Effectiveness of psychosocial interventions for pediatric patients with scoliosis: a systematic review.

Background: Pediatric patients affected by scoliosis have complex psychological and social care needs, and may benefit from psychosocial interventions. We therefore aimed to summarize evidence of the efficacy of psychosocial interventions for this patient population. Methods: Literature was identified by searching Medline, PsycINFO, Embase, EBSCO Cumulated Index to Nursing and Allied Health Literature (CINAHL), and Cochrane Central Register of Controlled Trials (CENTRAL) from database inception to 20 March 2022. Articles that evaluated the effectiveness of psychosocial interventions for pediatric patients diagnosed with scoliosis and reported at least one quantitative outcome were included. Article eligibility, data extraction, and quality assessment (using the Cochrane Collaboration's Risk of Bias Tool and Methodological Index for Non-Randomized Studies) were performed by two independent researchers. Findings are presented using narrative synthesis. Results: We identified ten studies, all of which focused on adolescent idiopathic scoliosis. Studies included a total of 1007 participants, most of whom were female. Three studies focused on patients undergoing bracing, six on patients undergoing spinal surgery, and one on patients broadly. Brace compliance monitoring and counseling were found to significantly improve brace compliance quality and quantity. Proactive mental healthcare delivery by nurses after spinal surgery was similarly found to improve outcomes. Several studies examined the efficacy of brief educational interventions; most did not report clear evidence of their efficacy. The methodological quality of studies was often unclear due to limitations in articles' reporting quality. Conclusions: Research on the efficacy of psychosocial interventions for pediatric patients with scoliosis is limited, with interventions involving frequent patient-provider interactions showing the most promise. Future clinical and research efforts should focus on developing and testing psychosocial interventions for this patient population, with emphasis on multidisciplinary teams delivering holistic care. Trial registration number: PROSPERO number CRD42022326957.

IL-33 modulates inflammatory brain injury but exacerbates systemic immunosuppression following ischemic stroke.

Stroke triggers a complex inflammatory process in which the balance between pro- and antiinflammatory mediators is critical for the development of the brain infarct. However, systemic changes may also occur in parallel with brain inflammation. Here we demonstrate that administration of recombinant IL-33, a recently described member of the IL-1 superfamily of cytokines, promotes Th2-type effects following focal ischemic stroke, resulting in increased plasma levels of Th2-type cytokines and fewer proinflammatory (3-nitrotyrosine+F4/80+) microglia/macrophages in the brain. These effects of IL-33 were associated with reduced infarct size, fewer activated microglia and infiltrating cytotoxic (natural killer-like) T cells, and more IL-10-expressing regulatory T cells. Despite these neuroprotective effects, mice treated with IL-33 displayed exacerbated post-stroke lung bacterial infection in association with greater functional deficits and mortality at 24 hours. Supplementary antibiotics (gentamicin and ampicillin) mitigated these systemic effects of IL-33 after stroke. Our findings highlight the complex nature of the inflammatory mechanisms differentially activated in the brain and periphery during the acute phase after ischemic stroke. The data indicate that a Th2-promoting agent can provide neuroprotection without adverse systemic effects when given in combination with antibiotics.

Effect of sodium ferulate on human colonic anion secretion and the underlying signaling mechanism.

The present study investigated the effect of ferulic acid, a compound purified from traditional Chinese herbal medicine Chuanxiong and Awei, on anion secretion by human colonic cells (T84) using the short circuit current (I(SC)) and microspectrofluorimetric technique. Basolateral administration of sodium ferulate (SF) produced a concentration-dependent increase of I(SC) in T84 cells with an EC50 of 1.2 mM. The SF-induced increase in I(SC) contained a transient peak followed by a sustained plateau. Removal of extracellular Cl-, basolateral addition of bumetanide, an inhibitor of the Na+ - K+ - Cl- cotransporter (NKCC) and apical pretreatment with DPC, a Cl- channels blocker, decreased the SF-induced increase in I(SC) by 94% (p < 0.001), 84% (p < 0.001) and 85% (p < 0.001) respectively. Pretreatment with thapsigargin, a specific microsomal Ca2+-ATPase inhibitor, in combination with EGTA, a Ca2+ chelator, decreased the SF-induced peak by 52% (p < 0.01) and inhibited the SF-induced plateau by 60% (p < 0.05). Pretreatment with MDL12330A, an adenylate cyclase inhibitor, blocked the SF-induced I(SC) plateau by 87% (p < 0.01) but did not affect the SF-induced I(SC) peak. Microspectrofluorimetric measurements show that SF induced a sustained increase in [Ca2+]i. The results suggested that SF could induce Cl- secretion in T84 cells via Ca2+ and cAMP-dependent pathways.