Low-dose exposure to malathion and radiation results in the dysregulation of multiple neuronal processes, inducing neurotoxicity and neurodegeneration in mouse.

Neurodegenerative disorders are a debilitating and persistent threat to the global elderly population, carrying grim outcomes. Their genesis is often multifactorial, with a history of prior exposure to xenobiotics such as pesticides, heavy metals, enviornmental pollutants, ionizing radiation etc,. A holistic molecular insight into their mechanistic induction upon single or combinatorial exposure to different toxicants is still unclear. In the present study, one-month-old C57BL/6 male mice were administered orally with malathion (50 mg/kg body wt. for 14 days) and single whole-body radiation (0.5 Gy) on the 8th day. Post-treatment, behavioural assays for exploratory behaviour, memory, and learning were performed. After sacrifice, brains were collected for histology, biochemical assays, and transcriptomic analysis. Transcriptomic analysis revealed several altered processes like synaptic transmission and plasticity, neuronal survival, proliferation, and death. Signalling pathways like MAPK, PI3K-Akt, Apelin, NF-κB, cAMP, Notch etc., and pathways related to neurodegenerative diseases were altered. Increased astrogliosis was observed in the radiation and coexposure groups, with significant neuronal cell death and a reduction in the expression of NeuN. Sholl analysis, dendritic arborization and spine density studies revealed decreased total apical neuronal path length and dendritic spine density. Reduced levels of the antioxidants GST and GSH and acetylcholinesterase enzyme activity were also detected. However, no changes were seen in exploratory behaviour or learning and memory post-treatment. Thus, explicating the molecular mechanisms behind malathion and radiation can provide novel insights into external factor-driven neurotoxicity and neurodegenerative pathogenesis.

Insights into smoking and its cessation among current smokers in India.

BACKGROUND: Initiation, perpetuation and cessation of smoking are all multifactorial. It is essential to explore interactions among various parameters influencing smoking and its cessation for effective smoking cessation interventions. OBJECTIVES: To obtain insights into smoking and its cessation among current smokers in India. MATERIALS AND METHODS: The present study was conducted among current smokers visiting the Department of Oral Medicine and Radiology, Manipal College of Dental Sciences (MCODS), Manipal University, Mangalore. Knowledge, attitudes, behavior, worksite practices towards smoking and its cessation, barriers to smoking cessation and socio-demographic variables were explored using a structured, pretested, self-administered questionnaire. RESULTS: A total of 175 current smokers participated in the study. Mean knowledge, attitude, worksite practice and barrier scores were 15.2±5.67 (66.1%), 57.5±7.67(82.1%), 4.18±2.02 (41.8%) and 57.4±12.37 (63.7%) respectively. Correlation analysis revealed: association of knowledge with education, occupation and religion; attitude with education and occupation; worksite practices with occupation; knowledge with attitude; and barriers negatively with worksite practices. The majority (85.7%) of respondents intended to quit smoking and this was associated with higher attitude scores, whereas actual quit attempts were associated with high knowledge, attitudes, worksite practices and low barrier scores. CONCLUSIONS: Various socio-demographic factors associated with smoking and its cessation were identified. The present study highlights the importance of identifying and targeting these interactions while framing guidelines and interventions for effective tobacco cessation in a developing country like India.

Psychiatric comorbidities in a community sample of women with fibromyalgia.

Prior studies of careseeking fibromyalgia (FM) patients often report that they have an elevated risk of psychiatric disorders, but biased sampling may distort true risk. The current investigation utilizes state-of-the-art diagnostic procedures for both FM and psychiatric disorders to estimate prevalence rates of FM and the comorbidity of FM and specific psychiatric disorders in a diverse community sample of women. Participants were screened by telephone for FM and MDD, by randomly selecting telephone numbers from a list of households with women in the NY/NJ metropolitan area. Eligible women were invited to complete physical examinations for FM and clinician-administered psychiatric interviews. Data were weighted to adjust for sampling procedures and population demographics. The estimated overall prevalence of FM among women in the NY/NJ metropolitan area was 3.7% (95% CI=3.2, 4.4), with higher rates among racial minorities. Although risk of current MDD was nearly 3-fold higher in community women with than without FM, the groups had similar risk of lifetime MDD. Risk of lifetime anxiety disorders, particularly obsessive compulsive disorder and post-traumatic stress disorder, was approximately 5-fold higher among women with FM. Overall, this study found a community prevalence for FM among women that replicates prior North American studies, and revealed that FM may be even more prevalent among racial minority women. These community-based data also indicate that the relationship between MDD and FM may be more complicated than previously thought, and call for an increased focus on anxiety disorders in FM.

Sexual and physical abuse in women with fibromyalgia syndrome: a test of the trauma hypothesis.

OBJECTIVES: According to the trauma hypothesis, women with fibromyalgia syndrome (FMS) are more likely to report a history of sexual and/or physical abuse than women without FMS. In this study, we rely on a community sample to test this hypothesis and the related prediction that women with FMS are more likely to have posttraumatic stress disorder than women without FMS. METHODS: Eligibility for the present study was limited to an existing community sample in which FMS and major depressive disorder were prevalent. The unique composition of the original sample allowed us to recruit women with and without FMS from the community. A total of 52 female participants were enrolled in the present FMS group and 53 in the control (no FMS) group. Sexual and physical abuse were assessed retrospectively using a standardized telephone interview. RESULTS: Except for rape, sexual and physical abuse were reported equally often by women in the FMS and control groups. Women who reported rape were 3.1 times more likely to have FMS than women who did not report rape (P<0.05). There was no evidence of increased childhood abuse in the FMS group. Women with FMS were more likely to have posttraumatic stress disorder symptoms (intrusive thoughts and arousal) as well as posttraumatic stress disorder diagnosis (P<0.01). DISCUSSION: With the exception of rape, no self-reported sexual or physical abuse event was associated with FMS in this community sample. In accord with the trauma hypothesis, however, posttraumatic stress disorder was more prevalent in the FMS group. Chronic stress in the form of posttraumatic stress disorder but not major depressive disorder may mediate the relationship between rape and FMS.

Familial aggregation of depression in fibromyalgia: a community-based test of alternate hypotheses.

Numerous studies report that fibromyalgia (FM), a syndrome characterized by widespread pain and generalized tender points, is comorbid with major depressive disorder (MDD). The current study tests two alternate explanations for their comorbidity using a family study methodology. The first is that FM is a depression spectrum disorder. The second is that depression is a consequence of living with FM. We recruited potential probands by initially screening by telephone for FM and MDD among women in the NY/NJ metropolitan area, randomly selecting telephone numbers from a list of households with women. Eligible women were invited for second stage physical examinations for FM diagnosis and psychiatric interviews for MDD diagnosis. All available adult, first-degree relatives received psychiatric interviews. Relatives of probands were divided into four groups on the basis of the probands' FM and MDD diagnoses (FM+/MDD+ (n = 156), FM+/MDD- (n = 51), FM-/MDD+ (n = 351) and FM-/MDD- (n = 101)). Results indicated that rates of MDD in the relatives of probands with FM but without personal histories of MDD were virtually identical to rates of MDD in relatives of probands with MDD themselves. This outcome is consistent with the hypothesis that FM is a depression spectrum disorder, in which FM and MDD are characterized by shared, familially mediated risk factors. The implications of these findings for a stress-vulnerability model of FM are discussed.

Comorbidity of fibromyalgia and posttraumatic stress disorder symptoms in a community sample of women.

OBJECTIVE: To test alternative explanations for the comorbidity between fibromyalgia (FM), a medically unexplained syndrome involving widespread pain, and posttraumatic stress disorder (PTSD). In contrast to a default "risk factor" hypothesis, tested hypotheses were that: A) The association is due to a sampling bias introduced by the study of care-seeking individuals; B) FM is an additive burden that strains coping resources when confronting life stress; and C) Arousal symptoms of PTSD and FM are confounded. DESIGN: Community-dwelling women in the New York/New Jersey metropolitan area (N=1,312) completed a telephone survey regarding FM-like symptoms prior to September 11, 2001. Approximately 6 months after the World Trade Center terrorist attacks, they again completed the survey, to which questions regarding PTSD symptoms were added. RESULTS: The odds of probable PTSD were more than three times greater in women with FM-like symptoms, both assessed after 9/11. The odds ratio was not reduced by controlling for FM-like symptoms before 9/11 or for the potentially confounded symptoms of PTSD specifically related to arousal. CONCLUSIONS: These findings lead us to reject alternate explanations for the comorbidity between FM and PTSD. Speculations that FM and PTSD share psychobiological risk factors remain plausible.

Complementary and alternative therapy use by patients with myofascial temporomandibular disorders.

AIMS: To examine the prevalence and predictors of complementary and alternative medicine (CAM) use among patients with temporomandibular disorders (TMD), prior to their first treatment with an intraoral splint. METHODS: Sixty-three women with a diagnosis of myofascial TMD, and who had never been prescribed an intraoral appliance, reported on their use of CAM and other treatments for their facial pain. In addition to providing a comprehensive symptom history, participants completed a 2-week daily diary in which they described the nature of daily efforts to reduce their facial pain. RESULTS: Although more than half of all participants had not sought any prior treatment for their facial pain, 22.2% had received CAM treatment. The only single type of treatment more commonly used than CAM treatment was medication (28.6%). The most common type of CAM treatment was relaxation therapy (12.7%), followed by chiropractic treatment (9.5%). Although pain duration, pain severity, or mood did not predict CAM use, users were significantly more likely to report work or social disability associated with their facial pain and were more likely to report onset associated with an accident. CAM users were more likely than non-users to employ multiple pain reduction strategies over the 2-week daily diary report, including prescription medication use. CONCLUSION: A sizeable minority of women with myofascial TMD report CAM treatment for their pain, even prior to an initial treatment with an intraoral splint. Since empirical reports have not adequately demonstrated their safety or efficacy, there is a need for controlled clinical trials evaluating the utility of CAM treatments for TMD.

Use of unconventional therapies by individuals with multiple sclerosis.

OBJECTIVE: To examine the prevalence and patterns of use of complementary and alternative medicine (CAM) among individuals with multiple sclerosis (MS) in the USA and to explore the reasons for use, symptoms treated and perceived effectiveness of these therapies. METHODS: Surveys were mailed to the entire mailing list of the MS Foundation, constituting 11,600 individuals with MS or their family members; 3,140 adults with MS returned surveys, yielding a response rate of 27.1%. RESULTS: More than half of the responding sample (57.1%) had used at least one CAM modality. The longer that people had MS and the less satisfied they were with conventional health care the more likely they were to use CAM therapies. The most common reasons for using CAMs were the desire to use holistic health care (i.e., treatments that recognized the interrelatedness of mind, body and spirit) and dissatisfaction with conventional medicine. Ingested herbs were the most frequently used CAM modalities (26.6%), followed by chiropractic manipulation (25.5%), massage (23.3%) and acupuncture (19.9%). Women were 25% more likely than men and whites were 30% more likely than non-whites to use CAM therapies. There was no significant relationship between the frequency of use and the reported efficacy of the CAM techniques (r = 0.17, p > 0.10). CONCLUSIONS: The prevalence of CAM use in this population warrants more research on the efficacy and safety of these therapies, especially those with high usage or high efficacy ratings, such as herbs, chiropractic manipulation and massage, but for which there is little or no research evidence for efficacy or safety.

A community-based survey of fibromyalgia-like pain complaints following the World Trade Center terrorist attacks.

A purported pathogenic mechanism for the development of fibromyalgia, a medically unexplained syndrome involving widespread pain, is stress and associated psychiatric disorder. The major stressor of recent World Trade Center terrorist attacks provides a natural experiment for evaluating this mechanism. This study sought to determine whether symptoms consistent with fibromyalgia increased post-September 11 and whether exposure to specific terrorism-related events or prior depression predicted symptom increase. In a large community sample of women in the New York/New Jersey metropolitan area (n=1,312), a cohort initially surveyed for pain and psychiatric symptoms before September 11th were recontacted approximately 6 months after the attacks to assess current symptoms and specific terrorism-related exposures. 'Fibromyalgia-like' (FM-L) four-quadrant pain reports consistent with a diagnosis of fibromyalgia were compared at baseline and follow-up. Result showed that FM-L rates did not increase significantly between baseline and post-attack follow-up. Event exposure did not relate to FM-L onset at follow-up, nor did depressive symptoms at baseline interact with event exposure. Depressive symptoms did not predict new onsets better than the extent of their comorbidity with FM-L at baseline. The failure to detect a significant increase in symptoms consistent with a diagnosis of fibromyalgia and the failure of new onsets of such symptoms to be accounted for by exposure to major stressors or prior depressive symptoms suggests that these hypothesized risk factors are unlikely to be of major importance in the pathogenesis of fibromyalgia.

Effect of Reiki treatments on functional recovery in patients in poststroke rehabilitation: a pilot study.

OBJECTIVES: The three objectives of this study were: (1) to evaluate the effectiveness of Reiki as an adjunctive treatment for patients with subacute stroke who were receiving standard rehabilitation as inpatients, (2) to evaluate a double-blinded procedure for training Reiki practitioners, and (3) to determine whether or not double-blinded Reiki and sham practitioners could determine which category they were in. DESIGN: A modified double-blinded, placebo-controlled clinical trial with an additional historic control condition. SETTING: The stroke unit of a major rehabilitation hospital. SUBJECTS: Fifty (50) inpatients with subacute ischemic stroke, 31 male and 19 female. INTERVENTIONS: There were four conditions: Reiki master, Reiki practitioner, sham Reiki, and no treatment (historic control). Subjects received up to 10 treatments over a 2(1/2)-week period in addition to standard rehabilitation. OUTCOME MEASURES: Functional independence measure (FIM), and Center for Epidemiologic Studies--Depression (CES-D) measure. RESULTS: No effects of Reiki were found on the FIM or CES-D, although typical effects as a result of age, gender, and time in rehabilitation were detected. Blinded practitioners (sham or reiki) were unable to determine which category they were in. Sham Reiki practitioners reported greater frequency of feeling heat in the hands compared to Reiki practitioners. There was no reported difference between the sham and the real Reiki practitioners in their ability to feel energy flowing through their hands. Post hoc analyses suggested that Reiki may have had limited effects on mood and energy levels. CONCLUSION: Reiki did not have any clinically useful effect on stroke recovery in subacute hospitalized patients receiving standard-of-care rehabilitation therapy. Selective positive effects on mood and energy were not the result of attentional or placebo effects.