Patients in Australian Memory Clinics: baseline characteristics and predictors of decline at six months

2011 ◽  
Vol 23 (7) ◽  
pp. 1086-1096 ◽  
Author(s):  
Henry Brodaty ◽  
Michael Woodward ◽  
Karyn Boundy ◽  
David Ames ◽  
Robert Balshaw
Keyword(s):  
Late Onset ◽  
Marked Change ◽  
Rate Of Change ◽  
Memory Clinics ◽  
Baseline Characteristics ◽  
The Difference ◽  
And Behavior ◽  
Assessment Scales ◽  
State Examination

ABSTRACTBackground: The Prospective Research In MEmory clinics (PRIME) is a three-year non-prescriptive, observational study identifying and measuring relationships among predictor and outcome variables.Methods: Patients from nine memory clinics, diagnosed with dementia or mild cognitive impairment (MCI), living in the community with <40 hours/week nursing care were divided into diagnostic groups defined at baseline as Alzheimer's disease (AD) early or late onset, frontotemporal dementia (FTD), vascular dementia (VaD), mixed (AD and VaD) and other dementia. To achieve outcome measures, baseline and change over six months in all measures by diagnostic group, and predictors of change at six months were examined.Results: Of the 970 patients enrolled, 967 were eligible for analysis. The most common disorder was AD (late onset) accounting for 46.5% of this population. Patients had an overall slight worsening on all assessment scales over the six-month period. Patients with FTD had a more marked change (decline) in cognition, function and behavior over six months compared to other diagnostic groups. However, in the regression analysis the difference was not significant between groups. Predictors of decline in Mini-Mental State Examination (MMSE) scores were not robust at six months, and longer follow-up is required. Patients with FTD were more likely to be prescribed psychotropics.Conclusion: The PRIME study is continuing and will provide important data on predictors of decline along with differences between diagnosis groups on the rate of change.

P6384Thrombotic-hemorrhagic balance evaluation in STEMI patients with or without associated cardiac arrest: an observational study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
F Picard ◽  
M Diefenbronn ◽  
D Laghlam ◽  
J F Llitjos ◽  
A Sokoloff ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Stent Thrombosis ◽  
Major Bleeding ◽  
Bleeding Complications ◽  
Thrombotic Complications ◽  
St Elevation ◽  
Baseline Characteristics ◽  
The Difference ◽  
Hospital Cardiac Arrest

Abstract Background Data is scarce on hemorrhagic and thrombotic complications in patients with ST-elevation myocardial infarction (STEMI) associated with out-of-hospital cardiac arrest (OHCA). Purpose We sought to evaluate the difference in the thrombotic-hemorrhagic balance in STEMI patients with or without associated cardiac arrest. Methods This is a monocentric, retrospective study conducted from January 2012 to December 2017. Over the study period, all consecutive patients who were treated for STEMI with our without OHCA were included. Baseline characteristics, treatments, haemorrhagic and thrombotic events were compared between STEMI patients associated or not with OHCA. Univariate and multivariate analysis were performed to identify predictors of 30-day mortality, occurrence of major bleeding, defined by BARC score ≥3 and early stent thrombosis. Results A total of 549 patients treated for STEMI and 146 patients for STEMI associated with OHCA were included. The incidence of stent thrombosis and major bleeding after coronary angioplasty in patients treated for STEMI was significantly higher when associated with OHCA (2.7% vs. 12.3%, p=0.04 and 3.3% vs. 19.2%, p<0.001, respectively). Independent predictors of major bleeding in OHCA patients were effective anticoagulation (HR=3.11, 95% CI [1.22–7.98], p=0.02) and the use of glycoprotein IIb/IIIa inhibitors (HR=4.16, 95% CI [1.61–10.79], p=0.003). Independent predictors of mortality in STEMI associated with OHCA were age (HR=1.05, 95% CI [1.02–1.09], p=0.004) and stent thrombosis (HR=5.62, 95% CI [1.61–19.65], p=0.007, with a protective effect of new anti-P2Y12 treatments (HR=0.20, 95% CI [0.08–0.46], p<0.001). Clinical outcomes at 30 days follow-up Conclusion Patients treated for STEMI associated with OHCA are at higher-risk of stent thrombosis and bleeding than those who did not experience cardiac arrest. The use of effective anticoagulation and glycoprotein IIb/IIIa inhibitors contributes to increase bleeding complications. In this subset of patients, prospective studies are needed to better evaluate thrombotic and haemorrhagic balance.

Trichoblastic Carcinosarcoma Arising From the Vagina: A Case Report With Comprehensive Immunophenotypic Analysis

2019 ◽  
Vol 28 (4) ◽  
pp. 440-446 ◽  
Author(s):  
Joshua Jing Xi Li ◽  
Joanna Ka Man Ng ◽  
Paul Cheung Lung Choi ◽  
Jacqueline Ho Sze Lee ◽  
Mei-yung Yu
Keyword(s):  
Hair Follicle ◽  
Side Wall ◽  
Resonance Imaging ◽  
Vaginal Mass ◽  
Gynecology And Obstetrics ◽  
First Case ◽  
The Difference ◽  
And Behavior ◽  
Disease Free

A 54-year-old woman presented with abdominal pain. Magnetic resonance imaging revealed an upper vaginal mass with no pelvic side wall involvement, nodal, or distant metastasis. Radical hysterectomy was performed. Histology showed trichoblastic carcinoma with hair follicle structures and malignant sarcomatous and carcinomatous components. Hair follicular differentiation was confirmed by positivity to hair follicle markers (Bcl-2, TLE1, CD56/NCAM, and TDAG51) and presence of CD10-positive trichogenic stroma. The tumor involved the vaginal muscularis only (FIGO [International Federation of Gynecology and Obstetrics] stage I) and was excised with clear margins. The patient remained disease free at 3-month follow-up. This is the first case of cutaneous-type carcinosarcoma reported in the vagina, highlighting the difference in histology, immunophenotype, and behavior compared with gynecologic carcinosarcomas.

scholarly journals Absence of dementia in late-onset schizophrenia: a one year follow-up of a Brazilian case series

2006 ◽  
Vol 64 (4) ◽  
pp. 946-949 ◽  
Author(s):  
Jerson Laks ◽  
Leonardo F. Fontenelle ◽  
Adriana Chalita ◽  
Mauro V. Mendlowicz
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Negative Symptoms ◽  
Late Onset ◽  
Case Series ◽  
Developed Countries ◽  
End Point ◽  
One Year ◽  
State Examination

BACKGROUND: Cognitive deficits of late-onset schizophrenia (LOS) patients have been reported as stable, although some prospective studies show that a sub-group develop a significant cognitive decline. Data on LOS from developing countries are scarce. OBJECTIVE: To evaluate the cognitive performance of Brazilian patients with LOS over the course of one year. METHOD: Thirteen LOS patients were evaluated at baseline and after one year with the Mini-Mental State Examination (MMSE), the CAMCOG, the Positive and Negative Symptoms Scale, the Pfeffer’s Activities of Daily Living (ADL), and the Neuropsychiatric Inventory (NPI). RESULTS: Cognition and activities of daily living remained stable over the course of one year [baseline MMSE= 21.31 (4.87) and CAMCOG=80.31 (16.68); end-point MMSE=20.77 (3.86) and CAMCOG=82.92 (14.42) (Z=-0.831; p=0.40); baseline ADL=4.31 (5.65); end-point ADL= 5.92 (3.86) (Z=-0.831; p=0.40)]; end-point NPI=10.54 (10.69) (Z=-0.737; p=0.46]. CONCLUSION: Like patients from developed countries, Brazilian patients with LOS do not seem develop dementia, at least over the course of one year.

Modulation of Retinal Atrophy With Rituximab in Multiple Sclerosis

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000011933
Author(s):  
Jeffrey Lambe ◽  
Hunter Risher ◽  
Angeliki G. Filippatou ◽  
Olwen C. Murphy ◽  
Elias S. Sotirchos ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Ganglion Cell ◽  
Plexiform Layer ◽  
Rate Of Change ◽  
Uncontrolled Hypertension ◽  
Inner Plexiform Layer ◽  
Disease Modifying Therapy ◽  
Retinal Atrophy ◽  
The Difference

Objective:To investigate the effects of rituximab on retinal atrophy in patients with relapsing-remitting multiple sclerosis (RRMS), we performed serial optical coherence tomography (OCT) scans among a cohort of RRMS patients on rituximab, and compared rates of ganglion cell+inner plexiform layer (GCIPL) atrophy to those observed among age- and sex-matched glatiramer acetate (GA)- and natalizumab-treated RRMS patients, and healthy controls (HCs).Methods:In this observational study, patients with RRMS treated with a single disease-modifying therapy, and HCs, were followed with serial OCT for a median duration of 2.8 years. Participants with uncontrolled hypertension, diabetes mellitus, or glaucoma, and eyes with optic neuritis ≤6 months prior to baseline OCT, or during follow-up, were excluded. Statistical analyses were performed using linear mixed-effects regression.Results:During the overall follow-up period, rates of GCIPL atrophy were -0.28±0.11µm/yr among rituximab-treated RRMS patients (n=35). This was similar to GA-treated (n=49; -0.33±0.05µm/yr; p=0.69) and natalizumab-treated patients (n=88; -0.17±0.10µm/yr; p=0.13), and faster than HCs (n=78; -0.15±0.03µm/yr; p=0.006). Rituximab-treated patients exhibited 0.55±0.23µm/yr faster rates of GCIPL atrophy during the first 12 months of treatment, relative to afterwards (n=25; p=0.02), during which period GCIPL atrophy rates were -0.14±0.13µm/yr.Conclusions:Retinal atrophy in RRMS is modulated by rituximab. Greater attenuation of retinal atrophy may occur after 12 months of rituximab treatment, following which time GCIPL atrophy rates are similar to those observed among natalizumab-treated RRMS patients and HCs. Our findings raise the possibility that the neuroprotective therapeutic response with rituximab in RRMS may take up to 12 months, though should be confirmed by larger studies.Classification of evidence:This study provides Class IV evidence on the difference in rate of change of the ganglion cell+inner plexiform layer thickness in patients with RRMS, comparing rituximab to other DMTs.

Graft Choice and the Incidence of Osteoarthritis After Anterior Cruciate Ligament Reconstruction: A Causal Analysis From a Cohort of 541 Patients

2018 ◽  
Vol 46 (12) ◽  
pp. 2842-2850 ◽  
Author(s):  
Flore-Anne Lecoq ◽  
Jean-Jacques Parienti ◽  
James Murison ◽  
Nicolas Ruiz ◽  
Khaled Bouacida ◽  
...  
Keyword(s):  
Anterior Cruciate Ligament ◽  
Cruciate Ligament ◽  
International Knee Documentation Committee ◽  
French Society ◽  
Level Of Evidence ◽  
Medial Meniscectomy ◽  
Baseline Characteristics ◽  
The Difference ◽  
Anterior Cruciate

Background: Anterior cruciate ligament (ACL) reconstruction is important to prevent knee osteoarthritis. Neither of the 2 most common graft techniques—the patellar tendon (PT) or hamstring tendon (HS) graft—has demonstrated superiority in terms of the long-term osteoarthritis rate. Hypothesis: Based on the International Knee Documentation Committee (IKDC) radiographic grading system, PT grafts decrease the incidence of osteoarthritis by providing better knee stability as compared with HS grafts over 12 years of follow-up. Study Design: Cohort study; Level of evidence, 3. Methods: All adults with a first ACL rupture who underwent surgery with a PT or HS graft technique between January 2002 and December 2003 were included in the 2014 French Society of Orthopedic Surgery and Traumatology Symposium database. Baseline characteristics were collected. The primary endpoint was the occurrence of moderate to severe osteoarthritis in each group. The secondary endpoints included clinical subjective evaluations by the IKDC score and Knee injury and Osteoarthritis Outcome Score. To control the differences in baseline characteristics, the data were analyzed with propensity score matching. Results: In the cohort, 541 patients from 18 centers were included: 311 PT and 230 HS ACL reconstructions. The baseline characteristics were similar after inverse probability weighting treatment (IPWT). The occurrence of osteoarthritis was similar after IPWT (19.3% for PT and 19.6% for HS, P = .94). Age at surgery >29 years and IKDC osteoarthritis stage B at the index surgery were identified as risk factors for moderate to severe osteoarthritis. Most functional outcomes were significantly higher in the HS group; however, the difference between groups remained <10 points. Of the 106 patients who needed a medial meniscectomy, the proportion of patients with moderate to severe osteoarthritis was much higher in the HS group (43.5% vs 18.3%, P = .006). However, after IPWT, the difference was not statistically significant. Conclusion: At 12 years of follow-up, neither graft technique was superior to the other in terms of the rate of osteoarthritis.

Abstract W P368: Longitudinal Change in fMRI Blood Oxygen Level Dependent Signal in Cerebral Amyloid Angiopathy

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Aaron R Switzer ◽  
Cheryl R McCreary ◽  
Richard Frayne ◽  
Bradley G Goodyear ◽  
Eric E Smith
Keyword(s):  
Blood Oxygen Level Dependent ◽  
Rate Of Change ◽  
Amyloid Angiopathy ◽  
Blood Oxygen ◽  
Bold Signal ◽  
Blood Oxygen Level ◽  
Change Over Time ◽  
The Difference ◽  
Over Time

Introduction: Previous cross-sectional studies show that cerebral amyloid angiopathy (CAA) is associated with reduced blood oxygen level dependent (BOLD) signal change in response to a visual task, and that this reduction is due to impaired vascular reactivity. However, there are no data on the rate at which the BOLD signal changes over time in CAA. We hypothesized that fMRI activation would decline in CAA, representing progressively impaired vasoreactivity, and this decline would be associated with increased white matter hyperintensity (WMH) volume. Methods: fMRI BOLD amplitude was measured in response to a visual task (alternating checkerboard pattern) at study entry and 1-year follow-up for 18 patients with probable CAA by Boston criteria, and 15 healthy controls. fMRI data were matched to a canonical BOLD signal using a general linear model resulting in z-statistic images with a significance threshold of p<0.05 using FSL. The amplitude of the BOLD signal percent change from baseline was measured in the 200 most active voxels in the primary visual cortex. WMH were identified on fluid attenuated inversion recovery (FLAIR) images and the volume was measured using Quantomo software (Cybertrials Inc, Canada). Results: BOLD amplitude was lower at follow-up than baseline in CAA, but the difference was not significant (mean change -0.14±0.55, p=0.30). Mean BOLD amplitude was similar at baseline and follow-up in controls (mean change 0.20±0.49, p=0.14). The difference in rate of change over time between CAA and controls was borderline significant (p=0.04). fMRI was lower at follow-up than baseline in 11/18 CAA compared to 4/15 controls (p=0.08). In CAA patients, WMH increased over time (median 1.44 mL interquartile range -0.22 to 9.70mL, p=0.01). However, BOLD amplitude change and WMH change were not related (r=-0.01, p=0.96). Discussion: Although we did not see significant fMRI BOLD signal reduction from baseline to 1 year in CAA, we did see a difference in change over time between CAA and controls, consistent with our hypothesis that impaired vasoreactivity is a feature of CAA. Studies with larger numbers of patients, or longer duration of follow-up, are needed to more precisely determine the rate of change over time in reduction of fMRI BOLD amplitude in CAA.

Re-Increased Male Suicide Rates in the Recovery Phase Following the Great East Japan Earthquake

Crisis ◽  
2020 ◽  
Vol 41 (6) ◽  
pp. 422-428 ◽  
Author(s):  
Masatsugu Orui
Keyword(s):  
Social Connectedness ◽  
Recovery Phase ◽  
Great East Japan Earthquake ◽  
Temporary Housing ◽  
Period Analysis ◽  
Suicide Rates ◽  
Male Suicide ◽  
The Social ◽  
The Difference

Abstract. Background: Monitoring of suicide rates in the recovery phase following a devastating disaster has been limited. Aim: We report on a 7-year follow-up of the suicide rates in the area affected by the Great East Japan Earthquake, which occurred in March 2011. Method: This descriptive study covered the period from March 2009 to February 2018. Period analysis was used to divide the 108-month study period into nine segments, in which suicide rates were compared with national averages using Poisson distribution. Results: Male suicide rates in the affected area from March 2013 to February 2014 increased to a level higher than the national average. After subsequently dropping, the male rates from March 2016 to February 2018 re-increased and showed a greater difference compared with the national averages. The difference became significant in the period from March 2017 to February 2018 ( p = .047). Limitations: Specific reasons for increasing the rates in the recovery phase were not determined. Conclusion: The termination of the provision of free temporary housing might be influential in this context. Provision of temporary housing was terminated from 2016, which increased economic hardship among needy evacuees. Furthermore, disruption of the social connectedness in the temporary housing may have had an influence. Our findings suggest the necessity of suicide rate monitoring even in the recovery phase.

Awareness of Pregnant Women for COVID-19 Infection

2020 ◽  
Author(s):  
Erhan Okuyan ◽  
Emre Gunakan ◽  
Sertaç Esin
Keyword(s):  
Pregnant Women ◽  
Respiratory Diseases ◽  
Prospective Observational Study ◽  
Information Source ◽  
Home Birth ◽  
Patient Characteristics ◽  
Emotional Status ◽  
Prevention Method ◽  
And Behavior

Covid outbreak has been getting worse and spread affected all over the world. Pregnant patients are also vulnerable to respiratory diseases. We aimed to evaluate the awareness, emotional status, and behavior of pregnant during the COVID outbreak. This study's main benefit is to analyze the knowledge and understanding of pregnant women about the pandemic and draw attention to the prevention issues that need improvement. This research is a prospective observational study that 199 patients subjected to a questionnaire including 29 questions about patient characteristics, pregnancy information, knowledge about COVID19-infection, behavioral and emotional changes. 130 (65.3) of the patients stated an above-average knowledge level. Television was the most frequent information source (75.4%, n:150) and was the only information source for 90 (45.1%) of the patients. Sixty-nine patients used more than one information source. More than one prevention method uses by 149 (75%) of the patients. Washing hands (n:183, 92.0%) and cleaning the house (n:122, 61.3%) were the most preferred methods. Only 55 (27.6%) of the patients used a mask for prevention. 88(44.2%) of the patients stated that they preferred a shorter hospital stay, and 75 (37.7%) of the patients indicated that they postponed or avoided the pregnancy follow-up visits due to the COVID-19 issue. Pregnant women seem to be aware and stressed of COVID-19, but knowledge of what to do seems insufficient. Patients informed of risks of COVID infection, unplanned hospital admission, and chances of avoiding necessary visits and home birth demands.

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