The role of theta and alpha oscillations for language comprehension in the human electroencephalogram

The hypothesis is tested, whether increasing language processing demands draw on the capacity of working memory thereby leading to an increase in theta band power. Previous research has shown that theta reflects working memory whereas upper alpha semantic memory demands. Sentences were presented in four chunks in a reading and a semantic task. In the latter, subjects had to find a superordinate concept to a noun presented in the third chunk. The data show an increase in theta during sentence processing which was significantly smaller in the semantic task. In contrast, the upper alpha band exhibited a significantly larger change in band power during the semantic task and that time window in which subjects searched for the superordinate concept. Thus, we conclude that semantic processing does not draw selectively on the capacity of working memory and that different linguistic processes have no direct influence on theta oscillations.     

The simple outpatient management of Bartholin's abscess using the Word catheter: a preliminary study

INTRODUCTION: Bartholin's cysts/abscess affects 2% of women. Conventional treatment is marsupialisation under general anaesthetic. We evaluated a conservative approach in a non-randomised prospective interventional study over 12 months. METHOD: Women with a Bartholin's abscess were counselled and those who opted for the Word catheter (WC) had it inserted under local anaesthetic (follow up at one week and four weeks, when catheter was removed). Women recorded pain scores and completed a qualitative questionnaire and had telephone follow up at six months. Outcome measures were abscess resolution and acceptability of treatment. RESULTS: Fifty-eight women attended with a Bartholin's abscess requiring drainage. Twenty-three of 58 (40%) elected for marsupialisation. Thirty-five of 58 (60%) women had a WC inserted. Twenty-seven of 35 (77%) women retained their catheter for four weeks (three catheters fell out within 24 h of insertion, three catheters fell out within one week, one fell out after 11 days and there was one failed insertion). One woman had a recurrence six months after treatment. Abscess resolution occurred in 34 of 35 (97%). No woman reported significant discomfort at one week. Twenty-four of 27 women (89%) said that if they suffered a recurrence, they would have another WC inserted. Three of 27 (11%) women had intercourse within the second week of catheter insertion and reported that it was not uncomfortable. Fourteen women who had marsupialisation were traced and none had suffered a recurrence six months after treatment. CONCLUSIONS: The WC is a safe and effective treatment for a Bartholin's abscess. It may be considered as an alternative to marsupialisation.     

Prediction of mortality in pediatric trauma patients: new injury severity score outperforms injury severity score in the severely injured

BACKGROUND: The Injury Severity Score (ISS) is a widely accepted method of measuring severity of traumatic injury. A modification has been proposed--the New Injury Severity Score (NISS). This has been shown to predict mortality better in adult trauma patients, but it had no predictive benefit in pediatric patients. The aim of this study was to determine whether the NISS outperforms the ISS in a large pediatric trauma population. METHODS: Admissions in the National Pediatric Trauma Registry between April 1996 and September 1999 were included. The ISS and NISS were calculated for each patient. The study endpoints were mortality at hospital discharge, functional outcome in three domains (expression, locomotion, and feeding), and discharge disposition for the survivors. Predictive ability of each score was assessed by area under the receiver operating characteristic curve. RESULTS: The NISS and ISS performed equally well at predicting mortality in patients with lower injury severity (ISS < 25), but the NISS was significantly better at predicting mortality in the more severely injured patients. Both scores performed equally well at predicting expression and feeding ability. The NISS was superior to the ISS in predicting locomotion ability at discharge. Thirty-seven percent of patients had an NISS that was higher than their ISS. These patients had a significantly higher mortality and suffered worse functional outcomes. CONCLUSION: The NISS performs as well as the ISS in pediatric patients with lower injury severity and outperforms the ISS in those with higher injury severity.     

Effects of silibinin hemisuccinate on the intraocular pressure in normotensive rabbits

OBJECTIVE: To evaluate the effects of silibinin hemisuccinate on the normal intraocular pressure (IOP) in rabbits. METHODS: This study took place in the Department of Pharmacology and Toxicology, College of Pharmacy, University of Baghdad during the period from January to June 2005. Twenty-five New Zealand white rabbits weighing 1.5-2.5 kg were used in this study. The effects of corneal instillation of various concentrations of silibinin hemisuccinate (0.5%, 0.75% and 1%) dissolved in arachis oil, on the normal intraocular pressure in rabbits were evaluated using indentation tonometry; in addition to the possible modulation of normal IOP-recovery time after intravenous infusion of 20% sodium chloride solution. RESULTS: The results showed that within 30 minutes of application, silibinin in various concentrations significantly reduces IOP in comparison to baseline values (p<0.05), with greater reduction being achieved with 0.75%. The effect of IOP reduction lasts 2-3 hours and proportionate to the concentration used. Moreover, remarkable delay in IOP recovery was observed after instillation of silibinin compared with the vehicle treated (arachis oil) animals, indicating interference with aqueous humor formation. CONCLUSION: The results obtained in this study provide experimental evidences for the effectiveness of silibinin in the reduction of IOP and possible modulation of its regulatory mechanisms.     

The Prospective Antifungal Therapy Alliance? registry: A two-centre Canadian experience

BACKGROUND:

The Prospective Antifungal Therapy Alliance^® registry is a prospective surveillance study that collected data on the diagnosis, management and outcomes of invasive fungal infections (IFIs) from 25 centres in North America from 2004 to 2008.

OBJECTIVE:

To evaluate surveillance data on IFIs obtained from study centres located in Canada.

METHODS:

Patients with proven or probable IFIs at two Canadian medical centres were enrolled in the registry. Information regarding patient demographics, fungal species, infection sites, diagnosis techniques, therapy and survival were analyzed.

RESULTS:

A total of 347 patients from Canada with documented IFIs were enrolled in the Prospective Antifungal Therapy Alliance registry. Infections occurred most commonly in general medicine (71.8%), nontransplant surgery (32.6%) and patients with hematological malignancies (21.0%). There were 287 proven IFIs, including 248 Candida infections. Forty-six patients had invasive aspergillosis (IA); all of these were probable infections. Most cases of invasive candidiasis were confirmed using blood culture (90.5%), while IA was most frequently diagnosed using computed tomography scan (82.6%) and serological methods (82.6%). Fluconazole was the most common therapy used for Candida infections, followed by the echinocandins. Voriconazole therapy was most commonly prescribed for IA.

CONCLUSIONS:

The present study demonstrated that general medicine, surgery and hematological malignancy patients in Canada are susceptible to developing IFIs. In contrast to the United States, Candida albicans remains responsible for most IFIs in these Canadian centres. Surrogate serum markers are commonly being used for the diagnosis of IA, while therapy for both IFIs has shifted to broader-spectrum azoles and echinocandins.     

Subclinical cardiovascular disease in plaque psoriasis: Association or causal link?

Background

Psoriasis patients have a high prevalence of cardiovascular events and are thought to have a relative risk increase of 25% as compared to the general population. However, a causal relationship between psoriasis and cardiovascular disease has not been established. We sought to perform a systematic review of existing data regarding the presence of endothelial dysfunction and subclinical atherosclerosis in patients with plaque psoriasis.

Methods

A systematic literature search was performed, using Medline database and Ovid SP for relevant literature up to November 2012. Twelve studies met inclusion criteria from an initial search result of 529 articles.

Results

Among the twelve studies meeting inclusion criteria, two (17%) reported increased mean coronary artery calcification (CAC) in psoriatic patients. Six studies (50%) showed carotid intima–media thickness [CIMT] increase in psoriasis. Five studies (42%) examined flow mediated dilation [FMD], of which three showed decreased FMD in psoriasis patients. One study (8%) each demonstrated a decreased coronary flow reserve and increased arterial stiffness as assessed by pulse wave velocity.

Conclusions

Patients with psoriasis have an increased burden of subclinical atherosclerosis and endothelial dysfunction. Patients with greater severity and/or disease duration should be targeted for primary screening for cardiovascular disease risk reduction     

The effect of nasal occlusion on the initiation of oral breathing in preterm infants

The ability to switch from nasal to oral breathing in response to nasal obstruction is crucial for survival, and has been suggested to be an important mechanism in preventing sudden infant death syndrome (SIDS). To know whether the ability to switch from nasal to oral breathing is uniformly present during the early neonatal period, we examined the effects of slow and fast nasal occlusions on the establishment of oral breathing in preterm infants. Slow occlusions were used to mimic more closely occlusions occurring spontaneously. We studied 17 healthy preterm infants [birth weight, 1830 ± 27 g (mean ± SE); study weight, 1800 ± 109 g; gestational age, 32 ± 1 weeks; postnatal age, 12 ± 2 days]. We used a nosepiece with a nasal occluder and a flow-through system to measure ventilation. A CO₂, sampling catheter at the mouth was used to detect oral breathing. Of 58 occlusions, 29 were slow [resistance increasing slowly from 0 to infinite (occlusion)], and 29 were fast (infinite elastance applied in <1 sec). Oral breathing was always established following slow and fast occlusions. In 44% of the slow occlusions, oral breathing started before complete occlusion. Arousal was observed in 12/58 (17%) of all occlusions, occurring primarily after initiation of oral breathing. Oxygen saturation and respiratory rate decreased significantly following occlusions, from 96 i 0.6 to 87 ± 1.2% and 49 ± 2.8 to 38 ± 2 breaths/min, respectively. These findings suggest (1) preterm infants usually establish oral breathing in response to nasal airway occlusion; (2) this switch to oral breathing is preceded by a decrease in O₂ saturation and in respiratory frequency; and (3) arousal does not always precede the switch to oral breathing as is traditionally accepted. Pediatr Pulmonol. 1994;18:374–378. ©1994 Wiley-Liss, Inc.     

Early detection of pandemic (H1N1) 2009, Bangladesh

To explore Bangladesh's ability to detect novel influenza, we examined a series of laboratory-confirmed pandemic (H1N1) 2009 cases. During June-July 2009, event-based surveillance identified 30 case-patients (57% travelers); starting July 29, sentinel sites identified 252 case-patients (1% travelers). Surveillance facilitated response weeks before the spread of pandemic (H1N1) 2009 infection to the general population.     

Prostate T(1) quantification using a magnetization-prepared spiral technique

Purpose

To adapt a magnetization‐prepared spiral imaging technique, termed T1prep, for time‐efficient radiofrequency (RF)‐insensitive prostate T₁ quantification at 1.5 T and evaluate signal‐to‐noise ratio (SNR) limits to voxel‐based versus subregion analysis.

Materials and Methods

A magnetization‐prepared spiral imaging technique was adapted for robust T₁ contrast development, multislice imaging within 5 minutes, and data regression to a monoexponential decay. In vitro testing evaluated RF insensitivity of the multislice acquisition plus method accuracy. A pilot study was performed in 15 patients with low or intermediate risk localized prostate cancer.

Results

The multislice design displayed excellent RF insensitivity (<1% error for RF mistunings to ± 20%) and accuracy (within 3% of gold standard for T₁ values between 140 and 2100 msec). A clinical pilot study reported significantly reduced T₁ from PZ to CG to tumor subregions (PZ: 1421 ± 168 msec, n = 11; CG: 1314 ± 49 msec, n = 13; 1246 ± 68 msec, n = 8). SNR measurements identified an inappropriateness of voxel‐based analysis.

Conclusion

T1prep can quantify prostate T₁ as an adjunct measure for quantitative perfusion measurements and longitudinal treatment response monitoring. Intrapatient heterogeneities support T₁ assessment within individual patients. SNR calculations will support a transition to voxel‐based analysis in future trials. J. Magn. Reson. Imaging 2011. © 2011 Wiley‐Liss, Inc.     

Radiological assessment of mesenteric and retroperitoneal cysts in adults: is there a role for chemical shift MRI?

Objective

The purpose of this study was to assess the potential role for chemical shift magnetic resonance imaging (MRI) in identifying lymphangiomas from other cystic mesenteric and retroperitoneal masses.

Materials and methods

A retrospective search of radiology database identified 24 consecutive patients with mesenteric and retroperitoneal cysts (nine men, 15 women; mean age, 41 years; age range, 19-75 years) who had undergone MR which included in-phase and opposed-phase chemical shift imaging. Signal intensity (SI) decrease between in-phase and opposed-phase MR images of the cyst was evaluated qualitatively by two radiologists. Ultrasound (US), computed tomography (CT), and MRI findings of the morphological appearances of all the cystic lesions that demonstrated significant signal drop on chemical shift MR were also recorded.

Results

Of mesenteric and retroperitoneal cysts, 33% (8/24) revealed qualitative decrease in intensity on opposed-phase MR images relative to that seen on in-phase images. On ultrasound, these cysts demonstrated anechoic simple fluid. Their mean CT attenuation was 13 HU (range: 5-20 HU). Signal loss on fat-suppressed T1-weighted sequences was displayed only by a single cyst. None of the lesions with qualitative SI decrease on opposed-phase MR showed suggestion of lipid on US and CT.

Conclusion

The presence of intra cystic lipid detected by chemical shift MR may not be overt on cross-sectional imaging such as US and CT. Chemical shift MRI provides additional sensitivity and specificity as an imaging test for demonstration of lipid within mesenteric and retroperitoneal cysts enabling a higher diagnostic yield for lymphangioma leading to more appropriate patient management.