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Copyright of Canadian Bulletin of Medical History is the property of University of Toronto Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Cost optimization approach of operational research is a predictive power and economy of compactness that is applied to solve specific clinical needs relevant to healthcare cost reduction. Technology helps the healthcare management, decision making, and policy that we have implemented in the interest of improving quality of patient care and treatment outcomes, thereby reducing costs and improving efficiency. The treatment cost of brain tumor is high. Sometimes, cost becomes a problem for individuals to get their complete treatment, which makes their health at risk and may lead to higher cost in future. Here we address neuroinformatics approach to optimize diagnosis cost in neurology through an operational research tool (optimization) on how the diagnosis cost of neuro-patient can optimize. In this context, we introduce a new and unique optimization approach in healthcare, yet what we are clearly lacking for applying applications of operational tools to translate this understanding to the different level to apply the concept in healthcare. The costs of treatment achieved by three standard initial basic feasible solutions (IBFS) methods (North-west corner method, Minimum cost method, Vogel's approximation method) are 763, 763, and 779. The optimal solution is 761, and three random tests (RT's) are 826, 783, and 788. Optimal solution provided an overall difference in treatment cost with IBFS 2, 2, 18 and with RT's 65, 22, and 27. These results establish the basis for a deliberate integration of operational research tools and neuroscience into diagnosis of cost optimization mechanisms for neuro-patient. [ABSTRACT FROM AUTHOR]

Copyright of Revista Brasileira em Promoção da Saúde is the property of Revista Brasileira em Promocao da Saude and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Abstract: Alzheimer’s data indicate that at present, approximately one new case of this form of dementia is identified in the USA every 68s and that by 2050 the incidence will be about every 33s, with projections from the Alzheimer Association (USA) indicating that nearly 25% of Americans will be affected by Alzheimer’s dementia by 2031. Despite the numerous advances in medical science and neurological research, the causes are still unknown and the incidence is not decreasing or levelling out. Most research on the causes of Alzheimer’s dementia indicates the possible roles of viruses, obesity, physical inactivity, diabetes, psychological depression, high blood pressure, frequent inflammation, environmental or domestic chemicals and toxins, or inescapable genetic factors. Alzheimer’s, being the degeneration of parts of the neural pathways in the brain, may indeed involve neuro-toxic compounds that can bypass the blood–brain barrier. Therefore, it is necessary to examine what is prolific in the environment and, in particular, the food supply. One of the many suggestions in the literature is the ingestion of food items derived from unfermented soybean products; the anti-thyroid, anti-nutrient, and endocrine disruption properties of soy can have a deleterious effect in many individuals. Among the many theories and different factors that may be involved in dementiae, soy consumption may be a significant contributor to Alzheimer’s dementia, and it cannot be excluded as a possible contributing cause. Our hypothesis argues that consumption of soy food products may contribute to the increasing incidence of Alzheimer’s dementia and other dementiae. [Copyright &y& Elsevier]

Copyright of Recherches Feministes is the property of Groupe de Recherche et d'Echange Multidisciplinaires Feministes and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Filosofia UNISINOS is the property of Universidade do Vale do Rio dos Sinos and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Collegium Antropologicum is the property of Croatian Anthropological Society and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Avances en PsicologÍa Latinoamericana is the property of Colegio Mayor de Nuestra Senora del Rosario and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

A 14-year-old male domestic shorthair cat presented with an acute onset of aggressive behaviour, fear and hypersalivation. Neurological examination revealed bilateral mydriasis and left-sided facial twitching and hemiparesis. Magnetic resonance imaging (MRI) showed moderate bilateral symmetrical T2-hyperintensity along the entire hippocampus and bilateral asymmetric T2-hyperintensity in the pyriform lobes. Marked bilateral contrast enhancement of the hippocampus was evident on post-contrast T1-weighted images. The partial complex seizures were refractory to medical treatment and the cat was euthanased 4 days after admission. The clinical and MRI findings were consistent with feline hippocampal necrosis (FHN). On histopathology, neuronal necrosis and astrocytosis were present in the hippocampi and pyriform lobes. In addition, an oligodendroglioma was detected in the right pyriform lobe. Contrary to previous reports of FHN in which no underlying cause could be identified, we believe that in this case the seizure focus arose from a neoplastic lesion within the right pyriform lobe. This unique case report represents the so-called ‘dual pathology’ of temporal lobe epilepsy in humans, in which an extrahippocampal lesion within the temporal lobe results in hippocampal sclerosis. [ABSTRACT FROM AUTHOR]

Introduction: Depression is common in patients with multiple sclerosis (MS) and has a negative effect on quality of life. The prevalence of depression in MS varies significantly, from 10-60%. Suicidal ideas are one of the problems that occur in MS, more often than in the general population. Iatrogenic factors, such as the use of corticosteroids and immunomodulatory therapies, further affect the development of depressive disorders. Aim: To determine the socio-demographic characteristics of patients with MS, and to examine the presence of depressive disorders in patients with MS based on gender, age, type of immunomodulatory therapy (Betaferon® or Enokorten ®), and the incidence of suicidal tendencies. Material and methods: The study was conducted at the Department of Neurology KCUS, partly retrospectively and partly prospectively, and concerned the epidemiological, descriptive / analytical and character of clinical application in patients with MS. Thirty patients were treated with Betaferon® and 30 patients were treated with Enkorten®. The study used Beck's Depression Scale. Results: In the study group women were predominantly present (63.3%, with an average age of 43 years on Enkorten® and 66.7% on Betaferon®) with a mean age of 34.7 years. Depressive symptoms were present in 63.34% of those on Betaferon® (severe depression in 3.3%) and 43.34% on Enkorten® (severe depression in 13.32%). Suicidal ideation was present in 6.6% of patients on Betaferon®). Conclusion: Depressive symptoms in our study were significantly more present in women with MS who were treated with Betaferon®, and suicidal thoughts were present in 6.6% of patients. We must keep this in mind when selecting immunomodulatory therapies for patients with MS who have developed depressive disorders. [ABSTRACT FROM AUTHOR]

Copyright of Musiktherapeutische Umschau is the property of Vandenhoeck & Ruprecht GmbH & Co. KG and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Teocomunicação is the property of EDIPUCRS - Editora Universitaria da PUCRS and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

This paper analyzes the tendency of taking the "I" and the "me" in G. H. Meads theory of role taking as two separate, qualitatively different parts of human personality, the "I" being of individual origin, the "roe" of social. In the original Meadian sense role taking gives rise to both the "I" and the "me". They arc dialectically united rather than dualistically separated aspects. They refer to rhe joint functional power of the subject, finding itsclf as so object, mediated by the Other. As a consequence, the link between body and the social world he- comes thcoretically more Stringent, as the body is given its place as a cognitive social object among others, this by contrast to interpretations where the body is left as an object mainly outside the human social experience and as a source of agency cui g~'neris, a conception which is in opposition to Meads. The stress on the "l"-phasc. as related to body and concrete action in combination with its direct relation to the "me"-phasc, actualiLcs Mead as a forerunner in modern biologic/neti- rologic research on human perceptual, motivational arid intentional capacity. Swedish Mead interpreters are critically analyzed. Interpretations of Charon, Giddens, Lois and Hahermas are partly scrutinized. The author defines the conceptual pair in terms of activity, subjectivity, temporal i-clan vity and distance. [ABSTRACT FROM AUTHOR]

The article assesses the neurological function of newborn infants of mothers working in citrus orchards in Northern Thailand for a period of one year where pesticide applications average 35 times a year. The article gathered data by using a cross-sectional approach on 41 participants, nine of which have mothers who worked in citrus orchards. Findings showed that twelve infants, and five of them were born to mothers from citrus orchards, revealed an abnormal muscle tone.

Objective: To investigate the influence of thrombolysis on functional outcomes after rehabilitation. Background: Systemic thrombolysis with tissue plasminogen activator (tPA) is considered the mainstay of acute stroke therapy and was found to improve short-term outcome. Design: Matched case-controlled design. Setting: Inpatient neurology and rehabilitation departments. Participants: Thirty-seven patients given tPA and 37 control patients not treated with lytics because of protocol limits. Methods: We retrospectively analyzed data from a cohort of stroke patients who were treated with systemic tPA. The rehabilitation outcome of thrombolysis-treated patients was compared with that observed for tPA-ineligible and age- and stroke severity-matched patients treated at the same neurology and rehabilitation departments. Main Outcome Measure: Neurological evaluation was assessed with the National Institutes of Health stroke scale (NIHSS). Activity of daily living was measured using the Functional Independence Measure (FIM) instrument. Functional outcome was measured using the modified Rankin scale (mRS). Results: The treatment group included 37 patients given tPA; 37 tPA-ineligible patients served as controls. On admission to rehabilitation, there were no significant differences in functional, neurological, and rehabilitation parameters between the groups. At the end of the rehabilitation period, NIHSS scores were significantly lower in the thrombolysis group (P = .036). More patients in the thrombolysis group reached functional independence defined as mRS ≤2 (20/37 versus 10/37; P = .03). At the end of rehabilitation, total FIM score (mean 102.8 versus 93.9; P = .039), total FIM gain (mean 27.8 versus 21.4; P = .09), and total FIM efficiency scores (0.8 versus 0.43; P = .013) were higher in the thrombolysis group and more patients in this group were discharged home. Conclusions: Although the bulk of neurological improvement occurred before the inpatient rehabilitation, thrombolysis-treated patients continue to improve faster and to a larger extent during the rehabilitation period suggesting that the beneficial effects of thrombolysis continue beyond the acute phase. [Copyright &y& Elsevier]

An overarching framework is proposed to guide the design of phase 2 studies in central nervous system disorders. Archetypes are considered for scenarios where dose response is highly relevant in clinical practice, as in the symptomatic treatment of acute disorders. Archetypes for scenarios where dose response is less relevant, as in disease modification for neurodegenerative disorders, are beyond the scope of this article. Primary design archetypes are determined by axes of development that are defined by optimism for success (probability of efficacy) and signal detection (magnitude of the anticipated effect size). The fast-to-registration primary archetype uses a dose-response study as the first efficacy, that is, proof of concept (PoC), study and is appropriate when the prospects for signal detection and the optimism for efficacy are higher. These conditions may exist when the anticipated effect size is large and when either testing a drug with a proven mechanism of action or when a favorable biomarker result was obtained in phase 1. The fast-to-PoC primary archetype tests one dose arm to establish PoC before assessing dose response and is appropriate when the optimism for efficacy and the prospects for signal detection are lower. These conditions may exist when testing a drug with a novel mechanism and/or the anticipated effect size is smaller. Secondary archetypes are used to mitigate the trade-offs between the quick-kill fast-to-PoC approach and the quick-win fast- to-registration approach, and are key areas where adaptive designs can be beneficial. [ABSTRACT FROM AUTHOR]

Syncope is a transient loss of consciousness precipitated by cerebral hypoperfusion, which is associated with a brief absence of postural tone and usually followed by a complete recovery. Th is clinical condition is a common medical problem and may be attributed to a multitude of disease processes. Risk stratification identifies the safest setting for the initial evaluation as well as which patients are most likely to have a life-threatening event. Establishing the diagnosis of syncope is important so that specific treatment can be instituted to prevent future recurrences and eliminate the underlying predisposing disease. Th is article reviews the etiology, risk stratification, diagnosis, and therapeutic management of syncope. [ABSTRACT FROM AUTHOR]

The article explores various aspects of brain-based learning (BBL). The theory of multiple intelligences conceptualized by psychologist Howard Gardner is tackled. BBL is defined as techniques developed from research in neurology and cognitive science aimed at improving teacher instruction. Other topics discussed, include the principles of BBL, application of BBL in education in the U.S. and the concept of a learning and brain community.

The causes of postoperative cardiovascular disturbances in neurosurgical patients include direct cardiac neurogenic effects, clinical situations where brain tissue is underperfused, and hyperdynamic states. EKG and echographic abnormalities are common in subarachnoid hemorrhage where cardiac troponin I is the most useful predictor of cardiac risk after SAH. Neurogenic pulmonary edema is short lived and often resolves with resolution of the neurologic problem. In traumatic brain injury, where areas of ischemia co-exist with luxury perfusion, advanced hemodynamic monitoring and prevention of jugular venous desaturation best avoid secondary brain injury and achieve optimal neurologic outcome. Induced hypertension improves blood flow through vessels compromised by cerebral stenting, angioplasty, microcatheters, thrombolysis, carotid clamping, intracranial bypass and cerebral vasospasm. Hyperdynamic lesions include vascular breakthrough after elimination of cerebral arteriovenous malformations, but also emergence hypertension and hyperemia. Pharmacologic agents and adjunctive measures are effective in controlling both the systemic and the cerebral circulation. [Copyright &y& Elsevier]

Abstract: Introduction: Vagus nerve stimulation (VNS) is a symptomatic add-on treatment for patients with medically refractory epilepsy. It consists of continuous electrical stimulation of the left vagus nerve by means of a helical electrode and an implantable, programmable pulse generator. Currently, over 50,000 patients are treated with VNS worldwide. Aim: This uncontrolled, open-label retrospective study evaluates long-term outcome in patients treated with VNS for refractory epilepsy in seven different epilepsy centres in Belgium. Methods: For the purpose of this study, a minimum of essential inclusion criteria were defined to collect relevant data. This limited the results to basic findings with regards to efficacy on the long term. Inclusion criteria were a follow-up of at least 12 months and a documented seizure diary before implantation and at maximum follow-up. Primary outcome measures were the reduction in mean monthly seizure frequency and the percentage of patients with a seizure reduction of at least 50% (responder rate). Results: About 138 patients (67M/71F) had a mean age of 30 years (range 4–59) at time of implantation and a mean post-implantation follow-up of 44 months (range 12–120). The mean number of AEDs before implantation was 3 (range 1–5). About 117/138 patients had focal epilepsy, 21 patients had symptomatic generalised epilepsy. About 117/138 patients were older than 16 years, 21 patients were 16 or younger. At maximum follow-up, mean stimulation output current was 1.84mA (range 0–3.25). Mean number of AEDs at maximum follow-up remained unchanged. The overall reduction in mean monthly seizure frequency was 51%. Mean seizure frequency before implantation was 41 seizures/month (SD=61; range 1–300), mean seizure frequency after implantation at maximum follow-up was 7 seizures/month (SD=25; range 0–120). Responder rate was 59%. 13% of patients had a seizure frequency decrease between 30% and 50%. About 28% had a seizure frequency decrease of<30%. Seizure freedom was obtained in 12/138 patients (9%). Conclusions: The long-term experience with VNS in Belgium confirms that VNS is an efficacious adjunctive antiepileptic treatment for patients with refractory epilepsy. [Copyright &y& Elsevier]

Objectives: To review the historical development and current status of endovascular techniques used in the treatment of symptomatic vasospasm following aneurysmal subarachnoid hemorrhage. Methods: This article summarizes the relevant literature on neurointerventional therapy for vasospasm, namely instillation of intraarterial medication (papaverine, nicardipine, verapamil) and transluminal balloon angioplasty. The authors synthesize the available literature with their own experience using the various endovascular modalities to treat vasospasm at high volume cerebrovascular centers. Technique: Indications for the use of neurointerventional therapy as well as a summary of the technique for transluminal angioplasty to treat vasospasm as employed by the authors is described. Discussion: Neurointerventional treatment of vasospasm following aneurysmal hemorrhage has been proven to be a safe and successful technique for those patients suffering symptomatic vasospasm refractory to medical management. The techniques contunue to undergo refinement as endovascular technology advances. We currently favor the use of balloon angioplasty over intraarterial antispasmotics due to the increased durability and long-lasting effects of the former and lower risk profile. [ABSTRACT FROM AUTHOR]

Background: Syncope or new onset focal neurologic deficits are described in as many as one fifth of patients with acute aortic dissection referred for surgery. Coma or stroke caused by involvement of the arch vessels and secondary brain malperfusion is considered a major contraindication for emergency aortic repair. Initial experience with emergency operation in selected patients with acute type A aortic dissection complicated by coma is described. Methods: Five comatose (median Glasgow coma score, 5.5), hemodynamically stable (systolic blood pressure ≥ 100 mm Hg) patients with preserved pupillary reactivity and coma duration of less than 12 hours underwent emergency surgical repair. The ascending aorta was always replaced using profound hypothermic circulatory arrest. Results: There were no operative deaths. No hemorrhagic brain infarction developed postoperatively. Ischemic strokes were documented by radiology in 3 patients, and were always right-sided. Four patients returned to normal life with no neurologic sequelae, whereas 1 patient showed partially recovered left hemiparesis and mild cognitive impairment. Conclusions: Coma may not represent an absolute contraindication for resuscitative surgery in hemodynamically stable patients with acute type A aortic dissection. A larger experience is necessary to draw more definitive conclusions. [Copyright &y& Elsevier]

Presents a commentary to a previously published study by W. S. Smith and other researchers about vertebral artery dissection. Failure of Smith and other authors to disclose other potential causes of vetebrebasilar artery accidents other than spinal manipulation; Nonobservance of cerebrovascular accidents cases after manipulation by parties other than licensed chiropractors; Inability to authors to place the risks of manipulatioon in the context of those produced by other medical treatments or lifestyle activities.

Clinical databases are continually growing and accruing more patient information. One of the challenges for managing this wealth of data is efficient retrieval and analysis of a broad range of image and non-image patient data from diverse data sources. This article describes the design and implementation of a new class of research data warehouse, neuroinformatics database system (NIDS), which will alleviate these problems for clinicians and researchers studying and treating patients with intractable temporal lobe epilepsy. The NIDS is a secured, multi-tier system that enables the user to gather, proofread, analyze, and store data from multiple underlying sources. In addition to data management, the NIDS provides several key functions including image analysis and processing, free text search of patient reports, construction of general queries, and on-line statistical analysis. The establishment of this integrated research database will serve as a foundation for future hypothesis-driven experiments, which could uncover previously unsuspected correlations and perhaps help to identify new and accurate predictors for image diagnosis. [Copyright &y& Elsevier]

Abstract: The clinical manifestations of pain affect millions of people worldwide and are therefore a huge focus of neurological research. In order to maximize the clinical effect of new pathophysiological findings, it is vital for basic science researchers to communicate closely with clinicians. This BNA and Pain Society joint symposium therefore provided an excellent forum for interesting discussions which focused on the molecular mechanisms of nociception and LTP in relation to sensory and psychological themes. [Copyright &y& Elsevier]