Markers of Alzheimer's disease in a population attending a memory clinic

BackgroundNew marker-based criteria for the diagnosis of Alzheimer's disease (AD) were recently proposed. We describe their operational translation in 144 consecutive patients referred to our Memory Clinic.MethodsVisual ratings of hippocampal atrophy and of cortical glucose hypometabolism in magnetic resonance imaging and positron emission tomography, and concentrations of total tau and Aβ1-42 in cerebrospinal fluid were assessed in 12 patients with subjective memory complaints (SMCs) (Mini-Mental State Examination [MMSE] score, 28.0 ± 1.1 [mean ± SD]), 37 with mild cognitive impairment (MCI) (MMSE, 25.1 ± 3.6), 55 with AD (MMSE, 21.1 ± 3.5), and 40 with non-AD dementia (MMSE, 21.6 ± 5.5).ResultsThe sensitivity for AD of each individual biomarker was higher (65% to 87%) than for MCI (18% to 50%). Each biomarker's specificity for SMC and non-AD dementias was good to moderate (83% and 53%). Positivity for at least one marker increased the probability 38 times of belonging to the AD group (P < 0.0001).ConclusionThe new diagnostic criteria can be operationalized in clinical routines, but longitudinal studies of MCI patients will need to assess the criteria's prognostic value.     

Weighted statistics for aggregation and linkage analysis of human longevity in selected families: the Leiden Longevity Study

Typically long-lived sibling pairs have been collected for linkage analysis of human longevity and information on life span of first-degree relatives is available to assess familial aggregation of life span. We propose a new weighted statistic for aggregation analysis, which tests for a relationship between a family history of excessive survival of the sibships of the long-lived pairs and the survival of their parents and their offspring. For linkage analysis, we derive a new weighted score statistic from a simple gamma frailty model, which assigns more weight to excessive long-lived pairs. We apply the methods to data from the Leiden Longevity Study, which consists of sibling pairs of age 90 years or above and their first-degree relatives. The pairs have been genotyped for microsatellite markers in a candidate region. Association was present between survival within the sibships and survival of the offspring, but not with the parental generation. For linkage analysis, weighting increased the value of the test statistic, but the result was not statistically significant. About the methods we conclude that the statistic for aggregation provides insight into clustering of life span and the statistic for linkage provides a new tool to include demographic information into the analysis.     

The Peer Aggressive and Reactive Behavior Questionnaire (Parb-Q): Measurement Invariance Across Italian and Brazilian Children, Gender and Age

This study examines measurement invariance, reliability and scores differences of the Peer Aggressive and Reactive Behaviors Questionnaire (PARB-Q) across Italian and Brazilian children, gender and age. Participants were 587 Italian and 727 Brazilian children, aged 7–13 years from 12 elementary schools. The PARB-Q is a brief self-report instrument composed by two scales that assess aggressive behavior and reactions to peer aggression. Multigroup confirmatory factor analyses indicated full measurement invariance of the PARB-Q across groups based on country, gender and age, providing support for the unidimensionality of the first scale (direct peer aggression, PA) and a 3-factor model of the second scale (reactive aggression, RA; seeking teacher support, STS; internalizing reaction, IR). Reliability indices were good for all factors. Italian children reported a higher frequency of PA and a lower frequency of IR than the Brazilian children. Boys scored higher than girls on PA and RA, while girls scored higher than boys on STS and IR. Younger children reported a lower frequency of PA and a higher frequency of STS than older children. Results provide support for structure validity and reliability of the PARB-Q in two countries and information on differences related to gender, age and culture in peer relationships in elementary school.     

Intraperitoneal Invasion of Retroperitoneal Sarcomas: A Risk Factor for Dismal Prognosis

Annals of Surgical Oncology - Retroperitoneal sarcomas (RPS) lie in the retroperitoneal space and are covered by a peritoneal layer. However, some RPS have an intraperitoneal component (IPC), which...     

Nonunion fracture healing: Evaluation of effectiveness of demineralized bone matrix and mesenchymal stem cells in a novel sheep bone nonunion model

Nonunion treatment has a high rate of success, although recalcitrant nonunion may determine the need for amputation. Therefore, new treatment options are continuously investigated in order to further reduce the risk of nonunion recurrence. This study aimed to (a) develop a new large animal model for bone atrophic nonunion and (b) compare the efficacy of demineralized bone matrix (DBM) and DBM in combination with mesenchymal stem cells (MSC) in the new nonunion model. The new model consists of a noncritical, full‐thickness segmental defect created in the sheep tibia, stabilized by an intramedullary nail, and involves the creation of a locally impaired blood supply achieved through periosteum excision and electrocauterization of the stump ends. Six weeks after defect creation, lack of hard tissue callus and established nonunion was observed in all operated tibiae both by radiographic and clinical evaluation. Nonunion was treated with allogeneic DBM or autologous MSC cultivated on DBM particles (DBM + MSC) for 1 day before implantation. Twelve weeks after treatment, radiographic, microtomographic, histologic, and histomorphometric analysis showed the formation of bone callus in DBM group, whereas the fracture healing appeared at an early stage in DBM + MSC group. Torsional strength and stiffness of the DBM group appeared higher than those of DBM + MSC group, although the differences were not statistically significant. In conclusion, a new sheep bone nonunion model resembling the complexity of the clinical condition was developed. DBM is an effective option for nonunion treatment, whereas MSC do not improve the healing process when cultivated on DBM particles before implantation.     

Prospective Study of the Burden of Acute Gastroenteritis and Rotavirus Gastroenteritis in Children Less Than 5 Years of Age, in Padova, Italy

BACKGROUND: : Data on the burden of rotavirus gastroenteritis in Europe are needed to help understand the potential impact of introducing new rotavirus vaccines. MATERIALS AND METHODS: : As part of prospective observational study (Rotavirus gastroenteritis Epidemiology and Viral types in Europe Accounting for Losses in Public Health and Society Study, REVEAL) conducted in 2004-2005 in seven European countries, we studied, the characteristics of acute gastroenteritis and rotavirus gastroenteritis in children less than 5 years in primary care, emergency room and hospital settings (Padova, Italy). RESULTS: : A total of 757 children with acute gastroenteritis were included and enzyme-linked immunoabsorbent assay (ELISA) results were available for 725 cases. The overall estimated annual incidence for rotavirus gastroenteritis was 4.7%. Overall, rotavirus gastroenteritis was estimated to account for 43.6% of acute gastroenteritis cases. Among children with acute gastroenteritis (AGE) aged 6-23 months, 61.2% were rotavirus positive. Rotavirus gastroenteritis (RVGE) was responsible for 68.8% of hospitalizations, 61% of emergency consultations, and 33% of primary care consultations. The most prevalent serotype was G9 (84.4%) followed by G1 (11.8%). The relative risk for rotavirus gastroenteritis of being referred to hospital after an initial consultation in primary care was 3.37 (95% CI: 1.77-6.43) and 3.38 (95% CI: 2.28-5.01) for emergency room referral. Children with rotavirus gastroenteritis generally had more severe disease than children with rotavirus-negative gastroenteritis. CONCLUSION: : Rotavirus accounts for a significant proportion of acute gastroenteritis cases in children less than 5 years in Italy, many of whom require frequent primary care consultations, or care in emergency room or hospital settings.