Procedure-oriented sectional anatomy of the hip

This is the fourth in a series of articles related to procedure-oriented joint anatomy. This article reviews the anatomy of the hip and its relationship to procedures in the clinical setting with or without imaging guidance. Anatomically correct axial and coronal schematics allow injections to be envisioned relative to clinically important anatomy for common hip procedures. Cross-sectional schematics for the hip were drawn as they appear in imaging projections. The levels and planes of cross section were selected to highlight important anatomic landmarks for injection. It is hoped that these schematics allow for safer and more accurate needle procedures in the knee area.

Comparison of SNOMED CT versus Medcin terminology concept coverage for mild Traumatic Brain Injury

BACKGROUND

Traumatic Brain Injury (TBI) is a "signature" injury of the current wars in Iraq and Afghanistan. Structured electronic data regarding TBI findings is important for research, population health and other secondary uses but requires appropriate underlying standard terminologies to ensure interoperability and reuse. Currently the U.S. Department of Veterans Affairs (VA) uses the terminology SNOMED CT and the Department of Defense (DOD) uses Medcin.

METHODS

We developed a comprehensive case definition of mild TBI composed of 68 clinical terms. Using automated and manual techniques, we evaluated how well the mild TBI case definition terms could be represented by SNOMED CT and Medcin, and compared the results. We performed additional analysis stratified by whether the concepts were rated by a TBI expert panel as having High, Medium, or Low importance to the definition of mild TBI.

RESULTS

SNOMED CT sensitivity (recall) was 90% overall for coverage of mild TBI concepts, and Medcin sensitivity was 49%, p < 0.001 (using McNemar's chi square). Positive predictive value (precision) for each was 100%. SNOMED CT outperformed Medcin for concept coverage independent of import rating by our TBI experts.

DISCUSSION

SNOMED CT was significantly better able to represent mild TBI concepts than Medcin. This finding may inform data gathering, management and sharing, and data exchange strategies between the VA and DOD for active duty soldiers and veterans with mild TBI. Since mild TBI is an important condition in the civilian population as well, the current study results may be useful also for the general medical setting.

Diagnosis and treatment of neuropsychiatric disorders

Neuropsychiatry is the subspecialty of psychiatry that deals with disorders at the intersection of neurology and psychiatry. Neuropsychiatric disorders are complex and incompletely understood. Neuroscience research is beginning to elucidate the biological underpinnings of many of these disorders. These advances have the potential to improve diagnosis, inform treatment selection, and facilitate development of new and better interventions.

METHYLPHENIDATE (RITALIN): BEHAVIORAL STUDIES IN THE RAT

Attention Deficit Hyperactivity Disorder (ADHD) is a neuropsychiatric syndrome with an onset in childhood characterized by an inability to remain focused or to concentrate for prolonged periods of time. Children suffering from this disease are many times described as either inattentive or as hyperactive-impulsive depending on what form of the disease they manifest. Methylphenidate is the preferred treatment for this behavioral disorder and is used for long term disease management. Much still remains unknown concerning this stimulant and its effects on behavior and future abuse potential are pertinent questions. Since animal models are used to study the mechanism of drug action and rats are used often in drug studies, the objective of this review is to summarize the research reports that mainly have used rats as the model to investigate the action of methylphenidate. Topics discussed in this review include: (1) What effect does a single dose of methylphenidate have on locomotion activity; (2) Does repeated administration of methylphenidate result in tolerance or sensitization; and (3) Does methylphenidate have rewarding properties as measured by the self-administration and condition placed preference paradigms.