Perinatal selective serotonin reuptake inhibitor exposure and behavioral outcomes: A systematic review and meta-analyses of animal studies.

In the Western world, 2-5 % of pregnant women use selective serotonin reuptake inhibitor (SSRI) antidepressants. There is no consensus on the potential long-term neurodevelopmental outcomes of early SSRI exposure. Our aim was to determine whether there is an overall effect of perinatal SSRI exposure in animals on a spectrum of behavioral domains. After a comprehensive database search in PubMed, PsycINFO, and Web of Science, we included 99 publications. We performed nine meta-analyses and two qualitative syntheses corresponding to different behavioral categories, aggregating data from thousands of animals. We found evidence for reduced activity and exploration behavior (standardized mean difference (SMD) -0.28 [-0.38, -0.18]), more passive stress coping (SMD -0.37 [-0.52, -0.23]), and less efficient sensory processing (SMD -0.37 [-0.69, -0.06]) in SSRI- versus vehicle-exposed animals. No differences were found for anxiety (p = 0.06), social behavior, learning and memory, ingestive- and reward behavior, motoric behavior, or reflex and pain sensitivity. Exposure in the period equivalent to the human third trimester was associated with the strongest effects.

The protective effect of meniscus allograft transplantation on articular cartilage: a systematic review of animal studies.

Despite widespread reporting on clinical results, the effect of meniscus allograft transplantation on the development of osteoarthritis is still unclear. The aim of this study was to systematically review all studies on the effect of meniscus allograft transplantation on articular cartilage in animals. Pubmed and Embase were searched for original articles concerning the effect of meniscus allograft transplantation on articular cartilage compared with both its positive (meniscectomy) and negative (either sham or non-operated) control in healthy animals. Outcome measures related to assessment of damage to articular cartilage were divided in five principal outcome categories. Standardized mean differences (SMD) were calculated and pooled to obtain an overall SMD and 95% confidence interval. 17 articles were identified, representing 14 original animal cohorts with an average timing of data collection of 24 weeks [range 4 weeks; 30 months]. Compared to a negative control, meniscus allograft transplantation caused gross macroscopic (1.45 [0.95; 1.95]), histological (3.43 [2.25; 4.61]) damage to articular cartilage, and osteoarthritic changes on radiographs (3.12 [1.42; 4.82]). Moreover, results on histomorphometrics and cartilage biomechanics are supportive of this detrimental effect on cartilage. On the other hand, meniscus allograft transplantation caused significantly less gross macroscopic (-1.19 [-1.84; -0.54]) and histological (-1.70 [-2.67; -0.74]) damage to articular cartilage when compared to meniscectomy. However, there was no difference in osteoarthritic changes on plain radiographs (0.04 [-0.48; 0.57]), and results on histomorphometrics and biomechanics did neither show a difference in effect between meniscus allograft transplantation and meniscectomy. In conclusion, although meniscus allograft transplantation does not protect articular cartilage from damage, it reduces the extent of it when compared with meniscectomy.

Identifying emotional adaptation: behavioural habituation to novelty and immediate early gene expression in two inbred mouse strains.

Normal anxiety is an adaptive emotional response. However, when anxiety appears to lack adaptive value, it might be defined as pathological. Adaptation in animals can be assessed for example by changes in behavioural responses over time, i.e. habituation. We hypothesize that non-adaptive anxiety might be reflected by impaired habituation. To test our hypothesis, we repeatedly exposed male mice from two inbred strains to a novel environment, the modified hole board. BALB/cJ mice were found to be initially highly anxious, but subsequently habituated to the test environment. In contrast, 129P3/J mice initially showed less anxiety-related behaviour compared with the BALB/cJ mice but no habituation in anxiety-related behaviour was observed. Notably, anxiety-related behaviour even increased during the experimental period. Complementary, 129P3/J mice did not show habituation in other parameters such as locomotor and exploratory activity, whereas significant changes appeared in these behaviours in BALB/c mice. Finally, the expression of the immediate early gene c-fos differed between the two strains in distinct brain areas, known to regulate the integration of emotional and cognitive processes. These results suggest that 129P3/J mice might be a promising (neuro)-behavioural animal model for non-adaptive, i.e. pathological anxiety.

Optimization of the PCR test for the mutation causing bovine leukocyte adhesion deficiency.

The recent emergence of the bovine leukocyte adhesion deficiency (BLAD) demonstrated the risks of narrowing the genetic basis of a population. About 6% of the Holstein-Friesian cattle now descends from one bull who was a heterozygous BLAD carrier. Crossing his descendants resulted in the birth of homozygous BLAD calves with a life expectancy of < 1 year. The BLAD syndrome is caused by a point mutation in the gene coding for CD18, a subunit of the beta 2 integrins on the surface of leukocytes. By using a PCR-RFLP test, large numbers of cattle are now being screened in several countries to eradicate the mutant allele. We describe an optimization of the PCR primer set that has led to an improvement of the test.

Application of a photodiode in dental radiology.

A photodiode in a light-tight housing was used as an x-ray detector. Calibration against a standard ionization chamber showed that, for the range of radiation qualities used in dentistry, its output was a reliable measure of the rate of exposure. Photodiodes are available in very small sizes and can be used intraorally. The feasibility of automatic exposure control for intraoral radiography was considered. Measurement of transmission fractions through the mandible with various radiation qualities resulted in a numerical evaluation of radiation risk approximated by the absorbed dose.

Multivariate logistic analysis of risk factors for stroke in Tilburg, The Netherlands.

By means of a case-control study conducted between October 1, 1978, and July 31, 1981, in Tilburg, The Netherlands, various characteristics and events, including personal data, health-related behavior, and medical history, were evaluated as risk factors for stroke. The study subjects included 132 stroke patients and 239 age- and sex-matched control patients interviewed at the two city hospitals. To assess joint effects and possible interactions, and to control for multiple confounding factors, a series of multivariate logistic models for matched data were studied. From this analysis, it appeared that hypertension, acute myocardial infarction, cardiac arrhythmias, transient cerebral ischemic attacks, obesity, physical activity during leisure time, education of head of household, and Rhesus factor were all significant stroke risk factors. These risk determinants demonstrated a multiplicative effect in general; however, the influence of some variables on stroke risk was not constant with age (hypertension, acute myocardial infarction, cardiac arrhythmias, obesity, and Rhesus factor) and sex (hypertension and education of head of household). The relationship of diabetes mellitus to stroke slightly decreased and became nonsignificant after adjustment for factors besides age and sex. Stroke risk was not associated with cigarette and alcohol use, family history of stroke and related disorders, marital status, and ABO blood typing.

Epidemiology of stroke in Tilburg, the Netherlands. The population-based stroke incidence register: 2. Incidence, initial clinical picture and medical care, and three-week case fatality.

The results of a prospective population study of stroke in Tilburg are reported. The average annual over-all incidence (per 100,000 population) for the period October 1, 1978-September 30, 1980 was 174 for total cases, 145 for first-ever cases. Males and older persons were at greater risk for a stroke. The vast majority of strokes were thrombo-embolic infarctions. Hemiplegia was the predominant neurological deficit resulting from an insult. Patients with speech problems, as opposed to those without, demonstrated more extreme motor deficit when such occurred. Seventy-four per cent of stroke cases had hypertensive blood pressure readings shortly after onset. Most patients were under hospital care during the initial phase of their attacks. The presence of such handling was related to specific patient characteristics. Three-week stroke case fatality was 30% for all patients registered, and varied significantly by age, sex and diagnostic type.

An evaluation of risk factors for stroke in a Dutch community.

The objective of the present epidemiological study was to reevaluate the relationship of various suspect risk factors to stroke within a Dutch community. The Tilburg study lends support to findings in other countries concerning the greater stroke risk of persons with high blood pressure, heart disorders, and diabetes mellitus. Significant interactions of both age and a history of myocardial infarction with hypertension on stroke risk were noted. The presence of overweight and possible transient ischemic attacks (TIA) were found related to stroke onset. No increase in stroke risk was associated with cigarette smoking. The extent of leisure time physical activity during one's lifetime was found inversely related to one's chances for stroke.

NMR: dental imaging without x-rays?

Recently, advances in a new method of medical imaging have been reported by various authors. The method is based on the physical phenomenon of nuclear magnetic resonance (NMR) and is a well-established technique used in chemistry and physics. Radio waves are transmitted and detected in the presence of magnetic fields; the method is noninvasive and does not use ionizing radiation. The potential use of NMR in dentistry and basic concepts of NMR imaging are discussed.

Epidemiology of stroke in Tilburg, The Netherlands. The population-based stroke incidence register: 1. Introduction and preliminary results.

We present the methodology and some preliminary findings of a population-based stroke incidence register operating in Tilburg (about 150,000 persons), The Netherlands. From October 1, 1978 to March 31, 1979, 152 new strokes occurred giving an estimated overall incidence (per 100,000 population) for total and first attacks of 202 and 162, respectively. No major sex difference in stroke risk (all ages) was noted, although males did have a significantly higher incidence at 55--64 years of age. Stroke incidence increased strikingly with age. Thromboembolic infarcts comprised 83% and intracranial hemorrhage 13% of attacks. Males and females differed little in distribution of stroke types. The proportion of cerebral infarction was higher among older than younger cases. The opposite was true regarding intracranial hemorrhage. Embolic infarcts constituted a significantly higher proportion of cases at 65--74 years of age than at other ages. Hemiplegia and speech deficits dominated the clinical picture at onset. The 3-week case fatality for all strokes was 26%. Both a lowering of consciousness (found among 38% of cases during the first 24 hours) and a history of prior stroke were found related to a reduction in survival. Of patients surviving 3 weeks 25% were completely dependent and 25% partially dependent upon others for personal care.

III. Profile, expectation and satisfaction of outpatients (1970-1972).

The present study deals with patients' assessment of the OPD and the experimental changes in terms of "patient satisfaction". The hypothesis tested, stated that the level of satisfaction of clients of the OPD at Machakos hospital would increase after the introduction of changes in the operational and technical procedures. Data on clients' profiles and satisfaction were collected by means of structured interview schedule; 24 background variables and 17 satisfaction indicators were selected for final analysis to compare profiles and satisfaction of 324 baseline and 367 evaluation respondents. Profiles and satisfaction differed significantly at the 5% level. The significant difference in satisfaction could not be explained by the difference in profiles; the hypothesis was confirmed. A detailed analysis showed that total clinic time (the total time patients spent in the clinic) was significantly correlated with some of the 24 background variables and with some of the 17 satisfaction indicators; its duration was one of the key determinants for patient satisfaction, with a highly discriminative value. Another key variable was the answer to the question: "Did you get the treatment you wanted?". OPD patients discriminated various aspects and facets of OPD process and procedures for their assessment.

IV. Health services research; the case of the outpatient department.

The main findings of the series of operational and satisfaction studies in the outpatient department of Machakos Hospital (1968-1972) were presented as a case study of evaluation research. The relevant theoretical aspects of evaluation research in the ambulatory care setting are reviewed. In an attempt to feed back the implications of the above studies for planning and management of services, for training of staff and for future research are presented.