Attention,Externalizing, and Internalizing Problems of Youth Exposed to Parental Incarceration

Few studies have examined the effects of parental incarceration (PI) on outcomes above and beyond other risk and adverse childhood experiences (ACEs). The objectives of this study were to (1) the associations between PI and mental health problems (attention, externalizing, internalizing, and total behavioral problems) and (2) the mediating role of current socioeconomic status and cumulative ACEs. An observational and cross-sectional design was employed. Analyses included hierarchical multivariable linear regression modeling. The analytic sample included 613 adolescents (11–17?years). On average, youth exposed to PI experienced three times as many ACEs compared with youth unexposed. Youth exposed to PI were more likely to have behavioral problems than their unexposed peers. The main effect for all models was attenuated by current economic hardship as well as exposure to increasing numbers of ACEs. Exposure to PI can be viewed as a marker of accumulative risk for intervention since youth impacted by PI are more likely to experience behavioral difficulties and associated adverse childhood experiences. Due to the associated adversity that impact youth exposed to PI, mental health providers need to be able to identify and screen for symptoms associated with trauma.     

The use of neoadjuvant lobar radioembolization prior to major hepatic resection for malignancy results in a low rate of post hepatectomy liver failure

BackgroundNeoadjuvant yttrium-90 transarterial radioembolization (TARE) is increasingly being used as a strategy to facilitate resection of otherwise unresectable tumors due to its ability to generate both tumor response and remnant liver hypertrophy. Perioperative outcomes after the use of neoadjuvant lobar TARE remain underinvestigated.MethodsA single center retrospective review of patients who underwent lobar TARE prior to major hepatectomy for primary or metastatic liver cancer between 2007 and 2018 was conducted. Baseline demographics, radioembolization parameters, pre- and post-radioembolization volumetrics, intra-operative surgical data, adverse events, and post-operative outcomes were analyzed.ResultsTwenty-six patients underwent major hepatectomy after neoadjuvant lobar TARE. The mean age was 58.3 years (17–88 years). 62% of patients (n=16) had primary liver malignancies while the remainder had metastatic disease. Liver resection included right hepatectomy or trisegmentectomy, left or extended left hepatectomy, and sectorectomy/segmentectomy in 77% (n=20), 8% (n=2), and 15% (n=4) of patients, respectively. The mean length of stay was 8.3 days (range, 3–33 days) and there were no grade IV morbidities or 90-day mortalities. The incidence of post hepatectomy liver failure (PHLF) was 3.8% (n=1). The median time to progression after resection was 4.5 months (range, 3.3–10 months). Twenty-three percent (n=6) of patients had no recurrence. The median survival was 28.9 months (range, 16.9–46.8 months) from major hepatectomy and 37.6 months (range, 25.2–53.1 months) from TARE.ConclusionsMajor hepatectomy after neoadjuvant lobar radioembolization is safe with a low incidence of PHLF.     

Thrombotic occlusion of the common carotid artery (CCA) in acute ischemic stroke treated with intravenous tissue plasminogen activator (TPA)

Although common carotid artery (CCA) occlusions are rare, acute clinical presentations vary from mild to devastating strokes primarily due to tandem occlusions in the intracranial arteries. Three patients with acute CCA occlusions were treated with systemic tissue plasminogen activator (TPA). Blood pressures were kept at the upper limits allowed with TPA therapy with fluid balance and the 'head-down' position. Recanalization occurred in intracranial vessels only. Marked early neurological improvement occurred in two of three patients. CCA occlusions should not be considered contra-indication to systemic thrombolysis.     

Comparison of 180° and 360° acquisition for myocardial perfusion SPECT with compensation for attenuation, detector response, and scatter: Monte Carlo and mathematical observer results

BACKGROUND: The optimal projection data acquisition strategy for myocardial perfusion (MP) single photon emission computed tomography (SPECT) remains controversial. METHODS: We compared MP SPECT using 180 degrees and 360 degrees projection data obtained with the same acquisition time, reconstructed either with filtered back projection (FBP) or the iterative ordered-subsets expectation maximization (OS-EM) algorithm with various combinations of attenuation, detector response, and scatter compensation using mathematical observers and a myocardial defect detection task. We used Monte Carlo-simulated projection data from a population of 3-dimensional nurbs-based cardiac-torso (NCAT) phantoms with ranges of variability in patient anatomy, organ uptake, defect location, defect size, and noise level based on clinical data. Projection data from 180 degrees and 360 degrees acquisitions were generated by assuming the same acquisition time. After iterative or FBP reconstruction, standard postprocessing methods were applied. For each acquisition and reconstruction method, we optimized the number of iterations and cut-off frequency of the Butterworth filter using the Channelized Hotelling Observer methodology. The optimum set of parameters was that which gave the maximum area under the curve. RESULTS: For both acquisition protocols, OS-EM with compensations provided better performance than FBP or OS-EM without compensation. For FBP, the optimized 180 degrees acquisition provided a statistically significant increase in AUC as compared with optimized 360 degrees acquisition. For OS-EM, the AUCs for 180 degrees were slightly larger than for 360 degrees acquisitions when comparing images reconstructed with the same compensations. However, the differences were smaller and not statistically significant. CONCLUSION: With optimized reconstruction and filtering parameters, 180 degrees acquisition provided a statistically significant improvement over 360 degrees acquisition for FBP reconstruction. However, for OS-EM the differences were small and not statistically significant.     

Parental alcohol use and brain volumes in early- and late-onset alcoholics.

BACKGROUND: Studies have shown that alcoholics have smaller brain volumes than non-alcoholic cohorts, but an effect of family history (FH) of heavy drinking on brain volume has not been demonstrated. We examined the relationship between an FH of heavy drinking and both brain shrinkage as measured by the ratio of brain volumes to intracranial volume (ICV) as well as maximal brain growth as measured by ICV in early-onset and late-onset alcoholics. METHODS: With T1-weighted resonance imaging, we measured ICV, brain volume, and white and gray matter volume in adult treatment-seeking late-onset and early-onset alcoholics with either a positive or a negative FH of heavy alcohol use, and in healthy control subjects. We also calculated brain shrinkage using a ratio of soft tissue volumes to ICV. RESULTS: The FH positive alcoholic patients had significantly smaller ICVs than FH negative patients, suggesting smaller premorbid brain growth. Brain shrinkage did not correlate with FH. Late-onset alcoholics showed a greater difference in ICV between FH positive and FH negative patients than early-onset alcoholics. Late-onset FH positive patients also had significantly lower IQ scores than late-onset FH negative patients, and IQ scores were correlated with ICV. CONCLUSIONS: These data provide evidence that parental alcohol use might increase risk for alcoholism in offspring in part by a genetic and/or environmental effect that might be related to reduced brain growth.     

Experimentelle Untersuchungen über die Ultraschallwirkung auf das Jensen-Sarkom der Ratte

Ohne ZusammenfassungMit 24 Textabbildungen.Vorgetragen: 1. I. Hausser, Ultraschall-Arbeitstagung Erlangen, 3. 5. 49; s. Kongreßbericht. 2. W. Doerr, ebendort; infolge Erkrankung vertreten durch I. Hausser. 3. R. Frey, Deutscher Chirurgenkongreß in Frankfurt, 9. 6. 49.     

Ein streng dominant erbliches Kinnmuskelzittern

Zusammenfassung An einem genealogisch zusammenhängenden Menschenmaterial von über 100 Personen wurde bis jetzt an 55 ein streng dominant erbliches, von Geburt an bestehendes Kinnmuskelzittern nachgewiesen.Bei vielen Trägern dieses Merkmals ist dieses mit gewissen bahnenden Tätigkeiten verknüpft, denen ein gemeinsamer spezifischer Gemütszustand (Achtsamkeit) innezuwohnen scheint, zu dessen Darstellung das Phänomen unter Umständen dienen könnte.Verf. sieht in dieser Verknüpfung eine Verwandtschaft des Phänomens mit den Affektäußerungen und mimischen Ausdrucksbewegungen des Menschen.Nach einem am 28. III. 1930 in der Wiener Gesellschaft der Ärzte gehaltenen Vortrage, wobei sieben Träger des Phänomens (Nr. 26, 28, 31, 34, 47, 50 und 52 des Stammbaums) vorgeführt wurden.Das Geburtsjahr wurde darum überall mitangeführt, weil es eine Hypothese, die sog. H. Swobodasche Siebenjahrlehre gibt, die den Einfluß eines Zeitfaktors in Form einer meist siebenjährigen Periodizität auf das erbliche Geschehen behauptet. Wie man sieht, könnte mau bei weniger ausführlichem Studium durch einige Beispiele (3, 11, 40!) versucht sein, auch aus dem vorliegenden Stammbaum ein solches Gesetz zu konstruieren. Genauerer Hinblick gibt aber schlagende Gegenbeispiele. Denn wie will H. Swoboda das unmittelbare Alternieren von Merkmalträgern und Merkmalfreien mit seiner Theorie in Einklang bringen? Z. B. Franz Sch. (4) ist tatsächlich 21, also dreimal sieben Jahre nach seiner Mutter Barbara (2) geboren. Der Einfluß dieses Siebenjahres muß nun aber schon im nächsten Jahr nach Swoboda erloschen sein, da ja der 1847 geborene Josef das KMZ. nicht bekam. Dann müßte aber das nächste Siebenjahr (1853) einen viel breiteren Einflußbereich (volle 5 Jahre) gehabt haben, da ihm sowohl Johanna (1850) wie Anton (1855) ihr KMZ. verdanken sollten. Das nächste Siebenjahr aber blieb überhaupt wirkungslos, denn Josefa (1860) ist frei von KMZ. Nun, was für das eine Siebenjahr recht ist, muß für das andere billig sein. Dies nur ein Beispiel für viele, das genugsam zeigt, wie trügerisch solches Spiel mit Zahlen ist. Und es ist immerhin bedenklich, wenn eine Lehre, die sich bis zu eugenetisehen Ratschlägen an hereditär belastete Eltern versteigt (!), an einem Erbmerkmal von so ungeheurer Durchschlagskraft, wie es das hier besprochene ist, ihre Gültigkeit nicht zeigen kann.     

Das Wachstum Nach Konstanten Proportionen

Ohne ZusammenfassungAntrittsvorlesung.