Is DBS-STN appropriate to treat severe Parkinson disease in an elderly population?

Objective: To assess the role of age in the results of bilateral deep brain stimulation in the subthalamic nucleus (DBS-STN), we carried out a study of two groups of patients regarding age at time of surgery.

Methods: We compared, up to 2 years after surgery, the clinical effects, safety, and quality of life in parkinsonian patients younger than 65 years old (young patients) vs parkinsonian patients 65 years old or older (old patients).

Results: The mean age was 57.

On physician well being-you'll get by with a little help from your friends.

This study identifies positive and negative factors associated with physician well being. We collected two sets of data from physicians at a university-based Department of Medicine in Western Canada. First, we conducted exploratory, in-depth interviews with 54 physicians to identify factors associated with their well being.

Reducing firearm violence: a research agenda.

In the United States, firearms are involved in tens of thousands of deaths and injuries each year. The magnitude of this problem prompted the National Academy of Sciences (NAS) to issue a report in 2004 detailing the strengths and limitations of existing research on the relationship between firearms and violence. In response, a multidisciplinary group of experts in the field of firearms and violence formed the National Research Collaborative on Firearm Violence.

Fingerprint vibrational spectra of protonated methyl esters of amino acids in the gas phase.

Infrared spectra of the protonated monomers of glycine, alanine, valine, and leucine methyl esters are presented. These protonated species are generated in the gas phase via matrix assisted laser desorption ionization (MALDI) within the cell of a Fourier transform ion cyclotron resonance spectrometer (FTICR) where they are subsequently mass selected as the only species trapped in the FTICR cell. Alternatively, they have also been generated by electrospray ionization and transferred to a Paul ion-trap mass spectrometer where they are similarly isolated.

Bilateral deep brain stimulation of the globus pallidus to treat tardive dyskinesia.

Context: Tardive dyskinesia (TD) is a common and potentially disabling disorder induced by use of antipsychotic drugs for which medical treatment often gives disappointing results.

Objective: To assess the efficacy of bilateral deep brain stimulation of the internal part of the globus pallidus to treat severe TD.

Design: Prospective phase 2 multicenter study.

Localization of Target Structures through Data Fusion Applied to Neurostimulation.

Symptoms of Parkinson's Disease can be relieved by Deep Brain Stimulation (DBS), which is based on an accurate positionning of electrodes in specific structures of the Basal Ganglia, e.g. the SubThalamic Nucleus (STN) and the Internal Globus Pallidus (GPi), and of the thalamus.

Transcranial Magnetic Stimulation : Magnetic Field Computation in empty free space.

Transcranial Magnetic Stimulation (TMS) is a technique for brain stimulation using magnetic field generated by an external coil. As another techniques like ECT or the implantation of electrodes into motor cortex, TMS has several applications in medical and clinical research. The main benefit of TMS is to be non invasive and painless.

Binding of Vac14 to neuronal nitric oxide synthase: Characterisation of a new internal PDZ-recognition motif.

PDZ domains mediate protein interactions primarily through either classical recognition of carboxyl-terminal motifs or PDZ/PDZ domain associations. Several studies have also described internal modes of PDZ recognition, most of which depend on beta-finger structures. Here, we describe a novel interaction between the PDZ domain of nNOS and Vac14, the activator of the PtdIns(3)P 5-kinase PIKfyve.

Manic behaviour induced by deep-brain stimulation in Parkinson's disease: evidence of substantia nigra implication?

We report the case of a patient who had benefited from bilateral subthalamic nucleus deep brain stimulation for Parkinson's disease and who presented acute and reproducible manic behaviour when stimulated mainly in the substantia nigra. A positron emission tomography scan showed an activation of the right dorsolateral prefrontal and inferior temporal cortex, the left anterior cingulate cortex and a deactivation of the left insula. This suggests that changes in cortical activation related to mania are subcortically driven, involving notably the substantia nigra.

[Test-retest reliability of the Work-related Physical Capacity Evaluation].

Background: Functional capacity evaluations are used to quantify and qualify the physical abilities of an individual in relation to the physical requirements of an occupation. One major observation associated with functional capacity evaluations is a lack of evidence on their psychometric properties.

Purpose: This article presents the results of a study on the test-retest reliability of a functional capacity evaluation tool: the Physical Work Performance Evaluation (PWPE).

Pi-complex structure of gaseous benzene-NO cations assayed by IR multiple photon dissociation spectroscopy.

[C(6)H(6)NO](+) ions, in two isomeric forms involved as key intermediates in the aromatic nitrosation reaction, have been produced in the gas phase and analyzed by IR multiple photon dissociation (IRMPD) spectroscopy in the 800-2200 cm(-)(1) fingerprint wavenumber range, exploiting the high fluence and wide tunability of a free electron laser (FEL) source. The IRMPD spectra were compared with the IR absorption spectra calculated for the optimized structures of potential isomers, thus allowing structural information on the absorbing species. [C(6)H(6)NO](+) ions were obtained by two routes, taking advantage of the FEL coupling to two different ion traps.

Total disc arthroplasty: consequences for sagittal balance and lumbar spine movement.

This in vivo biomechanical study was undertaken to analyze the consequences for sagittal balance and lumbar spine movement in three different lumbar disc prostheses. A total of 105 patients underwent total disc replacement in three different centers. The Maverick prosthesis was used in 46 patients, the SB Charité device was used in 49 patients and the Prodisc device was utilized in 10 patients.

[Pedicle closing-wedge osteotomy for the treatment of fixed sagittal imbalance].

Purpose Of The Study: The aim of this study was to analyze x-ray results in patients who underwent pedicle subtraction osteotomy for complex deformations (flat back, kyphosis) leading to fixed sagittal imbalance.

Material And Methods: Thirty-four patients underwent surgery between 1996 and March 2003 in two centers, the orthopedic surgery unit devoted to spinal surgery and sports traumatology at the Strasbourg University Hospitals and the spinal surgery unit at the Chenove Clinic (Dijon). The series included 20 women and 14 men, mean age 46.

IR spectroscopic features of gaseous C7H7O+ ions: benzylium versus tropylium ion structures.

Gaseous [C7H7O]+ ions have been formed by protonation of benzaldehyde or tropone (2,4,6-cycloheptatrienone) in the cell of an FT-ICR mass spectrometer using C2H5(+) as a Brønsted acid. The so-formed species have been assayed by infrared multiphoton dissociation (IRMPD) using the free electron laser (FEL) at the CLIO (Centre Laser Infrarouge Orsay) facility. The IRMPD features are quite distinct for ions from the two different precursors, pointing to two different isomers.

[Hemorrhagic lumbar juxta facet cyst. A case report].

We report the case of a hemorrhagic lumbar juxta facet cyst (L2-L3), revealed by a chronic right lumbocruralgia, in a 77-year-old woman treated by anticoagulants for cardiac arrhythmia. Computerized tomography and magnetic resonance imaging suggested the diagnosis of benign tumor. During surgical removal of the whole lesion, a hemorrhagic synovial cyst was evoked.

Protonation sites of isolated fluorobenzene revealed by IR spectroscopy in the fingerprint range.

Protonated fluorobenzene ions (C6H6F+) are produced by chemical ionization of C6H5F in the cell of a FT-ICR mass spectrometer using either CH5+ or C2H5+. The resulting protonation sites are probed by IR multiphoton dissociation (IRMPD) spectroscopy in the 600-1700 cm-1 fingerprint range employing the free electron laser at CLIO (Centre Laser Infrarouge Orsay). Comparison with quantum chemical calculations reveals that the IRMPD spectra are consistent with protonation in para and/or ortho position, which are the thermodynamically favored protonation sites.

Experimental infrared spectra of Cl-(ROH) (R = H, CH3, CH3CH2) complexes in the gas-phase.

Infrared multiple photon dissociation spectra for the chloride ion solvated by either water, methanol or ethanol have been recorded using an FTICR spectrometer coupled to a free-electron laser, and are presented here along with assignments to the observed bands. The assignments made to the Cl(-)/H(2)O, Cl(-)(CH(3)OH), and Cl(-)(CH(3)CH(2)OH) spectra are based on comparison with the neutral H(2)O, CH(3)OH, and CH(3)CH(2)OH spectra, respectively. This work confirms that a band observed around 1400 cm(-1) in the Cl(-)(H(2)O) spectrum is not due to the Ar tag in Ar predissociation spectra.

The effect of firearm deaths on life expectancy and insurance premiums in the United States.

Despite recent gains, the U.S. remains behind most other affluent countries in life expectancy.

The generation and gender shifts in medicine: an exploratory survey of internal medicine physicians.

Background: Two striking demographic shifts evident in today's workforce are also apparent in the medical profession. One is the entry of a new generation of physicians, Gen Xers, and the other is the influx of women. Both shifts are argued to have significant implications for recruitment and retention because of assumptions regarding the younger generation's and women's attitudes towards work and patient care.

[Subthalamic deep brain stimulation for severe idiopathic Parkinson's disease. Location study of the effective contacts].

The subthalamic nucleus (STN) is the main target of deep brain stimulation (DBS) treatment for severe idiopathic Parkinson's disease. But there is still no clear information on the location of the effective contacts (used during the chronic phase of stimulation). Our aim was to assess the anatomical structures of the subthalamic area (STA) involved during chronic DBS.

Association of postoperative complications with hospital costs and length of stay in a tertiary care center.

Background: Postoperative complications are a significant source of morbidity and mortality. There are limited studies, however, assessing the impact of common postoperative complications on health care resource utilization.

Objective: To assess the association of clinically important postoperative complications with total hospital costs and length of stay (LOS) in patients undergoing noncardiac surgery.

Cystemustine in recurrent high grade glioma.

In this study, we have assessed the efficacy of a nitrosourea, cystemustine, in treating patients with recurrent high grade glioma with overall survival analysis as primary end-point. Forty-eight patients with recurrent high grade glioma (24 glioblastomas, 17 astrocytomas and 5 oligodendrogliomas) were treated every 2 weeks with 60 mg/m2 cystemustine by a 15 min-infusion. The median number of treatment cycles was 4 (range 1-17).

Interaction of D2 with H2O amorphous ice studied by temperature-programmed desorption experiments.

The gas-surface interaction of molecular hydrogen D2 with a thin film of porous amorphous solid water (ASW) grown at 10 K by slow vapor deposition has been studied by temperature-programmed-desorption (TPD) experiments. Molecular hydrogen diffuses rapidly into the porous network of the ice. The D2 desorption occurring between 10 and 30 K is considered here as a good probe of the effective surface of ASW interacting with the gas.

Location of residence associated with the likelihood of patient visit to the preoperative assessment clinic.

Background: Outpatient preoperative assessment clinics were developed to provide an efficient assessment of surgical patients prior to surgery, and have demonstrated benefits to patients and the health care system. However, the centralization of preoperative assessment clinics may introduce geographical barriers to utilization that are dependent on where a patient lives with respect to the location of the preoperative assessment clinic.

Methods: The association between geographical distance from a patient's place of residence to the preoperative assessment clinic, and the likelihood of a patient visit to the clinic prior to surgery, was assessed for all patients undergoing surgery at a tertiary health care centre in a major Canadian city.