bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychiatric Comorbidity Among Children and Adolescents With and Without Persistent Attention-Deficit Hyperactivity Disorder
Authors: Gau Susan Shur-Fen , Ni Hsing-Chang , Shang Chi-Yung , Soong Wei-Tsuen , Wu Yu-Yu , Lin Liang-Ying , Chiu Yen-Nan
Published: February 2010

Objectives: The aims of the present study were to examine the current psychiatric comorbidity among children and adolescents with and without persistent attention-deficit hyperactivity disorder (ADHD) as compared to school controls, and to determine the factors predicting psychiatric comorbidity.

Method: The sample included 296 patients (male, 85.5%), aged 11–17, who were diagnosed with DSM-IV ADHD at the mean age of 6.7 ± 2.7 years and 185 school controls. The ADHD and other psychiatric diagnoses were made based on clinical assessments and confirmed by psychiatric interviews. The ADHD group was categorized into 186 patients (62.8%) with persistent ADHD and 110 (37.2%) without persistent ADHD.

Results: Compared to the controls, the two ADHD groups were more likely to have oppositional defiant disorder (ODD), conduct disorder (CD), tics, mood disorders, past and regular use of substances, substance use disorders and sleep disorders (odds ratios (ORs) = 1.8–25.3). Patients with persistent ADHD had higher risks for anxiety disorders, particularly specific phobia than the controls. Moreover, patients with persistent ADHD were more likely to have ODD than their partially remitted counterparts. Advanced analyses indicated that more severe baseline ADHD symptoms predicted ODD/CD at adolescence; longer methylphenidate treatment duration was associated with an increased risk for tics and ODD/CD at adolescence; and older age predicted higher risks for mood disorders and substance use disorders.

Conclusion: Reduced ADHD symptoms at adolescence may not lead to decreased risks for psychiatric comorbidity, and identification of severe ADHD symptoms at childhood and age-specific comorbid patterns throughout the developmental stage is important to offset the long-term adverse psychiatric outcomes of ADHD.
Using the Interaction of Mental Health Symptoms and Treatment Status to Estimate Lost Employee Productivity
Authors: Hilton Michael F. , Scuffham Paul A. , Vecchio Nerina , Whiteford Harvey A.
Published: February 2010

Objective: In Australia it has been estimated that mental health symptoms result in a loss of $ AU2.7 billion in employee productivity. To date, however, there has been only one study quantifying employee productivity decrements due to mental disorders when treatment-seeking behaviours are considered. The aim of the current paper was to estimate employee work productivity by mental health symptoms while considering different treatment-seeking behaviours.

Method: A total of 60 556 full-time employees responded to the World Health Organization Health and Work Performance Questionnaire. This questionnaire is designed to monitor the work productivity of employees for chronic and acute physical and mental health conditions. Contained within the questionnaire is the Kessler 6, a scale measuring psychological distress along with an evaluation of employee treatment-seeking behaviours for depression, anxiety and any other emotional problems. A univariate analysis of variance was performed for employee productivity using the interaction between Kessler 6 severity categories and treatment-seeking behaviours.

Results: A total of 9.6% of employees have moderate psychological distress and a further 4.5% have high psychological distress. Increasing psychological distress from low to moderate then to high levels is associated with increasing productivity decrements (6.4%, 9.4% and 20.9% decrements, respectively) for employees in current treatment. Combining the prevalence of Kessler 6 categories with treatment-seeking behaviours, mean 2009 salaries and number of Australian employees in 2009, it is estimated that psychological distress produces an $ AU5.9 billion reduction in Australian employee productivity per annum.

Conclusions: The estimated loss of $ AU5.9 billion in employee productivity due to mental health problems is substantially higher than previous estimates. This finding is especially pertinent given the global economic crisis, when psychological distress among employees is likely to be increasing. Effective treatment for mental health problems yields substantial increases in employee productivity and would be a sound economic investment for employers.
Hunter DBT Project: Randomized Controlled Trial of Dialectical Behaviour Therapy in Women with Borderline Personality Disorder
Authors: Carter Gregory L. , Willcox Christopher H. , Lewin Terry J. , Conrad Agatha M. , Bendit Nick
Published: February 2010

Objective: Deliberate self-harm (DSH), general hospital admission and psychiatric hospital admission are common in women meeting criteria for borderline personality disorder (BPD). Dialectical behaviour therapy (DBT) has been reported to be effective in reducing DSH and hospitalization.

Method: A randomized controlled trial of 73 female subjects meeting criteria for BPD was carried out with intention-to-treat analyses and per-protocol analyses. The intervention was DBT and the control condition was treatment as usual plus waiting list for DBT (TAU+WL), with outcomes measured after 6 months. Primary outcomes were differences in proportions and event rates of: any DSH; general hospital admission for DSH and any psychiatric admission; and mean difference in length of stay for any hospitalization. Secondary outcomes were disability and quality of life measures.

Results: Both groups showed a reduction in DSH and hospitalizations, but there were no significant differences in DSH, hospital admissions or length of stay in hospital between groups. Disability (days spent in bed) and quality of life (Physical, Psychological and Environmental domains) were significantly improved for the DBT group.

Conclusion: DBT produced non-significant reductions in DSH and hospitalization when compared to the TAU+WL control, due in part to the lower than expected rates of hospitalization in the control condition. Nevertheless, DBT showed significant benefits for the secondary outcomes of improved disability and quality of life scores, a clinically useful result that is also in keeping with the theoretical constructs of the benefits of DBT.
Management of Antipsychotic and Mood Stabilizer Medication in Pregnancy: Recommendations for Antenatal Care
Authors: Galbally Megan , Snellen Martien , Walker Susan , Permezel Michael
Published: February 2010

The aim of the present study was to develop recommendations for antenatal care and monitoring for women with bipolar disorder and schizophrenia who are on lithium carbonate, antipsychotic or anti-epileptic medication during pregnancy. A literature search and review of original research, published reviews and guidelines was undertaken for mood stabilizers and antipsychotics in pregnancy and for the management of bipolar disorder and schizophrenia in pregnancy. This information was summarized, condensed and then reviewed by representatives of psychiatry, pharmacy, paediatrics and obstetrics to produce an information booklet and subsequently monitoring recommendations and tables. A model of antenatal monitoring and care for women with schizophrenia, bipolar disorder and related disorders who are maintained on psychotropic medication was developed. This included an online and published booklet for clinicians summarizing psychotropic medication in pregnancy, and lactation and monitoring tables that could be part of patient case files. These were to assist in reminding and educating staff on the need for additional monitoring and assessment above standard antenatal care for women on mood stabilizers and antipsychotic medication. Women with bipolar disorder and schizophrenia have an increased risk of complications in pregnancy from their illness and from the medications they are prescribed. A summary of the risks and a model of suggested additional monitoring during pregnancy have been developed in consultation across a number of clinical disciplines.
The reliability of neuroanatomy as a predictor of eloquence: a review
Authors: Pouratian Nader , Bookheimer Susan Y.
Published: February 2010

The adjacency of intracranial pathology to canonical regions of eloquence has long been considered a significant source of potential morbidity in the neurosurgical care of patients. Yet, several reports exist of patients who undergo resection of gliomas or other intracranial pathology in eloquent regions without adverse effects. This raises the question of whether anatomical and intracranial location can or should be used as a means of estimating eloquence. In this review, the authors systematically evaluate the factors that are known to affect anatomical-functional relationships, including anatomical, functional, pathology-related, and modality-specific sources of variability. This review highlights the unpredictability of functional eloquence based on anatomical features alone and the fact that patients should not be considered ineligible for surgical intervention based on anatomical considerations alone. Rather, neurosurgeons need to take advantage of modern technology and mapping techniques to create individualized maps and management plans. An individualized approach allows one to expand the number of patients who are considered for and who potentially may benefit from surgical intervention. Perhaps most importantly, an individualized approach to mapping patients with brain tumors ensures that the risk of iatrogenic functional injury is minimized while maximizing the extent of resection.
The cerebral sulci and gyri
Authors: Ribas Guilherme Carvalhal
Published: February 2010

The aim of this study was to describe in detail the microanatomy of the cerebral sulci and gyri, clarifying the nomenclature for microneurosurgical purposes. An extensive review of the literature regarding the historical, evolutionary, embryological, and anatomical aspects pertinent to human cerebral sulci and gyri was conducted, with a special focus on microneuroanatomy issues in the field of neurosurgery. An intimate knowledge of the cerebral sulci and gyri is needed to understand neuroimaging studies, as well as to plan and execute current microneurosurgical procedures.
Intraoperative electrical stimulation in awake craniotomy: methodological aspects of current practice
Authors: Szelényi Andrea , Bello Lorenzo , Duffau Hugues , Fava Enrica , Feigl Guenther C. , Galanda Miroslav , Neuloh Georg , Signorelli Francesco , Sala Francesco
Published: February 2010

There is increasing evidence that the extent of tumor removal in low-grade glioma surgery is related to patient survival time. Thus, the goal of resecting the largest amount of tumor possible without leading to permanent neurological sequelae is a challenge for the neurosurgeon. Electrical stimulation of the brain to detect cortical and axonal areas involved in motor, language, and cognitive function and located within the tumor or along its boundaries has become an essential tool in combination with awake craniotomy. Based on a literature review, discussions within the European Low-Grade Glioma Group, and illustrative clinical experience, the authors of this paper provide an overview for neurosurgeons, neurophysiologists, linguists, and anesthesiologists as well as those new to the field about the stimulation techniques currently being used for mapping sensorimotor, language, and cognitive function in awake surgery for low-grade glioma. The paper is intended to help the understanding of these techniques and facilitate a comparison of results between users.
Musical hallucinations following insular glioma resection
Authors: Isolan Gustavo Rassier , Bianchin Marino Muxfeldt , Bragatti José Augusto , Torres Carolina , Schwartsmann Gilberto
Published: February 2010

Hallucinations can be auditory, visual, tactile, gustatory, or olfactory, and can be caused by psychiatric (such as schizophrenia and depression), neurological (such as cerebrovascular accidents, neoplasia, and infection), or endocrine and metabolic disorders. Musical hallucinations related to neurological disorders are rare. The authors present a case of a patient with a right insular glioma who developed transient musical hallucinations after microsurgical resection of the tumor.
Anaplastic oligodendrogliomas after treatment of acute lymphoblastic leukemia in children
Authors: Alexiou George A. , Moschovi Maria , Georgoulis George , Neroutsou Rosalia , Stefanaki Kalliopi , Sfakianos George , Prodromou Neofytos
Published: February 2010

Radiation-induced brain tumors are suggested to be the late complication of acute lymphoblastic leukemia (ALL) treatment. High-grade gliomas, meningiomas, and sarcomas are the most frequent neoplasms. Secondary anaplastic oligodendrogliomas are exceedingly rare. Five cases of pure anaplastic oligodendroglioma have been reported in the literature, and only 1 case was in a child after ALL treatment. The authors present 2 cases of pediatric anaplastic oligodendroglioma after treatment of ALL. Furthermore, they performed a molecular cytogenetic study and found loss of 1p in both cases. The authors provide a review of the previous cases and discuss their findings.
Prevention of growing skull fractures
Authors: Sanford Robert A.
Published: February 2010

The author describes 2 cases of children with growing skull fractures (GSFs). Surgical exploration of the widened fracture shortly after the head injury failed to reveal a dural tear because the neuroimaging studies (MR images, CT scans, and skull radiographs) had not been accurately interpreted, thereby allowing the development of a GSF at the site of the actual dural injury. In both cases, the dural and bony defect and the leptomeningeal cyst were successfully repaired.

To prevent GSFs associated with progressive neurological deficit, seizure, ventricular porencephaly, and encephalomalacia, the author surgically explores wide skull fractures in young children with head injury whose MR images demonstrate brain herniation through the dura mater. The importance of a brief delay in surgical exploration is emphasized to allow cerebral edema to resolve and the patient's condition to become medically stabilized.
Traumatic Type III odontoid fracture and severe rotatory atlantoaxial subluxation in a 3-year-old child
Authors: Panczykowski David , Nemecek Andrew N. , Selden Nathan R.
Published: February 2010

In this report, the authors describe the case of a 3-year-old child with a traumatic Type III odontoid fracture. To their knowledge, this is the first reported case of a true Type III odontoid fracture with atlantoaxial rotatory subluxation in a child. The patient presented with pain and had resisted manipulation of the neck following a motor vehicle crash. Plain cervical radiographs revealed an odontoid fracture, which was confirmed by CT imaging. The left lateral mass of C-1 was rotated anterior to that of C-2 with the displaced odontoid process acting as the pivot point of rotation. The C1–2 alignment was normalized, and the C-2 fracture was reduced completely. The regional anatomy and mechanism of injury, radiographic diagnosis, and management of cervical spine injuries in children are discussed.
Medulloblastoma and juvenile pilocytic astrocytoma presenting as synchronous primary brain tumors in a child
Authors: Jea Andrew , Coscarella Ernesto , Chintagumpala Murali , Bhattacharjee Meena , Whitehead William E. , Curry Daniel J. , Luerssen Thomas G.
Published: February 2010

Multiple metastatic brain tumors and multifocal primary brain tumors of a single histological type have been published in the adult and pediatric literature. However, the simultaneous occurrence of multiple primary brain tumors with different cell types is rare. Even more rare is the pediatric presentation of multiple primary brain tumors with different cell types.

The authors describe the case of an 8-year-old boy who presented with a 2-week history of progressive headache, nausea and vomiting, and imbalance. Brain MR imaging demonstrated a heterogeneously enhancing mixed solid/cystic mass of the left cerebellar hemisphere and a larger, midline, more homogeneously enhancing lesion of the superior vermis. Spinal MR imaging was unremarkable.

The patient underwent a suboccipital craniotomy and subsequent gross-total resection of both mass lesions. Pathological examination revealed the left cerebellar and superior vermian lesions to be a juvenile pilocytic astrocytoma and a medulloblastoma, respectively. The patient did well in the immediate postoperative period, was discharged home, and underwent neurooncological follow-up.

To the best of the authors' knowledge, they describe the first known pediatric case in which a medulloblastoma and a juvenile pilocytic astrocytoma presented as synchronous primary brain tumors. They review the literature on multiple primary brain tumors with different histological characteristics and rehash potential mechanisms for their development.
Nondysraphic pediatric intramedullary spinal cord lipomas
Authors: Fleming Karen L. , Davidson Laurence , Gonzalez-Gomez Ignacio , McComb J. Gordon
Published: February 2010

Object

Intramedullary spinal cord lipomas not associated with dysraphism are infrequently reported. When present, they typically occur in children and have a predilection for the cervical and thoracic spinal cord. The authors review the presentation, treatment, and disease course in 5 pediatric patients, and compare the outcomes with previously reported cases.

Methods

With institutional review board approval, a retrospective chart review was undertaken at Childrens Hospital Los Angeles.

Results

Four patients with intramedullary spinal cord lipomas and 1 patient with a lipoblastoma, none associated with dysraphism, were retrospectively reviewed. There were 2 boys and 3 girls ranging in age from 2 months to 4 years. Four patients underwent a laminectomy or laminoplasty with one or more subtotal resections. One patient initially underwent a decompressive laminoplasty without debulking. The median follow-up was 8 years (range 12 months–11 years). Two patients had regrowth of their lipoma, necessitating a second surgery in one patient and 3 debulking surgeries in the other. Postoperatively, 3 patients developed mild kyphosis, none significant enough to require orthopedic intervention. One patient underwent a stabilization procedure at the time of the initial laminectomy and tumor debulking. No patient received chemotherapy or radiation. At the most recent follow-up visit, patients demonstrated improved neurological function when compared with preoperative status.

Conclusions

In addition to a decompressive laminectomy, debulking of the lipoma provides the best long-term neurological outcome. Gross-total excision is not warranted and usually is not possible. Long-term follow-up is needed, and repeat debulking of the lipoma is indicated if there is an increase in tumor size due to hyperplasia of residual adipocytes, when tumor growth is associated with neurological deterioration.
Primary meningeal rhabdomyosarcoma associated with chronic subdural effusion
Authors: Lee Ji Yeoun , Kim Bo Sung , Phi Ji Hoon , Kang Hyoung Jin , Park Sung-Hye , Wang Kyu-Chang , Kim Il Han , Cho Byung-Kyu , Kim Seung-Ki
Published: February 2010

Primary sarcomas of the CNS are rare and are sometimes associated with chronic subdural effusion (SDE). Approximately 10 patients with such presentations have been reported. The authors report the case of a 5-year-old boy with multiple subdural masses and SDE. An SDE had been diagnosed when the patient was 2 months old, and he received a subduroperitoneal shunt when he was 5 months old. Since then, he had been clinically stable and well for 5 years. When he presented with acute headache, nausea, and vomiting, a newly developed tumor was found. Near-total resection of the tumor was performed, and the mass was diagnosed as an embryonal-type rhabdomyosarcoma. The child was given radiation therapy and 13 cycles of chemotherapy and is still free of disease 13 months after surgery.
Intraoperative assessment of cerebral aqueduct patency and cisternal scarring: impact on success of endoscopic third ventriculostomy in 403 African children
Authors: Warf Benjamin C. , Kulkarni Abhaya V.
Published: February 2010

Object

In the setting of a developing country where preoperative imaging may be limited, the authors wished to determine whether cisternal scarring or aqueduct patency at the time of surgery was sufficiently predictive of the failure of endoscopic third ventriculostomy (ETV) to justify shunt placement at the time of the initial operation.

Methods

The status of the prepontine cistern and aqueduct at the time of ventriculoscopy was prospectively recorded in 403 children in whom an ETV had been completed. Kaplan-Meier methods were used to construct survival curves. A Cox proportional hazards model was used to provide estimates of HRs for the time to ETV failure. Several independent variables were tested in a single multivariable model, including those previously shown to be associated with ETV survival, that is, age, hydrocephalus etiology, and extent of choroid plexus cauterization (CPC). In addition, intraoperative variables of particular interest were included in the analysis: status of the aqueduct at surgery (closed vs open) and status of the prepontine cistern at surgery (scarred vs clean/unscarred). Multicollinearity was not a concern since the variance inflation factors for all variables were < 2. The examination of stratified survival curves confirmed the appropriateness of the proportional hazards assumption for each variable.

Results

Overall actuarial 3-year success was 57%. Consistent with previous results, age, hydrocephalus etiology, and extent of CPC were significantly associated with ETV success. A closed aqueduct and an unscarred cistern were each independently associated with significantly better ETV success (HRs of 0.66 and 0.44, respectively). The presence of cisternal scarring more than doubled the risk of ETV failure, and an open aqueduct increased the risk of failure by 50%.

Conclusions

Intraoperative observations of the aqueduct and prepontine cistern are independent predictors of the risk of ETV failure and can be used to further refine outcome predictions based on age, hydrocephalus etiology, and extent of CPC. Further studies will test validity in several African centers and determine what threshold of failure risk should prompt shunt placement at the initial operation.
Globular subdural hematoma in a shunt-treated infant
Authors: Murata Takahiro , Shigeta Hiroaki , Horiuchi Tetsuyoshi , Sakai Keiichi , Hongo Kazuhiro
Published: February 2010

Subdural hematoma (SDH) is a well-known sequela of ventriculoperitoneal shunt insertion for hydrocephalus, usually spreads out over the cerebral convexity, and appears as a crescent-shaped lesion on imaging. The authors report the rare case of an infant with a globular SDH, which MR imaging revealed as a round mass lesion.

A 13-month-old girl with a history of severe congenital hydrocephalus associated with myeloschisis underwent ventriculoperitoneal shunt placement after repair of myeloschisis and developed convulsive seizure. Magnetic resonance imaging showed a large subdural round mass with a lesion like a pedestal in the left parietal region, suggesting a globular SDH surrounded by a thin cerebral mantle. Because of the seizures and because the hematoma did not respond to a change in valve pressure, the patient underwent a craniotomy to remove the hematoma and to resect the thick outer membranes of multiple layers. Postoperative MR imaging demonstrated the disappearance of the SDH, and no additional shunt complication was observed during a long follow-up period.

To the authors' knowledge, this is the first report of a patient with globular SDH published in the literature. The authors postulate that the globular SDH was caused by the thin cerebral mantle associated with severe craniocerebral disproportion, and they discuss the possible mechanisms for this unique formation.
Solvent-free and time-efficient Suzuki–Miyaura reaction in a ball mill: the solid reagent system KF–Al2O3under inspection
Authors: Bernhardt Franziska , Trotzki Ronald , Szuppa Tony , Stolle Achim , Ondruschka Bernd
Published: February 2010

Although a plethora of synthetic procedures mediated by KF-loaded aluminas is available in the literature, there is almost no data concerning the influence of parameters such as alumina modification or KF-loading on experimental results. Hence, the Pd-catalyzed, solvent-free Suzuki–Miyaura reaction was chosen as model reaction to investigate the effect of the above mentioned parameters on the results of coupling reactions. The results from ball milling experiments led to the conclusion that self-prepared and commercially available KF–Al2O3differ in water content. The higher the residual water content, the higher are the product yields.
A CONTROVERSIAL NOTE ON SOME SPECIES OF LYGAEUS (HEMIPTERA, LYGAEIDAE)
Authors: Parshley H. M.
Published: February 2010

In a brief note mentioning a few species of Lygaeus, Mr. Van Duzee suggests that I may have misidentified L., kalmii Stal in my paper on the distribution and forms of that species, but the basis for this notion remains obscure, since our senior hemipterist contents himself with a series of ex cathedra statements devoid of argument or documentation. He surmises quite correctly that I followed Stal in my identification of the species concerned-and why not? Stal's work is clear and, for aught we know to the contrary, perfectly sound. More-ever, in the most recent monograph of the genus, Barber reaches conclusions in harmony with Stal's fundamental treatment and my later elaboration. In Mr. Van Duzee's little note all this previous work is ignored and we are favored with a series of bare propositions. which, if they have a certain value as expressions of the author's revolutionary opinions, are nevertheless in conflict with the evidence, I believe, and hence to be rejected. Let us consider these propositions one by one.
NEW SPECIES OF BOLBOCEROSOMA (SCARABAEIDAE)
Authors: Dawson R. W. , Mccolloch J. W.
Published: February 2010

The generic name Bolbocerosoma was proposed by Mr. Schæffer in 1906 (Trans. Amer. Ent. Soc., XXII, pp. 250-254) to take care of the species Scarabaeus forcuts Fabricius and its supposed synonym tumefactus Beauvois. Oddly enough, the misgivings of M. Beauvois. recorded more than a century ago, that his species was “perhaps only a climatic variation” have been shared by all subsequent writers, and three additional forms have, doubtless, on this account failed to receive recognition. After carefully studying between two and three hundred specimens, the writers cannot concur in the opinion of Mr. Schæffer that “intermediates” occur, and that, therefore, the differential characters are unstable and valueless. It is true that an occasional specimen will deviate somewhat from the average color pattern of its species, but such specimens can in every instance be readily determined by the examination of the constant structural and genital characters diagnostic of the species.
Emotion Processing for Arousal and Neutral Content in Alzheimer's Disease
Authors: Satler Corina , Uribe Carlos , Conde Carlos , Da-Silva Sergio Leme , Tomaz Carlos
Published: February 2010

Objective. To assess the ability of Alzheimer's disease (AD) patients to perceive emotional information and to assign subjective emotional rating scores to audiovisual presentations.Materials and Methods. 24 subjects (14 with AD, matched to controls for age and educational levels) were studied. After neuropsychological assessment, they watched a Neutral story and then a story with Emotional content.Results. Recall scores for both stories were significantly lower in AD (Neutral and Emotional:P=.001). CG assigned different emotional scores for each version of the test,P=.001, while ratings of AD did not differ,P=.32. Linear regression analyses determined the best predictors of emotional rating and recognition memory for each group among neuropsychological tests battery.Conclusions. AD patients show changes in emotional processing on declarative memory and a preserved ability to express emotions in face of arousal content. The present findings suggest that these impairments are due to general cognitive decline.
A case of rheumatic fever with acute post-streptococcal glomerulonephritis and nephrotic syndrome caused by a cutaneous infection with beta-hemolytic streptococci
Authors: Mikkelsen Carsten Sauer , Gelvan Allan , Ibrahim Ahmad , Ladefoged Karin
Published: February 2010

A middle-aged patient of Greenlandic origin was referred for skin infection of the leg. An initial minor trauma of the skin of the distal right lower extremity was complicated by bullous erysipelas which cultured positive for group A β-hemolytic streptococci (GABHS). The clinical condition deteriorated and necrotizing fasciitis developed despite relevant surgical and antibiotic treatment. Approximately 3 weeks later, the patient developed arthralgia, impaired renal function with azotemia, hypertension and severe nephrotic syndrome with periorbital and peripheral edema. A kidney biopsy demonstrated endocapillary glomerulonephritis. Concomitantly, carditis with chest pain, moderately reduced left ventricular ejection fraction and mitral regurgitation were noted. The patient had no signs of pharyngitis in the whole period. The patient thus contracted poststreptococ glomerulonephritis and furthermore she fulfilled the criteria of acute rheumatic fever following a GABHS skin infection. We suggest a possible relation between a virulent GABHS clone causing NF and ARF.
Cutaneous papules in a patient with AIDS
Authors: Quatresooz Pascale , Piérard-Franchimont Claudine , Paquet Philippe , Piérard Gerald E.
Published: February 2010

During the past decade or so, the incidence of syphilis has increased in most parts of the world. In some urban regions, a coinfection with human immunodeficiency virus is disclosed in nearly 50% of the cases. Owing to the polymorphism of the lesions, the clinical diagnosis may be puzzling. The homing patterns and migration paths of Treponema pallidum in the skin during early syphilis represent the preliminary steps preceding dissemination to other organs. Immunohistochemistry directed to T. pallidum is a convenient means for reaching the diagnosis and for exploring the dissemination process. The present case illustrates the dermal clustering and the vascular spread of T. pallidum in a woman with acquired immu­no deficiency syndrome.
Salmonella typhimurium epidural Empyema in an HIV Infected Patient
Authors: Hachfi Wissem , Bellazreg Foued , Ladib Mohamed , Kaabia Naoufel , Khalifa Mabrouk , Krifa Hedi , Letaief Amel
Published: February 2010

Salmonella focal intracranial infections are reported rarely. They tend to occur in immunocompromised patients. We present here a case of Salmonella typhimurium epidural empyema, with osteomyelitis of the adjacent frontal bone, in a 37-year-old human immunodeficiency virus positive man who presented with a three-day history of headache, fever, and sweats. He was treated successfully with antibiotics and surgical drainage.
Cure or curse? Ambivalent attitudes towards neuroleptic medication in schizophrenia and non-schizophrenia patients
Authors: Moritz Steffen , Hocaoglu Cicek , Karow Anne , Deljkovic Azra , Tonn Peter , Naber Dieter
Published: February 2010

Neuroleptic non-compliance remains a serious challenge for the treatment of psychosis. Non-compliance is predominantly attributed to side effects, lack of illness insight, reduced well-being or poor therapeutic alliance. However, other still neglected factors may also play a role. Further, little is known about whether psychiatric patients without psychosis who are increasingly prescribed neuroleptics differ in terms of medication compliance or about reasons for non-compliance by psychosis patients. As direct questioning is notoriously prone to social desirability biases, we conducted an anonymous survey. After a strict selection process blind to results, 95 psychiatric patients were retained for the final analyses (69 participants with a presumed diagnosis of schizophrenia psychosis, 26 without psychosis). Self-reported neuroleptic non-compliance was more prevalent in psychosis patients than non-psychosis patients. Apart from side effects and illness insight, main reasons for non-compliance in both groups were forgetfulness, distrust in therapist, and no subjective need for treatment. Other notable reasons were stigma and advice of relatives/acquaintances against neuroleptic medication. Gain from illness was a reason for non-compliance in 11-18% of the psychosis patients. Only 9% of all patients reported no side effects and full compliance and at the same time acknowledged that neuroleptics worked well for them. While pills were preferred over depot injections by the majority of patients, depot was judged as an alternative by a substantial subgroup. Although many patients acknowledge the need and benefits of neuroleptic medication, non-compliance was the norm rather than the exception in our samples.
Health professionals' familiarity and attributions to mental illness
Authors: Chikaodiri Aghukwa Nkereuwem
Published: February 2010

A few months from the time of this survey, the nearly completed inpatient psychiatric facility within the Aminu Kano Teaching Hospital's complex would be ready for admissions. Understanding the health workers' level of experience of mental illness and their likely behavioural responses towards people with psychiatric illness, therefore, should be a good baseline to understanding their likely reactions towards admitting such patients within a general hospital setting.

The study, which used a pre-tested and adapted attribution questionnaire, was pro -spective and cross-sectional. Randomly selected health workers in Aminu Kano Teaching Hospital had their level of familiarity and attributions towards psychiatric patients assessed.

The respondents showed a high level of experience with mental illness, with more than 3 in 5 of them having watched movies on mental illness before. More than half of them held positive (favorable) attributions towards persons with mental illness on nine of the ten assessed attribution factors. Almost all held negative (unfavourable) opinion towards intimate relationships with such persons. Attribution factors, “Responsibility, “Anger”, “Dangerousness”, “Fear” and “Segregation” were significantly related to the respondents' level of education (P<0.05). Marital status of the respondents related significantly to “Pity” and “Avoidance” factors (P<0.05). Having watched movies on mental illness significantly related to “Responsibility” and “Fear” factors (P<0.05).

Programs designed to improve the health workers mental health literacy, and increased positive professional contacts with mentally ill persons on treatment, would further enhance their perceived positive attributions towards them.
Granulomatous hypophysitis by Mycobacterium gordonae in a non HIV-infected patient
Authors: Ruiz-Sandoval José Luis , Padilla-Martínez Juan José , González-Cornejo Salvador , Álvarez-Palazuelos Lucía Elizabeth , Villagómez-Méndez Jesús Alejandro , Chiquete Erwin , Domínguez-Rosales José Alfredo , Espejo-Plascencia Ismael , González-Díaz Esteban , Torres-Baranda José Rodrigo
Published: February 2010

Lymphocytic or granulomatous hypophysitis is a rare entity with a difficult diagnosis. Our objective was to report a patient with non-tuberculous granulomatous hypophysitis. An HIV-negative 45-year old man with confusional state, subacute ophthalmoplegia, and clinical and laboratory findings of panhypopituitarism was seen in the emergency unit. A cranial MRI showed a sellar mass suggestive of hypophysitis. After an unsuccessful attempt with steroids and antituberculous drugs the patient died. Post-mortem histopathology revealed granulomatous lesions and restriction fragment length polymorphism analysis confirmed the presence of Mycobacterium gordonae’s DNA. In conclusion, we should consider granulomatous hypophysitis in the differential diagnosis of non-secreting hypophyseal tumors. The etiology of a pituitary granuloma by a non-tuberculous mycobacteria is best reached by histopathological techniques and molecular assays. The optimal therapy is yet to be established.
Pupillary responses to single and sinusoidal light stimuli in diabetic patients
Authors: Zangemeister Wolfgang H. , Gronow Thilo , Grzyska Ulrich
Published: February 2010

We examined effects of diabetes mellitus (DM) on the pupillary light reflex (PLR). Phasic pupillary response to a single light stimulus (200 ms) (pPLR) and to continuous sinusoidal stimuli with four different frequencies (0.1, 0.3, 0.7, 1.3Hz) (cPLR) were examined in 52 DM patients and 21 control subjects. We asked: does recording and frequency analysis of cPLR together with short time fourier [STFT] analysis of pPLR differentiate better between DM patients and normal subjects than pPLR only? Initial pupil diameter was significantly decreased in the DM group. For pPLR. maximal contraction velocity (Vmax), Vmax of redilation 1, reflex-amplitude and pPLR latency were significantly reduced in those patients who also showed signs of diabetic autonomic neuropathy (DNP). Tests of dynamic pupillary light reflex (cPLR) revealed that all DM patients had a significantly reduced gain at lower frequencies. Pupil phase lag was greater at 0.1 and 0.3Hz and smaller at 0.7 and 1.3 Hz in the DNP group (p<0.001). Comparison of single pPLR recordings of 5 DNP patients with 5 subjects using short time fast fourier (STFT) analysis revealed a characteristic change from low frequency content in healthy subjects to high frequency content in DNP patients. Significant changes in the PLR in DM can be found only when symptoms of autonomic neuropathy have been shown. Both sympathetic and the parasympathetic nervous systems are affected by diabetic autonomic neuropathy. Only recording of cPLR , together with STFT of pPLR can identify significant pathological deficits of pupillary control in single cases.
Injuries in epilepsy: a review of its prevalence, risk factors, type of injuries and prevention
Authors: Tellez-Zenteno Jose , Nguyen Rita
Published: February 2010

Currently, there is intense clinical research into various aspects of the medical risks relating to epilepsy, including total and cause-specific mortality, accidents and injuries in patients with epilepsy and mortality related with seizures. Seizures occurring in precarious situations and resulting in injuries are still an important concern for patients with epilepsy, their employers and their caregivers. Submersion injuries, motor vehicle accidents, burns, and head injuries are among the most feared epilepsy-related injuries. These concerns seem valid because the hallmark of epilepsy, episodic impairment of consciousness and motor control, may occur during interictal EEG epileptiform discharges, even in the absence of a clinical seizure. In addition, psychomotor comorbidity and side effects of antiepileptic drugs may contribute to the risk of injuries in patients with epilepsy. Published risk factors for injuries include the number of antiepileptic drugs, history of generalized seizures, and seizure frequency. In general, epidemiological information about incidence of injuries has been conflicting and sparse. In general, studies focusing on populations with more severe forms of epilepsy tend to report substantially higher risks of injuries than those involving less selected populations. On the other hand, studies based on non-selected populations of people with epilepsy have not shown an increased frequency of injuries in people with epilepsy compared with the general population. Some studies have shown that patients with epilepsy are more frequently admitted to the hospital following an injury. Possible explanations include: more cautious attitude of clinicians toward injuries occurring in the setting of seizures; hospitalization required because of seizures and not to the injuries themselves; and hospitalization driven by other issues, such as comorbidities, which are highly prevalent in patients with epilepsy. Potentially the high rate of hospitalizations could be related with the severity of the injury. This article reviews the best available epidemiological information about injuries, including incidence and risk factors. Also this article reviews information about specific types of injuries such as fractures, burns, concussions, dislocations, etc. Information about accidents in people with epilepsy is also discussed.
Simultaneous central nervous system complications of C. neoformans infection
Authors: Gonzalez Duarte Alejandra , Higuera Jesus , Gijon-Mitre Vicente , García Ramos Guillermo
Published: February 2010

The most common neurological manifestation of Cryptococcus neoformans infection is meningitis. Other less common manifestations include parenchymal central nervous system (CNS) granulomatous disease, hydrocephalus and stroke. C. neoformans is often suspected in immunodepressed patients, but it can be easily overlooked in otherwise healthy patients. This paper provides a detailed clinical description of a patient without immunosupression who developed multiple simultaneous neurological manifestations after the infection with C. neoformans.
The Effectiveness of Antibiotic-Lock Therapy for the Prevention of Catheter-Related Bacteremia in Patients on Chronic Hemodialysis: Case Controlled Study in a Veteran Population
Authors: Lau Suetping , Kam Linda W. , Lamarche Jorge , Peguero Alfredo M
Published: February 2010

Central venous catheters (CVCs) are frequently used in patients with chronic renal failure who require long-term hemodialysis. CVCs are also known to be a major source of bloodstream infections. Though antibiotic-lock therapy (ALT) has previously been used to prevent and treat catheter-related infections, the use of ALT remains controversial due to the lack of large prospective randomized controlled trials. The purpose of this study was to evaluate the effectiveness of ALT in the prevention of catheter-related bacteremia (CRB) in a veteran population who required chronic hemodialysis. This was a retrospective, case-controlled study. All patients who underwent hemodialysis using a tunneled central catheter (TCC) from January 1, 2006 to October 8, 2008 were examined. Eleven patients who received ALT were compared with 15 case control subjects. The effectiveness of ALT for prevention of CRB was determined by the incidence of CRBs during the study period and catheter removal secondary to a CRB. A total of 10,961 catheter-days were calculated from 47 TCCs among 26 patients. The two groups had similar demographics and risk factors for CRBs. There were a total of 17 incidences of CRBs with a rate of 1.55 incidences/1,000 catheter-days. The rate of CRB was significantly lower in the ALT group (0.69 incidences/1,000 catheter-days) than the control group (2.54 incidences/1,000 catheter-days), p=0.041. The rate of catheters removal due to a CRB was also significantly less in the ALT group (0.5 catheter removed/1,000 catheter-days) than the control group (2.41 catheter removed/1,000 catheter-days), p=0.041. Seven out of 9 patients died in the control group secondary to CRBs. Three patients died in the ALT group; however none of these deaths were associated with CRB. Our study results revealed that ALT is an effective way to prevent catheter related bacteremia among veterans with central venous catheter for chronic hemodialysis.
Hemoglobin Cycling in Hemodialysis Patients
Authors: Schneider Andreas , Asmus Gernot , Biggar Patrick , Braun Johann , Dellanna Frank , Fiedler Roman , Galle Jan , Girndt Matthias , Gondolf Klaus , Hahn Kai , Koch Michael , Müller Hans-Joachim , Rump Lars-Christian , Vosskühler Andre , Winkler Roland , Wanner Christoph
Published: February 2010

Anemia is a well-recognized feature in patients with chronic kidney disease (CKD). Recently, two large-scale trials, CREATE and CHOIR, pointed to the complexity of maintaining stable hemoglobin (Hb) levels over time. According to these data, patients failing to achieve the target range of Hb levels between 11–12 g/dL may be at increased risk of dying. Both low and high Hb levels are associated with increased cardiovascular events and death. One reason for failure to achieve stable Hb levels within the target range is Hb cycling. Several causes may be responsible for a cyclic pattern of Hb levels: drug-related factors such as differences in pharmacokinetics and bioavailability in erythropoiesis-stimulating agents (ESAs) as well as difficulties in iron supplementation may induce Hb instability in patients with CKD. Similarly, patient-related factors such as an inflammatory status or protein energy wasting are associated with this phenomenon. Further, variations in fluid balance and bio-compatibility of dialyzer membranes, by differentially affecting inflammation, render the hemodialysis treatment itself a risk factor for Hb cycling. Strategies to reduce Hb cycling are necessary to obtain improved clinical out-comes. This review will describe the phenomenon of Hb cycling, highlighting potential contributing factors and discussing the possible clinical conditions.
Regularity and decay properties of weak solutions to Navier–Stokes equations in general domains
Authors: Han Pigong
Published: February 2010

In this paper we consider the regularity of weak solutions and find some regular criteria for 3D non-stationary Navier–Stokes equations. Moreover, we establish decay rates for weak solutions in general domains by means of the spectral decomposition method of fractional powers of the Stokes operator.
The number of continuous curves in digital geometry
Authors: Samieinia Shiva
Published: February 2010

As a model for continuous curves in digital geometry, we study the Khalimsky-continuous functions defined on the integers and with values in the set of integers or the set of natural numbers. We determine the number of such functions on a given interval. It turns out that these numbers are related to the Delannoy and Schröder arrays, and a relation between these numbers is established.
Does controlling for comorbidity matter? DSM‐oriented scales and violent offending in chicago youth
Authors: Boots Denise Paquette , Wareham Jennifer
Published: February 2010

Mental health problems have long been linked to antisocial behaviors. Despite an impressive body of literature demonstrating this relationship and claims that comorbidity matters, few studies examine comorbidity using multiple distinct mental health indicators, with most studies instead adopting single or composite mental health measures. This study tested separate and comorbid effects of five DSM‐oriented mental health issues on self‐reported violence using a community‐based sample of Chicago youths from the Project on Human Development in Chicago Neighborhoods. Moreover, it utilized both primary caregiver and youth self‐reports of psychopathology across four developmental stages of childhood and adolescence. When examined separately, the results indicated affective/depressive, anxiety, attention deficit hyperactivity, and oppositional defiant/antisocial personality problems independently predicted violence. When considering comorbidity, however, only oppositional defiant and antisocial personality problems significantly predicted violence at any stage, regardless of informant type. Implications for future studies and policy are discussed. Aggr. Behav. 36:141–157, 2010. © 2010 Wiley‐Liss, Inc.
Conjugated Carbon Monolayer Membranes: Methods for Synthesis and Integration
Authors: Unarunotai Sakulsuk , Murata Yuya , Chialvo Cesar E. , Mason Nadya , Petrov Ivan , Nuzzo Ralph G. , Moore Jeffrey S. , Rogers John A.
Published: February 2010

Monolayer membranes of conjugated carbon represent a class of nanomaterial with demonstrated uses in various areas of electronics, ranging from transparent, flexible, and stretchable thin film conductors, to semiconducting materials in moderate and high‐performance field‐effect transistors. Although graphene represents the most prominent example, many other more structurally and chemically diverse systems are also of interest. This article provides a review of demonstrated synthetic and integration strategies, and speculates on future directions for the field.