Evaluating metabolites in patients with major depressive disorder who received mindfulness-based cognitive therapy and healthy controls using short echo MRSI at 7 Tesla.

ObjectivesOur aim was to evaluate differences in metabolite levels between unmedicated patients with major depressive disorder (MDD) and healthy controls, to assess changes in metabolites in patients after they completed an 8-week course of mindfulness-based cognitive therapy (MBCT), and to exam the correlation between metabolites and depression severity.Materials and methodsSixteen patients with MDD and ten age- and gender-matched healthy controls were studied using 3D short echo-time (20 ms) magnetic resonance spectroscopic imaging (MRSI) at 7 Tesla. Relative metabolite ratios were estimated in five regions of interest corresponding to insula, anterior cingulate cortex (ACC), caudate, putamen, and thalamus.ResultsIn all cases, MBCT reduced severity of depression. The ratio of total choline-containing compounds/total creatine (tCr) in the right caudate was significantly increased compared to that in healthy controls, while ratios of N-acetyl aspartate (NAA)/tCr in the left ACC, myo-inositol/tCr in the right insula, and glutathione/tCr in the left putamen were significantly decreased. At baseline, the severity of depression was negatively correlated with my-inositol/tCr in the left insula and putamen. The improvement in depression severity was significantly associated with changes in NAA/tCr in the left ACC.ConclusionsThis study has successfully evaluated regional differences in metabolites for patients with MDD who received MBCT treatment and in controls using 7 Tesla MRSI

Estimating the effects of September 11 on Las Vegas Strip gaming volume

This paper examines the decrease in gross gaming volume, specifically slot machine coin-in, on the Las Vegas Strip resulting from the events of September 11, 2001. An intervention analysis based on a seasonal ARIMA model was developed from Nevada Gaming Control Board slot machine coin-in data analyzed from January 1990 to November 2004. The findings revealed that the Strip experienced an abrupt decline in gaming volume lasting five months. Although a quick recovery ensued, residual effects lasted approximately two years. In spite of the uniqueness of the events of September 11, this study should help managers in their response to future terrorist attacks and other catastrophic events

The Effects of Collargol as Employed in Pyelography: An Experimental Study

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The science of intentions and the intentions of science

Psychoanalysis is a special kind of science that needs to discover its systematic and scientific foundations on the grounds of its own being – the study of subjective life. In this essay, I describe how psychoanalysis is a ‘science of intentions’ and show how it can help us clarify the ‘intentions of science’ as we face a massive contemporary illusion: that we can understand our suffering through some version of biological determinism. Our methods of inquiry and our concerns and goals in psychoanalysis explicitly contrast with the assumptions and forms of investigation in biology, neuroscience, and physics. We cannot ground our work in studies of organic processes because we cannot ask or answer our questions through them

Endoscopic Barrett’s eradication: myth or reality?

Le traitement par résection endoscopique d’une lésion néoplasique superficielle au sein d’un oesophage de Barrett est le nouveau standard de la prise en charge de cette pathologie. Elle permet d’orienter la stratégie thérapeutique ultérieure et en particulier d’éviter l’oesophagectomie en cas de lésion intramuqueuse de bon pronostic. Cependant, ce traitement local pose le problème de la métaplasie intestinale résiduelle porteuse d’un risque de développement de nouvelle lésion. La destruction endoscopique de l’ensemble de la métaplasie et son remplacement par un épithélium malpighien, permettraient une réduction du risque néoplasique et de la nécessité de suivi de ces patients. À ce jour, malgré de bons résultats immédiats, plusieurs techniques d’ablation ont été abandonnées après démonstration d’une importante fréquence de réapparition de la métaplasie et un taux élevé de complications. L’ablation de la métaplasie par radiofréquence est une technique endoscopique récente permettant la destruction de larges plages de Barrett. Les résultats de suivi à 1 ou 2 ans des patients traités par cette technique sont encourageants et nous permettent de croire à l’avenir d’un traitement endoscopique global du Barrett en dysplasie.Endoscopic mucosal resection is a new standard of work up and therapeutic procedure in Barrett’s superficial neoplastic lesion. It allows a better therapeutic strategy and avoids unnecessary oesophagectomy even in case of low risk intramucosal cancer. However this local treatment raises the problem of residual intestinal metaplasia and the associated risk of new neoplastic lesion. The total endoscopic Barrett’s eradication and the intestinal metaplasia replacement with neosquamous epithelium could theoretically reduce the risk of neoplasia and the necessity of patient follow-up. Up to now, despite excellent immediate results, several Barrett’s ablation techniques were abandoned because of high rate of intestinal metaplasia reappearance and complications. Radiofrequency ablation is a new endoscopic technique, which allows destruction of large Barrett segments. One or two years’ follow-up studies of this technique are encouraging. There is still a hope for a future of global endoscopic treatment of dysplastic Barrett

Severe Neurological Impairment: Legal Aspects of Decisions to Reduce Care

Decisions to reduce care for patients with severe neurological impairment may raise legal questions. The laws of most states now authorize physicians to stop care for those who have suffered irreversible cessation of all functions of the brain (“brain death”). Where state law is not explicit, it is nevertheless probably lawful to regard brain death as death for legal purposes so long as currently accepted criteria are satisfied. Several courts have ruled that it is lawful to reduce care for patients in vegetative states, but have prescribed differing standards and procedures for implementing such decisions. The issue of whether parents can authorize physicians to reduce care for neurologically impaired children is the focus of current litigation. Implicit in this litigation is the question of how severe neurological impairment must be before parents and physicians may lawfully agree to reduce care. For severely impaired but not vegetative adults, there is some legal authority to justify certain decisions to reduce care. The issue of whether withholding feeding from a severely demented patient with life-threatening medical problems constitutes criminal behavior is now being considered by a state supreme court