scholarly journals The presence of total knee or hip replacements due to osteoarthritis enhances the positive association between hand osteoarthritis and atherosclerosis in women: the AGES–Reykjavik study

2011 ◽  
Vol 70 (6) ◽  
pp. 1087-1090 ◽  
Author(s):  
Helgi Jonsson ◽  
Gudrun P Helgadottir ◽  
Thor Aspelund ◽  
Gudny Eiriksdottir ◽  
Sigurdur Sigurdsson ◽  
...  
Keyword(s):  
White Matter ◽  
Carotid Plaque ◽  
Large Population ◽  
Positive Association ◽  
Periventricular White Matter ◽  
Hand Osteoarthritis ◽  
Coronary Calcifications ◽  
Hip Replacements ◽  
History Of ◽  
Total Knee

ObjectiveThis study examines the relationship between total knee replacements (TKR), total hip replacements (THR) or replacements of either joint (total joint replacement; TJR) due to osteoarthritis and atherosclerosis in a large population-based study.MethodsThe participants were 2195 men and 2975 women, mean age 76±6 years. The osteoarthritis data were analysed in relation to measures of atherosclerosis, including carotid artery intima media thickness and plaque severity (ultrasound), coronary and aortic calcifications (CT), cerebral white matter lesions (MRI) and a history of previous cardiac and cerebral events.ResultsThe prevalence of TKR was 223 (4.3%) and THR 316 (6.1%). The presence of TJR in women was associated with a non-significant trend towards increased carotid plaque severity, coronary calcifications and periventricular white matter hyperintensities (PVH) but not with a history of cardiac or cerebral events. No associations were seen in men. When TJR were grouped according to the presence or absence of hand osteoarthritis (HOA) there was a highly significant association in the order −TJR/−HOA < +TJR/−HOA < −TJR/+HOA < +TJR/+HOA, for carotid plaque severity, coronary calcifications and PVH.ConclusionThe presence of TJR did not show a significant independent association with atherosclerosis but enhanced the strength of the positive association between HOA and subclinical atherosclerosis in women.

Abstract TMP56: Differential Effect of Left versus Right White Matter Hyperintensity Burden on Functional Decline: The Northern Manhattan Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mandip S Dhamoon ◽  
Ying-Kuen Cheung ◽  
Ahmet M Bagci ◽  
Dalila Varela ◽  
Noam Alperin ◽  
...  
Keyword(s):  
White Matter ◽  
Large Population ◽  
Functional Decline ◽  
Frontal Lobes ◽  
White Matter Hyperintensity ◽  
Periventricular White Matter ◽  
Parietal Lobes ◽  
Brain White Matter ◽  
The Right

Background: We previously showed that overall brain white matter hyperintensity volume (WMHV) was associated with accelerated long-term functional decline. Asymmetry of brain dysfunction may disrupt brain network efficiency. We hypothesized that greater left-right WMHV asymmetry was associated with functional trajectories. Methods: In the Northern Manhattan MRI study, participants had brain MRI with axial T1, T2, and fluid attenuated inversion recovery sequences, with baseline interview and examination. Volumetric WMHV distribution across 14 brain regions (brainstem, cerebellum, and bilateral frontal, occipital, temporal, and parietal lobes, and bilateral anterior and posterior periventricular white matter) was determined separately by combining bimodal image intensity distribution and atlas based methods.. Participants had annual functional assessments with the Barthel index (BI, range 0-100) over a mean of 7.3 years. Generalized estimating equations models estimated associations of regional WMHV and regional left-right asymmetry with baseline BI and change over time, adjusted for baseline medical risk factors, sociodemographics, and cognition, and stroke and myocardial infarction during follow-up. Results: Among 1195 participants, mean age was 71 (SD 9) years, 39% were male, 67% had hypertension and 19% diabetes. Greater WMHV asymmetry in the frontal lobes (-3.53 BI points per unit greater WMHV on the right compared to left, 95% CI -0.18, -6.88) and whole brain (-7.23 BI points, 95% CI 0.07, -14.54) was associated with lower overall function. Greater WMHV asymmetry in the frontal lobes (-0.74 additional BI points per year per unit greater WMHV on the right compared to left, 95% CI 0.05, -1.54) and parietal lobes (1.11 additional BI points per year, 95% CI 0.30, 1.93) was independently associated with accelerated functional decline. Periventricular WMHV asymmetry was not associated with function. Conclusions: In this large population-based study with long-term repeated measures of function, greater regional WMHV asymmetry was associated with lower function and functional decline, especially with greater WMHV on the right. In addition to global WMHV, WHMV asymmetry may be an important predictor of long-term functional decline.

scholarly journals 1240. Evaluation of Preoperative Staphylococcus aureus (SA) Decolonization with Nasal Iodine for Hips/Knees and Fusion Surgeries

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S446-S447
Author(s):  
Anupama Neelakanta ◽  
Kristi Clutts ◽  
Stephanie Strollo ◽  
Catherine Passaretti
Keyword(s):  
Staphylococcus Aureus ◽  
Large Scale ◽  
Nasal Carriage ◽  
Pcr Screening ◽  
Total Knee Replacements ◽  
Alternative Approach ◽  
Hip Replacements ◽  
Intranasal Mupirocin ◽  
History Of ◽  
Total Knee

Abstract Background Preoperative decolonization for patients with known nasal carriage of Staphylococcus aureus is recommended in some surgical site infection (SSI) guidelines, however, meaningful implementation is often challenging with poor compliance. We evaluated utilization of nasal iodine with S. aureus polymerase chain reaction (PCR) screening on the day of surgery as an alternative approach. Methods For all total hip replacements (THR), total knee replacements (TKR) and fusion patients in a 250-bed community hospital, we implemented day of surgery S. aureus PCR for all patients who had not been screened in the 2 weeks prior in August 2018. Those known to have S. aureus colonization in the 2 weeks prior to surgery as well as those who had no screen in the 2 weeks prior were treated with nasal iodine and received a chlorhexidine (CHG) bath in the preoperative area. Postoperatively any patient found to have (methicillin-resistant S. aureus) MRSA from preoperative screen or who had a history of MRSA in the past year were automatically decolonized with 5 days of intranasal mupirocin and CHG baths in addition. Compliance with S. aureus screening in preoperative area, results of screens and rates of THR, TKR and fusion SSI per National Health Safety Network (NHSN) definitions were monitored throughout the study period. SSI standardized infection ratios (SIR) during the study were compared with data 1 year prior to intervention date. Results Between August 2018 and January 2019, 694 THR, TKR and fusion surgeries were performed. Preoperative nursing compliance with completing the SA screen was 79. 2% and percent compliance with administering/documenting nasal iodine was 77.8%. Of those screened 21.7% (126/578) were found to have SA. Only 15% (n = 19) of SA positive PCRs were positive for MRSA. SSIs decreased in intervention period compared with preintervention (August 2017–July 2018) as shown in Table 1. Conclusion Preoperative nasal iodine has been effective and helped reduce our infection SIR to below 1. These results could be confounded by the presence of other initiatives but looks promising and large-scale studies would be helpful to make these results generalizable. Disclosures All authors: No reported disclosures.

scholarly journals Premature white matter microstructure in female children with a history of concussion

2021 ◽  
Author(s):  
Eman Nishat ◽  
Sonja Stojanovski ◽  
Shannon E Scratch ◽  
Stephanie H Ameis ◽  
Anne L Wheeler
Keyword(s):  
White Matter ◽  
Cognitive Performance ◽  
Processing Speed ◽  
Large Population ◽  
Speed Test ◽  
Persistent Symptoms ◽  
Neurite Density ◽  
History Of ◽  
Brain Microstructure ◽  
The Brain

AbstractAs maturation of the brain continues throughout development, there is a risk of interference from concussions which are common in childhood. A concussion can cause widespread disruption to axons and inflammation in the brain and may influence emerging cognitive abilities. Females are more likely to experience persistent problems after a concussion, yet the sex-specific impact of concussions on brain microstructure in childhood is not well understood.In children from a large population sample, this study (1) investigated differences in white matter and cortical microstructure between children with and without a history of concussion, and (2) examined relationships between altered brain microstructure and cognitive performance.Neurite density measures from diffusion weighted magnetic resonance imaging were examined in 9-to 10-year-old children in the Adolescent Brain Cognitive Development Study with (n = 336) and without (n = 7368) a history of concussion. (1) Multivariate regression models were used to investigate the relationships between concussion history, sex, and age in the deep white matter, superficial white matter, subcortical structures, and cortex. (2) Principal component analysis was performed on neurite density, and components were examined in relation to performance on the Flanker Inhibitory Control and Attention Task and the Pattern Comparison Processing Speed Task to investigate the relationship between altered neurite density and cognitive performance.Neurite density in all tissue types demonstrated robust positive relationships with age reflecting maturation of brain microstructure. (1) Comparisons between children with and without a history of concussion revealed higher neurite density in deep and superficial white matter in females with concussion. No group differences were observed in subcortical or cortical neurite density. (2) Higher neurite density in superficial white matter beneath the frontal and temporal cortices was associated with lower scores on the processing speed test in females with concussion, and higher scores on the processing speed test in males with concussion.These findings suggest that concussion in childhood leads to premature white matter maturation in females and that this may be associated with slower processing speed. These sex-specific effects on the developing brain may contribute to the enhanced vulnerability to persistent symptoms after concussion in females.

Abstract WP192: Periventricular White Matter Hyperintensities Are Associated With Functional Decline: The Northern Manhattan Study

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Mandip S Dhamoon ◽  
Ying-Kuen Cheung ◽  
Ahmet M Bagci ◽  
Chensy Marquez ◽  
Noam Alperin ◽  
...  
Keyword(s):  
White Matter ◽  
Repeated Measures ◽  
Brain Mri ◽  
Large Population ◽  
Functional Decline ◽  
Brain Regions ◽  
White Matter Hyperintensity ◽  
Periventricular White Matter ◽  
Brain White Matter

Background: We previously showed that overall brain white matter hyperintensity volume (WMHV) was associated with accelerated long-term functional decline. However, it was unclear whether WMHV in particular brain regions was more predictive of decline. We hypothesized that WMHV in particular brain regions would be more predictive of functional decline. Methods: In the Northern Manhattan MRI study, participants had brain MRI with axial T1, T2, and fluid attenuated inversion recovery sequences, with baseline interview and examination. Volumetric WMHV distribution across 14 brain regions (brainstem, cerebellum, and bilateral frontal, occipital, temporal, and parietal lobes, and bilateral anterior and posterior periventricular white matter [PVWM]) was determined separately by combining bimodal image intensity distribution and atlas based methods. Participants had annual functional assessments with the Barthel index (BI, range 0-100) over a mean of 7.3 years and were followed for stroke and myocardial infarction (MI). Due to multiple collinear variables, lasso regression was used to select regional WMHV variables, and adjusted generalized estimating equations models estimated associations with baseline BI and change over time. Results: Among 1195 participants, mean age was 71 (SD 9) years, 460 (39%) were male, 802 (67%) had hypertension and 224 (19%) diabetes. Using lasso regularization, only right anterior PVWM was selected, and each SD increase was associated with accelerated functional decline, of -0.95 additional BI points per year (95% CI -1.20, -0.70) in an unadjusted model, -0.92 points per year (95% CI -1.18, -0.67) with baseline covariate adjustment, and -0.87 points per year (95% CI -1.12, -0.62) after adjusting for stroke and MI. This decline was in addition to a mean decline of -1.13 (95% CI -1.29, -0.97), -1.19 (95% CI -1.36, -1.01), and -1.04 (95% CI -1.21, -0.88) BI points per year, respectively. Conclusions: In this large population-based study with long-term repeated measures of function, periventricular WMHV was particularly associated with accelerated functional decline. Periventricular WMHV may have a greater effect on mobility due to dysfunction in descending leg motor tracts.

Clinical and Neuroimaging Changes of Subacute Sclerosing Panencephalitis – Experience 30 Cases in Tertiary Care Center in Bangladesh

2021 ◽  
Vol 2 (3) ◽  
pp. 1-4
Author(s):  
Gopen Kumar Kundu ◽  
Mohammad Monir Hossain
Keyword(s):  
Early Childhood ◽  
White Matter ◽  
Subacute Sclerosing Panencephalitis ◽  
Tertiary Care ◽  
Stage Ii ◽  
Cortical Atrophy ◽  
Periventricular White Matter ◽  
History Of ◽  
Signal Changes ◽  
Intense Signal

Background: Subacute sclersing panencephalitis (SSPE) is a very rare progressive, fatal neurodegenerative disease of the control nervous system of childhood and early adolescence. It is a slow virus disease caused by persistent defective measles virus infection of the brain Objective: To see the clinical andneuro-imaging findings in children with Subacute sclerosing panencephalitis. Methods: This retrospective study was conducted at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, a tertiary care premier Postgraduate Medical Institution in Bangladesh. Thirty (30) Subacute sclerosing panencephalitis (SSPE) children were evaluated at paediatric neurology ward during the period January 2010 to December 2017. Diagnosis was based on typical clinical characteristic features, the presence of periodic discharges on EEG, demonstration of raised antibody titer against measles in the plasma and cerebrospinal fluid Detected by ELISA in all patients. Results: Total number of studied children were 30. Mean age was 10.2±3.1 year and Male female ratio was 5:1. Most of the patient arrived from poor socio-economic (83.33%) background of rural area (66.67%) of Bangladesh. Among them 46.67% had history of measles infection during early childhood. Progressive deterioration of school performance (50%), gait disturbance (70%), myoclonus (83%) dysarthria (43%) and Ocular manifestations like optic atrophy & papilledema (83.33%) were the main presenting feature of our studied children. All of the patients (100%) showed positive measles specific antibody IgG in CSF and On electroencephalographic findings showed periodic burst suppression in 90.90% cases. Most of the children (56.6%) were in stage II category and other 3.3%, 33.3%,6.6%, were stage I, stage III, stage IV category respectively. Neuroimaging study showed abnormalities in 45.83% cases included periventricular white matter hyper intense signal changes, cortical atrophy and ischaemic change. Conclusion: In our study most of the SSPE patient were in stage II.About half of the patient had history of measles infection during early childhood. Neuroimaging abnormalities found in about half of the cases and majority cases were in stage II. Common neuroimaging abnormalities were periventricular white matter hyper intense signal changes and cortical atrophy.

scholarly journals White Matter Hyperintensities and Their Association With Suicidally in Major Affective Disorders: A Meta-Analysis of Magnetic Resonance Imaging Studies

CNS Spectrums ◽  
2010 ◽  
Vol 15 (6) ◽  
pp. 375-381 ◽  
Author(s):  
Maria Conceição Grangeon ◽  
Camila Seixas ◽  
Lucas C. Quarantini ◽  
Angela Miranda-Scippa ◽  
Maurizio Pompili ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Attempted Suicide ◽  
Suicide Attempts ◽  
Meta Analysis ◽  
Periventricular White Matter ◽  
Resonance Imaging ◽  
Imaging Studies ◽  
History Of ◽  
Bipolar Patients

ABSTRACTIntroduction: Individuals who have deep and periventricular white matter hyperintensities may have a higher risk for suicidal behavior. There are mixed results in the literature regarding whether unipolar or bipolar patients who have attempted suicide have more deep white matter hyperintensities (DWMH) or periventricular hyperintensities (PVH) relative to those who have no history of suicide attempts.Methods: A meta-analysis of studies examining white matter hyperintensities (WMH) in mood disorder patients with and without a history of suicide attempts was performed.Results: Four studies, including a total of 173 patients who attempted suicide and 183 who did not attempt suicide, were included. A significantly higher number of attempters were found to have WMH than non-attempters. Unipolar depressed patients who had attempted suicide had 1.9 times more DWMH and 2.1 times more PVH than those who did not. Bipolar patients who had attempted suicide had 5.4 times more PVH than those who had not. Taken together, unipolar and bipolar patients who had attempted suicide had 2.8 times more DWMH and 4.5 times more PVH than those who had never attempted suicide.

Abstract 109: Manipulative Dexterity is Associated with Occult White Matter Ischemic Lesions in Healthy Asymptomatic Persons at Increased Risk for Cardiovascular Disease

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Paul A Nyquist ◽  
Lisa R Yanek ◽  
Murat Bilgel ◽  
Jennifer L Cuzzocreo ◽  
Lewis C Becker ◽  
...  
Keyword(s):  
White Matter ◽  
Family History ◽  
Cerebrovascular Disease ◽  
Vascular Disease ◽  
Large Population ◽  
Manual Dexterity ◽  
Excess Risk ◽  
Small Vessel ◽  
Visual Spatial ◽  
History Of

Introduction: Persons with a family history of early-onset coronary artery disease (CAD) have an excess risk of stroke and CAD. White matter lesions (WML) on MRI represent small vessel ischemic cerebrovascular disease and are associated with incident stroke and neurocognitive decline with age. We hypothesized manipulative manual dexterity, an integration of fine motor, visual spatial, and cognition function, may be affected by increased WML burden in task-relevant brain regions across age ranges in persons at risk for pre-clinical occult vascular disease. We tested this in a large population with a family history of early CAD. Methods: Healthy 29-74 year old subjects (N=714; mean age 51± 11 years; mean education 14 ± 3 years; 42% male, 38% Black) were identified from probands with CAD <60 years. WML location and volumes were measured on 3T FLAIR MRI. Manipulative manual dexterity was measured with standardized timed grooved pegboard test. Left and right pegboard scores were averaged. Results: WML were observed in all age groups; mean overall pegboard scores were 108±18, and were within reference norms. In unadjusted analysis, pegboard scores were highly correlated in the expected direction with total WML volumes, r=0.34, p=<.0001; subcortical volumes r=0.30, <.0001 periventricular volumes r=0.31, <.0001; and with most regional WML volumes; frontal 0.34, <.0001; insula r=0.31, p<.0001, parietal r=0.31, p<.0001, and temporal volumes r=0.17, p <.0001. In separate multivariate regression analyses predicting (log) pegboard score adjusted for age, sex, race, education and nonindependence of families (GEE), total WML volume became more statistically significant ( p=5.79E-05) while other regions retained statistical significance, p< 0.01. Conclusions: Our findings in a large population-based sample with a family history of early CAD confirm that greater WML volumes in multiple brain locations are associated with higher pegboard scores (worse performance) independent of age, sex, race, and education. This suggests that small vessel cerebrovascular disease is present in an early preclinical state and that WML volumes impact manipulative manual dexterity in healthy middle-aged and younger individuals with excess risk for clinical vascular disease.

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