Migraine, stroke and patent foramen ovale--connected or not?

A relationship between migraine with aura and patent foramen ovale (PFO) has been established in clinical studies, and is now related to previous observation that migraine and stroke are connected. Studies have shown that the prevalence of PFO in patients with migraine is about 2.5-fold than in patients without migraine. Up to now, there is no consensus on the treatment of PFO in primary or secondary prevention, so both surgical and conservative methods are used. Most nonrandomized studies (and 1 randomized placebo-controlled study) have shown that migraine attacks are reduced after PFO closure; however, recent studies show that a new onset or worsening of migraine headaches may occur after closure of PFO or atrial septal defects. Therefore, no definite conclusions can be made on the treatment of migraines by PFO closure.     

Migraine and the influence of hormones

According to clinical observations, "pure" menstrual migraine refers to migraine attacks that occur exclusively 2 days from menstruation onset. AIM: The aim of this study was to determine the prevalence of menstrual migraine in a group of patients (N=289) attending a headache clinic; modification of migraine characteristics during pregnancy was also determined. RESULTS: Study results showed "pure" menstrual migraine to be present in 52 (18.0%) patients; 73 (25.3%) patients reported their migraine attacks to be always related to menstruation, yet also suffering attacks at other times; 95 (32.9%) patients stated that their migraine attacks were sometimes related to menstruation; and 121 (41.9%) patients observed no such relationship. In a subgroup of patients that had given birth to a child (n=145), migraine occurred for the first time in pregnancy in 14 (9.66%), improved or disappeared in 96 (66.2%), and worsened in 14 (9.66%) patients, whereas 21 (14.48%) patients reported no change in the character or frequency of migraine. CONCLUSION: Menstrual migraine is present in a high percentage of migraine patients. During pregnancy, migraine improves in the majority of patients while in a minority of patients migraine occurs for the first time or even worsens. The results of this study should serve as a basis to improve health care for patients with menstrual migraine.     

Phenomenology of bereavement process after suicide, traffic accident and terminal illness (in spouses)

Loss of a spouse provokes different reactions, which depend on the mode of death, age of the deceased and bereaved, length of the relationship, personality structure of the bereaved, and the social and cultural demands required after the death. The objective of the study was to obtain the average pattern of bereavement process after different modes of death and how it changes after a period of one year. Suicide survivors group was compared to the groups of bereaved after traffic accidents and after terminal illness. All the respondents were interviewed twice: two months after the death and a year after. The instruments used were the Beck Depression Inventory, Eysenck Personality Questionnaire and Bereavement Scale. The results show fewer differences between the groups than expected. The depression level and some other emotional reactions decline over a year and some increase, especially in the group of bereaved after accident. The significant differences between the groups are discussed. The results of the study will be used as a ground for the proposed psychotherapeutic help for the bereaved spouses, if deemed necessary.     

Unknown risk: co-exposure to lead and other heavy metals among children living in small-scale mining communities in Zamfara State,Nigeria

The lead poisoning crisis in Zamfara State, Northern Nigeria has been called the worst such case in modern history and it presents unique challenges for risk assessment and management of co-exposure to multiple heavy metals. More than 400 children have died in Zamfara as a result of ongoing lead intoxication since early in 2010. A review of the common toxic endpoints of the major heavy metals advances analysis of co-exposures and their common pathologies. Environmental contamination in Bagega village, examined by X-ray fluorescence of soils, includes lead, mercury, cadmium, arsenic and manganese. Co-exposure risk is explored by scoring common toxic endpoints and hazard indices to calculate a common pathology hazard risk ranking of Pb?>?As?>?Hg?>>?Cd?>?Mn. Zamfara presents an extreme picture of both lead and multiple heavy metal mortality and morbidity, but similar situations have become increasingly prevalent worldwide.     

Detection and Localization of Hyperfunctioning Parathyroid Glands on [18F]fluorocholine PET/ CT Using Deep Learning – Model Performance and Comparison to Human Experts

BackgroundIn the setting of primary hyperparathyroidism (PHPT), [¹⁸F]fluorocholine PET/CT (FCH-PET) has excellent diagnostic performance, with experienced practitioners achieving 97.7% accuracy in localising hyperfunctioning parathyroid tissue (HPTT). Due to the relative triviality of the task for human readers, we explored the performance of deep learning (DL) methods for HPTT detection and localisation on FCH-PET images in the setting of PHPT.Patients and methodsWe used a dataset of 93 subjects with PHPT imaged using FCH-PET, of which 74 subjects had visible HPTT while 19 controls had no visible HPTT on FCH-PET. A conventional Resnet10 as well as a novel mPETResnet10 DL model were trained and tested to detect (present, not present) and localise (upper left, lower left, upper right or lower right) HPTT. Our mPETResnet10 architecture also contained a region-of-interest masking algorithm that we evaluated qualitatively in order to try to explain the model’s decision process.ResultsThe models detected the presence of HPTT with an accuracy of 83% and determined the quadrant of HPTT with an accuracy of 74%. The DL methods performed statistically worse (p < 0.001) in both tasks compared to human readers, who localise HPTT with the accuracy of 97.7%. The produced region-of-interest mask, while not showing a consistent added value in the qualitative evaluation of model’s decision process, had correctly identified the foreground PET signal.ConclusionsOur experiment is the first reported use of DL analysis of FCH-PET in PHPT. We have shown that it is possible to utilize DL methods with FCH-PET to detect and localize HPTT. Given our small dataset of 93 subjects, results are nevertheless promising for further research.Key words: primary hyperparathyroidism, deep learning, nuclear medicine, fluorocholine, PET/CT     

Benign intracranial hypertension with minocycline therapy

A 17‐year‐old Caucasian female patient, who had been prescribed minocycline for acne vulgaris, presented with postural visual obscurations. Ophthalmoscopic examination revealed papilloedema in each eye. Neuro‐imaging of the brain and orbits was normal. A diagnosis of minocycline induced benign intracranial hypertension was made. Withdrawal of minocycline led to resolution of her symptoms and the papilloedema.     

Emotional dysregulation: association with coping-oriented marijuana use motives among current marijuana users

The present investigation, conducted between 2005 and 2006, examined the relation between emotion dysregulation and motives for marijuana use among 136 (71 women; M(age) = 20.61 years) young adult marijuana smokers. As expected, after covarying for theoretically relevant variables, the DERS-total score was significantly related to marijuana use coping motives, but no other motives for marijuana use. Further analysis indicated that the Non-acceptance of Emotional Responses subscale of the DERS accounted for the DERS-total score effect. Results are discussed in relation to better understanding the role of coping-motivated marijuana use within the context of an emotional dysregulation explanatory framework. Limitations of the study are noted.     

Expression of reelin in hepatic stellate cells and during hepatic tissue repair: a novel marker for the differentiation of HSC from other liver myofibroblasts

BACKGROUND/AIMS: Hepatic stellate cells (HSC) and rat liver myofibroblasts (rMF), two similar but not identical cell populations, play a major role during hepatic tissue repair. METHODS: To identify marker proteins for the different fibroblastic cell populations, m-RNA-profiling technology was employed using c-DNAs prepared from HSC and rMF. RESULTS/CONCLUSIONS: The extracellular matrix protein reelin was identified through its presence in HSC and absence in rMF derived samples. As confirmed by Northern blot analysis and by immunoprecipitation, reelin expression was present in similar amounts in resting and activated HSC and was not detectable in rMF. Therefore reelin is the only marker presently available to distinguish HSC at any stage of differentiation from rMF. Following a single CCl4 mediated liver injury, reelin specific mRNAs were induced early, were elevated up to 24 h following CCl4 dosage and were diminished afterwards. Hepatocytes and non-parenchymal liver cells located in the damaged areas were identified as the main cellular source of enhanced reelin expression. Although reelin expression was upregulated during liver injury, reelin deficient mice recovered completely suggesting either a more distinct role in tissue repair reactions or a case of redundancy through the action of related proteins.