PURPOSE: Some patients with temporal lobe epilepsy (TLE) lack evidence of hippocampal sclerosis (HS) on MRI (HS-ve). We hypothesized that this group would have a different pattern of 2-deoxy-2-[F-18]fluoro-D-glucose (FDG)-positron emission tomography (PET) hypometabolism than typical mesial TLE/HS patients with evidence of hippocampal atrophy on magnetic resonance imaging (MRI) (HS+ve), with a lateral temporal neocortical rather than mesial focus. PROCEDURES: Thirty consecutive HS-ve patients and 30 age- and sex-matched HS+ve patients with well-lateralized EEG were identified. FDG-PET was performed on 28 HS-ve patients and 24 HS+ve patients. Both groups were compared using statistical parametric mapping (SPM), directly and with FDG-PET from 20 healthy controls. RESULTS: Both groups showed lateralized temporal hypometabolism compared to controls. In HS+ve, this was antero-infero-mesial (T = 17.13); in HS-ve the main clustering was inferolateral (T = 17.63). When directly compared, HS+ve had greater hypometabolism inmesial temporal/hippocampal regions (T = 4.86); HS-ve had greater inferolateral temporal hypometabolism (T = 4.18). CONCLUSIONS: These data support the hypothesis that focal hypometabolism involves primarily lateal neocortical rather than mesial temporal structures in 'MRI-negative PET-positive TLE.'

Adult↗

PubMedDate not supplied

Three-dimensional fractal analysis of the white matter surface from magnetic resonance images of the human brain.

The convolutions of the cerebral cortex are difficult to describe and delineate. Our understanding of the development of the brain and its associated maldevelopment would be assisted by quantitative analysis of the cortex. Volumetric magnetic resonance (MR) imaging provides high-resolution anatomical data from which we can reconstruct the white matter as a three-dimensional object and extract its surface (the grey/white matter interface). Three-dimensional fractal analysis of this surface is a method of quantifying the surface complexity dependent upon the variation of the surface area under different scales of inspection. We estimate the fractal dimension of the white matter surface for each hemisphere and 10 coronal blocks of each hemisphere in 30 normal adult subjects. These values are tightly distributed and have been used to define a normal range of fractal dimensions. Abnormal fractal dimensions were found in 8/16 subjects with epilepsy and a gyral abnormality observed on routine MR imaging; and in 9/23 subjects with epilepsy and normal routine MR imaging. These analytical techniques offer additional information about the structure of the cortex in normal brains and about abnormalities of structure in subjects with suspected but unobserved structural abnormalities.

Adult↗

PubMedDate not supplied

Perimenopause: an opportunity for health promotion.

Women throughout the world experience menopause, yet the effects of estrogen deficiency, which are more extensive than the commonly reported symptoms of hot flashes, vaginal atrophy, and osteoporosis, are rarely discussed. Using an empathetic approach can enable nurses to teach women more effectively about the multisystem effects of perimenopause and counsel them to implement and maintain the life-style changes necessary for promoting health during this time of life.

Aged↗

PubMedDate not supplied

The attributes of effective clinical nurse leaders.

AIM: To identify the attributes of effective clinical nurse leaders. METHOD: A grounded theory research approach was adopted, using two research techniques: observation and interview. RESULTS: The literature review revealed that the role of the clinical nurse leader was ill-defined and addressed only in sparse, opinion-based literature. Novel outcomes of the research included: Identifying five attributes of effective clinical nurse leaders--highlighting, respecting, influencing, creativity and supporting. Distinguishing five typologies of effective clinical nurse leaders--discoverer, valuer, enabler, shaper and modifier. Elucidating factors that constrain and facilitate the development of effective clinical nurse leadership. CONCLUSION: The results imply that to enhance clinical nursing, leadership factors that enable and constrain clinical nursing leadership have to be identified and acted upon by individuals and those who they report to professionally.

Attitude of Health Personnel↗