WorldWideScience

Sample records for chronic cognitive sequelae

  1. Chronic otitis media sequelae in skeletal material from medieval Denmark

    DEFF Research Database (Denmark)

    Qvist, M; Grøntved, A M

    2001-01-01

    OBJECTIVES: Chronic otitis media sequelae (COMS) have been identified in archaeological skeletal materials from various ages. COMS reflecting episodes of upper respiratory tract infection may be used as a paleopathological indicator of general health. Estimation of the frequency of COMS may...

  2. Chronic pain and other sequelae in long-term breast cancer survivors: Nationwide survey in Denmark

    DEFF Research Database (Denmark)

    Peuckmann, V.; Ekholm, O.; Rasmussen, N.K.

    2008-01-01

    Cooperative Group register, which is representative regarding long-term BCS in Denmark. Assessment: Self-administered questionnaire including questions on sociodemography, chronic pain (>= 6 months), health-related quality Of life (HRQOL) and other sequelae related to breast cancer. Associations...... were radiotherapy and younger age. Future research should therefore prioritize sequelae prevention. (C) 2008 European Federation of Chapters of the International Association for the Study of Pain. Published by Elsevier Ltd. All rights reserved Udgivelsesdato: 2009/5...

  3. Long-term cognitive sequelae of antenatal maternal anxiety: involvement of the orbitofrontal cortex.

    Science.gov (United States)

    Mennes, Maarten; Stiers, Peter; Lagae, Lieven; Van den Bergh, Bea

    2006-01-01

    Anxiety and stress experienced by the mother during pregnancy are reported to have a negative association with the cognitive development of the child. An integration of recent evidence from cognitive reaction time tasks pointed to a deficit in endogenous response inhibition, a function ascribed to prefrontal cortex. To further delineate the cognitive sequelae associated with antenatal maternal anxiety, we reviewed recent neuro-imaging literature to create a cortical map of regions commonly and selectively activated by well-known cognitive tasks. The pragmatic value of this cortical map was tested in a follow-up sample of 49 17-year old adolescents. Adolescents of mothers with high levels of anxiety during week 12-22 of their pregnancy performed significantly lower in tasks which required integration and control of different task parameters. Working memory, inhibition of a prepotent response, and visual orienting of attention were not impaired. Based on the established cortical map, these results were related to subtle developmental aberrations in a part of, or in cortical and sub-cortical regions linked to, the orbitofrontal cortex.

  4. Magnetic resonance imaging of sequelae of central pontine myelinolysis in chronic alcohol abusers

    Energy Technology Data Exchange (ETDEWEB)

    Uchino, Akira; Kudo, Sho [Department of Radiology, Saga Medical School, 5-1-1 Nabeshima, 849-8501, Saga (Japan); Yuzuriha, Takefumi; Murakami, Masaru; Endoh, Koichi; Hiejima, Shigeto; Koga, Hiroshi [Center for Emotional and Behavional Disorders, Hizen National Hospital, 160 Mitsu, Higashisefuri, Kanzaki, 842-0192, Saga (Japan)

    2003-12-01

    Central pontine myelinolysis (CPM) is one of the serious neurological complications of alcoholism. This study evaluated magnetic resonance images of sequelae of CPM. Approximately 600 alcoholic patients were examined by a 1.0-T magnetic resonance imaging device, and 11 patients were retrospectively found to have a central pontine lesion, a presumed sequela of CPM. The lesions had various shapes and most were cavitary. In 3 of the 11 patients bilateral symmetrical oval lesions were faintly visible in the middle cerebellar peduncles. These middle cerebellar peduncular lesions were diagnosed as having Wallerian degeneration of the pontocerebellar tract secondary to CPM. (orig.)

  5. Neural and socio-cognitive sequelae of congenital visual impairment during midchildhood

    OpenAIRE

    Bathelt, J. M. C.

    2015-01-01

    Previous studies identified cognitive difficulties in individuals with congenital visual impairment that significantly impacted on wellbeing and educational attainment. However, factors leading to adverse outcome remained unclear. The current study aimed to identify associations and mechanisms of specific cognitive deficits associated with visual impairment from a neurodevelopmental perspective. Based on recent theoretical advances (Johnson, 2011), it was assumed that visual impairment leads ...

  6. Type 2 diabetes and cognition: Neuropsychological sequelae of vascular risk factors in the ageing brain

    OpenAIRE

    Van Den Berg, E.

    2009-01-01

    Type 2 diabetes mellitus (T2DM) is associated with slowly progressive changes in the brain, a complication referred to as diabetic encephalopathy. Previous studies have shown that patients with T2DM show mild to moderate decrements in cognitive functioning and an increased risk of dementia. The central topic of the studies in this thesis was to examine at which stage of the diabetes these cognitive decrements start to develop and how they progress over time. In addition, the role of exposure ...

  7. Comparative Study of the Cognitive Sequelae of School-Aged Victims of Shaken Baby Syndrome

    Science.gov (United States)

    Stipanicic, Annie; Nolin, Pierre; Fortin, Gilles; Gobeil, M. F.

    2008-01-01

    Objective: Shaken Baby Syndrome (SBS) is now recognized as being the main cause of severe traumatic brain injury in infancy. However, our understanding of the impact of this type of abuse on child development remains sketchy. The main objective of the current study was therefore to shed light on the cognitive dysfunctions that are particular to…

  8. Gestational Diabetes: Long-Term Central Nervous System Developmental and Cognitive Sequelae.

    Science.gov (United States)

    Perna, Robert; Loughan, Ashlee R; Le, Jessica; Tyson, Kelly

    2015-01-01

    Gestational diabetes is a common complication of pregnancy and occurs in approximately 7% of all pregnancies. It has been associated with an increased rate of congenital anomalies including disturbances of intrauterine growth, delayed brain maturity, and neurobehavioral abnormalities in the offspring. The resulting maternal and fetal metabolic dysfunction leads to diminished iron stores (which can affect red blood cell [RBC] production and subsequent organogenesis), a metabolism-placental perfusion mismatch, increased FFA, increased lactic acidosis, and potential hypoxia. Though most newborns born in the context of gestational diabetes are not significantly affected by it, empirical research suggests gestational diabetes has been associated with lower general intelligence, language impairments, attention weaknesses, impulsivity, and behavioral problems. In extreme cases, it may essentially function as a gestational brain insult. Children who are exposed to poorly controlled gestational diabetes may benefit from some form of tracking or follow-up assessments. Additionally, clinicians evaluating children with developmental learning or cognitive dysfunction may want to seek appropriate gestational diabetes-related information from the parents. A greater understanding of this significant gestational risk may help foster improved prenatal diabetes management and may help reduce the neurodevelopmental effects of gestational diabetes.

  9. Chronic stress, cognitive functioning and mental health.

    Science.gov (United States)

    Marin, Marie-France; Lord, Catherine; Andrews, Julie; Juster, Robert-Paul; Sindi, Shireen; Arsenault-Lapierre, Geneviève; Fiocco, Alexandra J; Lupien, Sonia J

    2011-11-01

    This review aims to discuss the evidence supporting the link between chronic stress, cognitive function and mental health. Over the years, the associations between these concepts have been investigated in different populations. This review summarizes the findings that have emerged from older populations as well as from populations suffering from pathological aging, namely Mild Cognitive Impairment and Alzheimer's Disease. Although older adults are an interesting population to study in terms of chronic stress, other stress-related diseases can occur throughout the lifespan. The second section covers some of these stress-related diseases that have recently received a great deal of attention, namely burnout, depression, and post-traumatic stress disorder. Given that chronic stress contributes to the development of certain pathologies by accelerating and/or exacerbating pre-existing vulnerabilities that vary from one individual to the other, the final section summarizes data obtained on potential variables contributing to the association between chronic stress and cognition.

  10. Neurodegenerative Properties of Chronic Pain: Cognitive Decline in Patients with Chronic Pancreatitis

    NARCIS (Netherlands)

    Jongsma, M.L.A.; Postma, S.A.E.; Souren, P.M.; Arns, M.W.; Gordon, E.; Vissers, K.C.P.; Wilder-Smith, O.H.G.; Rijn, C.M. van; Goor, H. van

    2011-01-01

    Chronic pain has been associated with impaired cognitive function. We examined cognitive performance in patients with severe chronic pancreatitis pain. We explored the following factors for their contribution to observed cognitive deficits: pain duration, comorbidity (depression, sleep disturbance),

  11. Cognitive function in patients with chronic pain treated with opioids

    DEFF Research Database (Denmark)

    Kurita, G P; de Mattos Pimenta, C A; Braga, P E;

    2012-01-01

    The paucity of studies regarding cognitive function in patients with chronic pain, and growing evidence regarding the cognitive effects of pain and opioids on cognitive function prompted us to assess cognition via neuropsychological measurement in patients with chronic non-cancer pain treated...... with opioids....

  12. Cognitive behavior therapy for chronic insomnia.

    Science.gov (United States)

    Smith, Michael T; Neubauer, David N

    2003-01-01

    Approximately 20% of patients presenting in general medical settings have severe and persistent insomnia. Studies consistently find that trouble initiating and maintaining sleep are independent risk factors for medical and psychiatric morbidity, but insomnia is often underdetected and undertreated in primary care settings. Cognitive-behavioral treatment approaches for chronic insomnia and related sleep disorders have been shown to be effective in various patient populations. This article reviews the most common cognitive-behavioral interventions for insomnia, and discusses their efficacy and durability. Possible adaptations for the integration of these approaches into primary care settings and a description of the emerging field of behavioral sleep medicine as a resource for health care providers treating patients with chronic insomnia are also presented.

  13. Cognitive impairment in human chronic Chagas' disease

    Directory of Open Access Journals (Sweden)

    C.A. Mangone

    1994-06-01

    Full Text Available We proposed to investigate subclinical cognitive impairment secondary to chronic Chagas' disease (CCD. No similar study was previously done. The neuropsychological performance of 45 chronic Chagasic patients and 26 matched controls (age, education place and years of residency in endemic area was compared using the Mini Mental State Exam (MMSE, Weschler Memory Scale (WMS and the Weschler Adult Intelligent Scale (WAIS. Non-parametric tests and Chi2 were used to compare group means and multivariate statistics in two way frequency tables for measures of independence and association of categorical variables with the disease. Results: Chagasic patients showed lower MMSE scores (p<004, poor orientation (p<.004, and attention (p<.007. Lower WMS MQ were associated with CCD (Chi2 5.9; p<.01; Fisher test p<.02. Lower WAIS IQ were associated with CCD (Chi2 6.3, p<.01; Fisher test p<.01 being the digit symbol (p<.03, picture completion (p<.03, picture arrangement (p<.01 and object assembly (p<.03 subtests the most affected. The impairment in non-verbal reasoning, speed of information processing, problem solving, learning and sequencing observed in chronic Chagas disease patients resembles the cognitive dysfunction associated with white matter disease.

  14. Treatment of Chronic Anger Through Cognitive and Relaxation Controls

    Science.gov (United States)

    Novaco, Raymond W.

    1976-01-01

    The study examined the extent to which cognitive self-control processes and relaxation techniques could be therapeutically applied to chronic anger problems. The cognitive treatment was implemented by self-instruction procedures. The cognitive coping procedures involved the use of self-statements for the management of anger and cognitive…

  15. Aspergilosis necrotizante crónica en un paciente con secuelas de tuberculosis pulmonar Chronic necrotizing aspergillosis in a patient with pulmonary tuberculosis sequelae

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    Alcides Zambrano F

    2007-03-01

    Full Text Available Aspergillus fumigatus puede causar diferentes patologías en el ser humano: aspergiloma, aspergilosis broncopulmonar alérgica, aspergilosis necrotizante crónica, aspergilosis invasora. En la aspergilosis necrotizante crónica hay invasión local del parénquima y destrucción. A diferencia de la aspergilosis invasora no invade vasos sanguíneos ni se disemina a otros órganos. La aspergilosis necrotizante crónica se presenta en pacientes de edad media o ancianos con patología pulmonar previa: EPOC, secuelas de tuberculosis, resección pulmonar, neumoconiosis, radioterapia, infarto pulmonar o sarcoidosis. La clínica es indolente e inespecífica, con fiebre, tos, expectoración y baja de peso. Se desconoce la incidencia de aspergilosis necrotizante crónica en nuestro medio. La aspergilosis necrotizante crónica es potencialmente fatal, por lo que requiere de un diagnóstico y tratamiento oportuno. Creemos que, debe considerarse esta entidad ante un cuadro consuntivo y febril prolongado, en pacientes con enfermedades predisponentes que producen una leve baja de la inmunidad. Describimos el caso de un paciente atendido en el Instituto Nacional del TóraxAspergillus fumigatus is the causative agent of differents pathologies in the human being: aspergilloma, allergic bronchopulmonary aspergillosis, chronic necrotizing aspergillosis and invasive aspergillosis. In chronic necrotizing aspergillosis there is local invasion of the lung tissue and parenchyma destruction. Chronic necrotizing aspergillosis is different from invasive aspergillosis, because the abscence of vascular invasion or dissemination. Chronic necrotizing aspergillosis is seen in middle-aged and elderly with underlying lung diseases: COPD, tuberculosis sequelae, lung resection, pneumoconiosis, radiotherapy, lung infarction or sarcoidosis. Clinical manifestations are non specific, being the most usual fever, cough, sputum production and weight loss. Incidence of chronic necrotizing

  16. Effects of “Danzhi Decoction” on Chronic Pelvic Pain, Hemodynamics, and Proinflammatory Factors in the Murine Model of Sequelae of Pelvic Inflammatory Disease

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    Xiaoling Bu

    2015-01-01

    Full Text Available Objective. To evaluate the effect of Danzhi decoction (DZD on chronic pelvic pain (CPP, hemodynamics, and proinflammatory factors of sequelae of pelvic inflammatory diseases (SPID in murine model. Methods. SPID mice were randomly treated with high-dose DZD, mid-dose DZD, low-dose DZD, aspirin, and vehicle for 3 estrous circles. The Mouse Grimace Scale (MGS was performed to evaluate CPP; blood flows of the upper genital tract, pelvic wall, and mesentery were used to assess hemodynamics in SPID mice; expressions of vascular endothelial growth factor (VEGF, angiopoietin-2 (Ang-2, and osteopontin (OPN were measured by Western blot and immunochemistry. Results. Treatment with dose-dependent DZD significantly decreased the MGS scores, accelerated blood flows of the pelvis, and reduced expressions of VEGF, Ang-2, and OPN in the upper genital tract. Conclusions and Discussions. DZD was effective in relieving CPP and improving hemodynamics of the pelvic blood-stasis microenvironment in SPID mice. There was a relationship between CPP and the pelvic blood-stasis microenvironment. Furthermore, DZD might play a positive role in the anti-inflammatory process.

  17. Neurodegenerative properties of chronic pain: cognitive decline in patients with chronic pancreatitis.

    Directory of Open Access Journals (Sweden)

    Marijtje L A Jongsma

    Full Text Available Chronic pain has been associated with impaired cognitive function. We examined cognitive performance in patients with severe chronic pancreatitis pain. We explored the following factors for their contribution to observed cognitive deficits: pain duration, comorbidity (depression, sleep disturbance, use of opioids, and premorbid alcohol abuse. The cognitive profiles of 16 patients with severe pain due to chronic pancreatitis were determined using an extensive neuropsychological test battery. Data from three cognitive domains (psychomotor performance, memory, executive functions were compared to data from healthy controls matched for age, gender and education. Multivariate multilevel analysis of the data showed decreased test scores in patients with chronic pancreatitis pain in different cognitive domains. Psychomotor performance and executive functions showed the most prominent decline. Interestingly, pain duration appeared to be the strongest predictor for observed cognitive decline. Depressive symptoms, sleep disturbance, opioid use and history of alcohol abuse provided additional explanations for the observed cognitive decline in some of the tests, but to a lesser extent than pain duration. The negative effect of pain duration on cognitive performance is compatible with the theory of neurodegenerative properties of chronic pain. Therefore, early and effective therapeutic interventions might reduce or prevent decline in cognitive performance, thereby improving outcomes and quality of life in these patients.

  18. Cognitive processes in comorbid poor sleep and chronic pain.

    Science.gov (United States)

    Byers, Haley D; Lichstein, Kenneth L; Thorn, Beverly E

    2016-04-01

    We examined the unique and shared contributions of pain catastrophizing, cognitive pre-sleep arousal, and somatic pre-sleep arousal, to the prediction of insomnia severity in chronic pain. Forty-eight adults with chronic pain completed self-report measures of these study variables, health, and mood. Hierarchical regression showed that pain catastrophizing accounted for unique variance in insomnia severity, independent of pain intensity, depression, restless legs symptoms, and demographics. However, when cognitive and somatic pre-sleep arousal were also taken into account, the significance of cognitive pre-sleep arousal rendered pain catastrophizing non-significant. We identify research and clinical implications of this study.

  19. Vascular cognitive impairments in chronic kidney disease

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    I. V. Rogova

    2015-01-01

    Full Text Available Objective: to study the specific features of development of cognitive impairments (CIs, the role of traditional cardiovascular risk factors and renal failure-induced factors in patients with Stages I–IV chronic kidney disease (CKD and to assess an association of CIs with the signs of vascular wall remodeling in them. Patients and methods. Fifty-one patients aged 53±10 years with CKD were examined. Among them, there were 20 patients with Stages I–II CKD: a glomerular filtration rate (GFR of і60 ml/min/1.73 m2, signs of renal lesion; 20 with Stages III CKD: a GFR of <60–30 ml/min/1.73 m2, and 11 with Stages VI CKD: a GFR of <30–15 ml/min/1.73 m2. Results and discussion. CIs were more common in the patients with Stages III–IV than in those with Stages I–II, as shown by the scores of the mini-mental state examination (p<0.001, the frontal assessment battery (p=0.001, and the regulatory function test (p<0.001. These tests showed that the magnitude of CIs increased with the higher stage of CKD. Stages III–IV CKD is an independent predictor of CIs in persons with predialysis-stage kidney lesion. CIs were found to be related to hyperhomocysteinemia, anemia, abdominal obesity, left ventricular hypertrophy, and patient age. The signs of atherosclerotic lesion of the common carotid arteries and the indicators of arterial stiffness were also associated with the incidence and magnitude of CIs in CKD. The detection of CIs in patients with early CKD allows one to timely initiate adequate therapy aimed particularly at improving cerebral circulation, eliminating the impact of risk factors, and slowing down the vascular remodeling. The management tactics for patients with CKD must involve the identification and correction of cardiovascular risk factors, and duplex scanning of the wall of the common carotid arteries may be used as a noninvasive method to assess the risk of the development and progression of CIs in predialysis CKD. 

  20. Neuropsychiatric sequelae of head injuries.

    Science.gov (United States)

    McAllister, T W

    1992-06-01

    Based on the above review several general points can be highlighted: Head injuries are extremely common, affecting probably close to 2,000,000 people in this country each year. The most common are nonmissile, closed-head injuries, the majority of which occur in association with motor vehicle accidents. Virtually all studies of head injury suggest a peak incidence in the 15 to 24 years of age group. Coarse measures of outcome suggest that the very young and the elderly have poorer outcomes. Because of improved acute care, however, a large number of young, otherwise healthy patients are surviving head injuries with a variety of profound neuropsychiatric sequelae. Because of the mechanics of brain injury in acceleration-deceleration injuries, certain brain injury profiles are common including orbitofrontal, anterior and inferior temporal contusions, and diffuse axonal injury. The latter particularly affects the corpus callosum, superior cerebellar peduncle, basal ganglia, and periventricular white matter. The neuropsychiatric sequelae follow from the above injury profiles. Cognitive impairment is often diffuse with more prominent deficits in rate of information processing, attention, memory, cognitive flexibility, and problem solving. Prominent impulsivity, affective instability, and disinhibition are seen frequently, secondary to injury to frontal, temporal, and limbic areas. In association with the typical cognitive deficits, these sequelae characterize the frequently noted "personality changes" in TBI patients. In addition, these changes can exacerbate premorbid problems with impulse control. Marked difficulties with substance use, sexual expression, and aggression often result. The constellation of symptoms, which make up the postconcussive syndrome, are seen across the whole spectrum of brain injury severity. Even in so-called mild or minor head injury, these symptoms are likely to have an underlying neuropathologic, neurochemical, or neurophysiologic cause

  1. A controlled study of cognitive deficits in children with chronic Lyme disease.

    Science.gov (United States)

    Tager, F A; Fallon, B A; Keilp, J; Rissenberg, M; Jones, C R; Liebowitz, M R

    2001-01-01

    Although neurologic Lyme disease is known to cause cognitive dysfunction in adults, little is known about its long-term sequelae in children. Twenty children with a history of new-onset cognitive complaints after Lyme disease were compared with 20 matched healthy control subjects. Each child was assessed with measures of cognition and psychopathology. Children with Lyme disease had significantly more cognitive and psychiatric disturbances. Cognitive deficits were still found after controlling for anxiety, depression, and fatigue. Lyme disease in children may be accompanied by long-term neuropsychiatric disturbances, resulting in psychosocial and academic impairments. Areas for further study are discussed.

  2. Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

    NARCIS (Netherlands)

    Burgmans, J.P.J.

    2015-01-01

    The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

  3. Cognitive Status in Patients with Chronic Cerebral Ischemia

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    Yokudhon N. Madjidova

    2013-12-01

    Full Text Available The aim of our study was to examine the cognitive functions in patients with chronic cerebral ischemia (stages I- II of discirculatory encephalopathy of various origins. Systematization of the patients was performed according to EV Schmidt’s classification of the vascular lesions of the brain. All the subjects were categorized into two groups. Group 1 consisted of 115 patients (42 men and 73 women with chronic cerebral ischemia (CCI that had developed, mainly, against the background of arterial hypertension (AH. Group 2 consisted of 122 patients (33 men and 89 women with CCI, which developed, mainly, against the backdrop of atherosclerosis of the cerebral vessels. The mean age was 54.2±0.7 years in Group 1 and 56.8±0.8 years Group 2, respectively. Control group included 30 healthy subjects (mean age: 52.2±0.9 years without any objective manifestations of CCI. The stage of cognitive deficit was determined by employing the MMSE test and the Bourdon test. The “Schulte Tables” technique was used for estimating the stability of attention and rate of sensorimotor reactions. Luria’s Memory Ten-Word Retrieval Test (LMTWRT was applied for estimating attention and memory. The present study indicates that the cognitive deficits detected in patients with CIC were characterized by the greatest severity against the background of AH. AH predominantly damages the subcortical structures, resulting in subcortical angioencephalopathy, which ultimately leads to a deterioration of the intellectual-mental processes.

  4. Cognitive status among patients with chronic obstructive pulmonary disease

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    Roncero, Carlos; Campuzano, Ana Isabel; Quintano, Jose Antonio; Molina, Jesús; Pérez, Joselín; Miravitlles, Marc

    2016-01-01

    Purpose We investigated the association between cognitive impairment and chronic obstructive pulmonary disease (COPD), taking into account demographic and clinical variables evaluated during routine practice. Patients and methods We performed a post hoc analysis of a cross-sectional study that included subjects with stable COPD. Sociodemographic and clinical information was recorded using the Body mass index, airflow Obstruction, Dyspnea and Exacerbations index and the Charlson comorbidity index. Cognitive performance was studied by the mini-mental state examination, with a score less than 27 indicating clinical impairment. Depressive symptoms, physical activity, and quality of life (EuroQoL-5 dimensions and COPD Assessment Test) were also evaluated. Results The analysis included 940 subjects. The prevalence of cognitive impairment was 39.4%. Multivariate logistic regression models revealed that cognitive impairment was associated with educational level (odds ratio [OR] =0.096, 95% confidence interval [CI] =0.011–0.447) and poorer quality of life measured by the EuroQoL-5 dimensions social tariff (OR =0.967, 95% CI =0.950–0.983). When questionnaires were not included in the analysis, cognitive impairment was associated with educational level (OR =0.063, 95% CI =0.010–0.934), number of exacerbations (OR =11.070, 95% CI =1.450–84.534), Body mass index, airflow Obstruction, Dyspnea and Exacerbations index score (OR =1.261, 95% CI =1.049–1.515), and the Charlson comorbidity index (OR =1.412, 95% CI =1.118–1.783). Conclusion Cognitive impairment is common in COPD and is associated with low educational level, higher disease severity, and increased comorbidity. This could have therapeutic implications for this population. PMID:27042043

  5. Telephone-Delivered Cognitive Behavioral Therapy for Chronic Pain Following Traumatic Brain Injury

    Science.gov (United States)

    2015-10-01

    AWARD NUMBER: W81XWH-12-2-0109 TITLE: Telephone-Delivered Cognitive Behavioral Therapy for Chronic Pain Following Traumatic Brain Injury...2014-29 Sept 2015 4. TITLE AND SUBTITLE Telephone-Delivered Cognitive Behavioral Therapy for Chronic Pain 5a. CONTRACT NUMBER W81XWH-12-2-0109...study is to evaluate the efficacy of a telephone-delivered cognitive behavioral treatment (T-CBT) in Veterans with a history of traumatic brain injury

  6. Cognitive mechanisms in chronic tinnitus: Psychological markers of a failure to switch attention

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    Krysta Jannaya Trevis

    2016-08-01

    Full Text Available The cognitive mechanisms underpinning chronic tinnitus (phantom auditory perceptions are underexplored but may reflect a failure to switch attention away from a tinnitus sound. Here, we investigated a range of components that influence the ability to switch attention, including cognitive control, inhibition, working memory and mood, on the presence and severity of chronic tinnitus. Our participants with tinnitus showed significant impairments in cognitive control and inhibition as well as lower levels of emotional wellbeing, compared to healthy-hearing participants. Moreover, the subjective cognitive complaints of tinnitus participants correlated with their emotional wellbeing whereas complaints in healthy participants correlated with objective cognitive functioning. Combined, cognitive control and depressive symptoms correctly classified 67% of participants. These results demonstrate the core role of cognition in chronic tinnitus. They also provide the foundations for a neurocognitive account of the maintenance of tinnitus, involving impaired interactions between the neurocognitive networks underpinning attention-switching and mood.

  7. Cognitive Dysfunction in Chronic Renal Disease: Impact of Dialysis Modality

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    Recep AK

    2015-12-01

    Full Text Available OBJECTIVE: Cognitive dysfunction (CD is common among patients with chronic kidney disease (CKD and contributes to morbidity and mortality. We aimed to explore the factors involved in the development of CD in patients with CKD and to compare cognitive function between hemodialysis (HD and peritoneal dialysis (PD patients. MATERIAL and METHODS: We studied 122 patients with different stages of CKD, and divided them into two groups: Predialysis Group: included 60 CKD patients, (28 stage III and 34 stage IV; Dialysis Group: included 60 patients on dialysis therapy, (30 on HD and 30 on PD. Psychometric tests were done all patients. The results were compared with 41 healthy subjects. RESULTS: We found that the CD rate was higher in patients with CKD (24.6% than controls (0%, p<0.001. The Mini Mental Test score was found to be correlated with age (r=-0.428, hemoglobin (r=0.336, CRP (r=-0.311, and albumin (r=0.336; the Calculation Test score was found to be correlated with LDL cholesterol (r=-0.336; the Praxis Test Score was found to be correlated with duration of CKD (r=-0.204, HDL (r=0.188; and the Visual Memory Test score was found to be correlated with parathormone levels (r=-0.270. We found the CD rate to be higher in patients on HD (50% than on PD (23.3%, p=0.032. CONCLUSION: Our findings suggest that anemia, malnutrition and inflammation play an important role in the development of CD in our patients, and cognitive functions are better preserved in the PD group than the HD group.

  8. Hippocampal dysfunction and cognitive impairments provoked by chronic early-life stress involve excessive activation of CRH receptors

    OpenAIRE

    Ivy, Autumn S.; Rex, Christopher S.; Chen, Yuncai; Dubé, Céline; Maras, Pamela M.; Grigoriadis, Dimitri E.; Christine M Gall; Lynch, Gary; Baram, Tallie Z.

    2010-01-01

    Chronic stress impairs learning and memory in humans and rodents and disrupts long-term potentiation (LTP) in animal models. These effects are associated with structural changes in hippocampal neurons, including reduced dendritic arborization. Unlike the generally reversible effects of chronic stress on adult rat hippocampus, we have previously found that the effects of early-life stress endure and worsen during adulthood, yet the mechanisms for these clinically important sequelae are poorly ...

  9. Effects of Chronic Stress on Cognition in Male SAMP8 Mice

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    Jinhua Wang

    2016-08-01

    Full Text Available Background/Aims: Chronic stress can lead to cognitive impairment. Senescence-accelerated mouse prone 8 (SAMP8 is a naturally occurring animal model that is useful for investigating the neurological mechanisms of Alzheimer's disease. Here we investigated the impact and mechanisms of chronic stress on cognition in male SAMP8 mice. Methods: Male 6-month- old SAMP8 and SAMR1 (senescence-accelerated mouse resistant 1 mice strains were randomly divided into 4 groups. Mice in the unpredictable chronic mild stress (UCMS groups were exposed to diverse stressors for 4 weeks. Then, these mice performed Morris water maze (MWM test to assess the effect of UCMS on learning and memory. To explore the neurological mechanisms of UCMS on cognition in mice, we evaluated changes in the expression of postsynaptic density 95 (PSD95 and synaptophysin (SYN, which are essential proteins for synaptic plasticity. Five mice from each group were randomly chosen for reverse transcription polymerase chain reaction (RT-PCR and western blotting analysis of SYN and PSD95. Results: The Morris water maze experiment revealed that the cognitive ability of the SAMP8 mice decreased with brain aging, and that chronic stress aggravated this cognitive deficit. In addition, chronic stress decreased the mRNA and protein expression of SYN and PSD95 in the hippocampus of the SAMP8 mice; however, the SAMR1 mice were unaffected. Conclusion: Our results demonstrate that decreased cognition and synaptic plasticity are related to aging. Moreover, we show that chronic stress aggravated this cognitive deficit and decreased SYN and PSD95 expression in the SAMP8 mice. Furthermore, the SAMP8 mice were more vulnerable to the detrimental effects of chronic stress on cognition than the SAMR1 mice. Our results suggest that the neurological mechanisms of chronic stress on cognition might be associated with a decrease in hippocampal SYN and PSD95 expression, which is critical for structural synaptic

  10. Severity of negative symptoms significantly affects cognitive functioning in patients with chronic schizophrenia: the slowing in cognitive processing

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    Flavia S. Galaverna

    2014-09-01

    Full Text Available Background and Objectives: Studies in patients with schizophrenia have shown a decreased overall cognitive performance, and it was found that processing speed and working memory functions are affected. The aim of this study was to describe the general cognitive performance of patients with chronic schizophrenia and analyze its relationship with the severity of psychotic symptoms. Methods: Forty-eight patients diagnosed with DSM IV-TR schizophrenia disorder were examined for symptom improvement, measured by scales SAPS and SANS. Participants also completed the full scale WAIS-III. Results: The results show a generalized cognitive deficit, reflected in the low level of general intelligence, as well as the different index that comprise the scale. The most compromised index was the processing speed. The correlations showed that the overall severity of negative symptoms significantly affects cognitive functioning of chronic patients. The formal thought disorder and alogia significantly correlated with almost all the WAIS-III measures. Conclusions: Multiple studies of specific cognitive domains in schizophrenia have shown that deficits in processing speed are the core element of cognitive impairment in schizophrenia. We support the hypothesis about the slowing in cognitive processing affect both the performance of the basic and more complex cognitive task.

  11. [How I treat... chronic insomnia by cognitive and behavioral therapy].

    Science.gov (United States)

    Dethier, M; Blairy, S; Poirrier, R

    2016-04-01

    Today, insomnia is predominantly treated by pharmacotherapy. Yet, cognitive-behavioral therapy has better long-term outcomes. In this paper, we describe the basic principles of this short-term psychotherapeutic treatment. It combines methods of sleep restriction and stimulus control, the learning of relaxation techniques, advices on sleep hygiene and cognitive therapy techniques applied to cognitions that overwhelm insomniac moments.

  12. Chronic Glucocorticoid Hypersecretion in Cushing's Syndrome Exacerbates Cognitive Aging

    Science.gov (United States)

    Michaud, Kathy; Forget, Helene; Cohen, Henri

    2009-01-01

    Cumulative exposure to glucocorticoid hormones (GC) over the lifespan has been associated with cognitive impairment and may contribute to physical and cognitive degeneration in aging. The objective of the present study was to examine whether the pattern of cognitive deficits in patients with Cushing's syndrome (CS), a disorder characterized by…

  13. Cognitive-Linguistic Deficit and Speech Intelligibility in Chronic Progressive Multiple Sclerosis

    Science.gov (United States)

    Mackenzie, Catherine; Green, Jan

    2009-01-01

    Background: Multiple sclerosis is a disabling neurological disease with varied symptoms, including dysarthria and cognitive and linguistic impairments. Association between dysarthria and cognitive-linguistic deficit has not been explored in clinical multiple sclerosis studies. Aims: In patients with chronic progressive multiple sclerosis, the…

  14. Cognitive dysfunction in patients with chronic obstructive pulmonary disease- A systematic review

    DEFF Research Database (Denmark)

    Schou, Lone; Østergaard, Birte; Rasmussen, Lars S;

    2012-01-01

    Substantial healthcare resources are spent on chronic obstructive pulmonary disease (COPD). In addition, the involvement of patients in monitoring and treatment of their condition has been suggested. However, it is important to maintain a view of self-care that takes differences in cognitive...... ability into account. The aim of this study was to determine the occurrence and severity of cognitive dysfunction in COPD patients, and to assess the association between severity of COPD and the level of cognitive function....

  15. Is a full recovery possible after cognitive behavioural therapy for chronic fatigue syndrome?

    NARCIS (Netherlands)

    Knoop, H.; Bleijenberg, G.; Gielissen, M.F.M.; Meer, J.W.M. van der; White, P.D.

    2007-01-01

    BACKGROUND: Cognitive behavioural therapy (CBT) for chronic fatigue syndrome (CFS) leads to a decrease in symptoms and disabilities. There is controversy about the nature of the change following treatment; some suggest that patients improve by learning to adapt to a chronic condition, others think t

  16. Effect of Melatonin on Sleep, Behavior, and Cognition in ADHD and Chronic Sleep-Onset Insomnia

    Science.gov (United States)

    Van der Heijden, Kristiaan B.; Smits, Marcel G.; Van Someren, Eus J. W.; Ridderinkhof, K. Richard; Gunning, W. Boudewijn

    2007-01-01

    Objective: To investigate the effect of melatonin treatment on sleep, behavior, cognition, and quality of life in children with attention-deficit/hyperactivity disorder (ADHD) and chronic sleep onset insomnia. Method: A total of 105 medication-free children, ages 6 to 12 years, with rigorously diagnosed ADHD and chronic sleep onset insomnia…

  17. Subjective cognitive dysfunction in first-episode and chronic schizophrenic patients.

    Science.gov (United States)

    Moritz, S; Lambert, M; Andresen, B; Böthern, A; Naber, D; Krausz, M

    2001-01-01

    Previous studies indicate that first-episode and chronic schizophrenic patients do not differ regarding neuropsychological performance as assessed with standard cognitive tasks. For the present study, it was investigated whether first-episode and chronic schizophrenics report similar subjective cognitive deficits. The Frankfurt Complaint Questionnaire (FCQ), a scale devised for assessing subjective cognitive disturbances in schizophrenia, was administered to 20 first-episode and 36 chronic schizophrenic patients, as well as 20 healthy controls. The schizophrenic subsamples did not differ on any of the FCQ subscales or on a "lie scale," measuring illness denial. Psychopathological ratings were comparable for both groups. As expected, healthy subjects reported significantly less cognitive and perceptual problems than schizophrenic patients. In marked contrast to a Kraepelinian view of schizophrenia, the present data confirm previous studies conducted with objective neuropsychological tests that schizophrenia is a neurodevelopmental rather than a neurodegenerative disorder.

  18. Chronic Effects of Boxing: Diffusion Tensor Imaging and Cognitive Findings.

    Science.gov (United States)

    Wilde, Elisabeth A; Hunter, Jill V; Li, Xiaoqi; Amador, Cristian; Hanten, Gerri; Newsome, Mary R; Wu, Trevor C; McCauley, Stephen R; Vogt, Gregory S; Chu, Zili David; Biekman, Brian; Levin, Harvey S

    2016-04-01

    We used magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) to evaluate the effects of boxing on brain structure and cognition in 10 boxers (8 retired, 2 active; mean age = 45.7 years; standard deviation [SD] = 9.71) and 9 participants (mean age = 43.44; SD = 9.11) in noncombative sports. Evans Index (maximum width of the anterior horns of the lateral ventricles/maximal width of the internal diameter of the skull) was significantly larger in the boxers (F = 4.52; p = 0.050; Cohen's f = 0.531). Word list recall was impaired in the boxers (F(1,14) = 10.70; p = 0.006; f = 0.84), whereas implicit memory measured by faster reaction time (RT) to a repeating sequence of numbers than to a random sequence was preserved (t = 2.52; p metrics were significantly correlated with declarative memory (e.g., left ventral striatum ADC with delayed recall, r = -0.74; p = 0.02) and with RT to the repeating number sequence (r = 0.70; p = 0.04) in the boxers. Years of boxing had the most consistent, negative correlations with FA, ranging from -0.65 for the right ventral striatum to -0.92 for the right cerebral peduncle. Years of boxing was negatively related to the number of words consistently recalled over trials (r = -0.74; p = 0.02), delayed recall (r = -0.83; p = 0.003), and serial RT (r = 0.66; p = 0.05). We conclude that microstructural integrity of white matter tracts is related to declarative memory and response speed in boxers and to the extent of boxing exposure. Implications for chronic traumatic encephalopathy are discussed.

  19. Chronic neuroendocrinological sequelae of radiation therapy

    Energy Technology Data Exchange (ETDEWEB)

    Sklar, C.A. [Memorial Sloan-Kettering Cancer Center, New York, NY (United States); Constine, L.S. [Univ. of Rochester Medical Center, Rochester, NY (United States)

    1995-03-30

    A variety of neuroendocrine disturbances are observed following treatment with external radiation therapy when the hypothalamic-pituitary axis (HPA) is included in the treatment field. Radiation-induced abnormalities are generally dose dependent and may develop many years after irradiation. Growth hormone deficiency and premature sexual development can occur following doses as low as 18 Gy fractionated radiation and are the most common neuroendocrine problems noted in children. Deficiency of gonadotropins, thyroid stimulating hormone, and adrenocorticotropin are seen primarily in individuals treated with > 40 Gy HPA irradiation. Hyperprolactinemia can be seen following high-dose radiotherapy (>40 Gy), especially among young women. Most neuroendocrine disturbances that develop as a result of HPA irradiation are treatable; patients at risk require long-term endocrine follow-up. 23 refs., 6 figs., 2 tabs.

  20. Recombinant human growth hormone improves cognitive capacity in a pain patient exposed to chronic opioids.

    Science.gov (United States)

    Rhodin, A; von Ehren, M; Skottheim, B; Grönbladh, A; Ortiz-Nieto, F; Raininko, R; Gordh, T; Nyberg, F

    2014-07-01

    During recent decades, the increasing use of opioids for chronic non-cancer pain has raised concerns regarding tolerance, addiction, and importantly cognitive dysfunction. Current research suggests that the somatotrophic axis could play an important role in cognitive function. Administration of growth hormone (GH) to GH-deficient humans and experimental animals has been shown to result in significant improvements in cognitive capacity. In this report, a patient with cognitive disabilities resulting from chronic treatment with opioids for neuropathic pain received recombinant human growth hormone (rhGH) replacement therapy. A 61-year-old man presented with severe cognitive dysfunction after long-term methadone treatment for intercostal neuralgia and was diagnosed with GH insufficiency by GH releasing hormone-arginine testing. The effect of rhGH replacement therapy on his cognitive capacity and quality of life was investigated. The hippocampal volume was measured using magnetic resonance imaging, and the ratios of the major metabolites were calculated using proton magnetic resonance spectroscopy. Cognitive testing revealed significant improvements in visuospatial cognitive function after rhGH. The hippocampal volume remained unchanged. In the right hippocampus, the N-acetylaspartate/creatine ratio (reflecting nerve cell function) was initially low but increased significantly during rhGH treatment, as did subjective cognitive, physical and emotional functioning. This case report indicates that rhGH replacement therapy could improve cognitive behaviour and well-being, as well as hippocampal metabolism and functioning in opioid-treated patients with chronic pain. The idea that GH could affect brain function and repair disabilities induced by long-term exposure to opioid analgesia is supported.

  1. Cognitive and emotional control of pain and its disruption in chronic pain

    OpenAIRE

    Bushnell, M. Catherine; Čeko, Marta; Low, Lucie A.

    2013-01-01

    Chronic pain is one of the most prevalent health problems in our modern world, with millions of people debilitated by conditions such as back pain, headache and arthritis. To address this growing problem, many people are turning to mind–body therapies, including meditation, yoga and cognitive behavioural therapy. This article will review the neural mechanisms underlying the modulation of pain by cognitive and emotional states — important components of mind–body therapies. It will also examine...

  2. Association of Chronic Obstructive Pulmonary Disease with Cognitive Decline in Very Elderly Men

    OpenAIRE

    Guoqing Zhou; Jinxia Liu; Fang Sun; Xiaofeng Xin; Lihui Duan; Xiaowei Zhu; Zhaorong Shi

    2012-01-01

    Aim To determine the change in cognitive function in very elderly men with chronic obstructive pulmonary disease (COPD) over a 3-year period relative to age-and education-matched controls. Methods In this hospital-based, prospective case-control study, we evaluated a consecutive series of 110 very elderly men with COPD and 110 control subjects who were hospitalized between January and December 2007. All the subjects performed cognitive tests at baseline and underwent annual evaluations (for 3...

  3. [Sleep in older adults: association between chronic insomnia and cognitive functioning].

    Science.gov (United States)

    Haimov, Iris; Vadas, Limor

    2009-05-01

    Chronic insomnia and cognitive impairment are both common complaints among older adults. Even so, only a few studies have examined the effects of chronic insomnia on cognitive functioning among the elderly, and the results of these studies are contradictory. The authors therefore examined whether insomnia is associated with changes in cognitive functioning among elderly people. The study population comprised two groups: 64 older adult subjects without sleep disorders, and 48 older adult insomniacs. All subjects were living independently in the community and were in good clinical condition. The cognitive capacity of each subject was tested at the subject's home using the computerized "MindFit" test (CogniFit, Inc.). The results demonstrate that chronic insomnia in older adults is associated with impairment in cognitive functioning. Specifically, we found that older people suffering from late-life insomnia exhibit significantly reduced performance in memory span, allocating attention to a target, time estimation, working memory and integration of two dimensions. The present findings suggest that late-life insomnia may be one of the factors contributing to the decline in cognitive functioning seen among older people. Thus, it is particularly important for health care practitioners to screen for, evaluate and treat insomnia symptoms in the elderly. The findings of this study offer hope that treatment of insomnia in older adults can have beneficial effects in improving cognitive functioning in these patients. Therefore, attention to and effective treatment of chronic insomnia in older persons may not only improve the quality of their nighttime sleep, but conceivabLy, may also maintain cognitive function, thus improving their overall quality of life.

  4. Citicoline Protects Against Cognitive Impairment in a Rat Model of Chronic Cerebral Hypoperfusion

    OpenAIRE

    Lee, Hyun Joon; Kang, Ji Seung; Kim, Yeong In

    2008-01-01

    Background and purpose Cerebral white matter (WM) lesions are frequently observed in human cerebrovascular diseases, and are believed to be responsible for cognitive impairment. Various neuroprotective agents can suppress this type of WM or neuronal damage. In this study, we investigated whether citicoline, a drug used to treat acute ischemic stroke, can attenuate WM lesions and cognitive decline caused by chronic hypoperfusion in the rat. Methods Animals were divided into immediate- and dela...

  5. Chronic non-specific low back pain; has cognitive behavioural therapy effect and

    OpenAIRE

    Hjermann, Mette Kristine

    2005-01-01

    Low back pain (LBP) presents a major public health problem. Half of the population will report acute LBP during the last year; approximately 80-90% is non-specific. Many will develop chronic / intermittent LBP and a part of these patients will become unable to maintain daily function and working life. Although non-specific chronic LBP is common, there is little knowledge of its cause and right treatment. In this paper the cognitive chronification process is seen together with newer neurobiolo...

  6. The 2013 Discovery Award from the Society for Free Radical Biology and Medicine: Selected Discoveries from the Butterfield Laboratory of Oxidative Stress and Its Sequelae in Brain in Cognitive Disorders Exemplified by Alzheimer Disease and Chemotherapy Induced Cognitive Impairment

    Science.gov (United States)

    Butterfield, D. Allan

    2014-01-01

    This retrospective review on discoveries of the roles of oxidative stress in brain of subjects with Alzheimer disease (AD) and animal models thereof as well as brain from animal models of chemotherapy induced cognitive impairment (CICI) results from the author receiving the 2013 Discovery Award from the Society for Free Radical Biology and Medicine. The paper reviews our laboratory's discovery of: protein oxidation and lipid peroxidation in AD brain regions rich in amyloid β-peptide (Aβ) but not in Aβ-poor cerebellum; redox proteomics as a means to identify oxidatively modified brain proteins in AD and its earlier forms that are consistent with the pathology, biochemistry, and clinical presentation of these disorders; how Aβ in in vivo, ex vivo, and in vitro studies can lead to oxidative modification of key proteins that also are oxidatively modified in AD brain; the role of the single methionine residue of Aβ(1-42) in these processes; and some of the potential mechanisms in the pathogenesis and progression of AD. CICI affects a significant fraction of the 14 million American cancer survivors, and due to diminished cognitive function, reduced quality of life of the persons with CICI (called “chemobrain” by patients) often results. A proposed mechanism for CICI employed the prototypical ROS-generating and non-blood brain barrier (BBB)-penetrating chemotherapeutic agent doxorubicin (Dox, also called adriamycin, ADR). Because of the quinone moiety within the structure of Dox, this agent undergoes redox cycling to produce superoxide free radical peripherally. This, in turn, leads to oxidative modification of the key plasma protein, Apolipoprotein A1 (ApoA1). Oxidized ApoA1 leads to elevated peripheral TNFα, a pro-inflammatory cytokine that crosses the BBB to induce oxidative stress in brain parenchyma that affects negatively brain mitochondria. This subsequently leads to apoptotic cell death resulting in CICI. This review outlines aspects of CICI consistent

  7. COGNITIVE MECHANISMS OF CHANGE IN MULTIDISCIPLINARY TREATMENT OF PATIENTS WITH CHRONIC WIDESPREAD PAIN : A PROSPECTIVE COHORT STUDY

    NARCIS (Netherlands)

    de Rooij, Aleid; de Boer, Michiel R.; van der Leeden, Marike; Roorda, Leo D.; Steultjens, Martijn P. M.; Dekker, Joost

    2014-01-01

    Objective: To evaluate the contribution of improvement in negative emotional cognitions, active cognitive coping, and control and chronicity beliefs to the outcome of multidisciplinary treatment in patients with chronic widespread pain. Design: Prospective cohort study. Patients: A total of 120 subj

  8. The possible impact of dialysis modality on cognitive function in chronic dialysis patients.

    Science.gov (United States)

    Radić, J; Ljutić, D; Radić, M; Kovaĉić, V; Sain, M; Curković, K Dodig

    2010-04-01

    Chronic kidney disease (CKD) is a growing public health problem. Individuals in all stages of CKD are at higher risk for development of cognitive impairment and this may be a major determinant in their quality of life (QOL). The prevalence of cognitive deficits is particularly high in subjects with end-stage renal disease (ESRD). While it is sufficiently well documented that ESRD is linked with a change in cognitive function, little is known about the influence of different dialysis modalities on cognitive function. The effect of dialysis modality on risk of cognitive impairment is unclear. Some data suggest that patients with ESRD treated with chronic ambulatory peritoneal dialysis (CAPD) had consistently better cognitive function than patients treated with haemodialysis (HD). We concluded that the previously observed apparent difference between two modalities of dialysis treatments resulted either from very low dialysis delivery or comparison with poorly matched controls. Regarding these data from previous studies we hypothesised that well-dialysed, well-nourished and medically stable HD patients had no cognitive dysfunction in comparison with well-dialysed, well-nourished, medically stable and demographically matched CAPD patients. Also, future studies are needed to differentiate between modality as a risk factor from the factors contributing to selection bias among patients choosing CAPD over HD.

  9. Cognitive Disorders, Depressive Status and Chronic Complications of Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Tache Mirela

    2014-12-01

    Full Text Available Background and aims: Depression and cognitive disorders were reported more frequently in patients with diabetes mellitus (DM. Our aim was to analyze the association of cognitive disorders and depression association with chronic complications of DM in a group of Romanian patients. Materials and methods: The data was analyzed from 181 patients, with a mean age of 58,3 years to whom we applied the MMSE (Mini- Mental State Examination and MADRS (Montgomery-Asberg Depression Rating Scale questionnaires. We also analyzed the presence of chronic DM complications, HbA1c and lipid profile. Results: Most patients with type 2 diabetes mellitus (T2DM had mild cognitive impairment (92%, more common in the age group 50-59 years. Chronic macrovascular complications were present in 74.58%, while chronic microvascular complications were present in 61.87% of patients with T2DM who associated mild and moderate cognitive impairment (p = 0.013. The most common form of depression was mild depression (90.2%, present in most patients with DM, regardless of progression and type of treatment. MADRS depression test scores were statistically significant correlated with the presence of peripheral artery disease - PAD (p <0.001, ischemic heart disease - IHD (p <0.001 and chronic kidney disease - CKD (p =0.05. We did not find a statistically significant correlation with HbA1c and serum lipid values (p˃0,05. Conclusion: Chronic diabetes macrovascular complications (PAD, IHD and CKD were more frequently associated with cognitive disorders and depression in patients with T2DM independent of the degree of metabolic control.

  10. Cognitive Impairment and Structural Neuroimaging Abnormalities Among Patients with Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Hai-Chen Pi

    2016-12-01

    Full Text Available Background/Aims: Cognitive impairment and abnormal structural neuroimaging is common in chronic kidney disease patients. We aimed to explore its association with dialysis modality and the relationship between cognitive impairment and abnormal structural neuroimaging. Methods: Sixty peritoneal dialysis patients and 30 hemodialysis and 30 non-dialyzed stage 3-5 chronic kidney disease patients without history of stroke were enrolled for the study. Participants were matched for age, gender, education, diabetes status, and dialysis duration (if appropriate. Cognitive functions were measured using a battery of recognized instruments. Brain features were examined with 3-dimensional magnetic resonance imaging. Results: Cognitive impairment was significantly more severe in dialysis patients than in non-dialyzed patients. The global and specific cognitive function were not significantly different between patients on peritoneal dialysis and hemodialysis. Hemodialysis patients had more severe white matter hyperintensity, sulcal and ventricular atrophy, and SVIs than other patients. In all groups, higher white matter grade, ventricular grade, and hippocampal atrophy were significantly associated with global cognitive impairment, with hazard ratios of 1.80 (1.22-2.64, 1.67 (1.09-2.57, and 2.49 (1.07-5.77, respectively. White matter grade was also significantly associated with delayed memory (hazard ratio 1.63; 1.12-2.39. Conclusion: Dialysis modality showed no association with cognitive impairment, although hemodialysis patients had more severe neuroimaging abnormalities. For the whole group, white matter hyperintensity, and ventricular and hippocampal atrophy, were independently associated with global cognitive impairment in chronic kidney disease patients.

  11. Neuropsychiatric sequelae of neuroleptic malignant syndrome.

    Science.gov (United States)

    Adityanjee; Sajatovic, Martha; Munshi, Kaizad R

    2005-01-01

    The authors review the literature on persistent sequelae of neuroleptic malignant syndrome (NMS). They highlight the clinical presentations, assessment, and management of persistent sequelae and stress the need to take preventive steps to minimize their occurrence. The authors conducted a Medline and PubMed search for papers on residual sequelae of NMS. They cross-referenced the available papers and "operationalized" the diagnostic criteria for persistent neuropsychiatric sequelae. A total of 31 cases of neuropsychiatric sequelae of NMS were identified. With reduction in mortality from NMS, persistent sequelae of NMS have assumed clinical importance. Long-term sequelae persist for weeks to months after amelioration of an acute episode. Individuals with a preexisting CNS insult are more predisposed to develop persistent sequelae. A high index of awareness for persistent sequelae is warranted because antipsychotics are widely used for psychiatric disorders besides schizophrenia. Awareness of such outcomes and the use of evidence-based strategies to minimize risk factors will help clinicians in reducing the persistent sequelae of NMS.

  12. Social-cognitive predictors of intended and actual benzodiazepine cessation among chronic benzodiazepine users

    NARCIS (Netherlands)

    Ten Wolde, Geeske B.; Dijkstra, Arie; Van Empelen, Pepijn; Neven, Arie Knuistingh; Zitman, Frans G.

    2008-01-01

    Long-term benzodiazepine use is associated with a variety of negative health consequences. Cessation of long-term use is therefore an important health goal. In a prospective study among chronic benzodiazepinc users (N=356) social-cognitive factors of benzodiazepine cessation were examined with a nin

  13. Somatic chronic diseases and 6-year change in cognitive functioning among older persons

    NARCIS (Netherlands)

    Comijs, H.; Kriegsman, D.M.W.; Dik, M.G.; Deeg, D.J.H.; Jonker, C.; Stalman, W.A.B.

    2009-01-01

    The influence of seven highly prevalent somatic chronic diseases on changes in cognitive functioning is investigated in older persons in a prospective design covering a 6-year follow-up period. The data were collected as part of the Longitudinal Aging Study Amsterdam (LASA). The associations between

  14. Childhood maltreatment and the response to cognitive behavior therapy for chronic fatigue syndrome.

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Lobbestael, J.; Bleijenberg, G.

    2011-01-01

    Objective: To examine the relationship between a history of childhood maltreatment and the treatment response to cognitive behavior therapy for chronic fatigue syndrome (CFS). Methods: A cohort study in a tertiary care clinic with a referred sample of 216 adult patients meeting the Centers for Disea

  15. Brief Report: Cognitive Emotion Regulation Strategies and Psychological Adjustment in Adolescents with a Chronic Disease

    Science.gov (United States)

    Garnefski, Nadia; Koopman, Hendrik; Kraaij, Vivian; ten Cate, Rebecca

    2009-01-01

    Objective of the study was to examine how cognitive emotion regulation strategies were related to psychological maladjustment in adolescents with a chronic disease. The sample consisted of adolescents with a diagnosis of Juvenile Idiopathic Arthritis (JIA). A self-report questionnaire was used to assess Internalizing problems and Quality of Life.…

  16. Cognitive Behavioral Therapy across the Stages of Psychosis: Prodromal, First Episode, and Chronic Schizophrenia

    Science.gov (United States)

    Valmaggia, Lucia R.; Tabraham, Paul; Morris, Eric; Bouman, Theo K.

    2008-01-01

    Since the early 1990s, cognitive behavioral therapy (CBT) has been increasingly used as an adjunctive treatment for psychotic disorders. This paper describes the CBT of three cases, each at a different stage of psychotic disorder: at-risk mental state, first-episode psychosis, and chronic psychotic disorder. For the at-risk mental state, treatment…

  17. Cognitive-Somatic Anxiety Response Patterning in Chronic Pain Patients and Nonpatients.

    Science.gov (United States)

    DeGood, Douglas E.; And Others

    1985-01-01

    Examined group differences in self-reporting anxiety for one hundred chronic pain patients, an equal number of college students, and two smaller comparison samples. Pain patients, relative to nonpatients, acknowledged dramatically fewer total signs of anxiety. Also, pain patients endorsed significantly more somatic than cognitive indicators of…

  18. Implementing Cognitive Behavioral Therapy for Chronic Fatigue Syndrome in a Mental Health Center: A Benchmarking Evaluation

    Science.gov (United States)

    Scheeres, Korine; Wensing, Michel; Knoop, Hans; Bleijenberg, Gijs

    2008-01-01

    Objective: This study evaluated the success of implementing cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) in a representative clinical practice setting and compared the patient outcomes with those of previously published randomized controlled trials (RCTs) of CBT for CFS. Method: The implementation interventions were the…

  19. Psychiatric sequelae of induced abortion.

    Science.gov (United States)

    Gibbons, M

    1984-03-01

    An attempt is made to identify and document the problems of comparative evaluation of the more recent studies of psychiatric morbidity after abortion and to determine the current consensus so that when the results of the joint RCGP/RCOG study of the sequelae of induced abortion become available they can be viewed in a more informed context. The legalization of abortion has provided more opportunities for studies of subsequent morbidity. New laws have contributed to the changing attitudes of society, and the increasing acceptability of the operation has probably influenced the occurrence of psychiatric sequelae. The complexity of measuring psychiatric sequelae is evident from the many terms used to describe symptomatology and behavioral patterns and from the number of assessment techniques involved. Numerous techniques have been used to quantify psychiatric sequelae. Several authors conclude that few psychiatric problems follow an induced abortion, but many studies were deficient in methodology, material, or length of follow-up. A British study in 1975 reported a favorable outcome for a "representative sample" of 50 National Health Service patients: 68% of these patients had an absence of or only mild feelings of guilt, loss, or self reproach and considered abortion as the best solution to their problem. The 32% who had an adverse outcome reported moderate to severe feelings of guilt, regret, loss, and self reproach, and there was evidence of mental illness. In most of these cases the adverse outcome was related to the patient's environment since the abortion. A follow-up study of 126 women, which compared the overall reaction to therapeutic abortion between women with a history of previous mild psychiatric illness and those without reported that a significantly different emotional reaction could not be demonstrated between the 2 groups. In a survey among women seeking an abortion 271 who were referred for a psychiatric opinion regarding terminations of pregnancy

  20. The role of cognitive behavioral therapy for chronic pain in adolescents.

    Science.gov (United States)

    Zagustin, Tamara K

    2013-08-01

    Chronic pain is frequently experienced in adolescents; it affects functionality and requires interventions to decrease the impairments caused by pain. Cognitive behavioral therapy (CBT) has been analyzed in numerous studies that evaluated its effects on reducing the different types of chronic pain in children and adolescents. Interestingly, the outcome of CBT was initially focused on pain intensity, but, because there is no correspondence between children's pain intensity and level of disability, the ability to participate in school and social and recreational activities have been the primary focus of recent studies. There are innovative methods of CBT (such as the third generation of CBT) with and without the use of technology that facilitates the availability of this psychological treatment to adolescents with chronic pain, optimizing its accessibility and comprehensiveness, and maintaining its effectiveness. In the future, specific types of CBT could be specific to the diagnosis of chronic pain in the adolescent, sociodemographics, and other unique features. Parents of children with chronic pain are usually included in these programs, either as coaches in the intervention or as recipients of psychological therapies (including CBT) to optimize benefits. CBT has no adverse effect on chronic pain in adolescents, and there is no literature that makes reference to the effectiveness of CBT in preventing chronic pain in adolescents. A review of the role of CBT in chronic pain in adolescents via a PubMed database search was performed to identify the role of CBT in the management of chronic pain in adolescents.

  1. Sequelae of pediatric osteoarticular infection.

    Science.gov (United States)

    Ilharreborde, B

    2015-02-01

    The epidemiology and diagnosis of osteoarticular infections (OAI) have changed considerably in recent years, partly due to the development of molecular biology. Kingella kingae is now recognized as the most frequent pathogen in children under 4 years of age, while methicillin-resistant Staphylococcus aureus (SA) has been increasingly reported. Although the clinical course of OAI is mostly benign, with shorter antibiotic regimens and simplified treatments, serious functional impairments and life-threatening complications can still occur, especially in case of delayed diagnosis or infection caused by Panton-Valentine leukocidin-producing strains of SA. Newborns and patients with sickle cell disease have greater risk of orthopaedic sequelae, which need to be detected and managed early. The main sequelae of osteomyelitis are angular limb deformity, due to partial growth arrest, and lower limb discrepancy. Therapeutic options are guided by the patient's age and predictions at maturity. The main complications of septic arthritis are joint stiffness and osteonecrosis. The procedures to consider are arthrodesis, joint reconstruction in immature children, and arthroplasty at the end of growth.

  2. Cognitive-behavioral treatments for chronic pain: what works for whom?

    Science.gov (United States)

    Vlaeyen, Johan W S; Morley, Stephen

    2005-01-01

    Since the introduction of behavioral medicine in the early 70s, cognitive-behavioral treatment interventions for chronic pain have expanded considerably. It is now well established that these interventions are effective in reducing the enormous suffering that patients with chronic pain have to bear. In addition, these interventions have potential economic benefits in that they appear to be cost-effective as well. Despite these achievements, there is still room for improvement. First, there is a substantial proportion of patients who do not appear to benefit from treatment interventions available. Second, although the effect sizes of most cognitive-behavioral treatments for chronic pain are comparable to those in psychopathology, they are quite modest. Third, there is little evidence for differential outcomes for different treatment methods. Fourth, there still is relatively little known about the specific biobehavioral mechanisms that lead to chronic pain and pain disability. One direction is to better match treatment programs to patients' characteristics. This can be done according to an "Aptitude X Treatment Interaction" framework, or from the perspective of the Moderator-Mediator distinction. In this introduction to the special series on what works for whom in cognitive-behavioral treatments for chronic pain, we review existing knowledge concerning both moderating and mediating variables in cognitive-behavioral treatments for chronic pain. We further argue in favor of theory-driven research as the only way to define specific a priori hypotheses about which patient-treatment interactions to expect. We also argue that replicated single-participant studies, with appropriate statistics, are likely to enhance new developments in this clinical research area.

  3. Cognitive Gains from Gist Reasoning Training in Adolescents with Chronic-Stage Traumatic Brain Injury

    Directory of Open Access Journals (Sweden)

    Lori G. Cook

    2014-06-01

    Full Text Available Adolescents with traumatic brain injury (TBI typically demonstrate good recovery of previously acquired skills. However, higher-order and later emergent cognitive functions are often impaired and linked to poor outcomes in academic and social/behavioral domains. Few control trials exist that test cognitive treatment effectiveness at chronic recovery stages. The current pilot study compared the effects of two forms of cognitive training, gist reasoning (top-down versus rote memory learning (bottom-up, on ability to abstract meanings, recall facts, and utilize core executive functions (i.e., working memory, inhibition in 20 adolescents (ages 12-20 who were six months or longer post-TBI. Participants completed eight 45-minute sessions over one month. After training, the gist reasoning group (n = 10 exhibited significant improvement in ability to abstract meanings and increased fact recall. This group also showed significant generalizations to untrained executive functions of working memory and inhibition. The memory training group (n = 10 failed to show significant gains in ability to abstract meaning or on other untrained specialized executive functions, although improved fact recall approached significance. These preliminary results suggest that relatively short-term training (6 hours utilizing a top-down reasoning approach is more effective than a bottom-up rote learning approach in achieving gains in higher-order cognitive abilities in adolescents at chronic stages of TBI. These findings need to be replicated in a larger study; nonetheless, the preliminary data suggest that traditional cognitive intervention schedules need to extend to later-stage training opportunities. Chronic-stage, higher-order cognitive trainings may serve to elevate levels of cognitive performance in adolescents with TBI.

  4. [Effects on children's cognitive development of chronic exposure to screens].

    Science.gov (United States)

    Harlé, B; Desmurget, M

    2012-07-01

    During the last few years, the time spent in front of various screens, including TV sets, video games, smartphones and computers, has dramatically increased. Numerous studies show, with a remarkable consistency, that this trend has a strong negative influence on the cognitive development of children and teenagers. The affected fields include, in particular, scholastic achievement, language, attention, sleep and aggression. We believe that this often disregarded - not to say denied - problem should now be considered a major public health issue. Primary care physicians should inform parents and children about this issue to support efficient prevention.

  5. Chronic obstructive pulmonary disease and cognitive impairment in the Chinese elderly population: a large national survey

    Directory of Open Access Journals (Sweden)

    Yin P

    2016-02-01

    Full Text Available Peng Yin,1,* Qingfeng Ma,2,* Limin Wang,1 Peng Lin,3 Mei Zhang,1 Shige Qi,1 Zhihui Wang1 1National Center for Chronic and Noncommunicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, 2Department of Neurology, Xuanwu Hospital of Capital Medical University, Beijing, 3Department of Health Education, Qingdao Municipal Center for Disease Control and Prevention, Qingdao, People’s Republic of China *These authors contributed equally to this work Background: Previous studies suggested an association between chronic obstructive pulmonary disease (COPD and cognitive impairment, mostly in developed countries. There is no evidence available on the association between these two common chronic disorders in the elderly people in People’s Republic of China where the population is aging rapidly.Methods: The study population was randomly selected from a nationally representative Disease Surveillance Point System in People’s Republic of China. A standardized questionnaire was administered by trained interviewers during a face-to-face interview in the field survey conducted in 2010–2011. Cognitive function was assessed using the Mini-Mental State Examination. COPD was measured by self-report and the Medical Research Council respiratory questionnaire was used to assess respiratory symptoms. A multivariate logistic regression model was applied to examine the association between COPD and cognitive impairment with adjustment for potential confounding factors.Results: A total of 16,629 subjects aged over 60 years were included in the study. The prevalence of cognitive impairment was 9.4% (95% confidence interval [CI] 7.7, 11.1. Chronic phlegm was associated with significantly higher prevalence of cognitive impairment in models adjusted for age, sex, marital status, geographic region, urban/rural, education, smoking status, alcohol drinking, and indoor air pollution (odds ratio [OR] 1.46, 95% CI 1.11, 1.93. Chronic

  6. Role of Vitamin D in Cognitive Function in Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    Zhen Cheng

    2016-05-01

    Full Text Available Both vitamin D deficiency and cognitive impairment are common in patients with chronic kidney disease (CKD. Vitamin D exerts neuroprotective and regulatory roles in the central nervous system. Hypovitaminosis D has been associated with muscle weakness and bone loss, cardiovascular diseases (hypertension, diabetes and hyperlipidemia, inflammation, oxidative stress, immune suppression and neurocognitive impairment. The combination of hypovitaminosis D and CKD can be even more debilitating, as cognitive impairment can develop and progress through vitamin D-associated and CKD-dependent/independent processes, leading to significant morbidity and mortality. Although an increasingly recognized comorbidity in CKD, cognitive impairment remains underdiagnosed and often undermanaged. Given the association of cognitive decline and hypovitaminosis D and their deleterious effects in CKD patients, determination of vitamin D status and when appropriate, supplementation, in conjunction with neuropsychological screening, should be considered integral to the clinical care of the CKD population.

  7. Cognitive dysfunction in patients with chronic obstructive pulmonary disease - A systematic review

    DEFF Research Database (Denmark)

    Schou, Lone; Østergaard, Birte; Rasmussen, Lars S;

    2012-01-01

    databases: Medline, PsychINFO, Cochrane Library, EMBASE, CINAHL, and SweMed up to July 2010. The articles were included if(1) participants were patients with COPD,(2) relevant outcome was cognitive function investigated by a neuropsychological test battery, and(3) the severity of COPD had been assessed......BACKGROUND: Substantial healthcare resources are spent on chronic obstructive pulmonary disease (COPD). In addition, the involvement of patients in monitoring and treatment of their condition has been suggested. However, it is important to maintain a view of self-care that takes differences...... in cognitive ability into account. The aim of this study was to determine the occurrence and severity of cognitive dysfunction in COPD patients, and to assess the association between severity of COPD and the level of cognitive function. METHODS: We conducted a systematic review, and a search in the following...

  8. The Effects of Chronic Partial Sleep Deprivation on Cognitive Functions of Medical Residents

    Directory of Open Access Journals (Sweden)

    Sara Samadzadeh

    2010-06-01

    Full Text Available "n  "n Objective:Because of on-call responsibilities, many medical residents are subjected to chronic partial sleep deprivation, a form of sleep restriction whereby individuals have chronic patterns of insufficient sleep. It is unclear whether deterioration in cognitive processing skills due to chronic partial sleep deprivation among medical residents would influence educational exposure or patient safety. Method: Twenty-six medical residents were recruited to participate in the study. Participants wore an Actigraph over a period of 5 consecutive days and nights so their sleep pattern could be recorded. Thirteen participants worked on services that forced chronic partial sleep deprivation (<6 hours of sleep per 24h for 5 consecutive days and nights. The other thirteen residents worked on services that permitted regular and adequate sleep patterns. Following the 5-day sleep monitoring period, the participants completed the three following cognitive tasks: (a the Wisconsin Card Sorting Test (WCST to assess abstract reasoning and prefrontal cortex performance; (b the Time Perception Task (TPT to assess time estimation and time reproduction skills; and (c the Iowa Gambling Task (IGT to assess decision-making ability. "nResults: The results of independent samples t-tests found no significant differences between the group who was chronically sleep deprived and the group who rested adequately (all ps > .05. "nConclusion: These results may have emerged for several possible reasons: (a chronic partial sleep deprivation may have a lesser impact on prefrontal cortex function than on other cognitive functions; (b fairly modest chronic sleep restriction may be less harmful than acute and more significant sleep restriction; or (c our research may have suffered from poor statistical power. Future research is recommended.

  9. Caught in the thickness of brain fog: exploring the cognitive symptoms of Chronic Fatigue Syndrome

    Directory of Open Access Journals (Sweden)

    Anthony James Ocon

    2013-04-01

    Full Text Available Chronic Fatigue Syndrome (CFS is defined as greater than 6 months of persistent fatigue that is experienced physically and cognitively. The cognitive symptoms are generally thought to be a mild cognitive impairment, but individuals with CFS subjectively describe them as brain fog. The impairment is not fully understood and often is described as slow thinking, difficulty focusing, confusion, lack of concentration, forgetfulness, or a haziness in thought processes. Causes of brain fog and mild cognitive impairment have been investigated. Possible physiological correlates may be due to the effects of chronic orthostatic intolerance in the form of the Postural Tachycardia Syndrome and decreases in cerebral blood flow. In addition, fMRI studies suggest that individuals with CFS may require increased cortical and subcortical brain activation to complete difficult mental tasks. Furthermore, neurocognitive testing in CFS has demonstrated deficits in speed and efficiency of information processing, attention, concentration, and working memory. The cognitive impairments are then perceived as an exaggerated mental fatigue. As a whole, this is experienced by those with CFS as brain fog and may be viewed as the interaction of physiological, cognitive, and perceptual factors. Thus, the cognitive symptoms of CFS may be due to altered cerebral blood flow activation and regulation that are exacerbated by a stressor, such as orthostasis or a difficult mental task, resulting in the decreased ability to readily process information, which is then perceived as fatiguing and experienced as brain fog. Future research looks to further explore these interactions, how they produce cognitive impairments, and explain the perception of brain fog from a mechanistic standpoint.

  10. The process of cognitive behaviour therapy for chronic fatigue syndrome: which changes in perpetuating cognitions and behaviour are related to a reduction in fatigue?

    NARCIS (Netherlands)

    Heins, M.J.; Knoop, H.; Burk, W.J.; Bleijenberg, G.

    2013-01-01

    Objective: Cognitive behaviour therapy (CBT) can significantly reduce fatigue in chronic fatigue syndrome (CFS), but little is known about the process of change taking place during CBT. Based on a recent treatment model (Wiborg et al. J Psych Res 2012), we examined how (changes in) cognitions and be

  11. Association between cognitive performance, physical fitness, and physical activity level in women with chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Kelly Ickmans, PT, MSc

    2013-08-01

    Full Text Available Limited scientific evidence suggests that physical activity is directly related to cognitive performance in patients with chronic fatigue syndrome (CFS. To date, no other study has examined the direct relationship between cognitive performance and physical fitness in these patients. This study examined whether cognitive performance and physical fitness are associated in female patients with CFS and investigated the association between cognitive performance and physical activity level (PAL in the same study sample. We hypothesized that patients who performed better on cognitive tasks would show increased PALs and better performance on physical tests. The study included 31 women with CFS and 13 healthy inactive women. Participants first completed three cognitive tests. Afterward, they undertook a test to determine their maximal handgrip strength, performed a bicycle ergometer test, and were provided with an activity monitor. In patients with CFS, lower peak oxygen uptake and peak heart rate were associated with slower psychomotor speed (p < 0.05. Maximal handgrip strength was correlated with working memory performance (p < 0.05. Both choice and simple reaction time were lower in patients with CFS relative to healthy controls (p < 0.05 and p < 0.001, respectively. In conclusion, physical fitness, but not PAL, is associated with cognitive performance in female patients with CFS.

  12. Does cognitive functioning predict chronic pain? Results from a prospective surgical cohort.

    Science.gov (United States)

    Attal, Nadine; Masselin-Dubois, Anne; Martinez, Valéria; Jayr, Christian; Albi, Aline; Fermanian, Jacques; Bouhassira, Didier; Baudic, Sophie

    2014-03-01

    It is well established that chronic pain impairs cognition, particularly memory, attention and mental flexibility. Overlaps have been found between the brain regions involved in pain modulation and cognition, including in particular the prefrontal cortex and the anterior cingulate cortex, which are involved in executive function, attention and memory. However, whether cognitive function may predict chronic pain has not been investigated. We addressed this question in surgical patients, because such patients can be followed prospectively and may have no pain before surgery. In this prospective longitudinal study, we investigated the links between executive function, visual memory and attention, as assessed by clinical measurements and the development of chronic pain, its severity and neuropathic symptoms (based on the 'Douleur Neuropathique 4' questionnaire), 6 and 12 months after surgery (total knee arthroplasty for osteoarthritis or breast surgery for cancer). Neuropsychological tests included the Trail-Making Test A and B, and the Rey-Osterrieth Complex Figure copy and immediate recall, which assess cognitive flexibility, visuospatial processing and visual memory. Anxiety, depression and coping strategies were also evaluated. In total, we investigated 189 patients before surgery: 96% were re-evaluated at 6 months, and 88% at 12 months. Multivariate logistic regression (stepwise selection) for the total group of patients indicated that the presence of clinical meaningful pain at 6 and 12 months (pain intensity ≥ 3/10) was predicted by poorer cognitive performance in the Trail Making Test B (P = 0.0009 and 0.02 for pain at 6 and 12 months, respectively), Rey-Osterrieth Complex Figure copy (P = 0.015 and 0.006 for pain at 6 and 12 months, respectively) and recall (P = 0.016 for pain at 12 months), independently of affective variables. Linear regression analyses indicated that impaired scores on these tests predicted pain intensity (P executive functioning or

  13. Short- and long-term cognitive effects of chronic cannabinoids administration in late-adolescence rats.

    Directory of Open Access Journals (Sweden)

    Hila Abush

    Full Text Available The use of cannabis can impair cognitive function, especially short-term memory. A controversial question is whether long-term cannabis use during the late-adolescence period can cause irreversible deficits in higher brain function that persist after drug use stops. In order to examine the short- and long-term effects of chronic exposure to cannabinoids, rats were administered chronic i.p. treatment with the CB1/CB2 receptor agonist WIN55,212-2 (WIN; 1.2 mg/kg for two weeks during the late adolescence period (post-natal days 45-60 and tested for behavioral and electrophysiological measures of cognitive performance 24 hrs, 10 and 30 days after the last drug injection. The impairing effects of chronic WIN on short-term memory in the water maze and the object recognition tasks as well as long-term potentiation (LTP in the ventral subiculum (vSub-nucleus accumbens (NAc pathway were temporary as they lasted only 24 h or 10 d after withdrawal. However, chronic WIN significantly impaired hippocampal dependent short-term memory measured in the object location task 24 hrs, 10, 30, and 75 days after the last drug injection. Our findings suggest that some forms of hippocampal-dependent short-term memory are sensitive to chronic cannabinoid administration but other cognitive impairments are temporary and probably result from a residue of cannabinoids in the brain or acute withdrawal effects from cannabinoids. Understanding the effects of cannabinoids on cognitive function may provide us with tools to overcome these impairments and for cannabinoids to be more favorably considered for clinical use.

  14. Cognitive impairments in first-episode drug-naive and chronic medicated schizophrenia: MATRICS consensus cognitive battery in a Chinese Han population.

    Science.gov (United States)

    Wu, Jing Qin; Chen, Da Chun; Tan, Yun Long; Xiu, Mei Hong; Yang, Fu De; Soares, Jair C; Zhang, Xiang Yang

    2016-04-30

    Cognitive deficits are a core feature of schizophrenia and we examined the cognitive profile of first-episode and chronic schizophrenia in a Chinese Han population using the MATRICS Consensus Cognitive Battery (MCCB). We recruited 79 first-episode drug-naïve (FEDN) schizophrenia, 132 chronic medicated schizophrenia inpatients and 124 healthy controls. We assessed patient psychopathology using the Positive and Negative Syndrome Scale (PANSS). MCCB total score (pMSCEIT) were significantly higher in FEDN than in chronic patients (all p<0.05). FEDN exhibited relative weakness in continuous performance, whereas chronic patients exhibited relative weakness in mazes. Multiple regression analysis confirmed that in FEDN and chronic patients, total score and negative symptom of PANSS were independent contributors to MCCB total score, respectively. Our results not only demonstrate the applicability of the MCCB as a sensitive measure of cognitive impairment for schizophrenia patients in a Chinese Han population, but also suggest that the compromised cognition is present in the early stage of schizophrenia, some of which could be more severe in the chronic stage of illness.

  15. Cognitive deficits in the rat chronic mild stress model for depression: relation to anhedonic-like responses

    DEFF Research Database (Denmark)

    Henningsen, Kim; Andreasen T., Jesper; Bouzinova, Elena V.

    2009-01-01

    The chronic mild stress (CMS) protocol is widely used to evoke depressive-like behaviours in laboratory rats. The aim of the present study was to examine the effects of chronic stress on cognitive performance. About 70% of rats exposed to 7 weeks of chronic mild stress showed a gradual reduction...... in consumption of a sucrose solution, indicating an anhedonic-like state. The remaining rats did not reduce their sucrose intake, but appeared resilient to the stress-induced effects on sucrose intake. Cognitive profiling of the CMS rats revealed that chronic stress had a negative effect on performance...

  16. l-Carnitine improves cognitive and renal functions in a rat model of chronic kidney disease.

    Science.gov (United States)

    Abu Ahmad, Nur; Armaly, Zaher; Berman, Sylvia; Jabour, Adel; Aga-Mizrachi, Shlomit; Mosenego-Ornan, Efrat; Avital, Avi

    2016-10-01

    Over the past decade, the prevalence of chronic kidney disease (CKD) has reached epidemic proportions. The search for novel pharmacological treatment for CKD has become an area of intensive clinical research. l-Carnitine, considered as the "gatekeeper" responsible for admitting long chain fatty acids into cell mitochondria. l-Carnitine synthesis and turnover are regulated mainly by the kidney and its levels inversely correlate with serum creatinine of normal subjects and CKD patients. Previous studies showed that l-carnitine administration to elderly people is improving and preserving cognitive function. As yet, there are no clinical intervention studies that investigated the effect of l-carnitine administration on cognitive impairment evidenced in CKD patients. Thus, we aimed to investigate the effects of l-carnitine treatment on renal function and on the cognitive performance in a rat model of progressive CKD. To assess the role of l-carnitine on CKD condition, we estimated the renal function and cognitive abilities in a CKD rat model. We found that all CKD animals exhibited renal function deterioration, as indicated by elevated serum creatinine, BUN, and ample histopathological abnormalities. l-Carnitine treatment of CKD rats significantly reduced serum creatinine and BUN, attenuated renal hypertrophy and decreased renal tissue damage. In addition, in the two way shuttle avoidance learning, CKD animals showed cognitive impairment which recovered by the administration of l-carnitine. We conclude that in a rat model of CKD, l-carnitine administration significantly improved cognitive and renal functions.

  17. Doubtful association of antipsychotic polypharmacy and high dosage with cognition in chronic schizophrenia.

    Science.gov (United States)

    Kontis, Dimitrios; Theochari, Eirini; Kleisas, Spyridon; Kalogerakou, Stamatina; Andreopoulou, Angeliki; Psaras, Rafael; Makris, Yannis; Karouzos, Charalambos; Tsaltas, Eleftheria

    2010-10-01

    Despite consistent recommendations for antipsychotic monotherapy, antipsychotic polypharmacy (the use of two or more antipsychotic agents) and the administration of excessive doses (higher than 1000 mgr/day of chloropromazine equivalents) is a common practice in schizophrenia. The therapeutic and adverse effects of this practice are poorly studied, in particular with regards to the cognitive symptoms of the disease. In this cross-sectional study we investigated the cognitive effects of antipsychotic polypharmacy and excessive doses in 53 patients with chronic schizophrenia using non-verbal cognitive tasks involving speed of movement, memory and executive functions. No significant difference in performance scores was found between the groups under polypharmacy and monotherapy, or the groups receiving either excessive or normal doses of antipsychotics. Since these groups did not also differ in demographic, clinical, other pharmacologic parameters, in the relative anticholinergic potency of antipsychotics, or in intelligence scores, we raise doubts about the association of polypharmacy and excessive doses with non-verbal cognitive performance in chronic schizophrenia.

  18. Clinical features of development of chronic cerebral ischemia against background of pronounced decrease of cognitive functions

    Directory of Open Access Journals (Sweden)

    Zalisna Yu.D.

    2013-12-01

    Full Text Available The paper presents the results of analyses of cognitive failure in chronic cerebral ischemia (CCI with lesion of deep divisions of the brain white matter and basal ganglia, leading to disruption of communication of frontal and subcortical brain structures (the phenomenon of separation. Mechanism of separation primarily is associated with hypertension, which leads to secondary changes of the vascular wall microvasculature. For cerebral vascular insufficiency and for diseases, primarily involving basal ganglia, intellectual inertia, bradyphreniya and decreased concentration are more common. According to studies, chronic cerebral ischemia (CCI is recorded in 20-30% of people of working age. The main etiological forms of CCI are considered to be hypertensive, atherosclerotic and mixed. For CCI of the second stage formation of neurological syndromes (pseu¬dobulbar, pyramidal, extrapyramidal, atactic, increased cognitive disorder that causes temporary or permanent disa¬bility of patients, reduction of their quality of life are characteristic. The aim of the study was to determine the cha¬racteristics of cognitive impairment in patients with CCI (hypertonic and mixed origin and their relationship to clinical and neurological manifestations of the disease. Based on the data obtained through clinical examination and neu¬ropsychological testing, marked processes of attention exhaustion and a higher risk of progression of cognitive impairment in the group with a mixed form (hypertension and atherosclerotic were revealed.

  19. A Randomized, Controlled Trial of Cognitive Behavioral Social Skills Training for Middle-Aged and Older Outpatients With Chronic Schizophrenia

    OpenAIRE

    2005-01-01

    The number of older patients with chronic schizophrenia is increasing. There is a need for empirically validated psychotherapy interventions for these older patients. A randomized controlled trial compared treatment as usual (TAU) with TAU plus cognitive-behavioral social skills training (TAU+CBSST) in 76 middle-aged and older patients with chronic schizophrenia. CBSST teaches cognitive-behavioral coping techniques, social functioning skills, problem solving and compensatory aids for neurocog...

  20. Assessing the role of cognitive behavioral therapy in the management of chronic nonspecific back pain

    Directory of Open Access Journals (Sweden)

    Sveinsdottir V

    2012-10-01

    Full Text Available Vigdis Sveinsdottir,1 Hege R Eriksen,1,2 Silje Endresen Reme1,31Uni Health, Uni Research, Bergen, Norway; 2Department of Health Promotion and Development, University of Bergen, Bergen, Norway; 3Department of Environmental Health, Harvard School of Public Health, Boston, MA, USAPurpose: The aim of this study is to provide a narrative review of the current state of knowledge of the role of cognitive behavioral therapy (CBT in the management of chronic nonspecific back pain.Methods: A literature search on all studies published up until July 2012 (PubMed and PsycINFO was performed. The search string consisted of 4 steps: cognitive behavioral therapy/treatment/management/modification/intervention, chronic, back pain (MeSH term or low back pain (MeSH term, and randomized controlled trial (MeSH term. The conclusions are based on the results from randomized controlled trials (RCTs and reviews of RCTs. Interventions were not required to be pure CBT interventions, but were required to include both cognitive and behavioral components.Results: The search yielded 108 studies, with 46 included in the analysis. Eligible intervention studies were categorized as CBT compared to wait-list controls/treatment as usual, physical treatments/exercise, information/education, biofeedback, operant behavioral treatment, lumbar spinal fusion surgery, and relaxation training. The results showed that CBT is a beneficial treatment for chronic back pain on a wide range of relevant variables, especially when compared to wait-list controls/treatment as usual. With regards to the other comparison treatments, results were mixed and inconclusive.Conclusion: The results of this review suggest that CBT is a beneficial treatment for chronic nonspecific back pain, leading to improvements in a wide range of relevant cognitive, behavioral and physical variables. This is especially evident when CBT is compared to treatment as usual or wait-list controls, but mixed and inconclusive when

  1. Profile of cognitive deficits and associations with depressive symptoms and intelligence in chronic early-onset schizophrenia patients

    DEFF Research Database (Denmark)

    Jepsen, Jens Richardt Møllegaard; Fagerlund, Birgitte; Pagsberg, Anne Katrine

    2013-01-01

    -onset schizophrenia patients, assess the potential associations with depressive symptom severity, and examine whether cognitive deficits within several domains reflect intelligence impairments. This study compared attention, visual-construction, aspects of visual and verbal memory, and executive functions in chronic......-onset schizophrenia, significant deficits were observed in all specific cognitive functions. The profile of cognitive deficits was jagged, and visual-construction, attention, and one aspect of verbal memory (verbal stories recall) were differentially impaired. Deficits of visual recall, visual recognition...

  2. Patterns of Change in Cognitive Function over Six Months in Adults with Chronic Heart Failure

    Directory of Open Access Journals (Sweden)

    Barbara Riegel

    2012-01-01

    Full Text Available Few investigators have studied cognition over time in adults with heart failure (HF. A battery of neuropsychological tests was administered to 279 adults with chronic systolic or diastolic HF at baseline, three and six months. Growth mixture modeling (GMM was used to model the measure anticipated to be most sensitive, the digit symbol substitution task (DSST. We describe how and why the DSST patterns change over time. Other measures of cognition were examined to identify consistency with the DSST patterns. The sample was predominantly male (63.2%, Caucasian (62.7%, mean age 62 years. The best fit GMM revealed two trajectories of DSST scores: Average processing speed group (40.5% and Below Average processing speed (59.9%. Neither group changed significantly over the six month study. Other measures of cognition were consistent with the DSST patterns. Factors significantly associated with increased odds of being in the Below Average processing speed group included older age, male gender, Non-Caucasian race, less education, higher ejection fraction, high comorbid burden, excessive daytime sleepiness, and higher BMI. As some of the factors related to cognitive impairment are modifiable, research is needed to identify interventions to preserve and improve cognition in these patients.

  3. Neuroimaging assessment of early and late neurobiological sequelae of traumatic brain injury: implications for CTE

    Directory of Open Access Journals (Sweden)

    Mark eSundman

    2015-09-01

    Full Text Available Traumatic brain injury (TBI has been increasingly accepted as a major external risk factor for neurodegenerative morbidity and mortality. Recent evidence indicates that the resultant chronic neurobiological sequelae following head trauma may, at least in part, contribute to a pathologically distinct disease known as Chronic Traumatic Encephalopathy (CTE. The clinical manifestation of CTE is variable, but the symptoms of this progressive disease include impaired memory and cognition, affective disorders (i.e., impulsivity, aggression, depression, suicidality, etc., and diminished motor control. Notably, mounting evidence suggests that the pathology contributing to CTE may be caused by repetitive exposure to subconcussive hits to the head, even in those with no history of a clinically evident head injury. Given the millions of athletes and military personnel with potential exposure to repetitive subconcussive insults and TBI, CTE represents an important public health issue. However, the incidence rates and pathological mechanisms are still largely unknown, primarily due to the fact that there is no in vivo diagnostic tool. The primary objective of this manuscript is to address this limitation and discuss potential neuroimaging modalities that may be capable of diagnosing CTE in vivo through the detection of tau and other known pathological features. Additionally, we will discuss the challenges of TBI research, outline the known pathology of CTE (with an emphasis on Tau, review current neuroimaging modalities to assess the potential routes for in vivo diagnosis, and discuss the future directions of CTE research.

  4. The association between daytime napping and cognitive functioning in chronic fatigue syndrome.

    Directory of Open Access Journals (Sweden)

    Zoe M Gotts

    Full Text Available The precise relationship between sleep and physical and mental functioning in chronic fatigue syndrome (CFS has not been examined directly, nor has the impact of daytime napping. This study aimed to examine self-reported sleep in patients with CFS and explore whether sleep quality and daytime napping, specific patient characteristics (gender, illness length and levels of anxiety and depression, predicted daytime fatigue severity, levels of daytime sleepiness and cognitive functioning, all key dimensions of the illness experience.118 adults meeting the 1994 CDC case criteria for CFS completed a standardised sleep diary over 14 days. Momentary functional assessments of fatigue, sleepiness, cognition and mood were completed by patients as part of usual care. Levels of daytime functioning and disability were quantified using symptom assessment tools, measuring fatigue (Chalder Fatigue Scale, sleepiness (Epworth Sleepiness Scale, cognitive functioning (Trail Making Test, Cognitive Failures Questionnaire, and mood (Hospital Anxiety and Depression Scale.Hierarchical Regressions demonstrated that a shorter time since diagnosis, higher depression and longer wake time after sleep onset predicted 23.4% of the variance in fatigue severity (p <.001. Being male, higher depression and more afternoon naps predicted 25.6% of the variance in objective cognitive dysfunction (p <.001. Higher anxiety and depression and morning napping predicted 32.2% of the variance in subjective cognitive dysfunction (p <.001. When patients were classified into groups of mild and moderate sleepiness, those with longer daytime naps, those who mainly napped in the afternoon, and those with higher levels of anxiety, were more likely to be in the moderately sleepy group.Napping, particularly in the afternoon is associated with poorer cognitive functioning and more daytime sleepiness in CFS. These findings have clinical implications for symptom management strategies.

  5. The role of fear-avoidance cognitions and behaviors in patients with chronic tinnitus.

    Science.gov (United States)

    Kleinstäuber, Maria; Jasper, Kristine; Schweda, Isabell; Hiller, Wolfgang; Andersson, Gerhard; Weise, Cornelia

    2013-01-01

    The current study investigated the role of fear-avoidance-a concept from chronic pain research-in chronic tinnitus. A self-report measure the "Tinnitus Fear-Avoidance Cognitions and Behaviors Scale (T-FAS)" was developed and validated. Furthermore, the role of fear-avoidance behavior as mediator of the relationship between anxiety sensitivity and tinnitus handicap was investigated. From a clinical setting, N = 373 patients with chronic tinnitus completed questionnaires assessing tinnitus handicap (Tinnitus Handicap Inventory), anxiety, depression (Hospital Anxiety and Depression Scale), anxiety sensitivity (Anxiety Sensitivity Index-3), personality factors (Big Five Inventory-10), and fear-avoidance. To analyze the psychometric properties, principal component analysis with parallel component extraction and correlational analyses were used. To examine a possible mediating effect, hierarchical regression analysis was applied. The principal component analysis resulted in a three-factor solution: Fear-avoidance Cognitions, Tinnitus-related Fear-Avoidance Behavior, and Ear-related Fear-Avoidance Behavior. Internal consistency was satisfactory for the total scale and all subscales. High correlations between tinnitus-related handicap scales, depressive and anxiety symptoms, and the T-FAS were found, whereas associations with personality factors were low. Moreover, results indicate a significant partial mediation of fear-avoidance behaviors in the relationship between anxiety sensitivity and the cognitive dimension of tinnitus handicap. Results show that fear-avoidance behavior plays an important role in tinnitus handicap. More attention should be paid to this concept in research and clinical practice of psychotherapy for chronic tinnitus.

  6. Chronic coffee and caffeine ingestion effects on the cognitive function and antioxidant system of rat brains.

    Science.gov (United States)

    Abreu, Renata Viana; Silva-Oliveira, Eliane Moretto; Moraes, Márcio Flávio Dutra; Pereira, Grace Schenatto; Moraes-Santos, Tasso

    2011-10-01

    Coffee is a popular beverage consumed worldwide and its effect on health protection has been well studied throughout literature. This study investigates the effect of chronic coffee and caffeine ingestion on cognitive behavior and the antioxidant system of rat brains. The paradigms of open field and object recognition were used to assess locomotor and exploratory activities, as well as learning and memory. The antioxidant system was evaluated by determining the activities of glutathione reductase (GR), glutathione peroxidase (GPx) and superoxide dismutase (SOD), as well as the lipid peroxidation and reduced glutathione content. Five groups of male rats were fed for approximately 80 days with different diets: control diet (CD), fed a control diet; 3% coffee diet (3%Co) and 6% coffee diet (6%Co), both fed a diet containing brewed coffee; 0.04% caffeine diet (0.04%Ca) and 0.08% caffeine diet (0.08%Ca), both fed a control diet supplemented with caffeine. The estimated caffeine intake was approximately 20 and 40 mg/kg per day, for the 3%Co-0.04%Ca and 6%Co-0.08%Ca treatments, respectively. At 90 days of life, the animals were subjected to the behavioral tasks and then sacrificed. The results indicated that the intake of coffee, similar to caffeine, improved long-term memory when tested with object recognition; however, this was not accompanied by an increase in locomotor and exploratory activities. In addition, chronic coffee and caffeine ingestion reduced the lipid peroxidation of brain membranes and increased the concentration of reduced-glutathione. The activities of the GR and SOD were similarly increased, but no change in GPx activity could be observed. Thus, besides improving cognitive function, our data show that chronic coffee consumption modulates the endogenous antioxidant system in the brain. Therefore, chronic coffee ingestion, through the protection of the antioxidant system, may play an important role in preventing age-associated decline in the cognitive

  7. Interactions between chronic ethanol consumption and thiamine deficiency on neural plasticity, spatial memory and cognitive flexibility

    Science.gov (United States)

    Vedder, Lindsey C.; Hall, Joseph M.; Jabrouin, Kimberly R.; Savage, Lisa M.

    2015-01-01

    Background Many alcoholics display moderate to severe cognitive dysfunction accompanied by brain pathology. A factor confounded with prolonged heavy alcohol consumption is poor nutrition and many alcoholics are thiamine deficient. Thus, thiamine deficiency (TD) has emerged as a key factor underlying alcohol–related brain damage (ARBD). TD in humans can lead to Wernicke Encephalitis that can progress into Wernicke–Korsakoff Syndrome and these disorders have a high prevalence among alcoholics. Animal models are critical for determining the exact contributions of ethanol- and TD-induced neurotoxicity, as well as the interactions of those factors to brain and cognitive dysfunction. Methods Adult rats were randomly assigned to one of six treatment conditions: Chronic ethanol treatment (CET) where rats consumed a 20% v/v solution of ethanol over 6 months; Severe pyrithiamine-induced TD (PTD-MAS); Moderate PTD (PTD-EAS); Moderate PTD followed by CET (PTD-CET); Moderate PTD during CET (CET-PTD); Pair-fed control (PF). After recovery from treatment, all rats were tested on spontaneous alternation and attentional set-shifting. After behavioral testing, brains were harvested for determination of mature brain-derived neurotrophic factor (BDNF) and thalamic pathology. Results Moderate TD combined with CET, regardless of treatment order, produced significant impairments in spatial memory, cognitive flexibility and reductions in brain plasticity as measured by BDNF levels in the frontal cortex and hippocampus. These alterations are greater than those seen in moderate TD alone and the synergistic effects of moderate TD with CET leads to a unique cognitive profile. However, CET did not exacerbate thalamic pathology seen after moderate TD. Conclusions These data support the emerging theory that subclinical TD during chronic heavy alcohol consumption is critical for the development of significant cognitive impairment associated with ARBD. PMID:26419807

  8. Sequelae and rehabilitation of stroke.

    Science.gov (United States)

    Ueda, S

    1991-10-01

    During rehabilitation after stroke, evaluation and treatment are carried out for sensorimotor impairments such as hemiplegia or dysphagia, perceptual-cognitive impairments such as unilateral spatial neglect, disabilities such as dependence in activities of daily living, as well as various types of handicaps. Research into these problems is reviewed.

  9. Altered social cognition in male BDNF heterozygous mice and following chronic methamphetamine exposure.

    Science.gov (United States)

    Manning, Elizabeth E; van den Buuse, Maarten

    2016-05-15

    Growing clinical evidence suggests that persistent psychosis which occurs in methamphetamine users is closely related to schizophrenia. However, preclinical studies in animal models have focussed on psychosis-related behaviours following methamphetamine, and less work has been done to assess endophenotypes relevant to other deficits observed in schizophrenia. Altered social behaviour is a feature of both the negative symptoms and cognitive deficits in schizophrenia, and significantly impacts patient functioning. We recently found that brain-derived neurotrophic factor (BDNF) heterozygous mice show disrupted sensitization to methamphetamine, supporting other work suggesting an important role of this neurotrophin in the pathophysiology of psychosis and the neuronal response to stimulant drugs. In the current study, we assessed social and cognitive behaviours in methamphetamine-treated BDNF heterozygous mice and wildtype littermate controls. Following chronic methamphetamine exposure male wildtype mice showed a 50% reduction in social novelty preference. Vehicle-treated male BDNF heterozygous mice showed a similar impairment in social novelty preference, with a trend for no further disruption by methamphetamine exposure. Female mice were unaffected in this task, and no groups showed any changes in sociability or short-term spatial memory. These findings suggest that chronic methamphetamine alters behaviour relevant to disruption of social cognition in schizophrenia, supporting other studies which demonstrate a close resemblance between persistent methamphetamine psychosis and schizophrenia. Together these findings suggest that dynamic regulation of BDNF signalling is necessary to mediate the effects of methamphetamine on behaviours relevant to schizophrenia.

  10. Early treatment of minocycline alleviates white matter and cognitive impairments after chronic cerebral hypoperfusion.

    Science.gov (United States)

    Ma, Jing; Zhang, Jing; Hou, Wei Wei; Wu, Xiao Hua; Liao, Ru Jia; Chen, Ying; Wang, Zhe; Zhang, Xiang Nan; Zhang, Li San; Zhou, Yu Dong; Chen, Zhong; Hu, Wei Wei

    2015-01-01

    Subcortical ischemic vascular dementia (SIVD) caused by chronic cerebral hypoperfusion develops with progressive white matter and cognitive impairments, yet no effective therapy is available. We investigated the temporal effects of minocycline on an experimental SIVD exerted by right unilateral common carotid arteries occlusion (rUCCAO). Minocycline treated at the early stage (day 0-3), but not the late stage after rUCCAO (day 4-32) alleviated the white matter and cognitive impairments, and promoted remyelination. The actions of minocycline may not involve the inhibition of microglia activation, based on the effects after the application of a microglial activation inhibitor, macrophage migration inhibitory factor, and co-treatment with lipopolysaccharides. Furthermore, minocycline treatment at the early stage promoted the proliferation of oligodendrocyte progenitor cells (OPCs) in subventricular zone, increased OPC number and alleviated apoptosis of mature oligodendrocytes in white matter. In vitro, minocycline promoted OPC proliferation and increased the percentage of OPCs in S and G2/M phases. We provided direct evidence that early treatment is critical for minocycline to alleviate white matter and cognitive impairments after chronic cerebral hypoperfusion, which may be due to its robust effects on OPC proliferation and mature oligodendrocyte loss. So, early therapeutic time window may be crucial for its application in SIVD.

  11. Molecular Signatures of Psychosocial Stress and Cognition Are Modulated by Chronic Lithium Treatment.

    Science.gov (United States)

    Brzózka, Magdalena M; Havemann-Reinecke, Ursula; Wichert, Sven P; Falkai, Peter; Rossner, Moritz J

    2016-07-01

    Chronic psychosocial stress is an important environmental risk factor of psychiatric diseases such as schizophrenia. Social defeat in rodents has been shown to be associated with maladaptive cellular and behavioral consequences including cognitive impairments. Although gene expression changes upon psychosocial stress have been described, a comprehensive transcriptome profiling study at the global level in precisely defined hippocampal subregions which are associated with learning has been lacking. In this study, we exposed adult C57Bl/6N mice for 3 weeks to "resident-intruder" paradigm and combined laser capture microdissection with microarray analyses to identify transcriptomic signatures of chronic psychosocial stress in dentate gyrus and CA3 subregion of the dorsal hippocampus. At the individual transcript level, we detected subregion specific stress responses whereas gene set enrichment analyses (GSEA) identified several common pathways upregulated upon chronic psychosocial stress related to proteasomal function and energy supply. Behavioral profiling revealed stress-associated impairments most prominent in fear memory formation which was prevented by chronic lithium treatment. Thus, we again microdissected the CA3 region and performed global transcriptome analysis to search for molecular signatures altered by lithium treatment in stressed animals. By combining GSEA with unsupervised clustering, we detected pathways that are regulated by stress and lithium in the CA3 region of the hippocampus including proteasomal components, oxidative phosphorylation, and anti-oxidative mechanisms. Our study thus provides insight into hidden molecular phenotypes of chronic psychosocial stress and lithium treatment and proves a beneficial role for lithium treatment as an agent attenuating negative effects of psychosocial stress on cognition.

  12. Does Chronic Unpredictable Stress during Adolescence Affect Spatial Cognition in Adulthood?

    Directory of Open Access Journals (Sweden)

    Lauren E Chaby

    Full Text Available Spatial abilities allow animals to retain and cognitively manipulate information about their spatial environment and are dependent upon neural structures that mature during adolescence. Exposure to stress in adolescence is thought to disrupt neural maturation, possibly compromising cognitive processes later in life. We examined whether exposure to chronic unpredictable stress in adolescence affects spatial ability in late adulthood. We evaluated spatial learning, reference and working memory, as well as long-term retention of visuospatial cues using a radial arm water maze. We found that stress in adolescence decreased the rate of improvement in spatial learning in adulthood. However, we found no overall performance impairments in adult reference memory, working memory, or retention caused by adolescent-stress. Together, these findings suggest that adolescent-stress may alter the strategy used to solve spatial challenges, resulting in performance that is more consistent but is not refined by incorporating available spatial information. Interestingly, we also found that adolescent-stressed rats showed a shorter latency to begin the water maze task when re-exposed to the maze after an overnight delay compared with control rats. This suggests that adolescent exposure to reoccurring stressors may prepare animals for subsequent reoccurring challenges. Overall, our results show that stress in adolescence does not affect all cognitive processes, but may affect cognition in a context-dependent manner.

  13. Does Chronic Unpredictable Stress during Adolescence Affect Spatial Cognition in Adulthood?

    Science.gov (United States)

    Chaby, Lauren E; Sheriff, Michael J; Hirrlinger, Amy M; Lim, James; Fetherston, Thomas B; Braithwaite, Victoria A

    2015-01-01

    Spatial abilities allow animals to retain and cognitively manipulate information about their spatial environment and are dependent upon neural structures that mature during adolescence. Exposure to stress in adolescence is thought to disrupt neural maturation, possibly compromising cognitive processes later in life. We examined whether exposure to chronic unpredictable stress in adolescence affects spatial ability in late adulthood. We evaluated spatial learning, reference and working memory, as well as long-term retention of visuospatial cues using a radial arm water maze. We found that stress in adolescence decreased the rate of improvement in spatial learning in adulthood. However, we found no overall performance impairments in adult reference memory, working memory, or retention caused by adolescent-stress. Together, these findings suggest that adolescent-stress may alter the strategy used to solve spatial challenges, resulting in performance that is more consistent but is not refined by incorporating available spatial information. Interestingly, we also found that adolescent-stressed rats showed a shorter latency to begin the water maze task when re-exposed to the maze after an overnight delay compared with control rats. This suggests that adolescent exposure to reoccurring stressors may prepare animals for subsequent reoccurring challenges. Overall, our results show that stress in adolescence does not affect all cognitive processes, but may affect cognition in a context-dependent manner.

  14. Association of Chronic Obstructive Pulmonary Disease with Cognitive Decline in Very Elderly Men

    Directory of Open Access Journals (Sweden)

    Guoqing Zhou

    2012-05-01

    Full Text Available Aim: To determine the change in cognitive function in very elderly men with chronic obstructive pulmonary disease (COPD over a 3-year period relative to age- and education-matched controls. Methods: In this hospital-based, prospective case-control study, we evaluated a consecutive series of 110 very elderly men with COPD and 110 control subjects who were hospitalized between January and December 2007. All the subjects performed cognitive tests at baseline and underwent annual evaluations (for 3 years, which included the Mini-Mental State Examination, word list recall, delayed recall, animal category fluency, and the symbol digit modalities test. Results: In mixed-effects models adjusted for hypertension and coronary heart disease, COPD was associated with a more rapid rate of cognitive decline based on the Mini-Mental State Examination, word list recall, delayed recall, animal category fluency, and the symbol digit modalities test (all p Conclusion: COPD is associated with a more rapid rate of cognitive decline in very elderly persons.

  15. Cognitive behavioural treatment for the chronic post-traumatic headache patient

    DEFF Research Database (Denmark)

    Kjeldgaard, Dorte; Forchhammer, Hysse B; Teasdale, Thomas William;

    2014-01-01

    BACKGROUND: Chronic post-traumatic headache (CPTH) after mild head injury can be difficult to manage. Research is scarce and successful interventions are lacking.To evaluate the effect of a group-based Cognitive Behavioural Therapy (CBT) intervention in relation to headache, pain perception...... intervention. At baseline and after 26 weeks all patients completed the Rivermead Post Concussion Symptoms Questionnaire, SF-36, SCL-90-R and a headache diary. RESULTS: The CBT had no effect on headache and pressure pain thresholds and only a minor impact on the CPTH patients' quality of life, psychological...... distress, and the overall experience of symptoms. The waiting-list group experienced no change in headache but, opposed to the treatment group, a significant decrease in somatic and cognitive symptoms indicating a spontaneous remission over time. CONCLUSIONS: Our primarily negative findings confirm...

  16. Virtual Reality Training with Cognitive Load Improves Walking Function in Chronic Stroke Patients.

    Science.gov (United States)

    Cho, Ki Hun; Kim, Min Kyu; Lee, Hwang-Jae; Lee, Wan Hee

    2015-01-01

    Virtual reality training is considered as an effective intervention method of stroke patients, and the virtual reality system for therapeutic rehabilitation has emphasized the cognitive factors to improve walking function. The purpose of current study was to investigate the effect of virtual reality training with cognitive load (VRTCL) on walking function of chronic stroke. Chronic stroke patients were randomly assigned to the VRTCL group (11 patients, including 5 men; mean age, 60.0 years; post-stroke duration, 273.9 days) or control group (11 patients, including 2 men; mean age, 58.6 years; post-stroke duration, 263.9 days). All subjects participated in the standard rehabilitation program that consisted of physical and occupational therapies. In addition, VRTCL group participated in the VRTCL for 4 weeks (30 min per day and five times a week), while those in the control group participated in virtual reality treadmill training. Walking function under single (walking alone) and dual task (walking with cognitive tasks) conditions was assessed using an electrical walkway system. After the 4-week intervention, under both single and dual task conditions, significant improvement on walking function was observed in VRTCL and control groups (P < 0.05). In addition, in the dual task condition, greater improvement on walking function was observed in the VRTCL group, compared with the control group (P < 0.05). These findings demonstrated the efficacy of VRTCL on the walking function under the dual task condition. Therefore, we suggest that VRTCL may be an effective method for the achievement of independent walking in chronic stroke patients.

  17. Sleep-Disordered Breathing in Chronic SCI: A Randomized Controlled Trial of Treatment Impact on Cognition, Quality of Life, and Cardiovascular Disease

    Science.gov (United States)

    2014-10-01

    Randomized Controlled Trial of Treatment Impact on Cognition, Quality of Life, and Cardiovascular Disease PRINCIPAL INVESTIGATOR: Shirin Shafazand...PAP) will improve cognitive impairment, sleep quality, quality of life, and cardiovascular disease (CVD) surrogate measures in persons with chronic

  18. Electroconvulsive stimulation reverses anhedonia and cognitive impairments in rats exposed to chronic mild stress

    DEFF Research Database (Denmark)

    Henningsen, K; Woldbye, D P D; Wiborg, O

    2013-01-01

    Electroconvulsive therapy remains the most effective treatment for depression including a fast onset of action. However, this therapeutic approach suffers from some potential drawbacks. In the acute phase this includes amnesia. Electroconvulsive stimulation (ECS) has previously been shown...... to reverse a depression-like state in the chronic mild stress model of depression (CMS), but the effect of ECS on cognition has not previously been investigated. In this study the CMS model was used to induce a depressive-like condition in rats. The study was designed to investigate the acute effect of ECS...

  19. Neurological, psychological, and cognitive disorders in patients with chronic kidney disease on conservative and replacement therapy

    Science.gov (United States)

    Lai, Silvia; Mecarelli, Oriano; Pulitano, Patrizia; Romanello, Roberto; Davi, Leonardo; Zarabla, Alessia; Mariotti, Amalia; Carta, Maria; Tasso, Giorgia; Poli, Luca; Mitterhofer, Anna Paola; Testorio, Massimo; Frassetti, Nicla; Aceto, Paola; Galani, Alessandro; Lai, Carlo

    2016-01-01

    Abstract Chronic kidney disease (CKD) is a highly prevalent condition in the world. Neurological, psychological, and cognitive disorders, related to CKD, could contribute to the morbidity, mortality, and poor quality of life of these patients. The aim of this study was to assess the neurological, psychological, and cognitive imbalance in patients with CKD on conservative and replacement therapy. Seventy-four clinically stable patients affected by CKD on conservative therapy, replacement therapy (hemodialysis (HD), peritoneal dialysis (PD)), or with kidney transplantation (KT) and 25 healthy controls (HC), matched for age and sex were enrolled. Clinical, laboratory, and instrumental examinations, as renal function, inflammation and mineral metabolism indexes, electroencephalogram (EEG), psychological (MMPI-2, Sat P), and cognitive tests (neuropsychological tests, NPZ5) were carried out. The results showed a significant differences in the absolute and relative power of delta band and relative power of theta band of EEG (P = 0.008, P 2D3) (P 2D3, intact parathyroid hormone (iPTH), phosphorus, and cynical and hysterical personality, are correlated with higher relative power of delta (P = 0.016) and theta band (P = 0.016). Moreover, all NPZ5 scores showed a significant difference between the means of nephropathic patients and the means of the HC, and a positive correlation with eGFR, serum nitrogen, CRP, iPTH, and vitamin D. In CKD patients, simple and noninvasive instruments, as EEG, and cognitive-psychological tests, should be performed and careful and constant monitoring of renal risk factors, probably involved in neuropsychological complications (inflammation, disorders of mineral metabolism, electrolyte disorders, etc.), should be carried out. Early identification and adequate therapy of neuropsychological, and cognitive disorders, might enable a better quality of life and a major compliance with a probable reduction in the healthcare costs. PMID

  20. The Neuropsychology of Cluster Headache: Cognition, Mood, Disability, and Quality of Life of Patients With Chronic and Episodic Cluster Headache

    OpenAIRE

    Torkamani, Mariam; Ernst, Lea; Cheung, Lok Sze; Lambru, Giorgio; Matharu, Manjit; Jahanshahi, Marjan

    2015-01-01

    Background Cluster headache (CH) is commonly regarded as one of the most disabling headache conditions, and referred to as one of the most painful conditions known to humankind. Although there has been some research indicating the severe impact of CH, there is little comprehensive evidence of its impact on quality of life, disability, mood, and cognitive function in both its episodic (ECH) and chronic (CCH) variants. Methods This cross-sectional study investigates various aspects of cognitive...

  1. Chronic behavioral and cognitive deficits in a rat survival model of paraoxon toxicity.

    Science.gov (United States)

    Deshpande, Laxmikant S; Phillips, Kristin; Huang, Beverly; DeLorenzo, Robert J

    2014-09-01

    Organophosphate (OP) compounds, including paraoxon (POX), are similar to nerve agents such as sarin. There is a growing concern that OP agents could be weaponized to cause mass civilian causalities. We have developed a rodent survival model of POX toxicity that is being used to evaluate chronic morbidity and to screen for medical countermeasures against severe OP exposure. It is well known that the survivors of nerve gas and chronic OP exposure exhibit neurobehavioral deficits such as mood changes, depression, and memory impairments. In this study we investigated whether animals surviving severe POX exposure exhibited long-term neurological impairments. POX exposure produced overt signs of cholinergic toxicity. Rats were rescued using an optimized atropine, 2-PAM and diazepam therapy. Surviving rats were studied using established behavioral assays for identifying symptoms of depression and memory impairment 3-months after POX exposure. In the forced swim test, POX rats exhibited increased immobility time indicative of a despair-like state. In the sucrose preference test, POX rats consumed significantly less sucrose water indicating anhedonia-like condition. POX rats also displayed increased anxiety as characterized by significantly lower performance in the open arm of the elevated plus maze. Further, when tested with a novel object recognition paradigm, POX rats exhibited a negative discrimination ratio indicative of impaired recognition memory. The results indicate that this model of survival from severe POX exposure can be employed to study some of the molecular bases for OP-induced chronic behavioral and cognitive comorbidities and develop therapies for their treatment.

  2. Chronic Stress Contributes to Cognitive Dysfunction and Hippocampal Metabolic Abnormalities in APP/PS1 Mice

    Directory of Open Access Journals (Sweden)

    Bing Han

    2017-03-01

    Full Text Available Background/Aims: Stress response is determined by the brain, and the brain is a sensitive target for stress. Our previous experiments have confirmed that once the stress response is beyond the tolerable limit of the brain, particularly that of the hippocampus, it will have deleterious effects on hippocampal structure and function; however, the metabolic mechanisms for this are not well understood. Methods: Here, we used morris water maze, elisa and gas chromatography-time of flight/mass spectrometry to observe the changes in cognition, neuropathology and metabolomics in the hippocampus of APP/PS1 mice and wild-type (C57 mice caused by chronic unpredictable mild stress (CUMS, we also further explored the correlation between cognition and metabolomics. Results: We found that 4 weeks of CUMS aggravated cognitive impairment and increased amyloid-β deposition in APP/PS1 mice, but did not affect C57 mice. Under non-stress conditions, compared with C57 mice, there were 8 different metabolites in APP/PS1 mice. However, following CUMS, 3 different metabolites were changed compared with untreated C57 mice. Compared to APP/PS1 mice, there were 7 different metabolites in APP/PS1+CUMS mice. Among these alterations, 3-hydroxybutyric acid, valine, serine, beta-alanine and o-phosphorylethanolamine, which are involved in sphingolipid metabolism, synthesis and degradation of ketone bodies, and amino acid metabolism. Conclusion: The results indicate that APP/PS1 mice are more vulnerable to stress than C57 mice, and the metabolic mechanisms of stress-related cognitive impairment in APP/PS1 mice are related to multiple pathways and networks, including sphingolipid metabolism, synthesis and degradation of ketone bodies, and amino acid metabolism.

  3. Impairment of cognitive function and reduced hippocampal cholinergic activity in a rat model of chronic intermittent hypoxia

    Institute of Scientific and Technical Information of China (English)

    Chunling Zhao; Yan Chen; Chunlai Zhang; Linya Lü; Qian Xu

    2011-01-01

    The present study established a rat model of chronic intermittent hypoxia (CIH) to simulate obstructive sleep apnea syndrome. CIH rats were evaluated for cognitive function using the Morris water maze, and neuronal pathology in the hippocampus was observed using hematoxylin-eosin staining. In addition, hippocampal choline acetyl transferase (ChAT) and nicotinic acetylcholine receptor (nAChR) expression was determined by immunohistochemistry. Our results revealed necrotic hippocampal neurons, decreased ChAT and nAChR expression, as well as cognitive impairment in CIH rats. These results suggest that hippocampal neuronal necrosis and decreased cholinergic activity may be involved in CIH-induced cognitive impairment in rats.

  4. Psychosocial factors involved in memory and cognitive failures in people with myalgic encephalomyelitis/chronic fatigue syndrome

    Directory of Open Access Journals (Sweden)

    Attree EA

    2014-02-01

    Full Text Available Elizabeth A Attree,1 Megan A Arroll,1 Christine P Dancey,1 Charlene Griffith,1 Amolak S Bansal1,2 1Chronic Illness Research Team, School of Psychology, University of East London, London, UK; 2Department of Immunology and the Sutton CFS Service, St Helier Hospital, Carshalton, UK Background: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS is characterized by persistent emotional, mental, and physical fatigue accompanied by a range of neurological, autonomic, neuroendocrine, immune, and sleep problems. Research has shown that psychosocial factors such as anxiety and depression as well as the symptoms of the illness, have a significant impact on the quality of life of people with ME/CFS. In addition, individuals may suffer from deficits in memory and concentration. This study set out to explore the relationships between variables which have been found to contribute to cognitive performance, as measured by prospective and retrospective memory, and cognitive failures. Methods: Eighty-seven people with ME/CFS answered questionnaires measuring fatigue, depression, anxiety, social support, and general self-efficacy. These were used in a correlational design (multiple regression to predict cognitive function (self-ratings on prospective and retrospective memory, and cognitive failures. Results: Our study found that fatigue, depression, and general self-efficacy were directly associated with cognitive failures and retrospective (but not prospective memory. Conclusion: Although it was not possible in this study to determine the cause of the deficits, the literature in this area leads us to suggest that although the pathophysiological mechanisms of ME/CFS are unclear, abnormalities in the immune system, including proinflammatory cytokines, can lead to significant impairments in cognition. We suggest that fatigue and depression may be a result of the neurobiological effects of ME/CFS and in addition, that the neurobiological effects of the illness

  5. Acute trauma induced disc displacement without reduction and its sequelae

    Science.gov (United States)

    He, DongMei; Yang, XiuJuan; Wang, FeiYu; Yang, Chi; Dong, MinJun

    2016-01-01

    Acute traumatic temporomandibular joint disc displacement (ATDD) and its sequelae are not familiar for most surgeons. This study is to discuss its sequelae in cases without disc reduction after failed conservative treatment. From 2010 to 2015, 26 patients with 34 joints were included in the study. All patients had at least 3 months conservative treatment. Their maximal incisor opening (MIO) was measured during follow-ups and MRI examination was used to check the condylar bone degeneration. The mean follow-up for conservative treatment after admission was 8.69 months, the patients reached an average of 25.7 mm MIO. MRI showed condylar bone intact in 8 joints (23.5%), condylar surface bone destruction (Wilks IV, V stages) in 14 joints (41.2%), and severe bone resorption in 12 joints (35.3%). 15 patients with 23 joints were asked for surgical treatment after a mean conservative treatment of 5.4 months (3–12 months) to improve mouth opening and relieve chronic pain. 12 joints had total joint replacement (TJR). 11 joints had disc repositioning. Their mean MIO before operation was 19.8 mm and significantly improved to 33.9 mm after operation (p = 0.0000). ATDD may cause severe osteoarthritis or ankylosis. Disc repositioning and TJR could significantly improve MIO. PMID:27582054

  6. Defining the Role of Cognitive Behavioral Therapy in Treating Chronic Low Back Pain: An Overview.

    Science.gov (United States)

    Hanscom, David A; Brox, Jens Ivar; Bunnage, Ray

    2015-12-01

    Study Design Narrative review of the literature. Objectives Determine if the term cognitive behavioral therapy (CBT) is useful in clinical care and research. What literature supports these variables being relevant to the experience of chronic pain? What effects of CBT in treating these factors have been documented? What methods and platforms are available to administer CBT? Methods Chronic low back pain (CLBP) is a complex neurologic disorder with many components. CBT refers to a broad family of therapies that address both maladaptive thoughts and behaviors. There are several ways to deliver it. CLBP was broken into five categories that affect the perception of pain, and the literature was reviewed to see the effects of CBT on these variables. Results The term cognitive behavioral therapy has little use in future research because it covers such a wide range of therapies. CBT should always be defined by the problem it is intended to solve. The format and method of delivery should be defined because they have implications for outcomes. They are readily available even at the primary care level. The effectiveness of CBT is unquestioned regarding its effectiveness in treating each of the variables that affect CLBP. It is unclear why it is not more widely implemented. Conclusions CBT represents a family of therapies that are effective for a wide range of problems, many of which coexist with and influence CLBP. Each of the variables can be improved with focused CBT. Early, widespread adoption of CBT in treating and preventing CLBP is recommended. Future research and clinical care should focus on strategies to operationalize these well-documented treatments utilizing a public health approach.

  7. Neurological, psychological, and cognitive disorders in patients with chronic kidney disease on conservative and replacement therapy.

    Science.gov (United States)

    Lai, Silvia; Mecarelli, Oriano; Pulitano, Patrizia; Romanello, Roberto; Davi, Leonardo; Zarabla, Alessia; Mariotti, Amalia; Carta, Maria; Tasso, Giorgia; Poli, Luca; Mitterhofer, Anna Paola; Testorio, Massimo; Frassetti, Nicla; Aceto, Paola; Galani, Alessandro; Lai, Carlo

    2016-11-01

    Chronic kidney disease (CKD) is a highly prevalent condition in the world. Neurological, psychological, and cognitive disorders, related to CKD, could contribute to the morbidity, mortality, and poor quality of life of these patients. The aim of this study was to assess the neurological, psychological, and cognitive imbalance in patients with CKD on conservative and replacement therapy.Seventy-four clinically stable patients affected by CKD on conservative therapy, replacement therapy (hemodialysis (HD), peritoneal dialysis (PD)), or with kidney transplantation (KT) and 25 healthy controls (HC), matched for age and sex were enrolled. Clinical, laboratory, and instrumental examinations, as renal function, inflammation and mineral metabolism indexes, electroencephalogram (EEG), psychological (MMPI-2, Sat P), and cognitive tests (neuropsychological tests, NPZ5) were carried out.The results showed a significant differences in the absolute and relative power of delta band and relative power of theta band of EEG (P = 0.008, P therapy, and Grade 2-3 in KT patients. The scales of MMPI-2 hysteria and paranoia, are significantly correlated with creatinine, eGFR, serum nitrogen, CRP, 1,25-(OH)2D3, intact parathyroid hormone (iPTH), phosphorus, and cynical and hysterical personality, are correlated with higher relative power of delta (P = 0.016) and theta band (P = 0.016). Moreover, all NPZ5 scores showed a significant difference between the means of nephropathic patients and the means of the HC, and a positive correlation with eGFR, serum nitrogen, CRP, iPTH, and vitamin D.In CKD patients, simple and noninvasive instruments, as EEG, and cognitive-psychological tests, should be performed and careful and constant monitoring of renal risk factors, probably involved in neuropsychological complications (inflammation, disorders of mineral metabolism, electrolyte disorders, etc.), should be carried out. Early identification and adequate therapy of neuropsychological

  8. Living and ageing with cognitive impairments and chronic diseases in the technological landscapes of homes and public places

    DEFF Research Database (Denmark)

    Kottorp, Anders; Brorsson, Anna; Hedman, Annicka

    2016-01-01

    ). For people with cognitive impairments and people living with chronic diseases, the ability to use everyday technologies, including e-health technologies, is also important for monitoring and/or compensating for their disease and impairments, and may become a prerequisite for activity and participation...

  9. A cognitive behavioral based group intervention for children with a chronic illness and their parents: a multicentre randomized controlled trial

    NARCIS (Netherlands)

    L. Scholten; A.M. Willemen; M.A. Grootenhuis; H. Maurice-Stam; C. Schuengel; B.F. Last

    2011-01-01

    Coping with a chronic illness (CI) challenges children's psychosocial functioning and wellbeing. Cognitive-behavioral intervention programs that focus on teaching the active use of coping strategies may prevent children with CI from developing psychosocial problems. Involvement of parents in the int

  10. Internet-based cognitive behavioral therapy for patients with chronic somatic conditions: a meta-analytic review

    NARCIS (Netherlands)

    Beugen, S. van; Ferwerda, M.; Hoeve, D.; Rovers, M.M.; Koulil, S. van; Middendorp, H. van; Evers, A.W.M.

    2014-01-01

    BACKGROUND: Patients with chronic somatic conditions face unique challenges accessing mental health care outside of their homes due to symptoms and physical limitations. Internet-based cognitive behavioral therapy (ICBT) has shown to be effective for various psychological conditions. The increasing

  11. Somatic versus cognitive symptoms of depression as predictors of all-cause mortality and health status in chronic heart failure

    DEFF Research Database (Denmark)

    Schiffer, Angélique A; Pelle, Aline J; Smith, Otto R F

    2009-01-01

    Depression is a predictor of adverse health outcomes in chronic heart failure (CHF), but it is not known whether specific symptoms drive this relationship. We examined the impact of somatic/affective, cognitive/affective, and total depressive symptoms on all-cause mortality and health status in CHF....

  12. The impact of informational interventions about cognitive behavioral therapy for chronic fatigue syndrome on GPs referral behavior.

    NARCIS (Netherlands)

    Scheeres, K.; Wensing, M.J.P.; Mes, C.; Bleijenberg, G.

    2007-01-01

    OBJECTIVE: This study investigated the impact of an informational intervention among general practitioners (GPs) about a new treatment with cognitive behavioral therapy (CBT) for chronic fatigue syndrome (CFS) in a mental health center (MHC). The outcome measures concerned GPs knowledge and attitude

  13. Possible cause for altered spatial cognition of prepubescent rats exposed to chronic radiofrequency electromagnetic radiation.

    Science.gov (United States)

    Narayanan, Sareesh Naduvil; Kumar, Raju Suresh; Karun, Kalesh M; Nayak, Satheesha B; Bhat, P Gopalakrishna

    2015-10-01

    The effects of chronic and repeated radiofrequency electromagnetic radiation (RFEMR) exposure on spatial cognition and hippocampal architecture were investigated in prepubescent rats. Four weeks old male Wistar rats were exposed to RF-EMR (900 MHz; SAR-1.15 W/kg with peak power density of 146.60 μW/cm(2)) for 1 h/day, for 28 days. Followed by this, spatial cognition was evaluated by Morris water maze test. To evaluate the hippocampal morphology; H&E staining, cresyl violet staining, and Golgi-Cox staining were performed on hippocampal sections. CA3 pyramidal neuron morphology and surviving neuron count (in CA3 region) were studied using H&E and cresyl violet stained sections. Dendritic arborization pattern of CA3 pyramidal neuron was investigated by concentric circle method. Progressive learning abilities were found to be decreased in RF-EMR exposed rats. Memory retention test performed 24 h after the last training revealed minor spatial memory deficit in RF-EMR exposed group. However, RF-EMR exposed rats exhibited poor spatial memory retention when tested 48 h after the final trial. Hirano bodies and Granulovacuolar bodies were absent in the CA3 pyramidal neurons of different groups studied. Nevertheless, RF-EMR exposure affected the viable cell count in dorsal hippocampal CA3 region. RF-EMR exposure influenced dendritic arborization pattern of both apical and basal dendritic trees in RF-EMR exposed rats. Structural changes found in the hippocampus of RF-EMR exposed rats could be one of the possible reasons for altered cognition.

  14. Mapping of cognitive functions in chronic intractable epilepsy: Role of fMRI

    Directory of Open Access Journals (Sweden)

    Kapil Chaudhary

    2014-01-01

    Full Text Available Background: Functional magnetic resonance imaging (fMRI, a non-invasive technique with high spatial resolution and blood oxygen level dependent (BOLD contrast, has been applied to localize and map cognitive functions in the clinical condition of chronic intractable epilepsy. Purpose: fMRI was used to map the language and memory network in patients of chronic intractable epilepsy pre- and post-surgery. Materials and Methods: After obtaining approval from the institutional ethics committee, six patients with intractable epilepsy with an equal number of age-matched controls were recruited in the study. A 1.5 T MR scanner with 12-channel head coil, integrated with audio-visual fMRI accessories was used. Echo planar imaging sequence was used for BOLD studies. There were two sessions in TLE (pre- and post-surgery. Results: In TLE patients, BOLD activation increased post-surgery in comparison of pre-surgery in inferior frontal gyrus (IFG, middle frontal gyrus (MFG, and superior temporal gyrus (STG, during semantic lexical, judgment, comprehension, and semantic memory tasks. Conclusion: Functional MRI is useful to study the basic concepts related to language and memory lateralization in TLE and guide surgeons for preservation of important brain areas during ATLR. This will help in understanding future directions for the diagnosis and treatment of such disease.

  15. Long-Term Effects of Chronic Oral Ritalin Administration on Cognitive and Neural Development in Adolescent Wistar Kyoto Rats

    Directory of Open Access Journals (Sweden)

    Jennifer L. Cornish

    2012-09-01

    Full Text Available The diagnosis of Attention Deficit Hyperactivity Disorder (ADHD often results in chronic treatment with psychostimulants such as methylphenidate (MPH, Ritalin®. With increases in misdiagnosis of ADHD, children may be inappropriately exposed to chronic psychostimulant treatment during development. The aim of this study was to assess the effect of chronic Ritalin treatment on cognitive and neural development in misdiagnosed “normal” (Wistar Kyoto, WKY rats and in Spontaneously Hypertensive Rats (SHR, a model of ADHD. Adolescent male animals were treated for four weeks with oral Ritalin® (2 × 2 mg/kg/day or distilled water (dH2O. The effect of chronic treatment on delayed reinforcement tasks (DRT and tyrosine hydroxylase immunoreactivity (TH-ir in the prefrontal cortex was assessed. Two weeks following chronic treatment, WKY rats previously exposed to MPH chose the delayed reinforcer significantly less than the dH2O treated controls in both the DRT and extinction task. MPH treatment did not significantly alter cognitive performance in the SHR. TH-ir in the infralimbic cortex was significantly altered by age and behavioural experience in WKY and SHR, however this effect was not evident in WKY rats treated with MPH. These results suggest that chronic treatment with MPH throughout adolescence in “normal” WKY rats increased impulsive choice and altered catecholamine development when compared to vehicle controls.

  16. Effects of Chronic Obstructive Pulmonary Disease and Obstructive Sleep Apnea on Cognitive Functions: Evidence for a Common Nature

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    Georgia Andreou

    2014-01-01

    Full Text Available Patients with chronic obstructive pulmonary disease (COPD and obstructive sleep apnea syndrome (OSAS show similar neurocognitive impairments. Effects are more apparent in severe cases, whereas in moderate and mild cases the effects are equivocal. The exact mechanism that causes cognitive dysfunctions in both diseases is still unknown and only suggestions have been made for each disease separately. The primary objective of this review is to present COPD and OSAS impact on cognitive functions. Secondly, it aims to examine the potential mechanisms by which COPD and OSAS can be linked and provide evidence for a common nature that affects cognitive functions in both diseases. Patients with COPD and OSAS compared to normal distribution show significant deficits in the cognitive abilities of attention, psychomotor speed, memory and learning, visuospatial and constructional abilities, executive skills, and language. The severity of these deficits in OSAS seems to correlate with the physiological events such as sleep defragmentation, apnea/hypopnea index, and hypoxemia, whereas cognitive impairments in COPD are associated with hypoventilation, hypoxemia, and hypercapnia. These factors as well as vascocerebral diseases and changes in systemic hemodynamic seem to act in an intermingling and synergistic way on the cause of cognitive dysfunctions in both diseases. However, low blood oxygen pressure seems to be the dominant factor that contributes to the presence of cognitive deficits in both COPD and OSAS.

  17. An investigation into the effects of cognitive behavioral therapy on patients with chronic depression: a small case series

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    Horn GL

    2012-10-01

    Full Text Available Gemma Louise HornUniversity of Dundee, Scotland, UKBackground: National Institute for Clinical Excellence (NICE guidelines recommend a combination of cognitive behavioral therapy (CBT and antidepressants to treat chronic depression. The Cognitive Behavioral Analysis System of Psychotherapy (CBASP is the only therapy model specifically designed for the treatment of chronic depression.Objectives: To determine the clinical response to the CBASP of patients in a specialist clinical service for affective disorder and to ascertain their views on the value of the CBASP for their condition.Methods: Qualitative data from interviews including a questionnaire and objective data from Becks Depression Inventory II symptom rating scales were used to monitor the progress of a small case series of five patients with chronic, treatment refractory depression as they received the CBASP over a 10-month period.Results: Common themes from patient interviews show very positive engagement and attitudes to the CBASP from the questionnaire. Rating scales from Becks Depression Inventory II pre- and posttreatment showed very little change for three patients with improvements between 2 and 7 points but deterioration in symptoms of 2 points for the fourth patient.Conclusion: The CBASP is a well-liked and positive therapy that helps patients manage their lives and deal with personal relationships, although objective data indicate little change in symptom severity.Keywords: cognitive behavioral therapy, chronic depression, CBASP

  18. Rehabilitation needs and participation restriction in patients with cognitive disorder in the chronic phase of traumatic brain injury

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    Sashika, Hironobu; Takada, Kaoruko; Kikuchi, Naohisa

    2017-01-01

    Abstract The purpose of this study was to clarify psychosocial factors/problems, social participation, quality of life (QOL), and rehabilitation needs in chronic-phase traumatic brain injury (TBI) patients with cognitive disorder discharged from the level-1 trauma center (L1-TC), and to inspect the effects of rehabilitation intervention to these subjects. A mixed-method research (cross-sectional and qualitative study) was conducted at an outpatient rehabilitation department. Inclusion criteria of subjects were transfer to the L1-TC due to TBI; acute-stage rehabilitation treatment received in the L1-TC from November 2006 to October 2011; age of ≥18 and social participation, QOL, psychosocial factors/problems, rehabilitation needs, and chronic-phase rehabilitation outcomes were evaluated using the Wechsler Adult Intelligence Scale, Third Edition, the Wechsler Memory Scale-Revised, the Zung Self-Rating Depression Scale, the Sydney Psychosocial Reintegration Scale, Version 2, and the Short Form 36, Version 2, qualitative analysis of semistructured interviews, etc. Participants were classified into achieved-social-participation (n = 11; employed: 8), difficult-social-participation (n = 12; unemployed: 8), and no-cognitive-dysfunction groups (n = 8; no social participation restriction). Relative to the achieved-social-participation group, the difficult-social-participation group showed greater injury and cognitive dysfunction and lower Sydney Psychosocial Reintegration Scale and Short Form 36 role/social component summary scores (64.9/49.1 vs 44.3/30.4, respectively, P social participation status was greatly affected by the later cognitive disorders and psychosocial factors/problems not by the severity of TBI. No changes were observed in these scores following chronic-phase rehabilitation intervention. Chronic-phase TBI with cognitive disorder led to rehabilitation needs, and improvement of subjects’ psychosocial problems and QOL was difficult. PMID

  19. Cognition and emotional decision-making in chronic low back pain: an ERPs study during Iowa gambling task

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    Stefano eTamburin

    2014-11-01

    Full Text Available Previous reports documented abnormalities in cognitive functions and decision-making (DM in patients with chronic pain, but these changes are not consistent across studies. Reasons for these discordant findings might include the presence of confounders, variability in chronic pain conditions, and the use of different cognitive tests. The present study was aimed to add evidence in this field, by exploring the cognitive profile of a specific type of chronic pain, i.e.: chronic low back pain (cLBP.Twenty four cLBP patients and 24 healthy controls underwent a neuropsychological battery and we focused on emotional DM abilities by means of Iowa gambling task (IGT. During IGT, behavioral responses and the electroencephalogram (EEG were recorded in 12 patients and 12 controls. Event-related potentials (ERPs were averaged offline from EEG epochs locked to the feedback presentation (4000 ms duration, from 2000 ms before to 2000 ms after the feedback onset separately for wins and losses and the feedback-related negativity (FRN and P300 peak-to-peak amplitudes were calculated. Among cognitive measures, cLBP patients scored lower than controls in the modified card sorting test (MCST and the score in this test was significantly influenced by pain duration and intensity. Behavioural IGT results documented worse performance and the absence of a learning process during the test in cLBP patients compared to controls, with no effect of pain characteristics. ERPs findings documented abnormal feedback processing in patients during IGT.cLBP patients showed poor performance in the MCST and the IGT. Abnormal feedback processing may be secondary to impingement of chronic pain in brain areas involved in DM or suggest the presence of a predisposing factor related to pain chronification. These abnormalities might contribute to the impairment in the work and family settings that often cLBP patients report.

  20. Transcranial LED therapy for cognitive dysfunction in chronic, mild traumatic brain injury: two case reports

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    Naeser, Margaret A.; Saltmarche, Anita; Krengel, Maxine H.; Hamblin, Michael R.; Knight, Jeffrey A.

    2010-02-01

    Two chronic, traumatic brain injury (TBI) cases are presented, where cognitive function improved following treatment with transcranial light emitting diodes (LEDs). At age 59, P1 had closed-head injury from a motor vehicle accident (MVA) without loss of consciousness and normal MRI, but unable to return to work as development specialist in internet marketing, due to cognitive dysfunction. At 7 years post-MVA, she began transcranial LED treatments with cluster heads (2.1" diameter with 61 diodes each - 9x633nm, 52x870nm; 12-15mW per diode; total power, 500mW; 22.2 mW/cm2) on bilateral frontal, temporal, parietal, occipital and midline sagittal areas (13.3 J/cm2 at scalp, estimated 0.4 J/cm2 to brain cortex per area). Prior to transcranial LED, focused time on computer was 20 minutes. After 2 months of weekly, transcranial LED treatments, increased to 3 hours on computer. Performs nightly home treatments (now, 5 years, age 72); if stops treating >2 weeks, regresses. P2 (age 52F) had history of closed-head injuries related to sports/military training and recent fall. MRI shows fronto-parietal cortical atrophy. Pre-LED, was not able to work for 6 months and scored below average on attention, memory and executive function. Performed nightly transcranial LED treatments at home (9 months) with similar LED device, on frontal and parietal areas. After 4 months of LED treatments, returned to work as executive consultant, international technology consulting firm. Neuropsychological testing (post- 9 months of transcranial LED) showed significant improvement in memory and executive functioning (range, +1 to +2 SD improvement). Case 2 reported reduction in PTSD symptoms.

  1. Caffeine prevents cognitive impairment induced by chronic psychosocial stress and/or high fat-high carbohydrate diet.

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    Alzoubi, K H; Abdul-Razzak, K K; Khabour, O F; Al-Tuweiq, G M; Alzubi, M A; Alkadhi, K A

    2013-01-15

    Caffeine alleviates cognitive impairment associated with a variety of health conditions. In this study, we examined the effect of caffeine treatment on chronic stress- and/or high fat-high carbohydrate Western diet (WD)-induced impairment of learning and memory in rats. Chronic psychosocial stress, WD and caffeine (0.3 g/L in drinking water) were simultaneously administered for 3 months to adult male Wistar rats. At the conclusion of the 3 months, and while the previous treatments continued, rats were tested in the radial arm water maze (RAWM) for learning, short-term and long-term memory. This procedure was applied on a daily basis to all animals for 5 consecutive days or until the animal reaches days to criterion (DTC) in the 12th learning trial and memory tests. DTC is the number of days that the animal takes to make zero error in two consecutive days. Chronic stress and/or WD groups caused impaired learning, which was prevented by chronic caffeine administration. In the memory tests, chronic caffeine administration also prevented memory impairment during chronic stress conditions and/or WD. Furthermore, DTC value for caffeine treated stress, WD, and stress/WD groups indicated that caffeine normalizes memory impairment in these groups. These results showed that chronic caffeine administration prevented stress and/or WD-induced impairment of spatial learning and memory.

  2. Improving effect of chronic resveratrol treatment on central monoamine synthesis and cognition in aged rats.

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    Sarubbo, F; Ramis, M R; Aparicio, S; Ruiz, L; Esteban, S; Miralles, A; Moranta, D

    2015-06-01

    Resveratrol is a polyphenol exhibiting antioxidant and neuroprotective effects in neurodegenerative diseases. However, neuroprotective properties during normal aging have not been clearly demonstrated. We analyzed the in vivo effects of chronic administration of resveratrol (20 mg/kg/day for 4 weeks) in old male rats (Wistar, 20 months), on tryptophan hydroxylase (TPH) and tyrosine hydroxylase (TH) activities which mediate central monoaminergic neurotransmitters synthesis, and besides, on hippocampal-dependent working memory test (radial maze). Our results show an age-related decline in neurochemical parameters that were reversed by resveratrol administration. The resveratrol treatment enhances serotonin (5-HT) levels in pineal gland, in hippocampus, and in striatum, and those of noradrenaline (NA) in hippocampus and also dopamine (DA) in striatum. These changes were largely due to an increased activity of TPH-1 (463 % in pineal gland), TPH-2 (70-51 % in hippocampus and striatum), and TH (150-36 % in hippocampus and striatum). Additionally, the observed hippocampal effects correlate with a resveratrol-induced restorative effect on working memory (radial maze). In conclusion, this study suggests resveratrol treatment as a restoring therapy for the impaired cognitive functions occurring along normal aging process, by preventing 5-HT, DA, and NA neurotransmission decline.

  3. Cognitive Decline in Patients with Chronic Hydrocephalus and Normal Aging: ‘Growing into Deficits'

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    Marlijn H. de Beer

    2016-10-01

    Full Text Available Background/Aim: To explore the theory of ‘growing into deficits', a concept known from developmental neurology, in a series of cases with chronic hydrocephalus (CH. Methods: Patients were selected from the Amsterdam Dementia Cohort and underwent extensive dementia screening. Results: Twelve patients with CH were selected, in whom Alzheimer's disease was considered unlikely, based on biomarker information and follow-up. Mean Mini-Mental State Examination score was 24 (range 7-30. Most patients were functioning on a level of mild dementia [Clinical Dementia Rating score of 0.5 in 8/11 (66.7% patients]. On neuropsychological examination, memory and executive functions, as well as processing speed were most frequently impaired. Conclusion: In our opinion, the theory of ‘growing into deficits' shows a parallel with the clinical course of CH and normal aging when Alzheimer's disease was considered very unlikely, because most of these patients were functioning well for a very large part of their lives. The altered cerebrospinal fluid dynamics might make the brain more vulnerable to aging-related changes, leading to a faster cognitive decline in CH patients compared to healthy subjects, especially in case of concomitant brain damage such as traumatic brain injury or meningitis.

  4. Piracetam improves cognitive deficits caused by chronic cerebral hypoperfusion in rats.

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    He, Zhi; Liao, Yun; Zheng, Min; Zeng, Fan-Dian; Guo, Lian-Jun

    2008-06-01

    Piracetam is the derivate of gamma-aminobutyric acid, which improves the cognition,memory,consciousness, and is widely applied in the clinical treatment of brain dysfunction. In the present experiments, we study the effects of piracetam on chronic cerebral hypoperfused rats and observe its influence on amino acids, synaptic plasticity in the Perforant path-CA3 pathway and apoptosis in vivo. Cerebral hypoperfusion for 30 days by occlusion of bilateral common carotid arteries induced marked amnesic effects along with neuron damage, including: (1) spatial learning and memory deficits shown by longer escape latency and shorter time spent in the target quadrant; (2) significant neuronal loss and nuclei condensation in the cortex and hippocampus especially in CA1 region; (3) lower induction rate of long term potentiation, overexpression of BAX and P53 protein, and lower content of excitatory and inhibitory amino acids in hippocampus. Oral administration of piracetam (600 mg/kg, once per day for 30 days) markedly improved the memory impairment, increased the amino acid content in hippocampus, and attenuated neuronal damage. The ability of piracetam to attenuate memory deficits and neuronal damage after hypoperfusion may be beneficial in cerebrovascular type dementia.

  5. Cognitive behavior therapy for chronic insomnia occurring within the context of medical and psychiatric disorders.

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    Smith, Michael T; Huang, Mary I; Manber, Rachel

    2005-07-01

    Insomnia is a pervasive problem for many patients suffering from medical and psychiatric conditions. Even when the comorbid disorders are successfully treated, insomnia often fails to remit. In addition to compromising quality of life, untreated insomnia may also aggravate and complicate recovery from the comorbid disease. Cognitive behavior therapy for insomnia (CBT-I) has an established efficacy for primary insomnia, but less is known about its efficacy for insomnia occurring in the context of medical and psychiatric conditions. The purpose of this article is to present a rationale for using CBT-I in medical and psychiatric disorders, review the extant outcome literature, highlight considerations for adapting CBT-I procedures in specific populations, and suggest directions for future research. Outcome studies were identified for CBT-I in mixed medical and psychiatric conditions, cancer, chronic pain, HIV, depression, posttraumatic stress disorder, and alcoholism. Other disorders discussed include: bipolar disorder, eating disorders, generalized anxiety, and obsessive compulsive disorder. The available data demonstrate moderate to large treatment effects (Cohen's d, range=0.35-2.2) and indicate that CBT-I is a promising treatment for individuals with medical and psychiatric comorbidity. Although the literature reviewed here is limited by a paucity of randomized, controlled studies, the available data suggest that by improving sleep, CBT-I might also indirectly improve medical and psychological endpoints. This review underscores the need for future research to test the efficacy of adaptations of CBT-I to disease specific conditions and symptoms.

  6. TNF-α protein synthesis inhibitor restores neuronal function and reverses cognitive deficits induced by chronic neuroinflammation

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    Belarbi Karim

    2012-01-01

    Full Text Available Abstract Background Chronic neuroinflammation is a hallmark of several neurological disorders associated with cognitive loss. Activated microglia and secreted factors such as tumor necrosis factor (TNF-α are key mediators of neuroinflammation and may contribute to neuronal dysfunction. Our study was aimed to evaluate the therapeutic potential of a novel analog of thalidomide, 3,6'-dithiothalidomide (DT, an agent with anti-TNF-α activity, in a model of chronic neuroinflammation. Methods Lipopolysaccharide or artificial cerebrospinal fluid was infused into the fourth ventricle of three-month-old rats for 28 days. Starting on day 29, animals received daily intraperitoneal injections of DT (56 mg/kg/day or vehicle for 14 days. Thereafter, cognitive function was assessed by novel object recognition, novel place recognition and Morris water maze, and animals were euthanized 25 min following water maze probe test evaluation. Results Chronic LPS-infusion was characterized by increased gene expression of the proinflammatory cytokines TNF-α and IL-1β in the hippocampus. Treatment with DT normalized TNF-α levels back to control levels but not IL-1β. Treatment with DT attenuated the expression of TLR2, TLR4, IRAK1 and Hmgb1, all genes involved in the TLR-mediated signaling pathway associated with classical microglia activation. However DT did not impact the numbers of MHC Class II immunoreactive cells. Chronic neuroinflammation impaired novel place recognition, spatial learning and memory function; but it did not impact novel object recognition. Importantly, treatment with DT restored cognitive function in LPS-infused animals and normalized the fraction of hippocampal neurons expressing the plasticity-related immediate-early gene Arc. Conclusion Our data demonstrate that the TNF-α synthesis inhibitor DT can significantly reverse hippocampus-dependent cognitive deficits induced by chronic neuroinflammation. These results suggest that TNF-α is a

  7. Trauma-focused cognitive behaviour therapy and exercise for chronic whiplash: protocol of a randomised, controlled trial

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    Letitia Campbell

    2015-10-01

    Discussion: This study will provide a definitive evaluation of the effects of adding trauma-focused cognitive behaviour therapy to physiotherapy exercise for individuals with chronic WAD and PTSD. This study is likely to influence the clinical management of whiplash injury and will have immediate clinical applicability in Australia, Denmark and the wider international community. The study will also have implications for both health and insurance policy makers in their decision-making regarding treatment options and funding.

  8. Long-term changes in cognitive bias and coping response as a result of chronic unpredictable stress during adolescence

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    Lauren eChaby

    2013-07-01

    Full Text Available Animals that experience adverse events in early life often have life-long changes to their physiology and behavior. Long-term effects of stress during early life have been studied extensively, but less attention has been given to the consequences of negative experiences solely during the adolescent phase. Adolescence is a particularly sensitive period of life when regulation of the glucocorticoid stress hormone response matures and specific regions in the brain undergo considerable change. Aversive experiences during this time might, therefore, be expected to generate long-term consequences for the adult phenotype. Here we investigated the long-term effects of exposure to chronic unpredictable stress during adolescence on adult decision making, coping response, cognitive bias, and exploratory behavior in rats. Rats exposed to chronic unpredictable stress (e.g. isolation, crowding, cage tilt were compared to control animals that were maintained in standard, predictable conditions throughout development. Unpredictable stress during adolescence resulted in a suite of long-term behavioral and cognitive changes including a negative cognitive bias (F1,12 = 5.000, P < 0.05, altered coping response (T1,14 = 2.216, P = 0.04, and accelerated decision making (T1,14 = 3.245, P = 0.01. Exposure to chronic stress during adolescence also caused a short-term increase in boldness behaviors; in a novel object test 15 days after the last stressor, animals exposed to chronic unpredictable stress had decreased latencies to leave a familiar shelter and approach a novel object (T1,14 = 2.240, P = 0.04; T1,14 = 2.419, P = 0.03, respectively. The results showed that stress during adolescence has long-term impacts on behavior and cognition that affect the interpretation of ambiguous stimuli, behavioral response to adverse events, and how animals make decisions. Stress during adolescence also induced short-term changes in the way animals moved around a novel environment.

  9. A randomized controlled trial of Mindfulness-Based Cognitive Therapy (MBCT) versus treatment-as-usual (TAU) for chronic, treatment-resistant depression: study protocol

    NARCIS (Netherlands)

    Cladder-Micus, M.B.; Vrijsen, J.N.; Becker, E.S.; Donders, A.R.T.; Spijker, J.; Speckens, A.E.M.

    2015-01-01

    Background: Major depression is a common psychiatric disorder, frequently taking a chronic course. Despite provision of evidence-based treatments, including antidepressant medication and psychological treatments like cognitive behavioral therapy or interpersonal therapy, a substantial amount of pati

  10. Chronic Trigeminal Nerve Stimulation Protects Against Seizures, Cognitive Impairments, Hippocampal Apoptosis, and Inflammatory Responses in Epileptic Rats.

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    Wang, Qian-Qian; Zhu, Li-Jun; Wang, Xian-Hong; Zuo, Jian; He, Hui-Yan; Tian, Miao-Miao; Wang, Lei; Liang, Gui-Ling; Wang, Yu

    2016-05-01

    Trigeminal nerve stimulation (TNS) has recently been demonstrated effective in the treatment of epilepsy and mood disorders. Here, we aim to determine the effects of TNS on epileptogenesis, cognitive function, and the associated hippocampal apoptosis and inflammatory responses. Rats were injected with pilocarpine to produce status epilepticus (SE) and the following chronic epilepsy. After SE induction, TNS treatment was conducted for 4 consecutive weeks. A pilocarpine re-injection was then used to induce a seizure in the epileptic rats. The hippocampal neuronal apoptosis induced by seizure was assessed by TUNEL staining and inflammatory responses by immunohistochemistry and enzyme-linked immunosorbent assay (ELISA). The spontaneous recurrent seizure (SRS) number was counted through video monitoring, and the cognitive function assessed through Morris Water Maze (MWM) test. TNS treatment attenuated the SRS attacks and improved the cognitive impairment in epileptic rats. A pilocarpine re-injection resulted in less hippocampal neuronal apoptosis and reduced level of interleukin-1 beta (IL-1β), tumor necrosis factor-α (TNF-α), and microglial activation in epileptic rats with TNS treatment in comparison to the epileptic rats without TNS treatment. It is concluded that TNS treatment shortly after SE not only protected against the chronic spontaneous seizures but also improved cognitive impairments. These antiepileptic properties of TNS may be related to its attenuating effects on hippocampal apoptosis and pro-inflammatory responses.

  11. Chronic pravastatin but not atorvastatin treatment impairs cognitive function in two rodent models of learning and memory.

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    Sarah A Stuart

    Full Text Available Statins are some of the most commonly prescribed drugs and are used to reduce blood cholesterol. Recent evidence suggests that, in some patients, they may adversely influence cognitive function including causing memory impairments. These clinical observations have led to statin prescriptions now including a warning about possible cognitive impairments. In order to better understand the relationship between statin treatment and cognitive function, studies in animals are needed. The present study investigated the effects of chronic treatment with two statins, pravastatin and atorvastatin, in two rodent models of learning and memory. Adult rats were treated once daily with pravastatin (10 mg/kg, orally or atorvostatin (10 mg/kg, orally for 18 days. Before, during and after treatment, animals were tested in a simple discrimination and reversal learning task. On the last day of treatment and following one week withdrawal, animals were also tested in a task of novel object discrimination. Pravastatin tended to impair learning over the last few days of treatment and this effect was fully reversed once treatment ceased. In the novel object discrimination task, pravastatin significantly impaired object recognition memory. No effects were observed for atorvostatin in either task. These data suggest that chronic treatment with pravastatin impairs working and recognition memory in rodents. The reversibility of the effects on cessation of treatment is similar to what has been observed in patients, but the lack of effect of atorvostatin suggests that lipophilicity may not be a major factor influencing statin-induced cognitive impairments.

  12. Patterns in response to chronic terrorism threats: A construct of emotional, cognitive, and behavioral responses among Israeli citizens.

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    Cohen-Louck, Keren; Saka, Yael

    2016-11-10

    Israeli citizens are exposed to unpredictable and chronic terrorism threats that significantly jeopardize their personal sense of safety. The purpose of the present study is to present how Israeli discourse is structured with regard to emotional, cognitive, and behavioral responses to chronic terrorism threats and to understand the range of responses as well as map the risk and protective factors of this existential threat. Semistructured in-depth interviews were conducted with 40 Israeli adults (22 women and 18 men). Qualitative analysis revealed three patterns of responses to ongoing terrorism: emotional, cognitive, and behavioral. Emotional responses include fear, worry, sense of empathy, and detachment. Cognitive responses include situational assessment and pursuit of solutions, the use of traumatic imagining, beliefs in fate and luck, and optimism. Behavioral responses include looking for information, alertness, and habituation. The findings also revealed another response, which combines cognitive and behavioral responses. Some of the responses are innovative and unique to the threat of terrorism. Mapping the responses revealed mental health risk factors, as well as protective factors that can help structure personal and national resilience. These findings have implications on the treatment and prevention of personal and social pathologies, and how to effectively cope with terrorism threats.

  13. Targeting the affective and cognitive aspects of chronic neuropathic pain using basal forebrain neuromodulation: rationale, review and proposal.

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    Oluigbo, Chima O; Salma, Asem; Rezai, Ali R

    2012-09-01

    Chronic pain is a major health problem in developed countries where it may affect as much as 20% of the adult population. There have been no significant clinical breakthroughs in therapeutic options for persons with chronic neuropathic pain. These limitations underscore the importance of developing new therapies for this disabling pain syndrome. We have reviewed the limitations of the present treatment strategies for chronic pain, neurophysiology of somatosensory transmission and nociception, mechanisms of neuropathic pain, the concept of a "pain matrix" and the "top-down" modulation of pain, and the cognitive affective role in processing of the pain experience. We found that affective and cognitive aspects of pain constitute important considerations in achieving improvements in the outcomes of pain neuromodulation in patients with chronic neuropathic pain. Based on our review, we propose that future novel neuromodulatory therapeutic strategies should be directed at areas in the brain that are involved in the neural mechanisms of reward valuation and appetitive motivation such as nucleus accumbens, ventral tegmental area, and prefrontal cortex.

  14. A modern neuroscience approach to chronic spinal pain: combining pain neuroscience education with cognition-targeted motor control training.

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    Nijs, Jo; Meeus, Mira; Cagnie, Barbara; Roussel, Nathalie A; Dolphens, Mieke; Van Oosterwijck, Jessica; Danneels, Lieven

    2014-05-01

    Chronic spinal pain (CSP) is a severely disabling disorder, including nontraumatic chronic low back and neck pain, failed back surgery, and chronic whiplash-associated disorders. Much of the current therapy is focused on input mechanisms (treating peripheral elements such as muscles and joints) and output mechanisms (addressing motor control), while there is less attention to processing (central) mechanisms. In addition to the compelling evidence for impaired motor control of spinal muscles in patients with CSP, there is increasing evidence that central mechanisms (ie, hyperexcitability of the central nervous system and brain abnormalities) play a role in CSP. Hence, treatments for CSP should address not only peripheral dysfunctions but also the brain. Therefore, a modern neuroscience approach, comprising therapeutic pain neuroscience education followed by cognition-targeted motor control training, is proposed. This perspective article explains why and how such an approach to CSP can be applied in physical therapist practice.

  15. Administration of Lactobacillus helveticus NS8 improves behavioral, cognitive, and biochemical aberrations caused by chronic restraint stress.

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    Liang, S; Wang, T; Hu, X; Luo, J; Li, W; Wu, X; Duan, Y; Jin, F

    2015-12-03

    Increasing numbers of studies have suggested that the gut microbiota is involved in the pathophysiology of stress-related disorders. Chronic stress can cause behavioral, cognitive, biochemical, and gut microbiota aberrations. Gut bacteria can communicate with the host through the microbiota-gut-brain axis (which mainly includes the immune, neuroendocrine, and neural pathways) to influence brain and behavior. It is hypothesized that administration of probiotics can improve chronic-stress-induced depression. In order to examine this hypothesis, the chronic restraint stress depression model was established in this study. Adult specific pathogen free (SPF) Sprague-Dawley rats were subjected to 21 days of restraint stress followed by behavioral testing (including the sucrose preference test (SPT), elevated-plus maze test, open-field test (OFT), object recognition test (ORT), and object placement test (OPT)) and biochemical analysis. Supplemental Lactobacillus helveticus NS8 was provided every day during stress until the end of experiment, and selective serotonin reuptake inhibitor (SSRI) citalopram (CIT) served as a positive control. Results showed that L. helveticus NS8 improved chronic restraint stress-induced behavioral (anxiety and depression) and cognitive dysfunction, showing an effect similar to and better than that of CIT. L. helveticus NS8 also resulted in lower plasma corticosterone (CORT) and adrenocorticotropic hormone (ACTH) levels, higher plasma interleukin-10 (IL-10) levels, restored hippocampal serotonin (5-HT) and norepinephrine (NE) levels, and more hippocampal brain-derived neurotrophic factor (BDNF) mRNA expression than in chronic stress rats. Taken together, these results indicate an anti-depressant effect of L. helveticus NS8 in rats subjected to chronic restraint stress depression and that this effect could be due to the microbiota-gut-brain axis. They also suggest the therapeutic potential of L. helveticus NS8 in stress-related and possibly other

  16. Unlearning chronic pain: A randomized controlled trial to investigate changes in intrinsic brain connectivity following Cognitive Behavioral Therapy

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    Marina Shpaner

    2014-01-01

    Full Text Available Chronic pain is a complex physiological and psychological phenomenon. Implicit learning mechanisms contribute to the development of chronic pain and to persistent changes in the central nervous system. We hypothesized that these central abnormalities can be remedied with Cognitive Behavioral Therapy (CBT. Specifically, since regions of the anterior Default Mode Network (DMN are centrally involved in emotional regulation via connections with limbic regions, such as the amygdala, remediation of maladaptive behavioral and cognitive patterns as a result of CBT for chronic pain would manifest itself as a change in the intrinsic functional connectivity (iFC between these prefrontal and limbic regions. Resting-state functional neuroimaging was performed in patients with chronic pain before and after 11-week CBT (n = 19, as well as a matched (ages 19–59, both sexes active control group of patients who received educational materials (n = 19. Participants were randomized prior to the intervention. To investigate the differential impact of treatment on intrinsic functional connectivity (iFC, we compared pre–post differences in iFC between groups. In addition, we performed exploratory whole brain analyses of changes in fractional amplitude of low frequency fluctuations (fALFF. The course of CBT led to significant improvements in clinical measures of pain and self-efficacy for coping with chronic pain. Significant group differences in pre–post changes in both iFC and fALFF were correlated with clinical outcomes. Compared to control patients, iFC between the anterior DMN and the amygdala/periaqueductal gray decreased following CBT, whereas iFC between the basal ganglia network and the right secondary somatosensory cortex increased following CBT. CBT patients also had increased post-therapy fALFF in the bilateral posterior cingulate and the cerebellum. By delineating neuroplasticity associated with CBT-related improvements, these results add to

  17. Volatile substance abuse: a review of possible long-term neurological, intellectual and psychiatric sequelae.

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    Ron, M A

    1986-03-01

    The possibility that chronic abuse of volatile substances can cause permanent neurological, psychiatric, and intellectual sequelae is critically reviewed. Toluene, present in the commonly used adhesives, is most often implicated in 'glue sniffing'; this review focuses on its potential long-term effects. Many criticisms--particularly poor matching of control samples and inability to distinguish between acute and chronic effects--can be levelled at the available studies, while no adequate follow-up studies have been performed. In the light of present knowledge, the possibility that permanent structural brain damage, with accompanying psychiatric manifestations, results from solvent abuse remains inconclusive.

  18. Magnitude and variability of effect sizes for the associations between chronic pain and cognitive test performances: a meta-analysis

    Science.gov (United States)

    Rathbone, Michél; Parkinson, William; Rehman, Yasir; Jiang, Shucui; Bhandari, Mohit; Kumbhare, Dinesh

    2016-01-01

    Objectives and Methods: A systematic review and meta-analysis were performed to estimate the size and variability of the association between chronic pain (CP) and poorer cognitive test performances as a function of individual tests, pain sub-types, and study sources on 22 studies having (1) a control group, (2) reported means and standard deviations (SDs) and (3) tests studied at least 3 times. Results: CP patients performed significantly poorer with small to moderate effects (d = −.31 to −.57) on Digit Span Backward; STROOP Word; Color and Color-Word; Digit Symbol; Trail Making A and B; Rey Auditory Learning Immediate and Delayed Recall and Recognition. For these 10 measures, single effects (no interaction) were supported (I2 = 0%–8%) and Random and Fixed models yielded similar results. No group differences were found for Corsi Blocks Forward or Wisconsin Cart Sorting Test Categories Achieved, or Perseveration. Effects for the Rey Complex Figure Immediate and Delayed Recall were significant, but effect size was inconclusive, given moderate to high heterogeneity and lack of consistency between Random and Fixed models. For the Paced Auditory Serial Addition Test, there was a homogeneous (I2 = 0%) and significantly lower performance in fibromyalgia (d = −.47), but no effect in diagnostically undifferentiated pain samples, and wide variability across studies of whiplash (d = −.15 to −1.04, I2 = 60%). Conclusion: The magnitude and consistency of the CP – cognition effect depended on the test, pain subgroup and study source. Summary points Among tests showing a chronic pain (CP) – cognition effect, the magnitude of this association was consistently small to moderate across tests. Effect size estimation was inconclusive for Digit Span Forwards, the Paced Auditory Serial Addition Test and the Rey Complex Figure Test. Variance was too heterogeneous for testing cognitive domain specificity of the CP – cognition effect. PMID:27583141

  19. Adjunctive treatment for cognitive impairment in patients with chronic schizophrenia: a double-blind, placebo-controlled study

    Directory of Open Access Journals (Sweden)

    Zhu W

    2014-07-01

    Full Text Available Weiwei Zhu,1,2,* Zhanchou Zhang,1,* Jingfeng Qi,1 Fang Liu,3 Jindong Chen,1,4,5 Jingping Zhao,1,4,5 Xiaofeng Guo1,4,5 1Institute of Mental Health, Second Xiangya Hospital, Central South University, 2Brain Hospital of Hunan Province, Changsha, 3First Affiliated Hospital of Kunming Medical University, Kunming, 4National Technology Institute of Psychiatry, 5Key Laboratory of Psychiatry and Mental Health of Hunan Province, Changsha, People’s Republic of China *These authors contributed equally to this work Abstract: Cognitive impairment is closely related to real-life functioning in patients with schizophrenia. The aim of the present study was to evaluate the effects of adjunctive treatment with donepezil on cognition in patients with chronic schizophrenia. This was a 12-week, double-blind, randomized, placebo-controlled study of donepezil as an adjunct to antipsychotic drug therapy in patients with chronic stable schizophrenia. Sixty-one subjects were randomized to receive donepezil 5 mg/day (n=31 and/or placebo (n=30. A nine-test neuropsychological assessment battery was administered at baseline and at the end of the study. At the 12-week end point, the donepezil group showed significant improvements in the Wechsler Memory Scale Third Edition Spatial Span, Brief Visuospatial Memory Test total recall and delayed recall, Trail-Making Test Part A, and Category Fluency Test-animal naming (all P≤0.018. Compared with placebo, donepezil was associated with significant improvement in several cognitive domains, including working memory, speed of information processing, and visual learning and memory (P≤0.008. The results of the present study suggest that adjunctive use of donepezil is beneficial for improving cognitive function in patients with schizophrenia. Keywords: schizophrenia, cognitive function, donepezil

  20. 'Postconcussive' symptoms in persons with chronic pain.

    Science.gov (United States)

    Iverson, G L; McCracken, L M

    1997-11-01

    The purpose of this study was to examine the base rate of cognitive and neurobehavioural complaints in patients with chronic pain (N = 170) who had not sustained a head injury. The patients completed a packet of questionnaires that contained numerous questions regarding physical, cognitive, and psychological symptoms. The 'postconcussive-like' symptoms were selected and analysed. Specific symptom endorsement rates ranged from 5% to 76.5%. Disturbed sleep, fatigue, and irritability were reported by the majority of chronic pain patients. Cognitive complaints relating to forgetfulness (29%), difficulty maintaining attention (18%), and difficulty with concentration or thinking (16.5%) were endorsed by a significant minority of patients. Most patients (80.6%) endorsed three or more symptoms from Category C of the DSM-IV Postconcussional Disorder research criteria. This study further illustrates that postconcussive-like symptoms are not unique sequelae of mild head injury, and the presence of chronic pain should be considered when interpreting patients' physical, cognitive, and psychological complaints following closed head injury.

  1. Group cognitive remediation therapy for chronic schizophrenia: A randomized controlled trial.

    Science.gov (United States)

    Tan, Shuping; Zou, Yizhuang; Wykes, Til; Reeder, Clare; Zhu, Xiaolin; Yang, Fude; Zhao, Yanli; Tan, Yunlong; Fan, Fengmei; Zhou, Dongfeng

    2016-07-28

    Individual-level cognitive remediation therapy (CRT) has been shown to be effective for cognitive improvement and social function amelioration. Here, we aimed to test the efficacy of group-based CRT in Chinese subjects with schizophrenia. One-hundred and four inpatients were randomly assigned to either 40 sessions of small-group CRT therapy or therapeutic contact-matched Musical and Dancing Therapy (MDT). Cognitive and social functioning, as well as clinical symptoms, were evaluated over the course of treatment. Specifically, cognitive function was evaluated using a battery of cognitive measurements, clinical symptoms were evaluated using the Positive and Negative Syndrome Scale, and social function was evaluated using the Nurse's Observation Scale for Inpatient Evaluation-30. All patients were evaluated pre- and post-treatment. Forty-four individuals in the CRT group and 46 in the MDT group completed all of the planned treatments and analyses. Cognitive functions, especially cognitive flexibility and memory, showed significant improvement in the CRT group over the course of the study. The MDT group also showed improvement in several cognitive flexibility assessments, but the degree of improvement was significantly greater in the CRT group. Several social-function factors exhibited a significant improvement in the CRT group, but not in the MDT group. Cognitive function improvement correlated positively with social function without predicting social function change. We conclude that group-based CRT is an effective and promising therapy.

  2. Association of Chronic Kidney Disease and Cerebral Small Vessel Disease with Cognitive Impairment in Elderly Patients with Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Toshitaka Umemura

    2013-07-01

    Full Text Available Background/Aims: In recent years, the relationship between chronic kidney disease (CKD and cognitive impairment has been attracting attention. Cerebral small vessel disease (SVD is also associated with an increased risk of cognitive impairment. However, it is still unknown whether CKD markers are associated with cognitive impairment independently of SVD in elderly diabetic patients. Methods: Seventy-nine type 2 diabetic patients (mean age, 76.0 years were enrolled in the present study. CKD was defined as the presence of albuminuria and/or a low estimated glomerular filtration rate (eGFR 2. SVD was evaluated by the presence and severity of silent brain infarcts (SBIs and white matter lesions (WMLs on brain magnetic resonance imaging. Neuropsychological tests were assessed using four validated cognitive instruments. Results: In multiple linear regression analyses, albuminuria was associated with worse modified Stroop Color Word scores (β = 0.284, p = 0.017 and low eGFR was associated with reduced Digit Symbol Substitution scores (β = -0.224, p = 0.026 after adjustment for age, sex, education years, diabetes duration, hypertension, multiple SBIs, and advanced WMLs. In contrast, there were no significant associations between CKD markers and Mini-Mental State Examination or Word Recall scores. Conclusion: Our findings suggest that albuminuria and low eGFR are associated with frontal lobe dysfunction independently of SVD in elderly type 2 diabetic patients.

  3. Cortical Activation during a Cognitive Challenge in Patients with Chronic Temporal Lobe Epilepsy—A Dynamic SPECT Study

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    P. J. Kirkpatrick

    1993-01-01

    Full Text Available In a pilot group of six patients suffering from chronic temporal lobe epilepsy, single photon emission computerized tomography (SPECT has been used to image the changes in relative cerebral blood flow between rest (static scan and conditions of cognitive activation (activated scan. The cognitive challenge used during activation comprised a test of word memory, and the performance was expressed as a word memory score (WMS for each individual. An activation index (AI was calculated from the mean normalized density counts in specific regions of interest (ROIs, and values obtained were analysed for correlation with the WMS. The mean AI was increased significantly in the right lateral temporal cortex, the right and left inferior frontal regions, the left temporal pole, and the right medial temporal cortex. A positive correlation with the WMS was found in the medial temporal cortices, and this relationship was significant for the right medial temporal ROI.

  4. Related factors and predictors of cognitive dysfunction in chronic kidney disease on maintenance hemodialysis in Nigeria

    Directory of Open Access Journals (Sweden)

    Lukman Femi Owolabi

    2016-01-01

    Full Text Available Background: Previous studies suggest a high frequency of cognitive impairment (CI in persons with chronic kidney disease (CKD; however, factors associated with CI and predictors of CI in persons with CKD remain largely unclear. The aim of this study was to determine the factors associated with CI and predictors of CI in CKD patients on maintenance hemodialysis. Materials and Methods: The first stage of the study included recruitment of 100 apparently healthy participants aimed at determining the reference values. The second stage of the study included eighty CKD patients on maintenance hemodialysis. The iron psychology (FEPSY was used to assess the memory, psychomotor speed, concentration, and attention using simple auditory reaction time (ART and visual reaction time (VRT tasks, recognition memory tests (RMT, finger tapping task (FTT, and binary choice task (BCT. Results: Using normative values generated in this study, 41 (51.3% and 43 (53.8% CKD patients had abnormal scores on ART dominant (D and nondominant (ND sides, respectively. Forty (50% and 42 (52.5% patients had abnormal scores on VRT D and ND sides, respectively. Twenty-one (26.3% and 68 (85% had abnormal scores on BCT and computer-assisted visual scanning task, respectively. Sixty-four (80% and 65 (81.3% had abnormal scores on RMT (words and RMT, respectively. Fifty-two (65% and 48 (60% patients had abnormal scores on D and ND sides of (FTT, respectively. Factors associated with psychomotor speed impairment were duration of CKD from diagnosis (P = 0.0001 and 0.043 in D and ND ART, respectively, duration on dialysis (P = 0.0001 across board in D and ND ART as well as in D and ND VRT, respectively, and plasma urea (PU and plasma creatinine (PCr (P < 0.05. Factors found to be associated with memory impairment included age (P = 0.045 and 0.025 on words and figures RMT, respectively, PU (P = 0.002 and 0.005 on words and figures RMT, respectively, and PCr (P = 0.012 and 0.040 on words and

  5. Pharmacological treatment of neurobehavioural sequelae of traumatic brain injury.

    Science.gov (United States)

    Lombardi, F

    2008-01-01

    Neurobehavioural sequelae of traumatic brain injuries require an appropriate/effective pharmacological response in that they represent an important cause of disability. In this field, there is no evidence that reaches the level of a standard: there are guidelines on the use of methylphenidate, donepezil and bromocriptine for the treatment of cognitive disturbances, for the non-use of phenytoin and for the use of beta-blockers for controlling aggressiveness. Resolving a single symptom is not relevant in a rehabilitation project if it is not in the context of a more complex picture of neurobehavioural recovery, in which the positive and negative effects of every therapeutic choice are considered. For example, phenytoin could be used for the positive control of epileptic crises but is not advised since it impedes the recovery of cognitive functions in general. Analogous effects not yet identified may concern benzodiazepine, neuroleptics and other sedatives usually prescribed in cases of cranial trauma. Psychotropic drugs are considered to be able to influence the neuronal plasticity processes. Studies on animals have shown that the administration of D-amphetamine combined with sensorial-motor exercise produces the steady acceleration of motor recovery, which acts as a catalyst to the neurological recovery process. On the other hand, alpha1-NA receptor antagonist drugs produce negative effects; these include clonidine (antihypertension) and haloperidol (neuroleptic). Studies need to be carried out to evaluate the effectiveness of particular drugs. These studies need to focus not only on the disappearance of symptoms but also on the positive and negative effects on overall rehabilitation and on the neurobiological recovery of the patient.

  6. Cognitive science speaks to the "common-sense" of chronic illness management.

    Science.gov (United States)

    Leventhal, Howard; Leventhal, Elaine A; Breland, Jessica Y

    2011-04-01

    We describe the parallels between findings from cognitive science and neuroscience and Common-Sense Models in four areas: (1) Activation of illness representations by the automatic linkage of symptoms and functional changes with concepts (an integration of declarative and perceptual and procedural knowledge); (2) Action plans for the management of symptoms and disease; (3) Cognitive and behavioral heuristics (executive functions parallel to recent findings in cognitive science) involved in monitoring and modifying automatic control processes; (4) Perceiving and communicating to "other minds" during medical visits to address the declarative and non-declarative (perceptual and procedural) knowledge that comprise a patient's representations of illness and treatment (the transparency of other minds).

  7. Non-analgesic effects of opioids: the cognitive effects of opioids in chronic pain of malignant and non-malignant origin. An update.

    Science.gov (United States)

    Højsted, Jette; Kurita, Geana Paula; Kendall, Sally; Lundorff, Lena; de Mattos Pimenta, Cibele Andrucioli; Sjøgren, Per

    2012-01-01

    Opioids constitute the basis for pharmacological treatment of moderate to severe pain in cancer pain and non-cancer pain patients. Their action is mediated by the activation of opioid receptors, which integrates the pain modulation system with other effects in the central nervous system including cognition resulting in complex interactions between pain, opioids and cognition. The literature on this complexity is sparse and information regarding the cognitive effects of opioids in chronic pain patients is substantially lacking. Two previous systematic reviews on cancer pain and non-cancer pain patients only using controlled studies were updated. Fourteen controlled studies on the cognitive effects of opioids in chronic non-cancer pain patients and eleven controlled studies in cancer pain patients were included and analyzed. Opioid treatment involved slightly opposite outcomes in the two patient groups: no effects or worsening of cognitive function in cancer pain patients and no effect or improvements in the chronic non-cancer pain patients, however, due to methodological limitations and a huge variety of designs definite conclusions are difficult to draw from the studies. In studies of higher quality of evidence opioid induced deficits in cognitive functioning were associated with dose increase and the use of supplemental doses of opioids in cancer patients. Future perspectives should comprise the conduction of high quality randomized controlled trials (RCTs) involving relevant control groups and validated neuropsychological assessments tools before and after opioid treatment in order to further explore the complex interaction between pain, opioids and cognition.

  8. Self-management programs based on the social cognitive theory for Koreans with chronic disease: a systematic review.

    Science.gov (United States)

    Jang, Yeonsoo; Yoo, Hyera

    2012-02-01

    Self-management programs based on social cognitive theory are useful to improve health care outcomes for patients with chronic diseases in Western culture. The purpose of this review is to identify and synthesize published research on the theory to enhance self-efficacy in disease management and examine its applicability to Korean culture regarding the learning strategies used. Ultimately, it was to identify the optimal use of these learning strategies to improve the self-efficacy of Korean patients in self-management of their hypertension and diabetic mellitus. The authors searched the Korean and international research databases from January 2000 to September 2009. Twenty studies were selected and reviewed. The most frequently used learning strategies of social cognitive theory was skill mastery by practice and feedback (N = 13), followed by social or verbal persuasion by group members (N = 7) and, however, observation learning and reinterpretation of symptoms by debriefing or discussion were not used any of the studies. Eight studies used only one strategy to enhance self-efficacy and six used two. A lack of consistency regarding the content and clinical efficacy of the self-efficacy theory-based self-management programs is found among the reviewed studies on enhancing self-efficacy in Koreans with hypertension and diabetes mellitus. Further research on the effectiveness of these theory-based self-management programs for patients with chronic diseases in Korea and other countries is recommended.

  9. Impact of cognitive behavior therapy on health-related quality of life among adult hypnotic users with chronic insomnia.

    Science.gov (United States)

    Dixon, Simon; Morgan, Kevin; Mathers, Nigel; Thompson, Joanne; Tomeny, Maureen

    2006-01-01

    Results were combined from representative surveys of health related quality of life (HRQoL; n=11,877; age range=16-104) with data from a randomized controlled trial of cognitive behavior therapy for chronic insomnia (n=209; age range=31-92). Secondary analyses of scores from the SF-36 measure of HRQoL were conducted in order: (a) to compare the health related quality of life profiles of adult hypnotic users with chronic insomnia with those of population norms, and (b) to assess the impact of cognitive behavior therapy (CBT) for insomnia on HRQoL outcomes over 6 months. Compared with the primary care reference values, HRQoL among the trial participants at baseline was generally poorer. The magnitude of these decrements reduced markedly with advancing age. In the evaluation of the CBT intervention, statistically significant differences in SF-36 scores in favor of the intervention were present for physical functioning, emotional role limitation, and mental health over 6 months. Overall, this study shows that the SF-36 can play an important role in describing HRQoL in this patient group, and in the evaluation of interventions within this group.

  10. Sequelae of closed craniocerebral trauma and the efficacy of piracetam in its treatment in adolescents.

    Science.gov (United States)

    Zavadenko, N N; Guzilova, L S

    2009-05-01

    The efficacy of piracetam in treating the sequelae of moderate and severe closed craniocerebral trauma (CCT) in adolescents was evaluated in studies of 42 patients aged 12-18 years who had suffered CCT 1.5-5 years prior to the study. Adolescents of the experimental group (20 individuals) received piracetam (Nootropil) at doses of 40-50 mg/kg (daily daily 1600-2400 mg) for one month; patients of group 2 (22 individuals) served as controls. Piracetam was found to have positive therapeutic effects on impairments to higher mental (memory, attention, executive) and motor (coordination) functions and on measures of the speeds of cognitive and motor operations.

  11. Prevalence of Cognitive Impairment in Recently Diagnosed Type 2 Diabetes Patients: Are Chronic Inflammatory Diseases Responsible for Cognitive Decline?

    Science.gov (United States)

    Lavielle, Pilar; Talavera, Juan O.; Reynoso, Nancy; González, Marissa; Gómez-Díaz, Rita A.; Cruz, Miguel; Vázquez, Felipe; Wacher, Niels H.

    2015-01-01

    Objective To estimate the prevalence of cognitive impairment (CI) among patients recently diagnosed with type 2 diabetes (RDD) and to identify any relationships between CI and RDD comorbidities. Methods: One thousand seven hundred twelve patients with RDD participated in a cross-sectional study. The patients’ sociodemographic and clinical data were registered. Results The sample population had an average age of 51 ± 11 years, and 63.26% of the patients were female. CI was diagnosed in 38 patients (2.2%) and was more common among both females (2.8% vs. 1.3%, p = 0.063) and the elderly (0% at an age ≤ 30 years vs. 10.4% at an age > 70 years, p = 0.0001). Rheumatoid arthritis (present in 15.8% vs. absent in 2.1%) and asthma (13% vs. 2.1%) correlated significantly with CI based on the results of our logistic regression analysis. Conclusion Age, female gender, rheumatoid arthritis and asthma are risk factors for CI in the setting of RDD. PMID:26517541

  12. The Immunomodulatory Effects of Plant Extracts and Plant Secondary Metabolites on Chronic Neuroinflammation and Cognitive Aging: A Mechanistic and Empirical Review.

    Science.gov (United States)

    Kure, Christina; Timmer, Jorinde; Stough, Con

    2017-01-01

    Advances in healthcare have considerably improved the life expectancy of the human population over the last century and this has brought about new challenges. As we live longer the capacity for cognitive aging increases. Consequently, it has been noted that decline in cognitive performance in the elderly in domains of reasoning, problem solving skills, attention, processing speed, working memory and episodic memory is a significant societal problem. Despite the enormity of this issue there are relatively few interventions for cognitive aging. This may be due to our current state of knowledge on biological factors that underpin cognitive aging. One of the biological contributors to cognitive aging is chronic neuroinflammation. This review will provide an overview of the peripheral and central mechanisms involved in chronic neuroinflammation and how neuroinflammation may be related to age-associated cognitive decline. Plant based extracts including herbal and nutritional supplements with anti-inflammatory properties will be examined in relation to their utility in treating age-related cognitive decline. Plant based extracts in particular offer interesting pharmacological properties that may be quickly utilized to prevent cognitive aging.

  13. The Immunomodulatory Effects of Plant Extracts and Plant Secondary Metabolites on Chronic Neuroinflammation and Cognitive Aging: A Mechanistic and Empirical Review

    Science.gov (United States)

    Kure, Christina; Timmer, Jorinde; Stough, Con

    2017-01-01

    Advances in healthcare have considerably improved the life expectancy of the human population over the last century and this has brought about new challenges. As we live longer the capacity for cognitive aging increases. Consequently, it has been noted that decline in cognitive performance in the elderly in domains of reasoning, problem solving skills, attention, processing speed, working memory and episodic memory is a significant societal problem. Despite the enormity of this issue there are relatively few interventions for cognitive aging. This may be due to our current state of knowledge on biological factors that underpin cognitive aging. One of the biological contributors to cognitive aging is chronic neuroinflammation. This review will provide an overview of the peripheral and central mechanisms involved in chronic neuroinflammation and how neuroinflammation may be related to age-associated cognitive decline. Plant based extracts including herbal and nutritional supplements with anti-inflammatory properties will be examined in relation to their utility in treating age-related cognitive decline. Plant based extracts in particular offer interesting pharmacological properties that may be quickly utilized to prevent cognitive aging. PMID:28344556

  14. Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: Design of a randomised controlled trial

    DEFF Research Database (Denmark)

    Ris Hansen, Inge; Christensen, Robin Daniel Kjersgaard; Thomsen, Bente

    2011-01-01

    is to present the design of a randomised controlled trial (RCT) aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients......ABSTRACT: BACKGROUND: Many patients suffer from chronic neck pain following a whiplash injury. A combination of cognitive, behavioural therapy with physiotherapy interventions has been indicated to be effective in the management of patients with chronic whiplash-associated disorders. The objective...... with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline. METHODS: The design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited...

  15. Internet-delivered cognitive-behavioral treatment for adolescents with chronic pain and their parents: a randomized controlled multicenter trial.

    Science.gov (United States)

    Palermo, Tonya M; Law, Emily F; Fales, Jessica; Bromberg, Maggie H; Jessen-Fiddick, Tricia; Tai, Gabrielle

    2016-01-01

    Internet-delivered interventions are emerging as a strategy to address barriers to care for individuals with chronic pain. This is the first large multicenter randomized controlled trial of Internet-delivered cognitive-behavioral therapy (CBT) for pediatric chronic pain. Participants included were 273 adolescents (205 females and 68 males), aged 11 to 17 years with mixed chronic pain conditions and their parents, who were randomly assigned in a parallel-group design to Internet-delivered CBT (n = 138) or Internet-delivered Education (n = 135). Assessments were completed before treatment, immediately after treatment, and at 6-month follow-up. All data collection and procedures took place online. The primary analysis used linear growth models. Results demonstrated significantly greater reduction on the primary outcome of activity limitations from baseline to 6-month follow-up for Internet CBT compared with Internet education (b = -1.13, P = 0.03). On secondary outcomes, significant beneficial effects of Internet CBT were found on sleep quality (b = 0.14, P = 0.04), on reducing parent miscarried helping (b = -2.66, P = 0.007) and protective behaviors (b = -0.19, P = 0.001), and on treatment satisfaction (P values pain, and improvement in parent behavioral responses to pain). In conclusion, our Internet-delivered CBT intervention produced a number of beneficial effects on adolescent and parent outcomes, and could ultimately lead to wide dissemination of evidence-based psychological pain treatment for youth and their families.

  16. [The cognitive disorders and raised free-radical activity of a brain of posterity of rats-females with experimental chronic alcoholic pathology of a liver].

    Science.gov (United States)

    Vakhnin, V A; Brukhin, G V

    2014-01-01

    It is established, that chronic alcoholic defeat of hepatobiliarity sistems leads to infringement of cognitive functions at posterity. At the given group of animals revealed distress of memory and ability to orientation in space in the conditions of Morris water maze is, the research behavior is oppressed. Besides, the animals, born from mothers with chronic alcoholic defeat of hepatobiliarity systems have raised free-radical activity, which plays an important role in maintenance of adaptive possibilities of a brain.

  17. [Neuropsychiatric sequelae of viral meningitis in adults].

    Science.gov (United States)

    Damsgaard, Jesper; Hjerrild, Simon; Renvillard, Signe Groth; Leutscher, Peter Derek Christian

    2011-10-10

    Viral meningitis is considered to be a benign illness with only mild symptoms. In contrast to viral encephalitis and bacterial meningitis, the prognosis is usually good. However, retrospective studies have demonstrated that patients suffering from viral meningitis may experience cognitive impairment following the acute course of infection. Larger controlled studies are needed to elucidate the potential neuropsychiatric adverse outcome of viral meningitis.

  18. Chronic Effects of a Wild Green Oat Extract Supplementation on Cognitive Performance in Older Adults: A Randomised, Double-Blind, Placebo-Controlled, Crossover Trial

    Directory of Open Access Journals (Sweden)

    Narelle M. Berry

    2012-05-01

    Full Text Available Background and aim: Preliminary evaluation of a wild green oat extract (WGOE (Neuravena® ELFA®955, Frutarom, Switzerland revealed an acute cognitive benefit of supplementation. This study investigated whether regular daily WGOE supplementation would result in sustained cognitive improvements. Method: A 12-week randomised, double-blind, placebo-controlled cross-over trial of WGOE supplementation (1500 mg/day versus placebo was undertaken in 37 healthy adults aged 67 ± 0.8 years (mean ± SEM. Cognitive assessments included the Stroop colour-word test, letter cancellation, the rule-shift task, a computerised multi-tasking test battery and the trail-making task. All assessments were conducted in Week 12 and repeated in Week 24 whilst subjects were fasted and at least 18 h after taking the last dose of supplement. Result: Chronic WGOE supplementation did not affect any measures of cognition. Conclusion: It appears that the cognitive benefit of acute WGOE supplementation does not persist with chronic treatment in older adults with normal cognition. It remains to be seen whether sustained effects of WGOE supplementation may be more evident in those with mild cognitive impairment.

  19. Effects of Risperidone on Cognitive-Motor Performance and Motor Movements in Chronically Medicated Children

    Science.gov (United States)

    Aman, Michael G.; Hollway, Jill A.; Leone, Sarah; Masty, Jessica; Lindsay, Ronald; Nash, Patricia; Arnold, L. Eugene

    2009-01-01

    This study was designed to explore the placebo-controlled effects of risperidone on cognitive-motor processes, dyskinetic movements, and behavior in children receiving maintenance risperidone therapy. Sixteen children aged 4-14 years with disruptive behavior were randomly assigned to drug order in a crossover study of risperidone and placebo for 2…

  20. Predictors of the Effect of Cognitive Behavioral Therapy for Chronic Insomnia Comorbid with Breast Cancer

    Science.gov (United States)

    Tremblay, Valerie; Savard, Josee; Ivers, Hans

    2009-01-01

    Prior studies have supported the efficacy of cognitive behavioral therapy (CBT) for insomnia comorbid with cancer. This article reports secondary analyses that were performed on one of these studies to investigate the predictive role of changes in dysfunctional beliefs about sleep, adherence to behavioral strategies, and some nonspecific factors…

  1. Telephone-Delivered Cognitive Behavioral Therapy for Chronic Pain Following Traumatic Brain Injury

    Science.gov (United States)

    2013-10-01

    mechanisms, including: shared neurotransmitter pathways; mutual impact on cognitive processes such as threat appraisal and catastrophizing; and a cycle of...9. Kroenke K, Wu J, Bair MJ, Krebs EE, Damush TM, Tu W. Reciprocal relationship between pain and depression: a 12-month longitudinal analysis in

  2. Cognitive-Behavioral Classifications of Chronic Pain in Patients with Multiple Sclerosis

    Science.gov (United States)

    Khan, Fary; Pallant, Julie F.; Amatya, Bhasker; Young, Kevin; Gibson, Steven

    2011-01-01

    The aim of this study was to replicate, in patients with multiple sclerosis (MS), the three-cluster cognitive-behavioral classification proposed by Turk and Rudy. Sixty-two patients attending a tertiary MS rehabilitation center completed the Pain Impact Rating questionnaire measuring activity interference, pain intensity, social support, and…

  3. Cognitive Dysfunction, Locus of Control and Treatment Outcome among Chronic Alcoholics.

    Science.gov (United States)

    Abbott, Max W.

    While alcoholism is no longer regarded as a unitary disorder, conventional measures of congition and personality have yet to be shown capable of consistently predicting clinical outcomes. To investigate cognitive dysfunction and locus of control as predictors of post treatment outcome in a large sample of alcoholics, 106 alcoholics (74 men, 32…

  4. Chronic anger as a precursor to adult antisocial personality features: The moderating influence of cognitive control.

    Science.gov (United States)

    Hawes, Samuel W; Perlman, Susan B; Byrd, Amy L; Raine, Adrian; Loeber, Rolf; Pardini, Dustin A

    2016-01-01

    Anger is among the earliest occurring symptoms of mental health, yet we know little about its developmental course. Further, no studies have examined whether youth with persistent anger are at an increased risk of exhibiting antisocial personality features in adulthood, or how cognitive control abilities may protect these individuals from developing such maladaptive outcomes. Trajectories of anger were delineated among 503 boys using annual assessments from childhood to middle adolescence (ages ∼7-14). Associations between these trajectories and features of antisocial personality in young adulthood (age ∼28) were examined, including whether cognitive control moderates this association. Five trajectories of anger were identified (i.e., childhood-onset, childhood-limited, adolescent-onset, moderate, and low). Boys in the childhood-onset group exhibited the highest adulthood antisocial personality features (e.g., psychopathy, aggression, criminal charges). However, boys in this group were buffered from these problems if they had higher levels of cognitive control during adolescence. Findings were consistent across measures from multiple informants, replicated across distinct time periods, and remained when controlling for general intelligence and prior antisocial behavior. This is the first study to document the considerable heterogeneity in the developmental course of anger from childhood to adolescence. As hypothesized, good cognitive control abilities protected youth with persistent anger problems from developing antisocial personality features in adulthood. Clinical implications and future directions are discussed.

  5. Cognitive-behavioral treatment for chronic nightmares in trauma-exposed persons: assessing physiological reactions to nightmare-related fear.

    Science.gov (United States)

    Rhudy, Jamie L; Davis, Joanne L; Williams, Amy E; McCabe, Klanci M; Bartley, Emily J; Byrd, Patricia M; Pruiksma, Kristi E

    2010-04-01

    Cognitive-behavioral treatments (CBTs) that target nightmares are efficacious for ameliorating self-reported sleep problems and psychological distress. However, it is important to determine whether these treatments influence objective markers of nightmare-related fear, because fear and concomitant physiological responses could promote nightmare chronicity and sleep disturbance. This randomized, controlled study (N=40) assessed physiological (skin conductance, heart rate, facial electromyogram) and subjective (displeasure, fear, anger, sadness, arousal) reactions to personally relevant nightmare imagery intended to evoke nightmare-related fear. Physiological assessments were conducted at pretreatment as well as 1-week, 3-months, and 6-months posttreatment. Results of mixed effects analysis of variance models suggested treatment reduced physiological and subjective reactions to nightmare imagery, gains that were generally maintained at the 6-month follow-up. Potential implications are discussed.

  6. A cognitive behavioral based group intervention for children with a chronic illness and their parents: a multicentre randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Schuengel Carlo

    2011-07-01

    Full Text Available Abstract Background Coping with a chronic illness (CI challenges children's psychosocial functioning and wellbeing. Cognitive-behavioral intervention programs that focus on teaching the active use of coping strategies may prevent children with CI from developing psychosocial problems. Involvement of parents in the intervention program may enhance the use of learned coping strategies in daily life, especially on the long-term. The primary aim of the present study is to examine the effectiveness of a cognitive behavioral based group intervention (called 'Op Koers' 1 for children with CI and of a parallel intervention for their parents. A secondary objective is to investigate why and for whom this intervention works, in order to understand the underlying mechanisms of the intervention effect. Methods/design This study is a multicentre randomized controlled trial. Participants are children (8 to 18 years of age with a chronic illness, and their parents, recruited from seven participating hospitals in the Netherlands. Participants are randomly allocated to two intervention groups (the child intervention group and the child intervention combined with a parent program and a wait-list control group. Primary outcomes are child psychosocial functioning, wellbeing and child disease related coping skills. Secondary outcomes are child quality of life, child general coping skills, child self-perception, parental stress, quality of parent-child interaction, and parental perceived vulnerability. Outcomes are evaluated at baseline, after 6 weeks of treatment, and at a 6 and 12-month follow-up period. The analyses will be performed on the basis of an intention-to-treat population. Discussion This study evaluates the effectiveness of a group intervention improving psychosocial functioning in children with CI and their parents. If proven effective, the intervention will be implemented in clinical practice. Strengths and limitations of the study design are discussed

  7. A randomized controlled trial of an Internet-based cognitive-behavioural intervention for non-specific chronic pain : An effectiveness and cost-effectiveness study

    NARCIS (Netherlands)

    de Boer, M.J.; Versteegen, G. J.; Vermeulen, K. M.; Sanderman, R.; Struys, M. M.

    2014-01-01

    BACKGROUND: Cognitive-behavioural treatment can nowadays be delivered through the Internet. This form of treatment can have various advantages with regard to availability and accessibility. Previous studies showed that Internet-based treatment for chronic pain is effective compared to waiting-list c

  8. NEUROLOGICAL SEQUELAE FOLLOWING ANAESTHETIC RECOVERY AFTER BILATERAL TOTAL KNEE REPLACEMENT – TWO CASE REPORTS

    Directory of Open Access Journals (Sweden)

    Harpreet

    2016-03-01

    Full Text Available BACKGROUND Thromboembolism is a common and serious complication of joint replacement surgery. Cognitive decline occurs in 5-29% of patients, undergoing major orthopaedic surgery. Many studies show that systemic embolism may occur in the absence of venous-arterial shunts leading to cognitive dysfunction and neurological sequelae. METHODS We present two cases of neurological consequences occurring post bilateral TKR. Cases were successfully done under Combined Spinal Epidural Anaesthesia. Steroids were not used intraoperatively. RESULTS Both cases had neurological complications following completion of surgery. First case had posterior circulation TIA while the other had a right upper motor neuron facial palsy. CONCLUSION We suspect both as cases of cerebral fat microembolism in the absence of any venous-arterial shunt.

  9. Effects of Mindfulness-Based Cognitive Therapy on Body Awareness in Patients with Chronic Pain and Comorbid Depression

    Science.gov (United States)

    de Jong, Marasha; Lazar, Sara W.; Hug, Kiran; Mehling, Wolf E.; Hölzel, Britta K.; Sack, Alexander T.; Peeters, Frenk; Ashih, Heidi; Mischoulon, David; Gard, Tim

    2016-01-01

    Body awareness has been proposed as one of the major mechanisms of mindfulness interventions, and it has been shown that chronic pain and depression are associated with decreased levels of body awareness. We investigated the effect of Mindfulness-Based Cognitive Therapy (MBCT) on body awareness in patients with chronic pain and comorbid active depression compared to treatment as usual (TAU; N = 31). Body awareness was measured by a subset of the Multidimensional Assessment of Interoceptive Awareness (MAIA) scales deemed most relevant for the population. These included: Noticing, Not-Distracting, Attention Regulation, Emotional Awareness, and Self-Regulation. In addition, pain catastrophizing was measured by the Pain Catastrophizing Scale (PCS). These scales had adequate to high internal consistency in the current sample. Depression severity was measured by the Quick Inventory of Depressive Symptomatology—Clinician rated (QIDS-C16). Increases in the MBCT group were significantly greater than in the TAU group on the “Self-Regulation” and “Not Distracting” scales. Furthermore, the positive effect of MBCT on depression severity was mediated by “Not Distracting.” These findings provide preliminary evidence that a mindfulness-based intervention may increase facets of body awareness as assessed with the MAIA in a population of pain patients with depression. Furthermore, they are consistent with a long hypothesized mechanism for mindfulness and emphasize the clinical relevance of body awareness. PMID:27445929

  10. Limitación crónica al flujo aéreo en pacientes con secuelas de tuberculosis pulmonar: Caracterización y comparación con EPOC Chronic airways obstruction in patients with tuberculosis sequelae: A comparison with EPOC

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    PATRICIO JIMÉNEZ P

    2006-06-01

    Borg al inicio de la prueba (r = 0,747; p Chronic airway obstruction (CAO resulting from tuberculosis (TB sequelae (CAO-TB is a frequent condition in our population. However the information in the medical literature is scarce. The management of these patients usually follows guidelines for other illnesses such as chronic obstructive pulmonary disease (COPD or asthma. To better characterize CAO-TB, 25 patients with this condition that never smoked nor were diagnosed having asthma, were studied by means of spirometry, arterial blood gases and 6-minute walk test. Furthermore, they were compared with 12 COPD patients with similar FEV1 values. CAO-TB patients had history of tuberculosis 35 ± 11 years earlier, and all of them presented with lung scarring in one or both upper lobes. They were younger than COPD (58 ± 11 vs 69 ± 6 y.o.; p = 0.001 and females predominated over males (20/5 vs 2/10; p = 0.001. The FEV1/FVC ratio pre- and post-bronchodilator were higher in CAO-TB than in COPD patients (67% ± 12 vs 54% ± 9 pre; p = 0.001; 65% ± 14 vs 51% ± 7; p = 0.003 post, respectively. There were no differences in the remaining spirometric indices nor in arterial blood gases. The 6-min distance walked was comparable in both groups: 343 m (69% in CAO-TB and 361 m (76% in COPD. There were no differences in the oxygen saturation nor in heart rate neither at the beginning nor at the end of the 6-min walk test. However, CAO-TB patients had a higher respiratory rate at the beginning (22.7 ± 4.7 vs 19.8 ± 3.1 breath/min; p = 0.05 and at the end of the walk test (27.3 ± 6.7 vs 21.9 ± 3.3; p = 0.01 than COPD patients; although the Borg dyspnoea score was not different (1 ± 0,7 vs 1 ± 0.5 initial, 3 ± 1.5 vs 2.5 ± 0.8 final. Furthermore, a significant linear correlation between respiratory rate and Borg score was found both at the beginning (r = 0.747; p < 0.001 and at the end (r = 0.507; p = 0.01 of the walk test. In conclusion, CAO-TB patients are functionally comparable

  11. Cognitive Mechanisms Underlying Risky Decision-Making in Chronic Cannabis Users

    Science.gov (United States)

    Fridberg, Daniel J.; Queller, Sarah; Ahn, Woo-Young; Kim, Woojae; Bishara, Anthony J.; Busemeyer, Jerome R.; Porrino, Linda; Stout, Julie C.

    2009-01-01

    Chronic cannabis users are known to be impaired on a test of decision-making, the Iowa Gambling Task (IGT). Computational models of the psychological processes underlying this impairment have the potential to provide a rich description of the psychological characteristics of poor performers within particular clinical groups. We used two computational models of IGT performance, the Expectancy-Valence Learning model (EVL) and the Prospect-Valence Learning model (PVL), to assess motivational, memory, and response processes in 17 chronic cannabis abusers and 15 control participants. Model comparison and simulation methods revealed that the PVL model explained the observed data better than the EVL model. Results indicated that cannabis abusers tended to be under-influenced by loss magnitude, treating each loss as a constant and minor negative outcome regardless of the size of the loss. In addition, they were more influenced by gains, and made decisions that were less consistent with their expectancies relative to non-using controls. PMID:20419064

  12. Centrophenoxine improves chronic cerebral ischemia induced cognitive deficit and neuronal degeneration in rats

    Institute of Scientific and Technical Information of China (English)

    Yun LIAO; Rui WANG; Xi-can TANG

    2004-01-01

    AIM: To study the effects of centrophenoxine (CPH, meclofenoxate) on chronic cerebral hypoperfusion induced deficits in rats. METHODS: Chronic hypoperfusion in rats was performed by permanent bilateral ligation of the common carotid arteries. Morris water maze was used to measure spatial memory performance. Spectrophotometrical techniques were used to assay SOD, GPx activities, MDA content, TXB2, and 6-keto-PGF1α levels. Morphological change was examined by HE staining. The expression of Bax and p53 protein were assayed by immunohistochemistry analysis. RESULTS: Chronic hypoperfusion in rats resulted in spatial memory impairments shown by longer escape latency and shorter time spent in the target quadrant. These behavioral dysfunction were accompanied by increase in SOD and GPx activities, the content of MDA, the levels of pro-inflammatory mediators (TXB2, 6-keto-PGF1α), overexpression of Bax and P53 protein, and delayed degeneration of neurons in cortex and hippocampus. Oral administration of CPH (100 mg/kg, once per day for 37 d) markedly improved the memory impairment, reduced the increase in antioxidant enzyme activities, MDA content and the levels of pro-inflammatory mediators to their normal levels, and attenuated neuronal damage. CONCLUSION: The abilities of CPH to attenuate memory deficits and neuronal damage after ischemia may be beneficial in cerebrovascular type dementia.

  13. DIFFERENTIAL KINETICS IN ALTERATION AND RECOVERY OF COGNITIVE PROCESSES FROM A CHRONIC SLEEP RESTRICTION IN YOUNG HEALTHY MEN.

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    Arnaud Alexandre Rabat

    2016-05-01

    Full Text Available Chronic sleep restriction (CSR induces neurobehavioral deficits in young and healthy people with a morning failure of sustained attention process. Testing both the kinetic of failure and recovery of different cognitive processes (i.e. attention, executive under CSR and their potential links with subject’s capacities (stay awake, baseline performance, age and with some biological markers of stress and anabolism would be useful in order to understand the role of sleep debt on human behavior. Twelve healthy subjects spent 14 days in laboratory with 2 baseline days (B1 and B2, 8h TIB followed by 7 days of sleep restriction (SR1-SR7, 4h TIB, 3 sleep recovery days (R1-R3, 8h TIB and 2 more ones 8 days later (R12-R13. Subjective sleepiness (KSS, maintenance of wakefulness latencies (MWT were evaluated 4 times a day (10:00, 12:00 a.m. and 2:00, 4:00 p.m. and cognitive tests were realized at morning (8:30 a.m. and evening (6:30 p.m. sessions during B2, SR1, SR4, SR7, R2, R3 and R13. Saliva (B2, SR7, R2, R13 and blood (B1, SR6, R1, R12 samples were collected in the morning. Cognitive processes were differently impaired and recovered with a more rapid kinetic for sustained attention process. Besides, a significant time of day effect was only evidenced for sustained attention failures that seemed to be related to subject’s age and their morning capacity to stay awake. Executive processes were equally disturbed/recovered during the day and this failure/recovery process seemed to be mainly related to baseline subject’s performance and to their capacity to stay awake. Morning concentrations of testosterone, cortisol and α-amylase were significantly decreased at SR6-SR7, but were either and respectively early (R1, tardily (after R2 and no recovered (R13. All these results suggest a differential deleterious and restorative effect of CSR on cognition through biological changes of the stress pathway and subject’s capacity (ClinicalTrials-NCT01989741.

  14. Differential Kinetics in Alteration and Recovery of Cognitive Processes from a Chronic Sleep Restriction in Young Healthy Men.

    Science.gov (United States)

    Rabat, Arnaud; Gomez-Merino, Danielle; Roca-Paixao, Laura; Bougard, Clément; Van Beers, Pascal; Dispersyn, Garance; Guillard, Mathias; Bourrilhon, Cyprien; Drogou, Catherine; Arnal, Pierrick J; Sauvet, Fabien; Leger, Damien; Chennaoui, Mounir

    2016-01-01

    Chronic sleep restriction (CSR) induces neurobehavioral deficits in young and healthy people with a morning failure of sustained attention process. Testing both the kinetic of failure and recovery of different cognitive processes (i.e., attention, executive) under CSR and their potential links with subject's capacities (stay awake, baseline performance, age) and with some biological markers of stress and anabolism would be useful in order to understand the role of sleep debt on human behavior. Twelve healthy subjects spent 14 days in laboratory with 2 baseline days (B1 and B2, 8 h TIB) followed by 7 days of sleep restriction (SR1-SR7, 4 h TIB), 3 sleep recovery days (R1-R3, 8 h TIB) and two more ones 8 days later (R12-R13). Subjective sleepiness (KSS), maintenance of wakefulness latencies (MWT) were evaluated four times a day (10:00, 12:00 a.m. and 2:00, 4:00 p.m.) and cognitive tests were realized at morning (8:30 a.m.) and evening (6:30 p.m.) sessions during B2, SR1, SR4, SR7, R2, R3 and R13. Saliva (B2, SR7, R2, R13) and blood (B1, SR6, R1, R12) samples were collected in the morning. Cognitive processes were differently impaired and recovered with a more rapid kinetic for sustained attention process. Besides, a significant time of day effect was only evidenced for sustained attention failures that seemed to be related to subject's age and their morning capacity to stay awake. Executive processes were equally disturbed/recovered during the day and this failure/recovery process seemed to be mainly related to baseline subject's performance and to their capacity to stay awake. Morning concentrations of testosterone, cortisol and α-amylase were significantly decreased at SR6-SR7, but were either and respectively early (R1), tardily (after R2) and not at all (R13) recovered. All these results suggest a differential deleterious and restorative effect of CSR on cognition through biological changes of the stress pathway and subject's capacity (ClinicalTrials-NCT01989741).

  15. PI3K/Akt signal pathway involved in the cognitive impairment caused by chronic cerebral hypoperfusion in rats.

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    Yi Shu

    Full Text Available Chronic cerebral hypoperfusion (CCH is a common pathophysiological state that usually occurs in conditions such as vascular dementia and Alzheimer's disease, both of which are characterized by cognitive impairment. In previous studies we found that learning capacity and memory were gradually impaired with CCH, which altered the expression of synaptophysin, microtubule associated protein-2, growth associated protein-43, brain-derived neurotrophic factor, nerve growth factor, N-methyl-D-aspartate receptor subunit 1, cAMP response element-binding protein and tau hyperphosphorylation in the hippocampus. However, the molecular basis of cognitive impairment in CCH remains obscure. Here we explore the hypothesis that the phosphoinositide 3-kinase (PI3K/protein kinase B (Akt signal pathway is involved in this type of cognitive impairment. In order to determine if the expression of PI3K, Akt and phosphorylated Akt (p-Akt proteins are altered at different stages of CCH with differing levels of cognitive impairment. we performed permanent, bilateral occlusion of the common carotid arteries (2-VO to induce CCH. Adult male SD rats were randomly divided into sham-operated group, 2-VO 1 week group, 2-VO 4 weeks group and 2-VO 8 weeks group. Behavior tests were utilized to assess cognitive abilities, while western blots were utilized to evaluate protein expression. Rats in the 2-VO groups spent less time exploring novel objects than those in the sham-operated group, and the discrimination ratio of the 2-VO 8 weeks group and the sham-operated group were higher than chance (0.50. Escape latencies in the Morris water maze task in the 2-VO 1 week group were longer than those in the sham-operated group on day 4 and day 5, while escape latencies in the 2-VO 4 weeks group were longer than those in the sham-operated group from day 3 to day 5. Escape latencies in 2-VO 8 weeks group were longer than those in the sham-operated group from day 2 to day 5. NE (northeast

  16. Cognitive function in Stage 5 chronic kidney disease patients on hemodialysis: no adverse effects of lanthanum carbonate compared with standard phosphate-binder therapy.

    Science.gov (United States)

    Altmann, P; Barnett, M E; Finn, W F

    2007-02-01

    Patients with Stage 5 chronic kidney disease who have hyperphosphatemia require treatment with phosphate binders to lower serum phosphorus levels. Existing binders are effective but may be associated with important safety disadvantages. Lanthanum carbonate is a phosphate binder with demonstrated efficacy, safety, and tolerability in clinical trials. Changes in cognitive function were evaluated over time using the Cognitive Drug Research computerized cognitive assessment system (Simple Reaction Time, Digit Vigilance Task, Choice Reaction Time, Numeric Working Memory, and Delayed Picture Recognition) in 360 hemodialysis patients who were enrolled in a 2-year, multicenter, comparative study of lanthanum carbonate versus standard therapy. A decline in cognitive function from baseline was observed in both groups. The deterioration in cognitive function was similar in both the lanthanum carbonate and standard therapy groups. One parameter - Numeric Working Memory - showed a statistically significant between-group difference in favor of lanthanum carbonate (P=0.02). Given the magnitude of the changes, however, and the differences that were observed at baseline between treatment groups, the clinical significance of this difference is doubtful. This study demonstrates that cognitive function deteriorates in hemodialysis patients over a 2-year time period. Use of lanthanum carbonate as a phosphate binder does not adversely affect cognitive function compared with standard therapy.

  17. Systematic review of the risk of dementia and chronic cognitive impairment after mild traumatic brain injury

    DEFF Research Database (Denmark)

    Godbolt, Alison K; Cancelliere, Carol; Hincapié, Cesar A

    2014-01-01

    criteria. Peer-reviewed reports in 6 languages were considered. STUDY SELECTION: Systematic reviews, meta-analyses, randomized controlled trials, cohort studies, and case-control studies, with a minimum of 30 MTBI cases in subjects of any age, assessing the risk of dementia or CCI after MTBI were selected....... Methodological quality was acceptable for 101 (34%) articles, of which 1 article considered dementia and 7 articles considered CCI. The study examining the risk of dementia after MTBI did not find an association. One randomized controlled trial found that being informed about possible cognitive dysfunction after....... CONCLUSIONS: There is a lack of evidence of an increased risk of dementia after MTBI. In children, objective evidence of CCI exists only for complicated MTBI. More definitive studies are needed to inform clinical decisions, assessment of prognosis, and public health policy....

  18. Ocular sequelae from the illicit use of class A drugs

    OpenAIRE

    Firth, A Y

    2004-01-01

    Aim: To highlight the changes that may take place in\\ud the visual system of the class A drug abuser.\\ud \\ud \\ud Methods: A literature review was carried out of\\ud ocular/visual sequelae of the more common class A\\ud drugs. These include stimulants (cocaine and crack\\ud cocaine), narcotics (heroin, morphine, methadone)\\ud and hallucinogenics (ecstasy, lysergic acid diethylamide,\\ud magic mushrooms, mescaline, phencyclidine).\\ud \\ud \\ud Results: Ocular sequelae affecting visual acuity, the\\ud ...

  19. [Vitamin D3 poisoning and irreversible sequela].

    Science.gov (United States)

    Navarro, M; Acevedo, C; Espinosa, L; Peña, A; Picazo, M L; Larrauri, M

    1985-02-01

    Twenty-four children with vitamin D intoxication and a follow-up of one to thirteen years old (means: four years and seven months) are reviewed. Over-dosage was prescribed by medical order in 66.6% of patients and by the mother herself in 16.6%. Intensity of clinical symptoms (renal, neurologic, digestive) were related with daily dose administered whilst final secuelae depends on duration of overdosage. Hipercalcemia was easily corrected by association of low calcium diet, corticoesteroids and/or furosemide in least than a month in 81% of cases. Two patients died during the acute fase and 22.7% remain with permanent damage (five in chronic renal failure, one in haemodialysis and three with low IC).

  20. Antidepressant-like effects and possible mechanisms of amantadine on cognitive and synaptic deficits in a rat model of chronic stress.

    Science.gov (United States)

    Yu, Mei; Zhang, Yuan; Chen, Xiaoyu; Zhang, Tao

    2016-01-01

    The aim of this study was to examine whether amantadine (AMA), as a low-affinity noncompetitive N-methyl-d-aspartate (NMDA) receptor antagonist, is able to improve cognitive deficits caused by chronic stress in rats. Male Wistar rats were divided into four groups: control, control + AMA, stress and stress + AMA groups. The chronic stress model combined chronic unpredictable stress (CUS) with isolated feeding. Animals were exposed to CUS continued for 21 days. AMA (25 mg/kg) was administrated p.o. for 20 days from the 4th day of CUS to the 23rd. Weight and sucrose consumption were measured during model establishing period. Spatial memory was evaluated using the Morris water maze (MWM) test. Following MWM testing, both long-term potentiation (LTP) and depotentiation were recorded in the hippocampal CA1 region. NR2B and postsynaptic density protein 95 (PSD-95) proteins were measured by Western-blot analysis. AMA increased weight and sucrose consumption of stressed rats. Spatial memory and reversal learning in stressed rats were impaired relative to controls, whereas AMA significantly attenuated cognitive impairment. AMA also mitigated the chronic stress-induced impairment of hippocampal synaptic plasticity, in which both the LTP and depotentiation were significantly inhibited in stressed rats. Moreover, AMA enhanced the expression of hippocampal NR2B and PSD-95 in stressed rats. The data suggest that AMA may be an effective therapeutic agent for depression-like symptoms and associated cognitive disturbances.

  1. TNF-alpha inhibition prevents cognitive decline and maintains hippocampal BDNF levels in the unpredictable chronic mild stress rat model of depression.

    Science.gov (United States)

    Şahin, Tuğçe Demirtaş; Karson, Ayşe; Balcı, Fuat; Yazır, Yusufhan; Bayramgürler, Dilek; Utkan, Tijen

    2015-10-01

    Previous findings have shown that patients with depression express higher levels of proinflammatory cytokines such as TNF-α and IL-6. We have recently found that Infliximab (a TNF-α inhibitor) decreased anhedonia and despair-like behavior in the rat unpredictable chronic mild stress (UCMS) model of depression suggesting that inflammation might play an important role in depression. An increasing number of studies suggest that inflammation is also associated with cognitive impairments. The current study aimed to investigate the effect of UCMS on the cognitive performance of rats and their hippocampal BDNF levels and the effect of chronic Infliximab (5mg/kg/weekly, i.p.) treatment on these measures. Rats were subjected to different types of stressors daily for a period of 56 days to induce depression-like state. The UCMS resulted in impairments in spatial and emotional memory acquisition and retention with no effect on the level of locomotor activity. These behavioral effects of UCMS were accompanied by reduction in the level of BDNF in the CA1 and CA3 regions of the hippocampus. Chronic Infliximab treatment prevented the UCMS-induced cognitive impairments as well as the reduction in the levels of hippocampal brain-derived neurotrophic factor (BDNF). These results suggest that Infliximab improves the spatial and emotional memory impairments induced by chronic stress in rats likely through its effects on hippocampal function by modulating inflammation.

  2. Time to gain trust and change--experiences of attachment and mindfulness-based cognitive therapy among patients with chronic pain and psychiatric co-morbidity.

    Science.gov (United States)

    Peilot, Birgitta; Andréll, Paulin; Samuelsson, Anita; Mannheimer, Clas; Frodi, Ann; Sundler, Annelie J

    2014-01-01

    The treatment of patients with chronic pain disorders is complex. In the rehabilitation of these patients, coping with chronic pain is seen as important. The aim of this study was to explore the meaning of attachment and mindfulness-based cognitive therapy (CT) among patients with chronic pain and psychiatric co-morbidity. A phenomenological approach within a lifeworld perspective was used. In total, 10 patients were interviewed after completion of 7- to 13-month therapy. The findings reveal that the therapy and the process of interaction with the therapist were meaningful for the patients' well-being and for a better management of pain. During the therapy, the patients were able to initiate a movement of change. Thus, CT with focus on attachment and mindfulness seems to be of value for these patients. The therapy used in this study was adjusted to the patients' special needs, and a trained psychotherapist with a special knowledge of patients with chronic pain might be required.

  3. Chronic recurrent multifocal osteomyelitis

    NARCIS (Netherlands)

    Wedman, Jan; van Weissenbruch, Ranny

    2005-01-01

    We report what is, to our best knowledge, the first case of chronic recurrent multifocal osteomyelitis (CRMO) in which the frontal and sphenoid bones were involved. Characterized by a prolonged and fluctuating course of osteomyelitis at different sites, CRMO is self-limited, although sequelae can oc

  4. Neuromuscular strain as a contributor to cognitive and other symptoms in Chronic Fatigue Syndrome: Hypothesis and conceptual model.

    Directory of Open Access Journals (Sweden)

    Peter C. Rowe

    2013-05-01

    Full Text Available Individuals with chronic fatigue syndrome (CFS have heightened sensitivity and increased symptoms following various physiologic challenges, such as orthostatic stress, physical exercise, and cognitive challenges. Similar heightened sensitivity to the same stressors in fibromyalgia (FM has led investigators to propose that these findings reflect a state of central sensitivity. A large body of evidence supports the concept of central sensitivity in FM. A more modest literature provides partial support for this model in CFS, particularly with regard to pain. Nonetheless, fatigue and cognitive dysfunction have not been explained by the central sensitivity data thus far. Peripheral factors have attracted attention recently as contributors to central sensitivity. Work by Brieg, Sunderland, and others has emphasized the ability of the nervous system to undergo accommodative changes in length in response to the range of limb and trunk movements carried out during daily activity. If that ability to elongate is impaired—due to movement restrictions in tissues adjacent to nerves, or due to swelling or adhesions within the nerve itself—the result is an increase in mechanical tension within the nerve. This adverse neural tension, also termed neurodynamic dysfunction, is thought to contribute to pain and other symptoms through a variety of mechanisms. These include mechanical sensitization and altered nociceptive signaling, altered proprioception, adverse patterns of muscle recruitment and force of muscle contraction, reduced intra-neural blood flow, and release of inflammatory neuropeptides. Because it is not possible to differentiate completely between adverse neural tension and strain in muscles, fascia, and other soft tissues, we use the more general term neuromuscular strain. In our clinical work, we have found that neuromuscular restrictions are common in CFS, and that many symptoms of CFS can be reproduced by selectively adding neuromuscular strain

  5. Chronic stress induced cognitive impairment in APP/PS-1 double transgenic mouse model of Alzheimer's disease

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    Bing HAN

    2015-08-01

    Full Text Available Objective  To observe the effect of chronic unpredictable mild stress (CUMS on the cognitive function and brain morphological changes in APP/PS-1 mice, one of the genetic mouse models of Alzheimer's disease (AD, and to investigate the possible role of environmental factors in genetic mouse model of AD. Methods  There were 22-week-old wild-type C57BL/6 male mice (control group, N = 15 and APP/PS-1 double transgenic male mice [N = 27: AD group (N = 13 and AD + CUMS group (N = 14] tested in this study. Morris water maze test was used to evaluate spatial learning and memory of the mice. Amyloid deposition in the hippocampus was determined by Congo red staining. The ultrastructure of neurons in hippocampal CA1 region was observed by transmission electron microscope (TEM.  Results  Compared with control group, AD + CUMS group had significantly longer fifth-day escape latency [(33.14 ± 14.37 s vs (21.22 ± 12.16 s; t = -2.701, P = 0.045], and significantly shortened time spent in platform quadrant [(9.74±1.35 s vs (15.02 ± 1.33 s; t = 2.639, P = 0.012] in Morris water maze test. Compared with AD group, the percentage of amyloid plaque area in hippocampal area was increased in AD + CUMS group [(0.59 ± 0.03% vs (0.04 ± 0.03%; t = -2.900, P = 0.005]. The ultrastructure of hippocampal neurons in AD group was slightly damaged: cellular membrane was intact; cell matrix was uniform; intracelluar lipofuscin could be seen; the structure of nucleus and nuclear membrane had no obvious changes; mild fusion of cristae and membrane was seen in mitochondria; Golgi apparatus was partially indistinct; endoplasmic reticulum was mildly expanded. The ultrastructure of hippocampal neurons in AD + CUMS group was obviously damaged, including blurred cell membrane, reduced low-density and high-density granules in cytoplasm, uneven cell matrix, reduced number of organelles, lipofuscin and autophagosome deposition, obvious condensation of chromatin distributing over

  6. Psychological, cognitive and quality of life features in the elderly with chronic headache.

    Science.gov (United States)

    Uthaikhup, Sureeporn; Sterling, Michele; Jull, Gwendolen

    2009-01-01

    Chronic headache is common in the elderly, but there is little specific research on the impact on quality of life of headache and beliefs about pain in this age group. This study investigated the influence of headache type as well as headache frequency (> or =15 headache days/month vs. pain beliefs and related headache features including commonly reported neck pain. 118 headache subjects and 44 non-headache controls, aged 60-75 years, were recruited from the community. Subjects completed a headache questionnaire for classification purposes, the SF-36, the Geriatric Depression Scale-short form (GDS-S), the Survey of Pain Attitudes (SOPA-35) and the Neck Disability Index (NDI). The results revealed that elders with headache compared to the control group scored lower on most SF-36 domains, higher on the GDS-S (p 0.05), noting that the GDS score was below the threshold value for depression. These measures were not different between the headache types but were influenced by headache frequency. Subjects with headaches > or =15 days/month scored lowest on SF-36 domains and highest on GDS-S questionnaire compared to those with headache neck pain and disability. There were no strong relationships between well-being and headache frequency, intensity and length of headache history. The NDI score had the greatest influence on physical well-being and GDS-S score on mental well-being (p neck pain and disability is an important factor influencing well-being and may warrant attention in the management of elders with chronic headache.

  7. Chronic stress induces a hyporeactivity of the autonomic nervous system in response to acute mental stressor and impairs cognitive performance in business executives.

    Science.gov (United States)

    Teixeira, Renata Roland; Díaz, Miguel Mauricio; Santos, Tatiane Vanessa da Silva; Bernardes, Jean Tofoles Martins; Peixoto, Leonardo Gomes; Bocanegra, Olga Lucia; Neto, Morun Bernardino; Espindola, Foued Salmen

    2015-01-01

    The present study examined the incidence of chronic stress in business executives (109 subjects: 75 male and 34 female) and its relationship with cortisol levels, cognitive performance, and autonomic nervous system (ANS) reactivity after an acute mental stressor. Blood samples were collected from the subjects to measure cortisol concentration. After the sample collection, the subjects completed the Lipp Inventory of Stress Symptoms for Adults and the Stroop Color-Word Test to evaluate stress and cognitive performance levels, respectively. Saliva samples were collected prior to, immediately after, and five minutes after the test. The results revealed that 90.1% of the stressed subjects experienced stress phases that are considered chronic stress. At rest, the subjects with chronic stress showed higher cortisol levels, and no gender differences were observed. No differences were found between the stressed and non-stressed subjects regarding salivary amylase activity prior to test. Chronic stress also impaired performance on the Stroop test, which revealed higher rates of error and longer reaction times in the incongruent stimulus task independently of gender. For the congruent stimulus task of the Stroop test, the stressed males presented a higher rate of errors than the non-stressed males and a longer reaction time than the stressed females. After the acute mental stressor, the non-stressed male group showed an increase in salivary alpha-amylase activity, which returned to the initial values five minutes after the test; this ANS reactivity was not observed in the chronically stressed male subjects. The ANS responses of the non-stressed vs stressed female groups were not different prior to or after the Stroop test. This study is the first to demonstrate a blunted reactivity of the ANS when male subjects with chronic psychological stress were subjected to an acute mental stressor, and this change could contribute to impairments in cognitive performance.

  8. Chronic stress induces a hyporeactivity of the autonomic nervous system in response to acute mental stressor and impairs cognitive performance in business executives.

    Directory of Open Access Journals (Sweden)

    Renata Roland Teixeira

    Full Text Available The present study examined the incidence of chronic stress in business executives (109 subjects: 75 male and 34 female and its relationship with cortisol levels, cognitive performance, and autonomic nervous system (ANS reactivity after an acute mental stressor. Blood samples were collected from the subjects to measure cortisol concentration. After the sample collection, the subjects completed the Lipp Inventory of Stress Symptoms for Adults and the Stroop Color-Word Test to evaluate stress and cognitive performance levels, respectively. Saliva samples were collected prior to, immediately after, and five minutes after the test. The results revealed that 90.1% of the stressed subjects experienced stress phases that are considered chronic stress. At rest, the subjects with chronic stress showed higher cortisol levels, and no gender differences were observed. No differences were found between the stressed and non-stressed subjects regarding salivary amylase activity prior to test. Chronic stress also impaired performance on the Stroop test, which revealed higher rates of error and longer reaction times in the incongruent stimulus task independently of gender. For the congruent stimulus task of the Stroop test, the stressed males presented a higher rate of errors than the non-stressed males and a longer reaction time than the stressed females. After the acute mental stressor, the non-stressed male group showed an increase in salivary alpha-amylase activity, which returned to the initial values five minutes after the test; this ANS reactivity was not observed in the chronically stressed male subjects. The ANS responses of the non-stressed vs stressed female groups were not different prior to or after the Stroop test. This study is the first to demonstrate a blunted reactivity of the ANS when male subjects with chronic psychological stress were subjected to an acute mental stressor, and this change could contribute to impairments in cognitive

  9. The Improvement Two Cases Coughing and Sputum sign Sequela of Pneumonia by Homins Placenta Aqua-Acupuncture

    Directory of Open Access Journals (Sweden)

    Kim, Eun-Gon

    2003-12-01

    Full Text Available Coughing and sputum are symptoms of sequela of Pneumonia. Oriental medicine call it Hae su. Hae su is common sign of lung disease. Hominis Placenta is the dried placenta of a healthy women. The nature of Hominis Placenta is warm and its taste sweet-salty. It has correspondence to the meridians of lung and kindey. Hominis Placenta acupuncture therapy has effect on invigoration of vital energy nourishing blood and tonifying the essence. It can be applied to the disease as Asthma, pulmonary tuberculosis, chronic hepatitis, liver cirrhosis, degenerative change and cerebrovascular disease. We treated two cases coughing and sputum sign Sequela of Pneumonia by Hominis Placenta Aqua-Acupuncture. The symptoms was improved and the patients satisfied

  10. A Brief Historic Overview of Clinical Disorders Associated with Tryptophan: The Relevance to Chronic Fatigue Syndrome (CFS) and Fibromyalgia (FM).

    Science.gov (United States)

    Blankfield, Adele

    2012-01-01

    Last century there was a short burst of interest in the tryptophan related disorders of pellagra and related abnormalities that are usually presented in infancy.1,2 Nutritional physiologists recognized that a severe human dietary deficiency of either tryptophan or the B group vitamins could result in central nervous system (CNS) sequelae such as ataxia, cognitive dysfunction and dysphoria, accompanied by skin hyperpigmentation.3,4 The current paper will focus on the emerging role of tryptophan in chronic fatigue syndrome (CFS) and fibromyalgia (FM).

  11. RELIABILITY OF PHYSIOLOGICAL, PSYCHOLOGICAL AND COGNITIVE VARIABLES IN CHRONIC FATIGUE SYNDROME AND THE ROLE OF GRADED EXERCISE

    Directory of Open Access Journals (Sweden)

    Karen E. Wallman

    2005-12-01

    Full Text Available The objective of this study was to assess variability in symptoms and physical capabilities in chronic fatigue syndrome (CFS participants both before and after a graded exercise intervention. Sixty-one CFS subjects participated in a 12-week randomized controlled trial of either graded exercise (n =32 or relaxation/stretching therapy (n = 29. Specific physiological, psychological and cognitive variables were assessed once weekly over a four-week period both prior to and after the intervention period. All scores were assessed for reliability using an intraclass correlation coefficient (ICC. Apart from mental and physical fatigue, baseline ICC scores for all variables assessed were moderately to highly reliable, indicating minimal variability. Baseline scores for mental and physical fatigue were of questionable reliability, indicating a fluctuating nature to these symptoms (R1 = 0.64 and 0.60, respectively. Variability in scores for mental fatigue was reduced after graded exercise to an acceptable classification (R1 = 0.76. Results from this study support a variable nature to the symptoms of mental and physical fatigue only. Consequently, in order to more accurately report the nature of mental and physical fatigue in CFS, future studies should consider using repeated-measures analysis when assessing these symptoms. Graded exercise resulted in the reclassification of scores for mental fatigue from questionable to acceptable reliability

  12. Prevention of chronic PTSD with early cognitive behavioral therapy. A meta-analysis using mixed-effects modeling.

    Science.gov (United States)

    Kliem, Sören; Kröger, Christoph

    2013-11-01

    Post-traumatic stress disorder (PTSD) is of great interest to public health, due to the high burden it places on both the individual and society. We meta-analyzed randomized-controlled trials to examine the effectiveness of early trauma-focused cognitive-behavioral treatment (TFCBT) for preventing chronic PTSD. Systematic bibliographic research was undertaken to find relevant literature from on-line databases (Pubmed, PsycINFO, Psyndex, Medline). Using a mixed-effect approach, we calculated effect sizes (ES) for the PTSD diagnoses (main outcome) as well as PTSD and depressive symptoms (secondary outcomes), respectively. Calculations of ES from pre-intervention to first follow-up assessment were based on 10 studies. A moderate effect (ES = 0.54) was found for the main outcome, whereas ES for secondary outcomes were predominantly small (ES = 0.27-0.45). The ES for the main outcome decreased to small (ES = 0.34) from first follow-up to long-term follow-up assessment. The mean dropout rate was 16.7% pre- to post-treatment. There was evidence for the impact of moderators on different outcomes (e.g., the number of sessions on PTSD symptoms). Future studies should include survivors of other trauma types (e.g., burn injuries) rather than predominantly survivors of accidents and physical assault, and should compare early TFCBT with other interventions that previously demonstrated effectiveness.

  13. The Impact of Acute and Chronic Weight Restriction and Weight Regulation practices on Physiological, Osteogenic, Metabolic and Cognitive Function in Elite Jockeys

    OpenAIRE

    Dolan, Eimear

    2010-01-01

    Horse racing is a weight category sport. One of the key challenges facing jockeys is the pressure of “making weight” throughout the protracted racing season. Aim: The aim of this study was to examine the effect of a chronically weight restrictive lifestyle and acute weight loss practices on aspects of physiological, osteogenic, metabolic and cognitive function in jockeys. Methods: The primary aim was achieved through the completion of four related studies. Study One: The effect of a 4% reduct...

  14. Fluoxetine ameliorates cognitive impairments induced by chronic cerebral hypoperfusion via down-regulation of HCN2 surface expression in the hippocampal CA1 area in rats.

    Science.gov (United States)

    Luo, Pan; Zhang, Xiaoxue; Lu, Yun; Chen, Cheng; Li, Changjun; Zhou, Mei; Lu, Qing; Xu, Xulin; Shen, Guanxin; Guo, Lianjun

    2016-01-01

    Chronic cerebral hypoperfusion (CCH) causes cognitive impairments and increases the risk of Alzheimer's disease (AD) and vascular dementia (VD) through several biologically plausible pathways, yet the underlying neurobiological mechanisms are still poorly understood. In this study, we investigated whether fluoxetine, a selective serotonin reuptake inhibitor (SSRI), could play a neuroprotective role against chronic cerebral hypoperfusion injury and to clarify underlying mechanisms of its efficacy. Rats were subjected to permanent bilateral occlusion of the common carotid arteries (two-vessel occlusion, 2VO). Two weeks later, rats were treated with 30 mg/kg fluoxetine (intragastric injection, i.g.) for 6 weeks. Cognitive function was evaluated by Morris water maze (MWM) and novel objects recognition (NOR) test. Long-term potentiation (LTP) was used to address the underlying synaptic mechanisms. Western blotting was used to quantify the protein levels. Our results showed that fluoxetine treatment significantly improved the cognitive impairments caused by 2VO, accompanied with a reversion of 2VO-induced inhibitory of LTP. Furthermore, 2VO caused an up-regulation of hyperpolarization-activated cyclic nucleotide-gated channel 2 (HCN2) surface expressions in the hippocampal CA1 area and fluoxetine also effectively recovered the disorder of HCN2 surface expressions, which may be a possible mechanism that fluoxetine treatment ameliorates cognitive impairments in rats with CCH.

  15. Chronic treatment with taurine after intracerebroventricular streptozotocin injection improves cognitive dysfunction in rats by modulating oxidative stress, cholinergic functions and neuroinflammation.

    Science.gov (United States)

    Reeta, K H; Singh, Devendra; Gupta, Y K

    2017-03-08

    The present study investigated the neuroprotective effects of taurine, an essential amino acid for growth and development of central nervous system. Intracerebroventricular streptozotocin (ICV-STZ) model of cognitive impairment was used in male Wistar rats (270 ± 20 g). Morris water maze, elevated plus maze and passive avoidance paradigm were used to assess cognitive performance. Taurine (40, 60 and 120 mg/kg) was administered orally for 28 days following STZ administration on day 1. Oxidative stress parameters (malondialdehyde, glutathione, nitric oxide and superoxide dismutase) and cholinesterases (acetylcholinesterase and butyrylcholinesterase) activity were measured at end of the study in the cortex and hippocampus. Levels of TNF-α, IL-1β, expression of rho kinase-II (ROCK-II), glycogen synthase kinase-3β (GSK-3β) and choline acetyltransferase (ChAT) were studied in cortex and hippocampus. STZ caused significant cognitive impairment as compared to normal control. Chronic administration of taurine attenuated STZ-induced cognitive impairment. Increased oxidative stress and increased levels of TNF-α, IL-1β induced by STZ were also significantly attenuated by taurine. Taurine significantly (p < 0.05) decreased the STZ-induced increased expression of ROCK-II in cortex and hippocampus. Further, STZ-induced increased activity of cholinesterases was significantly (p < 0.001) mitigated by taurine. STZ decreased the expression of ChAT in hippocampus which was significantly (p < 0.05) reversed by taurine. However, GSK-3β expression was not altered by either STZ or taurine. The present study indicates that taurine exerts a neuroprotective role against STZ-induced cognitive impairment in rats. This effect is probably mediated by modulating oxidative stress, cholinesterases, inflammatory cytokines and expression of ROCK-II. Thus, this study suggests a potential of chronic taurine administration in cognitive impairment of Alzheimer's type.

  16. The neurobehavioural rating scale: assessment of the behavioural sequelae of head injury by the clinician.

    Science.gov (United States)

    Levin, H S; High, W M; Goethe, K E; Sisson, R A; Overall, J E; Rhoades, H M; Eisenberg, H M; Kalisky, Z; Gary, H E

    1987-01-01

    To investigate the inter-rater reliability and validity of the Neurobehavioural Rating Scale at various stages of recovery after hospitalisation for closed head injury, we studied 101 head trauma patients who had no antecedent neuropsychiatric disorder. The results demonstrated satisfactory inter-rater reliability and showed that the Neurobehavioural Rating Scale reflects both the severity and chronicity of closed head injury. A principal components analysis revealed four factors which were differentially related to severity of head injury and the presence of a frontal lobe mass lesion. Although our findings provide support for utilising clinical ratings of behaviour to investigate sequelae of head injury, extension of this technique to other settings is necessary to evaluate the distinctiveness of the neurobehavioural profile of closed head injury as compared with other aetiologies of brain damage. PMID:3572433

  17. Research progress of chronic pain psychological cognitive factors%慢性疼痛患者认知行为疗法的研究进展

    Institute of Scientific and Technical Information of China (English)

    祁娟; 丁燕; 缪靓靓

    2016-01-01

    This paper introduces the concept of the chronic pain and cognitive behavior therapy, as well as pain cognitive theory and tools to measure the pain cognition in domestic and abroad from psychological aspects. It also reviews the cognitive behavior therapy treatment impacted on pain intervention and current status, puts forward the effective intervention from the pain cognitive behavior of this psychology aspect, so as to provide the patients with supplementary for more effective participation in pain management which is the direction of future research.%介绍慢性疼痛和认知行为疗法的概念、疼痛认知理论及国内外从心理层面评估疼痛认知的测量工具,综述认知行为疗法对疼痛干预的作用及认知行为治疗疼痛的研究现状,提出从患者的疼痛认知行为这一心理层面对其进行有效干预,为患者更有效地参与疼痛管理提供补充是今后研究的方向。

  18. The acute and sub-chronic effects of cocoa flavanols on mood, cognitive and cardiovascular health in young healthy adults: A randomized, controlled trial

    Directory of Open Access Journals (Sweden)

    Laura Amy Massee

    2015-05-01

    Full Text Available Cocoa supplementation has been associated with benefits to cardiovascular health. However, cocoa’s effects on cognition are less clear. A randomized, placebo-controlled, double-blind clinical trial (n=40, age M= 24.13 years, SD = 4.47 years was conducted to investigate the effects of both acute (same-day and sub-chronic (daily for four-weeks 250mg cocoa supplementation on mood and mental fatigue, cognitive performance and cardiovascular functioning in young, healthy adults. Assessment involved repeated 10-minute cycles of the Cognitive Demand Battery (CDB encompassing two serial subtraction tasks (Serial Threes and Sevens, a Rapid Visual Information Processing task, and a mental fatigue scale over the course of half an hour. The Swinburne University Computerised Cognitive Assessment Battery (SUCCAB was also completed to evaluate cognition. Cardiovascular function included measuring both peripheral and central blood pressure and cerebral blood flow. At the acute time point, consumption of cocoa significantly improved self-reported mental fatigue and performance on the Serial Sevens task in cycle one of the CDB. No other significant effects were found. This trial was registered with the Australian and New Zealand Clinical Trial Registry (Trial ID: ACTRN12613000626763. Accessible via http://www.anzctr.org.au/TrialSearch.aspx?searchTxt=ACTRN126130006 26763&ddlSearch=Registered

  19. Cognitive behavioral therapy for chronic insomnia [Terapia poznawczo-behawioralna w leczeniu bezsenności przewlekłej

    Directory of Open Access Journals (Sweden)

    Fornal-Pawłowska, Małgorzata

    2013-04-01

    Full Text Available Aim. To evaluate the efficacy of cognitive behavioral therapy (CBT-I in chronic insomnia treatment. Method. 236 patients with ICD-10 nonorganic insomnia were assigned to group CBT-I (6 sessions, 6-10 patients. From this pool, 72 participants with no history of other psychiatric or sleep disorders conditions were selected. Eventually, 51 patients (40 female, mean age: 54.6±13.9y, mean insomnia duration: 7±6.3y and 51 matched healthy controls (mean age: 55.4±14.3y completed the study. Outcomes in the insomnia group at baseline and post-treatment were compared to control group. Subjects underwent sleep diary, the Athens Insomnia Scale (AIS, the Beck Depression Inventory (BDI, the Ford Insomnia Response to Stress Test (FIRST, the SF-36 questionnaire and the State-Trait Anxiety Inventory (STAI. Results. At baseline, groups differed significantly in most dependent variables. At post-treatment, a substantial improvement in all sleep parameters was observed in insomnia group: sleep latency, number of awakenings, wake time after sleep onset, sleep time, sleep efficiency, sleep quality and frequency of hypnotic use. These outcomes were accompanied by lower AIS and FIRST scores, reductions of depression and anxiety symptoms, and improved energy and social functioning ratings. All changes were maintained during the 3-month follow-up. Only 10/51 patients had no clinically meaningful improvement at any post-treatment time points. After the therapy, patients did not differ significantly from good sleepers in number of awakenings, sleep quality, feeling in the morning, depression and anxiety symptoms, and quality of life related to mental health. Conclusions. The CBT-I produced a sustained, clinically meaningful improvement in nocturnal sleep and daytime functioning.

  20. Acute viral bronchiolitis and its sequelae in developing countries.

    Science.gov (United States)

    Fischer, Gilberto Bueno; Teper, Alejandro; Colom, Alejandro J

    2002-12-01

    Acute viral bronchiolitis (AVB) is a common disease found throughout the world. Various aspects of it are being studied: its epidemiology, diagnosis, prognosis and treatment. Most of these studies are being conducted in developed countries, with only a few taking place in developing countries. Risk factors such as poor nutrition, an adverse environment and early weaning should be studied where these features are common. Treatment aspects such as cost-effectiveness in low income settings need further study. Use of ribavirin and respiratory syncytial virus (RSV)-immunoglobulin are good examples. Post-bronchiolitic sequelae also need to be studied in low income countries. There is evidence that bronchiolitis obliterans is unusually frequent in some Latin-American countries such as Argentina and Brazil. It will be helpful to undertake combined studies in countries with the same socio-economics, investigating the preventive and management aspects of AVB and its sequelae to reduce the morbidity and mortality.

  1. Sequelae og død efter pneumokokmeningitis

    DEFF Research Database (Denmark)

    Korsholm, Jakob; Kristensen, Rasmus Nygård; Heslop, Anders;

    2009-01-01

    consciousness. The mortality was 11%, and 40% of the surviving population developed permanent sequelae, of which 88% suffered loss of hearing. Sixty one percent was not evaluated audiologically after hospitalization. CONCLUSION: Pre-admission antibiotics were associated with a decreased risk of death......INTRODUCTION: The aim was to evaluate prognostic factors and outcome parameters related to otogenic pneumococcal meningitis (OPM). MATERIALS AND METHODS: Retrospective analysis of patients with OPM in Aarhus County from 1994 to 2003. RESULTS: Seventy patients were included, corresponding...... and sequelae. Affected consciousness was a significant prognostic factor. The mortality rate was four times higher among adults than among children. Mastoidectomy was performed in 56% of adults without any significant influence on the outcome. Based on the presented results it appears relevant to treat cases...

  2. Sinus of Valsalva Pseudoaneurysm as a Sequela to Infective Endocarditis

    Science.gov (United States)

    Siegel, Robert J.

    2016-01-01

    Pseudoaneurysm is an uncommon sequela of infective endocarditis. We treated a 44-year-old man who had an active case of group B streptococcal infective endocarditis of the aortic valve despite no evidence of valvular dysfunction or vegetation on his initial transesophageal echocardiogram. After completing 6 weeks of intravenous antibiotic therapy, the patient developed a sinus of Valsalva pseudoaneurysm and severe aortic regurgitation caused by partial detachment of the left coronary cusp. We used a pericardial patch to close the pseudoaneurysm and repair the coronary cusp. This case shows the importance of routine clinical follow-up evaluation in infective endocarditis, even after completion of antibiotic therapy. Late sequelae associated with infective endocarditis or its therapy include recurrent infection, heart failure caused by valvular dysfunction (albeit delayed), and antibiotic toxicity such as aminoglycoside-induced nephropathy and vestibular toxicity. PMID:27047285

  3. Treatment Strategies for Chronic Cases

    Directory of Open Access Journals (Sweden)

    Susan M Lord

    2003-01-01

    Full Text Available The treatment of chronic somatic pain, including pain referred to the head, neck, shoulder girdle and upper limb from somatic structures, is addressed. Levels of evidence for the various treatments that have been prescribed for chronic whiplash associated disorders are considered. The challenge to find a treatment strategy for chronic pain after whiplash that completely relieves the condition and prevents its sequelae is reviewed.

  4. Lacrimal excretory system sequelae in patients treated for leishmaniasis

    OpenAIRE

    Hoyama,Erika; Schellini,Silvana Artioli; Stolf,Hamilton Ometo; Nakajima,Vitor

    2006-01-01

    Leishmaniasis infection may involve destruction of nasal tissues resulting in lacrimal drainage system alteration. PURPOSE: To evaluate the frequency of lacrimal excretory system sequelae in patients treated for leishmaniasis. METHODS: Forty-five leishmaniasis-treated patients (90 nasolacrimal ducts) were submitted to lacrimal excretory system evaluation. All were evaluated by Jones I test and when it was abnormal, dacryocystography and nasal endoscopy were performed. This situation occurred ...

  5. Life without the vein of Galen: Clinical and radiographic sequelae.

    Science.gov (United States)

    Youssef, A Samy; Downes, Angela E; Agazzi, Siviero; Van Loveren, Harry R

    2011-09-01

    A thorough understanding of the anatomy of the pineal region, particularly venous drainage, is critical for gaining open surgical access to the pineal gland. The adverse sequelae after intraoperative venous occlusion are assumed to be catastrophic but have been scarcely reported. We report a case of pineocytoma in which the vein of Galen was ligated without postoperative adverse sequelae. Pineal region anatomy with emphasis on deep veins was reviewed in large anatomical studies. There are tremendous anatomical variations in the vein of Galen and its tributaries. Several confounding factors can be encountered during surgery and may lead to accidental sacrifice of the vein of Galen. Survival after focal occlusion of a major deep vein depends on the development of collateral circulation as shown in our case report. Venous drainage remains the cornerstone in the surgical planning of the pineal region. Anatomical variations and venous collaterals undoubtedly contributed to the mixed reports of adverse sequelae after venous sacrifice. Vein of Galen ligation may be survivable but consequences cannot be predicted without a thorough pre-ligation assessment of regional venous collateral drainage. Thorough understanding of the venous anatomy, meticulous planning of the surgical approach and avoidance of the occlusion of the vein of Galen and its major tributaries are key factors to successful pineal region surgery.

  6. A multidisciplinary cognitive behavioural programme for coping with chronic neuropathic pain following spinal cord injury: the protocol of the CONECSI trial

    Directory of Open Access Journals (Sweden)

    Dijkstra Catja A

    2010-10-01

    Full Text Available Abstract Background Most people with a spinal cord injury rate neuropathic pain as one of the most difficult problems to manage and there are no medical treatments that provide satisfactory pain relief in most people. Furthermore, psychosocial factors have been considered in the maintenance and aggravation of neuropathic spinal cord injury pain. Psychological interventions to support people with spinal cord injury to deal with neuropathic pain, however, are sparse. The primary aim of the CONECSI (COping with NEuropathiC Spinal cord Injury pain trial is to evaluate the effects of a multidisciplinary cognitive behavioural treatment programme on pain intensity and pain-related disability, and secondary on mood, participation in activities, and life satisfaction. Methods/Design CONECSI is a multicentre randomised controlled trial. A sample of 60 persons with chronic neuropathic spinal cord injury pain will be recruited from four rehabilitation centres and randomised to an intervention group or a waiting list control group. The control group will be invited for the programme six months after the intervention group. Main inclusion criteria are: having chronic (> 6 months neuropathic spinal cord injury pain as the worst pain complaint and rating the pain intensity in the last week as 40 or more on a 0-100 scale. The intervention consists of educational, cognitive, and behavioural elements and encompasses 11 sessions over a 3-month period. Each meeting will be supervised by a local psychologist and physical therapist. Measurements will be perfomed before starting the programme/entering the control group, and at 3, 6, 9, and 12 months. Primary outcomes are pain intensity and pain-related disability (Chronic Pain Grade questionnaire. Secondary outcomes are mood (Hospital Anxiety and Depression Scale, participation in activities (Utrecht Activities List, and life satisfaction (Life Satisfaction Questionnaire. Pain coping and pain cognitions will be

  7. The Effectiveness of Mindfulness-based Cognitive Therapy (MBCT and Cognitive Behavior Therapy (CBT on Decreasing Pain, Depression and Anxiety of Patients with Chronic Low Back Pain

    Directory of Open Access Journals (Sweden)

    M Abdolghadery

    2014-02-01

    Conclusion: The results support the effectiveness of MBCT and CBT in decreasing pain, depression and anxiety. Therefore, taking account of these two therapeutic methods is very important for patients with chronic low back pain.

  8. Cognitive factors associated with facial pain.

    Science.gov (United States)

    Schwartz, S M; Gramling, S E

    1997-07-01

    Most well-accepted etiological models of facial pain (e.g., temporomandibular disorders and headache) implicate emotional distress as an important factor in the development and maintenance of pain. Data exists to support the notion that some facial pain sufferers are more emotionally distressed than no pain controls. However, many of these dependent measures of emotional distress are either lengthy assessment batteries, lack clear cut psychotherapeutic treatment implications, or focus exclusively on pain related sequela. As cognitive-behavioral interventions become more integrated into the treatment of chronic pain conditions, including various facial pain conditions, it becomes more imperative that the tools used to assess psychological functioning provide the clinician with specific cognitive/behavioral targets for change. The purpose of this study was to assess the degree to which symptomatic treatment seeking facial pain sufferers (N = 25), symptomatic non-treatment seeking facial pain sufferers (N = 48), and healthy pain-free controls (N = 70) differed on the Rational Beliefs Inventory (RBI). The RBI is a reliable, valid questionnaire assessing rational beliefs that are operationalized within a Rational Emotive Therapy (RET) framework. RET is a cognitive-behavioral treatment paradigm that focuses on how an individual's maladaptive cognitive errors or distortions exacerbate emotional distress. Group differences were assessed using a oneway Analysis of Covariance (ANCOVA) with the total RBI score serving as the dependent measure, and a Multivariate Analysis of Covariance (MANCOVA) using individual RBI belief subscales as dependent measures. These results indicated that groups differed significantly on the total score and several of the individual belief subscales. These findings indicated that facial pain sufferers generally hold maladaptive beliefs that may be of clinical significance for cognitive/behavioral treatment approaches.

  9. The ameliorative effects of exercise on cognitive impairment and white matter injury from blood-brain barrier disruption induced by chronic cerebral hypoperfusion in adolescent rats.

    Science.gov (United States)

    Lee, Jae-Min; Park, Jong-Min; Song, Min Kyung; Oh, Yoo Joung; Kim, Chang-Ju; Kim, Youn-Jung

    2017-01-18

    Vascular dementia is the progressive change in blood vessels that leads to neuronal injuries in vulnerable areas induced by chronic cerebral hypoperfusion (CCH). CCH induces disruption of blood-brain barrier (BBB), and this BBB disruption can initiate the cognitive impairment and white matter injury. In the present study, we evaluated the effect of treadmill exercise on the cognitive impairment, white matter injury, and BBB disruption induced by CCH. Vascular dementia was induced by permanent bilateral common carotid arteries occlusion (BCCAO) in rats. The rats in the exercise group were made to run on a treadmill for 30min once a day for 14 weeks, starting 4 weeks after birth. Our results revealed that treadmill exercise group was alleviated the cognitive impairment and myelin degradation induced by CCH. The disruption of BBB after CCH indicates degradation of occludin, zonula occluden-1 (ZO-1), and up-regulation of matrix metalloproteinases (MMPs). Treadmill exercise may provide protective effects on BBB disruption from degradation of occludin, ZO-1, and overexpression of MMP-9 after CCH. These findings suggest that treadmill exercise ameliorates cognitive impairment and white matter injury from BBB disruption induced by CCH in rats. The present study will be valuable for means of prophylactic and therapeutic intervention for patients with CCH.

  10. Effects of melatonin on changes in cognitive performances and brain malondialdehyde concentration induced by sub-chronic co-administration of chlorpyrifos and cypermethrin in male Wister rats

    Institute of Scientific and Technical Information of China (English)

    Idris Sherifat Banke; Ambali Suleiman Folorunsho; Bisalla Mohammed; Suleiman Mohammed Musa; Onukak Charles; Ayo Joseph Olusegun

    2014-01-01

    Objective: To evaluate the ameliorative effect of melatonin on sub-chronic chlorpyrifos (CPF) and cypermethrin (CYP)-evoked cognitive changes in male Wistar rats. Methods:Fifty adult male Wistar rats, divided into five groups of ten rats each, were used for the study. Groups 1 and II were given distilled water and soya oil (2 mL/kg) respectively. Group III was administered with melatonin at 0.5 mg/kg only. Group IV was administered with CPF [7.96 mg/kg (1/10th LD50)] and CYP [29.6 mg/kg (1/10th LD50)] , and Group V was administered with CPF [7.96 mg/kg (1/10th LD50)] and CYP [29.6 mg/kg (1/10th LD50)] 30 min after melatonin (0.5 mg/kg). The regimens were administered by gavage once daily for 12 weeks. Thereafter, cognitive performances were determined and the brain was evaluated for malonaldehyde concentration. Results: CPF and CYP induced cognitive deficits and increased brain malonaldehyde concentration, which were all ameliorated by melatonin.Conclusion: Cognitive deficits elicited by CPF and CYP was mitigated by melatonin due to its antioxidant property.

  11. Evolutionary medicine and chronic inflammatory state—known and new concepts in pathophysiology

    OpenAIRE

    Straub, Rainer H.

    2012-01-01

    During the last 10 years, a series of exciting observations has led to a new theory of pathophysiology using insights from evolutionary biology and neuroendocrine immunology to understand the sequelae of chronic inflammatory disease. According to this theory, disease sequelae can be explained based on redirection of energy-rich fuels from storage organs to the activated immune system. These disease sequelae are highly diverse and include the following: sickness behavior, anorexia, malnutritio...

  12. Global attentional-executive sequelae following surgical lesions to globus pallidus interna.

    Science.gov (United States)

    Scott, Richard B; Harrison, John; Boulton, Charlotte; Wilson, Joanna; Gregory, Ralph; Parkin, Simon; Bain, Peter G; Joint, Carol; Stein, John; Aziz, Tipu Z

    2002-03-01

    It has been demonstrated that selective unilateral surgical ablation of posteroventral globus pallidus interna relieves the movement disorders associated with advanced Parkinson's disease, without necessarily incurring the executive cognitive sequelae that have been observed following gross pathological lesions to this brain region. This finding is consistent with established theory that underlying neuronal circuitry is functionally segregated into parallel cortico-striatal-pallidal-thalamo-cortical 'loops'. We have studied a series of 12 patients with advanced Parkinson's disease at baseline, and then following bilateral pallidotomy, with a battery of neuropsychological tests including the Cambridge Neuro psychological Test Automated Battery. We identified a selective and universal loss of individual patients' ability to shift attention to novel dimensions in a test of abstract rule-learning following surgery, which was not reliably associated with any other change in cognition, personality, mood or medication. This finding is rare in its specificity and has implications for theoretical models of the functional architecture and pathophysiology of the globus pallidus, and the clinical practice of pallidotomy.

  13. Cognitive behavioural therapy versus multidisciplinary rehabilitation treatment for patients with chronic fatigue syndrome: study protocol for a randomised controlled trial (FatiGo

    Directory of Open Access Journals (Sweden)

    Vos-Vromans Desirée CWM

    2012-05-01

    Full Text Available Abstract Background Patients with chronic fatigue syndrome experience extreme fatigue, which often leads to substantial limitations of occupational, educational, social and personal activities. Currently, there is no consensus regarding the treatment. Patients try many different therapies to overcome their fatigue. Although there is no consensus, cognitive behavioural therapy is seen as one of the most effective treatments. Little is known about multidisciplinary rehabilitation treatment, a combination of cognitive behavioural therapy with principles of mindfulness, gradual increase of activities, body awareness therapy and pacing. The difference in effectiveness and cost-effectiveness between multidisciplinary rehabilitation treatment and cognitive behavioural therapy is as yet unknown. The FatiGo (Fatigue-Go trial aims to compare the effects of both treatment approaches in outpatient rehabilitation on fatigue severity and quality of life in patients with chronic fatigue syndrome. Methods One hundred twenty patients who meet the criteria of chronic fatigue syndrome, fulfil the inclusion criteria and sign the informed consent form will be recruited. Both treatments take 6 months to complete. The outcome will be assessed at 6 and 12 months after the start of treatment. Two weeks after the start of treatment, expectancy and credibility will be measured, and patients will be asked to write down their personal goals and score their current performance on these goals on a visual analogue scale. At 6 and 14 weeks after the start of treatment, the primary outcome and three potential mediators—self-efficacy, causal attributions and present-centred attention-awareness—will be measured. Primary outcomes are fatigue severity and quality of life. Secondary outcomes are physical activity, psychological symptoms, self-efficacy, causal attributions, impact of disease on emotional and physical functioning, present-centred attention-awareness, life

  14. Latissimus dorsi transposition for sequelae of obstetric palsy

    Directory of Open Access Journals (Sweden)

    Enrique Vergara-Amador

    2010-09-01

    Full Text Available Background: In obstetric palsy, limitation in the external abduction and rotation of the shoulder is the most frequent sequelae. Glenohumeral deformity is the result of muscular imbalance between the external and internal rotators. Releasing the contracted muscles and transferring the latissimus dorsi are the most common surgeries in this case.Patients and methods: We operated on 24 children between 4 and 8 years of age with obstetric palsy sequelae to elevate the subscapularis muscle off the anterior surface of the scapula posteriorly and transfer the latissimus dorsi. The patients received a minimum of 2 years of follow up. They were evaluated based on Mallet’s and Gilbert’s classifications.Results: All of the patients recovered within the above mentioned classifications. Out of 22 children evaluated via Mallet’s classification, all improved from 3 to 4 on that scale. With respect to Gilbert’s classification, 16 children improved one degree and 8 improved 2 degrees. All of the patients’ parents were satisfied with the results.Discussion: The benefit from releasing contracted muscles and muscle transfer to improve shoulder abduction in the sequelae of obstetric palsy has been amply reported in the literature. The results we had from elevating the subscapularis muscle off the anterior surface of the scapula and transferring the latissimus dorsi were good. Children who were difficult to classify based on the described scale were taken note of and some sub-classifications for Gilbert’s descriptions were proposed. Patients must be selected carefully. To transfer the latissimus dorsi, it is necessary to have good passive mobility in abduction, a minimum of 20º of external rotation and no joint deformities. When negative external rotation is found, the subscapularis muscle should be released. When there is glenohumeral joint deformity in older children, other methods are recommended, such as rotational humeral osteotomy.

  15. Latissimus dorsi transposition for sequelae of obstetric palsy

    Directory of Open Access Journals (Sweden)

    Enrique Vergara- Amador

    2010-10-01

    Full Text Available Background: In obstetric palsy, limitation in the external abduction and rotation of the shoulder is the most frequent sequelae. Glenohumeral deformity is the result of muscular imbalance between the external and internal rotators. Releasing the contracted muscles and transferring the latissimus dorsi are the most common surgeries in this case. Patients and methods: We operated on 24 children between 4 and 8 years of age with obstetric palsy sequelae to elevate the subscapularis muscle off the anterior surface of the scapula posteriorly and transfer the latissimus dorsi. The patients received a minimum of 2 years of follow up. They were evaluated based on Mallet’s and Gilbert’s classifications. Results: All of the patients recovered within the above mentioned classifications. Out of 22 children evaluated via Mallet’s classification, all improved from 3 to 4 on that scale. With respect to Gilbert’s classification, 16 children improved one degree and 8 improved 2 degrees. All of the patients’ parents were satisfied with the results. Discussion: The benefit from releasing contracted muscles and muscle transfer to improve shoulder abduction in the sequelae of obstetric palsy has been amply reported in the literature. The results we had from elevating the subscapularis muscle off the anterior surface of the scapula and transferring the latissimus dorsi were good. Children who were difficult to classify based on the described scale were taken note of and some sub-classifications for Gilbert’s descriptions were proposed. Patients must be selected carefully. To transfer the latissimus dorsi, it is necessary to have good passive mobility in abduction, a minimum of 20º of external rotation and no joint deformities. When negative external rotation is found, the subscapularis muscle should be released. When there is glenohumeral joint deformity in older children, other methods are recommended, such as rotational humeral osteotomy.

  16. The Putative Role of Viruses, Bacteria, and Chronic Fungal Biotoxin Exposure in the Genesis of Intractable Fatigue Accompanied by Cognitive and Physical Disability.

    Science.gov (United States)

    Morris, Gerwyn; Berk, Michael; Walder, Ken; Maes, Michael

    2016-05-01

    Patients who present with severe intractable apparently idiopathic fatigue accompanied by profound physical and or cognitive disability present a significant therapeutic challenge. The effect of psychological counseling is limited, with significant but very slight improvements in psychometric measures of fatigue and disability but no improvement on scientific measures of physical impairment compared to controls. Similarly, exercise regimes either produce significant, but practically unimportant, benefit or provoke symptom exacerbation. Many such patients are afforded the exclusionary, non-specific diagnosis of chronic fatigue syndrome if rudimentary testing fails to discover the cause of their symptoms. More sophisticated investigations often reveal the presence of a range of pathogens capable of establishing life-long infections with sophisticated immune evasion strategies, including Parvoviruses, HHV6, variants of Epstein-Barr, Cytomegalovirus, Mycoplasma, and Borrelia burgdorferi. Other patients have a history of chronic fungal or other biotoxin exposure. Herein, we explain the epigenetic factors that may render such individuals susceptible to the chronic pathology induced by such agents, how such agents induce pathology, and, indeed, how such pathology can persist and even amplify even when infections have cleared or when biotoxin exposure has ceased. The presence of active, reactivated, or even latent Herpes virus could be a potential source of intractable fatigue accompanied by profound physical and or cognitive disability in some patients, and the same may be true of persistent Parvovirus B12 and mycoplasma infection. A history of chronic mold exposure is a feasible explanation for such symptoms, as is the presence of B. burgdorferi. The complex tropism, life cycles, genetic variability, and low titer of many of these pathogens makes their detection in blood a challenge. Examination of lymphoid tissue or CSF in such circumstances may be warranted.

  17. Time to gain trust and change—Experiences of attachment and mindfulness-based cognitive therapy among patients with chronic pain and psychiatric co-morbidity

    Directory of Open Access Journals (Sweden)

    Birgitta Peilot

    2014-08-01

    Full Text Available The treatment of patients with chronic pain disorders is complex. In the rehabilitation of these patients, coping with chronic pain is seen as important. The aim of this study was to explore the meaning of attachment and mindfulness-based cognitive therapy (CT among patients with chronic pain and psychiatric co-morbidity. A phenomenological approach within a lifeworld perspective was used. In total, 10 patients were interviewed after completion of 7- to 13-month therapy. The findings reveal that the therapy and the process of interaction with the therapist were meaningful for the patients’ well-being and for a better management of pain. During the therapy, the patients were able to initiate a movement of change. Thus, CT with focus on attachment and mindfulness seems to be of value for these patients. The therapy used in this study was adjusted to the patients’ special needs, and a trained psychotherapist with a special knowledge of patients with chronic pain might be required.

  18. [Moderate sequelae secondary to noma: value of the nasogenal flap].

    Science.gov (United States)

    Trendel, D; Martin, J P; Martins-Carvalho, C

    2009-02-01

    Noma is a gangrenous disease leading to destruction of soft and hard tissue of the face. It mainly affects young poor children with poor oral care. Without treatment noma is fatal in 70 to 90% of cases. In survivors, esthetic and functional sequelae are severe. Emergency intravenous antibiotherapy improves survival but restoration of the face requires reconstructive surgery. Different surgical techniques with various degrees of complexity and reliability have been proposed. The purpose of this article is to describe the nasogenal flap technique. This simple, single-stage technique is well suited to conditions in Africa.

  19. Effect of aerobic exercise training and cognitive behavioural therapy on reduction of chronic fatigue in patients with facioscapulohumeral dystrophy: protocol of the FACTS-2-FSHD trial

    Directory of Open Access Journals (Sweden)

    van Engelen Baziel GM

    2010-06-01

    Full Text Available Abstract Background In facioscapulohumeral dystrophy (FSHD muscle function is impaired and declines over time. Currently there is no effective treatment available to slow down this decline. We have previously reported that loss of muscle strength contributes to chronic fatigue through a decreased level of physical activity, while fatigue and physical inactivity both determine loss of societal participation. To decrease chronic fatigue, two distinctly different therapeutic approaches can be proposed: aerobic exercise training (AET to improve physical capacity and cognitive behavioural therapy (CBT to stimulate an active life-style yet avoiding excessive physical strain. The primary aim of the FACTS-2-FSHD (acronym for Fitness And Cognitive behavioural TherapieS/for Fatigue and ACTivitieS in FSHD trial is to study the effect of AET and CBT on the reduction of chronic fatigue as assessed with the Checklist Individual Strength subscale fatigue (CIS-fatigue in patients with FSHD. Additionally, possible working mechanisms and the effects on various secondary outcome measures at all levels of the International Classification of Functioning, Disability and Health (ICF are evaluated. Methods/Design A multi-centre, assessor-blinded, randomized controlled trial is conducted. A sample of 75 FSHD patients with severe chronic fatigue (CIS-fatigue ≥ 35 will be recruited and randomized to one of three groups: (1 AET + usual care, (2 CBT + usual care or (3 usual care alone, which consists of no therapy at all or occasional (conventional physical therapy. After an intervention period of 16 weeks and a follow-up of 3 months, the third (control group will as yet be randomized to either AET or CBT (approximately 7 months after inclusion. Outcomes will be assessed at baseline, immediately post intervention and at 3 and 6 months follow up. Discussion The FACTS-2-FSHD study is the first theory-based randomized clinical trial which evaluates the effect and the

  20. Arnold-Chiari-II malformation and cognitive functioning in spina bifida.

    NARCIS (Netherlands)

    Vinck, A.; Maassen, B.A.M.; Mullaart, R.A.; Rotteveel, J.J.

    2006-01-01

    Spina bifida is a multifaceted neurological condition with complex neuropsychological sequelae. The cognitive outcome in spina bifida has frequently been attributed to the severity of the hydrocephalus. However, because of complex neuropathology, the influence of hydrocephalus alone does not suffici

  1. Fetal stem cells in combined treatment of chronic heart failure and their effect on morphofunctional parameters of the left ventricle myocardium and cognitive functions

    Directory of Open Access Journals (Sweden)

    Klunnyk MO

    2014-08-01

    Full Text Available Mariya O Klunnyk, Nataliia S Sych, Irina G Matiyashchuk, Olena V Ivankova, Marina V Skalozub Cell Therapy Center EmCell, Kyiv, Ukraine Aim: To investigate the effect of combined treatment with the inclusion of fetal stem cells (FSCs on the morphology and functional dynamics of the left ventricle and cognitive functions in patients with chronic heart failure (CHF. Materials and methods: A comparative study was carried out on patients with CHF to examine the effect of combined treatment, including the experimental application of FSCs, on the morphofunctional parameters of the left ventricle and cognitive functions. Patients were examined before FSC treatment (FSCT, and 1 month, 3 months, and 6 months after treatment. The control group consisted of 20 CHF patients of similar age, sex, and New York Heart Association class. Results: It has been proven that FSCs positively affect objective and subjective clinical parameters. A significant reduction of serum type B brain natriuretic peptide was reported as early as 1 month after treatment. Significant increases in the left ventricle ejection fraction and decreases of the end diastolic volume were observed 6 months after treatment. Cognitive performance tests showed improvements on the Mini-Mental State Examination and Frontal Assessment Battery (conceptualization, mental flexibility, programming, sensitivity to interference, inhibitory control, and environmental autonomy scales. The treatment resulted in significant improvements in the general score and across all cognitive areas of the Mini-Mental State Examination (recall, orientation, attention, calculation, and complex commands after 3 months, and significant improvements across all Frontal Assessment Battery areas after 6 months. In the control group, these scores showed significant increases only at 6 months after the treatment. In the study group, depression was significantly reduced within 1 month after treatment versus 3 months in the control

  2. Subacute and chronic, non-specific back and neck pain: cognitive-behavioural rehabilitation versus primary care. A randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Strender Lars-Erik

    2008-12-01

    Full Text Available Abstract Background In the industrial world, non-specific back and neck pain (BNP is the largest diagnostic group underlying sick-listing. For patients with subacute and chronic (= full-time sick-listed for 43 – 84 and 85 – 730 days, respectively BNP, cognitive-behavioural rehabilitation was compared with primary care. The specific aim was to answer the question: within an 18-month follow-up, will the outcomes differ in respect of sick-listing and number of health-care visits? Methods After stratification by age (≤ 44/≥ 45 years and subacute/chronic BNP, 125 Swedish primary-care patients were randomly allocated to cognitive-behavioural rehabilitation (rehabilitation group or continued primary care (primary-care group. Outcome measures were Return-to-work share (percentage and Return-to-work chance (hazard ratios over 18 months, Net days (crude sick-listing days × degree, and the number of Visits (to physicians, physiotherapists etc. over 18 months and the three component six-month periods. Descriptive statistics, Cox regression and mixed-linear models were used. Results All patients: Return-to-work share and Return-to-work chance were equivalent between the groups. Net days and Visits were equivalent over 18 months but decreased significantly more rapidly for the rehabilitation group over the six-month periods (p Return-to-work share was equivalent. Return-to-work chance was significantly greater for the rehabilitation group (hazard ratio 3.5 [95%CI1.001 – 12.2]. Net days were equivalent over 18 months but decreased significantly more rapidly for the rehabilitation group over the six-month periods and there were 31 days fewer in the third period. Visits showed similar though non-significant differences and there were half as many in the third period. Chronic patients: Return-to-work share, Return-to-work chance and Net days were equivalent. Visits were equivalent over 18 months but tended to decrease more rapidly for the

  3. Lack of behavioral and cognitive effects of chronic ethosuximide and gabapentin treatment in the Ts65Dn mouse model of Down syndrome.

    Science.gov (United States)

    Vidal, V; García, S; Martínez, P; Corrales, A; Flórez, J; Rueda, N; Sharma, A; Martínez-Cué, C

    2012-09-18

    The Ts65Dn (TS) mouse model of Down syndrome (DS) displays a number of behavioral, neuromorphological and neurochemical phenotypes of the syndrome. Altered GABAergic transmission appears to contribute to the mechanisms responsible for the cognitive impairments in TS mice. Increased functional expression of the trisomic gene encoding an inwardly rectifying potassium channel, subfamily J, member 6 (KCNJ6) has been reported in DS and TS mice, along with the consequent impairment in GAB Aergic function. Partial display of DS phenotypes in mice harboring a single trisomy of Kcnj6 provides compelling evidence for a functional role of increased channel expression in some of the abnormal neurological phenotypes found in DS. Notably, the antiepileptic drug (AED) ethosuximide (ETH), but not other AEDs such as gabapentin (GAB), is known to inhibit KCNJ6 channels in mice. Here, we report the effect of chronic ETH and GAB on the behavioral and cognitive phenotypes of TS and disomic control (CO) mice. Neither drug significantly affected sensorimotor abilities, motor coordination or spontaneous activity in TS and CO mice. Also, ETH and GAB did not induce anxiety in the open field or plus maze tests, did not alter performance in the Morris water maze, and did not affect cued - or context - fear conditioning. Our results thus suggest that KCNJ6 may not be a promising drug target candidate in DS. As a corollary, they also show that long-term use of ETH and GAB is devoid of adverse behavioral and cognitive effects.

  4. A combined robotic and cognitive training for locomotor rehabilitation: Evidences of cerebral functional reorganization in two chronic traumatic brain injured patients

    Directory of Open Access Journals (Sweden)

    Katiuscia eSacco

    2011-11-01

    Full Text Available It has been demonstrated that automated locomotor training can improve walking capabilities in spinal cord-injured subjects but its effectiveness on brain damaged patients has not been well established. A possible explanation of the discordant results on the efficacy of robotic training in patients with cerebral lesions could be that these patients, besides stimulation of physiological motor patterns through passive leg movements, also need to train the cognitive aspects of motor control. Indeed, another way to stimulate cerebral motor areas in paretic patients is to use the cognitive function of motor imagery. A promising possibility is thus to combine sensorimotor training with the use of motor imagery. The aim of this paper is to assess changes in brain activations after a combined sensorimotor and cognitive training for gait rehabilitation. The protocol consisted of the integrated use of a robotic gait orthosis prototype with locomotor imagery tasks. Assessment was conducted on two patients with chronic traumatic brain injury and major gait impairments, using functional magnetic resonance imaging. Physiatric functional scales were used to assess clinical outcomes. Results showed greater activation post-training in the sensorimotor and supplementary motor cortices, as well as enhanced functional connectivity within the motor network. Improvements in balance and, to a lesser extent, in gait outcomes were also found.

  5. Endocrine sequelae after radiotherapy in childhood and adolescence; Sequelas endocrinas da radioterapia no tratamento do cancer na infancia e adolescencia

    Energy Technology Data Exchange (ETDEWEB)

    Couto-Silva, Ana Claudia; Adan, Luis Fernando [Universidade Federal da Bahia, Salvador, BA (Brazil); Brauner, Raja [Paris-5 Univ. (France)

    2005-10-15

    Radiotherapy may result in endocrine abnormalities, osteoporosis, obesity and neurological sequelae in patients treated for cancer. In the hypothalamo-pituitary area, GH deficiency is the most frequent complication. The frequency, delay of appearance and severity of GH deficiency depend most on the dose delivered during cranial irradiation but variables as age at treatment and fractionation schedule may play an important role as well. Other hypothalamo-pituitary dysfunctions are also dose-dependent. Low dose cranial irradiation may induce precocious or early puberty, while high doses are related to gonadotropin deficiency. Endocrine complications due to extracranial irradiation such as gonadal or thyroid abnormalities are described. In spite of normal GH secretion, linear growth may be impaired by bone lesions secondary to craniospinal or total body irradiation. Results on final height have been optimized by better indicators of GH therapy associated with adequate treatment of early or precocious puberty. The purpose of this review is to explore the late endocrine sequelae of radiotherapy. (author)

  6. Chronic pain and severe disuse syndrome : long-term outcome of an inpatient multidisciplinary cognitive behavioural programme

    NARCIS (Netherlands)

    van Wilgen, C. Paul; Dijkstra, Pieter U.; Versteegen, Gerbrig J.; Fleuren, Marjo J. T.; Stewart, Roy; van Wijhe, Marten

    2009-01-01

    Objective: Patients with chronic pain and severe disuse syndrome have pain with physiological, psychological and social adaptations. The duration and severity of complaints, combined with previously failed treatments, makes them unsuitable for treatment in primary care. Design: A prospective waiting

  7. Comparison of the efficacy of electromyographic biofeedback, cognitive-behavioral therapy, and conservative medical interventions in the treatment of chronic musculoskeletal pain.

    Science.gov (United States)

    Flor, H; Birbaumer, N

    1993-08-01

    In this study, three types of treatments for chronic musculoskeletal pain were compared. Fifty-seven patients who suffered from chronic back pain and 21 patients who suffered from temporomandibular pain and dysfunction were randomly assigned to either electromyographic (EMG) biofeedback, cognitive-behavioral therapy, or conservative medical treatment. At posttreatment, improvements were noted in all three treatment groups, with the biofeedback group displaying the most substantial change. At the 6- and 24-month follow-up, only the biofeedback group maintained significant reductions in pain severity, interference, affective distress, pain-related use of the health care system, stress-related reactivity of the affected muscles, and an increase in active coping self-statements. Treatment outcome was predicted by chronicity and treatment-specific variables. Analysis of attrition showed a significant effect for therapist and extent of somatic pathology. Results suggest that pain patients who suffer from musculoskeletal pain problems and display few physical disabilities may profit the most from short-term EMG biofeedback treatment.

  8. A systematic review of the psychobiological burden of informal caregiving for patients with dementia: Focus on cognitive and biological markers of chronic stress.

    Science.gov (United States)

    Allen, Andrew P; Curran, Eileen A; Duggan, Áine; Cryan, John F; Chorcoráin, Aoife Ní; Dinan, Timothy G; Molloy, D William; Kearney, Patricia M; Clarke, Gerard

    2017-02-01

    As the physiological impact of chronic stress is difficult to study in humans, naturalistic stressors are invaluable sources of information in this area. This review systematically evaluates the research literature examining biomarkers of chronic stress, including neurocognition, in informal dementia caregivers. We identified 151 papers for inclusion in the final review, including papers examining differences between caregivers and controls as well as interventions aimed at counteracting the biological burden of chronic caregiving stress. Results indicate that cortisol was increased in caregivers in a majority of studies examining this biomarker. There was mixed evidence for differences in epinephrine, norepinephrine and other cardiovascular markers. There was a high level of heterogeneity in immune system measures. Caregivers performed more poorly on attention and executive functioning tests. There was mixed evidence for memory performance. Interventions to reduce stress improved cognition but had mixed effects on cortisol. Risk of bias was generally low to moderate. Given the rising need for family caregivers worldwide, the implications of these findings can no longer be neglected.

  9. Chronic gastritis.

    Science.gov (United States)

    Sipponen, Pentti; Maaroos, Heidi-Ingrid

    2015-06-01

    Prevalence of chronic gastritis has markedly declined in developed populations during the past decades. However, chronic gastritis is still one of the most common serious pandemic infections with such severe killing sequelae as peptic ulcer or gastric cancer. Globally, on average, even more than half of people may have a chronic gastritis at present. Helicobacter pylori infection in childhood is the main cause of chronic gastritis, which microbial origin is the key for the understanding of the bizarre epidemiology and course of the disease. A life-long and aggressive inflammation in gastritis results in destruction (atrophic gastritis) of stomach mucosa with time (years and decades). The progressive worsening of atrophic gastritis results subsequently in dysfunctions of stomach mucosa. Atrophic gastritis will finally end up in a permanently acid-free stomach in the most extreme cases. Severe atrophic gastritis and acid-free stomach are the highest independent risk conditions for gastric cancer known so far. In addition to the risks of malignancy and peptic ulcer, acid-free stomach and severe forms of atrophic gastritis may associate with failures in absorption of essential vitamins, like vitamin B12, micronutrients (like iron, calcium, magnesium and zinc), diet and medicines.

  10. [Doppler ultrasonography in children with sequelae of acute neuroinfections].

    Science.gov (United States)

    Rosin, Iu A

    1999-01-01

    Transcranial dopplerography was performed in 125 children with late (1-3 years) neurologic sequelae of acute neuroinfections. Decreased blood flow velocity (BFV) in middle cerebral arteries of (0.61 of the value in control group) was found in patients with movement disorders. Impairment of the intracranial venous outflow together with both acceleration and asymmetry of blood flow in basal veins was prevalent in children with intracranial hypertension and hydrocephaly syndrome. Hyperconstriction of cerebral vessels together with a low BFV (30% of the initial value) was observed during hyperventilation on the side of the lesion in patients with epileptic syndrome. In children with cerebrasthenic syndrome the effect of cavinton treatment depended on the type of changes in cerebral blood flow: positive effect was found in patients with asymmetric decrease of BFV in anterior cerebral arteries.

  11. Severe ocular sequelae of congenital toxoplasmosis: huge macular scar.

    Science.gov (United States)

    Zahir, Fadoua; Abdellaoui, Meriem; Younes, Samar; Benatiya, Idriss A; Tahri, Hicham

    2015-01-01

    Retinochoroiditis is the most common ocular manifestation of congenital toxoplasmosis, but other associated ophthalmological pathologies can also occur. Ophthalmologists are rarely able to distinguish between toxoplasmic retinochoroiditis due to infection acquired before or after birth, unless other clinical or serological indications are present. This article reports a case of a 3-year-old boy with abnormalities suggestive of congenital toxoplasmosis. The clinical and complementary examinations are discussed. The education of pregnant women is crucial for the prevention of congenital toxoplasmosis. Awareness of antenatal and postnatal presenting signs and symptoms is important for clinicians, because early diagnosis and treatment may minimize sequelae. Untreated, the majority of affected infants will develop chorioretinitis, deafness and/or neurological symptoms.

  12. Randomized Trial of Cognitive-Behavioral Therapy for Chronic Posttraumatic Stress Disorder in Adult Female Survivors of Childhood Sexual Abuse

    Science.gov (United States)

    McDonagh, Annmarie; Friedman, Matthew; McHugo, Gregory; Ford, Julian; Sengupta, Anjana; Mueser, Kim; Demment, Christine Carney; Fournier, Debra; Schnurr, Paula P.

    2005-01-01

    The authors conducted a randomized clinical trial of individual psychotherapy for women with posttraumatic stress disorder (PTSD) related to childhood sexual abuse (n = 74), comparing cognitive-behavioral therapy (CBT) with a problem-solving therapy (present-centered therapy; PCT) and to a wait-list (WL). The authors hypothesized that CBT would be…

  13. When Clients' Morbid Avoidance and Chronic Anger Impede Their Response to Cognitive-Behavioral Therapy for Depression

    Science.gov (United States)

    Newman, Cory F.

    2011-01-01

    In spite of the fact that cognitive-behavioral therapy (CBT) for major depressive disorder is an empirically supported treatment, some clients do not respond optimally or readily. The literature has provided a number of hypotheses regarding the factors that may play a role in these clients' difficulties in responding to CBT, with the current paper…

  14. Neck exercises, physical and cognitive behavioural-graded activity as a treatment for adult whiplash patients with chronic neck pain: Design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Hansen Inge

    2011-12-01

    Full Text Available Abstract Background Many patients suffer from chronic neck pain following a whiplash injury. A combination of cognitive, behavioural therapy with physiotherapy interventions has been indicated to be effective in the management of patients with chronic whiplash-associated disorders. The objective is to present the design of a randomised controlled trial (RCT aimed at evaluating the effectiveness of a combined individual physical and cognitive behavioural-graded activity program on self-reported general physical function, in addition to neck function, pain, disability and quality of life in patients with chronic neck pain following whiplash injury compared with a matched control group measured at baseline and 4 and 12 months after baseline. Methods/Design The design is a two-centre, RCT-study with a parallel group design. Included are whiplash patients with chronic neck pain for more than 6 months, recruited from physiotherapy clinics and an out-patient hospital department in Denmark. Patients will be randomised to either a pain management (control group or a combined pain management and training (interventiongroup. The control group will receive four educational sessions on pain management, whereas the intervention group will receive the same educational sessions on pain management plus 8 individual training sessions for 4 months, including guidance in specific neck exercises and an aerobic training programme. Patients and physiotherapists are aware of the allocation and the treatment, while outcome assessors and data analysts are blinded. The primary outcome measures will be Medical Outcomes Study Short Form 36 (SF36, Physical Component Summary (PCS. Secondary outcomes will be Global Perceived Effect (-5 to +5, Neck Disability Index (0-50, Patient Specific Functioning Scale (0-10, numeric rating scale for pain bothersomeness (0-10, SF-36 Mental Component Summary (MCS, TAMPA scale of Kinesiophobia (17-68, Impact of Event Scale (0-45, EuroQol (0

  15. Psychological states and neuropsychological performances in chronic Lyme disease.

    Science.gov (United States)

    Elkins, L E; Pollina, D A; Scheffer, S R; Krupp, L B

    1999-01-01

    The neuropsychiatric sequelae of chronic Lyme disease remains unclear. This study sought to characterize the psychological status of a group of participants who met criteria for post-Lyme syndrome (PLS). These measures were then used to examine the influence of psychological status on neuropsychological performances. Thirty PLS participants completed a structured psychiatric interview, the Positive and Negative Affect Schedule, the Lyme Symptom Checklist, and a battery of neuropsychological tests. As a group, the PLS participants did not appear to have an elevated incidence of psychiatric disorders, and psychiatric history was not useful for understanding neuropsychological performances or symptom reports. The mood of the PLS participants was characterized by lowered levels of positive affect (PA) and typical levels of negative affect. This combination can be distinguished from depression and is consistent with previous findings of affect patterns in individuals with chronic fatigue syndrome. PA was also linked to both total symptom severity and severity of cognitive complaints, but not to duration of illness, neurological manifestations at initial diagnosis, or treatment history. Relative to published normative data, neuropsychological performances were not in the impaired range on any measure. Neither psychological status nor symptom report were useful for understanding any aspect of cognitive functioning. It is concluded that decreased PA is the most useful marker of psychological functioning in PLS.

  16. Predicting clinically significant response to cognitive behavior therapy for chronic insomnia in general medical practice: analysis of outcome data at 12 months posttreatment.

    Science.gov (United States)

    Espie, C A; Inglis, S J; Harvey, L

    2001-02-01

    The clinical efficacy of cognitive behavior therapy (CBT) for chronic insomnia has been established, yet clinical effectiveness is less clear. This study presents data on 109 patients from general practice during a formal evaluation of clinical effectiveness. Two thirds achieved normative values of or =50%. Logistic regression revealed that initial severity did not contraindicate good outcome. Rather, greater sleep disturbance was positively associated with large symptom reduction, although lower endpoint scores were less likely. Similarly, symptoms of anxiety, depression, and thinking errors positively predicted good outcome. Hypnotic using patients responded equally well to CBT, and demographic factors were of no significant predictive value. It is concluded that CBT is clinically and durably effective for persistent insomnia in routine practice.

  17. A systematic review of the risk of dementia and chronic cognitive impairment after mild traumatic brain injury. Results of the International Collaboration on MTBI Prognosis (ICoMP)

    DEFF Research Database (Denmark)

    Godbolt, Allison; Cancelliere, Carol; Hincapié, Cesar A

    2014-01-01

    -defined criteria. Peer-reviewed reports in six languages were considered. Study selection: Systematic reviews, meta-analyses, randomized controlled trials (RCTs), cohorts and case-control studies, with a minimum of 30 MTBI cases in subjects of any age, assessing the risk of dementia or CCI after MTBI were selected...... synthesis: Evidence from accepted studies was synthesized qualitatively according to modified SIGN criteria and prognostic information was prioritized as exploratory or confirmatory, according to design. Of 77 914 records screened, 304 articles were eligible and reviewed. Methodological quality......Objective: To synthesize the best available evidence regarding the risk of dementia and chronic cognitive impairment (CCI), following mild traumatic brain injury (MTBI). Data sources: MEDLINE and other databases were searched (2001–2012), using a previously published search strategy and pre...

  18. Melatonin treatment and light therapy for chronic sleep onset insomnia in children : Effects on sleep, cognition, health, and psychosocial functioning

    NARCIS (Netherlands)

    van Maanen, A.

    2017-01-01

    Melatonin treatment is known to be an effective treatment for chronic sleep onset problems in children, as it can advance the sleep-wake rhythm and improve sleep. However, it is currently not known how long melatonin treatment should be continued, while especially in young children, short term treat

  19. Fatigue In Teenagers on the interNET--the FITNET Trial. A randomized clinical trial of web-based cognitive behavioural therapy for adolescents with chronic fatigue syndrome: study protocol. [ISRCTN59878666

    NARCIS (Netherlands)

    Nijhof, S.L.; Bleijenberg, G.; Uiterwaal, C.S.; Kimpen, J.L.L.; Putte, E.M. van de

    2011-01-01

    BACKGROUND: Chronic Fatigue Syndrome (CFS) is increasingly recognized as a cause of disability and inactivity in adolescents in the Netherlands. CFS is characterized by unexplained fatigue lasting more than 6 months. Cognitive Behavioural Therapy (CBT) has proven to be effective. However, CBT availa

  20. Cognitive-Behavioral Couple Therapies: Review of the Evidence for the Treatment of Relationship Distress, Psychopathology, and Chronic Health Conditions.

    Science.gov (United States)

    Fischer, Melanie S; Baucom, Donald H; Cohen, Matthew J

    2016-09-01

    Cognitive-behavioral couple therapy (CBCT) is an approach to assisting couples that has strong empirical support for alleviating relationship distress. This paper provides a review of the empirical status of CBCT along with behavioral couple therapy (BCT), as well as the evidence for recent applications of CBCT principles to couple-based interventions for individual psychopathology and medical conditions. Several meta-analyses and major reviews have confirmed the efficacy of BCT and CBCT across trials in the United States, Europe, and Australia, and there is little evidence to support differential effectiveness of various forms of couple therapy derived from behavioral principles. A much smaller number of effectiveness studies have shown that successful implementation in community settings is possible, although effect sizes tend to be somewhat lower than those evidenced in randomized controlled trials. Adapted for individual problems, cognitive-behavioral couple-based interventions appear to be at least as effective as individual cognitive behavioral therapy (CBT) across a variety of psychological disorders, and often more effective, especially when partners are substantially involved in treatment. In addition, couple-based interventions tend to have the unique added benefit of improving relationship functioning. Findings on couple-based interventions for medical conditions are more varied and more complex to interpret given the greater range of target outcomes (psychological, relational, and medical variables).

  1. Therapy and prophylaxis of acute and late radiation-induced sequelae of the esophagus

    Energy Technology Data Exchange (ETDEWEB)

    Zimmermann, F.B.; Geinitz, H.; Feldmann, H.J. [Klinik und Poliklinik fuer Strahlentherapie und Radiologische Onkologie, Klinikum rechts der Isar, Muenchen (Germany)

    1998-11-01

    Background: Radiation-induced esophagitis is a frequent acute side effect in curative and palliative radiotherapy of thoracal and cervical tumors. Late reactions are rare but might be severe. Methods: A resarch for reports on prophylactic and supportive therapies of radiation-induced esophagitis was performed (Medline, Cancerlit, and others). Results: Nutrition must be ensured and symptomatic relief of sequelae is important, especially in the case of dysphagia. The latter can be improved by topic or systemic analgetics. If esophageal spasm occurs, calcium antagonists might help. In case of gastro-esophageal reflux proton pump inhibitors should be used. There is no effective prophylactic measure for radiation esophagitis. Late side effects with clinical relevance are rare in conventional radiotherapy. Chronic ulcera, fistula or stenosis may develop. Before any treatment, a tumor infiltration of the esophagus should be excluded by biopsy. This can lead more often to late complications than radiation therapy itself. Nutrition should be ensured by endoscopic dilation, stent-implantation, or endoscopic percutaneous gastrostomy. Local injection of steroids might be used to avoid an early restenosis. Conclusions: An intensive symptomatic therapy of acute esophagitis is reasonable. Effective prophylaxis do not exist. Late radiation induced sequelae is rare. Therefore, a tumor recurrenc e should be excluded in cases of dysphagia. Securing nutrition by PEG, stent, or port is well in the fore. (orig.) [Deutsch] Hintergrund: Die radiogene Oesophagitis ist eine haeufige akute Nebenwirkung bei kurativen wie palliativen Bestrahlungen thorakaler und zervikaler Tumoren. Spaete Gewebereaktionen sind selten, koennen aber schwerwiegend sein. Methode: Es wurde eine Literaturrecherche nach prophylaktischen und supportiven Therapien der radiogen verursachten Oesophagitis durchgefuehrt (Medline, Cancerlit und andere). Ergebnisse: Therapeutisch stehen die Sicherung der Ernaehrung und die

  2. Factors Associated with Sequelae of Campylobacter and Non-typhoidal Salmonella Infections: A Systematic Review.

    Science.gov (United States)

    Esan, Oluwaseun B; Pearce, Madison; van Hecke, Oliver; Roberts, Nia; Collins, Dylan R J; Violato, Mara; McCarthy, Noel; Perera, Rafael; Fanshawe, Thomas R

    2017-02-01

    Despite the significant global burden of gastroenteritis and resulting sequelae, there is limited evidence on risk factors for sequelae development. We updated and extended previous systematic reviews by assessing the role of antibiotics, proton pump inhibitors (PPI) and symptom severity in the development of sequelae following campylobacteriosis and salmonellosis. We searched four databases, including PubMed, from 1 January 2011 to 29 April 2016. Observational studies reporting sequelae of reactive arthritis (ReA), Reiter's syndrome (RS), irritable bowel syndrome (IBS) and Guillain-Barré syndrome (GBS) following gastroenteritis were included. The primary outcome was incidence of sequelae of interest amongst cases of campylobacteriosis and salmonellosis. A narrative synthesis was conducted where heterogeneity was high. Of the 55 articles included, incidence of ReA (n=37), RS (n=5), IBS (n=12) and GBS (n=9) were reported following campylobacteriosis and salmonellosis. A pooled summary for each sequela was not estimated due to high level of heterogeneity across studies (I2>90%). PPI usage and symptoms were sparsely reported. Three out of seven studies found a statistically significant association between antibiotics usage and development of ReA. Additional primary studies investigating risk modifying factors in sequelae of GI infections are required to enable targeted interventions.

  3. Some musculo-skeletal sequelae in cancer survivors.

    Science.gov (United States)

    Aksnes, Liv Hege; Bruland, Øyvind Sverre

    2007-01-01

    This paper deals with some of the musculo-skeletal complication that can occur after cancer treatment. In particular, we focus on Cancer Treatment Induced Bone Loss (CTIBL) and the musculo-skeletal complications that can occur in patients treated for extremity sarcoma. In addition we discuss peripheral neuropathy, musculo-skeletal pain and briefly mention some of the complications related to radiotherapy. CTIBL is mostly studied in breast cancer and prostate cancer survivors. The cause in these groups is mainly due to treatment induced hypogonadism. Other causes of CTIBL are indirect or direct cause of chemotherapy, physical inactivity and inadequate intake of vitamin D and calcium. Treatment of CTIBL consists of diet and lifestyle changes and pharmacological intervention. Extremity bone sarcomas constitute a special group since they often experience mutilating surgery and heavy combination chemotherapy. The treatment results in worse function than the normal population and the amputated usually have lower physical functioning than patients treated with limb sparing surgery (LSS). However, most studies fail to show differences in quality of life between the amputated and LSS. Most of the studies performed on musculo-skeletal sequelae have been done on survivors of childhood cancer, breast cancer or prostate cancer. More studies among the other cancer groups are needed to reveal the extent and prevalence of these complications.

  4. Survival without sequelae after prolonged cardiopulmonary resuscitation after electric shock.

    Science.gov (United States)

    Motawea, Mohamad; Al-Kenany, Al-Sayed; Hosny, Mostafa; Aglan, Omar; Samy, Mohamad; Al-Abd, Mohamed

    2016-03-01

    "Electrical shock is the physiological reaction or injury caused by electric current passing through the human body. It occurs upon contact of a human body part with any source of electricity that causes a sufficient current through the skin, muscles, or hair causing undesirable effects ranging from simple burns to death." Ventricular fibrillation is believed to be the most common cause of death after electrical shock. "The ideal duration of cardiac resuscitation is unknown. Typically prolonged cardiopulmonary resuscitation is associated with poor neurologic outcomes and reduced long term survival. No consensus statement has been made and traditionally efforts are usually terminated after 15-30 minutes." The case under discussion seems worthy of the somewhat detailed description given. It is for a young man who survived after 65 minutes after electrical shock (ES) after prolonged high-quality cardiopulmonary resuscitation (CPR), multiple defibrillations, and artificial ventilation without any sequelae. Early start of adequate chest compressions and close adherence to advanced cardiac life support protocols played a vital role in successful CPR.

  5. Skeletal sequelae of radiation therapy for malignant childhood tumors

    Energy Technology Data Exchange (ETDEWEB)

    Butler, M.S.; Robertson, W.W. Jr.; Rate, W.; D' Angio, G.J.; Drummond, D.S. (UMDNJ Robert Wood Johnson Medical School, New Brunswick (USA))

    1990-02-01

    One hundred forty-three patients who received radiation therapy for childhood tumors, and survived to the age of skeletal maturity, were studied by retrospective review of oncology records and roentgenograms. Diagnoses for the patients were the following: Hodgkin's lymphoma (44), Wilms's tumor (30), acute lymphocytic leukemia (26), non-Hodgkin's lymphoma (18), Ewing's sarcoma (nine), rhabdomyosarcoma (six), neuroblastoma (six), and others (four). Age at the follow-up examination averaged 18 years (range, 14-28 years). Average length of follow-up study was 9.9 years (range, two to 18 years). Asymmetry of the chest and ribs was seen in 51 (36%) of these children. Fifty (35%) had scoliosis; 14 had kyphosis. In two children, the scoliosis was treated with a brace, while one developed significant kyphosing scoliosis after laminectomy and had spinal fusion. Twenty-three (16%) patients complained of significant pain at the radiation sites. Twelve of the patients developed leg-length inequality; eight of those were symptomatic. Three patients developed second primary tumors. Currently, the incidence of significant skeletal sequelae is lower and the manifestations are less severe than reported in the years from 1940 to 1970. The reduction in skeletal complications may be attributed to shielding of growth centers, symmetric field selection, decreased total radiation doses, and sequence changes in chemotherapy.

  6. Emotional sequelae of abortion: implications for clinical practice.

    Science.gov (United States)

    Lemkau, J P

    1988-12-01

    Without ambivalence, psychotherapy would be unnecessary; however there is a great deal of ambivalence about abortion so it is a therapy issue. In our society abortion decision are made in an ambivalent environment. Even when a woman makes a free decision to have a legal abortion, an emotional sequelae can ensue. This article reviews literature and relates professional experience about the psychological problems and treatment of women before and after having an abortion. A feeling of relief is the typical reaction to an abortion for the woman. The issues involved in the decision process are the woman's own health and happiness as well as that of her future family. The issues include medical and interpersonal ones and often present a moral crisis. Issues such as education, occupation, and relationships must be considered. Three major types of reactions seem to follow an abortion. The 1st is a positive feeling of happiness and relief. The 2nd and 3rd are negative, one being socially based guilt and the other being individually based guilt. Identifying abortion related issues in psychotherapy is not always easy, since they are no usually directly presented to the therapist. They often manifest themselves as symptoms of other problems. Research suggests that unmarried young women without children have a harder time resolving all the issues involved in making an abortion decision. One effective method of discovering emotional problems is to determine the reasons for delaying an abortion. If a woman is having problems making the decision is must be for an important reason. Just as important is the aftermath of the abortion. Attempts should be made to discover as much information about the procedure itself, the recovery time and any repercussions of the procedure. Neither research nor clinical experience has shown that abortion related psychotherapy is different than other forms of treatment. Griefwork, educational approaches, reviews of the decision making process and

  7. Context and Sequelae of Food Insecurity in Children's Development

    Science.gov (United States)

    Belsky, Daniel W.; Moffitt, Terrie E.; Arseneault, Louise; Melchior, Maria; Caspi, Avshalom

    2010-01-01

    The authors examined the role of food insecurity in the etiology of children's cognitive and mental health problems. Data from a prospective longitudinal study of 1,116 United Kingdom families with twins (sample constructed in 1999–2000) were used to test associations among household food insecurity; income; maternal personality; household sensitivity to children's needs; and children's cognitive, behavioral, and emotional development. Food-insecure children had lower IQs and higher levels of behavioral and emotional problems relative to their peers. After differences in household income, the personalities of children's mothers, and the sensitivity of household organization to children's needs were accounted for, food-insecure children had moderately higher levels of emotional problems relative to food-secure children (β = 0.22, P = 0.02). Differences in children's cognitive development were accounted for by household income, and differences in their behavioral development were accounted for by their mothers’ personalities and their households’ sensitivity to children's needs. Results suggest that food insecurity was associated with school-aged children's emotional problems but not with their cognitive or behavioral problems after accounting for differences in the home environments in which children were reared. Mothers’ personality and household sensitivity to children's needs may present challenges to improving outcomes of children with food insecurity. PMID:20716700

  8. Clinical and radiographic sequelae to primary teeth affected by dental trauma: a 9-year retrospective study.

    Science.gov (United States)

    Costa, Vanessa Polina Pereira; Goettems, Marilia Leão; Baldissera, Elaine Zanchin; Bertoldi, Andréa Dâmaso; Torriani, Dione Dias

    2016-08-18

    This retrospective study aimed at determining the predicted risks of clinical and radiographic complications in primary teeth following traumatic dental injuries, according to injury type, severity and child's age. Data were collected from records of children treated at a Dental Trauma Center in Brazil for nine years. Records of 576 children were included; clinical sequelae were assessed in 774 teeth, and radiographic sequelae, in 566 teeth. A total of 408 teeth (52.7%) had clinical sequelae and 185 teeth (32.7%), radiographic sequelae. The type of injury with the highest number of clinical sequelae was the crown-root fracture (86.4%). Clinical sequelae increased with injury severity (p teeth with enamel fracture, and 26.0% (95%CI 14-40) for teeth with enamel dentin fracture as well as enamel dentin pulp fracture. Risk of periapical radiolucency was higher for teeth with enameldentinpulp fracture (61.1% 95%CI 35-82) and those with subluxation (15.8% 95%CI 10-22). Risk of premature loss was 27.3% (95%CI 13-45) for teeth with extrusive luxation, and 10.2% (95%CI 5-17) for those with intrusive luxation. The assessment of predicted risks of sequelae showed that teeth with hard tissue trauma tended to present color change, periapical radiolucency and premature loss, whereas teeth with supporting tissue trauma showed color change, abnormal position, premature loss and periapical radiolucency as the most common sequelae. Knowledge about the predicted risks of complications may help clinicians establish appropriate treatment plans.

  9. Chronic caffeine treatment during prepubertal period confers long-term cognitive benefits in adult spontaneously hypertensive rats (SHR), an animal model of attention deficit hyperactivity disorder (ADHD).

    Science.gov (United States)

    Pires, Vanessa A; Pamplona, Fabrício A; Pandolfo, Pablo; Prediger, Rui D S; Takahashi, Reinaldo N

    2010-12-20

    The spontaneously hypertensive rat (SHR) is frequently used as an experimental model for the study of attention deficit hyperactivity disorder (ADHD) since it displays behavioural and neurochemical features of ADHD. Increasing evidence suggests that caffeine might represent an important therapeutic tool for the treatment of ADHD and we recently demonstrated that the acute administration of caffeine improves several learning and memory impairments in adult SHR rats. Here we further evaluated the potential of caffeine in ADHD therapy. Female Wistar (WIS) and SHR rats were treated with caffeine (3mg/kg, i.p.) or methylphenidate (MPD, 2mg/kg, i.p.) for 14 consecutive days during the prepubertal period (post-natal days 25-38) and they were tested later in adulthood in the object-recognition task. WIS rats discriminated all the objects used, whereas SHR were not able to discriminate pairs of objects with subtle structural differences. Chronic treatment with caffeine or MPD improved the object-recognition deficits in SHR rats. Surprisingly, these treatments impaired the short-term object-recognition ability in adult WIS rats. The present drug effects are independent of changes in locomotor activity, arterial blood pressure and body weight in both rat strains. These findings suggest that chronic caffeine treatment during prepubertal period confers long-term cognitive benefits in discriminative learning impairments of SHR, suggesting caffeine as an alternative therapeutic strategy for the early management of ADHD symptoms. Nevertheless, our results also emphasize the importance of a correct diagnosis and the caution in the use of stimulant drugs such as caffeine and MPD during neurodevelopment since they can disrupt discriminative learning in non-ADHD phenotypes.

  10. Effects of Ning Shen Ling Granule(宁神灵冲剂)and Dehydroepiandrosterone on Cognitive Function in Mice Undergoing Chronic Mild Stress

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao; DONG Yi-long; YANG Nan; LIU Yan-yong; GAO Rui-feng; ZUO Ping-ping

    2007-01-01

    Objective:To investigate the changes of spontaneous and cognitive behavior,and cholinergic M receptors in the brain of mice subjected to chronic mild stress (CMS),and to determine the effect of Ning Shen Ling Granule (宁神灵冲剂,NSL) and dehydroepiandrosterone (DHEA) on them.Methods:CMS model mice were established by applying stress every day for 3 consecutive weeks with 7 kinds of unforeseeable stress sources,and they were medicated for 1 week beginning at the 3rd week of modeling.The changes in behavior were determined by Morris Water Maze and spontaneous movement test,and M-receptor binding activity in cerebral cortex,hippocampus and hypothalamus were measured by radioactive ligand assay with 3H-QNB.Results:(1)The spontaneous movement in CMS model mice was significantly reduced,with the latency for searching platform in Morris Water Maze obviously prolonged (P<0.01),and these abnormal changes in behavior were improved in those treated with NSL and DHEA.(2)The binding ability of M-receptor in cerebral cortex and hippocampus of CMS mice was significantly decreased as compared with those in the control group (P<0.05),but could be restored to the normal level after intervention with NSL or DHEA.Conclusion:The decline of spontaneous movement and spatial learning and memory ability could be induced in animals by chronic mild stress,and that may be related to the low activity of central cholinergic M-receptors.Both NSL and DHEA could effectively alleviate the above-mentioned changes.

  11. Lentidão cognitiva e psicomotora em hemodialisados crônicos Cognitive and psychomotor slowing in chronic hemodialysis patients

    Directory of Open Access Journals (Sweden)

    Wagner Martignoni de Figueiredo

    2007-09-01

    Full Text Available FUNDAMENTOS: A encefalopatia urêmica subclínica pode levar a comprometimento ocupacional de difícil diagnóstico por requerer o emprego de medidas sensíveis. PROPÓSITO: Testar as hipóteses de que (1 pacientes em hemodiálise crônica (HDC se saem pior do que controles normais em uma bateria de desempenho, (2 um dia extra de uremia comprometeria ainda mais o comprometimento neuropsicológico desses pacientes, e (3 a uremia dificultaria a melhora do desempenho em uma segunda sessão de testes. MÉTODO: A agilidade cognitiva e motora de 28 pacientes em HDC foi avaliada com os testes de Trilhas (A e B, Algarismos e Símbolos, e Stroop. RESULTADOS: (1a o desempenho cognitivo e motor se encontravam mais lento nos pacientes, (2a um dia a mais de uremia comprometeu o desempenho na Parte B do Teste de Trilhas, e (3a pacientes em HDC apresentaram redução da capacidade de aprender novos procedimentos. CONCLUSÃO: Pacientes em HDC podem apresentar uma "encefalopatia subclínica" cuja detecção pode requerer a aplicação de testes sensíveis. A agilidade mental e motora, e a capacidade de aprender novas rotinas estão comprometidas em, pelo menos, alguns pacientes em HDC com cognição global normal.BACKGROUND: The diagnosis of "subclinical uremic encephalopathy" may need the administration of sensitive tests. PURPOSE: To test the hypotheses that (1 patients on chronic hemodialysis (CHD fare worse than normal controls on a brief performance battery, (2 one extra-day of uremia further jeopardizes the neuropsychological performance of CHD patients, and (3 uremia impairs improvement on a second testing session. METHOD: The cognitive and motor agility of 28 patients on CHD were assessed with the Trails A and B, Digit Symbol, and Stroop tests. RESULTS: (1a cognitive and psychomotor performance were slowed in patients, (2a one extra-day of uremia impaired performance further on Trail Making B, and (3a CHD patients had a decreased ability to learn novel

  12. Effects of chronic insomnia on cognitive functions assessed objectively%慢性失眠对客观认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    王海棠; 夏兰; 冯寅; 陈贵海

    2011-01-01

    duration(r=-0.293),sleep efficiency (r=-0.258)and sleep disturbances (r=-0.217)]or HAMD17 (anxiety/somatization,sleep and insight),respectively (Ps <0.05).The unconditional univariate and multivariate Logistic regression analysis showed that the cognitive function depended on the educated years (β=-0.434 ,P<0.001 ), the total scores of HAMD17 (β=0.434 ,P=0.009 )and PSQI (β=0.357 ,P=0.029), respectively.Conclusions Chronic insomnia,regardless of PI or CDI, did affect the cognitive function in certain extent.

  13. Childhood central nervous system leukemia: historical perspectives, current therapy, and acute neurological sequelae

    Energy Technology Data Exchange (ETDEWEB)

    Laningham, Fred H. [St. Jude Children' s Research Hospital, Division of Diagnostic Imaging, Department of Radiological Sciences, Memphis, TN (United States); University of Tennessee Health Sciences Center, Memphis, TN (United States); Kun, Larry E. [St. Jude Children' s Research Hospital, Division of Radiation Oncology, Department of Radiological Sciences, Memphis, TN (United States); University of Tennessee Health Sciences Center, Memphis, TN (United States); Reddick, Wilburn E.; Ogg, Robert J. [St. Jude Children' s Research Hospital, Division of Translational Imaging Research, Department of Radiological Sciences, Memphis, TN (United States); Morris, E.B. [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); Pui, Ching-Hon [St. Jude Children' s Research Hospital, Department of Oncology, Memphis, TN (United States); University of Tennessee Health Sciences Center, Memphis, TN (United States)

    2007-11-15

    During the past three decades, improvements in the treatment of childhood leukemia have resulted in high cure rates, particularly for acute lymphoblastic leukemia (ALL). Unfortunately, successful therapy has come with a price, as significant morbidity can result from neurological affects which harm the brain and spinal cord. The expectation and hope is that chemotherapy, as a primary means of CNS therapy, will result in acceptable disease control with less CNS morbidity than has been observed with combinations of chemotherapy and radiotherapy over the past several decades. In this review we discuss the poignant, historical aspects of CNS leukemia therapy, outline current methods of systemic and CNS leukemia therapy, and present imaging findings we have encountered in childhood leukemia patients with a variety of acute neurological conditions. A major objective of our research is to understand the neuroimaging correlates of acute and chronic effects of cancer and therapy. Specific features related to CNS leukemia and associated short-term toxicities, both disease- and therapy-related, are emphasized in this review with the specific neuroimaging findings. Specific CNS findings are similarly important when treating acute myelogenous leukemia (AML), and details of leukemic involvement and toxicities are also presented in this entity. Despite contemporary treatment approaches which favor the use of chemotherapy (including intrathecal therapy) over radiotherapy in the treatment of CNS leukemia, children still occasionally experience morbid neurotoxicity. Standard neuroimaging is sufficient to identify a variety of neurotoxic sequelae in children, and often suggest specific etiologies. Specific neuroimaging findings frequently indicate a need to alter antileukemia therapy. It is important to appreciate that intrathecal and high doses of systemic chemotherapy are not innocuous and are associated with acute, specific, recognizable, and often serious neurological

  14. A prospective study to evaluate a new residential community reintegration programme for severe chronic brain injury: the Brain Integration Programme.

    NARCIS (Netherlands)

    Geurtsen, G.J.; Martina, J.D.; Heugten, C.M. van; Geurts, A.C.H.

    2008-01-01

    PURPOSE: To assess the effectiveness of a residential community reintegration programme for participants with chronic sequelae of severe acquired brain injury that hamper community functioning. DESIGN: Prospective cohort study. SUBJECTS: Twenty-four participants with acquired brain injury (traumatic

  15. Chronic pancreatitis:a sequela of acute fatty liver of pregnancy

    Institute of Scientific and Technical Information of China (English)

    Wichian Apiratpracha; Eric M. Yoshida; Scudamore H. Charles

    2008-01-01

    BACKGROUND: Chronic pancreatitis following acute fatty liver of pregnancy is rarely reported. METHODS: We treated a 34-year-old woman who developed acute fatty liver of pregnancy (AFLP) after delivery by caesarean  section  at  32  weeks  of  gestation.  AFLP  was complicated by acute pancreatitis and multiple organ failure. The management of the disease was primarily supportive. She recovered from acute fulminant liver failure and multi-organ failure, apart from the development of symptomatic chronic pancreatitis thereafter. RESULTS: Investigations failed to identify any other causes of chronic pancreatitis. The patient responded very well to pancreatic enzyme supplement for the treatment of steatorrhoea. CONCLUSION: To our knowledge, this is the ifrst report of chronic pancreatitis as a consequence of multi-organ dysfunction caused by AFLP.

  16. Neuroplastic Correlates in the mPFC Underlying the Impairment of Stress-Coping Ability and Cognitive Flexibility in Adult Rats Exposed to Chronic Mild Stress during Adolescence

    Science.gov (United States)

    Zhang, Yu; Shao, Feng; Wang, Qiong; Xie, Xi

    2017-01-01

    Using a valid chronic mild stress (CMS) model of depression, we found that adolescent (postnatal days [PND] 28–41) CMS induced transient alterations in anhedonia that did not persist into adulthood after a 3-week recovery period. Previously stressed adult rats exhibited more immobility/despair behaviors in the forced swimming test and a greater number of trials to reach criterion in the set-shifting task, suggesting the impaired ability to cope with stressors and the cognitive flexibility that allows adaptation to dynamic environments during adulthood. In addition, adult rat exposure to adolescent CMS had a relatively inhibited activation in ERK signaling and downstream protein expression of phosphorylated cAMP-response element-binding protein (CREB) and brain-derived neurotrophic factor (BDNF) in the medial prefrontal cortex. Further correlation analysis demonstrated that immobility and set-shifting performance were positively correlated with the inhibition of ERK signaling. These results indicated adolescent CMS can be used as an effective stressor to model an increased predisposition to adult depression. PMID:28182105

  17. Ginsenoside Reduces Cognitive Impairment During Chronic Cerebral Hypoperfusion Through Brain-Derived Neurotrophic Factor Regulated by Epigenetic Modulation.

    Science.gov (United States)

    Wan, Qun; Ma, Xue; Zhang, Zhi-Jun; Sun, Ting; Xia, Feng; Zhao, Gang; Wu, Yu-Mei

    2016-03-28

    Increased expression of brain-derived neurotrophic factor (BDNF) has been associated with memory-enhancing and neuroprotective properties of some drugs under chronic cerebral hypoperfusion (CCH) condition. Ginsenoside Rd (GSRd), one of the main active ingredients in Panax ginseng, is widely used for brain protection. However, it is poorly understood whether epigenetic mechanisms implied in the BDNF modulation after GSRd treatment for CCH remain elusive. Here, we investigated the neuroprotective effects of GSRd and the involved mechanisms. We demonstrated that GSRd administration ameliorated CCH-induced impairment of learning and memory behaviors, evidenced by decreased escape latency and increased number of crossing the platform in Morris water maze test. This improvement was associated with promoted neuron survival and increased BDNF expression in the hippocampus and prefrontal cortex of CCH mice. GSRd improved neuron survival and decreased neuron apoptosis and the level of caspase-3 under oxygen-glucose deprivation/reoxygenation (OGD/R) by upregulation of BDNF as well as in vitro. The levels of acetylated histone H3 (Ac-H3) and histone deacetylase (histone deacetylase 2 (HDAC2)) were altered under OGD/R in a time-dependent manner, and GSRd reestablished the balance between Ac-H3 and HDAC2 which resulted in upregulation of BDNF and increased neuron survival. MS-275, an inhibitor of class I HDACs, abolished the levels of Ac-H3 at the bdnf promoters and enhanced upregulation of BDNF after GSRd administration, suggesting a synergistic effect between GSRd and MS-275. All the data suggested that GSRd provided neuroprotection by epigenetic modulation which accounted for the regulation of BDNF in CCH mice.

  18. The Efficacy of Syzygium aromaticum Essential Oil in Cognitive Disorders against Manganese Chronic Exposure in Rats during Development

    Directory of Open Access Journals (Sweden)

    Djallal Eddine Houari ADLI

    2014-06-01

    Full Text Available The essential oil of Syzygium aromaticum has been widely used in traditional medicine to treat a variety of diseases, including some neurological disorders. This study aims at testing, in vivo, the possible anxiolytic and antidepressant effects, of the Syzygium aromaticum essential oil against chronic manganese chloride (4.79 mg/l intoxication during the gestation and lactation period, in Wistar rat pups. Wistar rat pups were exposed to manganese via their dams’ drinking water from postnatal day (PND 1 to (PND 21. After their weaning, the rats exposed to manganese received injections of essential oil of Syzygium aromaticum (0.1 ml/kg for 18 days. The level of anxiety, depression and locomotor activity were studied. Locomotor activity (open field test, anxiety (elevated plus maze tests, and depression (forced swimming test were evaluated. The results of the present study indicate that Manganese exposure induces, on the one hand, impairments of body (p<0.001 and of brain weight (p<0.05. On the other hand, it increases level of anxiety (p<0.05, depression (p<0.001 and locomotor hyporactivity (p<0.001, when compared to control rats. Administration of essential oil of Syzygium aromaticum leads to a reduction in the level of anxiety (p<0.05, of depression (p<0.001 and corrects locomotor hyporactivity (p<0.05 in rats exposed to manganese beforehand. These results suggest that essential oil of Syzygium aromaticum can employ as a natural, protective agent against neuro-toxicity induced by manganese chloride during the gestation and lactation periods.

  19. Extrahepatic morbidity and mortality of chronic hepatitis C.

    Science.gov (United States)

    Negro, Francesco; Forton, Daniel; Craxì, Antonio; Sulkowski, Mark S; Feld, Jordan J; Manns, Michael P

    2015-11-01

    Chronic hepatitis C virus (HCV) infection is associated with several extrahepatic manifestations. Patients with HCV may develop mixed cryoglobulinemia and its sequelae, ranging from cutaneous and visceral vasculitis to glomerulonephritis and B-cell non-Hodgkin lymphoma. HCV-infected patients have increased rates of insulin resistance, diabetes, and atherosclerosis, which may lead to increased cardiovascular morbidity and mortality. Neurological manifestations of HCV infection include fatigue and cognitive impairment. The mechanisms causing the extrahepatic effects of HCV infection are likely multifactorial and may include endocrine effects, HCV replication in extrahepatic cells, or a heightened immune reaction with systemic effects. Successful eradication of HCV with interferon alfa and ribavirin was shown to improve some of these extrahepatic effects; sustained virological response is associated with resolution of complications of cryoglobulinemia, reduced levels of insulin resistance, reduced incidence of diabetes and stroke, and improved fatigue and cognitive functioning. The availability of new interferon-free, well-tolerated anti-HCV treatment regimens is broadening the spectrum of patients available for therapy, including those in whom interferon was contraindicated, and will likely result in greater improvements in the extrahepatic manifestations of HCV. If these regimens are shown to confer significant benefit in the metabolic, cardiovascular, or neuropsychiatric conditions associated with HCV infection, extrahepatic manifestations of HCV may become a major indication for treatment even in the absence of liver disease.

  20. Nicotine reverses anhedonic-like response and cognitive impairment in the rat chronic mild stress model of depression: comparison with sertraline

    DEFF Research Database (Denmark)

    Andreasen, Jesper T; Henningsen, Kim; Bate, Simon;

    2011-01-01

    is similar to that of a standard antidepressant drug. Moreover, the data suggest that nicotine alleviates CMS-induced cognitive disturbance. A treatment strategy involving the targeting of nicotinic acetylcholine receptors may prove beneficial for emotional and cognitive disturbances associated...

  1. Reduced cognitive function in children with toxocariasis in a nationally representative sample of the United States.

    Science.gov (United States)

    Walsh, Michael G; Haseeb, M A

    2012-12-01

    Toxocariasis has recently been recognised as a potentially important neglected infection in developed countries, particularly those that experience substantive health disparities such as the United States. Given a relatively high prevalence of infection, an association between Toxocara infection and cognitive function may elucidate an important mechanism by which toxocariasis could contribute significantly to morbidity while still remaining hidden and, thus, neglected. To assess the potential relationship between toxocariasis and cognitive function, this investigation measured differences in components of both the Wechsler Intelligence Scale for Children-Revised (WISC-R) and the Wide Range Achievement Test-Revised (WRAT-R) in children seropositive and in children seronegative for Toxocara antibodies in the Third National Health and Nutrition Examination Survey, a large, nationally-representative survey of the United States population. Seropositive children scored significantly lower on the WISC-R and WRAT-R compared with the seronegative children. Moreover, this relationship was independent of socioeconomic status, ethnicity, gender, rural residence, cytomegalovirus infection and blood lead levels. These results identify an important association that may reflect morbidity attributable to a genuine neglected infection. Nevertheless, longitudinal data are required to confirm an etiological connection between toxocariasis and cognitive function, as well as the true population attributable risk for toxocariasis and its chronic sequelae.

  2. Low-dose oral prolonged-release oxycodone/naloxone for chronic pain in elderly patients with cognitive impairment: an efficacy–tolerability pilot study

    Science.gov (United States)

    Petrò, Emiliano; Ruffini, Elena; Cappuccio, Melania; Guerini, Valeria; Belotti, Gloria; Fascendini, Sara; Licini, Cristina; Marcassa, Claudio

    2016-01-01

    Objective This pilot study evaluated the efficacy and safety of prolonged-release oxycodone/naloxone (OXN-PR) in older subjects with chronic pain and mild-to-moderate cognitive impairment. Methods This was a prospective, observational, open-label study of 45-day duration. Patients with moderate-to-severe chronic pain and naïve to strong opioids were recruited from nursing homes and Alzheimer’s disease centers. OXN-PR was initiated at low doses (5 mg od or bid) and increased to a maximum of 20 mg bid. The primary efficacy endpoint was a pain intensity reduction of ≥30% from baseline (T0) to 15 days after OXN-PR initiation, as assessed by a numerical rating scale or the Pain Assessment in Advanced Dementia scale. Other assessments included the Barthel activities of daily living index, Neuropsychiatric Inventory, Bowel Function Index, and adverse events. Results The analysis included 53 patients (mean age, 83.0 years; mean Mini-Mental State Examination score, 18.6) with severe pain (median Numerical Rating Scale/Pain Assessment in Advanced Dementia 6) and substantial impairment in daily functioning (mean Barthel index, 32.2). The primary endpoint was achieved by 92.4% of patients. OXN-PR significantly reduced mean pain intensity from baseline to study end (numerical rating scale, 6.6±1.0 vs 2.3±1.1, P<0.0001; Pain Assessment in Advanced Dementia, 6.9±1.6 vs 0.9±0.8, P<0.0001). Substantial improvements from T0 to T45 in daily functioning (mean Barthel index, 32.2±16.8 vs 53.7±23.9, P<0.0001) and neuropsychiatric symptoms (mean Neuropsychiatric Inventory, 25.5±27.3 vs 8.8±9.0, P<0.0001) were also reported. OXN-PR was well tolerated and did not worsen bowel function. Conclusion In this pilot study, OXN-PR was effective in improving pain and other symptoms associated with dementia, with a favorable safety and tolerability profile. Large-scale trials in people with dementia are needed to improve clinical guidance for the assessment and treatment of pain in

  3. Early trauma-focused cognitive-behavioural therapy to prevent chronic post-traumatic stress disorder and related symptoms: A systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Kirkehei Ingvild

    2008-09-01

    Full Text Available Abstract Background Early trauma-focused cognitive-behavioural therapy (TFCBT holds promise as a preventive intervention for people at risk of developing chronic post-traumatic stress disorder (PTSD. The aim of this review was to provide an updated evaluation of the effectiveness of early TFCBT on the prevention of PTSD in high risk populations. Methods We performed a systematic literature search in international electronic databases (MEDLINE, EMBASE, PsycINFO, CENTRAL, CINAHL, ISI and PILOTS and included randomised controlled trials comparing TFCBT delivered within 3 months of trauma, to alternative interventions. All included studies were critically appraised using a standardised checklist. Two independent reviewers selected studies for inclusion and assessed study quality. Data extraction was performed by one reviewer and controlled by another. Where appropriate, we entered study results into meta-analyses. Results Seven articles reporting the results of five RCTs were included. All compared TFCBT to supportive counselling (SC. The study population was patients with acute stress disorder (ASD in four trials, and with a PTSD diagnosis disregarding the duration criterion in the fifth trial. The overall relative risk (RR for a PTSD diagnosis was 0.56 (95% CI 0.42 to 0.76, 1.09 (95% CI 0.46 to 2.61 and 0.73 (95% CI 0.51 to 1.04 at 3–6 months, 9 months and 3–4 years post treatment, respectively. A subgroup analysis of the four ASD studies only resulted in RR = 0.36 (95% CI 0.17 to 0.78 for PTSD at 3–6 months. Anxiety and depression scores were generally lower in the TFCBT groups than in the SC groups. Conclusion There is evidence for the effectiveness of TFCBT compared to SC in preventing chronic PTSD in patients with an initial ASD diagnosis. As this evidence originates from one research team replications are necessary to assess generalisability. The evidence about the effectiveness of TFCBT in traumatised populations without an ASD

  4. Low-dose oral prolonged-release oxycodone/naloxone for chronic pain in elderly patients with cognitive impairment: an efficacy–tolerability pilot study

    Directory of Open Access Journals (Sweden)

    Petrò E

    2016-03-01

    Full Text Available Emiliano Petrò,1 Elena Ruffini,1 Melania Cappuccio,2 Valeria Guerini,2 Gloria Belotti,3 Sara Fascendini,4 Cristina Licini,4 Claudio Marcassa51Rehabiliation and Alzheimer Unit, San Pietro Polyclinic, Ponte San Pietro, 2Alzheimer Center, P. Gusmini Foundation, Vertova, 3Santa Maria Ausiliatrice Foundation, Bergamo, 4Alzheimer Center, Briolini Hospital FERB ONLUS, Gazzaniga, 5Cardiology, Maugeri Foundation IRCCS, Veruno, ItalyObjective: This pilot study evaluated the efficacy and safety of prolonged-release oxycodone/naloxone (OXN-PR in older subjects with chronic pain and mild-to-moderate cognitive impairment.Methods: This was a prospective, observational, open-label study of 45-day duration. Patients with moderate-to-severe chronic pain and naïve to strong opioids were recruited from nursing homes and Alzheimer’s disease centers. OXN-PR was initiated at low doses (5 mg od or bid and increased to a maximum of 20 mg bid. The primary efficacy endpoint was a pain intensity reduction of ≥30% from baseline (T0 to 15 days after OXN-PR initiation, as assessed by a numerical rating scale or the Pain Assessment in Advanced Dementia scale. Other assessments included the Barthel activities of daily living index, Neuropsychiatric Inventory, Bowel Function Index, and adverse events.Results: The analysis included 53 patients (mean age, 83.0 years; mean Mini-Mental State Examination score, 18.6 with severe pain (median Numerical Rating Scale/Pain Assessment in Advanced Dementia 6 and substantial impairment in daily functioning (mean Barthel index, 32.2. The primary endpoint was achieved by 92.4% of patients. OXN-PR significantly reduced mean pain intensity from baseline to study end (numerical rating scale, 6.6±1.0 vs 2.3±1.1, P<0.0001; Pain Assessment in Advanced Dementia, 6.9±1.6 vs 0.9±0.8, P<0.0001. Substantial improvements from T0 to T45 in daily functioning (mean Barthel index, 32.2±16.8 vs 53.7±23.9, P<0.0001 and neuropsychiatric symptoms

  5. 慢性乙型肝炎患者认知功能的调查研究%Investigation of cognitive functions in patients with chronic hepatitis B

    Institute of Scientific and Technical Information of China (English)

    苏莉; 孙玉梅; 林可可; 姬萍; 邢卉春; 臧娴娴

    2012-01-01

    目的 评估慢性乙型肝炎患者的认知功能.方法 对196例慢性乙型肝炎患者进行数字连接试验、数字符号试验、Stroop色词测验及画钟测验,并将其测评结果与196例健康对照者进行比较.结果 慢性乙型肝炎患者画钟测验得分为22.8±4.9分,低于健康对照组23.9±4.0分,两组间差异有统计学意义(t=-2.44,P0.05).结论 本组慢性乙型肝炎患者存在执行功能障碍,而无注意功能障碍.%Objective To measure the cognitive fimctions in patients with chronic hepatitis B (CHB). Method Number connection test, digit symbol test, Stroop color-word test and clock drawing test were conducted in 196 patients with CHB and in 196 healthy controls. Results The score of clock drawing test in patients with CHB(22.8±4.9) was lower than that in healthy controls (23.9±4.0, t=- 2.44, PO.05) ; While the results of other tests in the two groups were similar CP>0.05). Conclusion CHB patients have executive dysfimction,but they do not sho/v impairment in attention.

  6. Metabolic sequelae of cancers (excluding bone marrow transplantation).

    Science.gov (United States)

    Body, J J

    1999-07-01

    The pathogenesis of cancer anorexia/cachexia is still unclear, partly explaining why its treatment remains disappointing. Anorexia plays a central role but cancer cachexia is more complex than chronic starvation. One of the key differences is the preferential mobilization of fat and the sparing of skeletal muscle in simple starvation compared to an equal mobilization of fat and skeletal muscle in cancer patients. An increase in basal energy expenditure also appears to play a contributory role in many patients. Cytokines, essentially but not exclusively tumor necrosis factor-alpha, play an essential pathogenic role and the syndrome can be compared to a low grade chronic inflammatory state. Parenteral nutrition could facilitate the administration of complete doses of chemotherapy or radiotherapy but no significant survival benefit or decrease in treatment-induced toxicity have been demonstrated in prospective randomized trials. The gut should have the preference for nutritional support. Percutaneous endoscopic gastrostomy is used more and more often in patients with a functionally intact gastrointestinal tract, especially in patients with head and neck cancer. Progestational drugs can to some extent stimulate appetite, food intake, energy level, increase weight and decrease the severity of nausea and vomiting. However, pharmacological treatment of cancer cachexia remains disappointing and more trials with anticytokine drugs, anabolic agents or polyunsaturated fatty acids should be conducted.

  7. Early life socioeconomic adversity is associated in adult life with chronic inflammation, carotid atherosclerosis, poorer lung function and decreased cognitive performance: a cross-sectional, population-based study

    LENUS (Irish Health Repository)

    Packard, Chris J

    2011-01-17

    Abstract Background Socioeconomic gradients in health persist despite public health campaigns and improvements in healthcare. The Psychosocial and Biological Determinants of Ill-health (pSoBid) study was designed to uncover novel biomarkers of chronic disease that may help explain pathways between socioeconomic adversity and poorer physical and mental health. Methods We examined links between indicators of early life adversity, possible intermediary phenotypes, and markers of ill health in adult subjects (n = 666) recruited from affluent and deprived areas. Classical and novel risk factors for chronic disease (lung function and atherosclerosis) and for cognitive performance were assessed, and associations sought with early life variables including conditions in the parental home, family size and leg length. Results Associations were observed between father\\'s occupation, childhood home status (owner-occupier; overcrowding) and biomarkers of chronic inflammation and endothelial activation in adults (C reactive protein, interleukin 6, intercellular adhesion molecule; P < 0.0001) but not number of siblings and leg length. Lung function (forced expiratory volume in 1 second) and cognition (Choice Reaction Time, the Stroop test, Auditory Verbal Learning Test) were likewise related to early life conditions (P < 0.001). In multivariate models inclusion of inflammatory variables reduced the impact and independence of early life conditions on lung function and measures of cognitive ability. Including variables of adult socioeconomic status attenuated the early life associations with disease biomarkers. Conclusions Adverse levels of biomarkers of ill health in adults appear to be influenced by father\\'s occupation and childhood home conditions. Chronic inflammation and endothelial activation may in part act as intermediary phenotypes in this complex relationship. Reducing the \\'health divide\\' requires that these life course determinants are taken into account.

  8. Vein transplantion using human umbilical cord blood stem cells in the treatment of stroke sequela

    Institute of Scientific and Technical Information of China (English)

    Yong Man; Jianbin Li; Bo Yang; Ji Ma

    2006-01-01

    BACKGROUND: Transplanted mononuclear cell(MNC)of umbilical blood can survive in central nervous system (CNS)of host through blood brain barrier,differentiate into nerver cells,migrate to damaged site and integrate morphological strucgh and function with nerve cells of host so as to improve deficiencies of sensatory function,motor function and cognitive function and influence on stroke sequela.OBJECTIVE: To observe the vein transplantation of human umbilical cord blood stem cells(HUCBSC) for improving neurological function,limb funtion and activity of daily living of patients with stroke and evaluate the reliability.DESIGN: Self-controlled study.SETTING: Department of Neurosurgery,the Second People's Hospital of Zhengzhou City;Red-crossed Blood Center of Henan Province;Department of Neurosurgery,the Fist Affiliated Hospital of Zhenzhou University.PARTICIPANTS:A total of 10 patients with stoke sequela were selected from Department of Cerebral Surgery,the Second People's Hospital of Zhengzhou City from April to December 2005.There were 9males and 1 female aged from 35to 75years with the mean age of 56 years.All of them were diagnosed with CT and MRI examination and coincidence with diagnostic criteria of stroke established by the Fourth National Academic Meeting for Cerebrovascular Disease.All patients provided informed consent. METHODS:80-140 mL umbilical blood of term birth of newborn was selected hermetically and maintained in sterile plastic bag.And then,the blood was centrifugated at the speed of 1500 r/min for 30 minutes at 22℃ in order to separate MNC,i.e.,HUCBSC.In addition,after final diagnosis during hospitalization,stroke patients were perfused with HUCBSC through superficial vein of back of the hand.Each patient was averagely penfused with 6 portions of HUCBSC(cellular numbers≥1×108/portion)and the interval between each portion was 1-7 days with the mean interval of 4 days.MAIN OUTCOME MEASURES: ①Neurological function of stroke patients was

  9. Tool for objective quantification of pulmonary sequelae in monitoring of patients with tuberculosis; Ferramenta para quantificacao objetiva de sequelas pulmonares no acompanhamento de pacientes com tuberculose

    Energy Technology Data Exchange (ETDEWEB)

    Giacomini, Guilherme; Alvarez, Matheus; Pina, Diana R. de; Bacchim Neto, Fernando A.; Pereira, Paulo C.M.; Ribeiro, Sergio M.; Miranda, Jose Ricardo de A., E-mail: guigiacomini92@aluno.ibb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucaru, SP (Brazil)

    2014-07-01

    Tuberculosis (TB), caused by Mycobacterium tuberculosis, is an ancient infectious disease that remains a global health problem. Chest radiography is the method commonly employed in assessing the evolution of TB. However, lung damage quantification methods are usually performed on a computerized tomography (CT). This objective quantification is important in the radiological monitoring of the patient by assessing the progression and treatment of TB. However, precise quantification is not feasible by the number of CT examinations necessary due to the high dose subjected to the patient and high cost to the institution. The purpose of this work is to develop a tool to quantify pulmonary sequelae caused by TB through chest X-rays. Aiming the proposed objective, a computational algorithm was developed, creating a three-dimensional representation of the lungs, with regions of dilated sequelae inside. It also made the quantification of pulmonary sequelae of these patients through CT scans performed in upcoming dates, minimizing the differences in disease progression. The measurements from the two methods were compared with results suggest that the effectiveness and applicability of the developed tool, allowing lower doses radiological monitoring of the patient during treatment.

  10. Left atrial wall dissection: a rare sequela of native-valve endocarditis.

    Science.gov (United States)

    Saad, Marwan; Isbitan, Ahmad; Roushdy, Alaa; Shamoon, Fayez

    2015-04-01

    Left atrial wall dissection is a rare condition; most cases are iatrogenic after mitral valve surgery. A few have been reported as sequelae of blunt chest trauma, acute myocardial infarction, and invasive cardiac procedures. On occasion, infective endocarditis causes left atrial wall dissection. We report a highly unusual case in which a 41-year-old man presented with native mitral valve infective endocarditis that had caused left atrial free-wall dissection. Although our patient died within an hour of presentation, we obtained what we consider to be a definitive diagnosis of a rare sequela, documented by transthoracic and transesophageal echocardiography.

  11. Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report

    Energy Technology Data Exchange (ETDEWEB)

    Bagewadi, Shivanand B.; Awasthi, Ujjwala Rastogi; Mody, Bharat M.; Suma, Gundareddy N.; Garg, Shruti [Dept. of Medicine and Radiology, ITS Center for Dental Studies and Research, Ghaziabad, Uttar Pradesh (Korea, Republic of)

    2015-09-15

    Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma.

  12. Clinical Study on Kidney-Nourishing and Governor Vessel-Regulating Acupuncture Therapy for Apoplexy Sequela

    Institute of Scientific and Technical Information of China (English)

    LI Yan; PANG Yong; ZOU Zhuo-cheng; XIAO Yuan-chun

    2007-01-01

    To observe the clinical efficacy of kidney-nourishing and governor vessel-regulating therapy for apoplexy sequela.Methods:Sixty subjects were equally randomized into observation group and control group,and respectively treated for 35 days.The scores of survival quality,interleukin-6(IL-6),interleukin-8(IL-8)and tumor necrosis factor (TNF) were measured,and the clinical efficacy were compared between two groups.Results and Conclusion:After treatment.all the observational items were improved,with better results in observation group than in control group.This therapy has better effects than regular method in the treatment of apoplexy sequela.

  13. Bony fusion of the maxilla and mandible as a sequelae of noma: A rare case report.

    Science.gov (United States)

    Bagewadi, Shivanand B; Awasthi, Ujjwala Rastogi; Mody, Bharat M; Suma, Gundareddy N; Garg, Shruti

    2015-09-01

    Noma is a gangrenous disease of the orofacial region that leads to severe facial tissue destruction and is a significant cause of death among children. With the advent of modern antibiotics and improved nutrition, children with noma may survive into adulthood, but must face the challenge of undergoing repair of the sequelae of noma. This report describes a case of bony fusion of the maxilla and mandible in a 28-year-old female patient, which was a sequelae of a childhood case of noma.

  14. Cognitive behavioral therapy for back pain

    Science.gov (United States)

    ... this page: //medlineplus.gov/ency/patientinstructions/000415.htm Cognitive behavioral therapy for back pain To use the sharing features on this page, please enable JavaScript. Cognitive behavioral therapy (CBT) can help many people deal with chronic ...

  15. Neuropathological sequelae of developmental exposure to antiepileptic and anesthetic drugs

    Directory of Open Access Journals (Sweden)

    Chrysanthy eIkonomidou

    2012-08-01

    Full Text Available Glutamate (Glu and aminobutyric acid (GABA are major neurotransmitters in the mammalian brain which regulate brain development at molecular, cellular and systems level. Sedative, anesthetic and antiepileptic drugs interact with glutamate and GABA receptors to produce their desired effects. The question is posed whether such interference with glutamatergic and GABAergic neurotransmission may exert undesired, and perhaps even detrimental effects on human brain development. Preclinical research in rodents and non-human primates has provided extensive evidence that sedative, anesthetic and antiepileptic drugs can trigger suicide of neurons and oligodendroglia, suppress neurogenesis, and inhibit normal synapse development and sculpting. Behavioral correlates in rodents and non-human primates consist of long-lasting cognitive impairment. Retrospective clinical studies in humans exposed to anesthetics or antiepileptic drugs in utero, during infancy or early childhood have delivered conflicting but concerning results in terms of a correlation between drug exposure and impaired neurodevelopmental outcomes. Prospective studies are currently ongoing. This review provides a short overview of the current state of knowledge on this topic.

  16. Cognitive Outcome of Status Epilepticus in Children

    Directory of Open Access Journals (Sweden)

    Emilie Sheppard

    2012-01-01

    Full Text Available Epileptic encephalopathy encompasses conditions in which cognitive, motor, or sensory deficits result as a consequence of epileptic activity defining certain syndromes. It therefore represents a more severe subset of epilepsy, which can be generally characterized as frequent or severe seizures leading to cerebral dysfunction. This disturbance in cerebral functioning can in turn hinder, somewhat dramatically, cognitive development and further impact the future lives of patients. In this paper, we describe the cognitive consequences of status epilepticus in children and in adults in the context of plasticity theories. Recent studies maintain that consequences of SE may be severe cognitive sequelae, especially in early life. Since the residual consequences of SE in adulthood seem less detrimental and long-lasting, we argue that early life insults, such as those created by SE, during a rapid period of development and functional specialization, result in specific cognitive deficits dependent on the sensitive period at which SE occurred.

  17. A 5-year longitudinal study of fatigue in patients with late-onset sequelae of poliomyelitis.

    NARCIS (Netherlands)

    Tersteeg, I.M.; Koopman, F.S.; Stolwijk-Swuste, J.M.; Beelen, A.; Nollet, F.

    2011-01-01

    Objectives: To study the severity and 5-year course of fatigue in patients with late-onset sequelae of poliomyelitis (LOSP) and to identify physical and psychosocial determinants of fatigue. Design: Prospective cohort study with 5 measurements over 5 years. Setting: University hospital.Participants:

  18. Predicting sequelae and death after bacterial meningitis in childhood: A systematic review of prognostic studies

    NARCIS (Netherlands)

    R.C.J. de Jonge; A.M. van Furth; M. Wassenaar; R.J.B.J. Gemke; C.B. Terwee

    2010-01-01

    Background: Bacterial meningitis (BM) is a severe infection responsible for high mortality and disabling sequelae. Early identification of patients at high risk of these outcomes is necessary to prevent their occurrence by adequate treatment as much as possible. For this reason, several prognostic m

  19. Endocrine Disorders in Childhood: A Selective Survey of Intellectual and Educational Sequelae.

    Science.gov (United States)

    Sandberg, David E.; Barrick, Christopher

    1995-01-01

    Examines intellectual and educational sequelae of selected endocrine systems and the psychosocial impact of their medical conditions. Many conditions are named including: Growth Hormone Deficiency, Turner Syndrome, Precocious Puberty, Klinefelters Syndrome, Congenital Hypothyroidism, and Insulin-Dependent Diabetes Mellitus. Gives psychoeducational…

  20. Family-focused cognitive behaviour therapy versus psycho-education for adolescents with chronic fatigue syndrome: long-term follow-up of an RCT.

    Science.gov (United States)

    Lloyd, Samantha; Chalder, Trudie; Rimes, Katharine A

    2012-11-01

    The aim of this study was to investigate the long term efficacy of family-focused cognitive behaviour therapy (CBT) compared with psycho-education in improving school attendance and other secondary outcomes in adolescents with chronic fatigue syndrome (CFS). A 24 month follow-up of a randomised controlled trial was carried out. Participants received either 13 one-hour sessions of family-focused CBT or four one-hour sessions of psycho-education. Forty-four participants took part in the follow-up study. The proportion of participants reporting at least 70% school attendance (the primary outcome) at 24 months was 90% in CBT group and 84% in psycho-education group; the difference between the groups was not statistically significant (OR = 1.29, p = 0.80). The proportion of adolescents who had recovered in the family-focused CBT group was 79% compared with 64% in the psycho-education, according to a definition including fatigue and school attendance. This difference was not statistically significant (Fisher's exact test, p = 0.34). Family-focused CBT was associated with significantly better emotional and behavioural adjustment at 24 month follow-up compared to psycho-education, as reported by both adolescents (F = 6.49, p = 0.02) and parents (F = 4.52, P = 0.04). Impairment significantly decreased in both groups between six and 24 month follow-ups, with no significant group difference in improvement over this period. Gains previously observed for other secondary outcomes at six month follow-up were maintained at 24 month follow-up with no further significant improvement or group differences in improvement. In conclusion, gains achieved by adolescents with CFS who had undertaken family-focused CBT and psycho-education generally continued or were maintained at two-year follow-up. The exception was that family-focused CBT was associated with maintained improvements in emotional and behavioural difficulties whereas psycho-education was associated with

  1. Dressing-related trauma: clinical sequelae and resource utilization in a UK setting

    Directory of Open Access Journals (Sweden)

    Charlesworth B

    2014-04-01

    Full Text Available Bruce Charlesworth,1 Claire Pilling,1 Paul Chadwick,2 Martyn Butcher31Adelphi Values, Macclesfield, 2Salford Royal Foundation Trust, Salford, 3Northern Devon Healthcare Trust, Devon, UKBackground: Dressings are the mainstay of wound care management; however, adherence of the dressing to the wound or periwound skin is common and can lead to dressing-related pain and trauma. Dressing-related trauma is recognized as a clinical and economic burden to patients and health care providers. This study was conducted to garner expert opinion on clinical sequelae and resource use associated with dressing-related trauma in a UK setting.Methods: This was an exploratory study with two phases: qualitative pilot interviews with six wound care specialists to explore dressing-related trauma concepts, sequelae, and resource utilization; and online quantitative research with 30 wound care specialists to validate and quantify the concepts, sequelae, and resource utilization explored in the first phase of the study. Data were collected on mean health care professional time, material costs, pharmaceutical costs, and inpatient management per sequela occurrence until resolution. Data were analyzed to give total costs per sequela and concept occurrence.Results: The results demonstrate that dressing-related trauma is a clinically relevant concept. The main types of dressing-related trauma concepts included skin reactions, adherence to the wound, skin stripping, maceration, drying, and plugging of the wound. These were the foundation for a number of clinical sequelae, including wound enlargement, increased exudate, bleeding, infection, pain, itching/excoriation, edema, dermatitis, inflammation, and anxiety. Mean total costs range from £56 to £175 for the complete onward management of each occurrence of the six main concepts.Conclusion: These results provide insight into the hidden costs of dressing-related trauma in a UK setting. This research successfully conceptualized

  2. Altered Wnt Signaling Pathway in Cognitive Impairment Caused by Chronic Intermittent Hypoxia: Focus on Glycogen Synthase Kinase-3β and β-catenin

    Directory of Open Access Journals (Sweden)

    Yue-Ying Pan

    2016-01-01

    Conclusions: Wnt/β-catenin signaling pathway abnormalities possibly play an important role in the development of cognitive deficits among mice exposed to CIH and that LiCl might attenuate CIH-induced cognitive impairment via Wnt/β-catenin signaling pathway.

  3. Persisting Inflammation and Chronic Immune Activation but Intact Cognitive Function in HIV-Infected Patients After Long-Term Treatment With Combination Antiretroviral Therapy

    DEFF Research Database (Denmark)

    Pedersen, Karin K; Pedersen, Maria; Gaardbo, Julie C;

    2013-01-01

    Impaired cognitive function in HIV-infected patients has been suggested. Treatment with combination antiretroviral therapy (cART) restores CD4⁺ cell counts and suppresses viral replication, but immune activation and inflammation may persist. The aim of the study was to examine if cognitive function...

  4. Translational aspects of the novel object recognition task in rats abstinent following sub-chronic treatment with phencyclidine (PCP: effects of modafinil and relevance to cognitive deficits in schizophrenia?

    Directory of Open Access Journals (Sweden)

    John P Redrobe

    2010-11-01

    Full Text Available Phencyclidine (PCP induces a behavioural syndrome in rodents that bears remarkable similarities to some of the core symptoms observed in schizophrenic patients, among those cognitive deficits. The successful alleviation of cognitive impairments associated with schizophrenia (CIAS has become a major focus of research efforts as they remain largely untreated. The aim of the present study was to investigate the effects of selected antipsychotic and cognition enhancing drugs, namely haloperidol, risperidone, donepezil, and modafinil in an animal model widely used in preclinical schizophrenia research. To this end, the novel object recognition (NOR task was applied to rats abstinent following sub-chronic treatment with PCP. Rats were administered either PCP (5 mg/kg, i.p. or vehicle twice a day for 7 days, followed by a 7-day washout period, before testing in NOR. Upon testing, vehicle-treated rats successfully discriminated between novel and familiar objects, an effect abolished in rats that had previously been exposed to PCP-treatment. Acute treatment with modafinil (64 mg/kg, p.o. ameliorated the PCP-induced deficit in novel object exploration, whereas haloperidol (0.1 mg/kg, s.c., risperidone (0.2 mg/kg, i.p. and donepezil (3 mg/kg, p.o. were without significant effect. Given the negligible efficacy of haloperidol and risperidone, and the contradictory data with donepezil to treat CIAS in the clinic, together with the promising preliminary pro-cognitive effects of modafinil in certain subsets of schizophrenic patients, the sub-chronic PCP-NOR abstinence paradigm may represent an attractive option for the identification of potential novel treatments for CIAS.

  5. 认知行为治疗对慢性精神分裂症患者的疗效研究%Randomized control ed trial of cognitive behavior therapy for patients with chronic schizophrenia

    Institute of Scientific and Technical Information of China (English)

    张叶; 许俊亭

    2013-01-01

    Objectives: To investigate whether cognitive behavior therapy results in significant improvement in patients with chronic schizophrenia. Method: Patients with chronic schizophrenia were randomly al ocated to cognitive behavior therapy and routine care, supportive counseling and routine care, and routine care alone. 90 patients participated in the research, 85 completed treatment. Results: Significant improvements were found in BPRS score(F = 5.42, df = 2,86; P = 0.006) and GAF score (F = 4.99, df = 2,86; P = 0.009) in those treated with cognitive behavior therapy. The supportive counseling group showed a nonsignificant improvement. Logistic regression indicated that receipt of cognitive behavior therapy results in almost eight times greater odds (odds ratio 7.88) of showing this improvement. The group receiving routine care alone also experienced more exacerbations and days spent in hospital. Conclusions: Cognitive behavior therapy is a potential y useful adjunct treatment in the management of patients with chronic schizophrenia.%目的:研究认知行为疗法对慢性分裂症患者精神病症状的疗效。方法:将慢性分裂症患者随机分为常规治疗联合认知行为治疗组,常规治疗联合支持性心理治疗组以及单纯常规治疗组。90名慢性分裂症患者接受了研究,85例患者完成研究。结果:认知行为治疗组患者的简明精神病量表(BPRS)得分(F=5.42, df=2,86; P=0.006)和大体功能评定量表(GAF)得分(F=4.99, df=2,86; P=0.009)显著改善。联合支持性心理治疗的患者的症状无显著改善。回归分析表明,联合认知行为治疗能够显著改善患者症状,而只接受常规治疗的患者会更有可能出现症状的恶化,延长住院天数。结论:认知行为治疗对慢性分裂症患者治疗有效。

  6. Prevalência de sequelas auditivas pós meningite piogênica em crianças Prevalence of auditory sequelae after pyogenic meningitis in children

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    Luzia Poliana Anjos da Silva

    2009-01-01

    Full Text Available OBJETIVO: Analisar a prevalência de déficit auditivo e caracterizar as principais sequelas auditivas e neurológicas pós-meningite, correlacionando o tipo de antibiótico utilizado durante o período de internação e a frequência de surdez, além do tipo de meningite mais prevalente como causa de déficit auditivo. MÉTODOS: Trata-se de um estudo de coorte transversal. Foram enviadas 289 cartas para os responsáveis pelas crianças que apresentaram meningite piogênica entre 28 dias e 24 meses, admitidas no Hospital Couto Maia (HC Maia entre janeiro de 2002 a dezembro de 2003. A amostra foi constituída por 55 crianças que sobreviveram com ou sem sequelas evidentes, que compareceram para as avaliações audiológica e neurológica. Foi realizada avaliação audiológica completa, incluindo a bateria subjetiva e objetiva de avaliação, com utilização de instrumentos validados para investigação da audição da criança. RESULTADOS: A faixa etária, no momento da avaliação audiológica, variou de dois a cinco anos. A deficiência auditiva foi encontrada em 29% da amostra, sendo a maioria do tipo neurossensorial, bilateral e de grau profundo. As principais sequelas neurológicas encontradas foram epilepsia, hemiparesia, hidrocefalia, disfasia e hiperatividade. CONCLUSÃO: Os resultados destacam a necessidade de monitoramento audiológico e acompanhamento neurológico nas crianças com história prévia de meningite piogênica, especialmente aquelas infectadas em idade precoce, buscando, desta forma, detectar as possíveis alterações auditivas e intervir o mais precocemente possível, por meio de intervenção especializada, protetização e reabilitação da linguagem oral.PURPOSE: To analyze the prevalence of hearing impairment and to characterize the main auditory and neurological sequelae after meningitis, correlating the type of antibiotic used during the hospitali66zation period and the frequency of deafness, as well as the most

  7. Early life socioeconomic adversity is associated in adult life with chronic inflammation, carotid atherosclerosis, poorer lung function and decreased cognitive performance: a cross-sectional, population-based study

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    Sattar Naveed

    2011-01-01

    Full Text Available Abstract Background Socioeconomic gradients in health persist despite public health campaigns and improvements in healthcare. The Psychosocial and Biological Determinants of Ill-health (pSoBid study was designed to uncover novel biomarkers of chronic disease that may help explain pathways between socioeconomic adversity and poorer physical and mental health. Methods We examined links between indicators of early life adversity, possible intermediary phenotypes, and markers of ill health in adult subjects (n = 666 recruited from affluent and deprived areas. Classical and novel risk factors for chronic disease (lung function and atherosclerosis and for cognitive performance were assessed, and associations sought with early life variables including conditions in the parental home, family size and leg length. Results Associations were observed between father's occupation, childhood home status (owner-occupier; overcrowding and biomarkers of chronic inflammation and endothelial activation in adults (C reactive protein, interleukin 6, intercellular adhesion molecule; P P Conclusions Adverse levels of biomarkers of ill health in adults appear to be influenced by father's occupation and childhood home conditions. Chronic inflammation and endothelial activation may in part act as intermediary phenotypes in this complex relationship. Reducing the 'health divide' requires that these life course determinants are taken into account.

  8. Navigating Adolescence with a Chronic Health Condition: A Perspective on the Psychological Effects of HAIR-AN Syndrome on Adolescent Girls

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    Kimberly K. McClanahan

    2006-01-01

    Full Text Available HAIR-AN syndrome is a subphenotype of polycystic ovary syndrome and is characterized by acne, obesity, hirsutism, and acanthosis nigricans. It usually manifests in early adolescence, a time of significant developmental change in females across physical, cognitive, social, and emotional domains. We contend that adolescent development for females is difficult, even in the best of circumstances, and having a chronic health condition, like HAIR-AN syndrome, will likely impact the afflicted individual’s development and psychological well-being. While many researchers have discussed the long-term health effects of HAIR-AN and similar disorders, little has been written about the potential psychological sequelae of HAIR-AN on the adolescent girl. We discuss the normal developmental sequence for adolescent girls across early, middle, and late adolescence; discuss common mental health problems that adolescents experience; define HAIR-AN syndrome and its clinical manifestations; and discuss its likely psychological impact on adolescent girls. We also make suggestions for future clinical interventions and research in the area of HAIR-AN syndrome and its psychological sequelae.

  9. Neuropsychological functioning in chronic Lyme disease.

    Science.gov (United States)

    Westervelt, Holly James; McCaffrey, Robert J

    2002-09-01

    Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease.

  10. Clinical Evaluation of Effects of Chronic Resveratrol Supplementation on Cerebrovascular Function, Cognition, Mood, Physical Function and General Well-Being in Postmenopausal Women—Rationale and Study Design

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    Hamish Michael Evans

    2016-03-01

    Full Text Available Background: This methodological paper presents both a scientific rationale and a methodological approach for investigating the effects of resveratrol supplementation on mood and cognitive performance in postmenopausal women. Postmenopausal women have an increased risk of cognitive decline and dementia, which may be at least partly due to loss of beneficial effects of estrogen on the cerebrovasculature. We hypothesise that resveratrol, a phytoestrogen, may counteract this risk by enhancing cerebrovascular function and improving regional blood flow in response to cognitive demands. A clinical trial was designed to test this hypothesis. Method: Healthy postmenopausal women were recruited to participate in a randomised, double-blind, placebo-controlled (parallel comparison dietary intervention trial to evaluate the effects of resveratrol supplementation (75 mg twice daily on cognition, cerebrovascular responsiveness to cognitive tasks and overall well-being. They performed the following tests at baseline and after 14 weeks of supplementation: Rey Auditory Verbal Learning Test, Cambridge Semantic Memory Battery, the Double Span and the Trail Making Task. Cerebrovascular function was assessed simultaneously by monitoring blood flow velocity in the middle cerebral arteries using transcranial Doppler ultrasound. Conclusion: This trial provides a model approach to demonstrate that, by optimising circulatory function in the brain, resveratrol and other vasoactive nutrients may enhance mood and cognition and ameliorate the risk of developing dementia in postmenopausal women and other at-risk populations.

  11. Fisetin reverses cognitive impairment provoked by chronic stress and mechanism in mice%漆黄素逆转慢性应激鼠认知损害及其机制

    Institute of Scientific and Technical Information of China (English)

    涂传龙; 庄聪文; 石晓磊; 翁向群

    2016-01-01

    目的:探讨漆黄素是否逆转慢性束缚应激小鼠认知损害及其机制。方法用 CD1小鼠建立慢性束缚应激模型,漆黄素(25 mg·kg -1·d -1)灌胃给药14 d。Morris 水迷宫检测空间学习记忆功能,Western blot 检测相关蛋白表达变化。结果漆黄素明显改善应激鼠空间学习记忆功能,提高海马细胞外信号调节激酶 ERK 磷酸化水平,同时增加突触蛋白 synapsin I、PSD95表达。ERK 特异性阻断剂 U0126完全阻断漆黄素改善认知。结论漆黄素改善慢性应激鼠认知功能,可能通过 ERK 通路调节神经可塑性有关。%Objective To investigate whether fisetin treatment prevents cognitive deficits provoked by chronic stress and mechanism in mice.Methods Mice were subjected to chronic restraint stress for 21 days.Stressed mice received repeated gavage of 25 mg·kg -1 fi-setin once daily for 14 consecutive days.Morris water maze (MWM)task was conducted for evaluating hippocampus -associated learning and memory.The expression levels of proteins in the hippocampus of mice were analyzed by western blot.Results Fisetin dramatically ameliorated the cognitive impairments in the stressed mice,rescued the decrease of hippocampal phospho -ERK level. Moreover,fisetin significantly improved synapse -associated proteins synapsin I and PSD95 expression.The ERK inhibitor,U0126, antagonize the fisetin -induced enhancement of cognitive function.Conclusions Fisetin improves cognitive deficits provoked by chron-ic stress in mice,which may attribute to ERK signaling pathway involved in the hippocampus.

  12. Effect of quetiapine and olanzapine on cognitive function in patients with chronic schizophrenia%喹硫平和奥氮平对慢性精神分裂症患者认知功能的影响

    Institute of Scientific and Technical Information of China (English)

    王美玲

    2014-01-01

    目的:比较喹硫平和奥氮平对慢性精神分裂症患者认知功能的影响。方法:80例慢性精神分裂症患者随机分配接受喹硫平、奥氮平治疗。分别在入组时、12周、24周末测定PANSS、WCST、言语流畅性测验、成人言语学习测验、CPT、WMS、WAIS、连线试验测定、手指叩击试验。结果:喹硫平组患者在言语流畅性、CPT和执行功能方面优于奥氮平组,有统计学差异(P<0.05);认知功能的改善与PANSS量表总分、阴性症状的改善之间有显著的相关性(r=-0.33, P<0.05)。结论:喹硫平、奥氮平均可不同程度改善慢性精神分裂症患者的认知功能,喹硫平在某些方面优于奥氮平。%Objective:To compare effects of quetiapine and olanzapine on cognitive function in patients with chronic schizo-phrenia. Methods:A total of 80 patients with chronic schizophrenia were randomly divided into quetiapine group and olanzapine group. The cognitive function was assessed at baseline,12th weekend and 24th weekend with positive and negative syndrome scale (PANSS), Wisconsin card sorting test (WCST), verbal fluency test, adult verbal learning test, continuous performance test (CPT), Wechsler memory scale ( WMS) , Wechsler adult intelligence scale ( WAIS) , trail marking test ( TMT) and finger tapping test ( FIT) . Results:Quetiapine had more significant improvement on executive function, CPT and verbal fluency than olanzapine (P<0. 05). The cognitive function change was related to change of total score and negative symptoms score in PANSS (r=-0. 33, P<0. 05). Conclusions:Que-tiapine and olanzapine could improve the cognitive function for the patients with chronic schizophrenia, and the former is better in some aspects.

  13. Chronic Dehydration and Regularly Drinking Water to Mitigate Age-Related Cognitive Impairment%慢性脱水与老年认知损伤及饮水干预

    Institute of Scientific and Technical Information of China (English)

    李婷; 强敏; 赫荣乔

    2012-01-01

    Age-related cognitive impairment undergoes a continuous progression:pre-mild cognitive impairment(preMCI),mild cognitive impairment(MCI)and Alzheimer’s disease(AD). So far,chronic dehydration is regarded as a common symptom for the patients with age-related cognitive impairment,in particular of those with AD. Monitored with an infrared-CCD camera,a marked decrease in the drinking frequency(P65 years old)and in the hippocampus of Alzheimer’s patients. Regularly drinking water relieves not only chronic dehydration for aging people,but also significantly decreases the concentration of endogenous formaldehyde, which may offer protection of central nervous system. Therefore,building the habit to regularly drink water should be emphasized at the early stage to relieve chronic dehydration and scavenge cytotoxic metabolic products including formaldehyde for aging people,which might be beneficial to mitigate age-related cognitive impairment at its early stage.%老年认知损伤被认为是一个连续发展的病理生理学过程,包括轻度认知损伤前期(pre-mild cognitive impairment,pre-MCI)、轻度认知损伤(mild cognitive impairment,MCI)、阿尔茨海默病(Alzheimer’s disease, AD)三个阶段,慢性脱水是老年性痴呆患者共同具有的一种特征。红外线摄像监控C57 BL/6小鼠饮水频率和饮水量的结果显示,老龄鼠的饮水频率和饮水量均较年轻对照组显著减少(P65岁)而逐渐升高,且AD病人脑内甲醛含量也显著升高。研究表明,甲醛代谢失调所造成的中枢神经系统慢性损伤被认为是老年认知损伤的原因之一,合理饮水不但可以改善老龄化人群的慢性脱水状态,同时能够明显降低体内的甲醛浓度,防止甲醛过量对中枢神经系统的危害,因此,合理饮水习惯的建立,被认为是减缓中老年人慢性脱水和体内细胞毒性代谢产物累积的方法之一,也可能在某种程度上,起

  14. Contact radiotherapy of cutaneous hemangiomas: therapeutic effects and radiation sequelae in 818 patients.

    Science.gov (United States)

    Braun-Falco, O; Schultze, U; Meinhof, W; Goldschmidt, H

    1975-10-29

    The paper presents statistical data on the therapeutic effects and radiation sequelae following Chaoul contact therapy of 818 cutaneous hemangiomas treated between 1938 and 1952. 73.3% of all irradiated hemangiomas showed initial improvement but complete involution with an excellent cosmetic result was observed in only 50% of lesions 5 years after treatment. During the same period of time, more than one-third of all patients developed mild to moderate cutaneous radiation sequelae (hyper- or hypopigmentation and telangiectases, rarely atrophy). The high incidence of late radiation effects is probably relation to the high total doses administered in this series of patients, the very short intervals between treatments and the age of the patients. Other radiation radiation hazards are also discussed. Since large studies have proven conclusively that spontaneous involution occurs in 95% of hemangiomas after several years, indications for radiotherapy of hemangiomas are extremely limited.

  15. Stroke with neuropsychiatric sequelae after cannabis use in a man: a case report

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    Giroud Maurice

    2011-06-01

    Full Text Available Abstract Introduction The outcome of cerebral ischemic stroke associated with cannabis use is usually favorable. Here we report the first case of cannabis-related stroke followed by neuropsychiatric sequelae. Case presentation A 24-year-old Caucasian man was discovered in a deeply comatose non-reactive state after cannabis use. A magnetic resonance imaging scan of his brain showed bilateral multiple ischemic infarcts. The patient remained deeply comatose for four days, after which time he developed other behavioral impairments and recurrent seizures. Conclusion Stroke related to cannabis use can be followed by severe neuropsychiatric sequelae. Concomitant alcohol intoxication is essential neither to the occurrence of this neurologic event nor to its severity.

  16. Electrical impedance spectroscopy as electrical biopsy for monitoring radiation sequelae of intestine in rats.

    Science.gov (United States)

    Chao, Pei-Ju; Huang, Eng-Yen; Cheng, Kuo-Sheng; Huang, Yu-Jie

    2013-01-01

    Electrical impedance is one of the most frequently used parameters for characterizing material properties. The resistive and capacitive characteristics of tissue may be revealed by electrical impedance spectroscopy (EIS) as electrical biopsy. This technique could be used to monitor the sequelae after irradiation. In this study, rat intestinal tissues after irradiation were assessed by EIS system based on commercially available integrated circuits. The EIS results were fitted to a resistor-capacitor circuit model to determine the electrical properties of the tissue. The variations in the electrical characteristics of the tissue were compared to radiation injury score (RIS) by morphological and histological findings. The electrical properties, based on receiver operation curve (ROC) analysis, strongly reflected the histological changes with excellent diagnosis performance. The results of this study suggest that electrical biopsy reflects histological changes after irradiation. This approach may significantly augment the evaluation of tissue after irradiation. It could provide rapid results for decision making in monitoring radiation sequelae prospectively.

  17. Electrical Impedance Spectroscopy as Electrical Biopsy for Monitoring Radiation Sequelae of Intestine in Rats

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    Pei-Ju Chao

    2013-01-01

    Full Text Available Electrical impedance is one of the most frequently used parameters for characterizing material properties. The resistive and capacitive characteristics of tissue may be revealed by electrical impedance spectroscopy (EIS as electrical biopsy. This technique could be used to monitor the sequelae after irradiation. In this study, rat intestinal tissues after irradiation were assessed by EIS system based on commercially available integrated circuits. The EIS results were fitted to a resistor-capacitor circuit model to determine the electrical properties of the tissue. The variations in the electrical characteristics of the tissue were compared to radiation injury score (RIS by morphological and histological findings. The electrical properties, based on receiver operation curve (ROC analysis, strongly reflected the histological changes with excellent diagnosis performance. The results of this study suggest that electrical biopsy reflects histological changes after irradiation. This approach may significantly augment the evaluation of tissue after irradiation. It could provide rapid results for decision making in monitoring radiation sequelae prospectively.

  18. [Sudden death of a young man as late sequelae complicating a pediatric disease: About a case].

    Science.gov (United States)

    Pierry, Clémence; Franchet, Camille; Tuchtan-Torrents, Lucile; Macon, Céline; Torrents, Julia; Capuani, Caroline; Piercecchi-Marti, Marie-Dominique

    2017-04-01

    In France, sudden death is responsible every year for 40,000 deaths. The most frequent etiology is cardiac disease. Atheromatous-related pathology is the most common etiology beyond 35, but cardiomyopathies and channelopathies are responsible for a significant number of deaths in young adults. Some acquired disorders can also cause sudden cardiac death. We report the case of a 17-year-old man who died suddenly after sport. Autopsy and pathological study found multiple giant coronary aneurysms. Thrombosis and fibrous scar of myocardial ischemic events were observed. These lesions were in favor of late sequelae of Kawasaki disease. Kawasaki disease is a rare but not exceptional cause of sudden cardiac death in young adults. In the lack of known clinical history, some aspects, even not specific, should evoke this diagnosis. Even in front of apparent good clinical tolerance, these sequelae require appropriate follow-up because of a significant risk of sudden death.

  19. A novel useful tool of computerized touch panel-type screening test for evaluating cognitive function of chronic ischemic stroke patients.

    Science.gov (United States)

    Deguchi, Kentaro; Kono, Syoichiro; Deguchi, Shoko; Morimoto, Nobutoshi; Kurata, Tomoko; Ikeda, Yoshio; Abe, Koji

    2013-10-01

    Cognitive and affective impairments are important non-motor features of ischemic stroke (IS) related to white-matter hyperintensity, including periventricular hyperintensity (PVH). To confirm the usefulness of a novel computerized touch panel-type screening test, we investigated cognitive and affective functioning among 142 IS patients and 105 age-and gender-matched normal control subjects. Assessment using the mini-mental state examination, Hasegawa Dementia Scale-Revised, and frontal assessment battery revealed reduced cognitive function in IS patients, with the most severe reduction exhibited by cardiogenic embolism patients, followed by lacunar infarction patients, and atherothrombotic infarction patients. Our novel touch panel screening test revealed a similar pattern of results. In addition, PVH grading, classified using Fazekas' magnetic resonance imaging method, was also correlated with cognitive decline and touch panel screening test performance. In contrast, affective function, assessed with the 15-item Geriatric Depression Scale, vitality index, and apathy scale, was not significantly decreased in IS, and did not correlate with touch panel screening test results or PVH, although the number of microbleeds was correlated with apathy scale results. The present findings revealed that IS and PVH grading were significantly correlated with decline in general cognitive status (mini-mental state examination and Hasegawa Dementia Scale-Revised) and frontal lobe function (frontal assessment battery). Performance on all touch panel screening tests was correlated with IS and PVH grading, but was largely independent of depression or apathy. Touch panel screening tests were easily understood and performed by almost all patients with mild cognitive and motor dysfunction, due to visually clear images and simple methods not involving detailed manual-handling tasks such as writing. Touch panel screening tests may provide a useful tool for the early screening of cognitive

  20. Predicting sequelae and death after bacterial meningitis in childhood: A systematic review of prognostic studies

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    Gemke Reinoud JBJ

    2010-08-01

    Full Text Available Abstract Background Bacterial meningitis (BM is a severe infection responsible for high mortality and disabling sequelae. Early identification of patients at high risk of these outcomes is necessary to prevent their occurrence by adequate treatment as much as possible. For this reason, several prognostic models have been developed. The objective of this study is to summarize the evidence regarding prognostic factors predicting death or sequelae due to BM in children 0-18 years of age. Methods A search in MEDLINE and EMBASE was conducted to identify prognostic studies on risk factors for mortality and sequelae after BM in children. Selection of abstracts, full-text articles and assessment of methodological quality using the QUIPS checklist was performed by two reviewers independently. Data on prognostic factors per outcome were summarized. Results Of the 31 studies identified, 15 were of moderate to high quality. Due to substantial heterogeneity in study characteristics and evaluated prognostic factors, no quantitative analysis was performed. Prognostic factors found to be statistically significant in more than one study of moderate or high quality are: complaints >48 hours before admission, coma/impaired consciousness, (prolonged duration of seizures, (prolonged fever, shock, peripheral circulatory failure, respiratory distress, absence of petechiae, causative pathogen Streptococcus pneumoniae, young age, male gender, several cerebrospinal fluid (CSF parameters and white blood cell (WBC count. Conclusions Although several important prognostic factors for the prediction of mortality or sequelae after BM were identified, the inability to perform a pooled analysis makes the exact (independent predictive value of these factors uncertain. This emphasizes the need for additional well-conducted prognostic studies.

  1. The Clinical Study on 34 Admission Patients due to Sequela of Traffic Accident

    OpenAIRE

    No, Bu-Rae; Lee, Eun-Yong

    2006-01-01

    Objectives : The purpose of this study was to investigate the clinical progress of patients diagnosed as sequela of traffic accident. Methods : We studied 34 cases who were admitted in Semyung University Oriental Hospital from 1st, January, 2005 to the 31st, December, 2005. And we came to some conclusion about clinical tendencies as follows. Results and Conclusions : 1. Women had occupied more than men, and 14 persons in 20th were the most distribution of age. 2. In distribution o...

  2. COgnitive-Pulmonary Disease

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    Fiona A. H. M. Cleutjens

    2014-01-01

    Full Text Available Over the past few decades, chronic obstructive lung disease (COPD has been considered a disease of the lungs, often caused by smoking. Nowadays, COPD is regarded as a systemic disease. Both physical effects and effects on brains, including impaired psychological and cognitive functioning, have been demonstrated. Patients with COPD may have cognitive impairment, either globally or in single cognitive domains, such as information processing, attention and concentration, memory, executive functioning, and self-control. Possible causes are hypoxemia, hypercapnia, exacerbations, and decreased physical activity. Cognitive impairment in these patients may be related to structural brain abnormalities, such as gray-matter pathologic changes and the loss of white matter integrity which can be induced by smoking. Cognitive impairment can have a negative impact on health and daily life and may be associated with widespread consequences for disease management programs. It is important to assess cognitive functioning in patients with COPD in order to optimize patient-oriented treatment and to reduce personal discomfort, hospital admissions, and mortality. This paper will summarize the current knowledge about cognitive impairment as extrapulmonary feature of COPD. Hereby, the impact of smoking on cognitive functioning and the impact of cognitive impairment on smoking behaviour will be examined.

  3. COGNITIVE INTERVENTIONS IN BEHAVIORAL MEDICINE

    NARCIS (Netherlands)

    EMMELKAMP, PMG; VANOPPEN, P

    1993-01-01

    In this report an overview is given of the contribution of cognitive approaches to behavioral medicine. The (possible) contribution of cognitive therapy is reviewed in the area of coronary heart disease, obesity, bulimia nervosa, chronic pain, benign headache, cancer, acquired immunodeficiency syndr

  4. Acupuncture for sequelae of Bell's palsy: a randomized controlled trial protocol

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    Kim Yong-Suk

    2011-03-01

    Full Text Available Abstract Objective Incomplete recovery from facial palsy has a long-term impact on the quality of life, and medical options for the sequelae of Bell's palsy are limited. Invasive treatments and physiotherapy have been employed to relieve symptoms, but there is limited clinical evidence for their effectiveness. Acupuncture is widely used on Bell's palsy patients in East Asia, but there is insufficient evidence for its effectiveness on Bell's palsy sequelae. The objective is to evaluate the efficacy and safety of acupuncture in patients with sequelae of Bell's palsy. Method/Design This study consists of a randomized controlled trial with two parallel arms: an acupuncture group and a waitlist group. The acupuncture group will receive acupuncture treatment three times per week for a total of 24 sessions over 8 weeks. Participants in the waitlist group will not receive any acupuncture treatments during this 8 week period, but they will participate in the evaluations of symptoms at the start of the study, at 5 weeks and at 8 weeks after randomization, at which point the same treatment as the acupuncture group will be provided. The primary outcome will be analyzed by the change in the Facial Disability Index (FDI from baseline to week eight. The secondary outcome measures will include FDI from baseline to week five, House-Brackmann Grade, lip mobility, and stiffness scales. Trial registration Current Controlled-Trials ISRCTN43104115; registration date: 06 July 2010; the date of the first patient's randomization: 04 August 2010

  5. Sequelae of foodborne illness caused by 5 pathogens, Australia, circa 2010.

    Science.gov (United States)

    Ford, Laura; Kirk, Martyn; Glass, Kathryn; Hall, Gillian

    2014-11-01

    In Australia circa 2010, 4.1 million (90% credible interval [CrI] 2.3-6.4 million) episodes of foodborne gastroenteritis occurred, many of which might have resulted in sequelae. We estimated the number of illnesses, hospitalizations, and deaths from Guillain-Barré syndrome, hemolytic uremic syndrome, irritable bowel syndrome, and reactive arthritis that were associated with contaminated food in Australia. Data from published studies, hospital records, and mortality reports were combined with multipliers to adjust for different transmission routes. We used Monte Carlo simulation to estimate median estimates and 90% CrIs. In Australia, circa 2010, we estimated that 35,840 (90% CrI 25,000-54,000) illnesses, 1,080 (90% CrI 700-1,600) hospitalizations, and 10 (90% CrI 5-14) deaths occurred from foodborne gastroenteritis-associated sequelae. Campylobacter spp. infection was responsible for 80% of incident cases. Reducing the incidence of campylobacteriosis and other foodborne diseases would minimize the health effects of sequelae.

  6. Chronic pancreatitis

    Science.gov (United States)

    Chronic pancreatitis - chronic; Pancreatitis - chronic - discharge; Pancreatic insufficiency - chronic; Acute pancreatitis - chronic ... alcohol abuse over many years. Repeated episodes of acute ... chronic pancreatitis. Genetics may be a factor in some cases. ...

  7. Sequelas bucais da radioterapia de cabeça e pescoço Oral sequelae of head and neck radiotherapy

    Directory of Open Access Journals (Sweden)

    Daniel Antunes Freitas

    2011-12-01

    Full Text Available TEMA: cirurgia, radioterapia e quimioterapia são as modalidades terapêuticas usadas no tratamento de câncer bucal. Podem ser usadas isoladas ou conjuntamente. Radiação ionizante causa lesões nos tecidos normais localizados no campo de radiação. Isto se torna particularmente evidente nas regiões de cabeça, uma área complexa composta de várias estruturas diferentes que respondem diferentemente à radiação. As seqüelas orais resultantes podem causar problemas substanciais durante e depois da terapia de radiação e são os maiores fatores de determinação na qualidade de vida dos pacientes. Dentre as complicações da radioterapia estão a xerostomia, osteorradionecrose, mucosite e candidose. OBJETIVO: apresentar aos profissionais de saúde uma reflexão sobre as questões pertinentes às sequelas bucais da radioterapia de cabeça e pescoço. CONCLUSÃO: o acompanhamento odontológico sistemático pode minimizar os efeitos da radiação sobre os tecidos da cavidade bucal.BACKGROUND: surgery, radiotherapy and chemotherapy are therapeutic modalities used in the treatment of oral cancer. They can be used separately or in combination. Ionizing irradiation causes damage to normal tissues located at the radiation field. This becomes particularly evident in the head and neck region, a complex area composed of several dissimilar structures that respond differently to radiation. The resulting oral sequelae may cause substantial problems during and after radiation therapy and are major factors in determining the patient's quality of life. Xerostomia, osteoradionecrosis, mucositis and candidosis are some of radiotherapy's complications. PURPOSE: introduce health professionals to reflect on issues relevant to oral sequelae of head and neck radiotherapy. CONCLUSION: regular dental follow-up may reduce the effects of radiation in the tissues of the oral cavity.

  8. 老年脑卒中后遗症期患者肺炎危险因素的分析%Risk factors for pneumonia in elderly patients with cerebral stroke sequela

    Institute of Scientific and Technical Information of China (English)

    徐洁; 程鎏

    2013-01-01

    Objective To study the risk factors for pneumonia in elderly patients with cerebral stroke sequela .Methods Clinical data about 330 elderly patients with cerebral stroke sequela (171 pneumonia patients and 159 pneumonia-free patients) were retrospectively analyzed .Results Advanced age(OR= 2 .586 ),history of smoking (OR= 2 .353 ),chronic heart failure (OR= 2 .062 ), dysbulia(OR=2.319),nasal feeding (OR = 4 .708 ) ,completely bedridden (OR= 2 .471) and hy-poalbuminemia(OR=2 .388) were the risk factors for pneumonia in patients with cerebral stroke sequela . Hyperglycemia(OR=0 .341) was a protective factor for it .Conclusion The incidence of pneumonia is high in patients with cerebral stoke sequela due to a variate of risk factors .%目的 探讨脑卒中后遗症期患者肺炎的危险因素.方法 回顾性分析330例脑卒中后遗症期患者的临床资料,进行相关因素分析,其中肺炎患者171例和无肺炎患者159例.结果 高龄(OR=2.586)、吸烟史(OR=2.353)、慢性心力衰竭(OR=2.062)、意识障碍(OR=2.319)、鼻饲(OR=4.708)、完全卧床(OR=2.471)及低白蛋白血症(OR=2.388)是脑卒中后遗症期肺炎的危险因素,高脂血症(OR=0.341)是其保护因素.结论 脑卒中后遗症期肺炎发病率高,危险因素多.

  9. 外治法治疗盆腔炎性疾病后遗症的研究进展%Review of treating sequelae of pelvic inflammatory disease by external therapy

    Institute of Scientific and Technical Information of China (English)

    刘娅; 王永周

    2014-01-01

    Sequela of pelvic inflammatory disease could lead to chronic pelvic pain, infertility, recurrence of pelvic inflammatory disease, and effect women’s health seriously. This disease is difficult to cure, easily to recrudesce with long course. External treatment is one of many methods on treating sequela of pelvic inflammatory disease. In this paper, literature on treating sequela of pelvic inflammatory disease with external treatment were reviewed, the results is that the efficacy of external treatment is confirmed, fewer side effects, and easily to accept. Research progress on treating sequela of pelvic inflammatory disease with external treatment as followed.%盆腔炎性疾病后遗症会导致慢性盆腔痛、不孕、盆腔炎反复发作等,严重影响妇女的身心健康。本病具有病程长、难治愈、顽固易复发等特点。目前临床上治疗本病的方法种类繁多,外治法是其中的一个大类。笔者通过对近年来外治法治疗盆腔炎性疾病后遗症的文献回归,发现外治法对于本病的治疗具有良好疗效,且毒副作用小,患者易于接受。本文就目前外治法治疗盆腔炎性疾病后遗症的研究进展作一综述。

  10. A simple bracing technique to correct kinking of arterial branches to avoid ischemic sequelae during neurovascular surgery

    Directory of Open Access Journals (Sweden)

    Yasushi Motoyama

    2016-01-01

    Conclusion: The insertion of prostheses with fibrin glue into the crotch of a kinked artery for repair is considered a simple and useful method for correcting a kinked artery that avoids ischemic sequelae.

  11. Neurological images and the predictors for neurological sequelae of epidemic herpangina/hand-foot-mouth disease with encephalomyelitis.

    Science.gov (United States)

    Tsai, Jeng-Dau; Kuo, Hung-Tsung; Chen, Shan-Ming; Lue, Ko-Huang; Sheu, Ji-Nan

    2014-04-01

    Since 1998 in Taiwan, enterovirus (EV) 71 epidemics have caused encephalomyelitis and placed a significant burden on parents and physicians. In this study, we present clinical manifestations, magnetic resonance (MR) imaging findings, and neurological sequelae on epidemic EV-infected patients with encephalomyelitis. Of the 46 patients, 14 patients presented with neurological sequelae; of them, 3 patients suffered from complications of mental regression. Predictors of unfavorable neurological sequelae were myoclonic jerks (> 4 times/night) and pleocytosis (167/μL) of the cerebrospinal fluid (CSF). Results from viral culture and MR imaging indicated that positive identification of EV71 infection was associated significantly with lesions on MR imaging. Our results show that hand-foot-mouth disease carries a higher risk of encephalomyelitis and that frequent myoclonic jerks and pleocytosis of the CSF are risk factors for subsequent neurological sequelae. Positive identification of EV71 might be useful as a predictor of lesions in MR imaging.

  12. 加味温胆汤配合认知-行为疗法治疗慢性失眠%Clinical Research on Treating Chronic Insomnia by Jiawei Wendan Decoction Combined with Cognitive Behavior Therapy

    Institute of Scientific and Technical Information of China (English)

    李燕; 周振华; 周秀芳; 董湘玉; 肖成

    2013-01-01

    目的:观察加味温胆汤配合认知-行为疗法治疗慢性失眠痰热内扰证的临床疗效.方法:将60例慢性失眠痰热内扰证患者,通过随机方法分成治疗组和对照组各30例.对照组予以认知-行为疗法治疗,治疗组予以中药加味温胆汤配合认知-行为疗法进行治疗,观察两组临床疗效及匹兹堡睡眠质量指数(PSQI)积分、中医症状积分.结果:治疗后治疗组PSQI各量表积分和总分均显著下降,与治疗前比较,差异有非常显著性意义(P<0.01);治疗后对照组PSQI睡眠质量、入睡时间、睡眠障碍、睡眠药物等量表积分和总分下降,与治疗前比较,差异有显著性意义(P<0.05).两组PSQI各量表积分和总分治疗后比较,差异均有显著性意义(P<0.05).中医症状积分变化比较,对于失眠症的改善差异有统计学差异(P<0.05),而治疗组对于中医症状的改善如失眠、胸闷脘痞和易惊醒方面有显著的优势(P<0.05).结论:加味温胆汤配合认知-行为疗法治疗慢性失眠疗效优.%Objective: To investigate the clinical efficacy of Jiawei Wendan decoction combined with cognitive behavioral therapy in the treating chronic insomnia of internal disturbance of phlegm-heat. Method: Sixty chronic insomnia patients with the syndrome of internal disturbance of phlegm-heat were randomly divided into the treatment group and the control group. The treatment group patients was given the Jiawei Wendan decoction combined with cognitive behavioral therapy. The control group was only given cognitive behavioral therapy. The changes between after and before treatmentaccording to traditional Chinese medicine sign and PSQI scores were observed. The effect of Jiawei Wendan decoction combined with cognitive behavioral therapy. Was evaluated. Result; Two groups showed differences between after and before treatment inthe aspects of PSQI scores, but treatment group was better than control group ( P < 0. 05 ). Two groups

  13. Stop Thinking and Start Doing: Switching from Cognitive Therapy to Behavioral Activation in a Case of Chronic Treatment-Resistant Depression

    Science.gov (United States)

    Bottonari, Kathryn A.; Roberts, John E.; Thomas, Sherilyn N.; Read, Jennifer P.

    2008-01-01

    Several recent investigations have demonstrated that Cognitive Therapy (CT) and Behavioral Activation (BA) are both efficacious treatments for depression (Butler, Chapman, Forman, & Beck, 2006; Dimidjian et al., 2006; Dobson, 1989; Gloaguen, Cottraux, Cucherat, & Blackburn, 1998; Hollon, Thase, & Markowitz, 2002; Jacobson et al., 1996). This…

  14. [Chronic renal failure secondary to uterine prolapse].

    Science.gov (United States)

    Peces, R; Canora, J; Venegas, J L

    2005-01-01

    Acute and chronic renal failure secondary to bilateral severe hydroureteronephrosis is a rare sequela of uterine prolapse. We report a case of neglected complete uterine prolapse in a 72-year-old patient resulting in bilateral hydroureter, hydronephrosis, and chronic renal failure. In an attempt to diminish the ureteral obstruction a vaginal pessary was used to reduce the uterine prolapse. Finally, surgical repair of prolapse by means of a vaginal hysterectomy was performed. In conclusion, all patients presenting with complete uterine prolapse should be screened to exclude urinary tract obstruction. If present, obstructive uropathy should be relieved by the reduction or repair of the prolapse before irreversible renal damage occurs.

  15. Chronic caffeine consumption prevents cognitive decline from young to middle age in rats, and is associated with increased length, branching, and spine density of basal dendrites in CA1 hippocampal neurons.

    Science.gov (United States)

    Vila-Luna, S; Cabrera-Isidoro, S; Vila-Luna, L; Juárez-Díaz, I; Bata-García, J L; Alvarez-Cervera, F J; Zapata-Vázquez, R E; Arankowsky-Sandoval, G; Heredia-López, F; Flores, G; Góngora-Alfaro, J L

    2012-01-27

    Chronic caffeine consumption has been inversely associated with the risk of developing dementia and Alzheimer's disease. Here we assessed whether chronic caffeine treatment prevents the behavioral and cognitive decline that male Wistar rats experience from young (≈3 months) to middle age (≈10 months). When animals were young they were evaluated at weekly intervals in three tests: motor activity habituation in the open field (30-min sessions at the same time on consecutive days), continuous spontaneous alternation in the Y-maze (8 min), and elevated plus-maze (5 min). Afterward, rats from the same litter were randomly assigned either to a caffeine-treated group (n=13) or a control group (n=11), which received only tap water. Caffeine treatment (5 mg/kg/day) began when animals were ≈4 months old, and lasted for 6 months. Behavioral tests were repeated from day 14 to day 28 after caffeine withdrawal, a time period that is far in excess for the full excretion of a caffeine dose in this species. Thirty days after caffeine discontinuation brains were processed for Golgi-Cox staining. Compared with controls, we found that middle-aged rats that had chronically consumed low doses of caffeine (1) maintained their locomotor habituation during the second consecutive day exposure to the open field (an index of non-associative learning), (2) maintained their exploratory drive to complete the conventional minimum of nine arm visits required to calculate the alternation performance in the Y-maze in a greater proportion, (3) maintained their alternation percentage above chance level (an index of working memory), and (4) did not increase the anxiety indexes assessed by measuring the time spent in the open arms of the elevated plus maze. In addition, morphometric analysis of hippocampal neurons revealed that dendritic branching (90-140 μm from the soma), length of 4th and 5th order branches, total dendritic length, and spine density in distal dendritic branches were greater in

  16. 认知行为干预在慢性心力衰竭患者中的应用%Application of cognitive - behavioral intervention in patients with chronic heart failure condition

    Institute of Scientific and Technical Information of China (English)

    罗容莲; 谢美琼

    2015-01-01

    Objective:Explored the effect of cognitive behavioral intervention for improving cardiac function in patients with chronic heart failure. Methods:120 patients with chronic heart failure were randomly divided into experimental group and control group,the control group received routine care,the experi-mental group received cognitive behavioral intervention,include:the development of cognitive interventions in patients with chronic heart failure clinical road map,ability to teach patients self - management,and encourage patients to establish the behavior of reconstruction,teach your family to master the correct way to rescue establish network platform Q group of patients after discharge telephone interviews and home visits. Results:Six months after the intervention using 6min walk test,cardiac functional status of patients in the experimental group than the control group;comparing two groups of heart rate,pulse,blood pressure in the experimental group than the control group (P < 0. 05),Two groups of patients discharged within a year,the experimental patient readmission rate was significantly lower than the control group (P < 0. 05). there are significant differences. Conclusion:Cognitive - behavioral intervention can improve heart function in patients with chronic heart failure condition,the heart rate,pulse,reduce readmission rates for patients.%目的::探讨认知行为干预在慢性心力衰竭(CHF)患者中的应用效果。方法:选择我院内科2012年1月~2013年6月住院的的老年CHF 患者120例,将其随机等分为试验组和对照组,对照组给予常规护理,试验组实施认知行为干预,包括制定 CHF 患者认知干预临床路径图,指导患者培养自我管理的能力,鼓励患者树立行为重建,教导家人掌握正确施救的方法,建立患者 Q 群网络平台,出院后电话回访及家庭探视。结果:干预半年后采用6 min 步行试验,试验组患者心功能状况明显优于对照组

  17. Effect of aerobic exercise training and cognitive behavioural therapy on reduction of chronic fatigue in patients with facioscapulohumeral dystrophy: protocol of the FACTS-2-FSHD trial.

    NARCIS (Netherlands)

    Voet, N.B.M.; Bleijenberg, G.; Padberg, G.W.A.M.; Engelen, B.G.M. van; Geurts, A.C.H.

    2010-01-01

    BACKGROUND: In facioscapulohumeral dystrophy (FSHD) muscle function is impaired and declines over time. Currently there is no effective treatment available to slow down this decline. We have previously reported that loss of muscle strength contributes to chronic fatigue through a decreased level of

  18. Cerebral Malaria; Mechanisms Of Brain Injury And Strategies For Improved Neuro-Cognitive Outcome

    OpenAIRE

    Idro, Richard; Marsh, Kevin; John, Chandy C.; Newton, Charles RJ

    2010-01-01

    Cerebral malaria is the most severe neurological complication of infection with Plasmodium falciparum. With over 575,000 cases annually, children in sub-Saharan Africa are the most affected. Surviving patients have an increased risk of neurological and cognitive deficits, behavioral difficulties and epilepsy making cerebral malaria a leading cause of childhood neuro-disability in the region. The pathogenesis of neuro-cognitive sequelae is poorly understood: coma develops through multiple mech...

  19. Study progress of sequelaes and risk factors of bacterial meningitis in children%儿童细菌性脑膜炎的后遗症及其危险因素研究进展

    Institute of Scientific and Technical Information of China (English)

    张金晶; 王亚娟

    2013-01-01

    儿童细菌性脑膜炎仍是导致儿童死亡的重要原因,而细菌性脑膜炎所致后遗症也并不少见,细菌性脑膜炎患者出院后至少发生1种后遗症的平均概率为19.9%,包括听力障碍、认知障碍、运动障碍、癫(癎)、视力障碍等,其中听力障碍是最常见的后遗症,多种后遗症可同时存在.入院时患儿的意识水平、惊厥、起病时间>48 h、外周循环衰竭、致病菌为肺炎链球菌是细菌性脑膜炎发生后遗症的公认危险因素.外周血白细胞计数、脑脊液糖及蛋白水平亦与细菌性脑膜炎预后密切相关.入院时低钠血症提示预后不良.男童及激素的应用对细菌性脑膜炎后遗症影响尚无定论.%Bacterial meningitis in children is still a life-threatening disease which causes a serious of sequelaes,the median risk of at least 1 major or minor sequelae after hospital discharge is 19.9%,including hearing impairment,cognitive impairment,motor disorders,seizures,visual impairment and so on.Of all these sequelaes,hearing impairment is the most common type.Multiple sequelae is recognized.Prognostic factors are found to be statistically significant:coma/impaired consciousness,complaints > 48 hours before admission,seizures at admission,peripheral circulatory failure,respiratory distress,Streptococcus pneumonia as causative pathogen were recognized as the risk factors for sequeales.And cerebrospinal fluid parameters and white blood cell count were closely related to sequelaes.Hypokaliemia at admission also indicate poor prognosis,but need independent validation in clinical works.Male gender and corticoids were still in discussion.

  20. Eustachian tube dysfunction and its sequelae in patients with cleft palate.

    Science.gov (United States)

    Goldman, J L; Martinez, S A; Ganzel, T M

    1993-11-01

    The incidence of middle ear disorders in patients with cleft palate deformities was determined in a retrospective review of 110 children with palate or palate and lip involvement. Ages ranged from 2 months to 18 years and included patients with associated abnormalities such as Pierre Robin syndrome and Treacher Collins syndrome. Clinical manifestations of eustachian tube dysfunction were found in 79% in the form of effusions, retraction pockets, adhesions, and ossicular erosion. Only two patients had confirmed cholesteatoma formation. Despite the low incidence of acquired cholesteatoma in these patients, the frequent occurrence of other disorders that affect hearing warrants early and aggressive otologic management to prevent long-term sequelae.

  1. Does the Influenza Vaccine Prevent Sequelae Such as Myocarditis from Developing?

    Science.gov (United States)

    Whitney, Ryan; Dazley, Jason; Gilbert, Ryan; Slim, Jihad

    2015-01-01

    Vaccination continues to be a valuable and simple procedure to guard patients from an illness that may prevent them from completing their normal everyday tasks, missing days of work, and even lead to unnecessary sequelae. The following case describes one of the many complications that are seen on a regular basis in any community hospital in different regions of the world. The objective of this publication is to remind the public and practitioner of the urgency to vaccinate each season; thereby, curbing the virus's ability to mutate and preventing unwanted consequences such as bacterial super infection or myocarditis. PMID:26392720

  2. Does the influenza vaccine prevent sequelae such as myocarditis from developing?

    Directory of Open Access Journals (Sweden)

    Ryan Whitney

    2015-01-01

    Full Text Available Vaccination continues to be a valuable and simple procedure to guard patients from an illness that may prevent them from completing their normal everyday tasks, missing days of work, and even lead to unnecessary sequelae. The following case describes one of the many complications that are seen on a regular basis in any community hospital in different regions of the world. The objective of this publication is to remind the public and practitioner of the urgency to vaccinate each season; thereby, curbing the virus′s ability to mutate and preventing unwanted consequences such as bacterial super infection or myocarditis.

  3. Late Maternal Deaths and Deaths from Sequelae of Obstetric Causes in the Americas from 1999 to 2013: A Trend Analysis

    Science.gov (United States)

    de Cosio, Federico G.; Sanhueza, Antonio; Soliz, Patricia N.; Becerra-Posada, Francisco; Espinal, Marcos A.

    2016-01-01

    Background Data on maternal deaths occurring after the 42 days postpartum reference time is scarce; the objective of this analysis is to explore the trend and magnitude of late maternal deaths and deaths from sequelae of obstetric causes in the Americas between 1999 and 2013, and to recommend including these deaths in the monitoring of the Sustainable Development Goals (SDGs). Methods Exploratory data analysis enabled analyzing the magnitude and trend of late maternal deaths and deaths from sequelae of obstetric causes for seven countries of the Americas: Argentina, Brazil, Canada, Colombia, Cuba, Mexico and the United States. A Poisson regression model was developed to compare trends of late maternal deaths and deaths from sequelae of obstetric causes between two periods of time: 1999 to 2005 and 2006 to 2013; and to estimate the relative increase of these deaths in the two periods of time. Findings The proportion of late maternal deaths and deaths from sequelae of obstetric causes ranged between 2.40% (CI 0.85% – 5.48%) and 18.68% (CI 17.06% – 20.47%) in the seven countries. The ratio of late maternal deaths and deaths from sequelae of obstetric causes per 100,000 live births has increased by two times in the region of the Americas in the period 2006-2013 compared to the period 1999-2005. The regional relative increase of late maternal death was 2.46 (p<0.0001) times higher in the second period compared to the first. Interpretation Ascertainment of late maternal deaths and deaths from sequelae of obstetric causes has improved in the Americas since the early 2000’s due to improvements in the quality of information and the obstetric transition. Late and obstetric sequelae maternal deaths should be included in the monitoring of the SDGs as well as in the revision of the International Classification of Diseases’ 11th version (ICD-11). PMID:27626277

  4. Avaliação espirométrica de doentes com sequela de tuberculose submetidos à lobectomia Spirometry evaluation in patient with tuberculosis sequelae treated by lobectomy

    Directory of Open Access Journals (Sweden)

    Elias Amorim

    2013-04-01

    Full Text Available OBJETIVO: Avaliar a espirometria no pré e pós-operatório de doentes com sequela de tuberculose, submetidos à lobectomia. MÉTODOS: Foram selecionados 20 doentes, com idade entre 15 e 56 anos, de ambos os sexos, com história pregressa de tratamento de tuberculose, apresentando infecção de repetição ou hemoptises. Foram submetidos à lobectomia pulmonar. O tempo de tratamento da tuberculose foi seis meses e o aparecimento dos sintomas entre um e 32 anos. Foram avaliadas a capacidade vital (CV, a capacidade vital forçada (CVF, o volume expiratório forçado (VEF1, o VEF1/CVF, o fluxo expiratório forçado (FEF e o pico de fluxo expiratório (PFE após o primeiro, terceiro e sexto meses em relação ao pré-operatório. O nível de significância (á aplicado em todos os testes foi 5%, ou seja, considerou-se significativo quando pOBJECTIVE: To evaluate pre and post-operative spirometry in patients with tuberculosis sequelae undergoing lobectomy. METHODS: We selected 20 patients, aged between 15 and 56 years, of both genders, with a history of tuberculosis treatment, with repeated infections or hemoptysis and indication of pulmonary lobectomy. The tuberculosis treatment time was six months, and onset of symptoms, between one and 32. We evaluated and compared vital capacity (VC, forced vital capacity (FVC, forced expiratory volume (FEV1, the FEV1/FVC, forced expiratory flow (FEF and peak expiratory flow (PEF preoperatively and after the first, third and sixth postoperative months (POM. The significance level (á used in all tests was 5%, ie, it was considered significant when p <0.05. RESULTS: The averages found were: Vital Capacity (VC - Preoperative: 2.83; 1st POM: 2.12; 3rd POM: 2.31; 6th POM: 2.43. Forced Vital Capacity (FVC - Preoperative: 2.97; 1st POM: 2.21; 3rd POM: 2.35; 6th POM: 2.53. Expiratory Volume in 1 second (FEV1 - Preoperative: 2.23; 1st POM: 1.75; 3rd POM: 1.81; 6th POM 1.97. There was marked decrease in lung function in

  5. Investigation of cognitive reappraisal and life satisfaction in patients with chronic hepatitis B%慢性乙型肝炎患者认知重评策略与生活满意度关系的调查研究

    Institute of Scientific and Technical Information of China (English)

    郑瑞丹; 杨滨妮; 林苏娜; 尤可贤; 张灵聪; 沈镇文

    2014-01-01

    Objective To investigate the relationship between cognitive reappraisal and life satisfaction in patients with chronic hepatitis B. Methods Total of 130 outpatients with chronic hepatitis B were consecutively recruited and completed the cognitive emotion regulation questionnaire (ERS), the satisfaction with life scale (SWLS), the connor-davidson resilience scale (CD-RISC). Results The cognitive reappraisal were more strongly correlated with life satisfaction and resilience in patients with chronic hepatitis B (P< 0.05), cognitive reappraisal were more strongly correlated with dimensions of resilience (P < 0.05), the resilience plays the mediation effect on the influences of cognitive reappraisal and life satisfaction. conclusions Life satisfaction could be directly affected by cognitive reappraisal in patients with chronic hepatitis B by resilience.%目的:探讨CHB患者认知重评策略与生活满意度的关系。方法采用情绪调节问卷(ERS)、生活满意度量表(SWLS)、心理韧性量表(CD-RISC)对130例CHB患者进行施测。结果 CHB患者的认知重评和生活满意度、心理韧性显著相关(P <0.05),认知重评与心理韧性各维度也存在显著相关(P <0.05),且CHB患者的心理韧性在认知重评策略和生活满意度上起完全中介作用。结论CHB患者的认知重评策略通过心理韧性影响患者的生活满意度。

  6. Effects of Mindfulness-Based Stress Reduction vs Cognitive-Behavioral Therapy and Usual Care on Back Pain and Functional Limitations among Adults with Chronic Low Back Pain: A Randomized Clinical Trial

    Science.gov (United States)

    Cherkin, Daniel C.; Sherman, Karen J.; Balderson, Benjamin H.; Cook, Andrea J.; Anderson, Melissa L.; Hawkes, Rene J.; Hansen, Kelly E.; Turner, Judith A.

    2016-01-01

    Importance Mindfulness-based stress reduction (MBSR) has not been rigorously evaluated for young and middle-aged adults with chronic low back pain. Objective To evaluate the effectiveness for chronic low back pain of MBSR versus usual care (UC) and cognitive-behavioral therapy (CBT). Design, Setting, and Participants Randomized, interviewer-blind, controlled trial in integrated healthcare system in Washington State of 342 adults aged 20–70 years with CLBP enrolled between September 2012 and April 2014 and randomly assigned to MBSR (n = 116), CBT (n = 113), or UC (n = 113). Interventions CBT (training to change pain-related thoughts and behaviors) and MBSR (training in mindfulness meditation and yoga) were delivered in 8 weekly 2-hour groups. UC included whatever care participants received. Main Outcomes and Measures Co-primary outcomes were the percentages of participants with clinically meaningful (≥30%) improvement from baseline in functional limitations (modified Roland Disability Questionnaire [RDQ]; range 0 to 23) and in self-reported back pain bothersomeness (0 to 10 scale) at 26 weeks. Outcomes were also assessed at 4, 8, and 52 weeks. Results Among 342 randomized participants (mean age, 49 (range, 20–70); 225 (66%) women; mean duration of back pain, 7.3 years (range 3 months to 50 years), low back pain, treatment with MBSR and CBT, compared with UC, resulted in greater improvement in back pain and functional limitations at 26 weeks, with no significant differences in outcomes between MBSR and CBT. These findings suggest that MBSR may be an effective treatment option for patients with chronic low back pain. PMID:27002445

  7. Changes in Hippocampus Morphology, Cognitive Function and Coping Style Induced by Chronic Military Stress%慢性军事应激致军人海马形态、认知功能和应对方式的变化

    Institute of Scientific and Technical Information of China (English)

    王丽杰; 孙秋德; 严进; 刘爱丽; 董建树; 刘佳佳; 王建平

    2011-01-01

    通过对572名连续4~16个月高强度军事训练的军人进行SCL-90测评,研究慢性军事应激条件下军人海马形态、认知、心理特质和特质应对方式的变化特征.将其中17例焦虑因子分≥3分者(焦虑或伴焦虑)设为研究组(A),并以匹配法设对照组(B).检测两组军人血皮质醇,并用MRI观察海马形态、检测简单和复杂认知作业功能、以STAI测评状态-特质焦虑及以CCSQ测评应对方式,探讨两组对应变化.研究结果显示:(1)血皮质醇:A、B组均高于正常水平,有差异显著,A组显著高于B组.(2)海马形态:A组与B组MRI海马形态标准化后,A组海马形态显著萎缩,与B组相比有显著性差异,但各组每个同体的左右两侧之间相比无显著性差异.(3)认知作业功能:A组简单认知作业成绩与B组无显著差异,但复杂认知作业成绩与B组相比有显著性差异.(4)状态-特质焦虑:A组的状态焦虑、特质焦虑分别与B组和常模比较均有显著变化,B组与常模相比状态焦虑变化显著,特质焦虑变化不显著.(5)应对方式:A组积极应对方式平均值低于B组和常模并有显著性差异,B组高于常模;A组消极应对方式平均值高于B组和常模且有非常显著性差异,B组与常模无显著改变.结论在慢性军事应激条件下,特质焦虑个体的海马形态出现双侧萎缩,复杂认知功能下降,更易发生状态焦虑,行为取向表现出积极应对方式降低、消极应对方式增加.%Many organic functions will be changed undergoing chronic strong stress, especially in the continuous activation of the HPA axis, which results in successive high level of glucocorticoid in blood. Afterward it will make hippocampal neurons become atrophic and cognitive function impairment, which has been confirmed in laboratory. This investigation studied the morphological changes of hippocampus, cognitive functions and coping styles undergoing the chronic military stress

  8. Animal Models of Virus-Induced Neurobehavioral Sequelae: Recent Advances, Methodological Issues, and Future Prospects

    Directory of Open Access Journals (Sweden)

    Marco Bortolato

    2010-01-01

    Full Text Available Converging lines of clinical and epidemiological evidence suggest that viral infections in early developmental stages may be a causal factor in neuropsychiatric disorders such as schizophrenia, bipolar disorder, and autism-spectrum disorders. This etiological link, however, remains controversial in view of the lack of consistent and reproducible associations between viruses and mental illness. Animal models of virus-induced neurobehavioral disturbances afford powerful tools to test etiological hypotheses and explore pathophysiological mechanisms. Prenatal or neonatal inoculations of neurotropic agents (such as herpes-, influenza-, and retroviruses in rodents result in a broad spectrum of long-term alterations reminiscent of psychiatric abnormalities. Nevertheless, the complexity of these sequelae often poses methodological and interpretational challenges and thwarts their characterization. The recent conceptual advancements in psychiatric nosology and behavioral science may help determine new heuristic criteria to enhance the translational value of these models. A particularly critical issue is the identification of intermediate phenotypes, defined as quantifiable factors representing single neurochemical, neuropsychological, or neuroanatomical aspects of a diagnostic category. In this paper, we examine how the employment of these novel concepts may lead to new methodological refinements in the study of virus-induced neurobehavioral sequelae through animal models.

  9. Effects of Standardized Rehabilitation on Quality of Life of Stroke Patients at Convalescence and Sequelae Stages

    Institute of Scientific and Technical Information of China (English)

    XU Dongyan; JIA Jie; WU Yi; LI Mingfen; XIE Hongyu; YU Kewei; GUO Zhenzhen

    2013-01-01

    Objective:To explore the effects of standardized rehabilitation on quality of life (QOL) of stroke patients at convalescence and sequelae stages.Method:A total of 251 stroke patients were randomly divided into a standardized rehabilitation group and a control group.The simplified Fugl-Meyer assessment(FMA) scale,the 36-item short-form health survey questionnaire (SF-36) and functional comprehensive assessment (FCA) were administered before as well as after 3,6and at 12 months a follow-up study respectively.Statistical analysis was conducted based on the evaluations at 4 testing time points.Result:There was no significant difference in FMA,SF-36 and FCA scores of the two groups before and after 3 months treatments,while FMA,SF-36 and FCA scores of the rehabilitation group were obviously higher than those of the control group either after 6 months treatments or of follow-up study.Moreover,after 6 months treatments FMA score was apparently higher than the score at the beginning and after 3 months treatments.The FMA,SF-36 and FAC scores during the follow-up visit decreased when compared with scores after 6 months treatments,but increased significantly when compared with the scores at the beginning and after 3months treatments.Conclusion:Standardized tertiary rehabilitation (STR) at convalescence and sequelae stages can significantly improve motor functions and QOL of stroke patients.

  10. Intraoperative Hemorrhage and Postoperative Sequelae after Intraoral Vertical Ramus Osteotomy to Treat Mandibular Prognathism

    Directory of Open Access Journals (Sweden)

    Chun-Ming Chen

    2015-01-01

    Full Text Available Objective. To investigate the factors affecting intraoperative hemorrhage and postoperative sequelae after orthognathic surgery. Materials and Methods. Eighty patients with mandibular prognathism underwent surgical mandibular setback with intraoral vertical ramus osteotomy (IVRO. The correlation between the blood loss volume and postoperative VAS with the gender, age, and operating time was assessed using the t-test and Spearman rank correlation coefficient. The correlation between the magnitude of mandibular setback with the presence of TMJ clicking symptoms and lip sensation was also assessed. Results. The mean operating time and blood loss volume for men and women were 249.52 min and 229.39 min, and 104.03 mL and 86.12 mL, respectively. The mean VAS in men and women was 3.21 and 2.93, and 1.79 and 1.32 on the first and second postoperative days. There is no gender difference in the operating time, blood loss, VAS, TMJ symptoms, and lip numbness. The magnitude of mandibular setback was not correlated with immediate and long-term postoperative lip numbness. Conclusion. There are no gender differences in the intraoperative hemorrhage and postoperative sequelae (pain, lip numbness, and TMJ symptoms. In addition, neither symptom was significantly correlated with the amount of mandibular setback.

  11. Postural Control of Healthy Elderly Individuals Compared to Elderly Individuals with Stroke Sequelae.

    Science.gov (United States)

    Alfieri, Fábio Marcon; Riberto, Marcelo; Lopes, José Augusto Fernandes; Filippo, Thais Raquel; Imamura, Marta; Battistella, Linamara Rizzo

    2016-01-01

    A stroke and aging process can modify the postural control. We aimed to compare the postural control of health elderly individuals to that of individuals with stroke sequelae. This cross-sectional transversal study was made with individuals capable of walking without any assistance and that were considered clinically stable. The study had 18 individuals in the group with stroke sequelae (SG) and 34 in the healthy elderly control group (CG). The participants were evaluated for the timed up and go test (TUG) and force platform. The SG showed the worst results in relation to the time of execution of the TUG and the force platform evaluation. The displacement of center of pressure was worse for both groups in the eyes-closed situation, especially in the anteroposterior direction for the CG. The GS showed worse results in the static and dynamic postural control. The healthy elderly showed more dependence on sight to maintain their static balance and there was no difference in the balance tests in relation to the side affected by the stroke.

  12. Grounded cognition.

    Science.gov (United States)

    Barsalou, Lawrence W

    2008-01-01

    Grounded cognition rejects traditional views that cognition is computation on amodal symbols in a modular system, independent of the brain's modal systems for perception, action, and introspection. Instead, grounded cognition proposes that modal simulations, bodily states, and situated action underlie cognition. Accumulating behavioral and neural evidence supporting this view is reviewed from research on perception, memory, knowledge, language, thought, social cognition, and development. Theories of grounded cognition are also reviewed, as are origins of the area and common misperceptions of it. Theoretical, empirical, and methodological issues are raised whose future treatment is likely to affect the growth and impact of grounded cognition.

  13. From traditional cognitive-behavioural therapy to acceptance and commitment therapy for chronic pain: a mixed-methods study of staff experiences of change.

    Science.gov (United States)

    Barker, Estelle; McCracken, Lance M

    2014-08-01

    Health care organizations, both large and small, frequently undergo processes of change. In fact, if health care organizations are to improve over time, they must change; this includes pain services. The purpose of the present study was to examine a process of change in treatment model within a specialty interdisciplinary pain service in the UK. This change entailed a switch from traditional cognitive-behavioural therapy to a form of cognitive-behavioural therapy called acceptance and commitment therapy. An anonymous online survey, including qualitative and quantitative components, was carried out approximately 15 months after the initial introduction of the new treatment model and methods. Fourteen out of 16 current clinical staff responded to the survey. Three themes emerged in qualitative analyses: positive engagement in change; uncertainty and discomfort; and group cohesion versus discord. Quantitative results from closed questions showed a pattern of uncertainty about the superiority of one model over the other, combined with more positive views on progress reflected, and the experience of personal benefits, from adopting the new model. The psychological flexibility model, the model behind acceptance and commitment therapy, may clarify both processes in patient behaviour and processes of staff experience and skilful treatment delivery. This integration of processes on both sides of treatment delivery may be a strength of acceptance and commitment therapy.

  14. Neurocognitive performance and physical function do not change with physical-cognitive-mindfulness training in female laboratory technicians with chronic musculoskeletal pain

    DEFF Research Database (Denmark)

    Jay, Kenneth; Brandt, Mikkel; Schraefel, M. C.;

    2016-01-01

    nervous system vital signs neurocognitive assessment battery, for example, Psychomotoer Speed 1.9 (-1.0 to 4.7), Reaction Time -4.0 (-19.5 to 11.6), Complex Attention -0.3 (-1.9 to 1.4), and Executive Function -0.2 (-3.5 to 3.0). Similarly, we found no change in maximal voluntary isometric strength -0...... allocated 112 female laboratory technicians with chronic upper limb pain to group-based PCMT at the worksite or a reference group for 10 weeks. Neurocognitive performance was measured by the computerized central nervous system vital signs neurocognitive assessment battery. Physical function was assessed...

  15. Can Chronic Ankle Instability be Prevented? Rethinking Management of Lateral Ankle Sprains.

    Science.gov (United States)

    Denegar, Craig R.; Miller, Sayers J., III

    2002-01-01

    Investigates whether chronic ankle instability can be prevented, discussing: the relationship between mechanical and functional instability; normal ankle mechanics, sequelae to lateral ankle sprains, and abnormal ankle mechanics; and tissue healing, joint dysfunction, and acute lateral ankle sprain management. The paper describes a treatment model…

  16. Occupational solvent exposure and cognition

    Science.gov (United States)

    Sabbath, E.L.; Glymour, M.M.; Berr, C.; Singh-Manoux, A.; Zins, M.; Goldberg, M.

    2012-01-01

    Objective: Chronic occupational solvent exposure is associated with long-term cognitive deficits. Cognitive reserve may protect solvent-exposed workers from cognitive impairment. We tested whether the association between chronic solvent exposure and cognition varied by educational attainment, a proxy for cognitive reserve. Methods: Data were drawn from a prospective cohort of French national gas and electricity (GAZEL) employees (n = 4,134). Lifetime exposure to 4 solvent types (chlorinated solvents, petroleum solvents, benzene, and nonbenzene aromatic solvents) was assessed using a validated job-exposure matrix. Education was dichotomized at less than secondary school or below. Cognitive impairment was defined as scoring below the 25th percentile on the Digit Symbol Substitution Test at mean age 59 (SD 2.8; 88% of participants were retired at testing). Log-binomial regression was used to model risk ratios (RRs) for poor cognition as predicted by solvent exposure, stratified by education and adjusted for sociodemographic and behavioral factors. Results: Solvent exposure rates were higher among less-educated patients. Within this group, there was a dose-response relationship between lifetime exposure to each solvent type and RR for poor cognition (e.g., for high exposure to benzene, RR = 1.24, 95% confidence interval 1.09–1.41), with significant linear trends (p < 0.05) in 3 out of 4 solvent types. Recency of solvent exposure also predicted worse cognition among less-educated patients. Among those with secondary education or higher, there was no significant or near-significant relationship between any quantification of solvent exposure and cognition. Conclusions: Solvent exposure is associated with poor cognition only among less-educated individuals. Higher cognitive reserve in the more-educated group may explain this finding. PMID:22641403

  17. Two young women with chronic daily headache and cognitive impairment: why we need to ask about headache in the postpartum period.

    Science.gov (United States)

    Beams, Jennifer L; Rozen, Todd D

    2013-06-01

    Headache, which has a variety of causes, is a common and disabling complaint following childbirth. An important aetiology not to be missed is headache from epidural spinal anaesthesia, known as postdural puncture headache (PDPH), which has been reported in upwards of 85% of pregnant women and is a manifestation of intracranial hypotension from leakage of cerebrospinal (CSF) fluid through a dural tear. The common presenting symptom of PDPH is head pain occurring when a patient is in an upright position that resolves with recumbency. Other neurological issues associated with intracranial hypotension can include cranial nerve palsies, encephalopathy and Parkinsonism. We present two cases of persistent PDPH after pregnancy with secondary cognitive impairment. A review of the clinical manifestations, neuroimaging findings and treatment for PDPH will be presented. Better recognition of this disorder by obstetricians, physicians and anaesthetics will help to reduce the considerable morbidity this syndrome can produce in young mothers.

  18. Cognitive deterioration in adult epilepsy: Does accelerated cognitive ageing exist?

    Science.gov (United States)

    Breuer, L E M; Boon, P; Bergmans, J W M; Mess, W H; Besseling, R M H; de Louw, A; Tijhuis, A G; Zinger, S; Bernas, A; Klooster, D C W; Aldenkamp, A P

    2016-05-01

    A long-standing concern has been whether epilepsy contributes to cognitive decline or so-called 'epileptic dementia'. Although global cognitive decline is generally reported in the context of chronic refractory epilepsy, it is largely unknown what percentage of patients is at risk for decline. This review is focused on the identification of risk factors and characterization of aberrant cognitive trajectories in epilepsy. Evidence is found that the cognitive trajectory of patients with epilepsy over time differs from processes of cognitive ageing in healthy people, especially in adulthood-onset epilepsy. Cognitive deterioration in these patients seems to develop in a 'second hit model' and occurs when epilepsy hits on a brain that is already vulnerable or vice versa when comorbid problems develop in a person with epilepsy. Processes of ageing may be accelerated due to loss of brain plasticity and cognitive reserve capacity for which we coin the term 'accelerated cognitive ageing'. We believe that the concept of accelerated cognitive ageing can be helpful in providing a framework understanding global cognitive deterioration in epilepsy.

  19. Aesthetic skin branding: a novel form of body art with adverse clinical sequela.

    Science.gov (United States)

    Karamanoukian, Raffy; Ukatu, Chidi; Lee, Edward; Hyman, Josh; Sundine, Michael; Kobayashi, Mark; Evans, Gregory R D

    2006-01-01

    Branding is a form of body art wherein third-degree burns are inflicted on the skin to produce permanent scars. This method of scarification is a common practice among many indigenous cultures and has become exceedingly common in western societies. As with other forms of body art, branding is not a manifestation of a psychiatric disorder but, rather, a method of self-expression. The process can be performed through the use of electrocautery, laser, chemicals, freezing, and hot metal. Complications arising from the procedure include acute infection, transmission of blood-borne pathogens, allergic reactions, and sequelae arising from third-degree burns. In addition, skin branding has been shown to be associated with substance abuse and high-risk behaviors among adolescents. The purpose of this article is to present the following case report and review to familiarize clinicians with this dangerous method of body art.

  20. Spontaneous bronchoesophageal fistula in an adult – A possible delayed sequela of pulmonary tuberculosis

    Directory of Open Access Journals (Sweden)

    Surendra Patel

    2015-01-01

    Full Text Available Spontaneous bronchoesophageal fistula in the adult is a rare clinical entity. Most bronchoesophageal fistulae are due to malignancy, prolonged endotracheal intubation or trauma. Granulomatous infections like tuberculosis, HIV and mediastinitis are rare causes of acquired bronchoesophageal fistula. We report a case of a 50 year old man, treated for pulmonary tuberculosis 15 years ago, who developed a spontaneous bronchoesophageal fistula between the mid-esophagus and right main stem bronchus, having no history of malignancy or trauma. Surgical closure of the fistula was done and post operative recovery was uneventful. In this case, the bronchoesophageal fistula probably developed as a delayed sequela of pulmonary tuberculosis as the patient had no active signs of pulmonary tuberculosis clinically or histopathologically.

  1. Neurocognitive sequelae of cerebral malaria in adults:A pilot study in Benguela Central Hospital, Angola

    Institute of Scientific and Technical Information of China (English)

    Bruno Peixoto; Isabel Kalei

    2013-01-01

    Objective: To characterize the neurocognitive sequelae of cerebral malaria (CM) in an adult sample of the city of Benguela, Angola. Methods:A neuropsychological assessment was carried out in 22 subjects with prior history of CM ranging from 6 to 12 months after the infection. The obtained results were compared to a control group with no previous history of cerebral malaria. The study was conducted in Benguela Central Hospital, Angola in 2011. Results: CM group obtained lower results on the two last trials of a verbal learning task and on an abstract reasoning test. Conclusions: CM is associated to a slower verbal learning rate and to difficulties in the ability to discriminate and perceive relations between new elements.

  2. ESTUDO DO MAPEAMENTO SENSORIAL DO ESQUELETO AXIAL E APENDICULAR DE PORTADORES DE SEQUELAS DE PARALISIA CEREBRAL

    Directory of Open Access Journals (Sweden)

    Marcelo de Oliveira Rosário

    2012-01-01

    Full Text Available A paralisia cerebral caracteriza-se por comprometimento de variável severidade do sistema nervoso central, de caráter não progressivo. Este estudo teve como objetivo, realizar o mapeamento sensorial (avaliação da sensibilidade por meio de dermátomos do esqueleto axial e apendicular de indivíduos portadores de sequelas de paralisia cerebral, para avaliar e verificar as principais alterações sensitivas dos mesmos e ainda, analisar a importância da avaliação somatossensorial ser realizada com esses indivíduos. Foi realizado o mapeamento sensorial com o uso dos monofilamentos de Semmes – Weinstein, em 22 indivíduos,com idade entre 5 e 32 anos, estudantes da E.E.E.V.M. Verificou-se uma maior média de alteração de sensibilidade sempre na região anterior dos membros e também, do esqueleto axial dos indivíduos avaliados. Na região posterior do esqueleto axial, encontraram-se alterações mais homogêneas do que na região anterior do mesmo, onde as alterações foram mais heterogêneas. Ainda,observou-se com o presente trabalho, por meio de análise quantitativa, que oesqueleto apendicular apresentou alterações mais significativamente relevantes quando comparadas com as alterações do esqueleto axial. Com base nos resultados obtidos, comprovou-se a importância de indivíduos com sequelas de paralisia cerebral receberem constantemente estímulos sensitivos, de forma global euniforme, e ainda, serem avaliados sensitivamente de forma adequada porfisioterapeutas.

  3. Frontal Lobe Contusion in Mice Chronically Impairs Prefrontal-Dependent Behavior.

    Directory of Open Access Journals (Sweden)

    Austin Chou

    Full Text Available Traumatic brain injury (TBI is a major cause of chronic disability in the world. Moderate to severe TBI often results in damage to the frontal lobe region and leads to cognitive, emotional, and social behavioral sequelae that negatively affect quality of life. More specifically, TBI patients often develop persistent deficits in social behavior, anxiety, and executive functions such as attention, mental flexibility, and task switching. These deficits are intrinsically associated with prefrontal cortex (PFC functionality. Currently, there is a lack of analogous, behaviorally characterized TBI models for investigating frontal lobe injuries despite the prevalence of focal contusions to the frontal lobe in TBI patients. We used the controlled cortical impact (CCI model in mice to generate a frontal lobe contusion and studied behavioral changes associated with PFC function. We found that unilateral frontal lobe contusion in mice produced long-term impairments to social recognition and reversal learning while having only a minor effect on anxiety and completely sparing rule shifting and hippocampal-dependent behavior.

  4. Cognitive ecology.

    Science.gov (United States)

    Hutchins, Edwin

    2010-10-01

    Cognitive ecology is the study of cognitive phenomena in context. In particular, it points to the web of mutual dependence among the elements of a cognitive ecosystem. At least three fields were taking a deeply ecological approach to cognition 30 years ago: Gibson's ecological psychology, Bateson's ecology of mind, and Soviet cultural-historical activity theory. The ideas developed in those projects have now found a place in modern views of embodied, situated, distributed cognition. As cognitive theory continues to shift from units of analysis defined by inherent properties of the elements to units defined in terms of dynamic patterns of correlation across elements, the study of cognitive ecosystems will become an increasingly important part of cognitive science.

  5. Effects of a rapid-resisted elliptical training program on motor, cognitive and neurobehavioral functioning in adults with chronic traumatic brain injury.

    Science.gov (United States)

    Damiano, Diane L; Zampieri, Cristiane; Ge, Jie; Acevedo, Ana; Dsurney, John

    2016-08-01

    This small clinical trial utilized a novel rehabilitation strategy, rapid-resisted elliptical training, in an effort to increase motor, and thereby cognitive, processing speed in ambulatory individuals with traumatic brain injury (TBI). As an initial step, multimodal functional abilities were quantified and compared in 12 ambulatory adults with and 12 without TBI. After the baseline assessment, the group with TBI participated in an intensive 8-week daily exercise program using an elliptical trainer and was reassessed after completion and at an 8-week follow-up. The focus of training was on achieving a fast movement speed, and once the target was reached, resistance to motion was increased in small increments to increase intensity of muscle activation. Primary outcomes were: High-Level Mobility Assessment Tool (HiMAT), instrumented balance tests, dual-task (DT) performance and neurobehavioral questionnaires. The group with TBI had poorer movement excursion during balance tests and poorer dual-task (DT) performance. After training, balance reaction times improved and were correlated with gains in the HiMAT and DT. Sleep quality also improved and was correlated with improved depression and learning. This study illustrates how brain injury can affect multiple linked aspects of functioning and provides preliminary evidence that intensive rapid-resisted training has specific positive effects on dynamic balance and more generalized effects on sleep quality in TBI.

  6. Attachment Theory as a Framework for Understanding Sequelae of Severe Adolescent Psychopathology: An 11-Year Follow-Up Study.

    Science.gov (United States)

    Allen, Joseph P.; And Others

    1996-01-01

    Examined long-term sequelae of severe adolescent psychopathology from the perspective of adult attachment theory. Compared 66 upper-middle-class adolescents who were psychiatrically hospitalized at age 14 for problems other than thought or organic disorders, to 76 socio-demographically similar high school students. When reviewed at age 25,…

  7. 漆黄素逆转慢性应激鼠认知损害突触可塑性研究%Synaptic plasticity following fisetin’s reversion of cognitive impairment provoked by chronic stress in mice

    Institute of Scientific and Technical Information of China (English)

    杨仙萍; 涂传龙; 庄聪文; 石晓磊; 翁向群

    2016-01-01

    目的:探讨漆黄素逆转慢性束缚应激小鼠认知损害的突触可塑性研究。方法用 CD1小鼠建立慢性束缚应激模型,漆黄素(25 mg·kg -1·d -1)灌胃给药,漆黄素给药前30 min 双侧背侧海马微量注射 U0126(0.5μg/侧)。场电生理研究海马CA1区长时程增强(LTP)的变化,高尔基染色观察树突棘数量改变,Western blot 检测突触膜蛋白表达。结果漆黄素逆转慢性应激鼠海马 CA1区 LTP 损害,提高海马树突棘数量,ERK 特异性阻断剂 U0126阻断其效应。结论漆黄素逆转慢性应激鼠海马突触可塑性损害,可能与 ERK 通路有关。%Objective To investigate synaptic plasticity following the prevention of cognitive deficits by fisetin treatment provoked by chronic stress in mice.Methods Mice were subjected to chronic restraint stress for 21 days.Stressed mice received repeated gavage of 25 mg·kg -1 fisetin once daily for 14 consecutive days.Mice were injected with U0126(0.5 μg/side)30 min before fisetin treatment. Effects of fisetin on long-term potentiation (LTP)in mouse hippocampal slices were investigated by electrophysiological methods.The expressive levels of proteins in the hippocampus of mice were analyzed by Western blot.The spine density in mice was investigated by Golgi staining.Results Fisetin reversed hippocampal LTP in stressed mice,increased the density of dendritic spines.However,pre-treatment with U0126,a specific ERK inhibitor,blocked the restoration of synaptic plasticity by fisetin in stressed mice.Conclusions Chronic oral administration of fisetin restores synaptic plasticity in stressed mice,which may be related to ERK signaling pathway in-volved in the hippocampus.

  8. Correlation research of disease cognition and health management among chronic disease patients%慢性病患者疾病认知与健康管理的相关性研究

    Institute of Scientific and Technical Information of China (English)

    李桂玲; 李娜; 杜璇; 周晖; 李晨; 赵飞

    2015-01-01

    目的:调查慢性病患者疾病认知与健康管理状况,探讨两者之间的相关性,为慢性病患者的治疗与康复提供干预依据。方法2014年6—8月采用中文修订版疾病感知问卷( CIPQ-R)和健康促进生活方式量表Ⅱ( HPLPⅡ)对286例慢性病患者进行问卷调查。结果慢性病患者疾病急/慢性因子、疾病周期性因子、严重后果因子、个人控制因子、治疗控制因子、疾病相关性因子及情绪陈述因子得分分别为(22.96±0.49),(15.82±0.67),(24.88±0.38),(24.34±0.55),(21.06±0.47),(21.76±0.51),(27.16±0.44)分。慢性病患病者HPLPⅡ总分为(127.92±12.14)分,健康责任维度、运动锻炼维度、营养维度、自我实现维度、人际关系维度及压力管理维度得分分别为(22.26±3.67),(21.47±4.38),(23.58±3.65),(20.74±3.17),(21.62±3.01),(18.37±3.44)分。相关分析显示,CIPQ-R与HPLPⅡ具有高度负相关性,差异有统计学意义(r=-0.4145~-0.576,P<0.01)。结论慢性病患者疾病认知水平和健康管理能力不高,有待进一步加强,疾病认知是健康管理能力的重要影响因素,医务工作者应帮助慢性病患者提高疾病感知水平,以提高健康管理能力,促进治疗与康复。%Objective To survey the condition of disease cognition and health management in the patients with chronic disease ( CD) , to explore their correlation, in order to afford the intervention basis for the treatment and rehabilitation of the patients with CD. Methods To survey the condition of disease cognition and health management in the patients with chronic disease ( CD) , to explore their correlation, in order to afford the intervention basis for the treatment and rehabilitation of the patients with CD. Results The score of acute /chronic factor, cyclical factor, consequences factor, personal control factor, treatment control factor, illness coherence factor, and emotional representation factor for CD patients were respectively (22. 96

  9. Influence of acute or chronic calcium channel antagonists on the acquisition and consolidation of memory and nicotine-induced cognitive effects in mice.

    Science.gov (United States)

    Biala, Grazyna; Kruk-Slomka, Marta; Jozwiak, Krzysztof

    2013-07-01

    Nicotinic cholinergic receptors (nAChRs) form a heterogeneous family of ligand-gated ion channels found in the nervous system. The main objective of our research was to investigate the interaction between cholinergic nicotinic system and calcium homeostasis in cognitive processes using the modified elevated plus maze memory model in mice. The time each mouse took to move from the open arm to either of the enclosed arms on the retention trial (transfer latency, TL2) was used as an index of memory. Our results showed that a single injection of nicotine (0.035 and 0.175 mg/kg) shortened TL2 values, improving memory-related processes. Similarly, L-type calcium channel antagonists (CCAs), i.e., flunarizine, verapamil, amlodipine, nimodipine, nifedipine, and nicardipine (at the range of dose 5-20 mg/kg) administered before or after training, decreased TL2 value improving memory acquisition and/or consolidation. Interestingly, at the subthresold doses, flunarizine, nicardipine, amlodipine, verapamil, and bupropion, a nAChR antagonist, significantly reversed the nicotine improvement of memory acquisition, while flunarizine, verapamil, and bupropion attenuated the improvement of memory consolidation provoked by an acute injection of nicotine (0.035 mg/kg, s.c.). After subchronic administration (14 days, i.p.) of verapamil and amlodipine, two CCAs with the highest affinity for nAChRs, only verapamil (5 mg/kg) impaired memory acquisition and consolidation while both verapamil and amlodipine, at the subthresold, ineffective dose (2.5 mg/kg), significantly reversed the improvement of memory provoked by an acute injection of nicotine (0.035 mg/kg, s.c.). Our findings can be useful to better understand the interaction between cholinergic nicotinic receptors and calcium-related mechanisms in memory-related processes.

  10. Rendimiento cognitivo y percepción de problemas de memoria en pacientes con dolor crónico: con fibromialgia versus sin fibromialgia Cognitive performance and memory complaints in chronic pain patients: with fibromyalgia versus without fibromyalgia

    Directory of Open Access Journals (Sweden)

    A. Castel

    2008-09-01

    Full Text Available Objetivos. 1 Comparar la percepción de problemas de memoria y el rendimiento cognitivo (memoria verbal, atención concentrada, rapidez de procesamiento en pacientes con y sin diagnóstico de fibromialgia. 2 Comparar estos mismos procesos entre pacientes con fibromialgia primaria y pacientes con fibromialgia concomitante a otras patologías de dolor crónico. Sujetos. Ciento diez pacientes de sexo femenino [21-64 años]. Edad 47.6 años. 68 pacientes con fibromialgia [28 fibromialgia primaria, 40 fibromialgia concomitante con otras patologías de dolor] y 42 pacientes con otros diagnósticos de dolor crónico. Material y método. El examen neuropsicológico se realizó de forma individual. Los problemas de memoria se evaluaron con el Cuestionario de Fallos de Memoria en la Vida Cotidiana (MFE, la memoria con el Test de Aprendizaje Verbal (TAVEC, las aptitudes perceptivas y de atención con el Test Toulouse-Piéron (TP y la rapidez de procesamiento e interferencia con el Test de Colores y Palabras (STROOP. También se aplicó la Escala de Ansiedad y Depresión (HADS. Resultados. No hubo diferencias entre los distintos grupos en duración e intensidad del dolor, nivel de estudios o tipo de ocupación. No se encontraron diferencias significativas entre pacientes con y sin fibromialgia en ninguna de las subescalas de los tests TAVEC, TP y STROOP. Tampoco en la subescala ansiedad del HADS. Por el contrario, sí hubo diferencias entre pacientes con y sin fibromialgia en percepción de problemas de memoria (MFE-FBM=100,4; MFE-NoFBM=77.9; F(1,106=7,754, pAims. 1 To compare memory complaints and cognitive performance (verbal memory, attention and information processing in chronic pain patients with and without fibromyalgia. 2 To compare those processes in patients with primary fibromyalgia and concomitant fibromyalgia. Subjetcs. One hundred and ten female patients [21-64 years oíd]. Mean age 47.6 years. 68 patients with fibromyalgia [28 with primary

  11. The Efficacy of Syzygium aromaticum Essential Oil in Cognitive Disorders against Manganese Chronic Exposure in Rats during Development

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    Djallal Eddine Houari ADLI

    2014-06-01

    Full Text Available The essential oil of Syzygium aromaticum has been widely used in traditional medicine to treat a variety of diseases, including some neurological disorders. This study aims at testing, in vivo, the possible anxiolytic and antidepressant effects, of the Syzygium aromaticum essential oil against chronic manganese chloride (4.79 mg/l intoxication during the gestation and lactation period, in Wistar rat pups. Wistar rat pups were exposed to manganese via their dams’ drinking water from postnatal day (PND 1 to (PND 21. After their weaning, the rats exposed to manganese received injections of essential oil of Syzygium aromaticum (0.1 ml/kg for 18 days. The level of anxiety, depression and locomotor activity were studied. Locomotor activity (open field test, anxiety (elevated plus maze tests, and depression (forced swimming test were evaluated. The results of the present study indicate that Manganese exposure induces, on the one hand, impairments of body (p<0.001 and of brain weight (p<0.05. On the other hand, it increases level of anxiety (p<0.05, depression (p<0.001 and locomotor hyporactivity (p<0.001, when compared to control rats. Administration of essential oil of Syzygium aromaticum leads to a reduction in the level of anxiety (p<0.05, of depression (p<0.001 and corrects locomotor hyporactivity (p<0.05 in rats exposed to manganese beforehand. These results suggest that essential oil of Syzygium aromaticum can employ as a natural, protective agent against neuro-toxicity induced by manganese chloride during the gestation and lactation periods.

  12. Cognitive performance in patients with COPD

    NARCIS (Netherlands)

    Liesker, JJW; Postma, DS; Beukema, RJ; ten Hacken, NHT; van der Molen, T; Riemersma, RA; van Zomeren, EH; Kerstjens, HAM

    2004-01-01

    Background: Hypoxemic patients with Chronic Obstructive Pulmonary Disease (COPD) have impaired cognitive performance. These neuropsychological impairments are related to the degree of hypoxemia. So far, cognitive performance has not been tested in non-hypoxemic patients with COPD. Methods: We recrui

  13. 大鼠慢性脑缺血认知、情绪及小胶质细胞的变化%Changes in cognition, emotion and microglia condition caused by chronic cerebral ischemia in rats

    Institute of Scientific and Technical Information of China (English)

    王丽晔; 林参; 赵海苹; 张陈诚; 闫峰; 陈志刚; 王荣亮; 王宁群; 罗玉敏

    2014-01-01

    Objective To observe the cognition, emotion, tissue condition and microglia condition after chronic cerebral ischemia caused by bilateral common carotid artery(BCCA) occlusion on 42nd and 56th day, and provide the basis to understand forming time of chronic cerebral ischemic model. Methods Sprague-Dawley(SD) rats were divided into 4 groups by sortition randomization method: 42 d-Sham, 42 d-Model, 56 d-Sham and 56 d-Model. Morris water maze, object location test and open field test were measured to evaluate cognition and emotion. To observe tissue condition of hippocampus, we chose H&E staining. The microglia activity was measured by Iba1 immunofluorescent staining(IF). Results The result of morris water maze showed that compared with the Sham group, the cognition of Model group was decreased, the decrease was more significant in 56 d-Model. Model group showed that the escape latency was longer, and the frequency of platform crossing was reduced. The result of object location test also showed the cognition of Model group was decreased. The discrimination index and explore time of new object was reduced. But there were no significant difference between them. The open field test showed vertical number and crossing number of Model group increased clearly, indicating that Model group had anxiety behavior. The H&E staining result showed that there were no changes in hippocampus tissue condition in the four groups. The IF staining showed that there were significant differences between the Model group and Sham group in Iba1 protein expression. Number of microglia in Model group was higher, colour was deepening, the cell was bigger, and the protuberances were increased and shortened, the protuberances like amoebocyte. Conclusion The cognition of rats was reduced at 42 days after BCCA operation, and the microglia were activated. It indicated that we can choose 42 day as forming time of chronic cerebral ischemia model. According to the cognition of 56 d-Model was worse than

  14. Pathology and differential diagnosis of chronic, noninfectious gastritis.

    Science.gov (United States)

    Polydorides, Alexandros D

    2014-03-01

    The histologic finding of chronic inflammation in an endoscopic mucosal biopsy of the stomach (chronic gastritis) is very common and usually reflects the presence of Helicobacter pylori infection. However, infectious organisms are not always present in biopsy material, and some cases of chronic gastritis do not result from H. pylori infection. Thus, the differential diagnosis of this finding is an important one for pathologists to keep in mind. This review presents the three most common and clinically significant causes of chronic, noninfectious gastritis, namely, autoimmune atrophic gastritis, lymphocytic gastritis, and gastric involvement in the setting of inflammatory bowel disease, especially Crohn disease. For each entity, a brief discussion of its etiology and pathogenesis, a review of the clinical and endoscopic features, and a description of the microscopic findings are presented in the context of the differential diagnosis of chronic gastritis with emphasis on helpful histopathologic hints and long-term sequelae.

  15. Non-reproducible results in genetic association studies in chronic hepatitis B due to the inadequate controls

    Institute of Scientific and Technical Information of China (English)

    ZHOU Yi-hua

    2010-01-01

    @@ Infection of hepatitis B virus (HBV) is ubiquitous although the prevalence of hepatitis B surface antigen (HBsAg) varies considerably worldwide. Persistent HBV infection may lead to severe sequelae such as cirrhosis and hepatocellular carcinoma. Thus, clarification of the mechanism of susceptibility to persistent HBV infection would be valuable for the prevention and treatment of chronic hepatitis B.

  16. Fixator-assisted tibial lengthening over a plate in a patient with sequelae of poliomyelitis.

    Science.gov (United States)

    Tosun, Haci Bayram; Serbest, Sancar; Uludag, Abuzer; Gumustas, Seyitali; Celik, Suat

    2016-11-01

    There are many techniques for limb lengthening. Lengthening over a plate is an alternative choice of fixation in children or when nailing is difficult. We present a new technique for tibial lengthening with using a monolateral external fixator over a lengthening plate.Lengthening over an intramedullary nail is a commonly used method in patients with short stature or limb-length discrepancy. However, in patients with a narrow and excessively sclerotic intramedullary cavity in the pediatric age group where the skeletal system has not yet fully developed, difficulties have been observed in lengthening methods with nailing.Therefore, in these cases, the use of lengthening techniques over a plate is an alternative treatment option. Nevertheless, in lengthening techniques over a plate, if one side of the osteotomy area cannot be fixed, associated mechanical axis problems have been reported.We applied tibia lengthening with external fixator assistance over a custom-made lengthening plate in a patient with sequelae of poliomyelitis. This new lengthening technique applied over a plate could be the solution to the problems observed in other lengthening techniques over a plate.

  17. Late sequelae of retained foreign bodies after world war II missile injuries.

    Science.gov (United States)

    Surov, Alexey; Thermann, Florian; Behrmann, Curd; Spielmann, Rolf-Peter; Kornhuber, Malte

    2012-09-01

    A number of people injured during the second world war harbour foreign bodies such as grenade splinters or bullets in some part of the body. Most of these metal fragments remain clinically silent. Some of them, however, may cause delayed complications. The purpose of this study was to determine the characteristics of delayed complications associated with foreign bodies after world war II injuries. 159 patients with retained foreign bodies after world war II injuries were retrospectively identified radiologically in our data bases in the time interval from 1997 to 2009. Diverse delayed complications secondary to the metal objects were diagnosed in 3 cases (2%): one patient with grenade splinter migration into the choledochal duct, one case with pseudotumoural tissue reaction, and one patient with late osteomyelitis. The time from injury to clinical presentation varied from 56 to 61 years. PubMed and Medline were screened for additional cases with delayed sequelae after foreign body acquisition during the 2nd world war. A 30 year search period from 1980 up to date was selected. 15 cases were identified here. Our study demonstrates that health consequences of the 2nd world war extend into the present time, and therefore physicians should be aware of the presence of hidden foreign bodies and their different possible late reactions.

  18. The metaphyseal bone defect predicts outcome in reverse shoulder arthroplasty for proximal humerus fracture sequelae.

    Science.gov (United States)

    Greiner, Stefan; Uschok, Stephan; Herrmann, Sebastian; Gwinner, Clemens; Perka, Carsten; Scheibel, Markus

    2014-06-01

    Reverse shoulder arthroplasty (RSA) represents an established procedure for treatment of fracture sequelae (FS) after proximal humerus fractures. The present work evaluates which factors are of influence for the clinical outcome. Fifty cases (mean age 69, range 44-89) have been evaluated postoperatively clinically [Constant Score (CS)] and radiographically (mean FU 34; range 24-93 months). The type of primary treatment, the amount of a metaphyseal bone defect, the preoperative status of the rotator cuff, the number of previous operative interventions and the type of FS according to Boileau were analysed whether they are of influence for clinical outcome. The mean CS increased significantly from 16.9 ± 6.7 preoperatively to 54.1 ± 15.7 points postoperatively. The CS of primary conservative treatment was significantly higher in comparison to primary operative treatment. Patients with a metaphyseal bone defect of more than 3 cm had significantly lower CS results. Degenerative changes of the teres minor muscle also had a significant negative influence on clinical results. Score results decreased with increasing number of previous operations. There were no significant difference in between patients classified as Boileau type I and II (category 1) compared to types III and IV (category 2). RSA significantly improved the clinical result. A metaphyseal bone defect and preoperative degeneration of the teres minor showed to be negative prognostic factors. Primary operative treatment and the number of previous operations also negatively influenced the clinical result.

  19. Minimizing the effect of TBI-related physical sequelae on vocational return.

    Science.gov (United States)

    McNamee, Shane; Walker, William; Cifu, David X; Wehman, Paul H

    2009-01-01

    This article evaluated the common physical sequelae that affect return to work (RTW) after traumatic brain injury (TBI). We performed a Medline search and evaluation of current TBI rehabilitation texts. The information presented is a combination of published literature and clinical guidelines. The limitations faced by many patients with TBI can best be overcome through clever job search, job redesign, and community linkages with business and industry that are willing to partner in helping the patient with TBI regain employment. The physician plays a key role in communicating suggestions to the vocational specialist. The comorbidities described represent challenges to successful RTW. These problems are recurrent, long-term, and clearly affect job procurement, nature of job, level of required support, and likelihood of job retention. Conversely, these challenges should not be viewed as impenetrable obstacles. With appropriate supports such as compensatory strategies, job coaching, assistive technology, medical management, and job restructuring, successful RTW is viable option. Physicians must focus on employment outcomes in real jobs and not settle for volunteer work, sheltered work, or assessment and planning. Individuals should be placed in real work for real pay. Through close collaboration between the survivor of TBI, the physician, the vocational specialist, and community resources, successful employment for survivors of TBI is possible and must be prescribed a high value.

  20. Dysarthria and dysphagia as long-term sequelae in a child treated for posterior fossa tumour.

    Science.gov (United States)

    Cornwell, Petrea L; Murdoch, Bruce E; Ward, Elizabeth C; Morgan, Angela

    2003-01-01

    The current case report provides a comprehensive description of the persistent dysarthria and dysphagia evident in a 7.5 year old child treated for recurrent posterior fossa tumour (PFT). AC was assessed on a comprehensive perceptual and instrumental test battery incorporating all components of the speech production system (respiration, phonation, resonance, articulation and prosody) 2 years and 4 months following completion of her treatment. The nature of her swallowing impairment was investigated through the use of videofluoroscopic evaluation of swallowing (VFS). A mild dysarthria with ataxic and LMN components was identified, although overall speech intelligibility was not affected. A moderate dysphagia was also identified with impairment in all three phases of the swallowing process; oral preparatory, oral and pharyngeal. Dysarthria and dysphagia as persistent sequelae in children treated for PFT have implications for the long-term management of these children. The need for appropriate treatment regimes, as well as pre-surgical counselling regarding dysarthria and dysphagia as possible outcomes following surgery are highlighted.

  1. Tomographic Aspects of Advanced Active Pulmonary Tuberculosis and Evaluation of Sequelae following Treatment

    Directory of Open Access Journals (Sweden)

    Rafael Barcelos Capone

    2017-01-01

    Full Text Available Objectives. To evaluate tomographic changes in pulmonary tuberculosis (TB, degree of agreement among three radiologists regarding tomographic diagnoses, and sequelae following treatment. Methods. Cross-sectional and descriptive study of 74 TB patients confirmed by sputum culture and chest computed tomography before (CT1 and 6 months after (CT2 drug therapy. Results were performed by three radiologists blinded to clinical and laboratory results. Results. Main findings in CT1 included nodules indicating the presence of a tree-in-bud pattern in 93% of cases, ill-defined nodules in 84% of cases, consolidation in 77% of cases, architectural distortion in 71% of cases, cavitary lesions in 62% of cases, and ground glass opacities in 37% of cases. Airway involvement, characterized by increased thickness and dilatation of the bronchial walls, occurred in 93% of cases. Pleural involvement occurred in 54%. There was an agreement on active TB among the three radiologists in 85% of cases. The results in CT2 indicated the presence of architectural distortion in 91% of cases and cylindrical bronchiectasis in 86%. Conclusions. The study established a tomographic pattern for diagnosis of active TB characterized by the presence of airway nodules, consolidation, architectural distortion, and cavitary lesions, and an almost complete degree of agreement (Kappa was observed among the radiologists (0.85. CT after treatment assists in defining the cure.

  2. A positive Babinski reflex predicts delayed neuropsychiatric sequelae in Chinese patients with carbon monoxide poisoning.

    Science.gov (United States)

    Zou, Jian-Fang; Guo, Qiming; Shao, Hua; Li, Bin; Du, Yuxiu; Liu, Maofeng; Liu, Fengling; Dai, Lixin; Chung, Min-Hsien; Lin, Hung-Jung; Guo, How-Ran; Yang, Tzu-Meng; Huang, Chien-Cheng; Hsu, Chien-Chin

    2014-01-01

    As the human population increased in China, the carbon monoxide is a serious environmental toxin in public health. However, predicting the delayed neuropsychiatric sequelae (DNS) of carbon monoxide poisoning (COP) has not been well studied. We investigated the independent predictors of DNS in patients with COP. This study was conducted at four hospitals in China. Data were retrospectively collected from 258 patients with COP between November 1990 and October 2011. DNS was the primary endpoint. A positive Babinski reflex was the independent predictor for DNS: sensitivity = 53.8% (95% confidence interval [CI]: 26.1-79.6), specificity = 88.6% (95% CI: 83.7-92.1), positive predictive value (PPV) = 20.0% (95% CI: 9.1-37.5), and negative predictive value (NPV) = 97.3% (95% CI: 94.0-98.9). The area under the receiver operating characteristic curve = 0.712 (95% CI: 0.544-0.880). A positive Babinski reflex was very memorable, immediately available, and applicable in clinical practice. Even when the sensitivity and PPV of a positive Babinski reflex were unsatisfactory, it had a good specificity and NPV for excluding the risk of DNS. In patients without a positive Babinski reflex, the risk for DNS was only 2.7%. This finding may help physicians make decisions about dispositions for patients with COP.

  3. A Positive Babinski Reflex Predicts Delayed Neuropsychiatric Sequelae in Chinese Patients with Carbon Monoxide Poisoning

    Directory of Open Access Journals (Sweden)

    Jian-Fang Zou

    2014-01-01

    Full Text Available As the human population increased in China, the carbon monoxide is a serious environmental toxin in public health. However, predicting the delayed neuropsychiatric sequelae (DNS of carbon monoxide poisoning (COP has not been well studied. We investigated the independent predictors of DNS in patients with COP. This study was conducted at four hospitals in China. Data were retrospectively collected from 258 patients with COP between November 1990 and October 2011. DNS was the primary endpoint. A positive Babinski reflex was the independent predictor for DNS: sensitivity = 53.8% (95% confidence interval [CI]: 26.1–79.6, specificity = 88.6% (95% CI: 83.7–92.1, positive predictive value (PPV = 20.0% (95% CI: 9.1–37.5, and negative predictive value (NPV = 97.3% (95% CI: 94.0–98.9. The area under the receiver operating characteristic curve = 0.712 (95% CI: 0.544–0.880. A positive Babinski reflex was very memorable, immediately available, and applicable in clinical practice. Even when the sensitivity and PPV of a positive Babinski reflex were unsatisfactory, it had a good specificity and NPV for excluding the risk of DNS. In patients without a positive Babinski reflex, the risk for DNS was only 2.7%. This finding may help physicians make decisions about dispositions for patients with COP.

  4. Visual cognition

    Energy Technology Data Exchange (ETDEWEB)

    Pinker, S.

    1985-01-01

    This book consists of essays covering issues in visual cognition presenting experimental techniques from cognitive psychology, methods of modeling cognitive processes on computers from artificial intelligence, and methods of studying brain organization from neuropsychology. Topics considered include: parts of recognition; visual routines; upward direction; mental rotation, and discrimination of left and right turns in maps; individual differences in mental imagery, computational analysis and the neurological basis of mental imagery: componental analysis.

  5. Chronic myelogenous leukemia (CML)

    Science.gov (United States)

    CML; Chronic myeloid leukemia; Chronic granulocytic leukemia; Leukemia - chronic granulocytic ... Chronic myelogenous leukemia is grouped into phases: Chronic Accelerated Blast crisis The chronic phase can last for ...

  6. 扩充痴呆量表对慢性阻塞性肺疾病认知功能的评价%Extended Scale for Dementia on Cognitive Function of Patients with Chronic Obstructive Pulmonary Disease

    Institute of Scientific and Technical Information of China (English)

    赵松林; 聂秀红; 张威; 魏兵; 任魁; 冀瑞俊

    2012-01-01

    目的 探讨扩充痴呆量表(ESD)对稳定期慢性阻塞性肺疾病(COPD)患者认知功能的评价作用.方法 稳定期COPD患者37 例(COPD 组)根据动脉血氧分压(PaO2)分组;同期北京市城区健康居民40 名为对照组.两组均采用ESD 及简易智能精神状态检查量表(MMSE)进行评定.结果 COPD 组ESD 总分及学习、记忆、计算、结构4 项分测验评分均显著低于对照组(P<0.001).COPD 组MMSE 总分及注意力和计算力、回忆能力、记忆力3 项分测验评分均低于对照组(P<0.05).PaO2<60 mmHg COPD 患者ESD总分及学习、记忆力和计算力3 项分测验评分均低于PaO2≥60 mmHg COPD患者(P<0.05),MMSE 总分及注意力和计算力、回忆能力、记忆力3 项分测验评分也低(P<0.05).ESD总分、MMSE 总分与PaO2均明显相关(P<0.01).结论 ESD可以作为评价稳定期COPD患者认知功能的工具.%Objective To evaluate the cognitive function of chronic obstructive pulmonary disease (COPD) stable patients with Extended Scale for Dementia (ESD). Methods 37 patients with stable COPD (COPD group) and 40 healthy persons (control group) were enrolled. The COPD patients were divided into different groups as their PaO2 They were assessed with ESD and Mini Mental Status Examination (MMSE). Results The total score of ESD and the subtest scores of ESD in leaning, memory, calculation, constructive function were significantly lower in the COPD group than in the control group (P<0.001). The total score of MMSE and the subtest scores of MMSE in memory, attention and calculation, short- and long-term memory were significantly lower in the COPD group than in the control group (P<0.05). The total score and the subtest scores in learning, memory, calculation of ESD were lower in patients with PaO2<60 mmHg than those with PaO2≥60 mmHg (P<0.05), same as the total score and the subtest scores in memory, attention and calculation, short- and long-term memory of MMSE (P<0.05). Both ESD and MMSE

  7. Prognostic factors and course for successful clinical outcome quality of life and patients' perceived effect after a cognitive behavior therapy for chronic non-specific low back pain: A 12-months prospective study.

    Science.gov (United States)

    Verkerk, Karin; Luijsterburg, Pim A J; Heymans, Martijn W; Ronchetti, Inge; Miedema, Harald S; Koes, Bart W; Pool-Goudzwaard, Annelies

    2015-02-01

    This study investigates the clinical course of and prognostic factors for quality of life (Short Form 36 items Health survey (SF-36)) and global perceived effect (GPE) in patients treated for chronic non-specific low back pain at 5 and 12-months follow-up. Data from a prospective cohort (n = 1760) of a rehabilitation center were used, where patients followed a 2-months cognitive behavior treatment. The outcome 'improvement in quality of life (SF-36)' was defined as a 10% increase in score on the SF-36 at follow-up compared with baseline. On the GPE scale, patients who indicated to be 'much improved' were coded as 'clinically improved'. Multivariable logistic regression analysis included 23 baseline characteristics. At 5-months follow-up, scores on the SF-36 Mental Component Scale (SF-36; MCS) and the Physical Component Scale (SF-36; PCS) had increased from 46.6 (SD 10.3) to 50.4 (SD 9.8) and from 31.9 (SD 7.1) to 46.6 (SD 10.3), respectively. At 5-months follow-up, 53.0% of the patients reported clinical improvement (GPE) which increased to 60.3% at 12-months follow-up. The 10% improvement in quality of life (SF-36 MCS) at 5-months follow-up was associated with patient characteristics and psychological factors. At 5-months follow-up, the 10% improvement in quality of life (SF-36 PCS) and GPE was associated with patient characteristics, physical examination, work-related factors and psychological factors; for GPE, an association was also found with clinical status. At 12-months follow-up GPE was associated with patient characteristics, clinical status, physical examination and work-related factors. The next phase in this prognostic research is external validation of these results.

  8. ‘The COPD breathlessness manual’: a randomised controlled trial to test a cognitive-behavioural manual versus information booklets on health service use, mood and health status, in patients with chronic obstructive pulmonary disease

    Science.gov (United States)

    Howard, Claire; Dupont, Simon

    2014-01-01

    Background: Chronic obstructive pulmonary disease (COPD) is a costly long-term condition associated with frequent Accident and Emergency (A&E) and hospital admissions. Psychological difficulties and inadequate self-management can amplify this picture. Aims: To compare a cognitive-behavioural manual versus information booklets (IB) on health service use, mood and health status. Methods: Two hundred and twenty-two COPD patients were randomly allocated to receive either the COPD breathlessness manual (CM) or IB. They were instructed to work through their programme at home, over 5 weeks. Guidance from a facilitator was provided at an initial home visit plus two telephone call follow-ups. Results: After 12 months, total A&E visits had reduced by 42% in the CM group, compared with a 16% rise in the IB group. The odds of people in the IB group attending A&E 12 months post-intervention was 1.9 times higher than for the CM group (CI 1.05–3.53). Reduction in hospital admissions and bed days were greatest in the CM group. At 6 months, there were significantly greater improvements in anxiety (F (2,198)=5.612, P=0.004), depression (F (1.8,176.1)=10.697, P⩽0.001) and dyspnoea (F (2,198)=18.170, P⩽0.001) in the CM group. Estimated savings at 12 months were greatest in the CM group, amounting to £30k or £270 per participant. Conclusion: The COPD manual, which addresses physical and mental health, is a straightforward cost-effective intervention that is worth offering to COPD patients within primary or secondary care. PMID:25322078

  9. Chronic traumatic encephalopathy in an Iraqi war veteran with posttraumatic stress disorder who committed suicide.

    Science.gov (United States)

    Omalu, Bennet; Hammers, Jennifer L; Bailes, Julian; Hamilton, Ronald L; Kamboh, M Ilyas; Webster, Garrett; Fitzsimmons, Robert P

    2011-11-01

    Following his discovery of chronic traumatic encephalopathy (CTE) in football players in 2002, Dr. Bennet Omalu hypothesized that posttraumatic stress disorder (PTSD) in military veterans may belong to the CTE spectrum of diseases. The CTE surveillance at the Brain Injury Research Institute was therefore expanded to include deceased military veterans diagnosed with PTSD. The authors report the case of a 27-year-old United States Marine Corps (USMC) Iraqi war veteran, an amphibious assault vehicle crewman, who committed suicide by hanging after two deployments to Fallujah and Ramadi. He experienced combat and was exposed to mortar blasts and improvised explosive device blasts less than 50 m away. Following his second deployment he developed a progressive history of cognitive impairment, impaired memory, behavioral and mood disorders, and alcohol abuse. Neuropsychiatric assessment revealed a diagnosis of PTSD with hyperarousal (irritability and insomnia) and numbing. He committed suicide approximately 8 months after his honorable discharge from the USMC. His brain at autopsy appeared grossly unremarkable except for congestive brain swelling. There was no atrophy or remote focal traumatic brain injury such as contusional necrosis or hemorrhage. Histochemical and immunohistochemical brain tissue analysis revealed CTE changes comprising multifocal, neocortical, and subcortical neurofibrillary tangles and neuritic threads (ranging from none, to sparse, to frequent) with the skip phenomenon, accentuated in the depths of sulci and in the frontal cortex. The subcortical white matter showed mild rarefaction, sparse perivascular and neuropil infiltration by histiocytes, and mild fibrillary astrogliosis. Apolipoprotein E genotype was 3/4. The authors report this case as a sentinel case of CTE in an Iraqi war veteran diagnosed with PTSD to possibly stimulate new lines of thought and research in the possible pathoetiology and pathogenesis of PTSD in military veterans as part of

  10. [Reconstructive surgery of sequelae of compartment syndrome of the lower leg and/or foot. Presentation of a new classification].

    Science.gov (United States)

    Zwipp, H

    2008-10-01

    The sequelae of an undiagnosed insufficiently treated or unpreventable (by crush injury) compartment or postischemic syndrome, most often after lower leg fracture or popliteal artery injury, are caused by necrosis and contracture of the extrinsic foot muscles. Therefore claw toes, pes equinus or other forms, such as a severe pes equino varus related to the compartment involved will decide the kind of foot deformity. In cases of a combined compartment syndrome of the lower leg and foot, not only the extrinsic but also the intrinsic muscles especially the short flexors are involved, leading to extensive claw toeing of the hallux and the lesser toes as well. In the case of an isolated compartment syndrome of the foot one will see contracted hammer toes most often after open or third degree closed calcaneal fractures. A new classification of all the different deformities of the foot and ankle as sequelae of a compartment and/or postischemic syndrome, is introduced distinguishing 5 degrees of deformity. Between 1994 and 2006, a total of 66 patients with sequelae of a compartment and/or postischemic syndrome were treated at the Department of Trauma and Reconstructive Surgery of the University Hospital"Carl Gustav Carus" of the Technical University of Dresden. Patients with contract hammer toes after calcaneal fractures were seen most often (n=26). Another large group of 24 patients suffered from the sequelae of a compartment and/or postischemic syndrome of the extrinsic muscles of the superficial and deeper compartment of the flexor tendons, producing a severe pes equino varus. Less common (n=16) were the deformities caused by an isolated compartment syndrome, such as necrosis of the anterior tibialis, long extensor muscles, peroneal muscles or a combined compartment syndrome of the lower leg and foot.

  11. Hydrokinesitherapy program using the Halliwick method on strength endurance and flexibility in a person with poliomyelitis sequelae

    OpenAIRE

    Paulina Yesica Ochoa Martínez; Javier Arturo Hall López; Adriana Griselda Mateos Valenzuela

    2015-01-01

    This case study attempts to determine the effect of ahydrokinesitherapy program by means of the Halliwickmethod on physical fitness in a female aged 35 yearswith poliomyelitis sequelae. The intervention followedsixteen weeks of hydrokinesitherapy during 70 minutes,five times a week, where we carried out exercises fromthe Halliwick method. There was an assessment both be-fore and after the application. Strength endurance andflexibility were determined according to a senior fitnesstest protocol...

  12. Nutritional status and cognitive impairment in elderly.

    Science.gov (United States)

    Daradkeh, Ghazi; Essa, Musthafa M; Al-Adawi, S Samir; Koshy, Roopa P; Al-Asmi, Abdullah; Waly, Mostafa I

    2014-10-01

    The elderly population is increasing worldwide and it has been suggested that senior citizens will continue to constitute the bulk of the population in many countries. Nutritional status of senior citizens are adversely affected by their frailty, chronic condition and declining cognitive functioning. Conversely, malnourished elderly further deteriorate their frailty, chronic disease and cognitive functioning. The aim of this review article is to recognize the importance of nutritional assessment of elderly population particularly those with cognitive impairment. First part is to highlight characteristic cognitive impairment among senior citizens and the second one highlight t he background in which malnutrition is a factor that leads to increased risk of morbidity and mortality in the elderly. This review also highlight salgorithms for safeguarding nutritional status among senior citizen and focuses on importance of nutritional screening, assessment and early intervention for safeguarding further deterioration of elderly who are likely to prone to cognitive impairment.

  13. Visual cognition

    Energy Technology Data Exchange (ETDEWEB)

    Pinker, S.

    1985-01-01

    This collection of research papers on visual cognition first appeared as a special issue of Cognition: International Journal of Cognitive Science. The study of visual cognition has seen enormous progress in the past decade, bringing important advances in our understanding of shape perception, visual imagery, and mental maps. Many of these discoveries are the result of converging investigations in different areas, such as cognitive and perceptual psychology, artificial intelligence, and neuropsychology. This volume is intended to highlight a sample of work at the cutting edge of this research area for the benefit of students and researchers in a variety of disciplines. The tutorial introduction that begins the volume is designed to help the nonspecialist reader bridge the gap between the contemporary research reported here and earlier textbook introductions or literature reviews.

  14. The impact of otitis media on cognitive and educational outcomes.

    Science.gov (United States)

    Williams, Corinne J; Jacobs, Ann M

    2009-11-01

    Otitis media is a common disease in childhood that can adversely affect cognitive and educational outcomes. The literature in this area is equivocal, and findings may be influenced by research design. The impact of otitis media on individual children's development appears to depend on the inter-relationship between several factors. Children who have early-onset otitis media (under 12 months) are at high risk of developing long-term speech and language problems. Otitis media has been found to interact negatively with pre-existing cognitive or language problems. For biological or environmental reasons, some populations have a pattern of early onset, higher prevalence and episodes of longer duration; this pattern leads to a higher risk of long-term speech and language problems. These factors suggest that Indigenous children may be at higher risk of cognitive and educational sequelae than non-Indigenous children.

  15. Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: an observational prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Mario Cortina-Borja

    2010-10-01

    Full Text Available BACKGROUND: The effectiveness of prenatal treatment to prevent serious neurological sequelae (SNSD of congenital toxoplasmosis is not known. METHODS AND FINDINGS: Congenital toxoplasmosis was prospectively identified by universal prenatal or neonatal screening in 14 European centres and children were followed for a median of 4 years. We evaluated determinants of postnatal death or SNSD defined by one or more of functional neurological abnormalities, severe bilateral visual impairment, or pregnancy termination for confirmed congenital toxoplasmosis. Two-thirds of the cohort received prenatal treatment (189/293; 65%. 23/293 (8% fetuses developed SNSD of which nine were pregnancy terminations. Prenatal treatment reduced the risk of SNSD. The odds ratio for prenatal treatment, adjusted for gestational age at maternal seroconversion, was 0.24 (95% Bayesian credible intervals 0.07-0.71. This effect was robust to most sensitivity analyses. The number of infected fetuses needed to be treated to prevent one case of SNSD was three (95% Bayesian credible intervals 2-15 after maternal seroconversion at 10 weeks, and 18 (9-75 at 30 weeks of gestation. Pyrimethamine-sulphonamide treatment did not reduce SNSD compared with spiramycin alone (adjusted odds ratio 0.78, 0.21-2.95. The proportion of live-born infants with intracranial lesions detected postnatally who developed SNSD was 31.0% (17.0%-38.1%. CONCLUSION: The finding that prenatal treatment reduced the risk of SNSD in infected fetuses should be interpreted with caution because of the low number of SNSD cases and uncertainty about the timing of maternal seroconversion. As these are observational data, policy decisions about screening require further evidence from a randomized trial of prenatal screening and from cost-effectiveness analyses that take into account the incidence and prevalence of maternal infection. Please see later in the article for the Editors' Summary.

  16. The Clinical Study on 34 Admission Patients due to Sequela of Traffic Accident

    Directory of Open Access Journals (Sweden)

    No, Bu-Rae

    2006-06-01

    Full Text Available Objectives : The purpose of this study was to investigate the clinical progress of patients diagnosed as sequela of traffic accident. Methods : We studied 34 cases who were admitted in Semyung University Oriental Hospital from 1st, January, 2005 to the 31st, December, 2005. And we came to some conclusion about clinical tendencies as follows. Results and Conclusions : 1. Women had occupied more than men, and 14 persons in 20th were the most distribution of age. 2. In distribution of onset, less than 7 days was the most(58.8 %, followed by less then 28 days(20.6 %. 3. Most patients used western medical hospital(47.1 % and oriental medical hospital(44.1 % as primary hospital. 4. In chief complaint, cervical pain was most(32 cases, 94.1%, the others were low back pain(22 cases, 64.7 %, back pain(5 cases, 14.7 %, chest pain(5 cases, 14.7 %. 5. In treatment methods, acupuncture and physical therapy was most(33 cases, 97.1%, the others were Extract-med.(31 cases, 94.0%, electric-acupuncture(27 cases, 79.4%, Herb-med.(23 cases, 67.6%, Herb-acupuncture(l8 cases, 52.9% and Taping therapy(15 cases, 44.1%. 6. In hospital days, days was most(l5 cases, 44.1%, the other were 15-21days(l2 cases, 35.3%. over the 29 days(4 cases, 11.8% and 22-28 days(3 cases, 8.8%. 7. 34 patients were examined, and all cases were 'improved'. And statistically significance compared after-treatment with before-treatment group(p<0.005.

  17. EFFECT OF ACUPUNCTURE ON BLOOD OXYGEN FREE RADICAL AND NO LEVELS IN TREATMENT OF APOPLECTIC SEQUELAE

    Institute of Scientific and Technical Information of China (English)

    袁青; 马瑞玲; 靳瑞

    2003-01-01

    Objective: To observe the effect of acupuncture on blood oxygen free radical (OFR) and nitric oxide(NO) levels in the treatment of apoplectic sequelae. Methods: A total of 61 cases of apoplectic patients were subject-ed into this study and randomly divided into "JIN San Zhen" group (n=30) and control group (n=31). Blood lipid per-oxidase (LPO), superoxide dismutase (SOD), glutathione peroxidase(GSH-Px) and nitric oxide (NO) contents beforeand after acupuncture treatment were determined with radioimmunoassay. In both groups, acupuncture was given oncedaily, six times a week, with 4 weeks being a therapeutic course and with the interval between two weeks being aweek, 3 courses all together. In "JIN San Zhen" group, acupoints of "JIN San Zhen" were used predominately, whilein control group, scalp-point Motor Sensory Area (MS 8) was used as the main point. Results: Self-comparison showedthat after 3 courses of treatment, in both groups, LPO and NO levels decreased significantly ( P < 0.05 - 0.01 ), SODand GST-Px values increased considerably ( P< 0.05 - 0.01 ). Comparison between two groups indicated that the ef-fects of "JIN San Zhen" group are significantly superior to those of control group in raising blood SOD and GST-Px lev-els ( P< 0.05- 0.01 ) and in lowering blood NO content ( P< 0.01 ). Analysis on the correlation between the restora-tion of neural function and the changes of LPO, SOD and GST-Px levels suggested that the effect of acupuncture in im-proving neural function may be related to changes of the aforementioned indexes. Conclusion: Acupuncture therapy cansignificantly lower blood LPO and NO levels and evidently raise blood SOD and GST-Px levels in stroke patients.

  18. Treatment of chronic inflammatory demyelinating polyradiculoneuropathy.

    Science.gov (United States)

    Lehmann, Helmar C; Hughes, Richard A C; Hartung, Hans-Peter

    2013-01-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a sporadically occurring, acquired neuropathic condition of autoimmune origin with chronic progressive or relapsing-remitting disease course. CIDP is a treatable disorder; a variety of immunosuppressive and immunomodulatory agents are available to modify, impede, and even reverse the neurological deficits and sequelae that manifest in the course of the disease. However, in many cases CIDP is not curable. Challenges that remain in the treatment of CIDP patients are well recognized and include a remarkably individual heterogeneity in terms of disease course and treatment response as well as a lack of objective and feasible measures to predict and monitor the responsiveness to the available therapies. In this chapter an overview of the currently used drugs in the treatment of CIDP patients is given and some important and controversial issues that arise in the context of care for CIDP patients are discussed.

  19. Cognitive Performance and Cognitive Style.

    Science.gov (United States)

    International Journal of Behavioral Development, 1985

    1985-01-01

    Investigates (1) the relationships between cognitive performance and cognitive styles and predictive possibilities and (2) performance differences by sex, school, grade, and income in 92 Indian adolescents. Assessment measures included Liquid Conservation, Islands, Goat-Lion, Hanoi-Tower, Rabbits (Piagetian); Block Design (WISC-R); Paper Cutting…

  20. Cognitive Neuropsychology

    DEFF Research Database (Denmark)

    Starrfelt, Randi

    2012-01-01

    Traditionally, studies in cognitive neuropsychology have reported single cases or small groups of patients with seemingly selective impairments of specific cognitive processes or modules. Many studies, particularly older ones, have used simple and coarse tasks to show that patients are disproport......Traditionally, studies in cognitive neuropsychology have reported single cases or small groups of patients with seemingly selective impairments of specific cognitive processes or modules. Many studies, particularly older ones, have used simple and coarse tasks to show that patients...... for cognitive neuropsychology are opened up. The questions addressed in this symposium is whether the questions posed by cognitive neuropsychology are still relevant, and whether new methods can spark a new interest in the field, or if the time has passed when the observation of single and double dissociations...... in patients’ test performance can inform theories of (normal) cognitive function. In four talks, this symposium will present and discuss methods for investigating impairment patterns in neuropsychological patients: 1) a talk on basic assumptions and statistical methods in single case methodology; 2) a talk...

  1. [Long term evaluation of sensation sequelae of bipedicled digital advancement island flaps. Comparison of clinical and electrophysiological results. Apropos of 13 cases].

    Science.gov (United States)

    Milliez, P Y; Parain, D; Menard, J F; Magnier, P; Plot, E

    1994-06-01

    Thirteen homodigital bipedicle island flaps for digital pulp amputation were reviewed to allow a better evaluation of sensory sequelae. A clinical and electrophysiological study of the sensory score of the pulp were compared to the contralateral normal digit and expressed in relative values. Sensory sequelae, even minor, are constant. The summated scores of dynamic and static 2 point discrimination test, appeared correlated to the electrophysiological amplitude modulations. This result seems particularly interesting as it adds another test for the objective evaluation of sensitivity.

  2. Cognitive anthropology is a cognitive science.

    Science.gov (United States)

    Boster, James S

    2012-07-01

    Cognitive anthropology contributes to cognitive science as a complement to cognitive psychology. The chief threat to its survival has not been rejection by other cognitive scientists but by other cultural anthropologists. It will remain a part of cognitive science as long as cognitive anthropologists research, teach, and publish.

  3. Embodying cognition

    DEFF Research Database (Denmark)

    Martiny, Kristian Møller Moltke; Aggerholm, Kenneth

    2016-01-01

    During the last decades, research on cognition has undergone a reformation, which is necessary to take into account when evaluating the cognitive and behavioural aspects of therapy. This reformation is due to the research programme called Embodied Cognition (EC). Although EC may have become...... and CBT that could contribute to the development of theory and practice for both of them. We present a case-study of an EC-based model of intervention for working with self-control in cerebral palsy.We centre the results of the study and its discussion on how we should understand and work with self...

  4. Sexual function of women with chronic illness and cancer.

    Science.gov (United States)

    Basson, Rosemary

    2010-05-01

    Addressing the sexual sequelae of chronic disease and its treatment is now accepted as a fundamental part of healthcare. Most of the sexual effects of chronic disease are negative, and ongoing illness continues to modulate a woman's sexual self-image, energy and interest in sexual activity, as well as her ability to respond to sexual stimuli with pleasurable sensations, excitement, orgasm and freedom from pain with genital stimulation or intercourse. Nevertheless, for many women with chronic illness, sexuality remains extremely important despite the commonly associated fatigue and acquired sexual dysfunctions; sexual resilience can be substantial. Following recovery from cancer surgery, chemotherapy and radiation, prognosis can be excellent and a return to full health can often be expected, and yet, there may have been devastating changes to sexual function owing to the cancer treatment. Women with metastatic disease may still treasure sexual intimacy. Assessment and management of sexual dysfunction is therefore necessary in all women with chronic illness or past or present cancer.

  5. Near death experiences, cognitive function and psychological outcomes of surviving cardiac arrest.

    Science.gov (United States)

    Parnia, S; Spearpoint, K; Fenwick, P B

    2007-08-01

    Cardiac arrest is associated with a number of cognitive processes as well as long term psychological outcomes. Recent studies have indicated that approximately 10-20% of cardiac arrest survivors report cognitive processes, including the ability to recall specific details of their resuscitation from the period of cardiac arrest. In addition it has been demonstrated that these cognitive processes are consistent with the previously described near death experience and that those who have these experiences are left with long term positive life enhancing effects. There have also been numerous studies that have indicated that although the quality of life for cardiac arrest survivors is generally good, some are left with long term cognitive impairments as well as psychological sequelae such as post-traumatic stress disorder. This paper will review near death experiences, cognitive function and psychological outcomes in survivors of cardiac arrest.

  6. [Cognitive and emotional alterations in chronic insomnia].

    Science.gov (United States)

    Medrano-Martínez, Pablo; Ramos-Platón, María J

    2016-02-16

    Introduccion. Las alteraciones cognitivas y emocionales asociadas al insomnio cronico son poco conocidas. Desarrollo. Tras revisar la etiologia y fisiopatologia del insomnio cronico, considerando la vulnerabilidad a este y su heredabilidad, se describe el estado actual de conocimientos acerca de los deficits cognitivos y las alteraciones emocionales observados en el insomnio cronico. Conclusiones. La mayoria de los modelos etiologicos incluye factores que predisponen al insomnio, que lo precipitan y que lo mantienen. Los factores predisponentes pueden ser de tipo biologico o psicosocial. Un factor predisponente que desempeña un importante papel es la vulnerabilidad al insomnio, que se relaciona con un modo no adaptativo de afrontar el estres (centrado en la emocion en vez de en el problema) y la internalizacion de las emociones negativas, lo cual favorece un estado de hiperactivacion fisiologica, cognitiva y emocional que altera el sueño y puede desembocar en insomnio. Esta vulnerabilidad es en gran parte hereditaria. Se han descrito dos fenotipos, basados en la duracion objetiva del sueño, que difieren en la gravedad del trastorno. Los insomnes con duracion objetiva del sueño menor de seis horas presentan deficits cognitivos significativos. Estos se manifiestan en tareas que requieren gran cantidad de recursos cognitivos, tareas de atencion complejas, cambio de foco de atencion, proceso de consolidacion de la memoria durante el sueño y memoria operativa. Estos datos sugieren la existencia de una disfuncion prefrontal. Se da una alta comorbilidad entre insomnio y ansiedad-depresion. La ansiedad-depresion provocada por la internalizacion de las emociones predispone al insomnio, y este, a su vez, intensifica la depresion.

  7. Cognitive Changes

    Science.gov (United States)

    ... decline tend to occur in parallel as the disease progresses. Significant cognitive impairment in PD is often associated with: Caregiver distress Worse day-to-day function Diminished quality of life Poorer treatment outcomes Greater medical costs due to ...

  8. Spatial cognition

    Science.gov (United States)

    Kaiser, Mary Kister; Remington, Roger

    1988-01-01

    Spatial cognition is the ability to reason about geometric relationships in the real (or a metaphorical) world based on one or more internal representations of those relationships. The study of spatial cognition is concerned with the representation of spatial knowledge, and our ability to manipulate these representations to solve spatial problems. Spatial cognition is utilized most critically when direct perceptual cues are absent or impoverished. Examples are provided of how human spatial cognitive abilities impact on three areas of space station operator performance: orientation, path planning, and data base management. A videotape provides demonstrations of relevant phenomena (e.g., the importance of orientation for recognition of complex, configural forms). The presentation is represented by abstract and overhead visuals only.

  9. Cognitive Systems

    DEFF Research Database (Denmark)

    user models and user interaction models. Research in cognitive information processing is inherently multi-disciplinary and involves natural science and technical disciplines, e.g., control, automation, and robot research, physics and computer science, as well as humanities such as social sciences......The tutorial will discuss the definition of cognitive systems as the possibilities to extend the current systems engineering paradigm in order to perceive, learn, reason and interact robustly in open-ended changing environments. I will also address cognitive systems in a historical perspective...... and its relation and potential over current artificial intelligence architectures. Machine learning models that learn from data and previous knowledge will play an increasingly important role in all levels of cognition as large real world digital environments (such as the Internet) usually are too complex...

  10. Cognitive Robotics

    OpenAIRE

    Levesque, Hector J.; Lakemeyer, Gerhard

    2010-01-01

    This chapter is dedicated to the memory of Ray Reiter. It is also an overview of cognitive robotics, as we understand it to have been envisaged by him.1 Of course, nobody can control the use of a term or the direction of research. We apologize in advance to those who feel that other approaches to cognitive robotics and related problems are inadequately represented here.

  11. Long-term osseous sequelae after acute trauma of the knee joint evaluated by MRI

    Energy Technology Data Exchange (ETDEWEB)

    Roemer, F.W.; Bohndorf, K. [Department of Radiology, Klinikum Augsburg, Stenglinstrasse 2, 86152 Augsburg (Germany)

    2002-11-01

    articular surface injuries such as subchondral bone impaction or chondral/osteochondral fractures will heal without obvious osseous long-term sequelae. Post-traumatic osteonecrosis, as reported in the literature, must be a rare event after acute knee trauma. (orig.)

  12. Chronic cholecystitis

    Science.gov (United States)

    Cholecystitis - chronic ... Most of the time, chronic cholecystitis is caused by repeated attacks of acute (sudden) cholecystitis. Most of these attacks are caused by gallstones in the gallbladder. These ...

  13. Chronic Pain

    Science.gov (United States)

    ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. × ... pain. Psychotherapy, relaxation and medication therapies, biofeedback, and behavior modification may also be employed to treat chronic pain. ...

  14. Chronic Pain

    Science.gov (United States)

    ... a problem you need to take care of. Chronic pain is different. The pain signals go on ... there is no clear cause. Problems that cause chronic pain include Headache Low back strain Cancer Arthritis ...

  15. Monitoring and optimising cognitive function in cancer patients: Present knowledge and future directions

    Directory of Open Access Journals (Sweden)

    S.B. Schagen

    2014-06-01

    Full Text Available The potentially detrimental effects of cancer and related treatments on cognitive functioning are emerging as a key focus of cancer survivorship research. Many patients with central nervous system (CNS or non-CNS tumours develop cognitive problems during the course of their disease that can result in diminished functional independence. We review the state of knowledge on the cognitive functioning of patients with primary and secondary brain tumours at diagnosis, during and after therapy, and discuss current initiatives to diminish cognitive decline in these patients. Similarly, attention is paid to the cognitive sequelae of cancer and cancer therapies in patients without CNS disease. Disease and treatment effects on cognition are discussed, as well as current insights into the neural substrates and the mechanisms underlying cognitive dysfunction in these patients. In addition, rehabilitation strategies for patients with non-CNS disease confronted with cognitive dysfunction are described. Special attention is given to knowledge gaps in the area of cancer and cognition, in CNS and non-CNS diseases. Finally, we point to the important role for cooperative groups to include cognitive endpoints in clinical trials in order to accelerate our understanding and treatment of cognitive dysfunction related to cancer and cancer therapies.

  16. El deterioro cognitivo: un factor a tener en cuenta en la evaluación e intervención de pacientes con dolor crónico Cognitive impairment: a factor to consider in the assesment and intervention of chronic pain patients

    Directory of Open Access Journals (Sweden)

    B. Ojeda

    2011-10-01

    Full Text Available El dolor crónico constituye un grave problema de salud pública, dada su elevada prevalencia y las consecuencias personales y sociales que produce. La presencia de dolor crónico se ha asociado con un deterioro cognitivo leve, sobre todo en los pacientes afectados por fibromialgia o dolor neuropático, habiéndose relacionado esto con la concurrencia en estos pacientes, de otros procesos, como la ansiedad, la depresión, los trastornos del sueño y el consumo de ciertos fármacos, todos ellos habituales en los pacientes con dolor crónico. En esta revisión, hacemos un repaso del complejo proceso de la cognición así como de los distintos elementos que lo integran. Asimismo, revisamos los mecanismos mediante los que el dolor crónico puede afectar el proceso de la cognición y el modo en el que este puede verse afectado por la concurrencia de otras patologías, o por los fármacos habitualmente utilizados para su tratamiento. Finalmente se plantea la necesidad de evaluar el deterioro cognitivo en los pacientes con dolor crónico, con el objetivo de evitar la progresión de la enfermedad cognitiva hacia un cuadro de deterioro más grave, así como de contribuir a mejorar la respuesta terapéutica al dolor y el aumento de la calidad de vida de los pacientes.Chronic pain constitutes a serious public health problem due to its high prevalence and the social and personal consequences. The presence of chronic pain has been associated with mild cognitive impairment, especially in patients with fibromyalgia and neuropathic pain, and it has been also related with other disease like anxiety, depression, sleep disorders and the use of certain drugs, usually taken on these patients. This document revises the complex issue of the cognitive process and the several elements that comprise it. Likewise, we review the different mechanisms by which pain affect cognitive process and the way it could be affected by other disease, or by drugs commonly used on

  17. Cognitive Impairments Associated with CFS and POTS

    Directory of Open Access Journals (Sweden)

    Leonard A. Jason

    2013-05-01

    Full Text Available Chronic fatigue syndrome (CFS is characterized by fatigue, sleep dysfunction, and cognitive deficits (Fukuda et al., 1994. Research surrounding cognitive functioning among patients with CFS has found difficulty with memory, attention, and information processing. A similar disorder, postural tachycardia syndrome (POTS, is characterized by increased heart rate, fatigue, and mental cloudiness (Raj et al., 2009. Potential implications of cognitive deficits for patients with CFS and/or POTS are discussed, including difficulties with school and/or employment. A few biological theories (i.e., kindling, impairments in the central nervous system, and difficulty with blood flow have emerged as potential explanations for the cognitive deficits reported in both CFS and POTS Future research should continue to examine possible explanations for cognitive impairments in CFS and POTS, and ultimately use this information to try and reduce cognitive impairments for these patients.

  18. The woodchuck as an animal model for pathogenesis and therapy of chronic hepatitis B virus infection

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    This review describes the woodchuck and the woodchuck hepatitis virus (WHV) as an animal model for pathogenesis and therapy of chronic hepatitis B virus (HBV) infection and disease in humans. The establishment of woodchuck breeding colonies, and use of laboratory-reared woodchucks infected with defined WHV inocula, have enhanced our understanding of the virology and immunology of HBV infection and disease pathogenesis, including major sequelae like chronic hepatitis and hepatocellular carcinoma. The role of persistent WHV infection and of viral load on the natural history of infection and disease progression has been firmly established along the way. More recently, the model has shed new light on the role of host immune responses in these natural processes,and on how the immune system of the chronic carrier can be manipulated therapeutically to reduce or delay serious disease sequelae through induction of the recovery phenotype. The woodchuck is an outbred species and is not well defined immunologically due to a limitation of available host markers. However, the recent development of several key host response assays for woodchucks provides experimental opportunities for further mechanistic studies of outcome predictors in neonatal- and adult-acquired infections. Understanding the virological and immunological mechanisms responsible for resolution of self-limited infection, and for the onset and maintenance of chronic infection, will greatly facilitate the development of successful strategies for the therapeutic eradication of established chronic HBV infection. Likewise, the results of drug efficacy and toxicity studies in the chronic carrier woodchucks are predictive for responses of patients chronically infected with HBV. Therefore, chronic WHV carrier woodchucks provide a well-characterized mammalian model for preclinical evaluation of the safety and efficacy of drug candidates, experimental therapeutic vaccines, and immunomodulators for the treatment and

  19. Chronic prostatitis

    OpenAIRE

    Le, Brian; Schaeffer, Anthony J.

    2011-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome [CP/CPPS]). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  20. Chronic prostatitis

    OpenAIRE

    Erickson, Bradley A.; Schaeffer, Anthony J.; Le, Brian

    2008-01-01

    Chronic prostatitis can cause pain and urinary symptoms, and usually occurs without positive bacterial cultures from prostatic secretions (known as chronic abacterial prostatitis or chronic pelvic pain syndrome, CP/CPPS). Bacterial infection can result from urinary tract instrumentation, but the cause and natural history of CP/CPPS are unknown.

  1. Offloading Cognition onto Cognitive Technology

    CERN Document Server

    Dror, Itiel

    2008-01-01

    "Cognizing" (i.e., thinking, understanding, knowing, and having the capacity to do what cognizers can do) is a mental state. Systems without mental states, such as cognitive technology, can sometimes also do some of what cognizers can do, but that does not make them cognizers. Cognitive technology allows cognizers to offload some of the functions they would otherwise have had to execute with their own brains and bodies alone; it also extends cognizers' performance powers beyond those of brains and bodies alone. Language itself is a form of cognitive technology that allows cognizers to offload some of their brain functions onto the brains of other cognizers. Language also extends cognizers' individual and joint performance powers, distributing the load through interactive and collaborative cognition. Reading, writing, print, telecommunications and computing further extend cognizers' capacities. And now the web, with its distributed network of cognizers, digital databases and sofware agents, has become the Cogn...

  2. 慢性心力衰竭患者甲状腺激素水平与认知功能的相关性研究%Correlation between thyroid hormone and cognitive function in hospitalized patients with chronic heart failure

    Institute of Scientific and Technical Information of China (English)

    牛伟华; 李广平

    2016-01-01

    目的:探讨慢性心力衰竭(CHF)患者甲状腺激素(TH)水平与认知功能的关系。方法:便利抽取181例CHF患者,记录年龄、性别、文化程度、心衰病因、心衰病程等一般资料,测定空腹TH水平,采用蒙特利尔认知评估量表(MoCA)评估认知功能。根据MoCA评分将CHF患者分为认知功能障碍组(MoCA评分<26分)与认知功能正常组(MoCA评分≥26分),比较两组间TH水平的差异,同时探讨CHF患者TH与认知功能之间的关系。结果:CHF患者的认知功能总分为(24.99±2.81)分。认知功能障碍组比认知功能正常组血清游离三碘甲状腺原氨酸(FT3)水平低,差异有统计学意义(P<0.05)。相关分析显示:CHF患者FT3与认知功能总分、视空间与执行能力、注意力、定向得分呈正相关(P<0.05);血清游离甲状腺素(FT4)与视空间与执行能力得分呈正相关(P<0.05)。结论:CHF患者FT3水平的降低与认知功能障碍之间存在一定的相关性。%Objective:To investigate the relationship between thyroid hormone and cognitive function in hospitalized patients with chronic heart failure(CHF). Methods:A convenience sample of 181 hospitalized patients with CHF was selected to assess cognitive function using the Montreal Cognitive Assessment(MoCA). The levels of free three iodine thyroid original acid(FT3), free thyroxine(FT4)and thyroid stimulating hormone(TSH)were measured by chemical radiation immune method. The baseline clinical data were detected, including age, sex, education level, the cause of heart failured, and the course of disease. According to the MoCA scores, CHF patients were divided into normal cognitive function group and abnormal cognitive function group, respectively. The levels of TH between two groups were compared, and the relationship between TH and cognitive function was evaluated. Results:The total scores of cognitive function in patients with CHF

  3. Tumor necrosis factor alpha production from CD8+ T cells mediates oviduct pathological sequelae following primary genital Chlamydia muridarum infection.

    Science.gov (United States)

    Murthy, Ashlesh K; Li, Weidang; Chaganty, Bharat K R; Kamalakaran, Sangamithra; Guentzel, M Neal; Seshu, J; Forsthuber, Thomas G; Zhong, Guangming; Arulanandam, Bernard P

    2011-07-01

    The immunopathogenesis of Chlamydia trachomatis-induced oviduct pathological sequelae is not well understood. Mice genetically deficient in perforin (perforin(-/-) mice) or tumor necrosis factor alpha (TNF-α) production (TNF-α(-/-) mice) displayed comparable vaginal chlamydial clearance rates but significantly reduced oviduct pathology (hydrosalpinx) compared to that of wild-type mice. Since both perforin and TNF-α are effector mechanisms of CD8(+) T cells, we evaluated the role of CD8(+) T cells during genital Chlamydia muridarum infection and oviduct sequelae. Following vaginal chlamydial challenge, (i) mice deficient in TAP I (and therefore the major histocompatibility complex [MHC] I pathway and CD8(+) T cells), (ii) wild-type mice depleted of CD8(+) T cells, and (iii) mice genetically deficient in CD8 (CD8(-/-) mice) all displayed similar levels of vaginal chlamydial clearance but significantly reduced hydrosalpinx, compared to those of wild-type C57BL/6 mice, suggesting a role for CD8(+) T cells in chlamydial pathogenesis. Repletion of CD8(-/-) mice with wild-type or perforin(-/-), but not TNF-α(-/-), CD8(+) T cells at the time of challenge restored hydrosalpinx to levels observed in wild-type C57BL/6 mice, suggesting that TNF-α production from CD8(+) T cells is important for pathogenesis. Additionally, repletion of TNF-α(-/-) mice with TNF-α(+/+) CD8(+) T cells significantly enhanced the incidence of hydrosalpinx and oviduct dilatation compared to those of TNF-α(-/-) mice but not to the levels found in wild-type mice, suggesting that TNF-α production from CD8(+) T cells and non-CD8(+) cells cooperates to induce optimal oviduct pathology following genital chlamydial infection. These results provide compelling new evidence supporting the contribution of CD8(+) T cells and TNF-α production to Chlamydia-induced reproductive tract sequelae.

  4. A one-year observational study of all hospitalized acute poisonings in Oslo: complications, treatment and sequelae

    Directory of Open Access Journals (Sweden)

    Lund Cathrine

    2012-07-01

    Full Text Available Abstract Objectives Changes in poisoning trends may affect both complications and outcomes in patients with acute poisoning. This study reports the treatments given and the frequency of complications, also related to treatment, mortality and sequelae related to various toxic agents. Methods All acute poisonings in adults (≥16 years admitted to the five hospitals in Oslo were included consecutively during one year (2008 to 2009 in an observational cross-sectional multicenter study. A standardized form was completed by the treating physician, which covered the study aims. Results There were 1065 admissions in 912 patients. The median length of hospital stay was one day, and 49% were observed in an intensive care unit (ICU. Active treatment was given to 83%, and consisted of supportive therapy (70%, antidote(s (38%, activated charcoal (16% and gastric lavage (9%. The most commonly used antidotes were flumazenil (19%, naloxone (17% and N-acetylcysteine (11%. The rate of treatment-related complications was 2.4% (21/884. Neither flumazenil, naloxone, nor the combination, was associated with convulsions or other complications. Among those receiving N-acetylcysteine, 5% (6/120 developed allergic reactions, one of which mandated discontinuation of treatment. Nineteen percent presented in a coma. Complications developed in 30%, compared with 18% in a 2003 study, mainly respiratory depression (12%, prolonged QTc interval (6% and hypotension (5%. Eight patients died (0.8% and five (0.5% survived with permanent sequelae, mainly anoxic brain damage. Discussion Few patients stayed more than two days. The use of the ICU was liberal, considering that only one out of five presented in a coma. Antidotes were frequently given diagnostically. Although N-acetylcysteine induced allergic reactions, most were mild and treatment discontinuation was only necessary once. The frequency of complications had almost doubled in five years, although the poisoning pattern was

  5. Premature loss of primary anterior teeth due to trauma--potential short- and long-term sequelae.

    Science.gov (United States)

    Holan, Gideon; Needleman, Howard L

    2014-04-01

    Traumatic dental injuries (TDIs) can result in the premature loss of primary anterior teeth due to an immediate avulsion, extraction later after the injury because of poor prognosis or late complications, or early exfoliation. There are a number of potential considerations or sequelae as a result of this premature loss that have been cited in the dental literature, which include esthetics, quality of life, eating, speech development, arch integrity (space loss), development and eruption of the permanent successors, and development of oral habits. This article provides a comprehensive review of the dental literature on the possible consequences of premature loss of maxillary primary incisors following TDI.

  6. Calcified subdural haematomas associated with arrested hydrocephalus - late sequelae of shunt operation in infancy

    Energy Technology Data Exchange (ETDEWEB)

    Barmeir, E.P.; Stern, D.; Harel, S.; Holtzman M.; Krije, T.J.

    1985-08-01

    Calcified chronic subdural haematoms (SDH) and features of arrested (compensated) hydrocephalus were demonstrated by skull radiography and cranial computed tomography (CT) in two children who had no neurological deficit. Ventricular surgical drainage had been performed 8 and 11 years prior to admission and the haematomas remained subsequently undetected. The following presentation will serve to illustrate the characteristic radiological features of this entity, the issue of management, and includes a review of the literature.

  7. Psychiatric Sequelae of Organophosphorous Poisoning: A Case Study and Review of the Literature

    Directory of Open Access Journals (Sweden)

    R. H. Bradwell

    1994-01-01

    Full Text Available This is the case of a young farm worker presenting with episodes of acute organic psychosis superimposed on a state of chronic anergy and hypersomnia. It is suggested that he developed an encephalopathic illness presenting with an organic bipolar affective disorder as a result of organophosphate exposure. In proposing this aetiology, an hypothesis is developed which links clinical observations and investigative results with research findings in relation to organophosphorus compounds and neuropharmacology.

  8. Chronic Pituitary Failure Resembling Sheehan's Syndrome Following a Bite of Russell's Viper. A Case Report.

    Science.gov (United States)

    Srinivasan, K G; Srividya, S; Usha Nandhini, K P; Ramprabananth, S

    2010-03-01

    Hypopituitarism can be the sequela of a variety of causes like postpartum pituitary necrosis or Sheehan's syndrome, lymphocytic hypophysitis, trauma and encephalitis. A very rare cause is envenomation by a bite of a Russell's viper. Very few cases with documented imaging findings of chronic pituitary failure resulting from snake bite have been reported. We describe a case of hypopituitarism with clinical, endocrine and magnetic resonance (MR) imaging studies occurring as a delayed complication of snake bite.

  9. Imaging changes associated with cognitive abnormalities in Parkinson's disease.

    Science.gov (United States)

    Koshimori, Yuko; Segura, Barbara; Christopher, Leigh; Lobaugh, Nancy; Duff-Canning, Sarah; Mizrahi, Romina; Hamani, Clement; Lang, Anthony E; Aminian, Kelly; Houle, Sylvain; Strafella, Antonio P

    2015-07-01

    The current study investigates both gray and white matter changes in non-demented Parkinson's disease (PD) patients with varying degrees of mild cognitive deficits and elucidates the relationships between the structural changes and clinical sequelae of PD. Twenty-six PD patients and 15 healthy controls (HCs) were enrolled in the study. Participants underwent T1-weighted and diffusion tensor imaging (DTI) scans. Their cognition was assessed using a neuropsychological battery. Compared with HCs, PD patients showed significant cortical thinning in sensorimotor (left pre- and postcentral gyri) and cognitive (left dorsolateral superior frontal gyrus [DLSFG]) regions. The DLSFG cortical thinning correlated with executive and global cognitive impairment in PD patients. PD patients showed white matter abnormalities as well, primarily in bilateral frontal and temporal regions, which also correlated with executive and global cognitive impairment. These results seem to suggest that both gray and white matter changes in the frontal regions may constitute an early pathological substrate of cognitive impairment of PD providing a sensitive biomarker for brain changes in PD.

  10. Cognitive linguistics.

    Science.gov (United States)

    Evans, Vyvyan

    2012-03-01

    Cognitive linguistics is one of the fastest growing and influential perspectives on the nature of language, the mind, and their relationship with sociophysical (embodied) experience. It is a broad theoretical and methodological enterprise, rather than a single, closely articulated theory. Its primary commitments are outlined. These are the Cognitive Commitment-a commitment to providing a characterization of language that accords with what is known about the mind and brain from other disciplines-and the Generalization Commitment-which represents a dedication to characterizing general principles that apply to all aspects of human language. The article also outlines the assumptions and worldview which arises from these commitments, as represented in the work of leading cognitive linguists. WIREs Cogn Sci 2012, 3:129-141. doi: 10.1002/wcs.1163 For further resources related to this article, please visit the WIREs website.

  11. Ankle fusion with a retrograde locked intramedullary nail for sequela of lower extremity compartment syndrome

    Institute of Scientific and Technical Information of China (English)

    WANG Xu; MA Xin; ZHANG Chao; HUANG Jia-zhang; GU Xiang-jie; JIANG Jian-yuan

    2012-01-01

    Objective: To assess the value of ankle fusion with a retrograde locked intramedullary nail in the treatment of sequela of lower extremity compartment syndrome.Methods:Thirty-five cases of equinus deformity following tibiofibular compartment syndrome treated by means of ankle fusion with a retrograde locked intramedullary nail from January 2001 to December 2010 were retrospectively reviewed.The complications,the time needed for bony fusion of the ankle joint assessed by anteroposterior and lateral X-ray photographs as well as patients' subjective evaluation were recorded and analysed.Results: Among the 35 patients,15 had previously undergone surgical treatment twice on the same limb,13 had thrice and 7 had to be operated on four times before ankle fusion.An anterior midpoint approach to the ankle joint was adopted in 29 cases,while anterior midpoint approach plus a small incision on the posterior ankle joint was made in 17 cases,whereas lateral approach in 6 cases.Tarsus joint fusion was performed on 4 cases.The follow-up period ranged 6-124 months,averaged 40.6 months.Bone grafting was not performed in this series.Preoperative tibial shaft fracture occurred in one patient and was healed after conservative treatment.Incision dehiscence located at previous Achilles tendon incision was found in two patients.As a result,one received an intramedullary nail emplacement at calcaneoplantar part while the wound at anterosuperior part of the other one was healed by dressing change.Two patients failed to bony union 5 months postoperatively,in which one healed 10 weeks after retrieval of proximal tibial nail and another by iliac grafting.Terminal necrosis of the toe due to blood supply dysfunction was not found in this series.All the patients were satisfied with the ankle joint function postoperatively.The time for bony union on X-rays was 9.8 weeks on average.Except for one patient who demanded removal of intramedullary nail,all the intramedullary nails were not retrieved at

  12. Cognitive fitness.

    Science.gov (United States)

    Gilkey, Roderick; Kilts, Clint

    2007-11-01

    Recent neuroscientific research shows that the health of your brain isn't, as experts once thought, just the product of childhood experiences and genetics; it reflects your adult choices and experiences as well. Professors Gilkey and Kilts of Emory University's medical and business schools explain how you can strengthen your brain's anatomy, neural networks, and cognitive abilities, and prevent functions such as memory from deteriorating as you age. The brain's alertness is the result of what the authors call cognitive fitness -a state of optimized ability to reason, remember, learn, plan, and adapt. Certain attitudes, lifestyle choices, and exercises enhance cognitive fitness. Mental workouts are the key. Brain-imaging studies indicate that acquiring expertise in areas as diverse as playing a cello, juggling, speaking a foreign language, and driving a taxicab expands your neural systems and makes them more communicative. In other words, you can alter the physical makeup of your brain by learning new skills. The more cognitively fit you are, the better equipped you are to make decisions, solve problems, and deal with stress and change. Cognitive fitness will help you be more open to new ideas and alternative perspectives. It will give you the capacity to change your behavior and realize your goals. You can delay senescence for years and even enjoy a second career. Drawing from the rapidly expanding body of neuroscience research as well as from well-established research in psychology and other mental health fields, the authors have identified four steps you can take to become cognitively fit: understand how experience makes the brain grow, work hard at play, search for patterns, and seek novelty and innovation. Together these steps capture some of the key opportunities for maintaining an engaged, creative brain.

  13. Cognitive maps

    DEFF Research Database (Denmark)

    Minder, Bettina; Laursen, Linda Nhu; Lassen, Astrid Heidemann

    2014-01-01

    . Conceptual clustering is used to analyse and order information according to concepts or variables from within the data. The cognitive maps identified are validated through the comments of some of the same experts. The study presents three cognitive maps and respective world-views explaining how the design...... and innovation field are related and under which dimensions they differ. The paper draws preliminary conclusions on the implications of the different world- views on the innovation process. With the growing importance of the design approach in innovation e.g. design thinking, a clear conception...

  14. The school inclusion and use of assistive technology with myelomeningocele sequelae students: a view of the teachers

    Directory of Open Access Journals (Sweden)

    Caroline Penteado Assis

    2011-06-01

    Full Text Available Myelomeningocele is a congenital malformation that affects the fetus during pregnancy. It can causes numerous consequences for the development of the child and consequently in their schooling process. So, there are several challenges that can be experienced by these children in their inclusion at school. The use of assistive technology in the school context has been implanted with goal to high from the functional abilities of these students. In Brazil are conducted a lot of studies to know the reality of children with myelomeningocele. Therefore, the goal of this study was to investigate, from the teacher ́s perspective of regular and multifunctional class, as was the process of schooling for students with myelomeningocele sequelae and resource utilization of assistive technology in the school context. The participants of this research were seven teachers and four students with myelomeningocele sequels enclosed in regular scholl.The researcher confectioned the instruments used in interviews. Data were analyzed using content of interview analysis. The results reveal that there are present challenges for inclusion of students with myelomeningocele sequelae and that teachers did not use assistive technology resources at school. It is considered that for the real practice of educational inclusion of these students the knowledge about meningomyelocele and various technologies that can be used in the school context must be published.

  15. Psychological sequelae of the station nightclub fire: Comparing survivors with and without physical injuries using a mixed-methods analysis.

    Directory of Open Access Journals (Sweden)

    Nhi-Ha T Trinh

    Full Text Available Surveying survivors from a large fire provides an opportunity to explore the impact of emotional trauma on psychological outcomes.This is a cross-sectional survey of survivors of The Station Fire. Primary outcomes were post-traumatic stress (Impact of Event Scale - Revised and depressive (Beck Depression Inventory symptoms. Linear regression was used to examine differences in symptom profiles between those with and without physical injuries. The free-response section of the survey was analyzed qualitatively to compare psychological sequelae of survivors with and without physical injuries.104 participants completed the study survey; 47% experienced a burn injury. There was a 42% to 72% response rate range. The mean age of respondents was 32 years, 62% were male, and 47% experienced a physical injury. No significant relationships were found between physical injury and depressive or post-traumatic stress symptom profiles. In the qualitative analysis, the emotional trauma that survivors experienced was a major, common theme regardless of physical injury. Survivors without physical injuries were more likely to experience survivor guilt, helplessness, self-blame, and bitterness. Despite the post-fire challenges described, most survivors wrote about themes of recovery and renewal.All survivors of this large fire experienced significant psychological sequelae. These findings reinforce the importance of mental health care for all survivors and suggest a need to understand factors influencing positive outcomes.

  16. Tibial lengthening over humeral and tibial intramedullary nails in patients with sequelae of poliomyelitis: a comparative study.

    Science.gov (United States)

    Chen, Daoyun; Chen, Jianmin; Jiang, Yao; Liu, Fanggang

    2011-06-01

    Leg discrepancy is common after poliomyelitis. Tibial lengthening is an effective way to solve this problem. It is believed lengthening over a tibial intramedullary nail can provide a more comfortable lengthening process than by the conventional technique. However, patients with sequelae of poliomyelitis typically have narrow intramedullary canals allowing limited space for inserting a tibial intramedullary nail and Kirschner wires. To overcome this problem, we tried using humeral nails instead of tibial nails in the lengthening procedure. In this study, we used humeral nails in 20 tibial lengthening procedures and compared the results with another group of patients who were treated with tibial lengthening over tibial intramedullary nails. The mean consolidation index, percentage of increase and external fixation index did not show significant differences between the two groups. However, less blood loss and shorter operating time were noted in the humeral nail group. More patients encountered difficulty with the inserted intramedullary nail in the tibial nail group procedure. The complications did not show a statistically significant difference between the two techniques on follow-up. In conclusion, we found the humeral nail lengthening technique was more suitable in leg discrepancy patients with sequelae of poliomyelitis.

  17. Magnetic Resonance Imaging Findings in Chronic Carbon Monoxide Intoxication

    Energy Technology Data Exchange (ETDEWEB)

    Durak, A. C.; Coskun, A.; Yikilmaz, A.; Erdogan, F.; Mavili, E.; Guven, M. [Hospital of Erciyes Univ., Kayseri (Turkey). Dept. of Radiology

    2005-05-01

    Purpose: To define the cranial magnetic resonance imaging (MRI) features of the chronic stage of carbon monoxide (CO) poisoning in patients with and without neuropsychiatric sequelae. Material and Methods: Eight patients who had neither symptoms nor neurological sequelae and eight patients with neuropsychiatric sequelae were included in the study. Patients aged between 9 to 57 (mean 32.2 years). All patients had been comatose at initial admittance and awoke after normobaric 100% oxygen therapy within 1-7 days. In this study, the patients were being examined with routine cranial MRI between 1 and 10 years (mean 3.4 years) after exposure to CO. Results: The most common finding was bilateral symmetric hyperintensity of the white matter, which was more significant in the centrum semiovale, with relative sparing of the temporal lobes and anterior parts of the frontal lobes on T2-weighted and FLAIR images in all patients. Cerebral cortical atrophy was seen in 10 patients; mild atrophy of cerebellar hemispheres in 8; and vermian atrophy in 11. Corpus callosum was atrophic in one patient. Bilateral globus pallidus lesions were seen in three patients. The lesions were hypointense on T1-weighted images and hyperintense on T2-weighted and FLAIR images. Conclusion: Patients with severe CO intoxication may develop persistent cerebral changes independently of their neuropsychiatric findings in the chronic stage. They may present with characteristic MRI findings as described here, even if asymptomatic. The history of CO exposure is therefore helpful for recognizing and interpreting the MRI findings of chronic stage CO intoxication.

  18. Aberrant hippocampal neurogenesis contributes to epilepsy and associated cognitive decline.

    Science.gov (United States)

    Cho, Kyung-Ok; Lybrand, Zane R; Ito, Naoki; Brulet, Rebecca; Tafacory, Farrah; Zhang, Ling; Good, Levi; Ure, Kerstin; Kernie, Steven G; Birnbaum, Shari G; Scharfman, Helen E; Eisch, Amelia J; Hsieh, Jenny

    2015-03-26

    Acute seizures after a severe brain insult can often lead to epilepsy and cognitive impairment. Aberrant hippocampal neurogenesis follows the insult but the role of adult-generated neurons in the development of chronic seizures or associated cognitive deficits remains to be determined. Here we show that the ablation of adult neurogenesis before pilocarpine-induced acute seizures in mice leads to a reduction in chronic seizure frequency. We also show that ablation of neurogenesis normalizes epilepsy-associated cognitive deficits. Remarkably, the effect of ablating adult neurogenesis before acute seizures is long lasting as it suppresses chronic seizure frequency for nearly 1 year. These findings establish a key role of neurogenesis in chronic seizure development and associated memory impairment and suggest that targeting aberrant hippocampal neurogenesis may reduce recurrent seizures and restore cognitive function following a pro-epileptic brain insult.

  19. Cognitive remission

    DEFF Research Database (Denmark)

    Bortolato, Beatrice; Miskowiak, Kamilla W; Köhler, Cristiano A

    2016-01-01

    dysfunction in MDD. Several other novel agents may be repurposed as cognitive enhancers for MDD treatment, including minocycline, insulin, antidiabetic agents, angiotensin-converting enzyme inhibitors, S-adenosyl methionine, acetyl-L-carnitine, alpha lipoic acid, omega-3 fatty acids, melatonin, modafinil...

  20. Cognitive Science.

    Science.gov (United States)

    Cocking, Rodney R.; Mestre, Jose P.

    The focus of this paper is on cognitive science as a model for understanding the application of human skills toward effective problem-solving. Sections include: (1) "Introduction" (discussing information processing framework, expert-novice distinctions, schema theory, and learning process); (2) "Application: The Expert-Novice…

  1. Moral Cognition

    NARCIS (Netherlands)

    Schleim, Stephan; Clausen, Jens; Levy, Neil

    2015-01-01

    Research on moral cognition is a growing and heavily multidisciplinary field. This section contains chapters addressing foundational psychological, neuroscientific, and philosophical issues of research on moral decision-making. Further- more, beyond summarizing the state of the art of their respecti

  2. Chronic inflammatory demyelinating polyneuropathy in common variable immunodeficiency.

    Science.gov (United States)

    Özdemir, Özlem; Okan, Mehmet S; Kilic, Sara S

    2012-04-01

    Common variable immunodeficiency comprises a heterogeneous group of primary antibody deficiencies with complex clinical and immunologic phenotypes. Immune dysregulation leads to the generation of multiple autoantibodies against various antigenic targets in patients with common variable immunodeficiency. Chronic inflammatory demyelinating polyneuropathy is a heterogeneous disorder that indicates an autoimmune response against peripheral nerve myelin. We describe a 7-year-old girl with common variable immunodeficiency who developed chronic inflammatory polyneuropathy. A 5-day course of intravenous immunoglobulin (500 mg/kg/day) improved her neurologic disorder. Chronic inflammatory demyelinating polyneuropathy should be added to the broadening spectrum of neurologic complications in common variable immunodeficiency. Early detection and consequent treatment may reverse the neurologic sequelae.

  3. Cognitive adaptation to nonmelanoma skin cancer.

    Science.gov (United States)

    Czajkowska, Zofia; Radiotis, George; Roberts, Nicole; Körner, Annett

    2013-01-01

    Taylor's (1983) cognitive adaptation theory posits that when people go through life transitions, such as being diagnosed with a chronic disease, they adjust to their new reality. The adjustment process revolves around three themes: search for positive meaning in the experience or optimism, attempt to regain a sense of mastery in life, as well as an effort to enhance self-esteem. In the sample of 57 patients with nonmelanoma skin cancer the Cognitive Adaptation Index successfully predicted participants' distress (p accounting for 60% of the variance and lending support for the Taylor's theory of cognitive adaptation in this population.

  4. Potential of Cognitive Computing and Cognitive Systems

    Science.gov (United States)

    Noor, Ahmed K.

    2014-11-01

    Cognitive computing and cognitive technologies are game changers for future engineering systems, as well as for engineering practice and training. They are major drivers for knowledge automation work, and the creation of cognitive products with higher levels of intelligence than current smart products. This paper gives a brief review of cognitive computing and some of the cognitive engineering systems activities. The potential of cognitive technologies is outlined, along with a brief description of future cognitive environments, incorporating cognitive assistants - specialized proactive intelligent software agents designed to follow and interact with humans and other cognitive assistants across the environments. The cognitive assistants engage, individually or collectively, with humans through a combination of adaptive multimodal interfaces, and advanced visualization and navigation techniques. The realization of future cognitive environments requires the development of a cognitive innovation ecosystem for the engineering workforce. The continuously expanding major components of the ecosystem include integrated knowledge discovery and exploitation facilities (incorporating predictive and prescriptive big data analytics); novel cognitive modeling and visual simulation facilities; cognitive multimodal interfaces; and cognitive mobile and wearable devices. The ecosystem will provide timely, engaging, personalized / collaborative, learning and effective decision making. It will stimulate creativity and innovation, and prepare the participants to work in future cognitive enterprises and develop new cognitive products of increasing complexity. http://www.aee.odu.edu/cognitivecomp

  5. Intervenção fisioterapêutica nas sequelas de drenagem linfática manual iatrogênica: relato de caso Physical therapy in sequelae of iatrogenic manual lymphatic drainage: a case report

    Directory of Open Access Journals (Sweden)

    Rogério Eduardo Tacani

    2011-06-01

    Full Text Available Atualmente, a drenagem linfática manual (DLM é um dos recursos de grande destaque no tratamento de edemas, linfedemas e condições inestéticas, porém, na prática clínica têm-se observado sua aplicação de forma iatrogênica. Os objetivos deste relato de caso foram apontar as sequelas da aplicação iatrogênica da DLM, em uma jovem caucasiana, e verificar os efeitos da intervenção fisioterapêutica no tratamento dessas. Voluntária de 27 anos, apresentava-se com uma equimose importante na região lateral da coxa esquerda (28 x 9,5 cm, telangiectasias, microvaricosidades e petéquias em ambas as coxas e pernas, dor de forte intensidade e edema, após ter se submetido a um procedimento manual iatrogênico com finalidade estética há dois dias. As condutas fisioterapêuticas adotadas foram: Ultrassom 3 MHz, pulsado (2 ms on, 8 ms off, 0,4 W/cm² SATP na região da equimose e DLM (Método Leduc durante 20 minutos, na coxa esquerda. Foram realizadas nove sessões até a alta no 16º dia pós-lesão, observando-se apenas a redução gradativa da dor e da equimose. Verificou-se a efetividade da intervenção fisioterapêutica em apenas algumas das sequelas provocadas pela iatrogenia, sem desconsiderar que a remissão espontânea dos sinais e sintomas também pode ter contribuído para tal. Destaca-se a importância de conscientizar os fisioterapeutas que atuam com este procedimento para que o aplique de forma adequada, evitando tais iatrogenias.Recently, the manual lymphatic drainage (MLD is an important resource in the treatment of edemas, lymphedemas, and other unaesthetic conditions. However, problems caused by the incorrect application of this therapy have been observed in the clinical practice. The aims of this case report were to describe sequelae resulting from the negligent application of MLD on a young patient, and to determine the effects of physical therapy on the treatment of sequelae. A 27-year-old Caucasian woman presented

  6. Podem as escalas preditivas de mortalidade ser utilizadas para prever a ocorrência de sequelas nos sobreviventes de cuidados intensivos?

    OpenAIRE

    Oom, Paulo

    2014-01-01

    Introdução: Não existem disponíveis escalas capazes de prever a ocorrência de sequelas nos sobreviventes de cuidados intensivos.Objectivos: Foram objectivos deste estudo avaliar o desempenho das escalas preditivas de mortalidade na previsão da ocorrência de sequelas nas crianças que sobrevivem ao internamento em unidades de cuidados intensivos. Métodos: Estudo prospectivo que decorreu numa unidade de cuidados intensivos de pediatria de um hospital universitário durante um período de 21 meses....

  7. [Chronicity, chronicization, systematization of delusions].

    Science.gov (United States)

    Trapet, P; Fernandez, C; Galtier, M C; Gisselmann, A

    1984-05-01

    Chronicity in psychopathology is indicative of a term, a decay. Chronicization only leads the way to this term. Here, chronicization is taken literally as an inscription in the time course of delusions. The mechanism of systematization seems to be a central mark in the approach to chronic delusions. It is not an alienation or an irreversible closing but an attempted accommodation with reality in the life of psychotic subjects, irrespective of the delusional structure. The role of therapy and drug treatment as a follow-up may in that case assume another meaning.

  8. Polycystic ovary syndrome: a common hormonal condition with major metabolic sequelae that physicians should know about.

    Science.gov (United States)

    Shorakae, S; Boyle, J; Teede, H

    2014-08-01

    Polycystic ovary syndrome (PCOS) is a prevalent, chronic and heterogeneous endocrine condition, with reproductive, metabolic and psychological features. Insulin resistance and hyperandrogenaemia are the key pathophysiological hormonal abnormalities. Insulin resistance is a significant contributor to the reproductive and metabolic complications of PCOS, both independently and in the setting of excess bodyweight. While the diagnostic criteria are now internationally uniformly accepted, individual components of the criteria are ill-defined, making diagnosis challenging. This, along with low awareness of PCOS, has resulted in a significant proportion of women remaining undiagnosed. While reproductive features are best recognised in PCOS and form the basis of the diagnostic criteria, awareness of psychological and metabolic features, recommended screening protocols, and management strategies to prevent metabolic complications are important. In this review, we focus on diagnostic criteria, and reproductive, metabolic and psychological features of PCOS, as well as recommended screening and management strategies suggested by national and international evidence-based guidelines.

  9. New Developments in Intimate Partner Violence and Management of Its Mental Health Sequelae.

    Science.gov (United States)

    Stewart, Donna E; Vigod, Simone; Riazantseva, Ekaterina

    2016-01-01

    Intimate partner violence (IPV) is a global public health and human rights problem that causes physical, sexual and psychological harms to men and women. IPV includes physical aggression, sexual coercion, psychological abuse and/or controlling behaviours perpetrated by a current or previous intimate partner in a heterosexual or same-sex relationship. IPV affects both men and women, but women are disproportionately affected with nearly one third reporting IPV during their lifetime. Physical and sexual harms from IPV include injury, increased risk for sexually transmitted diseases, pregnancy complications and sometimes death. Psychological consequences include depression, anxiety, posttraumatic stress disorder, substance abuse, impulsivity and suicidality and non-specific physical complaints thought to be related to the traumatic nature and chronic stress of IPV. Children who witness IPV are also negatively impacted in the short and long term. This paper reviews prevalence, risk factors, adverse effects and current evidence-based mental health treatment advice for IPV victims.

  10. Cognitive disorders after sporadic ecstasy use? A case report

    NARCIS (Netherlands)

    Ruis, Carla; Postma, Albert; Bouvy, Willem; van der Ham, Ineke

    2015-01-01

    Memory problems and changes in hippocampal structures after chronic ecstasy use are well described in the literature. Cognitive problems after incidental ecstasy use are rare, and the few patients described in case reports returned to their normal cognitive level after a relative short period. FV is

  11. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M.; Froeling, Fieke EM

    2008-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas owing to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects 3–9 people in 100,000; 70% of cases are alcohol-induced.

  12. Chronic pancreatitis

    OpenAIRE

    Kocher, Hemant M.; Kadaba, Raghu

    2011-01-01

    Chronic pancreatitis is characterised by long-standing inflammation of the pancreas due to a wide variety of causes, including recurrent acute attacks of pancreatitis. Chronic pancreatitis affects between 3 and 9 people in 100,000; 70% of cases are alcohol-induced.

  13. Cognitive impairment in chronic obstructive pulmonary disease and its relation to depression、anxiety and BODE index%慢性阻塞性肺疾病患者认知功能与抑郁、焦虑及BODE指数的关系

    Institute of Scientific and Technical Information of China (English)

    袁娜娜; 陈余清

    2015-01-01

    目的::了解慢性阻塞性肺疾病( COPD)患者的认知功能状况,并探讨其认知功能和抑郁、焦虑及BODE指数的关系。方法:选取COPD患者53例( COPD组)和同期健康体检者49名(对照组),分别进行认知功能及抑郁、焦虑状态测定,比较2组认知功能及抑郁、焦虑差异。并对COPD组进行BODE指数测定,分析COPD组认知功能和抑郁、焦虑及BODE指数的关系。结果:COPD组认知功能评分较对照组明显下降(P<0.01),COPD组抑郁、焦虑评分均较对照组明显升高(P<0.01)。将COPD组按照认知功能评分(24分为界值)分为认知正常组和认知障碍组,认知障碍组抑郁、焦虑及BODE指数评分均较认知正常组增高(P<0.01),COPD组认知功能与焦虑、抑郁及BODE指数总分均呈负相关关系(P<0.01)。结论:COPD患者认知功能和抑郁、焦虑及BODE指数密切相关。%Objective:To investigate the relationships between cognitive function,depression,anxiety and BODE index( including body mass index,airflow obstruction,dyspnea and exercise capacity index) in patients with chronic obstructive pulmonary disease( COPD) . Methods:In the cross-sectional study method,53 patients diagnosed as COPD were evaluated for cognitive function,depression,anxiety and BODE scores,49 normal health controls were evaluated for cognitive function,depression,anxiety scores. The differences of COPD group and control group in cognitive function and depression, anxiety were analyzed. The relationship between cognitive function and depression,anxiety and BODE index in COPD group were analyzed. Results:Compared with control group,cognitive function in COPD group decreased significantly(P<0. 01)and the depression and anxiety scores of COPD group all increased significantly(P<0. 01). Compared with COPD patients without cognitive impairment,the scores of depression,anxiety and BODE index of COPD patients with cognitive impairment all increased significantly(P<0. 01). The

  14. Does childhood diarrhea influence cognition beyond the diarrhea-stunting pathway?

    Directory of Open Access Journals (Sweden)

    Christa L Fischer Walker

    Full Text Available BACKGROUND: Diarrhea is a leading cause of morbidity among children under 5 years of age in low- and middle-income countries yet the additional effects and sequelae, such as cognitive impairment associated with diarrhea, have not been quantified. METHODS: We quantified the association between diarrhea prevalence and cognitive outcomes while controlling for linear growth in 4 study populations. Cognition was assessed using different methods across sites and was expressed in standardized units. We built linear regression models for each study with standardized cognitive score as the outcome and diarrhea prevalence as the main predictor variable. We then conducted meta-analyses of the regression coefficients to generate pooled estimates of the association between diarrhea prevalence and cognition whilst controlling for anthropometric status and other covariates. RESULTS: Diarrhea was not a significant predictor of cognitive score in any site in the regression models or in the meta-analyses (Coefficient = 0.07; 95% CI: -0.1, 0.2. The length for age Z- score was negatively related to cognition in all sites (0.18; 95% CI: 0.14, 0.21, with coefficients remarkably similar across sites (Coefficient Range: 0.168-0.186. CONCLUSIONS: We did not demonstrate an association between diarrhea and cognition with stunting included in the model. The links between diarrhea, stunting, and cognition provide additional rationale for accelerating interventions to reduce diarrhea.

  15. Adjusting to Chronic Health Conditions.

    Science.gov (United States)

    Helgeson, Vicki S; Zajdel, Melissa

    2017-01-03

    Research on adjustment to chronic disease is critical in today's world, in which people are living longer lives, but lives are increasingly likely to be characterized by one or more chronic illnesses. Chronic illnesses may deteriorate, enter remission, or fluctuate, but their defining characteristic is that they persist. In this review, we first examine the effects of chronic disease on one's sense of self. Then we review categories of factors that influence how one adjusts to chronic illness, with particular emphasis on the impact of these factors on functional status and psychosocial adjustment. We begin with contextual factors, including demographic variables such as sex and race, as well as illness dimensions such as stigma and illness identity. We then examine a set of dispositional factors that influence chronic illness adjustment, organizing these into resilience and vulnerability factors. Resilience factors include cognitive adaptation indicators, personality variables, and benefit-finding. Vulnerability factors include a pessimistic attributional style, negative gender-related traits, and rumination. We then turn to social environmental variables, including both supportive and unsupportive interactions. Finally, we review chronic illness adjustment within the context of dyadic coping. We conclude by examining potential interactions among these classes of variables and outlining a set of directions for future research.

  16. Nonquantum Cognition

    CERN Document Server

    Ghose, Partha

    2012-01-01

    The Hilbert space structure of classical field theory is proposed as a general theoretical framework to model human cognitive processes which do not often follow classical (Bayesian) probability principles. This leads to an extension of the circumplex model of affect and a Poincar\\'{e} sphere representation. A specific toy field theoretic model of the brain as a coherent structure in the presence of noise is also proposed that agrees qualitatively with Pavlovian fear conditioning studies.

  17. Can cognitive science create a cognitive economics?

    Science.gov (United States)

    Chater, Nick

    2015-02-01

    Cognitive science can intersect with economics in at least three productive ways: by providing richer models of individual behaviour for use in economic analysis; by drawing from economic theory in order to model distributed cognition; and jointly to create more powerful 'rational' models of cognitive processes and social interaction. There is the prospect of moving from behavioural economics to a genuinely cognitive economics.

  18. Hydrokinesitherapy program using the Halliwick method on strength endurance and flexibility in a person with poliomyelitis sequelae.

    Science.gov (United States)

    Ochoa Martínez, Paulina Yesica; Hall Lopez, Javier Arturo; Mateos Valenzuela, Adriana Griselda

    2014-09-12

    This case study attempts to determine the effect of a hydrokinesitherapy program by means of the Halliwick method on physical fitness in a female aged 35 years with poliomyelitis sequelae. The intervention followed sixteen weeks of hydrokinesitherapy during 70 minutes, five times a week, where we carried out exercises from the Halliwick method. There was an assessment both before and after the application. Strength endurance and flexibility were determined according to a senior fitness test protocol. The results showed positive improvements when carrying out the exercises from the Halliwick method and the percentage change (Δ%) of strength endurance increase 361.5% in the right arm and 300% in the left arm. Flexibility increased 2 cm in the right shoulder and 10 cm in the left shoulder. In conclusion the subject was able to improve the performance of Halliwick exercises while showing an increase in strength endurance and flexibility.

  19. Management of mental health disorders and central nervous system sequelae in HIV-positive children and adolescents

    Directory of Open Access Journals (Sweden)

    R Nassen

    2014-09-01

    Full Text Available HIV-positive children and adolescents are at increased risk of both central nervous system (CNS sequelae and mental disorders owing to a number of factors, including the impact of HIV infection on the brain, social determinants of health (e.g. poverty and orphanhood and psychosocial stressors related to living with HIV. Every effort should be made to identify perinatally HIV-infected children and initiate them on antiretroviral therapy early in life. HIV clinicians should ideally screen for mental health and neurocognitive problems, as part of the routine monitoring of children attending antiretroviral clinics. This guideline is intended as a reference tool for HIV clinicians to support the early identification, screening and management of mental health disorders and/or CNS impairment in children and adolescents. This guideline covers mental disorders (section 1 and HIV-associated neurocognitive disorders (section 2 among children and adolescents.  

  20. Chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    V K Vijayan

    2013-01-01

    Full Text Available The global prevalence of physiologically defined chronic obstructive pulmonary disease (COPD in adults aged >40 yr is approximately 9-10 per cent. Recently, the Indian Study on Epidemiology of Asthma, Respiratory Symptoms and Chronic Bronchitis in Adults had shown that the overall prevalence of chronic bronchitis in adults >35 yr is 3.49 per cent. The development of COPD is multifactorial and the risk factors of COPD include genetic and environmental factors. Pathological changes in COPD are observed in central airways, small airways and alveolar space. The proposed pathogenesis of COPD includes proteinase-antiproteinase hypothesis, immunological mechanisms, oxidant-antioxidant balance, systemic inflammation, apoptosis and ineffective repair. Airflow limitation in COPD is defined as a postbronchodilator FEV1 (forced expiratory volume in 1 sec to FVC (forced vital capacity ratio <0.70. COPD is characterized by an accelerated decline in FEV1. Co morbidities associated with COPD are cardiovascular disorders (coronary artery disease and chronic heart failure, hypertension, metabolic diseases (diabetes mellitus, metabolic syndrome and obesity, bone disease (osteoporosis and osteopenia, stroke, lung cancer, cachexia, skeletal muscle weakness, anaemia, depression and cognitive decline. The assessment of COPD is required to determine the severity of the disease, its impact on the health status and the risk of future events (e.g., exacerbations, hospital admissions or death and this is essential to guide therapy. COPD is treated with inhaled bronchodilators, inhaled corticosteroids, oral theophylline and oral phosphodiesterase-4 inhibitor. Non pharmacological treatment of COPD includes smoking cessation, pulmonary rehabilitation and nutritional support. Lung volume reduction surgery and lung transplantation are advised in selected severe patients. Global strategy for the diagnosis, management and prevention of Chronic Obstructive Pulmonary Disease

  1. "What is there in a name?": A literature review on chronic and aggressive periodontitis

    Directory of Open Access Journals (Sweden)

    Sameera G Nath

    2011-01-01

    Full Text Available The objective of this review is to bring the reader up-to-date on the current understanding of chronic and aggressive forms of periodontitis and the implications for diagnosis and treatment of these diseases. The only difference between chronic periodontitis and aggressive periodontitis with regard to tissue destruction appear to be perhaps the magnitude, sequelae, and control of the response. While there may be some differences in the cellular infiltrate between these two diseases, the molecular mediators and pathologic processes are generally the same.

  2. Neuropathological sequelae of Human Immunodeficiency Virus and apathy: A review of neuropsychological and neuroimaging studies.

    Science.gov (United States)

    McIntosh, Roger C; Rosselli, Monica; Uddin, Lucina Q; Antoni, Michael

    2015-08-01

    Apathy remains a common neuropsychiatric disturbance in the Human Immunodeficiency Virus (HIV-1) despite advances in anti-retroviral treatment (ART). The goal of the current review is to recapitulate findings relating apathy to the deleterious biobehavioral effects of HIV-1 in the post-ART era. Available literatures demonstrate that the emergence of apathy with other neurocognitive and neuropsychiatric symptoms may be attributed to neurotoxic effects of viral proliferation, e.g., aggregative effect of Tat and gp120 on apoptosis, transport and other enzymatic reactions amongst dopaminergic neurons and neuroglia. An assortment of neuroimaging modalities converge on the severity of apathy symptoms associated with the propensity of the virus to replicate within frontal-striatal brain circuits that facilitate emotional processing. Burgeoning research into functional brain connectivity also supports the effects of microvascular and neuro-inflammatory injury linked to aging with HIV-1 on the presentation of neuropsychiatric symptoms. Summarizing these findings, we review domains of HIV-associated neurocognitive and neuropsychiatric impairment linked to apathy in HIV. Taken together, these lines of research suggest that loss of affective, cognitive and behavioral inertia is commensurate with the neuropathology of HIV-1.

  3. Inflammatory Mechanisms Associated with Skeletal Muscle Sequelae after Stroke: Role of Physical Exercise

    Science.gov (United States)

    Coelho Junior, Hélio José; Gambassi, Bruno Bavaresco; Diniz, Tiego Aparecido; Fernandes, Isabela Maia da Cruz; Caperuto, Érico Chagas; Uchida, Marco Carlos; Lira, Fabio Santos

    2016-01-01

    Inflammatory markers are increased systematically and locally (e.g., skeletal muscle) in stroke patients. Besides being associated with cardiovascular risk factors, proinflammatory cytokines seem to play a key role in muscle atrophy by regulating the pathways involved in this condition. As such, they may cause severe decrease in muscle strength and power, as well as impairment in cardiorespiratory fitness. On the other hand, physical exercise (PE) has been widely suggested as a powerful tool for treating stroke patients, since PE is able to regenerate, even if partially, physical and cognitive functions. However, the mechanisms underlying the beneficial effects of physical exercise in poststroke patients remain poorly understood. Thus, in this study we analyze the candidate mechanisms associated with muscle atrophy in stroke patients, as well as the modulatory effect of inflammation in this condition. Later, we suggest the two strongest anti-inflammatory candidate mechanisms, myokines and the cholinergic anti-inflammatory pathway, which may be activated by physical exercise and may contribute to a decrease in proinflammatory markers of poststroke patients. PMID:27647951

  4. Frequency, imaging findings, risk factors, and long-term sequelae of distal clavicular osteolysis in young patients

    Energy Technology Data Exchange (ETDEWEB)

    Roedl, Johannes B.; Nevalainen, Mika; Gonzalez, Felix M.; Morrison, William B.; Zoga, Adam C. [Thomas Jefferson University Hospital, Thomas Jefferson University, Division of Musculoskeletal Imaging and Interventions, Department of Radiology, Philadelphia, PA (United States); Dodson, Christopher C. [Thomas Jefferson University Hospital, Rothman Institute, Sidney Kimmel Medical College at Thomas Jefferson University, Division of Sports Medicine, Department of Orthopedic Surgery, Philadelphia, PA (United States)

    2015-05-01

    Atraumatic distal clavicular osteolysis (DCO) has been described in adult male weightlifters. Our purpose was to investigate the frequency, magnetic resonance imaging (MRI) characteristics, risk factors, and long-term sequelae of DCO in young patients. Individuals with atraumatic DCO were identified in a retrospective review of 1,432 consecutive MRI shoulder reports in patients between 13 and 19 years of age. MRI findings of DCO, association with athletic activity, short-term clinical outcome after 3-6 months, and long-term clinical and MRI outcome after 2 years were analyzed. A pre-MRI questionnaire assessed the patients' athletic history including overhead activity and weightlifting. At a mean age of 15.9 years, 6.5 % (93/1432) of patients had atraumatic DCO, and 24 % were females. The combination of an overhead sport (basketball, volleyball, tennis, swimming) and supplemental weight training was a risk factor for DCO (odds ratio = 38, p = 0.01). Ninety-three percent of patients responded to conservative therapy. On follow-up imaging, 71 % of DCO patients had acromioclavicular (AC) joint osteoarthritis (vs. 35 % in controls, p = 0.006); 79 % had flattening of the distal clavicle and interval widening of the AC joint to a mean of 5.0 mm (compared to 2.4 mm in controls, p < 0.001). Severity of DCO edema was associated with pain (p < 0.02) at initial presentation and with AC joint osteoarthritis (p = 0.004) on follow-up. In athletic teenagers, the combination of weightlifting and overhead activity is a risk factor for atraumatic DCO, and females are affected in 24 %. Long-term sequelae include widening of the AC joint and AC joint osteoarthritis. (orig.)

  5. [Lipomodelling for correction of breast conservative treatment sequelae. Medicolegal aspects. Expert opinion on five problematic clinical cases].

    Science.gov (United States)

    Gosset, J; Flageul, G; Toussoun, G; Guérin, N; Tourasse, C; Delay, E

    2008-04-01

    In our unit, breast cancer patients suffering mild sequelae of conservative cancer treatment receive fat transfer (lipomodelling), following a precise protocol, based on mammographic and ultrasound examinations and MRI. Available data do not seem to indicate any deleterious impact on patient outcome, notably in view of radiological images, but recurrence (or rather occurrence of new ipsilateral or contralateral cancer) is frequent. The correlation between new or recurrent breast cancer and lipomodelling is high; misinterpretations are possible and frequently arise. The present paper is a description of five complex clinical cases and a discussion of the medicolegal issues that may possibly arise; it also provides tentative expert evaluation of the cases. Clinical findings are reported and analyzed. The second step is a discussion of the radiological impact of lipomodelling, and of the problems caused by the transfer of potentially malignant cells when no preoperative diagnosis of recurrence is made; the morphological and esthetic benefits of the method are described, as well as the potential beneficial impact of fat transfer, notably associated with lower breast density and injections of fat stem cells. Our conclusion is that specialized radiologists, as well as plastic surgery and oncology experts should address the question of fat transfer in operated breast cancer patients and give their reasoned opinion about potentially litigious cases. This would help minimize or solve the conflicts between patients, doctors and experts. Establishing common ground between the different stakeholders would allow the development of the technique, as lipomodelling is, according to our experience, a tremendous advance in the treatment of sequelae from conservative breast cancer surgery.

  6. Effectiveness of clinical assessment in Spanish forensic practice: detecting malingered psychological sequelae in victims of intimate partner violence

    Directory of Open Access Journals (Sweden)

    Miguel Ángel Soria

    2011-03-01

    Full Text Available Background and Objectives: According to Spanish legislation, the psychological harm suffered by the victim of a criminal act is determined by assessing its impact on the victim's mental state. Usually, the victim's pain and suffering is estimated by administering clinical scales. The aim of the present study was to explore the effectiveness of psychopathological assessment using commonly used scales in clinical practice and whose results are presented as legal evidence in a forensic context in order to detect malingered psychological sequelae (anxiety, depression and low self-esteem in victims of intimate partner violence in forensic contexts. Methods: In the present study three scales based in a clinical setting and regularly used in a forensic context were administered (BDI, STAI and Rosenberg to assess malingering of symptoms. The sample comprised 66 women: 36 students, and 30 real victims. The non-clinical sample was evaluated twice: the first time they gave sincere responses, and the second time they were instructed to answer as if they were victims. The real victims underwent testing in a forensic context. Results and Conclusions: The results of our research show that, even without previous knowledge of the scales, people can distort the test results by malingering symptoms that are normally accepted as sequelae of intimate partner violence, especially depression and low self-esteem; however, the results for anxiety, were less homogeneous. Although these tests are used extensively in clinical psychology, our study confirms that, just by themselves, they are not a reliable source of information in a forensic context.

  7. The negative emotional impact of cognitive-behavioral intervention on high school students with chronic hepatitis B virus carriers%认知行为干预对高中生慢性乙型肝炎病毒携带者负性情绪的影响

    Institute of Scientific and Technical Information of China (English)

    李静娣; 陈桂凤; 张静

    2010-01-01

    目的 探讨认知行为干预对高中生慢性乙型肝炎病毒携带者负性情绪的影响.方法 将120例体检的高中生慢性乙型肝炎病毒携带者随机分为对照组和观察组各60例,对照组按常规的方法进行宣教;观察组在常规的宣教方法基础上采用认知行为干预.分别在干预前及干预后第6周进行焦虑自评量表(SAS)和抑郁自评量表(SDS)评定.结果 干预后2组对象SAS、SDS评分较干预前下降(P<0.05),观察组与对照组比较,差异有统计学意义(P<0.05).结论 认知行为干预能改善高中生慢性乙型肝炎病毒携带者负性情绪,帮助其矫正不良认知,重塑健康行为,保持乐观自信的良好个性.%Objective To investigate the negative emotional impact of cognitive-behavioral intervention on high school students with chronic hepatitis B virus carriers. Methods A total of 120 cases of high school students with chronic hepatitis B virus carriers who received physical examination were randomly divided into control group and observation group (60 cases respectively ). The cases in the control group received conventional methods, while those in experiment group received cognitive-behavioral intervention . Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were assessed before and 6 months postintervention between groups. Results The SAS, SDS score were lower after 6 months intervention than before the intervention in two groups ( P < 0. 05 ). The SAS, SDS score reduced much more in experiment group than those in the control group ( P < 0. 05 ). Conclusions Cognitive-behavioral intervention can improve the negative emotions of high school students with chronic hepatitis B virus carriers, help them correct the negative perception, reshape health behavior, self-confident optimism and a good personality.

  8. 认知行为疗法对慢性精神分裂症患者强迫症状的疗效观察%Observation of effects of cognitive behavior therapy on obsessive-compulsive symptoms in patients with chronic schizophrenia

    Institute of Scientific and Technical Information of China (English)

    赵衍山; 马文华; 周之平; 王娟; 施潇潇; 胡小平

    2016-01-01

    Objective:To investigate effects of cognitive behavior therapy on obsessive-compulsive symptoms of patients with chronic schizophrenia. Methods:66 patients with obsessive-compulsive symptoms and chronic schizophrenia were randomly divided into observation group (33 cases) and control group (33 cases). The observation group adopted cognitive behavior therapy combined with traditional therapy, while control group only received traditional therapy. Two groups were evaluated by Yale-Brown obsessive-compulsive scale and clinical global impression-severity of illness ( CGI-S) at 3 and 6 months after the treatment. Results:At the end of 3 and 6 months, there were significant differences in the scores of Yale-Brown obsessive-compulsive scale and CGI-S of observation group before and after the treatment, and between observation group and control group (P0. 05). Conclusions:The effects of cognitive behavior therapy on the obsessive compulsive symptoms of the patients with chronic schizophrenia are obvious;therefore, it is worth to be promoted.%目的::探讨认知行为疗法对慢性精神分裂症患者强迫症状的治疗效果。方法:将66例伴有强迫症状的慢性精神分裂症患者随机分为观察组和对照组,每组各33例。观察组患者采取传统治疗联合认知行为疗法,对照组患者只采用传统治疗;两组患者均以Yale-Brown强迫量表、临床疗效总评量表( CGI-SI)作3、6个月的评定。结果:3、6月末观察组患者的Yale-Brown强迫量表及CGI-SI评分与治疗前和与对照组同期比较,均有显著性差异(P0.05)。结论:认知行为疗法对慢性精神分裂症患者强迫症状的疗效明显,值得推广。

  9. Sleep, Cognition and Dementia.

    Science.gov (United States)

    Porter, Verna R; Buxton, William G; Avidan, Alon Y

    2015-12-01

    The older patient population is growing rapidly around the world and in the USA. Almost half of seniors over age 65 who live at home are dissatisfied with their sleep, and nearly two-thirds of those residing in nursing home facilities suffer from sleep disorders. Chronic and pervasive sleep complaints and disturbances are frequently associated with excessive daytime sleepiness and may result in impaired cognition, diminished intellect, poor memory, confusion, and psychomotor retardation all of which may be misinterpreted as dementia. The key sleep disorders impacting patients with dementia include insomnia, hypersomnolence, circadian rhythm misalignment, sleep disordered breathing, motor disturbances of sleep such as periodic leg movement disorder of sleep and restless leg syndrome, and parasomnias, mostly in the form of rapid eye movement (REM) sleep behavior disorder (RBD). RBD is a pre-clinical marker for a class of neurodegenerative diseases, the "synucleinopathies", and requires formal polysomnographic evaluation. Untreated sleep disorders may exacerbate cognitive and behavioral symptoms in patients with dementia and are a source of considerable stress for bed partners and family members. When left untreated, sleep disturbances may also increase the risk of injury at night, compromise health-related quality of life, and precipitate and accelerate social and economic burdens for caregivers.

  10. Road Map to Address Cognitive Health

    Centers for Disease Control (CDC) Podcasts

    2014-06-09

    In this podcast, CDC’s Dr. Lynda Anderson highlights the important roles that states and communities can play in addressing cognitive health as part of overall health.  Created: 6/9/2014 by National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 6/9/2014.

  11. Interactive and additive influences of Gender, BMI and Apolipoprotein 4 on cognition in children chronically exposed to high concentrations of PM2.5 and ozone. APOE 4 females are at highest risk in Mexico City.

    Science.gov (United States)

    Calderón-Garcidueñas, Lilian; Jewells, Valerie; Galaz-Montoya, Carolina; van Zundert, Brigitte; Pérez-Calatayud, Angel; Ascencio-Ferrel, Eric; Valencia-Salazar, Gildardo; Sandoval-Cano, Marcela; Carlos, Esperanza; Solorio, Edelmira; Acuña-Ayala, Hilda; Torres-Jardón, Ricardo; D'Angiulli, Amedeo

    2016-10-01

    Children's air pollution exposures are associated with systemic and brain inflammation and the early hallmarks of Alzheimer's disease (AD). The Apolipoprotein E (APOE) 4 allele is the most prevalent genetic risk for AD, with higher risk for women. We assessed whether gender, BMI, APOE and metabolic variables in healthy children with high exposures to ozone and fine particulate matter (PM2.5) influence cognition. The Wechsler Intelligence Scale for Children (WISC-R) was administered to 105 Mexico City children (12.32±5.4 years, 69 APOE 3/3 and 36 APOE 3/4). APOE 4v 3 children showed decrements on attention and short-term memory subscales, and below-average scores in Verbal, Performance and Full Scale IQ. APOE 4 females had higher BMI and females with normal BMI between 75-94% percentiles had the highest deficits in Total IQ, Performance IQ, Digit Span, Picture Arrangement, Block Design and Object Assembly. Fasting glucose was significantly higher in APOE 4 children p=0.006, while Gender was the main variable accounting for the difference in insulin, HOMA-IR and leptin (p75% to <94% BMI percentiles are at the highest risk of severe cognitive deficits (1.5-2SD from average IQ). Young female results highlight the urgent need for gender-targeted health programmes to improve cognitive responses. Multidisciplinary intervention strategies could provide paths for prevention or amelioration of female air pollution targeted cognitive deficits and possible long-term AD progression.

  12. Robust and enduring atorvastatin-mediated memory recovery following the 4-vessel occlusion/internal carotid artery model of chronic cerebral hypoperfusion in middle-aged rats.

    Science.gov (United States)

    Zaghi, Gislene Gonçalves Dias; Godinho, Jacqueline; Ferreira, Emilene Dias Fiuza; Ribeiro, Matheus Henrique Dal Molin; Previdelli, Isolde Santos; de Oliveira, Rúbia Maria Weffort; Milani, Humberto

    2016-02-01

    Chronic cerebral hypoperfusion (CCH) is a common condition associated with the development and/or worsening of age-related dementia.We previously reported persistent memory loss and neurodegeneration after CCH in middle-aged rats. Statin-mediated neuroprotection has been reported after acute cerebral ischemia. Unknown, however, is whether statins can alleviate the outcome of CCH. The present study investigated whether atorvastatin attenuates the cognitive and neurohistological outcome of CCH. Rats (12–15 months old) were trained in a non-food-rewarded radial maze, and then subjected to CCH. Atorvastatin (10 mg/kg, p.o.) was administered for 42 days or 15 days, beginning 5 h after the first occlusion stage. Retrograde memory performance was assessed at 7, 14, 21, 28, and 35 days of CCH, and expressed by “latency,” “number of reference memory errors” and “number of working memory errors.” Neurodegeneration was then examined at the hippocampus and cerebral cortex. Compared to sham, CCH caused profound and persistent memory loss in the vehicle-treated groups, as indicated by increased latency (91.2% to 107.3%) and number of errors (123.5% to 2508.2%), effects from which the animals did not spontaneously recover across time. This CCH-induced retrograde amnesia was completely prevented by atorvastatin (latency: −4.3% to 3.3%; reference/working errors: −2.5% to 45.7%), regardless of the treatment duration. This effect was sustained during the entire behavioral testing period (5 weeks), even after discontinuing treatment. This robust and sustained memory-protective effect of atorvastatin occurred in the absence of neuronal rescue (39.58% to 56.45% cell loss). We suggest that atorvastatin may be promising for the treatment of cognitive sequelae associated with CCH.

  13. 老年慢性肾衰竭认知功能障碍患者血清白介素-6、C反应蛋白水平变化%Change of inflammatory factors serum IL-6 and CRP in cognitive impairment in older chronic renal failure patients

    Institute of Scientific and Technical Information of China (English)

    牛铁明; 黄葵; 熊焰

    2016-01-01

    目的 通过老年慢性肾衰竭认知功能障碍患者血清白介素-6、C反应蛋白水平的变化,分析老年慢性肾衰竭认知功能障碍与血清白介素-6、C反应蛋白之间的关系,探讨老年慢性肾衰竭患者认知功能的影响因素.方法 选择45例老年慢性肾衰竭患者,进行简明精神状态评估量表(Mini-mental state examination MMSE)评估,根据MMSE评分结果分为认知功能障碍组和认知功能正常组.检测白介素-6、C反应蛋白水平,检测血肌酐、尿素氮、血红蛋白、血脂、钙、磷、甲状旁腺素等指标,计算肌酐清除率.结果 本组老年慢性肾衰竭患者存在认知功能障碍者为28例;认知功能障碍组血清白介素-6、C反应蛋白水平显著高于认知功能正常组;与认知功能正常组比较,年龄、慢性肾衰竭病程、血肌酐、血红蛋白、肌酐清除率的差异具有统计学意义(P<0.05);相关分析表明血清白介素-6水平与MMSE评分成显著负相关(P<0.05).结论 老年慢性肾衰竭患者认知功能障碍发生率较高,微炎症反应与老年慢性肾衰竭认知障碍密切相关.%Objectives To investigate the diversity of serum IL-6 and CRP in older chronic renal failure(CRF) patients with cognitive impairment.Methods 45 older CRF patients were enrolled in this study.(Mini-mental state examination MMSE)were performed.The objects were divided into cognitive damage group and normalcognitive function group according to the presence or absent of cognitive impairment.Serum interleukin-6 (IL-6) and creative protein(CRP) were measured as markers of chronic inflammation.Creatinine (Cr),Hemoglobin (Hb),Parathyroid Hormone (PTH),Creatinine clearance rate(Ccr) and other biochemical indicators were also measured in all subjects.Results IL-6 and CRP levels in the cognitive damage group were higher than that in nomal cognitive function group,and there were significant differences (P < 0.05);Age,CRF course,Cr,Hb,PTH,Ccr were

  14. Neurologic sequela in a patient with galactosemia potentially mediated by interleukin-11 dysfunction.

    Science.gov (United States)

    Winter, Gidon N; Ben-Pazi, Hilla

    2015-06-01

    A 16-year-old galactosemic patient, homozygous for the 5.5-kb gene deletion, suffered severe neurologic regression following streptococcal infection. Since the gene deletion includes the promoter of interleukin-11a receptor involved in neuronal apoptosis, we questioned whether this patient had no interleukin-11a receptor activity-resulting in neuronal toxicity during septicemia. We hypothesized that interleukin-11 levels would be elevated because of a loss of feedback induced by the absent interleukin-11Ra receptor complex. To assess this, we compared interleukin-11 levels in the proband and 2 of his siblings with the same genetic deletion, to age-matched controls. No differences were found in interleukin-11 levels between groups. Our study was not carried out during acute infective states, when the disrupted immunoregulation triggered by sepsis is relevant, and is thus limited. In conclusion, although interleukin-11 was not chronically elevated in individuals with galactosemia and 5.5-kb gene deletion, data do not rule out potential interleukin-11 dysfunction during acute infection.

  15. [Psychological sequelae of accidents. A problem in accident and liability insurance].

    Science.gov (United States)

    Rehfeldt, M; Sittaro, N A; Wehking, E

    2001-03-01

    Active and successful management predominantly depends on good and trustful cooperation between the claims manager, the field representatives of the administration and the injured or damaged person. Only the early assessment and prompt and purposeful claims handling can minimize the risk of an unexpected claims development. In the early stage, particularly probands with acute psychological maldevelopment can still be helped effectively. The introduction of an adequate therapy is beneficial to the afflicted person and at the same time lowers the final developing costs. As early as in 1918, Horn stated that the early occupational reintegration, apart from granting compensation, positively affects the process of the psychological disturbance. In general, no substantial restriction on the quality of life occurs if the injuries of a physical and mental type have been treated successfully and if occupational reintegration has taken place. However, if a continuous performance loss remains in occupational life due to a chronic psychological disturbance and if the damaged person does not achieve his/her ability to work again, even the contribution of high compensation payments does generally not improve the quality of life.

  16. Effects of melatonin on cognitive processes and astroglia state in rats with experimental diabetes

    OpenAIRE

    N. V. Nedzvetskaya; N. I. Таshevskaya

    2010-01-01

    There was investigated protective effect of chronic melatonin injection on the development of cognitive deficit in rats with streptozotocine induced diabetes. There were observed decrease of astrogliosis and of cognitive deficit in animals that were injected with melatonin. Presented results are evidence that melatonin can prevent the development of cognitive deficit in diabetic animals by decreasing oxidative stress level and astrogliosis inhibition.

  17. 认知疗法对改善慢性骨科患者负性情绪及疼痛感的效果评价%The impact evaluation of cognitive therapy for chronic orthopedic and pain in patients with negative emotions

    Institute of Scientific and Technical Information of China (English)

    李良登

    2014-01-01

    目的:探讨认知疗法对改善慢性骨科患者负性情绪及疼痛感的效果。方法将85例慢性关节疼痛患者随机分为观察组43例以及对照组42例,对照组患者应用常规性护理,观察组患者在对照组的基础上应用认知疗法,对比分析两组患者干预前后医学治疗依从率、心理状况及疼痛程度改善情况。结果观察组干预后医学治疗依从率显著高于对照组,差异有统计学意义(P<0.05)。观察组干预后HAMA评分、HAMD评分显著优于对照组,差异有统计学意义(P<0.05)。观察组患者干预后疼痛程度与干预前相比显著下降,而对照组干预后与干预前相比疼痛程度无显著变化(P>0.05)。结论认知疗法能有效改善慢性骨科患者负性情绪,缓解患者疼痛感。%Objective To investigate the effect of cognitive therapy to improve mood in patients with chronic orthopedic pain and negative emotions in nature .Methods Eighty-five cases of chronic joint pain were randomly divided into observation group ( n=43 ) and control group(n=42).The control group were treated with routine care and the observation group with chronic orthopedics .The intervention around compliance ,psychological status and pain improvement of the two groups were compared .Results The rate of compliance of observa-tion group was higher than that of the control group (P<0.05).The scores of HAMA and HAMD of observation group were better than those of the control group after the intervention (P<0.05).The degree of pain of observation group was decreased compared with the control group after the intervention(P<0.05).Conclusion Chronic orthopedic applications of cognitive therapy for patients can improve their negative e -motions and relieve the pain .

  18. Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than conventional rotary instruments? A systematic review and meta analysis.

    Science.gov (United States)

    Al-Moraissi, E A; Elmansi, Y A; Al-Sharaee, Y A; Alrmali, A E; Alkhutari, A S

    2016-03-01

    A systematic review and meta-analysis was conducted to answer the clinical question "Does the piezoelectric surgical technique produce fewer postoperative sequelae after lower third molar surgery than conventional rotary instruments?" A systematic and electronic search of several databases with specific key words, a reference search, and a manual search were performed from respective dates of inception through November 2014. The inclusion criteria were clinical human studies, including randomized controlled trials (RCTs), controlled clinical trials (CCTs), and retrospective studies, with the aim of comparing the piezoelectric surgical osteotomy technique to the standard rotary instrument technique in lower third molar surgery. Postoperative sequelae (oedema, trismus, and pain), the total number of analgesics taken, and the duration of surgery were analyzed. A total of nine articles were included, six RCTs, two CCTs, and one retrospective study. Six studies had a low risk of bias and three had a moderate risk of bias. A statistically significant difference was found between piezoelectric surgery and conventional rotary instrument surgery for lower third molar extraction with regard to postoperative sequelae (oedema, trismus, and pain) and the total number of analgesics taken (P=0.0001, P=0.0001, Ppiezoelectric osteotomy group (Ppiezoelectric surgery significantly reduced the occurrence of postoperative sequelae (oedema, trismus, and pain) and the total number of analgesics taken compared to the conventional rotary instrument technique in lower third molar surgery, but required a longer surgery time.

  19. The Role of Reverse Shoulder Arthroplasty in Management of Proximal Humerus Fractures with Fracture Sequelae: A Systematic Review of the Literature

    Science.gov (United States)

    Holton, James; Yousri, Tahir; Arealis, George; Levy, Ofer

    2017-01-01

    Fracture sequelae of the proximal humerus poses a complex management decision due to the frequent deformity and its consequences on the peri-articular soft tissues. These patients are frequently elderly with significant medical comorbidities. Due to the age of the patient there is frequently rotator cuff deficiency and therefore the reverse shoulder arthroplasty (RSA) becomes the arthroplasty of choice. We have performed a systematic review of the literature and report nine studies presenting RSA for the treatment of fracture sequelae of the proximal humerus. It is clear that RSA can improve the range of movement and function following proximal humerus fracture sequelae. However, there is a risk of significant complications including dislocation (16.7%), infection (6.7%), intra-operative fracture (3%) and neurological injury (2.6%). There is a need to invest in future prospective comparative studies and randomised trials to further test RSA in fracture sequelae patients. This will provide us with information regarding the longevity of different prosthesis, outcomes and cost-effectiveness of treatment. PMID:28286622

  20. The role of reverse shoulder arthroplasty in management of proximal humerus fractures with fracture sequelae: a systematic review of the literature

    Directory of Open Access Journals (Sweden)

    James Holton

    2017-02-01

    Full Text Available Fracture sequelae of the proximal humerus poses a complex management decision due to the frequent deformity and its consequences on the peri-articular soft tissues. These patients are frequently elderly with significant medical comorbidities. Due to the age of the patient there is frequently rotator cuff deficiency and therefore the reverse shoulder arthroplasty (RSA becomes the arthroplasty of choice. We have performed a systematic review of the literature and report nine studies presenting RSA for the treatment of fracture sequelae of the proximal humerus. It is clear that RSA can improve the range of movement and function following proximal humerus fracture sequelae. However, there is a risk of significant complications including dislocation (16.7%, infection (6.7%, intra-operative fracture (3% and neurological injury (2.6%. There is a need to invest in future prospective comparative studies and randomised trials to further test RSA in fracture sequelae patients. This will provide us with information regarding the longevity of different prosthesis, outcomes and costeffectiveness of treatment.

  1. Pathophysiology and Natural History of Anorectal Sequelae Following Radiation Therapy for Carcinoma of the Prostate

    Energy Technology Data Exchange (ETDEWEB)

    Yeoh, Eric K., E-mail: eric.yeoh@health.sa.gov.au [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia); Discipline of Medicine, University of Adelaide, Adelaide (Australia); Holloway, Richard H. [Discipline of Medicine, University of Adelaide, Adelaide (Australia); Department of Gastroenterology, Royal Adelaide Hospital, Adelaide (Australia); Fraser, Robert J. [Discipline of Medicine, University of Adelaide, Adelaide (Australia); Gastrointestinal Investigation Unit, Repatriation General Hospital, Adelaide (Australia); Botten, Rochelle J.; Di Matteo, Addolorata C.; Butters, Julie [Department of Radiation Oncology, Royal Adelaide Hospital, Adelaide (Australia)

    2012-12-01

    Purpose: To characterize the prevalence, pathophysiology, and natural history of chronic radiation proctitis 5 years following radiation therapy (RT) for localized carcinoma of the prostate. Methods and Materials: Studies were performed in 34 patients (median age 68 years; range 54-79) previously randomly assigned to either 64 Gy in 32 fractions over 6.4 weeks or 55 Gy in 20 fractions over 4 weeks RT schedule using 2- and later 3-dimensional treatment technique for localized prostate carcinoma. Each patient underwent evaluations of (1) gastrointestinal (GI) symptoms (Modified Late Effects in Normal Tissues Subjective, Objective, Management and Analytic scales including effect on activities of daily living [ADLs]); (2) anorectal motor and sensory function (manometry and graded balloon distension); and (3) anal sphincteric morphology (endoanal ultrasound) before RT, at 1 month, and annually for 5 years after its completion. Results: Total GI symptom scores increased after RT and remained above baseline levels at 5 years and were associated with reductions in (1) basal anal pressures, (2) responses to squeeze and increased intra-abdominal pressure, (3) rectal compliance and (4) rectal volumes of sensory perception. Anal sphincter morphology was unchanged. At 5 years, 44% and 21% of patients reported urgency of defecation and rectal bleeding, respectively, and 48% impairment of ADLs. GI symptom scores and parameters of anorectal function and anal sphincter morphology did not differ between the 2 RT schedules or treatment techniques. Conclusions: Five years after RT for prostate carcinoma, anorectal symptoms continue to have a significant impact on ADLs of almost 50% of patients. These symptoms are associated with anorectal dysfunction independent of the RT schedules or treatment techniques reported here.

  2. Ear infection - chronic

    Science.gov (United States)

    Middle ear infection - chronic; Otitis media - chronic; Chronic otitis media; Chronic ear infection ... up. When this happens, infection can occur. A chronic ear infection develops when fluid or an infection ...

  3. 基于中医认知疗法探讨慢性乙型病毒性肝炎“话疗”%Discussion Based on Cognitive Therapy of TCM about Communicating Treatment on Patients with Chronic Hepatitis B

    Institute of Scientific and Technical Information of China (English)

    赵朋涛; 池晓玲; 李泽鹏; 韩露; 萧焕明; 谢玉宝

    2013-01-01

    Chronic hepatitis B,as a clinical common chronic disease,severely impacts the patients' physical and mental health.Modern research shows that patients with chronic hepatitis B have different degrees of psychological problems.With the biological-psychological-social medical model proposed,people gradually begin to attach importance to the psychological and social factors on disease development.The communicate treatment on patients with chronic hepatitis B and their families can improve the patients'mental state and compliance,making a better therapeutic effect.%慢性乙型病毒性肝炎作为一种临床常见的慢性传染病,严重的影响着患者的身心健康,现代研究表明,慢乙肝患者均存在着不同程度上的心理问题.随着“生物-心理-社会”医学模式的提出,人们逐渐开始重视心理和社会因素对疾病的发生发展的影响.通过对慢乙肝患者及其家属的“话疗”,可以改善患者的心理状态,提高患者的依从性,从而达到更好的治疗效果.

  4. Prognostic factors and course for successful clinical outcome quality of life and patients' perceived effect after a cognitive behavior therapy for chronic non-specific low back pain: A 12-months prospective study

    NARCIS (Netherlands)

    Verkerk, K.; Luijsterburg, P.A.J.; Heymans, M.W.; Ronchetti, I.; Miedema, H.S.; Koes, B.W.; Pool-Goudzwaard, A.

    2015-01-01

    This study investigates the clinical course of and prognostic factors for quality of life (Short Form 36 items Health survey (SF-36)) and global perceived effect (GPE) in patients treated for chronic nonspecific low back pain at 5 and 12-months follow-up. Data from a prospective cohort (n ¼ 1760) of

  5. Conceptions of cognition for cognitive engineering

    DEFF Research Database (Denmark)

    Blomberg, Olle

    2011-01-01

    as part of the development of a new understanding of what cognition is and where the boundaries of cognitive systems are. Cognition, it is claimed, is not just situated or embedded, but extended and distributed in the world. My main question in this article is what the practical significance...... that there is not anything special about the biological boundary of the skin and skull per se, rather than some positive claim about where the boundaries of extended or distributed cognitive systems really are. I also examine the role of the concept of cognition in the theoretical frameworks of Distributed Cognition, Joint...

  6. Cognitive interventions for addiction medicine: Understanding the underlying neurobiological mechanisms.

    Science.gov (United States)

    Zilverstand, Anna; Parvaz, Muhammad A; Moeller, Scott J; Goldstein, Rita Z

    2016-01-01

    Neuroimaging provides a tool for investigating the neurobiological mechanisms of cognitive interventions in addiction. The aim of this review was to describe the brain circuits that are recruited during cognitive interventions, examining differences between various treatment modalities while highlighting core mechanisms, in drug addicted individuals. Based on a systematic Medline search we reviewed neuroimaging studies on cognitive behavioral therapy, cognitive inhibition of craving, motivational interventions, emotion regulation, mindfulness, and neurofeedback training in addiction. Across intervention modalities, common results included the normalization of aberrant activity in the brain's reward circuitry, and the recruitment and strengthening of the brain's inhibitory control network. Results suggest that different cognitive interventions act, at least partly, through recruitment of a common inhibitory control network as a core mechanism. This implies potential transfer effects between training modalities. Overall, results confirm that chronically hypoactive prefrontal regions implicated in cognitive control in addiction can be normalized through cognitive means.

  7. 认知行为疗法联合药物治疗改善慢性前列腺炎患者临床症状的疗效观察%Efficacy of cognitive behavioral therapy combined with drug treatment to improve the clinical symptoms of patients with chronic prostatitis

    Institute of Scientific and Technical Information of China (English)

    李小滨; 曾媛媛; 谭友果; 刘跃江; 黄俊; 曾柯

    2013-01-01

    目的 观察认知行为疗法联合药物治疗改善慢性前列腺炎(CP)患者焦虑抑郁情绪、尿路刺激症状、慢性疼痛、性功能障碍的疗效.方法 将240例CP患者随机分为两组,对照组120例,采用临床常规方法进行治疗;治疗组120例,在接受临床常规治疗的同时联合认知行为治疗,疗程12周,治疗前后分别用焦虑自评量表(SAS)、抑郁自评量表(SDS)、国际慢性前列腺炎症状评分(NIH-CPSI)和国际勃起功能指数-5(IIEF-5)评分对治疗组和对照组患者进行评估,最后对各项结果进行统计学分析.结果 12周治疗结束后,患者前列腺炎临床症状和性功能障碍改善程度治疗组明显优于对照组(P<0.01),焦虑抑郁症状改善情况治疗组显著优于对照组(P<0.01).结论 认知行为疗法联合药物治疗可有效改善慢性前列腺炎(CP)患者的焦虑抑郁情绪、尿路刺激症状、慢性疼痛和性功能障碍.%Objective To observe the efficacy of cognitive behavioral therapy combined with drug treatment to improve the anxiety and depression,urinary tract irritation,chronic pain,sexual dysfunction in patients with chronic prostatitis (CP).Methods Two hundred and forty patients with CP were randomly divided into two groups,the control group (n=120) and the study group (n=120).Patients in the control received clinical routine drug treatment,while those in the study group received cognitive behavioral therapy combined with drug treatment,both for 12 weeks.The patients were evaluated with Self-Rating Anxiety Scale (SAS),Self-Rating Depression Scale (SDS),NIH-Chronic Prostatitis Symptom Index (NIH-CPSI) and International Index of Erectile Function-5 (IIEF-5) score before and after treatment.The results were statistically analyzed.Results After 12 weeks of treatment,the degree of improvement of clinical symptoms and sexual dysfunction in the study group was significantly better than that in the control group(P<0.01),anxiety and

  8. Imaging of the late sequelae of spinal cord injuries; Radiologie von Spaetschaeden nach Rueckenmarkverletzungen

    Energy Technology Data Exchange (ETDEWEB)

    Bodley, R. [Dept. of Radiology, National Spinal Injuries Centre, Stoke Mandeville Hospital, Aylesbury (United Kingdom)

    1994-12-01

    With an increasing ability to diagnose and treat the neurological complications, surveillance of the state of the spinal cord has now assumed great importance. Magnetic resonance imaging (MRI), or computerized tomography (CT) with myelography if MRI is contra-indicated is the method of choice and can demonstrate the pathology with great clarity. In most patients, midline sagittal T1W images are sufficient for screening purposes and for monitoring the success of treatment. Operative, imaging and postmortem studies have shown that the two main changes that occur are: (a) atrophic and (b) cystic - the microcystic and myxoid gel changes of myelomalacia, focal cysts and the larger, more expansive, syringomyelia. As yet, there is no standardization of terminology to describe the various pathological and radiological states. This is critical as only one condition, syringomyelia, is currently amenable to definitive surgery and without conformity, comparisons of incidence in different populations and assessment of the results of surgery are impossible. The published small studies of predominantly symptomatic patients at varying stages of chronicity give differing incidences of changes. Preliminary results of a surveillance MRI study of the spinal cord changes in 153 patients who had had a spinal cord injury over 20 years previously are presented. Altrophy was present in 62%, myelomalacia in 54%, syringomyelia in 22%, focal cysts in 9% and disruption in 7%. (orig./VHE) [Deutsch] Zunehmenden Verbesserungen in Diagnose und Behandlung von neurologischen Komplikationen haben die Bedeutung von Rueckenmarkkontrollen stark erhoeht. Als Methode der Wahl steht die Magnetresonanztomographie (MRT) zur Verfuegung. Als Screeningverfahren genuegt bei den meisten Patienten die Anfertigung einer mediansagittalen T1-gewichteten MR-Aufnahme. Dies ist auch bei Kontrollaufnahmen in der Nachbehandlung in vielen Faellen ausreichend. Operative, bildgebende und Postmortemstudien haben gezeigt, dass

  9. 老年慢性病患者抑郁、焦虑障碍认知情况及与身心疾病识别的相关性研究%Correlation between cognition of depression and anxiety and recognition of physical and mental illness in hospitalized elderly patients with chronic diseases

    Institute of Scientific and Technical Information of China (English)

    李梦阳; 宋颖; 赵岳; 戴必兵

    2016-01-01

    目的:调查老年慢性病住院患者对抑郁和焦虑障碍的认知情况、对慢性躯体性疾病和心理疾病的识别情况,并分析两者的相关性,为老年慢性病住院患者常规进行抑郁和焦虑心理评估提供理论依据。方法采用横断面研究的方法,以简易精神状态检查量表(MMSE)、汉密尔顿抑郁量表(HAMD)、焦虑自评量表(SAS)以及老年慢性病患者调查问卷作为测量工具对某三甲医院的206例老年慢性病住院患者进行调查。结果老年慢性病住院患者对抑郁认知总水平得分为(5.95±3.05)分,焦虑认知总水平得分(4.92±3.20)分,对慢性病判断正确率为(97±8)%,对心理疾病判断正确率仅为(47±29)%。抑郁认知总分和心境、思维、精神3个维度与对心理疾病的识别呈正相关(P <0.01);对焦虑认知总分和情绪、其他症状两个维度与对心理疾病的识别呈正相关(P <0.01),而抑郁、焦虑认知中躯体维度与对心理疾病判断正确情况无显著相关性(P >0.05)。结论老年慢性病住院患者抑郁、焦虑认知水平低,且对以躯体症状为主要表现的抑郁、焦虑障碍识别能力低,将心理疾病误认为是慢性躯体性疾病,严重影响疾病的治疗和预后。因此,护士应为老年慢性病患者常规进行抑郁、焦虑心理健康评估,早期识别心理健康问题,避免延误心理干预和治疗的最佳时间。%Objective To investigate the cognition of depression and anxiety and recognition of physical and mental illness,and analyze their correlation in hospitalized elderly patients with chronic diseases. Methods A cross-sectional study was performed.A total of 206 hospitalized elderly patients with chronic diseases from a hospital were investigated using mini mental state examination (MMSE),Hamilton depression rating scale (HAMD),self rating anxiety scale (SAS

  10. Cognitive Impairment in Heart Failure

    Directory of Open Access Journals (Sweden)

    Efthimios Dardiotis

    2012-01-01

    Full Text Available Cognitive impairment (CI is increasingly recognized as a common adverse consequence of heart failure (HF. Although the exact mechanisms remain unclear, microembolism, chronic or intermittent cerebral hypoperfusion, and/or impaired cerebral vessel reactivity that lead to cerebral hypoxia and ischemic brain damage seem to underlie the development of CI in HF. Cognitive decline in HF is characterized by deficits in one or more cognition domains, including attention, memory, executive function, and psychomotor speed. These deficits may affect patients’ decision-making capacity and interfere with their ability to comply with treatment requirements, recognize and self-manage disease worsening symptoms. CI may have fluctuations in severity over time, improve with effective HF treatment or progress to dementia. CI is independently associated with disability, mortality, and decreased quality of life of HF patients. It is essential therefore for health professionals in their routine evaluations of HF patients to become familiar with assessment of cognitive performance using standardized screening instruments. Future studies should focus on elucidating the mechanisms that underlie CI in HF and establishing preventive strategies and treatment approaches.

  11. COGNITIVE COMPETENCE COMPARED TO COGNITIVE INDEPENDENCE AND COGNITIVE ACTIVITY

    Directory of Open Access Journals (Sweden)

    Irina B. Shmigirilova

    2014-01-01

    Full Text Available The research is aimed at identifying the essence of the cognitive competence concept in comparison with the concepts of cognitive independence and activity.Methods: The methodology implies a theoretical analysis of psychopedagogical and methodological materials on the cognitive competence formation; generalized teaching experience; empirical methods of direct observations of educational process in the secondary school classrooms; interviews with school teachers and pupils.Results: The research outcomes reveal a semantic intersection between the cognitive competence, independence and activity, and their distinctive features. The paper emphasizes the importance of cognitive competence as an adaptive mechanism in situations of uncertainty and instability.Scientific novelty: The author clarifies the concept of cognitive competence regarding it as a multi-component and systematic characteristic of a personality.Practical significance: The research findings can be used by specialists in didactics developing the teaching techniques of cognitive competence formation for schoolchildren.

  12. [Quality assurance in therapy of chronic pain. Results obtained by a taskforce of the German Section of the Association for the Study of Pain on psychological assessment of chronic pain. V. Instruments for the assessment of pain-related cognitions and coping with pain.].

    Science.gov (United States)

    Denecke, H; Klinger, R; Kröner-Herwig, B; Nilges, P; Redegeld, M; Weiß, L; Glier, B

    1995-07-01

    The present paper is one of a series of publications, reviewing German instruments for psychological assessment of pain. Their main focus is on the results of a task force on quality testing for each subject. This paper describes and comments on methods regarding self-reporting of pain cognitions and both cognitive and behavioral strategies for coping with pain. Concerning pain cognitions one focus is on patients' attributions of causes of pain and the modes of controlling pain (subjective pain model). The other focus is on instruments recording "pain beliefs" in the sense of dysfunctional congitions associated with the experience of pain. Each instrument was examined with reference to approved psychometric criteria, empirical foundation and clinical relevance. It was noted that several instruments are deficient in their psychometric criteria and their empirical foundations. We used these data as a basis to elaborate a specific and differential recommendation. A similar procedure was followed with instruments for the assessment of pain-related coping strategies. According to our research there are two subgroups of coping instruments, one more specifically for cognitive coping with pain, and the other combined with behavioral coping strategies. Once again, we elaborated a specific and differential recommendation, giving priority to instruments taking account of both cognitive and behavioral dimensions of coping with pain.

  13. Lesões sequelares na laringe em pacientes com paracoccidiodomicose Sequelae lesions in the larynxes of patients with paracoccidioidomycosis

    Directory of Open Access Journals (Sweden)

    Jose Mauricio Lopes Neto

    2011-02-01

    Full Text Available A Paracoccidioidomicose (PCM é uma doença sistêmica que em sua forma sequelar se caracteriza por manifestações clínicas relacionadas às alterações anatômicas ou funcionais de órgãos e sistemas comprometidos no período de estado. OBJETIVO: Descrever as alterações anatômicas e funcionais laríngeas sequelares em pacientes com paracoccidioidomicose. MATERIAL E MÉTODOS: Estudo retrospectivo, sendo avaliados 49 pacientes do sexo masculino, na faixa etária de 30 a 60 anos, entre 1999 a 2004, com diagnóstico de PCM em acompanhamento pela disciplina de Moléstias Infecciosas e Parasitárias, confirmado pela demonstração do fungo em escarro, exame citológico ou histopatológico. RESULTADOS: As pregas vocais foram a estrutura laríngea mais afetada, em 67% dos pacientes verificaram-se alterações. A epiglote estava acometida em 55% dos casos. As pregas ariepiglóticas tinham modificações em 53% dos pacientes. As pregas vestibulares estavam alteradas em 46% dos casos. Em 40% dos casos verificaram-se alterações em aritenoides. Na fonação, 28% tinham limitação ao movimento das cordas vocais, paresia unilateral ocorreu em 4% casos. Em 24% havia restrição da luz supraglótica e 4% tinham estenose glótica, sendo que 2% precisaram de traqueotomia. CONCLUSÃO: As lesões sequelares na laringe devido à infecção pelo P. brasilienses são extensas e causam restrições funcionais na maioria dos casos.Paracoccidioidomycosis (PCM is a systemic disease that in its aftermath form is characterized by clinical manifestations related to anatomic or functional sequelae of organs and systems affected during the period of state. AIM: To describe the anatomical and functional sequelae in patients with treated laryngeal PCM. MATERIALS AND METHODS: Retrospective study. We reviewed the charts from of 49 male patients, aged between 30 to 60 years, diagnosed with laryngeal PCM during the period of 1999 to 2004. In all patients the diagnosis of

  14. Modafinil combined with cognitive training: pharmacological augmentation of cognitive training in schizophrenia.

    Science.gov (United States)

    Michalopoulou, Panayiota G; Lewis, Shôn W; Drake, Richard J; Reichenberg, Abraham; Emsley, Richard; Kalpakidou, Anastasia K; Lees, Jane; Bobin, Tracey; Gilleen, James K; Pandina, Gahan; Applegate, Eve; Wykes, Til; Kapur, Shitij

    2015-08-01

    Several efforts to develop pharmacological treatments with a beneficial effect on cognition in schizophrenia are underway, while cognitive remediation has shown modest effects on cognitive performance. Our goal was to test if pharmacological augmentation of cognitive training would result in enhancement of training-induced learning. We chose modafinil as the pharmacological augmenting agent, as it is known to have beneficial effects on learning and cognition. 49 participants with chronic schizophrenia were enroled in a double-blind, placebo-controlled study across two sites and were randomised to either modafinil (200mg/day) or placebo. All participants engaged in a cognitive training program for 10 consecutive weekdays. The primary outcome measure was the performance on the trained tasks and secondary outcome measures included MATRICS cognitive battery, proxy measures of everyday functioning and symptom measures. 84% of the participants completed all study visits. Both groups showed significant improvement in the performance of the trained tasks suggesting potential for further learning. Modafinil did not induce differential enhancement on the performance of the trained tasks or any differential enhancement of the neuropsychological and functional measures compared to placebo. Modafinil showed no significant effects on symptom severity. Our study demonstrated that combining pharmacological compounds with cognitive training is acceptable to patients and can be implemented in large double-blind randomised controlled trials. The lack of differential enhancement of training-induced learning raises questions, such as choice and optimal dose of drug, cognitive domains to be trained, type of cognitive training, intervention duration and chronicity of illness that require systematic investigation in future studies.

  15. Chronic Traumatic Encephalopathy: The Neuropathological Legacy of Traumatic Brain Injury.

    Science.gov (United States)

    Hay, Jennifer; Johnson, Victoria E; Smith, Douglas H; Stewart, William

    2016-05-23

    Almost a century ago, the first clinical account of the punch-drunk syndrome emerged, describing chronic neurological and neuropsychiatric sequelae occurring in former boxers. Thereafter, throughout the twentieth century, further reports added to our understanding of the neuropathological consequences of a career in boxing, leading to descriptions of a distinct neurodegenerative pathology, termed dementia pugilistica. During the past decade, growing recognition of this pathology in autopsy studies of nonboxers who were exposed to repetitive, mild traumatic brain injury, or to a single, moderate or severe traumatic brain injury, has led to an awareness that it is exposure to traumatic brain injury that carries with it a risk of this neurodegenerative disease, not the sport or the circumstance in which the injury is sustained. Furthermore, the neuropathology of the neurodegeneration that occurs after traumatic brain injury, now termed chronic traumatic encephalopathy, is acknowledged as being a complex, mixed, but distinctive pathology, the detail of which is reviewed in this article.

  16. [Anesthetic Management of Three Patients with Chronic Inflammatory Demyelinating Polyradiculoneuropathy].

    Science.gov (United States)

    Maruyama, Naoko; Wakimoto, Mayuko; Inamori, Noriko; Nishimura, Shinya; Mori, Takahiko

    2015-08-01

    Chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) is a chronically progressing or relapsing disease caused by immune-mediated peripheral neuropathy. We report the anesthetic management of three CIDP patients who underwent elective orthopedic surgeries. Owing to the risk of neuraxial anesthetics triggering demyelination, general anesthesia was selected to avoid epidural or spinal anesthesia or other neuraxial blockade. It was also judged prudent to avoid prolonged perioperative immobilization, which might compress vulnerable peripheral nerves. For Patient 1, general anesthesia was induced with propofol, remifentanil, and sevoflurane, and was maintained with sevoflurane and remifentanil. For Patients 2 and 3, general anesthesia was induced and maintained with propofol and remifentanil. For tracheal intubation, under careful monitoring with peripheral nerve stimulators, minimal doses of rocuronium (0.6-0.7 mg x kg(-1)) were administered. When sugammadex was administered to reverse the effect of rocuronium, all patients rapidly regained muscular strength. Postoperative courses were satisfactory without sequelae.

  17. [Chronic hepatitis].

    Science.gov (United States)

    Figueroa Barrios, R

    1995-01-01

    Medical literature about chronic hepatitis is reviewed. This unresolving disease caused by viruses, drugs or unknown factors may progress to in cirrhosis and hepatocarcinoma. A classification based on liver biopsy histology into chronic persistent and chronic active types has been largely abandoned and emphasis is placed on recognizing the etiology of the various types. One is associated with continuing hepatitis B virus infection; another is related to chronic hepatitis C virus infection and the third is termed autoinmune, because of the association with positive serum autoantibodies. A fourth type with similar clinical functional and morphologic features is found with some drug reactions. Long term corticoesteroid therapy is usually successful in autoinmune type. Associations between antibodies to liver-kidney microsomes and the hepatitis C virus can cause diagnostic difficulties. Antiviral treatment of chronic hepatitis B and C with interpheron alfa is employed, controlling symptoms and abnormal biochemistry and the progression to cirrhosis and liver cancer in 30 to 40% patients. Alternative therapies or combinations with interpheron are being evaluated waiting for final results.

  18. Social functioning in children with a chronic illness

    NARCIS (Netherlands)

    Meijer, SA; Sinnema, G; Bijstra, JO; Mellenbergh, GJ; Wolters, WHG

    2000-01-01

    Behavioural, cognitive, and affective aspects of social functioning of 107 children with a chronic illness were studied. The aim of the study was twofold. (I) to describe peer interaction of children with a chronic illness in comparison with normative data of healthy children; (2) to examine whether

  19. Peer interaction in adolescents with a chronic illness

    NARCIS (Netherlands)

    Meijer, SA; Sinnema, G; Bijstra, JO; Mellenbergh, GJ; Wolters, WHG

    2000-01-01

    This study examined behavioural, cognitive and affective aspects of peer interaction of adolescents with a chronic illness. The aim of the study was twofold: (1) describe peer interaction of adolescents with a chronic illness in comparison with norms of healthy adolescents; (2) examine the relations

  20. Avaliação espirométrica de doentes com sequela de tuberculose submetidos à lobectomia

    Directory of Open Access Journals (Sweden)

    Elias Amorim

    2013-04-01

    Full Text Available OBJETIVO: Avaliar a espirometria no pré e pós-operatório de doentes com sequela de tuberculose, submetidos à lobectomia. MÉTODOS: Foram selecionados 20 doentes, com idade entre 15 e 56 anos, de ambos os sexos, com história pregressa de tratamento de tuberculose, apresentando infecção de repetição ou hemoptises. Foram submetidos à lobectomia pulmonar. O tempo de tratamento da tuberculose foi seis meses e o aparecimento dos sintomas entre um e 32 anos. Foram avaliadas a capacidade vital (CV, a capacidade vital forçada (CVF, o volume expiratório forçado (VEF1, o VEF1/CVF, o fluxo expiratório forçado (FEF e o pico de fluxo expiratório (PFE após o primeiro, terceiro e sexto meses em relação ao pré-operatório. O nível de significância (á aplicado em todos os testes foi 5%, ou seja, considerou-se significativo quando p<0,05. RESULTADOS: As Médias encontradas foram as seguintes: Capacidade Vital (CV Pré-operatória-2,83 ; 1º PO 2,12; 3º PO 2,31; 6º PO 2,43. Capacidade Vital Forçada (CVF Pré-operatória- 2,97; 1º PO 2,21; 3º PO 2,35; 6º PO 2,53. Volume Expiratório no 1º Segundo (VEF1 Pré-operatório 2,23; 1º PO 1,75; 3º PO 1,81; 6º PO 1,97. Houve diminuição acentuada das funções respiratórias no primeiro mês de pós-operatório, porém houve melhora dos parâmetros a partir do terceiro mês, com progressivo aumento até o sexto mês de pós-operatório. CONCLUSÃO: Não houve recuperação dos parâmetros espirométricos, comparados aos do pré operatório, após seis meses de pós-operatório nos pacientes com sequela de tuberculose submetidos à lobectomia.

  1. Evaluation of some oral postradiotherapy sequelae in patients treated for head and neck tumors; Avaliacao de algumas sequelas bucais pos-radioterapia em pacientes tratados de neoplasias de cabeca e pescoco

    Energy Technology Data Exchange (ETDEWEB)

    Rubira, Cassia Maria Fischer; Devides, Nadia Juliana; Ubeda, Liliane Torsani; Lauris, Jose Roberto; Rubira-Bullen, Izabel Regina Fischer; Damante, Jose Humberto [University of Sao Paulo, Bauru, SP (Brazil). School of Dentistry. Stomatology Dept.; Bortolucci Junior, Antonio Geraldo [Amaral Carvalho Hospital, Jau, SP (Brazil)]. E-mail: damante@fob.usp.br

    2007-07-01

    The aim of this study was to evaluate the oral sequelae of radiotherapy in patients treated between 1999 and 2003 for head and neck tumors. One-hundred patients (24 women, 76 men) ranging in age from 30 to 83 years (mean 59.2 years) were examined. Time since radiotherapy ranged from 1 to 72 months (mean 28 months). The total mean radiation dose received by the patients was 5,955 cGy. The evaluation protocol included anamnesis, intraoral and extraoral examination, measurement of stimulated salivary flow and salivary pH. Symptoms reported by the patients included dry mouth (68%), dysphagia (38%), and dysgeusia (30%). In 64% of the patients, the mean stimulated salivary flow rate was less than 0.7 ml/min. The mean salivary pH was 6.97 ({+-} 0.714). Stimulated salivary flow increased with increasing postradiotherapy time (p < 0.05). The prevalence of mucositis was associated with higher radiation doses (p < 0.05), and the prevalence of atrophic candidiasis was related to a longer post-treatment period (p < 0.05). Two cases of recurrence of the primary tumor were detected during the study. The main effect of radiotherapy in the head and neck region was a reduction of the salivary flow rate, even though our study demonstrated that there was a modest late improvement of the salivary flow. (author)

  2. Mindfulness, Acceptance and Catastrophizing in Chronic Pain

    NARCIS (Netherlands)

    de Boer, Maaike J.; Steinhagen, Hannemike E.; Versteegen, Gerbrig J.; Struys, Michel M. R. F.; Sanderman, Robbert

    2014-01-01

    Objectives: Catastrophizing is often the primary target of the cognitive-behavioral treatment of chronic pain. Recent literature on acceptance and commitment therapy (ACT) suggests an important role in the pain experience for the concepts mindfulness and acceptance. The aim of this study is to exami

  3. Efficacy of clozapine and quetiapine on chronic schizophrenia patients and their cognitive function changes%慢性精神分裂症患者应用氯氮平和喹硫平的疗效及认知功能变化

    Institute of Scientific and Technical Information of China (English)

    梁颂游

    2014-01-01

    目的:观察氯氮平和喹硫平对慢性精神分裂症的治疗效果及治疗后患者认知功能的变化。方法选取2010-02-2012-11在我院就诊的90例慢性精神分裂症患者,将经典抗精神病药物随机分配替换为氯氮平和喹硫平,分别对入组时和8个月末的精神症状及认知功能进行评估,用不良反应症状量表评定治疗16周后的不良反应。结果88例临床稳定型慢性精神分裂症患者在经氯氮平或喹硫平治疗8个月后精神症状均明显好转,8个月后的认知功能也有显著改善,差异有统计学意义(P<0.05)。换药16周后喹硫平组患者出现活动减少、嗜睡、便秘、流涎、头晕及体质量增加等不良反应的发生率明显少于氯氮平组,差异有统计学意义(P<0.05)。结论氯氮平和喹硫平对慢性精神分裂症均有显著治疗作用,且二者在认知功能的改善及疗效方面无显著差异,但与氯氮平相比,喹硫平的不良反应较少,是一种相对安全有效的抗精神病药物。%Objective To observe the efficacy and effects of clozapine and quetiapine on chronic schizophrenia patients and their cognitive function changes.Methods 90 patients with chronic schizophrenia admitted to our hospital from February 2010 to November 2012 were selected,and after the classic antipsychotic treatment,as to the poor efficacy or patients could not tol-erate the adverse reactions.The classical antipsychotics were randomly assigned to clozapine and quetiapine,respectively,and at the end of 8 months,psychiatric symptoms and cognitive function were assessed,symptom rating scale with adverse reac-tions was used to evaluate side effects after treatment for 16 weekends.Results psychotic symptoms of 88 clinically stable pa-tients after clozapine or quetiapine treatment for 8 months were significantly improved,their cognitive function after 8 months’ treatment also had been significantly improved

  4. a慢性阻塞性肺疾病患者血浆中性粒细胞明胶酶蛋白及内皮素-1水平与认知功能障碍的相关性%Correlation between plasma NGAL and ET-1 levels and cognitive dysfunction in patients with chronic obstructive pulmonary disease

    Institute of Scientific and Technical Information of China (English)

    胡玲玲; 戈艳蕾; 黄超; 李丽蕊; 王红阳

    2016-01-01

    Objective To investigate the relationship between the plasma neutrophil gelatinase-associated lipocalin (NGAL)and endothelin-1 (ET-1) levels and cognitive dysfunction in chronic obstructive pulmonary disease (COPD) patients.Methods A case-control study was performed,consisting of 128 patients with COPD(68 patients without cognitive dysfunction and 60 patients with cognitive dysfunction) and 70 normal controls.All patients with COPD were diagnosed by pulmonary function tests and plasma levels of NGAL and ET-1 were determined by enzyme immunoassay.The cognitive function was evaluated by the MMSE and MoCA.Results ①Compared with normal control,the levels of plasma NGAL and ET-1 were increased(NGAL:(2.20±0.60) μg/L vs (1.69±0.73) μg/L,P<0.05;ET-1:(26.19± 10.55)pg/ml vs (13.05±2.37) pg/ml,P<0.05) in COPD patients without cognitive dysfunction and in COPD patients with cognitive dysfunction(NGAL:(3.80±2.75) μg/L vs (1.69±0.73) μg/L,P<0.01;ET-1:(37.82±0.29) pg/ml vs (13.05±2.37) pg/ml,P<0.01).Compared with the COPD patients without cognitive dysfunction,the levels of plasma NGAL and ET-1 were also increased in COPD patients with cognitive dysfunction (all P<0.05).②The plasma NGAL levels were correlated negatively with MMSE scores(r=-0.524,P<0.05),and negatively correlated with MoCA scores (r=-0.527,P<0.05).The plasma ET-1 levels were negatively correlated with MMSE scores(r=-0.549,P<0.05),and negatively correlated with MoCA scores(r=-0.558,P<0.05).The levels of NGAL and ET-1 were positively correlated(r=0.564,P<0.05).Conclusion NGAL and ET-1 may be involved in the pathophysiological process of cognitive dysfunction in patients with COPD,which provides a certain clinical value for the assessment of cognitive dysfunction in patients with COPD.%目的 探讨慢性阻塞性肺疾病(chronic obstructive pulmonary disease,COPD)患者血浆中性粒细胞明胶酶蛋白(neutrophil gelatinase-associated lipocalin,NGAL)及内皮素-1(endothelin-1

  5. Reversal of cognitive deficits by an ampakine (CX516) and sertindole in two animal models of schizophrenia--sub-chronic and early postnatal PCP treatment in attentional set-shifting

    DEFF Research Database (Denmark)

    Broberg, Brian Villumsen; Glenthøj, Birte Yding; Dias, Rebecca;

    2009-01-01

    /kg, subcutaneously (s.c.)) and tested on PNDs 56-95, after reaching adulthood. The single test session required rats to dig for food rewards in a series of discriminations following acute administration of either vehicle, or CX516 (5-40 mg/kg, s.c.), or sertindole (1.25 mg/kg, perorally). RESULTS: The specific......RATIONALE: Therapies treating cognitive impairments in schizophrenia especially deficits in executive functioning are not available at present. OBJECTIVE: The current study evaluated the effect of ampakine CX516 in reversing deficits in executive functioning as represented in two animal models...

  6. Smartphone chronic gaming consumption and positive coping practice

    OpenAIRE

    Jouan de Kervenoael, Ronan; Schwob, A.; Palmer, M.; Simmons, G

    2016-01-01

    Purpose - Chronic consumption practice has been greatly accelerated by mobile, interactive and smartphone gaming technology devices. This study explores how chronic consumption of smartphone gaming produces positive coping practice. Design/methodology/approach - Underpinned by cognitive framing theory, empirical insights from eleven focus groups (n=62) reveal how smartphone gaming enhances positive coping amongst gamers and non-gamers. Findings - The findings reveal how the chronic consum...

  7. Neuroinflammation and neurological alterations in chronic liver diseases

    Directory of Open Access Journals (Sweden)

    Carmina Montoliu

    2015-01-01

    Full Text Available Several million people with chronic liver diseases (cirrhosis, hepatitis show neurological alterations, named hepatic encephalopathy (HE with cognitive and motor alterations that impair quality of life and reduces life span. Inflammation acts synergistically with hyperammonemia to induce cognitive and motor alterations in patients with chronic liver disease and minimal hepatic encephalopathy (MHE. Previous studies in animal models have suggested that neuroinflammation is a major player in HE. This would also be the case in patients with liver cirrhosis or hepatitis C with HE. Rats with MHE show microglial activation and neuroinflammation that is associated with cognitive impairment and hypokinesia. The anti-inflammatory drug ibuprofen reduces microglial activation and neuroinflammation and restores cognitive and motor functions in rats with MHE. Chronic hyperammonemia per se induces neuroinflammation. Both peripheral inflammation and hyperammonemia would contribute to neuroinflammation in chronic liver failure. Therefore, neuroinflammation may be a key therapeutic target to improve the cognitive and motor alterations in MHE and overt HE. Identifying new targets to reduce neuroinflammation in MHE without inducing secondary effects would serve to develop new therapeutic tools to reverse the cognitive and motor alterations in patients with HE associated with chronic liver diseases.

  8. The clinical features of patients with Parkinson's disease with chronic pain and its correlation with cognitive function%帕金森病伴慢性疼痛的临床特征及其与认知功能的相关性研究

    Institute of Scientific and Technical Information of China (English)

    黄翠兰; 肖井楠

    2016-01-01

    量、抑郁等不良情绪的产生均有影响,PD 伴慢性疼痛的发生与患者抑郁、认知功能障碍密切相关,认知、情感障碍可能共同参与了慢性疼痛的发病。%Objective To study clinical features of patients with Parkinson's disease (PD)with chronic pain and its correlation with cognitive function.Methods 100 PD patients with chronic pain were selected as the observa-tion group.100 PD patients without chronic pain were selected as disease control group.90 healthy subjects with pain were selected as control group.Statistical and clinical features of PD patients with pain,and the relationship between cognitive function were made.Results 100 patients with chronic pain with PD skeletal muscle pain in 42 cases (42.0%),motility pain in 23 cases (23.0%),23 cases of nerve root pain (23.0%),9 cases of central pain (9.0%),akathisia in 3 patients (3.0%);Control pain in patients with chronic pain with part mainly in the head and neck and the waist,PD patients with chronic pain with mainly in the limbs,pain in the two groups the incidence of head and neck pain,waist pain,limb pain had statistical differences (χ2 =10.017,4.990,21.770,all P 0.05).Conclusion PD associated with chronic pain is given priority to with skeletal muscle pain,PD associated with chronic pain pain is different from normal people,PD associated with chronic pain has influence on daily life, sleep quality and depression of patients bad feelings,PD associated with chronic pain are closely related to the depres-sion and cognitive dysfunction of patients.Cognitive and emotional disorders may be involved in the pathogenesis of chronic pain.

  9. Exercise and Cognition in Older Adults: Is there a Role for Resistance Training Programs?

    Science.gov (United States)

    Liu-Ambrose, Teresa; Donaldson, Meghan G

    2017-01-01

    In recent years, there has been a strong interest in physical activity as a primary behavioural prevention strategy against cognitive decline. A number of large prospective cohort studies have highlighted the protective role of regular physical activity in lowering the risk of cognitive impairment and dementia. The majority of prospective intervention studies of exercise and cognition to date have focused on aerobic-based exercise training. These studies highlight that aerobic-based exercise training enhances both brain structure and function. However, it has been suggested that other types of exercise training, such as resistance training, may also benefit cognition. The purpose of this brief review is to examine the evidence regarding resistance training and cognitive benefits. Three recent randomized exercise trials involving resistance training among seniors provide evidence that resistance training may have cognitive benefits. Resistance training may prevent cognitive decline among seniors via mechanisms involving IGF-1 and homocysteine. A side benefit of resistance training, albeit a very important one, is its established role in reducing morbidity among seniors. Resistance training specifically moderates the development of sarcopenia. The multifactorial deleterious sequelae of sarcopenia include increased falls and fracture risk as well as physical disability. Thus, clinicians should consider encouraging their clients to undertake both aerobic-based exercise training and resistance training not only for ‘physical health’ but also because of the almost certain benefits for ‘brain health’. PMID:19019904

  10. [First-episode psychosis, cognitive difficulties and remediation].

    Science.gov (United States)

    Vidailhet, P

    2013-09-01

    Cognitive difficulties are a core feature of schizophrenia. They are frequent, severe, and clearly associated with functional disabilities. They have been explored during different phases of the disease, but what we know essentially concerns the chronic period in middle-age patients. In this article we will specifically focus on cognition at the time of first episode. First episode is a key life period, occurring while social demands are increasing and more complex on the one hand, and while there are important changes in structural and functional cerebral anatomy on the other hand. Exploring cognitive difficulties at the time of first episode offers the opportunity to better know their time course, to avoid interpretative difficulties due to the chronicity of the disease and its treatments, and to develop early therapeutics in order to improve outcome. Cognitive difficulties are clearly present at the time of first episode; their nature and severity appear similar to those observed in more chronic patients. Therefore, they cannot be entirely explained by treatments, hospitalizations or chronicity, and appear more as an intrinsic feature of the disease. The course of their trajectory through the progression of the disease remains uncertain; while they are already present during childhood or adolescence in some subjects who will later declare schizophrenia, they seem to worsen during the period of early prodroms, that is years before psychotic symptoms emerge. Whether they aggravate again during the first episode process is still a matter of debate. While longer DUP is associated with a poor outcome, this does not seem to hold true for cognitive impairments. Cannabis or tobacco use are neither associated with worse cognitive abilities in first-episode patients; a reverse relationship even sometimes exists. Cognitive impairment appears as largely independent from other clinical dimensions, acknowledging its own physiopathology and requiring specific evaluation and

  11. Chronic Bronchitis

    Science.gov (United States)

    ... breathing. You may also have other tests. Chronic bronchitis is a long-term condition that keeps coming back or never goes away completely. If you smoke, it is important to quit. Treatment can help with your symptoms. It often includes ...

  12. Strain-dependent Effects of Acute, Chronic, and Withdrawal from Chronic Nicotine on Fear Conditioning

    OpenAIRE

    Portugal, George S.; Wilkinson, Derek S.; Kenney, Justin W.; Sullivan, Colleen; Gould, Thomas J.

    2011-01-01

    The effects of nicotine on cognitive processes such as learning and memory may play an important role in the addictive liability of tobacco. However, it remains unknown whether genetic variability modulates the effects of nicotine on learning and memory. The present study characterized the effects of acute, chronic, and withdrawal from chronic nicotine administration on fear conditioning, somatic signs, and the elevated plus maze in 8 strains of inbred mice. Strain-dependent effects of acute ...

  13. Chronic pain management: nonpharmacological therapies for chronic pain.

    Science.gov (United States)

    Chang, Ku-Lang; Fillingim, Roger; Hurley, Robert W; Schmidt, Siegfried

    2015-05-01

    Nonpharmacologic therapies have become a vital part of managing chronic pain (CP). Although these can be used as stand-alone therapies, nonpharmacologic treatments often are used to augment and complement pharmacologic treatments (ie, multimodal therapy). Nonpharmacologic approaches can be classified as behavioral, cognitive, integrative, and physical therapies. Core principles in developing a treatment plan are explaining the nature of the CP condition, setting appropriate goals, and developing a comprehensive treatment approach and plan for adherence. Clinicians should become familiar with these interventions so that they can offer patients flexibility in the pain management approach. Effective noninvasive treatment modalities for CP include behavioral therapy for short-term pain relief; cognitive behavioral therapy for reducing long-term pain and disability; hypnosis as adjunctive therapy; guided imagery, diaphragmatic breathing, and muscle relaxation, especially for cancer-related pain; mindfulness-based stress reduction for patients with chronic low back pain; acupuncture for multiple pain conditions; combination manipulation, manual therapy, endurance exercise, stretching, and strengthening for chronic neck pain; animal-assisted therapy; and S-adenosyl-L-methionine for joint pain. Guidelines for use of these treatment modalities are based on expert panel recommendations in combination with data from randomized controlled trials.

  14. COGNITIVE COMPETENCE COMPARED TO COGNITIVE INDEPENDENCE AND COGNITIVE ACTIVITY

    OpenAIRE

    2014-01-01

    The research is aimed at identifying the essence of the cognitive competence concept in comparison with the concepts of cognitive independence and activity.Methods: The methodology implies a theoretical analysis of psychopedagogical and methodological materials on the cognitive competence formation; generalized teaching experience; empirical methods of direct observations of educational process in the secondary school classrooms; interviews with school teachers and pupils.Results: The researc...

  15. Immunology in the Clinic Review Series; focus on metabolic diseases: development of islet autoimmune disease in type 2 diabetes patients: potential sequelae of chronic inflammation.

    Science.gov (United States)

    Brooks-Worrell, B; Palmer, J P

    2012-01-01

    Historically, the development of type 2 diabetes has been considered not to have an autoimmune component, in contrast to the autoimmune pathogenesis of type 1 diabetes. In this review we will discuss the accumulating data supporting the concept that islet autoreactivity and inflammation is present in type 2 diabetes pathogenesis, and the islet autoimmunity appears to be one of the factors associated with the progressive nature of the type 2 diabetes disease process.

  16. GDNF在慢性应激和老化致小鼠行为与认知损伤中的作用%Role of GDNF in the behavior and cognitive impairment of mice induced by chronic stress and aging

    Institute of Scientific and Technical Information of China (English)

    李亚; 张亚楠; 陈亚静; 张冠雄; 史建勋

    2013-01-01

    Objective: To investigate the effects of chronic stress on the spatial learning-memory and the role of glial cell line-derived neurotrophic factor (GDNF) of prefrontal cortex (PFC) and hippocampus (HP) in different age mice. Methods: The chronic stress model mice in 21 days with multiple chronic unpredictable stressors were applied. The spontaneous behavior and spatial learning-memory ability of mice were tested, using Open field and Morris water maze task, and the expression of GDNF in HP and PFC were detected by immunohistoche-mical method. Results: Compared with young mice, the spontaneous behaviors were significantly decreased and the spatial learning-memory function were significantly decreased (P<0.05, P<0.01) in aged mice. The GDNF expression in the CA3, DG of HP and PFC were significantly reduced in aged mice (P<0.05, P<0.01). After chronic stress, the spontaneous behaviors were remarkably decreased and the ability of spatial learning-memory of the stress group mice were significantly decreased (P< 0.05, P<0.01) compared with those of the