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Relationships between functional capacity measures and baseline psychological measures in chronic pain patients.

The extent to which baseline psychological measures, pain, and compensation status are related to admission and posttreatment functional capacity and employment outcome was investigated. Four pass/fail functional capacity tests based on the DOT (Dictionary of Occupational Titles) classification system and previously shown to be predictive of treatment outcome in chronic pain patients were analyzed in relation to baseline measures of depression, state and trait anxiety, and perceived stress. Statistical tests of all measures with employment level at admission to treatment, 1 month follow-up and at long-term follow-up were also performed. The results showed that pain level and/or compensation status were the primary predictors of functional capacity and employment status at follow-up. Admission functional capacity measures were also predictors of employment outcome. Depression scores at admission predicted some admission functional capacity results, however, psychological scores were not as significantly related to discharge functional capacity tests. One functional capacity test, the crouching test, was an independent predictor of short- and long-term employment outcome. Trait anxiety was the only psychological factor that was independently predictive of long-term employment outcome. In conclusion, these results suggest that psychological variables are related to measures of functional capacity measured at admission. However, psychological measures at admission are not good predictors of later functional capacity measures. Functional capacity measures are important predictors of follow-up employment outcome, but return to work cannot be predicted without taking pain into account.

Adult↗

Major depression and drug disorders in adolescence: general and specific impairments in early adulthood.

OBJECTIVE: To identify adulthood impairments associated with major depression and drug disorders in adolescence, distinguishing between general impairments for both disorders and specific impairments for each disorder. METHOD: Within a longitudinal community study (N= 365), the Diagnostic Interview Schedule provided 1-year diagnoses of major depression and drug abuse/dependence at age 18. At age 21, current functioning was assessed. RESULTS: Adolescents with either depression or drug disorders had substantial deficits in later functioning, with few impairments shared in common. General areas of impairment included lower global functioning, externalizing behavior problems, and suicidal behaviors. Difficulties specific to depression encompassed multiple internalizing problems: interpersonal difficulties, decreased psychological well-being, career dissatisfaction, and active major depression at age 21. For males only, overall poor health was also a specific depression outcome. Age 21 problems unique to drug disorders included lower likelihood of post-high school education, being fired, and active drug disorders. Males, but not females, were also more likely to report antisocial behaviors in adulthood. CONCLUSIONS: Despite several significant commonalities, including suicide attempts, deficits associated with depression and drug disorders were primarily specific, suggesting distinct trajectories. Results highlight the need for specific follow-up services to alleviate continuing problems associated with these disorders.

Adolescent↗

Proteinuria is an early marker in the development of progressive renal failure in hypertensive fawn-hooded rats.

Male spontaneously hypertensive fawn-hooded (FH) rats can be divided into two classes on the basis of their proteinuria. We investigated the relationship between early proteinuria and the impairment of renal function later in life. Urinary protein excretion (UpV), systolic blood pressure (SBP) and parameters of renal function were sequentially determined in male FH rats. A significant difference in UpV was already present from the age of 10 weeks. Class I rats excreted less protein than class II animals. Initially, the glomerular filtration rate (GFR) of class II animals was somewhat higher than that of class I rats, but from week 50 onwards a decrease in GFR of class II rats was noted and from then on rats died due to uraemia. The GFR of class I animals fell from week 75. The fall in GFR was preceded by a concomitant increase in UpV and SBP. The increase occurred earlier and the rate of increase was higher in class II rats. We conclude that a number of hypertensive FH rats die prematurely from end-stage renal failure. The presence of an increased UpV at an early age is an early marker for the development of renal failure.

Age Factors↗

Alcohol drinking and cognitive functions: findings from the Cardiovascular Risk Factors Aging and Dementia (CAIDE) Study.

BACKGROUND: Moderate alcohol drinking is suggested to be beneficial for cognitive functions, but the results of previous studies have varied greatly. Little is known about the effects of midlife alcohol drinking on the cognitive functions later in life. METHODS: Participants were derived from random, population-based samples studied in Eastern Finland in 1972, 1977, 1982, or 1987. A total of 1,341 participants were reexamined in 1998, after an average follow-up period of 21 years, at ages 65-79 years. RESULTS: The participants who did not drink alcohol at midlife had a poorer performance in episodic memory, psychomotor speed, and executive function in late life as compared with infrequent and frequent drinkers, adjusted for sociodemographic and vascular factors. Also late-life nondrinkers had poorer psychomotor speed and executive function. These findings were evident especially among nonsmokers. Further, no interactions between apolipoprotein E4 and alcohol or sex and alcohol were found. CONCLUSIONS: Alcohol drinking both at midlife and later is favorably related to the function in several cognitive domains, including episodic memory, psychomotor speed, and executive function, in late life. However, it is not clear whether the association is causal, what is the possible mechanism, and what would be a safe limit of drinking for the best cognitive function.

Aged↗

Real-time volume rendering of four-dimensional images based on three-dimensional texture mapping.

A four-dimensional (4-D) image consists of three-dimensional (3-D) volume data that varies with time. It is used to express a deforming or moving object in virtual surgery or 4-D ultrasound. It is difficult to obtain 4-D images by conventional ray-casting or shear-warp factorization methods because of their time-consuming rendering process and the pre-processing stage necessary whenever the volume data are changed. Even when 3-D texture mapping is used, repeated volume loading is time-consuming in 4-D image rendering. In this study, we propose a method to reduce data loading time using coherence between currently loaded volume and previously loaded volume in order to achieve real-time rendering based on 3-D texture mapping. Volume data are divided into small bricks and each brick being loaded is tested for similarity to one that was already loaded in memory. If the brick passes the test, it is defined as 3-D texture by OpenGL functions. Later, the texture slices of the brick are mapped into polygons and blended by OpenGL blending functions. All bricks undergo this test. Using continuous deforming, 50 volumes are rendered in interactive time with SGI ONYX. Realtime volume rendering based on 3-D texture mapping is currently available for personal computers.

Humans↗

An expanded role for the TWN1 gene in embryogenesis: defects in cotyledon pattern and morphology in the twn1 mutant of Arabidopsis (Brassicaceae).

The suspensor is a specialized basal structure that differentiates early in plant embryogenesis to support development of the embryo proper. Suspensor differentiation in Arabidopsis is maintained in part by the TWIN1 (TWN1) gene, which suppresses embryogenic development in suspensor cells: twn1 mutants produce supernumerary embryos via suspensor transformation. To better understand mechanisms of suspensor development and further investigate the function of TWN1, we have characterized late-embryo and post-embryonic development in the twn1 mutant, using seedling culture, microscopy, and genetics. We report here that the twn1 mutation disrupts cotyledon number, arrangement, and morphology and occasionally causes partial conversion of cotyledons into leaves. These defects are not a consequence of suspensor transformation. Thus, in addition to its basal role in suspensor differentiation, TWN1 influences apical pattern and morphology in the embryo proper. To determine whether other genes can similarly affect both suspensor and cotyledon development, we looked for twinning in Arabidopsis mutants previously identified by their abnormal cotyledon phenotypes. One such mutant, amp1, produced a low frequency of twin embryos by suspensor transformation. Our results suggest that mechanisms that maintain suspensor identity also function later in development to influence organ formation at the embryonic shoot apex. We propose that TWN1 functions in cell communication pathways that convey local positional information in both the apical and basal regions of the Arabidopsis embryo.

Journal Article↗

Lipids in infant nutrition and their impact on later development.

Numerous studies on infant nutrition show that breast-feeding has a beneficial effect on growth, morbidity, and neurological and cognitive functioning later in life. Moreover, there are indications that a relationship exists between the diet consumed during early childhood and morbidity in adulthood, such as atherosclerosis and insulin-dependent diabetes mellitus. The mechanism causing this advantageous effect of breast-feeding might be found in the fatty acid composition of human milk. The fatty acid content of formula milk is associated with biochemical parameters, cognitive development, and growth. Further research concentrating on randomized trials of 'fatty acid-enriched' formula milks is needed for the sake of children of mothers who opt for bottle-feeding.

Animals↗

Antibodies against the C-terminal peptide of rabbit oviductin inhibit mouse early embryo development to pass 2-cell stage.

A full-length rabbit oviductin cDNA(1909bp) was cloned. It consists of a 5'-UTR of 52bp, an open reading frame (ORF) of 1374bp and a 3'-UTR of 483bp and has more than 80% homology with that of other mammal oviductins. N-terminal peptide (NTP) (384 residues) and C-terminal peptide (CTP) (73 residues) of deduced protein precursor has about 80% and 50% identity with that of other mammals respectively. Fusion proteins GST-NTP 368(1R-368N)and GST-CTP73 (369F-441A) were expressed and purified. NH2-terminal of CTP sequencing reveals that the purified protein is consistent with the deduced one. In order to study the function of NTP and CTP the mouse anti-NTP and rabbit anti-CTP antisera were prepared. Tissue-specific (skeleton muscle, oviduct, uterus, ovary, liver, heart and brain) analysis indicated that rabbit oviductin was only found in oviduct. The conditioned medium derived from the rabbit oviduct mucosa epithelial cells has a function of overcoming the early embryonic development block of Kunming mouse cultured in vitro. Anti-CTP antiserum could totally inhibit the early embryo development at 2-cell stage cultured in the conditioned culture medium, but anti-NTP antiserum couldn't. There was a positive relationship between the ratio of early embryos at development block and the dosage of anti-CTP antiserum added in the conditioned culture medium. These results suggest that oviductin has a function not only on fertilization, but also on the release of early embryonic development block, and the later function domain of rabbit oviductin may be situate in its C-terminal.

Amino Acid Sequence↗

Cognitive impairment in hip fracture patients: timing of detection and longitudinal follow-up.

OBJECTIVES: To examine the prevalence, incidence, persistence, predictors, and outcomes of cognitive impairment after hip fracture. DESIGN: Longitudinal cohort study. SETTING: Eight hospitals in Baltimore, Maryland. PARTICIPANTS: Six hundred seventy-four hip fracture patients aged 65 and older living in the community before fracture. MEASUREMENT: Delirium at admission and postsurgery, Mini-Mental State Examination (MMSE) scores postsurgery, and prefracture proxy ratings of MMSE and dementia. Follow-up measures at 2 and 12 months postfracture included mortality, MMSE, physical activities of daily living (PADLs), instrumental activities of daily living (IADLs), social functioning, and the Center for Epidemiologic Studies-Depression Scale. RESULTS: Overall, 28% had prefracture dementia or MMSE impairment, 8% had cognitive impairment first detected presurgery, 14% had impairment first detected postsurgery, and 50% were not impaired before or during hospitalization. Incident cognitive impairment was more likely in patients who were older, male, and less educated and had more prefracture PADL impairment, intertrochanteric fractures, and higher anesthesia risk ratings. Presurgery incident cases did not differ significantly from those detected postsurgery in functional outcomes or in persistence of cognitive impairment. Cognitive impairment first noted in the hospital persisted through 2 and 12 months in more than 40% of patients. Those with cognitive impairment persisting through 2 months had poorer 12-month PADLs and social functioning. CONCLUSION: Prefracture cognitive impairment and incident cognitive impairment during hospitalization are risk factors for poor functional outcomes. Many incident cognitive problems persisted over 2 to 12 months, and per-sistence predicted later functional and social impairment.

Activities of Daily Living↗

Is cognitive therapy consistent with what we know about emotions?

The cognitive perspective has been a dominant force in psychology and psychotherapy since the 1970s. Cognitive therapies share an emphasis on the priority of changing cognition as the key to bringing about changes in patterns of dysfunctional emotional reactions and symptomatic behaviors. In this article, the author examined the basis for the assumptions of cognitive therapy in the context of recent evidence of the long-term effects of stressful experiences. This evidence contradicts the assumption of many cognitive therapists that changing cognition is prior to and necessary to changing emotional reactions. Neurobiological evidence indicates that emotions can be experienced without cortical interpretations of stimuli, and clinical evidence indicates that experiences can be stored as isolated affective fragments that function later to distort cognition. This suggests that cognitive therapies are based on a limited model of mental functions that sometimes must be supplemented by broader psychodynamic concepts if lasting changes are to occur.

Amygdala↗

Cerebral lateralization of bilingual functions after handedness switch in childhood.

Chinese-English bilingual undergraduates who had been forced to switch their preferred hand from the left to the right during childhood were identified. In hemifield perception of Chinese and English words, ordinary left-handers and handedness-switch subjects showed a less strong left-hemisphere advantage when compared with right-handers. The latter showed a significant superiority in identifying words presented in the right visual field. Handedness switch during early childhood did not seem to affect lateralization of language functions, although other motor functions may be affected.

Adult↗

Dietary essential fatty acids and brain function: a developmental perspective on mechanisms.

Brain development is a complex interactive process in which early disruptive events can have long-lasting effects on later functional adaptation. It is a process that is dependent on the timely orchestration of external and internal inputs through sophisticated intra- and intercellular signalling pathways. Long-chain polyunsaturated fatty acids (LCPUFA), specifically arachidonic acid and docosahexaenoic acid (DHA), accrue rapidly in the grey matter of the brain during development, and brain fatty acid (FA) composition reflects dietary availability. Membrane lipid components can influence signal transduction cascades in various ways, which in the case of LCPUFA include the important regulatory functions mediated by the eicosanoids, and extend to long-term regulation through effects on gene transcription. Our work indicates that FA imbalance as well as specific FA deficiencies can affect development adversely, including the ability to respond to environmental stimulation. For example, although the impaired water-maze performance of mice fed a saturated-fat diet improved in response to early environmental enrichment, the brains of these animals showed less complex patterns of dendritic branching. Dietary n-3 FA deficiency influences specific neurotransmitter systems, particularly the dopamine systems of the frontal cortex. We showed that dietary deficiency of n-3 FA impaired the performance of rats on delayed matching-to-place in the water maze, a task of the type associated with prefrontal dopamine function. We did not, however, find an association over a wider range of brain DHA levels and performance on this task. Some, but not all, studies of human infants suggest that dietary DHA may play a role in cognitive development as well as in some neurodevelopmental disorders; this possibility has important implications for population health.

Animals↗

Functional asymmetry in human primary auditory cortex: identified from longitudinal fMRI study.

The leftward hemispheric dominance in language processing may be associated with fundamental functional asymmetry in the primary auditory cortex (PAC). Based on repeated functional MRI (fMRI) measurements, we investigated the presence of functional asymmetry in the human PAC using binaural presentation of linguistic sounds (two-syllable nouns) and simple tonal stimulation. Eight right-handed volunteers underwent nine fMRI sessions, approximately eight weeks apart, spanning the duration of more than a year. The PAC from each hemisphere was manually segmented and the volume of activation, detected within the segmented region-of-interest, was measured across the subjects and sessions to generate functional laterality indices. Although variations existed in activation volume between sessions and subjects, we found predominant and consistent leftward functional asymmetry in PAC during both linguistic and non-linguistic sound stimulations.

Acoustic Stimulation↗

A troubled youth: relations with somatization, depression and anxiety in adulthood.

BACKGROUND: Childhood experiences profoundly affect later functioning as an adult. Family practitioners are well-placed to discover the links between childhood troubles and later somatization, depression or anxiety. OBJECTIVES: We aimed to study the interrelation of somatization, depressive and anxiety disorders in frequently attending patients in general practice; to investigate whether these problems are related to a childhood history of illness experiences, deprivation, life events and abuse; and to determine the independent contributions of these childhood factors to the prediction of adult somatization, depressive and anxiety disorders. METHODS: One hundred and six adult general practice patients with high consultation frequency were studied. Somatization was operationalized as a more comprehensive version of DSM-III-R somatization disorder (5 complaints; SSI 5/5). For depression (ever depressive and/or dysthymic) and anxiety (panic, phobias and/or generalized anxiety) DSM-III-R criteria were used. Using a structured questionnaire we assessed illness experiences, deprivation of parental care, abuse (sexual/physical) and other life events before age 19. RESULTS: The overlap between somatization, depression and anxiety was largely accounted for by 16 patients with a triple problem: somatization and depression and anxiety. Somatization was specifically related to deprivation, depression to other life events. Abuse (prevalence 16%) independently predicted psychiatric problems in general. Youth experiences before age 12 were most important. CONCLUSIONS: The high prevalence of triple problems suggests a need to reconsider concepts like somatic anxiety and anxious depression. The specificity of the relation between deprivation and somatization and of the relation between other life events and depression indicates that distinct causal mechanisms (in youth) contribute to these problems.

Abdominal Pain↗

Myogenic regulatory factors and the specification of muscle progenitors in vertebrate embryos.

Embryological and genetic studies of mouse, bird, zebrafish, and frog embryos are providing new insights into the regulatory functions of the myogenic regulatory factors, MyoD, Myf5, Myogenin, and MRF4, and the transcriptional and signaling mechanisms that control their expression during the specification and differentiation of muscle progenitors. Myf5 and MyoD genes have genetically redundant, but developmentally distinct regulatory functions in the specification and the differentiation of somite and head muscle progenitor lineages. Myogenin and MRF4 have later functions in muscle differentiation, and Pax and Hox genes coordinate the migration and specification of somite progenitors at sites of hypaxial and limb muscle formation in the embryo body. Transcription enhancers that control Myf5 and MyoD activation in muscle progenitors and maintain their expression during muscle differentiation have been identified by transgenic analysis. In epaxial, hypaxial, limb, and head muscle progenitors, Myf5 is controlled by lineage-specific transcription enhancers, providing evidence that multiple mechanisms control progenitor specification at different sites of myogenesis in the embryo. Developmental signaling ligands and their signal transduction effectors function both interactively and independently to control Myf5 and MyoD activation in muscle progenitor lineages, likely through direct regulation of their transcription enhancers. Future investigations of the signaling and transcriptional mechanisms that control Myf5 and MyoD in the muscle progenitor lineages of different vertebrate embryos can be expected to provide a detailed understanding of the developmental and evolutionary mechanisms for anatomical muscles formation in vertebrates. This knowledge will be a foundation for development of stem cell therapies to repair diseased and damaged muscles.

Animals↗

The Dougados Functional Index with the 5-point Likert scale is sensitive to change due to intensive physiotherapy and exercise in spondyloarthropathy.

OBJECTIVE: The aim of the present study was to evaluate whether the Dougados Functional Index (DFI) with 5-point Likert scale is sensitive enough to demonstrate the efficacy of intensive physiotherapy and exercise. METHODS: Eight-one consecutive patients with spondyloarthropathy (SpA) completed self-administered questionnaires on functional analysis, the Bath Ankylosing Spondylitis Functional Index (BASFI) and the DFI with 5-point Likert scale, at the beginning and end of a 3-week in-patient course based on intensive physiotherapy and exercise. The objective effect of the course was measured with 10 ranges of movement. After a 6-month follow-up the patients completed the questionnaires by mail for analysis of the lasting impact of rehabilitation on function. RESULTS: The in-patient course was highly effective: all ranges of movement and both functional indices including the DFI with 5-point Likert scale improved to a highly significant degree. Six months later functional ability as measured by the DFI remained significantly better than at baseline before the in-patient course, but the BASFI had returned to the baseline level. CONCLUSION: The DFI with 5-point Likert scale is sensitive enough to demonstrate the effect of intensive physiotherapy and exercise.

Adult↗

Treatment of lateral instability of the ankle--a new modification of the Evans repair.

A modification of the Evans repair using only half of the peroneus brevis tendon was applied in the treatment of 34 patients with chronic functional lateral instability of the ankle. With a median follow-up of 25 months, 32 patients were examined. Functional stability was achieved in all but one patient. This modification of Evans' repair is recommended, as it is technically easy, gives good functional stability, and has the theoretical advantage of saving an important pronator of the foot.

Adolescent↗

Reversed laterality of cerebral functions in a non-right-hander: neuropsychological and spect findings in a case of 'atypical' dominance.

A 54-year-old non-right-handed man with positive familial sinistrality showed a pure right hemisphere syndrome following a left hemisphere stroke. Severe right side hemineglect, transcortical motor dysprosodia, spatial dysgraphia and visuo-constructive impairments were observed. At no time were the expected left hemisphere abnormalities such as aphasia, alexia, right-left disorientation or finger agnosia noted. A left fronto-temporal subcortical lesion was documented on CT scan. A Tc-99m HM-PAO SPECT study revealed no cerebral blood flow changes in the right hemisphere while in the left hemisphere a fronto-temporo-parietal cerebral blood flow reduction was evident. This case of a complete reversed laterality of cognitive functions argues for a distinction to be made between 'anomalous' cerebral dominance and 'atypical' cerebral dominance.

Brain↗