Prenatal exposure to air pollution is associated with altered brain structure, function, and metabolism in childhood.

Background: Prenatal exposure to air pollution disrupts cognitive, emotional, and behavioral development. The brain disturbances associated with prenatal air pollution are largely unknown.

Methods: In this prospective cohort study, we estimated prenatal exposures to fine particulate matter (PM ) and polycyclic aromatic hydrocarbons (PAH), and then assessed their associations with measures of brain anatomy, tissue microstructure, neurometabolites, and blood flow in 332 youth, 6-14 years old.

Complex regional pain syndrome following southern pacific rattlesnake () envenoming.

Complex regional pain syndrome (CRPS) has rarely been reported in the setting of snakebite but might be more common than previously reported. We present the third case of CRPS reported in North America and the first resulting from a pit-viper's bite.

S.M.A.R.T. self-expanding nitinol stent for the treatment of atherosclerotic lesions in the superficial femoral artery (STROLL): 1-year outcomes.

Purpose: To assess safety and efficacy of the S.M.A.

Psychodynamic psychiatry in the general medical setting.

For more than half a century analytically trained psychiatrists have been making observations about psychodynamic factors impacting on medical illness and treatment. Some of these reports have been subsequently supported by evidence-based research while others have been found to be clinically useful to varying degrees even if not substantiated by research. In this article we have presented some of the highlights of the application of psychodynamics to the treatment of physical illness in the general medical setting.

The kappa-opiate receptor impacts the pathophysiology and behavior of substance use.

There is increasing evidence that the kappa-opiate receptor, in addition to the mu-opiate receptor, plays an important role in substance use pathophysiology and behavior. As dopamine activity is upregulated through chronic substance use, kappa receptor activity, mediated through the peptide dynorphin, is upregulated in parallel. Dynorphin causes dysphoria and decreased locomotion, and the upregulation of its activity on the kappa receptor likely dampens the excitation caused by increased dopaminergic activity.

Adolescents and their parents: a critical review of measures to assess their satisfaction with one another.

The importance of assessing the parent-adolescent relationship has been stressed in the literature. However, an integration of studies that have been conducted to assess satisfaction in the parent-adolescent relationship is warranted, including evaluation of measures to assess their satisfaction with one another. Therefore, the purpose of this paper is to provide a critical examination of the clinical utility and psychometric properties of such measures.

The role of quantitative electromyography in inclusion body myositis.

Objective And Methods: Inclusion body myositis is said to have both myopathic and neurogenic features on electrophysiological tests. Twenty one studies from 20 patients with biopsy defined inclusion body myosis, 13 of whom had quantitative electromyography (qEMG), were reviewed to determine if this technique added diagnostic specificity (one patient had both needle EMG and a later study with qEMG before muscle biopsy).

Results: Excessive numbers of polyphasic motor unit potentials (MUPs) (> 12% per muscle) were seen in 11 of the 13 patients.

Controversies about amyotrophic lateral sclerosis.

Controversy regarding amyotrophic lateral sclerosis (ALS) concerns aspects of relatively little consequence (such as the role of lead intoxication or trauma in the pathogenesis of the disease) and others of greater relevance, particularly the two following questions regarding treatment options: 1) Are we in a new era of therapy for ALS? Prior to the 1990's no controlled study showed consistent benefit from any of the treatments tried. We have now had announcements of benefit for four entirely different agents: riluzole, insulin-like growth hormone, brain derived neurotrophic hormone and gabapentin. The benefit, at most, is marginal or questionable.

The value of coarse needle biopsy in evaluating thyroid nodules.

At Columbia Presbyterian Medical Center, CPMC, the incidence of thyroid cancer found at surgery (CI) has recently changed. CI prior to 1950 was 3-4%. The CI gradually increased to 29% in 1975 without the use of needle biopsy.

Physician use of computers: is age or value the predominant factor?

One common explanation for the failure to achieve broad physician utilization of computer applications has been the suggestion that "We can't teach older individuals to use computers." To investigate this hypothesis, we examined utilization patterns for the Clinical Information System (CIS) at Columbia Presbyterian Medical Center (CPMC). We analyzed CIS usage for 925 attending physicians who were listed as an admitting or attending physician or surgeon for at least one patient during the year 1992.

An algorithm for prostate cancer detection in a patient population using prostate-specific antigen and prostate-specific antigen density.

Prostate-specific antigen (PSA) is the most accurate serum marker for cancer of the prostate (CaP). However, its sensitivity and specificity are suboptimal, especially at values ranging between 4.1 and 10.

Importance of adequate staging and of hormone receptors in women older than age 70 with breast cancer.

This report includes 479 women older than 70 years of age who were operated on between January 1980 and January 1988 and who were followed for 2.5 to 10.5 years (mean, 4.