scholarly journals Association of epileptiform abnormalities and seizures in Alzheimer disease

Neurology ◽  
2020 ◽  
Vol 95 (16) ◽  
pp. e2259-e2270 ◽  
Author(s):  
Alice D. Lam ◽  
Rani A. Sarkis ◽  
Kyle R. Pellerin ◽  
Jin Jing ◽  
Barbara A. Dworetzky ◽  
...  
Keyword(s):  
Alzheimer Disease ◽  
Late Onset ◽  
Early Stage ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Cognitively Normal ◽  
Scalp Eeg ◽  
Epileptiform Discharges ◽  
Potential Biomarker ◽  
The Relationship

ObjectiveTo examine the relationship between scalp EEG biomarkers of hyperexcitability in Alzheimer disease (AD) and to determine how these electric biomarkers relate to the clinical expression of seizures in AD.MethodsIn this cross-sectional study, we performed 24-hour ambulatory scalp EEGs on 43 cognitively normal elderly healthy controls (HC), 41 participants with early-stage AD with no history or risk factors for epilepsy (AD-NoEp), and 15 participants with early-stage AD with late-onset epilepsy related to AD (AD-Ep). Two epileptologists blinded to diagnosis visually reviewed all EEGs and annotated all potential epileptiform abnormalities. A panel of 9 epileptologists blinded to diagnosis was then surveyed to generate a consensus interpretation of epileptiform abnormalities in each EEG.ResultsEpileptiform abnormalities were seen in 53% of AD-Ep, 22% of AD-NoEp, and 4.7% of HC. Specific features of epileptiform discharges, including high frequency, robust morphology, right temporal location, and occurrence during wakefulness and REM, were associated with clinical seizures in AD. Multiple EEG biomarkers concordantly demonstrated a pattern of left temporal lobe hyperexcitability in early stages of AD, whereas clinical seizures in AD were often associated with bitemporal hyperexcitability. Frequent small sharp spikes were specifically associated with epileptiform EEGs and thus identified as a potential biomarker of hyperexcitability in AD.ConclusionEpileptiform abnormalities are common in AD but not all equivalent. Specific features of epileptiform discharges are associated with clinical seizures in AD. Given the difficulty recognizing clinical seizures in AD, these EEG features could provide guidance on which patients with AD are at high risk for clinical seizures.

scholarly journals Effect of number of medications and use of potentially inappropriate medications on frailty among early-stage older outpatients

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuya Uragami ◽  
Kazuhiro Takikawa ◽  
Hajime Kareki ◽  
Koji Kimura ◽  
Kazuyuki Yamamoto ◽  
...  
Keyword(s):  
Early Stage ◽  
Linear Trend ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medications ◽  
Sectional Study ◽  
Antithrombotic Drugs ◽  
Cross Sectional ◽  
The Relationship ◽  
Inappropriate Medications ◽  
Frailty Score

Abstract Background Frailty is an urgent concern among an aging population worldwide. However, the relationship between frailty and number and types of medications has not been studied in detail among early-stage older patients, and it is unclear what prescriptions may have a role in preventing frailty. This study aimed to clarify the effects of number of medications and use of potentially inappropriate medications (PIMs) on frailty among early-stage older outpatients in Japan. Methods A cross-sectional study was undertaken. Frailty scores and medications of outpatients aged 65–74 years who regularly visited community pharmacies were investigated. Frailty scores were classified as 0 (non-frailty), 1–2 (pre-frailty), and ≥ 3 (frailty). The association between frailty and number of medications was analyzed by age and compared between PIM use and non-use groups. The proportion of patients who used PIMs was also analyzed by frailty score. Results Of 923 older outpatients, 49 (5.3%) and 318 (34.5%) patients had frailty and pre-frailty scores, respectively. The numbers of medications among patients with pre-frailty and frailty were significantly higher than among those with non-frailty (p <  0.001 for both). A similar increase was shown for PIM use groups aged 69–71 and 72–74 years, but not for the PIM use group aged 65–68 years and all groups without PIM use. An increasing linear trend was observed for the relationship between the proportion of patients who used any PIM, as well as some subcategories of PIMs (such as NSAIDs, benzodiazepines, loop diuretics and antithrombotic drugs) and frailty score. Conclusions Unnecessary medication use among early-stage older outpatients, especially patients aged ≥69 years who use PIMs and many medications, seems to be associated with frailty, but further research is needed to confirm these findings.

scholarly journals Relationship Between Expression of MAGE-A3 with The Histopathology in NSCLC Patients

2020 ◽  
Vol 40 (2) ◽  
pp. 112-118
Author(s):  
Mokhammad Mukhlis ◽  
Isnin Anang Marhana
Keyword(s):  
Lung Cancer ◽  
Tumor Antigens ◽  
Early Stage ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Exact Test ◽  
Pulmonary Surgery ◽  
Ct Antigens ◽  
Nsclc Patients ◽  
The Relationship

Backgrounds: Most patients with lung cancer was diagnosted in advanced stage (around 57%). Those diagnosed at early stage were only 15%. To increase the cure rate and life expectancy, lung cancer detection should be performed early. Melanoma-associated antigen 3 (MAGE-A3) is a testicular cancer antigen and is widely expressed in various types of tumor tissue. MAGE-A3 is expressed in about 35-40% of NSCLC. Previous research reported the expression of MAGE-A3 in lung cancer was 30-50%. To detect tumor antigens, CT antigens of the MAGE family can be detected through real time polymerase chain reaction (RT-PCR). This study aimed to analyze the relationship between MAGE A3 expression and histopathology type from forceps biopsy specimens in NSCLC patients. Methods: This study was a cross-sectional study conducted on 14 patients with lung cancer in September 2018 to February 2019. Subjects underwent force biopsy with guidance from bronchoscopy in the pulmonary surgery room Dr. Soetomo. The analysis used was the Fisher's exact test. Results: There were six subjects with histopathology type of adenocarcinoma (42.9%) and eight subjects (57.1%) with the histopathology of squamous cell carcinoma. Expression of MAGE-A3 was positive in 5 subjects (35.7%). Conclusions: There was no significant relationship between the expression of MAGE-A3 and the type of histopathology. (J Respir Indo. 2020; 40(2): 113-9)

scholarly journals Mild behavioral impairment is related to frailty in cognitively normal older adults: a cross-sectional study

2020 ◽  
Author(s):  
Shaoyi Fan ◽  
Ximin Liang ◽  
Tianchan Yun ◽  
Zhong Pei ◽  
Bin Hu ◽  
...  
Keyword(s):  
Older Adults ◽  
Logistic Regression ◽  
Neuropsychiatric Symptoms ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Multivariate Logistic Regression ◽  
Behavioral Impairment ◽  
Cross Sectional ◽  
Cognitively Normal ◽  
The Relationship

Abstract Background: Frailty and cognitive decline are highly prevalent among older adults. However, the relationship between frailty and mild behavioral impairment (MBI), a neurobehavioral syndrome characterized by later-life emergence of sustained neuropsychiatric symptoms, has yet to be elucidated.We aimed to evaluate the associations between mild behavioral impairment and frailty in cognitively normal older adults.Methods: This is a cross-sectional study. A consecutive series of 137 cognitively normal older adults in the Anti-Aging study, recruited from primary care clinics, were enrolled. Frailty was estimated using the original Fried phenotype. MBI was evaluated by the Mild Behavioral Impairment Checklist at a cut-off point of >8 (optimizing sensitivity and specificity), which was developed to assess emergent neuropsychiatric symptoms in accordance with the MBI criteria. Cognition was assessed with the Chinese versions of the Montreal Cognitive Assessment (MoCA-BC) and Mini-mental State Examination (MMSE). Multivariate logistic regression was performed to estimate the relationship between MBI and objective cognition with frailty status.Results: At baseline, 30.6% of the older adults had frailty, 35.0% had prefrailty and 18.2% had MBI (MBI+ status). Multivariate logistic regression analysis demonstrated that compared to MBI- status (without MBI), MBI+ was more likely to have frailty (odds ratio [OR] = 7.44, p = 0.02). The frailty and MBI categories were both significantly associated with both MMSE and MoCA-BC score (p<0.05).Conclusions: Both frailty and MBI status are related to higher risk of cognitive impairment. MBI is significantly associated with an increased risk of having frailty before overt cognitive impairment. This association merits further study to identify strategies to the early detection, prevention and therapeutic intervention of frailty.

scholarly journals Cerebrospinal Fluid Markers of Synaptic Injury and Functional Connectivity in Alzheimer Disease: Protocol for a Cross-Sectional Study (Preprint)

2019 ◽  
Author(s):  
Rawan Tarawneh
Keyword(s):  
Cerebrospinal Fluid ◽  
Semantic Memory ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Cognitively Normal ◽  
Default Mode ◽  
Csf Biomarker ◽  
The Relationship ◽  
Normal Controls

BACKGROUND Synaptic loss is the best surrogate for cognitive decline in Alzheimer disease (AD) and is more closely associated with cognitive function than amyloid or tau pathologies. Neurogranin (Ng) and synaptosome–associated protein-25 (SNAP-25) have demonstrated utility as cerebrospinal fluid (CSF) markers of synaptic injury in presymptomatic and symptomatic AD. While these synaptic markers have been shown to correlate with cognitive impairment and whole brain or regional atrophy in previous studies of AD, to our knowledge, the relationship between fluid markers of synaptic injury and functional brain imaging has not been previously investigated. OBJECTIVE The main objective of this study is to examine the relationship between CSF markers of synaptic injury (Ng and SNAP-25) and functional connectivity (FC) in the default mode and semantic memory networks in individuals with mild cognitive impairment (MCI) and mild dementia due to AD (Clinical Dementia Rating [CDR] 0.5-1) and cognitively normal controls (CDR 0), adjusting for age, gender, and the apolipoprotein E4 (APOE4) genotype. Secondary objectives include investigating the associations between CSF markers of amyloid and tau pathology (CSF tau, p-tau181, and Aβ42) and FC in the default mode and semantic memory networks in AD (CDR 0.5-1) and controls (CDR 0), adjusting for age, gender, and the APOE4 genotype. METHODS This is a cross-sectional study of individuals with MCI or mild dementia due to AD (CDR 0.5-1; n=20), and cognitively normal controls (CDR 0; n=20). Participants will undergo detailed clinical and neuropsychological assessments, CSF biomarker assessments (CSF Ng, SNAP-25, tau, p-tau181, and Aβ42 levels) and functional magnetic resonance imaging assessments, using a Siemens 3.0 Tesla Prisma scanner, during resting state and during the performance of a semantic memory task. All study procedures will be completed within 4 months of enrollment. Partial correlation analyses will examine associations of CSF biomarker measures with FC in the default mode and semantic memory networks in AD and controls. RESULTS This study was funded by the Chronic Brain Injury Discovery Themes of the Ohio State University College of Medicine. Study enrollment began in April 2018. Study procedures and data analysis are currently underway. Results are expected by December 2019. CONCLUSIONS Findings from this study will further support the utility of CSF Ng and SNAP-25 as markers of synaptic injury by examining their associations with functional alterations in cortical networks affected by early AD pathology. INTERNATIONAL REGISTERED REPOR DERR1-10.2196/14302

scholarly journals 2396

2017 ◽  
Vol 1 (S1) ◽  
pp. 37-37
Author(s):  
Sarah Youssof ◽  
Carol Romero-Clark
Keyword(s):  
Muscular Dystrophy ◽  
Disease Duration ◽  
Outcome Measure ◽  
Late Onset ◽  
Objective Measure ◽  
Cross Sectional Study ◽  
Barium Swallow ◽  
Cross Sectional ◽  
Study Population ◽  
The Relationship

OBJECTIVES/SPECIFIC AIMS: Oculopharyngeal muscular dystrophy (OPMD) is a rare, late-onset muscular dystrophy that causes severe swallowing impairment (dysphagia). Although promising therapies are in the pipeline, validated dysphagia outcome measures for use in OPMD trials have not been established. Videofluoroscopic swallow studies (VFSS) are considered the clinical gold standard for dysphagia assessment, yet the optimal objective measure of VFSS in OPMD is not known. Our aim was to investigate the utility of the Modified Barium Swallow Impairment Profile (MBSImP) as an objective measure of VFSS in OPMD patients. METHODS/STUDY POPULATION: This was a single-center, prospective, cross-sectional study. In total, 26 individuals with OPMD underwent VFSS and other measures of dysphagia including 50-mL water swallow time (ST). Validity was assessed by examining correlations with an OPMD Global Severity Score (GSS) and with dysphagia duration. RESULTS/ANTICIPATED RESULTS: The MBSImP demonstrated moderate correlations with GSS (Pearson r=0.52, p=0.006) and ST (r=0.39, p=0.049). The relationship between MBSImP and dysphagia duration appeared nonlinear, and levelled off with long dysphagia duration. In contrast, ST did not correlate significantly with GSS (r=0.27, p=0.18), nor with disease duration (r=0.05, p=0.83). DISCUSSION/SIGNIFICANCE OF IMPACT: Objective measurement of VFSS is a promising outcome measure in OPMD. With long disease duration, the MBSImP may not be sufficiently sensitive to detect disease progression. More sensitive measures for scoring dysphagia severity on VFSS should be explored for application to future s of OPMD.

scholarly journals Do Insurers Compete on the Federal Health Insurance Exchange?

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 25
Author(s):  
Jesse N. Cohen ◽  
Alexander Coppock ◽  
Arnab K. Ghosh ◽  
Benjamin P. Geisler
Keyword(s):  
Health Insurance ◽  
Affordable Care Act ◽  
Early Stage ◽  
Cross Sectional Study ◽  
Insurance Plan ◽  
Cross Sectional ◽  
Data Set ◽  
Insurance Premiums ◽  
The Relationship ◽  
Early Market

Background: On the U.S. Federal Health Insurance Exchange established by the Affordable Care Act, states with fewer insurers have higher insurance premiums than states with more insurers. This expected feature of a competitive market has not been studied within states, however. We tested the hypothesis that insurance premiums decrease in more competitive geographic rating areas within states in the U.S.A.Methodology/principle findings: This cross-sectional study utilized publicly available premiums from the Federal Health Insurance Exchange website, www.healthcare.gov. Univariate and multivariate analyses were used to model premiums based on the number of insurers in geographic rating areas. The relationship between premiums and the number of insurers competing in a geographic rating area was also calculated for each unique insurance plan offered on the exchange. The data set and statistical code used for this research is linked in the publication. We found that there was an unexpected, marginally positive relationship between average monthly premiums and the number of insurers in a geographic rating area (+$5.71 in monthly premiums per additional insurer, p<0.001). We also found that identical plans tend to be offered with marginally higher premiums in rating areas with more insurers (+$3.18 in monthly premiums per additional insurer, p=0.002), contrary to the relationship we expected from a competitive marketplace. The principle limitation of the study is that this unexpected relationship, which suggests a lack of competitiveness of this early market, could be due to unobserved confounding factors that influence pricing in more competitive rating areas.Conclusion: On the Federal Health Insurance Exchange, the price of insurance is higher in more competitive rating areas within states. This may be explained by lack of competition in this early stage market.

Coping Style as a Mediator of the Relationship Between Depressive Symptoms and Deliberate Self-Harm

Crisis ◽  
2011 ◽  
Vol 32 (5) ◽  
pp. 272-279 ◽  
Author(s):  
Allison S. Christian ◽  
Kristen M. McCabe
Keyword(s):  
Depressive Symptoms ◽  
Undergraduate Students ◽  
Cross Sectional Study ◽  
Self Report ◽  
Hierarchical Regression ◽  
Cross Sectional ◽  
Deliberate Self Harm ◽  
Self Blame ◽  
Self Harm ◽  
The Relationship

Background: Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH. Aims: The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students. Methods: 202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures. Results: A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant. Limitations: The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship. Conclusions: Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.

IDENTIFIKASI SERTA HUBUNGAN KONSTRUKSI SUMUR GALI TERHADAP KANDUNGAN COLIFORM PADA AIR SUMUR GALI DI DUSUN JIKEN KABUPATEN LOMBOK TIMUR

2019 ◽  
Vol 7 (2) ◽  
pp. 115
Author(s):  
Dini Yuliansari
Keyword(s):  
Cross Sectional Study ◽  
Coliform Bacteria ◽  
Well Water ◽  
Chi Square ◽  
Cross Sectional ◽  
Content Variable ◽  
Chi Square Test ◽  
Dug Wells ◽  
Dug Well ◽  
The Relationship

The well is one of the source water used for bathing, washing, and drinking by the citizens in Jiken Hamlet, Rarang Village, Terara Sub-District. Poor dug well construction conditions can affect the amount of coliform bacteria contained in the dug well water. The purpose of this study is to identify the construction of dug wells and the content of coliform bacteria in dug well water and determine the relationship between dug well construction and the content of coliform bacteria. This research is analytic with a cross sectional study design. The results were obtained from 11 samples of dug wells which were observed in construction and the coliform content was known that all samples did not requirements as good dug well construction. Coliform content test results showed that as many as 5 dug well water samples did not pass the clean water quality standards. The results of data analysis with the chi-square test variable construction of dug wells with coliform content variable  showed 0,172 > 0,05, then the concluded is the dug well not suitable to use by people in that area as a source of water for daily needs.

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