The common neurodegenerative diseases are mostly idiopathic disturbances of unclear pathogenesis. Most common diseases are possibly expected to be induced from a complex interaction among multiple predisposing genes and other factors. In this concern, genetic mapping and gene-isolation created by the Human Genome Project helped in investigation of genes involved in the inherited forms of Alzheimers disease (AD) and Parkinsons Disease (PD). The aggregates of Aß42 and a-synuclein which are neurotoxic in both diseases, may explain the pathogenesis not only of the inherited forms of these diseases but also of the idiopathic variety. Such hypothesis on the cause and pathogenesis help to identify new treatment targets for these debilitating disorders. PD begins between ages 50 and 65, before onset of AD, with a few cases starting before the age of 40. With a prevalence of around 3 cases per 1,000 people, PD is less common than AD but still an important cause of neurological disorder among people .

Objective: Evolving pressure on surgical education necessitates safe and efficient learning of techniques. We evaluated the effect of training year using anatomic, percutaneous fluoroscopy guided and computer navigated techniques on the accuracy of pedicle screw placement to attempt to determine if different modalities may be better suited for different levels of training. Methods: All instrumented thoracic and lumbar cases performed at Detroit Medical Center by the Neurosurgery Service between August 2012 and June 2013 were included.Cases had hardware verified by post-operative CT. Hardware placement was graded according to Mirza SK et al., grade 0 (within pedicle), grade 1 (< 2 mm breach), grade 2 (> 2 mm breach) , and grade 3 (extrapedicular). Pedicle screws were reviewed independently by a resident and attending surgeon. Rates of pedicle breach, EBL, length of case, pedicle size and pedicle starting point were all reviewed. Pedicles were analyzed on PACS system in axial views, using sagittal views to identify the correct level. Results: A total of 306 pedicle screws were evaluated in 36 patients. The overall rate of accurate pedicle screw placement among residents defined as Grade 0 or 1 placement was 86.8%.Fluoroscopically placed screws had significantly less breaches than anatomic screws 11% vs 20% (p = 0.03). Fluoroscopic cases had significantly less medial breeches (20%) than anatomic (50%) (p < 0.05) and computer assisted cases (73%) (p < 0.05). EBL values for fluoroscopic, anatomic and Body Tom cases were 425 cc, 720 cc, and 816 cc respectively. Resident level was found to be inversely proportional to breech rate (R squared 0.45). We did not see any clear difference in breach rate for resident level in different modalities. Conclusion: Supervised neurosurgical residents can place pedicle screws within published rates of acceptable breach. Interestingly our study revealed an inverse relationship between resident experience and pedicle screw accuracy. Fluoroscopic placement of pedicle screws compared to computer assisted and anatomic techniques results in lower medial breach rate and may be better suited for junior level residents.

Background: Previous research has shown that women with fear of childbirth often suffer from other mental health issues. Continuity of caregiver through a known midwife is best practice for pregnant women, and women with childbirth related fear value continuity of care. In Sweden the maternity care is fragmented and women’s opinion remains under-investigated. Objective: The aim of this study was to investigate emotional well-being and the importance of having a known midwife during birth in women referred to counselling for childbirth related fear. Design: Cross sectional study Setting: 3 Swedish hospitals providing counseling for childbirth related fear. Participants: Women who were referred for counseling due to fear of childbirth. Measures: The importance of having a known midwife at birth, background factors, emotional well-being and attitudes. Results: 77 women referred to counseling consented to participate. The majority of women were likely to present with previous or ongoing emotional distress, high levels of anxiety or depressive symptoms, low Sense of Coherence and Major worries. For the majority of women (71%) it was important to have a known midwife at birth and most important for women with high levels of childbirth fear. Conclusion: This study highlights that women referred to counseling due to fear of childbirth might need additional support to cope with their emotional distress. The results also indicated that having a known midwife at birth was important to these women, especially for women with higher fear. The option of having a known midwife during birth is rarely accomplished in Sweden due to the fragmentation of care.

We are naturally stupid. That is, we can be stupid just by being ourselves. In fact, this article is based on two fundamental contentions: we cannot really understand ourselves without understanding stupidity, and if we understand stupidity, we will understand our-selves. Although the focus of this work is on stupidity, it is really a study of how the human mind functions. Sometimes it is "Intelligent"; more often it is "Stupid", but most of the time, it, like daily life, just plugs along unobtrusively in a manner unnamed because it is so common as never to have been named anything at all. Regardless of the labels used, our characteristic interactions with the environment are all directed by the same basic mental process by which our linguistic schemas shape perception via the n-dox into posfed cognitions, beliefs and behavior.

It is increasingly difficult to define what an anxiolytic is, since anxiety is multiple although many symptoms are common. On the other hand the most used drugs in different forms of anxiety were first used as antidepressants. This article tries to put together the different effective anxiolytics used and describe their pharmacology.