Neural functional correlates of emotional processing in patients with first-episode psychoses: an activation likelihood estimation (ALE) meta-analysis.

BACKGROUND: Early emotional recognition impairment characterises rst-episode psychoses (FEP) and remains stable thereafter. Patients with FEP consistently show brain activation changes during emotional processing in functional neuroimaging studies. AIM AND METHODS: To identify and compare cerebral activation correlates of FEP patients and healthy controls (HCs) during emotional task performances, we performed an Activation Likelihood Estimation (ALE) meta-analysis of peer-reviewed functional magnetic resonance imaging (fMRI) studies. RESULTS: Five studies included 71 patients with FEP and 75 HCs. Within-group analyses showed that HCs activated during emotional task performance the bilateral inferior parietal lobule (BAs 39 and 40), left inferior frontal gyrus (BAs 9 and 47), right amygdala, left middle frontal gyrus (BA 9), right cingulate gyrus (BA 32), and right middle temporal gyrus (BA 21). FEP activations correlating with emotional tasks included the right cuneus (BA 17) and right angular gyrus (BA 39). CONCLUSIONS: During emotional task performance, FEP patients fail to activate an extensive brain network comprising emotional processing-related areas, including both cortical and subcortical areas.

Maternal collapse: Challenging the four-minute rule.

INTRODUCTION: The current approach to, cardiopulmonary resuscitation of pregnant women in the third trimester has been to adhere to the "four-minute rule": If pulses have not returned within 4min of the start of resuscitation, perform a cesarean birth so that birth occurs in the next minute. This investigation sought to re-examine the evidence for the four-minute rule. METHODS: A literature review focused on perimortem cesarean birth was performed using the same key words that were used in formulating the "four-minute rule." Maternal and neonatal injury free survival rates as a function of arrest to birth intervals were determined, as well as actual incision to birth intervals. RESULTS: Both maternal and neonatal injury free survival rates diminished steadily as the time interval from maternal arrest to birth increased. There was no evidence for any specific survival threshold at 4min. Skin incision to birth intervals of 1min occurred in only 10% of women. CONCLUSION: Once a decision to deliver is made, care providers should proceed directly to Cesarean birth during maternal cardiac arrest in the third trimester rather than waiting for 4min for restoration of the maternal pulse. Birth within 1min from the start of the incision is uncommon in these circumstances.

Dissenting view. A Brief, Liberal, Catholic Defense of Abortion [by] Daniel A. Dombrowski and Robert Deltete. Book review.

PIP: This paper reviews the book "A Brief, Liberal, Catholic Defense of Abortion", by Daniel A. Dombrowski and Robert Deltete. In this book, the authors argue that the Catholic tradition on abortion is very different from the present teaching of the Catholic Church. The issue of abortion is explored in the book through two different philosophies and two major Catholic theologians. The two philosophies are the perversity of sex (abortion distorts sex) and the ontological (the fetus as a person) philosophies. Saint Augustine primarily identified with the perversity of sex and viewed early and late stages of abortion as evil, because it destroys the conceptus, which is the only justification for sex and because human life is present--after sensation and quickening occur. On the other hand, Saint Thomas Aquinas with the ontological approach was less interested in abortion, rather developed hylomorphism. He stated that there is no human life in the womb until the 5th or 6th month, but rather a cluster of cells; thus God cannot infuse a soul into a small cluster of cells since body and soul belong together. The authors believe that this book is a model of reasoned discourse about abortion issues and is proves to be beneficial to a Catholic as well as any thoughtful person.^ieng

Roe v. Wade. Reflective compassion.

PIP: The US has arrived at the correct legal status for induced abortion by permitting it on constitutional grounds within limits. In addition, the general consensus among American Catholics is in favor of abortion rights while disapproving of abortion and wishing to discourage it. Concerns about the morality of abortion, however, arise out of our uncertainty about the personhood of a fetus before birth or before viability. Early church leaders taught that a fetus did not obtain personhood until it acquired a human form, and the Catholic church did not baptize aborted fetuses without human shape or hold formal funeral services for dead fetuses. While official church teaching is adamant about the immorality of abortion, official church teaching has changed in the past in regard to the salvation of non-Catholics, slavery, inquisitions and torture, ecumenism, worship in the vernacular, and divorce and remarriage. No one is forced to have an abortion in the US because the legal right exists, and Catholics are more likely to heed Church teachings that do not seek legal force and punishment though "infallible" pronouncements and insensitive condemnation of women. If the Catholic church expects compassion for its wrong decisions in the past, then it should extend compassion to women in difficult situations.^ieng

Dosimeter inhalation test with lysine acetylsalicylate for the detection of aspirin-induced asthma.

Inhalation challenge with lysine acetylsalicylate (L-ASA) is often used to diagnose aspirin-induced asthma. The aim of this study was to evaluate the specificity and safety of performing L-ASA inhalation challenge with a dosimeter. Twenty-four subjects entered the study: ten ASA-sensitive asthmatic patients, seven non-ASA-sensitive asthmatic patients, and seven normal control subjects. The investigation was performed on two consecutive days. On day 1 a dosimeter inhalation test with methacholine was performed to establish the provocation dose (PD20). On day 2, patients underwent the L-ASA inhalation test, whereby increasing doses of L-ASA (from 1 to 32 mg cumulative dose) were inhaled using a dosimeter and a dose response curve was constructed. In subjects negative to the top dose, an additional oral dose of 500 mg of aspirin was administered to exclude aspirin sensitivity not revealed with the inhaled drug. The ten ASA-sensitive asthmatic patients developed early reactions within 30 minutes of PD20 administration. Recovery time from induced bronchoconstriction varied from two to three hours to six hours or longer resulting in an "early prolonged reaction." The response was limited to airways. No clear late reactions were observed. There was no correlation between PD20 with methacholine and PD20 with L-ASA. The L-ASA challenge was negative in the seven non-ASA-sensitive asthmatic patients and in the seven normal control subjects. In conclusion the dosimeter method is sensitive, specific, and safe for the detection of aspirin-induced asthma.

Aspirin-induced asthma and bronchial hyperresponsiveness.

The inhalation challenge with lysine-aspirin (L-ASA) using the dosimeter method allows the construction of a dose-response curve and the quantitative estimation of airway responsiveness to the drug. We assessed the modifications of airway responsiveness to methacholine in four groups of subjects: aspirin-sensitive asthmatics, aspirin-sensitive subjects with urticaria/angioedema, subjects with an equivocal history of aspirin intolerance and normal control subjects. The L-ASA challenge was positive in all aspirin-sensitive asthmatics. The pattern of bronchial response to the challenge was different from that observed after challenge with allergens or occupational sensitizers. The main difference was found in the recovery from induced bronchoconstriction. The recovery lasted from 3 to 6-8 hours, and a peculiar dose-response curve was obtained that we call "early prolonged reaction". In five of 18 ASA-sensitive subjects there was a significant increase in airway responsiveness. Airway responsiveness was normal in aspirin-sensitive nonasthmatic subjects and in the other two groups studied. We conclude that L-ASA inhalation challenge may increase bronchial hyperresponsiveness in some ASA-sensitive asthmatics. This presence of enhanced bronchial hyperesponsiveness seems to be a marker with which to distinguish ASA-sensitive asthmatics from ASA-sensitive subjects with urticaria/angioedema.