Literature search from ms 29/4/2010

Jones, C. A., S. L. Pohar, et al. (2009). "Major depression and health-related quality of life in Parkinson's disease." GENERAL HOSPITAL PSYCHIATRY 31(4): 334-40.

Depression is a common psychiatric condition in Parkinson's disease (PD), yet the burden of depression on health-related quality of life (HRQL) has not been clearly delineated in this patient population. OBJECTIVE: To evaluate the impact of depression and life stress on HRQL in the Canadian community dwelling population with PD. METHODS: A total of 259 respondents from the Canadian Community Health Survey (CCHS 1.1) with self-reported PD were interviewed. Measures included Health Utilities Index Mark 3 (HUI3), Composite International Diagnostic Interview Short Form for Major Depression and a single question regarding the amount of stress in their lives most days. Adjusted HUI3 scores were compared according to depression and life stress using ANCOVA models. RESULTS: Respondents without depression had overall HUI3 scores that were 0.29 units higher than respondents with depression [adjusted mean (95% CI) 0.49 (0.39-0.59) vs. 0.20 (0.03-0.37)]. The difference in overall HUI3 scores between respondents who reported high levels of stress as those who did not was 0.19 [adjusted mean (95% CI) 0.42 (0.29-0.55) vs. 0.23 (0.10-0.36)]. CONCLUSIONS: Substantial impact of depression and life stress, two modifiable factors, on HRQL is seen in PD. HRQL may be improved by clinical management of these nonmotor symptoms in PD.

Jones, C. A., S. L. Pohar, et al. (2008). "The burden of multiple sclerosis: a community health survey." Health & Quality of Life Outcomes 6: 1.

BACKGROUND: Health-related quality of life (HRQL) in persons with multiple sclerosis (MS) who reside within the community relative to the general population is largely unknown. Data from the Canadian Community Health Survey Cycle 1.1 (CCHS 1.1) were used to compare HRQL of persons with MS and the general population. METHODS: A representative sample of adults (18 years or older) from the cross sectional population health survey, CCHS 1.1, was examined to compare scores on the Health Utilities Index Mark 3 (HUI3), a generic preference-based HRQL measure, of respondents with (n = 302) and without (n = 109,741) MS. Selected sociodemographic covariates were adjusted for in ANCOVA models. Normalized sampling weights and bootstrap variance estimates were used in the analysis. RESULTS: The mean difference in overall HUI3 scores between respondents with and without MS was 0.25 (95% CI: 0.20, 0.31); eight times greater than the clinically important difference. The largest differences in scores were seen with the ambulation (0.26; 95% CI: 0.20, 0.32) and pain attributes (0.14; 95% CI: 0.09, 0.19). Clinically important differences with dexterity and cognition were also observed. CONCLUSION: While the proportion of the Canadian population with MS is relatively small in comparison to other diseases, the magnitude of the burden is severe relative to the general population.

Jong Hong, S., H. Chae, et al. (2004). "Molecular cloning and characterization of the promoter region of the human Phox2b gene." BRAIN RESEARCH Molecular Brain Research. 125(1-2): 29-39.

The closely related homeodomain transcription factors, Phox2a and Phox2b, are restrictively expressed in central and peripheral noradrenergic (NA) neurons in an overlapping but distinct manner, and critically regulate the differentiation and neurotransmitter identity of NA neurons. The structure and function of the human Phox2a (hPhox2a) promoter has recently been reported. Towards the long-term goal of delineating the regulatory cascade of NA neuron differentiation, we isolated a human Phox2b (hPhox2b) genomic clone encompassing approximately 7.8 kb of the 5' upstream promoter region, the entire exon-intron structure and 4.5 kb of the 3' flanking region. Two transcription start sites are identified to reside 115 and 110 nucleotides upstream of the start codon, based on both primer extension and 5'-rapid amplification of the cDNA ends analyses. In addition, transient transfection assays indicate that 1.1 kb or longer upstream sequences of the hPhox2b gene may confer cell type-specific gene expression in certain, but not all cell lines. The promoter activity of the hPhox2b gene is modestly transactivated by forced co-expression of Phox2b and the hPhox2b gene promoter contains a high-affinity binding site at -320 to -295 bp. This study provides a frame to further elucidate the molecular mechanisms underlying the regulation of Phox2a and Phox2b gene expression and its relation to NA differentiation.

Ju, M. J., P. Aroca, et al. (2004). "Molecular profiling indicates avian branchiomotor nuclei invade the hindbrain alar plate." NEUROSCIENCE 128(4): 785-796.

It is generally believed that the spinal cord and hindbrain consist of a motor basal plate and a sensory alar plate. We now have molecular markers for these territories. The relationship of migrating branchiomotor neurons to molecularly defined alar and basal domains was examined in the chicken embryo by mapping the expression of cadherin-7 and cadherin-6B, in comparison to genetic markers for ventrodorsal patterning (Otp, Pax6, Pax7, Nkx2.2, and Shh) and motoneuron subpopulations (Phox2b and Isl1). We show cadherin-7 is expressed in a complete radial domain occupying a lateral region of the hindbrain basal plate. The cadherin-7 domain abuts the medial border of Pax7 expression; this common limit defines, or at least approximates, the basal/alar boundary. The hindbrain branchiomotor neurons originate in the medial part of the basal plate, close to the floor plate. Their cadherin-7-positive axons grow into the alar plate and exit the hindbrain close to the corresponding afferent nerve root. The cadherin-7-positive neuronal cell bodies later translocate laterally, following this axonal trajectory, thereby passing through the cadherin-7-positive basal plate domain. Finally, the cell bodies traverse the molecularly defined basal/alar boundary and move into positions within the alar plate. After the migration has ended, the branchiomotor neurons switch expression from cadherin-7 to cadherin-6B. These findings demonstrate that a specific subset of primary motor neurons, the branchiomotor neurons, migrate into the alar plate of the chicken embryo. Consequently, the century-old concept that all primary motor neurons come to reside in the basal plate should be revised. copyright 2004 IBRO. Published by Elsevier Ltd. All rights reserved.

Juhl, B. and F. O. Norregaard (1995). "[Congenital central hypoventilation--treated with nocturnal biphasic intermittent respiration via nasal mask]." UGESKRIFT FOR LAEGER 157(12): 1683-4.

A case of congenital central hypoventilation syndrome (CCHS) was undiagnosed until the girl in question was eight years old. Her development was normal, although with symptoms and signs of nocturnal hypoventilation. At the age of eight, with an interval of eight months, she suffered two attacks of acute respiratory insufficiency necessitating intubation and respiratory treatment. The episodes were considered to be pneumonia/septicaemia, but were in retrospect proven to be lung congestion as a consequence of hypercapnia and hypoxaemia. After the last episode CCHS was confirmed. The difficulties in diagnosing CCHS are discussed. After extubation she has been successfully treated with nocturnal nasal intermittent positive pressure ventilation (NIPPV) with BiPAP (Respironic), and she has in this way avoided tracheostomy.

Kabinoff, G., K. C. Sharma, et al. (1996). "Death by syrinx: worse than Ondine's curse?" CHEST 109(3): 598-9.

Kaida, A., I. Colman, et al. (2008). "Recent Pap tests among Canadian women: is depression a barrier to cervical cancer screening?" Journal of Women's Health 17(7): 1175-81.

BACKGROUND: Previous studies have shown that depression is associated with both lower use of preventive cancer screening programs and lower probability of cancer survival. Given the increasing incidence of depression among Canadian women, this study sought to determine if recent Pap testing varies by the presence of depression. METHODS: This population-based study used cross-sectional, self-reported data from the Canadian Community Health Survey (CCHS) Cycle 3.1 (2005) to estimate the association between depression and recent Pap testing within the previous 3 years among 2351 Canadian women without hysterectomy aged 18-69 years. RESULTS: After adjustment for confounders, depressed women had nonsignificantly increased odds of a recent Pap test (OR 1.08, 95% CI 0.95, 1.29); however, age was an important effect modifier of this relationship. Young depressed women (18-29 and 30-39 years) were significantly more likely to report a recent Pap test (AOR 1.78, 95% CI 1.37, 2.31, and AOR 1.47, 95% CI 1.00, 2.15, respectively), whereas middle-aged depressed women (40-49 and 50-59 years) were significantly less likely to report a recent Pap test (AOR 0.76, 95% CI 0.58, 0.98, and AOR 0.68, 95% CI 0.50, 0.93, respectively) compared with their nondepressed counterparts. No significant relationship was detected for the oldest age group (60-69 years). CONCLUSIONS: To our knowledge, these results are the first to demonstrate an interaction effect of age on the association between depression and recent Pap testing. Longitudinal studies should be conducted to explore the role of age as an effect modifier of this relationship and to inform policy and programming aimed at improving rates of cervical cancer screening across all age groups.
Kairouz, S., L. Nadeau, et al. (2005). "Area variations in the prevalence of substance use and gambling behaviours and problems in Quebec: a multilevel analysis." Canadian Journal of Psychiatry - Revue Canadienne de Psychiatrie 50(10): 591-8.

OBJECTIVES: This study aimed to examine whether variations among regions in Quebec existed after we controlled for individual characteristics in the prevalence of 1) alcohol, cannabis, and gambling behaviours and 2) substance-related disorders and pathological gambling. METHODS: Using data derived from the Canadian Community Health Survey: Mental Health and Well-Being (CCHS 1.2), we nested 5332 respondents from the province of Quebec within 374 regions equivalent to census subdivisions (CSDs). Outcome variables included 1) drinking status (past 12 months), alcohol consumption (last week), and 12-month diagnosis of alcohol dependence; 2) cannabis use (past 12 months and lifetime) and diagnosis of illicit drug dependence; and 3) gambling status, severity of gambling problems, and number of reported gambling activities (past 12 months). Multilevel regression models with individuals (Level 1) nested in regions (CSDs, Level 2) assessed the variations among regions in the prevalence of various outcomes and disorders when individual characteristics were controlled for. RESULTS: Variance component models revealed that all alcohol-related variables, the prevalence of cannabis use (12 months), and problem gambling did not vary among areas. Gambling rates and the average number of reported gambling activities varied among areas, even when individual-level variables were accounted for in the models, whereas for lifetime cannabis use, variations among areas became nonsignificant. CONCLUSION: Intervention programs may need to address the environment as a relevant determinant of health-related behaviours and lifestyles.

Kamm, M., R. Burger, et al. (2001). "Survey of children supported by long-term mechanical ventilation in Switzerland." Swiss Medical Weekly 131(19-20): 261-6.

OBJECTIVE: The aim of the present study was to identify the number of children, from birth to 16 years of age, on long-term mechanical ventilation in Switzerland, and to establish their current location, underlying diagnoses and ventilatory needs. METHODS: Postal questionnaires were sent to all chest physicians (pulmonologists), intensive care specialists, neurologists, national health care organisations, rehabilitation services and ventilator suppliers known or thought to be involved in paediatric long-term ventilation in Switzerland. RESULTS: Detailed information was obtained on 32 children from 7 centers. Underlying disorders included congenital central hypoventilation syndrome (CCHS, 41%), neuromuscular disorders (41%), spinal cord injury (6%), craniofacial anomalies (6%) and others (6%). 10 children received positive pressure ventilation by tracheostomy and 19 children by nasal mask. Two children were ventilated by phrenic nerve pacing and one child with the help of a pneumatic belt. Children with CCHS were almost equally divided into nasal mask and tracheostomy users. Ventilation for 16-24 hours a day was necessary in 5 children, exclusively during sleep in 24 children and only episodically in 3 children. All but 2 children were cared for at home. The majority of families received home care support. The most common reasons for readmission into hospital were regular follow-up examinations and respiratory tract infections. The children were mainly admitted to paediatric intensive care units. CONCLUSIONS: There are few ventilator-supported children in Switzerland and most of them are cared for at home. Nevertheless, there is a need to establish a system for continuing data collection in this particular patient population to assess outcome and quality of home care support and to follow incidence trends.

Kamstrup, P. R., A. Tybjaerg-Hansen, et al. (2009). "Genetically elevated lipoprotein(a) and increased risk of myocardial infarction." JAMA 301(22): 2331-9.

CONTEXT: High levels of lipoprotein(a) are associated with increased risk of myocardial infarction (MI). OBJECTIVE: To assess whether genetic data are consistent with this association being causal. DESIGN, SETTING, AND PARTICIPANTS: Three studies of white individuals from Copenhagen, Denmark, were used: the Copenhagen City Heart Study (CCHS), a prospective general population study with 16 years of follow-up (1991-2007, n = 8637, 599 MI events); the Copenhagen General Population Study (CGPS), a cross-sectional general population study (2003-2006, n = 29 388, 994 MI events); and the Copenhagen Ischemic Heart Disease Study (CIHDS), a case-control study (1991-2004, n = 2461, 1231 MI events). MAIN OUTCOME MEASURES: Plasma lipoprotein(a) levels, lipoprotein(a) kringle IV type 2 (KIV-2) size polymorphism genotype, and MIs recorded from 1976 through July 2007 for all participants. RESULTS: In the CCHS, multivariable-adjusted hazard ratios (HRs) for MI for elevated lipoprotein(a) levels were 1.2 (95% confidence interval [CI], 0.9-1.6; events/10,000 person-years, 59) for levels between the 22nd and 66th percentile, 1.6 (95% CI, 1.1-2.2; events/10,000 person-years, 75) for the 67th to 89th percentile, 1.9 (95% CI, 1.2-3.0; events/10,000 person-years, 84) for the 90th to 95th percentile, and 2.6 (95% CI, 1.6-4.1; events/10,000 person-years, 108) for levels greater than the 95th percentile, respectively, vs levels less than the 22nd percentile (events/10,000 person-years, 55) (trend P < .001). Numbers of KIV-2 repeats (sum of repeats on both alleles) ranged from 6 to 99 and on analysis of variance explained 21% and 27% of all variation in plasma lipoprotein(a) levels in the CCHS and CGPS, respectively. Mean lipoprotein(a) levels were 56, 31, 20, and 15 mg/dL for the first, second, third, and fourth quartiles of KIV-2 repeats in the CCHS, respectively (trend P < .001); corresponding values in the CGPS were 60, 34, 22, and 19 mg/dL (trend P < .001). In the CCHS, multivariable-adjusted HRs for MI were 1.5 (95% CI, 1.2-1.9; events/10,000 person-years, 75), 1.3 (95% CI, 1.0-1.6; events/10,000 person-years, 66), and 1.1 (95% CI, 0.9-1.4; events/10,000 person-years, 57) for individuals in the first, second, and third quartiles, respectively, as compared with individuals in the fourth quartile of KIV-2 repeats (events/10,000 person-years, 51) (trend P < .001). Corresponding odds ratios were 1.3 (95% CI, 1.1-1.5), 1.1 (95% CI, 0.9-1.3), and 0.9 (95% CI, 0.8-1.1) in the CGPS (trend P = .005), and 1.4 (95% CI, 1.1-1.7), 1.2 (95% CI, 1.0-1.6), and 1.3 (95% CI, 1.0-1.6) in the CIHDS (trend P = .01). Genetically elevated lipoprotein(a) was associated with an HR of 1.22 (95% CI, 1.09-1.37) per doubling of lipoprotein(a) level on instrumental variable analysis, while the corresponding value for plasma lipoprotein(a) levels on Cox regression was 1.08 (95% CI, 1.03-1.12). CONCLUSION: These data are consistent with a causal association between elevated lipoprotein(a) levels and increased risk of MI.
Kanai, M., C. Numakura, et al. (2002). "Congenital central hypoventilation syndrome: a novel mutation of the RET gene in an isolated case." TOHOKU JOURNAL OF EXPERIMENTAL MEDICINE 196(4): 241-6.

Recently, a few genetic abnormalities were identified in congenital central hypoventilation syndrome (CCHS or Ondine's curse). CCHS is often associated with other neurocristopathies, especially with Hirschsprung's disease (HSCR). Mutations of the genes involved in the receptor tyrosine kinase RET (REarranged during Transfection) (RET)-glial cell line-derived neurotrophic factor (GDNF) and/or endothelin 3 (EDN3)-endothelin receptor-B (EDNRB) signaling pathway have been found in some of HSCR patients. In this study, we analyzed candidates for HSCR, namely the RET, GDNF, EDN3 and EDNRB genes in three isolated CCHS patients to confirm the hypothesis that some CCHS patients have a common genetic abnormality with patients having HSCR or other neurocristopathies. We found a novel R114H mutation of the RET gene in one patient. The R114H mutation is unlikely to be a polymorphism and appears to be associated with CCHS. In addition, we also examined the HOX11L2 (RNX) gene, for which knock-out mice showed CCHS-like syndrome in these isolated CCHS patients and did not detected any mutation. Further cases should be analyzed for more candidates to clarify the pathophysiology of CCHS.

Kang, B. J., D. A. Chang, et al. (2007). "Central nervous system distribution of the transcription factor Phox2b in the adult rat." JOURNAL OF COMPARATIVE NEUROLOGY 503(5): 627-641.

Phox2b is required for development of the peripheral autonomic nervous system and a subset of cranial nerves and lower brainstem nuclei. Phox2b mutations in man cause diffuse autonomic dysfunction and deficits in the automatic control of breathing. Here we study the distribution of Phox2b in the adult rat hindbrain to determine whether this protein is selectively expressed by neurons involved in respiratory and autonomic control. In the medulla oblongata, Phox2b-immunoreactive nuclei were present in the dorsal vagal complex, intermediate reticular nucleus, dorsomedial spinal trigeminal nucleus, nucleus ambiguus, catecholaminergic neurons, and retrotrapezoid nucleus (RTN). Phox2b was expressed by both central excitatory relays of the sympathetic baroreflex (nucleus of the solitary tract and C1 neurons) but not by the inhibitory relay of this reflex. Phox2b was absent from the ventral respiratory column (VRC) caudal to RTN and rare within the parabrachial nuclei. In the pons, Phox2b was confined to cholinergic efferent neurons (salivary, vestibulocochlear) and noncholinergic peritrigeminal neurons. Rostral to the pons, Phox2b was detected only in the oculomotor complex. In adult rats, Phox2b is neither a comprehensive nor a selective marker of hindbrain autonomic pathways. This marker identifies a subset of hindbrain neurons that control orofacial movements (dorsomedial spinal trigeminal nucleus, pontine peritrigeminal neurons), balance and auditory function (vestibulocochlear efferents), the eyes, and both divisions of the autonomic efferent system. Phox2b is virtually absent from the respiratory rhythm and pattern generator (VRC and dorsolateral pons) but is highly expressed by neurons involved in the chemical drive and reflex regulation of this oscillator. copyright 2007 Wiley-Liss, Inc.

Kanpolat, Y., J. T. Goodrich, et al. (2005). "Retracing "Ondine's Curse": Comments." NEUROSURGERY 57(2): 362-363.

Kashiwagi, M., H. Onimaru, et al. (1993). "Correlation analysis of respiratory neuron activity in ventrolateral medulla of brainstem-spinal cord preparation isolated from newborn rat." EXPERIMENTAL BRAIN RESEARCH 95(2): 277-290.

Cross-correlation analysis was used to study functional connections between one inspiratory (I) neuron and another, and between one pre-inspiratory (Pre-I) neuron and another, in 54 brainstem-spinal cord preparations isolated from newborn rats. Pre-I neurons usually fired in the pre- and post-inspiratory phases. Neurons were recorded extracellularly with pairs of microelectrodes placed on the same or opposite sides of the brainstem. Fourteen pairs of Pre-I neurons recorded bilaterally in the rostral ventrolateral medulla (RVL), 14 pairs of ipsilateral Pre-I neurons in the RVL, 14 pairs of bilateral I neurons in the RVL and 12 pairs of ipsilateral I neurons in the ventrolateral medulla were studied. Cross-correlation histograms (CCHs) were computed. Significantly high peak bin counts were detected in 24 of 54 pairs. Peaks on one side of the origin of the CCHs were observed for one pair of ipsilateral Pre-I neurons, four pairs of bilateral I neurons and five pairs of ipsilateral I neurons. These findings suggest mono- or oligo-synaptic excitatory connections between paired neurons or shared inputs. Only one trough suggesting an oligo-synaptic inhibitory connection was evident in a CCH obtained from the pair of bilateral I neurons. This CCH revealed the peak and the trough on opposite sides of the origin, which was consistent with reciprocal excitatory and inhibitory connections between recorded neurons. Peaks on both sides of the origin were observed for three pairs of bilateral I neurons. From auto-correlation analysis and the latencies of these peaks, two of the three CCHs were consistent with reciprocal excitatory connections between recorded neurons, whereas the other CCH suggests shared inputs. Peaks at the origin were observed for two pairs of ipsilateral Pre-I neurons, four pairs of bilateral I neurons and five pairs of ipsilateral I neurons. These results suggest shared inputs. For Pre-I neurons recorded in opposite sides, no significant bin counts were detected. Peaks on one side were detected for three pairs. Present results suggest short-term synchronisation of I neurons, and of Pre-I neurons via excitatory coupling, and the likelihood of comparatively strong interaction between I neurons, which may be important in maintaining the I burst.
Kassam, A. and S. B. Patten (2006). "Hypnotic use in a population-based sample of over thirty-five thousand interviewed Canadians." Population Health Metrics 4: 15.

BACKGROUND: As with most medications, benzodiazepine and similar sedative hypnotics (BDZ/SSH) can produce both beneficial and adverse effects. Pharmacoepidemiological studies have been limited in their capacity to evaluate the relationship between these medications and psychiatric diagnoses in non-clinical populations. The objective of this study was to provide a description of the pattern of use of BDZ/SSH medications in relation to both demographic and diagnostic data in a community population. METHODS: The source of data for this study was the Canadian Community Health Survey (CCHS 1.2), also known as the Canadian National Study of Mental Health and Well-being. This study was based on a nationally representative sample that included over 35 thousand subjects with a response rate of 77%. The survey interview included the latest version of the Composite International Diagnostic Interview (CIDI), which was developed for the World Health Organization's WHO Mental Health 2000 project. Current medication use was also recorded. RESULTS: As expected, BDZ/SSH use was more common in women than in men (4.2%, 95% CI 3.9 to 4.6 vs. 2.5%, 95% CI 2.2 to 2.8) and its frequency increased with age, 8.5% (95% CI 7.7 to 9.4) of those over the age of 65 compared to 2.4% (95% CI 2.2 to 2.7) of those aged 18 to 64 years. These medications were more frequently used in subjects with low levels of education (4.8%, 95% CI% 4.3 to 5.2) vs. high levels of education (2.4%, 95% CI 2.1 to 2.6) and low personal incomes (5.7%, 95% CI 5.2 to 6.3) vs. high personal incomes (2.3%, 95% CI 2.0 to 2.6). BDZ/SSH use was strongly associated with the presence of mood or anxiety disorders, but not with substance use disorders. Demographic differences persisted after statistical adjustment for diagnosis. CONCLUSION: The observation that benzodiazepine use is more frequent in women, increases with age and is higher in low income and education groups supports previous findings. These results help to confirm that these differences are not accounted for by psychiatric diagnoses.