002: 4(Suppl. 1): 102. © Blackwell Munksgaard, 2002 [source]

    Can we face the challenge of expanding use of intravenous immunoglobulin in neurology?

    ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
    I. Elovaara
    Elovaara I, Hietaharju A. Can we face the challenge of expanding use of intravenous immunoglobulin in neurology? Acta Neurol Scand: 2010: 122: 309,315. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. The use of high-dose polyclonal intravenous immunoglobulin (IVIG) in the treatment of autoimmune neurological diseases has expanded over the last decade. Based on controlled clinical trials IVIG can be considered currently as the first-line treatment in Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy and multifocal motor neuropathy, and it may be used as a rescue therapy in worsening myasthenia gravis. IVIG is a second-line therapy in dermatomyositis, stiff-person syndrome and pregnancy-associated or postpartum relapses of multiple sclerosis. Although the biological efficacy of IVIG is due to multiple effects on the immune system, many mechanisms are still unknown. The awareness of risks and complications of IVIG therapy has increased, but severe side effects are still considered rare. Due to increasing costs of this treatment, careful selection of patients who will benefit from IVIG is extremely important. [source]

    Cerebellar apparent diffusion coefficient changes in patients with supratentorial ischemic stroke

    ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
    Y. Liu
    Liu Y, Nuutinen J, Laakso MP, Karonen JO, Könönen M, Vanninen E, Kuikka JT, Vanninen RL. Cerebellar apparent diffusion coefficient changes in patients with supratentorial ischemic stroke. Acta Neurol Scand: 2010: 122: 316,322. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, To evaluate apparent diffusion coefficient (ADC) in cerebellar subregions in patients with stroke. Materials and methods,,, The total counts and ADCs were bilaterally measured on cerebellar white matter, gray matters of medial (G1), intermediate (G2), and lateral zones (G3) on SPECT and ADC maps from 20 patients with supratentorial ischemic stroke within the first 48 h and on day 8 after onset. ADCs were also obtained from 15 age-matched controls. Results,,, Within 48 h, the ADCs were significantly increased bilaterally in the G3, and tended to be increased bilaterally in the white matter and G1, and contralateral G2 compared with controls. On day 8, the ADCs were significantly increased in all contralateral cerebellar subregions and in ipsilateral G1 and G2, and tended to be increased in ipsilateral G3. The ADC value was significantly higher in contralateral than in ipsilateral white matter on day 8. The interhemispheric asymmetry indices (AIs) of ADC and SPECT were significantly associated with each other in G2 and G3 within 48 h, but not on day 8. The AIs of ADC and SPECT were significantly related to each other in the G3 within 48 h and on day 8. Conclusions,,, Supratentorial ischemic stroke may cause mild cerebellar vasogenic edema. [source]

    Subclinical pulmonary dysfunction in spinocerebellar ataxias 1, 2 and 3

    ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
    S. J. Sriranjini
    Sriranjini SJ, Pal PK, Krishna N, Sathyaprabha TN. Subclinical pulmonary dysfunction in spinocerebellar ataxias 1, 2 and 3. Acta Neurol Scand: 2010: 122: 323,328. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, Evaluation of pulmonary function in patients with spinocerebellar ataxias (SCA) 1, 2 and 3 without clinical evidence of pulmonary dysfunction. Methods,,, Thirty patients (F:M = 7:23; age: 35 ± 11.3 years; SCA1 , 13, SCA2 , 9 and SCA3 , 8) without clinical manifestations of respiratory dysfunction and 30 controls underwent pulmonary function tests. The percentage predicted values of forced vital capacity (FVC), volume of air exhaled during first second of FVC (FEV1), peak expiratory flow rate (PEFR) and maximal voluntary ventilation (MVV), actual values of maximal inspiratory and expiratory pressures (MIP and MEP in mmHg), and ratios of actual values of FEV1/FVC (%) and FEV1/PEFR (ml/l/min) were analyzed. Results,,, Compared with controls SCA patients had significant reductions of FVC (71.1 ± 17.5 vs 85.5 ± 18.7; P < 0.01), PEFR (51.5 ± 20.7 vs 77.1 ± 24.9; P < 0.001), MVV (64.4 ± 21.6 vs 97.2 ± 22.7; P < 0.001), MIP (27.7 ± 16.8 vs 50.1 ± 15.1; P < 0.001) and MEP (38.1 ± 18.7 vs 74.7 ± 16.0; P < 0.001), elevation of FEV1/PEFR (10.5 ± 2.8 vs 7.4 ± 2.1; P < 0.001), but no significant change of FEV1 and FEV1/FVC. FEV1/PEFR correlated positively with illness duration and MVV negatively with severity of illness. Conclusions,,, The present study showed subclinical restrictive type of pulmonary dysfunction in SCA, and possible presence of upper airway obstruction. Chest physiotherapy and breathing exercises should be introduced early in management of SCA. [source]

    Heart rate variability in type 2 spinocerebellar ataxia

    ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
    J. Montes-Brown
    Montes-Brown J, Sánchez-Cruz G, García AM, Báez ME, Velázquez-Pérez L. Heart rate variability in type 2 spinocerebellar ataxia. Acta Neurol Scand: 2010: 122: 329,335. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Objectives,,, To explore cardiovascular autonomic regulation in Spinocerebellar ataxia type 2 (SCA2) patients, using heart rate variability (HRV) analysis and neurophysiologic autonomic reflex tests, and determine relations and causal related factors of dysautonomia in SCA2. Materials and methods,,, Heart rate variability indices for 5 min series of RR intervals were analyzed in 97 SCA2 patients, assessed quantitatively for somatic and autonomic nervous system complaints applying the International Cooperative Ataxia Rating Scale and Scales for Outcomes in Parkinson's disease (SCOPA-AUT), respectively. Autonomic testing included: resting control, standing, Valsalva maneuver and deep breathing. Results,,, Mean RR, long- and short-term variability indices and spectral density power (LF, HF) indices were lower in the patients group, whereas LF/HF ratio and LF (nu) were higher. Highly differences between groups were observed for seven diagnostic autonomic test indices. Significant correlations were found between different clinical and demographic indices and between clinical indices and some HRV indices. Conclusions,,, We confirm the presence of cardiovascular autonomic dysfunction in a large group of SCA2 patients. [source]

    Coping with multiple sclerosis: a 5-year follow-up study

    ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
    K. Lode
    Lode K, Bru E, Klevan G, Myhr KM, Nyland H, Larsen JP. Coping with multiple sclerosis: a 5-year follow-up study. Acta Neurol Scand: 2010: 122: 336,342. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objectives,,, To examine how coping styles among patients with multiple sclerosis (MS) change over time and how patients' coping styles after 5 years are associated with disability pension. Materials and methods,,, Seventy-six MS patients and 94 healthy controls were included in this study. The patients were examined at baseline and 5 years later. This included a neurological examination and information on disability pension and a questionnaire assessing coping (the COPE scale). Controls were registered at baseline only. Results,,, Compared to healthy controls, MS patients were more passive in coping with disease related distress. This was even more pronounced 5 years later. Disability pensioned patients employed more social support, venting of emotions and behavioural disengagement at follow-up. Conclusion,,, This study shows that patients with MS employ coping styles that may be inadequate and this is not improved by adaption over time. Although patients also use strategies to enhance their lives, these findings suggest that there may be a potential for improving the lives of patients with MS through interventions that may enhance adequate coping with the disease. [source]

    Dysphagia and dysphonia among persons with post-polio syndrome , a challenge in neurorehabilitation

    ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
    S. Söderholm
    Söderholm S, Lehtinen A, Valtonen K, Ylinen A. Dysphagia and dysphonia among persons with post-polio syndrome , a challenge in neurorehabilitation. Acta Neurol Scand: 2010: 122: 343,349. © 2009 The Authors Journal compilation © 2009 Blackwell Munksgaard. Objective,,, To study the occurrence of dysphagia and dysphonia in persons with post-polio syndrome admitted into the centre for neurological rehabilitation in Finland. Materials and methods,,, Fifty-one persons with post-polio syndrome who were rehabilitated at Käpylä Rehabilitation Centre, Helsinki, Finland, in 2003,2004 were interviewed on problems with swallowing and voice production. Pulmonary function testing and grip strength measurement were performed. A clinical assessment of oral motor and laryngeal functions was carried out for those who reported daily problems with voice production or swallowing. Results,,, Fifteen persons (29.4%) reported daily problems with swallowing or voice production. In the clinical assessment, the most commonly observed deficits in swallowing included decreased pharyngeal transit (n = 13) and the food catching in the throat (n = 4). The disturbance of co-ordination of breathing and voice production was seen in 12 persons. There were no significant differences in any of the potential predictors between the groups. Conclusions,,, Professionals need to be aware of the routine evaluation of dysphagia and dysphonia in patients with post-polio syndrome. [source]

    Tetranectin and apolipoprotein A-I in cerebrospinal fluid as potential biomarkers for Parkinson's disease

    ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
    E.-S. Wang
    Wang E-S, Sun Y, Guo J-G, Gao X, Hu J-W, Zhou L, Hu J, Jiang C-C. Tetranectin and apolipoprotein A-I in cerebrospinal fluid as potential biomarkers for Parkinson's disease. Acta Neurol Scand: 2010: 122: 350,359. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Objective,,, The application of biomarkers may potentially improve the efficiency of the diagnosis for Parkinson's disease (PD). However, no reliable biomarker has been identified to date. This study is aimed to identify proteins that might serve as potential biomarkers for PD diagnosis or pathogenesis. Materials and methods,,, Two-dimensional difference gel electrophoresis (2D DIGE) technique, in combination with matrix-assisted laser desorption/ionization-time of flight mass spectrometry (MALDI-TOF MS), was used to determine the differentially expressed cerebrospinal fluid (CSF) proteins in PD patients (n = 3) compared with normal controls (n = 3). Selected proteins were further confirmed by Western blotting analysis in the CSF of PD patients (n = 8), Alzheimer's disease (AD) patients (n = 6) and normal control subjects (n = 7). Results,,, Eight proteins were identified after MS and protein database interrogation. In the CSF of PD patients, the expression levels of one isoform of apolipoprotein A-I (apoA-I), tetranectin, myosin phosphatase target subunit 1 (MYPT1), and two unknown proteins were down-regulated, whereas the expression levels of another apoA-I isoform, proapolipoprotein, and lipoprotein were up-regulated. Western blotting indicates that the expression of tetranectin was reduced in the CSF from PD patients and elevated in AD, while the expression of apoA-I was changed only in the CSF from PD patients. Conclusion,,, Our preliminary results suggest that tetranectin and apoA-I may serve as potential biomarkers for PD, though further validation is needed. [source]

    The clinical and neuroimaging studies in Holmes tremor

    ACTA NEUROLOGICA SCANDINAVICA, Issue 5 2010
    A. Gajos
    Gajos A, Bogucki A, Schinwelski M, So,tan W, Rudzi,ska M, Budrewicz S, Koszewicz M, Majos A, Górska-Chrz,stek M, Bie,kiewicz M, Ku,mierek J, S,awek J. The clinical and neuroimaging studies in Holmes tremor. Acta Neurol Scand: 2010: 122: 360,366. © 2010 The Authors Journal compilation © 2010 Blackwell Munksgaard. Aim,,, Holmes tremor (HT) is a combination of rest, postural and action tremor. A parallel dysfunction of cerebello-thalamic and nigrostriatal pathways seems necessary to produce this kind of tremor. We present the clinical and neuroimaging study verifying that hypothesis. Material and methods,,, A total of 10 patients: five male, five female, fulfilling consensus criteria were included. Demographic, clinical and neuroimaging data (MRI = 9; CT = 1, SPECT with the use of 123-I-FP CIT: DaTSCAN in six patients to assess the presynaptic dopaminergic nigrostriatal system involvement, indices of asymmetry for ligand uptake for each striatum were calculated) were analyzed. Results,,, Hemorrhage was the most frequent etiology and thalamus , the most commonly involved structure. Contrary to the previous reports, the visual assessment did not reveal remarkable interhemispheric differences of DaTSCAN uptake. Quantitative measurements showed only minimal differences. Conclusions,,, It is open to debate whether nigrostriatal pathway damage is crucial for the phenomenology of HT. Alternative hypothesis is presented that HT represents the heterogeneous spectrum of tremors with similar phenomenology, but different pathophysiology. [source]