Verbal Cuing Is Not the Path to Enlightenment. Psychological Effects of a 10-Session Hatha Yoga Practice.

Verbal instructions provided during yoga classes can differ substantially. Yoga instructors might choose to focus on the physical aspects of yoga (e.g., by emphasizing the characteristics of the poses), or they might take a more spiritual approach (e.g., by mentioning energy flow and chakras). The present study investigated the effects of verbal cues during yoga practice on various psychological measures. Eighty-four female students (22.0 ± 3.80 years) participated in the study. Two groups attended a beginner level hatha yoga course in which physically identical exercise was accompanied by different verbal cues. The so-called "Sport group" (N = 27) received instructions referring primarily to the physical aspects of yoga practice, while the "Spiritual group" (N = 23) was additionally provided with philosophical and spiritual information. A control group (N = 34) did not receive any intervention. Mindfulness, body awareness, spirituality, and affect were assessed 1 week before and after the training. 2 × 3 mixed (time × intervention) ANOVAs did not show an interaction effect for any of the variables. However, when the two yoga groups were merged and compared to the control group, we found that spirituality increased, and negative affect decreased among yoga participants. In conclusion, yoga practice might influence psychological functioning through its physical components, independent of the style of verbal instructions provided.

There Are no Short-Term Longitudinal Associations Among Interoceptive Accuracy, External Body Orientation, and Body Image Dissatisfaction.

Background: Objectification theory assumes that individuals with low level of interoceptive accuracy may develop an external orientation for information concerning their body. Past research has found associations between interoceptive accuracy and body image concerns. We aimed to explore temporal relationships between the tendency to monitor one's body from a third-party perspective, body image dissatisfaction, and interoceptive accuracy. Method: In a short longitudinal research, 38 Hungarian and 59 Norwegian university students completed the Schandry heartbeat tracking task and filled out baseline and follow-up questionnaires assessing private body consciousness, body surveillance, and body image dissatisfaction 8 weeks apart. Results: Interoceptive accuracy and indicators of external body orientation did not predict body image dissatisfaction after controlling for gender, nationality, and body image dissatisfaction at baseline. Similarly, body surveillance was not predicted by baseline levels of interoceptive accuracy and body image dissatisfaction. Conclusion: Contrary to the tenets of objectification theory, body image dissatisfaction and body surveillance are not predicted by interoceptive accuracy over a short period of time among young individuals.

Association between varicose veins anatomical pattern and procedural complications following endovascular laser photothermolysis for chronic venous insufficiency.

We sought to assess clinical characteristics and pattern of collateral network involvement associated with development of truncal (systematized) versus diffuse/non-truncal (non-systematized) varicose veins (VVs) in patients undergoing endovascular laser photothermolysis for chronic venous insufficiency (CVI). Secondly, we aimed to assess whether the type of VVs influenced the procedural complications of endovascular laser therapy. A total of 508 patients with hydrostatic VVs of the lower limbs who underwent endovenous laser treatment were included, out of which 84.1% (n=427) had truncal VVs (group 1) and 15.9% (n=81) had diffuse (non-systematized) VVs (group 2). Patients with truncal varices were significantly older (47.50±12.80 vs 43.15±11.75 years, P=0.004) and those with associated connective tissue disorders were more prone to present diffuse VVs (P=0.004). Patients in group 1 presented a significantly higher number of Cockett 1 (P=0.0017), Cockett 2 (P=0.0137), Sherman (P<0.0001), and Hunter (P=0.0011) perforator veins compared to group 2, who presented a higher incidence of Kosinski perforators (P<0.0001). There were no significant differences regarding postoperative complications: thrombophlebitis (P=0.773), local inflammation (P=0.471), pain (P=0.243), paresthesia (P=1.000), or burning sensation (P=0.632). Patients with more advanced CEAP (clinical, etiologic, anatomic, pathophysiologic) classes were older (P<0.0001), more were males (39.05 vs 27.77%, P=0.0084), more were prone to present ulcers (P<0.0001) and local hyperthermia (P=0.019), and presented for endovenous phlebectomy after a longer time from symptom onset. In patients with CVI, systematized VVs were associated with a more severe clinical status and a distinct anatomical pattern of perforators network compared to non-systematized VVs, which is more common in advanced stages.

Association between varicose veins anatomical pattern and procedural complications following endovascular laser photothermolysis for chronic venous insufficiency

We sought to assess clinical characteristics and pattern of collateral network involvement associated with development of truncal (systematized) versus diffuse/non-truncal (non-systematized) varicose veins (VVs) in patients undergoing endovascular laser photothermolysis for chronic venous insufficiency (CVI). Secondly, we aimed to assess whether the type of VVs influenced the procedural complications of endovascular laser therapy. A total of 508 patients with hydrostatic VVs of the lower limbs who underwent endovenous laser treatment were included, out of which 84.1% (n=427) had truncal VVs (group 1) and 15.9% (n=81) had diffuse (non-systematized) VVs (group 2). Patients with truncal varices were significantly older (47.50±12.80 vs 43.15±11.75 years, P=0.004) and those with associated connective tissue disorders were more prone to present diffuse VVs (P=0.004). Patients in group 1 presented a significantly higher number of Cockett 1 (P=0.0017), Cockett 2 (P=0.0137), Sherman (P<0.0001), and Hunter (P=0.0011) perforator veins compared to group 2, who presented a higher incidence of Kosinski perforators (P<0.0001). There were no significant differences regarding postoperative complications: thrombophlebitis (P=0.773), local inflammation (P=0.471), pain (P=0.243), paresthesia (P=1.000), or burning sensation (P=0.632). Patients with more advanced CEAP (clinical, etiologic, anatomic, pathophysiologic) classes were older (P<0.0001), more were males (39.05 vs 27.77%, P=0.0084), more were prone to present ulcers (P<0.0001) and local hyperthermia (P=0.019), and presented for endovenous phlebectomy after a longer time from symptom onset. In patients with CVI, systematized VVs were associated with a more severe clinical status and a distinct anatomical pattern of perforators network compared to non-systematized VVs, which is more common in advanced stages.

The neuropsychophysiology of tingling.

Tingling is a bodily sensation experienced under a variety of conditions from everyday experiences to experimental and therapeutic situations. It can be induced by both peripheral or afferent (external stimulation, peripheral pathology) and higher cognitive (expectation) processes. The paper summarizes the current scientific knowledge on the neurophysiological and psychological concomitants of the tingling sensation. Four possible models are identified and presented: the afferent, the attention-disclosed, the attention-evoked, and the efferent model. Of these, only the attention-disclosed model, i.e., attention discloses the sensation by opening the gate for suppressed sensory information, appears to be able to explain every aspect of the tingling phenomenon. Terminological issues and the possible role of the tingling phenomenon in medically unexplained symptoms, nocebo and placebo reactions, and body-oriented therapeutic interventions are also discussed.

Interoceptive accuracy and body awareness - Temporal and longitudinal associations in a non-clinical sample.

OBJECTIVE: Various aspects of interoception are regarded as temporally stable phenomena. This study investigates the temporal stability of and longitudinal associations between interoceptive accuracy (as measured with heartbeat tracking task) and a related concept, body awareness (assessed by self-report). METHODS: In a two-month longitudinal study 103 university students (31% male, 23.34±4.34yrs.; 44 Hungarians; 36.4% male, 21.4±1.67yrs. and 59 Norwegians; 25.4% male, 24.8±5.09yrs) were investigated using Schandry's heartbeat tracking task and the Body Awareness Questionnaire. RESULTS: Both interoceptive accuracy and body awareness showed good test-retest reliability (r=0.60 and r=0.73, respectively; p<0.001 in both cases). The two concepts were independent of each other at baseline (r=0.06, p=0.587), and did not predict each other over an eight weeks period of time. CONCLUSION: Self-reported body awareness and objectively measured interoceptive accuracy are temporally stable and not related to each other.

Characteristics of attention-related body sensations. Temporal stability and associations with measures of body focus, affect, sustained attention, and heart rate variability.

AIM: This study investigated the temporal stability and correlates of attention-related body sensations that emerge without external stimulation during rest and due to focused attention on a body part. MATERIALS: To assess attention-related body sensations, participants were asked to focus on a freely chosen body area with closed eyes, and had to report whether the sensation of that area had changed. Self-report questionnaires were used to assess various aspects of body focus (body awareness, body responsiveness, somatosensory amplification, subjective somatic symptoms), and positive and negative affectivity. Previous experiences in body-mind therapies were also measured. PEBL Continuous Performance Test was used to assess sustained attention. Heart rate variability scores were based on a 3-minute long resting heart rate measurement. METHODS: Fifty-eight university students (22.3 ± 3.95 years; 34 females) participated in the study. The stability of attention-related body sensations was measured 8 weeks later on a randomly chosen sub-group (n = 28). RESULTS: Attention-related body sensations showed a mediocre temporal stability (rρ = 0.47, p = 0.012). People reporting attention-related body sensations showed significantly higher body awareness, somatosensory amplification, and resting heart rate; and marginally higher somatic symptoms. No relation was found with body-mind practice, body responsiveness, positive and negative affect, the vagal component of heart rate variability, and performance in the sustained attention task. CONCLUSION: Attention-related sensations are relatively stable over time. They are connected to some, but not to all of the aspects of body focus. Further studies are needed to elaborate the influencing stable and situational factors.

Sequence analysis of 16S rRNA, gyrB and catA genes and DNA-DNA hybridization reveal that Rhodococcus jialingiae is a later synonym of Rhodococcus qingshengii.

The results of 16S rRNA, gyrB and catA gene sequence comparisons and reasserted DNA-DNA hybridization unambiguously proved that Rhodococcus jialingiae Wang et al. 2010 and Rhodococcus qingshengii Xu et al. 2007 represent a single species. On the basis of priority R. jialingiae must be considered a later synonym of R. qingshengii.

History of the development of corticosteroid therapy.

The first clinical evidence that an extract of animal adrenocortical tissue could counteract human adrenal failure was demonstrated in 1930. As chemical analyses of cortical extracts proceeded, mainly in the laboratories of Kendall at the Mayo Clinic and Reichstein in Zurich, it became evident that there is not one cortical hormone, but that all are steroids. By 1940 it was understood that there are two categories: those that cause sodium and fluid retention and those that counteract shock and inflammation. Structurally the presence or lack of oxygenation at C11 on the steroid skeleton was critical. In 1948 the first patient with rheumatoid arthritis was treated with cortisone and soon thereafter other rheumatologic patients received cortisone or, to stimulate native cortisone production, ACTH. Oral and intra-articular administration of cortisone and hydrocortisone began in 1950-51. Several lines of research to produce cortisone semi-synthetically showed some success by 1952. Between 1954 and 1958 six synthetic steroids were introduced for systemic anti-imflammatory therapy. By 1960 all of the toxic effects of chronic corticosteroid administration had been described, as well as protocols to withdraw such drugs while minimising symptoms of cortical insufficiency. To enable use of lower corticosteroid dosages, companion use of non-steroidal anti-inflammatory drugs began in the late 1950s, with phenylbutazone the first. In the 1970s the introduction of methotrexate and other anti-metabolites further circumscribed the dosages and indications for corticosteroids in the rheumatic diseases.

Complex propagation patterns characterize human cortical activity during slow-wave sleep.

Cortical electrical activity during nonrapid eye movement (non-REM) sleep is dominated by slow-wave activity (SWA). At larger spatial scales (∼2-30 cm), investigated by scalp EEG recordings, SWA has been shown to propagate globally over wide cortical regions as traveling waves, which has been proposed to serve as a temporal framework for neural plasticity. However, whether SWA dynamics at finer spatial scales also reflects the orderly propagation has not previously been investigated in humans. To reveal the local, finer spatial scale (∼1-6 cm) patterns of SWA propagation during non-REM sleep, electrocorticographic (ECoG) recordings were conducted from subdurally implanted electrode grids and a nonlinear correlation technique [mutual information (MI)] was implemented. MI analysis revealed spatial maps of correlations between cortical areas demonstrating SWA propagation directions, speed, and association strength. Highest correlations, indicating significant coupling, were detected during the initial positive-going deflection of slow waves. SWA propagated predominantly between adjacent cortical areas, albeit spatial noncontinuities were also frequently observed. MI analysis further uncovered significant convergence and divergence patterns. Areas receiving the most convergent activity were similar to those with high divergence rate, while reciprocal and circular propagation of SWA was also frequent. We hypothesize that SWA is characterized by distinct attributes depending on the spatial scale observed. At larger spatial scales, the orderly SWA propagation dominates; at the finer scale of the ECoG recordings, non-REM sleep is characterized by complex SWA propagation patterns.

Methotrexate: from its introduction to non-oncologic therapeutics to anti-TNF-α.

The history of the rheumatologic use of methotrexate until the 1990s will be reviewed, beginning with its pharmacology, with the focus on rheumatoid arthritis (RA). The insufficient availability of cortisone in the 1950s as well as the early recognition of its potential toxicity stimulated searches for alternative anti-inflammatory drugs. Two related derivatives of folic acid, aminopterin and amethopterin (MTX,) were found to give rapid symptomatic relief in cases of psoriasis vulgaris and psoriatic arthritis. For several years MTX was used primarily to treat psoriasis, and the dermatologic treatment protocols came to be used by rheumatologists. Giving MTX weekly rather than daily was found to diminish the risk of toxic effects. MTX became favoured over cyclophosphamide because of its lack of carcinogenicity, and although azathioprine lacked the hepatotoxicity of MTX, its anti-rheumatic effects were considered to be somewhat weaker. Although trials of MTX for the treatment of severe RA began in the 1960s, the first placebo-controlled study of MTX in RA was reported in 1985 and a comparison with Myochrysine in 1987. MTX has replaced gold compounds because it has been found to be more rapidly effective and better tolerated. The mechanisms of its anti-rheumatic effects remain incompletely explained, as are explanations of instances of its failure. Its recent use in combination with anti-TNFα agents appears to be another therapeutic advance.

How did ankylosing spondylitis become a separate disease?

Individual patients whose disease in retrospect is compatible with a diagnosis of ankylosing spondylitis (AS) began to be described in the 19th century, at a time when "rheumatism" comprised an undefined conglomeration of ailments. In the 1890s, rheumatoid arthritis (RA) began to be extricated from rheumatic fever and gout. But what criteria should delimit the diagnosis of RA? The first assistance came with the introduction of radiology in the first decade of the new century. By the 1930s, objective radiologic distinctions between RA and A S were being made, beginning with the preferential involvement of the sacroiliac joints in AS. The first useful serologic test was developed in the 1950s: "rheumatoid factor" that eventually is present in about three-fourths of cases of RA, but is absent in AS. In the 1970s discovery of clinical associations with specific histocompatibility antigens finalized the distinction between RA and AS with the discovery that one antigen, B-27, is associated ten times as frequently with AS than with RA, while it occurs no more frequently with RA than in the general population. Associations between B-27 and certain radiologic appearances has further been mutually confirmatory of their diagnostic significance.

A history of the understanding of cartilage.

OBJECTIVE: To review the historic development of the understanding of articular cartilage from the earliest comment in the fourth century BCE until about 2000. DESIGN: The history up to 1900 is told chronologically, divided into (1) recognition of the tissue, (2) structure, and (3) chemistry. The twentieth century is sketched with a timeline of discoveries that at the time were important and a bibliography of journal review articles. RESULTS: By 1900 the avascular, aneural state and fibrillar composition have been accepted. The nutrition of articular cartilage remained in dispute. The composition of the binding substance and its relation to collagen remained unknown. Research in the first half of the twentieth century continued to be impeded by lack of technology. The advent of electron microscopy, isotopic tracer technics and enzymology rapidly accelerated the understanding of hyaline cartilage beginning in the 1950s. CONCLUSIONS: The history of research on hyaline cartilage illustrates the dependence of scientific progress on technologic innovation.

Typhoid spine: somatic versus psychosomatic diagnosis in Osler's time.

OBJECTIVE: To review the history of typhoidal spondylitis as a paradigm of conflicts between medical and psychiatric diagnoses. METHODS: Because William Osler was the principal advocate for a psychogenic cause of this disease, all of his relevant writings are reviewed together with pertinent psychiatric concepts of the late 19th century, as well as the relevant bacteriologic and clinical research. RESULTS: Bacteriologic research had advanced sufficiently by 1903 that "typhoid spine" could be proved an osteomyelitis. Nevertheless, the belief that at least some cases were manifestations of a traumatic neurosis analogous to "railway spine" persisted, the trauma having been the acute typhoid infection. The last vestiges of this concept were represented by Osler's article of 1919. CONCLUSIONS: Osler's 25 year struggle to understand typhoidal spondylitis is an example of the persistent tendency of physicians to attribute a psychologic cause to a syndrome, often pejoratively, because of the absence of a sufficient pathophysiologic explanation or reluctance to acknowledge a new concept.

William Osler and development of the concept of systemic lupus erythematosus.

OBJECTIVE: This historical review summarizes the understanding of lupus erythematosus (LE) during the time of the career of William Osler and analyzes factors that may have retarded the clinical identification of this disease. METHODS: All of Osler's writings related to diseases that he defined as the "erythema group" were studied, in conjunction with relevant writings on Schönlein-Henoch purpura and erythema multiforme. RESULTS: Osler did not knowingly describe cases of LE, nor did he discuss the disease in general. He proposed that a primary skin disease, which in some cases has visceral manifestations, may develop as a purely visceral disease, using cases from his "erythema group" cohort as evidence. CONCLUSIONS: The reluctance into the 1940s to diagnose systemic LE was primarily a consequence of the erroneous belief that a skin eruption was required to establish the diagnosis. Osler's teaching the possible dissociation of visceral from cutaneous symptoms with regard to the erythema group was not analogized to LE. The interpretation that Osler had elucidated aspects of LE has developed since 1937 and attributes insights to Osler that his writings do not substantiate.