Performance-based everyday functioning after stroke: relationship with IADL questionnaire and neurocognitive performance

Neuropsychologists frequently are asked to comment on everyday functioning, but the research relies mostly on questionnaire-based assessment of daily functioning. While performance-based assessment of everyday functioning has many advantages over commonly used questionnaires, there are few empirically validated comprehensive performance-based measures. We present data here on a performance-based battery of daily living skills, the Functional Impact Assessment (FIA) in 47 unilateral stroke patients and 37 matched healthy controls. The FIA was validated by comparing it to performance on the self- and informant-report version of the Functional Activities Questionnaire (FAQ). We also examined the relationship between the FIA and cognitive functioning using the Neuropsychological Assessment Battery (NAB). The stroke group's performance on the FIA, FAQ (self and informant), and NAB (total and domain scores) was significantly (d's ≥ .80) lower than the control group. The NAB total score and all domain scores were highly correlated with the FIA in the stroke group (r's > .7), and only one NAB domain score (visuospatial) was a unique predictor. This may be due to the fact that most of the NAB domains have a statistical problem of multicollinearity, which may explain why only the spatial domain was a unique predictor. While the informant FAQ was significantly correlated with FIA total score (r = .48, p < .01), the NAB total score was a significantly better predictor (r = .83, p < .001) than the informant FAQ. NAB total scaled score of less than 86 predicted impairment on the FIA with 92% sensitivity and 84% specificity. Our findings argue that the FIA is sensitive to deficits associated with stroke and is highly associated with all neuropsychological domains (attention, executive functions, language and spatial skills, and memory).     

冠状动脉狭窄与猝死关系分析

目的：分析冠状动脉狭窄与猝死关系。方法：对2005~2009年内蒙古医学院法医系接收的66例尸检病理资料进行分析。结果：猝死案例以30~50岁男性为主,有39例。无明显诱因猝死23例,有明显诱因猝死28例。冠状动脉粥样硬化Ⅰ~Ⅱ级狭窄者23例,Ⅱ~Ⅲ级狭窄者19例,Ⅲ~Ⅳ级狭窄者24例。其中左前降支狭窄最多,其次为右冠状动脉、左旋支。陈旧性心肌梗死（OMI）27例,急性心肌梗塞（AMI）14例,OMI和AMI混合存在15例。结论：猝死中冠状动脉狭窄占有很大比例,存在狭窄者大部分都有不同程度的心肌梗死。所以平素健康人群也需要预防冠状动脉粥样硬化狭窄,高危人群应做检查（如超声心动图、MDCT、冠状动脉造影）,排除冠状动脉狭窄,避免意外的发生。     

A Collaborative Nationwide Lymphoma Study in Lebanon: Incidence of Various Subtypes and Analysis of Associations with Viruses

Incidence of various Hodgkin (HL) and non-Hodgkin lymphoma (NHL) subtypes and association with viruses in Lebanon are not known. We undertook a nationwide study of 272 patients diagnosed with lymphoma in 2007. HL comprised 32.7 % (n?=?89) of cases while NHL represented 67.3 % (n?=?183). Consistent with the literature, nodular sclerosis was the most predominant HL subtype (n?=?57/89). Among NHL, B-cell NHL represented 88 % (n?=?161/183), T-cell NHL 9 % (n?=?17/183), whereas in 2.7 % it was not classifiable. The B-cell NHL comprised predominantly diffuse large B-cell lymphoma (46 %) and follicular lymphoma (23 %). 81 cases were reviewed by a panel of pathologists with 87.6 % concordance rate. Serology was negative for hepatitis C in 122 tested cases. HIV was positive in 2 cases. Two adult T-cell leukemia/lymphoma were HTLV-I positive. EBV IgG were positive in 88.5 % of cases. 38 EBV seropositive cases [27 NHL (24 B-cell, 3 T-cell) and 11 HL] were studied for EBV genome expression using EBV-encoded RNA (EBER)-in situ hybridization. EBER expression was positive in 8 (21 %) cases (6 HL, 2 T-cell NHL). The distribution of lymphoma subtypes in Lebanon appears similar to that of Western countries. The high rate of EBV positivity in HL and T-cell lymphoma by EBER deserves further investigation.     

Hypothesis: Role for the circadian Clock system and sleep in the pathogenesis of adhesions and chronic pelvic pain?

Intra-peritoneal adhesions ensuing from surgery or infection may lead to chronic pelvic pain, bowel obstruction, infertility and additional invasive surgery to resolve adhesion-related complications. As a result adhesions are a major clinical, social and economic concern. The cumulative year-on-year direct costs of adhesion-related readmissions for a 10-year period are more than ￡ 569 million. The degree of intra-abdominal adhesion formation in an individual patient after a surgical or infective insult remains difficult to predict. This reflects a lack of understanding as to the underlying aetiologies. Several different mechanisms leading to adhesion formation and re-formation have been proposed. These include abnormal modulations in inflammatory status, fibrinolytic pathways and matrix remodelling. A number of preventative strategies have been designed accordingly. However, although each individual model offers specific insights into the aetiology of adhesion formation, none have been shown to provide the basis for a highly effective clinical intervention. A unifying fundamental mechanism remains elusive. In this article we propose that such a mechanism can be found within the molecular control of circadian rhythms and "Clock" gene biology. A number of physiological processes demonstrating circadian variation have been shown to involve 'Clock genes' in the suprachiasmatic nucleus (SCN), which then entrains a similar set of Clock genes in peripheral tissues such as the heart, brain, spleen, lung, liver, skeletal muscle and kidney. The intrinsic time-keeping system influences activity, such as sleep, temperature regulation, rates of metabolism, immune responses, blood pressure and hormone secretion. The function and availability of mediators involved in the inflammatory response, fibrinolytic and anti-coagulation pathways are all under the tight control of the molecular Clock system. These include IL-6, PAI-1, fibrinogen, fibroblasts and TNF-α. We hypothesise that disruptions in the 'Clock system' are central to the causal pathway of adhesion formation. Our hypothesis takes into consideration and utilises current understanding in the field uniting individual principles. Moreover; this hypothesis suggests strategies for optimising existing therapeutic interventions.     

Mephedrone (4-methylmethcathinone) and d-methamphetamine improve visuospatial associative memory,but not spatial working memory,in rhesus macaques

BACKGROUND AND PURPOSE

The novel cathinone derivative 4-methylmethcathinone (4-MMC; mephedrone) is increasingly popular with recreational users. Little scientific information is available but users report both entactogen-like and classic stimulant-like subjective properties. A recent study in humans reported psychomotor speed improvement after intranasal 4-MMC suggesting classic stimulant properties. Limitations of the user group (which was impaired on some tasks) prompt controlled laboratory investigation.

EXPERIMENTAL APPROACH

Adult male rhesus monkeys were trained to perform tasks from the non-human primate Cambridge Neuropsychological Test Automated Battery, which assess spatial working memory, visuospatial associative memory, learning and motivation for food reward. Test of bimanual motor coordination and manual tracking were also included. The subjects were challenged with 0.178–0.56 mg·kg⁻¹ 4-MMC and 0.056–0.56 mg·kg⁻¹ d-methamphetamine (MA), i.m., in randomized order for behavioural evaluation.

KEY RESULTS

A pronounced improvement in visuospatial memory and learning was observed after the 0.32 mg·kg⁻¹ dose of each compound, this effect was confirmed with subsequent repetition of these conditions. Spatial working memory was not improved by either drug, and the progressive ratio, bimanual motor and rotating turntable tasks were all disrupted in a dose-dependent manner.

CONCLUSIONS AND IMPLICATIONS

These studies show that 4-MMC produces behavioural effects, including improvements in complex spatial memory and learning that are in large part similar to those of MA in non-human primates. Thus, the data suggest that the effects of 4-MMC in monkeys can be classified with classical psychomotor stimulants.     

超声弹性成像在乳腺疾病鉴别诊断中的应用

目的:探讨超声弹性成像在乳腺疾病鉴别诊断中的价值.方法:分析44例(86个病灶)乳腺疾病的超声弹性成像图表现.将图像分为0～Ⅵ级,并与病理结果对比.结果:良性病变以0～Ⅱ级多见,恶性病变以Ⅲ～Ⅵ级多见.结论:超声弹性成像对乳腺疾病诊断具有重要价值.     

校正新化合物在体筛选模型评价方法可降低假阳性

药物发现早期通常在啮齿类模型上进行在体药效实验,以优化筛选,迅速发现先导化合物,但当采用预先或同时给药方式进行时,常有过高估计新化合物疗效的可能。不利于科学决策、降低成本、时间安排及合乎伦理地使用动物。放弃预先给药方式,在模型动物上监测重要的生理参数及系统地应用简单药代-药效动力学分析可以减少假阳性结果。