Nonpharmacological therapy of vertigo and balance disorder by means of the OCULOSTIM hardware-software complex

A new computerized method for the correction and inhibition of unfavorable illusory (vertigo), vestibular-oculomotor (nystagmus), and vestibular-postural (balance) responses is proposed for teaching subjects to block generalization of an afferent signal to the effector mechanisms of the central nervous system by developing a fixation reflex with the employment of delayed feedback for self-testing. Three variants of this method were used, depending on the type of stimulation programs aimed at the induction of illusory and oculomotor responses of a certain sensory modality (visual, vestibular, or combined). The study was carried out in 36 subjects divided into three equal groups taught using visual, vestibular, and combined techniques. Each group included patients with vestibulopathies of organic (peripheral and central origin) and psychic genesis. Comparative analysis of the teaching efficiency for the three versions of the method showed that the visual, vestibular, and combined variants of correction were the most efficient for patients with peripheral, central, and psychogenic vestibulopathies, respectively.     

Serum cholesterol concentrations in suicidal and non-suicidal male patients suffering from persistent delusional disorder

Suicidal behavior is a major health risk in psychiatric disorders, especially in affective and psychotic disorders. The neurobiology of suicidal behavior is still unclear. Suicidality has been related to a reduced cholesterol levels. The aim of this study was to evaluate serum cholesterol concentrations in suicidal and non-suicidal men suffering from persistent delusional disorder and in healthy volunteers. Results showed that serum cholesterol concentrations were significantly lower in suicidal than in non-suicidal patients and healthy controls. Also, level of psychopathology (measured by Brief Psychiatric Rating Scale) is significantly marked in the group of suicidal patients, which indicates the importance of detecting some clinical symptoms in patients with persistent delusional disorder in order to prevent suicidal behavior.     

手外伤激光照射康复护理观察研究

目的：探讨激光照射对手外伤患者的康复效果。方法：随机选取87例手外伤患者为观察组,采用激光照射与作业疗法,支具、心理疗法相结合;对照组63例,只采用作业疗法、支具及心理疗法。观测伤部疼痛减轻及消退情况,肿胀消退时间,康复治疗2月进行手功能评定。结果：观察组疼痛消失时间,肿胀消退时间,手功能康复均优于对照组,两组比较,差异均具有显著意义。结论：手外伤术后患者激光照射治疗能明显缩短手康复时间,提高康复质量。     

Substrate deprivation therapy: a new hope for patients suffering from neuronopathic forms of inherited lysosomal storage diseases

Lysosomal storage diseases are a group of disorders caused by defects in enzymes responsible for degradation of particular compounds in lysosomes. In most cases, these diseases are fatal, and until recently no treatment was available. Introduction of enzyme replacement therapy was a breakthrough in the treatment of some of the diseases. However, while this therapy is effective in reduction of many somatic symptoms, its efficacy in the treatment of the central nervous system is negligible, if any, mainly because of problems with crossing the blood-brain-barrier by intravenously administered enzyme molecules. On the other hand, there are many lysosomal storage diseases in which the central nervous system is affected. Results of very recent studies indicate that in at least some cases, another type of therapy, called substrate deprivation therapy (or substrate reduction therapy) may be effective in the treatment of neuronopathic forms of lysosomal storage diseases. This therapy, based on inhibition of synthesis of the compounds that cannot be degraded in cells of the patients, has been shown to be effective in several animal models of various diseases, and recent reports demonstrate its efficacy in the treatment of patients suffering from Niemann-Pick C disease and Sanfilippo disease.     

Serum cholesterol concentration and structured individual psychoanalytic psychotherapy in suicidal and non-suicidal male patients suffering from borderline personality disorder

Findings from numerous studies suggest an association between low cholesterol levels and suicidal behavior in patients with different psychiatric diagnoses. The aims of this case-control study were to test whether cholesterol levels in male suicidal patients (N=20) with borderline personality disorder (BPD) are lower than in male non-suicidal patients (N=20) with BPD and male healthy control group (N=20), and to evaluate the influence of structured individual psychoanalytic psychotherapy on suicidal behavior. The groups were matched for age and body mass index (BMI). Results showed that serum cholesterol levels did not differ significantly between suicidal and non-suicidal BPD patients and healthy controls. The level of psychopathology (measured by Brief Psychiatric Rating Scale and Hamilton Depression Rating Scale) was significantly higher in the group of suicidal patients, which indicates the importance of evaluating particular clinical symptoms in BPD, in order to prevent suicidal behavior. Non-suicidal male patients suffering from BPD received more frequently structured individual psychoanalytic psychotherapy prior to the hospitalization than suicidal group. These results emphasized the role of this type of psychotherapy in preventing suicidal behavior in BPD patients.     

Significance of immune response to enzyme-replacement therapy for patients with a lysosomal storage disorder

Lysosomal storage disorders are collectively important because they cause significant morbidity and mortality. Patients can present with severe symptoms that include somatic tissue and bone pathology, developmental delay and neurological impairment. Enzyme-replacement therapy has been developed as a treatment strategy for patients with a lysosomal storage disorder, and for many of these disorders this treatment is either in clinical trial or clinical practice. One major complication arising from enzyme infusion into patients with a lysosomal storage disorder is an immune response to the replacement protein. From clinical trials, it is clear that there is considerable variability in the level of immune response to enzyme-replacement therapy, dependent upon the replacement protein being infused and the individual patient. Hypersensitivity reactions, neutralizing antibodies to the replacement protein and altered enzyme targeting or turnover are potential concerns for patients exhibiting an immune response to enzyme-replacement therapy. The relative occurrence and significance of these issues have been appraised.     

Stigmatization of patients suffering from schizophrenia

For the general public, but also for healthcare professionals, schizophrenia is still one of those areas of medicine connected with feelings of unease, fear and prejudice. These feelings lead to stigmatization and discrimination which are unjust processes which put patients suffering from mental illnesses into undesirable and unequal positions. Aim of this research was to establish the extent of stigmatization of mentally ill patients among the population of healthcare professionals and future healthcare professionals and if they differ from general population. Results show that stigmatization of schizophrenic patients is high among all included populations. Although there were no statistical differences between groups regarding the assessment of schizophrenic patients, nurses employed in psychiatric wards exhibited a tendency towards higher acceptance of schizophrenic patients, as well as better understanding of that illness. This data emphasizes a growing need for continuous education of general population but also of healthcare professionals.     

Primary cilia in energy balance signaling and metabolic disorder

Energy homeostasis in our body system is maintained by balancing the intake and expenditure of energy. Excessive accumulation of fat by disrupting the balance system causes overweight and obesity, which are increasingly becoming global health concerns. Understanding the pathogenesis of obesity focused on studying the genes related to familial types of obesity. Recently, a rare human genetic disorder, ciliopathy, links the role for genes regulating structure and function of a cellular organelle, the primary cilium, to metabolic disorder, obesity and type II diabetes. Primary cilia are microtubule based hair-like membranous structures, lacking motility and functions such as sensing the environmental cues, and transducing extracellular signals within the cells. Interestingly, the subclass of ciliopathies, such as Bardet-Biedle and Alström syndrome, manifest obesity and type II diabetes in human and mouse model systems. Moreover, studies on genetic mouse model system indicate that more ciliary genes affect energy homeostasis through multiple regulatory steps such as central and peripheral actions of leptin and insulin. In this review, we discuss the latest findings in primary cilia and metabolic disorders, and propose the possible interaction between primary cilia and the leptin and insulin signal pathways which might enhance our understanding of the unambiguous link of a cell’s antenna to obesity and type II diabetes. [BMB Reports 2015; 48(12): 647-654]     

Bridging the gap between temporomandibular disorders,static balance impairment and cervicogenic dizziness: Posturographic and clinical outcomes

Several studies have investigated the possible influence of temporomandibular disorders (TMD) on body posture and whether cervical spine disorders, such as cervicogenic dizziness (CGD) could play an additional role in affecting static balance. The purpose of this study was to analyze static postural behavior by means of static posturography, in patients affected by either TMD or CGD alone or by both conditions, and to compare findings with a group of healthy subjects. Significant changes in posturographic parameters were found among the three groups of patients and when compared with controls. When the three study groups were compared to each other, subjects affected by a combination of TMD and CGD showed worse postural performances with respect to subjects affected by CGD or TMD alone. Correlations with self-perceived dizziness, anxiety, depression and jaw functionality, investigated by means of validated questionnaires, were found among all patient groups. These results provide new evidences for the presence of static balance alterations in patients suffering from TMD with and without associated cervical spine impairment, by using a reliable diagnostic technique. Further studies are needed in order to identify any causal relation between these two disorders.     

Psychiatry: cognitive therapy for depression and panic disorder

The Scientific Board of the California Medical Association presents the following inventory of items of progress in psychiatry. Each item, in the judgment of a panel of knowledgeable physicians, has recently become reasonably firmly established both as to scientific fact and important clinical significance. The items are presented in simple epitome and an authoritative reference, both to the item itself and to the subject as a whole, is generally given for those who may be unfamiliar with a particular item. The purpose is to assist busy practitioners, students, research workers, or scholars to stay abreast of these items of progress in psychiatry that have recently achieved a substantial degree of authoritative acceptance, whether in their own field of special interest or another.The items of progress listed below were selected by the Advisory Panel to the Section on Psychiatry of the California Medical Association, and the summaries were prepared under its direction.     

草地农业生态系统的碳平衡分析方法

根据草地农业生态系统的结构,它的碳平衡为4个生产层的碳平衡之和,也是3个界面的碳平衡之和,而某一生产层或者某一界面的碳平衡则是其固定、输入、排放和输出的碳之和。草地农业生态系统4个生产层的碳平衡分析方法定量重要生产环节的碳汇与碳源过程,便于草业生产改进碳汇管理;草地农业生态系统3个界面的碳平衡分析方法显示碳源和碳汇的发生机理,及其空间和数量关系,便于调控草业生产组分以增汇减排;但是,这两个方法不易区分碳的来源和去向,难以明确其利用效率。草地农业生态系统碳平衡分析的输入/输出法定量地指示碳的来源和去向,以及碳效率,计算简单,但是较为概括,不利于牧场尺度的草业碳汇管理。以中国祁连山甘肃马鹿牧场和澳大利亚塔斯玛尼亚奶牛牧场为例,用3种方法分析了两个牧场的碳平衡,结果表明,放牧管理的草业系统的主要碳源是休闲旅游、产品加工流通环节产生的温室气体,主要碳汇是草地和土壤中贮存的碳,好的草地管理可以增汇减排。     

Artificial mountain climate in therapy and rehabilitation of patients with chronic nonspecific pulmonary diseases]

Therapeutic efficiency of artificial Alpine climate was studied in a group of 318 patients with chronic nonspecific pulmonary diseases (CNDP). The Alpine climate was modelled on device "Orotron". The base, progradient and prolonged regimes of therapy by artificial Alpine climate (orhotherapy) were used in work. It is shown that application of optimal conditions of orhotherapy promotes normalization of the external respiration function in patients with CNPD due to a decrease in expression of broncho-obstructive and bronchitic syndromes and in nonuniformity of regional ventilation of lungs. Therapy by artificial Alpine climate is recommended to be used in wide clinical practice for treatment and rehabilitation of patients with CNDP.     

Use of balance methods for assessment of short-term changes in body composition

Balance methods reveal changes in body energy, nitrogen, macro‐ and micronutrients as well as fluid in response to different feeding regimens. Under metabolic ward conditions, where physical activity is restricted and activity and food intake are controlled, the errors of estimates of energy intake, energy expenditure, and energy losses are about 2, 4, and 2%, respectively. Balance techniques can be used to validate techniques of in vivo body composition analysis (BCA). This is necessary since immediate and transient changes in body composition in response to a change in diet adversely affect the validity of techniques by violating the assumptions underlying standard methods (i.e., a constant composition or hydration of lean mass). Using two compartment reference methods, like densitometry, dual X‐ray absorptiometry (DXA) or deuterium dilution, changes in fat mass with caloric restriction and overfeeding can be measured with a minimal detectable change (MDC) of 1.0–2.0 kg. However, when compared against balance data, the validity of these techniques to measure short‐term changes in body composition is poor. The noninvasive and rapid new quantitative magnetic resonance (QMR) technique has a high precision with a MDC of 0.18 kg of fat mass. The validity of QMR to assess short‐term changes in fat mass is challenged by comparison to balance data. Today, techniques used for in vivo BCA should be related to steady state conditions only, while in the nonsteady state, the use of balance methods is recommended to assess short‐term changes in body composition.     

Evaluating cancer patients for rehabilitation potential.

The Karnofsky performance scale is the most widely used method of quantifying cancer patients'' ability to function. It has also been used to measure patients'' function before and after treatment. Because identifying problems with function is the cornerstone of rehabilitating patients with cancer, we developed a table that relates the functional independence measure with the Karnofsky scale. This approach encourages oncologists to consider inpatient or outpatient rehabilitation services for a broader range of cancer patients. We assessed 70 cancer patients undergoing rehabilitation to identify similarities between the functional independence measure used at our facility and the Karnofsky scale. In activities we considered vital, only 14% of patients were independent with ambulation on admission and, at discharge, 80% were independent or supervised with ambulation. Toilet transfers and bowel and bladder continence improved by the time of discharge. Three months after they were discharged, 28 of the 37 patients had maintained their discharge function level or had improved. Of the original group, 19 had died.     

Problems of rehabilitation and prophylaxis of adverse reactions to antiestrogen therapy in patients with breast cancer

The principles of specific rehabilitation in females with hormone sensitive breast cancer depending on the type of the antiestrogen hormonotherapy are described. According to the different mechanisms of action of the antiestrogen blockers impact (blocking of estrogen receptors, steroid and nonsteroid aromatase inhibition) programs for rehabilitation depending on the different spectra of antiestrogen therapy side effects were designed.     

Perception of unsteadiness in patients with dizziness: association with handicap and imbalance

Dizziness is a common problem in patients seeking medical help and is often associated with imbalance and handicap. This study aimed to reveal whether the perception of unsteadiness could be an indication of greater imbalance and handicap in these patients. Patients with dizziness were categorized into two groups, steady patients (n = 15) and unsteady patients (n = 23), based on the presence or absence of self-perceived unsteadiness. The level of self-perceived handicap was evaluated by the Dizziness Handicap Inventory. Static balance ability was evaluated using a force platform and the center of pressure motion was calculated during various quiet standing conditions. Dynamic balance ability was evaluated by the functional forward reach test and Dynamic Gait Index. All the patients also went through isometric strength tests of the lower extremities. It was found that all patients reported themselves to be handicapped by dizziness. Patients who perceived themselves to be unsteady had greater handicap and poorer static standing, but did not differ from the steady patients in regard to muscle strength or functional balance tests. Thus, self- perceived unsteadiness was associated with greater handicap and poorer static balance in dizzy patients. In clinical management of these patients, special attention should be paid to balance and handicap.