Lower Proportion Of Individuals Research Articles

Modifiable cardiovascular risk factors in adolescents and adults with congenital heart disease.

Individuals with congenital heart disease (CHD) may be at higher risk of acquired cardiovascular disease than the general population due to their underlying physiology and/or surgical sequelae. We sought to assess the prevalence of cardiovascular disease risk factors in youth and adults with CHD. We assessed cardiovascular health as per the Cardiovascular Health in Ambulatory Care Research Team (CANHEART) health index in patients with CHD aged 15+ years who attended cardiology outpatient clinics. Participants self-reported smoking behavior, fruit and vegetable consumption, physical activity, and whether they had diabetes and hypertension. Individual health indices were categorized into ideal/not ideal, and sum of individual health indices was categorized as poor, intermediate or ideal cardiovascular health as per CANHEART criteria. We included n = 102 adults (35.4 ± 12.9 years, 46% female) and n = 88 youth (17.2 ±1.1 years, 41% female). Most individuals reported to be nonsmokers (88% youth vs 86% adults) and to consume ≥5 servings of fruit and vegetables per day (83% vs 85%, respectively). More adults than youth were overweight/obese (52% vs 22%, p < 0.001) though more adults than youth reported meeting age-specific physical activity guidelines (84% vs 55%, p < 0.001). According to CANHEART health index criteria, 32% of youth and 27% of adults were in ideal cardiovascular health. A low proportion of individuals with CHD are in ideal cardiovascular health, suggesting a need to promote healthy lifestyles during adolescence and throughout adulthood in these individuals.

Effectiveness of Colonic Decompression in Patients Hospitalized With Acute Colonic Pseudoobstruction: Propensity-Matched Analysis

Introduction: Colonic decompression (CD) is recommended for treatment of acute colonic pseudoobstruction (ACPO) when pharmacologic and conservative management fails. The efficacy of CD has not been evaluated in RCTs. Furthermore, current studies are limited by size. This is the largest study to address the effectiveness of CD. Methods: The EMRs of inpatients at the Cleveland Clinic with a clinical and radiographic diagnosis of ACPO between 2000 and 2016 were reviewed. Patients were divided into two groups based on treatment with or without CD. These patients were propensity matched with Greedy-algorithm by age, electrolyte imbalance, sepsis, Charleson comorbidity score, symptoms, hypothyroidism, renal insufficiency, use of opiate or anti-cholinergic medicines, use of neostigmine, recent surgery, recent trauma, and maximum colonic diameter. Chi-square or t-test were used to compare matched and unmatched groups with respect to percent change in maximum colonic diameter, resolution per radiologist, and change in symptoms (distension, abdominal pain, nausea, and ability to tolerate diet) within 48 hours. Results: 113 patients had confirmed ACPO; mean age was 70.1 ±14.5 and 79 (69.9%) were male. In unmatched analysis, the CD group achieved a greater reduction in maximum diameter (30.1% ±16.8 v.non-CD group 20.3% ±14.1; p=0.001) with a lower proportion of individuals who had no improvement in abdominal pain (CD- 3.6% v. non-CD 31.8%; p=0.013). Propensity matching yielded 36 matched subjects with a mean age of 70 ±13.9 and 27 (75%) males. After propensity matching, no significant difference was noted between mean colon diameter or radiographic resolution between both groups. Conclusion: Colonic decompression results in a significant decrease in mean colonic diameter and abdominal pain compared to conservative and medical management. However, these benefits are no longer noted after propensity matching.Table: Baseline characteristics of patients with ACPO.Table: Efficacy of colonic decompression (without propensity score matching).Table: Efficacy of colonic decompression (propensity matched).

Infliximab Maintenance Dosing in Inflammatory Bowel Disease: an Example for In Silico Assessment of Adaptive Dosing Strategies.

Infliximab is an anti-tumour necrosis factor alpha monoclonal antibody used to treat inflammatory diseases. Many patients fail during induction and others respond initially but relapse during maintenance therapy. Although anti-drug antibodies (ADA) are associated with some clinical failures, there is evidence that some failures may be due to subtherapeutic exposure. Adapting doses based on clinical outcomes and trough concentrations can improve response and reduce the proportion that develop ADA, but identification of appropriate doses in the presence of time-varying patient factors is complicated. Several adaptive dosing strategies (label recommendations versus therapeutic drug monitoring with an established stepwise algorithm or proportional dose adjustments or Bayesian population pharmacokinetic model-based dosing) were simulated on a virtual population (constructed with time-varying covariates and random effects on individual pharmacokinetic parameters) using R to assess their relative performance. Strategies were evaluated on their ability to maintain trough infliximab concentrations above an established target, 3mg/L, during maintenance phase. Model-based dosing was superior in maintaining target trough concentrations, showing individuals in maintenance achieving concentrations above the target faster and a lower proportion of individuals who developed ADA. Model-based dosing results were consistent across a range of baseline covariate groups. This in silico assessment of adaptive dosing strategies demonstrated that, when challenged with dynamic covariate and random effect changes occurring in individual pharmacokinetic parameters, model-based approaches were superior to other strategies. Model-based dosing has not been tested clinically; however, the potential benefits of model-based dosing for infliximab suggest that it should be investigated to reduce subtherapeutic exposure.

Efficacy and safety of panchgavya GHRIT along with flunarizine in prophylaxis for migraine patients: a comparitive study

Background: Propranolol and flunarizine have proven to be useful tools in migraine prophylaxis. This trial aims the comparison of the efficacy of flunarizine, flunarizine and placebo and flunarizine and panchgavya ghrit in migraine prophylaxis.Methods: The present study was a prospective, randomized, open-label, blinded-endpoint trial. Patients with chronic migraine were randomized (1:1:1) to flunarizine and flunarizine and placebo and flunarizine and panchgavya ghrit in three treatment groups. The study was carried out in outdoor patients in the department of Psychiatry, T.S. Mishra Medical College and Hospital, Lucknow and K.G.M.U, Ayush Department, Lucknow after clearance from Institutional Ethical Committee. Data was analysed using SPSS software.Results: The prevalence of migraine was found to be higher in the age group greater than 30 years and females. Overall there was more reduction in CGI scores in flunarizine with panchgavya ghrit and the other two groups equally at the end of 4, 6 8 and 10 weeks. Decrease in MIDAS score was observed after the therapy. Clinical Global Impression rating scale employed revealed that to start with subjects scored 7 which stands for pathology interfering in many life functions which reduced drastically in Group C as compared to Group B and Group A in descending order. Pain scales namely VAS (visual analogue scale), NPRS (Numeric Pain Rating Scale), VRS (verbal rating scale) when employed denoted there was decreased migraine frequency, decreased perception of pain, less intake of abortive medication consumed by subjects implying there were reduction in number of migraine days and there was decrease in the abortive medications taken for the same. Group C scored better on pain scales followed by Group B and Group A. Lower proportion of individuals in group C had Behavioural Toxicity and Neurological Side effects as compared to Group A and B.Conclusions: Panch gavya ghrit when administered along with flunarizine was more efficacious and safe when compared with other two groups. However large multicentric RCTs of long duration and involving more number of subjects are required to ascertain these facts.

Epidemiological, clinical and genetic aspects of adult onset isolated focal dystonia in Ireland.

Adult onset idiopathic isolated focal dystonia presents with a number of phenotypes. Reported prevalence rates vary considerably; well-characterized cohorts are important to our understanding of this disorder. To perform a nationwide epidemiological study of adult onset idiopathic isolated focal dystonia in the Republic of Ireland. Patients with adult onset idiopathic isolated focal dystonia were recruited from multiple sources. Diagnosis was based on assessment by a neurologist with an expertise in movement disorders. When consent was obtained, a number of clinical features including family history were assessed. On the prevalence date there were 592 individuals in Ireland with adult onset idiopathic isolated focal dystonia, a point prevalence of 17.8 per 100 000 (95% confidence interval 16.4-19.2). Phenotype numbers were cervical dystonia 410 (69.2%), blepharospasm 102 (17.2%), focal hand dystonia 39 (6.6%), spasmodic dysphonia 18 (3.0%), musician's dystonia 17 (2.9%) and oromandibular dystonia six (1.0%). Sixty-two (16.5%) of 375 consenting index cases had a relative with clinically confirmed adult onset idiopathic isolated focal dystonia (18 multiplex and 24 duplex families). Marked variations in the proportions of patients with tremor, segmental spread, sensory tricks, pain and psychiatric symptoms by phenotype were documented. The prevalence of adult onset idiopathic isolated focal dystonia in Ireland is higher than that recorded in many similar service-based epidemiological studies but is still likely to be an underestimate. The low proportion of individuals with blepharospasm may reflect reduced environmental exposure to sunlight in Ireland. This study will serve as a resource for international comparative studies of environmental and genetic factors in the pathogenesis of the disorder.

Disparities in the prevalence of comorbidities among US adults by state Medicaid expansion status

IntroductionAbout 92% of US older adults have at least one chronic disease or medical condition and 77% have at least two. Low-income and uninsured adults in particular experience a higher burden of comorbidities, and the Medicaid expansion provision of the Affordable Care Act was designed to improve access to healthcare in this population group. However, a significant number of US states have declined expansion. The purpose of this study is to determine the distribution of low-income and uninsured adults in expanded versus non-expanded states, and evaluate the prevalence of comorbidities in both groups. MethodsData from the 2013 Behavioral Risk Factor Surveillance System (BRFSS) dataset was analyzed, and Medicaid expansion status was assessed from the Center for Medicare and Medicaid Services report on State Medicaid and CHIP Income Eligibility Standards. Next, age adjusted mean number of comorbidities between expanded and non-expanded states was compared, with adjustment for socio-demographic differences. ResultsExpanded states had a higher proportion of adults with income of at least $50,000 per year (39.6% vs. 35.5%, p<0.01) and a lower proportion of individuals with no health insurance coverage (15.2% vs. 20.3%, p<0.01) compared with non-expanded states. Among the uninsured, there was a higher proportion of obese (31.6% vs. 26.9%, p<001), and higher average number of comorbidities (1.62 vs. 1.52, p<0.01) in non-expanded states compared to expanded states. Overall, the prevalence of comorbidities was higher among BRFSS participants in states that did not expand Medicaid compared with those in expanded states. ConclusionStates without Medicaid expansion have a greater proportion of poor, uninsured adults with more chronic diseases and conditions.

Genotipos del Gen Kappa-Caseína en Ganado Bovino Criollo del Distrito de Bambamarca, Cajamarca, Perú

El presente estudio tuvo como objetivo determinar la frecuencia alélica y genotípica del gen kappa-caseína (κ-CN) en ganado bovino criollo. Se recolectaron 48 muestras de sangre de bovinos de nueve centros poblados del distrito de Bambamarca (Cajamarca, Perú). Se extrajo el ADN y la genotipificación se realizó mediante análisis de RFLP-PCR del gen κ-CN. Las frecuencias genotípicas encontradas fueron de 0.56, 0.27 y 0.17 para los genotipos AB, AA y BB, respectivamente, en tanto que las frecuencias alélicas resultaron ser de 0.552 y 0.448 para los alelos A y B, respectivamente. Se concluye que los animales evaluados presentan una baja proporción de individuos con el genotipo deseado BB, genotipo que favorece la producción de queso.

Social Media as a Sentinel for Disease Surveillance: What Does Sociodemographic Status Have to Do with It?

Introduction: Data from social media have been shown to have utility in augmenting traditional approaches to public health surveillance. Quantifying the representativeness of these data is needed for making accurate public health inferences.Methods: We applied machine-learning methods to explore spatial and temporal dengue event reporting trends on Twitter relative to confirmed cases, and quantified associations with sociodemographic factors across three Brazilian states (São Paulo, Rio de Janeiro, and Minas Gerais) at the municipality level.Results: Education and income were positive predictors of dengue reporting on Twitter. In contrast, municipalities with a higher percentage of older adults, and males were less likely to report suspected dengue disease on Twitter. Overall, municipalities with dengue disease tweets had higher mean per capita income and lower proportion of individuals with no primary school education.Conclusions: These observations highlight the need to understand population representation across locations, age, and racial/ethnic backgrounds in studies using social media data for public health research. Additional data is needed to assess and compare data representativeness across regions in Brazil.

An experimental test for age-related improvements in reproductive performance in a frog that cares for its young.

Reproductive performance often increases with age in long-lived iteroparous organisms, a pattern that can result from within-individual increases in effort and/or competence. In free-living populations, it is typically difficult to distinguish these mechanisms or to isolate particular features of reproduction-influencing outcomes. In captive Oophaga pumilio, a frog in which mothers provide extended offspring provisioning via trophic eggs, we experimentally manipulated the age at which females started breeding and then monitored them across repeated reproductive events. This experiment allowed us to decouple age and experience and isolate maternal care as the proximate source of any differences in performance. Younger first-time mothers produced larger broods than older first-time mothers, but did not rear more offspring to independence. Across repeated reproductive events, maternal age was unassociated with any metric of performance. At later reproductive events, however, mothers produced fewer metamorphs, and a lower proportion of individuals in their broods reached independence. These patterns suggest that performance does not improve with age or breeding experience in this frog, and that eventual declines in performance are driven by reproductive activity, not age per se. Broadly, age-specific patterns of reproductive performance may depend on the proximate mechanism by which parents influence offspring fitness and how sensitive these are to effort and competence.

Return-to-work intentions during spinal cord injury rehabilitation: an audit of employment outcomes.

Single-centre, retrospective cohort study. To analyse the return-to-work intentions during spinal cord injury (SCI) rehabilitation. Tertiary care, spinal cord injury rehabilitation unit, National Spinal Injuries Centre, Stoke Mandeville Hospital, Ayelsbury, UK. Employment outcomes were obtained from the Needs Assessment Checklist (NAC), for all patients admitted to the unit between February 2008 and October 2014. NAC1 is completed within 4 weeks post-mobilisation and NAC2 upon the patient moving to the pre-discharge ward. Data from 362 participants were analysed for return-to-work intentions, by gender, age and injury severity. Seventy-six percent of the sample population was employed at the time of their injury. At NAC1, 22.4% of individuals had made plans to return to work, whereas 44.2% had not; at NAC2, 34.3% had made plans to return to work and 31.2% had not. This difference was found to be statistically significant. There were significant differences in return-to-work intentions by injury severity at NAC1 but not NAC2, and by age group at NAC2 but not NAC1. Less than half of those employed at the time of their injury had made plans to return to work before their discharge from the unit. The low proportion of individuals with SCI returning to work--just one in three--is concerning in view of the lost health and psychosocial benefits, and requires greater prominence during rehabilitation. Future research into effective employment interventions to improve employment outcomes in this population is required.

The role of low cognitive effort and negative symptoms in neuropsychological impairment in schizophrenia.

Two experiments were conducted to examine whether insufficient effort, negative symptoms (e.g., avolition, anhedonia), and psychological variables (e.g., anhedonia and perception of low cognitive resources) predict generalized neurocognitive impairment in individuals with schizophrenia (SZ). In Experiment 1, participants included 97 individuals with SZ and 63 healthy controls (CN) who completed the Victoria Symptom Validity Test (VSVT), the MATRICS Consensus Cognitive Battery (MCCB), and self-report anhedonia questionnaires. In Experiment 2, participants included 46 individuals with SZ and 33 CN who completed Green's Word Memory Test (WMT), the MCCB, and self-reports of anhedonia, defeatist performance beliefs, and negative expectancy appraisals. RESULTS indicated that a low proportion of individuals with SZ failed effort testing (1.0% Experiment 1; 15.2% Experiment 2); however, global neurocognitive impairment was significantly predicted by low effort and negative symptoms. Findings indicate that low effort does not threaten the validity of neuropsychological test results in the majority of individuals with schizophrenia; however, effort testing may be useful in SZ patients with severe negative symptoms who may be more likely to put forth insufficient effort due to motivational problems. Although the base rate of failure is relatively low, it may be beneficial to screen for insufficient effort in SZ and exclude individuals who fail effort testing from pharmacological or cognitive remediation trials.

Genetic diversification of local onion populations under different production systems in Uruguay

In Uruguay, onion (Allium cepaL.) germplasm is mainly derived from the genetic material introduced by several waves of European immigrants and subsequently multiplied by household farmers, resulting in a wealth of locally adapted populations. This study examined the genetic diversity in a collection of 27 local onion populations and two cultivars derived from them. A total of 843 onion plants were fingerprinted, and 83 inter-simple sequence repeat polymorphic bands were generated. Analysis of molecular variance showed high diversity within the populations (66% of the total variation). Some short-day populations from different geographical origins were grouped together by the unweighted pair-group method using arithmetic averages, principal coordinate analysis and cluster analysis, while the more extensively sampled long- and intermediate-day populations showed a widespread distribution, with no significant subgrouping among them. This weakly structured gene pool is probably the consequence of seed and bulb exchange between farmers and natural inter-pollination. Nevertheless, a Bayesian analysis allowed the distinction of four genetic backgrounds of alleles in the whole collection, and populations were predominately assigned to each genetic background. In addition, mitochondrial variants determining normal (N) pollen fertility or the sterile S or T types were analysed for the same set of plants using specific primers. Most accessions showed a proportion of male-sterile individuals. Cytoplasm type T was the most represented (26 out of 29 accessions), and cytoplasm type S was found in a low proportion of individuals in seven populations. Uruguayan onion germplasm maintains a low degree of genetic differentiation despite the small cultivated area and intense seed exchange, probably due in part to different market purposes based on the growing cycle.

Health behaviour of adolescents in Slovenia: major results from 2010 and trends from 2002 to 2010

Introduction: Monitoring of health behaviours, especially of adolescents, is essential for the future of each nation. Over the last decades, many changes have occurred in all aspects of our lives, affecting the health and quality of life of all people, including children and adolescents.Methods: The study is based on a quantitative research method. The survey was conducted on a representative sample of Slovenian 11-, 13- and 15-year-old adolescents, using a standardised international questionnaire (HBSC study – Health Behaviour in School-Aged Children). The survey was carried out with the assistance of school counsellors in the spring of 2002, 2006 and 2010 (n = 15.080). For determining the correlation between two individual years, the chi-square test (c2) was used. The significance level was calculated using the statistical significance value of p ≤ 0.05. Through the Cochran-Armitage trend test, it was established whether a trend existed for the selected indicators in the period between 2002 and 2010.Results: There are some favourable trends, e.g. eating breakfast (p = 0.000), tooth brushing (p = 0.000), lower proportion of individuals who rate their health as poor (p = 0.002) and experience several psychosomatic symptoms (p = 0.000), but also unfavourable trends, e.g. decrease in physical activity (p = 0.023), increase in early alcohol consumption (p = 0.000), dissatisfaction with school (p = 0.000) and bullying others (p = 0.000).Discussion and conclusion: The conclusions of the analyses can serve as a useful basis for further work and development of systemic measures to promote healthy behaviours and prevent risky and unhealthy behaviours among children and adolescents.

Ecological context and metapopulation dynamics affect sex-ratio variation among dioecious plant populations.

Populations of dioecious flowering plants commonly exhibit heterogeneity in sex ratios and deviations from the equilibrium expectation of equal numbers of females and males. Yet the role of ecological and demographic factors in contributing towards biased sex ratios is currently not well understood. Species-level studies from the literature were analysed to investigate ecological correlates of among-population sex-ratio variation and metapopulation models and empirical data were used to explore the influence of demography and non-equilibrium conditions on flowering sex ratios. The survey revealed significant among-population heterogeneity in sex ratios and this was related to the degree of sampling effort. For some species, sex-ratio bias was associated with the proportion of non-reproductive individuals, with greater male bias in populations with a lower proportion of individuals that were flowering. Male-biased ratios were also found at higher altitudes and latitudes, and in more xeric sites. Simulations and empirical data indicated that clonal species exhibited greater heterogeneity in sex ratios than non-clonal species as a result of their slower approach to equilibrium. The simulations also indicated the importance of interactions between reproductive mode and founder effects, with greater departures from equilibrium in clonal populations with fewer founding individuals. The results indicate that sex-based differences in costs of reproduction and non-equilibrium conditions can each play important roles in affecting flowering sex ratios in populations of dioecious plants.

Cross-reactive neutralizing activity in HIV-1 infected injecting drug users

Background Vaccine elicited HIV-1 specific cross-reactive neutralizing humoral immunity may provide protection against acquisition of HIV-1. Several studies have focussed on a better understanding of cross-reactive neutralizing activity (CrNA) in natural infection, but only in homosexual and heterosexual HIV-1 transmission cases. Methods To analyze the prevalence and characteristics of CrNA in HIV-1 infected individuals who reported injecting drug use as the only risk factor, we screened serum samples from 50 male and 35 female participants of the Amsterdam Cohort Studies (ACS) on injecting drug users (IDU) for CrNA across a heterologous 6-viral panel. For comparison, similar data from the ACS on men who have sex with men (MSM) were available. Results HIV-1 infected IDU showed significantly lower geometric mean IC50 values and a lower proportion of individuals that was capable of neutralizing the majority of viruses in the panel as compared to MSM. This difference was however no longer observed when women were excluded from the IDU group. Interestingly, three out of 50 in the male IDU population qualified as elite neutralizer as compared to 1 out of 299 among MSM. Multivariate analysis with viral load at setpoint, CD4+ count at setpoint, gender and transmission route as co-variates revealed only CD4+ count at setpoint as independently associated with CrNA in serum. Conclusion CrNA prevalence and potency in HIV-1 infected IDU was lower than in MSM. This could be attributed to the presence of women in the cohort, rather than the route of exposure, which could be explained by the fact that women had a higher CD4+ T cell count at setpoint, which was the only independent predictor for the presence of CrNA. Our data may implicate that the ability of an HIV-1 vaccine to elicit CrNA may be lower in women and testing for gender dependent future vaccine efficacy may be recommended.

Variação na estrutura diamétrica, composição florística e características sucessionais de fragmentos florestais da bacia do rio Guapiaçu (Guapimirim/Cachoeiras de Macacu, RJ, Brasil)

O presente trabalho compara a composição e estrutura de assembléias vegetais de fragmentos florestais, com diferentes características em relação ao tipo de propriedades rurais do entorno, tamanho e histórico de uso, com uma área localizada dentro de uma unidade de conservação (área controle), na bacia do rio Guapiaçu. Em cada fragmento foram delimitadas duas parcelas de 50 x 100m, na mesma orientação sudoeste, no interior das quais foram medidos os DAP (Diâmetro Acima do Peito) e altura de todos indivíduos com DAP ≥ 5 cm e identificados até o menor nível taxonômico possível. A densidade, área basal total, riqueza e diversidade foram calculados. As assembléias foram comparadas quanto aos seus valores diâmétricos e proporção de indivíduos em classes de diâmetro. Os parâmetros fitossociológicos foram calculados e as vinte espécies de maior cobertura foram selecionadas com vistas à comparação da composição específica e de suas caracteríticas sucessionais. Todas as assembleías estudadas apresentam alta riqueza e diversidade de espécies, sendo igualmente constatadas, em relação à área controle, diferenças significativas em pelo menos uma das caracteríticas analisadas. Todas apresentam uma menor proporção de indivíduos nas classes diâmetricas maiores e de espécies secundárias tardias que na área controle. No entanto, para algumas delas correspondem valores totais de diâmetro igual ou maiores que os da área controle por conta da maior proporção de indivíduos em classes diâmetricas intermediárias que parece contribuir mais para o aumento desses valores. De forma geral, há maior abundância de espécies pioneiras e secundárias iniciais nos fragmentos florestais, porém a proporção destas categorias sucessionais varia entre eles evidenciando diferenças dos estágios sucessionais em que se encontram. Estas diferenças poderiam estar relacionadas a certa variabilidade dos distúrbios identificados no entorno. Os resultados obtidos aqui sugerem que fragmentos de mata rodeados por pequenas propriedades encontram-se em estágios sucessionais mais inicias e sujeitos a distúrbios mais severos.

Between-year stability of individual alarm calls in the yellow ground squirrelSpermophilus fulvus

Although individuality in alarm calls has been reported for many ground-dwelling sciurids, the degree to which the vocal identity encoded in alarm calls is stable with time has been studied only for a single sciurid species. Thus, no comparable data are available. We examined the retention of the vocal keys to individual identity after hibernation in a natural colony of yellow ground squirrels (Spermophilus fulvus), long-lived, obligate-hibernating rodents that maintain stable social groups for years. We recorded alarm calls in 2 subsequent years, separated by hibernation, from 22 individually marked animals. All individuals could be distinguished with high probability by their alarm calls within a year. However, only 6 of the 22 animals kept their alarm calls stable after hibernation. Sex, age, year of data collection, and the distance that individuals moved between years did not have significant effects on the retention of a stable alarm call structure after hibernation. Given the low proportion of individuals with stable alarm calls, vocal identity cannot be the only modality sufficient to secure the recovery of personalized social relationships after hibernation in the yellow ground squirrel.

Factor Analysis of the Rivermead Post-Concussion Symptoms Questionnaire in Mild-to-Moderate Traumatic Brain Injury Patients

Factor Analysis of the Rivermead Post-Concussion Symptoms Questionnaire in Mild-to-Moderate Traumatic Brain Injury Patients

Trastornos neurocognitivos en la infección por el virus de la inmunodeficiencia humana

Disruption of neurocognitive functioning is one of most frequent complications in patients with HIV infection nowadays. The Highly Active Antiretroviral Therapy (HAART) has demonstrated an improvement associated with its use, although there are different works that show this improvement is achieved in a low proportion of individuals who initiate therapy. The most known characterization of neurocognitive dysfunction is the HIV-associated Dementia (HAD), yet there may also exist the asymptomatic neurocognitive impairment (ANI) or the Minor Cognitive-Motor Disorder (MCMD). This review describes the disorders related to HIV infection, and comments on possible interventions focused on the protection of neurocognitive functioning in HIV-infected people.

Screening practice and misplaced priorities

To estimate cancer screening coverage among a large sample of Greek individuals. 7012 adults from 30 Hellenic areas were surveyed. Tests included: faecal occult blood test, sigmoidoscopy,chest X-ray, urine test, testicular examination,trans-rectal ultrasound, full blood count, skin examination,digital rectal examination, PSA, Pap test, mammography,clinical breast examination (CBE), self breast examination and breast ultrasound. Eighty-eight percent of males and 93% of females declared being interested in cancer screening; 37.8% of men and 37.9% of women had had a medical consultation for screening purpose in the previous 2 years. Less than 2%reported having received screening for colorectal cancer or skin malignancies. Screening for cervical cancer, mammography and CBE was reported by 39.6%, 22.8% and 27.9% of females respectively. Twenty percent of males reported screening for prostate cancer. The actual opportunistic screening approach presents important deficiencies with displaced priorities in test performance and a low proportion of individuals undergoing recommended tests.