The Impact of Sleep Deprivation on the Brain

Each sleep phase is characterized by specific chemical, cellular and anatomic events of vital importance for normal neural functioning. Different forms of sleep deprivation may lead to a decline of cognitive functions in individuals. Studies in this field make a distinction between total sleep deprivation, chronic sleep restriction, and the situation of sleep disruption. Investigations covering the acute effects of sleep deprivation on the brain show that the discovered behavioral deficits in most cases regenerate after two nights of complete sleep. However, some studies done on mice emphasize the possible chronic effects of long-term sleep deprivation or chronic restriction on the occurrence of neurodegenerative diseases such as Alzheimer's disease and dementia. In order to better understand the acute and chronic effects of sleep loss, the mechanisms of neural adaptation in the situations of insufficient sleep need to be further investigated. Future integrative research on the impact of sleep deprivation on neural functioning measured through the macro level of cognitive functions and the micro molecular and cell level could contribute to more accurate conclusions about the basic cellular mechanisms responsible for the detected behavioral deficits occurring due to sleep deprivation.

A coincidence of HLA-B27 negative spondyloarthritis and paravertebral non-Hodgkin's lymphoma--a lesson to be learnt from the past experience.

We reported a case of a 71-year-old woman with progressive low back pain and neurologic symptoms of lower extremities, who in the background had the coexistence of spondyloarthritis (SpA) and non Hodgkin's lymphoma of the paravertebral location. This example describes a situation where SpA with minimal sacroiliac joints affection has nevertheless led to the overt axial SpA. This situation included undifferentiated or reactive SpA, as well as unusual disease context, presented with late-life disease onset, older age, female gender and no obvious hereditary predisposition. This combination of comorbid factors could allow environmental and disease-specific factors to accumulate over time and to, by modifying the primary, low-penetrant genetic background, lead to the development of lymphoma. By achieving better understanding of disease pathophysiology dynamic, we will be able to improve our capabilities to navigate biologic therapy in the future, in order to prevent the development of both, overt SpA and lymphoproliferative disease.

The most common deviations in the development of hand motoricity in children from birth to one year of age.

The early child development, from birth until the age of one year is, amongst other changes, characterized by intense motor learning. During that period, the voluntary learning patterns evolve from reflexive patterns to coordinated voluntary patterns. All of the child's voluntary movements present active forms in which the child communicates with the environment. In this communication, the hand plays an important role. Its brain representation covers one-third of the entire motor region, situated in the close proximity to the speech region. For this reason, some authors refer to hand as a "speech organ". According to numerous studies, each separate finger also has a relatively large representation in the cerebral cortex, which points to the importance of the fine motor skills development, or precise, highly differentiated movements of hand muscles following the principles of differentiation and hierarchical integration. Development of the fine motor skills in the hand is important for the overall child development, and it also serves as a predictor pointing to immaturity of the central nervous system. The aim of this paper is to present the development of hand motoricity from birth until the age of one year, as well as the most frequent deviations observed in children hospitalized at Children's Department of Rehabilitation, Clinical Department of Rheumatology, Physical Medicine and Rehabilitation, Sestre milosrdnice University Hospital Center.

Virtual reality in rehabilitation and therapy.

This paper describes virtual reality and some of its potential applications in rehabilitation and therapy. Some aspects of this technology are discussed with respect to different problem areas (sensorimotor impairments, autism, learning difficulties), as well as previous research which investigated changes within some motor and motivation parameters in relation to rehabilitation of children with motor impairments. Emphasis is on the positive effects of virtual reality as a method in which rehabilitation and therapy can be offered and evaluated within a functional, purposeful and motivating context.

Preference for weekly and monthly bisphosphonates among patients with postmenopausal osteoporosis: results from the Croatian PROMO Study.

The PROMO (preference for once monthly bisphosphonate) Study, conducted in seven hospital centres in Croatia between June 2007 and June 2008, was designed to analyse patient preference for weekly and monthly bisphosphonates in everyday clinical practice where the significant proportion of patients are not completely satisfied with the current osteoporosis treatment. Eligible participants were women with postmenopausal osteoporosis taking weekly bisphosphonates for the last 6 months. Those who agreed to be enrolled were transferred from weekly to monthly ibandronate for the next 6 months. There was no washout period between the two treatment regimens. At the baseline, patients expressed their satisfaction with the weekly treatment. At the end of the study, all patients were asked to complete the five-question survey specially designed for this study. Study population comprised 258 participants. Among 248 patients who completed the study, 244 (98.4%) declared their preference for one of the regimens or they had no preference. Once-monthly regimen was preferred by 231 patients (94.7%), whereas once-weekly regimen was preferred by five patients (2.0%). Eight patients (3.3%) indicated no preference. Furthermore, 93.0% of patients thought that monthly dosing was more convenient. Compared to weekly regimen, monthly dosing was associated with significantly higher satisfaction with the treatment and with significantly less adverse events. In line with these data, 85.9% of patients stated improved quality of life with monthly ibandronate. In summary, the PROMO Study demonstrated strong patient preference for monthly over weekly dosing which is expected to improve suboptimal adherence to weekly bisphosphonates.