Developmental course(s) of lifetime cigarette use and panic attack comorbidity: an equifinal phenomenon?

The present investigation examined the developmental course(s) of lifetime cigarette use and panic attack comorbidity. Participants included 4,409 adults, ages 15 to 54 years of age (M(Age) = 33.1, SD = 10.7, N (females) = 2,221) from the National Comorbidity Survey (NCS). The primary objective of the present investigation was to better understand the developmental course(s) of lifetime cigarette use and panic attacks. A second objective of the investigation was to evaluate the developmental features of smoking-panic comorbidity in relation to other comorbid psychiatric and substance outcomes. Results demonstrated two distinct and novel operative developmental patterns of smoking-panic attack co-occurrence. The theoretical and clinical implications of delineating course-related factors underlying smoking-panic attack comorbidity are discussed.     

Physiogenomic association of statin-related myalgia to serotonin receptors

We employed physiogenomic analyses to investigate the relationship between myalgia and selected polymorphisms in serotonergic genes, based on their involvement with pain perception and transduction of nociceptive stimuli. We screened 195 hypercholesterolemic, statin-treated patients, all of whom received either atorvastatin, simvastatin, or pravastatin. Patients were classified as having no myalgia, probable myalgia, or definite myalgia, and assigned a myalgia score of 0, 0.5, or 1, respectively. Fourteen single nucleotide polymorphisms (SNPs) were selected from candidates within the 5-HT receptor gene families [5a-hydroxytryptamine receptor genes (HTR) 1D, 2A, 2C, 3A, 3B, 5A, 6, 7] and the serotonin transporter gene (SLC6A4). SNPs in the HTR3B and HTR7 genes, rs2276307 and rs1935349, respectively, were significantly associated with the myalgia score. Individual differences in pain perception and nociception related to specific serotonergic gene variants may affect the development of myalgia in statin-treated patients.     

What is in a name? Spatial brain circuits are used to track discourse references

Pronouns are commonly used instead of explicitly repeating a name, and, in many cases, we comprehend language faster when pronouns are used instead of repetitive references. This is surprising because pronouns are often ambiguous, whereas repeated names provide precise reference. We used functional MRI to investigate the neural correlates of this paradoxical preference. Reading repeated names elicited more activation than pronouns in the middle and inferior temporal gyri and intraparietal sulcus. The temporal lobe activation suggests that repeated names but not pronouns evoke multiple representations that have to be integrated. The intraparietal sulcus activation suggests that this integration relies on brain regions used for spatial attention and perceptual integration.     

Gastrointestinal complications associated with hepatic arterial Yttrium-90 microsphere therapy

Hepatic arterial therapy with yttrium-90 microspheres exploits the avenue provided by the neoplastic microvasculature to deliver high-energy, low-penetrating therapeutic doses of radiation. Variant hepatic arterial anatomy, collateral vessels, and changes in flow dynamics during treatment can affect particle dispersion and lead to nontarget particle distribution and subsequent gastrointestinal morbidity. Awareness of these variances and techniques to prevent gastrointestinal tract microsphere delivery is essential in mitigating this serious complication. Our aim is to increase the understanding of the role of various imaging and preventative techniques in minimizing this undesired effect.     

Esophageal reconstruction with larynx preservation using forearm-free flap

Surgery for cervical esophageal malignancy frequently involves comcomitant total laryngectomy carried out because of either oncologic or functional concerns. Though uncommon, preservation of the larynx has, in recent years, been described in patients undergoing cervical esophagectomy with reconstruction of the resulting circumferential esophageal defect achieved using either free jejunal flaps or gastric pullup procedures. The use of tubed-free cutaneous flaps for circumferential cervical esophageal reconstruction, however, has been rarely described in situations where the larynx has been preserved. We describe successful use of a tubed radial forearm-free flap for reconstruction of a circumferential cervical esophageal defect with preservation of the larynx. Use of the radial forearm flap in this situation resulted in minimal donor site-related morbidity, avoided the need for laparotomy and excellent voice and swallowing function were maintained. As such, use of tubed cutaneous free flaps can be considered an option for cervical esophageal reconstruction when the larynx has been preserved.