Focal Cortical Dysplasia (FCD) lesion analysis with complex diffusion approach

Identification of Focal Cortical Dysplasia (FCD) can be difficult due to the subtle MRI changes. Though sequences like FLAIR (fluid attenuated inversion recovery) can detect a large majority of these lesions, there are smaller lesions without signal changes that can easily go unnoticed by the naked eye. The aim of this study is to improve the visibility of focal cortical dysplasia lesions in the T1 weighted brain MRI images. In the proposed method, we used a complex diffusion based approach for calculating the FCD affected areas. Based on the diffused image and thickness map, a complex map is created. From this complex map; FCD areas can be easily identified. MRI brains of 48 subjects selected by neuroradiologists were given to computer scientists who developed the complex map for identifying the cortical dysplasia. The scientists were blinded to the MRI interpretation result of the neuroradiologist. The FCD could be identified in all the patients in whom surgery was done, however three patients had false positive lesions. More lesions were identified in patients in whom surgery was not performed and lesions were seen in few of the controls. These were considered as false positive. This computer aided detection technique using complex diffusion approach can help detect focal cortical dysplasia in patients with epilepsy.     

Cognitive Therapy for Bipolar Illness—A Pilot Study of Relapse Prevention

Twenty-five (25) bipolar patients taking mood stabilizers and yet still relapsing were recruited into a randomized controlled pilot cognitive therapy study. All subjects were taking mood stabilizers on recruitment. The control group had treatment as usual—that is, the usual outpatients and multidisciplinary team input. The therapy group received between 12 and 20 sessions of cognitive therapy adapted for bipolar illness in addition to treatment as usual. Therapy consisted of a relapse prevention approach and lasted 6 months. Independent assessments showed that the therapy group had significantly fewer bipolar episodes, higher social functioning, and better coping strategies for bipolar prodromes. Furthermore, there was evidence of less fluctuation in symptoms of mania and depression, less hopelessness, and better medication compliance from subjects' monthly self reports. There was no evidence that improvement in the therapy group was due to more medication being prescribed. In fact, there were significantly less neuroleptics being prescribed in the therapy group for the 6 months after therapy. A further study with a larger sample size and longer follow-up period is warranted.     

Parental and retail supply of tobacco to minors: Findings from a community-based social supply intervention study

Aim

We report on findings from a quasi-experimental community trial of a complex intervention aimed at reducing social and commercial supply of cigarettes to young people.

Materials and methods

The intervention comprised a package of school, community and home-based smokefree strategies implemented over three years from 2007 to 2009 in a low-income area of Auckland, New Zealand, with another area serving as the control population. The main outcome measures were relative change in parental and retailer behaviour and in attitudes to the provision of tobacco to youth. We analysed baseline and follow-up data from questionnaires administered to parents and children living in the intervention and control areas using PASW Statistics 18.

Results

No difference was found between groups in parents’ permissiveness of smoking and in retailer compliance to the tobacco sale legislation over the course of the study, either because our intervention had no or only a limited effect, or alternatively because limitations in the study design diluted any effect.

Conclusions

Nevertheless, a key finding was that parents and retailers persisted as important sources of cigarettes for young people. Further study is required to identify effective interventions to address this issue.