Double Concussions and Cognitive Dysfunction: A Population Study of Young Men

2012 ◽  
Vol 13 (2) ◽  
pp. 197-202 ◽  
Author(s):  
Thomas W. Teasdale ◽  
Aase W. Engberg ◽  
Linda G. Holte
Keyword(s):  
Risk Factor ◽  
Cognitive Dysfunction ◽  
Odds Ratio ◽  
Early Adulthood ◽  
Age Groups ◽  
Young Men ◽  
Cognitive Testing ◽  
Cognitive Screening ◽  
Comparable Sample

Aims: To determine whether double concussions can result in longer-lasting cognitive dysfunctioning than a single concussion and/or whether cognitive dysfunction is a greater risk factor for double concussions than for a single concussion.Method: Through a national hospitalisation database, 2753 men were found who, at ages between infancy and early adulthood, had, on two separate occasions, been briefly hospitalised after a concussion. This cohort was compared with a previously obtained and comparable sample of men who had suffered a single concussion. From Draft Board records a dichotomised index was obtained indicating whether or not they had performed at or above a cut-off total score on a cognitive screening test involving four timed subtests, below cut-off being considered as dysfunctional.Findings: For all age groups, double concussions were associated with higher rates of cognitive dysfunction than single concussions. This was especially true where the concussion(s) had occurred after cognitive testing [odds ratio = 2.53, 95% confidence interval (CI) = 1.92–3.36]. Where double concussions had occurred before cognitive testing but after age 12, cognitive dysfunction was more prevalent when the interval between concussions was less than 1 month than at longer intervals (odds ratio = 3.91, 95%CI = 1.14–13.34). It is concluded that cognitive dysfunction in young men is a risk factor for repeat concussions; at the same time cognitive dysfunction can also be a long-term consequence of two concussions occurring in close temporal proximity.

scholarly journals Labor Dystocia and Risk of Histological Chorioamnionitis and Funisitis: A Study from a Single Tertiary Referral Center

2020 ◽  
Author(s):  
Hyo Kyozuka ◽  
Tuyoshi Murata ◽  
Toma Fukuda ◽  
Shun Yasuda ◽  
Aya Kanno ◽  
...  
Keyword(s):  
Risk Factor ◽  
Preterm Birth ◽  
Confidence Interval ◽  
Umbilical Cord ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Neonatal Outcomes ◽  
Spontaneous Preterm Birth ◽  
Labor Dystocia

Abstract Background: Intrauterine inflammation affects short- and long-term neonatal outcomes. Histological chorioamnionitis and funisitis are acute inflammatory responses in the fetal membranes and umbilical cord, respectively. Although labor dystocia includes a potential risk of intrauterine inflammation, the risk of labor dystocia in histological chorioamnionitis and funisitis has not been evaluated yet. This study aimed to examine the association between labor dystocia and risk of histological chorioamnionitis and funisitis.Methods: In this retrospective cohort study, the patients who underwent histopathological examinations of the placenta and umbilical cord at Fukushima Medical University Hospital, Japan, between 2015 and 2020, were included. From the dataset, the pathological findings of the patients with labor dystocia and spontaneous preterm birth were reviewed. Based on the location of leukocytes, the inflammation in the placenta (histological chorioamnionitis) and umbilical cord (funisitis) was graded as 0–3. Multiple logistic regression analysis was performed to evaluate the risk of histological chorioamnionitis, histological chorioamnionitis stage ≥2, funisitis, and funisitis stage ≥2.Result: Of 317 women who met the study criteria, 83 and 144 women had labor dystocia and spontaneous preterm birth, respectively, and 90 women were included as controls. Labor dystocia was a risk factor for histological chorioamnionitis (adjusted odds ratio, 6.3; 95% confidential interval, 1.9-20.5), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 6.0; 95% confidence interval, 1.7-21.8), funisitis (adjusted odds ratio, 9.4; 95% confidence interval, 1.8-48.2), and funisitis stage ≥2 (adjusted odds ratio, 23.5; 95% confidence interval, 2.3-23.8). Spontaneous preterm birth was also a risk factor for histological chorioamnionitis (adjusted odds ratio, 3.7; 95% confidence interval, 1.7-7.8), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 3.0; 95% confidence interval, 1.2-7.9), and funisitis (adjusted odds ratio, 4.5; 95% confidence interval, 1.2-16.8). However, the adjusted odds ratio was smaller in spontaneous preterm births than in labor dystocia. Conclusion: Labor dystocia is a risk factor for severe histological chorioamnionitis and funisitis. Further studies are required to evaluate the effects of histological chorioamnionitis and funisitis on long-term neonatal outcomes.

Preoperative depression is a risk factor for postoperative short-term and long-term cognitive dysfunction in patients with diabetes mellitus

2010 ◽  
Vol 25 (1) ◽  
pp. 10-17 ◽  
Author(s):  
Yuji Kadoi ◽  
Chikara Kawauchi ◽  
Masanobu Ide ◽  
Masataka Kuroda ◽  
Kenichiro Takahashi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Cognitive Dysfunction ◽  
Short Term ◽  
Patients With Diabetes

scholarly journals Labor dystocia and risk of histological chorioamnionitis and funisitis: a study from a single tertiary referral center

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Hyo Kyozuka ◽  
Tuyoshi Murata ◽  
Toma Fukuda ◽  
Erina Suzuki ◽  
Riho Yazawa ◽  
...  
Keyword(s):  
Risk Factor ◽  
Preterm Birth ◽  
Confidence Interval ◽  
Umbilical Cord ◽  
Odds Ratio ◽  
Adjusted Odds Ratio ◽  
Neonatal Outcomes ◽  
Spontaneous Preterm Birth ◽  
Labor Dystocia

Abstract Background Intrauterine inflammation affects short- and long-term neonatal outcomes. Histological chorioamnionitis and funisitis are acute inflammatory responses in the fetal membranes and umbilical cord, respectively. Although labor dystocia includes a potential risk of intrauterine inflammation, the risk of histological chorioamnionitis and funisitis of labor dystocia has not been evaluated yet. This study aimed to examine the association between labor dystocia and risk of histological chorioamnionitis and funisitis. Methods In this retrospective cohort study, the cases who underwent histopathological examinations of the placenta and umbilical cord at Fukushima Medical University Hospital, Japan, between 2015 and 2020, were included. From the dataset, the pathological findings of the patients with labor dystocia and spontaneous preterm birth were reviewed. Based on the location of leukocytes, the inflammation in the placenta (histological chorioamnionitis) and umbilical cord (funisitis) was staged as 0–3. Multiple logistic regression analysis was performed to evaluate the risk of histological chorioamnionitis, histological chorioamnionitis stage ≥2, funisitis, and funisitis stage ≥2. Result Of 317 women who met the study criteria, 83 and 144 women had labor dystocia and spontaneous preterm birth, respectively, and 90 women were included as controls. Labor dystocia was a risk factor for histological chorioamnionitis (adjusted odds ratio, 6.3; 95% confidential interval, 1.9–20.5), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 6.0; 95% confidence interval, 1.7–21.8), funisitis (adjusted odds ratio, 15.4; 95% confidence interval, 2.3–101.3), and funisitis stage ≥2 (adjusted odds ratio, 18.5; 95% confidence interval, 2.5–134.0). Spontaneous preterm birth was also a risk factor for histological chorioamnionitis (adjusted odds ratio, 3.7; 95% confidence interval, 1.7–7.8), histological chorioamnionitis stage ≥2 (adjusted odds ratio, 3.0; 95% confidence interval, 1.2–7.9), and funisitis (adjusted odds ratio, 6.6; 95% confidence interval, 1.4–30.6). However, the adjusted odds ratio was smaller in spontaneous preterm births than in labor dystocia. Conclusion Labor dystocia is a risk factor for severe histological chorioamnionitis and funisitis. Further studies are required to evaluate the effects of histological chorioamnionitis and funisitis on long-term neonatal outcomes.

Abstract WMP5: Endovascular Therapy Stroke Outcome in Very Elderly: Meta-analysis

Stroke ◽  
2016 ◽  
Vol 47 (suppl_1) ◽  
Author(s):  
Michelle P Lin ◽  
David S Liebeskind ◽  
Steven Cen ◽  
William J Mack ◽  
Arun P Amar ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Elderly Patients ◽  
Acute Ischemic Stroke ◽  
Functional Outcome ◽  
Endovascular Therapy ◽  
Odds Ratio ◽  
Age Groups ◽  
Large Vessel ◽  
Very Elderly

Introduction: Very elderly (age ≥80yo) individuals account for about one-third of all stroke admissions with mixed literature demonstrating relative poor stroke outcomes. With overwhelming recent evidence supporting the use of intra-arterial thrombectomy in addition to IV thrombolysis for large-vessel occlusive stroke, we conducted a metaanalysis to assess long-term functional outcome following mechanical thrombectomy in very elderly. Hypothesis: Very elderly patients with acute ischemic stroke treated with thrombectomy have equally favorable long-term functional outcomes to their younger counterparts Methods: Stroke endovascular trials published in New England Journal of Medicine 2014-2015 were included if they reported odds ratio of good functional outcome (improvement in modified Rankin score, mRS) comparing thrombectomy vs IV-tPA dichotomized by age groups (age ≤ 80yo vs >80yo, 2 studies dichotomized age at 70yo). Multivariate adjusted odds ratios and the corresponding standard errors were used for the metaanalysis. Pooled odds ratio estimates across trials were synthesized by using a random-effects model based on Mantel-Haenszel methods. The pooled estimates with 95% confidence interval were compared between elderly and younger age groups. Forest plots constructed. Results: Of the 5 recent intraartrial thrombectomy trials, 4 studies reported subgroup analysis by age with 1,206 participants, 28% (N=334) were above the age of 80yo, 72% (N=872) were ≤80yo. Among very elderly patients undergoing thrombectomy, the pooled odds ratio of good functional outcome at 3 months was 1.91 (1.13-3.24), in the younger group the pooled odds ratio was 1.95 (1.50-2.53). Conclusions: Endovascular therapy was an effective therapy for very elderly individuals presenting with acute ischemic stroke caused by large vessel occlusive disease. Future studies are needed to further assess the safety and effectiveness of thrombectomy in this growing population.

scholarly journals Cognitive Disorders and Neuropsychiatric Sequellae Associated with COVID-19

Doctor Ru ◽  
2021 ◽  
Vol 20 (5) ◽  
pp. 6-12
Author(s):  
E.V. Kostenko ◽  
◽  
M.A. Eneeva ◽  
L.V. Petrova ◽  
I.V. Pogonchenkova ◽  
...  
Keyword(s):  
Age Groups ◽  
Cognitive Disorders ◽  
Medical Rehabilitation ◽  
Cognitive Screening ◽  
Short Term ◽  
Average Value ◽  
Rehabilitation Outcomes ◽  
Rehabilitation Programs ◽  
Key Points

Objective of the Review: To summarise and analyse references published during COVID-19 pandemic regarding possible pathogenic mechanisms of neuropsychiatric and cognitive disorders (CD) in COVID patients, based on their manifestations, changes in severity and course of the disease associated with comorbid CD. Key Points. CDs following an acute COVID-19 period, especially in combination with comorbid cognitive disorders, are often diagnosed in various age groups of patients. Since the risk that mild CDs progress and transform to moderate and severe CDs in these patients is higher than the statistically average value, clinicians should be aware of the significance of early diagnosis of cognitive disorders. In selecting methods for psychological diagnostics and correction, it is advisable to rely of the data and lessons learnt from earlier SARS-CoV and MERS-CoV pandemics. Conclusion. A multi-disciplinary approach to organisation of medical rehabilitation involving physiological and cognitive screening will allow personifying neuropsychologic rehabilitation programs, thus improving both short-term and long-term rehabilitation outcomes. Keywords: cognitive disorders, SARS-CoV-2, COVID-19, medical rehabilitation.

scholarly journals The Long-Term Efficacy and Safety of Carotid Artery Stenting among the Elderly: A Single-Center Study in China

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Lan Wen ◽  
Suxia Wang ◽  
Lei Liu ◽  
Lin Chen ◽  
Jia Geng ◽  
...  
Keyword(s):  
Risk Factor ◽  
Carotid Artery ◽  
Confidence Interval ◽  
Elderly Patients ◽  
Carotid Artery Stenting ◽  
Odds Ratio ◽  
Independent Risk Factor ◽  
Stroke Recurrence ◽  
Disability Score

Compared to carotid endarterectomy, carotid artery stenting (CAS) is reportedly associated with higher perioperative risks in elderly patients. To verify the long-term safety and efficacy of CAS with embolic protection in elderly patients, we retrospectively reviewed the medical records of patients with carotid stenosis treated between January 2003 and March 2010 at the Department of Neurology of a large university hospital in China. We included patients with symptomatic, moderate, or severe carotid stenosis of atherosclerotic etiology (other etiologies were excluded), with a disability score ≤ 3 on the modified Rankin Scale, and who received CAS instead of carotid endarterectomy. The clinical endpoints studied were stroke recurrence and all-cause death. The 84 patients included in this study (median follow-up, 8.08 years) were stratified according to age at surgery (<70 vs. ≥70 years), and no significant between-group difference was found regarding baseline characteristics. Of the 14 patients (16.67%) who experienced a defined clinical endpoint, 4 (7.14%) were aged <70 years and 10 (35.71%) were aged ≥70 years (P=0.002). Overall mortality was 14.29% (12/84), with 3 (5.36%) and 9 (32.14%) deaths among patients aged <70 and ≥ 70 years, respectively (P=0.002). Heart disease and cancer accounted for most deaths. The two groups did not differ regarding stroke recurrence, disability score, or rate of in-stent restenosis (blockage ≥ 50%), but patients aged ≥70 years had a higher risk of mortality (odds ratio, 8.3684; 95% confidence interval, 2.048–34.202; P=0.003), and age was an independent risk factor for death (odds ratio, 20.054; 95% confidence interval, 3.094–129.987, P=0.002). Among elderly patients in Southwest China, CAS can effectively prevent stroke recurrence without increasing the risk of stroke-related death, but the risk of all-cause death is higher, with age as an independent risk factor. Careful patient selection is of key importance in the treatment of symptomatic carotid artery stenosis.

The Impact of Subjective and Objective Hearing Loss on Cognition and Memory in Older Adults

2015 ◽  
Vol 20 (2) ◽  
pp. 49-57 ◽  
Author(s):  
Yvonne Rogalski ◽  
Amy Rominger
Keyword(s):  
Older Adults ◽  
Hearing Loss ◽  
Reading Aloud ◽  
Cognitive Testing ◽  
Professional Collaboration ◽  
Cognitive Screening ◽  
Speech Language Pathologist ◽  
Text Passage ◽  
The Impact ◽  
Audiologic Evaluation

For this exploratory cross-disciplinary study, a speech-language pathologist and an audiologist collaborated to investigate the effects of objective and subjective hearing loss on cognition and memory in 11 older adults without hearing loss (OAs), 6 older adults with unaided hearing loss (HLOAs), and 16 young adults (YAs). All participants received cognitive testing and a complete audiologic evaluation including a subjective questionnaire about perceived hearing difficulty. Memory testing involved listening to or reading aloud a text passage then verbally recalling the information. Key findings revealed that objective hearing loss and subjective hearing loss were correlated and both were associated with a cognitive screening test. Potential clinical implications are discussed and include a need for more cross-professional collaboration in assessing older adults with hearing loss.

The 20210 A Allele of the Prothrombin Gene Is a Common Risk Factor among Swedish Outpatients with Verified Deep Venous Thrombosis

1997 ◽  
Vol 78 (03) ◽  
pp. 0990-0992 ◽  
Author(s):  
Andreas Hillarp ◽  
Bengt Zӧller ◽  
Peter J Svensson ◽  
Bjӧrn Dahlbäck
Keyword(s):  
Risk Factor ◽  
Venous Thrombosis ◽  
Deep Venous Thrombosis ◽  
Odds Ratio ◽  
Untranslated Region ◽  
Control Group ◽  
Common Risk Factor ◽  
Apc Resistance ◽  
Healthy Control ◽  
Prothrombin Gene

SummaryA dimorphism in the 3’-untranslated region of the prothrombin gene (G to A transition at position 20210) has recently been reported to be associated with increases in plasma prothrombin levels and in the risk of venous thrombosis (1). We have examined the prothrombin dimorphism among 99 unselected outpatients with phlebography verified deep venous thrombosis, and in 282 healthy controls. The prevalence of the 20210 A allele was 7.1% (7/99) in the patient group, and 1.8% (5/282) in the healthy control group (p = 0.0095). The relative risk of venous thrombosis was calculated to be 4.2 (95% Cl, 1.3 to 13.6), and was still significant when adjustment was made for age, sex and the factor V:R506Q mutation causing APC resistance [odds ratio 3.8 (95% Cl, 1.1 13.2)]. As previously reported, 28% of the patients were carriers of the factor V:R506Q mutation. Thus, 34% (one patient carried both traits) of unselected patients with deep venous thrombosis were carriers of an inherited prothrombotic disorder. To sum up, our results confirm the 20210 A allele of the prothrombin gene to be an important risk factor for venous thrombosis.

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