Asmussenconnor1184

is did not have an increased risk of developing psychiatric diseases that required hospital care or treatment with prescription medication. The increased receipt of psychiatric medication among patients with Lyme neuroborreliosis within the first year after diagnosis, but not thereafter, suggests that most symptoms associated with the diagnosis subside within a short period.

In this population-based matched cohort study, patients with Lyme neuroborreliosis did not have an increased risk of developing psychiatric diseases that required hospital care or treatment with prescription medication. The increased receipt of psychiatric medication among patients with Lyme neuroborreliosis within the first year after diagnosis, but not thereafter, suggests that most symptoms associated with the diagnosis subside within a short period.Comparing heat production after ad libitum (ADLIB) and restricted (RESTRICT) feeding periods may offer insight into how residual feed intake (RFI) groups change their energy requirements based on previous feeding levels. In this study, the authors sought to explain the efficiency changes of high- and low-RFI steers after feed restriction. To determine RFI classification, 56 Angus-cross steers with initial body weight (BW) of 350 ± 28.7 kg were individually housed, offered ad libitum access to a total mixed ration, and daily intakes were recorded for 56 d. RFI was defined as the residual of the regression of dry matter intake on mid-test BW0.75 and average daily gain. High- and low-RFI groups were defined as >0.5 SD above or below the mean of zero, respectively. Fourteen steers from each high and low groups (n = 28) were selected for the subsequent 56-d RESTRICT period. During the RESTRICT period, intake was restricted to 75% of previous ad libitum intake on a BW0.75 basis, and all other conditions remained constant. After the RESTRICT period, both RFI groups had decreased maintenance energy requirements. However, the low-RFI group decreased maintenance energy requirements by 32% on a BW0.75 basis, more (P less then 0.05) than the high-RFI group decreased maintenance requirements (18%). Iressa Thus, the low-RFI steers remained more efficient after a period of feed restriction. We conclude that feed restriction decreases maintenance energy requirement in both high- and low-RFI groups that are restricted to the same degree.

Middle meningeal artery (MMA) embolization has emerged as a promising treatment for chronic subdural hematoma (cSDH).

To determine the safety and efficacy of MMA embolization.

Consecutive patients who underwent MMA embolization for cSDH (primary treatment or recurrence after conventional surgery) at 15 centers were included. Clinical details and follow-up were collected prospectively. Primary clinical and radiographic outcomes were the proportion of patients requiring additional surgical treatment within 90 d after index treatment and proportion with>50% cSDH thickness reduction on follow-up computed tomography imaging within 90 d. National Institute of Health Stroke Scale and modified Rankin Scale were also clinical outcomes.

A total of 138 patients were included (mean age 69.8, 29% female). A total of 15 patients underwent bilateral interventions for 154 total embolizations (66.7% primary treatment). At presentation, 30.4% and 23.9% of patients were on antiplatelet and anticoagulation therapy, respectively. Median admission cSDH thickness was 14 mm. A total of 46.1% of embolizations were performed under general anesthesia, and 97.4% of procedures were successfully completed. A total of 70.2% of embolizations used particles, and 25.3% used liquid embolics with no significant outcome difference between embolization materials (P>.05). On last follow-up (mean 94.9 d), median cSDH thickness was 4 mm (71% median thickness reduction). A total of 70.8% of patients had >50% improvement on imaging (31.9% improved clinically), and 9 patients (6.5%) required further cSDH treatment. There were 16 complications with 9 (6.5%) because of continued hematoma expansion. Mortality rate was 4.4%, mostly unrelated to the index procedure but because of underlying comorbidities.

MMA embolization may provide a safe and efficacious minimally invasive alternative to conventional surgical techniques.

MMA embolization may provide a safe and efficacious minimally invasive alternative to conventional surgical techniques.

Intractable aggressive behavior (iAB) is a devastating behavioral disorder that may affect psychiatric patients. These patients have reduced quality of life, are more challenging to treat as they impose a high caregiver burden and require specialized care. Neuromodulatory interventions targeting the amygdala, a key hub in the circuitry of aggressive behavior (AB), may provide symptom alleviation.

To Report clinical and imaging findings from a case series of iAB patients treated with bilateral amygdala ablation.

This series included 4 cases (3 males, 19-32 years old) who underwent bilateral amygdala radiofrequency ablation for iAB hallmarked by life-threatening self-injury and social aggression. Pre- and postassessments involved full clinical, psychiatric, and neurosurgical evaluations, including scales quantifying AB, general agitation, quality of life, and magnetic resonance imaging (MRI).

Postsurgery assessments revealed decreased aggression and agitation and improved quality of life. AB was correlated with testosterone levels and testosterone/cortisol ratio in males. No clinically significant side effects were observed. Imaging analyses showed preoperative amygdala volumes within normal populational range and confirmed lesion locations. The reductions in aggressive symptoms were accompanied by significant postsurgical volumetric reductions in brain areas classically associated with AB and increases in regions related to somatosensation. The local volumetric reductions are found in areas that in a normal brain show high expression levels of genes related to AB (eg, aminergic transmission) using gene expression data provided by the Allen brain atlas.

These findings provide new insight into the whole brain neurocircuitry of aggression and suggest a role of altered somatosensation and possible novel neuromodulation targets.

These findings provide new insight into the whole brain neurocircuitry of aggression and suggest a role of altered somatosensation and possible novel neuromodulation targets.