MR imaging of the brain in pediatric patients: diagnostic value of HASTE sequences

OBJECTIVE: The objective of this study was to determine the diagnostic value of half-Fourier single-shot turbo spin-echo (HASTE) sequences in MR imaging of the brain in pediatric patients. SUBJECTS AND METHODS: HASTE sequences were performed in 80 infants and children. Two radiologists who were unaware of the patients' medical histories independently reviewed the images for the presence of nine findings: defects of the parenchyma, hypoplasia or agenesis of the corpus callosum, edema, signs of increased intracranial pressure, myelination disorders, migration disorders, malformations, tumors, and widening of spaces of the cerebrospinal fluid. A conventional MR imaging examination that served as the reference examination was evaluated by the same two radiologists in a final consensus interpretation. The findings detected on the HASTE images were compared with the findings seen on the conventional MR images. The sensitivity and specificity of HASTE sequences were calculated, and Cohen's kappa statistic was used to determine interobserver agreement. RESULTS: Both radiologists correctly diagnosed all 20 defects of the parenchyma that were present in the patients. Radiologist 1 correctly identified 20 and radiologist 2 correctly identified 21 of the 22 patients with hypoplasia or agenesis of the corpus callosum. Both radiologists correctly diagnosed edema in eight of the nine patients in whom edema was present, and both correctly identified signs of increased intracranial pressure in eight of the nine children who had this condition. Radiologist 1 correctly diagnosed seven and radiologist 2 correctly identified nine of the 11 cases of myelination disorders. Both radiologists correctly diagnosed six of the 14 cases with migration disorders. All 13 brain malformations present in the patients were correctly identified by both reviewers. Both radiologists correctly identified all 11 patients with tumors, and both correctly identified all 35 patients with widening of spaces of the cerebrospinal fluid. CONCLUSION: HASTE images are highly sensitive for excluding the presence of brain tumor, hydrocephalus, or malformations of the brain. HASTE images are not reliable for evaluating patients with suspected myelination disorders or migration disorders.     

2-Aminobenzo[b]thiophencarbonsäureester aus 3-Hydroxy-2-nitro-1-thiochromon

2-Aminobenzo[b]thiophenecarboxylic esters from 3-Hydroxy-2-nitro-1-thiochromone 3-Hydroxy-2-nitro-1-thiochromone (1b) , when mixed with bases in alcoholic solution, yields the 2-nitro-benzothiophene-3-carboxylates 4a and 4b as well as the 2-amino-3-benzothiophene-3-carboxylates 11a and 11b . Under the same conditions, 3-methoxy-2-nitro-1-thiochromone (1c) yields 3-amino-2-nitro-1-thiochromone (12) . Compound 1b reacts with morpholine in dioxane to give 2-nitro-benzothiophene-3-carboxamide (10) .     

Craving and other characteristics of the comorbidity of alcohol and nicotine dependence.

PURPOSE: In this cross-sectional study we compared alcohol-dependent smokers and non-alcohol-dependent smokers with respect to intensity of nicotine dependence, craving conditions, sleep disturbances, comorbidity with major depression, reasons for smoking, accompanying somatic diseases and patients' prolonged abstinence from smoking during the 3 years preceding the study. SUBJECTS AND METHODS: Fifty-one alcohol-dependent smokers and 327 non-alcohol-dependent smokers diagnosed as ICD-10 and DSM-IV-nicotine dependent, were investigated by means of the Fagerstr?m Test for Nicotine Dependence, the Lübeck Craving-Recurrence Risk Questionnaire and the Lesch Alcohol Dependence Typology (both adapted to smoking). RESULTS: The intensity of nicotine dependence was more enhanced in alcohol-dependent smokers compared to non-alcohol-dependent smokers. Several variables of all factors of craving ("depressive mood", "stimulation", "relaxation", "socially triggered tension") were significantly increased in alcohol-dependent patients (P<0.05). Alcohol-dependent smokers showed depressive symptoms and sleep disturbances, whilst non-alcohol-dependent individuals mainly smoked for stress release and weight control. DISCUSSION: Our study demonstrates that the intensity of nicotine dependence, several conditions of craving for nicotine, sleep disturbances and symptoms of depression appear to be enhanced in alcohol-dependent smokers compared with non-alcohol-dependent smokers. Conclusions. - It is hoped that the factors of craving and reasons for smoking identified in this study will contribute to a better understanding of smoking temptation in alcohol-dependent smokers and non-alcohol-dependent smokers in future.     

The Carers' Needs Assessment for Dementia (CNA-D): development, validity and reliability

BACKGROUND: A variety of interventions are available to support the caregivers of dementia patients. For the purposes of service planning, we developed an instrument to assess the needs of these caregivers and to determine whether needs are met. The reliability and validity of this new instrument was also investigated. METHODS: The development of the Carers' Needs Assessment for Dementia (CNA-D), was based on in-depth interviews and a focus group. The combined inter-rater and test-retest reliability was investigated among 45 dementia caregivers. Correlations of the CNA-D with the Zarit Burden Inventory were used to analyze concurrent validity. Content validity was investigated by performing a separate survey among 40 caregivers and 40 professionals. RESULTS: The CNA-D is a semi-structured research interview including 18 problem areas. For each problem area, the CNA-D offers several possible interventions. The relevance of the problem areas and the interventions (content validity) was confirmed by most of the study participants. Significant positive associations were found between the total score of the Zarit Burden Inventory and the number of problems and the number of unmet needs according to the CNA-D. The agreement between the interviewers was "excellent" (kappa above 0.75) in 73.7% of the problem areas and in 69.9% of the interventions. CONCLUSIONS: The CNA-D is a valid and reliable instrument for comprehensively assessing the needs of dementia caregivers.     

Cerebral infarction in eclampsia

OBJECTIVE: This study was undertaken to characterize the neuroimaging findings of cerebral edema associated with eclamptic seizures by use of diffusion-weighted magnetic resonance imaging (MRI). STUDY DESIGN: During the 3-year period ending March 2002, 27 nulliparous women with eclampsia were evaluated with diffusion-weighted MRI and apparent diffusion coefficient mapping. Those with findings of restricted diffusion suggestive of cytotoxic edema underwent neuroimaging again 6 weeks post partum. RESULTS: All but 2 of these 27 women (93%) had reversible vasogenic edema. Six were also found to have areas of cytotoxic edema consistent with cerebral infarction. Five of these 6 women had persistent imaging findings of infarction when studied post partum, however, without clinical neurologic deficits. CONCLUSION: The spectrum of cerebral lesions in eclampsia as seen with MRI varies from initially reversible areas of vasogenic edema that may progress to cytotoxic edema and infarction in up to a fourth of women.