Budd-Chiari syndrome recurring in a transplanted liver

A patient with Budd-Chiari syndrome who underwent orthotopic liver transplantation and developed recurrent disease is described. The immediate postoperative period was complicated by multiple thrombotic episodes, followed by a period of apparent remission associated with the initiation of coumadin and persantine therapy. After discontinuation of such antithrombotic therapy in order to biopsy the liver, the patient experienced another series of clinically overt vascular thromboses and ultimately died of sepsis 15 mo posttransplantation after a prolonged and complicated terminal hospital course. At autopsy, recurrent Budd-Chiari syndrome as well as thromboses in numerous other organs was demonstrated. © 1983

Community-Based Health Plans for the Uninsured: Expanding Access, Enhancing Dignity

Highlights community-based initiatives in Albuquerque, New Mexico; Ingham County, Michigan; El Paso, Texas; Alameda County, California; and North Carolina that have developed health plans for uninsured individuals and families

Seasonal effects on depression risk and suicidal symptoms in postpartum women

Background: Postpartum depression (PPD) is the most common complication of childbirth. Suicide is a leading cause of maternal death in the first postpartum year. Depressed mothers often have suicidal ideation (SI). Depression and suicidality may vary across the seasons. Previous studies of seasonality and PPD were relatively small or encumbered by study design constraints. We examined the possible relationship between seasonality, depression, and SI in 9,339 new mothers. Methods: From 2006 to 2010, the investigators screened women within 4-6 weeks postpartum with the Edinburgh Postnatal Depression Scale (EPDS). We used spectral analysis to explore seasonal variation in risk for depression and suicidality. Results: The study team screened 9,339 new mothers, of whom 1,316 (14%) women had positive depression scores (EPDS≥10) which suggest PPD risk; 294 (3%) women had SI (item 10≥1). A positive EPDS was associated significantly with SI. PPD risk varied significantly across 12-months-risk was highest in December. We detected no seasonal variation in SI. Conclusions: Effects of seasonal light variation may contribute to increased risk for depressive symptoms. Suicidality could be related to maternal depression but not seasonal variation. Depression and Anxiety, 2011. © 2011 Wiley-Liss, Inc. © 2011 Wiley-Liss, Inc

The Error in Trial and Error: Exercises on Phrasal Verbs

An analysis of 44 commercially available EFL textbooks found that it is common for textbooks to present learners with exercises on phrasal verbs without first providing relevant input to help them. In these cases, the learners are likely to resort to trial-and-error and are then expected to learn from feedback. We report an experiment conducted with Japanese EFL students (N=140) in which we compare the effectiveness of such a trial-and-error method with a retrieval procedure in which students first study a set of phrasal verbs and then complete an exercise. Scores on both an immediate and a one-week delayed post-test suggest superiority of retrieval over the trial-and-error procedure, where, despite the provision of feedback, 25% of the wrong exercise responses were reproduced in the delayed post-test

Association of Pancreatic Steatosis With Chronic Pancreatitis, Obesity, and Type 2 Diabetes Mellitus

Objective: The aim of this study was to determine the association of the pancreatic steatosis with obesity, chronic pancreatitis (CP), and type 2 diabetes mellitus. Methods: Patients (n = 118) were retrospectively identified and categorized into no CP (n = 60), mild (n = 21), moderate (n = 27), and severe CP (n = 10) groups based on clinical history and magnetic resonance cholangiopancreatography using the Cambridge classification as the diagnostic standard. Visceral and subcutaneous compartments were manually segmented, and fat tissue was quantitatively measured on axial magnetic resonance imaging. Results: Pancreatic fat fraction showed a direct correlation with fat within the visceral compartment (r = 0.54). Patients with CP showed higher visceral fat (P = 0.01) and pancreatic fat fraction (P < 0.001): mild, 24%; moderate, 23%; severe CP, 21%; no CP group, 15%. Patients with type 2 diabetes mellitus showed higher pancreatic steatosis (P = 0.03) and higher visceral (P = 0.007) and subcutaneous fat (P = 0.004). Interobserver variability of measuring fat by magnetic resonance imaging was excellent (r ≥ 0.90–0.99). Conclusions: Increased visceral adipose tissue has a moderate direct correlation with pancreatic fat fraction. Chronic pancreatitis is associated with higher pancreatic fat fraction and visceral fat. Type 2 diabetes mellitus is associated with higher pancreatic fat fraction and visceral and subcutaneous adiposity

Motor function and behaviour across the ALS-FTD spectrum

BACKGROUND: Behavioural/functional disturbances, characteristic of frontotemporal dementia (FTD), are also a feature of amyotrophic lateral sclerosis (ALS) and patients with combined ALS and FTD (FTD-ALS).  AIM OF THE STUDY: To investigate the progression of behavioural disturbances in ALS and FTD using the frontotemporal dementia functional rating scale (FTDFRS).  METHODS: Patients with ALS, FTD-ALS, and FTD were recruited from specialist clinics. Baseline assessments included the FTDFRS and the amyotrophic lateral sclerosis functional rating scale – revised (ALSFRS-R). Baseline assessments were included, as were longitudinal assessments in a proportion of patients.  RESULTS: In total, 21 ALS, 12 FTD-ALS and 14 behavioural variant FTD (bvFTD) patients were included in the study. Moderate or severe behavioural disturbance was common in ALS patients at baseline (47.6%), although less frequent than in bvFTD patients; FTDALS patients displayed intermediate impairment. The ALSFRS-R showed the opposite pattern and did not correlate with the FTDFRS. During the follow-up period, significant (p<0.05) behaviouraldeterioration was demonstrated in bvFTD and FTD-ALS patients, with a trend for decline in ALS patients (p=0.06).  CONCLUSION: Motor disturbance is the primary marker of disease severity in ALS, but behavioural and functional impairment are common, and may decline independently of motor function. As such, the FTDFRS may provide valuable information in the assessment andmonitoring of ALS

The Diverse Applications of Cladistic Analysis of Molecular Evolution, with Special Reference to Nested Clade Analysis

The genetic variation found in small regions of the genomes of many species can be arranged into haplotype trees that reflect the evolutionary genealogy of the DNA lineages found in that region and the accumulation of mutations on those lineages. This review demonstrates some of the many ways in which clades (branches) of haplotype trees have been applied in recent years, including the study of genotype/phenotype associations at candidate loci and in genome-wide association studies, the phylogeographic history of species, human evolution, the conservation of endangered species, and the identification of species