Neurodevelopmental outcome at 5 years of age after general anaesthesia or awake-regional anaesthesia in infancy (GAS): an international, multicentre, randomised, controlled equivalence trial.

Background: In laboratory animals, exposure to most general anaesthetics leads to neurotoxicity manifested by neuronal cell death and abnormal behaviour and cognition. Some large human cohort studies have shown an association between general anaesthesia at a young age and subsequent neurodevelopmental deficits, but these studies are prone to bias. Others have found no evidence for an association.

Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial.

Background: Preclinical data suggest that general anaesthetics affect brain development. There is mixed evidence from cohort studies that young children exposed to anaesthesia can have an increased risk of poor neurodevelopmental outcome. We aimed to establish whether general anaesthesia in infancy has any effect on neurodevelopmental outcome.

Reliability and validity of a DSM-IV based ADHD screener.

The Diagnostic Rating Scale (DRS) was completed by the parents and teachers of 82 children referred for clinical evaluations, 73 referred children seen twice, and 218 non-referred children from the community. The DRS, which uses a categorical rather than a dimensional rating approach, was 70% to 90% sensitive to diagnoses of Attention Deficit/Hyperactivity Disorder (ADHD) made by blind clinical teams. In research and clinical applications, the DRS could improve screening efficiency, especially in situations where it would be desirable to exclude all children who might have ADHD or identify all children with Hyperactive-Impulsive symptoms.

Mother and teacher reports of ADHD symptoms: DSM-IV Questionnaire data.

Objective: Diagnosis of attention-deficit/hyperactivity disorder (ADHD) is thought to be best accomplished by a multimodal approach. In many research and clinical settings, such extensive procedures may not be feasible. A screening instrument that could identify children meeting necessary (but not sufficient) criteria would permit selection of subgroups for more resource-intensive diagnostic procedures.

Medical marijuana.

Although many clinical studies suggest the medical utility of marijuana for some conditions, the scientific evidence is weak. Many patients in California are self-medicating with marijuana, and physicians need data to assess the risks and benefits. The only reasonable solution to this problem is to encourage research on the medical effects of marijuana.

An Escherichia coli chromosomal ars operon homolog is functional in arsenic detoxification and is conserved in gram-negative bacteria.

Arsenic is a known toxic metalloid, whose trivalent and pentavalent ions can inhibit many biochemical processes. Operons which encode arsenic resistance have been found in multicopy plasmids from both gram-positive and gram-negative bacteria. The resistance mechanism is encoded from a single operon which typically consists of an arsenite ion-inducible repressor that regulates expression of an arsenate reductase and inner membrane-associated arsenite export system.

Feasibility and Costs of Monitoring Physical Activity in Young Children Using the Caltrac Accelerometer.

Monitoring of physical activity among 3- to 7-year-old children was achieved with an electronic motion sensor, the Caltrac accelerometer, for 1,666 days (of 2,030 scheduled) over a 2-year period. Failure of the monitor averaged once for each 45 days of successful monitoring. The total cost of devices, repairs, and batteries over the 2 years averaged $1.

Factors encouraging cohort maintenance in a longitudinal study.

Maintenance of the cohort is one of the primary challenges of a longitudinal study. At the end of 3 years of follow up in the Framingham Children's Study, a longitudinal study of young children and their parents, 100 of the original 106 families (94.3%) have remained in the study.

Psychiatry in a troubled world: the relation of clinical practice and social reality.

Based on studies conducted over the course of the past half-century, elements common to all forms of effective psychotherapy are reviewed. The emergence of innovative modes of therapy is noted, with special attention to the recent advent of systems-theoretical approaches to intervention. Contradictions between therapeutic goals of personal harmony and our current competitive social ethic are considered, and the mental health implications of achieving a more just society are highlighted.

Impact of adjuvant chemotherapy on cosmesis and complications in stages I and II carcinoma of the breast treated by biopsy and radiation therapy.

Cosmesis and complication rates were examined in patients with early stage carcinoma of the breast treated by biopsy and radiation therapy with and without adjuvant chemotherapy in an attempt to determine the effect of chemotherapy upon these parameters. Between April 1, 1975 and June 1, 1980, 51 patients were treated with radiation therapy and adjuvant chemotherapy (XRT + ACT) and 83 patients with radiotherapy alone (XRT). Chemotherapy usually consisted of cytoxan, methotrexate and 5-fluorouracil for 6 or 12 cycles.

Systems thinking in psychiatry: some theoretical and clinical implications.

The author discusses the theoretical and pragmatic value of systems thinking in psychiatry. An awareness of the pluralistic, multifactorial origins of psychopathology broadens the psychiatrist's understanding and increases his or her therapeutic potential. The psychiatrist who thinks in systems terms is a true generalist in medicine, and to practice that way is the most effective way of treating people.

Work in progress: serial evaluation of tumor volume using computed tomography and contrast kinetics.

Computed tomography can be used to evaluate tumor volume changes after therapy. Pre- and posttreatment results are presented for nine human neoplasms. Volume changes are correlated with the behavior of intravenous diatrizoate contrast material.

Clinical studies with ultrasound-induced hyperthermia.

Results obtained in clinical studies in which ultrasound was used for hyperthermia induction are reviewed. High intensity ultrasound has certain advantages for the induction of local hyperthermia: Well-collimated beams can be produced, which makes good localization possible; ultrasound can be focused; and absorption in tissue is proportional to frequency, hence the depth of penetration can be controlled. Limitations include the fact that ultrasound is reflected from tissue-air interfaces and thus cannot be used to heat tumors in the lung.