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1.  Peer assessment of journal quality in clinical neurology 
Objective: To explore journal quality as perceived by clinicians and researchers in clinical neurology.
Methods: A survey was conducted from August 2003 to January 2004. Ratings for 41 selected clinical neurology journals were obtained from 254 members of the World Federation of Neurology (1,500 solicited; response rate 17%). Participants provided demographic information and rated each journal on a 5-point Likert scale. Average ratings for all journals were compared with the ISI's journal impact factors. Ratings for each journal were also compared across geographic regions and respondent publication productivity.
Results: The top 5 journals were rated much more highly than the others, with mean ratings greater than 4. Mean journal ratings were highly correlated with journal impact factors (r = 0.67). Most of the top 10 journal ratings were consistent across the subgroups of geographic regions and journal paper productivity. However, significant differences among the different geographical regions and respondent productivity groups were also found for a few journals.
Conclusions: The results provide valuable insight on how neurological experts perceive journals in clinical neurology. These results will likely aid researchers and clinicians in identifying potentially desirable research outlets and indicate journal status for editors. Likewise, biomedical librarians may use these results for serials collection development.
PMCID: PMC1773051  PMID: 17252069
2.  Guillain-Barré syndrome variants in Emilia-Romagna, Italy, 1992-3: incidence, clinical features, and prognosis 
OBJECTIVES—To estimate the incidence rate of Guillain-Barré syndrome variants in an unselected population and to describe their clinical features and prognosis.
METHODS—A two year prospective multicentre study on the incidence and prognosis of Guillain-Barré syndrome was performed in Emilia-Romagna, northern Italy (3 909 512 inhabitants). A surveillance system was instituted within the study area, which comprised all the neurological departments, private and public general hospitals, and practising neurologists. The international classification of diseases (ICD) codes 357.XX (any peripheral neuropathy) of hospital discharges were also reviewed.
RESULTS—Data were separately analysed for Miller Fisher syndrome and other Guillain-Barré syndrome variants. During the study period 18 patients with Guillain-Barré syndrome variants including seven with Miller Fisher syndrome were recruited; the incidence rates were 0.14/100 000/year (95% confidence interval (95% CI) 0.07-0.25) for Guillain-Barré syndrome variants (excluding Miller Fisher syndrome) and 0.09/100 000/year (95% CI 0.04-0.18) for Miller Fisher syndrome. Guillain-Barré syndrome variants alone (excluding Miller Fisher syndrome) accounted for 10.5% of total cases. Death and relapses were not found. Details of clinical, electrophysiological, and CSF findings of Guillain-Barré syndrome variants are provided.
CONCLUSIONS—Guillain-Barré syndrome variants other than Miller Fisher syndrome, as obtained through a population based study, account for about 10% of total cases of Guillain-Barré syndrome and, as a whole, have a good prognosis. Their clinical features are heterogeneous; bifacial weakness (associated with other signs, mainly sensory disturbances) represents the most frequent finding.


PMCID: PMC2170214  PMID: 9703176
3.  Publication trends of neurology articles in a biomedical journal from India 
Background:
The details about the research productivity in the neurology specialty from India is lacking. We analyzed the publishing trends and the research productivity of neurology-related articles in the Journal of the Association of Physicians of India (JAPI).
Materials and Methods:
We carried the bibliometric analysis of articles related to neurology specialty from JAPI published between 2000 and 2011. Data were derived from the journal's website and the articles were analyzed for type (original article, case reports, etc.), disease (infection, vascular, etc.), place, and timelines for publication.
Results:
Out of total 2977 articles published, 256 articles belong to neurology. Neurology contributed to 7--20% of the published articles per year in JAPI. Case reports (52%) constitute the majority type of articles followed by Original Articles (20%), Correspondence and Images (15% each). Infections (27%), structural disorders (19%), cerebrovascular and peripheral nervous system disorders (16% each) contribute the majority of research articles in Neurology. Mumbai (15%), Delhi (13%), and Chennai (9%) are the top three contributors followed by Lucknow and Varanasi. All types of articles took about 9--10 months for acceptance and another 4--5 months for publication. Letters to the Editor were published faster when compared to other articles (P=0.0035).
Conclusion:
Neurology specialty contributes an average 14% of articles per annum in JAPI. Infections, vascular, structural, and peripheral nervous system disorders together account for 80% of published literature with a small representation from other diseases. Mumbai and Delhi are the leading contributors toward research productivity in neurology.
doi:10.4103/0972-2327.99695
PMCID: PMC3424791  PMID: 22919186
Biomedical journals; India; neurology; publication trends; research productivity
4.  Time Lapses in Information Dissemination: Research Laboratory to Physician's Office 
To illustrate the extent of time lags from manuscript submission to journal publication certain “core” journals in neurology and general medicine have been surveyed. The clinical journals experience less time lag, but more of a problem with backlogs of manuscripts, than basic research journals. Most editors of the journals surveyed cited the following as the major causes for publication delay: failure of authors to follow journal requirements, slowness of editorial and referee reviews, and author revisions.
After reviewing the results of the journal survey and articles concerning information dissemination, it seems that the role of the journal is changing. Publication speed in a journal is not of vital importance to members within an “invisible college” but is important to those conducting research in fields outside of their “invisible college” contacts. Distinctions will have to be made between the archival function and the rapid dissemination function if efficient and effective modes of information dissemination are to be developed.
PMCID: PMC198791  PMID: 4466502
5.  Italian neurology: past, present and future  
Functional Neurology  2011;26(2): 73 - 76 .
Summary
This short history of the Italian Society of Neurology focuses on its founders and leading personalities. The article also considers the present and the future of Italian neurology, emphasising in particular the scientific impact of Italian neurological research on the main international journals and the activities undertaken to increase the role of neurologists.
PMCID: PMC3814448  PMID: 21729588
history of Italian neurology ;  Italian Society of Neurology ;  future of neurology
6.  Norah Schuster student presentations 
PMCID: PMC1294233
George James Guthrie; military surgeon; history of hay fever; women pioneers in medicine; development of neurological examination; the journal Brain
7.  Trends in American Board of Psychiatry and Neurology specialties and neurologic subspecialties 
Neurology  2010;75(12):1110-1117.
Objective: To review the current status and recent trends in the American Board of Psychiatry and Neurology (ABPN) specialties and neurologic subspecialties and discuss the implications of those trends for subspecialty viability.
Methods: Data on numbers of residency and fellowship programs and graduates and ABPN certification candidates and diplomates were drawn from several sources, including ABPN records, Web sites of the Accreditation Council for Graduate Medical Education and the American Medical Association, and the annual medical education issues of the Journal of the American Medical Association.
Results: About four-fifths of neurology graduates pursue fellowship training. While most recent neurology and child neurology graduates attempt to become certified by the ABPN, many clinical neurophysiologists elect not to do so. There appears to have been little interest in establishing fellowships in neurodevelopmental disabilities. The pass rate for fellowship graduates is equivalent to that for the “grandfathers” in clinical neurophysiology. Lower percentages of clinical neurophysiologists than specialists participate in maintenance of certification, and maintenance of certification pass rates are high.
Conclusion: The initial enthusiastic interest in training and certification in some of the ABPN neurologic subspecialties appears to have slowed, and the long-term viability of those subspecialties will depend upon the answers to a number of complicated social, economic, and political questions in the new health care era.
doi:10.1212/WNL.0b013e3181f39a41
PMCID: PMC3463033  PMID: 20855855
ABMS = American Board of Medical Specialties; ABPN = American Board of Psychiatry and Neurology; ACGME = Accreditation Council for Graduate Medical Education; MOC = maintenance of certification; RRC-N = Residency Review Committee in Neurology.
8.  Cerebral Near-Infrared Spectroscopy (NIRS) Monitoring and Neurologic Outcomes in Adult Cardiac Surgery Patients and Neurologic Outcomes: A Systematic Review 
Anesthesia and analgesia  2012;116(3):10.1213/ANE.0b013e318277a255.
Background
Near-infrared spectroscopy is used during cardiac surgery to monitor the adequacy of cerebral perfusion. In this systematic review, we evaluated available data for adult patients to determine (1) whether decrements in cerebral oximetry during cardiac surgery are associated with stroke, postoperative cognitive dysfunction (POCD), or delirium and (2) whether interventions aimed at correcting cerebral oximetry decrements improve neurologic outcomes.
Methods
We searched PubMed, Cochrane, and Embase databases from inception until January 31, 2012, without restriction on languages. Each article was examined for additional references. A publication was excluded if it did not include original data (e.g., review, commentary) or if it was not published as a full-length article in a peer-reviewed journal (e.g., abstract only). The identified abstracts were screened first, and full texts of eligible papers were reviewed independently by two investigators. For eligible publications, we recorded the number of subjects, type of surgery, and criteria for diagnosis of neurologic endpoints.
Results
We identified 13 case reports, 27 observational studies, and two prospectively randomized intervention trials that met our inclusion criteria. Case reports and two observational studies contained anecdotal evidence suggesting that regional cerebral O2 saturation (rScO2) monitoring could be used to identify cardiopulmonary bypass (CPB) cannula malposition. Six of nine observational studies reported an association between acute rScO2 desaturation and POCD based on the Mini-Mental Status Examination (n=3 studies) or more detailed cognitive testing (n=6 studies). Two retrospective studies reported a relationship between rScO2 desaturation and stroke or type I and II neurologic injury after surgery. The observational studies had many limitations, including small sample size, assessments only during the immediate postoperative period, and failure to perform risk adjustments. Two randomized studies evaluated the efficacy of interventions for treating rScO2 desaturation during surgery, but adherence to the protocol was poor in one. In the other study, interventions for rScO2 desaturation were associated with less major organ injury and shorter intensive care unit hospitalization compared with nonintervention.
Conclusions
Reductions in rScO2 during cardiac surgery may identify CPB cannula malposition, particularly during aortic surgery. Only low-level evidence links low rScO2 during cardiac surgery to postoperative neurologic complications, and data are insufficient to conclude that interventions to improve rScO2 desaturation prevent stroke or POCD.
doi:10.1213/ANE.0b013e318277a255
PMCID: PMC3863709  PMID: 23267000
9.  The Neurological Information Network of the National Institute of Neurological Diseases and Blindness * 
The National Institute of Neurological Diseases and Blindness (NINDB) has the responsibility of trying to alleviate the morbid and mortal effects of all the diseases of the nervous system and the special senses including speech, hearing, and vision. The information problem facing the NINDB is only a fraction of the total information problem of the biomedical community, but it is probably representative. The NINDB information audience has a core of about 19,000 persons, 10 percent of whom are nonclinical research scientists; 10 percent of whom are engaged in patient care, teaching, and some research; 12 percent in training (post doctoral); and 68 percent chiefly involved in the care of patients. In addition, there is an unknown number of other interested scientists. Fifty to eighty thousand journal articles, an unknown number of technical reports, and other items produced each year are potentially valuable to this group. The exact needs of each subgroup must be identified and ways developed to deliver the required information quickly, accurately, and in an easily useable form. NINDB has undertaken a large information program as a service to the biomedical community to help cope with these information problems. This program is to serve the needs of the practicing physician, the research scientist, and NINDB program analysis and planning. The Neurological Information Network is the core effort of the program.
The Neurological Information Network envisions large units incorporating both information storage and retrieval and information analysis. These will be in universities with strong biomedical libraries where there are ongoing research programs in some area relevant to NINDB responsibilities. These units are to be integrated and will interact with each other and with the National Library of Medicine to avoid duplication of work. In addition to their own information analysis activities, the major documentation centers will be able to support information analysis satellites at other research centers where specific categorical research programs are underway.
PMCID: PMC199045  PMID: 6041825
10.  Three Twentieth-Century Multiauthored Neurological Handbooks – A Historical Analysis and Bibliometric Comparison 
The emergence of neurology as a separate specialty from internal medicine and psychiatry took several decades, starting at the end of the nineteenth century. This can be adequately reconstructed by focusing on the establishment of specialized journals, societies, university chairs, the invention and application of specific instruments, medical practices, and certainly also the publication of pivotal textbooks in the field. Particularly around 1900, the German-speaking countries played an integral role in this process. In this article, one aspect is extensively explored, notably the publication (in the twentieth century) of three comprehensive and influential multivolume and multiauthor handbooks entirely devoted to neurology. All available volumes of Max Lewandowsky's Handbuch der Neurologie (1910–1914) and the Handbuch der Neurologie (1935–1937) of Oswald Bumke and Otfrid Foerster were analyzed. The handbooks were then compared with Pierre Vinken's and George Bruyn's Handbook of Clinical Neurology (1968–2002).
Over the span of nearly a century these publications became ever more comprehensive and developed into a global, encompassing project as is reflected in the increasing number of foreign authors. Whereas the first two handbooks were published mainly in German, “Vinken & Bruyn” was eventually published entirely in English, indicating the general changes in the scientific language of neurology after World War II. Distinctions include the uniformity of the series, manner of editorial involvement, thematic comprehensiveness, inclusion of volume editors in “Vinken & Bruyn,” and the provision of index volumes. The increasing use of authorities in various neurological subspecialties is an important factor by which these handbooks contrast with many compact neurological textbooks that were available at the time.
For historiographical purposes, the three neurological handbooks considered here were important sources for the general study of the history of medicine and science and the history of neurology in particular. Moreover, they served as important catalyzers of the emergence of neurology as a new clinical specialty during the first decades of the twentieth century.
doi:10.1080/0964704X.2013.774246
PMCID: PMC3933202  PMID: 24083680
German and Dutch handbooks; clinical neurology; history of medicine; history of neurology; bibliometric analysis; specialization in medicine
11.  Reference for the 2011 revision of the international standards for neurological classification of spinal cord injury 
The latest revision of the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) was available in booklet format in June 2011, and is published in this issue of the Journal of Spinal Cord Medicine. The ISNCSCI were initially developed in 1982 to provide guidelines for the consistent classification of the neurological level and extent of the injury to achieve reliable data for clinical care and research studies. This revision was generated from the Standards Committee of the American Spinal Injury Association in collaboration with the International Spinal Cord Society's Education Committee. This article details and explains the updates and serves as a reference for these revisions and clarifications.
doi:10.1179/107902611X13186000420242
PMCID: PMC3232637  PMID: 22330109
Physical examination; Neurological; Motor; Sensory; Classification; Spinal cord injuries; Manual muscle testing; International standards for the neurological classification of spinal cord injury; ASIA impairment scale; Revisions; American spinal injury association; International spinal cord society
12.  A new age of peer reviewed scientific journals 
The principles of peer reviewed scientific publications date back two and one-half centuries to the origins of Medical Essays and Observations published by the Royal Society of Edinburgh (1731). This year (2012) is notable in that perhaps the most prestigious and best-known medical journal, the New England Journal of Medicine, crossed the second century mark. The methodologies of peer review have undeniably served medicine well and helped to usher in unimaginable advances in human health. Despite such illustrious history, the winds of change are in the air.
doi:10.4103/2152-7806.103889
PMCID: PMC3515965  PMID: 23230526
Crowd sourcing; medical journals; peer review; scientific journals
13.  A KnowledgeBase Built from a Weekly Journal Conference 
This paper describes a departmental database created on an ongoing basis by the output of a regular educational activity: the weekly Current Literature Review Conference or Journal Club. Four core neurology journals are reviewed monthly by a team of an attending and a resident. Neurology papers appearing in widely-read medical journals are read bimonthly. A handout containing a summary of each article published in the journal to be reviewed is distributed at the time of the conference and facilitates discussion. After 11 months of use, the database (2.4 megabytes in size) contains 1,327 articles. Information on the articles in the database can be obtained by text search or by specifying a numeric range in the appropriate fields. It is used by the residents and faculty for patient care and to prepare conferences and papers.
PMCID: PMC2245321
16.  What is the purpose of launching the World Journal of Nephrology? 
The launch of the World Journal of Nephrology (WJN) has distinct purposes. Its main purpose is to incorporate the fields of diabetes, hypertension, urology, cardiology and neurology, which are related to kidney disease, and to make all of our readers, contributors and allied health professionals feel at home with the WJN. The WJN aims to rapidly report new theories, methods and techniques for prevention, diagnosis, treatment, rehabilitation and nursing skill in the field of nephrology. The WJN will cover diagnostic imaging, disorders of kidney development, renal obstruction, atrophy and regeneration, kidney tumors, renal pharmacology and therapy, renal replacement therapies including transplantation, and Chinese herbal medicine. The WJN issues will include an editorial, frontier, invited review of articles and commentaries in addition to original articles submitted. The WJN will solicit articles from investigators in areas of diabetes and hypertension, and high priority will be given to those articles with an emphasis on the prevention of dialysis. Final decision for publication will be based on the merit of the article, language and lucidity.
doi:10.5527/wjn.v1.i1.1
PMCID: PMC3782211  PMID: 24175235
Nephrology; Biomedical sciences; Peer-reviewed; Open-access; Journal
17.  High reprint orders in medical journals and pharmaceutical industry funding: case-control study 
Objectives To assess the extent to which funding and study design are associated with high reprint orders.
Design Case-control study.
Setting Top articles by size of reprint orders in seven journals, 2002-09.
Participants Lancet, Lancet Neurology, Lancet Oncology (Lancet Group), BMJ, Gut, Heart, and Journal of Neurology, Neurosurgery & Psychiatry (BMJ Group) matched to contemporaneous articles not in the list of high reprint orders.
Main outcome measures Funding and design of randomised controlled trials or other study designs.
Results Median reprint orders for the seven journals ranged from 3000 to 126 350. Papers with high reprint orders were more likely to be funded by the pharmaceutical industry than were control papers (industry funding versus other or none: odds ratio 8.64, 95% confidence interval 5.09 to 14.68, and mixed funding versus other or none: 3.72, 2.43 to 5.70).
Conclusions Funding by the pharmaceutical industry is associated with high numbers of reprint orders.
doi:10.1136/bmj.e4212
PMCID: PMC3386142  PMID: 22745328
18.  Using text mining to link journal articles to neuroanatomical databases 
The Journal of comparative neurology  2012;520(8):10.1002/cne.23012.
The electronic linking of neuroscience information, including data embedded in the primary literature, would permit powerful queries and analyses driven by structured databases. This task would be facilitated by automated procedures which can identify biological concepts in journals. Here we apply an approach for automatically mapping formal identifiers of neuroanatomical regions to text found in journal abstracts, and apply it to a large body of abstracts from the Journal of Comparative Neurology (JCN). The analyses yield over one hundred thousand brain region mentions which we map to 8,225 brain region concepts in multiple organisms. Based on the analysis of a manually annotated corpus, we estimate mentions are mapped at 95% precision and 63% recall. Our results provide insights into the patterns of publication on brain regions and species of study in the Journal, but also point to important challenges in the standardization of neuroanatomical nomenclatures. We find that many terms in the formal terminologies never appear in a JCN abstract, while conversely, many terms authors use are not reflected in the terminologies. To improve the terminologies we deposited 136 unrecognized brain regions into the Neuroscience Lexicon (NeuroLex). The training data, terminologies, normalizations, evaluations and annotated journal abstracts are freely available at http://www.chibi.ubc.ca/WhiteText/.
doi:10.1002/cne.23012
PMCID: PMC3812935  PMID: 22120205
neuroinformatics; brain mapping; homology; brain reference system; brain atlases
19.  Welcome to the Journal of Neuroinflammation! 
Welcome to the Journal of Neuroinflammation, an open-access, peer-reviewed, online journal that focuses on innate immunological responses of the central nervous system, involving microglia, astrocytes, cytokines, chemokines, and related molecular processes. 'Neuroinflammation' is an encapsulization of the idea that microglial and astrocytic responses and actions in the central nervous system have a fundamentally inflammation-like character, and that these responses are central to the pathogenesis and progression of a wide variety of neurological disorders. This concept has its roots in the discoveries of inflammatory cytokines and proteins in the plaques of Alzheimer disease, and these ideas have been extended to other neurodegenerative diseases, to ischemic/toxic diseases, to tumor biology and even to normal brain development. The Journal of Neuroinflammation, published by BioMed Central, will bring together work focusing on microglia, astrocytes, cytokines, chemokines, and related molecular processes in the central nervous system. All articles published in the Journal of Neuroinflammation will be immediately listed in PubMed, and access to published articles will be universal and free through the internet.
doi:10.1186/1742-2094-1-1
PMCID: PMC483051  PMID: 15285806
20.  The scatter of research: cross sectional comparison of randomised trials and systematic reviews across specialties 
Objective To estimate the degree of scatter of reports of randomised trials and systematic reviews, and how the scatter differs among medical specialties and subspecialties.
Design Cross sectional analysis.
Data source PubMed for all disease relevant randomised trials and systematic reviews published in 2009.
Study selection Randomised trials and systematic reviews of the nine diseases or disorders with the highest burden of disease, and the broader category of disease to which each belonged.
Results The scatter across journals varied considerably among specialties and subspecialties: otolaryngology had the least scatter (363 trials across 167 journals) and neurology the most (2770 trials across 896 journals). In only three subspecialties (lung cancer, chronic obstructive pulmonary disease, hearing loss) were 10 or fewer journals needed to locate 50% of trials. The scatter was less for systematic reviews: hearing loss had the least scatter (10 reviews across nine journals) and cancer the most (670 reviews across 279 journals). For some specialties and subspecialties the papers were concentrated in specialty journals; whereas for others, few of the top 10 journals were a specialty journal for that area. Generally, little overlap occurred between the top 10 journals publishing trials and those publishing systematic reviews. The number of journals required to find all trials or reviews was highly correlated (r=0.97) with the number of papers for each specialty/subspecialty.
Conclusions Publication rates of speciality relevant trials vary widely, from one to seven trials per day, and are scattered across hundreds of general and specialty journals. Although systematic reviews reduce the extent of scatter, they are still widely scattered and mostly in different journals to those of randomised trials. Personal subscriptions to journals, which are insufficient for keeping up to date with knowledge, need to be supplemented by other methods such as journal scanning services or systems that cover sufficient journals and filter articles for quality and relevance. Few current systems seem adequate.
doi:10.1136/bmj.e3223
PMCID: PMC3354729  PMID: 22597353
21.  Validity of a Screening Instrument for Neurologic Disability in Resource-Poor African Communities 
Background
There have been no recent population-based studies on all-cause adult neurological morbidity in Sub Saharan Africa. We have developed a screening survey to improve the feasibility in performing these studies.
Methods
Our screening instrument contains both history questions and examination items. We pilot tested this instrument in the Hai District, Tanzania, and Butajira, Ethiopia using trained individuals from the local communities. To measure sensitivity, we applied the instrument blindly to 25 previously-identified subjects with Parkinson’s disease, stroke or epilepsy. To measure specificity, we examined 42 randomly selected previously screened subjects. We also compared the validity of the entire instrument to the history-only section.
Results
There were 669 adult subjects screened in both communities (150 screen-positives, and 519 screen-negatives). The sensitivity of the instrument was 100% (95% CI 84.2–100%) and the specificity was 82.4 % (95% CI 66.1–92.0%). However, when restricting the instrument to the history-only section, the sensitivity remained unchanged, but the specificity became 91.2% (95% CI 76.3–97.7%; p=0.48).
Conclusions
We have created a valid tool to screen adults for neurologic morbidity in resource-poor communities. The use of the history-only section of the tool is adequate as a screen and will improve feasibility.
doi:10.1016/j.jns.2012.06.007
PMCID: PMC3414652  PMID: 22795389
neurology; prevalence; neurologic disability; neurologic impairment; resource-poor settings; Africa; community-based; population based; sensitivity; specificity
22.  Occupational Therapy in Neurological Disorders: Looking Ahead to the American Occupational Therapy Association’s Centennial Vision 
The Centennial Vision articulated by the American Occupational Therapy Association includes moving the profession to being science driven and evidence based. The American Journal of Occupational Therapy contributes to this vision by publishing high-quality research. I reviewed research in the practice area of neurological rehabilitation published between May 2010 and October 2011. In particular, I reviewed effectiveness and efficacy studies, instrument development and testing, and basic research studies. Concerns emerging from the review were (1) few studies in neurological rehabilitation; (2) many disorders not represented; (3) exclusive use of impairment-level outcomes in some studies; and (4) high preponderance of case series designs in effectiveness studies. To achieve the Centennial Vision, the field needs to improve the volume and diversity of research in neurological rehabilitation. It is also important to modify academic and clinical practice to enable occupational therapists to spend more time in producing high-quality evidence to support the crucial role they play in neurological rehabilitation.
doi:10.5014/ajot.2012.005280
PMCID: PMC3665413  PMID: 23106997
diagnostic techniques, neurological; nervous system diseases; occupational therapy; research; treatment outcome
23.  Neurological soft signs in schizophrenia – The past, the present and the future 
Indian Journal of Psychiatry  2012;54(1):73-80.
Clinical neurological abnormalities in patients with schizophrenia have been generally called “Neurological Soft Signs” (NSS). Studies have consistently shown increased NSS in patients with schizophrenia as compared to healthy persons. Early studies were limited by possible confounds of prior neuroleptic medications and illness chronicity. Studies in first episode never treated schizophrenia patients have addressed these confounds. The clinical significance of these findings and the correlation with cognitive dysmetria is the focus of the current review. Relevant literature was obtained using PUBMED and MEDLINE search (1980–2008) and a direct search of reference list of pertinent journal articles. In a 2003 study, neuroleptic-naive schizophrenia patients had significantly more NSS than controls. Patients who were more neurologically impaired had more negative symptoms. Higher NSS scores in treatment-naive schizophrenia patients and the absence of correlation between NSS and illness duration lends support to a neurodevelopmental pathogenesis for schizophrenia. The finding of incoordination and cerebellar signs in most studies also supports the “cognitive dysmetria” explanatory model for schizophrenia. A significant subgroup of patients with schizophrenia may have more neuropathological abnormalities, which predisposes them for a more severe and chronic course of illness. These patients may potentially be identified by clinical neurological examination, which might be very important for prognostication and evolving better methods of treatment for these patients. NSS, by themselves or as a composite index with other neurobiological parameters, hold potential as a candidate endophenotype for schizophrenia.
doi:10.4103/0019-5545.94653
PMCID: PMC3339227  PMID: 22556444
Cognitive dysmetria; endophenotype; neurological soft signs; schizophrenia
24.  Progress in Pediatrics in 2012: choices in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses 
In this review, we summarize the progresses in allergy, endocrinology, gastroenterology, hematology, infectious diseases, neurology, nutrition and respiratory tract illnesses that have been published in The Italian Journal of Pediatrics in 2012. The induction of Treg activity by probiotics might be effective for promoting tolerance towards food allergens. Nasal cytology is useful in patients with rhinitis for diagnosing chronic non-allergic non-infectious diseases. Atopic eczema is associated both with an aberrant skin matrix and impaired systemic immune response. Therefore, isolated topical treatment may have suboptimal effect. Diagnostic work-up of exercise-induced anaphylaxis, including exercise challenge test, is necessary to reach a diagnosis. Studies may support a role for nutrition on prevention of asthma and cardiovascular diseases. Clinicians need to early identify adolescent menstrual abnormalities to minimize sequelae, and to promote health information. In Multiple Endocrine Neoplasia type 2B investigations include acetylcholinesterase study of rectal mucosa followed by the molecular analysis of RET mutation. Low adherence to gluten-free diet and osteopenia are common problems in children with diabetes mellitus type 1 and celiac disease. In infantile colic, laboratory tests are usually unnecessary and the treatment is based on reassurance. Prevalence of obesity and stunting is elucidated by several studies. Evidences are growing that dietetic measures are needed to prevent obesity in children with acute leukemia. Treatment studies for infectious diseases show promise for probiotics along with standard triple therapy in children with Helicobacter pilori infection, while zinc has no effect on pneumonia. Educational programs about the proper management of the febrile child are warranted. A new hour-specific total serum bilirubin nomogram has been shown to be able to predict newborns without hyperbilirubinemia after 48 to 72 hours of life. Newborns with hypoxic-ischemic encephalopathy present ECG and cardiac enzymes alterations leading to reduced neonatal survival. Rehabilitation programs including sensory integration therapy and motor performance, may improve activities of daily life in children with developmental coordination disorder. Aerobic exercise training in addition to chest physiotherapy might be useful in children with cystic fibrosis. Studies on effectiveness of leukotriene receptor antagonists, alone or with other drugs in preschool wheezing are needed.
doi:10.1186/1824-7288-39-26
PMCID: PMC3660281  PMID: 23651601
Allergy; Endocrinology; Gastroenterology; Hematology; Infectious diseases; Neurology; Nutrition; Respiratory tract illnesses
25.  Occupational Neurological Disorders in Korea 
Journal of Korean Medical Science  2010;25(Suppl):S26-S35.
The purpose of this article was to provide a literature review of occupational neurological disorders and related research in Korea, focusing on chemical hazards. We reviewed occupational neurological disorders investigated by the Occupational Safety and Health Research Institute of Korean Occupational Safety and Health Agency between 1992 and 2009, categorizing them as neurological disorders of the central nervous system (CNS), of the peripheral nervous system (PNS) or as neurodegenerative disorders. We also examined peer-reviewed journal articles related to neurotoxicology, published from 1984 to 2009. Outbreaks of occupational neurological disorder of the CNS due to inorganic mercury and carbon disulfide poisoning had helped prompt the development of the occupational safety and health system of Korea. Other major neurological disorders of the CNS included methyl bromide intoxication and chronic toxic encephalopathy. Most of the PNS disorders were n-hexane-induced peripheral neuritis, reported from the electronics industry. Reports of manganese-induced Parkinsonism resulted in the introduction of neuroimaging techniques to occupational medicine. Since the late 1990s, the direction of research has been moving toward degenerative disorder and early effect of neurotoxicity. To understand the early effects of neurotoxic chemicals in the preclinical stage, more follow-up studies of a longer duration are necessary.
doi:10.3346/jkms.2010.25.S.S26
PMCID: PMC3023358  PMID: 21258587
Neurotoxic Chemicals; Korea; Carbon Disulfide; Manganese; n-Hexane; CNS; PNS; Neurodegenerative Disorders

Results 1-25 (56758)