Influence of a HTR2B Stop Codon on Glucagon Homeostasis and Glucose Excursion in Non-Diabetic Men.

Limited data are available about the role of the serotonin 2B (5-HT2B) receptor in the function of human islets. This study aimed to test whether the 5-HT2B receptor contributes to glucose, insulin, and glucagon homeostasis in humans, utilizing a hereditary loss-of-function gene mutation in the receptor, which causes a 50% reduction in the production of the receptor protein in heterozygotes. This clinical study enrolled participants recruited by newspaper advertisements and from mental status examinations. A cohort of participants from a young Finnish founder population composed of 68 non-diabetic males with a mean age of 30 was divided into groups for comparison based on being a 5-HT2B receptor loss-of-function gene mutation (HTR2B Q20*) heterozygote carrier (n=11) or not (n=57). Serum levels of glucose, insulin, and glucagon were measured in a 5 h oral glucose tolerance test using a 75 g glucose challenge. Insulin resistance, insulin sensitivity, and beta cell activity were calculated using the homeostasis model assessment (HOMA2) and whole body insulin sensitivity index (WBISI), as well as the ratio of glucagon to insulin was noted. The areas under the curves (AUCs) were also determined. Concentrations of the serotonin metabolite 5-hydroxyindoleacetic acid (5-HIAA) were measured in cerebrospinal fluid (CSF). Covariate adjusted mean score comparisons were applied. Lower glucagon secretion and decreased glucose excursion were observed among HTR2B Q20* carriers as compared with individuals who were homozygotes for the wild-type Q20 allele (controls). No differences in insulin secretion, beta cell activity, insulin resistance, or insulin sensitivity were observed. The glucagon to insulin ratio differed between the HTR2B Q20* carriers and controls. CSF levels of 5-HIAA were similar between groups. Our findings indicate that the 5-HT2B receptor may contribute to the regulation of human glucagon and glucose homeostasis and the interplay between glucagon and insulin secretion.

Predicting improvement after surgery for palmar hyperhidrosis.

OBJECTIVES: Endoscopic transthoracic sympathectomy (ETS) is a surgical procedure used to improve Quality of Life (QoL) in patients with treatment resistant palmar hyperhidrosis (PHH). The aim of this study was to test the hypothesis that low preoperative scores on The Everyday Life Questionnaire (EDLQ) would predict QoL improvement after surgery. MATERIALS AND METHODS: Pre- and post-operative QoL scores from a series of 30 consecutive patients who underwent ETS at our institution were analyzed. RESULTS: Preoperative QoL scores was a significant predictor of post-operative improvement across all dimensions covered by the questionnaire. CONCLUSION: Preoperative low QoL can be used as a guide in selecting patients with most improved QoL after ETS.

Deep brain stimulation in the treatment of depression.

OBJECTIVE: To present the technique of deep brain stimulation (DBS) and to evaluate the studies conducted on DBS in the treatment of therapy-refractory major depressive disorder (MDD). METHOD: A review of the literature on DBS in the treatment of MDD was conducted. RESULTS: The results of DBS in MDD have been presented in 2 case reports and 3 studies of 47 patients operated upon in 5 different target areas. Positive effects have been presented in all studies and side effects have been minor. DBS in the nucleus accumbens resulted in a mean reduction of Hamilton depression rating scale (HDRS) of 36% after 1 year and 30% of the 10 patients achieved remission. DBS in the internal capsule/ventral striatum resulted in a reduction of 44% after 1 year, and at the last evaluation after in mean 2 years, 40% of the 15 patients were in remission. The 20 patients with subcallosal cingulated gyrus DBS had a reduction of HDRS of 52% after 1 year, and 35% were within 1 point from remission or in remission. CONCLUSION: DBS is a promising treatment for therapy-refractory MDD. The published experience is, however, limited, and the method is at present an experimental therapy.

Delayed disclosure and disrupted communication during forensic investigation of child sexual abuse: a study of 47 corroborated cases.

AIM: To study factors of relevance for the understanding of disclosure of child sexual abuse. METHODS: Cases from a Swedish district court involving 47 children in which allegations of child sexual abuse had been corroborated by a confession from the defendant were studied. RESULTS: Delayed disclosure was related to a close relationship with the perpetrator and young age at the first experience of abuse. Disrupted communication during the police interview was related to less violent abuse. CONCLUSION: The findings highlight the importance of social factors in children's disclosure of sexual abuse.

[Childhood amnesia and emotional trauma. Easiest to prompt the smallest children to provide erroneous details concerning abuse]. / Barndomsamnesi och emotionella trauman. Lättast att få de minsta barnen att lämna felaktiga uppgifter om övergrepp.

A basic understanding of children's memories for emotional trauma is of importance for physicians and other health care professionals. The aim of this paper is to describe recent research and discuss important dilemmas within this field. The ability of infants and toddlers to verbally describe autobiographical memories is for several reasons limited. Very early experiences of e.g. intense pain can leave traces in the nervous system but of a kind which is not specific enough to allow retrospective conclusions about the nature of these experiences. Research during the past decades has relatively consistently demonstrated that pre-school children are more vulnerable to suggestion including abuse-related suggestions than are older children and adults. However, many children who have been subject to sexual abuse seem to maintain a lifelong silence about their experiences. The use of autobiographical testimony from young children is more complex and risky than many professionals believed about a decade ago. Establishing the knowledge derived from recent years' research in this area as a basis for clinical practice is one of the most important tasks for the future.

The catechism effect: child testimonies during a 17th-century witch panic as related to educational achievement.

Testimonies from 488 children given to the priests of the parish of Rättvik during a preliminary investigation of a Swedish witch panic in 1670-71 are examined in relation to records from parish catechetical meetings held in 1671. The result implies that children who knew and understood at least parts of Luther's catechism were less liable to have falsely alleged that they had been kidnapped by female satanists during the witch panic of the previous year. It is suggested that these effects were caused by differences in cognitive, social, and emotional resources among these children as compared to those who were unable to learn and understand any parts of Luther's catechism.

False allegations of satanic abuse: case studies from the witch panic in Rättvik 1670-71.

The creation of false memories, psychiatric symptoms and false allegations of satanic child abuse during an outbreak of witch hysteria in Sweden in the seventeenth century are described and related to contemporary issues in child testimonies. Case studies of 28 children and 14 adults are presented. The mechanisms underlying the spread of these allegations, as well as the reactions and influence of the adult world on the children's testimonies, are discussed.

Child testimonies during an outbreak of witch hysteria: Sweden 1670-1671.

Eight hundred and nine testimonies given by children between the ages of 1 and 16 to the priests of the parish of Rättvik, and to the Royal commission of inquiry, during an outbreak of witch hysteria in 1670-71 are examined. The result implies that the capacity to separate reality from fantasy as well as the tendency to give stereotyped testimonies are related to age, social influence from other children and sex. The results also suggest that the testimonies were influenced by the person investigating the child.