颈动脉支架置入患者术后不同时期的认知功能变化

目的 探讨颈动脉支架置入(CAS)患者术后不同时期的认知功能变化及其可能机制.方法 选取76例接受CAS的颈动脉狭窄患者(病例组)和63例接受冠脉支架置入术的冠心病患者(对照组)作为研究对象,所有患者术前行DSA检查,分别在支架置入术前及术后3 d、10个月,应用蒙特利尔认知评估量表对患者进行认知评估.结果 病例组术后3 d与术前比较,MoCA总分、交替连线试验,复制立方体、画钟、注意力、延迟回忆测评得分降低,具有显著性差异;术后10个月与术前比较,注意力、延迟回忆测评得分升高,差异具有显著性;术后3 d与术后10个月比较,MoCA总分、交替连线试验、复制立方体、画钟、注意力、延迟回忆测评得分的差异均有显著性.病例组与对照组比较,术前、术后3 d的注意力、延迟回忆测评得分差异有显著性.结论 颈动脉狭窄置入术可最终改善注意力和延迟回忆功能.术后早期可出现暂时的、可逆的认知功能恶化,但认知功能在远期多会改善.     

136例获得性免疫缺陷综合征患者神经认知功能障碍的研究

目的:评估上海市获得性免疫缺陷综合征(AIDS)门诊患者中人类免疫缺陷病毒(HIV)相关认知功能损害(HAND)的发生情况。方法:对2012年12月1日至31日在上海市公共卫生临床中心就诊的门诊患者进行横断面的研究。收集患者性别、年龄、受教育程度以及抗反转录病毒治疗(ART)等情况。用蒙特利尔认知功能评估量表(MoCA)、日常生活活动(ADL)量表以及认知筛查问题等对患者的认知功能进行评估。结果:MoCA评分正常和异常的患者分别为71例(52.2%)和65例(47.8%),在性别方面没有显著性差异(P=0.004)。MoCA评分异常组中年龄以及文化程度低的患者比例显著升高(均P     

The social and economic impact of the Montreal Longitudinal and Experimental Study

Background

The effectiveness of early prevention programmes and their viability as a public policy option have increasingly caught the attention of scholars and policymakers. Given the implementation costs of such programmes, it is important to assess whether they achieved anticipated objectives and whether they made efficient use of taxpayer money.

Aim

To discuss the social and economic impact of a 2-year randomised intervention aimed to improve social skills and self-control (i.e., non-cognitive skills) among disruptive boys from low-income neighbourhoods in Montreal.

Method

We review findings from published studies documenting the impact of the intervention at different stages of the life course, as well as its cost-effectiveness and cost-benefit.

Results

The intervention improved behavioural indicators throughout adolescence and eventually led to greater high school graduation rates, reduced crime, and better labour market outcomes in adulthood. Importantly, the prevention programme generated considerable returns to taxpayer investments.

Conclusion

Findings from the Montreal Longitudinal Experimental Study have been well-received and have contributed to an early prevention ‘awakening’ in Quebec and elsewhere.

     

Quantitative Transcranial Sonography Evaluation of Substantia Nigra Hyperechogenicity Is Useful for Predicting Levodopa-Induced Dyskinesia in Parkinson Disease

Levodopa-induced dyskinesia (LID) is a common motor complication in Parkinson disease (PD). Abnormal substantia nigra hyperechogenicity (SN+), detected by transcranial sonography (TCS), plays an important role in the differential diagnosis of PD. The purpose of this study was to investigate the predictive performance of quantitative SN+ evaluations for LID. Five hundred sixty-two individuals were included in our analysis, and 198 individuals were followed up. These individuals were divided into two groups at baseline: the PD with LID (PD+LID) group and the PD without LID (PD-LID) group. The association between total hyperechogenic area of the SN on both sides (SN_T) and LID was analyzed by binary logistic analysis. A binary logistic regression model including SN_T was applied to establish a model for discriminating LID. At baseline, 105 (18.7%) individuals were diagnosed with LID. The PD+LID group had a longer disease duration, shorter education duration, higher levodopa equivalent doses, greater disease severity and larger SN_T. A model combining clinical features and SN_T was further established with better efficiency (area under the receiver operating characteristic curve = 0.839). One hundred ninety-eight individuals were followed up; individuals with a larger SN_T and a higher predicted probability were more likely to develop LID in our follow-up. Our study determined that quantitative TCS evaluation of SN echogenicity is useful in predicting LID in PD.