Using Catchment Population to Estimate Sporadic Creutzfeldt-Jakob Disease Incidence.

Introduction: Catchment populations have several uses. A method using catchment population to estimate the incidence of sporadic Creutzfeldt-Jakob disease (sCJD) is described.

Materials And Methods: A cohort of nine consecutive patients diagnosed with sCJD, symptom onset spanning 26 months, were observed at a rural tertiary university medical center that has approximately 40,000 hospital discharges annually.

Intravenous thrombolysis of large vessel occlusions is associated with higher hospital costs than small vessel strokes: a rationale for developing stroke severity-based financial models.

Background: Owing to their severity, large vessel occlusion (LVO) strokes may be associated with higher costs that are not reflected in current coding systems. This study aimed to determine whether intravenous thrombolysis costs are related to the presence or absence of LVO.

Methods: Patients who had undergone intravenous thrombolysis over a 9-year period were divided into LVO and no LVO (nLVO) groups based on admission CT angiography.

Discordant thymectomy in identical twins concordant for myasthenia gravis.

Background: Thymectomy is standard therapy fornonthymomatousmyasthenia gravis despite the absence of randomized clinical trials (1). Myasthenia gravis is uncommonly reported in monozygous twins; disease concordance occurs in approximately one third of such identical twin pairs; and treatment for myasthenia gravis, when described,is usually concordant in identical twin pairs (2).

Objective: To report an 11-year clinical course of a pair of identical twins concordant for generalized acetylcholine receptor antibody–positive nonthymomatous myasthenia gravis in whom only 1 was treated with extended transsternal thymectomy.

Infant homicide and accidental death in the United States, 1940-2005: ethics and epidemiological classification.

Potential ethical issues can arise during the process of epidemiological classification. For example, unnatural infant deaths are classified as accidental deaths or homicides. Societal sensitivity to the physical abuse and neglect of children has increased over recent decades.

The role of CT perfusion imaging in acute stroke diagnosis: a large single-center experience.

The objective of this study was to determine the utility of computed tomography perfusion (CTP) scans in diagnosing acute ischemic stroke (AIS). CTP abnormalities in two contiguous supratentorial levels were correlated with diffusion weighted image (DWI) abnormalities on magnetic resonance imaging (the standard for stroke diagnosis) performed within 1 week in 422 suspected acute ischemic strokes. Of 157 AIS confirmed by DWI, 78 showed CTP abnormalities (sensitivity 49.

Impact of institution of a stroke program upon referral bias at a rural academic medical center.

Context: Referral bias reflecting the preferential hospital transfer of patients with intracerebral hemorrhage (ICH) has been demonstrated as the major contributing factor for an observed high nonrisk-adjusted in-hospital crude acute stroke mortality rate at a rural academic medical center.

Purpose: This study was done to assess the impact of a clinical acute stroke program upon referral bias in August 2000.

Methods: A chart review of acute stroke (DRG 14) discharges during 2001 from a rural academic medical center was compared with the same data from 1999.

Epilepsy's role in the historical differentiation of religion, magic, and science.

A distinction between religion, magic, and science has not always been recognized. Ancient Greek physicians, in their writings about epilepsy, were likely among the first to record the historically important differentiation between religion, magic, and science.

The contributions of Lavoisier, Carnot, and Mayer to understanding heat illness.

Although heat illness has been described throughout recorded history, an understanding of its pathophysiology was only achieved in the 20th century. Lavoisier, Carnot, and Mayer described fundamental concepts about thermodynamics in the late 18th and early 19th centuries that were crucial to the eventual understanding of heat illness. Lavoisier recognized that the human body was a heat engine.

Critical illness myopathy associated with hyperthyroidism.

A 51-year-old woman was admitted to the intensive care unit for exacerbation of chronic obstructive pulmonary disease. She received antibiotics, neuromuscular blocking agents, and steroids. After 8 days in the intensive care unit, she was noted to be severely weak, her serum creatine kinase had risen to 1,692 U/L (normal, 20-220 U/L), and a muscle biopsy was consistent with critical illness myopathy.

"Guessing it right," John A. Simpson, and myasthenia gravis: the role of analogy in science.

In 1960, John A. Simpson hypothesized that myasthenia gravis "is an 'auto-immune' response of muscle in which an antibody to end-plate protein may be formed." Simpson's speculation was subsequently shown to be correct.

Congenital myopathies/dystrophies.

The congenital myopathies and congenital muscular dystrophies are a group of relatively infrequent neuromuscular disorders. Ultimate understanding of these disorders, however, will undoubtedly shed considerable light on skeletal muscle development and function. Three classical congenital myopathies are central core disease, nemaline myopathy, and centronuclear myopathy.

Channelopathies in pediatric neurology.

Although the genetic neurologic channelopathies are uncommon, they serve as models that further understanding of disease mechanisms in paroxysmal disorders. Many other neurologic channelopathies likely will be identified in the future.

Motor axonal injury and amyotrophic lateral sclerosis: risk assessment using a reverse probability analysis technique.

A relationship between antecedent trauma and amyotrophic lateral sclerosis (ALS) has been clinically suspected for over a century. Nine cases of ALS that occurred over a 14-year period in young U.S.

Association between early returns and frequent ED visits at a rural academic medical center.

The objective of this study was to examine the influence of frequent emergency department (ED) use on early returns to the ED at a large rural academic medical center. An analysis was done of all 35,440 visits by 22,442 individuals to a large rural academic medical center ED during calendar year 2000. Of 35,440 ED visits, there were 1,992 (5.