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Optic development involves sequential interactions between several different tissue types, including the overlying ectoderm, adjacent mesoderm, and neural crest mesenchyme and the neuroectoderm. In an ongoing expression screen, we identified that Tfap2ß, Casq2, Penk, Zic1, and Zic3 are expressed in unique cell types in and around the developing eye. Tfap2ß, Zic1, and Zic3 are transcription factors, Casq2 is a calcium binding protein and Penk is a neurotransmitter. Tfap2ß, Zic1, and Zic3 have reported roles in brain and craniofacial development, while Casq2 and Penk have unknown roles. These five genes are expressed in the major tissue types in the eye, including the muscles, nerves, cornea, and sclera. Penk expression is found in the sclera and perichondrium. At E12.5 and E15.5, the extra-ocular muscles express Casq2, the entire neural retina expresses Zic1, and Zic3 is expressed in the optic disk and lip of the optic cup. The expression of Tfap2ß expanded from corneal epithelium to the neural retina between E12.5 to E15.5. These genes are expressed in similar domains as Hedgehog (Gli1, and Ptch1) and the Wnt (Lef1) pathways. The expression patterns of these five genes warrant further study to determine their role in eye morphogenesis.

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BACKGROUND: Myofascial pain syndrome (MPS) of the shoulder girdle and cervical region is a common musculoskeletal problem that is often chronic or recurrent. Physical therapy (PT) and lidocaine injections (LI) are two treatments with demonstrated effectiveness compared to a control group, however little is known about their combined value. The objective of this study was to determine whether LI into trigger points combined with a PT program would be more effective than each separate treatment alone in improving pain, function, and quality of life in a group of patients with MPS of the shoulder girdle and cervical region. METHODS: A single-blind, randomized, controlled clinical trial (RCT) was conducted with three parallel groups in the Departments of Physical Medicine and Rehabilitation of two urban hospitals in Medellin, Colombia. One hundred and twenty seven patients with shoulder girdle MPS for more than 6 weeks and pain greater than 40 mm on the visual analog scale (VAS) were assigned to 1 of 3 intervention groups: PT, LI, or the combination of both (PT + LI). The primary outcome was VAS pain rating at 1-month post-treatment. The secondary outcomes included VAS pain rating at 3 months, and, at both 1 and 3 months post-treatment: (a) function, evaluated by hand-back maneuver and the hand-mouth maneuver, (b) quality of life, as measured by sub-scales of the Short Form - 36 (SF-36), and (c) depressive symptoms, as measured by the Patient Health Questionnaire - 9 (PHQ-9). Independent t-tests were used to compare outcomes between groups at 1 month and 3 months post-treatment. RESULTS: In the per protocol analysis, there were no significant intergroup differences in VAS at 1 month PT + LI, 40.8 [25.3] vs. PT, 37.8 [21.9], p = 0.560 and vs. LI, 44.2 [24.9], p = 0.545. There were also no differences between groups on secondary outcomes except that the PT and PT + LI groups had higher right upper limb hand-back maneuver scores compared to the LI alone group at both 1 and 3 months (p = 0.013 and p = 0.016 respectively). CONCLUSIONS: The results of this RCT showed that no differences in pain ratings were observed between the individual treatments (PT or LI) compared to the combined treatment of PT and LI. In general, no difference in primary or secondary outcomes was observed between treatments. TRIAL REGISTRATION: NTC01250184 November 27, 2010.

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Abstract Background In the 1920s, heart disease (a noncommunicable disease), was the new leading cause of death in the USA. Simultaneously, experimental progress in the study of stress provided scientific justification for a new type of risk factor. The objective of the present work is to examine the history of heart disease as a public health problem and the contribution of advancements in scientific knowledge about stress in the 1930s-1960s supporting the hypothesis of stress as one cause of disease. Results In the process of studying heart disease risk factors in the 1950s, medical practitioners became responsible for the early detection of risk factors in order to "catch" chronic disease in its earliest stage. Coronary heart disease specifically was a disease of white, middle class, professional males, and "stress" was hypothesized as one reason why this population was particularly vulnerable. Walter Cannon and Hans Selye provided experimental evidence that stress might cause physical disease. In the 1930s, Cannon described how the body seeks to maintain homeostasis. When the body's systemic equilibrium is challenged by something dangerous in the environment or an insult directly to the body, the sympathetic nervous system (SNS) and adrenals are stimulated. In the 1940s and 1950s, Selye discovered that a universal triad of stress effects (hypertrophy of the adrenal glands, involution of the thymus and lymphoid tissue, and ulceration in the gastrointestinal tract) was seen repeatedly after any noxious or aversive event (i.e., noise, shock, etc.). The stress responses occurred in a certain pattern, known as the general adaptation syndrome or GAS. Autopsy from Selye's laboratory animals showed that, in addition to the general pathological effects of GAS, arteries were thickened and hardened, just as would be seen in human victims of heart and circulatory disorders. Conclusions Since then, large scale, prospective epidemiological studies, meta-analyses, and systematic reviews, as well as smaller scale basic science studies, have established the relationship between stress and heart disease development and progression. Most evidence centers on depression and the biobehavioral mechanisms underlying its contribution to heart disease. However, effective prevention/intervention strategies that improve stress and physical disease outcomes are still needed.

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RESUMOObjetivo:Analisar a relação entre a qualidade de vida (QV) específica da doença e fatores sociodemográficos, clínicos e psicossociais em pacientes colombianos com artrite reumatoide (AR).Métodos:Recrutaram-se 103 pacientes com AR em centros ambulatoriais de Neiva, na Colômbia. Eles responderam ao Disease Activity Scale 28 (DAS-28), QOL-RA, Escala de Autoavaliação da Depressão de Zung, Inventário de Ansiedade Traço-Estado (Idate), Interpersonal Support Evaluation List-12 (Isel-12) e Symptom Checklist-90 Revised (SCL-90R).Resultados:Escores mais baixos de QOL-RA estiveram associados a uma pior condição socioeconômica (CSE; r = 0,26, p < 0,01), maior probabilidade de usar opioides (t = -2,51, p < 0,05), maior probabilidade de doença pulmonar comórbida (t = -2,22, p < 0,05) e pontuações inferiores nas subescalas do ISEL-12 (r's = 0,41-0,31, p's < 0,001). Uma menor pontuação no QOL-RA esteve associada a escores mais elevados no DAS-28 (r = -0,28, p < 0,01), Escala Analógica Visual (EVA; r = -0,35, p < 0,001), Escala de Autoavaliação da Depressão de Zung (r = -0,72, p < 0,001), Idate-Estado (r = -0,66, p < 0,001), Idate-Traço (r = -0,70, p < 0,001), SCL-90R Índice de Gravidade Global (r = -0,50, p < 0,001), SCL-90R Total de Sintomas Positivos (r = -0,57, p < 0,001) e todas as subescalas do SCL-90R (r's = -0,54 a -0,21, p's < 0,01). Um modelo de regressão linear múltipla indicou que a CSE (B = 2,77, p < 0,05), a Escala de Autoavaliação da Depressão de Zung (B = -0,53, p < 0,001), o Idate-Estado (B = -0,26, p < 0,05) e o Isel-12 Pertencimento (B = 1,15, p < 0,01) estavam independentemente associados à pontuação no QOL-RA, mesmo quando controlados por associações significativas.Conclusões:Mais sintomas depressivos e de ansiedade estiveram independentemente associados a uma menor QV específica da doença, enquanto a percepção aumentada de ter pessoas com quem fazer atividades (pertencimento, apoio social) e CSE mais elevados estiveram independentemente associados a uma maior QV específica da doença. Os fatores psicossociais impactam na QV na AR acima e além da atividade da doença. É necessária pesquisa adicional acerca dos benefícios da avaliação psicossocial do paciente com AR e da prestação de cuidados abrangentes para melhorar a QV.

ABSTRACTObjective:To examine the relationship between disease-specific quality of life (QOL) and socio-demographic, medical, and psychosocial factors in Colombian patients with Rheumatoid Arthritis (RA).Methods:One hundred and three RA patients recruited from ambulatory centers in Neiva, Colombia were administered the Disease Activity Scale 28 (DAS-28), QOL-RA, Zung Self-Rating Depression Scale, State-Trait Anxiety Inventory (STAI), Interpersonal Support Evaluation List-12 (ISEL-12), and Symptom Checklist-90 Revised (SCL-90R).Results:Lower QOL-RA was associated with lower socio-economic status (r = 0.26, p < 0.01), higher likelihood of using opioids (t = -2.51, p< 0.05), higher likelihood of comorbid pulmonary disease (t = -2.22, p < 0.05), and lower ISEL-12 sub-scales (r's = 0.41-0.31, p's < 0.001). Lower QOL-RA was associated with higher DAS-28 (r = -0.28, p < 0.01), Visual Analog Scale (VAS; r = -0.35, p < 0.001), Zung Depression (r = -0.72, p < 0.001), STAI-State (r = -0.66, p < 0.001), STAI-Trait (r = -0.70, p < 0.001), SCL-90R Global Severity Index (r = -0.50, p < 0.001), SCL-90R Positive Symptom Total (r = -0.57, p < 0.001), and all SCL-90R sub-scales (r's = -0.54 to -0.21, p's < 0.01). A multivariate linear regression model indicated that SES (B = 2.77, p < 0.05), Zung Depression (B = -0.53, p < 0.001), STAI-State (B = -0.26, p < 0.05), and ISEL-12 Belonging (B = 1.15, p< 0.01) were independently associated with QOL-RA, controlling for significant associations.Conclusions:More depressive and anxiety symptoms were independently associated with lower disease-specific QOL, while higher perceptions of having people to do activities with (belonging social support) and higher SES were independently associated with higher disease-specific quality of life. Psychosocial factors impact QOL in RA above and beyond disease activity. Additional research into the benefits of psychosocial assessment of RA patients and provision of comprehensive care to improve QOL is warranted.

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OBJECTIVE: To examine the relationship between disease-specific Quality of Life (QOL) and socio-demographic, medical, and psychosocial factors in Colombian patients with Rheumatoid Arthritis (RA). METHODS: One hundred and three RA patients recruited from ambulatory centers in Neiva, Colombia were administered the Disease Activity Scale 28 (DAS-28), QOL-RA, Zung Self-Rating Depression Scale, State-Trait Anxiety Inventory (STAI), Interpersonal Support Evaluation List-12 (ISEL-12), and Symptom Checklist-90 Revised (SCL-90R). RESULTS: Lower QOL-RA was associated with lower socio-economic status (SES; r=0.26, p<0.01), higher likelihood of using opioids (t=-2.51, p<0.05), higher likelihood of comorbid pulmonary disease (t=-2.22, p<0.05), and lower ISEL-12 sub-scales (r's=0.41-0.31, p's<0.001). Lower QOL-RA was associated with higher DAS-28 (r=-0.28, p<0.01), Visual Analog Scale (VAS; r=-0.35, p<0.001), Zung Depression (r=-0.72, p <0.001), STAI-State (r=-0.66, p<0.001), STAI-Trait (r=-0.70, p<0.001), SCL-90R Global Severity Index (r=-0.50, p<0.001), SCL-90R Positive Symptom Total (r=-0.57, p<0.001), and all SCL-90R sub-scales (r's=-0.54--0.21, p's<0.01). A multivariate linear regression model indicated that SES (B=2.77, p<0.05), Zung Depression (B=-0.53, p<0.001), STAI-State (B=-0.26, p<0.05), and ISEL-12 Belonging (B=1.15, p<0.01) were independently associated with QOL-RA, controlling for significant associations. CONCLUSIONS: More depressive and anxiety symptoms were independently associated with lower disease-specific QOL, while higher perceptions of having people to do activities with (belonging social support) and higher SES were independently associated with higher disease-specific QOL. Psychosocial factors impact QOL in RA above and beyond disease activity. Additional research into the benefits of psychosocial assessment of RA patients and provision of comprehensive care to improve QOL is warranted.

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BACKGROUND/OBJECTIVE: The purpose of this study was to examine the influence of appraisal, belonging, and tangible social support on the mental health (depression, satisfaction with life, anxiety, and burden) of Colombian spinal cord injury (SCI) caregivers. METHODS: Forty SCI caregivers from Neiva, Colombia completed questionnaires assessing their perceived social support and mental health. RESULTS: Four multiple regressions found that the three social support variables explained 42.8% of the variance in caregiver depression, 22.3% of the variance in satisfaction with life, 24.1% of the variance in anxiety, and 16.5% of the variance in burden, although the effect on burden was marginally significant. Within these regressions, higher belonging social support was uniquely associated with lower depression, and higher tangible social support was uniquely associated with higher caregiver satisfaction with life. CONCLUSIONS: Social support may have a particularly important influence on SCI caregiver mental health in Colombia, due in part to the high levels of collectivism and strong family values shown to exist in Latin America, and may therefore be an important target for SCI caregiver interventions in this region.

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OBJECTIVE: The aim of this study was to examine the influence of three types of social support (appraisal, belonging, and tangible) on caregiver mental health (anxiety, burden, depression, and satisfaction with life) among Mexican caregivers of individuals with traumatic brain injury. DESIGN: This is a cross-sectional study of 90 family caregivers from Hospital Civil Fray Antonio Alcade in Guadalajara, Mexico. RESULTS: More months spent caregiving was associated with decreases in all three types of social support. Older age and fewer years of education were associated with lower appraisal social support. More hours per week spent caregiving was associated with lower caregiver state anxiety and greater satisfaction with life. Appraisal, belonging, and tangible social support were all significantly correlated with more salubrious caregiver mental health outcomes, except satisfaction with life. Appraisal social support independently predicted lower caregiver depression. CONCLUSIONS: Particularly in Latin America, strong social support networks and family connections seem closely tied to key mental health outcomes such as depression. Rehabilitation interventions aimed at strengthening perceptions of social support of caregivers of individuals with traumatic brain injury that specifically target availability of advice may improve mental health and contribute to more optimal informal care for individuals with traumatic brain injury.

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OBJETIVOS:evaluar la trayectoria de la Calidad de Vida (CV) en pacientes con enfermedad cardiovascular (ECV), analizando la influencia que tienen el sexo y la depresión. METODOLOGIA:i se tomó una muestra de 100 pacientes con la enfermedad y se les aplicó el sf36 durante su hospitalización y cada seis meses durante dos años. Mediante análisis multinivel, se evaluó la trayectoria de la CV de estos pacientes y se analizó la influencia de la depresión, medida con el Cuestionario de salud del Paciente (PHQ-9) y el sexo, en el componente físico de la calidad de vida. RESULTADOS el componente físico de la CV tiende a mejorar en los pacientes con ECV a lo largo del tiempo, en el cual los hombres presentan mayores niveles que las mujeres. Los síntomas depresivos se asocian con menores puntuaciones en el momento del evento cardíaco, pero también afectan la trayectoria, produciendo un declive significativo en este componente, en comparación con los pacientes sin depresión. CONCLUSION la CV de los pacientes con ECV tiende a mejorar en los meses posteriores al evento cardíaco para luego estabilizarse. Esta trayectoria tiende al declive en pacientes depresivos y presenta diferencias por sexos, en la cual las mujeres presentan menores niveles de CV.

OBJECTIVE: to evaluate Quality of Life (QOL) trajectory in Coronary Heart Disease (CHD) patients by analyzing the influence of variables such as gender and depression. METHODOLOGY the sf-36 was administered to a sample of 100 CHD inpatients. Additionally, the same instrument was administered to them every 6 months for two years following hospital discharge. Multilevel analyses were used to analyze the QOL trajectory of these patients. Similarly, the influence of depression was measured using the Patient Health Questionnaire (PHQ-9), and patient sex was included in the physical component of the QOL. RESULTS : the physical component of the QOL of CHD patients tended to improve overtime, with men showing higher scores than women. Moreover, depression symptoms were associated with lower scores at the moment of the cardiac event, but they also affected trajectory by producing a significant decline in this component in comparison to patients without depression. CONCLUSION: the QOL of patients with CHD had a tendency improve and stabilize itself some months after the cardiac event. This trajectory tends to decline for depressed patients and is different for each sex, since women had lower levels of QOL.

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Este estudio tuvo como objetivo comparar los niveles de ira, y sus componentes, entre un grupo de personas con Cardiopatía Isquémica y un grupo control sin esta enfermedad. Participaron 90 pacientes con cardiopatía isquémica de la Clínica Cardiovascular en Medellín y 78 controles sin la enfermedad. A cada uno de los participantes de les administró la prueba del STAXI- 2. Los resultados muestran que, comparado con los controles, los pacientes con cardiopatía isquémica tuvieron niveles significativamente más altos de ira como rasgo (p < 0.01), específicamente en la subescala reacción de ira (p < 0.05), y expresión interna de ira (p < 0.05). Los pacientes con cardiopatía isquémica experimentan más frecuentemente sentimientos de ira (ira rasgo), aparentemente debido a que son más sensibles a las críticas de los demás (reacción de ira), pero tienden a suprimir la expresión de esta emoción (expresión de ira interna). Estos datos confirman la necesidad de implementar programas dirigidos al manejo adecuado de la ira en estos pacientes y entender mejor las implicaciones que pueda tener la ira en la progresión de su enfermedad.

Objective: To compare levels of anger, and its components, between a group of Colombians individuals with coronary heart disease and a healthy control group. Measures: Each participant was administered the STAXI-2. Results: Compared to controls, patients with coronary artery disease had significantly higher Trait Anger (p < 0.01), specifically the Angry Reaction sub-scale (p < 0.05), and Anger Expression-In (p < 0.05). Conclusion: Patients with coronary artery disease experience more frequent feelings of anger (trait anger), apparently because they are more sensitive to criticism (angry reaction), but they tend to suppress the expression of their anger (anger expression -in). These results confirm the need for implementing anger management programs with these patients and gain a better understanding of how anger/hostility might influence the progression of their disease.