Structural malformations of the brain, eye, and pituitary gland in PHACE syndrome

PHACE syndrome is the association of segmental facial hemangiomas with congenital arterial, brain, cardiac, and ocular anomalies. Structural brain malformations affect 41–52% of PHACE patients and can be associated with focal neurologic deficits, developmental delays, and/or intellectual disability. To better characterize the spectrum of structural brain and other intracranial anomalies in PHACE syndrome, MRI scans of the head/neck were retrospectively reviewed in 55 patients from the PHACE Syndrome International Clinical Registry and Genetic Repository. All registry patients with a diagnosis of definite PHACE syndrome who had MRI scans of satisfactory quality were included. Of 55 patients, 34 (62%) demonstrated ≥1 non-vascular intracranial anomaly; structural brain malformations were present in 19 (35%). There was no difference in the prevalence of brain anomalies between genders. Brain anomalies were more likely in patients with S1 and/or S2 distribution of facial hemangioma. The most common structural brain defects were cerebellar hypoplasia (25%) and fourth ventricle abnormalities (13%). Dandy–Walker complex and malformations of cortical development were present in 9% and 7%, respectively. Extra-axial findings such as pituitary anomalies (18%) and intracranial hemangiomas (18%) were also observed. Six patients (11%) had anomalies of the globes or optic nerve/chiasm detectable on MRI. Brain malformations comprise a diverse group of structural developmental anomalies that are common in patients with PHACE syndrome. Along with brain malformations, numerous abnormalities of the pituitary, meninges, and globes were observed, highlighting the need for careful radiologic assessment of these structures in the neuroimaging workup for PHACE syndrome.

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Inactive lifestyles and sedentary behavior in persons with chronic aneurysmal subarachnoid hemorrhage: evidence from accelerometer-based activity monitoring

Aneurysmal subarachnoid hemorrhage (a-SAH) is a potential life-threatening stroke. Because survivors may be at increased risk for inactive and sedentary lifestyles, this study evaluates physical activity (PA) ...

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From electromyographic activity to frequency modulation in zebra finch song

Abstract

Behavior emerges from the interaction between the nervous system and peripheral devices. In the case of birdsong production, a delicate and fast control of several muscles is required to control the configuration of the syrinx (the avian vocal organ) and the respiratory system. In particular, the syringealis ventralis muscle is involved in the control of the tension of the vibrating labia and thus affects the frequency modulation of the sound. Nevertheless, the translation of the instructions (which are electrical in nature) into acoustical features is complex and involves nonlinear, dynamical processes. In this work, we present a model of the dynamics of the syringealis ventralis muscle and the labia, which allows calculating the frequency of the generated sound, using as input the electrical activity recorded in the muscle. In addition, the model provides a framework to interpret inter-syllabic activity and hints at the importance of the biomechanical dynamics in determining behavior.

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Respiratory regulation by steroids in newborn rats: a sex-specific balance between allopregnanolone and progesterone receptors

Abstract

We tested the hypothesis that the effects of progesterone on apnoea frequency in newborn rats are the result of a balance between its neuroactive metabolite allopregnanolone (GABAa receptor modulator) and progesterone receptors. We used male and female rats between 10 and 12 days of age and recorded respiratory and metabolic parameters (whole-body plethysmography), and assessed the frequency and duration of apnoeas under normoxia. We tested the effects of a single injection of progesterone (4 mg kg⁻¹, i.p.), finasteride (10 mg kg⁻¹, i.p. – 5α-reductase antagonist: blocks the conversion of progesterone to allopregnanolone), finasteride+progesterone, or agonists of the nuclear or membrane progesterone receptors (R5020 or Org-od-02-0, 4 mg kg⁻¹). To test the hypothesis that chronic exposure to progesterone reduces the frequency of apnoeas we used male and female daily treated with progesterone between postnatal days 3–12. The acute injection of progesterone reduced minute ventilation and metabolic rate and increased the frequency of apnoeas. Finasteride decreased the frequency of apnoeas, and finasteride+progesterone did not increase apnoea frequency but decreased minute ventilation in female rats. While R5020 decreased apnoea frequency only in males, Org-od-02-0 decreased apnoea frequency in males and females and decreased respiratory frequency in females. Chronic progesterone treatment reduced apnoea frequency more efficiently in males than in females, but in females (not in males) an acute injection of caffeine (the gold standard for the treatment of apnoea in preterm neonates) further reduced apnoea frequency. Apnoea frequency in newborn rats is in part determined by a sex-specific balance between allopregnanolone, GABAa receptors, and progesterone receptors.

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Interventions to improve social determinants of health among elderly ethnic minority groups: a review

Abstract

Background

Like the European general population, ethnic minorities are aging. In this group, important social determinants of health (social participation, social isolation and loneliness) that lead to negative health outcomes frequently occur. Interventions targeting these determinants may decrease negative health outcomes. The goal of this article was to identify effective interventions that improve social participation, and minimise social isolation and loneliness in community dwelling elderly ethnic minorities.

Methods

An electronic database (PubMed) was systematically searched using an extensive search strategy, for intervention studies in English, French, Dutch of German, without time limit. Additional articles were found using references. Articles were included if they studied an intervention aimed to improve social participation or minimise social isolation or loneliness and were focusing on community dwelling elderly ethnic minorities. Data regarding studies characteristics and results were extracted.

Results

Six studies (three randomized controlled trials, three non-controlled intervention studies) were included in the review. All studies were group-based interventions and had a theoretical basis. Five out of six studies showed improvement on a social participation, -isolation or loneliness outcome. Type of intervention included volunteering-, educational- and physical activities. In three studies active participation of the participant was required, these interventions were not more effective than other interventions.

Conclusion

Some interventions improved the included social determinants of health in community dwelling elderly ethnic minorities. Investment in further development and implementation of these interventions may help to improve social determinants of health in these populations. It is necessary to evaluate these interventions in the European setting.

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Socioeconomic differences in the pathways to diagnosis of coronary heart disease: a qualitative study

Abstract

Background

Socioeconomic inequalities in coronary heart disease (CHD)-related morbidity and mortality are well explored. However, less is known about the causes of inequalities in CHD treatment. In this qualitative study, we explored socioeconomic differences in the pathways to diagnosis of CHD.

Methods

The data originated from 38 semi-structured interviews with older CHD patients, aged 59–80 years, conducted at the university hospital in Halle, Germany, between November 2014 and April 2015. We analysed the narratives related to the time before CHD was confirmed by coronary angiography electively or urgently. Transcripts were analysed following inductive qualitative content analysis and we identified socioeconomic differences by comparing and contrasting patients' narratives.

Results

The patients interpreted their symptoms based on expectations, normalization, relief and obtaining help from third parties. For those experiencing chronic CHD symptoms, only patients with low socioeconomic status (SES) waited to seek healthcare until they suffered myocardial infarction. Mainly low-SES patients procrastinated in undergoing diagnostic procedures. We found no socioeconomic differences in the urgent pathway. However, along the elective pathway, only low-SES patients reported receiving assistance from a general practitioner in accessing a cardiologist.

Conclusions

Socioeconomic differences in CHD diagnosis were mainly apparent before patients sought healthcare. These differences were more pronounced when CHD was electively diagnosed due to chronic symptoms rather than urgently diagnosed due to acute symptoms. To address socioeconomic differences, general practitioners should focus on any indication of symptoms and interpretation mentioned by low-SES patients, and coordinate these patients' pathways to diagnosis while emphasizing the seriousness of CHD.

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A systematic literature review on the use and outcomes of maternal and child healthcare services by undocumented migrants in Europe

Abstract

Background

Undocumented migrants, in particular pregnant women and their newborns, constitute a particularly vulnerable group of migrants. The aim of this study was to systematically review the academic literature on the use and outcomes of maternal and child healthcare by undocumented migrants in the European Union (EU) and European Free Trade Association (EFTA) countries.

Methods

The databases, MEDLINE, Embase, CINAHL Plus, Global Health and Popline were searched for the period 2007 to 2017. Two independent reviewers judged the eligibility of studies. The final number of included studies was 33.

Results

The results of quantitative, qualitative and mixed methods studies were analysed separately due to their differences in study design, sample size and quality. Overall, the quantitative studies found that undocumented women underutilised essential maternal and child healthcare services, and experienced worse health outcomes. Qualitative studies supported these results, indicating that undocumented migrants were hesitant to use services due to a lack of knowledge and fear of deportation. Studies included in the review covered 10 of 32 EU or EFTA countries, making a European comparison impossible.

Conclusions

Despite major methodological differences between included studies, the results of this review indicate that the status of undocumented migrants exacerbates known health risks and hampers service use.

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