Contemporary approach to neurologic prognostication of coma after cardiac arrest.

Coma after cardiac arrest (CA) is an important cause of admission to the ICU. Prognosis of post-CA coma has significantly improved over the past decade, particularly because of aggressive postresuscitation care and the use of therapeutic targeted temperature management (TTM). TTM and sedatives used to maintain controlled cooling might delay neurologic reflexes and reduce the accuracy of clinical examination. In the early ICU phase, patients' good recovery may often be indistinguishable (based on neurologic examination alone) from patients who eventually will have a poor prognosis. Prognostication of post-CA coma, therefore, has evolved toward a multimodal approach that combines neurologic examination with EEG and evoked potentials. Blood biomarkers (eg, neuron-specific enolase [NSE] and soluble 100-β protein) are useful complements for coma prognostication; however, results vary among commercial laboratory assays, and applying one single cutoff level (eg, > 33 μg/L for NSE) for poor prognostication is not recommended. Neuroimaging, mainly diffusion MRI, is emerging as a promising tool for prognostication, but its precise role needs further study before it can be widely used. This multimodal approach might reduce false-positive rates of poor prognosis, thereby providing optimal prognostication of comatose CA survivors. The aim of this review is to summarize studies and the principal tools presently available for outcome prediction and to describe a practical approach to the multimodal prognostication of coma after CA, with a particular focus on neuromonitoring tools. We also propose an algorithm for the optimal use of such multimodal tools during the early ICU phase of post-CA coma.

Combination of androgen deprivation therapy and radiotherapy for localized prostate cancer in the contemporary era.

Currently, androgen deprivation therapy (ADT) has a well-defined role when administered together with radiotherapy (RT): neo-adjuvant and concurrent combination for intermediate risk-disease and adjuvant therapy for high risk disease. Evidence of this association was generated by randomized trials designed and led approximately 30 years ago; thus the question which arises is how relevant and portable are these data in our current clinical practice? In the present review, we examine the pitfalls of these published randomized controlled trials, their relevance to present daily clinics, where high-dose external beam RT or brachytherapy is applied, as well as the adoption of ADT in patients with concomitant cardiovascular disorders.

Conjuring the Curse of Repetition or « Sleeping Beauty » Revamped : Angela Carter's Vampirella and The Lady of the House of Love

Abstract:This article illustrates Angela Carter's literary practice through her utilization of "Sleeping Beauty" in the radio play Vampirella and its prose variation The Lady of the House of Love. It argues that she vampirised European culture as she transfused old stories into new bodies to give them new life and bite. Carter's experiments with forms, genres and mediums in her vampire fiction capture the inherent hybridity of the fairy tale as it sheds new light on her main source, Charles Perrault's La Belle au bois dormant, bringing to the fore the horror and terror as well as the textual ambiguities of the French conte that were gradually obscured in favor of the romance element. Carter's vampire stories thus trace the 'dark' underside of the reception of the tale in Gothic fiction and in the subculture of comic books and Hammer films so popular in the 1970s, where the Sleeping Beauty figure is revived as a femme fatale or vamp who takes her fate in her own hands.Résumé:Cet article s'attache à montrer comment l'utilisation de La Belle au bois dormant dans deux histoires de vampire d'Angela Carter, la pièce radiophonique Vampirella et sa réécriture en prose The Lady of the House of Love, illustre la pratique littéraire de l'auteur, qui consiste à vampiriser la culture européenne et à transfuser les vieilles histoires dans de nouvelles formes, genres, et médias afin de leur donner une nouvelle vie. Le traitement du conte de fée permet d'aborder un aspect essentiel de la démarche créative de l'auteur, tout en offrant un éclairage inédit sur le conte de Perrault. En effet, Carter met en évidence les éléments inquiétants et l'atmosphère de menace qui caractérisent la deuxième partie du conte, tout en jouant sur les ambiguités du texte français souvent négligés au profit de la veine romanesque. A cet égard, ses histoires de vampire peuvent se lire comme une réflexion sur la réception 'obscure' du conte de fées dans la culture populaire, qui voit le personnage de la Belle au bois dormant prendre son destin en main et se réinventer en femme fatale ou vamp dans la bande dessinée et les séries B des années 1970.

Specificity of psychosis, mania and major depression in a contemporary family study.

There has been increasing attention to the subgroups of mood disorders and their boundaries with other mental disorders, particularly psychoses. The goals of the present paper were (1) to assess the familial aggregation and co-aggregation patterns of the full spectrum of mood disorders (that is, bipolar, schizoaffective (SAF), major depression) based on contemporary diagnostic criteria; and (2) to evaluate the familial specificity of the major subgroups of mood disorders, including psychotic, manic and major depressive episodes (MDEs). The sample included 293 patients with a lifetime diagnosis of SAF disorder, bipolar disorder and major depressive disorder (MDD), 110 orthopedic controls, and 1734 adult first-degree relatives. The diagnostic assignment was based on all available information, including direct diagnostic interviews, family history reports and medical records. Our findings revealed specificity of the familial aggregation of psychosis (odds ratio (OR)=2.9, confidence interval (CI): 1.1-7.7), mania (OR=6.4, CI: 2.2-18.7) and MDEs (OR=2.0, CI: 1.5-2.7) but not hypomania (OR=1.3, CI: 0.5-3.6). There was no evidence for cross-transmission of mania and MDEs (OR=.7, CI:.5-1.1), psychosis and mania (OR=1.0, CI:.4-2.7) or psychosis and MDEs (OR=1.0, CI:.7-1.4). The strong familial specificity of psychotic, manic and MDEs in this largest controlled contemporary family study challenges the growing assertion that the major types of mood disorders are manifestations of a common underlying diathesis.

The Gothic in Contemporary Literature and Popular Culture : Pop Goth

This interdisciplinary collection brings together world leaders in Gothic Studies, offering new readings on popular Gothic cultural productions from the last decade. Topics covered include, but are not limited to: contemporary High Street Goth/ic fashion, Gothic performance and art festivals, Gothic popular fiction from Twilight to Shadow of the Wind, Goth/ic popular music, Goth/ic on TV and film, new trends like Steampunk, well-known icons Batman and Lady Gaga, and theorizations of popular Gothic monsters (from zombies and vampires to werewolves and ghosts) in an age of terror/ism.

Evolutionary and dispersal history of Eurasian house mice Mus musculus clarified by more extensive geographic sampling of mitochondrial DNA.

We examined the sequence variation of mitochondrial DNA control region and cytochrome b gene of the house mouse (Mus musculus sensu lato) drawn from ca. 200 localities, with 286 new samples drawn primarily from previously unsampled portions of their Eurasian distribution and with the objective of further clarifying evolutionary episodes of this species before and after the onset of human-mediated long-distance dispersals. Phylogenetic analysis of the expanded data detected five equally distinct clades, with geographic ranges of northern Eurasia (musculus, MUS), India and Southeast Asia (castaneus, CAS), Nepal (unspecified, NEP), western Europe (domesticus, DOM) and Yemen (gentilulus). Our results confirm previous suggestions of Southwestern Asia as the likely place of origin of M. musculus and the region of Iran, Afghanistan, Pakistan, and northern India, specifically as the ancestral homeland of CAS. The divergence of the subspecies lineages and of internal sublineage differentiation within CAS were estimated to be 0.37-0.47 and 0.14-0.23 million years ago (mya), respectively, assuming a split of M. musculus and Mus spretus at 1.7 mya. Of the four CAS sublineages detected, only one extends to eastern parts of India, Southeast Asia, Indonesia, Philippines, South China, Northeast China, Primorye, Sakhalin and Japan, implying a dramatic range expansion of CAS out of its homeland during an evolutionary short time, perhaps associated with the spread of agricultural practices. Multiple and non-coincident eastward dispersal events of MUS sublineages to distant geographic areas, such as northern China, Russia and Korea, are inferred, with the possibility of several different routes.