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Classification Methods For Identifying The Neural Characterics Of Antidepressant Treatment
Depression is a major public health problem, and one of the most important challenges for psychiatrists is to determine whether an individual with depression should receive cognitive-behavioral therapy or treatment with antidepressant medication. A study by researchers from Emory University, presented at the Annual Meeting of the Organization for Human Brain Mapping in San Francisco, used brain imaging along with sophisticated statistical techniques to examine the differences in brain function that result from these two different kinds of treatment. Forty individuals with depression were scanned with magnetic resonance imaging after undergoing cognitive behavioral therapy or antidepressant therapy. The researchers found that they could distinguish the brain activity of individuals undergoing the two different treatments, and in particular that the two treatments differently affected the communication of the brain areas that are thought to play a role in depression, including the communication between the prefrontal cortex and the nucleus accumbens, and between the subgenual cingulate and the thalamus. The results provide a basis for future research that will try to predict which individuals will benefit from different treatments for depression.
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Online Reporting System For Swine Flu Antiviral Side Effects
Suspected side effects to swine flu antiviral medicines can now be reported to the Medicines and Healthcare products Regulatory Agency (MHRA) via a new dedicated webpage (http://www.mhra.gov.uk/swineflu).
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Supreme Court Nominee Sotomayor Pledges 'Fidelity To The Law' As Confirmation Hearing Begins
In the first day of her confirmation hearings before the Senate Judiciary Committee, Supreme Court nominee Judge Sonia Sotomayor said on Monday that "fidelity to the law" is central to her judicial philosophy and that the role of a judge is "not to make law" but "to apply the law," the Washington Post reports. Sotomayor said her record as a district and federal appeals judge "reflects my rigorous commitment to interpreting the Constitution according to its terms, interpreting statutes according to their terms and Congress" intent, and hewing faithfully to precedents established by the Supreme Court and by my circuit court." She also said her "personal and professional experiences help me listen and understand, with the law always commanding the result in every case" (Barnes et al., Washington Post, 7/14). The first day of the hearings was dedicated to opening statements from Sotomayor and senators, with the questioning portion scheduled to begin on Tuesday. According to the Wall Street Journal, Sotomayor is expected to be confirmed, as Democrats outnumber Republicans on the committee 12-7 and hold a 60-member majority in the Senate (Bravin/Bendavid, Wall Street Journal, 7/14). The New York Times reports that senators from both parties are likely to use Sotomayor"s confirmation as a way to frame the debate for the next Supreme Court nominee, with Democrats hoping to "build a lopsided victory" to give President Obama more leeway to choose a more liberal nominee. Conservatives, on the other hand, "hoped to draw a line making the president think twice about picking someone" like Sotomayor in the future, the Times reports (Baker/Lewis, New York Times, 7/14).In Monday"s hearing, both parties gave indications of how they plan to proceed for the rest of the confirmation process, the Post reports. Democrats in their statements portrayed Sotomayor as a role model for the country and a judge with a modest approach who would bring balance to the conservative-leaning court (Washington Post, 7/14). Sen. Charles Schumer (D-N.Y.) said Sotomayor "puts rule of law above everything else." He added, "Given her extensive and evenhanded record, I am not sure how any member of this panel can sit here today and seriously suggest that she comes to the bench with a personal agenda" (Stern/Perine, CQ Today, 7/13). Republicans used their statements to cast Sotomayor as a partial judge, saying previous statements and rulings show she is an activist judge (Washington Post, 7/14). In particular, GOP senators on the committee referenced a comment from a 2001 speech in which Sotomayor said that a "wise Latina" would reach better decisions than a white man in some cases (Baker/Lewis, New York Times, 7/14). Sen. Jeff Sessions (Ala.), the ranking Republican on the committee, said, "No senator should vote for an individual ... who believes it is acceptable for a judge to allow their own personal background, gender, prejudices or sympathies to sway their decision." He continued, "Call it empathy, call it prejudice or call it sympathy, but whatever it is, it"s not law" (Wall Street Journal, 7/14). However, Sen. Lindsey Graham (R-S.C.) noted that Republicans lost in last year"s presidential election and told Sotomayor, "Unless you have a complete meltdown, you"re going to get confirmed" (Lewis, New York Times, 7/14).Antiabortion-Rights Protesters Arrested During HearingsFour antiabortion-rights protesters were arrested for shouting comments during the senators" remarks (CQ Today, 7/13). One of the arrested protesters was Norma McCorvey, the plaintiff "Jane Roe" in Roe v. Wade. According to the AP/Google.com, McCorvey began screaming that Sotomayor was "wrong" about abortion during the opening statement of Sen. Al Franken (D-Minn.). McCorvey and the other three arrested protesters were charged with unlawful conduct-disruption of Congress. The protesters also prompted a warning from Senate Judiciary Committee Chair Patrick Leahy (D-Vt.), who said, "We"ll show respect to everybody who is here, we will show respect to everyb
Public Health

New Tests For The Investigation Of Patients With Painful Metal-on-metal Resurfacing Arthroplasties

This paper investigates 26 patients with painful metal-on-metal resurfacing arthroplasties and describes three tests for the investigation of the phenomenon. The tests are metal artefact-reduction MRI, 3-D CT measurement of the position of the component and inductively-coupled plasma mass spectrometry. Current techniques for assessing patients with painful MOM hips are the same as for painful non-MOM hips, however, this research demonstrates that hip resurfacing appears to have specific modes of failure which are not detectable using these methods. Therefore, the authors investigated the use of metal artefact-reduction MRI, 3-D CT measurement of the position on the component and inductively-coupled plasma mass spectrometry analysis of cobalt and chromium levels in the whole blood. As an aseptic lymphocyte-dominated vasculitis-lesion can be a possible cause of unexplained pain in a MOM hip the 26 patients were tested with MRI and 16 hips showed periprosthetic lesions, with 14 collections of fluid and two soft tissue masses. The diagnosis of aseptic lymphocyte-dominated vasculitis-lesion can only be made from tissue samples, usually collected during revision. Therefore, because the lesions were seen in both men and women and in symptomatic and asymptomatic hips the significance of this finding is unclear. It has also been suggested that unexplained hip pain is associated with high levels of metal ions in the blood so the levels of cobalt and chromium may be biomarkers of early failure. In the patients tested, the levels of blood metal ions tended to be higher in painful compared to well-functioning metal-on-metal hips. Specifically the level of cobalt were significantly greater, suggesting that painful hip resurfacings have greater wear rates. However, the levels of chromium were barely raised in patients with unilateral MOM hips and therefore analysis of blood metals ions as a screening test for painful MOM is likely to be sensitive but not specific. The 3-D CT scans showed that the median inclination of the acetabular component was 55° and its positioning was outside the Lewinnk safe zone in 13 of 16 cases. The position of the component may influence the risk of failure of a MOM hip because suboptimal acetabular version may cause impingement, and inclination angles of greater than 50° may cause high rates of wear. The authors protocol for the painful MOM hip demonstrated a high probability of periprosthetic masses on metal artefact reduction sequences, a higher blood metal level than in the well-functioning MOM hip and a position of the component outside the Lewinnek safe zone. Taken together, these observations may help to determine causes of failure, indicate the most appropriate treatment and aid the choice of prosthesis if replacing the contralateral hip. Read the full text article. The Journal of Bone and Joint Surgery


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