The sharp slowdown in growth of medical imaging: an early analysis suggests combination of policies was the cause.

The growth in the use of advanced imaging for Medicare beneficiaries decelerated in 2006 and 2007, ending a decade of growth that had exceeded 6 percent annually. The slowdown raises three questions. Did the slowdown in growth of imaging under Medicare persist and extend to the non-Medicare insured? What factors caused the slowdown? Was the slowdown good or bad for patients? Using claims file data and interviews with health care professionals, we found that the growth of imaging use among both Medicare beneficiaries and the non-Medicare insured slowed to 1-3 percent per year through 2009.

[The general practitioner faced with memory problems in the aged patient in Luxembourg: a study of the management employed, the experience of the physicians and the perception of the specific treatment].

Memory impairments are common in elderly. General practitioners are in first line to detect and manage these troubles, for which many countries published recommendations. For Alzheimer disease there are currently four treatments, none of which is healing.

Impact of a phosphorylcholine-coated cardiac bypass circuit on blood loss and platelet function: a prospective, randomized study.

Platelet dysfunction due to cardiopulmonary bypass (CPB) surgery increases the risk of bleeding. This study analyzed the effect of a phosphorylcholine (PC)-coated CPB circuit on blood loss, transfusion needs, and platelet function. We performed a prospective, randomized study at Strasbourg University Hospital, which included 40 adults undergoing coronary artery bypass graft surgery (CABG) (n = 20) or mitral valve repair (n = 20) using CPB.

[Energy drinks: an unknown risk].

The term "energy drink" designates "any product in the form of a drink or concentrated liquid, which claims to contain a mixture of ingredients having the property to raise the level of energy and vivacity". The main brands, Red Bull, Dark Dog, Rockstar, Burn, and Monster, are present in food stores, sports venues, and bars among other soft drinks and fruit juices. Their introduction into the French market raised many reluctances, because of the presence of taurine, caffeine and glucuronolactone.

12p13.33 microdeletion including ELKS/ERC1, a new locus associated with childhood apraxia of speech.

Speech sound disorders are heterogeneous conditions, and sporadic and familial cases have been described. However, monogenic inheritance explains only a small proportion of such disorders, in particular in cases with childhood apraxia of speech (CAS). Deletions of <5 Mb involving the 12p13.

A few days of social separation affects yearling horses' response to emotional reactivity tests and enhances learning performance.

Learning performance is influenced by emotional reactivity, low reactivity being generally beneficial. Previous experiments show that emotional reactivity can be modified after a period of social isolation. We hypothesized that eleven days of isolation would affect yearlings' emotional reactivity and improve their learning abilities.

Dynamics of olfactory and hippocampal neurogenesis in adult sheep.

Although adult neurogenesis has been conserved in higher vertebrates such as primates and humans, timing of generation, migration, and differentiation of new neurons appears to differ from that in rodents. Sheep could represent an alternative model to studying neurogenesis in primates because they possess a brain as large as a macaque monkey and have a similar life span. By using a marker of cell division, bromodeoxyuridine (BrdU), in combination with several markers, the maturation time of newborn cells in the dentate gyrus (DG) and the main olfactory bulb (MOB) was determined in sheep.

Stimulant side effects and inverted-U: implications for ADHD guidelines.

Objective: To review literature relevant to a possible prediction of stimulant side effects in attention deficit hyperactivity disorder (ADHD), with implications for guidelines.

Method: Recent literature on inverted-U effects of dopamine in the prefrontal cortex (PFC), default mode processing, and motor circuits relevant to stimulant side effects is reviewed.

Results: The literature on inverted-U effects in the PFC suggests that catechol-O-methyltransferase (COMT) Met versus Val polymorphisms may predict excess dopaminergic effects, including headache and introversion in Met/Met subjects, but therapeutic effects in Val/Val subjects, while dopamine transporter polymorphisms may predict motor side effects.

Prostanoid-mediated inotropic responses are attenuated in failing human and rat ventricular myocardium.

Prostanoid-modulatory approaches in heart failure patients have displayed effects which may seem to be mutually incompatible. Both treatment with prostanoids and inhibition of prostanoid synthesis have resulted in increased mortality in heart failure patients. Currently, it is unknown if prostanoids mediate contractile effects in failing human heart and if this can explain some of the clinical effects seen after prostanoid modulatory treatments.

Cardiomyocyte-restricted inhibition of G protein-coupled receptor kinase-3 attenuates cardiac dysfunction after chronic pressure overload.

Transgenic mice with cardiac-specific expression of a peptide inhibitor of G protein-coupled receptor kinase (GRK)3 [transgenic COOH-terminal GRK3 (GRK3ct) mice] display myocardial hypercontractility without hypertrophy and enhanced α(1)-adrenergic receptor signaling. A role for GRK3 in the pathogenesis of heart failure (HF) has not been investigated, but inhibition of its isozyme, GRK2, has been beneficial in several HF models. Here, we tested whether inhibition of GRK3 modulated evolving cardiac hypertrophy and dysfunction after pressure overload.

Biochemical and pharmacological study of N-linked glycosylation of the human serotonin 5-HT₇a receptor.

The 5-hydroxytryptamine (5-HT)(7(a)) receptor is a G-protein-coupled receptor critically involved in human psychiatric and neurological disorders. In the present study, we evaluate the presence and the functional role of N-glycosylation of the human 5-HT(7) receptor. Western blot analysis of HEK293T cells transiently expressing the 5-HT(7(a)) receptor in the presence of tunicamycin gave rise to a band shift, indicating the existence of an N-glycosylated form of the 5-HT(7(a)) receptor.

ICU triage: the potential legal liability of withdrawing ICU care during a catastrophic event.

In the event of a catastrophic disaster, healthcare resources may be completely overwhelmed. To address this, the federal Agency for Healthcare Research and Quality has recommended using "crisis standards of care"during such an event. These standards would recommend allocating scarce medical resources to do the greatest good for the greatest number of patients.

Mirror neurons, birdsong, and human language: a hypothesis.

THE MIRROR SYSTEM HYPOTHESIS AND INVESTIGATIONS OF BIRDSONG ARE REVIEWED IN RELATION TO THE SIGNIFICANCE FOR THE DEVELOPMENT OF HUMAN SYMBOLIC AND LANGUAGE CAPACITY, IN TERMS OF THREE FUNDAMENTAL FORMS OF COGNITIVE REFERENCE: iconic, indexical, and symbolic. Mirror systems are initially iconic but can progress to indexical reference when produced without the need for concurrent stimuli. Developmental stages in birdsong are also explored with reference to juvenile subsong vs complex stereotyped adult syllables, as an analogy with human language development.

Practitioner characteristics and the treatment of children and adolescents with attention deficit hyperactivity disorder.

Aim: To investigate whether recent Australian practice conforms to the draft 2009 National Health and Medical Research Council (NHMRC) guidelines on the management of attention deficit hyperactivity disorder.

Methods: Data from the 2007 Special Review on Attention Deficit Hyperactivity Disorder in Children and Adolescents in New South Wales (NSW) were examined.

Results: Two hundred seven approved stimulant prescribers in NSW responded to a detailed survey on treatment practice (including 121 paediatricians and 67 psychiatrists).

The developmental stage of chicken embryos modulates the impact of in ovo olfactory stimulation on food preferences.

Like mammals, bird embryos are capable of chemosensory learning, but the ontogeny of their feeding preferences has not been examined. We tested if the timing of stimulation in chicken embryos modulates the impact of in ovo olfactory stimulation on later food preferences. We exposed chicken embryos to an olfactory stimulus for a 4-day period in the middle or toward the end of the incubation period.

Low systolic blood pressure at admission predicts long-term mortality in heart failure with preserved ejection fraction.

Background: Systolic blood pressure (SBP) at hospital admission predicts in-hospital and postdischarge mortality in patients with left ventricular systolic dysfunction. The relationship between admission SBP and mortality in heart failure with preserved (≥50%) ejection fraction (HFPEF) is still unclear.

Methods And Results: We aimed to investigate the relationship between admission SBP and 5-year outcome in 368 consecutive patients hospitalized for new-onset HFPEF.

Agents increasing cyclic GMP amplify 5-HT4-elicited positive inotropic response in failing rat cardiac ventricle.

Activation of 5-HT(4) receptors in failing ventricles elicits a cAMP-dependent positive inotropic response which is mainly limited by the cGMP-inhibitable phosphodiesterase (PDE) 3. However, PDE4 plays an additional role which is demasked by PDE3 inhibition. The objective of this study was to evaluate the effect of cGMP generated by particulate and soluble guanylyl cyclase (GC) on the 5-HT(4)-mediated inotropic response.

Multiple exposures to familiar conspecific withdrawal is a novel robust stress paradigm in ewes.

Paradigms used so far to study the effects of social isolation in sheep confound the effects of social isolation with those of other stressors (e.g. new environment) and showed contradictory effects after multiple social isolations.

Mother-young relationships in sheep: a model for a multidisciplinary approach of the study of attachment in mammals.

The onset of maternal responsiveness and the development of mother-young attachment in sheep are under the combined influence of hormonal and sensory stimulations. In the mother, the prepartum rise in oestrogen and vaginocervical stimulation caused by expulsion of the foetus act on the main olfactory system and on hypothalamic regions. This induces maternal care through the central release of oxytocin, modulated by opiates and corticotrophin-releasing hormone.

Plasticity of the parental brain: a case for neurogenesis.

Profound behavioural changes occur in the mother at parturition, together with extensive remodelling of neural circuits. These changes include neurochemical, morphological and functional plasticity. The continuous generation of new neurones in the hippocampus and the olfactory system is an additional form of neuroplasticity that contributes to motherhood.

Predicting left ventricular dysfunction after valve repair for mitral regurgitation due to leaflet prolapse: additive value of left ventricular end-systolic dimension to ejection fraction.

Aims: Left ventricular (LV) dysfunction is the first cause of late mortality after mitral valve surgery. In this retrospective analysis, we studied the association between preoperative echocardiographic LV measures and occurrence of LV dysfunction after mitral valve repair (MVR).

Methods And Results: Between 1991 and 2009, 335 consecutive patients underwent MVR for severe mitral regurgitation due to leaflet prolapse in our institution.