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Background and purpose Twenty-four-hour ambulatory blood pressure and heart rate monitoring (24-h ABPM) can provide vital information on circadian blood pressure ( BP) profiles, which are commonly abnormal in Parkinson's disease with and without autonomic failure ( PD + AF and PD) and multiple system atrophy ( MSA). Twenty-four-hour ABPM has not been directly compared between these disorders regarding cardiovascular autonomic function. Our aim was to determine the usefulness of 24-h ABPM with diary compared to head-up tilting ( HUT) in diagnosing orthostatic hypotension ( OH) in these patients. Methods Seventy-four patients (23 MSA, 18 PD + AF, 33 PD) underwent cardiovascular autonomic screening followed by 24-h ABPM with diary. Standing tests were included during 24-h ABPM. The sensitivity and specificity in detecting OH from the 24-h ABPM standing test were compared with HUT. Results There was no difference in OH during HUT between MSA and PD + AF ( P > 0.05). There was a higher proportion of abnormal BP circadian rhythms in MSA and PD + AF compared to PD ( P < 0.05) but not between MSA and PD + AF ( P > 0.05). Patients were divided into groups with OH ( OH+) and without OH ( OH−) on HUT. Using the standing test during 24-h ABPM, a systolic BP fall of >20 mmHg showed a sensitivity and specificity of 82% and 100% (area under the curve 0.91, 95% confidence interval 0.84-0.98) in differentiating OH+ from OH−. Conclusions Parkinson's disease with autonomic failure and MSA patients had similar circadian BP patterns suggesting that autonomic dysfunction influences abnormal BP circadian patterns similarly in these disorders. The higher sensitivity and specificity in detecting OH using a systolic BP fall of >20 mmHg compared to a diastolic BP fall of >10 mmHg during the standing test supports its usefulness to assess autonomic function in MSA and PD. [ABSTRACT FROM AUTHOR]

Aim The disturbed circadian rhythm in haemodialysis patients results in perturbed sleep. Short term melatonin supplementation has alleviated these sleep problems. Our aim was to investigate the effects of long-term melatonin supplementation on quality of life and sleep. Methods In this randomized double-blind placebo-controlled trial haemodialysis patients suffering from subjective sleep problems received melatonin 3 mg day−1 vs. placebo during 12 months. The primary endpoint quality of life parameter 'vitality' was measured with Medical Outcomes Study Short Form-36. Secondary outcomes were improvement of three sleep parameters measured by actigraphy and nighttime salivary melatonin concentrations. Results Sixty-seven patients were randomized. Forty-two patients completed the trial. With melatonin, no beneficial effect on vitality was seen. Other quality of life parameters showed both advantageous and disadvantageous effects of melatonin. Considering sleep, at 3 months sleep efficiency and actual sleep time had improved with melatonin compared with placebo on haemodialysis days (difference 7.6%, 95% CI 0.77, 14.4 and 49 min, 95% CI 2.1, 95.9, respectively). At 12 months none of the sleep parameters differed significantly from placebo. Melatonin salivary concentrations at 6 months had significantly increased in the melatonin group compared with the placebo group. Conclusions The high drop-out rate limits the strength of our conclusions. However, although a previous study reported beneficial short term effects of melatonin on sleep in haemodialysis patients, in this long-term study the positive effects disappeared during follow up (6-12 months). Also the quality of life parameter, vitality, did not improve. Efforts should be made to elucidate the mechanism responsible for the loss of effect with chronic use. [ABSTRACT FROM AUTHOR]

Background and purpose The aim of the study was to compare the incidence, causes, severity and mortality of traumatic spinal cord injury ( TSCI) in Western Norway and Estonia from 1997 to 2001. Methods The patients were identified from hospital records. All patients were followed until death or 14 October 2011. Analysed data included demographic data, causes of injury, neurological level, American Spinal Injury Association Impairment Scale and mortality. Results A total of 71 patients in Western Norway and 244 in Estonia were included. The standardized incidence rate per million was 24.9 ( CI 95%, 19.4-31.7) for Western Norway and 37.4 ( CI 95%, 32.8-42.5) for Estonia. Falls was the most frequent cause of TSCI in both countries. The incidence of TSCI was highest among men in their 20s in Estonia and men in their 70s in Western Norway. The median survival time among the deceased was 4.0 (95% CI, 1.50-6.50) years in Norway and 2.8 (95% CI, 1.54-4.04) in Estonia. The mean standardized mortality ratio ( SMR) was 5.00 (95% CI, 4.00-6.20) in Estonia and 1.89 (95% CI, 1.23-2.77) in Western Norway. Conclusion Although the two cohorts had similar demographic, injury and clinical characteristics, the age profile of the victims was different. The incidence rate was 1.5 times higher and SMR was 2.7 times higher in Estonia. Probable explanations for the different outcomes of the two European countries are socioeconomic differences, lower physical activity level, lower life expectancy and insufficient injury prevention programmes in Estonia. [ABSTRACT FROM AUTHOR]

The article discusses the first International Chapel Hill Consensus Conference (CHCC 2012), held to discuss on the Nomenclature of Systemic Vasculitides and to reach consensus on names for the most common forms of vasculitis and construct a specific definition. It states that CHCC nomenclature and definitions do not provide diagnostic and classification criteria but provide a framework for inferring and rigorously verifying.

Objective - A spinal cord injury (SCI) above the sixth thoracic vertebra interrupts the supraspinal control of the sympathetic nervous system causing an imbalance between the sympathetic and theparasympathetic nervous system. This article focuses on the symptoms, treatment and examination of autonomic disturbances of the cardiovascular and the urinary system after a SCI. Methods - A nonsystematic literature search in the PubMed database. Results - Frequent complications in the acute phase of cervical and high thoracic SCI are bradyarrhythmias, hypotension, hypothermia/hyperthermia, increased neurogenic shock, vagovagal reflex, supraventricular/ventricular ectopic beats, vasodilatation and congestion. Serious complications in the chronic phase of SCI are orthostatic hypotension, impaired cardiovascular reflexes, autonomicdysreflexia (AD), reduced sensation of cardiac pain, loss of reflex cardiac acceleration, quadriplegic cardiac atrophy due to loss of left ventricular mass and pseudo-myocardial infarction. AD is associated with a sudden, uncontrolled sympathetic response, triggered by stimuli below the injury. It may cause mild symptoms like skin rash or slight headache, but also severe hypertension, cerebral haemorrhage and death. Early recognition and prompt treatment are important. Urinaryautonomic dysfunctions include hyperreflexia or areflexia of detrusor and/or sphincter of the bladder. Conclusions - Patients with SCI have a high risk of cardiovascular complications, AD and urinaryautonomic dysfunction both in the acute phase and later, affecting their prognosis and quality of life. Knowledge of cardiovascular and urological complications after SCI is important for proper diagnosisand treatment. [ABSTRACT FROM AUTHOR]

Hagen EM, Eide GE, Rekand T, Gilhus NE, Gronning M. Traumatic spinal cord injury and concomitant brain injury: a cohort study. Acta Neurol Scand: 2010: 122 (Suppl. 190): 51–57. © 2010 John Wiley & Sons A/S. Objective – To assess the temporal trends in the incidence and demographic characteristics of traumatic spinal cord injury (TSCI) with clinical concomitant traumatic brain injury (TBI), in an unselected, geographically defined cohort, 1952–2001. Material and methods – The patients were identified from hospital records. TBI was classified as none, mild, moderate, and severe. Results – Of 336 patients, 157 (46.7%) patients had a clinical concomitant TBI. Clinical TBI was classified as mild in 30.1%, moderate in 11.0% and severe in 5.7%. The average annual incidence increased from 3.3 per million in the first decade to 10.7 per million in the last. Alcohol was the strongest risk factor of clinical TBI (OR = 3.69) followed by completeness of TSCI (OR = 2.18). Conclusions – The incidence of TSCI with concomitant TBI has increased during the last 50 years. Alcohol and completeness of injury are strong risk factors. Increased awareness of dual diagnoses is necessary. [ABSTRACT FROM AUTHOR]

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT • Disturbances of sleep–wake rhythm are frequently reported in daytime haemodialysis patients. • The melatonin rhythm, which plays an important role in synchronization of the sleep–wake rhythm, is disturbed in this patient group. • In other patient groups with disturbed melatonin rhythm, use of exogenous melatonin resulted in an improvement of sleep quality and melatonin rhythm. WHAT THIS STUDY ADDS • This is the first study on the effects of exogenous melatonin on sleep–wake rhythm in haemodialysis patients. • Due to exogenous melatonin, sleep parameters such as sleep fragmentation, sleep onset latency and subjective sleep quality improved. • Nocturnal melatonin rise was recovered. AIM The aim of this study was to investigate the effects of exogenous melatonin on sleep–wake rhythm in haemodialysis patients. METHODS The study design is a randomized, double-blind, placebo-controlled, cross-over study of 3 × 6 weeks melatonin 3 mg at 22.00 h every night. Haemodialysis patients were asked to fill out a sleep questionnaire and to wear an actometer to record their sleep problems objectively. Furthermore, melatonin concentrations in saliva were sampled the night after daytime haemodialysis and the consecutive night. Actometers, the sleep questionnaire and melatonin concentrations were repeated during the study. RESULTS In total, 20 patients (six female, median age 71 years) completed the investigation. On nights after daytime dialysis, objective sleep onset latency decreased significantly from a median of 44.5 (placebo) to a median of 15.5 min with melatonin ( P < 0.01). Sleep efficiency increased from 67.3 to 73.1% with melatonin ( P < 0.05). Actual sleep time increased from 376 min (placebo) to 388 min with melatonin ( P < 0.01), and sleep fragmentation decreased from 4.5 to 3.1 ( P < 0.01). Furthermore, subjective sleep parameters improved also. Patients reported less time needed to fall asleep ( P < 0.05) and fewer wake periods ( P < 0.05) on the nights with and without daytime dialysis and an increase in sleep time on the night of daytime dialysis ( P < 0.05). Furthermore, the nocturnal melatonin rise was recovered. CONCLUSION Treatment with melatonin resulted in an improvement of subjective and objective sleep parameters, as well as a recovered nocturnal melatonin rhythm. [ABSTRACT FROM AUTHOR]

Anthropologists have long been interested in the survival of Indian cultural traits in the New World. In this article, we present results of an ongoing project with a Costa Rican community that descends from East Indian indentured servants. We focus on the group's marriage patterns and how these patterns might have helped keep the community as a cohesive ethnic group. We investigate the group's level of inbreeding by computing the inbreeding coefficient using two different methods. We show that the community has been successful at keeping its inbreeding low, despite its small size, by allowing marriage with nonmembers of the community. We propose that unless consanguineous marriages are allowed virtually all of the community's marriages will be with noncommunity members. Absorption into tourism, as well as the community's staunch avoidance of consanguineous marriages and virtually universal marriage with noncommunity members, will likely contribute to their disappearance as a viable ethnic group. [ABSTRACT FROM AUTHOR]

The article discusses a study that analyzed the effect of treatment with either pulse cyclophosphamide (CYC) or azathioprine (AZA) combined with methylprednisolone (MP) on serial biopsy results in patients with proliferative lupus nephritis. Results showed that only 39 of the 87 patients enrolled in the study underwent repeat biopsy. It also found that the main characteristic of patients who still had proliferative lupus nephritis at two years was higher creatinine level at entry and greater proteinuria at last visit.

Background Tachykinins-like substance P (SP) have been shown to play an important role in initiating and perpetuating airway inflammation. Furthermore, they are supposed to be released into tissues in response to stress. Objective The aim of this study was to investigate the effects of stress alone or in combination with allergic airway inflammation on SP expression in sensory neurons innervating the mouse airways. Methods Balb/c mice were systemically sensitized to ovalbumin (OVA), followed by allergen aerosol exposure, and compared with non-sensitized controls. Additionally, OVA-sensitized and -challenged and non-sensitized mice were exposed to sound stress. SP expression in airway-specific and overall vagal sensory neurons of the jugular and nodose ganglion complex was analysed using retrograde neuronal tracing in combination with immunohistochemistry. Preprotachykinin A (PPT-A) mRNA, the precursor for SP, was quantified in lung tissue by real-time PCR. Bronchoalveolar lavage (BAL) fluid was obtained, and cell numbers and differentiation were determined. Results Stress and/or allergic airway inflammation significantly increased SP expression in retrograde-labelled vagal sensory neurons from the mouse lower airways compared with controls [stress: 15.7±0.8% (% of retrograde-labelled neurons, mean±SEM); allergen: 17.9±0.4%; allergen/stress: 13.1±0.7% vs. controls: 6.3±0.3%]. Similarly, SP expression increased in overall vagal sensory neurons identified by the neuronal marker protein gene product (PGP) 9.5 [stress: 9.3±0.6% (% of PGP 9.5-positive neurons, means±SEM); allergen: 12.5±0.4%; allergen/stress: 10.2±0.4% vs. controls: 5.1±0.3%]. Furthermore, stress significantly increased PPT-A mRNA expression in lung tissue from OVA-sensitized and -challenged animals, and immune cells were identified as an additional source of SP in the lung by immunohistochemistry. Associated with enhanced neuronal SP expression, a significantly higher number of leucocytes were found in the BAL following allergen exposure. Further, stress significantly increased allergen-induced airway inflammation identified by increased leucocyte numbers in BAL fluids. Conclusion The central event of sound stress leads to the stimulation of SP expression in airway-specific neurons. However, in sensitized stressed mice an additional local source of SP (probably inflammatory cells) might enhance allergic airway inflammation. [ABSTRACT FROM AUTHOR]

In a well-established murine abortion model, stress is thought to trigger fetal rejection by inducing a proinflammatory immune response via substance P (SP), being tumour necrosis factor (TNF)-α-producing CD8+ T cells involved. Interestingly, the SP metabolite SP5-11 also binds to SP receptors and mediates SP-like effects on immune cells at sites of inflammation. No data were available regarding the effects of SP5-11 on pregnancy outcome in the CBA/J × DBA/2J abortion-prone combination. We investigated the influence of SP5-11 in contrast to stress or SP on the abortion rate and the cytokine production by lymphocytes as well as on the levels of CD8+ T cells. Stress and SP boosted the abortion rate and increased the percentage of type 1 [TNF-α, interferon-γ, interleukin (IL)-12] and type 2 (IL-4 and IL-10) cytokine-producing lymphocytes in blood and decidua, predominantly CD8+ T cells. Interestingly, SP5-11 did not significantly affect the abortion rate or cytokine production in the decidua, while increasing the Th1 and Th2 cytokine production systemically. Our data suggest that stress and SP induce abortion by augmenting the local levels of TNF-α, which seems therefore to be a potent trigger of miscarriage. On the contrary, the SP metabolite SP5-11 only affects the systemic cytokine production without boosting the abortion rate in this experimental model. [ABSTRACT FROM AUTHOR]

Problem: We previously reported a diminished expression of the heme-degrading enzymes heme oxygenases (HO)-1 and HO-2 in decidua and placenta from mice undergoing Th1-mediated abortion, strongly indicating the protective effect of HO in murine pregnancy maintenance. Here we investigated whether the expression of HO-1 and HO-2 is also reduced at the feto-maternal interface of pathologic human pregnancies. Method of Study: Immunohistochemistry was used to detect HOs expression in placental and decidual first-trimester tissue from patients with: spontaneous abortion (n = 14), choriocarcinoma (n = 14), hydatidiform mole (H-mole) (n = 12), compared with normally progressing pregnancies (n = 15). Further, we investigated early third-trimester decidual and placental tissue from patients with pre-eclampsia (n = 13) compared with fetal growth retardation (n = 14) as age-matched controls. Results: In first trimester tissue, we observed a significant reduction of HO-2 expression in invasive trophoblast cells, endothelial cells, and syncytiotrophoblasts in samples from patients with spontaneous abortion compared with normal pregnancy. H-mole samples showed a diminished expression of HO-2 in invasive trophoblast cells and endothelial cells in comparison with NP, whereas choriocarcinoma samples showed no significant differences compared with the control. In third trimester tissue, HO-2 was also reduced in syncytiotrophoblasts and invasive trophoblast cells from pre-eclampsia compared with samples from fetal growth retardation. HO-1 expression was diminished in all pathologies investigated; however, the differences did not reach levels of significance. Conclusions: Our data indicate that HOs play a crucial role in pregnancy and low expression of HO-2, as observed in pathologic pregnancies, may lead to enhanced levels of free heme at the feto-maternal interface, with subsequent upregulation of adhesion molecules, allowing enhanced inflammatory cells migration to the... [ABSTRACT FROM AUTHOR]

PROBLEM: The immune system contributes to the outcome of pregnancy by complex immunological interactions. Cytokines especially influence the immune milieu pro or contra pregnancy. T helper 1 (Th1) cytokines [tumor necrosis factor-α (TNF-α) and interferon-γ (IFN-γ)] cause inflammation and together are thought to threaten the maintenance of pregnancy. It has been proposed that increased levels of these Th1 cytokines activate coagulation via up-regulating the novel prothrombinase, fgl2. This study further investigates the Th1 cytokine up-regulation of fgl2 expression in a pathophysiological, stress induced abortion model, and an inflammatory, interleukin-12 (IL-12) triggered abortion model.. METHOD: The DBA/2J-mated CBA/J female mice were exposed to sonic sound stress or were injected with IL-12 during early gestation. On day 13.5 of pregnancy the uteri were removed and the resorption rate was calculated. We evaluated TNF-α, IFN-γ, fgl2 as well as IL-12 messenger RNA (mRNA) expression in decidual samples of all mice by quantitative, real-time polymerase chain reaction (PCR). RESULTS: A similar resorption rate of 24% was detected in stressed mice, as well as in IL-12 injected mice compared with approximately 11% in non-stressed, non-injected control mice. In stressed mice compared with controls, we observed on day 13.5 up-regulated TNF-α, unchanged IFN-γ down-regulated fgl2, and a slightly increased levels of IL-12. In the IL-12 triggered abortion model, we observed up-regulated levels of TNF-α, IFN-γ and fgl2. CONCLUSION: These novel data suggest two distinct cytokine patterns leading to similar abortion rates. A physiological cascade associated with up-regulation of TNF-α, and an IL-12-triggered cascade characterized by persistent up-regulation of TNF-α and IFN-γ as well as a persistent increase in fgl2. [ABSTRACT FROM AUTHOR]

Heme oxygenases (HOs) are responsible for heme degradation. Besides their enzymatic activities, HOs are involved in tissue protection. Failing upregulation of HOs has been linked to increased necrosis in inflammatory tissues. Interestingly, previously published data indicated that mice exposed to sonic stress during early gestation show an augmented production of decidual inflammatory T-helper 1 (Th1) cytokines, thus resulting in increased abortion rate. No data linked the Th1-inducer interleukin (IL)-12 with the event of abortion. As little is known about the role of HO in pregnancy maintenance, we evaluated the expression of decidual and placental HO-1 and HO-2 in the abortion-prone murine mating combination CBA/J × DBA/2 J with (1) CBA/J female control mice, (2) CBA/J mice exposed to stress during early gestation and (3) CBA/J females injected with recombinant IL-12. Decidual and placental HOs protein expression was analysed by immunohistochemistry and mRNA levels by real time polymerase chain reaction (PCR). As expected, an increased abortion rate was present in mice exposed to stress compared with the control. IL-12 injections also boosted the abortion rate compared with control mice, mimicking the effect of stress. HOs' proteins could be detected in placenta and decidua. Real time PCR revealed lower levels of HO-1 and HO-2 mRNA in stress-triggered and IL-12-injected mice. We conclude that increased Th1-cytokine levels during murine pregnancy may result in low expression of HO-1 and HO-2, thus leading to placental necrosis and foetal rejection. [ABSTRACT FROM AUTHOR]

According to a conventional evolutionary perspective, the human propensity for substance use is the product of a 'mismatch' between emotional mechanisms that evolved in a past without pure drugs or direct routes of drug administration, and the occurrence of these phenomena in the contemporary environment. The primary purpose of this review is to assert that, contrary to the conventional view, humans have shared a co‐evolutionary relationship with psychotropic plant substances that is millions of years old. We argue that this 'deep time' relationship is self‐evident both in the extant chemical–ecological adaptations that have evolved in mammals to metabolize psychotropic plant substances and in the structure of plant defensive chemicals that have evolved to mimic the structure, and interfere with the function, of mammalian neurotransmitters. Given this evidence, we question how emotional mechanisms easily triggered by plant toxins can have evolved. Our argument is also supported with archeological and historical evidence of substance use in antiquity suggesting that, for people in the past, psychotropic plant substances were as much a mundane everyday item as they are for many people today. Our second, and more speculative objective is to suggest provisional hypotheses of human substance‐using phenomena that can incorporate the evolutionary implications of a deep time relationship between psychotropic substances and people. We discuss hypotheses of selective benefits of substance use, including the idea that neurotransmitter‐analog plant chemicals were exploited as substitutes for costly, nutritionally constrained endogenous neurotransmitters. However, even if substance seeking was adaptive in the environment of our hominid ancestors, it may not still be so in the contemporary environment. Thus, the implications of our argument are not that the mismatch concept does not apply to human substance‐using phenomena, but that it must be reconsidered and extended to incorporate the implications of a substance‐rich, rather than substance‐free, evolutionary past. [ABSTRACT FROM AUTHOR]

Click here to view the accompanying paper in this issue. [ABSTRACT FROM AUTHOR]

Background: Recently, there has been a marked increase in the use of in vitro fertilization (IVF) to treat couples for infertility. In cases where donor gametes are required, special consideration should be given to women with preexisting red cell antibodies to select donors that decrease the incidence of hemolytic disease of the newborn (HDN). Case Report: A 39 year old (G3P0) A Rh Positive (most likely R R genotype as her red cells were negative for c and E) female with a history of anti-K and anti-c became pregnant via IVF with twin embryos comprised of her spouse's sperm and anonymously donated oocytes (red cell phenotype unknown). Throughout the entire pregnancy the anti-K titer ranged between 512 and 1024 but the anti-c titer never exceeded 4. One fetus expired in utero at 12 weeks gestation. At 32 weeks gestation, the mother prematurely delivered a stillborn fetus and a viable male infant (group B Rh negative and negative for C, E, and K) with a 1+ positive direct antiglobulin test, and hemoglobin (Hb) of 12.8 gm/dL with a total bilirubin (TB) of 11.7 gm/dL. Anti-c and anti-B were detected in the eluate. One-week postpartum, his bilirubin increased to 15.0 mg/dL, and his Hb was 8.6 gm/dL with a reticulocyte count of 4.6%. A request for compatible blood was sent to a reference laboratory that confirmed the previous serologic findings on the maternal and infant samples, but upon red cell phenotyping excluded the mother as being the genetic parent. Subsequently, the referring transfusion service learned for the first time about the donation of maternal ova. The baby was transfused successfully and discharged to home but twenty-two days later required another transfusion for a Hb of 7.5 gm/dL (reticulocyte count 7.1%). His Hb increased to 11.9 gm/dL and no additional therapy was needed. Conclusions: This donor egg was selected without consulting the blood bank about potential incompatibilities between the selected donor's phenotype and the patient's antibodies. Furthermore, the blood bank was not prepared to obtain rare group O Rho negative (r'r') had it been needed urgently for intrauterine transfusion. As gamete transplantation becomes more commonplace, careful planning involving all members of the healthcare team is needed to prevent complications of HDN in these pregnancies. [ABSTRACT FROM AUTHOR]

Opioid use disorder (OUD) and mental disorders are often comorbid, with increased morbidity and mortality. The causes underlying this relationship are poorly understood. Although these conditions are highly heritable, their shared genetic vulnerabilities remain unaccounted for. We applied the conditional/conjunctional false discovery rate (cond/conjFDR) approach to analyse summary statistics from independent genome wide association studies of OUD, schizophrenia (SCZ), bipolar disorder (BD) and major depression (MD) of European ancestry. Next, we characterized the identified shared loci using biological annotation resources. OUD data were obtained from the Million Veteran Program, Yale-Penn and Study of Addiction: Genetics and Environment (SAGE) (15 756 cases, 99 039 controls). SCZ (53 386 cases, 77 258 controls), BD (41 917 cases, 371 549 controls) and MD (170 756 cases, 329 443 controls) data were provided by the Psychiatric Genomics Consortium. We discovered genetic enrichment for OUD conditional on associations with SCZ, BD, MD and vice versa, indicating polygenic overlap with identification of 14 novel OUD loci at condFDR < 0.05 and 7 unique loci shared between OUD and SCZ (n = 2), BD (n = 2) and MD (n = 7) at conjFDR < 0.05 with concordant effect directions, in line with estimated positive genetic correlations. Two loci were novel for OUD, one for BD and one for MD. Three OUD risk loci were shared with more than one psychiatric disorder, at DRD2 on chromosome 11 (BD and MD), at FURIN on chromosome 15 (SCZ, BD and MD) and at the major histocompatibility complex region (SCZ and MD). Our findings provide new insights into the shared genetic architecture between OUD and SCZ, BD and MD, indicating a complex genetic relationship, suggesting overlapping neurobiological pathways., (© 2023 The Authors. Addiction Biology published by John Wiley & Sons Ltd on behalf of Society for the Study of Addiction.)

Objectives: To study the causes and the rehabilitation outcome of traumatic spinal cord injury (SCI) in patients older than 60 years at the time of injury., Material: Forty-four patients were included., Methods: The American Spinal Injury Association Motor Impairment Scale on admission and at discharge and the Functional Independence Measure Motor subscale at discharge were calculated retrospectively according to the patient records. The causes of injury and treatment were obtained. The MRI-scans in patients with cervical injuries during the last 5 years were evaluated., Results: Thirty-four patients (77%) were injured after falling from a height, 24 with cervical lesions. Thirty-five patients (80%) had incomplete lesions and they had the best outcome with regard to functional level. MR images of 15 patients with cervical lesions revealed preexisting cervical stenosis in 80%., Conclusions: A high proportion of the patients had a cervical spinal stenosis and incomplete SCI; most of them regained good function., (Copyright Blackwell Munksgaard 2005.)