scholarly journals Driving and visual deficits in stroke patients

2018 ◽  
Vol 76 (2) ◽  
pp. 85-88 ◽  
Author(s):  
Marina Marcondes Braga ◽  
Renato Nickel ◽  
Marcos Lange ◽  
Élcio Juliato Piovesan
Keyword(s):  
High Risk ◽  
Visual Attention ◽  
Visual Processing ◽  
Moderate Risk ◽  
Interference Factor ◽  
Visual Deficits ◽  
Useful Field Of View ◽  
High Level ◽  
Safe Performance ◽  
Intention Group

ABSTRACT Objective: The aim of the present study was to conduct an exploratory assessment of visual impairment following stroke, and to discuss the possibilities of reintroducing patients to the activity of driving. Methods: The Useful Field of View test was used to assess visual processing and visual attention. Results: A total of 18 patients were included in the study, and were assigned to either the drive group (n = 9) or the intention group (n = 9). In the drive group, one patient was categorized as moderate-to-high risk; whereas, in the intention group, one patient was categorized as low-to-moderate risk. Additionally, two patients in the intention group were categorized as high risk. The patients did not perceive their visual deficits as a limitation. Conclusion: Visual attention is an interference factor in terms of the safe performance of driving after a stroke. All patients showed a high level of interest for the independence provided through being able to drive.

scholarly journals Prevalence of obesity and need for screening using tools like Indian Diabetes Risk Scale in Diabetes prevention among medical students

2020 ◽  
Vol 32 (2) ◽  
pp. 348-353
Author(s):  
Vikrant Prabhakar ◽  
Amrit Virk ◽  
Parmal Singh
Keyword(s):  
Medical Students ◽  
High Risk ◽  
Risk Group ◽  
Work Conditions ◽  
High Risk Group ◽  
Low Risk ◽  
Moderate Risk ◽  
Validated Questionnaire ◽  
High Level ◽  
Lifestyle Diseases

Introduction: The prevalence of lifestyle diseases in increasing throughout the world. They are increasingly taking over communicable diseases as the major cause of morbidity and mortality. Medical students usually have sedentary lifestyle coupled with high level of stress, owing to academic requirements. Hence, they are at a much higher risk of developing lifestyle diseases. Materials and Methods: Study subjects were administered a validated questionnaire to collect information related with the components of IDRS. Based on the score, they were divided into high risk, moderate risk and low risk. Data was analysed using the SPSS version 21. Result: Half of all the students were in the moderate risk group. The rest was distributed among low risk (17.33 %) and high risk (27.33%). Among those with low risk of developing T2DM, 73% were males, whereas females constituted 70.7% of those with high risk of developing T2DM. The association of developing T2DM was also highly significant with obesity. Statistically significant association of high T2DM risk were found with gender being female, family history of T2DM and BMI≥23 Kg/m2 Conclusion: IDRS has been shown to be an effective tool for screening populations. Hence, regular programs with IDRS along with blood sugar and lipid profile of moderate and high risk group along with stress management can be effective in supporting medical students to cope with demanding study and work conditions among medical students and doctors.

Isolating Risk Factors for Crash Frequency among Older Drivers

1993 ◽  
Vol 37 (2) ◽  
pp. 211-214 ◽  
Author(s):  
Karlene Ball ◽  
Cynthia Owsley ◽  
Daniel Roenker ◽  
Michael Sloane
Keyword(s):  
Visual Attention ◽  
Visual Processing ◽  
Adult Population ◽  
The Elderly ◽  
Cognitive Status ◽  
Older Drivers ◽  
Sensory Function ◽  
Field Of View ◽  
Useful Field Of View ◽  
Age Related

By the year 2024, 25% of drivers in the U.S. will be over the age of 65. Older drivers have more crashes and fatalities per mile driven than any other adult age group. Although driving is a highly visual task and vision impairment is more prevalent in the elderly, previous research has failed to identify visual factors which are strongly associated with increased crashes in the elderly. Using a comprehensive approach to assess several aspects of visual processing in a large sample of older drivers, this study has identified a measure of visual attention that had high sensitivity (89%) and specificity (85%) in predicting which older drivers had a history of crash problems, a level of predictability unprecedented in research on crash risk in older drivers. The “useful field of view”, as it is called, measures the spatial area within which an individual can be rapidly alerted to visual stimuli. Older adults with substantial shrinkage in the useful field of view were six times more likely to have incurred one or more crashes in the previous five year period. By comparison, visual sensory function, cognitive status, and chronological age were poor predictors of crash involvement. This study suggests that policies which restrict driving privileges based solely on age or on stereotypes of age-related declines in vision and cognition are scientifically unfounded. With the identification of a visual attention measure highly predictive of crash problems in the elderly, decisions on the suitability of licensure in the older adult population can be based on objective, visual-performance-based criteria.

scholarly journals A Peri-Implant Disease Risk Score for Patients with Dental Implants: Validation and the Influence of the Interval between Maintenance Appointments

2019 ◽  
Vol 8 (2) ◽  
pp. 252 ◽  
Author(s):  
Miguel de Araújo Nobre ◽  
Francisco Salvado ◽  
Paulo Nogueira ◽  
Evangelista Rocha ◽  
Peter Ilg ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Score ◽  
Disease Risk ◽  
Disease Incidence ◽  
Risk Groups ◽  
Risk Profile ◽  
Moderate Risk ◽  
C Statistic ◽  
Disease Risk Score ◽  
Very High

Background: There is a need for tools that provide prediction of peri-implant disease. The purpose of this study was to validate a risk score for peri-implant disease and to assess the influence of the recall regimen in disease incidence based on a five-year retrospective cohort. Methods: Three hundred and fifty-three patients with 1238 implants were observed. A risk score was calculated from eight predictors and risk groups were established. Relative risk (RR) was estimated using logistic regression, and the c-statistic was calculated. The effect/impact of the recall regimen (≤ six months; > six months) on the incidence of peri-implant disease was evaluated for a subset of cases and matched controls. The RR and the proportional attributable risk (PAR) were estimated. Results: At baseline, patients fell into the following risk profiles: low-risk (n = 102, 28.9%), moderate-risk (n = 68, 19.3%), high-risk (n = 77, 21.8%), and very high-risk (n = 106, 30%). The incidence of peri-implant disease over five years was 24.1% (n = 85 patients). The RR for the risk groups was 5.52 (c-statistic = 0.858). The RR for a longer recall regimen was 1.06, corresponding to a PAR of 5.87%. Conclusions: The risk score for estimating peri-implant disease was validated and showed very good performance. Maintenance appointments of < six months or > six months did not influence the incidence of peri-implant disease when considering the matching of cases and controls by risk profile.

scholarly journals Proposal for the use of echocardiography in bloodstream infections due to different streptococcal species

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sandra Chamat-Hedemand ◽  
Niels Eske Bruun ◽  
Lauge Østergaard ◽  
Magnus Arpi ◽  
Emil Fosbøl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Risk Factor ◽  
High Risk ◽  
Blood Culture ◽  
Positive Blood Culture ◽  
Bloodstream Infections ◽  
Low Risk ◽  
Moderate Risk ◽  
Streptococcal Species ◽  
Very High

Abstract Background Infective endocarditis (IE) is diagnosed in 7–8% of streptococcal bloodstream infections (BSIs), yet it is unclear when to perform transthoracic (TTE) and transoesophageal echocardiography (TOE) according to different streptococcal species. The aim of this sub-study was to propose a flowchart for the use of echocardiography in streptococcal BSIs. Methods In a population-based setup, we investigated all patients admitted with streptococcal BSIs and crosslinked data with nationwide registries to identify comorbidities and concomitant hospitalization with IE. Streptococcal species were divided in four groups based on the crude risk of being diagnosed with IE (low-risk < 3%, moderate-risk 3–10%, high-risk 10–30% and very high-risk > 30%). Based on number of positive blood culture (BC) bottles and IE risk factors (prosthetic valve, previous IE, native valve disease, and cardiac device), we further stratified cases according to probability of concomitant IE diagnosis to create a flowchart suggesting TTE plus TOE (IE > 10%), TTE (IE 3–10%), or “wait & see” (IE < 3%). Results We included 6393 cases with streptococcal BSIs (mean age 68.1 years [SD 16.2], 52.8% men). BSIs with low-risk streptococci (S. pneumoniae, S. pyogenes, S. intermedius) are not initially recommended echocardiography, unless they have ≥3 positive BC bottles and an IE risk factor. Moderate-risk streptococci (S. agalactiae, S. anginosus, S. constellatus, S. dysgalactiae, S. salivarius, S. thermophilus) are guided to “wait & see” strategy if they neither have a risk factor nor ≥3 positive BC bottles, while a TTE is recommended if they have either ≥3 positive BC bottles or a risk factor. Further, a TTE and TOE are recommended if they present with both. High-risk streptococci (S. mitis/oralis, S. parasanguinis, G. adiacens) are directed to a TTE if they neither have a risk factor nor ≥3 positive BC bottles, but to TTE and TOE if they have either ≥3 positive BC bottles or a risk factor. Very high-risk streptococci (S. gordonii, S. gallolyticus, S. mutans, S. sanguinis) are guided directly to TTE and TOE due to a high baseline IE prevalence. Conclusion In addition to the clinical picture, this flowchart based on streptococcal species, number of positive blood culture bottles, and risk factors, can help guide the use of echocardiography in streptococcal bloodstream infections. Since echocardiography results are not available the findings should be confirmed prospectively with the use of systematic echocardiography.

scholarly journals Visuopathy of prematurity: is retinopathy just the tip of the iceberg?

2021 ◽  
Author(s):  
Sigrid Hegna Ingvaldsen ◽  
Tora Sund Morken ◽  
Dordi Austeng ◽  
Olaf Dammann
Keyword(s):  
Visual Processing ◽  
Structural Changes ◽  
Developmental Trajectories ◽  
Visual Pathway ◽  
Visual Stream ◽  
Visual Deficits ◽  
Cortical Areas ◽  
Cellular Architecture ◽  
Increased Risk ◽  
Dorsal Visual Stream

AbstractResearch on retinopathy of prematurity (ROP) focuses mainly on the abnormal vascularization patterns that are directly visible for ophthalmologists. However, recent findings indicate that children born prematurely also exhibit changes in the retinal cellular architecture and along the dorsal visual stream, such as structural changes between and within cortical areas. Moreover, perinatal sustained systemic inflammation (SSI) is associated with an increased risk for ROP and the visual deficits that follow. In this paper, we propose that ROP might just be the tip of an iceberg we call visuopathy of prematurity (VOP). The VOP paradigm comprises abnormal vascularization of the retina, alterations in retinal cellular architecture, choroidal degeneration, and abnormalities in the visual pathway, including cortical areas. Furthermore, VOP itself might influence the developmental trajectories of cerebral structures and functions deemed responsible for visual processing, thereby explaining visual deficits among children born preterm.

The Preventive Effect of Alprostadil on the Contrast-Induced Nephropathy of Coronary Heart Disease Treated by Percutaneous Coronary Intervention in Moderate and High-Risk Population Stratified by Mehran Score

Angiology ◽  
2021 ◽  
pp. 000331972110155
Author(s):  
Xiaogang Liu ◽  
Peng Zhang ◽  
Jing Zhang ◽  
Xue Zhang ◽  
Shicheng Yang ◽  
...  
Keyword(s):  
Coronary Heart Disease ◽  
Percutaneous Coronary Intervention ◽  
Heart Disease ◽  
High Risk ◽  
Risk Groups ◽  
Coronary Intervention ◽  
Preventive Effect ◽  
Moderate Risk ◽  
Contrast Induced Nephropathy ◽  
Percutaneous Coronary

The Mehran risk score (MRS) was used to classify patients with coronary heart disease and evaluate the preventive effect of alprostadil on contrast-induced nephropathy (CIN) after percutaneous coronary intervention. The patients (n = 1146) were randomized into an alprostadil and control group and then divided into 3 groups on the basis of the MRS: low-risk, moderate-risk, and high-risk groups. The primary end point was the occurrence of CIN (alprostadil + hydration vs simple hydration treatment); secondary end points included serum creatinine, blood urea nitrogen, creatinine clearance rate, cystatin C, interleukin-6, C-reactive protein, proteinuria, and differences in the incidence of major adverse events. In the low-risk, moderate-risk, and high-risk groups, the incidence of CIN in the control and alprostadil group was 2.9 versus 2.6% ( P = .832), 11.4 versus 4.9% ( P = .030), 19.1 versus 7.7% ( P = .041), respectively. Multivariate logistic regression analysis showed that alprostadil treatment was a favorable protective factor for moderate-risk and high-risk CIN patients (OR = 0.343, 95% CI: 0.124-0.951, P = .040). Alprostadil can be used as a preventive treatment for moderate- and high-risk CIN patients classified by the MRS. The reduction of CIN by alprostadil may be related to an anti-inflammatory effect.

scholarly journals Sustained Splits of Attention within versus across Visual Hemifields Produce Distinct Spatial Gain Profiles

2016 ◽  
Vol 28 (1) ◽  
pp. 111-124 ◽  
Author(s):  
Sabrina Walter ◽  
Christian Keitel ◽  
Matthias M. Müller
Keyword(s):  
Visual Attention ◽  
Visual Processing ◽  
Behavioral Performance ◽  
Lower Visual Field ◽  
Light Emitting ◽  
Visual Hemifield ◽  
Attention Tasks ◽  
Visual Cortices ◽  
Cortical Visual Processing ◽  
Visual Hemifields

Visual attention can be focused concurrently on two stimuli at noncontiguous locations while intermediate stimuli remain ignored. Nevertheless, behavioral performance in multifocal attention tasks falters when attended stimuli fall within one visual hemifield as opposed to when they are distributed across left and right hemifields. This “different-hemifield advantage” has been ascribed to largely independent processing capacities of each cerebral hemisphere in early visual cortices. Here, we investigated how this advantage influences the sustained division of spatial attention. We presented six isoeccentric light-emitting diodes (LEDs) in the lower visual field, each flickering at a different frequency. Participants attended to two LEDs that were spatially separated by an intermediate LED and responded to synchronous events at to-be-attended LEDs. Task-relevant pairs of LEDs were either located in the same hemifield (“within-hemifield” conditions) or separated by the vertical meridian (“across-hemifield” conditions). Flicker-driven brain oscillations, steady-state visual evoked potentials (SSVEPs), indexed the allocation of attention to individual LEDs. Both behavioral performance and SSVEPs indicated enhanced processing of attended LED pairs during “across-hemifield” relative to “within-hemifield” conditions. Moreover, SSVEPs demonstrated effective filtering of intermediate stimuli in “across-hemifield” condition only. Thus, despite identical physical distances between LEDs of attended pairs, the spatial profiles of gain effects differed profoundly between “across-hemifield” and “within-hemifield” conditions. These findings corroborate that early cortical visual processing stages rely on hemisphere-specific processing capacities and highlight their limiting role in the concurrent allocation of visual attention to multiple locations.

scholarly journals Nutritional and Functional Assessment of Hospitalized Elderly: Impact of Sociodemographic Variables

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Emam M. M. Esmayel ◽  
Mohsen M. Eldarawy ◽  
Mohamed M. M. Hassan ◽  
Hassan Mahmoud Hassanin ◽  
Walid M. Reda Ashour ◽  
...  
Keyword(s):  
High Risk ◽  
Functional Status ◽  
Low Income ◽  
Barthel Index ◽  
Nutritional Risk ◽  
Moderate Risk ◽  
Sociodemographic Variables ◽  
Hospitalized Elderly ◽  
Ward Nurse ◽  
Good Nutrition

Background.This work was constructed in order to assess the nutritional and functional status in hospitalized elderly and to study the associations between them and sociodemographic variables.Methods.200 elderly patients (>65 years old) admitted to Internal Medicine and Neurology Departments in nonemergency conditions were included. Comprehensive geriatric assessments, including nutritional and functional assessments, were done according to nutritional checklist and Barthel index, respectively. Information was gathered from the patients, from the ward nurse responsible for the patient, and from family members who were reviewed.Results.According to the nutritional checklist, 56% of participants were at high risk, 18% were at moderate risk of malnutrition, and 26% had good nutrition. There was a high nutritional risk in patients with low income and good nutrition in patients with moderate income. Also, there was a high nutritional risk in rural residents (61.9%) in comparison with urban residents (25%). Barthel index score was significantly lower in those at high risk of malnutrition compared to those at moderate risk and those with good nutrition.Conclusions.Hospitalized elderly are exposed to malnutrition, and malnourished hospitalized patients are candidates for functional impairment. Significant associations are noticed between both nutritional and functional status and specific sociodemographic variables.

scholarly journals The Rapid Extraction of Gist—Early Neural Correlates of High-level Visual Processing

2012 ◽  
Vol 24 (2) ◽  
pp. 521-529 ◽  
Author(s):  
Frank Oppermann ◽  
Uwe Hassler ◽  
Jörg D. Jescheniak ◽  
Thomas Gruber
Keyword(s):  
Visual Processing ◽  
Time Course ◽  
Occipital Cortex ◽  
Stimulus Onset ◽  
Gamma Band ◽  
Oscillatory Activity ◽  
Rapid Extraction ◽  
The Right ◽  
High Level ◽  
Individual Objects

The human cognitive system is highly efficient in extracting information from our visual environment. This efficiency is based on acquired knowledge that guides our attention toward relevant events and promotes the recognition of individual objects as they appear in visual scenes. The experience-based representation of such knowledge contains not only information about the individual objects but also about relations between them, such as the typical context in which individual objects co-occur. The present EEG study aimed at exploring the availability of such relational knowledge in the time course of visual scene processing, using oscillatory evoked gamma-band responses as a neural correlate for a currently activated cortical stimulus representation. Participants decided whether two simultaneously presented objects were conceptually coherent (e.g., mouse–cheese) or not (e.g., crown–mushroom). We obtained increased evoked gamma-band responses for coherent scenes compared with incoherent scenes beginning as early as 70 msec after stimulus onset within a distributed cortical network, including the right temporal, the right frontal, and the bilateral occipital cortex. This finding provides empirical evidence for the functional importance of evoked oscillatory activity in high-level vision beyond the visual cortex and, thus, gives new insights into the functional relevance of neuronal interactions. It also indicates the very early availability of experience-based knowledge that might be regarded as a fundamental mechanism for the rapid extraction of the gist of a scene.

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