Tremor in multiple sclerosis

Tremor is estimated to occur in about 25 to 60 percent of patients with multiple sclerosis (MS). This symptom, which can be severely disabling and embarrassing for patients, is difficult to manage. Isoniazid in high doses, carbamazepine, propranolol and gluthetimide have been reported to provide some relief, but published evidence of effectiveness is very limited. Most trials were of small size and of short duration. Cannabinoids appear ineffective. Tremor reduction can be obtained with stereotactic thalamotomy or thalamic stimulation. However, the studies were small and information on long-term functional outcome is scarce. Physiotherapy, tremor reducing orthoses, and limb cooling can achieve some functional improvement. Tremor in MS remains a significant challenge and unmet need, requiring further basic and clinical research

Exploration of Shared Genetic Architecture Between Subcortical Brain Volumes and Anorexia Nervosa

In MRI scans of patients with anorexia nervosa (AN), reductions in brain volume are often apparent. However, it is unknown whether such brain abnormalities are influenced by genetic determinants that partially overlap with those underlying AN. Here, we used a battery of methods (LD score regression, genetic risk scores, sign test, SNP effect concordance analysis, and Mendelian randomization) to investigate the genetic covariation between subcortical brain volumes and risk for AN based on summary measures retrieved from genome-wide association studies of regional brain volumes (ENIGMA consortium, n = 13,170) and genetic risk for AN (PGC-ED consortium, n = 14,477). Genetic correlations ranged from − 0.10 to 0.23 (all p > 0.05). There were some signs of an inverse concordance between greater thalamus volume and risk for AN (permuted p = 0.009, 95% CI: [0.005, 0.017]). A genetic variant in the vicinity of ZW10, a gene involved in cell division, and neurotransmitter and immune system relevant genes, in particular DRD2, was significantly associated with AN only after conditioning on its association with caudate volume (pFDR = 0.025). Another genetic variant linked to LRRC4C, important in axonal and synaptic development, reached significance after conditioning on hippocampal volume (pFDR = 0.021). In this comprehensive set of analyses and based on the largest available sample sizes to date, there was weak evidence for associations between risk for AN and risk for abnormal subcortical brain volumes at a global level (that is, common variant genetic architecture), but suggestive evidence for effects of single genetic markers. Highly powered multimodal brain- and disorder-related genome-wide studies are needed to further dissect the shared genetic influences on brain structure and risk for AN

Phylogenetic and biological characterization of <I>Fusarium oxysporum</I> isolates associated with onion in South Africa

AgriwetenskappePlantpatologiePlease help us populate SUNScholar with the post print version of this article. It can be e-mailed to: [email protected]

Involvement in and Views on Social Responsibility of Gauteng Members of the South African Society of Physiotherapy: A Cross-sectional Survey

How do physiotherapists in Gauteng Province,who are members of the South African Society of Physiotherapy(SASP), view social responsibility?A cross-sectional survey was conducted after ethics approval.All 1 098 Gauteng members of the SASP were invited via a thirdpartye-mail to reach the a priori minimum sample size of 97. Theweb-based questionnaire was developed from literature, an earlierSASP survey and a position paper of the American Physical TherapyAssociation (APTA). Five experts validated the instrument.The Likert scale scores indicating agreement with indicatorsof social responsibility were totalled to form a composite socialresponsibility score. The chi-square test for independence was used to determine associations between the categorisedcomposite social responsibility score and categorical variables. Mean difference of continuous variables betweenthe categorised core for two groups were tested using the two-sample t-test. All variables with a P-value less than0.05 were included in the logistic regression analysis to investigate predictors of the necessity of social responsibility.The survey was completed by 163 participants. Of the sample, 96.9% viewed social responsibility as important.Subjects agreed most with “advocating for the health needs of society” (74,2%) and the least with “political activism”(6.1%). Compulsory community service positively influenced 74.6%.Most physiotherapists in the study viewed social responsibility as important and were involved in volunteering.There is scope to broaden the understanding among physiotherapists of what social responsibility entails

Nationwide registration of clinical &quot;XTC&quot;-incidents

De studie Landelijke registratie klinische XTC-incidenten is bedoeld om gedurende een jaar het voorkomen, de ernst en omstandigheden van XTC intoxicaties, waarbij opname in een Nederlands ziekenhuis heeft plaatsgevonden, in kaart te brengen. Door middel van analytisch-toxicologisch onderzoek van serum, urine en overgebleven tabletten werd nagegaan of de waargenomen intoxicatie verschijnselen al dan niet samenhangen met het "XTC"-gebruik. Tevens werd onderzocht welke actieve bestanddelen van de ingenomen producten verantwoordelijk geacht kunnen worden voor het klinisch beeld. In het onderzoek werden 36 mannen en 14 vrouwen geincludeerd van wie het merendeel 18 tot 28 jaar oud was. Slechts 5 patienten (10 %) hadden de "XTC" op een houseparty gebruikt. Daarentegen gebruikte 60 % van de patinten "XTC" thuis of in een bar of disco. De overige 30 % nam bewust een intentionele overdosering of kreeg de "XTC" accidenteel binnen. Vrijwel alle patienten hadden naast "XTC" nog andere middelen ingenomen, meestal alcohol. Van de patienten bleek 80 % mild geintoxiceerd te zijn, waarbij opwinding, motorische onrust, tachycardie, mydriasis, misselijkheid en een overmatige zweetproductie op de voorgrond stonden. Daarnaast was 20 % ernstig geintoxiceerd met symptomen als hypo- of hypertensie, convulsies of coma.De analyses bevestigden dat deze groep "XTC" gebruikers feitelijk een groep van poly-drug-gebruikers is, die tegelijk verschillende andere middelen (zoals alcohol, cocaine, amfetamine, cannabis en gamma-hydroxy-boterzuur (GHB)) binnen heeft gekregen. Door serum- en urineanalyses te vergelijken met de gerapporteerde inname werd bevestigd dat "XTC" een verzamelnaam is voor verschillende actieve stoffen. In deze studie werden 17 verschillende verbindingen (zoals MDA, MDMA, amfetamine, 2-CB, MDDM, 2-CT-2) aangetroffen die de patienten binnen hadden gekregen zonder dat de inname daarvan uit de anamnese is gebleken. Er was geen verschil in ernst van het klinisch beeld tussen de mono MDMA en MDEA intoxicaties en de rest van de studie populatie, met uitzondering van GHB. In deze studie was het aantal gerapporteerde opnames tengevolge van "XTC" gebruik relatief beperkt. Deze studie bevestigt dat de samenstelling van de "XTC" tabletten heterogeen is. Bovendien bleek dat gecombineerd druggebruik een extra risicofactor is. Het is belangrijk zich te realiseren dat wanneer effecten van XTC, i.e. MDMA, worden bestudeerd, de samenstelling van de tabletten bekend dient te zijn en, d.m.v. analytisch toxicologisch onderzoek bij de patient, gecontroleerd dient te worden of er daadwerkelijk MDMA is ingenomen. Daarbij dient bijkomend druggebruik in kaart te zijn gebracht. Anders is het niet mogelijk om de geobserveerde "XTC"-effecten toe te schrijven aan XTC, i.e. MDMA, gebruik.The present study is a registration during one year, of the extent, the severity and the circumstances of acute "XTC" intoxications for which admission was considered necessary in a hospital in the Netherlands. The clinical phenomena as well as serum and urine samples of patients suspected of having used "XTC" were analysed. This drug screening made it possible to relate the symptoms to the substances that were found present in the urine or serum samples of each patient.36 men and 14 women were included in the study and most of them were 18 - 28 years of age. Only five patients (10%) had used "XTC" at a mega-dance-party and 60% of the patients had used the "XTC" at home, or in a bar or disco. The other 30 % of the patients took the tablets accidently or in a suicidal attempt. Nearly all the patients had used one or more substances besides "XTC", mostly alcohol. Of the patients 80% were mildly intoxicated, with symptoms as restlessness, tachycardia, mydriasis, nausea and perspiration. In addition to these, 20 % of the patients were severely intoxicated, with symptoms such as hypo- or hypertension, convulsions or coma. One patient died.The analysis confirmed that most patients had used several drugs (such as alcohol, cocaine, amphetamin, cannabis and Gamma-hydroxy-butyric-acid (GHB)) besides "XTC". Moreover, by comparing the serum and urine results with the reported intake, it became clear that the exposure varied widely. In this study 17 different substances (such as MDA, MDMA, amphetamin, 2-CB, MDDM, 2-CT-2 and ephedrin) were found. There was no difference in clinical severity between the mono MDMA and MDEA intoxications and the rest of the study population, with the exception of GHB. In this study the reported number of hospital admissions due to the "XTC" use was relatively low and of these patients 20% were severely intoxicated. This study confirms that the content of "XTC" tablets is heterogeneous and that concomitant drug abuse is a risk factor. When one wants to study the effects of XTC, i.e. MDMA, it is necessary that one knows the composition of the "XTC" tablets and to evaluate concomitant drug abuse. Otherwise it is not possible to confidently attribute observed "XTC"-effects to XTC, i.e. MDMA, itself.VWS-GV