Poland syndrome with ipsilateral hypoplasia of gluteal muscles and contralateral hidradenitis suppurativa

Background: Poland syndrome (PS) is a rare congenital anomaly associated with absent or hypoplastic pectoralis major muscle and a wide spectrum of ipsilateral thoracic and upper extremity deformities. Hidradenitis suppurativa (HS) is a recurrent inflammatory follicular disease that commonly affects the apocrine-bearing skin and involves follicular occlusion and hyperkeratosis. Case Report: We report a case of a 46-year-old male with a history of chronic recurrent hidradenitis suppurativa who was incidentally found to have a simple type of Poland syndrome with incidental hypoplasia of ipsilateral gluteal muscles. Conclusions: Not only can PS present with HS, which we describe for the first time, but it is also associated with a wide variability of symptoms such as previously unknown co-existence of gluteal muscles hypoplasia

Changes in brain activation following psychotherapy for youth with mood dysregulation at familial risk for bipolar disorder

BACKGROUND: Psychotherapy for youth with mood dysregulation can help to stabilize mood and improve functioning, but the neural mechanisms of this improvement are not known. In this study we investigated changes in brain activation underlying improvement in mood symptoms. METHODS: Twenty-four subjects (ages 13–17) participated: 12 patients with clinically significant symptoms of depression and/or mania, and 12 healthy comparison subjects (HC) matched for age and sex. All subjects completed functional magnetic resonance imaging while viewing facial expressions. The patients then received up to 4 months of psychotherapy and were rescanned at end of treatment. Whole brain differences between patient and control groups were assessed with a voxel wise analysis. Changes in activation from pre to post treatment within the patient group were tested for correlation with changes in mood symptoms RESULTS: At baseline the patient group had hypoactivation in the DLPFC and hyperactivation in the posterior cingulate cortex compared to the HC group. Between pre- and post-treatment activation increased in the DLPFC and decreased in the amygdala. Increases in DLPFC activation were significantly correlated with improvement in mania symptoms. DISCUSSION: Enhancement of frontal executive control brain regions may underlie improvement in mood dysregulation in pediatric patients at familial risk for bipolar disorder