Posterior wiring with sublaminar polyester bands, titanium-peek fixation system for C2 fracture management: a 4-patient case series with a maximum of 18 months' follow-up.

Background: C2 fractures can be classified differently when dens, pedicles or body are injured. With regards to the best management of Type-II Anderson-D'Alonzo fractures, Hangman's fractures of pedicles and C2 body fractures are more debatable. However, vertebral pedicle and/or articular screw and dorsal wiring are the most common surgical posterior approaches opted for. Compared to the screw technique, dorsal wiring provides certain benefits such as a lower risk of vertebral artery injury, no need for navigation, less lateral dissection of the paraspinal muscles, shorter surgery time and lower medical costs. Case Description: Two patients with failed conservative treatment for Anderson-D'Alonzo Type-III fractures (Cases 1A and 1B), a patient suffering from a Type-II Hangman's fracture (Case 2) and a patient with failed conservative treatment for a C2 transversal body fracture (Case 3) underwent surgery at the Neurosurgery Division of the University Hospital of Modena (Italy) between July 2020 and September 2021. All patients were treated with posterior wiring with 5 mm Polyester bands, titanium-peek fixation system (Jazz-Lock system MediNext®-Implanet) inserted through the C1 posterior arch and either the C2 or C3 laminae. A fracture diastasis reduction was observed ranging between 4.5 and 1 mm. No intraoperative and post-operative complications were encountered. The duration of the period of hospitalisation ranged between 5 and 12 days. All patients who had worked prior to the traumatic event were able to return to work 18 months following surgery. Conclusions: In reducing C2 fractures, a sublaminar fixation with polyester bands and a titanium-peek fixation system can be proposed for fragile and elderly patients.

Oneiric activity in schizophrenia: textual analysis of dream reports.

This work evaluated the structure of dreams in people affected by schizophrenia. The verbal reports of 123 schizophrenic patients were compared with 123 dream reports from a control group. In accordance with the Jungian conceptualization of, dreams as texts, dream reports were assessed using textual analysis processing techniques. Significant differences were found in textual parameters, showing that the dreams reports of schizophrenic patients differ from those of the control group. It is thus possible that schizophrenia probably underlies changes in the oneiric production and dream reports. This work confirms the value of textual analysis in the study of oneiric material.

Personality differences between depressed melancholic and non-melancholic inpatients.

OBJECTIVE: The aim of the present study was to confirm that non-melancholic depression corresponds to a higher degree of personality dysfunction compared to melancholia. METHOD: A total of 188 inpatients, with a main DSM-IV diagnosis of major depressive disorder, were classified as melancholic and non-melancholic according to CORE system, DSM-IV, Research Diagnostic Criteria (RDC) Retarded Depression, and RDC Agitated Depression. Personality was assessed by means of the Temperament and Personality Questionnaire (T&P). Only patients at the nadir of their episode were included. RESULTS: Compared to non-melancholic depressives, patients with CORE melancholia scored lower on social avoidance and higher on effectiveness and cooperativeness; patients with RDC Retarded Depression scored lower on Anxious-Worrying and Cooperativeness; patients with RDC Agitated Depression scored lower on Social Avoidance, Rejection Sensitivity and Anxious-Worrying, and higher on Effectiveness; while patients with DSM-IV melancholia scored higher on Irritability and lower on Cooperativeness. Both CORE and RDC Agitated Depression were associated with higher scores of Perfectionism. CONCLUSIONS: The hypothesis of an association of melancholic depression with less marked personality dysfunction was confirmed for CORE melancholia and RDC Agitated Depression, and not supported for DSM-IV melancholia. Mixed evidence was obtained for RDC Retarded Depression. Personality of melancholic depressives seems to be characterized not only by less dysfunction but also by perfectionism, akin to the features of Tellenbach's typus melancholicus.

Dreams by persons with mood disorders.

This work evaluated the structure of dreams in depressed patients. The verbal reports of dreams of 100 depressed patients were compared with 251 dreams of a control group. In accordance with the Jungian thought, which views dreams as texts, dream reports were assessed using textual analysis processing techniques. Significant differences were found in parameter values, as well as in the role of the dreamer as an external observer. Considering the length of the dreams' texts, depressed patients used fewer words than the control group. With regard to sensory field, there were fewer lemmas referring to sight for depressed patients than for healthy participants. This work seems to confirm the value of textual analysis in the study of oneiric material

Decreased plasma adiponectin concentration in major depression.

Adiponectin is the most abundant adipose-derived plasma protein. Recently adiponectin levels have been linked to most variables of metabolic syndrome and conventional risk factors for cardiovascular disease. However, its relation with major depression is yet unclear. We evaluated plasma adiponectin levels in 32 first-episode drug-naïve major depression (DSM-IV-TR) patients without conventional risk factors for cardiovascular disease and 32 matched healthy subjects. Major depression patients displayed lower adiponectin plasma levels compared to controls (P<0.01). Adiponectin significantly correlated with depression severity, as assessed by HAM-D (rho=0.83, P<0.001). This study shows decreased plasma adiponectin concentrations in major depression patients and relates adiponectinemia reduction to major depression severity.

Dreams and age.

This work evaluated the association of age and dream reports. The verbal reports of 148 dreams of elderly people (M age=75.8 yr.) were compared with 151 dreams of a group of young people (M age=22.0). The dreams were analyzed according to the Jungian vision (which looks at the dream as a text produced by the dreamer's unconscious while sleeping), using processing techniques derived from textual analysis. Significant differences were found between the number of words denoting emotion, with the young people reporting more explicit statements regarding emotional states. Significant differences were found also in use of verb tenses. When older people explicitly expressed an emotional state in a dream text, they shifted between present and past tense more frequently than young people. A significant prevalence in the semantic field of visual sense was evident as younger subjects used more sentences referring to sight than the elderly participants.

Characterization of salivary proteins of schizophrenic and bipolar disorder patients by top-down proteomics.

The analysis of whole saliva of 32 subjects with diagnosis of schizophrenia (SZ), 17 with diagnosis of bipolar disorder (BD), and 31 healthy subjects divided in non-smokers (HN; n=19) and smokers (HS; n=12) using an HPLC-ESI-MS top-down platform is reported in this study. Both SZ and BD revealed more than 10 fold mean increase of α-defensins 1-4, S100A12, cystatin A and S-derivatives of cystatin B levels with respect to the HN and HS control groups. No differences of protein levels were observed between SZ and BD groups and between HN and HS groups. Moreover, the correlation coefficients among the different proteins were significantly better in BD group than in SZ group. BIOLOGICAL SIGNIFICANCE: This study on whole saliva confirms a schizophrenia-associated dysregulation of immune pathway of peripheral white blood cells and suggests that the dysregulation of BD group could involve the activation of more specific cell type than that of SZ group.

Association between enhanced soluble CD40 ligand and proinflammatory and prothrombotic states in major depressive disorder: pilot observations on the effects of selective serotonin reuptake inhibitor therapy.

OBJECTIVE: Major depressive disorder (MDD) is associated with low-grade inflammation, and it is considered a risk factor for coronary artery disease (CAD). CD40 ligand (CD40L) plays an important role in inflammation, platelet activation, and clotting system activation. We investigated soluble CD40L (sCD40L) expression in MDD and assessed whether it may represent a molecular mechanism that links inflammation and a prothrombotic state and whether this condition may be modified by selective serotonin reuptake inhibitor (SSRI) therapy. METHOD: Levels of sCD40L, interleukin-1beta (IL-1beta), interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), soluble P-selectin (sP-selectin), activated factor VII (FVIIa), and prothrombin fragment 1+2 (F1+2) were measured in 46 drug-naïve, first-episode MDD patients without conventional CAD risk factors and in 46 matched healthy controls. Participants were screened between March 2002 and November 2005. Twenty of the 46 MDD patients were then randomly assigned to either sertraline 100 mg/day (N = 10) or citalopram 20 mg/day (N = 10); the aforementioned variables were measured at baseline and after 6 weeks of treatment. RESULTS: Compared with control subjects, MDD patients had higher baseline levels of sCD40L, IL-1beta, IL-6, TNF-alpha, sP-selectin, FVIIa, and F1+2. In the clinical group, sCD40L levels, HAM-D total scores, and proinflammatory markers were strongly intercorrelated. In contrast, there were no significant correlations in the control group. Mood improvement achieved with SSRI therapy was associated with significant reduction in sCD40L, proinflammatory markers, and prothrombotic markers expression. (All p values < .0001.) CONCLUSIONS: This pilot study shows that CD40/ CD40L pathway up-regulation in MDD patients relates increased levels of sCD40L to a prothrombotic state and, preliminarily, indicates that SSRI therapy may significantly reduce sCD40L and CD40L levels associated with proinflammatory and prothrombotic states.