Book Reviews

Sensitive Periods, Language Aptitude, and Ultimate L2 Attainment Editors: Gisela Granena and Mike Long Publisher: John Benjamins, 2013 ISBN:978-90272131294357357810Studies in Second Language Learning and Teachin

Nonmalignant Features Associated with Inherited Colorectal Cancer Syndromes-Clues for Diagnosis

Simple Summary: Familiarity with nonmalignant features and comorbidities of cancer predisposition syndromes may raise awareness and assist clinicians in the diagnosis and interpretation of molecular test results. Genetic predisposition to colorectal cancer (CRC) should be suspected mainly in young patients, in patients with significant family histories, multiple polyps, mismatch repair-deficient tumors, and in association with malignant or nonmalignant comorbidities. The aim of this review is to describe the main nonmalignant comorbidities associated with selected CRC predisposition syndromes that may serve as valuable diagnostic clues for clinicians and genetic professionals.& nbsp;Genetic diagnosis of affected individuals and predictive testing of their at-risk relatives, combined with intensive cancer surveillance, has an enormous cancer-preventive potential in these families. A lack of awareness may be part of the reason why the underlying germline cause remains unexplained in a large proportion of patients with CRC. Various extracolonic features, mainly dermatologic, ophthalmic, dental, endocrine, vascular, and reproductive manifestations occur in many of the cancer predisposition syndromes associated with CRC and polyposis. Some are mediated via the WNT, TGF-beta, or mTOR pathways. However the pathogenesis of most features is still obscure. Here we review the extracolonic features of the main syndromes, the existing information regarding their prevalence, and the pathways involved in their pathogenesis. This knowledge could be useful for care managers from different professional disciplines, and used to raise awareness, enable diagnosis, and assist in the process of genetic testing and interpretation

Nightly treatment of primary insomnia with prolonged release melatonin for 6 months: a randomized placebo controlled trial on age and endogenous melatonin as predictors of efficacy and safety

<p>Background: Melatonin is extensively used in the USA in a non-regulated manner for sleep disorders. Prolonged release melatonin (PRM) is licensed in Europe and other countries for the short term treatment of primary insomnia in patients aged 55 years and over. However, a clear definition of the target patient population and well-controlled studies of long-term efficacy and safety are lacking. It is known that melatonin production declines with age. Some young insomnia patients also may have low melatonin levels. The study investigated whether older age or low melatonin excretion is a better predictor of response to PRM, whether the efficacy observed in short-term studies is sustained during continued treatment and the long term safety of such treatment.</p> <p>Methods: Adult outpatients (791, aged 18-80 years) with primary insomnia, were treated with placebo (2 weeks) and then randomized, double-blind to 3 weeks with PRM or placebo nightly. PRM patients continued whereas placebo completers were re-randomized 1:1 to PRM or placebo for 26 weeks with 2 weeks of single-blind placebo run-out. Main outcome measures were sleep latency derived from a sleep diary, Pittsburgh Sleep Quality Index (PSQI), Quality of Life (World Health Organzaton-5) Clinical Global Impression of Improvement (CGI-I) and adverse effects and vital signs recorded at each visit.</p> <p>Results: On the primary efficacy variable, sleep latency, the effects of PRM (3 weeks) in patients with low endogenous melatonin (6-sulphatoxymelatonin [6-SMT] ≤8 μg/night) regardless of age did not differ from the placebo, whereas PRM significantly reduced sleep latency compared to the placebo in elderly patients regardless of melatonin levels (-19.1 versus -1.7 min; P = 0.002). The effects on sleep latency and additional sleep and daytime parameters that improved with PRM were maintained or enhanced over the 6-month period with no signs of tolerance. Most adverse events were mild in severity with no clinically relevant differences between PRM and placebo for any safety outcome.</p> <p>Conclusions: The results demonstrate short- and long-term efficacy and safety of PRM in elderly insomnia patients. Low melatonin production regardless of age is not useful in predicting responses to melatonin therapy in insomnia. The age cut-off for response warrants further investigation.</p&gt

Diagnosis and treatment of muscle pain according to Tipaldos (literature review)

This review contents the information on the theory of the structure and mechanisms of damage to the body fascial system, proposed by American osteopath S. Tipaldos and named by him the Fascial Distortion Model (FDM), as well as on the original method of diagnosis and treatment of muscle pain syndromes associated with fascial damage (distortion). The author describes classifications of connective tissue and fascial structures, created by S.  Tipaldos, which are based on anatomical and functional features that determine the role of each type of fascia in compensating for various types of external influences. The conditions, mechanisms of formation and characteristics of six types of fascial lesions identified by S. Tipaldos are considered in detail: triggerband, herniated triggerpoint, continuum distortion, folding distortion, cylinder distortion, tectonic fixation. All elements of the fascial distortions diagnosis are discussed in detail, including the specification of complaints (characteristics of pain syndrome), anamnesis (history of the pain onset and its development) and an objective examination (the actual diagnostic techniques). At the same time, the special role of the patient’s description of his own painful sensations with the help of specific gestures and movements, called «body language», is emphasized. The principles and some methods of therapeutic effects used in FDM-therapy, indications and contraindications for the use of the considered manual techniques, possible side reactions that may occur during manipulation or after a session of FDMtherapy are presented. Particular attention is paid to  the evidence base of FDM therapy effectiveness in comparison with traditional methods of myofascial pain syndromes manual treatment: the results of controlled studies by foreign authors, confirming the new technique effectiveness in the treatment of certain muscle algic phenomena types, are considered