La tomografía computarizada de doble energía: ¿para qué la quiero?

Dual-energy CT is one of the newest and most attractive fields in radiology today. New generation scanners can acquire datasets with different X-ray spectra, which facilitates the characterization of certain chemical elements, making it possible to detect functional alterations in the absence of morphologic or densitometric anomalies. The capability of characterizing these elements is enabling new applications to be developed for clinical practice and changing the way we work. The aim of this article is to explain what dual-energy CT studies are, the techniques available for performing them, the advantages and disadvantages of these studies, and what we might expect from this field in the future.     

White matter architecture rather than cortical surface area correlates with the EEG alpha rhythm

There are few studies on the neuroanatomical determinants of EEG spectral properties that would explain its substantial inter-individual variability in spite of decades of biophysical modeling that predicts this type of relationship. An exception is the negative relation between head size and the spectral position of the alpha peak (P_α) reported in Nunez et al. (1978)—proposed as evidence of the influence of global boundary conditions on slightly damped neocortical waves. Here, we attempt to reexamine this finding by computing the correlations of occipital P_α with various measures of head size and cortical surface area, for 222 subjects from the EEG/MRI database of the Cuban Human Brain Mapping Project. No relation is found (p > 0.05). On the other hand, biophysical models also predict that white matter architecture, determining time delays and connectivities, could have an important influence on P_α. This led us to explore relations between P_α and DTI fractional anisotropy by means of a multivariate penalized regression. Clusters of voxels with highly significant relations were found. These were positive within the Posterior and Superior Corona Radiata for both hemispheres, supporting biophysical theories predicting that the period of cortico-thalamocortical cycles might be modulating the alpha frequency. Posterior commissural fibers of the Corpus Callosum present the strongest relationships, negative in the inferior part (Splenium), connecting the inferior occipital lobes and positive in the superior part (Isthmus and Tapetum), connecting the superior occipital cortices. We found that white matter architecture rather than neocortical area determines the dynamics of the alpha rhythm.     

Prevalence and implications of multiple cancer screening needs among Hispanic community health center patients

Objectives  

To examine adherence rates for multiple cancer screening tests, which will inform prevention efforts in community health centers (CHCs).     

A randomized trial of a screening, case finding, and referral system for older veterans in primary care

OBJECTIVES: To test whether a system of screening, assessment, referral, and follow-up provided within primary care for high-risk older outpatients improves recognition of geriatric conditions and healthcare outcomes. DESIGN: Controlled clinical trial with 3-year follow-up; intervention versus control group allocation based on practice group assignment. SETTING: Department of Veterans Affairs (VA) ambulatory care center. PARTICIPANTS: Seven hundred ninety-two community-dwelling patients aged 65 and older identified by postal screening survey. INTERVENTION: The intervention combined a structured telephone geriatric assessment by a physician assistant, individualized referrals and recommendations, selected referral to outpatient geriatric assessment, and ongoing telephone case management. MEASUREMENTS: Main outcomes were VA medical record evidence of recognition and evaluation of target geriatric conditions (depression, cognitive impairment, urinary incontinence, falls, functional impairment), functional status (Functional Status Questionnaire, FSQ), and hospitalization (VA databases and self-reported non-VA usage). RESULTS: Intervention participants were more likely to have target conditions recognized, evaluated, and referred to specialized services within 12 months of enrollment, although there were no significant differences in FSQ scores or acute hospitalization between intervention and control groups at 1, 2, or 3 years follow-up. Subgroup analyses suggested improvements in depression symptoms and functional impairment at 1-year follow-up in intervention participants with these problems at baseline, but these findings were not evident at later follow-up. CONCLUSION: The intervention increased recognition and evaluation of target geriatric conditions but did not improve functional status or decrease hospitalization. Innovative screening methods can identify older people in need of geriatric services, but achieving measurable improvement in functional status or hospitalization rates will likely require a more-intensive intervention than a program involving primarily unsolicited referrals and short-term consultations.     

Emotional Intelligence and Acculturation to the United States: Interactions on the Perceived Social Consequences of Smoking in Early Adolescents

High emotional intelligence (EI) is associated with decreased adolescent smoking. Acculturation to the United States is a risk factor for adolescent smoking. High EI may buffer the relationship between acculturation to the United States and perceptions of the social consequences of smoking (PSC).

Emotional intelligence is the ability to: accurately perceive, appraise, and express emotion; access and/or generate feelings in facilitating thought; understand emotion and emotional knowledge; and regulate emotions. Emotional intelligence (measured by the Multifactor Emotional Intelligence Scale, Adolescent Version), acculturation, and PSC were assessed in 2001 from 416 Southern California sixth graders (47% boys; mean age = 11.3 yrs; 32% Hispanic/ Latino, 29% Asian/Pacific Islander, 13% White, 19% Multiethnic, 6% Other).

There was a significant EI × US acculturation interaction (p < 0.01) suggesting that those with high EI perceived more social consequences associated with smoking. As the U.S. population becomes increasingly diversified, identifying protective variables and designing effective prevention programs for adolescents of diverse ethnic and cultural backgrounds becomes important.     

Relationship between family history of breast cancer and health-related behavior

This article explores the relationship between family history of breast cancer (FHBC) and health-related behavior and medical management, using a cross-sectional analysis of 685 women, based on self-report. The influence of FHBC on lifestyle (alcohol use, physical activity, weight and diet) and medical management decisions (screening for chronic diseases) was assessed using odds ratios (OR) and 95% confidence interval (CI). Adjustment for confounders was performed using unconditional logistic regression. Sixty five women (9.5%) reported relatives with breast cancer. Women with FHBC are more likely to have had a mammography and colonoscopy or sigmoidoscopy. These women have about twice the probability of performing more intense physical exercise, contrasting with high-risk women whose consumption of fibre is lower and sweets is higher. No significant association was found between alcohol consumption or Body Mass Index and family history. Spontaneous behavioral change to a more preventive lifestyle in relatives of cancer patients is very low.