ADHD deficit as measured in adolescent boys with a continuous performance task is related to antenatal maternal anxiety

Antenatal maternal anxiety has been shown to be related to infant temperament, childhood disorders, and impulsivity in adolescence. This study prospectively investigated whether antenatal maternal anxiety is associated with performance on a continuous performance task. Sixty-four adolescents (mean age, 15 y; 34 boys, 30 girls) were examined with a computerized continuous performance task (CPT) measuring sustained attention. Results showed that the CPT performance of boys of mothers with high levels of state anxiety during the 12th to 22nd postmenstrual week of pregnancy declined as the task progressed: their processing speed became slower and the variability in their reaction times increased. The study controlled for the possible confounding influences of postnatal maternal anxiety, the parents' educational level, and intelligence. Establishing a link between antenatal maternal anxiety and an objective measure of sustained attention/self-regulation, our results extend the growing evidence for an association between antenatal maternal anxiety and the neurobehavioral development of the offspring up into adolescence.     

Novel risk factors for peripheral arterial disease in young women

PURPOSE: To investigate traditional and novel risk factors (homocysteine and C-reactive protein levels, and exposure to infections) for peripheral arterial disease in young women. SUBJECTS AND METHODS: In a multicenter, population-based, case-control study, 212 young women (mean [+/- SD] age, 48.2 +/- 7.0 years) with peripheral arterial disease and 475 healthy control women (mean age, 45.5 +/- 8.1 years) completed a standardized questionnaire and provided blood samples. Peripheral arterial disease was angiographically confirmed if a stenotic lesion (more than 50% reduction of the lumen) was present in at least one major peripheral artery. Hyperhomocysteinemia was defined as a nonfasting plasma homocysteine level exceeding the 90th percentile of the control group. History of infectious diseases was determined by questionnaire. RESULTS: Elevated C-reactive protein levels were associated with an increased likelihood of peripheral arterial disease (odds ratio [OR] = 3.9; 95% confidence interval [CI]: 1.8 to 8.5 for women in the third quartile; OR = 3.1; 95% CI: 1.4 to 6.8 for women in the fourth quartile; both comparisons with women in the first quartile). Hyperhomocysteinemia was not associated with a significantly increased risk of peripheral arterial disease (OR = 1.6; 95% CI: 0.9 to 3.0). A history of chickenpox, shingles, mumps, pneumonia, chronic bronchitis, peptic ulcer, or periodontitis was independently related to peripheral arterial disease, with adjusted odds ratios varying from 1.7 (95% CI: 1.0 to 3.1) for mumps to 3.4 (95% CI: 1.5 to 7.7) for peptic ulcer. The risk of peripheral arterial disease increased with the number of these infections; exposure to five or more infections increased the odds 3.7-fold (95% CI: 1.7 to 8.2). This association was not affected by the level of C-reactive protein. CONCLUSION: Our results do not support a strong relation between homocysteine and peripheral arterial disease in young women. However, an elevated C-reactive protein level and several types of symptomatic infection were associated with peripheral arterial disease.     

Patients’ and Psychologists’ Preferences for Feedback Reports on Expected Mental Health Treatment Outcomes: A Discrete-Choice Experiment

In recent years, there has been an increasing focus on routine outcome monitoring (ROM) to provide feedback on patient progress during mental health treatment, with some systems also predicting the expected treatment outcome. The aim of this study was to elicit patients’ and psychologists’ preferences regarding how ROM system-generated feedback reports should display predicted treatment outcomes. In a discrete-choice experiment, participants were asked 12–13 times to choose between two ways of displaying an expected treatment outcome. The choices varied in four different attributes: representation, outcome, predictors, and advice. A conditional logistic regression was used to estimate participants’ preferences. A total of 104 participants (68 patients and 36 psychologists) completed the questionnaire. Participants preferred feedback reports on expected treatment outcome that included: (a) both text and images, (b) a continuous outcome or an outcome that is expressed in terms of a probability, (c) specific predictors, and (d) specific advice. For both patients and psychologists, specific predictors appeared to be most important, specific advice was second most important, a continuous outcome or a probability was third most important, and feedback that includes both text and images was fourth in importance. The ranking in importance of both the attributes and the attribute levels was identical for patients and psychologists. This suggests that, as long as the report is understandable to the patient, psychologists and patients can use the same ROM feedback report, eliminating the need for ROM administrators to develop different versions.

     

Acquired, Stuttering after a Second Stroke in a Two-year-oId

An almost two-year-old left-handed girl with a history of a left-hemisphere stroke at the age of one year developed a transient stutter with newly acquired white matter infarctions. Her course suggests that developmental stuttering may reflect anomalous dominance and/or atypical interhemispheric connectivity.  

RÉSUMÉ

Begaiernenr acquis apré line seconde atraque chez une fillette de deux ans Une fillette gauchere de prh de deux ans. avec une anamnese dune attaque herniplegique gauche a ľ âge ď un an, présenfa un bégaiement transitoire à ľ occasion ď infarcissements nouveaux de la substance blanche. Son évolution suggtréqu'un bégaiernent de développernent peut traduire une dominance anormale et/ou une connectivityé interhérnisphérique typique.  

ZUSAMMENFASSUNG

Erworbenes Slottern nach eineni zweiten Schlagan/oll hei einer Zweijährigen Ein fast zweijähriges linkshändiges Mädchen, das im Alter von einern Jahr einen linksseitigen vorubergehendes Stottern. Dieser Verlauf zeigt, daß das Stottern in der Entwicklung Ausdruck einer  

RESUMEN

Tartamudeo adquirido despues de un segundo ictus en una niña de dos años de edad Una niña de casi dos aaos de edad. zurda. con una historia de un ictus en el hernisferio izquierdo al año de edad, sufrio una tartamudez transitoria después de un nuevo infarto de substancia blanco. El Schlaganfall hatte, entwickelte durch weitere lnfarkte im Bereich der weiRen Substanz ein nicht normalen Dorninanz undloder einer atypischen interhemispharischen Verknupfung sein kann. curso que siguio sugiere que el tartamudeo de desarrollo puede reflejar una dominancia anómala y/o una conexión atípica interhemisférica     

Assembling organ donation: situating organ donation in hospital practice

In this article I argue for the need to situate deceased organ donation in and as a hospital practice. This study puts the spotlight on the practical conditions that enable and emplace organ donation in the hospital setting. The analytical move serves the political purpose to inform and interrogate dominant policy framings intended to address the problem of organ shortage. I present an ethnographic investigation that draws upon a Science and Technology Studies (STS) approach to make visible the sociomaterial arrangements that bring together people, things and politics in the assembling of organ donation at a Catalan hospital. A progressive and indeterminate process which might fall through and become disassembled at any given time. This, as I explain, challenges current opt-out policy that unnecessarily reduces donation to an individual choice to be decided upon in life. Instead, and drawing on ethnographic materials, I propose a situated and relational understanding of organ donation: an embedded health care and procurement practice enacted as a collective accomplishment. I conclude that (more) responsible donation policies need to be informed by, and attuned to, the situated practicalities and enduring tensions that condition and constrain the assembling of organ donation at the hospital setting.     

Papel del estudio radiológico multimodal en el código ictus

In stroke code patients, multimodal imaging workup encompasses various imaging techniques, including baseline computed tomography (CT), magnetic resonance (MR) imaging, diffusion MR imaging, CT or MR perfusion studies, and CT or MR angiography, that are used to rule out bleeding, confirm arterial occlusion, establish tissue viability, and help select candidates for endovascular treatment as early as possible. Five recently published relevant clinical trials have demonstrated the efficacy of mechanical thrombectomy in proximal arterial occlusions; all these trials used different imaging techniques to select patients. Analyzing these trials and the scientific literature, we conclude that conventional CT interpreted with the Alberta Stroke Programme Computed Tomography Score (ASPECTS) and CT or MR angiography should always be used (level of evidence I, grade of recommendation A) and that CT and MR perfusion studies are useful in specific circumstances.     

The "why" and "how" of JointICA: results from a visual detection task

Since several years, neuroscience research started to focus on multimodal approaches. One such multimodal approach is the combination of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI). However, no standard integration procedure has been established so far. One promising data-driven approach consists of a joint decomposition of event-related potentials (ERPs) and fMRI maps derived from the response to a particular stimulus. Such an algorithm (joint independent component analysis or JointICA) has recently been proposed by Calhoun et al. (2006). This method provides sources with both a fine spatial and temporal resolution, and has shown to provide meaningful results. However, the algorithm's performance has not been fully characterized yet, and no procedure has been proposed to assess the quality of the decomposition. In this paper, we therefore try to answer why and how JointICA works. We show the performance of the algorithm on data obtained in a visual detection task, and compare the performance for EEG recorded simultaneously with fMRI data and for EEG recorded in a separate session (outside the scanner room). We perform several analyses in order to set the necessary conditions that lead to a sound decomposition, and to give additional insights for exploration in future studies. In that respect, we show how the algorithm behaves when different EEG electrodes are used and we test the robustness with respect to the number of subjects in the study. The performance of the algorithm in all the experiments is validated based on results from previous studies.     

Occurrence of delirium is severely underestimated in the ICU during daily care

Objective  Delirium is associated with prolonged intensive care unit (ICU) stay and higher mortality. Therefore, the recognition of delirium is important. We investigated whether intensivists and ICU nurses could clinically identify the presence of delirium in ICU patients during daily care. Methods  All ICU patients in a 3-month period who stayed for more than 48 h were screened daily for delirium by attending intensivists and ICU nurses. Patients were screened independently for delirium by a trained group of ICU nurses who were not involved in the daily care of the patients under study. The Confusion Assessment Method for the ICU (CAM-ICU) was used as a validated screening instrument for delirium. Values are expressed as median and interquartile range (IQR; P25–P75). Results  During the study period, 46 patients (30 male, 16 female), median age 73 years (IQR = 64–80), with an ICU stay of 6 days (range 4–11) were evaluated. CAM-ICU scores were obtained during 425 patient days. Considering the CAM-ICU as the reference standard, delirium occurred in 50% of the patients with a duration of 3 days (range 1–9). Days with delirium were poorly recognized by doctors (sensitivity 28.0%; specificity 100%) and ICU nurses (sensitivity 34.8%; specificity 98.3%). Recognition did not differ between hypoactive or active status of the patients involved. Conclusion  Delirium is severely under recognized in the ICU by intensivists and ICU nurses in daily care. More attention should be paid to the implementation of a validated delirium-screening instrument during daily ICU care. Electronic supplementary material  The online version of this article (doi:) contains supplementary material, which is available to authorized users.