Clinical variables related to the diagnostic stability of demential syndromes

2017 ◽  
Vol 29 (10) ◽  
pp. 1735-1741 ◽  
Author(s):  
Fabiano Moulin de Moraes ◽  
Paulo Henrique Ferreira Bertolucci
Keyword(s):  
Physical Examination ◽  
Neuropsychological Tests ◽  
Clinical Information ◽  
Initial Diagnosis ◽  
Long Term Memory ◽  
Neuropsychological Battery ◽  
Clinical Dementia Rating ◽  
Diagnostic Stability ◽  
University Center ◽  
One Year

ABSTRACTBackground:Assigning a diagnosis to a patient with dementia is important for the present treatment of the patient and caregivers, and scientific research. Nowadays, the dementia diagnostic criteria are based on clinical information regarding medical, history, physical examination, neuropsychological tests, and supplementary exams and, therefore, subject to variability through time.Methods:A retrospective observational study to evaluate variables related to clinical diagnostic stability in dementia syndromes in at least one year follow up. From a sample of 432 patients, from a single university center, data were collected regarding sociodemographic aspects, Clinical Dementia Rating, physical examination, neuropsychological tests, and supplementary exams including a depression triage scale.Results:From this sample, 113 (26.6%) patients have their diagnosis changed, most of them adding a vascular component to initial diagnosis or depression as comorbidity or main disease. Our findings show that many factors influence the diagnostic stability including the presence of symmetric Parkinsonism, initial diagnosis of vascular dementia, presence of diabetes and hypertension, the presence of long term memory deficit in the neuropsychological evaluation, and normal neuroimaging. We discuss our findings with previous findings in the literature.Conclusion:Every step of the clinical diagnosis including history, vascular comorbidities and depression, physical examination, neuropsychological battery, and neuroimaging were relevant to diagnosis accuracy.

Latent Structure of a Brief Clinical Battery of Neuropsychological Tests Administered In-Home Via Telephone

2020 ◽  
Author(s):  
Anastasia Matchanova ◽  
Michelle A Babicz ◽  
Luis D Medina ◽  
Samina Rahman ◽  
Briana Johnson ◽  
...  
Keyword(s):  
Executive Functions ◽  
Factor Structure ◽  
Neuropsychological Tests ◽  
Factor Model ◽  
Digit Span ◽  
Neuropsychological Battery ◽  
Memory And Attention ◽  
Sociodemographic Correlates ◽  
List Learning ◽  
Trail Making

Abstract Objective To examine the factor structure and sociodemographic correlates of a battery of clinical neuropsychological tests administered in-home and via telephone. Method Participants included 280 healthy adults who completed a 35–40 min battery consisting of seven auditory-verbal neuropsychological tests (i.e., 10 variables) that included digit span, list learning and memory, prospective memory, verbal fluency, and oral trail making. Results After removing oral trail making part A, a three-factor model comprised of executive functions, memory and attention demonstrated the best fit to the data. Nevertheless, the shared variance between the nine remaining neuropsychological variables was also adequately explained by a single-factor model and a two-factor model comprised of executive functions and memory. Factor scores were variably associated with education, race/ethnicity, and IQ, but not with sex or age. Conclusions Findings provide preliminary support for the feasibility and factor structure and sociodemographic correlates of a brief telephone-based screening neuropsychological battery comprised mostly of commonly administered clinical measures. Future studies are needed to determine the test–retest reliability, sensitivity, and ecological relevance of this battery, as well as equivalency to in-person assessment.

scholarly journals Characteristics and resolution of hypertension in obese African American bariatric cohort

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Charu Gandotra ◽  
Motahar Basam ◽  
Ankit Mahajan ◽  
Julius Ngwa ◽  
Gezzer Ortega ◽  
...  
Keyword(s):  
Weight Loss Surgery ◽  
Surgical Techniques ◽  
Antihypertensive Medications ◽  
University Center ◽  
First Line Therapy ◽  
Howard University ◽  
Long Term Effect ◽  
Bariatric Patients ◽  
One Year

AbstractWeight reduction continues to be first-line therapy in the treatment of hypertension (HTN). However, the long-term effect of bariatric malabsorptive surgical techniques such as Roux-en-Y Gastric Bypass (RYGB) surgery in the management of hypertension (HTN) is less clear. African Americans (AA) are disproportionately affected by obesity and hypertension and have inconsistent outcomes after bariatric surgery (BS). Despite a plethora of bariatric literature, data about characteristics of a predominantly AA bariatric hypertensive cohort including hypertension in obese (HIO) are scarce and underreported. The aims of this study were, (1) to describe the preoperative clinical characteristics of HIO with respect to HTN status and age, and (2) to identify predictors of HTN resolution one year after RYGB surgery in an AA bariatric cohort enrolled at the Howard University Center for Wellness and Weight Loss Surgery (HUCWWS). In the review of 169 AA bariatric patients, the average BMI was 48.50 kg/m2 and the average age was 43.86 years. Obese hypertensive patients were older (46 years vs. 37.89 years; p < .0001); had higher prevalence of diabetes mellitus (DM, 43.09% vs. 10.87%; p < .0001) and dyslipidemia (38.2% vs. 13.04%; p 0.002). Hypertensive AA who were taking ≥ 2 antihypertensive medications prior to RYGB were 18 times less likely to experience HTN resolution compared to hypertensive AA taking 0–1 medications, who showed full or partial response. Also, HIO was less likely to resolve after RYGB surgery in patients who needed ≥ 2 antihypertensive medications prior to surgical intervention.

Cognitive impairment in long-term benzodiazepine users

1988 ◽  
Vol 18 (2) ◽  
pp. 365-374 ◽  
Author(s):  
Susan Golombok ◽  
Parimala Moodley ◽  
Malcolm Lader
Keyword(s):  
Neuropsychological Tests ◽  
Matched Control ◽  
Control Group ◽  
Therapeutic Practice ◽  
The Past ◽  
Visual Spatial ◽  
Wide Range ◽  
High Doses ◽  
One Year

SynopsisIn view of the very extensive and often prolonged use of benzodiazepines in therapeutic practice, this study was designed to investigate whether or not cognitive ability is impaired in longterm benzodiazepine users, and to determine the nature and extent of any deficit. Fifty patients currently taking benzodiazepines for at least one year, thirty-four who had stopped taking benzodiazepines, and a matched control group of subjects who had never taken benzodiazepines or who had taken benzodiazepines in the past for less than one year were administered a battery of neuropsychological tests designed to measure a wide range of cognitive functions. It was found that patients taking high doses of benzodiazepines for long periods of time perform poorly on tasks involving visual-spatial ability and sustained attention. This is consistent with deficits in posterior cortical cognitive function.

A Case of Splenic Sarcoidosis: Initial Diagnosis and One-Year Symptom Follow-up

CHEST Journal ◽  
2014 ◽  
Vol 145 (3) ◽  
pp. 210A
Author(s):  
Abhay Vakil ◽  
Hineshkumar Upadhyay ◽  
Khalid Sherani ◽  
Kelly Cervellione ◽  
Alan Fein
Keyword(s):  
Initial Diagnosis ◽  
One Year

Symmetrical brachydactyly in a dog

2017 ◽  
Vol 30 (04) ◽  
pp. 306-309
Author(s):  
Ursula Krotscheck ◽  
Anthony Fischetti ◽  
Kim Tong ◽  
Megan Cray
Keyword(s):  
Case Report ◽  
Physical Examination ◽  
Congenital Malformations ◽  
General Term ◽  
Abnormal Development ◽  
Unaffected Sibling ◽  
Radiographic Imaging ◽  
One Year

SummaryCongenital malformations of the canine manus and pes are infrequently reported in the veterinary literature. This includes brachydactyly which is a general term used to indicate the shortening of digits due to abnormal development of the phalanges, metacarpals, or metatarsals. This case report describes isolated brachydactyly in a one-year-old male Maremma Sheepdog affecting all of the phalanges, metacarpals, and metatarsals of digits two through five. This condition was confirmed by determining the length of each phalanx, metacarpal, and metatarsal of the affected dog as well as an unaffected littermate. The affected dog’s metacarpal, metatarsal, and phalanx lengths ranged from 50% to 77% of that of the unaffected sibling. Other abnormalities found on physical examination as well as on radiographic imaging are discussed.

scholarly journals Older Black Adults’ Satisfaction and Anxiety Levels After Completing Alternative Versus Traditional Cognitive Batteries

2018 ◽  
Vol 75 (7) ◽  
pp. 1462-1474 ◽  
Author(s):  
Alyssa A Gamaldo ◽  
Shyuan Ching Tan ◽  
Angie L Sardina ◽  
Carolyn Henzi ◽  
Rosalyn Guest ◽  
...  
Keyword(s):  
Neuropsychological Tests ◽  
Cognitive Status ◽  
Comfort Level ◽  
Education Quality ◽  
Neuropsychological Battery ◽  
Black Adults ◽  
Computer Based ◽  
Paper And Pencil ◽  
And Performance ◽  
Age Range

Abstract Objective The objective of this study was to examine satisfaction, test anxiety, and performance using computer-based cognitive batteries versus a paper-and-pencil neuropsychological battery among older Blacks. Method Self-identified Black adults (n = 87, age range: 55–86; mean education = 14) completed two computer-based tests (CogState and Joggle) and a paper-and-pencil neuropsychological battery. After each battery, participants reported their testing anxiety and satisfaction using the batteries. Descriptive, correlational, and regression analyses compared satisfaction, anxiety, and performance across the batteries. Results Majority of the participants reported more satisfaction with the computer-based (Joggle: 66%; CogState: 77%) than the neuropsychological (52%) battery. Participants also reported less testing anxiety after completing the computer-based batteries than the neuropsychological battery, F(2, 172) = 22.96, p &lt; .001. Older adults’ familiarity and comfort level with the computer were not associated with their performance on the computer-based tests (p &gt; .05). Although testing anxiety was not associated with performance across the batteries, age and education quality were uniquely associated with performance on the CogState and neuropsychological batteries. Conclusions Computer-based cognitive batteries appear to be less intimidating than the commonly used paper-and-pencil neuropsychological tests for Black adults. Thus, these cognitive batteries may be useful tools for monitoring older Blacks’ cognitive status.

scholarly journals Observation of genotype C infected chronic hepatitis B patients in clinical practice

2011 ◽  
Vol 5 (12) ◽  
pp. 882-889 ◽  
Author(s):  
Myo Nyein Aung ◽  
Wattana Leowattana ◽  
Noppadon Tangpukdee ◽  
Chatporn Kittitrakul
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Clinical Information ◽  
Hbv Dna ◽  
Hbv Genotype ◽  
Surrogate Outcome ◽  
Treatment Naïve ◽  
Genotype C ◽  
One Year

Introduction: Hepatitis B virus (HBV) genotype C is prevalent in many areas of the world including Thailand and Southeast Asia. It is a strong risk for hepatocellular carcinoma (HCC) by evidence. We aimed to describe the baseline clinical information of treatment naïve genotype C infected chronic hepatitis B (CHB) patients and to describe the treatment response by surrogate outcome markers in genotype C infected CHB patients after one year of nucleos(t)ide analogues (NA) treatment Methodology:  Thirty-four genotype C CHB patients were studied at the Hospital for Tropical Diseases, Bangkok, including 12 patients treated with lamivudine, 11 with telbivudine, 8 with adefovir, and 3 with entecavir. Serum HBV DNA levels, serum alanine amino transferase ( ALT ) levels, HBeAg status, and alpha-feto protein (AFP) levels were recorded at the start and after twelve months of ongoing treatment. HBV genotyping was performed by line-probe assay. Results: About half of the patients (58.8%) were HBeAg positive. Mean HBV viral load was 6.53 + 1.15 log10 copies per ml at baseline and reduced to 3.63 + 1.3 log10 copies per ml after one year of NA treatment. Serum HBV DNA levels became undetectable in 47.1 % of the patients and serum ALT was normalized in 23.5 % of the patients. Conclusion: Most of the genotype C patients were aged above 40 years. More than half of the genotype C infected patients did not achieve virological response and biochemical remission. Among the CHB patients, genotype C infected patients are a high priority group for intervention.

Asthma and Pneumomediastinum

PEDIATRICS ◽  
1985 ◽  
Vol 75 (5) ◽  
pp. 990-991
Author(s):  
JACOB HEN
Keyword(s):  
Physical Examination ◽  
Subcutaneous Emphysema ◽  
Childhood Asthma ◽  
Previous History ◽  
Clinical Information ◽  
Mediastinal Emphysema ◽  
Respiratory Problems ◽  
The Past ◽  
History Of ◽  
Clinical Clue

To the Editor.— An important piece of clinical information to add to Sturtz's recent review of spontaneous mediastinal emphysema in children1 is that mediastinal emphysema may be the first clinical clue to the presence of childhood asthma. Over the past 4 years, we have seen four children with cough and subcutaneous emphysema in the neck and no previous history of respiratory problems or asthma. These children had hyperinflated lungs and mediastinal emphysema demonstrated on admission chest roentgenograms and physical examination revealed wheezing.

scholarly journals Development and Preliminary Validation of Standardized Regression-Based Change Scores as Measures of Transitional Cognitive Decline

2020 ◽  
Vol 35 (7) ◽  
pp. 1168-1181 ◽  
Author(s):  
Andrew M Kiselica ◽  
Alyssa N Kaser ◽  
Troy A Webber ◽  
Brent J Small ◽  
Jared F Benge
Keyword(s):  
Cognitive Decline ◽  
Base Rate ◽  
Neuropsychological Battery ◽  
Clinical Dementia Rating ◽  
Aging Research ◽  
Data Set ◽  
Change Scores ◽  
Cognitive Measure ◽  
Preliminary Validation ◽  
User Friendly

Abstract Objective An increasing focus in Alzheimer’s disease and aging research is to identify transitional cognitive decline. One means of indexing change over time in serial cognitive evaluations is to calculate standardized regression-based (SRB) change indices. This paper includes the development and preliminary validation of SRB indices for the Uniform Data Set 3.0 Neuropsychological Battery, as well as base rate data to aid in their interpretation. Method The sample included 1,341 cognitively intact older adults with serial assessments over 0.5–2 years in the National Alzheimer’s Coordinating Center Database. SRB change scores were calculated in half of the sample and then validated in the other half of the sample. Base rates of SRB decline were evaluated at z-score cut-points, corresponding to two-tailed p-values of .20 (z = −1.282), .10 (z = −1.645), and .05 (z = −1.96). We examined convergent associations of SRB indices for each cognitive measure with each other as well as concurrent associations of SRB indices with clinical dementia rating sum of box scores (CDR-SB). Results SRB equations were able to significantly predict the selected cognitive variables. The base rate of at least one significant SRB decline across the entire battery ranged from 26.70% to 58.10%. SRB indices for cognitive measures demonstrated theoretically expected significant positive associations with each other. Additionally, CDR-SB impairment was associated with an increasing number of significantly declined test scores. Conclusions This paper provides preliminary validation of SRB indices in a large sample, and we present a user-friendly tool for calculating SRB values.

scholarly journals Role of Multidetector Computerised Tomography in Evaluation of Proptosis

2019 ◽  
Vol 9 (2) ◽  
pp. 24-31
Author(s):  
Elina Shrestha ◽  
Narayan Bikram Thapa ◽  
Shankar Bahadur Singh Rajbhandari
Keyword(s):  
Predictive Value ◽  
Clinical Information ◽  
Cross Sectional Study ◽  
Computerised Tomography ◽  
Cross Sectional ◽  
Female Ratio ◽  
Male Female Ratio ◽  
One Year ◽  
Female Male Female

Introduction: Proptosis is defined as bulging of eye anteriorly out of the orbit. Our main objective was to analyze the pattern of computerised tomographic findings in evaluation of proptosis. Computerised tomography (CT) is noninvasive, easily accessible, affordable and reliable imaging which helps in early diagnosis and prompt treatment. Methods: A descriptive cross sectional study of total 58 patients presenting with proptosis referred to our department of radiology for computerised tomography evaluation during one year period were undertaken into study. The clinical information provided by ophthalmologist also helped our study to derive into conclusion. SPSS version 20 software was used for statistical data analysis. Results: Out of 58 patients, the most common cause of proptosis was neoplasm constituting of 25 cases (43.1%). Retinoblastoma was the commonest orbital tumor. Out of remaining cases, 15 (25.8%) were infective, 14 (24.1%) were inflammatory, two (3.44%) were traumatic and remaining two cases (3.44%) had no definitive cause for proptosis. Bilateral proptosis was commonly associated with thyroid ophthalmopathy. Among the subjects 32 were male, 26 were female. Male: Female ratio was 1:1.23. Age group was ranging from 1 month to 73 years.Mean age was 26.4 ± 22 years. Conclusions: Computerised tomography has an important role in distinguishing the different types of lesions based on their characteristics, location and extension prior to undertaking definitive surgical and medical treatment. Overall accuracy of CT in our study was 81%, sensitivity of 82.6%, specificity of 80.6%, positive predictive value of 76% and negative predictive value of 86.2%.

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