Long-term effects of acute and of chronic hypoxia on behavior and on hippocampal histology in the developing brain

Ten-day-old rat pups (P10) subjected to acute hypoxia (down to 4% O2) had as adults increased aggression (handling test), memory impairment (water maze test), and decreased CA1 cell counts. Pups subjected to chronic hypoxia (10% O2 from P0 to P21) had increased aggression, hyperactivity (open-field test), and decreased CA1 cell counts. Chronic hypoxia with superimposed acute hypoxia resulted in consequences that were not different from those of chronic hypoxia.     

Online aggressor/targets, aggressors, and targets: a comparison of associated youth characteristics

BACKGROUND: While most youth report positive experiences and activities online, little is known about experiences of Internet victimization and associated correlates of youth, specifically in regards to Internet harassment. METHODS: The Youth Internet Safety Survey is a cross-sectional, nationally representative telephone survey of young regular Internet users in the United States. Interviews were conducted between the fall of 1999 and the spring of 2000 and examined characteristics of Internet harassment, unwanted exposure to sexual material, and sexual solicitation that had occurred on the Internet in the previous year. One thousand, five hundred and one regular Internet users between the ages of 10 and 17 years were interviewed, along with one parent or guardian. To assess the characteristics surrounding Internet harassment, four groups of youth were compared: 1) targets of aggression (having been threatened or embarrassed by someone; or feeling worried or threatened by someone's actions); 2) online aggressors (making rude or nasty comments; or harassing or embarrassing someone with whom the youth was mad at); 3) aggressor/targets (youth who report both being an aggressor as well as a target of Internet harassment); and 4) non-harassment involved youth (being neither a target nor an aggressor online). RESULTS: Of the 19% of young regular Internet users involved in online aggression, 3% were aggressor/targets, 4% reported being targets only, and 12% reported being online aggressors only. Youth aggressor/targets reported characteristics similar to conventional bully/victim youth, including many commonalities with aggressor-only youth, and significant psychosocial challenge. CONCLUSIONS: Youth aggressor/targets are intense users of the Internet who view themselves as capable web users. Beyond this, however, these youth report significant psychosocial challenge, including depressive symptomatology, problem behavior, and targeting of traditional bullying. Implications for intervention are discussed.     

Validity and reliability of the school function assessment in elementary school students with disabilities

This study examined validity of the School Function Assessment (SFA) and interrater reliability of occupational therapist and teacher ratings of students' school function. The validity of the SFA was examined using the known-group method in 35 participants in kindergarten through 7th grade attending elementary schools; 15 students with learning disabilities (LD), 11 students with autism, and 9 students with traumatic brain injury (TBI). The SFA criterion scores for the 23 individual scales were clustered into five distinct parts for the validity analyses. Significant differences in SFA scores among the 3 groups of students were found using Kruskal-Wallis analyses (Chi2 ranged from 9.28 to 20.55, p <.01). Two discriminant analyses demonstrated high correct classification of students with autism and LD, but showed less accurate classification of students with TBI, indicating that the SFA scores of students with TBI did not fall into a systematic pattern for classification. For the interrater reliability study, 16 students' ratings by their teacher and occupational therapist were analyzed. Intraclass correlations resulted in moderate relationships between teacher and occupational therapist ratings for the average criterion scores for the three main sections of the SFA: participation,.70; task supports,.68; and activity performance,.73. Results of this study are discussed in terms of validity of score interpretation and the reliability of different team members completing the SFA questionnaire.     

Severe pneumococcal meningitis heralding a deep hypogammaglobulinaemia related to common variable immunodeficiency, at the age of 27 years

Common variable immunodeficiency with an associated broad immunoglobulin (0.7%) deficit affecting all subclasses, was revealed in a 27-y-old previously healthy female, upon development of a severe pneumococcal meningitis. We report the third case of purulent meningitis complicating this primary immunodeficiency, and the second due to Streptococcus pneumoniae. Clinicians should maintain an elevated suspicion for congenital immunodeficiency, especially when observing adult patients with a negligible prior history.     

Retrospective case series on patients with chronic spinal pain treated with dextrose prolotherapy

OBJECTIVES: To determine the clinical benefits of dextrose prolotherapy in patients with chronic spinal pain. DESIGN: Retrospective case series. SETTING/LOCATION: During the first 2 years at an outpatient prolotherapy clinic. SUBJECTS: One hundred and seventy-seven (177) consecutive patients with a history of chronic spinal pain completed prolotherapy treatment and were followed for a period ranging from 2 months to 2.5 years. INTERVENTIONS: Patients were treated with a proliferant solution containing 20% dextrose and 0.75% xylocaine. One half milliliter (0.5 mL) of proliferant was injected into the facet capsules of the cervical, thoracic, and lumbar spine, or combinations of the three areas. The iliolumbar and dorsal sacroiliac ligaments were also injected in patient with low back pain. Injections were typically done on a weekly basis for up to 3 weeks. A set of three injections was repeated in 1 month's time if needed. OUTCOME MEASURES: Level of pain, and improvement in activities of daily living were measured on a five-point scale. Improvement in ability to work was also assessed. RESULTS: Ninety-one percent (91.0%) of patients reported reduction in level of pain; 84.8% of patients reported improvement in activities of daily living, and 84.3% reported an improvement in ability to work. Women required on average, three more injections than men. Cervical spine response rates were lower than thoracic or lumbar spine. No complications from treatment were noted. CONCLUSIONS: Dextrose prolotherapy appears to be a safe and effective method for treating chronic spinal pain that merits further investigation. Future studies need to consider differences in gender response rates.     

Cancer immunotherapy and heat-shock proteins: promises and challenges

Recent mechanistic studies on the role of heat-shock proteins (HSPs) to induce innate and adaptive immune responses have resulted in conflicting reports. Whereas some groups reported that HSPs have direct immunological function, others emphasised the endotoxin contamination of HSP preparations and questioned the antigen-specificity of HSP vaccines. The present review will discuss these issues and suggest that HSPs have diverse and distinct immunological functions that could be superimposed on effects resulting from endotoxin contamination or misunderstood by using experimental procedures with inadequate controls. To understand the actual function of HSPs in their interaction with the immune system, methods and procedures need to be optimised and appropriate controls need to be used. These points should also clarify the conflicting findings about HSPs and promote our knowledge about other immuologically important components that may be present in HSP preparations.     

Three-dimensional virtual cholangioscopy: a reliable tool for the diagnosis of common bile duct stones

OBJECTIVE: Our goal was to evaluate the clinical reliability of a new software system employing 3-dimensional (3D) virtual anatomic reconstruction and intraluminal virtual exploration for detection of choledocholithiasis and preoperative visualization of the biliary anatomy. SUMMARY BACKGROUND DATA: Virtual reality systems have been proposed for gastroscopy, bronchoscopy, and colonoscopy, as well as for the 3D reconstruction of liver anatomy and hepatic lesions. The impact of these systems in preoperative diagnostics has not been established due to the lack of large clinical series evaluating their reliability. METHODS: From November 2000 to July 2002, all patients presenting to our Institute with suspected choledocholithiasis were prospectively included in the study. All patients underwent conventional magnetic resonance cholangiopancreatography (MRCP) and either intraoperative cholangiogram (IOC) or endoscopic retrograde cholangiopancreatography (ERCP). The digital data from MRCP were incorporated into an original virtual reality software system to generate a 3D reconstruction. All 3D reconstructions were evaluated by a surgeon and a computer software engineer who were blind to the results of the IOC or ERCP. Sensitivity and specificity were then calculated based on the results of either the IOC or ERCP. RESULTS: Sixty-five patients were enrolled in the study. The average time required to reconstruct the images into navigable virtual reality was 7.5 minutes (range, 4-13.5). The 3D virtual cholangioscopy had sensitivity and specificity rates of 71% and 91%, respectively, compared with 61% and 86% of the standard MRCP. CONCLUSION:: The 3D virtual cholangioscopy provides detailed preoperative reconstruction of biliary anatomy and reliable identification of choledocholithiasis with acceptable sensitivity and specificity in a clinical setting. Newer software developments may further enhance its accuracy, so that virtual cholangioscopy might challenge or replace more invasive diagnostic measures in the near future.