ABSTRACT
OBJECTIVE: To determine the prevalence of hypertension (HPT) in the acute phase after ischemic stroke (IS) and explore its relationship to outcome. METHODS: We performed a retrospective review of children aged 1 month to 18 years with first IS admitted to a tertiary hospital between 2003 and 2008. Blood pressure readings recorded over the first 72 hours after diagnosis and morbidity or mortality at 12 months were documented. HPT was defined as 2 consecutive readings of systolic blood pressure ≥95th percentile for age. RESULTS: Ninety children were identified (median age 3.8 years). Fifty-three of 84 patients (63%) who had blood pressure readings available had at least 1 episode of HPT and 19 (22%) had HPT on 3 consecutive days. HPT was more prevalent at both ends of the age spectrum. The relative risk of 12-month mortality was 4.5 times higher (95% confidence interval = 0.6-34.5, p = 0.096) and relative risk of death in the hospital was 1.7 times higher (95% confidence interval = 1.4-2.0, p = 0.05) if the patient experienced HPT. There was no association between HPT and vascular territory, etiology, or neurologic disability. CONCLUSIONS: HPT is prevalent in children with IS in the first 3 days after diagnosis and is associated with increased risk of death. Larger prospective studies involving systematic recording of blood pressure are required to delineate the impact of HPT on risk of death or disability.
Subject(s)
Brain Ischemia/epidemiology , Hypertension/diagnosis , Stroke/epidemiology , Adolescent , Age Factors , Blood Pressure , Brain Ischemia/mortality , Child , Child, Preschool , Female , Humans , Hypertension/epidemiology , Hypertension/mortality , Infant , Male , Prevalence , Retrospective Studies , Risk , Stroke/complications , Stroke/diagnosis , Stroke/mortality , Time Factors , Treatment OutcomeABSTRACT
This study examined multiple risk factor models of links among callous-unemotional traits, aggression beliefs, social information processing, impulsivity, and aggressive behavior in a sample of 150 antisocial adolescents. Consistent with past research, results indicated that beliefs legitimizing aggression predicted social information processing biases and that social information processing biases mediated the effect of beliefs on aggressive behavior. Callous-unemotional traits accounted for unique variance in aggression above and beyond effects of more established risk factors of early onset of antisocial behavior, social information processing, and impulsivity. These findings add to recent research showing that callous-unemotional traits are a unique risk factor associated with aggression and criminal offending and suggest that targeting both affective and cognitive vulnerabilities may enhance clinical intervention with antisocial youth.
Subject(s)
Aggression/psychology , Antisocial Personality Disorder/psychology , Models, Psychological , Adolescent , Child , Female , Humans , Male , Prisons , Risk Factors , Surveys and QuestionnairesABSTRACT
We reanalyzed the behavioral and fMRI data from seven previously published studies of working memory in order to assess the behavioral and neural effects of item-nonspecific proactive interference (PI; attributable to the accrual of antecedent information independent of the repetition of particular items). We hypothesized that item-nonspecific PI, implicated in age-related declines in working memory performance, is mediated by the same mechanism(s) that mediate item-specific PI (occurring when an invalid memory probe matches a memorandum from the previous trial). Reaction time increased across trials as a function of position within the block, a trend that reversed across the duration of each multiblock experiment. The fMRI analyses revealed sensitivity to item-nonspecific PI during the probe epoch in the left anterior inferior frontal gyrus and the left dorsolateral prefrontal cortex(PFC). They also revealed a negative trend, across trials, in the transient probe-evoked component of the global signal. A common PFC-based mechanism may mediate many forms of PI.
Subject(s)
Brain Mapping , Frontal Lobe/physiology , Memory, Short-Term/physiology , Prefrontal Cortex/physiology , Proactive Inhibition , Reaction Time/physiology , Adult , Analysis of Variance , Attention/physiology , Female , Humans , Magnetic Resonance Imaging , Male , Mental Processes/physiology , Reference Values , Retrospective StudiesABSTRACT
Mediating proactive interference (PI), the deleterious effect of antecedent information on current memory representations, is believed to be a key function of prefrontal cortex (PFC). Item-specific PI results when an invalid probe matches a memorandum from the preceding trial; item-nonspecific PI is produced by the accumulation of no-longer-relevant items from previous trials. We tested the hypothesis that these two types of PI are mediated by common PFC-based processes with an fMRI study of a delayed-recognition task designed to produce both types of PI. Our results indicated that the fMRI correlates of both effects were restricted both to Brodmann's area 45 in the left hemisphere and to the memory probe epoch of the trial. These results suggest that a unification of the literatures and approaches that have independently studied these phenomena might offer a fruitful new perspective from which to study the relations between working memory, executive control, and the PFC.
