Chronic use of benzodiazepines and cognitive deficit complaints: A risk factor study

Benzodiazepines produce an anterograde amnesia after acute administration but whether their chronic use is hazardous to memory processes remains unclear. The present study analyses the risk of increasing cognitive complaints with chronic benzodiazepine use. Subjects seeking medical assistance at the General Internal Medicine Outpatient Clinic of Hospital de Clinicas de Porto Alegre, were interviewed before seeing physicians. They were asked about use of benzodiazepines, history of neurological and psychiatric diseases, use of alcohol, and deficits in remembering and learning as well as age, sex and level of education. Age (over 51 years), low level of education, a history of neurological and psychiatric diseases and use of benzodiazepines showed significant associations with cognitive complaints. After a conditional logistic regression analysis, benzodiazepine use lost its association with memory complaints. These data support the hypothesis that the chronic use of benzodiazepines does not carry a risk for cognitive deficits complaints. Research supported by CNPq (No. 403524/90).     

Neuropsychological performance in DSM-IV ADHD subtypes: an exploratory study with untreated adolescents.

OBJECTIVE: To explore neuropsychological performance in untreated Brazilian adolescents suffering from attention-deficit hyperactivity disorder (ADHD). METHOD: We assessed 30 untreated adolescents with ADHD and 60 healthy control subjects, aged 12 to 16 years, using a neuropsychological battery including the Wisconsin Card-Sorting Test (WCST), the Stroop Test (ST), the Digit Span, and the Word Span. RESULTS: We found neuropsychological differences among the DSM-IV ADHD subtypes. Adolescents with the predominantly inattentive subtype (ADHD-I) performed more poorly than did control subjects on both the Digit Span and the ST. On both the Digit Span and the WCST, adolescents with the combined subtype (ADHD-C) presented significantly more impairments than did control subjects. Adolescents with the predominantly hyperactive-impulsive type (ADHD-HI) did not differ significantly from the control subjects in any measure assessed, but had a better performance than did those with ADHD-C on both the Digit Span and the WCST. In addition, adolescents with ADHD-HI performed better on the ST than did adolescents with ADHD-I. CONCLUSIONS: These findings suggest cognitive differences among ADHD subtypes, supporting the diagnostic distinction among them. Adolescents with ADHD-HI do not seem to have significant cognitive deficits.     

Hemoglobin decline,function, and mortality in the elderly: The cardiovascular health study

While anemia is associated with poor functional and mortality outcomes in the elderly, the impact of hemoglobin decline is less studied. We evaluated the determinants and consequences of hemoglobin decline in 3,758 non‐anemic participants from the Cardiovascular Health Study, a prospective cohort of community‐dwelling elderly ≥65 years old at baseline and followed for up to 16 years. Hemoglobin was measured at baseline and 3 years later and anemia defined by World Health Organization (WHO) criteria. We modeled hemoglobin decline in two ways: (1) per each 1 g/dL decrease in hemoglobin and (2) development of anemia by the WHO criteria. Among participants without baseline anemia, hemoglobin decreased by 0.4 g/dL and 9% developed anemia over 3 years. Baseline increasing age, female sex, diabetes, and kidney disease predicted hemoglobin decline over 3 years. Baseline increasing age, being African‐American, and kidney disease predicted anemia development over 3 years. Hemoglobin decline was associated with subsequent worse cognitive function in men and anemia development with subsequent worse cognitive function in women. Both anemia development (HR 1.39, 95% CI 1.15, 1.69) and hemoglobin decline (HR 1.11, 95% CI 1.04, 1.18 per 1 g/dL decrease) predicted subsequent mortality in men and women. Hemoglobin decreases identified a large group of elderly individuals at risk for subsequent adverse outcomes who would not be identified using the WHO anemia criteria. These data may allow clinicians to identify at‐risk elderly individuals for early intervention to improve the quality and quantity of life. Am. J. Hematol. 2013. © 2012 Wiley Periodicals, Inc.     

Diagnostic criteria and follow-up in neuroendocrine cell hyperplasia of infancy: a case series

OBJECTIVE:

Neuroendocrine cell hyperplasia of infancy (NEHI) is a form of childhood interstitial lung disease characterized by tachypnea, retractions, crackles, and hypoxia. The aim of this study was to report and discuss the clinical, imaging, and histopathological findings in a series of NEHI cases at a tertiary pediatric hospital, with an emphasis on diagnostic criteria and clinical outcomes.

METHODS:

Between 2003 and 2011, 12 full-term infants were diagnosed with NEHI, based on clinical and tomographic findings. Those infants were followed for 1-91 months. Four infants were biopsied, and the histopathological specimens were stained with bombesin antibody.

RESULTS:

In this case series, symptoms appeared at birth in 6 infants and by 3 months of age in the remaining 6. In all of the cases, NEHI was associated with acute respiratory infection. The most common initial chest HRCT findings were ground-glass opacities that were in the middle lobe/lingula in 12 patients and in other medullary areas in 10. Air trapping was the second most common finding, being observed in 7 patients. Follow-up HRCT scans (performed in 10 patients) revealed normal results in 1 patient and improvement in 9. The biopsy findings were nonspecific, and the staining was positive for bombesin in all samples. Confirmation of NEHI was primarily based on clinical and tomographic findings. Symptoms improved during the follow-up period (mean, 41 months). A clinical cure was achieved in 4 patients.

CONCLUSIONS:

In this sample of patients, the diagnosis of NEHI was made on the basis of the clinical and tomographic findings, independent of the lung biopsy results. Most of the patients showed clinical improvement and persistent tomographic changes during the follow-up period, regardless of the initial severity of the disease or type of treatment.     

Integrated Control and Related Technology of Assistive Devices

Assistive devices are now available that allow persons with severe physical disabilities to complete tasks independently. When the user has severe physical limitations, it may be advantageous to have an integrated control system where a single control interface (e.g., joystick, head switches, voice recognition system, keypad) is used to operate two or more assistive devices (e.g., power wheelchairs, augmentative communication devices, computers, environmental control units, and other devices that are controlled electronically). The advantages of integrated control are that persons with limited motor control can access several devices with one access site without assistance, and the user does not need to learn a different operating mechanism for each device. The purpose of this review is to convey the depth and breadth of the research that has been conducted on integrated control systems, as well as to provide some insights into future directions. We reviewed research works pertaining to communication and environmental control, computer access, and wheelchair guidance systems. Information gathered in this study will help people become fully aware of the status of contemporary integrated control technology in order to increase the quality of life of people who use electronic assistive devices.     

Effects of high voltage electrical stimulation on the rate of pH decline,meat quality and color stability in chilled beef carcasses

Objective

To determine the effects of high voltage electrical stimulation (HVES, 800 Voltage) on rapid decreases in pH values and improvements in meat quality.

Methods

A total of 50 beef carcasses were applied, divided into two groups, one as a control and another for HVES. Meat quality was evaluated based on M. longissimus dorsi by examining pH and temperature levels at 1, 2, 5, 10 and 24 h, while color stability was examined seven days after slaughter.

Results

HVES decreased the pH values of the meat and accelerated rigor mortis (P<0.05). HVES caused differences in instrumental color values compared with the control groups across the ageing period at 4 °C.

Conclusion

the HVES had positive effects on meat quality and color stability, in contrast to undesirable consumer preferences.     

Effects of oral administration of Bifidobacterium animalis subsp. lactis HN019 on the treatment of plaque-induced generalized gingivitis

Objectives

This double-blind, randomized, placebo-controlled clinical trial evaluated the adjuvant effects of Bifidobacterium lactis HN019 on the treatment of plaque-induced generalized gingivitis.

Materials and methods

Sixty patients were submitted to professional supragingival scaling and prophylaxis. They were randomly assigned to test (probiotic lozenges containing B. lactis HN019, n?=?30) or control (placebo lozenges, n?=?30) groups. Lozenges were consumed twice a day for 8 weeks. Bleeding on probing (BoP), Gingival Index (GI), Plaque Index (PI), probing depth (PD), and clinical attachment level (CAL) were evaluated at baseline and after 2 and 8 weeks. Gingival crevicular fluid (GCF) was collected at baseline and at 8 weeks for analysis of the inflammatory mediators IL-1β, IL-1α, IL-8, MCP-1, and MIP-1β. Data were statistically analyzed (p?<?0.05).

Results

After 8 weeks, both groups showed reduction in the percentage of PI, with no significant difference between groups (p?=?0.7423). The test group presented a lower percentage of BoP and a higher percentage of sites with GI?≤?1 when compared with the control group at the end of the study (p?<?0.0001). At 8 weeks, the test group had a greater number of patients without generalized gingivitis than the control group (20 and 11 patients, respectively; p?<?0.05). The test group presented significantly lower levels of IL-1α, IL-1β, and MCP-1 in GCF than the control group at the end of the study (p?<?0.05).

Conclusion

The adjunct use of B. lactis HN019 promotes additional clinical and immunological benefits in the treatment of generalized gingivitis.

Clinical relevance

B. lactis HN019 can be an efficient and side-effect-free adjunct strategy in the treatment of generalized gingivitis.

     

Low-level laser therapy is effective in controlling postoperative pain in lower third molar extractions: a systematic review and meta-analysis

Lasers in Medical Science - This systematic review aimed to evaluate the effectiveness of low-level laser therapy in controlling postoperative pain in lower third molar extractions. A search was...