WorldWideScience

Sample records for functional amnesia clinical

  1. Functional ("psychogenic") amnesia.

    Science.gov (United States)

    Brandt, Jason; Van Gorp, Wilfred G

    2006-07-01

    Patients who present with severely impaired memory functioning without a discernable neurological cause typically have experienced one or more severely stressful life events. These patients, who are described as having "psychogenic" or "dissociative" amnesia, typically differ from patients with the neurologic amnestic syndrome in that memory for their personal life histories is much more severely affected than is their ability to learn and retain new information; that is, they have isolated retrograde amnesia. Recent cognitive and brain imaging research has begun to reveal some of the cerebral mechanisms underlying functional amnesia, but this disorder remains best conceptualized as a relatively rare form of illness-simulating behavior rather than a disease. Neuropsychological assessment is often useful in revealing the circumscribed nature of the patient's performance deficits, the spared functions that can be brought to bear in rehabilitation, and the emotional disorders requiring psychiatric treatment. Controlled treatment trials are nonexistent, but case reports suggest that supportive psychotherapy, systematic relaxation training, hypnosis, and sedative/anxiolytic medications are useful in facilitating recovery. These treatments are often combined with a psychoeducational approach that essentially reteaches the patient his or her life story.

  2. Amnesia

    Science.gov (United States)

    ... permanent amnesia. Another rare type of amnesia, called dissociative (psychogenic) amnesia, stems from emotional shock or trauma, such as being the victim of a violent crime. In this disorder, a person may lose personal memories and autobiographical ...

  3. Amnesia

    Science.gov (United States)

    ... leading to thiamin (vitamin B-1) deficiency (Wernicke-Korsakoff syndrome) Tumors in areas of the brain that control ... most types of amnesia. Amnesia caused by Wernicke-Korsakoff syndrome involves a lack of thiamin. Treatment includes replacing ...

  4. Dissociative amnesia.

    Science.gov (United States)

    Staniloiu, Angelica; Markowitsch, Hans J

    2014-08-01

    Dissociative amnesia is one of the most enigmatic and controversial psychiatric disorders. In the past two decades, interest in the understanding of its pathophysiology has surged. In this report, we review new data about the epidemiology, neurobiology, and neuroimaging of dissociative amnesia and show how advances in memory research and neurobiology of dissociation inform proposed pathogenetic models of the disorder. Dissociative amnesia is characterised by functional impairment. Additionally, preliminary data suggest that affected people have an increased and possibly underestimated suicide risk. The prevalence of dissociative amnesia differs substantially across countries and populations. Symptoms and disease course also vary, indicating a possibly heterogeneous disorder. The accompanying clinical features differ across cultural groups. Most dissociative amnesias are retrograde, with memory impairments mainly involving the episodic-autobiographical memory domain. Anterograde dissociative amnesia occurring without significant retrograde memory impairments is rare. Functional neuroimaging studies of dissociative amnesia with prevailing retrograde memory impairments show changes in the network that subserves autobiographical memory. At present, no evidence-based treatments are available for dissociative amnesia and no broad framework exists for its rehabilitation. Further research is needed into its neurobiology, course, treatment options, and strategies to improve differential diagnoses. Copyright © 2014 Elsevier Ltd. All rights reserved.

  5. Stranger than fiction: literary and clinical amnesia.

    Science.gov (United States)

    Dieguez, Sebastian; Annoni, Jean-Marie

    2013-01-01

    This chapter broadly covers literary uses of amnesia and memory disorders. Amnesia in fiction offers authors an efficient and dramatic device to tackle themes such as identity, personal liberty, or guilt. We argue against the common complaint that fictional amnesia is scientifically inaccurate, pointing out that the goals of literature are different from those of science, that amnesia is still poorly understood, and that real-life cases can sometimes be stranger than fiction. The chapter provides examples from the neuropsychological literature, media reports, mythology, historical cases, detective stories, war stories, theatrical plays, and other genres. Special attention is given to retrograde and dissociative amnesia, as these are the most frequent types of amnesia portrayed in fiction, while other types of memory disorders are more shortly treated. We argue that the predominance of disorders affecting autobiographical memory in fiction is in itself a revealing fact about the mechanisms of human memory, illustrating how fictional treatments of pathology can inform back neurological and psychological research.

  6. Validation of Malingered Amnesia Measures with a Large Clinical Sample.

    Science.gov (United States)

    Greiffenstein, Manfred F.; And Others

    1994-01-01

    A sample of chronic postconcussive patients with and without overt malingering signs was compared with objectively brain-injured patients (total sample=106) on common episodic memory and malingered amnesia measures. Findings validate commonly cited malingering measures and new methods of classifying malingering in real-world clinical samples. (SLD)

  7. Towards Solving the Riddle of Forgetting in Functional Amnesia: Recent Advances and Current Opinions

    Directory of Open Access Journals (Sweden)

    Angelica eStaniloiu

    2012-11-01

    Full Text Available Remembering the past is a core feature of human beings, enabling them to maintain a sense of wholeness and identity and preparing them for the demands of the future. Forgetting operates in a dynamic neural connection with remembering, allowing the elimination of unnecessary or irrelevant information overload and decreasing interference. Stress and traumatic experiences could affect this connection, resulting in memory disturbances, such as functional amnesia. An overview of clinical, epidemiological, neuropsychological and neurobiological aspects of functional amnesia is presented, by preponderantly resorting to own data from patients with functional amnesia. Patients were investigated medically, neuropsychologically and neuroradiologically. A detailed report of a new case is included to illustrate the challenges posed by making an accurate differential diagnosis of functional amnesia, a condition that may encroach on the boundaries between psychiatry and neurology. Several mechanisms may play a role in forgetting in functional amnesia, such as retrieval impairments, consolidating defects, motivated forgetting, deficits in binding and reassembling details of the past, deficits in establishing a first person autonoetic connection with personal events and loss of information. In a substantial number of patients, we observed a synchronization abnormality between a frontal lobe system, important for autonoetic consciousness, and a temporo-amygdalar system, important for evaluation and emotions, which provides empirical support for an underlying mechanism of dissociation (a failure of integration between cognition and emotion. This observation suggests a mnestic blockade in functional amnesia that is triggered by psychological or environmental stress and is underpinned by a stress hormone mediated synchronization abnormality during retrieval between processing of affect-laden events and fact-processing.

  8. Transient epileptic amnesia: clinical report of a cohort of patients.

    Science.gov (United States)

    Lapenta, Leonardo; Brunetti, Valerio; Losurdo, Anna; Testani, Elisa; Giannantoni, Nadia Mariagrazia; Quaranta, Davide; Di Lazzaro, Vincenzo; Della Marca, Giacomo

    2014-07-01

    Transient epileptic amnesia is a seizure disorder, usually with onset in the middle-elderly and good response to low dosages of antiepileptic drugs. We describe the clinical, electroencephalography (EEG), and neuroimaging features of 11 patients with a temporal lobe epilepsy characterized by amnesic seizures as the sole or the main symptom. We outline the relevance of a detailed clinical history to recognize amnesic seizures and to avoid the more frequent misdiagnoses. Moreover, the response to monotherapy was usually good, although the epileptic disorder was symptomatic of acquired lesions in the majority of patients.

  9. Three dimensions of dissociative amnesia.

    Science.gov (United States)

    Dell, Paul F

    2013-01-01

    Principal axis factor analysis with promax rotation extracted 3 factors from the 42 memory and amnesia items of the Multidimensional Inventory of Dissociation (MID) database (N = 2,569): Discovering Dissociated Actions, Lapses of Recent Memory and Skills, and Gaps in Remote Memory. The 3 factors' shared variance ranged from 36% to 64%. Construed as scales, the 3 factor scales had Cronbach's alpha coefficients of .96, .94, and .93, respectively. The scales correlated strongly with mean Dissociative Experiences Scale scores, mean MID scores, and total scores on the Structured Clinical Interview for DSM-IV Dissociative Disorders-Revised (SCID-D-R). What is interesting is that the 3 amnesia factors exhibited a range of correlations with SCID-D-R Amnesia scores (.52, .63, and .70, respectively), suggesting that the SCID-D-R Amnesia score emphasizes gaps in remote memory over amnesias related to dissociative identity disorder. The 3 amnesia factor scales exhibited a clinically meaningful pattern of significant differences among dissociative identity disorder, dissociative disorder not otherwise specified-1, dissociative amnesia, depersonalization disorder, and nonclinical participants. The 3 amnesia factors may have greater clinical utility for frontline clinicians than (a) amnesia as discussed in the context of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, nosology of the dissociative disorders or (b) P. Janet's (1893/1977 ) 4-fold classification of dissociative amnesia. The author recommends systematic study of the phenomenological differences within specific dissociative symptoms and their differential relationship to specific dissociative disorders.

  10. Functional MRI study of diencephalic amnesia in Wernicke-Korsakoff syndrome.

    Science.gov (United States)

    Caulo, M; Van Hecke, J; Toma, L; Ferretti, A; Tartaro, A; Colosimo, C; Romani, G L; Uncini, A

    2005-07-01

    Anterograde amnesia in Wernicke-Korsakoff syndrome is associated with diencephalic lesions, mainly in the anterior thalamic nuclei. Whether diencephalic and temporal lobe amnesias are distinct entities is still not clear. We investigated episodic memory for faces using functional MRI (fMRI) in eight controls and in a 34-year-old man with Wernicke-Korsakoff syndrome and diencephalic lesions but without medial temporal lobe (MTL) involvement at MRI. fMRI was performed with a 1.5 tesla unit. Three dual-choice tasks were employed: (i) face encoding (18 faces were randomly presented three times and subjects were asked to memorize the faces); (ii) face perception (subjects indicated which of two faces matched a third face); and (iii) face recognition (subjects indicated which of two faces belonged to the group they had been asked to memorize during encoding). All activation was greater in the right hemisphere. In controls both the encoding and recognition tasks activated two hippocampal regions (anterior and posterior). The anterior hippocampal region was more activated during recognition. Activation in the prefrontal cortex was greater during recognition. In the subject with Wernicke-Korsakoff syndrome, fMRI did not show hippocampal activation during either encoding or recognition. During recognition, although behavioural data showed defective retrieval, the prefrontal regions were activated as in controls, except for the ventrolateral prefrontal cortex. fMRI activation of the visual cortices and the behavioural score on the perception task indicated that the subject with Wernicke-Korsakoff syndrome perceived the faces, paid attention to the task and demonstrated accurate judgement. In the subject with Wernicke-Korsakoff syndrome, although the anatomical damage does not involve the MTL, the hippocampal memory encoding has been lost, possibly as a consequence of the hippocampal-anterior thalamic axis involvement. Anterograde amnesia could therefore be the expression of

  11. Anterograde Amnesia

    Directory of Open Access Journals (Sweden)

    Serap Erdogan

    2010-08-01

    Full Text Available Memory can be divided into two categories (i.e. short term memory and long term memory according to time span. Information at our long term memory that can be remembered with conscious effort are placed in declarative memory. Information that can not be remembered conciously are placed in nondeclarative memory. The definition of anterograde amnesia is inability to generate new memories after the event causing amnesia. Episodic and semantic memories are usually unaffected among patients’ who had such amnesia. Anterograde amnesia could mostly result from head trauma but in some cases the cause could be serebrovascular events, Wernicke-Korsakoff Syndrome, santral nervous system enfections, anoxia or various substances. Medial temporal lobe and medial diencephalon are two brain regions mainly related with this condition. Medial temporal lobe is consisted of hippocampus, amygdala, parahippocampal cortex, perirhinal cortex and entorhinal cortex. Hypothalamus, thalamus, mamillary bodies and several thalamic nucleases compose medial diencephalon. Fornix and rarely serebellum damage may also play role in the development of anterograde amnesia. After the famous H.M case, who had anterograde amnesia after an epileptic surgery operation, hippocampus has been placed in the focus of memory researches. In the literature there are several reports evaluating brain tissues of amnesic patients at postmortem stage. Postmortem histological evaluations consistently revealed hippocampal neuronal loss among these patients’ brain tissues. Benzodiazepines usually cause short term anterograde amnesia. Benzodiazepine receptors are allosteric modulatory sites on gamma-aminobutyric acid-A (GABA-A receptors. GABA-A receptors composed of five subunits and anterograde amnesia emerges by means of alfa 1 subunit. Anterograde amnesia has been suggested to occur by the blocking of long term potentiation in hippocampus and piriform cortex. For the treatment of the anterograde

  12. Transient global amnesia mimics: Transient epileptic amnesia

    Directory of Open Access Journals (Sweden)

    Nicolas Nicastro

    2014-01-01

    Full Text Available We describe the case of a 79-year-old patient referred for suspected transient global amnesia, after an episode of anterograde amnesia which lasted 90 min. An EEG, performed after the episode, showed bilateral temporal electrographic seizures, orienting the diagnosis toward a transient epileptic amnesia. Transient epileptic amnesia is defined by temporal lobe epilepsy characterized by recurrent transient amnestic episodes of 30–90 min in duration, sometimes associated with olfactory hallucinations or oral automatisms. Response to antiepileptic drugs is excellent. We would like to raise awareness toward this epileptic amnesia when facing atypical or recurrent transient amnestic episodes.

  13. Disconnection between the default mode network and medial temporal lobes in post-traumatic amnesia.

    Science.gov (United States)

    De Simoni, Sara; Grover, Patrick J; Jenkins, Peter O; Honeyfield, Lesley; Quest, Rebecca A; Ross, Ewan; Scott, Gregory; Wilson, Mark H; Majewska, Paulina; Waldman, Adam D; Patel, Maneesh C; Sharp, David J

    2016-12-01

    SEE BIGLER DOI101093/AWW277 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Post-traumatic amnesia is very common immediately after traumatic brain injury. It is characterized by a confused, agitated state and a pronounced inability to encode new memories and sustain attention. Clinically, post-traumatic amnesia is an important predictor of functional outcome. However, despite its prevalence and functional importance, the pathophysiology of post-traumatic amnesia is not understood. Memory processing relies on limbic structures such as the hippocampus, parahippocampus and parts of the cingulate cortex. These structures are connected within an intrinsic connectivity network, the default mode network. Interactions within the default mode network can be assessed using resting state functional magnetic resonance imaging, which can be acquired in confused patients unable to perform tasks in the scanner. Here we used this approach to test the hypothesis that the mnemonic symptoms of post-traumatic amnesia are caused by functional disconnection within the default mode network. We assessed whether the hippocampus and parahippocampus showed evidence of transient disconnection from cortical brain regions involved in memory processing. Nineteen patients with traumatic brain injury were classified into post-traumatic amnesia and traumatic brain injury control groups, based on their performance on a paired associates learning task. Cognitive function was also assessed with a detailed neuropsychological test battery. Functional interactions between brain regions were investigated using resting-state functional magnetic resonance imaging. Together with impairments in associative memory, patients in post-traumatic amnesia demonstrated impairments in information processing speed and spatial working memory. Patients in post-traumatic amnesia showed abnormal functional connectivity between the parahippocampal gyrus and posterior cingulate cortex. The strength of this functional

  14. Gudden's Ventral Tegmental Nucleus Is Vital for Memory: Re-Evaluating Diencephalic Inputs for Amnesia

    Science.gov (United States)

    Vann, Seralynne D.

    2009-01-01

    Mammillary body atrophy is present in a number of neurological conditions and recent clinical findings highlight the importance of these nuclei for memory. While most accounts of diencephalic amnesia emphasize the functional importance of the hippocampal projections to the mammillary bodies, the present study tested the importance of the other…

  15. A mathematical model of forgetting and amnesia

    Directory of Open Access Journals (Sweden)

    Jaap M. J. Murre

    2013-02-01

    Full Text Available We describe a mathematical model of learning and memory and apply it to the dynamics of forgetting and amnesia. The model is based on the hypothesis that the neural systems involved in memory at different time-scales share two fundamental properties: (1 representations in a store decline in strength (2 while trying to induce new representations in higher-level more permanent stores. This paper addresses several types of experimental and clinical phenomena: (i the temporal gradient of retrograde amnesia (Ribot's Law, (ii forgetting curves with and without anterograde amnesia, and (iii learning and forgetting curves with impaired cortical plasticity. Results are in the form of closed-form expressions that are applied to studies with mice, rats, and monkeys. In order to analyze human data in a quantitative manner, we also derive a relative measure of retrograde amnesia that removes the effects of non-equal item difficulty for different time periods commonly found with clinical retrograde amnesia tests. Using these analytical tools, we review studies of temporal gradients in the memory of patients with Korsakoff's Disease, Alzheimer's Dementia, Huntington's Disease, and other disorders.

  16. Dense amnesia in a professional musician following herpes simplex virus encephalitis.

    Science.gov (United States)

    Wilson, B A; Baddeley, A D; Kapur, N

    1995-10-01

    We describe the memory functioning of C, a professional musician who became amnesic following herpes simplex encephalitis in 1985. Although transient amnesia in a professional musician has previously been described, this is the first reported case of chronic amnesia in a highly talented professional musician. C is unusual in three respects. First, his amnesia is particularly severe. Second, his amnesia includes semantic as well as episodic memory deficits. Third, he believes he has just woken up and his preoccupation with this state of 'just wakening' has persisted for over 9 years. This appears to be the result of a delusion rather than the consequence of his amnesia.

  17. Studies on effects of Emblica officinalis (Amla) on oxidative stress and cholinergic function in scopolamine induced amnesia in mice.

    Science.gov (United States)

    Golechha, Mahaveer; Bhatia, Jagriti; Arya, Dharmveer Singh

    2012-01-01

    Emblica officinalis, commonly known as amla, is an important medicinal plant of India. Its fruits have potent antioxidant activity due to the presence of tannoids, tannins, vitamin C and flavonoids. The aim of this study was to investigate the beneficial effect of the hydroalcoholic extract of the fruits of Emblica officinalis (EO) on memory impairment in Swiss albino mice. Scopolamine (1 mg kg(-1), i.p)was administered to induce amnesia and the memory was evaluated by using elevated plus-maze and passive avoidance tests. Piracetam (200 mg kg(-1), i.p.) was used as a standard nootropic agent. The EO extract was administered intraperitoneally in four graded doses (150, 300, 450 and 600 mg kg(-1)) for 7 consecutive days to different groups of mice. The mice were sacrificed on the 8th day following assessment of memory. The brain malondialdehyde (MDA) and glutathione (GSH) as well as acetylcholinesterase (AchE)) activity was determined. It was observed that EO extract reversed the amnesia induced by scopolamine. The mean transfer latency and retention latency in the EO extract 600 mg kg(-1) group vs the vehicle treated scopolamine group was 13.46 sec (p<0.001) and 134.4 sec (p<0.001) vs 23.99 sec and 44.55 sec, respectively. EO extract treatment also significantly (p<0.001) ameliorated the oxidative stress induced by scopolamine administration. The mice brain MDA and GSH levels in the EO extract 600 mg kg(-1) group vs the scopolamine group were 29.95 nmol g(-1) of wet tissue and 51.87 microg g(-1) tissue vs 55.22 nmol g(-1) of wet tissue and 28.33 microg g(-1) tissue, respectively. Further, EO extract (300, 450 and 600 mg kg(-1), i.p) significantly (p<0.001) reversed the rise in brain acetyl cholinesterase (AchE) level induced by scopolamine. The mice brain Ach E levels in the EO extract 600 mg kg(-1) group as compared to the scopolamine group was 70.23 vs 151.49 U mg(-1) protein(-1), respectively. These results suggestthat EO possesses memory enhancing, antioxidant

  18. Hypnosis, memory and amnesia.

    OpenAIRE

    Kihlstrom, J F

    1997-01-01

    Hypnotized subjects respond to suggestions from the hypnotist for imaginative experiences involving alterations in perception and memory. Individual differences in hypnotizability are only weakly related to other forms of suggestibility. Neuropsychological speculations about hypnosis focus on the right hemisphere and/or the frontal lobes. Posthypnotic amnesia refers to subjects' difficulty in remembering, after hypnosis, the events and experiences that transpired while they were hypnotized. P...

  19. Transient Global Amnesia: Emergency Department Evaluation And Management.

    Science.gov (United States)

    Faust, Jeremy Samuel; Nemes, Andreea

    2016-08-01

    Transient global amnesia is a clinically distinct syndrome characterized by the acute inability to form new memories. It can last up to 24 hours. The diagnosis is dependent on eliminating other more serious etiologies including toxic ingestions, acute strokes, complex partial seizures, and central nervous system infections. Transient global amnesia confers no known long-term risks; however, when abnormal signs or symptoms are present, they take precedence and guide the formulation of a differential diagnosis and investigation. In witnessed transient global amnesia with classic features, a minimalist approach is reasonable, avoiding overtesting, inappropriate medication, and medical interventions in favor of observation, ensuring patient safety, and reassuring patients and their families. This review provides a detailed framework for distinguishing transient global amnesia from its dangerous mimics and managing its course in the emergency department.

  20. The Many Faces of Amnesia

    Science.gov (United States)

    Gold, Paul E.

    2006-01-01

    Results from studies of retrograde amnesia provide much of the evidence for theories of memory consolidation. Retrograde amnesia gradients are often interpreted as revealing the time needed for the formation of long-term memories. The rapid forgetting observed after many amnestic treatments, including protein synthesis inhibitors, and the parallel…

  1. How we recall (or don't): the hippocampal memory machine and anesthetic amnesia.

    Science.gov (United States)

    Perouansky, Misha; Pearce, Robert A

    2011-02-01

    The hippocampal formation occupies a central position for the processing of sensory input into learned, remembered, and consciously retrievable information. The mechanisms by which anesthetic drugs interfere with these processes are now emerging. We review the current understanding of the role of the hippocampal formation in the generation of memory traces and how anesthetics might interfere with its function. Intraoperative amnesia is a desired endpoint of general anesthesia from the perspective of both the patient and the practitioner. "Intraoperative awareness with recall" can result when learning and memory do occur. In addition, anesthetics are capable of inducing a state of "conscious amnesia" that can provide insight into the workings of the brain and might be useful clinically. Anesthesiologists routinely induce the most fascinating pharmacologic effects in existence, the reversible interference of anesthetics with higher cognitive functions. Understanding how the drugs in our custody exert their effects should be our contribution to mankind's universal knowledge base.

  2. Transient Global Amnesia: A Case Report

    Directory of Open Access Journals (Sweden)

    Richard Alan Rison

    2012-08-01

    Full Text Available Introduction: Transient global amnesia is a syndrome of temporary and reversible disruption of short-term memory accompanied by repetitive questioning. Although the etiology is unknown, the prognosis usually benign, and no particular treatment is required, it is important for all involved clinicians to recognize the diagnosis and possess knowledge about the evaluation of these affected patients. Case Presentation: A middle-aged Caucasian woman presented for neurologic evaluation for acute forgetfulness. Neurologic examination disclosed repetitive questioning with preserved orientation and no focal motor, speech, sensory, coordination, or cranial nerve deficits. Neurologic investigations did not reveal any pathologic findings. Her memory improved and reverted to normal baseline over the course of a 24-hour hospital stay. Conclusion: Transient global amnesia is an interesting syndrome of reversible anterograde amnesia associated with repetitive questioning that occurs with an unclear etiology in middle-aged and elderly individuals. Due clinical diligence is required in the investigation of these patients. Treatment is generally not required, and the condition usually does not recur. Clinicians, including neurologists, internists, family practice physicians, and psychiatrists, need awareness of this condition.

  3. Focal cerebral hyperemia in postconcussive amnesia.

    Science.gov (United States)

    Nariai, T; Suzuki, R; Ohta, Y; Ohno, K; Hirakawa, K

    2001-12-01

    Transient amnesia caused by minor head injury is commonly encountered in daily neurosurgical practice, but the mechanism of such amnesia has not been extensively studied. We measured the regional cerebral blood flow (rCBF) of patients with postconcussive amnesia with Xe/CT CBF to examine whether a focal disturbance of CBF exists. The Xe/CT CBF study was performed in eight patients with closed head injury without organic cerebral lesion while they were suffering from posttraumatic amnesia (concussion group). The time interval between accident and CBF measurement was less than 2 h in three patients, 5-6 h in two, 8-9 h in two, and 18 in one. The results were compared with those of nine normal volunteers and eight other age-matched patients who recovered without any neurological deficit despite the presence of hemorrhagic regions (mild hemorrhage group). The rCBF of the concussion group was significantly elevated in the bilateral mesial temporal cortex in comparison to the normal group. The rCBF in the mild hemorrhage group was lower than that of normal controls in all regions. The analysis of right-left difference in CBF indicated that there was significant asymmetry (right > left) in the frontal and temporal cortex in the concussion group, but not in the normal and mild hemorrhage group. This Xe/CT CBF study in acute stages of cerebral concussion, in which patients were amnestic, detected focal cerebral hyperemia. Such hyperemia in regions closely related to human memory function may be the result of vasoparalysis or the compensatory activation of memory circuits after denervation injury.

  4. Persistent Autobiographical Amnesia: A Case Report

    Directory of Open Access Journals (Sweden)

    C. Repetto

    2007-01-01

    Full Text Available We describe a 47-year-old man who referred to the Emergency Department for sudden global amnesia and left mild motor impairment in the setting of increased arterial blood pressure. The acute episode resolved within 24 hours. Despite general recovery and the apparent transitory nature of the event, a persistent selective impairment in recollecting events from some specific topics of his personal life became apparent. Complete neuropsychological tests one week after the acute onset and 2 months later demonstrated a clear retrograde memory deficit contrasting with the preservation of anterograde memory and learning abilities. One year later, the autobiographic memory deficit was unmodified, except for what had been re-learnt. Brain MRI was normal while H20 brain PET scans demonstrated hypometabolism in the right globus pallidus and putamen after 2 weeks from onset, which was no longer present one year later. The absence of a clear pathomechanism underlying focal amnesia lead us to consider this case as an example of functional retrograde amnesia.

  5. Memory formation, amnesia, improved memory and reversed amnesia: 5-HT role.

    Science.gov (United States)

    Perez-Garcia, G; Meneses, A

    2008-12-16

    Traditionally, the search for memory circuits has been focused on examinations of amnesic and AD patients, cerebral lesions and neuroimaging. A complementary alternative has become the use of autoradiography with radioligands, aiming to identify neurobiological markers associated with memory formation, amnesia states and (more recently) recovery from memory deficits. Indeed, ex vivo autoradiographic studies offer the advantage of detecting functionally active receptors altered by pharmacological tools during memory formation, amnesia states and memory recovery. Moreover, serotonin (5-hydroxytryptamine, 5-HT) systems have become a pharmacological and genetic target in the treatment of memory disorders. Herein evidence from studies involving expression of 5-HT(1A), 5-HT(2A), 5-HT(4), and 5-HT(6) receptors in memory formation, amnesia conditions (e.g., pharmacological models or aging) and recovery of memory is reviewed. Thus, specific 5-HT receptors were expressed in trained animals relative to untrained in brain areas such as cortex, hippocampus and amygdala. However, relative to the control group, rats showing amnesia or recovered memory, showed in the hippocampus, region where explicit memory is formed, a complex pattern of 5-HT receptor expression. An intermediate expression occurred in amygdala, septum and some cortical areas in charge of explicit memory storage. Even in brain areas thought to be in charge of procedural memory such as basal ganglia, animals showing recovered memory displayed an intermediate expression, while amnesic groups, depending on the pharmacological amnesia model, showed up- or down-regulation. In conclusion, evidence indicates that autoradiography, by using specific radioligands, offers excellent opportunities to map dynamic changes in brain areas engaged in these cognitive processes. The 5-HT modulatory role strengthens or suppresses memory is critically depend on the timing of the memory formation.

  6. Empathy in hippocampal amnesia.

    Science.gov (United States)

    Beadle, J N; Tranel, D; Cohen, N J; Duff, M C

    2013-01-01

    Empathy is critical to the quality of our relationships with others and plays an important role in life satisfaction and well-being. The scientific investigation of empathy has focused on characterizing its cognitive and neural substrates, and has pointed to the importance of a network of brain regions involved in emotional experience and perspective taking (e.g., ventromedial prefrontal cortex, amygdala, anterior insula, cingulate). While the hippocampus has rarely been the focus of empathy research, the hallmark properties of the hippocampal declarative memory system (e.g., representational flexibility, relational binding, on-line processing capacity) make it well-suited to meet some of the crucial demands of empathy, and a careful investigation of this possibility could make a significant contribution to the neuroscientific understanding of empathy. The present study is a preliminary investigation of the role of the hippocampal declarative memory system in empathy. Participants were three patients (1 female) with focal, bilateral hippocampal (HC) damage and severe declarative memory impairments and three healthy demographically matched comparison participants. Empathy was measured as a trait through a battery of gold standard questionnaires and through on-line ratings and prosocial behavior in response to a series of empathy inductions. Patients with hippocampal amnesia reported lower cognitive and emotional trait empathy than healthy comparison participants. Unlike healthy comparison participants, in response to the empathy inductions hippocampal patients reported no increase in empathy ratings or prosocial behavior. The results provide preliminary evidence for a role for hippocampal declarative memory in empathy.

  7. Empathy in hippocampal amnesia

    Directory of Open Access Journals (Sweden)

    Janelle N Beadle

    2013-03-01

    Full Text Available The scientific investigation of empathy has become a cornerstone in the field of social cognition. Empathy is critical to the quality of our relationships with others and plays an important role in life satisfaction and well-being. Scientific investigations of empathy have focused on characterizing its cognitive and neural substrates, pointing to a network of brain regions involved in emotional experience and perspective taking (e.g., ventromedial prefrontal cortex, amygdala, anterior insula, cingulate. While the hippocampus has rarely been the focus of empathy research, we propose that there are compelling reasons to inquire about the contribution of the hippocampus to social cognition. We propose that the hallmark properties of the hippocampal declarative memory system (e.g., representational flexibility, relational binding, on-line processing capacity make it well-suited to meet the demands of empathy. The present study is a preliminary investigation of the role of the hippocampal declarative memory system in empathy. Participants were three patients (1 female with focal, bilateral hippocampal (HC damage and severe declarative memory impairments and three healthy demographically matched comparison participants. Empathy was measured as a trait through a battery of gold standard questionnaires and through on-line ratings and prosocial behavior in response to a series of empathy inductions. Patients with hippocampal amnesia reported lower cognitive and emotional trait empathy than healthy comparison participants. In response to the empathy inductions, unlike healthy comparison participants, hippocampal patients reported no increase in empathy ratings or prosocial behavior from the control condition. Taken together, these results provide preliminary evidence for a role of hippocampal declarative memory in empathy.

  8. [Developmental amnesia in the premature infant].

    Science.gov (United States)

    Mouron, V; Hays, S; Gonzalez-Monge, S

    2010-02-01

    All types of memory disorders have been observed in children, although these reports are rare. Developmental amnesia selectively involves episodic daily life memory while semantic learning is respected and general intelligence is not affected. Daily life is severely disturbed by this cognitive disorder usually occurring after hypoxic ischemic injury with bilateral hippocampal atrophy on MRI. Memory disorders are underdiagnosed in at-risk patients and rarely reported. We report on a former small-for-gestational-age preterm infant with no obvious hypoxic event during perinatal life. The follow-up was normal until elementary school. He had to spend 2 years in 1st grade and exhibited some behavioral troubles. At the age of 9, he was suspected of suffering from dyspraxia and was referred to a pediatrics rehabilitation center. IQ and neuropsychological tests were administered and showed selective autobiographical memory impairment defining developmental amnesia. Despite a typical clinical presentation, brain MRI was normal, including the hippocampal area. This observation underlines the need for a prolonged follow-up until school age to assess the outcome of preterm infants. Otherwise, the evaluation will be limited to motor impairment. Particular attention should be paid to memory during the follow-up to avoid misdiagnoses and to plan and adapt these children's educational strategies. Copyright 2009 Elsevier Masson SAS. All rights reserved.

  9. Just do it! How performing an action enhances remembering in transient global amnesia.

    Science.gov (United States)

    Hainselin, Mathieu; Quinette, Peggy; Juskenaite, Aurelija; Desgranges, Béatrice; Martinaud, Olivier; de La Sayette, Vincent; Hannequin, Didier; Viader, Fausto; Eustache, Francis

    2014-01-01

    Transient global amnesia (TGA) is a clinical syndrome characterized by the sudden onset of a massive episodic memory deficit that spares other cognitive functions. As such, it provides a unique human amnesia model for testing the enactment effect (i.e., better memory for performed actions than for verbally encoded sentences). Our main aim was to test whether the enactment effect is preserved in TGA patients, both to have a better understanding and to test the robustness of this effect in a massive amnesia. Object-action pairs were encoded under four conditions: verbal, experimenter-performed, and two enacted conditions (self-performed and self-performed with choice). We tested object-action pair retrieval using cued recall (CR) and recognition tasks, and source memory using a free recall task. We also assessed binding, executive functions, short-term memory, episodic memory, anxiety and mood. We run correlations to control for their putative effects on memory for action. Data were collected from 24 patients, 16 of whom were examined during the acute phase and eight the day-after, as well as from 18 healthy controls. The memory performances of the patients in the acute phase improved for both (i) the CR score, between the verbal, experimenter-performed and self-performed with choice conditions, and (ii) the total recognition score, between the verbal condition and the two enacted conditions. Correlations were found between self-performed task (SPT) enhancement and both the binding and anxiety. In spite of their severely impaired episodic memory, patients with TGA benefit from the enactment effect. These results are discussed in relation to the role of motor components and episodic integration in memory for actions. We suggest that enactment effect can be used in clinical practice and rehabilitation, possible even for patients with a massive memory impairment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  10. Transient global amnesia as a revealing sign of giant transtentorial meningioma: case report and review of the literature.

    Science.gov (United States)

    Dinca, Eduard B; Carron, Romain; Gay, Emmanuel

    2011-06-01

    Since 1974, only 14 papers in MEDLINE-indexed journals have linked transient global amnesia (TGA) to a brain tumor. Among these, two described the entity of transient epileptic amnesia (TEA), whereas most reports lacked the functional investigations that might differentiate the two conditions. Only six cases have linked TGA or TEA to a meningioma, and none of them were transtentorial. We report the case of a 75-year-old woman who presented with one episode of TGA as a sole symptom of a giant transtentorial meningioma in the right hemisphere. A sudden attack of TGA with a rather typical clinical presentation--anterograde amnesia with selective retrograde features that lasted for a few hours, with stereotypic questions, no associated symptoms or neurological impairment, and no recurrence--occurred while she was at home; this was witnessed by her husband. The neurological examination was unremarkable, with the exception of a slight left homonymous superior quadrantonopia. Brain imaging (computed tomography and magnetic resonance imaging) showed a huge meningioma originating from the right tentorium, extending from the cerebellar hemisphere to the midst of the temporal lobe. An electroencephalogram did not reveal temporal spikes. The tumor was completely excised, and she has remained asymptomatic for 6 months. Although TGA is generally a functional entity, without an organic substrate to prompt surgical sanction, a full investigation may be warranted to rule out the possibility of a silent intracranial tumor.

  11. On resolving the enigma of infantile amnesia.

    Science.gov (United States)

    Howe, M L; Courage, M L

    1993-03-01

    Historical and current theories of infantile amnesia are examined. To evaluate the viability of these theories, as well as the phenomenon of infantile amnesia itself, a review of memory development from birth through the preschool years is provided, including an overview of relevant perceptual and neurological maturation. In the context of this review, extant theories of infantile amnesia are shown to falter, and it is concluded that infantile amnesia is a chimera of a previously unexplored relationship between the development of a cognitive sense of self and the personalization of event memory. This hypothesis is examined in detail and discussed in the context of related developments in language and social cognition.

  12. [Biographical anamnesis and social amnesia. A review of medical history taking, exploration, clinical interview, biographical analysis and diagnostic-clinical consultation].

    Science.gov (United States)

    Kobbé, U

    1988-06-01

    The article describes the historical roots of the development of anamnesis including life-event-research and offers an overview of objective, subjective and situative information levels during diagnostic interviews. The author proposes as method the narrative interview completed by the so-called regressive-progressive method from Sartre. He calls special attention to the interpersonal aspect and to the therapeutic function of anamnesis as well as autobiographical writing.

  13. Resolution of disorientation and amnesia during post-traumatic amnesia.

    Science.gov (United States)

    Tate, R L; Pfaff, A; Jurjevic, L

    2000-02-01

    Despite the growing number of instruments for the prospective measurement of post-traumatic amnesia (PTA) after traumatic brain injury, fundamental issues about the natural history of its resolution and methods of examination remain unresolved. The aims of the present study were to: (1) examine the sequence of resolution of disorientation and amnesia, and (2) determine if the method of measuring the memory component affected the duration of PTA. The sample comprised 31 severely injured patients admitted to a brain injury rehabilitation unit who were examined daily until they emerged from PTA. They were administered a composite PTA scale, covering orientation and memory items from standard PTA scales. Patients were consecutively allocated to one of two groups according to the method of measuring the memory component. Each group was administered identical materials with a different procedure. The most common sequence for resolution of disorientation in both groups was person, followed by place, then time. Overall, amnesia resolved before disorientation in 94% of cases. Correlation coefficients between return of components of orientation and memory were all highly significant, ranging from r=0. 81 to 0.93. Significant variability occurred in the number of days to emerge from PTA according to the scale used. There was evidence that the method of measuring memory influenced the patient's capacity to consistently sustain criterion scores on the scale. These results are contrary to findings in mildly injured patients, in whom orientation usually returns before memory. They also demonstrate that the duration of PTA will be dictated by the method used. These findings raise validity issues with respect to the prospective measurement of PTA, and in particular determining when an individual patient has emerged from PTA, which require further investigation.

  14. Successful life outcome and management of real-world memory demands despite profound anterograde amnesia.

    Science.gov (United States)

    Duff, Melissa C; Wszalek, Tracey; Tranel, Daniel; Cohen, Neal J

    2008-11-01

    We describe the case of Angie, a 50-year-old woman with profound amnesia (General Memory Index = 49, Full Scale IQ = 126) following a closed head injury in 1985. This case is unique in comparison to other cases reported in the literature in that, despite the severity of her amnesia, she has developed remarkable real-world life abilities, shows impressive self-awareness and insight into the impairment and sparing of various functional memory abilities, and exhibits ongoing maturation of her identity and sense of self following amnesia. The case provides insights into the interaction of different memory and cognitive systems in handling real-world memory demands and has implications for rehabilitation and for successful life outcome after amnesia.

  15. Long-Term Recency in Anterograde Amnesia.

    Directory of Open Access Journals (Sweden)

    Deborah Talmi

    Full Text Available Amnesia is usually described as an impairment of a long-term memory (LTM despite an intact short-term memory (STM. The intact recency effect in amnesia had supported this view. Although dual-store models of memory have been challenged by single-store models based on interference theory, this had relatively little influence on our understanding and treatment of amnesia, perhaps because the debate has centred on experiments in the neurologically intact population. Here we tested a key prediction of single-store models for free recall in amnesia: that people with amnesia will exhibit a memory advantage for the most recent items even when all items are stored in and retrieved from LTM, an effect called long-term recency. People with amnesia and matched controls studied, and then free-recalled, word lists with a distractor task following each word, including the last (continual distractor task, CDFR. This condition was compared to an Immediate Free Recall (IFR, no distractors and a Delayed Free Recall (DFR, end-of-list distractor only condition. People with amnesia demonstrated the full long-term recency pattern: the recency effect was attenuated in DFR and returned in CDFR. The advantage of recency over midlist items in CDFR was comparable to that of controls, confirming a key prediction of single-store models. Memory deficits appeared only after the first word recalled in each list, suggesting the impairment in amnesia may emerge only as the participant's recall sequence develops, perhaps due to increased susceptibility to output interference. Our findings suggest that interference mechanisms are preserved in amnesia despite the overall impairment to LTM, and challenge strict dual-store models of memory and their dominance in explaining amnesia. We discuss the implication of our findings for rehabilitation.

  16. Long-Term Recency in Anterograde Amnesia.

    Science.gov (United States)

    Talmi, Deborah; Caplan, Jeremy B; Richards, Brian; Moscovitch, Morris

    2015-01-01

    Amnesia is usually described as an impairment of a long-term memory (LTM) despite an intact short-term memory (STM). The intact recency effect in amnesia had supported this view. Although dual-store models of memory have been challenged by single-store models based on interference theory, this had relatively little influence on our understanding and treatment of amnesia, perhaps because the debate has centred on experiments in the neurologically intact population. Here we tested a key prediction of single-store models for free recall in amnesia: that people with amnesia will exhibit a memory advantage for the most recent items even when all items are stored in and retrieved from LTM, an effect called long-term recency. People with amnesia and matched controls studied, and then free-recalled, word lists with a distractor task following each word, including the last (continual distractor task, CDFR). This condition was compared to an Immediate Free Recall (IFR, no distractors) and a Delayed Free Recall (DFR, end-of-list distractor only) condition. People with amnesia demonstrated the full long-term recency pattern: the recency effect was attenuated in DFR and returned in CDFR. The advantage of recency over midlist items in CDFR was comparable to that of controls, confirming a key prediction of single-store models. Memory deficits appeared only after the first word recalled in each list, suggesting the impairment in amnesia may emerge only as the participant's recall sequence develops, perhaps due to increased susceptibility to output interference. Our findings suggest that interference mechanisms are preserved in amnesia despite the overall impairment to LTM, and challenge strict dual-store models of memory and their dominance in explaining amnesia. We discuss the implication of our findings for rehabilitation.

  17. Prose recall and amnesia: more implications for the episodic buffer.

    Science.gov (United States)

    Gooding, P A; Isaac, C L; Mayes, A R

    2005-01-01

    Baddeley and Wilson [Baddeley, A. D., & Wilson, F. B. (2002). Prose recall and amnesia: implications for the structure of working memory. Neuropsychologia 40, 1737-1743.] have argued that their finding of a positive association between amnesics' immediate prose recall scores and their scores on measures of executive function and fluid intelligence supports the view that an episodic buffer exists. However, the pattern of data from amnesics tested in our laboratory presented some problems for this conceptualisation of the episodic buffer.

  18. Posthypnotic amnesia for material learned before hypnosis.

    Science.gov (United States)

    Bryant, R A; Barnier, A J; Mallard, D; Tibbits, R

    1999-01-01

    The impact of a suggestion for posthypnotic amnesia on material learned either before or during hypnosis was investigated across 2 experiments. In Experiment 1, very high, high, and low hypnotizable participants learned a word list either before or immediately after a hypnotic induction. During hypnosis, participants were given a suggestion for posthypnotic amnesia for the word list. After hypnosis, they were tested on recall, word-fragment, and word-recognition tasks. Experiment 2 replicated and extended Experiment 1 through application of the real-simulating paradigm. Across the 2 experiments, there was no difference in the performance of participants who learned the word list either before or during hypnosis. Although amnesia on direct memory measures was associated with high hypnotizability (Experiment 1), an explanation based on demand characteristics could not be excluded (Experiment 2). The implications of these findings for the use of post-hypnotic amnesia as a laboratory analog of disorders of autobiographical memory are discussed.

  19. Autobiogutobiographical amnesia and cognltive disorder resulgting from bilateral severe thalamic infarction Two cases reports

    Institute of Scientific and Technical Information of China (English)

    Ytt Kai; Yu Feng Qi; Lei Zheng Lin; Zhang Jun

    2000-01-01

    Objective To report two cases of patients with bilateral severe thalamic infarction.which showed autobiographical amnesia and cognitive disorders and to shed light on the mechanisms underlying thc retrograde amenesia. Method The two cases were studied clinically, CT and MRI were performed also, Language and neuropsychological tests were evaluated. Results Two patients with a chronic amnesia and cogntive disorders resulting from bilateral paramedian thalamic infarction showed a pattern of retrograde amnesia personally relevent autobiographical memory were prefoundly impaired .Whereas about the famous people and public events were relatively impaired. The patients almost had no thalamic aphasia.The events the one described showed spontaneously confabulated. Conclusion We think a probable explanation that the disorders at the thematic retrieval fiomwork ievel of memory and the information reconstruction due to a disconnetion of frontal and medial temperal memory systems.

  20. Pure retrograde amnesia following a mild head trauma: a neuropsychological and metabolic study.

    Science.gov (United States)

    Sellal, François; Manning, Lilianne; Seegmuller, Caroline; Scheiber, Christian; Schoenfelder, Francis

    2002-09-01

    After a minor closed head injury, a 33-year-old man acquired extensive retrograde amnesia (RA) covering the previous ten years and concerning autobiographical, semantic and procedural memories. The patient's learning abilities remained excellent and he recovered considerable information from his wife, the media and personal documents. This relearned information did not, however, provide a sense of personal experience in the first weeks. CT and MRI failed to show brain damage, but EEG and SPECT examination showed a marked right temporal dysfunction. After three months the patient had almost completely recovered from RA. Interestingly, a parallel recovery was observed in the second SPECT obtained at this period. There was clearly a blockade of retrieval, while the stored engrams were probably intact. The mechanisms underlying such a functional amnesia are discussed in the light of previous reports of amnesia without brain lesions.

  1. Retrograde amnesia for semantic information in Alzheimer's disease.

    Science.gov (United States)

    Meeter, Martijn; Kollen, Ariane; Scheltens, Philip

    2005-01-01

    Patients with mild to moderate Alzheimer's disease and normal controls were tested on a retrograde amnesia test with semantic content (Neologism and Vocabulary Test, or NVT), consisting of neologisms to be defined. Patients showed a decrement as compared to normal controls, pointing to retrograde amnesia within semantic memory. No evidence for a gradient within this amnesia was found, although one was present on an autobiographic test of retrograde amnesia that had a wider time scale. Several explanations for these results are presented, including one that suggests that extended retrograde amnesia and semantic memory deficits are in fact one and the same deficit.

  2. Clinical functional MRI. Presurgical functional neuroimaging

    Energy Technology Data Exchange (ETDEWEB)

    Stippich, C. (ed.) [Heidelberg Univ. (Germany). Div. of Neuroradiology

    2007-07-01

    Functional magnetic resonance imaging (fMRI) permits noninvasive imaging of the ''human brain at work'' under physiological conditions. This is the first textbook on clinical fMRI. It is devoted to preoperative fMRI in patients with brain tumors and epilepsies, which are the most well-established clinical applications. By localizing and lateralizing specific brain functions, as well as epileptogenic zones, fMRI facilitates the selection of a safe treatment and the planning and performance of function-preserving neurosurgery. State of the art fMRI procedures are presented, with detailed consideration of the physiological and methodological background, imaging and data processing, normal and pathological findings, diagnostic possibilities and limitations, and other related techniques. All chapters are written by recognized experts in their fields, and the book is designed to be of value to beginners, trained clinicians and experts alike. (orig.)

  3. Benjamin Franklin and Shock-Induced Amnesia

    Science.gov (United States)

    Finger, Stanley; Zaromb, Franklin

    2006-01-01

    Shock-induced amnesia received considerable attention after Cerletti popularized electroconvulsive shock therapy in the late 1930s. Yet, often overlooked is the fact that Benjamin Franklin recognized that passing electricity through the head could affect memory for the traumatic event. Franklin described his findings on himself and others in…

  4. Infantile Amnesia: Forgotten but Not Gone

    Science.gov (United States)

    Li, Stella; Callaghan, Bridget L.; Richardson, Rick

    2014-01-01

    Unlike adult memories that can be remembered for many years, memories that are formed early in life are more fragile and susceptible to being forgotten (a phenomenon known as "infantile" or "childhood" amnesia). Nonetheless, decades of research in both humans and nonhuman animals demonstrate the importance of early life…

  5. Recovery from retrograde amnesia: a learning process.

    Science.gov (United States)

    Schneider, A M; Tyler, J; Jinich, D

    1974-04-01

    Retrograde amnesia was produced in rats by electroconvulsive shock. Memory recovered if the animals were given repeated test trials. Memory did not recover if steps were taken to reduce the conditioning properties of the test trials; the manipulations included eliminating the response, altering the apparatus cues, or extinguishing conditioned "fear" by confining animals to the apparatus during the first test trial.

  6. A mathematical model of forgetting and amnesia

    NARCIS (Netherlands)

    Murre, J.M.J.; Chessa, A.G.; Meeter, M.

    2013-01-01

    We describe a mathematical model of learning and memory and apply it to the dynamics of forgetting and amnesia. The model is based on the hypothesis that the neural systems involved in memory at different time scales share two fundamental properties: (1) representations in a store decline in strengt

  7. The learned reinterpretation of fluency in amnesia.

    Science.gov (United States)

    Geurten, Marie; Willems, Sylvie

    2017-07-01

    Fluency is one of many cues that are involved in memory decisions. To date, however, the extent to which fluency-based decisions are preserved in amnesia is not yet clear. In this study, we tested and found differences in how patients with amnesia (n=8) and control participants (n=16) use fluency when making recognition decisions (Experiment 1). Our results suggested that these differences could be due to changes in the readiness with which patients attribute the subjective feeling of fluency to pre-exposure when an alternative explanation is available (i.e., the perceptual quality of the item). Secondly, we explored the hypothesis that changes in attribution processes in patients with amnesia are explained by a decrease in contingency between processing fluency and previous occurrence of stimuli in patients' daily lives, leading them to consider that fluency is not a relevant cue for memory (Experiment 2). Specifically, 42 healthy participants were put either in a condition where the positive contingency between fluent processing and previous encounters with an item was systematically confirmed (classic condition) or in a condition where the classical association between fluency and prior exposure was systematically reversed (reversed condition). Results indicated that participants more readily attribute fluency to the alternative external source than to past experience in the reversed condition than in the classic condition, mimicking the pattern of results shown by participants with amnesia in Experiment 1. Implications of these findings are discussed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Developing an Animal Model of Human Amnesia: The Role of the Hippocampus

    Science.gov (United States)

    Kesner, Raymond P.; Goodrich-Hunsaker, Naomi J.

    2010-01-01

    This review summarizes a series of experiments aimed at answering the question whether the hippocampus in rats can serve as an animal model of amnesia. It is recognized that a comparison of the functions of the rat hippocampus with human hippocampus is difficult, because of differences in methodology, differences in complexity of life experiences,…

  9. Clinical evaluation of functional dysphonia.

    Science.gov (United States)

    Monday, L A

    1983-10-01

    Functional dysphonia is a voice impairment without any organic lesion of the phonating system. It may be classified into two categories: functional dysphonia itself where no lesions are found and functional laryngopathies where vocal cord lesions may be attributed to vocal abuse or misuse. The clinical evaluation of a dysphonic patient is performed in three steps: history taking, vocal evaluation, and examination. History taking helps the diagnosis and may be considered also as a therapeutic procedure. Vocal evaluation is oriented toward the voice itself and how it is produced. Then an ENT examination is performed with special attention to the larynx. In functional dysphonia, usually, everything looks normal but there may be signs of inflammation, hyperkinetism, hypokinetism, excessive laryngeal movements, etc. Functional laryngopathies include vocal nodules, laryngitis, polyps, and contact ulcer.

  10. Seasonal Changes in the Incidence of Transient Global Amnesia

    OpenAIRE

    Keret, Ophir; Lev, Nirit; Shochat, Tzippy; Steiner, Israel

    2016-01-01

    Background and Purpose Transient global amnesia (TGA) is a stereotypic condition characterized by anterograde and retrograde amnesia that typically resolves within 24 hours. The pathophysiology of TGA is still unclear. We noted that patients hospitalized with TGA tend to appear in seasonal clusters, and decided to investigate this phenomenon. Methods Every patient with acute presentation of amnesia at our medical center is hospitalized for observation and evaluation. We reviewed the monthly o...

  11. Conjugated Linoleic Acid Administration Induces Amnesia in Male Sprague Dawley Rats and Exacerbates Recovery from Functional Deficits Induced by a Controlled Cortical Impact Injury

    Science.gov (United States)

    Geddes, Rastafa I.; Hayashi, Kentaro; Bongers, Quinn; Wehber, Marlyse; Anderson, Icelle M.; Jansen, Alex D.; Nier, Chase; Fares, Emily; Farquhar, Gabrielle; Kapoor, Amita; Ziegler, Toni E.; VadakkadathMeethal, Sivan; Bird, Ian M.

    2017-01-01

    Long-chain polyunsaturated fatty acids like conjugated linoleic acids (CLA) are required for normal neural development and cognitive function and have been ascribed various beneficial functions. Recently, oral CLA also has been shown to increase testosterone (T) biosynthesis, which is known to diminish traumatic brain injury (TBI)-induced neuropathology and reduce deficits induced by stroke in adult rats. To test the impact of CLA on cognitive recovery following a TBI, 5–6 month old male Sprague Dawley rats received a focal injury (craniectomy + controlled cortical impact (CCI; n = 17)) or Sham injury (craniectomy alone; n = 12) and were injected with 25 mg/kg body weight of Clarinol® G-80 (80% CLA in safflower oil; n = 16) or saline (n = 13) every 48 h for 4 weeks. Sham surgery decreased baseline plasma progesterone (P4) by 64.2% (from 9.5 ± 3.4 ng/mL to 3.4 ± 0.5 ng/mL; p = 0.068), T by 74.6% (from 5.9 ± 1.2 ng/mL to 1.5 ± 0.3 ng/mL; p CLA treatment did not reverse hypogonadism in Sham (P4: 2.5 ± 1.0 ng/mL; T: 0.9 ± 0.2 ng/mL) or CCI-injured (P4: 2.2 ± 0.9 ng/mL; T: 1.0 ± 0.2 ng/mL, p > 0.05) animals by post-injury day 29, but rapidly reversed by post-injury day 1 the hypoadrenalism in Sham (11-DOC: 372.6 ± 36.6 ng/mL; corticosterone: 202.6 ± 15.6 ng/mL) and CCI-injured (11-DOC: 384.2 ± 101.3 ng/mL; corticosterone: 234.6 ± 43.8 ng/mL) animals. In Sham surgery animals, CLA did not alter body weight, but did markedly increase latency to find the hidden Morris Water Maze platform (40.3 ± 13.0 s) compared to saline treated Sham animals (8.8 ± 1.7 s). In CCI injured animals, CLA did not alter CCI-induced body weight loss, CCI-induced cystic infarct size, or deficits in rotarod performance. However, like Sham animals, CLA injections exacerbated the latency of CCI-injured rats to find the hidden MWM platform (66.8 ± 10.6 s) compared to CCI-injured rats treated with saline (30.7 ± 5.5 s, p CLA at a dose of 25 mg/kg body weight in adult male rats over 1

  12. Diffusion magnetic resonance imaging in transient global amnesia

    Energy Technology Data Exchange (ETDEWEB)

    Godeiro-Junior, Clecio; Miranda-Alves, Maramelia Araujo de [Federal University of Sao Paulo (UNIFESP-EPM), Sao Paulo SP (Brazil). Dept. of Neurology and Neurosurgery], e-mail: cleciojunior@yahoo.com.br; Massaro, Ayrton Roberto [Fleury Diagnostic Center, Sao Paulo SP (Brazil)

    2009-03-15

    Transient global amnesia (TGA) is a well known clinical entity characterized by anterograde memory disturbance of sudden onset that lasts 1 to 24 hours. Orientation in space and time is impaired while consciousness remains undisturbed. TGA may refer to a single expression of several physiopathological phenomena. Conceptually, cerebral ischemia, epileptic discharge, and migraine constitute the main pathogenic hypothesis. Diffusion-weighted imaging (DWI) has become a powerful tool in the evaluation of patients with suspected stroke owing to its high sensitivity and specificity, even for small areas of acute ischemia. Consequently, this method has also been applied to TGA to gain further insights into the ischemic hypothesis of this condition. We report a patient with a typical TGA presentation and MRI findings suggestive of an ischemic insult. We further discuss the ischemic hypothesis of TGA. (author)

  13. The relationship between psychopathy and crime-related amnesia

    NARCIS (Netherlands)

    Cima, M.; Oorsouw, K. van

    2013-01-01

    The objective of this study was to investigate whether levels of psychopathy predicted claims of crime-related amnesia. Different characteristics of psychopathy were based on the factor structure of the self-report questionnaire Psychopathic Personality Inventory (PPI). Crime-related amnesia claims

  14. Disrupting circadian rhythms in rats induces retrograde amnesia

    NARCIS (Netherlands)

    Fekete, Mátyás; Ree, J.M. van; Niesink, Raymond J.M.; Wied, D. de

    1985-01-01

    Disrupting circadian organization in rats by phase-shifting the illumination cycle or by exposure to a reversed day/night cycle or to continuous light, resulted in retrograde amnesia for passive avoidance behavior. This retrograde amnesia induced by phase-shifting lasted at least 2 days, and

  15. Disrupting circadian rhythms in rats induces retrograde amnesia

    NARCIS (Netherlands)

    Fekete, Mátyás; Ree, J.M. van; Niesink, Raymond J.M.; Wied, D. de

    1985-01-01

    Disrupting circadian organization in rats by phase-shifting the illumination cycle or by exposure to a reversed day/night cycle or to continuous light, resulted in retrograde amnesia for passive avoidance behavior. This retrograde amnesia induced by phase-shifting lasted at least 2 days, and gradual

  16. The relationship between psychopathy and crime-related amnesia

    NARCIS (Netherlands)

    Cima, M.; Oorsouw, K. van

    2013-01-01

    The objective of this study was to investigate whether levels of psychopathy predicted claims of crime-related amnesia. Different characteristics of psychopathy were based on the factor structure of the self-report questionnaire Psychopathic Personality Inventory (PPI). Crime-related amnesia claims

  17. Non-declarative memory in the rehabilitation of amnesia.

    Science.gov (United States)

    Cavaco, S; Malec, J F; Bergquist, T

    2005-09-01

    The ability of amnesic patients to learn and retain non-declarative information has been consistently demonstrated in the literature. This knowledge provided by basic cognitive neuroscience studies has been widely neglected in neuropsychological rehabilitation of memory impaired patients. This study reports the case of a 43 year old man with severe amnesia following an anterior communicating artery (ACoA) aneurysm rupture. The patient integrated a comprehensive (holistic) day treatment programme for rehabilitation of brain injury. The programme explored the advantages of using preserved non-declarative memory capacities, in the context of commonly used rehabilitation approaches (i.e. compensation for lost function and domain-specific learning). The patient's ability to learn and retain new cognitive and perceptual-motor skills was found to be critical for the patient's improved independence and successful return to work.

  18. Anterograde and Retrograde Amnesia following Bitemporal Infarction

    Directory of Open Access Journals (Sweden)

    A. Schnider

    1994-01-01

    Full Text Available A patient suffered very severe anterograde and retrograde amnesia following infarction of both medial temporal lobes (hippocampus and adjacent cortex and the left inferior temporo-occipital area. The temporal stem and the amygdala were intact; these structures do not appear to be critical for new learning in humans. Extension of the left-sided infarct into the inferior temporo-occipital lobe, an area critically involved in visual processing, appears to be responsible for our patient's loss of remote memories.

  19. Preserved cumulative semantic interference despite amnesia

    Directory of Open Access Journals (Sweden)

    Gary Michael Oppenheim

    2015-05-01

    As predicted by Oppenheim et al’s (2010 implicit incremental learning account, WRP’s BCN RTs demonstrated strong (and significant repetition priming and semantic blocking effects (Figure 1. Similar to typical results from neurally intact undergraduates, WRP took longer to name pictures presented in semantically homogeneous blocks than in heterogeneous blocks, an effect that increased with each cycle. This result challenges accounts that ascribe cumulative semantic interference in this task to explicit memory mechanisms, instead suggesting that the effect has the sort of implicit learning bases that are typically spared in hippocampal amnesia.

  20. Route learning in amnesia: a comparison of trial-and-error and errorless learning in patients with the Korsakoff syndrome.

    NARCIS (Netherlands)

    Kessels, R.P.C.; Loon, E. van; Wester, A.J.

    2007-01-01

    OBJECTIVE: To examine the errorless learning approach using a procedural memory task (i.e. learning of actual routes) in patients with amnesia, as compared to trial-and-error learning. DESIGN: Counterbalanced self-controlled cases series. SETTING: Psychiatric hospital (Korsakoff clinic). SUBJECTS: A

  1. Amnesia produced by altered release of neurotransmitters after intraamygdala injections of a protein synthesis inhibitor

    OpenAIRE

    Canal, Clinton E.; Chang, Qing; Paul E Gold

    2007-01-01

    Amnesia produced by protein synthesis inhibitors such as anisomycin provides major support for the prevalent view that the formation of long-lasting memories requires de novo protein synthesis. However, inhibition of protein synthesis might disrupt other neural functions to interfere with memory formation. Intraamygdala injections of anisomycin before inhibitory avoidance training impaired memory in rats tested 48 h later. Release of norepinephrine (NE), dopamine (DA), and serotonin, measured...

  2. Counterfactual thinking in patients with amnesia.

    Science.gov (United States)

    Mullally, Sinéad L; Maguire, Eleanor A

    2014-11-01

    We often engage in counterfactual (CF) thinking, which involves reflecting on "what might have been." Creating alternative versions of reality seems to have parallels with recollecting the past and imagining the future in requiring the simulation of internally generated models of complex events. Given that episodic memory and imagining the future are impaired in patients with hippocampal damage and amnesia, we wondered whether successful CF thinking also depends upon the integrity of the hippocampus. Here using two nonepisodic CF thinking tasks, we found that patients with bilateral hippocampal damage and amnesia performed comparably with matched controls. They could deconstruct reality, add in and recombine elements, change relations between temporal sequences of events, enabling them to determine plausible alternatives of complex episodes. A difference between the patients and control participants was evident, however, in the patients' subtle avoidance of CF simulations that required the construction of an internal spatial representation. Overall, our findings suggest that mental simulation in the form of nonepisodic CF thinking does not seem to depend upon the hippocampus unless there is the added requirement for construction of a coherent spatial scene within which to play out scenarios.

  3. Large cerebral perfusion defects observed in brain perfusion SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients

    Energy Technology Data Exchange (ETDEWEB)

    So, Young; Kim, Hahn Young; Roh, Hong Gee; Han, Seol Heui [Konkuk University School of Medicine, Seoul (Korea, Republic of)

    2007-07-01

    Transient global amnesia (TGA) is a memory disorder characterized by an episode of antegrade amnesia and bewilderment which persists for several hours. We analyzed brain perfusion SPECT findings and clinical outcome of patients who suffered from TGA. From September 2005 to August 2007, 12 patients underwent Tc-99m ECD brain perfusion SPECT for neuroimaging of TGA. All patients also underwent MRI and MRA including DWI (MRI). Among them, 10 patients who could be chased more than 6 months were included in this study. Their average age was 60.74.0 yrs (M: F = 2: 8) and the average duration of amnesia was 4.42.2 hrs (1 hr {approx} 7 hrs). Duration from episode of amnesia to SPECT was 4.32.4 days (1{approx}9 days). Precipitating factors could be identified in 6 patients: emotional stress 3, hair dyeing 1, taking a nap 1 and angioplasty 1. SPECT and MRI was visually assessed, No cerebral perfusion defect was observed on SPECT in 3 patients and their clinical outcome was all good. Among 7 patients who had cerebral perfusion defects on SPECT, 3 patients had good clinical outcome, while others did not: one had hypercholesterolemia, another had depression, and 2 patients with cerebral perfusion defects at both temporoparetal cortex was later diagnosed as early Alzheimer's disease (AD) and mild cognitive impairment (MCI). MRI was negative in 6 patients and 3 of them had excellent clinical outcome while other 3 were diagnosed as hypercholesterolemia, early AD and MCI. Among 4 patients with positive MRI, 3 showed good clinical outcome and their MRI showed lesions at medial temporal cortex and/or vertebral artery. One patient with microcalcification at left putamen was diagnosed to have depression. Large cerebral perfusion defects on SPECT may herald psychiatric or neurodegenerative diseases of transient global amnesia patients which usually shows negative MRI.

  4. Pain and intra-operative amnesia evaluation with local anesthesia and sedation in patients subjected to rhinosseptoplasties

    Directory of Open Access Journals (Sweden)

    Weber, Raimar

    2010-03-01

    Full Text Available Introduction: The local anesthesia practice and sedation to rhinoplasty and others aesthetics procedures of the face are each time more frequents. In the Brazil, the Federal Council of Medicine defines it and regulate its practice. Objective: To analyze the analgesia' effectiveness and of the intro operative amnesia through analogous visual and subjective scales in the rhinosseptoplasties performed under local anesthesia and sedation, looking for associations with the medium quantities of medication utilized. Method: A retrospective study based in reports relatives to 158 aesthetic-functional rhinoplasties. The surgeon recorded in a protocol the data relatives to the use of local anesthetics and sedatives (including concentration and quantities utilized as well as the side effects. In the first return post surgery the patient quantifies the pain that he felt in the intra operative utilizing a analogous visual scale as described by Hasen and collaborators. The Amnesia considered ideal when the patient referred to remind "nothing" or "a few of the procedure. Results: The sample constituted of 80 (73,4% women and 29 26,6% men, average of age of 29,3 ± 9,5 years. The median of the pain by the analogous visual scale was 0,05; 80% under 3,35. The amnesia was ideal in 51 (46,8% surgeries. The midazolam was utilized in all the surgeries. Fentanyl in 32 (29,4% and, pethidine in 77 (70,6%. Had not statistically significants differences between the quantities of medication utilized between the groups of patients with ideal amnesia when compared with those that do not obtained satisfactory amnesia. Conclusion: Local anesthesia and sedation in rhinoplasties are comfortable and secures in the majority of the cases, even without have a satisfactory amnesia.

  5. Autism, amnesia, hippocampus, and learning.

    Science.gov (United States)

    DeLong, G R

    1992-01-01

    Autism is held to be the result of the failure of a central cognitive processor which is necessary for flexible multidimensional association of sensorial stimuli, memory, and motivational states. Failure of this processor produces rigid, invariant, rote behavior, thought and language and aberrant modulation of emotion. It is argued that this central processing function is critically dependent on the hippocampus. Thus autism is postulated to be the developmental syndrome of hippocampal dysfunction. The hippocampus is postulated to be necessary for normal development in the child of language syntax, semantics, and pragmatics; the capacity for creativity and generativity in language and behavior, and combinatorial possibilities in general; for the integration of motivational states with experience and learning; and for the construction of a complex, useful and flexible structure of meaning. These constructs may become independent of hippocampus for use, but hippocampus is still required to modify or add to them. Finally, this analysis suggests a specific hypothesis of hippocampal organization which I advance as an hypothesis: that the hippocampus can be modelled as a multidimensional system in which the unique intersection of all input dimensions is the resultant.

  6. Hippocampal amnesia disrupts creative thinking.

    Science.gov (United States)

    Duff, Melissa C; Kurczek, Jake; Rubin, Rachael; Cohen, Neal J; Tranel, Daniel

    2013-12-01

    Creativity requires the rapid combination and recombination of existing mental representations to create novel ideas and ways of thinking. The hippocampal system, through its interaction with neocortical storage sites, provides a relational database necessary for the creation, updating, maintenance, and juxtaposition of mental representations used in service of declarative memory. Given this functionality, we hypothesized that hippocampus would play a critical role in creative thinking. We examined creative thinking, as measured by verbal and figural forms of the torrance tests of creative thinking (TTCT), in a group of participants with hippocampal damage and severe declarative memory impairment as well as in a group of demographically matched healthy comparison participants. The patients with bilateral hippocampal damage performed significantly worse than comparison participants on both the verbal and figural portions of the TTCT. These findings suggest that hippocampus plays a role critical in creative thinking, adding to a growing body of work pointing to the diverse ways the hallmark processing features of hippocampus serve a variety of behaviors that require flexible cognition.

  7. Amnesia Associated with Bilateral Hippocampal and Bilateral Basal Ganglia Lesions in Anoxia with Stimulant Use

    Science.gov (United States)

    Haut, Marc W.; Hogg, Jeffery P.; Marshalek, Patrick J.; Suter, Blair C.; Miller, Liv E.

    2017-01-01

    We report a case of a 55-year-old man with ischemic lesions of the bilateral hippocampus and bilateral basal ganglia following a myocardial infarction during an episode of multiple drug use with subsequent anoxia requiring resuscitation. He presented for a neuropsychological evaluation with an anterograde amnesia for both explicit and procedural memory. There are two main points to this case, the unique aspects of the bilateral multifocal lesions and the functional, cognitive impact of these lesions. We hypothesize that his rare focal bilateral lesions of both the hippocampus and basal ganglia are a result of anoxia acting in synergy with his stimulant drug use (cocaine and/or 3,4-methylenedioxy-methamphetamine). Second, his unique lesions produced an explicit and implicit/procedural anterograde amnesia. PMID:28228745

  8. Severe global amnesia presenting as Wernicke-Korsakoff syndrome but resulting from atypical lesions.

    Science.gov (United States)

    Welch, L W; Nimmerrichter, A; Kessler, R; King, D; Hoehn, R; Margolin, R; Martin, P R

    1996-03-01

    A female alcoholic presented with Wernicke's encephalopathy subsequent to administration of diazepam and glucose (without thiamine) for treatment of withdrawal seizures. Nystagmus and cerebellar ataxia quickly resolved when administered thiamine, although severe global amnesia consistent with Korsakoff's syndrome persisted. Magnetic resonance imaging (MRI) revealed infarction of the right temporal lobe with hippocampal atrophy, but no lesions of thalamus or atrophy of mammillary bodies. Positron emission tomography (PET) confirmed decreased cerebral metabolic rates for glucose (CMRglu) in the right temporal lobe corresponding to MRI findings, but also significant metabolic asymmetry of dorsal thalamus, i.e. reduced CMRglu in left versus right. This patient is unique in that neuroradiological findings revealed intact mammillary bodies and suggest asymmetrical dysfunctions (structural right temporal and functional left diencephalic) to produce her profound amnesia.

  9. Amnesia produced by altered release of neurotransmitters after intraamygdala injections of a protein synthesis inhibitor.

    Science.gov (United States)

    Canal, Clinton E; Chang, Qing; Gold, Paul E

    2007-07-24

    Amnesia produced by protein synthesis inhibitors such as anisomycin provides major support for the prevalent view that the formation of long-lasting memories requires de novo protein synthesis. However, inhibition of protein synthesis might disrupt other neural functions to interfere with memory formation. Intraamygdala injections of anisomycin before inhibitory avoidance training impaired memory in rats tested 48 h later. Release of norepinephrine (NE), dopamine (DA), and serotonin, measured at the site of anisomycin infusions, increased quickly by approximately 1,000-17,000%, far above the levels seen under normal conditions. NE and DA release later decreased far below baseline for several hours before recovering at 48 h. Intraamygdala injections of a beta-adrenergic receptor antagonist or agonist, each timed to blunt effects of increases and decreases in NE release after anisomycin, attenuated anisomycin-induced amnesia. In addition, similar to the effects on memory seen with anisomycin, intraamygdala injections of a high dose of NE before training impaired memory tested at 48 h after training. These findings suggest that altered release of neurotransmitters may mediate amnesia produced by anisomycin and, further, raise important questions about the empirical bases for many molecular theories of memory formation.

  10. Social Cognition in a Case of Amnesia with Neurodevelopmental Mechanisms

    Directory of Open Access Journals (Sweden)

    Hans J. Markowitsch

    2013-06-01

    Full Text Available Episodic-autobiographical memory (EAM is considered to emerge gradually in concert with the development of other cognitive abilities. Developmental studies have emphasized socio-cultural-linguistic mechanisms that may be unique to the development of EAM. Furthermore it was hypothesized that one of the main functions of EAM is the social one. In the research field, the link between EAM and social cognition remains however debated. Herein we aim to bring new insights into the relation between EAM and social information processing (including social cognition by describing a young adult patient with amnesia with neurodevelopmental mechanisms due to perinatal complications accompanied by hypoxia. The patient was investigated medically, psychiatrically and with neuropsychological and neuroimaging methods. Structural high resolution MRI revealed significant bilateral hippocampal atrophy as well as indices for degeneration in the amygdalae, basal ganglia and thalamus, when a less conservative threshold was applied. In addition to extensive memory investigations and testing other (non-social cognitive functions, we employed a broad range of tests that assessed social information processing (social perception, social cognition, social regulation. Our results point to both preserved (empathy, core theory of mind functions, visual affect selection and discrimination, affective prosody discrimination and impaired domains of social information processing (incongruent affective prosody processing, complex social judgments. They support proposals for a role of the hippocampal formation in processing more complex social information that likely requires multimodal relational handling.

  11. Specific, personally meaningful cues can benefit episodic prospection in medial temporal lobe amnesia.

    Science.gov (United States)

    Kwan, Donna; Kurczek, Jake; Rosenbaum, R Shayna

    2016-06-01

    To determine whether severity of episodic prospection impairment in medial temporal lobe (MTL) amnesia is reduced by the types of cues that are used to elicit personal future episodes and, if so, whether episodic memory impairment is similarly affected. Multiple case study of five individuals with MTL amnesia and healthy control participants. Participants were administered two tests of episodic prospection: A commonly used Galton-Crovitz task that uses generic cues (e.g., lemon) and a novel task that includes specific, personally meaningful cues referring to planned or plausible future events (e.g., granddaughter's recital). Narratives were scored for episodic detail using the Autobiographical Interview protocol (Levine et al., 2002), which distinguishes between internal (episodic) details and external (non-episodic) details. Results showed that specific, personally meaningful cues led to an appreciable reduction of episodic memory and prospection impairment in three of the amnesic cases tested. Clinical benefit from more structured, self-related cues may depend on factors such as extent of MTL damage or general severity of episodic memory and prospection impairment, highlighting the importance of methodological approaches to neuropsychological research that treat each case on an individual basis. In cases of mild-moderate amnesia, specific, personal cues afford more detailed episodic remembering and prospective imagining than individual cue words. Previous reports of episodic prospection impairment in medial temporal lobe (MTL) amnesia might misrepresent an individual case's true prospective abilities Specific cues drawn from a patient's everyday life have greater ecological validity than the more typical generic cues used to elicit episodic prospection and can aid some individuals with MTL amnesia in the ability to imagine future experiences Assessment and rehabilitation tools for MTL amnesic populations should attempt to minimize broad, open-ended questions and

  12. Function: A Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Shakuri Seyed Kazem

    2015-03-01

    Full Text Available Introduction: Prevention of pulmonary complications after coronary artery bypass graft is attended as a very important issue. The aim of this study was to evaluate the role of pulmonary rehabilitation before surgery for reducing the risk of pulmonary complications after surgery. Methods: In a randomized clinical trial, 60 patients undergoing heart surgery were randomly divided into two groups A and B. Chest physiotherapy was performed before and after surgery on group A patients however it was done on group B’s, only after surgery. Effects of preoperative pulmonary rehabilitation were compared between two groups, using spirometry and arterial blood gas (ABG. Results: Thirty nine males (65% and 21 females (35% with mean age of 8.10 ± 9.56 were analyzed.The mean differences were statistically significant for predicted forced vital capacity (FVC (CI95%:1.3 to 8.7 and Predicted Peak Flow indices (PEF (CI 95%: 1.9 to 9.4 of spirometry indicator,PCO2 index (of ABG parameter (CI 95%: 1.4 to 8.9 and mean oxygen saturation (mean Spo2 (CI 95%: 0.6 to 1.7 of ABG index in two groups. Conclusion: The performance of pulmonary rehabilitation program before surgery is recommended, as it may result in the reduction of complications of heart surgery.

  13. Narrative construction is intact in episodic amnesia.

    Science.gov (United States)

    Keven, Nazim; Kurczek, Jake; Rosenbaum, R Shayna; Craver, Carl F

    2017-07-28

    Autobiographical remembering and future imagining overlap in their underlying psychological and neurological mechanisms. The hippocampus and surrounding regions within the medial temporal lobes (MTL), known for their role in forming and maintaining autobiographical episodic memories, are also thought to play an essential role in fictitious and future constructions. Amnesic individuals with bilateral hippocampal damage cannot reconstruct their past personal experiences and also have severe deficits in the ability to construct coherent fictitious or future narratives. However, it is not known whether this impairment reflects a failure to generate details from autobiographical episodic memory to populate personal narratives or an inability to bind such details into coherent narratives. We show that four individuals with hippocampal damage and episodic amnesia can construct narratives when the relevant details of the story are provided in a picture book and that their narratives maintain overall coherence on several measures. These findings indicate that individuals with hippocampal damage can bind details into coherent narratives when details are available to them. We conclude that the hippocampal system instead likely plays a role in the generation of details from which narratives are constructed. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Dissociations in cognitive memory: the syndrome of developmental amnesia.

    Science.gov (United States)

    Vargha-Khadem, F; Gadian, D G; Mishkin, M

    2001-09-29

    The dearth of studies on amnesia in children has led to the assumption that when damage to the medial temporal lobe system occurs early in life, the compensatory capacity of the immature brain rescues memory functions. An alternative view is that such damage so interferes with the development of learning and memory that it results not in selective cognitive impairments but in general mental retardation. Data will be presented to counter both of these arguments. Results obtained from a series of 11 amnesic patients with a history of hypoxic ischaemic damage sustained perinatally or during childhood indicate that regardless of age at onset of hippocampal pathology, there is a pronounced dissociation between episodic memory, which is severely impaired, and semantic memory, which is relatively preserved. A second dissociation is characterized by markedly impaired recall and relatively spared recognition leading to a distinction between recollection-based versus familiarity-based judgements. These findings are discussed in terms of the locus and extent of neuropathology associated with hypoxic ischaemic damage, the neural basis of 'remembering' versus 'knowing', and a hierarchical model of cognitive memory.

  15. Individuals with episodic amnesia are not stuck in time.

    Science.gov (United States)

    Craver, Carl F; Kwan, Donna; Steindam, Chloe; Rosenbaum, R Shayna

    2014-05-01

    The metaphor that individuals with episodic amnesia due to hippocampal damage are "stuck in time" persists in science, philosophy, and everyday life despite mounting evidence that episodic amnesia can spare many central aspects of temporal consciousness. Here we describe some of this evidence, focusing specifically on KC, one of the most thoroughly documented and severe cases of episodic amnesia on record. KC understands the concept of time, knows that it passes, and can orient himself with respect to his personal past and future. He expresses typical attitudes toward his past and future, and he is able to make future-regarding decisions. Theories claiming that the hippocampus plays an essential role in temporal consciousness need to be revised in light of these findings. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Novelty preference in patients with developmental amnesia.

    Science.gov (United States)

    Munoz, M; Chadwick, M; Perez-Hernandez, E; Vargha-Khadem, F; Mishkin, M

    2011-12-01

    To re-examine whether or not selective hippocampal damage reduces novelty preference in visual paired comparison (VPC), we presented two different versions of the task to a group of patients with developmental amnesia (DA), each of whom sustained this form of pathology early in life. Compared with normal control participants, the DA group showed a delay-dependent reduction in novelty preference on one version of the task and an overall reduction on both versions combined. Because VPC is widely considered to be a measure of incidental recognition, the results appear to support the view that the hippocampus contributes to recognition memory. A difficulty for this conclusion, however, is that according to one current view the hippocampal contribution to recognition is limited to task conditions that encourage recollection of an item in some associated context, and according to another current view, to recognition of an item with the high confidence judgment that reflects a strong memory. By contrast, VPC, throughout which the participant remains entirely uninstructed other than to view the stimuli, would seem to lack such task conditions and so would likely lead to recognition based on familiarity rather than recollection or, alternatively, weak memories rather than strong. However, before concluding that the VPC impairment therefore contradicts both current views regarding the role of the hippocampus in recognition memory, two possibilities that would resolve this issue need to be investigated. One is that some variable in VPC, such as the extended period of stimulus encoding during familiarization, overrides its incidental nature, and, because this condition promotes either recollection- or strength-based recognition, renders the task hippocampal-dependent. The other possibility is that VPC, rather than providing a measure of incidental recognition, actually assesses an implicit, information-gathering process modulated by habituation, for which the hippocampus is

  17. Dissociative amnesia in dissociative disorders and borderline personality disorder: self-rating assessment in a college population.

    Science.gov (United States)

    Sar, Vedat; Alioğlu, Firdevs; Akyuz, Gamze; Karabulut, Sercan

    2014-01-01

    Dissociative amnesia (DA) among subjects with a dissociative disorder and/or borderline personality disorder (BPD) recruited from a nonclinical population was examined. The Steinberg Dissociative Amnesia Questionnaire (SDAQ), the Childhood Trauma Questionnaire, and the self-report screening tool of the BPD section of the Structured Clinical Interview for DSM-IV(SCID-BPD) were administered to 1,301 college students. A total of 80 participants who were diagnosed with BPD according to the clinician-administered SCID-BPD and 111 nonborderline controls were evaluated using the Structured Clinical Interview for DSM-IV Dissociative Disorders (SCID-D) by a psychiatrist blind to diagnosis and scale scores. Internal consistency analyses and test-retest evaluations suggested that the SDAQ is a reliable instrument for the population studied. Of the participants, 20.6% reported an SDAQ score of 20 or above and impairment by DA. Those who had both dissociative disorder and BPD (n = 78) had the highest SDAQ scores. Both disorders had significant effects on the SCID-D total and amnesia scores in the variance analysis. On SDAQ scores, however, only BPD had this effect. There was a significant interaction between the 2 disorders for the SCID-D total but not for the SDAQ or SCID-D amnesia scores. BPD represented the severity of dissociation and childhood trauma in this study group. However, in contrast to the dissociative disorders, BPD was characterized by better awareness of DA in self-report. The discrepancies between self-report and clinical interview associated with BPD and dissociative disorders are discussed in the context of betrayal theory (J. J. Freyd, 1994) of BPD and perceptual theory (D. B. Beere, 2009) of dissociative disorders.

  18. Dissociations in future thinking following hippocampal damage: evidence from discounting and time perspective in episodic amnesia.

    Science.gov (United States)

    Kwan, Donna; Craver, Carl F; Green, Leonard; Myerson, Joel; Rosenbaum, R Shayna

    2013-11-01

    Recollecting past experiences and imagining future experiences activate a common set of brain regions that includes the hippocampus (Schacter, Addis, & Buckner, 2007), and both functions are impaired in people with compromised hippocampal function (Klein, Loftus, & Kihlstrom, 2002; Tulving, 1985). These findings indicate a role for the hippocampus that extends beyond declarative memory. However, a case study revealed that a person with extensive medial temporal lobe (MTL) damage and episodic amnesia was able to forgo smaller, immediate rewards for a larger future payoff to a degree similar to control participants (Kwan et al., 2012). This finding suggests that typical regard for the future does not depend on hippocampal integrity. To test this hypothesis, the current study examined the nature and limits of the role of the hippocampus in future thinking and decision making in amnesic individuals with hippocampal damage and associated impairments in episodic memory and future imagining. The amnesic individuals were administered a delay discounting task to assess valuation of future rewards, a probability discounting task to assess risk taking, and the Zimbardo Time Perspective Inventory to assess personal orientation toward the past, present, and future. Comparisons with demographically matched controls indicated that aspects of temporal thought and future-oriented decision making are preserved in individuals with hippocampal amnesia despite their inability to imagine themselves in detailed future events. Thus, even extensive MTL damage and the resulting episodic amnesia do not preclude prudent decision making, including consideration of future financial outcomes and personal identification with the past and future. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  19. Reactivation-Dependent Amnesia in Pavlovian Approach and Instrumental Transfer

    Science.gov (United States)

    Lee, Jonathan L. C.; Everitt, Barry J.

    2008-01-01

    The theory of memory reconsolidation relates to the hypothesized restabilisation process that occurs following the reactivation of a memory through retrieval. Thus, the demonstration of reactivation-dependent amnesia for a previously acquired memory is a prerequisite for showing that such a memory undergoes reconsolidation. Here, we show that the…

  20. Retrograde amnesia for semantic information in Alzheimer's disease

    NARCIS (Netherlands)

    Meeter, M.; Kollen, A.; Scheltens, P.

    2005-01-01

    Patients with mild to moderate Alzheimer's disease and normal controls were tested on a retrograde amnesia test with semantic content (Neologism and Vocabulary Test, or NVT), consisting of neologisms to be defined. Patients showed a decrement as compared to normal controls, pointing to retrograde am

  1. Formation and Functions of Alter Personalities in Dissociative Identity Disorder: A Theoretical and Clinical Elaboration

    Directory of Open Access Journals (Sweden)

    2016-12-01

    Full Text Available Dissociative identity disorder [DID] is a chronic complex psychiatric condition related to cumulative psychological traumatization in childhood. It is characterized by a marked disturbance of identity due to the presence of distinct personality states and repetitive dissociative amnesias which interfere with the continuity of the affected persons autobiography. These personality states [alter personalities] recurrently take control of or influence the individual undermining one’s sense of self and agency. Although working with alter personalities is the hallmark of psychotherapy in DID, a detailed and specific clinical and theoretical psychopathology of alter personalities do not exist yet. Hence, the present paper addresses the formation and functions of alter personalitiesin DID. The hypotheses, proposals, andassumptions developed in this paper have been derived from experiences inintensive treatment of a very large number of patients with DID over more than two decades. The authors propose that the reconciliation between diverse perspectives about one’s internal world and external reality carried by various personalities is necessary for successful treatment of DID. The hallmark of dealing with alter and host personalities constitutes of the elimination of misperceptions of themabout each other personality state and even about themselves.This requires an analysis of the missions and functions of alter personalities which are usually different thanthe perceived conceptualizations.This recognition usually increases the therapeutic alliance and even consent between the therapist, and alter and host personalities and decreases the duration of treatment. The present paper is a preliminary one on this subject and may serve as a basis both for further theoretical elaborations as well as for development of hypotheses in empirical research devoted to understanding operations of human mind when exposed to stress in particular as well as the

  2. Efficacy study of Prunus amygdalus (almond nuts in scopolamine-induced amnesia in rats

    Directory of Open Access Journals (Sweden)

    Kulkarni Kirti

    2010-01-01

    Full Text Available Objective : Cognitive disorders such as amnesia, attention deficit and Alzheimer′s disease are emerging nightmares in the field of medicine because no exact cure exists for them, as existing nootropic agents (piractam, tacrine, metrifonate have several limitations. The present study was undertaken to investigate the effect of Prunus amygdalus (PA nuts on cognitive functions, total cholesterol levels and cholinesterase (ChE activity in scopolamine-induced amnesia in rats. Materials and Methods : The paste of PA nuts was administered orally at three doses (150, 300 and 600 mg/kg for 7 and 14 consecutive days to the respective groups of rats. Piracetam (200 mg/kg was used as a standard nootropic agent. Learning and memory parameters were evaluated using elevated plus maze (EPM, passive avoidance and motor activity paradigms. Brain ChE activity and serum biochemical parameters like total cholesterol, total triglycerides and glucose were evaluated. Results : It was observed that PA at the above-mentioned doses after 7 and 14 days of administration in the respective groups significantly reversed scopolamine (1 mg/kg i.p.-induced amnesia, as evidenced by a decrease in the transfer latency in the EPM task and step-down latency in the passive avoidance task. PA reduced the brain ChE activity in rats. PA also exhibited a remarkable cholesterol and triglyceride lowering property and slight increase in glucose levels in the present study. Conclusion : Because diminished cholinergic transmission and increase in cholesterol levels appear to be responsible for the development of amyloid plaques and dementia in Alzheimer patients, PA may prove to be a useful memory-restorative agent. It would be worthwhile to explore the potential of this plant in the management of Alzheimer′s disease.

  3. Proteome Analysis of Rat Hippocampus Following Morphine-induced Amnesia and State-dependent Learning.

    Science.gov (United States)

    Jafarinejad-Farsangi, Saeideh; Farazmand, Ali; Rezayof, Ameneh; Darbandi, Niloufar

    2015-01-01

    Morphine's effects on learning and memory processes are well known to depend on synaptic plasticity in the hippocampus. Whereas the role of the hippocampus in morphine-induced amnesia and state-dependent learning is established, the biochemical and molecular mechanisms underlying these processes are poorly understood. The present study intended to investigate whether administration of morphine can change the expression level of rat hippocampal proteins during learning of a passive avoidance task. A step-through type passive avoidance task was used for the assessment of memory retention. To identify the complex pattern of protein expression induced by morphine, we compared rat hippocampal proteome either in morphine-induced amnesia or in state-dependent learning by two-dimensional gel electerophoresis and combined mass spectrometry (MS and MS/MS). Post-training administration of morphine decreased step-through latency. Pre-test administration of morphine induced state-dependent retrieval of the memory acquired under post-training morphine influence. In the hippocampus, a total of 18 proteins were identified whose MASCOT (Modular Approach to Software Construction Operation and Test) scores were inside 95% confidence level. Of these, five hippocampal proteins altered in morphine-induced amnesia and ten proteins were found to change in the hippocampus of animals that had received post-training and pre-test morphine. These proteins show known functions in cytoskeletal architecture, cell metabolism, neurotransmitter secretion and neuroprotection. The findings indicate that the effect of morphine on memory formation in passive avoidance learning has a morphological correlate on the hippocampal proteome level. In addition, our proteomicscreensuggests that morphine induces memory impairment and state-dependent learning through modulating neuronal plasticity.

  4. Clinical applications of the functional connectome.

    Science.gov (United States)

    Castellanos, F Xavier; Di Martino, Adriana; Craddock, R Cameron; Mehta, Ashesh D; Milham, Michael P

    2013-10-15

    Central to the development of clinical applications of functional connectomics for neurology and psychiatry is the discovery and validation of biomarkers. Resting state fMRI (R-fMRI) is emerging as a mainstream approach for imaging-based biomarker identification, detecting variations in the functional connectome that can be attributed to clinical variables (e.g., diagnostic status). Despite growing enthusiasm, many challenges remain. Here, we assess evidence of the readiness of R-fMRI based functional connectomics to lead to clinically meaningful biomarker identification through the lens of the criteria used to evaluate clinical tests (i.e., validity, reliability, sensitivity, specificity, and applicability). We focus on current R-fMRI-based prediction efforts, and survey R-fMRI used for neurosurgical planning. We identify gaps and needs for R-fMRI-based biomarker identification, highlighting the potential of emerging conceptual, analytical and cultural innovations (e.g., the Research Domain Criteria Project (RDoC), open science initiatives, and Big Data) to address them. Additionally, we note the need to expand future efforts beyond identification of biomarkers for disease status alone to include clinical variables related to risk, expected treatment response and prognosis.

  5. Focal retrograde amnesia: voxel-based morphometry findings in a case without MRI lesions.

    Directory of Open Access Journals (Sweden)

    Bernhard Sehm

    Full Text Available Focal retrograde amnesia (FRA is a rare neurocognitive disorder presenting with an isolated loss of retrograde memory. In the absence of detectable brain lesions, a differentiation of FRA from psychogenic causes is difficult. Here we report a case study of persisting FRA after an epileptic seizure. A thorough neuropsychological assessment confirmed severe retrograde memory deficits while anterograde memory abilities were completely normal. Neurological and psychiatric examination were unremarkable and high-resolution MRI showed no neuroradiologically apparent lesion. However, voxel-based morphometry (VBM-comparing the MRI to an education-, age-and sex-matched control group (n = 20 disclosed distinct gray matter decreases in left temporopolar cortex and a region between right posterior parahippocampal and lingual cortex. Although the results of VBM-based comparisons between a single case and a healthy control group are generally susceptible to differences unrelated to the specific symptoms of the case, we believe that our data suggest a causal role of the cortical areas detected since the retrograde memory deficit is the preeminent neuropsychological difference between patient and controls. This was paralleled by grey matter differences in central nodes of the retrograde memory network. We therefore suggest that these subtle alterations represent structural correlates of the focal retrograde amnesia in our patient. Beyond the implications for the diagnosis and etiology of FRA, our results advocate the use of VBM in conditions that do not show abnormalities in clinical radiological assessment, but show distinct neuropsychological deficits.

  6. A Case of Persistent Generalized Retrograde Autobiographical Amnesia Subsequent to the Great East Japan Earthquake in 2011

    Directory of Open Access Journals (Sweden)

    Yuji Odagaki

    2017-01-01

    Full Text Available Functional retrograde autobiographical amnesia is often associated with physical and/or psychological trauma. On 11 March 2011, the largest earthquake on record in Japan took place, and subsequent huge tsunami devastated the Pacific coast of northern Japan. This case report describes a patient suffering from retrograde episodic-autobiographical amnesia for whole life, persisting for even more than five years after the disaster. A Japanese man, presumably in his 40s, got police protection in April 2016 but was unable to respond to question about his own name. He lost all information about his personal identity, and his memory was wholly lost until the disaster on 11 March 2011. He was able to recall his life after the disaster, and semantic memories and social abilities were largely preserved. A medical examination performed on 1 November 2016 verified that he was awake, alert, and oriented to time, place, and person (except for himself. General physical and neurological examinations revealed no pathological findings. He also experienced some symptoms associated with posttraumatic stress disorder (PTSD, such as intrusive thoughts, flashbacks, and nightmares. No abnormalities were detected by biochemical test and brain magnetic resonance imaging (MRI. Physicians and other professionals who take care of victims of disaster should be aware of dissociative spectrum disorders, such as psychogenic amnesia.

  7. A Case of Persistent Generalized Retrograde Autobiographical Amnesia Subsequent to the Great East Japan Earthquake in 2011

    Science.gov (United States)

    2017-01-01

    Functional retrograde autobiographical amnesia is often associated with physical and/or psychological trauma. On 11 March 2011, the largest earthquake on record in Japan took place, and subsequent huge tsunami devastated the Pacific coast of northern Japan. This case report describes a patient suffering from retrograde episodic-autobiographical amnesia for whole life, persisting for even more than five years after the disaster. A Japanese man, presumably in his 40s, got police protection in April 2016 but was unable to respond to question about his own name. He lost all information about his personal identity, and his memory was wholly lost until the disaster on 11 March 2011. He was able to recall his life after the disaster, and semantic memories and social abilities were largely preserved. A medical examination performed on 1 November 2016 verified that he was awake, alert, and oriented to time, place, and person (except for himself). General physical and neurological examinations revealed no pathological findings. He also experienced some symptoms associated with posttraumatic stress disorder (PTSD), such as intrusive thoughts, flashbacks, and nightmares. No abnormalities were detected by biochemical test and brain magnetic resonance imaging (MRI). Physicians and other professionals who take care of victims of disaster should be aware of dissociative spectrum disorders, such as psychogenic amnesia.

  8. The Clinical Functional Impairment Scale Development.

    Science.gov (United States)

    Sandler, Adrian; Wright, Mary Ellen; Denslow, Sheri

    2017-10-01

    The purpose of the project was to review content validity and assess the span of responses for the newly developed Clinical Functional Impairment Scale (CFIS). A cross-sectional, content validity process using focus groups of developmental, behavioral pediatric clinicians was conducted. After qualitative analysis of the focus group data, adjustments were made in the CFIS based on the recommendations of the content experts. A survey was conducted of clinicians participating in the online Society of Developmental and Behavioral Pediatrics Discussion Board. Clinicians reviewed 2 case studies and used the CFIS to score severity and interval change of predetermined functional impairments. The amount of spread in the answers was assessed by calculating the index of dispersion. Qualitative analysis of the focus groups resulted in adjustment to the CFIS to 20 functional impairments, with a 5-point Likert scale of severity and a 7-point Likert scale of interval change. Ninety-four clinicians participated in the survey. The index of dispersion ranged from 0.49 to 0.88. The interval ratings of severity and interval change had lower dispersion ranges. The CFIS uses a mutual prioritization by the family and clinician of the child's functional impairments. The study demonstrated that the clinicians' ratings of the case studies were more variable in the initial symptom severity score than their ratings of symptom severity and interval change in symptoms. Further testing of the CFIS is planned using face-to-face clinical encounters and including parent/caregiver ratings of severity and interval change.

  9. Functional foods: salient features and clinical applications.

    Science.gov (United States)

    Riezzo, Giuseppe; Chiloiro, Marisa; Russo, Francesco

    2005-09-01

    The term "functional food" refers to foods or ingredients of foods providing an additional physiological benefit beyond their basic nutritional needs. Health benefits are best obtained through a varied diet containing fruits, vegetables, grains, legumes and seeds. However, fortified foods and dietary supplements have been marketed and food industry have made functional food one of their current leading trends. Recently, the number of functional foods that have a potential benefit on health has hugely grown and scientific evidence is supporting the role of functional foods in prevention and treatment of several diseases. Cancer, diabetes, heart disease and hypertension are the most important diseases that can be treated or prevented by functional foods; other diseases are osteoporosis, abnormal bowel motility, and arthritis. It has been estimated that 80% of cancer in USA have a nutrition/diet component suggesting a great impact of functional food and foods components on incidence and treatment of cancer. Numerous factors complicate the evaluation of scientific evidence such as the complexity of food substance, effect on food, metabolic changes associated to dietary changes, the lack of biological markers of disease development. This paper reviews the scientific evidence supporting this area regarding only those foods and ingredients in which a clear experimental and clinical evidence exists for their chemopreventive and therapeutic effects.

  10. Transient global amnesia: a complication of incremental exercise testing.

    Science.gov (United States)

    Richardson, R S; Leek, B T; Wagner, P D; Kritchevsky, M

    1998-10-01

    Incremental exercise testing is routinely used for diagnosis, rehabilitation, health screening, and research. We report the case of a 71-yr-old patient with chronic obstructive pulmonary disease (COPD) who suffered an episode of transient global amnesia (TGA) several minutes after successfully completing an incremental exercise test on a cycle ergometer. TGA, which is known to be precipitated by physical or emotional stress in about one-third of cases, is a transient neurological disorder in which memory impairment is the prominent deficit. TGA has a benign course and requires no treatment although 24-h observation is recommended. Recognition of TGA as a potential complication of incremental graded exercise testing is important to both aid diagnosis of the amnesia and to spare a patient unnecessary evaluation.

  11. Supporting the self-concept with memory: insight from amnesia

    OpenAIRE

    Grilli, Matthew D.; Verfaellie, Mieke

    2015-01-01

    We investigated the extent to which personal semantic memory supports the self-concept in individuals with medial temporal lobe amnesia and healthy adults. Participants completed eight ‘I Am’ self-statements. For each of the four highest ranked self-statements, participants completed an open-ended narrative task, during which they provided supporting information indicating why the I Am statement was considered self-descriptive. Participants then completed an episodic probe task, during which ...

  12. Comparing Prospectively Recorded Posttraumatic Amnesia Duration With Retrospective Accounts.

    Science.gov (United States)

    Roberts, Caroline M; Spitz, Gershon; Ponsford, Jennie L

    2016-01-01

    Limited research has been conducted comparing different methods for determining the duration of posttraumatic amnesia (PTA). This study compared prospectively recorded PTA duration (P-PTA) with retrospective reports of the return of continuous memory (R-PTA). Fifty-nine individuals admitted to a head injury rehabilitation unit with a traumatic brain injury who had their PTA duration recorded using the Westmead Post-Traumatic Amnesia Scale. Participants were between 6 months and 6 years postinjury at the time of study. P-PTA was determined on the basis of Westmead Post-Traumatic Amnesia Scale responses. R-PTA was ascertained using a semistructured telephone interview. Although the PTA measures were significantly positively correlated (r = 0.76), mean R-PTA was significantly longer than mean P-PTA. In 34 cases (57.6%), R-PTA was longer than P-PTA (13 participants moved to a higher injury severity band), and in 22 cases (37.3%), R-PTA was shorter than P-PTA (8 participants moved to a lower injury severity band). The difference between P-PTA and R-PTA was not significantly associated with age, Glasgow Coma Scale score, overall PTA duration, or the number of days postinjury of the retrospective interview. Prospective and retrospective estimates of PTA duration were not comparable within the present sample. Further research comparing the two methods is needed.

  13. Neural Correlate of Anterograde Amnesia in Wernicke-Korsakoff Syndrome.

    Science.gov (United States)

    Nahum, Louis; Pignat, Jean-Michel; Bouzerda-Wahlen, Aurélie; Gabriel, Damien; Liverani, Maria Chiara; Lazeyras, François; Ptak, Radek; Richiardi, Jonas; Haller, Sven; Thorens, Gabriel; Zullino, Daniele F; Guggisberg, Adrian G; Schnider, Armin

    2015-09-01

    The neural correlate of anterograde amnesia in Wernicke-Korsakoff syndrome (WKS) is still debated. While the capacity to learn new information has been associated with integrity of the medial temporal lobe (MTL), previous studies indicated that the WKS is associated with diencephalic lesions, mainly in the mammillary bodies and anterior or dorsomedial thalamic nuclei. The present study tested the hypothesis that amnesia in WKS is associated with a disrupted neural circuit between diencephalic and hippocampal structures. High-density evoked potentials were recorded in four severely amnesic patients with chronic WKS, in five patients with chronic alcoholism without WKS, and in ten age matched controls. Participants performed a continuous recognition task of pictures previously shown to induce a left medial temporal lobe dependent positive potential between 250 and 350 ms. In addition, the integrity of the fornix was assessed using diffusion tensor imaging (DTI). WKS, but not alcoholic patients without WKS, showed absence of the early, left MTL dependent positive potential following immediate picture repetitions. DTI indicated disruption of the fornix, which connects diencephalic and hippocampal structures. The findings support an interpretation of anterograde amnesia in WKS as a consequence of a disconnection between diencephalic and MTL structures with deficient contribution of the MTL to rapid consolidation.

  14. Anterograde amnesia as a possible postoperative complication of Midazolam as an agent for intravenous conscious sedation.

    Science.gov (United States)

    Malamed, S F; Nikchevich, D; Block, J

    1988-01-01

    Anterograde amnesia is often considered to be a beneficial effect of intravenous conscious sedation. The recently introduced benzodiazepine, midazolam, has associated with its administration a significant anterograde amnesic period. In the case presented here, a healthy young female presented for third molar extraction under midazolam conscious sedation and local anesthesia. After uncomplicated removal of the teeth and clinically adequate recovery from sedation, it was noted that the patient had swallowed the postsurgical gauze packs. Efforts at recovery of the gauze packs were futile. Follow-up discussion with the patient revealed a complete lack of recall of all events occurring for up to an hour or more after the administration of intravenous midazolam. The need for written and oral postoperative instructions to both the patient and his/her escort is emphasized.

  15. Transient Global Amnesia Associated with an Acute Infarction at the Cingulate Gyrus

    Directory of Open Access Journals (Sweden)

    Alejandro Gallardo-Tur

    2014-01-01

    Full Text Available Background. Transient global amnesia (TGA is a syndrome of sudden, unexplained isolated short-term memory loss. In the majority of TGA cases, no causes can be identified and neuroimaging, CSF studies and EEG are usually normal. We present a patient with TGA associated with a small acute infarct at the cingulate gyrus. Case Report. The patient, a 62 year-old man, developed two episodes of TGA. He had hypertension and hypercholesterolemia. He was found to have an acute ischemic stroke of small size (15 mm of maximal diameter at the right cerebral cingulate gyrus diagnosed on brain magnetic resonance imaging. No lesions involving other limbic system structures such as thalamus, fornix, corpus callosum, or hippocampal structures were seen. The remainder of the examination was normal. Conclusion. Unilateral ischemic lesions of limbic system structures may result in TGA. We must bear in mind that TGA can be an associated clinical disorder of cingulate gyrus infarct.

  16. Anterograde Amnesia as a Possible Postoperative Complication of Midazolam as an Agent for Intravenous Conscious Sedation

    Science.gov (United States)

    Malamed, Stanley F.; Nikchevich, Donald; Block, James

    1988-01-01

    Anterograde amnesia is often considered to be a beneficial effect of intravenous conscious sedation. The recently introduced benzodiazepine, midazolam, has associated with its administration a significant anterograde amnesic period. In the case presented here, a healthy young female presented for third molar extraction under midazolam conscious sedation and local anesthesia. After uncomplicated removal of the teeth and clinically adequate recovery from sedation, it was noted that the patient had swallowed the postsurgical gauze packs. Efforts at recovery of the gauze packs were futile. Follow-up discussion with the patient revealed a complete lack of recall of all events occurring for up to an hour or more after the administration of intravenous midazolam. The need for written and oral postoperative instructions to both the patient and his/her escort is emphasized. PMID:3166354

  17. Computer assistance in clinical functional analysis.

    Science.gov (United States)

    Ahlers, M O; Jakstat, H A

    2002-10-01

    The use of computers in the dental practice has been primarily restricted to the acquisition of billing data. Additional possibilities for use of PCs exist in diagnostic data acquisition and evaluation; clinical functional analysis seems a particularly suitable application. Such software is now available: CMDfact. Dentally, it is based on a previously developed and published examination and documentation system, the graphic user interface of which is used in the newly developed software. After the examination data have been acquired by mouse click or numerical entry, these are available for evaluation. A special function, the "Diagnosis pilot" is integrated to support the user. This helps in the assignment of the appropriate "Initial diagnoses", since it brings together the individually existing principal symptoms and suitable diagnoses for the initial diagnosis in question and also states which diagnoses "would be appropriate" for this, but are not available. With 3D animation, the software also helps the dentist to explain aspects of CMD to patients. The software also assists the dentist with a detailed multimedia help system, which provides context-sensitive help for every examination step. These help functions explain the sense of the relevant examinations, their performance and evaluation in the form of short texts and explanatory photographs and videos.

  18. Child Sexual Abuse Survivors with Dissociative Amnesia: What's the Difference?

    Science.gov (United States)

    Wolf, Molly R.; Nochajski, Thomas H.

    2013-01-01

    Although the issue of dissociative amnesia in adult survivors of child sexual abuse has been contentious, many research studies have shown that there is a subset of child sexual abuse survivors who have forgotten their abuse and later remembered it. Child sexual abuse survivors with dissociative amnesia histories have different formative and…

  19. Reexposure to the Amnestic Agent Alleviates Cycloheximide-Induced Retrograde Amnesia for Reactivated and Extinction Memories

    Science.gov (United States)

    Briggs, James F.; Olson, Brian P.

    2013-01-01

    We investigated whether reexposure to an amnestic agent would reverse amnesia for extinction of learned fear similar to that of a reactivated memory. When cycloheximide (CHX) was administered immediately after a brief cue-induced memory reactivation (15 sec) and an extended extinction session (12 min) rats showed retrograde amnesia for both…

  20. The effects of ACTH- and vasopressin-analogues on CO2-induced retrograde amnesia in rats

    NARCIS (Netherlands)

    Rigter, H.; Riezen, H. van; Wied, D. de

    1974-01-01

    Amnesia for a one-trial step-through passive avoidance response was induced in rats by application of CO2 until respiratory arrest occurred. The ACTH-analogue ACTH4–10 alleviated the amnesia when administered 1 hr prior to the retrieval test but not when given 1 hr prior to the acquisition trial. Th

  1. Child Sexual Abuse Survivors with Dissociative Amnesia: What's the Difference?

    Science.gov (United States)

    Wolf, Molly R.; Nochajski, Thomas H.

    2013-01-01

    Although the issue of dissociative amnesia in adult survivors of child sexual abuse has been contentious, many research studies have shown that there is a subset of child sexual abuse survivors who have forgotten their abuse and later remembered it. Child sexual abuse survivors with dissociative amnesia histories have different formative and…

  2. Naïve Beliefs About the Natural World in a Case of Childhood Onset Amnesia

    Directory of Open Access Journals (Sweden)

    William Winter

    2016-10-01

    Full Text Available The individual profiled here (M.S. suffered an episode of severe oxygen deprivation (anoxia at the age of eight, damaging memory relevant structures in the mid-temporal lobes, including the hippocampus bilaterally. The resulting anterograde amnesia was characterized by profound deficits in autobiographical memory, but also a compromised ability to acquire new facts and information (semantic memory, resulting in the formation of idiosyncratic and naïve beliefs about the natural world that have persisted into his adult years. This article presents an interview with M.S. in which many of these idiosyncratic beliefs are detailed, and argues that they can be broadly viewed as the interaction of; 1 intact frontal lobe functioning that supports the application of rational analysis to his lived experience, and 2 an impoverished factual knowledge base upon which to construct sophisticated and evidence-based models of his lived experience and of natural world processes.

  3. A review on citation amnesia in depression and inflammation research.

    Science.gov (United States)

    Maes, Michael

    2015-01-01

    Once original scientific results are published the author has the "intellectual property" and may claim ownership. Discovery credit is one of the most important "rewards" for scientists and thus incorrect credits undermine the reward system of science. Scientists who publish should therefore give proper credit and acknowledge the primary sources. Failure to do so is regarded as "citation negligence", "the disregard syndrome", "citation amnesia", "plagiarism by omission", "bibliographic plagiarism" or "citation plagiarism", and may range from an unconscious or conscious "failure to credit a prior discoverer so as to give an improper impression of priority" to "the appropriation of another person's ideas or results without given proper credit". False discovery credit is considered to be "a menace to honest science", "a serious transgression" or "intellectual theft, be it intentional or not". This paper describes some examples of citation amnesia showing that scientists often fail to credit prior sources and give false discovery credit to other scientists. One example is the association between major depression and activated immuno-inflammatory pathways, a discovery by European groups and published in many papers since 1990. Now, 25 years later, it is commonplace that these theories are credited to secondary American sources whose work in "the last decade", did or did not examine these pathways in major depression. This gives an improper impression of priority of American-based scientists. Here it is proposed that this citation amnesia and plagiarism reinforced the wrong science and had negative effects on the development of immune-inflammatory biomarkers and new immune-related treatments for depression. It is concluded that journal editors should improve their citation standards to guarantee correct assignment of discovery credit for example by demanding a signed pledge from the authors that correct citations to the primary sources were made.

  4. The scope of preserved procedural memory in amnesia.

    Science.gov (United States)

    Cavaco, Sara; Anderson, Steven W; Allen, John S; Castro-Caldas, Alexandre; Damasio, Hanna

    2004-08-01

    The finding that patients with amnesia retain the ability to learn certain procedural skills has provided compelling evidence of multiple memory systems in the human brain, but the scope, defining features and ecological significance of the preserved mnemonic abilities have not yet been explored. Here, we tested the hypothesis that subjects with amnesia would be able to learn and retain a broad range of procedural skills, by examining their acquisition and retention performance on five novel experimental tasks. The tasks are based on real-world activities and encompass a broad range of perceptual-motor demands: (i) the weaving task involves weaving pieces of fabric from woollen strings, using a manual weaver's loom; (ii) the geometric figures task consists of tracing geometric figures with a stylus as they move horizontally across a touch screen monitor; (iii) the control stick task involves tracking a sequence of visual target locations using a joystick control; (iv) the pouring task consists of pouring 200 ml of water from a watering can into a series of graduated cylinders, from a point 20 cm above the cylinders; and (v) the spatial sequence task involves learning an ordered sequence of pushing five spatially distributed buttons without visual guidance. Ten chronic and stable amnesic subjects (nine with bilateral medial temporal lobe damage due to herpes simplex encephalitis or anoxia, and one with thalamic stroke) and 25 matching normal comparison subjects were tested on three occasions: initial learning at time 1; retention at time 2 (24 h later); and retention at time 3 (2 months later). Despite impaired declarative memory for the tasks, the amnesic subjects demonstrated acquisition and retention of the five skills; their learning slopes over repeated trials were comparable with those of comparison subjects. These findings indicate that preserved learning of complex perceptual-motor skills in patients with amnesia is a robust phenomenon, and that it can be

  5. The impact of fluency on explicit memory tasks in amnesia.

    Science.gov (United States)

    Hayes, Scott M; Verfaellie, Mieke

    2012-01-01

    Abstract Distinguishing implicit and explicit memory and delineating their relationship has haunted memory researchers for decades, and Voss et al. provide an impressive overview of their work examining these issues. We briefly comment on the following: (1) There is evidence indicating that implicit memory impacts cued recall, in addition to recognition; (2) Fluency can manifest as priming in implicit memory or it can be experienced as familiarity (in association with attribution processes) in recognition tasks; and (3) The impact of fluency on accuracy of "guess" responses during recognition memory in normal subjects is reminiscent of similar effects on recognition in amnesia.

  6. Transient Global Amnesia After Cerebral Angiography With Iomeprol

    Science.gov (United States)

    Tiu, Cristina; Terecoasă, Elena Oana; Grecu, Nicolae; Dorobăţ, Bogdan; Marinescu, Andreea Nicoleta; Băjenaru, Ovidiu Alexandru

    2016-01-01

    Abstract Transient global amnesia is now considered a very rare complication of cerebral angiography. Various etiological mechanisms have been suggested to account for this complication, but no consensus has been reached yet. This case report documents one of the few reported cases of cerebral angiography-related transient global amnesia associated with magnetic resonance imaging (MRI) evidence of unilateral hippocampal ischemia, most probably as a consequence of a transient reduction in regional hippocampal blood flow. However, the possibility of a direct neurotoxic effect of the nonionic contrast media Iomeprol on the Cornu ammonis – field 1 neurons cannot be firmly ruled out. We describe the case of a 54-year-old woman admitted to our department for left upper limb weakness with acute onset 8 days before. The brain computed tomography (CT) scan performed at admission revealed subacute ischemic lesions in the right watershed superficial territories and a right thalamic lacunar infarct. Diagnostic digital subtraction cerebral angiography was performed 4 days after admission with the nonionic contrast media Iomeprol. A few minutes after completion of the procedure, the patient developed symptoms suggestive for transient global amnesia. The brain MRI performed 22 hours after the onset of symptoms demonstrated increased signal within the lateral part of the right hippocampus on the diffusion-weighted imaging (DWI) sequences, associated with a corresponding reduction in the apparent diffusion coefficient (ADC) and increased signal on the fluid-attenuated inversion recovery (FLAIR) sequences, consistent with acute hippocampal ischemia and several T2/FLAIR hyperintensities in the right watershed superficial territories and in the right thalamus, corresponding to the lesions already identified on the CT scan performed at admission. A follow-up MRI, performed 2 months later, demonstrated the disappearance of the increased signal within the right hippocampus on the DWI

  7. Transient global amnesia during a professional cello concert.

    Science.gov (United States)

    Thakur, Kiran; Ropper, Allan

    2011-09-01

    Transient global amnesia (TGA) is a great curiosity in medicine, the underlying pathophysiology of which remains under debate. When an episode occurs during the performance of a task requiring refined technical skills and an intense level of concentration such as a musical performance, it draws attention to the relationship between memory and performance. It also raises questions of access to procedural memory and other aspects of stored information. We encountered a renowned and highly proficient musician who was amnestic for a challenging concert. Copyright © 2011 Elsevier Ltd. All rights reserved.

  8. Value of dynamic susceptibility contrast perfusion MRI in the acute phase of transient global amnesia.

    Directory of Open Access Journals (Sweden)

    Alex Förster

    Full Text Available Transient global amnesia (TGA is a transitory, short-lasting neurological disorder characterized by a sudden onset of antero- and retrograde amnesia. Perfusion abnormalities in TGA have been evaluated mainly by use of positron emission tomography (PET or single-photon emission computed tomography (SPECT. In the present study we explore the value of dynamic susceptibility contrast perfusion-weighted MRI (PWI in TGA in the acute phase.From a MRI report database we identified TGA patients who underwent MRI including PWI in the acute phase and compared these to control subjects. Quantitative perfusion maps (cerebral blood flow (CBF and volume (CBV were generated and analyzed by use of Signal Processing In NMR-Software (SPIN. CBF and CBV values in subcortical brain regions were assessed by use of VOI created in FIRST, a model-based segmentation tool in the Oxford Centre for Functional Magnetic Resonance Imaging of the Brain (FMRIB Software Library (FSL.Five TGA patients were included (2 men, 3 women. On PWI, no relevant perfusion alterations were found by visual inspection in TGA patients. Group comparisons for possible differences between TGA patients and control subjects showed significant lower rCBF values bilaterally in the hippocampus, in the left thalamus and globus pallidus as well as bilaterally in the putamen and the left caudate nucleus. Correspondingly, significant lower rCBV values were observed bilaterally in the hippocampus and the putamen as well as in the left caudate nucleus. Group comparisons for possible side differences in rCBF and rCBV values in TGA patients revealed a significant lower rCBV value in the left caudate nucleus.Mere visual inspection of PWI is not sufficient for the assessment of perfusion changes in TGA in the acute phase. Group comparisons with healthy control subjects might be useful to detect subtle perfusion changes on PWI in TGA patients. However, this should be confirmed in larger data sets and serial PWI

  9. Stress-related factors in the emergence of transient global amnesia with hippocampal lesion

    Directory of Open Access Journals (Sweden)

    Juliane eDöhring

    2014-08-01

    Full Text Available The transient global amnesia (TGA is a rare amnesic syndrome that is characterized by an acute onset episode of an anterograde and retrograde amnesia. Its origin is still debated, but there is evidence for psychological factors involved in TGA. In neuroimaging, selective lesions in the CA1 fields of the hippocampus can be detected, a region that is particularly involved in the processing of memory, stress and emotion. The aim of this study was to assess the role of psychological stress in TGA by studying the prevalence of stress related precipitating events and individual stress-related personality profiles as well as coping strategies in patients. The hypothesis of a functional differentiation of the hippocampus in mnemonic and stress-related compartments was also evaluated. From all 113 patients, 18 % (n= 24 patients experienced emotional and psychological stress episodes directly before the TGA. In a cohort of 21 acute patients, TGA patients tend to cope with stress less efficiently and less constructively than controls. Patients who experienced a stress related precipitant event exhibited a higher level of anxiety in comparison to non-stress patients and controls. However, there was no difference between the general experience of stress and the number of stress inducing life events. The majority of patients (73% did show typical MRI lesions in the CA1 region of the hippocampal cornu ammonis. There was no clear association between stressful events, distribution of hippocampal CA1 lesions and behavioral patterns during the TGA. Disadvantageous coping strategies and an elevated anxiety level may increase the susceptibility to psychological stress which may facilitate the pathophysiological cascade in TGA. The findings suggest a role of emotional stress factors in the manifestation of TGA in a subgroup of patients. Stress may be one trigger involved in the emergence of transient lesions in the hippocampal CA1 region, which are thought to be the

  10. Concepts of Causality in Psychopathology: Applications in Clinical Assessment, Clinical Case Formulation and Functional Analysis

    NARCIS (Netherlands)

    Haynes, S.H.; O'Brien, W.H.; Kaholokula, J.K.; Witteman, C.L.M.

    2012-01-01

    This paper discusses and integrates concepts of causality in psychopathology, clinical assessment, clinical case formulation and the functional analysis. We propose that identifying causal variables, relations and mechanisms in psychopathology and clinical assessment can lead to more powerful and e

  11. Contribution of Embodiment to Solving the Riddle of Infantile Amnesia

    Directory of Open Access Journals (Sweden)

    Arthur M Glenberg

    2016-01-01

    Full Text Available At least since the late nineteenth century, researchers have sought an explanation for infantile amnesia (IA—the lack of autobiographical memories dating from early childhood—and childhood amnesia (CA, faster forgetting of events up until the age of about seven. Evidence suggests that IA occurs across altricial species, and a number of studies using animal models have converged on the hypothesis that maturation of the hippocampus is an important factor. But why does the hippocampus mature at one time and not another, and how does that maturation relate to memory? Our hypothesis is rooted in theories of embodied cognition, and it provides an explanation both for hippocampal development and the end of IA. Specifically, the onset of locomotion prompts the alignment of hippocampal place cells and grid cells to the environment, which in turn facilitates the ontogeny of long-term episodic memory and the end of IA. That is, because the animal can now reliably discriminate locations, location becomes a stable cue for memories. Furthermore, as the mode of human locomotion shifts from crawling to walking, there is an additional shift in the alignment of the hippocampus that marks the beginning of adult-like episodic memory and the end of CA. Finally, given a reduction in self-locomotion and exploration with aging, the hypothesis suggests a partial explanation for cognitive decline with aging.

  12. Musical memory in a patient with severe anterograde amnesia.

    Science.gov (United States)

    Cavaco, Sara; Feinstein, Justin S; van Twillert, Henk; Tranel, Daniel

    2012-01-01

    The ability to play a musical instrument represents a unique procedural skill that can be remarkably resilient to disruptions in declarative memory. For example, musicians with severe anterograde amnesia have demonstrated preserved ability to play musical instruments. However, the question of whether amnesic musicians can learn how to play new musical material despite severe memory impairment has not been thoroughly investigated. We capitalized on a rare opportunity to address this question. Patient S.Z., an amateur musician (tenor saxophone), has extensive bilateral damage to his medial temporal lobes following herpes simplex encephalitis, resulting in a severe anterograde amnesia. We tested S.Z.'s capacity to learn new unfamiliar songs by sight-reading following three months of biweekly practices. Performances were recorded and were then evaluated by a professional saxophonist. S.Z. demonstrated significant improvement in his ability to read and play new music, despite his inability to recognize any of the songs at a declarative level. The results suggest that it is possible to learn certain aspects of new music without the assistance of declarative memory.

  13. Evolución de la amnesia postraumática en un paciente con ACV

    OpenAIRE

    I. López-García, Sara I.

    2014-01-01

    La amnesia postraumática puede ser evaluada con la “Galveston Orientation Amnesia Test” (GOAT), que nos ayuda tanto a detectarla como a determinar su duración. El problema de esta escala es que tiene algunas limitaciones que hacen que, en ciertos casos, dependiendo de las capacidades cognitivas del paciente tras el accidente, los resultados no sean demasiado fiables. El objetivo de este trabajo fue valorar la amnesia postraumática de un paciente tras sufrir un accidente cerebrovascular a trav...

  14. Route learning in amnesia: a comparison of trial-and-error and errorless learning in patients with the Korsakoff syndrome.

    Science.gov (United States)

    Kessels, Roy P C; van Loon, Eke; Wester, Arie J

    2007-10-01

    To examine the errorless learning approach using a procedural memory task (i.e. learning of actual routes) in patients with amnesia, as compared to trial-and-error learning. Counterbalanced self-controlled cases series. Psychiatric hospital (Korsakoff clinic). A convenience sample of 10 patients with the Korsakoff amnestic syndrome. All patients learned a route in four sessions on separate days using an errorless approach and a different route using trial-and-error. Error rate was scored during route learning and standard neuro-psychological tests were administered (i.e. subtest route recall of the Rivermead Behavioural Memory Test (RBMT) and the Dutch version of the California Verbal Learning Test (VLGT)). A significant learning effect was found in the trial-and-error condition over consecutive sessions (P = 0.006), but no performance difference was found between errorless and trial-and-error learning of the routes. VLGT performance was significantly correlated with a trial-and-error advantage (P amnesia).

  15. A review study on medicinal plants affecting amnesia through cholinergic system

    Directory of Open Access Journals (Sweden)

    Baradaran Azar

    2012-01-01

    Full Text Available Neurotransmitter modification is an important method for the treatment of memory loss or amnesia. Cholinomimetic drugs, particularly, acetylcholine esterase inhibitors are the mainstream in pharmacotherapy of amnesia. Donepezil, tacrine, galantamine, and rivastigmine are cholinesterase inhibitors which are widely used in the treatment of amnesia, however, their therapeutic effects are not significant. Therefore, other possibilities including herbal medicine sources have been considered for memory loss therapy. There are some Medicinal plants with cholinomimetic property which mostly possess antioxidant activity, too. These plants may not only ameliorate amnesia but also can be a good source for drug discovery. In this paper other than introducing the medicinal plants and their components affective on cholinergic system and effective on memory loss, their probable advantages over synthetic drugs are discussed.

  16. Inter-identity autobiographical amnesia in patients with dissociative identity disorder.

    Directory of Open Access Journals (Sweden)

    Rafaële J C Huntjens

    Full Text Available BACKGROUND: A major symptom of Dissociative Identity Disorder (DID; formerly Multiple Personality Disorder is dissociative amnesia, the inability to recall important personal information. Only two case studies have directly addressed autobiographical memory in DID. Both provided evidence suggestive of dissociative amnesia. The aim of the current study was to objectively assess transfer of autobiographical information between identities in a larger sample of DID patients. METHODS: Using a concealed information task, we assessed recognition of autobiographical details in an amnesic identity. Eleven DID patients, 27 normal controls, and 23 controls simulating DID participated. Controls and simulators were matched to patients on age, education level, and type of autobiographical memory tested. FINDINGS: Although patients subjectively reported amnesia for the autobiographical details included in the task, the results indicated transfer of information between identities. CONCLUSION: The results call for a revision of the DID definition. The amnesia criterion should be modified to emphasize its subjective nature.

  17. Inter-Identity Autobiographical Amnesia in Patients with Dissociative Identity Disorder

    NARCIS (Netherlands)

    Huntjens, R.J.C.; Verschuere, B.; McNally, R.J.

    2012-01-01

    Background: A major symptom of Dissociative Identity Disorder (DID; formerly Multiple Personality Disorder) is dissociative amnesia, the inability to recall important personal information. Only two case studies have directly addressed autobiographical memory in DID. Both provided evidence suggestive

  18. Inter-Identity Autobiographical Amnesia in Patients with Dissociative Identity Disorder

    NARCIS (Netherlands)

    Huntjens, R.J.C.; Verschuere, B.; McNally, R.J.

    2012-01-01

    Background: A major symptom of Dissociative Identity Disorder (DID; formerly Multiple Personality Disorder) is dissociative amnesia, the inability to recall important personal information. Only two case studies have directly addressed autobiographical memory in DID. Both provided evidence suggestive

  19. Inter-identity autobiographical amnesia in patients with dissociative identity disorder

    NARCIS (Netherlands)

    Huntjens, R.J.C.; Verschuere, B.; McNally, R.J.

    2012-01-01

    Background A major symptom of Dissociative Identity Disorder (DID; formerly Multiple Personality Disorder) is dissociative amnesia, the inability to recall important personal information. Only two case studies have directly addressed autobiographical memory in DID. Both provided evidence suggestive

  20. Angiography and coronary function, a clinical approach

    NARCIS (Netherlands)

    Stoel, Martin Gerrit

    2013-01-01

    Coronary angiography has the potential to determine coronary function in addition to merely showing coronary anatomy. In this thesis, we describe several facets of angiographic evaluation of coronary flow velocity and function. Measurement of the length of the coronary vessels by means of a guide

  1. Cognitive rehabilitation of amnesia after virus encephalitis: a case report.

    Science.gov (United States)

    Miotto, Eliane Correa

    2007-01-01

    A number of memory rehabilitation techniques have targeted people with various degrees of memory impairments. However, few studies have shown the contribution of preserved non-declarative memory capacity and errorless learning in the treatment of amnesic patients. The current case report describes the memory rehabilitation of a 44-year-old man with amnesia following viral encephalitis. The patient's procedural memory capacity had an important role in the use of a motor imagery strategy to remember people's names. It was further demonstrated that the application of a verbal learning technique was helpful in recalling new verbal information. These different memory rehabilitation techniques are discussed in terms of alternative possibilities in the rehabilitation of amnesic patients.

  2. Personal semantic memory: insights from neuropsychological research on amnesia.

    Science.gov (United States)

    Grilli, Matthew D; Verfaellie, Mieke

    2014-08-01

    This paper provides insight into the cognitive and neural mechanisms of personal semantic memory, knowledge that is specific and unique to individuals, by reviewing neuropsychological research on stable amnesia secondary to medial temporal lobe damage. The results reveal that personal semantic memory does not depend on a unitary set of cognitive and neural mechanisms. Findings show that autobiographical fact knowledge reflects an experience-near type of personal semantic memory that relies on the medial temporal lobe for retrieval, albeit less so than personal episodic memory. Additional evidence demonstrates that new autobiographical fact learning likely relies on the medial temporal lobe, but the extent to which remains unclear. Other findings show that retrieval of personal traits/roles and new learning of personal traits/roles and thoughts/beliefs are independent of the medial temporal lobe and thus may represent highly conceptual types of personal semantic memory that are stored in the neocortex.

  3. Clinical Observation of Midazolam's Sedative Effect and Anterograde Amnesia Effect on Gynecologic Surgery Patients Undergoing Spinal-Epidural Anesthesia%咪唑安定联合腰硬联合麻醉对妇科手术患者镇静和术后遗忘效果观察

    Institute of Scientific and Technical Information of China (English)

    谢锐捷; 刘少芬; 张松林; 房瑞林; 陈铭君; 莫坚

    2013-01-01

    Objective:To explore the sedative effects and anterograde amnesia effect of midazolam intravenous injection used before combined spinal-epidural anesthesia on calming down the patients and their forgetting degree of procedure.Method:200 ASA Ⅰ-Ⅱpatients scheduled for gynecologic surgery under spinal-epidural anesthesia were included in the study.Patients were randomly assigned into two groups with 100 cases each.Group A used midazolam while Group B used 0.9% sodium as control.Group A used midazolam (0.lmg/kg) as intravenous injection 30 minutes before anesthesia while group B used 2ml 0.9% sodium as control.Record and compare the patients' sedative effect before operation began and the forgetting degree 24 hours after operation finished.Result:According to the Ramsay standard,the patients in group A have significant better sedative effect than group B since operation started (P<0.05).In group A the transient global amnesia rate of was 97% while the transient partial amnesia rate was 3%.Meanwhile,the transient global amnesia rate,the transient partial amnesia rate and the unforgotten rate were 68,25% and 7% in Group B separately.There was a significant difference between two groups (P<0.05).Conclusions:Midazolam (0.1mg/kg) as intravenous injection 30 minutes before anesthesia can reduce the patients' worries and horrors.It not only helps to keep patients sedative but also cooperate with anesthesia and controlling body position.It has good calm and amnesia effects on anesthesia and procedure.%目的:本文旨在观察咪唑安定联合腰硬联合麻醉对妇科手术患者术后镇痛遗忘效果.方法:将200例ASA Ⅰ~Ⅱ级腰硬联合麻醉下行妇科手术患者随机分为两组:咪唑安定组(A组)和对照组(B组).两组患者分别于麻醉前30分钟静脉注射咪唑安定0.1 mg/kg和0.9%生理盐水2mL.观察用药前后病人镇静情况,镇静分级,对麻醉和手术操作的遗忘程度和病人的心理状态.结果:根

  4. On remembering and forgetting our autobiographical pasts: retrograde amnesia and Andrew Mayes's contribution to neuropsychological method.

    Science.gov (United States)

    Kopelman, M D; Bright, P

    2012-11-01

    Andrew Mayes's contribution to the neuropsychology of memory has consisted in steadily teasing out the nature of the memory deficit in the amnesic syndrome. This has been done with careful attention to matters of method at all stages. This particularly applies to his investigations of forgetting rates in amnesia and to his studies of retrograde amnesia. Following a brief outline of his work, the main current theories of retrograde amnesia are considered: consolidation theory, episodic-to-semantic shift theory, and multiple trace theory. Findings across the main studies in Alzheimer dementia are reviewed to illustrate what appears to be consistently found, and what is much more inconsistent. A number of problems and issues in current theories are then highlighted--including the nature of the temporal gradient, correlations with the extent of temporal lobe damage, what we would expect 'normal' remote memory curves to look like, how they would appear in focal retrograde amnesia, and whether we can pinpoint retrograde amnesia to hippocampal/medial temporal damage on the basis of existing studies. A recent study of retrograde amnesia is re-analysed to demonstrate temporal gradients on recollected episodic memories in hippocampal/medial temporal patients. It is concluded that there are two requirements for better understanding of the nature of retrograde amnesia: (i) a tighter, Mayesian attention to method in terms of both the neuropsychology and neuroimaging in investigations of retrograde amnesia; and (ii) acknowledging that there may be multiple factors underlying a temporal gradient, and that episodic and semantic memory show important interdependencies at both encoding and retrieval. Such factors may be critical to understanding what is remembered and what is forgotten from our autobiographical pasts.

  5. Functional (psychogenic) movement disorders - Clinical presentations.

    Science.gov (United States)

    Hallett, Mark

    2016-01-01

    Functional or psychogenic movement disorders are common and disabling, and sometime difficult to diagnose. The history and physical exam can give positive features that will support the diagnosis, which should not be based solely on exclusion. Some clues in the history are sudden onset, intermittent time course, variability of manifestation over time, childhood trauma, history of other somatic symptom and secondary gain. Anxiety and depression are common, but not necessarily more than the general population. On examination, distraction and suggestibility may be present. There are specific signs that should be looked for with different types of movements. For example, with tremor, change in frequency over time and entrainment are common features. With myoclonus, the movements might be complex in type with long latencies to stimulus induced jerks. Gait disorders show good balance despite claims to the contrary. Functional dystonia still remains a challenging diagnosis in many circumstances, although fixed dystonia is one sign more likely to be functional.

  6. Clinical implications of the solitary functioning kidney

    NARCIS (Netherlands)

    Westland, R.; Schreuder, M.F.; Goudoever, J.B. van; Sanna-Cherchi, S.; Wijk, J.A. van

    2014-01-01

    Congenital anomalies of the kidney and urinary tract are the major cause of ESRD in childhood. Children with a solitary functioning kidney form an important subgroup of congenital anomalies of the kidney and urinary tract patients, and a significant fraction of these children is at risk for progress

  7. Social memory, amnesia, and autism: brain oxytocin secretion is regulated by NAD+ metabolites and single nucleotide polymorphisms of CD38.

    Science.gov (United States)

    Higashida, Haruhiro; Yokoyama, Shigeru; Huang, Jian-Jun; Liu, Li; Ma, Wen-Jie; Akther, Shirin; Higashida, Chiharu; Kikuchi, Mitsuru; Minabe, Yoshio; Munesue, Toshio

    2012-11-01

    Previously, we demonstrated that CD38, a transmembrane protein with ADP-ribosyl cyclase activity, plays a critical role in mouse social behavior by regulating the release of oxytocin (OXT), which is essential for mutual recognition. When CD38 was disrupted, social amnesia was observed in Cd38 knockout mice. The autism spectrum disorders (ASDs), characterized by defects in reciprocal social interaction and communication, occur either sporadically or in a familial pattern. However, the etiology of ASDs remains largely unknown. Therefore, the theoretical basis for pharmacological treatments has not been established. Hence, there is a rationale for investigating single nucleotide polymorphisms (SNPs) in the human CD38 gene in ASD subjects. We found several SNPs in this gene. The SNP rs3796863 (C>A) was associated with high-functioning autism (HFA) in American samples from the Autism Gene Resource Exchange. Although this finding was partially confirmed in low-functioning autism subjects in Israel, it has not been replicated in Japanese HFA subjects. The second SNP of interest, rs1800561 (4693C>T), leads to the substitution of an arginine (R) at codon 140 by tryptophan (W; R140W) in CD38. This mutation was found in four probands of ASD and in family members of three pedigrees with variable levels of ASD or ASD traits. The plasma levels of OXT in ASD subjects with the R140W allele were lower than those in ASD subjects lacking this allele. The OXT levels were unchanged in healthy subjects with or without this mutation. One proband with the R140W allele receiving intranasal OXT for approximately 3years showed improvement in areas of social approach, eye contact and communication behaviors, emotion, irritability, and aggression. Five other ASD subjects with mental deficits received nasal OXT for various periods; three subjects showed improved symptoms, while two showed little or no effect. These results suggest that SNPs in CD38 may be possible risk factors for ASD by

  8. Clinically important factors influencing endothelial function.

    Science.gov (United States)

    Vapaatalo, H; Mervaala, E

    2001-01-01

    The endothelium, a continuous cellular monolayer lining the blood vessels, has an enormous range of important homeostatic roles. It serves and participates in highly active metabolic and regulatory functions including control of primary hemostasis, blood coagulation and fibrinolysis, platelet and leukocyte interactions with the vessel wall, interaction with lipoprotein metabolism, presentation of histocompatibility antigens, regulation of vascular tone and growth and further of blood pressure. Many crucial vasoactive endogenous compounds like prostacyclin, thromboxane, nitric oxide, endothelin, angiotensin, endothelium derived hyperpolarizing factor, free radicals and bradykinin are formed in the endothelial cells to control the functions of vascular smooth muscle cells and of circulating blood cells. These versatile and complex systems and cellular interactions are extremely vulnerable. The balances may be disturbed by numerous endogenous and exogenous factors including psychological and physical stress, disease states characterized by vasospasm, inflammation, leukocyte and platelet adhesion and aggregation, thrombosis, abnormal vascular proliferation, atherosclerosis and hypertension. The endothelial cells are also the site of action of many drugs and exogenous toxic substances (e.g. smoking, alcohol). As markers and assays for endothelial dysfunction, direct measurement of nitric oxide, its metabolites from plasma and urine, functional measurement of vascular nitric oxide dependent responses and assay of different circulating markers have been used. In numerous pathological conditions (e.g. atherosclerosis, hypertension, congestive heart failure, hyperhomocysteinemia, diabetes, renal failure, transplantation, liver cirrhosis) endothelial dysfunction has been described to exist. Some of them, as well as hormonal and nutritional factors and drug treatment will be discussed in this short review.

  9. Galveston Orientation and Amnesia Test: applicability and relation with the Glasgow Coma Scale Galveston Orientation and Amnesia Test: aplicabilidad y relación con la Escala de Coma de Glasgow Galveston Orientation and Amnesia Test: aplicabilidade e relação com a Escala de Coma de Glasgow

    OpenAIRE

    Silvia Cristina Fürbringer e Silva; Regina Marcia Cardoso de Sousa

    2007-01-01

    Restrictions in the application of the Galveston Orientation and Amnesia Test and questionings about the relationship between conscience and post-traumatic amnesia motivated this study, which aims to identify, through the Glasgow Coma Scale scores, when to initiate the application of this amnesia test, as well to verify the relationship between the results of these two indicators. The longitudinal prospective study was carried at a referral center for trauma care in São Paulo - Brazil. The sa...

  10. Clinical functional MRI. Persurgical functional neuroimaging. 2. ed.

    Energy Technology Data Exchange (ETDEWEB)

    Stippich, Christoph (ed.) [Univ. Hospitals Basel (Switzerland). Division of Diagnostic and Inventional Neuroradiology

    2015-06-01

    The second, revised edition of this successful textbook provides an up-to-date description of the use of preoperative fMRI in patients with brain tumors and epilepsies. State of the art fMRI procedures are presented, with detailed consideration of practical aspects, imaging and data processing, normal and pathological findings, and diagnostic possibilities and limitations. Relevant information on brain physiology, functional neuroanatomy, imaging technique, and methodology is provided by recognized experts in these fields. Compared with the first edition, chapters have been updated to reflect the latest developments and in particular the current use of diffusion tensor imaging (DTI) and resting-state fMRI. Entirely new chapters are included on resting-state presurgical fMRI and the role of DTI and tractography in brain tumor surgery. Further chapters address multimodality functional neuroimaging, brain plasticity, and pitfalls, tips, and tricks.

  11. Clinical application of functional magnetic resonance imaging

    CERN Document Server

    Alwatban, A Z W

    2002-01-01

    The work described in this thesis was carried out at the Magnetic Resonance Centre of the University of Nottingham during the time from May 1998 to April 2001, and is the work of the except where indicated by reference. The main source of signal changes in functional magnetic resonance imaging (fMRJ) is the fluctuation of paramagnetic deoxyhaemoglobin in the venous blood during different states of functional performance. For the work of this thesis, fMRI studies were carried out using a 3 T MR system with an echo planar imaging (EPI) pulse sequence. Hearing research utilising fMRI has been previously reported in normal subjects. Hearing fMRI is normally performed by stimulating the auditory cortex via an acoustic task presentation such as music, tone, etc. However, performing the same research on deaf subjects requires special equipment to be designed to allow direct stimulation of the auditory nerve. In this thesis, a new method of direct electrical stimulation of the auditory nerve is described that uses a ...

  12. EXTRACELLULAR VESICLES: CLASSIFICATION, FUNCTIONS AND CLINICAL RELEVANCE

    Directory of Open Access Journals (Sweden)

    A. V. Oberemko

    2014-12-01

    Full Text Available This review presents a generalized definition of vesicles as bilayer extracellular organelles of all celular forms of life: not only eu-, but also prokaryotic. The structure and composition of extracellular vesicles, history of research, nomenclature, their impact on life processes in health and disease are discussed. Moreover, vesicles may be useful as clinical instruments for biomarkers, and they are promising as biotechnological drug. However, many questions in this area are still unresolved and need to be addressed in the future. The most interesting from the point of view of practical health care represents a direction to study the effect of exosomes and microvesicles in the development and progression of a particular disease, the possibility of adjusting the pathological process by means of extracellular vesicles of a particular type, acting as an active ingredient. Relevant is the further elucidation of the role and importance of exosomes to the surrounding cells, tissues and organs at the molecular level, the prospects for the use of non-cellular vesicles as biomarkers of disease.

  13. Visuospatial declarative learning despite profound verbal declarative amnesia in Korsakoff's syndrome.

    Science.gov (United States)

    Oudman, Erik; Postma, Albert; Nijboer, Tanja C W; Wijnia, Jan W; Van der Stigchel, Stefan

    2017-03-20

    Korsakoff's syndrome (KS) is a neuropsychiatric disorder characterised by severe amnesia. Although the presence of impairments in memory has long been acknowledged, there is a lack of knowledge about the precise characteristics of declarative memory capacities in order to implement memory rehabilitation. In this study, we investigated the extent to which patients diagnosed with KS have preserved declarative memory capacities in working memory, long-term memory encoding or long-term memory recall operations, and whether these capacities are most preserved for verbal or visuospatial content. The results of this study demonstrate that patients with KS have compromised declarative memory functioning on all memory indices. Performance was lowest for the encoding operation compared to the working memory and delayed recall operation. With respect to the content, visuospatial memory was relatively better preserved than verbal memory. All memory operations functioned suboptimally, although the most pronounced disturbance was found in verbal memory encoding. Based on the preserved declarative memory capacities in patients, visuospatial memory can form a more promising target for compensatory memory rehabilitation than verbal memory. It is therefore relevant to increase the number of spatial cues in memory rehabilitation for KS patients.

  14. Hippocampal α7-nicotinic cholinergic receptors modulate memory reconsolidation: a potential strategy for recovery from amnesia.

    Science.gov (United States)

    Blake, M G; Boccia, M M; Krawczyk, M C; Baratti, C M

    2013-11-01

    When subjects are exposed to new learning experiences, the novel information could be acquired and eventually stored through memory consolidation process. The exposure of mice to a novel experience (a hole-board) after being trained in an inhibitory avoidance apparatus is followed by impaired performance of the avoidance memory in subsequent tests. The same impairing effect is produced when mice are exposed to the novel environment after the reactivation of the avoidance memory. This interfering effect is due to impaired consolidation or reconsolidation of the avoidance memory. The administration of the α7-nicotinic receptor agonist choline (Ch) in the dorsal hippocampus (0.8 μg/hippocampus) immediately after the inhibitory avoidance memory reactivation, allowed memory recovery. This effect of Ch was time-dependent, and retention performance was not affected in drug-treated mice that were not subjected to memory reactivation, suggesting that the effects on performance are not due to non-specific effects of the drug. The effects of Ch also depended on the age of the reactivated memory. Altogether, our results suggest that Ch exerts its effects by modulating memory reconsolidation, and that the memory impairment induced by new learning is a memory expression failure and not a storage deficit. Therefore, reconsolidation, among other functions, might serve to change whether a memory will be expressed in later tests. Summarizing, our results open new avenues about the behavioral significance and the physiological functions of memory reconsolidation, providing new strategies for recovering memories from some types of amnesia.

  15. Neuromodulatory effects of the dorsal hippocampal endocannabinoid system in dextromethorphan/morphine-induced amnesia.

    Science.gov (United States)

    Ghasemzadeh, Zahra; Rezayof, Ameneh

    2017-01-05

    Dextromethorphan which is an active ingredient in many cough medicines has been previously shown to potentiate amnesic effect of morphine in rats. However, the effect of dextromethorphan, that is also a noncompetitive N-methyl-D-aspartate (NMDA) receptor antagonist, in combination with morphine on hippocampus-based long term memory has not been well characterized. The aim of the present study was to assess the possible role of endocannabinoid system of the dorsal hippocampus in dextromethorphan /morphine-induced amnesia. Our results showed that intraperitoneal (i.p.) injection of morphine (5mg/kg) or dextromethorphan (5-15mg/kg) before testing the passive avoidance learning induced amnesia. Combination of ineffective doses of dextromethorphan (7.5mg/kg, i.p.) and morphine (2mg/kg, i.p.) also produced amnesia, suggesting the enhancing effects of the drugs. To assess the effect of the activation or inhibition of the dorsal hippocampal cannabinoid CB1 receptors on this amnesia, ACPA or AM251 as selective receptor agonists or antagonists were respectively injected into the CA1 regions before systemic injection of dextromethorphan and morphine. Interestingly, intra-CA1 microinjection of ACPA (0.5-1ng/rat) improved the amnesic effect of dextromethorphan /morphine combination. The microinjection of AM251 into the CA1 region enhanced the response of the combination of dextromethorphan /morphine in inducing amnesia. Moreover, Intra-CA1 microinjection of AM251 inhibited the improving effect of ACPA on dextromethorphan /morphine-induced amnesia. It is important to note that intra-CA1 microinjection of the same doses of the agonist or antagonist by itself had no effects on memory formation. Thus, it can be concluded that the dorsal hippocampal endocannabinoid system, via CB1 receptor-dependent mechanism, may be involved in morphine/dextromethorphan -induced amnesia.

  16. Clinical application of functional magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Alwatban, Adnan Z.W

    2002-07-01

    The work described in this thesis was carried out at the Magnetic Resonance Centre of the University of Nottingham during the time from May 1998 to April 2001, and is the work of the author except where indicated by reference. The main source of signal changes in functional magnetic resonance imaging (fMRJ) is the fluctuation of paramagnetic deoxyhaemoglobin in the venous blood during different states of functional performance. For the work of this thesis, fMRI studies were carried out using a 3 T MR system with an echo planar imaging (EPI) pulse sequence. Hearing research utilising fMRI has been previously reported in normal subjects. Hearing fMRI is normally performed by stimulating the auditory cortex via an acoustic task presentation such as music, tone, etc. However, performing the same research on deaf subjects requires special equipment to be designed to allow direct stimulation of the auditory nerve. In this thesis, a new method of direct electrical stimulation of the auditory nerve is described that uses a transtympanic electrode implanted onto the surface of the cochlea. This approach would however, result in electromotive forces (EMFs) being induced by the time varying magnetic field, which would lead to current flow and heating, as well as deflection of the metallic electrode within the static magnetic field, and image distortion due to the magnetic susceptibility difference. A gold-plated tungsten electrode with a zero magnetic susceptibility was developed to avoid image distortion. Used with carbon leads and a carbon reference pad, it enabled safe, distortion-free fMRI studies of deaf subjects. The study revealed activation of the primary auditory cortex. This fMRI procedure can be used to demonstrate whether the auditory pathway is fully intact, and may provide a useful method for pre-operative assessment of candidates for cochlear implantation. Glucose is the energy source on which the function of the human brain is entirely dependent. Failure to

  17. Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study.

    Science.gov (United States)

    Briggs, Rachel; Birse, Jason; Tate, Robyn; Brookes, Naomi; Epps, Adrienne; Lah, Suncica

    2016-01-01

    The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Fifty children aged 8 to 15 years consecutively admitted to a children's hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.

  18. "Galveston Orientation and Amnesia Test": tradução e validação "Galveston Orientation and Amnesia Test": traducción y validación "Galveston Orientation and Amnesia Test": translation and validation

    Directory of Open Access Journals (Sweden)

    Silvia Cristina Fürbringer e Silva

    2007-03-01

    Full Text Available OBJETIVO: Traduzir e validar o Galveston Orientation and Amnesia Test para uso em nosso meio. MÉTODOS: Esse teste foi traduzido para o português e retro-traduzido para o inglês por diferentes especialistas na língua e por fim, feita a avaliação da equivalência entre o instrumento original e a versão retro-traduzida. Sua aplicação em 73 vítimas de trauma crânio-encefálico contuso e a indicação da gravidade dessa lesão, estabelecida pela Escala de Coma de Glasgow, permitiram verificar as propriedades de medida do instrumento. RESULTADOS: A confiabilidade verificada pelo Alfa de Cronbach resultou em 0,76. Houve indicação de validade convergente e discriminante do instrumento quando os resultados de aplicação do Galveston Orientation and Amnésia Test foram analisados perante a gravidade do trauma crânio-encefálico. CONCLUSÃO: Os resultados observados dão suporte para a aplicação do Galveston Orientation and Amnesia Test em nosso meio como indicador do término da amnésia pós-traumática.OBJETIVO: Traducir y validar el Galveston Orientation and Amnesia Test para su uso en nuestro medio. MÉTODOS: El test fue traducido al portugués retrotraducido al inglés por diferentes especialistas en la lengua y por fin, realizada la evaluación de la equivalencia entre el instrumento original y la versión retrotraducida. Su aplicación en 73 víctimas de traumatismo encéfalo craneano con constusión y la indicación de la gravedad de esa lesión, establecida por la Escala de Coma de Glasgow, permitieron verificar las propiedades de medida del instrumento. RESULTADOS: La confiabilidad verificada por el Alfa de Cronbach fue de 0,76. Hubo indicación de validez convergente y discriminante del instrumento cuando los resultados de aplicación del Galveston Orientation and Amnésia Test fueron analizados frente a la gravedad del traumatismo encéfalo craneano. CONCLUSIÓN: Los resultados observados dan soporte para la aplicación del

  19. Platelet function testing: methods of assessment and clinical utility.

    LENUS (Irish Health Repository)

    Mylotte, Darren

    2012-02-01

    Platelets play a central role in the regulation of both thrombosis and haemostasis yet tests of platelet function have, until recently, been exclusively used in the diagnosis and management of bleeding disorders. Recent advances have demonstrated the clinical utility of platelet function testing in patients with cardiovascular disease. The ex vivo measurement of response to antiplatelet therapies (aspirin and clopidogrel), by an ever-increasing array of platelet function tests, is with some assays, predictive of adverse clinical events and thus, represents an emerging area of interest for both the clinician and basic scientist. This review article will describe the advantages and disadvantages of the currently available methods of measuring platelet function and discuss both the limitations and emerging data supporting the role of platelet function studies in clinical practice.

  20. Platelet function testing: methods of assessment and clinical utility.

    LENUS (Irish Health Repository)

    Mylotte, Darren

    2011-01-01

    Platelets play a central role in the regulation of both thrombosis and haemostasis yet tests of platelet function have, until recently, been exclusively used in the diagnosis and management of bleeding disorders. Recent advances have demonstrated the clinical utility of platelet function testing in patients with cardiovascular disease. The ex vivo measurement of response to antiplatelet therapies (aspirin and clopidogrel), by an ever-increasing array of platelet function tests, is with some assays, predictive of adverse clinical events and thus, represents an emerging area of interest for both the clinician and basic scientist. This review article will describe the advantages and disadvantages of the currently available methods of measuring platelet function and discuss both the limitations and emerging data supporting the role of platelet function studies in clinical practice.

  1. Supporting the self-concept with memory: insight from amnesia.

    Science.gov (United States)

    Grilli, Matthew D; Verfaellie, Mieke

    2015-12-01

    We investigated the extent to which personal semantic memory supports the self-concept in individuals with medial temporal lobe amnesia and healthy adults. Participants completed eight 'I Am' self-statements. For each of the four highest ranked self-statements, participants completed an open-ended narrative task, during which they provided supporting information indicating why the I Am statement was considered self-descriptive. Participants then completed an episodic probe task, during which they attempted to retrieve six episodic memories for each of these self-statements. Supporting information was scored as episodic, personal semantic or general semantic. In the narrative task, personal semantic memory predominated as self-supporting information in both groups. The amnesic participants generated fewer personal semantic memories than controls to support their self-statements, a deficit that was more pronounced for trait relative to role self-statements. In the episodic probe task, the controls primarily generated unique event memories, but the amnesic participants did not. These findings demonstrate that personal semantic memory, in particular autobiographical fact knowledge, plays a critical role in supporting the self-concept, regardless of the accessibility of episodic memories, and they highlight potential differences in the way traits and roles are supported by personal memory.

  2. Transient global amnesia and neurological events: the Framingham Heart Study

    Directory of Open Access Journals (Sweden)

    Jose Rafael Romero

    2013-05-01

    Full Text Available Background/ objective: Transient global amnesia (TGA is a temporary amnestic syndrome characterized by lack of other focal neurological deficits. Cerebrovascular disease, migraine and seizures have been suggested as underlying mechanisms. TGA may be a risk factor for cerebrovascular or other neurological events. We studied the relation of TGA, vascular risk factors, brain magnetic resonance imaging (MRI indices of subclinical ischemia and neurological events in a community-based sample. Design/setting: A total of 12 TGA cases were ascertained using standard criteria by experienced neurologists, and matched to 41 stroke- and seizure-free controls. Vascular risk factors, brain MRI findings, and subsequent cerebrovascular or seizure events were compared in cases and controls. Participants: Framingham Heart Study (FHS original and offspring cohort participants were included.Results: No significant differences between the groups were observed in the prevalence of vascular risk factors, or brain MRI measures. Few incident stroke/transient ischemic attacks (TIA (1 event among the cases and 4 in controls or subsequent seizures occurred in either group. Head CT during the acute event (n=11 and brain MRI (n=7 were negative for acute abnormalities. Electroencephalograms (EEG (n=5 were negative for epileptiform activity. Extracranial vascular studies were negative for significant stenosis in all cases.Conclusions: In our community-based study TGA was not related to traditional vascular risk factors, or cerebrovascular disease. However, our study is limited by small sample size and power, and larger studies are required to exclude an association.

  3. Hippocampal amnesia impairs all manner of relational memory

    Directory of Open Access Journals (Sweden)

    Alex Konkel

    2008-10-01

    Full Text Available Relational memory theory holds that the hippocampus supports, and amnesia following hippocampal damage impairs, memory for all manner of relations. Unfortunately, many studies of hippocampal-dependent memory have either examined only a single type of relational memory or conflated multiple kinds of relations. The experiments reported here employed a procedure in which each of several kinds of relational memory (spatial, associative, and sequential could be tested separately using the same materials. In Experiment 1, performance of amnesic patients with medial temporal lobe damage was assessed on memory for the three types of relations as well as for items. Compared to the performance of matched comparison participants, amnesic patients were impaired on all three relational tasks. But for those patients whose MTL damage was limited to the hippocampus, performance was relatively preserved on item memory as compared to relational memory, although still lower than that of comparison participants. In Experiment 2, study exposure was reduced for comparison participants, matching their item memory to the amnesic patients in Experiment 1. Relational memory performance of comparison subjects was well above amnesic patient levels, showing the disproportionate dependence of all three relational memory performances on the integrity of the hippocampus. Correlational analyses of the various task performances of comparison participants and of college-age participants showed that our measures of item memory were not influenced significantly by memory for associations among the items.

  4. Impaired inference in a case of developmental amnesia.

    Science.gov (United States)

    D'Angelo, Maria C; Rosenbaum, R Shayna; Ryan, Jennifer D

    2016-10-01

    Amnesia is associated with impairments in relational memory, which is critically supported by the hippocampus. By adapting the transitivity paradigm, we previously showed that age-related impairments in inference were mitigated when judgments could be predicated on known pairwise relations, however, such advantages were not observed in the adult-onset amnesic case D.A. Here, we replicate and extend this finding in a developmental amnesic case (N.C.), who also shows impaired relational learning and transitive expression. Unlike D.A., N.C.'s damage affected the extended hippocampal system and diencephalic structures, and does not extend to neocortical areas that are affected in D.A. Critically, despite their differences in etiology and affected structures, N.C. and D.A. perform similarly on the task. N.C. showed intact pairwise knowledge, suggesting that he is able to use existing semantic information, but this semantic knowledge was insufficient to support transitive expression. The present results suggest a critical role for regions connected to the hippocampus and/or medial prefrontal cortex in inference beyond learning of pairwise relations. © 2016 The Authors Hippocampus Published by Wiley Periodicals, Inc.

  5. Profound loss of general knowledge in retrograde amnesia: evidence from an amnesic artist.

    Science.gov (United States)

    Gregory, Emma; McCloskey, Michael; Landau, Barbara

    2014-01-01

    Studies of retrograde amnesia have focused on autobiographical memory, with fewer studies examining how non-autobiographical memory is affected. Those that have done so have focused primarily on memory for famous people and public events-relatively limited aspects of memory that are tied to learning during specific times of life and do not deeply tap into the rich and extensive knowledge structures that are developed over a lifetime. To assess whether retrograde amnesia can also cause impairments to other forms of general world knowledge, we explored losses across a broad range of knowledge domains in a newly-identified amnesic. LSJ is a professional artist, amateur musician and history buff with extensive bilateral medial temporal and left anterior temporal damage. We examined LSJ's knowledge across a range of everyday domains (e.g., sports) and domains for which she had premorbid expertise (e.g., famous paintings). Across all domains tested, LSJ showed losses of knowledge at a level of breadth and depth never before documented in retrograde amnesia. These results show that retrograde amnesia can involve broad and deep deficits across a range of general world knowledge domains. Thus, losses that have already been well-documented (famous people and public events) may severely underestimate the nature of human knowledge impairment that can occur in retrograde amnesia.

  6. Profound loss of general knowledge in retrograde amnesia: Evidence from an amnesic artist

    Directory of Open Access Journals (Sweden)

    Emma eGregory

    2014-05-01

    Full Text Available Studies of retrograde amnesia have focused on autobiographical memory, with fewer studies examining how non-autobiographical memory is affected. Those that have done so have focused primarily on memory for famous people and public events—relatively limited aspects of memory that are tied to learning during specific times of life and do not deeply tap into the rich and extensive knowledge structures that are developed over a lifetime. To assess whether retrograde amnesia can also cause impairments to other forms of general world knowledge, we explored losses across a broad range of knowledge domains in a newly-identified amnesic. LSJ is a professional artist, amateur musician and history buff with extensive bilateral medial temporal and left anterior temporal damage. We examined LSJ's knowledge across a range of everyday domains (e.g., sports and domains for which she had premorbid expertise (e.g., famous paintings. Across all domains tested, LSJ showed losses of knowledge at a level of breadth and depth never before documented in retrograde amnesia. These results show that retrograde amnesia can involve broad and deep deficits across a range of general world knowledge domains. Thus, losses that have already been well-documented (famous people and public events may severely underestimate the nature of human knowledge impairment that can occur in retrograde amnesia.

  7. Profound loss of general knowledge in retrograde amnesia: evidence from an amnesic artist

    Science.gov (United States)

    Gregory, Emma; McCloskey, Michael; Landau, Barbara

    2014-01-01

    Studies of retrograde amnesia have focused on autobiographical memory, with fewer studies examining how non-autobiographical memory is affected. Those that have done so have focused primarily on memory for famous people and public events—relatively limited aspects of memory that are tied to learning during specific times of life and do not deeply tap into the rich and extensive knowledge structures that are developed over a lifetime. To assess whether retrograde amnesia can also cause impairments to other forms of general world knowledge, we explored losses across a broad range of knowledge domains in a newly-identified amnesic. LSJ is a professional artist, amateur musician and history buff with extensive bilateral medial temporal and left anterior temporal damage. We examined LSJ's knowledge across a range of everyday domains (e.g., sports) and domains for which she had premorbid expertise (e.g., famous paintings). Across all domains tested, LSJ showed losses of knowledge at a level of breadth and depth never before documented in retrograde amnesia. These results show that retrograde amnesia can involve broad and deep deficits across a range of general world knowledge domains. Thus, losses that have already been well-documented (famous people and public events) may severely underestimate the nature of human knowledge impairment that can occur in retrograde amnesia. PMID:24834048

  8. APOE genotype and verbal memory recovery during and after emergence from post-traumatic amnesia.

    Science.gov (United States)

    Noé, E; Ferri, J; Colomer, C; Moliner, B; Chirivella, J

    2010-01-01

    To determine if APOE genotype is linked to memory function after moderate-severe traumatic brain injury (TBI). Eighty-two patients in post-traumatic amnesia (PTA) and 107 patients who had emerged from PTA were selected from 239 consecutive patients admitted to the facility. Verbal memory assessments, including the Spanish version of the California Verbal Learning Test and the Working-Memory Index of the WAIS-III, were conducted immediately after PTA resolution or during the first week after admission for patients who were out of PTA. Both groups were reassessed 6 months after inclusion in a multidisciplinary rehabilitation programme. Patients with the APOE-epsilon 4 allele (n = 17 in the PTA group and n = 9 in the out of PTA group) entered rehabilitation at a more impaired level, but made remarkable progress during follow-up. Fifty-five patients from the initial sample emerged from PTA during the follow-up period. Age, GOAT at admission and chronicity, but not APOE genotype or initial trauma severity, were significant predictors of emergence from PTA. APOE genotype seems to be associated with the trajectory of cognitive recovery after TBI, but does not play a determinant role in the efficacy of memory rehabilitation in this population.

  9. Language and cognitive communication during post-traumatic amnesia: A critical synthesis.

    Science.gov (United States)

    Steel, Joanne; Ferguson, Alison; Spencer, Elizabeth; Togher, Leanne

    2015-01-01

    There is minimal speech pathology literature on communication presentation during post-traumatic amnesia (PTA) and the early recovery period after traumatic brain injury. While a body of research reports on other cognitive and behavioural functions during PTA, language and/or cognitive communication are not routinely the primary focus of current research literature. This critical synthesis provides an overview of research to date on communication during PTA to inform speech pathology assessment practice and to assist with information provision to the multidisciplinary team and family members. A search was conducted of studies reporting on language, cognition, and cognitive communication during the acute, inpatient and early recovery period after TBI. These were examined for relevance to speech pathology practice during PTA and acute confusional state. Historic and recent literature has described types of language and communication impairment during PTA and early recovery after TBI. Recently, aspects of communication impairment during PTA have been found relevant for outcome prediction. Few studies were found originating from speech pathology on communication during PTA. Communication disruption forms a key feature of PTA. Existing literature indicates that speech pathology monitoring of communication during PTA may be of benefit as part of multidisciplinary team management during early recovery.

  10. An individual patient comparison of response to a memory training program--psychogenic V organic amnesia: brief report.

    Science.gov (United States)

    Izumi, S I; Yasueda, M; Hihara, N; Yamamoto, E; Sawatari, M; Ishida, A

    1998-01-01

    Psychogenic amnesia ("dissociative amnesia" in DSM-IV) has received relatively little attention in the literature. We compared neuropsychological and behavioral findings between a patient with psychogenic amnesia and one with organic amnesia from their early stages in a rehabilitation program. A 52-yr-old man developed anterograde and retrograde amnesia and short-term memory disturbance 1 mo after an operation for esophageal carcinoma, with no loss of personal identity and information. No apparent organic causes were identified, but because the patient and his wife rejected psychiatric treatment and memory deficit characteristics were compatible with that of an organic origin, the patient was referred to a physiatrist. A 46-yr-old man with anterograde amnesia was diagnosed with limbic encephalitis based on findings of magnetic resonance imaging and single-photon emission computed tomography, which showed lesions in both medial temporal lobes. Both patients underwent "memory book" training because they showed preserved performance in motor learning tasks. The first patient's responses to training contrasted with the other's and were indicative of psychogenic amnesia, with cancer representing a precipitating stress. Counseled by the physiatrist, the patient and his wife accepted suggestions to undergo psychiatric treatment. We propose that it is important to consider behavioral responses to memory rehabilitation as well as neuropsychological findings in differentiating psychogenic amnesia from an organic one and that physiatrists may be pivotal in diagnosing and initiating treatment in such psychiatric disorders.

  11. Clinical Testing of Otolith Function: Perceptual Thresholds and Myogenic Potentials

    OpenAIRE

    Agrawal, Yuri; BREMOVA, TATIANA; Kremmyda, Olympia; Strupp, Michael; MacNeilage, Paul R.

    2013-01-01

    Cervical and ocular vestibular-evoked myogenic potential (cVEMP/oVEMP) tests are widely used clinical tests of otolith function. However, VEMP testing may not be the ideal measure of otolith function given the significant inter-individual variability in responses and given that the stimuli used to elicit VEMPs are not physiological. We therefore evaluated linear motion perceptual threshold testing compared with cVEMP and oVEMP testing as measures of saccular and utricular function, respective...

  12. The GABAB receptor agonist, baclofen, contributes to three distinct varieties of amnesia in the human brain - A detailed case report.

    Science.gov (United States)

    Zeman, Adam; Hoefeijzers, Serge; Milton, Fraser; Dewar, Michaela; Carr, Melanie; Streatfield, Claire

    2016-01-01

    We describe a patient in whom long-term, therapeutic infusion of the selective gamma-amino-butyric acid type B (GABAB) receptor agonist, baclofen, into the cerebrospinal fluid (CSF) gave rise to three distinct varieties of memory impairment: i) repeated, short periods of severe global amnesia, ii) accelerated long-term forgetting (ALF), evident over intervals of days and iii) a loss of established autobiographical memories. This pattern of impairment has been reported in patients with temporal lobe epilepsy (TLE), in particular the subtype of Transient Epileptic Amnesia (TEA). The amnesic episodes and accelerated forgetting remitted on withdrawal of baclofen, while the autobiographical amnesia (AbA) persisted. This exceptional case highlights the occurrence of 'non-standard' forms of human amnesia, reflecting the biological complexity of memory processes. It suggests a role for GABAB signalling in the modulation of human memory over multiple time-scales and hints at its involvement in 'epileptic amnesia'.

  13. Amnesia syndrome following left anterior thalamic infarction; with intrahemispheric and crossed cerebro-cerebellar diaschisis on brain SPECT.

    Science.gov (United States)

    Kim, M. H.; Hong, S. B.; Roh, J. K.

    1994-01-01

    We report a 61-year-old right-handed man developing disturbance of memory after a discrete thalamic infarction. Neuropsychological assessment revealed deficits in memory with retrograde and anterograde components, especially for verbal material. Brain MRI showed a left anterior thalamic infarction with normal angiographic findings. Despite the small lesion in the thalamus, he showed prolonged memory disturbance and a Brain SPECT image revealed decreased uptake in the ipsilateral fronto-temporo-parietal cortex and contralateral cerebellum. This diaschisis, a phenomenon caused by disconnection of the neural pathway helped us to evaluate the functional state of the patient and this imaging technique was valuable for obtaining to get more information for the evaluation of the neurological state and neuronal connections. In conclusion our findings correspond well with the understanding of amnesia as a disconnection syndrome because of the evidence of diaschisis on the Brain SPECT image. PMID:7702792

  14. Transient Epileptic Amnesia with Preserved Consciousness: a Report of Two Cases.

    Science.gov (United States)

    Cho, Soohyun; Lee, Wong-Woo; Kang, Kyusik; Park, Jong-Moo; Kim, Byung-Kun; Kwon, Ohyun; Lee, Jung-Ju

    2017-06-01

    Transient epileptic amnesia (TEA) is defined as recurrent ictal and interictal transient memory disturbances typically occurring upon waking. Patients with TEA usually cannot remember the episodes. Electroencephalographic (EEG) abnormalities are usually localized on the dominant or bilateral temporal lobes. Here we report two cases of TEA with atypical features. The patients could remember the episodes afterwards, and abnormal discharges on EEG were detected in the temporal lobes of the non-dominant hemisphere. We suggest that confinement of epileptic discharge to the non-dominant temporal lobe can lead to partial preservation of consciousness during seizure attacks that produce transient amnesia.

  15. Effectiveness of lorazepam-assisted interviews in an adolescent with dissociative amnesia A case report

    Institute of Scientific and Technical Information of China (English)

    Yuna Seo; Mi-Hee Shin; Sung-Gon Kim; Ji-Hoon Kim

    2013-01-01

    To facilitate gathering information during a psychiatric interview, some psychiatrists advocate augmenting the interview using drugs. Rather than barbiturates, benzodiazepines have been used for drug-assisted interviews. Dissociative amnesia is one of the indications for these interviews. Herein, we present the case of a 15-year-old female who was diagnosed as having dissociative amnesia because of conflicts with her friends. She was administered a lorazepam-assisted interview to aid recovery of her memories. In this case, a small dose of lorazepam was sufficient to recover her memories without any adverse effects.

  16. Functional speech disorders: clinical manifestations, diagnosis, and management.

    Science.gov (United States)

    Duffy, J R

    2016-01-01

    Acquired psychogenic or functional speech disorders are a subtype of functional neurologic disorders. They can mimic organic speech disorders and, although any aspect of speech production can be affected, they manifest most often as dysphonia, stuttering, or prosodic abnormalities. This chapter reviews the prevalence of functional speech disorders, the spectrum of their primary clinical characteristics, and the clues that help distinguish them from organic neurologic diseases affecting the sensorimotor networks involved in speech production. Diagnosis of a speech disorder as functional can be supported by sometimes rapidly achieved positive outcomes of symptomatic speech therapy. The general principles of such therapy are reviewed. © 2016 Elsevier B.V. All rights reserved.

  17. Reducing inadvertent clinical errors: Guidelines from functional analytic psychotherapy.

    Science.gov (United States)

    Tsai, Mavis; Mandell, Tien; Maitland, Daniel; Kanter, Jonathan; Kohlenberg, Robert J

    2016-09-01

    Two common types of clinical errors, inadvertently reinforcing client problem behaviors or inadvertently punishing client improvements, are conceptualized from the viewpoint of Functional Analytic Psychotherapy (FAP), a treatment that harnesses the power of the therapeutic relationship. Understanding the functions of client behaviors such as incessant talking and over compliance can lead to more compassionate and effective intervention, and a functional analysis of seemingly problematic behaviors such as silence and lack of cooperation indicate how they may be client improvements. Suggestions are provided for how to more accurately conceptualize whether client behaviors are problems or improvements, and to increase awareness of therapist vulnerabilities that can lead to errors. While FAP is rooted in a functional contextual philosophy, the goal of this article is to offer a framework that crosses theoretical boundaries to decrease the likelihood of clinical errors and to facilitate client growth. (PsycINFO Database Record

  18. A Health Science Process Framework for Comprehensive Clinical Functional Assessment

    Science.gov (United States)

    2014-02-01

    longterm care, spinal cord injuries, amputations , and other clinical situations that can benefit from rehabilitation activities. One of the five...forces. The project vision is to improve TBI functional classification, health care processes, and rehabilitation outcomes by establishing and...create a cross-systems tool set for TBI rehabilitation models and functional health optimization. The second set of objectives is focused on development

  19. Clinical presentation and functional prognosis in syndrome X.

    OpenAIRE

    Chauhan, A; Mullins, P A; Thuraisingham, S I; Petch, M C; Schofield, P. M.

    1993-01-01

    OBJECTIVES--To assess the effect of clinical presentation on functional prognosis in patients with syndrome X. DESIGN--A prospective study. Patients with syndrome X presenting with unstable angina and stable angina were followed up with a questionnaire to examine their functional state. PATIENTS--41 patients with syndrome X and unstable angina and 41 patients with syndrome X and stable angina. Syndrome X was defined as typical anginal chest pain, a positive exercise test, and normal coronary ...

  20. Cholinergic dysfunction and amnesia in patients with Wernicke-Korsakoff syndrome: a transcranial magnetic stimulation study.

    Science.gov (United States)

    Nardone, Raffaele; Bergmann, Jürgen; De Blasi, Pierpaolo; Kronbichler, Martin; Kraus, Jörg; Caleri, Francesca; Tezzon, Frediano; Ladurner, Gunther; Golaszewski, Stefan

    2010-03-01

    The specific neurochemical substrate underlying the amnesia in patients with Wernicke-Korsakoff syndrome (WKS) is still poorly defined. Memory impairment has been linked to dysfunction of neurons in the cholinergic system. A transcranial magnetic stimulation (TMS) protocol, the short latency afferent inhibition (SAI), may give direct information about the function of some cholinergic pathways in the human motor cortex. In the present study, we measured SAI in eight alcoholics with WKS and compared the data with those from a group of age-matched healthy individuals; furthermore, we correlated the individual SAI values of the WKS patients with memory and other cognitive functions. Mean SAI was significantly reduced in WKS patients when compared with the controls. SAI was increased after administration of a single dose of donezepil in a subgroup of four patients. The low score obtained in the Rey Complex Figure delayed recall test, the Digit Span subtest of the Wechsler Adult Intelligence Scale-Revised (WAIS-R) and the Corsi's Block Span subtest of the WAIS-R documented a severe impairment in the anterograde memory and short-term memory. None of the correlations between SAI values and these neuropsychological tests reached significance. We provide physiological evidence of cholinergic involvement in WKS. However, this putative marker of central cholinergic activity did not significantly correlate with the memory deficit in our patients. These findings suggest that the cholinergic dysfunction does not account for the memory disorder and that damage to the cholinergic system is not sufficient to cause a persisting amnesic syndrome in WKS.

  1. Transient Global Amnesia Deteriorates the Network Efficiency of the Theta Band

    Science.gov (United States)

    Yi, SangHak; Lim, Jae-Sung; Jang, Jae-Won; Im, Chang-Hwan; Kim, SangYun

    2016-01-01

    Acute perturbation of the hippocampus, one of the connector hubs in the brain, is a key step in the pathophysiological cascade of transient global amnesia (TGA). We tested the hypothesis that network efficiency, meaning the efficiency of information exchange over a network, is impaired during the acute stage of TGA. Graph theoretical analysis was applied to resting-state EEG data collected from 21 patients with TGA. The EEG data were obtained twice, once during the acute stage ( 2 months after symptom onset) of TGA. Characteristic path lengths and clustering coefficients of functional networks constructed using phase-locking values were computed and normalized as a function of the degree in the delta, theta, alpha, beta 1, beta 2 and gamma frequency bands of the EEG. We investigated whether the normalized characteristic path length (nCPL) and normalized clustering coefficients (nCC) differed significantly between the acute and resolved stages of TGA at each frequency band using the Wilcoxon signed-rank test. For networks where the nCPL or nCC differed significantly between the two stages, we also evaluated changes in the connections of the brain networks. During the acute stage of TGA, the nCPL of the theta band networks with mean degrees of 8, 8.5, 9 and 9.5 significantly increased (P < 0.05). During the acute stage, the lost edges for these networks were mostly found between the anterior (frontal and anterior temporal) and posterior (parieto-occipital and posterior temporal) brain regions, whereas newly developed edges were primarily found between the left and right frontotemporal regions. The nCC of the theta band with a mean degree of 5.5 significantly decreased during the acute stage (P < 0.05). Our results indicate that TGA deteriorates the network efficiency of the theta frequency band. This effect might be related to the desynchronization between the anterior and posterior brain areas. PMID:27741293

  2. Upper Limb Assessment in Tetraplegia: Clinical, Functional and Kinematic Correlations

    Science.gov (United States)

    Cacho, Enio Walker Azevedo; de Oliveira, Roberta; Ortolan, Rodrigo L.; Varoto, Renato; Cliquet, Alberto

    2011-01-01

    The aim of this study was to correlate clinical and functional evaluations with kinematic variables of upper limp reach-to-grasp movement in patients with tetraplegia. Twenty chronic patients were selected to perform reach-to-grasp kinematic assessment using a target placed at a distance equal to the arm's length. Kinematic variables (hand peak…

  3. Evaluating computer-assisted memory retraining programmes for people with post-head injury amnesia.

    Science.gov (United States)

    Tam, Sing-Fai; Man, Wai-Kwong

    2004-05-01

    The present study was designed to perform theory-driven empirical work that might contribute to a better understanding of computer-assisted training effects adopting theoretically different memory retraining strategies for people who had amnesia as a result of a brain injury. A pre-test and post-test control group quasi-experimental design was adopted to test the differences in effectiveness of four different computer-assisted memory training strategies, which were hypothesized to improve different memory skills of persons with brain injury. Twenty-six persons with brain injury were randomly assigned to four age- and gender-matched memory training groups (self-paced, feedback, personalized, visual presentation) and they were trained using the related computer software, evaluated by the Rivermead Behavioural Memory Test (RBMT), self-efficacy scale and built-up computer performance records. All the four memory training methods showed positive among the persons with brain injury as compared with a control group, although there was no statistically significant difference among the four training methods. However, clinical improvement was found in all four methods and the Feedback group showed significant improvement in self efficacy, in comparison with the other groups. This attempt to develop and evaluate different computer applications for memory retraining was made and the effectiveness of applying customized computer technology in memory rehabilitation was critically evaluated. Results of the present study showed that the unique customized therapeutic characteristics of computer-assisted memory retraining (e.g. self-paced practice, performance feedback, salient visual presentation and personalized training contents) are positive attributes of memory skill retraining outcomes.

  4. Advances in functional magnetic resonance imaging: technology and clinical applications.

    Science.gov (United States)

    Dickerson, Bradford C

    2007-07-01

    Functional MRI (fMRI) is a valuable method for use by clinical investigators to study task-related brain activation in patients with neurological or neuropsychiatric illness. Despite the relative infancy of the field, the rapid adoption of this functional neuroimaging technology has resulted from, among other factors, its ready availability, its relatively high spatial and temporal resolution, and its safety as a noninvasive imaging tool that enables multiple repeated scans over the course of a longitudinal study, and thus may lend itself well as a measure in clinical drug trials. Investigators have used fMRI to identify abnormal functional brain activity during task performance in a variety of patient populations, including those with neurodegenerative, demyelinating, cerebrovascular, and other neurological disorders that highlight the potential utility of fMRI in both basic and clinical spheres of research. In addition, fMRI studies reveal processes related to neuroplasticity, including compensatory hyperactivation, which may be a universally-occurring, adaptive neural response to insult. Functional MRI is being used to study the modulatory effects of genetic risk factors for neurological disease on brain activation; it is being applied to differential diagnosis, as a predictive biomarker of disease course, and as a means to identify neural correlates of neurotherapeutic interventions. Technological advances are rapidly occurring that should provide new applications for fMRI, including improved spatial resolution, which promises to reveal novel insights into the function of fine-scale neural circuitry of the human brain in health and disease.

  5. Validity of PROMIS® Physical Function Measures in Diverse Clinical Samples

    Science.gov (United States)

    Schalet, Benjamin D.; Hays, Ron D.; Jensen, Sally E.; Beaumont, Jennifer L.; Fries, James F.; Cella, David

    2016-01-01

    Objective To evaluate the validity of the PROMIS® Physical Function measures using longitudinal data collected in six chronic health conditions. Study Design and Setting Individuals with rheumatoid arthritis (RA), major depressive disorder (MDD), back pain, chronic obstructive pulmonary disease (COPD), chronic heart failure (CHF), and cancer completed the PROMIS Physical Function computerized adaptive test (CAT) or fixed-length short form (SF) at baseline and at the end of clinically-relevant follow-up intervals. Anchor items were also administered to assess change in physical function and general health. Linear mixed effects models and standardized response means were estimated at baseline and follow-up. Results 1415 individuals participated (COPD n = 121; CHF n = 57; back pain n = 218; MDD n = 196, RA n = 521; cancer n = 302). The PROMIS Physical Function scores improved significantly for treatment of CHF and back pain patients, but not for patients with MDD or COPD. Most of the patient subsamples that reported improvement or worsening on the anchors showed a corresponding positive or negative change in PROMIS Physical Function. Conclusion This study provides evidence that the PROMIS Physical Function measures are sensitive to change in intervention studies where physical function is expected to change and able to distinguish among different clinical samples. The results inform the estimation of meaningful change, enabling comparative effectiveness research. PMID:26970039

  6. The therapeutic effect of crocin on ketamine-induced retrograde amnesia in rats

    Directory of Open Access Journals (Sweden)

    Namdar Yousefvand

    2016-09-01

    Full Text Available Introduction: The glutamatergic system plays an important role in learning and memory. Administration of crocus sativus (Saffron or its constituent, crocin, facilitates the formation of memory. This research investigated the effect of crocin on antagonizing retrograde amnesia induced by ketamine, a glutamatergic receptor antagonist, in rats by shuttle box. Methods: Male Wistar rats were tested to measure their learning behavior in the passive avoidance task. All animals were trained by a 1 mA shock. The drugs were injected immediately after the training was successfully performed. The animals were tested 24h after training to measure Step Through Latency (STL. Results: On the test day, administration of ketamine (12 mg/kg, ip impaired the memory after training. Different doses of crocin (2, 5 or 10 mg/kg, ip were injected 30 min after ketamine, but only 2 mg/kg crocin could improve retrograde amnesia and 5 and 10 mg/kg doses did not have any significant effect on retrograde amnesia. Moreover, administration of crocin (2, 5 or 10 mg/kg, ip after training had no significant impact on passive avoidance memory by itself. Conclusion: Considering the therapeutic effect of post-training administration of crocin on ketamine-induced retrograde amnesia, it can be argued that crocin has an interaction with glutamatergic system in formation of passive avoidance memory in rats.

  7. Intrahippocampal Infusions of Anisomycin Produce Amnesia: Contribution of Increased Release of Norepinephrine, Dopamine, and Acetylcholine

    Science.gov (United States)

    Qi, Zhenghan; Gold, Paul E.

    2009-01-01

    Intra-amygdala injections of anisomycin produce large increases in the release of norepinephrine (NE), dopamine (DA), and serotonin in the amygdala. Pretreatment with intra-amygdala injections of the beta-adrenergic receptor antagonist propranolol attenuates anisomycin-induced amnesia without reversing the inhibition of protein synthesis, and…

  8. Intrahippocampal Infusions of Anisomycin Produce Amnesia: Contribution of Increased Release of Norepinephrine, Dopamine, and Acetylcholine

    Science.gov (United States)

    Qi, Zhenghan; Gold, Paul E.

    2009-01-01

    Intra-amygdala injections of anisomycin produce large increases in the release of norepinephrine (NE), dopamine (DA), and serotonin in the amygdala. Pretreatment with intra-amygdala injections of the beta-adrenergic receptor antagonist propranolol attenuates anisomycin-induced amnesia without reversing the inhibition of protein synthesis, and…

  9. A Patient with Difficulty of Object Recognition: Semantic Amnesia for Manipulable Objects

    Directory of Open Access Journals (Sweden)

    A. Yamadori

    1992-01-01

    Full Text Available We studied a patient who had recognition difficulty for manipulable objects. MRI showed a lesion in the left occipito-parietotemporal area. Differential diagnosis of agnosia, aphasia and apraxia is discussed. We believe this “object meaning amnesia” constitutes a distinct subtype of semantic amnesia.

  10. The Review of Retrograde Amnesia%逆行性遗忘研究综述

    Institute of Scientific and Technical Information of China (English)

    黄晓雪

    2015-01-01

    Retrograde amnesia has great important influence on internal memory of the human, especially in cognitive neuro-science. Through literature analysis, the temporal graded retrograde amnesia is the most extensive type. The characteristics of retro-grade amnesia is different and graded, and it is also featured with the full implicit memory. It mainly stems from the brain injury such as medial temporal lobe, diencephalon, and frontal lobe. In addition, drinking, lacking of vitamin B1 and trauma can also cause the symptoms. Now the main methods of memory rehabilitation are operation therapy, implicit memory rehabilitation and error-less learning. In the future, the memory rehabilitation about retrograde amnesia will more effectively promote the progress of the treatment.%遗忘症主要分为逆行性遗忘和顺行性遗忘。逆行性遗忘指病人失去提取脑损伤前事件记忆的能力,即能学习新东西和编码新事件,但是不能回忆发生在脑损伤前的经历和事件。它具有逆行期的梯度性、差异性,语义记忆、内隐记忆正常等特点;受伤脑区多与颞叶内侧、额叶、间脑损伤相关联。

  11. Psychogenic Amnesia for Childhood Sexual Abuse and Risk for Sexual Revictimisation in Both Adolescence and Adulthood

    Science.gov (United States)

    Wager, Nadia

    2012-01-01

    This study was an investigation of the additional risk conferred by the experience of psychogenic amnesia for memories of childhood sexual abuse (CSA) on the likelihood of becoming a victim of sexual assault in later life. A total of 210 community respondents completed a retrospective web-based trauma survey. The majority of respondents were…

  12. Functional clinical typology of the foot and kinematic gait parameters

    Directory of Open Access Journals (Sweden)

    Jitka Marenčáková

    2016-06-01

    Full Text Available Background: The foot plays a key role in a standing posture, walking and running performance. Changes in its structure or function may alter upper segments of kinematic chain which can lead to formation of musculoskeletal disorders. Although functional clinical typology provides a complex view of foot kinesiology there is a lack of knowledge and evidence about influences of different foot types on human gait. Objective: The aim of the study was to analyse differences of kinematic gait parameters of lower extremity joints and pelvis between functional clinical foot types in healthy young men. Methods: Three-dimensional kinematic analysis by the Vicon Motion Capture MX System device in synchronization with 2 Kistler force platforms was used to obtain kinematic data from 18 healthy men (mean age 23.2 ± 1.9 years. The functional clinical foot type was clinically examined and sorted into 3 basic foot type groups - forefoot varus (FFvar, rearfoot varus (RFvar and forefoot valgus (FFvalg. Peak angular values and range of an angular displacement in all of three movement planes were analysed for pelvis, hip, knee and ankle joint. For statistical analysis of kinematic gait parameters differences between foot types Mann Whitney U test at a statistical significance level p < .05 and Cohen's coefficient d for effect size were used. Results: This study showed that functional clinical foot type can affect kinematic parameters of gait in the joints of the lower limb and pelvis. Significant differences were presented in the FFvar in comparison with other two foot type groups with middle and high size of effect. The most alterations were observed in pelvis area and in a sagittal plane of movement. Nevertheless, significant differences between FFvalg and RFvar foot types were not noticed. Conclusions: Functional clinical foot typology provides one of the possible methods to describe foot structure and function. Our results showed that foot type could

  13. Functional neuroimaging of traumatic brain injury: advances and clinical utility

    Directory of Open Access Journals (Sweden)

    Irimia A

    2015-09-01

    Full Text Available Andrei Irimia, John Darrell Van Horn USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA Abstract: Functional deficits due to traumatic brain injury (TBI can have significant and enduring consequences upon patients’ life quality and expectancy. Although functional neuroimaging is essential for understanding TBI pathophysiology, an insufficient amount of effort has been dedicated to the task of translating functional neuroimaging findings into information with clinical utility. The purpose of this review is to summarize the use of functional neuroimaging techniques – especially functional magnetic resonance imaging, diffusion tensor imaging, positron emission tomography, magnetic resonance spectroscopy, and electroencephalography – for advancing current knowledge of TBI-related brain dysfunction and for improving the rehabilitation of TBI patients. We focus on seven core areas of functional deficits, namely consciousness, motor function, attention, memory, higher cognition, personality, and affect, and, for each of these, we summarize recent findings from neuroimaging studies which have provided substantial insight into brain function changes due to TBI. Recommendations are also provided to aid in setting the direction of future neuroimaging research and for understanding brain function changes after TBI. Keywords: cognitive decline, personality change, magnetic resonance imaging, diffusion tensor imaging

  14. CLINICAL AND FUNCTIONAL FEATURES OF PANCREAS STATE IN RHEUMATOID ARTHRITIS

    Directory of Open Access Journals (Sweden)

    O. O. Basieva

    2000-01-01

    Full Text Available Aim of study: complex pancreas study in rheumatoid arthritis (RA. Material and methods: 120 RA pts were examined clinically Pancreas US-and biochemical study (level of a-amylase and lipase of blood serum by kinetic-calorimetric method was performed in this grouh. Results: 50.8% of pts demonstrated increase of pancreas echo, in 23.3%- widened Wirsung s duct, in 45%- single small focal indurations, more often in the body and cauda pancreatis. Decrease of lipolitic and amylolytic pancreas activity is characteristic for RA, especially in systemic process and long-term disease. Clinical and functional disturbances are connected with morphological changes.

  15. Using Post-Traumatic Amnesia To Predict Outcome after Traumatic Brain Injury.

    Science.gov (United States)

    Ponsford, Jennie L; Spitz, Gershon; McKenzie, Dean

    2016-06-01

    Duration of post-traumatic amnesia (PTA) has emerged as a strong measure of injury severity after traumatic brain injury (TBI). Despite the growing international adoption of this measure, there remains a lack of consistency in the way in which PTA duration is used to classify severity of injury. This study aimed to establish the classification of PTA that would best predict functional or productivity outcomes. We conducted a cohort study of 1041 persons recruited from inpatient admissions to a TBI rehabilitation center between 1985 and 2013. Participants had a primary diagnosis of TBI, emerged from PTA before discharge from inpatient hospital, and engaged in productive activities before injury. Eight models that classify duration of PTA were evaluated-six that were based on the literature and two that were statistically driven. Models were assessed using area under the receiver operating characteristic curve (AUC) as well as model-based Akaike Information Criterion (AIC) and Bayesian Information Criterion (BIC) statistics. All categorization models showed longer PTA to be associated with a greater likelihood of being nonproductive at 1 year after TBI. Classification systems with a greater number of categories performed better than two-category systems. The dimensional (continuous) form of PTA resulted in the greatest AUC, and lowest AIC as well as BIC, of the classification systems examined. This finding indicates that the greatest accuracy in prognosis is likely to be achieved using PTA as a continuous variable. This enables the probability of productive outcomes to be estimated with far greater precision than that possible using a classification system. Categorizing PTA to classify severity of injury may be reducing the precision with which clinicians can plan the treatment of patients after TBI.

  16. Platelet Function Tests: A Review of Progresses in Clinical Application

    Directory of Open Access Journals (Sweden)

    Jae-Lim Choi

    2014-01-01

    Full Text Available The major goal of traditional platelet function tests has been to screen and diagnose patients who present with bleeding problems. However, as the central role of platelets implicated in the etiology of arterial thrombotic diseases such as myocardial infarction and stroke became widely known, platelet function tests are now being promoted to monitor the efficacy of antiplatelet drugs and also to potentially identify patients at increased risk of thrombosis. Beyond hemostasis and thrombosis, an increasing number of studies indicate that platelets play an integral role in intercellular communication, are mediators of inflammation, and have immunomodulatory activity. As new potential biomarkers and technologies arrive at the horizon, platelet functions testing appears to take on a new aspect. This review article discusses currently available clinical application of platelet function tests, placing emphasis on essential characteristics.

  17. Clinical application of functional magnetic resonance imaging in China

    Institute of Scientific and Technical Information of China (English)

    MA Lin

    2006-01-01

    @@ Functional magnetic resonance imaging (fMRI)has been widely used in basic research in the past decade, and more clinically in recent years.Unlike conventional MRI that demonstrates the anatomy and morphology of the brain, fMRI provides the functional information of the brain, including neuronal activation, perfusion, diffusion, metabolism,and fiber connection. Since the publication of the pioneer study by Ogawa et al1 in 1990, blood oxygenation level dependent (BOLD) technique has been adopted by neuroscientists and psychologists in research into the mechanisms of motion, vision,hearing, language, memory, and functions of the brain. Soon after, clinical studies with BOLD technique were conducted in some fields like surgery (surgical planning). In China, however, basic and clinical studies on fMRI in the early years were limited by the shortage of funding, difficulty in integrating personnel of different disciplines from different institutions, and long-term use of MR scanners. In recent years, the studies on fMRI in this country have been flourishing as the conditions are greatly improved, and the number of published papers has increased because more and more radiologists and clinicians are involved.

  18. Antagonism by exifone, a new cognitive enhancing agent, of the amnesias induced by four benzodiazepines in mice.

    Science.gov (United States)

    Porsolt, R D; Lenègre, A; Avril, I; Doumont, G

    1988-01-01

    Exifone is a novel compound proposed for treating cognitive decline associated with age and shows corrective effects in animal models of memory dysfunction. The present experiments examined the antagonism by exifone of the amnesias induced in mice in a passive avoidance test by four benzodiazepines: bromazepam, diazepam, lorazepam and triazolam. Subsequent experiments investigated the specificity of exifone's antagonism of benzodiazepine-induced amnesia by examining its interaction with the effects of the benzodiazepines in the staircase test (anxiolytic/sedative activity) and the electroshock test (anticonvulsant activity). The results indicated that exifone clearly antagonised the amnesias induced by the four benzodiazepines, but was without intrinsic effects in the staircase or electroshock test and did not antagonise the effects of the benzodiazepines in these two tests. These results suggest that exifone might be useful for decreasing the amnesias induced by commonly used benzodiazepines without affecting their anxiolytic or anticonvulsant activity.

  19. Sleep and cognitive (memory) function: research and clinical perspectives.

    Science.gov (United States)

    Roth, T; Costa e Silva, J A; Chase, M H

    2001-09-01

    The field of memory and sleep is controversial and extremely interesting, and the relationships between thought processes, i.e. cognition and sleep, have recently been examined in a variety of clinical and basic research settings, as well as being the object of intense interest by the general public. For example, there are data which demonstrate that insomnia, as well as specific sleep disorders, can have a negative impact on sleep cognition as well as affect daytime patterns of cognitive functioning. Thus, sleep, disturbed sleep and the lack of sleep appear to affect cognitive and memory functions. An International Workshop dealing with Sleep and Cognitive Function: Research and Clinical Perspectives was convened in Cancún, Mexico, 1-4 March 1999 under the auspices of the World Health Organization Worldwide Project on Sleep and Health and the World Federation of Sleep Research Societies. A great number of areas of intersection between sleep and cognitive function were examined during the course of the Workshop, such as aging, cognition and sleep and the dream process and sleep. The results of these discussions are included in a WHO publication (WHO Doc.: MSD/MBD/00.8). In the present report we concentrate on presenting a summary of a coherent set of data which examine memory consolidation during sleep and the impact of insomnia on cognitive functions. Based upon these data, a review of memory and drug effects that are sleep-related, and an examination of the relationship between hypnotics and cognitive function are included. Finally, a summary of recommendations of the Workshop participants is presented.

  20. Functional profile of swallowing in clinical intensive care

    Directory of Open Access Journals (Sweden)

    Aline Rodrigues Padovani

    2007-12-01

    Full Text Available Objective: To describe the functional profile of swallowing and feedingin patients admitted to a clinical intensive care unit. Methods: Asurvey on the speech therapy care provided at clinical intensive careunit, from May to August 2006, to establish indicators to describeswallowing functional profile. In this study we included patients referredfor suspected dysphagia after undergoing long periods of mechanicalventilation and/or tracheostomy, and we excluded those suspectedof neurogenic dysphagia. Results: We observed a 65% prevalence oforopharyngeal dysphagia in four months of speech therapy. Amongthe patients who were previously submitted to orotracheal intubation,we observed oropharyngeal dysphagia in 64% of assessments, and wenoticed a reduction in dysphagia severity after speech therapy. Thirtyninepercent of cases required further speech therapy. Conclusion:Speech therapy in non-neurogenic dysphagia in clinical intensive careunit focuses mainly on patients who were intubated for more than 48hours. These patients benefited from the intervention through the useof therapeutic techniques based on the necessary criteria for safefeeding habits.

  1. Clinical assessment of social cognitive function in neurological disorders.

    Science.gov (United States)

    Henry, Julie D; von Hippel, William; Molenberghs, Pascal; Lee, Teresa; Sachdev, Perminder S

    2016-01-01

    Social cognition broadly refers to the processing of social information in the brain that underlies abilities such as the detection of others' emotions and responding appropriately to these emotions. Social cognitive skills are critical for successful communication and, consequently, mental health and wellbeing. Disturbances of social cognition are early and salient features of many neuropsychiatric, neurodevelopmental and neurodegenerative disorders, and often occur after acute brain injury. Its assessment in the clinic is, therefore, of paramount importance. Indeed, the most recent edition of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduced social cognition as one of six core components of neurocognitive function, alongside memory and executive control. Failures of social cognition most often present as poor theory of mind, reduced affective empathy, impaired social perception or abnormal social behaviour. Standard neuropsychological assessments lack the precision and sensitivity needed to adequately inform treatment of these failures. In this Review, we present appropriate methods of assessment for each of the four domains, using an example disorder to illustrate the value of these approaches. We discuss the clinical applications of testing for social cognitive function, and finally suggest a five-step algorithm for the evaluation and treatment of impairments, providing quantitative evidence to guide the selection of social cognitive measures in clinical practice.

  2. Functional symptoms in clinically definite MS--pseudo-relapse syndrome.

    LENUS (Irish Health Repository)

    Merwick, A

    2012-02-03

    Although the diagnostic criteria for multiple sclerosis (MS) have become more formalized and sensitive in the era of magnetic resonance imaging (MRI) scanning, the assessment of individual relapses may not always be straightforward or easily linked to a particular lesion seen on imaging. In addition, acute episodes often have to be assessed outside of normal working hours or when the individual patients usual medical team is not available. Often the emergency department physicians have little formal neurological training and are under time pressure to get patients through the system as quickly as possible. It is therefore possible to mislabel functional symptoms as being true relapses. To illustrate scenarios of possible pseudo-relapse, three clinical vignettes are described. Misclassification of functional symptoms as relapse carries a number of inherent risks. Functional symptoms can be multifactorial and may cause a burden of disease. A multidisciplinary approach may be useful in minimizing unnecessary harm and identify if there is more than meets the eye to an episode of clinical deterioration.

  3. The future of functional MRI in clinical medicine.

    Science.gov (United States)

    Bullmore, Ed

    2012-08-15

    In the last 20 years or so, functional MRI has matured very rapidly from being an experimental imaging method in the hands of a few labs to being a very widely available and widely used workhorse of cognitive neuroscience and clinical neuroscience research internationally. FMRI studies have had a considerable impact on our understanding of brain system phenotypes of neurological and psychiatric disorders; and some impact already on development of new therapeutics. However, the direct benefit of fMRI to individual patients with brain disorders has so far been minimal. Here I provide a personal perspective on what has already been achieved, and imagine how the further development of fMRI over the medium term might lead to even greater engagement with clinical medicine.

  4. Polymeric nanotherapeutics: clinical development and advances in stealth functionalization strategies

    Science.gov (United States)

    Hu, Che-Ming J.; Fang, Ronnie H.; Luk, Brian T.; Zhang, Liangfang

    2013-12-01

    Long-circulating polymeric nanotherapeutics have garnered increasing interest in research and in the clinic owing to their ability to improve the solubility and pharmacokinetics of therapeutic cargoes. Modulation of carrier properties promises more effective drug localization at the disease sites and can lead to enhanced drug safety and efficacy. In the present review, we highlight the current development of polymeric nanotherapeutics in the clinic. In light of the importance of stealth properties in therapeutic nanoparticles, we also review the advances in stealth functionalization strategies and examine the performance of different stealth polymers in the literature. In addition, we discuss the recent development of biologically inspired ``self'' nanoparticles, which present a differing stealth concept from conventional approaches.

  5. Direct, quantitative clinical assessment of hand function: usefulness and reproducibility.

    Science.gov (United States)

    Goodson, Alexander; McGregor, Alison H; Douglas, Jane; Taylor, Peter

    2007-05-01

    Methods of assessing functional impairment in arthritic hands include pain assessments and disability scoring scales which are subjective, variable over time and fail to take account of the patients' need to adapt to deformities. The aim of this study was to evaluate measures of functional strength and joint motion in the assessment of the rheumatoid (RA) and osteoarthritic (OA) hand. Ten control subjects, ten RA and ten OA patients were recruited for the study. All underwent pain and disability scoring and functional assessment of the hand using measures of pinch/grip strength and range of joint motion (ROM). Functional assessments including ROM analyses at interphalangeal (IP), metacarpophalangeal (MCP) and wrist joints along with pinch/grip strength clearly discriminated between patient groups (RA vs. OA MCP ROM P<0.0001), pain and disability scales were unable to. In the RA there were demonstrable relationships between ROM measurements and disability (R2=0.31) as well as disease duration (R2=0.37). Intra-patient measures of strength were robust whereas inter-patient comparisons showed variability. In conclusion, pinch/grip strength and ROM are clinically reproducible assessments that may more accurately reflect functional impairment associated with arthritis.

  6. Language and cognitive communication disorder during post-traumatic amnesia: Profiles of recovery after TBI from three cases.

    Science.gov (United States)

    Steel, Joanne; Ferguson, Alison; Spencer, Elizabeth; Togher, Leanne

    2017-09-25

    There has been limited empirical speech-language pathology (SLP) study of language and cognitive communication during post-traumatic amnesia (PTA) and the early stages after TBI. The purpose of the current research was to explore the potential means and utility of assessing cognitive communication during PTA and the post-acute recovery period. This research used a longitudinal mixed methods design to describe language and cognitive communication assessment and recovery profiles of three patients with TBI. Cognitive communication was assessed with repeated standardised and non-standardised methods during PTA (rated with Westmead PTA Scale) and at follow-up 3 months after PTA emergence. All participants demonstrated a profile of language and cognitive communication strengths and weaknesses during PTA and the post-acute period, also evident at follow-up. Improvement occurred gradually throughout PTA, although with individual fluctuation across test occasions. There was no marked change in communication function immediately before and after PTA emergence, indicating that cognitive communication ability and those functions measured on the Westmead PTA Scale (memory and orientation) did not recover at the same rate. It was feasible to assess language and cognitive communication throughout PTA and the post-acute period, and early assessment results were relevant to the patient's ongoing communicative function. It is suggested that early and repeated SLP assessment may contribute to the prediction of persisting cognitive communication issues.

  7. Attenuating effect of bioactive coumarins from Convolvulus pluricaulis on scopolamine-induced amnesia in mice.

    Science.gov (United States)

    Malik, Jai; Karan, Maninder; Vasisht, Karan

    2016-01-01

    Convolvulus pluricaulis Chois. (Convolvulaceae) has been used in Ayurveda as Medhya Rasyana (nervine tonic) to treat various mental disorders. This study was designed to isolate the bioactive compound(s) of this plant and to evaluate their effect against scopolamine-induced amnesia. Column chromatography of the chloroform and ethyl-acetate fractions led to the isolation of three coumarins identified as scopoletin, ayapanin and scopolin. All the three compounds at 2.5, 5, 10 and 15 mg/kg, p.o. were evaluated for memory-enhancing activity against scopolamine-induced amnesia using elevated plus maze and step down paradigms. Effect on acetylcholinesterase activity in mice brain was also evaluated. Scopoletin and scopolin, in both the paradigms, significantly and dose dependently attenuated the scopolamine-induced amnesic effect. Furthermore, these compounds at 10 and 15 mg/kg exhibited activity comparable to that of standard drug, donepezil. The compounds also exhibited significant acetylcholinesterase inhibitory activity.

  8. Amnesia global transitoria : aspectos clínicos y epidemiológicos

    OpenAIRE

    Reguero del Cura, Leandra

    2016-01-01

    La amnesia global transitoria es un síndrome clínico caracterizado por la aparición brusca de amnesia anterógrada acompañada de preguntas reiterativas, que en determinadas ocasiones asocia un componente retrógrado, de duración inferior a 24 horas, sin compromiso de las funciones neurológicas. Aunque hace más de 50 años desde que se describió por primera vez, la etiología de este síndrome permanece aún desconocida, siendo uno de los síndromes más enigmáticos de la neurología clínica. Existen d...

  9. The economics of functional magnetic resonance imaging: clinical and research.

    Science.gov (United States)

    Yousem, David M

    2014-11-01

    It is difficult to justify maintaining a clinical functional magnetic resonance imaging (fMRI) program based solely on revenue generation. The use of fMRI is, therefore, based mostly in patient care considerations, leading to better outcomes. The high costs of the top-of-the-line equipment, hardware, and software needed for state-of-the-art fMRI and the time commitment by multiple professionals are not adequately reimbursed at a representative rate by current payor schemes for the Current Procedure Terminology codes assigned.

  10. Small airway function changes and its clinical significance of asthma patients in different clinical phases

    Institute of Scientific and Technical Information of China (English)

    Yan-Hui Zhou; Jun-Ti Lu

    2016-01-01

    Objective:To observe the small airways function changes of asthmatic patients in different clinical phases and to discuss its clinical significance.Methods:A total of 127 patients diagnosed as asthma were selected randomly and pulmonary function (PF) of them was determined by conventional method. Then they were divided into A, B and C group based on PF results. All 34 patients in A group suffered from acute asthma attack for the first time. All 93 patients in B group had been diagnosed as asthma but in remission phase. C Group was regarded as Control group with 20 healthy volunteers. Then FEV1, FEF50%, FEF75% levels of patients in each group were analyzed, and FEV1, FEF75% and FEF50% levels of patients in each group were compared after bronchial dilation test.Results:It was found that most patients in group A and B had abnormal small airways function, and their small airways function was significantly different compared with that of group C (P<0.01). In addition, except for group C, FEF75%, FEF50% levels in A and B group were improved more significantly than FEV1 levels (P<0.01).Conclusions:Asthma patients in acute phase all have abnormal small airways function. Most asthma patients in remission phase also have abnormal small airways function. After bronchial dilation test, whether patients in acute phase or in remission phase, major and small airways function of them are improved, but improvement of small airways function is weaker than that of major airways. This indicates that asthma respiratory tract symptoms in different phases exists all the time and so therapeutic process is needed to perform step by step.

  11. Memory without context: amnesia with confabulations after infarction of the right capsular genu.

    OpenAIRE

    Schnider, A.; Gutbrod, K; Hess, C. W.; Schroth,G.

    1996-01-01

    OBJECTIVE--To explore the mechanism of an amnesia marked by confabulations and lack of insight in a patient with an infarct of the right inferior capsular genu. The confabulations could mostly be traced back to earlier events, indicating that the memory disorder ensued from an inability to store the temporal and spatial context of information acquisition rather than a failure to store new information. METHODS--To test the patient's ability to store the context of information acquisition, two ...

  12. GABA, glutamate, dopamine and serotonin transporters expression on memory formation and amnesia.

    Science.gov (United States)

    Tellez, Ruth; Gómez-Víquez, Leticia; Meneses, Alfredo

    2012-02-01

    Notwithstanding several neurotransmission systems are frequently related to memory formation, amnesia and/or therapeutic targets for memory alterations, the role of transporters γ-aminobutyric acid (GABA, GAT1), glutamate (neuronal glutamate transporter excitatory amino acid carrier; EACC1), dopamine (DAT) and serotonin (SERT) is poorly understood. Hence, in this paper Western-blot analysis was used to evaluate expression changes on them during memory formation in trained and untrained rats treated with the selective serotonin transporter inhibitor fluoxetine, the amnesic drug d-methamphetamine (METH) and fluoxetine plus METH. Transporters expression was evaluated in the hippocampus, prefrontal cortex and striatum. Data indicated that in addition of memory performance other behavioral parameters (e.g., explorative behavior, food-intake, etc.) that memory formation was recorded. Thus, memory formation in a Pavlovian/instrumental autoshaping was associated to up-regulation of prefrontal cortex GAT1 and EAAC1, striatal SERT, DAT and EACC1; while, hippocampal EACC1, GAT1 and SERT were down-regulated. METH impaired short (STM) and long-term memory (LTM), at 24 or 48h. The METH-induced amnesia down-regulated SERT, DAT, EACC1 and GAT1 in hippocampus and the GAT1 in striatum; no-changes were observed in prefrontal cortex. Post-training administration of fluoxetine improved LTM (48h), which was associated to DAT, GAT1 (prefrontal cortex) up-regulation, but GAT1 (striatum) and SERT (hippocampus) down-regulation. Fluoxetine plus METH administration was able to prevent amnesia, which was associated to DAT, EACC1 and GAT1 (prefrontal cortex), SERT and DAT (hippocampus) and EACC1 or DAT (striatal) up-regulation. Together these data show that memory formation, amnesia and anti-amnesic effects are associated to specific patters of transporters expression.

  13. Proteome Analysis of Rat Hippocampus Following Morphine-induced Amnesia and State-dependent Learning

    OpenAIRE

    Jafarinejad-Farsangi, Saeideh; Farazmand, Ali; Rezayof, Ameneh; Darbandi, Niloufar

    2015-01-01

    Morphine’s effects on learning and memory processes are well known to depend on synaptic plasticity in the hippocampus. Whereas the role of the hippocampus in morphine-induced amnesia and state-dependent learning is established, the biochemical and molecular mechanisms underlying these processes are poorly understood. The present study intended to investigate whether administration of morphine can change the expression level of rat hippocampal proteins during learning of a passive avoidance t...

  14. Evidence of an amnesia-like cued-recall memory impairment in nondementing idiopathic Parkinson's disease.

    Science.gov (United States)

    Edelstyn, Nicola M J; John, Christopher M; Shepherd, Thomas A; Drakeford, Justine L; Clark-Carter, David; Ellis, Simon J; Mayes, Andrew R

    2015-10-01

    Medicated, non-dementing mild-to-moderate Parkinson's disease (PD) patients usually show recall/recollection impairments but have only occasionally shown familiarity impairments. We aimed to assess two explanations of this pattern of impairment. Recollection typically improves when effortful planning of encoding and retrieval processing is engaged. This depends on prefrontally-dependent executive processes, which are often disrupted in PD. Relative to an unguided encoding and retrieval of words condition (C1), giving suitable guidance at encoding alone (C2) or at encoding and retrieval (C3) should, if executive processes are disrupted, improve PD recollection more than control recollection and perhaps raise it to normal levels. Familiarity, being a relatively automatic kind of memory, whether impaired or intact, should be unaffected by guidance. According to the second explanation, PD deficits are amnesia-like and caused by medial temporal lobe dysfunction and although poorer recollection, which is caused by hippocampal disruption, may be improved by guidance, it should not improve more than control recollection. Familiarity impairment will also occur if the perirhinal cortex is disrupted, but will be unimproved by guidance. Without guidance, recollection/recall was impaired in thirty PD patients relative to twenty-two healthy controls and remained relatively equally impaired when full guidance was provided (C1 vs C3), both groups improving to broadly the same extent. Although impaired, and markedly less so than recollection, familiarity was not improved by guidance in both groups. The patients showed elevated rates of subclinical depressive symptoms, which weakly correlated with recall/recollection in all three conditions. PD executive function was also deficient and correlated with unguided/C1 recollection only. Our results are consistent with a major cause of the patients' recall/recollection impairments being hippocampal disruption, probably exacerbated by

  15. Long-term neuropsychological, neuroanatomical, and life outcome in hippocampal amnesia

    Science.gov (United States)

    Warren, David E.; Duff, Melissa C.; Magnotta, Vincent; Capizzano, Aristides A; Cassell, Martin D.; Tranel, Daniel

    2012-01-01

    Focal bilateral hippocampal damage typically causes severe and selective amnesia for new declarative information (facts and events), a cognitive deficit that greatly impacts the ability to live a normal, fully-independent life. We describe the case of 1846, a 48-year-old woman with profound hippocampal amnesia following status epilepticus and an associated anoxic episode at age 30. 1846 has undergone extensive neuropsychological testing on many occasions over the 18 years since her injury, and we present data indicating that her memory impairment has remained severe and stable during that time. New, high-resolution structural MRI studies of 1846's brain reveal substantial bilateral hippocampal atrophy resembling that of other well-known amnesic patients. In spite of severe amnesia, 1846 lives a full and mostly independent adult life, facilitated by an extensive social support network of family and friends. Her case provides an example of a rare and unlikely positive outcome in the face of severe memory problems. PMID:22401298

  16. Effect of bacosides, alcoholic extract of Bacopa monniera Linn. (brahmi), on experimental amnesia in mice.

    Science.gov (United States)

    Kishore, Kamal; Singh, Manjeet

    2005-07-01

    To investigate the effect of bacosides (alcoholic extract of brahmi) on scopolamine (3 mg kg(-1), ip), sodium nitrite (75 mg kg(-1), ip) and BN52021 (15 mg kg(-1), ip) induced experimental amnesia in mice, using Morris water maze test, all the agents were administered 30 min before the acquisition trials on each day and repeated for 4 consecutive days, and on 5th day during the retrieval trials. Bacosides on anterograde administration (before training) in mice, significantly decreased the escape latency time (ELT) during the acquisition trials for 4 consecutive days and increased the time spent (TS) in target quadrant during the retrieval trials on 5th day, and on retrograde administration (after training) bacosides were found not to affect TS significantly. Bacosides also significantly decreased the ELT and increased the TS in mice treated anterogradely with scopolamine and sodium nitrite. Bacosides did not exhibit any significant effect on TS of mice treated retrogradely with sodium nitrite. On the other hand, bacosides significantly increased the TS of mice treated retrogradely with BN52021. On the basis of the present results it can be concluded that bacosides facilitate anterograde memory and attenuate anterograde experimental amnesia induced by scopolamine and sodium nitrite possibly by improving acetylcholine level and hypoxic conditions, respectively. Beside this bacosides also reversed BN52021 induced retrograde amnesia, probably due to increase in platelet activating factor (PAF) synthesis by enhancing cerebral glutamate level.

  17. Faces are special but not too special: spared face recognition in amnesia is based on familiarity.

    Science.gov (United States)

    Aly, Mariam; Knight, Robert T; Yonelinas, Andrew P

    2010-11-01

    Most current theories of human memory are material-general in the sense that they assume that the medial temporal lobe (MTL) is important for retrieving the details of prior events, regardless of the specific type of materials. Recent studies of amnesia have challenged the material-general assumption by suggesting that the MTL may be necessary for remembering words, but is not involved in remembering faces. We examined recognition memory for faces and words in a group of amnesic patients, which included hypoxic patients and patients with extensive left or right MTL lesions. Recognition confidence judgments were used to plot receiver operating characteristics (ROCs) in order to more fully quantify recognition performance and to estimate the contributions of recollection and familiarity. Consistent with the extant literature, an analysis of overall recognition accuracy showed that the patients were impaired at word memory but had spared face memory. However, the ROC analysis indicated that the patients were generally impaired at high confidence recognition responses for faces and words, and they exhibited significant recollection impairments for both types of materials. Familiarity for faces was preserved in all patients, but extensive left MTL damage impaired familiarity for words. These results show that face recognition may appear to be spared because performance tends to rely heavily on familiarity, a process that is relatively well preserved in amnesia. In addition, the findings challenge material-general theories of memory, and suggest that both material and process are important determinants of memory performance in amnesia.

  18. A Single-System Model Predicts Recognition Memory and Repetition Priming in Amnesia

    Science.gov (United States)

    Kessels, Roy P.C.; Wester, Arie J.; Shanks, David R.

    2014-01-01

    We challenge the claim that there are distinct neural systems for explicit and implicit memory by demonstrating that a formal single-system model predicts the pattern of recognition memory (explicit) and repetition priming (implicit) in amnesia. In the current investigation, human participants with amnesia categorized pictures of objects at study and then, at test, identified fragmented versions of studied (old) and nonstudied (new) objects (providing a measure of priming), and made a recognition memory judgment (old vs new) for each object. Numerous results in the amnesic patients were predicted in advance by the single-system model, as follows: (1) deficits in recognition memory and priming were evident relative to a control group; (2) items judged as old were identified at greater levels of fragmentation than items judged new, regardless of whether the items were actually old or new; and (3) the magnitude of the priming effect (the identification advantage for old vs new items) overall was greater than that of items judged new. Model evidence measures also favored the single-system model over two formal multiple-systems models. The findings support the single-system model, which explains the pattern of recognition and priming in amnesia primarily as a reduction in the strength of a single dimension of memory strength, rather than a selective explicit memory system deficit. PMID:25122896

  19. 5-HT6 receptor memory and amnesia: behavioral pharmacology--learning and memory processes.

    Science.gov (United States)

    Meneses, Alfredo; Pérez-García, Georgina; Ponce-Lopez, Teresa; Castillo, Carlos

    2011-01-01

    Growing evidence indicates that antagonists of the 5-hydroxytryptamine (serotonin) receptor6 (5-HT6) improve memory and reverse amnesia, although the mechanisms involved are poorly understood. Hence, in this paper an attempt was made to summarize recent findings. Available evidence indicates that diverse 5-HT6 receptor antagonists produce promnesic and/or antiamnesic effects in diverse conditions, including memory formation, age-related cognitive impairments, memory deficits in diseases such as schizophrenia, Parkinson, and Alzheimer's disease (AD). Notably, some 5-HT6 receptor agonists seem to have promnesic and/or antiamnesic effects. At the present, it is unclear why 5-HT6 receptor agonists and antagonists may facilitate memory or may reverse amnesia in some memory tasks. Certainly, 5-HT6 drugs modulate memory, which are accompanied with neural changes. Likewise, memory, aging, and AD modify 5-HT6 receptors and signaling cascades. Further investigation in different memory tasks, times, and amnesia models together with more complex control groups might provide further clues. Notably, human studies suggest a potential utility of 5-HT6 receptor antagonists in mild-to-moderate AD patients. Even individuals with mild cognitive impairment (MCI) offer a great opportunity to test them.

  20. Systematic Approach toward the Clinical Diagnosis of Functional Dyspepsia

    Directory of Open Access Journals (Sweden)

    Pierre Paré

    1999-01-01

    Full Text Available Functional dyspepsia (FD is the most common condition in patients consulting with upper gastrointestinal tract symptoms, resulting in up to 5% of visits to family physicians. By definition, patients with FD have no clinical, biochemical or endoscopic evidence of an organic disease that is likely to explain their symptoms. The process to be used in a structured interview for establishing a clinical diagnosis of FD is presented. The steps are as follows: determine the duration and the course of the disease; characterize the current syndrome and review the alarm symptoms; elicit the patient-perceived dominant symptom and/or condition; and identify the patient’s reason for consulting and address the psychosocial factors. According to the clinical characteristics of the three most frequent causes of dyspepsia (peptic ulcer, gastroesophageal reflux and FD and acknowledging that these conditions may coexist rather than overlap in some patients, an algorithm is suggested for establishing a working diagnosis of FD and indications for investigation, and initiating a management strategy.

  1. Hemicrania Continua: Functional Imaging and Clinical Features With Diagnostic Implications.

    Science.gov (United States)

    Sahler, Kristen

    2013-04-10

    This review focuses on summarizing 2 pivotal articles in the clinical and pathophysiologic understanding of hemicrania continua (HC). The first article, a functional imaging project, identifies both the dorsal rostral pons (a region associated with the generation of migraines) and the posterior hypothalamus (a region associated with the generation of cluster and short-lasting unilateral neuralgiform headache with conjunctival injection and tearing [SUNCT]) as active during HC. The second article is a summary of the clinical features seen in a prospective cohort of HC patients that carry significant diagnostic implications. In particular, they identify a wider range of autonomic signs than what is currently included in the International Headache Society criteria (including an absence of autonomic signs in a small percentage of patients), a high frequency of migrainous features, and the presence of aggravation and/or restlessness during attacks. Wide variations in exacerbation length, frequency, pain description, and pain location (including side-switching pain) are also noted. Thus, a case is made for widening and modifying the clinical diagnostic criteria used to identify patients with HC.

  2. Predicting cognitive function from clinical measures of physical function and health status in older adults.

    Directory of Open Access Journals (Sweden)

    Niousha Bolandzadeh

    Full Text Available Current research suggests that the neuropathology of dementia-including brain changes leading to memory impairment and cognitive decline-is evident years before the onset of this disease. Older adults with cognitive decline have reduced functional independence and quality of life, and are at greater risk for developing dementia. Therefore, identifying biomarkers that can be easily assessed within the clinical setting and predict cognitive decline is important. Early recognition of cognitive decline could promote timely implementation of preventive strategies.We included 89 community-dwelling adults aged 70 years and older in our study, and collected 32 measures of physical function, health status and cognitive function at baseline. We utilized an L1-L2 regularized regression model (elastic net to identify which of the 32 baseline measures were strongly predictive of cognitive function after one year. We built three linear regression models: 1 based on baseline cognitive function, 2 based on variables consistently selected in every cross-validation loop, and 3 a full model based on all the 32 variables. Each of these models was carefully tested with nested cross-validation.Our model with the six variables consistently selected in every cross-validation loop had a mean squared prediction error of 7.47. This number was smaller than that of the full model (115.33 and the model with baseline cognitive function (7.98. Our model explained 47% of the variance in cognitive function after one year.We built a parsimonious model based on a selected set of six physical function and health status measures strongly predictive of cognitive function after one year. In addition to reducing the complexity of the model without changing the model significantly, our model with the top variables improved the mean prediction error and R-squared. These six physical function and health status measures can be easily implemented in a clinical setting.

  3. Clinical assessment tools identify functional deficits in fragility fracture patients

    Directory of Open Access Journals (Sweden)

    Ames TD

    2016-05-01

    Full Text Available Tyler D Ames,1 Corinne E Wee,1 Khoi M Le,1 Tiffany L Wang,1 Julie Y Bishop,2 Laura S Phieffer,2 Carmen E Quatman2 1The Ohio State University College of Medicine, 2Department of Orthopaedics, The Ohio State University Wexner Medical Center, Columbus, OH, USA Purpose: To identify inexpensive, noninvasive, portable, clinical assessment tools that can be used to assess functional performance measures that may put older patients at risk for falls such as balance, handgrip strength, and lumbopelvic control.Patients and methods: Twenty fragility fracture patients and 21 healthy control subjects were evaluated using clinical assessment tools (Nintendo Wii Balance Board [WBB], a handheld dynamometer, and an application for the Apple iPod Touch, the Level Belt that measure functional performance during activity of daily living tasks. The main outcome measurements were balance (WBB, handgrip strength (handheld dynamometer, and lumbopelvic control (iPod Touch Level Belt, which were compared between fragility fracture patients and healthy controls.Results: Fragility fracture patients had lower scores on the vertical component of the WBB Torso Twist task (P=0.042 and greater medial–lateral lumbopelvic sway during a 40 m walk (P=0.026 when compared to healthy controls. Unexpectedly, the fracture patients had significantly higher scores on the left leg (P=0.020 and total components (P=0.010 of the WBB Single Leg Stand task as well as less faults during the left Single Leg Stand task (P=0.003.Conclusion: The clinical assessment tools utilized in this study are relatively inexpensive and portable tools of performance measures capable of detecting differences in postural sway between fragility fracture patients and controls. Keywords: fall risk, geriatric fracture, Nintendo Wii Balance Board, Level Belt, fragility fracture

  4. Natural killer cells: Biology, functions and clinical relevance

    Directory of Open Access Journals (Sweden)

    Vojvodić Svetlana

    2010-01-01

    Full Text Available Introduction. Natural Killer cells (NK cells represent the subset of peripheral lymphocytes that play critical role in the innate immune response to virus-infected and tumor transformed cells. Lysis of NK sensitive target cells could be mediated independently of antigen stimulation and without requirement of peptide presentation by the major histocompatibility complex (MHC molecules. NK cell activity and functions are controlled by a considerable number of cell surface receptors, which exist in both inhibitory and activating isoforms. There are several groups of NK cell surface receptors: 1 killer immunoglobulin like receptors-KIR, 2 C-type lectin receptors,3natural citotoxicity receptors-NCR and 4 Toll-like receptors-TLR. Functions of NK receptors. Defining the biology of NK cell surface receptors has contributed to the concept of the manner how NK cells selectively recognize and lyse tumor and virally infected cells while sparing normal cells. Further, identification of NK receptor ligands and their expression on the normal and transformed cells has led to the development of clinical approaches to manipulating receptor/ligand interactions that showed clinical benefit. NK cells are the first lymphocyte subset that reconstitute the peripheral blood following allogeneic HSCT and multiple roles for alloreactive donor NK cells have been demonstrated, in diminishing Graft vs. Host Disease (GvHD through selective killing recipient dendritic cells, prevention of graft rejection by killing recipient T cells and participation in Graft vs. Leukaemia (GvL effect through destruction of residual host tumor cells. Conclusion. Besides their role in HSCT, NK cell receptors have an important clinical relevance that reflects from the fact that they play a crucial role in the development of some diseases as well as in possibilities of managing all NK receptors through selective expansion and usage of NK cells in cancer immunotherapy.

  5. Functional imaging in oncology. Clinical applications. Vol. 2

    Energy Technology Data Exchange (ETDEWEB)

    Luna, Antonio [Case Western Reserve Univ., Cleveland, OH (United States). Dept. of Radiology; MRI Health Time Group, Jaen (Spain); Vilanova, Joan C. [Girona Univ. (Spain). Clinica Girona - Hospital Sta. Caterina; Hygino da Cruz, L. Celso Jr. (ed.) [CDPI and IRM, Rio de Janeiro (Brazil). Dept. of Radiology; Rossi, Santiago E. [Centro de Diagnostico, Buenos Aires (Argentina)

    2014-06-01

    Easy-to-read manual on new functional imaging techniques in oncology. Explains current clinical applications and outlines future avenues. Includes numerous high-quality illustrations to highlight the major teaching points. In the new era of functional and molecular imaging, both currently available imaging biomarkers and biomarkers under development are expected to lead to major changes in the management of oncological patients. This two-volume book is a practical manual on the various imaging techniques capable of delivering functional information on cancer, including diffusion MRI, perfusion CT and MRI, dual-energy CT, spectroscopy, dynamic contrast-enhanced ultrasonography, PET, and hybrid modalities. This second volume considers the applications and benefits of these techniques in a wide range of tumor types, including their role in diagnosis, prediction of treatment outcome, and early evaluation of treatment response. Each chapter addresses a specific malignancy and is written by one or more acclaimed experts. The lucid text is complemented by numerous high-quality illustrations that highlight key features and major teaching points.

  6. Implicit learning in transient global amnesia and the role of stress

    Directory of Open Access Journals (Sweden)

    Frauke Nees

    2016-11-01

    Full Text Available Transient global amnesia (TGA is a disorder with reversible anterograde disturbance of explicit memory, frequently preceded by an emotionally or physically stressful event. By using magnetic resonance imaging (MRI following an episode of TGA, small hippocampal lesions have been observed. Hence it has been postulated that the disorder is caused by the stress-related transient inhibition of memory formation in the hippocampus. In experimental studies, stress has been shown to affect both explicit and implicit learning – the latter defined as learning and memory processes that lack conscious awareness of the information acquired. To test the hypothesis that impairment of implicit learning in TGA is present and related to stress, we determined the effect of experimental exposure to stress on hippocampal activation patterns during an implicit learning paradigm in patients who suffered a recent TGA and healthy matched control subjects. We used a hippocampus-dependent aversive learning procedure (context conditioning with the phases habituation, acquisition, and extinction during functional MRI following experimental stress exposure (socially evaluated cold pressor test. After a control procedure, controls showed successful learning during the acquisition phase, indicated by increased valence, arousal and contingency ratings to the paired (CON+ versus the non-paired (CON- conditioned stimulus, and successful extinction of the conditioned responses. Following stress, acquisition was still successful, however extinction was impaired with persistently increased contingency ratings. In contrast, TGA patients showed impairment of conditioned responses and insufficient extinction after the control procedure, indicated by a lack of significant differences between CON+ and CON- for valence and arousal ratings after the acquisition phase and by significantly increased contingency ratings after the extinction. After stress, aversive learning was not successful

  7. Implicit Learning in Transient Global Amnesia and the Role of Stress.

    Science.gov (United States)

    Nees, Frauke; Griebe, Martin; Ebert, Anne; Ruttorf, Michaela; Gerber, Benjamin; Wolf, Oliver T; Schad, Lothar R; Gass, Achim; Szabo, Kristina

    2016-01-01

    Transient global amnesia (TGA) is a disorder with reversible anterograde disturbance of explicit memory, frequently preceded by an emotionally or physically stressful event. By using magnetic resonance imaging (MRI) following an episode of TGA, small hippocampal lesions have been observed. Hence it has been postulated that the disorder is caused by the stress-related transient inhibition of memory formation in the hippocampus. In experimental studies, stress has been shown to affect both explicit and implicit learning-the latter defined as learning and memory processes that lack conscious awareness of the information acquired. To test the hypothesis that impairment of implicit learning in TGA is present and related to stress, we determined the effect of experimental exposure to stress on hippocampal activation patterns during an implicit learning paradigm in patients who suffered a recent TGA and healthy matched control subjects. We used a hippocampus-dependent aversive learning procedure (context conditioning with the phases habituation, acquisition, and extinction) during functional MRI following experimental stress exposure (socially evaluated cold pressor test). After a control procedure, controls showed successful learning during the acquisition phase, indicated by increased valence, arousal and contingency ratings to the paired (CON+) vs. the non-paired (CON-) conditioned stimulus, and successful extinction of the conditioned responses. Following stress, acquisition was still successful, however extinction was impaired with persistently increased contingency ratings. In contrast, TGA patients showed impairment of conditioned responses and insufficient extinction after the control procedure, indicated by a lack of significant differences between CON+ and CON- for valence and arousal ratings after the acquisition phase and by significantly increased contingency ratings after the extinction. After stress, aversive learning was not successful with non

  8. Documentation of functional and clinical effects of infant nutrition

    DEFF Research Database (Denmark)

    Koletzko, Berthold; Szajewska, Hania; Ashwell, Margaret

    2012-01-01

    The Early Nutrition Academy and the Child Health Foundation, in collaboration with the Committee on Nutrition, European Society for Paediatric Gastroenterology, Hepatology and Nutrition, held a workshop in March 2011 to explore guidance on acquiring evidence on the effects of nutritional interven...... interventions in infants and young children. The four objectives were to (1) provide guidance on the quality and quantity of evidence needed to justify conclusions on functional and clinical effects of nutrition in infants and young children aged......The Early Nutrition Academy and the Child Health Foundation, in collaboration with the Committee on Nutrition, European Society for Paediatric Gastroenterology, Hepatology and Nutrition, held a workshop in March 2011 to explore guidance on acquiring evidence on the effects of nutritional...

  9. Clinical and functional characterization of URAT1 variants.

    Directory of Open Access Journals (Sweden)

    Velibor Tasic

    Full Text Available Idiopathic renal hypouricaemia is an inherited form of hypouricaemia, associated with abnormal renal handling of uric acid. There is excessive urinary wasting of uric acid resulting in hypouricaemia. Patients may be asymptomatic, but the persistent urinary abnormalities may manifest as renal stone disease, and hypouricaemia may manifest as exercise induced acute kidney injury. Here we have identified Macedonian and British patients with hypouricaemia, who presented with a variety of renal symptoms and signs including renal stone disease, hematuria, pyelonephritis and nephrocalcinosis. We have identified heterozygous missense mutations in SLC22A12 encoding the urate transporter protein URAT1 and correlate these genetic findings with functional characterization. Urate handling was determined using uptake experiments in HEK293 cells. This data highlights the importance of the URAT1 renal urate transporter in determining serum urate concentrations and the clinical phenotypes, including nephrolithiasis, that should prompt the clinician to suspect an inherited form of renal hypouricaemia.

  10. Novel Findings into AIRE Genetics and Functioning: Clinical Implications.

    Science.gov (United States)

    De Martino, Lucia; Capalbo, Donatella; Improda, Nicola; Lorello, Paola; Ungaro, Carla; Di Mase, Raffaella; Cirillo, Emilia; Pignata, Claudio; Salerno, Mariacarolina

    2016-01-01

    Autoimmune polyendocrinopathy candidiasis ectodermal dystrophy (APECED), formerly known as autoimmune polyendocrine syndrome type 1, is a paradigm of a monogenic autoimmune disease caused by mutations of a gene, named autoimmune regulator (AIRE). AIRE acts as a transcription regulator that promotes immunological central tolerance by inducing the ectopic thymic expression of many tissue-specific antigens. Although the syndrome is a monogenic disease, it is characterized by a wide variability of the clinical expression with no significant correlation between genotype and phenotype. Indeed, many aspects regarding the exact role of AIRE and APECED pathogenesis still remain unraveled. In the last decades, several studies in APECED and in its mouse experimental counterpart have revealed new insights on how immune system learns self-tolerance. Moreover, novel interesting findings have extended our understanding of AIRE's function and regulation thus improving our knowledge on the pathogenesis of APECED. In this review, we will summarize recent novelties on molecular mechanisms underlying the development of APECED and their clinical implications.

  11. Long-term outcome in transient global amnesia patients with and without focal hyperintensities in the CA1 region of the hippocampus.

    Science.gov (United States)

    Uttner, Ingo; Prexl, Sascha; Freund, Wolfgang; Unrath, Alexander; Bengel, Dietmar; Huber, Roman

    2012-01-01

    Focal hippocampal diffusion-weighted imaging (DWI) lesion patterns are detected in transient global amnesia (TGA) patients in different frequency. It has been speculated that acute diffusion restrictions are associated with a worse outcome. Therefore, we evaluated the influence of acute DWI lesions on the cognitive long-term outcome in TGA patients. Seventeen otherwise healthy patients with the clinical syndrome of TGA, who had MRI investigations on admission as well as 1 day later, were investigated with a comprehensive neuropsychological test battery 2 years later. Acute hippocampal DWI lesions in TGA patients were detected in almost two thirds of the patients. Psychometric evaluation revealed no differences in cognitive performance between patients with and without DWI lesions as well as compared to healthy subjects. In addition, no relapse of the attack has been recognized in either group of TGA patients.

  12. Nebivolol: impact on cardiac and endothelial function and clinical utility

    Directory of Open Access Journals (Sweden)

    Toblli JE

    2012-03-01

    Full Text Available Jorge Eduardo Toblli1, Federico DiGennaro1, Jorge Fernando Giani2, Fernando Pablo Dominici21Hospital Aleman, 2Instituto de Química y Fisicoquímica Biológicas (IQUIFIB, Facultad de Farmacia y Bioquímica, Facultad de Medicina, Universidad de Buenos Aires, Buenos Aires, ArgentinaAbstract: Endothelial dysfunction is a systemic pathological state of the endothelium characterized by a reduction in the bioavailability of vasodilators, essentially nitric oxide, leading to impaired endothelium-dependent vasodilation, as well as disarrangement in vascular wall metabolism and function. One of the key factors in endothelial dysfunction is overproduction of reactive oxygen species which participate in the development of hypertension, atherosclerosis, diabetes, cardiac hypertrophy, heart failure, ischemia-reperfusion injury, and stroke. Because impaired endothelial activity is believed to have a major causal role in the pathophysiology of vascular disease, hypertension, and heart failure, therapeutic agents which modify this condition are of clinical interest. Nebivolol is a third-generation β-blocker with high selectivity for β1-adrenergic receptors and causes vasodilation by interaction with the endothelial L-arginine/nitric oxide pathway. This dual mechanism of action underscores several hemodynamic qualities of nebivolol, which include reductions in heart rate and blood pressure and improvements in systolic and diastolic function. Although nebivolol reduces blood pressure to a degree similar to that of conventional β-blockers and other types of antihypertensive drugs, it may have advantages in populations with difficult-to-treat hypertension, such as patients with heart failure along with other comorbidities, like diabetes and obesity, and elderly patients in whom nitric oxide-mediated endothelial dysfunction may be more pronounced. Furthermore, recent data indicate that nebivolol appears to be a cost-effective treatment for elderly patients with

  13. Numerical simulations of clinical focused ultrasound functional neurosurgery

    Science.gov (United States)

    Pulkkinen, Aki; Werner, Beat; Martin, Ernst; Hynynen, Kullervo

    2014-04-01

    A computational model utilizing grid and finite difference methods were developed to simulate focused ultrasound functional neurosurgery interventions. The model couples the propagation of ultrasound in fluids (soft tissues) and solids (skull) with acoustic and visco-elastic wave equations. The computational model was applied to simulate clinical focused ultrasound functional neurosurgery treatments performed in patients suffering from therapy resistant chronic neuropathic pain. Datasets of five patients were used to derive the treatment geometry. Eight sonications performed in the treatments were then simulated with the developed model. Computations were performed by driving the simulated phased array ultrasound transducer with the acoustic parameters used in the treatments. Resulting focal temperatures and size of the thermal foci were compared quantitatively, in addition to qualitative inspection of the simulated pressure and temperature fields. This study found that the computational model and the simulation parameters predicted an average of 24 ± 13% lower focal temperature elevations than observed in the treatments. The size of the simulated thermal focus was found to be 40 ± 13% smaller in the anterior-posterior direction and 22 ± 14% smaller in the inferior-superior direction than in the treatments. The location of the simulated thermal focus was off from the prescribed target by 0.3 ± 0.1 mm, while the peak focal temperature elevation observed in the measurements was off by 1.6 ± 0.6 mm. Although the results of the simulations suggest that there could be some inaccuracies in either the tissue parameters used, or in the simulation methods, the simulations were able to predict the focal spot locations and temperature elevations adequately for initial treatment planning performed to assess, for example, the feasibility of sonication. The accuracy of the simulations could be improved if more precise ultrasound tissue properties (especially of the

  14. Cytochrome P450 structure, function and clinical significance: A review.

    Science.gov (United States)

    Palrasu, Manikandan; Nagini, Siddavaram

    2017-01-25

    The cytochrome P450 (CYP) enzymes are membrane-bound hemoproteins that play a pivotal role in the detoxification of xenobiotics, cellular metabolism and homeostasis. Induction or inhibition of CYP enzymes is a major mechanism that underlies drug-drug interactions. CYP enzymes can be transcriptionally activated by various xenobiotics and endogenous substrates through receptor-dependent mechanisms. CYP enzyme inhibition is a principal mechanism for metabolism-based drug-drug interactions. Many chemotherapeutic drugs can cause drug interactions due to their ability to either inhibit or induce the CYP enzyme system. Predictions based on in silico analyses followed by validation have identified several microRNAs that regulate CYPs. Genetic polymorphisms and epigenetic changes in CYP genes may be responsible for inter-individual and inter-ethnic variations in disease susceptibility and the therapeutic efficacy of drugs. Knowledge about the substrates, inducers, inhibitors of CYP isoforms, and the polymorphisms of CYP enzymes may be used as an aid by clinicians to determine therapeutic strategy, and treatment doses for drugs that are metabolized by CYP gene products. The present review is a comprehensive compilation of cytochrome P450 structure, function, pharmacogenetics, and pharmacoepigenetics and clinical significance.

  15. Transient Global Amnesia After Cerebral Angiography With Iomeprol: A Case Report.

    Science.gov (United States)

    Tiu, Cristina; Terecoasă, Elena Oana; Grecu, Nicolae; Dorobăţ, Bogdan; Marinescu, Andreea Nicoleta; Băjenaru, Ovidiu Alexandru

    2016-05-01

    Transient global amnesia is now considered a very rare complication of cerebral angiography. Various etiological mechanisms have been suggested to account for this complication, but no consensus has been reached yet. This case report documents one of the few reported cases of cerebral angiography-related transient global amnesia associated with magnetic resonance imaging (MRI) evidence of unilateral hippocampal ischemia, most probably as a consequence of a transient reduction in regional hippocampal blood flow. However, the possibility of a direct neurotoxic effect of the nonionic contrast media Iomeprol on the Cornu ammonis - field 1 neurons cannot be firmly ruled out.We describe the case of a 54-year-old woman admitted to our department for left upper limb weakness with acute onset 8 days before. The brain computed tomography (CT) scan performed at admission revealed subacute ischemic lesions in the right watershed superficial territories and a right thalamic lacunar infarct. Diagnostic digital subtraction cerebral angiography was performed 4 days after admission with the nonionic contrast media Iomeprol. A few minutes after completion of the procedure, the patient developed symptoms suggestive for transient global amnesia. The brain MRI performed 22 hours after the onset of symptoms demonstrated increased signal within the lateral part of the right hippocampus on the diffusion-weighted imaging (DWI) sequences, associated with a corresponding reduction in the apparent diffusion coefficient (ADC) and increased signal on the fluid-attenuated inversion recovery (FLAIR) sequences, consistent with acute hippocampal ischemia and several T2/FLAIR hyperintensities in the right watershed superficial territories and in the right thalamus, corresponding to the lesions already identified on the CT scan performed at admission. A follow-up MRI, performed 2 months later, demonstrated the disappearance of the increased signal within the right hippocampus on the DWI, T2/FLAIR

  16. ‘Becoming Mozambicanised’: Nostalgic amnesia among Zimbabweans adapting to ‘disorder’ in Mozambique

    DEFF Research Database (Denmark)

    Hammar, Amanda

    2017-01-01

    This article explores the ways in which displaced Zimbabweans who migrated to Mozambique’s Manica Province in the 2000s in the wake of political and economic crisis, constructed a largely unreflective discursive dichotomy between remembered ‘order’ in Zimbabwe and perceived ‘disorder’ in Mozambique......-simplifications and stereotypes. It suggests that rememberings and representations of an ‘ordered’ past in Zimbabwe set in contrast to a ‘disordered’ Mozambique, are part of a nostalgic amnesia that assists these ambivalent migrants to deal with (or deny) their displacement and losses, and helps them adapt to the new and strange...

  17. The clinical suitability of laparoscopic instrumentation. A prospective clinical study of function and hygiene.

    Science.gov (United States)

    Fengler, T W; Pahlke, H; Bisson, S; Kraas, E

    2000-04-01

    On the basis of experience gained from 6,000 laparoscopies (73% cholecystectomies) at the Moabit Hospital in Berlin, we carried out a cohort study to analyze the failure rate and decontamination of labeled "tracer" instruments processed in three test trays that were each subjected to 100 cycles. The majority of repairs focused on the functional parts of separable scissors and damaged or lost components. At 4%, the repair index after laparascopic use was less than that of a previously documented investigation period covering 1990 to 1996. A comparison of the costs of disposable and reusable instruments showed that reusable instruments were more cost-effective by a factor of > or =10, indicating that the price gap reported in our previous calculation for 1992 and 1994 has closed only slightly. After 100 cycles, we found traces of proteinaceous material in the eluate on every fourth instrument inspected (eight of 32); half of them (four) gave a positive reading when tested with a hemoglobin pseudoperoxidase test stick. It must be said, however, that similar residual contamination has been found on instruments used in conventional open surgery, with no indication of clinical relevance. This study was designed to examine the clinical suitability of laparoscopic instruments in terms of function and hygiene. Improvements in instrument design and cleanability must focus in particular on the reproducibility of cleaning results, because cleaning is the most important step in processing sterile supplies. As the number of minimally invasive operations has risen considerably, a mere visual check no longer meets the requirements prescribed by modern quality assurance. A multicenter study of residual proteins found on tracer instruments in all surgical fields is now in progress.

  18. Walking function in clinical monitoring of multiple sclerosis by telemedicine.

    Science.gov (United States)

    Sola-Valls, Núria; Blanco, Yolanda; Sepúlveda, Maria; Llufriu, Sara; Martínez-Lapiscina, Elena H; La Puma, Delon; Graus, Francesc; Villoslada, Pablo; Saiz, Albert

    2015-07-01

    Walking limitation is a key component of disability in patients with multiple sclerosis (MS), but the information on daily walking activity and disability over time is limited. To determine, (1) the agreement between the standard measurements of MS-related disability [expanded disability status scale (EDSS), functional systems (FS) and ambulation index (AI)] obtained by conventional and remote evaluation using a multimedia platform; (2) the usefulness of monitoring 6-min walk test (6MWT) and average daily walking activity (aDWA) to better characterize patients disability. Twenty-five patients (EDSS score 1.0-6.5) were evaluated every 3 months for the first year, and aDWA repeated at year 2. Remote visits included the recording of a video with self-performed neurological examination and specific multimedia questionnaires. aDWA was measured by a triaxial accelerometer. All but two patients completed the study. Modest agreement between conventional and multimedia EDSS was found for EDSS ≤ 4.0 (kappa = 0.2) and good for EDSS ≥ 4.5 (kappa = 0.6). For the overall sample, pyramidal, cerebellar and brainstem FS showed the greatest agreement (kappa = 0.7). SR-AI showed a modest agreement for EDSS ≤ 4.0 and good for EDSS ≥ 4.5 (kappa = 0.3 and 0.6, respectively). There was a strong correlation between conventional and 6MWT measured by accelerometer (r = 0.76). The aDWA correlated strongly with the EDSS (r = -0.86) and a cut-off point of 3279.3 steps/day discriminated patients with ambulatory impairment. There was a significant decline in aDWA over 2 years in patients with ambulatory impairment that were not observed by standard measurements of disability. MS clinical monitoring by telemedicine is feasible, but the observed lower agreement in less disabled patients emphasizes the need to optimize the assessment methodology. Accelerometers capture changes that may indicate deterioration over time.

  19. Effect of propofol on the medial temporal lobe emotional memory system: a functional magnetic resonance imaging study in human subjects

    Science.gov (United States)

    Pryor, K. O.; Root, J. C.; Mehta, M.; Stern, E.; Pan, H.; Veselis, R. A.; Silbersweig, D. A.

    2015-01-01

    Background Subclinical doses of propofol produce anterograde amnesia, characterized by an early failure of memory consolidation. It is unknown how propofol affects the amygdala-dependent emotional memory system, which modulates consolidation in the hippocampus in response to emotional arousal and neurohumoral stress. We present an event-related functional magnetic resonance imaging study of the effects of propofol on the emotional memory system in human subjects. Methods Thirty-five healthy subjects were randomized to receive propofol, at an estimated brain concentration of 0.90 μg ml−1, or placebo. During drug infusion, emotionally arousing and neutral images were presented in a continuous recognition task, while blood-oxygen-level-dependent activation responses were acquired. After a drug-free interval of 2 h, subsequent memory for successfully encoded items was assessed. Imaging analysis was performed using statistical parametric mapping and behavioural analysis using signal detection models. Results Propofol had no effect on the stereotypical amygdalar response to emotional arousal, but caused marked suppression of the hippocampal response. Propofol caused memory performance to become uncoupled from amygdalar activation, but it remained correlated with activation in the posterior hippocampus, which decreased in proportion to amnesia. Conclusions Propofol is relatively ineffective at suppressing amygdalar activation at sedative doses, but abolishes emotional modulation and causes amnesia via mechanisms that commonly involve hyporesponsiveness of the hippocampus. These findings raise the possibility that amygdala-dependent fear systems may remain intact even when a patient has diminished memory of events. This may be of clinical importance in the perioperative development of fear-based psychopathologies, such as post-traumatic stress disorder. Clinical trial registration NCT00504894. PMID:26174294

  20. The disruptive effects of processing fluency on familiarity-based recognition in amnesia.

    Science.gov (United States)

    Ozubko, Jason D; Yonelinas, Andrew P

    2014-02-01

    Amnesia leads to a deficit in recollection that leaves familiarity-based recognition relatively spared. Familiarity is thought to be based on the fluent processing of studied items compared to novel items. However, whether amnesic patients respond normally to direct manipulations of processing fluency is not yet known. In the current study, we manipulated processing fluency by preceding each test item with a semantically related or unrelated prime item, and measured both recollection and familiarity using a remember-know recognition procedure. In healthy controls, enhancing processing fluency increased familiarity-based recognition responses for both old and new words, leaving familiarity-based accuracy constant. However, in patients with MTL damage, enhancing fluency only increased familiarity-based recognition responses for new items, resulting in decreased familiarity-based recognition accuracy. Importantly, this fluency-related decrease in recognition accuracy was not due to overall lower levels of performance or impaired recollection of studied items because it was not observed in healthy subjects that studied words under conditions that lowered performance by reducing recollection. The results indicate that direct manipulations of processing fluency can disrupt familiarity-based discrimination in amnesia. Potential accounts of these findings are discussed.

  1. Amnesia of inhibitory avoidance by scopolamine is overcome by previous open-field exposure

    Science.gov (United States)

    Colettis, Natalia C.; Snitcofsky, Marina; Kornisiuk, Edgar E.; Gonzalez, Emilio N.; Quillfeldt, Jorge A.

    2014-01-01

    The muscarinic cholinergic receptor (MAChR) blockade with scopolamine either extended or restricted to the hippocampus, before or after training in inhibitory avoidance (IA) caused anterograde or retrograde amnesia, respectively, in the rat, because there was no long-term memory (LTM) expression. Adult Wistar rats previously exposed to one or two open-field (OF) sessions of 3 min each (habituated), behaved as control animals after a weak though over-threshold training in IA. However, after OF exposure, IA LTM was formed and expressed in spite of an extensive or restricted to the hippocampus MAChR blockade. It was reported that during and after OF exposure and reexposure there was an increase in both hippocampal and cortical ACh release that would contribute to “prime the substrate,” e.g., by lowering the synaptic threshold for plasticity, leading to LTM consolidation. In the frame of the “synaptic tagging and capture” hypothesis, plasticity-related proteins synthesized during/after the previous OF could facilitate synaptic plasticity for IA in the same structure. However, IA anterograde amnesia by hippocampal protein synthesis inhibition with anisomycin was also prevented by two OF exposures, strongly suggesting that there would be alternative interpretations for the role of protein synthesis in memory formation and that another structure could also be involved in this “OF effect.” PMID:25322799

  2. Trachyspermum ammi Seeds Supplementation Helps Reverse Scopolamine, Alprazolam and Electroshock Induced Amnesia.

    Science.gov (United States)

    Soni, Kapil; Parle, Milind

    2017-01-17

    The present study was designed to explore the beneficial effects of successive 10 days administration of Trachyspermum ammi seed's powder (TASP) along with diet (at the dose of 0.5%, 1.0% and 2.0% w/w) on learning and memory of mice. A total of 306 mice divided in 51 equal groups were employed in the study. Passive avoidance paradigm (PAP) and Object recognition Task (ORT) were employed as exteroceptive models. The brain acetylcholinesterase activity (AChE), serum cholesterol, brain monoaldehyde (MDA), brain reduced glutathione (GSH) and brain nitrite were estimated and Alprazolam, Scopolamine and Electroshock induced amnesia was employed to describe the actions. Treatment of TASP significantly increased step down latency of PAA and significantly increased discrimination index of ORT in groups with or without amnesia when compared to respective control groups. Furthermore, TASP administration resulted in significant fall in brain AChE activity, brain MDA level and brain nitrite level with simultaneous rise in brain GSH level, thereby decreased oxidative damage. A significant decrease in serum cholesterol was also observed. Ajowan supplementation may prove a remedy for the management of cognitive disorders owing to have pro-cholinergic, antioxidant and hypo-lipidemic activities.

  3. Memory decay and susceptibility to amnesia dissociate punishment--from relief-learning.

    Science.gov (United States)

    Diegelmann, Sören; Preuschoff, Stephan; Appel, Mirjam; Niewalda, Thomas; Gerber, Bertram; Yarali, Ayse

    2013-08-23

    Painful events shape future behaviour in two ways: stimuli associated with pain onset subsequently support learned avoidance (i.e. punishment-learning) because they signal future, upcoming pain. Stimuli associated with pain offset in turn signal relief and later on support learned approach (i.e. relief-learning). The relative strengths of such punishment- and relief-learning can be crucial for the adaptive organization of behaviour in the aftermath of painful events. Using Drosophila, we compare punishment- and relief-memories in terms of their temporal decay and sensitivity to retrograde amnesia. During the first 75 min following training, relief-memory is stable, whereas punishment-memory decays to half of the initial score. By 24 h after training, however, relief-memory is lost, whereas a third of punishment-memory scores still remain. In accordance with such rapid temporal decay from 75 min on, retrograde amnesia erases relief-memory but leaves a half of punishment-memory scores intact. These findings suggest differential mechanistic bases for punishment- and relief-memory, thus offering possibilities for separately interfering with either of them.

  4. Memory decay and susceptibility to amnesia dissociate punishment- from relief-learning

    Science.gov (United States)

    Diegelmann, Sören; Preuschoff, Stephan; Appel, Mirjam; Niewalda, Thomas; Gerber, Bertram; Yarali, Ayse

    2013-01-01

    Painful events shape future behaviour in two ways: stimuli associated with pain onset subsequently support learned avoidance (i.e. punishment-learning) because they signal future, upcoming pain. Stimuli associated with pain offset in turn signal relief and later on support learned approach (i.e. relief-learning). The relative strengths of such punishment- and relief-learning can be crucial for the adaptive organization of behaviour in the aftermath of painful events. Using Drosophila, we compare punishment- and relief-memories in terms of their temporal decay and sensitivity to retrograde amnesia. During the first 75 min following training, relief-memory is stable, whereas punishment-memory decays to half of the initial score. By 24 h after training, however, relief-memory is lost, whereas a third of punishment-memory scores still remain. In accordance with such rapid temporal decay from 75 min on, retrograde amnesia erases relief-memory but leaves a half of punishment-memory scores intact. These findings suggest differential mechanistic bases for punishment- and relief-memory, thus offering possibilities for separately interfering with either of them. PMID:23658002

  5. The characteristics and clinical manifestation of subjects with non-specific pattern of pulmonary function tests

    Institute of Scientific and Technical Information of China (English)

    周德训

    2014-01-01

    Objective To analyze the characteristics of pulmonary function and the clinical significance of non-specific pattern(NSP).Methods A total of 1 933 pulmonary function tests of adult patients were analyzed,and those with NSP were selected.The pulmonary function test results,clinical diagnosis and radiological manifestations were

  6. Amnesiacs might get the gist: reduced false recognition in amnesia may be the result of impaired item-specific memory.

    Science.gov (United States)

    Nissan, Jack; Abrahams, Sharon; Sala, Sergio Della

    2013-01-01

    It is a common finding in tests of false recognition that amnesic patients recognize fewer related lures than healthy controls, and this has led to assumptions that gist memory is damaged in these patients (Schacter, Verfaellie, & Anes, 1997, Neuropsychology, 11; Schacter, Verfaellie, Anes, & Racine, 1998, Journal of Cognitive Neuroscience, 10; Schacter, Verfaellie, & Pradere, 1996, Journal of Memory and Language, 35). However, clinical observations find that amnesic patients typically hold meaningful conversations and make relevant remarks, and there is some experimental evidence highlighting preserved immediate recall of prose (Baddeley & Wilson, 2002, Neuropsychologia, 40; Gooding, Isaac, & Mayes, 2005, Neuropsychologia, 43; Rosenbaum, Gilboa, Levine, Winocur, & Moscovitch, 2009, Neuropsychologia, 47), which suggests that amnesiacs can get the gist. The present experiment used false recognition paradigms to assess whether the reduced rate of false recognition found in amnesic patients may be a consequence of their impaired item-specific memory. It examined the effect of increasing the item-specific memory of amnesic patient DA by bringing her to criterion on relevant study-lists and compared her performance on a false recognition paradigm with a group of 32 healthy young adults. Results indicated that when DA's item-specific memory was increased she was more able to gist and her performance was no different to the healthy young adults. Previous assumptions that gist memory is necessarily damaged in amnesia might therefore be revisited, since the reduced rate of false recognition could be caused by impaired item-specific memory. The experiment also highlights a positive relationship between item-specific and gist memory which has not previously been accounted for in false-recognition experiments.

  7. Conditional discrimination and reversal in amnesia subsequent to hypoxic brain injury or anterior communicating artery aneurysm rupture

    Science.gov (United States)

    Myers, C.E.; DeLuca, J.; Hopkins, R.O.; Gluck, M.A.

    2007-01-01

    Human anterograde amnesia can develop following bilateral damage to the hippocampus and medial temporal lobes, as in hypoxic brain injury, or following damage to the basal forebrain, as following anterior communicating artery (ACoA) aneurysm rupture. In both cases, the mnestic deficit may be similar when assessed by standard neuropsychological measures. However, animal and computational models suggest that there are qualitative differences in the pattern of impaired and spared memory abilities following damage to hippocampus versus basal forebrain. Here, we show such a dissociation in human amnesia using a single two-stage task, involving conditional discrimination and reversal. Consistent with a prior study, 10 individuals with anterograde amnesia subsequent to hypoxic brain injury were spared on acquisition but impaired at reversal. However, 10 individuals with amnesia subsequent to ACoA aneurysm showed the opposite pattern of impaired acquisition but spared reversal. The differences between groups cannot be easily ascribed to severity of mnestic or cognitive deficit, since the two amnesic groups performed similarly on neuropsychological tests of memory, intelligence and attention. The results illustrate qualitative differences in memory impairments in hypoxic and ACoA amnesics and highlight the importance of considering etiology in evaluating mnemonic deficits in amnesic populations. PMID:15885718

  8. Can postictal suppression of the perforant path - fascia dentata responses account for the ECS-induced anterograde amnesia in rats?

    Science.gov (United States)

    Peréz-Saad, H; Valousková, V; Bures, J

    1984-07-15

    Electroconvulsive shock (ECS) decreases fascia dentata responses to entorhinal stimulation by 50% in unanesthetized rats. Synaptic potentials and population spikes return to pre-ECS level during 1 h and 3 h, respectively. This recovery rate is compared with the dynamics of ECS-induced anterograde amnesia.

  9. Cognitive deficits and social functioning in schizophrenia : A clinical perspective

    NARCIS (Netherlands)

    van Beilen, Marije; Kiers, Henk A.L.; Bouma, A; van Zomeren, Ed H.; Withaar, Frederiec; Arends, J; van den Bosch, RJ

    2003-01-01

    Impaired social functioning is one of the diagnostic features of schizophrenia. Cognitive functioning is also often impaired in several domains. Meta-analysis has shown a predictive value of cognition for a variety of domains related to social functioning (Green, Kern, Braff, & Mintz, 2000). The sig

  10. Building sustainable multi-functional prospective electronic clinical data systems.

    Science.gov (United States)

    Randhawa, Gurvaneet S; Slutsky, Jean R

    2012-07-01

    A better alignment in the goals of the biomedical research enterprise and the health care delivery system can help fill the large gaps in our knowledge of the impact of clinical interventions on patient outcomes in the real world. There are several initiatives underway to align the research priorities of patients, providers, researchers, and policy makers. These include Agency for Healthcare Research and Quality (AHRQ)-supported projects to build flexible prospective clinical electronic data infrastructure that meet the needs of these diverse users. AHRQ has previously supported the creation of 2 distributed research networks as a new approach to conduct comparative effectiveness research (CER) while protecting a patient's confidential information and the proprietary needs of a clinical organization. It has applied its experience in building these networks in directing the American Recovery and Reinvestment Act funds for CER to support new clinical electronic infrastructure projects that can be used for several purposes including CER, quality improvement, clinical decision support, and disease surveillance. In addition, AHRQ has funded a new Electronic Data Methods forum to advance the methods in clinical informatics, research analytics, and governance by actively engaging investigators from the American Recovery and Reinvestment Act-funded projects and external stakeholders.

  11. A functional and clinical reinterpretation of human perineal neuromuscular anatomy: Application to sexual function and continence.

    Science.gov (United States)

    Plochocki, Jeffrey H; Rodriguez-Sosa, Jose R; Adrian, Brent; Ruiz, Saul A; Hall, Margaret I

    2016-11-01

    Modern anatomical and surgical references illustrate perineal muscles all innervated by branches of the pudendal nerve but still organized into anatomically distinct urogenital and anal triangles with muscles inserting onto a central perineal body. However, these conflict with the anatomy commonly encountered during dissection. We used dissections of 43 human cadavers to characterize the anatomical organization of the human perineum and compare our findings to standard references. We found bulbospongiosus and the superficial portion of the external anal sphincter (EAS) were continuous anatomically with a common innervation in 92.3% of specimens. The superficial transverse perineal muscle inserted anterior and lateral to the midline, interdigitating with bulbospongiosus. The three EAS subdivisions were anatomically discontinuous. Additionally, in 89.2% of our sample the inferior rectal nerve emerged as a branch of S3 and S4 distinct from the pudendal nerve and innervated only the subcutaneous EAS. Branches of the perineal nerve innervated bulbospongiosus and the superficial EAS and nerve to levator ani innervated the deep EAS. In conclusion, we empirically demonstrate important and clinically relevant differences with perineal anatomy commonly described in standard texts. First, independent innervation to the three portions of EAS suggests the potential for functional independence. Second, neuromuscular continuity between bulbospongiosus and superficial EAS suggests the possibility of shared or overlapping function of the urogenital and anal triangles. Clin. Anat. 29:1053-1058, 2016. © 2016 Wiley Periodicals, Inc.

  12. Activation of cannabinoid CB1 receptors in the ventral hippocampus improved stress-induced amnesia in rat.

    Science.gov (United States)

    Mohammadmirzaei, Negin; Rezayof, Ameneh; Ghasemzadeh, Zahra

    2016-09-01

    The ventral hippocampus (VH) has a high distribution of cannabinoid CB1 receptors which are important in modulating stress responses. Stress exposure activates the hypothalamic-pituitary-adrenal axis (HPA) which can impact hippocampal formation to change hippocampus-based memories. The purpose of the present study was to determine the possible role of the VH cannabinoid CB1 receptors in stress-induced amnesia using a step-through passive avoidance procedure in male Wistar rats. In order to induce acute stress, the animals were placed on an elevated platform for different time periods (10, 20 and 30min). Our results indicated that post-training 20 and 30min exposure to stress, but not 10min, induced amnesia. Post-training microinjection of a cannabinoid CB1 receptor agonist, arachydonilcyclopropylamide (ACPA; 2.5-7.5ng/rat) into the VH (intra-VH) induced amnesia. Interestingly, post-training intra-VH microinjection of the same doses of ACPA improved stress-induced amnesia. On the other hand, post-training intra-VH microinjection of a selective CB1 receptor antagonist, AM-251 (20-50ng/rat) with exposure to an ineffective stress (10min) potentiated the effect of stress on memory consolidation and induced amnesia. It should be noted that post-training intra-VH microinjection of the same doses of AM-251 alone had no effect on memory consolidation. Our results revealed that post-training intra-VH microinjection of AM-251, prior to ACPA microinjection, inhibited the reversal effect of ACPA on acute elevated platform stress. Taken together, it can be concluded that exposure to post-training inescapable stress impaired memory consolidation. The impairing effects of stress on memory retrieval may be mediated by the VH cannabinoid CB1 receptors.

  13. SU-C-BRA-06: Developing Clinical and Quantitative Guidelines for a 4DCT-Ventilation Functional Avoidance Clinical Trial

    Energy Technology Data Exchange (ETDEWEB)

    Vinogradskiy, Y; Waxweiler, T; Diot, Q; Kavanagh, B; Schubert, L; Miften, M [University of Colorado Denver, Aurora, CO (United States); Castillo, R [University of Texas Medical Branch of Galveston, Pearland, TX (United States); Guerrero, T; Castillo, E [Beaumont Health System, Royal Oak, MI (United States)

    2015-06-15

    Purpose: 4DCT-ventilation is an exciting new imaging modality that uses 4DCTs to calculate lung ventilation. Because 4DCTs are acquired as part of routine care, calculating 4DCT-ventilation allows for lung function evaluation without additional cost or inconvenience to the patient. Development of a clinical trial is underway at our institution to use 4DCT-ventilation for thoracic functional avoidance with the idea that preferential sparing of functional lung regions can decrease pulmonary toxicity. The purpose of our work was to develop the practical aspects of a 4DCT-ventilation functional avoidance clinical trial including: 1.assessing patient eligibility 2.developing trial inclusion criteria and 3.developing treatment planning and dose-function evaluation strategies. Methods: 96 stage III lung cancer patients from 2 institutions were retrospectively reviewed. 4DCT-ventilation maps were calculated using the patient’s 4DCTs, deformable image registrations, and a density-change-based algorithm. To assess patient eligibility and develop trial inclusion criteria we used an observer-based binary end point noting the presence or absence of a ventilation defect and developed an algorithm based on the percent ventilation in each lung third. Functional avoidance planning integrating 4DCT-ventilation was performed using rapid-arc and compared to the patient’s clinically used plan. Results: Investigator-determined clinical ventilation defects were present in 69% of patients. Our regional/lung-thirds ventilation algorithm identified that 59% of patients have lung functional profiles suitable for functional avoidance. Compared to the clinical plan, functional avoidance planning was able to reduce the mean dose to functional lung by 2 Gy while delivering comparable target coverage and cord/heart doses. Conclusions: 4DCT-ventilation functional avoidance clinical trials have great potential to reduce toxicity, and our data suggest that 59% of lung cancer patients have lung

  14. Midazolam sedation to produce complete amnesia for bronchoscopy: 2 years' experience at a district general hospital.

    Science.gov (United States)

    Williams, T J; Bowie, P E

    1999-05-01

    Patients may find bronchoscopy without sedation unpleasant. There is some evidence that patient satisfaction correlates with amnesia for the procedure. For several years we have used doses of midazolam sufficient to put patients lightly asleep hoping to produce complete amnesia. We looked at practical aspects of this technique over a 2-year period. We studied 337 consecutive patients. They were 219 men and 118 women of mean age 63 +/- 12.4 (SD). Sixty-seven patients were aged 75 years or over and the eldest was 86. Sixty-three patients were already hospital inpatients but the remainder were seen as day cases. Midazolam was given by slow i.v. injection over several minutes until the patient was judged to be lightly asleep. Patients were given supplemental oxygen (3 l min-1) and monitored by ECG and pulse oximetry. A note was made of the time at which they awakened, defined as when nursing staff felt the patients were awake enough to have a cup of tea and toast. Patients were asked if they had any memory of the procedure both on awakening and when seen a few days later to discuss the results. The procedures were carried out in a well-staffed Day Case Unit with a recovery area. The mean dose of midazolam used was 10.8 mg (mean +/- SD = 0.16 +/- 0.095 mg kg-1). The midazolam was given over a median of 4 min (range 1-15 min). Patients took 59 +/- 45 min (mean +/- SD) to wake up. Twenty-eight patients were given flumazanil to reverse the sedation (11 for concern over bleeding following biopsies, three for desaturation during and three after procedure, four as they were frail, two as they were restless, two as they were hypotensive after procedure and three for miscellaneous reasons). Only nine patients could remember any part of the procedure. Incremental doses of midazolam given slowly until patients are lightly asleep almost invariably produce complete amnesia for bronchoscopy. This is a safe technique but patients need careful monitoring and may require reversal of

  15. Clinical and functional correlates of foot pain in diabetic patients.

    NARCIS (Netherlands)

    Rijken, P.M.; Dekker, J.; Rauwerda, J.A.; Dekker, E.; Lankhorst, G.J.; Bakker, K.; Dooren, J.

    1998-01-01

    Purpose: patients with diabetes mellitus frequently suffer from foot pain. This pain seems to be a neglected area in studies on the diabetic foot. The purpose of this study was to identify clinical variables associated with foot pain in diabetic patients. In addition, the relationships between foot

  16. The Clinical Validity of the Process for Assessment of Effective Student Functioning.

    Science.gov (United States)

    Lambert, Nadine M.

    1981-01-01

    Reports the clinical validity of the Process for Assessment of Effective Student Functioning. A clinical team studied 300 representative second and fifth graders. Found the Process was valid for predicting independent clinical judgments of the status of these children, and located potentially handicapped children better than teacher referral.…

  17. Assessment of Functioning of RTI-STI Clinics associated with A Tertiary Care Centre, Jaipur

    Directory of Open Access Journals (Sweden)

    Priyanka Kapoor, Monika Rathore, Amita Kashyap, Abhinav Agrawal, Vaseem Naheed Baig

    2015-01-01

    Conclusion: More female reported to these clinics than male. Condoms provision was practiced most regularly. Other components of counselling and services were not practiced consistently. Partner treatment and revisits were particularly lacking. Consistent presence of counsellor at clinic is vital for functioning of clinics."

  18. Clinical Supervision and Psychological Functions: A New Direction for Theory and Practice.

    Science.gov (United States)

    Pajak, Edward

    2002-01-01

    Relates Carl Jung's concept of psychological functions to four families of clinical supervision: the original clinical models, the humanistic/artistic models, the technical/didactic models, and the developmental/reflective models. Differences among clinical supervision models within these families are clarified as representing "communication…

  19. Unexpected anterograde amnesia associated with Buscopan used as a predmedication for endocscopy

    Institute of Scientific and Technical Information of China (English)

    2007-01-01

    It has been known that peripheral adverse event is caused by peripheral antimuscarinic action, from hyoscine butylbromide (Buscopan; Boehringer Ingelheim, Germany)used as a premedication for endoscopy. However,symptoms or signs associated with the central nervous system are rarely reported in the field of anesthesiology and peripartum labor. This central anticholinergic syndrome is likely caused by blockade of muscarinic cholinergic receptors in the central nervous system. There is no report on Buscopan-induced central anticholinergic syndrome in endoscopy room so far. Three middle-aged females unexpectedly suffered from anterograde amnesia after intramuscular injection of hyoscine butylbromide as an antispasmodic premedication for endoscopy at our endoscopy unit in the Health Promotion Center.

  20. The elusive engram: what can infantile amnesia tell us about memory?

    Science.gov (United States)

    Callaghan, Bridget L; Li, Stella; Richardson, Rick

    2014-01-01

    Revealing the engram is one of the greatest challenges in neuroscience. Many researchers focus on understanding the cellular and molecular mechanisms underlying the formation and maintenance of the engram, but an underutilized approach has been to investigate analogous processes associated with forgetting. Infant rodents present an ideal model for this purpose because they display a rapid form of non-pathological forgetting known as infantile amnesia (IA). Despite the widespread importance of this interesting phenomenon, the study of the neural bases of IA has remained largely neglected. Here, we consider what IA can tell us about memory. We argue that to understand the mechanisms underlying the engram we must also gain an appreciation of the mechanisms that drive forgetting.

  1. Posthypnotic amnesia for material learned before or during hypnosis: explicit and implicit memory effects.

    Science.gov (United States)

    Barnier, A J; Bryant, R A; Briscoe, S

    2001-10-01

    This article focuses on dissociations between explicit and implicit expressions of memory during posthypnotic amnesia (PHA). Despite evidence of such dissociations, experimental design in this area has not always been consistent with contemporary memory research. Within a paradigm that aimed for conceptual and methodological clarity, we presented 40 high and 38 low hypnotizable individuals with a word list either before or during hypnosis, gave them a PHA suggestion for the word list, and tested them on explicit and implicit memory tasks. In the absence of conscious recollection, highs showed equivalent levels of priming (perceptual and semantic) to lows. However, when analysis focused only on those highs who remained amnesic after the implicit memory tasks, we confirmed perceptual, but not semantic, priming. These findings highlight the impact of methodological choices on theoretical interpretations of memory performance following a suggestion for PHA.

  2. Functional Imaging of Breast Tissue and Clinical Application

    Institute of Scientific and Technical Information of China (English)

    2006-01-01

    A novel approach to image hemoglobin concentration(ΔDhb) and oxygen saturation (ΔDoxy) of breast tissue is presented. The scenograph of dual-wavelength (760 and 850 nm) near infrared lights through breast tissue is acquired by high sensitive charge coupled device (CCD) camera. The evaluation criterion of the difference of ΔDhb and ΔDoxy between detected and referenced breast tissue can be obtained by a calculation formula without complicate caculation. This approach is applied to clinic detection in breast tissue. The ongoing clinical experiments indicate that malignant tumor usually exhibits characterize of "higher ΔDhb and lower ΔDoxy", while benign lesion often shows "lower ΔDhb and higher ΔDoxy" or other characters. So it is useful to assist the diagnosis of breast disease.

  3. Hepatitis E Virus Mutations: Functional and Clinical Relevance

    OpenAIRE

    Hoang van Tong; Nghiem Xuan Hoan; Bo Wang; Heiner Wedemeyer; C.-Thomas Bock; Velavan, Thirumalaisamy P.

    2016-01-01

    Highlights • HEV causes acute hepatitis and recently comes into focus because of persistent infection in immunocompromised patients. • HEV variability can be associated with clinical pathogenesis and transmission dynamics. • Mutations in the HEV genome can influence HEV physiology and virus-host interaction. • HEV mutations and variability are likely associated with fulminant hepatic failure and chronic hepatitis E. • The Y1320H and G1634R/K mutations in the RdRp domain contribute to antivira...

  4. Brain atlas for functional imaging. Clinical and research applications

    Energy Technology Data Exchange (ETDEWEB)

    Nowinski, W.L.; Thirunavuukarasuu, A.; Kennedy, D.N

    2001-07-01

    This CD-ROM: Allows anatomical and functional images to be loaded and registered. Enables interactive placement of the Talairach landmarks in 3D Space. Provides automatic data-to-atlas warping based on the Talairaich proportional gridsystem transformation. Real-time interactive warping for fine tuning is also available. Allows the user to place marks on the activation loci in the warped functional images, display these marks with the atlas, and edit them in three planes. Mark placement is assisted by image thresholding. Provides simultaneous display of the atlas, anatomical image and functional image within one interactively blended image. Atlas-data blending and anatomical-functional image blending are controlled independently. Labels the data by means of the atlas. The atlas can be flipped left/right so that Brodmann's areas and gyri can be labeled on both hemispheres. Provides additional functions such as friendly navigation, cross-referenced display, readout of the Talairach coordinates and intensities, load coordinates, save, on-line help. (orig.)

  5. [Functional MRI at 1 Tesla. Basic paradigms and clinical application].

    Science.gov (United States)

    Schwarcz, Attila; Auer, Tibor; Komoly, Sámuel; Dóczi, Tamás; Janszky, József

    2007-07-30

    To perform functional MRI experiments at low magnetic field, and to set up routine protocol to help the planning of neurosurgical operations and the examination of epilepsy patients. An optimized 2D EPI sequence was applied to yield functional MR images in basic paradigms such as finger tapping and internal word generation. Further, activation was induced also by a task involving mental navigation based on the retrieval of individually familiar visuo-spatial knowledge. Low resolution (matrix of 64x64) functional MR images satisfactorily visualized moto-sensor strip and speech centers. In the mental navigation task bilateral activation of the hippocampal formation was observed. Determination of motor area was also performed in an epilepsy patient whose seizure focus had been found in the area of pre- and post-central gyrus. The dislocation of the motor cortex was demonstrated. Functional MR images with fine quality can be obtained in basic paradigms even at low magnetic field if MR imaging parameters and paradigms are optimized.

  6. Respiratory hazards: clinical and functional assessment in aluminum industry workers

    Directory of Open Access Journals (Sweden)

    Lamiaa H. Shaaban

    2016-04-01

    Conclusions: Aluminum industry is hazardous to both the workers and the community. The pulmonary hazards are significantly higher in workers who are continuously exposed to gases and pollutants for more than 8 h/day. Moreover the free radicals of silica and polycyclic aromatic hydrocarbons may have a direct relationship with the recorded changes in diaphragmatic and pulmonary functions and may be precancerous.

  7. Clinical decision-making in functional and hyperkinetic movement disorders

    NARCIS (Netherlands)

    van der Salm, Sandra M. A.; van Rootselaar, Anne-Fleur; Cath, Danielle C.; de Haan, Rob J.; Koelman, Johannes H. T. M.; Tijssen, Marina A. J.

    2017-01-01

    Objective: Functional or psychogenic movement disorders (FMD) present a diagnostic challenge. To diagnose FMD, clinicians must have experience with signs typical of FMD and distinguishing features from other hyperkinetic disorders. The aim of this study was to clarify the decision-making process of

  8. Clinical and functional outcomes of tibial intercalary allograft reconstructions

    Directory of Open Access Journals (Sweden)

    Lucas López Millán

    2012-12-01

    Full Text Available Background The purpose of this study was to evaluate the survival, the complications and the functional outcome of intercalary tibial allografts reconstructions following tumor resections. Methods Intercalary tibia segmental allografts were implanted in 26 consecutive patients after segmental resections. Average follow-up was 6 years. Allograft survival was determined with the Kaplan-Meier method. Function was evaluated with the Musculoskeletal Tumor Society scoring system (MSTS. Results The rate of survival was 84% (CI 95%: 90%- 70% at 5 years and 79% at 10 years (CI 95%: 95%-63%. Allografts were removed in 5 patients (3 due to infections and 2 due to local recurrences. Two patients showed diaphyseal nonunion and 3 had an incomplete fracture, but it was not necessary to remove the allografts. Average MSTS functional score was 29 points (range 27 to 30. Conclusions Despite the incidence of complications, this analysis showed an acceptable survival with excellent functional scores. The use of intercalary allograft clearly has a place in the reconstruction of a segmental defect created by the resection of a tumor in the diaphyseal and/or metaphyseal portion of the tibia.

  9. Clinical practice Diagnosis and treatment of functional constipation

    NARCIS (Netherlands)

    Tabbers, Merit M.; Boluyt, Nicole; Berger, Marjolein Y.; Benninga, Marc A.

    2011-01-01

    Childhood functional constipation has an estimated prevalence of 3% in the Western world and is probably the most common gastrointestinal complaint in children. It is characterized by infrequent painful defecation, faecal incontinence and abdominal pain. Only less than 5% of children with constipati

  10. Clinical practice. Diagnosis and treatment of functional constipation

    NARCIS (Netherlands)

    Tabbers, M.M.; Boluyt, N.; Berger, M.Y.; Benninga, M.A.

    2011-01-01

    Childhood functional constipation has an estimated prevalence of 3% in the Western world and is probably the most common gastrointestinal complaint in children. It is characterized by infrequent painful defecation, faecal incontinence and abdominal pain. Only less than 5% of children with constipati

  11. [Osteogenesis imperfecta. Clinical, functional and multidisciplinary evaluation of 65 patients].

    Science.gov (United States)

    Fano, V; Rodríguez Celin, M; Del Pino, M; Buceta, S; Obregón, M G; Primomo, C; García, H; Miscione, H; Lejarraga, H

    2010-05-01

    Osteogenesis Imperfecta (OI) is a genetic disease, in which the main clinical features are increased bone fragility, pathological fractures, blue sclera, dentinogenesis imperfecta and conductive or mixed hearing loss. Clinical variability is wide. Although there is no curative treatment, there are several therapeutic tools capable of improving the course of the condition and patient quality of life. Sixty-five children seen in a Paediatric Hospital during six months in 2007 were evaluated. Thirty-five were type I OI, and thirty were types III-IV. Median age was 7.8 years (range 1.9-19.2); mean length of follow up was 4.7 years. The majority of children attended regular school for their corresponding age. Mean height was -1.4 sDS and -5.64 sDS in types I and III-IV respectively. Nineteen percent of patients were overweight and 11% were obese. Mean age at first orthopaedic surgery inserting telescopic rods was 6.5 years. Scoliosis was present in 44.6% of patients and was directly related to severity. Bleck's motor scale showed that 93% of patients with mild forms and 29% of severe forms had a sustainable walking ability. A wheelchair was used by 25% of patients. Family inheritance was confirmed in 65% of cases. Integral care using a multidisciplinary approach is required due to the complexity and clinical variability of the condition. Copyright 2009 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

  12. Functional and clinical relevance of chondroitin sulfate proteoglycan 4.

    Science.gov (United States)

    Campoli, Michael; Ferrone, Soldano; Wang, Xinhui

    2010-01-01

    The lack of effective conventional therapies for the treatment of advanced stage melanoma has stimulated interest in the development of novel strategies for the management of patients with malignant melanoma. Among them, immunotherapy has attracted much attention because of the potential role played by immunological events in the clinical course of melanoma. For many years, T cell-based immunotherapy has been emphasized in part because of the disappointing results of the monoclonal antibody (mAb)-based clinical trials conducted in the early 1980s and in part because of the postulated major role played by T cells in tumor growth control. More recently, mAb-based therapies have gained in popularity given their clinical and commercial success for a variety of malignant diseases. As a result, there has been increased interest in identifying and characterizing antibody-defined melanoma antigens. Among them, the chondroitin sulfate proteoglycan 4 (CSPG4), also known as high molecular weight-melanoma associated antigen (HMW-MAA) or melanoma chondroitin sulfate proteoglycan (MCSP), has attracted much attention in recent years because of the growing experimental evidence that it fulfills two requirements for immunotherapy to be therapeutically effective: (1) targeting of cancer stem cells (CSC) and (2) development of combinatorial therapies to counteract the escape mechanisms driven by the genetic instability of tumor cells. With this in mind, in this chapter, we have reviewed recent information related to the distribution of CSPG4 on various types of tumors, including CSC, its expression on pericytes in the tumor microenvironment, its recognition by T cells, its role in cell biology as well as the potential mechanisms underlying the ability of CSPG4-specific immunity to control malignant cell growth.

  13. Optimizing the patient transport function at Mayo Clinic.

    Science.gov (United States)

    Kuchera, Dustin; Rohleder, Thomas R

    2011-01-01

    In this article, we report on the implementation of a computerized scheduling tool to optimize staffing for patient transport at the Mayo Clinic. The tool was developed and implemented in Microsoft Excel and Visual Basic for Applications and includes an easy-to-use interface. The tool allows transport management to consider the trade-offs between patient waiting time and staffing levels. While improved staffing efficiency was a desire of the project, it was important that patient service quality was also maintained. The results show that staffing could be reduced while maintaining historical patient service levels.

  14. Management of clinically non-functioning pituitary adenoma.

    Science.gov (United States)

    Chanson, Philippe; Raverot, Gerald; Castinetti, Frédéric; Cortet-Rudelli, Christine; Galland, Françoise; Salenave, Sylvie

    2015-07-01

    Clinically NFPA is currently the preferred term for designing all the pituitary adenomas which are not hormonally active (in other words, not associated with clinical syndromes such as amenorrhea-galactorrhea in the context of prolactinomas, acromegaly, Cushing's disease or hyperthyroidism secondary to TSH-secreting adenomas). They account for 15-30% of pituitary adenomas. Diagnosis is usually made either in the context of mass effect due to a macroadenoma or, increasingly, fortuitously during imaging performed for some unrelated purpose; the latter case is known as pituitary incidentaloma. Surgery is indisputably indicated in case of tumoral syndrome, but other aspects of NFPA (hormonal work-up, follow-up, and especially postoperative follow-up, management of remnant or recurrence, the special case of incidentaloma, or apoplexy) remain controversial. The French Endocrinology Society (SFE) therefore set up an expert working group of endocrinologists, neurosurgeons, ophthalmologists, neuroradiologists, pathologists and biologists to draw up guidelines, at the 2012 SFE Congress in Toulouse, France. The present article presents the guidelines suggested by this group of French-speaking experts. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  15. Clinical and Functional Outcomes of the Birmingham Hip Resurfacing System.

    Science.gov (United States)

    Pascual-Garrido, Cecilia; Morris, Brandon L; Dayton, Michael R

    2016-01-01

    This study reported the outcomes of patients treated with the Birmingham Hip Resurfacing System (Smith & Nephew, Memphis, Tennessee) to identify the prevalence of complications and failures. A retrospective review of 202 patients (206 hips) was performed. Outcomes were assessed clinically with Harris Hip Score at 6 and 12 months and then yearly. Subanalysis was performed, with the hips divided according to patient sex and size of the femoral component. Mean patient age was 51±8 years, and mean follow-up was 4±1.6 years. Of the patients, 163 were men (83%) and 35 were women (17%). Postoperative improvement was significant, with preoperative Harris Hip Score of 62.9±10.6 and postoperative Harris Hip Score of 98.6±6.7 (Phips (2.4%) underwent revision. At 3 years, mean survival was better for men than for women (99% vs 92%, respectively). Survival was lowest in patients with femoral component diameter of less than 46 mm. According to the authors' results, the Birmingham Hip Resurfacing System resulted in good clinical outcomes at 4 years. Survival and outcomes in women, particularly those with modest bone size, are inferior.

  16. Clinical investigations of receptive and expressive musical functions after stroke

    OpenAIRE

    Ken eRosslau; Daniel eSteinwede; Christine eSchröder; Sibylle eHerholz; Claudia eLappe; Christian eDobel; Eckart eAltenmüller

    2015-01-01

    There is a long tradition of investigating various disorders of musical abilities after stroke. These impairments, associated with acquired amusia, can be highly selective, affecting only music perception (i.e., receptive abilities/functions) or expression (music production abilities), and some patients report that these may dramatically influence their emotional state. The aim of this study was to systematically test both the melodic and rhythmic domains of music perception and expression in...

  17. Clinical investigations of receptive and expressive musical functions after stroke

    Directory of Open Access Journals (Sweden)

    Ken eRosslau

    2015-06-01

    Full Text Available There is a long tradition of investigating various disorders of musical abilities after stroke. These impairments, associated with acquired amusia, can be highly selective, affecting only music perception (i.e., receptive abilities/functions or expression (music production abilities, and some patients report that these may dramatically influence their emotional state. The aim of this study was to systematically test both the melodic and rhythmic domains of music perception and expression in left- and right-sided stroke patients compared to healthy subjects. Music perception was assessed using rhythmic and melodic discrimination tasks, while tests of expressive function involved the vocal or instrumental reproduction of rhythms and melodies. Our approach revealed deficits in receptive and expressive functions in stroke patients, mediated by musical expertise. Those patients who had experienced a short period of musical training in childhood and adolescence performed better in the receptive and expressive subtests compared to those without any previous musical training. While discrimination of specific musical patterns was unimpaired after a right-sided stroke, patients with a left-sided stroke had worse results for fine melodic and rhythmic analysis. In terms of expressive testing, the most consistent results were obtained from a test that required patients to reproduce sung melodies. This implies that the means of investigating production abilities can impact the identification of deficits.

  18. Clinical investigations of receptive and expressive musical functions after stroke.

    Science.gov (United States)

    Rosslau, Ken; Steinwede, Daniel; Schröder, C; Herholz, Sibylle C; Lappe, Claudia; Dobel, Christian; Altenmüller, Eckart

    2015-01-01

    There is a long tradition of investigating various disorders of musical abilities after stroke. These impairments, associated with acquired amusia, can be highly selective, affecting only music perception (i.e., receptive abilities/functions) or expression (music production abilities), and some patients report that these may dramatically influence their emotional state. The aim of this study was to systematically test both the melodic and rhythmic domains of music perception and expression in left- and right-sided stroke patients compared to healthy subjects. Music perception was assessed using rhythmic and melodic discrimination tasks, while tests of expressive function involved the vocal or instrumental reproduction of rhythms and melodies. Our approach revealed deficits in receptive and expressive functions in stroke patients, mediated by musical expertise. Those patients who had experienced a short period of musical training in childhood and adolescence performed better in the receptive and expressive subtests compared to those without any previous musical training. While discrimination of specific musical patterns was unimpaired after a left-sided stroke, patients with a right-sided stroke had worse results for fine melodic and rhythmic analysis. In terms of expressive testing, the most consistent results were obtained from a test that required patients to reproduce sung melodies. This implies that the means of investigating production abilities can impact the identification of deficits.

  19. Assessment of positive functioning in clinical psychology: theoretical and practical issues.

    Science.gov (United States)

    Joseph, Stephen; Wood, Alex

    2010-11-01

    Positive psychology has led to an increasing emphasis on the promotion of positive functioning in clinical psychology research and practice, raising issues of how to assess the positive in clinical setting. Three key considerations are presented. First, existing clinical measures may already be assessing positive functioning, if positive and negative functioning exist on a single continuum (such as on bipolar dimensions from happiness to depression, and from anxiety to relaxation). Second, specific measures of positive functioning (e.g., eudemonic well-being) could be used in conjunction with existing clinical scales. Third, completely different measures would be needed depending on whether well-being is defined as emotional or medical functioning, or as humanistically orientated growth (e.g., authenticity). It is important that clinical psychologists introduce positive functioning into their research and practice in order to widen their armoury of therapeutic interventions, but in doing so researchers and practitioners need also to be aware that they are shifting the agenda of clinical psychology. As such, progress in clinical psychology moving toward the adoption of positive functioning requires reflection on epistemological foundations. Copyright © 2010 Elsevier Ltd. All rights reserved.

  20. Functional MRI in human motor control studies and clinical applications

    Energy Technology Data Exchange (ETDEWEB)

    Toma, Keiichiro [Kyoto Univ. (Japan). Graduate School of Medicine; Nakai, Toshiharu [Inst. of Biomedical Research and Innovation, Kobe (Japan)

    2002-07-01

    Functional magnetic resonance imaging (fMRI) has been a useful tool for the noninvasive mapping of brain function associated with various motor and cognitive tasks. Because fMRI is based on the blood oxygenation level dependent (BOLD) effect, it does not directly record neural activity. With the fMRI technique, distinguishing BOLD signals creased by cortical projection neurons from those created by intracortical neurons appears to be difficult. Two major experimental designs are used in fMRI studies: block designs and event-related designs. Block-designed fMRI presupposes the steady state of regional cerebral blood flow and has been applied to examinations of brain activation caused by tasks requiring sustained or repetitive movements. By contrast, the more recently developed event-related fMRI with time resolution of a few seconds allows the mapping of brain activation associated with a single movement according to the transient aspects of the hemodynamic response. Increasing evidence suggests that multiple motor areas are engaged in a networked manner to execute various motor acts. In order to understand functional brain maps, it is important that one understands sequential and parallel organizations of anatomical connections between multiple motor areas. In fMRI studies of complex motor tasks, elementary parameters such as movement length, force, velocity, acceleration and frequency should be controlled, because inconsistency in those parameters may alter the extent and intensity of motor cortical activation, confounding interpretation of the findings obtained. In addition to initiation of movements, termination of movements plays an important role in the successful achievement of complex movements. Brain areas exclusively related to the termination of movements have been, for the first time, uncovered with an event-related fMRI technique. We propose the application of fMRI to the elucidation of the pathophysiology of movement disorders, particularly dystonia

  1. Clinical decision support must be useful, functional is not enough

    DEFF Research Database (Denmark)

    Kortteisto, Tiina; Komulainen, Jorma; Mäkelä, Marjukka

    2012-01-01

    ABSTRACT: BACKGROUND: Health information technology, particularly electronic decision support systems, can reduce the existing gap between evidence-based knowledge and health care practice but professionals have to accept and use this information. Evidence is scant on which features influence......'s intention to use eCDS. The decisive reason for using or not using the eCDS is its perceived usefulness. Functional characteristics such as speed and ease of use are important but alone these are not enough. Specific information technology, professional, patient and environment features can help or hinder...

  2. Clinical Finding and Thyroid Function in Women with Struma Ovarii

    Directory of Open Access Journals (Sweden)

    Ali Hosseini

    2013-01-01

    Full Text Available Background. Struma ovarii (SO is a variant of dermoid tumors which completely or mainly composed of thyroid tissues. Objective. We report our experience in the diagnosis and thyroid function of patients with SO in our hospital and also review the management and treatment option of this tumor. Materials and Methods. Between 2000 and 2012, 15 consecutive females with SO who were presented to our hospital were fully assessed. All women had histologically confirmed struma ovarii. The medical records of all patients including presenting symptoms, CT scan finding, and hormonal levels were collected for final analysis. Results. Average patient age was 36.6 years (ranging from 21 to 69. The mean ± SDs of serum TSH, T4, and T3 were  mUI/mL,  ng/dL, and  ng/dL, respectively. The value of TSH was lower than normal value in 26.7%. Also, antithyroglobulin and anti-TPO were positive in 2 and one cases, respectively. Conclusion. Based on our data, it is more likely to see a disturbance in serum values of thyroid function test in women with SO.

  3. [Functional aniseikonia: clinical study of 110 cases (author's transl)].

    Science.gov (United States)

    Reboud, F N; Vola, J L; Berard, P V

    1981-01-01

    A clinical study was conducted in 110 cases of subjective aniseikonia, a syndrome that is often neglected. After in practice summarizing the different distortions composing the phenomenon of aniseikonia, a description of the prototype apparatus used for the experiments is given: it is eikonometric stereo-projector the originality of which lies in the measuring system, constituted by the projected stereograms. Three parameters were studied: depth-perception, peerception threshold of anseiikonic disparity, and value of the found aniseikonia. The results are presented in relation to 3 groups of subjects: 14 emmetropic, 32 isometropic, and 64 anisometropic, 32 isometropic, and 64 anisometropic patients, including 24 monocular aphakic. The author shows the advantage of contact lens correction in the last cases: with an average of 3.5 p. cent, the found aniseikonia was always inferior to 6 p. cent and to the theorectical levels currently accepted. Finally, the phenomenon of "cortical malleability" arises in the adaptation of the patient to his optical correction and could regularly and progressively be increased.

  4. Functional limitations in the phase of clinically suspect arthralgia are as serious as in early clinical arthritis; a longitudinal study.

    Science.gov (United States)

    Ten Brinck, Robin M; van Steenbergen, Hanna W; Mangnus, Lukas; Burgers, Leonie E; Reijnierse, Monique; Huizinga, Tom Wj; van der Helm-van Mil, Annette Hm

    2017-01-01

    A phase of arthralgia may precede the emergence of rheumatoid arthritis (RA). Although several studies have focused on biomarkers, the relevance of this phase for patients is less studied. It is unknown if patients already have functional limitations and if this is correlated to the extent of subclinical inflammation. Therefore, we assessed functional disability in patients with clinically suspect arthralgia (CSA), its association with MRI-detected subclinical inflammation and its course during progression to clinical arthritis. From April 2012 to March 2015, 241 patients had arthralgia for <1 year and were, based on clinical presentation, considered at risk for RA by their rheumatologists. At baseline, Health Assessment Questionnaire (HAQ) scores were determined and unilateral 1.5 T MRI of metacarpophalangeal, wrist and metatarsophalangeal joints were made. Presence of MRI-detected subclinical inflammation was assessed by summing synovitis, tenosynovitis and bone marrow oedema scores (range 0-189). Patients were followed on arthritis development and HAQ scores were repeated when clinical arthritis had developed. The median HAQ score at presentation with CSA was 0.50. Higher MRI-inflammation scores were associated with higher HAQ scores (β=0.017, 95% CI=0.004 to 0.030). During median 103 weeks follow-up, 44 patients progressed to clinical arthritis. HAQ scores ≥1.0 were associated with arthritis development (HR=2.50, 95% CI=1.03 to 6.10). Within converters, median HAQ scores did not increase from presentation with CSA to arthritis development (0.88 and 0.75, p=0.36). HAQ scores ≥1.0 at presentation were associated with the development of clinical arthritis. Functional limitations in the prearthritis phase of CSA were as serious as in the early clinical phase, demonstrating the relevance of CSA from patients' perspectives.

  5. Lipids and skin barrier function - a clinical perspective

    DEFF Research Database (Denmark)

    Jungersted, J.M.; Hellgren, Lars; Jemec, G.B.E.

    2008-01-01

    and in particular, the role of barrier function in the pathogenesis of skin disease and its subsequent treatment protocols. The 3 major lipids in the SC of importance are ceramides, free fatty acids, and cholesterol. Human studies comparing levels of the major SC lipids in patients with atopic dermatitis...... and healthy controls have suggested a possible role for ceramide 1 and to some extent ceramide 3 in the pathogenesis of the disease. Therapies used in diseases involving barrier disruption have been sparely investigated from a lipid perspective. It has been suggested that ultraviolet light as a treatment......The stratum corneum (SC) protects us from dehydration and external dangers. Much is known about the morphology of the SC and penetration of drugs through it, but the data are mainly derived from in vitro and animal experiments. In contrast, only a few studies have the human SC lipids as their focus...

  6. Time-course of 5-HT(6) receptor mRNA expression during memory consolidation and amnesia.

    Science.gov (United States)

    Huerta-Rivas, A; Pérez-García, G; González-Espinosa, C; Meneses, A

    2010-01-01

    Growing evidence indicates that antagonists of the 5-hydroxytryptamine (serotonin) receptor(6) (5-HT(6)) improve memory and reverse amnesia although the mechanisms involved are poorly understood. Hence, in this paper RT-PCR was used to evaluate changes in mRNA expression of 5-HT(6) receptor in trained and untrained rats treated with the 5-HT(6) receptor antagonist SB-399885 and amnesic drugs scopolamine or dizocilpine. Changes in mRNA expression of 5-HT(6) receptor were investigated at different times in prefrontal cortex, hippocampus and striatum. Data indicated that memory in the Pavlovian/instrumental autoshaping task was a progressive process associated to reduced mRNA expression of 5-HT(6) receptor in the three structures examined. SB-399885 improved long-term memory at 48h, while the muscarinic receptor antagonist scopolamine or the non-competitive NMDA receptor antagonist dizocilpine impaired it at 24h. Autoshaping training and treatment with SB-399885 increased 5-HT(6) receptor mRNA expression in (maximum increase) prefrontal cortex and striatum, 24 or 48h. The scopolamine-induced amnesia suppressed 5-HT(6) receptor mRNA expression while the dizocilpine-induced amnesia did not modify 5-HT(6) receptor mRNA expression. SB-399885 and scopolamine or dizocilpine were able to reestablish memory and 5-HT(6) receptor mRNA expression. These data confirmed previous memory evidence and of more interest is the observation that training, SB-399885 and amnesic drugs modulated 5-HT(6) receptor mRNA expression in prefrontal cortex, hippocampus and striatum. Further investigation in different memory tasks, times and amnesia models together with more complex control groups might provide further clues.

  7. Lactobacillus casei-01 facilitates the ameliorative effects of proanthocyanidins extracted from lotus seedpod on learning and memory impairment in scopolamine-induced amnesia mice.

    Directory of Open Access Journals (Sweden)

    Juan Xiao

    Full Text Available Learning and memory abilities are associated with alterations in gut function. The two-way proanthocyanidins-microbiota interaction in vivo enhances the physiological activities of proanthocyanidins and promotes the regulation of gut function. Proanthocyanidins extracted from lotus seedpod (LSPC have shown the memory-enhancing ability. However, there has been no literature about whether Lactobacillus casei-01 (LC enhances the ameliorative effects of LSPC on learning and memory abilities. In this study, learning and memory abilities of scopolamine-induced amnesia mice were evaluated by Y-maze test after 20-day administration of LC (10(9 cfu/kg body weight (BW, LSPC (low dose was 60 mg/kg BW (L-LSPC and high dose was 90 mg/kg BW (H-LSPC, or LSPC and LC combinations (L-LSPC+LC and H-LSPC+LC. Alterations in antioxidant defense ability and oxidative damage of brain, serum and colon, and brain cholinergic system were investigated as the possible mechanisms. As a result, the error times of H-LSPC+LC group were reduced by 41.59% and 68.75% relative to those of H-LSPC and LC groups respectively. LSPC and LC combinations ameliorated scopolamine-induced memory impairment by improving total antioxidant capacity (TAOC level, glutathione peroxidase (GSH-Px and total superoxide dismutase (T-SOD activities of brain, serum and colon, suppressing malondialdehyde (MDA level of brain, serum and colon, and inhibiting brain acetylcholinesterase (AchE, myeloperoxidase, total nitric oxide synthase and neural nitric oxide synthase (nNOS activities, and nNOS mRNA level. Moreover, LC facilitated the ameliorative effects of H-LSPC on GSH-Px activity of colon, TAOC level, GSH-Px activity and ratio of T-SOD to MDA of brain and serum, and the inhibitory effects of H-LSPC on serum MDA level, brain nNOS mRNA level and AchE activity. These results indicated that LC promoted the memory-enhancing effect of LSPC in scopolamine-induced amnesia mice.

  8. Functional Gastrointestinal Disorders in a Primary Care Pediatric Clinic

    Directory of Open Access Journals (Sweden)

    Ronen Stein MD

    2015-01-01

    Full Text Available Functional gastrointestinal disorders (FGIDs are a common problem in pediatric patients and can affect quality of life. However, the extent of these disorders may vary in different subpopulations of children. This study investigated the prevalence of FGIDs in an inner-city primary care practice. Healthy patients between the ages of 9 and 17 were administered a validated questionnaire that assessed for FGIDs and other somatic complaints. Eleven of 145 patients (7.5% met criteria for FGIDs based on Rome III Diagnostic Criteria. Raynaud-like symptoms tended to occur more often in patients meeting criteria for FGIDs, although this association was not statistically significant (P = .07. The lower prevalence of FGIDs in this population compared with earlier studies may suggest a link between socioeconomic status and the prevalence of FGIDs. Larger population-based studies consisting of a heterogeneous cohort from a variety of socioeconomic backgrounds are necessary to further elucidate the true connection between FGIDs and socioeconomic status.

  9. Clinical implications of disturbances of uterine vascular morphology and function.

    Science.gov (United States)

    Hickey, M; Fraser, I S

    2000-12-01

    Menstrual disturbances are one of the most common problems presenting to the gynaecologist. In order for the endometrium to bleed, vessels must break down. Disruption in the regulation of endometrial vascular growth and function has been found in association with spontaneous and sex steroid-induced disturbances of menstrual bleeding. Although circulating oestrogens and progestogens influence the endometrial vessels, this effect appears to be indirect, and regulation is primarily via local factors. Deficient vasoconstriction and haemostasis with excessive fibrinolysis is seen in menorrhagia. Breakthrough bleeding in users of progestogen-only contraceptives is associated with increased superficial vascular fragility and disruptions in the supporting basement membrane. Blood vessels in uterine fibroids are abnormal in distribution and appearance. Adenomyosis is also commonly associated with menstrual disturbance, and alterations in vascular distribution suggest altered angiogenesis. Successful human embryo implantation requires endometrial vascular breakdown. Excessive thrombosis associated with the antiphospholipid syndrome may interfere with this re-modelling and compromise implantation. Arteriovenous malformations are a rare but important cause of excessive or irregular vaginal bleeding. Abundant vessels with abnormal morphology, associated with aberrant angiogenesis can be seen, and embolization of these vessels may be an effective conservative treatment. Improved understanding of the regulation of the uterine vasculature is likely to lead to targeted therapies to prevent unscheduled vascular breakdown and to control menstrual disturbance at an endometrial level.

  10. The thoracolumbar fascia: anatomy, function and clinical considerations

    Science.gov (United States)

    Willard, F H; Vleeming, A; Schuenke, M D; Danneels, L; Schleip, R

    2012-01-01

    In this overview, new and existent material on the organization and composition of the thoracolumbar fascia (TLF) will be evaluated in respect to its anatomy, innervation biomechanics and clinical relevance. The integration of the passive connective tissues of the TLF and active muscular structures surrounding this structure are discussed, and the relevance of their mutual interactions in relation to low back and pelvic pain reviewed. The TLF is a girdling structure consisting of several aponeurotic and fascial layers that separates the paraspinal muscles from the muscles of the posterior abdominal wall. The superficial lamina of the posterior layer of the TLF (PLF) is dominated by the aponeuroses of the latissimus dorsi and the serratus posterior inferior. The deeper lamina of the PLF forms an encapsulating retinacular sheath around the paraspinal muscles. The middle layer of the TLF (MLF) appears to derive from an intermuscular septum that developmentally separates the epaxial from the hypaxial musculature. This septum forms during the fifth and sixth weeks of gestation. The paraspinal retinacular sheath (PRS) is in a key position to act as a ‘hydraulic amplifier’, assisting the paraspinal muscles in supporting the lumbosacral spine. This sheath forms a lumbar interfascial triangle (LIFT) with the MLF and PLF. Along the lateral border of the PRS, a raphe forms where the sheath meets the aponeurosis of the transversus abdominis. This lateral raphe is a thickened complex of dense connective tissue marked by the presence of the LIFT, and represents the junction of the hypaxial myofascial compartment (the abdominal muscles) with the paraspinal sheath of the epaxial muscles. The lateral raphe is in a position to distribute tension from the surrounding hypaxial and extremity muscles into the layers of the TLF. At the base of the lumbar spine all of the layers of the TLF fuse together into a thick composite that attaches firmly to the posterior superior iliac spine

  11. Functional Assessment of Genetic Variants with Outcomes Adapted to Clinical Decision-Making

    National Research Council Canada - National Science Library

    Thouvenot, Pierre; Ben Yamin, Barbara; Fourrière, Lou; Lescure, Aurianne; Boudier, Thomas; Del Nery, Elaine; Chauchereau, Anne; Goldgar, David E; Houdayer, Claude; Stoppa-Lyonnet, Dominique; Nicolas, Alain; Millot, Gaël A

    2016-01-01

    ..., to be implemented in the clinical decision-making process. Here, we assessed 25 pathogenic and 15 neutral missense variants of the BRCA1 breast/ovarian cancer susceptibility gene in four BRCA1 functional assays...

  12. Ketamine in adult cardiac surgery and the cardiac surgery Intensive Care Unit: An evidence-based clinical review

    Directory of Open Access Journals (Sweden)

    Michael Mazzeffi

    2015-01-01

    Full Text Available Ketamine is a unique anesthetic drug that provides analgesia, hypnosis, and amnesia with minimal respiratory and cardiovascular depression. Because of its sympathomimetic properties it would seem to be an excellent choice for patients with depressed ventricular function in cardiac surgery. However, its use has not gained widespread acceptance in adult cardiac surgery patients, perhaps due to its perceived negative psychotropic effects. Despite this limitation, it is receiving renewed interest in the United States as a sedative and analgesic drug for critically ill-patients. In this manuscript, the authors provide an evidence-based clinical review of ketamine use in cardiac surgery patients for intensive care physicians, cardio-thoracic anesthesiologists, and cardio-thoracic surgeons. All MEDLINE indexed clinical trials performed during the last 20 years in adult cardiac surgery patients were included in the review.

  13. Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function

    OpenAIRE

    Øilo, Marit; Hardang, Anne Dybdahl; Ulsund, Amanda Hembre; Gjerdet,Nils Roar

    2014-01-01

    Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based res...

  14. Functional capacity of Brazilian patients with Parkinson's disease (PD): relationship between clinical characteristics and disease severity.

    Science.gov (United States)

    Barbieri, Fabio A; Rinaldi, Natalia M; Santos, Paulo Cezar R; Lirani-Silva, Ellen; Vitório, Rodrigo; Teixeira-Arroyo, Cláudia; Stella, Florindo; Gobbi, Lilian Teresa B

    2012-01-01

    The present study had three objectives: (a) to characterize the functional capacity of patients with PD, (b) to assess the relationship between the physical fitness components of functional capacity with clinical characteristics and disease severity, and (c) to compare the physical fitness components of functional capacity with clinical characteristics according to disease severity. The study included 54 patients with idiopathic PD who were distributed into two groups according to PD severity: unilateral group (n=35); and bilateral group (n=19). All patients underwent psychiatric assessment by means of the Hoehn and Yahr (HY) staging of PD, the Unified Parkinson's Disease Rating Scale (UPDRS), the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively), and The Mini-Mental State Examination (MMSE). The physical fitness components of functional capacity were evaluated over a 2-day period, using recommendations by the American Alliance for Health, Physical Education, Recreation and Dance, and the Berg Balance Scale (BBS). Pearson correlation coefficients and multiple regressions were calculated to test the correlation between functional capacity and clinical characteristics, and to predict clinical scores from physical performance, respectively. Clinical variables and physical component data were compared between groups using analysis of variance to determine the effects of disease severity. Patients with advanced disease showed low levels of functional capacity. Interestingly, patients with good functional capacity in one of the physical fitness components also showed good capacities in the other components. Disease severity is a major factor affecting functional capacity and clinical characteristics. Medical providers should take disease severity into consideration when prescribing physical activity for PD patients, since the relationship between functional capacity and clinical characteristics is dependent on disease severity.

  15. Childhood adversity and social functioning in psychosis: Exploring clinical and cognitive mediators.

    Science.gov (United States)

    Palmier-Claus, Jasper; Berry, Katherine; Darrell-Berry, Hannah; Emsley, Richard; Parker, Sophie; Drake, Richard; Bucci, Sandra

    2016-04-30

    Childhood adversity may increase risk of impaired social functioning across the continuum of psychosis. However, the pathways by which adversity dictates functional outcome remain underexplored. This study investigated the association between childhood adversity and social functioning, and the clinical and cognitive mediators of this relationship. Fifty-four clinical (20 chronic, 20 first episode, 14 at ultra-high risk) and 120 non-clinical participants completed standardised questionnaires, semi-structured interviews and tests of theory of mind ability. The authors used multiple group structural equation modelling to fit mediation models allowing for differential relationships between the clinical and non-clinical samples. When examining each pathway separately, depression, paranoia and anxious attachment mediated the effect of childhood adversity on social functioning. In a combined model, depression was the only significant mediating variable with greater adversity predicting lower mood across groups. Childhood adversity did not significantly predict theory of mind ability in any of the models. This is the first study to indicate that childhood adversity acts on social functioning by increasing levels of depression, suggesting a common mechanism across the spectrum of psychosis. Clinical interventions should target low mood in order to improve social functioning at all stages of psychotic disorder.

  16. The quick motor function test: a new tool to rate clinical severity and motor function in Pompe patients

    NARCIS (Netherlands)

    C.I. van Capelle (Carine); N.A.M.E. van der Beek (Nadine); J.M. de Vries (Juna); P.A. van Doorn (Pieter); H.J. Duivenvoorden (Hugo); R.T. Leshner (Robert T.); M.L.C. Hagemans (Marloes); A.T. van der Ploeg (Ans)

    2012-01-01

    textabstractPompe disease is a lysosomal storage disorder characterized by progressive muscle weakness. With the emergence of new treatment options, psychometrically robust outcome measures are needed to monitor patients' clinical status. We constructed a motor function test that is easy and quick

  17. Maternal Drug Abuse History, Maltreatment, and Functioning in a Clinical Sample of Urban Children

    Science.gov (United States)

    Onigu-Otite, Edore C.; Belcher, Harolyn M. E.

    2012-01-01

    Objective: This study examined the association between maternal drug abuse history, maltreatment exposure, and functioning, in a clinical sample of young children seeking therapy for maltreatment. Methods: Data were collected on 91 children, mean age 5.3 years (SD 1.0). The Preschool and Early Childhood Functional Assessment Scales (PECFAS) was…

  18. Functional dyspepsia of ulcer-dysmotility type: clinical incidence and therapeutic strategy

    Institute of Scientific and Technical Information of China (English)

    1998-01-01

    @@ Functional dyspepsia is a commonly occurring chronic digestive disorder affecting 20%-40% of the general population[1]. It is a syndromic term applied to patients who complain of symptoms presumably arising from the upper abdomen, often in response to meal ingestion, but with absence of organic abnormalities demonstrable by conventional diagnostic tests. Although functional dyspepsia is very common in the community, the classification and the clinical therapy are still uncertain. Therefore this study deals with the clinical incidence and the therapeutic strategy of functional dyspepsia of the ulcer-dysmotility mixed type.

  19. ANTIAMNESIC POTENTIAL OF SOLASODINE AGAINST β-AMYLOID PROTEIN INDUCED AMNESIA IN MICE

    Directory of Open Access Journals (Sweden)

    Desai Alpesh B

    2011-05-01

    Full Text Available Alzheimer’s disease (AD, the most common form of dementia in the elderly population, is characterized by an insidious onset with memory impairment and an inexorable progression of cognitive decline. Nootropic agents are a heterogeneous groups of drugs developed for use in dementia and other cerebral disorders. Nootropics agents are being primarily used to improve memory, mood and behavior. However, the resulting adverse effects associated with these agents have limited their use. Therefore, it is worthwhile to explore the utility of traditional medicines for the treatment of various cognitive disorders. The present study was undertaken to assess the potential of solasodine on β-amyloid induced amnesia in mice. Elevated plus maze (EPM and Morris water maze (MWM was employed to evaluate learning and memory parameters. Piracetam was used as the standard drug. Solasodine (1, 2 and 4 mg/kg, p.o. was screened for claimed potential in mice. Solasodine improved both short term memory and long term memory when assessed on Elevated pluz maze and Morris Water maze respectively. Hence, solasodine might prove to be a useful memory restorative agent in the treatment of dementia seen in the Alzheimer’s disease.

  20. Nootropic, neuroprotective and neurotrophic effects of phloretin in scopolamine induced amnesia in mice.

    Science.gov (United States)

    Ghumatkar, Priya J; Patil, Sachin P; Jain, Pankaj D; Tambe, Rufi M; Sathaye, Sadhana

    2015-08-01

    Phloretin (PHL), a dihydrochalcone flavonoid usually present in the roots and leaves of apple tree. In vitro study on GT1-7 immortalized hypothalamic neurons exposed to amyloid beta (25-35), demonstrated that PHL significantly influenced membrane fluidity and potential. PHL also significantly decreased excitotoxicity by restoring the calcium homeostasis in the same. Thus, PHL proves to be a promising therapeutic moiety which should be further screened in the treatment of Alzheimer's disease. The objective of the present study was to evaluate the nootropic, neuroprotective and neurotrophic roles of PHL in the subacute scopolamine induced amnesia in mice. In this study, mice were pretreated with PHL 2.5mg/kg, 5mg/kg, 10mg/kg and Donepezil (DON) 1mg/kg intraperitoneally (i.p) for 14days. The last 7days of treatment regimen included daily injection of SCP 1.5mg/kg to induce cognitive deficits. Mice were subjected to behavioral analysis. Biochemical estimation of the brain homogenates for acetylcholinesterase and oxidative stress biomarkers were conducted. Furthermore, immunohistochemical analysis for the brain derived neurotrophic factor (BDNF) was carried out particularly in the hippocampus. PHL was found to significantly improve the performance of mice in Morris water maze test (Pnootropic, neuroprotective and neurotrophic activities in SCP induced memory impaired mice and hence, is a promising therapeutic moiety in the treatment of AD.

  1. Long-term spacing effect benefits in developmental amnesia: case experiments in rehabilitation.

    Science.gov (United States)

    Green, Janet L; Weston, Tina; Wiseheart, Melody; Rosenbaum, R Shayna

    2014-09-01

    The spacing effect describes the typical finding that repeated items are remembered best when additional items are introduced between each repetition than when the repetitions occur in immediate succession. In this study, we investigated the nature and limits of the spacing effect in the developmental amnesic case H.C. In Experiment 1, we compared the performance of H.C. to that of controls on a short-term, free recall, verbal learning spacing paradigm while controlling for retention interval (timing of item review and recall). In Experiment 2, we compared the performance of H.C. to that of controls on a multiday, cued recall, verbal learning spacing paradigm, in which memory was assessed after 1 week. In both experiments, H.C. demonstrated a spacing effect comparable to the effect exhibited by controls. In Experiment 1, her final recall memory for long-lag (spaced) items was better than recall for no-lag (massed) items t(23) = 10.99, p memory for next-day-reviewed (spaced) items was better than cued recall for same-day-reviewed (massed) items, t(20) = 17.6, p memory development and is the first to show long-term benefits of spacing in amnesia. Substantially slower learning-to-criterion suggests an alternate mechanism supporting the spacing effect, perhaps independent of the hippocampus. Spacing should be considered as a candidate memory intervention technique given its effectiveness in both short- and long-term learning settings. (c) 2014 APA, all rights reserved.

  2. Is there a positive bias in false recognition? Evidence from confabulating amnesia patients.

    Science.gov (United States)

    Alkathiri, Nura H; Morris, Robin G; Kopelman, Michael D

    2015-10-01

    Although there is some evidence for a positive emotional bias in the content of confabulations in brain damaged patients, findings have been inconsistent. The present study used the semantic-associates procedure to induce false recall and false recognition in order to examine whether a positive bias would be found in confabulating amnesic patients, relative to non-confabulating amnesic patients and healthy controls. Lists of positive, negative and neutral words were presented in order to induce false recall or false recognition of non-presented (but semantically associated) words. The latter were termed 'critical intrusions'. Thirteen confabulating amnesic patients, 13 non-confabulating amnesic patients and 13 healthy controls were investigated. Confabulating patients falsely recognised a higher proportion of positive (but unrelated) words, compared with non-confabulating patients and healthy controls. No differences were found for recall memory. Signal detection analysis, however, indicated that the positive bias for false recognition memory might reflect weaker memory in the confabulating amnesic group. This suggested that amnesia patients with weaker memory are more likely to confabulate and the content of these confabulations are more likely to be positive.

  3. Suggesting a possible role of CA1 histaminergic system in harmane-induced amnesia.

    Science.gov (United States)

    Nasehi, Mohammad; Mashaghi, Elham; Khakpai, Fatemeh; Zarrindast, Mohammad-Reza

    2013-11-27

    A number of tremorogenic β-carboline alkaloids such as harmane are naturally present in the human food chain. They are derived from medicinal plants such as Peganum harmala that have been used as folk medicine in anticancer therapy. In the present study, effects of the histaminergic system of the dorsal hippocampus (CA1) on harmane-induced amnesia were examined. One-trial step-down was used to assess memory retention in adult male mice. The results showed that pre-training intra-CA1 administration of histamine (5μg/mouse), ranitidine (H2 receptor antagonist; at the doses of 0.25 and 0.5μg/mouse) and pyrilamine (H1 receptor antagonist; at the dose of 5μg/mouse) decreased memory formation. Pre-training intraperitoneal (i.p.) administration of harmane (12mg/kg) also decreased memory formation. Moreover, pre-training intra-CA1 injection of a sub-threshold dose of histamine (2.5μg/mouse) could reverse harmane (12mg/kg, i.p.)-induced impairment of memory. On the other hand, pre-training intra-CA1 injection of sub-threshold doses of ranitidine (0.0625μg/mouse) and pyrilamine (2.5μg/mouse) increased harmane-induced impairment of memory. In conclusion, the present findings suggest the involvement of the CA1 histaminergic system in harmane-induced impairment of memory formation.

  4. Medial temporal and neocortical contributions to remote memory for semantic narratives: evidence from amnesia.

    Science.gov (United States)

    Verfaellie, Mieke; Bousquet, Kathryn; Keane, Margaret M

    2014-08-01

    Studies of remote memory for semantic facts and concepts suggest that hippocampal lesions lead to a temporally graded impairment that extends no more than ten years prior to the onset of amnesia. Such findings have led to the notion that once consolidated, semantic memories are represented neocortically and are no longer dependent on the hippocampus. Here, we examined the fate of well-established semantic narratives following medial temporal lobe (MTL) lesions. Seven amnesic patients, five with lesions restricted to the MTL and two with lesions extending into lateral temporal cortex (MTL+), were asked to recount fairy tales and bible stories that they rated as familiar. Narratives were scored for number and type of details, number of main thematic elements, and order in which the main thematic elements were recounted. In comparison to controls, patients with MTL lesions produced fewer details, but the number and order of main thematic elements generated was intact. By contrast, patients with MTL+ lesions showed a pervasive impairment, affecting not only the generation of details, but also the generation and ordering of main steps. These findings challenge the notion that, once consolidated, semantic memories are no longer dependent on the hippocampus for retrieval. Possible hippocampal contributions to the retrieval of detailed semantic narratives are discussed.

  5. Exposure to hypomagnetic field space for multiple generations causes amnesia in Drosophila melanogaster.

    Science.gov (United States)

    Zhang, Bin; Lu, Huimin; Xi, Wang; Zhou, Xianju; Xu, Shiyu; Zhang, Ke; Jiang, Jinchang; Li, Yan; Guo, Aike

    2004-11-23

    This is the introduction of Drosophila into the study of learning and memory affected by removal of the geomagnetic field (GMF) for successive generations. Using the operant visual learning/memory paradigm at a flight simulator, the present study revealed that wild-type flies raised in a hypomagnetic field environment continuously for 10 successive generations were gradually impaired in visual conditioning learning and memory formation and finally the 10th generation flies became morphs of nonlearners and completely amnesiac. The control experiments show that the impairment could not be ascribed to any apparent sensorimotor problems in Drosophila. The reverse shift from hypomagnetic field (HMF) to natural GMF restored the GMF-free induced amnesia fully after six consecutive generations. Thus, our findings demonstrate conclusively that some serious, but reversible learning and memory impairment may occur for living organisms in a prolonged separation from GMF over many consecutive generations. And Drosophila has the potential to develop into a new model organism for the study of the neurobiology of magnetism for multiple generations.

  6. MEDIAL TEMPORAL LOBE CONTRIBUTIONS TO FUTURE THINKING: EVIDENCE FROM NEUROIMAGING AND AMNESIA

    Science.gov (United States)

    Verfaellie, Mieke; Race, Elizabeth; Keane, Margaret M.

    2013-01-01

    Following early amnesic case reports, there is now considerable evidence suggesting a link between remembering the past and envisioning the future. This link is evident in the overlap in neural substrates as well as cognitive processes involved in both kinds of tasks. While constructing a future narrative requires multiple processes, neuroimaging and lesion data converge on a critical role for the medial temporal lobes (MTL) in retrieving and recombining details from memory in the service of novel simulations. Deficient detail retrieval and recombination may lead to impairments not only in episodic, but also in semantic prospection. MTL contributions to scene construction and mental time travel may further compound impairments in amnesia on tasks that pose additional demands on these processes, but are unlikely to form the core deficit underlying amnesics’ cross-domain future thinking impairment. Future studies exploring the role of episodic memory in other forms of self-projection or future-oriented behaviour may elucidate further the adaptive role of memory. PMID:23447709

  7. Prominent and persistent loss of past awareness in amnesia: delusion, impaired consciousness or coping strategy?

    Science.gov (United States)

    Wilson, Barbara A; Kopelman, Michael; Kapur, Narinder

    2008-01-01

    Profound loss of awareness for the past in amnesia has implications for our understanding of memory and belief systems, and how they may become disrupted in neurological conditions. We report the case of CW, a professional musician who became severely amnesic in 1985 following herpes simplex viral encephalitis (HSVE) at the age of 46 years. For many years CW stated several times a day that he had just woken up. He frequently wrote this in his diary too. When shown examples of his diary entries or videos of himself playing or conducting music, he recognised both his handwriting and himself on the video screen but stated vehemently that he "was not conscious then". In a previous paper (Wilson, Baddeley, & Kapur 1995), it was suggested that this lack of awareness for the past was a delusion, defined as a strongly held belief in the face of contradictory evidence (rather than implying any kind of psychiatric disorder per se). As a contribution to the academic debate regarding theories of "self", in the present paper we will review this explanation of CW's state as it had been in those early years, and we will also consider two other possibilities - namely, that CW had suffered from a loss of "autobiographical self" or "extended consciousness" (see Damasio, 2000, pp. 198-199), and that his verbal reports simply reflected a form of coping strategy to help him deal with the limited evidence he had available in "declarative" memory.

  8. Historical amnesia and its consequences: the need to build histories of practice

    Directory of Open Access Journals (Sweden)

    Sioban Nelson

    2009-01-01

    Full Text Available Este artículo se centra en dos cuestiones fundamentales: el papel de la historia como un testigo clave de los acontecimientos, los momentos o los cambios en la historia; y el papel de la historia en el actual desarrollo de la identidad - la identidad de los individuos, grupos, naciones y generaciones. Concluyo con algunas observaciones sobre la forma en que el estudio y la enseñanza de la historia puede ser abordada. Mi argumento tiene varias vertientes: en primer lugar, la historia es útil en las especificidades - a veces hay historias que no debemos olvidar. Tenemos esa deuda con los testigos. Cada cultura posee esos momentos de recuerdo. Algunos, como el de Hiroshima o el Holocausto, pertenecen a toda la humanidad. En segundo lugar, existen historias que es sabio no olvidar - nosotros deberíamos aprender con los errores de los que vinieron antes de nosotros y nos mostraron algo de su sabiduría. Por último, demuestro que la amnesia histórica es peligrosa. La memoria es necesaria - necesitamos saber quiénes somos si queremos tener alguna esperanza de saber hacia dónde vamos.

  9. The effects of live, taped, and no music on people experiencing posttraumatic amnesia.

    Science.gov (United States)

    Baker, F

    2001-01-01

    This study compared the effects of live, taped, and no music, on agitation and orientation levels of people experiencing posttraumatic amnesia (PTA). Participants (N = 22) were exposed to all 3 conditions, twice over 6 consecutive days. Songs used in the live and taped music conditions were identical and were selected based on participants' own preferred music. Pre and posttesting was conducted for each condition using the Agitated Behavior Scale (Corrigan, 1989) and the Westmead PTA Scale (Shores, Marosszeky, Sandanam, Batchelor, 1986). Participants' memory for the music used was also tested and compared with their memory for pictorial material presented in the Westmead PTA Scale. Results indicate that music significantly reduced agitation (p music was not significant (p =.7). The mean number of pictures in the Westmead PTA scale recalled was 0.84 and the mean number of music selections recalled was 1.22 but this difference was not significant (p =.7). However, the trend suggests that music selections are more easily encoded in memory and then retrieved on request, than that of pictures. Analysis of responses in a follow-up assessment questionnaire showed that 77% of participants recalled the music program while in PTA, indicating that it reached the memory threshold. Sixty-four percent recalled the live music and 55% recalled the taped music condition however this difference was not significant (p =.7). Results suggest that music therapy programs have an important role to play in the management of people in PTA.

  10. Enduring amnesia induced by ICV scopolamine is reversed by sesame oil in male rats.

    Science.gov (United States)

    Tabari, Shabnam-Sadat Seyedi; Babri, Shirin; Mirzaie, Fariba; Farajdokht, Fereshteh; Mohaddes, Gisou

    2016-08-01

    To evaluated the long-term effect of scopolamine and sesame oil on spatial memory. Memory impairment induced by Intracerebroventricular (ICV) injection of scopolamine hydrochloride (10 μg/ rat). Animals were gavaged for 4 weeks with saline, sesame oil (0.5, 1, or 2 mL/kg/day), or 3 weeks with memantine (30 mg/kg/day) in advance to induction of amnesia. Morris water maze (MWM) test was conducted 6 days after microinjection of scopolamine. Then, blood and brain samples were collected and evaluated for the malondialdehyde (MDA) levels, superoxide dismutase (SOD) and glutathione peroxidase (GPX) activities, and total antioxidant status (TAS) and ferric reducing ability of plasma (FRAP). Scopolamine significantly decreased traveled distance and time spent in target quadrant in probe test. Pretreatment of rats with sesame oil (0.5 mg/kg) mitigated scopolamine-induced behavioral alterations. Measurement of MDA, SOD, and GPX in brain tissue, and FRAP and TAS in blood showed little changes in animals which had received scopolamine or sesame oil. Intracerebroventricular injection of scopolamine has a residual effect on memory after six days. Sesame oil has an improving effect on spatial memory; however this effect is possibly mediated by mechanisms other than antioxidant effect of sesame oil.

  11. Galveston Orientation and Amnesia Test: applicability and relation with the Glasgow Coma Scale Galveston Orientation and Amnesia Test: aplicabilidad y relación con la Escala de Coma de Glasgow Galveston Orientation and Amnesia Test: aplicabilidade e relação com a Escala de Coma de Glasgow

    Directory of Open Access Journals (Sweden)

    Silvia Cristina Fürbringer e Silva

    2007-08-01

    Full Text Available Restrictions in the application of the Galveston Orientation and Amnesia Test and questionings about the relationship between conscience and post-traumatic amnesia motivated this study, which aims to identify, through the Glasgow Coma Scale scores, when to initiate the application of this amnesia test, as well to verify the relationship between the results of these two indicators. The longitudinal prospective study was carried at a referral center for trauma care in São Paulo - Brazil. The sample consisted of 73 victims of blunt traumatic brain injury, admitted at this institution between January 03rd and May 03rd 2001. Regarding the applicability, the test could be applied in patients with a Glasgow Coma Scale score > 12; however, the end of post traumatic amnesia was verified in patients who scored > 14 on the scale. A significant relationship (r s = 0.65 was verified between these measures, although different kinds of relationship between the end of the amnesia and changes in consciousness were observed.Restricciones en la aplicación del Galveston Orientation and Amnesia Test y los cuestionamientos sobre la relación entre conciencia y amnesia post-traumática motivaron este estudio que visa identificar, a través de la puntuación de la Escala de Coma de Glasgow, el periodo más adecuado para la aplicación de la prueba de amnesia, y observar la relación entre los resultados de esos dos indicadores. El estudio prospectivo y longitudinal fue realizado en un centro de referencia para traumas en São Paulo - Brasil. El número fue de 73 victimas de trauma craneoencefálico contuso, internadas en esta institución en el periodo de 03/01 a 03/05/2001. Con relación a la aplicabilidad, la prueba puede ser aplicada en los pacientes con la Escala de Coma de Glasgow > 12, pero el término de la amnesia post-traumática fue observado en los pacientes con puntuación > 14 en la escala. Correlación significativa (rs = 0,65 fue observada entre esas

  12. Clinical and Pre-Clinical Evidence for Functional Interactions of Cannabidiol and Δ(9)-Tetrahydrocannabinol.

    Science.gov (United States)

    Boggs, Douglas L; Nguyen, Jacques D; Morgenson, Daralyn; Taffe, Michael A; Ranganathan, Mohini

    2017-09-06

    The plant Cannabis sativa, commonly called cannabis or marijuana, has been used for its psychotropic and mind-altering side effects for millennia. There has been growing attention in recent years on its potential therapeutic efficacy as municipalities and legislative bodies in the United States, Canada, and other countries grapple with enacting policy to facilitate the use of cannabis or its constituents for medical purposes. There are over 550 chemical compounds and over 100 phytocannabinoids isolated from cannabis, including Δ(9)-tetrahydrocannabinol (THC) and Cannabidiol (CBD). THC is thought to produce the main psychoactive effects of cannabis, while CBD does not appear to have similar effects. Studies conflict as to whether CBD attenuates or exacerbates the behavioral and cognitive effects of THC. This includes effects of CBD on THC induced anxiety, psychosis and cognitive deficits. In this article, we review the available evidence on the pharmacology and behavioral interactions of THC and CBD from pre-clinical and human studies particularly with reference to anxiety and psychosis like symptoms. Both THC and CBD, as well as other cannabinoid molecules, are currently being evaluated for medicinal purposes, separately and in combination. Future cannabis-related policy decisions should include consideration of scientific findings including the individual and interactive effects of CBD and THC.Neuropsychopharmacology accepted article preview online, 06 September 2017. doi:10.1038/npp.2017.209.

  13. Mapping causal functional contributions derived from the clinical assessment of brain damage after stroke.

    Science.gov (United States)

    Zavaglia, Melissa; Forkert, Nils D; Cheng, Bastian; Gerloff, Christian; Thomalla, Götz; Hilgetag, Claus C

    2015-01-01

    Lesion analysis reveals causal contributions of brain regions to mental functions, aiding the understanding of normal brain function as well as rehabilitation of brain-damaged patients. We applied a novel lesion inference technique based on game theory, Multi-perturbation Shapley value Analysis (MSA), to a large clinical lesion dataset. We used MSA to analyze the lesion patterns of 148 acute stroke patients together with their neurological deficits, as assessed by the National Institutes of Health Stroke Scale (NIHSS). The results revealed regional functional contributions to essential behavioral and cognitive functions as reflected in the NIHSS, particularly by subcortical structures. There were also side specific differences of functional contributions between the right and left hemispheric brain regions which may reflect the dominance of the left hemispheric syndrome aphasia in the NIHSS. Comparison of MSA to established lesion inference methods demonstrated the feasibility of the approach for analyzing clinical data and indicated its capability for objectively inferring functional contributions from multiple injured, potentially interacting sites, at the cost of having to predict the outcome of unknown lesion configurations. The analysis of regional functional contributions to neurological symptoms measured by the NIHSS contributes to the interpretation of this widely used standardized stroke scale in clinical practice as well as clinical trials and provides a first approximation of a 'map of stroke'.

  14. Levels of personality functioning and their association with clinical features and interpersonal functioning in patients with personality disorders.

    Science.gov (United States)

    Lowyck, Benedicte; Luyten, Patrick; Verhaest, Yannic; Vandeneede, Bart; Vermote, Rudi

    2013-06-01

    Recently, the DSM-5 Personality and Personality Disorders Work Group has proposed a multiple level approach toward the classification and diagnosis of personality disorders (PDs), with the first level entailing a rating of impairments in levels of personality functioning. Although a number of measures that assess levels of personality functioning have been validated, given its prominent status in the DSM-5 proposal and contemporary theories of personality pathology, the Work Group has called for more research in this area (e.g., Bender, Morey, & Skodol, 2011). In response to this call, this study investigates the relationship between two major, well-validated dimensional measures of levels of personality functioning, that is, the Differentiation-Relatedness Scale (DR-S; Diamond, Blatt, Stayner, & Kaslow, 1991), as scored on the Object Relations Inventory (ORI; Blatt, Wein, Chevron, & Quinlan, 1979), and the Inventory of Personality Organization (IPO; Lenzenweger, Clarkin, Kernberg, & Foelsch, 2001), a self-report instrument, and their relationship with different measures of clinical and interpersonal functioning in 70 patients with a PD. First, results showed that higher levels of differentiation and relatedness of descriptions of self and significant others, and of the self in particular, were negatively related to indices of personality functioning as assessed by the IPO. Lower levels of personality functioning, as measured with both the DR-S and the IPO, were positively related to severity of depression, symptomatic distress, self-harm, and interpersonal problems. Finally, results showed that the DR-S and the IPO independently predicted clinical features and interpersonal functioning. Hence, this study lends further support for the concurrent and predictive validity of the DR-S and the IPO in assessing levels of personality functioning. However, more research concerning the validity of these measures in assessing levels of personality functioning is needed

  15. Can Clinical Assessment of Locomotive Body Function Explain Gross Motor Environmental Performance in Cerebral Palsy?

    Science.gov (United States)

    Sanz Mengibar, Jose Manuel; Santonja-Medina, Fernando; Sanchez-de-Muniain, Paloma; Canteras-Jordana, Manuel

    2016-03-01

    Gross Motor Function Classification System has discriminative purposes but does not assess short-term therapy goals. Locomotion Stages (LS) classify postural body functions and independent activity components. Assessing the relation between Gross Motor Function Classification System level and Locomotion Stages will make us understand if clinical assessment can explain and predict motor environmental performance in cerebral palsy. A total of 462 children were assessed with both scales. High reliability and strong negative correlation (-0.908) for Gross Motor Function Classification System and Locomotion Stages at any age was found. Sensitivity was 83%, and specificity and positive predictive value were 100% within the same age range. Regression analysis showed detailed probabilities for the realization of the Gross Motor Function Classification System depending on the Locomotion Stages and the age group. Postural body function measure with Locomotion Stages is reliable, sensitive, and specific for gross motor function and able to predict environmental performance.

  16. Immune Monitoring in Cancer Vaccine Clinical Trials: Critical Issues of Functional Flow Cytometry-Based Assays

    Directory of Open Access Journals (Sweden)

    Iole Macchia

    2013-01-01

    Full Text Available The development of immune monitoring assays is essential to determine the immune responses against tumor-specific antigens (TSAs and tumor-associated antigens (TAAs and their possible correlation with clinical outcome in cancer patients receiving immunotherapies. Despite the wide range of techniques used, to date these assays have not shown consistent results among clinical trials and failed to define surrogate markers of clinical efficacy to antitumor vaccines. Multiparameter flow cytometry- (FCM- based assays combining different phenotypic and functional markers have been developed in the past decade for informative and longitudinal analysis of polyfunctional T-cells. These technologies were designed to address the complexity and functional heterogeneity of cancer biology and cellular immunity and to define biomarkers predicting clinical response to anticancer treatment. So far, there is still a lack of standardization of some of these immunological tests. The aim of this review is to overview the latest technologies for immune monitoring and to highlight critical steps involved in some of the FCM-based cellular immune assays. In particular, our laboratory is focused on melanoma vaccine research and thus our main goal was the validation of a functional multiparameter test (FMT combining different functional and lineage markers to be applied in clinical trials involving patients with melanoma.

  17. Assessment of brain function in clinical pediatric research: behavioral and biological strategies.

    Science.gov (United States)

    Young, J G; Cohen, D J; Shaywitz, S E; Caparulo, B K; Kavanagh, M E; Hunt, R D; Leckman, J F; Anderson, G M; Detlor, J; Harcherik, D; Shaywitz, B A

    1982-01-01

    Psychobiological research in child psychiatry requires rigorous assessment of behavior and multiple perspectives on brain function through neurochemical, neuroendocrine, psychophysiological, and other advanced methods. The serious neuropsychiatric disorders of childhood, such as autism, attention deficit disorder, and language disorders, can be studied in complementary clinical protocols aimed at explicating patterns of behavioral and metabolic dysfunction which characterize various clinical syndromes. Clinical research with children raises sensitive ethical issues; the ethical problems can be addressed when children and families are active collaborators with the investigators and a long-term relationship is established. In this setting, participation in research can facilitate better treatment for a child. The use of novel biological strategies, such as pharmacological challenge tests, permits evaluation of the relation of specific neuronal systems to behavioral dimensions in clinical disorders. The development of a new treatment for Tourette's syndrome illustrates the integration of basic and clinical research methods.

  18. Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Lund, Hans; Juul-Kristensen, Birgit

    2014-01-01

    patient sample with SIS, and to assess the clinimetric properties of clinical assessment methods of scapular kinematics as important aspects for optimising effect measures of treatment in order to improve clinical guidelines in this area. METHODS: Scapular muscle activity was examined, 1) during......Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics Larsen CM1, Juul-Kristensen B1,2 Holtermann A3, Lund H1,2, Søgaard K1 1University of Southern Denmark, Institute of Sports Science and Clinical Biomechanics, DK 2Institute...... a voluntary arm movement task and 2) selective activation tasks during sessions with and without on-line biofeedback, in a general population consisting of 16 SIS patients and 15 controls (No-SIS). Furthermore, 3) a systematic review was conducted of all available clinical scapular assessment methods...

  19. The Relations Between Temperament, Character, and Executive Functions in Children With ADHD and Clinical Controls

    DEFF Research Database (Denmark)

    Drechsler, Renate; Zulauf Logoz, Marina; Walitza, Susanne;

    2016-01-01

    OBJECTIVE: The purpose of this study was to investigate the overlap between executive functions and temperament as measured by two questionnaires and to examine characteristic profiles in children with ADHD and clinical controls. METHOD: Parents of 111 clinically referred children, half of whom...... were diagnosed with ADHD and half with other or no diagnoses, completed the Behavior Rating Inventory of Executive Function (BRIEF) and the Cloninger Junior Temperament and Character Inventory (JTCI). RESULTS: Factor analysis of both instruments resulted in three common factors representing aspects...

  20. Effects of protein synthesis inhibitors during reactivation of associative memory in the common snail induces reversible and irreversible amnesia.

    Science.gov (United States)

    Solntseva, S V; Nikitin, V P; Kozyrev, S A; Shevelkin, A V; Lagutin, A V; Sherstnev, V V

    2007-11-01

    The effects of protein synthesis inhibitors on the reactivation of an associative skill consisting of refusing a particular food by common snails were studied. Animals were given single injections of a protein synthesis inhibitor (cycloheximide at 0.6 mg/snail or anisomycin at 0.4 mg) 24 h after three days of training, and were then presented with a "reminding" stimulus (the "conditioned reflex" food-banana) and tested for retention of the skill. Observations revealed an impairment of reproduction of the acquired skill 2.5 h after the "reminder," with spontaneous restoration at 4.5-5.5 h. Other snails were given single 1.8-mg doses of cycloheximide or three 0.6-mg doses with intervals of 2 h. "Reminders" were presented after each injection. In these conditions, impairment of reproduction of the conditioned reflex also appeared 2.5 h after the first "reminder," though amnesia lasted at least 30 days and repeat training of the animals produced only partial recovery of the skill. Thus, we have provided the first demonstration that recovery of a long-term memory "trace" on exposure to relatively low doses of protein synthesis inhibitors produces transient and short-lived amnesia, lasting 2-3 h, while long-term, irreversible amnesia occurs after longer-lasting or more profound suppression of protein synthesis. These results suggest that the "reminding" process induces reconsolidation of the " initial" memory, suppression of which by protein synthesis inhibitors leads to "erasure" of the memory "trace" and impairs consolidation on repeat training.

  1. Clinical Case Reporting in the Peer-Reviewed Physical Therapy Literature: Time to Move Toward Functioning.

    Science.gov (United States)

    Davenport, Todd E

    2015-12-01

    Physical therapists increasingly are contributing clinical case reports to the health literature, which form the basis for higher quality evidence that has been incorporated into clinical practice guidelines. Yet, few resources exist to assist physical therapists with the basic mechanics and quality standards of producing a clinical case report. This situation is further complicated by the absence of uniform standards for quality in case reporting. The importance of including a concise yet comprehensive description of patient functioning in all physical therapy case reports suggest the potential appropriateness of basing quality guidelines on the World Health Organization's International Classification of Functioning Disability and Health (ICF) model. The purpose of this paper is to assist physical therapists in creating high-quality clinical case reports for the peer-reviewed literature using the ICF model as a guiding framework. Along these lines, current recommendations related to the basic mechanics of writing a successful clinical case report are reviewed, as well and a proposal for uniform clinical case reporting requirements is introduced with the aim to improve the quality and feasibility of clinical case reporting in physical therapy that are informed by the ICF model.

  2. The Effect of Clinical Pilates on Functional Movement in Recreational Runners.

    Science.gov (United States)

    Laws, Anna; Williams, Sean; Wilson, Cassie

    2017-09-01

    Biomechanical imbalances and inefficient functional movements are considered contributing factors to running-related injuries. Clinical Pilates uses a series of exercises focused on retraining normal movement patterns. This study investigated whether a 6-week course of Clinical Pilates improves functional movement and thereby, potentially, reduces the risk of running-related injuries associated with movement dysfunction. A modified functional movement screen was used to analyze the functional movement ability of forty runners. Forty participants completed a 6-week course of Clinical Pilates delivered by a Clinical Pilates instructor. The movement screen was carried out 3 times for each runner: 6 weeks pre-intervention (baseline), within one week pre-intervention (pre) and within one week post-intervention (post). Repeated-measures analysis of variance and post-hoc tests found significant increases in scores between baseline and post (mean±SD; 13.4±2.4 vs. 17.0±1.7, pPilates significantly improves functional movement in recreational runners, and this may lead to a reduction in the risk of running-related injuries. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Neurophysiological evidence for a recollection impairment in amnesia patients that leaves familiarity intact.

    Science.gov (United States)

    Addante, Richard James; Ranganath, Charan; Olichney, John; Yonelinas, Andrew P

    2012-11-01

    In several previous behavioral studies, we have identified a group of amnestic patients that, behaviorally, appear to exhibit severe deficits in recollection with relative preservation of familiarity-based recognition. However, these studies have relied exclusively on behavioral measures, rather than direct measures of physiology. Event-related potentials (ERPs) have been used to identify putative neural correlates of familiarity- and recollection-based recognition memory, but little work has been done to determine the extent to which these ERP correlates are spared in patients with relatively specific memory disorders. ERP studies of recognition in healthy subjects have indicated that recollection and familiarity are related to a parietal old-new effect characterized as a late positive component (LPC) and an earlier mid-frontal old-new effect referred to as an 'FN400', respectively. Here, we sought to determine the extent to which the putative ERP correlates of recollection and familiarity are intact or impaired in these patients. We recorded ERPs in three amnestic patients and six age matched controls while they made item recognition and source recognition judgments. The current patients were able to discriminate between old and new items fairly well, but showed nearly chance-level performance at source recognition. Moreover, whereas control subjects exhibited ERP correlates of memory that have been linked to recollection and familiarity, the patients only exhibited the mid-frontal FN400 ERP effect related to familiarity-based recognition. The results show that recollection can be severely impaired in amnesia even when familiarity-related processing is relatively spared, and they also provide further evidence that ERPs can be used to distinguish between neural correlates of familiarity and recollection.

  4. Is a cancer diagnosis associated with subsequent risk of transient global amnesia?

    Directory of Open Access Journals (Sweden)

    Jianwei Zhu

    Full Text Available Psychological stress has been associated with transient global amnesia (TGA. Whether a cancer diagnosis, a severely stressful life event, is associated with subsequent risk of TGA has not been studied.Based on the Swedish Cancer Register and Patient Register, we conducted a prospective cohort study including 5,365,608 Swedes at age 30 and above during 2001-2009 to examine the relative risk of TGA among cancer patients, as compared to cancer-free individuals. Incidence rate ratios (IRRs and their 95% confidence intervals (CIs derived from Poisson regression were used as estimates of the association between cancer diagnosis and the risk of TGA.During the study 322,558 individuals (6.01% received a first diagnosis of cancer. We identified 210 cases of TGA among the cancer patients (incidence rate, 0.22 per 1000 person-years and 4,887 TGA cases among the cancer-free individuals (incidence rate, 0.12 per 1000 person-years. Overall, after adjustment for age, sex, calendar year, socioeconomic status, education and civil status, cancer patients had no increased risk of TGA than the cancer-free individuals (IRR, 0.99; 95% CI, 0.86-1.13. The IRRs did not differ over time since cancer diagnosis or across individual cancer types. The null association was neither modified by sex, calendar period or age.Our study did not provide support for the hypothesis that patients with a new diagnosis of cancer display a higher risk of TGA than cancer-free individuals.

  5. Stronger pharmacological cortisol suppression and anticipatory cortisol stress response in transient global amnesia

    Directory of Open Access Journals (Sweden)

    Martin eGriebe

    2015-03-01

    Full Text Available Transient global amnesia (TGA is a disorder characterized by a sudden attack of severe anterograde memory disturbance that is frequently preceded by emotional or physical stress and resolves within 24 hours. By using MRI following the acute episode in TGA patients, small lesions in the hippocampus have been observed. Hence it has been hypothesized that the disorder is caused by a stress-related transient inhibition of memory formation in the hippocampus. To study the factors that may link stress and TGA, we measured the cortisol day-profile, the dexamethasone feedback inhibition and the effect of experimental exposure to stress on cortisol levels (using the socially evaluated cold pressor test and a control procedure in 20 patients with a recent history of TGA and in 20 healthy controls. We used self-report scales of depression, anxiety and stress and a detailed neuropsychological assessment to characterize our collective. We did not observe differences in mean cortisol levels in the cortisol day-profile between the two groups. After administration of low-dose dexamethasone, TGA patients showed significantly stronger cortisol suppression in the daytime profile compared to the control group (p = 0.027. The mean salivary cortisol level was significantly higher in the TGA group prior to and after the experimental stress exposure (p = 0.008; p = 0.010 respectively, as well as prior to and after the control condition (p = 0.022; p= 0.024 respectively. The TGA group had higher scores of depressive symptomatology (p = 0.021 and anxiety (p = 0.007, but the groups did not differ in the neuropsychological assessment. Our findings of a stronger pharmacological suppression and higher cortisol levels in anticipation of experimental stress in participants with a previous TGA indicate a hypersensitivity of the HPA axis. This suggests that an individual stress sensitivity might play a role in the pathophysiology of TGA.

  6. False recognition in behavioural variant frontotemporal dementia and Alzheimer’s disease – disinhibition or amnesia?

    Directory of Open Access Journals (Sweden)

    Emma C Flanagan

    2016-07-01

    Full Text Available Episodic memory recall processes in Alzheimer’s disease (AD and behavioural variant frontotemporal dementia (bvFTD can be similarly impaired, whereas recognition performance is more variable. A potential reason for this variability could be false-positive errors made on recognition trials and whether these errors are due to amnesia per se or a general over-endorsement of recognition items regardless of memory. The current study addressed this issue by analysing recognition performance on the Rey Auditory Verbal Learning Test (RAVLT in 39 bvFTD, 77 AD and 61 control participants from two centres (India, Australia, as well as disinhibition assessed using the Hayling test. Whereas both AD and bvFTD patients were comparably impaired on delayed recall, bvFTD patients showed intact recognition performance in terms of the number of correct hits. However, both patient groups endorsed significantly more false-positives than controls, and bvFTD and AD patients scored equally poorly on a sensitivity index (correct hits - false-positives. Furthermore, measures of disinhibition were significantly associated with false positives in both groups, with a stronger relationship with false-positives in bvFTD. Voxel-based morphometry analyses revealed similar neural correlates of false positive endorsement across bvFTD and AD, with both patient groups showing involvement of prefrontal and Papez circuitry regions, such as medial temporal and thalamic regions, and a DTI analysis detected an emerging but non-significant trend between false positives and decreased fornix integrity in bvFTD only. These findings suggest that false-positive errors on recognition tests relate to similar mechanisms in bvFTD and AD, reflecting deficits in episodic memory processes and disinhibition. These findings highlight that current memory tests are not sufficient to accurately distinguish between bvFTD and AD patients.

  7. A Computational Model of Perceptual and Mnemonic Deficits in Medial Temporal Lobe Amnesia.

    Science.gov (United States)

    Sadil, Patrick S; Cowell, Rosemary A

    2017-02-14

    Damage to the medial temporal lobe (MTL) has long been known to impair declarative memory, and recent evidence suggests that it also impairs visual perception. A theory termed the representational-hierarchical account explains such impairments by assuming that MTL stores conjunctive representations of items and events, and that individuals with MTL damage must rely upon representations of simple visual features in posterior visual cortex, which are inadequate to support memory and perception under certain circumstances. One recent study of visual discrimination behavior revealed a surprising antiperceptual learning effect in MTL-damaged individuals: With exposure to a set of visual stimuli, discrimination performance worsened rather than improved [Barense, M. D., Groen, I. I. A., Lee, A. C. H., Yeung, L. K., Brady, S. M., Gregori, M., et al. Intact memory for irrelevant information impairs perception in amnesia. Neuron, 75, 157-167, 2012]. We extend the representational-hierarchical account to explain this paradox by assuming that difficult visual discriminations are performed by comparing the relative "representational tunedness"-or familiarity-of the to-be-discriminated items. Exposure to a set of highly similar stimuli entails repeated presentation of simple visual features, eventually rendering all feature representations maximally and, thus, equally familiar; hence, they are inutile for solving the task. Discrimination performance in patients with MTL lesions is therefore impaired by stimulus exposure. Because the unique conjunctions represented in MTL do not occur repeatedly, healthy individuals are shielded from this perceptual interference. We simulate this mechanism with a neural network previously used to explain recognition memory, thereby providing a model that accounts for both mnemonic and perceptual deficits caused by MTL damage with a unified architecture and mechanism.

  8. Clinical characteristics and epidermal barrier function of papulopustular rosacea: A comparison study with acne vulgaris

    OpenAIRE

    Zhou, Maosong; Xie, Hongfu; Cheng, Lin; Li, Ji

    2016-01-01

    Objective: To evaluate the clinical characteristics and epidermal barrier function of papulopustular rosacea by comparing with acne vulgaris. Methods: Four hundred and sixty-three papulopustular rosacea patients and four hundred and twelve acne vulgaris patients were selected for the study in Xiangya Hospital of Central South University from March 2015 to May 2016. They were analyzed for major facial lesions, self-conscious symptoms and epidermal barrier function. Results: Erythema, burning, ...

  9. Lack of executive function deficits among adult ADHD individuals from a Brazilian clinical sample

    OpenAIRE

    Eloisa Saboya; Gabriel Coutinho; Daniel Segenreich; Vanessa Ayrão; Paulo Mattos

    2009-01-01

    Abstract Executive function deficits have been previously documented in individuals with Attention Deficit Hyperactivity Disorder (ADHD). Objective: The current study aimed to compare measures of executive functions among a clinical sample of adults with ADHD and normal control subjects, matched for age, gender and education. Methods: Twenty-three self-referred adults diagnosed with ADHD according to DSM-IV criteria, and twenty-five control subjects were assessed using a neuropsychological ...

  10. ERP in chronic pancreatitis - ductal morphology, relation to exocrine function and pain - clinical value

    Energy Technology Data Exchange (ETDEWEB)

    Norup Lauridsen, K.; Raahede, J.; Kruse, A.; Thommesen, P.

    1985-08-01

    ERP was analyzed in 87 patients with chronic pancreatitis with special reference to its clinical value in management of pain, the dominating symptom in uncomplicated chronic pancreatitis. A significant correlation was found between ductal changes due to pancreatitis and decrease in pancreatic function. However, no association was found between severe pancreatic pain and pancreatic function or pancreatic morphology. The significance of ERP in management of patients with persistent severe pancreatic pain is discussed.

  11. Clinical and pathological features of alcohol-related brain damage.

    Science.gov (United States)

    Zahr, Natalie M; Kaufman, Kimberley L; Harper, Clive G

    2011-05-01

    One of the sequelae of chronic alcohol abuse is malnutrition. Importantly, a deficiency in thiamine (vitamin B(1)) can result in the acute, potentially reversible neurological disorder Wernicke encephalopathy (WE). When WE is recognized, thiamine treatment can elicit a rapid clinical recovery. If WE is left untreated, however, patients can develop Korsakoff syndrome (KS), a severe neurological disorder characterized by anterograde amnesia. Alcohol-related brain damage (ARBD) describes the effects of chronic alcohol consumption on human brain structure and function in the absence of more discrete and well-characterized neurological concomitants of alcoholism such as WE and KS. Through knowledge of both the well-described changes in brain structure and function that are evident in alcohol-related disorders such as WE and KS and the clinical outcomes associated with these changes, researchers have begun to gain a better understanding of ARBD. This Review examines ARBD from the perspective of WE and KS, exploring the clinical presentations, postmortem brain pathology, in vivo MRI findings and potential molecular mechanisms associated with these conditions. An awareness of the consequences of chronic alcohol consumption on human behavior and brain structure can enable clinicians to improve detection and treatment of ARBD.

  12. Sociodemographic, clinical, and functional long-term outcomes in adolescents and young adults with mental disorders.

    Science.gov (United States)

    Asselmann, E; Wittchen, H-U; Lieb, R; Beesdo-Baum, K

    2017-08-31

    To examine unfavorable sociodemographic, clinical, and functional long-term outcomes for a range of adolescent mental disorders. A total number of 2210 adolescents and young adults (14-24 years at baseline, T0) from a representative community sample were prospectively followed up (T1-T3) over 10 years. DSM-IV mental disorders, sociodemographic, clinical, and functional outcomes were assessed using the DIA-X/M-CIDI and its embedded assessment modules. In (multinomial) logistic regressions adjusted for sex, age, other baseline disorders and sociodemographics, baseline anxiety, affective, substance use, somatoform and eating disorders (lifetime) predicted various unfavorable sociodemographic, clinical, and functional outcomes at T3. Particularly, strong associations were found between baseline disorders and adverse clinical outcomes at T3 (12-month diagnosis of the same/other disorder(s), drug use, suicide attempts, and help-seeking due to psychological problems). While substance use disorders were primarily associated with unfavorable sociodemographic and educational outcomes, anxiety and eating disorders were associated with unfavorable interpersonal outcomes, affective disorders with pregnancy-/childbirth-related complications and financial issues, and somatoform disorders with unfavorable educational/occupational and interpersonal outcomes. The risk of unfavorable outcomes increased with clinical severity, especially a higher number of baseline diagnoses. Our findings emphasize the importance of effective treatment of mental disorders to prevent unfavorable long-term outcomes in various life domains. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Clinical Validation of 4-Dimensional Computed Tomography Ventilation With Pulmonary Function Test Data

    Energy Technology Data Exchange (ETDEWEB)

    Brennan, Douglas [University of Colorado School of Medicine, Aurora, Colorado (United States); Schubert, Leah; Diot, Quentin [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Castillo, Richard [Department of Radiation Oncology, The University of Texas Medical Branch, Galveston, Texas (United States); Castillo, Edward; Guerrero, Thomas [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Martel, Mary K. [Department of Radiation Physics, The University of Texas M. D. Anderson Cancer Center, Houston, Texas (United States); Linderman, Derek; Gaspar, Laurie E.; Miften, Moyed; Kavanagh, Brian D. [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States); Vinogradskiy, Yevgeniy, E-mail: yevgeniy.vinogradskiy@ucdenver.edu [Department of Radiation Oncology, University of Colorado School of Medicine, Aurora, Colorado (United States)

    2015-06-01

    Purpose: A new form of functional imaging has been proposed in the form of 4-dimensional computed tomography (4DCT) ventilation. Because 4DCTs are acquired as part of routine care for lung cancer patients, calculating ventilation maps from 4DCTs provides spatial lung function information without added dosimetric or monetary cost to the patient. Before 4DCT-ventilation is implemented it needs to be clinically validated. Pulmonary function tests (PFTs) provide a clinically established way of evaluating lung function. The purpose of our work was to perform a clinical validation by comparing 4DCT-ventilation metrics with PFT data. Methods and Materials: Ninety-eight lung cancer patients with pretreatment 4DCT and PFT data were included in the study. Pulmonary function test metrics used to diagnose obstructive lung disease were recorded: forced expiratory volume in 1 second (FEV1) and FEV1/forced vital capacity. Four-dimensional CT data sets and spatial registration were used to compute 4DCT-ventilation images using a density change–based and a Jacobian-based model. The ventilation maps were reduced to single metrics intended to reflect the degree of ventilation obstruction. Specifically, we computed the coefficient of variation (SD/mean), ventilation V20 (volume of lung ≤20% ventilation), and correlated the ventilation metrics with PFT data. Regression analysis was used to determine whether 4DCT ventilation data could predict for normal versus abnormal lung function using PFT thresholds. Results: Correlation coefficients comparing 4DCT-ventilation with PFT data ranged from 0.63 to 0.72, with the best agreement between FEV1 and coefficient of variation. Four-dimensional CT ventilation metrics were able to significantly delineate between clinically normal versus abnormal PFT results. Conclusions: Validation of 4DCT ventilation with clinically relevant metrics is essential. We demonstrate good global agreement between PFTs and 4DCT-ventilation, indicating that 4DCT

  14. A NEW FUNCTIONAL CLASSIFICATION OF STOMACH CANCER AND ITS PATHOBIOLOGICAL AND CLINICAL SIGNIFICANCE

    Institute of Scientific and Technical Information of China (English)

    辛彦; 赵风凯; 宫伟; 王艳萍; 张荫昌; 闫瑞方

    1994-01-01

    The functional differentiations of stomach cancer specimens from 121patients were investigated by enzyme-,mucin-,affinity-and immunohistochemical methods,and the stomach cancers were divided into five functionally differentiated types:1)Absorptive Function Differentiation Type (AFDT),19.8%;2)Mucin Secreting Func-tion Differentiation Type (MSFDT),24.0%;3)Absorptive and Mucin-Producing Function Differentiation Type (AMPFDT),47.1%;4)Special Function Differentiation Type (SFDT),0.8%;and 5)Non-Function Differ-entiation Type(NFDT),8.3%.The results indicate that stomach cancer tissues of the same histological type of -ten display differing functional differentiation,and these functionally differentiated types have different invasive and metastatic characteristics.In addition,the functionally differentiated types have particular organic affinities of metastasis and different clinical prognoses.This study suggests that this new functional classification may supple-ment histological classification.The mechanisms of liver and ovary metastases of stomach cancer are also dis-cussed.

  15. Relationship between linguistic functions and cognitive functions in a clinical study of Chinese patients with post-stroke aphasia

    Institute of Scientific and Technical Information of China (English)

    YU Zeng-zhi; JIANG Shu-jun; BI Sheng; LI Jun; LEI Di; SUN Li-ling

    2013-01-01

    Background There has been a long debate among scholars surrounding the relationship between language and cognition.The worldwide study of aphasia is actively exploring the function of language from cognitive point of view.This study aimed to investigate the relationship between linguistic functions and cognitive functions in a clinical study of Chinese patients with post-stroke aphasia.Methods Cognitive functions of 63 Chinese patients with aphasia following a stroke were assessed with the Chinese version of the second edition of Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) battery and their linguistic functions were tested with the Western Aphasia Battery (WAB) Scale,respectively.The correlation between the results observed on the LOTCA battery and those on the WAB was analyzed.Aphasia quotient,performance quotient,cortical quotient,and linguistic function of the patients were compared.Then,each language function was analyzed by way of dependent adopt multiple regression analysis.Results The total score of 63 patients as shown on the LOTCA battery was significantly correlated with the aphasia quotient,performance quotient,and cortical quotient observed on the WAB Scale (P <0.05,P <0.01).However,the correlation between visuomotor organization under LOTCA and repeat under WAB was not significant (P >0.05).The attention of LOTCA and WAB's spontaneous speech,repeat,naming,and aphasia quotient was not relevant either (P>0.05).In addition,correlations between the results observed on the LOTCA battery and the WAB were significant (P<0.05,P <0.01).Among the significant variables finally entered into the standardized canonical discriminant functions,main factors affected the aphasia.Multiple regression analysis showed that orientation,spatial perception,and visual perception had a notable influence on aphasia quotient and naming.Orientation and thinking operation was found to have a notable influence on spontaneous speech.Spatial perception and

  16. The clinical evaluation of the upper limb joints' function: back to Hippocrates.

    Science.gov (United States)

    Kapandji, Adalbert I

    2003-08-01

    This article provides evidence that evaluation of upper limb joint function may be performed without the use of instruments and using only clinical means to diagnose in most cases. Hippocrates would have proceeded the same way in the early ages of medicine.

  17. Loss-of-function variants of the filaggrin gene are associated with clinical reactivity to foods

    NARCIS (Netherlands)

    van Ginkel, C. D.; Flokstra-de Blok, B. M. J.; Kollen, B. J.; Kukler, J.; Koppelman, G. H.; Dubois, A. E. J.

    The aim of this study was to assess the genetic association of Filaggrin loss-of-function (FLG LOF) genetic variants with food allergy, and to investigate the added value of this test in diagnosing food allergy. Clinical reactivity to foods was diagnosed by the gold standard, the double-blind,

  18. Pain response of healthy workers following a Functional Capacity Evaluation and implications for clinical interpretation

    NARCIS (Netherlands)

    Soer, Remko; Groothoff, Johan W.; Geertzen, Jan H. B.; van der Schans, Cees P.; Reesink, David D.; Reneman, Michiel F.

    2008-01-01

    Background and aim Functional Capacity Evaluations (FCEs) are used to quantify physical aspects of work capacity. Safety is a critical issue for clinical use of an FCE. Patients with Chronic Low Back Pain (CLBP) are known to report a temporary increase in pain following an FCE, but it is not known w

  19. Poststroke Shoulder Pain in Turkish Stroke Patients: Relationship with Clinical Factors and Functional Outcomes

    Science.gov (United States)

    Barlak, Aysegul; Unsal, Sibel; Kaya, Kurtulus; Sahin-Onat, Sule; Ozel, Sumru

    2009-01-01

    The objective of this study was to assess the possible causes of hemiplegic shoulder pain (HSP) in Turkish patients with stroke, to identify the correlation between HSP and clinical factors, and to review the effects of HSP on functional outcomes. A total of 187 consecutive patients with stroke were evaluated for the presence of HSP and for the…

  20. Pain response of healthy workers following a Functional Capacity Evaluation and implications for clinical interpretation

    NARCIS (Netherlands)

    Soer, Remko; Groothoff, Johan W.; Geertzen, Jan H. B.; van der Schans, Cees P.; Reesink, David D.; Reneman, Michiel F.

    2008-01-01

    Background and aim Functional Capacity Evaluations (FCEs) are used to quantify physical aspects of work capacity. Safety is a critical issue for clinical use of an FCE. Patients with Chronic Low Back Pain (CLBP) are known to report a temporary increase in pain following an FCE, but it is not known w

  1. Functional brain network changes associated with clinical and biochemical measures of the severity of hepatic encephalopathy.

    Science.gov (United States)

    Jao, Tun; Schröter, Manuel; Chen, Chao-Long; Cheng, Yu-Fan; Lo, Chun-Yi Zac; Chou, Kun-Hsien; Patel, Ameera X; Lin, Wei-Che; Lin, Ching-Po; Bullmore, Edward T

    2015-11-15

    Functional properties of the brain may be associated with changes in complex brain networks. However, little is known about how properties of large-scale functional brain networks may be altered stepwise in patients with disturbance of consciousness, e.g., an encephalopathy. We used resting-state fMRI data on patients suffering from various degrees of hepatic encephalopathy (HE) to explore how topological and spatial network properties of functional brain networks changed at different cognitive and consciousness states. Severity of HE was measured clinically and by neuropsychological tests. Fifty-eight non-alcoholic liver cirrhosis patients and 62 normal controls were studied. Patients were subdivided into liver cirrhosis with no outstanding HE (NoHE, n=23), minimal HE with cognitive impairment only detectable by neuropsychological tests (MHE, n=28), and clinically overt HE (OHE, n=7). From the earliest stage, the NoHE, functional brain networks were progressively more random, less clustered, and less modular. Since the intermediate stage (MHE), increased ammonia level was accompanied by concomitant exponential decay of mean connectivity strength, especially in the primary cortical areas and midline brain structures. Finally, at the OHE stage, there were radical reorganization of the topological centrality-i.e., the relative importance-of the hubs and reorientation of functional connections between nodes. In summary, this study illustrated progressively greater abnormalities in functional brain network organization in patients with clinical and biochemical evidence of more severe hepatic encephalopathy. The early-than-expected brain network dysfunction in cirrhotic patients suggests that brain functional connectivity and network analysis may provide useful and complementary biomarkers for more aggressive and earlier intervention of hepatic encephalopathy. Moreover, the stepwise deterioration of functional brain networks in HE patients may suggest that hierarchical

  2. A functional neuroimaging study of the clinical reasoning of medical students.

    Science.gov (United States)

    Chang, Hyung-Joo; Kang, June; Ham, Byung-Joo; Lee, Young-Mee

    2016-12-01

    As clinical reasoning is a fundamental competence of physicians for good clinical practices, medical academics have endeavored to teach reasoning skills to undergraduate students. However, our current understanding of student-level clinical reasoning is limited, mainly because of the lack of evaluation tools for this internal cognitive process. This functional magnetic resonance imaging (fMRI) study aimed to examine the clinical reasoning processes of medical students in response to problem-solving questions. We recruited 24 2nd-year medical students who had completed their preclinical curriculum. They answered 40 clinical vignette-based multiple-choice questions during fMRI scanning. We compared the imaging data for 20 problem-solving questions (reasoning task) and 20 recall questions (recall task). Compared to the recall task, the reasoning task resulted in significantly greater activation in nine brain regions, including the dorsolateral prefrontal cortex and inferior parietal cortex, which are known to be associated with executive function and deductive reasoning. During the recall task, significant activation was observed in the brain regions that are related to memory and emotions, including the amygdala and ventromedial prefrontal cortex. Our results support that medical students mainly solve clinical questions with deductive reasoning involving prior knowledge structures and executive functions. The problem-solving questions induced the students to utilize higher cognitive functions compared with the recall questions. Interestingly, the results suggested that the students experienced some emotional distress while they were solving the recall questions. In addition, these results suggest that fMRI is a promising research tool for investigating students' cognitive processes.

  3. Comparison of statistical and clinical predictions of functional outcome after ischemic stroke.

    Directory of Open Access Journals (Sweden)

    Douglas D Thompson

    Full Text Available To determine whether the predictions of functional outcome after ischemic stroke made at the bedside using a doctor's clinical experience were more or less accurate than the predictions made by clinical prediction models (CPMs.A prospective cohort study of nine hundred and thirty one ischemic stroke patients recruited consecutively at the outpatient, inpatient and emergency departments of the Western General Hospital, Edinburgh between 2002 and 2005. Doctors made informal predictions of six month functional outcome on the Oxford Handicap Scale (OHS. Patients were followed up at six months with a validated postal questionnaire. For each patient we calculated the absolute predicted risk of death or dependence (OHS≥3 using five previously described CPMs. The specificity of a doctor's informal predictions of OHS≥3 at six months was good 0.96 (95% CI: 0.94 to 0.97 and similar to CPMs (range 0.94 to 0.96; however the sensitivity of both informal clinical predictions 0.44 (95% CI: 0.39 to 0.49 and clinical prediction models (range 0.38 to 0.45 was poor. The prediction of the level of disability after stroke was similar for informal clinical predictions (ordinal c-statistic 0.74 with 95% CI 0.72 to 0.76 and CPMs (range 0.69 to 0.75. No patient or clinician characteristic affected the accuracy of informal predictions, though predictions were more accurate in outpatients.CPMs are at least as good as informal clinical predictions in discriminating between good and bad functional outcome after ischemic stroke. The place of these models in clinical practice has yet to be determined.

  4. Lack of executive function deficits among adult ADHD individuals from a Brazilian clinical sample

    Directory of Open Access Journals (Sweden)

    Eloisa Saboya

    Full Text Available Abstract Executive function deficits have been previously documented in individuals with Attention Deficit Hyperactivity Disorder (ADHD. Objective: The current study aimed to compare measures of executive functions among a clinical sample of adults with ADHD and normal control subjects, matched for age, gender and education. Methods: Twenty-three self-referred adults diagnosed with ADHD according to DSM-IV criteria, and twenty-five control subjects were assessed using a neuropsychological battery which included the Wisconsin Card Sorting Test, Tower of Hanoi, Digit Span, Trail Making Test (A and B, Stroop Test and Raven's Progressive Matrices. Results: The ADHD group did not differ significantly from the control subjects on any of the measures assessed. Conclusion: Measures of executive functions using this test battery were unable to discriminate between adults with ADHD and control subjects in this clinical sample.

  5. Long-term benefits of the Memory-Link programme in a case of amnesia.

    Science.gov (United States)

    Savage, Kimberley R; Svoboda, Eva

    2013-06-01

    To systematically evaluate the maintenance of clinical gains from a structured memory intervention programme. Efficacy of the programme was initially demonstrated in RR, a woman with moderate-to-severe memory impairment following colloid cyst removal. In the current study (Svoboda and Richards, 2009), we examined RR's day-to-day memory functioning 18 months after completion of the intervention programme. Within-subject A(1)B(1)A(2)B(2)B(3) single-case experimental design. Outpatient memory rehabilitation clinic. A theory-driven training programme in the use of commercially available smartphones for individuals with moderate-to-severe memory impairment. A phone call task was used as an objective measure of prospective memory function. Self-report, ecologically valid questionnaires were also completed to further assess generalization of smartphone use to day-to-day memory function. Eighteen months after intervention, RR completed 80% of scheduled calls using the smartphone, a rate significantly higher than at baseline (40%) and comparable to her success rate immediately following intervention (90%) and at the four-month follow-up (90%). Responses to questionnaires indicated that RR felt more confident in her ability to handle memory-demanding situations and was making fewer memory mistakes. This favourable outcome was not found with the use of another smartphone brand for which training was not received. Results from ecologically valid measures of memory functioning demonstrated robust maintenance of independent commercial smartphone use over an 18-month period, with increases observed in independence, confidence and real-life memory functioning. The findings further suggest poor cross-device generalizability.

  6. The role of nondeclarative memory in the skill for language: Evidence from syntactic priming in patients with amnesia.

    Science.gov (United States)

    Heyselaar, Evelien; Segaert, Katrien; Walvoort, Serge J W; Kessels, Roy P C; Hagoort, Peter

    2017-07-01

    Syntactic priming, the phenomenon in which participants adopt the linguistic behaviour of their partner, is widely used in psycholinguistics to investigate syntactic operations. Although the phenomenon of syntactic priming is well documented, the memory system that supports the retention of this syntactic information long enough to influence future utterances, is not as widely investigated. We aim to shed light on this issue by assessing patients with Korsakoff's amnesia on an active-passive syntactic priming task and compare their performance to controls matched in age, education, and premorbid intelligence. Patients with Korsakoff's syndrome display deficits in all subdomains of declarative memory, yet their nondeclarative memory remains intact, making them an ideal patient group to determine which memory system supports syntactic priming. In line with the hypothesis that syntactic priming relies on nondeclarative memory, the patient group shows strong priming tendencies (12.6% passive structure repetition). Our healthy control group did not show a priming tendency, presumably due to cognitive interference between declarative and nondeclarative memory. We discuss the results in relation to amnesia, aging, and compensatory mechanisms. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Deliberate self-injury functions and their clinical correlates among adolescent psychiatric inpatients.

    Science.gov (United States)

    Radziwiłłowicz, Wioletta; Lewandowska, Magdalena

    2017-04-30

    The aim of the study was to analyze the relationships between clinical variables (the severity of depression symptoms, feelings towards the body, dissociation, number and type of traumatic events) and deliberate self-injury functions. Moreover, we investigated whether the of group self-mutilating adolescents is internally diverse in terms of how important individual functions of self-mutilation are, and whether the subgroups singled out by these functions differ between each other in terms of clinical variables. The Inventory of Statements about Self-Injury was used. Characterizations of examined individuals and other research tools are included in our previous article (year, issue, pages). Associated with negative feelings towards the body are the functions of self-injuries (anti-dissociation, self-punishment) that can be described as interpersonal. High levels of depression symptoms (self-depreciation included) are mainly associated with the self-injury functions: self-punishment, anti-dissociation, establishing interpersonal boundaries. Affect regulation becomes more important as a function of self-inflicted injuries in cases of biological dysregulation and intense dissociative symptoms. The adolescents psychiatric inpatients are internally diverse in terms of dominant functions of self-injuries, which can be categorized into intra- and interpersonal. Intrapersonal functions dominate when an individual experiences severe depression, dissociative symptoms, and negative feelings towards the body. In cases of moderate intensity of depression, dissociative symptoms and negative feelings towards the body, both intrapersonal and interpersonal functions of self-mutilation are similarly important. Further research is required to explain the lowest severity of depression symptoms, dissociative symptoms and negative feelings towards the body co-occurs with no awareness of self-injuries functions.

  8. Magnetic resonance lung function – a breakthrough for lung imaging and functional assessment? A phantom study and clinical trial

    Directory of Open Access Journals (Sweden)

    Rauh Manfred

    2006-08-01

    Full Text Available Abstract Background Chronic lung diseases are a major issue in public health. A serial pulmonary assessment using imaging techniques free of ionizing radiation and which provides early information on local function impairment would therefore be a considerably important development. Magnetic resonance imaging (MRI is a powerful tool for the static and dynamic imaging of many organs. Its application in lung imaging however, has been limited due to the low water content of the lung and the artefacts evident at air-tissue interfaces. Many attempts have been made to visualize local ventilation using the inhalation of hyperpolarized gases or gadolinium aerosol responding to MRI. None of these methods are applicable for broad clinical use as they require specific equipment. Methods We have shown previously that low-field MRI can be used for static imaging of the lung. Here we show that mathematical processing of data derived from serial MRI scans during the respiratory cycle produces good quality images of local ventilation without any contrast agent. A phantom study and investigations in 85 patients were performed. Results The phantom study proved our theoretical considerations. In 99 patient investigations good correlation (r = 0.8; p ≤ 0.001 was seen for pulmonary function tests and MR ventilation measurements. Small ventilation defects were visualized. Conclusion With this method, ventilation defects can be diagnosed long before any imaging or pulmonary function test will indicate disease. This surprisingly simple approach could easily be incorporated in clinical routine and may be a breakthrough for lung imaging and functional assessment.

  9. Functional recovery measures for spinal cord injury : An evidence-based review for clinical practice and research - Functional recovery outcome measures work group

    NARCIS (Netherlands)

    Anderson, Kim; Aito, Sergio; Atkins, Michal; Biering-Sorensen, Fin; Charlifue, Susan; Curt, Armin; Ditunno, John; Glass, Clive; Marino, Ralph; Marshall, Ruth; Mulcahey, Mary Jane; Post, Marcel; Savic, Gordana; Scivoletto, Giorgio; Catz, Amiram

    2008-01-01

    Background/Objective: The end goal of clinical care and clinical research involving spinal cord injury (SCI) is to improve the overall ability of persons living with SCI to function on a daily basis. Neurologic recovery does not always translate into functional recovery. Thus, sensitive outcome meas

  10. HRV biofeedback for pediatric irritable bowel syndrome and functional abdominal pain: a clinical replication series.

    Science.gov (United States)

    Stern, Mark J; Guiles, Robert A F; Gevirtz, Richard

    2014-12-01

    Irritable bowel syndrome (IBS) and Functional Abdominal Pain (FAP) are among the most commonly reported Functional Gastrointestinal Disorders. Both have been associated with varying autonomic dysregulation. Heart Rate Variability Biofeedback (HRVB) has recently begun to show efficacy in the treatment of both IBS and FAP. The purpose of this multiple clinical replication series was to analyze the clinical outcomes of utilizing HRVB in a clinical setting. Archival data of twenty-seven consecutive pediatric outpatients diagnosed with IBS or FAP who received HRVB were analyzed. Clinical outcomes were self-report and categorized as full or remission with patient satisfaction, or no improvement. Qualitative reports of patient experiences were also noted. Full remission was achieved by 69.2 % and partial remission was achieved by 30.8 % of IBS patients. Full remission was achieved by 63.6 % and partial remission was achieved by 36.4 % of FAP patients. No patients in either group did not improve to a level of patient satisfaction or >50 %. Patient's commonly reported feeling validated in their discomfort as a result of psychophysiological education. Results suggest that HRVB is a promising intervention for pediatric outpatients with IBS or FAP. Randomized controlled trials are necessary to accurately determine clinical efficacy of HRVB in the treatment of IBS and FAP.

  11. Implementation of workflow engine technology to deliver basic clinical decision support functionality

    Directory of Open Access Journals (Sweden)

    Oberg Ryan

    2011-04-01

    Full Text Available Abstract Background Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. Results We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language process definition language (XPDL. The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent. We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. Conclusions We

  12. Implementation of workflow engine technology to deliver basic clinical decision support functionality.

    Science.gov (United States)

    Huser, Vojtech; Rasmussen, Luke V; Oberg, Ryan; Starren, Justin B

    2011-04-10

    Workflow engine technology represents a new class of software with the ability to graphically model step-based knowledge. We present application of this novel technology to the domain of clinical decision support. Successful implementation of decision support within an electronic health record (EHR) remains an unsolved research challenge. Previous research efforts were mostly based on healthcare-specific representation standards and execution engines and did not reach wide adoption. We focus on two challenges in decision support systems: the ability to test decision logic on retrospective data prior prospective deployment and the challenge of user-friendly representation of clinical logic. We present our implementation of a workflow engine technology that addresses the two above-described challenges in delivering clinical decision support. Our system is based on a cross-industry standard of XML (extensible markup language) process definition language (XPDL). The core components of the system are a workflow editor for modeling clinical scenarios and a workflow engine for execution of those scenarios. We demonstrate, with an open-source and publicly available workflow suite, that clinical decision support logic can be executed on retrospective data. The same flowchart-based representation can also function in a prospective mode where the system can be integrated with an EHR system and respond to real-time clinical events. We limit the scope of our implementation to decision support content generation (which can be EHR system vendor independent). We do not focus on supporting complex decision support content delivery mechanisms due to lack of standardization of EHR systems in this area. We present results of our evaluation of the flowchart-based graphical notation as well as architectural evaluation of our implementation using an established evaluation framework for clinical decision support architecture. We describe an implementation of a free workflow technology

  13. A clinicopathological and immunohistochemical study of clinically non-functioning pituitary adenomas: A single institutional experience

    Directory of Open Access Journals (Sweden)

    Rishi Arvind

    2010-01-01

    Full Text Available Background : Non-functioning pituitary adenomas (NFPA are characterized by the lack of clinical syndrome as compared to functioning adenomas (FA but not all functioning adenomas have clinical effects. Their exact incidence varies in different series. Materials and Methods : This study was undertaken to analyze the hormonal profile of NFPA at the immunohistochemical level in the Indian population and to see if any differences exist from the earlier studies. Their biological aggressiveness was also studied by MIB-1 labeling index (MIB-! LI and Epidermal Growth Factor Receptor (EGFR expression. These parameters along with their clinical behavior were correlated with radiological features of invasiveness and size. Results : Of the 151 pituitary adenomas diagnosed during a period of one and half years, 77 (51% were NFPA with a male predominance. There was increase in the incidence of NFPA with increase in age. Immunopositivity for various hormones was observed in 64 (83% cases, either singly or in various combinations. On the basis of immunohistochemistry, NFPA were classified into three subtypes; gonadotroph adenomas, silent adenomas, and null cell adenomas. Gonadotroph adenomas were the commonest subtype. In general, NFPA showed low MIB-1LI but invasive NFPA had LI on the higher side, however, this difference was not significant. We observed EGFR positivity in two cases only; therefore the tumorigenesis mechanism may be different in NFPA. Conclusion : Although non-functional at the clinical level immunohistochemistry showed reactivity for various hormones. If a battery of immunostains including seven hormones is studied, a significant number of cases are shifted to the functional group.

  14. Exploring brainstem function in multiple sclerosis by combining brainstem reflexes, evoked potentials, clinical and MRI investigations.

    Science.gov (United States)

    Magnano, Immacolata; Pes, Giovanni Mario; Pilurzi, Giovanna; Cabboi, Maria Paola; Ginatempo, Francesca; Giaconi, Elena; Tolu, Eusebio; Achene, Antonio; Salis, Antonio; Rothwell, John C; Conti, Maurizio; Deriu, Franca

    2014-11-01

    To investigate vestibulo-masseteric (VMR), acoustic-masseteric (AMR), vestibulo-collic (VCR) and trigemino-collic (TCR) reflexes in patients with multiple sclerosis (MS); to relate abnormalities of brainstem reflexes (BSRs) to multimodal evoked potentials (EPs), clinical and Magnetic Resonance Imaging (MRI) findings. Click-evoked VMR, AMR and VCR were recorded from active masseter and sternocleidomastoid muscles, respectively; TCR was recorded from active sternocleidomastoid muscles, following electrical stimulation of the infraorbital nerve. EPs and MRI were performed with standard techniques. Frequencies of abnormal BSRs were: VMR 62.1%, AMR 55.1%, VCR 25.9%, TCR 58.6%. Brainstem dysfunction was identified by these tests, combined into a four-reflex battery, in 86.9% of cases, by EPs in 82.7%, MRI in 71.7% and clinical examination in 37.7% of cases. The sensitivity of paired BSRs/EPs (93.3%) was significantly higher than combined MRI/clinical testing (70%) in patients with disease duration ⩽6.4years. BSR alterations significantly correlated with clinical, EP and MRI findings. The four-BSR battery effectively increases the performance of standard EPs in early detection of brainstem impairment, otherwise undetected by clinical examination and neuroimaging. Multiple BSR assessment usefully supplements conventional testing and monitoring of brainstem function in MS, especially in newly diagnosed patients. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  15. Functional and structural MRI biomarkers to detect pre-clinical neurodegeneration.

    Science.gov (United States)

    Abdulkadir, Ahmed; Ronneberger, Olaf; Wolf, Robert Christian; Pfleiderer, Bettina; Saft, Carsten; Klöppel, Stefan

    2013-02-01

    The availability of an accurate genetic test to identify Huntington's Disease (HD) in the pre-symptomatic stage makes HD an important model to develop biomarkers for other neurodegenerative diseases, such as pre-clinical Alzheimer's Disease. We reasoned that functional changes, measured by functional MRI (fMRI), would precede gray matter changes and that performing a task specifically affected by the disease would carry the clearest signature. Separate cohorts of HD gene mutations carriers and controls performed four different fMRI tasks, probing functions either primarly affected by the disease (i.e. motor control), higher cognitive functions (i.e. working memory and irritability), or basic sensory functions (i.e. auditory system). With the aim to compare fMRI and structural MRI biomarkers, all subjects underwent an additional high-resolution T1-weighted MRI. Best classification performance was achived from fMRI-based activations with motor sequence tapping and task-induced irritation. Classification performance based on gray matter probability maps was also significantly above chance and similar to that of fMRI. Both were sufficiently informative to separate gene mutation carriers that were on average 17 years before predicted disease onset from controls with up to 80% accuracy. Further analyses showed that classification accuracy was best in regions of interest with low within-group heterogeneity in relation to disease specific changes. Our study indicates that structural and some functional markers can accurately detect pre-clinical neurodegeneration. However, the lower variability and easier processing of the strucutral MRI data make latter the more useful tool for disease detection in a clinical setting.

  16. Clinical and functional evaluation of the joint status of hemophiliac adults at a Brazilian blood center

    Directory of Open Access Journals (Sweden)

    Adriana Aparecida Ferreira

    2013-01-01

    Full Text Available BACKGROUND: Hemophilia is a potentially disabling condition as hemophilic arthropathy develops early in life and is progressive, especially in patients treated in an on-demand regime. Objective: This study aimed to describe the structural joint status and the functional independence score of hemophiliac adults and correlate structural damage with the functional deficits found in these patients. METHODS: Hemophiliacs at the Juiz de Fora Regional Blood Center - HEMOMINAS Foundation, aged 18 years and over and treated in an on-demand regime, were clinically evaluated in respect to structural joint damage using the World Federation of Hemophilia Physical Examination Scale (WFH-PE and functional deficits using the Functional Independence Score in Hemophilia (FISH. The Spearman rank test was used to evaluate the correlation between the two scores. RESULTS: Thirty-nine patients were evaluated. The mean age was 36.8 years. Target joints were detected in 69.2% of patients studied. The mean Physical Examination Scale and Functional Independence Score were 16.87 and 25.64, respectively. Patients with mild hemophilia showed no significant joint involvement. Patients with severe or moderate hemophilia had similar results regarding structural damage (p-value < 0.001 and functional deficits (p-value = 0.001. There was statistical significance in the correlation between the two scores (r = -0.850; p-value = 0.01. CONCLUSIONS: The World Federation of Hemophilia Physical Examination Scale and Functional Independence Score in Hemophilia may be useful to clinically assess structural joint damage and functional deficits in hemophiliacs as the tools are inexpensive and easy to administer and may be able to detect hemophilic arthropathy, which results from recurrent hemarthrosis and is common in the population studied.

  17. Improving function in age-related macular degeneration: design and methods of a randomized clinical trial.

    Science.gov (United States)

    Rovner, Barry W; Casten, Robin J; Hegel, Mark T; Massof, Robert W; Leiby, Benjamin E; Tasman, William S

    2011-03-01

    Age-Related Macular Degeneration (AMD) is the leading cause of severe vision loss in older adults and impairs the ability to read, drive, and live independently and increases the risk for depression, falls, and earlier mortality. Although new medical treatments have improved AMD's prognosis, vision-related disability remains a major public health problem. Improving Function in AMD (IF-AMD) is a two-group randomized, parallel design, controlled clinical trial that compares the efficacy of Problem-Solving Therapy (PST) with Supportive Therapy (ST) (an attention control treatment) to improve vision function in 240 patients with AMD. PST and ST therapists deliver 6 one-hour respective treatment sessions to subjects in their homes over 2 months. Outcomes are assessed masked to treatment assignment at 3 months (main trial endpoint) and 6 months (maintenance effects). The primary outcome is targeted vision function (TVF), which refers to specific vision-dependent functional goals that subjects highly value but find difficult to achieve. TVF is an innovative outcome measure in that it is targeted and tailored to individual subjects yet is measured in a standardized way. This paper describes the research methods, theoretical and clinical aspects of the study treatments, and the measures used to evaluate functional and psychiatric outcomes in this population. Copyright © 2010 Elsevier Inc. All rights reserved.

  18. FUNCTIONAL STUDIES ON BLOOD MICROCIRCULATION SYSTEM WITH LASER DOPPLER FLOWMETRY IN CLINICAL MEDICINE: PROBLEMS AND PROSPECTS

    Directory of Open Access Journals (Sweden)

    D. G. Lapitan

    2016-01-01

    Full Text Available The paper presents a  review of the research update on the blood microcirculation system assessed with laser Doppler flowmetry (LDF. Specific procedures for measurement of the microcirculation index by LDF and individual variability of microcirculation parameters during their real time assessment in vivo are discussed. In physiological conditions, a relative deviation of the results of measurements by LDF is within the range±35% and above from the mean value of the microcirculation index. This imposes certain limitations on the interpretation of the diagnostic results in terms of the “normal or pathologic”. Specifics of performance of functional stress tests on the microcirculation system are reviewed. Diagnostic criteria based on functional stress testing of the microcirculation system, which can be implemented with methodologically strict normatives and regulations, for examples, those for the occlusion test, are more reliable from metrologic perspective and significant compared to the results obtained without stress testing. Problems of implementation of the functional tests into clinical practice are discussed. It was shown that they may have a potentially wide spectrum of clinical indications, from functional diagnostics and early detection of microcirculatory abnormalities in diabetes mellitus, arterial hypertension and other diseases associated with microcirculatory disorders, to the physical rationale of exposure parameters, as well as objectification of efficiency of medical procedures aimed to stimulation of the microcirculatory functions in a patient's tissues and organs.

  19. Treating Tobacco Dependence in Clinically Depressed Smokers: Effect of Smoking Cessation on Mental Health Functioning

    Science.gov (United States)

    Prochaska, Judith J.; Hall, Sharon M.; Tsoh, Janice Y.; Eisendrath, Stuart; Rossi, Joseph S.; Redding, Colleen A.; Rosen, Amy B.; Meisner, Marc; Humfleet, Gary L.; Gorecki, Julie A.

    2008-01-01

    We analyzed data from a randomized trial of 322 actively depressed smokers and examined the effect of smoking cessation on their mental health functioning. Only 1 of 10 measures at 4 follow-up time points was significant: participants who successfully stopped smoking reported less alcohol use than did participants who continued smoking. Depressive symptoms declined significantly over time for participants who stopped smoking and those who continued smoking; there were no group differences. Individuals in treatment for clinical depression can be helped to stop smoking without adversely affecting their mental health functioning. PMID:17600251

  20. Clinical functional MRI of sensorimotor cortex using passive motor and sensory stimulation at 3 Tesla.

    Science.gov (United States)

    Blatow, Maria; Reinhardt, Julia; Riffel, Katharina; Nennig, Ernst; Wengenroth, Martina; Stippich, Christoph

    2011-08-01

    To establish a passive motor paradigm for clinical functional MRI (fMRI) that could be beneficial for patients with motor or attention deficits who are not able to perform active motor tasks. A novel standardized sensorimotor fMRI protocol was applied in 16 healthy volunteers at 3 Tesla (T) using active and passive motor tasks as well as sensory stimulation of hands and feet. Data analysis was carried out individually using a dynamic thresholding routine. Active motor tasks yielded time efficient and robust blood-oxygen-level-dependent (BOLD) signals in primary motor cortex. Noteworthy, it was possible to achieve equal activation levels within identical anatomical localization for passive and active motor tasks with these paradigms. Patients unable to perform active movements can benefit from paradigms with passive motor and sensory stimulation. Therefore, we recommend these paradigms for functional somatotopic mapping of the central region at 3T in clinical routine. Copyright © 2011 Wiley-Liss, Inc.

  1. Cervical spinal cord injury:tailoring clinical trial endpoints to relfect meaningful functional improvements

    Institute of Scientific and Technical Information of China (English)

    Lisa M Bond; Lisa McKerracher

    2014-01-01

    Cervical spinal cord injury (SCI) results in partial to full paralysis of the upper and lower extrem-ities. Traditional primary endpoints for acute SCI clinical trials are too broad to assess functional recovery in cervical subjects, raising the possibility of false positive outcomes in trials for cervical SCI. Endpoints focused on the recovery of hand and arm control (e.g., upper extremity motor score, motor level change) show the most potential for use as primary outcomes in upcoming trials of cervical SCI. As the field moves forward, the most reliable way to ensure meaningful clinical testing in cervical subjects may be the development of a composite primary endpoint that measures both neurological recovery and functional improvement.

  2. Restoring function after spinal cord injury: towards clinical translation of experimental strategies.

    Science.gov (United States)

    Ramer, Leanne M; Ramer, Matt S; Bradbury, Elizabeth J

    2014-12-01

    Spinal cord injury is currently incurable and treatment is limited to minimising secondary complications and maximising residual function by rehabilitation. Improved understanding of the pathophysiology of spinal cord injury and the factors that prevent nerve and tissue repair has fuelled a move towards more ambitious experimental treatments aimed at promoting neuroprotection, axonal regeneration, and neuroplasticity. By necessity, these new options are more invasive. However, in view of recent advances in spinal cord injury research and demand from patients, clinicians, and the scientific community to push promising experimental treatments to the clinic, momentum and optimism exist for the translation of candidate experimental treatments to clinical spinal cord injury. The ability to rescue, reactivate, and rewire spinal systems to restore function after spinal cord injury might soon be within reach. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Functional Electrical Stimulation in Spinal Cord Injury: Clinical Evidence Versus Daily Practice.

    Science.gov (United States)

    Bersch, Ines; Tesini, Stefani; Bersch, Ulf; Frotzler, Angela

    2015-10-01

    Functional electrical stimulation (FES) has clinical evidence in the rehabilitation of patients with spinal cord injury as indicated by several studies. Both inpatients and outpatients benefit from the therapeutic effect of the FES. The application areas are multifaceted and can be customized on the need for patients. This is represented by the individuality of the programmability of the stimulators and the variety of stimulation schedules that are based on the knowledge about the effects of FES on structural and functional level. Nevertheless, looking into daily clinical practice, the use of FES is rather poor. Expenditure of time, complexity of technical equipment, and compliance and acceptance of therapists and patients should be taken into account as limiting factors. Copyright © 2015 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  4. Methodological problems with clinical functional MRI investigations; Methodische Probleme klinischer funktioneller MRT-Untersuchungen

    Energy Technology Data Exchange (ETDEWEB)

    Foki, T.; Beisteiner, R. [Medizinische Universitaet Wien, AG Klinische fMRT, Universitaetsklinik fuer Neurologie, Exzellenzzentrum Hochfeld-MR, Wien (Austria)

    2010-02-15

    During presurgical diagnostics clinical functional magnetic resonance imaging is increasingly being performed to improve the management of epilepsy and tumor patients. Rapid technical developments in fMRI technology continuously further new diagnostic applications. Safe clinical application requires a profound and critical handling of the various methodological problems inherent with this complex technique. This article reviews relevant problems and solutions for patient investigations up to the preparation of an individual clinical fMRI report. (orig.) [German] Die klinische funktionelle Magnetresonanztomographie (fMRT) hat als individuelles Untersuchungsverfahren v. a. in der praeoperativen Diagnostik bei Epilepsie- und Tumorpatienten einen zunehmenden Stellenwert, da sie hier zu einer klinischen Entscheidung beitragen kann. Die rasche Entwicklung der fMRT-Technologie eroeffnet dabei kontinuierlich neue diagnostische Moeglichkeiten, erfordert aber auch einen kritischen Umgang mit den zahlreichen methodischen Problemen dieses komplexen Verfahrens. Dieser Artikel beschreibt patientenrelevante Probleme und Loesungsmoeglichkeiten von der Untersuchung bis zur Erstellung des individuellen fMRT-Befundes. (orig.)

  5. The cachexia clinic: from staging to managing nutritional and functional problems in advanced cancer patients.

    Science.gov (United States)

    Vigano, Antonio; Del Fabbro, Egidio; Bruera, Eduardo; Borod, Manuel

    2012-01-01

    Panels of experts have agreed on the definition of cancer cachexia stages (CCS). We evaluated the clinical relevance of these stages and proposed ways to apply the CCSs to the clinical practice via standardized methods. The CCS were applied to 207 patients with advanced non-small-cell lung or gastrointestinal cancers from the Human Cancer Cachexia Database via consensus among the coauthors. Patients were categorized as noncachectic, precachectic, cachectic, and in refractory cachexia. Through analysis of variance, χ2, and Kaplan-Meier analyses, we tested the relationships between CCSs and selected outcomes. The CCS were significantly correlated (P model for diagnosing more precisely the pathophysiology and severity of precachectic and cachectic conditions. The cachexia clinic, by working closely with palliative care programs, may offer the best environment for a comprehensive and personalized approach to the nutritional and functional problems in advanced cancer patients.

  6. CLINICAL AND FUNCTIONAL FEATURES IN COURSE CHRONIC PANCREATITIS WITH ACCOMPANYING DUODENOSTASIS

    Directory of Open Access Journals (Sweden)

    Ya. M. Vahrushev

    2016-01-01

    Full Text Available The aim. Research the clinical features, functional state of duodenum among patients with chronic pancreatitis and accompanying duodenostasis.Materials and methods. The clinical course of chronic pancreatitis with accompanying duodenostasis (85 cases and isolated chronic pancreatitis (56 cases has been studied. Along with the general clinical data the study includes the results of exocrine pancreatic function examination (fecal elastase-1, blood alpha amylase and lipase and its endocrine function (insulin and С-peptide. Regulating hormonal factors (gastrin and somatotropin have been studied. Was used results of rentgenology and endoscopic examinations, intraduodenal manometry results in verification of duodenostasis.Results. In the observation group resistant pain syndrome was revealed in 93% cases (at patient with isolated pancreatitis in 57% cases and in more degree was expressed coprological syndromes (amilorhea in 82,29% cases, creatorhea in 82,14% cases, steatorhea in 87,5% cases. In the observation group were significantly more diagnosed hyperperistaltic (in 88% cases of observation group and in 9,4% cases of the comparison group and duodenal hypertension (in 22% cases of observation group and in 0.0% cases of the comparison group. The phenomenon of «semolina» was reveals more often in observation group (in 31,9% cases of observation group and in 5% cases of the comparison group.Among patients with chronic pancreatitis and accompanying duodenostasis decrease the level of C-peptid and increase secretion of insulin, somatotropin and gastrin.Conclusion. It reveals that according to the comprehensive clinical and functional investigation chronic pancreatitis with accompanying duodenostasis gets a more severe course in comparison with isolated pancreatitis.

  7. THE RARE DISEASES CLINICAL RESEARCH NETWORK CONTACT REGISTRY UPDATE: FEATURES AND FUNCTIONALITY

    OpenAIRE

    Richesson, Rachel; Sutphen, Rebecca; Shereff, Denise; Krischer, Jeff

    2012-01-01

    The Rare Diseases Clinical Research Network (RDCRN) Contact Registry has grown in size and scope since it was first reported in this journal in 2007. In this paper, we reflect on our seven years’ experience developing and expanding the RDCRN Contact Registry to include many more rare diseases. We present the functional and data requirements that motivated this registry, and the new features and policies that have been developed since. Given the high costs and long-term commitme...

  8. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions

    OpenAIRE

    Ravikiran Kisan; Sujan, M. U.; Meghana Adoor; Raghavendra Rao; Nalini, A.; Bindu M Kutty; B T Chindanda Murthy; Raju, T. R.; T N Sathyaprabha

    2014-01-01

    Context and Aims: Migraine is an episodic disabling headache requiring long-term management. Migraine management through Yoga therapy would reduce the medication cost with positive health benefits. Yoga has shown to improve the quality of life, reduce the episode of headache and medication. The aim of the present study was to evaluate the efficacy of Yoga as an adjuvant therapy in migraine patients by assessing clinical outcome and autonomic functions tests. Subjects and Methods: Migraine...

  9. Ex vivo study of 5-HT(1A) and 5-HT(7) receptor agonists and antagonists on cAMP accumulation during memory formation and amnesia.

    Science.gov (United States)

    Perez-García, G; Meneses, A

    2008-12-16

    The cyclic adenosine monophosphate (cAMP) is a second messenger and a central component of intracellular signaling pathways that regulate a wide range of biological functions, including memory. Hence, in this work, firstly the time-course of memory formation was determined in an autoshaping learning task, which had allowed the identification of testing times for increases or decreases in performance. Next, untrained, trained and overtrained groups were compared in cAMP production. Moreover, selective stimulation and antagonism of 5-HT(1A) and 5-HT(7) receptors during memory formation and cAMP production were determined. Finally, since there is scarce information about how pharmacological models of amnesia affect cAMP production, the cholinergic or glutamatergic antagonists, scopolamine and dizocilpine, were tested. The major findings of this work showed that when the time-course was determined inasmuch as training and testing sessions occurred, memory performance was graduate and progressive. Notably, for the fourth to seventh (i.e., 48-120 h following autoshaping training session) testing session performance was significantly higher from the previous ones. When animals received 5-HT(1A) and 5-HT(7) receptor agonists and antagonists or amnesic drugs significant increases or decrements in memory performance were observed at 24 and 48 h. Moreover, when ex vivo cAMP production from trained and overtrained groups were compared to untrained ones, significant differences were observed among groups and brain areas. Trained animals treated with 8-OHDPAT, AS19, 8-OHDPAT plus AS19, WAY100635, SB-269970, scopolamine or dizocilpine were compared to similar untrained groups, and eightfold-reduced cAMP production was evident, showing the importance of cAMP production in the signaling case in mammalian memory formation.

  10. Clinical utility of resting-state functional connectivity magnetic resonance imaging for mood and cognitive disorders.

    Science.gov (United States)

    Takamura, T; Hanakawa, T

    2017-07-01

    Although functional magnetic resonance imaging (fMRI) has long been used to assess task-related brain activity in neuropsychiatric disorders, it has not yet become a widely available clinical tool. Resting-state fMRI (rs-fMRI) has been the subject of recent attention in the fields of basic and clinical neuroimaging research. This method enables investigation of the functional organization of the brain and alterations of resting-state networks (RSNs) in patients with neuropsychiatric disorders. Rs-fMRI does not require participants to perform a demanding task, in contrast to task fMRI, which often requires participants to follow complex instructions. Rs-fMRI has a number of advantages over task fMRI for application with neuropsychiatric patients, for example, although applications of task fMR to participants for healthy are easy. However, it is difficult to apply these applications to patients with psychiatric and neurological disorders, because they may have difficulty in performing demanding cognitive task. Here, we review the basic methodology and analysis techniques relevant to clinical studies, and the clinical applications of the technique for examining neuropsychiatric disorders, focusing on mood disorders (major depressive disorder and bipolar disorder) and dementia (Alzheimer's disease and mild cognitive impairment).

  11. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions

    Science.gov (United States)

    Kisan, Ravikiran; Sujan, MU; Adoor, Meghana; Rao, Raghavendra; Nalini, A; Kutty, Bindu M; Chindanda Murthy, BT; Raju, TR; Sathyaprabha, TN

    2014-01-01

    Context and Aims: Migraine is an episodic disabling headache requiring long-term management. Migraine management through Yoga therapy would reduce the medication cost with positive health benefits. Yoga has shown to improve the quality of life, reduce the episode of headache and medication. The aim of the present study was to evaluate the efficacy of Yoga as an adjuvant therapy in migraine patients by assessing clinical outcome and autonomic functions tests. Subjects and Methods: Migraine patients were randomly given either conventional care (n = 30) or Yoga with conventional care (n = 30). Yoga group received Yoga practice session for 5 days a week for 6 weeks along with conventional care. Clinical assessment (frequency, intensity of headache and headache impact) and autonomic function test were done at baseline and at the end of the intervention. Results: Yoga with conventional care and convention care groups showed significant improvement in clinical variables, but it was better with Yoga therapy. Improvement in the vagal tone along with reduced sympathetic activity was observed in patients with migraine receiving Yoga as adjuvant therapy. Conclusions: Intervention showed significant clinical improvement in both groups. Headache frequency and intensity were reduced more in Yoga with conventional care than the conventional care group alone. Furthermore, Yoga therapy enhanced the vagal tone and decreased the sympathetic drive, hence improving the cardiac autonomic balance. Thus, Yoga therapy can be effectively incorporated as an adjuvant therapy in migraine patients. PMID:25035622

  12. Shoulder Structure and Function Following the Modified Latarjet Procedure: A Clinical and Radiological Review

    Science.gov (United States)

    Garewal, Devinder; Evans, Mathew; Taylor, David; Hoy, Gregory A.; Barwood, Shane; Connell, David

    2013-01-01

    Background To evaluate the clinical and radiological outcomes of the modified Latarjet procedure for traumatic, antero-inferior glenohumeral joint instability. Methods Case series were used with a mean follow-up of 21.3 months for clinical and radiological review and 47.2 months for recurrent instability. Shoulder function was evaluated by clinical examination and validated shoulder scales: Western Ontario Shoulder Stability Index (WOSI), Melbourne Instability Shoulder Score (MISS) and l'Insalata Shoulder Questionnaire. Shoulder structure was evaluated by computed tomography. Results Thirty-two cases were enrolled (mean age 27.0 years). One patient reported a redislocation during the follow-up period. Clinical examination revealed that the median external rotation (at 0° and 90° abduction) was reduced on the operative side by 7.5° (p 0.05). Radiological evaluation revealed a mean (SD) pre-operative glenoid surface area loss of 169.5 (48.5) mm2 reconstituted surgically by a bone block of 225.4 (73.8) mm2. Subscapularis muscle bulk was reduced on the operative side, above the level of the muscle split (p Latarjet procedure reliably restores lost glenoid surface area, shoulder stability, strength and function. A small loss of external rotation is expected and related to altered subscapularis anatomy. PMID:27582905

  13. Effect of Yoga on migraine: A comprehensive study using clinical profile and cardiac autonomic functions.

    Science.gov (United States)

    Kisan, Ravikiran; Sujan, Mu; Adoor, Meghana; Rao, Raghavendra; Nalini, A; Kutty, Bindu M; Chindanda Murthy, Bt; Raju, Tr; Sathyaprabha, Tn

    2014-07-01

    Migraine is an episodic disabling headache requiring long-term management. Migraine management through Yoga therapy would reduce the medication cost with positive health benefits. Yoga has shown to improve the quality of life, reduce the episode of headache and medication. The aim of the present study was to evaluate the efficacy of Yoga as an adjuvant therapy in migraine patients by assessing clinical outcome and autonomic functions tests. Migraine patients were randomly given either conventional care (n = 30) or Yoga with conventional care (n = 30). Yoga group received Yoga practice session for 5 days a week for 6 weeks along with conventional care. Clinical assessment (frequency, intensity of headache and headache impact) and autonomic function test were done at baseline and at the end of the intervention. Yoga with conventional care and convention care groups showed significant improvement in clinical variables, but it was better with Yoga therapy. Improvement in the vagal tone along with reduced sympathetic activity was observed in patients with migraine receiving Yoga as adjuvant therapy. Intervention showed significant clinical improvement in both groups. Headache frequency and intensity were reduced more in Yoga with conventional care than the conventional care group alone. Furthermore, Yoga therapy enhanced the vagal tone and decreased the sympathetic drive, hence improving the cardiac autonomic balance. Thus, Yoga therapy can be effectively incorporated as an adjuvant therapy in migraine patients.

  14. The clinical effect of hippotherapy on gross motor function of children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    K Litlle

    2013-12-01

    Full Text Available Background: Cerebral palsy (CP is the most common cause of physical disability affecting gross motor function (GMF in early childhood. Hippotherapy is a treatment approach aimed at improving GMF in children with CP. Several systematic reviews have been published showing an improvement in Dimension E of the Gross Motor Function Measure (GMFM after hippotherapy. However, these reviews failed to evaluate the clinical effect of hippotherapy in improving GMF in children with CP.Objective: To critically appraise the evidence of hippotherapy to ascertain whether it is a clinically meaningful approach for children with CP.Methodology: Five computerised bibliographic databases were searched. Predetermined inclusion and exclusion criteria were set. The PEDro scale was used to assess the quality of the studies. A revised JBI Data extraction tool was used to extract data from the selected articles. Revman© Review Manager Software was used to create forest plots for comparisons of results.Results: All studies used the GMFM as an outcome measure for gross motor function. The added benefit of hippotherapy is a minimum 1% and a maximum 7% increase on the GMFM scores. However, all 95% confidence intervals (CI around all the mean differences were insignificant.Conclusion: The clinical effect of hippotherapy on the GMF of children with CP is small. Larger studies are required to provide evidence of the effect of hippotherapy within this population.

  15. Enhancing clinically-relevant shoulder function assessment using only essential movements.

    Science.gov (United States)

    Pichonnaz, C; Lécureux, E; Bassin, J-P; Duc, C; Farron, A; Aminian, K; Jolles, B M; Gleeson, N

    2015-03-01

    Kinematic functional evaluation with body-worn sensors provides discriminative and responsive scores after shoulder surgery, but the optimal movements' combination has not yet been scientifically investigated. The aim of this study was the development of a simplified shoulder function kinematic score including only essential movements. The P Score, a seven-movement kinematic score developed on 31 healthy participants and 35 patients before surgery and at 3, 6 and 12 months after shoulder surgery, served as a reference. Principal component analysis and multiple regression were used to create simplified scoring models. The candidate models were compared to the reference score. ROC curve for shoulder pathology detection and correlations with clinical questionnaires were calculated. The B-B Score (hand to the Back and hand upwards as to change a Bulb) showed no difference to the P Score in time*score interaction (P > .05) and its relation with the reference score was highly linear (R(2) > .97). Absolute value of correlations with clinical questionnaires ranged from 0.51 to 0.77. Sensitivity was 97% and specificity 94%. The B-B and reference scores are equivalent for the measurement of group responses. The validated simplified scoring model presents practical advantages that facilitate the objective evaluation of shoulder function in clinical practice.

  16. Clinical Correlates of Awareness for Balance, Function, and Memory: Evidence for the Modality Specificity of Awareness

    Directory of Open Access Journals (Sweden)

    Megan E. O'Connell

    2014-01-01

    Full Text Available Awareness in dementia is increasingly recognized not only as multifactorial, but also as domain specific. We demonstrate differential clinical correlates for awareness of daily function, awareness of memory, and the novel exploration of awareness of balance. Awareness of function was higher for participants with mild cognitive impairment (aMCI and non-aMCI than for those with dementia (due to Alzheimer disease; AD and non-AD, whereas awareness of memory was higher for both non-aMCI and non-AD dementia patients than for those with aMCI or AD. Balance awareness did not differ based on diagnostic subgroup. Awareness of function was associated with instrumental activities of daily living and caregiver burden. In contrast, awareness of balance was associated with fall history, balance confidence, and instrumental activities of daily living. Clinical correlates of awareness of memory depended on diagnostic group: associations held with neuropsychological variables for non-AD dementia, but for patients with AD dementia, depression and instrumental activities of daily living were clinical correlates of memory awareness. Together, these data provide support for the hypothesis that awareness and dementia are not unitary and are, instead, modality specific.

  17. Measurement properties of exsisting clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H

    2014-01-01

    MEASUREMENT PROPERTIES OF EXISTING CLINICAL ASSESSMENT METHODS EVALUATING SCAPULAR POSITIONING AND FUNCTION. A SYSTEMATIC REVIEW1,2Camilla Marie Larsen, 1,3Birgit Juul-Kristensen, 1,3Hans Lund, 1Karen Søgaard1Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark2De...... base for optimal muscle activation both at rest and during functional tasks. There is evidence suggesting that scapular positioning are altered in patients with musculoskeletal shoulder disorders, e.g. in shoulder impingement syndrome and in patients with glenohumeral osteoarthritis [1......,2]. Rehabilitation exercises are aiming at altering abnormal/asymmetric scapular positioning and/or function. Numerous assessment methods have measured the degree of scapular dyskinesis, subjectively by visual evaluation and objectively by measurements of static and dynamic scapular positioning, by either a 3...... of the available clinical scapular assessment methods and critically appraise the methodological quality of the involved studies. METHODS A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were...

  18. [Satisfaction with life and functionality among elderly patients in a geriatric outpatient clinic].

    Science.gov (United States)

    Sposito, Giovana; D'Elboux, Maria José; Neri, Anita Liberalesso; Guariento, Maria Elena

    2013-12-01

    Aging is often accompanied by functional limitations that affect self esteem, lowering the level of satisfaction with life. Studies highlight satisfaction with life as a predictor of quality of life and has a marked correlation with a decrease in functionality. Therefore, this study sought to examine the relationship between satisfaction with life and functional independence and performance of the lower limbs (muscle strength, gait speed and balance) among the elderly in outpatient care with respect to age groups and genders. A total of 125 elderly men and women aged 60 years and above, attending a geriatric outpatient clinic. The instruments used were: 1) Functional Independence Measure (FIM) to evaluate functional dependence; 2) Short Physical Performance Battery (SPPB) to measure physical performance; 3) Satisfaction with life. The sample was random, with a predominance of females, in which the older participants had greater functional impairment. In univariate logistic regression analysis and multivariate analysis, overall self reported and comparative satisfaction with life was more satisfactory among the oldest elderly. The results suggest that older individuals have better satisfaction with life even though they have greater functional impairment.

  19. Variation in lung function is associated with worse clinical outcomes in cystic fibrosis

    Science.gov (United States)

    Heinzmann-Filho, João Paulo; Pinto, Leonardo Araujo; Marostica, Paulo José Cauduro; Donadio, Márcio Vinícius Fagundes

    2015-01-01

    ABSTRACT OBJECTIVE: To determine whether the variation in lung function over one year is associated with worse clinical outcomes, as well as with a decline in lung function in the following years, in patients with cystic fibrosis (CF). METHODS: This was a retrospective study involving CF patients (4-19 years of age), evaluated over a three-year period. We evaluated demographic characteristics, chronic Pseudomonas aeruginosa infection, antibiotic use, hospitalization, six-minute walk distance (6MWD), and lung function. The inclusion criterion was having undergone pulmonary function testing at least three times in the first year and at least once in each of the next two years. RESULTS: We evaluated 35 CF patients. The variation in FEV1 in the first year (ΔFEV1) was greater among those who, in the third year, showed reduced FEV1, had a below-average 6MWD, or were hospitalized than among those with normal FEV1, normal 6MWD, or no hospital admissions, in that same year (p < 0.05), although no such difference was found for antibiotic use in the third year. Subjects showing a ΔFEV1 ≥ 10% also showed a greater decline in FEV1 over the two subsequent years (p = 0.04). The ΔFEV1 also showed an inverse correlation with absolute FEV1 in the third year (r = −0.340, p = 0.04) and with the rate of FEV1 decline (r = −0.52, p = 0.001). Linear regression identified ΔFEV1 as a predictor of FEV1 decline (coefficient of determination, 0.27). CONCLUSIONS: Significant variation in lung function over one year seems to be associated with a higher subsequent rate of FEV1 decline and worse clinical outcomes in CF patients. Short-term ΔFEV1 might prove useful as a predictor of CF progression in clinical practice. PMID:26785959

  20. Global functioning and disability in dissociative disorders.

    Science.gov (United States)

    Mueller-Pfeiffer, Christoph; Rufibach, Kaspar; Perron, Noelle; Wyss, Daniela; Kuenzler, Cornelia; Prezewowsky, Cornelia; Pitman, Roger K; Rufer, Michael

    2012-12-30

    Dissociative disorders are frequent comorbid conditions of other mental disorders. Yet, there is controversy about their clinical relevance, and little systematic research has been done on how they influence global functioning. Outpatients and day care patients (N=160) of several psychiatric units in Switzerland were assessed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV Axis I Disorders, Structured Clinical Interview for DSM-IV Dissociative Disorders, Global Assessment of Functioning Scale, and World Health Organization Disability Assessment Schedule-II. The association between subjects with a dissociative disorder (N=30) and functional impairment after accounting for non-dissociative axis I disorders was evaluated by linear regression models. We found a proportion of 18.8% dissociative disorders (dissociative amnesia=0%, dissociative fugue=0.6%, depersonalization disorder=4.4%, dissociative identity disorder=7.5%, dissociative disorder-not-otherwise-specified=6.3%) across treatment settings. Adjusted for other axis I disorders, subjects with a comorbid dissociative identity disorder or dissociative disorder-not-otherwise-specified had a median global assessment of functioning score that was 0.86 and 0.88 times, respectively, the score of subjects without a comorbid dissociative disorder. These findings support the hypothesis that complex dissociative disorders, i.e., dissociative identity disorder and dissociative disorder-not-otherwise-specified, contribute to functional impairment above and beyond the impact of co-existing non-dissociative axis I disorders, and that they qualify as "serious mental illness". Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  1. Hand functions in systemic sclerosis and rheumatoid arthritis and influence on clinical variables.

    Science.gov (United States)

    Erol, Kemal; Gok, Kevser; Cengiz, Gizem; Ozgocmen, Salih

    2017-03-21

    Hand joints are the main target in rheumatoid arthritis (RA) and hand involvement in terms of thickening of the skin and contractures are also well known in systemic sclerosis (SSc). Assessment of hand function in SSc is generally an overlooked entity with respect to RA. Therefore the aim of this study was to compare hand functions and potential influence of functional loss on patients' overall physical functions, health-related quality of life (HRQoL) and psychological status in RA and SSc. Age- and gender-matched adult patients with SSc and RA were consecutively recruited. Patients' hand functions were evaluated by using the Duruöz Hand Index (DHI), and hand span and hand grip strength were measured. Patients were evaluated for disease-specific and generic outcome measures including disease activity parameters and HRQoL measures. Fifty patients (44 female, six male) with SSc and 51 (45 female, six male) with RA were included. Despite similar functioning and HRQoL, patients with RA had higher visual analog scale-pain and body mass index. In both groups DHI revealed similar functional loss and correlated with various measurements related to HRQoL. In SSc, hand span, grip strength and modified Rodnan skin score had major influences on hand functions. Assessment of hand function is an important component in the clinical evaluation of patients with RA and SSc. Loss of hand functions is an important feature contributing negatively to the overall physical status and HRQoL in patients with SSc and may be more frequent and important than expected. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

  2. Clinical-Functional Vulnerability Index-20 (IVCF-20): rapid recognition of frail older adults

    Science.gov (United States)

    de Moraes, Edgar Nunes; do Carmo, Juliana Alves; de Moraes, Flávia Lanna; Azevedo, Raquel Souza; Machado, Carla Jorge; Montilla, Dalia Elena Romero

    2016-01-01

    ABSTRACT OBJECTIVE To evaluate the adequacy of the Clinical-Functional Vulnerability Index-20, a rapid triage instrument to test vulnerability in Brazilian older adults, for the use in primary health care. METHODS The study included convenience sample of 397 patients aged older than or equal to 60 years attended at Centro de Referência para o Idoso (Reference Center for Older Adults) and of 52 older adults the same age attended at the community. The results of the questionnaire, consisting of 20 questions, were compared with those of the Comprehensive Geriatric Assessment, considered a reference for identifying frail older adults. Spearman’s correlation was evaluated in the Clinical-Functional Vulnerability Index-20 with the Comprehensive Geriatric Assessment; the validity was verified by the area under the ROC curve; reliability was estimated by the percentage of agreement among evaluators and by the kappa coefficient, both with quadratic weighted. The cut-off point was obtained based on the higher accuracy criterion. Cronbach’s alpha, a measure of internal consistency, was estimated. RESULTS The Spearman’s correlation coefficient was high and positive for both groups (0.792 for older adults attended at the Reference Center and 0.305 for older adults from the community [p < 0.001]). The area under the ROC curve for older adults attended at the Reference Center was substantial (0.903). The cut-off point obtained was six, and older adults with scores in Clinical-Functional Vulnerability Index-20 above that value had strong possibility of being frail. For older adults from the community, the quadratic weighted agreement among evaluators was 99.5%, and the global quadratic weighted kappa coefficient was 0.94. Cronbach’s alpha was high for older adults attended at the Reference Center (0.861) and those attended at the community (0.740). CONCLUSIONS The Clinical-Functional Vulnerability Index-20 questionnaire, in the sample examined, turned out to be positively

  3. The institutionalized elderly: sociodemographic and clinical-functional profiles related to dizziness

    Directory of Open Access Journals (Sweden)

    Tábada Samantha Marques Rosa

    2016-04-01

    Full Text Available ABSTRACT INTRODUCTION: Dizziness is among the most common complaints in the elderly population. OBJECTIVE: To determine the sociodemographic and clinical-functional profiles of institutionalized elderly people related to dizziness. METHODS: Cross-sectional prospective study with institutionalized elderly people aged 60 or more years. A questionnaire on sociodemographic and clinical-functional characteristics was applied, and an anamnesis of occurrence of dizziness was held, as well as the Dizziness Handicap Inventory questionnaire. RESULTS: 48.9% of the elderly subjects had dizziness. The mean numbers of diseases and medications associated with dizziness were, respectively, 4.5 diseases and 7.8 medications. We found a significant association between the occurrence of dizziness and diseases of the musculoskeletal system, sub-connective tissue and genitourinary system, as well as the use of medications for the musculoskeletal system. The scores for handicap degree in functional DHI were significantly higher among elderly subjects who needed walking aids, who had suffered falls, and those manifesting anxiety. CONCLUSION: Our sample included subjects of advanced age, primarily women, who were institutionalized less than five years, with multiple diseases and polypharmacy users. They presented long-standing short-duration mixed dizziness, that occurred more than once a month and affected mainly the functional aspect.

  4. Functional connectivity magnetic resonance imaging in stroke: an evidence-based clinical review.

    Science.gov (United States)

    Varsou, Ourania; Macleod, Mary Joan; Schwarzbauer, Christian

    2014-02-01

    Stroke is a common condition that may lead to various degrees of neurological deficit and long-term disability. It has become increasingly recognized that cortical reorganization of neuronal networks plays a significant role in regaining function following a focal brain injury. However, the mechanisms involved in this process are still not fully understood. Resting-state functional connectivity magnetic resonance imaging is a rapidly evolving scanning technique that has the potential to shed light into this neuronal rearrangement. A better understanding of the underlying neurological pathways may contribute to the development of targeted treatment that will promote repair and reduce poststroke deficit. The aim of this review is to provide an up-to-date summary of the available scientific data evaluating the clinical application of functional connectivity magnetic resonance imaging among stroke survivors. © 2013 The Authors. International Journal of Stroke © 2013 World Stroke Organization.

  5. CT densitovolumetry in children with obliterative bronchiolitis: correlation with clinical scores and pulmonary function test results

    Directory of Open Access Journals (Sweden)

    Helena Mocelin

    2013-12-01

    Full Text Available OBJECTIVE: To determine whether air trapping (expressed as the percentage of air trapping relative to total lung volume [AT%] correlates with clinical and functional parameters in children with obliterative bronchiolitis (OB.METHODS: CT scans of 19 children with OB were post-processed for AT% quantification with the use of a fixed threshold of −950 HU (AT%950 and of thresholds selected with the aid of density masks (AT%DM. Patients were divided into three groups by AT% severity. We examined AT% correlations with oxygen saturation (SO2 at rest, six-minute walk distance (6MWD, minimum SO2 during the six-minute walk test (6MWT_SO2, FVC, FEV1, FEV1/FVC, and clinical parameters.RESULTS: The 6MWD was longer in the patients with larger normal lung volumes (r = 0.53. We found that AT%950 showed significant correlations (before and after the exclusion of outliers, respectively with the clinical score (r = 0.72; 0.80, FVC (r = 0.24; 0.59, FEV1 (r = −0.58; −0.67, and FEV1/FVC (r = −0.53; r = −0.62, as did AT%DM with the clinical score (r = 0.58; r = 0.63, SO2 at rest (r = −0.40; r = −0.61, 6MWT_SO2 (r = −0.24; r = −0.55, FVC (r = −0.44; r = −0.80, FEV1 (r = −0.65; r = −0.71, and FEV1/FVC (r = −0.41; r = −0.52.CONCLUSIONS: Our results show that AT% correlates significantly with clinical scores and pulmonary function test results in children with OB.

  6. Evaluation of a BED-SIDE Platelet Function Assay : Performance and Clinical Utility.

    Directory of Open Access Journals (Sweden)

    Lau Wei

    2002-01-01

    Full Text Available Platelets have a pivotal role in the initial defense against insult to the vasculature and are also recognized of critical importance in the acute care settings of percutaneous coronary intervention and cardiopulmonary bypass. In these environments both platelet count and function may be markedly compromised. Unfortunately, current assays to evaluate the parameters of platelet count and function are of limited utility for bed-side testing. Moreover, it is suggested that there may be significant inter patient variation in response to antiplatelet therapy that may be exacerbated by other agents (e.g. heparin that are routinely administered during cardiac intervention. Here we describe a practical, rapid and user-friendly whole blood platelet function assay that has been developed for use in bed-side settings. Platelet agonists were formulated with an anticoagulant and lyophilized in blood collection tubes standardised to receive a l mL fresh whole blood sample. In the presence of an agonist, platelets are activated and interact (aggregate. Using traditional cell counting principles, non-aggregated platelets are counted whereas aggregated platelets are not. The percentage (% of functional platelets in reference to a baseline tube may then be determined. Results are available within four minutes. Platelet aggregation in whole blood demonstrated good correlation with turbidometric aggregometry for both ADP (r=0.91 and collagen (r=0.88. Moreover, in clinical settings where antiplatelet agents were administered, this rapid, bed-side, platelet function assay demonstrated utility in monitoring patient response to these therapies. This novel bed-side assay of platelet function is extremely suitable for the clinical environment with a rapid turn-around time. In addition, it provides a full haematology profile, including platelet count, and should permit enhancement of transfusion and interventional decisions.

  7. Structural-functional relationships between eye orbital imaging biomarkers and clinical visual assessments

    Science.gov (United States)

    Yao, Xiuya; Chaganti, Shikha; Nabar, Kunal P.; Nelson, Katrina; Plassard, Andrew; Harrigan, Rob L.; Mawn, Louise A.; Landman, Bennett A.

    2017-02-01

    Eye diseases and visual impairment affect millions of Americans and induce billions of dollars in annual economic burdens. Expounding upon existing knowledge of eye diseases could lead to improved treatment and disease prevention. This research investigated the relationship between structural metrics of the eye orbit and visual function measurements in a cohort of 470 patients from a retrospective study of ophthalmology records for patients (with thyroid eye disease, orbital inflammation, optic nerve edema, glaucoma, intrinsic optic nerve disease), clinical imaging, and visual function assessments. Orbital magnetic resonance imaging (MRI) and computed tomography (CT) images were retrieved and labeled in 3D using multi-atlas label fusion. Based on the 3D structures, both traditional radiology measures (e.g., Barrett index, volumetric crowding index, optic nerve length) and novel volumetric metrics were computed. Using stepwise regression, the associations between structural metrics and visual field scores (visual acuity, functional acuity, visual field, functional field, and functional vision) were assessed. Across all models, the explained variance was reasonable (R2 0.1-0.2) but highly significant (p < 0.001). Instead of analyzing a specific pathology, this study aimed to analyze data across a variety of pathologies. This approach yielded a general model for the connection between orbital structural imaging biomarkers and visual function.

  8. Clinical Practice Guideline: Irritable bowel syndrome with constipation and functional constipation in the adult.

    Science.gov (United States)

    Mearin, Fermín; Ciriza, Constanza; Mínguez, Miguel; Rey, Enrique; Mascort, Juan José; Peña, Enrique; Cañones, Pedro; Júdez, Javier

    2016-06-01

    In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants). Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone, biofeedback

  9. Clinical Practice Guideline: irritable bowel syndrome with constipation and functional constipation in the adult

    Directory of Open Access Journals (Sweden)

    Fermín Mearin

    Full Text Available In this Clinical Practice Guideline we discuss the diagnostic and therapeutic approach of adult patients with constipation and abdominal complaints at the confluence of the irritable bowel syndrome spectrum and functional constipation. Both conditions are included among the functional bowel disorders, and have a significant personal, healthcare, and social impact, affecting the quality of life of the patients who suffer from them. The first one is the irritable bowel syndrome subtype, where constipation represents the predominant complaint, in association with recurrent abdominal pain, bloating, and abdominal distension. Constipation is characterized by difficulties with or low frequency of bowel movements, often accompanied by straining during defecation or a feeling of incomplete evacuation. Most cases have no underlying medical cause, and are therefore considered as a functional bowel disorder. There are many clinical and pathophysiological similarities between both disorders, and both respond similarly to commonly used drugs, their primary difference being the presence or absence of pain, albeit not in an "all or nothing" manner. Severity depends not only upon bowel symptom intensity but also upon other biopsychosocial factors (association of gastrointestinal and extraintestinal symptoms, grade of involvement, and perception and behavior variants. Functional bowel disorders are diagnosed using the Rome criteria. This Clinical Practice Guideline has been made consistent with the Rome IV criteria, which were published late in May 2016, and discuss alarm criteria, diagnostic tests, and referral criteria between Primary Care and gastroenterology settings. Furthermore, all the available treatment options (exercise, fluid ingestion, diet with soluble fiber-rich foods, fiber supplementation, other dietary components, osmotic or stimulating laxatives, probiotics, antibiotics, spasmolytics, peppermint essence, prucalopride, linaclotide, lubiprostone

  10. A Functional Neuroimaging Analysis of the Trail Making Test-B: Implications for Clinical Application

    Directory of Open Access Journals (Sweden)

    Mark D. Allen

    2011-01-01

    Full Text Available Recent progress has been made using fMRI as a clinical assessment tool, often employing analogues of traditional “paper and pencil” tests. The Trail Making Test (TMT, popular for years as a neuropsychological exam, has been largely ignored in the realm of neuroimaging, most likely because its physical format and administration does not lend itself to straightforward adaptation as an fMRI paradigm. Likewise, there is relatively more ambiguity about the neural systems associated with this test than many other tests of comparable clinical use. In this study, we describe an fMRI version of Trail Making Test-B (TMTB that maintains the core functionality of the TMT while optimizing its use for both research and clinical settings. Subjects (N = 32 were administered the Functional Trail Making Test-B (f-TMTB. Brain region activations elicited by the f-TMTB were consistent with expectations given by prior TMT neurophysiological studies, including significant activations in the ventral and dorsal visual pathways and the medial pre-supplementary motor area. The f-TMTB was further evaluated for concurrent validity with the traditional TMTB using an additional sample of control subjects (N = 100. Together, these results support the f-TMTB as a viable neuroimaging adaptation of the TMT that is optimized to evoke maximally robust fMRI activation with minimal time and equipment requirements.

  11. Dengue in renal transplant recipients: Clinical course and impact on renal function

    Science.gov (United States)

    Fernandes, Paula Frassinetti Castelo Branco Camurça; Siqueira, Reed André; Girão, Evelyne Santana; Siqueira, Rainne André; Mota, Márcia Uchoa; Marques, Leyla Castelo Branco Fernandes; Andrade, Silvana Cristina Albuquerque; Barroso, Wilson Mendes; Silva, Sônia Leite; Rodrigues dos Santos, Bruno Gomes; de Oliveira, Claúdia Maria Costa

    2017-01-01

    AIM To present clinical characteristics from renal transplant recipients with dengue fever and its impact on graft function. METHODS We retrospectively evaluated 11 renal transplant recipients (RTR) with dengue infection confirmed by laboratory test, between January 2007 and July 2012, transplanted in the Renal Transplant Center of Walter Cantídio University Hospital from Federal University of Ceará. RESULTS Positive dengue serology (IgM) was found in all patients. The mean time between transplant and dengue infection was 43 mo. Fever was presented in all patients. Nine patients presented with classical dengue and two (18%) with dengue hemorrhagic fever. All cases had satisfactory evolution with complete recovery of the symptoms. The time for symptom resolution varied from 2 to 20 d, with an average of 9 d. An increase of creatinine after the infection was observed in three (27.2%) patients with no clinically impact on the kidney graft function. CONCLUSION RTR with dengue infection seems to have a clinical presentation and evolution similar to those seen in the general population, with no long-term damage to patient and to the graft. PMID:28280696

  12. The clinical utility of functional capacity evaluations: the opinion of health professionals working within occupational rehabilitation.

    Science.gov (United States)

    James, Carole; MacKenzie, Lynette

    2009-01-01

    Functional Capacity Evaluations (FCE's) are used within the occupational rehabilitation arena with the aim of assessing an individual's functional abilities in relation to work tasks. Therapists use a variety of different FCE's, both standardized and non standardized. This study aimed to investigate therapists' views on the clinical utility of FCE's in general and to identify if these differed between professional groups. A cross sectional study design was used. Health professionals who conduct FCE's and who worked for WorkCover accredited rehabilitation providers in NSW were surveyed. Surveys were returned from 79 participants working for 65 different rehabilitation providers. Of those who replied, 82\\% (n=63) were occupational therapists, 13% (n=10) physiotherapists and 5% (n=5) exercise physiologists. The mean years of professional experience was 10.9 years and the mean years of FCE experience was 5.3 years. Data were analyzed using STATA [v8.0] and the clinical utility of FCE's was considered relating to: usefulness & relevance; adaptability and flexibility; therapist perceived requirements and issues in practice. No differences were found related to the clinical utility of FCE's between professional groups or years of professional experience. The results suggest consistency and similarities in how FCE's are currently used in practice across NSW (Australia). Limitations of this study and areas for further research are suggested.

  13. Predicting clinically significant changes in motor and functional outcomes after robot-assisted stroke rehabilitation.

    Science.gov (United States)

    Hsieh, Yu-wei; Lin, Keh-chung; Wu, Ching-yi; Lien, Hen-yu; Chen, Jean-lon; Chen, Chih-chi; Chang, Wei-han

    2014-02-01

    To investigate the predictors of minimal clinically important changes on outcome measures after robot-assisted therapy (RT). Observational cohort study. Outpatient rehabilitation clinics. A cohort of outpatients with stroke (N=55). Patients with stroke received RT for 90 to 105min/d, 5d/wk, for 4 weeks. Outcome measures, including the Fugl-Meyer Assessment (FMA) and Motor Activity Log (MAL), were measured before and after the intervention. Potential predictors include age, sex, side of lesion, time since stroke onset, finger extension, Box and Block Test (BBT) score, and FMA distal score. Statistical analysis showed that the BBT score (odds ratio[OR]=1.06; P=.04) was a significant predictor of clinically important changes in the FMA. Being a woman (OR=3.9; P=.05) and BBT score (OR=1.07; P=.02) were the 2 significant predictors of clinically significant changes in the MAL amount of use subscale. The BBT score was the significant predictor of an increased probability of achieving clinically important changes in the MAL quality of movement subscale (OR=1.07; P=.02). The R(2) values for the 3 logistic regression models were low (.114-.272). The results revealed that patients with stroke who had greater manual dexterity measured by the BBT appear to have a higher probability of achieving clinically significant motor and functional outcomes after RT. Further studies are needed to evaluate other potential predictors to improve the models and validate the findings. Copyright © 2014 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  14. Cognitive functioning throughout the treatment history of clinical late-life depression

    Science.gov (United States)

    Dzierzewski, Joseph M.; Potter, Guy G.; Jones, Richard N.; Rostant, Ola S.; Ayotte, Brian; Yang, Frances M.; Sachs, Bonnie C.; Feldman, Betsy J.; Steffens, David C.

    2015-01-01

    Objective Previous investigations into the relationship between late-life depressive symptoms and cognitive functioning have resulted in mixed findings concerning whether or not depressive symptoms and cognitive functioning are related. The mixed reports may be due in part to differences in clinical and nonclinical samples and to inadequate consideration of the dynamic nature (i.e., fluctuating course) of depressive symptoms and cognitive functioning in older adults. The current study examined the chronic, acute, and longitudinal relationships between depressive symptoms and cognitive functioning in older adults in an ongoing treatment study of major depressive disorder (MDD). Methods The neurocognitive outcomes of depression in the elderly study operates in a naturalistic treatment milieu using a pharmacological treatment algorithm and regular psychiatric assessment. Four hundred and fifty-three older adults [mean age 70 years, standard deviation (SD) = 7.2] meeting criteria for MDD at study enrollment received annual neuropsychological testing and depressive symptom monitoring for an average of 8.5 years (SD = 4.5). Results Hierarchical linear modeling revealed that higher age, lower education, and higher average/chronic levels of depressive symptoms were related to lower cognitive functioning. Additionally, results revealed that when an individual’s depressive symptoms are higher than is typical for a specific individual, general cognitive function was worse than average. There was no evidence of lagged/longitudinal relationships between depressive symptoms and cognitive functioning in older adults in treatment for MDD. Conclusions Cognitive functioning and depressive symptoms are concurrently associated in older adults with MDD, highlighting the potential importance for stabilizing mood symptoms as a means to manage cognitive deficits in late-life depression. PMID:25703072

  15. The clinical overlap between functional dyspepsia and irritable bowel syndrome based on Rome III criteria

    Directory of Open Access Journals (Sweden)

    LIU SiChun

    2008-09-01

    Full Text Available Abstract Background Epidemiological studies suggest considerable overlap between functional dyspepsia (FD and irritable bowel syndrome (IBS. To date, no surveys have been performed to investigate the clinical overlap between these two disorders using Rome III criteria. Our aim was to investigate the prevalence and risk factors for the overlap of FD and IBS based on Rome III criteria in a large clinical sample. Methods Consecutive patients at the general gastroenterology outpatient clinic were requested to complete a self-report questionnaire. FD and IBS were defined by Rome III criteria. Results Questionnaires were returned by 3014 patients (52.8% female, 89% response rate. FD-IBS overlap was observed in 5.0% of the patients, while 15.2% and 10.9% of the patients were classified as FD alone and IBS alone, respectively. Compared with non-IBS patients, the odds ratio of having FD among IBS patients was 2.09 (95% CI: 1.68–2.59. Patients with FD-IBS overlap had higher severity scores for the postprandial fullness symptom (2.35 ± 1.49 vs. 1.72 ± 1.59, P Conclusion Clinical overlap of FD and IBS according to Rome III criteria is very common. One risk factor for FD-IBS overlap is the presence of postprandial fullness symptom. This study provides clues for future pathophysiological studies of FD and IBS.

  16. Experimental Validation of Depth Cameras for the Parameterization of Functional Balance of Patients in Clinical Tests

    Science.gov (United States)

    Moreno, Francisco-Ángel; Merchán-Baeza, José Antonio; González-Sánchez, Manuel; González-Jiménez, Javier; Cuesta-Vargas, Antonio I.

    2017-01-01

    In clinical practice, patients’ balance can be assessed using standard scales. Two of the most validated clinical tests for measuring balance are the Timed Up and Go (TUG) test and the MultiDirectional Reach Test (MDRT). Nowadays, inertial sensors (IS) are employed for kinematic analysis of functional tests in the clinical setting, and have become an alternative to expensive, 3D optical motion capture systems. In daily clinical practice, however, IS-based setups are yet cumbersome and inconvenient to apply. Current depth cameras have the potential for such application, presenting many advantages as, for instance, being portable, low-cost and minimally-invasive. This paper aims at experimentally validating to what extent this technology can substitute IS for the parameterization and kinematic analysis of the TUG and the MDRT tests. Twenty healthy young adults were recruited as participants to perform five different balance tests while kinematic data from their movements were measured by both a depth camera and an inertial sensor placed on their trunk. The reliability of the camera’s measurements is examined through the Interclass Correlation Coefficient (ICC), whilst the Pearson Correlation Coefficient (r) is computed to evaluate the correlation between both sensor’s measurements, revealing excellent reliability and strong correlations in most cases. PMID:28241455

  17. Clinical and electrophysiologic attributes as predictors of results of autonomic function tests

    Science.gov (United States)

    Wu, C. L.; Denq, J. C.; Harper, C. M.; O'Brien, P. C.; Low, P. A.

    1998-01-01

    Autonomic dysfunction is a feature of some neuropathies and not others. It has been suggested that some clinical and electrophysiologic attributes are predictable of autonomic impairment detected using laboratory testing; however, dear guidelines are unavailable. We evaluated 138 relatively unselected patients with peripheral neuropathy who underwent neurologic evaluation, electromyography (EMG), nerve conduction studies, and autonomic function tests to determine which variables were predictive of laboratory findings of autonomic failure. The variables evaluated were 1) clinical somatic neuropathic findings, 2) clinical autonomic symptoms, and 3) electrophysiologic findings. Autonomic symptoms were strongly predictive (Rs = 0.40, p < 0.001) of autonomic failure. Among the non-autonomic indices, absent ankle reflexes were mildly predictive (Rs = 0.19, p = 0.022) of autonomic impairment, but all others were not (duration, clinical pattern, severity, weakness, sensory loss). Electrophysiologic changes of an axonal neuropathy predicted autonomic impairment while demyelinating neuropathy did not. We conclude that autonomic studies will most likely be abnormal in patients who have symptoms of autonomic involvement and those who have an axonal neuropathy.

  18. Pre-clinical functional Magnetic Resonance Imaging Part I: The kidney.

    Science.gov (United States)

    Zöllner, Frank G; Kalayciyan, Raffi; Chacón-Caldera, Jorge; Zimmer, Fabian; Schad, Lothar R

    2014-12-01

    The prevalence of chronic kidney disease (CKD) is increasing worldwide. In Europe alone, at least 8% of the population currently has some degree of CKD. CKD is associated with serious comorbidity, reduced life expectancy, and high economic costs; hence, the early detection and adequate treatment of kidney disease is important. Pre-clinical research can not only give insights into the mechanisms of the various kidney diseases but it also allows for investigating the outcome of new drugs developed to treat kidney disease. Functional magnetic resonance imaging provides non-invasive access to tissue and organ function in animal models. Advantages over classical animal research approaches are numerous: the same animal might be repeatedly imaged to investigate a progress or a treatment of disease over time. This has also a direct impact on animal welfare and the refinement of classical animal experiments as the number of animals in the studies might be reduced. In this paper, we review current state of the art in functional magnetic resonance imaging with a focus on pre-clinical kidney imaging. Copyright © 2014. Published by Elsevier GmbH.

  19. Functional state of kidneys in patients with clinical manifestations of hypothyroidism

    Directory of Open Access Journals (Sweden)

    Marina M. Orlova

    2013-05-01

    Full Text Available The research goal is to study the function of kidneys and serum concentration of immunoregulatory cytokines (IL-1ß, IL-6, IL-8, IL-10 in conditions of thyroid hormone deficit. Methods – The character and severity of renal dysfunction were investigated in patients with primary hypothyroidism. The clinical examination included study of serum concentration of creatinine, urea level, potassium and natrium in blood serum, blood and urine analyses, total cholesterol, high and low density lipoproteins, daily microalbuminuria, the performing of Zimnitsky test, urinary excretion of chemokines MCP-1, RANTES, rate calculation of glomerular filtration, thyroid hormone state. Results – The renal function in clinical hypothyroidism without concomitant kidney disturbances was characterized by normal parameters of the concentrational kidney function, reduction of glomerular filtration rate, increased of serum creatinine, urea excretion level of chemokineMCP-1 and level of cytokines IL-6, IL-8 in patients with autoimmune hypothyroidism were revealed. Conclusion – It was revealed that autoimmune hypothyroidism effected balance disturbance of cytokine-producing activity of Th1 and Th2 type therefore developing autoimmune state and disease progression.

  20. Functional state of kidneys in patients with clinical manifestations of hypothyroidism

    Directory of Open Access Journals (Sweden)

    Rodionova T.I.

    2012-06-01

    Full Text Available The research goal is to study the function of kidneys and serum concentration of immunoregulatory cytokines (IL-1ГА, IL-6, IL-8, IL-10 in conditions of thyroid hormone deficit. Methods: The character and severity of renal dysfunction were investigated in patients with primary hypothyroidism. The clinical examination included study of serum concentration of creatinine, urea level, potassium and natrium in blood serum, blood and urine analyses, total cholesterol, high and low density lipoproteins, daily microalbuminuria, the performing of Zimnitsky test, urinary excretion of chemokines MCP-1, RANTES, rate calculation of glomerular filtration, thyroid hormone state. Results: The renal function in clinical hypothyroidism without concomitant kidney disturbances was characterized by normal parameters of the concentra-tional kidney function, reduction of glomerular filtration rate, increased of serum creatinine, urea excretion level of chemokine MCP-1 and level of cytokines IL-6, IL-8 in patients with autoimmune hypothyroidism were revealed. Conclusion: It was revealed that autoimmune hypothyroidism effected balance disturbance of cytokine-producing activity of Th1 and Th2 type therefore developing autoimmune state and disease progression

  1. Pre-clinical functional magnetic resonance imaging. Pt. I. The kidney

    Energy Technology Data Exchange (ETDEWEB)

    Zoellner, Frank G.; Kalayciyan, Raffi; Chacon-Caldera, Jorge; Zimmer, Fabian; Schad, Lothar R. [Heidelberg Univ., Mannheim (Germany). Computer Assisted Clinical Medicine

    2014-07-01

    The prevalence of chronic kidney disease (CKD) is increasing worldwide. In Europe alone, at least 8% of the population currently has some degree of CKD. CKD is associated with serious comorbidity, reduced life expectancy, and high economic costs; hence, the early detection and adequate treatment of kidney disease is important. Pre-clinical research can not only give insights into the mechanisms of the various kidney diseases but it also allows for investigating the outcome of new drugs developed to treat kidney disease. Functional magnetic resonance imaging provides non-invasive access to tissue and organ function in animal models. Advantages over classical animal research approaches are numerous: the same animal might be repeatedly imaged to investigate a progress or a treatment of disease over time. This has also a direct impact on animal welfare and the refinement of classical animal experiments as the number of animals in the studies might be reduced. In this paper, we review current state of the art in functional magnetic resonance imaging with a focus on pre-clinical kidney imaging.

  2. Neutrophilic Bronchial Inflammation Correlates with Clinical and Functional Findings in Patients with Noncystic Fibrosis Bronchiectasis

    Directory of Open Access Journals (Sweden)

    Federico L. Dente

    2015-01-01

    Full Text Available Background. Neutrophilic bronchial inflammation is a main feature of bronchiectasis, but not much is known about its relationship with other disease features. Aim. To compare airway inflammatory markers with clinical and functional findings in subjects with stable noncystic fibrosis bronchiectasis (NCFB. Methods. 152 NFCB patients (62.6 years; females: 57.2% underwent clinical and functional cross-sectional evaluation, including microbiologic and inflammatory cell profile in sputum, and exhaled breath condensate malondialdehyde (EBC-MDA. NFCB severity was assessed using BSI and FACED criteria. Results. Sputum neutrophil percentages inversely correlated with FEV1 (P<0.0001; rho = −0.428, weakly with Leicester Cough Questionnaire score (P=0.068; rho = −0.58, and directly with duration of the disease (P=0.004; rho = 0.3 and BSI severity score (P=0.005; rho = 0.37, but not with FACED. Sputum neutrophilia was higher in colonized subjects, P. aeruginosa colonized subjects showing greater sputum neutrophilia and lower FEV1. Patients with ≥3 exacerbations in the last year showed a significantly greater EBC-MDA than the remaining patients. Conclusions. Sputum neutrophilic inflammation and biomarkers of oxidative stress in EBC can be considered good biomarkers of disease severity in NCFB patients, as confirmed by pulmonary function, disease duration, bacterial colonization, BSI score, and exacerbation rate.

  3. Effect of cerebrolysin on gross motor function of children with cerebral palsy: a clinical trial.

    Science.gov (United States)

    Nasiri, Jafar; Safavifar, Faezeh

    2017-01-10

    Gross motor dysfunction is considered as the most challenging problem in cerebral palsy (CP). It is proven that improvement of gross motor function could reduce CP-related disabilities and provide better quality of life in this group of patients. Therefore, the aim of this trial is to evaluate the effectiveness of cerebrolysin (CBL) on gross motor function of children with CP who are undergoing treatment. In this clinical trial study, paediatric patients aged 18-75 months with spastic diplegic or quadriplegic cerebral palsy, who were under rehabilitation therapy, were selected and randomly allocated in control and CBL groups. Patients in CBL group underwent treatment with standard rehabilitation therapy plus CBL. The latter was administrated intramuscularly as a single daily dose of 0.1 cc/kg for 10 days and then continued weekly for 4 months. Gross motor function of participants in the two studied groups, before and after trial, was evaluated and compared using the validated Persian version of gross motor function classification system-expanded and revised (GMFCS-E&R). During this trial, 108 patients with CP were evaluated for eligibility. From these, 50 patients were enrolled and randomly allocated in the CBL and control groups. Four months after trial, the mean level of GMFCS decreased significantly in the two groups (P < 0.05). However, it was significantly lower in the CBL group than in the control group (2.1 vs. 3.16, P < 0.05). The results of this trial indicated that CBL could improve gross motor function in patients with CP. This finding is consistent with neurotrophic and neuroprotective effects of CBL, which have been reported in various clinical trials in other neurological disorders. Further studies are recommended to establish the value of continued neuroprotection and to determine the pharmacokinetics/dynamics of CBL in this group of patients.

  4. Clinical and functional evaluation of the efficacy of otilonium bromide: a multicenter study in Italy.

    Science.gov (United States)

    Baldi, F; Longanesi, A; Blasi, A; Monello, S; Cestari, R; Missale, G; Corazziari, E; Badiali, G; Pescatori, M; Anastasio, G

    1991-11-01

    Seventy-two patients complaining of abdominal pain were studied in a double blind trial with otilonium bromide (OB) (40 mg tid or placebo). In our patients we performed, before and after the treatment, a clinical evaluation (symptom variations) and functional studies (sigmoid manometry during bowel distension). As regards clinical parameters, otilonium bromide significantly reduced abdominal pain and bloating and significantly increased (p less than 0.02) the pain threshold. However the comparison with the placebo group did not show any difference between the two groups. Sigmoid motility during distension was significantly reduced (p less than 0.05) in OB group, whereas it did not change in the placebo group. We can conclude that, in irritable bowel syndrome (IBS) patients, OB is able to improve symptoms and to reduce stimulated motor activity of the sigmoid.

  5. [Influence of prostatilen on smooth muscle organs functional activity in surgical patients (clinical and experimental study)].

    Science.gov (United States)

    Al'-Shukri, S Kh; Aĭvazian, A I; Barabanov, S V; Barabanova, V V; Bobkov, Iu A; Gorbachev, A G; Parastaeva, M M

    1999-01-01

    The action of prostatilen on contractile activity of smooth muscles of isolated line slices of urine bladder of Wistar rats (myography) and arterial vessels of cat kidneys (resistography) was studied. On the basis of clinical cases effectiveness of prostatilen was analysed as a treatment restorting urine bladder function in acute reflex urinary retention after operations in the area of rectal sphincter, as well as in treatment of patients with chronic prostatitis. It is shown, that prostatilen produces contractile action on smooth muscles of renal blood vessels in cats and urine bladder walls in rats and it raises contractile activity of smooth muscles of human urine bladder. The results of experimental and clinical investigations make it possible to recommend the application of this bioregulating preparation for treatment and prophylaxis of disturbances in urination.

  6. Predictive biomarker discovery through the parallel integration of clinical trial and functional genomics datasets

    DEFF Research Database (Denmark)

    Swanton, C.; Larkin, J.M.; Gerlinger, M.

    2010-01-01

    RNA screens to identify and validate functionally important genomic or transcriptomic predictive biomarkers of individual drug response in patients. PREDICT's approach to predictive biomarker discovery differs from conventional associative learning approaches, which can be susceptible to the detection...... inhibitor. Through the analysis of tumour tissue derived from pre-operative renal cell carcinoma (RCC) clinical trials, the PREDICT consortium will use established and novel methods to integrate comprehensive tumour-derived genomic data with personalised tumour-derived shRNA and high throughput si......, reducing ineffective therapy in drug resistant disease, leading to improved quality of life and higher cost efficiency, which in turn should broaden patient access to beneficial therapeutics, thereby enhancing clinical outcome and cancer survival. The consortium will also establish and consolidate...

  7. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Science.gov (United States)

    Brenner, Stephan; De Allegri, Manuela; Gabrysch, Sabine; Chinkhumba, Jobiba; Sarker, Malabika; Muula, Adamson S

    2015-01-01

    A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH) programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs), a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC), the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example. We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi. Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks. The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining MNH program

  8. Clinical and laboratory characteristics of adolescents with platelet function disorders and heavy menstrual bleeding

    Directory of Open Access Journals (Sweden)

    Amesse Lawrence S

    2013-01-01

    Full Text Available Abstract Background Platelet function disorders (PFDs have emerged as an important etiology of heavy menstrual bleeding (HMB in adolescents. However, neither clinical nor laboratory data have been methodically analyzed in this population subset. The objective of this study was to evaluate these parameters in order to distinguish characteristics of the disorder that in turn will lead to earlier diagnosis and therapy initiation. Methods Retrospective review of medical records from postmenarcheal adolescents with documented PFDs referred to a hemophilia treatment center and university faculty practices for bleeding diatheses with their clinical and laboratory data evaluated. Results Of 63 teens with documented PFDs, HMB was the most common clinical manifestation of PFD (43; 68.3%. Of these, 37 (86% were diagnosed with PFD either at or after menarche with the diagnosis based on HMB symptoms alone. Only 6 (14% were diagnosed with a PFD prior to menarche, based on associated bleeding, i.e., epistaxis, ecchymosis, and all developed HMB after menstruation onset. Interestingly, 20 girls were diagnosed with a PFD prior to menarche and of these, only 6 (30% went on to develop HMB after pubertal transition, while the majority (14; 70% did not. The average age-at-PFD diagnosis was 14.5yrs, significantly differing from the 10.9yrs average age-at-PFD diagnosis in their counterparts that, after menarche, did not develop HMB (PP P Conclusions Adolescents with PFDs and HMB appear to be clinically distinct from their non-HMB counterparts. This group of girls is characterized by HMB the major bleeding symptom, significantly high incidences of blood group O and the δ-SPD with a PFD diagnosed well after menarche. High false negative standard platelet function study results indicate additional diagnostic strategies, particularly for δ-SPD, should be considered.

  9. The quality of clinical maternal and neonatal healthcare - a strategy for identifying 'routine care signal functions'.

    Directory of Open Access Journals (Sweden)

    Stephan Brenner

    Full Text Available A variety of clinical process indicators exists to measure the quality of care provided by maternal and neonatal health (MNH programs. To allow comparison across MNH programs in low- and middle-income countries (LMICs, a core set of essential process indicators is needed. Although such a core set is available for emergency obstetric care (EmOC, the 'EmOC signal functions', a similar approach is currently missing for MNH routine care evaluation. We describe a strategy for identifying core process indicators for routine care and illustrate their usefulness in a field example.We first developed an indicator selection strategy by combining epidemiological and programmatic aspects relevant to MNH in LMICs. We then identified routine care process indicators meeting our selection criteria by reviewing existing quality of care assessment protocols. We grouped these indicators into three categories based on their main function in addressing risk factors of maternal or neonatal complications. We then tested this indicator set in a study assessing MNH quality of clinical care in 33 health facilities in Malawi.Our strategy identified 51 routine care processes: 23 related to initial patient risk assessment, 17 to risk monitoring, 11 to risk prevention. During the clinical performance assessment a total of 82 cases were observed. Birth attendants' adherence to clinical standards was lowest in relation to risk monitoring processes. In relation to major complications, routine care processes addressing fetal and newborn distress were performed relatively consistently, but there were major gaps in the performance of routine care processes addressing bleeding, infection, and pre-eclampsia risks.The identified set of process indicators could identify major gaps in the quality of obstetric and neonatal care provided during the intra- and immediate postpartum period. We hope our suggested indicators for essential routine care processes will contribute to streamlining

  10. Impact of Preeclampsia on Clinical and Functional Outcomes in Women With Peripartum Cardiomyopathy.

    Science.gov (United States)

    Lindley, Kathryn J; Conner, Shayna N; Cahill, Alison G; Novak, Eric; Mann, Douglas L

    2017-06-01

    Preeclampsia is a risk factor for the development of peripartum cardiomyopathy (PPCM), but it is unknown whether preeclampsia impacts clinical or left ventricular (LV) functional outcomes. This study sought to assess clinical and functional outcomes in women with PPCM complicated by preeclampsia. This retrospective cohort study included women diagnosed with PPCM delivering at Barnes-Jewish Hospital between 2004 to 2014. The primary outcome was one-year event-free survival rate for the combined end point of death and hospital readmission. The secondary outcome was recovery of LV ejection fraction. Seventeen of 39 women (44%) with PPCM had preeclampsia. The groups had similar mean LV ejection fraction at diagnosis (29.6 with versus 27.3 without preeclampsia; P=0.5). Women with preeclampsia had smaller mean LV end-diastolic diameters (5.2 versus 6.0 cm; P=0.001), greater relative wall thickness (0.41 versus 0.35 mm Hg; P=0.009), and lower incidence of eccentric remodeling (12% versus 48%; P=0.03). Clinical follow-up was available for 32 women; 5 died of cardiovascular complications within 1 year of diagnosis (4/15 with versus 1/17 without preeclampsia; P=0.16). In time to event analysis, patients with preeclampsia had worse event-free survival during 1-year follow-up (P=0.047). Echocardiographic follow-up was available in 10 survivors with and 16 without preeclampsia. LV ejection fraction recovered in 80% of survivors with versus 25% without preeclampsia (P=0.014). PPCM with concomitant preeclampsia is associated with increased morbidity and mortality and different patterns of LV remodeling and recovery of LV function when compared with patients with PPCM that is not complicated by preeclampsia. © 2017 American Heart Association, Inc.

  11. Minocycline in leprosy patients with recent onset clinical nerve function impairment.

    Science.gov (United States)

    Narang, Tarun; Arshdeep; Dogra, Sunil

    2017-01-01

    Nerve function impairment (NFI) in leprosy may occur and progress despite multidrug therapy alone or in combination with corticosteroids. We observed improvement in neuritis when minocycline was administered in patients with type 2 lepra reaction. This prompted us to investigate the role of minocycline in recent onset NFI, especially in corticosteroid unresponsive leprosy patients. Leprosy patients with recent onset clinical NFI (leprosy patients. However, larger and long term comparative trials are needed to validate the efficacy of minocycline in leprosy neuropathy. © 2016 Wiley Periodicals, Inc.

  12. Does exercise and the stress of clinical examination influence endothelial function in dogs with mitral regurgitation?

    DEFF Research Database (Denmark)

    Moesgaard, Sophia Gry; Pedersen, Henrik Duelund; Holte, Andreas

    2005-01-01

    amount of stress and agitation, which may affect the cardiovascular system and endothelial function. Plasma NOx measured in dogs with MR in their home environment was similar to that of dogs without MR which were measured in the clinic. However, the same dogs with MR showed a significant decrease...... the day, however, exercise significantly increased the plasma NOx (1.78±1.24 vs. 8.19±4.13 µM NOx before and after exercise, respectively, P affected by stress in dogs with and without MR. Samples for the measurement of plasma...

  13. Prevalence, conservation and functional analysis of Yersinia and Escherichia CRISPR regions in clinical Pseudomonas aeruginosa isolates.

    Science.gov (United States)

    Cady, K C; White, A S; Hammond, J H; Abendroth, M D; Karthikeyan, R S G; Lalitha, P; Zegans, M E; O'Toole, G A

    2011-02-01

    Here, we report the characterization of 122 Pseudomonas aeruginosa clinical isolates from three distinct geographical locations: Dartmouth Hitchcock Medical Center in New Hampshire, USA, the Charles T. Campbell Eye Microbiology Lab at the University of Pittsburgh Medical Center, USA, and the Aravind Eye Hospital in Madurai, India. We identified and located clustered regularly interspaced short palindromic repeats (CRISPR) in 45/122 clinical isolates and sequenced these CRISPR, finding that Yersinia subtype CRISPR regions (33 %) were more prevalent than the Escherichia CRISPR region subtype (6 %) in these P. aeruginosa clinical isolates. Further, we observed 132 unique spacers from these 45 CRISPR that are 100 % identical to prophages or sequenced temperate bacteriophage capable of becoming prophages. Most intriguingly, all of these 132 viral spacers matched to temperate bacteriophage/prophages capable of inserting into the host chromosome, but not to extrachromosomally replicating lytic P. aeruginosa bacteriophage. We next assessed the ability of the more prevalent Yersinia subtype CRISPR regions to mediate resistance to bacteriophage infection or lysogeny by deleting the entire CRISPR region from sequenced strain UCBPP-PA14 and six clinical isolates. We found no change in CRISPR-mediated resistance to bacteriophage infection or lysogeny rate even for CRISPR with spacers 100 % identical to a region of the infecting bacteriophage. Lastly, to show these CRISPR and cas genes were expressed and functional, we demonstrated production of small CRISPR RNAs. This work provides both the first examination to our knowledge of CRISPR regions within clinical P. aeruginosa isolates and a collection of defined CRISPR-positive and -negative strains for further CRISPR and cas gene studies.

  14. Predicting functional remission in patients with schizophrenia: a cross-sectional study of symptomatic remission, psychosocial remission, functioning, and clinical outcome

    Directory of Open Access Journals (Sweden)

    Valencia M

    2015-09-01

    Full Text Available Marcelo Valencia,1 Ana Fresán,2 Yoram Barak,3 Francisco Juárez,1 Raul Escamilla,4 Ricardo Saracco41Division of Epidemiological and Psychosocial Research, 2Division of Clinical Research, National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico; 3Psychiatry Department, Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel; 4Schizophrenia Clinic, National Institute of Psychiatry Ramón de la Fuente, Mexico City, MexicoBackground: New approaches to assess outcome in schizophrenia include multidimensional measures such as remission, cognition, psychosocial functioning, and quality of life. Clinical and psychosocial measures have been recently introduced to assess functional outcome.Objective: The study presented here was designed to examine the rates of symptomatic remission, psychosocial remission, global functioning, and clinical global impressions in a sample of schizophrenia outpatients in order to assess functional remission and to identify predictive factors for functional remission.Methods: A total of 168 consecutive Mexican outpatients receiving pharmacological treatment at the National Institute of Psychiatry in Mexico City were enrolled in a cross-sectional study. Symptomatic remission was assessed according to the definition and criteria proposed by the Remission in Schizophrenia Working Group using the Positive and Negative Symptom Scale. Psychosocial remission was assessed according to Barak criteria using the Psychosocial Remission in Schizophrenia scale. Functioning was measured with the Global Assessment of Functioning, and clinical outcome with the Clinical Global Impressions (CGI Scale.Results: Findings showed that 45.2% of patients fulfilled the symptomatic remission criteria, 32.1% achieved psychosocial remission, and 53% reported adequate functioning. However, the combination of these three outcome criteria – symptomatic, psychosocial remission, and functioning – indicated that 14.9% of the

  15. Effects of youth football on selected clinical measures of neurologic function: a pilot study.

    Science.gov (United States)

    Munce, Thayne A; Dorman, Jason C; Odney, Tryg O; Thompson, Paul A; Valentine, Verle D; Bergeron, Michael F

    2014-12-01

    We assessed 10 youth football players (13.4 ± 0.7 y) immediately before and after their season to explore the effects of football participation on selected clinical measures of neurologic function. Postseason postural stability in a closed-eye condition was improved compared to preseason (P = .017). Neurocognitive testing with the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) battery revealed that reaction time was significantly faster at postseason (P = .015). There were no significant preseason versus postseason differences in verbal memory (P = .507), visual memory (P = .750), or visual motor speed (P = .087). Oculomotor performance assessed by the King-Devick test was moderately to significantly improved (P = .047-.115). A 12-week season of youth football did not impair the postural stability, neurocognitive function, or oculomotor performance measures of the players evaluated. Though encouraging, continued and more comprehensive investigations of this at-risk population are warranted.

  16. Undersized annuloplasty for functional mitral regurgitation: is it responsible for clinically relevant mitral stenosis during exercise?

    Science.gov (United States)

    Grimaldi, Antonio; De Bonis, Michele; Pappalardo, Federico; Taramasso, Maurizio; Verzini, Alessandro; Calabrese, Maria Chiara; Maisano, Francesco; Alfieri, Ottavio

    2012-07-01

    The study aim was to assess if an undersized mitral annuloplasty for functional mitral regurgitation (FMR) in dilated cardiomyopathy can determine a clinically relevant mitral stenosis during exercise. Both, rest and stress echocardiography were performed in 12 patients submitted to an undersized ring annuloplasty for FMR in dilated cardiomyopathy. The mean ring size was 27 +/- 1.3 mm. All patients were in NYHA functional classes I-II, were in stable sinus rhythm, and without significant residual mitral regurgitation (grade stroke volume (63 +/- 15 versus 77 +/- 14 ml, p FMR. Stress echocardiography represents a valuable tool to assess an appropriate cardiac response to exercise and to detect a significant exercise-induced pulmonary hypertension after undersized annuloplasty ring surgery.

  17. Clinical Presentation of Acute Gastroenteritis in Children With Functional Abdominal Pain Disorders.

    Science.gov (United States)

    Saps, Miguel; Mintjens, Stijn; Pusatcioglu, Cenk K; Cohen, Daniel M; Sternberg, Petra

    2017-08-01

    Visceral hypersensitivity and abnormal coping are common in children with functional abdominal pain disorders (FAPDs). Thus, it would be expected that children with visceral hypersensitivity would report more pain if their gut is acutely inflamed. The aim of the study was to compare clinical symptoms and somatization of children with and without FAPDs at time of an episode of acute gastroenteritis. Seventy children with acute gastroenteritis and their parents completed the Rome III Diagnostic Questionnaire for Pediatric Functional GI Disorders and the Children's Somatization Inventory. Twenty-one percent of children were diagnosed with an FAPD. Children with FAPDs showed significantly more nongastrointestinal somatic symptoms than children without FAPDs. There were no significant differences in abdominal pain, nausea, vomiting, or school absenteeism between both groups at time of consultation.

  18. Physical function continues to improve when clinical remission is sustained in rheumatoid arthritis patients.

    Science.gov (United States)

    Radner, Helga; Alasti, Farideh; Smolen, Josef S; Aletaha, Daniel

    2015-08-11

    To investigate the course of functional status assessed by health assessment questionnaire (HAQ) in rheumatoid arthritis (RA) patients with sustained clinical remission (REM). In recent RA clinical trials, we identified patients with subsequent visits of ≥24 weeks in clinical REM according to the disease activity score using 28-joint counts including C-reactive protein (DAS28) (≤2.6), or simplified disease activity index (SDAI) (≤3.3). Area under the curve (AUC) and mean HAQ scores throughout the time in sustained REM were compared using t test, analyses of variance (ANOVA) and adjusted general linear modeling (GLM) with repeated measures. In Cox regression analyses, the time to regain full physical function was modeled. Sensitivity analyses were performed in patients of sustained SDAI low disease activity (LDA; SDAI ≤11). A total of 610 out of 4364 patients achieved sustained DAS28 REM (14%) and 252 SDAI REM (5.8%). ANOVA testing for linear trend showed significant decrease of mean HAQ from week 0 (start of REM) to week 24, regardless of REM criteria used. AUC of HAQ throughout 24 weeks of REM was higher in DAS28 compared to SDAI REM (p ≤0.01). GLM adjusting for covariates showed significant decrease of monthly HAQ scores from week 0 to 24 (DAS28: 0.276, 0.243, 0.229, 0.222, 0.219, 0.209 to 0.199; p = 0.0001; SDAI: 0.147, 0.142, 0.149, 0.129, 0.123, 0.117 to 0.114; p = 0.029). Similarly, a decrease of HAQ over time was found in patients of sustained SDAI LDA. In DAS28 REM, the chance of regaining full physical function was higher for female (hazard ratio HR [95% confidence interval]: 1.41 [1.13-1.76]) and early RA patients (disease duration ≤2 years: HR 1.29 [1.01-1.65]); in SDAI REM no significant differences were found. Physical function continues to improve if the target of REM or LDA is sustained. The stringency of the remission criteria determines achievement of the best possible functional improvement.

  19. Changes and clinical significance of liver function and myocardial zymogram in children with rotavirus enteritis

    Institute of Scientific and Technical Information of China (English)

    Lan-Ping Yang

    2016-01-01

    Objective:To explore the changes and clinical significance of liver function and myocardial zymogram in children with rotavirus (RV) enteritis.Methods:A total of 70 children with RV enteritis who were admitted in our hospital were included in the study and served as the observation group. The liver function and myocardial zymogram before and after treatment were detected. The proportion of RV enteritis children with liver and myocardial damage was calculated. The effect of dehydration on the liver function and myocardial zymogram in children with RV enteritis was analyzed. A total of 65 children with non-RV enteritis who were admitted in our hospital at the same stage were served as the control group.Results:The serum ALT, AST, CK, CK-MB, LDH, andα-HBDH levels, and liver myocardial damage children proportion in the observation group were significantly higher than those in the control group (P<0.05). The serum ALT, AST, CK, CK-MB, LDH, andα-HBDH levels in the observation group were significantly elevated with the acceleration of dehydration degree (P<0.05). In the observation group, 45 children had liver and myocardial damage, whose ALT, AST, CK, CK-MB, LDH, andα-HBDH levels after treatment were significantly reduced when compared with before treatment (P<0.05).Conclusions:Early detection of liver function and myocardial zymogram can accurately reflect the condition in children with RV enteritis, which can provide an evidence for the formulation of clinical treatment protocol.

  20. Clinical, functional and health-related quality of life correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis: a cross-sectional survey.

    Directory of Open Access Journals (Sweden)

    Christelle Nguyen

    Full Text Available OBJECTIVES: To identify clinical, functional and health-related quality of life (HRQoL correlates of clinically significant symptoms of anxiety and depression in patients with systemic sclerosis (SSc. METHODS: Three-hundred-and-eighty-one patients fulfilling the American College of Rheumatology and/or the Leroy and Medsger criteria for SSc were assessed for visceral involvement, disability and HRQoL (assessed by SF-36. Clinically significant symptoms of anxiety and depression were evaluated with the Hospital Anxiety Depression Scale (HAD (defined cut-off≥8. RESULTS: 9.2% the patients had limited SSc, 50.5% limited cutaneous SSc (lcSSc, and 40.3% diffuse cutaneous SSc (dcSSc. Overall, 40.4% and 58.8% of the patients had clinically significant symptoms of depression and anxiety, respectively. Compared to patients without clinically significant symptoms of depression, patients with clinically significant symptoms of depression had poorer health status, HRQoL mental and physical component, and greater global disability, hand disability and aesthetic impairment. Compared to patients without clinically significant symptoms of anxiety, patients with clinically significant symptoms of anxiety had poorer SF-36 mental and physical component scores. On multivariable analysis, excluding mental component score of SF-36, variables independently associated with clinically significant symptoms of depression and anxiety were global disability and physical component of SF-36, plus female gender for clinically significant symptoms of anxiety only. Remarkably, patients with and without clinically significant psychiatric symptoms were comparable for all disease-related clinical features assessed. CONCLUSION: High levels of clinically significant symptoms of anxiety and depression are observed among SSc patients. Clinically significant psychiatric symptoms are rather associated with increased disability and altered HRQoL, than with disease-specific organ

  1. Xerostomia in complete denture wearers: prevalence, clinical findings and impact on oral functions.

    Science.gov (United States)

    Al-Dwairi, Ziad; Lynch, Edward

    2014-03-01

    To investigate the prevalence of dry mouth in a select sample of edentulous Jordanian older population wearing complete dentures and to evaluate its impact on oral functions. The prevalence and impact of Xerostomia as a cofactor in causing denture problems in Jordanians have not been previously investigated. This study included 455 participants (253 men and 202 women). Perception of dry mouth was measured by a pilot-tested questionnaire. Xerostomic status was confirmed clinically. Complete denture function was also assessed. One hundred and thirty six subjects (29.9%) had reported a subjective feeling of dry mouth with a prevalence of 24.9% in men (n = 63) and 36.1% in women (n = 73) (p dentures showed one or more signs suggestive of Xerostomia. The majority of xerostomic participants with different sets of complete dentures were dissatisfied with oral functions (p complete denture wearers, Xerostomia is significantly more prevalent in women and associated with increased age and smoking. Xerostomia adversely affects oral functions and overall satisfaction with dentures. © 2012 John Wiley & Sons A/S and The Gerodontology Association. Published by John Wiley & Sons Ltd.

  2. Clinical features of unspecified functional bowel disorder in servicemen from a Chinese army unit

    Directory of Open Access Journals (Sweden)

    Xin YAO

    2017-02-01

    Full Text Available Objective To investigate clinical manifestation of unspecified functional bowel disorder (UFBD, the features of coexistence with functional gastrointestinal disorder (FGID and its relationship with psychological factors and sleep disturbance in the Chinese Army servicemen. Methods cFGIDs were diagnosed based on the Rome Ⅲ Modular Questionnaire. The subjects were 189 servicemen with UFBD (UFBD group and 372 without FGID (control group. All subjects completed symptom checklist 90 (SCL-90 and Pittsburgh Sleep Quality Index (PSQI questionnaire. Results 'Have to rush to the toilet when having a desire to defecate' was the most frequent symptom of UFBD (93.7%. More than one half of UFBD patients had the symptom 'a feeling of incomplete emptying as bowel movements' or 'straining during bowel movements'. Twenty-eight percent of UFBD subjects had combined FGID (namely cFGID. Among them, the most frequent was proctalgia fugax (7.9%, followed by cyclic vomiting syndrome (6.3%, functional fecal incontinence (6.3%, functional dyspepsia (4.8% and belching (4.8%. The UFBD group scored significantly higher than the control group in the global severity index (GSI and in all SCL-90 subscales (P0.05. Conclusion Pathogenesis of UFBD may be closely correlated with psychiatric and psychological factors and sleep disturbance. cFGID are associated with an increased severity of psychopathological features. DOI: 10.11855/j.issn.0577-7402.2017.01.15

  3. Metabolic Control of Dendritic Cell Activation and Function: Recent Advances and Clinical Implications

    Directory of Open Access Journals (Sweden)

    Bart eEverts

    2014-05-01

    Full Text Available Dendritic cells (DCs are key regulators of both immunity and tolerance by controlling activation and polarization of effector T helper cell and regulatory T cell responses. Therefore, there is a major focus on developing approaches to manipulate DC function for immunotherapy. It is well known that changes in cellular activation are coupled to profound changes in cellular metabolism. Over the past decade there is a growing appreciation that these metabolic changes also underlie the capacity of immune cells to perform particular functions. This has led to the concept that the manipulation of cellular metabolism can be used to shape innate and adaptive immune responses. While most of our understanding in this area has been gained from studies with T cells and macrophages, evidence is emerging that the activation and function of DCs are also dictated by the type of metabolism these cells commit to. We here discuss these new insights and explore whether targeting of metabolic pathways in DCs could hold promise as a novel approach to manipulate the functional properties of DCs for clinical purposes.

  4. Preserving knee function following osteoarthritis diagnosis: a sustainability theory and social ecology clinical commentary.

    Science.gov (United States)

    Nyland, J; Wera, J; Henzman, C; Miller, T; Jakob, R; Caborn, D N M

    2015-02-01

    To sustain natural systems, there must be an ongoing balance between environmental, social, and economic considerations. A key element of sustainability theory is to identify the most vulnerable surroundings. The most vulnerable knee tissue is the articular cartilage as it is the last line of osteoarthritis (OA) defense. This tissue has a poor capacity for healing. Based on sustainability theory and social ecology concepts we propose that several key factors contribute to knee function preservation. Factors include health history, genetic predisposition, personal behaviors, and socio-environmental factors in addition to local-regional-global physiological system function. Addressing only some of these factors or any one factor in isolation may lead to less than optimal treatment effectiveness. The purpose of this commentary is to introduce a medical, surgical and rehabilitation management approach for patients with knee OA that considers more than physical function improvement. This approach also considers social, emotional, and environmental factors to better ensure patient satisfaction, fulfilled expectations and successful outcomes. A clinical care pathway is presented for a 57-year-old patient with medial compartment knee OA who is contemplating early arthroplasty versus a knee function preservation treatment approach. Early arthroplasty refers to high revision likelihood based on a minimum 15 year prosthesis life-expectancy.

  5. Change in Neuropsychological Functioning over One Year in Youth at Clinical High Risk for Psychosis

    Science.gov (United States)

    Woodberry, Kristen A.; McFarlane, William R.; Giuliano, Anthony J.; Verdi, Mary B.; Cook, William L.; Faraone, Stephen V.; Seidman, Larry J.

    2013-01-01

    Schizophrenia and related psychotic disorders are associated with significant neuropsychological (NP) impairments. Yet the onset and developmental evolution of these impairments remains incompletely characterized. This study examined NP functioning over one year in a sample of youth at clinical high risk (CHR) for psychosis participating in a treatment study. We assessed functioning across six cognitive domains at two time points in a sample of 53 CHR and 32 healthy comparison (HC) subjects. Linear regression of HC one-year scores was used to predict one-year performance for CHR from baseline scores and relevant demographic variables. We used raw scores and MANOVAs of the standardized residuals to test for progressive impairment over time. NP functioning of CHR at one year fell significantly below predicted levels. Effects were largest and most consistent for a failure of normative improvement on tests of executive function. CHR who reached the highest positive symptom rating (6, severe and psychotic) on the Structured Interview of Prodromal Syndromes after the baseline assessment (n = 10/53) demonstrated a particularly large (d= −1.89), although non-significant, discrepancy between observed and predicted one-year verbal memory test performance. Findings suggest that, although much of the cognitive impairment associated with psychosis is present prior to the full expression of the psychotic syndrome, some progressive NP impairments may accompany risk for psychosis and be greatest for those who develop psychotic level symptoms. PMID:23434505

  6. Diabetes and beta cell function: from mechanisms to evaluation and clinical implications.

    Science.gov (United States)

    Cernea, Simona; Dobreanu, Minodora

    2013-01-01

    Diabetes is a complex, heterogeneous condition that has beta cell dysfunction at its core. Many factors (e.g. hyperglycemia/glucotoxicity, lipotoxicity, autoimmunity, inflammation, adipokines, islet amyloid, incretins and insulin resistance) influence the function of pancreatic beta cells. Chronic hyperglycaemia may result in detrimental effects on insulin synthesis/secretion, cell survival and insulin sensitivity through multiple mechanisms: gradual loss of insulin gene expression and other beta-cell specific genes; chronic endoplasmic reticulum stress and oxidative stress; changes in mitochondrial number, morphology and function; disruption in calcium homeostasis. In the presence of hyperglycaemia, prolonged exposure to increased free fatty acids result in accumulation of toxic metabolites in the cells ("lipotoxicity"), finally causing decreased insulin gene expression and impairment of insulin secretion. The rest of the factors/mechanisms which impact on the course of the disease are also discusses in detail. The correct assessment of beta cell function requires a concomitant quantification of insulin secretion and insulin sensitivity, because the two variables are closely interrelated. In order to better understand the fundamental pathogenetic mechanisms that contribute to disease development in a certain individual with diabetes, additional markers could be used, apart from those that evaluate beta cell function. The aim of the paper was to overview the relevant mechanisms/factors that influence beta cell function and to discuss the available methods of its assessment. In addition, clinical considerations are made regarding the therapeutical options that have potential protective effects on beta cell function/mass by targeting various underlying factors and mechanisms with a role in disease progression.

  7. Fractographic features of glass-ceramic and zirconia-based dental restorations fractured during clinical function.

    Science.gov (United States)

    Oilo, Marit; Hardang, Anne D; Ulsund, Amanda H; Gjerdet, Nils R

    2014-06-01

    Fractures during clinical function have been reported as the major concern associated with all-ceramic dental restorations. The aim of this study was to analyze the fracture features of glass-ceramic and zirconia-based restorations fractured during clinical use. Twenty-seven crowns and onlays were supplied by dentists and dental technicians with information about type of cement and time in function, if available. Fourteen lithium disilicate glass-ceramic restorations and 13 zirconia-based restorations were retrieved and analyzed. Fractographic features were examined using optical microscopy to determine crack initiation and crack propagation of the restorations. The material comprised fractured restorations from one canine, 10 incisors, four premolars, and 11 molars. One crown was not categorized because of difficulty in orientation of the fragments. The results revealed that all core and veneer fractures initiated in the cervical margin and usually from the approximal area close to the most coronally placed curvature of the margin. Three cases of occlusal chipping were found. The margin of dental all-ceramic single-tooth restorations was the area of fracture origin. The fracture features were similar for zirconia, glass-ceramic, and alumina single-tooth restorations. Design features seem to be of great importance for fracture initiation.

  8. Functional Magnetic Resonance Imaging at 3T as a Clinical Tool in Patients with Intracranial Tumors

    Energy Technology Data Exchange (ETDEWEB)

    Westen, D. van; Skagerberg, G.; Olsrud, J.; Fransson, P.; Larsson, E.M. [Univ. Hospital, Lund (Sweden). Depts. of Diagnostic Radiology and Neurosurgery

    2005-10-01

    Purpose: To investigate the potential of functional magnetic resonance imaging (fMRI) at 3T as a clinical tool in the preoperative evaluation of patients with intracranial tumors. High magnetic field strength such as 3T is of benefit for fMRI because signal-to-noise ratio and sensitivity to susceptibility changes are field-strength-dependent. Material and Methods: Twenty patients with tumors close to eloquent sensorimotor or language areas were studied. Motor, sensory, and two language paradigms (word generation, rhyming) were used; their effectiveness was determined as the percentage of patients in whom the functional area of interest was activated. Activation maps were calculated and their quality rated as high, adequate, or insufficient. The influence of fMRI on the neurosurgical decision regarding operability, surgical approach, and extent of the resection, was assessed. Results: Paradigm effectiveness was 90% for motor and 95% for sensory stimulation, and varied from 79% to 95% for word generation and rhyming in combination. Ninety percent of the activation maps held high or adequate quality. fMRI proved useful: in the decision to operate (9 patients), in the surgical approach (13 patients), and in extent of the resection (12 patients). Conclusion: fMRI at 3T is a clinically applicable tool in the work-up of patients with intracranial tumors.

  9. Concurrent functional endoscopic sinus surgery and septorhinoplasty: using evidence to make clinical decisions.

    Science.gov (United States)

    Patel, Zara M; Setzen, Michael; Sclafani, Anthony P; Del Gaudio, John M

    2013-06-01

    Concurrent septorhinoplasty (SRP) and functional endoscopic sinus surgery (FESS) has been a controversial topic in the literature over the last decade. Warnings and admonitions about the risks of performing these procedures together in a single surgery are both published and voiced at national meetings. Although pros and cons have been discussed in the literature, there have been no guidelines published based solely on a review of the level of evidence. A systematic review of the literature was performed and the Clinical Practice Guideline Manual, Conference on Guideline Standardization (COGS), and the Appraisal of Guidelines and Research Evaluation (AGREE) instrument recommendations were followed. Study inclusion criteria were an adult population >18 years old, description or implication of study design available, concurrent FESS and SRP performed without additional procedures, and report of complications included in the study. We identified and evaluated the literature meeting those criteria: 11 retrospective studies. The literature was reviewed for both quality of research design as well as benefit and harm of the proposed interventions. If a patient is in need of FESS and SRP, either for functional or cosmetic reasons, and is found on the risk matrix to either have low or moderate risk, that patient is a good candidate for a concurrent procedure. If the patient is found to have higher risk, it is not an absolute contraindication, but the surgeon must use best clinical judgment when deciding to move forward and must counsel the patient preoperatively about possible increased risks. © 2013 ARS-AAOA, LLC.

  10. The clinical overlap between functional dyspepsia and irritable bowel syndrome based on Rome III criteria.

    Science.gov (United States)

    Wang, Anjiang; Liao, XianHua; Xiong, LiShou; Peng, Sui; Xiao, YingLian; Liu, SiChun; Hu, PinJin; Chen, MinHu

    2008-09-23

    Epidemiological studies suggest considerable overlap between functional dyspepsia (FD) and irritable bowel syndrome (IBS). To date, no surveys have been performed to investigate the clinical overlap between these two disorders using Rome III criteria. Our aim was to investigate the prevalence and risk factors for the overlap of FD and IBS based on Rome III criteria in a large clinical sample. Consecutive patients at the general gastroenterology outpatient clinic were requested to complete a self-report questionnaire. FD and IBS were defined by Rome III criteria. Questionnaires were returned by 3014 patients (52.8% female, 89% response rate). FD-IBS overlap was observed in 5.0% of the patients, while 15.2% and 10.9% of the patients were classified as FD alone and IBS alone, respectively. Compared with non-IBS patients, the odds ratio of having FD among IBS patients was 2.09 (95% CI: 1.68-2.59). Patients with FD-IBS overlap had higher severity scores for the postprandial fullness symptom (2.35 +/- 1.49 vs. 1.72 +/- 1.59, P Rome III criteria is very common. One risk factor for FD-IBS overlap is the presence of postprandial fullness symptom. This study provides clues for future pathophysiological studies of FD and IBS.

  11. A global amnesia associated with the specific variant of posterior reversible encephalopathy syndrome (PRES) that developed due to severe preeclampsia and malignant hypertension

    Science.gov (United States)

    Borovac, Josip Anđelo; Božić, Joško; Žaja, Nikola; Kolić, Krešimir; Hrboka, Vedran

    2016-01-01

    A case is reported of a 26-year-old primiparous woman in the 32nd week of gestation who presented to the emergency department with the symptoms of a severe headache, nausea and vomiting. The patient was diagnosed with preeclampsia that later progressed to eclampsia. This state was characterized by a sudden onset of a headache and diplopia that advanced to cortical blindness and precipitated significant alterations in mental status, most notable being global amnesia that resolved within 48 h. A post-partum magnetic resonance imaging of the brain in FLAIR mode revealed multiple cortico-subcortical areas of hyperintense signals suggestive of edematous lesions that chiefly involved occipital and parietal lobes with additional atypical manifestations. Such radiologic findings suggested a posterior reversible encephalopathy syndrome variant with the global amnesia as an extraordinary constituent. This unique feature should be acknowledged when treating a preeclamptic or hypertensive patient that exhibits neurological symptomatology and vision disturbances. PMID:27099774

  12. A global amnesia associated with the specific variant of posterior reversible encephalopathy syndrome (PRES) that developed due to severe preeclampsia and malignant hypertension.

    Science.gov (United States)

    Borovac, Josip Anđelo; Božić, Joško; Žaja, Nikola; Kolić, Krešimir; Hrboka, Vedran

    2016-04-01

    A case is reported of a 26-year-old primiparous woman in the 32nd week of gestation who presented to the emergency department with the symptoms of a severe headache, nausea and vomiting. The patient was diagnosed with preeclampsia that later progressed to eclampsia. This state was characterized by a sudden onset of a headache and diplopia that advanced to cortical blindness and precipitated significant alterations in mental status, most notable being global amnesia that resolved within 48 h. A post-partum magnetic resonance imaging of the brain in FLAIR mode revealed multiple cortico-subcortical areas of hyperintense signals suggestive of edematous lesions that chiefly involved occipital and parietal lobes with additional atypical manifestations. Such radiologic findings suggested a posterior reversible encephalopathy syndrome variant with the global amnesia as an extraordinary constituent. This unique feature should be acknowledged when treating a preeclamptic or hypertensive patient that exhibits neurological symptomatology and vision disturbances.

  13. New insights of an old defense system: structure, function, and clinical relevance of the complement system.

    Science.gov (United States)

    Ehrnthaller, Christian; Ignatius, Anita; Gebhard, Florian; Huber-Lang, Markus

    2011-01-01

    The complement system was discovered a century ago as a potent defense cascade of innate immunity. After its first description, continuous experimental and clinical research was performed, and three canonical pathways of activation were established. Upon activation by traumatic or surgical tissue damage, complement reveals beneficial functions of pathogen and danger defense by sensing and clearing injured cells. However, the latest research efforts have provided a more distinct insight into the complement system and its clinical subsequences. Complement has been shown to play a significant role in the pathogenesis of various inflammatory processes such as sepsis, multiorgan dysfunction, ischemia/reperfusion, cardiovascular diseases and many others. The three well-known activation pathways of the complement system have been challenged by newer findings that demonstrate direct production of central complement effectors (for example, C5a) by serine proteases of the coagulation cascade. In particular, thrombin is capable of producing C5a, which not only plays a decisive role on pathogens and infected/damaged tissues, but also acts systemically. In the case of uncontrolled complement activation, "friendly fire" is generated, resulting in the destruction of healthy host tissue. Therefore, the traditional research that focuses on a mainly positive-acting cascade has now shifted to the negative effects and how tissue damage originated by the activation of the complement can be contained. In a translational approach including structure-function relations of this ancient defense system, this review provides new insights of complement-mediated clinical relevant diseases and the development of complement modulation strategies and current research aspects.

  14. Clinical manifestations of hysteria: an epistemological perspective or how historical dynamics illuminate current practice.

    Science.gov (United States)

    Medeiros De Bustos, Elisabeth; Galli, Sylvio; Haffen, Emmanuel; Moulin, Thierry

    2014-01-01

    Hysteria has generated the most heated debates among physicians, from antiquity to the present day. It has been long confused with neuroses and neurological pathologies such as Parkinson's disease and epilepsy, principally associated with women and sexual disorders. The clinical manifestations must first be seen in their historical context, as interpretation varies according to the time period. Recently, the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association marked a break in the consensus that previously seemed to apply to the concept of hysteria and approach to the clinical manifestations. The clinical manifestations of hysteria are numerous and multifaceted, comprising 3 main classifications: paroxysms, attacks, and acute manifestations; long-lasting functional syndromes, and visceral events. Each main classification can be subdivided into several subgroups. The first main group of paroxysms, attacks, and acute manifestations includes major hysterical attacks, such as prodrome, trance and epileptic states, minor hysterical attacks such as syncope and tetany, twilight states, paroxysmal amnesia, and cataleptic attacks. The second group includes focal hysterical symptoms, paralyses, contractures and spasms, anesthesia, and sensory disorders. Visceral manifestations can be subdivided into spasms, pain, and general and trophic disorders. The diversity of the symptoms of hysteria and its changing clinical presentation calls into question the same hysterical attacks and the same symptoms, which have had only a few differences for over 2,000 years. A new definition of hysteria should be proposed, in that it is a phenomenon that is not pathological, but physiological and expressional.

  15. How much are radiological parameters related to clinical symptoms and function in osteoarthritis of the shoulder?

    Science.gov (United States)

    Kircher, Jörn; Morhard, Markus; Magosch, Petra; Ebinger, Nina; Lichtenberg, Sven; Habermeyer, Peter

    2010-06-01

    Loss of joint space, formation of osteophytes and deformation are common features of osteoarthritis. Little information exists about the radiological features of arthrosis in relation to clinical findings and the radiological appearance in degenerative shoulder joint disease especially with regard to decision making about the timing of joint replacement. We retrospectively examined 120 standardised X-rays of patients with advanced osteoarthritis of the shoulder. Exclusion criteria included rotator cuff tear, severe glenoid erosion or protrusion. Measurements of joint space width at three levels in each plane (anteroposterior and axillary view), humeral head diameter and size of humeral osteophytes were made by two independent examiners. Osteoarthritis was graded according to Samilson and Prieto. Seventy-five of these patients had a complete record from the clinical investigation (pain record on VAS scale, active and passive range of motion) and the constant score (CS). Mean joint space width in the central anteroposterior level was 1.46 mm +/- 1.08 and in the central axillary 0.98 mm +/- 1.02. Increasing age was positively correlated with joint space narrowing at all measured levels. The joint space width was not correlated with the Samilson grade or the size of osteophytes. The joint space width was neither correlated with pain nor active or passive ROM. Pain was correlated with active and passive flexion and abduction but not for internal or external rotation. The size of the osteophytes was negatively correlated (active and passive) with flexion, abduction and external and internal rotation. The study illustrates that joint space narrowing and development of osteophytes are reliable but independent parameters of primary shoulder arthrosis and should be recorded separately. The size of the caudal humeral osteophyte is a predictive factor for function and should be taken into account for clinical decision making. The primary clinical feature, pain, as the main

  16. Soluble Angiotensin Converting Enzyme 2 in Human Heart Failure: Relation with Myocardial Function and Clinical Outcomes

    Science.gov (United States)

    Epelman, Slava; Shrestha, Kevin; Troughton, Richard W.; Francis, Gary S.; Sen, Subha; Klein, Allan L.; Tang, W .H. Wilson

    2011-01-01

    Objective Angiotensin converting enzyme 2 (ACE2) is an endogenous counter-regulator of the renin-angiotensin system. The relationship between soluble ACE2 (sACE2), myocardial function, and clinical outcomes in patients with chronic systolic heart failure is not well established. Methods We measured sACE2 activity in 113 patients with chronic systolic heart failure (left ventricular ejection fraction [LVEF] ≤ 35%, NYHA class II-IV). Comprehensive echocardiography was performed at the time of blood sampling. We prospectively examined adverse clinical events (death, cardiac transplant, and heart failure hospitalizations) over 34 ± 17 months. Results Patients who had higher sACE2 plasma activity were more likely to have a lower LVEF (Spearman’s r= −0.36, p <0.001), greater RV systolic dysfunction (r=0.33, p<0.001), higher estimated pulmonary artery systolic pressure (r=0.35, p=0.002), larger LV end diastolic diameter (r=0.23, p=0.02), and higher plasma NT-proBNP levels (r=0.35, p<0.001). sACE2 was less associated with diastolic dysfunction (r=0.19, p=0.05), and was similar between patients with ischemic and non-ischemic cardiomyopathies. There was no relationship between sACE2 activity and markers of systemic inflammation. After adjusting for NT-proBNP and LVEF, sACE2 activity remained an independent predictor of adverse clinical events (HR=1.7 [95% CI: 1.1 – 2.6], p=0.018). Conclusions Elevated plasma sACE2 activity was associated with greater severity of myocardial dysfunction and was an independent predictor of adverse clinical events. PMID:19700132

  17. Localized muscle vibration reverses quadriceps muscle hypotrophy and improves physical function: a clinical and electrophysiological study.

    Science.gov (United States)

    Benedetti, Maria Grazia; Boccia, Gennaro; Cavazzuti, Lorenzo; Magnani, Elena; Mariani, Elisabetta; Rainoldi, Alberto; Casale, Roberto

    2017-07-18

    Quadriceps weakness has been associated with knee osteoarthritis (OA). High-frequency localized muscle vibration (LMV) has been proposed recently for quadriceps strengthening in patients with knee OA. The purpose of this study was (a) to investigate the clinical effectiveness of high-frequency LMV on quadriceps muscle in patients with knee OA and (b) to disentangle, by means of surface electromyography (sEMG), the underlying mechanism. Thirty patients, aged between 40 and 65 years, and clinically diagnosed with knee OA were included in this randomized, controlled, single-blinded pilot study. Participants were randomly assigned to two groups: a study group treated with LMV, specifically set for muscle strengthening (150 Hz), by means of a commercial device VIBRA, and a control group treated with neuromuscular electrical stimulation. Clinical outcome was measured using the Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analogue Scale, knee range of motion, Timed Up and Go test, and Stair climbing test. To assess changes in muscle activation and fatigue a subgroup of 20 patients was studied with the use of sEMG during a sustained isometric contraction. The LMV group showed a significant change in Western Ontario and McMaster Universities Osteoarthritis Index score, Visual Analogue Scale score, Timed Up and Go test, Stair Climbing Test, and knee flexion. These improvements were not significant in patients treated with neuromuscular electrical stimulation. sEMG analysis suggested an increased involvement of type II muscle fibers in the group treated with LMV. In conclusion, the present study supports the effectiveness of local vibration in muscle function and clinical improvement of patients with knee OA.

  18. Clinical, genetic, neurophysiological and functional study of new mutations in episodic ataxia type 1.

    Science.gov (United States)

    Tomlinson, Susan Elizabeth; Rajakulendran, Sanjeev; Tan, Stella Veronica; Graves, Tracey Dawn; Bamiou, Doris-Eva; Labrum, Robyn W; Burke, David; Sue, Carolyn M; Giunti, Paola; Schorge, Stephanie; Kullmann, Dimitri M; Hanna, Michael G

    2013-10-01

    Heterozygous mutations in KCNA1 cause episodic ataxia type 1 (EA1), an ion channel disorder characterised by brief paroxysms of cerebellar dysfunction and persistent neuromyotonia. This paper describes four previously unreported families with EA1, with the aim of understanding the phenotypic spectrum associated with different mutations. 15 affected individuals from four families underwent clinical, genetic and neurophysiological evaluation. The functional impact of new mutations identified in the KCNA1 gene was investigated with in vitro electrophysiology and immunocytochemistry. Detailed clinical documentation, dating back to 1928 in one family, indicates that all patients manifested episodic ataxia of varying severity. Four subjects from three families reported hearing impairment, which has not previously been reported in association with EA1. New mutations (R167M, C185W and I407M) were identified in three out of the four families. When expressed in human embryonic kidney cells, all three new mutations resulted in a loss of K(v)1.1 channel function. The fourth family harboured a previously reported A242P mutation, which has not been previously described in association with ataxia. The genetic basis of EA1 in four families is established and this report presents the earliest documented case from 1928. All three new mutations caused a loss of K(v)1.1 channel function. The finding of deafness in four individuals raises the possibility of a link between K(v)1.1 dysfunction and hearing impairment. Our findings broaden the phenotypic range associated with mutations in KCNA1.

  19. A clinical case study of a psychoanalytic psychotherapy monitored with functional neuroimaging

    Directory of Open Access Journals (Sweden)

    Anna eBuchheim

    2013-10-01

    Full Text Available This case study describes one year of the psychoanalytic psychotherapy using clinical data, a standardized instrument of the psychotherapeutic process (Psychotherapy process Q-Set, PQS, and functional neuroimaging (fMRI. A female dysthymic patient with narcissistic traits was assessed at monthly intervals (12 sessions. In the fMRI scans, which took place immediately after therapy hours, the patient looked at pictures of attachment-relevant scenes (from the Adult Attachment Projective Picture System, AAP divided into two groups: those accompanied by a neutral description, and those accompanied by a description tailored to core conflicts of the patient as assessed in the AAP.Clinically, this patient presented defense mechanisms that influenced the relationship with the therapist and that was characterized by fluctuations of mood that lasted whole days, following a pattern that remained stable during the year of the study. The two modes of functioning associated with the mood shifts strongly affected the interaction with the therapist, whose quality varied accordingly (‘easy’ and ‘difficult’ hours. The PQS analysis showed the association of 'easy' hours with the topic of the involvement in significant relationships and of 'difficult hours' with self-distancing, a defensive manoeuvre common in narcissistic personality structures. In the fMRI data, the modes of functioning visible in the therapy hours were significantly associated with modulation of the signal elicited by personalized attachment-related scenes in the posterior cingulate (p=0.017 cluster-level, whole-volume corrected. This region has been associated in previous studies to self-distancing from negatively valenced pictures presented during the scan.The present study may provide evidence of the possible involvement of this brain area in spontaneously enacted self-distancing defensive strategies, which may be of relevance in resistant patient reactions in the course of a

  20. The Program of External Quality Evaluation in Clinical Chemistry. An overview and evaluation after 11 years of functioning

    National Research Council Canada - National Science Library

    Martins, M C; Rodrigues, M O; Gomes, M A; Fonseca, A; Freitas, M M; Miguel, J P; Gomes, E M

    1994-01-01

    After an eleven-year period, the goals and way of functioning are remembered the External Quality Assessment Scheme in Clinical Chemistry, under the responsibility of the National Institute of Health...

  1. Clinical Effectiveness of Board-certificated Physiatrists on Functional Recovery in Elderly Stroke Patients During Convalescence: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Ryo Momosaki

    2017-03-01

    Conclusions: Our results suggest that clinical management provided to elderly stroke patients by board-certificated physiatrists is associated with good functional improvement. Board certification should be encouraged to improve the quality of rehabilitative management of post-stroke patients.

  2. Renal artery stenting in solitary functioning kidneys: Technical and clinical results

    Energy Technology Data Exchange (ETDEWEB)

    Sahin, Sinan [Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Hospital, Department of Radiology, Istanbul (Turkey)]. E-mail: sinan.sahin@e-kolay.net; Cimsit, Cagatay [Marmara University, School of Medicine, Department of Radiology, Istanbul (Turkey); Andac, Nurten [Marmara University, School of Medicine, Department of Radiology, Istanbul (Turkey); Baltacioglu, Feyyaz [Marmara University, School of Medicine, Department of Radiology, Istanbul (Turkey); Tuglular, Serhan [Marmara University, School of Medicine, Department of Nephrology, Istanbul (Turkey); Akoglu, Emel [Marmara University, School of Medicine, Department of Nephrology, Istanbul (Turkey)

    2006-01-15

    Objective: To evaluate the clinical and technical results of renal artery stenting for the treatment of renovascular hypertension and renal failure in patients with solitary functioning kidney. Materials and methods: Fifteen patients with solitary functioning kidney underwent renal artery stenting and were followed up for 12-60 months. Before the procedures, systolic and diastolic blood pressures and serum creatinine levels were measured and the number of antihypertensive drugs was recorded and followed up after stenting. In case of restenosis, either in-stent percutaneous transluminal renal angioplasty or stent-in-stent placement was performed. Results: Primary technical success rate was 100%. One lesion was nonostial while 14 were ostial. Primary patency rates were 100% for 6 months, 92.3% for 12 months, and 69.2% for 24 months. The secondary patency rate at 24 months was 100%. The differences between the baseline and postprocedural values of systolic blood pressures, diastolic blood pressures and the number of antihypertensive drug were statistically significant (P < 0.05), except the values of serum creatinine. Hypertension was cured in 1 (6.7%) patient, improved in 4 (26.6%) and stabilized in 10 (66.7%) patients. Renal function improved in 9 (60%), stabilized in 4 (26.6%), and deteriorated in 2 (13.4%) patients. Minor complication rate was 13.4% and major complication rate was 13.4%. Conclusion: Revascularization of renal artery stenosis using stent in solitary functioning kidneys is a safe and efficient procedure with high primary technical results, low restenosis rates and acceptable complication rates. It has an improving and controlling effect on blood pressure and renal functions.

  3. Clinical evaluation of immune-promoting functions of the developed product (HemoHIM)

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Kyoung Soo; Lee, Ill Kyoo; Kwon, Soon Gil [The Catholic University of Korea, Seoul (Korea, Republic of)

    2007-07-15

    We performed a clinical study to evaluate the immune promotion and antioxidant effects of the developed product (HemoHIM) in healthy or subhealthy people. Volunteers with white blood cell numbers between 5000 and 10000/ul were recruited and the subjects were selected by appropriate inclusion and exclusion rules. The subjects were randomly assigned to 3 groups (HemoHIM 6g/day, HemoHIM 12g/day, Placebo). HemoHIM or placebo were adminstered for 2 months and the blood were collected and analyzed at 1 month and 2 month after the intake. The collected blood was analyzed for blood cell number, serum biochemical values (liver and kidney function), immunological activity of blood cells, antioxidant activity of blood plasma, and stress hormone level in the saliva. Finally the data of 88 subjects were analyzed for the immune promoting and antioxidant effects of HemoHIM. In results, no significant changes in blood cell numbers (white blood cell, lymphocyte, red blood cell) were observed in HemoHIM intake groups. However, NK cell activity were increased in HemoHIM intake groups and also IFN-gamma and IL-12, the biomarkers of immune cell functions, were increased in proportion to the dose and intake periode of HemoHIM. The antioxidant biomarker (TAS) was not significantly changed by HemoHIM intake. Besides, the serum biochemical analysis for liver and kidney functions, and the general medical examination showed the HemoHIM showed no side-effects, thus reconfirming its safety in humans. In conclusion, this study showed HemoHIM has a significant effects on the promotion of immune functions, while it has neither side-effects nor toxicity in humans. The results of this study may be utilized for the scientific data to acquire the Health Functional Food Certification of HemoHIM from Korea FDA

  4. Improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery

    OpenAIRE

    Elliott, D; Patla, A.; Bullimore, M.

    1997-01-01

    AIMS—To determine the improvements in clinical and functional vision and perceived visual disability after first and second eye cataract surgery.
METHODS—Clinical vision (monocular and binocular high and low contrast visual acuity, contrast sensitivity, and disability glare), functional vision (face identity and expression recognition, reading speed, word acuity, and mobility orientation), and perceived visual disability (Activities of Daily Vision Scale) were measured in 25 subjects before a...

  5. Evaluation of the Military Functional Assessment Program: Preliminary Assessment of the Construct Validity Using an Archived Database of Clinical Data

    Science.gov (United States)

    2013-08-01

    Status (Rbans): Clinical Utility in a Traumatic Brain Injury Sample. Clinical Neuropsychology. 1-14. Moses , J. A. 2004. Test review-Comprehensive...traumatic brain injury (mTBI) have persistent symptoms and/or functional limitations (Iverson, Zasler, & Lange, 2006; Ruff, Camenzuli, & Mueller...diagnoses and symptoms. Diagnosis/symptom Frequency Traumatic brain injury 54 mild TBI 7 penetrating TBI 2 unknown

  6. Regional MRI Perfusion Measures Predict Motor/Executive Function in Patients with Clinically Isolated Syndrome

    Directory of Open Access Journals (Sweden)

    Efrosini Z. Papadaki

    2014-01-01

    Full Text Available Background. Patients with clinically isolated syndrome (CIS demonstrate brain hemodynamic changes and also suffer from difficulties in processing speed, memory, and executive functions. Objective. To explore whether brain hemodynamic disturbances in CIS patients correlate with executive functions. Methods. Thirty CIS patients and forty-three healthy subjects, matched for age, gender, education level, and FSIQ, were administered tests of visuomotor learning and set shifting ability. Cerebral blood volume (CBV, cerebral blood flow (CBF, and mean transit time (MTT values were estimated in normal-appearing white matter (NAWM and normal-appearing deep gray Matter (NADGM structures, using a perfusion MRI technique. Results. CIS patients showed significantly elevated reaction time (RT on both tasks, while their CBV and MTT values were globally increased, probably due to inflammatory vasodilation. Significantly, positive correlation coefficients were found between error rates on the inhibition condition of the visuomotor learning task and CBV values in occipital, periventricular NAWM and both thalami. On the set shifting condition of the respective task significant, positive associations were found between error rates and CBV values in the semioval center and periventricular NAWM bilaterally. Conclusion. Impaired executive function in CIS patients correlated positively with elevated regional CBV values thought to reflect inflammatory processes.

  7. Perspectives on the clinical significance of functional pain syndromes in children

    Directory of Open Access Journals (Sweden)

    Basch MC

    2015-10-01

    Full Text Available Molly C Basch,1,2 Erika T Chow,1,3 Deirdre E Logan,1,4 Neil L Schechter,4 Laura E Simons1,2,4 1Division of Pain Medicine, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 2Boston Children's Hospital, Center for Pain and the Brain, PAIN Research Group, 3Boston University School of Medicine, Boston University, 4Department of Psychiatry, Harvard Medical School, Boston, MA, USA Abstract: Functional pain syndromes (FPS characterize a subset of individuals who experience pain and related symptoms and disability without clear structural or disease etiology. In the pediatric population, FPS hold high clinical importance due to significant prevalence rates and potential to persist into adulthood. Although extensive research has been executed to disambiguate FPS, the syndromes that fall within its spectrum remain conceptually complex and sometimes ill-defined. This paper provides an overview of available research on the classification and multifaceted etiology of FPS in youth and their effects on interpersonal, psychological, and familial function. Vital aspects of a successful multidisciplinary approach to treating this population are described; however, it is evident that future research requires more longitudinal studies. Keywords: overlapping chronic pain, functional pain, primary pain disorders, pediatrics, biopsychosocial model

  8. Clinical features of Bloom syndrome and function of the causative gene, BLM helicase.

    Science.gov (United States)

    Kaneko, Hideo; Kondo, Naomi

    2004-05-01

    Bloom syndrome is a rare autosomal recessive genetic disorder characterized by growth deficiency, unusual facies, sun-sensitive telangiectatic erythema, immunodeficiency and predisposition to cancer. The causative gene for Bloom syndrome is BLM, which encodes the BLM RecQ helicase homolog protein. The first part of this review describes a long-term follow-up study of two Bloom syndrome siblings. Subsequently, the focus is placed on the functional domains of BLM. Laboratory diagnosis of Bloom syndrome by detecting mutations in BLM is laborious and impractical, unless there are common mutations in a population. Immunoblot and immunohistochemical analyses for the detection of the BLM protein using a polyclonal BLM antibody, which are useful approaches for clinical diagnosis of Bloom syndrome, are also described. In addition, a useful adjunct for the diagnosis of Bloom syndrome in terms of the BLM function is investigated, since disease cells must have the defective BLM helicase function. This review also discusses the nuclear localization signal of BLM, the proteins that interact with BLM and tumors originating from Bloom syndrome.

  9. Phosphodiesterase Inhibition and Regulation of Dopaminergic Frontal and Striatal Functioning: Clinical Implications

    Science.gov (United States)

    Heckman, Pim R. A.; van Duinen, Marlies A.; Bollen, Eva P. P.; Nishi, Akinori; Wennogle, Lawrence P.; Blokland, Arjan

    2016-01-01

    Background: The fronto-striatal circuits are the common neurobiological basis for neuropsychiatric disorders, including schizophrenia, Parkinson’s disease, Huntington’s disease, attention deficit hyperactivity disorder, obsessive-compulsive disorder, and Tourette’s syndrome. Fronto-striatal circuits consist of motor circuits, associative circuits, and limbic circuits. All circuits share 2 common features. First, all fronto-striatal circuits consist of hyper direct, direct, and indirect pathways. Second, all fronto-striatal circuits are modulated by dopamine. Intracellularly, the effect of dopamine is largely mediated through the cyclic adenosine monophosphate/protein kinase A signaling cascade with an additional role for the cyclic guanosine monophosphate/protein kinase G pathway, both of which can be regulated by phosphodiesterases. Phosphodiesterases are thus a potential target for pharmacological intervention in neuropsychiatric disorders related to dopaminergic regulation of fronto-striatal circuits. Methods: Clinical studies of the effects of different phosphodiesterase inhibitors on cognition, affect, and motor function in relation to the fronto-striatal circuits are reviewed. Results: Several selective phosphodiesterase inhibitors have positive effects on cognition, affect, and motor function in relation to the fronto-striatal circuits. Conclusion: Increased understanding of the subcellular localization and unraveling of the signalosome concept of phosphodiesterases including its function and dysfunction in the fronto-striatal circuits will contribute to the design of new specific inhibitors and enhance the potential of phosphodiesterase inhibitors as therapeutics in fronto-striatal circuits. PMID:27037577

  10. Cardiac Alpha1-Adrenergic Receptors: Novel Aspects of Expression, Signaling Mechanisms, Physiologic Function, and Clinical Importance

    Science.gov (United States)

    O’Connell, Timothy D.; Jensen, Brian C.; Baker, Anthony J.

    2014-01-01

    Adrenergic receptors (AR) are G-protein-coupled receptors (GPCRs) that have a crucial role in cardiac physiology in health and disease. Alpha1-ARs signal through Gαq, and signaling through Gq, for example, by endothelin and angiotensin receptors, is thought to be detrimental to the heart. In contrast, cardiac alpha1-ARs mediate important protective and adaptive functions in the heart, although alpha1-ARs are only a minor fraction of total cardiac ARs. Cardiac alpha1-ARs activate pleiotropic downstream signaling to prevent pathologic remodeling in heart failure. Mechanisms defined in animal and cell models include activation of adaptive hypertrophy, prevention of cardiac myocyte death, augmentation of contractility, and induction of ischemic preconditioning. Surprisingly, at the molecular level, alpha1-ARs localize to and signal at the nucleus in cardiac myocytes, and, unlike most GPCRs, activate “inside-out” signaling to cause cardioprotection. Contrary to past opinion, human cardiac alpha1-AR expression is similar to that in the mouse, where alpha1-AR effects are seen most convincingly in knockout models. Human clinical studies show that alpha1-blockade worsens heart failure in hypertension and does not improve outcomes in heart failure, implying a cardioprotective role for human alpha1-ARs. In summary, these findings identify novel functional and mechanistic aspects of cardiac alpha1-AR function and suggest that activation of cardiac alpha1-AR might be a viable therapeutic strategy in heart failure. PMID:24368739

  11. Clinical Correlates of Hachinski Ischemic Score and Vascular Factors in Cognitive Function of Elderly

    Directory of Open Access Journals (Sweden)

    Youn Ho Kim

    2014-01-01

    Full Text Available The aim of this study is to investigate the relationship between Hachinski ischemic score (HIS and vascular factors as well as between HIS and the cognitive function in elderly community. Demographic characteristics, such as sex, age, education, history of drinking and smoking, family history of dementia and stroke, diabetes mellitus, hypertension, hyperlipidemia, cardiovascular disease, stroke, and dementia, were surveyed. Neurological examination was administered to every subject and HIS was checked by a neurologist. From a total of 392 participants aged 65 and over in a rural community, 348 completed the survey and were finally enrolled. Among the vascular factors, history of hypertension (P=0.008, history of stroke (P<0.001, family history of dementia (P=0.01, and history of cardiac diseases (P=0.012 showed a significant relationship with HIS. In the cognitive function tests, both Korean version of the Mini-Mental State Examination and the Clinical Dementia Rating (Global and Sum of Boxes had a significant relationship with HIS. Our study suggested HIS may have an association with some vascular factors and cognitive scales in community dwelling elderly. In this study, the HIS seemed to contribute to the evaluation of the quantity of vascular factors and to the prediction of status of cognitive function.

  12. Psychiatric morbidity, functioning and quality of life in young people at clinical high risk for psychosis.

    Science.gov (United States)

    Hui, Christy; Morcillo, Carmen; Russo, Debra A; Stochl, Jan; Shelley, Gillian F; Painter, Michelle; Jones, Peter B; Perez, Jesus

    2013-08-01

    Recent studies suggest that psychotic-like experiences may also act as markers for non-psychotic psychiatric disorders, which may indicate that the focus of research in individuals at high risk (HR) for psychosis needs updating. In this study we thoroughly examined the clinical and functional characteristics of a consecutive cohort of young people at HR for psychosis and compared them to a matched sample of healthy volunteers. Between February 2010 and September 2012 60 help-seeking HR individuals, aged 16-35, were recruited from CAMEO Early Intervention in Psychosis Service, Cambridgeshire, UK. Forty-five age- and gender-matched healthy volunteers were randomly recruited from the same geographical area. Sociodemographic, psychiatric morbidity, functioning and quality of life measures were compared between both groups. HR individuals suffered a wide range of DSM-IV psychiatric disorders, mainly within the affective and anxiety diagnostic spectra. In comparison to healthy volunteers, young people at HR reported more suicidal ideation/intention, depressive and anxiety symptoms and presented with remarkably poor functioning and quality of life. The presence of co-morbid moderate or severe depressive and anxiety symptoms was common in our sample of young people at enhanced risk for psychosis. A HR mental state may be associated not only with an increased risk for psychosis, but also other psychiatric disorders. Our findings may have implications for the future implementation of therapeutic interventions that this population could benefit from. Copyright © 2013 Elsevier B.V. All rights reserved.

  13. Extubation failure influences clinical and functional outcomes in patients with traumatic brain injury

    Directory of Open Access Journals (Sweden)

    Helena Franca Correia dos Reis

    2013-06-01

    Full Text Available OBJECTIVE: To evaluate the association between extubation failure and outcomes (clinical and functional in patients with traumatic brain injury (TBI. METHODS: A prospective cohort study involving 311 consecutive patients with TBI. The patients were divided into two groups according to extubation outcome: extubation success; and extubation failure (defined as reintubation within 48 h after extubation. A multivariate model was developed in order to determine whether extubation failure was an independent predictor of in-hospital mortality. RESULTS: The mean age was 35.7 ± 13.8 years. Males accounted for 92.3%. The incidence of extubation failure was 13.8%. In-hospital mortality was 4.5% and 20.9% in successfully extubated patients and in those with extubation failure, respectively (p = 0.001. Tracheostomy was more common in the extubation failure group (55.8% vs. 1.9%; p < 0.001. The median length of hospital stay was significantly greater in the extubation failure group than in the extubation success group (44 days vs. 27 days; p = 0.002. Functional status at discharge was worse among the patients in the extubation failure group. The multivariate analysis showed that extubation failure was an independent predictor of in-hospital mortality (OR = 4.96; 95% CI, 1.86-13.22. CONCLUSIONS: In patients with TBI, extubation failure appears to lengthen hospital stays; to increase the frequency of tracheostomy and of pulmonary complications; to worsen functional outcomes; and to increase mortality.

  14. Clinical heterogeneity among people with high functioning autism spectrum conditions: evidence favouring a continuous severity gradient

    Directory of Open Access Journals (Sweden)

    Woodbury-Smith Marc

    2008-02-01

    Full Text Available Abstract Background Autism Spectrum Conditions (ASCs are characterized by a high degree of clinical heterogeneity, but the extent to which this variation represents a severity gradient versus discrete phenotypes is unclear. This issue has complicated genetic studies seeking to investigate the genetic basis of the high hereditability observed clinically in those with an ASC. The aim of this study was to examine the possible clustering of symptoms associated with ASCs to determine whether the observed distribution of symptom type and severity supported either a severity or a symptom subgroup model to account for the phenotypic variation observed within the ASCs. Methods We investigated the responses of a group of adults with higher functioning ASCs on the fifty clinical features examined in the Autism Spectrum Quotient, a screening questionnaire used in the diagnosis of higher functioning ASCs. In contrast to previous studies we have used this instrument with no a priori assumptions about any underlying factor structure of constituent items. The responses obtained were analyzed using complete linkage hierarchical cluster analysis. For the members of each cluster identified the mean score on each Autism Spectrum Quotient question was calculated. Results Autism Spectrum Quotient responses from a total of 333 individuals between the ages of 16.6 and 78.0 years were entered into the hierarchical cluster analysis. The four cluster solution was the one that generated the largest number of clusters that did not also include very small cluster sizes, defined as a membership comprising 10 individuals or fewer. Examination of these clusters demonstrated that they varied in total Autism Spectrum Quotient but that the profiles across the symptoms comprising the Autism Spectrum Quotient did not differ independently of this severity factor. Conclusion These results are consistent with a unitary spectrum model, suggesting that the clinical heterogeneity observed

  15. [Clinical-functional evolution of patients with ankylosing spondylitis following physio-kinetotheraphy].

    Science.gov (United States)

    Roşu, Mihaela Oana; Ancuţa, Codrina; Chirieac, Rodica

    2012-01-01

    Ankylosing spondylitis enigmatic from the etiologic point of view, appears with subjects who are still in school or involved in a productive activity. If detected in its early stages, under complex, constant and long-term treatment, patients have a good evolution. The objectives of the study are to describe the clinical and functional profile of patients with AS, sacroiliitis stage, and the evol ution of physical and functional parameters under traditional physio-kinetotherapy. This retrospective study was performed on 40 patients with ankylosing spondylitis (AS), who were hospitalized in the Clinic of Rheumatology Iaşi, during 2008-1010, who satisfied the amended New York criteria for this. Subjects underwent an initial evaluation (first admission) and another one at the end of the study (second admission), after approximately 6 months. The demographic characteristics, the clinical and functional elements of the study sample have indicated: the average age of 24.83 +/- 3.948, predominantly male (82.5%) and 62.5% were from rural areas. Most cases occurred at the age of 19-25 (57.5%), beginning at 18-25 (77.5%), with an average of 19.60 +/- 2.318. Following the radiological changes in the various stages of sacroiliitis, stage II prevailed (40%), then stage III (32.5%) and IV (15%). The evaluation of ASAS (Assessment of Spondylo Arthritis International Society) parameters and the respiratory system showed significant improvements of: BASDAI score with 31.53%, BASFI with 37.62%, BASMI with 20.66%, DIE % with 27.53 and of CV with 5.08% as well as a decrease in pain perception measured by VAS scale (p = 0.017). In the early stages of the disease, as far as the sample involved in the study is concerned, when the spine and vertebrae joints were not blocked by the evolution of the disease, corrective gymnastics and respiratory exercises, stretching and a good posture are very important, along with other therapies used to prevent axial ankylosis.

  16. INFLUENCE OF RESIDUAL VARUS DEFORMITY ON CLINICAL, FUNCTIONAL, RADIOLOGICAL AND DYNAMOMETRIC OUTCOMES OF TOTAL KNEE ARTHROPLASTY

    Directory of Open Access Journals (Sweden)

    M. P. Zinoviev

    2017-01-01

    Full Text Available Purpose of the study – to evaluate the influence of residual varus deformity of the lower leg on clinical, functional and dynamometric outcomes of TKR.Material and methods. In the period from September 2014 till May 2015 951 total knee replacement surgeries were performed in Ural clinical and rehabilitation center in 933 patients with initial varus deformity of lower limb. However, in 52 cases (5.5% residual varus deformity of >3° persisted. The main group included 36 patients with mean residual varus deformity of lower leg of 3.9°±0.74° (from 3.1° to 5.6°, the control group included 34 patients with neutral mechanic axis of the lower leg. Evaluation of treatment outcomes was performed on average 14.2±1.8 months after the procedure using functional assessment of the patients according to KSS (Knee Society Score, subjective assessment of life quality (SF36, as well as evaluation of the static-dynamic function of the lower leg on diagnostic and treatment complex Biodex Systems 4 Quick Set and assessment of stability of components fixation by F.C. Ewald scale in modification of O.A. Kudinov et al.Results. Functional assessment of the patients according to KSS (Knee Society Score for the main group was 84.0±4.6, in control group – 82.2±4.1 points (p>0.05. Subjective assessment of life quality (SF36 in the main group was 162.6±6.4 points, in control group – 164.3±8.1 points (p>0.05. In terms of flexion and extension of lower leg there were no significant differences between two groups when assessing static and dynamic function by treatment and diagnostic complex «Biodex Systems 4 Quick Set» on average in 14.2±1.8 months after procedure: neither isometric nor isokinetic parameters in both groups demonstrated statistically significant differences (p>0.05. Based on X-rays evaluation there were no abnormalities in components fixation in both groups. There were no statistically significant differences identified in KSS and SF36 scales

  17. Clinical Implications of Human Population Differences in Genome-wide Rates of Functional Genotypes

    Directory of Open Access Journals (Sweden)

    Ali eTorkamani

    2012-11-01

    Full Text Available There have been a number of recent successes in the use of whole genome sequencing and sophisticated bioinformatics techniques to identify pathogenic DNA sequence variants responsible for individual idiopathic congenital conditions. However, the success of this identification process is heavily influenced by the ancestry or genetic background of a patient with an idiopathic condition. This is so because potential pathogenic variants in a patient’s genome must be contrasted with variants in a reference set of genomes made up of other individuals’ genomes of the same ancestry as the patient. We explored the effect of ignoring the ancestries of both an individual patient and the individuals used to construct reference genomes. We pursued this exploration in two major steps. We first considered variation in the per-genome number and rates likely functional derived (i.e., non-ancestral, based on the chimp genome single nucleotide variants and small indels in 52 individual whole human genomes sampled from 10 different global populations. We took advantage of a suite of computational and bioinformatics techniques to predict the functional effect of over 24 million genomic variants, both coding and non-coding, across these genomes. We found that the typical human genome harbors ~5.5-6.1 million total derived variants, of which ~12,000 are likely to have a functional effect (~5000 coding and ~7000 non-coding. We also found that the rates of functional genotypes per the total number of genotypes in individual whole genomes differ dramatically between human populations. We then created tables showing how the use of comparator or reference genome panels comprised of genomes from individuals that do not have the same ancestral background as a patient can negatively impact pathogenic variant identification. Our results have important implications for clinical sequencing initiatives.

  18. Associations of proanthocyanidin intake with renal function and clinical outcomes in elderly women.

    Directory of Open Access Journals (Sweden)

    Kerry L Ivey

    Full Text Available BACKGROUND: Progression to chronic renal failure involves accelerated atherosclerosis and vascular calcification. Oxidative stress and endothelial dysfunction play a role in renal failure pathophysiology. In addition to improving vascular health and function, proanthocyanidins have been shown to exert renoprotective effects in animal models. Thus we hypothesize that proanthocyanidins may contribute to the maintenance of healthy renal function. OBJECTIVE: Determine the association of habitual proanthocyanidin intake with renal function and the risk of clinical renal outcomes in a population of elderly women. DESIGN: 948 women aged over 75 y, free of prevalent renal disease at baseline, were randomly selected from ambulant Caucasian women. Proanthocyanidin consumption was determined using a validated food frequency questionnaire and the United States Department of Agriculture proanthocyanidin food content database. Fasting serum cystatin C and creatinine were assessed at baseline. Renal failure hospitalisations and deaths were assessed over 5 years of follow-up through the Western Australia Data Linkage System. RESULTS: Compared to participants with low consumption, participants in the highest tertile of proanthocyanidin intake had a 9% lower cystatin C concentration (P<0.001. High proanthocyanidin consumers were at 50% lower risk of moderate chronic kidney insufficiency, and 65% lower risk of experiencing a 5-year renal disease event (P<0.05. These relationships remained significant following adjustment for renal disease risk factors and diet-related potential confounders. CONCLUSION: Increased consumption of proanthocyanidins was associated with better renal function and substantially reduced renal associated events, which has been supported by mechanistic and animal model data. Proanthocyanidin intake should be further examined as a dietary contributor to better renal health.

  19. Clinical outcomes of glued transscleral fixated intraocular lens in functionally one-eyed patients.

    Science.gov (United States)

    Ashok Kumar, Dhivya; Agarwal, Amar; Agarwal, Athiya; Chandrasekar, Radhika

    2014-07-01

    To analyze the indications, visual outcome, mental status, and quality of life after glued transscleral fixated intraocular lens (IOL) in functionally one-eyed individuals. Dr Agarwal's Eye Hospital and Eye Research Centre, Chennai, India. Prospective observational comparative case series. Patients with one functioning eye with surgical indications (aphakia, luxated IOL, or dislocated lens) and the fellow eye with no perception of light were included. Indications, uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), mental status (Amsterdam Preoperative Anxiety and Information Scale) and quality of life (visual function scoring VF-14) were assessed. Outcomes of nonsurgical and surgical management were evaluated and compared. Of 22 patients, 10 (45.4%) patients underwent glued IOL (group A) and 12 (54.5%) wore spectacles (group B). There was a strong association between the initial clinical presentation and management (χ, P=0.000). Subluxated cataract and dislocated lens (or IOL) required surgical treatment. Postoperative aphakia with adequate spectacle correction were conservatively treated. There was change (P=0.005) in UDVA and CDVA after glued IOL surgery. There was no loss of CDVA. There was difference between the 2 groups in reading small prints (P=0.021), sporting activities (P=0.000), and night driving (P=0.000). Surgical anxiety was higher in group B (P=0.014). Females were more anxious than the males (P=0.014). There was an association of increasing age and the decision for nonsurgical management (χ, P=0.005). Glued transscleral fixated IOL can be safely performed in one-eyed patients for specific indications to provide good functional results.

  20. Improving function in age-related macular degeneration: a randomized clinical trial.

    Science.gov (United States)

    Rovner, Barry W; Casten, Robin J; Hegel, Mark T; Massof, Robert W; Leiby, Benjamin E; Ho, Allen C; Tasman, William S

    2013-08-01

    To compare the efficacy of problem-solving therapy (PST) with supportive therapy (ST) to improve targeted vision function (TVF) in age-related macular degeneration (AMD). Single-masked, attention-controlled, randomized clinical trial with outcome assessments at 3 months (main trial endpoint) and 6 months (maintenance effects). Patients with AMD (n = 241) attending retina practices. Whereas PST uses a structured problem-solving approach to reduce vision-related task difficulty, ST is a standardized attention-control treatment. We assessed TVF, the 25-item National Eye Institute Vision Function Questionnaire plus Supplement (NEI VFQ), the Activities Inventory (AI), and vision-related quality of life (QoL). There were no between-group differences in TVF scores at 3 (P = 0.47) or 6 (P = 0.62) months. For PST subjects, mean ± standard deviation TVF scores improved from 2.71±0.52 at baseline to 2.18±0.88 at 3 months (P = 0.001) and were 2.18±0.95 at 6 months (change from 3 to 6 months, P = 0.74). For ST subjects, TVF scores improved from 2.73±0.52 at baseline to 2.14±0.96 at 3 months (P = 0.001) and were 2.15±0.96 at 6 months (change from 3 to 6 months, P = 0.85). Similar proportions of PST and ST subjects had less difficulty performing a TVF goal at 3 months (77.4% vs 78.6%, respectively; P = 0.83) and 6 months (76.2% vs 79.1%, respectively; P = 0.61). There were no changes in the NEI VFQ or AI. Vision-related QoL improved for PST relative to ST subjects at 3 months (F(4, 192) = 2.46; P = 0.05) and at 6 months (F(4, 178) = 2.55; P = 0.05). The PST subjects also developed more adaptive coping strategies than ST subjects. We found that PST was not superior to ST at improving vision function in patients with AMD, but that PST improved their vision-related QoL. Despite the benefits of anti-vascular endothelial growth factor treatments, AMD remains associated with disability, depression, and diminished QoL. This clinical reality necessitates new rehabilitative

  1. Clinical trial shows lasting function of a new moisturizing cream against vaginal dryness.

    Science.gov (United States)

    Henneicke-von Zepelin, Hans-Heinrich; Williams, Ragna; Havemeister, Wiebke; Wigger-Alberti, Walter; Nolte, Klaus-Ulrich

    2017-01-13

    Vaginal dryness and associated symptoms may occur in women of any age and are a frequent burden after menopause. The North American Menopause Society recommends long-acting non-hormonal vaginal creams as first-line therapy. A new type of such creams was developed (Remifemin® FeuchtCreme in Austria and Germany). This hormone-free cream contains hamamelis virginiana distillate and well-established vaginal cream ingredients. We explored its physical function and tolerability in an open interventional clinical trial. 20 postmenopausal women (54 to 76 years, median 60) treated their vaginal dryness using this cream once daily for 7 days and reported about their symptoms before, 4 to 8 h after first and 14 to 22 h after last application. A physician assessed tolerability and local physical function. All patients completed the study. Local physical function significantly improved from dryness at baseline (mean 4.0 ± SD 1.8) to a normal moisture level, on average (6.3 ± 2.1 after first, 6.7 ± 2.1 after last application, p = 0.0001). Subjective assessment of a feeling vaginal dryness showed a significant improvement at both times (p = 0.0001). Onset and duration of feeling moisturized were reported to be 0 to 2 min and 11.3 ± 6.9 h after application. All women reported vaginal dryness at baseline. 55 and 80% of patients reported no dryness after first application and at the end of the investigation. The cream was seen at the application site for up to 21 h. Tolerability assessments did not reveal any relevant change over time. There were four adverse events in 4 patients, all not serious and of mild intensity: urinary urgency (2), diarrhoea (1) and mild spotting after first application (1). The latter was caused by the dry surface of the applicator and was avoided by moisturizing the surface of the applicator at subsequent applications. In conclusion, these study results indicate a well-tolerated and long-acting function of this new

  2. Research progress of motor function assessments and their clinical applications in Duchenne muscular dystrophy

    Directory of Open Access Journals (Sweden)

    Wei SHI

    2015-07-01

    Full Text Available Duchenne muscular dystrophy (DMD, clinically featured as progressive skeletal muscle atrophy with gradual loss of muscle strength and activity abilities, is the most common genetic muscular disease in children throughout the world. The core and continuous characteristic of DMD is motor dysfunction. Motor function assessments of DMD are now focusing on muscle strength, walking ability, range of motion and ability of activities, still without unified standards. Confirming the comprehensive, scientific, reasonable and accurate evaluation tools for DMD assessment is the premise of research in motor developmental rules of DMD, which will help to better understand the motor progress of DMD and to supply evidences for choosing treatment methods, confirming timing of intervention, assessing effect of treatments and designing rehabilitation plans. DOI: 10.3969/j.issn.1672-6731.2015.06.002

  3. Neuromuscular function in patients with Subacromial Impingement Syndrome and clinical assessment of scapular kinematics

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Lund, Hans; Juul-Kristensen, Birgit

    a voluntary arm movement task and 2) selective activation tasks during sessions with and without on-line biofeedback, in a general population consisting of 16 SIS patients and 15 controls (No-SIS). Furthermore, 3) a systematic review was conducted of all available clinical scapular assessment methods...... parts were below 1.5% activity or (ii) an activation ratio above 95% of the total activity of all muscles, significantly fewer SIS subjects than No-SIS subjects achieved selective activation of individual scapular muscle compartments without on-line biofeedback of muscle activity from each muscle...... in neuromuscular activity of scapular stabilising muscles were observed, 2) and when provided with visual EMG feedback, the SIS group performed equally well as the No-SIS group, However, when assessing the neuromuscular function with and without the use of biofeedback, the findings show that without biofeedback...

  4. Functional and clinical insights from neuroimaging studies in childhood-onset schizophrenia.

    Science.gov (United States)

    Ordóñez, Anna E; Sastry, Nevin V; Gogtay, Nitin

    2015-08-01

    Childhood-onset schizophrenia is a rare pediatric onset psychiatric disorder continuous with and typically more severe than its adult counterpart. Neuroimaging research conducted on this population has revealed similarly severe neural abnormalities. When taken as a whole, neuroimaging research in this population shows generally decreased cortical gray matter coupled with white matter connectivity abnormalities, suggesting an anatomical basis for deficits in executive function. Subcortical abnormalities are pronounced in limbic structures, where volumetric deficits are likely related to social skill deficits, and cerebellar deficits that have been correlated to cognitive abnormalities. Structures relevant to motor processing also show a significant alteration, with volumetric increase in basal ganglia structures likely due to antipsychotic administration. Neuroimaging of this disorder shows an important clinical image of exaggerated cortical loss, altered white matter connectivity, and differences in structural development of subcortical areas during the course of development and provides important background to the disease state.

  5. Clinical and functional outcomes and treatment options for paediatric elbow dislocations: Experiences of three trauma centres.

    Science.gov (United States)

    Subasi, M; Isik, M; Bulut, M; Cebesoy, O; Uludag, A; Karakurt, L

    2015-07-01

    Although elbow dislocations are seen rarely in children, their management remains controversial. In this study, over a 7 years period, we evaluated retrospectively the clinical and functional results of paediatric elbow dislocations managed in three different trauma centres. Pure dislocations and dislocations with associated injuries were evaluated separately. In total 56 patients met the inclusion criteria. The number of patients without additional injury was 22 out of which according to the Robert's criteria, 15 children (68%) had an excellent, four (18%) a good, one (5%) a fair, and two (9%) a poor outcome. From the thirty-four patients that had associated injuries, two (6%) had an excellent, 6 (18%) a good, 10 (29%) a fair and 16 (47%) a poor result. Overall, patients with pure dislocation were found to have a better range of motion compared to patients with dislocation and associated injuries. Prolonged follow ups, and effective rehabilitation programs are required in order to expect good outcomes.

  6. Gain-of-Function Research and the Relevance to Clinical Practice.

    Science.gov (United States)

    Kilianski, Andy; Nuzzo, Jennifer B; Modjarrad, Kayvon

    2016-05-01

    The ongoing moratorium on gain-of-function (GOF) research with highly pathogenic avian influenza virus, severe acute respiratory syndrome coronavirus, and Middle East respiratory syndrome coronavirus has drawn attention to the current debate on these research practices and the potential benefits and risks they present. While much of the discussion has been steered by members of the microbiology and policy communities, additional input from medical practitioners will be highly valuable toward developing a broadly inclusive policy that considers the relative value and harm of GOF research. This review attempts to serve as a primer on the topic for the clinical community by providing a historical context for GOF research, summarizing concerns about its risks, and surveying the medical products that it has yielded.

  7. Total cervical disk replacement with a prestige LP® prosthesis: clinical and functional outcomes

    Directory of Open Access Journals (Sweden)

    Rafael Osório Rocha

    2014-01-01

    Full Text Available Objective: To determine the clinical and functional results of short- and medium-term cervical arthroplasty with the Prestige LP® prosthesis for the treatment of compressive myelopathy, radiculopathy and axial pain with radiculopathty. Methods: This retrospective study, conducted from 2009 to 2012, included 18 patients. Only 16 were found for the second stage of research, conducted in 2011 and 2012. Pre- and postoperative assessments were carried out using the CSOQ (Cervical Spine Outcomes Questionnaire. Odom criteria were used only in the postoperative evaluation. Both were translated and adapted to the local culture. Results: There was no postoperative radiculopathy or other complications requiring prolonged hospitalization. In most patients, there was a significant improvement in axial pain and radiculopathy, and there was only one indication of conversion to fusion. Conclusions: In selected cases of cervical degenerative disc disease, herniated cervical disc and compressive myeolopathy, cervical arthroplasty proved to be an effective and safe treatment in the short and medium terms.

  8. Epidermal growth factor receptor (EGFR) and EGFR mutations, function and possible role in clinical trials

    DEFF Research Database (Denmark)

    Voldborg, B R; Damstrup, L; Spang-Thomsen, M;

    1997-01-01

    The epidermal growth factor receptor (EGFR) is a growth factor receptor that induces cell differentiation and proliferation upon activation through the binding of one of its ligands. The receptor is located at the cell surface, where the binding of a ligand activates a tyrosine kinase...... in the intracellular region of the receptor. This tyrosine kinase phosphorylates a number of intracellular substrates that activates pathways leading to cell growth, DNA synthesis and the expression of oncogenes such as fos and jun. EGFR is thought to be involved the development of cancer, as the EGFR gene is often...... amplified, and/or mutated in cancer cells. In this review we will focus on: (I) the structure and function of EGFR, (II) implications of receptor/ligand coexpression and EGFR mutations or overexpression, (III) its effect on cancer cells, (IV) the development of the malignant phenotype and (V) the clinical...

  9. Added clinical value of applying myocardial deformation imaging to assess right ventricular function.

    Science.gov (United States)

    Sokalskis, Vladislavs; Peluso, Diletta; Jagodzinski, Annika; Sinning, Christoph

    2017-06-01

    Right heart dysfunction has been found to be a strong prognostic factor predicting adverse outcome in various cardiopulmonary diseases. Conventional echocardiographic measurements can be limited by geometrical assumptions and impaired reproducibility. Speckle tracking-derived strain provides a robust quantification of right ventricular function. It explicitly evaluates myocardial deformation, as opposed to tissue Doppler-derived strain, which is computed from tissue velocity gradients. Right ventricular longitudinal strain provides a sensitive tool for detecting right ventricular dysfunction, even at subclinical levels. Moreover, the longitudinal strain can be applied for prognostic stratification of patients with pulmonary hypertension, pulmonary embolism, and congestive heart failure. Speckle tracking-derived right atrial strain, right ventricular longitudinal strain-derived mechanical dyssynchrony, and three-dimensional echocardiography-derived strain are emerging imaging parameters and methods. Their application in research is paving the way for their clinical use. © 2017, Wiley Periodicals, Inc.

  10. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, B; Lund, H

    2014-01-01

    that scapular positioning are altered in patients with musculoskeletal shoulder disorders, e.g in shoulder impingement syndrome and in patients with glenohumeral osteoarthritis. Rehabilitation exercises are aiming at altering abnormal/asymmetric scapular positioning and/or function. Numerous assessment methods...... have measured the degree of scapular dyskinesis, subjectively by visual evaluation and objectively by measurements of static and dynamic scapular positioning, by either a 3-dimensional electromagnetic device or 2-dimensional clinically applicable methods. Since advanced equipment (i.e. 3D motion....... Methods A systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. The overall method used in this review can be divided into four steps: 1) Compile...

  11. Measurement properties of existing clinical assessment methods evaluating scapular positioning and function. A systematic review

    DEFF Research Database (Denmark)

    Larsen, Camilla Marie; Juul-Kristensen, Birgit; Lund, Hans

    suggesting that scapular positioning are altered in patients with musculoskeletal shoulder disorders, e.g in shoulder impingement syndrome and in patients with glenohumeral osteoarthritis. Rehabilitation exercises are aiming at altering abnormal/asymmetric scapular positioning and/or function. Numerous...... assessment methods have measured the degree of scapular dyskinesis, subjectively by visual evaluation and objectively by measurements of static and dynamic scapular positioning, by either a 3-dimensional electromagnetic device or 2-dimensional clinically applicable methods. Since advanced equipment (i.e. 3D...... studies.MethodsA systematic, computer-assisted literature search using Medline, CINAHL, SportDiscus and EMBASE was performed from inception to October 2013. Reference lists in articles were also screened for publications. The overall method used in this review can be divided into four steps: 1) Compile...

  12. Clinical Comparative Study on Massage Therapy and Cisapride in Treating Functional Dyspepsia

    Institute of Scientific and Technical Information of China (English)

    ZHANG Jia-fu; LIN Qiang; LIU Hong-bo; ZHOU Ping; XIAO Yuan-chun

    2007-01-01

    To observe the clinical efficacy of massage therapy and Cisapride in the treatment of functional dyspepsia (FD).Methods:Eighty subjects were randomized into two groups:treatment group in which 40 cases were treated by massage therapy and control group in which 40 cases were treated by Cisapride,with a course of 4 weeks;meanwhile,another 40 healthy people were taken as normal group.Abdominal fullness,acid regurgitation,diminished appetite and anorexia,nausea and vomiting and health survey were observed;symptom scores were recorded.Results:These two treatment methods were effective for FD.Conclusion:Mental disorder is one cause of FD;massage therapy is quite effective for it.

  13. Memory assessment in the clinical context using functional magnetic resonance imaging: a critical look at the state of the field.

    Science.gov (United States)

    McAndrews, Mary Pat

    2014-11-01

    The use of functional magnetic resonance imaging to map language and sensorimotor regions in the brain is rapidly becoming a clinical standard in neurosurgical centers. Despite a wealth of cognitive neuroscience data showing focal medial temporal activation elicited by memory encoding and retrieval tasks in controls, translating such findings to generate reliable metrics for clinical use has been slow. The current review documents some of the successes that have been achieved, using both activation and resting-state functional connectivity in the clinical context of temporal lobe epilepsy, and discusses some of the challenges that remain to be addressed.

  14. Perspectives for clinical measures of dynamic foot function-reference data and methodological considerations.

    Science.gov (United States)

    Rathleff, M S; Nielsen, R G; Simonsen, O; Olesen, C G; Kersting, U G

    2010-02-01

    Several studies have investigated if static posture assessments qualify to predict dynamic function of the foot showing diverse outcomes. However, it was suggested that dynamic measures may be better suited to predict foot-related overuse problems. The purpose of this study was to establish the reliability for dynamic measures of longitudinal arch angle (LAA) and navicular height (NH) and to examine to what extent static and dynamic measures thereof are related. Intra-rater reliability of LAA and NH measures was tested on a sample of 17 control subjects. Subsequently, 79 subjects were tested while walking on a treadmill. The ranges and minimum values for LAA and NH during ground contact were identified over 20 consecutive steps. A geometric error model was used to simulate effects of marker placement uncertainty and skin movement artifacts. Results demonstrated the highest reliability for the minimum NH (MinNH), followed by the minimum LAA (MinLAA), the dynamic range of navicular height (DeltaNH) and the range of LAA (DeltaLAA) while all measures were highly reliable. Marker location uncertainty and skin movement artifacts had the smallest effects on measures of NH. The use of an alignment device for marker placement was shown to reduce error ranges for NH measures. Therefore, DeltaNH and MinNH were recommended for functional dynamic foot characterization in the sagittal plane. There is potential for such measures to be a suitable predictor for overuse injuries while being obtainable in clinical settings. Future research needs to include such dynamic but simple foot assessments in large-scale clinical studies.

  15. The clinical and functional significance of c-Met in breast cancer: a review.

    Science.gov (United States)

    Ho-Yen, Colan M; Jones, J Louise; Kermorgant, Stephanie

    2015-04-08

    c-Met is a receptor tyrosine kinase that upon binding of its ligand, hepatocyte growth factor (HGF), activates downstream pathways with diverse cellular functions that are important in organ development and cancer progression. Anomalous c-Met signalling has been described in a variety of cancer types, and the receptor is regarded as a novel therapeutic target. In breast cancer there is a need to develop new treatments, particularly for the aggressive subtypes such as triple-negative and basal-like cancer, which currently lack targeted therapy. Over the last two decades, much has been learnt about the functional role of c-Met signalling in different models of breast development and cancer. This work has been complemented by clinical studies, establishing the prognostic significance of c-Met in tissue samples of breast cancer. While the clinical trials of anti-c-Met therapy in advanced breast cancer progress, there is a need to review the existing evidence so that the potential of these treatments can be better appreciated. The aim of this article is to examine the role of HGF/c-Met signalling in in vitro and in vivo models of breast cancer, to describe the mechanisms of aberrant c-Met signalling in human tissues, and to give a brief overview of the anti-c-Met therapies currently being evaluated in breast cancer patients. We will show that the HGF/c-Met pathway is associated with breast cancer progression and suggest that there is a firm basis for continued development of anti-c-Met treatment, particularly for patients with basal-like and triple-negative breast cancer.

  16. Can a Clinical Test of Reaction Time Predict a Functional Head-Protective Response?

    Science.gov (United States)

    ECKNER, JAMES T.; LIPPS, DAVID B.; KIM, HOGENE; RICHARDSON, JAMES K.; ASHTON-MILLER, JAMES A.

    2015-01-01

    Purpose Reaction time is commonly prolonged after a sport-related concussion. Besides being a marker for injury, a rapid reaction time is necessary for protective maneuvers that can reduce the frequency and severity of additional head impacts. The purpose of this study was to determine whether a clinical test of simple visuomotor reaction time predicted the time taken to raise the hands to protect the head from a rapidly approaching ball. Methods Twenty-six healthy adult participants recruited from campus and community recreation and exercise facilities completed two experimental protocols during a single session: a manual visuomotor simple reaction time test (RTclin) and a sport-related head-protective response (RTsprt). RTclin measured the time required to catch a thin vertically oriented device on its release by the tester and was calculated from the distance the device fell before being arrested. RTsprt measured the time required to raise the hands from waist level to block a foam tennis ball fired toward the subject’s face from an air cannon and was determined using an optoelectronic camera system. A correlation coefficient was calculated between RTclin and RTsprt, with linear regression used to assess for effect modification by other covariates. Results A strong positive correlation was found between RTclin and RTsprt (r = 0.725, P < 0.001) independent of age, gender, height, or weight. Conclusions RTclin is predictive of a functional sport-related head-protective response. To our knowledge, this is the first demonstration of a clinical test predicting the ability to protect the head in a simulated sport environment. This correlation with a functional head-protective response is a relevant consideration for the potential use of RTclin as part of a multifaceted concussion assessment program. PMID:20689458

  17. Enhancement of cognitive and neural functions through complex reasoning training: evidence from normal and clinical populations.

    Science.gov (United States)

    Chapman, Sandra B; Mudar, Raksha A

    2014-01-01

    Public awareness of cognitive health is fairly recent compared to physical health. Growing evidence suggests that cognitive training offers promise in augmenting cognitive brain performance in normal and clinical populations. Targeting higher-order cognitive functions, such as reasoning in particular, may promote generalized cognitive changes necessary for supporting the complexities of daily life. This data-driven perspective highlights cognitive and brain changes measured in randomized clinical trials that trained gist reasoning strategies in populations ranging from teenagers to healthy older adults, individuals with brain injury to those at-risk for Alzheimer's disease. The evidence presented across studies support the potential for Gist reasoning training to strengthen cognitive performance in trained and untrained domains and to engage more efficient communication across widespread neural networks that support higher-order cognition. The meaningful benefits of Gist training provide compelling motivation to examine optimal dose for sustained benefits as well as to explore additive benefits of meditation, physical exercise, and/or improved sleep in future studies.

  18. Personality, clinical features, and test instructions can affect executive functions in Eating Disorders.

    Science.gov (United States)

    Pignatti, Riccardo; Bernasconi, Valentina

    2013-04-01

    Cognitive deficits in Eating Disorders have been related to the executive function domain. Yet, to date, only few works investigated the relationship between neuropsychological and clinical issues, and these studies were separately conducted either on Anorexia Nervosa (AN) or Bulimia Nervosa (BN). In this study, three groups of AN, BN and matched controls were administered the Trail Making Test, the Wisconsin Card Sorting Test, and the Hayling Sentence Completion Test, in addition to personality and clinical assessments (Temperament and Character Inventory, SCL-90-R, EDI-2). Results from AN indicated a relationship between cognitive rigidity and fixed psychological traits. Conversely, BN showed broader correlations among slowness, inhibition, and psychopathology-state indexes, confirming the clear relation published in the literature. We also hypothesize that task peculiar characteristics can affect high-order attentional activities in Eating Disorders. In fact, these patients do not differ from controls when the examiner provides overt instruction and run-in examples, but they can find serious difficulties when the correct rule is to be derived and modified from feedbacks during the test, as in the Wisconsin Card Sorting Test. Perfectionist stable traits support this hypothesis, especially in AN, as excessive cognitive control can either improve or damage set-shifting and decision-making procedures.

  19. Enhancement of Cognitive and Neural Functions through Complex Reasoning Training: Evidence from Normal and Clinical Populations

    Directory of Open Access Journals (Sweden)

    Sandra Bond Chapman

    2014-04-01

    Full Text Available Public awareness of cognitive health is fairly recent compared to physical health. Growing evidence suggests that cognitive training offers promise in augmenting cognitive brain performance in normal and clinical populations. Targeting higher-order cognitive functions, such as reasoning in particular, may promote generalized cognitive changes necessary for supporting the complexities of daily life. This data-driven perspective highlights cognitive and brain changes measured in randomized clinical trials that trained gist reasoning strategies in populations ranging from teenagers to healthy older adults, individuals with brain injury to those at-risk for Alzheimer’s disease. The evidence presented across studies support the potential for Gist reasoning training to strengthen cognitive performance in trained and untrained domains and to engage more efficient communication across widespread neural networks that support higher-order cognition. The meaningful benefits of Gist training provide compelling motivation to examine optimal dose for sustained benefits as well as to explore additive benefits of meditation, physical exercise, and/or improved sleep in future studies.

  20. Clinical prediction of postoperative seizure control: structural, functional findings and disease histories.

    Science.gov (United States)

    Stefan, H; Hildebrandt, M; Kerling, F; Kasper, B S; Hammen, T; Dörfler, A; Weigel, D; Buchfelder, M; Blümcke, I; Pauli, E

    2009-02-01

    Mesial temporal lobe epilepsy (MTLE) constitutes a heterogenic entity with different clinical histories, pathomorphological hippocampal findings and varying postoperative outcome. 64 patients with MTLE, scheduled for hippocampal resection, were included. Initial precipitating injuries (IPI), structural and functional findings and neuropathological classification of hippocampal specimens were related to prediction of surgical outcome. Patients with severe hippocampal sclerosis (mesial temporal sclerosis (MTS) type 1b) became completely seizure free (80% Engel Ia) significantly more often compared with approximately 40% of seizure freedom in other types of MTS or in patients without hippocampal cell loss (non-MTS), irrespective of the extent of hippocampal resection. Age at IPI was found to be related to MTS variants (psilent period of about 5 years; (3) unequivocal unilateral EEG localisation; (4) MRI signs of MTS; and (5) Wada Test indicates contralateral memory compensation and ipsilateral reduced memory capacity. MTS type 1b, characterised by severe cell loss in all hippocampal subfields including the dentate gyrus, and associated with optimal postoperative seizure control, was preoperatively clinically best differentiated from other MTS types by the Wada Memory Test.

  1. Acupuncture for Parkinson's Disease: a review of clinical, animal, and functional Magnetic Resonance Imaging studies.

    Science.gov (United States)

    Xiao, Danqing

    2015-12-01

    Acupuncture has been commonly used as an adjuvant therapy or monotherapy in the treatment of Parkinson's disease in China and in other countries. Animal studies have consistently show that this treatment is both neuroprotective, protecting dopaminergic neurons from degeneration and also restorative, restoring tyrosine hydroxylase positive dopaminergic terminals in striatum, resulting in improvements in motor performance in animal models of Parkinsonism. Studies show that this protection is mediated through the same common mechanisms as other neuroprotective agents, including anti-oxidative stress, anti-inflammatory and anti-apoptotic pathways at molecular and cellular levels. Restoration of function seems to involve activation of certain compensatory brain regions as a mechanism at the network level to correct the imbalances to the nervous system resulting from loss of dopaminergic neurons in substantia nigra. Clinical studies in China and Korea, in particular, have shown a positive benefit of acupuncture in treating Parkinson's disease, especially in reducing the doses of dopaminergic medications and the associated side effects. However, large and well-controlled clinical trials are still needed to further demonstrate the efficacy and effectiveness of acupuncture in the treatment of Parkinson's disease.

  2. Performance of the tutorial function in the Professor of Hematology, specialty: Clinical Laboratory.

    Directory of Open Access Journals (Sweden)

    Oriol Meneses Echemendia

    2014-09-01

    Full Text Available In the context of the battle of ideas, arises the career, degree in health technology, imposing new challenges to the medical university context, inserting new actors to the teaching - learning process and with them the professor-tutor's figure. For that reason , an evaluative project was developed in the hematology profile in the specialty of clinical laboratory, with the purpose of elaborating a strategy for the improvement of the teaching tutorial, on the base of systematic-structural-functional model; giving answer to the main detected problems. To carry out the study was used a qualitative focus, selecting the integrated paradigm. It was done an investigation action in the seven municipal university headquarters of the county where the process of teaching-learning of the new pedagogic model is developed in the profile. once selecting the scale of priority of the detected difficulties using the interaction and the interdependence among investigator and investigated, the "methodological strategy for the improvement of the teaching tutorial in hematology of clinical laboratory" was designed to propose three strategic actions, valued positively by the expert ones who endorsed the feasibility and effectiveness of their setting in practice to contribute to the improvement of the teaching tutorial in the formation of health technologies.

  3. Correlation of clinical symptoms and function with fatty degeneration of infraspinatus in rotator cuff tear.

    Science.gov (United States)

    Seo, Joong-Bae; Yoo, Jae-Sung; Jang, Ho-Seong; Kim, Jung-Sang

    2015-05-01

    The aim of this study was to analyse the correlation of clinical symptoms and function with the fatty degeneration of the infraspinatus in rotator cuff tears. A total of 152 patients who had rotator cuff tears was enroled retrospectively. The infraspinatus muscle was divided into two compartments according to the bundle of fibres, and the patients were divided into four groups that reflected fatty degeneration. The muscle strength of the shoulder and clinical symptoms was investigated. The severity of the rotator cuff tear and retraction increased with fatty degeneration of both the superior and inferior parts in the infraspinatus muscles. Because of the increasing fatty degeneration of the superior part of the infraspinatus, the shoulder strength index (SSI) of abduction had poor results. Additionally, as the fatty degeneration of the inferior part of the infraspinatus increased, the SSI of abduction and external rotation had worse results. Fatty degeneration of the superior part of the infraspinatus has no correlation with the power of external rotation but has a negative correlation with the power of abduction. Moreover, fatty degeneration of the inferior part of the infraspinatus has a negative correlation with both the power of abduction and external rotation. Retrospective study, Level IV.

  4. Form Follows Function: A Model for Clinical Supervision of Genetic Counseling Students.

    Science.gov (United States)

    Wherley, Colleen; Veach, Patricia McCarthy; Martyr, Meredith A; LeRoy, Bonnie S

    2015-10-01

    Supervision plays a vital role in genetic counselor training, yet models describing genetic counseling supervision processes and outcomes are lacking. This paper describes a proposed supervision model intended to provide a framework to promote comprehensive and consistent clinical supervision training for genetic counseling students. Based on the principle "form follows function," the model reflects and reinforces McCarthy Veach et al.'s empirically derived model of genetic counseling practice - the "Reciprocal Engagement Model" (REM). The REM consists of mutually interactive educational, relational, and psychosocial components. The Reciprocal Engagement Model of Supervision (REM-S) has similar components and corresponding tenets, goals, and outcomes. The 5 REM-S tenets are: Learning and applying genetic information are key; Relationship is integral to genetic counseling supervision; Student autonomy must be supported; Students are capable; and Student emotions matter. The REM-S outcomes are: Student understands and applies information to independently provide effective services, develop professionally, and engage in self-reflective practice. The 16 REM-S goals are informed by the REM of genetic counseling practice and supported by prior literature. A review of models in medicine and psychology confirms the REM-S contains supervision elements common in healthcare fields, while remaining unique to genetic counseling. The REM-S shows promise for enhancing genetic counselor supervision training and practice and for promoting research on clinical supervision. The REM-S is presented in detail along with specific examples and training and research suggestions.

  5. Development of computer-aided functions in clinical neurosurgery with PACS

    Science.gov (United States)

    Mukasa, Minoru; Aoki, Makoto; Satoh, Minoru; Kowada, Masayoshi; Kikuchi, K.

    1991-07-01

    The introduction of the "Picture Archiving and Communications System (known as PACS)," provides many benefits, including the application of C.A.D., (Computer Aided Diagnosis). Clinically, this allows for the measurement and design of an operation to be easily completed with the CRT monitors of PACS rather than with film, as has been customary in the past. Under the leadership of the Department of Neurosurgery, Akita University School of Medicine, and Southern Tohoku Research Institute for Neuroscience, Koriyama, new computer aided functions with EFPACS (Fuji Electric's PACS) have been developed for use in clinical neurosurgery. This image processing is composed of three parts as follows: (1) Automatic mapping of small lesions depicted on Magnetic Resonance (or MR) images on the brain atlas. (2) Superimposition of two angiographic films onto a single synthesized image. (3) Automatic mapping of the lesion's position (as shown on the. CT images) on the processing image referred to in the foregoing clause 2. The processing in the clause (1) provides a reference for anatomical estimation. The processing in the clause (2) is used for general analysis of the condition of a disease. The processing in the clause (3) is used to design the operation. This image processing is currently being used with good results.

  6. [Technical and functional standards and implementation of a clinical information system in intensive care units].

    Science.gov (United States)

    Gómez Tello, V; Alvarez Rodríguez, J; Núñez Reiz, A; González Sánchez, J A; Hernández Abadía de Barbará, A; Martínez Fresneda, M; Morrondo Valdeolmillos, P; Nicolás Arfelis, J M; Pujol Varela, I; Calvete Chicharro, M

    2011-11-01

    Clinical Information Systems (CIS) are becoming a useful tool for managing patients and data in the ICU. However, the existing CIS differ in their capabilities and technical requirements. It is therefore essential for intensivists, as the end clients of these applications, to define the suitable minimum specifications required in order to be operative and helpful. The Spanish Society of Intensive Care Medicine and Coronary Units, through its Organization and Management Workgroup, has designated a group of clinical and software experts to draft a document with the recommendable technical and operating requirements of these systems. The group was formed by ten people supported by managers or engineers from the five principal industries producing CIS in Spain. The project involved the following phases: a) Completion of a check list. This step was considered necessary in order to establish the precise current situation of CIS applications. b) Discussion of the results by the group of experts in a meeting and in online format. The requirements were grouped into four sections: technical, functional, safety and data management. All requirements were classified as basic and optional in order to allow the end user to choose among different options according to the existing budget, though ensuring a minimal set of useful characteristics. A chronogram for the installation process was also proposed. Copyright © 2011 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  7. The Clinical Utility of the Behavior Rating Inventory of Executive Function (BRIEF) in the Diagnosis of ADHD

    Science.gov (United States)

    McCandless, Stephen; O'Laughlin, Liz

    2007-01-01

    Objective: Current theories hypothesize that deficits in executive functioning (EF) are responsible for the symptoms of ADHD and that specific patterns of EF deficits may be associated with different subtypes of ADHD. The present study evaluates the validity and clinical usefulness of the Behavior Rating Inventory of Executive Function, a behavior…

  8. Functional MRT in psychiatry and neurology. 2. rev. and upd. ed.; Funktionelle MRT in Psychiatrie und Neurologie

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Frank [Universitaetsklinikum Aachen (Germany); Fink, Gereon R. (eds.) [Forschungszentrum Juelich GmbH (Germany); Uniklinik Koeln (Germany)

    2013-08-01

    The book on functional MRT in psychiatry and neurology covers the following topics: (I) Fundamentals: functional neuro-anatomy, fundamentals of NMR imaging, basic research on the clinical use for diagnostics and therapy; basics of morphometry; real-time fMRT, planning and execution of experimental paradigms; data analysis and statistics; reliability and quality of fMRT experiments; eye movement, neuropharmacologic functional imaging, gender dependent effects, age dependent effects, resting state fMRT; meta analyses. (II) Higher brain achievements: movement and action, perception and attention, visual system and object processing, auditory system, executive functions, somatosensoric system, memory, learning and gratification system, functional neuro-anatomy of speech, number processing and calculation, connectivity, social cognition, emotions, olfactory system, functional imaging in the pain research. (III) Disease pattern: dystonia, Parkinson syndrome, Chorea Huntington, aphasia, apraxia, neglect, amnesia, function recovery following apoplexy, schizophrenia, affective disturbances, anxiety and fear, post-traumatic disturbances, hyperactivity syndrome, personality disorder. (IV) Working tools: brain atlas, tool for integrated analyses of structure, functionality and connectivity (SPM anatomy toolbox).

  9. Neurologic Functional and Quality of Life Outcomes after TBI: Clinic Attendees versus Non-Attendees.

    Science.gov (United States)

    Patel, Mayur B; Wilson, Laura D; Bregman, Jana A; Leath, Taylor C; Humble, Stephen S; Davidson, Mario A; de Riesthal, Michael R; Guillamondegui, Oscar D

    2015-07-01

    This investigation describes the relationship between TBI patient demographics, quality of life outcome, and functional status outcome among clinic attendees and non-attendees. Of adult TBI survivors with intracranial hemorrhage, 63 attended our TBI clinic and 167 did not attend. All were telephone surveyed using the Extended-Glasgow Outcome Scale (GOSE), the Quality of Life after Brain Injury (QOLIBRI) scale, and a post-discharge therapy questionnaire. To determine risk factors for GOSE and QOLIBRI outcomes, we created multivariable regression models employing covariates of age, injury characteristics, clinic attendance, insurance status, post-discharge rehabilitation, and time from injury. Compared with those with severe TBI, higher GOSE scores were identified in individuals with both mild (odds ratio [OR]=2.0; 95% confidence interval [CI]: 1.1-3.6) and moderate (OR=4.7; 95% CI: 1.6-14.1) TBIs. In addition, survivors with private insurance had higher GOSE scores, compared with those with public insurance (OR=2.0; 95% CI: 1.1-3.6), workers' compensation (OR=8.4; 95% CI: 2.6-26.9), and no insurance (OR=3.1; 95% CI: 1.6-6.2). Compared with those with severe TBI, QOLIBRI scores were 11.7 points (95% CI: 3.7-19.7) higher in survivors with mild TBI and 17.3 points (95% CI: 3.2-31.5) higher in survivors with moderate TBI. In addition, survivors who received post-discharge rehabilitation had higher QOLIBRI scores by 11.4 points (95% CI: 3.7-19.1) than those who did not. Survivors with private insurance had QOLIBRI scores that were 25.5 points higher (95% CI: 11.3-39.7) than those with workers' compensation and 16.8 points higher (95% CI: 7.4-26.2) than those without insurance. Because neurologic injury severity, insurance status, and receipt of rehabilitation or therapy are independent risk factors for functional and quality of life outcomes, future directions will include improving earlier access to post-TBI rehabilitation, social work services, affordable insurance

  10. Evaluation of Functional Outcomes after Stapes Surgery in Patients with Clinical Otosclerosis in a Teaching Institution

    Directory of Open Access Journals (Sweden)

    Souza, José Celso Rodriques de

    2015-11-01

    Full Text Available Introduction Otosclerosis is a primary disease of the temporal bone that leads to stapes ankylosis. Hearing loss is the main symptom. Treatment includes surgery, medical treatment, and sound amplification therapy alone or in combination. Objective To evaluate the functional outcomes of patients with clinical diagnosis of otosclerosis undergoing primary stapes surgery in a teaching institution. Method Retrospective descriptive study. Results A total of 210 ears of 163 patients underwent stapes surgery. Of the 163 patients, 116 (71.2% underwent unilateral surgery and 47 (28.8% underwent bilateral surgery. Six of the 210 operated ears had obliterative otosclerosis. The average preoperative and postoperative air–bone gap was 32.06 and 4.39 dB, respectively. The mean preoperative and postoperative bone conduction threshold was 23.17 and 19.82 dB, respectively. A total of 184 (87.6% ears had a residual air–bone gap <10 dB, and 196 (93.3% had a residual air–bone gap ≤15 dB. Two patients (0.95% had severe sensorineural hearing loss. Conclusion Stapes surgery showed excellent functional hearing outcomes in this study. This surgery may be performed in educational institutions with the supervision of experienced surgeons.

  11. [Measurement of the reserve function of inspiratory muscle and its clinical significance].

    Science.gov (United States)

    Xiao, X; Luo, Y; Chen, W; Yuan, Y; He, T; Zeng, J

    1995-06-01

    The principles of measuring inspiratory muscle tension-time index (TTim) and the ratio of the works of inspiration over the maximal works of inspiration (Wi/Wi(max)) were investigated and their formulae were deduced, i.e. TTim = (Pi x Ti)/(MIP x Ttot) and Wi/Wi(max) = (Pi x VT)/(MIP x IC). The importance of the inspiratory pressure and the maximal inspiratory pressure (MIP) measured at function residual capacity (FRC) level was emphasized. Both TTim and Wi/Wi(max) were measured in 35 normal subjects and 89 patients with chronic obstructive pulmonary disease (COPD). The results showed that normal value of TTim was 0.0253 +/- 0.0055 which corresponds to the normal value of the diaphragm tension-time index (TTdi = 0.02-0.03) reported by Bellemare. Patients with COPD had a mean TTim much higher than that of normals (P Wimax (r = 0.7891, 0.9738, 0.6459, 0.9327, P Wimax can be used as clinical indices to reflect the reserve function of inspiratory muscles.

  12. The different functions and clinical significances of caveolin-1 in human adenocarcinoma and squamous cell carcinoma

    Science.gov (United States)

    Fu, Pin; Chen, Fuchun; Pan, Qi; Zhao, Xianda; Zhao, Chen; Cho, William Chi-Shing; Chen, Honglei

    2017-01-01

    Caveolin-1 (Cav-1), a major structural protein of caveolae, is an integral membrane protein which plays an important role in the progression of carcinoma. However, whether Cav-1 acts as a tumor promoter or a tumor suppressor still remains controversial. For example, the tumor-promoting function of Cav-1 has been found in renal cancer, prostate cancer, tongue squamous cell carcinoma (SCC), lung SCC and bladder SCC. In contrast, Cav-1 also plays an inhibitory role in esophagus adenocarcinoma, lung adenocarcinoma and cutaneous SCC. The role of Cav-1 is still controversial in thyroid cancer, hepatocellular carcinoma, gastric adenocarcinoma, colon adenocarcinoma, breast cancer, pancreas cancer, oral SCC, laryngeal SCC, head and neck SCC, esophageal SCC and cervical SCC. Besides, it has been reported that the loss of stromal Cav-1 might predict poor prognosis in breast cancer, gastric cancer, pancreas cancer, prostate cancer, oral SCC and esophageal SCC. However, the accumulation of stromal Cav-1 has been found to be promoted by the progression of tongue SCC. Taken together, Cav-1 seems playing a different role in different cancer subtypes even of the same organ, as well as acting differently in the same cancer subtype of different organs. Thus, we hereby explore the functions of Cav-1 in human adenocarcinoma and SCC from the perspective of clinical significances and pathogenesis. We envision that novel targets may come with the further investigation of Cav-1 in carcinogenesis. PMID:28243118

  13. Clinical outcome and bowel function after surgical treatment in Hirschsprung′s disease

    Directory of Open Access Journals (Sweden)

    Maryam Khazdouz

    2015-01-01

    Full Text Available Background: Bowel function has been reported to be adversely affected following surgery in cases of Hirschsprung. We retrospectively studied both the clinical outcome and bowel function status following surgery in patients diagnosed with Hirschprung′s disease (HD. 161 cases, who underwent pull-through operations for HD in Sheikh Pediatric Tertiary Centre, Mashhad, Iran. The specified time bracket spanned between 2006 and 2011. Materials and Methods: Data was extracted from Health Information System with the aim of investigating patients for both short and long-term gastrointestinal (GI complications after surgery bases in addition to the concurrence of any associated anomalies. Three main procedures were analysed in this respect (Swenson, Duhamel and Soave. Results: In a study of 96 (59% boys and 65 (40.3% girls, mortality rate was reported to be 15.5% (15 males and 10 females. A considerable majority of almost three fourths were detected with both early and late GI complications after surgery. The latter mainly included constipation (30.8%, incontinence (19.8%, enterocolitis (8%, diarrhea (11% in a declining order of incidence. Down syndrome and others HD-associated anomalies were detected in 3.7% and 24.3% of cases respectively. Conclusions: Constipation and foecal incontinence were the most prevalent postoperative complications, which were reported almost as frequent in other studies. Yet, Enterocolitis, was reported slightly less in prevalence. Also mortality rates were considerably higher, compared to developed nations.

  14. Pulmonary function tests in idiopathic inflammatory myopathy: association with clinical parameters in children.

    Science.gov (United States)

    Prestridge, Adrienne; Morgan, Gabrielle; Ferguson, Lori; Huang, Chiang-Ching; Pachman, Lauren M

    2013-09-01

    To determine the association of decreased lung function in children with idiopathic inflammatory myopathies (IIMs) with specific clinical parameters. This study of 38 children ages 6-23 years diagnosed with definite/probable IIM evaluated the association of myositis-specific/-associated antibodies (MSAs/MAAs), duration of untreated disease at diagnosis, Disease Activity Score for muscle (DAS-M), muscle-derived enzymes (aldolase, lactate dehydrogenase [LDH], aspartate transaminase, and creatine phosphokinase [CPK]), neopterin and von Willebrand factor antigen, and the Childhood Myositis Assessment Scale (CMAS) scores with data from pulmonary function testing (PFT). Impaired PFTs were defined as total lung capacity (TLC) or diffusing capacity for carbon monoxide (DLCO) of LDH, and had elevated levels of neopterin and aldolase, with low CMAS scores for items 1, 3, 10, 11, and 14. Assessment of PFTs in children with IIMs should be considered, since more than one-third of patients were found to be impaired. The presence of MSAs/MAAs, an elevated serum neopterin level (mean ± SD 12.4 ± 9.6 nmoles/liter, normal value <10.5), older age at diagnosis, and shorter duration of untreated disease at diagnosis suggest the presence of potential lung pathology. Copyright © 2013 by the American College of Rheumatology.

  15. Clinical significance of knowledge about the structure, function, and impairments of working memory.

    Science.gov (United States)

    Brodziak, Andrzej; Brewczyński, Adam; Bajor, Grzegorz

    2013-05-03

    A review of contemporary research on the working memory system (WMS) is important, both due to the need to focus the discussion on further necessary investigations on the structure and function of this key part of the human brain, as well as to share this knowledge with clinicians. In our introduction we try to clarify the actual terminology and provide an intuitively understandable model for 3 basic cognitive operations: perception, recognition, imagery, and manipulation of recalled mental images. We emphasize the importance of knowledge of the structure and function of the WMS for the possibility to demonstrate the links between genetic polymorphisms and the prevalence to some mental disorders. We also review current knowledge of working memory dysfunction in the most common diseases and specific clinical situations such as maturation and aging. Finally, we briefly discuss methods for assessment of WMS capacity. This article establishes a kind of compendium of knowledge for clinicians who are not familiar with the structure and operation of the WMS.

  16. [Diffuse infiltrative lung disease in scleroderma. Analysis of radio-clinical and functional semiology].

    Science.gov (United States)

    El Khattabi, W; Afif, H; Moussali, N; Aichane, A; Abdelouafi, A; Bouayad, Z

    2013-06-01

    Scleroderma (SD) is a systemic disease that predominantly affects the skin. Diffuse infiltrative lung disease (DILD) is rare and occurs most often in the course of the disease. We analyzed seven cases of DILO of SD recorded between 2003 and 2010 among 196 PID (3.6%). Functional signs were limited to respiratory dyspnea, it was associated to dysphagia in six cases, dry syndrome in five cases and Raynaud's phenomenon in four cases. Clinical examination found crackles in the bases of the thorax in all cases and specific cutaneous signs in six cases. The chest radiograph showed that interstitial disease predominates at the lung bases in all cases with a large aspect of the pulmonary arteries in two cases. The chest CT scan confirmed the predominance of basal and peripheral damage with signs of fibrosis in six cases. The pulmonary function objectified a severe restrictive ventilatory defect in all cases. Bronchoscopy showed a normal macroscopic appearance in all cases, the broncho-alveolar lavage was predominated by neutrophilic formula in four cases. SCL 70 antibodies were positive in four cases. All patients were treated by steroids with improvement of dyspnea and stabilization of radiographs. A patient had died in an array of acute respiratory failure and one patient was lost to follow-up. DILD in scleroderma is rare and seldom reveals the disease, it affects the patient's prognosis especially when associated with arterial pulmonary hypertension. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  17. Male sexual function and its disorders: physiology, pathophysiology, clinical investigation, and treatment.

    Science.gov (United States)

    Kandeel, F R; Koussa, V K; Swerdloff, R S

    2001-06-01

    This review is designed to help the reproductive endocrinologist integrate his or her professional activity with those of other disciplines including urology, radiology, neurology, and psychology in order to successfully manage all of the inseparable aspects of male sexual and reproductive functioning. Significant advances in the field of male sexual physiology and pathophysiology and new methods of investigation and treatment of male sexual disorders are outlined. The review synthesizes available data on the following: norms of sexual organs, aging and sexuality, role of central and peripheral neurochemicals in each stage of the sexual cycle, role of corporeal smooth muscles in the hemodynamic control of erection and detumescence, influence of psychological factors, drugs, and disease on all aspects of sexual functioning, and use of nocturnal penile tumescence monitoring, imaging investigations, and neurophysiologic studies in the diagnostic workup of males with sexual dysfunction. Clinical algorithms are presented where appropriate. Extensive discussions on newly developed strategies in psychological and behavioral counseling, drug therapy, tissue engineering, nonsurgical devices, and surgical treatments for all forms of sexual disorders are also provided. Lastly, the effect of sexual dysfunction and its treatment on quality of life in affected men is addressed, along with recommendations for future research endeavors.

  18. Diagnostic precision of PET imaging and functional MRI in disorders of consciousness: a clinical validation study.

    Science.gov (United States)

    Stender, Johan; Gosseries, Olivia; Bruno, Marie-Aurélie; Charland-Verville, Vanessa; Vanhaudenhuyse, Audrey; Demertzi, Athena; Chatelle, Camille; Thonnard, Marie; Thibaut, Aurore; Heine, Lizette; Soddu, Andrea; Boly, Mélanie; Schnakers, Caroline; Gjedde, Albert; Laureys, Steven

    2014-08-09

    Bedside clinical examinations can have high rates of misdiagnosis of unresponsive wakefulness syndrome (vegetative state) or minimally conscious state. The diagnostic and prognostic usefulness of neuroimaging-based approaches has not been established in a clinical setting. We did a validation study of two neuroimaging-based diagnostic methods: PET imaging and functional MRI (fMRI). For this clinical validation study, we included patients referred to the University Hospital of Liège, Belgium, between January, 2008, and June, 2012, who were diagnosed by our unit with unresponsive wakefulness syndrome, locked-in syndrome, or minimally conscious state with traumatic or non-traumatic causes. We did repeated standardised clinical assessments with the Coma Recovery Scale-Revised (CRS-R), cerebral (18)F-fluorodeoxyglucose (FDG) PET, and fMRI during mental activation tasks. We calculated the diagnostic accuracy of both imaging methods with CRS-R diagnosis as reference. We assessed outcome after 12 months with the Glasgow Outcome Scale-Extended. We included 41 patients with unresponsive wakefulness syndrome, four with locked-in syndrome, and 81 in a minimally conscious state (48=traumatic, 78=non-traumatic; 110=chronic, 16=subacute). (18)F-FDG PET had high sensitivity for identification of patients in a minimally conscious state (93%, 95% CI 85-98) and high congruence (85%, 77-90) with behavioural CRS-R scores. The active fMRI method was less sensitive at diagnosis of a minimally conscious state (45%, 30-61) and had lower overall congruence with behavioural scores (63%, 51-73) than PET imaging. (18)F-FDG PET correctly predicted outcome in 75 of 102 patients (74%, 64-81), and fMRI in 36 of 65 patients (56%, 43-67). 13 of 41 (32%) of the behaviourally unresponsive patients (ie, diagnosed as unresponsive with CRS-R) showed brain activity compatible with (minimal) consciousness (ie, activity associated with consciousness, but diminished compared with fully conscious individuals

  19. Association of upper gastrointestinal symptoms with functional and clinical characteristics in the elderly

    Institute of Scientific and Technical Information of China (English)

    Alberto Pilotto; Stefania Maggi; Marianna Noale; Marilisa Franceschi; Giancarlo Parisi; Gaetano Crepaldi

    2011-01-01

    AIM: To evaluate the prevalence of upper gastrointestinal symptoms and their association with clinical and functional characteristics in elderly outpatients. METHODS: The study involved 3238 outpatients ≥ 60 years consecutively enrolled by 107 general practitioners. Information on social, behavioral and demographic characteristics, function in the activities of daily living (ADL), co-morbidities and drug use were collected by a structured interview. Upper gastrointestinal symptom data were collected by the 15-items upper gastro-intestinal symptom questionnaire for the elderly, a validated diagnostic tool which includes the following five symptom clusters: (1) abdominal pain syndrome; (2) reflux syndrome; (3) indigestion syndrome; (4) bleeding; and (5) non-specific symptoms. Presence and severity of gastrointestinal symptoms were analyzed through a logistic regression model. RESULTS: 3100 subjects were included in the final analysis. The overall prevalence of upper gastrointestinal symptoms was 43.0%, I.e. Cluster (1) 13.9%, (2) 21.9%, (3) 30.2%, (4) 1.2%, and (5) 4.5%. Upper gastrointestinal symptoms were more frequently reported by females (P < 0.0001), with high number of co-morbidities (P < 0.0001), who were taking higher number of drugs (P < 0.0001) and needed assistance in the ADL. Logistic regression analysis demonstrated that female sex (OR = 1.39, 95% CI: 1.17-1.64), disability in the ADL (OR = 1.47, 95% CI: 1.12-1.93), smoking habit (OR = 1.29, 95% CI: 1.00-1.65), and body mass index (OR = 1.06, 95% CI: 1.04-1.08), as well as the presence of upper (OR = 3.01, 95% CI: 2.52-3.60) and lower gastroenterological diseases (OR = 2.25, 95%CI: 1.70-2.97), psychiatric (OR = 1.60, 95% CI: 1.28-2.01) and respiratory diseases (OR = 1.25, 95% CI: 1.01-1.54) were significantly associated with the presence of upper gastrointestinal symptoms. CONCLUSION: Functional and clinical characteristics are associated with upper gastrointestinal symptoms. A multidimensional

  20. The Impact of Clinical and Cognitive Variables on Social Functioning in Parkinson's Disease: Patient versus Examiner Estimates

    Directory of Open Access Journals (Sweden)

    Patrick McNamara

    2010-01-01

    Results. Patients' estimates of their own social functioning were not significantly different from examiners' estimates. The impact of clinical variables on social functioning in PD revealed depression to be the strongest association of social functioning in PD on both the patient and the examiner version of the Social Adaptation Self-Evaluation Scale. Conclusions. PD patients appear to be well aware of their social strengths and weaknesses. Depression and motor symptom severity are significant predictors of both self- and examiner reported social functioning in patients with PD. Assessment and treatment of depression in patients with PD may improve social functioning and overall quality of life.

  1. Clinical and laboratory evaluation of thyroid function following total laryngectomy in laryngeal cancer

    Directory of Open Access Journals (Sweden)

    Motasaddi Zarandy M

    2007-07-01

    Full Text Available Background: Hypothyroidism is a well-documented complication after treatment of laryngeal cancer and is particularly significant among patients undergoing laryngectomy. We investigated the frequency of hypothyroidism in patients treated with total laryngectomy for laryngeal cancer. We also evaluated the effect of neck radiotherapy on thyroid function after total laryngectomy for laryngeal cancer. Methods: In a cross-sectional study, we evaluated 31 patients with laryngeal squamous cell carcinoma (mean age 53.6 years. Among these patients, 14 were treated with surgery only and 17 were treated with surgery plus radiotherapy. Laboratory evaluation included levels of thyroid stimulating hormone (TSH, free T4, free T3, and antithyroid antibodies both preoperatively and postoperatively at the first day, as well as one and six months after surgery. Results: All patients had normal thyroid function before treatment; however, after 6 months, five patients (16.1% were hypothyroid. Of these, three patients (9.6% had subclinical symptoms, including elevated thyroid-stimulating hormone with normal free T4, and two patients (6.5% showed clinical symptoms of hypothyroidism. Radiotherapy and neck dissection were significantly associated with higher incidences of hypothyroidism. Conclusion: Our data suggest that hypothyroidism occurs in a substantial proportion of patients undergoing surgery for laryngeal cancer. The results indicate that thyroid function studies should be routinely performed in the follow-up care of laryngeal cancer patients, especially if radiotherapy and neck dissection were part of the treatment. We suggest that this approach will improve the patient's quality of life and diminish the co-morbidity associated with this kind of surgery.

  2. Structural synaptic plasticity has high memory capacity and can explain graded amnesia, catastrophic forgetting, and the spacing effect.

    Directory of Open Access Journals (Sweden)

    Andreas Knoblauch

    Full Text Available Although already William James and, more explicitly, Donald Hebb's theory of cell assemblies have suggested that activity-dependent rewiring of neuronal networks is the substrate of learning and memory, over the last six decades most theoretical work on memory has focused on plasticity of existing synapses in prewired networks. Research in the last decade has emphasized that structural modification of synaptic connectivity is common in the adult brain and tightly correlated with learning and memory. Here we present a parsimonious computational model for learning by structural plasticity. The basic modeling units are "potential synapses" defined as locations in the network where synapses can potentially grow to connect two neurons. This model generalizes well-known previous models for associative learning based on weight plasticity. Therefore, existing theory can be applied to analyze how many memories and how much information structural plasticity can store in a synapse. Surprisingly, we find that structural plasticity largely outperforms weight plasticity and can achieve a much higher storage capacity per synapse. The effect of structural plasticity on the structure of sparsely connected networks is quite intuitive: Structural plasticity increases the "effectual network connectivity", that is, the network wiring that specifically supports storage and recall of the memories. Further, this model of structural plasticity produces gradients of effectual connectivity in the course of learning, thereby explaining various cognitive phenomena including graded amnesia, catastrophic forgetting, and the spacing effect.

  3. Relative contribution of attention and memory toward disorientation or post-traumatic amnesia in an acute brain injury sample.

    Science.gov (United States)

    Tittle, Ashana; Burgess, Gerald H

    2011-01-01

    To examine the relative contribution of attention and memory to orientation/disorientation following moderate-to-severe brain injury. It was hypothesized that attention would be a comparable contributor to orientation, compared to memory; suggesting assessing attention has a role in understanding and estimating duration of post-traumatic amnesia. One hundred and five brain-injured inpatients were divided into three groups of high, moderate or low orientation. ANOVA was run on attention, memory and (as a control) language scores to examine group differences. Correlational analysis was run between orientation items and attention and memory indexes to examine the relative contribution of attention and memory on specific orientation item performance. Multiple regression examined the contribution of memory and attention to being oriented. METHODS AND POCEDURES: Patients' orientation, attention, memory and language were assessed during their inpatient rehabilitation. Groups differed significantly and attention recovered more sharply between low and moderate orientation states compared to memory and language recovery. Memory contributed most to orientation, followed closely by attention, both surpassing language. Attention most related to temporal estimation, while memory most related to retrieval of well-consolidated memories. Attention contributes significantly to orientation, although to a slightly lesser degree than memory. Attention should be assessed routinely. The relative 'load' and contribution of attention to orientation and answering orientation-type questions is discussed.

  4. Time of flight MR angiography assessment casts doubt on the association between transient global amnesia and intracranial jugular venous reflux

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Yeonah; Kim, Eunhee; Kim, Jae Hyoung; Choi, Byung Se; Jung, Cheolkyu; Bae, Yun Jung; Lee, Kyung Mi [Seoul National University College of Medicine, Seoul National University Bundang Hospital, Department of Radiology, Seongnam-si, Gyeonggi-do (Korea, Republic of); Lee, Dong Hoon [Seoul Medical Center, Department of Radiology, Seoul (Korea, Republic of)

    2014-10-03

    Evidence of intracranial venous reflux flow due to jugular venous reflux (JVR) on time of flight (TOF) MR angiography (MRA) is thought to be highly associated with transient global amnesia (TGA) - evidence that supports the venous congestion theory of TGA pathophysiology. However, recent studies indicate that intracranial JVR on TOF MRA is occasionally observed in normal elderly. Therefore, the purpose of this study was to compare the prevalence of intracranial JVR on TOF MRA in patients with TGA and two control groups. Three age- and sex-matched groups of subjects that received MRI and MRA were enrolled. The groups comprised 167 patients with TGA, 167 visitors to the emergency room (ER) and 167 visitors to a health promotion centre (HPC). Intracranial JVR was defined as abnormal venous signals in the inferior petrosal, sigmoid and/or transverse sinuses on TOF MRA. The prevalence of intracranial JVR was assessed across the three groups. Intracranial JVR was seen in seven (4.2 %) TGA patients, eight (4.8 %) ER visitors and three (1.8 %) HPC visitors, respectively. No statistically significant differences were observed among the three groups. TGA patients showed a low prevalence of intracranial JVR on TOF MRA, and no statistical differences were found in comparison with control groups. (orig.)

  5. Clinical usefulness of Adeli suit therapy for improving gait function in children with spastic cerebral palsy: a case study

    Science.gov (United States)

    Lee, Byoung-Hee

    2016-01-01

    [Purpose] The purpose of this study was to determine the effects of Adeli suit therapy (AST) on gross motor function and gait function in children with cerebral palsy. [Subjects and Methods] Two participants with spastic cerebral palsy were recruited to undergo AST. AST was applied in 60-minute sessions, five times per week, with 20 sessions total over 4 weeks. Assessments of gross motor function, spatiotemporal parameters, and functional ambulation performance for gait were conducted. [Results] Gross motor function