Cortical Thinning in Patients with Recent Onset Post-Traumatic Stress Disorder after a Single Prolonged Trauma Exposure

Most of magnetic resonance imaging (MRI) studies about post-traumatic stress disorder (PTSD) focused primarily on measuring of small brain structure volume or regional brain volume changes. There were rare reports investigating cortical thickness alterations in recent onset PTSD. Recent advances in computational analysis made it possible to measure cortical thickness in a fully automatic way, along with voxel-based morphometry (VBM) that enables an exploration of global structural changes throughout the brain by applying statistical parametric mapping (SPM) to high-resolution MRI. In this paper, Laplacian method was utilized to estimate cortical thickness after automatic segmentation of gray matter from MR images under SPM. Then thickness maps were analyzed by SPM8. Comparison between 10 survivors from a mining disaster with recent onset PTSD and 10 survivors without PTSD from the same trauma indicates cortical thinning in the left parietal lobe, right inferior frontal gyrus, and right parahippocampal gyrus. The regional cortical thickness of the right inferior frontal gyrus showed a significant negative correlation with the CAPS score in the patients with PTSD. Our study suggests that shape-related cortical thickness analysis may be more sensitive than volumetric analysis to subtle alteration at early stage of PTSD

Pneumonia and poverty: a prospective population-based study among children in Brazil

<p>Abstract</p> <p>Background</p> <p>Children in developing country suffer the highest burden of pneumonia. However, few studies have evaluated associations between poverty and pneumonia.</p> <p>Methods</p> <p>A prospective population-based study on pneumonia was carried out as part of the Latin America Epidemiological Assessment of Pneumococcus (LEAP study). Chest x-rays were obtained for children one to 35 months old with suspected pneumonia presenting to emergency care centers and hospital emergency rooms in Goiania, Brazil. Chest radiographs were evaluated according to WHO guidelines. Clustering of radiologically-confirmed pneumonia were evaluated using a Poisson-based spatial scan statistic. Associations between census socioeconomic indicators and pneumonia incidence rates were analyzed using generalized linear models.</p> <p>Results</p> <p>From May, 2007 to May, 2009, chest radiographs were obtained from 11 521 children with clinical pneumonia; 3955 episodes were classified as radiologically-confirmed. Incidence rates were significantly higher in very low income areas (4825.2 per 10⁵) compared to high income areas (1637.3 per 10⁵). Spatial analysis identified clustering of confirmed pneumonia in Western (RR 1.78; p = 0.001) and Southeast (RR 1.46; p = 0.001) regions of the city, and clustering of hospitalized pneumonia in the Western region (RR 1.69; p = 0.001). Lower income households and illiteracy were associated with pneumonia incidence.</p> <p>Conclusions</p> <p>In infants the risk of developing pneumonia is inversely associated with the head of household income and with the woman educational level. Areas with deprived socioeconomic conditions had higher incidence of pneumonia and should be targeted for high vaccination coverage.</p

ICAR: endoscopic skull‐base surgery

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Perfil de gestantes atendidas nos períodos pré-natal e perinatal: estudo comparativo entre os serviços público e privado em Guaratinguetá, São Paulo Pregnants' profile in prenatal and perinatal stages: comparative study between public and private health services in Guaratinguetá, São Paulo

OBJETIVOS: comparar as proporções de gestantes atendidas nos serviços de saúde público e privado segundo variáveis sociais, demográficas e médicas. MÉTODOS: estudo transversal realizado com 590 mães que freqüentaram o Centro de Saúde de Guaratinguetá, para vacinação de rotina do último filho. RESULTADOS: a análise mostrou, dentre aquelas que realizaram o pré-natal no serviço público, maior proporção de mães com menor intervalo interpartal, fumantes, mais baixa escolaridade, idade menor ou igual a 19 anos, desempregadas, que realizaram parto vaginal, menor número de consultas no pré-natal, relato de infecção urinária durante o pré-natal, sem pediatra no momento do parto, e cujos recém-nascidos não ficaram em alojamento conjunto ou tinham baixo peso ao nascer. CONCLUSÕES: a inclusão de um item sobre o local de realização do pré-natal, na "Declaração de Nascido Vivo" do Ministério da Saúde, poderia permitir análises rotineiras sobre o atendimento às mães pelos serviços público e privado.<br>OBJECTIVES: to compare ratios of pregnant women seen in public health clinics and private health clinics according to social, demographic and medical variables. METHODS: a cross-sectional study was performed with 590 mothers who visited the Health Clinic of Guaratinguetá, for routine vaccination of the last child. RESULTS: analysis of the survey demonstrated higher statistically significant ratios of mothers with a shorter period of time between pregnancies, smokers, less educated, aged 19 or less, unemployed, who had normal deliveries with less medical visits during prenatal care, with reports of urinary infection during prenatal care and who did not have the assistance of a Pediatrician at the time of delivery, whose newborns did not stay with them in the room and had low birth weights, among the mothers whose prenatal care was provided in public clinics. CONCLUSIONS: the inclusion of one item related to prenatal care provision in the "Born Alive Report" of the Ministry of Health would enable routine analysis of the services provided to mothers in public and private clinics