Publications by authors named "Meehan W"

Traumatic brain injury results in a metabolic cascade of changes that occur at the molecular level, invisible to conventional imaging methods such as computed tomography or magnetic resonance imaging. Non-invasive metabolic imaging tools such as single photon emission computed tomography (SPECT), positron emission tomography (PET), and magnetic resonance spectroscopy (MRS) are the ideal methods for providing insight to these changes by measuring regional cerebral blood flow, glucose metabolism, and brain metabolite concentrations, respectively, after mild traumatic brain injury (mTBI). The purpose of this review is to provide an overview of the different methodologies and provide an up-to-date summary of recent findings with SPECT, PET, and MRS technologies, specifically after mTBI, as defined by standardized criteria.

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Objectives: To describe the prevalence of computerized neurocognitive testing for the assessment of high school athletes who sustain concussions, and to describe associations between using computerized neurocognitive tests, timing of return-to-play, and medical provider managing the athlete.

Methods: Concussions recorded in the High School Reporting Information Online injury surveillance system during the 2009-2010 academic year were included. Measures of association between use of computerized neurocognitive testing and outcomes were analyzed.

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Background: Little existing data describe which medical professionals and which medical studies are used to assess sport-related concussions in high school athletes.

Purpose: To describe the medical providers and medical studies used when assessing sport-related concussions. To determine the effects of medical provider type on timing of return to play, frequency of imaging, and frequency of neuropsychological testing.

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Objectives: The objectives were to identify patient and hospital characteristics associated with the use of computed tomography (CT) imaging of the cervical spine (c-spine) in the evaluation of injured children and, in particular, to examine the influence of hospital setting.

Methods: This was a retrospective cohort of children younger than 19 years of age from the Massachusetts Hospital Emergency Department (ED) database who were discharged from the ED with an injury diagnosis from 2005 through 2009. Multivariable logistic regression was used to analyze characteristics associated with CT imaging of the c-spine.

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Objectives: To investigate the variation and trends in neuroimaging in children examined for minor head injury at major US pediatric emergency departments.

Study Design: We conducted a retrospective study of children <19 years of age with mild head injury who were examined and discharged home from the emergency department at 40 pediatric hospitals from 2005 to 2009 by using the Pediatric Health Information Systems database. Variation in computed tomography (CT) rates between hospitals was assessed for correlation with hospital-specific rates of intracranial hemorrhage, admission, and return visits.

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This article presents some quantitative findings from a survey of 89 psychoanalysts (all members of the American Psychoanalytic Association or the International Psychoanalytical Association) about their own experiences in analysis. A comprehensive questionnaire was used to collect retrospective data about (1) how participants felt they benefited from their analyses and (2) how they remembered their analysts' technique, personality, and style of relating. A correlational analysis found that, according to our participants' ratings, the most beneficial analyses were associated with having a caring and emotionally engaged analyst who possessed positive relational and personality qualities, used supportive techniques in addition to classical techniques, and pursued therapeutic as well as analytic goals.

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Objectives: The objectives of the study were (1) to determine the relative use of strategies for managing the well-appearing febrile infant and (2) to determine clinician adherence to protocol recommendations.

Methods: Members of the American Academy of Pediatrics Section on Emergency Medicine were asked to complete an online, interactive, case-based questionnaire. Infants with a temperature of 38.

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Although much of the lay media attention surrounding sport-related concussion (SRC) focuses on professional athletes, SRC is a common injury in pediatric sports. The anatomy, biomechanics, and response to injury of the developing pediatric brain differ from those of the adult. Similarly, the neurocognitive abilities of the child are developing more rapidly than in an adult.

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Clinicians who manage sport-related concussions have excellent guidelines by which most injuries can be managed. Because sport-related concussions typically resolve within a short time frame, most can be managed with physical and cognitive rest alone. However, clinicians who specialize in the assessment and management of this diagnosis encounter patients with prolonged recovery courses, persistent symptoms, and significant deficits in cognitive functioning.

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Tumor necrosis factor alpha (TNFα) and Fas receptor contribute to cell death and cognitive dysfunction after focal traumatic brain injury (TBI). We examined the role of TNFα/Fas in postinjury functional outcome independent of cell death in a novel closed head injury (CHI) model produced with weight drop and free rotational head movement in the anterior-posterior plane. The CHI produced no cerebral edema or blood-brain barrier damage at 24 to 48 hours, no detectable cell death, occasional axonal injury (24 hours), and no brain atrophy or hippocampal cell loss (day 60).

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Background: An estimated 136 000 concussions occur per academic year in high schools alone. The effects of repetitive concussions and the potential for catastrophic injury have made concussion an injury of significant concern for young athletes.

Purpose: The objective of this study was to describe the mechanism of injury, symptoms, and management of sport-related concussions using the High School Reporting Information Online (HS RIO) surveillance system.

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Objectives: To estimate the incidence and demographics of concussions in children coming to emergency departments (EDs) in the United States and describe the rates of neuroimaging and follow-up instructions in these patients.

Study Design: This is a cross-sectional study of children 0 to 19 years old diagnosed with concussion from the National Hospital Ambulatory Medical Care Survey. National Hospital Ambulatory Medical Care Survey collects data on approximately 25,000 visits annually to 600 randomly selected hospital emergency and outpatient departments.

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Unlabelled: Although sport-related concussion is a common injury, it is infrequently associated with seizure. While concussive convulsions, consisting of brief, generalized myoclonic activity while an athlete is unconscious have been described, the authors are aware of no published cases of concussion complicated by focal motor seizures. The authors describe the case of a 16-year-old male wrestler who sustained a sport-related concussion complicated by a focal motor seizure.

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Sport-related concussion is a common injury in children and adolescents. Athletes seldom report concussive symptoms, which makes the diagnosis a challenge. The management of sport-related concussion has changed significantly over the last several years.

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We describe the case of an 18-month-old child with recurrent apneic episodes, often requiring resuscitation, who was admitted to an academic pediatric medical center after previous evaluations had been unrevealing.

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Background: Young infants with fever routinely undergo laboratory evaluation, and many are treated with empirical antibiotics even when the infant seems well. The requirement of a lumbar puncture (LP) as part of a routine evaluation is debated; however, administration of antibiotics without an LP can cause concerns for partially treated bacterial meningitis and make subsequent evaluation of the cerebrospinal fluid (CSF) confusing. The ability to predict which febrile infants have a CSF pleocytosis would assist in the decision to perform LP in febrile infants.

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Studying the genetic history of the Orang Asli of Peninsular Malaysia can provide crucial clues to the peopling of Southeast Asia as a whole. We have analyzed mitochondrial DNA (mtDNAs) control-region and coding-region markers in 447 mtDNAs from the region, including 260 Orang Asli, representative of each of the traditional groupings, the Semang, the Senoi, and the Aboriginal Malays, allowing us to test hypotheses about their origins. All of the Orang Asli groups have undergone high levels of genetic drift, but phylogeographic traces nevertheless remain of the ancestry of their maternal lineages.

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Breast cancer metastasis suppressor 1 (BRMS1) is a member of the mSin3-HDAC transcription co-repressor complex. However, the proteins associated with BRMS1 have not been fully identified. Yeast two-hybrid screen, immuno-affinity chromatography, and co-immunoprecipitation experiments were performed to identify BRMS1 interacting proteins (BIPs).

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Background: Delusional parasitosis is a rare disorder in which patients have a fixed, false belief of being infested with parasites. It is often accompanied by a refusal to seek psychiatric care. Delusions of parasitosis is classically treated with typical antipsychotic agents, the traditional dermatologic choice being pimozide.

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A recent dispersal of modern humans out of Africa is now widely accepted, but the routes taken across Eurasia are still disputed. We show that mitochondrial DNA variation in isolated "relict" populations in southeast Asia supports the view that there was only a single dispersal from Africa, most likely via a southern coastal route, through India and onward into southeast Asia and Australasia. There was an early offshoot, leading ultimately to the settlement of the Near East and Europe, but the main dispersal from India to Australia approximately 65,000 years ago was rapid, most likely taking only a few thousand years.

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Introduction: Breast cancer is one of the most common malignancies affecting women in the United States and Europe. Approximately three out of every four women with breast cancer develop metastases in bone which, in turn, diminishes quality of life. The alpha(v)beta3 integrin has previously been implicated in multiple aspects of tumor progression, metastasis and osteoclast bone resorption.

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Breast cancer metastasis suppressor 1 (BRMS1) suppresses metastasis of multiple human and murine cancer cells without inhibiting tumorigenicity. By yeast two-hybrid and co-immunoprecipitation, BRMS1 interacts with retinoblastoma binding protein 1 and at least seven members of the mSin3 histone deacetylase (HDAC) complex in human breast and melanoma cell lines. BRMS1 co-immunoprecipitates enzymatically active HDAC proteins and represses transcription when recruited to a Gal4 promoter in vivo.

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This article reviews information related to the BRMS1 (BReast Metastasis Suppressor 1) metastasis suppressor gene. BRMS1 was identified by differential display comparing metastasis-suppressed chromosome 11 hybrids with metastatic, parental MDA-MB-435 human breast carcinoma cells. BRMS1 has subsequently been shown to suppress metastasis, but not tumorigenicity of human melanoma cells.

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Introduction of normal, neomycin-tagged human chromosome 11 (neo11) reduces the metastatic capacity of MDA-MB-435 human breast carcinoma cells by 70-90% without affecting tumorigenicity. Differential display comparing MDA-MB-435 and neo11/435 led to the discovery of a human breast carcinoma metastasis suppressor gene, BRMS1, which maps to chromosome 11q13.1-q13.

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