Genome-wide association study for methane emission traits in Danish Holstein cattle.

Selecting for lower methane emitting cows requires insight into the most biologically relevant phenotypes for methane emission, which are close to the breeding goal. Several methane phenotypes have been suggested over the last decade. However, the (dis)similarity of their underlying genetic architecture and correlation structures are poorly understood. Therefore, the objective of this study was to test association of SNP and genomic regions through GWAS on 8 CH4 emission traits in Danish Holstein cattle. The traits studied were methane concentration (MeC; ppm), methane production (MeP ; g/d), 2 definitions of residual methane (RMETc and RMETp: MeC and MeP regressed on metabolic body weight and energy-corrected milk, respectively), 2 definitions of methane intensity (MeI; MeIc = MeC/ECM and MeIp = MeP/ECM); 2 definitions of methane yield per kilogram of dry matter intake (MeY; MeYc = MeC/dry matter intake and MeYp = MeP/dry matter intake). A total of 1,962 cows with genotypes (Illumina BovineSNP50 Chip or Eurogenomic custom SNP chip) and repeated records of the above-mentioned 8 methane traits were analyzed. Strong associations were found with 3 traits (MeC, MeP, and MeYc) on chromosome 13 and with 5 traits (MeC, MeP, MeIp, MeYp, and MeYc) on chromosome 26. For MeIc, MeIp, RMETc, MeYc, and MeYp, some suggestive association signals were identified on chromosome 1. Genomic segments of 1 Mbp (n = 2,525) were tested for their association with these traits, which identified between 33 to 54 significantly associated regions. In a pairwise comparison, MeC and MeP were the traits that shared the highest number of significant segments (17). The same trend was observed when comparing SNP significantly associated with the traits MeC and MeP shared from 23 to 25 SNP (most of which were located in chromosomes 11, 13, and 26). Based on our results on GWAS and genetic correlations, we conclude that MeC is (genetically) more closely linked to MeP than any of the other methane traits analyzed.

Limbically augmented pain syndrome (LAPS): kindling, corticolimbic sensitization, and the convergence of affective and sensory symptoms in chronic pain disorders.

There is abundant clinical evidence that depression occurs with high frequency among chronic pain patients. When compared with other serious medical disorders, the prevalence of depression in chronic pain appears high. The fundamental reason for this association is unknown. Theories have attempted to explain the link between pain and depression in terms of psychologic mechanisms. Other theories highlight shared neurobiologic substrates. However, a comprehensive theory integrating biologic and psychologic viewpoints remains elusive. In this article, we draw on research on neuroplastic processes in corticolimbic structures to model the linkage between the sensory and affective domains of pain. Our hypothesis is based on kindling experiments in animals that elucidate the complex neurobiologic mechanisms that transduce exteroceptive and interoceptive stimuli into "memory" at the cellular/synaptic level. This experimental model has found application in the affective disorders to explain how a person's history of exposure to psychologic trauma configures the neurobiologic substrate for later-amplified pathologic response. In applying kindling research to pain, we begin by reviewing the literature on nociception-induced neuroplasticity at the corticolimbic level. We suggest that kindling and related models of neuroplasticity can be used to describe ways in which exposure to a noxious stimulus may, under certain conditions, lead to a sensitized corticolimbic state. This sensitized state can be described in terms of the kindling properties of amplification, spontaneity, neuroanatomic spreading, and cross-sensitization. A case example illustrates how these properties offer a neurobiologic framework for understanding the sensory/affective/behavioral symptom complex seen in a subset of chronic pain patients. These patients are characterized by atypical and treatment-refractory pain complaints, in association with disturbances of mood, sleep, energy, libido, memory/concentration, behavior, and stress intolerance. We introduce the term "limbically augmented pain syndrome" to describe this symptom complex.

Liver transplantation for patients with alcoholism and end-stage liver disease.

Liver transplantation for alcoholic cirrhosis remains controversial. In particular, criteria for the selection of patients who will remain recovered from alcoholism post-transplant require better definition. We analyzed the long-term predictive value of categorizing transplant referral patients with alcoholism and end-stage liver disease into risk groups for recidivism and noncompliance. Forty-seven patients with the diagnosis of alcoholism and advanced liver disease were evaluated and placed into predefined risk groups (low-, moderate-, and high-risk) for recidivism and noncompliance. No absolute period of abstinence from alcohol was required. All patients were asked to sign a contract not to drink alcohol and comply with a rehabilitation program before and after transplantation. Compliance with alcohol rehabilitation, abstinence, functional level, employment, and survival were assessed. Patients who were not compliant with the rehabilitation program or consumed alcohol were scored as failures. Thirty-one patients were ranked as low risk, and were accepted for liver transplantation; 27 patients were transplanted. Five of 31 patients (16%) drank alcohol. One patient drank before and four patients drank transiently after transplantation. Ten patients were categorized as moderate risk, and were deferred for transplantation; two patients underwent later transplantation. All 10 patients (100%) were noncompliant or drank alcohol, including two patients who drank after transplantation after a period of abstinence and rehabilitation. Six patients were ranked as high risk, and were denied liver transplantation. Five patients (83%) drank alcohol and were noncompliant. Minimum follow-up was 12 months (mean, 24 months; range, 12-41 months). The mean Karnofsky performance score was 34 before and 84 after liver transplantation. Actuarial survival of alcoholic patients undergoing transplantation was 93%. We conclude that categorization of transplant referral patients with alcoholism and liver failure into predefined risk groups for recidivism and noncompliance accurately predicts pre- and post-transplant behavior. As defined, only low-risk alcoholic patients are good candidates for liver transplantation.

Multifactorial facial pain--differential diagnosis: a case report.

A multidisciplinary algology team was formed to facilitate the diagnosis and treatment of complex head and neck pain disorders. The standard patient evaluation includes a history and physical, surface electromyography, Minnesota Multi-phasic Personality Inventory (MMPI), brief psychiatric interview, dental/occlusal analysis, a postural/musculoskeletal examination; and necessary diagnostic imaging. Clinicians meet in conference after each clinic session. Organic and psychiatric findings are compiled and a differential diagnosis is made. Treatment recommendations are outlined and a review of the evaluation and the therapeutic plan are forwarded to the referring doctor. A typical conference discussion is presented here.

Psychological and behavioral aspects of chronic facial pain.

This article provides an overview of psychological and behavioral factors contributing to chronic facial pain. Psychiatric diagnostic issues are presented from the perspective of the primary treating physician or dentist, with emphasis on practical ways of identifying and managing patients with psychosocial complications of their presenting complaints. Behavioral factors contributing to facial pain, including parafunctional habits such as bruxism and muscular tension, and their connection to stress are discussed. Various behavioral and psychological treatment approaches are reviewed.