bluuebunny/crossref_metadata_2025 huggingface dataset:
Informed consent when prescribing medication: A randomized controlled trial
Authors: Glicksman Jordan T. , Sherman Irvin , Rotenberg Brian W.
Published: November 2013

Objectives/Hypothesis

To determine patient recall of specific risks associated with medication prescription and whether or not handouts are an effective tool to augment the informed consent process.

Study Design

Double‐blinded, randomized, controlled trial.

Methods

Informed consent for prednisone prescriptions was studied by comparing the effect of a verbal discussion (describing 10 specific adverse drug reactions) in conjunction with a handout going over same, to a verbal discussion alone. Blinded assessments occurred by telephone interview 2 to 4 weeks following the intervention. Outcomes assessed were the number of risks of prednisone that patients could list and the number of risks they recalled having discussed with their physician. Other demographic details were also collected.

Results

Twenty‐five participants were randomly allocated to each group. Without prompting, the median number of risks spontaneously recalled by the handout group was not significantly different than the control group, and both groups had very low recall (two vs. one, P = .24). When provided a list of potential side effects, it was observed that the handout group recalled a higher median number of risks having been discussed with their physician compared to patients in the control group (eight vs. five, P = .003). The groups' demographics were otherwise identical.

Conclusions

Patients in general did not remember discussing adverse prednisone risks with their physician even a short time after the discussion took place. Although the patient handout resulted in improved recall of risks following the prescription of prednisone, its importance in the informed medication consent process remains an open question.

Level of Evidence

1b Laryngoscope, 124:1296–1300, 2014
Balloon laryngoplasty for pediatric laryngeal stenosis: Case series and systematic review
Authors: Wentzel Jennifer L. , Ahmad Sidrah M. , Discolo Christopher M. , Gillespie M. Boyd , Dobbie Allison M. , White David R.
Published: November 2013

Objectives/Hypothesis

The aim of this study was to systematically review available literature on the outcomes of children treated with balloon laryngoplasty (BLP) as a primary or adjuvant treatment for subglottic or laryngeal stenosis, as well as briefly report on a new series of 60 children treated at the Medical University of South Carolina from 2007 to 2013.

Study Design

Review of published case series and retrospective chart review.

Methods

A literature search was performed in PubMed and MEDLINE to identify trials that reported clinical outcomes of BLP in human patients under the age of 18 with subglottic or laryngeal stenosis. Single case reports and series studying the dilation of tracheal or bronchial stenosis alone were excluded. Hospital billing codes were used to identify appropriate patients for retrospective chart review. A successful outcome for chart review was determined to be decannulation of previous tracheostomy or avoidance of open laryngotracheoplasty or tracheostomy.

Results

Seven studies published between 1991 and 2012 met inclusion criteria and reported outcomes with success defined through improvement of symptoms, decrease in Myer‐Cotton level of stenosis, decannulation, or avoidance of reconstructive procedures. Including 60 children from our institution, 202 patients between 1 day and 22 years of age (average 35 months) underwent 457 dilations, with an average of 2.26 dilations per patient (2.25 in our population). The overall success rate was 64% (77% in our population). No complications were reported with subglottic or laryngeal dilations.

Conclusions

BLP is a highly effective, low‐risk alternative or adjunct to traditional reconstructive procedures in children with subglottic or laryngeal stenosis.

Level of Evidence

4 Laryngoscope, 124:1707–1712, 2014
Broadband Dielectric Relaxation Spectroscopy of Functionalized Biobased Castor Oil Copolymer Thermosets
Authors: Madbouly Samy A. , Xia Ying , Kessler Michael R.
Published: November 2013

Novel biorenewable copolymer thermosets are successfully synthesized by the ring‐opening metathesis polymerization (ROMP) of norbornenyl‐functionalized castor oil (NCO) and norbornenyl‐functionalized castor oil alcohol (NCA) with controlled amounts of 0.8 and 1.8 norbornene rings per fatty acid chain, respectively. The NCO and NCA monomers are mixed in different concentrations and simultaneously polymerized via ROMP using Grubbs catalyst. Broadband dielectric relaxation spectroscopy (BDRS) is used to investigate the molecular dynamics of the fully cured copolymer thermosets over a wide range of frequencies (5 × 10−2 to 0.5 × 107 Hz) at different constant temperatures (−70 to 125 °C). Four phenomena, namely α‐, β‐, and γ‐relaxation processes and ionic conductivity are observed for all the measured samples.

image
Genomewide association study in cervical dystonia demonstrates possible association with sodium leak channel
Authors: Mok Kin Y. , Schneider Susanne A. , Trabzuni Daniah , Stamelou Maria , Edwards Mark , Kasperaviciute Dalia , Pickering‐Brown Stuart , Silverdale Monty , Hardy John , Bhatia Kailash P.
Published: November 2013

Dystonia is a common movement disorder. A number of monogenic causes have been identified. However, the majority of dystonia cases are not explained by single gene defects. Cervical dystonia is one of the commonest forms without genetic causes identified. This pilot study aimed to identify large effect‐size risk loci in cervical dystonia. A genomewide association study (GWAS) was performed. British resident cervical dystonia patients of European descent were genotyped using the Illumina‐610‐Quad. Comparison was made with controls of European descent from the Wellcome Trust Case Control Consortium using logistic regression algorithm from PLINK. SNPs not genotyped by the array were imputed with 1000 Genomes Project data using the MaCH algorithm and minimac. Postimputation analysis was done with the mach2dat algorithm using a logistic regression model. After quality control measures, 212 cases were compared with 5173 controls. No single SNP passed the genomewide significant level of 5 × 10−8 in the analysis of genotyped SNP in PLINK. Postimputation, there were 5 clusters of SNPs that had P value <5 × 10−6, and the best cluster of SNPs was found near exon 1 of NALCN, (sodium leak channel) with P = 9.76 × 10−7. Several potential regions were found in the GWAS and imputation analysis. The lowest P value was found in NALCN. Dysfunction of this ion channel is a plausible cause for dystonia. Further replication in another cohort is needed to confirm this finding. We make this data publicly available to encourage further analyses of this disorder. © 2013 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.
Taphonomic Study of Japanese Quail (Coturnix japonica) Bone Modification Resulting from the Burial and Feeding Behavior of the American Burying Beetle (Nicrophorus americanus)
Authors: Dirrigl F. J. , Perrotti L.
Published: November 2013

Actualistic and observational studies of bird bone disarticulation, wear, and damage contribute to understanding the development of fossil assemblages and distinguishing non‐cultural from cultural deposition. The American burying beetle (Nicrophorus americanus) is known for seeking small bird carcasses to lay eggs and provide food for its brooding larvae. In this study, we examine the resulting body parts of Japanese quail (Coturnix japonica) carcasses to investigate the taphonomy resulting from the burial and feeding behavior of the beetles. Evidence of breakage, cracking, embedding, flaking, furrowing, pitting, polishing, and staining was observed on the bones of carcasses balled and brooded by the beetles. Based on the results, the implication of potential bird carcass intrusion in archaeological sites, where the beetle is found, is discussed. Copyright © 2013 John Wiley & Sons, Ltd.
Birds in Subsistence and Culture at Viking Age Sites in Denmark
Authors: Gotfredsen A. B.
Published: November 2013

This paper reviews the evidence for consumption and use of birds at Danish Viking Age sites. The presence and diversity of wild and domestic bird species were studied on the basis of the avian material retrieved from sites representing a wide range of different habitats covering a period from the Late Germanic Iron Age to early medieval times (ca 5th–12th centuries ad). A large diversity of at least 20 avian families with more than 60 taxa in addition to domestic fowl was documented. Although variation in species diversity and abundance in the assemblages were influenced by recovery methods, some genuine differences emerged regarding site type as well as topographical and geographic variation. Marked differences among avian species within certain bird families were revealed; herons (Ardeidae), birds of prey (Accipitridae), cranes (Gruidae), tetraonids (Tetraonidae) and waders (Scolopacidae) occurred more commonly at certain categories of sites such as high‐status manorial and early urban sites. The usage of eagle feathers was evidenced by cut marks on eagle wing bones and falconry was documented at a few high‐status sites. Copyright © 2013 John Wiley & Sons, Ltd.
Strategy, market orientation and performance: the political context
Authors: Ormrod Robert P. , Zaefarian Ghasem , Henneberg Stephan C. , de Vries Philippe
Published: November 2013

This paper investigates the fit between the strategic posture of a political party and its political market orientation, and analyses the impact of this fit on party performance. For this purpose, a configuration theory logic is applied to the context of the political market; in particular, we develop strategic profiles (i.e. strategic postures and political market orientation) of four Belgian political parties represented in the Flemish Parliament. By comparing the strategic profiles derived from a questionnaire administered to 3148 party members with those of ‘theoretically ideal’ profiles, we uncover the ‘strategic misfit’ (or ‘misalignment’) for each party and then relate this misfit to party performance. Results indicate that there is a strong, negative relationship between the misalignment of actual and perceived strategic profiles on the one hand and performance on the other. However, the ‘ideal profiles’ differ with the strategic posture of a party. Thus, our findings show that it is not so much the strategic posture itself that will determine superior performance, but it is the strategic posture that the party aligns with implementing a particular political market orientation that is the most important factor. Copyright © 2013 John Wiley & Sons, Ltd.
PERSONAL AND SCHOOL CULTURAL FACTORS ASSOCIATED WITH THE PERCEPTIONS OF TEACHERS’ EFFICACY IN HANDLING STUDENT MISBEHAVIOR
Authors: Tsouloupas Costas N. , Carson Russell L. , Matthews Russell A.
Published: November 2013

One approach for understanding teachers’ behavioral responses to classroom student misbehavior is through the perceptions of efficacy in handling this stressor. The present study investigated the relationship and predictive ability of personal and school cultural factors as they relate to perceptions of teachers’ efficacy in handling student misbehavior (TEHSM). Participants were 344 primary (n = 189) and secondary (n = 155), full‐time, public school teachers from a southeastern state in the USA. Teachers completed online self‐report measures of TEHSM and all personal and school cultural factors. Student socioeconomic status (SES) information was provided by the school districts. Structure equation modeling (SEM) results indicated the final empirical model to account for 66% of the variance in TESHM, with professional development and student SES having the strongest association with TEHSM. This study provides a vital step towards understanding factors that drive teachers’ perceptions of their efficacy in handling misbehaving students.
iTRAQ‐based proteomic analysis of dioscin on human HCT‐116 colon cancer cells
Authors: Chen Hao , Xu Lina , Yin Lianhong , Xu Youwei , Han Xu , Qi Yan , Zhao Yanyan , Liu Kexin , Peng Jinyong
Published: November 2013

Dioscin shows various pharmacological effects. However, its activity on colorectal cancer is still unknown. The present work showed that dioscin significantly inhibited cell proliferation on human HCT‐116 colon cancer cells, and affected Ca2+ release and ROS generation. The content of nitric oxide (NO) and its producer inducible NO synthase (iNOS) associated with DNA damage and aberrant cell signaling were assayed using the kits. DNA damage and cell apoptosis caused by dioscin were also analyzed through single‐cell gel electrophoresis and in situ terminal deoxynucleotidyl transferase dUTP nick‐end labeling assays. The results showed that dioscin increased the levels of NO and inducible NO synthase. The comet length in dioscin‐treated groups was much longer than that of the control group, and the number of terminal deoxynucleotidyl transferase dUTP nick‐end labeling positive cells (apoptotic cells) was significantly increased by the compound (p < 0.01). Furthermore, dioscin caused mitochondrial damage and G2/M cell cycle arrest through transmission electron microscopy and flow cytometry analysis, respectively. To study the cytotoxic mechanism of dioscin, an iTRAQ‐based proteomics approach was used. There were 288 significantly different proteins expressed in response to dioscin, which were connected with each other and were involved in different Kyoto Encyclopedia of Genes and Genomes pathways. Then, some differentially expressed proteins involved in oxidative phosphorylation, Wnt, p53, and calcium signaling pathways were validated by Western blotting and quantitative real‐time PCR assays. Our work elucidates the molecular mechanism of dioscin‐induced cytotoxicity in colon cancer cells, and the identified targets may be useful for treatment of colorectal cancer in future.
Influence of Water Vapor Addition on the Surface Modification of Polyethylene in an Argon Dielectric Barrier Discharge
Authors: Van Deynse Annick , De Geyter Nathalie , Leys Christophe , Morent Rino
Published: November 2013

In this paper, water vapor up to 41% is added to an argon dielectric barrier discharge at medium pressure to profoundly investigate the effect of water vapor addition on the surface modification of polyethylene (PE). Contact angle measurements show that the wettability of PE significantly increases after a pure argon plasma treatment. However, the addition of water vapor to the argon feeding gas can give an extra 30% decrease in water contact angle. This extra decrease is due to the incorporation of additional oxygen containing groups such as CO, CO, OCO, and OCO. AFM results reveal that the surface roughness of PE only increases for plasma treatments with no or low water vapor concentrations. All this indicates that a water vapor based plasma can be an excellent tool for the surface activation of PE.
Development of a neuromedin U–human serum albumin conjugate as a long‐acting candidate for the treatment of obesity and diabetes. Comparison with the PEGylated peptide
Authors: Neuner Philippe , Peier Andrea M. , Talamo Fabio , Ingallinella Paolo , Lahm Armin , Barbato Gaetano , Di Marco Annalise , Desai Kunal , Zytko Karolina , Qian Ying , Du Xiaobing , Ricci Davide , Monteagudo Edith , Laufer Ralph , Pocai Alessandro , Bianchi Elisabetta , Marsh Donald J. , Pessi Antonello
Published: November 2013

Neuromedin U (NMU) is an endogenous peptide implicated in the regulation of feeding, energy homeostasis, and glycemic control, which is being considered for the therapy of obesity and diabetes. A key liability of NMU as a therapeutic is its very short half‐life in vivo. We show here that conjugation of NMU to human serum albumin (HSA) yields a compound with long circulatory half‐life, which maintains full potency at both the peripheral and central NMU receptors. Initial attempts to conjugate NMU via the prevalent strategy of reacting a maleimide derivative of the peptide with the free thiol of Cys34 of HSA met with limited success, because the resulting conjugate was unstable in vivo. Use of a haloacetyl derivative of the peptide led instead to the formation of a metabolically stable conjugate. HSA–NMU displayed long‐lasting, potent anorectic, and glucose‐normalizing activity. When compared side by side with a previously described PEG conjugate, HSA–NMU proved superior on a molar basis. Collectively, our results reinforce the notion that NMU‐based therapeutics are promising candidates for the treatment of obesity and diabetes. Copyright © 2013 European Peptide Society and John Wiley & Sons, Ltd.
Damage characteristics of n‐GaN thin film surfaces etched by N2 plasmas
Authors: Kawakami Retsuo , Niibe Masahito , Nakano Yoshitaka , Shirahama Tatsuo , Yamada Tetsuya , Aoki Kazuma , Takabatake Mari , Tominaga Kikuo , Mukai Takashi
Published: November 2013

Damage characteristics of n‐GaN surfaces etched by capacitively‐coupled radio frequency N2 plasma, generated with a high applied voltage of 400 V, was studied in terms of synergistic effect between ion bombardment and ultraviolet (UV) light irradiation. The result was compared with that obtained with a low applied voltage of 200 V. Morphology of the surface etched at a low gas pressure of 10 mTorr is similar to that of the as‐grown surface even with increasing etching time, whereas N/Ga ratio at the surface decreases. The result can be explained in terms of the physical etching, though the surface is irradiated with the UV light emitted from the plasma. The result obtained at the low gas pressure is independent of the applied voltage. In contrast, the characteristic at the surface etched at a high gas pressure of 50‐100 mTorr depends on the applied voltage. A morphological change in the surface etched with the high applied voltage occurs, whereas the N/Ga ratio increases The increase in the N/Ga ratio is not reproduced by the simulation, which implies the contribution of the UV light irradiation. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Band structures of Si/InGaP heterojunctions by using surface‐activated bonding
Authors: Liang Jianbo , Morimoto Masashi , Nishida Shota , Shigekawa Naoteru
Published: November 2013

The band structure of p‐Si/n‐InGaP heterojunctions fabricated by using surface‐activated bonding (SAB) was investigated by measuring their current‐voltage (I‐V) and capacitance‐voltage (C‐V) characteristics. The I‐V characteristics of p‐Si/n‐InGaP junctions showed rectifying properties similarly to p‐Si/n‐GaAs junctions. The conduction band discontinuity of the p‐Si/n‐InGaP junctions was determined to be 0.41 eV from C‐V measurements, which indicated that the Si/InGaP junctions revealed the type‐I band line‐up in contrast to the Si/GaAs junctions. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Ion beam analysis of quaternary Heusler alloy Co2(Mn1–xFex)Si(111) epitaxially grown on Ge(111)
Authors: Kawakubo Yuki , Noguchi Yuuya , Hirata Tomoaki , Narumi Kazumasa , Sakai Seiji , Yamada Shinya , Hamaya Kohei , Miyao Masanobu , Maeda Yoshihito
Published: November 2013

We have investigated crystal quality of Co2(Mn1–xFex)Si (CMFS) epitaxially grown on Ge(111) by using Rutherford backscattering spectrometry and axial ion channeling technique. It was found that the CMFS/Ge and Co2FeSi (CMFS with x = 1)/Ge have larger static atomic displacement than Fe based ternary Heusler alloy Fe2MnSi and Fe2CoSi/Ge(111). Quaternary alloys may be affected by increase of mixing entropy. Significant disordering at the interface of 0.75CMFS was found, and discussed on basis of thermodynamics. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Growth kinetics and interface structure of copper silicides studied by atom probe tomography
Authors: Ibrahim M. , Parditka B. , Fuhrich A. , Balogh Z. , Stender P. , Erdélyi Z. , Schmitz G.
Published: November 2013

Laser‐assisted atom probe shows a unique potential in the analysis of embedded Si/metal interfaces, owing to its ability to deliver 3D information with atomic resolution. The interface structures in tri‐layer specimens Cu/amorphous Si/Cu are investigated by this technique. For amorphous Si (a‐Si) deposited on Cu, a sharp transition occurred with an interface width of 2.4 nm. On the contrary, a much broader mixed zone, 5.3 nm wide, is formed when Cu is deposited on top of a‐Si. Only in the latter case, brief annealing leads to immediate nucleation of the Cu3Si. Secondary neutral mass spectrometry confirmed independently the existence of this asymmetry in phase formation and demonstrates linear growth kinetics of the silicide. (© 2013 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Surface Supported Gold–Organic Hybrids: On‐Surface Synthesis and Surface Directed Orientation
Authors: Zhang Haiming , Franke Jörn‐Holger , Zhong Dingyong , Li Yan , Timmer Alexander , Arado Oscar Díaz , Mönig Harry , Wang Hong , Chi Lifeng , Wang Zhaohui , Müllen Klaus , Fuchs Harald
Published: November 2013

The surface‐assisted synthesis of gold–organic hybrids on Au (111) and Au (100) surfaces is repotred by thermally initiated dehalogenation of chloro‐substituted perylene‐3,4,9,10‐tetracarboxylic acid bisimides (PBIs). Structures and surface‐directed alignment of the Au–PBI chains are investigated by scanning tunnelling microscopy in ultra high vacuum conditions. Using dichloro‐PBI as a model system, the mechanism for the formation of Au–PBI dimer is revealed with scanning tunnelling microscopy studies and density functional theory calculations. A PBI radical generated from the homolytic C‐Cl bond dissociation can covalently bind a surface gold atom and partially pull it out of the surface to form stable PBI‐Au hybrid species, which also gives rise to the surface‐directed alignment of the Au–PBI chains on reconstructed Au (100) surfaces.
On the Phenomenological Reconstruction of Complex Systems—The Scale‐Free Conceptualization Hypothesis
Authors: Aranda‐Corral Gonzalo A. , Borrego‐Dí­az Joaquín , Galán‐Páez Juan
Published: November 2013

Phenomenological reconstruction of a complex system (CS) from collected and selected data allows us to work with formal models (representations) of the system. The task of building a qualitative model necessitates the formalization of relationships among observations and concrete features. Formal concept analysis can help to understand the conceptual structure behind these qualitative representations by means of the so‐called concept lattices (CLs). The study of these kinds of semantic networks suggests that a strong relationship exists between its topological structure and its soundness/usefulness as a qualitative representation of the CS. The present paper is devoted to this question by presenting the so‐called scale‐free conceptualization hypothesis. The hypothesis claims that a scale‐free distribution of node connectivity appears on the CL associated to complex systems (CLCS) only when two requirements hold: CLCS is useful both to represent qualitative and reliable attributes on the CS, as well as to provide a basis for (qualitatively) successfully reasoning about the CS. Experiments revealed that the topologies of CLCS are similar when the amount of information on the CS is sufficient, whereas it is different in other CLs associated to random formal contexts or to other systems in which some of the former requirements do not hold. Copyright © 2013 John Wiley & Sons, Ltd.
Lanthanide‐doped hollow nanomaterials as theranostic agents
Authors: Kang Xiaojiao , Li Chunxia , Cheng Ziyong , Ma Ping'an , Hou Zhiyao , Lin Jun
Published: November 2013

The field of theranostics has sprung up to achieve personalized medicine. The theranostics fuses diagnostic and therapeutic functions, empowering early diagnosis, targeted drug delivery, and real‐time monitoring of treatment effect into one step. One particularly attractive class of nanomaterials for theranostic application is lanthanide‐doped hollow nanomaterials (LDHNs). Because of the existence of lanthanide ions, LDHNs show outstanding fluorescent and paramagnetic properties, enabling them to be used as multimodal bioimaging agents. Synchronously, the huge interior cavities of LDHNs are able to be applied as efficacious tools for storage and delivery of therapeutic agents. The LDHNs can be divided into two types based on difference of component: single‐phase lanthanide‐doped hollow nanomaterials and lanthanide‐doped hollow nanocomposites. We describe the synthesis of first kind of nanomaterials by use of hard template, soft template, template‐free, and self‐sacrificing template method. For lanthanide‐doped hollow nanocomposites, we divide the preparation strategies into three kinds (one‐step, two‐step, and multistep method) according to the synthetic procedures. Furthermore, we also illustrate the potential bioapplications of these LDHNs, including biodetection, imaging (fluorescent imaging and magnetic resonance imaging), drug/gene delivery, and other therapeutic applications. WIREs Nanomed Nanobiotechnol 2014, 6:80–101. doi: 10.1002/wnan.1251

This article is categorized under:

Diagnostic Tools > In Vivo Nanodiagnostics and Imaging

Nanotechnology Approaches to Biology > Nanoscale Systems in Biology
Prospective Study to Compare Peri‐operative Hemodynamic Alterations following Preparation for Pheochromocytoma Surgery by Phenoxybenzamine or Prazosin
Authors: Agrawal Ritesh , Mishra Saroj Kanta , Bhatia Eesh , Mishra Anjali , Chand Gyan , Agarwal Gaurav , Agarwal Amit , Verma Ashok Kumar
Published: November 2013

Background

Prospective studies comparing the efficacy of selective versus nonselective alpha blockers for preoperative preparation of pheochromocytoma (PCC) are lacking. In this prospective nonrandomized study, we compared the outcome of preoperative preparation with phenoxybenzamine (PBZ) and prazosin (PRZ) in terms of perioperative hemodynamic alterations.

Methods

The study was conducted at a tertiary referral center from July 2010 to December 2012. Thirty‐two patients with PCC underwent operation after adequate preparation with PBZ (n = 15) or PRZ (n = 17). Five pediatric and adolescent patients were excluded because of different hemodynamics in this population. Perioperative monitoring was done for pulse rate (PR) and blood pressure (BP) alterations, occurrence of arrhythmias, and time taken to achieve hemodynamic stability. Groups were compared with the Mann–Whitney test, Student’s t test, and the χ2 test as applicable.

Results

Patients in the two groups were similar in age, gender, 24 h urinary metanephrine and normetanephrine levels, and type of procedure. Patients prepared with PRZ had significantly more intraoperative episodes of transient hypertension (systolic BP ≥ 160 mmHg) and hypertensive urgency (BP > 180/110 mmHg) (p 0.02, 0.03, respectively). More patients receiving PRZ suffered from transient severe hypertension (SBP ≥ 220 mmHg) (p 0.03). The PRZ group also had more median maximum SBP (233 mmHg vs PBZ 181.5 mmHg) (p = 0.01) and lesser median minimum SBP (71 mmHg vs PBZ 78 mmHg) (p 0.03). No significant differences were found between the study groups for changes in PR, postoperative BP alterations, occurrence of arrhythmias, and time taken to achieve hemodynamic stability.

Conclusions

PBZ was found superior to PRZ in having fewer intraoperative hemodynamic fluctuations.
Utilization and Impact of Repeat Biopsy for Follicular Lesion/Atypia of Undetermined Significance
Authors: Broome J. T. , Cate F. , Solorzano C. C.
Published: November 2013

Background

The Bethesda System for Reporting Thyroid Cytopathology (BSRTC) created a new diagnostic category, follicular lesion/atypia of undetermined significance (FLUS/AUS). The recommended management of FLUS/AUS lesions is repeat biopsy to re‐classify the lesion and guide therapy. Prior surgical studies suggest a higher than expected malignancy rate for FLUS/AUS. The present study evaluates a large institutional experience with all FLUS/AUS lesions analyzing use and impact of repeat biopsy.

Methods

A total of 322 patients with FLUS/AUS cytology have been retrospectively identified since adoption of the BSRTC (2/2009–6/2012). Patient demographics, the results of clinical follow‐up, repeat biopsy, or surgical pathology results were evaluated.

Results

Among the 322 patients, 16 had concurrent cytology of higher acuity and were excluded. For the remaining 306 patients, 101 (33 %) underwent repeat biopsy, yielding 49 (48.5 %) with FLUS/AUS, 43 (42.5 %) with benign cytology, and 9 (9 %) with higher acuity cytology. Among the 205 patients without repeat biopsy, 117 (57 %) chose thyroidectomy, and 88 (43 %) are being observed. Overall, 170/306 (55.6 %) patients underwent surgery to remove the index lesion, yielding a malignancy rate of 16.5 %. In contrast, the malignancy rate for the entire cohort was 28/306 (9 %).

Conclusions

Repeat biopsy was underutilized in FLUS/AUS cases. Repeat biopsy allows a significant proportion of FLUS/AUS patients without other indications for surgery to move to surveillance. In patients who have indications for thyroidectomy regardless of FLUS/AUS results, repeat biopsy does not appear necessary. Malignancy and thyroidectomy rates were similar among patients who did or did not have a repeat biopsy. Further data must be obtained to determine the long‐term outcomes for surveillance of FLUS/AUS lesions in patients who do not undergo surgical removal.
Association Between Serum Thyrotropin Concentration and Growth of Asymptomatic Papillary Thyroid Microcarcinoma
Authors: Sugitani Iwao , Fujimoto Yoshihide , Yamada Keiko
Published: November 2013

Background

Thyrotropin (TSH) is a known thyroid growth factor. Several studies have suggested its potential role in carcinogenesis and the progression of differentiated thyroid carcinoma. We have been conducting a prospective trial of nonsurgical observation for asymptomatic papillary thyroid microcarcinoma (PMC) since 1995. The aim of this study was to investigate whether serum TSH concentrations can be used to predict PMC growth.

Methods

This study examined 415 asymptomatic PMCs. Three hundred twenty‐two patients decided to undergo nonsurgical observation by ultrasonography and were followed for ≥2 years.

Results

After a mean of 6.5 years of observation (range 2–22 years), 25 lesions (6 %) had increased in size, 377 (91 %) showed no change and 13 (3 %) had decreased in size. Both baseline TSH and mean TSH during follow‐up for PMC that increased in size did not differ significantly from those lesions that were unchanged or decreased in size. Increases in size were seen in 0 of 18 (0 %), 15 of 260 (6 %), 10 of 126 (8 %), and 0 of 11 (0 %) for PMCs with baseline TSH < 0.50, 0.50–1.99, 2.00–3.99, and ≥4.00 mIU/L, respectively. A logistic regression model analyzing the association between baseline TSH and outcome showed an odds ratio of 1.01 (95 % confidence interval [CI], 0.66–1.29). No significant correlations were apparent between mean TSH during follow‐up and change in PMC volume (r = 0.019, p = 0.70).

Conclusions

No significant association between TSH and tumor progression was verified during the nonsurgical observation trial for PMC. TSH is not a good predictor of PMC growth.
Mid-Term Results following Ulna Shortening Osteotomy
Authors: Fufa Duretti T. , Carlson Michele G. , Calfee Ryan P. , Sriram Nandita , Gelberman Richard H. , Weiland Andrew J.
Published: November 2013

Background

Successful short-term results of diaphyseal ulna shortening osteotomy are documented in both idiopathic and post-traumatic ulnar impaction.

Questions/Purposes

The purpose of this study was to evaluate the mid-term outcomes of ulnar shortening osteotomy with respect to radiographic assessment of corrected alignment and healing as well as patient satisfaction, pain, and function assessed using the Disability of the Arm, Shoulder, and Hand (DASH) score.

Patients and Methods

This retrospective case series included follow-up of 33 patients with ulnar impaction syndrome following ulna shortening osteotomy at a minimum of 5 years. Patient-rated outcomes included satisfaction, pain assessment, and DASH score. Pre- and postoperative radiographs were reviewed to quantify ulnar variance and osteotomy union rates. Subsequent operations were also recorded.

Results

Average follow-up was 10 years (range, 5–20 years). Eighty-eight percent of patients reported they were either satisfied or very satisfied with the procedure and 91% reported they would have the same procedure again. Average pain rating was 2 out of 10 at final follow-up. The mean DASH score was 11 (range, 0–39). Removal of hardware was performed in 10 patients (30%). The overall rate of reoperation was 45%.

Conclusions

Ulna shortening osteotomy yields reliable midterm satisfaction and pain relief in patients with idiopathic and post-traumatic ulnar impaction syndrome. Reoperation is frequent. Consistent with results of short-term follow-up, plate irritation requiring removal remains the most common cause for reoperation over time.
Comment conjuguer approche psychothérapique et nouveaux paradigmes pharmacologiques ?
Authors: Aubin H.-J.
Published: November 2013

L’Agence européenne des médicaments a récemment approuvé la mise sur le marché du premier médicament visant la réduction de la consommation chez les personnes alcoolodépendantes. Jusque là, tous les médicaments proposés dans l’alcoolodépendance s’adressaient à des patients devant viser (implicitement ou explicitement) l’abstinence. Ce nouveau paradigme pharmacologique a évidemment un impact marqué sur l’approche psychothérapeutique des patients.

Entretien motivationnel

Le nouveau paradigme pharmacologique permet de renforcer l’idée que le choix de l’objectif du traitement (réduction ou abstinence) ne doit pas être imposé par le thérapeute, mais sera le fruit de l’interaction thérapeute-patient. Le respect du choix de l’objectif par le patient permet d’éviter le phénomène de « réactance psychologique », phénomène induit par la menace d’entraver la liberté d’action d’un individu. La réactance psychologique se manifeste par la tentative de restaurer cette liberté perdue. D’où des réactions paradoxales à la prescription de l’abstinence par le thérapeute.

Thérapie cognitivo-comportementale de l’alcoolodépendance

Les programmes les plus classiquement proposés en France sont orientés vers l’abstinence. Les stratégies classiques de gestion du craving ou le développement d’un plan d’urgence pour faire face à un faux-pas sont typiquement adaptées à l’objectif de l’abstinence, mais pas à celui de la réduction. De nouveaux principes doivent être intégrés pour la réduction de la consommation d’alcool : définition de l’objectif de consommation (fréquence, quantité, situations), monitoring rigoureux, et stratégies de modération de la consommation (rythme, alternance avec boissons non alcoolisées,…). Finalement, alors que l’état d’esprit de la prise en charge est notablement modifié avec l’intégration du nouveau paradigme vers plus de souplesse et d’acceptation par le thérapeute, l’essentiel des composantes psychothérapiques reste similaire à l’approche classique orientée vers l’abstinence.
Réhabilitation du déficit d’initiation de l’activité chez les personnes souffrant de schizophrénie : utilisation de l’outil prACTice
Authors: Véhier A.
Published: November 2013

La plupart des troubles psychiques sont associés à une perturbation des fonctions cognitives qui engagent des processus attentionnels [1]. Or ces processus constituent un facteur prédictif du fonctionnement global des patients, notamment en ce qui concerne ses facultés d’entreprendre et d’entretenir des activités quotidiennes, sociales ou professionnelles. Cela constitue à moyen terme un facteur de rechute et de passage à la chronicité non négligeable. Au sein du Centre de réhabilitation d’évaluation de soins et d’orientation en psychiatrie (CRESOP) se développe un outil d’entraînement cognitif informatisé et innovant axé sur un processus attentionnel particulièrement pertinent dans l’initiation d’activités : l’attention préparatoire [3]. L’effet de ce programme est évalué par une étude randomisée à deux bras et en double aveugle. Le programme prACTice dans sa version active consiste pour le sujet à activer et maintenir des attentes en lien avec des objectifs de la vie quotidienne qui lui sont proposés (e.g., « Faire des courses »). Ensuite des objets cibles sont présentés et le sujet doit répondre s’ils sont utiles ou non pour réaliser l’objectif. Les temps de réaction et les erreurs sont enregistrés. Le niveau de difficulté augmente durant l’entraînement. Des temps de réaction plus rapides indiquent que les sujets pré-activent des représentations mentales en lien avec l’objectif proposé. Cela devrait permettre de manière plus globale, une augmentation de leurs capacités à initier des actions au quotidien (généralisation de l’effet). Nous conceptualiserons cette démarche à l’aide du modèle de Frith [2].
Ocytocine et comportement maternel : de l’adaptation à la pathologie
Authors: Koehl M.
Published: November 2013

L’ocytocine est connue pour son implication dans le développement des relations d’attachement entre individus en général, et dans le cas qui nous intéressera plus particulièrement ici, entre une mère et sa progéniture. Ces relations s’expriment à travers la mise en place d’un comportement maternel dont la qualité va conditionner le devenir phénotypique de l’enfant, chez l’Homme comme chez l’animal. Comprendre donc, à travers les modèles animaux, les mécanismes qui gouvernent la mise en place et le maintien de ce comportement apparaît fondamental. Dans ce contexte, nous ferons le point des connaissances acquises chez le rongeur sur les liens entre ocytocine et soin maternel, en conditions physiologiques et pathologiques. En particulier, nous dresserons un bilan de la littérature associant le niveau d’activité du système ocytocinergique central au niveau de soin maternel prodigué par les mères et détaillerons les structures mises en jeu. Nous évaluerons également le rôle de l’ocytocine dans la transmission du profil comportemental maternel d’une génération à la suivante. Enfin, nous nous intéresserons aux modèles de gestations pathologiques qui peuvent entraîner des troubles du post-partum se traduisant par un déficit d’attachement. Nous testerons sur ces modèles l’hypothèse selon laquelle une altération du système ocytocinergique pourrait être impliquée dans l’apparition des troubles de l’attachement, suggérant que ce système pourrait constituer une cible thérapeutique importante dans de telles pathologies.
Remédiation cognitive des troubles de l’intentionnalité dans la schizophrénie
Authors: Peyroux E.
Published: November 2013

La cognition sociale, définie par Penn et al. [3] comme : « la faculté de comprendre soi-même et autrui dans le monde social » est déficitaire chez la plupart des personnes souffrant de schizophrénie [2]. Cette composante est pourtant d’une importance fondamentale pour le fonctionnement social, professionnel et interpersonnel [1]. Dans la schizophrénie, 5 processus du domaine de la cognition sociale sont régulièrement altérés : la théorie de l’esprit, la perception sociale, les connaissances sociales, le style attributionnel et les processus émotionnels. Dans le champ de la remédiation cognitive, plusieurs équipes ont développé des programmes afin de cibler les déficits de cognition sociale. On peut décomposer ces interventions en fonction de leur base théorique. Certaines procédures, qualifiées de « larges », reposent sur l’idée que les compétences neurocognitives renforcent les aptitudes relationnelles des patients, d’autres programmes « ciblés », plus restrictifs, permettent d’améliorer efficacement une composante de la cognition sociale, enfin, plus récemment, des interventions « globales », tenant compte de l’ensemble des processus de la cognition sociale altérés dans la schizophrénie ont été développés [4]. Le programme RC2S (Remédiation Cognitive de la Cognition Sociale) mis au point à Lyon est ainsi le premier programme en langue française entrant dans le champ des interventions globales. Cette intervention est individualisée et repose en partie sur l’outil informatique par le biais de situations de réalité virtuelle. Ce type de technologie offre en effet la possibilité de construire des environnements réalistes en 3D où toutes les composantes d’une interaction sociale réelle peuvent être mises en jeu. Des études de cas uniques multiples sont aujourd’hui en cours afin d’évaluer la pertinence de cet outil pour la prise en charge des déficits de cognition sociale chez les personnes souffrant de schizophrénie ou de troubles associés.
Impact de l’évaluation de la métacognition « on line » sur les performances cognitives auprès d’une population non clinique
Authors: Quilès C. , Prouteau A. , Verdoux H.
Published: November 2013

Contexte

La métacognition se définit comme la surveillance et le contrôle de ses propres processus cognitifs [1,3] au cours de la tâche cognitive, « on line ».

Objectif

Évaluation de l’impact de la mesure de la métacognition « on line » sur les performances cognitives auprès d’une population non clinique.

Methods

Les participants ont été recrutés parmi les donneurs de plaquettes de l’Établissement français du sang de Bordeaux, France. Les critères d’exclusion étaient les antécédents de trouble psychiatrique sévère évalués par le Mini International Neuropsychiatric Interview, l’abus d’alcool ou de substance et la prise régulière de psychotropes. Un premier groupe (n = 20) a passé la version standard de tests évaluant les fonctions exécutives (Modified Card Sorting Test), la mémoire épisodique (Rappel Libre Rappel Indicé 16 ou RLRI16), la mémoire de travail (Mémoire des chiffres Weschler Adult Intelligence Scale III), la cognition sociale (Facial Test). Un deuxième groupe (n = 50) a passé la version métacognitive de ces mêmes tests, consistant en l’ajout après chaque item du test neuropsychologique d’une question de confiance en sa réponse et d’une question de validation de sa réponse [2,4]. Les caractéristiques démographiques et les performances neuropsychologiques des deux groupes ont été comparées.

Résultats

Aucune différence significative n’a été retrouvée entre les deux groupes concernant les caractéristiques démographiques. Le groupe ayant passé la version métacognitive présentait de meilleurs résultats que le groupe standard au test de mémoire des chiffres (t = 2,12, ddl = 68, p = 0,04), mais des résultats moindres au RLRI16 (2e rappel libre t = −2,50, ddl = 68, p = 0,01 ; 3e rappel libre t = −3,52, ddl = 68, p = 0,0008).

Conclusion

L’évaluation de la métacognition « on line » améliore les performances en mémoire de travail en forçant la concentration sur la tâche. Elle altère les performances en mémoire épisodique, en agissant comme un distracteur. Il paraît essentiel de prendre en compte ces effets dans les programmes de remédiation cognitive.
Évolution de la densité de matière grise à disparition des symptômes dans l’état de stress post-traumatique. Étude en IRM à haute résolution : Voxel Based Morphometry (VBM)
Authors: Boukezzi S. , Rousseau P.F. , Cancel A. , Comte M. , Khalfa S.
Published: November 2013

Introduction

Une controverse existe concernant la nature et l’origine des réductions de densité de matière grise (dMG) dans l’État de Stress Post-Traumatique (ESPT). Ces atrophies pourraient être des facteurs de vulnérabilité pour le développement de l’ESPT [2] ou bien être la conséquence des symptômes liés au traumatisme [1]. Le but de cette étude a été d’étudier la question. Notre hypothèse est que les principales atrophies décrites dans la littérature évolueront avec l’amélioration des symptômes une semaine et 6 mois après une thérapie de désensibilisation et de retraitement de l’information par les mouvements oculaires (EMDR).

Patients et méthodes

Nous avons étudié l’évolution des symptômes et la dMG chez 9 sujets atteints d’ESPT et chez 17 sujets témoins avant, une semaine et 6 mois après thérapie. Cette étude a été réalisée avec une technique d’IRM à haute résolution : la Voxel Based Morphometry (VBM).

Résultats

Avant thérapie, les patients atteints d’ESPT présentaient des atrophies au niveau de 4 régions incluant le lobe frontal (Aire de Brodmann [BA] 32 droite, BA 10 droite, BA 9 gauche, BA 11 droite), le lobe pariétal (BA 43 droite, BA 40 droite), le lobe temporal (BA 42 droite, BA 38 droite) et le cervelet postérieur gauche. L’intensité des symptômes a diminué une semaine et 6 mois après thérapie. Pour BA 38, nous avons observé une augmentation de la dMG une semaine et 6 mois après traitement, mais pas pour les autres régions.

Discussion et conclusion

Les atrophies trouvées dans cette étude sont en accord avec la littérature et expliqueraient notamment les déficits concernant les processus de peur et la régulation des émotions [3]. Certaines structures semblent constituer des facteurs de risque et leurs atrophies pourraient préexister avant la venue de l’événement traumatique alors que d’autres atrophies pourraient être la conséquence de cet événement.
Troubles neuro-développementaux, troubles du spectre de l’autisme
Authors: Crocq M.-A.
Published: November 2013

Le DSM-5 a introduit le chapitre des « Troubles NeuroDéveloppementaux » (TND) qui regroupe certaines catégories qui appartenaient aux Troubles apparaissant dans la petite enfance, l’enfance et l’adolescence. Les TND incluent les troubles du développement intellectuel, de la communication, du spectre de l’autisme (TSA), des apprentissages, moteurs (p. ex., Tourette), et le déficit de l’attention/hyperactivité. La catégorie TSA remplace les Troubles Envahissants du Développement. Les TSA sont définis par deux critères seulement : déficit persistant dans la communication et les interactions sociales, intérêts et comportements limités et stéréotypés. Ces modifications peuvent influencer les recherches et l’accès aux soins [1].
Les affres de la création de l’espace : les carnets à dessin de Nijinski
Authors: Jover F.
Published: November 2013

La carrière fulgurante du danseur Vaslav Nijinski a duré dix ans de 1908 à 1917. Surnommé le « Dieu bondissant », il a quitté la scène publique pour un dernier saut dans la maladie à l’âge de 28 ans. Son histoire s’est mêlée à celle de la psychiatrie dont il va rencontrer les grands noms, A. Adler, M. Sakel, L. Binswanger et E. Bleuler qui va diagnostiquer « …une confusion mentale de nature schizophrénique avec une légère excitation maniaque… ». Le soir de sa dernière représentation en janvier 1919 au grand hôtel de St-Moritz devant 200 personnes Nijinski débute la rédaction de ses cahiers et confie à sa femme Romola qu’il veut montrer « les affres de la création, la souffrance endurée par l’artiste en train de travailler ». Parallèlement, il réalise des carnets à dessin avec le projet d’une nouvelle cotation chorégraphique. Ce faire-œuvre testamentaire de sa vie d’artiste avant de s’enfermer dans un long silence représente un manifeste de sa vaine habitation du monde face à la désorganisation psychotique et ses tentatives pour le reconstruire. Confronté à une modification du Sentir qu’il s’efforce d’endiguer par la rédaction de ce qu’il nomme « le livre du sentiment », il nous laisse son mystérieux catalogue à dessins, à la fois magnifique et effrayant, des transcriptions picturales d’une présence accablée par la proximité du monde et de ses objets hallucinatoires qui viennent le prendre au corps et dont il ne peut prendre distance.