Quantitative assessments of traumatic axonal injury in human brain: concordance of microdialysis and advanced MRI.

Axonal injury is a major contributor to adverse outcomes following brain trauma. However, the extent of axonal injury cannot currently be assessed reliably in living humans. Here, we used two experimental methods with distinct noise sources and limitations in the same cohort of 15 patients with severe traumatic brain injury to assess axonal injury.

Cerebellar white matter abnormalities following primary blast injury in US military personnel.

Little is known about the effects of blast exposure on the human brain in the absence of head impact. Clinical reports, experimental animal studies, and computational modeling of blast exposure have suggested effects on the cerebellum and brainstem. In US military personnel with isolated, primary blast-related 'mild' traumatic brain injury and no other known insult, we found diffusion tensor MRI abnormalities consistent with cerebellar white matter injury in 3 of 4 subjects.

Electroconvulsive therapy in patients with vagus nerve stimulation.

Numerous studies have demonstrated the safety and efficacy of electroconvulsive therapy (ECT) for various psychiatric conditions, and it has been approved by the Food and Drug Administration for the treatment of refractory depression. Recently, the Food and Drug Administration also approved vagus nerve stimulation as a treatment for chronic or recurrent depression. Although electrical stimulation is used for both ECT and vagus nerve stimulation, the mechanisms of their action are very different.

Electroconvulsive therapy and ocular dystonia.

Electroconvulsive therapy (ECT) has been reported to be beneficial in various movement disorders, especially tardive dystonic reactions. In this article, we report an interesting case of drug-induced blepharospasm with ocular dystonia which improved with ECT. To our knowledge, a case of ocular dystonia improving with ECT has not been previously reported in the literature.

The pleasure of dissent: a critical theory of psychotherapy as an emancipatory practice.

The intent of this paper is to examine the inherent contradictions in the practice of psychotherapy that, if left unexamined, ruin the emancipatory prospects that it holds. Critical theory and, more specifically, Jurgen Habermas' theory of communicative action is utilized as a starting point for reconceptualizing psychotherapy. This paper then establishes a phenomenological and ethical basis for solidarity despite the power differences and conflicting goals for therapists and clients.

An exploratory study of constructions of masculinity, sexuality and HIV/AIDS in Namibia, Southern Africa.

The goal of the current study was to explore notions of masculinity and their linkages to HIV/AIDS among Owambo men and women in Namibia, where an estimated one-fifth of 15-49 year-olds have acquired HIV. Thirteen open-ended interviews and three focus groups were conducted with 50 male and female participants aged 19-50 in rural and urban Namibia. Qualitative analysis revealed six central themes: the evolving meanings of masculinity, power dynamics between men and women, women as active agents, the tension between formal and informal education and HIV transmission, alcohol and masculinity, and the blending of masculinity and explanations of HIV and AIDS.

Sexual functioning in patients with end-stage liver disease before and after transplantation.

The effects of end-stage liver disease (ESLD) on sexual functioning are complex and often overlooked in the context of chronic illness and the transplantation evaluation. The aim of the present study is to report on the prevalence of sexual dysfunction in patients with ESLD presenting for liver transplantation evaluation, as well as to examine a cohort after transplantation. Participants included 173 consecutive adult outpatients with ESLD who presented for orthotopic liver transplantation evaluation.

Cognitive impairment in people diagnosed with end-stage liver disease evaluated for liver transplantation.

Cognitive impairments are common in patients with end-stage liver disease (ESLD). The aim of the present study was to identify and characterize the neuropsychological deficits between groups of patients with a variety of causes of ESLD and to assess the impact of heavy alcohol use on cognitive functioning. Cognitive functioning in 300 consecutive outpatients presenting for liver transplantation evaluation was assessed using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS).

Aripiprazole-induced parkinsonism.

Dopamine receptor antagonism is associated not only with antipsychotic action, but also with the generation of extrapyramidal side-effects of antipsychotic medications. Positron emission tomography studies reveal that an approximate 60-70% blockade of the D2 receptors is required for typical antipsychotics to be efficacious, but a blockade of > or =75-80% results in acute extrapyramidal side-effects. The newer atypical antipsychotics have a lower propensity to produce extrapyramidal side-effects.

Waiting for a liver transplant.

The waiting period for liver transplantation is a difficult time fraught with uncertainty and associated with a high rate of morbidity and mortality. To understand better what it means for a transplant patient to wait, the authors explore in this phenomenological study the meaning that people with liver failure ascribe to the experience of waiting for a transplant. They conducted 9 interviews using phenomenological methods of inquiry as a guide for analysis.