Dopamine D4 Receptor Gene Associated with Fairness Preference in Ultimatum Game

In experimental economics, the preference for reciprocal fairness has been observed in the controlled and incentivized laboratory setting of the ultimatum game, in which two individuals decide on how to divide a sum of money, with one proposing the share while the second deciding whether to accept. Should the proposal be accepted, the amount is divided accordingly. Otherwise, both would receive no money. A recent twin study has shown that fairness preference inferred from responder behavior is heritable, yet its neurogenetic basis remains unknown. The D4 receptor (DRD4) exon3 is a well-characterized functional polymorphism, which is known to be associated with attention deficit hyperactivity disorder and personality traits including novelty seeking and self-report altruism. Applying a neurogenetic approach, we find that DRD4 is significantly associated with fairness preference. Additionally, the interaction among this gene, season of birth, and gender is highly significant. This is the first result to link preference for reciprocal fairness to a specific gene and suggests that gene × environment interactions contribute to economic decision making

Between a Rock and a Hard Place: Anticipating Poor Surgical Outcomes while Honoring Patient Autonomy

http://deepblue.lib.umich.edu/bitstream/2027.42/175716/2/Between a Rock and a Hard Place Chapter.pdfPublished versionDescription of Between a Rock and a Hard Place Chapter.pdf : Published versio

Endarterectomia de carótida sob anestesia local: evolução de 104 pacientes Carotid endarterectomy under regional anesthesia: follow-up of 104 patients

A estenose carotídea cervical é uma das causas mais freqüentes de acidente vascular cerebral isquêmico. A endarterectomia de carótida é um tratamento eficaz para lesões estenóticas moderadas e graves, tanto sintomáticas quanto assintom��ticas. A endarterectomia realizada sob anestesia local permite a monitorização neurológica do paciente durante o ato cirúrgico. O objetivo deste trabalho foi avaliar as complicações cirúrgicas e acompanhar a evolução dos pacientes submetidos a endarterectomia sob anestesia local em nossa instituição, comparando os resultados com outras publicações. 104 pacientes foram submetidos a 110 procedimentos no período de abril de 1996 a maio de 2002. 64 pacientes eram sintomáticos (61,54%) e 40 assintomáticos (38,46%). Todos possuíam grau de estenose carotídea igual ou superior a 70%. Os pacientes foram avaliados retrospectivamente. O tempo de evolução variou de um a 72 meses (média: 29,5). Três pacientes apresentaram hematoma cervical necessitando drenagem cirúrgica. Dois pacientes (1,92%) tiveram acidente vascular cerebral do mesmo lado da endarterectomia no pós-operatório e outros dois durante o seguimento. Dois pacientes faleceram em decorrência da cirurgia (1,92%). Os resultados desta série, comparados com a literatura, permitem concluir que a endarterectomia é uma forma segura de tratamento para as estenoses carotídeas moderadas e graves.<br>Cervical carotid stenosis is one of the main causes of ischemic stroke. Carotid endarterectomy is a safe procedure for treatment of moderate and severe symptomatic and asymptomatic carotid stenosis. Regional anesthesia allows neurological evaluation of the patient during the surgery. We reviewed the results of 104 patients operated on at our institution under regional anesthesia during the period of April 1996 and May 2002. 64 patients were symptomatic (61.54%) and 40 asymptomatic (38.46%). All patients had carotid stenosis over 70%. The patients were followed from one to 72 months (Mean: 29.5). Three patients had cervical hematoma, that required surgical drainage. Two patients had minor stroke at the same side of the endarterectomy at the post-operative period and another two during the follow-up (1.92%). Two patients died due to complications related to the surgery (1.92%). Our results, compared with the literature, show that endarterectomy is a safe procedure to treat moderate or severe carotid artery stenosis