Long-term radiographic follow-up of the Nissen fundoplication in children

This study examined 46 children 5–9 years (mean 6.7) after Nissen fundoplication surgery for gastroesophageal reflux (GER). Eleven were deceased and ten of the 35 families declined objective evaluation. The remaining 25 children (71%) had a barium swallow examination. In 16 of the 25 patients the fundoplication was intact. In 2 patients a small portion of the fundoplication was displaced above the diaphragm. In 5 patients there was residual esophageal disease. In 3 patients (one with esophageal disease), with a hiatus hernia prior to surgery, despite immediate postoperative reduction, the barium swallow examination done for this study revealed recurrent hiatus hernia but no GER. Long-term results of the Nissen fundoplication reveal success in eliminating clinically significant gastroesophageal reflux. Those patients with esophageal disease prior to the surgery need close interval follow-up to monitor continuing problems.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/46689/1/247_2006_Article_BF02389563.pd

Gene expression clines reveal local adaptation and associated trade-offs at a continental scale

Local adaptation, where fitness in one environment comes at a cost in another, should lead to spatial variation in trade-offs between life history traits and may be critical for population persistence. Recent studies have sought genomic signals of local adaptation, but often have been limited to laboratory populations representing two environmentally different locations of a species' distribution. We measured gene expression, as a proxy for fitness, in males of Drosophila subobscura, occupying a 20° latitudinal and 11 °C thermal range. Uniquely, we sampled six populations and studied both common garden and semi-natural responses to identify signals of local adaptation. We found contrasting patterns of investment: transcripts with expression positively correlated to latitude were enriched for metabolic processes, expressed across all tissues whereas negatively correlated transcripts were enriched for reproductive processes, expressed primarily in testes. When using only the end populations, to compare our results to previous studies, we found that locally adaptive patterns were obscured. While phenotypic trade-offs between metabolic and reproductive functions across widespread species are well-known, our results identify underlying genetic and tissue responses at a continental scale that may be responsible for this. This may contribute to understanding population persistence under environmental change

Current and prospective pharmacological targets in relation to antimigraine action

Migraine is a recurrent incapacitating neurovascular disorder characterized by unilateral and throbbing headaches associated with photophobia, phonophobia, nausea, and vomiting. Current specific drugs used in the acute treatment of migraine interact with vascular receptors, a fact that has raised concerns about their cardiovascular safety. In the past, α-adrenoceptor agonists (ergotamine, dihydroergotamine, isometheptene) were used. The last two decades have witnessed the advent of 5-HT1B/1D receptor agonists (sumatriptan and second-generation triptans), which have a well-established efficacy in the acute treatment of migraine. Moreover, current prophylactic treatments of migraine include 5-HT2 receptor antagonists, Ca2+ channel blockers, and β-adrenoceptor antagonists. Despite the progress in migraine research and in view of its complex etiology, this disease still remains underdiagnosed, and available therapies are underused. In this review, we have discussed pharmacological targets in migraine, with special emphasis on compounds acting on 5-HT (5-HT1-7), adrenergic (α1, α2, and β), calcitonin gene-related peptide (CGRP 1 and CGRP2), adenosine (A1, A2, and A3), glutamate (NMDA, AMPA, kainate, and metabotropic), dopamine, endothelin, and female hormone (estrogen and progesterone) receptors. In addition, we have considered some other targets, including gamma-aminobutyric acid, angiotensin, bradykinin, histamine, and ionotropic receptors, in relation to antimigraine therapy. Finally, the cardiovascular safety of current and prospective antimigraine therapies is touched upon

Large expert-curated database for benchmarking document similarity detection in biomedical literature search

Document recommendation systems for locating relevant literature have mostly relied on methods developed a decade ago. This is largely due to the lack of a large offline gold-standard benchmark of relevant documents that cover a variety of research fields such that newly developed literature search techniques can be compared, improved and translated into practice. To overcome this bottleneck, we have established the RElevant LIterature SearcH consortium consisting of more than 1500 scientists from 84 countries, who have collectively annotated the relevance of over 180 000 PubMed-listed articles with regard to their respective seed (input) article/s. The majority of annotations were contributed by highly experienced, original authors of the seed articles. The collected data cover 76% of all unique PubMed Medical Subject Headings descriptors. No systematic biases were observed across different experience levels, research fields or time spent on annotations. More importantly, annotations of the same document pairs contributed by different scientists were highly concordant. We further show that the three representative baseline methods used to generate recommended articles for evaluation (Okapi Best Matching 25, Term Frequency–Inverse Document Frequency and PubMed Related Articles) had similar overall performances. Additionally, we found that these methods each tend to produce distinct collections of recommended articles, suggesting that a hybrid method may be required to completely capture all relevant articles. The established database server located at https://relishdb.ict.griffith.edu.au is freely available for the downloading of annotation data and the blind testing of new methods. We expect that this benchmark will be useful for stimulating the development of new powerful techniques for title and title/abstract-based search engines for relevant articles in biomedical research

Influence of PTSD and MDD on Somatic Symptoms in Treatment-Seeking Military Members and Veterans

Introduction: Using a treatment-seeking sample of military personnel and Veterans (n = 736), the objectives were to determine the prevalence of somatic symptoms in the sample and investigate whether the mean severity of somatic symptoms differed between common probable psychiatric conditions and comorbidity. Methods: The Patient Health Questionnaire–15 was used to determine somatic symptom severity. One-way analyses of variance and Tukey post hoc tests determined whether the severity of somatic symptom categories (musculoskeletal pain, neurological, cardiovascular, gastrointestinal, sleep, and lethargy) and total somatic symptom severity differed significantly between groups. Results: Most participants (80%) reported moderate to high levels of somatic symptoms, and more than half the sample had probable comorbid post-traumatic stress disorder (PTSD) and major depressive disorder (MDD). Mean total somatic symptom severity for the comorbid PTSD–MDD group was high and differed significantly from that of the PTSD- and MDD-only groups (medium severity) and the group with neither condition (mild severity). Severity of most mean somatic symptom categories differed significantly between comorbid PTSD and MDD for all other groups. Discussion: Results suggest that the presentation of comorbid PTSD and MDD is more detrimental in terms of somatic symptom severity than that of either disorder separately. Although there were some differences in the severity of specific somatic symptom types between the PTSD-only and the MDD-only groups, overall severity did not differ. After diagnosis of a mental health condition, military personnel and Veterans should be screened for somatic symptoms. Article is in English Introduction : Les objectifs de cette recherche basée sur un échantillon de personnel militaire et de vétérans (N = 736) étaient de déterminer l’importance des symptômes somatiques et d’étudier leur sévérité en comparaison avec des conditions psychiatriques et des comorbidités. Méthodologie : Le Questionnaire 15 de santé du patient a été employé afin de déterminer l’ampleur des symptômes somatiques. Une analyse de variance à variable unique suivie de tests Tukey post-hoc ont permis de déterminer si la sévérité des catégories de symptômes somatiques (douleur musculosquelettique, neurologique, cardiovasculaire, gastrointestinal, sommeil et léthargie) ainsi que la mesure selon laquelle ces symptômes différaient entre les groupes. Résultats : La plupart (80%) des participants ont rapporté des niveaux de symptômes somatiques entre moyen et élevé. De plus, au-delà de la moitié de l’échantillon vivant avec une probable comorbidité de SSPT et de BM. La sévérité moyenne totale des symptômes somatiques du groupe comorbide SSPT-BM était élevée et significative vis-à-vis des groupes vivant avec uniquement le SSPT ou une BM (sévérité moyenne) ou aucune des conditions (basse sévérité). La sévérité de la plupart des moyennes des symptômes somatiques différait grandement entre le groupe comorbide SSPT-BM et les autres groupes. Discussion : Les résultats suggèrent que la présence d’une comorbidité SSPT-BM est plus nuisible en termes de symptômes somatiques que chacun des troubles vécu séparément. Bien qu’il y ait des différences dans la sévérité des types de symptômes somatiques vis-à-vis des groupes vivant uniquement le SSPT ou la BM, la sévérité globale demeurait la même. Avec le diagnostic d’une de ces conditions, le personnel militaire et les vétérans devraient être évalués pour des symptômes somatiques