Participation after acquired brain injury: Associations with everyday technology and activities in daily life

Background: The development of the information society has led to increased use of everyday technology and changed the conditions for participation. Enabling participation in everyday life situations is an important rehabilitation goal after acquired brain injury (ABI). Identifying factors associated with individuals’ experienced participation and problems therein is therefore essential. Objective: This study aimed at exploring the relationship between perceived difficulty in everyday technology use, perceived ability in the activities of daily living (ADL), and perceived participation, and participation problems in persons with ABI. Methods: Eighty-one persons with ABI participated in the study and were assessed by the Impact on Participation and Autonomy questionnaire, the Everyday Technology Use Questionnaire, and the ADL taxonomy. Results: Findings showed that the combined model of difficulty in everyday technology (ET) use, ADL ability, and the interaction between them explained both participation in various domains of everyday life, and also overall level of perceived participation and the perceived problems. Conclusions: The findings underscore the importance of evaluating individuals’ ability in both ET use and ADL after ABI to increase the probability of explaining these persons’ participation in desired everyday life situations and, also, for rehabilitation design.     

Insulin Sensitivity and Variability in Hepatitis C Virus Infection Using Direct Measurement

Background and Aims

Studies investigating insulin resistance (IR) in chronic hepatitis C virus (HCV) infection have used surrogate measures of IR that have limited reliability. We aimed to describe the distribution and risk factors associated with IR and its change over time in HCV using direct measurement.

Methods

One hundred two non-cirrhotic, non-diabetic, HCV-infected subjects underwent clinical, histologic, and metabolic evaluation, and 27 completed repeat evaluation at 6 months. Insulin-mediated glucose uptake was measured by steady-state plasma glucose (SSPG) concentration during the insulin suppression test.

Results

Three subjects with diabetes were excluded and 95 completed all testing. SSPG ranged from 39 to 328 mg/dL (mean 135 mg/dL) and was stable over time (mean SSPG change ?0.3 mg/dL). SSPG was associated with Latino ethnicity (Coef 67, 95 % CI 37–96), BMI (Coef 19 per 5 kg/m², 95 % CI 5–32), ferritin (Coef 1.4 per 10 ng/ml, 95 % CI 0.2–2.5), male gender (Coef ?48, 95 % CI ?80 to ?16), and HDL (Coef ?16, 95 % CI ?28 to ?5 mg/dL). Current tobacco use (Coef 55, 95 % CI 19–90), steatosis (Coef ?44, 95 % CI ?86 to ?3), and increases in BMI (Coef 30 per 5 kg/m², 95 % CI 6–53) and triglyceride (Coef 3.5 per 10 mg/dL, 95 % CI 0.3–6.7) predicted change in SSPG.

Conclusions

There was a wide spectrum of insulin resistance in our HCV population. Host factors, rather than viral factors, appeared to more greatly influence insulin action and its change in HCV.     

Incidence of hip fracture in Kermanshah, Iran

Summary

The aim of this study was to estimate the incidence of hip fracture in Kermanshah, Iran. 161 cases (88 men and 73 women) were recorded. The annual age-standardized incidence rates were 181.1/100,000 in men and 214.6/100,000 in women. Incidence rate of hip fracture was less than in Western countries.

Introduction

Hip fracture is the most serious complication of osteoporosis, the most common metabolic bone disease worldwide. The incidence of hip fracture in the elderly patients varies in different areas. The aim of this study was to estimate the incidence rate of hip fracture in Kermanshah, Iran.

Materials and methods

All cases of hip fracture patients who aged 50 years or more admitted in six referral orthopedic hospitals in Kermanshah from May 21, 2007 to May 21, 2008 were studied. The age- and sex-specific incidence rates of hip fracture per 100,000 persons were calculated using the population data from the last national census in Iran, 2007.

Results

A total of 161 cases of hip fracture (88 men and 73 women) were recorded. The annual age-standardized incidence rates were 181.1/100,000 in men and 214.6/100,000 in women. The female to male ratio of hip fracture incidence was 1.18.

Conclusion

We found a relatively low incidence of hip fracture in Iran than in Western countries, which is mostly due to the lower rate in women. This is probably related to the different lifestyle factors in different societies.     

Breast cancer in Iran: an epidemiological review

Breast cancer is one of the most frequent malignancies among Iranian women, however; the epidemiological aspects of breast cancer among Iranian patients are uncertain. A literature review of the published articles from January 1998 to December 2005 was conducted using different search engines: MEDLINE, Scientific information data base of Academic Center for Education, Culture and Research, and over 2000 issues of 94 Persian medical journals. The headings "Breast Cancer,"Breast Tumor,"Breast Malignancy," and "Breast Carcinoma" were combined with the word "Iran" to execute the search. In all, 85 full papers were reviewed. These findings showed that participants ranged from 15 to 84 years old, with those 40-49 being the most prevalent. The incidence of breast cancer in women was 22 per 100,000. The prevalence in this same population was 120 per 100,000. Stage I was diagnosed in 18%, stage II in 57% and stage III in 25% of the cases. About 72% of the patients were diagnosed with a tumor over 2 cm. Sixty-three percent of the patients had lymph node involvement at the diagnostic time. Infiltrative ductal carcinoma was found to be the most common at 77% and lobular carcinoma the least at 5%. This review indicates that the epidemiological aspects of breast cancer in Iran are relatively well-studied. Shortcomings in study of its clinical aspects are evident and need to be a central part of upcoming investigations.     

Are large nonfunctional kidneys risk factors for posttransplantation urinary tract infection in patients with end-stage renal disease due to autosomal dominant polycystic kidney disease?

OBJECTIVES: The objective of this study was to evaluate the effect of bilateral nephrectomy on posttransplantation urinary tract infection (UTI) among patients with end-stage renal disease (ESRD) due to autosomal dominant polycystic kidney disease (ADPKD). METHODS: In a retrospective case-control design, 62 patients with ESRD with ADPKD were divided into 2 groups: (A) 24 patients who underwent bilateral nephrectomies, and (B) 38 patients in whom bilateral nephrectomies had not been done. Pretransplantation and posttransplantation urine cultures were evaluated for UTI. RESULTS: Sixty-two patients with ESRD with ADPKD were enrolled in this study. The average age was 42 years (range, 6-60 years). Forty patients (64.5%) were male and 22 (35.5%) were female. The mean duration of hemodialysis was 24 months (range, 2-120 months), which was the same for both groups. Bilateral nephrectomies were done for 24 participants (38.7%). There were 38 patients (61.3%) in group B who did not have the operation. UTI occurred in 23 patients (37.1%): 6 patients (25%) in group A and 17 patients (44.7%) in group B. The incidence of UTI was not statistically different between the 2 groups (P>.05). Furthermore, no relationship was found between age, gender, blood group, and UTI in patients with ADPKD (P>.05). CONCLUSION: According to our study, the presence of large nonfunctional kidneys is not a risk factor for posttransplantation UTI in patients with ADPKD and ESRD.     

Evaluation of enzyme-linked immunosorbent assays for detecting circulating antibodies to Candida albicans

Published studies indicate that Candida albicans antibody assays utilizing cytoplasmic antigens offer greater utility for identifying cases of systemic candidiasis when compared with assays utilizing cell wall components. We assessed the performance characteristics of a commercially available system that utilizes cytoplasmic antigens to measure C. albicans IgG, IgM, and IgA (Candida Detect ELISA reagents). Intra-assay variation was < or =5%, inter-assay variation was < or =10%, and good linearity was observed for all the three antibody isotypes. Results for specimens stored under various conditions were comparable to those obtained initially. Inter-laboratory reproducibility was excellent; qualitative concordance was > or =93% for all the three isotypes, with slopes and R(2) values approaching 1.0 in linear regression analyses. Seroprevalence in persons without apparent systemic candidiasis was evaluated using three different serum panels; seroprevalence rates ranged from 24 to 32% for IgG, 2-14% for IgM, and 15-36% for IgA. Seroprevalence rates in a panel of sera containing antibodies to other fungi were similar to rates observed in panels from individuals without systemic candidiasis. These findings demonstrate the acceptable performance of assay systems employing Candida Detect ELISA reagents.