A new rechargeable device for deep brain stimulation: a prospective patient satisfaction survey

Background: Deep brain stimulation (DBS) is highly successful in treating Parkinson's disease (PD), dystonia, and essential tremor (ET). Until recently implantable neurostimulators were nonrechargeable, battery-driven devices, with a lifetime of about 3-5 years. This relatively short duration causes problems for patients (e.g. programming and device-use limitations, unpredictable expiration, surgeries to replace depleted batteries). Additionally, these batteries (relatively large with considerable weight) may cause discomfort. To overcome these issues, the first rechargeable DBS device was introduced: smaller, lighter and intended to function for 9 years. Methods: Of 35 patients implanted with the rechargeable device, 21 (including 8 PD, 10 dystonia, 2 ET) were followed before and 3 months after surgery and completed a systematic survey of satisfaction with the rechargeable device. Results: Overall patient satisfaction was high (83.3 ± 18.3). Dystonia patients tended to have lower satisfaction values for fit and comfort of the system than PD patients. Age was significantly negatively correlated with satisfaction regarding process of battery recharging. Conclusions: Dystonia patients (generally high-energy consumption, severe problems at the DBS device end-of-life) are good, reliable candidates for a rechargeable DBS system. In PD, younger patients, without signs of dementia and good technical understanding, might have highest benefit.

Familial occurrence and heritable connective tissue disorders in cervical artery dissection

OBJECTIVE In a large series of patients with cervical artery dissection (CeAD), a major cause of ischemic stroke in young and middle-aged adults, we aimed to examine frequencies and correlates of family history of CeAD and of inherited connective tissue disorders. METHODS We combined data from 2 large international multicenter cohorts of consecutive patients with CeAD in 23 neurologic departments participating in the CADISP-plus consortium, following a standardized protocol. Frequency of reported family history of CeAD and of inherited connective tissue disorders was assessed. Putative risk factors, baseline features, and 3-month outcome were compared between groups. RESULTS Among 1,934 consecutive patients with CeAD, 20 patients (1.0%, 95% confidence interval: 0.6%-1.5%) from 17 families (0.9%, 0.5%-1.3%) had a family history of CeAD. Family history of CeAD was significantly more frequent in patients with carotid location of the dissection and elevated cholesterol levels. Two patients without a family history of CeAD had vascular Ehlers-Danlos syndrome with a mutation in COL3A1. This diagnosis was suspected in 2 additional patients, but COL3A1 sequencing was negative. Two patients were diagnosed with classic and hypermobile Ehlers-Danlos syndrome, one patient with Marfan syndrome, and one with osteogenesis imperfecta, based on clinical criteria only. CONCLUSIONS In this largest series of patients with CeAD to date, family history of symptomatic CeAD was rare and inherited connective tissue disorders seemed exceptional. This finding supports the notion that CeAD is a multifactorial disease in the vast majority of cases.

Cantate : Psalm 45 ; [Cantate aus Anlass der Feier der silbernen Hochzeit unseres ... Kaiserpaares ... Franz Joseph I. und ... Elisabeth Amalie Eugenia ; 24te April 1854 - 1879]

[in Musik gesetzt von] J[acob] Bachmann

Poetik des Unbehagens. Unlust als 'point de départ' in Romanen Marie NDiayes

Die Romane der französischen Autorin Marie NDiaye (geb. 1967) sind durchzogen von Zuständen des Unwohlseins: NDiayes Protagonistinnen werden auf diffuse Weise sozial ausgegrenzt oder massiv bedrängt, verlieren die Kontrolle über ihren Körper oder geraten in schwindelerregende Zweifel über den Realitätsgehalt ihrer Sinneswahrnehmungen und Erinnerungen. Anhand der Romane "En famille" (1990), "Autoportrait en vert" (2005) und "Mon cœur à l’étroit" (2007) zeigt der Aufsatz, dass diese Momente des Unbehagens nicht nur die Suchbewegungen und Erkenntnisprozesse der Romanfiguren auslösen, sondern auch die kreative Spannung bilden, die den Vorgang der literarischen inventio in Gang setzt. Theoretische Modelle einer Psychologie, in der Unlust als Antrieb fungiert, finden sich bei Leibniz, Locke und Freud; Elemente einer Narratologie der Unlust, mit der sich die quête-Struktur von NDiayes Romanen beschreiben lässt, bietet die strukturalistische Märchentheorie Wladimir Propps und seiner Nachfolger.

Lactate dehydrogenase concentration in nasal wash fluid indicates severity of rhinovirus-induced wheezy bronchitis in preschool children.

The clinical course of rhinovirus (RV)-associated wheezing illnesses is difficult to predict. We measured lactate dehydrogenase concentrations, RV load, antiviral and proinflammatory cytokines in nasal washes obtained from 126 preschool children with RV wheezy bronchitis. lactate dehydrogenase values were inversely associated with subsequent need for oxygen therapy. lactate dehydrogenase may be a useful biomarker predicting disease severity in RV wheezy bronchitis.

Die tiefgefrorene Lederhose. Sensationelle Geschichten aus dem Gletscher-Eis (von Elisabeth Brückner)

Das Schnidejoch ist ein Gebirgspass 2700 Meter hoch in den Berner Alpen, seit tausenden Jahren von Eis bedeckt. Mittlerweile ist fast alles Eis infolge der globalen Klimaerwärmung geschmolzen. SWR2 Kontext-Radiosendung von Elisabeth Brückner.

Gletscherarchäologie. Steinzeitfunde aus dem Eis (von Elisabeth Brückner)

Der Ötzi ist kein Einzelfall. Immer mehr Hinterlassenschaften der Vorzeit kommen ans Tageslicht, seit die globale Erwärmung nach und nach die alpinen Gletscher zum Schmelzen bringt. Insbesondere am Schnidejoch im Berner Oberland sind Archäologen fündig geworden: Das Eis, das hier jahrtausendelang den Bergsattel bedeckte, ist mittlerweile bis auf einen kleinen Eisfleck geschmolzen und hat rund 900 Artefakte freigegeben. Darunter eine 6.800 Jahre alte Schüssel aus Ulmenholz, eine komplette Jägerausrüstung, römische Schuhnägel aus dem Mittelalter. Und das große Schmelzen geht weiter ...

Tagebuch eines Kriegsgefangenen auf "Dronning Marie", April bis September 1848 : herausgegeben zur Erinnerung an den 24. März 1848

Welsch (Projektbearbeiter): Schilderung der deutsch-dänischen Auseinandersetzung um Schleswig-Holstein (April bis September 1848) aus der Sicht des an Bord des dänischen Kriegsschiffes "Dronning Marie" internierten Kriegsgefangenen Karl Heinrich Christian Keck

Allgemeines Grundgesetz für das Kuratorium in Potsdam und die Frauen- und Jungfrauen-Vereine des Landes unter dem hohen Protectorate Ihrer Majestät der Königin zur Verwaltung der Central-Stiftung des Königin-Elisabeth-Vereins als nationales Ehren-Denkmal an die silberne Jubelhochzeitfeier des hohen Königspaares Friedrich Wilhelm IV. und Elisabeth von Preussen : zu Potsdam am 29. November 1849

Boberach: Die vom Verein errichtete Stiftung soll "durch geistige und materielle Mittel das Familienwohl" fördern, die "Geistes- und Herzensbildung besonders des weiblichen Geschlechts" heben und die "unerschütterliche Anhänglichkeit an das Königshaus" befestigen

Meta-analysis identifies seven susceptibility loci involved in the atopic march.

Eczema often precedes the development of asthma in a disease course called the 'atopic march'. To unravel the genes underlying this characteristic pattern of allergic disease, we conduct a multi-stage genome-wide association study on infantile eczema followed by childhood asthma in 12 populations including 2,428 cases and 17,034 controls. Here we report two novel loci specific for the combined eczema plus asthma phenotype, which are associated with allergic disease for the first time; rs9357733 located in EFHC1 on chromosome 6p12.3 (OR 1.27; P=2.1 × 10(-8)) and rs993226 between TMTC2 and SLC6A15 on chromosome 12q21.3 (OR 1.58; P=5.3 × 10(-9)). Additional susceptibility loci identified at genome-wide significance are FLG (1q21.3), IL4/KIF3A (5q31.1), AP5B1/OVOL1 (11q13.1), C11orf30/LRRC32 (11q13.5) and IKZF3 (17q21). We show that predominantly eczema loci increase the risk for the atopic march. Our findings suggest that eczema may play an important role in the development of asthma after eczema.

Evolutionary history and global spread of the Mycobacterium tuberculosis Beijing lineage.

Mycobacterium tuberculosis strains of the Beijing lineage are globally distributed and are associated with the massive spread of multidrug-resistant (MDR) tuberculosis in Eurasia. Here we reconstructed the biogeographical structure and evolutionary history of this lineage by genetic analysis of 4,987 isolates from 99 countries and whole-genome sequencing of 110 representative isolates. We show that this lineage initially originated in the Far East, from where it radiated worldwide in several waves. We detected successive increases in population size for this pathogen over the last 200 years, practically coinciding with the Industrial Revolution, the First World War and HIV epidemics. Two MDR clones of this lineage started to spread throughout central Asia and Russia concomitantly with the collapse of the public health system in the former Soviet Union. Mutations identified in genes putatively under positive selection and associated with virulence might have favored the expansion of the most successful branches of the lineage.

Impact of comorbidities on overall survival in patients with chronic myeloid leukemia: results of the randomized CML study IV.

We studied the influence of comorbidities on remission rate and overall survival (OS) in patients with chronic myeloid leukemia (CML). Participants of the CML Study IV, a randomized 5-arm trial designed to optimize imatinib therapy, were analyzed for comorbidities at diagnosis using the Charlson Comorbidity Index (CCI); 511 indexed comorbidities were reported in 1519 CML patients. Age was an additional risk factor in 863 patients. Resulting CCI scores were as follows: CCI 2, n = 589; CCI 3 or 4, n = 599; CCI 5 or 6, n = 229; and CCI ≥ 7, n = 102. No differences in cumulative incidences of accelerated phase, blast crisis, or remission rates were observed between patients in the different CCI groups. Higher CCI was significantly associated with lower OS probabilities. The 8-year OS probabilities were 93.6%, 89.4%, 77.6%, and 46.4% for patients with CCI 2, 3 to 4, 5 to 6, and ≥7, respectively. In multivariate analysis, CCI was the most powerful predictor of OS, which was still valid after removal of its age-related components. Comorbidities have no impact on treatment success but do have a negative effect on OS, indicating that survival of patients with CML is determined more by comorbidities than by CML itself. OS may therefore be inappropriate as an outcome measure for specific CML treatments. The trial was registered at www.clinicaltrials.gov as #NCT00055874.